tbuckley/cabot-search huggingface dataset:
Outcomes of elective induction of labour compared with expectant management: population based study
Authors: S. J. Stock, E. Ferguson, A. Duffy, I. Ford, J. Chalmers, J. E. Norman
Journal: BMJ (2012)

<b>Objective</b> To determine neonatal outcomes (perinatal mortality and special care unit admission) and maternal outcomes (mode of delivery, delivery complications) of elective induction of labour compared with expectant management. <b>Design</b> Retrospective cohort study using an unselected population database. <b>Setting</b> Consultant and midwife led obstetric units in Scotland 1981-2007. <b>Participants</b> 1 271 549 women with singleton pregnancies of 37 weeks or more gestation. <b>Interventions</b> Outcomes of elective induction of labour (induction of labour with no recognised medical indication) at 37, 38, 39, 40, and 41 weeks' gestation compared with those of expectant management (continuation of pregnancy to either spontaneous labour, induction of labour or caesarean section at a later gestation). <b>Main outcome measures</b> Extended perinatal mortality, mode of delivery, postpartum haemorrhage, obstetric anal sphincter injury, and admission to a neonatal or special care baby unit. Outcomes were adjusted for age at delivery, parity, year of birth, birth weight, deprivation category, and, where appropriate, mode of delivery. <b>Results</b> At each gestation between 37 and 41 completed weeks, elective induction of labour was associated with a decreased odds of perinatal mortality compared with expectant management (at 40 weeks' gestation 0.08% (37/44 764) in the induction of labour group versus 0.18% (627/350 643) in the expectant management group; adjusted odds ratio 0.39, 99% confidence interval 0.24 to 0.63), without a reduction in the odds of spontaneous vertex delivery (at 40 weeks' gestation 79.9% (35 775/44 778) in the induction of labour group versus 73.7% (258 665/350 791) in the expectant management group; adjusted odds ratio 1.26, 1.22 to 1.31). Admission to a neonatal unit was, however, increased in association with elective induction of labour at all gestations before 41 weeks (at 40 weeks' gestation 8.0% (3605/44 778) in the induction of labour group compared with 7.3% (25 572/350 791) in the expectant management group; adjusted odds ratio 1.14, 1.09 to 1.20). <b>Conclusion</b> Although residual confounding may remain, our findings indicate that elective induction of labour at term gestation can reduce perinatal mortality in developed countries without increasing the risk of operative delivery.
Hydroxyl Radical-Induced Acute Diastolic Dysfunction Is Due to Calcium Overload via Reverse-Mode Na <sup>+</sup> -Ca <sup>2+</sup> Exchange
Authors: Oliver Zeitz, A. Eveline Maass, Phuc Van Nguyen, Geerd Hensmann, Harald Kögler, Karsten Möller, Gerd Hasenfuss, Paul M.L. Janssen
Journal: Circulation Research (2002)

Hydroxyl radicals (OH) are involved in the development of reperfusion injury and myocardial failure. In the acute phase of the OH-mediated diastolic dysfunction, increased intracellular Ca(2+) levels and alterations of myofilaments may play a role, but the relative contribution of these systems to myocardial dysfunction is unknown. Intact contracting cardiac trabeculae from rabbits were exposed to OH, resulting in an increase in diastolic force (F(dia)) by 540%. Skinned fiber experiments revealed that OH-exposed preparations were sensitized for Ca(2+) (EC(50): 3.27+/-0.24 x 10(-6) versus 2.69+/-0.15 x 10(-6) mol/L; P<0.05), whereas maximal force development was unaltered. Western blots showed a proteolytic degradation of troponin T (TnT) with intact troponin I (TnI). Blocking of calpain I by MDL-28.170 inhibited both TnT-proteolysis and Ca(2+) sensitization, but failed to prevent the acute diastolic dysfunction in the intact preparation. The OH-induced diastolic dysfunction was similar in preparations with intact (540+/-93%) and pharmacologically blocked sarcoplasmic reticulum (539+/-77%), and was also similar in presence of the L-type Ca(2+)-channel antagonist verapamil. In sharp contrast, inhibition of the reverse-mode sodium-calcium exchange by KB-R7943 preserved diastolic function completely. Additional experiments were performed in rat myocardium; the rise in diastolic force was comparable to rabbit myocardium, but Ca(2+) sensitivity was unchanged and maximal force development was reduced. This was associated with a degradation of TnI, but not TnT. Electron microscopic analysis revealed that OH did not cause irreversible membrane damage. We conclude that OH-induced acute diastolic dysfunction is caused by Ca(2+) influx via reverse mode of the sodium-calcium exchanger. Degradation of troponins appears to be species-dependent but does not contribute to the acute diastolic dysfunction.
Contralateral Breast Cancer and Thromboembolic Events in African American Women Treated With Tamoxifen
Authors: W. McCaskill-Stevens, J. Wilson, J. Bryant, E. Mamounas, L. Garvey, J. James, W. Cronin, D. L. Wickerham
Journal: JNCI Journal of the National Cancer Institute (2004)

