tbuckley/cabot-search huggingface dataset:
Minimally invasive decompression versus open laminectomy for central stenosis of the lumbar spine: pragmatic comparative effectiveness study
Authors: U. S. Nerland, A. S. Jakola, O. Solheim, C. Weber, V. Rao, G. Lonne, T. K. Solberg, O. Salvesen, S. M. Carlsen, O. P. Nygaard, S. Gulati
Journal: BMJ (2015)

<b>Objective</b> To test the equivalence for clinical effectiveness between microdecompression and laminectomy in patients with central lumbar spinal stenosis. <b>Design</b> Multicentre observational study. <b>Setting</b> Prospective data from the Norwegian Registry for Spine Surgery. <b>Participants</b> 885 patients with central stenosis of the lumbar spine who underwent surgery at 34 Norwegian orthopaedic or neurosurgical departments. Patients were treated from October 2006 to December 2011. <b>Interventions</b> Laminectomy and microdecompression. <b>Main outcome measures</b> The primary outcome was change in Oswestry disability index score one year after surgery. Secondary endpoints were quality of life (EuroQol EQ-5D), perioperative complications, and duration of surgical procedures and hospital stays. A blinded biostatistician performed predefined statistical analyses in unmatched and propensity matched cohorts. <b>Results</b> The study was powered to detect a difference between the groups of eight points on the Oswestry disability index at one year. 721 patients (81%) completed the one year follow-up. Equivalence between microdecompression and laminectomy was shown for the Oswestry disability index (difference 1.3 points, 95% confidence interval −1.36 to 3.92, P&lt;0.001 for equivalence). Equivalence was confirmed in the propensity matched cohort and full information regression analyses. No difference was found between groups in quality of life (EQ-5D) one year after surgery. The number of patients with complications was higher in the laminectomy group (15.0% <i>v</i> 9.8%, P=0.018), but after propensity matching for complications the groups did not differ (P=0.23). The duration of surgery for single level decompression was shorter in the microdecompression group (difference 11.2 minutes, 95% confidence interval 4.9 to 17.5, P&lt;0.001), but after propensity matching the groups did not differ (P=0.15). Patients in the microdecompression group had shorter hospital stays, both for single level decompression (difference 1.5 days, 95% confidence interval 1.7 to 2.6, P&lt;0.001) and two level decompression (0.8 days, 1.0 to 2.2, P=0.003). <b>Conclusion</b> At one year the effectiveness of microdecompression is equivalent to laminectomy in the surgical treatment of central stenosis of the lumbar spine. Favourable outcomes were observed at one year in both treatment groups. <b>Trial registration</b> ClinicalTrials.gov NCT02006901.
Increasing use of private practice by patients in Oxford requiring common elective surgical operations.
Authors: K McPherson, A Coulter, I Stratton
Journal: BMJ (1985)

A random sample of 6000 people from eight general practices in and around Oxford was studied to ascertain their surgical histories and method of care received. The proportion of operations that were performed privately had increased with time and had a steep gradient according to social class. Different procedures had different likelihoods of being performed privately, but the age and sex of the patient had a non-significant association with private surgery. Adjustment for possible confounding variables using logistic analysis indicated that in the 1980s elective surgery is five times more likely to be performed privately than it was at the institution of the National Health Service.
Efficacy of Autologous Melanocyte Transplantation on Amniotic Membrane in Patients With Stable Leukoderma
Authors: Pedro Redondo, Ana Gímenez de Azcarate, Jorge M. Núñez-Córdoba, Enrique J. Andreu, María García-Guzman, Leyre Aguado, Felipe Prosper
Journal: JAMA Dermatology (2015)

