tbuckley/cabot-search huggingface dataset:
Uterine Rupture by Intended Mode of Delivery in the UK: A National Case-Control Study
Authors: Kathryn E. Fitzpatrick, Jennifer J. Kurinczuk, Zarko Alfirevic, Patsy Spark, Peter Brocklehurst, Marian Knight
Journal: PLoS Medicine (2012)

Recent reports of the risk of morbidity due to uterine rupture are thought to have contributed in some countries to a decrease in the number of women attempting a vaginal birth after caesarean section. The aims of this study were to estimate the incidence of true uterine rupture in the UK and to investigate and quantify the associated risk factors and outcomes, on the basis of intended mode of delivery.A UK national case-control study was undertaken between April 2009 and April 2010. The participants comprised 159 women with uterine rupture and 448 control women with a previous caesarean delivery. The estimated incidence of uterine rupture was 0.2 per 1,000 maternities overall; 2.1 and 0.3 per 1,000 maternities in women with a previous caesarean delivery planning vaginal or elective caesarean delivery, respectively. Amongst women with a previous caesarean delivery, odds of rupture were also increased in women who had ≥ two previous caesarean deliveries (adjusted odds ratio [aOR] 3.02, 95% CI 1.16-7.85) and <12 months since their last caesarean delivery (aOR 3.12, 95% CI 1.62-6.02). A higher risk of rupture with labour induction and oxytocin use was apparent (aOR 3.92, 95% CI 1.00-15.33). Two women with uterine rupture died (case fatality 1.3%, 95% CI 0.2-4.5%). There were 18 perinatal deaths associated with uterine rupture among 145 infants (perinatal mortality 124 per 1,000 total births, 95% CI 75-189).Although uterine rupture is associated with significant mortality and morbidity, even amongst women with a previous caesarean section planning a vaginal delivery, it is a rare occurrence. For women with a previous caesarean section, risk of uterine rupture increases with number of previous caesarean deliveries, a short interval since the last caesarean section, and labour induction and/or augmentation. These factors should be considered when counselling and managing the labour of women with a previous caesarean section.
TREATMENT OF VENTRICULAR ARRHYTHMIAS AFTER RECOVERY FROM MYOCARDIAL INFARCTION
Authors: L. Brent Mitchell, M.D
Journal: Annual Review of Medicine (1994)

▪ Abstract Demonstrated associations between postmyocardial infarction ventricular arrhythmias and a higher subsequent risk of both sudden and all-cause mortality have prompted a search for effective and safe treatment modalities. Recently completed clinical trials have provided a rationale for treatment recommendations in some specific settings. Beta-blocking therapy is recommended for postinfarction patients with frequent or complex ventricular premature beats. In contrast, calcium antagonist therapy is not helpful in these cases, and Class I antiarrhythmic therapy is actually harmful. Early indications of benefit from Class III antiarrhythmic therapies, particularly amiodarone, are under evaluation in large trials. Patients with sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) occuring late after myocardial infarction require therapy. Viable therapeutic methods include individualized antiarrhythmic therapy selected by the noninvasive approach, individualized antiarrhythmic therapy selected by the invasive approach, empiric amiodarone therapy, transcatheter or surgical ablative therapy (for VT), and use of an implantable cardioverter defibrillator. Clinical trial data have yet to determine which of these approaches is most effective under which circumstances. Postinfarction patients with nonsustained VT are the focus of several ongoing treatment trials. Early data suggest that risks requiring specific therapy are reached only by those patients who also have significant left ventricular dysfunction. The presence of inducible sustained ventricular tachycardia at an electrophysiologic study may further risk stratify such patients. High-risk patients with nonsustained ventricular tacycardia, left ventricular dysfunction, and inducible sustained ventricular tachycardia should participate in ongoing clinical trials. In the absence of this opportunity, intensive treatment should be considered.
The Case of the "Beeping" Heart
Authors: Fred K. Nakhjavan
Journal: JAMA (1968)

