tbuckley/cabot-search huggingface dataset:
Increasing skin cancer incidence in young, affluent, urban populations: a challenge for prevention
Authors: S. Deady, L. Sharp, H. Comber
Journal: British Journal of Dermatology (2014)

Nonmelanoma skin cancer (NMSC) is the most common cancer in white people, but is registered inconsistently by population-based registries.To analyse the changing profile of NMSC in a national population, to interpret evolving patterns of sun exposure and to recommend measures to reduce risk.We analysed trends in the demographic, clinical and socioeconomic profile of > 50 000 cases of NMSC registered between 1994 and 2011 by the Irish National Cancer Registry, which aims to register all episodes of NMSC in the Irish population to a high degree of completeness.The incidence of cutaneous basal cell (BCC) and squamous cell carcinoma (SCC) was stable from 1994 to 2002, but increased significantly (BCC more than SCC) in the subsequent decade. The largest relative increases in the incidence of BCC were in younger populations and in clothed body sites. The incidence of both cancers was lower in rural areas. Incidence of BCC and, to a lesser extent, of SCC, increased with increasing affluence in urban, but not in rural, areas.Recent increases in skin cancers on the trunk and limbs in younger people appear to be related to increasing affluence and consequent leisure-related, episodic sun exposure. This population is at high risk of subsequent skin cancers throughout life and will need active surveillance. As preventive programmes are cost-effective in lowering the incidence of NMSC, they should be targeted at leisure exposure in young people. The recording of consistent international data on NMSC should also be a priority.
Crohn's disease or abdominal tuberculosis?
Authors: A Forbes
Journal: Gut (2007)

This is an introduction to the Gut tutorial “Crohn’s disease or abdominal tuberculosis?” hosted on BMJ Learning—the best available learning website for medical professionals from the BMJ Group.

A case-based discussion highlights recent trends in the investigation of patients suspected to have Crohn’s disease and their management. The phenotype of Crohn’s disease can be more accurately described using …
Distal tears of the hamstring muscles: review of the literature and our results of surgical treatment
Authors: Lasse Lempainen, Janne Sarimo, Kimmo Mattila, Jouni Heikkilä, Sakari Orava
Journal: British Journal of Sports Medicine (2006)

Background: Hamstring strains are among the most frequent injuries in sports, especially in events requiring sprinting and running. Distal tears of the hamstring muscles requiring surgical treatment are scarcely reported in the literature. Objective: To evaluate the results of surgical treatment for distal hamstring tears. Design: A case series of 18 operatively treated distal hamstring muscle tears combined with a review of previously published cases in the English literature. Retrospective study; level of evidence 4. Setting: Mehiläinen Sports Trauma Research Center, Mehiläinen Hospital and Sports Clinic, Turku, Finland. Patients: Between 1992 and 2005, a total of 18 athletes with a distal hamstring tear were operated at our centre. Main outcome measurements: At follow-up, the patients were asked about possible symptoms (pain, weakness, stiffness) and their return to the pre-injury level of sport. Results: The final results were rated excellent in 13 cases, good in 1 case, fair in 3 cases and poor in 1 case. 14 of the 18 patients were able to return to their former level of sport after an average of 4 months (range 2–6 months). Conclusions: Surgical treatment seems to be beneficial in distal hamstring tears in selected cases.
The science, economics, and effectiveness of combination therapy for hepatitis C
Authors: B READ
Journal: Gut (2001)

Editor,—No one affected by hepatitis C virus (HCV) will question Professor Dusheiko's insistence on the importance of effective therapy standards for HCV and the funding to meet them (Gut2000;47:159–61[OpenUrl][1][FREE Full Text][2]). With research and clinical evidence pointing to a prevalence of HCV infection far in excess of human immunodeficiency virus (HIV),1 the issue has now become urgent. Patients and clinicians alike will await the forthcoming NICE appraisal in the hope it recommends in favour of allocating sufficient resources to cover treatment costs for those most in need and best able to benefit. However, while a positive response will be welcome it will also uncover issues that have still to be fully addressed. These centre on who will/should be selected for treatment … [1]: {openurl}?query=rft.jtitle%253DGut%26rft.stitle%253DGut%26rft.aulast%253DDUSHEIKO%26rft.auinit1%253DG%26rft.volume%253D47%26rft.issue%253D2%26rft.spage%253D159%26rft.epage%253D161%26rft.atitle%253DThe%2Bscience%252C%2Beconomics%252C%2Band%2Beffectiveness%2Bof%2Bcombination%2Btherapy%2Bfor%2Bhepatitis%2BC%26rft_id%253Dinfo%253Apmid%252F10896900%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=FULL&journalCode=gutjnl&resid=47/2/159&atom=%2Fgutjnl%2F48%2F3%2F441.1.atom
Health benefits of tennis
Authors: Babette M Pluim, Jack L Groppel, Dave Miley, Miguel Crespo, Michael S Turner
Journal: British Journal of Sports Medicine (2017)

