tbuckley/cabot-search huggingface dataset:
Integrated Screening for Down's Syndrome Based on Tests Performed during the First and Second Trimesters
Authors: N.J. Wald, H.C. Watt, A.K. Hackshaw
Journal: New England Journal of Medicine (1999)

Both first-trimester screening and second-trimester screening for Down's syndrome are effective means of selecting women for chorionic-villus sampling or amniocentesis, but there is uncertainty about which screening method should be used in practice. We propose a new screening method in which measurements obtained during both trimesters are integrated to provide a single estimate of a woman's risk of having a pregnancy affected by Down's syndrome.We used data from published studies of various screening methods employed during the first and second trimesters. The first-trimester screening consisted of measurement of serum pregnancy-associated plasma protein A in 77 pregnancies affected by Down's syndrome and 383 unaffected pregnancies and measurements of nuchal translucency obtained by ultrasonography in 326 affected and 95,476 unaffected pregnancies. The second-trimester tests were various combinations of measurements of serum alpha-fetoprotein, unconjugated estriol, human chorionic gonadotropin, and inhibin A in 77 affected and 385 unaffected pregnancies.When we used a risk of 1 in 120 or greater as the cutoff to define a positive result on the integrated screening test, the rate of detection of Down's syndrome was 85 percent, with a false positive rate of 0.9 percent. To achieve the same rate of detection, current screening tests would have higher false positive rates (5 to 22 percent). If the integrated test were to replace the triple test (measurements of serum alpha-fetoprotein, unconjugated estriol, and human chorionic gonadotropin), currently used with a 5 percent false positive rate, for screening during the second trimester, the detection rate would be higher 85 percent vs. 69 percent), with a reduction of four fifths in the number of invasive diagnostic procedures and consequent losses of normal fetuses.The integrated test detects more cases of Down's syndrome with a much lower false positive rate than the best currently available test.
Determinants of mortality when primary LV failure complicates acute myocardial infarction
Authors: J Col, J Boland, J Dens, F Van de Werf, J S Hochman, J Webb, L Sleeper, D Miller, J Slater, A Jacobs, R Forman, J D Talley, M Porway, T Sanborn, H White, T H LeJemtel
Journal: Intensive Care Medicine (1996)
Continuous androgen-deprivation therapy increased risk for diabetes and fragility fractures in older men with prostate cancer
Authors: Julio Hajdenberg
Journal: Annals of Internal Medicine (2009)

ACP Journal Club15 December 2009Continuous androgen-deprivation therapy increased risk for diabetes and fragility fractures in older men with prostate cancerJulio Hajdenberg, MD, FACPJulio Hajdenberg, MD, FACPMD Anderson Cancer Center Orlando, Orlando, Florida, USA (J.H.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-151-12-200912150-02014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationAlibhai SM, Duong-Hua M, Sutradhar R, et al. Impact of androgen deprivation therapy on cardiovascular disease and diabetes. J Clin Oncol. 2009;27:3452−8. https://pubmed.ncbi.nlm.nih.gov/19506162Clinical Impact RatingsGIM/FP/GP: Endocrinology: Oncology: References1 Saigal CS, Gore JL, Krupski TL, et al. Androgen deprivation therapy increases cardiovascular morbidity in men with prostate cancer. Cancer. 2007;110:1493-1500. [PMID: 17657815] Google Scholar2 Efstathiou JA, Bae K, Shipley WU, et al. Cardiovascular mortality and duration of androgen deprivation for locally advanced prostate cancer: analysis of RTOG 92-02. Eur Urol. 2008;54:816-23. [PMID: 18243498] Google Scholar3 Nanda A, Chen MH, Braccioforte MH, Moran BJ, D’Amico AV. Hormonal therapy use for prostate cancer and mortality in men with coronary artery disease-induced congestive heart failure or myocardial infarction. JAMA. 2009;302:866−73. [PMID: 19706860] Google Scholar4 National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology. Prostate cancer. Version 1; 2009. www.nccn.org/professionals/physician_gls/f_guidelines.asp (accessed 26 Oct 2009). Google Scholar Author, Article, and Disclosure InformationAffiliations: MD Anderson Cancer Center Orlando, Orlando, Florida, USA (J.H.)This article was published at Annals.org on 1 December 2009. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAndrogen deprivation therapy is associated with diabetes: Evidence from meta‐analysis 15 December 2009Volume 151, Issue 12Page: JC6-14KeywordsCardiovascular therapyDatabasesDiabetes mellitusHeart failureMortalityMyocardial infarctionProstate cancerSudden cardiac deathSurgeryToxicity ePublished: 15 December 2009 Issue Published: 15 December 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Factor VIII/von Willebrand factor protein. Galactose a cryptic determinant of von Willebrand factor activity.
Authors: H R Gralnick
Journal: Journal of Clinical Investigation (1978)

