tbuckley/cabot-search huggingface dataset:
Offending in psychiatric patients after discharge from medium secure units: Language used to describe results is misleading
Authors: Thomas Marshall
Journal: BMJ (2004)

EDITOR—The study by Maden et al adds to limited knowledge on the risk of further offending in patients discharged from medium secure units,1 but the results are reported in a misleading way.

Maden et al claim that only 6% of discharged patients commit a violent offence in the two years after discharge. …
Injuries to health workers are common but safety checks are rare, report finds
Authors: M. McCarthy
Journal: BMJ (2013)

Healthcare workers suffer more of certain types of injury than workers in any other sector in the United States, including manufacturing and construction, but federal safety inspections are rare, a report has found.

The report was prepared by Public Citizen,1 a non-profit consumer advocacy organization based in Washington, DC.

According to the paper, healthcare employers reported nearly 654 000 workplace injuries in 2010, the year for which the most recent comprehensive data were available, 152 000 more than the industry with the next highest number of reports—manufacturing.

Because of the size of the healthcare sector, the overall rate of injuries and illnesses per worker was less …
Mechanical and Structural Characteristics of Carotid Plaques by Combined Analysis With Echotracking System and MR Imaging
Authors: Hélène Beaussier, Olivier Naggara, David Calvet, Robinson Joannides, Evelyne Guegan-Massardier, Emmanuel Gerardin, Michelle Iacob, Brigitte LaLoux, Erwan Bozec, Jérémy Bellien, Emmanuel Touze, Ingrid Masson, Christian Thuillez, Catherine Oppenheim, Pierre Boutouyrie, Stéphane Laurent
Journal: JACC. Cardiovascular imaging (2011)
Duplication of Philadelphia Chromosome in Acute Transition of Chronic Granulocytic Leukaemia
Authors: F. OBERLING
Journal: Annals of Internal Medicine (1975)

Letters1 August 1975Duplication of Philadelphia Chromosome in Acute Transition of Chronic Granulocytic LeukaemiaF. OBERLING, M.D., C. STOLL, J. M. LANG, G. MAYERF. OBERLING, M.D., C. STOLL, J. M. LANG, G. MAYERAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-83-2-231_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptDuplication of the Philadelphia (Ph1) chromosome is known to occur in the course of chronic granulocytic leukaemia (1). Usually, if not always, this acquired cytogenetic development precedes or occurs with an acute transition of chronic granulocytic leukaemia. The acute phase of chronic granulocytic leukaemia with duplication of the Ph1 chromosome is frequently associated with the development of enlarged myeloid lymph nodes, resembling reticulum cell malignancies on histologic examination (2). We present here a pertinent case report of a 39-year-old woman with typical chronic granulocytic leukaemia whom we have followed for 7 years.She was treated with successive courses of busulfan...References1. HAMMOUDAQUAGLINOHAYHOE FDF: Blastic crisis in chronic granulocytic leukaemia. Cytochemical, cytogenetic, and autoradiographic studies in four cases. Br Med J 5393:1275-1281, 1964 CrossrefGoogle Scholar2. GARFINKELBENNETT LD: Extramedullary myeloblastic transformation in chronic myelocytic leukemia simulating a coexistent malignant lymphoma. Am J Clin Pathol 51:638-645, 1969 CrossrefMedlineGoogle Scholar3. DUVALLCARBONEBELL CPW: Chronic myelocytic leukemia with two Philadelphia chromosomes and prominent peripheral lymphadenopathy. Blood 29:652-666, 1967 CrossrefGoogle Scholar4. GROUCHYNAVAFEINGOLD JDCDJ: Onze observations d'un modèle précis d'évolution caryotypique au cours de la leucémie myéloide chronique. Eur J Cancer 4:481-492, 1968 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Service des Maladies du Sang, et Laboratoire de Cytogénétique Clinique Infantile CHU 67000 Strasbourg, France PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEradication of the intramedullary Ph1 positive cell live without accompanying improved survival in chronic myelogenous leukemiaErythroblastic transformation of chronic granulocytic leukemia 1 August 1975Volume 83, Issue 2Page: 231-231KeywordsChromosomesCytogeneticsLymph nodes Issue Published: 1 August 1975 PDF downloadLoading ...
Temporal Lobectomy for Refractory Epilepsy
Authors: Michael R. Sperling, Michael J. O'Connor, Andrew J. Saykin, Carrie Plummer
Journal: JAMA (1996)

