tbuckley/cabot-search huggingface dataset:
P233 Long-term Impact Of Inhaled Corticosteroids On Bone Mineral Density And Fracture Risk In Patients With Asthma: Systematic Review And Meta-analysis
Authors: Y. Loke, D. Gilbert, M. Thavarajah, P. Blanco, A. Wilson
Journal: Thorax (2014)

<h3>Background</h3> A recent meta-analysis of 16 randomised controlled trials (RCTs) and 7 observational studies demonstrated a modest but statistically significant increase in fracture risk with inhaled corticosteroid (ICS) use in chronic obstructive pulmonary disease. However, it is not clear whether ICS use has similar skeletal adverse effects in patients with asthma. We aimed to evaluate the association between ICS and fractures and changes in bone mineral density when used for &gt;12 months in asthma. <h3>Methods</h3> We initially searched MEDLINE and EMBASE in July 2013, and performed an updated PubMed search in June 2014. We used a combination of search terms involving drug name and adverse effects of interest, and we also hand-searched reference lists of existing systematic reviews and trial reports. We selected RCTs and controlled observational studies of any ICS vs non-ICS control treatment for asthma (at least 52 weeks duration). Meta-analysis of odds ratios was conducted using RevMan 5.3 with the primary outcome measure being fracture events. We also analysed mean differences in bone mineral density (gram per cm squared) using inverse variance method. Heterogeneity was assessed using the I2 statistic. <h3>Results</h3> We selected nine RCTs and 11 observational studies for the meta-analysis. There was no significant association between ICS and fractures in children in one RCT, or in a pooled analysis of two observational studies, (OR 1.02, 95% CI 0.94–1.10). No significant fracture risk in adults was reported in 4 observational studies (pooled OR 1.09, 95% CI 0.45–2.62). Meta-analysis of bone mineral density at the lumbar spine did not show significant reductions with ICS use in children (three RCTs and three observational studies), or in adults (three RCTs and four observational studies). Similarly, meta-analysis of bone mineral density at the neck of femur in adults did not demonstrate significant reductions compared to control (three RCTs and four observational studies). <h3>Conclusion</h3> In our systematic review of 20 studies, use of ICS for &gt;12 months in patients with asthma was not associated with statistically significant adverse effects on bone mineral density or fractures.
Prognostic impact and targeting of CRM1 in acute myeloid leukemia
Authors: Kensuke Kojima, Steven M. Kornblau, Vivian Ruvolo, Archana Dilip, Seshagiri Duvvuri, R. Eric Davis, Min Zhang, Zhiqiang Wang, Kevin R. Coombes, Nianxiang Zhang, Yi Hua Qiu, Jared K. Burks, Hagop Kantarjian, Sharon Shacham, Michael Kauffman, Michael Andreeff
Journal: Blood (2013)
Inactivation of MOXD2 and S100A15A by Exon Deletion during Human Evolution
Authors: Yoonsoo Hahn, Sangkyun Jeong, Byungkook Lee
Journal: Molecular Biology and Evolution (2007)

We devised a bioinformatics method for systematic identification of putative human-specific exon-deletion mutations that occurred after the divergence of human and chimpanzee and experimentally verified 2 of the predicted mutations in MOXD2 and S100A15A genes. MOXD2 gene encodes a monooxygenase that is highly conserved in mammals and is mostly expressed in the olfactory epithelium in mouse. The presence of a deletion of the last 2 exons and a polymorphic nonsense mutation in exon 6 suggests that MOXD2 gene is inactive in humans. S100A15A is a member of the S100 family of calcium-binding proteins, the mouse ortholog of which is expressed during epidermal maturation. Human S100A15A gene is likely to be inactive because the start codon–bearing exon is deleted in human. We propose that modification or inactivation of MOXD2 and S100A15A genes have contributed to the loss of certain smell sense in humans and to the development of human skin.
Hypothyroidism
Authors: Christine Laine
Journal: Annals of Internal Medicine (2009)

The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including PIER (Physicians' Information and Education Resource) and MKSAP (Medical Knowledge and Self Assessment Program). Annals of Internal Medicine editors develop In the Clinic from these primary sources in collaboration with the ACP's Medical Education and Publishing division and with assistance of science writers and physician writers. Editorial consultants from PIER and MKSAP provide expert review of the content. Readers who are interested in these primary resources for more detail can consult www.acponline.org, http://pier.acponline.org, and other resources referenced within each issue of In the Clinic.
Landmark article, Oct. 1941: Maternal pulmonary embolism by amniotic fluid as a cause of obstetric shock and unexpected deaths in obstetrics. By Paul E. Steiner and C. C. Lushbaugh
Authors: P. E. Steiner
Journal: JAMA (1986)