Clinical TrialVitiligo is a disfiguring disease with no definitive treatment options that significantly affects patients' quality of life.We aimed to compare, for what we believe to be the first time, the repigmentation efficacy of cultured epidermal cell suspension (CES) and amniotic membrane (AM)-cultured epidermal cell grafting (CEG) in the treatment of stable vitiligo.
In situ polymerase chain reaction-based localization studies support role of human herpesvirus-8 as the cause of two AIDS-related neoplasms: Kaposi's sarcoma and body cavity lymphoma.
Authors: K E Foreman, P E Bacon, E D Hsi, B J Nickoloff
Journal: Journal of Clinical Investigation (1997)

Several lines of investigation point to a new herpesvirus, human herpesvirus-8 (HHV-8), as the cause of two different neoplasms seen in AIDS patients-Kaposi's sarcoma (KS) and body cavity B cell lymphoma. If this virus is the etiological agent, rather than another opportunistic infectious agent, it should be present in the earliest detectable clinical lesions on a temporal basis, and localize to specific target cells in a spatial pattern consistent with tumorigenic pathways. In this study, we take advantage of the clinical accessibility to biopsy early (patch stage) skin lesions of KS to address the temporal issue, combined with in situ PCR and dual immunostaining using a marker identifying malignant cells, to address the spatial localization issue. 21 different tissue samples were subjected to PCR analysis and in situ PCR with and without simultaneous immunostaining. In normal skin from healthy individuals, no HHV-8 DNA was detected by PCR or in situ PCR. However, in all PCR-positive tissues, distinct and specific in situ PCR staining was observed. In four different patch stage KS lesions, in situ PCR staining localized to nuclei of endothelial cells and perivascular spindle-shaped tumor cells. Later stage KS lesions (plaques and nodules) revealed additional positive cells, including epidermal keratinocytes (four of five), and eccrine epithelia (two of four). These patterns were nonrestricted to skin, as pulmonary KS also revealed HHV-8-specific infection of endothelial cells and KS tumor cells, as well as epithelioid pneumocytes (two of two). In body cavity B cell lymphoma by dual staining, HHV-8 was present in malignant tumor cells (EMA immunostained positive) and not in reactive lymphocytes. These results reveal an early temporal onset and nonrandom tissue and cellular distribution pattern for HHV-8 infection that is consistent with a causal link between this DNA virus and two AIDS-related neoplasms.
Optimal culture conditions for the generation of natural killer cell-induced dendritic cells for cancer immunotherapy
Authors: Thanh-Nhan Nguyen-Pham, Deok-Hwan Yang, Truc-Anh Thi Nguyen, Mi-Seon Lim, Cheol Yi Hong, Mi-Hyun Kim, Hyun Ju Lee, Youn-Kyung Lee, Duck Cho, Soo-Young Bae, Jae-Sook Ahn, Yeo-Kyeoung Kim, Ik-Joo Chung, Hyeoung-Joon Kim, Je-Jung Lee
Journal: Cellular and Molecular Immunology (2011)
Excretion of Acid by the Kidney — Functional Organization and Cellular Aspects of Acidification
Authors: Philip R. Steinmetz
Journal: New England Journal of Medicine (1968)

THE task of regulating acid–base balance in the body is shared by the lungs and the kidneys. Each day the lungs remove some 20 moles of carbon dioxide, and the kidneys excrete 40 to 80 mEq of nonvolatile acid. This presentation concerns the renal disposition of hydrogen ion.Knowledge of the mechanisms of acidification of the urine has been expanded and modified in recent years by new investigations of the intact kidney, by micropuncture studies of individual nephrons and by a variety of in vitro studies of renal metabolism and ion transport. I shall begin the discussion with a brief . . .
Improving retinoblastoma outcomes through a stage-based intervention model
Authors: Meaghann S Weaver, Catherine G Lam
Journal: The Lancet Global Health (2014)