To examine the long-term effectiveness of anterior temporal lobectomy for refractory epilepsy with regard to seizure control and related medical and psychosocial measures and to determine how patterns of early seizure recurrence relate to long-term prognosis.A cohort of patients prospectively followed up for 5 years after surgery.Tertiary care comprehensive epilepsy center.Eighty-nine patients with medically refractory epilepsy who were consecutively treated with anterior temporal lobectomy between 1986 and 1990. All patients had noninvasive preoperative evaluations, and 31 were evaluated with intracranial electrodes prior to surgery.Postoperative seizure frequency, neuropsychologic function, mortality, and postoperative employment status.Five years after surgery, 62 patients (70 percent) were seizure free, 8 (9 percent) had seizures on fewer than 3 days per year or exclusively had nocturnal seizures, 10 (11 percent) had greater than 80 percent reduction in seizure frequency, 5 (6 percent) had less than 80 percent reduction in seizure frequency, and 4 (4 percent) died of causes unrelated to surgery. The proportion of patients in each outcome class remained stable throughout the 5-year period. Fifty-five percent of seizure recurrences happened within 6 months of surgery, and 93 percent occurred within 2 years after surgery. Outcome at 1 year related only moderately well to outcome at 5 years. No significant cognitive or linguistic deficits occurred. All patients who died had persistent seizures after surgery. Underemployment and unemployment declined significantly after surgery, with improvement noted in seizure-free patients.Temporal lobectomy provides sustained seizure relief over 5 years to most patients who have surgery. Outcome at 2 years predicts long-term outcome. A seizure-free state is associated with reduced mortality and increased employment. Mere reduction in seizure frequency is not associated with improvement in those measures.
Proinflammatory cytokine production by human keratinocytes stimulated with Propionibacterium acnes and P. acnes GroEL
Authors: G.M. Graham, M.D. Farrar, J.E. Cruse-Sawyer, K.T. Holland, E. Ingham
Journal: British Journal of Dermatology (2004)

Background Keratinocytes form the first line of defence in the skin and alert the host to danger by the production of a number of cytokines and chemokines. However, the interaction of commensal microorganisms with keratinocytes has not been well studied. Objectives To investigate the effect of viable and nonviable cells of Propionibacterium acnes in both exponential and stationary growth phases, and of P. acnes GroEL on cytokine production by human primary keratinocytes. Methods Actively proliferating or contact‐inhibited keratinocytes were cocultured with viable or formaldehyde‐killed P. acnes cells in either the exponential or stationary phase of growth. Culture supernatants were assayed by enzyme‐linked immunosorbent assay for the cytokines interleukin (IL)‐1α, tumour necrosis factor (TNF)‐α and granulocyte/macrophage colony‐stimulating factor (GM‐CSF). Keratinocytes were also stimulated with different concentrations of P. acnes GroEL and supernatants assayed for cytokines. Results Viable P. acnes in the stationary phase of growth stimulated keratinocyte monolayers to produce significantly higher amounts of IL‐1α, TNF‐α and GM‐CSF than unstimulated keratinocytes. Viable exponential‐phase bacteria stimulated production of significantly higher amounts of TNF‐α and GM‐CSF but these levels were significantly lower than those for stimulation with stationary‐phase bacteria. Nonviable P. acnes from either growth phase was not able to stimulate cytokine production. P. acnes GroEL at concentrations in the range 0·05–1·0 µg mL−1 was able to induce increased production of cytokines by keratinocytes in a dose‐dependent manner. This was analogous to stimulation with Escherichia coli GroEL. Conclusions Stimulation of cytokine production by P. acnes and P. acnes GroEL may be important in the pathogenesis of inflammatory acne vulgaris and may have wider implications for the immunomodulation of the human immune system by commensal skin microorganisms.
Glimepiride Combined with Morning Insulin Glargine, Bedtime Neutral Protamine Hagedorn Insulin, or Bedtime Insulin Glargine in Patients with Type 2 Diabetes
Authors: Andreas Fritsche, Matthias Axel Schweitzer, Hans-Ulrich Hring
Journal: Annals of Internal Medicine (2003)

