tbuckley/cabot-search huggingface dataset:
Diet, Exercise Habits, and Risk of Alzheimer Disease—Reply
Authors: Nikolaos Scarmeas
Journal: JAMA (2009)

Diet, Exercise Habits, and Risk of Alzheimer DiseaseTo the Editor: In their cohort study, Dr Scarmeas and colleagues 1 found an association of self-reported adherence to a Mediterranean-type diet and high levels of physical activity with a reduced risk of developing Alzheimer disease in a population of elderly residents of New York.However, we have several concerns about the study.First, self-selection represents a potentially important source of bias, since individuals who adopt healthy lifestyle habits may be different in various ways from those who do not engage in such habits.Second, self-report measures of diet and exercise can be inaccurate.The accuracy of the Food Frequency Questionnaire is controversial, 2 especially in individuals who may already have memory impairment, and objective measures of physical activity, such as accelerometers, are likely more accurate.Third, the study assessed only one of many possible diets.The DASH (Dietary Approaches to Stop Hypertension) diet is similar but emphasizes greater consumption of low-fat dairy products and carbohydrates and is lower in fat and cholesterol.Moreover, its efficacy in reducing blood pressure has been demonstrated in all segments of the population, including African Americans, 3 a group disproportionately affected by vascular disease and Alzheimer disease. 4e agree with the authors that randomized controlled trials (RCTs) are needed to establish a causal relationship between dietary and exercise habits and risk of Alzheimer disease.While numerous observational studies have shown that physically active individuals perform better on neurocognitive tests compared with their less active counterparts, results of RCTs of exercise have been inconsistent. 5here also have been many observational studies of diet and neurocognition, but most RCTs have focused on dietary supplementation, with generally negative or inconsistent results.Although the observations of Scarmeas et al are encouraging and potentially important, establishing the value of dietary and activity recommendations should await results from future RCTs.
Systemic and Vascular Oxidation Limits the Efficacy of Oral Tetrahydrobiopterin Treatment in Patients With Coronary Artery Disease
Authors: Colin Cunnington, Tim Van Assche, Cheerag Shirodaria, Ilias Kylintireas, Alistair C. Lindsay, Justin M. Lee, Charalambos Antoniades, Marios Margaritis, Regent Lee, Ruha Cerrato, Mark J. Crabtree, Jane M. Francis, Rana Sayeed, Chandi Ratnatunga, Ravi Pillai, Robin P. Choudhury, Stefan Neubauer, Keith M. Channon
Journal: Circulation (2012)

The endothelial nitric oxide synthase cofactor tetrahydrobiopterin (BH4) plays a pivotal role in maintaining endothelial function in experimental vascular disease models and in humans. Augmentation of endogenous BH4 levels by oral BH4 treatment has been proposed as a potential therapeutic strategy in vascular disease states. We sought to determine the mechanisms relating exogenous BH4 to human vascular function and to determine oral BH4 pharmacokinetics in both plasma and vascular tissue in patients with coronary artery disease.Forty-nine patients with coronary artery disease were randomized to receive low-dose (400 mg/d) or high-dose (700 mg/d) BH4 or placebo for 2 to 6 weeks before coronary artery bypass surgery. Vascular function was quantified by magnetic resonance imaging before and after treatment, along with plasma BH4 levels. Vascular superoxide, endothelial function, and BH4 levels were determined in segments of saphenous vein and internal mammary artery. Oral BH4 treatment significantly augmented BH4 levels in plasma and in saphenous vein (but not internal mammary artery) but also increased levels of the oxidation product dihydrobiopterin (BH2), which lacks endothelial nitric oxide synthase cofactor activity. There was no effect of BH4 treatment on vascular function or superoxide production. Supplementation of human vessels and blood with BH4 ex vivo revealed rapid oxidation of BH4 to BH2 with predominant BH2 uptake by vascular tissue.Oral BH4 treatment augments total biopterin levels in patients with established coronary artery disease but has no net effect on vascular redox state or endothelial function owing to systemic and vascular oxidation of BH4. Alternative strategies are required to target BH4-dependent endothelial function in established vascular disease states.
A method for non-overlapping identification of human myeloid derived suppressor cells
Authors: Michael Gustafson, Yi Lin, Mary Maas, Dennis Gastineau, Allan Dietz
Journal: Journal for ImmunoTherapy of Cancer (2014)

Meeting abstracts The function of human myeloid derived suppressor cells (MDSCs) cannot be precisely measured without the proper identification of homogeneous populations. Indeed, many published accounts of human MDSCs are really describing multiple distinct populations confused either by sample
Isotretinoin treatment alters steroid metabolism in women with acne
Authors: M. RADEMAKER, M. WALLACE, W. CUNLIFFE, N. B. SIMPSON
Journal: British Journal of Dermatology (1991)

