tbuckley/cabot-search huggingface dataset:
Recent advances: Rheumatology
Authors: P. Brooks
Journal: BMJ (1998)

In this review of recent advances in rheumatology I focus on treatment. This is not because our understanding of the pathogenesis or other aspects of rheumatology has progressed little but because there have been some particularly important changes in treatment (particularly of rheumatoid arthritis) that need to be communicated to a wider medical audience. Rheumatoid arthritis is usually an aggressive disease that needs to be treated forcefully if subsequent deformity and disability are to be reduced. Referring patients to a specialist rheumatology unit that can implement new treatment regimens at an early stage is therefore important.

I scanned the major rheumatology journals for articles on the treatment of rheumatoid arthritis and on advances in non-steroidal anti-inflammatory drug treatment. I also reviewed the abstracts of major rheumatology conferences that took place in 1996 and 1997.

Although non-steroidal anti-inflammatory drugs are the mainstay of treatment for rheumatic diseases, they are being used less worldwide. This is particularly true in Australia, where the prescribing of these drugs has fallen by about 25%—probably as a result of an educational campaign directed at general practitioners and the public that highlighted adverse reactions to these agents.1The box lists factors in the reduced use of non-steroidal anti-inflammatory drugs.

### Cyclo-oxygenase inhibitors

It is now understood that the cyclo-oxygenase enzyme system that produces prostaglandins consists of at least two basic isoforms—cyclo-oxygenase 1 and cyclo-oxygenase 2.5 The cyclo-oxygenase 1 enzyme performs “housekeeping” duties, maintaining a normal gastrointestinal mucosa and renal blood flow. Cyclo-oxygenase 2 (the inducible form) is seen in inflammation, the brain, and colon cancer cells. Description of the structure of human recombinant cyclo-oxygenase 2 and its interaction with non-steroidal anti-inflammatory drugs has enabled highly specific inhibitors to be developed.6 The effectiveness and low incidence of gastrointestinal or renal side effects of drugs such as the preferential …
Down syndrome critical region protein 1 (DSCR1), a novel VEGF target gene that regulates expression of inflammatory markers on activated endothelial cells
Authors: Boris A. Hesser, Xiao Huan Liang, Gieri Camenisch, Suya Yang, David A. Lewin, Richard Scheller, Napoleone Ferrara, Hans-Peter Gerber
Journal: Blood (2004)
THE INDICATIONS FOR THE OPERATIVE TREATMENT OF FRACTURES
Authors: CHARLES L. SCUDDER
Journal: JAMA (1927)

The treatment of fractures is the most important subject today in surgery without any exception. It is important for three reasons:   The severity of the injury to the whole individual in a case of fracture.  The need for developing a sane judgment in deciding at the outset on a line of treatment suitable to each case and the treatment to be carried through to the conclusion of the case.  The generally unsatisfactory ideas of treatment prevalent throughout our profession.   We all agree that most cases of nonunion, malunion with symptoms, and all compound fractures require operation. In our daily life, such events as the Great War, industrial awakenings and the appearance of complicated machinery, the workman's compensation acts, and the increased use of the automobile and other motor vehicles, have been tremendous stimuli to the surgery of fractures. The loss to industry alone from poorly treated and maltreated fractures is
Safe sex message fails to get through to young people
Authors: Tony Sheldon
Journal: BMJ (2001)

Statistics for sexually transmitted diseases in the Netherlands show that after 13 years of campaigns the messages about safer sex, especially among some young people, are being ignored.

In its latest annual report on the prevention of sexually transmitted diseases Amsterdam's Municipal Health Services has reported an “alarming” doubling of the number of cases of gonorrhoea among young heterosexual men and women in the Dutch capital in 2000 compared with 1999. Among all ages gonorrhoea has now, after …
Current cost of medical negligence in NHS hospitals: analysis of claims database
Authors: P. Fenn
Journal: BMJ (2000)

