tbuckley/cabot-search huggingface dataset:
Chronic urticaria: a patient survey on quality‐of‐life, treatment usage and doctor–patient relation
Authors: M. Maurer, J ‐P. Ortonne, T. Zuberbier
Journal: Allergy (2009)

Chronic urticaria (CU) is a common skin disorder characterized by recurrent spontaneous outbreaks of itchy wheals and/or angioedema. It has been shown to have substantial impact on patient quality-of-life, but little else is known about patient perspectives on CU and its treatment.An internet survey was conducted with 321 randomly selected, representative adults in Germany and France who were diagnosed with CU. The survey included the Skindex-29 questionnaire on quality-of-life and questions about treatment usage and patients' relation to their physician. Regression analyses were used to identify predictors of quality-of-life, use of prescription medication and various aspects of the doctor-patient relation.The survey confirmed that CU has substantial impact on quality-of-life, with median Skindex scores of 68 for symptoms, 50 for functioning and 53 for emotions. Only two in three respondents were taking prescription medication for their CU. Older respondents, French respondents and fully employed respondents were significantly (P < 0.01) more likely to be taking prescription medication. Only three in five respondents under a physician's care reported that their physician had discussed the emotional impact of CU on them. Patients whose physicians had discussed this emotional impact were significantly (P < 0.001) more satisfied with treatment and more trusting of their physician.CU has a heavy impact on quality-of-life. Physicians need to be aware that many patients are not taking second generation anti-histamines and counsel them better on this point. Physicians should also discuss the emotional impact of CU with patients, because it improves their satisfaction and trust.
Analyses of a novel SCN5A mutation (C1850S): conduction vs. repolarization disorder hypotheses in the Brugada syndrome
Authors: Séverine Petitprez, Thomas Jespersen, Etienne Pruvot, Dagmar I. Keller, Cora Corbaz, Jürg Schläpfer, Hugues Abriel, Jan P. Kucera
Journal: Cardiovascular Research (2008)

Brugada syndrome (BrS) is characterized by arrhythmias leading to sudden cardiac death. BrS is caused, in part, by mutations in the SCN5A gene, which encodes the sodium channel alpha-subunit Nav1.5. Here, we aimed to characterize the biophysical properties and consequences of a novel BrS SCN5A mutation. SCN5A was screened for mutations in a male patient with type-1 BrS pattern ECG. Wild-type (WT) and mutant Nav1.5 channels were expressed in HEK293 cells. Sodium currents (INa) were analysed using the whole-cell patch-clamp technique at 37°C. The electrophysiological effects of the mutation were simulated using the Luo-Rudy model, into which the transient outward current (Ito) was incorporated. A new mutation (C1850S) was identified in the Nav1.5 C-terminal domain. In HEK293 cells, mutant INa density was decreased by 62% at −20 mV. Inactivation of mutant INa was accelerated in a voltage-dependent manner and the steady-state inactivation curve was shifted by 11.6 mV towards negative potentials. No change was observed regarding activation characteristics. Altogether, these biophysical alterations decreased the availability of INa. In the simulations, the Ito density necessary to precipitate repolarization differed minimally between the two genotypes. In contrast, the mutation greatly affected conduction across a structural heterogeneity and precipitated conduction block. Our data confirm that mutations of the C-terminal domain of Nav1.5 alter the inactivation of the channel and support the notion that conduction alterations may play a significant role in the pathogenesis of BrS.
Doctors in Germany protest at a new restrictive law on tissue banks
Authors: Annette Tuffs
Journal: BMJ (2006)

Doctors in Germany say that patients will suffer if a proposed new law regulating use of human tissue is passed. The law will state that donated tissue must be subject to the same strict regulation as pharmaceutical products.

