tbuckley/cabot-search huggingface dataset:
Effects of alternative maternal micronutrient supplements on low birth weight in rural Nepal: double blind randomised community trial
Authors: Parul Christian, Subarna K Khatry, Joanne Katz, Elizabeth K Pradhan, Steven C LeClerq, Sharada Ram Shrestha, Ramesh K Adhikari, Alfred Sommer, Keith P West
Journal: BMJ (2003)

<h3>Abstract</h3> <b>Objective:</b> To assess the impact on birth size and risk of low birth weight of alternative combinations of micronutrients given to pregnant women. <b>Design:</b> Double blind cluster randomised controlled trial. <b>Setting:</b> Rural community in south eastern Nepal. <b>Participants:</b> 4926 pregnant women and 4130 live born infants. <b>Interventions:</b> 426 communities were randomised to five regimens in which pregnant women received daily supplements of folic acid, folic acid-iron, folic acid-iron-zinc, or multiple micronutrients all given with vitamin A, or vitamin A alone (control). <b>Main outcome measures:</b> Birth weight, length, and head and chest circumference assessed within 72 hours of birth. Low birth weight was defined &lt;2500 g. <b>Results:</b> Supplementation with maternal folic acid alone had no effect on birth size. Folic acid-iron increased mean birth weight by 37 g (95% confidence interval −16 g to 90 g) and reduced the percentage of low birthweight babies (&lt;2500 g) from 43% to 34% (16%; relative risk=0.84, 0.72 to 0.99). Folic acid-iron-zinc had no effect on birth size compared with controls. Multiple micronutrient supplementation increased birth weight by 64 g (12 g to 115 g) and reduced the percentage of low birthweight babies by 14% (0.86, 0.74 to 0.99). None of the supplement combinations reduced the incidence of preterm births. Folic acid-iron and multiple micronutrients increased head and chest circumference of babies, but not length. <b>Conclusions:</b> Antenatal folic acid-iron supplements modestly reduce the risk of low birth weight. Multiple micronutrients confer no additional benefit over folic acid-iron in reducing this risk. <h3>What is already known on this topic</h3> Deficiencies in micronutrients are common in women in developing countries and have been associated with low birth weight and preterm delivery <h3>What this study adds</h3> In rural Nepal maternal supplementation with folic acid-iron reduced the incidence of low birth weight by 16% A multiple micronutrient supplement of 14 micronutrients, including folic acid, iron, and zinc, reduced low birth weight by 14%, thus conferring no advantage over folic acid-iron
Multivisceral Resection for Locally Advanced Gastric Cancer
Authors: Fabio Pacelli
Journal: JAMA Surgery (2013)

Importance:The role of multivisceral resection, in the setting of locally advanced gastric cancer, is still debated.Previous studies have reported a higher risk for perioperative morbidity and mortality, with limited objective benefit in terms of survival.Conversely, recent studies have shown the feasibility of enlarged resections and the potential advantage of extended resection for clinical stage T4b gastric adenocarcinoma with good longterm results.Objective: To analyze the role of multivisceral resection for locally advanced gastric cancer with particular attention to the brief and long-term results and to the prognostic value of clinical and pathologic factors.Design: Prospective multicenter study using data from between January 1, 1995, and December 31, 2008.Settings: Seven Italian surgery centers.Patients: A total of 2208 patients underwent curative resections for gastric carcinoma at the centers.Among them, 206 patients presented with a clinical T4b carcinoma.One hundred twelve underwent a combined resection of the adjacent organs with a gastrectomy owing to suspicion or direct invasion of these organs by the gastric cancer.Main Outcomes and Measures: Clinical and pathologic variables were prospectively collected and the feasibility and efficacy of multivisceral resection for locally advanced clinical T4b gastric cancer were assessed.Results: Postoperative mortality and complication rates of patients who underwent a gastrectomy with a combined resection of the involved organs were 3.6% and 33.9%, respectively.Pathologic factors revealed that the nodal involvement was present in about 89.3% of patients and the mean (SD) number of pathologic lymph nodes was 14.8 (16.6).The overall 5-year survival rate was 27.2%.The completeness of resection and lymph node invasion represent independent prognostic parameters at multivariate analysis.Conclusions and Relevance: Our study indicates that patients undergoing extended resections experience acceptable postoperative morbidity and mortality rates, and an en bloc multivisceral resection should be performed in patients when a complete resection can be realistically obtained and when lymph node metastasis is not evident.
ELECTROENCEPHALOGRAPHIC STUDIES IN ORGANIC PSYCHOSES
Authors: PAUL HOCH, JOSEPH KUBIS
Journal: American Journal of Psychiatry (1941)

