tbuckley/cabot-search huggingface dataset:
Quality of chronic disease care for older people in care homes and the community in a primary care pay for performance system: retrospective study
Authors: S. M. Shah, I. M. Carey, T. Harris, S. DeWilde, D. G. Cook
Journal: BMJ (2011)

Objective To describe the quality of care for chronic diseases among older people in care homes (nursing and residential) compared with the community in a pay for performance system. Design Retrospective analysis of The Health Improvement Network (THIN), a large primary care database. Setting 326 English and Welsh general practices, 2008-9. Participants 10 387 residents of care homes and 403 259 residents in the community aged 65 to 104 and registered for 90 or more days with their general practitioner. Main outcome measure 16 process quality indicators for chronic disease management appropriate for vulnerable older people for conditions included in the UK Quality and Outcomes Framework. Results After adjustment for age, sex, dementia, and length of registration, attainment of quality indicators was significantly lower for residents of care homes than for those in the community for 14 of 16 indicators. The largest differences were for prescribing in heart disease (β blockers in coronary heart disease, relative risk 0.70, 95% confidence interval 0.65 to 0.75) and monitoring of diabetes (retinal screening, 0.75, 0.71 to 0.80). Monitoring hypothyroidism (0.93, 0.90 to 0.95), blood pressure in people with stroke (0.92, 0.90 to 0.95), and electrolytes for those receiving loop diuretics (0.89, 0.87 to 0.92) showed smaller differences. Attainment was lower in nursing homes than in residential homes. Residents of care homes were more likely to be identified by their doctor as unsuitable or non-consenting for all Quality and Outcomes Framework indicators for a condition allowing their exclusion from targets; 33.7% for stroke and 34.5% for diabetes. Conclusion There is scope for improving the management of chronic diseases in care homes, but high attainment of some indicators shows that pay for performance systems do not invariably disadvantage residents of care homes compared with those living in the community. High use of exception reporting may compromise care for vulnerable patient groups. The Quality and Outcomes Framework, and other pay for performance systems, should monitor attainment and exception reporting in vulnerable populations such as residents of care homes and consider measures that deal with the specific needs of older people.
Immunological intervention with anti-immunoglobulin-E antibody to prevent asthma exacerbations
Authors: P. Chanez
Journal: European Respiratory Journal (2001)

The challenge to develop new therapeutic strategies to treat asthma is difficult, since drugs such as inhaled steroids and long-acting β2-agonists are very successful and advocated by most national and international guidelines to be the long-term therapies of choice in most of the chronic situations 1. The better understanding of the mechanisms of asthma as an inflammatory disease has led to the development of several new immunological approaches, which have been mostly disappointing after introduction in the clinic. The major reasons for this are linked to the complexity and the redundancy of the inflammatory processes in asthma, which are able to counterpoise the inhibition of a single cellular or molecular pathway 2.

Therefore, the global situation for asthma should be increasingly satisfactory based on the currently available treatments, but there are several remaining problems. First, the prevalence and the costs of the disease are still increasing. Secondly, most of the patients deny their asthma symptoms and severity and are mostly under-treated and uncontrolled 3. If mild and moderate asthma can be controlled by the current strategies, poor compliance of the patients still contributes to the excess morbidity and costs. And finally, there is a group of …
A practice approach for identifying previously unsuspected environmental contributors to systemic lupus erythematosus and other complex diseases.
Authors: Morris W Foster, Christopher E Aston
Journal: Environmental Health Perspectives (2002)

Existing medical records and health surveys provide insights into potential environmental contributors to complex chronic diseases. Those recognizable risks (e.g., workplace exposures and behaviors including smoking) do not, however, exhaust the domain of potential environmental contributors. Qualitative ethnographic investigation can be used to generate statistically testable hypotheses about environmental contributors to complex disease that otherwise would not be recognized as such. Consequently, we can empirically specify lifestyle beliefs and behaviors usually summarized by proxy identities such as race, ethnicity, gender, class, and culture. The investigation of potential environmental contributors to complex diseases may be particularly useful in confirming or disconfirming suggestive or established linkages and for indicating the kind of gene-environment interaction that may be involved.
The Prostanoid EP4 Receptor and Its Signaling Pathway
Authors: Utako Yokoyama, Kousaku Iwatsubo, Masanari Umemura, Takayuki Fujita, Yoshihiro Ishikawa
Journal: Pharmacological Reviews (2013)

