tbuckley/cabot-search huggingface dataset:
Benzydamine: an alternative nonsteroidal anti‐inflammatory drug in patients with nimesulide‐induced urticaria
Authors: E. Nettis, R. Di Paola, G. Napoli, A. Ferrannini, A. Tursi
Journal: Allergy (2002)

Background: Cutaneous adverse reactions to nonsteroidal anti‐inflammatory drugs (NSAIDs), in particular urticaria/angiedema syndrome, represent a frequent problem in clinical practice. To date laboratory tests for the diagnosis of these adverse reactions are not available. A patient with an adverse drug reaction to NSAIDs needs an alternative drug to assume if necessary. Nimesulide is a highly prescribed nonsteroidal anti‐inflammatory drug (NSAID) world‐wide. It is also described as one of the most tolerated NSAID. In this paper we present data on the tolerability of benzydamine in nimesulide‐sensitive patients. Patients and methods: One hundred and thirty‐seven patients with nimesulide‐induced urticaria were submitted to a single‐blind, placebo‐controlled peroral challenge with increasing doses of benzydamine. Results: One hundred and thirty‐four out of 137 (98%) patients tolerated benzydamine without adverse effects, only three (2%) experienced immediate systemic urticaria (1 at the first dose and 2 at the second dose). Conclusion: Benzydamine is a well tolerated drug in patients with nimesulide‐induced urticaria and it may represent a valid alternative NSAID in nimesulide‐sensitive patients.
Incidence of Poliomyelitis in Pregnancy
Authors: Morris Siegel, Morris Greenberg
Journal: New England Journal of Medicine (1955)

PREGNANCY has long been considered one of the host factors disposing to the occurrence of poliomyelitis. An increase in susceptibility has been observed in animal studies, clinical case reports and surveys of both hospitalized cases and population groups.1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Currently, however, the validity of an association between pregnancy and poliomyelitis has been questioned as a result of recent investigations of population groups in which no significant increase in incidence and mortality could be demonstrated.5 , 13 Because of the conflicting evidence and the need for additional data on a community-wide basis, the susceptibility of the host during pregnancy was investigated. Three aspects of . . .
Prostatic hypertrophy in the elderly cirrhotic patient: An estrogenic or androgenic response?
Authors: David H. Van Thiel, Judith S. Gavaler
Journal: Hepatology (1989)

In elderly males hormonal changes occur that are believed to cause benign prostatic hyperplasia (BPH). These are decreased testosterone production, an increased testosterone SHBG and a slightly increased estradiol production. Liver cirrhosis in males causes similar endocrine changes. We carried out a post mortem study evaluating the prostates of 51 men who died with liver cirrhosis compared with a similar group without any hepatic disease. The occurrence of BPH in cirrhotic subjects was diminished and delayed compared to total population. Furthermore in cirrhotic men BPH is more common as early nodular hyperplasia (early stage) or stromal hyperplasia (suggesting estrogenic prevalence), while in the general population stromal and epithelial hyperplasia (androgenic stimulation), were almost equally present.
Allergy to Hymenoptera Stings
Authors: Solomon E. Barr
Journal: JAMA (1974)

Allergy to Hymenoptera stings may be severe or even fatal. Records were examined of 249 insect-allergic patients seen over 12 years. Evaluation included careful history taking. Intradermal skin tests were of value in diagnosis and treatment, but correlation with history was imperfect. Patients were instructed in methods to decrease the possibility of subsequent stings and given emergency treatment kits containing epinephrine. Results of hyposensitizing injections were excellent, with 303 of 308 subsequent stings resulting in less reaction than before beginning injections. (JAMA 228:718-720, 1974)
The treatment of an abscess is . . .
Authors: S. V Ramanan
Journal: BMJ (2002)

My last month of internship was spent in Chronic Surgery, well removed from the acute units but deliberately located several feet above the tuberculosis wards in a beautiful hill station. Acute Medicine housed patients with pneumonia, infectious hepatitis, severe anaemia, dysentery, amoebic liver abscess, and typhoid. Patients with acute abdominal pain, trauma, subacute intestinal obstruction (often caused by hyperinfestation with Ascaris lumbricoides ), and head injuries patronised Acute Surgery. A fractured skull caused by a falling coconut was one of the commonest reasons for admission. Patients with uncontrolled hypertension and diabetes as well as those convalescing from acute illnesses were placed in Chronic Medicine, while Chronic Surgery accommodated patients with slowly healing wounds and a variety of other illnesses that needed continuing care. Here I …
Curcumin, a Dietary Component, Has Anticancer, Chemosensitization, and Radiosensitization Effects by Down-regulating the <i>MDM2</i> Oncogene through the PI3K/mTOR/ETS2 Pathway
Authors: Mao Li, Zhuo Zhang, Donald L. Hill, Hui Wang, Ruiwen Zhang
Journal: Cancer Research (2007)