The effect of isotretinoin (Roaccutane) on serum steroids and urinary steroid metabolites was investigated in seven female patients receiving the drug for treatment of severe acne over a 16-week period. Serum concentrations of dehydroepiandrosterone sulphate (DHAS), androstenedione (A2), and free androgen index (FAI) were not significantly altered. There was a significant fall in testosterone during treatment and a significant reduction in the 24 h urinary excretion of androsterone, tetrahydrocortisone (THE) and tetrahydrocortisol (THF) from week 8 onwards and for aetiocholanolone and allo-THF from week 12 (P less than 0.05). Although pretreatment levels of urinary steroid metabolites were not abnormal, the ratios of the 5 alpha/5 beta metabolites (androsterone:aetiocholanolone and allo-THF:THF) were at the upper limit of the reference range and were lowered after treatment, suggesting that 5 alpha-reductase activity is sensitive to isotretinoin.
Alan William Fowler
Authors: J. Fowler
Journal: BMJ (2013)

Alan William Fowler was brought up at Wokingham, Berkshire, where his father was medical superintendant at Pinewood Sanatorium. He trained in orthopaedics at Halifax and Winford, near Bristol. He was assistant and later consultant orthopaedic surgeon at Bridgend General Hospital from 1953 to his retirement in 1986.

He published a technique for embedded toenails by …
A1.49 Anti-carbamylated protein antibodies (ANTI-CARP) precede the onset of rheumatoid arthritis
Authors: Jing Shi, Lotte A van de Stadt, Marije Verheul, E W Nivine Levarht, Tom W J Huizinga, Dörte Hamann, Dirkjan van Schaardenburg, René E M Toes, Leendert A Trouw
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background and Objective</h3> Anti-citrullinated protein antibodies (ACPA) and IgM-rheumatoid factor (IgM-RF) are auto-antibodies that can be detected many years before the clinical diagnosis of rheumatoid arthritis (RA). In recent studies we discovered a novel family of autoantibodies, anti-carbamylated protein (anti-CarP) antibodies. Carbamylation, like citrullination, is a post-translational modification of proteins. We observed that in RA, next to an antibody response against citrullinated proteins, also an immune response against carbamylated proteins exists. These anti-CarP antibodies are of prognostic value in RA as they associate with severe joint destruction in ACPA negative RA. In addition anti-CarP antibodies associate with future development of RA in patients suffering from arthralgia. Here we analysed whether anti-CarP antibodies are already present prior to symptom onset of RA and which auto-antibody appears first over time. <h3>Materials and Methods</h3> Sera of 79 RA patients prior to diagnosis and 141 age and sex matched controls that were regular blood donors of the Amsterdam Bloodbank (Amsterdam, The Netherlands) were tested for the presence of anti-CarP antibodies, anti-CCP2 antibodies and RF-IgM using sequential pre-RA sera, obtained at 1-2 year intervals. <h3>Results</h3> Anti-CarP antibodies were present in 39% of the serum samples that were drawn just prior to the diagnosis of RA of blood donors compared to 4% of the matched control samples. Anti-CarP antibodies were present in both ACPA positive and in ACPA negative patients. Of the 79 individuals that developed RA, 42% were positive for anti-CCP2 antibodies and 24% for IgM RF. Analysis of the longitudinal samples revealed a gradual increase in the number of samples positive for anti-CarP antibodies and in the levels of anti-CarP antibodies towards the diagnosis of RA. We observed that anti-CarP antibodies could be detected many years before the onset of symptoms with a median of 8 years and a maximum of 14 years. Comparing the first appearance of the three autoantibody families revealed that both ACPA and anti-CarP antibodies appear earlier than IgM-RF. <h3>Conclusions</h3> Next to ACPA and IgM-RF also the newly identified anti-CarP antibodies appear many years before the onset of clinical symptoms of RA.
Association of 1,5-Anhydroglucitol and 2-h Postprandial Blood Glucose in Type 2 Diabetic Patients
Authors: Christoph Stettler, Matthias Stahl, Sabin Allemann, Peter Diem, Kurt Schmidlin, Marcel Zwahlen, Walter Riesen, Ulrich Keller, Emanuel Christ
Journal: Diabetes Care (2008)

