tbuckley/cabot-search huggingface dataset:
Comorbidity profiles among patients with ankylosing spondylitis: a nationwide population-based study
Authors: Jiunn-Horng Kang, Yi-Hua Chen, Herng-Ching Lin
Journal: Annals of the Rheumatic Diseases (2010)

Ankylosing spondylitis (AS) is a systemic inflammatory disease that can result in chronic pain and disability. This study aimed to analyse the prevalence and risk of medical comorbidities in patients with AS compared with the general population.11 701 patients with AS and 58 505 matching controls were selected for analysis from the National Health Insurance Research Dataset (NHIRD) in Taiwan. The Elixhauser comorbidity index was used for selecting medical comorbidities. Pearson chi2 tests and conditional logistic regression a nalyses were performed to examine the prevalence and risk of comorbidities between these two groups.Patients with AS were at increased risk for multiple systemic comorbidities including cardiovascular, neurological, pulmonary, gastrointestinal, endocrine, haematological and mental illness. The most prevalent comorbidities in patients with AS were hypertension (16.4%), peptic ulcers (13.9%) and headaches (10.2%).The results show that patients with AS have a higher prevalence of multiple comorbidities than the general population in Taiwan. These findings are consistent with previous studies done in Western populations. The results could be useful for both the clinical management of patients with AS and for researching the underlying pathological mechanisms.
Intramuscular Transplantation of Human Postnatal Myoblasts Generates Functional Donor-Derived Satellite Cells
Authors: Daniel Skuk, Martin Paradis, Marlyne Goulet, Pierre Chapdelaine, David M Rothstein, Jacques P Tremblay
Journal: Molecular Therapy (2010)

Myogenic cell transplantation is an experimental approach for the treatment of myopathies. In this approach, transplanted cells need to fuse with pre-existing myofibers, form new myofibers, and generate new muscle precursor cells (MPCs). The last property was fully reported following myoblast transplantation in mice but remains poorly studied with human myoblasts. In this study, we provide evidence that the intramuscular transplantation of postnatal human myoblasts in immunodeficient mice generates donor-derived MPCs and specifically donor-derived satellite cells. In a first experiment, cells isolated from mouse muscles 1 month after the transplantation of human myoblasts proliferated in vitro as human myoblasts. These cells were retransplanted in mice and formed myofibers expressing human dystrophin. In a second experiment, we observed that inducing muscle regeneration 2 months following transplantation of human myoblasts led to myofiber regeneration by human-derived MPCs. In a third experiment, we detected by immunohistochemistry abundant human-derived satellite cells in mouse muscles 1 month after transplantation of postnatal human myoblasts. These human-derived satellite cells may correspond totally or partially to the human-derived MPCs evidenced in the first two experiments. Finally, we present evidence that donor-derived satellite cells may be produced in patients that received myoblast transplantation. Myogenic cell transplantation is an experimental approach for the treatment of myopathies. In this approach, transplanted cells need to fuse with pre-existing myofibers, form new myofibers, and generate new muscle precursor cells (MPCs). The last property was fully reported following myoblast transplantation in mice but remains poorly studied with human myoblasts. In this study, we provide evidence that the intramuscular transplantation of postnatal human myoblasts in immunodeficient mice generates donor-derived MPCs and specifically donor-derived satellite cells. In a first experiment, cells isolated from mouse muscles 1 month after the transplantation of human myoblasts proliferated in vitro as human myoblasts. These cells were retransplanted in mice and formed myofibers expressing human dystrophin. In a second experiment, we observed that inducing muscle regeneration 2 months following transplantation of human myoblasts led to myofiber regeneration by human-derived MPCs. In a third experiment, we detected by immunohistochemistry abundant human-derived satellite cells in mouse muscles 1 month after transplantation of postnatal human myoblasts. These human-derived satellite cells may correspond totally or partially to the human-derived MPCs evidenced in the first two experiments. Finally, we present evidence that donor-derived satellite cells may be produced in patients that received myoblast transplantation.
Two thousand health staff sign petition calling for euthanasia to be decriminalised
Authors: Brad Spurgeon
Journal: BMJ (2007)

More than 2000 doctors, nurses, and other health workers have published a petition in a French news magazine admitting to having assisted the deaths of terminally ill patients at some time in their careers ( Le Nouvel Observateur 2007 March 8:98 http://tempsreel.nouvelobs.com/actualites/societe/20070312.OBS6433/euthanasie_\_le\_proces\_dun\_medecinet\_dune\_infirmiere_sou.html).

