tbuckley/cabot-search huggingface dataset:
Dermoscopy of lentigo maligna melanoma: report of 125 cases
Authors: P. Pralong, E. Bathelier, S. Dalle, N. Poulalhon, S. Debarbieux, L. Thomas
Journal: British Journal of Dermatology (2012)

Background Lentigo maligna melanoma (LMM) is the most common subtype of melanoma on the face. Its presentation may be quite subtle, particularly in early stages, and delayed diagnosis is common. Few dermoscopic studies have been performed and the main dermoscopic features of LMM were defined by Stolz and coworkers in 2000. Objectives To investigate classical as well as new dermoscopic features in a large series of LMM in a white-skinned population, in order to evaluate their diagnostic value. Methods One hundred and twenty-five consecutive histopathology-proven LMMs were analysed retrospectively based on medical records, clinical and dermoscopic photographs by three independent observers for the presence of 19 predefined criteria. Results At least one of the classical Stolz criteria was present in 87% of cases (hyperpigmented follicular opening, annular-granular pattern, pigmented rhomboidal structures, obliterated hair follicles). Three original criteria were also present at a relatively high frequency: increased density of the vascular network (58%), red rhomboidal structures (40%), target-like patterns (41%). Darkening at dermoscopic examination (when compared with naked-eye examination) was observed in 25% of lesions. Classical dermoscopic features of extrafacial melanoma (atypical pigment network, irregularly distributed globules, dots, streaks and pseudopods) and vertical growth phase-associated dermoscopic criteria (ulceration, blue papular areas and black structureless areas) were rarely seen. A large number of colours, pigmented rhomboidal structures, obliterated hair follicles and red rhomboidal structures were significantly more frequent in invasive LMMs. In contrast, in situ melanomas were more often associated with one or two colours and few distinctive dermoscopic features. Conclusions We present herein, in a large series of LMM, confirmation of the diagnostic value of the classical Stolz dermoscopic criteria and describe four additional original criteria, mainly vascular. A correlation between the presence of some dermoscopic features and thicker tumoral invasion has also been demonstrated.
Placental Growth Factor as a Predictor of Cardiovascular Events in Patients with CKD from the NARA-CKD Study
Authors: Masaru Matsui, Shiro Uemura, Yukiji Takeda, Ken-ichi Samejima, Takaki Matsumoto, Ayako Hasegawa, Hideo Tsushima, Ei Hoshino, Tomoya Ueda, Katsuhiko Morimoto, Keisuke Okamoto, Sadanori Okada, Kenji Onoue, Satoshi Okayama, Hiroyuki Kawata, Rika Kawakami, Naoki Maruyama, Yasuhiro Akai, Masayuki Iwano, Hideo Shiiki, Yoshihiko Saito
Journal: Journal of the American Society of Nephrology (2015)

Placental growth factor (PlGF) contributes to atherogenesis through vascular inflammation and plaque destabilization. High levels of PlGF may be associated with mortality and cardiovascular disease, but the relationship between PlGF level and adverse outcomes in patients with CKD is unclear. We conducted a prospective cohort study of 1351 consecutive participants with CKD enrolled in the Novel Assessment of Risk management for Atherosclerotic diseases in CKD (NARA-CKD) study between April 1, 2004, and December 31, 2011. During a median follow-up of 3 years, 199 participants died and 383 had cardiovascular events, defined as atherosclerotic disease or heart failure requiring hospitalization. In adjusted analyses, mortality and cardiovascular risk increased in each successive quartile of serum PlGF level; hazard ratios (HRs) (95% confidence intervals [95% CIs]) for mortality and cardiovascular risk, respectively, were 1.59 (0.83 to 3.16) and 1.55 (0.92 to 2.66) for the second quartile, 2.97 (1.67 to 5.59) and 3.39 (2.20 to 5.41) for the third quartile, and 3.87 (2.24 to 7.08) and 8.42 (5.54 to 13.3) for the fourth quartile. The composite end point of mortality and cardiovascular events occurred during the study period in 76.4% of patients in both the highest PlGF quartile (≥19.6 pg/ml) and the lowest eGFR tertile (<30 ml/min per 1.73 m(2)). The association between PlGF and mortality or cardiovascular events was not attenuated when participants were stratified by age, sex, traditional risk factors, and eGFR. These data suggest elevated PlGF is an independent risk factor for all-cause mortality and cardiovascular events in patients with CKD.
Fertility and pregnancy in the patient with inflammatory bowel disease
Authors: U Mahadevan
Journal: Gut (2005)

