tbuckley/cabot-search huggingface dataset:
Translating Clinical Trial Results into Practice: The Effect of an AIDS Clinical Trial on Prescribed Antiretroviral Therapy for HIV-Infected Pregnant Women
Authors: Barbara J. Turner
Journal: Annals of Internal Medicine (1999)

Background: The success of Pediatric AIDS Clinical Trials Group (PACTG) Protocol 076 in preventing vertical HIV transmission prompted intensive efforts to inform laypersons and professionals about the trial's results. Objective: To explore community responsiveness to these efforts by assessing temporal, maternal, and health care factors associated with prescribed antiretroviral therapy before and after PACTG Protocol 076. Design: Retrospective cohort study. Setting: New York State Medicaid program. Patients: 2607 HIV-infected women who delivered a living child between January 1993 and September 1996. Measurements: Adjusted odds of being prescribed antiretroviral treatment in the second or third trimester for women who delivered in period 1 (during the trial [January 1993 to February 1994]), period 2 (after the trial's end and announcement of the results to publication of the results [March 1994 to November 1994]), and period 3 (after publication of the trial results [December 1994 to September 1996]). Results: The adjusted odds of being prescribed antiretroviral therapy increased 21% per month in period 2 and decreased to 3% per month in period 3. In all time periods, the adjusted odds of being prescribed antiretroviral therapy were at least 60% greater (P < 0.05) for women who were treated at an institution that performed HIV clinical trials, received HIV-focused ambulatory care, or had adequate prenatal care visits. After the trial, women receiving methadone treatment had at least twofold (95% CI, 1.5- to 4.3-fold) greater adjusted odds of being prescribed antiretroviral therapy than women who did not take any illicit drugs. Latin-American women, older women, and women born in the United States had greater adjusted odds (P < 0.05) of being prescribed treatment in period 3. Conclusion: Community practice responded rapidly to efforts to disseminate the results of PACTG Protocol 076; however, the absolute increase in prescribed therapy was greatest for women who had adequate prenatal visits or were receiving HIV-focused care, care at a site that performed clinical trials, or methadone therapy.
Global initiative is launched to boost protection of hospitals in disasters
Authors: J. Zarocostas
Journal: BMJ (2009)

A new initiative has been launched to try to limit the destruction that natural disasters inflict on hospitals and other healthcare facilities, especially in poorer nations.

The World Health Organization, the United Nations Secretariat for International Strategy for Disaster Reduction, and the World Bank, with the support of the UK Health Protection Agency, launched the initiative on risk reduction in London on Wednesday 14 October. It aims to enhance emergency preparedness around the globe.

“Health has not been as strong a voice as it should be,” said Jonathan Abrahams, a WHO coordinator for risk reduction and …
How Effective Are Treatments for Diabetic Retinopathy?
Authors: Frederick L. Ferris
Journal: JAMA (1993)

ANALYSIS of data from four decades of clinical research demonstrates that currently recommended treatments are considerably more effective in preventing blindness from proliferative diabetic retinopathy (PDR) than has been previously appreciated. In fact, careful follow-up, timely photocoagulation, and vitrectomy when necessary strikingly reduce the risk of blindness for patients with PDR. This remarkable finding lends even greater urgency to current efforts to ensure that virtually all persons with diabetes receive at least yearly dilated eye examinations and are offered appropriate treatment when indicated. Based on the results of clinical trials supported by the National Eye Institute and extensive clinical experience, specific recommendations have been developed concerning for whom and when treatment is appropriate.<sup>1-5</sup>Prior to the availability of these treatments, the development of PDR was reason for extreme concern by both patients and their physicians about the risk of impending blindness. A 1963 study by Beetham<sup>6</sup>showed that
The Centenary Festival of the Royal College of Surgeons of England: An Address of Welcome
Authors: W. Mac Cormac
Journal: BMJ (1900)

