tbuckley/cabot-search huggingface dataset:
Medical homoeopathy
Authors: K. Ryan
Journal: BMJ (1998)

When I give a talk on homoeopathy my first acetate reads, “Homoeopathy for sceptics; By an ex-sceptic.” When, as a senior house officer, I heard that an acquaintance had got involved with homoeopathy my response was, “how unwise and unsound.” But the realisation of the limitations of conventional medicine starts to dawn fairly early, usually as a student, when, as the patient leaves, the registrar says exasperatedly over his shoulder, “She's mad.” Sometimes this is justified, but the truth of the matter is that the patient has needs which traditional medicine cannot address. Such patients are commonplace. They have symptoms we cannot explain: one quarter of GP consultations, and half of outpatient attendances are with people with unexplained physical symptoms(1); they have symptoms which add up to a diagnosis, but there is little treatment; they have a ‘proper' illness which should respond to our medication but doesn't; they don't like our drugs or have side effects from them; they say funny things like, “I haven't been right since I had that D&C…” and so on. What does one do with such patients? It was exactly this frustration which led me to start looking at complementary medicine.

Homoeopathy does not have all the answers, but audits of homoeopathic treatment show that around 70% of patients have a moderate to major improvement. It remains controversial, but there is evidence to support its use.(2)–(4)

Integrating homoeopathy into general practice, rather than pursuing it as a career in itself, is straightforward. All homoeopathic medicines may be prescribed on an FP10, in addition to, or as an alternative to, conventional strategies. Hospital doctors must get the approval of the hospital's …
Fluoroquinolone resistance in multidrug-resistant <i>Mycobacterium tuberculosis</i> independent of fluoroquinolone use
Authors: Yang Che, Qifa Song, Tianchi Yang, Guohua Ping, Mei Yu
Journal: European Respiratory Journal (2017)

During the 1990s, multidrug-resistant tuberculosis (MDR-TB), resistant to at least isoniazid and rifampin, emerged as a great threat to global tuberculosis (TB) control [1]. For most MDR-TB patients, the World Health Organization (WHO) recommends a treatment regimen including second-line anti-TB drugs [2]. One of the most effective second-line drugs is fluoroquinolone [3]. During the treatment, MDR-TB may develop resistance to fluoroquinolone, or even become extensively drug-resistant (XDR-TB), which is resistant to both fluoroquinolone and at least one of three injectable second-line drugs [4]. The main genetic mechanism of fluoroquinolone resistance lies in the mutations in the quinolone-resistance-determining region of gyrA and gyrB [5]. Fluoroquinolone resistance in multidrug-resistant tuberculosis develops with various anti-tuberculosis regimens <http://ow.ly/Rnfb30gv1xI>
Large Outbreak of <i>Neisseria meningitidis</i> Serogroup C — Nigeria, December 2016–June 2017
Authors: Chimeremma Nnadi, John Oladejo, Sebastian Yennan, Adesola Ogunleye, Chidinma Agbai, Lawal Bakare, Mohammed Abdulaziz, Amina Mohammed, Mary Stephens, Kyadindi Sumaili, Olivier Ronveaux, Helen Maguire, Debra Karch, Mahmood Dalhat, Martin Antonio, Andre Bita, Ifeanyi Okudo, Patrick Nguku, Ryan Novak, Omotayo Bolu, Faisal Shuaib, Chikwe Ihekweazu
Journal: MMWR Morbidity and Mortality Weekly Report (2017)

