tbuckley/cabot-search huggingface dataset:
Turning the Page
Authors: Paul Rousseau
Journal: Annals of Internal Medicine (2008)

Ad Libitum16 September 2008Turning the PagePaul Rousseau, MDPaul Rousseau, MDFrom Medical University of South Carolina, Charleston, SC 29425.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-6-200809160-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail I was reading andgazed sideways fromthe bitterness of deathwhere words of despair,being so distant,did not allow me totouch them,yet I preciselymeasured themin anticipation ofthe thick lonely night. Author, Article, and Disclosure InformationAffiliations: From Medical University of South Carolina, Charleston, SC 29425.Current Author Address: Paul Rousseau, MD, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425; e-mail, [email protected]com. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 16 September 2008Volume 149, Issue 6Page: 432KeywordsTouch ePublished: 16 September 2008 Issue Published: 16 September 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Is it bronchiolitis obliterans syndrome or is it chronic rejection: a reappraisal?
Authors: G. M. Verleden, L. J. Dupont, D. E. Van Raemdonck
Journal: European Respiratory Journal (2005)

Chronic rejection (obliterative bronchiolitis) is the single most important cause of chronic allograft dysfunction and late mortality after lung transplantation. As this condition is difficult to prove using biopsy specimens, a clinical term, bronchiolitis obliterans syndrome (BOS) has been in use for &gt;10 yrs to describe the progressive decrease of pulmonary function. However, before diagnosing a patient as having BOS, based on a sustained and progressive decrease in forced expiratory volume in one second and/or forced mid-expiratory flow between 25–75% of forced vital capacity, different confounding factors have to be eliminated. Treatment of BOS mainly consists of an increase or a change in the immunosuppressive drug regimen, which may lead to more pronounced infectious complications. Recently, two new options have become available to treat patients with BOS, treatment of gastro-oesophageal reflux and azithromycin. In the present paper, the authors give an overview of the current data on these two modalities, which may lead to a restoration of the pulmonary function in some of the patients, illustrating once more the fact that bronchitis obliterans syndrome is not always a manifestation of chronic rejection.
Cigarette Smoking and Prostate Cancer Recurrence After Prostatectomy
Authors: C. E. Joshu, A. M. Mondul, C. L. Meinhold, E. B. Humphreys, M. Han, P. C. Walsh, E. A. Platz
Journal: JNCI Journal of the National Cancer Institute (2011)

Toward the establishment of evidence-based recommendations for the prevention of prostate cancer recurrence after treatment, we examined the association between smoking and prostate cancer recurrence in a retrospective cohort study of 1416 men who underwent radical prostatectomy. Surgeries were performed by a single surgeon at Johns Hopkins Hospital between January 1, 1993, and March 31, 2006. Smoking status at 5 years before and 1 year after surgery was assessed by survey. Prostate cancer recurrence was defined as confirmed re-elevation of prostate-specific antigen levels, local recurrence, metastasis, or prostate cancer death. The cumulative incidence of recurrence was 34.3% among current smokers, 14.8% among former smokers, and 12.1% among never smokers, with a mean follow-up time of 7.3 years. Men who were current smokers at 1 year after surgery were more likely than never smokers to have disease recurrence after adjusting for pathological characteristics, including stage and grade (hazard ratio for recurrence = 2.31, 95% confidence interval = 1.05 to 5.10). This result suggests an association between cigarette smoking and risk of prostate cancer recurrence.
Vernal Keratoconjunctivitis (vkc) Treated With 0.1% Fk-506 Ophthalmic Ointment: Result Of A Three Years Follow-up
Authors: P. Pacharn, N. Visitsunthorn, O. Jirapongsananuruk, P. Vichyanond
Journal: Journal of Allergy and Clinical Immunology (2007)
Consultant contract has not resulted in any increased productivity
Authors: Adrian O'Dowd
Journal: BMJ (2007)

