tbuckley/cabot-search huggingface dataset:
875-4 The incidence of cerebral embolism after percutaneous occlusion of the left atrial appendage: A serial and prospective study using cerebral magnetic resonance imaging scanning
Authors: Heyder Omran, Harald Schmidt, Peter Bernhardt, Christoph Hammerstingl, Stephanie Kuntz-Hehner, Thorsten Sommer, Berndt Lüderitz, David Hardung
Journal: Journal of the American College of Cardiology (2004)
Autosomal dominant Alport syndrome caused by a COL4A3 splice site mutation
Authors: Frank T.L. Van Der Loop, Laurence Heidet, Erika D.J. Timmer, Bianca J.C. Van Den Bosch, Anu Leinonen, Corinne Antignac, J. Ashley Jefferson, A. Peter Maxwell, Leo A.H. Monnens, Cornelis H. Schröder, Hubert J.M. Smeets
Journal: Kidney International (2000)
High-dose interleukin-2 (hd-IL2) in treatment-naïve metastatic renal cell carcinoma (mrcc) - a 10 year single-site experience and outcome of prospective pathology-based patient selection
Authors: Shien Chow, Manon Evans, Victoria Galvis, Rebecca Leach, Elizabeth Keene, Kevin Chan, Andrea Spencer-Shaw, Shanks Jonathan, Alaaeldin Shabalak, Fiona Thistlethwaite, Robert Hawkins
Journal: Journal for ImmunoTherapy of Cancer (2014)

Meeting abstracts Despite the advent of targeted therapies, mRCC remains difficult to treat with limited prospect of cure. HD-IL2 is the only agent consistently capable of achieving durable long-term remissions. Shablak et al have previously reported improved outcomes in patients prospectively
Anaphylactic reaction to chlorpropamide.
Authors: M Ravid, E Rubinstein, S Cabili
Journal: BMJ (1971)

The total incidence of untoward reactions to chlorpropamideis about 6% (Sayers and Travis, 1965). Gastrointestinal symp-toms, skin reactions, and blood dyscrasias constitute the majorgroups (Stein et al., 1964; Dinsdale et al., 1968; Aecker andHynes, 1969; Norman et al., 1970). The anaphylactic reactionto chlorpropamide as described in the following case has,
Vaccine-acquired Rotavirus Infection in Two Infants with Severe Combined Immunodeficiency
Authors: N.C. Patel, P.M. Hertel, M.K. Estes, M. Dela Morena, L.M. Noroski, P.A. Revell, I.C. Hanson, M.E. Paul, H.M. Rosenblatt, S.L. Abramson
Journal: Journal of Allergy and Clinical Immunology (2009)
The Place of Chemotherapy in the Treatment of Testicular Tumors
Authors: Robert B. Golbey
Journal: JAMA (1970)

The fact that the course of disseminated testicular carcinomas can be favorably influenced by chemotherapy has been thoroughly documented.<sup>55-61</sup>A problem now is how to blend surgery, radiation therapy, and chemotherapy into a program for the optimal management of patients with these tumors. A rational approach to this problem requires an awareness of the histogenesis and natural history of these tumors as well as a knowledge of the biological peculiarities of the different histological types. The tumors which are of concern here arise in the "germ cell" in the testicular tubule. Neoplastic change in this totipotential cell can produce a spectrum of tumors, depending on the state of differentiation in the normal cell which undergoes neoplasia and on the degree to which differentiation continues in the cancer cell.<sup>62</sup>Teratocarcinoma and choriocarcinoma can evolve from embryonal carcinoma. Electron microscopic studies have revealed an evolution of the submicroscopic cellular organization
Diagnosis of Early Carcinoma of the Cervix by Sponge Biopsy
Authors: Sidney A. Gladstone
Journal: New England Journal of Medicine (1949)

SINCE cancer in its early stage is a localized lesion, successful treatment depends on complete surgical removal of the diseased tissue or its complete destruction by adequate radiation. The diagnosis of cancer by the recognition and proper interpretation of early clinical signs and symptoms is in several important categories wholly inadequate, as witnessed by the poor results in the treatment of gastric and bronchogenic carcinoma. In lesions of the stomach and lung the symptoms appear and the diagnosis is made at a stage of the disease in which the cancer most often has advanced beyond the possibility of complete removal. . . .
Chronic disease management: a Singapore perspective
Authors: J. Cheah
Journal: BMJ (2001)

The scope for chronic disease management programmes in Asian countries is tremendous. Rapidly ageing populations, demographic and epidemiological transitions, and changing disease profiles have prompted reviews of healthcare delivery across Asia. This paper provides a brief description of disease management approaches used for chronic illnesses in Singapore and shows that disease management can be successfully implemented in systems very different from that in the United Sates, where it originated.