Motivated by the summary of the global burden of blindness by Rupert Bourne and colleagues (December, p e339),1 we believe an opportunity exists to reduce preventable blindness and potentially loss of life through development of interventions informed by public health theory. Retinoblastoma—a diagnosis that affects not only vision but also survival for many individuals—is the most common intraocular tumour of childhood. Although approaches that improve how health care is delivered have been a focus for management of paediatric oncology in low-income and middle-income settings, this essential focus is not sufficient.
The performance of a component‐based allergen‐microarray in clinical practice
Authors: S. Wöhrl, K. Vigl, S. Zehetmayer, R. Hiller, R. Jarisch, M. Prinz, G. Stingl, T. Kopp
Journal: Allergy (2006)

Background: Currently, the diagnosis of IgE‐mediated allergy is based on allergen‐specific history and diagnostic procedures using natural allergen extracts for in vivo and in vitro tests. Objective: The aim of the study was to comparatively analyse a new component‐based allergen‐microarray and the ‘quasi‐standard’ ImmunoCAP ® for their clinical relevance in patients with allergic rhinoconjunctivitis to five aeroallergens [house dust mite (HDM), cat dander, birch, grass and mugwort pollen] in a prospective, double‐centre study. Methods: We enrolled 120 subjects at the two study centres. Allergic patients were defined as having an allergen‐specific history plus a concomitant positive skin‐prick test (SPT) to natural allergen extracts and specific serum IgE was measured by both methods. Each allergen was analysed separately. Results: The microarray performed equally well in receiver‐operating characteristic curve (ROC) analyses when compared with the CAP in cat (23 allergic vs 97 non‐allergic, ROC area under the curve microarray 0.950 vs CAP 0.894, P = 0.211), birch (31/89, 0.908 vs 0.878, P = 0.483) and grass pollen (47/73, 0.923 vs 0.915, P = 0.770). It was slightly less sensitive in HDM‐allergic subjects (26 allergic vs 94 non‐allergic, ROC area microarray 0.808 vs CAP 0.911, P = 0.053) and displayed a reduced sensitivity in the mugwort pollen‐allergic patients (17/103, 0.723 vs 0.879, P = 0.032). Conclusions: Component‐based testing and the whole‐allergen CAP are equally relevant in the diagnosis of grass‐, birch‐ and cat‐allergic patients. Although slightly less sensitive, the microarray is sufficient for the diagnosis of HDM‐allergic patients, but needs alternative and/or additional components for detecting mugwort allergy.
Gamma-Interferon Gene Expression in the Bone Marrow of Patients with Aplastic Anemia
Authors: Antonia Nistico
Journal: Annals of Internal Medicine (1994)

To determine gamma-interferon gene expression in the bone marrow of patients with aplastic anemia and controls. Most patients with acquired aplastic anemia respond to immunosuppressive therapy, implicating an immune pathophysiologic origin for this disease.Clinical Center, National Institutes of Health.25 patients with aplastic anemia on presentation, 18 patients after treatment, 39 patients with other hematologic syndromes, and 20 normal controls.gamma-Interferon signal was detected in the bone marrow of 14 of 18 patients with severe aplasia on presentation, 4 of 7 patients with moderate aplastic anemia, and 1 of 2 patients with the paroxysmal nocturnal hemoglobinuria-aplasia syndrome. The gamma-interferon gene was not expressed in marrow from 20 normal persons or in patients who had received many transfusions for chronic anemia; with pancytopenia after chemotherapy; or with marrow failure of other types, including myelodysplasia, inherited anemias, or constitutional aplastic anemia. In serial studies, gamma-interferon RNA disappeared from the marrow of patients as they responded to immunosuppression; the signal was present in 3 of 4 patients who had a relapse but not in previously treated, now recovered patients. Determination of marrow gamma-interferon gene expression was more specific and sensitive than concurrent determinations in peripheral blood. Quantitative titration of mRNA showed that gamma-interferon expression was not a simple function of the number of lymphocytes in samples.gamma-Interferon expression is prevalent in acquired aplastic anemia and may be a specific marker of this disease. Local production of this inhibitory lymphokine in the target organ, the bone marrow, may be important in mediating aplastic anemia. Measurement of this lymphokine's message may be useful in distinguishing acquired aplastic anemia from other forms of bone marrow failure.
Anaphylactoid reactions during hemodialysis in sheep are ACE inhibitor dose-dependent and mediated by bradykinin
Authors: Detlef H. Krieter, Matthias Grude, Horst-Dieter Lemke, Edwin Fink, Gerd Bönner, Bernward A. Schölkens, Egbert Schulz, Gerhard A. Müller
Journal: Kidney International (1998)
Using the modified Barthel index to estimate survival in cancer patients in hospice: observational study
Authors: M. Bennett, N. Ryall
Journal: BMJ (2000)

