tbuckley/cabot-search huggingface dataset:
The Exercise is Medicine Global Health Initiative: a 2014 update
Authors: Felipe Lobelo, Mark Stoutenberg, Adrian Hutber
Journal: British Journal of Sports Medicine (2014)

Background A third of the world's population does not engage in recommended levels of physical activity (PA), leading to substantial health and economic burdens. The healthcare sector offers a variety of resources that can help counsel, refer and deliver PA promotion programmes for purposes of primordial, primary, secondary and tertiary prevention. Substantial evidence already exists in support of multipronged PA counselling, prescription and referral strategies, in particular those linking healthcare and community-based resources. Methods The Exercise is Medicine (EIM) initiative was introduced in 2007 to advance the implementation of evidence-based strategies to elevate the status of PA in healthcare. In this article, we describe the evolution and global expansion of the EIM initiative, its components, their implementation, an evaluation framework and future initiative activities. Results Until now, EIM has a presence in 39 countries with EIM Regional Centers established in North America, Latin America, Europe, Africa, Southeast Asia, China and Australasia. The EIM Global Health Initiative is transitioning from its initial phase of infrastructure and awareness building to a phase of programme implementation, with an emphasis in low-to-middle income countries, where 80% of deaths due to non-communicable diseases already occur, but where a large gap in research and implementation of PA strategies exists. Conclusions Broad implementation of PA counselling and referral systems, as clinical practice standard of care, has the potential to improve PA at the population level by complementing and leveraging other efforts and to contribute to achieving global targets for the reduction of inactivity and related morbidity and mortality.
How to Organize a Fellowship Program: Lessons Learned and How to Include Accreditation Council for Graduate Medical Education Competencies in the Curriculum
Authors: Frances A. Collichio, Michael P. Kosty, Timothy J. Moynihan, Thomas H. Davis, James A. Stewart
Journal: Journal of Clinical Oncology (2010)

Over the past 15 years, the complexity in fellowship training in hematology/oncology has increased. This is because of the vast growth of knowledge in these fields and a change in the structure and accreditation requirements of graduate medical education. The latter was put into place by the Accreditation Council for Graduate Medical Education (ACGME) in the mid 1990s. The ACGME responded to a sense that it was difficult to determine whether physicians were properly trained. Medical students, residents, and fellows work in complex environments and, unlike in formal classrooms in high school and college where teaching and testing are uniform, physicians in training can be exposed to a range of unique experiences, and assessments of progress can be arbitrary. The ACGME review called into question the entire process and prompted a structure that is known as the “Six Competencies of Graduate Medical Education.” Now, fellowship programs in hematology/oncology must expose their trainees to the knowledge in the field while also complying with assessments of these six competencies and must show by a variety of measures that their trainees are achieving accepted standards. This article is intended to show programs, program administrators, trainees, and the oncology community in general, steps that can lead to a successful hematology/ oncology training program with the ultimate goal of having the finest trained specialists in the field of hematology and oncology.
Corticosteroid-modulated Immune Activation in the Tuberculosis Immune Reconstitution Inflammatory Syndrome
Authors: Graeme Meintjes, Keira H. Skolimowska, Katalin A. Wilkinson, Kerryn Matthews, Rebecca Tadokera, Anali Conesa-Botella, Ronnett Seldon, Molebogeng X. Rangaka, Kevin Rebe, Dominique J. Pepper, Chelsea Morroni, Robert Colebunders, Gary Maartens, Robert J. Wilkinson
Journal: American Journal of Respiratory and Critical Care Medicine (2012)

