tbuckley/cabot-search huggingface dataset:
A New Look — Form Follows Function
Authors: Jeffrey M. Drazen, Kent R. Anderson, Gregory D. Curfman
Journal: New England Journal of Medicine (2003)

With this issue, we introduce a new look for the Journal. The new design reflects our continuing effort to improve many aspects of the Journal. This redesign was not undertaken lightly and required months of work by many people. Although aesthetics played a part, we strove in all changes to live by the maxim “form follows function.” In the newly designed Journal, the pages are less crowded, and more distinctive headings have been added in order to facilitate navigation and improve readability. The page layout gives us greater flexibility in the presentation of complex tables and figures. The . . .
Effects of supplementation with unsaturated fatty acids on plasma and membrane lipid composition and platelet function in patients with cirrhosis and defective aggregation
Authors: Fabio Marra, Donato Riccardi, Lorenzo Melani, Saura Spadoni, Claudio Galli, Paola Fabrizio, Cristina Tosti-Guerra, Vinicio Carloni, Paolo Gentilini, Giacomo Laffi
Journal: Journal of Hepatology (1998)
Solitary Fibular Metastasis From Lung Cancer Mimicking Stress Fracture
Authors: Chien-Chin Hsu, Ya-Wen Chuang, Chia-Yang Lin, Ying-Fong Huang
Journal: Clinical Nuclear Medicine (2006)

Most metastatic bone disease appears in the axial skeleton. Appendicular bone metastases are usually found in cases of general spread of the disease, and frequent sites are in the femur and humerus. A solitary appendicular bone metastasis is rare. The authors report a case of lung cancer with unusual presentation of a solitary fibular metastasis. The bone scan showed a solitary fusiform hot lesion in the fibular shaft mimicking the typical appearance of a stress fracture. A metastatic fibular lesion from lung cancer was confirmed by excision biopsy.
Imported malaria is falling in Netherlands and Europe
Authors: P. J v. Genderen, D. A Hesselink, J. M Bezemer
Journal: BMJ (2008)

The increase in falciparum malaria in the UK reported by Smith et al1 does not correspond with our own observations on imported malaria in the Netherlands during recent years. We examined all consecutive malaria cases in the Harbour Hospital and Institute for Tropical Diseases in Rotterdam between 1 January 1999 and 1 January 2008. The number of falciparum cases fell from 40 patients …
Abstract S5-2: HERA TRIAL: 2 years versus 1 year of trastuzumab after adjuvant chemotherapy in women with HER2-positive early breast cancer at 8 years of median follow up
Authors: A Goldhirsch, MJ Piccart-Gebhart, M Procter, E de Azambuja, HA Weber, M Untch, I Smith, L Gianni, C Jackisch, D Cameron, R Bell, M Dowsett, RD Gelber, B Leyland-Jones, J Baselga
Journal: Cancer Research (2012)

Abstract Background: One year (yr) of trastuzumab (T) significantly improves disease-free (DFS) and overall survival (OS) in patients with HER2-positive early breast cancer (EBC) and is considered the standard of care. HERA is the only randomized trial investigating whether longer duration of T can further improve efficacy outcome. Materials and Methods: HERA (BIG 01–01) is an international, multicenter, phase III randomized trial involving 5102 women with HER2-positive EBC. Pts were randomized, after completion of primary therapy [surgery, chemotherapy and radiotherapy as indicated], to T every 3 weeks for 1 yr, 2 years (yrs), or observation. This landmark efficacy analysis compares the outcome of pts randomized to either 2 yrs or 1 yr of T who were disease-free at 1 yr after randomization (N = 1553 for 2 yrs, and N=1552 for 1 yr). The primary endpoint is DFS and secondary endpoints are OS and time to distant recurrence (TTDR). Updated efficacy analyses of the T arms vs. observation at 8-yrs of median follow-up (FU) are also presented. Results: On 12 April 2012 HERA reached the target number of 725 DFS events needed for 80% power to detect a true hazard ratio (HR) of 0.80 for the comparison of 2 yrs vs. 1 yr of T. The unadjusted HR for an event in the 2-yr vs. 1-yr T arms was 0.99 (95% CI 0.85–1.14; p = 0.86). OS in the two arms was comparable [HR=1.05 (95% CI 0.86–1.28; p = 0.63)]. TTDR results were similar. The primary cardiac endpoint* was comparable (1.0% vs. 0.8% for 2-yr and 1-yr arms, respectively), but the secondary cardiac endpoint** was higher in the 2-yr arm (7.2% vs. 4.1%). Importantly, the durable benefit in DFS and OS for both 1 yr and 2 yrs of T compared with observation remains stable at 8 yrs of median FU. Subgroup analyses including by hormone receptor status will be available for the meeting. Conclusions: These results confirm that 1 yr of adjuvant T remains the standard of care for HER2-positive EBC pts. It is also reassuring that the significant improvement in DFS and OS persists over time and that the incidence of cardiac endpoints remains low at a median FU of 8 yrs. * NYHA class III or IV, confirmed by a cardiologist, and LVEF &amp;lt; 50% and ≥ 10% below baseline, OR cardiac death. ** LVEF &amp;lt; 50% and ≥ 10% below baseline confirmed by repeat assessment, excluding patients with a primary cardiac endpoint. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr S5-2.
Clinical significance versus statistical significance
Authors: P. Sedgwick
Journal: BMJ (2014)

