tbuckley/cabot-search huggingface dataset:
Recent developments: Management of pain
Authors: A. Holdcroft
Journal: BMJ (2003)

The management of pain differs if pain is self limiting or persistent; for example, if pain is prolonged then treatment will be managed by a multidisciplinary team in a pain clinic. Pain is not just from physical disorders but also from combinations of physiological, pathological, emotional, psychological, cognitive, environmental, and social factors (fig 1). The keys to successful pain control are the mechanisms that initiate and maintain pain. Major advances in neurobiology, from molecular studies to imaging the cortex of the brain, show the complex integration of nerve cell activity and have generated a fundamental change in attitude and expectation about the control of pain.1 Now, the public and health professionals expect to control pain by using preventive and active strategies, including drugs and physical and psychosocial interventions.



Fig 1 
Biopsychosocial factors that interact and modulate the experience of pain



The topics we have chosen result from discussions with all grades of staff involved in the management of acute and chronic pain and range from new drug development based on scientific evidence that may impact on future pain management to a holistic approach to patient care. Our searches focused on the key words “pain,” “systematic review,” “management,” and “neuropathic.” We searched Medline, the Cochrane Library, and Health Technology Assessments, and we scrutinised the BMJ and the National Institutes of Health websites as well as professionally based websites for pain, such as that of the International Association for the Study of Pain and scientific websites such as that of the National Academy of Sciences. We identified systematic reviews from the past three years from these sources and leading scientific papers.

#### Recent developments

A major change in pain management is a move from empirical therapies to a mechanism based approach

New drug developments are targeting specific receptor subtypes

Pain assessment includes qualitative sensory affective and …
Diagnosis of Perforated Enterocystoplasty
Authors: Eric Fontaine, Rachel Leaver, Christopher R J Woodhouse
Journal: Journal of the Royal Society of Medicine (2003)

In the operation of enterocystoplasty, now widely practised, segments of bowel are used to augment or replace the urinary bladder. An occasional complication is perforation, and this may present in non-specialist settings. We investigated the management of spontaneous perforations among 264 patients with enterocystoplasty followed by one surgeon for 2-18 years. Patients' charts were examined for data on presentation, diagnosis and treatment. 10 patients had thirteen perforations; data were available for nine perforations in 9 patients. Mean time from enterocystoplasty to perforation was 45 months. Presentation was shoulder pain in 1 and abdominal pain (with or without fever) in 8. Perforation was diagnosed without delay in 3, but the initial diagnosis was urinary tract infection in 4 and small-bowel obstruction in 2. Ultrasound was the most useful investigation being diagnostic in 6 of 7 cases; contrast cystography showed a leak in only 2 of the 6 patients in whom it was performed. Treatment was successful in 8 cases (surgery 6; percutaneous drainage 2); 1 patient, who remained undiagnosed, was treated medically and died. Patients with enterocystoplasty need to be educated about this potentially lethal complication, so that they can alert non-specialist clinicians to what may have happened. In any patient with enterocystoplasty who reports abdominal pain or shoulder pain, perforation has to be ruled out.
High intensity exercise or conventional exercise for patients with rheumatoid arthritis? Outcome expectations of patients, rheumatologists, and physiotherapists
Authors: M Munneke
Journal: Annals of the Rheumatic Diseases (2004)

