tbuckley/cabot-search huggingface dataset:
Definition of disease duration in ankylosing spondylitis: reassessing the concept
Authors: J C Davis, M Dougados, J Braun, J Sieper, D van der Heijde, S van der Linden
Journal: Annals of the Rheumatic Diseases (2006)

The concept and definition of disease duration in patients with ankylosing spondylitis is ambiguous, and often many years pass between the onset of symptoms and diagnosis. Members of the Assessment in Ankylosing Spondylitis (ASAS) International Working Group by consensus recently recommended identifying specific components of the medical history to better define and document the concept of disease duration. These include (1) the time of onset of the first symptoms of axial manifestations (including inflammatory back pain); (2) the time of onset of the first symptoms of each individual manifestation, which may be an extra-axial sign or symptom of ankylosing spondylitis, such as peripheral arthritis and enthesitis; (3) the time of onset of associated diseases belonging to the spondyloarthritides, in particular acute anterior uveitis, inflammatory bowel disease and psoriasis; and (4) the time since actual diagnosis by a healthcare provider. Such uniformity in data collection will ensure comparability across studies and facilitate future research.
Can Evolutionary Tools Reliably Tell Us about Dengue Virus' Past Outbreaks?
Authors: J. Caspermeyer
Journal: Molecular Biology and Evolution (2013)

The mosquito-borne dengue virus is most prevalent in southeastern Asia, with four common strains or “serotypes” of the virus infecting up to 10% of children in Vietnam annually. Dengue virus is a major challenge for evolutionary biologists because of its complex ecology and rapidly changing disease dynamics. But can evolutionary models become a reliable tool for epidemiologists studying infectious disease? Coming up with a model to relate dengue’s genealogical history, or phylodynamics, with the epidemiology of the disease is challenging because of its complexity: seasonal infection rates, changes in mosquito population sizes, different viral strains, urban versus rural populations densities, and the widespread movement of people—where viruses can usurp geographic boundaries—are all contributing factors. Now, Rasmussen et al. (2013) have looked at dengue virus serotype 1 (DENV-1) in southern Vietnam, the most dominant endemic strain of the virus, for which a large number of sequence samples (237) are available along with reliable data on dengue hospitalizations. They incorporated some of these additional ecological complexities to tweak different phylodynamic models and were able to reconstruct dengue’s past dynamics from genealogies that are consistent with the observed hospitalization data and also lead to new insights into the factors shaping viral family histories. Their best-fit models accounted for population variation in urban versus rural areas or the population dynamics of mosquitos, matching the hospital-reported cases. This gave new insights for the researchers to create new and improved models that are more reliable and accurate for the complex dynamics of infectious disease.
The effects of electrical field stimulation and tetrodotoxin on ion transport by the isolated rabbit ileum.
Authors: K A Hubel
Journal: Journal of Clinical Investigation (1978)

To determine whether intramural nerves affect intestinal ion transport, we studied the effect of electrical field stimulation (EFS) on the movement of ions across isolated rabbit ileum. EFS increased the transmural electrical potential difference and the short circuit current (Isc), caused C1 secretion, and reduced conductance, but did not alter fluxes of Na or the residual current (JRnet). The neurotoxin, tetrodotoxin, prevented all the changes caused by EFS but did not prevent the increase in Isc caused by theophylline (5 mM), carbachol (10 micrometer), or glucose (10 mM), or the reduction in Isc caused by norepinephrine (10 micrometer), implying that tetrodotoxin prevented responses to EFS by affecting electrically excitable cells rather than epithelial cells. Tetrodotoxin also enhanced the mucosa to serosa fluxes of Na and C1, reduced the potential difference and Isc, and increased conductance. The site of tetrodotoxin action is uncertain because it may affect the release of at least four neuro-transmitters and the release of peptides from endoctine cells. The Isc response to EFS was not affected by atropine (10 micrometer), physostigmine (10 micrometer), or by hemicholinium (1 micrometer). The mechanism by which EFS causes C1 secretion remains to be determined.
Underwater birth and neonatal respiratory distress:Authors' reply
Authors: Zainab Kassim, Anne Greenough, Maria Sellars
Journal: BMJ (2005)

