tbuckley/cabot-search huggingface dataset:
The long-term course of mastalgia
Authors: E L Davies, C A Gateley, M Miers, R E Mansel
Journal: Journal of the Royal Society of Medicine (1998)

Mastalgia is a common condition in women of reproductive years. We have assessed the long-term course in patients with severe mastalgia by distributing a postal questionnaire to 212 patients previously studied in 1983 who had attended the mastalgia clinic at the University Hospital of Wales, Cardiff. 175 patients (83%) responded, with an original diagnosis of cyclical mastalgia (CM) in 120 and non-cyclical mastalgia (NCM) in 55. The median age of onset of breast pain was 36 years (range 12–63 years). The average duration of pain was long (median 12 years), especially if it started in the second or third decade of life. Pain persisted in 68 (57%) of CM and 35 (64%) of NCM patients. In CM patients resolution was commonly associated with a ‘hormonal' event, notably the menopause; in NCM patients it more often seemed to be spontaneous. Severe mastalgia ran a chronic relapsing course often requiring repeated drug treatments.
Differences in abdominal and neck circumferences in patients with and without obstructive sleep apnoea
Authors: V Hoffstein, S Mateika
Journal: European Respiratory Journal (1992)

We have recently shown that patients with sleep apnoea have thicker necks than non-apnoeic snoring controls. However, it was not clear whether this difference simply reflects the fact that apnoeic patients are more obese than the non-apnoeic ones, or whether it represents a preferential distribution of fat over the neck region compared to the abnormal region. We therefore measured the neck and abdominal circumferences in a large group of 670 patients suspected of having sleep apnoea, all of whom had full nocturnal polysomnography, including measurement of snoring. We divided these patients into apnoeic and non-apnoeic groups based on the apnoea/hypopnoea index (AHI) of 10. Apnoeic patients had significantly higher body mass index (BMI), neck, and abdominal circumferences than non-apnoeic controls. We then matched apnoeic and non-apnoeic patients exactly, one-for-one for BMI and age; this procedure left us with 156 patients in each group. Abdominal circumferences were similar, but the neck circumference was significantly higher in apnoeic patients (41.2 +/- 3.5 cm vs 39.1 +/- 3.7 cm, p less than 0.0001). Multiple stepwise linear regression analysis revealed that neck circumference and BMI correlated significantly with apnoea (multiple R2 = 0.27, p less than 0.001) and snoring (multiple R2 = 0.19, p less than 0.001). We conclude that obese patients with sleep apnoea have fatter necks than equally obese non-apnoeic snorers, and that the neck circumference could be a significant determinant of apnoea and snoring.
Length of Barrett's oesophagus and cancer risk: implications from a large sample of patients with early oesophageal adenocarcinoma
Authors: Heiko Pohl, Oliver Pech, Haris Arash, Manfred Stolte, Hendrik Manner, Andrea May, Klaus Kraywinkel, Amnon Sonnenberg, Christian Ell
Journal: Gut (2015)

<h3>Objective</h3> Although it is well understood that the risk of oesophageal adenocarcinoma increases with Barrett length, transition risks for cancer associated with different Barrett lengths are unknown. We aimed to estimate annual cancer transition rates for patients with long-segment (≥3 cm), short-segment (≥1 to &lt;3 cm) and ultra-short-segment (&lt;1 cm) Barrett9s oesophagus. <h3>Design</h3> We used&nbsp;three data sources to estimate the annual cancer transition rates for each Barrett length category: (1) the distribution of long, short and ultra-short Barrett9s oesophagus among a large German cohort with newly diagnosed T1 oesophageal adenocarcinoma; (2) population-based German incidence of oesophageal adenocarcinoma; and (3) published estimates of the population prevalence of Barrett9s oesophagus for each Barrett length category. <h3>Results</h3> Among 1017 patients with newly diagnosed T1 oesophageal adenocarcinoma, 573 (56%) had long-segment, 240 (24%) short-segment and 204 (20%) ultra-short-segment Barrett9s oesophagus. The base-case estimates for the prevalence of Barrett9s oesophagus among the general population were 1.5%, 5% and 14%, respectively. The annual cancer transition rates for patients with long, short and ultra-short Barrett9s oesophagus were 0.22%, 0.03% and 0.01%, respectively. To detect one cancer, 450 patients with long-segment Barrett9s oesophagus would need to undergo annual surveillance endoscopy; in short segment and ultra-short segment, the corresponding numbers of patients would be 3440 and 12 364. Similar results were obtained when applying US incidence data. <h3>Conclusions</h3> The large number of patients, who need to undergo endoscopic surveillance to detect one cancer, raises questions about the value of surveillance endoscopy in patients with short segment or ultra-short segment of Barrett9s oesophagus.
The real elephant in the room
Authors: Mohammad Farhad Peerally
Journal: BMJ (2007)