On February 16, 2017, the Ministry of Health in Zamfara State, in northwestern Nigeria, notified the Nigeria Centre for Disease Control (NCDC) of an increased number of suspected cerebrospinal meningitis (meningitis) cases reported from four local government areas (LGAs). Meningitis cases were subsequently also reported from Katsina, Kebbi, Niger, and Sokoto states, all of which share borders with Zamfara State, and from Yobe State in northeastern Nigeria. On April 3, 2017, NCDC activated an Emergency Operations Center (EOC) to coordinate rapid development and implementation of a national meningitis emergency outbreak response plan. After the outbreak was reported, surveillance activities for meningitis cases were enhanced, including retrospective searches for previously unreported cases, implementation of intensified new case finding, and strengthened laboratory confirmation. A total of 14,518 suspected meningitis cases were reported for the period December 13, 2016-June 15, 2017. Among 1,339 cases with laboratory testing, 433 (32%) were positive for bacterial pathogens, including 358 (82.7%) confirmed cases of Neisseria meningitidis serogroup C. In response, approximately 2.1 million persons aged 2-29 years were vaccinated with meningococcal serogroup C-containing vaccines in Katsina, Sokoto, Yobe, and Zamfara states during April-May 2017. The outbreak was declared over on June 15, 2017, after high-quality surveillance yielded no evidence of outbreak-linked cases for 2 consecutive weeks. Routine high-quality surveillance, including a strong laboratory system to test specimens from persons with suspected meningitis, is critical to rapidly detect and confirm future outbreaks and inform decisions regarding response vaccination.
Abstract 13434: Relationship Between Fluoroscopy Time, Absorbed Dose And Effective Dose In A High-volume Electrophysiology Laboratory
Authors: Carola Gianni, Jason T Engel, Sanghamitra Mohanty, Chintan Trivedi, Rong Bai, Amin Al-Ahmad, J D Burkhardt, G J Gallinghouse, Patrick M Hranitzky, Rodney P Horton, Javier E Sanchez, Luigi Di Biase, Andrea Natale
Journal: Circulation (2016)

Introduction: It is important to correctly quantify radiation exposure to assess the deterministic (tissue damage) and stochastic (cancer and genetic changes) risk associated with fluoroscopy use. Hypothesis: There is little correlation between fluoroscopy time and both the absorbed dose (AD; deterministic risk) and the effective dose (ED; stochastic risk) measured during EP procedures. Methods: A retrospective analysis of radiation dose data for subjects undergoing EP procedures in which fluoroscopy was used. Data collected included fluoroscopy time (min), dose area product (DAP - Gy*cm 2 ) and AD or air kerma (AK - mGy). The ED was calculated by multiplying DAP with a conversion factor of 0.20 mSv/(Gy*cm 2 ). Results: 3331 consecutive EP procedures were analyzed. Overall, the correlation between DAP/ED and AD is strong (r = 0.63, P &lt; .000001), while between fluoroscopy time and AD is moderate (r = 0.46, P &lt; .000001), and between fluoroscopy time and DAP/ED is weak (r = 0.26, P &lt; .000001). There were wide variations in dose and statistically significant differences in fluoroscopy time, DAP/ED, and AD depending on the nature of the procedure, with AF ablation conferring the highest values, followed by BIV implant, LAA exclusion and VT ablation procedures (Table). When considering AF ablation procedures, radiation exposure was found to be highly operator dependent (Figure). Conclusions: Fluoroscopy time does not correlate well with both ED and AD. Therefore, it shouldn’t be the sole indicator of radiation exposure reported for EP procedures, as it does not accurately reflect neither the stochastic nor the deterministic risk.
Appropriate training in eating disorders could save many lives
Authors: Agnes Ayton, Ali Ibrahim
Journal: BMJ (2017)

We agree with Womersley and Ripullone that nutrition should be prioritised in medical education.1 This is essential not only for prevention, but also for recognising and managing malnutrition in all patient groups, including people with mental disorders. People with eating disorders, in particular, are often overlooked in medical education. Eating disorders are often regarded as rare and self limiting …
A child with nail changes
Authors: Ge Qian, Chong-Chen Zhou
Journal: BMJ (2017)

An otherwise healthy 3 year old boy presented with a 3 week history of painless nail alterations, which were noticed by his mother, with incidental findings of nail discoloration and brittle nails with cracks. All the nail changes moved distally with nail growth. Physical examination found proximal nail plate separation from the nail matrix on the right thumbnail and left index fingernail, one white transverse furrow in the right third fingernail, and one transverse whitish, non-palpable, non-blanching line on the right fourth fingernail (fig 1). No toenails were involved. The child was usually well, however had seen a doctor for hand, foot, and mouth disease five weeks before the nail presentations.



Fig 1 
Changes on the thumb and fingernails



What are the nail changes shown in figure 1, and what are the possible causes in this child?

