tbuckley/cabot-search huggingface dataset:
Hormone replacement therapy and risk of venous thromboembolism in postmenopausal women: systematic review and meta-analysis
Authors: Marianne Canonico, Geneviève Plu-Bureau, Gordon D O Lowe, Pierre-Yves Scarabin
Journal: BMJ (2008)

<b>Objective</b> To assess the risk of venous thromboembolism in women using hormone replacement therapy by study design, characteristics of the therapy and venous thromboembolism, and clinical background. <b>Design</b> Systematic review and meta-analysis. <b>Data sources</b> Medline. <b>Studies reviewed</b> Eight observational studies and nine randomised controlled trials. <b>Inclusion criteria</b> Studies on hormone replacement therapy that reported venous thromboembolism. <b>Review measures</b> Homogeneity between studies was analysed using χ<sup>2</sup> and I<sup>2</sup> statistics. Overall risk of venous thromboembolism was assessed from a fixed effects or random effects model. <b>Results</b> Meta-analysis of observational studies showed that oral oestrogen but not transdermal oestrogen increased the risk of venous thromboembolism. Compared with non-users of oestrogen, the odds ratio of first time venous thromboembolism in current users of oral oestrogen was 2.5 (95% confidence interval 1.9 to 3.4) and in current users of transdermal oestrogen was 1.2 (0.9 to 1.7). Past users of oral oestrogen had a similar risk of venous thromboembolism to never users. The risk of venous thromboembolism in women using oral oestrogen was higher in the first year of treatment (4.0, 2.9 to 5.7) compared with treatment for more than one year (2.1, 1.3 to 3.8; P&lt;0.05). No noticeable difference in the risk of venous thromboembolism was observed between unopposed oral oestrogen (2.2, 1.6 to 3.0) and opposed oral oestrogen (2.6, 2.0 to 3.2). Results from nine randomised controlled trials confirmed the increased risk of venous thromboembolism among women using oral oestrogen (2.1, 1.4 to 3.1). The combination of oral oestrogen and thrombogenic mutations or obesity further enhanced the risk of venous thromboembolism, whereas transdermal oestrogen did not seem to confer additional risk in women at high risk of venous thromboembolism. <b>Conclusion</b> Oral oestrogen increases the risk of venous thromboembolism, especially during the first year of treatment. Transdermal oestrogen may be safer with respect to thrombotic risk. More data are required to investigate differences in risk across the wide variety of hormone regimens, especially the different types of progestogens.
A Randomized Controlled Trial of Intravenous Montelukast in Acute Asthma
Authors: Carlos A. Camargo, Howard A. Smithline, Marie-Pierre Malice, Stuart A. Green, Theodore F. Reiss
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

Many patients with acute asthma do not respond adequately to currently accepted therapy, including oxygen, beta-agonists, and corticosteroids. Leukotriene receptor antagonists such as montelukast have demonstrated efficacy in chronic asthma, but their efficacy in acute asthma is unknown. In this randomized, double-blind, parallel-group pilot study, adults with moderate to severe acute asthma received standard therapy plus either intravenous montelukast (7 or 14 mg) or matching placebo. A total of 201 patients were randomized, and 194 had complete data available for analysis. There was no difference in FEV1 response between the 7- and 14-mg montelukast groups. Montelukast improved FEV1 over the first 20 minutes after intravenous administration (mean percentage change from prerandomization baseline, 14.8% versus 3.6% for the pooled montelukast and placebo treatment groups, respectively; p = 0.007). This benefit was observed at 10 minutes and over 2 hours after intravenous therapy. Patients treated with montelukast tended to receive less beta-agonists and have fewer treatment failures than patients receiving placebo. The tolerability profile for montelukast was similar to that observed for placebo, and no unexpected adverse experiences were observed. We conclude that intravenous montelukast in addition to standard therapy causes rapid benefit and is well tolerated in adults with acute asthma.
REVASCULARIZATION OF VIABLE MYOCARDIUM INSIGHTS FROM META-ANALYSES OF RANDOMIZED CLINICAL TRIALS AND RECENT NON-RANDOMIZED STUDIES ON THE EFFECT ON ALL CAUSE MORTALITY USING TRIAL SEQUENTIAL ANALYSES AND META-REGRESSION ANALYSIS
Authors: Saurav Chatterjee, Partha Sardar, Jørn Wetterslev, Giuseppe Biondi-Zoccai, Debabrata Mukherjee
Journal: Journal of the American College of Cardiology (2013)
Neuraminidase inhibitors in pandemic A/H1N1 flu
Authors: J T. Weber, A. Nicoll, C. B Bridges, B. C Ciancio
Journal: BMJ (2010)

Jefferson and colleagues describe the effectiveness of neuraminidase inhibitors in otherwise healthy adults infected with seasonal flu virus,1 but it is mainly the A/H1N1 flu virus that is currently in circulation.