Abstract The oncoprotein MDM2, a major ubiquitin E3 ligase of tumor suppressor p53, has been suggested as a novel target for human cancer therapy based on its p53-dependent and p53-independent activities. We have identified curcumin, which has previously been shown to have anticancer activity, as an inhibitor of MDM2 expression. Curcumin down-regulates MDM2, independent of p53. In a human prostate cancer cell lines PC3 (p53null), curcumin reduced MDM2 protein and mRNA in a dose- and time-dependent manner, and enhanced the expression of the tumor suppressor p21Waf1/CIP1. The inhibitory effects occur at the transcriptional level and seem to involve the phosphatidylinositol 3-kinase/mammalian target of rapamycin/erythroblastosis virus transcription factor 2 pathway. Curcumin induced apoptosis and inhibited proliferation of PC3 cells in culture, but both MDM2 overexpression and knockdown reduced these effects. Curcumin also inhibited the growth of these cells and enhanced the cytotoxic effects of gemcitabine. When it was administered to tumor-bearing nude mice, curcumin inhibited growth of PC3 xenografts and enhanced the antitumor effects of gemcitabine and radiation. In these tumors, curcumin reduced the expression of MDM2. Down-regulation of the MDM2 oncogene by curcumin is a novel mechanism of action that may be essential for its chemopreventive and chemotherapeutic effects. Our observations help to elucidate the process by which mitogens up-regulate MDM2, independent of p53, and identify a mechanism by which curcumin functions as an anticancer agent. [Cancer Res 2007;67(5):1988–96]
State Plans for Surrogate Decision Making
Authors: Ronald D. Eckoff
Journal: JAMA (1994)

To the Editor.  —The recent Law and Medicine article 1 described the New York State Surrogate Decision-Making Committee program. A State Substitute Medical Decision-Making Board was established in Iowa by 1989 legislation, using the New York rules as a guide. The Iowa law also allows counties to appoint local boards, but is broader than the New York law. It can be applied to anyone who is unable to understand the nature and consequences of proposed medical care, and thus cannot give informed consent, and who does not have a guardian or family members.  The rules in Iowa have been in effect for about 18 months. Seven counties have established local boards. Where there is no local board, the state board has jurisdiction and now has acted on 12 cases. The cases have involved people who ranged in age from 36 to 95 years and have included residents of nursing homes
Management of childhood diarrhoea by pharmacists and parents: is Britain lagging behind the Third World?
Authors: E Goodburn, S Mattosinho, P Mongi, T Waterston
Journal: BMJ (1991)

OBJECTIVE--To investigate the role of community pharmacists in providing advice and treatment for children with diarrhoea; to investigate mothers9 responses to diarrhoea in their children. DESIGN--Cross sectional questionnaire study of a random selection of community pharmacists and of mothers attending child health clinics. Pharmacists were interviewed and given a questionnaire and a separate group was visited by a researcher posing as a parent; mothers were interviewed at the clinic. SETTING--Newcastle upon Tyne. SUBJECTS--20 pharmacists were interviewed and visits by a researcher posing as a parent were carried out to 10 different pharmacists; 58 mothers were interviewed. MAIN OUTCOME MEASURES--Advice given by pharmacists was contrasted with standard advice on management of diarrhoea in children. RESULTS--Half of the pharmacists interviewed and 70% of pharmacists visited by a researcher posing as a parent recommended inappropriate treatment of childhood diarrhoea (such as antidiarrhoeal drugs and withholding breast milk), and only 30% at interview stated that they would ask for the age of the child. Mothers9 knowledge of home treatment was inadequate. All pharmacists in the posed visits recommended a purchased treatment. CONCLUSION--Pharmacists are widely used by parents for consultation for children9s ailments but their advice is not always appropriate; hence they should be given more consistent training in recognising and managing clinical problems. Medical advice on management of diarrhoea is also inconsistent and should be modified to conform to the guidelines of the World Health Organisation.
Statistics Notes: Interaction 2: compare effect sizes not P values
Authors: J. N S Matthews, D. G Altman
Journal: BMJ (1996)

As we have previously described,1 the statistical term interaction relates to the non-independence of the effects of two variables on the outcome of interest. For example, in a controlled trial comparing a new treatment with a standard treatment we may want to examine whether the observed benefit was the same for different subgroups of patients. A common approach to answering this question is to analyse the data separately in each subgroup. Here we illustrate this approach and explain why it is incorrect.