HIV-tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) is an immunopathological reaction to mycobacterial antigens induced by antiretroviral therapy. Prednisone reduces morbidity in TB-IRIS, but the mechanisms are unclear.To determine the effect of prednisone on the inflammatory response in TB-IRIS (antigen-specific effector T cells, cytokines, and chemokines).Blood was taken from participants in a randomized placebo-controlled trial of prednisone for TB-IRIS, at 0, 2, and 4 weeks. Participants received prednisone at a dosage of 1.5 mg/kg/day for 2 weeks followed by 0.75 mg/kg/day for 2 weeks, or placebo at identical dosages.Analyses included IFN-γ enzyme-linked immunospot (ELISPOT), reverse transcription-polymerase chain reaction on peripheral blood mononuclear cells after restimulation with heat-killed Mycobacterium tuberculosis, Luminex multiplex cytokine analysis of corresponding tissue culture supernatants, and Luminex multiplex cytokine analysis of serum. Fifty-eight participants with TB-IRIS (31 receiving prednisone, 27 receiving placebo) were included. In serum, significant decreases in IL-6, IL-10, IL-12 p40, tumor necrosis factor-α, IFN-γ, and IFN-γ-induced protein-10 concentrations during prednisone, but not placebo, treatment were observed. No differences in ELISPOT responses comparing prednisone and placebo groups were shown in response to ESAT-6 (early secreted antigen target-6), Acr1, Acr2, 38-kD antigen, or heat-killed H37Rv M. tuberculosis. Purified protein derivative ELISPOT responses increased over 4 weeks in the prednisone group and decreased in the placebo group (P = 0.007).The beneficial effects of prednisone in TB-IRIS appear to be mediated via suppression of predominantly proinflammatory cytokine responses of innate immune origin, not via a reduction of the numbers of antigen-specific T cells in peripheral blood.
Sperm transport in the female reproductive tract
Authors: S.S. Suarez, A. A. Pacey
Journal: Human Reproduction Update (2005)

At coitus, human sperm are deposited into the anterior vagina, where, to avoid vaginal acid and immune responses, they quickly contact cervical mucus and enter the cervix. Cervical mucus filters out sperm with poor morphology and motility and as such only a minority of ejaculated sperm actually enter the cervix. In the uterus, muscular contractions may enhance passage of sperm through the uterine cavity. A few thousand sperm swim through the uterotubal junctions to reach the Fallopian tubes (uterine tubes, oviducts) where sperm are stored in a reservoir, or at least maintained in a fertile state, by interacting with endosalpingeal (oviductal) epithelium. As the time of ovulation approaches, sperm become capacitated and hyperactivated, which enables them to proceed towards the tubal ampulla. Sperm may be guided to the oocyte by a combination of thermotaxis and chemotaxis. Motility hyperactivation assists sperm in penetrating mucus in the tubes and the cumulus oophorus and zona pellucida of the oocyte, so that they may finally fuse with the oocyte plasma membrane. Knowledge of the biology of sperm transport can inspire improvements in artificial insemination, IVF, the diagnosis of infertility and the development of contraceptives.
Colonoscopy quality measures: experience from the NHS Bowel Cancer Screening Programme
Authors: Thomas J W Lee, Matthew D Rutter, Roger G Blanks, Sue M Moss, Andrew F Goddard, Andrew Chilton, Claire Nickerson, Richard J Q McNally, Julietta Patnick, Colin J Rees
Journal: Gut (2011)

Colonoscopy is central to colorectal cancer (CRC) screening. Success of CRC screening is dependent on colonoscopy quality. The NHS Bowel Cancer Screening Programme (BCSP) offers biennial faecal occult blood (FOB) testing to 60-74 year olds and colonoscopy to those with positive FOB tests. All colonoscopists in the screening programme are required to meet predetermined standards before starting screening and are subject to ongoing quality assurance. In this study, the authors examine the quality of colonoscopy in the NHS BCSP and describe new and established measures to assess and maintain quality.The NHS BCSP database collects detailed data on all screening colonoscopies. Prospectively collected data from the first 3 years of the programme (August 2006 to August 2009) were analysed. Colonoscopy quality indicators (adenoma detection rate (ADR), polyp detection rate, colonoscopy withdrawal time, caecal intubation rate, rectal retroversion rate, polyp retrieval rate, mean sedation doses, patient comfort scores, bowel preparation quality and adverse event incidence) were calculated along with measures of total adenoma detection.2,269,983 individuals returned FOB tests leading to 36,460 colonoscopies. Mean unadjusted caecal intubation rate was 95.2%, and mean withdrawal time for normal procedures was 9.2 min. The mean ADR per colonoscopist was 46.5%. The mean number of adenomas per procedure (MAP) was 0.91; the mean number of adenomas per positive procedure (MAP+) was 1.94. Perforation occurred after 0.09% of procedures. There were no procedure-related deaths.The NHS BCSP provides high-quality colonoscopy, as demonstrated by high caecal intubation rate, ADR and comfort scores, and low adverse event rates. Quality is achieved by ensuring BCSP colonoscopists meet a high standard before starting screening and through ongoing quality assurance. Measuring total adenoma detection (MAP and MAP+) as adjuncts to ADR may further enhance quality assurance.
Changes in oesophageal wall biomechanics after portal vein banding and variceal sclerotherapy measured by a new technique. An experimental study in rabbits.
Authors: H Gregersen, L S Jensen, J C Djurhuus
Journal: Gut (1988)

