tbuckley/cabot-search huggingface dataset:
Could cardiovascular disease risk stratification and management in rheumatoid arthritis be enhanced?
Authors: Patrick H Dessein, Anne G Semb
Journal: Annals of the Rheumatic Diseases (2013)

The markedly enhanced risk of atherosclerotic cardiovascular disease (CVD) in rheumatoid arthritis (RA) is well documented.1 ,2 This prompted a European League Against Rheumatism (EULAR) task force to make a commendable effort in producing recommendations for cardiovascular risk management in patients with inflammatory arthritis.3 These included the application of the systematic coronary risk evaluation score (SCORE), a multiple major traditional risk factor assessment equation. In addition, the EULAR task force recommended applying a multiplier of 1.5 in patients with RA that met 2 of 3 criteria consisting of (1) a disease duration >10 years, (2) rheumatoid factor or anticyclic citrullinated peptide positivity and (3) the presence of extra-articular manifestation, thereby creating the modified (m) SCORE.

Risk factor assessment algorithms, including the SCORE and the Framingham risk equation, are recommended worldwide as part of CVD risk management in the population at large.4 ,5 These equations allow for stratifying subjects into low, intermediate, high and very high risk groups. With regard to CVD risk management, lifestyle factors should be addressed in all individuals. The use of cardiovascular drugs, particularly antihypertensive and lipid-lowering agents should be considered in those at high or very high risk as these interventions markedly reduce CVD event rates in such persons. Patients with established CVD, diabetes and chronic kidney disease are at high or very high risk and hence, risk factor equation application is not indicated.

Nonetheless, approximately a third of CVD events are not attributable to major CVD risk factors.6 Congruent with this, although multiple risk factor equations are useful in determining the overall CVD risk among different populations, they often underestimate the actual risk in individual subjects. This is particularly evident in those who are at moderate risk according to major risk factor assessment equations.4 ,5 Consequently, based on …
Biomechanical factors as triggers of vascular growth
Authors: Imo E. Hoefer, Brigit den Adel, Mat J. A. P. Daemen
Journal: Cardiovascular Research (2013)

Haemodynamic factors influence all forms of vascular growth (vasculogenesis, angiogenesis, arteriogenesis). Because of its prominent role in atherosclerosis, shear stress has gained particular attention, but other factors such as circumferential stretch are equally important to maintain the integrity and to (re)model the vascular network. While these haemodynamic forces are crucial determinants of the appearance and the structure of the vasculature, they are in turn subjected to structural changes in the blood vessels, such as an increased arterial stiffness in chronic arterial hypertension and ageing. This results in an interplay between the various forces (biomechanical forces) and the involved vascular elements. Although many molecular mediators of biomechanical forces still need to be identified, there is plenty of evidence for the causal role of these forces in vascular growth processes, which will be summarized in this review. In addition, we will discuss the effects of concomitant diseases and disorders on these processes by altering either the biomechanics or their transduction into biological signals. Particularly endothelial dysfunction, diabetes, hypercholesterolaemia, and age affect mechanosensing and -transduction of flow signals, thereby underpinning their influence on cardiovascular health. Finally, current approaches to modify biomechanical forces to therapeutically modulate vascular growth in humans will be described.
Implanted depleted uranium fragments cause soft tissue sarcomas in the muscles of rats.
Authors: Fletcher F Hahn, Raymond A Guilmette, Mark D Hoover
Journal: Environmental Health Perspectives (2002)

