tbuckley/cabot-search huggingface dataset:
Early and unexpectedly severe start of influenza epidemic in the Czech Republic during influenza season 2012-13
Authors: J Kyncl, M Havlickova, A Nagy, H Jirincova, I Piskova
Journal: Eurosurveillance (2013)

A sudden increase in severe influenza has been registered in the Czech Republic since the end of 2012, with 264 cases requiring intensive care, including 51 deaths. Most patients had at least one risk factor. Severe influenza in patients with obesity, smoking and/or haematological disorders including haematological cancers was more frequent than in the pre-pandemic period. The seasonal influenza vaccination status of the cases indicates indirect efficiency of the current vaccine in preventing severe influenza.
AB0083 Arthritis Induces Early Bone Structural Degradation and Mechanical Weakness
Authors: B. Vidal, R. Cascão, I. Lopes, M. Finnila, S. Saarakkala, H. Canhão, J.E. Fonseca
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> We have previously found in the chronic SKG mouse model of arthritis that long standing (5 and 8 months) inflammation directly leads to high collagen bone turnover, disorganization of the collagen network, disturbed bone microstructure and ultimately declining of bone biomechanical properties [1]. <h3>Objectives</h3> Our main goal was to study the effects of the inflammatory process on the microarchitecture and mechanical properties of bone in the early stages of arthritis development. <h3>Methods</h3> Fifty Wistar adjuvant-induced arthritis (AIA) rats were monitored throughout arthritis development and sacrificed after 4, 11 and 22 days of disease induction. Thirty healthy non-arthritic rats, age and sex-matched, were sacrificed at the end of the experiment and used as controls for comparison. The inflammatory score, ankle perimeter and body weight were measured over the experimental period. At the time of sacrifice, bone and serum samples were collected for micro-CT and 3-point bending analysis as well as bone turnover markers (CTX-I and P1NP), respectively. All experiments were approved by the Animal User and Ethical Committees at the Instituto de Medicina Molecular (Lisbon University), according to the Portuguese law and the European recommendations. <h3>Results</h3> We have observed that bone turnover markers, CTX-I and P1NP, increased soon after arthritis onset (p&lt;0.0001 and p=0.0034, respectively, when compared to healthy controls). Moreover, micro-CT analyses showed both in trabecular and cortical parameters, that the effects of inflammation on bone microstructure were evident since the 4th day of arthritis development. Of particular interest, trabecular bone volume fraction decreased and cortical porosity increased at day 22 post disease induction when comparing to healthy controls (p=0.0001 and p&lt;0.0001, respectively). Biomechanical tests revealed that arthritic bone have altered biomechanical properties, such as maximal bending force (arthritic group lower than healthy control, p&lt;0.0001). <h3>Conclusions</h3> The inflammatory process induced bone loss, and reduces bone strength since the very early phase of arthritis. <h3>References</h3> Caetano-Lopes J, Nery AM, Canhao H, Duarte J, Cascao R, et al. (2010) Chronic arthritis leads to disturbances in the bone collagen network. Arthritis Res Ther 12: R9. <h3>Disclosure of Interest</h3> None declared
Reply
Authors: Salvatore Piano, Paolo Angeli
Journal: Hepatology (2016)