The EP4 prostanoid receptor is one of four receptor subtypes for prostaglandin E<sub>2</sub>. It belongs to the family of G protein–coupled receptors. It was originally identified, similar to the EP2 receptor as a G<sub>s</sub><i>α</i>-coupled, adenylyl cyclase–stimulating receptor. EP4 signaling plays a variety of roles through cAMP effectors, i.e., protein kinase A and exchange protein activated by cAMP. However, emerging evidence from studies using pharmacological approaches and genetically modified mice suggests that EP4, unlike EP2, can also be coupled to G<sub>i</sub><i>α</i>, phosphatidylinositol 3-kinase, <i>β</i>-arrestin, or <i>β</i>-catenin. These signaling pathways constitute unique roles for the EP4 receptor. EP4 is widely distributed in the body and thus plays various physiologic and pathophysiologic roles. In particular, EP4 signaling is closely related to carcinogenesis, cardiac hypertrophy, vasodilation, vascular remodeling, bone remodeling, gastrointestinal homeostasis, renal function, and female reproductive function. In addition to the classic anti-inflammatory action of EP4 on mononuclear cells and T cells, recent evidence has shown that EP4 signaling contributes to proinflammatory action as well. The aim of this review is to present current findings on the biologic functions of the EP4 receptor. In particular, we will discuss its diversity from the standpoint of EP4-mediated signaling.
Teledermatology: a review
Authors: D.J. Eedy, R. Wootton
Journal: British Journal of Dermatology (2001)

Journal Article Teledermatology: a review Get access D.J. Eedy, D.J. Eedy Department of Dermatology, Craigavon Area Hospital Group Trust, 68 Lurgan Road, Portadown BT63 5QQ, U.K. *Centre for Online Health, University of Queensland, Brisbane, Australia Dr D.J.Eedy. E‐mail: Eedydj@aol.com Search for other works by this author on: Oxford Academic Google Scholar R. Wootton R. Wootton Department of Dermatology, Craigavon Area Hospital Group Trust, 68 Lurgan Road, Portadown BT63 5QQ, U.K. *Centre for Online Health, University of Queensland, Brisbane, Australia Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 144, Issue 4, 1 April 2001, Pages 696–707, https://doi.org/10.1046/j.1365-2133.2001.04124.x Published: 01 April 2001
Lower incidence of arm-to-head contact incidents with stricter interpretation of the Laws of the Game in Norwegian male professional football
Authors: John Bjørneboe, Roald Bahr, Jiri Dvorak, Thor Einar Andersen
Journal: British Journal of Sports Medicine (2013)

Background Video analyses reveal that the rate of incidents with a propensity for injury caused by opponent-to-player contact has increased by about 50% from 2000 to 2010 in Norwegian male professional football. The aim of the study was to assess whether a stricter interpretation of the Laws of the Game (red cards for high elbows in heading duels and for late/two foot tackles) could reduce the potential for injuries in Norwegian male professional football. Methods A preintervention/postintervention design was employed, where the rate of incidents and injuries from the 2010 season (pre) was compared to the 2011 season (post). An incident was recorded if the match was interrupted by the referee, and the player lay down for more than 15 s, and appeared to be in pain or received medical treatment. Time-loss injuries were recorded by the medical staff of each club. Results A total of 1421 contact incidents were identified, corresponding to a rate of 92.7 (95% CI 86.0 to 99.4) in the 2010 season and 86.6 (95% CI 80.3 to 99.4) in the 2011 season, with no difference between the two season. We found a reduction in the incidence of total head incidents (rate ratio (RR) 0.81, 95% CI 0.67 to 0.99), and head-incidents caused by arm-to-head contact (RR 0.72, 95% CI 0.54 to 0.97). We found no difference in tackling characteristics or contact injury rate. Conclusions We found no significant differences in the overall rate of incidents after the introduction of stricter rule enforcement. However, the rate of head and arm-to head incidents was lower in the 2011 season.
Anthracyclines in the Treatment of HER2 -Negative Breast Cancer
Authors: Soonmyung Paik, Yusuke Taniyama, Charles E. Geyer
Journal: JNCI Journal of the National Cancer Institute (2007)

In this issue of the Journal, Gennari et al. ( 1 ) report results of a meta-analysis of eight published studies that tested the worth of HER2 as a predictive marker of benefit from anthracycline regimens over nonanthracycline regimens. The test for treatment by HER2 status interaction yielded statistically significant results. The authors propose that it is time to stop the use of cardiotoxic anthracycline regimens for the treatment of HER2 -negative breast cancer.
Akt Phosphorylation at Ser473 Predicts Benefit of Paclitaxel Chemotherapy in Node-Positive Breast Cancer
Authors: Sherry X. Yang, Joseph P. Costantino, Chungyeul Kim, Eleftherios P. Mamounas, Dat Nguyen, Jong-Hyeon Jeong, Norman Wolmark, Kelley Kidwell, Soonmyung Paik, Sandra M. Swain
Journal: Journal of Clinical Oncology (2010)

