tbuckley/cabot-search huggingface dataset:
Declines in number of tender and swollen joints in patients with rheumatoid arthritis seen in standard care in 1985 versus 2001: possible considerations for revision of inclusion criteria for clinical trials
Authors: T Pincus
Journal: Annals of the Rheumatic Diseases (2005)

<b>Objective:</b> To analyse tender and swollen joint counts in three cohorts of patients with rheumatoid arthritis (RA), with a focus on the proportions of patients who had fewer than 6–12 tender or swollen joints, as possible evidence based information toward more generalisable inclusion criteria for current and future RA clinical trials. <b>Methods:</b> Tender and swollen joint counts were analysed in three cohorts of patients with RA: 125 in 1985, 138 in 2000, and 232 with early RA in 2001. <b>Results:</b> The median numbers of tender joints were 11, 2, and 4 in 1985, 2000, and in early RA in 2001, respectively. The median numbers of swollen joints were 12, 6, and 5 in 1985, 2000, and 2001, respectively. The numbers of tender joints among 28 assessed were ⩾12, ⩾6, ⩾4, and ⩾3 in 47%, 80%, 85%, and 90% of patients in 1985; 20%, 37%, 44%, and 49% in 2000; and 17%, 37%, 50%, and 58% in early RA in 2001. The numbers of swollen joints among 28 assessed were ⩾12, ⩾6, ⩾4, and ⩾3 in 51%, 78%, 86%, and 90% of patients in 1985; 20%, 50%, 64%, and 67% in 2000; and 14%, 46%, 58%, and 72% in 2001. The number of patients with ⩾6 tender or swollen joints in 1985 was greater than the number with ⩾3 joints in 2000 and in early RA in 2001. <b>Conclusion:</b> Contemporary cohorts of patients seen in standard care have smaller numbers of tender and swollen joints than in previous times. These findings suggest that revision of inclusion criteria for numbers of tender and swollen joints in contemporary RA clinical trials might improve generalisability.
A Comparison of Family Functioning, Temperament, and Childhood Conditions in Monozygotic Twin Pairs Discordant for Lifetime Bulimia Nervosa
Authors: Tracey D. Wade, Susan A. Treloar, Nicholas G. Martin
Journal: American Journal of Psychiatry (2001)

OBJECTIVE: The authors investigated differences between twins in nine pairs of female monozygotic twins in the Australian Twin Registry who were discordant for lifetime bulimia nervosa. METHOD: The twins affected and unaffected by lifetime bulimia nervosa were compared on self-report measures, including a measure of parental bonding, four measures of temperament, and six early-childhood medical conditions. RESULTS: No twins had current bulimia nervosa, and there was no difference in weight or eating status between the affected and unaffected twins. The affected twins reported significantly lower self-esteem and less warmth but more overprotection by their mothers during childhood. CONCLUSIONS: Although limited by the small number of discordant twin pairs and the inability to detect causal relationships, these results suggest that environmental influences that promote low self-esteem may also increase the risk for bulimia nervosa. These temperamental differences may explain the discrepancies in parenting or perceived parenting.
Rheumatoid arthritis: pathogenesis, assessment, outcome and treatment
Authors: J M W Hazes
Journal: Annals of the Rheumatic Diseases (1995)

<b>Introduction:</b> The most frequently used parameters for assessing bronchoconstriction and bronchodilation are forced expiratory volume in 1 s (FEV 1) and peak expiratory flow (PEF). <b>Objectives:</b> To assess the sensitivity of other parameters after induced bronchoconstriction and bronchodilation. <b>Methods:</b> Forced vital capacity, FEV 1, PEF, maximum expiratory flows (MEF) at 25, 50 and 75% of vital capacity and the area under the maximal expiratory flow- volumeMEFV curve (Area ex) were measured in two groups of asthmatic patients after induced bronchoconstriction and bronchodilation. <b>Results:</b> In 158 asthmatics without airway obstruction, bronchoconstriction was induced by inhalation of 1% histamine aerosol. The 20% fall in Area ex compared to baseline was found in all asthmatics, while the 20 and 15% falls in FEV 1 were noted in 31 and 69% of the patients, respectively. Other parameters were less sensitive. Another 102 asthmatics with mild-moderate airway obstruction were treated with various bronchodilators. The 20% increase in Area ex was observed in all asthmatics, while the 20% increase in FEV 1 was found in only 28% of the patients and the 15% increase in FEV 1 in 56%. <b>Conclusion:</b> In evaluation of correlation between dynamic functional parameters the most accurate parameter is Area<sub>ex</sub> – value defining surface under the expiratory part of “flow – volume” curve. Area ex was a sensitive parameter in the evaluation of airway patency in comparison withf MEF<sub>25</sub>, MEF<sub>50</sub>, MEF<sub>75</sub>, FEV 1 and other parameters measured from the MEFV curve in our study patients.
Hepatic expression ofANG2 RNA in metastatic colorectal cancer
Authors: Minoru Ogawa, Hirofumi Yamamoto, Hiroaki Nagano, Yasuhiro Miyake, Yurika Sugita, Taishi Hata, Byung-no Kim, Chew Yee Ngan, Bazarragchaa Damdinsuren, Masakazu Ikenaga, Masataka Ikeda, Masayuki Ohue, Shoji Nakamori, Mitsugu Sekimoto, Masato Sakon, Nariaki Matsuura, Morito Monden
Journal: Hepatology (2004)