Potential conflict of interest: Nothing to report. Reply: We appreciate the interest of de Mattos and de Mattos in our article recently published in hepatology1 comparing the administration of terlipressin in continuous intravenous infusion (TERLI‐INF) versus intravenous boluses (TERLI‐BOL) in the treatment of hepatorenal syndrome (HRS). In our study the primary endpoint was the onset of drug‐related adverse events, and the sample size was calculated accordingly. Regarding the efficacy of treatment, we think 90‐day survival is not the optimal indicator of efficacy in HRS. Indeed, several variables, other than response to treatment, affect survival in patients with HRS, such as age, failure of organs other than the kidney, and degree of liver failure.1 Anyway, when we adjusted our analysis for all these variables, the randomization had no effect on survival. Moving to a more adequate parameter of efficacy, response to treatment, a higher rate of response was observed in the TERLI‐INF group than the TERLI‐BOL group, although the difference was not significant. Concerning the initial dose of terlipressin, we want to highlight that studies on pharmacokinetics and pharmacodynamics of terlipressin are lacking in patients with HRS; thus, the optimal initial dose is still to be determined. de Mattos and de Mattos, while citing our article comparing terlipressin versus midodrine/octreotide in the treatment of HRS,2 forgot to cite our first study on the use of terlipressin in HRS,3 in which we used terlipressin by continuous intravenous infusion starting from 2 mg/24 hours. Therefore, when we planned the study, we selected a 2 mg/24 hours initial dose in the TERLI‐INF group. We accept the speculation that a lower starting dose may justify a lower incidence of side effects in the TERLI‐INF versus the TERLI‐BOL group, but a lower dose could have caused the risk to be less effective. Nevertheless, most of the patients in the TERLI‐INF group responded to 2 mg/24 hours (Fig. 1).Figure 1: Dose of terlipressin needed to achieve response to treatment in patients assigned to TERLI‐BOL (A) and those assigned to TERLI‐INF (B).Finally, concerning economic issues, our study was not planned to identify differences in costs between the two groups. We agree that a comprehensive economic evaluation should take into account the whole treatment administered, invasive procedures, days of hospitalization, and so on. Thus, although in the whole population the mean dose of terlipressin was significantly lower in the TERLI‐INF group than in the TERLI‐BOL group (2.6 ± 1.4 versus 3.5 ± 1.7 mg/day, P < 0.025), no speculation can be made about the global cost of treatment. In conclusion, although there are still open questions, our study provided an answer to what is the most tolerated way of administration of terlipressin in patients with HRS.
Suicide in children and young people in England: a consecutive case series
Authors: Cathryn Rodway, Su-Gwan Tham, Saied Ibrahim, Pauline Turnbull, Kirsten Windfuhr, Jenny Shaw, Nav Kapur, Louis Appleby
Journal: The Lancet Psychiatry (2016)

There is concern about the mental health of children and young people and a possible rise in suicidal behaviour in this group. We have done a comprehensive national multi-agency study of suicide in under 20s in England. We aimed to establish how frequently suicide is preceded by child-specific and young person-specific suicide risk factors, as well as all-age factors, and to identify contact with health-care and social-care services and justice agencies.This study is a descriptive examination of suicide in a national consecutive sample of children and young people younger than 20 years who died by suicide in England between Jan 1, 2014, and April 30, 2015. We obtained general population mortality data from the Office for National Statistics (ONS). We collected information about antecedents considered to be relevant to suicide (eg, abuse, bullying, bereavement, academic pressures, self-harm, and physical health) from a range of investigations and inquiries, including coroner inquest hearings, child death investigations, criminal justice system reports, and the National Health Service, including data on people in contact with mental health services in the 12 months before their death.145 suicides in people younger than 20 years were notified to us during the study period, of which we were able to obtain report data about antecedents for 130 (90%). The number of suicides rose sharply during the late teens with 79 deaths by suicide in people aged 18-19 years compared with 66 in people younger than 18 years. 102 (70%) deaths were in males. 92 (63%) deaths were by hanging. Various antecedents were reported among the individuals for whom we had report data, including academic (especially exam) pressures (35 [27%] individuals), bullying (28 [22%]), bereavement (36 [28%]), suicide in family or friends (17 [13%]), physical health conditions (47 [36%]), family problems (44 [34%]), social isolation or withdrawal (33 [25%]), child abuse or neglect (20 [15%]), excessive drinking (34 [26%]), and illicit drug use (38 [29%]). Suicide-related internet use was recorded in 30 (23%) cases. In the week before death 13 (10%) individuals had self-harmed and 35 (27%) had expressed suicidal ideas. 56 (43%) individuals had no known contact with health-care and social-care services or justice agencies.Improved services for self-harm and mental health are crucial to suicide prevention, but the wide range of antecedents emphasises the roles of schools, primary care, social services, and the youth justice system.The Healthcare Quality Improvement Partnership.
Phase II trial of vatalinib in patients with advanced or metastatic pancreatic adenocarcinoma who failed gemcitabine therapy
Authors: T. Dragovich, D. A. Laheru, J. J. Crowley, L. S. Smith, J. Seng, H. A. Burris, P. J. Rosen, D. D. Von Hoff, V. Bolejack, M. Hidalgo
Journal: Journal of Clinical Oncology (2008)