In this study, we determined the carcinogenicity of depleted uranium (DU) metal fragments containing 0.75% titanium in muscle tissues of rats. The results have important implications for the medical management of Gulf War veterans who were wounded with DU fragments and who retain fragments in their soft tissues. We compared the tissue reactions in rats to the carcinogenicity of a tantalum metal (Ta), as a negative foreign-body control, and to a colloidal suspension of radioactive thorium dioxide ((232)Th), Thorotrast, as a positive radioactive control. DU was surgically implanted in the thigh muscles of male Wistar rats as four squares (2.5 x 2.5 x 1.5 mm or 5.0 x 5.0 x 1.5 mm) or four pellets (2.0 x 1.0 mm diameter) per rat. Ta was similarly implanted as four squares (5.0 x 5.0 x 1.1 mm) per rat. Thorotrast was injected at two sites in the thigh muscles of each rat. Control rats had only a surgical implantation procedure. Each treatment group included 50 rats. A connective tissue capsule formed around the metal implants, but not around the Thorotrast. Radiographs demonstrated corrosion of the DU implants shortly after implantation. At later times, rarifactions in the radiographic profiles correlated with proliferative tissue responses. After lifetime observation, the incidence of soft tissue sarcomas increased significantly around the 5.0 x 5.0 mm squares of DU and the positive control, Thorotrast. A slightly increased incidence occurred in rats implanted with the 2.5 x 2.5 mm DU squares and with 5.0 x 5.0 mm squares of Ta. No tumors were seen in rats with 2.0 x 1.0 mm diameter DU pellets or in the surgical controls. These results indicate that DU fragments of sufficient size cause localized proliferative reactions and soft tissue sarcomas that can be detected with radiography in the muscles of rats.
Study of lipid profile of trained and untrained population
Authors: Sunil Purohit, Rabindra Kumar, Kunjama Sebastian, Simarjeet Singh
Journal: British Journal of Sports Medicine (2010)

The aim of the present study was to determine the effect of competitive training on serum lipid profile. Three groups of subjects were studied, that is, walker (n = 11), boxers (n = 11) and sedentary subjects (n = 11). Triglycerides, cholesterol/HDL cholesterol ratio (C/H ratio), total cholesterol and its fractions – HDL, LDL and VLDL cholesterols were determined in serum by an enzymatic/colorimetric method. Result shows that sedentary subjects have least favourable concentrations of lipid profile. But a statistically significant difference of C/H ratio, LDL and HDL-cholesterol was found in walkers as compared with other groups. On the basis of the results we can conclude that competitive sport training has beneficial effect on serum lipid profile and endurance-directed activity has more favourable effects on lipid parameters.
Primary care groups and the right to prescribe Commentary: Bevan's covenant continues intact
Authors: C. Newdick, B. Hurwitz
Journal: BMJ (1998)

# Primary care groups and the right to prescribe {#article-title-2}

In matters of NHS funding, politicians tend to say one thing and health economists another. Governments commit themselves to the Hippocratic ethic that patients should be treated solely on the basis of need. But economic reality has always required us to make hard choices between deserving patients. Today we require a legal dimension to this tension. This article examines the general practitioner's legal duty to prescribe medicines.

The terms of service of general practitioners impose a duty to prescribe on the basis of need. Yet, primary care groups will be expected to operate within a “cash limited envelope.” Is this duty to prescribe dependent on patients' needs or limited by available resources? Will it be lawful to deny access to effective but expensive medicine on grounds of cost? As patients litigate for NHS resources, general practitioners need to know who is to blame when patients are denied access to expensive medicines.

What are the rights and duties of general practitioners to prescribe medicines to their patients? Since the start of the NHS doctors have been assured that the principle of legitimate clinical freedom will be preserved. In 1948, Ernest Bevan promised doctors “all the facilities, resources, apparatus and help I can, and then to leave you alone as professional men and women to use your skills and judgment without hindrance.”1 And in the new white paper, the present government “has committed itself to the historic principle of the NHS: that if you are ill or injured there will be a national health service there to help; and access to it will be based on need and need alone.”2

But the pressure imposed by scarce resources is not always consistent with political rhetoric. In addition, the proposals to create primary care groups will require general practitioners to manage NHS …
Peak expiratory flow variation and bronchial hyperresponsiveness in asthmatic children during periods of antigen avoidance and reexposure
Authors: E. A. Valletta, A. Comis, G. Del Col, E. Spezia, A. L Boner
Journal: Allergy (1995)

