tbuckley/cabot-search huggingface dataset:
A low-risk tumour, at a high-risk site? Basal cell carcinoma of the nipple-areola complex
Authors: C. Williams, W. Hussain
Journal: British Journal of Dermatology (2013)

Funding sources: none. Conflicts of interest: none declared. Madam, A 42‐year‐old caucasian man presented with a lesion on the right nipple–areola complex (NAC), highly suspicious clinically of recurrent basal cell carcinoma (BCC). His past medical history was significant for Gorlin syndrome and a renal transplant for end‐stage renal failure secondary to glomerulonephritis. His regular medications comprised ciclosporin and prednisolone. In 2009 a biopsy‐proven primarily superficial BCC affecting the right nipple and areola region was treated, at that time successfully, with two cycles of photodynamic therapy. In July 2011, however, a 33 × 21 mm poorly defined plaque affecting the right upper outer quadrant of the NAC was noted (Fig. 1). Repeat biopsies confirmed this to be a multifocal BCC with a mixed superficial and nodular growth pattern. Clinical examination revealed no puckering or tethering of the NAC itself and no lymphadenopathy in the draining lymph node basin. In view of the ill‐defined clinical margins, the recurrent nature of the tumour and the need for tissue preservation in this cosmetically sensitive site, Mohs micrographic surgery (MMS) was performed. Tumour‐free margins were achieved following one stage and two sections and the resulting 36 × 23 mm defect (Fig. 2) closed primarily with an excellent cosmetic outcome at review 3 months later.
Hepatic stellate cell and monocyte interaction contributes to poor prognosis in hepatocellular carcinoma
Authors: Juling Ji, Tobias Eggert, Anuradha Budhu, Marshonna Forgues, Atsushi Takai, Hien Dang, Qinghai Ye, Ju‐Seog Lee, Ji Hoon Kim, Tim F. Greten, Xin Wei Wang
Journal: Hepatology (2015)

Hepatocellular carcinoma (HCC) patients suffer from a poor survival rate and a high incidence of postoperative recurrence. The hepatic microenvironment plays a significant role in the initiation, progression, and recurrence of HCC; however, the causal mechanisms of these phenomena are unclear. Given the predominant underlying fibrotic and cirrhotic conditions of the liver prone to HCC and its recurrence, alterations of components of the inflammatory milieu have been suggested as factors that promote HCC development. In particular, activated hepatic stellate cells (A-HSCs), which play a key role in liver fibrosis and cirrhosis, have been suggested as contributors to the HCC-prone microenvironment. Here, we have identified and validated an A-HSC-specific gene expression signature among nontumor tissues of 319 HCC patients that is significantly and independently associated with HCC recurrence and survival. Peritumoral, rather than tumor tissue-related, A-HSC-specific gene expression is associated with recurrence and poor survival. Analyses of A-HSC-specific gene signatures and further immunohistochemical validation in an additional 143 HCC patients have revealed that A-HSCs preferentially affect monocyte populations, shifting their gene expression from an inflammatory to an immunosuppressive signature. In addition, the interaction between A-HSCs and monocytes induces protumorigenic and progressive features of HCC cells by enhancing cell migration and tumor sphere formation.A-HSCs play a significant role in promoting HCC progression through interaction with and alteration of monocyte activities within the liver microenvironment; thus, disrupting the interactions and signaling events between the inflammatory milieu and components of the microenvironment may be useful therapeutic strategies for preventing HCC tumor relapse.
Stable state MR-proadrenomedullin level in COPD patients; a validation study
Authors: Maaike Zuur-Telgen, Paul vanderValk, Job van der Palen, Huib Kerstjens, Marjolein Brusse-Keizer
Journal: European Respiratory Journal (2014)

