tbuckley/cabot-search huggingface dataset:
Diagnostic Application of the A1c Assay in Renal Disease
Authors: Adnan Sharif, Keshwar Baboolal
Journal: Journal of the American Society of Nephrology (2010)

A recent International Expert Committee, jointly appointed by the American Diabetes Association, the European Association for the Study of Diabetes, and the International Diabetes Federation, now advocates the use of glycated hemoglobin, measured by A1c assay, for diagnosing diabetes in nonpregnant individuals.1 Their recommendations suggest the diagnosis of diabetes when the A1c level is >6.5%, confirmed on repeat testing when patients are asymptomatic. In addition, patients with an A1c between 6.0 and 6.5% should be considered high risk, analogous to the state of prediabetes defined by either impaired fasting glucose or glucose tolerance. The rationale for this new approach emphasizes the advantages of the A1c assay over current diagnostic measures for accuracy, precise measurement of chronic glycemia, correlation with diabetic complications, and logistical ease of use. This proposal is under consideration by diabetic associations for possible implementation but lacks analysis of the validity of the A1c assay for diagnosing diabetes in the setting of renal impairment and renal replacement therapy (RRT).

Hemoglobin A1c is the product of a nonenzymatic reaction between circulating hemoglobin and glucose. In the normal 120-day life cycle of the average red blood cell, the magnitude of glycated hemoglobin is reflective of longitudinal exposure to glucose. Glycation rate can be influenced by temperature, pH, red cell turnover, hemoglobin concentration, glucose concentration, and length of exposure to glucose.2 The Diabetes Control and Complications Trial (DCCT) and United Kingdom Prospective Diabetes Study (UKPDS), conducted of patients with type 1 and type 2 diabetes respectively, were the pivotal studies demonstrating a link between A1c and diabetes-related complications.3,4 …
Child resistant containers needed for liquid medications.
Authors: M Jacobs
Journal: BMJ (1993)

general practice tutor who now visits and assesses practices applying to employ a retained doctor and who meets the retained doctors annually to assess whether their educational needs are being met.Toynton also recommends a system whereby retained doctors can be given a free pass for educational activities.At this postgraduate centre, and many others in this region, this has been the system for some time.Fees are charged only to doctors who require a postgraduate education allowance certificate.Doctors on the retainer scheme, and trainees, assistants, retired doctors, and anyone else who does not require a certificate, are welcome to contact our postgraduate administrator for details of our educational programmes, to which they will be admitted free of charge.
WHO sets new guidelines for air pollution
Authors: D. Carnall
Journal: BMJ (1995)

No safe level exists for particulate air pollution, says a draft report from the World Health Organisation, and governments will be forced to make a political judgment between the level of asthma exacerbations and deaths and the economic, social, and political costs of restricting polluting activities. The new guidelines also recommend halving the current recommended limits of nitrogen dioxide from 210 parts per billion to 110 parts per billion.

Particulate air pollution is the term used to describe particles of less than 10 µm in diameter; these can …
THE PRACTICAL USES OF SUGGESTIVE THERAPEUTICS.
Authors: WILLIAM LEE HOWARD
Journal: JAMA (1896)

I conceive it to be your desire to have a plain statement of the uses and limitations of suggestion, and I shall confine myself to this conception. To those of you who desire a more comprehensive statement of the psychologic side of the subject I refer to my paper read last year before the Neurologic Section of thisAssociation.<sup>1</sup>In this paper I shall avoid as much as possible the misnomer hypnotism, as we shall see later on that often curative effects of suggestion are produced without inducing hypnosis. To anyone familiar with modern pathology the limitations of the therapeutic uses of suggestion will be readily understood. To those familiar with the trend of modern psychology its application for harmful effects will be fully appreciated. In treating patients by suggestion it is necessary to remember one fundamental factor,<i>i.e.</i>, the subjective state of the patients. Without this latter condition
Imaging of the hand and wrist in RA
Authors: B Taouli
Journal: Annals of the Rheumatic Diseases (2002)