The biomechanical properties of the oesophageal wall were investigated in a rabbit model using a four electrode impedance technique. A specially designed probe with the electrodes inside a low pressure expandable insulating latex balloon was introduced in the oesophagus. Stepwise inflation and deflation was done for analysis of oesophageal compliance and hysteresis. The rabbits were allocated to three groups: a control group, one with oesophageal varices and one with varices which were treated by sclerotherapy. The oesophageal varices were induced by portal banding five months before the investigation. A uniform pattern of changes in the biomechanical properties of the oesophageal wall was seen in the group with oesophageal varices when compared with controls. The compliance was significantly decreased, and the hysteresis was lessened. Endoscopic sclerotherapy changed the wall properties to a pattern not distinguishable from normal. Thus, in vivo investigation of the biomechanical wall properties showed a significant loss of distensibility of the oesophagus with varices and restorement of the wall distensibility when the varices were treated with endoscopic sclerotherapy.
Mediastinal thoracic duct cyst.
Authors: F J Gowar
Journal: Thorax (1978)

A case of mediastinal thoracic duct cyst is described; it is believed to be the first to be reported in Britain. Five surgically treated cases have been reported but in none was the diagnosis made before operation. Symptoms are caused by pressure of the cyst on the trachea and oesophagus and my be aggravted by eating a fatty meal. Differential diagnosis from other mediastinal tumours, especially bronchogenic cyst and neurofibroma, could perhaps be established before operation by lymphangiography.
Management of multiple myeloma in Asia: resource-stratified guidelines
Authors: Daryl Tan, Wee Joo Chng, Takaaki Chou, Weerasak Nawarawong, Shang-Yi Hwang, Chor Sang Chim, Wenming Chen, Brian G M Durie, Jae Hoon Lee
Journal: The Lancet Oncology (2013)
Patients with acute myeloid leukemia and an activating mutation in FLT3 respond to a small-molecule FLT3 tyrosine kinase inhibitor, PKC412
Authors: Richard M. Stone, Daniel J. DeAngelo, Virginia Klimek, Ilene Galinsky, Eli Estey, Stephen D. Nimer, Wilson Grandin, David Lebwohl, Yanfeng Wang, Pamela Cohen, Edward A. Fox, Donna Neuberg, Jennifer Clark, D. Gary Gilliland, James D. Griffin
Journal: Blood (2004)
Unique Clinicopathologic Features Characterize <i>ALK</i>-Rearranged Lung Adenocarcinoma in the Western Population
Authors: Scott J. Rodig, Mari Mino-Kenudson, Sanja Dacic, Beow Y. Yeap, Alice Shaw, Justine A. Barletta, Hannah Stubbs, Kenny Law, Neal Lindeman, Eugene Mark, Pasi A. Janne, Thomas Lynch, Bruce E. Johnson, A. John Iafrate, Lucian R. Chirieac
Journal: Clinical Cancer Research (2009)

The anaplastic large cell kinase gene (ALK) is rearranged in approximately 5% of lung adenocarcinomas within the Asian population. We evaluated the incidence and the characteristics of ALK-rearranged lung adenocarcinomas within the western population and the optimal diagnostic modality to detect ALK rearrangements in routine clinical practice.We tested 358 lung adenocarcinomas from three institutions for ALK rearrangements by fluorescent in situ hybridization (FISH) and immunohistochemistry with and without tyramide amplification. The clinicopathologic characteristics of tumors with and without ALK rearrangements were compared.We identified 20 (5.6%) lung adenocarcinomas with ALK rearrangements within our cohort of western patients. ALK rearrangement was associated with younger age (P = 0.0002), never smoking (P < 0.0001), advanced clinical stage (P = 0.0001), and a solid histology with signet-ring cells (P < 0.0001). ALK rearrangement was identified by FISH in 95% of cases and immunohistochemistry with and without tyramide amplification in 80% and 40% of cases, respectively, but neither FISH nor immunohistochemistry alone detected all cases with ALK rearrangement on initial screening. None of the ALK-rearranged tumors harbored coexisting EGFR mutations.Lung adenocarcinomas with ALK rearrangements are uncommon in the western population and represent a distinct entity of carcinomas with unique characteristics. For suspected cases, dual diagnostic testing, with FISH and immunohistochemistry, should be considered to accurately identify lung adenocarcinomas with ALK rearrangement.
Living unrelated (commercial) renal transplantation in children.
Authors: Y Frishberg, S Feinstein, A Drukker
Journal: Journal of the American Society of Nephrology (1998)

