tbuckley/cabot-search huggingface dataset:
Dual energy CT in gout: a prospective validation study
Authors: Hyon K Choi, Lindsay C Burns, Kamran Shojania, Nicole Koenig, Graham Reid, Mohammed Abufayyah, Genevieve Law, Alison S Kydd, Hugue Ouellette, Savvas Nicolaou
Journal: Annals of the Rheumatic Diseases (2012)

<h3>Objective</h3> The authors prospectively determined: (1) the specificity and sensitivity of dual energy CT (DECT) for gout; and (2) the interobserver and intraobserver reproducibility for DECT urate volume measurements. <h3>Methods</h3> Forty crystal-proven gout patients (17 tophaceous) and 40 controls with other arthritic conditions prospectively underwent DECT scans of all peripheral joints using a gout protocol that color-codes the composition of tissues. A blinded radiologist identified urate deposition to calculate specificity and sensitivity of DECT for gout. Inter-rater volumetric reproducibility was determined by two independent radiologists on 40 index tophi from the 17 tophaceous gout patients using automated software. <h3>Results</h3> The mean age of the 40 gout patients was 62 years, the mean gout duration was 13 years and 87% had a history of urate-lowering therapy (ULT). The specificity and sensitivity of DECT for gout were 0.93 (95% CI, 0.80 to 0.98) and 0.78 (0.62 to 0.89), respectively. When the authors excluded three gout cases with unreadable or incomplete scans, the sensitivity was 0.84 (95% CI, 0.68 to 0.94). The urate volumes of 40 index tophi ranged from 0.06 cm<sup>3</sup> to 18.74 cm<sup>3</sup> with a mean of 2.45 cm<sup>3</sup>. Interobserver and intraobserver intraclass correlation coefficients for DECT volume measurements were 1.00 (95% CI, 1.00 to 1.00) and 1.00 (95% CI, 1.00 to 1.00) with corresponding bias estimates (SD) of 0.01 (0.00) cm<sup>3</sup> and 0.01 (0.03) cm<sup>3</sup>. <h3>Conclusions</h3> These prospective data indicate high reproducibility of DECT urate volume measures. The specificity was high, but sensitivity was more moderate, potentially due to frequent ULT use in our patients.
High proportion of trials published in Chinese medical journals are flawed, study shows
Authors: J. Wise
Journal: BMJ (2009)

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Variation in Precursor Lesions of Pancreatic Cancer among High-Risk Groups
Authors: Thomas P. Potjer, Ingrid Schot, Peter Langer, Johannes T. Heverhagen, Martin N.J.M. Wasser, Emily P. Slater, Günter Klöppel, Hans M. Morreau, Bert A. Bonsing, Wouter H. de Vos tot Nederveen Cappel, Mathias Bargello, Thomas M. Gress, Hans F.A. Vasen, Detlef K. Bartsch
Journal: Clinical Cancer Research (2012)

Pancreatic ductal adenocarcinoma (PDAC) surveillance programs are currently offered to high-risk individuals aiming to detect precursor lesions or PDAC at an early stage. We assessed differences in frequency and behavior of precursor lesions and PDAC between two high-risk groups.Individuals with a p16-Leiden germline mutation (N = 116; median age 54 years) and individuals from familial pancreatic cancer (FPC) families (N = 125; median age 47 years) were offered annual surveillance by MRI and magnetic resonance cholangiopancreatography (MRCP) with or without endoscopic ultrasound (EUS) for a median surveillance period of 34 months (0-127 months) or 36 months (0-110 months), respectively. Detailed information was collected on pancreatic cystic lesions detected on MRCP and precursor lesions in surgical specimens of patients who underwent pancreatic surgery.Cystic lesions were more common in the FPC cohort (42% vs. 16% in p16-Leiden cohort), whereas PDAC was more common in the p16-Leiden cohort (7% vs. 0.8% in FPC cohort). Intraductal papillary mucinous neoplasm (IPMN) was a common finding in surgical specimens of FPC-individuals, and was only found in two patients of the p16-Leiden cohort. In the p16-Leiden cohort, a substantial proportion of cystic lesions showed growth or malignant transformation during follow-up, whereas in FPC individuals most cystic lesions remain stable.In p16-Leiden mutation carriers, cystic lesions have a higher malignant potential than in FPC-individuals. On the basis of these findings, a more intensive surveillance program may be considered in this high-risk group.
WHAT IS THE ROLE OF KEY SPORTS SAFETY AGENCIES IN THE DEVELOPMENT AND DISSEMINATION OF SPORT SAFETY POLICIES FOR COMMUNITY SPORT SETTINGS?
Authors: S Bekker, P White, A Donaldson, J Cook, B Gabbe, D Lloyd, CF Finch
Journal: British Journal of Sports Medicine (2014)