Winyard has missed the issue of non-European Union UK medical graduates.1 These students make up about 15% of medical undergraduates, and UK medical schools depend on their financial backing to survive. Each student would have forked out at least £80 000 (€114 000; $162 000) by year 5, …
Structure of the Gross Leukemia Virus&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: Donald F. Parsons
Journal: JNCI Journal of the National Cancer Institute (1963)

The structure of the Gross virus has been investigated in partially purified preparations by the technique of negative staining. The virus was also examined in situ, without preliminary purification, in and around leukemic cells, by a new technique which permits the negative staining method to be employed on cells thinly spread on a water interface. With the use of both methods the nucleoid was clearly outlined in some (type C) particles. Its surface was smooth without projecting capsomeres. No filamentous components, similar to those seen in myxoviruses, were found in association with the nucleoid after treatments with formaldehyde, ether, pepsin, or trypsin. Negative staining indicated that the Gross virus resembled the Rous sarcoma virus in possessing an envelope covered with a fringe of fine projections. This fringe differed markedly from that covering the envelope of the mouse mammary tumor virus. It is suggested that the classification of murine tumor viruses into types A, B, and C should be extended to take these differences of envelope structure into account.
Molecular Profiles of Prostate Cancer: To Treat or Not to Treat
Authors: Itay A. Sternberg, Ian Vela, Peter T. Scardino
Journal: Annual Review of Medicine (2015)

A major dilemma in the selection of treatment for men with prostate cancer is the difficulty in accurately characterizing the risk posed by the cancer. This uncertainty has led physicians to recommend aggressive therapy for most men diagnosed with prostate cancer and has led to concerns about the benefits of screening and the adverse consequences of excessive treatment. Genomic analyses of prostate cancer reveal distinct patterns of alterations in the genomic landscape of the disease that show promise for improved prediction of prognosis and better medical decision making. Several molecular profiles are now commercially available and are being used to inform medical decisions. This article describes the clinical tests available for distinguishing aggressive from nonaggressive prostate cancer, reviews the new genomic tests, and discusses their advantages and limitations and the evidence for their utility in various clinical settings.
Network stabilization on unstable manifolds: Computing with middle layer transients
Authors: Arnold J. Mandell, Karen A. Selz
Journal: Behavioral and Brain Sciences (2001)

Studies have failed to yield definitive evidence for the existence and/or role of well-defined chaotic attractors in real brain systems. Tsuda's transients stabilized on unstable manifolds of unstable fixed points using mechanisms similar to Ott's algorithmic “control of chaos” are demonstrable. Grebogi's order in preserving “strange nonchaotic” attractor with fractal dimension but Lyapounov is suggested for neural network tasks dependent on sequence.
Mir-17 modulates smooth muscle cell markers, apoptosis and BMPR-II levels in human pulmonary artery smooth muscle cells
Authors: Gurukumar Kollongod Ramanathan, Prasanna Tamarapu, Asfiya Younis, Samuel Jalali, Sara Garcia, Richard F. Lockey, Narasaiah Kolliputi
Journal: European Respiratory Journal (2012)

Pulmonary Arterial Hypertension (PAH) is a progressively devastating disease characterized by excessive proliferation of the Pulmonary Arterial Smooth Muscle Cells (PASMCs). Recently micro RNA (miR) have been shown to play an important role in the pathogenesis of PAH. We describe in the present study the effects of over expression of miR17/92 as a cluster or miR17 alone on human pulmonary artery smooth muscle cells (HPASMC). HPASMC were commercially obtained and were transfected with miR17/92 or miR17 encoding plasmid or control vector by electroporation. Proliferation and apoptosis resistant state of PASMC transfected with miR was assessed by MTS and caspase3/7 Glo assays respectively. RNA and protein levels of important target genes in PAH were measured using Real-time RT-PCR and western blots. HPASMC transfected with miR17/92 or miR17 show decreased cell numbers and showed an increased apoptosis as assessed by increased caspase activity. Real-time RT-PCR analysis reveal that proliferation markers such as PCNA and Cyclin D1 are not significantly altered. SMC marker calponin and bone morphogenetic protein receptor-II levels were down regulated in both miR17/92 or mir17 transfected cells. Voltage gated potassium channel (Kv1.5) was up regulated in PASMCS treated with mir17/92 cluster but not miR17 alone indicating that different miRs in the 17/92 cluster differentially may regulate key molecules in the development of PAH.
Synchronous cancers: An analysis of SEER registry from 1973 to 2003.
Authors: A. Y. Lin, T. Lu, S. L. Gomez
Journal: Journal of Clinical Oncology (2010)

