tbuckley/cabot-search huggingface dataset:
PTU-249 Key worker alerts in emergency admissions of patients with gastrointestinal cancer substantially shorten length of stay and readmission rates
Authors: N Trudgill, J Harvey, A Kearns, T Davies
Journal: Gut (2012)

<h3>Introduction</h3> A retrospective audit of data from 2007 to 2009 revealed that patients known to have gastrointestinal (GI) cancer admitted as an emergency to our trust had long median length of stays (LOS) of 13 days, despite coding in 80% indicating no procedural intervention was undertaken or limited to diagnostic testing. 50% of such GI cancer patients were admitted for symptom management or disease progression and only 18% had documented interaction with their key worker (clinical nurse specialist) during their admission. <h3>Methods</h3> A pilot study of alerting the patient9s key worker, when a patient known to have GI cancer was admitted as an emergency, was organised to establish whether early key worker intervention could shorten LOS and lower 30-day re-admission rates. Patients with GI cancer were flagged on Lorenzo (IPM) and an email and text message to the key worker generated via an ADT HL7 message to the Rhapsody Interface Engine, when a GI cancer patient was admitted as an emergency. The study initially involved patients with colorectal cancer but patients with upper GI cancer were also subsequently included. <h3>Results</h3> During the 10-month study period, 146 colorectal alerts were received, 52 related to the patient9s cancer, and during 8 months 57 upper GI cancer alerts were received, 42 related to the patient9s cancer. Key worker intervention reduced LOS for colorectal patients admitted as an emergency from a median of 13 to 2 days and upper GI cancer from 7 to 1 day. Re-admittance rates were reduced from 28 to 8% for colorectal cancer patients and 35 to 23% for upper GI cancer. The principal interventions undertaken included symptom control and referral to specialist palliative care teams. Projections for 2011/2012 suggest that key worker alerts for GI cancer emergency admissions based on 260 colorectal and 146 upper GI cancer emergency admissions will save 3654 bed days. <h3>Conclusion</h3> Key worker alerts are an inexpensive intervention that shortens LOS, prevents re-admission, does not adversely affect key worker workload and improves patient experience. The system has obvious potential benefits for patients with other cancer sites and patients with inflammatory bowel disease admitted as an emergency. <h3>Competing interests</h3> None declared.
Abstract 4335: Imaging of cancer stem cells with radiolabeled Hedgehog
Authors: Izabela Tworowska, Jessica Li, Firas Mourtada, Wendy Woodward, Jennifer Sims-Mourtada
Journal: Cancer Research (2010)

Abstract Recent studies have shown that the majority of early disseminated cancer cells detected in the bone marrow of breast cancer patients have a putative breast cancer “stem cell-like” phenotype. Moreover, activation of stem cell pathways in cancer cells has also been associated with resistance to radiation and chemotherapy. Early detection of these micrometastatic “stem cell-like” cancer cells could allow for earlier commencement of aggressive treatment to minimize relapse and disease spread and to improve therapeutic outcome. However, there is currently no stem cell targeted method to detect this population in vivo. New imaging agents are needed for real-time, non-invasive detection of stem cell pathway activation in micrometastatic disease in breast cancer. The stem cell pathway Hedgehog (HH) is known to regulate cell cycle entry and proliferation of embryonic neural and mammary progenitor cells as well as self-renewal of malignant mammary stem cells. Furthermore, the hedgehog receptor PTCH is overexpressed on cancer stem cells compared to normal mammary stem cells. Therefore, we sought to radiolabel the natural hedgehog ligand, sonic (SHH) with the positron emitter Gallium 68 (68Ga) for detection of cancer stem cells by positron emission tomography (PET). Recombinant SHH ligand was conjugated to the bifunctional chelator DOTA. DOTA-SHH was obtained with a total yield of 45%-60% as assessed by HPLC. DOTA-SHH was further characterized using MALDI-MS, ESI-MS with purity &amp;gt; 90%. The conjugate was radiolabeled with 68Ga, with radiochemical purity of &amp;gt;98% and specific activity of 4.3E+05 MBq/gram (theoretical specific activity = 9.18E+09 MBq/gram) as assessed by ITLC and radioHPLC. 68Ga-DOTA-SHH maintains high receptor binding in breast cancer cells and cellular uptake was correlated with PTCH receptor expression levels. Addition of 100-fold excess cold SHH reduced cellular uptake by approximately 90%. PTCH receptor expression is increased in MCF-7 stem cell-enriching culture conditions (mammospheres) and cellular uptake of 68Ga-DOTA-SHH was approximately 12-fold higher in mammosphere MCF-7 cultures compared to the total cell population. These findings demonstrate that chemical modification and radiolabeling of SHH ligand is feasible. Our studies suggest that 68Ga-DOTA-SHH has potential for molecular imaging of breast cancer by PET. Additionally, our studies suggest that 68Ga-DOTA-SHH can potentially identify aggressive tumors that may be rich in cancer stem cells. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4335.
Ethanol Ingestion in Children
Authors: Francis Avery Ragan
Journal: JAMA (1979)