We tested the hypothesis that Akt-Ser473 phosphorylation (pAkt) predicts benefit from the sequential addition of paclitaxel to adjuvant doxorubicin plus cyclophosphamide (AC) chemotherapy in patients with node-positive breast cancer participating in the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-28 trial.Primary tumors from the NSABP B-28 trial tissue microarray were available from 1,581 of 3,060 patients who were randomly assigned to receive either four cycles of AC alone or followed by four cycles of paclitaxel. Immunohistochemistry and quantitative analysis of pAkt were performed at the National Cancer Institute blinded to clinical outcome. Association between pAkt and clinical outcome was assessed using multivariate Cox modeling adjusting for age, tumor size, number of positive nodes, tumor grade, estrogen receptor status, and human epidermal growth factor receptor 2 status.With a median follow-up of 9.1 years, there were no differences in disease-free survival (adjusted hazard ratio [HR], 1.02; P = .81) or overall survival (HR, 0.97; P = .80) with and without receiving paclitaxel among 975 patients with pAkt-negative tumors. In 606 patients with pAkt-positive tumors, the sequential addition of paclitaxel resulted in a 26% improvement in disease-free survival (HR, 0.74; P = .02) or a 20% improvement in overall survival (HR, 0.80; P = .17).pAkt significantly predicts disease-free benefit from the sequential addition of paclitaxel to AC chemotherapy in patients with node-positive breast cancer. Patients with pAkt-negative breast tumors do not appear to benefit from the addition of paclitaxel.
Influence of treatment on morphological features of mucosal inflammation
Authors: K Geboes, I Dalle
Journal: Gut (2002)

Microscopic analysis of endoscopically obtained tissue samples is important for the diagnosis of several gastrointestinal disorders such as gastritis and chronic inflammatory bowel disease (IBD). Histologically disease activity is based on the presence of neutrophilic polymorphonuclear leucocytes in conjunction with epithelial damage. Effective eradication treatment for <i>Helicobacter pylori</i> related gastritis reduces active inflammation rapidly whereas chronic inflammation decreases only slowly. Similar findings have been obtained for IBD. A literature review of clinical drug trials in IBD and the effect of various drugs on the microscopic features of Crohn9s disease and immunohistochemistry for different markers was performed. Diagnostic microscopic features and the features characteristic for disease activity vary with time and treatment. The more recently developed drugs used for Crohn9s disease can induce mucosal healing.
Access to heart surgery for smokers. The NHS can't treat only saints.
Authors: E Vithayathil
Journal: BMJ (1993)

Access to heart surgery for smokersDenying treatment is indefensible EDrrOR,-M J Underwood and J S Bailey believe that coronary bypass surgery should not be offered to smokers.' Medical professionals tend to ignore the fact that they are appointed in the NHS to provide service to patients on the basis of their clinical needs irrespective of their shortcomings and degree of culpability.After all, it is the money of taxpayers (smokers and non-smokers) that is used to train cardiac surgeons and to pay their wages.The taxpayers, in return, expect them to provide prompt and efficient service when required.I am sure that no cardiac surgeon would refuse to operate on a smoker if he or she was paying a handsome fee as a private patient.We should all feel privileged to be in a position to make decisions affecting the lives and livelihoods of our fellow beings and resist the temptation to abuse our authority.Those who believe that smokers should not be offered necessary investigations and treatment solely on the basis of their habit, in my opinion, have an indefensible case.Gentle persuasion and counselling are the only decent ways of changing a patient's lifelong habit.
Aldehyde Dehydrogenase Expression Drives Human Regulatory T Cell Resistance to Posttransplantation Cyclophosphamide
Authors: Christopher G. Kanakry, Sudipto Ganguly, Marianna Zahurak, Javier Bolaños-Meade, Christopher Thoburn, Brandy Perkins, Ephraim J. Fuchs, Richard J. Jones, Allan D. Hess, Leo Luznik
Journal: Science Translational Medicine (2013)

Regulatory T cells become resistant to cyclophosphamide after allogeneic stimulation, protecting against GVHD.
Right Ventricular Systolic Dysfunction in Young Adults Born Preterm
Authors: Adam J. Lewandowski, William M. Bradlow, Daniel Augustine, Esther F. Davis, Jane Francis, Atul Singhal, Alan Lucas, Stefan Neubauer, Kenny McCormick, Paul Leeson
Journal: Circulation (2013)

