tbuckley/cabot-search huggingface dataset:
Breast brachytherapy in the United States: how is this emerging modality being incorporated into the care of older breast cancer patients?.
Authors: GL Smith, YT Shih, Y Xu, SH Giordano, BD Smith, TA Buchholz
Journal: Cancer Research (2009)

Abstract Abstract #6087 Introduction: Several studies have demonstrated the potential value of brachytherapy in the treatment of breast cancer, either as local boost irradiation, or alone as accelerated partial breast irradiation, after breast conserving surgery (BCS). In 2002, the Food and Drug Administration approved the first balloon-based brachytherapy delivery system, signaling the beginning of broader incorporation of partial breast irradiation into breast cancer treatment. While subsequent studies have been seeking to define the patient population that will derive optimal clinical benefit from breast brachytherapy, this treatment option has remained widely available for use in a variety of settings. However, no prior study has described the frequency of breast brachytherapy use in the US. In a population-based cohort of older breast cancer patients, we characterized utilization of breast brachytherapy across the nation at the inception of this era.&amp;#x2028; Methods: A cross-sectional sample from a national Medicare database identified 37,323 beneficiaries (age≥65) with newly diagnosed invasive breast cancer treated with BCS in 2003. ICD-9 and CPT codes indicated receipt of external beam radiotherapy (EBRT) and brachytherapy. Percent use by state, region, age, and race was compared using Pearson χ2.&amp;#x2028; Results: Across the nation, 73% of older patients were treated with any radiotherapy after BCS. Of these patients, 97% were treated with EBRT alone, 3% with brachytherapy alone, and &amp;lt;1% with EBRT plus brachytherapy boost. For patients treated with brachytherapy, 98% received interstitial therapy and 2% intracavitary therapy. Though percent utilization of brachytherapy modalities ranged from 1% to 4% across different locations in the US, no statistically significant variation was detected by state (P=0.62) or by region (P=0.32). In addition, brachytherapy use did not differ by race (P=0.63) or age (P=0.59).&amp;#x2028; Conclusions: At the inception of the era in which partial breast irradiation was becoming incorporated into the care of breast cancer patients, only a small percentage of all patients received breast brachytherapy across the US. As contemporary data become available, future studies may seek to trace how this new treatment strategy is becoming more widely integrated into routine breast cancer treatment. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6087.
PTU-157 Outcomes Of Oesophageal Dilatation In Achalasia And Post-fundoplication Dysphagia
Authors: M Kasi, S Ahmad, J Wright, K Knowles, M Fox
Journal: Gut (2014)

<h3>Introduction</h3> Dilatation of the Oesophago-Gastric Junction (OGJ) provides effective symptom relief in 58–95% of patients with achalasia, similar to that achieved by Heller’s myotomy. Dilatation is also used in patients with persistent (&gt;6 months) dysphagia after fundoplication surgery; there is insufficient safety and outcome data of this procedure. Our aim is to compare patient outcome of endoscopic dilatation for both these conditions. <h3>Methods</h3> We present 18 month experience of referrals to the dysphagia service 2012–2013. All patients underwent a diagnostic gastroscopy with biopsies, excluding inflammation or neoplasia. Patients with achalasia or clinically relevant outlet obstruction post-fundoplication diagnosed by elevated integrated relaxation pressure (&gt;25 mmHg) on high resolution manometry were selected. Dilatation was performed by 30–35mm Rigiflex II Balloon or Savary-Gillard Bougies (max 18mm) under fluoroscopic guidance. Primary outcome was symptom response at 3–6 months post-procedure by clinic or telephone follow-up. Overall symptom response was documented on an analogue scale from 0% &gt;100% (inadequate &lt;40%, satisfactory 40–60%, good 60–80% and excellent &gt;80%). <h3>Results</h3> 46/71 referrals had either achalasia or dysphagia post fundoplication. 30 (41%) had achalasia, 6 had prior Heller’s myotomy and 7 had prior Botulinum toxin. 16 (22%) patients had OGJ obstruction after fundoplication. 29/30 patients with achalasia underwent pneumatic dilatation, one bougie dilatation. Overall symptom response was inadequate in 5 (16% referred for surgery), satisfactory in 3 (11%) and good-excellent in 22 (73%).14/16 patients with post fundoplication dysphagia had pneumatic balloon dilatation, 2 had bougie dilatation. Overall symptom response was inadequate in 7 (44% referred for surgery), satisfactory in 4 (25%) and good-excellent in 5 (31%). Complications from the both groups include chest pain (n = 2), chest infection (n = 1), reflux symptoms (n = 4 in each group) and minor bleeding. All resolved with conservative treatment. More than half of achalasia and post-fundoplication patients reported “at least satisfactory” outcome 3–6 months after dilatation (84% vs. 56%; p &lt; 0.07 Fisher Exact Test). A good-excellent symptom response was reported more often by achalasia patients (p = 0.010). <h3>Conclusion</h3> Endoscopic dilatation is safe and effective treatment for patients with dysphagia related to achalasia and also OGJ obstruction post-fundoplication. A good-excellent response was reported less frequently by the post-fundoplication patients; however more than half had at least “satisfactory” symptom relief and, therefore, a trial of endoscopic dilatation can be considered a viable alternative to re-operation. <h3>Disclosure of Interest</h3> None Declared.
Drink, drugs, and driving.
Authors: T C Mayer
Journal: BMJ (1971)