Background   Proadrenomedullin (proADM) has been shown to be a good predictor for mortality in stable state. This study aims to provide an external validation of earlier observed cutoff values used by Zuur-Telgen et al. and Stolz.et al. in stable state and at hospitalization for an AECOPD.    Methods   From the COMIC study we included respectively 490 and 101 COPD patients with a blood sample obtained in stable state and at hospitalization for an AECOPD. Time to death was compared between patients with proADM above or below the median of 0.71 and 0.75 nmol/L for stable state or 0.79 and 0.84 nmol/l for AECOPD. The predictive value of proADM for survival was determined by calculating the C statistic. Risk ratios were corrected for gender, age, BMI, heart failure and GOLD stage.    Results   Patients above the cut-off of 0.75 nmol/l had a 2 fold higher risk of dying than patient below this cut-off (95% CI: 1.20 – 3.41). The cut-off of 0.71 nmol/l showed only a borderline significant higher risk of 1.67 (95% CI: 0.98 – 2.85). The Odds Ratio corrected for one year mortality was 3.15 (95% CI 1.15 – 8.64) and 3.70 (95% CI 1.18 – 11.6) in patients with proADM levels above the cut-off of 0.75 and 0.71 nmol/l measured in stable state respectively, compared to patients with low levels (table 2). ProADM levels in samples at hospitalization for an AECOPD were not predictive for mortality in this validation cohort.    Conclusions   ProADM shows to be a powerful predictor for mortality in stable state. The following step will be the comparison with other multi-component indices such as the BODE and ADO. Furthermore, proADM could be used for risk stratification in controlled trials to optimize therapy for survival prolonging.
Germany introduces new criteria for organ allocation
Authors: Annette Tuffs
Journal: BMJ (1999)

Germany's Federal Medical Council has published new criteria for the allocation of organs to patients who have transplants after the passage of a recent law that specified that organs should be allocated to individuals rather than to transplant centres, as had occurred in the past.

The new guidelines try to give equal chances to each patient while taking into account the urgency and prospective outcome of transplantation. For each organ a system has been …
Phytoestrogens and Risk of Lung Cancer
Authors: Peter C. H. Hollman, Ivon E. J. Milder, Ilja C. W. Arts, Edith J. M. Feskens, H. Bas Bueno de Mesquita, Daan Kromhout
Journal: JAMA (2006)

To the Editor: In their study of phytoestrogens and risk of lung cancer, Dr Schabath and colleagues1 report on the intake of lignans in a US population. Their results, while interesting, are discrepant with those of other studies.
Subcellular localization of the protein product of epithelial-stromal interaction 1 (breast) EPSTI1
Authors: Michala Wissing, René Villadsen, Fritz Rank, Lone Ronnov-Jessen, Ole W. Petersen
Journal: Cancer Research (2005)