While most of the deaths occurring during labor and in the early puerperium are said to be due to hemorrhage, toxemia, heart disease or other less common obstetric and medical causes, a few fatalities remain unexplained even after careful postmortem examination.<sup>1</sup>In the absence of pathologic chemical and anatomic changes such deaths are often considered, without proof, to be on a functional basis. It is the object of this paper to attempt to fill this gap in our knowledge and to point out that some of these obscure deaths form a disease entity with its characteristic causation, symptoms and pathologic changes by (<i>a</i>) presenting the clinical histories of 8 patients to show that they form a distinct group, (<i>b</i>) demonstrating in them a pathologic-anatomic basis for this series of symptoms and (<i>c</i>) demonstrating the experimental production of this disease in animals, the disease in them having a similar symptomatology
TRPM3 and miR-204 Establish a Regulatory Circuit that Controls Oncogenic Autophagy in Clear Cell Renal Cell Carcinoma
Authors: Daniel P. Hall, Nicholas G. Cost, Shailaja Hegde, Emily Kellner, Olga Mikhaylova, Yiwen Stratton, Birgit Ehmer, William A. Abplanalp, Raghav Pandey, Jacek Biesiada, Christian Harteneck, David R. Plas, Jarek Meller, Maria F. Czyzyk-Krzeska
Journal: Cancer Cell (2014)
Surgery for Cerebrovascular Disease
Authors: Christopher K. Zarins
Journal: JAMA (1988)

The surgical treatment of cerebrovascular disease is currently an area of intense interest with active reappraisal of the existing body of data on the natural history of cerebrovascular disease and the role of medical and surgical management. The indications for surgical treatment and the definitions of acceptable morbidity and mortality rates are being scrutinized, and several prospective randomized trials are under way. Thus, the appearance of this book is very timely, for it provides a broad and comprehensive view of the many issues related to the rational treatment of cerebrovascular disease. The volume encompasses more than 950 pages and draws on knowledge from various disciplines including anatomy, physiology, pathology, radiology, neurology, neurosurgery, and vascular surgery. Recognized experts from each of these areas have written excellent chapters dealing with the epidemiology, pathology, clinical presentation, angiographic findings, and noninvasive evaluation as well as the medical and surgical management of patients with cerebral
Abnormalities of PIG-A Transcripts in Granulocytes from Patients with Paroxysmal Nocturnal Hemoglobinuria
Authors: Toshio Miyata, Norio Yamada, Yoshiyasu Iida, Junichi Nishimura, Junji Takeda, Teruo Kitani, Taroh Kinoshita
Journal: New England Journal of Medicine (1994)

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired disorder in which there is a deficiency in the synthesis by hematopoietic cells of the glycosyl-phosphatidylinositol molecules that anchor proteins to the cell membrane. Recently, we demonstrated that a gene termed PIG-A (for phosphatidylinositol glycan class A), a component of glycosyl-phosphatidylinositol biosynthesis, was responsible for PNH in two patients. The present study was undertaken to elucidate whether PIG-A is the gene responsible for all cases of PNH and to characterize further the somatically acquired abnormalities of this gene.
Assessment of nailfold capillaroscopy by נ30 digital epiluminescence (dermoscopy) in patients with Raynaud phenomenon
Authors: E. Beltrán, A. Toll, A. Pros, J. Carbonell, R.M. Pujol
Journal: British Journal of Dermatology (2007)

