tbuckley/cabot-search huggingface dataset:
RHEUMATIC INFECTION IN CHILDREN
Authors: R. Miller
Journal: BMJ (1927)

<h3>Objectives</h3> Our aim was to run a successful quality improvement project and improve patient care over two inpatient wards at The Meadows Community Psychiatric Hospital, Stockport. <h3>Background</h3> There is an average of 38,000 falls each year in community hospitals across the UK which Results in high levels of morbidity and mortality. We noted that the quality of post-falls reviews taking place by doctors at The Meadows varied greatly and were often not meeting NICE guidance on multifactorial risk assessments for falls, potentially leading to patient harm. <h3>Methods</h3> Initially, we reviewed 34 inpatient falls by retrospectively analysing patients’ notes in January 2018. Following this a post-falls pro forma was designed and implemented to guide doctors when performing their reviews. Feedback was collected, education sessions delivered and changes made accordingly. We then reviewed a further 20 falls on the same wards over March-April 2019 and improvements over 11 NICE standards were recorded. <h3>Results</h3> The quality and consistency of falls reviews improved in all but 1 of the 11 NICE standards and 5 categories achieved 100%. These included receiving a medical assessment &lt; 12 hours post fall, sending for a CT head if appropriate, performing neurovascular and cardiovascular examinations and recording medical observations post-fall. In addition, 85% now met the standard of having a medication review as part of the intervention to prevent further falls when using the pro forma (compared to 24% when the project started.) <h3>Conclusion</h3> Our project highlights that junior doctors can effectively lead and manage a successful project to improve patient care. Despite our junior status within the team, we were able to implement strong leadership and management skills and are currently expanding the project from its original objective to a Trust-wide project, reflecting its success.
Effect of Dexfenfluramine Treatment in Rats Exposed to Acute and Chronic Hypoxia
Authors: SAADIA EDDAHIBI, BERNADETTE RAFFESTIN, JEAN-MARIE LAUNAY, MARYVONNE SITBON, SERGE ADNOT
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

The anorexiant dexfenfluramine, which inhibits 5-hydroxytryptamine (5-HT) uptake, has been associated with an increase in the relative risk of developing primary pulmonary hypertension. The aim of this study was to investigate in rats whether dexfenfluramine (1) alters the pulmonary vasomotor effects of 5-HT and (2) aggravates the development of pulmonary hypertension during exposure to various levels of chronic hypoxia. In isolated lungs from normoxic rats, dexfenfluramine up to 10− 4 M did not elicit any vasoactive effects, and neither did pretreatment with dexfenfluramine (10− 5 M in the perfusate) modify the vasoactive effects of 5-HT. In normoxic conscious rats, dexfenfluramine given intravenously potentiated the pulmonary pressor response to acute hypoxia (10% O2). In rats chronically treated with dexfenfluramine during a 2-wk exposure to 15% or 10% O2 , plasma 5-HT concentrations were significantly increased compared with hypoxic controls, whereas no differences were found for pulmonary artery pressure, right ventricular hypertrophy, or pulmonary vessel muscularization. In contrast, a continuous 5-HT infusion providing a sustained increase in plasma 5-HT levels was associated with increased muscularization of distal pulmonary arteries in response to 10% O2. Simultaneous administration of dexfenfluramine prevented the effect of exogenous 5-HT on vascular remodeling. Our findings show that dexfenfluramine does not potentiate the development of pulmonary hypertension in rats exposed to chronic hypoxia, despite its effect on plasma 5-HT concentrations.
Risk factors associated with hepatocellular carcinoma in primary biliary cirrhosis
Authors: Annarosa Floreani, Fabio Farinati
Journal: Hepatology (2013)

