tbuckley/cabot-search huggingface dataset:
Neuromuscular patterns in chronic ankle instability
Authors: A Leumann, L Ebneter, V Von Tscharner, V Valderrabano
Journal: British Journal of Sports Medicine (2011)

Background Ankle sprains are the most frequent injury in sports. Up to 40% of acute sprains develop chronic ankle instability (CAI). CAI may be seen either as mechanical (ligamentous) instability or functional (neuromuscular) instability. So far, no method is known to objectivate functional instability. Purpose To measure neuromuscular patterns in patients with mechanical ligamentous CAI. Design Prospective cohort study. Setting and patients 15 Patients (age 15–58 years) were included evidencing chronic unilateral mechanical ankle instability undergoing ligament reconstruction. As control, the contralateral healthy ankle and 15 sex- and age-matched participants were used. Interventions Superficial Electromyography (EMG) analysis of four muscles were recorded: gastrocnemius medialis (GM), tibialis anterior (TA), peroneus longus (PL) and soleus (SO) while the patient performed single stance tests on a Biodex Balance System (BBS). Main outcome measurements EMG was analyzed by intensity and frequency using Wavelet Transformation. Neuromuscular controal was analyzed by the results of the BBS. Results CAI patients showed significantly decreased results in neuromuscular ankle joint control correlating to increased ankle pain. EMG analyses showed a significant decrease in frequency recruitment for the PL (average frequency, 138.3 Hz for the unstable ankle versus 158.3 Hz for the contralateral healthy side, p&lt;0.001). Instead, no change in intensity was found for the PL. For the GM, TA, and SO, changes neither for intensity, nor frequency were found. Conclusion This shift of frequency in the PL muscle due to chronic ligamentous ankle instability is the sign of lower muscle activation coming along with type II muscle atrophy. This is the first study to report on the fact that functional ankle instability may be measured as muscle damage seen by a shift in EMG frequency. Therefore, prevention and rehabilitation of chronic ligamentous instability has to address also a functional chronic muscle damage.
Boosting the Sensitivity of Real-Time Polymerase-Chain-Reaction Testing for SARS
Authors: Albert Cheung-Hoi Yu, Lok-Ting Lau, Yin-Wan Wendy Fung
Journal: New England Journal of Medicine (2004)

To the Editor: In view of recent concern about the recurrence of severe acute respiratory syndrome (SARS) in Guangdong, China, we would like to highlight the tremendous importance of sensitivity in...
Hospital formularies: need for continuous intervention.
Authors: J Feely, R Chan, L Cocoman, K Mulpeter, P O'Connor
Journal: BMJ (1990)

The effects of introducing a hospital formulary alone and with active intervention were compared prospectively with regard to drug costs and the quality of prescribing. Intervention comprised feedback on prescribing habits, peer comparison, and information on drugs. Aspects of prescribing that were not subjected to intervention did not alter. In the year in which intervention occurred generic prescribing rose by 50%; inappropriate prescribing and overall use of third generation cephalosporins fell; and compliance with the recommended list of drugs was good. Overall, drug costs remained static, compared with a projected increase of 0.25 m pounds; in a comparative control hospital drug costs rose by 18%. During the next year, when no form of intervention took place, previous gains were eroded and drug costs rose. Continuous intervention, review, and feedback are required if a formulary is to continue to achieve its objectives.
Activation of mitogen-activated protein kinases and activator protein-1 in myocardial infarction in rats
Authors: Naruhito Shimizu, Minoru Yoshiyama, Takashi Omura, Akihisa Hanatani, Shokei Kim, Kazuhide Takeuchi, Hiroshi Iwao, Junichi Yoshikawa
Journal: Cardiovascular Research (1998)