The effectiveness of topical chloramphenicol in preventing wound infection after minor dermatological surgery was evaluated. A randomised placebo controlled double blind superiority trial was performed. The intervention was a single application of topical chloramphenicol ointment applied to the sutured wound immediately after suturing. Participants were patients with high risk sutured wounds who had undergone minor surgery.1 The primary outcome was infection on the agreed day of removal of sutures or sooner if the patient re-presented with a perceived infection. The required sample size was based on a projected infection rate of 10% in the placebo group. The smallest effect of clinical interest was an absolute decrease in the incidence of infection of 5%. To achieve this difference with a power in excess of 80% and a critical level of significance of 0.05, 473 patients were needed in each treatment group. In total, 972 patients were recruited and randomised to topical chloramphenicol ointment (n=488) or placebo (n=484). The proportion of participants with an infection in the topical chloramphenicol group was statistically significantly lower than for placebo (6.6% v 11.0%; difference −4.4%, 95% confidence interval −7.9% to −0.8%; P=0.010). Which of the following statements, if any, are true?
A STUDY OF INSIGHT OF PSYCHIATRIC PATIENTS
Authors: CARROLL W. OSGOOD
Journal: American Journal of Psychiatry (1940)

1. The insight of 100 patients discharged from a private sanitarium has been studied. 2. Among those diagnosed as depressions there was a greater proportion of patients who showed good insight on admission than among those with other psychoses. Psychoneurotics all showed fair to good insight. 3. All but one of the patients discharged as "much improved" or "recovered" showed some insight and most of this group showed good insight. 4. Absence of insight on admission did not impair the prognosis for recovery, but patients with partial insight showed a poorer recovery rate than either those with no insight or those with good insight. 5. Lack of insight was frequently associated with such manifestations as disorientation, poor comprehension, irrelevance, memory impairment, hallucinations, delusions, conduct disorders and retardation.
Interaction of the heterozygous nude gene with the asplenia trait in mammary tumorigenesis.
Authors: D M Lopez, R J Pauley, B B Lozzio
Journal: The Journal of Experimental Medicine (1985)

The BALB/c mouse strain has been shown to contain endogenous mouse mammary tumor virus (MMTV) proviral sequences. However, no exogenous MMTV particles have been detected in their tissues. Female BALB/c mice from our colonies exhibit a very low incidence of spontaneous mammary tumors (SMT); less than 1% at up to 20 mo of age. Immunodeficient BALB/c mice heterozygous for the nude gene (nu/+, +/+), for the dominant hemimelia gene associated with asplenia (+/+, Dh/+), or for both traits (nu/+, Dh/+) have been examined for SMT incidence and the presence of MMTV proviruses. Based on restriction digestion with Eco RI, Bam HI, and Pst I, the immunodeficient mice have an MMTV provirus copy number and organization identical to the BALB/cCrgl strain. This MMTV DNA pattern is distinct from the MMTV proviruses in C3H/He, C57BL/6J and CBA/CaJ mice, which were parental strains of the immunodeficient mutants. Normal female BALB/c or BALB/c heterozygous for the asplenic trait do not develop significant numbers of SMT at up to 19 mo of age. In contrast, an incidence of 23.8% and 57.7% SMT was observed in BALB/c nu/+ heterozygotes, and in BALB/c nu/+, Dh/+ heterozygotes, respectively. These results indicate that agenesis of the spleen, concomitant with the presence of the heterozygous nude gene, contribute to a high incidence of SMT in the low-SMT BALB/c mouse strain.
The Importance of Placebo Effects in Pain Treatment and Research
Authors: Judith A. Turner
Journal: JAMA (1994)