Background Although sports clubs have a responsibility to protect their players with a safe training and playing environment, little is known about actual safety policies and procedures adopted by community sports clubs. Currently, there is no definitive macro-level sport safety policy available for clubs to implement in Australia. Community sports clubs use micro-policies around issues deemed relevant to their club, which are sourced from various agencies. Objective This presentation will describe the full range of safety resources (policy documents, guidelines, action plans, research papers, fact sheets, posters, and procedures) as developed and disseminated online by key sports safety agencies in Australia. The gaps and duplications in the set of safety resources will also be identified. Finally, a recommendation around the safety needs of community sports clubs with regards to a macro sports safety policy that covers all relevant aspects which can easily be implemented and adopted will be made. Design Document analysis as a qualitative research method. Sources Online sport safety documents from key sport safety agencies in Australia. Main outcome measurements To determine the relevant sport safety resources available online to community sport clubs through key sport safety agencies. Results A collated list of recommended sport safety policies and procedures as developed and disseminated online by key sport safety agencies in Australia, for use by community sports clubs. An analysis of the gaps in current sports safety policy is also discussed. Conclusions Sport safety policies and procedures are currently provided in the form of micro-polices that cover single issues (SunSmart, blood rule, concussion policy etc). It is recommended that key sport safety agencies collaborate to develop a macro-level policy around sport safety that comprehensively covers the full spectrum of safety under one plan that can be easily accessed, adapted and implemented in a variety of community sports club settings.
Effectiveness of Olanzapine, Quetiapine, and Risperidone in Patients With Chronic Schizophrenia After Discontinuing Perphenazine: A CATIE Study
Authors: T. Scott Stroup, Jeffrey A. Lieberman, Joseph P. McEvoy, Marvin S. Swartz, Sonia M. Davis, George A. Capuano, Robert A. Rosenheck, Richard S.E. Keefe, Alexander L. Miller, Irving Belz, John K. Hsiao,
Journal: American Journal of Psychiatry (2007)

The relative effectiveness of newly started antipsychotic drugs for individuals with schizophrenia may depend on multiple factors, including each patient's previous treatment response and the reason for a new medication trial. This randomized, double-blind study compared olanzapine, quetiapine, and risperidone in patients who had just discontinued the older antipsychotic perphenazine.Subjects with schizophrenia (N=114) who had been randomly assigned to and then discontinued perphenazine in phase 1 of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia study were reassigned randomly to double-blinded treatment with olanzapine, 7.5-30.0 mg/day (N=38); quetiapine, 200-800 mg/day (N=38); or risperidone, 1.5-6.0 mg/day (N=38). The primary aim was to determine whether there were differences among these three treatments in effectiveness, as measured by time to treatment discontinuation for any reason. Secondary outcomes included reasons for treatment discontinuation and measures of drug tolerability.The time to treatment discontinuation was longer for patients treated with quetiapine (median, 9.9 months) and olanzapine (7.1 months) than with risperidone (3.6 months). There were no significant differences between treatments on discontinuation due to inefficacy, intolerability, or patient decision.Among this group of patients with chronic schizophrenia who had just discontinued the older antipsychotic perphenazine, quetiapine and olanzapine were more effective than risperidone, as reflected by longer time to discontinuation for any reason. In the context of other results from the CATIE study, the effectiveness and acceptability of antipsychotic drugs appears to vary considerably according to clinical circumstances.
Doctors, detectives, and common sense
Authors: Alexander McCall Smith
Journal: BMJ (2005)