Background— Young adults born preterm have distinct differences in left ventricular mass, function, and geometry. Animal studies suggest that cardiomyocyte changes are evident in both ventricles after preterm birth; therefore, we investigated whether these young adults also have differences in their right ventricular structure and function. Methods and Results— We studied 102 preterm-born young adults followed up prospectively since birth and 132 term-born control subjects born to uncomplicated pregnancies. We quantified right ventricular structure and function by cardiovascular magnetic resonance on a 1.5-T Siemens scanner using Argus and TomTec postprocessing software. Preterm birth was associated with a small right ventricle (end diastolic volume, 79.8±13.2 versus 88.5±11.8 mL/m 2 ; P &lt;0.001) but greater right ventricular mass (24.5±3.5 versus 20.4±3.4 g/m 2 ; P &lt;0.001) compared with term-born controls, with the severity of differences proportional to gestational age ( r =−0.47, P &lt;0.001). Differences in right ventricular mass and function were proportionally greater than previously reported for the left ventricle. This was most apparent for systolic function; young adults born preterm had significantly lower right ventricular ejection fraction (57±8% versus 60±5%; P =0.006). Indeed, 21% had values below the lower limit observed in the term-born adults and 6% had mild systolic dysfunction (&lt;45%). Postnatal ventilation accounted for some of the variation in mass but not function. Conclusions— Preterm birth is associated with global myocardial structural and functional differences in adult life, including smaller right ventricular size and greater mass. The changes are greater in the right ventricle than previously observed in the left ventricle, with potentially clinically significant impairment in right ventricular systolic function.
The Lesch-Nyhan Syndrome
Authors: LARRY H. DIZMANG, CLAUDIA F. CHEATHAM
Journal: American Journal of Psychiatry (1970)

The authors report their observations of five children with the Lesch-Nyhan syndrome and review the literature to describe the general characteristics of the disorder, the development and types of self-mutilative behavior, and the types of outward-directed aggression. The authors suggest that these children may have a very low threshold for the activation of a mechanism that controls repetitive, compulsive, pain-causing behavior. This factor may also explain other forms of self-destructive behavior in children and may represent the psychobiological basis for the development of masochistic behavior.
Effect of Fixed Airflow Obstruction (FAO) Status on Lung Function, Asthma Control Days (ACD), and Asthma Symptom Score (AS) Responses to Budesonide/Formoterol (BUD/FM) Treatment in Patients with Moderate-to-Severe Asthma
Authors: Donald P. Tashkin, Frank Trudo, Michael DePietro, Bradley E. Chipps
Journal: Journal of Allergy and Clinical Immunology (2015)
Golimumab monotherapy in Japanese patients with active rheumatoid arthritis despite prior treatment with disease-modifying antirheumatic drugs: results of the phase 2/3, multicentre, randomised, double-blind, placebo-controlled GO-MONO study through 24 weeks
Authors: Tsutomu Takeuchi, Masayoshi Harigai, Yoshiya Tanaka, Hisashi Yamanaka, Naoki Ishiguro, Kazuhiko Yamamoto, Nobuyuki Miyasaka, Takao Koike, Minoru Kanazawa, Takuya Oba, Toru Yoshinari, Daniel Baker
Journal: Annals of the Rheumatic Diseases (2012)

To evaluate the efficacy and safety of golimumab 50 and 100 mg monotherapy in Japanese patients with active rheumatoid arthritis (RA) despite treatment with disease-modifying antirheumatic drugs (DMARDs).A total of 316 patients were randomised to receive subcutaneous injections every 4 weeks of placebo (group 1), golimumab 50 mg (group 2) or golimumab 100 mg (group 3); group 1 crossed over to golimumab 50 mg at week 16. The primary end point was the proportion of patients achieving ≥20% improvement in the American College of Rheumatology criteria (ACR20) at week 14. ACR50 and ACR70 response rates were also measured. Adverse events (AEs) were monitored throughout the study.Demographics were similar across groups; the mean age was 52 years and 81.8% of patients (252/308) were female. Week 14 ACR20 response rates were significantly greater in groups 2 (51/101 (50.5%)) and 3 (60/102 (58.8%)) than in group 1 (20/105 (19.0%); p<0.0001 for both), as were ACR50 and ACR70 response rates. After placebo crossover at week 16, week 24 ACR response rates were similar in groups 1 and 2. Through week 16, 63.8% of patients in group 1, 62.4% in group 2 and 60.8% in group 3 had AEs and 1.9%, 1.0% and 2.0% had serious AEs. After week 16, one malignancy was reported (breast cancer, group 3). Infections were the most common AEs. No deaths or cases of tuberculosis were reported through week 24.Golimumab monotherapy (50 and 100 mg) was effective in reducing the signs and symptoms of RA in Japanese patients with active disease despite DMARD treatment.
Association of Diabetes and HbA1c Levels With Gastrointestinal Manifestations
Authors: Ping-Huei Tseng, Yi-Chia Lee, Han-Mo Chiu, Chien-Chuan Chen, Wei-Chih Liao, Chia-Hung Tu, Wei-Shiung Yang, Ming-Shiang Wu
Journal: Diabetes Care (2012)

