tbuckley/cabot-search huggingface dataset:
Not all wheeze is asthma: time for patients to<i>exercise</i>their rights
Authors: J H Hull
Journal: Thorax (2014)

It is now over a century since Sir William Osler first highlighted the fact that not all breathlessness and wheeze is caused by asthma; with a description that in some, … ‘the laryngeal muscle can spasm during periods of stress’ and as such act to mimic bronchoconstriction.1

Yet despite 100 years of medical progress, when a young individual presents with exertional breathlessness, all too often he or she will get promptly labelled as asthmatic.2 ,3 Indeed, we know from studies conducted in both the UK3 and USA,4 that when faced with this clinical presentation, primary care physicians have poor access to the most accurate diagnostic tools and a trial of inhaled asthma therapy is often, therefore, employed with ‘diagnostic’ intent. This is despite the countless number of studies indicating that clinical assessment in this capacity is at best imprecise and at worst no better than a coin toss.5–7 In other words, in young individuals objective testing is required to determine the cause of their exertional breathlessness.

But work, gathering pace over recent years, is now acting to shine a light on the importance of diagnostic precision in this area.2 ,8 It is on this basis we should welcome the study by Johansson et al 9 with the aim of evaluating the prevalence of the differential diagnoses for exertional breathlessness in adolescents.

A key condition addressed in this study is exercise-induced laryngeal obstruction (EILO); …
Assessment of Impact of Medicare Prospective Payment System on Care of Persons With Diabetes Mellitus
Authors: E D Bransome
Journal: Diabetes Care (1986)

Professional review organizations (PROs) have been reviewing hospital admissions on diagnosis-related groups (DRGs) 294 and 295 (uncomplicated diabetes mellitus) at the direction of the Health Care Financing Administration (HCFA) to control inappropriate hospital admissions. Because of the possibility of an adverse effect from this policy on the quality of medical care for people with diabetes, letters were sent and/or telephone calls were made to each PRO to request information on denials of admissions or of reimbursement for the hospitalization of patients with diabetes. The answers revealed variations in PRO review procedures, little attention to quality of care, and an apparently inadequate data retrieval system. These inadequacies of the Medicare Prospective Payment System (PPS), which currently obscure its impact on the quality of the hospital care of diabetic patients, can be remedied.
New Evidence on Variations of Human Body Burden of Methylmercury from Fish Consumption
Authors: René Canuel, Sylvie Boucher de Grosbois, Laura Atikessé, Marc Lucotte, Paul Arp, Charles Ritchie, Donna Mergler, Hing Man Chan, Marc Amyot, Robin Anderson
Journal: Environmental Health Perspectives (2006)

Epidemiologic studies commonly use mercury (Hg) level in hair as a valid proxy to estimate human exposure to methylmercury (MeHg) through fish consumption. This study presents the results yielded by a complete data set on fish consumption habits, Hg levels in edible fish resources, and corresponding Hg accumulation in hair, gathered in three distinct communities of eastern Canada. For one of these communities, the average hair Hg concentration was 14 times less than the expected value based on calculated daily oral exposure and current knowledge of MeHg metabolism. This finding could be explained by differences in specific genetic characteristics and/or interactive effects of other dietary components.
Assertive case management versus enhanced usual care for people with mental health problems who had attempted suicide and were admitted to hospital emergency departments in Japan (ACTION-J): a multicentre, randomised controlled trial
Authors: Chiaki Kawanishi, Tohru Aruga, Naoki Ishizuka, Naohiro Yonemoto, Kotaro Otsuka, Yoshito Kamijo, Yoshiro Okubo, Katsumi Ikeshita, Akio Sakai, Hitoshi Miyaoka, Yoshie Hitomi, Akihiro Iwakuma, Toshihiko Kinoshita, Jotaro Akiyoshi, Naoshi Horikawa, Hideto Hirotsune, Nobuaki Eto, Nakao Iwata, Mototsugu Kohno, Akira Iwanami, Masaru Mimura, Takashi Asada, Yoshio Hirayasu
Journal: The Lancet Psychiatry (2014)
REACTIONS OF RABBITS TO INTRACUTANEOUS INJECTIONS OF PNEUMOCOCCI AND THEIR PRODUCTS
Authors: Louis A. Julianelle
Journal: The Journal of Experimental Medicine (1930)