Dermoscopy is a useful tool for dermatologists to study melanocytic lesions. Its possible usefulness in the assessment of capillary nailfold morphological changes (capillaroscopy) has recently been advocated.To assess the practical utility of digital epiluminescence microscopy as a capillaroscopic instrument in patients with Raynaud phenomenon (RP). To compare the sensitivity and specificity rates obtained by epiluminescence microscopy with those previously reported with conventional capillaroscopic devices.Fifty-six consecutive patients with primary RP (PRP; n = 5) or secondary RP (SRP; n = 51) (11 men and 45 women in total) were included in the study. A control group of 10 healthy subjects was also evaluated. Twenty-six patients (46%) had systemic sclerosis (SS), 12 (21%) presystemic sclerosis (pre-SS), one (2%) dermatopolymyositis-SS, one (2%) mixed connective tissue disease, two (4%) Sjögren syndrome, two (4%) an overlap syndrome, one (2%) rheumatoid arthritis and six (11%) other connective tissue diseases. Capillary nailfold changes were studied using a nonportable digital epiluminescence device (magnification x 30). Following a systematized protocol, capillary nailfold morphology, density and distribution were evaluated. Several capillaroscopic patterns were identified (normal, sclerodermic, nonspecific, nondiagnostic) as previously defined. A possible relationship between capillary nailfold changes and the intensity of RP or the presence of associated autoimmune diseases was assessed.The sclerodermic pattern showed a sensitivity of 76.9% and a specificity of 90.9% in SS. A typical capillaroscopic SS pattern was observed in 73% of cases of limited SS and in 82% of cases of diffuse SS. Patients with Sjögren syndrome and dermatopolymyositis-SS showed a nonspecific capillaroscopic pattern. All patients with PRP presented a normal capillaroscopic pattern. A normal capillaroscopic pattern was also observed in 11 of 12 patients with pre-SS. In one of two patients presenting severe sclerodactyly and in all patients showing hand oedema (three of 56), capillaroscopic changes could not be evaluated. Avascular areas correlated significantly with severe RP (P < 0.002), bone resorption (P < 0.007) and diffuse SS (P < 0.008).Digital epiluminescence seems to be a useful and reliable technique in the evaluation of capillary nailfold morphological changes. This technical variation allows the identification of specific capillaroscopic patterns associated with connective tissue diseases. It also permits us to differentiate PRP from SRP. The results obtained with this technique are similar to those previously reported using standard capillaroscopy devices.
Management of Trigeminal Neuralgia (Tic Douloureux)
Authors: Rand Voorhies
Journal: JAMA (1981)

The initial treatment of trigeminal neuralgia is accomplished with drugs, primarily carbamazepine and occasionally phenytoin sodium. However, many patients become refractory to treatment or side effects develop such as drowsiness or ataxia. In these circumstances, surgical therapy is appropriate. At our institution, microsurgical decompression has yielded good to excellent results in 29 of 32 patients and is currently recommended for persons in good general health who are younger than 70 years. Because of the notable incidence of unpleasant dysesthesias in the face, percutaneous radiofrequency rhizotomy is reserved for persons whose age or general medical condition precludes craniotomy. (<i>JAMA</i>1981;245:2521-2523)
Exenatide Alters Absorption of Hydrocortisone in a Diabetic Patient With Panhypopituitarism: Iatrogenic Adrenal Insufficiency
Authors: Yukari Fujita, Tetsuhiro Kitamura, Michio Otsuki, Daisuke Tamada, Yukiko Tabuchi, Junji Kozawa, Tetsuyuki Yasuda, Kohei Okita, Akihisa Imagawa, Hideaki Kaneto, Tohru Funahashi, Iichiro Shimomura
Journal: Diabetes Care (2012)

Exenatide, which is widely used for patients with type 2 diabetes, inhibits gastric emptying and small intestinal motility (1). We report a diabetic patient with panhypopituitarism who developed general fatigue and appetite loss with hypotension because of absorption delay of hydrocortisone in association with exenatide treatment.

A 50-year-old diabetic woman was admitted to our hospital because of poor glycemic control in December 2011. She had been treated with hydrocortisone and L-thyroxine for hypopituitarism as a result from surgeries and radiotherapy for carniopharyngioma. She was started on treatment with 5 μg exenatide twice a day. Nine days after exenatide treatment, the dose was increased …
Screening for hypothyroidism in elderly inpatients.
Authors: M Bahemuka, H M Hodkinson
Journal: BMJ (1975)

Routine biochemical screening for hypothyroidism in 2000 geriatric inpatients proved valuable and practicable and yielded 46 cases (2.3%). A non-specific clinical picture was particularly common, with less than a third of the cases showing "typical" signs and symptoms. Psychiatric manifestations, especially depression, were important and frequent and responded well to thyroxine. There was a preponderance of female cases of hypothyroidism and a strong association with other autoimmune diseases, notably pernicious anaemia and rheumatoid arthritis.
Septic Pulmonary Emboli from Pulmonic Valvular Endocarditis Demonstrated by Serial Ventilation-Perfusion Lung Imaging
Authors: TEJAS MEHTA, DWIGHT M. ACHONG, ELIZABETH OATES
Journal: Clinical Nuclear Medicine (1993)

