tbuckley/cabot-search huggingface dataset:
Urinary 8‐hydroxy‐2′‐deoxyguanosine reflects symptomatic status and severity of systolic dysfunction in patients with chronic heart failure
Authors: Shigeki Kobayashi, Takehisa Susa, Takeo Tanaka, Yasuaki Wada, Shinichi Okuda, Masahiro Doi, Tomoko Nao, Yasuhiro Yoshiga, Jutaro Yamada, Takayuki Okamura, Takeshi Ueyama, Syuji Kawamura, Masafumi Yano, Masunori Matsuzaki
Journal: European Journal of Heart Failure (2010)
THE POWER OF IRRATIONAL BELIEF
Authors: E. W. Barnes
Journal: BMJ (1925)

appenidices.The first contains brief notices of some of the distinguished men who have served on the honorary staff.Among these the first and fullest is that of Dr. Thomas Bevill Peacock (1812-1882), who.was one of -the two first acting physicians and-" the guiding spirit of the institu- tion and almost its ruler."Like so many of the founders
Endoscopic Clip Application for Postoperative Residual Esophageal Duplication Cyst
Authors: R. Kochhar, H. Saluja, R. Singh, U. Dutta, S. Sinha
Journal: Endoscopy (2006)

A 35-year-old woman presented with coughing, left-sided chest pain, and high-grade intermittent fever that had persisted for 3 weeks. She had received a course of antibiotics for a week, without any response. At admission, the clinical examination was unremarkable except for toxemia. The chest examination did not reveal any abnormality. A chest radiograph showed mediastinal widening and chest computed tomography revealed a cyst 8 × 10 × 4 cm in size communicating with the mid-esophagus, with an air-fluid level. An infected esophageal duplication cyst was diagnosed and the patient underwent surgery. Due to extensive adhesions, however, only partial excision of the cyst was achieved, and only a partially successful attempt could be made to suture the defect in the esophageal wall. Ten days after surgery, the patient developed chest pain, with a spiking fever. A contrast study revealed an esophageal leak into the posterior mediastinum (Figures [1 ] a). An upper endoscopic examination revealed a tear 7 - 8 mm long in the mid-esophagus (Figures [2 ] a).
Competing Risks for Patients With Localized Prostate Cancer
Authors: J. Seidenfeld, D. J. Samson, P. C. Albertsen
Journal: JNCI Journal of the National Cancer Institute (2007)

In health care, as in the rest of life, decisions have consequences. A chosen treatment for prostate cancer can yield benefits, but it can also cause harm. In localized prostate cancer, as in most diseases, baseline characteristics influence the natural history of the disease and thus a treatment’s potential for benefit. The most relevant estimates for an individual come from studies involving patients who are similar to the individual selecting treatment. The recently updated guideline from the American Urological Association lists the following primary treatments for localized prostate cancer: watchful waiting, active surveillance, interstitial brachytherapy, external beam radiotherapy, radical prostatectomy, primary hormonal therapy, and others (e.g., cryotherapy) ( 1 ). To choose from this menu, patients must fi rst weigh their individualized risk of death from prostate cancer in the absence of treatment and then each treatment’s likely effect on that risk, along with associated specifi c types and risks of complications. These guidelines caution patients that there are important limitations to the available studies because follow-up is often insuffi cient for most treatment options, researchers use inconsistent defi nitions for the most commonly reported complications, and authors often fail to adequately detail baseline patient characteristics. Finally, because most evidence is derived from case series and small randomized trials that frequently pool data from patients with various levels of disease burden, the evidence base is subject to selection and other biases. Selecting a primary therapy is not the only choice facing patients with localized prostate cancer. Some patients are offered androgen deprivation therapy (ADT) after prostatectomy or radiation therapy (adjuvant ADT) that can continue for years. Others are offered several months of ADT (neoadjuvant ADT) before defi nitive primary therapy. Many trials on adjuvant or neoadjuvant ADT for localized or locally advanced prostate cancer fail to report the key outcome of interest, and most do not report outcomes stratifi ed by risk groups. Some reviews address side effects of ADT ( 2 , 3 ) but focus primarily on morbidity and quality of life. A recently published Cochrane systematic review ( 4 ) reported estimates for outcomes of treatment effi cacy by primary therapy (prostatectomy or radiation therapy) and by type of hormonal deprivation (adjuvant or neoadjuvant). ADT use for patients with localized prostate cancer has increased substantially over time ( 5 ), and recent evidence suggests that ADT may be associated with increased risk for diabetes and cardiovascular disease ( 6 ). In this issue of the Journal, Tsai et al. ( 7 ) use registry data from the Cancer of the Prostate
Multiple self-healing squamous epithelioma is caused by a disease-specific spectrum of mutations in TGFBR1
Authors: David R Goudie, Mariella D'Alessandro, Barry Merriman, Hane Lee, Ildikó Szeverényi, Stuart Avery, Brian D O'Connor, Stanley F Nelson, Stephanie E Coats, Arlene Stewart, Lesley Christie, Gabriella Pichert, Jean Friedel, Ian Hayes, Nigel Burrows, Sean Whittaker, Anne-Marie Gerdes, Sigurd Broesby-Olsen, Malcolm A Ferguson-Smith, Chandra Verma, Declan P Lunny, Bruno Reversade, E Birgitte Lane
Journal: Nature Genetics (2011)
Treatment of Primary Sjögren Syndrome With Rituximab
Authors: Valérie Devauchelle-Pensec, Xavier Mariette, Sandrine Jousse-Joulin, Jean-Marie Berthelot, Aleth Perdriger, Xavier Puéchal, Véronique Le Guern, Jean Sibilia, Jacques-Eric Gottenberg, Laurent Chiche, Eric Hachulla, Pierre Yves Hatron, Vincent Goeb, Gilles Hayem, Jacques Morel, Charles Zarnitsky, Jean Jacques Dubost, Jacques Olivier Pers, Emmanuel Nowak, Alain Saraux
Journal: Annals of Internal Medicine (2014)