Given the limited availability of vaccine against 2009 pandemic A/H1N1 flu, antiviral drugs have assumed a prominent role in reducing severe flu …
Serum Cholesterol Levels and Six-Year Mortality from Stroke in 350,977 Men Screened for the Multiple Risk Factor Intervention Trial
Authors: Hiroyasu Iso, David R. Jacobs, Deborah Wentworth, James D. Neaton, Jerome D. Cohen
Journal: New England Journal of Medicine (1989)

We examined the relation between the serum total cholesterol level and the risk of death from stroke during six years of follow-up in 350,977 men, 35 to 57 years of age, who had no history of heart attack and were not currently being treated for diabetes mellitus. The diagnosis of stroke and the type of stroke were obtained from death certificates. Using proportional-hazards regression to control for age, cigarette smoking, diastolic blood pressure, and race or ethnic group, we found that the six-year risk of death from Intracranial hemorrhage (International Classification of Diseases, ninth edition [ICD-9], categories 431 and 432) was three times higher in men with serum cholesterol levels under 4.14 mmol per liter (160 mg per deciliter) than in those with higher cholesterol levels (P = 0.05 by omnibus test across five cholesterol levels). On the other hand, a positive association was observed between the serum cholesterol level and death from nonhemorrhagic stroke (P = 0.007). The inverse association of the serum cholesterol level with the risk of death from intracranial hemorrhage was confined to men with diastolic blood pressure ≥90 mm Hg, in whom death from intracranial hemorrhage is relatively common. We conclude that there is an inverse relation between the serum cholesterol level and the risk of death from hemorrhagic stroke in middle-aged American men, but that its public health impact is overwhelmed by the positive association of higher serum cholesterol levels with death from nonhemorrhagic stroke and total cardiovascular disease (ICD-9 categories 390 through 459). (N Engl J Med 1989; 320:904–10.)
Human parvovirus B19
Authors: J R Pattison
Journal: BMJ (1994)

Infection with parvovirus B19 is most common in children between the ages of 4 and 11. About half the infections are asymptomatic, and many of the remainder cause a non-specific illness of the respiratory tract.1 The most common distinct disease associated with the infection is erythema infectiosum - also known as fifth disease or slapped cheek disease.2 Erythema infectiosum is usually diagnosed clinically only when there is an outbreak of illness with a rash in young children and red cheeks are a prominent feature. Illness with an erythematous rash due to parvovirus B19 infection is worldwide and common, but in the absence of laboratory tests it is often diagnosed as rubella (both rubella and parvovirus B19 infection have a similar seasonality), allergy, or simply a “viral infection.

An arthropathy similar to that seen in rubella may be associated with parvovirus B19 infection. The most common pattern is symmetric arthralgia or arthritis in the small joints of the hands, with the wrists, knees, and ankles affected …
Finger deformities in Renaissance art
Authors: C. Fras
Journal: Journal of the Royal Society of Medicine (2005)

Dr Hijmans and Dr Dequeker presented an interesting argument for camptodactyly in the paintings of Dirk Bouts (November 2004 JRSM1). However, in their desire to distinguish these paintings from others of the period that show similar finger deformities, they misstate the nature of camptodactyly. Green's Operative Hand Surgery and the International Federation of Societies for Surgery of the Hand define camptodactyly as a congenital flexion deformity of the proximal interphalangeal joint of the fifth finger.2 Specifically, hyperextension of the distal interphalangeal joint is not necessary for the diagnosis; indeed, if this is present to a significant degree, the clinician should consider the possibility of a boutonniere deformity rather than camptodactyly. Also, extension of the metacarpophalangeal joint, while often present, is not a requirement for the diagnosis of camptodactyly.