he majority of patients with inflammatory bowel disease (IBD) are affected during their peak reproductive years. 1 While initial concerns focus on attaining a durable remission and avoiding the side effects of medications, once in remission the focus often shifts to the effect of disease and the medications used to treat it on fertility and the ability to conceive a healthy child.This paper summarises the existing literature on the effects of ulcerative colitis (UC) and Crohn's disease (CD) and the medications used to treat it on fertility and pregnancy outcomes. GENETICS AND INHERITANCE cPatients are naturally concerned about passing their disease on to their offspring.Unfortunately, family history is the strongest predictor for developing IBD.If one parent is affected, the risks of the offspring developing IBD are 2-13 times higher than in the general population. 2 3 One study estimated that the risks of IBD in first degree relatives of probands with UC and CD were 1.6% and 5.2%, respectively, values that were even higher in the Jewish population. 4If both parents have IBD, the risk of their offspring developing IBD over their lifetime was estimated to be 36%. 5everal studies suggest that breastfeeding may be protective against the development of IBD in the infant.In a meta-analysis of 17 studies, the eight highest quality studies showed a pooled odds ratio of 0.45 (0.26, 0.79) for CD and 0.56 (0.38, 0.81) for UC. 6 However, these were not mothers who had IBD themselves.
Bosentan treatment in patients with primary pulmonary hypertension receiving nonparenteral prostanoids
Authors: M.M. Hoeper, N. Taha, A. Bekjarova, R. Gatzke, E. Spiekerkoetter
Journal: European Respiratory Journal (2003)

Primary pulmonary hypertension (PPH) is a life-threatening disease. Nonparenteral prostanoids, i.e. aerosolised iloprost or oral beraprost sodium show beneficial therapeutic effects but are not sufficiently active in all patients with this devastating disease. The purpose of the present study was to determine whether the endothelin-receptor antagonist bosentan is safe and effective in patients with PPH already receiving nonparenteral prostanoids. The effect of bosentan as add-on medication was studied in 20 patients with PPH, who received either inhaled iloprost (n=9) or oral beraprost (n=11) for a median period of 16±13 months, by means of the 6‐min walk test and cardiopulmonary exercise testing. After 3 months of administration of bosentan in addition to prostanoids, the walking distance in the 6‐min walk test increased by 58±43 m. Cardiopulmonary exercise testing revealed an increase in maximal oxygen consumption from 11.0±2.3 to 13.8±3.6 mL·kg −1 ·min −1 accompanied by significant improvements in anaerobic threshold, oxygen pulse and minute ventilation/carbon dioxide production slope. Peak systolic blood pressure increased from 120±17 to 139±21 mmHg. Combination treatment was well tolerated by all patients. It is concluded that the addition of the endothelin-receptor antagonist bosentan to inhaled iloprost or oral beraprost therapy appears to be safe for patients with primary pulmonary hypertension, resulting in a marked increase in exercise capacity. Therefore, rigorous studies should address whether combination treatment is more effective than either therapeutic intervention alone.
RCN general secretary may face "no confidence" vote
Authors: R. Coombes
Journal: BMJ (2002)

Beverly Malone, the general secretary of the Royal College of Nursing, may face a vote of “no confidence” by members after serious concerns about her behaviour.

Kentucky born Dr Malone, who came to the United Kingdom last year on a work permit to take up the post, was also due to be questioned about internal affairs by the union's ruling council this week.

Among the complaints against the nursing leader, a former aide to Bill Clinton, are that she pulled strings to enable her mother, a US citizen, to receive a quick cataract operation at an NHS hospital …
Evaluation of Long-Term Treatment Effect in a Type 1 Diabetes Intervention Trial: Differences After Stimulation With Glucagon or a Mixed Meal. Diabetes Care 2014;37:1384–1391. DOI: 10.2337/dc13-1392
Authors: Paolo Pozzilli, Itamar Raz, Dana Peled, Dana Elias, Ann Avron, Merana Tamir, Rachel Eren, Shlomo Dagan, Irun R. Cohen
Journal: Diabetes Care (2014)

On behalf of the authors identified below, the corresponding author has formally requested to retract the above-cited article. An accompanying article (1) has also been retracted.

The study described in this article uses data from the DIA-AID 1 trial on DiaPep277 to compare treatment effects in patients with type 1 diabetes. The DIA-AID 1 trial, as noted in the Duality of Interest section, was funded by Andromeda Biotech, Ltd.