The aim of the study was to explore the role of tennis in the promotion of health and prevention of disease. The focus was on risk factors and diseases related to a sedentary lifestyle, including low fitness levels, obesity, hyperlipidaemia, hypertension, diabetes mellitus, cardiovascular disease, and osteoporosis. A literature search was undertaken to retrieve relevant articles. Structured computer searches of PubMed, Embase, and CINAHL were undertaken, along with hand searching of key journals and reference lists to locate relevant studies published up to March 2007. These had to be cohort studies (of either cross sectional or longitudinal design), case-control studies, or experimental studies. Twenty four studies were identified that dealt with physical fitness of tennis players, including 17 on intensity of play and 16 on maximum oxygen uptake; 17 investigated the relation between tennis and (risk factors for) cardiovascular disease; and 22 examined the effect of tennis on bone health. People who choose to play tennis appear to have significant health benefits, including improved aerobic fitness, a lower body fat percentage, a more favourable lipid profile, reduced risk for developing cardiovascular disease, and improved bone health.
G Protein Coupled Receptor Kinase 3 (GRK3) Negatively Regulates CXCL12/CXCR4 Signaling and Tumor Migration in Breast Cancer
Authors: D.J. Fitzhugh, M.W. McGinnis, R. Timoshchenko, R. Lininger, N. Demore, J. Serody, T.K. Tarrant
Journal: Journal of Allergy and Clinical Immunology (2011)
EAACI/GA<sup>2</sup>LEN task force consensus report: the autologous serum skin test in urticaria
Authors: G. N. Konstantinou, R. Asero, M. Maurer, R. A. Sabroe, P. Schmid‐Grendelmeier, C. E. H. Grattan
Journal: Allergy (2009)

Injection of autologous serum collected during disease activity from some patients with chronic spontaneous urticaria (CU) into clinically normal skin elicits an immediate weal and flare response. This observation provides a convincing demonstration of a circulating factor or factors that may be relevant to the understanding of the pathogenesis and management of the disease. This test has become known as the autologous serum skin test (ASST) and is now widely practised despite incomplete agreement about its value and meaning, the methodology and the definition of a positive response. It should be regarded as a test for autoreactivity rather than a specific test for autoimmune urticaria. It has only moderate specificity as a marker for functional autoantibodies against IgE or the high affinity IgE receptor (FcepsilonRI), detected by the basophil histamine release assay, but high negative predictive value for CU patients without them. It is usually negative in other patterns of CU, including those that are physically induced. Positive ASSTs have been reported in some subjects without CU, including those with multiple drug intolerance, patients with respiratory allergy and healthy controls, although the clinical implications of this are uncertain. It is essential that failsafe precautions are taken to ensure that the patient's own serum is used for skin testing and aseptic procedures are followed for sample preparation and handling. CU patients with a positive ASST (ASST(+)) are more likely to be associated with HLADR4, to have autoimmune thyroid disease, a more prolonged disease course and may be less responsive to H1-antihistamine treatment than those with a negative ASST (ASST(-)) although more evidence is needed to confirm these observations conclusively.
Guggulsterone Inhibits Osteoclastogenesis Induced by Receptor Activator of Nuclear Factor-κB Ligand and by Tumor Cells by Suppressing Nuclear Factor-κB Activation
Authors: Haruyo Ichikawa, Bharat B. Aggarwal
Journal: Clinical Cancer Research (2006)