To estimate the importance and implications of placebo effects in pain treatment and research from the existing literature, with emphasis on their magnitude and duration, the conditions influencing them, and proposed explanations.English-language articles and books identified through MEDLINE (1980 through 1993) and PsycLIT (1967 through 1993) database searching, bibliography review, and expert consultation.Articles were included if they pertained to the review objectives.Placebo response rates vary greatly and are frequently much higher than the often-cited one third. Placebos have time-effect curves, and peak, cumulative, and carryover effects similar to those of active medications. As with medication, surgery can produce substantial placebo effects, and this possibility is commonly overlooked in case series reports on back surgery. Individuals are not consistent in their placebo responses, and a placebo-responder personality has not been identified. Models advanced to explain placebo effects emphasize the role of anxiety, expectations, and learning.Placebo effects influence patient outcomes after any treatment, including surgery, that the clinician and patient believe is effective. Placebo effects plus disease natural history and regression to the mean can result in high rates of good outcomes, which may be misattributed to specific treatment effects. The true causes of improvements in pain after treatment remain unknown in the absence of independently evaluated randomized controlled trials.
Lentiviral-mediated Targeted NF-κB Blockade in Dorsal Spinal Cord Glia Attenuates Sciatic Nerve Injury–induced Neuropathic Pain in the Rat
Authors: Alice Meunier, Alban Latrémolière, Elisa Dominguez, Annie Mauborgne, Stéphanie Philippe, Michel Hamon, Jacques Mallet, Jean-Jacques Benoliel, Michel Pohl
Journal: Molecular Therapy (2007)

Neuropathic pain developing after peripheral nerve injury is associated with altered neuronal and glial cell functions in the spinal cord. Activated glia produces algogenic mediators, exacerbating pain. Among the different intracellular pathways possibly involved in the modified glial function, the nuclear factor κB (NF-κB) system is of particular interest, as numerous genes encoding inflammation- and pain-related molecules are controlled by this transcription factor. NF-κB is a pleiotropic factor also involved in central nervous system homeostasy. To study its role in chronic pain, it is thus essential to inhibit the NF-κB pathway selectively in activated spinal glial cells. Here, we show that when restricted to spinal cord and targeted to glial cells, lentiviral vector-mediated delivery of NF-κB super- repressor IκBα resulted in an inhibition of the NF-κB pathway activated in the rat spinal cord after sciatic nerve injury (chronic constriction injury, CCI). Concomitantly, IκBα overproduction prevented the enhanced expression of interleukin-6 and of inducible nitric oxide synthase associated with chronic constriction injury and resulted in prolonged antihyperalgesic and antiallodynic effects. These data show that targeted blockade of NF-κB activity in spinal glia efficiently alleviates pain behavior in CCI rats, demonstrating the active participation of the glial NF-κB pathway in the development of neuropathic pain after peripheral nerve injury.
Prophylactic Endoscopic Sclerotherapy of Esophageal Varices - A Prospective Randomized Trial
Authors: E. Kobe, B. Zipprich, K.-U. Schentke, R. Nilius
Journal: Endoscopy (1990)

Sixty-three patients with degree III or IV esophageal varices and the so-called red color sign, but without previous bleeding were randomly assigned to either prophylactic sclerotherapy (PST) (n = 30) or to a control group (n = 33). In 58 cases the portal hypertension was caused by liver cirrhosis (40 % alcoholics). The two groups were comparable with respect to demographic data and endoscopic appearance, causes and severity of liver damage. Sclerotherapy was performed as combined intra- and paravariceal injections of 2 or 3 % polidocanol. All patients, both in the treatment and in the control groups, who bled from varices after randomization, received sclerotherapy until the varices were eradicated, and remained in their groups. After a mean follow-up of 44.5 months, the bleeding rate in the PST group was significantly lower (30 % vs 75 %; p < 0.01). The difference became significant from the second year onward. Fourteen patients of the PST group and 19 of the controls died (4 and 14, respectively, p < 0.05 as a result of the bleeding). Life table analysis (Kaplan-Meier) revealed no differences in survival between the two groups. At the present time PST cannot yet be recommended as a method for clinical routine use.
Clinical significance of clonality and Epstein‐Barr virus infection in adult patients with hemophagocytic lymphohistiocytosis
Authors: Jae‐Sook Ahn, Sung‐Yoon Rew, Myung‐Geun Shin, Hye‐Ran Kim, Deok‐Hwan Yang, Duck Cho, Soo‐Hyun Kim, Soo Young Bae, Se Ryeon Lee, Yeo‐Kyeoung Kim, Hyeoung‐Joon Kim, Je‐Jung Lee
Journal: American Journal of Hematology (2010)

