tbuckley/cabot-search huggingface dataset:
Prevalence, severity and underdiagnosis of COPD in the primary care setting
Authors: M Bednarek, J Maciejewski, M Wozniak, P Kuca, J Zielinski
Journal: Thorax (2008)

<h3>Background:</h3> Chronic obstructive pulmonary disease (COPD) is a common disease with a steadily increasing prevalence and mortality. However, recent epidemiological estimates differ depending on the population studied and methods used. <h3>Aim:</h3> To investigate the prevalence, severity and burden of COPD in a primary care setting. <h3>Methods:</h3> From 4730 patients registered in a single primary care practice, all 2250 patients aged 40 years or more were invited to participate. Participants completed a questionnaire on smoking, respiratory symptoms, education and social status. A physical examination was followed by pre- and post-bronchodilator (BD) spirometry. <h3>Results:</h3> Of the eligible patients, 1960 (87%) participated. 92% of spirometric tests met the ATS criteria. Airflow limitation was demonstrated in 299 (15%) of the participants pre-BD and in 211 (11%) post-BD. COPD was diagnosed in 183 patients (9.3%). Of these patients, the degree of post-BD airflow limitation was mild in 30.6%, moderate in 51.4%, severe in 15.3% and very severe in 2.7%. Only 18.6% of these patients had previously been diagnosed with COPD; almost all of these had severe or very severe airflow limitation. As a result of the study, a diagnosis of asthma was made in 122 patients. <h3>Conclusions:</h3> The prevalence and underdiagnosis of COPD in adult patients in this primary care setting made case finding worthwhile. Large numbers of newly detected patients were symptomatic and needed treatment. Limiting investigations to smokers would have reduced the number of COPD diagnoses by 26%.
Spreading the word on sports concussion: citation analysis of summary and agreement, position and consensus statements on sports concussion
Authors: Sridhar Alla, S John Sullivan, Paul McCrory, Leigh Hale
Journal: British Journal of Sports Medicine (2010)

Background The growing concern over concussion in sports has led to the publication of five major summary and agreement, position and consensus statements since 2000. The dissemination of information from these statements is largely unknown and difficult to quantify, but their impact on the research community can be quantified by analysing the number of citations to these key publications. The purpose of this review is to report the number and pattern of citations to the key published statements on sports concussion. Methods Web of Science, Scopus and PubMed were searched from 2000 to mid-December 2009 using two different search strategies. The first strategy used the search terms ‘concussion’ and ‘first author’ of the statement article, while the second used the ‘title’ of the target article as the key search term. Results The publications resulting from the three ‘Concussion in Sport’ (CIS) group conferences were cited by 532 journal articles, while the National Athletic Trainers' Association position statement was cited 123 times. The highest number of citations to each of the five identified statements was seen in 2009. British Journal of Sports Medicine was the most frequently cited journal. Conclusion The citation analysis of the key statements on sports concussion has shown that the target papers have been widely cited in the research literature, with the highest number of citations being from the publications arising from the CIS group conferences. The authors have shown their preference to cite source articles published in the British Journal of Sports Medicine .
Royal colleges admit some responsibility for recruitment chaos
Authors: Adrian O’Dowd
Journal: BMJ (2008)

The royal colleges are partly to blame for some of the chaos faced by UK junior doctors in securing a training place last year, MPs have been told.

College representatives admitted that they could have done more to resist the Modernising Medical Careers (MMC) system for recruitment to training posts that was “imposed” on junior doctors in the NHS and that, if they had worked together, the colleges might have had a greater influence.

Witnesses appeared before MPs on the parliamentary health select committee last week as part of its inquiry into MMC and the implementation of the system through the medical training application service …
Inflammatory Pathogenesis of Prostate Cancer and Celecoxib
Authors: Paul Mathew
Journal: Journal of Clinical Oncology (2010)