strains and 11 antibiotics, with the findings of Dr. Stokes's and Professor Mary Barber's departments.In all, the participating labo- ratories reported on 3,386 tests, and only 114 of their results were classified as errors.On this basis, 97 % of their reports were "correct".The clinicians who depend on us for vitally important information may find this figure more reassuring.
Health Status, Job Satisfaction, Job Stress, and Life Satisfaction Among Academic and Clinical Faculty
Authors: Lawrence S. Linn
Journal: JAMA (1985)

The present study compares academic and clinical faculty affiliated with a major teaching hospital in terms of work characteristics, job stress, conflict between work and personal life, job and life satisfaction, and perceived health. There were no significant differences between the two physician groups on job satisfaction, total stress, anxiety, or depression scores. However, academic faculty reported working longer hours, taking less vacation time, and spending more time in research and teaching, but seeing fewer outpatients. Academic physicians experienced more conflict between work and personal life, were burdened by a variety of time pressures, and were less satisfied with their finances, but experienced fewer recent episodes of physical illness than clinical faculty. However, compared with what is known about the general population, both physician samples seemed equally or more satisfied with their health and their lives. (<i>JAMA</i>1985;254:2775-2782
Scoliosis and Other Deformities of the Axial Skeleton
Authors: Leonard F. Peltier
Journal: JAMA (1976)

During the last 20 years, there has been a great deal of attention devoted to the study of scoliosis and other spinal deformities. This has resulted in the accumulation of large amounts of information dealing with genetics, natural history, the associated diseases, the results of conservative and surgical treatment, and the like. Family physicians, pediatricians, and orthopedists need a concise, clear summary of this material for quick reference and orientation. This new book by Riseborough and Herndon fills this need in a general way. There is something for everyone. The book is attractively printed, and the illustrations, with some exceptions, are adequately reproduced. The extralarge blanked-out areas on the clinical photographs are annoying. At a time of high paper and book costs, the large blank areas, even full pages, would seem to be an unnecessary luxury. To define scoliosis as "a lateral curve of the spinal column" ignores the basic
The Inotropic Effects of Digoxin in Hyperkalemia
Authors: ROBERT H. GOLDMAN, D. JOHN COLTART, JOEL P. FRIEDMAN, GAETON T. NOLA, DAVID K. BERKE, ESTHER SCHWEIZER, DONALD C. HARRISON
Journal: Circulation (1973)

The effects of hyperkalemia on the inotropic properties of digoxin were studied in anesthetized mongrel dogs. With preload, afterload and heart rate maintained constant in dogs who received atropine and practolol to block cardiac reflexes, 0.08 mg/kg digoxin increased the first derivative of the left ventricular pressure curve (LV dp/dt) 53.1 ± 8.3% (SEM) in normokalemic animals but only 9.5 ± 2.5% in hyperkalemic animals at 60 min. This decrease in the inotropic effects of digoxin by hyperkalemia was accompanied by significant decreases in both total left ventricular digoxin concentration and microsomal-bound digoxin. (Na + , K + )-ATPase was inhibited 43.3 ± 2.4% in normokalemic animals but only 27.4 ± 2.5% in hyperkalemic animals ( P &lt; 0.01), while (Mg ++ )-ATPase levels were similar in normokalemia and hyperkalemia. In animals not given digoxin, hyperkalemia had no effect on either LV dp/dt or (Na + , K + )-ATPase. There was a good correlation between the positive inotropic effects of digoxin and percent inhibition of (Na + , K + )-ATPase. These studies provide further support for the importance of (Na + , K + )-ATPase inhibition and microsomal-bound digoxin in determining the inotropic effects of digoxin. Hyperkalemia alters the inotropic effects of digoxin by decreasing binding of digoxin to a microsomal cell fraction containing (Na + , K + )-ATPase activity. These studies also provide support for the importance of reflex withdrawal of sympathetic tone in modifying the inotropic properties of digoxin in normokalemic and hyperkalemic animals.
UPPER RESPIRATORY INFECTIONS
Authors: David Selman
Journal: JAMA (1960)