We assessed the clinical significance of T or B cell clonality and Epstein-Barr virus (EBV) infection in adult patients with hemophagocytic lymphohistiocytosis (HLH) to identify factors related to prognosis. A total of 30 adult patients with diagnosed HLH were included in the study. In all patients, EBV-DNA in peripheral blood was examined by quantitative real-time polymerase chain reaction and bone marrow cells were examined for clonal rearrangement of T cell receptor gamma(TCRG) and immunoglobulin heavy chain (IGH) genes. TCRG clones were detected in 10 patients (33.3%) and IGH clones were detected in 8 patients (26.7%). We found no correlation between clonality and patient outcome. The patients less than 1,000 copies (mL)21 of EBVDNA showed a significantly higher clinical response (P 5 0.008) and longer overall survival (P 5 0.01) than those with high viral load of EBV-DNA. Our results suggest that TCRG and IGH rearrangement do not have any clinical significance in adult patients with HLH, but that high viral load of EBV-DNA may be a risk factor for poor outcomes. In HLH, high viral load of EBV-DNA should thus suggest a prompt approach with aggressive therapeutic interventions.
Cortistatin, a new antiinflammatory peptide with therapeutic effect on lethal endotoxemia
Authors: Elena Gonzalez-Rey, Alejo Chorny, Gema Robledo, Mario Delgado
Journal: The Journal of Experimental Medicine (2006)

Cortistatin is a recently discovered cyclic neuropeptide related to somatostatin that has emerged as a potential endogenous antiinflammatory factor based on its production by and binding to immune cells. Because human septic shock involves excessive inflammatory cytokine production, we investigated the effect of cortistatin on the production of inflammatory mediators and its therapeutic action in various murine models of endotoxemia. Cortistatin down-regulated the production of inflammatory mediators by endotoxin-activated macrophages. The administration of cortistatin protected against lethality after cecal ligation and puncture, or injection of bacterial endotoxin or Escherichia coli, and prevented the septic shock-associated histopathology, such as infiltration of inflammatory cells and intravascular disseminated coagulation in various target organs. The therapeutic effect of cortistatin was mediated by decreasing the local and systemic levels of a wide spectrum of inflammatory mediators, including cytokines, chemokines, and acute phase proteins. The combined use of cortistatin and other antiinflammatory peptides was very efficient treating murine septic shock. This work provides the first evidence of cortistatin as a new immunomodulatory factor with the capacity to deactivate the inflammatory response. Cortistatin represents a potential multistep therapeutic agent for human septic shock, to be used in combination with other immunomodulatory agents or as a complement to other therapies.
Serum Hyaluronate Reflects Hepatic Fibrogenesis in Alcoholic Liver Disease and Is Useful As A Marker of Fibrosis
Authors: A Pares, R Deulofeu, A Gimenez, L Caballeria, M Bruguera, J Caballeria, A M Ballesta, J Rodes
Journal: Hepatology (1996)