The nail changes are consistent …
Enhancing toxicity of topoisomerase II inhibitors using a c-Myc inhibiting polypeptide
Authors: Gene Bidwell, Drazen Raucher
Journal: Cancer Research (2005)

4946   Topoisomerase II inhibitors are widely used in cancer chemotherapy. However, their use is limited by severe adverse effects to normal tissues, including cardiotoxicity. One approach to reduce the cytotoxicity in normal tissues may be to sensitize cancer cells to the toxicity of these agents, allowing them to be administered in a lower and safer dose. Here, we report that pretreatment of cells with a polypeptide which inhibits c-Myc transcriptional function causes cells to be more susceptible to the topoisomerase II inhibitors doxorubicin and etoposide. Inhibition of c-Myc and Max dimerization by this polypeptide leads to as much as a two-fold reduction in the doxorubicin and etoposide IC 50  in three different cell lines tested. Furthermore, the c-Myc inhibitor enhances doxorubicin or etoposide induced accumulation in G2 or M phase of the cell cycle. We have shown that this effect is not due to enhanced drug accumulation or inhibited drug efflux. Rather, it is likely due to inhibition of c-Myc transcriptional activity, which results in reduction in the levels of the polyamine synthesizing enzyme ornithine decarboxylase. Polypeptides which inhibit c-Myc transcriptional function may prove to be a useful tool in combination therapy with topoisomerase II inhibiting drugs.
Randomised trial and open-label extension study of an anti-interleukin-6 antibody in Crohn’s disease (ANDANTE I and II)
Authors: Silvio Danese, Séverine Vermeire, Paul Hellstern, Remo Panaccione, Gerhard Rogler, Gerald Fraser, Anna Kohn, Pierre Desreumaux, Rupert W Leong, Gail M Comer, Fabio Cataldi, Anindita Banerjee, Mary K Maguire, Cheryl Li, Natalie Rath, Jean Beebe, Stefan Schreiber
Journal: Gut (2017)

Objective Neutralising pro-inflammatory interleukin-6 (IL-6) may effectively treat Crohn’s disease (CD). Effects of PF-04236921, an anti-IL-6 antibody, in adults with CD are reported. Design Parallel-group, dose-ranging, double-blind trial with 4-week screening and 12-week treatment periods. After induction, patients entered 28-week follow-up or 48-week open-label extension (OLE) with 28-week follow-up. Adults with confirmed CD and inadequate response to anti-tumour necrosis factor (TNF) therapy were included. Induction study : 249 patients randomised 1:1:1:1 to placebo, PF-04236921 10, 50 or 200 mg by subcutaneous injection on days 1 and 28. OLE study : PF-04236921 50 mg every 8 weeks up to six doses followed by 28-week follow-up. Results 247 patients were randomised and received treatment in the induction study. The 200 mg dose was discontinued due to safety findings in another study ( NCT01405196 ) and was not included in the primary efficacy analysis. Crohn’s Disease Activity Index (CDAI)-70 response rates with PF-04236921 50 mg were significantly greater than placebo at weeks 8 (49.3% vs 30.6%, P&lt;0.05) and 12 (47.4% vs 28.6%, P&lt;0.05) and met the primary end point. Week 12 CDAI remission rates with PF-04236921 50 mg and placebo were 27.4% and 10.9%, respectively (16.5% difference; P&lt;0.05). 191 subjects received treatment in the OLE. Common treatment-emergent and serious adverse events in both studies included worsening CD, abdominal pain and nasopharyngitis. Conclusions PF-04236921 50 mg induced clinical response and remission in refractory patients with moderate-to-severe CD following failure of anti-TNF therapy. GI abscess and perforation were observed, a specific focus of attention during future clinical development. Trial registration number NCT01287897 and NCT01345318 .
An Ode to Intern Year
Authors: Paul E. George
Journal: JAMA Pediatrics (2017)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Pediatrics journal
CaV2.2 Gates Calcium-Independent but Voltage-Dependent Secretion in Mammalian Sensory Neurons
Authors: Zuying Chai, Changhe Wang, Rong Huang, Yuan Wang, Xiaoyu Zhang, Qihui Wu, Yeshi Wang, Xi Wu, Lianghong Zheng, Chen Zhang, Wei Guo, Wei Xiong, Jiuping Ding, Feipeng Zhu, Zhuan Zhou
Journal: Neuron (2017)
Abstract 20525: The Cumulative Burden of Potentially Modifiable Cardiac Risk Factors is Modestly Associated With a Perceived Need to Improve Physical Health: A Population-Based Study of Canadian Adults
Authors: F. Daniel Ramirez, Yue Chen, Pietro Di Santo, Trevor Simard, Pouya Motazedian, Benjamin Hibbert
Journal: Circulation (2016)