<h3>To the Editor:—</h3> In the paper by Dr. Nunnelly (<i>J. A. M. A.</i><b>173</b>:1020 [July 2] 1960) are a number of points that require clarification: Of the 106 "respiratory and associated conditions," presumably screened to eliminate viral infections but at the same time representing a random sample," there are (Table 1) 106 associated organisms. One must assume one organism for each patient. Does this proportion of Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli, 58 out of 106 respiratory bacteria (Table 1), represent a peculiar geographic phenomenon? In Case 2 one encounters something unusual, a beta-hemolytic streptococcus that is penicillin resistant. Does this apply to one or more of the other 25 streptococci of Table 1? This is mentioned because of the difficulty we have in our efforts at rheumatic fever prophylaxis in convincing house officers of the necessity to treat hemolytic streptococcal infections with penicillin for at
Incidental Finding of Multiple Cavernous Angiomas on FDG PET/CT
Authors: María Luz Domínguez, Juan Ignacio Rayo, Justo Serrano, Román Sánchez, Jose Rafael Infante, Lucía García, Carmen Durán
Journal: Clinical Nuclear Medicine (2011)

FDG PET/CT studies allow evaluation of many areas not imaged with routine cancer staging. Although hypermetabolic lesions are detected, abnormalities of significance may be present that are not metabolically active, and such findings may have potential relevance for future patient care. In brain cortex, decreased FDG uptake is often associated with dementia, epilepsy, infarction, previous surgery, brain metastases, or radiation. We present a woman who underwent an FDG PET/CT study to evaluate response to chemotherapy for lymphoma. Several ametabolic areas were shown at both frontal and cerebellar cortex, and MRI confirmed the presence of multiple cavernous angiomas.
Induction of arthritis in monkeys by immunization with type II collagen.
Authors: T J Yoo, S Y Kim, J M Stuart, R A Floyd, G A Olson, M A Cremer, A H Kang
Journal: The Journal of Experimental Medicine (1988)

Immunization of two cynomolugus and three rhesus monkeys with purified type II collagen resulted in the development of polyarthritis. Arthritis first became clinically apparent 7 wk after primary immunization and persisted for 16 mo. Radiologic examination of the limbs demonstrated soft tissue swelling with severe joint destruction including loss of cartilage and bone. Involved joints eventually became ankylosed with permanent loss of some motion. All of the monkeys developed a response to the immunizing collagen as determined by ELISA of serum for antibodies. Arthritis was associated with weight loss and constitutional symptoms, including lethargy and refusal to eat. One monkey became so debilitated that it was necessary to euthanize it. Histologic examination of the joints showed synovial hypertrophy with pannus formation. A control monkey immunized with type I collagen suffered no apparent ill effects.
Resistance of Haemophilus influenzae to Trimethoprim
Authors: J. R. May, J. Davies
Journal: BMJ (1972)

Out of 210 isolates of Haemophilus influenzae obtained from the sputum of 63 patients with chronic respiratory infections 109 (52%) were resistant to trimethoprim-sulphamethoxazole by the disc test. The minimal inhibitory concentrations of trimethoprim for 17 out of 18 strains recorded as resistant were 10 mug/ml or higher. Resistant strains were isolated from time to time from 32 (82%) out of 39 patients known to have been treated with trimethoprim-sulphamethoxazole, compared with only 1 (12.5%) out of 8 patients known not to have been treated with this drug combination. Resistant strains were isolated most frequently from patients who had received long-term treatment. Since sulphamethoxazole penetrates from the blood into the bronchial secretions less readily than does trimethoprim it seems likely that the ratio of the two drugs in the bronchial tree is far from ideal. This may be an important factor in the use of these drugs for chest infections.
Hepatic encephalopathy-Definition, nomenclature, diagnosis, and quantification: Final report of the Working Party at the 11th World Congresses of Gastroenterology, Vienna, 1998
Authors: Peter Ferenci, Alan Lockwood, Kevin Mullen, Ralph Tarter, Karin Weissenborn, Andres T. Blei
Journal: Hepatology (2002)