We examined the RNA content of the gene encoding angiopoietin (Ang)-2, a modifier of angiogenesis, in hepatic metastases of colorectal cancer (CRC) to explore the role of this protein in neovascularization of metastatic foci. Metastatic CRC exhibited notable blood flow and tumor vessel formation at tumor frontiers. Reverse-transcription polymerase chain reaction assays indicated that the ANG2 RNA content was greater in metastatic CRC than in primary CRC. Investigation of metastatic foci using laser capture microdissection revealed that the RNA content of ANG2 , but not ANG1 , increased from the bordering liver region to the periphery of the metastatic disease, and also from the periphery to the intermediate portion of the metastatic lesion; immunohistochemical analysis confirmed that there was a corresponding gradual increase in Ang-2 protein expression. Tie-2, a receptor for angiopoietins, was preferentially expressed in the bordering liver region rather than in metastatic CRC. Vascular endothelial growth factor (VEGF) also exhibited an expression pattern similar to that of Ang-2, and there was a significant correlation between the RNA content of ANG2 and that of VEGF in dissected samples ( P = .002). Western blot analysis suggested that expression of Ang-1, Ang-2, Tie-2, and VEGF may be regulated at a transcriptional level. The increase in ANG2 RNA content from the peripheral portion of the tumor to the intermediate portion, coinciding with the decrease in recruitment of periendothelial supporting cells around the vascular endothelial cells, suggests that Ang-2 may play a role in the immaturity of tumor vessels. In conclusion, the current study suggests that Ang-2 and VEGF may cooperate to enhance the formation of new blood vessels in metastases of CRC to the liver. (Hepatology 2004;39:528-539.)
Relationship of Hair Dye Use, Benign Breast Disease, and Breast Cancer
Authors: Philip C. Nasca, Charles E. Lawrence, Peter Greenwald, Sherry Chorost, Jeffrey T. Arbuckle, Albert Paulson
Journal: JNCI Journal of the National Cancer Institute (1980)

An epidemiologic case-control study of 118 breast cancer patients and 233 controls was conducted to test the hypothesis that hair dyes are related to breast cancer. Matched controls were selected by "random digit dialing," and all epidemiologic data were collected by telephone interviews. No overall association was detected. On a prospective basis, the interaction between hair dye exposure and six variables known to be risk factors for breast cancer then were examined: previous benign breast disease (BBD), "ever" versus "never" pregnant, age at first pregnancy, menopause induced by operation, age at menarche, and education. A statistically significant increased risk of breast cancer was found for women with a history of BBD and exposure to hair dyes as compared to women with BBD but no hair dye exposure: The relative risk (RR) was 4.5, and the 95% confidence intervals (C) were 1.20 and 15.78. A total of 24 women (19 patients and 5 controls) reported a history of BBD and hair dye use. Further analysis revealed a significant association between hair dye use and breast cancer among women 40-49 years of age (RR = 3.33; 95% CI: 1.1 and 10.85) and a highly significant (P = 0.0008) dose-response relationship among women who used hair dyes for changing their natural color as opposed to covering gray hair. The numbers of patients and controls included in this study were small and several hypotheses were tested. Additional epidemiologic studies are needed before firm conclusions can be reached concerning the nature of these associations.
Pulmonary arterial development during childhood: branching pattern and structure
Authors: A. Hislop, L. Reid
Journal: Thorax (1973)