The petition was published four days before a trial opened in Perigueux, in south west France, of a doctor and a nurse accused of killing a 65 year old patient who was terminally ill with pancreatic cancer by administering a lethal dose of potassium in August 2003. If they …
Prepartum or Postpartum Pleural Effusion
Authors: MATTHEW A. PARKER
Journal: Annals of Internal Medicine (1983)

Letters and Corrections1 March 1983Prepartum or Postpartum Pleural EffusionMATTHEW A. PARKER, M.D.MATTHEW A. PARKER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-98-3-413_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The paper by Hughson and associates (1) is an example of how clinical accumen and academic skills can be combined to produce valuable, practical information. It is easy to imagine many situations in which the presence of a pleural effusion would lead to unnecessary and potentially dangerous steps.However, the logic of calling these pleural effusions "postpartum" and attempting to explain them on the basis of events during labor and delivery escapes me. It seems possible that the effusions were present before delivery for the same hemodynamic and vascular reasons cited. A pleural effusion during pregnancy would...Reference1. HUGHSONFRIEDMANFEIGINRESNIKMOSER WPDRK. Postpartum pleural effusion: a common radiologic finding. Ann Intern Med. 1982;97:856-8. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: 1234 19th Street, N.W., Suite 508; Washington, D.C. 20036 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 March 1983Volume 98, Issue 3Page: 413-414KeywordsHemodynamicsLabor and deliveryPleural effusionPregnancy Issue Published: 1 March 1983 PDF DownloadLoading ...
You scratch my back..
Authors: T Greenhalgh
Journal: BMJ (1994)

“I done me Gazza ligament, innit, doc?” He had been route marching with the Territorial Army. I examined the knee, diagnosed simple overuse, and gave standard advice.

“No x ray then, doc? Don't get no letter for the specialist?”

“No x ray; no specialist,” I confirmed. He shrugged, hesitated, and asked for a chest x ray instead.

He was young and had never smoked. I reminded him that this was not Marks and Spencers. But, he insisted, his mate had seen a bloke on the private for a routine checkup and got an x ray. He just knew I would have done more …
p21Waf1/Cip1 Expression by Curcumin in U-87MG Human Glioma Cells: Role of Early Growth Response-1 Expression
Authors: Byeong Hyeok Choi, Chang Gun Kim, Young-Seuk Bae, Yoongho Lim, Young Han Lee, Soon Young Shin
Journal: Cancer Research (2008)

Curcumin, a natural compound, is a well-known chemopreventive agent with potent anticarcinogenic activity in a wide variety of tumor cells. Curcumin inhibits cancer cell proliferation in part by suppressing cyclin D1 and inducing expression of the cyclin-dependent kinase inhibitor p21(Waf1/Cip1). Both p53-dependent and p53-independent mechanisms regulate p21(Waf1/Cip1) expression, but the mechanism by which curcumin regulates p21(Waf1/Cip1) expression remains unknown. Here, we report that transcription of the p21(Waf1/Cip1) gene is activated by early growth response-1 (Egr-1) independently of p53 in response to curcumin treatment in U-87MG human glioblastoma cells. Egr-1 is a transcription factor that helps regulate differentiation, growth, and apoptosis in many cell types. Egr-1 expression is induced by curcumin through extracellular signal-regulated kinase (ERK) and c-Jun NH(2)-terminal kinase (JNK), but not the p38, mitogen-activated protein kinase (MAPK) pathways, which mediate the transactivation of Elk-1. Transient expression of Egr-1 enhanced curcumin-induced p21(Waf1/Cip1) promoter activity, whereas suppression of Egr-1 expression by small interfering RNA abrogated the ability of curcumin to induce p21(Waf1/Cip1) promoter activity. In addition, stable knockdown of Egr-1 expression in U-87MG cells suppressed curcumin-induced p21 expression. Our results indicate that ERK and JNK MAPK/Elk-1/Egr-1 signal cascade is required for p53-independent transcriptional activation of p21(Waf1/Cip1) in response to curcumin in U-87MG human glioblastoma cells.
Autotransplantation of Human Cancer
Authors: Sigmond H. Nadler
Journal: JAMA (1965)