Some correlation exists between the EEG findings and the clinical status of the patient in cases of general paresis, senile psychosis, psychosis with cerebral arteriosclerosis and alcoholic psychosis, Korsakoff type. This relationship is by no means an absolute one. There are cases, acute as well as chronic, in which clinically the patient shows psychotic manifestations and the EEG is normal. In acute cases of organic psychosis where the mental disorder develops rather rapidly, often slow waves can be observed, especially in patients who suffer from marked confusional states, and in cases in which the consciousness is narrowed. In acute cases with only moderate mental impairment, the EEG findings are often normal or borderline. In chronic cases some parallelism exists between the degree of deterioration and the EEG findings. Slow waves can be demonstrated in many cases. They are, however, patients of long standing mental deterioration who did not show noticeable corticoelectric changes. It is possible that if an organic process is very slow in developing, findings are missing for some time because the brain has had an opportunity to adapt itself to the damage. Another possibility is that in some of these cases the structural changes are not so much cortical but are localized in sub-cortical associative areas, producing inconspicuous EEG findings. We found that the electroencephalogram has a distinct diagnostic value in organic psychoses if definite slow waves from one to five per second were present, because in such cases a definite mental impairment was demonstrable, but if the electroencephalogram was normal this did not exclude the presence of an organic psychosis. Due to the fact that no absolute correlation exists between the electroencephalographic findings and clinical observations, the diagnostic value of this method is limited at present until we shall be able to work out a closer correlation between organic psychotic processes and corticoelectric phenomena. We agree fully with the statement made by P. A. Davis and H. Davis that: "Although the psychotic individual cannot be recognized by his EEG, nevertheless, as a group the psychotics have a significantly larger percentage of abnormalities in their EEG's than do normals." This is especially true of patients suffering from the organic type of mental disorders.
Medicine for football: football for health
Authors: M D'Hooghe
Journal: British Journal of Sports Medicine (2011)

Lecture 7 Football has developed enormously over the last 25 years but there is no doubt that over the same period the world around football has developed even further. The medical world around football has been no exception to this. In the first part of the conference I will explain how the Medical Commission of FIFA and UEFA try to answer the challenge: medicine for football. It started with the four classical themes of sports medicine: traumatology, physiology, psychology and pharmacology. We should add that important aspects of nutrition, hydration and hygiene have been gradually joining this leading quartet. Quite rightly too, another major focus has been the prevention of injuries. Over the last years, especially due to the many cases of sudden death, the importance of emergency medicine was largely emphasised. Even more specific fields have also joined the list: for example, youth football, women's football, medical care in relation to refereeing, specific traumatology of the goalkeeper. The globalisation of football has created new problems in the medical sector: ▶ What are the criteria for adaptation to jetlag? ▶ What medical preparation and care is needed for a team playing matches and tournaments at high altitude? ▶ What measures should be taken for matches played in extremely hot conditions with an obvious risk of serious dehydration? We must also highlight the problem of the fight against doping in football. We test the presence of amphetamines, narcotics and anabolic steroids, diuretics, and peptide hormones, particularly erythropoietin and growth hormone. We are confronted with excessive use of β 2 -agonists and corticosteroids. Looking into the future we can already detect the advent of genetic doping whereby athletes will be genetically prepared to improve artificially all former sport performances. Our philosophy is there are three important reasons for refusing any form of doping: ▶ The use of doping is opposed to the ethics of sport. In a world of sports where ethical arguments are defeated every day by commercial considerations the medical world should stand firm as the first guardian of ethics. ▶ Doping is prejudicial to the integrity of our competitions. We must not collaborate in the organisation of football games where artificial medications take the place of natural values such as talent, training, skill, character and endurance. ▶ Above all we must respect the health of the athletes. We will discuss the importance of football for health: studies have proven that weekly practice of football is superior to many other exercises in the care for health. The importance of physical exercise, particularly by football, will be underlined as an important preventive factor in the health of people of all ages.
Implantable Pump Therapy Restores Metabolic Control and Quality of Life in Type 1 Diabetic Patients With Buschke’s Nonsystemic Scleroderma
Authors: Sabine Baillot-Rudoni, Dominique Apostol, Geneviève Vaillant, Jean-Marcel Brun, Eric Renard
Journal: Diabetes Care (2006)