A five-year review of ethanol ingestions in children at Charity Hospital of Louisiana at New Orleans, revealed nine cases with blood ethanol levels in excess of 21.7 mmole/L (100 mg/dL); none resulted in death. We describe four patients in whom the blood ethanol levels were potentially life-threatening. In one case, we were able to follow the affected child's blood ethanol level serially; the rate of decrease was about twice that reported for an adult. (<i>JAMA</i>242:2787-2788, 1979)
Management of endoscopic submucosal dissection complications
Authors: H. Messmann, A. Probst
Journal: Endoscopy (2009)

Endoscopic submucosal dissection (ESD) is a new promising technique that allows endoscopic en bloc resection of premalignant and early malignant lesions in the gastrointestinal tract. In contrast to conventional endoscopic mucosal resection (EMR), lesions can be resected en bloc irrespective of their size. Clear advantages are an improvement in histopathological assessment of R0 resections and a lower risk of recurrence. Large series from Japan have shown significant improvement of en bloc resections after ESD compared with EMR in early gastric cancers [1], colonic lesions [2], and early esophageal neoplasms [3]. Guideline criteria for the resection of early gastric cancers in the pre-ESD era restricted the lesion size to 20 mm or less for conventional EMR [4]. New data on the risk of lymph node metastasis in early gastric cancer and the new ESD technique have allowed an extension of the resection criteria [5] [6]; for differentiated intramucosal cancers, the restriction on size could be lifted completely.
Association between C-Reactive Protein, Endothelial Nitric Oxide Synthase, and Interleukin-6 Gene Polymorphisms in Adolescents with a Family History of Premature Atherosclerosis
Authors: Ataç Çelik, Mustafa Özçetin, Ömer Ateş, Fatih Altunkaş, Kayıhan Karaman, İlker Akar, İlker İnce, Murat Yalçın, Köksal Ceyhan, Fatih Koç
Journal: Journal of the American College of Cardiology (2013)
Androgen Receptor Expression and Breast Cancer Survival in Postmenopausal Women
Authors: Rong Hu, Shaheenah Dawood, Michelle D. Holmes, Laura C. Collins, Stuart J. Schnitt, Kimberley Cole, Jonathan D. Marotti, Susan E. Hankinson, Graham A. Colditz, Rulla M. Tamimi
Journal: Clinical Cancer Research (2011)

Androgen receptor (AR) is commonly expressed in breast cancers. However, the association between tumor AR status and breast cancer survival is uncertain. Hence, we examined the association between AR status and breast cancer survival in the Nurses' Health Study (NHS).It was a prospective study of postmenopausal women enrolled in the Nurses' Health Study with stage I to III breast cancer diagnosed between 1976 and 1997 and followed from the date of diagnosis until January 1, 2008 or death. Analyses were conducted using Kaplan-Meier methods and Cox proportional hazard models, to determine the association of AR status with survival outcomes adjusting for covariates.Among 1467 breast cancers, 78.7% were AR-positive (AR+). Among 1,164 estrogen receptor (ER)-positive cases, 88.0% were AR+. AR positivity was associated with a significant reduction in breast cancer mortality (HR, 0.68; 95% CI, 0.47-0.99) and overall mortality (HR, 0.70; 95% CI, 0.53-0.91) after adjustment for covariates. In contrast, among women with ER-negative tumors (303 cases), 42.9% were AR+. There was a nonsignificant association between AR status and breast cancer death (HR, 1.59; 95% CI, 0.94-2.68).The association of AR status and breast cancer survival is dependent on ER status. In particular, AR expression was associated with a more favorable prognosis among women with ER-positive tumors. Thus, determination of AR status may provide additional information on prognosis for postmenopausal women with breast cancer, and provide novel opportunities for targeted therapy.
Abstract 3534: Proposed pathway of disposition of ON 01910. Na, a novel clinical trial stage anti-cancer agent: Implicaton of Mrp2 in biliary excretion in the isolated perfused rat liver system
Authors: David Taft, Amy Chun, Chen Ren, Manoj Maniar
Journal: Cancer Research (2010)