The German Medical Association and the Association of Surgeons are demanding that the law be amended so that tissues are regulated under Germany's Transplant Act rather than the Pharmaceuticals Act. This would ensure that the tissues are safe and would prevent the commercialisation of tissue donation, proponents of the law say. The law does not change the rules for tissue …
Activation of the classical pathway of complement by Hageman factor fragment.
Authors: B Ghebrehiwet, M Silverberg, A P Kaplan
Journal: The Journal of Experimental Medicine (1981)

A fragment of activated Hageman factor (HFf) has been demonstrated to activate the classical pathway of complement in a manner that is analogous to complement activation by antigen-antibody complexes or aggregated IgG. Thus C1, C4, C2, C3, and C5 were found to be depleted on addition of HFf to serum. The reduction of serum hemolytic activity was maximal upon addition of 5 micrograms HFf and an incubation time of 60 min at 37 degrees C. Consumption of the total complement activity and of the individual components proceeded in a dose-dependent fashion. No comparable activity was observed when equimolar concentrations of either the native Hageman factor (HF) or two-chain activated form of Hageman factor (HFa) were incubated with serum. Further, the ability of HFf to convert serum C3 and C4 was similar to that of aggregated IgG as assessed by immunoelectrophoresis. This function of HFf appeared to be independent of plasminogen (or plasmin) since plasminogen-free serum was indistinguishable from normal serum. Radial double immunodiffusion experiments using antiserum to C1q, C1r, and C1s on HFf-treated serum demonstrated the dissociation of the C1 trimolecular complex, with concomitant reduction of C1r antigenicity that is indicative of C1 activation. Thus, HFf appears to lead to C1 activation upon incubation with serum or when incubated with partially purified C1. This may represent a control link between activation of the intrinsic coagulation-kinin pathway and the initiation of the classical complement cascade.
Independent prognostic factors in patients with metastatic (stage D2) prostate cancer. The Zoladex Study Group
Authors: G. W. Chodak
Journal: JAMA (1991)

The independent prognostic factors affecting survival were assessed in 240 men undergoing treatment for metastatic prostate cancer as part of a randomized clinical trial comparing the gonadotropin releasing hormone analogue Zoladex (goserelin acetate implant) with castration. In a multivariate analysis, the most highly significant predictors were the presence or absence of bone pain, serum testosterone levels, serum alkaline phosphatase levels, and performance status. Patients with all four factors favorable for survival had a 2-year survival rate of 84% as compared with only 8% for patients with none of the four factors favorable for survival. No other factors were significant. A separate analysis of serum testosterone levels revealed that the higher the pretreatment serum testosterone level, the greater the survival rate. Compared with patients with serum testosterone levels less than 6.9 nmol/L, significant differences in survival were observed for patients with serum testosterone levels of 10.4 to 13.9,13.9 to 17.3, and over 17.3 nmol/L. These results have important implications for the design and analysis of future clinical trials of hormone therapy and for counseling patients regarding the short-term prognosis of their disease. (<i>JAMA</i>. 1991;265:618-621)
The Heart Image as a Model to Internal-Organ Body Image
Authors: I. Kaminer, H. Munitz, S. Tyano, H. Wijsenbeek
Journal: Psychotherapy and Psychosomatics (1978)

We show that there is indeed an internal-organ body image: the heart. Using questionnaires and drawings, we compared a group of healthy subjects, a group of acutely ill cardiac patients and a group of chronic cardiac patients. A constant body image emerged which was not influenced by heart disease. It seems to us that this approach can serve as a model of further studies of internal-organ body image.
Abciximab in Patients With Acute ST-Segment–Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention After Clopidogrel Loading
Authors: Julinda Mehilli, Adnan Kastrati, Stefanie Schulz, Stefan Früngel, Stephan G. Nekolla, Werner Moshage, Franz Dotzer, Kurt Huber, Jürgen Pache, Josef Dirschinger, Melchior Seyfarth, Stefan Martinoff, Markus Schwaiger, Albert Schömig
Journal: Circulation (2009)

