tbuckley/cabot-search huggingface dataset:
Follow up by telephone
Authors: J. N. Rao
Journal: BMJ (1994)

It may be just as good to talk on the telephone as in a clinic

Health service workers seem to regard the telephone as intrusive. For patients and staff alike, mention of the telephone conjures up images of haughty, unhelpful receptionists and tardy, impolite switchboard operators. Its insistent ring demands immediate attention, interrupting the ward round and disturbing consultations. For patients a call from the hospital is often bad news, and they are expected to call the hospital only when absolutely necessary. Even in the newly consumer conscious NHS the interaction between staff and patients over the telephone can hardly be described as convivial.

And yet, with a little imagination, the much maligned telephone could be used to improve patients' care. Take several examples from the United States. Jones et al have shown that telephone follow up of patients attending an emergency room can be beneficial.1 In one month 281 patients (15% of the total) were selected for such contact. Two fifths of the patients needed clarification of instructions they had received on discharge, and six out of seven patients who reported a worsening of symptoms received medical intervention. More recently, a randomised trial tested whether telephone follow up can be used as a substitute for routine follow up in clinics.2 Doctors doubled the interval between clinic visits in the intervention group and contacted …
Association between hormone replacement therapy and subsequent stroke: a meta-analysis
Authors: Philip M W Bath, Laura J Gray
Journal: BMJ (2005)

<h3>Abstract</h3> The American Society of Regional Anesthesia and Pain Medicine9s Third Practice Advisory on local anesthetic systemic toxicity is an interim update from its 2010 advisory. The advisory focuses on new information regarding the mechanisms of lipid resuscitation, updated frequency estimates, the preventative role of ultrasound guidance, changes to case presentation patterns, and limited information related to local infiltration anesthesia and liposomal bupivacaine. In addition to emerging information, the advisory updates recommendations pertaining to prevention, recognition, and treatment of local anesthetic systemic toxicity. <h3>What’s New in This Update?</h3> This interim update summarizes recent scientific findings that have enhanced our understanding of the mechanisms that lead to lipid emulsion reversal of LAST, including rapid partitioning, direct inotropy, and post-conditioning. Since the previous practice advisory, epidemiological data have emerged that suggest a lower frequency of LAST as reported by single institutions and some registries, nevertheless a considerable number of events still occur within the general community. Contemporary case reports suggest a trend toward delayed presentation, which may mirror the increased use of ultrasound guidance (fewer intravascular injections), local infiltration techniques (slower systemic uptake), and continuous local anesthetic infusions. Small patient size and sarcopenia are additional factors that increase potential risk for LAST. An increasing number of reported events occur outside of the traditional hospital setting and involve non-anesthesiologists.
HTLV-I infection in British and Jamaican relatives of British patients with tropical spastic paraparesis.
Authors: S Nightingale, U Desselberger
Journal: BMJ (1990)

<h3></h3> <b>Background:</b> Paranasal sinus pneumatization is a complex process, and numerous computed tomography (CT) studies document developmental variations in the setting of underlying sinus disease. The purpose of this study was to investigate variation in paranasal sinus pneumatization in a population of nondiseased subjects using a metric validated for tracking individual anatomic variants as well as total sinus volume. <b>Methods:</b> A total of 591 consecutive sinus and maxillofacial CT scans were considered for study inclusion. After patients with inflammatory sinus or respiratory disease were excluded, 323 CT scans were scored using the Assessment of Pneumatization of the Paranasal Sinuses (APPS) instrument, and relevant demographic data were recorded for each scan. APPS findings were compared according to demographic characteristics and laterality. <b>Results:</b> Laterality and sex were associated with differences in paranasal sinus pneumatization in a nondiseased population. Based on APPS score, the left side (4.95) was more pneumatized than the right (4.74, <i>P</i>=0.006), and males (10.16) were more extensively pneumatized than females (9.18, <i>P</i>=0.005). We found no correlation of age with sinus pneumatization (ρ=0.025). The probability of perceptible asymmetry in any given individual9s paranasal sinus pneumatization was 69%, and the probability of left-sided dominance was 53%. <b>Conclusion:</b> Substantial anatomic variation exists in paranasal sinus anatomy, even among patients without sinus disease. Significant differences are found between males and females and between the left and right sides. Continued systematic research of paranasal sinus anatomy may facilitate a standard for CT sinus assessment that will aid clinician evaluation of anatomic variation and surgical decision making.
Ohno's Model Revisited: Measuring the Frequency of Potentially Adaptive Mutations under Various Mutational Drifts
Authors: Shimon Bershtein, Dan S. Tawfik
Journal: Molecular Biology and Evolution (2008)