The purpose of this study was to examine the activation of mitogen-activated protein kinases (MAPK) plus activator protein-1 (AP-1) and nuclear factor-kB (NF-kB) DNA binding activities, all of which seem to be important in a signal transduction cascade upstream of the increased level of mRNA expression observed after myocardial infarction.Myocardial infarction was produced in Wistar rats. The activities of MAPKs in the ischemic region were measured using an in-gel kinase method or an in vitro kinase method. AP-1 and NF-kB binding was determined using an electrophoretic mobility shift assay. Levels of transforming growth factor beta-1(TGF-beta-1) and collagen I and III mRNAs were analyzed by Northern blot hybridization.p42 Extracellular signal-regulated kinase (ERK), p44ERK and p38MAPK activities increased 5.2-fold, 4.3-fold and 1.9-fold (P < 0.01), respectively, at 5 min after coronary artery ligation but returned to normal levels by 30 min. p55c-Jun NH2-terminal kinase (JNK) and p46JNK activities increased 4.0-fold and 3.2-fold (P < 0.01), respectively, at 15 min and returned to normal levels by 24 h after ligation. AP-1 DNA and NF-kB binding activities increased 8.7-fold and 7.1-fold (P < 0.01), respectively, at 3 days but returned to normal levels by 7 days after ligation. Interestingly, analyses of the levels of TGF-beta-1, collagen I and III mRNAs revealed increases of 6.3-fold, 15.2-fold and 12.0-fold (P < 0.01), respectively, at 1 week after myocardial infarction.Myocardial ischemia increased MAPK activities, which were followed by enhancement of AP-1 and NF-kB DNA binding activity in areas of myocardial infarction in rats. These signal transduction mechanisms may contribute to the myocardial ischemia and injury associated with myocardial infarction by causing an increased expression of TGF-beta-1 mRNA, collagen I and III in the area.
A New Look at Death
Authors: Robert J. Joynt
Journal: JAMA (1984)

Death concerns all of us and is a subject of interest as old as humankind. It is, therefore, surprising that a whole new look at death should have been initiated less than 20 years ago with publication of a report from the Ad Hoc Committee of the Harvard Medical School.<sup>1</sup>Reports from committees are, in many instances, deservedly ignored. It is equally surprising that a set of guidelines set up by one institution should have such wide acceptance. The ad hoc committee was chaired by Henry K. Beecher, MD, an anesthesiologist, and various disciplines were represented: neurology, psychiatry, neurosurgery, electroencephalography, theology, and law. There were two reasons for the report. First, the benignity of nature is such that the organs of the body, which are normally interdependent, usually die together. Unfortunately, the nervous system may not fit into this scheme. The result is a dead brain or a damaged
The Public's View of the Future of Health Care
Authors: Robert J. Blendon
Journal: JAMA (1988)

An analysis of more than two decades of poll results has identified six major trends in public opinion likely to affect the health care system of the 1990s. Americans favor more rather than less health spending, at least as long as the economy remains strong, and they do not think the deficit problem requires cuts in medical care outlays. Should there be a serious economic downturn, however, the public would reverse itself and would favor reduced spending that relies on a different set of strategies than those favored by most health policy experts, particularly in regard to spending for care for the elderly. In either case, the poll results suggest that Americans may be less inclined to participate in newer forms of medical practice, such as health maintenance organizations or preferred provider organizations, than anticipated, and that the commercialization of health care is leading to a decline in public confidence in the leaders of medicine. This latter trend may result in a lack of trust in professionals' views concerning the quality of care and may presage more stringent government involvement in and regulation of health services.
P86 Do We Need A Specific Guideline For The Management Of Aspiration Pneumonia (ap)?
Authors: S. Cormack
Journal: Thorax (2014)

<h3>Introduction and objectives</h3> Aspiration-related pneumonia accounts for 10–15% of cases hospitalised with community acquired pneumonia. Guideline-directed pathways for the diagnosis and management of AP are lacking in detail (BTS/ATS/IDSA). The local practice of assessing patients admitted with primary diagnosis of AP and outcome was evaluated in a large tertiary hospital in the UK. <h3>Methods</h3> A retrospective cohort study that reviewed the case notes of 34 consecutive patients admitted to hospital with a high likelihood for a diagnosis of community acquired aspiration pneumonia (CAAP). Aspiration risk assessment on admission, appropriate antimicrobial therapy, dietetic and Speech and Language Therapy (SALT) team input, airway assessment, length of hospital stay and mortality were included in the data analysis. <h3>Results</h3> A crude risk assessment for aspiration was performed in all patients on admission. An aspiration event was witnessed in 35% of cases. Pre-existing neurological pathology was the predominant risk factor (70%). Appropriate antimicrobial therapy was commenced within 4 h of admission in 14 (58%) cases. Airway assessment by a SALT team was performed in 4 patients within 48 h of admission. None of the patients underwent video fluoroscopy. An initial dietetic review within 72 h of admission was observed in 6 patients (18%). Median hospital stay was 8 days and in hospital mortality was 41%. <h3>Conclusion</h3> The study demonstrates a significant inconsistency in the initial management of patients hospitalised with AP. The lack of early intervention by SALT and dietetic services and routine video fluoroscopy use in the majority of patients is of concern. A specific guideline with an evidence based diagnostic pathwayand managementis needed for patients at high risk for AP.
Effect of graded doses of pentagastrin in patients with and without gastritis
Authors: A. Berstad, J. Myren
Journal: Gut (1970)