Background: Information about breast cancer treatment and prevention in African American women is scant, and recommendations for therapy from clinical trials for breast cancer are based primarily on data obtained from white women. Methods: We compared the effects of tamoxifen on risk of contralateral breast cancer and thromboembolic events in African American women and white women with a history of primary breast cancer. Data from 13 National Surgical Adjuvant Breast and Bowel Project clinical trials were pooled for analyses of time to contralateral breast cancer as a first event (eight trials and 10 619 patients) and of time to any thromboembolic phenomenon as a first event (all 13 trials and 20 878 patients). Risk factors for contralateral breast cancer and thromboembolic events among all women were determined using univariate proportional hazards models. (For each racial group, the rate of events associated with tamoxifen use was calculated as the ratio of the incidence rate with tamoxifen to that without tamoxifen.) Proportional hazards regression models were used to calculate 95% confidence intervals (CIs) and risk ratios. All statistical tests were two-sided. Results: Risk factors for contralateral breast cancer were body mass index (BMI) and lymph node positivity; those for thromboembolic events were BMI and age. In women of both ethnicities with estrogen receptor–positive breast cancer, those who took tamoxifen experienced a similar reduction in contralateral breast cancer (risk ratio for African American women = 0.74, 95% CI = 0.46 to 1.17, n = 690; risk ratio for white women = 0.76, 95% CI = 0.59 to 0.98, n = 9929; P = .92). Tamoxifen was also associated with an increase in thromboembolic events. The relative risk for thromboembolic events was higher in both African American and white women treated with tamoxifen and chemotherapy than in those who were treated with tamoxifen alone (risk ratio for African American women = 10.70, 95% CI = 5.94 to 19.28 versus 2.16, 95% CI = 1.26 to 3.71; n = 1842; risk ratio for white women = 15.49, 95% CI = 9.53 to 25.17 versus 3.13, 95% CI = 2.04 to 4.79, n = 19 036), and this effect was similar between the races (P = .10). Conclusions: African American and white women appear to have the same risks of contralateral breast cancer and thromboembolic events in response to tamoxifen treatment.
Tolerance to and Physical Dependence on Opiates, Barbiturates, and Alcohol
Authors: H F Fraser
Journal: Annual Review of Medicine (1957)

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), emerged in China in December 2019 and quickly spread around the globe, killing more than 4 million people and causing a severe economic crisis. ...Read More
Skin cancers or premalignant lesions occur in half of high-dose PUVA patients
Authors: L.R. LEVER, P.M. FARR
Journal: British Journal of Dermatology (2006)

Although treatment of psoriasis with psoralen and ultraviolet A (PUVA) is associated with a long-term risk of development of cutaneous squamous cell carcinoma (SCC), the role of PUVA alone is not established, as many patients in reported series had also received treatment with other carcinogens, such as superficial X-rays or arsenic. We have recalled and examined 54 of the 63 patients still alive who have had PUVA treatment in our department, and who have been exposed to a cumulative UVA dose greater than 2000J/cm2. None of the patients had been treated with superficial X-rays or arsenicals. Ten patients (19%) had developed SCC, and 25 (46%) had histologically atypical squamous keratoses arising at body sites similar to the carcinomas. The patients with SCC were significantly older at the start of PUVA treatment than those with keratoses alone. None of the 13% of patients without PUVA lentigines had keratoses or SCCs. These results show that high-dose PUVA treatment in the U.K., even when given alone, can frequently result in the development of SCC. Further malignancies are to be expected with continued follow-up of the patients with squamous keratoses. Absence of PUVA lentigines may be a useful indicator of a lower risk of PUVA malignancy.
One-Stage Penectomy and Phalloplasty for Epithelioid Sarcoma of the Penis in an Adolescent
Authors: Piet B. Hoebeke, Sylvie Rottey, Nathalie Van Heddeghem, Geert Villeirs, Patrick Pauwels, Wim Schrauwen, Peter Ceulemans, Stanislas Monstrey
Journal: European Urology (2006)
Year in review in Intensive Care Medicine 2012: III. Noninvasive ventilation, monitoring and patient–ventilator interactions, acute respiratory distress syndrome, sedation, paediatrics and miscellanea
Authors: Massimo Antonelli, Marc Bonten, Maurizio Cecconi, Jean Chastre, Giuseppe Citerio, Giorgio Conti, J. R. Curtis, Goran Hedenstierna, Michael Joannidis, Duncan Macrae, Salvatore M. Maggiore, Jordi Mancebo, Alexandre Mebazaa, Jean-Charles Preiser, Patricia Rocco, Jean-François Timsit, Jan Wernerman, Haibo Zhang
Journal: Intensive Care Medicine (2013)