OBJECTIVE To determine the prevalence of gastrointestinal (GI) manifestations associated with diabetes mellitus (DM) in a Taiwanese population undergoing bidirectional endoscopies. RESEARCH DESIGN AND METHODS Subjects voluntarily undergoing upper endoscopy/colonoscopy as part of a medical examination at the National Taiwan University Hospital were recruited during 2009. Diagnosis of DM included past history of DM, fasting plasma glucose ≥126 mg/dL, or glycated hemoglobin (HbA1c) ≥6.5%. Comparisons were made between diabetic and nondiabetic subjects, subjects with lower and higher HbA1c levels, and diabetic subjects with and without complications, respectively, for their GI symptoms, noninvasive GI testing results, and endoscopic findings. RESULTS Among 7,770 study subjects, 722 (9.3%) were diagnosed with DM. The overall prevalence of GI symptoms was lower in DM subjects (30.3 vs. 35.4%, P = 0.006). In contrast, the prevalence of erosive esophagitis (34.3 vs. 28.6%, P = 0.002), Barrett's esophagus (0.6 vs. 0.1%, P = 0.001), peptic ulcer disease (14.8 vs. 8.5%, P &amp;lt; 0.001), gastric neoplasms (1.8 vs. 0.7%, P = 0.003), and colonic neoplasms (26.6 vs. 16.5%, P &amp;lt; 0.001) was higher in diabetic subjects. Diagnostic accuracy of immunochemical fecal occult blood test for colonic neoplasms was significantly decreased in DM (70.7 vs. 81.7%, P &amp;lt; 0.001). Higher HbA1c levels were associated with a decrease of GI symptoms and an increase of endoscopic abnormalities. Diabetic subjects with complications had a higher prevalence of colonic neoplasms (39.2 vs. 24.5%, P = 0.002) than those without. CONCLUSIONS DM and higher levels of HbA1c were associated with lower prevalence of GI symptoms but higher prevalence of endoscopic abnormalities.
BIPHASIC PATTERN OF THYMUS REGENERATION AFTER WHOLE-BODY IRRADIATION
Authors: Akikazu Takada, Yumiko Takada, Chester C. Huang, Julian L. Ambrus
Journal: The Journal of Experimental Medicine (1969)

Whole-body irradiation of mice with 300 or 400 R causes a precipitous fall in thymus weight, followed by an increase in the mitotic index and an almost complete restoration of thymus mass. This phase is followed by a secondary fall in thymus weight and gradual recovery. This secondary fall can be prevented by intravenous injection of bone marrow or shielding of the hind limbs during irradiation. The hypothesis is proposed that the thymus depends on the migration of cells from the bone marrow to the thymus for the maintenance of its cell population. Bone marrow cells with chromosome markers injected intravenously into normal or lightly irradiated (150 R) animals do not populate the host bone marrow to any significant degree. After whole-body irradiation with heavy doses (400 R), donor cells dominate the marrow. There may be a competition between dividing cells in the bone marrow which regulates proliferation of hemic cells. Bone marrow cells with marker chromosomes do not repopulate the thymus in irradiated animals until long after repopulating the bone marrow. It is possible that these cells have to pass through the marrow or the blood-marrow barrier to acquire characteristics needed for entering the thymus. After whole-body irradiation with 500 R or more, the first phase of regeneration of the thymus, represented by an increase in the mitotic index, does not occur to a significant degree. Apparently cells in the thymus capable of proliferation have been largely eliminated, and restoration of organ mass depends chiefly on seeding from other sources, probably the bone marrow. After whole-body irradiation with 200 R, only the first phase of thymus weight loss and regeneration takes place. Probably bone marrow injury is too small to interfere with the supply of cells repopulating the thymus.