tbuckley/cabot-search huggingface dataset:
Systematic review of randomized trials for hepatocellular carcinoma treated with percutaneous ablation therapies
Authors: Yun Ku Cho, Jae Kyun Kim, Mi Young Kim, Hyunchul Rhim, Joon Koo Han
Journal: Hepatology (2008)

Abstract According to the American Association for the Study of Liver Diseases guidelines, percutaneous ethanol injection (PEI) is a safe and highly effective treatment for small hepatocellular carcinomas (HCC) and should be the standard against which any new therapy is compared. The primary purpose of this study was to identify survival benefit of any percutaneous ablation therapy as compared with PEI in the treatment of patients with unresectable HCC. The secondary endpoints were initial tumor response, local tumor progression, and complications. Randomized controlled trials that compared pecutaneous ablative therapies with PEI were included. MEDLINE, the Cochrane Library, CANCERLIT, and manual search from 1978 to July 2008 were used. To control the potential heterogeneity, the random effects model of DerSimonian and Laird was used for a meta-analysis. Egger's test was performed to test a potential publication bias. We identified seven randomized controlled trials (RCTs), but only four RCTs including 652 patients that compared radiofrequency ablation (RFA) with PEI met the inclusion criteria to perform a meta-analysis assessing 3-year survival. A meta-analysis of the four RCTs demonstrated a significant improvement in 3-year survival favoring RFA over PEI (odds ratio 0.477, 95% confidence interval 0.340-0.670; P &lt; 0.001). Heterogeneity among the four trials was not significant (Q = 4.586; P = 0.205). Egger's test revealed that the publication bias was not significant ( P = 0.647). However, the number of patients included in the analysis was insufficient for a robust meta-analysis of initial tumor response. The definition of local tumor progression or major complication was not unified among the trials included in the meta-analysis. Conclusion: RFA demonstrated significantly improved 3-year survival status for patients with HCC, when compared to PEI. (Hepatology 2008.)
Hunt's priorities on entitlement to use the NHS are wrong
Authors: H. D. E. Carter, G. Bowsher
Journal: BMJ (2013)

Policy makers need to consider the serious implications of restricting migrants’ access to healthcare.1 Such a policy could put the general population at risk.

Restricted access to healthcare leads to late presentation of many conditions, some of which are easily treatable in primary care. This then results in more costly and complicated treatment in hospital, often with worse …
The Stimulation of 1,25-Dihydroxycholecalciferol Metabolism in Vitamin D-deficient Rats by 1,25-Dihydroxycholecalciferol Treatment
Authors: C. A. Frolik, H. F. DeLuca
Journal: Journal of Clinical Investigation (1973)

Daily oral administration of 1,25-dihydroxycholecalciferol to vitamin D-deficient rats increases the rate of disappearance of [3H]1,25-dihydroxycholecalciferol and increases the rate of appearance of metabolites both less polar and more polar than 1,25-dihydroxycholecalciferol in the intestine, bone, liver, kidney, plasma, and muscle. Since 1,25-dihydroxycholecalciferol is believed to be the metabolically active form of vitamin D in the stimulation of intestinal calcium transport and bone calcium mobilization, these results provide an explanation for the fact that daily oral administration of 1,25-dihydroxycholecalciferol is relatively ineffective in the maintenance of serum calcium and in the calcification of bone in rats.
Expression of IL-4, Cϵ RNA, and Iϵ RNA in the nasal mucosa of patients with seasonal rhinitis: Effect of topical corticosteroids☆☆☆★★★
Authors: Lisa A. Cameron, Stephen R. Durham, Mikila R. Jacobson, Keisuke Masuyama, Sigurdur Juliusson, Hannah J. Gould, Olle Lowhagen, Eleanor M. Minshall, Qutayba A. Hamid
Journal: Journal of Allergy and Clinical Immunology (1998)
Blood glucose concentration and risk of pancreatic cancer: systematic review and dose-response meta-analysis
Authors: W.-C. Liao, Y.-K. Tu, M.-S. Wu, J.-T. Lin, H.-P. Wang, K.-L. Chien
Journal: BMJ (2015)