Long waiting times for cadaveric renal transplantation has led the frustrated parents of Arab children with end-stage renal disease treated in our center to seek commercial renal transplantation (CRT) outside Israel. During the past 3 yr, 18 children, aged 13 +/- 1 yr, underwent CRT in one center in Iraq. Post-CRT follow-up was 20.2 +/- 2.5 mo. Immediate complications (abroad) included: death on the day of surgery (n = 1) and vascular thrombotic events requiring removal of a previously functioning graft (n = 2). There was a high incidence of urologic problems, mainly as a result of inadequate uretero-vesical anastomosis. Calculated creatinine clearance at 6, 12, 18, 24, and 30 mo was 84.7 +/- 6.4, 91.0 +/- 6.8, 90.8 +/- 6.2, 82.5 +/- 9.5, and 77.7 +/- 8.2 ml/min per 1.73 m2 respectively, representing excellent graft function in 13 patients and slightly compromised function in two children. One- and two-year patient survival was 94.4%, with a graft survival of 83.3%. CRT in these Arab children had a favorable outcome despite severe early postoperative complications. Graft function at follow-up was comparable to cadaveric renal transplantation in Israel. This may reflect a propensity for healthy young adult donors. Despite these results, the authors oppose and discourage the practice of CRT on legal and ethical grounds. Not to provide follow-up care in this specific group of patients would not have been in their best interest.
Human astrocytes inhibit Cryptococcus neoformans growth by a nitric oxide-mediated mechanism.
Authors: S C Lee, D W Dickson, C F Brosnan, A Casadevall
Journal: The Journal of Experimental Medicine (1994)

Cryptococcus neoformans is an opportunistic fungus that causes life-threatening meningoencephalitis in 5-10% of patients with acquired immune deficiency syndrome. Cryptococcal meningoencephalitis is characterized by a lymphohistiocytic infiltrate, accumulation of encapsulated forms of C. neoformans, and varying degrees of glial reaction. Little is known about the contribution of endogenous central nervous system cells to the pathogenesis of cryptococcal infections. In this study, we investigated the role of astrocytes as potential effector cells against C. neoformans. Primary cultures of human fetal astrocytes, activated with interleukin 1 beta plus interferon gamma inhibited the growth of C. neoformans. The inhibition of C. neoformans growth was paralleled by production of nitrite, and reversed by the inhibitors of nitric oxide (NO.) synthase, NG-methyl-mono-arginine and NG-nitro-arginine methyl ester. The results suggest a novel function for human astrocytes in host defence and provide a precedent for the use of NO. as an antimicrobial effector molecule by human cells.
Determination of density of follicles on various regions of the face by cyanoacrylate biopsy: correlation with sebum output
Authors: A. PAGNONI, A.M. KLIGMAN, S.EL GAMMAL, T. STOUDEMAYER
Journal: British Journal of Dermatology (1994)

The density of follicles on various regions of the human face has received scant attention. We used cyanoacrylate follicular biopsies to determine the number of follicles on the forehead, cheek, chin and nose of 12 healthy adult white women. Sebum output was assessed on the same regions by means of Sebutape. The density of follicles and sebum output followed a centrolateral decreasing gradient. There was no correlation between these two parameters. These regional patterns are important for studies of the pathogenesis of common disorders of the face and their response to treatment.
SWALLOWING FOREIGN BODIES FOR A LIVELIHOOD
Authors: I. L. Johnstone
Journal: BMJ (1935)

A case of unusual surgical and psychological interest came under my notice in January, 1923, when I was surgical dresser to IvIr.John Murray at the Middlesex Hospital.A man was admitted for the removal of three three-inch nails from his small intestine.That it was not the first time that he had been in such a case was evident from his profusely apologetic attitude to the surgeon for troubling him again, and from the appearance of his abdominal wall.It was a mass of scars, and was throwin into hills and valleys by small herniae scattered among the scars.
Hepatitis C virus versus innate and adaptive immune responses: a tale of coevolution and coexistence
Authors: Barbara Rehermann
Journal: Journal of Clinical Investigation (2009)

Since the identification of the hepatitis C virus (HCV) 20 years ago, much progress has been made in our understanding of its life cycle and interaction with the host immune system. Much has been learned from HCV itself, which, via decades of coevolution, gained an intricate knowledge of host innate and adaptive immune responses and developed sophisticated ways to preempt, subvert, and antagonize them. This review discusses the clinical, virological, and immunological features of acute and chronic hepatitis C and the role of the immune response in spontaneous and treatment-induced HCV clearance.
Pyrophosphate arthropathy in the carpal and metacarpophalangeal joints.
Authors: M Bourqui, T L Vischer, P Stasse, C Docquier, G H Fallet
Journal: Annals of the Rheumatic Diseases (1983)