We read with interest the article by Liang et al.,1 presenting a systematic review and meta-analysis of cancer risk in primary biliary cirrhosis (PBC) patients. We congratulate the authors for their accuracy and the exhaustive data presented, which clearly demonstrate that PBC is closely associated with a greater risk of hepatocellular carcinoma (HCC), but not of other extrahepatic cancers. We would like, however, to highlight some key points. PBC is characterized by a long natural history that is influenced by a number of factors that modulate mortality risk, including: clinical symptoms/signs of liver disease, associated autoimmune conditions, comorbidity with other nonautoimmune-associated conditions (i.e., osteoporosis), and response to ursodeoxycholic acid (UDCA). Table 1 summarizes the 10 most important studies dealing with the incidence of HCC in PBC patients, also reported in Liang et al.'s review article,1 for a total of 6,040 PBC patients. Five studies report a relationship between HCC and PBC histological stage; all of them clearly indicate that HCC arises in advanced histological stages. This behavior is most commonly observed in all types of liver disease in Western countries, with viral and nonviral etiology, with only very few exceptions. These data also confirm our previous observation, i.e., that the relative risk for HCC in female patients with stage IV PBC is similar to that of female patients with cirrhosis of different etiologies.2 Only a few studies report a statistical analysis of the risk factors associated with HCC development. The most impressive data regard the association with male gender and the lack of response to UDCA (although these data should be considered with caution). In our opinion it is remarkable that UDCA may favorably influence the natural history of PBC in responders. There are no sufficient elements to consider UDCA as a protective agent toward HCC, however. Screening for HCC with cross-sectional imaging, with or without alpha-fetoprotein at 6-month intervals, should be recommended for PBC patients with advanced stage disease (histological stage IV or Mayo prognostic score >4.1), or evidence of portal hypertension. Due to the lack of an evidence-based association with other extrahepatic liver malignancies, cancer screening in PBC patients should not differ from what is indicated in the general population. Having said that, it must be also kept in mind that, overall, PBC-related HCC appears to be a low-impact problem, since in a consecutive series of about 3,000 consecutive cases of HCC diagnosed in Italy and registered in the ITA.LI.CA database, only 10 (0.03%) are diagnosed in PBC patients. ANNAROSA FLOREANI, M.D. FABIO FARINATI, M.D. Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
Microsatellite DNA instability and COPD exacerbations
Authors: D. Makris, N. Tzanakis, A. Damianaki, E. Ntaoukakis, E. Neofytou, M. Zervou, N. M. Siafakas, E. G. Tzortzaki
Journal: European Respiratory Journal (2008)

Increased frequency of microsatellite DNA instability (MSI) has been detected in the sputum of chronic obstructive pulmonary disease (COPD) patients. The aim of the present study was to investigate the relationship between MSI in sputum cells and exacerbation frequency, which is an important parameter in the clinical course of the disease. Induced sputum samples and peripheral blood obtained from 36 patients with COPD at stable state were analysed. The control group consisted of 30 nonsmoking healthy subjects. DNA was extracted and analysed for MSI using the following microsatellite markers: RH70958, D5S207, D6S2223, D6S344, D6S263, G29802, D13S71, D14S588, D14S292 and D17S250. Following MSI analysis, exacerbations were recorded for 3 yrs in total. No MSI was detected in healthy nonsmokers. A total of 18 (50%) out of 36 patients exhibited MSI in their sputum cells. Patients who exhibited MSI showed significantly increased frequency of exacerbations compared with patients that did not. In addition, a significantly increased frequency of purulent and of severe type exacerbations was found in patients exhibiting MSI. Patients positive for marker G29802, D13S71 or D14S588 presented increased exacerbation frequency. The significant association between microsatellite DNA instability and chronic obstructive pulmonary disease exacerbations indicates that somatic mutations could be involved in the pathogenesis and natural history of the disease.
HAVCR/KIM-1 Activates the IL-6/STAT-3 Pathway in Clear Cell Renal Cell Carcinoma and Determines Tumor Progression and Patient Outcome
Authors: Thaïs Cuadros, Enric Trilla, Eduard Sarró, Maya R. Vilà, Jordi Vilardell, Inés de Torres, Mayte Salcedo, Joan López-Hellin, Alex Sánchez, Santiago Ramón y Cajal, Emilio Itarte, Juan Morote, Anna Meseguer
Journal: Cancer Research (2014)

