tbuckley/cabot-search huggingface dataset:
PWE-105 Long term survival of cirrhotics following icu admission – a subgroup of patients with 'resilient' cirrhosis
Authors: J Lloyd-Evans, T Pembroke, A Godkin
Journal: Gut (2015)

<h3>Introduction</h3> Patients with cirrhosis who are admitted to the ICU are considered to have a poor prognosis. Previous studies have sought to identify markers of high predictive value in patients who will not survive their critical care stay. These studies have focused upon early prognosis, rather than longer term survival. We sought to validate previously described outcome predictors and review long-term survival in a cohort of cirrhotic patients admitted to ICU. <h3>Method</h3> We performed a retrospective analysis of cirrhotic patients admitted to adult ICU, University Hosptial of Wales (Cardiff, UK) between 2009–14. Admission information was collated from the Intensive Care National Audit and Research Centre database. Child-Pugh, Model for End-stage Liver Disease-Na (MELD-Na) and Acute Physiology and Chronic Health Evaluation (APACHE II) scores were derived from data on admission to critical care. Statisical analyses were conducted with SPSS. <h3>Results</h3> One hundred and fifty one cirrhotics (2.8% of all critical care admissions) were admitted to the ICU with a mean age of 54 (range 22–80) and a male preponderance (65.6%). The predominant aetiology was alcoholic liver disease (ALD, 107/151, 70.9%). The reasons for ICU admission were variceal bleed 29.8%; sepsis 25.2%; decompensation 13.9%;non variceal bleed 5.3% and other 26%. ICU mortality was 43.7% for the 151 patients. Mean follow up after ICU discharge was 788 days (range 26–1722). Hyponatraemia (p &lt; 0.001), coagulopathy (p = 0.02), APACHE II (p = 0.004) and MELD-Na scores (p &lt; 0.0001) were significantly associated with mortality. Patients diagnosed as decompensation with no obvious underlining precipitant had a worse prognosis than those with precipitants (e.g. variceal bleeding, sepsis) which was maintained at follow up (p = 0.05). Child’s A, B and C stage patients had a mean overall survival of 1274, 976 and 690 days respectively (p = 0.01). Seventy-eight patients were discharge from hospital. Only 6 of these patients died, all with Child’s B liver disease. Only attending outpatient follow up clinic was associated with increased survival (p = 0.01 1373 v 1668 days). <h3>Conclusion</h3> Nearly half of all cirrhotics admitted to the ICU die before discharge, and two thirds of all patients have alcohol as an aetiological factor, emphasising the burden on our society. As expected, commonly used scoring systems predict short-term outcome, but often do not reflect long-term survival. Cirrhotics who survive the challenge of ICU admission seem to have quite marked physiological resilience and capacity for recovery with a good long term prognosis. Interestingly only patients with Child’s B cirrhosis continued to demonstrate a post-hospital discharge mortality, warranting further investigation for underlying reasons. <h3>Disclosure of interest</h3> None Declared.
ATNT-24KETOGENIC DIETS IN CANCER THERAPIES: ARE WE SPEAKING THE SAME LANGUAGE?
Authors: Michele Nikolai, Mary Noel, Kenneth Schwartz
Journal: Neuro-Oncology (2015)

BACKGROUND: The definition and parameters of the ketogenic diet are not universal. Consistency of terms, type of diet and measurement of ketones need to be defined. These therapies and the parameters have been well established in the nutrition and neurology literature, but require standardization if ketosis is going to be evaluated as an oncologic therapy. METHODS: Comparison of ketogenic diets to other modified diets that are commonly thought of as ketogenic diets includes the following: Classic Ketogenic Diet (KD), Medium Chain Triglyceride oil diet (MCT), Low Glycemic Index Therapy (LGIT), Modified Atkins (MAD and Atkins (AD) diets and the biological parameters for monitoring ketosis (labs, including blood and or urine ketones). RESULTS: Comparison graphics for the KD, MCT, LGIT, MAD and AD will be presented and will include the following: Proportions of fat, protein and carbohydrate in each type of diet; how foods are measured, whether calories are controlled; presence of blood and urine ketones reported for each diet; and one sample day of each diet. CONCLUSIONS: Ketogenic diet therapies (KD, MCT, LGIT, MAD, and AD) are complicated and different from the public's thinking of a healthy diet for cancer. Individual patient's response and compliance with different diets vary. Without consensus about what constitutes a ketogenic diet and twice daily measurements of blood ketones to ensure the state of ketosis is maintained, metabolic changes cannot be documented. Since the purpose of this therapy is to induce the state of ketosis, the type of ketogenic diet used must actually promote ketone formation and be monitored. Without those key elements, comparisons between trials cannot be achieved and the value of the ketogenic diet as an anticancer treatment will remain an unanswered question.
만성 B형 간질환에서의 지질과산화
Authors: 김경철, 이관식, 한광협, 최원, 전재윤, 이상인, 문영명, 강진경, 박인서, 김혜영 ( Kyung Chul Kim), Kwan Sik Lee, Kwang Hyub Han, Won Choi, Chae Yoon Chon, Sang In Lee, Young Myung Moon, Jin Kyung Kang, In Suh Park, Hye Young Kim
Journal: Clinical and Molecular Hepatology (1997)