Buschke’s nonsystemic scleroderma is an uncommon dermatosis characterized by thickened and indurate skin of unknown origin, mostly affecting upper parts of the body but also the abdominal area. While diabetes is rarely associated, subcutaneous insulin treatment may be hardly feasible and effective because of incomplete absorption of insulin (1).

After approval of our institutional ethical committees, four type 1 diabetic patients (one male and three female subjects) affected by this condition received Medtronic MiniMed implantable pumps (Northridge, …
Rehabilitation of lumbar multifidus dysfunction in low back pain: strengthening versus a motor re-education model
Authors: R S Jemmett
Journal: British Journal of Sports Medicine (2003)

Treatment for opioid use disorder (OUD) is often in the context of biobehavioural interventions, consisting of medication for OUD (for example, methadone and buprenorphine), which is accompanied by psychoeducation and/or behavioural therapies. Patients with OUD often display weaknesses in cognitive function that may impact the efficacy of such behavioural interventions. A review of the literature was conducted to: (1) describe common cognitive dysfunction profiles among patients with OUD, (2) outline intervention approaches for patients with OUD, (3) consider the cognitive demands that interventions place on patients with OUD and (4) identify potential accommodation strategies that may be used to optimise treatment outcomes. Cognitive profiles of patients with OUD often include weaknesses in executive function, attention, memory and information processing. Behavioural interventions require the patients’ ability to learn, understand and remember information (placing specific cognitive demands on patients). Accommodation strategies are, therefore, needed for patients with challenges in one or more of these areas. Research on accommodation strategies for patients with OUD is very limited. We applied research from populations with similar cognitive profiles to form a comprehensive collection of potential strategies to compensate for cognitive dysfunction among patients with OUD. The cognitive profiles and accommodation strategies included in this review are intended to inform future intervention research aimed at improving outcomes among patients with OUD.
Effects of Chromatin-Modifying Agents on CD34+ Cells from Patients with Idiopathic Myelofibrosis
Authors: Jun Shi, Yan Zhao, Takefumi Ishii, Wenyang Hu, Selcuk Sozer, Wei Zhang, Edward Bruno, Valerie Lindgren, Mingjiang Xu, Ronald Hoffman
Journal: Cancer Research (2007)

Abstract Idiopathic myelofibrosis (IM) is likely the consequence of both the acquisition of genetic mutations and epigenetic changes that silence critical genes that control cell proliferation, differentiation, and apoptosis. We have explored the effects of the sequential treatment with the DNA methyltransferase inhibitor, decitabine [5-aza-2′-deoxycytidine (5azaD)], followed by the histone deacetylase inhibitor, trichostatin A (TSA), on the behavior of IM CD34+ cells. Unlike normal CD34+ cells where 5azaD/TSA treatment leads to the expansion of CD34+ cells and marrow-repopulating cells, treatment of IM CD34+ cells results in a reduction of the number of total cells, CD34+ cells, and assayable hematopoietic progenitor cells (HPC). In IM, HPCs are either heterozygous or homozygous for the JAK2V617F mutation or possess wild-type JAK2 in varying proportions. Exposure of IM CD34+ cells to 5azaD/TSA resulted in a reduction of the proportion of JAK2V617F-positive HPCs in 83% of the patients studied and the reduction in the proportion of homozygous HPCs in 50% of the patients. 5azaD/TSA treatment led to a dramatic reduction in the number of HPCs that contained chromosomal abnormalities in two JAK2V617F-negative IM patients. IM is characterized by constitutive mobilization of HPCs, which has been partly attributed to decreased expression of the chemokine receptor CXCR4. Treatment of IM CD34+ cells with 5azaD/TSA resulted in the up-regulation of CXCR4 expression by CD34+ cells and restoration of their migration in response to SDF-1. These data provide a rationale for sequential therapy with chromatin-modifying agents for patients with IM. [Cancer Res 2007;67(13):6417–24]
CONKO-001: Final results of the randomized, prospective, multicenter phase III trial of adjuvant chemotherapy with gemcitabine versus observation in patients with resected pancreatic cancer (PC)
Authors: P. Neuhaus, H. Riess, S. Post, K. Gellert, K. Ridwelski, H. Schramm, C. Zuelke, J. Fahlke, J. Langrehr, H. Oettle
Journal: Journal of Clinical Oncology (2008)