acquired pneumonia treated with NIV, and determined the
A spontaneous rheumatoid arthritis-like disease in MRL/l mice.
Authors: L Hang, A N Theofilopoulos, F J Dixon
Journal: The Journal of Experimental Medicine (1982)

MRL/l mice spontaneously develop an arthritis very similar in many respects to human rheumatoid arthritis. A detailed morphologic and serologic analysis of this disease revealed the following: (a) a 75% incidence of synovial and periarticular inflammation, very similar to human rheumatoid arthritis, in 5-6 mo-old females, (b) close associations between presence of joint inflammation and subsynovial and/or periarticular vasculitis, and (c) a close correlation between presence of circulating IgM rheumatoid factor (RF) and demonstrable synovial and/or joint pathology, i.e., 95% of mice with significant levels of IgMRF had synovitis and/or arthritis.
P37 Flying--safer than we thought? A questionnaire-based study of 156 individuals with hereditary haemorrhagic telangiectasia; 95 with pulmonary AVMs
Authors: C. Mason, C. Shovlin
Journal: Thorax (2010)

<h3>Introduction</h3> Flight has become an integral part of modern life: 65.9 million passengers used Heathrow airport in 2009.1 Flight, however, exposes us to a unique environment with a reduced FiO<sub>2−</sub>, increased humidity and relative immobility. Although guidelines have been published,2 there are relatively limited published data regarding flight safety. Patients with particular conditions may provide high risk models for the general population regarding the safety of the flight environment. Here we report the results of a questionnaire-based study in individuals with hereditary haemorrhagic telangiectasia (HHT), a condition that leads to recurrent nosebleeds, but more importantly for respiratory physicians, frequent pulmonary arteriovenous malformations (PAVMs) that result in a right to left shunt, hypoxaemia, and risk of paradoxical embolic stroke.3 <h3>Methods</h3> PubMed searches identified no studies into the effect of flight in HHT or PAVM patients. With ethical approval (NRES 10/H0806/8), patients with definite HHT who had attended our hospital9s HHT clinic, were sent a questionnaire. Participants were asked to document flights they had taken, and to list any symptoms they experienced during or shortly afterwards. Responses were correlated with physiological variables in their hospital records. <h3>Results</h3> 156 replies were received from 308 questionnaires (response rate 50.6%). 145 individuals (95 [65%] with pulmonary AVMs), had flown, reporting 18 943 flight hours in 3950 flights. The median number of flights per patient was 17 short haul, and 8 long haul. There was no difference in erect SaO<sub>2</sub> between those who reported breathlessness and those who did not (median 93 (range 85–96)% vs median 94 (84–99)% respectively. Individuals who reported breathlessness stated that in-flight oxygen was of benefit (Abstract P37 Table 1). <h3>Conclusion</h3> These data suggest that even in a population group expected to be more susceptible to complications, flying appeared safe for the vast majority of individuals. A minority of HHT patients did experience adverse symptoms. These were difficult to predict based on clinic measurements.
Antiarrhythmic Drug-Induced Internalization of the Atrial-Specific K <sup>+</sup> Channel Kv1.5
Authors: Sarah M. Schumacher, Dyke P. McEwen, Lian Zhang, Kristin L. Arendt, Kristin M. Van Genderen, Jeffrey R. Martens
Journal: Circulation Research (2009)