The divergence of new gene functions is described by various scenarios that involve gene duplication, albeit, at fundamentally different stages. We performed experimental measurements and developed a subsequent model, aimed at predicting the rate of divergence under different scenarios. We used gene libraries of TEM-1 beta-lactamase that were drifted under purifying selection toward the original penicillinase activity or under no selection at all. The frequency of genes conferring a new function (degradation of a cephalosporin antibiotic) was measured at various stages of the drift, and a model that accounts for the differences in the observed adaptation dynamics of the drifting TEM-1 populations was derived. The results indicate that rapid nonfunctionalization in the population relieved from selection (Ohno's model) afforded only a narrow window of adaptation to cefotaxime (neofunctionalization). The trade-off between TEM-1's original function and the new evolving function also disfavored the "gene sharing" model. The rate of adaptation was maximal when selection for the original function was partially relieved to enable the accumulation of potentially adaptive mutations, while still purging a large fraction of otherwise deleterious mutations. Altogether, scenarios of subfunctionalization seem more feasible, whereby sustaining the original function by two copies facilitates the accumulation potentially adaptive mutations while purging nonfunctionalization mutations.
Glucocorticoid receptor polymorphisms in Korean patients with rheumatoid arthritis
Authors: E B Lee, J Y Kim, Y J Lee, Y W Song
Journal: Annals of the Rheumatic Diseases (2004)

It has been suggested that dysregulation of the neuroendocrine system is an important pathogenetic mechanism of rheumatoid arthritis (RA). The dramatic response of patients with RA to glucocorticoids, the aggravation of RA after resection of bilateral adrenal glands, the inappropriately normal plasma cortisol levels in patients with RA, the blunted plasma cortisol responses after surgical stress, and the essential role of glucocorticoids in the development of streptococcal cell wall induced arthritis in Lewis rats provide evidence that dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis or relative glucocorticoid deficiency might play a part in the development of RA.1,2 The involvement of glucocorticoids in the development of thymocytes further supports the role of glucocorticoid in autoimmune diseases like RA.3

The human glucocorticoid receptor (hGR) is a transcriptional factor …
Long term vagal stimulation in patients with advanced heart failure First experience in man
Authors: Peter J. Schwartz, Gaetano M. De Ferrari, Antonio Sanzo, Maurizio Landolina, Roberto Rordorf, Claudia Raineri, Carlo Campana, Miriam Revera, Nina Ajmone‐Marsan, Luigi Tavazzi, Attilio Odero
Journal: European Journal of Heart Failure (2008)
Evidence for Increased Collagenolysis by Interstitial Collagenases-1 and -3 in Vulnerable Human Atheromatous Plaques
Authors: Galina K. Sukhova, Uwe Schönbeck, Elena Rabkin, Frederick J. Schoen, A. Robin Poole, R. Clark Billinghurst, Peter Libby
Journal: Circulation (1999)

Background —Several recent studies attempted to classify plaques as those prone to cause clinical manifestations (vulnerable, atheromatous plaques) or those less frequently associated with acute thrombotic complication (stable, fibrous plaques). Defining the cellular and molecular mechanisms that underlie these morphological features remains a challenge. Because interstitial forms of collagen determine the biomechanical strength of the atherosclerotic lesion, this study investigated expression of the collagen-degrading matrix metalloproteinase (MMP) interstitial collagenase-3 (MMP-13) and the previously studied MMP-1 in human atheroma and used a novel technique to test the hypothesis that collagenolysis in atheromatous lesions exceeds that in fibrous human atherosclerotic lesions. Methods and Results —Human carotid atherosclerotic plaques, similar in size, were separated by conventional morphological characteristics into fibrous (n=10) and atheromatous (n=10) lesions. Immunohistochemical and Western blot analysis demonstrated increased levels of MMP-1 and MMP-13 in atheromatous versus fibrous plaques. In addition, collagenase-cleaved type I collagen, demonstrated by a novel cleavage-specific antibody, colocalized with MMP-1– and MMP-13–positive macrophages. Macrophages, rather than endothelial or smooth muscle cells, expressed MMP-13 and MMP-1 on stimulation in vitro. Furthermore, Western blot analysis demonstrated loss of interstitial collagen type I and increased collagenolysis in atheromatous versus fibrous lesions. Finally, atheromatous plaques contained higher levels of proinflammatory cytokines, activators of MMPs. Conclusions —This report demonstrates that atheromatous rather than fibrous plaques might be prone to rupture due to increased collagenolysis associated with macrophages, probably mediated by the interstitial collagenases MMP-1 and MMP-13.
Prevalence of polycystic ovaries in women with anovulation and idiopathic hirsutism.
Authors: J Adams, D W Polson, S Franks
Journal: BMJ (1986)