Changes of diurnal variation of peak expiratory flow rate (%PEF variation) and their relationship with bronchial hyperresponsiveness (BHR) to methacholine (PC20) were evaluated in 12 children with mild-to-moderate asthma and house-dust mite allergy, during successive periods of stay in a mite-free environment at high altitude (1756 m) and at their home at sea level. The children remained at the high altitude from October until the end of December; then they spent a 3-week period at home and returned to high altitude residence in January. PEF was measured daily, in the morning and in the evening, during the 3 months' stay at high altitude and them for 10 days after the return in January. PC20 was assessed in 8/12 children, once a month from October to December, and at the return in January. Mean absolute PEF values did not change significantly throughout the study. From October to December, patients showed a significant decrease of mean %PEF variation (P = 0.04), while PC20 showed an increase (P = 0.05). After the 3 weeks at home, both %PEF variation (P = 0.03) and PC20 (P = 0.05) significantly worsened. The correlation between PC20 values and mean %PEF variation in the 2 days before and after each methacholine test was r = -0.63 (P = 0.001). Our data suggest that there is a beneficial effect of a prolonged stay in a mite-free environment, on both PEF variability and BHR, also in asthmatic children with good pulmonary function. PEF variability and bronchial responsiveness to methacholine were significantly correlated also for small changes of the two variables.
E2F8 Contributes to Human Hepatocellular Carcinoma via Regulating Cell Proliferation
Authors: Qing Deng, Qun Wang, Wei-Ying Zong, Da-Li Zheng, Yi-Xin Wen, Ke-Sheng Wang, Xiao-Mei Teng, Xin Zhang, Jian Huang, Ze-Guang Han
Journal: Cancer Research (2010)

Abstract The E2F family member of transcription factors includes the atypical member E2F8, which has been little studied in cancer. We report that E2F8 is strongly upregulated in human hepatocellular carcinoma (HCC), where it was evidenced to contribute to oncogenesis and progression. Ectopic overexpression of E2F8 promoted cell proliferation, colony formation, and tumorigenicity, whereas E2F8 knockdown inhibited these phenotypes, as documented in Huh-7, Focus, Hep3B, and YY-8103 HCC cell lines. Mechanistic analyses indicated that E2F8 could bind to regulatory elements of cyclin D1, regulating its transcription and promoting accumulation of S-phase cells. Together, our findings suggest that E2F8 contributes to the oncogenic potential of HCC and may constitute a potential therapeutic target in this disease. Cancer Res; 70(2); 782–91
Study of traumatic extrathoracic lesions associated with lung contusions
Authors: Voicu Voiculescu, Ovidiu Burlacu, Gabriel Cozma, Calin Tunea, Iris Miron, Alexandru Nicodin
Journal: European Respiratory Journal (2011)

Objectives:  This study brings an original contribution in setting some extrathoracic lesion associations according to lung contusions9 extent, aspects that have not been fully discussed in the medical literature.   Methods:  We analyze 253 lung contusion cases, from the point of view of 89 variable categories, within the context of 1353 thoracic traumas. The data were analyzed by the statistical processing system SPSS 15.0 for Windows.   Results:  This study proves that the cranial traumas are associated with extensive lung contusions (Chi-Square Tests 0,464), while the upper limb traumas are associated with limited lung contusions (Chi-Square Tests 0,711). Abdominal traumas are also associated with limited lung contusions (Chi-Square Tests 0,862). This aspects suggest a certain pattern in lung contusion induction, and they represent important etiopathogenical elements.  The clinical use of the results has an improved prognostic capacity according to the described associations. The existence of an extrathoracic lesion warns on a possible lung contusion of a certain extension and it justifies subsequent various radiological investigations in order to make it evident in complicated cases.   Conclusions:  According to this study data, cranial traumas are frequently associated with extensive lung contusions in polytrauma cases. If the lung contusion is not shown by the first thoracic radiography, subsequent Rx studies or CT scans are needed, especially in the complicated cases.
Early Use of TIPS in Patients with Cirrhosis and Variceal Bleeding
Authors: Juan Carlos García-Pagán, Karel Caca, Christophe Bureau, Wim Laleman, Beate Appenrodt, Angelo Luca, Juan G. Abraldes, Frederik Nevens, Jean Pierre Vinel, Joachim Mössner, Jaime Bosch
Journal: New England Journal of Medicine (2010)