For many years a great deal of stress has been placed on the elimination of the possibilities of autotransplantation of tumor during a surgical procedure. Various techniques have been evolved for different surgical procedures which would tend to prevent spillage and implantation of tumor. This study purposely involved autotransplantation of tumors to obtain knowledge of the nature of takes, length of incubation, growth rate, and possible action of autogenous tumor transplants as an autovaccine. <h3>Materials and Methods</h3> Volunteer patients with incurable cancer on the Chemotherapy Service at Roswell Park Memorial Institute were involved in this study; a total number of 82 patients were used. At the time of surgical exploration, multiple specimens of tumor were obtained; one portion was sent for pathological examination for confirmation of the diagnosis. After all necrotic or extraneous tissue had been excised, the other pieces of sterile tumor were finely minced with a scalpel and
Simvastatin reduced major vascular events at 5 years in at-risk patients; benefits were maintained at 11 years
Authors: Edward P. Havranek
Journal: Annals of Internal Medicine (2012)

Source Citation Heart Protection Study Collaborative Group. Effects on 11-year mortality and morbidity of lowering LDL cholesterol with simvastatin for about 5 years in 20 536 high-risk individuals: a randomised controlled trial. Lancet. 2011;378:2013-20. 22115874
Steps towards cost-benefit analysis of regional neurosurgical care.
Authors: J D Pickard, S Bailey, H Sanderson, M Rees, J S Garfield
Journal: BMJ (1990)

OBJECTIVE--To determine the cost of averting death or severe disability by neurosurgical intervention. DESIGN--Retrospective analysis of one year9s admissions for neurosurgery; comparison of outcome with expected outcome in the absence of neurosurgical intervention and with the cost of neurosurgery. SETTING--Wessex Neurological Centre. PATIENTS--1026 Patients were admitted to the neurosurgical service in 1984. Of 1185 admissions, 978 case records were available and outcome was known in 919. MAIN OUTCOME MEASURES--Outcome was assessed with the Glasgow outcome scale, modified as necessary, from the case notes, or by letter follow up to the general practitioner. Expected outcomes for each of the 54 diagnoses were derived from both published reports where available and an expert panel of 18 consultant neurosurgeons. The cost of the neurosurgical service for 1983-4 was known from a separate study and the cost per patient was calculated using the length of stay. RESULTS--The cost of neurosurgery in 1983-4 was 1.8 million pounds. In all, 243 deaths or severe disabilities were estimated to have been averted at an average cost of 7325 pounds (range 5000 pounds to 70,000 pounds). The overall cost per quality adjusted life year (QALY) was 350 pounds (range 34 pounds to greater than 400,000 pounds). The cost of long term care for severely disabled survivors is at least 18-fold greater than the cost of neurosurgical intervention to avert such disability. CONCLUSIONS--In Britain neurosurgery is not expensive in comparison with the costs and benefits of other areas of medicine, and the cost per QALY is unexpectedly low except for severe diffuse head injury, malignant brain tumors, and cerebral metastases. The neurosurgical budget should be assessed in the context of managing a patient in hospital and subsequently in the community.
Efficacy and Safety of Tenofovir DF vs Stavudine in Combination Therapy in Antiretroviral-Naive Patients&lt;SUBTITLE&gt;A 3-Year Randomized Trial&lt;/SUBTITLE&gt;
Authors: Joel E. Gallant, Schlomo Staszewski, Anton L. Pozniak, Edwin DeJesus, Jamal M. A. H. Suleiman, Michael D. Miller, Dion F. Coakley, Biao Lu, John J. Toole, Andrew K. Cheng
Journal: JAMA (2004)