4615 Background: Adenocarcinomas of the pancreas overexpress VEGF and PDGF receptors, both targeted by vatalinib, a small molecule inhibitor of receptor tyrosine kinases. We have examined the ramp-up BID dosing schedule of vatalinib in patients (pts) with unresectable pancreatic adenocarcinoma whose tumors progressed on or were unable to tolerate gemcitabine-based chemotherapy. Methods: Eligible pts with unresectable and or metastatic pancreatic adenocarcinoma, > 18 years old, Zubrod performance status (PS) of 0–2, and good organ function. The planned accrual goal was 65. The primary objective was 6-month overall survival (OS) rate in pancreatic cancer patients treated with vatalinib as 2nd-line therapy. The treatment consisted of vatalinib daily PO, continuously, starting at 250 mg BID, up to 500 mg BID in the second week, and up to 750 mg BID in the third week in pts who tolerated dose escalation. Tumor tissue and serum samples were collected for biomarker analyses. Results: As of January 7, 2008, 65 pts have been enrolled. Median age is 64 years, pts had a median of 1 prior treatment regimen (minimum 1, maximum 4), 91% pts had metastatic disease, and Zubrod PS (0/1/2) was 48%/42%/10%. 56 pts have been evaluated for toxicity. Hypertension and fatigue were most common gr 3/4 toxicities attributable to study treatment, occurring in 17% and 13%, respectively, of treated pts. Only 4% of pts experienced grade 3 dizziness. There were 5 deaths on/within 30 days of study treatment, all related to disease progression. Among the 57 evaluable pts, the 6-month OS rate was 31 %, which met the primary study endpoint. The 6-month progression-free survival (PFS) rate was 14%. Biomarker studies are ongoing. Conclusions: Treatment with BID ramp-up vatalinib was well tolerated and resulted in a promising 6-month OS rate and 6-month PFS rate in patients with advanced pancreatic cancer who failed prior gemcitabine-based therapy. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Concordia, Genentech Novartis Bristol-Myers Squibb, Cell Genesys, Genentech, Genvec
Ethnic Considerations for Metabolic Surgery
Authors: John Magaña Morton
Journal: Diabetes Care (2016)

Obesity and diabetes represent twin health concerns in the developed world. Metabolic surgery has emerged as an established and enduring treatment for both obesity and diabetes. As the burden of obesity and diabetes varies upon the basis of ethnicity, it is also apparent that there may be differences for indications and outcomes for different ethnic groups after metabolic surgery. Whereas there appears to be evidence for variation in weight loss and complications for different ethnic groups, comorbidity remission particularly for diabetes appears to be free of ethnic disparity after metabolic surgery. The impacts of access, biology, culture, genetics, procedure, and socioeconomic status upon metabolic surgery outcomes are examined. Further refinement of the influence of ethnicity upon metabolic surgery outcomes is likely imminent.
First aid and treatment of minor burns
Authors: Jackie Hudspith, Sukh Rayatt
Journal: BMJ (2004)

Some 250 000 burns occur annually in the United Kingdom. About 90% of these are minor and can be safely managed in primary care. Most of these will heal regardless of treatment, but the initial care can have a considerable influence on the cosmetic outcome. All burns should be assessed by taking an adequate history and examination.

The aims of first aid should be to stop the burning process, cool the burn, provide pain relief, and cover the burn.

   ![][1] 

A superficial scald suitable for management in primary care

Stop the burning process —The heat source should be removed. Flames should be doused with water or smothered with a blanket or by rolling the victim on the ground. Rescuers should take care to avoid burn injury to themselves. Clothing can retain heat, even in a scald burn, and should be removed as soon as possible. Adherent material, such as nylon clothing, should be left on. Tar burns should be cooled with water, but the tar itself should not be removed. In the case of electrical burns the victim should be disconnected from the source of electricity before first aid is attempted.

Cooling the burn —Active cooling removes heat and prevents progression of the burn. This is effective if performed within 20 minutes of the injury. Immersion or irrigation with running tepid water (15½C) should be continued for up to 20 minutes. This also removes noxious agents and reduces pain, and may reduce oedema by stabilising mast cells and histamine release. Iced water should not be used as intense vasoconstriction can cause burn progression. Cooling large areas of skin can lead to hypothermia, especially in children. Chemical burns should be irrigated with copious amounts of water.