LBA4504 Background: Prognosis of patients (pts) with PC is dismal, even after curatively intended resection. Whereas gemcitabine-based chemotherapy is standard in advanced PC, the role of adjuvant chemotherapy is still under discussion. Methods: CONKO-001, a prospective, open, multicenter, controlled phase 3 study was designed to evaluate the efficacy and toxicity of gemcitabine in PC pts after complete (R0 or R1) resection. After stratification for R0/R1, nodal tumour involvement and tumour stage pts were randomized to receive either gemcitabine (G) (1g/m2 d 1, 8 and 15 every 4 weeks) for 6 months or observation (O). Pts in the observation group received no specific anticancer treatment. Primary study endpoint was disease free survival (DFS), secondary endpoints included OS and toxicity. The study was powered to detect a significant difference in DFS with 90% probability at a significance level of .05 on all eligible patients. Results: Between July 1998 and December 2004 368 pts were randomized and 354 were eligible for intent-to-treat-analysis. As previously discribed in JAMA 2007 first results showed that postoperative G is well tolerated and significantly delays the development of recurrent disease after complete resection of PC. By December 1st 2007 303 events (85.6%) have occurred for DFS and 293 events (82.8%) for OS. The analyses confirm the significant improvement for G in median DFS [G:13.4 months (m), O: 6.9m, p< .001]. Estimated DFS at 3 and 5 years was 23.5% and 16.0% in the G group vs. 8.5% and 6.5% in the O group, respectively. Subgroup analyses demonstrate significant increased DFS for G in all subgroups of stratification. G significantly improves median OS [G:22.8m, O: 20.2m, p=.005]. Estimated survival at 3 and 5 years was 36.5% and 21.0% for G pts vs. 19.5% and 9.0% for O pts, respectively. Conclusion: Treatment with G for 6 months for pts after complete resection of PC significantly increases DFS and OS compared with O alone. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Amgen, Bayer, Lilly Oncology, Merck, Novartis, Pfizer, Roche, sanofi-aventis
Combination treatment with extracorporeal photopheresis, interferon alfa and interleukin-2 in a patient with the Sézary syndrome
Authors: None Fritz, None Kleinhans, None Nestle, None Burg, None Dummer
Journal: British Journal of Dermatology (1999)

Journal Article Combination treatment with extracorporeal photopheresis, interferon alfa and interleukin‐2 in a patient with the Sézary syndrome Get access T.M. Fritz, T.M. Fritz Department of Dermatology, University Hospital Zürich, Gloriastraße 31, 8091 Zürich, Switzerland Search for other works by this author on: Oxford Academic Google Scholar M. Kleinhans, M. Kleinhans Department of Dermatology, University Hospital Zürich, Gloriastraße 31, 8091 Zürich, Switzerland Search for other works by this author on: Oxford Academic Google Scholar F.O. Nestle, F.O. Nestle Department of Dermatology, University Hospital Zürich, Gloriastraße 31, 8091 Zürich, Switzerland Search for other works by this author on: Oxford Academic Google Scholar G. Burg, G. Burg Department of Dermatology, University Hospital Zürich, Gloriastraße 31, 8091 Zürich, Switzerland Search for other works by this author on: Oxford Academic Google Scholar R. Dummer R. Dummer Department of Dermatology, University Hospital Zürich, Gloriastraße 31, 8091 Zürich, Switzerland Dummer E‐mail: dummer@derm.unizh.ch Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 140, Issue 6, 1 June 1999, Pages 1144–1147, https://doi.org/10.1046/j.1365-2133.1999.02889.x Published: 01 June 1999
Isosorbide dinitrate in experimental portal hypertension: A study of factors that modulate the hemodynamic response
Authors: Andres T. Blei, Jeanne Gottstein
Journal: Hepatology (1986)