Background— The glycoprotein IIb/IIIa receptor inhibitor abciximab has improved the efficacy of primary percutaneous coronary interventions in patients with acute myocardial infarction. However, it is not known whether abciximab remains beneficial after adequate clopidogrel loading in patients with acute ST-segment–elevation myocardial infarction. Methods and Results— A total of 800 patients with acute ST-segment–elevation myocardial infarction within 24 hours from symptom onset, all treated with 600 mg clopidogrel, were randomly assigned in a double-blind fashion to receive either abciximab (n=401) or placebo (n=399) in the intensive care unit before being sent to the catheterization laboratory. The primary end point, infarct size measured by single-photon emission computed tomography with technetium-99m sestamibi before hospital discharge, was 15.7±17.2% (mean±SD) of the left ventricle in the abciximab group and 16.6±18.6% of the left ventricle in the placebo group ( P =0.47). At 30 days, the composite of death, recurrent myocardial infarction, stroke, or urgent revascularization of the infarct-related artery was observed in 20 patients in the abciximab group (5.0%) and 15 patients in the placebo group (3.8%) (relative risk, 1.3; 95% CI, 0.7 to 2.6; P =0.40). Major bleeding complications were observed in 7 patients in each group (1.8%). Conclusion— Upstream administration of abciximab is not associated with a reduction in infarct size in patients presenting with acute myocardial infarction within 24 hours of symptom onset and receiving 600 mg clopidogrel.
Isoflurane compared with midazolam for sedation in the intensive care unit.
Authors: K. L. Kong, S. M. Willatts, C. Prys-Roberts
Journal: BMJ (1989)

OBJECTIVE--To compare isoflurane with midazolam for sedation of ventilated patients. DESIGN--Randomised control study. Setting--Intensive care unit in university teaching hospital. PATIENTS--Sixty patients aged 18-76 who required mechanical ventilation. INTERVENTIONS--Sedation with either 0.1-0.6% isoflurane in an air-oxygen mixture (30 patients) or a continuous intravenous infusion of midazolam 0.01-0.20 mg/kg/h (30 patients). Sedation was assessed initially and hourly thereafter on a six point scale. Incremental intravenous doses of morphine 0.05 mg/kg were given for analgesia as required. The trial sedative was stopped when the patient was judged ready for weaning from ventilatory support or at 24 hours (whichever was earlier). END POINT--Achievement of a predetermined level of sedation for as much of the time as possible. MAIN RESULTS--Isoflurane produced satisfactory sedation for a greater proportion of time (86%) than midazolam (64%), and patients sedated with isoflurane recovered more rapidly from sedation. CONCLUSION--Isoflurane is a promising alternative technique for sedation of ventilated patients in the intensive care unit.
Repigmentation of vitiligo by transplantation of autologous melanocyte cells cultured on amniotic membrane
Authors: P. Redondo, J. del Olmo, M. García-Guzman, L. Guembe, F. Prósper
Journal: British Journal of Dermatology (2008)

Conflicts of interest: none declared. Sir, Vitiligo is an acquired skin disease that affects 1% of the world’s population, and which significantly impacts the quality of life of patients. In patients with stable vitiligo, lack of effective medical therapies has led to the development of surgical treatment options using transplantation of autologous melanocytes. These techniques include split‐thickness grafts, punch grafts and suction blister grafts, that do not require cell expansion.1, 2 Transplantation methods include cultured mixed melanocyte–keratinocyte suspension with or without carrier, and cultured pure melanocyte suspension.3, 4 To date, pure single‐layer melanocyte cultures have not been reported in the treatment of vitiligo, nor has the use of amniotic membrane (AM) as a scaffold been documented. The AM, the inner part of the placenta, consists of a thick basement membrane of collagen type IV and laminin, and an avascular stroma. AM has been successfully used in skin transplantation5 and has been applied for ocular surface reconstruction in patients with severe corneal diseases.6
Points: Effect of maternal dietary exclusion on breast fed infants with eczema
Authors: S. Drew
Journal: BMJ (1986)

August, p 395) make an important point which deserves highlighting.Fracture dislocation of the cervical spine complicating near drowning is a rare event in Britain but is seen more commonly in Australia, where body surfing is a popular sport.The advice given to rescuers in Britain is that any unconscious patient found in standing depth water should be handled as though he or she had suffered fracture dislocation of the neck.It is possible on occasions to ventilate adequately without extending the neck, but if this is not the case then the rescuer has no alternative but to tilt the head back.
OSU-03012, a Novel Celecoxib Derivative, Is Cytotoxic to Myeloma Cells and Acts through Multiple Mechanisms
Authors: Shuhong Zhang, Attaya Suvannasankha, Colin D. Crean, Valerie L. White, Amy Johnson, Ching-Shih Chen, Sherif S. Farag
Journal: Clinical Cancer Research (2007)