<h3>Background</h3> Multiple tobacco product (MTP) use is common among young adults. Most MTP users are combustible cigarette smokers that use one or more other tobacco products. This study aims to explore menthol as a risk factor for MTP use among a cohort of young adult cigarette smokers. <h3>Methods</h3> Participants were 18–29 years cigarette smokers at 24 Texas colleges in a 6-wave study. Participants (n=4700 observations) were classified as: single product users (ie, exclusive cigarette smoking); dual product users and poly product users. A multilevel, ordered logistic regression model was used to examine the association between menthol cigarette smoking and MTP use. Two longitudinal, multilevel, multinomial logistic regressions were used to examine the relationship between menthol cigarette smoking and number of tobacco products used. <h3>Results</h3> Overall, 40.7% of the sample were single product users, 33.7% were dual product users and 25.6% were poly product users. Menthol was associated with 1.28 greater odds of MTP use. Further, menthol was associated with 1.19 greater risk of dual and 1.40 greater risk of poly product use, relative to single product use. Lastly, menthol cigarette smoking was associated with 1.18 greater risk of poly product use, relative to dual product use. <h3>Conclusions</h3> There was a gradient relationship between menthol cigarette smoking and number of tobacco products used among young adult cigarette smokers. Findings provide for greater regulatory and programmatic efforts to reduce the use of menthol cigarettes.
The medical management of problem gamblers
Authors: H. Bowden-Jones, N. Smith
Journal: BMJ (2012)

Welcome new guidance highlights scanty evidence base to guide screening and treatment 

Pathological gambling is an addiction that afflicts 0.9% of the population of the United Kingdom according to the findings of the 2010 British gambling prevalence survey.1 This means that there are about 450 000 problem gamblers in the UK. In these people, gambling has a profound negative impact on mental health and quality of life, which leads to disrupted family and professional relationships, as well as to debt and possibly crime to fund further gambling activities.2 The recent publication of the Australian Monash University guidelines is a welcome first step in trying to pull together the scant evidence on screening and treatment for those with gambling addiction.3 

The 2007 British gambling prevalence survey estimated that the prevalence of gambling addiction in the UK was 0.6%, a figure that had remained stable since the previous 2000 survey.4 The reasons for the more recent increase in problem gambling in the UK have been debated by academics and policy makers. Some experts have urged caution in interpreting the survey results, particularly in view of the small sample of people interviewed (just over 7500). Others suggest that the overall increase in gambling among people …
THE IMPACT OF LEFT VENTRICULAR FUNCTION ON MORTALITY IN PATIENTS WITH ST-SEGMENT ELEVATION ACUTE MYOCARDIAL INFARCTION: ANALYSIS OF THE HARMONIZING OUTCOMES WITH REVASCULARIZATION AND STENTS IN ACUTE MYOCARDIAL INFARCTION (HORIZONS-AMI) STUDY
Authors: Alexandra J. Lansky, Vivian Ng, Bernhard Witzenbichler, Giulio Guagliumi, Jan Z. Peruga, Kenji Goto, Helen Parise, Roxana Mehran, Gregg W. Stone
Journal: Journal of the American College of Cardiology (2010)
Combined modality doxorubicin-based chemotherapy and chitosan-mediated p53 gene therapy using double-walled microspheres for treatment of human hepatocellular carcinoma
Authors: Qingxing Xu, Jiayu Leong, Qi Yi Chua, Yu Tse Chi, Pierce Kah-Hoe Chow, Daniel W. Pack, Chi-Hwa Wang
Journal: Biomaterials (2013)
Unusual Gas Shadow in Pelvis of Asymptomatic Patient
Authors: Edwin L. Lame
Journal: JAMA (1977)

<h3>History</h3> A 47-year-old patient had anteroposterior and lateral films of the pelvis taken because of a minor injury to the left hip and knee. <h3>Diagnosis</h3> Transsexual pelvis. <h3>Comment</h3> A 47-year-old patient, originally a male, had had a transsexual conversion some years ago at another hospital. The anteroposterior roentgenogram of the pelvis (Fig 1) shows a typical normal male bony contour and structure (heavy bones and small pelvic cavity), with what appears to be a semiopaque speculum or obturator in the midline. The lateral view (Fig 2) locates this shadow not in the rectum but in the vagina. The patient then indicated that the shadow was that of a vaginal dilator, used frequently and over long periods to maintain patency in the surgically produced vagina. The dilator is a standard product produced by dealers in gynecologic material and measures about 13.34 cm in length and about 3.18 cm in diameter (Fig
The endgame for tobacco
Authors: A. Jain
Journal: BMJ (2013)

“You can live to be a hundred if you give up all the things that make you want to live to be a hundred.”—Woody Allen

Renowned Hollywood director, Woody Allen, withdrew the release of his much acclaimed film, Blue Jasmine in India last week, refusing to comply with regulations on anti-tobacco messages. This brings the debate on appropriateness of anti-tobacco messages in films to the fore again. In the accompanying feature (doi:10.1136/bmj.f5258), Balaji Ravichandran reports on the new Indian law that requires all television programmes and films to carry prominent anti-tobacco messages. If you have been to any cinemas recently, you will have noticed a flashing anti-tobacco warning pop up on the screen every time a character in the film smokes. Predictably, filmmakers and audiences are not happy about it.