<b>Objective:</b> To examine the outcome expectations of RA patients, rheumatologists, and physiotherapists regarding high intensity exercise programmes compared with conventional exercise programmes. <b>Methods:</b> An exercise outcome expectations questionnaire was administered to 807 RA patients, 153 rheumatologists, and 624 physiotherapists. The questionnaire consisted of four statements regarding positive and negative outcomes of high intensity exercise programmes and four similar statements for conventional exercise programmes. A total expectation score for both conventional and high intensity exercise was calculated, ranging from −2 (very negative expectation) to 2 (very positive expectation). <b>Results:</b> The questionnaire was returned by 662 RA patients (82%), 132 rheumatologists (86%), and 467 physiotherapists (75%). The mean (95% confidence interval) scores for high intensity exercise programmes were 0.30 (0.25 to 0.34), 0.68 (0.62 to 0.74), and −0.06 (−0.15 to 0.02), and for conventional exercise programmes were 0.99 (0.96 to 1.02), 1.13 (1.09 to 1.17), and 1.27 (1.21 to 1.34) for RA patients, rheumatologists, and physiotherapists, respectively. In all three respondent groups, the outcome expectations of high intensity exercise were significantly less positive than those of conventional exercise programme. <b>Conclusions:</b> Despite the existing evidence regarding the effectiveness and safety of high intensity exercise programmes, RA patients, rheumatologists, and physiotherapists have more positive expectations of conventional exercise programmes than of high intensity exercise programmes. Physiotherapists were the least positive about outcomes of high intensity exercise programmes while rheumatologists were the most positive. To help the implementation of new insights in the effectiveness of physical therapy modalities in rheumatology, the need for continuous education of patients, rheumatologists and physiotherapists is emphasised.
Study of Chromosomes in Human Leukaemia by a Direct Method
Authors: M. A. Kinlough, H. N. Robson
Journal: BMJ (1961)

TRIPLE-X SYNDROME MBEDIJOH dva in each, and the additional finding of corpora lutea in two, indicate that these patients are potentially fertile.Examination of clinical and laboratory data of all similar cases at present available fails to reveal a characteristic syndrome related to the presence of an extra X chromosome and distinguishable on clinical grounds.
A NOTE ON PATCH-TESTING TECHNIQUE
Authors: E. LIPMAN COHEN
Journal: British Journal of Dermatology (1945)

Journal Article A NOTE ON PATCH‐TESTING TECHNIQUE Get access E. LIPMAN COHEN E. LIPMAN COHEN Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology and Syphilis, Volume 57, Issue 3-4, 1 March 1945, Pages 67–68, https://doi.org/10.1111/j.1365-2133.1945.tb11201.x Published: 01 March 1945
Heat Pyrexia treated by Lumbar Puncture
Authors: J. F. Corr
Journal: BMJ (1942)

mperatureDigos 1 24 Gradual Pains legs, swelling knee.+ 0 + 0 Intermittent 12.000 Rheumatic fever Throat swabs and sinus lavage-Vomiting 3 days to 1040 P.65%, L.30% pneumococci but no meningococci.Effusion knee 2 32
Hemorrhagic Erosive Gastritis Appearance on Gated Cardiac Imaging
Authors: RUSSELL GELMAN, EDUARD V. KOTLYAROV
Journal: Clinical Nuclear Medicine (1992)

Hemorrhagic erosive gastritis is a common cause of upper gastrointestinal bleeding. A case is presented where visualization of the gastric wall during gated cardiac imaging in a patient on chemotherapy for acute myeloid leukemia was observed, in keeping with a diagnosis of hemorrhagic gastritis.
Donor risk index for African American liver transplant recipients with hepatitis C virus
Authors: Nathan J. Shores, Jennifer L. Dodge, Sandy Feng, Norah A. Terrault
Journal: Hepatology (2013)

African American (AA) liver transplant (LT) recipients with hepatitis C virus (HCV) have higher rates of graft loss than other racial/ethnic groups. The Donor Risk Index (DRI) predicts graft loss but is neither race- nor disease-specific and may not be optimal for assessing donor risk for AA HCV-positive LT recipients. We developed a DRI for AA with HCV with the goal of enhancing graft loss predictions. All U.S. HCV-positive adult AA first deceased donor LTs surviving ≥30 days from March 2002 to December 2009 were included. A total of 1,766 AA LT recipients were followed for median 2.8 (interquartile range [IQR] 1.3-4.9) years. Independent predictors of graft loss were donor age (40-49 years: hazard ratio [HR] 1.54; 50-59 years: HR 1.80; 60+ years: HR 2.34, P &lt; 0.001), non-AA donor (HR 1.66, P &lt; 0.001), and cold ischemia time (CIT) (HR 1.03 per hour &gt;8 hours, P = 0.03). Importantly, the negative effect of increasing donor age on graft and patient survival among AAs was attenuated by receipt of an AA donor. A new donor risk model for AA (AADRI-C) consisting of donor age, race, and CIT yielded 1-year, 3-year, and 5-year predicted graft survival rates of 91%, 77%, and 68% for AADRI &lt;1.60; 86%, 67%, and 55% for AADRI 1.60-2.44; and 78%, 53%, and 39% for AADRI &gt;2.44. In the validation dataset, AADRI-C correctly reclassified 27% of patients (net reclassification improvement P = 0.04) compared to the original DRI. Conclusion : AADRI-C identifies grafts at higher risk of failure and this information is useful for risk-benefit discussions with recipients. Use of AA donors allows consideration of older donors. (Hepatology 2013;58:1263–1269)
Recurrent major haemoptysis: progression to pneumonectomy.
Authors: W A Baumgartner, J B Mark
Journal: Thorax (1980)