One of several subgroup analyses in a trial of antenatal steroids for preventing neonatal respiratory distress syndrome2 was performed to see whether the effect of treatment was different in mothers who did or did not develop pre-eclampsia. Among mothers with preeclampsia 21.2% (7/33) of babies whose mothers were given dexamethasone developed neonatal respiratory …
Preventing back pain
Authors: Niels Wedderkopp, Charlotte Leboeuf-Yde
Journal: BMJ (2008)

Every month, back pain affects 18-45% of the adult Western population,1 and the costs to society are between €200 (£150; $290) and €400 per capita per year.2 People who do heavy physical work are particularly susceptible because back problems are likely to be exacerbated when the back is used in its full range of movements.

In the accompanying paper, Martimo and colleagues report a systematic review of the prevention of back pain in people whose jobs involve heavy lifting.3None of the randomised controlled trials or cohort studies included in the reviewfound a positive effect of advice or training in working techniques—with or without lifting equipment—for preventing back pain or consequent disability.

Although the results are disappointing, they are not surprising, because few pathological and anatomical labels(such as a tumour, fracture, inflammatory disease, or acute disc protrusion)can be used to explain the aetiology of back pain.4 After removing the relatively few cases with obvious pathology, most patients are labelled as having non-specific back pain,4 and it is not easy to treat a condition without a clear understanding of its cause. This lack of diagnostic refinement may explain why most randomised controlled clinical trials of the treatment or prevention of back pain show relatively inconclusive results.5

The review by Martimo and colleagues confirms how little we know about how to prevent and treat back pain. This may be because back pain is a symptom and not a disease.Or perhaps the disorder cannot be reversed once it becomes established, so that no treatment could be effective.

Low back pain has been shown to start at puberty.6 7 In adults it is likely to recur or to become persistent,8 9 10 so perhaps we should aim for primary prevention—prevent the problem from occurring in the first place. Studies of prevention should therefore take place before puberty, but such studies are very rare.

So what further research needs to be done? Funding for studies on the causes of disease is harder to obtain than for studies that look at treatment. But we must identify the causes of low back pain before we study how we can prevent it. We would go so far as to suggest that randomised clinical trials of non-specific low back pain should be suspended as they include so many different types of back pain that the results are difficult to interpret.

What then can we do for our patients while we wait for further studies to be performed? The commonly given advice to patients to stay at work and be as physically active as possible may not be appropriate for people whose work involves heavy lifting and who have a history of recurrent back pain and several periods of sick leave. Continuing heavy manual work in their job and increasing leisure time physical activity may not be a good idea as no clearly effective treatment is available.5 A change of job and (prudently) staying active in daily life may be the best way for these patients to regain command of their back and their occupation.
In-111-DTPA-IgG: A NON-SPECIFIC POLYCLONAL ANTIBODY FOR IMAGING INFECTION/INFLAMATION
Authors: W A Wegener, M G Velchik, D Weiss, A Byar, S Ter, M Neptune, A Alavi
Journal: Clinical Nuclear Medicine (1990)

Wegener, W. A.; Velchik, H. G.; Weiss, D.; Byar, A.; Ter, S.; Neptune, M.; Alavi, A. Author Information
Reply to Erik B. Cornel’s Letter to the Editor re: Irina Soljanik, Armin J. Becker, Christian G. Stief, et al. Repeat Retrourethral Transobturator Sling in the Management of Recurrent Postprostatectomy Stress Urinary Incontinence After Failed First Male Sling. Eur Urol. 2010;58:767–772
Authors: Irina Soljanik, Ricarda M. Bauer
Journal: European Urology (2010)
Developmental structure in brain evolution
Authors: Barbara L. Finlay, Richard B. Darlington, Nicholas Nicastro
Journal: Behavioral and Brain Sciences (2001)