proliferative inflammatory atrophy (PIA), a putative preneoplastic lesion, and described the immunophenotype of the inflammatory stroma that invariably accompanied PIA as largely consisting of CD3 T cells, but also CD20 B lymphocytes and CD-68 macrophages. Luo et al 2 have reported that RANKL-expressing T lymphocytes and macrophages in the inflammatory microenvironment may activate IKK in prostate cancer cells, repressing maspin expression and thereby promoting metastatic behavior of prostate cancer cells, largelyunlinkedfromproliferativebehavior.Inthisimportantpreoperative study of the anti-inflammatory agent celecoxib in low and intermediate-gradeadenocarcinomaoftheprostatebyAntonarakiset al, 3 tissueeffectsofcelecoxibcouldnotbedetectedwithbiomarkersof oxidative damage, prostaglandin concentrations, COX-1 and 2, and Ki-67 expression. Given that peripheral blood lymphocytes and monocyteslikelytrafficcontinuallythroughtheinflammatorymicroenvironment of the preneoplastic and neoplastic prostate, one questions whether biomarkers of celecoxib effect 4 could be detected in the
Government backs down on merger of regulators but gives go-ahead to inter-species embryos
Authors: Adrian O'Dowd
Journal: BMJ (2007)

The government has decided not to merge the United Kingdom's two regulatory bodies in the field of human reproduction and embryo research. But it gave approval for the creation of human-animal embryos (“inter-species embryos”) for the purposes of research into disease, with the agreement of the regulator.

The Department of Health's previous proposal to merge the Human Fertilisation and Embryology Authority (HFEA) and the Human Tissue Authority (HTA) has been formally dropped.

The decision was announced as part of the government's formal response last week to a report published in August by a committee (representing both houses of Parliament) that scrutinised …
Polymorphonuclear leucocyte function and previous yersinia arthritis: enhanced chemokinetic migration and oxygen radical production correlate with the severity of the acute disease.
Authors: P Koivuranta-Vaara, M Leirisalo-Repo, H Repo
Journal: Annals of the Rheumatic Diseases (1987)

Polymorphonuclear leucocyte (PMN) functions (migration in vitro, chemiluminescence, O-2 production, binding of chemotactic peptide, and aggregation) were studied in HLA-B27 positive patients with previous yersinia arthritis (YA). PMNs of patients whose disease had been severe showed chemokinetic and chemiluminescence responses significantly higher than the PMNs of those with a mild disease. The results support the view that enhanced PMN function contributes to inflammatory symptoms in patients with YA.
Partial Recovery of Brain Metabolism in Methamphetamine Abusers After Protracted Abstinence
Authors: Gene-Jack Wang, Nora D. Volkow, Linda Chang, Eric Miller, Mark Sedler, Robert Hitzemann, Wei Zhu, Jean Logan, Yeming Ma, Joanna S. Fowler
Journal: American Journal of Psychiatry (2004)

Methamphetamine is a highly addictive drug of abuse that is neurotoxic to dopamine terminals. The authors recently reported that decreases in dopamine transporters (used as markers of dopamine terminals) in the striatum of methamphetamine abusers recover with protracted abstinence and that relative to comparison subjects, recently detoxified methamphetamine abusers have lower metabolism in the striatum and thalamus. In this study, the authors assessed whether metabolism recovers with protracted abstinence.Brain glucose metabolism was measured with positron emission tomography and [18F]fluorodeoxyglucose in five methamphetamine abusers who were evaluated after both a short (<6 months) and protracted (12-17 months) abstinence interval, eight methamphetamine abusers tested only after protracted abstinence, and 11 comparison subjects who were not drug users.Significantly greater thalamic, but not striatal, metabolism was seen following protracted abstinence relative to metabolism assessed after a short abstinence interval, and this increase was associated with improved performance in motor and verbal memory tests. Relative to the comparison subjects, the methamphetamine abusers tested after protracted abstinence had lower metabolism in the striatum (most accentuated in the caudate and nucleus accumbens) but not in the thalamus.The persistent decreases in striatal metabolism in methamphetamine abusers could reflect long-lasting changes in dopamine cell activity, and decreases in the nucleus accumbens could account for the persistence of amotivation and anhedonia in detoxified methamphetamine abusers. The recovery of thalamic metabolism could reflect adaptation responses to compensate for the dopamine deficits, and the associated improvement in neuropsychological performance further indicates its functional significance. These results suggest that while protracted abstinence may reverse some of the methamphetamine-induced alterations in brain function, other deficits persist.
Clinicopathologic and Genetic Profile of Intracranial Marginal Zone Lymphoma: A Primary Low-Grade CNS Lymphoma That Mimics Meningioma
Authors: Pang-hsien Tu, Caterina Giannini, Alexander R. Judkins, Jason M. Schwalb, Richard Burack, Brian P. O'Neill, Anthony T. Yachnis, Peter C. Burger, Bernd W. Scheithauer, Arie Perry
Journal: Journal of Clinical Oncology (2005)