1. Rabbits receiving either intracutaneous or intravenous injections of crystalline egg albumin acquire a "skin sensitivity" but not an "eye sensitivity" to the albumin. 2. Rabbits receiving either intracutaneous or intravenous injections of the "nucleoprotein" of Pneumococcus acquire a specific "skin sensitivity" to the "nucleoprotein" but not an "eye sensitivity." 3. Rabbits receiving intravenous injections of a suspension of heat-killed pneumococci acquire a "skin hypersensitiveness" but not an "eye hypersensitiveness" to the "nucleoprotein." 4. The skin hypersensitiveness to the respective proteins is associated with the presence of antibodies in the blood and is transferable by the injection of serum from an actively sensitized to a normal rabbit. 5. Rabbits receiving intracutaneous injections of a suspension of heat-killed pneumococci also acquire a "skin hypersensitiveness" to the "nucleoprotein" of the cell, but they may acquire an eye hypersensitiveness as well. 6. Rabbits injected intracutaneously with a suspension of heat-killed pneumococci show a primary and a secondary skin reaction following the first injection. The intensity of the reactions increases with subsequent injections up to the fourth to the sixth injection. With later injections these reactions change in character and decrease in intensity. These reactions bear no apparent relation to the presence of antibodies in the blood. 7. Rabbits injected intracutaneously with a suspension of heat-killed pneumococci develop "eye hypersensitiveness" which, under the experimental conditions, is not transferable from "eye reactive" to normal rabbits. 8. It appears, therefore, that following the injection of heat-killed pneumococci into the skin a special kind of "eye" and "skin hypersensitiveness" develops which is not related to the presence of circulating antibodies and which cannot be transferred from the sensitive to normal rabbits.
THE OPEN PSYCHIATRIC WARD AND ITS VICISSITUDES
Authors: COLIN M. SMITH, LOIS L. McKAY
Journal: American Journal of Psychiatry (1965)

The nature and frequency of untoward events occurring on an open ward psychiatric unit in a general hospital over a one-year period is described, and the age-sex distribution is discussed. It is pointed out that the unit concerned accepts an unusually wide range of psychiatric conditions. The value of an unusual occurrence form to record such events is stressed. It is argued that a number of such occurrences must be expected on a well run liberal unit and that excessive precautions may be harmful to patients. Using the system outlined it is possible to review and eliminate such events as medication errors and to make comparisons between the number of unusual occurrences under different conditions.
IL-17A- versus IL-17F-induced intracellular signal transduction pathways and modulation by IL-17RA and IL-17RC RNA interference in rheumatoid synoviocytes
Authors: A. Hot, S. Zrioual, M.-L. Toh, V. Lenief, P. Miossec
Journal: Annals of the Rheumatic Diseases (2010)

<h3>Objective</h3> The aim of this study was to compare the effects of interleukin (IL)-17A and IL-17F on gene expression and signalling in human rheumatoid arthritis (RA) synoviocytes. <h3>Methods</h3> IL-17A- and IL-17F-induced mRNA expression was analysed using Affymetrix microarrays. IL-6 and IL-8 secretion was evaluated by ELISA. Inhibition of two receptors (IL-17RA and IL-17RC) was achieved by small interfering RNA (saran). The effects on mitogen-activated protein kinase (MAPK), activator protein 1 (AP-1) and nuclear factor κB (NF-κB) expression and activation were evaluated by western blotting, qRT-PCR and DNA binding assay. <h3>Results</h3> IL-17A and IL-17F induced a molecular pattern characterised by 27 inflammation-related genes for IL-17F and 165 for IL-17A. Virtually all IL-17A and IL-17F inducible genes were dependent on NF-κB activation, whereas a small number were modulated by p38. IL-17A induced activation of all three MAPKs (ERK, p38 and JNK) and downstream transcription factors AP-1 and p65 NF-κB. IL-17F was less potent but induced activation of p50 NF-κB. IL-17A was more potent at inducing IL-6 secretion than IL-17F, which was inactive alone. IL-17A and, to a lesser extent, IL-17F induced TRAF6 but not MyD88. Inhibition of either IL-17RA or IL-17RC expression via siRNA led to near complete abrogation of IL-6 expression mediated by IL-17A and the combination of IL-17F and tumour necrosis factor α. <h3>Conclusion</h3> Like IL-17A, IL-17F regulates proinflammatory gene expression by a very similar but not identical signalling pathway involving IL-17RA and IL-17RC.
Long-lasting CCR5 internalization by antibodies in a subset of long-term nonprogressors: a possible protective effect against disease progression
Authors: Claudia Pastori, Barbara Weiser, Claudia Barassi, Caterina Uberti-Foppa, Silvia Ghezzi, Renato Longhi, Giliola Calori, Harold Burger, Kimdar Kemal, Guido Poli, Adriano Lazzarin, Lucia Lopalco
Journal: Blood (2006)
Evidence for a distinctive pattern of bone formation in enthesophytes
Authors: M Benjamin, H Toumi, D Suzuki, K Hayashi, D McGonagle
Journal: Annals of the Rheumatic Diseases (2008)