ContextTenofovir disoproxil fumarate (DF) is a once-daily nucleotide analogue reverse transcriptase inhibitor.ObjectiveTo evaluate the efficacy and safety of tenofovir DF compared with stavudine in antiretroviral-naive patients.Design, Setting, and ParticipantsA prospective, randomized, double-blind study conducted at 81 centers in the United States, South America, and Europe from June 9, 2000, to January 30, 2004. A total of 753 patients infected with HIV who were antiretroviral naive were screened and 602 patients entered the study.InterventionPatients were randomized to receive either tenofovir DF (n = 299) or stavudine (n = 303), with placebo, in combination with lamivudine and efavirenz.Main Outcome MeasureProportion of patients with HIV RNA levels of less than 400 copies/mL at week 48.ResultsIn the primary intent-to-treat analysis in which patients with missing data or who added or switched antiretroviral medications before week 48 were considered as failures, the proportion of patients with HIV RNA of less than 400 copies/mL at week 48 was 239 (80%) of 299 in patients receiving tenofovir DF and 253 (84%) of 301 in patients receiving stavudine (95% confidence interval, −10.4% to 1.5%), exceeding the predefined −10% limit for equivalence. However, equivalence was demonstrated in the secondary analyses (HIV RNA &lt;50 copies/mL) at week 48 and through 144 weeks. Virologic failure was associated most frequently with efavirenz and lamivudine resistance. Through 144 weeks, the K65R mutation emerged in 8 and 2 patients in the tenofovir DF and stavudine groups, respectively (P = .06). A more favorable mean change from baseline in fasting lipid profile was noted in the tenofovir DF group at week 144: for triglyceride levels (+1 mg/dL for tenofovir DF [n = 170] vs +134 mg/dL for stavudine [n = 162], P&lt;.001), total cholesterol (+30 mg/dL [n = 170] vs +58 mg/dL [n = 162], P&lt;.001), direct low-density lipoprotein cholesterol (+14 mg/dL [n = 169] vs +26 mg/dL [n = 161], P&lt;.001), and high-density lipoprotein cholesterol (+9 mg/dL [n = 168] vs +6 mg/dL [n = 154], P = .003). Investigator-reported lipodystrophy was less common in the tenofovir DF group compared with the stavudine group (9 [3%] of 299 vs 58 [19%] of 301, P&lt;.001). The number of bone fractures and the renal safety profile were similar between the 2 groups.ConclusionsThrough 144 weeks, the combination of tenofovir DF, lamivudine, and efavirenz was highly effective and comparable with stavudine, lamivudine, and efavirenz in antiretroviral-naive patients. However, tenofovir DF appeared to be associated with better lipid profiles and less lipodystrophy.
Professional and Managerial Aspects of Clinical Audit
Authors: M. Lawrence
Journal: BMJ (1995)

Ed Anthony Hopkins Royal College of Physicians, £14, pp 148 ISBN 1 873 240 77 5

When a subject is rapidly changing, a book based on a conference can be a good way of defining the “state of the art.” This is very much what Professional and Managerial Aspects of Clinical Audit does, and successive sections provide the current views on audit of purchasers and providers, the nine royal colleges, information technologists, and managers. The picture is comprehensive and clear—and depressing. If this is the offering of the best, what hope for the rest of us?

Lack of direction and vision permeates the pages. The Royal College of Obstetricians and Gynaecologists has as one main function “to suggest …
Geographical heterogeneity of multidrug-resistant tuberculosis in Georgia, January 2009 to June 2011
Authors: H E Jenkins, M Gegia, J Furin, I Kalandadze, U Nanava, T Chakhaia, T Cohen
Journal: Eurosurveillance (2014)

In 2011, Georgia, in the Caucasus, reported that 11% of new and 32% of previously treated tuberculosis (TB) cases nationally had multidrug-resistant TB (MDR-TB). To help understand the mechanisms driving these high risks of drug-resistance and plan for targeted interventions, we identified geographical variability in the MDR-TB burden in Georgia and patient-level MDR-TB risk factors. We used routinely collected surveillance data on notified TB cases to estimate the MDR-TB incidence/100,000 people and the percentage of TB cases with MDR-TB for each of 65 districts and regression modelling to identify patient-level MDR-TB risk factors. 1,795 MDR-TB cases were reported (January 2009–June 2011); the nationwide notified MDR-TB incidence was 16.2/100,000 but far higher (837/100,000) in the penitentiary system. We found substantial geographical heterogeneity between districts in the average annual MDR-TB incidence/100,000 (range: 0.0–5.0 among new and 0.0–18.9 among previously treated TB cases) and the percentage of TB cases with MDR-TB (range: 0.0%–33.3% among new and 0.0%–75.0% among previously treated TB cases). Among treatment-naïve individuals, those in cities had greater MDR-TB risk than those in rural areas (increased odds: 43%; 95% confidence interval: 20%–72%). These results suggest that interventions for interrupting MDR-TB transmission are urgently needed in prisons and urban areas.
1163-112 Homocysteine levels predict risk for congestive heart failure in patients with and without coronary artery disease
Authors: Sandra P Reyna, Jeffrey L Anderson, Benjamin D Horne, Tami L Bair, Jamison Jones, Kimberlee M Robinson, Robert R Pearson, Stephanie A Moore, Joseph B Muhlestein, Dale G Renlund
Journal: Journal of the American College of Cardiology (2004)
Dutch and Swiss support heroin on prescription
Authors: T. Sheldon
Journal: BMJ (1997)