On 8 September 2014, Hyperion Therapeutics, Inc., which acquired Andromeda Biotech in June 2014, announced that it had chosen to terminate the …
From trades to professions
Authors: N. Black
Journal: Journal of the Royal Society of Medicine (2007)

This is the last of four articles that provides the background to one of the walks in a new book, Walking London's Medical History, which aims to tell the story of how health services developed, to help preserve our legacy of buildings and to inform current debates about health care. Walking London's Medical History is available from the RSM Press website: http://www.rsmpress.co.uk/bkblack2.htm
Platelet interaction with bacteria. VI. Contrasting the role of fibrinogen and fibronectin
Authors: C. C. Clawson, James G. White, Mark C. Herzberg
Journal: American Journal of Hematology (1980)

Abstract The roles of fibrinogen and fibronectin were contasted in the responses of human platelets to Staphylococcus aureus and collagen. Congenital afibrinogenemic (CA) platelets and washed normal platelets had delayed aggregation due to a prolonged latent phase in response to contact with the bacteria when fibrinogen was absent from the suspending media. When a physiologic level of human fibrinogen was added to the CA platelets in autologous plasma or to the washed platelets in balanced saline, the times to aggregation were significantly shortened (P &lt; 0.05) and restored to rates comparable to those of normal platelets in whole plasma. In contrast, the presence or absence of fibrinogen in the media had no significant effect on the initial adherence and shape‐change response of CA or washed platelets to collagen. Platelets with a demonstrated aberration of fibronectin responded normally to all ratios of S aureus, but they responded only to doses of collagen that were several times the threshold levels for normal platelets. These results demonstrate an important role for fibrinogen as a cofactor in platelet interactions with S aureus and indicate that fibronectin is not a major factor in the responses of human platelets to this microorganism.
Prevalence of Dementia in Older Japanese-American Men in Hawaii
Authors: Lon White
Journal: JAMA (1996)

<h3>Objective.</h3> —To determine prevalence of dementia and its subtypes in Japanese-American men and compare these findings with rates reported for populations in Japan and elsewhere. <h3>Design and Setting.</h3> —The Honolulu Heart Program is a prospective populationbased study of cardiovascular disease established in 1965. Prevalence estimates were computed from cases identified at the 1991 to 1993 examination. Cognitive performance was assessed using standardized methods, instruments, and diagnostic criteria. <h3>Participants.</h3> —Subjects were 3734 Japanese-American men (80% of surviving cohort) aged 71 through 93 years, living in the community or in institutions. <h3>Main Outcome Measures.</h3> —Age-specific, age-standardized, and cohort prevalence estimates were computed for dementia (all cause) defined by 2 sets of diagnostic criteria and 4 levels of severity. Prevalence levels for Alzheimer disease and vascular dementia were also estimated. <h3>Results.</h3> —Dementia prevalence by<i>Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised</i>ranged from 2.1% in men aged 71 through 74 years to 33.4% in men aged 85 through 93 years. Age-standardized prevalence was 7.6%. Prevalence estimates for the cohort were 9.3% for dementia (all cause), 5.4% for Alzheimer disease (primary or contributing), and 4.2% for vascular dementia (primary or contributing). More than 1 possible cause was found in 26% of cases. The Alzheimer disease/vascular dementia ratio was 1.5 for cases attributed primarily to Alzheimer disease or vascular dementia. <h3>Conclusions.</h3> —Prevalence of Alzheimer disease in older Japanese-American men in Hawaii appears to be higher than in Japan but similar to European-ancestry populations. Prevalence of vascular dementia appears to be only slightly lower than in Japan, but higher than in European-ancestry populations. Further cross-national research with emphasis on standardized diagnostic methods is needed.
Abdominal Actinomycosis treated with Sulphapyridine
Authors: W. H. Ogilvie
Journal: BMJ (1940)

SULPHAPYRID1NE FOR ABDOMINAL ACTINOMYCOSIS TMiEBRITIS1 had been partially cleaned and treated with methyl-violet, and the patient died four days after admission.The average healing time with the silver-nitrate-tannic- acid method was three and a half weeks, and the aesthetic appearance of such scars was particularly gratifying.At the seventh week the recently grafted cases alone had not yet regained full movements of the fingers. SummaryThe principles of the treatment of burns, with special reference to the Dunkirk cases, are discussed.The importance of a prepared scheme of treatment, especially in war, is stressed.The silver-nitrate-tannic-acid method is strongly recom- mended.The use of plaster for the later treatment of deep burns is advocated.
The Challenge of Hepatitis C in the HIV-Infected Person
Authors: David L. Thomas
Journal: Annual Review of Medicine (2008)