Abstract Bone resorption is commonly associated with aging and with certain types of cancer, including multiple myeloma and breast cancer. What induces bone resorption is not fully understood, but the role of osteoclasts is well established. Recently, receptor activator of nuclear factor-κB (NF-κB) ligand (RANKL), a member of the tumor necrosis factor superfamily, was implicated as a major mediator of bone resorption, suggesting that agents that can suppress RANKL signaling have the potential to inhibit bone resorption or osteoclastogenesis. Guggulsterone [4,17(20)-pregnadiene-3,16-dione], isolated from the guggul tree Commiphora mukul and used to treat osteoarthritis and bone fractures, was recently shown to antagonize the farnesoid X receptor, decrease the expression of bile acid–activated genes, and suppress the NF-κB activation induced by various carcinogens. We investigated whether guggulsterone could modulate RANKL signaling and osteoclastogenesis induced by RANKL or tumor cells. We found that treatment of monocytes with guggulsterone suppressed RANKL-activated NF-κB activation (as indicated by gel-shift assay) and that this suppression correlated with inhibition of IκBα kinase and phosphorylation and degradation of IκBα, an inhibitor of NF-κB. Guggulsterone also suppressed the differentiation of monocytes to osteoclasts in a dose-dependent and time-dependent manner. Suppression of osteoclastogenesis by the NF-κB-specific inhibitory peptide implies a link between NF-κB and osteoclastogenesis. Finally, differentiation to osteoclasts induced by coincubating human breast tumor cells (MDA-MB-468) or human multiple myeloma (U266) cells with monocytes was also completely suppressed by guggulsterone. Collectively, our results indicate that guggulsterone suppresses RANKL and tumor cell–induced osteoclastogenesis by suppressing the activation of NF-κB.
Letter in response to: Stark P<i>et al</i>Amoxycillin-clavulanate for chronic wet cough in children: cautious interpretation of study findings warranted
Authors: Julie Marchant, Helen Petsky, Anne B Chang
Journal: Thorax (2013)

We thank Stark and colleagues1 for comments on our paper and their interest in our recent randomised controlled trial (RCT) of amoxycillin-clavulanate compared with placebo for children with chronic wet cough,2 which as they state are a ‘group of patients that often present paediatricians with a management dilemma’ and which ‘represents a valuable contribution to the literature’. We feel it is important to clarify a few points raised.

First, the criteria used for defining chronic cough in children (>3 weeks) was at the time of the study commencement the definition of chronic childhood cough. We acknowledge following the study completion (enrolment between …
Body dysmorphic disorder: the distress of imagined ugliness
Authors: K A Phillips
Journal: American Journal of Psychiatry (1991)

Body dysmorphic disorder, a preoccupation with an imagined defect in physical appearance, has a rich tradition in European psychiatry but has been largely neglected in the United States. Because this little-known disorder is probably more common than is generally realized and can have profound consequences, the author reviews its history, clinical features, and possible relationship to other psychiatric disorders.Data sources consisted of the MEDLINE database and relevant references in articles obtained from this search. Of 145 articles and books obtained, 100 were selected for inclusion in this review on the basis of how closely they conformed to the concept of body dysmorphic disorder as defined in DSM-III-R and how substantially they contributed to an understanding of the disorder's history, clinical features, or nosologic status.Body dysmorphic disorder has been colorfully described in the European literature for more than a century. Although its concerns might sound trivial, this disorder can lead to social isolation (including being housebound), occupational dysfunction, unnecessary cosmetic surgery, and suicide. The most commonly associated psychiatric disorder appears to be depression. Although a definitive treatment does not exist, preliminary evidence suggests that serotonergic antidepressant medications may be useful. Whether body dysmorphic disorder is related to other psychiatric disorders, such as psychosis, mood disorder, social phobia, or obsessive-compulsive disorder, is unclear at this time.More research on the nosology, clinical features, and treatment response of body dysmorphic disorder is important, given the distress and impairment this often secret disorder can cause.
The National Diabetes Education Program, Changing the Way Diabetes Is Treated
Authors: Charles M. Clark, Judith E. Fradkin, Roland G. Hiss, Rodney A. Lorenz, Frank Vinicor, Elizabeth Warren-Boulton
Journal: Diabetes Care (2001)

The National Diabetes Education Program (NDEP) was initiated in 1997 jointly by the National Institutes of Health and the Centers for Disease Control and Prevention to promote early diagnosis and to improve the treatment and outcomes for people with type 1 and type 2 diabetes. This partnership now involves over 200 public, voluntary, and private organizations dedicated to improving the lives of people with diabetes.

Because of the Diabetes Control and Complications Trial (DCCT) findings that improved blood glucose control markedly reduces the risk for retinopathy, nephropathy, and neuropathy, the NDEP initially focused on blood glucose control (1,2). This month, the NDEP and its partners are launching an expanded initiative to promote optimal control of lipids and blood pressure, in addition to optimal control of blood glucose.