<h3>Introduction</h3> Newham University Hospital, Bart’s NHS Trust, serves the London Borough of Newham which had the highest incidence of tuberculosis in the UK at 78.0 per 100,000 in 2014. Newham also has the highest average annual rate of new reported acute hepatitis B infection in the UK. There have been clear guidelines on pre-biologic screening for opportunistic infections since 2014. Our aim is to assess whether patients who are on biologic therapy have been appropriately screened prior to initiation of biologic therapy. <h3>Methods</h3> A retrospective review of all IBD patients on the biologic database was performed in November 2019. Patients who were initiated on biologics prior to the publication of guidelines in June 2014 were excluded. <h3>Results</h3> The total number of patients was 63. 31 patients (49.2%) had latent tuberculosis testing with Interferon-gamma release assay (IGRA) testing and 2 were positive. Screening with Chest XR (CXR) was better with 58.9% concordance. 36 patients had normal CXRs and 1 had an appearance of a granuloma. In comparison, viral screening had higher completion rates. Hepatitis B Surface Antigen (HbsAg) was sent in 53 patients (84%) and all were negative. Hepatitis B Core Antibody (HbcAb) was sent in 23 patients (36.5%) and 1 was positive. 1 patient was HbcAb positive but HbsAg negative. In terms of Hepatitis C, 51 patients (80.9%) had Hepatitis C IgG sent and all were negative. All 50 patients (79.3%) who were tested for Human immunodeficiency virus (HIV I+II antibody) were negative. Ebstein Bar Virus IgG was sent in 20 patients (31.7%), out of which, 15 were negative. Varicella-Zoster Virus IgG was sent in 39 patients (61.9%) and 2 were positive. An infection history was not taken, for either bacterial, fungal or viral infections and Bacille Calmette-Guerin vaccination status was not documented. No documentation was present regarding measles status. Routine vaccination status was not confirmed for diphtheria, poliomyelitis, pertussis, tetanus or Human Papilloma Virus. Prior to initiation of immunomodulation, vaccination was not considered for pneumococcal or influenza infections. <h3>Conclusions</h3> Despite suboptimal pre biologics screening in this high risk region of East London for Tuberculosis and Hepatitis B, no cases of reactivation of either Tuberculosis or Hepatitis B have been identified to date. The results suggest that clinicans are requesting some tests but not all. Following on from these results, we will be streamlining the process for ensuring all tests are performed prior to biologic initiation with a checklist proforma for the patients notes and on our biologics database for all prescribing gastroenterologists, as per ECCO guidelines.
Abstract SY35-03: Novel anti-tumor activity of targeted LSD1 inhibition
Authors: Ryan G. Kruger
Journal: Cancer Research (2014)

Abstract Lysine specific demethylase 1 (LSD1) is a histone H3K4me1/2 demethylase found in various transcriptional co-repressor complexes. These complexes include Histone Deacetylases (HDAC1/2) and Co-Repressor for Element-1-Silencing Transcription factor (CoREST). LSD1 mediated H3K4 demethylation can result in a repressive chromatin environment that silences gene expression and has been shown to play a role in development. LSD1 can interact with pluripotency factors in human embryonic stem cells and is essential for decommissioning enhancers in stem cell differentiation. Beyond embryonic settings, LSD1 is also critical for hematopoietic differentiation. LSD1 dysregulation plays a key role in cancer and LSD1 is overexpressed in multiple tumor types, including acute myeloid leukemia (AML). Recent literature suggests inhibition of LSD1 reactivates the all-trans retinoic acid differentiation pathway in AML. Together, these observations suggest LSD1 is an important regulator of the epigenome that modulates gene expression through post-translational modification of histones and its presence in transcriptional complexes. The current study describes the anti-tumor effects of a novel LSD1 inhibitor (GSK2879552). GSK2879552 is a potent, selective, mechanism-based irreversible inhibitor of LSD1 currently in clinical development. Screening of over 150 cancer cell lines revealed that while many tumor types appear resistant to LSD1 inhibition, specific tumor types were uniquely sensitive. For example, AML cells have a distinct requirement for LSD1, and LSD1 inhibition results in a prodifferentiation effect in this setting. Preclinical characterization of the anti-tumor activities of GSK2879552 both in vitro and in vivo in AML as well as the solid tumor setting will be discussed. All studies were conducted in accordance with the GSK Policy on the Care, Welfare and Treatment of Laboratory Animals and were reviewed the Institutional Animal Care and Use Committee either at GSK or by the ethical review process at the institution where the work was performed. Citation Format: Ryan G. Kruger. Novel anti-tumor activity of targeted LSD1 inhibition. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr SY35-03. doi:10.1158/1538-7445.AM2014-SY35-03
Neurochemical Mechanisms of Opiates and Endorphins
Authors: Lawrence D. Grouse
Journal: JAMA (1980)