The normal Factor VIII/von Willebrand factor protein has the ability to agglutinate or aggregate normal platelets in the presence of ristocetin (von Willebrand factor activity). Removal of greater than 95% of the sialic acid from this protein by neuraminidase did not affect the von Willebrand factor or procoagulant activity. However, oxidation of the penultimate galactose of the asialo Factor VIII/von Willebrand factor protein with galactose oxidase resulted in a progressive loss of von Willebrand factor activity with no effect on procoagulant activity. Reduction of the 6-aldehydo intermediate by potassium borohydride caused full regeneration of von Willebrand factor activity. These studies confirm the identification of the intact penultimate galactose moiety as a critical determinant of von Willebrand factor activity.
Community-Based Teaching: A Guide to Developing Education Programs for Medical Students and Residents in the Practitioner's Office
Authors: Rick Kellerman
Journal: Annals of Internal Medicine (1998)

Medical Writings15 January 1998Community-Based Teaching: A Guide to Developing Education Programs for Medical Students and Residents in the Practitioner's OfficeRick KellermanRick KellermanUniversity of Kansas School of Medicine, Wichita; Wichita, KansasSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-2-199801150-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Deutsch SL, Noble J; eds. 284 pages. Philadelphia: American Coll Physicians; 1997. $25.00. ISBN 0943126592. Order phone 800-523-1546, extension 2600.Field of medicine: Medical education.Format: Softcover book.Audience: Course directors newly charged with developing community-based educational programs and community-based faculty interested in medical education.Purpose: As medical care shifts from an inpatient to an outpatient focus and as academic health centers struggle to compete in a managed care environment, successful innovation in medical student and resident education in community-based settings is necessary. This book explains how to plan teaching programs with volunteer faculty in office and community settings.Content: ... Author, Article, and Disclosure InformationAffiliations: University of Kansas School of Medicine, Wichita; Wichita, Kansas PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 January 1998Volume 128, Issue 2Page: 159KeywordsGraduate medical educationInpatientsMedical educationMedicareMotivationOutpatientsPatients ePublished: 15 August 2000 Issue Published: 15 January 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Research Misconduct in Low- and Middle-Income Countries
Authors: Joseph Ana, Tracey Koehlmoos, Richard Smith, Lijing L. Yan
Journal: PLoS Medicine (2013)

As part of a cluster of articles critically reflecting on the theme of "no health without research," Richard Smith and colleagues lay out what is currently known about research misconduct in low- and middle-income countries, summarizing some high profile cases and making suggestions on ways forward.
Long-term observation of the mineral trioxide aggregate extrusion into the periapical lesion: a case series
Authors: Seok-Woo Chang, Tae-Seok Oh, WooCheol Lee, Gary Shun-Pan Cheung, Hyeon-Cheol Kim
Journal: International Journal of Oral Science (2013)

One-step apexification using mineral trioxide aggregate (MTA) has been reported as an alternative treatment modality with more benefits than the use of long-term calcium hydroxide for teeth with open apex. However, orthograde placement of MTA is a challenging procedure in terms of length control. This case series describes the sequence of events following apical extrusion of MTA into the periapical area during a one-step apexification procedure for maxillary central incisor with an infected immature apex. Detailed long-term observation revealed complete resolution of the periapical radiolucent lesion around the extruded MTA. These cases revealed that direct contact with MTA had no negative effects on healing of the periapical tissues. However, intentional MTA overfilling into the periapical lesion is not to be recommended.
Treatment of 283 Consecutive Patients With Metastatic Melanoma or Renal Cell Cancer Using High-Dose Bolus Interleukin 2
Authors: Steven A. Rosenberg
Journal: JAMA (1994)