Abstract Introduction: ON 01910. Na is a novel targeted anti-cancer agent under clinical investigation in Phase I and Phase II trials. Preclinical studies indicate that the compound preferentially distributes to the liver but is not extensively metabolized in vivo The purpose of this study was to evaluate the disposition of ON 01910. Na employing the isolated perfused rat liver (IPRL) model. The specific goals were to 1) Assess the dose-linearity of ON 01910. Na disposition; 2) Probe the role of the Mrp2 transporter on ON 01910. Na biliary excretion; and 3) Establish the effect of concurrent dosing with oxaliplatin and doxorubicin on ON 01910. Na hepatobiliary disposition. Methods: Perfusion experiments (n=3/group) were performed at 4 doses (0.8, 4, 8, 20 mg), targeting a range of perfusate levels between 10 and 250 ug/ml. ON 01910. Na (10 ug/ml) disposition was then studied in the presence of doxorubicin (2.5 ug/ml) and oxaliplatin (2 ug/ml). IPRL experiments were also conducted using livers from Mrp2 deficient rats. ON 01910. Na was assayed in perfusate and bile samples by HPLC. Results: ON 01910. Na parameter estimates are provided in the table below. The compound displayed nonlinear excretion in the IPRL, and ON 01910. Na disposition was altered in mrp2-deficient rats. The effect of co-administered chemotherapeutic agents is being investigated. Conclusions: ON 01910. Na showed extensive biliary excretion in the IPRL, and IPRL findings correlated with in vivo data in rats. ON 01910. Na biliary transport appears to be mediated in part by Mrp2.ON 01910. Na Disposition in the IPRLaPARAMETERON 01910. Na (µg/ml) 10.050.0100250t1/2 (hr)0.460 (0.0340)0.327 (0.0674)0.585 (0.0810)1.26 (0.318)Cmax (µg/ml)11.3 (1.75)56.1 (7.12)106 (11.2)257 (658)AUC (0-∞) (µg*min/ml)290 (87.1)1480 (73.0)4010 (963)21100 (2580)Cl (ml/min)2.91 (0.753)2.71 (0.134)2.08 (0.557)0.959 (0.125)% Drug Excreted in Bile57.2 (5.04)59.2 (7.40)68.4 (0.870)45.6 (2.66)aData presented as mean (standard deviation) Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3534.
Diagnostics is not Cinderella of health technology assessment
Authors: John Gabbay, Tom Walley
Journal: BMJ (2006)

EDITOR—Furness makes an important point about the lack of emphasis on diagnostics but ironically has the wrong diagnosis.1 As we tried to make clear in our editorial, 2 there is a long chain from health technology assessment (the scientific summation of evidence about effectiveness) through appraisal (the policy related judgments that the National Institute …
Plasma volume, intravascular albumin and its transcapillary escape rate in patients with extensive skin disease
Authors: HANS-HENRIK PARVING, ANNE-MARIE WORM, NIELS ROSSING
Journal: British Journal of Dermatology (1976)

Plasma volume and plasma concentration and transcapillary escape rate of albumin (TER alb), i.e. the fraction of intravascular mass of albumin that passes to the extravascular space per unit time, were determined using 125I-labelled human albumin in eight patients with extensive skin disease. Plasma volume and plasma albumin concentration were reduced (P less than 0-05). Thus the intravascular albumin mass was moderately decreased to an average of 0-55 +/- 0-06 (s.d.) g/cm height compared with a normal mean value of 0-77 +/- 0-07 (s.d.) g/cm. This 29% decrease is statistically significant (P less than 0-001). The transcapillary escape rate of albumin (TER alb) was significantly elevated, mean 8-6 +/- 1-1 (s.d.) % X h-1, as compared to normal subjects, mean 5-6 +/- 1-1 (s.d.) % X h-1, (+54%, P less than 0-001). The same patients were studied again after a 1-week treatment with prednisone, 25-60 mg per day. Plasma albumin concentration, plasma volume and intravascular mass of albumin were unchanged, while TER alb decreased significantly during treatment, mean 5-9 +/- 0-8 (s.d.) % X h-1, (P less than 0-01). It is suggested that displacement of albumin into the skin and loss of albumin from the skin are the dominating mechanisms of the reduction in the intravascular albumin mass in patients with extensive skin disease.
Support for Part-Time Teaching
Authors: ALAN S. KING
Journal: Annals of Internal Medicine (1974)