In lungs from 18 children aged between birth and 11 years the development of the branching pattern and structure of the pulmonary arteries, particularly the intralobular and intra-acinar, has been quantitatively analysed after injection with a radio-opaque medium. Up to 18 months of age as new alveolar ducts appear conventional arterial branches develop within the acinus: supernumerary arteries increase in number up to 8 years as new alveoli form. Both types increase in size with age. After birth there is an immediate drop in wall thickness of the vessels below 200 μm diameter while the larger vessels take up to 4 months to fall to adult thickness, suggesting two types of response—one dilatation, the other a growth rate change of the muscle cells. During childhood muscle cell formation in the intra-acinar arteries lags behind increase in artery size so that during childhood few muscular arteries are found within the acinus. The functional significance of these changes is discussed.
Factors That Limit the Effectiveness of Herpes Simplex Virus Type 1 for Treatment of Oral Cancer in Mice
Authors: Edward J. Shillitoe, Christopher Pellenz
Journal: Clinical Cancer Research (2005)

Abstract Although the growth of experimental oral cancers can be inhibited by infection with the herpes simplex virus type 1 (HSV-1), the effect is incomplete. To define factors that might limit the effectiveness of the virus, we examined the roles of the innate immune system and the replication status of the tumor cells. AT-84 tumors were induced in strains of mice that had specific immune defects and were treated with the virus. Explanted tumors and tumor cells in culture were also infected. No differences in viral replication or in the effect of virus on the tumor were seen between mice with a lack of T or B lymphocytes, natural killer cells, phagocytic spleen cells, or complement. The virus did not replicate significantly more in tumors that were maintained as explants. Immediately after recovery of cells from a tumor the proportion of cells in the S phase was around 18%, and replication of virus in those cells was very limited. After 3 weeks in culture, the proportion in S had increased to 50% and both the recovery of virus from the cells and the toxic effect of the virus on the cells had increased significantly. The innate immune system thus seemed to have a minimal effect on replication of HSV-1 when used as an oncolytic virus for oral cancers in mice. Instead, the fraction of cells in the S phase was important. Because human oral cancers, like mouse tumors, have a low fraction of cells in the S phase, it is likely that the in vivo use of HSV-1 as cancer therapy will be limited by the replication of the virus.
African Americans With Cancer Pain Are More Likely to Receive an Analgesic With Toxic Metabolite Despite Clinical Risks: A Mediation Analysis Study
Authors: Salimah H. Meghani, Youjeong Kang, Jesse Chittams, Erin McMenamin, Jun J. Mao, Jeffrey Fudin
Journal: Journal of Clinical Oncology (2014)

Renal impairment is highly prevalent among patients with cancer, and many patients have undiagnosed chronic kidney disease (CKD) from underlying disease, treatment, or both. African American individuals have disproportionate risk factors (diabetes, hypertension) predisposing them to CKD. We investigated whether African American patients are more likely than white patients to receive morphine with 3- and 6-glucuronide metabolites, which are known to be neurotoxic and accumulate in CKD; whether insurance type mediates the relationship between race and the prescriber's opioid selection; and whether the chosen opioid has a resultant negative effect according to race.Patients (N = 182) were recruited from oncology clinics within the University of Pennsylvania Health System. Inclusion was based on self-identified African American or white race, age older than 18 years, and the presence of cancer-related pain plus a prescription for morphine or oxycodone. Kidney function was estimated using the abbreviated Modification of Diet in Renal Disease formula.Patients with CKD who received morphine reported a greater severity of analgesic-related adverse effects than patients with CKD who received oxycodone (P = .010). Controlling for health insurance type, African American patients had 71% lower odds of receiving a prescription of oxycodone than white patients (P < .001). Limiting analysis to those with CKD, the effect of private insurance became insignificant. However, race still remained a significant predictor of the prescribed opioid selection. Race was a strong predictor of adverse effect severity in the presence of CKD, and the type of opioid selection partially mediated this relationship.Reducing racial disparities in the type of opioid prescription and understanding mechanisms of disproportionate opioid-related adverse effects in African American patients might decrease the clinical disparities in cancer pain outcomes.
Endothelial signal transduction system enhances neutrophil‐induced pulmonary vascular permeability
Authors: T. Tanita, C. Song, H Kubo, S Ono, S Fujimura
Journal: European Respiratory Journal (2000)