The evolution of multiple ventilation-perfusion mismatches on serial lung scintigraphy in a fully anticoagulated, bacteremic patient with small pulmonary infiltrates and repeatedly negative Doppler ultrasonography of the lower extremities suggested pulmonary emboli from right-sided valvular endocarditis. The demonstration of pulmonic valvular vegetations on follow-up transesophageal echocardiography supported this diagnosis. In the proper clinical setting, septic pulmonary emboli should be included in the differential diagnosis of high-probability ventilation-perfusion lung imaging.
THE TRANSMISSION OF ROCKY MOUNTAIN SPOTTED FEVER BY THE BITE OF THE WOOD-TICK (DERMACENTOR OCCIDENTALIS).
Authors: H. T. RICKETTS
Journal: JAMA (1906)

InThe Journal, July 7, I reported briefly my success in transmitting Rocky Mountain spotted fever to the guinea-pig and monkey. With these results in hand, it at once became apparent that a means had been provided by which to test the theory of transmission by the wood-tick, a theory which was primarily advanced by Wilson and Chowning. It was my first aim to establish, beyond the opportunity of doubt, the susceptibility of the animals mentioned, and it was only after this susceptibility had been determined by inoculation from two different patients that the study of the tick as an intermediate host for the parasite was taken up. On June 19 a small female tick was placed at the base of the ear of "Bradley" Guinea-pig 1. This guinea-pig had been inoculated intraperitoneally on June 11 with three cubic cm. of defibrinated blood from the patient, Bradley, and died with
Evidence based palliative care
Authors: I. J Higginson
Journal: BMJ (1999)

In the first decades of the 21st century much healthcare spending will be concentrated on the end of life. Predictions for the year 2025 show an ageing population, with more people worldwide dying from chronic or progressive illnesses rather than acute conditions.1 Indeed, this revolution is already upon us. In the United States end of life expenditure through Medicare consumes 10-12% of the total health budget and 27% of the Medicare budget.2 Among older people healthcare expenditure for those in the last year of life was 276% higher than for people of similar age.3 Cartwright and Seale estimated that in England about 22% of hospital bed days were taken up by people in the last year of life.4 Although discussion of death is still taboo in our society, all health and social professionals must now be assessing the best way of caring for a person with a progressive illness and their family. This underlines the importance of palliative care.

Palliative care is a person centred approach concerned with physical, psychosocial, and spiritual care in progressive disease. It focuses on both the quality of life remaining to patients and supporting their families and those close to them. Throughout the world specialist palliative care services have grown, though their distribution is uneven. In 1999 there were over 6560 hospice or palliative care services in 84 countries, with 933 services in …
Evaluation of Peripheral Vascular Disease
Authors: George D. LeMaitre
Journal: JAMA (1982)

<h3>To the Editor.—</h3> I should like to comment on the article by Stefan A. Carter, MD, "Arterial Oscultation in Peripheral Vascular Disease" (1981; 246:1682). Dr Carter makes the point, among others, that stress-amplified bruits and diminished ankle BPs can aid in the diagnosis and evaluation of vaso-obstructive disease of the lower extremities. I should like to comment on a protocol that I have used for years in the initial evaluation of the "claudicator" both from the perspective of diagnosis as well as assessment of the degree of disability present. I receive a large number of patients with leg pain on exertion and quite a few of them turn out to be "pseudoclaudicators." To make this distinction, I routinely walk each patient on a treadmill, measuring ankle BPs before and after the stress. These patients are generally walked an average of three to five minutes at 1.6 to 2.4 km/hr with
Pre-admission Investigations
Authors: B. Taylor
Journal: BMJ (1973)

Pre-admission Investigations SIR,-I presume that hospital case summar- ies are frequently used for research purposes and should therefore be as accurate as possible.During 20 years in general practice it has struck me as very odd that according to these summaries the patient's investigations and specific treatment nearly always start on his admission to hospital or attendance at the outpatient department.There is rarely any reference to investigations done by the gen- eral practitioner before the patient came under the care of the hospital.Yet with open access to x-ray and laboratory facilities con- siderable information may have been obtain- ed concerning the patient's illness before referral to a hospital consultant.The case summaries also give the impression that a considerable time has elapsed between the patient presenting his symptoms to the G.P. and his subsequent referral to hospital, with- out the G.P. doing anything positive.
Outcomes 5 years after response to rituximab therapy in children and adults with immune thrombocytopenia
Authors: Vivek L. Patel, Matthieu Mahévas, Soo Y. Lee, Roberto Stasi, Susanna Cunningham-Rundles, Bertrand Godeau, Julie Kanter, Ellis Neufeld, Tillmann Taube, Ugo Ramenghi, Shalini Shenoy, Mary J. Ward, Nino Mihatov, Vinay L. Patel, Philippe Bierling, Martin Lesser, Nichola Cooper, James B. Bussel
Journal: Blood (2012)
Primary Prevention of Sexually Transmitted Diseases-Reply
Authors: Katherine M. Stone
Journal: JAMA (1986)