To identify trends in the incidence and cost of clinical negligence claims. To determine the current annual cost to the NHS as a whole in terms of cash paid out to patients and their solicitors and the defence costs incurred.Analysis of records on database.A well defined group of hospitals within one health authority which collected information on a consistent basis over many years.Data on individual claims. Trends in incidence of claims and costs identified independently from organisational reforms and changes in accounting practices.The rate of litigation increased from 0.46 to 0.81 closed claims per 1000 finished consultant episodes between 1990 and 1998. Overall expenditure on clinical negligence by the NHS in England in 1998 was estimated at 84 pound sterling million (95% confidence interval 48 pound sterling million to 130 pound sterling million).After adjustment for hospital activity, the rate of closed claims increased during the 1990s by about 7% per annum, a substantial rate of growth but not the uncontrolled explosion sometimes alluded to in the wider media. More coordination and openness are needed in data collection.
Improved diagnostic evaluation of suspected tuberculosis by use of t cell-based assay in routine practice
Authors: Davinder Dosanjh, Timothy Hinks, John Innes, Jonathan Deeks, Geoffrey Pasvol, Sarah Hackforth, Hansa Varia, Xiao-Quing Liu, Kerry Millington, Rubamalar Gunatheesan, Valerie Guyot-Revol, Ajit Lalvani
Journal: Journal of Infection (2008)
The Effects of Pacemaker-Induced Tachycardia on Myocardial Metabolism in Human Coronary Artery Disease (CAD).
Authors: Lawrence D. Baker
Journal: Annals of Internal Medicine (1969)

s1 May 1969The Effects of Pacemaker-Induced Tachycardia on Myocardial Metabolism in Human Coronary Artery Disease (CAD).Lawrence D. Baker, M.D., Juan C. Pomposiello, M.D., Jerry A. Snow, M.D., Joseph V. Messer, M.D.Lawrence D. Baker, M.D.Search for more papers by this author, Juan C. Pomposiello, M.D.Search for more papers by this author, Jerry A. Snow, M.D.Search for more papers by this author, Joseph V. Messer, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-70-5-1073_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAlterations in myocardial oxygen and lactate extraction during exercise and isoproterenol infusion permit estimation of the metabolic consequences of coronary artery disease. The effects of these stresses are often poorly tolerated, elicit complex total-body metabolic changes, are difficult to quantitate reproducibly, and cannot be terminated abruptly. Pacemaker-induced tachycardia is well tolerated, easily controlled, reproducible, and has few extracardiac effects. The efficacy of pacemaker-induced tachycardia in eliciting metabolic abnormalities was assessed in six patients with cineangiographically proved anterolateral coronary artery disease by measuring regional myocardial oxygen and lactate extraction during rest and pacemaker-induced tachycardia and isoproterenol infusion (1 to 4 µg/min)... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Lawrence D. Baker, M.D.; Juan C. Pomposiello, M.D.; Jerry A. Snow, M.D.; Joseph V. Messer, M.D.Affiliations: Boston, Massachusetts PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMyocardial anaerobiosis in anemia in ur?mic man 1 May 1969Volume 70, Issue 5Page: 1073-1074KeywordsExerciseIsoproterenolLactatesOxygenStable coronary artery diseaseTachycardia ePublished: 1 December 2008 Issue Published: 1 May 1969 PDF downloadLoading ...
Choriocarcinoma: A Study of Its Pathology
Authors: J. D. Woodruff
Journal: JAMA (1972)

In 200 fact-filled pages, Wallace Park divulges the results of his more than two decades of devoted study of the pathophysiologic intricacies of the trophoblast. Following an opening, brief, but thorough survey of the historical highlights of trophoblastic neoplasia, he discusses in detail the confusing and controversial aberrations of these novel and bizarre lesions. The foibles and frustrations, facts and fancies surrounding this strangely acceptable allograft are woven into the fabric of this monograph. Controversial opinions concerning the genesis, behavior, and host reaction are debated and, insofar as possible, the author presents and defends the validity of his favorite thesis. The usual problems of trophoblastic disease are discussed, including the place of prior pregnancy, terminology, and the differential in malignant potential between proliferative and nonproliferative moles, a feature never well documented by any investigator. Most challenging is the analysis of potential etiologic factors, including a proposal that a virus fulfills
THE INFLUENCE OF INTRAVENOUSLY ADMINISTERED SURFACE-ACTIVE AGENTS ON THE DEVELOPMENT OF EXPERIMENTAL ATHEROSCLEROSIS IN RABBITS
Authors: Aaron Kellner, James W. Correll, Anthony T. Ladd
Journal: The Journal of Experimental Medicine (1951)