To determine the efficacy of treatment using high-dose bolus interleukin 2 (IL-2) in patients with metastatic melanoma or renal cell cancer.Consecutive series of all patients treated with high-dose IL-2 in the Surgery Branch of the National Cancer Institute from September 1985 through December 1992.Two hundred eighty-three patients with metastatic melanoma or metastatic renal cell cancer who had failed standard treatment for their cancers.Patients received IL-2 at a dose of 720,000 IU/kg intravenously every 8 hours for a maximum of 15 doses per cycle. Two cycles constituted a treatment course, and patients with stable or responding disease received additional treatment courses. A total of 447 courses of treatment were administered.Regression of measurable tumor, durability of response to treatment, and survival.Nine patients (7%) with metastatic melanoma achieved complete regression of all disease and 14 patients (10%) had partial regression. Ten patients (7%) with metastatic renal cell cancer experienced complete regression and 20 patients (13%) had partial regression. Of the 19 patients with complete regression, 15 have remained in complete remission from 7 to 91 months after treatment. Three treatment-related deaths (1.1%) occurred early in this series, but as experience with the administration of this IL-2 regimen increased, no treatment-related deaths occurred in 214 patients treated during the last 5 years of the study.Biologic therapy with IL-2 can cause significant antitumor effects in patients with advanced metastatic melanoma or renal cell cancer. Because IL-2 does not have a direct effect on cancer cells but rather mediates its antitumor activity by altering host immune reactions, these data represent the best available evidence that immunologic therapy for cancer can be effective in selected patients.
Unbalanced Expression of Bcl-2 Family Proteins in Follicular Lymphoma: Contribution of CD40 Signaling in Promoting Survival
Authors: Paolo Ghia, Vassiliki A. Boussiotis, Joachim L. Schultze, Angelo A. Cardoso, David M. Dorfman, John G. Gribben, Arnold S. Freedman, Lee M. Nadler
Journal: Blood (1998)
803. The Effects of Intratumoral Injection of a Replicating Morbillivirus in a Canine Model of Naturally Occurring Lymphoma
Authors: Michael S. Henson, Steven E. Suter, Veronika A. von Messling, Roberto Cattaneo, Adele K. Fielding
Journal: Molecular Therapy (2005)

Many viruses have a greater capacity to replicate within and lyse transformed cells than in normal cells. Those replicating oncolytic viruses with low pathogenicity in humans are receiving increasing attention as potential therapies for cancer. We previously established that the non-pathogenic, vaccine strain of measles virus (MV) could cause regression of established lymphoma xenografts in mice. However, murine models have considerable limitations in predicting response in humans; this is particularly true in the case of studies with MV in particular, since MV does not infect murine cells.
Exome-wide Sequencing Shows Low Mutation Rates and Identifies Novel Mutated Genes in Seminomas
Authors: Ioana Cutcutache, Yuka Suzuki, Iain Beehuat Tan, Subhashini Ramgopal, Shenli Zhang, Kalpana Ramnarayanan, Anna Gan, Heng Hong Lee, Su Ting Tay, Aikseng Ooi, Choon Kiat Ong, Jonathan T. Bolthouse, Brian R. Lane, John G. Anema, Richard J. Kahnoski, Patrick Tan, Bin Tean Teh, Steven G. Rozen
Journal: European Urology (2015)

Testicular germ cell tumors are the most common cancer diagnosed in young men, and seminomas are the most common type of these cancers. There have been no exome-wide examinations of genes mutated in seminomas or of overall rates of nonsilent somatic mutations in these tumors. The objective was to analyze somatic mutations in seminomas to determine which genes are affected and to determine rates of nonsilent mutations. Eight seminomas and matched normal samples were surgically obtained from eight patients. DNA was extracted from tissue samples and exome sequenced on massively parallel Illumina DNA sequencers. Single-nucleotide polymorphism chip-based copy number analysis was also performed to assess copy number alterations. The DNA sequencing read data were analyzed to detect somatic mutations including single-nucleotide substitutions and short insertions and deletions. The detected mutations were validated by independent sequencing and further checked for subclonality. The rate of nonsynonymous somatic mutations averaged 0.31 mutations/Mb. We detected nonsilent somatic mutations in 96 genes that were not previously known to be mutated in seminomas, of which some may be driver mutations. Many of the mutations appear to have been present in subclonal populations. In addition, two genes, KIT and KRAS, were affected in two tumors each with mutations that were previously observed in other cancers and are presumably oncogenic. Our study, the first report on exome sequencing of seminomas, detected somatic mutations in 96 new genes, several of which may be targetable drivers. Furthermore, our results show that seminoma mutation rates are five times higher than previously thought, but are nevertheless low compared to other common cancers. Similar low rates are seen in other cancers that also have excellent rates of remission achieved with chemotherapy. We examined the DNA sequences of seminomas, the most common type of testicular germ cell cancer. Our study identified 96 new genes in which mutations occurred during seminoma development, some of which might contribute to cancer development or progression. The study also showed that the rates of DNA mutations during seminoma development are higher than previously thought, but still lower than for other common solid-organ cancers. Such low rates are also observed among other cancers that, like seminomas, show excellent rates of disease remission after chemotherapy.
Childbirth practice should take women's wishes into account
Authors: A. Oakley
Journal: BMJ (1996)