<h3>ABSTRACT</h3> WalKR (YycFG) is the only essential two-component regulator in the human pathogen <i>Staphylococcus aureus.</i> WalKR regulates peptidoglycan synthesis, but this function alone appears not to explain its essentiality. To understand WalKR function we investigated a suppressor mutant that arose when WalKR activity was impaired; a single histidine to tryptophan substitution (H271Y) in the cytoplasmic Per-Arnt-Sim (PAS<sup>CYT</sup>) domain of the histidine kinase WalK. Introduction of the WalK<sup>H271Y</sup> mutation into wild-type <i>S</i>. <i>aureus</i> activated the WalKR regulon. Structural analyses of the WalK PAS<sup>CYT</sup> domain revealed a hitherto unknown metal binding site, in which a zinc ion (Zn<sup>2+</sup>) was tetrahedrally-coordinated by four amino acid residues including H271. The Wallk<sup>H271Y</sup> mutation abrogated metal binding, increasing WalK kinase activity and WalR phosphorylation. Thus, Zn<sup>2+</sup>-binding negatively regulates WalKR activity. Identification of a metal ligand sensed by the WalKR system substantially expands our understanding of this critical <i>S</i>. <i>aureus</i> regulon.
Consumer involvement in research is essential
Authors: D. Tallon
Journal: BMJ (2000)

EDITOR—We agree with Goodare and Lockwood that consumer involvement in the research process is lacking.1 Our work on osteoarthritis has shown the potential benefit of involving consumers when trying to prioritise the research agenda.

In a survey of 112 people with osteoarthritis of the knee we found that a wider range of treatment options was being used by patients than the research literature would suggest. From a recent systematic …
Deficiency of nicotinamide adenine dinucleotide phosphate, reduced form oxidase enhances hepatocellular injury but attenuates fibrosis after chronic carbon tetrachloride administration
Authors: Ghazaleh Aram, James J. Potter, Xiaopu Liu, Lan Wang, Michael S. Torbenson, Esteban Mezey
Journal: Hepatology (2008)