The mechanism of new bone formation at entheses in spondyloarthritis (SpA) is poorly understood, but it is a key factor contributing to disability in disease. As bony spur development is also an age-related phenomenon, spurs in elderly dissecting room cadavers were studied in order to establish general principles relating to their development.Spurs of different sizes were studied by routine histology at 26 different entheses (a total of 76 specimens) from the upper limb, lower limb and spine. The percentage of bone:marrow was compared in the posterior part of the calcaneus in cadavers with and without Achilles spurs to ascertain the relationship between spurs and immediately adjacent trabecular bone.Bony spur formation was a common age related phenomena and typically occurred in the most fibrous part of an enthesis. Paradoxically, it was often heralded by the initial appearance of a thick zone of calcified fibrocartilage that subsequently developed bony nodules within it. Uncalcified fibrocartilage was more prominent around large spurs. Endochondral, intramembranous and chondroidal ossification all contributed to spur formation and growth, but cell hypertrophy and florid vascular invasion of a cellular calcified cartilage, typical of endochondral ossification, were not conspicuous features.Entheseal new bone formation occurs by a combination of three methods of ossification. However, endochondral ossification was atypical and differed from that seen in the normal development of cartilage bones or during fracture healing. How the inflammatory process modulates these processes could lead to a better understanding of entheseal new bone formation in SpA.
Low-Dose Cortisol for Symptoms of Posttraumatic Stress Disorder
Authors: Amanda Aerni, Rafael Traber, Christoph Hock, Benno Roozendaal, Gustav Schelling, Andreas Papassotiropoulos, Roger M. Nitsch, Ulrich Schnyder, Dominique J.-F. de Quervain
Journal: American Journal of Psychiatry (2004)

OBJECTIVE: Because elevated cortisol levels inhibit memory retrieval in healthy human subjects, the present study investigated whether cortisol administration might also reduce excessive retrieval of traumatic memories and related symptoms in patients with chronic posttraumatic stress disorder (PTSD). METHOD: During a 3-month observation period, low-dose cortisol (10 mg/day) was administered orally for 1 month to three patients with chronic PTSD in a double-blind, placebo-controlled, crossover design. RESULTS: In each patient investigated, there was a significant treatment effect, with cortisol-related reductions of at least 38% in one of the daily rated symptoms of traumatic memories, as assessed by self-administered rating scales. In accordance, Clinician-Administered PTSD Scale ratings assessed after each month showed cortisol-related improvements for reexperiencing symptoms and, additionally, in one patient for avoidance symptoms. CONCLUSIONS: The results of this pilot study indicate that low-dose cortisol treatment reduces the cardinal symptoms of PTSD.
Short-Term Diagnostic Stability of Schizotypal, Borderline, Avoidant, and Obsessive-Compulsive Personality Disorders
Authors: M. Tracie Shea, Robert Stout, John Gunderson, Leslie C. Morey, Carlos M. Grilo, Thomas McGlashan, Andrew E. Skodol, Regina Dolan-Sewell, Ingrid Dyck, Mary C. Zanarini, Martin B. Keller
Journal: American Journal of Psychiatry (2002)