Research on hepatic encephalopathy is hampered by the imprecise definition of this disabling complication of liver disease. Under this light, the Organisation Mondiale de Gastroentérologie commissioned a Working Party to reach a consensus in this area and to present it at the 11th World Congress of Gastroenterology in Vienna (1998). The Working Party continued its work thereafter and now present their final report. In summary, the Working Party has suggested a modification of current nomenclature for clinical diagnosis of hepatic encephalopathy; proposed guidelines for the performance of future clinical trials in hepatic encephalopathy; and felt the need for a large study to redefine neuropsychiatric abnormalities in liver disease, which would allow the diagnosis of minimal (subclinical) encephalopathy to be made on firm statistical grounds. In the interim, it proposes the use of a psychometric hepatic encephalopathy score, based on the result of 5 neuropsychologic tests. Finally, the need for a careful evaluation of the newer neuroimaging modalities for the diagnosis of hepatic encephalopathy was stressed.
THE BACTERIAL FLORA OF WAR WOUNDS: INFLUENCE OF TREATMENT
Authors: K. Goadby
Journal: BMJ (1918)

The ribonucleoprotein telomerase counteracts telomere shortening by adding repetitive sequences to the ends of human chromosomes. Telomerase is composed of the reverse transcriptase TERT, the telomerase RNA, and several auxiliary proteins that associate with the telomerase RNA, including TCAB1. TCAB1 is necessary for telomere maintenance in human cells and has been proposed to play a role in telomerase trafficking to Cajal bodies and telomeres, and in telomerase RNA folding. Here we show that, contrary to previous findings, TCAB1 is essential for telomerase assembly. We demonstrate that in the absence of TCAB1, the telomerase RNA is trapped in the nucleolus, a phase separated nuclear organelle, while TERT localizes to the nucleoplasm and is excluded from the nucleolus. Thus, nucleolar phase separation constitutes a barrier that counteracts telomerase assembly and TCAB1 is required to extract the telomerase RNA from the nucleolus, providing a molecular mechanism for the essential role of TCAB1 in telomerase function.
Gastric mucosal protection with selective inhibition of thromboxane synthesis.
Authors: R P Walt, R T Kemp, B Filipowicz, J G Davies, N K Bhaskar, C J Hawkey
Journal: Gut (1987)

Because thromboxane synthesis enhances gastric mucosal damage we have investigated whether the thromboxane synthesis inhibitor dazmegrel might be protective to the mucosa. Dazmegrel at a dose of 1 and 5 mg per rat (4.8 and 23.8 mg/kg) significantly reduced the damage caused by acidified taurocholate. In parallel experiments dazmegrel exerted a selective and dose dependent inhibition of ex vivo thromboxane synthesis by gastric fragments over the dose range in which protection was observed. As dazmegrel can be given to man, these experiments suggest that investigation of mucosal protection would be justified.
Analysis of segmental phosphate absorption in intact rats. A compartmental analysis approach.
Authors: L H Kayne, D Z D'Argenio, J H Meyer, M S Hu, N Jamgotchian, D B Lee
Journal: Journal of Clinical Investigation (1993)

Available information supports the dominance of the proximal intestine in inorganic phosphate (Pi) absorption. However, there is no strategy for analyzing segmental Pi absorption from a spontaneously propelled meal in an intact animal. We propose a solution using compartmental analysis. After intragastric administration of a 32P-labeled Pi liquid meal containing a nonabsorbable marker, [14C]polyethylene glycol (PEG), rats were killed at 2, 10, 20, 30, 60, 120, and 240 min. The gastrointestinal tract was removed and divided into seven segments, from which 32P and [14C]PEG were recovered. Data was expressed as a percentage of the dose fed, i.e., (32P[in segment] divided by 32P[fed]) and [14C]PEG[in segment] divided by [14C]PEG[fed]), respectively. A compartmental model was constructed and the rate constants for intersegmental transit and segmental absorption were estimated. The "goodness of fit" between the simulated model and the actual data indicates the estimated rate constants reflect in vivo events. The duodenum, with the highest transit and absorption rates, accounted for a third of the total absorption. However, the terminal ileum, with a lower absorption rate but a longer transit time, absorbed an equal amount of Pi. This approach allows the analysis of the mechanism and the regulation of Pi absorption under more authentic in vivo conditions.
Electric Shock Hazards in Cardiac Catheterization
Authors: Daniel I. Weinberg, John L. Artley, Robert E. Whalen, Henry D. McIntosh
Journal: Circulation Research (1962)