Zosia Kmietowicz� LondonPractice based commissioning is failing to deliver the benefit for patients envisaged by the government because of a lack of incentives to get GPs on board, says the public spending watchdog.The policy to devolve responsibility for commissioning services from primary care trusts to general practices at the local level was introduced in 2005-6 and is a main plank of the NHS reform programme.But the Audit Commission says it is suffering from poor support from primary care trusts for GPs to develop projects-including accurate information on budgets, what savings have been made, and how these savings could be used to develop other services."Unless you get the financial infrastructure right it [practice based commissioning] won't work," said Andy McKeon, managing director for health at the Audit Commission.For its new report the commission interviewed staff at 16 primary care trusts and three general practices and conducted a survey of 623 general practices, to which 122 GPs and practice managers (20%) replied."The scale of service redesign achieved through PBC [practice based commissioning] has been modest so far," says the report.Most practices reported that they had neither the resources nor the time to implement commissioning; only 18% of practices responded positively to both questions.Nearly three quarters of survey respondents said that their primary care trust was not supporting them in building capacity to implement commissioning. Putting Commissioning intoPractice is available at www.
An epidemiological study of lung cancer: history and histological types in a general population in northern Finland
Authors: R Makitaro, P Paakko, E Huhti, R Bloigu, VL Kinnula
Journal: European Respiratory Journal (1999)

A prospective epidemiological study was conducted to assess the incidence, diagnosis, histology and surgical treatment of lung cancer in northern Finland. The results were compared with those obtained in a similar survey 20 yrs earlier. Most of the patients with a suspected lung tumour were interviewed (72%) and the information was combined with that obtained from the national cancer registry. All pathological specimens were re-evaluated by a pathologist. A total of 602 new lung cancer cases (85% male, 15% female) were diagnosed during the years 1990-1992, the annual incidence per 100,000 being 63 for males and 9.5 for females. The number not reported to the Finnish Cancer Registry was low (&lt;1%). Lung cancer was confirmed histologically in 381 cases (63%) and in addition cytologically in 135 cases (23%). Squamous cell carcinoma was the most common histological type (40%), the proportion of adenocarcinoma being 26%, small cell carcinoma 24% and large cell carcinoma 4%. The incidence of lung cancer had decreased significantly among males (from 87 to 63 per 100,000) compared with 20 yrs earlier but had increased among females (from 4.1 to 9.5), chiefly on account of adenocarcinoma. The findings of this prospective study show an increase in the incidence of lung adenocarcinoma among females, a histological type which is less closely related to smoking than the other cancers. This suggests that other risk factors may play an increasing role in the aetiology of lung cancer.
Association between testosterone levels and risk of future rheumatoid arthritis in men: a population-based case–control study
Authors: Mitra Pikwer, Aleksander Giwercman, Ulf Bergström, Jan-Åke Nilsson, Lennart T H Jacobsson, Carl Turesson
Journal: Annals of the Rheumatic Diseases (2013)

Rheumatoid arthritis (RA) is less common among men than women, and sex hormones have been suggested to play a part in the pathogenesis. Lower levels of testosterone have been demonstrated in men with RA, but it is not known if these changes precede the disease.In a nested case-control study, using information and blood samples from a population-based health survey, we identified incident cases of RA by linking the cohort to local and national RA registers. Two controls for each validated case, matched for age, sex and year of screening, were selected from the health survey. Using stored blood samples, collected between 08:00 and 10:00 am after an overnight fast, we analysed levels of testosterone and other reproductive hormones.Serum was available from 104 cases (median time from screening to RA diagnosis 12.7 years (range 1-28); 73% rheumatoid factor (RF) positive at diagnosis or later) and 174 matched controls. In conditional logistic regression models, adjusted for smoking and body mass index, lower levels of testosterone were associated with subsequent development of RF-negative RA (OR 0.31 per SD, 95% CI 0.12 to 0.85), with a weaker association with RF-positive RA (OR 0.87 per SD; 95% CI 0.53 to 1.43). Levels of follicle-stimulating hormone were significantly increased in pre-RF-negative RA (p=0.02), but decreased in pre-RF-positive RA (p=0.02).Lower levels of testosterone were predictive of RF-negative RA, suggesting that hormonal changes precede the onset of RA and affect the disease phenotype.
Multicentre controlled trial of parenting groups for childhood antisocial behaviour in clinical practice Commentary: nipping conduct problems in the
Authors: S. Scott, Q. Spender, M. Doolan, B. Jacobs, H. Aspland, C. Webster-Stratton
Journal: BMJ (2001)