The General Medical Council and the future of revalidation GMC member respondsEditor-Esmail and Kmietowicz give an inaccurate account of the General Medical Council's policy development on revalidation, ignoring an iterative process with interested parties since 1998 in an attempt to introduce the most fundamental change to medical regulation since its foundation in 1858. 1 2 The GMC clearly has had regard to the legitimate interests of three principal groups-government and the NHS, patients and the public, and the various tribes that make up the UK medical profession.Despite suggestions to the contrary, an initial exploratory meeting on revalidation convened by Sir Donald Irvine in June 1998 was held in the context of a high profile professional conduct case, but well before the Bristol inquiry report and absolutely nothing to do with Rodney Ledward or, indeed, Harold Shipman.It was recognised then that some doctors were not keeping fully up to date nor were they indulging in reflective practice.Irvine correctly proposed that there was a need to make registration with the GMC more meaningful to the public than a mere recognition that doctors had reached a certain standard of professional knowledge in their early 20s.Both articles promote the idea that the doctors' regulator should be filling the vacuum within the NHS created by its failing to fulfil its public responsibility to monitor doctors' clinical standards.Clinical governance is now, slowly, being developed and eventually will extend from systems and teams to individuals-but is it reasonable, as both authors postulate, that such monitoring should become the financial and moral responsibility of the GMC sitting in London and Manchester rather than local managers at the coalface?Although revalidation is a continuing process, it becomes summative only every five years.The NHS and its local systems must not be allowed to abrogate their responsibility for the safety of patients on a day to day basis.Nor should they demand that the GMC and its prime function of assuring fitness to practise and the meaning of the medical register be inappropriately promoted as the first line of defence for the maintenance of clinical quality and safety.
Incidence of community-acquired pneumonia and Chlamydia pneumoniae infection: a prospective multicentre study
Authors: J Almirall, I Morato, F Riera, A Verdaguer, R Priu, P Coll, J Vidal, L Murgui, F Valls, F Catalan, al. et
Journal: European Respiratory Journal (1993)

This one year prospective multicentre study was designed to determine the incidence of community-acquired pneumonia in adults. It was carried out in primary health care centres and three reference hospitals, located in the 'Maresme' region (Barcelona, Spain) serving a population of 39,733 subjects over 13 years of age. Patients suspected of having contracted community-acquired pneumonia were visited by their family doctors and referred to the three reference hospitals for confirmation of the diagnosis. Patients attending the emergency services of these hospitals were also included. Urine and blood samples were obtained for culture, antigen detection, blood count, serological tests, blood gases and biochemical profile. The diagnosis of community-acquired pneumonia was made in 105 patients. Forty-six patients had an identifiable microbial etiology. Chlamydia pneumoniae was the most common pathogen (16 cases) followed by Streptococcus pneumoniae (13 cases) and Mycoplasma pneumoniae (8 cases). In conclusion; the annual incidence rate of community-acquired pneumonia in adults in this area was 2.6 cases per 1,000 inhabitants and Chlamydia pneumoniae was the most frequent causative pathogen.
Pre-employment chest radiography for health service staff: who needs it?
Authors: I Madan
Journal: BMJ (1993)

pulmonary infarct and he was treated with anticoagulants.Two days later he suffered a cardiopulmonary arrest and despite maximum resuscitative efforts he died. Correct answerThis is unlikely to be a natural cause of death: the sequence of events begins with a fall, which leads to an operation, immobility, and then a pulmonary embolus.The case must be reported.There was no suggestion of an osteoporotic fracture in the history.
Phacoemulsification Versus Combined Phacotrabeculectomy in Medically Controlled Chronic Angle Closure Glaucoma with Cataract
Authors: Clement C.Y. Tham, Yolanda Y.Y. Kwong, Dexter Y.L. Leung, S.W. Lam, Felix C.H. Li, Thomas Y.H. Chiu, Jonathan C.H. Chan, Catherine H.Y. Chan, Agnes S.Y. Poon, Doris W.F. Yick, C.C. Chi, Dennis S.C. Lam, Jimmy S.M. Lai
Journal: Ophthalmology (2008)
Is there a true association between Rosai-Dorfman disease and malignancy?
Authors: G. Ratzinger, B.G. Zelger, B. Zelger
Journal: British Journal of Dermatology (2003)