Patients with cirrhosis in Child-Pugh class C or those in class B who have persistent bleeding at endoscopy are at high risk for treatment failure and a poor prognosis, even if they have undergone rescue treatment with a transjugular intrahepatic portosystemic shunt (TIPS). This study evaluated the earlier use of TIPS in such patients.We randomly assigned, within 24 hours after admission, a total of 63 patients with cirrhosis and acute variceal bleeding who had been treated with vasoactive drugs plus endoscopic therapy to treatment with a polytetrafluoroethylene-covered stent within 72 hours after randomization (early-TIPS group, 32 patients) or continuation of vasoactive-drug therapy, followed after 3 to 5 days by treatment with propranolol or nadolol and long-term endoscopic band ligation (EBL), with insertion of a TIPS if needed as rescue therapy (pharmacotherapy-EBL group, 31 patients).During a median follow-up of 16 months, rebleeding or failure to control bleeding occurred in 14 patients in the pharmacotherapy-EBL group as compared with 1 patient in the early-TIPS group (P=0.001). The 1-year actuarial probability of remaining free of this composite end point was 50% in the pharmacotherapy-EBL group versus 97% in the early-TIPS group (P<0.001). Sixteen patients died (12 in the pharmacotherapy-EBL group and 4 in the early-TIPS group, P=0.01). The 1-year actuarial survival was 61% in the pharmacotherapy-EBL group versus 86% in the early-TIPS group (P<0.001). Seven patients in the pharmacotherapy-EBL group received TIPS as rescue therapy, but four died. The number of days in the intensive care unit and the percentage of time in the hospital during follow-up were significantly higher in the pharmacotherapy-EBL group than in the early-TIPS group. No significant differences were observed between the two treatment groups with respect to serious adverse events.In these patients with cirrhosis who were hospitalized for acute variceal bleeding and at high risk for treatment failure, the early use of TIPS was associated with significant reductions in treatment failure and in mortality. (Current Controlled Trials number, ISRCTN58150114.)
Suprascapular neuropathy in volleyball players
Authors: E Witvrouw, A Cools, R Lysens, D Cambier, G Vanderstraeten, J Victor, C Sneyers, M Walravens
Journal: British Journal of Sports Medicine (2000)

Suprascapular nerve entrapment with isolated paralysis of the infraspinatus muscle is uncommon. However, this pathology has been reported in volleyball players. Despite a lack of scientific evidence, excessive strain on the nerve is often cited as a possible cause of this syndrome. Previous research has shown a close association between shoulder range of motion and strain on the suprascapular nerve. No clinical studies have so far been designed to examine the association between excessive shoulder mobility and the presence of this pathology.To study the possible association between the range of motion of the shoulder joint and the presence of suprascapular neuropathy by clinically examining the Belgian male volleyball team with respect to several parameters.An electromyographic investigation, a clinical shoulder examination, shoulder range of motion measurements, and an isokinetic concentric peak torque shoulder internal/external rotation strength test were performed in 16 professional players.The electrodiagnostic study showed a severe suprascapular neuropathy in four players which affected only the infraspinatus muscle. In each of these four players, suprascapular nerve entrapment was present on the dominant side. Except for the hypotrophy of the infraspinatus muscle, no significant differences between the affected and non-affected players were observed on clinical examination. Significant differences between the affected and non-affected players were found for range of motion measurements of external rotation, horizontal flexion and forward flexion, and for flexion of the shoulder girdle (protraction); all were found to be higher in the affected players than the non-affected players.This study suggests an association between increased range of motion of the shoulder joint and the presence of isolated paralysis of the infraspinatus muscle in volleyball players. However, the small number of patients in this study prevents definite conclusions from being drawn.
Phase I study of proteasome inhibitor bortezomib plus CHOP in patients with advanced, aggressive T-cell or NK/T-cell lymphoma
Authors: J. Lee, C. Suh, H.J. Kang, B.-Y. Ryoo, J. Huh, Y.H. Ko, H.-S. Eom, K. Kim, K. Park, W.S. Kim
Journal: Annals of Oncology (2008)
1043 IN HEPATOCELLULAR CARCINOMA miR-494 IS REGULATED BY EPIGENETIC MECHANISMS AND TARGETS p27, PTEN AND PUMA
Authors: F. Fornari, M. Milazzo, E. Callegari, M. Negrini, M. Galassi, S. Marinelli, L. Gramantieri, L. Bolondi
Journal: Journal of Hepatology (2013)
Propofol versus midazolam/fentanyl for outpatient colonoscopy: administration by nurses supervised by endoscopists
Authors: Brian J. Ulmer, Jonathan J. Hansen, Christine A. Overley, Michelle R. Symms, Vidyasree Chadalawada, Suthat Liangpunsakul, Eloise Strahl, April M. Mendel, Douglas K. Rex
Journal: Clinical Gastroenterology and Hepatology (2003)
A phase III randomised study comparing two differentdose-intensity regimens as induction chemotherapy followedby thoracic irradiation in patients with advanced locoregionalnon-small-cell lung cancer
Authors: J.-P. Sculier, J.-J. Lafitte, T. Berghmans, P. Van Houtte, J. Lecomte, J. Thiriaux, A. Efremidis, G. Koumakis, V. Giner, M. Richez, J.-L. Corhay, P. Wackenier, P. Lothaire, M. Paesmans, P. Mommen, V. Ninane
Journal: Annals of Oncology (2004)
Exacerbations of COPD: quantifying the patient's perspective using discrete choice modelling
Authors: J. Haughney, M. R. Partridge, C. Vogelmeier, T. Larsson, R. Kessler, E. Ståhl, R. Brice, C-G. Löfdahl
Journal: European Respiratory Journal (2005)