<h3>Abstract</h3> <b>Objective:</b> To see whether a behaviourally based group parenting programme, delivered in regular clinical practice, is an effective treatment for antisocial behaviour in children. <b>Design:</b> Controlled trial with permuted block design with allocation by date of referral. <b>Setting:</b> Four local child and adolescent mental health services. <b>Participants:</b> 141 children aged 3-8 years referred with antisocial behaviour and allocated to parenting groups (90) or waiting list control (51). <b>Intervention:</b> Webster-Stratton basic videotape programme administered to parents of six to eight children over 13-16 weeks. This programme emphasises engagement with parental emotions, rehearsal of behavioural strategies, and parental understanding of its scientific rationale. <b>Main outcome measures:</b> Semistructured parent interview and questionnaires about antisocial behaviour in children administered 5-7 months after entering trial; direct observation of parent-child interaction. <b>Results:</b> Referred children were highly antisocial (above the 97th centile on interview measure). Children in the intervention group showed a large reduction in antisocial behaviour; those in the waiting list group did not change (effect size between groups 1.06 SD (95% confidence interval 0.71 to 1.41), P&lt;0.001). Parents in the intervention group increased the proportion of praise to ineffective commands they gave their children threefold, while control parents reduced it by a third (effect size between groups 0.76 (0.16 to 1.36), P=0.018). If the 31 children lost to follow up were included in an intention to treat analysis the effect size on antisocial behaviour was reduced by 16%. <b>Conclusions:</b> Parenting groups effectively reduce serious antisocial behaviour in children in real life conditions. Follow up is needed to see if the children9s poor prognosis is improved and criminality prevented. <h3>What is already known on this topic</h3> Children who persistently display a high level of antisocial behaviour are at high risk of social rejection, juvenile delinquency, and long term unemployment; the cost to society is high While some behaviourally based parenting programmes have been shown to be effective in university centre trials with volunteers or specially selected cases, most trials of psychological treatments for children in real life settings have shown no effect <h3>What this study adds</h3> An evidence based intervention is available for use in regular clinical practice that effectively reduces antisocial behaviour in referred children The intervention works well with children at risk of criminality from a combination of highly antisocial behaviour, multiple psychopathology, and social deprivation
Microvascular proliferations in arteriovenous malformations relate to high-flow characteristics, inflammation, and previous therapeutic embolization of the lesion
Authors: Lorine B. Meijer-Jorna, Chris M. van der Loos, Onno J. de Boer, Anton J.G. Horrevoets, Jan R. Mekkes, Chantal M.A.M. van der Horst, Allard C. van der Wal
Journal: Journal of the American Academy of Dermatology (2012)
Long term failure of endoscopic gastroplication (EndoCinch)
Authors: I Schiefke
Journal: Gut (2005)

<b>Introduction:</b> Endoluminal gastroplication (EndoCinch; Bard) has been introduced as an endoscopic treatment option in gastro-oesophageal reflux disease (GORD) patients with promising short term results. However, little is known about the long term efficacy of endoscopic suturing. The aim of this study was to evaluate prospectively the long term outcome after EndoCinch. <b>Patients and methods:</b> A total of 70 patients treated with EndoCinch at a single referral centre were studied prospectively. All patients were interviewed using a standardised questionnaire regarding their symptoms and medication prior to and 18 months after EndoCinch. In addition, follow up included endoscopy, 24 hour pH monitoring, and oesophageal manometry. <b>Results:</b> The procedure was well tolerated without major short or long term complications. Eighteen months after EndoCinch, 56/70 patients (80%) were considered treatment failures as their heartburn symptoms did not improve or proton pump inhibitor medication exceeded 50% of the initial dose. Endoscopy showed all sutures in situ in 12/70 (17%) patients while no remaining sutures could be detected in 18/70 (26%). In 54 and 50 patients examined, respectively, no significant changes in 24 hour pH monitoring (median pH &lt;4/24 hours, 9.1% <i>v</i> 8.5%; p = 0.82) or lower oesophageal sphincter (LOS) pressure (7.7 <i>v</i> 10.3 mm Hg; p = 0.051) were observed while median LOS length slightly increased (3.0 to 3.2 cm; p&lt;0.05). <b>Conclusion:</b> Endoscopic gastroplication (EndoCinch) is a safe and minimally invasive endoscopic treatment for GORD with reasonable short term results. In contrast, long term outcome is disappointing, probably due to suture loss in the majority of patients. Therefore, technical improvements to ensure suture durability are mandatory before endoscopic suturing can evolve as a therapeutic option for GORD treatment.
Exercise reduces pain and improves physical function for people awaiting hip replacement surgery
Authors: Nicholas Henschke, Joanna Diong
Journal: British Journal of Sports Medicine (2013)

