tbuckley/cabot-search huggingface dataset:
Interventions for the Treatment and Management of Chronic Fatigue Syndrome
Authors: Penny Whiting, Anne-Marie Bagnall, Amanda J. Sowden, John E. Cornell, Cynthia D. Mulrow, Gilbert Ramírez
Journal: JAMA (2001)

ContextA variety of interventions have been used in the treatment and management of chronic fatigue syndrome (CFS). Currently, debate exists among health care professionals and patients about appropriate strategies for management.ObjectiveTo assess the effectiveness of all interventions that have been evaluated for use in the treatment or management of CFS in adults or children.Data SourcesNineteen specialist databases were searched from inception to either January or July 2000 for published or unpublished studies in any language. The search was updated through October 2000 using PubMed. Other sources included scanning citations, Internet searching, contacting experts, and online requests for articles.Study SelectionControlled trials (randomized or nonrandomized) that evaluated interventions in patients diagnosed as having CFS according to any criteria were included. Study inclusion was assessed independently by 2 reviewers. Of 350 studies initially identified, 44 met inclusion criteria, including 36 randomized controlled trials and 8 controlled trials.Data ExtractionData extraction was conducted by 1 reviewer and checked by a second. Validity assessment was carried out by 2 reviewers with disagreements resolved by consensus. A qualitative synthesis was carried out and studies were grouped according to type of intervention and outcomes assessed.Data SynthesisThe number of participants included in each trial ranged from 12 to 326, with a total of 2801 participants included in the 44 trials combined. Across the studies, 38 different outcomes were evaluated using about 130 different scales or types of measurement. Studies were grouped into 6 different categories. In the behavioral category, graded exercise therapy and cognitive behavioral therapy showed positive results and also scored highly on the validity assessment. In the immunological category, both immunoglobulin and hydrocortisone showed some limited effects but, overall, the evidence was inconclusive. There was insufficient evidence about effectiveness in the other 4 categories (pharmacological, supplements, complementary/alternative, and other interventions).ConclusionsOverall, the interventions demonstrated mixed results in terms of effectiveness. All conclusions about effectiveness should be considered together with the methodological inadequacies of the studies. Interventions which have shown promising results include cognitive behavioral therapy and graded exercise therapy. Further research into these and other treatments is required using standardized outcome measures.
Effects of "Pacatal" on Symptoms in Chronic Psychotic Female In-patients
Authors: P. H. Mitchell, P. Sykes, A. King
Journal: BMJ (1957)

<h3>Background and importance</h3> The effectiveness that the new migraine drugs have demonstrated is as much less as compared to placebo, so it is important to know the effectiveness in real life. <h3>Aim and objectives</h3> Determine the efficacy of anti-migraine monoclonal antibody treatments in our Health Area. <h3>Material and methods</h3> Retrospective observational study in which all patients undergoing treatment with any biological drug for migraine prophylaxis were included and their demographic data were recorded. It was classified as chronic migraine when the patient suffered more than 15 days of migraine per month (MMD) and episodic when they had more than 8 MMD. DMMs were recorded at the start of treatment and efficacy was reassessed after at least 3 months of continuous treatment. <h3>Results</h3> A total of 38 patients, with an average age of 41.3 years, and 80% women, began treatment with anti-migraine biologics in our centre: 14 did so with galacanezumab, 13 with erenumab and 8 with fremanezumab, according to efficiency criteria in every moment. 29% had chronic migraine. The mean baseline MMD was 11.4 and the mean MMD at re-evaluation was 3.5 days, registering an overall reduction of 7.9 MMD. 7.8% of the patients (2 with 10 baseline MMD and 1 with 8 MMD) were able to reduce the MMD to 0. <h3>Conclusion and relevance</h3> In our sample, a global reduction in monthly migraine days of 7.9 compared to baseline was observed and 8% of patients went on to not having any migraine days. <h3>References and/or acknowledgements</h3> <h3>Conflict of interest</h3> No conflict of interest
Regulatory iNKT cells lack expression of the transcription factor PLZF and control the homeostasis of Treg cells and macrophages in adipose tissue
Authors: Lydia Lynch, Xavier Michelet, Sai Zhang, Patrick J Brennan, Ashley Moseman, Chantel Lester, Gurdyal Besra, Emilie E Vomhof-Dekrey, Mike Tighe, Hui-Fern Koay, Dale I Godfrey, Elizabeth A Leadbetter, Derek B Sant'Angelo, Ulrich von Andrian, Michael B Brenner
Journal: Nature Immunology (2014)
Breast cancer screening for younger women is not an efficient use of resources
Authors: M. Baum
Journal: BMJ (1997)