   ![][2] 

Burnshield is a cooling gel used to cover burn and reduce pain

Analgesia —Exposed nerve endings …

 [1]: /embed/graphic-1.gif
 [2]: /embed/graphic-2.gif
Melancholia: from DSM-III to DSM-III-R
Authors: M Zimmerman, R L Spitzer
Journal: American Journal of Psychiatry (1989)

On July 26, 1985, an ad hoc committee appointed by the APA Work Group to Revise DSM-III met and reviewed the research on the validity of the DSM-III criteria for melancholia. In this paper the proceedings of the meeting are related. After reviewing studies of the validity of the DSM-III melancholia criteria, the authors describe the committee's discussion of alternative proposals for DSM-III-R and the process of developing the new DSM-III-R criteria.
Opposition to "coercive continuing medical education and mandatory recertification"
Authors: J A Talbott
Journal: American Journal of Psychiatry (1979)

A district branch survey on attitudes toward obligatory continuing medical education (CME) and mandatory recertification indicated that most respondents approved the concept of lifelong learning. However, proposed methods of implementation of CME were criticized on grounds of commercialization, bureaucratization, poor quality, wasting time and money, excessive external control over learning, and flawed requirements. Objections to mandatory recertification centered mainly on an abhorrence of Board-type examinations. The author offers suggestions to program directors and sponsors, educational researchers, and CME administrators as to ways to answer these criticisms of CME and recertification.
A Restriction Fragment Length Polymorphism for Human Topoisomerase II: Possible Relationship to Drug-Resistance
Authors: Leonard A. Zwelling, Janice Mayes, Karl Deisseroth, Michael Hinds, Grace Grant, Sen Pathak, Fred D. Ledley, Rohini Vyas, Walter Hittelman
Journal: Cancer Communications (1990)

In previous studies we used Southern blotting to examine the topoisomerase II locus (on chromosome 17) in human leukemia cell lines and noted a difference in the XmnI restriction endonuclease digestion pattern between an m-AMSA-resistant line and its m-AMSA-sensitive parent line (Zwelling, L. A.; Hinds, M,; Chan, D.; Mayes, J.; Sie, K. L.; Parker, E.; Silberman, L.; Radcliffe, A.; Beran, M.; Blick, M. Characterization of an amsacrine-resistant line of human leukemia cells. Evidence for a drug-resistant form of topoisomerase II. Journal of Biological Chemistry 264:16411-16420; 1989). We now demonstrate that the variable XmnI digestion pattern represents a normal restriction fragment length polymorphism (RFLP) which is observed in subjects without malignant disease and exhibits an autosomal pattern of inheritance. These data suggest that the previously described deviation in the genomic structure of topoisomerase II in the m-AMSA-resistant cell line did not reflect a new mutation, but rather a reduction to homozygosity at the topoisomerase II locus. This reduction to homozygosity is not due to chromosomal loss, as chromosome 17-specific gene probes clearly identify two chromosome 17's in the sensitive line and four in the resistant line, using chromosome painting with a chromosome 17-specific library. Some other genetic change must be the cause of the resistance of HL-60/AMSA and its topoisomerase II to the inhibiting actions of m-AMSA.
Long-term benzodiazepine users 3 years after participation in a discontinuation program
Authors: K Rickels, W G Case, E Schweizer, F Garcia-Espana, R Fridman
Journal: American Journal of Psychiatry (1991)

Clinical status and use of benzodiazepines and other psychotropic drugs at follow-up were assessed in patients who had been chronically dependent on benzodiazepines and had been referred for participation in a discontinuation study.Of 123 benzodiazepine-dependent patients screened for entry into a tapered discontinuation program, 48 had completed the program, 38 had not, and 37 had not undergone drug tapering. Follow-up information was obtained through a structured telephone interview and a mail questionnaire that included a global severity scale assessing anxiety and depression and the Hopkins Symptom Checklist. The time to follow-up was 2.7-5.0 years, and the mean +/- SD interval between screening and follow-up was 2.9 +/- 0.9 years.Outcome at follow-up significantly favored the patients who had completed the discontinuation program; 73% were not using benzodiazepines, compared to 39% in the unsuccessful taper group and 14% in the no-taper group. Moderate or marked anxiety was still reported by 35% of the patients who were taking benzodiazepines and 25% of those who were not. At follow-up, 22% of the patients were being treated with nonbenzodiazepine psychotropic agents, primarily antidepressants.The high percentage of patients who were benzodiazepine-free at follow-up and the continued anxiety and depression present in many patients suggest that some patients may have been taking benzodiazepines because of chronic or recurrent anxiety or depression, not physical dependence.
Development and Validation of a Small Single-domain Antibody That Effectively Inhibits Matrix Metalloproteinase 8
Authors: Delphine Demeestere, Eline Dejonckheere, Sophie Steeland, Paco Hulpiau, Jurgen Haustraete, Nick Devoogdt, Rielana Wichert, Christoph Becker-Pauly, Elien Van Wonterghem, Sylviane Dewaele, Griet Van Imschoot, Jeroen Aerts, Lutgarde Arckens, Yvan Saeys, Claude Libert, Roosmarijn E Vandenbroucke
Journal: Molecular Therapy (2016)