Reactive oxygen species (ROS) activate hepatic stellate cells and enhance fibrogenesis. This study determined the role of nicotinamide adenine dinucleotide phosphate, reduced form (NADPH) oxidase deficiency in the development of hepatocellular necrosis, inflammation, and apoptosis in relation to fibrosis produced by chronic carbon tetrachloride (CCl4) administration. Wild-type (WT) mice or mice with deficiency of the gp91phox subunit of NADPH complex (gp91) were subjected to biweekly CCl4 injections over 8 weeks, whereas controls were given isovolumetric injections of olive oil. Serum aspartate aminotransferase (AST) was higher after CCl4 administration in gp91 than in WT mice, correlating with increased necrosis on liver histology. By contrast, more hepatocyte apoptosis was found after CCl4 in the WT than in the gp91 mice, which was associated with changes in components of the mitochondrial pathway of apoptosis, namely, an increase in the pro-apoptotic BAX protein in the WT, but not in the gp91 mice and also a lower cytosolic cytochrome c in the gp91 mice. There were fewer stellate cells and less fibrosis after CCl4 in the gp91 as compared with the WT mice. The increase in α1(I) collagen messenger RNA (mRNA), however, was greater after CCl4 in the gp91 mice. Matrix metalloproteinase-2 (MMP-2) and MMP-9 mRNA increased more in the gp91 than in WT mice after CCl4. Tissue inhibitor of metalloproteinase 1 (TIMP-1) and TIMP-2 increased after CCl4 only in the gp91 mice. Conclusion: Decreased hepatic fibrosis after chronic CCl4 administration in mice with NADPH oxidase deficiency occurs in the setting of greater necrosis and inflammation but decreased apoptosis. (HEPATOLOGY 2009.)
Crystal structure of a soluble CD28-Fab complex
Authors: Edward J Evans, Robert M Esnouf, Raquel Manso-Sancho, Robert J C Gilbert, John R James, Chao Yu, Janet A Fennelly, Cheryl Vowles, Thomas Hanke, Björn Walse, Thomas Hünig, Poul Sørensen, David I Stuart, Simon J Davis
Journal: Nature Immunology (2005)
SmcHD1, containing a structural-maintenance-of-chromosomes hinge domain, has a critical role in X inactivation
Authors: Marnie E Blewitt, Anne-Valerie Gendrel, Zhenyi Pang, Duncan B Sparrow, Nadia Whitelaw, Jeffrey M Craig, Anwyn Apedaile, Douglas J Hilton, Sally L Dunwoodie, Neil Brockdorff, Graham F Kay, Emma Whitelaw
Journal: Nature Genetics (2008)
Abstract B13: Cycloartane-3,24,25-triol: A cancer chemopreventive cycloartane inhibits MRCKα kinase and demonstrates anti prostate cancer activity in vitro
Authors: Henry I.C. Lowe, Ngeh J. Toyang, Joseph Bryant
Journal: Cancer Research (2012)

Abstract In our study of the Jamaican ball moss (Tillandsia recurvata L.) for its prostate cancer chemotherapeutic properties, we have identified a number of cycloartane-type compounds from the chloroform crude extract. Cycloart-23-ene-3,25-diol was isolated and characterized from the extract. Attempts to run this compound in our kinase and antiproliferative assays were unsuccessful because of solubility problems. A search of the literature led us to Cycloartane-3,24,25-triol, a close analog of Cycloart-23-ene-3,25-diol. Cycloart-23-ene-3,25-diol differs from Cycloartane-3,24,25-triol only in the presence of a third hydroxyl group in this compound while Cycloart-23-ene-3,25-diol has only two hydroxyl groups. We isolated Cycloartane-3,24,25-triol from its source plant (Chrysanthemum morifolium) and screened it against a 451 kinase panel for inhibitory properties as well as for anti- prostate cancer cell proliferation activity using DU145 and PC-3 cell lines. Cycloartane-3,24,25-triol inhibited MRCKα (Myotonic dystrophy kinase-related Cdc42–binding kinase) kinase at a Kd of 0.26μM and showed IC50 values of 1.56±0.18μM and 2.04±0.28μM against DU145 and PC-3 prostate cancer cell lines respectively. MRCK kinases are now known to contribute to the process of tumor progression and metastasis through the control of the cytoskeleton which regulates tumor cell motility and invasion. In prostate cancer, the MRCKα kinase indirectly contributes to tumor progression by activating other kinases including the Lim kinase 1 (LIMK 1) which is over-expressed in prostate cancer and known to contribute to tumor cell invasion and migration leading to metastasis to other organs. This is the first report on the anti-prostate cancer activity and kinase inhibitory activity of Cycloartane-3,24,25-triol. The combined kinase and in vitro antiproliferation activity of Cycloartane-3,24,25-triol makes it a good candidate for further studies to determine its in vivo efficacy against prostate cancer. Citation Format: Henry I.C. Lowe, Ngeh J. Toyang, Joseph Bryant. Cycloartane-3,24,25-triol: A cancer chemopreventive cycloartane inhibits MRCKα kinase and demonstrates anti prostate cancer activity in vitro [abstract]. In: Proceedings of the AACR Special Conference on Advances in Prostate Cancer Research; 2012 Feb 6-9; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2012;72(4 Suppl):Abstract nr B13.
Digoxin Intoxication and Hyperkalemia
Authors: Gordon W. Josephson
Journal: JAMA (1980)