Background: Patients with type 2 diabetes are often treated with oral antidiabetic agents plus a basal insulin. Objective: To investigate the efficacy and safety of glimepiride combined with either morning or bedtime insulin glargine or bedtime neutral protamine Hagedorn (NPH) insulin in patients with type 2 diabetes. Design: Open-label, randomized, controlled trial. Setting: 111 centers in 13 European countries. Patients: 695 patients with type 2 diabetes who were previously treated with oral antidiabetic agents. Intervention: Randomization to treatment with morning insulin glargine, bedtime NPH insulin, or bedtime insulin glargine for 24 weeks in addition to 3 mg of glimepiride. The insulin dose was titrated by using a predefined regimen to achieve fasting blood glucose levels of 5.56 mmol/L or lower ( 100 mg/dL). Measurements: Hemoglobin A1c values, blood glucose levels, insulin dose, and body weight. Results: Hemoglobin A1c levels improved by 1.24% (two-sided 90% CI, 1.10% to 1.38%) with morning insulin glargine, by 0.96% (CI, 0.81% to 1.10%) with bedtime insulin glargine, and by 0.84% (CI, 0.69% to 0.98%) with bedtime NPH insulin. Hemoglobin A1c improvement was more pronounced with morning insulin glargine than with NPH insulin (0.40% [CI, 0.23% to 0.58%]; P = 0.001) or bedtime insulin glargine (0.28% [CI, 0.11% to 0.46%]; P = 0.008). Baseline to end-point fasting blood glucose levels improved similarly in all three groups. Nocturnal hypoglycemia was less frequent with morning (39 of 236 patients [17%]) and bedtime insulin glargine (52 of 227 patients [23%]) than with bedtime NPH insulin (89 of 232 patients [38%]) (P < 0.001). Conclusion: The risk for nocturnal hypoglycemia was lower with glimepiride in combination with morning and bedtime insulin glargine than with glimepiride in combination with bedtime NPH insulin in patients with type 2 diabetes. Morning insulin glargine provided better glycemic control than did bedtime insulin glargine or bedtime NPH insulin. *For members of the 4001 Study Group, see the Appendix.
No leg to stand on
Authors: Alexander Clark
Journal: BMJ (2004)

new service by the nurse consultant liaising with the anticoagulation clinic, flexibly adjusting admission dates (placing other patients into vacated slots), and obtaining urgent investigations (for example, echocardiograms).Over time the coordinator developed relationships with the previously disparate parts of the service. ConclusionAn elective DC cardioversion service can be safely operated by an appropriately trained nurse in a day surgery unit remote from an acute general hospital.This model of care is effective and can reduce waiting times and relieve pressure on acute beds and junior doctors.Documents used to support the establishment of the service are available from the authors.
Food Allergy in Runners
Authors: Tim D. Noakes
Journal: JAMA (1982)

<h3>To the Editor.—</h3> I refer to the informative article by Richard Fogoros, MD, on the proposed mechanisms explaining gastrointestinal disturbances during running (1980; 243:1743). George A. Sheehan, MD,<sup>1</sup>described the case of a runner who experienced abdominal pain with occasional bloody diarrhea every time he ran competitive, long-distance races. During his normal day, and when not running competitive races, the athlete had no such symptoms. By eliminating gluten from his diet, the athlete cured his racing-induced gastrointestinal symptoms. I have recently encountered a runner who had, for seven years, suffered from the identical symptoms reported by Sheehan and who had become so incapacitated that he had considered forgoing all forms of competitive distance running. By eliminating all dairy products from his diet, he has, like Sheehan's athlete, achieved a complete symptomatic cure. Physicians faced with athletes in whom this condition develops would do well to consider the possibility of
Recruitment of New Sites of Synaptic Transmission During the cAMP-Dependent Late Phase of LTP at CA3–CA1 Synapses in the Hippocampus
Authors: Vadim Y. Bolshakov, Hava Golan, Eric R. Kandel, Steven A. Siegelbaum
Journal: Neuron (1997)

Long-term potentiation at CA3–CA1 hippocampal synapses exhibits an early phase and a late phase, which can be distinguished by their underlying molecular mechanisms. Unlike the early phase, the late phase is dependent on both cAMP and protein synthesis. Quantal analysis of unitary synaptic transmission between a single presynaptic CA3 neuron and a single postsynaptic CA1 neuron suggests that, under certain conditions, the early phase of LTP involves an increase in the probability of release of a single quantum of transmitter from a single presynaptic release site, with no change in the number of quanta that are released or in postsynaptic sensitivity to transmitter. Here, we show that the cAMP-induced late phase of LTP involves an increase in the number of quanta released in response to a single presynaptic action potential, possibly due to an increase in the number of sites of synaptic transmission between a single CA3 and a single CA1 neuron.
Portrayal of caesarean section in Brazilian women's magazines: 20 year review
Authors: M. R. Torloni, S. Daher, A. P. Betran, M. Widmer, P. Montilla, J. P. Souza, M. Merialdi
Journal: BMJ (2011)