1. These studies demonstrate that ventricular fibrillation can be produced in anesthetized, mechanically ventilated dogs by a current as low as 35 microamperes and a voltage as low as 0.06 volt. 2. Analysis of circuits of medical electronic equipment which is usually considered safe indicates that such low current levels may exist in the heart during catheterization. 3. The safety procedures established for our laboratory to minimize the hazard of electric shock are presented.
Osteomalacia and Phenytoin Therapy
Authors: A. M. Parfitt
Journal: Annals of Internal Medicine (1995)

Letters15 April 1995Osteomalacia and Phenytoin TherapyA. M. ParfittA. M. ParfittHenry Ford Hospital, Detroit, MI 48202-2689.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-122-8-199504150-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Contrary to the statement in a recent letter by Siddiqui [1], osteomalacia verified by iliac bone histologic findings after double tetracycline labeling is rare in patients treated with anticonvulsant agents who are normally active and adequately nourished [2-4]. In the only systematic studies of such patients, no case of osteomalacia was found [2, 3]. Far more common is increased bone turnover caused by secondary hyperparathyroidism, a condition that causes accelerated loss of cortical bone, particularly in the extremities [4]. This abnormality is referred to by French [5] as “osteoporosis,” although vertebral fracture rates are not increased. An ...References1. Siddiqui MA. Osteomalacia and phenytoin therapy (Letter). Ann Intern Med. 1994; 121:550. Google Scholar2. Mosekilde L, Melsen F. Dynamic differences in trabecular bone remodeling between patients after jejuno-ileal bypass for obesity and epileptic patients receiving anticonvulsant therapy. Metab Bone Dis Rel Res. 1980; 2:77-82. Google Scholar3. Weinstein RS, Bryce GF, Sappington LJ, King DW, Gallagher BB. Decreased serum ionized calcium and normal vitamin D metabolite levels with anticonvulsant drug treatment. J Clin Endocrinol Metab. 1984; 58:1003-9. Google Scholar4. Parfitt AM. Osteomalacia and related disorders. In: Avioli LV, Krane SM, eds. Metabolic Bone Disease and Clinically Related Disorders. 2d ed. Philadelphia: W. B. Saunders; 1990:329-96. Google Scholar5. French J. The long-term therapeutic management of epilepsy. Ann Intern Med. 1994; 120:411-22. Google Scholar Author, Article, and Disclosure InformationAffiliations: Henry Ford Hospital, Detroit, MI 48202-2689. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byOstéopathiesOstéomalaciesOsteomalacia 15 April 1995Volume 122, Issue 8Page: 632KeywordsAnticonvulsantsBone remodelingBone resorptionHyperparathyroidismMetabolitesOsteoporosisParathyroid hormonePhosphatasesTetracyclinesVitamin D Issue Published: 15 April 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Bendectin—Birth Defects Controversy-Reply
Authors: Andrew Skolnick
Journal: JAMA (1990)

In Reply.—  My article referred to the large body of epidemiologic research, which has found no association between Bendectin  birth defects. As Richard Leavitt, director of science information for the March of Dimes Birth Defects Foundation, said, Bendectin has been the best-studied drug used in pregnancy, and the great preponderance of evidence generally exonerates it from any harmful effect.  Strictly speaking, Dr Newman is right to say that these studies are inconclusive. As the tobacco industry is fond of telling us, epidemiologic studies can never prove cause  effect with absolute certainty; they are even less able to prove the absence of a cause-and-effect relationship. Epidemiologic studies, however, are the only ethical way we
[789] A PHASE 3 STUDY COMPARING VACCINATION WITH HEPATITIS B SURFACE ANTIGEN COMBINED WITH IMMUNOSTIMULATORY PHOSPHOROTIOATE OLIGONUCLEOTIDE (1018 ISS) TO CONVENTIONAL HEPATITIS B VACCINE IN OLDER ADULTS
Authors: B.P. Sablan, D.J. Kim, N.G. Barzaga, W.C. Chow, M. Cho, S.H. Ahn, S.G. Hwang, T.H. Lee, M. Malhame, D. Bomba, E.B. Martins
Journal: Journal of Hepatology (2007)