Primary Sjögren syndrome (pSS) is an autoimmune disorder characterized by ocular and oral dryness or systemic manifestations.To evaluate efficacy and harms of rituximab in adults with recent-onset or systemic pSS.Randomized, placebo-controlled, parallel-group trial conducted between March 2008 and January 2011. Study personnel (except pharmacists), investigators, and patients were blinded to treatment group. (ClinicalTrials.gov: NCT00740948).14 university hospitals in France.120 patients with scores of 50 mm or greater on at least 2 of 4 visual analogue scales (VASs) (global disease, pain, fatigue, and dryness) and recent-onset (< 10 years) biologically active or systemic pSS.Randomization (1:1 ratio) to rituximab (1 g at weeks 0 and 2) or placebo.Primary end point was improvement of at least 30 mm in 2 of 4 VASs by week 24.No significant difference between groups in the primary end point was found (difference, 1.0% [95% CI, -16.7% to 18.7%]). The proportion of patients with at least 30-mm decreases in at least two of the four VAS scores was higher in the rituximab group at week 6 (22.4% vs. 9.1%; P = 0.036). An improvement of at least 30 mm in VAS fatigue score was more common with rituximab at weeks 6 (P < 0.001) and 16 (P = 0.012), and improvement in fatigue from baseline to week 24 was greater with rituximab. Adverse events were similar between groups except for a higher rate of infusion reactions with rituximab.Low disease activity at baseline and a primary outcome that may have been insensitive to detect clinically important changes.Rituximab did not alleviate symptoms or disease activity in patients with pSS at week 24, although it alleviated some symptoms at earlier time points.
Autoantibodies to gliadin-binding 90 kDa glycoprotein in coeliac disease.
Authors: C P Maury, A M Teppo, M Vuoristo, U Turunen, I Virtanen
Journal: Gut (1986)

Patients with untreated coeliac disease were found to have high concentrations of circulating antibodies to 90 kDa glycoprotein, a mannose rich protein found in skin and intestinal mucosa. In contrast, patients with active Crohn9s disease or ulcerative colitis had antibody concentrations within the normal range. In coeliac disease the antibody concentrations fell significantly after gluten withdrawal. 90 kDa glycoprotein bound gliadin in a carbohydrate and calcium dependent manner. The results show that circulating antibodies directed against a gliadin-binding antigen are present in coeliac disease. 90 kDa glycoprotein may be a receptor for gliadin; in susceptible subjects ligand receptor interaction may result in cytotoxicity and antibody formation.
Factors associated with lack of awareness of HIV infection before diagnosis of AIDS.
Authors: K Porter, P G Wall, B G Evans
Journal: BMJ (1993)