e12018 Background: The population-based incidence of synchronous cancers (SC), defined as two or more histologically distinct cancers diagnosed within two months of each other, is unknown. Methods: The Surveillance, Epidemiologic, and End Results (SEER) database for the years 1973-2003, in 17 areas accounting for 26% of U.S. population, was queried for incidence of SC. Since each record in the SEER databases represents one primary tumor, SC was selected and defined by more than one record in the same patient within two months of each other. Patients' demographic and clinico-pathologic data were then collected and surveyed. Incidence rates and trends, age-adjusted to the 2000 US standard population, were calculated (per a population of 100,000). Results: Out of 4,123,001 patients (4,539,680 records), a total of 80,955 patients with 172,590 tumor records met the study criteria, accounting for 1.96% (median, range: 1.38 - 2.27 per year) of all patients. Median age at diagnosis of the first cancer was 68 (range 1–105) with the male to female ratio of 1:1 (40055:40900). Most, or 88.6%, of the patients with SC had 2 cancers at the time of diagnosis. The incidence rates were 8.43 per 100,000 (range: 7.68 – 9.58 per 100,000 per year; between 1984 - 2003). The most common combination is male genital cancers and urinary tract cancers, followed by colorectal and non-colorectal digestive tract cancers. Conclusions: SC, although uncommon, account for 1.96% of all patients with a stable cancer incidence of 8.43 per 100,000 over the last 20 years in the US. The most common combination is male genital cancers and urinary tract cancers. Further study is needed to improve our understanding of the connections between primary and subsequent synchronous tumors. No significant financial relationships to disclose.
The effects of beta-blocker therapy on heart rate, symptoms and exercise in pulmonary arterial hypertension
Authors: Jasmijn van Campen, Karin de Boer, Martha Wagenaar, Louis Handoko, Cor Allaart, A.C. van Rossum, Frances de Man, Harm Jan Bogaard, Anton Vonk Noordegraaf
Journal: European Respiratory Journal (2013)

Experimental studies have suggested potential benefit of beta-blocker therapy in pulmonary hypertension. However, it is uncertain whether a reduction in heart rate can be achieved without impairing exercise testing and at the costs of little side effects.  Therefore we analyzed side effects, heart rate and exercise capacity in the first 13 patients (6/7 NYHA II/III; age 46,0 years±14,8) who received beta-blocker therapy in an escalating dose as part of the ongoing randomized placebo controlled cross-over trial assessing safety and efficacy of bisoprolol in iPAH-patients (NCT01246037).  An average dose of 4 mg (0 -7,5mg) of bisoprolol was achieved. None of the patients collapsed during the treatment period. One patient developed fluid retention after the start of bisoprolol despite oral diuretics and she had to be treated with IV diuretics for several days.  Heart rate was significantly reduced by bisoprolol (baseline 78/min± 3,3 vs. bisoprolol 68/min±3,7) with only a small, clinically not relevant decrease in exercise capacity (6MWD baseline 463m±27vs. bisoprolol 441m±31; VO 2 /kg baseline 15,5 ml/kg/min±1,1 vs. bisoprolol 14,7 ml/kg/min ±1,2). Bisoprolol treatment didn’t influence the quality of life (Minnesota quality of life questionnaire baseline 27,5 ± 6,8vs bisoprolol 28±6,4).   Conclusions   This preliminary study demonstrates that heart rate reduction by beta-blocker therapy could be achieved with minimal side-effects and only a small, decrease in exercise capacity.
Confluence, Not Conflict of Interest
Authors: Anne R. Cappola, Garret A. FitzGerald
Journal: JAMA (2015)