The mechanism by which stimulated polymorphonuclear leukocytes and neutrophils (PMNs) damage pulmonary vascular endothelium was investigated. The authors assessed the ability of unstimulated and mechanically stimulated PMNs to adhere to pulmonary endothelial cells and, thereby, alter pulmonary vascular permeability, measured as the pulmonary filtration coefficient (K) and haemodynamics. PMNs were stimulated by gentle agitation in a glass vial for 10 s. Perfusing lungs with the stimulated PMNs (n=6) resulted in significant accumulation of PMNs within the lungs, assessed by myeloperoxidase levels, and elicited a 4-fold increase in K and a 2-fold increase in pulmonary vascular resistance as compared to lungs perfused with unstimulated cells (n=6). The increases in K were completely blocked by GF109203X, a protein kinase C inhibitor (n=6); however, GF109203X only partially attenuated the increase in vascular resistance and had little effect on the accumulation of stimulated PMNs. An agonist of protein kinase C, phorbol myristate acetate, elicited dose dependent increases in both K and pulmonary vascular resistance even in the absence of PMNs (n=6). These findings indicate that the increases in pulmonary filtration coefficient and pulmonary vascular resistance induced by polymorphonuclear neutrophils result from endothelial cell injury mediated by activation of protein kinase C within the endothelial cells themselves.
Cost Effectiveness of Direct-Acting Antiviral Therapy for Treatment-Naive Patients With Chronic HCV Genotype 1 Infection in the Veterans Health Administration
Authors: Kee Chan, Mai Ngan Lai, Erik J. Groessl, Amresh D. Hanchate, John B. Wong, Jack A. Clark, Steven M. Asch, Allen L. Gifford, Samuel B. Ho
Journal: Clinical Gastroenterology and Hepatology (2013)
Sports medicine education
Authors: David Garlick
Journal: British Journal of Sports Medicine (2001)

EDITOR,-I read the section on sports medicine education in the August issue of the journal with great interest because of the issues raised for all of us involved.It stimulated me to raise two points.Firstly, although it is desirable for undergraduate medical students to be introduced to sports medicine, it does seem to be an area of practice that seems very appropriate for continuing medical education and for postgraduate qualifications.Although a case can be made out for medical practitioners who wish to practice full time in sports medicine, the number of such practitioners will be relatively few.The much greater need is for the "up-skilling" in sports medicine of medical practitioners whatever their practice-family medicine, emergency medicine, rehabilitation medicine, paediatrics, orthopaedics.There is a great need for much better "duty of care" in sports medicine practice by local medical practitioners with regard to promotion of physical activity, recreational sport, school and regional sporting teams, and community sporting and physical activity events.Secondly, the useful article by Professor Peter Fricker on sports medicine education in Australia does contain statements that require correction for the public record.He states that there are two classes of medical practitioners with an interest in the practice of sports medicine in Australia: sports physicians and "sports medicine practitioners".In fact, there are now two discipline bodies representing medical practitioners in Sports Medicine Australia, the Australian College of Sports Physicians and Sports Doctors Australia, members of which quite properly refer to themselves as sports doctors, either possessing a Masters of Sports Medicine or demonstrating a continuing involvement in sports medicine.This new body was formed two years ago in response to a request from Sports Medicine Australia to represent doctors who wished to incorporate sports medicine into their existing practice.In referring to the sports medicine programmes at the University of New South Wales in Sydney, Professor Fricker states that the teaching in these programs is carried out by "sports physicians and researchers".In fact, in the distance delivery postgraduate programs (MSpMed, GradDipSpMed, GradCertSpMed), teaching is conveyed in weekly video presentations in which the contribution of sports physicians is 20%, valuable particularly in the area of musculoskeletal medicine.As is to be expected in the multidisciplinary area of sports medicine, 80% of teaching is provided by medical physiologists such as myself, cardiologists, rehabilitation physicians, rheumatologists, ophthalmologists, anatomists, respiratory physiologists,
On the Influence of Pathological States upon the Elimination of Water and Carbon Dioxide by the Skin
Authors: J. O. W. Barratt
Journal: BMJ (1899)

79 man, wlho, after treating her for some months for cystitis, sent her into the Royal Hospital, where she is at present a patient.During the three years she has suffered from cystitis she has been troubled with headaches, which she states increase with the pain in the bladder region.
Artesunate Derived from Traditional Chinese Medicine Induces DNA Damage and Repair
Authors: Paul C.H. Li, Elena Lam, Wynand P. Roos, Małgorzata Z. Zdzienicka, Bernd Kaina, Thomas Efferth
Journal: Cancer Research (2008)