To identify characteristics of people likely to be unaware of their HIV infection before diagnosis of AIDS defining disease.Survey of continuing surveillance of voluntarily reported AIDS cases.4127 adults with AIDS diagnosed during 1989-92 and reported to the Public Health Laboratory Service AIDS Centre.England and Wales.Lack of prolonged awareness of infection before diagnosis of AIDS, defined as an interval of nine months or less between first positive test result and diagnosis of AIDS.Of 3556 adults with known dates of first positive HIV test result and AIDS diagnosis, 1742 (49%) had been unaware of their infection for up to nine months before AIDS was diagnosed. Lack of awareness was independently and positively associated with infection through heterosexual contact (odds ratio 4.46, 95% confidence interval 3.15 to 6.33), AIDS reported outside the Thames regions (1.64, 1.38 to 1.96), and being non-white (1.99, 1.51 to 2.61). Women were less likely to be unaware than men (0.50, 0.33 to 0.76), and people diagnosed in 1992 were least likely to be unaware (0.48, 0.39 to 0.60). Those aged 25-49 years at diagnosis were less likely to be unaware than those aged 15-24 years and those aged 50 and over.People with certain characteristics are more likely than others to be unaware of their HIV infection before AIDS is diagnosed and are therefore less likely to receive prophylaxis. Methods for educating this heterogeneous group need to be investigated.
Abciximab as Adjunctive Therapy to Reperfusion in Acute ST-Segment Elevation Myocardial Infarction
Authors: Giuseppe De Luca, Harry Suryapranata, Gregg W. Stone, David Antoniucci, James E. Tcheng, Franz-Josef Neumann, Frans Van de Werf, Elliott M. Antman, Eric J. Topol
Journal: JAMA (2005)

ContextThe benefits of abciximab in patients with ST-segment elevation myocardial infarction (STEMI) are still a matter of debate.ObjectiveTo combine data from all randomized trials conducted with abciximab in STEMI.Data SourcesFormal searches of electronic databases (MEDLINE, PubMed) from from January 1990 to December 2004.Study SelectionWe examined all completed, published, randomized trials of abciximab in STEMI. The following key words were used for study selection: randomized trial, myocardial infarction, reperfusion, primary angioplasty, facilitated angioplasty, stenting, fibrinolysis, IIb-IIIa inhibitors, and abciximab.Data ExtractionInformation on study design, type and dosage of drugs, inclusion and exclusion criteria, number of patients, and clinical outcome was extracted by 2 investigators. Disagreements were resolved by consensus.Data SynthesisEleven trials were analyzed, involving 27115 patients (12 602 [46.5%] in the abciximab group, 14 513 [53.5%] in the control group). When compared with the control group, abciximab was associated with a significant reduction in short-term (30 days) mortality (2.4% vs 3.4%, P = .047) and long-term (6-12 months) mortality (4.4% vs 6.2%, P = .01) in patients undergoing primary angioplasty but not in those treated with fibrinolysis or in all trials combined. Abciximab was associated with a significant reduction in 30-day reinfarction, both in all trials combined (2.1% vs 3.3%, P<.001), in primary angioplasty (1.0% vs 1.9%, P = .03), and in fibrinolysis trials (2.3% vs 3.6%, P<.001). Abciximab did not result in an increased risk of intracranial bleeding (0.61% vs 0.62%, P = .62) but was associated with an increased risk of major bleeding complications when combined with fibrinolysis (5.2% vs 3.1%, P<.001) but not with primary angioplasty (4.7% vs 4.1%, P = .36).ConclusionsThis meta-analysis shows that, when compared with the control group, adjunctive abciximab for STEMI is associated with a significant reduction in 30-day and long-term mortality in patients treated with primary angioplasty but not in those receiving fibrinolysis. The 30-day reinfarction rate is significantly reduced in patients treated with either fibrinolysis or primary angioplasty. A higher risk of major bleeding complications is observed with abciximab in association with fibrinolysis.
Beneficial Effects of Vasodilator Agents in Severe Mitral Regurgitation Due to Dysfunction of Subvalvar Apparatus
Authors: KANU CHATTERJEE, WILLIAM W. PARMLEY, H. J. C. SWAN, GILBERT BERMAN, JAMES FORRESTER, HAROLD S. MARCUS
Journal: Circulation (1973)