Nicotine replacement therapy should be prescribable on NHSEditor-I welcome the publication of the open letter to the prime minister about tobacco-the most important preventable cause of death in Europe. 1 As Jo E Asvall points out in the letter, tobacco control demands the support of, and action by, the total government, not just the Department of Health.Among the actions Asvall calls for is that "support for smoking cessation is made widely available, particularly through primary health care professionals, including doctors, nurses, pharmacists, and dentists."Nicotine replacement therapy (nicotine gum, patches, nasal spray, and oral inhaler) is now fully established as an effective adjunct to such professional advice and support.Systematic review of many trials has shown a doubling of sustained smoking cessation when nicotine replacement therapy is compared with placebo. 2 The offer of nicotine patches to motivated subjects for a week in the first instance could be a useful policy. 3 But the recommendation of such therapy by health professionals and the use of such therapy by smokers are severely limited by NHS "blacklisting."I can prescribe on the NHS for alcohol problems and even obesity.I can also prescribe for tobacco addiction-but only products of unproved efficacy for this problem, such as tranquillisers and antidepressants, not one of proved effectiveness.Why not nicotine replacement therapy?So much for evidence based medicine.
Meal frequency and duration of overnight fast: a role in gall-stone formation?
Authors: J P Capron, J Delamarre, M A Herve, J L Dupas, P Poulain, P Descombes
Journal: BMJ (1981)

Meal frequency and duration of overnight fast: a role in gall-stone formation?Supersaturation of bile with cholesterol is a necessary condition for the formation of cholesterol gall stones.'Most normal people have lithogenic bile after an overnight fast,2 and short-term fasting is associated with a decreased rate of biliary bile-acid secretion and an increase in cholesterol saturation of hepatic and gall-bladder bile.3-Thus meal frequency-that is, the duration of fasting throughout the day-might have an effect on gall-stone formation.We therefore tested this hypothesis by comparing, in a prospective case-controlled study, the duration of overnight fasting in patients with gall stones and controls.
Undescended testes in low birthweight infants.
Authors: R Morley, A Lucas
Journal: BMJ (1987)

Undescended testes in low birthweight infantsCryptorchidism is a known risk factor for infertility and testicular malignancy.The reported incidence is rising and is now over 2%,' bilateral abnormality occurring in 10-25% of cases.Undescended testes are more common in low birthweight infants,2 but there is little detailed information on this subgroup.We collected extensive data on preterm infants, enabling us to determine the incidence of cryptorchidism and its associations.
Fibrinolytic abnormalities in two different cutaneousmanifestations of venous disease
Authors: David J. Margolis, E.K.O. Kruithof, Morris Barnard, Ken Howe, Gerald S. Lazarus
Journal: Journal of the American Academy of Dermatology (1996)

Chronic venous insufficiency may be associated with lipodermatosclerosis or atrophie blanche. Coagulation abnormalities may be related to these cutaneous disorders.Our purpose was to determine whether fibrinolytic abnormalities exist in patients with lipodermatosclerosis or atrophie blanche.A case control study of patients with venous disease and atrophie blanche or lipodermatosclerosis was performed. Plasma levels of tissue plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) in a resting and venous occluded state were measured.Plasma levels of PAI-1 were different between the two groups of patients. The lipodermatosclerosis group had significantly higher levels of PAI-1 in both the resting and venous occluded states (p < 0.001). Patients with atrophie blanche had milder elevations of PAI-1 in the resting and venous occluded state (p = 0.06).Fibrinolytic abnormalities are present in patients with venous disease. These abnormalities are different between patients with lipodermatosclerosis and patients with atrophie blanche.
Simple mechanical methods for cardioversion: defence of the precordial thump and cough version.
Authors: G Caldwell, G Millar, E Quinn, R Vincent, D A Chamberlain
Journal: BMJ (1985)