Proc Amer Assoc Cancer Res, Volume 46, 2005

5483 

Protein degradation plays an important role in cell cycle regulation of Aurora-A kinase expression and its kinase activity. Aurora-A kinase was currently known to be degraded in late mitosis till early G1 through the APC/C-ubiquitin-proteosome-dependent pathway, which is mediated through the A and D degradation boxes via Cdh1. Here, we report the alternative degradation pathway for Aurora-A kinase, which is proteosome-dependent but ubiquitin-independent and mediated through the AKIP (Aurora-A Kinase Interacting Protein), previously identified as a direct negative regulator of Aurora-A kinase. AKIP is normally sequestered in nucleolus in interphase cells and localized to mitotic spindle in mitosis, indicating AKIP may target Aurora-A degradation in mitosis. Use of proteosome-specific inhibitors reverses the AKIP-mediated Aurora-A degradation indicating the proteosome-dependence of this alternative pathway. Under conditions where cellular ubiquitination is suppressed by dominant negative ubiquitin mutant, Aurora-A kinase degradation by AKIP is not abolished. In vivo Aurora-A ubiquitination assays have shown that degradation of Aurora-A kinase by AKIP occurs without detectable polyubiquitination. However, a non-interacting deletion mutant of AKIP, which is defective in degrading Aurora-A, restored similar level of polyubiquitination as the negative vector control. On the other hand, S51D mutant, a stabilizing mutant of Aurora-A kinase can still be targeted for degradation by AKIP. The antizyme, one of the regulators for ubiquitin-independent proteolysis, may play a role in this alternative degradation pathway as its up-regulation by the polyamine spermine causes reduction of intracellular Aurora-A kinase level. The functional link between antizyme and AKIP in regulating this alternative pathway will be probed further. Our findings have uncovered an alternative proteosome-dependent but ubiquitin-independent degradation pathway for Aurora-A kinase, mediated by AKIP.
Characterization of the genome-wide TLX1 binding profile in T-cell acute lymphoblastic leukemia
Authors: K Durinck, W Van Loocke, J Van der Meulen, I Van de Walle, M Ongenaert, P Rondou, A Wallaert, C E de Bock, N Van Roy, B Poppe, J Cools, J Soulier, T Taghon, F Speleman, P Van Vlierberghe
Journal: Leukemia (2015)
Endothelial Cells in Physiology and in the Pathophysiology of Vascular Disorders
Authors: Douglas B. Cines, Eleanor S. Pollak, Clayton A. Buck, Joseph Loscalzo, Guy A. Zimmerman, Rodger P. McEver, Jordan S. Pober, Timothy M. Wick, Barbara A. Konkle, Bradford S. Schwartz, Elliot S. Barnathan, Keith R. McCrae, Bruce A. Hug, Ann Marie Schmidt, David M. Stern
Journal: Blood (1998)
PANCYTOPENIA ASSOCIATED WITH DISSEMINATED TUBERCULOSIS
Authors: W COOPER
Journal: Annals of Internal Medicine (1959)

Excerpt The importance of recognizing disseminated tuberculosis as a cause of obscure blood disorders cannot be sufficiently emphasized. Unless early diagnosis of the underlying disease is made and appropriate treatment given, a fatal outcome is almost inevitable. The purpose of this paper is to record a case of pancytopenia due to disseminated tuberculosis, and again to draw attention to the difficulties encountered in diagnosis. Another interesting feature of this case was that splenectomy restored the blood to normal, supporting the contention that in at least some of these cases hypersplenism is an important factor, responsible for the hematologic disturbance. CASE REPORT
Strategies to Diagnose and Treat Group A Streptococcal Pharyngitis
Authors: Ralph Gonzales, Richelle J Cooper, Jerome R Hoffman
Journal: JAMA (2004)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Abstract 1794: Evaluation of Usefulness and Efficacy of a “Segmental Perfusion Abnormality Index”: A Novel Diagnostic Approach with Conventional Enhanced Computed Tomography for the Differentiation of Acute Coronary Syndrome in Patients with Acute Onset of Chest or Back Pain
Authors: Nami Okamoto, Yoshihiro Morino, Hiroki Takeuchi, Takashi Matsukage, Eri Toda, Misako Iino, Toru Aizawa, Teruhisa Tanabe, Yuji Ikari
Journal: Circulation (2007)

Background: Immediate and accurate differential diagnosis is critically important for the patients who present acute onset of chest and/or back pain. We have noticed that regions of decreased contrast enhancement existed within the myocardial wall of the patients with acute coronary syndrome (ACS) on conventional computed tomography (CT) images, performed to differentiate other acute thoracic diseases (e.g. aortic dissection, pulmonary embolism). This study was designed to utilize these features for the differential diagnosis of ACS. Methods: The study population consisted of 95 consecutive patients who required enhanced CT for the differential diagnosis of acute chest discomfort at the emergency room. Using the representative apical four-chamber view, the left ventricular (LV) wall was divided into the following 6 segments: 1) basal septum, 2) mid septum, 3) apex, 4) mid lateral, 5) basal lateral and 6) basal posterior. A CT number was measured at each segment, and was then fitted into either of the following formula to calculate a segmental perfusion abnormality (SPA) index based on the existence of visually-apparent low density segments (VALDS): 1) In case of VALDS presence: average CT numbers of VALDS/average CT number of the rest normal segments × 100 (%), 2) in case of VALDS absence: the minimum CT number/average CT number of the rest 5 segments × 100 (%). The SPA index was compared between the two groups, one with ACS and another without ACS, both confirmed by coronary angiography. Results: Forty-five patients (47.4%) were eventually diagnosed as ACS by coronary angiography. Importantly, the SPA index was significantly smaller in the ACS group compared to the non ACS group (48.7±17.2% vs 85.5 ± 7.1%, p&lt;0.0001). The standard receiver operating characteristic curve indicated that an optimal threshold of the SPA index is estimated to be 65%, with an achievement of high diagnostic accuracy (sensitivity: 86.7%, specificity: 98.0%, positive predictive value: 97.5%, and negative predictive value: 89.0%). Conclusions: The SPA index, a novel CT-based diagnostic approach for the non-invasive visualization of the ischemic LV wall, is confirmed to be easy and accurate method to differentiate ACS among the various patients who present acute chest or back pain.
Intrathoracic Complications of Amoebic Liver Abscess
Authors: Adebayo O Adeyemo, Adebimpe Aderounmu
Journal: Journal of the Royal Society of Medicine (1984)