The effect of graded doses of pentagastrin on the gastric scretion of acid was compared in patients with and without gastritis. Biopsies were taken from the body of the stomach. Ten subjects had normal gastric mucosa, eight had superficial gastritis, and 10 atrophic gastritis. Pentagastrin in a dose of 1·5 μg/kg/hr elicited a near maximal HCl response from both the normal gastric mucosa and the mucosa with gastritis. The response to 0·3 μg/kg/hr was significantly lower than the response to 7·5 μg/kg/hr in the subjects with atrophic gastritis, while there was no significant difference in the response between the dose levels in the subjects with a normal mucosa.
Adjuvant Sequencing of Tamoxifen and Anastrozole Is Superior to Tamoxifen Alone in Postmenopausal Women with Low Proliferating Breast Cancer
Authors: Zsuzsanna Bago-Horvath, Margaretha Rudas, Peter Dubsky, Raimund Jakesz, Christian F. Singer, Ralf Kemmerling, Richard Greil, Andrea Jelen, Gerhard Böhm, Zerina Jasarevic, Anton Haid, Christine Gruber, Sabine Pöstlberger, Martin Filipits, Michael Gnant
Journal: Clinical Cancer Research (2011)

To assess the predictive value of Ki67 expression in postmenopausal hormone receptor-positive early-breast cancer patients, who were either treated with adjuvant tamoxifen (TAM) alone or with TAM followed by anastrozole (ANA).Expression of Ki67 was determined centrally by immunohistochemistry on whole tissue sections of postmenopausal endocrine-responsive breast cancers from patients who had been enrolled in the prospectively randomized Austrian Breast and Colorectal Cancer Study Group Trial 8, and had received TAM for 5 years, or TAM for 2 years followed by ANA for 3 years. Ki67 expression was evaluated both as a continuous variable and dichotomized to low (≤10%) and high (>10%). Recurrence-free survival (RFS) and overall survival (OS) were analyzed using Cox models adjusted for clinical and pathologic parameters.Patients with a high Ki67 expression (394/1,587; 23%) had a significantly shorter RFS (adjusted HR for recurrence = 1.90, 95% CI: 1.37-2.64, P = 0.0001) and OS (adjusted HR for death = 1.78, 95% CI: 1.18-2.70, P = 0.006). In women with breast tumors expressing medium or high ER levels (n = 1,438), the interaction between Ki67 and adjuvant endocrine treatment was significant for RFS (P = 0.03). TAM followed by ANA was superior to TAM alone in patients with low Ki67 (adjusted HR = 0.53, 95% CI: 0.34-0.83, P = 0.005) but not in high Ki67 disease (adjusted HR = 1.18, 95% CI: 0.66-1.89, P = 0.68).Adjuvant sequencing of TAM and ANA is superior to TAM alone, particularly in postmenopausal women with medium or high ER expressing, low proliferating breast cancer.
Response Assessment of Hormonal Therapy in Prostate Cancer by [11C] Choline PET/CT
Authors: Alexandra De Waele, Sofie Van Binnebeek, Felix M. Mottaghy
Journal: Clinical Nuclear Medicine (2010)

A 57-year-old man with an adenocarcinoma of the prostate, presented with multiple lymph nodes in the para-aortic and right iliac region on computer tomography (CT). However, since the radiologic images were taken 3 weeks following an urosepsis, the differentiation between inflamed and metastatic lymph nodes is difficult. Thus, an integrated [C] choline positron emission tomography and computer tomography (PET/CT) was performed, showing multiple lymph nodes. The patient was staged as cT3N1M0 and treated with hormonal therapy. The choline PET/CT performed after hormonal treatment showed no more hypermetabolic lymph nodes. This case substantiate the hypothesis that choline PET/CT could be used to evaluate therapy response in prostate cancer patients.
INTELLIGENCE OF NORMAL AND EPILEPTIC TWINS
Authors: WILLIAM G. LENNOX, A. L. COLLINS
Journal: American Journal of Psychiatry (1945)