<h3>To the Editor.—</h3> The recent article discussing digoxin intoxication by Warren and Fanestil (242:2100, 1979), "Digoxin Overdose: Limitations of Hemoperfusion-Hemodialysis Treatment," raises many questions. While I am sure that the authors would now agree that their failure to influence serum digoxin levels and clinical outcome substantially by charcoal hemoperfusion was predictable in light of digoxin's high volume of distribution, the use of hemodialysis for reduction of serum potassium levels can also be questioned. It is generally accepted that hyperkalemia secondary to digoxin intoxication results from poisoning of the adenosine triphosphatase (ATPase)dependent sodium potassium membrane transport system.<sup>1,2</sup>This has the effect of raising extracellular potassium levels at the expense of intracellular stores (ie, depletion) and results in a reduced resting membrane potential with decreased automaticity. Hence, potassium infusion, even in the absence of arrhythmias or hypokalemia, is an accepted treatment for digoxin intoxication, particularly when "digoxin-toxic" dysrhythmias are observed.<sup>3</sup>
Saudi Arabia has several strategies to care for pilgrims on the Hajj
Authors: Z. A. Memish
Journal: BMJ (2011)

The following link provides information on the Hajj for health practitioners and pilgrims in six languages (www.moh.gov.sa/en/Hajj/Pages/default.aspx).1 Toll-free information is available by calling +8002494444.

It is essential to coordinate local messaging with official Saudi Arabia ministry sources. Details do matter. What might seem a trivial digression from official Saudi Arabia …
Combination Therapy With Hormone Replacement and Alendronate for Prevention of Bone Loss in Elderly Women
Authors: Susan L. Greenspan, Neil M. Resnick, Robert A. Parker
Journal: JAMA (2003)

Therapy with individual antiresorptive agents has been shown to be effective for prevention and treatment of postmenopausal osteoporosis, but whether combination antiresorptive therapy with hormones and bisphosphonates is safe or efficacious or how these agents compare in elderly women is unknown.To determine whether hormone replacement and the bisphosphonate alendronate sodium in combination are efficacious and safe, and how they compare with monotherapy in community-dwelling elderly women.Randomized, double-blind, placebo-controlled, clinical trial.Five hundred seventy-three community-dwelling women age 65 years or older were screened: 485 completed screening and 373 (aged 65 to 90 years) were randomized following a 3-month, open-label, run-in phase with hormone replacement and alendronate placebo. The trial was conducted at a single academic US medical center from January 1996 to May 2001.Participants were randomly assigned in a 2 x 2 factorial design to receive hormone replacement (conjugated equine estrogen, 0.625 mg/d, with or without medroxyprogesterone, 2.5 mg/d) and alendronate, 10 mg daily, both agents, or neither. All participants received calcium and vitamin D supplements.Annualized change in bone mineral density of the hip and spine and occurrence of adverse events.Bone mineral density at 3 years was significantly greater at all femoral and vertebral sites in women treated with combination therapy than with monotherapy, with mean (SD) increases of 5.9% (3.8) at the total hip, 10.4% (5.4) at the posteroanterior lumbar spine, and 11.8% (6.8) at the lateral lumbar spine. Mean (SD) increases in bone mass at the hip in women treated with alendronate alone were significantly greater than in those treated with hormone replacement therapy alone (4.2% [3.8] vs 3.0% [4.9]; P<.05, respectively), and alendronate resulted in more responders to therapy. All therapies were well tolerated and participant retention was 90% at 3 years.Combination therapy with hormone replacement and alendronate was efficacious and well tolerated in this cohort. Alendronate was superior to hormone replacement, and combination therapy was superior to either therapy alone. Combination therapy may represent an option for women with more severe disease or for those who have failed to achieve an adequate response to monotherapy.