Introduction:  An individual’s perceived need to improve physical health (PNIPH) is an essential precursor to adopting healthy behaviors. Nine potentially modifiable risk factors (PMRFs) for myocardial infarction collectively account for ≥90% of the population attributable risk: smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, low fruit and vegetable consumption, lack of or excessive alcohol intake, physical inactivity, and raised apolipoprotein B/A1 ratio. Though widely recognized, their impact on individuals’ health perceptions is unclear.   Methods:  Residents from 6 provinces were administered a module on changes to improve health as part of the 2011-2012 Canadian Community Health Survey (CCHS). The CCHS uses a complex survey design with stratification, multiple stages of selection, and unequal probability sampling. Sampling weighting was therefore taken into account to derive estimates that are representative of the covered population and an approximate method for incorporating the survey design effect was used. Modified Poisson regression was used to calculate prevalence ratios (PRs) of individual and collective PMRFs for PNIPH. Relevant data were available for 8 of the 9 PMRFs sought.   Results:  In total, 45,443 adult respondents were included, representing 11,006,123 Canadians and corresponding to 96.8% of the adult population of the sampled provinces. The sum of PMRFs was positively associated with PNIPH (adjusted PR 1.08, 95% CI 1.07-1.09 for each additional PMRF) with 82.3% of individuals with ≥5 PMRFs reporting this perception. After adjusting for potential confounders, the PMRFs most strongly associated with PNIPH were obesity (PR 1.16, 95% CI 1.12-1.21), smoking (PR 1.15, 95% CI 1.11-1.19), and physical inactivity (PR 1.13, 95% CI 1.10-1.16). Diabetes and a lack of or excessive alcohol intake were not associated with PNIPH.   Conclusions:  PMRFs are differentially associated with PNIPH yet their cumulative burden is positively associated with this perception. Among those at highest cardiac risk, approximately 1 in 5 denied PNIPH. A greater understanding of factors underlying health perceptions and behaviors is needed to capitalize on cardiovascular preventive healthcare efforts.
Oncolytic HSV therapy sensitizes glioma cells to integrin antagonists in vitro and in vivo.
Authors: Kazuhiko Kurozumi, Christopher Alvarez-Breckenridge, Jeffrey Kutsikovich, E. Antonio Chiocca, Balveen Kaur
Journal: Cancer Research (2008)

LB-236   Oncolytic viral therapy exploits the natural or engineered propensity of some viruses to replicate in cancer cells, causing their lytic destruction with minimal damage to non-neoplastic tissue. We have been investigating oncolytic HSV-1 (OV) therapy - induced changes in tumor microenvironment, and have uncovered a significant, induction of CYR61 gene expression (8.94 fold,  P  = 0.001) in tumors treated with OV  in vivo . CYR61 is a secreted extra cellular matrix protein, which can bind to and activate integrin αvβ3, and αvβ5 on glioma and endothelial cells. Further CYR61 mRNA and protein were induced upon infection using different HSV-1 derived OVs in multiple human cancer cell lines and primary human tumor derived cells  in vitro  and in orthotopic human gliomas grown in nude mice  in vivo . Increased CYR61 in the ECM of breast cancer cells has also been shown to activate an autocrine loop resulting in upregulation of its own receptor α v β 3  resulting and increased sensitization to integrin anatgonists (Menendez JA, et al. Oncogene 2005). Consistent with this we found that glioma cells stably over expressing CYR61 were much more sensitive to cell killing by integrin antagonist Cilengetide, than control cells (LD50=146.5 ng/ml of overexpressing Vs control LD50=521.1 ng/ml) (P  =  0.48 to 0.49). These results suggested that treatment of glioma with OV followed by treatment with Cilengitide would enhance therapeutic efficacy. We tested this hypothesis in human glioma cells (U87ΔEGFR) grown as intracranial tumors  in vivo . Briefly, seven days after tumor cell implantation, mice were treated with OV or PBS by direct intratumoral injection. Five days after OV treatment mice were injected systemically with a single dose of cRGD (5mg/kg) or PBS. Mice treated with OV and Cilengitide survived significantly longer than mice treated with OV alone (median survival: Control: 12d; OV: d16; cRGD + OV: d25) (P
New Inroads Against Multiple Sclerosis
Authors: Jeff Lyon
Journal: JAMA (2017)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Study of locust bean gum reinforced cyst-chitosan and oxidized dextran based semi-IPN cryogel dressing for hemostatic application
Authors: Lalit Kumar Meena, Pavani Raval, Dhaval Kedaria, Rajesh Vasita
Journal: Bioactive Materials (2017)