Abstract Purpose: OSU-03012 is a novel celecoxib derivative, without cyclooxygenase-2 inhibitory activity, capable of inducing apoptosis in various cancer cells types, and is being developed as an anticancer drug. We investigated the in vitro activity of OSU-03012 in multiple myeloma (MM) cells. Experimental Design: U266, ARH-77, IM-9, and RPMI-8226, and primary myeloma cells were exposed to OSU-03012 for 6, 24, or 72 h. Cytotoxicity, caspase activation, apoptosis, and effects on intracellular signaling pathways were assessed. Results: OSU-03012 was cytotoxic to MM cells with mean LC50 3.69 ± 0.23 and 6.25 ± 0.86 μmol/L and at 24 h for primary MM cells and cell lines, respectively. As a known PDK-1 inhibitor, OSU-03012 inhibited the PI3K/Akt pathway with downstream effects on BAD, GSK-3β, FoxO1a, p70S6K, and MDM-2. However, transfection of MM cells with constitutively active Akt failed to protect against cell death, indicating activity against other pathways is important. Phospho (p)-signal transducers and activators of transcription 3 and p-MAP/ERK kinase 1/2 were down-regulated, suggesting that OSU-03012 also inhibited the Janus-activated kinase 2/signal transducer and activator of transcription 3 and mitogen-activated protein kinase pathways. Although expression of Bcl-2 proteins was unchanged, OSU-03012 also down-regulated survivin and X-linked inhibitor of apoptosis (XIAP), and also induced G2 cell cycle arrest with associated reductions in cyclins A and B. Finally, although OSU-03012 induced cleavage of caspases 3, 8 and 9, caspase inhibition did not prevent cell death. Conclusions: We conclude that OSU-03012 has potent activity against MM cells and acts via different mechanisms in addition to phosphoinositide-3-kinase/Akt pathway inhibition. These studies provide rationale for the clinical investigation of OSU-03012 in MM.
Medical Research in Pedophilia—Reply
Authors: Fred S. Berlin, Peter J. Fagan, Thomas N. Wise, Chester W. Schmidt
Journal: JAMA (2003)

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Corrosive Sublimate Poisoning by Means of Antiseptic Tablets.
Authors: W. H. Allen
Journal: JAMA (1913)

<h3>To the Editor:</h3> —Cases of poisoning by corrosive sublimate were in the past comparatively rare, but in view of the sensational statements in the Walker case it is probable that there will be more cases of mercuric poisoning, suicidal or accidental, by these easily obtained articles. Therefore the publication of a few facts and also theories may not be out of place. Since the newspaper reports appeared we have had two cases of poisoning by antiseptic tablets (HgCl<sub>2</sub>) in our city. One patient died; the other was given calx sulphurata and the outcome has not yet been settled. The general antidote appears to be white of egg, and it is of this we wish to speak first. It is true that on adding eggalbumin to a solution of corrosive sublimate the albuminate of mercury is formed, but the compound is not entirely insoluble in the gastric juice; further, the
Implementing Open-Access Scheduling of Visits in Primary Care Practices: A Cautionary Tale
Authors: Ateev Mehrotra
Journal: Annals of Internal Medicine (2008)