A prospective study was made of the value of the precordial thump and of cough version in life threatening ventricular arrhythmias. Of about 5000 medical and surgical patients, 68 were treated for persistent ventricular tachycardia and 248 for ventricular fibrillation, 86 of whom had presented outside hospital. Mechanical intervention was successful in 26 incidents occurring in 23 patients. Electrocardiographic records were obtained in 14 instances. Ventricular fibrillation was terminated by a thump in five patients and ventricular tachycardia by either a thump or a cough in a total of 17 patients. Four additional instances were recorded of successful recovery from asystolic or unspecified circulatory arrest after a precordial thump. Fifteen patients survived to be discharged from hospital. The potential benefit of the precordial thump and cough versions greatly outweighs their risks; hence these manoeuvres should probably be reintroduced into schedules for first aid resuscitation.
Anthracycline Dose Intensification in Acute Myeloid Leukemia
Authors: Hugo F. Fernandez, Zhuoxin Sun, Xiaopan Yao, Mark R. Litzow, Selina M. Luger, Elisabeth M. Paietta, Janis Racevskis, Gordon W. Dewald, Rhett P. Ketterling, John M. Bennett, Jacob M. Rowe, Hillard M. Lazarus, Martin S. Tallman
Journal: New England Journal of Medicine (2009)

In young adults with acute myeloid leukemia (AML), intensification of the anthracycline dose during induction therapy has improved the rate of complete remission but not of overall survival. We evaluated the use of cytarabine plus either standard-dose or high-dose daunorubicin as induction therapy, followed by intensive consolidation therapy, in inducing complete remission to improve overall survival.
Genital ulcers, other sexually transmitted diseases, and the sexual transmission of HIV.
Authors: P. Piot, M. Laga
Journal: BMJ (1989)

There is increasing evidence that genital ulceration, including syphilis, chancroid, and herpes simplex type 2, increases susceptibility to HIV infection. It may be that the HIV penetrates more easily through ulcerated membranes or that the lymphocytes associated with the inflammatory response present target cells for HIV infection. There is also evidence that HIV-infected women with genital ulcers are themselves more infective due to shedding of the virus in the genital tract. Nonulcerative sexually-transmitted diseases have also been associated as cofactors of HIV infection. Programs for the control of sexually transmitted diseases should be strengthened and should focus on eliminating chancroid, which is easily treated with antibiotics. Patients with genital ulcer disease should receive counseling, so that they will know that untreated genital ulcers increase the risk of HIV infection.
Distribution of Physicians
Authors: Richard Ament
Journal: JAMA (1972)

<h3>To the Editor.—</h3> In my opinion, the basic premise of Dr. Charles Aring's article on the distribution of physicians into rural as opposed to urban practice is challengeable and derogatory to the medical profession (<b>21</b>:606, 1972). Having spoken to many physicians who have left general practice to enter specialty training, it was not that they sought more income that they chose not to continue in rural practice. It was the constant "on-call" night and day, seven days a week, and the lack of educational and cultural opportunities for their families and themselves that influenced their decisions to seek further training. Young physicians do not choose isolated practices for similar reasons, and, in addition, they are more comfortable with the technological backup of the hospital medical center. Recommendations for regional primary care centers such as Dr. Bornemeier has proposed (<b>219</b>:359, 1972) might be of significant importance in solving the
Damage to the Aortic Valve as a Cause of Death in Bacterial Endocarditis
Authors: LAWRENCE COHEN
Journal: Annals of Internal Medicine (1961)

Excerpt The most common cause of death in patients with bacterial endocarditis is heart failure (1). Bacteriologic cure is generally easily achieved with antibiotics, and complications such as renal failure, cerebral embolism, and rupture of mycotic aneurysms are unusual. Heart failure in bacterial endocarditis mainly results from [1] myocarditis, [2] coronary embolism, and [3] valvular deformity. The purpose of the present study is to call attention to a particular kind of valvular deformity, perforation, or erosion of the aortic valve, as the most common cause of death from bacterial endocarditis in our hospital during the past five years. MATERIALS AND METHODS
Minor tumor infiltrating B cells opened a door to reveal and eliminate cancer initiating cells in metastatic melanomas
Authors: Beatrix Kotlan, Gabriella Liszkay, Gyorgy Naszados, Judit Olasz, Szabolcs Horvath, Vanda Plotar, Andras Szollar, Istvan Nagy Vamosi, Akos Savolt, Laszlo Toth, Orsolya Csuka, Maria Godeny, Miklos Kasler, Francesco M Marincola
Journal: Journal for ImmunoTherapy of Cancer (2014)