While the exact cause of the deformity is not entirely known, it appears to be related to muscular abnormalities, particularly in the lumbrical or intrinsic muscles. It is present in both hands in two thirds of cases (in some, but not all, of the paintings by Bouts it is bilateral).

Shortly after reading the article by Hijmans and Dequeker I noted camptodactyly on one of the Christmas cards I was writing (Figure 1). This work, from the collection of the Metropolitan Museum of Art in New York, was painted by Gerard David (c. 1455–1523). Interestingly, this artist was independently mentioned by Dr Horton Johnson in his letter to the editor (February 2005 JRSM3) as one of several other examples of camptodactyly in art, although the painting he used was different.



Figure 1

The Virgin, by Gerard David. The Metropolitan Museum of Art, Bequest of Mary Stillman Harkness, 1950



In view of the number of artists and paintings that show evidence of camptodactyly (as defined by hand surgery authorities), it seems more likely that Bouts and his son were employing an artistic convention than that they were illustrating a hand deformity specific to their model.
The Social Issues Research Centre
Authors: D. Miller, M. De Andrade
Journal: BMJ (2010)

The Social Issues Research Centre (SIRC) is an “independent, non-profit organisation”1 that says it carries out “balanced, calm and thoughtful”2 research on lifestyle issues such as drinking, diet, and pharmaceuticals. However, it may be perceived that the company acts more like a public relations agency for the corporations that fund its activities. These include Diageo, Flora, Coca-Cola, GlaxoSmithKline, and Roche, among others.3 Although SIRC does publish this partial list of funders, it is not immediately apparent which company has sponsored which study. And in some instances this information is not included in media reports.4

SIRC has produced guidelines for journalists on the reporting of science and health issues,5 but the guidelines include little on transparency or avoiding conflicts of interest.6 SIRC is not always transparent about its own funding. For example, it was commissioned by HRT Aware to produce a report that concluded that “well-informed women” taking hormone replacement therapy are “benefiting” and feeling happier, healthier, …
The Iron Lung at Rancho Los Amigos
Authors: K. Lawrence Cohen
Journal: JAMA (1986)

<h3>To the Editor.—</h3> Our professional staff enjoyed the LANDMARK ARTICLE and the LANDMARK PERSPECTIVE on the iron lung published in the March 21 issue.<sup>1,2</sup>We were also excited to see Fig 3 on page 1479 because that picture hangs in several different areas of our hospital: Rancho Los Amigos Medical Center in Downey, Calif, a Los Angeles suburb. Rancho takes great pride in its heritage as one of the early respiratory centers for patients afflicted with polio, and the picture is incorrectly identified as having been taken at Los Angeles County Hospital. It was really taken at a special gathering, attended by Hollywood celebrities, in our auditorium for all of our polio patients in Drinker tanks and on rocking beds (upper right and left hand corners). Although Rancho is a Los Angeles County facility it was, and still is, a distinct entity separate from Los Angeles County Hospital (now
Dynamics of hypervariable region 1 variation in hepatitis C virus infection and correlation with clinical and virological features of liver disease
Authors: Sabrina Brambilla, Giorgio Bellati, Margherita Asti, Antonella Lisa, Maria Elena Candusso, Maria D’Amico, Gabriele Grassi, Mauro Giacca, Angelo Franchini, Savino Bruno, Gaetano Ideo, Mario U. Mondelli, Enrico M. Silini
Journal: Hepatology (1998)

Hepatitis C virus (HCV) infection is a dynamic process during which molecular variants are continously selected as the result of virus adaptation to the host. Understanding the nature of HCV genetic variation is central to current theories of pathogenesis and immune response. We prospectively studied hypervariable region 1 (HVR1) variation in the E2 gene of 36 hepatitis C patients, including 10 asymptomatic carriers, followed up for 1 to 2 years. Sequence changes in single and consecutive serum samples were assessed and correlated with clinical and virological parameters of liver disease. A region of the E1 gene was sequenced for comparison in 3 subjects. HVR1 heterogeneity at single time points widely varied in individual patients, did not increase cumulatively over the follow-up period, and did not correlate with HVR1 evolutionary rates. Conversely, the process of HVR1 sequence diversification, although differed considerably among patients, was stable over time and directly correlated with infections by HCV type 2, lower alanine aminotransferase (ALT) levels, and absence of cirrhosis. HCV carriers showed the highest HVR1 variation rates. Our findings indicate that HVR1 variation has an adaptive significance and is associated with favorable features of liver disease and suggest that prospective, rather than static, observations are required to model the process of HCV variation.
Histochemistry of the Skin—Psoriasis: A Monograph on Normal and Parakeratotic Epidermal Keratinization With Special Reference to Psoriasis and Its Treatment
Authors: Richard M. Caplan
Journal: JAMA (1965)