Dutch MPs have agreed to launch a pilot study for providing heroin on prescription as part of a strictly controlled medical experiment. The move came as a referendum in Switzerland gave overwhelming backing for the government's three year old scheme to provide heroin to addicts.

Researchers have shown that crime levels among Swiss drug misusers taking part in the scheme have fallen by 60% since the scheme started. The Swiss government signalled that it might expand the programme, which …
Outcome of breech delivery at term.
Authors: L. D. Cardozo, C. J. Kelleher
Journal: BMJ (1992)

Health effects of organophosphate sheep dipsEDITOR,-We wish to draw attention to the possible health effects of exposure to sheep dips containing organophosphates (diazinon, propetamphos, or chlorfenvinphos).Toxic exposure to organophos- phate substances may cause acute cholinergic inhibition' that correlates poorly with clinical effects.'Acute clinical effects after exposure to organophosphate dips are uncommon, and because these effects are non-specific, resembling influenza, diagnosis may be difficult.During the dipping season last year (22 Septem- ber to 3 November) the National Poisons Unit, in collaboration with the Veterinary Medicines Direc- torate of the Ministry of Agriculture, Fisheries and Food, investigated cases of suspected exposure reported to the poisons unit by doctors requesting information on management.We obtained details of the cases by telephone and by sending follow up questionnaires to the doctors.If a case was reported within seven days of exposure the doctor was asked to take a blood sample (5 ml EDTA) straight away and another at least one month later.The National Poisons Unit Laboratory measured erythrocyte and plasma cholinesterase activities with an assay based on the method of Ellman et al." Thirty four reports were received.The age of the patients, recorded in 31 cases, ranged from 2 to 75 years.Twenty nine patients were exposed while working with sheep, but three were exposed accidentally, including a 2 year old child who fell into a dip.Circumstances were unknown in two cases.
Prophylaxis of central venous catheter-related thrombosis with minidose warfarin in patients treated with high-dose chemotherapy and peripheral-blood stem-cell transplantation: Retrospective analysis of 228 cancer patients
Authors: Massimo Magagnoli, Giovanna Masci, Luca Castagna, Vittorio Pedicini, Dario Poretti, Emanuela Morenghi, Giorgio Brambilla, Armando Santoro
Journal: American Journal of Hematology (2005)

Patients with a central venous catheter (CVC) undergoing high-dose chemotherapy (HDC) followed by peripheral-blood stem-cell transplantation (PBSCT) for malignancies are at high risk of thrombosis, but the use of anti-coagulant prophylaxis remains debatable in this setting of patients. We analyzed the efficacy and the safety of minidose warfarin in 228 patients in whom CVCs had been placed and who had received 292 HDC courses of therapy. The catheters remained in place for a mean of 173 (range 40-298) days. All patients received prophylactic oral warfarin in the fixed dose of 1 mg/day starting on the day of CVC insertion. Prophylaxis was interrupted during aplasia when platelet counts fell below 50,000/dL. There were no toxic deaths related to the prophylaxis. Overall there were 4 thrombotic events. Three occurrences were directly related to the catheter, while the remaining event was a deep saphenous-vein thrombosis. A number of potential predictive factors were analyzed for their impact on thrombotic events without finding any significant correlation. Four episodes of bleeding occurred, with each of these individuals having a normal INR but a platelet count below 50,000/dL. Minidose warfarin is effective and safe to use for preventing thrombotic events in this setting of patients.
A Tribute: Wisconsin's McArdle Laboratory Celebrates Its 50th Anniversary
Authors: Gail McBride
Journal: JNCI Journal of the National Cancer Institute (1990)

Journal Article A Tribute: Wisconsin's McArdle Laboratory Celebrates Its 50th Anniversary Get access Gail McBride Gail McBride Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 82, Issue 20, 17 October 1990, Pages 1602–1610, https://doi.org/10.1093/jnci/82.20.1602 Published: 17 October 1990