The argument is …
Functional Roles of the Rho/Rho Kinase Pathway and Protein Kinase C in the Regulation of Cerebrovascular Constriction Mediated by Hemoglobin
Authors: Grant Wickman, Christopher Lan, Bozena Vollrath
Journal: Circulation Research (2003)

Although there is evidence that the Rho/Rho kinase pathway and protein kinase C (PKC) are involved in the development of cerebral vasospasm, the mechanism by which subarachnoid hemorrhage (SAH) activates these pathways is unclear. A large body of evidence points to oxyhemoglobin (OxyHb) as a major causative component of blood clot responsible for vasospasm. Therefore, the present studies were conducted to explore whether the Rho/Rho kinase and PKC may be involved in a sustained vasoconstriction induced by OxyHb in cerebral arteries. OxyHb evoked sustained vasoconstriction in the endothelium-denuded rabbit basilar arteries, which was reversed by the selective inhibitors of Rho kinase, Y-27632, and HA-1077, with the IC50 values of 0.26+/-0.02 and 0.74+/-0.1 micromol/L, respectively. In quiescent cerebrovascular smooth muscle (CVSM) cells, OxyHb induced Rho translocation, as assessed by immunoblotting, with a time course, which paralleled the contractile action of OxyHb. Rho translocation was also observed in intact arteries stimulated with OxyHb for 24 hours (219%) and 48 hours (160%). The increase in Rho translocation was fully inhibited by GGTI-297, an inhibitor of Rho prenylation. OxyHb also caused significant translocation of both PKCalpha and PKCepsilon (P<0.01), which was maximal at the time corresponding to maximal tension developed in response to OxyHb. Ro-32-0432, an inhibitor of PKC, attenuated vasoconstriction mediated by OxyHb in basilar artery. These results show, for the first time, that OxyHb-mediated signaling in CVSM utilizes the Rho/Rho kinase and PKC-based mechanisms.
ALLOANTIBODY PRODUCTION MEASURED BY PLAQUE ASSAY IN RELATION TO STRONG AND WEAK HISTOINCOMPATIBILITY
Authors: W. H. Hildemann, W. Pinkerton
Journal: The Journal of Experimental Medicine (1966)

A plaque technique which provides a sensitive and quantitative determination of allohemolysin (isohemolysin) production by lymphoid cells of mice and Syrian hamsters is described. Much ongoing attention has been given to minimizing sources of spurious plaques while improving the reproducibility of the technique. Primary intravenous immunization with allogeneic blood cells led to the early appearance of plaque-forming spleen cells responding to both strong and weak histocompatibility antigens in inbred strains of mice. The strongest histoincompatibility (A/J --> BL/6), characterized by H-2 plus non-H-2 differences and a median skin allograft survival time of 8.2 +/- 0.5 days, gave a peak average plaque production of 29.6 per 10 x 10(6) viable spleen cells after 6 days. At the other extreme with an average allograft survival time of 91 days, C3H(H-1(a)) --> C3H.K(H-1(b)) showed a feeble production of plaque-forming cells with a peak response of 3.7 per 10 x 10(6) viable spleen cells at 9 days. Histocompatibility antigens determined by genes at the H-1, H-Y, and H-X loci were demonstrated to be erythrocyte antigens as well. Peak plaque production occurred earlier and reached higher levels across the stronger histocompatibility barriers (H-2 plus non-H-2 or H-2 alone) in temporal accord with the rapidity of skin allograft rejection. Weak H-Y or H-1 differences leading to prolonged allograft survival were associated with moderate, but not commensurate delays in the initial occurrence and recruitment of plaque-forming cells. With one exception (C57BL/10 --> B10.A), the average plaque counts found at the peak of the primary responses were inversely proportional to the median survival times of skin allografts in the same strain combinations. Nevertheless, in light of the disparity between the times of allograft rejection and the time course of appearance of plaque-forming cells with the "weaker" congenic combinations, the early 19S antibodies do not appear to be directly involved in allograft rejection. There appears to be no limitation in the weakness of histocompatibility antigens capable of evoking antibodies detectible by plaque assay. The extent to which molecular species of mouse antibodies other than 19S hemolysins are induced and detected under the conditions employed remains to be determined. The responses in strain combinations involving stronger histocompatibility barriers were characterized by exponential increases in plaque-forming cells, for 2 to 4 days until maximal levels were reached. Repeated immunization in several trials led to substantial increases over the maximum primary response in the number of demonstrable plaque-forming cells. Further preliminary results are reported concerning alloimmune plaque production in three strains of Syrian hamsters exhibiting intermediate to weak histocompatibility differences.
THE SIGNIFICANCE OF SOME ENLARGEMENTS OF THE THYROID GLAND
Authors: A. F. Martin
Journal: BMJ (1906)