Renal cell carcinoma (RCC), the third most prevalent urological cancer, claims more than 100,000 lives/year worldwide. The clear cell variant (ccRCC) is the most common and aggressive subtype of this disease. While commonly asymptomatic, more than 30% of ccRCC are diagnosed when already metastatic, resulting in a 95% mortality rate. Notably, nearly one-third of organ-confined cancers treated by nephrectomy develop metastasis during follow-up care. At present, diagnostic and prognostic biomarkers to screen, diagnose, and monitor renal cancers are clearly needed. The gene encoding the cell surface molecule HAVCR1/KIM-1 is a suggested susceptibility gene for ccRCC and ectodomain shedding of this molecule may be a predictive biomarker of tumor progression. Microarray analysis of 769-P ccRCC-derived cells where HAVCR/KIM-1 levels have been upregulated or silenced revealed relevant HAVCR/KIM-1-related targets, some of which were further analyzed in a cohort of 98 ccRCC patients with 100 month follow-up. We found that HAVCR/KIM-1 activates the IL-6/STAT-3/HIF-1A axis in ccRCC-derived cell lines, which depends on HAVCR/KIM-1 shedding. Moreover, we found that pSTAT-3 S727 levels represented an independent prognostic factor for ccRCC patients. Our results suggest that HAVCR/KIM-1 upregulation in tumors might represent a novel mechanism to activate tumor growth and angiogenesis and that pSTAT-3 S727 is an independent prognostic factor for ccRCC.
Four-year follow-up of surgical versus non-surgical therapy for chronic low back pain
Authors: J. I. Brox, O. P. Nygaard, I. Holm, A. Keller, T. Ingebrigtsen, O. Reikeras
Journal: Annals of the Rheumatic Diseases (2009)

Objective: To evaluate the prevalence of sexually transmitted infections (STIs) and mode of presentation in patients originating from Bangladesh and resident in the United Kingdom in comparison with non-Bangladeshi patients attending an inner London genitourinary medicine (GUM) clinic. Methods: A retrospective, cross sectional study with comparator group was carried out at an open access GUM clinic in east London. 104 consecutive newly attending Bangladeshi men were compared with 199 consecutive newly attending non-Bangladeshi men and 115 consecutive newly attending Bangladeshi women were compared with 218 consecutive newly attending non-Bangladeshi women. Any diagnosed sexually transmitted infections, sexual history characteristics, reasons for presentation, and referral patterns were noted. Results: Bangladeshi men (28.8% compared with 7.5%; p&lt;0.0001) and women (42.7% compared with 12.8%; p&lt;0.0001) were more likely to be referred by their general practitioners or other medical services. Bangladeshi men were more likely to present with sexual dysfunction (12.5% compared with 2.5%; p=0.001). The prevalence of STIs was broadly similar across the study groups; however, syphilis was significantly more common in the Bangladeshi men (10.9% compared with 4%; p=0.04) and non-gonococcal urethritis (NGU) in the control men (35% compared with 20.2%; p=0.02). Bacterial vaginosis was an infrequent diagnosis in the Bangladeshi women (3.5% compared with 22.4%; p&lt;0.0001). Conclusions: STI prevalence in Bangladeshis attending GUM services is similar to other populations although patterns of presentation and referral do show variation. Bangladeshi men are more likely to access GUM clinics for psychosexual services. The presence of STIs in Bangladeshis particularly those imported from Bangladesh provides an opportunity for HIV transmission between the United Kingdom and Bangladesh.
Establishment and evaluation of transgenic models of Alzheimer's disease with senescence accelerated background
Authors: Wenjuan Zhao, KengHoe Lok, Hong Zhao, Anyang Sun, Ming Yin
Journal: Molecular Neurodegeneration (2012)

Method In the experiments, APP/PS1 and tau transgenic mice of C57BL/6J background were interbred with SAMP8 mice for five generations. Gene identification of filial generation was tested by PCR. The grading score system developed by Takeda T et al was used for evaluation of the degree of senescence in mice. The agerelated decline of learning and memory ability was analyzed using passive avoidance shuttle box and Morris water maze tasks. Immunofluorescence study was performed to ascertain the presence of b-amyloid (Ab) and tau pathology in AD mouse models by using b-amyloid antibody and specific phosphorylated tau antibody at Ser404.
Identification of α-Enolase as an Autoantigen in Lung Cancer: Its Overexpression Is Associated with Clinical Outcomes
Authors: Gee-Chen Chang, Ko-Jiunn Liu, Chia-Ling Hsieh, Tsai-Shu Hu, Suparat Charoenfuprasert, Hsiung-Kun Liu, Kwen-Tay Luh, Li-Han Hsu, Chew-Wen Wu, Chou-Chik Ting, Chih-Yi Chen, Kun-Chieh Chen, Tsung-Ying Yang, Teh-Ying Chou, Wen-Hua Wang, Jacqueline Whang-Peng, Neng-Yao Shih
Journal: Clinical Cancer Research (2006)