Comments and Correction1 August 1974Support for Part-Time TeachingALAN S. KING, M.D.ALAN S. KING, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-81-2-270_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: As a "teaching-patient care" internist (cardiologist) rather than an "investigative-administrative" scientist, I found Dr. Fein's article, "Tensions in Medical Education: the Search for Balance" (Ann intern Med 80:651-656, 1974), stimulating. Much of Dr. Fein's discussion relates to my own recent decision to direct my career toward private practice, with part-time teaching, rather than to continue in full-time academic medicine.To make academic positions attractive to the clinically oriented teacher, the following changes are needed.1. The federal government should recognize that support for teaching by clinicians should be provided since most private and state institutions cannot support... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 August 1974Volume 81, Issue 2Page: 270-270KeywordsAcademic medicineMedical educationScientists Issue Published: 1 August 1974 PDF DownloadLoading ...
Intensive investigation in management of Hodgkin's disease.
Authors: S B Sutcliffe, P F Wrigley, J F Smyth, J A Webb, A K Tucker, M E Beard, M Irving, A G Stansfeld, J S Malpas, D Crowther, J M Whitehouse
Journal: BMJ (1976)

Ninety-eight patients with clinically localised Hodgkin's disease underwent laparotomy and splenectomy to determine the extent of microscopic spread. In 68 patients the procedure was carried out for untreated disease apparently confined above the diaphragm. Abdominal disease cannot be confidently excluded on the basis of non-invasive investigation at presentation. Clinical assessment of splenic disease was unreliable unless gross splenomegaly was present. Pedal lymphography was accurate in assessing para-aortic and iliac disease but of no value in assessing other intra-abdominal lymph node involvement, including that of the mesenteric lymph node. Trephine bone marrow biopsy findings were normal in all patients before surgery, and only one patient was found to have diseased bone marrow by Stryker-saw biopsy at operation. Liver disease was identified at operation in nine patients, some of whom were asymptomatic with clinically undetectable splenic and nodal disease. Detailed clinical staging failed to detect disease in one-third of patients who underwent laparotomy. These studies show that if radiotherapy is to remain the treatment of choice for disease truly localised to lymph nodes a detailed staging procedure, including laparotomy and splenectomy, remains essential. The value of this potentially curative treatment is considerably diminished in the patient who has been inadequately staged.
Geographic Variations in the Use of Health Care Services
Authors: Philip Caper
Journal: JAMA (1988)

<h3>To the Editor.</h3> —The article by Chassin et al<sup>1</sup>attempts to address a central question in the debate over the meaning of variations in the use of medical care among geographic areas. Unfortunately, the research design changes the terms of reference so drastically that it not only fails to answer the question it asked but in fact fails to address it. First, the geographic areas used by Chassin et al were so large that variations in local use rates are masked. The range of variations between these large areas is many times smaller than within them. In contrast, the study of how discrete populations, defined around one or a small number of dominant hospitals, "consume" care can elucidate the practice patterns of local physicians and can facilitate communication and change. Second, the ability to quantify practice patterns sheds important light on the nature of consensus-based agreement on clinical criteria.
Thromboxane A2 mediates lung vasoconstriction but not permeability after endotoxin.
Authors: R Winn, J Harlan, B Nadir, L Harker, J Hildebrandt
Journal: Journal of Clinical Investigation (1983)

The effect of dazoxiben, a selective thromboxane (Tx) synthetase inhibitor, on systemic and pulmonary hemodynamics, eicosanoids, and lung permeability was assessed in awake goats with lung lymph fistulae following infusion of Escherichia coli endotoxin (1 microgram/kg). Animals received endotoxin either with no treatment or pretreatment with a bolus (25 mg/kg) followed by a maintenance infusion (10 mg/kg per h) of dazoxiben. In untreated animals, the peak rise of 26.8 cm H2O in pulmonary artery (Ppa) and of 13.5 cm H2O in wedge (Pw) pressures occurred at the same time as the peak elevations in plasma thromboxane B2 (T X B2). Maximum reduction in cardiac output (Qt) also occurred at the same time. Lung lymph flow (QL) increased during this period and remained elevated for at least 6 h after endotoxin. T X B2 levels had returned from a peak of 13.1 to 0.7 ng/ml by 2 h. In dazoxiben-treated animals, plasma concentrations of T X B2 were never significantly elevated. Increases in Ppa and Pw were markedly reduced and decreased Qt was transient. QL in treated animals began to increase by 30 min after endotoxin and reached a peak by 2 h. Increased QL in treated animals was not as great as in the untreated animals. Moreover, lymph-plasma protein ratios increased significantly in treated animals. Plasma prostaglandin (PG)F2 alpha and 6-keto-PGF1 alpha concentrations were elevated in both groups after endotoxin with values significantly greater in treated animals. We conclude that selective inhibition of Tx ameliorates many adverse hemodynamic consequences of endotoxemia but does not prevent lung permeability changes.
Immunology of bovine heart valves. I. Cross-reaction with the C-polysaccharide of Streptococcus pyogenes.
Authors: E Kasp-Grochowska, D Kingston, L E Glynn
Journal: Annals of the Rheumatic Diseases (1972)