To assess the association of 1,5-anhydroglucitol (1,5-AG) with 2-h postprandial glucose values in type 2 diabetic patients followed over 12 months in an outpatient setting.In 55 patients, we examined self-measured postprandial blood glucose values for correlations with 1,5-AG values over prespecified preceding time periods (3 days, 1 week, and weekly up to 12 weeks).The correlation coefficients for postprandial glucose values were -0.34 (P < 0.05) for 3 days, -0.38 (P < 0.001) for 1 week, and -0.40 (P < 0.001) for 2 weeks preceding the measurement of 1,5-AG. Correlations declined for time periods >2 weeks before measurement of 1,5-AG. The correlation was lower with fasting/preprandial plasma glucose levels. There was no time dependency for the correlation between A1C and fasting or postprandial glucose.1,5-AG best reflected the 2-h postprandial glucose values of the 2 previous weeks.
Charity says NICE takes too long to assess cancer drugs
Authors: Lynn Eaton
Journal: BMJ (2005)

A cancer charity is calling for reform of the way in which cancer drugs are made available on the NHS, claiming that there are sometimes delays of up to three years between a drug being licensed and it becoming widely available.

CancerBACUP, an information service for people with cancer, says that approval for a total of 23 cancer treatments is being held up because of delays in the system.

After drugs are …
Acheson: a missed opportunity for the new public health
Authors: A. Nicoll
Journal: BMJ (1988)

<h3>Background</h3> Stents have widened the indications of endovascular intervention for the cerebral aneurysms. <h3>Purpose</h3> We aimed to elucidate the effect of stents on radiologic outcomes and to analyze the risk factors for aneurysmal recanalization via a propensity score matching. <h3>Methods</h3> Among 735 aneurysms treated with coil embolization with stents (n = 187) and without stents (n = 548) during the years 2009 to 2011, 157 propensity score-matched pairs of cases were selected. Recanalization rates and relevant risk factors were analyzed. The mean follow-up interval was 24.1 ± 11.3 months (range, 6–48 months) and 22.9 ± 11.4 months (range, 6–56 months) in the stent and the non-stent groups, respectively (P = 0.388). <h3>Results</h3> The stent group demonstrated lower recanalization rates than the non-stent group in both the 6-month (1.9% vs 10.2%, P = 0.004) and the final follow-up periods (8.3% vs 18.5%, P = 0.005). In the multivariate analysis, significant factors for recanalization included the use of stents (hazard ratio 0.40, 95% confidence interval 0.21–0.76, P = 0.005), larger aneurysm size (hazard ratio 1.21, 95% confidence interval 1.11–1.31, P &lt; 0.001), and initially incomplete occlusion (hazard ratio 2.39, 95% confidence interval, 1.28–4.43, P = 0.006). <h3>Conclusion</h3> In this propensity score-matched analysis, stent implantation reduced recanalization of the coiled cerebral aneurysms. <h3>Disclosures</h3> H. Kang: None. W. Cho: None. H. Hong: None. J. Kim: None. Y. Cho: None. O. Kwon: None. J. Bang: None. G. Hwang: None. Y. Son: None. C. Oh: None. M. Han: None.
Interferon Therapy after Tumor Ablation Improves Prognosis in Patients with Hepatocellular Carcinoma Associated with Hepatitis C Virus
Authors: Yasushi Shiratori, Shuichiro Shiina, Takuma Teratani, Masatoshi Imamura, Shun'taro Obi, Shin'pei Sato, Yukihiro Koike, Haruhiko Yoshida, Masao Omata
Journal: Annals of Internal Medicine (2003)

Background: Even after the surgical or medical treatment of hepatocellular carcinoma, tumors frequently develop at new foci, leading to a poor prognosis. Objective: To assess whether combined tumor ablation and interferon therapy can reduce the occurrence of new foci of hepatocellular carcinoma, thereby improving survival rate. Design: Randomized, controlled study. Setting: University hospital. Patients: 74 patients with compensated cirrhosis, three or fewer nodules of hepatocellular carcinoma, and low hepatitis C virus RNA loads ( 2 106 copies/mL). Intervention: After all patients had complete ablation of lesions by percutaneous ethanol injection therapy, 49 patients were assigned to receive 6 million U of interferon three times weekly for 48 weeks and 25 did not receive treatment. Measurements: Abdominal ultrasonography, computed tomography, and determination of blood biochemical measures. Results: Of the 49 patients treated with interferon, 21 showed a sustained biochemical response and 14 showed a sustained virologic response. The rate of first recurrence of new foci of hepatocellular carcinoma was similar in patients treated with interferon and untreated patients; however, the rates of second or third recurrence seemed to be lower in the interferon group than in the untreated group. Patients treated with interferon had a survival rate of 68% at 5 years and 53% at 7 years; untreated patients had a survival rate of 48% at 5 years and 23% at 7 years. Conclusion: After tumor ablation by ethanol injection, interferon therapy may enhance patient survival in selected patients with chronic hepatitis C.
Paroxysmal Tachycardia And Bundle-Branch Block: Unusual Response to Carotid Sinus Massage
Authors: Yu-Chen Lee
Journal: JAMA (1971)