<b>Objective</b> To assess the quality and comprehensiveness of the information on caesarean section provided in Brazilian women's magazines. <b>Design</b> Review of articles published during 1988-2008 in top selling women's magazines. <b>Setting</b> Brazil, one of the countries with the highest caesarean section rates in the world. <b>Data sources</b> Women's magazines with the largest distribution during the study period, identified through the official national media indexing organisations. <b>Selection criteria</b> Articles with objective scientific information or advice, comments, opinions, or the experience of ordinary women or celebrities on delivery by caesarean section. <b>Main outcome measures</b> Sources of information mentioned by the author of the article, the accuracy and completeness of data presented on caesarean section, and alleged reasons why women would prefer to deliver though caesarean section. <b>Results</b> 118 articles were included. The main cited sources of information were health professionals (78% (n=92) of the articles). 71% (n=84) of the articles reported at least one benefit of caesarean section, and 82% (n=97) reported at least one short term maternal risk of caesarean section. The benefits most often attributed to delivery by caesarean section were reduction of pain and convenience for family or health professionals. The most frequently reported short term maternal risks of caesarean section were increased time to recover and that it is a less natural way of giving birth. Only one third of the articles mentioned any long term maternal risks or perinatal complications associated with caesarean section. Fear of pain was the main reported reason why women would prefer to deliver by caesarean section. <b>Conclusions</b> Most of the articles published in Brazilian women's magazines do not use optimal sources of information. The portrayal of caesarean section is mostly balanced, not explicitly in favour of one or another route of delivery, but incomplete and may be leading women to underestimate the maternal/perinatal risks associated with this route of delivery.
Peroxisome Proliferator-Activated Receptor γ–Mediated Up-regulation of Syndecan-1 by n-3 Fatty Acids Promotes Apoptosis of Human Breast Cancer Cells
Authors: Haiguo Sun, Isabelle M. Berquin, Rick T. Owens, Joseph T. O'Flaherty, Iris J. Edwards
Journal: Cancer Research (2008)

Abstract Diets enriched in n-3 polyunsaturated fatty acids (n-3 PUFA) may protect against breast cancer but biochemical mechanisms are unclear. Our studies showed that the n-3 fatty acid docosahexaenoic acid (DHA) up-regulated syndecan-1 (SDC-1) in human breast cancer cells, and we tested the hypothesis that DHA-mediated up-regulation of SDC-1 induces apoptosis. DHA was delivered to MCF-7 cells by n-3 PUFA–enriched low-density lipoproteins (LDL) or by albumin in the presence or absence of SDC-1 small interfering RNA. The n-3 PUFA induced apoptosis, which was blocked by SDC-1 silencing. We also confirmed that SDC-1 up-regulation and apoptosis promotion by n-3 PUFA was mediated by peroxisome proliferator-activated receptor γ (PPARγ). Using a luciferase gene driven by either a PPAR response element or a DR-1 site present in the SDC-1 promoter, reporter activities were enhanced by n-3 LDL, DHA, and PPARγ agonist, whereas activity of a luciferase gene placed downstream of a mutant DR-1 site was unresponsive. Cotransfection with dominant-negative PPARγ DNA eliminated the increase in luciferase activity. These data provide strong evidence that SDC-1 is a molecular target of n-3 PUFA in human breast cancer cells through activation of PPARγ and that n-3 PUFA–induced apoptosis is mediated by SDC-1. This provides a novel mechanism for the chemopreventive effects of n-3 PUFA in breast cancer. [Cancer Res 2008;68(8):2912–9]
ENTERIC FEVER—ITS INFECTION, PATHOLOGY, AND PRESENT TREATMENT.
Authors: FRANKLIN STAPLES
Journal: JAMA (1899)

The more important advances made in the different departments of medicine in modern times appear to have resulted more or less directly from various discoveries and developments in the science of bacteriology. In this way not only has the domain of practical medicine and surgery been widely extended, and new fields opened for advanced work, but in like manner great improvements in the management of disease have resulted from bringing into more intelligent and better use much of the means acquired in former times. A brief mention of certain points in the etiology, pathology, and treatment of the common infectious disease, enteric (typhoid) fever, as they are now understood, may illustrate. The wide prevalence and great mortality shown in the history of this disease give much importance to any discovery which promises improvement either in its management or in the means of its prevention. <h3>TYPHOID IN THE PAST.</h3> The time
Plasma insulin-like growth factor 1, insulin-like growth factor binding protein 3, and risk of colorectal cancer: a prospective study in northern Sweden
Authors: R Palmqvist
Journal: Gut (2002)

