tbuckley/cabot-search huggingface dataset:
Referrals to rheumatology.
Authors: P S Helliwell, V Wright
Journal: BMJ (1991)

bladder.They have been plucked from the gall bladder percutaneously or reduced to tiny fragments with extra- corporeal shock wave lithotripsy.But cholecystectomy has the unique advantage of removing the organ in which gall stones form and therefore of providing a lifetime cure.A compromise method is to perform minilap cholecystectomy, but this tends to combine the worst of all worlds and compares unfavourably with the endoscopic method.4In England, over 30 000 cholecystectomies are performed each year.'If all these were performed by laparoscopic methods the saving resulting from a reduction in bed days alone would amount to £2 Im.In these days of strict financial and medical audit endoscopic cholecystectomy will inevitably become the only method for routine cholecystectomy.It is an innovation that has the virtue of being advantageous for both the customer and the community.
Living in towers as risk factor of pollen allergy
Authors: A. Armentia, T. Asensio, J. Subiza, M. L. Arranz, F.‐J. Martín Gil, A. Callejo
Journal: Allergy (2004)

The effects of fluctuations in pollen counts have important implications for health services. Little research on the clinical implications of the vertical distribution of pollen in allergy symptoms has been carried out.We have investigated the allergic symptoms of a population of 17 171 patients coming from our health area (Valladolid, Spain) and living in the city and villages. We compared the prevalence of sensitization to different pollens: Graminae, trees and shrub in relation with the floor of the building where they were living.Relative risk of pollen sensitization (confidence index, CI 95%) was higher in patients who were living at high floors than in those patients who were living in lower floors or at street level, independently of rural or urban conditions The chi-square showed a lineal trend in this relationship in the case of sensitization to grass pollen: chi(2): 1794, P > 0.00001On the basis of our local investigations, natural pollen sensitization appears to increase with height where the patient lives. This paper reports clinical results on the influence of vertical pollen distribution in pollen allergy.
Serial Cardiac Output and Blood Volume Studies Following Cardiac Valve Replacement
Authors: FRANK E. KLOSTER, J. DAVID BRISTOW, ALBERT STARR, COLIN W. MCCORD, HERBERT E. GRISWOLD
Journal: Circulation (1966)

The cardiac output and blood volume were measured preoperatively and sequentially during the early postoperative period in 45 patients undergoing cardiac valve replacement. Most patients showed a prompt, highly significant increase in cardiac output. Those with uncorrected valvular disease, even though apparently trivial, had lower cardiac outputs. The blood volume was sharply reduced from the preoperative level in almost every patient. When this was associated with low cardiac output, replacement of the blood volume deficit was usually accompanied by a prompt increase in cardiac output. Failure to respond in this way occurred only in patients with residual valvular lesions or myocardial disease.
Effects of a Supportive-Expressive Group Intervention on Long-Term Psychosocial Adjustment in HIV-Infected Gay Men
Authors: Jeffrey J. Weiss, Cornelis L. Mulder, Michael H. Antoni, Ernest M.M. de Vroome, Bert Garssen, Karl Goodkin
Journal: Psychotherapy and Psychosomatics (2003)

&lt;i&gt;Background:&lt;/i&gt; This study compared the effects of a supportive-expressive group intervention (GI) with an educational control condition (EC) on long-term psychosocial adjustment in gay men with HIV infection. &lt;i&gt;Method:&lt;/i&gt; Subjects (n = 85) were randomized after stratification for disease stage and use of antiretroviral medication. GI consisted of 4 months of weekly group sessions followed by 5 monthly maintenance sessions plus written educational material, whereas the EC subjects received educational material only. &lt;i&gt;Results:&lt;/i&gt; There were no between-group differences in effects on distress, coping or social support in analyses examining 4 time points over 15 months. Both conditions decreased in distress over time on the Hopkins Symptom Checklist and Beck Depression Inventory. &lt;i&gt;Conclusions:&lt;/i&gt; Several explanations are offered for the reason why no additional benefit of the GI was found on outcome measures studied when compared with the EC condition and recommendations are made for future psychosocial intervention research with HIV-infected persons.
Survivin mediates aberrant hematopoietic progenitor cell proliferation and acute leukemia in mice induced by internal tandem duplication of Flt3
Authors: Seiji Fukuda, Pratibha Singh, Akira Moh, Mariko Abe, Edward M. Conway, H. Scott Boswell, Seiji Yamaguchi, Xin-Yuan Fu, Louis M. Pelus
Journal: Blood (2009)
Anakinra, a Recombinant Human Interleukin-1 Receptor Antagonist, Inhibits Apoptosis in Experimental Acute Myocardial Infarction
Authors: Antonio Abbate, Fadi N. Salloum, Elena Vecile, Anindita Das, Nicholas N. Hoke, Stefania Straino, Giuseppe G.L. Biondi-Zoccai, Jon-Erik Houser, Ian Z. Qureshi, Evan D. Ownby, Edoardo Gustini, Luigi M. Biasucci, Anna Severino, Maurizio C. Capogrossi, George W. Vetrovec, Filippo Crea, Alfonso Baldi, Rakesh C. Kukreja, Aldo Dobrina
Journal: Circulation (2008)