Abstract Purpose: Although existence of humoral immunity has been previously shown in malignant pleural effusions, only a limited number of immunogenic tumor-associated antigens (TAA) have been identified and associated with lung cancer. In this study, we intended to identify more TAAs in pleural effusion–derived tumor cells. Experimental Design: Using morphologically normal lung tissues as a control lysate in Western blotting analyses, 54 tumor samples were screened with autologous effusion antibodies. Biochemical purification and mass spectrometric identification of TAAs were done using established effusion tumor cell lines as antigen sources. We identified a p48 antigen as α-enolase (ENO1). Semiquantitative immunohistochemistry was used to evaluate expression status of ENO1 in the tissue samples of 80 patients with non–small cell lung cancer (NSCLC) and then correlated with clinical variables. Results: Using ENO1-specifc antiserum, up-regulation of ENO1 expression in effusion tumor cells from 11 of 17 patients was clearly observed compared with human normal lung primary epithelial and non-cancer-associated effusion cells. Immunohistochemical studies consistently showed high level of ENO1 expression in all the tumors we have examined thus far. Log-rank and Cox's analyses of ENO1 expression status revealed that its expression level in primary tumors was a key factor contributing to overall- and progression-free survivals of patients (P &amp;lt; 0.05). The same result was also obtained in the early stage of NSCLC patients, showing that tumors expressing relatively higher ENO1 level were tightly correlated with poorer survival outcomes. Conclusions: Our data strongly support a prognostic role of ENO1 in determining tumor malignancy of patients with NSCLC.
The Progression from MGUS to Smoldering Myeloma and Eventually to Multiple Myeloma Involves a Clonal Expansion of Genetically Abnormal Plasma Cells
Authors: Lucía López-Corral, Norma C. Gutiérrez, Maria Belén Vidriales, Maria Victoria Mateos, Ana Rasillo, Ramón García-Sanz, Bruno Paiva, Jesús F. San Miguel
Journal: Clinical Cancer Research (2011)

Genetic aberrations detected in multiple myeloma (MM) have also been reported in the premalignant conditions monoclonal gammopathy of undetermined significance (MGUS) and smoldering MM (SMM). Our aim was to investigate in depth the level of clonal heterogeneity of recurrent genetic abnormalities in these conditions.Immunoglobulin heavy chain (IGH) translocations, 13q14 and 17p13 deletions, and 1q21 gains using FISH were evaluated in 90 MGUS, 102 high-risk SMM, and 373 MM. To this end, we not only purified plasma cells (PC) for the FISH analysis (purity > 90%), but subsequently, we examined the correlation between the proportion of PC with cytogenetic changes and the number of clonal PC present in the same sample, as measured by multiparametric flow cytometry.We observed a significant difference between the proportion of clonal PC with specific genetic abnormalities in MGUS compared with SMM and in SMM compared with MM. Thus, the median proportion of PC with IGH translocations globally considered, t(11;14) and 13q deletions was significantly lower in MGUS than in SMM, and in SMM than in MM [IGH translocations: 34% vs. 57% vs. 76%; t(11;14): 38% vs. 61% vs. 81%; and 13q deletion: 37% vs. 61% vs. 74% in MGUS, SMM, and MM, respectively]. For t(4;14), the difference was significant in the comparison between MGUS/SMM and MM and for 1q between MGUS and SMM/MM.This study demonstrates that the progression from MGUS to SMM, and eventually to MM, involves a clonal expansion of genetically abnormal PC.
New Tool Advances Investigations of Disease Outbreaks
Authors: J. Caspermeyer
Journal: Molecular Biology and Evolution (2014)

Now, a new field called genomic epidemiology is taking advantage of the rapidly reduced costs of next-generation DNA sequencing to better inform public health officials faced with ongoing outbreaks. Authors Didelot et al. (2014) developed a versatile computational tool that can rely on genomic data alone or be customized to add weighted information from field epidemiology (such as timing of infectivity, level of infectivity, and geographic location). The research group tested the new tool’s reliability against a real-world data set to reconstruct the transmission of an outbreak of Mycobacterium tuberculosis. “We’re on the edge of an exciting new era in public health epidemiology, as genomics gives us the ability to reconstruct outbreaks in far more detail and with much greater accuracy than ever before. This paper addresses an important question—just how much information about an outbreak can we reliably derive from genomic data alone—and gives public health officials a new tool for their detective kits,” according to Didelot. With their tool, they found that they were able to capture several aspects of known epidemiology. For example, their method correctly inferred the most likely source case and several key transmission clusters. Although the authors caution that genomics alone cannot truly replace traditional epidemiology, they show the value and potential of using their sequence data analysis tool as a companion method for public health officials to shed light on outbreaks.
A comparative study of incentive motivation, achievement motivation and anxiety level between national and international hockey players
Authors: D K Dureha, Moradhvaj Singh, Santosh Yaduvanshi, Pooja Mishra
Journal: British Journal of Sports Medicine (2010)