<h3>To the Editor.—</h3> Transient bundle branch block may be precipitated by many factors, such as, tachycardia, myocardial infarction, pulmonary embolism, anemia, anoxemia, and metabolic disturbances.<sup>1,2</sup>If transient bundle-branch block is due to tachycardia, slowing of the heart rate may restore normal intraventricular conduction. The following case is unusual in that left bundle-branch block was abolished by left carotid sinus massage although paroxysmal atrial tachycardia persisted. <h3>Report of a Case.—</h3> A 47-year-old man was brought to the University of Maryland Hospital emergency room on Sep 19, 1969, due to the sudden onset of severe palpitations of two hours' duration. The palpitations were associated with dyspnea and retrosternal pressure sensation. A similar attack had occurred several months before and had terminated spontaneously. He had been an alcoholic for many years. There was no history of rheumatic fever, hypertension, or heart disease. Physical examination revealed an anxious man who appeared acutely ill
IMPACT OF METABOLIC SYNDROME ON PATIENTS WITH CORONARY ARTERY BYPASS GRAFTS
Authors: Samer Shuaib, V. Shrinivas Murthy, Naoyo Mori, Hani Hashim, Tahseen Siddiqui, Dennis Baumgardner, Alfred J. Anderson, Anjan Gupta, Tanvir Bajwa, Suhail Allaqaband
Journal: Journal of the American College of Cardiology (2012)
Micropuncture measurement of microvascular pressures in isolated lamb lungs during hypoxia.
Authors: J U Raj, P Chen
Journal: Circulation Research (1986)

To study the effect of alveolar hypoxia on the pulmonary circulation of the newborn, we determined the longitudinal distribution of vascular pressures and the distribution of blood flow in isolated blood perfused lungs of newborn lambs during normoxia and hypoxia. We also examined the effect of hypoxia on the slope and intercept of the vascular pressure-flow (P/Q) relation. In 14 lungs, we used the micropipette servonulling technique to measure pressures in 20-80 micron subpleural arterioles and venules during normoxia and hypoxia at constant blood flow. In 5 other lungs, we used radiolabelled microspheres to determine the effect of hypoxia on regional distribution of blood flow. Under baseline normoxic conditions, segmental pressure drops in arteries, microvessels, and veins were approximately equal. During hypoxia pulmonary artery pressure always increased, resulting in a 60% increase in total vascular resistance. All segmental pressure drops increased with hypoxia. Arterial and venous pressure drops increased by 80 and 70% respectively, contributing almost equally to the increase in total pulmonary vascular resistance. Regional distribution of blood flow was uniform during normoxia and was unchanged during hypoxia. Hypoxia increased both the slope and intercept of the P/Q relation significantly, with an increase in fluid filtration rate. We conclude that in the newborn lamb alveolar hypoxia leads to pulmonary arterial and venous constriction, resulting in increased microvascular pressure and fluid filtration.
Mixed malarial infection due to Plasmodium falciparum and P vivax.
Authors: C Gilks, G Pasvol, B Juel-Jensen
Journal: BMJ (1985)

Meteorological factors play a crucial role in malaria transmission, but limited evidence is available from China. This study aimed to estimate the weekly associations between meteorological factors and Plasmodium vivax and Plasmodium falciparum malaria in China.
Selective Suction and Pressure-Regulated Retroinfusion: An Effective and Safe Approach to Retrograde Protection Against Myocardial Ischemia in Patients Undergoing Normal and High Risk Percutaneous Transluminal Coronary Angioplasty
Authors: Peter Boekstegers, Wolfgang Giehrl, Georges von Degenfeld, Gerhard Steinbeck
Journal: Journal of the American College of Cardiology (1998)
The Reliability of Peer Assessments of Quality of Care
Authors: Ronald L. Goldman
Journal: JAMA (1992)