To evaluate potential linear and non-linear dose-response relations between blood glucose and risk of pancreatic cancer.Systematic review and dose-response meta-analysis of prospective observational studies.Search of PubMed, Scopus, and related reviews before 30 November 2013 without language restriction.Prospective studies evaluating the association between blood glucose concentration and pancreatic cancer. Retrospective and cross sectional studies excluded to avoid reverse causality.Two reviewers independently extracted relevant information and assessed study quality with the Newcastle-Ottawa scale. Random effects dose-response meta-analysis was conducted to assess potential linear and non-linear dose-response relations.Nine studies were included for analysis, with a total of 2408 patients with pancreatic cancer. There was a strong linear dose-response association between fasting blood glucose concentration and the rate of pancreatic cancer across the range of prediabetes and diabetes. No non-linear association was detected. The pooled rate ratio of pancreatic cancer per 0.56 mmol/L (10 mg/dL) increase in fasting blood glucose was 1.14 (95% confidence interval 1.06 to 1.22; P<0.001) without significant heterogeneity. Sensitivity analysis excluding blood glucose categories in the range of diabetes showed similar results (pooled rate ratio per 0.56 mmol/L increase in fasting blood glucose was 1.15, 95% confidence interval 1.05 to 1.27; P=0.003), strengthening the association between prediabetes and pancreatic cancer.Every 0.56 mmol/L increase in fasting blood glucose is associated with a 14% increase in the rate of pancreatic cancer. As prediabetes can be improved or even reversed through lifestyle changes, early detection of prediabetes coupled with lifestyle changes could represent a viable strategy to curb the increasing incidence of pancreatic cancer.
Savannah River Parkway
Authors: Adam O. Goldstein
Journal: JAMA (1989)

Officially it's called the Savannah River Plant, or SRP. Many call it the bomb factory. It is located 15 miles east of Augusta, Ga, where I live and work. Most people know little of what occurs there every day, despite the fact that SRP is responsible for the manufacture of virtually all the nuclear weapons materials in our country. Covering more than 600 square miles of land, the facility is tremendous. I drive through SRP occasionally, usually on my way to the beach. Highway 125 takes you through the heart of the complex for 20 miles. The early sun beams brightly through the windshield, promising a day of the childhood frolicking, corebody warming, and spiritual nourishment that occur only with ocean sounds. Yet, for 20 minutes, silent nuclear sounds eclipse the sun, waiting for an exit reprieve. The signs, buildings, roads, and security personnel offer small reality reminders, standing in
Virus–Induced Anti–Asialoglycoprotein Receptor Autoimmunity in Experimental Hepadnaviral Hepatitis
Authors: J Diao, T I Michalak
Journal: Hepatology (1997)

The relationship between hepatitis virus invasion and emergence of liver-specific autoantibodies against asialoglycoprotein receptor (anti-ASGPR) and the occurrence patterns, prognostic value, and specificity of these autoantibodies toward polypeptides of host ASGPR were investigated in experimental viral hepatitis in the woodchuck system. Sequential sera (n = 231) obtained before and after inoculation with woodchuck hepatitis virus (WHV) from animals which resolved acute infection (n = 7) or developed chronic hepatitis (n = 6) were tested for anti-ASGPR using radio and enzyme-immunodetection assays. In addition, the outcome of WHV hepatitis was analyzed in 30 other woodchucks whose preinoculation sera were tested for anti-ASGPR. The receptor subunit specificity of virus-induced anti-ASGPR was determined by Western blotting and compared with that of anti-ASGPR raised in woodchucks challenged with a heterologous (rabbit) receptor. The results revealed that WHV infection triggered anti-ASGPR in all except one of the initially autoantibody nonreactive animals (eight of nine; 89.9%). Once induced, anti-ASGPR were detectable throughout the entire follow-up independent of histological severity of liver damage or the outcome of hepatitis. In healthy WHV-naive woodchucks, anti-ASGPR occurred at low titers in approximately one third of the animals. Importantly, woodchucks reactive for anti-ASGPR before WHV inoculation developed chronic hepatitis with a significantly greater frequency (55.5%) than those autoantibody negative (15.6%; P < .05). In contrast to anti-ASGPR elicited by immunization with a heterologous receptor, which initially recognized only the ASGPR 40-kd polypeptide, anti-ASGPR emerging after virus invasion reacted with both the ASGPR 40- and 47-kd subunits from the moment of their appearance. This study provides the first direct evidence that hepatitis virus in the natural host triggers autoantibodies against a unique hepatocyte antigen and shows that anti-ASGPR autoimmunity existing before virus infection is associated with a high rate of progression to chronic disease in experimental hepadnaviral hepatitis.
Giant Left Atrium
Authors: Roderick Tung, Roman DeSanctis
Journal: New England Journal of Medicine (2004)