Abstract Artesunate is a semisynthetic derivative from artemisinin, a natural product from the Chinese herb Artemisia annua L. It exerts antimalarial activity, and, additionally, artemisinin and its derivatives are active against cancer cells. The active moiety is an endoperoxide bridge. Its cleavage leads to the formation of reactive oxygen species and carbon-centered radicals. These highly reactive molecules target several proteins in Plasmodia, which is thought to result in killing of the microorganism. DNA damage induced by artemisinins has not yet been described. Here, we show that artesunate induces apoptosis and necrosis. It also induces DNA breakage in a dose-dependent manner as shown by single-cell gel electrophoresis. This genotoxic effect was confirmed by measuring the level of γ-H2AX, which is considered to be an indication of DNA double-strand breaks (DSB). Polymerase β–deficient cells were more sensitive than the wild-type to artesunate, indicating that the drug induces DNA damage that is repaired by base excision repair. irs1 and VC8 cells defective in homologous recombination (HR) due to inactivation of XRCC2 and BRCA2, respectively, were more sensitive to artesunate than the corresponding wild-type. This was also true for XR-V15B cells defective in nonhomologous end-joining (NHEJ) due to inactivation of Ku80. The data indicate that DSBs induced by artesunate are repaired by the HR and NHEJ pathways. They suggest that DNA damage induced by artesunate contributes to its therapeutic effect against cancer cells. [Cancer Res 2008;68(11):4347–51]
When is drug treatment not necessary in epilepsy? Factors that should influence the decision to prescribe
Authors: R. W Newton
Journal: Journal of the Royal Society of Medicine (2003)

Epilepsy is a common treatable disorder with an incidence in the UK of about 0.05% and a prevalence of 0.5%.1 The average secondary school has about 6 children with the condition. A paediatrician who has diagnosed epilepsy will feel pressure to prescribe medication—as indeed will a clinician in adult practice. In view of the efficacy of anti-epileptic drugs,2 this is understandable. The primary aim of therapy is of course to prevent seizures, but do anti-epileptic drugs alter the natural history of the condition, either in the short term or by enhancing the chance of long-term remission? Should the benign epilepsies of childhood be treated differently? How do medication and everyday life issues interact? This paper deals with the factors that should influence the decision to prescribe. The focus is on childhood and adolescence, but much of the published work relates to adults and many of the points are relevant to an adult population too.
Late-Occurring Neurologic Sequelae in Adult Survivors of Childhood Acute Lymphoblastic Leukemia: A Report From the Childhood Cancer Survivor Study
Authors: Robert E. Goldsby, Qi Liu, Paul C. Nathan, Daniel C. Bowers, Amanda Yeaton-Massey, Shannon H. Raber, Daniel Hill, Gregory T. Armstrong, Yutaka Yasui, Lonnie Zeltzer, Leslie L. Robison, Roger J. Packer
Journal: Journal of Clinical Oncology (2009)

Children with acute lymphoblastic leukemia (ALL) are often cured, but the therapies they receive may be neurotoxic. Little is known about the incidence and severity of late-occurring neurologic sequelae in ALL survivors. Data were analyzed to determine the incidence of adverse long-term neurologic outcomes and treatment-related risk factors.We analyzed adverse neurologic outcomes that occurred after diagnosis in 4,151 adult survivors of childhood ALL who participated in the Childhood Cancer Survivor Study (CCSS), a retrospective cohort of 5-year survivors of childhood cancer diagnosed between 1970 and 1986. A randomly selected cohort of the survivors' siblings served as a comparison group. Self-reported auditory-vestibular-visual sensory deficits, focal neurologic dysfunction, seizures, and serious headaches were assessed.The median age at outcome assessment was 20.2 years for survivors. The median follow-up time to death or last survey since ALL diagnosis was 14.1 years. Of the survivors, 64.5% received cranial radiation and 94% received intrathecal chemotherapy. Compared with the sibling cohort, survivors were at elevated risk for late-onset auditory-vestibular-visual sensory deficits (rate ratio [RR], 1.8; 95% CI, 1.5 to 2.2), coordination problems (RR, 4.1; 95% CI, 3.1 to 5.3), motor problems (RR, 5.0; 95% CI, 3.8 to 6.7), seizures (RR, 4.6; 95% CI, 3.4 to 6.2), and headaches (RR, 1.6; 95% CI, 1.4 to 1.7). In multivariable analysis, relapse was the most influential factor that increased risk of late neurologic complications.Children treated with regimens that include cranial radiation for ALL and those who suffer a relapse are at increased risk for late-onset neurologic sequelae.