Polycystic ovaries were defined with ultrasound imaging in a series of 173 women who presented to a gynaecological endocrine clinic with anovulation or hirsutism. Polycystic ovaries were found in 26% of women with amenorrhoea, 87% with oligomenorrhoea, and 92% with idiopathic hirsutism--that is, hirsutism but with regular menstrual cycles. Fewer than half the anovulatory patients with polycystic ovaries were hirsute, but in 93% of cases there was at least one endocrine abnormality to support the diagnosis of polycystic ovaries--that is, raised serum concentrations of luteinising hormone, raised luteinising hormone: follicle stimulating hormone ratio, or raised serum concentrations of testosterone or androstenedione. This study shows that polycystic ovaries, as defined by pelvic ultrasound, are very common in anovulatory women (57% of cases) and are not necessarily associated with hirsutism or a raised serum luteinising hormone concentration. Most women with hirsutism and regular menses have polycystic ovaries so that the term "idiopathic" hirsutism no longer seems appropriate.
Formation of gouty tophi is initiated by extranuclear DNA
Authors: C. Schorn, B. Frey, C. Janko, L. E. Munoz, E. Naschberger, M. Herrmann
Journal: Annals of the Rheumatic Diseases (2011)

<h3>Background and objectives</h3> Analysis of gouty tophi initiated by injection of MSU (monosodium urate) crystals intraperitoneally in mice and patients suffering from gout. <h3>Materials and methods</h3> Human PMN (polymorphonuclear cells) were incubated with MSU crystals and analysed by fluorescence microscopy (DAPI). Moreover, mice were treated intraperitoneally with MSU crystals resulting in generation of gouty tophi. Paraffin sections of the tophi were analysed by nuclear staining and immunhistology. Furthermore, synovial fluids and tophi of patients with acute gouty attacks were analysed. <h3>Results</h3> In the in vitro assays we found the formation of extracellular DNA induced by MSU crystals. Next we analysed the gouty tophi generated intraperitoneally in mice and again detected extranuclear DNA and histones. Last we investigated material of gouty patients and observed the formation of extranuclear DNA in the synovial fluid and in tophous material. <h3>Conclusions</h3> We conclude that the extranuclear DNA has been ejected by the neutrophils in order to trap the inflammation inducing crystals. A similar mechanism is employed by neutrophils in the defense against massive bacterial or fungal infection, where the extranuclear DNA helps for immobilisation and inactivation of pathogeneic microoragnisms. Further investigations are required to elucidate whether the extranuclear DNA is ameliorating or precipitating inflammation and pathology in gout.
Tau protein directly interacts with the amyloid β-protein precursor: Implications for Alzheimer's disease
Authors: M.A. Smith, S.L. Siedlak, P.L. Richey, P. Mulvihill, J. Ghiso, B. Frangione, F. Tagliavini, G. Giaccone, O. Bugiani, D. Praprotnik, R.N. Kalaria, G. Perry
Journal: Nature Medicine (1995)
IL2 Inducible T-cell Kinase, a Novel Therapeutic Target in Melanoma
Authors: Craig C. Carson, Stergios J. Moschos, Sharon N. Edmiston, David B. Darr, Nana Nikolaishvili-Feinberg, Pamela A. Groben, Xin Zhou, Pei Fen Kuan, Shaily Pandey, Keefe T. Chan, Jamie L. Jordan, Honglin Hao, Jill S. Frank, Dennis A. Hopkinson, David C. Gibbs, Virginia D. Alldredge, Eloise Parrish, Sara C. Hanna, Paula Berkowitz, David S. Rubenstein, C. Ryan Miller, James E. Bear, David W. Ollila, Norman E. Sharpless, Kathleen Conway, Nancy E. Thomas
Journal: Clinical Cancer Research (2015)