In this monograph by two experienced British investigators the real hero is keratinization, the process which forms the relatively impermeable surface layer of the body. This thin protective film is as remarkable for the complexity of its formation and structure as for its several functions, not the least of which is that it keeps us from drying up and blowing away.  In recent years sophisticated investigational techniques have been employed in dermatological research, and much of this has concerned the nature of normal and abnormal keratinization. Too often such methods have produced diverse tidbits of information that are extremely difficult to understand, interrelate, or remember. Such details will, however, become a sensible mosaic when someone writes the whole story from beginning to end. This small volume is only an attempt in that direction, but it does try with good effect to make reasonable sense of a jumble of information. The
RENAL CLEARANCE OF EIGHTEEN INDIVIDUAL AMINO ACIDS IN HUMAN SUBJECTS 1
Authors: Paul D. Doolan, Harold A. Harper, Maxine E. Hutchin, Walton W. Shreeve
Journal: Journal of Clinical Investigation (1955)

Studies of renal clearance of individual amino acids have been comparatively few in number. With the exception of those of Sheffner, Kirsner, and Palmer (1) such investigations have been performed solely on experimental animals and in certain respects the results which they have yielded have been conflicting. In part, the conflict has arisen because of the limited specificity of the analytical methods which the earlier investigators were forced to employ (2-7). Beyer and his associates (8-12), and Kamin and Handler (13), using the more specific methods of microbiological assay, were able to define these areas of conflict as well as to confirm and extend certain of the earlier findings. The most important findings of these previous investigations and the present state
Xanthoma disseminatum with respiratory tract involvement and fatal outcome
Authors: Christopher W H Davies, Pauline Marren, Mark C Juniper, Winifred Gray, Fenella Wojnorowska, Malcolm K Benson
Journal: Thorax (2000)

Xanthoma disseminatum (XD) is a rare mucocutaneous xanthomatosis classified as a benign form of non-Langerhans9 cell histiocytosis. The case history is presented of a 61 year old woman with XD who developed dyspnoea and spirometric features of airflow obstruction. Bronchoscopy and computed tomography confirmed involvement of the large and medium sized bronchi and she subsequently died from acute respiratory failure. The post-mortem findings and the importance of respiratory tract disease in this unusual condition are discussed.
Ligature of Innominate for Subclavian Aneurysm
Authors: W. I. d. C. Wheeler
Journal: BMJ (1942)

A survey is made of 1,498 skin cases seen in the Royal Navy in wartime.It is shown that five conditions cause the majority of skin casualties in the Navy.The treatment used for those five condi- tions in two and a half years of wartime dermatology is very briefly described.Emphasis is placed on the treatment of mycosis-for which chrysarobin is recommended-as those cases were unusually severe and numerous.The difference between the civil practice of dermatology and dermatology in the Service is mentioned and the added difficul- ties of war conditions are noted.A plea is made for greater economy and simplicity in the.treatment of skin conditions.
The General Practitioner and Cancer of the Ear, Nose and Throat
Authors: Daniel Miller
Journal: New England Journal of Medicine (1952)

THERE are few orifices of the body through which symptoms of disease can be detected with such ease as the ears, nose and throat.1 It is true that cancer in this region of the body is not so common that it is seen every week, or even every month, in the general physician's office but a few figures demonstrate how common it can be. Despite the fact that the Ear, Nose and Throat Tumor Clinic at the Massachusetts General Hospital meets one morning a week, records show 1750 visits to this clinic during the past year as compared with the . . .
REPORT OF CASES ILLUSTRATING THE ADVANTAGES OF A NEW AND ORIGINAL METHOD OF OBTAINING MATERIAL FOR SKIN-GRAFTING.
Authors: Z. J. LUSK
Journal: JAMA (1896)