EDITOR,—I was interested to read Kathryn M Grady's and Charles Essex's letters about my personal view of the experience of becoming a grandmother.1 Unfortunately, the BMJ's convention for personal views is that scientific references are not included. I had included some references in the original version of my article, including one to the evidence assembled and analysed by the international Cochrane Collaboration. These data suggest that the presence of a supportive birth …
Response of antidiuretic hormone to chlorpropamide.
Authors: M C Champion, P Padfield, J J Morton
Journal: BMJ (1980)

Response of antidiuretic hormone to chlorpropamideChlorpropamide has been used to treat diabetes insipidus since 1966,1 but its mode of action is still not entirely clear.There is good agree- ment that it augments the renal effects of endogenous antidiuretic hormone,2 but it might also cause pituitary release.3To help clarify this we have measured serial plasma concentrations of antidiuretic hormone in a group of patients receiving long-term chlorpropamide. Patients, methods, and resultsEleven patients with maturity-onset diabetes (two women; age range 38-66 years, mean 56 years) requiring treatment with oral hypoglycaemics were studied.All were receiving conventional dietary advice.Blood was taken from an antecubital vein (after 30 minutes' sitting and overnight fast) before and four, eight, and 12 weeks after they started taking 250 mg chlorpropamide daily.Plasma concentrations of antidiuretic hormone were measured by radioimmunoassay (normal range 4-12 jtg/l).This method is reliable in
Long-term dietary treatment with increased amounts of fiber-rich low-glycemic index natural foods improves blood glucose control and reduces the number of hypoglycemic events in type 1 diabetic patients.
Authors: R Giacco, M Parillo, A A Rivellese, G Lasorella, A Giacco, L D'Episcopo, G Riccardi
Journal: Diabetes Care (2000)

To evaluate in type 1 diabetic patients 1) the long-term feasibility of a high-fiber (HF) diet composed exclusively of natural foodstuffs and 2) the efficacy of this diet in relation to blood glucose control and incidence of hypoglycemic episodes.The study was randomized with parallel groups. Participants were part of a larger multicenter study on the effects of acarbose on glucose control in diabetes. A total of 63 type 1 diabetic patients, age 28 +/- 9 years, BMI 24 +/- 0.6 kg/m2, after a 4-week run-in period on their habitual diet, were randomized to either an HF (n = 32) or a low-fiber (LF) diet (n = 31) for 24 weeks. The two diets, composed exclusively of natural foodstuffs, were weight-maintaining and, aside from their fiber content, were similar for all nutrients. At the end of the run-in period and the dietary treatment, fasting blood samples for the measurement of plasma cholesterol, HDL cholesterol, triglyceride, and HbA(1c) were collected. A daily glycemic profile was performed on a day in which the participants had consumed a standard menu representative of their treatment diet (HF or LF).Of the 63 study subjects, 29 in the HF group (91%) and 25 in the LF group (81%) completed the study Compared with the LF diet, the HF diet after 24 weeks decreased both mean daily blood glucose concentrations (P < 0.05) and number of hypoglycemic events (P < 0.01). When compliance to diet was taken into account, 83% of the subjects on the HF diet and 88% on the LF diet were compliant. In this subgroup, compared with the LF diet, the HF diet significantly reduced mean daily blood glucose concentrations (P < 0.001), HbA(1c) (P < 0.05), and number of hypoglycemic events (P < 0.01).In type 1 diabetic patients, an HF diet is feasible in the long term and, compared with an LF diet, improves glycemic control and reduces the number of hypoglycemic events.
Fact and speculation on nuclear war
Authors: N. Simpson
Journal: BMJ (1982)