Amoebiasis is a world-wide parasitic infestation but is more prevalent and virulent in warm countries. Of 33 patients with amoebic liver abscess (ALA) seen over a 5-year period, 24 had intrathoracic complications. Management consisted mainly of the administration of the antiamoebic agent metronidazole (Flagyl), repeated needle aspiration of ALA and surgical drainage when aspiration failed. Closed tube thoracostomy was the preferred management of amoebic empyema. Associated cerebral involvement in 4 cases improved with parenteral metronidazole. Pericardial amoebic abscess claimed 100% mortality in our series.
Family medicine: Two case histories
Authors: J. Brown
Journal: BMJ (2000)

At the end stage of a terminal disease, 68 people (94%) said they would refuse surgery, 67 (93%) artificial feeding, 66 (92%) ventilation, 65 (90%) cardiopulmonary resuscitation, 62 (86%) subcutaneous or intravenous fluids, and 59 (82%) antibiotics.Fifty participants (74%) expressed interest in writing a living will, most commonly because their views would be known (25; 34%) and to relieve the burden of decisions on their family (22; 30%).Women and men were equally interested in writing a living will.
Abstract 13380: The Effects of Pre-LVAD Obesity on Post-LVAD Re-Hospitalizations
Authors: Burhan Mohamedali, Gardner Yost, Geetha Bhat
Journal: Circulation (2014)

Introduction: Obesity is a major risk factor for cardiovascular outcomes and it is prevalent in patients (pts) with advanced heart failure requiring left ventricular assist devices (LVAD). The understanding of high body mass index (BMI) after LVAD implantation outcomes continues to evolve. In this study, we investigated the effects of obesity on post-LVAD re-hospitalization. Methods: In this retrospective study, 288 pts with both HeartMate II and HeartWare HVAD, implanted for bridge to transplantation (BTT) and destination therapy (DT), were enrolled. Pts were stratified based on a BMI ≥ 30. Baseline demographics were obtained. Post LVAD incidence of readmissions and major adverse effects were tabulated. Results: The cohort was comprised of 95 (33%) obese and 193 (67%) non-obese pts, (63 (25%) women vs 225 (75%) men), BTT 48 (20%), vs DT 240(80%). The mean BMI in the obese group was 35.2 Kg/M2 compared to 24.3 Kg/M2 (p=&lt;0.001) in the control group. There were no differences in the index length of stay and time to readmissions between the two groups. However, obese pts had a higher mean total number of hospitalizations compared to non-obese pts (4.2 vs. 3.4, p=0.03). Other than the incidence of post-LVAD heart failure and hemolysis being higher in the obese group, there were no other statistically significant differences between the two groups (Table 1). There was a trend towards higher thrombosis in the obese cohort. Conclusions: Obese pts had a higher number of total hospitalizations compared to non-obese pts. There was no difference in time to readmission between the groups. These readmissions appear to be mainly driven by heart failure and hemolysis. Further investigation to determine causality is indicated.
Harnessing Brain Signals Shows Promise for Helping Patients With Paralysis
Authors: M J Friedrich
Journal: JAMA (2004)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Randomized clinical trials: is periodontal research good for patients?
Authors: Karen B. Williams, Alan Glaros, Mary P. Walker, Charles M. Cobb
Journal: Periodontology 2000 (2012)