The impact of cardiovascular disease on mortality and morbidity in people with diabetes has been known for years. Approximately two-thirds of people with diabetes die from cardiovascular disease (coronary heart disease, stroke, and other vascular diseases). Recently, data from the National Health and Nutrition Examination Survey showed that over the past 30 years there was a 27% decline in age-adjusted heart disease mortality in women without diabetes, but in women with diabetes, there was a 23% increase (3). In men without diabetes, there was a 36% decline compared with a 13% decline in men with diabetes. …
The elastic modulus of canine aortic valve leaflets in vivo and in vitro.
Authors: M Thubrikar, W C Piepgrass, L P Bosher, S P Nolan
Journal: Circulation Research (1980)

Aortic valve leaflets undergo extraordinary flexion due to the complete reversal of their curvature during billions of cardiac cycles. The flexion stresses in the leaflet depend on its elastic modulus which we investigated in vivo and in vitro. In six dogs, we placed radiopaque markers on an aortic leaflet. Leaflet length was calculated from the marker positions recorded fluoroscopically. Aortic and ventricular pressures were recorded. Dogs were killed and leaflet stress-strain curves determined in vitro. Leaflet length in vivo decreased 10.4 +/- 4.7% from diastole to systole in each cardiac cycle. Using the law of LaPlace, pressure gradients across the leaflets were converted into the stresses in the leaflets. The leaflets had an initial "elastic phase" of low modulus in systole followed by an "inelastic phase" of high modulus in diastole. The elastic modulus was 2.4 +/- 0.7 x 10(6) dynes/cm2 in systole and 5.2 +/- 1.7 x 10(7) dynes/cm2 in diastole. These results were similar to those obtained in vitro. Since flexion rigidity is proportional to (elastic modulus) x (thickness)3, the lower modulus in systole greatly reduces flexion stresses in the leaflet and increases leaflet longevity. The higher elastic modulus in diastole prevents excessive bulging or prolapse of the leaflet while it is subjected to the diastolic pressure gradient. We conclude that a natural or prosthetic leaflet which is thickened or has a high elastic modulus throughout the cardiac cycle will have a greater flexion stress that could cause early failure.
In Type 2 Diabetes, Rosiglitazone Therapy for Insulin Resistance Ameliorates Endothelial Dysfunction Independent of Glucose Control
Authors: Frank Pistrosch, Jens Passauer, Sabine Fischer, Katja Fuecker, Markolf Hanefeld, Peter Gross
Journal: Diabetes Care (2004)

OBJECTIVE—Insulin resistance is an independent risk factor for arteriosclerosis and cardiovascular mortality. However, the mechanism by which insulin resistance contributes to arteriosclerosis is unknown. Conceivably, endothelial dysfunction could be involved. Therefore, we asked whether therapy for insulin resistance ameliorates any endothelial dysfunction. RESEARCH DESIGN AND METHODS—We performed a double-blind cross-over trial of 12 patients with recently diagnosed type 2 diabetes. They received rosiglitazone 4 mg b.i.d. for 12 weeks and nateglinide 60 mg b.i.d. for the same number of weeks in random order. To assess the degree of endothelial dysfunction, we used venous occlusion plethysmography. We studied vasodilation in response to acetylcholine (ACh) with and without exogenous insulin. The agents were infused into the brachial artery. Furthermore, we determined insulin resistance by euglycemic clamp. RESULTS—Glycemic control was comparable under rosiglitazone and nateglinide. Rosiglitazone ameliorated insulin resistance by 60% compared with nateglinide. ACh response was significantly increased after rosiglitazone treatment (maximum forearm blood flow 12.8 ± 1.3 vs. 8.8 ± 1.3 ml/100 ml after rosiglitazone and nateglinide, respectively; P &amp;lt; 0.05) but did not attain the level of healthy control subjects (14.0 ± 0.7 ml/100 ml). Coinfusion of exogenous insulin increased ACh response further in the rosiglitazone group. N-monomethyl-l-arginine-acetate (l-NMMA), an antagonist of nitric oxide synthase, largely prevented the increased vasodilation after rosiglitazone, regardless of the presence or absence of insulin. Insulin sensitivity and blood flow response were found to be correlated (P &amp;lt; 0.01). CONCLUSIONS—Insulin resistance is a major contributor toward endothelial dysfunction in type 2 diabetes. Both endothelial dysfunction and insulin resistance are amenable to treatment by rosiglitazone.
Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomised, double-blinded, placebo-controlled trial
Authors: Donna McCann, Angelina Barrett, Alison Cooper, Debbie Crumpler, Lindy Dalen, Kate Grimshaw, Elizabeth Kitchin, Kris Lok, Lucy Porteous, Emily Prince, Edmund Sonuga-Barke, John O Warner, Jim Stevenson
Journal: The Lancet (2007)
Cholesterol Testing in Young Adults
Authors: C. David Naylor
Journal: JAMA (1993)