Background— Experimental interleukin-1 receptor antagonist gene overexpression has shown that interleukin-1 receptor antagonist is cardioprotective during global cardiac ischemia. The aim of the present study was to test the impact of an exogenous recombinant human interleukin-1 receptor antagonist (anakinra) in experimental acute myocardial infarction. Methods and Results— Two animal studies were conducted: one of immediate anakinra administration during ischemia in the mouse and one of delayed anakinra administration 24 hours after ischemia in the rat. Seventy-eight Institute of Cancer Research mice and 20 Wistar rats underwent surgical coronary artery ligation (or sham operation) and were treated with either anakinra 1 mg/kg or NaCl 0.9% (saline). Treatment was administered during surgery and then daily for 6 doses in the mice and starting on day 2 daily for 5 doses in the rats. Twenty-eight mice underwent infarct size assessment 24 hours after surgery, 6 saline-treated mice and 22 mice treated with increasing doses of anakinra (1 mg/kg [n=6], 10 mg/kg [n=6], and 100 mg/kg [n=10]); 6 mice were euthanized at 7 days for protein expression analysis. The remaining animals underwent transthoracic echocardiography before surgery and 7 days later just before death. Cardiomyocyte apoptosis was measured in the peri-infarct regions. The antiapoptotic effect of anakinra was tested in a primary rat cardiomyocyte culture during simulated ischemia and in vitro on caspase-1 and -9 activities. At 7 days, 15 of the 16 mice (94%) treated with anakinra were alive versus 11 of the 20 mice (55%) treated with saline ( P =0.013). No differences in infarct size at 24 hours compared with saline were observed with the 1- and 10-mg/kg doses, whereas a 13% reduction in infarct size was found with the 100-mg/kg dose ( P =0.015). Treatment with anakinra was associated with a significant reduction in cardiomyocyte apoptosis in both the immediate and delayed treatment groups (3.1±0.2% versus 0.5±0.3% [ P &lt;0.001] and 4.2±0.4% versus 1.1±0.2% [ P &lt;0.001], respectively). Compared with saline-treated animals, anakinra-treated mice and rats showed signs of more favorable ventricular remodeling. In vitro, anakinra significantly prevented apoptosis induced by simulated ischemia and inhibited caspase-1 and -9 activities. Conclusions— Administration of anakinra within 24 hours of acute myocardial infarction significantly ameliorates the remodeling process by inhibiting cardiomyocyte apoptosis in 2 different experimental animal models of AMI. This may open the door for using anakinra to prevent postischemic cardiac remodeling and heart failure.
More data using same database
Authors: E. Wright, P. T. Seed, P. Schofield, R. Jones
Journal: BMJ (2010)

Green and colleagues report the risk of various gastrointestinal cancers with oral bisphosphonates.1 Using a similar dataset from the same database, we independently compared bisphosphonate prescribing in cases of upper gastrointestinal cancer with that in controls from 1995 (when alendronate was first licensed) to 2007.