Sir, Sinus histiocytosis with massive lymphadenopathy (SHML) is a rare disease that was first described by Destombes in 19651 and recognized as a distinct clinicopathological entity by Rosai and Dorfman in 1969.2, 3 It typically appears with cervical lymphadenopathy accompanied by unspecific signs of immunoactivation. Other lymph node groups also may be involved. In approximately 40% of cases, extranodal lesions in skin, respiratory tract, eyes and soft tissue can be found;4 exclusively extranodal manifestation is rare.5 Typical histopathological features comprise a sheet‐like infiltrate of faintly stained macrophages intermingled with lymphocytes and plasma cells (Fig. 1). In addition, lymphocytes within the cytoplasm of macrophages, so called emperipolesis, can be observed. Immunohistochemistry shows positivity for S100 protein and with KiM1p and negativity for CD1a.6 The disease course is usually benign. Local excision is sufficient in most cases. Rare fatal outcomes due to infiltration of vital organs or immunological abnormalities are described. Association of SHML with haematological disorders also has been observed.7 The cause of the disease remains unknown; most probably it comprises a disease of acquired immune dysregulation.8 We recently followed the interesting course of the disease in two patients with SHML who were previously affected or subsequently developed a solid neoplasia.
A Once-Daily, Oral, Direct Factor Xa Inhibitor, Rivaroxaban (BAY 59-7939), for Thromboprophylaxis After Total Hip Replacement
Authors: Bengt I. Eriksson, Lars C. Borris, Ola E. Dahl, Sylvia Haas, Menno V. Huisman, Ajay K. Kakkar, Eva Muehlhofer, Christoph Dierig, Frank Misselwitz, Peter Kälebo
Journal: Circulation (2006)

Rivaroxaban (BAY 59-7939)--an oral, direct Factor Xa inhibitor--could be an alternative to heparins and warfarin for the prevention and treatment of thromboembolic disorders.This randomized, double-blind, double-dummy, active-comparator-controlled, multinational, dose-ranging study assessed the efficacy and safety of once-daily rivaroxaban relative to enoxaparin for prevention of venous thromboembolism in patients undergoing elective total hip replacement. Patients (n=873) were randomized to once-daily oral rivaroxaban doses of 5, 10, 20, 30, or 40 mg (initiated 6 to 8 hours after surgery) or a once-daily subcutaneous enoxaparin dose of 40 mg (given the evening before and > or = 6 hours after surgery). Study drugs were continued for an additional 5 to 9 days; mandatory bilateral venography was performed the following day. The primary end point (composite of any deep vein thrombosis, objectively confirmed pulmonary embolism, and all-cause mortality) was observed in 14.9%, 10.6%, 8.5%, 13.5%, 6.4%, and 25.2% of patients receiving 5, 10, 20, 30, and 40 mg rivaroxaban, and 40 mg enoxaparin, respectively (n=618, per-protocol population). No significant dose-response relationship was found for efficacy (P=0.0852). Major postoperative bleeding was observed in 2.3%, 0.7%, 4.3%, 4.9%, 5.1%, and 1.9% of patients receiving 5, 10, 20, 30, and 40 mg rivaroxaban, and 40 mg enoxaparin, respectively (n=845, safety population), representing a significant dose-response relationship (P=0.0391).Rivaroxaban showed efficacy and safety similar to enoxaparin for thromboprophylaxis after total hip replacement, with the convenience of once-daily oral dosing and without the need for coagulation monitoring. When both efficacy and safety are considered, these results suggest that 10 mg rivaroxaban once daily should be investigated in phase III studies.
Letter from the Editorial Team
Authors: Robin Graham-Brown, Iona Tulloch
Journal: British Journal of Dermatology (2002)

The year 2002 is going to witness a number of positive changes and modi®cations to the British Journal of Dermatology, all of which aim to improve the ef®ciency of the Journal as a whole, while we publish increasingly cutting-edge research.Although many of these will not be overtly noticed by the readership, in this ®rst issue of 2002 we are introducing a feature that we hope will enhance the overall readability of the BJD.You will notice that in the table of contents we have included focused headings for related groups of original articles.These ÔsignpostsÕ are ¯exible and will vary between issues of the BJD depending on the topics of the papers published.Secondly, we have added more detailed information about book reviews in the
Perioperative epidural analgesia for major abdominal surgery for cancer and recurrence-free survival: randomised trial
Authors: P. S. Myles, P. Peyton, B. Silbert, J. Hunt, J. R. A. Rigg, D. I. Sessler
Journal: BMJ (2011)