<h3>To the Editor:—</h3> The extracardiac origin of chest sounds synchronous with heart beat is well established. Most of the reported cases have had supradiaphragmatic pathologic conditions, ie, mediastinal emphysema, pneumothorax, lung interstitial emphysema, pneumopericardium, air embolism, and hiatus hernia.<sup>1</sup>Recently we examined a patient with an unusual chest sound, which was easily heard several feet away from the patient, in whom the gas bubble in splenic flexure seemed to be the cause. <h3>Report of a Case:—</h3> The patient was 10 years old, and she had been referred because of a murmur discovered four months previously during the course of an apparently insignificant gastrointestinal tract illness. However, for approximately nine months the patient had been aware of a phenomenon which she described quite simply: "I beep." The parents also had noted the sound and described it as "like a radio signal." It could be heard from a distance, occurred at
Genetic Determination of the Hypothalamic-Pituitary-Thyroid Axis: Where Do We Stand?
Authors: Marco Medici, W. Edward Visser, Theo J. Visser, Robin P. Peeters
Journal: Endocrine Reviews (2015)

For a long time it has been known that both hypo- and hyperthyroidism are associated with an increased risk of morbidity and mortality. In recent years, it has also become clear that minor variations in thyroid function, including subclinical dysfunction and variation in thyroid function within the reference range, can have important effects on clinical endpoints, such as bone mineral density, depression, metabolic syndrome, and cardiovascular mortality. Serum thyroid parameters show substantial interindividual variability, whereas the intraindividual variability lies within a narrow range. This suggests that every individual has a unique hypothalamus-pituitary-thyroid axis setpoint that is mainly determined by genetic factors, and this heritability has been estimated to be 40–60%. Various mutations in thyroid hormone pathway genes have been identified in persons with thyroid dysfunction or altered thyroid function tests. Because these causes are rare, many candidate gene and linkage studies have been performed over the years to identify more common variants (polymorphisms) associated with thyroid (dys)function, but only a limited number of consistent associations have been found. However, in the past 5 years, advances in genetic research have led to the identification of a large number of new candidate genes. In this review, we provide an overview of the current knowledge about the polygenic basis of thyroid (dys)function. This includes new candidate genes identified by genome-wide approaches, what insights these genes provide into the genetic basis of thyroid (dys)function, and which new techniques will help to further decipher the genetic basis of thyroid (dys)function in the near future.
Traffic exposure and lung function in adults: the Atherosclerosis Risk in Communities study
Authors: H. Kan, G. Heiss, K. M Rose, E. Whitsel, F. Lurmann, S. J London
Journal: Thorax (2007)

<b>Background:</b> Traffic exposure is a major contributor to ambient air pollution for people living close to busy roads. The relationship between traffic exposure and lung function remains inconclusive in adults. <b>Methods:</b> A cross-sectional study was conducted to investigate the association between traffic exposure and lung function in the Atherosclerosis Risk in Communities (ARIC) study, a community based cohort of 15 792 middle aged men and women. Traffic density and distance to major roads were used as measures of traffic exposure. <b>Results:</b> After controlling for potential confounders including demographic factors, personal and neighbourhood level socioeconomic characteristics, cigarette smoking and background air pollution, higher traffic density was significantly associated with lower forced expiratory volume in 1 s (FEV<sub>1</sub>) and forced vital capacity (FVC) in women. Relative to the lowest quartile of traffic density, the adjusted differences across increasing quartiles were 5.1, −15.4 and −21.5 ml for FEV<sub>1</sub> (p value of linear trend across the quartiles = 0.041) and 1.2, −23.4 and −34.8 ml for FVC (p trend = 0.010). Using distance from major roads as a simpler index of traffic related air pollution exposure, the FEV<sub>1</sub> was −15.7 ml (95% CI −34.4 to 2.9) lower and the FVC was −24.2 ml (95% CI −46.2 to −2.3) lower for women living within 150 m compared with subjects living further away. There was no significant effect of traffic density or distance to major roads on lung function in men. The FEV<sub>1</sub>/FVC ratio was not significantly associated with traffic exposure in either men or women. <b>Conclusions:</b> This is the largest published study of traffic exposure and pulmonary function in adults to date. These results add to growing evidence that chronic exposure to traffic related air pollution may adversely affect respiratory health.
Troubles with the foreskin: one hundred consecutive referrals to paediatric surgeons
Authors: J S Huntley, M C Bourne, F D Munro, D Wilson-Storey
Journal: Journal of the Royal Society of Medicine (2003)