Although rare overall, marginal zone B-cell lymphoma (MZBCL) is the most common primary low-grade CNS lymphoma reported in the literature. The aim of this study is to elucidate the biology and genetic features of this unusual tumor.Fifteen CNS MZBCLs were studied clinically, pathologically, and genetically, including fluorescent in situ hybridization analyses with commercially available MALT1 and IgH break-apart and centromere 3, 7, 12, and 18 probes.CNS MZBCLs preferentially affect middle-aged women (female-to-male ratio, 4:1), with 93% presenting as dural-based masses mimicking meningioma. Ten patients with 1 to 7.6 years of follow-up after diagnosis showed no evidence of disease after radiation and/or chemotherapy. Like MZBCLs outside of the CNS, they consisted of CD20+, CD3- small B lymphocytes with varying degrees of plasmacytic differentiation and predominantly kappa light-chain restriction (78%). Lymphoid follicles with follicular colonization were seen in three patients and deposition of amyloid was noted in samples from two patients, one of which was tumefactive. Neither Bcl-6 protein nor Epstein-Barr virus-encoded RNA was expressed. Trisomy 3 was detected in six of 12 patients, with no rearrangements of MALT1 or IgH and no trisomies of 7, 12, or 18 detected.Our data suggest that intracranial MZBCL is an indolent primary CNS lymphoma that typically presents as a meningioma-like dural-based mass. Trisomy 3, but not MALT1 or IgH translocation, is a common genetic abnormality that may contribute to the pathogenesis of this CNS lymphoma.
Viewpoints on the Way to a Consensus Session
Authors: Gianluca Perseghin
Journal: Diabetes Care (2009)

Insulin resistance and the insulin resistance syndrome refer to a constellation of anthropometric and metabolic features that may be summarized as overweight/obesity, glucose intolerance, dyslipidemia, and hypertension. These anthropometric and metabolic abnormalities are associated with type 2 diabetes, cardiovascular disease, polycystic ovary syndrome, and nonalcoholic fatty liver disease. The liver plays a central role in the regulation of whole-body glucose, fatty acid, and amino acid metabolism. It is the main source of endogenous glucose production, it is a major site of fatty acid disposal (esterification and oxidation) and of amino acid metabolism, and it is the primary site of insulin degradation.

### Tissue-specific insulin receptor knockout mice

Studies using tissue-specific insulin receptor knockout have demonstrated that mice lacking the muscle insulin receptor alone (MIRKO) are characterized by reduced insulin-stimulated muscle glucose uptake, but total-body glucose homeostasis remained normal (1). Adipose tissue insulin receptor knockout mice (FIRKO) had impaired adipose tissue glucose uptake but were protected against obesity, glucose intolerance, and dyslipidemia and manifested a prolonged lifespan (1). In contrast, knockout of the insulin receptor in the liver resulted in both fasting and postprandial hyperglycemia and the subsequent development of peripheral (muscle) insulin resistance. Collectively, these observations support the view that hepatic insulin resistance is the primary event and leads to the subsequent development of peripheral (muscle and adipose) tissue insulin resistance.

### The model of nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease (NAFLD) is part of the broad spectrum of nonalcoholic fatty liver diseases, which also includes steatosis. The distinction between fatty liver and steatohepatitis only can be made by examination of liver histology, which allows the assessment of inflammatory infiltrate, cellular degeneration, and necrosis and fibrosis, and cannot be made on the basis of clinical or laboratory parameters. Despite the weak correlation between liver function tests and the severity of liver disease, epidemiological studies have shown that transaminases, and, in particular, elevated …
Phase III Randomized Trial of Docetaxel-Carboplatin Versus Paclitaxel-Carboplatin as First-line Chemotherapy for Ovarian Carcinoma
Authors: P. A. Vasey, G. C. Jayson, A. Gordon, H. Gabra, R. Coleman, R. Atkinson, D. Parkin, J. Paul, A. Hay, S. B. Kaye
Journal: JNCI Journal of the National Cancer Institute (2004)