Severe blood loss due to traumatic injuries remains one of the leading causes of death in emergency settings. Chitosan continues to be the candidate material for hemostatic applications due to its inherent hemostatic properties. However, available chitosan-based dressings have been reported to have an acidic odor at the wound site due to the incorporation of acid based solvents for their fabrication and deformation under compression owing to low mechanical strength limiting its usability. In the present study semi-IPN cryogel was fabricated via Schiff's base cross-linking between the polyaldehyde groups of oxidized dextran and thiolated chitosan in presence of locust bean gum (LBG) known for its hydrophilicity. Polymerization at -12 °C yielded macroporous semi-IPN cryogels with an average pore size of 124.57 ± 20.31 μm and 85.46% porosity. The hydrophobicity index of LBG reinforced semi-IPN cryogel was reduced 2.42 times whereas the swelling ratio was increased by 156.08% compare to control cryogel. The increased hydrophilicity and swelling ratio inflated the compressive modulus from 28.1 kPa to 33.85 for LBG reinforced semi-IPN cryogel. The structural stability and constant degradation medium pH were also recorded over a period of 12 weeks. The cryogels demonstrated lower adsorption affinity towards BSA. The cytotoxicity assays (direct, indirect) with 3T3-L1 fibroblast cells confirmed the cytocompatibility of the cryogels. The hemolysis assay showed <5% hemolysis confirming blood compatibility of the fabricated cryogel, while whole blood clotting and platelet adhesion assays confirmed the hemostatic potential of semi-IPN cryogel.
Bleeding complications in acute liver failure
Authors: R. Todd Stravitz, Caitlyn Ellerbe, Valerie Durkalski, Michael Schilsky, Robert J. Fontana, Carolyn Peterseim, William M. Lee
Journal: Hepatology (2017)

In patients with acute liver failure (ALF), elevated prothrombin time and thrombocytopenia can fuel a perception of a bleeding tendency. However, the incidence, site, risk factors, and clinical significance of bleeding complications have not been quantified in a large cohort of patients with ALF. We studied 1,770 adult patients enrolled in the ALF Study Group Registry between 1998 and 2016. Bleeding complications and blood component transfusions were collected for 7 days after admission. The relationship of bleeding complications to 21‐day mortality was assessed. Despite a median international normalized ratio of 2.7 and platelet count of 96 × 10 9 /L on admission, bleeding complications were observed in only 187 patients (11%), including 173 spontaneous and 22 postprocedural bleeding episodes. Eighty‐four percent of spontaneous bleeding episodes were from an upper gastrointestinal source and rarely resulted in red blood cell transfusion. Twenty patients experienced an intracranial bleed; half of these occurred spontaneously and half after intracranial pressure monitor placement, and this was the proximate cause of death in 20% and 50%, respectively. Bleeders and patients who received red blood cell transfusions were more acutely ill from extrahepatic organ system failure but not from hepatocellular failure. Consistent with this observation, bleeding complications were associated with lower platelet counts but not higher international normalized ratio. Transfusion of any blood component was associated with nearly 2‐fold increased death or need for liver transplantation at day 21, but bleeding complications were the proximate cause of death in only 5% of cases. Conclusions . Despite a perceived bleeding diathesis, clinically significant bleeding is uncommon in patients with ALF; bleeding complications in patients with ALF are markers of severe systemic inflammation rather than of coagulopathy and so portend a poor prognosis. (H epatology 2018;67:1931‐1942)