A 59-year-old woman with a history of rheumatic heart disease presented with an eight-month history of increasing ascites. Her condition was complicated by mitral stenosis, which had required a Bjork–Shiley mitral-valve replacement 20 years earlier. Chest radiography showed massive cardiomegaly (Panels A and B). A computed tomographic scan of the chest (Panel C) revealed severe enlargement of the left atrium (LA), which measured 15.0 by 15.8 cm and filled the entire lower right hemithorax; the scan also revealed anterior displacement of the Bjork–Shiley valve (arrow) and compression of the left ventricle (LV), right ventricle (RV), and right atrium (RA) against . . .
Lifetime Fruit and Vegetable Consumption and Arterial Pulse Wave Velocity in Adulthood
Authors: Heikki Aatola, Teemu Koivistoinen, Nina Hutri-Kähönen, Markus Juonala, Vera Mikkilä, Terho Lehtimäki, Jorma S.A. Viikari, Olli T. Raitakari, Mika Kähönen
Journal: Circulation (2010)

The relationships between childhood lifestyle risk factors and adulthood pulse wave velocity (PWV) have not been reported. We studied whether childhood and adulthood lifestyle risk factors are associated with PWV assessed in adulthood.The study cohort comprised 1622 subjects of the Cardiovascular Risk in Young Finns Study followed up for 27 years since baseline (1980; aged 3 to 18 years) with lifestyle risk factor data available since childhood. Arterial PWV was measured in 2007 by whole-body impedance cardiography device. Vegetable consumption in childhood was inversely associated with adulthood PWV (β=-0.06, P=0.02), and this association remained significant (β=-0.07, P=0.004) when adjusted for traditional risk factors (high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, systolic blood pressure, body mass index, and smoking). Vegetable consumption was also an independent predictor of PWV in adulthood when adjusted for lifestyle or traditional risk factors (β=-0.08, P=0.002 and β=-0.07, P=0.0007, respectively). Persistently high consumption of both fruits and vegetables from childhood to adulthood was associated with lower PWV compared with persistently low consumption (P=0.03 for both). The number of lifestyle risk factors (the lowest quintile for vegetable consumption, fruit consumption, physical activity, and smoking) in childhood was directly associated with PWV in adulthood (P=0.001). This association remained significant when adjusted for the number of lifestyle risk factors in adulthood (P=0.003).These findings suggest that lifetime lifestyle risk factors, with low consumption of fruits and vegetables in particular, are related to arterial stiffness in young adulthood.
(Not) warts and all
Authors: Phil Hammond
Journal: BMJ (2008)

“You’d be mad not to protect your daughter against genital warts if you can afford to.” So advised Peter Greenhouse, a sexual health consultant in Bristol, when I asked him which human papillomavirus vaccine I should choose for my daughter. The NHS vaccination programme may have opted for the bivalent vaccine (Cervarix) to concentrate resources on preventing cervical cancer, but every doctor I’ve spoken to has chosen the quadrivalent vaccine (Gardasil) for their own daughters (and the odd son, though of course this is off licence).

Genital warts are common (100 000 new cases in England each year), and the condition is on the rise, particularly among young people: in women 60% of cases occur in the 16-24 years age group. They don’t kill you, but they can kill your sex life, and in some people they can be recurrent and extensive. The health minister Dawn Primarolo claims that warts are “preventable,” but meticulous condom use cuts transmission of the human papillomavirus by only 50%. A far safer option is to vaccinate.

The NHS Choices website (www.nhs.uk) promotes Cervarix but doesn’t return a single hit for Gardasil. Having chosen one vaccine for …
Sudden Death after the Administration of Sodium Succinate
Authors: Richard M. Watson, Charles D. Allen, Miles J. Schwartz
Journal: New England Journal of Medicine (1962)

REPORTS of sudden death after the administration of sodium dehydrocholate have stimulated search for a safer agent for estimation of circulation time. Because of its relative lack of toxicity, sodium succinate, recommended for this procedure several years ago,1 is enjoying increasing popularity. Sodium succinate (Soduxin) is supplied in a 2-ml. ampoule containing 0.6 gm. of sodium succinate hexahydrate in aqueous solution. Several seconds after injection of this material into an antecubital vein the subject experiences a sensation of warmth about the face and a desire to cough. One observer2 has compared this experience with that of taking a large sip . . .
CHRONIC VOLVULUS PRODUCED BY ABSORPTION OF A MYOMATOUS TUMOR AFTER SALPINGO-OOPHORECTOMY; A CLINICAL NOTE.
Authors: JAMES F. W. ROSS
Journal: JAMA (1899)