The odds of being a case increased 1.17 times for those taking bisphosphonates (odds …
Sports doctors' resuscitation skills under examination—additional facts
Authors: M B Bottomley
Journal: British Journal of Sports Medicine (2001)

The football club doctor system EDITOR,-I read with interest the paper by Waddington et al 1 highlighting the inadequacies of the football club doctor system in Britain.This paper confirms the situation that many people already knew to exist.Advertisements for club doctors are rarely published in medical journals, doctors normally being appointed on a "who you know" basis.It is also particularly disappointing that, at a time when the specialty of sports and exercise medicine is being established in this country, the majority of doctors working with professional footballers have no qualifications or little experience in the specialty.However, this is not confined to football clubs and probably also applies to rugby clubs and many other sporting associations.One aspect not mentioned in the paper is medical litigation.It is to be hoped that doctors involved with football clubs have arranged medical defence cover, because, if a situation arises in which a player's sporting career is threatened by medical mismanagement and the doctor involved has no professionally recognised sports medicine qualification, he or she could be found guilty of medical negligence.With the amount of money involved in professional football, this could lead to dire consequences for the medical career of the practitioner involved.From a report commissioned by the Football League on the Hillsborough tragedy, the concept of the "crowd doctor" was introduced, meaning that any doctor involved in the medical care of the crowd at a football stadium would be required to possess at least the Diploma in Immediate Medical Care. 2 Before that, the situation was similar to that of the present club doctor system, and few doctors held any recognisable qualifications or training in medical emergencies and resuscitation.A similar recommendation by sports medicine authorities is required to enhance the quality of service provided to football clubs and increase the stature of the specialty.However, it is not a one sided situation.Football clubs must realise the importance of a medical team in looking after their prime assets, the players.Advertising of jobs in medical journals, insisting on experience and qualifications, adequate remuneration, and the provision of job descriptions and contracts should all be implemented.By working together to improve the current situation, a service can be provided in which both professional football players and the medical profession can have confidence.
Incidence of clinically manifest ulcers and their complications in patients with rheumatoid arthritis
Authors: K S S Steen
Journal: Annals of the Rheumatic Diseases (2001)

<h3>BACKGROUND</h3> Non-steroidal anti-inflammatory drugs (NSAIDs) are often prescribed in patients with rheumatoid arthritis (RA). Because of its frequency and severity, NSAID gastropathy is the most important side effect. The clinical spectrum of NSAID gastropathy includes gastrointestinal complaints, ulcers and their complications. To reduce NSAID gastropathy, rheumatologists in greater Amsterdam decided in January 1997 that prophylactic agents should be prescribed for patients with RA at high risk for NSAID gastropathy, defined as age 60 or older or a history of gastrointestinal (GI) ulcers, or both. <h3>OBJECTIVE</h3> To determine the incidence of clinically manifest ulcers and their complications in patients with RA at high risk for NSAID gastropathy during a period in which prophylaxis was recommended. Published reports show that the incidence of clinically manifest ulcers and their complications varies from 1.3% to 5%. <h3>PATIENTS AND METHODS</h3> Within one year, three questionnaires were sent to all outpatients with RA of our clinic (n=2680). The patients were asked if they had had a gastroscopy and/or complication of an ulcer in the preceding months. When a GI event (ulcer or complication) had occurred an analysis was carried out to determine whether the event was possibly related to a compliance failure or a policy failure—for example, no prophylaxis prescribed when it was recommended. <h3>RESULTS</h3> The response rate for the three questionnaires was 88%, 76%, and 77%, respectively. All three questionnaires were returned by 1856 patients; NSAIDs were used in 1246 (67%) of them. Of the NSAID users 731 (59%) were in the high risk group. Clinically manifest ulcers occurred in seven high risk NSAID users (four gastric ulcers, two duodenal ulcers, and in one patient both types of ulcer). Complications of ulcers were diagnosed in eight (other) patients: seven (upper) GI bleedings and one perforation. Thus the incidence during one year of clinically manifest ulcers in the high risk group was 1.0% and of complications of ulcers 1.1%, together 2.1%. In the group of 15 patients with GI events, only one patient had not taken the adequately prescribed gastroprotective drugs (compliance failure). Misguidedly, gastroprotective drugs were not prescribed in seven patients (policy failure), but in the remaining seven patients gastroprotective drugs were adequately prescribed and used. <h3>CONCLUSION</h3> The incidence of clinically manifest ulcers and of complications of ulcers in patients with RA at high risk for NSAID gastropathy is relatively low, and might be related to our strategy to prescribe prophylactic agents in these patients.
Minicircle DNA-based Gene Therapy Coupled With Immune Modulation Permits Long-term Expression of α-L-Iduronidase in Mice With Mucopolysaccharidosis Type I
Authors: Mark J Osborn, Ron T McElmurry, Christopher J Lees, Anthony P DeFeo, Zhi-Ying Chen, Mark A Kay, Luigi Naldini, Gordon Freeman, Jakub Tolar, Bruce R Blazar
Journal: Molecular Therapy (2010)