To assess the reasons for and outcomes of referrals concerning the foreskin, 100 consecutive patients seen in paediatric clinics were followed to discharge. 18 referrals were for circumcision on religious grounds. Of the other 82, the main reason for referral was non-retractability or phimosis. At clinic, 24 (29%) of these were deemed normal for age, 31 (38%) were treated with topical steroid (successfully in 25), 9 (11%) were listed for preputioplasty, 7 (9%) were listed for adhesiolysis, 7 (9%) were listed for circumcision, and 4 were listed for other forms of surgery. 6 patients were identified as having balanitis xerotica obliterans (BXO), a condition that had not been suggested on referral. With the advent of new treatments for foreskin disorders, circumcision is decreasingly necessary. Knowledge of the natural history of the foreskin, and the use of topical steroids, could shift the management of paediatric foreskin problems from the hospital outpatient department to primary care. BXO is not sufficiently recognized as a form of phimosis that requires operation.
Role of European mitochondrial DNA haplogroups in the prevalence of hip osteoarthritis in Galicia, Northern Spain
Authors: I Rego, M Fernández-Moreno, C Fernández-López, J J Gómez-Reino, A González, J Arenas, F J Blanco
Journal: Annals of the Rheumatic Diseases (2009)

Objective: To analyse the mitochondrial DNA (mtDNA) haplogroups of patients with hip osteoarthritis (OA) and those of healthy controls in a Spanish population. Methods: mtDNA haplogroups were assigned to 550 cases of hip OA and 505 clinically asymptomatic controls. Sets of controls with healthy knees and hips (n = 179) and patients with knee and/or hip OA (n = 977) were also analysed in a multivariate analysis after adjusting for sex, age and smoking. Results: Individuals carrying haplogroup J showed a significantly decreased risk of developing hip OA (OR 0.661; 95% CI 0.440 to 0.993; p = 0.045). In addition to haplogroup J, smoking protected against the development of hip OA (OR 0.543; 95% CI 0.311 to 0.946; p = 0.031). However, no relationship was found between rheumatoid arthritis and mtDNA haplogroups. Conclusion: The results of this study support the hypothesis that the mtDNA haplogroups have a role in the complex osteoarthritic process.
Limits of commercial molecular tests for diagnosis of pulmonary tuberculosis
Authors: L Lebrun, D Mathieu, C Saulnier, P Nordmann
Journal: European Respiratory Journal (1997)

Several studies report high specificity, but variable sensitivity, of Amplified Mycobacterium tuberculosis Direct Test (AMTDT, Gen-Probe) based on ribosomal ribonucleic acid (rRNA) amplification and Amplicor Mycobacterium tuberculosis test (Amplicor, Roche) based on deoxyribonucleic acid (DNA) amplification for diagnosis of pulmonary tuberculosis. We have retrospectively evaluated these assays on selected acid-fast bacilli (AFB)-positive and -negative smear specimens and compared the results obtained from nucleic acid amplification with those of AFB staining of semi-quantitative cultures as determined by radiometric Bactec and Lowenstein-Jensen cultures. In comparison to cultures, Amplicor and AMTDT assays exhibited identical overall sensitivities of 80%, while the staining had a lower sensitivity of 62%. The sensitivities of Amplicor and AMTDT were 98% and 100%, respectively, for the AFB-positive specimens, and 50 and 46%, respectively for the AFB-negative specimens in comparison to cultures. The sensitivities of both assays appeared similar, and were directly related to the number of bacilli in the specimens studied. The low sensitivity (50%) for smear-negative specimens showed that current amplification assays may be unsuitable to replace cultures for diagnosis of tuberculosis. The decision to perform these molecular techniques should result from close co-operation between clinicians and microbiologists, taking into account the sensitivity results reported here, as well as the expense of the assays.
Effect of Socioeconomic Status on Mortality Among People With Type 2 Diabetes
Authors: Jeremy J. Walker, Shona J. Livingstone, Helen M. Colhoun, Robert S. Lindsay, John A. McKnight, Andrew D. Morris, John R. Petrie, Sam Philip, Naveed Sattar, Sarah H. Wild
Journal: Diabetes Care (2011)

The study objective was to describe the effect of socioeconomic status (SES) on mortality among people with type 2 diabetes.We used a population-based national electronic diabetes database for 35- to 84-year-olds in Scotland for 2001-2007 linked to mortality records. SES was derived from an area-based measure with Q5 and Q1 representing the most deprived and affluent quintiles, respectively. Poisson regression was used to estimate relative risks (RRs) for mortality among people with type 2 diabetes compared with the population without diabetes stratified by age (35-64 and 65-84 years), sex, duration of diabetes (< 2 and ≥ 2 years), and SES.Complete data were available for 210,994 eligible individuals (99.4%), and there were 33,842 deaths. Absolute mortality from all causes among people with type 2 diabetes increased with increasing age and socioeconomic deprivation and was higher for men than women. RR for mortality associated with type 2 diabetes was highest for women aged 35-64 years in Q1 with diabetes duration < 2 years at 4.83 (95% CI 3.15-7.40) and lowest for men aged 65-84 years in Q5 with diabetes duration ≥ 2 years at 1.13 (1.03-1.24).SES modifies the association between type 2 diabetes and mortality so that RR for mortality is lower among more deprived populations. Age, sex, and duration of diabetes also interact with type 2 diabetes to influence RR of mortality. Differences in prevalence of comorbidities may explain these findings.
Eradication of Helicobacter pylori in patients with duodenal ulcer lowers basal and peak acid outputs to gastrin releasing peptide and pentagastrin.
Authors: A W Harris, P A Gummett, J J Misiewicz, J H Baron
Journal: Gut (1996)