Hepatitis C virus (HCV) coinfection occurs in an estimated one quarter of HIV-infected persons in Europe, Australia, and the United States. As use of highly active antiretroviral drugs has markedly reduced opportunistic infections, HCV-related liver disease has emerged as a leading cause of death. HIV infection adversely affects both the natural history and the treatment of hepatitis C. Because there are no experimental models of coinfection and because the pathogenesis of each infection is incompletely understood, how HIV infection alters hepatitis C is not clear. This review considers the epidemiology, natural history, treatment, and pathogenesis of hepatitis C in HIV-infected persons.
Migratory Activity of Circulating Mononuclear Cells Is Associated With Cardiovascular Mortality in Type 2 Diabetic Patients With Critical Limb Ischemia
Authors: Gaia Spinetti, Claudia Specchia, Orazio Fortunato, Elena Sangalli, Giacomo Clerici, Maurizio Caminiti, Flavio Airoldi, Sergio Losa, Costanza Emanueli, Ezio Faglia, Paolo Madeddu
Journal: Diabetes Care (2014)

Prediction of clinical outcome in diabetic patients with critical limb ischemia (CLI) is unsatisfactory. This prospective study investigates if the abundance and migratory activity of a subpopulation of circulating mononuclear cells, namely, CD45(dim)CD34(pos)CXCR4(pos)KDR(pos) cells, predict major amputation and cardiovascular death in type 2 diabetic patients undergoing percutaneous transluminal angioplasty for CLI.A consecutive series of 119 type 2 diabetic patients with CLI was enrolled. CD45(dim)CD34(pos)CXCR4(pos)KDR(pos) cells were assessed by flow cytometry upon isolation and also after spontaneous or stromal cell-derived factor 1α-directed migration in an in vitro assay. The association between basal cell counts and migratory activity and the risk of an event at 18-month follow-up was evaluated in a multivariable regression analysis.Time-to-event analysis of amputation (n = 13) showed no association with the candidate predictors. Sixteen cardiovascular deaths occurred during 18 months of follow-up. Abundance of CD45(dim)CD34(pos)CXCR4(pos)KDR(pos) cells was not associated with cardiovascular mortality. Interestingly, in vitro migration of CD45(dim)CD34(pos)CXCR4(pos)KDR(pos) cells was higher in patients with cardiovascular death compared with event-free subjects (percentage of migrated cells median value and interquartile range, 0.03 [0.02-0.07] vs. 0.01 [0.01-0.03]; P = 0.0095). Multivariable regression model analysis showed that cell migration forecasts cardiovascular mortality independently of other validated predictors, such as age, diagnosed coronary artery disease, serum C-reactive protein, and estimated glomerular filtration rate. In this model, doubling of migrated cell counts increases the cardiovascular death hazard by 100% (P < 0.0001).The new predictor could aid in the identification of high-risk patients with type 2 diabetes requiring special diagnostic and therapeutic care after revascularization.
Expanding global access to radiotherapy
Authors: Rifat Atun, David A Jaffray, Michael B Barton, Freddie Bray, Michael Baumann, Bhadrasain Vikram, Timothy P Hanna, Felicia M Knaul, Yolande Lievens, Tracey Y M Lui, Michael Milosevic, Brian O'Sullivan, Danielle L Rodin, Eduardo Rosenblatt, Jacob Van Dyk, Mei Ling Yap, Eduardo Zubizarreta, Mary Gospodarowicz
Journal: The Lancet Oncology (2015)
Switching from Insulin to Oral Sulfonylureas in Patients with Diabetes Due to Kir6.2 Mutations
Authors: Ewan R. Pearson, Isabelle Flechtner, Pål R. Njølstad, Maciej T. Malecki, Sarah E. Flanagan, Brian Larkin, Frances M. Ashcroft, Iwar Klimes, Ethel Codner, Violeta Iotova, Annabelle S. Slingerland, Julian Shield, Jean-Jacques Robert, Jens J. Holst, Penny M. Clark, Sian Ellard, Oddmund Søvik, Michel Polak, Andrew T. Hattersley
Journal: New England Journal of Medicine (2006)

Heterozygous activating mutations in KCNJ11, encoding the Kir6.2 subunit of the ATP-sensitive potassium (KATP) channel, cause 30 to 58 percent of cases of diabetes diagnosed in patients under six months of age. Patients present with ketoacidosis or severe hyperglycemia and are treated with insulin. Diabetes results from impaired insulin secretion caused by a failure of the beta-cell KATP channel to close in response to increased intracellular ATP. Sulfonylureas close the KATP channel by an ATP-independent route.
Clinical and biochemical disorders of the skeleton
Authors: J D Wark
Journal: British Journal of Sports Medicine (2006)