To compare long term recurrence of cancer and survival of patients having major abdominal surgery for cancer.Long term follow-up of prospective randomised controlled clinical trial in which patients were randomly assigned to receive general anaesthesia with or without epidural block for at least three postoperative days. Setting 23 hospitals in Australia, New Zealand, and Asia.503 adult patients who had potentially curative surgery for cancer.Cancer-free survival (analysis was by intention to treat).Long term follow-up data were available for 94% (n=446) of eligible participants. The median time to recurrence of cancer or death was 2.8 (95% confidence interval 0.7 to 8.7) years in the control group and 2.6 (0.7 to 8.7) years in the epidural group (P=0.61). Recurrence-free survival was similar in both epidural and control groups (hazard ratio 0.95, 95% confidence interval 0.76 to 1.17; P=0.61).Use of epidural block in abdominal surgery for cancer is not associated with improved cancer-free survival.Australian New Zealand Clinical Trials Registry ACTRN12607000637448.
Evaluation of antral motility in humans using manometry and scintigraphy.
Authors: K Jones, M Edelbroek, M Horowitz, W M Sun, J Dent, J Roelofs, T Muecke, L Akkermans
Journal: Gut (1995)

Recent studies suggest that scintigraphy can be used to evaluate non-invasively antral motility in humans, although scintigraphic techniques have not yet been compared with more conventional measurements of intraluminal pressures by manometry. Simultaneous scintigraphic and manometric measurements of antral motility were performed in nine healthy volunteers. After intubation with a sleeve/sidehole catheter which incorporated five pressure sideholes located at 1.5 cm intervals spanning the antrum, each subject ingested 100 g minced beef labelled with 100 MBq 99mTc-chicken liver and 150 ml water. Between 40-43, 60-63, 80-83, and 100-103 minutes after meal ingestion, radioisotopic data were acquired in two second frames. Time-activity curves showing antral 9contractions9 resulting from wall motion were derived by drawing small regions of interest over the antrum to coincide with the position of the antral manometric sideholes. Scintigraphic contraction rates approximated 3/minute, whereas antral pressure waves that occluded the lumen were less frequent (p &lt; 0.01 for all), particularly in the proximal antrum. The amplitude of wall motion, evaluated scintigraphically, and the amplitude of pressure waves were both inversely related to the distance from the pylorus (r &gt; -0.32, p &lt; 0.05) and antral volume r &gt; -0.29 (p &lt; 0.05). There were significant relationships between the amplitude of contractions assessed scintigraphically and the number of lumen-occlusive antral pressure waves in the distal antrum (r -0.48, p &lt; 0.05) but not in the more proximal antral regions. It is concluded that scintigraphy can detect antral wall motion with greater sensitivity than manometry, particularly in the proximal antrum. As manometry gives information on the amplitude as well as the temporal and spatial organisation of those contractions which result in lumen occlusion, the combination of scintigraphic and manometric techniques in the evaluation of antral motility shows considerable promise.
Hidradenitis suppurativa and metabolic syndrome: a comparative cross‐sectional study of 3207 patients
Authors: G. Shalom, T. Freud, I. Harman‐Boehm, I. Polishchuk, A.D. Cohen
Journal: British Journal of Dermatology (2015)

Hidradenitis suppurativa (HS) is a chronic relapsing inflammatory skin disease. To evaluate the association between HS and metabolic syndrome and its component morbidities in a large, community‐based cohort of patients with HS, using the database of Clalit Health Services, the largest public healthcare provider in Israel. A cross‐sectional study was performed. Metabolic syndrome was defined as the presence of at least three of the following conditions: diabetes, hyperlipidaemia, hypertension and obesity. The association between HS and metabolic syndrome was assessed by a multivariate logistic regression model, adjusting for age, sex, diabetes, hypertension, hyperlipidaemia, obesity and smoking status. The study included 3207 patients with HS (general frequency of 0·07%) diagnosed by a dermatologist in primary‐care centres, and 6412 age‐ and sex‐matched control patients without HS. HS was significantly associated with metabolic syndrome [odds ratio (OR) 1·61, 95% confidence interval (CI) 1·36–1·89], diabetes (OR 1·41, 95% CI 1·19–1·66), obesity (OR 1·71, 95% CI 1·53–1·91), hyperlipidaemia (OR 1·14, 95% CI 1·02–1·28) and hypertension (OR 1·19, 95% CI 1·03–1·38). We found an association between HS and diabetes, hyperlipidaemia, obesity, hypertension and metabolic syndrome among a large community‐based cohort of patients with HS. Clinicians should take into account that patients with HS may have one or more undiagnosed components of metabolic syndrome despite their young age. Thus, appropriate targeted screening is advised.
Seminal tract infections: impact on male fertility and treatment options
Authors: C Keck
Journal: Human Reproduction Update (1998)