A 50-year-old white man with recurrent major haemoptysis is described. The main problem in management was in detecting the aetiology and source of the haemoptysis. Rigid bronchoscopy is essential in the evaluation and treatment of patients with massive haemoptysis, and once the site of bleeding has been established, pulmonary resection offers the best chance of survival. The operation performed is usually lobectomy, although pneumonectomy, as with our patient, may be necessary.
Restoration of Fuel Homeostasis in IDDM Patients During Pregnancy by an Open-Loop Insulin Infusion System
Authors: Milton C Foss, Thomas T Aoki
Journal: Diabetes Care (1993)

Objective— To characterize the effects of subcutaneous insulin pump therapy on the metabolic response (CHO and lipid oxidation, and nonoxidative glucose metabolism) to a glucose challenge of diabetic women at early pregnancy. Research Design and Methods— Seven nondiabetic and seven IDDM pregnant patients on insulin pump therapy were studied at the first trimester. Fuel oxidation rates were determined by indirect calorimetry, and blood levels of substrates and hormones were measured before and for 2 h after ingestion of a 50 g oral glucose load. Results— The increments in npRQ and CHO oxidation rates after the glucose meals in the diabetic women on insulin pump therapy were similar to those in the normal subjects. The glucose disposal data during the 2 h of the studies revealed that the amounts of oxidative and nonoxidative glucose utilization in the control subjects and in the IDDM patients on insulin pump therapy did not show significant differences. Conclusions— This investigation demonstrated that the treatment of IDDM patients during early pregnancy by an open-loop insulin infusion system is sufficient to normalize their glucose-processing capability with respect to cellular oxidative and nonoxidative glucose metabolism in response to an oral glucose challenge, but some abnormalities in their blood profiles of glucose, lactate, and pyruvate persisted.
Molecular Pathogenesis of Diffuse Large B-Cell Lymphoma
Authors: Izidore S. Lossos
Journal: Journal of Clinical Oncology (2005)

Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous clinicopathologic entity accounting for 30% of non-Hodgkin's lymphomas. The pathogenesis of DLBCL is complex and heterogeneous. Recent studies using analysis of global gene expression with DNA microarrays and the classical molecular approaches demonstrate presence of several DLBCL subtypes characterized by different cells of origin, cytogenetic and molecular aberrations, and distinct pathogenesis. This review summarizes the progress in understanding of DLBCL biology and presents a state-of-the-art overview of DLBCL molecular pathogenesis.
Toward Better Treatment of Primary Sclerosing Cholangitis
Authors: Marshall M. Kaplan
Journal: New England Journal of Medicine (1997)

Primary sclerosing cholangitis is a chronic, progressive cholestatic liver disease characterized by continuing inflammation, necrosis, and obliteration of intrahepatic and extrahepatic bile ducts.1 The pathognomonic finding on liver biopsy, albeit rarely seen, is the onionskin lesion, consisting of concentric rings of dense connective tissue that surround a necrotic, often totally obliterated bile duct.2 These lesions cause bile-duct strictures, the cholangiographic finding required for the diagnosis.3 The bile ducts are often dilated above the strictures, indicating chronic obstruction of bile flow. Alternating strictures and dilatations give affected bile ducts the beaded appearance that is characteristic of the disease. About two thirds . . .
Amelioration of bleomycin-induced lung fibrosis in hamsters by dietary supplementation with taurine and niacin: biochemical mechanisms.
Authors: S N Giri, R Blaisdell, R B Rucker, Q Wang, D M Hyde
Journal: Environmental Health Perspectives (1994)