By Roger Smith, Paul Wordsworth. Published by Oxford University Press, 2005, £125.00, 471 pp, hardcover. ISBN 0192617400

For a book that looks relatively modest in size, this one is remarkably comprehensive. Perhaps the clear, concise, and fairly uncomplicated writing style has helped to achieve this outcome. The contents are as expected: background on bone biology and the investigation of bone and mineral disorders; a substantial discourse on osteoporosis; osteomalacia and rickets; parathyroid disorders; Paget’s disease; neoplastic disease and the skeleton; and osteogenesis imperfecta, followed by a scholarly presentation covering the wide range of uncommon-to-rare conditions afflicting the skeleton. The final chapter is entitled “Recent advances” and reviews a number of the exciting advances in bone research in the year or so prior to the book’s publication: it is …
Diarrhoea as a presentation of bird flu infection: a summary on its correlation to outcome in Thai cases
Authors: V Wiwanitkit
Journal: Gut (2005)

Bird flu or avian flu, caused by H5N1 virus, is a new emerging infectious disease. There has been worldwide avian influenza infections in poultry since 1997. Recently, H5N1 caused severe disease with high mortality in humans in Vietnam and Thailand.1 Most infected cases usually developed progressive pneumonia with acute respiratory distress syndrome and consequently died. Atypical presentations of patients with bird flu were also noted. de Jong et al recently reported a fatal bird …
Incubation Phase of Acute Hepatitis B in Man: Dynamic of Cellular Immune Mechanisms
Authors: George J.M. Webster, Stephanie Reignat, Mala K. Maini, Simon A. Whalley, Graham S. Ogg, Abigail King, David Brown, Peter L. Amlot, Roger Williams, Diego Vergani, Geoffrey M. Dusheiko, Antonio Bertoletti
Journal: Hepatology (2000)

After hepatitis B virus (HBV) infection, liver injury and viral control have been thought to result from lysis of infected hepatocytes by virus–specific cytotoxic T cells. Patients are usually studied only after developing significant liver injury, and so the viral and immune events during the incubation phase of disease have not been defined. During a single–source outbreak of HBV infection, we identified patients before the onset of symptomatic hepatitis. The dynamics of HBV replication, liver injury, and HBV–specific CD8+ and CD4+ cell responses were investigated from incubation to recovery. Although a rise in alanine transaminase (ALT) levels was present at the time of the initial fall in HBV–DNA levels, maximal reduction in virus level occurred before significant liver injury. Direct ex vivo quantification of HBV–specific CD4+ and CD8+ cells, by using human leukocyte antigen (HLA) class I tetramers and intracellular cytokine staining, showed that adaptive immune mechanisms are present during the incubation phase, at least 4 weeks before symptoms. The results suggest that the pattern of reduction in HBV replication is not directly proportional to tissue injury during acute hepatitis B in humans. Furthermore, because virus–specific immune responses and significant reductions in viral replication are seen during the incubation phase, it is likely that the immune events central to viral control occur before symptomatic disease.
Defining chronic obstructive pulmonary disease... and the elephant in the room
Authors: D. M. Mannino
Journal: European Respiratory Journal (2007)

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of disability and death in both the developed and developing world 1. We are starting to understand about pathogenesis, progression and prognosis in COPD, but the understanding of any disease starts with defining what one is actually talking about 2.

So what constitutes disease in COPD? Combinations of the forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and the slow vital capacity (SVC) are used to help classify lung disease. What is normal? What reference equations does one use? Is the lower limit of normal (LLN) for the FEV1/FVC more accurate than the fixed ratio of 0.70? Does lung function have to be measured after bronchodilation? All of the factors mentioned contribute to the determination of COPD prevalence in populations, as is seen in the article by Shirtcliffe et al. 3 in the current issue of the European Respiratory Journal .

What is “normal”? An online dictionary lists the following definitions: “Conforming with, adhering to, or constituting a norm, standard, pattern, level, or type; typical. Functioning or occurring in a natural way; lacking observable abnormalities or deficiencies. Occurring naturally and not because of disease, inoculation, or any experimental treatment” 4. A related question is: what constitutes “disease”? In discussing COPD, Snider 2 defined disease as: “a condition or state in a group of persons who have specified characteristics by …