Patients with duodenal ulcer (DU) have high basal (BAO) and peak (PAO) acid outputs. The effect of Helicobacter pylori eradication on these variables is unclear.To discover if gastric acid hypersecretion in patients with DU is caused by H pylori.BAO, gastrin releasing peptide (GRP), and pentagastrin stimulated PAO in 10 H pylori negative controls, and in 10 H pylori positive patients with DU was measured before and six months after H pylori eradication. H pylori status was determined by histology, culture, and by the 13C-urea breath test. After collecting a 30 minute basal aspirate, GRP 40 pmol/kg/h was infused for 45 minutes, and after a 30 minute washout, pentagastrin 6 micrograms/kg was injected intramuscularly.Basal and stimulated acid output (PAOGRP and PAOPg) were significantly higher in H pylori positive DU than in H pylori negative controls. Six months after H pylori eradication, basal and stimulated acid outputs were all significantly lower than before H pylori eradication.This study has shown that BAO, PAOGRP, and PAOPg are higher in H pylori positive DU than in H pylori negative controls. All decreased significantly six months after H pylori eradication, to fall within the range of controls. These results are compatible with a hypothesis that acid hypersecretion in duodenal ulcer disease is caused by H pylori infection.
Donor characteristics as risk factors in recipients after transplantation of bone marrow from unrelated donors: the effect of donor age
Authors: Craig Kollman, Craig W. S. Howe, Claudio Anasetti, Joseph H. Antin, Stella M. Davies, Alexandra H. Filipovich, Janet Hegland, Naynesh Kamani, Nancy A. Kernan, Roberta King, Voravit Ratanatharathorn, Daniel Weisdorf, Dennis L. Confer
Journal: Blood (2001)
Detection of skin cancer margins in Mohs excisions with high-speed strip mosaicing confocal microscopy: a feasibility study
Authors: B. Larson, S. Abeytunge, E. Seltzer, M. Rajadhyaksha, K. Nehal
Journal: British Journal of Dermatology (2013)

Fluorescence confocal mosaicing microscopy is an emerging technology for rapid imaging of nuclear and morphological detail directly in excised tissue, without the need for frozen or fixed section processing. Basal cell carcinomas (BCCs) can be detected with high sensitivity and specificity in Mohs excisions with this approach. For translation to clinical trials and towards potentially routine implementation, a new and faster approach called strip mosaicing confocal microscopy was recently developed.To perform a preliminary assessment of fluorescence strip mosaicing confocal microscopy for detecting skin cancer margins in Mohs excisions.Tissue samples from 17 Mohs cases were imaged in the form of strip mosaics. Each mosaic was divided into two halves (submosaics) and graded by a Mohs surgeon and a dermatologist who were blinded to the pathology. The 34 submosaics were compared with the corresponding Mohs pathology.The overall image quality was excellent for resolution, contrast and stitching in the 34 submosaics. Components of normal skin including the epidermis, dermis, dermal appendages and subcutaneous tissue were easily visualized. The preliminary measures of sensitivity and specificity were both 94% for detecting skin cancer margins.The new strip mosaicing approach represents another advance in confocal microscopy for imaging of large areas of excised tissue. Strip mosaicing may enable rapid assessment of BCC margins in fresh excisions during Mohs surgery and may serve as an adjunct to frozen pathology.
Population prevalence of COPD
Authors: M. R. Sears
Journal: European Respiratory Journal (2007)