Interstitial pulmonary fibrosis induced by intratracheal instillation of bleomycin (BL) involves an excess production of reactive oxygen species, unavailability of adequate levels of NAD and ATP to repair the injured pulmonary epithelium, and an overexuberant lung collagen reactivity followed by deposition of highly cross-linked mature collagen fibrils resistant to enzymatic degradation. In the present study, we have demonstrated that dietary supplementation with taurine and niacin offered almost complete protection against the lung fibrosis in a multidose BL hamster model. The mechanisms for the protective effect of taurine and niacin are multifaceted. These include the ability of taurine to scavenge HOCl and stabilize the biomembrane; niacin's ability to replenish the BL-induced depletion of NAD and ATP; and the combined effect of taurine and niacin to suppress all aspects of BL-induced increases in the lung collagen reactivity, a hallmark of interstitial pulmonary fibrosis. It was concluded from the data presented at this Conference that the combined treatment with taurine and niacin, which offers a multipronged approach, will have great therapeutic potential in the intervention of the development of chemically induced interstitial lung fibrosis in animals and humans.
Book: Hamilton Bailey: A Surgeon's Life
Authors: A. Paton
Journal: BMJ (1999)

Adrian Marston Greenwich Medical Media, £29.95, pp 157 ISBN 1 84110 024 2 Rating:![Graphic][1]</img>![Graphic][2]</img>![Graphic][3]</img> Thirty eight years after his death, the name of Hamilton Bailey is well known to doctors throughout the world. His reputation rests on three of the most popular and influential textbooks ever written, all of which are still in print: Demonstrations of Physical Signs in Clinical Surgery (1927), Emergency Surgery (1930-1), and A Short Practice … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif
Gynecologic Operations: Indications, Technic and Results
Authors: Richard J. Babcock
Journal: JAMA (1968)

The first edition of this text, published in German in 1960, elicited a highly favorable British review that urged prompt English translation. This task has been accomplished by that reviewer, employing the second edition released in 1965. He indicates that the translation is not literal and that "considerable liberties have been taken... to bring it into line with U. S. and British practice." Unfortunately, the result is a potpourri of English, European, and American customs which lacks consistency. For example, the section on the Manchester procedure, occupying 13 pages, overshadows the eight pages on vaginal hysterectomy, the latter being far more commonly employed in this country. Much of the text material is out of date, with complete omission of some newer techniques. Indeed, the latest bibliographical references are 1962. Bougies to induce abortion are described at length, but intrauterine hypertonic saline is only briefly mentioned, without discussion of technique, efficacy,
Hill-Robertson Interference is a Minor Determinant of Variations in Codon Bias Across Drosophila melanogaster and Caenorhabditis elegans Genomes
Authors: Gabriel Marais, Gwenaël Piganeau
Journal: Molecular Biology and Evolution (2002)

According to population genetics models, genomic regions with lower crossing-over rates are expected to experience less effective selection because of Hill-Robertson interference (HRi). The effect of genetic linkage is thought to be particularly important for a selection of weak intensity such as selection affecting codon usage. Consistent with this model, codon bias correlates positively with recombination rate in Drosophila melanogaster and Caenorhabditis elegans. However, in these species, the G+C content of both noncoding DNA and synonymous sites correlates positively with recombination, which suggests that mutation patterns and recombination are associated. To remove this effect of mutation patterns on codon bias, we used the synonymous sites of lowly expressed genes that are expected to be effectively neutral sites. We measured the differences between codon biases of highly expressed genes and their lowly expressed neighbors. In D. melanogaster we find that HRi weakly reduces selection on codon usage of genes located in regions of very low recombination; but these genes only comprise 4% of the total. In C. elegans we do not find any evidence for the effect of recombination on selection for codon bias. Computer simulations indicate that HRi poorly enhances codon bias if the local recombination rate is greater than the mutation rate. This prediction of the model is consistent with our data and with the current estimate of the mutation rate in D. melanogaster. The case of C. elegans, which is highly self-fertilizing, is discussed. Our results suggest that HRi is a minor determinant of variations in codon bias across the genome.
Abstract 1392: The Pursuit of p73 Regulation: interaction partners tell many different stories
Authors: Yatendra K. Satija, Sanjeev Das
Journal: Cancer Research (2014)