▸  Gill SD , McBurney H. Does exercise reduce pain and improve physical function before hip or knee replacement surgery? A systematic review and meta-analysis of randomised controlled trials. Arch Phys Med Rehabil 2013; 94 :164–76

Hip and knee replacement surgery can reduce pain and improve physical function in people with osteoarthritis.1 Interventions to improve or maintain physical function before surgery may improve postoperative outcomes,2 but only a small proportion of people receive such interventions before surgery3 and the effects of most preoperative exercise interventions remain uncertain.4

This systematic review aimed to determine whether preoperative exercise interventions can reduce pain and improve physical function before hip or knee joint replacement surgery.

Four computer databases (CINAHL, MEDLINE, EMBASE and Cochrane Library) were searched up to July 2012 and reference lists of retrieved articles were screened. Titles and abstracts were screened by one reviewer for eligibility.

Studies were eligible if the effect of preoperative exercise-based intervention compared to no intervention on pain and/or physical function was assessed in participants awaiting hip or knee replacement surgery using a randomised or quasi-randomised design, and the study …
A long-term follow-up study of methotrexate in juvenile localized scleroderma (morphea)
Authors: Francesco Zulian, Cristina Vallongo, Annalisa Patrizi, Anna Belloni-Fortina, Mario Cutrone, Maria Alessio, Silvana Martino, Valeria Gerloni, Fabio Vittadello, Giorgia Martini
Journal: Journal of the American Academy of Dermatology (2012)
High-risk Human Papillomavirus E7 Oncoprotein Detection in Cervical Squamous Cell Carcinoma
Authors: Sigrun Ressler, René Scheiden, Kerstin Dreier, Andreas Laich, Elisabeth Müller-Holzner, Haymo Pircher, Dieter Morandell, Ines Stein, Hans-Peter Viertler, Frédéric R. Santer, Andreas Widschwendter, Jos Even, Pidder Jansen-Dürr, Catherine Capesius, Werner Zwerschke
Journal: Clinical Cancer Research (2007)

Abstract Purpose: Persistent infections by high-risk human papillomavirus (HPV) types are the main etiologic factor for cervical cancer. The objective of this study was to evaluate whether high-risk E7 oncoprotein is adequate as a marker for the detection of cervical cancer. Experimental Design: HPV typing was done in biopsies from 58 cervical carcinoma and 22 normal cervical squamous epithelia. The HPV-16 E7, HPV-18 E7, and HPV-45 E7 oncoprotein levels were monitored by immunohistochemistry and compared with those of p16INK4a and Ki67. Results: Fifty-five (94.8%) tumors were high-risk HPV-DNA–positive (46 HPV-16, 2 HPV-16 and HPV-18, 4 HPV-18, 1 HPV-33, and 2 HPV-45). HPV-DNA could not be detected in three tumors (5.2%). High HPV E7 oncoprotein levels were shown in 57 cervical cancers (98.3%), without correlation between expression levels and tumor stages. Conclusion: This is the first study which systematically analyzes the levels of the major HPV oncoproteins in cervical carcinomas demonstrating that the high-risk HPV E7 proteins are regularly expressed in these cancers. This suggests that high-risk E7 oncoproteins are necessary for cervical cancers and apparently essential as tumor marker.
Putting evidence into practice: how middle and low income countries “get it together”
Authors: Paul Garner, Martin Meremikwu, Jimmy Volmink, Qian Xu, Helen Smith
Journal: BMJ (2004)