Background/Aims .' Oxidative stress is known to play a role in the pathogenesis of a certain liver diseases such as alcoholic liver disease, metal storage disease, and ischemia/reperfusion injury. Recently oxidative stress(lipid peroxidation) has also been implicated in hepatic fibrosis, which is now regarded as a common response to chronic liver injury regardless of its nature. Development of fibrosis and cirrhosis are the major complications of chronic hepatitits B. So we aimed to detect lipid peroxidation in chronic hepatitis B and to investigate its potential role in the pathophysiology of the disease. Methods .' The subjects were histologically-proven 56 patients, including fatty liver(FL, n=8), healthy HBsAg carrier(n=6), chronic persistent hepatitis(CPH, n=8), mild chronic active hepatitis(CAH- m, n=10), severe CAH(CAH-s, n=16), and liver cirrhosis(LC, n=8). All patients were serologically HBsAg-positive except those with FL. Lipid peroxidation was detected in serum and liver specimen with TBARS(thiobarbituric acid-reacting substances) assay. Western blot and immunohistochemical stain of liver specimen were also performed, using polyclonal antibody against malondialdehyde (MDA). Results '. 1. There were no significant differences in serum TBARS levels among groups(p= 0.24). 2. The mean tissue TBARS level(nmol/g) was significantly higher in CAH-s group(175.4+ 41.5) than in other groups(FL 54.0+ 6.4, Carrier 51.1+ 15.9, CPH 63.9+ 2.9, CAH-m 68.9+ 7.9, LC 22.6+ 5.1) (p<0.05). 3. Tissue TBARS levels correlated with serum ALT levels(r=0.5934, p<0.05). 4. Western blot showed MDA bands only in CAH-s group. 5. Immunohistochemistry showed a strong MDA stain around portal and periportal area in CAH-s group, but weak or no stain in other groups. Conclusions . This study shows that lipid peroxidation can be detected in situ and commonly occurs in severe chronic hepatitis B. Oxidative stress may be related to active necroinflammatory change  of the liver and contribute to the progression of the disease in chronic hepatitis B.
Nutritional Rickets
Authors: T D Thacher
Journal: New England Journal of Medicine (1999)

Figure 1 A 30-month-old girl had had progressive bowing of the legs since she began walking at the age of 11 months. She reported bilateral thigh pain. Physical examination revealed genu varum (Panel A) and enlarged wrists. A radiograph of the wrists revealed cupping and fraying of the metaphyses of the distal radius and ulna (Panel B). The child's serum alkaline phosphatase and parathyroid hormone concentrations were high, the serum calcium concentration was low, and the serum 25-hydroxyvitamin D concentration was normal (35 ng per milliliter [87 nmol per liter]). She was usually exposed to sunlight for more than three hours a day. She had stopped breast-feeding at the age of six months, and her average dietary calcium intake was 160 mg per day. Figure 1 A 30-month-old girl had had progressive bowing of the legs since she began walking at the age of 11 months. She reported bilateral thigh pain. Physical examination revealed genu varum (Panel A) and enlarged wrists. A radiograph of the wrists revealed cupping and fraying of the metaphyses of the distal radius and ulna (Panel B). The child's serum alkaline phosphatase and parathyroid hormone concentrations were high, the serum calcium concentration was low, and the serum 25-hydroxyvitamin D concentration was normal (35 ng per milliliter [87 nmol per liter]). She was usually exposed to sunlight for more than three hours a day. She had stopped breast-feeding at the age of six months, and her average dietary calcium intake was 160 mg per day. Tom D. Thacher, M.D.Jos University Teaching Hospital, Jos, Nigeria
(60) Melkersson-Rosenthal syndrome
Authors: P.D. Wilson
Journal: British Journal of Dermatology (1987)