At the meeting of the New York State Medical Association on October 17, 1895, I read a paper describing a "new and original method of obtaining material for skin-grafting," reporting two cases in which it had been successfully employed. The paper was subsequently published in the<i>Medical Record</i>Dec. 7, 1895, Vol. 48, page 800. It was illustrated with three cuts of Case I, showing his condition nine months after over 800 square inches of raw granulating surface had been healed. The accident which deprived this large surface of its integument occurred on Jan. 14, 1895, and was caused by patient falling into a pan of boiling brine at the salt works. His injuries were so severe and shock so profound that I did not think it possible for him to long survive. He rallied, however, and negatived my prognosis from day to day for four weeks, when I began
Effect of Pulmonary Rehabilitation on Quadriceps Fatiguability during Exercise
Authors: M. JEFFERY MADOR, THOMAS J. KUFEL, LILIBETH A. PINEDA, ANN STEINWALD, AJAY AGGARWAL, AMITA M. UPADHYAY, MOHAMMED A. KHAN
Journal: American Journal of Respiratory and Critical Care Medicine (2001)

We have recently shown that patients with chronic obstructive pulmonary disease (COPD) develop contractile fatigue of their quadriceps muscle following endurance exercise. Pulmonary rehabilitation can produce physiological adaptations in patients with COPD. We hypothesized that if pulmonary rehabilitation induces physiological adaptations in the exercising muscle, it should become more fatigue resistant. Twenty one patients with COPD, mean age 69.9 ± 1.9 yr, FEV1 45 ± 4% predicted, participated in an 8-wk outpatient, supervised pulmonary rehabilitation exercise program. Quadriceps contractile fatigue was detected by a fall in quadriceps twitch force postexercise. Twitch force was measured during magnetic stimulation of the femoral nerve. Because potentiated twitches may be more sensitive at detecting fatigue, both unpotentiated (TwQu) and potentiated (TwQp) twitches were obtained before and 10, 30, and 60 min after constant load cycle exercise. Prerehabilitation, during constant load exercise, patients exercised at 37 ± 4 W for 11.2 ± 1.8 min. Prerehabilitation, TwQu fell significantly postexercise down to a minimum value of 82.5 ± 3.1% of the baseline preexercise value (p < 0.001). Similarly, prerehabilitation, TwQp fell significantly postexercise down to a minimum value of 73.9 ± 3.9% of baseline (p < 0.001). Postrehabilitation, for the same intensity and duration of exercise, TwQu was not significantly different from baseline at any time postexercise. Postrehabilitation, TwQp fell significantly postexercise but the fall in TwQp with exercise was significantly less postrehabilitation compared with prerehabilitation (p < 0.001). In conclusion, pulmonary rehabilitation resulted in increased fatigue resistance of the quadriceps muscle in patients with COPD.
Loss of function of the IAA-glucose hydrolase gene TGW6 enhances rice grain weight and increases yield
Authors: Ken Ishimaru, Naoki Hirotsu, Yuka Madoka, Naomi Murakami, Nao Hara, Haruko Onodera, Takayuki Kashiwagi, Kazuhiro Ujiie, Bun-ichi Shimizu, Atsuko Onishi, Hisashi Miyagawa, Etsuko Katoh
Journal: Nature Genetics (2013)
Precipitation of Diazepam From Intravenous Preparations
Authors: William J. Jusko
Journal: JAMA (1973)

To the Editor.—  The recent article by Langdon et al inThe Journal(223:184, 1973) described the 3.5% incidence of thrombophlebitis that occurs when diazepam (Valium) is given intravenously. Precipitation of the relatively water-insoluble diazepam may account for this problem.  Studies of the precipitation of diazepam were prompted by our observation that this product was frequently administered by injection through the tubing of an intravenous infusion set, rather than directly into the patient. This is contrary to the warning of the manufacturer who stated in the package insert that: When used intravenously the solution should be injected slowly, directly into the vein, taking at least one minute for each 5 mg (1 ml) given. Do not add to I.V. fluids. The limited aqueous solubility of diazepam necessitates its formulation into a solution containing propylene glycol (40%) and alcohol (10%), buffered with benzoate sodium and benzoic acid (5%), and preserved with benzyl