OBJECTIVE: Personality disorders are defined as enduring patterns of maladaptive behaviors and traits that are stable over time. This study prospectively examined the stability of four personality disorders (schizotypal, borderline, avoidant, and obsessive-compulsive) over a 1-year follow-up period. METHOD: Subjects (N=668) were recruited from multiple clinical settings at four collaborating institutions. Subjects met criteria for one or more of the four personality disorders or were part of a comparison group of subjects with major depressive disorder and no personality disorder. Diagnoses were established by using semistructured interviews. Follow-up assessments, conducted 6 and 12 months after the baseline assessment, included monthly ratings of all criteria for the four personality disorders and weekly ratings of the course of major depressive disorder. The current report is based on 621 subjects with complete data through 12 months of the follow-up period. RESULTS: Significantly more subjects in each personality disorder group remained at diagnostic threshold throughout the 12 months of the follow-up period than did those in the major depressive disorder group. A continuous measure of number of criteria met was highly correlated across the three assessments. The majority of personality disorder subjects, however, did not consistently remain at diagnostic threshold, and the mean number of criteria met decreased significantly for each group. CONCLUSIONS: Individual differences in personality disorder features appear to be highly stable, although the number of criteria present decreases over time. Personality disorders may be characterized by stable trait constellations that fluctuate in degree of maladaptive expression.
Long noncoding RNA PVT1 indicates a poor prognosis of gastric cancer and promotes cell proliferation through epigenetically regulating p15 and p16
Authors: Rong Kong, Er-bao Zhang, Dan-dan Yin, Liang-hui You, Tong-peng Xu, Wen-ming Chen, Rui Xia, Li Wan, Ming Sun, Zhao-xia Wang, Wei De, Zhi-hong Zhang
Journal: Molecular Cancer (2015)

Mounting evidence indicates that long noncoding RNAs (lncRNAs) could play a pivotal role in cancer biology. However, the overall biological role and clinical significance of PVT1 in gastric carcinogenesis remains largely unknown. Expression of PVT1 was analyzed in 80 GC tissues and cell lines by qRT-PCR. The effect of PVT1 on proliferation was evaluated by MTT and colony formation assays, and cell apoptosis was evaluated by Flow-cytometric analysis. GC cells transfected with shPVT1 were injected into nude mice to study the effect of PVT1 on tumorigenesis in vivo. RIP was performed to confirm the interaction between PVT1 and EZH2. ChIP was used to study the promoter region of related genes. The higher expression of PVT1 was significantly correlated with deeper invasion depth and advanced TNM stage. Multivariate analyses revealed that PVT1 expression served as an independent predictor for overall survival (p = 0.031). Further experiments demonstrated that PVT1 knockdown significantly inhibited the proliferation both in vitro and in vivo. Importantly, we also showed that PVT1 played a key role in G1 arrest. Moreover, we further confirmed that PVT1 was associated with enhancer of zeste homolog 2 (EZH2) and that this association was required for the repression of p15 and p16. To our knowledge, this is the first report showed that the role and the mechanism of PVT1 in the progression of gastric cancer. Together, these results suggest that lncRNA PVT1 may serve as a candidate prognostic biomarker and target for new therapies in human gastric cancer.
Maternal Immune Response and Neonatal Seroprotection From a Single Dose of a Monovalent Nonadjuvanted 2009 Influenza A(H1N1) Vaccine
Authors: Vassilis Tsatsaris
Journal: Annals of Internal Medicine (2011)

Pregnant women and infants who get influenza are at increased risk for severe illness.To evaluate the immunogenicity and transplacental antibody transfer of 2009 pandemic influenza A(H1N1) vaccine administered during pregnancy.Prospective, multicenter, single-group clinical trial. (ClinicalTrials.gov registration number: NCT01024400)Five level-3 perinatal centers in France.107 pregnant women between 22(0/7) and 32(0/7) weeks of gestation.An intramuscular dose of a nonadjuvanted H1N1 vaccine that contained 15 mcg of hemagglutinin.Proportion of women with an influenza antibody titer of 1:40 or greater at days 21 and 42 after vaccination, delivery, and 3 months after delivery. Seroconversion rate, fold increase in the geometric mean titer 21 days after vaccination, and proportion of neonates with an antibody titer of 1:40 or greater at birth were also assessed.At baseline, 19% of the women had an antibody titer of 1:40 or greater. At day 21, 98% of the women had an antibody titer of 1:40 or greater, the seroconversion rate was 93%, and the fold increase in geometric mean titer was 67.4. At day 42, delivery, and 3 months after delivery, 98%, 92%, and 90% of the women, respectively, had an antibody titer of 1:40 or greater. Ninety-five percent of the cord serum samples obtained from 88 neonates showed an antibody titer of 1:40 or greater. The median neonate-mother antibody titer ratio was 1.4.Only healthy pregnant women were selected. Data on hemagglutination inhibition antibody titers of infants were reported only at birth.A single dose of a nonadjuvanted influenza A(H1N1) vaccine with 15 mcg of hemagglutinin triggered a strong immune response in pregnant women and a high rate of neonatal seroprotection.French National Institute of Health and Medical Research.
Non-opaque Ureteric Calculi
Authors: J. C. Ross
Journal: BMJ (1939)