Insulin-like growth factor 1 (IGF-1) has antiapoptotic and mitogenic effects on various cell types, and raised IGF-1 levels are increasingly being implicated as potential risk factors for cancer.To examine the relationship between IGF-1 and its major plasma binding protein, IGF binding protein 3 (IGFBP-3), and the risk of colorectal cancer.We conducted a case-control study nested within the Northern Sweden Health and Disease Cohort. IGF-1 and IGFBP-3 were measured in prediagnostic plasma samples from 168 men and women who developed cancers of the colon (n=110) or rectum (n=58), and from 336 matched controls.Conditional logistic regression analyses showed an increase in colon cancer risk with increasing levels of IGF-1 (odds ratios (ORs) 1.00, 1.89, 2.30, 2.66; p(trend)=0.03) and IGFBP-3 (ORs 1.00, 0.91, 1.80, 1.93; p(trend)=0.02). Rectal cancer risk was inversely related to levels of IGF-1 (ORs 1.00, 0.45, 0.33, 0.33; p(trend)=0.09) and IGFBP-3 (ORs 1.00, 0.75, 0.66, 0.49; p(trend)=0.21). Mutual adjustments between IGF-1 and IGFBP-3 did not materially alter these relationships.These results support earlier findings of increased risk of colon cancer in subjects with elevated plasma IGF-1. Our results however do not support the hypothesis that the risk of rectal cancer could also be directly related to IGF-1 levels.
Infertility and Pelvic Inflammatory Disease: The Role of Mycoplasma Infection
Authors: Herbert W. Horne
Journal: JAMA (1986)

<h3>To the Editor.—</h3> May I commend you for your April 4, 1986, issue and its recognition of sexually transmitted diseases as an important and growing problem in our society. However, in neglecting to include studies on the genital mycoplasmas, you have over-looked a possibly more important cause of pelvic inflammatory disease with its devastating social ramifications. One of the genital mycoplasmas was recognized officially as the third on a list of sexually transmitted diseases published by the National Institutes of Health in 1979 (publication 79-909). It is unfortunate that researchers studying<i>Chlamydia trachomatis</i>infections did not consider the importance of simultaneous cultures for other microorganisms. In a study reported at the recent Pan American Conference on Infertility, we presented the results of cultures and antibodies obtained from 100 consecutive infertile female patients in my private practice; gonorrhea, syphilis, mycoplasmas,<i>Chlamydia</i>, Epstein-Barr virus, herpes types 1 and 2, and the acquired
Host Resistance and Survival in Carcinoma of Breast: A Study of 104 Cases of Medullary Carcinoma in a Series of 1,411 Cases of Breast Cancer Followed for 20 years
Authors: H. J. G. Bloom, W. W. Richardson, J. R. Field
Journal: BMJ (1970)

This paper deals with a special type of mammary carcinoma, generally of high-grade malignancy, which carries a remarkably good prognosis-the so-called "medullary carcinoma of the breast with lymphoid infiltrate." Probably the increased lymphoid tissue seen in these tumours is concerned with cell-mediated and humoral immunological reactions and reflects a strong host-defence mechanism which is responsible for the remarkably high survival rates following radical treatment. Since the evidence for host resistance to malignant disease is based largely on animal data, the opportunity to study a group of patients followed for 20 years, in whom this type of defence reaction appears to exist, is of considerable clinical interest.Among 1,411 cases of breast cancer there were 104 with medullary carcinoma (7.4%), for which the corrected 5- to 20-year survival rates have been calculated. After 20 years 74% of cases with operable medullary tumours were alive, compared with 14% of cases with similar stage non-medullary cancer. In the presence of histologically proved axillary metastases the 20-year survival rate was 61% for medullary cases, compared with only 13% for other types of breast cancer.In 30 cases of medullary cancer in which the axilla was free, the corrected 20-year survival rate was 95% following a combination of radical operation and radiotherapy. No evidence could be found that axillary dissection or postoperative irradiation is harmful to women with operable highly malignant breast cancer in whom a well-marked host resistance is thought to be present. A combination of radical mastectomy and postoperative irradiation appears to be the most effective treatment for such cases. The present grounds for rejecting a radical approach to treatment of breast cancer, based on current immunological considerations, are regarded as being quite inadequate.