Meeting abstracts The theory and investigations on cancer stem cells (CSCs) have received growing attention, as these cells are responsible for the failure of cancer therapeutic strategies and the return of cancer. A complex tumorimmunological study on primary and metastatic cancerous tissue
Correlation of Thymidine Phosphorylase Expression and Lymphocyte Infiltration Detected by Microarray Analysis of Breast Cancer.
Authors: E. Ruckhäberle, A. Rody, U. Holtrich, K. Engels, R. Gaetje, H. Turley, L. Hanker, C. Solbach, T. Karn, M. Kaufmann
Journal: Cancer Research (2009)

Abstract Background:Thymidine phosphorylase (TP) expression in carcinoma cells has been described as a prognostic factor in breast cancer and a predictive factor for response to 5-FU chemotherapy in some studies. Analysis from prostate cancer reported a correlation of TP with lymphocyte infiltrates of tumors.Material and Methods:Affymetrix microarray data of n=79 normal tissue samples and n=1781 primary breast cancers were analyzed for TP mRNA expression. To study relationships of TP expression with immune cell infiltration of breast tumors we used several metagenes representing certain types of immune cells. Immunohistochemical analysis of TP protein expression using a monoclonal antibody was applied for validation studies.Results:Among normal tissues highest expression of TP mRNA was observed in cells and tissues of the immune system. The profile of TP expression displayed highest correlation with a metagene representing cells of the myeloid lineage as moncytes, macrophages and dendritic cells. Analysis of microarray data from 1781 breast cancer samples suggests that TP expression detected by this method originates mainly from infiltrating immune cells. In line with this observation TP mRNA expression correlated with a immune cell infiltration score determined by pathological inspection of the tumor. However, we also observed a correlation of TP with a metagene of interferone inducible genes which seem to be expressed by carcinoma cells. When we tried to validate these data on the protein level using immunohistochemistry TP expression was demonstrated both in carcinoma cells and stromal cells of the tumor to a varying degree.Discussion:We were able to confirm previous data from prostate cancer that TP expression is strongly correlated to the presence of an intense lymphocyte infiltrate of the tumor for breast cancer. However, microarray data of a bulk tumor sample cannot reveal the cellular origin of TP expression.Conclusion:Thus from this data it is not clear whether lymphocytes of the myeloid lineage either are the actual source of TP expression or induce its expression in carcinoma cells. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 2139.
Private provider clarifies its position on Bournemouth and Poole hospitals merger
Authors: G. Iacobucci
Journal: BMJ (2013)

A leading private hospital provider that has expressed concerns about the merger of two NHS hospitals has not opposed the move because of concerns for its own position in the market, it has told the BMJ .

The proposal to merge the Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust and Poole Hospital NHS Foundation Trust in Dorset has been …
Misleadingly Low Free Thyroxine Index and Usefulness of Reverse Triiodothyronine Measurement in Nonthyroidal Illnesses
Authors: INDER J. CHOPRA
Journal: Annals of Internal Medicine (1979)

Nonthyroidal illness is frequently associated with subnormal serum thyroxine (T4) and free T4 index. To unravel the resultant diagnostic problems, we have studied several variables of thyroid function in the sera of 47 patients hospitalized with nonthyroidal illnesses and seven hypothyroid patients encountered during the same period. Of the 47 euthyroid sick patients, 18 had low T4. Among these 18, free T4 index was normal in only five, whereas free T4 concentration measured by equilibrium dialysis was normal or high in 15 and 3,3',5'-triiodothyronine (reverse T3) normal or high in all 18. Reverse T3, free T4 concentration, and free T4 index were subnormal in all seven hypothyroid patients. Thus, measurement of free T4 index may be misleading in evaluation of thyroid function in patients with nonthyroidal illnesses, whereas measurement of serum concentration of reverse T3 and free T4 is quite discriminating.
In Vivo Tumor Targeting of a Recombinant Single-Chain Antigen-Binding Protein
Authors: D. Colcher, R. Bird, M. Roselli, K. D. Hardman, S. Johnson, S. Pope, S. W. Dodd, M. W. Pantoliano, D. E. Milenic, J. Schlom
Journal: JNCI Journal of the National Cancer Institute (1990)