A detrimental role for matrix metalloproteinase 8 (MMP8) has been identified in several pathological conditions, e.g., lethal hepatitis and the systemic inflammatory response syndrome. Since matrix MMP8-deficient mice are protected in the above-mentioned diseases, specific MMP8 inhibitors could be of clinical value. However, targeting a specific matrix metalloproteinase remains challenging due to the strong structural homology of matrix metalloproteinases, which form a family of 25 members in mammals. Single-domain antibodies, called nanobodies, offer a range of possibilities toward therapy since they are easy to generate, express, produce, and modify, e.g., by linkage to nanobodies directed against other target molecules. Hence, we generated small MMP8-binding nanobodies, and established a proof-of-principle for developing nanobodies that inhibit matrix metalloproteinase activity. Also, we demonstrated for the first time the possibility of expressing nanobodies systemically by in vivo electroporation of the muscle and its relevance as a potential therapy in inflammatory diseases. A detrimental role for matrix metalloproteinase 8 (MMP8) has been identified in several pathological conditions, e.g., lethal hepatitis and the systemic inflammatory response syndrome. Since matrix MMP8-deficient mice are protected in the above-mentioned diseases, specific MMP8 inhibitors could be of clinical value. However, targeting a specific matrix metalloproteinase remains challenging due to the strong structural homology of matrix metalloproteinases, which form a family of 25 members in mammals. Single-domain antibodies, called nanobodies, offer a range of possibilities toward therapy since they are easy to generate, express, produce, and modify, e.g., by linkage to nanobodies directed against other target molecules. Hence, we generated small MMP8-binding nanobodies, and established a proof-of-principle for developing nanobodies that inhibit matrix metalloproteinase activity. Also, we demonstrated for the first time the possibility of expressing nanobodies systemically by in vivo electroporation of the muscle and its relevance as a potential therapy in inflammatory diseases.
"WHAT'S WHAT."
Authors: H. Quilter
Journal: BMJ (1902)

white after the eye trouble had set in.These cases are certainly rare and it has been stated that the whiteness of the eyelashes is a mere coincidence.This I do not believe and I think that the neurotic origin of the blanching in these cases is supported by evidence derived from com- parative pathology.Mr. Beddard in his book on "Animal Coloration" writes (pp.19-20) : "There is certainly evidence that coloration has some relation to the distribution of the underlying nerves.Mr. Allen has stated that the white marks on the head of the tiger correspond to the area of dis- tribution of the infra-orbital nerves.The nerves terminate in or near the skin, and it is clear that there must be some connexion between nerve-supply and coloration from the fact that in a hedgehog whose spines were white the nerves in connexion with the muscles for contraction of the skin were greatly diseased.There are plenty of other pathological
ON THE ENUCLEATION OF TONSILS WITH THE GUILLOTINE
Authors: S. S. Whillis, F. C. Pybus
Journal: BMJ (1911)

IN a recent paper1 we called attentioni to certain im- portant facts regardinig the aniatomy and patlhology of the faucial tonsil.We also showed that by lileans of tlle guillotine, colmibilned wvitlh finger pressure on the alnterior
Respiratory diphtheria in an asylum seeker from Afghanistan arriving to Finland via Sweden, December 2015
Authors: Jussi Sane, Tiina Sorvari, Micael Widerström*, Heikki Kauma, Ulla Kaukoniemi, Eveliina Tarkka, Taneli Puumalainen, Markku Kuusi, Mika Salminen, Outi Lyytikäinen
Journal: Eurosurveillance (2016)

In December 2015, an asylum seeker originating from Afghanistan was diagnosed with respiratory diphtheria in Finland. He arrived in Finland from Sweden where he had already been clinically suspected and tested for diphtheria. Corynebacterium diphtheriae was confirmed in Sweden and shown to be genotypically and phenotypically toxigenic. The event highlights the importance of early case detection, rapid communication within the country and internationally as well as preparedness plans of diphtheria antitoxin availability.