Mucopolysaccharidosis type I (MPS I) is a lysosomal storage disease characterized by mutations to the α-L-iduronidase (IDUA) gene resulting in inactivation of the IDUA enzyme. The loss of IDUA protein results in the progressive accumulation of glycosaminoglycans within the lysosomes resulting in severe, multi-organ system pathology. Gene replacement strategies have relied on the use of viral or nonviral gene delivery systems. Drawbacks to these include laborious production procedures, poor efficacy due to plasmid-borne gene silencing, and the risk of insertional mutagenesis. This report demonstrates the efficacy of a nonintegrating, minicircle (MC) DNA vector that is resistant to epigenetic gene silencing in vivo. To achieve sustained expression of the immunogenic IDUA protein we investigated the use of a tissue-specific promoter in conjunction with microRNA target sequences. The inclusion of microRNA target sequences resulted in a slight improvement in long-term expression compared to their absence. However, immune modulation by costimulatory blockade was required and permitted for IDUA expression in MPS I mice that resulted in the biochemical correction of pathology in all of the organs analyzed. MC gene delivery combined with costimulatory pathway blockade maximizes safety, efficacy, and sustained gene expression and is a new approach in the treatment of lysosomal storage disease. Mucopolysaccharidosis type I (MPS I) is a lysosomal storage disease characterized by mutations to the α-L-iduronidase (IDUA) gene resulting in inactivation of the IDUA enzyme. The loss of IDUA protein results in the progressive accumulation of glycosaminoglycans within the lysosomes resulting in severe, multi-organ system pathology. Gene replacement strategies have relied on the use of viral or nonviral gene delivery systems. Drawbacks to these include laborious production procedures, poor efficacy due to plasmid-borne gene silencing, and the risk of insertional mutagenesis. This report demonstrates the efficacy of a nonintegrating, minicircle (MC) DNA vector that is resistant to epigenetic gene silencing in vivo. To achieve sustained expression of the immunogenic IDUA protein we investigated the use of a tissue-specific promoter in conjunction with microRNA target sequences. The inclusion of microRNA target sequences resulted in a slight improvement in long-term expression compared to their absence. However, immune modulation by costimulatory blockade was required and permitted for IDUA expression in MPS I mice that resulted in the biochemical correction of pathology in all of the organs analyzed. MC gene delivery combined with costimulatory pathway blockade maximizes safety, efficacy, and sustained gene expression and is a new approach in the treatment of lysosomal storage disease.
The mouse uterotrophic assay: a reevaluation of its validity in assessing the estrogenicity of bisphenol A.
Authors: C M Markey, C L Michaelson, E C Veson, C Sonnenschein, A M Soto
Journal: Environmental Health Perspectives (2001)

The prevalence of synthetic chemicals in our environment that are capable of mimicking the female hormone estrogen is a growing concern. One such chemical, bisphenol A (BPA), has been shown to leach from a variety of resin-based and plastic products, including dental sealants and food and beverage containers, in concentrations that are sufficient to induce cell proliferation in vitro. The response to BPA in vivo has been varied; thus the aims of this study were to investigate a) whether BPA has an estrogenic effect in CD-1 mice, a strain that is useful for developmental studies; and b) whether the uterotrophic assay is a valid means of determining the estrogenicity of BPA by comparing it with other end points measured in the uterus. Immature female CD-1 mice were exposed to BPA in concentrations ranging from 0.1 to 100 mg/kg body weight for 3 days. Results showed that BPA induced a significant increase in the height of luminal epithelial cells within the uterus at concentrations of 5, 75, and 100 mg/kg and that BPA induced lactoferrin at concentrations of 75 and 100 mg/kg. A uterotrophic response (increase in uterine wet weight) was induced by 100 mg/kg BPA only. Further, the proportion of mice showing vaginal opening was greater after exposure to 0.1 and 100 mg/kg BPA, relative to the control animals and those receiving intermediate doses of BPA. These results demonstrate that BPA induces changes in the mouse uterus that differ depending on the exposure dose and the end point measured, and reveal that certain tissue effects show a nonmonotonic relationship with dose. These data also demonstrate that BPA induces estrogenic changes in the uterus of the CD-1 mouse, and highlight the need to reevaluate the validity of the mouse uterotrophic assay as an end point for determining the estrogenicity of suspected environmental estrogens.
Mary Rose Kirkpatrick
Authors: J. Clegg
Journal: BMJ (2004)