Conventional antiarrhythmic drugs target the ion permeability of channels, but increasing evidence suggests that functional ion channel density can also be modified pharmacologically. Kv1.5 mediates the ultrarapid potassium current (I(Kur)) that controls atrial action potential duration. Given the atrial-specific expression of Kv1.5 and its alterations in human atrial fibrillation, significant effort has been made to identify novel channel blockers. In this study, treatment of HL-1 atrial myocytes expressing Kv1.5-GFP with the class I antiarrhythmic agent quinidine resulted in a dose- and temperature-dependent internalization of Kv1.5, concomitant with channel block. This quinidine-induced channel internalization was confirmed in acutely dissociated neonatal myocytes. Channel internalization was subunit-dependent, activity-independent, stereospecific, and blocked by pharmacological disruption of the endocytic machinery. Pore block and channel internalization partially overlap in the structural requirements for drug binding. Surprisingly, quinidine-induced endocytosis was calcium-dependent and therefore unrecognized by previous biophysical studies focused on isolating channel-drug interactions. Importantly, whereas acute quinidine-induced internalization was reversible, chronic treatment led to channel degradation. Together, these data reveal a novel mechanism of antiarrhythmic drug action and highlight the possibility for new agents that selectively modulate the stability of channel protein in the membrane as an approach for treating cardiac arrhythmias.
Alemtuzumab Therapy for Hypereosinophilic Syndrome and Chronic Eosinophilic Leukemia
Authors: Srdan Verstovsek, Ayalew Tefferi, Hagop Kantarjian, Taghi Manshouri, Raja Luthra, Animesh Pardanani, Alfonso Quintás-Cardama, Farhad Ravandi, Pat Ault, Carlos Bueso-Ramos, Jorge E. Cortes
Journal: Clinical Cancer Research (2008)

Abstract Purpose: Patients with hypereosinophilic syndrome (HES) or chronic eosinophilic leukemia (CEL) that are refractory to standard therapies are difficult to manage and have significantly shortened life expectancy. Experimental Design: CD52 is a surface glycoprotein highly expressed on eosinophils. We treated 11 patients with advanced HES/CEL with alemtuzumab, a humanized anti-CD52 monoclonal antibody. Alemtuzumab was administered, in general, first in escalating doses (5, 10, 30 mg i.v. on days 1-3), then at the tolerated dose thrice per week for a total of 12 doses. Patients with complete hematologic response (CHR; normal percent and absolute eosinophil count) were allowed to continue therapy once weekly as maintenance. Results: Ten patients (91%) achieved CHR after a median of 2 weeks (0.5-5 weeks) of therapy. Bone marrow eosinophilia resolved in four of seven evaluable patients. The median duration of CHR was 3 months (1.5-17+ months). Seven of the 10 CHR patients relapsed, five while off-therapy. Two patients achieved second CHR upon alemtuzumab rechallenge. Three patients experienced mild infusion-related symptoms, two developed cytomegalovirus reactivation requiring therapy, and one developed orbital lymphoma that was successfully treated. Conclusions: Our limited experience suggests alemtuzumab to be a valuable therapy for advanced HES or CEL, refractory to standard therapies, and supports the clinical evaluation of alemtuzumab in a larger trial.
The FitzPatrick Lectures ON GREEK MEDICINE IN ROME
Authors: T. C. Allbutt
Journal: BMJ (1909)

Amateur Emigrant: " An aim in life is the only fortune worth the finding."Each one of yon must at times sit down seriously and think over the intentions, if you have any, with which you have come to the university.The qualifying clause, " if you have any," is not of the nature of a sneer.It so happens that a very large number of men are sent to the university in order to make up their minds what their life-work is to be, and therefore it often happens that amongst the undergraduates a considerable proportion are found not to have any very definite views as to their future.Let us, therefore, take it that each one of you is of a mind to do the best in order to be fitted for the duties of life.The first piece of advice which any of us will venture to give you is to work hard.It is one of the ghastly portents of ttiis age that men are demanding that no one should be allowed to work more than eight hours a day, an eye being kept on the clock every minute of the time.That kind of thing, in no matter what sphere of life, will certainly, if persisted in, wreck this country.It means a fatal descent from the strong tendencies of individual independence to a weak refuge in socialistic dependence.Try to picture for yourselves the successful professional man or bnsiness man, reaching any position of eminence on an eight hours day I No I we have all, with- out exception, to make up our minds that if we really wish to arrive, it can only be by unremitting and self.sacrificing labour.If any of you desire to see how this aspect of academic life struck one of the most strenuous men of last century, let me recommend you to read Thomas Carlyle's letter to a medical student.It is but a type of what all the great men have reiterated." Work while it is the day" is no less true in this age than it was nineteen hundred years ago, and let me urge you, furthermore, to remember that the present is the only time in which you will be able to 'work at all.Life holds not an hour that is better to live in: The past is a tale that is told, The future a sun-flecked shadow, alive and asleep, with a blessing in store.But, let me add, the blessing in store is only won by those who seek for it.You must not, however, go away
Assessing genetic structure with multiple classes of molecular markers: a case study involving the introduced fire ant Solenopsis invicta
Authors: K. G. Ross, D. D. Shoemaker, M. J. Krieger, C. J. DeHeer, L. Keller
Journal: Molecular Biology and Evolution (1999)