A study was made of the relationship of blood lipids to the development of experimental atherosclerosis. Rabbits fed a diet containing cholesterol were found to develop hyperlipemia characterized by a great increase in blood cholesterol and a much lesser increase in blood phospholipids; after several weeks they manifested conspicuous atherosclerosis of the aorta, as has often been observed by others. Comparable rabbits fed the same diets containing added cholesterol were given in addition repeated intravenous injections of the surface-active agents Tween 80 and Triton A20; these animals developed hyperlipemia which was characterized by a great increase in blood cholesterol and an equivalent or even greater increase in phospholipids, and they had much less atherosclerosis than did the control rabbits fed cholesterol alone. In further experiments it was observed that repeated intravenous injections of Tween 80 did not result in resorption of previously induced atherosclerosis in rabbits. The findings are discussed in relation to the pathogenesis of natural and experimental atherosclerosis.
SAT0583-HPR Differences between Service Providers and Users when Defining Feasible Optimal NHs Occupational Therapy Treatment for Patients with Thumb Base OA: Results from a Delphi Study
Authors: S. Barbosa Boucas, K. Hislop Lennie, K. Dziedzic, N. Arden, J. Burridge, A. Hammond, M. Stokes, M. Lewis, R. Gooberman-Hill, K. Coales, J. Adams
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> The OTTER (OsTeoarthritis Thumb ThERapy) trial is a two-year developmental study for a full randomised controlled trial (RCT) into the clinical and cost effectiveness of an occupational therapy and splint intervention for thumb base OA. To develop an optimal package of care for evaluation within a multi-centre RCT, the views of both clinicians and patients are crucial. <h3>Objectives</h3> To conduct a Delphi study to obtain agreement between both patients with thumb base OA and AHPs concerning the most appropriate optimal NHS OT programme, splint and placebo splint intervention to use in the RCT. <h3>Methods</h3> The Delphi panel consisted of 63 AHPs experienced in treating adults with thumb base OA, and 7 patients with thumb base OA. The panel were asked to rate how much they agreed or disagreed about what optimal NHS OT care for thumb base OA should include, and what method(s) of delivery (individual one-to-one, group, patient leaflets, or telephone advice) they deemed were more appropriate. The Delphi study comprised 3 rounds. A seven-point Likert-type scale was used. Pre-defined inclusion and exclusion criteria were applied in order to reach a final number of statements which, in turn, created the desired tool. Group differences were analysed using Mann-Whitney U tests. <h3>Results</h3> Between-groups analyses showed significant differences in the ratings of overall importance of items to be included in an optimal NHS OT consultation (Table 1). <h3>Conclusions</h3> AHPs and patients differed in their views about the importance of including 'Education for Family/Significant Others/Carers', 'NHS Clinic Procedures', 'Prognosis Advice', 'Referral to other Health Care Professional', 'Sleep Assessment and Management' and 'Treatment Options' in an optimal NHS OT consultation, and in the methods of delivery used in the consultation. AHPs placed significantly less importance than patients on 'One-to-One Contact', 'Leaflets' and 'Telephone Advice'. These findings demonstrate the importance of consultingwith patients at an early stage in developing an intervention. <h3>Disclosure of Interest</h3> None Declared
The Role of Erythropoietin and Erythropoiesis-Stimulating Agents in Tumor Progression
Authors: Benjamin D. Hedley, Alison L. Allan, Anargyros Xenocostas
Journal: Clinical Cancer Research (2011)

Over the past few decades, understanding of the physiologic function of erythropoietin (EPO) has evolved significantly. EPO binds to erythropoietin receptors (EPOR), initiating signaling that stimulates growth, inhibits apoptosis, and induces the differentiation of erythroid progenitors to increase red blood cell mass. EPO has additionally been shown to exert tissue-protective effects on multiple tissues, suggesting a pleiotropic mechanism of action. Erythropoiesis-stimulating agents (ESA) are used clinically for treating cancer-related anemia [chemotherapy-induced anemia (CIA)]. Recent clinical trials have reported increased adverse events and/or reduced survival in ESA-treated cancer patients receiving chemotherapy, potentially related to EPO-induced cancer progression. Signaling pathways downstream of EPO/EPOR have been shown to influence numerous cellular functions in both normal and tumor cells, including proliferation, apoptosis, and drug resistance. Some studies have reported effects on proliferation, reduced chemotherapy efficacy, reduction of apoptosis, and resistance to selective therapies on cancer cell lines, whereas others have shown null effects. In addition, newer targeted cancer therapies that are directed toward specific signaling pathways may be antagonized by ESAs. This molecular interplay between anticancer agents and potential survival signals triggered by ESAs may have been underestimated and may contribute toward decreased survival seen in certain trials. As more targeted anticancer therapies become available, these types of interactions may mitigate therapeutic efficacy by allowing tumor cells to acquire drug resistance. Therefore, a more complete understanding of the complex pathways involved will allow for the rational use of ESAs for the safe treatment of CIA in oncology patients.
Prevention and Management of Cardiovascular Emergencies
Authors: HOWARD B. SPRAGUE, JAMES METCALFE, BENJAMIN M. GASUL, LOUIS A. SOLOFF, MAURICE SOKOLOW, STEWART G. WOLF
Journal: Circulation (1958)