A 69! Every individual, every municipality, every province, as well as our Federal Government, has a special duty in this crusade to fight a disease which has attacked over one-half of our homes.By increasing the efficiency of the means now at our disposal, by the introduction of such measures where now none obtain, and by earnest, active, aggressive work of education our large annual mortality should soon show a maarked decrease.
Adrenal Beta-Arrestin 1 Inhibition In Vivo Attenuates Post-Myocardial Infarction Progression to Heart Failure and Adverse Remodeling Via Reduction of Circulating Aldosterone Levels
Authors: Anastasios Lymperopoulos, Giuseppe Rengo, Carmela Zincarelli, Jihee Kim, Walter J. Koch
Journal: Journal of the American College of Cardiology (2011)
Abstract IA18: Evolutionary dynamics of high-grade serous ovarian cancer genomes across anatomic space and time
Authors: Sohrab Shah
Journal: Clinical Cancer Research (2013)

Abstract High-grade serous ovarian cancer (HGSC) is characterized by poor outcome, often attributed to emergence of treatment-resistant sub-clones. We sought to measure the degree of genomic diversity within primary, untreated HGSC to examine the natural state of tumor evolution prior to therapy. We performed exome sequencing, copy number analysis, targeted amplicon deep sequencing and gene expression profiling on thirty-one spatially and temporally separated HGSC tumor specimens (six patients) including ovarian masses, distant metastases, and fallopian tube lesions. We found widespread intra-tumoral variation in mutation, copy number, and gene expression profiles, with key driver alterations in genes present in only a subset of samples (e.g. PIK3CA, CTNNB1, NF1). On average, only 51.5% of mutations were present in every sample of a given case (range: 10.2%-91.4%), with TP53 as the only somatic mutation consistently present in all samples. Complex segmental aneuploidies, such as whole genome doubling, were present in a subset of samples from the same individual, with divergent copy number changes segregating independently of point mutation acquisition. Reconstruction of evolutionary histories showed one patient with mixed HGSC and endometrioid histology with common etiologic origin in the fallopian tube and subsequent selection of different driver mutations in the histologically distinct samples. In this patient, we observed mixed cell populations in the early fallopian tube lesion, indicating diversity arises at early stages of tumorigenesis. Our results reveal that HGSC exhibit highly individual evolutionary trajectories and diverse genomic tapestries prior to therapy, exposing an essential biological characteristic to inform future design of personalized therapeutic solutions and investigation of drug resistance mechanisms. Citation Format: Sohrab Shah. Evolutionary dynamics of high-grade serous ovarian cancer genomes across anatomic space and time. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research: From Concept to Clinic; Sep 18-21, 2013; Miami, FL. Philadelphia (PA): AACR; Clin Cancer Res 2013;19(19 Suppl):Abstract nr IA18.
Short‐term prophylaxis in hereditary angioedema due to deficiency of the <scp>C</scp>1‐inhibitor – a long‐term survey
Authors: H. Farkas, Z. Zotter, D. Csuka, E. Szabó, Z. Nébenfűhrer, G. Temesszentandrási, L. Jakab, L. Varga, G. Harmat, I. Karádi
Journal: Allergy (2012)