Patient-centred care is the current vogue in chronic obstructive pulmonary disease (COPD), but it is only recently that robust techniques have become available to determine patients' values and preferences. In this international cross-sectional study, patients' concerns and expectations regarding COPD exacerbations were explored using discrete choice modelling. A fractional factorial design was used to develop scenarios comprising a combination of levels for nine different attributes. In face-to-face interviews, patients were presented with paired scenarios and asked to choose the least preferable. Multinomial logit (with hierarchical Bayes) methods were used to estimate utilities. A total of 125 patients (82 males; mean age 66 yrs; 4.6 mean exacerbations·yr −1 ) were recruited. The attributes of exacerbations considered most important were impact on everyday life (20%), need for medical care (16%), number of future attacks (12%) and breathlessness (11%). The next most important attributes were speed of recovery, productive cough and social impact (all 9%), followed by sleep disturbance and impact on mood (both 7%). Importantly, analysis of utility shifts showed that patients most feared being hospitalised, housebound or bedridden. These issues were more important than symptom improvement. Strategies for the clinical management of chronic obstructive pulmonary disease should clearly address patients' concerns and focus on preventing and treating exacerbations to avoid these feared outcomes.
Expression of CXCR4 Predicts Poor Prognosis in Patients with Malignant Melanoma
Authors: Stefania Scala, Alessandro Ottaiano, Paolo Antonio Ascierto, Manuela Cavalli, Ester Simeone, Paola Giuliano, Maria Napolitano, Renato Franco, Gerardo Botti, Giuseppe Castello
Journal: Clinical Cancer Research (2005)

Abstract Purpose: CXCR4 receptor and its unique ligand, the CXCL12 chemokine, have been recently implicated in cancer metastasis. Evidence about the role of CXCR4/CXCL12 axis has been reported in several cancers including melanoma. Our goal was to investigate if CXCR4 expression has a prognostic value in malignant melanoma. Experimental Design: Immunohistochemical expression of CXCR4 was evaluated on 71 specimens of primary cutaneous melanoma with a Breslow tumor thickness of &amp;gt;1 mm after radical resection. Associations between baseline patient features and tumors were analyzed by χ2 test. The prognostic value of CXCR4 expression was evaluated by univariate and multivariate analyses adjusted by age, sex, Breslow tumor thickness, presence of ulceration, and sentinel lymph node metastases. Results: CXCR4 expression was detected in 31 of 71 (43.6%) primary cutaneous melanomas. Membrane or cytoplasmic staining for CXCR4 protein was absent in 56% of the tumors. The positive cases were divided into three score classes according to their staining: low in 15 cases (21%), moderate in 10 (14%), and high in 6 (8%). After a median follow-up of 38 months, 26 patients progressed (16 of 26 expressed CXCR4) and 19 died (12 of 19 expressed CXCR4). The CXCR4 expression on tumor cells was correlated with an unfavorable prognosis with a median disease-free and overall survival of 22 and 35 months, respectively. The hazard ratios of relapse and death, compared with patients with CXCR4-negative tumors, were 2.5 (95% confidence interval, 1.2-6.1) and 3.1 (95% confidence interval, 1.1-7.2), respectively. Median time-to-event (progression and survival) was not reached in patients with CXCR4-negative tumors. In the multivariate analysis, CXCR4 expression, presence of ulceration, and sentinel lymph node status emerged as independent prognostic factors. Conclusions: This article provides the first evidence that CXCR4 expression could be an independent and powerful prognostic marker in primary cutaneous malignant melanomas.