Isosorbide dinitrate, a long–acting vasodilator, has been tested in human portal hypertension with conflictingresults. In order to determine some of the factors that could affect the individual response to this drug, we infused isosorbide dinitrate at a low dose (10 to 25 μg per kg per min) and a high dose (100 μg per kg per min) to rats with portal vein stenosis. Under pentobarbital anesthesia, portal pressure was measured with an ileocolic vein catheter while cardiac output and regional blood flows were measured with the microsphere technique. At a dose that decreased arterial pressure by approximately 10%, cardiac output remained unchanged while portal vein inflow decreased significantly; portal pressure was not reduced (10.7 ± 0.2 vs. 10.0 ± 0.3 mm Hg), indicating a rise in portal vascular resistance. At a high dose of isosorbide dinitrate, arterial pressure and cardiac output fell markedly; portal pressure decreased only modestly (11.3 ± 0.3 vs. 9.8 ± 0.6 mm Hg, p &lt; 0.05), but portal flow was unchanged, indicating a reduction in portal vascular resistance. In addition, portal hypertensive rats received a constant i.v. infusion of N –acetyl–cysteine the combination of the latter and isosorbide dinitrate markedly potentiated the effects on arterial pressure. Thus, the dose of the drug and the presence of cysteine–containing compounds appear to modulate the hemodynamic response to isosorbide dinitrate. Clinical testing with this drug should be undertaken with consideration of these factors.
Prognostic significance of a combination of pre- and post-treatment tumor markers for hepatocellular carcinoma curatively treated with hepatectomy
Authors: Hidenori Toyoda, Takashi Kumada, Toshifumi Tada, Takuro Niinomi, Takanori Ito, Yuji Kaneoka, Atsuyuki Maeda
Journal: Journal of Hepatology (2012)
Hip fractures in healthy patients
Authors: J. J Dias
Journal: BMJ (1987)

In this review, I summarize some of the recent insight into pharmacological targeting of hypoxia in disease models. Studies from cultured cell systems, animal models, and translation to human patients have revealed that posttranslational modifications of individual proteins within NF-κB and hypoxia-inducible factor pathways serve as ideal targets for analysis in disease models. Studies defining differences and similarities between these responses have taught us a number of important lessons about the complexity of the inflammatory response. A clearer definition of these pathways has provided new insight into disease pathogenesis and, importantly, the potential for new therapeutic targets.
Bacillus Calmette-Guérin-activated murine macrophages kill syngeneic melanoma cells under strict anaerobic conditions.
Authors: V H Freedman, T E Gorrell, C F Nathan, C S Copeland, S C Silverstein
Journal: The Journal of Experimental Medicine (1984)

We have studied the spontaneous killing of B5(59) melanoma cells by Bacillus Calmette-Guérin (BCG)-elicited macrophages under strictly anaerobic conditions to investigate the role of oxygen in macrophage-mediated cytotoxicity. The number of melanoma cells capable of forming colonies after aerobic or anaerobic incubation with BCG-macrophages was used as the index of cytotoxicity. The BCG-macrophages killed melanoma cells regardless of the amount of oxygen present. The killing observed was proportional to the ratio of effector cells added; a ratio of 25:1 effector to target cells was required to achieve nearly 90% cytotoxicity both aerobically and anaerobically. This cytotoxicity was not dependent on a diffusible macrophage product nor on alteration of the medium by macrophages, since tumor cells incubated in the same culture medium, but not in contact with a mixed population of tumor cells and macrophages, were not killed. These results also indicated that macrophage-mediated cytotoxicity was dependent on macrophage-tumor cell contact. The mechanism responsible for the oxygen-independent cytotoxicity is unknown at present.
A Multicentre, Randomised Prospective Trial Comparing Three Intravesical Adjuvant Therapies for Intermediate-Risk Superficial Bladder Cancer: Low-Dose Bacillus Calmette-Guerin (27 mg) versus Very Low-Dose Bacillus Calmette-Guerin (13.5 mg) versus Mitomycin C
Authors: Antonio Ojea, José Luís Nogueira, Eduardo Solsona, Nicolás Flores, Jesús María Fernández Gómez, Jesús Rodríguez Molina, Venancio Chantada, José Emilio Camacho, Luís Martínez Piñeiro, Rafael Hernandez Rodríguez, Santiago Isorna, Miguel Blas, José A. Martínez-Piñeiro, Rosario Madero
Journal: European Urology (2007)