Intelligence tests were carried out on 93 twins or 186 co-twins. Of these 63 twins were without history of epilepsy or brain injury and 30 had a history of seizures. The average I. Q. for the 149 non-epileptic persons was 108. For the 27 persons with epilepsy but without definite evidence of brain injury, 96; and for the 10 epileptics with brain injury, 77. Among monozygotic twins the difference between the average high and low scores of 47 non-epileptic twins was six points. Among seven monozygotic twins in which both co-twins had chronic epilepsy, the spread was seven points. Among six pairs in which only one co-twin had epilepsy, the spread was five points and among the eight twins in which only one had chronic epilepsy and also evidence of brain injury, the spread was 30 points or six times the spread in normal twins. Among dizygotic twins the average spread between high and low scores was 10 points for 16 non-epileptic twins and 23 points for seven twins in which one had chronic seizures. In only two of these twins had the epileptic co-twin suffered brain injury. These data emphasize that with a good mental inheritance a patient is able to maintain a normal intelligence in spite of epilepsy, but that acquired gross pathology of the brain has a serious effect on mentality. In other words, contrary to common medical opinion, a person with a normal mentality who develops idiopathic (genetic) epilepsy is much less likely to become mentally deteriorated than a person who develops symptomatic (acquired) epilepsy.
Detection of platelet isoantibodies by (3H)serotonin platelet release and its clinical application to the problem of platelet matching.
Authors: J P Gockerman, R P Bowman, M E Conrad
Journal: Journal of Clinical Investigation (1975)

The detection of platelet isoantibodies by the release of (3H)serotonin from platelets has been evaluated. The conditions for optimal release of (3H)serotonin with platelet isoantibodies using a microtechnique have been defined. A group of cardiac surgery patients were followed pre- and post-transfusions, with 48percent developing a positive serotonin release assay. Of these patients, 16percent also had a platelet complement-fixing and/or lymphocytotoxic isoantibody. There was variation in the degree of correlation between (3H)serotonin release and lymphocytotoxicity using individual National Institutes of Health typing serum. The matching obtained between family members by both techniques showed a close correlation when each technique was evaluated separately using the same NIH typing serum. The detection of iso-antibodies in patients with hematological malignancies correlated with the unresponsiveness to unmatched platelet transfusions in 15 out of 17 cases. The use of the patient's isoantibody to matched platelets of family members by (3H)serotonin release correlated well with the clinical response to transfusion with these platelets. The data suggest that (a) platelet isoantibodies can be detected with increased frequency by (3H)serotonin release; (b) (3H)serotonin release is a specific reaction depending on the surface antigen of the platelet; and (c) the method can be used to match compatible family members for platelet transfusions.
Spontaneous haemoperitoneum from rupture of a primary hepatic adenoma in an adult man--an update.
Authors: P D McInerney
Journal: Gut (1988)

an important predisposing factor, but that progres- sive oesophageal mucosal damage may exacerbate the problem, thus establishing a vicious cycle.Fortunately, this latter component appears to be reversible by effective reflux control.In these circum- stances, the association of reflux oesophagitis, not only with abnormalities of oesophageal body motility, but also with impaired gastric emptying' and duo- denogastric reflux7 suggests that gastrooesophageal reflux may well be part of a diffuse upper gastro- intestinal motility disorder.
Timing of Tuberculosis Transmission and the Impact of Household Contact Tracing. An Agent-based Simulation Model
Authors: Parastu Kasaie, Jason R. Andrews, W. David Kelton, David W. Dowdy
Journal: American Journal of Respiratory and Critical Care Medicine (2014)

Household contact tracing has recently been endorsed for global tuberculosis (TB) control, but its potential population-level impact remains uncertain.To project the maximum impact of household contact tracing for TB in a moderate-burden setting.We developed a stochastic, agent-based simulation model of a simplified TB epidemic, calibrated to a setting of moderate TB incidence. We used data from the literature to generate "community-driven" and "household-driven" scenarios in which 22 and 50% of TB transmission occurred within the household, respectively. In each scenario, we simulated an intervention in which the household members are screened and treated for TB at the time of an index patient's active TB diagnosis.By the time of TB diagnosis, 75 to 95% of initial household infections had already occurred, but only 1.5 to 3.0% of contacts had sufficient time to progress to active TB. With 100% sensitive tracing of all contacts for 5 consecutive years, TB incidence declined by 10 to 15%, with a mean year-over-year decline of 2% per year. Effects were sustained for many years after stopping the intervention. Providing preventive therapy with contact tracing nearly doubled this impact (17-27% decline in incidence). Impact was proportional to sensitivity and coverage; thus, if 50% of contacts were screened with a 50% sensitive test, TB incidence declined by only 0.5% per year.Household contact tracing is unlikely to transform TB epidemiology in isolation but has the potential, especially with provision of preventive therapy, to augment a comprehensive package of interventions that could substantially reduce the population-level burden of TB.
Mild hypothermia for post cardiac arrest syndrome
Authors: Jasmeet Soar, Jerry P Nolan
Journal: BMJ (2007)