Abstract Background Hereditary angioedema is a potentially life‐threatening disorder, because edema occurring in the mucosa of the upper airways can lead to suffocation. The management of HAE consists of avoiding the triggering factors, prophylaxis, and the acute treatment of edematous episodes. Medical procedures can also provoke edematous attacks, and therefore, short‐term prophylaxis ( STP ) is recommended before such interventions. Our aim was to evaluate the efficacy and safety of STP administered before medical procedures. Methods We conducted a retrospective analysis before and a prospective survey after establishing the diagnosis in a group of 137 (60 males, 77 females; 20 pediatric and 117 adult) patients with HAE . Both were implemented using questionnaires, patient diaries and hospital charts focusing on medical interventions provoking edematous attack, and the medicinal products ( C 1‐ INH concentrate, tranexamic acid, and danazol) administered for STP . Results Comparing surgical interventions performed without pre‐event STP (in 39/89 patients before HAE was diagnosed), or after STP (in 3/55 cases after diagnosis), we found a significant ( P &lt; 0.0001, Fisher's exact test) reduction in the number of edematous episodes. Evaluating the efficacy of the drugs administered for STP revealed that C 1‐ INH concentrate (Berinert ® , CSL Behring, Marburg, Germany) was significantly ( P = 0.0096, Fisher's exact test) superior to orally administered drugs in reducing the instances of postprocedural edema. None of the medicinal products caused adverse events potentially related to STP . Conclusions STP reduces the number of postprocedural edematous episodes. C 1‐ INH concentrate is safe and effective for prophylaxis. When this agent is not available, danazol is a potential alternative for prophylaxis before elective medical interventions.
Tiotropium as add-on to inhaled corticosteroids significantly improves asthma control as reflected by the ACQ responder rate
Authors: H.A.M. Kerstjens, E. Bleecker, E. Meltzer, T. Casale, E. Pizzichini, O. Schmidt, M. Engel, L.J. Bour, C.B. Verkleij, P.M. Moroni-Zentgraf, E.D. Bateman
Journal: European Respiratory Journal (2013)

Background: Despite current medications, there remains an unmet need for asthma control in patients with moderate asthma receiving at least ICS. We analysed ACQ data in patients treated with once-daily long-acting anticholinergic bronchodilator tiotropium who had symptomatic asthma despite treatment with medium-dose ICS (400-800 µg budesonide equivalent).

Methods: 2103 patients were randomised in 2 identical Phase III, double-blind, double-dummy, parallel-group studies ([NCT01172808][1] and [NCT01172821][2]). Patients received tiotropium 2.5 µg or 5 µg or placebo (all doses via Respimat® Soft Mist™ Inhaler). A salmeterol arm (active comparator) was included with no inferential analysis. Key inclusion criteria included a pre-bronchodilator FEV1 60-90% of predicted and ACQ score ≥1.5. A pre-planned pooled analysis was performed for ACQ responder rate, a co-primary end point; responders were defined as ACQ improvement ≥0.5 at 24 weeks.

Results: Baseline characteristics in patients were similar across both trials and all treatment groups. Mean baseline ACQ total score was 2.18 (SD 0.49). Both doses of tiotropium significantly improved the ACQ responder rate at 24 weeks compared with placebo (299/518 responders; 57.7%): tiotropium 2.5 µg, 332/515 (64.5%; p=0.03); tiotropium 5 µg, 330/513 (64.3%; p=0.03); salmeterol 356/535 (66.5%; p=0.004).

Conclusion: In patients with symptomatic asthma despite ICS therapy, the addition of once-daily tiotropium provided a statistically significant and clinically relevant improvement in asthma control. A similar ACQ responder rate was observed with tiotropium (2.5 µg and 5 µg) and the active comparator salmeterol.

 [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT01172808&atom=%2Ferj%2F42%2FSuppl_57%2FP4130.atom
 [2]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT01172821&atom=%2Ferj%2F42%2FSuppl_57%2FP4130.atom
Simultaneous activation of both cardiac angiotensin formation and degradation in the acute phase of myocardial infarction
Authors: Maria Boddi, Mirella Coppo, Maria Letizia Papa, Ilaria Cecioni, Gianluca Polidori, Niccolo' Marchionni, Pietro Amedeo Modesti, Gian Gastone Neri Serneri
Journal: Journal of the American College of Cardiology (2002)
Children in cars: how are they being restrained?
Authors: R Eatough, T Swage, P Willson, J Broomhall
Journal: BMJ (1985)

The authors give the results of a survey carried out among 130 parents using a standard questionnaire to determine the number and ages of children carried in each car; the type, make and anchorage of restraints used; and whether the restraints were fitted by the owner of the car or a professional. It was found that only one third of children under the age of 14 were correctly restrained, yet only two of the cases contravened the present law. (TRRL)