The hand x-rays of group of patients with generalised osteoarthrosis alone were compared with those patients with generalised osteoarthrosis and chondrocalcinosis (CC). An arthropathy seemingly specific for CC could be identified in the metacarpophalangeal (MCP) and carpal joints. In the MCP joints it was characterised by subchondral rarefactions, deviation of the joint axis, joint space narrowing, and osteophytosis. Usually only the second and/or third MCP joints are affected. In the carpal joints similar subchondral cysts, sometimes associated with joint space narrowing, were found much more frequently in the group with CC. There was no direct relation with the presence of calcification.
The I-Ab mutant B6.C-H-2bm12 allows definition of multiple T cell epitopes on I-A molecules.
Authors: B N Beck, P A Nelson, C G Fathman
Journal: The Journal of Experimental Medicine (1983)

The experiments presented in this study demonstrate that there exist at least two functional epitopes on an I-A molecule that can be recognized by T cell clones. By comparing the abilities of spleen cells from C57BL/6 mice and the congenic I-A mutant line B6.C-H-2bm12 to stimulate alloreactive T cell clones specific for the I-Ab molecule, we have discriminated two sets of clones, those recognizing the I-Ab and I-Abm12 molecule equally well and those able to recognize only the I-Ab molecule. These results imply that the two sets of clones have different receptors for I-A and that they therefore recognize separate epitopes on the I-A molecule. We have similarly been able to separate T cell clones, both alloreactive and L-glutamic acid60-L-alanine30-L-tyrosine10-reactive, specific for the Ab alpha Ak beta hybrid molecule into two groups based on their ability to recognize bm 12 spleen cells. Although the recognition of bm 12 spleen cells by these clones was unexpected since none of them responds to B6 spleen cells, these data again allow us to conclude that these groups of clones have different receptors for the same I-A molecule and therefore that they recognize distinct epitopes on the molecule. Additional studies, in which monoclonal anti-I-A antibodies were used to block the stimulation of T cells by stimulator or antigen-presenting cells, have demonstrated that this blockade can be a steric effect and therefore is not necessarily indicative of direct competition between the antibody and the T cell for the same site on an I-A molecule. Although this study does not reveal the physical nature of an I region-controlled "antigen-restriction site," we can suggest that increasing the number of possible functional Ia restriction sites either through combinatorial association of alpha and beta chains or by using more than one site per molecule will increase the number of configurations the ternary complex of Ia, antigen and T cell receptor(s) can form.
Chemical leucoderma: a clinico-aetiological study of 864 cases in the perspective of a developing country
Authors: S. Ghosh, S. Mukhopadhyay
Journal: British Journal of Dermatology (2008)

Chemical leucoderma, often clinically mimicking idiopathic vitiligo and other congenital and acquired hypopigmentation, has been increasing rapidly in incidence in developing countries such as India.This study attempts to detect clinical and epidemiological patterns of chemical leucoderma.Detailed history-taking, especially of exposure to contributory chemicals, clinical examination, relevant investigations, data recording and analysis were done.In a total of 864 cases of chemical leucoderma, 65.6% cases started de novo and vitiligo patches were pre-existing in the remaining cases. Patches were limited to the contact area in 73.7% but had spread to remote areas in 26.3% cases. The face (41.1%) and scalp (5.9%) were the commonest and least involved sites. Confetti macules were seen in 89% and pruritus was complained of in 21.8%. Aetiological agents identified were hair dye 27.4% (21% self-use; 6.4% not self-use), deodorant and spray perfume 21.6%, detergent and cleansers 15.4%, adhesive bindi 12%, rubber chappal 9.4%, black socks and shoes 9.1%, eyeliner 8.2%, lipliner 4.8%, rubber condoms 3.5%, lipstick 3.3%, fur toys 3.1%, toothpaste 1.9%, insecticides 1.7%, 'alta' 1.2%, amulet string colour 0.9%. Therapeutic response was much better in 'pure' chemical leucoderma (73.4%) than in those with co-existing vitiligo (20.9%).Chemical leucoderma, a disease of mostly industrial origin in developed countries, may be induced by common domestic products in developing countries. Diagnosis and differentiation from other causes of hypopigmentation can be done confidently by following the clinical criteria as proposed. The therapeutic response of chemical leucoderma is better than that of vitiligo.