I intend to place on record my experience with a rather rare disease, a disease that has not been much written of and certainly is rarely seen. It is not my intention to discuss the subject of acute volvulus nor of acute intestinal obstruction, but the subject of chronic volvulus, chronic intestinal obstruction lasting over a considerable period of time, an obstruction partial, not complete, and an obstruction that may at any time become complete, and set up symptoms of acute intestinal obstruction. I find a record in the<i>British Medical Journal</i>, of a case reported to the Manchester Pathological Society, by Dr. Ashby. He showed the pathologic specimens removed from the abdomen of a man, 19 years of age, who had been subject to attacks of vomiting for two or three weeks from the time of his birth. He had frequently vomited large quantities of fluid during a single
Ivan Myer Sievers
Authors: Graham Sievers
Journal: BMJ (2005)

invented the Swan-Ganz cardiac catheter and was at the forefront of advances in cardiology for 40 years.A former president of the American College of Cardiology, Swan was an intellectual maverick who had vision, compassion, and wit.His cardiac catheter, made with a student of his called Willie Ganz, revolutionised heart surgery at its invention in 1968.It enabled bedside monitoring in critically ill patients by measuring heart output and capillary pressure in the lungs.This hugely improved the survival of patients with heart attacks, serious burns, acute respiratory failure, and many other conditions.Swan was born in Sligo Town, Ireland, the son of two general practitioners, and educated at Castle Knock School.From there he went to St Vincent's College, Dublin, but his studies were soon interrupted by meningitis and he lapsed into a coma.Penicillin was not yet available, but his mother gave him sulfa drugs, which saved his life.He recovered completely, both as a scholar and as a middle weight boxer.At St Thomas' Hospital Medical School his fellow students regarded him as a genius, and indeed, he was allowed to take his MRCP exams after six months instead of the usual two years.After six months as a casualty surgeon he did two years' war service with the Royal Air Force, mainly stationed at a military hospital in Iraq.Returning to St Thomas', he spent three years as physiology lecturer and was awarded a PhD for his early work on cardiac catheterisation and pharmacology, researching under Henry Barcroft, a historic figure in heart physiology.
Excess liver-related morbidity of chronic hepatitis C patients, who achieve a sustained viral response, and are discharged from care
Authors: Hamish A. Innes, Sharon J. Hutchinson, Samuel Allen, Diptendu Bhattacharyya, Peter Bramley, Toby E.S. Delahooke, John F. Dillon, Ewan Forrest, Andrew Fraser, Ruth Gillespie, David J. Goldberg, Nicholas Kennedy, Scott McDonald, Allan McLeod, Peter R. Mills, Judith Morris, Peter Hayes
Journal: Hepatology (2011)

Our aim was to address two shortfalls in the hepatitis C virus (HCV) literature: (1) Few data exist comparing post-treatment liver-related mortality/morbidity in HCV-sustained virologic response (SVR) patients to non-SVR patients and (2) no data exist examining liver-related morbidity among treatment response subgroups, particularly among noncirrhotic SVR patients, a group who, in the main, are discharged from care without further follow-up. A retrospective cohort of 1,215 previously naïve HCV interferon patients (treated 1996-2007) was derived using HCV clinical databases from nine Scottish clinics. Patients were followed up post-treatment for a mean of 5.3 years. (1) By Cox-regression, liver-related hospital episodes (adjusted hazard ratio [AHR]: 0.22; 95% confidence interval [CI]: 0.15-0.34) and LRM (AHR: 0.22; 95% CI: 0.09-0.58) were significantly lower in SVR patients, compared to non-SVR patients. (2) Rates of liver-related hospitalization were elevated among all treatment subgroups, compared to the general population: Among noncirrhotic SVR patients, adjusted standardized morbidity ratio (SMBR) was up to 5.9 (95% CI: 4.5-8.0); among all SVR patients, SMBR was up to 10.5 (95% CI 8.7-12.9); and among non-SVR patients, SMBR was up to 53.2 (95% CI: 49.4-57.2). Considerable elevation was also noted among patients who have spontaneously resolved their HCV infection (a control group used to gauge the extent to which lifestyle factors, and not chronic HCV, can contribute to liver-related morbidity), with SMBR up to 26.8 (95% CI: 25.3-28.3). Conclusions: (1) Patients achieving an SVR were more than four times less likely to be hospitalized, or die for a liver-related reason, than non-SVR patients and (2) although discharged, noncirrhotic SVR patients harbor a disproportionate burden of LRM (i.e., up to six times that of the general population). Furthermore, alarming levels of LRM in spontaneous resolvers is an important finding warranting further study. (Hepatology 2011;)
Abstract PR8: Insensitivity to RAF inhibition by vemurafenib in BRAF mutant colorectal cancer by EGFR-mediated reactivation of MAPK signaling
Authors: Ryan B. Corcoran, Kenneth E. Hung, Keith T. Flaherty, Adriano Piris, Jennifer A. Wargo, Jeffrey Settleman, Mari Mino-Kenudson, Jeffrey A. Engelman, Hiromichi Ebi, Alexa B. Turke, Erin M. Coffee, Michiya Nishino, Alexandria P. Cogdill, Ronald D. Brown, Patricia Della Pelle, Dora Dias-Santagata
Journal: Clinical Cancer Research (2012)