Abstract p73 is a member of the p53 tumor suppressor family, which can trigger cell cycle arrest and apoptosis through its ability to bind p53 DNA target sites, thereby it acts as a negative regulator of tumorigenesis. Similar to p53, at normal state p73 is maintained at very low level but it rapidly gets induced upon genotoxic stress. Accumulating evidences demonstrated that p73 is mainly regulated at the protein level but its significance is still not clearly understood. It is believed that it is a consequence of post-translational modifications (PTMs) of p73 upon DNA damage. Emerging reports suggested that other than PTMs, various co-factors are responsible for regulating its level and activity. But all these reports remained inadequate to explain the molecular mechanisms behind regulation and activity of p73 under non-stressed and stressed conditions. The aim of our study is to find out novel interactors of p73 which distinctively affect its stability and activity in normal state and upon DNA damage. We employed a proteomic approach to identify differential interactors of p73 under unstressed and genotoxic stress conditions. We prepared adenovirus system to ectopically overexpress dual-tagged p73 into cells. Our tandem affinity purification screening lead us to identification of many p73-associated proteins. Among the novel interactors, TRIM28, a RING-type E3 ligase, was of particular interest because it interacts with p73 under unstressed condition but no visible interaction was detected after DNA damage. We show here that TRIM28 ubiquitylates and targets p73 for proteasome-mediated degradation in unstressed conditions. Upon genotoxic stress, p73 gets phosphorylated at tyrosine 99 position in c-Abl-dependent manner leading to abrogation of its interaction with TRIM28 which subsequently leads to p73 stabilization. Another protein, MED15 was of particular interest because it interacts with p73 in phosphorylation-dependent manner and it serves as a coactivator of p73. Interestingly, we found that phosphorylation of p73 is a prerequisite for its interaction with MED15. Furthermore, loss of MED15 leads to decline in p73-mediated transactivation of its downstream target genes under DNA damaging conditions. Therefore, we propose a model in which DNA damage-induced phosphorylation of p73 affects its interaction with its negative regulator and leads to its preferential association with its coactivator. Citation Format: Yatendra K. Satija, Sanjeev Das. The Pursuit of p73 Regulation: interaction partners tell many different stories. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1392. doi:10.1158/1538-7445.AM2014-1392
Oxidation of membrane cholesterol alters active and passive transsarcolemmal calcium movement.
Authors: M J Kutryk, T G Maddaford, B Ramjiawan, G N Pierce
Journal: Circulation Research (1991)

Oxygen free radicals have the ability to oxidize cholesterol. However, nothing is known about the effects of cholesterol oxidation on ion transport in isolated myocardial membranes. The purpose of the present study was to investigate the effects of in situ oxidative modification of sarcolemmal cholesterol on Ca2+ flux. Cholesterol oxidase was used to oxidatively modify membrane cholesterol. After incubation of cardiac sarcolemmal vesicles with cholesterol oxidase, cholest-4-en-3-one (cholestenone) was the predominant species of oxidated cholesterol produced. Cholesterol oxidase inhibited sarcolemmal Na(+)-Ca2+ exchange in a concentration-dependent manner. Both the Vmax and Km of the reaction were altered after cholesterol oxidase treatment. Extensive treatment of the sarcolemmal membranes with cholesterol oxidase increased the passive permeability characteristics of the membrane. Passive Ca2+ efflux from the sarcolemmal vesicles was stimulated by increasing the concentration of cholesterol oxidase. ATP-dependent Ca2+ uptake was also inhibited after cholesterol oxidase treatment, but it was not as sensitive as the Na(+)-Ca2+ exchange. Conversely, passive Ca2+ binding to sarcolemmal vesicles was strikingly stimulated by cholesterol oxidase treatment. The results demonstrate that oxidative modification of sarcolemmal membrane cholesterol can directly affect ionic interactions with the sarcolemmal vesicle and provide potentially important mechanistic information for the molecular basis of the effects of free radicals on ion flux and function in the heart.