since the charter granted by King George III incorporated the Surgeons of England into a Royal College, whereby the art and science of surgery might be the better cultivated and the commonweal of the people of this kingdom benefited.We meet to-day in order to celebrate the centenary of our incorporation, and the occasion compels us to reflect how far the College has fulfilled its high mission and merited the public consideration and confidence it enjoys, and, as we be- lieve, deserves to enjoy, through unselfish service to the State.My first and most pleasant duty is to welcome our illustrious guests who have come from many and distant countries to do honour to our College.Amongst them are great surgeons from almost all nations, men who not only hold the highest pro- fessional position in their respective countries, but whose public record has made their name familiar to us all, while many of them are dear personal friends.We have guests, too, our own countrymen, whom we delight to honour: dignitaries of the Church and of the Law, and heads of our ancient seats of learning.Although I cannot enumerate all, I can and do extend to each and every one the most cordial welcome, and would wish to express our grateful appreciation of their presence amongst us.An occasion like this possesses 'historic interest.We
Infectious mononucleosis and fibrosing alveolitis.
Authors: J W Millar
Journal: BMJ (1977)

Infectious mononucleosis and fibrosing alveolitisI report a case of infectious mononucleosis with acute diffuse fibrosing alveolitis.Pulmonary lesions in this disease have been reported but without detailed pulmonary physiological studies.' 2 The aetiology of acute fibrosing alveolitis is obscure,3 but in this case the Epstein-Barr virus was implicated. Case reportA previously fit 21-year-old woman was admitted to hospital with a short history of a "head cold" and sore throat which had responded to oral penicillin.An irritating unproductive cough persisted.She became progressively more dyspnoeic, initially only on exertion but eventually also when at rest.She complained of headache, profuse sweating, and general malaise.She was cyanosed and feverish (38-8 C).There was no finger clubbing.Cervical and supraclavicular lymphadenopathy was noted but no splenomegaly.Chest expansion was reduced and a few fine crepitations were
Circulating complement breakdown products in patients with rheumatoid arthritis. Correlation between plasma C3d, circulating immune complexes, and clinical activity.
Authors: U E Nydegger, R H Zubler, R Gabay, G Joliat, C H Karagevrekis, P H Lambert, P A Miescher
Journal: Journal of Clinical Investigation (1977)

Quantitative determination of the small C3 breakdown product, C3d, was used to investigate complement activation in 45 plasma samples from 30 patients with rheumatoid arthritis (RA). The mean plasma C3e level in these samples (3.0 +/- 1.3 mg/100 ml) was significantly increased (P less than 0.001) as compared to patients with degenerative joint disease (0.9 +/- 0.4 mg/100 ml) and healthy blood donors (0.8 +/- 0.5 mg/100 ml). C3d levels were increased by more than s SD in 79% of RA samples. Plasma C3d levels were compared with C3d concentrations in synovial fluid. In most RA patients, the C3d levels were higher in synovial fluid than in plasma. A very significant correlation between plasma C3d levels and circulating immune complexes, as measured by determination of Clq binding activity (Clq BA), was observed (P less than 0.001). C3d levels were more elevated in RA patients with extra-articular disease manifestations (3.8 +/- 1.2 mg/100 ml) as compared to patients with joint disease alone (2.2 +/- 1.0 mg/100 ml). C3d levels and Clq BA were also significantly correlated (P less than 0.001) with the RA disease activity expressed by an index derived from sedimentation rate, joint score, and duration of morning stiffness. A close relationship between C3d levels, Clq BA, and the clinical activity further appeared during follow-up studies. The present observations suggest that a parallel but rather independent activation of the complement system may be induced by immune complexes in circulating blood and in the joint spaces during the course of rheumatoid arthritis.
Pigmentary changes after pulsed dye laser treatment in 125 northern European patients with port wine stains
Authors: None Fiskerstrand, None Svaasand, None Volden
Journal: British Journal of Dermatology (1998)

We investigated the occurrence of pigmentary changes after flash lamp pumped dye laser treatment in 125 Norwegian patients. Post-treatment hyperpigmentation occurred with equal frequency during summer and winter (23%), and the facial regions did not exhibit higher occurrence than lesions located elsewhere. The patients that achieved hyperpigmented skin were not exposed to any higher fluence than those without this complication. On the contrary, we found that during the summer period from April to September the patients with post-treatment hyperpigmentation had been exposed to a significantly lower dose than those without pigmentary changes. These results indicate that the epidermal melanin content is not the only criterion for obtaining post-treatment hyperpigmentation. There might also be a constitutional disposition. In predisposed individuals the threshold dose for hyperpigmentation might be reduced in summer when the skin is more pigmented.
To the Editor of the Journal of the American Medical Association:
Authors: J. G. Truax
Journal: JAMA (1892)