Background: Open-access scheduling (also known as advanced access or same-day access) is a popular tool for improving patient access to primary care appointments. Objective: To assess the effect of open-access scheduling and describe the barriers to implementing the open-access scheduling model in primary care. Design: Case series. Setting: Boston, Massachusetts, metropolitan area. Participants: 6 primary care practices studied from October 2003 through June 2006. Intervention: Implementation of open-access scheduling. Measurements: Time to third available appointments, no-show rates, and patient and staff satisfaction with appointment availability. Results: 5 of 6 practices were able to implement open-access scheduling. Within 4 months of implementation, these 5 practices substantially reduced their mean wait for third available appointments from 21 to 8 days for 15-minute visits and from 39 to 14 days for 30-minute visits. However, none of the 5 practices attained the goal of same-day access, and waits for third available appointments increased during 2 years of follow-up. No consistent changes in patient or staff satisfaction or patient no-show rates were found. Barriers to implementation included decreases in appointment supply from provider leaves of absence and departures and increases in appointment demand when practices reopened to new patients after initial implementation of open-access scheduling. Limitations: The study lacked control practices. The small number of practices and providers precluded formal statistical comparisons. Conclusion: In 5 of 6 primary care practices, implementation of open-access scheduling improved appointment access in some practices. However, none was able to achieve same-day access and patient and staff satisfaction and patient no-show rates were unchanged. Broader evaluation of open-access scheduling in primary care is needed.
HYPERMOBILITY- A RISK FACTOR FOR RECURRENT SHOULDER DISLOCATIONS
Authors: Adeel Akhtar Muhammad, Paul Jenkins, Fiona Ashton, Michael Robinson Christopher
Journal: British Journal of Sports Medicine (2013)

Background Hypermobility is associated with increased risk of sporting injuries. This study was performed to assess the risk of recurrent shoulder dislocations in patients with hypermobility. Methods Prospective data was collected for 38 patients with primary shoulder dislocations between October 2008 and July 2009 including demographic details, contact sport played, hypermobility, family history of laxity and Benign Joint Hypermobility Syndrome (BJHS). Electronic records from emergency and orthopaedic departments were checked in January 2013 to confirm recurrent shoulder dislocation. Beighton score of 6 or above was used for hypermobility. Brighton criteria were used to diagnose BJHS. Results The mean age was 25 years (range 15–55). There were 35 males and 3 females. twenty-two patients (58%) were involved in contact sports and most common sport played was rugby in twelve patients (55%). The mean Beighton score for these patients was 3.6 (range 0–9). Ten patients (26%) in this group had a Beighton score of 6 or more indicating hypermobility (Group A). twenty-eight patients (74%) had Beighton score less than 6 (Group B). The mean age for Group A (10 patients) was 26 years (range 15–55). There were 9 males and 1 female. Five patients were involved in contact sports. Six patients (60%) in this group had a recurrent shoulder dislocation. The mean Beighton score for these patients was 7.4 (range 6–9). Three patients (30%) had BJHS and six patients (60%) had a family history of laxity. The mean age for Group B (28 patients) was 25 years (range 15–44). There were 26 males and 2 females. Eleven patients (39%) were involved in contact sports. The mean Beighton score for these patients was 2 (range 0–5). One patient (3%) had BJHS and three patients (11%) had a family history of laxity. Eleven patients (39%) in this group had a recurrent shoulder dislocation. Discussion/Conclusion Hypermobile patients had a higher incidence of recurrent shoulder dislocations (60% vs 39%). 30% patients fulfilled the Brighton criteria for BJHS and 60% had a family history of laxity. These factors should be assessed in patients after primary shoulder dislocation to decide appropriate rehabilitation and treatment plan to prevent recurrence.
Factor XIII in the Treatment of Hemophilia A
Authors: Catherine J. Rea, Jonathan H. Foley, Benny Sørensen
Journal: New England Journal of Medicine (2012)

One facet of the clotting abnormality in factor VIII deficiency is clot instability. Factor XIII stabilizes clots. The authors show that augmenting factor XIII levels can stabilize clot formation even when factor VIII levels are low.
An alcoholic patient who continues to drink: endoscopic treatment is preferred
Authors: Mark Hudson
Journal: BMJ (2006)

EDITOR—Patients like Mr Bond in the last interactive case report are increasingly common and present difficult clinical decisions.1 Leon and McCambridge highlighted the large increase in deaths from cirrhosis in the United Kingdom between 1987-91 and 1997-2001.2 Mortality doubled (104% increase) in men in Scotland during that time, and per capita alcohol consumption also doubled in the UK between 1960 and 2002. Treatment of Mr Bond's variceal haemorrhage and associated decisions on how far to go with intervention should be based on clinical need, …