IL2 inducible T-cell kinase (ITK) promoter CpG sites are hypomethylated in melanomas compared with nevi. The expression of ITK in melanomas, however, has not been established and requires elucidation.An ITK-specific monoclonal antibody was used to probe sections from deidentified, formalin-fixed paraffin-embedded tumor blocks or cell line arrays and ITK was visualized by IHC. Levels of ITK protein differed among melanoma cell lines and representative lines were transduced with four different lentiviral constructs that each contained an shRNA designed to knockdown ITK mRNA levels. The effects of the selective ITK inhibitor BI 10N on cell lines and mouse models were also determined.ITK protein expression increased with nevus to metastatic melanoma progression. In melanoma cell lines, genetic or pharmacologic inhibition of ITK decreased proliferation and migration and increased the percentage of cells in the G0-G1 phase. Treatment of melanoma-bearing mice with BI 10N reduced growth of ITK-expressing xenografts or established autochthonous (Tyr-Cre/Pten(null)/Braf(V600E)) melanomas.We conclude that ITK, formerly considered an immune cell-specific protein, is aberrantly expressed in melanoma and promotes tumor development and progression. Our finding that ITK is aberrantly expressed in most metastatic melanomas suggests that inhibitors of ITK may be efficacious for melanoma treatment. The efficacy of a small-molecule ITK inhibitor in the Tyr-Cre/Pten(null)/Braf(V600E) mouse melanoma model supports this possibility.
866-1 Evaluation of left anterior descending coronary artery by high-frequency transthoracic echocardiography: Comparison with simultaneous intravascular ultrasound measurements
Authors: Nozomi Wada, Takashi Akasaka, Noriko Okahashi, Kosuke Kagamihara, Teruyoshi Kume, Yoji Neishi, Hidetoshi Yoshitani, Yuji Koyama, Yasuko Yamaura, Nozomi Watanabe, Takahiro Kawamoto, Kiyoshi Yoshida
Journal: Journal of the American College of Cardiology (2004)
GP bashing not the answer to antibiotic overprescribing, professor tells summit
Authors: M. Limb
Journal: BMJ (2014)

The NHS should be made to cut total consumption of antibiotics to 2010 levels, under binding new targets, medical experts have said.

Leading professional bodies said that halting the “relentless” rise of antimicrobial resistance would require reductions in antibiotic use of around 1% a year over the next few years. They called for urgent action across the health system to change the culture of antibiotic prescribing and educate patients to alter their thinking about the drugs.

A summit on antimicrobial resistance was held in London at the Royal Pharmaceutical Society on 6 November. The society and four other bodies—the UK Faculty of Public Health, Royal College of Physicians, Royal College of Nursing, and Royal College of General Practitioners—said that providers of care should be held to account for their “antimicrobial stewardship.”

Nigel Mathers, honorary secretary of the Royal College of GPs, said that people had developed a “worrying reliance on antibiotics, and many patients now saw them as a cure all. “We need to do everything we can to prevent resistance …
COMPARISON OF SPECT AND PLANAR TC-99M SESTAMIBI (MIBI) IN THE EVALUATION OF PRIMARY BREAST CARCINOMA
Authors: N. Nagaraj, A. Waxman, G. Ashok, S. Khan, L. Memsic, J. Yadegar, A. Silberman, E. Phillips
Journal: Clinical Nuclear Medicine (1994)

Nagaraj, N.; Waxman, A.; Ashok, G.; Khan, S.; Memsic, L.; Yadegar, J.; Silberman, A.; Phillips, E. Author Information
The effect of graphene oxide on conformation change, aggregation and cytotoxicity of HIV-1 regulatory protein (Vpr)
Authors: Min Zhang, Xiaobo Mao, Chenxuan Wang, Wenfeng Zeng, Chunling Zhang, Zhongjun Li, Ying Fang, Yanlian Yang, Wei Liang, Chen Wang
Journal: Biomaterials (2012)
Pruritic Effect of Bile Salts
Authors: J. Kirby, K. W. Heaton, J. L. Burton
Journal: BMJ (1974)

The pruritic effect of purified bile salts has been tested by applying them to blister bases. All the salts tested were pruritogens, but the dihydroxy salts (especially unconjugated chenodeoxycholate) were more effective than the trihydroxy salts. This may explain the poor correlation between total serum bile salt concentration and pruritus in obstructive jaundice.
Ureteral Metastasis From an Appendiceal Carcinoma and Diagnosis by Endoscopic Ultrasound-Guided Fine-Needle Aspiration
Authors: N. Schmulewitz, R. Hawes
Journal: Endoscopy (2004)