This volume comprises 21 articles that present a fairly complete survey of current opiate research. As such, it is a primary resource for scientists working with opiates and opiate peptides. However, the research it presents is also of considerable exemplary value to other neurobiologists and to neuropharmacologists. Unfortunately, in a scientific area where the tempo of discovery is extremely rapid, it is difficult for an edition of this sort to remain current for long. Moreover, due to the youth of this field, many of the biochemical details of the synthesis of the opiate peptides and their precursor forms are sketchy, and the theories of the activities and the actions of the peptides remain tentative. It would be premature to take the title of the volume too seriously in terms of providing a final integrated view of the mechanism of opiates and endorphins. This should not be interpreted as a criticism
The Role of Medical Necessity and Cost-Effectiveness in Making Medical Decisions
Authors: Peter A. Glassman, Karyn E. Model, James P. Kahan, Peter D. Jacobson, John W. Peabody
Journal: Annals of Internal Medicine (1997)

The term "medical necessity" is used ubiquitously in health care, but its meaning and implementation vary substantially among providers, payers, and patients.This ambiguity has led some to suggest that cost-effectiveness be used as a basis for decision rules. This paper presents an analytical framework that is familiar to clinicians and shows that medical necessity and cost-effectiveness do not provide deterministic rules for clinical decision making. First, 2 × 2 tables are used to show the tradeoff between the sensitivity and specificity of decision rules. Then, the example of asymptomatic abdominal aortic aneurysm is used to show that these tradeoffs can be seen as a continuum of decision rules on a receiver-operating characteristic curve. Society can therefore choose a decision threshold on the basis of medical necessity that optimizes the number of lives saved or any other desired outcome, but the tradeoff between sensitivity and specificity cannot be avoided. Applying cost-effectiveness criteria may change the decision threshold because cost-effectiveness itself involves inherent tradeoffs that create additional ambiguity for clinical decisions. The conclusion is that decision rules based on medical necessity or cost-effectiveness should not be considered deterministic. Rather, decision rules are useful when they make assumptions explicit and specify tradeoffs so that clinicians, patients, and payers can make better decisions.
Glomerular-specific protein kinase C-β-induced insulin receptor substrate-1 dysfunction and insulin resistance in rat models of diabetes and obesity
Authors: Akira Mima, Yuzuru Ohshiro, Munehiro Kitada, Motonobu Matsumoto, Pedro Geraldes, Chenzhong Li, Qian Li, Gregory S. White, Christopher Cahill, Christian Rask-Madsen, George L. King
Journal: Kidney International (2011)
Repression of Gadd45α by activated FLT3 and GM-CSF receptor mutants contributes to growth, survival and blocked differentiation
Authors: M Perugini, C H Kok, A L Brown, C R Wilkinson, D G Salerno, S M Young, S M Diakiw, I D Lewis, T J Gonda, R J D'Andrea
Journal: Leukemia (2009)
The errr-portfolio
Authors: D. Spence
Journal: BMJ (2009)

There was no need for a pipe, old school tie inspection, or manly back slapping. But punctuality, hard work, being pleasant, passing your exams, and conforming to professional norms saw doctors admitted to their chosen postgraduate specialty. Educational assessment was down to judgment and opinion. Problems were dealt with by a quiet word and some remedial intervention. However, these were the dark ages of the 1990s, and now education has “uniform validated assessments,” all overseen by expensive and distant “inclusive” quangos full of Whitehall grandees and …
Absence of IL-12Rβ2 in CD33+CD38+ pediatric acute myeloid leukemia cells favours progression in NOD/SCID/IL2RγC-deficient mice
Authors: E Ferretti, D Montagna, E Di Carlo, C Cocco, D Ribatti, E Ognio, C Sorrentino, D Lisini, A Bertaina, F Locatelli, V Pistoia, I Airoldi
Journal: Leukemia (2011)
Official Torture and Human Rights: The American Courts and International Law
Authors: William J. Curran
Journal: New England Journal of Medicine (1981)

PHYSICIANS have a particular interest in the prevention of torture and in the effective punishment of barbarous acts of official torture by police and other government agencies. The profession of medicine is based fundamentally on the premise: do no harm. Physicians are often called on to examine the victims of torture. Competent medical evaluation is usually essential to proof of the use of torture on a person. Medical-ethics groups have condemned participation in official torture by the medical profession — or its tacit support — through supplying medical facilities or services to agencies conducting torture. The primary international pronouncement in . . .
Diabetic End-Stage Renal Disease Among Native Americans
Authors: Ben Muneta, Jeff Newman, John Stevenson, Paul Eggers
Journal: Diabetes Care (1993)