To assess the potential beneficial effects of vasodilator agents in patients with severe mitral regurgitation, sodium nitroprusside was administered intravenously at a rate of 16 to 100 µg/min in eight patients with clinically significant mitral regurgitation presumably due to dysfunction of the subvalvar apparatus. In all patients there was a decrease in the magnitude of the peak `V' wave (from 50 ± 4.5 to 19 ± 2.9 mm Hg) and in left ventricular filling pressure (33 ± 1.8 to 16 ± 1.4 mm Hg), together with a decreased intensity of the apical pansystolic murmur. There was a significant increase in forward cardiac index (2.2 ± 3.5 to 3.3 ± .47 liter/min/M 2 ) and forward stroke volume index (23 ± 4.4 to 36 ± 6.6 ml/M 2 ) along with a reduction in systemic vascular resistance (1802 ± 331 to 1102 ± 241 dynes/sec/cm -5 ). In the five patients in whom the therapy was continued, relief of symptoms of pulmonary venous congestion occurred. In the four patients in whom left ventricular volumes were determined angiographically, the observed increase in forward stroke volume was due to a reduction in the regurgitant fraction. These findings suggest that the use of vasodilator agents like nitroprusside can achieve the major objectives of treatment of patients with mitral regurgitation: an increase in forward stroke output, a reduction in regurgitant volume and a decrease in pulmonary venous pressure.
Waste not, want not
Authors: Howard A. Rockman
Journal: Journal of Clinical Investigation (2014)

As of the writing of this Editorial, the current JCI Editorial Board has evaluated approximately 7,000 manuscripts over the past 22 months for their suitability for publication in our journal. While many of you have received a negative decision on your manuscript, I suspect few are aware of the changes we have made to our review process to limit reviewers' requests for what is in our view unnecessary and excessive experimentation.
When can odds ratios mislead?
Authors: H. T. O. Davies, I. K. Crombie, M. Tavakoli
Journal: BMJ (1998)

Odds ratios are a common measure of the size of an effect and may be reported in case-control studies, cohort studies, or clinical trials. Increasingly, they are also used to report the findings from systematic reviews and meta-analyses. Odds ratios are hard to comprehend directly and are usually interpreted as being equivalent to the relative risk. Unfortunately, there is a recognised problem that odds ratios do not approximate well to the relative risk when the initial risk (that is, the prevalence of the outcome of interest) is high. 1 2 Thus there is a danger that if odds ratios are interpreted as though they were relative risks then they may mislead.



The advice given in many texts is unusually coy on the matter. For example: “The odds ratio is approximately the same as the relative risk if the outcome of interest is rare. For common events, however, they can be quite different.”3 How close is “approximately the same,” how uncommon does an event have to be to qualify as “rare,” and how different is “quite different”?

#### Summary points

If the odds ratio is interpreted as a relative risk it will always overstate any effect size: the odds ratio is smaller than the relative risk for odds ratios of less than one, and bigger than the relative risk for odds ratios of greater than one

The extent of overstatement increases as both the initial risk increases and the odds ratio departs from unity

However, serious divergence between the odds ratio and the relative risk occurs only with large effects on groups at high initial risk. Therefore qualitative judgments based on interpreting odds ratios as though they were relative risks are unlikely to be seriously in error

In studies which show reductions in risk (odds ratios of less than one), the odds ratio …
O35 PREDICTING SURVIVAL OF HIV-INFECTED PATIENTS WITH LIVER CANCER – THE SHILCA SCORE AND STAGING MODEL
Authors: N. Merchante, B. Mínguez, C. Tural, L. Kikuchi, F. Rodríguez-Arrondo, T.-Y. Chen, M. Ventura, M. Harris, J. Daruich, D.E. Kaplan, E. Merino, M.F. Silva, J. Rockstroh, J. Muñoz, F. Jover, H. Klinker, M. Delgado-Fernández, S. Marcus, J. Aberg, J.A. Pineda, M. Sherman, Y. Hoshida, J. Marrero, N. Bräu
Journal: Journal of Hepatology (2014)
Adiponectin
Authors: Ling Tao, Yajing Wang, Erhe Gao, Hangxiang Zhang, Yuexing Yuan, Wayne B. Lau, Lawrence Chan, Walter J. Koch, Xin L. Ma
Journal: Circulation Research (2009)