InThe Journalof June 25, is published a report of the proceedings of the meeting of June 8. In that report there is nothing said of my substitute or amendment to Dr. Willis P. King's motion in regard to the committee of five from the American Medical Association, and one of five from the New York State Medical Society. My amendment added five from the New York State Medical Association. It was carried. The report reads: After further discussion Dr. Gihon offered the following amendment to Dr. King's resolution, which was accepted by the latter. Then follows the resolution, in which the names of Drs.Potter and Vander Veer are mentioned. Their names were not mentioned in the original motion. It was so decided next day.
Hepatitis C database will provide information and tissue samples for researchers
Authors: B. Christie
Journal: BMJ (2013)

Ten thousand patients with hepatitis C virus (HCV) are being recruited into a UK network that aims over the next decade to help improve treatment of this condition.

HCV Research UK is a collaboration of almost 40 centres around the UK that aims to provide valuable information that will help researchers to understand the natural progression of the disease. It also plans to work closely with the drug industry on the development of emerging new treatments.

It will supply anonymised clinical information on patients, together with tissue samples, to enable approved researchers to conduct research studies …
Efficacy of Endoscopic Management of Anastomotic Biliary Strictures after Hepatic Transplantation
Authors: R. V. Mahajani, S. J. Cotler, M. F. Uzer
Journal: Endoscopy (2000)

Anastomotic biliary strictures are the most common cause of biliary obstruction following liver transplantation. We studied the efficacy and safety of endoscopic management of anastomotic strictures retrospectively.A stricture at choledocho-choledochal anastomosis was identified in 30 of 354 sequential adult liver-transplant recipients at our institution. Balloon dilation was performed in 29 patients and a stent was inserted across the anastomotic stricture in one patient at initial endoscopy. A total of nine patients did not require further treatment; ten had repeated dilation (median 2). A stent was placed for persistent anastomotic stricture in six patients and for other indications in four patients. Outcomes studied were improvement in cholestasis, stricture diameter, and need for surgical treatment. Safety of therapy was assessed with nature and number of procedural complications.The median serum bilirubin level decreased from 3.25 mg/dl to 1.1 mg/dl (P < 0.001) and median alkaline phosphatase decreased from 451.5 IU/l to 125 IU/l (P = 0.001) following endoscopic therapy. Cholestasis improved in 26 of 30 patients with therapy. Of the remainder, three of three patients with concurrent nonanastomotic strictures and one patient with anastomotic stricture and histologic evidence of rejection showed worsening cholestasis at follow-up. Stricture diameter improved from a median of 2.5 mm to 7 mm (P < 0.001). Median follow-up was 17.9 months from the last therapeutic endoscopy. Five treatable, nonlethal complications occurred after 77 procedures. None of the patients required surgery for anastomotic stricture during a follow-up period up to 58 months.Endoscopic management offers effective and safe treatment for posttransplantation anastomotic biliary strictures and avoids the need for surgical intervention.
Efficacy of Oral Sildenafil in the Treatment of Erectile Dysfunction in Diabetic Men With Positive Response to Intracavernosal Injection of Alprostadil
Authors: Giuseppe Lepore, Italo Nosari
Journal: Diabetes Care (2001)

Erectile dysfunction (ED) is a common complication of diabetes and has a multifactorial etiology that includes psychogenic factors, autonomic neuropathy, vascular disease, and drug intake. A number of drugs have been used for the medical treatment of ED in diabetic men. Several studies have investigated the effects of the intracavernosal treatment with alprostadil (1,2); 60-87% of diabetic patients included in these studies reported satisfactory sexual activity. Transurethral alprostadil is a less invasive alternative with the advantages of a lower rate of priapism and penile fibrosis. In a recent study, 64.9% of patients treated with transurethral alprostadil had successful intercourse (3). A meta-analysis of seven controlled trials demonstrated that yohimbine is also a therapeutic option for ED when psychogenic causes are identified as the origin (4). More recently, oral sildenafil resulted to be an effective well-tolerated treatment for men with ED (5). A total of 56% of the diabetic patients taking sildenafil reported improved erections compared with 10% of patients taking placebo.