OBJECTIVE— To examine why ESRD has become a major source of morbidity and mortality for Native Americans with diabetes mellitus. RESEARCH DESIGN AND METHODS— Using data from the Medicare ESRD Program, we examined incidence rates for ESRD among Native Americans for the years 1983–1987. RESULTS–During this period, the annual incidence of total ESRD in Native Americans increased by 18%, from 170.5/million to 200.1/million. The incidence of diabetic ESRD increased by 47%, from 80.6/million to 118.2/million. In 1987, the age-adjusted incidence rate of diabetic ESRD was 6.8 times higher in Native Americans than in whites. CONCLUSIONS— Recommendations for the prevention of diabetic ESRD include early identification of renal disease and improved control of hypertension and blood glucose. The magnitude of diabetic ESRD among Native Americans also underscores the need for primary prevention of non-insulin-dependent diabetes mellitus.
Breast conservation: factors predictive of residual disease following reoperation for narrow surgical margins.
Authors: P Forouhi, DH Brahmbhatt, JR Benson, GC Wishart
Journal: Cancer Research (2009)

Abstract Abstract #5152 Introduction:&amp;#x2028; Ensuring pathologically tumor free surgical margins reduces local recurrence rates following breast conserving surgery for breast cancer or DCIS. There is no general agreement regarding the definition of a clear margin but units with an agreed policy report reduced local recurrence rates. In our unit all patients with a surgical clearance of &amp;lt;5mm are offered further surgery either by mastectomy or by re-excision. We have examined factors that may predict residual disease in re-excised tissues.&amp;#x2028; Method:&amp;#x2028; All attempted breast conserving operations between 01/01/2004 to 31/09/2007 were identified from a dedicated database. Patient age, presentation (symptomatic or screening), surgeon (any of 4 surgeons), weight of tissue removed, tumour size, grade, presence of lymphovascular invasion (LVI) and the closest radial margin (categorised as involved, &amp;lt;2mm, 2-5mm) were examined.&amp;#x2028; Results:&amp;#x2028; Breast conservation was attempted in 605 women (mean age 60; 297 symptomatic, 308 screening). Further surgery was performed in 166 (27.4%) women, including 89 (14.7%) mastectomies. Median tumour size was 20mm (range 0-109). Residual disease was found in 83(50%) of re excisions (66/111 with involved margins, 16/40 for non involved margins up to 2mm, and 1/15 for margins over 2mm). On univariate analysis excision margin (OR=0.33, p=0.000) and total tumor size (OR=4.0 p=0.045 for the smallest size quartile versus the largest) were associated with residual disease. On multivariate analysis only tumor margin remained predictive (OR for &amp;lt;2mm vs involved: 0.46, p=0.043; OR for 2-5mm vs involved: 0.05, p=0.004).&amp;#x2028; Conclusion:&amp;#x2028; In a unit with an aggressive re-excision policy, involved or close surgical margins predict the presence of residual disease in re-excision specimens. A margin of greater than 2mm reduces the risk of residual disease to 1/20 of that seen with microscopically involved margins. This study supports a 2mm minimum radial margin policy when attempting breast conservation for breast malignancy. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5152.
Cigarette Smoking and Peripheral Atherosclerotic Occlusive Disease
Authors: Jere W. Lord
Journal: JAMA (1965)

IN THE COURSE of the practice of general and vascular surgery, an interesting observation was made while taking the history of nondiabetic patients complaining of pains or aches in their legs. If the reply to the question, "Are you a heavy cigarette smoker?" was "no," then rarely would the trouble prove to be due to peripheral arterial occlusive disease on an atherosclerotic basis. Rather, an explanation for the leg pains would be found in the area of sciatic nerve involvement, varicose veins, or arthritic joint; or occasionally no lesion would be demonstrable. This observation seemed to be so constant that a detailed review of patients operated upon in my private practice for occlusive arterial disease was made. <h3>Definitions</h3> Heavy Cigarette Smoker: a man or woman who consumed one pack of cigarettes or more daily for 20 years or longer. Casual Cigarette Smoker: a man or woman who consumed