Abstract BRAF mutations occur in 10–15% of colorectal cancers (CRCs) and confer adverse outcome in the metastatic setting. While RAF inhibitors such as vemurafenib (PLX4032) have proven effective in BRAF mutant melanoma (∼60–80% response rates), they are surprisingly ineffective in BRAF mutant CRCs (∼5% response rate), and the reason for this disparity remains unclear. Compared to BRAF mutant melanoma cells, BRAF mutant CRC cells were less sensitive to vemurafenib, and P-ERK suppression was not sustained in response to treatment. Although transient inhibition of phospho-ERK by vemurafenib was observed in CRC, rapid ERK re-activation occurred through EGFR-mediated activation of RAS and CRAF. BRAF mutant CRC cell lines and patient tumor specimens expressed significantly higher levels of phospho-EGFR than BRAF mutant melanoma cell lines and primary tumor specimens, suggesting that CRCs are specifically poised for EGFR-mediated resistance. Combined RAF and EGFR inhibition blocked reactivation of MAPK signaling in BRAF mutant CRC cells and markedly improved efficacy in vitro. In vivo, combined RAF and EGFR inhibition led to sustained suppression of MAPK signaling and to robust tumor regressions in BRAF mutant colorectal xenografts. These findings support evaluation of combined RAF and EGFR inhibition in clinical trials in patients with BRAF mutant CRC. This proffered talk is also presented as Poster B11.
Whole-Body F-18 Sodium Fluoride PET-CT in a Patient With Renal Cell Carcinoma
Authors: Peeyush Bhargava, Muzammil Hanif, Carey Nash
Journal: Clinical Nuclear Medicine (2008)

A 59-year-old male with metastatic renal cell cancer presented with pain in the right heel. Radiographs showed a large lytic lesion in the right calcaneus, suspicious for bone metastasis. For a comprehensive morphologic and scintigraphic evaluation, a whole-body F-18 sodium fluoride (NaF) PET-CT was acquired. All lytic lesions seen on the CT showed intense peripheral fluoride uptake. Five fluoride avid lesions were not seen on the CT scan. Eight foci of mild to moderate fluoride activity were identified as degenerative joint disease on the CT scan. Intense peripheral NaF uptake was seen in the lytic lesion in the right calcaneus, which was later proven by needle biopsy to be metastasis from renal cell cancer.
Management of Suspected Deep Venous Thrombosis in Outpatients by Using Clinical Assessment and <scp>d</scp>-dimer Testing
Authors: Clive Kearon, Jeffrey S. Ginsberg, James Douketis, Mark Crowther, Patrick Brill-Edwards, Jeffrey I. Weitz, Jack Hirsh
Journal: Annals of Internal Medicine (2001)

Background: When deep venous thrombosis is suspected, objective testing is required to confirm or refute the diagnosis. Objective: To determine whether the combination of a low clinical suspicion and a normal d-dimer result rules out deep venous thrombosis. Design: Prospective cohort study. Setting: Three tertiary care hospitals in Canada. Patients: 445 outpatients with a suspected first episode of deep venous thrombosis. Interventions: Patients were categorized as having low, moderate, or high pretest probability of thrombosis and underwent whole-blood d-dimer testing. Patients with a low pretest probability and a negative result on the d-dimer test had no further diagnostic testing and received no anticoagulant therapy. Additional diagnostic testing was done in all other patients. Measurements: Venous thromboembolic events during 3-month follow-up. Results: 177 (40%) patients had both a low pretest probability and a negative d-dimer result. One of these patients had deep venous thrombosis during follow-up (negative predictive value, 99.4% [95% CI, 96.9% to 100%]). Conclusion: The combination of a low pretest probability of deep venous thrombosis and a negative result on a whole-blood d-dimer test rules out deep venous thrombosis in a large proportion of symptomatic outpatients.