The aim of our study was to assess whether oral sildenafil citrate could be an effective alternative for the treatment of ED in diabetic men with a positive response to intracavernosal injection of alprostadil. We studied 52 men, aged 35-74 years (mean ± SEM 56.7 ± 4.5), with a diagnosis of ED (duration 2.2 ± 0.3 years, range 0.5-5.6) already effectively treated with alprostadil for no longer than 1 year (range 1-11 months). Only men in a stable sexual relationship for at least 6 months were included in the study. …
Benign Duodenocolic Fistula
Authors: Harold E. Nash, Ernest M. Daland
Journal: New England Journal of Medicine (1956)

ALTHOUGH duodenocolic fistulas due to carcinoma are common, we have been impressed by the paucity of reports concerning this condition in benign disease. The following case is therefore believed to be of interest.Case ReportL.J. (P.H. #32316), a 39-year-old Negro, was admitted to the hospital on July 14, 1952. He had been studied at a general hospital in June because of gnawing epigastric pain and the presence of anemia (the hemoglobin was 3.7 gm. per 100 ml.). He was given a transfusion. An upper gastrointestinal series reportedly showed a defect of the prepyloric area. Barium-enema examination revealed deficient filling . . .
The Use of Quinine Hydrochloride Solution as a Dressing for Infected Wounds
Authors: K. Taylor
Journal: BMJ (1915)

IT was found in previous experiments in this laboratory tllat quinine hydrochloride possessed the following qualifications which are desirable in a dressing solution for infected wounds:1.It had high bactericidal properties in vitro, especially marked in the case of the B. aFrogenes capsulatus, against wlhich it was more than ten times as effective as carbolic acid.It reduced the mortality of experimental gaseous gangrene in guinea-pigs from 100 to 41 per cent.It did not inhibit phagocytosis in the animals treated.2. It had a strong antiferment (antitryptic) action in vitro, preventing the digestion of proteins and the consequent production of a medium favourable to bacterial growtil.3. It formed no stable chemical combination with proteins, so that its activity was not greatly reduced by tho presence of serum or pus.4. It was practically non-irritating when applied in effective concentration to exposed tissues, or even when injected hypodermically into muscles.5. It waas non-toxic when used in adequate dosage, producing no systemic reaction except a frequently desirable antipyretic effect.6.The cost of tille materials used was not prohibi- tive for general application.7. It presented no difficulties of preparation and did not alter its cormposition on standing.
Rhinovirus Wheezing Illness and Genetic Risk of Childhood-Onset Asthma
Authors: Minal Çalışkan, Yury A. Bochkov, Eskil Kreiner-Møller, Klaus Bønnelykke, Michelle M. Stein, Gaixin Du, Hans Bisgaard, Daniel J. Jackson, James E. Gern, Robert F. Lemanske, Dan L. Nicolae, Carole Ober
Journal: New England Journal of Medicine (2013)

Both genetic variation at the 17q21 locus and virus-induced respiratory wheezing illnesses are associated with the development of asthma. Our aim was to determine the effects of these two factors on the risk of asthma in the Childhood Origins of Asthma (COAST) and the Copenhagen Prospective Study on Asthma in Childhood (COPSAC) birth cohorts.We tested genotypes at the 17q21 locus for associations with asthma and with human rhinovirus (HRV) and respiratory syncytial virus (RSV) wheezing illnesses and tested for interactions between 17q21 genotypes and HRV and RSV wheezing illnesses with respect to the risk of asthma. Finally, we examined genotype-specific expression of 17q21 genes in unstimulated and HRV-stimulated peripheral-blood mononuclear cells (PBMCs).The 17q21 variants were associated with HRV wheezing illnesses in early life, but not with RSV wheezing illnesses. The associations of 17q21 variants with asthma were restricted to children who had had HRV wheezing illnesses, resulting in a significant interaction effect with respect to the risk of asthma. Moreover, the expression levels of ORMDL3 and of GSDMB were significantly increased in HRV-stimulated PBMCs, as compared with unstimulated PBMCs. The expression of these genes was associated with 17q21 variants in both conditions, although the increase with exposure to HRV was not genotype-specific.Variants at the 17q21 locus were associated with asthma in children who had had HRV wheezing illnesses and with expression of two genes at this locus. The expression levels of both genes increased in response to HRV stimulation, although the relative increase was not associated with the 17q21 genotypes. (Funded by the National Institutes of Health.).
New national clinical directors are appointed to drive clinically led NHS
Authors: Z. Kmietowicz
Journal: BMJ (2013)

The medical director of England’s NHS Commissioning Board, Bruce Keogh, has announced the names of 22 doctors who have been appointed as national clinical directors to give expert advice on specialist areas of care in the NHS.