Population prevalence of COPDTo the Editors:The study by SHIRTCLIFFE et al. [1] discusses the use of various definitions of abnormal spirometric results to estimate the prevalence of chronic obstructive pulmonary disease in New Zealand and raises a major question that is not addressed in the analyses.Childhood asthma is common and can lead to a degree of irreversible airflow obstruction in adulthood.In another New Zealand study, based on the Dunedin longitudinal populationbased cohort, SEARS et al. [2] reported that persistent or relapsing childhood asthma was present in 26.9% of 26-yrold study subjects.This is not dissimilar to the prevalence of doctor-diagnosed asthma (24%) in subjects undergoing pulmonary function testing in the Wellington study.RASMUSSEN et al. [3] also reported that airway remodelling, based on an abnormal post-bronchodilator forced expiratory volume in one second/forced vital capacity ratio, determined as a ratio o2 SD below the mean for healthy age-and sex-matched individuals, was present in 22% of males and 10.5% of females with asthma at 26 yrs of age.It is likely, therefore, that a proportion of subjects determined by spirometry to have ''chronic obstructive pulmonary disease'' in the Wellington study [1] have asthma-related impairment of lung function.The prevalence of nonasthmarelated chronic obstructive pulmonary disease could be determined by excluding subjects with a history of doctordiagnosed asthma, and if so I suspect the actual prevalence of chronic obstructive pulmonary disease, especially in the younger age groups, reported by SHIRTCLIFFE et al. [1] as 5.6% in those aged ,40 yrs and 12% among nonsmokers, would then be significantly lower than reported.
Response to Letter Regarding Article, “Outcomes in Patients With De Novo Left Main Disease Treated With Either Percutaneous Coronary Intervention Using Paclitaxel-Eluting Stents or Coronary Artery Bypass Graft Treatment in the Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX) Trial”
Authors: Marie-Claude Morice
Journal: Circulation (2011)
Multicenter retrospective analysis of metastatic colorectal cancer (CRC) with high-level microsatellite instability (MSI-H)
Authors: J. Goldstein, B. Tran, J. Ensor, P. Gibbs, H.L. Wong, S.F. Wong, E. Vilar, J. Tie, R. Broaddus, S. Kopetz, J. Desai, M.J. Overman
Journal: Annals of Oncology (2014)
Clinical features and virological analysis of a case of Middle East respiratory syndrome coronavirus infection
Authors: Christian Drosten, Michael Seilmaier, Victor M Corman, Wulf Hartmann, Gregor Scheible, Stefan Sack, Wolfgang Guggemos, Rene Kallies, Doreen Muth, Sandra Junglen, Marcel A Müller, Walter Haas, Hana Guberina, Tim Röhnisch, Monika Schmid-Wendtner, Souhaib Aldabbagh, Ulf Dittmer, Hermann Gold, Petra Graf, Frank Bonin, Andrew Rambaut, Clemens-Martin Wendtner
Journal: The Lancet Infectious Diseases (2013)
From probiotics to therapeutics: another step forward?
Authors: Fayez K. Ghishan, Pawel R. Kiela
Journal: Journal of Clinical Investigation (2011)

Preclinical studies with probiotics continue to unravel mechanisms of cytoprotection and suggest that approaches utilizing microbial products as therapeutics in acute and chronic gastrointestinal disorders could be effective. However, clinical trials using these bacteria have thus far been inconsistent. In this issue of the JCI, Yan et al. describe a novel mechanism of cytoprotection by p40, a soluble product of Lactobacillus rhamnosus GG, mediated via EGFR. The efficacy of p40 in three models of chemically induced colitis indicates tremendous therapeutic potential, though this finding will need to be verified in human patients.
Late-breaking abstract: The influence of four weeks of beta2-adrenoceptor activation with oral terbutaline on body composition and skeletal muscle contractile properties in active men
Authors: Morten Hostrup, Anders Kalsen, Christoffer Haase, Jens Bangsbo, Vibeke Backer
Journal: European Respiratory Journal (2014)

Chronic beta2-adrenoceptor activation with beta2-agonists has been shown to induce muscle hypertrophy and modify contractile characteristics of skeletal muscles in rodents. In humans, these effects are unexplored. The purpose of the present study was to investigate the effect of four weeks of beta2-adrenoceptor activation with oral terbutaline on lean body mass and quadriceps contractile properties in active men. Eighteen men were randomly assigned in two groups (terbutaline, n=9 (TER) or placebo, n=9 (PLA)). Before and after four weeks of oral administration of 5 mg/30 kgbw terbutaline twice daily or placebo, subjects9 body composition were determined by dual X-ray absorbance. Furthermore, subjects9 VO2max and quadriceps contractile properties were measured before and after the intervention. After the intervention, lean body mass was 1.7±0.7 kg higher (P