<h3>Objective.</h3> —To critically examine the literature regarding the interreviewer reliability of the standard practice of peer assessment of quality of care. <h3>Data Sources.</h3> —Computerized searches of the English-language literature from 1966 through 1990 using MEDLINE, HEALTHLINE, and SCISEARCH databases were performed to identify studies reporting data on interreviewer agreement of implicit evaluations of patient care episodes. <h3>Study Selection.</h3> —Seventeen studies were identified. Five studies were excluded from this review because of deficiencies in the methods or lack of data on chance-corrected indexes of agreement. <h3>Data Extraction Synthesis.</h3> —The degree of agreement beyond chance was compared with accepted standards in the 12 remaining studies. Most of these studies found agreement corrected for chance to be in the range regarded as poor, indicating that physician agreement regarding quality of care is only slightly better than the level expected by chance. <h3>Conclusions.</h3> —Given the magnitude of the resources devoted to quality assurance and the centrality of peer assessment to these efforts, there is a need for a global reexamination of the peer review process. A number of proposals appear to have potential for improving the peer review process including more objective assessment procedures, multiple reviewers, higher standards for reviewers, elimination of systematic reviewer bias, use of outcome judgments, and adoption of practice guidelines. (<i>JAMA</i>. 1992;267:958-960)
Potential arrhythmogenic role of cyclic adenosine monophosphate (AMP) and cytosolic calcium overload: Implications for prophylactic effects of beta-blockers in myocardial infarction and proarrhythmic effects of phosphodiesterase inhibitors
Authors: Wilhelm F. Lubbe, Thomas Podzuweit, Lionel H. Opie
Journal: Journal of the American College of Cardiology (1992)
Which Page of The Journal Shall One Believe?
Authors: Samuel D. Allison
Journal: JAMA (1965)

<h3>To the Editor:—</h3> An editorial in the Sept 6 issue ofThe Journal(p 831) reads, "A 1965 publication, entitled 'Sexual Inversion,' under the editorship of Marmor, is an excellent and up-to-date reference...." But on p 856 a book review says, "this volume suffers from more than the average ills of multiple authorship. In addition to a loosely coordinated text, there is undue repetition and semantic haggling...," etc. I am confused. The editorialist and the reviewer are writing about the same book. Would it be a good idea to forget about it all, and just go fishing?
Alcohol drinking and cutaneous melanoma risk: a systematic review and dose-risk meta-analysis
Authors: M. Rota, E. Pasquali, R. Bellocco, V. Bagnardi, L. Scotti, F. Islami, E. Negri, P. Boffetta, C. Pelucchi, G. Corrao, C. La Vecchia
Journal: British Journal of Dermatology (2014)

It has been suggested that alcohol intake increases sunburn severity, a major risk factor for cutaneous melanoma (CM). Several epidemiological studies have investigated the relationship between alcohol consumption and CM, but the evidence is inconsistent. Therefore, we aimed to quantify this relationship better, using a meta-analytical approach. The dose–risk relationship was also modelled through a class of flexible nonlinear meta-regression random effects models. The present meta-analysis included 16 studies (14 case–control and two cohort investigations) with a total of 6251 cases of CM. The pooled relative risk (RR) for any alcohol drinking compared with no/occasional drinking was 1·20 [95% confidence interval (CI) 1·06–1·37]. The risk estimate was similar in case–control (RR 1·20, 95% CI 1·01–1·44) and cohort studies (RR 1·26, 95% CI 1·19–1·35). The pooled RR was 1·10 (95% CI 0·96–1·26) for light alcohol drinking (≤ 1 drink per day) and 1·18 (95% CI 1·01–1·40) for moderate-to-heavy drinking. The pooled RR from 10 studies adjusting for sun exposure was 1·15 (95% CI 0·94–1·41), while the RR from six unadjusted studies was 1·27 (95% CI 1·20–1·35). No evidence of publication bias was detected. This meta-analysis of published data reveals that alcohol consumption is positively associated with the risk of CM. However, caution in interpreting these results is required, as residual confounding by sun exposure cannot be ruled out.
Leukocyte Alkaline Phosphatase Activity in Rickets Due to Vitamin D Deficiency
Authors: Şinasi Özsoylu
Journal: New England Journal of Medicine (1969)

LEUKOCYTE alkaline phosphatase (LAP) activity has been assayed under different hematologic and clinical conditions,1 2 3 4 but has generally been used to differentiate chronic myelocytic leukemia from severe leukemoid reactions.5 , 6 Recently, however, studies on LAP activity have been performed from the genetic standpoint and as a possible chromosome marker.7 8 9 10 11 The rise of serum alkaline phosphatase is a characteristic finding in rickets along with the decrease of serum phosphorus level. The type of isoenzyme in the serum in this condition has also been determined, but tissue alkaline phosphatase has not been investigated.12 In this study, the LAP levels were measured in patients with . . .