The purpose of the study is to compare the status of national and international hockey players on the selected psychological variables. Sixty male hockey players of India divided into two groups national (n=30) and international (n=30). The age range of the subjects was 17–25 years. The collection of data was based on four test-batteries that is, Alberta Incentive Motivation Inventory, the Sports Achievement Motivation Test, State and Trait Anxiety Inventory and Sports Competition Anxiety Test. As shown by the result of the study there were insignificant difference was found in incentive motivation, achievement motivation, state anxiety and trait anxiety between national and international hockey players and significant difference was found in sports competition anxiety. In order to test t test was used and 0.05 level of significance was used. The hypothesis that international and national players would not differ accepted in achievement motivation and rejected in the case of achievement motivation, state, trait and sports competition anxiety.
Hidden diabetes in the UK: use of capture-recapture methods to estimate total prevalence of diabetes mellitus in an urban population
Authors: G. V Gill, A. A Ismail, N. J Beeching, S. B J Macfarlane, M. A Bellis
Journal: Journal of the Royal Society of Medicine (2003)

An early requirement of the UK's Diabetes National Service Framework is enumeration of the total affected population. Existing estimates tend to be based on incomplete lists. In a study conducted over one year in North Liverpool, we compared crude prevalence rates for type 1 and type 2 diabetes with estimates obtained by capture-recapture (CR) analysis of multiple incomplete patient lists, to assess the extent of unascertained but diagnosed cases. Patient databases were constructed from six sources—a hospital diabetes centre; general practitioner registers; hospital admissions with a diagnosis of diabetes; a hospital diabetic retinal clinic; a research list of patients with diabetes admitted with stroke; and a local children's hospital. Log linear modelling was used to estimate missing cases, hence total prevalence. The crude prevalence of diabetes was 1.5% (95% confidence interval [CI] 1.41, 1.52), compared with a CR-adjusted rate of 3.1% (CI 3.03, 3.19). Age-banded CR-adjusted prevalence was always higher in males than in females and the difference became more pronounced with increasing age. Among males, CR-adjusted prevalence rose from 0.4% at age 10-19 years to 18.3% at 80+ years; in females the corresponding figures were 0.4% and 9.3%. The gap between crude and CR-estimated prevalence points to a rate of ‘hidden diabetes’ that has substantial implications for future diabetes care.
Activated monocytes in peritumoral stroma of hepatocellular carcinoma foster immune privilege and disease progression through PD-L1
Authors: Dong-Ming Kuang, Qiyi Zhao, Chen Peng, Jing Xu, Jing-Ping Zhang, Changyou Wu, Limin Zheng
Journal: The Journal of Experimental Medicine (2009)

Macrophages (Mphi) are prominent components of solid tumors and exhibit distinct phenotypes in different microenvironments. We have recently found that tumors can alter the normal developmental process of Mphi to trigger transient activation of monocytes in peritumoral stroma. We showed that a fraction of monocytes/Mphi in peritumoral stroma, but not in cancer nests, expresses surface PD-L1 (also termed B7-H1) molecules in tumors from patients with hepatocellular carcinoma (HCC). Monocytes activated by tumors strongly express PD-L1 proteins with kinetics similar to their activation status, and significant correlations were found between the levels of PD-L1(+) and HLA-DR(high) on tumor-infiltrating monocytes. Autocrine tumor necrosis factor alpha and interleukin 10 released from activated monocytes stimulated monocyte expression of PD-L1. The PD-L1(+) monocytes effectively suppressed tumor-specific T cell immunity and contributed to the growth of human tumors in vivo; the effect could be reversed by blocking PD-L1 on those monocytes. Moreover, we found that PD-L1 expression on tumor-infiltrating monocytes increased with disease progression, and the intensity of the protein was associated with high mortality and reduced survival in the HCC patients. Thus, expression of PD-L1 on activated monocytes/Mphi may represent a novel mechanism that links the proinflammatory response to immune tolerance in the tumor milieu.