Journal Article (60) Melkersson‐Rosenthal syndrome Get access P.D. Wilson P.D. Wilson Grimsby District Hospital Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 117, Issue s32, 1 June 1987, Pages 117–118, https://doi.org/10.1111/j.1365-2133.1987.tb12100.x Published: 01 June 1987
Phase II study of everolimus (E) in refractory germ cell tumors (GCTs).
Authors: Michal Mego, Daniela Svetlovska, Jana Obertova, Maria Reckova, Viera Miskovska, Jan Rajec, Zuzana Sycova-Mila, Patrik Palacka, Stefania Liskova, Michal Chovanec, Tomas Salek, Jozef Mardiak
Journal: Journal of Clinical Oncology (2012)

TPS4677 Background: GCTs represent a model for the cure of cancer. Nonetheless, a small proportion of patients (pts) develop disease recurrence. Because of insufficient results in the treatment of relapsed GCTs, evaluation of new treatments is a priority. Loss of the tumor suppressor gene PTEN (phosphatase and tensin homolog) marks the transition from intratubular germ cell neoplasias (ITGCN) to invasive GCTs. In the testis, PTEN was abundantly expressed in germ cells whereas it was virtually absent from 56% of seminomas as well as from 86% of embryonal carcinomas and virtually all teratomas. On the contrary, ITGCN intensely expressed PTEN, indicating that loss of PTEN expression is not in early event in GCTs development, but is associated with disease progression. PTEN inactivation is associated with dysregulation of PI3K/Akt pathway and increased mTOR signalling. We hypothesize that dysregulation of PI3K/Akt pathway due to PTEN inactivation in GCTs suggests that these pts could have greater benefit from mTOR inhibition. Methods: In December 2011, National Cancer Institute of Slovakia launched an one arm, two-staged phase II study aimed to evaluate the efficacy and toxicity of E in pts with refractory GCTs. The primary objective is to determine the efficacy of E in patients with refractory GCTs. Secondary objectives includes favourable response rate, time to progression and safety. The pts with radiological and/or serological proof of relapsed GCTs, who were not amenable to be cured by chemotherapy or surgery and who failed at least two platinum-based regimens or one platinum regimen in case of platinum-refractory disease or primary mediastinal non-seminomatous GCTs were eligible. All other standard inclusion and exclusion criteria for study of salvage treatment in refractory GCTs pts were applied. E will be administered at a dose of 10mg daily until progression or unacceptable toxicity. Assuming a response rate of clinical interest of ≥40%, a minimal response rate of 20%, a probability of 5% for rejecting an active drug, and a probability of 20% to further evaluate an ineffective drug, 18 pts will be enrolled into the first cohort. If &lt;4 responses will be observed, the study will be terminated, otherwise, it will be continued with a second cohort of 20 pts.
What the health-care consumer should know about chiropractic
Authors: R. S. Wilbur
Journal: JAMA (1971)

The public spotlight these days is on the American consumer. Government and private groups are acting on many fronts to keep the consumer from being bilked out of his money. Of even greater concern, we think, is safeguarding the consumer's health. He must be adequately informed about and protected from unscientific cults such as chiropractic that can endanger his health, or threaten his life— by delaying proper medical care. We believe all of you know what the medical profession thinks of chiropractic: that chiropractic is an unscientific cult whose practitioners lack the necessary education and training to diagnose and treat human diseases and illnesses. And I assume all of you know that this opinion is shared by the rest of the nation's scientific community. We are here to discuss not what the scientific community thinks of chiropractic, although that always has been and is of vital importance in protecting the
Deoxyspergualin inhibits mesangial cell proliferation and major histocompatibility complex class II expression.
Authors: D J Nikolic-Paterson, G H Tesch, H Y Lan, R Foti, R C Atkins
Journal: Journal of the American Society of Nephrology (1995)