Patients treated with peroxisome proliferator-activated receptor (PPAR)-gamma agonist manifest favorable metabolic profiles associated with increased plasma adiponectin (APN). However, whether increased APN production as a result of PPAR-gamma agonist treatment is an epiphenomenon or is causatively related to the cardioprotective actions of PPAR-gamma remains unknown.To determine the role of APN in rosiglitazone (RSG) cardioprotection against ischemic heart injury.Adult male wild-type (WT) and APN knockdown/knockout (APN(+ or -) and APN(- or -)) mice were treated with vehicle or RSG (20 mg/kg per day), and subjected to coronary artery ligation 3 days after beginning treatment. In WT mice, RSG (7 days) significantly increased adipocyte APN expression, elevated plasma APN levels (2.6-fold), reduced infarct size (17% reduction), decreased apoptosis (0.23 + or - 0.02% versus 0.47 + or - 0.04% TUNEL-positive in remote nonischemic area), attenuated oxidative stress (48.5% reduction), and improved cardiac function (P<0.01). RSG-induced APN production and cardioprotection were significantly blunted (P<0.05 versus WT) in APN(+ or -), and completely lost in APN(- or -) (P>0.05 versus vehicle-treated APN(- or -) mice). Moreover, treatment with RSG for up to 14 days significantly improved the postischemic survival rate of WT mice (P<0.05 versus vehicle group) but not APN knockdown/knockout mice.The cardioprotective effects of PPAR-gamma agonists are critically dependent on its APN stimulatory action, suggesting that under pathological conditions where APN expression is impaired (such as advanced type 2 diabetes), the harmful cardiovascular effects of PPAR-gamma agonists may outweigh its cardioprotective benefits.
Collagenase in Sjogren's syndrome.
Authors: Y T Konttinen, P Kangaspunta, O Lindy, M Takagi, T Sorsa, M Segerberg, H Tschesche, A Z Eisen
Journal: Annals of the Rheumatic Diseases (1994)

OBJECTIVE--To study collagenase production in labial salivary glands in patients with Sjögren9s syndrome (SS). METHODS--Collagenases were localised in labial salivary glands by immunohistochemistry. Collagenase activity against triple helical type I collagen monomers in stimulated saliva was measured using sodium dodecyl sulphate polyacrylamide gel electrophoresis and laser densitometry; tissue inhibitor metalloproteinase (TIMP) was measured by enzyme linked immunosorbent assay. RESULTS--Cells containing collagenase of matrix metalloproteinase (MMP)-1 type were more frequent and more intensely staining in SS than in healthy glands. Only SS saliva contained functional enzyme (11.7 (6.8) x 10(-6) IU/1). Cells containing MMP-8 type neutrophil collagenase were not found in situ, which was in accordance with sialochemical findings/doxycycline inhibition studies. TIMP was found in both SS and normal saliva. CONCLUSIONS--Fibroblast, but not neutrophil type, collagenase is synthesised, secreted, and subsequently activated, but is not inhibited by TIMP in labial salivary glands or saliva in SS. Collagenase may destroy glandular and salivary duct tissue and perturb factors influencing the morphogenetic extracellular matrix.
English NHS wastes 300m of drugs every year, study finds
Authors: O. Mashta
Journal: BMJ (2010)

A1 London

Up to £300m (€354m; $473m) is wasted in NHS primary and community care prescription drugs in England annually, according to a new report. The health service, however, does not have a systemic problem with drug wastage, it maintains.

The wastage includes £90m worth of unused prescription drugs stored in people’s homes, £110m returned to community pharmacies over the course of a year, and up to £50m worth of NHS supplied drugs that are disposed of annually by care homes, the research showed.

The study by the York Health Economics Consortium and the School of Pharmacy …
Roles, Tasks and Practitioners
Authors: Daniel Levinson
Journal: New England Journal of Medicine (1977)

The accelerating entry of nurses, medical corpsmen and others of diverse educational and experience backgrounds into clinical areas once the exclusive domain of physicians is testing fundamental assumptions about the nature of primary care and the clinical process. Considerable uncertainty exists about the role and activity of these new clinicians. Nonphysician practitioners themselves are not always in agreement about who or what they are. Nurse practitioners, as a group, assert that they are basically nurses acting in an "extended" role. Physician assistants emphasize that their activities are delegated and assigned by their supervising physicians. All insist that they are not . . .