How does evolution grow bigger brains? It has been widely assumed that growth of individual structures and functional systems in response to niche-specific cognitive challenges is the most plausible mechanism for brain expansion in mammals. Comparison of multiple regressions on allometric data for 131 mammalian species, however, suggests that for 9 of 11 brain structures taxonomic and body size factors are less important than covariance of these major structures with each other. Which structure grows biggest is largely predicted by a conserved order of neurogenesis that can be derived from the basic axial structure of the developing brain. This conserved order of neurogenesis predicts the relative scaling not only of gross brain regions like the isocortex or mesencephalon, but also the level of detail of individual thalamic nuclei. Special selection of particular areas for specific functions does occur, but it is a minor factor compared to the large-scale covariance of the whole brain. The idea that enlarged isocortex could be a "spandrel," a by-product of structural constraints later adapted for various behaviors, contrasts with approaches to selection of particular brain regions for cognitively advanced uses, as is commonly assumed in the case of hominid brain evolution.
Hospital Privileges of Performing Gastrointestinal Endoscopy
Authors: Henry Colcher
Journal: JAMA (1973)

Sophisticated fiber optic endoscopes for the examination of the esophagus, stomach and duodenum, and of the entire colon are currently in use and are being distributed rather widely. A high degree of diagnostic accuracy can be obtained with these instruments, when they are appropriately employed by skilled and experienced physicians. The benefit to the patient under these circumstances is evident and has created a demand for these examinations that cannot be met by the number of trained endoscopists now available. Many hospitals have no one equipped to meet this need, but a number of untrained persons have purchased instruments and have begun to use them.  Hospital facilities are frequently utilized, the examination being carried out in an outpatient examining room, often employing instruments owned by the hospital. The chief of the hospital service has the prerogative and responsibility of determining which members of his department may have the privilege to
Kidney Graft and Patient Survival With and Without a Simultaneous Pancreas Utilizing Contralateral Kidneys From the Same Donor
Authors: Kayo Waki, Paul I. Terasaki
Journal: Diabetes Care (2006)

Simultaneous pancreas-kidney transplantation (SPK) is considered the treatment of choice for type 1 diabetic patients with end-stage renal disease. The American Diabetes Association supports pancreas transplantation for diabetic patients who have had, or plan to have, a kidney transplant (1). When the procedure is successful, a majority of pancreas transplant recipients have normal levels of glycemia and normal to nearly normal levels of HbA1c (2,3), improving their quality of life (3,4). However, whether pancreas transplants independently contribute to the survival benefit following an SPK above that achieved by a kidney-alone transplantation (KA) is inconclusive (5–9). We analyzed those patients who received SPK or KA using contralateral kidneys from the same deceased donors, who were ideal paired control patients for donor variables.

We analyzed data from all approved U.S. transplant programs collected by the United Network for Organ Sharing (UNOS). Eligible patients were those who received their first SPK or KA from January 1995 to December 2002. In the 544 type 1 diabetic patient pairs, one of the patients received a KA and the other patient received an SPK from the same deceased donors. Our analysis included follow-up information received through December 2004.

Patient characteristics were compared using the paired t test for continuous variables and the McNemar’s test for …
Bortezomib With or Without Irinotecan in Relapsed or Refractory Colorectal Cancer: Results From a Randomized Phase II Study
Authors: Peter S. Kozuch, Caio Max Rocha-Lima, Tomislav Dragovich, Howard Hochster, Bert H. O'Neil, Omar T. Atiq, J. Marc Pipas, David P. Ryan, Heinz-Josef Lenz
Journal: Journal of Clinical Oncology (2008)