The Panel Discussion on prevention and management of cardiovascular emergencies was conducted at the Thirtieth Scientific Session of the American Heart Association held at the Sherman Hotel, Chicago, Illinois, on Friday afternoon, October 25, 1957.
ASSESSMENT OF THE LIVER IN PATIENTS WITH FONTAN PHYSIOLOGY USING ULTRASONIC SHEAR WAVE ELASTOGRAPHY
Authors: Shaija Shelby, Qinghai Peng, Rallyn Renner, Ling Li, Cynthia Scott, Marion Meckelburg, Scott E. Fletcher, John Kugler, Kim F. Duncan, Ruben E. Quiros-Tejeira, David A. Danford, Shelby Kutty
Journal: Journal of the American College of Cardiology (2013)
Impaired rat sciatic nerve sodium-potassium adenosine triphosphatase in acute streptozocin diabetes and its correction by dietary myo-inositol supplementation.
Authors: D A Greene, S A Lattimer
Journal: Journal of Clinical Investigation (1983)

Nerve conduction impairment in experimental diabetes has been empirically but not mechanistically linked to altered nerve myo-inositol metabolism. The phospholipid-dependent membrane-bound sodium-potassium ATPase provides a potential mechanism to relate defects in diabetic peripheral nerve myo-inositol-phospholipid metabolism, impulse conduction, and energy utilization. Therefore, the effect of streptozocin-induced diabetes mellitus and dietary myo-inositol supplementation on rat sciatic nerve sodium-potassium ATPase was studied. ATPase activity was measured enzymatically in sciatic nerve homogenates from 4-wk streptozocin diabetic rats and age-matched controls either fed a standard or 1% myo-inositol supplemented diet. The sodium-potassium ATPase components were assessed by ouabain inhibition or the omission of sodium and potassium ions. Diabetes reduced the composite ATPase activity recovered in crude homogenates of sciatic nerve. The 40% reduction in the sodium-potassium ATPase was selectively prevented by 1% myo-inositol supplementation (which preserved normal nerve conduction). Thus, in diabetic peripheral nerve, abnormal myo-inositol metabolism is associated with abnormal sodium-potassium ATPase activity. The mechanism of the effect of dietary myo-inositol to correct diabetic nerve conduction may be through changes in a sodium-potassium ATPase, possibly via changes in myo-inositol-containing phospholipids.
Effect of Insurance Payer Status on the Surgical Treatment of Early Stage Breast Cancer
Authors: Linda Adepoju, Stephen Wanjiku, Megan Brown, Weikai Qu, Mallory Williams, Roberta E. Redfern, Joseph J. Sferra
Journal: JAMA Surgery (2013)

The effect of insurance payer status on surgical treatment of early stage breast cancer is unclear. This retrospective study examined the effect of insurance payer on mastectomy rates of 1539 women treated within a single health system. Women with Medicaid had significantly larger tumors compared with those with private insurance (PI) at diagnosis (3.3 cm vs 2.1 cm, P < .05) and were more likely to be treated with mastectomy for larger tumors compared with women with PI. However, women with PI were more likely to have mastectomy for smaller tumors; among women with tumors less than 2 cm, 11% with Medicaid underwent mastectomy compared with 47% with PI (P < .05). Overall, when compared with those with PI, women with Medicaid were more likely to receive mastectomy (60% vs 39%, P < .05).
872 CHARACTERIZATION OF CD4 T-CELL IMMUNE RESPONSE TO NUCLEOPORIN P62 IN PATIENTS WITH PRIMARY BILIARY CIRRHOSIS
Authors: F. Meda, M.S. Longhi, D.P. Bogdanos, P. Invernizzi, Y. Ma, G. Mieli-Vergani, J. Wesierska-Gadek, M. Zuin, M. Podda, D. Vergani
Journal: Journal of Hepatology (2008)
'Routine Urinalysis'
Authors: Seth T. Shaw
Journal: JAMA (1985)