The cross-reaction between the C-polysaccharide of Streptococcus pyogenes and material extracted from heart valves (Goldstein, Halpern, and Robert, 1967; Goldstein, Rebeyrotte, Parlebas, and Halpern, 1968) is potentially of great importance as an ex- planation of valvular damage in rheumatic fever.We therefore undertook a detailed examination of this system, but were unsuccessful in our attempts to confirm the existence of a cross-reaction.We also wish to record the chemical nature ofthe various valve fractions tested, and a number of possible technical snags which in our opinion may partially explain the previous results.In the second paper we describe the cross-reactions between heart valves and other connective tissues and draw attention to the potential usefulness of one of the valve extracts as a source of connective tissue antigens. MaterialsArmeen M2C was obtained from Armour Hess Chemicals Ltd, and Collagenase type III Fraction "A" (pfs) from Sigma London Chemical Company Ltd.Bovine heart valves were collected at a local slaughterhouse within 2 hrs of killing the animals.They were frozen immediately with solid CO2 and kept stored at -20°C.until required.The anti-streptococcal sera were those used by Kingston and Glynn (1971).They were raised in rabbits by intravenous inoculation of washed whole streptococci grown in a synthetic medium supplemented with tryptic digest of casein.The properties of these sera are summarized in Table I.The rabbit antiserum to tubercle bacilli ("antiTB serum") was kindly supplied by Dr. E. Nassau of Harefield Hospital.It was prepared by injecting, intramuscularly in adjuvant and intravenously in saline, a phenol-killed washed culture of Mycobacterium tuberculosis, strain H37 Rv, grown in Dubos's medium.The sera were stored at -20°C.
Abstract 2639: MicroRNA miR-99a exerts anti-tumorigiceffect through decreasing myotubularin related protein 3 expression in oralcancer.
Authors: Li-Wha Wu
Journal: Cancer Research (2013)

Abstract Head and neck cancer is the six most common carcinomas worldwide. Oral cancer, one head and neck cancer subtype, is the fourth leading causes of male cancer death in Taiwan. The deregulation of certain microRNAs has been associated with the progression and metastasis of various cancer types. MicroRNAs are noncoding RNA molecules in a length of 19∼25 nucleotides, which can mediate gene expression by base pairing to the 3’untralslated region of target mRNAs. Using human microRNA microarray analysis, we found that miR-99a was most down-regulated among 1146 miRs in oral cancer cells when compared to normal oral keratinocytes. Real-time PCR analysis further confirmed the down-regulation of miR-99a both in both tested oral cancer cell lines and human clinical specimens. Transient and stable expression of miR-99a inhibited the migration and invasion of oral cancer cells while having differential effects on cell proliferation depending on the cell types. The introduction of anti-miR-99a, silencing the effect of miR-99a, led to the increase of cell migration and invasion. Luciferase reporter assays and site-directed mutagenesis identified MTMR3, a member of myotubularin-related genes encoding phosphatidylinositol 3-phosphate 3-phosphatases, to be a downstream target of miR-99a. Knocking down MTMR3 expression in high MTMR3-expressing oral cancer cells significantly impaired the ability of oral cancer cells to proliferate, migrate or invade Matrigel, suggesting an oncogenic role of MTMR3 in oral cancer cells. Together, our findings suggest that miR-99a plays a repressive role in cell migration and invasion partly through regulating MTMR3 expression in oral cancer cells. Citation Format: Li-Wha Wu. MicroRNA miR-99a exerts anti-tumorigiceffect through decreasing myotubularin related protein 3 expression in oralcancer. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 2639. doi:10.1158/1538-7445.AM2013-2639