Purpose To evaluate the efficacy and toxicity of bortezomib with or without irinotecan, in patients with relapsed or refractory colorectal cancer (CRC). Patients and Methods Patients were randomly assigned in a 3:4 ratio to bortezomib 1.5 mg/m 2 (arm A) or bortezomib 1.3 mg/m 2 plus irinotecan 125 mg/m 2 (arm B). A treatment cycle of 21 days consisted of four bortezomib doses on days 1, 4, 8, and 11, plus, in arm B, irinotecan on days 1 and 8. The primary objective of this randomized, multicenter, open-label, phase II study was to determine tumor response to treatment. Secondary objectives were safety and tolerability. Results A preplanned interim analysis to assess efficacy revealed inadequate activity, resulting in early termination of this study. A total of 102 patients were treated, 45 in arm A and 57 in arm B. Baseline characteristics were comparable. The investigator-assessed response rate was 0 in arm A and 3.5% in arm B (all partial responses). Adverse events in both treatment arms were as expected, with no significant additive toxicity. The most common grade ≥ 3 adverse events reported, per patient, during the study were fatigue (27%), vomiting (13%), nausea (11%), and peripheral sensory neuropathy (11%) in arm A, and diarrhea (33%), fatigue (25%), neutropenia (23%), thrombocytopenia (18%), dyspnea (12%), abdominal pain (12%), dehydration (12%), and anemia (11%) in arm B. Conclusion Bortezomib alone or in combination with irinotecan was not effective in patients with relapsed or refractory CRC.
Cardiovascular Disease and Glycemic Treatment
Authors: Zachary T. Bloomgarden
Journal: Diabetes Care (2010)

At the 57th Annual Advanced Postgraduate Course of the American Diabetes Association (ADA) held 5–7 February 2010 in San Francisco, California, Peter Raven (Phoenix, AZ) addressed the question of which patients should be targeted for glucose control as pertains to cardiovascular disease (CVD). He termed “the big question [for] tight glucose control … [whether] the benefits of tight glycemic control, cardiovascular but, of course, also microvascular, outweigh the risks of hypoglycemia, mortality, time, and quality of life.” The Diabetes Control and Complications Trial (DCCT) (1) and the Stockholm Diabetes Intervention Study (2) in persons with type 1 diabetes and the University Group Diabetes Program (UGDP) (3), UK Prospective Diabetes Study (UKPDS) (4), Kumamoto (5), and the Veterans Affairs Cooperative Study (6) in type 2 diabetes were followed by the Action to Control Cardiovascular Risk in Diabetes (ACCORD) (7), the Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation (ADVANCE) (8), and the Veterans Affairs Diabetes Trial (VADT) (9) that addressed a glycemic goal of A1C from ∼7% and going to even lower levels.

Comparing the older with newer studies, although we have a good understanding of the relationship between control and microvascular risk, Reaven suggested that the DCCT and UKPDS appear to show that the relationship of glycemia to outcome for microvascular disease shows a steeper slope than that for macrovascular disease, making it more difficult to determine the importance of the latter. In the DCCT itself, there was no significant cardiovascular benefit, although the trial was not intended for this. This was similarly the case for Kumamoto; in UKPDS, the 16% decrease in myocardial infarction was not statistically significant at the completion of the trial, although all three trials showed reduction in microvascular disease. UKPDS also had a metformin arm, which did show significant cardiovascular reduction with …
Asthma: New Ideas About an Old Disease
Authors: Gildon N. Beall, Douglas C. Heiner, Donald P. Tashkin, Brian J. Whipp
Journal: Annals of Internal Medicine (1973)

Asthma is a common and important disease, characterized by widespread bronchial obstruction that is reversible either spontaneously or with therapy. Its principal causes seem to be allergy, infections, irritants, and psychophysiologic reactions, usually in combinations. Induction of asthma by allergens is related to the presence of IgE antibodies fixed to mast cells and basophils. When these antibodies react with allergens, histamine and slow-reacting substance of anaphylaxis are released from the mast cells. There is also evidence of disturbance of control of the bronchi by the autonomic nervous system. Probably both increased cholinergic and decreased beta adrenergic effects are contributors. Some common manifestations of asthma have not been widely appreciated until recently. Hypoxia, due to altered ventilation-perfusion relationships, is nearly always present in severe asthma. Exercise-induced bronchospasm, of not yet completely understood origin, is a common problem for asthmatics and can usually be prevented by prophylactic administration of a bronchodilator.
Healthcare providers have new panel to appeal to against unfair competition
Authors: N. Timmins
Journal: BMJ (2009)

A new body has been created to preside over the fair use of competition in primary care in England. 

The Co-operation and Competition Panel is a court of appeal for healthcare providers that believe that a primary care trust has not put services out to tender when it should have done or has not run the tendering process fairly. It began operations at the end of January with the formal job description “to support the delivery to patients and taxpayers of the benefits of competition.” 

Private healthcare providers, the voluntary sector, GPs, NHS organisations, and others can appeal to the panel if a complaint about …