America's cardiovascular establishment has strongly supported the National Cholesterol Education Program (NCEP) and its clinical guidelines for detection and management of dyslipidemias. 1 In this issue of JAMA , Hulley et al 2 trenchantly criticize the NCEP guidelines for young adults—men under 35 years of age and premenopausal women. They conclude that routine testing of all such persons every 5 years is of unproven effectiveness for prolonging life, very inefficient from an economic and clinical standpoint, and perhaps unethical given that primary preventive maneuvers alter the lives of otherwise well persons.  See also p 1416.  Underpinning their criticisms is a simple observation. In isolation, an elevated total cholesterol (TC) or low-density lipoprotein cholesterol (LDL) level is a mediocre marker for short-term and even longer-term risk of coronary events. 3,4 This is especially so for young men and premenopausal women where coronary heart disease (CHD) is a rare cause of death. There
Ovariectomy decreases plasma triglyceride levels and both prevents and alleviates glomerular disease in uninephrectomized female analbuminemic rats.
Authors: J A Joles, H van Goor, M L van der Horst, A van Tol, J J Weening, H A Koomans
Journal: Journal of the American Society of Nephrology (1996)

Female Nagase analbuminemic rats (NAR) are profoundly hypertriglyceridemic and develop proteinuria and glomerulosclerosis when aging and after uninephrectomy (UNX). Ovariectomy (OVX) markedly decreases plasma triglyceride levels in this species. This study evaluated whether decreasing triglyceride levels by OVX could prevent renal disease or alleviate its progression in UNX female NAR. Female NAR underwent OVX at 0, 12, 24, or 36 wk after UNX. In the absence of OVX, the animals developed progressive proteinuria from 18 wk after UNX and showed extensive glomerular sclerosis, lipid deposition, and hypertrophy at euthanasia (49 wk after UNX). These changes were prevented by OVX carried out at 0 or 12 wk, and attenuated by OVX at 24 wk after UNX. If performed at 36 wk after UNX, OVX had no effect on glomerulosclerosis, although it reduced proteinuria. In 95% (20 of 21) of the rats with proteinuria over 10 mg/day, proteinuria decreased in the first 6 wk after OVX. The percentage decrease in proteinuria correlated inversely with the glomerulosclerosis score at euthanasia (r = -0.58, P < 0.01). OVX had no effect on hyperfiltration and hyperperfusion in the UNX rats. OVX consistently reduced plasma triglyceride levels in rats both with and without proteinuria, and it also reduced plasma cholesterol, but only in conjunction with reduction in proteinuria. It was concluded that OVX in UNX female NAR prevents glomerulosclerosis if performed before proteinuria and attenuates further development of established renal disease if performed in a timely manner. This study's data suggest that in UNX female NAR, the lowering of plasma triglyceride levels plays a central role in the renoprotective action of OVX.
A twist on the athlete's ankle twist: some ankles are more equal than others
Authors: Gino MMJ Kerkhoffs, Johannes L Tol
Journal: British Journal of Sports Medicine (2012)

Ankle injuries are prolific but not benign. Kerkhoffs et al 1 present a consensus statement on the diagnosis and treatment of acute lateral ligament ruptures that will help us to treat the majority of our athletes in an evidence-based way. However, is it reasonable to assume that all these injuries and athletes are equal? Should we necessarily treat high-level athletes in a different way than recreational athletes or is the proposed simple functional treatment sufficient for all?

Complete cast immobilisation was the treatment of choice until the sixties, when Freeman introduced the concept of using coordination exercises to reduce the proprioceptive deficit and symptoms of the ankle ‘giving way’.2 Primary surgical repair became treatment of choice from 1966, after the PhD research of Brostrom.3 While Brostrom reported lower rates of long-term complaints after surgical intervention, he still recommended functional treatment initially due to the quicker return to work and sports.

In high-level athletes, goals are often set in the short term and only the upcoming game really counts. From daily clinical practice we know that it …