<h3>Abstract</h3> Global climate change is altering coral reef ecosystems. Notably, marine heat waves are producing widespread coral bleaching events that are increasing in frequency, with projections for annual bleaching events on reefs worldwide by mid-century. The response of corals to elevated seawater temperatures can be modulated by abiotic factors at site of origin and dominant endosymbiont type, which can result in a shift in multiple coral traits and drive physiological legacy effects that influence the trajectory of reef corals under subsequent thermal stress events. It is critical, therefore, to evaluate the potential for shifting physiological and cellular baselines driven by these factors in <i>in situ</i> bleaching (and recovery) events. Here, we use the back-to-back regional bleaching events of 2014 and 2015 in the Hawaiian Islands and subsequent recovery periods to test the hypothesis that coral multivariate trait space (here termed physiotype, sensu (Van Straalen, 2003) shift in multiple bleaching events, modulated by both environmental histories and symbiotic partnerships (Symbiodiniaceae). Despite fewer degree heating weeks in the first-bleaching event relative to the second (7 <i>vs</i>. 10), bleaching severity in a dominant reef building coral on Hawaiian reefs, <i>Montipora capitata</i>, was greater (~70% <i>vs</i>. 50% bleached cover) and differences due to environmental history (reef site) were more pronounced. Melanin, an immune cytotoxic response, provided an initial defense during the first event, potentially priming antioxidant activity, which peaked in the second-bleaching event (i.e., a legacy effect). While magnitude of bleaching differed, immune response patterns were shared among corals harboring heat-sensitive and heat-tolerant Symbiodiniaceae. This supports a pattern of increased constitutive immunity in corals resulting from repeat bleaching events, with greater specialized enzymes (catalase, peroxidase, superoxide dismutase) and attenuated melanin synthesis. This study demonstrates bleaching events have implications for reef corals beyond shaping their ecological assemblages. These events can change the magnitude and/or identity of response variables contributing to physiotype, thus generating physiological legacies carried over into the future. Quantifying baseline coral physiotypes and tracking their shifts will be critical to understanding and forecasting the effects of increased bleaching frequency on coral biology and ecology in the Anthropocene.
Adjuvant Use of Anastrozole in Breast Cancer
Authors: Jack Cuzick, Aman Buzdar, Michael Baum, Raffaele Bianco, Robert Coleman, Manuel Constenla, Wolfgang Distler, Mitch Dowsett, John Forbes, Jean Paul Guastalla, Joan Houghton, Norman Williams, Anthony Howell, Gershon Locker, John MacKey, Richard Sainsbury, Jeffrey Tobias
Journal: Journal of Clinical Oncology (2004)

the Journal of Clinical Oncology requires comment to permit accurate scientific perspective.In contrast to the statement "we are not aware of any published reports from the large, single institutions, reporting outcome for these patients (metachronous skeletal osteosarcoma) when treated with a combined modality treatment approach," the experience of post-therapy multiple metachronous primary osteosarcoma tumors in the pediatric population was presented in a general poster session at the annual meeting of the American Society of Clinical Oncology in May 2001. 2 The abstract presented data on 11 pediatric patients, following a review of 250 patients under 18 years of age, who presented to the M.D. Anderson Cancer Center (Houston, TX) with primary osteosarcoma of the skeleton without pulmonary metastases over the past 25 years.The interval between appearance of the primary and metachronous tumor varied from 12 to 78 months.Inter alia, the abstract addressed the concordance and discordance of the histologic varieties of the primary and metachronous tumors and referred to a possible increased incidence of the condition in patients with retinoblastoma.The abstract also contradicts the statement "There is little information available on the experience and outcomes of metachronous metastatic skeletal overall survival."At the time of the report, with the use of cisplatin, adriamycin, high-dose methotrexate, cyclophosphamide, and ifosfamide with surgical resection of the metachronous tumors, five of the 11 patients were alive, 20ϩ to 50ϩ months and disease-free (four are currently still active and disease-free; the patient with a second rib metachronous tumor later succumbed to pulmonary metastases).These facts were not addressed in the Aung et al article. 1 Finally, we also emphasized that diligent follow-up of survivors of osteosarcoma is required to permit early detection and appropriate successful intervention.