We used 30 genetic markers of 6 different classes to describe hierarchical genetic structure in introduced populations of the fire ant Solenopsis invicta. These included four classes of presumably neutral nuclear loci (allozymes, codominant random amplified polymorphic DNAs (RAPDs), microsatellites, and dominant RAPDs), a class comprising two linked protein-coding nuclear loci under selection, and a marker of the mitochondrial DNA (mtDNA). Patterns of structure revealed by F statistics and exact tests of differentiation were highly concordant among the four classes of neutral nuclear markers, although the microsatellites were the most effective markers for detecting structure. The results from the mtDNA complemented those from the neutral nuclear markers by revealing that strong limitations to female-mediated gene flow were the cause of the local structure registered by the nuclear markers. The pattern of structure inferred from the selected nuclear loci was markedly different from the patterns derived from the other sets of markers but was predictable on the basis of the presumed mode of selection acting on these loci. In general, the results for all six classes of markers can be explained by known features of the social and reproductive biology of fire ants. Thus, the results from these diverse sets of markers, combined with detailed natural history data, provide an unusually complete picture of how the fundamental evolutionary forces of gene flow, drift, and selection govern the distribution of genetic variation within and between fire ant populations.
Mechanisms of suppression in the transfer of contact sensitivity. Analysis of an I-J+ molecule required for Ly2 suppressor cell activity.
Authors: W Ptak, R K Gershon, P M Flood
Journal: The Journal of Experimental Medicine (1983)

The passive transfer of contact sensitivity (CS) by immune cells can be inhibited with an antigen-specific T suppressor factor. This factor is composed of two subfactors: an antigen-specific subfactor made by an Ly1+ cell (PC1-F) and a antigen nonspecific subfactor made by an Ly2+ T cell (TNBSA-F). The suppressive activity of the complete factor can be eliminated by depleting the assay population of Ly2+ cells, even though it is the Ly1+ cell in the population that transfers the adoptive immunity. This suggests that the Ly2+ cell in the assay population is needed to transduce the suppressive signal to the Ly1+ effector cell of DTH. We found that an Ly2+ cell from immune animals could be induced to produce a cell free subfactor that overcame the requirement for this Ttrans cell in the suppression of CS by TsF. The induction required only PC1-F, TNP-coupled spleen cells, and resulted in the production of an antigen-nonspecific I-J+ subfactor by immune Ly2+, I-J+ cells. The need for the Ly2+ transducer cell could also be overcome by addition of an I-J+ molecule secreted by Ly1 T cells hyperimmunized to SRBC. A suppressor complex made from mixing the I-J+ molecule with TNBSA-F could directly suppress the functional activity of immune T cells not only to transfer CS, but also to deliver help to B cells in an in vitro PFC response. This suppressive complex is antigen-nonspecific and does not require Ly2+ T cells in the assay population for suppressive activity. These results indicate that effector factors of the suppressor circuit require two molecules; one that contains the functional suppressor material and one that serves as a "schlepper," a molecule needed to deliver the suppression to the appropriate target cell. The ability to construct a functional suppressor complex from two subfactors raised against different antigens, using different immunization procedures, which were isolated from factors exhibiting different functional activities suggests that certain cells of the immune system may play a universal role in "transducing" the suppressive signal.
Polymyalgia rheumatica. Abrupt and gradual withdrawal of prednisolone treatment, clinical and laboratory observations.
Authors: W Esselinckx, S M Doherty, A S Dixon
Journal: Annals of the Rheumatic Diseases (1977)

Eighteen patients with polymyalgia rheumatica had corticosteroid treatment withdrawn abruptly under close observation. In each case polymyalgic symptoms reappeared but were controlled rapidly when prednisolone was reintroduced. Prednisolone withdrawal was then started by slow decrements of dose. In no patient was it possible to withdraw prednisolone treatment, after using either method, during the period of observation.