Abstract Randomized controlled trials, in which randomization is used to allocate patients to a treatment arm, are a relatively new concept. Randomized controlled trials are increasingly high‐stakes endeavors requiring a high level of planning and considerable financial support. Randomized controlled trials are the gold standard by which effectiveness of various treatments or interventions are determined. However, the methods involved in randomized controlled trials raise the question: is clinical research good for the participants? This paper discusses patient‐centered issues relating to randomized controlled trials, for example, whether the informed‐consent process results in subjects who are knowledgeable and informed about their participation, which, in turn, involves patient autonomy, health literacy and treatment preferences. Other issues discussed are those of statistical vs. clinical significance, professional ethics and ethical justification for randomized controlled trials, and differences in perceptions between patients and clinicians regarding the level of care being provided by the randomized controlled trials. Because our goal, as clinicians, is to provide treatment that improves the quality of life for the patient, it would seem logical that randomized controlled trials should include variables rated as important by patients as valid outcome measures. As clinicians and researchers, we can no longer afford to view randomized controlled trials from an ivory tower. Research participants, although autonomous agents, are inherently different from the patient seeking clinical care. Researchers have an ethical responsibility to consider the informed consent process as it relates to the subject’s health literacy and potential for therapeutic and procedural misperceptions.
Clinical predictors for emesis in breast cancer patients receiving anthracycline-based chemotherapy: Do Asians measure up?
Authors: A. Chan, V. Shih, K. Y. Yap, S. Tan, X. Low
Journal: Journal of Clinical Oncology (2010)

e19603 Background: In a post hoc analysis of 856 breast cancer patients (majority Caucasians) receiving anthracycline-based chemotherapy (Warr et al., MASCC 2009), patient characteristics, including young age, low alcohol consumption, and history of morning sickness, were associated with higher risks for emesis (E). However, whether these risk factors predict for E in the Asian population is unknown. This is the largest study to date that establishes the association of these predictors in a similar treatment cohort of Asian cancer patients through analysis of E events. Methods: This is a prospective, observational study conducted at the largest cancer center in Singapore from 2006 to 2009. On the day of chemotherapy, patients' demographics were retrieved via interview. They were also given a standardized 5-day diary to document their E events. Multiple logistic regressions were used to analyze the impact of these predictors on acute and delayed E. Results: 244 eligible women (mean 50 ± 8.9 years) were recruited. Incidences of acute and delayed E were 23.5% and 25.4% respectively. Multivariate analysis showed that young age (OR=2.13, 95%CI 1.13-4.02), histories of motion sickness (OR=2.44, 95%CI 1.17-5.08) and chemotherapy-induced E (OR=2.95, 95%CI 1.20-7.26) were significantly associated with increased likelihoods of acute E, while the latter two predictors were also significantly associated with increased likelihoods of delayed E (OR=2.29, 95%CI 1.13-4.64 and OR=2.42, 95%CI 1.03-5.69 respectively). Conclusions: In Asians, histories of motion sickness and chemotherapy-induced E are important predictors, but alcohol history and history of morning sickness are less likely to play a role. Clinicians should aware of the differences in E predictors between Asians and non-Asians. Multivariate analysis of emesis events Warr et al. (N = 856) Current study (N = 244) Overall emesis Acute emesis Delayed emesis Predictors p value p value p value Young age 0.006 0.02 NS Alcohol history (+) 0.0048 NS NS Morning sickness (+) 0.0007 NS NS Motion sickness (+) NS 0.02 0.02 History of chemotherapy-induced emesis NA 0.02 0.04 Abbreviations: NS, not statistically significant (p > 0.05); NA, not available. No significant financial relationships to disclose.