significantly associated with loss of the late bronchial reaction.This clinical improvement could not, however, be correlated with any striking change in the concentrations of specific IgG or IgE antimite antibodies.We cannot accept the statement that we used an inadequate course of injections with inadequate antigenic content.There was clearly sufficient antigen to boost both IgG and IgE antibodies to the major allergen Rye I. Indeed, when the treated patients entered the heavy pollen season of year one they already had concentrations of these antibodies comparable to those reached after recent natural exposure.It seems unlikely that grasses other than rye are a major cause of asthma in our children, as it is the most common pasture grass in this part of Australia.Other less abundant grasses in this area share antigens with rye.7
Hypophosphataemic rickets after ifosfamide treatment in children.
Authors: R. Skinner, A. D. Pearson, L. Price, K. Cunningham, A. W. Craft
Journal: BMJ (1989)

Description of three children with previously normal renal function and bone biochemistry who developed hypophosphataemic rickets due to urinary loss of phosphate after high dose ifosfamide treatment for malignancy
Fluoroscopic Control in Reduction of Fractures
Authors: F. H. Kemp
Journal: BMJ (1942)

Ketosteroid output has been estimated in the following groups of cases: adrenal tumour, primary virilism, and secondary virifism.Both primary virilism and adrenal tumour groups show very high excretion rates.At a pre-pubertal age it is impossible, solely on the basis of the ketosteroid output, to differentiate between adrenal hyperplasia and adrenal tumour.Rather more than 50% of cases of secondary virilism give ketosteroid values that are within the normal female range.Some of these have ketosteroid/creatinine ratios that are higher than normal, for which reason this ratio is believed to have a diagnostic significance.Three cases diagnosed as " feminism " (representing in males a near clinical counterpart of adrenal virilism in females) have shown a low ketosteroid excretion rate.Comparative androgen and ketosteroid determinations in all groups support the view that the latter assay furnishes a reliable index of the cortical hyperfunction associated with virilism.We are particularly indebted to Mr. L. R. Broster of Charing Cross Hospital, whose cases have constituted our main clinical material, and our warmest thanks are due to him for his close co-operation throughout.We also express our gratitude to Dr.
Role of cardiopulmonary exercise testing and the criteria used to determine disability in patients with severe chronic obstructive pulmonary disease.
Authors: F Ortega, T Montemayor, A Sánchez, F Cabello, J Castillo
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

The aim of this study was to evaluate the precision and variability with which resting pulmonary function tests (resting PFTs) can be used to predict the capacity in exercise, and the usefulness of the different measurements of pulmonary function in the evaluation of impairment/disability in patients with chronic obstructive pulmonary disease (COPD). We studied 78 patients with stabilized COPD (FEV1 45.1 +/- 17.1%). Of these, 39 suffered severe impairment according to the resting PFTs. Both the group with severe impairment (maximal oxygen consumption [VO2,max]: 16.22 +/- 5 ml/kg/min; maximal minute ventilation [VEmax]: 31.87 +/- 7.1 L/min; maximal heart rate [HRmax]: 133.8 +/- 10.9 beats/min) and the group with nonsevere impairment according to the resting PFTs (VO2max: 22.55 +/- 7.9 ml/kg/min; VEmax: 42.11 +/- 10.9 L/min; HRmax: 138 +/- 13.7 beats/min) showed ventilatory limitation during exercise. FEV1 was the most prevalent criterion for the determination of severe impairment (FEV1 < 40%), and was the variable best correlated to VO2max (r = 0.52 with VO2max as absolute value and r = 0.54 with VO2max expressed as a percentage of the reference value), but the resting PFTs were not predictive of exercise performance including patients with severe COPD. Evaluation of working capacity (based on VO2max) revealed a significant number of inaccurate predictions among the results of the resting PFTs. Sensitivity and specificity analysis were used to compare the different criteria used to evaluate the severity of disability. They reveal that the classification will be different according to the criteria used.(ABSTRACT TRUNCATED AT 250 WORDS)