Background: Chemotherapy with a platinum agent and a taxane (paclitaxel) is considered the standard of care for treatment of ovarian carcinoma. We compared the combination of docetaxel–carboplatin with the combination of paclitaxel–carboplatin as first-line chemotherapy for stage Ic–IV epithelial ovarian or primary peritoneal cancer. Methods: We randomly assigned 1077 patients to receive docetaxel at 75 mg/m 2 of body surface area (1-hour intravenous infusion) or paclitaxel at 175 mg/m 2 (3-hour intravenous infusion). Both treatments then were followed by carboplatin to an area under the plasma concentration–time curve of 5. The treatments were repeated every 3 weeks for six cycles; in responding patients, an additional three cycles of single-agent carboplatin was permitted. Survival curves were calculated by the Kaplan–Meier method, and hazard ratios were estimated with the Cox proportional hazards model. All statistical tests were two-sided. Results: After a median follow-up of 23 months, both groups had similar progression-free survival (medians of 15.0 months for docetaxel–carboplatin and 14.8 months for paclitaxel–carboplatin; hazard ratio [HR] docetaxel–paclitaxel = 0.97, 95% confidence interval [CI] = 0.83 to 1.13; P = .707), overall survival rates at 2 years (64.2% and 68.9%, respectively; HR = 1.13, 95% CI = 0.92 to 1.39; P = .238), and objective tumor (58.7% and 59.5%, respectively; difference between docetaxel and paclitaxel = –0.8%, 95% CI = –8.6% to 7.1%; P = .868) and CA-125 (75.8% and 76.8%, respectively; difference docetaxel–paclitaxel = –1.0%, 95% CI = –7.2% to 5.1%; P = .794) response rates. However, docetaxel–carboplatin was associated with substantially less overall and grade 2 or higher neurotoxicity than paclitaxel–carboplatin (grade ≥2 neurosensory toxicity in 11% versus 30%, difference = 19%, 95% CI = 15% to 24%; P <.001; grade ≥2 neuromotor toxicity in 3% versus 7%, difference = 4%, 95% CI = 1% to 7%; P <.001). Treatment with docetaxel–carboplatin was associated with statistically significantly more grade 3–4 neutropenia (94% versus 84%, difference = 11%, 95% CI = 7% to 14%; P <.001) and neutropenic complications than treatment with paclitaxel–carboplatin, although myelosuppression did not influence dose delivery or patient safety. Global quality of life was similar in both arms, but substantive differences in many symptom scores favored docetaxel. Conclusions: Docetaxel–carboplatin appears to be similar to paclitaxel–carboplatin in terms of progression-free survival and response, although longer follow-up is required for a definitive statement on survival. Thus, docetaxel–carboplatin represents an alternative first-line chemotherapy regimen for patients with newly diagnosed ovarian cancer.
Asthma and rhinitis symptoms among parents of preschool children in relation to the home environment in Chongqing, China
Authors: Juan Wang, Baizhan Li, Qin Yang, Han Wang, Dan Norback, Jan Sundell
Journal: European Respiratory Journal (2013)

Aim: To study associations between rhinitis symptoms in Chongqing adults with preschool children, and home environment.  Methods: The study is part of a large Chinese multicenter study (China, Children, Home, Health, CCHH). Questionnaires (one/child) were sent to parents in randomly selected kindergartens (response rate 74.5%). There were questions on parents’ history of asthma and allergic rhinitis and rhinitis in the last 3 months (irritating, stuffy or runny nose) (every week; sometimes; never). The associations between rhinitis symptoms and home environment were analysed by multiple logistic regression, controlling for gender and smoking.  Results: Among 4950 participants: 70.4% were females; 1.5% reported a history of asthma; 2.5% allergic rhinitis; 15.5% were current smokers (47.9% males and 1.9% females); 2.5% had weekly rhinitis symptoms and 39.4% had less common symptoms. Current rhinitis was more common among asthmatics [OR(95%CI):3.08(1.70,5.58)] and allergic rhinitis [OR(95%CI):8.62(4.70,15.80)]. Asthma was more common in homes with water damage [OR(95%CI):2.66(1.15,6.16)]. Current rhinitis was more common in rural areas [OR(95%CI):1.52(1.10,2.11)] (reference group: urban areas), living near a main road or high way [OR(95%CI):1.39(1.16,1.66)], and in homes with new furniture [OR(95%CI):1.22(1.02,1.47)], water damage [OR(95%CI):1.88(1.34,2.62)], cockroaches [OR(95%CI):1.43(1.17,1.76)], current pets [OR(95%CI):1.37(1.10,1.71)], and less common among those often putting bedding to sunshine [OR(95%CI):0.72(0.60,0.86)].  Conclusions: Parents’ current rhinitis symptoms were related to a history of asthma, allergic rhinitis and factors of the home environment.
VARIABILITY OF BCG STRAINS (BACILLUS CALMETTE-GUÉRIN)
Authors: W. Emanuel Suter, René J. Dubos
Journal: The Journal of Experimental Medicine (1951)