<i>The scarcity of resources in poorer countries means that ensuring health care is evidence based is particularly important. A group of workers active in the field describe their experiences of trying to do just that</i>
6-month efficacy, tolerance, and acceptability of a short regimen of oral zidovudine to reduce vertical transmission of HIV in breastfed children in Côte d'Ivoire and Burkina Faso: a double-blind placebo-controlled multicentre trial
Authors: François Dabis, Philippe Msellati, Nicolas Meda, Christiane Welffens-Ekra, Bruno You, Olivier Manigart, Valériane Leroy, Arlette Simonon, Michel Cartoux, Patrice Combe, Amadou Ouangré, Rosa Ramon, Odette Ky-Zerbo, Crépin Montcho, Roger Salamon, Christine Rouzioux, Philippe Van de Perre, Laurent Mandelbrot
Journal: The Lancet (1999)
Interrelations of Platelet Aggregation and Secretion
Authors: Israel F. Charo, Richard D. Feinman, Thomas C. Detwiler
Journal: Journal of Clinical Investigation (1977)

The mechanism of stimulus-response coupling in human platelets was investigated with a new instrument that simultaneously monitors aggregation and secretion in the same sample of plateletrich plasma. When platelets were stimulated by high concentrations of ADP, secretion began only after aggregation was almost complete. With lower concentrations of ADP or with epinephrine, biphasic aggregation was observed, and secretion began simultaneously with, or slightly after, the second phase of aggregation. When platelets were stimulated with high concentrations of γ-thrombin or A23187, secretion and aggregation began essentially together. With very low concentrations of γ-thrombin or A23187, biphasic aggregation was observed with secretion paralleling the second phase. At every concentration of collagen, secretion and aggregation appeared to be parallel events. Under every condition where the beginning of secretion lagged behind aggregation, secretion was dependent upon aggregation and was inhibited by indomethacin; this is referred to as aggregation-mediated platelet activation. When secretion began at the same time as aggregation, it also occurred in the absence of aggregation and was not blocked by indomethacin; this is referred to as directly induced platelet activation. These observations are consistent with a simple model of platelet stimulus-response coupling that includes two mechanisms for activation; aggregation-mediated activation is inhibited by indomethacin, while direct activation does not depend upon aggregation and is not inhibited by indomethacin. Secretion and second wave aggregation appear to be parallel events, with little evidence for second wave aggregation being a consequence of secretion as usually described.
Genetic predisposition to parthenium dermatitis in an Indian cohort due to lower-producing genotypes of interleukin-10 (−) 1082 G&gt;A and (−) 819 C&gt;T loci but no association with interferon-γ (+) 874 A&gt;T locus
Authors: R. Khatri, K. Mukhopadhyay, K.K. Verma, G. Sethuraman, A. Sharma
Journal: British Journal of Dermatology (2011)

Parthenium dermatitis is an activated T cell-mediated type IV hypersensitivity. Its pathogenesis is well characterized, with interindividually varying serum levels of pro- and anti-inflammatory and regulatory T-cell cytokines and coherently perturbed cross-regulation between them. The functional single nucleotide polymorphisms (SNPs) in these cytokine genes might function as risk/susceptibility factors for the disease.We analysed the serum levels of interferon (IFN)-γ and interleukin (IL)-10 cytokines in cases vs. controls and investigated whether IFN-γ (+) 874 A>T and IL-10 (-) 1082 G > A and (-) 819 C>T are associated with serum levels and genetically predispose to the disease.The study included 60 patch test-confirmed patients and 60 age- and sex-matched controls. The serum levels of cytokines were estimated by high-sensitivity enzyme-linked immunosorbent assay kits. SNP genotyping was performed by amplification refractory mutational system-polymerase chain reaction.In patients, the serum level of IFN-γ was significantly increased and that of IL-10 was significantly decreased, with no difference in IgE concentration. Genetically no IFN-γ (+) 874 A>T alleles/genotypes were associated with the disease, but a strong predisposition was found due to lower-producing genotypes of IL-10 (-) 1082 G>A and (-) 819 C>T SNPs, with 2·1 and 3·5 times more risk, respectively, while intermediate IL-10-producing genotypes provided resistance.High serum IFN-γ might play a role in disease pathogenesis, but this is genetically not endowed by the IFN-γ SNP studied. In contrast, low serum IL-10 was very much connected, with the genetics of both studied IL-10 loci. These might be key managing factors concerning pathogenesis/susceptibility.