Endoscopic ultrasound (EUS) is a standard tool for imaging the gastrointestinal tract and adjacent structures. EUS-guided fine-needle aspiration (FNA) allows the endosonographer easy access to these structures for both diagnostic and therapeutic purposes. We describe a case of metastatic lesion, adherent to a stented right ureter, which was imaged with transrectal EUS, with successful cytologic identification after EUS-guided FNA. EUS and EUS-guided FNA can be valuable tools in the evaluation of some soft-tissue abnormalities of the pelvis.
Cannabinoid receptor 2 agonist ameliorates mesenteric angiogenesis and portosystemic collaterals in cirrhotic rats
Authors: Hui-Chun Huang, Sun-Sang Wang, I-Fang Hsin, Ching-Chih Chang, Fa-Yauh Lee, Han-Chieh Lin, Chiao-Lin Chuang, Jing-Yi Lee, Hsian-Guey Hsieh, Shou-Dong Lee
Journal: Hepatology (2012)

Angiogenesis in liver cirrhosis leads to splanchnic hyperemia, increased portal inflow, and portosystemic collaterals formation, which may induce lethal complications, such as gastroesophageal variceal hemorrhage and hepatic encephalopathy. Cannabinoids (CBs) inhibit angiogenesis, but the relevant influences in cirrhosis are unknown. In this study, Spraque-Dawley rats received common bile duct ligation (BDL) to induce cirrhosis. BDL rats received vehicle, arachidonyl-2-chloroethylamide (cannabinoid receptor type 1 [CB1] agonist), JWH-015 (cannabinoid receptor type 2 [CB2] agonist), and AM630 (CB2 antagonist) from days 35 to 42 days after BDL. On the 43rd day, hemodynamics, presence of CB receptors, severity of portosystemic shunting, mesenteric vascular density, vascular endothelial growth factor (VEGF), VEGFR-1, VEGFR-2, phospho-VEGFR-2, cyclooxygenase (COX)-1, COX-2, and endothelial nitric oxide synthase (eNOS) expressions as well as plasma VEGF levels were evaluated. Results showed that CB1 and CB2 receptors were present in left adrenal veins of sham rats, splenorenal shunts (the most prominent intra-abdominal shunts) of BDL rats, and mesentery of sham and BDL rats. CB2 receptor was up-regulated in splenorenal shunts of BDL rats. Both acute and chronic JWH-015 treatment reduced portal pressure and superior mesenteric arterial blood flow. Compared with vehicle, JWH-015 significantly alleviated portosystemic shunting and mesenteric vascular density in BDL rats, but not in sham rats. The concomitant use of JWH-015 and AM630 abolished JWH-015 effects. JWH-133, another CB2 agonist, mimicked the JWH-015 effects. JWH-015 decreased mesenteric COX-1, COX-2 messenger RNA expressions, and COX-1, COX-2, eNOS protein expressions. Furthermore, JWH-015 decreased intrahepatic angiogenesis and fibrosis. Conclusions: CB2 agonist alleviates portal hypertension (PH), severity of portosystemic collaterals and mesenteric angiogenesis, intrahepatic angiogenesis, and fibrosis in cirrhotic rats. The mechanism is, at least partly, through COX and NOS down-regulation. CBs may be targeted in the control of PH and portosystemic collaterals. (HEPATOLOGY 2012;56:248–258)
Pulmonary involvement in ankylosing spondylitis.
Authors: N Feltelius, H Hedenstrom, G Hillerdal, R Hallgren
Journal: Annals of the Rheumatic Diseases (1986)

Thirty two patients with ankylosing spondylitis were investigated with a set of pulmonary function tests and the results compared with those for a control population. The patients had no complaints about lung symptoms and their chest radiographs were normal. The main pathological findings were reduced lung volumes, a raised closing volume/vital capacity ratio, and a decreased volumic airway conductance. The lung volume reduction correlated with disease duration, thoracic mobility, and degree of acute phase reaction. The stiff spondylitic thorax probably makes the main contribution to the impairment of lung function in these patients, but the findings in this study also suggest an involvement of the small airways. This type of pulmonary function testing seems valuable even in patients with ankylosing spondylitis without lung symptoms and it might be used as a tool in the staging of the disease, to evaluate treatment and to differentiate from fibrosis.