It has previously been shown that the immunosuppressive drug deoxyspergualin can inhibit renal injury in experimental glomerulonephritis. This study examined whether deoxyspergualin can modulate the mesangial cell response to glomerular injury. Antiglomerular basement membrane glomerulonephritis was induced in primed rats. Groups of five animals were treated with deoxyspergualin (5 mg/kg per day) or saline from Day 0 until being euthanized on Day 1, 7, 14, or 21. Deoxyspergualin treatment significantly inhibited mesangial cell proliferation (proliferating cell nuclear antigen expression) over the disease course as assessed by double immunohistochemistry staining (P < 0.001 versus saline treated) and reduced glomerular major histocompatibility complex (MHC) class II expression. To demonstrate if this was a direct action of deoxyspergualin, an in vitro system was studied. The addition of deoxyspergualin caused a time- and dose-dependent inhibition of [3H]thymidine uptake by cultured rat mesangial cells. Of particular interest was the finding that deoxyspergualin inhibited the de novo cell surface expression of MHC class II antigens after interferon-gamma stimulation. However, deoxyspergualin did not prevent the cytoplasmic accumulation of MHC class II molecules, indicating that the drug interfered with a posttranslational event in MHC class II processing and/or assembly. Deoxyspergualin was not a general inhibitor of mesangial cells, and it had no effect on constitutive or lipopolysaccharide-induced transforming growth factor beta 1 expression. In conclusion, deoxyspergualin has been shown to inhibit the mesangial cell response to glomerular injury. This novel mode of action may provide an additional therapeutic benefit in the treatment of proliferative forms of glomerulonephritis.
A new decade, a new seasonal influenza: the Council of the European Union Recommendation on seasonal influenza vaccination
Authors: A Nicoll
Journal: Eurosurveillance (2010)

Preview this article: A new decade, a new seasonal influenza: the Council of the European Union Recommendation on seasonal influenza vaccination, Page 1 of 1 < Previous page | Next page > /docserver/preview/fulltext/eurosurveillance/15/1/art19458-en-1.gif
Physiotherapy and Occupational Therapy and Mild to Moderate Parkinson Disease—Reply
Authors: Carl E. Clarke, Marion F. Walker, Catherine M. Sackley
Journal: JAMA Neurology (2016)

In Reply On behalf of the PD REHAB Collaborative Group, we are pleased that the PD REHAB Trial1 has prompted debate. The issues raised are common to the 3 letters2-4 and all were covered in the original article.1
Soundings: The big man
Authors: Colin Douglas
Journal: BMJ (2000)

In a small country with a new parliament there was a big man. The big man was quite important in the new parliament. In fact he was the leader. And long before that, when most people in the small country thought it didn't need a parliament, he had worked hard and talked to a lot of people to persuade them that it did.

So when the people voted they got a parliament. On its first day the Queen came to open it. Everyone cheered, and the big man looked happy.

He did not always look happy. In fact he had often been sad. He was an only child. His parents were old and rich and ill, and sent him away to school when he was 3 years old. His best friend was the school rabbit, which was black and white.

At college he made lots of real friends, and became happier, but he still cared a lot about unhappy people, and poor people, and wanted to help them. So he did something called politics, and went to a big parliament far away to try to help people of the small country. But soon he thought a new parliament would be better for helping them, so he worked for that.

He was very tall and very clever and kind, but also a bit clumsy and untidy, so that in a strange sort of way many of the people he wanted to help ended up wanting to help him, which is good in politics.

After many years, when the new parliament opened, lots of people told the big man that he should be an elder statesman, with a title and robes, but he said: “No, I haven't finished. I still want to help people. That is what the new parliament is for.” So he went back to work in his crumpled grey suit.

But quite soon he got ill and needed an operation to make him better. Then one day at work his office friends noticed that he was ill again. “Can we send for the doctor?” they asked. “No,” he said, “I'm getting better and there's a lot to do.”

But he wasn't getting better and the next day he died. And everyone was very sad because the big man had been kind and helped a lot of people. And even though the new parliament was on its holidays, they all came back and had a meeting about him, and made nice speeches, and a lot of them cried.

Donald Dewar, first minister in the new Scottish executive, died on 11 October.
Current issues in national insurance for mental health services
Authors: S H Nelson
Journal: American Journal of Psychiatry (1976)

The current economic crisis has again placed in jeopardy the inclusion of mental health benefits under national health insurance. The author notes that progress has been made in establishing effective peer review systems and in demonstrating that costs of mental health services are reasonable. Yet the lack of agreement on diagnosis and appropriate treatment, the inadequacy of utilization, cost, and treatment outcome data, and the absence of professional self-regulation remain causes for concern in the effort toward eventual comprehensive coverage for mental disorders.
Prenatal Organophosphorus Pesticide Exposure and Child Neurodevelopment at 24 Months: An Analysis of Four Birth Cohorts
Authors: Stephanie M. Engel, Asa Bradman, Mary S. Wolff, Virginia A. Rauh, Kim G. Harley, Jenny H. Yang, Lori A. Hoepner, Dana Boyd Barr, Kimberly Yolton, Michelle G. Vedar, Yingying Xu, Richard W. Hornung, James G. Wetmur, Jia Chen, Nina T. Holland, Frederica P. Perera, Robin M. Whyatt, Bruce P. Lanphear, Brenda Eskenazi
Journal: Environmental Health Perspectives (2015)