Former medical officer of health Norfolk (b 1921; q London 1945; DCH), died on 1 October 2003 following a road traffic incident.

After qualifying Mary Rose Kirkpatrick worked at Birmingham Children's Hospital. Then at the age of 40 she went to Zululand as the medical superintendent of St Mary's Hospital, Kwa Magwaza, a long established Anglican mission hospital. On returning to England she became a medical officer of health in 1974 with the North Norfolk Community Health Service, where she remained until her retirement in 1986.
1002-82 Impact of body mass index on outcomes after primary angioplasty in acute myocardial infarction: The obesity paradox
Authors: Eugenia Nikolsky, Roxana Mehran, Alexandra J Lansky, Cindy L Grines, David A Cox, Eulogio Garcia, James E Tcheng, John J Griffin, Giulio Guagliumi, Thomas Stuckey, Mark Turco, David A Cohen, Barry Rutherford, Gregg W Stone
Journal: Journal of the American College of Cardiology (2004)
<i>Clostridium difficile</i> — Beyond the Usual Suspects
Authors: Curtis J. Donskey
Journal: New England Journal of Medicine (2013)

One of the central concepts guiding efforts to prevent Clostridium difficile infection has been that symptomatic patients in hospitals are the major source of transmission.1 Infected patients with diarrhea shed large numbers of spores, contaminating their skin, clothing, and surrounding surfaces. The basic measures that are used to prevent transmission include placement of infected patients under contact precautions until diarrhea resolves and the disinfection of surfaces and equipment with sporicidal products such as sodium hypochlorite.Unfortunately, these measures have often proved to be ineffective during the past decade, when infection rates have risen dramatically in association with large outbreaks of . . .
Stability of siRNA polyplexes from poly(ethylenimine) and poly(ethylenimine)-g-poly(ethylene glycol) under in vivo conditions: Effects on pharmacokinetics and biodistribution measured by Fluorescence Fluctuation Spectroscopy and Single Photon Emission Computed Tomography (SPECT) imaging
Authors: Olivia M. Merkel, Damiano Librizzi, Andreas Pfestroff, Tino Schurrat, Kevin Buyens, Niek N. Sanders, Stefaan C. De Smedt, Martin Béhé, Thomas Kissel
Journal: Journal of Controlled Release (2009)
Management of "brittle" diabetes with a preprogrammable implanted insulin pump delivering intraperitoneal insulin.
Authors: D F Wood, K Goodchild, P Guillou, D J Thomas, D G Johnston
Journal: BMJ (1990)

OBJECTIVE--Glycaemic control in a young woman with "brittle" diabetes. DESIGN--Use of a preprogrammable fully implanted pump (Infusaid) to deliver insulin intraperitoneally at variable rates, giving a total dose of about 60 units/24 h. SETTING--Endocrinology department in a teaching hospital. PATIENT--Thirty year old woman with 15 years9 history of "brittle" diabetes. MAIN OUTCOME MEASURES--Glycated haemoglobin concentration; plasma glucose concentration. RESULTS--After implantation of the pump there was an immediate and sustained improvement in diabetic control. The patient9s glycated haemoglobin concentration decreased from 15.2% to 9.2% over seven months. Her daily glucose concentrations were in the range 3.5-12 mmol/l. She has not been admitted to hospital since implantation of the pump, which was eight months before the time of writing. CONCLUSION--The implanted programmable intraperitoneal insulin pump may be of value in the management of patients with "brittle" diabetes in whom other attempts at glycaemic control have failed.
Antibiotics and Acute Otitis Media in Children
Authors: Paul Glasziou, Chris Del Mar, Maroeska Rovers
Journal: JAMA (2011)

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