Is recommended by evidence based guidelines yet uptake remains poor

Most people who have a cardiac arrest die. Many who are resuscitated subsequently die over the next few hours or days, and those who survive are at risk of cognitive dysfunction. This gloomy reality has prompted research into interventions to improve the prognosis of cardiac arrest; one of these interventions is the induction of mild hypothermia after spontaneous circulation has been restored.

Apart from patients resuscitated from a very brief cardiac arrest, most survivors will be comatose initially, and those without extensive comorbidity will be admitted to an intensive care unit. Unconscious, mechanically ventilated survivors of cardiac arrest account for one in 17 of all admissions to intensive care in the United Kingdom.1 A third of these patients survive to hospital discharge. In one centre, two thirds of deaths in intensive care in initial survivors of cardiac arrest that occurred out of hospital, and a quarter of deaths after cardiac arrest that occurred in hospital, were attributed primarily to a neurological cause.2

Organ injury caused by …
Abstract 4691: Rationale for combining PARP inhibitors with topotecan or irinotecan: taking advantage of the alternative DNA repair pathways involving XPF-ERCC1 and PARP-TDP1
Authors: Yongwei Zhang, Marie Regairaz, Jennifer Seiler, Keli Agama, James Doroshow, Yves Pommier
Journal: Cancer Research (2012)

Abstract Poly(ADP-Ribose) (PAR) polymerase (PARP) inhibitors represent an important class of novel anticancer agents. The present study explores the molecular rationale for combining veliparib (ABT-888) with camptothecin (CPT) and its clinical derivatives, topotecan and irinotecan. ABT-888 inhibited PAR induction by CPT and increased CPT-induced cell killing and DNA damage measured by histone gamma-H2AX and comet assays. Notably, increased DNA breaks by ABT-888 was not associated with a corresponding increase of topoisomerase I cleavage complexes (Top1cc). Also, ABT-888 failed to further enhance the gamma-H2AX response in tyrosyl-DNA-phosphodiesterase (TDP1) knockout cells, which indicates that PARP inhibition no longer enhances Top1-induced DNA damage once TDP1 is inactivated. To explore alternative endonuclease pathway for the repair of Top1cc upon PARP inhibition, we tested the role of the 3′-flap endonuclease XPF-ERCC1. XPF-ERCC1 inactivation reduced the ABT-888-induced gamma-H2AX response both in non-replicating and replicating cells, and further enhanced the antiproliferative effect of ABT-888 in CPT-treated cells. Together, our findings demonstrate that XPF-ERCC1 acts as an alternative endonuclease pathway for the repair of Top1-induced DNA damage. Its function becomes critical when the PARP-TDP1 excision repair pathway is inactivated. Our study suggests the rationale for combining Top1 and PARP inhibitors in tumors with XPF-ERCC1 deficiency. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4691. doi:1538-7445.AM2012-4691
Pensions and the freeze.
Authors: M S Campbell
Journal: BMJ (1978)

disease.The latter disease may be more common than what was conveniently known as Friedlander's pneumonia, due to infection with K edwardsii or K atla7itae, and must be considered in all severe cases of pneumonia.For this reason and for the very wide anti- bacterial spectrum, I would advocate that gentamicin and erythromycin be regarded as the drug combination of choice in the face of fulminating pneumonia, particularly one which is not responding to treatment with a penicillin or tetracycline.The combination of gentamicin and erythromycin not only has the virtue that it will cover almost the whole range of bacterial infections, excluding tuberculosis, but also includes cover for at least some Bacteroides species, which, admittedly, are very rare causes of pneumonia, and will be effective against Mybcoplasrna pneunioniiae infection, though this is rarely the cause of life-threatening disease.The recently suggested alternative' of tetracycline and rifampicin might not have the same wide spectrum cover against Gram- negative bacteria.