Background:Organophosphorus pesticides (OPs) are used in agriculture worldwide. Residential use was common in the United States before 2001.Objectives:We conducted a pooled analysis of four birth cohorts (children’s centers; n = 936) to evaluate associations of prenatal exposure to OPs with child development at 24 months.Methods:Using general linear models, we computed site-specific and pooled estimates of the association of total dialkyl (ΣDAP), diethyl (ΣDEP), and dimethylphosphate (ΣDMP) metabolite concentrations in maternal prenatal urine with mental and psychomotor development indices (MDI/PDI) and evaluated heterogeneity by children’s center, race/ethnicity, and PON1 genotype.Results:There was significant heterogeneity in the center-specific estimates of association for ΣDAP and ΣDMP and the MDI (p = 0.09, and p = 0.05, respectively), as well as heterogeneity in the race/ethnicity-specific estimates for ΣDAP (p = 0.06) and ΣDMP (p = 0.02) and the MDI. Strong MDI associations in the CHAMACOS population per 10-fold increase in ΣDAP (β = –4.17; 95% CI: –7.00, –1.33) and ΣDMP (β = –3.64; 95% CI: –5.97, –1.32) were influential, as were associations among Hispanics (β per 10-fold increase in ΣDAP = –2.91; 95% CI: –4.71, –1.12). We generally found stronger negative associations of ΣDAP and ΣDEP with the 24-month MDI for carriers of the 192Q PON1 allele, particularly among blacks and Hispanics.Conclusions:Data pooling was complicated by center-related differences in subject characteristics, eligibility, and changes in regulations governing residential use of OPs during the study periods. Pooled summary estimates of prenatal exposure to OPs and neurodevelopment should be interpreted with caution because of significant heterogeneity in associations by center, race/ethnicity, and PON1 genotype. Subgroups with unique exposure profiles or susceptibilities may be at higher risk for adverse neurodevelopment following prenatal exposure.Citation:Engel SM, Bradman A, Wolff MS, Rauh VA, Harley KG, Yang JH, Hoepner LA, Barr DB, Yolton K, Vedar MG, Xu Y, Hornung RW, Wetmur JG, Chen J, Holland NT, Perera FP, Whyatt RM, Lanphear BP, Eskenazi B. 2016. Prenatal organophosphorus pesticide exposure and child neurodevelopment at 24 months: an analysis of four birth cohorts. Environ Health Perspect 124:822–830; http://dx.doi.org/10.1289/ehp.1409474
Going public
Authors: James Owen Drife
Journal: BMJ (2007)

A television interview involves some heart searching. More so now than when I was a college spokesman. In that role you could reassure your colleagues (and yourself) that you were driven by duty. You received briefings and a line to take, and you could usually confine yourself to facts.

But when you're on your own, the phone call takes you by surprise. The questions are less research, more audition. “Are Britain's maternity services getting worse?” “Well, yes and no,” you reply, “or to put it another way, no and yes.” Finally the voice asks: “Would you be willing to talk to us?”

Would you? Do you trust the person behind the voice? She sounds concerned and well informed and her programme has a good reputation. The real question is, how deep is your despair? Services across the country are now controlled by national politicians who no longer listen to practising doctors. Let's go for it.

“We're in your area on Saturday,” says the voice, “but in the morning we're interviewing a real person.” Shared irony is a good sign. I ask if the interview will be over in time for me to get to the opera. The reply is not entirely reassuring.

Our managers, relaxed and helpful, say it's okay to film in the hospital. On Saturday afternoon, men with drills begin long awaited repairs to the lift. I feel a pang of conscience asking them to stop. The television crew decide my untidy bookshelves make a good background. “We like random,” says the cameraman, removing my wall clock.

The interviewer already knows all the facts and figures. What she wants are opinions, succinctly expressed. Professors don't do succinct. She nudges me to be more outspoken, but I say I can't bring myself to frighten women viewers. Gently, she points out that this may be the only way to change things. We're both thinking the same: what a way to run a health service.

A final take in the ward. Beds are screened off, but the midwife and I sign a release allowing our images to be distributed “throughout the universe.” Big in Ursa Minor, maybe. Will any of this be used? Will it make a difference? I suspect not. Anyway, I made it to the opera. The heroine died but, thank goodness, she wasn't pregnant.