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Quorum-sensing activity and related virulence factor expression in clinically pathogenic isolates of Pseudomonas aeruginosa
Authors: R. Le Berre, S. Nguyen, E. Nowak, E. Kipnis, M. Pierre, F. Ader, R. Courcol, B.P. Guery, K. Faure
Journal: Clinical Microbiology and Infection (2008)
Surgical Excision Without Radiation for Ductal Carcinoma in Situ of the Breast: 12-Year Results From the ECOG-ACRIN E5194 Study
Authors: Lawrence J. Solin, Robert Gray, Lorie L. Hughes, William C. Wood, Mary Ann Lowen, Sunil S. Badve, Frederick L. Baehner, James N. Ingle, Edith A. Perez, Abram Recht, Joseph A. Sparano, Nancy E. Davidson
Journal: Journal of Clinical Oncology (2015)

To determine the 12-year risk of developing an ipsilateral breast event (IBE) for women with ductal carcinoma in situ (DCIS) of the breast treated with surgical excision (lumpectomy) without radiation.A prospective clinical trial was performed for women with DCIS who were selected for low-risk clinical and pathologic characteristics. Patients were enrolled onto one of two study cohorts (not randomly assigned): cohort 1: low- or intermediate-grade DCIS, tumor size 2.5 cm or smaller (n = 561); or cohort 2: high-grade DCIS, tumor size 1 cm or smaller (n = 104). Protocol specifications included excision of the DCIS tumor with a minimum negative margin width of at least 3 mm. Tamoxifen (not randomly assigned) was given to 30% of the patients. An IBE was defined as local recurrence of DCIS or invasive carcinoma in the treated breast. Median follow-up time was 12.3 years.There were 99 IBEs, of which 51 (52%) were invasive. The IBE and invasive IBE rates increased over time in both cohorts. The 12-year rates of developing an IBE were 14.4% for cohort 1 and 24.6% for cohort 2 (P = .003). The 12-year rates of developing an invasive IBE were 7.5% and 13.4%, respectively (P = .08). On multivariable analysis, study cohort and tumor size were both significantly associated with developing an IBE (P = .009 and P = .03, respectively).For patients with DCIS selected for favorable clinical and pathologic characteristics and treated with excision without radiation, the risks of developing an IBE and an invasive IBE increased through 12 years of follow-up, without plateau. These data help inform the treatment decision-making process for patients and their physicians.
Incidence of medically attended influenza during pandemic and post-pandemic seasons through the Influenza Incidence Surveillance Project, 2009–13
Authors: Ashley Fowlkes, Andrea Steffens, Jon Temte, Steve Di Lonardo, Lisa McHugh, Karen Martin, Heather Rubino, Michelle Feist, Carol Davis, Christine Selzer, Jose Lojo, Oluwakemi Oni, Katie Kurkjian, Ann Thomas, Rachelle Boulton, Nicole Bryan, Ruth Lynfield, Matthew Biggerstaff, Lyn Finelli
Journal: The Lancet Respiratory Medicine (2015)
Deposition of tenascin C and collagen IV in bronchial basement membrane of children with chronic respiratory diseases
Authors: Lenka Honková, Katarína Beránková, Jirí Uhlík, Petra Simunková, Petr Pohunek
Journal: European Respiratory Journal (2014)

Aim:   The aim of the study was to compare histological changes of bronchial mucosa in children with bronchial asthma (AB), cystic fibrosis (CF), primary ciliary dyskinesia (PCD) and healthy subjects and to decide whether these changes are specific for AB or may be present in other chronic respiratory diseases as well.   Methods:   Sixty-three children aged 4 to 19 years (10.8±4.1, 55% males) were enrolled in this observational study. We examined 27 children with AB (9.8±3.1), 15 with CF (11.6±4.3), 14 with PCD (14.8±4.3) and 7 controls (12.4±3.9) with neither any lower repiratory tract morbidity nor history of atopy. In each subject we obtained an endobronchial biopsy during a clinically indicated bronchoscopy. Thickness of the basement membrane (BM) and thickness of tenascin C and collagen IV positive layers were measured using immunohistochemical examination and light microscopy.   Results:   Increased BM thickness (6.65±1.22 vs. 2.93±0.75 µm, pl0.01) was observed in children with AB, CF and PCD compared to controls, the tenascin C-positive layer was also significantly thickened (3.00±0.46 vs. 1.14±0.43 µm, pl0.01), but the thickness of collagen IV layer was not different (1.14±0.37 vs. 1.11±0.49 µm, p=0.82). No differences were found between AB, CF and PCD groups in any of the studied parameters.   Conclusion:   We found increased deposition of tenascin C but not of collagen IV in children with AB, CF and PCD. Observed changes of bronchial BM were not specific for the diagnosis of AB. We suggest that this might be a common generic feature of bronchial remodelling in chronic respiratory diseases.  Supported by GAUK 340911 and IGA MZ NT/11444.
Clinical characteristics and outcomes of pyogenic vertebral osteomyelitis in patients with cirrhosis
Authors: Seong Yeon Park, Ki‐Ho Park, Oh‐Hyun Cho, Yu‐Mi Lee, Sang‐Ho Choi, Mi Suk Lee
Journal: Hepatology (2015)