The high levels of hyaluronic acid (HA), a glycosaminoglycan of the liver extracellular matrix, which is synthesized and degraded in the liver sinusoidal cells, have been related with a decreased function of the endothelial sinusoidal cells. The relevance of HA in alcoholic liver disease has not been sufficiently evaluated, and therefore the current study was addressed to assess whether serum HA reflects the severity of liver fibrosis and fibrogenesis as well as the potential usefulness of hyaluronic acid as a marker of early fibrosis in alcoholics with liver damage. Serum HA and aminoterminal propeptide of collagen III (PIIIP) levels, a marker of liver fibrogenesis in alcoholics with liver disease, were assessed in 45 chronic alcoholic patients (31 men and 14 women, age: 44.1 ± 1.5 years) (normal liver = 7; fatty changes = 8; fibrosis = 7; alcoholic hepatitis = 6; cirrhosis = 6; and cirrhosis plus alcoholic hepatitis = 11). The severity of liver inflammation and fibrosis were scored in liver specimens as: 0, no lesion; 1+ mild; 2+ moderate; and 3+ severe. Twenty–seven patients (60%) had HA above normal values (1 patient with fatty changes, 3 patients with fibrosis, and all patients with alcoholic hepatitis or cirrhosis). Hyaluronic acid and (PIIIP) levels increased in parallel with the severity of liver damage. Hyaluronic acid levels were higher in those patients with more liver inflammation (0, 128 ± 38; 1+, 553 ± 141; 2+, 668 ± 259; 3+, and 1,073 ± 419 microg/L; P = .004) and of fibrosis (0, 79 ± 32; 1+, 156 ± 70; 2+, 219 ± 105; and 3+, 695 ± 114 microg/L; P &lt; .001). Procollagen III peptide levels were related with fibrosis (0, 17 ± 1; 1+, 25 ± 6; 2+, 47 ± 13; 3+, and 55 ± 9 ng/mL; P = .002) but not with inflammation (0, 29 ± 7; 1+, 45 ± 7; 2+, 54 ± 9; 3+, and 66 ± 30 ng/mL, P : not significant). Moreover, a direct linear correlation was observed between HA and PIIIP (r = .72, P &lt; .001). A receiver operating characteristic (ROC) curve analysis revealed that HA was similar to PIIIP levels in discriminating between alcoholics without fibrosis and those with fibrosis (area under the ROC curves) (.913 ± .042 vs. .867 ± .054; P : n.s). In conclusion, serum HA reflects the severity of liver inflammation, fibrosis, and fibrogenesis in patients with alcoholic liver disease and is useful as a marker of precirrhotic and cirrhotic stages.
Patient-physician communication about end-of-life care for patients with severe COPD
Authors: J.R. Curtis, R.A. Engelberg, E.L. Nielsen, D.H. Au, D.L. Patrick
Journal: European Respiratory Journal (2004)

Since patients with chronic obstructive pulmonary disease (COPD) infrequently discuss treatment preferences about end-of-life care with physicians, the goal of the present study was to identify which specific areas of communication about end-of-life care occur between patients with severe COPD and their physicians, and how patients rate the quality of this communication. A total of 115 patients with oxygen-dependent COPD, identified in pulmonary clinics in three hospitals and through an oxygen delivery company, were enrolled in this study. A 17‐item quality of communication questionnaire (QOC) was administered to patients, along with other measures, including satisfaction with care. The patients reported that most physicians do not discuss how long the patients have to live, what dying might be like or patients' spirituality. Patients rated physicians highly at listening and answering questions. Areas patients rated relatively low included discussing prognosis, what dying might be like and spirituality/religion. Patients' assessments of physicians' overall communication and communication about treatment correlated well with the QOC. Patients' overall satisfaction with care also correlated significantly with the QOC. In conclusion, this study identifies areas of communication that physicians do not address and areas that patients rate poorly, including talking about prognosis, dying and spirituality. These areas may provide targets for interventions to improve communication about end-of-life care for patients with chronic obstructive pulmonary disease. Future studies should determine the responsiveness of these items to interventions, and the effect such interventions have on patient satisfaction and quality of care.
Chronic enteric carriers: management of personal problems.
Authors: J. C. Sharp
Journal: BMJ (1966)

Anaemia and Big Spleen Disease-Hamilton et al.Bp'Isii 551 cases were found to have lymphocytic infiltrates in the hepatic sinusoids on liver biopsy and a significantly raised antibody titre for malaria, and 26 of the 29 had palpable splenomegaly.This syndrome is called locally big spleen disease.These 29 cases constitute a special group, and are described in detail.Thirteen patients presented with acute haemolytic episodes shown by acholuric jaundice and high reticulocyte counts.Such acute episodes have not been seen in 90 non-pregnant cases with this syndrome.Non-pregnant cases have all been shown to have a shortened red-cell survival of varying degrees.It is concluded that the pregnant patients have a chronic low-grade haemolytic process which predisposes them to acute haemolytic episodes during pregnancy.The possible factors producing these acute attacks and the danger to the mother and foetus are discussed.Big spleen disease is believed to be an abnormal immune response to malaria.It should be suspected when splenomegaly is found, and can be diagnosed by liver biopsy.Pregnant women with this condition with or without anaemia should be treated with a course of 15 mg. of primaquine daily for 15 days coupled with a curative course of chloroquine and followed by prolonged chemoprophylaxis against malaria throughout pregnancy and in all subsequent pregnancies.