Results of this study indicated that a protein-negative, blood-negative dipstick result may be used to rule out the necessity for performing a microscopic examination in "routine urinalysis" only if one is willing to accept 13% false-negative results. On the other hand, a protein-, blood-, and leukocyte esterase-negative dipstick result was associated with 1.4% to 3.3% false-negative results. The high sensitivity of the leukocyte esterase— measuring dipstick for microscopically abnormal urine samples was dependent on its ability to detect small numbers of leukocytes only when interpreted<i>five minutes after immersing it in the sample</i>. Various approaches may be used by which these findings could be applied to produce cost savings and also protect the small number of patients who may have dipstick-negative, microscopically positive urine. (<i>JAMA</i>1985;253:1596-1600)
Asthma endotypes: A new approach to classification of disease entities within the asthma syndrome
Authors: Jan Lötvall, Cezmi A. Akdis, Leonard B. Bacharier, Leif Bjermer, Thomas B. Casale, Adnan Custovic, Robert F. Lemanske, Andrew J. Wardlaw, Sally E. Wenzel, Paul A. Greenberger
Journal: Journal of Allergy and Clinical Immunology (2011)
Comparison of Biosynthetic Human Insulin and Pork Insulin During Rest, Food Ingestion, and Physical Work in Insulin-dependent Diabetic Subjects Using a Glucose Controlled Insulin Infusion System
Authors: J Beyer, Th Weber, G Schulz, W Hassinger, A Westerburg, U Cordes
Journal: Diabetes Care (1981)

In six insulin-dependent diabetic subjects, we investigated whether differences between biosynthetic human insulin (BHI) and pork insulin are present as measured by an automatic glucose controlled insulin infusion system (GCIIS) (Biostator). The parameters measured were basal insulin requirement and food-dependent insulin requirement, as well as the blood sugar-lowering and insulin-saving effect of standardized physical work. The results show that BHI does not reveal any differences with regard to the basal food-independent and food-dependent insulin requirement compared to pork insulin in insulin-requiring diabetic subjects. Delayed food-dependent initial rise in blood sugar and insulin during physical work, which was observed with BHI, does not show any differences in the integral over 180 min. These investigations confirm the results found in vitro and in animal experiments. At the same time, they indicate discrete differences in the activity spectrum.
Leukopenia and Anergy as Predictors of AIDS-Reply
Authors: Harold M. Ginzburg
Journal: JAMA (1986)

<h3>In Reply.—</h3> Cohen and associates, in their accompanying letter, have collected WBC counts on more than 11,000 adult inmates of a division of the New York City jail and determined that approximately 2.5% were leukopenic. This is certainly consistent with our historical data.<sup>1</sup>They have also determined that less than 10% of those who were leukopenic were also anergic. All 22 anergic inmates had a history of parenteral drug abuse. No data on human T-cell lymphotropic virus type III (HTLV-III) antibody appear to be available. Leukopenia, per se, does not seem to be predictive of anergy or other prodromal signs and symptoms associated with AIDS. The development of testing procedures for HTLV-III antibody permits identification of those who have been exposed to the virus associated with AIDS, of whom only a portion are either prodromal or overtly ill.<sup>2</sup>Antibodies against HTLV-I, HTLV-II, and HTLV-III are prevalent among intravenous
Study finds "know-do" gap in treatment of pneumonia and diarrhoea in children in rural areas
Authors: C. Travasso
Journal: BMJ (2015)

Many rural paediatric healthcare practitioners in India are not correctly diagnosing and managing pneumonia and diarrhoea, two of the leading causes of children’s deaths, a study has shown.

The study, published in JAMA Pediatrics , evaluated 340 private and public healthcare practitioners in Bihar and is among the first to report estimates of the “know-do” gap: that between what practitioners know about disease management and the care actually delivered to the patient.1

The study involved a combination of vignette interviews and standardised patients. During the vignettes participants were presented with a hypothetical case by two interviewers who recorded their …
Reflux and Barrett’s disease
Authors: S. Crockett, N. Shaheen
Journal: Endoscopy (2011)

In this study, a team of Harvard researchers conducted human testing of a novel technique known as endoscopic polarized scanning spectroscopy (EPSS) in Barrett’s esophagus. This technology relies on the fact that dense and enlarged epithelial nuclei are a key pathological feature of dysplasia. Because dysplastic nuclei scatter light differently from normal nuclei, the back-scattering of spectra can be analyzed to detect foci of dysplasia. Using polarized light, the researchers were able to isolate the spectroscopic signal of the epithelial layer, as light back-scattered from deeper tissues becomes depolarized and can therefore be cancelled out. The EPSS instrument uses a 2.5-mm stainless-steel probe, which can be inserted into the working channel of a standard upper endoscope ([Fig. 1]).