Some of the clinical areas covered by the directorships are new, such as “integration and frail elderly,” “gastrointestinal and liver,” “spinal,” and “end of life care.” 

There is a …
NADPH Oxidase 4 Induces Cardiac Fibrosis and Hypertrophy Through Activating Akt/mTOR and NFκB Signaling Pathways
Authors: Qingwei David Zhao, Suryavathi Viswanadhapalli, Paul Williams, Qian Shi, Chunyan Tan, Xiaolan Yi, Basant Bhandari, Hanna E. Abboud
Journal: Circulation (2015)

NADPH oxidase 4 (Nox4) has been implicated in cardiac remodeling, but its precise role in cardiac injury remains controversial. Furthermore, little is known about the downstream effector signaling pathways activated by Nox4-derived reactive oxygen species in the myocardium. We investigated the role of Nox4 and Nox4-associated signaling pathways in the development of cardiac remodeling.Cardiac-specific human Nox4 transgenic mice (c-hNox4Tg) were generated. Four groups of mice were studied: (1) control mice, littermates that are negative for hNox4 transgene but Cre positive; (2) c-hNox4 Tg mice; (3) angiotensin II (AngII)-infused control mice; and (4) c-hNox4Tg mice infused with AngII. The c-hNox4Tg mice exhibited an ≈10-fold increase in Nox4 protein expression and an 8-fold increase in the production of reactive oxygen species, and manifested cardiac interstitial fibrosis. AngII infusion to control mice increased cardiac Nox4 expression and induced fibrosis and hypertrophy. The Tg mice receiving AngII exhibited more advanced cardiac remodeling and robust elevation in Nox4 expression, indicating that AngII worsens cardiac injury, at least in part by enhancing Nox4 expression. Moreover, hNox4 transgene and AngII infusion induced the expression of cardiac fetal genes and activated the Akt-mTOR and NFκB signaling pathways. Treatment of AngII-infused c-hNox4Tg mice with GKT137831, a Nox4/Nox1 inhibitor, abolished the increase in oxidative stress, suppressed the Akt-mTOR and NFκB signaling pathways, and attenuated cardiac remodeling.Upregulation of Nox4 in the myocardium causes cardiac remodeling through activating Akt-mTOR and NFκB signaling pathways. Inhibition of Nox4 has therapeutic potential to treat cardiac remodeling.
Systemic lupus erythematosus in a patient with<i>PTEN</i>hamartoma tumour syndrome
Authors: T. Lee, E.N. Le, D.A. Glass, C.D. Bowen, A.R. Dominguez
Journal: British Journal of Dermatology (2013)

Journal Article Systemic lupus erythematosus in a patient with PTEN hamartoma tumour syndrome Get access T. Lee, T. Lee University of Texas Southwestern Medical School University of Texas Southwestern Medical Center 5323 Harry Hines Blvd Dallas TX 75390‐9191 U.S.A Search for other works by this author on: Oxford Academic Google Scholar E.N. Le, E.N. Le Department of Dermatology University of Texas Southwestern Medical Center 5323 Harry Hines Blvd Dallas TX 75390‐9191 U.S.A Search for other works by this author on: Oxford Academic Google Scholar D.A. Glass, II, D.A. Glass, II Department of Dermatology University of Texas Southwestern Medical Center 5323 Harry Hines Blvd Dallas TX 75390‐9191 U.S.A Search for other works by this author on: Oxford Academic Google Scholar C.D. Bowen, C.D. Bowen Department of Dermatology San Antonio Uniformed Services Health Education Consortium San Antonio TX U.S.A Search for other works by this author on: Oxford Academic Google Scholar A.R. Dominguez A.R. Dominguez Department of Dermatology University of Texas Southwestern Medical Center 5323 Harry Hines Blvd Dallas TX 75390‐9191 U.S.A Correspondence: Arturo Dominguez. E‐mail: arturo.dominguez@utsouthwestern.edu Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 170, Issue 4, 1 April 2014, Pages 990–992, https://doi.org/10.1111/bjd.12767 Published: 01 April 2014