<h3>In Reply.—</h3> We appreciate the opportunity to respond the questions posed in Dr Myers' letter. Mention of "postcoital disinfection" among males was intentionally omitted from our review of local measures because we could find no controlled studies of efficacy. Supervised application of local germicides for personal use were widespread during wartime. The efficacy of these measures was inferred from subsequent dramatic declines in rates of sexually transmitted diseases.<sup>1</sup>However, the mandatory punishment for acquisition of these diseases (court martial) probably resulted in dramatic declines in reporting. In the early 1900s, any "enthusiastic endorsement" by the medical profession for local preventive methods probably resulted from the alarming lack of antibiotic cures for gonorrhea and syphilis rather than from the inherent efficacy of the methods. Although in vitro germicidal qualities of spermicides were described decades ago, in vivo efficacy has been studied only recently. The first report of clinical efficacy was
GPs will not negotiate with government "with a gun to their head," GP leader says
Authors: G. Iacobucci
Journal: BMJ (2012)

The UK government was “holding a gun to the head” of GPs by saying that they must negotiate on changes to their contract, even though it was determined to introduce them regardless, a GP leader said last week.

The Department of Health for England has offered GPs a 1.5% uplift to their funding if they agree to changes to the general medical services (GMS) contract for next year. These changes would include a range of new indicators in the Quality and Outcomes Framework (QOF), the incentive scheme that rewards GPs for achieving targets in a range of treatment domains, and a raising of the achievement thresholds for all indicators in the framework.

But it …
Reply to Michael Froehner, Manfred P. Wirth's Letter to the Editor re: Jim C. Hu, Giorgio Gandaglia, Pierre I. Karakiewicz, et al. Comparative Effectiveness of Robot-assisted Versus Open Radical Prostatectomy Cancer Control. Eur Urol 2014;66:666–72
Authors: Jim C. Hu
Journal: European Urology (2014)
Additive effects of nicorandil on coronary blood flow during continuous administration of nitroglycerin
Authors: Atsunori Okamura, Hiromi Rakugi, Mitsuru Ohishi, Yoshihiro Yanagitani, Masumi Shimizu, Tadahiko Nishii, Yoshiaki Taniyama, Takashi Asai, Shin Takiuchi, Koichi Moriguchi, Masashi Ohkuro, Norio Komai, Kazuo Yamada, Nozomu Inamoto, Atsuhiro Otsuka, Jitsuo Higaki, Toshio Ogihara
Journal: Journal of the American College of Cardiology (2001)
Morphologic and ultrastructural evidence for interleukin‐6 induced platelet activation
Authors: Leslie Oleksowicz, Zbigniew Mrowiec, Randi Isaacs, Janice P. Dutcher, Elena Puszkin
Journal: American Journal of Hematology (1995)

Abstract The in vitro effect of IL‐6 on platelet activation was investigated. When human platelets were incubated with high (1,000 ng/ml) or low (1 ng/ml) dose IL‐6, expression of GMP‐140 was enhanced by 42% (N = 6; P &lt; 0.009) and 46% (N = 6; P &lt; 0.061) in 1 hr low and high dose IL‐6‐platelet incubations, respectively, as assessed by flow cytometry. In platelet specimens incubated with high dose IL‐6 for 3 hr, a 70% (N = 6; P &lt; 0.009) increase in GMP‐140 expression over control was observed. Parallel high dose IL‐6 incubations subjected to scanning electron microscopic studies revealed a 3.4‐fold increase (N = 6; P &lt; 0.001) in spheroid morphologic platelet forms in 1 hr incubations in comparison to control platelet preparations, whereas in 3 hr IL‐6‐platelet incubations, a 96% uncrease in dendritic platelet forms was observed (N = 6; P &lt; 0.001). Significant increases in platelet ATP levels were observed in both 1 min and 1 hr high dose and low dose IL‐6 platelet incubations. In 3 hr high dose‐IL‐6 platelet incubations, a significant 18% (N = 8; P &lt; 0.001) decrease in platelet ATP was parallelled by a significant 40% increase (N = 8; P &lt; 0.014) in plasma ATP in the same specimens. This increased plasma ATP was highly correlated with a reduction in platelet ATP when analyzed by bivarlate regression analysis. Lastly, transmission electron microscopic analysis demonstrated a significant reduction in dense granule number and ratio of dense granule surface area/cell surface area in 3 hr high dose IL‐6 incubations. These findings suggests that IL‐6 activates platelets in Vitro.