Potential conflict of interest: Nothing to report. To the Editor: Pyogenic vertebral osteomyelitis (PVO) is uncommon, but its incidence is increasing.1 However, the clinical significance of PVO is unclear in the setting of cirrhosis. Herein, we report on the clinical characteristics of 39 patients with PVO and cirrhosis. Diagnosis of PVO was established by (1) compatible clinical picture, (2) consistent imaging findings on magnetic resonance imaging, and (3) isolation of pyogenic microorganisms in blood culture (in 36 patients) or samples obtained by computed tomography CT‐guided bone biopsy (2 cases) or by open surgery (1 case) as described in our previous report.2 Median patient age was 59 (interquartile range [IQR]: 49‐67), and 25 (64%) patients were male. According to the Child‐Pugh classes, 13% of patients were defined as grade A, 54% as grade B, and 33% as grade C. Back pain and fever were the most common symptoms. Bacteremia was documented in 36 patients (92%). The responsible organisms were Staphylococcus aureus in 20 (54%; methicillin resistant in 9) cases, Streptococci spp., in 8 (21%), and Enterobacteriaceae in 8 (21%) cases. The most frequently prescribed intravenous antibiotics were a β‐lactam agent (63%) and vancomycin (32%). Median antibiotic treatment duration was 56 days (IQR, 41‐80). Twenty (51%) patients with PVO developed renal failure. Nine had hepatic encephalopathy and 10 had concomitant SBP during the hospitalization. Within a 90‐day follow‐up period, resolution of infection was achieved in 29 patients. Overall 90‐day mortality rate was 38% (15 of 39). The most striking finding of our study is the high frequency of renal failure (51%), an incidence much higher than other reported infections.3 Multivariate analysis revealed that concomitant SBP was an independent predictor of renal failure (odds ratio: 14.7; 95% confidence interval: 1.64‐132.6; P = 0.02). The 90‐day mortality in the present study was higher than that observed for patients with cirrhosis and non‐PVO infections.3 PVO may be incite acute‐on‐chronic liver failure as can skin and soft tissue infection.4 PVO usually presents insidiously and follows an indolent clinical course; thus, life expectancy may not be affected in the general population.1 However, the same may not be true for patients with cirrhosis.
Surfactant protein D and its oligomeric forms in chronic obstructive pulmonary disease
Authors: Svetlana Lyamina, Sergei Kalish, Igor Malyshev
Journal: European Respiratory Journal (2013)

Surfactant protein D (SP-D) is a significant regulatory component of alveolar macrophages activity. SP-D influences phenotyping and M1/M2 macrophages balance . Objective : Assessment of quantitative and qualitative composition of SP-D in broncho-alveolar fluid (BALF) in chronic obstructive pulmonary disease in comparison with healthy volunteers (HV). Methods : Quantitative analysis of SP-D in BALF in COPD patients of I-III stage (I – n=12, 55,71±3,92 y.o.; II - n=15, 56,46±1,72 y.o.; III - n=14, 57,54±1,86 y.o.) and healthy volunteers (n=10, 51,83±3,52 y.o.) was performed by ELISA. Qualitative assessment of SP-D oligomeric forms in BALF in COPD and HV was performed by western blot analysis using tris-acetate gels. Results : SP-D level in COPD of I-III stage patients was 1.4, 1.6 and 1.8 times, respectively, decreased as compared to HV. Oligomeric forms of SP-D in II and III stage COPD were presented only by monomers, while oligomeric forms in I stage COPD patients were similar to healthy volunteers - monomers, trimers and dodecamers. Conclusion : In developing COPD (I-III stage) quantitative and qualitative composition of SP-D in BALF vary against healthy volunteers: SP-D level in BALF progressively decreases and monomeric forms prevail in II-III stages of COPD. The educed variations in oligomeric forms of SP-D allows to explain imbalance of M1/M2 macrophages in COPD.