We describe here the first in vivo targeting of tumors with a single-chain antigen-binding protein. The molecule, which was constructed and expressed in Escherichia coli, is a novel recombinant protein composed of a variable light-chain (VL), amino acid sequence of an immunoglobulin tethered to a variable heavy-chain (VH) sequence by a designed peptide. We show that this protein, derived from the DNA sequence of the variable regions of the antitumor monoclonal antibody B6.2, has the same in vitro antigen-binding properties as the B6.2 Fab' fragment. Comparative pharmacokinetic studies in athymic mice demonstrate much more rapid alpha and beta phases of plasma clearance for the single-chain antigen-binding protein than for the Fab' fragment, as well as an extremely rapid whole-body clearance. Half-life values for alpha and beta phases of single-chain antigen-binding protein clearance were 2.4 minutes and 2.8 hours, respectively, versus 14.8 minutes and 7.5 hours for Fab'. Furthermore, the single-chain antigen-binding protein molecule did not show accumulation in the kidney as did the Fab' molecule or, as previously shown, the F(ab')2 molecule. Despite its rapid clearance, the single-chain antigen-binding protein showed uptake in a human tumor xenograft comparable to that of the Fab' fragment, resulting in tumor to normal tissue ratios comparable to or greater than those obtained with the Fab' fragment. These studies thus demonstrate the in vivo stability of recombinant single-chain antigen-binding proteins and their potential in some diagnostic and therapeutic clinical applications in cancer and other diseases.
HER-2 Is an Independent Prognostic Factor in Endometrial Cancer: Association With Outcome in a Large Cohort of Surgically Staged Patients
Authors: Carl Morrison, Vanna Zanagnolo, Nilsa Ramirez, David E. Cohn, Nicole Kelbick, Larry Copeland, Larry G. Maxwell, Jeffrey M. Fowler
Journal: Journal of Clinical Oncology (2006)

To evaluate HER-2 expression and amplification in a large cohort of endometrial cancer with complete surgical staging and outcome data.A tissue microarray was constructed of 483 patients with endometrial cancer of diverse histologic type and stage and tested for HER-2 expression and amplification using current standards of practice. There was outcome data for 83% of all patients and 81% with complete surgical staging.Both expression and amplification of HER-2 was associated with high-grade (P = .0001) and high stage (P = .0001) endometrial cancer. The highest rate of HER-2 expression and amplification was seen in serous carcinoma (43% and 29%), while grade 1 endometrioid adenocarcinoma showed the lowest levels (3% and 1%). For all histologic types, the rate of HER-2 expression and amplification was remarkably different (P < .0001) for grade 3 cancers (31% and 15%) versus grade 2 (7% and 3%) and grade 1 cancers (3% and 1%), with similar results for endometrioid type (P < .0001). Both HER-2 expression and amplification correlated with disease-specific survival and progression-free survival in univariate analyses. By multivariate analysis HER-2 expression in the presence of amplification (P = .012) correlated with overall survival, but not expression in the absence of amplification. Overall survival was significantly shorter (P = .0001) in patients who overexpressed (median, 5.2 years) and/or showed amplification of HER-2 (median, 3.5 years) versus those that did not (median of all cases, 13 years).Our results would suggest that HER-2 is an important oncogene in high grade and stage endometrial cancer, but plays only a minor role in the much more common low grade and stage tumors that encompass the majority of clinical practice.
Chronic fatigue syndrome and human retrovirus XMRV
Authors: M. McClure, S. Wessely
Journal: BMJ (2010)

Three studies now refute the original study reporting the link

In the linked case-control study (doi:10.1136/bmj.c1018), van Kuppeveld and colleagues describe their failure to find evidence of a new human retrovirus in Dutch patients with chronic fatigue syndrome.1 The study is the latest contribution to a controversy that has surrounded two conflicting publications on the retroviral aetiology of this syndrome.2 3

The saga started, not with chronic fatigue syndrome or a virus, but with an enzyme (RNaseL) that plays a pivotal role in antiviral defences when activated by the interferon released in response to infection. Variants of the gene encoding this enzyme have been linked to an increased susceptibility to prostate cancer, and this led to the identification of a new virus in prostate tissue that was related to, but different from, known xenotropic murine leukaemia viruses4; hence the designation xenotropic murine leukaemia virus-related virus (XMRV). Sequence analyses showed that it is not an endogenous human virus, and the fact that eight clones derived from eight different patients are slightly different from one another confirms it as a new virus that has …