Three different cultures of BCG propagated for over 2 years in a liquid medium containing Tween 80 and albumin were found to differ in several of their intrinsic properties. Cultures of the three strains were found to consist of morphologically heterogeneous populations—each culture being made up of three main colonial types—spreading, intermediate, and non-spreading. The percentage distribution of colonial types was characteristic for each culture and remained constant during cultivation in liquid media. Injection of the various cultures into mice and guinea pigs resulted in a self-limited disease. The distribution, extent, and duration of the lesions were also characteristic for each culture. Both the spreading and non-spreading substrains derived from the various cultures exhibited the degree of attenuation of virulence characteristic of the parent strain.
Absence of Fms-like tyrosine kinase 3 ligand (Flt3L) signalling protects against collagen-induced arthritis
Authors: M I P Ramos, O N Karpus, P Broekstra, S Aarrass, S E Jacobsen, P P Tak, M C Lebre
Journal: Annals of the Rheumatic Diseases (2013)

Objective Comprehending the mechanisms that regulate activation of autoreactive T cells and B cell antibody production is fundamental for understanding the breakdown in self-tolerance and development of autoimmunity. Here we studied the role of Fms-like tyrosine kinase 3 ligand (Flt3L) signalling in the pathogenesis of collagen-induced arthritis (CIA). Methods CIA was induced in mice lacking Flt3L (Flt3L −/− ) and wild-type (WT) littermates (C57/BL6, 8–10 weeks old). Mice were killed in the initial phase (acute phase: experiment 1) and late phase (chronic phase: experiment 2) of the disease. Arthritis severity was assessed using a semiquantitative scoring system (0–4), and histological analysis of cellular infiltration, cartilage destruction and peptidoglycan loss was performed. Phenotypic and functional analysis of T and B cells, FoxP3 expression, activation and lymphocyte costimulatory markers, and cytokine production were performed ex vivo by flow cytometry in lymph nodes. Serum collagen type II (CII)-specific antibodies were measured by ELISA. Results Flt3L −/− mice showed a marked decrease in clinical arthritis scores and incidence of arthritis in both acute and chronic phases of CIA compared with WT mice. Moreover, decreased synovial inflammation and joint destruction was observed. Both the magnitude and quality of T cell responses were altered in Flt3L −/− . In the acute phase, the amount of CII-specific IgG2a antibodies was lower in Flt3L −/− than WT mice. Conclusions These results strongly suggest a role for Flt3L signalling in the development of arthritis.
Rheumatoid arthritis increases the risk of deep vein thrombosis and pulmonary thromboembolism: a nationwide cohort study
Authors: Wei-Sheng Chung, Chiao-Ling Peng, Cheng-Li Lin, Yen-Jung Chang, Yung-Fu Chen, John Y Chiang, Fung-Chang Sung, Chia-Hung Kao
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Objective</h3> Studies on the association between rheumatoid arthritis (RA) and deep vein thrombosis (DVT) and pulmonary thromboembolism (PE) are scarce. This study identifies the effects of RA on the risks of developing DVT and PE in a nationwide prospective cohort study. <h3>Methods</h3> We studied the entire Taiwan population from 1998 to 2008, with a follow-up period extending to the end of 2010. We identified patients with RA using the catastrophic illness registry of the Taiwan National Health Insurance Research Database (NHIRD). We also selected a comparison cohort that was randomly frequency-matched by age (each 5-year span), sex and index year from the general population. We analysed the risks of DVT and PE using Cox proportional hazards regression models, including sex, age and comorbidities. <h3>Results</h3> From 23.74 million people in the cohort, 29 238 RA patients (77% women, mean age of 52.4 years) and 1 16 952 controls were followed 1 93 753 and 7 92 941 person-years, respectively. The risk of developing DVT and PE was 3.36-fold and 2.07-fold, respectively, in patients with RA compared with patients without RA, after adjusting for age, sex and comorbidities. The multiplicative increased risks of DVT and PE were also significant in patients with RA with any comorbidity. <h3>Conclusions</h3> This nationwide prospective cohort study demonstrates that DVT and PE risks significantly increased in patients with RA compared with those of the general population.