Bacterial and viral infections of the genital tract may be important aetiological factors for male infertility. Infectious processes may lead to deterioration of spermatogenesis, impairment of sperm function and/or obstruction of the seminal tract. Detection of bacteria in semen does not necessarily signify infection since bacteriospermia may represent contamination, colonization or infection. Reported prevalence of Ureaplasma urealyticum in human semen varies from 10 to 40%. Enterobacteria can even be found in up to 90% of semen samples depending on the sensitivity of detection methods used. Chlamydia trachomatis is the most frequent sexually transmitted bacterial organism in industrialized countries. It is suggested that its main influence is due to sexual transmission resulting in tubal disease and subsequent infertility in the female partner rather than a direct influence on male reproductive functions. The effect of leukocytospermia on male fertility is controversial. This is probably due to different detection methods, different populations studied and to the fact that leukocyte subtypes in semen may have different functions. In addition to potentially negative effects, leukocytes may even have protective effects on spermatozoa. Only recently have amplification methods been established to detect viruses in semen with high sensitivity and specificity. It is unclear if these infections significantly contribute to male infertility.
Supplemental and Dietary Vitamin E, β-Carotene, and Vitamin C Intakes and Prostate Cancer Risk
Authors: Victoria A. Kirsh, Richard B. Hayes, Susan T. Mayne, Nilanjan Chatterjee, Amy F. Subar, L. Beth Dixon, Demetrius Albanes, Gerald L. Andriole, Donald A. Urban, Ulrike Peters
Journal: JNCI Journal of the National Cancer Institute (2006)

Vitamin E, beta-carotene, and vitamin C are micronutrient antioxidants that protect cells from oxidative damage involved in prostate carcinogenesis. In separate trials, supplemental vitamin E was associated with a decreased risk of prostate cancer among smokers and supplemental beta-carotene was associated with a decreased risk of prostate cancer among men with low baseline plasma beta-carotene levels.We evaluated the association between intake of these micronutrient antioxidants from foods and supplements and the risk of prostate cancer among men in the screening arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. At baseline, trial participants completed a 137-item food frequency questionnaire that included detailed questions on 12 individual supplements. Cox proportional hazards models were used to estimate relative risks (RRs) and 95% confidence intervals (CIs). All statistical tests were two-sided.We identified 1338 cases of prostate cancer among 29 361 men during up to 8 years of follow-up. Overall, there was no association between prostate cancer risk and dietary or supplemental intake of vitamin E, beta-carotene, or vitamin C. However, among current and recent (i.e., within the previous 10 years) smokers, decreasing risks of advanced prostate cancer (i.e., Gleason score > or = 7 or stage III or IV) were associated with increasing dose (RR for > 400 IU/day versus none = 0.29, 95% CI = 0.12 to 0.68; Ptrend = .01) and duration (RR for > or = 10 years of use versus none = 0.30, 95% CI = 0.09 to 0.96; Ptrend = .01) of supplemental vitamin E use. Supplemental beta-carotene intake at a dose level of at least 2000 microg/day was associated with decreased prostate cancer risk in men with low (below the median of 4129 microg/day) dietary beta-carotene intake (RR = 0.52, 95% CI = 0.33 to 0.81). Among smokers, the age-adjusted rate of advanced prostate cancer was 492 per 100,000 person-years in those who did not take supplemental vitamin E, 153 per 100,000 person-years in those who took more than 400 IU/day of supplemental vitamin E, and 157 per 100,000 person-years in those who took supplemental vitamin E for 10 or more years. Among men with low dietary beta-carotene intake, the age-adjusted rate of prostate cancer was 1122 per 100,000 person-years in those who did not take supplemental beta-carotene, and 623 per 100,000 person-years in those who took at least 2000 microg/day of supplemental beta-carotene.Our results do not provide strong support for population-wide implementation of high-dose antioxidant supplementation for the prevention of prostate cancer. However, vitamin E supplementation in male smokers and beta-carotene supplementation in men with low dietary beta-carotene intakes were associated with reduced risk of this disease.