#### Summary points

Asian countries have generally not yet tackled the issue of chronic disease management despite their recent epidemiological and demographic changes

Chronic disease management provides an approach that would enable healthcare systems in Asia to take a more holistic view of the care of patients with chronic illnesses

The literature on disease management might confuse Asian healthcare professionals because most comes from the context of managed care in the United States

The approach needs to be adapted to run within a state run and funded healthcare system; the experience of Singapore shows that this is possible

Chronic diseases have now overtaken infectious diseases as the main cause of mortality and morbidity in developed countries—as well as contributing to escalating healthcare costs. In most developed countries the dual problem of a rising prevalence of chronic disease and escalating costs has caused healthcare policymakers to consider innovative approaches to containing costs and improving the quality of care. An increasing number of reports propose a more holistic and integrated approach for patients with chronic diseases—disease management.1–8 This approach was first described by the Boston Consulting Group in 1993 and has been gaining popularity in managed care organisations in the United States.4–6

Most Asian healthcare systems combine state run and financed facilities with private providers. Managed care on a large scale does not exist. Most doctors in the public sector …
Hospitals in Wales need to reconfigure to improve patient outcomes, says report
Authors: M. Limb
Journal: BMJ (2012)

Hospital services in Wales need to be reorganised urgently, as some are close to “collapse” despite a decade of improved NHS performance, says an independent review.

The report highlights increasing demand for care and acute pressure on medical staffing in some specialties.1

It says that patients’ lives may be at risk and argues that there is a “strong case” for centralising some services, such as trauma, orthopaedic, and paediatrics, to improve safety and the quality of care.

The review was carried out by Marcus Longley, a professor at the Welsh Institute for Health and Social Care, University of Glamorgan.

He says in the report, “There is now convincing evidence that hospital services …
Adult-Type Granulosa Cell Tumors and FOXL2 Mutation
Authors: Martin Köbel, C. Blake Gilks, David G. Huntsman
Journal: Cancer Research (2009)

Little is known about the pathogenesis of ovarian granulosa cell tumors. Recently, we reported the identification of a somatic FOXL2 402C-->G mutation that is present in virtually all adult-type granulosa cell tumors, but not in a wide range of other tumor types. This finding has important implications for the diagnosis and classification of ovarian sex cord-stromal tumors, provides insight into the pathogenesis of adult-type granulosa cell tumors, and opens possibilities for the development of targeted therapies.
Abstract 2417: A new mouse model for epithelial ear neoplasms based upon expression of mutant EGFRL858R/T790M
Authors: Shigeru Kawabata, M. Christine Hollander, Jeeva P. Munasinghe, Jose Mercado, Lauren R. Brinster, John A. Butman, Russell R. Lonser, Lucia Regales, William Pao, Pasi A. Janne, Kwok-Kin Wong, Phillip A. Dennis
Journal: Cancer Research (2011)

Abstract Epithelial neoplasms of the ear are rare and difficult to detect before the development of audiovestibular or facial nerve dysfunction. Complete resection is often difficult because of location and the late stage at diagnosis, so effective chemotherapy is required. No preclinical models exist for these tumors. During the generation of mice using CC10 or surfactant protein C (SP-C) promoters to drive expression of mutant EGFR (EGFRL858R/T790M) in lung tissues, we observed that no SP-C mice developed lung tumors, but approximately 30% of them developed head tilt and a circular gait by 25 wk. MRI scans showed bilateral ear tumors located in the tympanic cavity that partially invaded into temporal bone, which suggested the presence of middle ear tumors or endolymphatic sac tumors (ELSTs). Histology of the ear tumors showed well-differentiated adenocarcinomas with multiple papillary and microcystic structures. Immunohistochemical (IHC) analysis showed that the mutant EGFR was active and selectively expressed in the tumors, and that downstream components of EGFR signaling such as Akt, mTOR and ERK were activated. SP-C expression was also detected, suggesting that surfactant proteins are expressed in ear epithelium at specific times during tumor development. To determine if these tumors were addicted to EGFR signaling, EGFR-based therapies were tested in symptomatic mice. Consistent with the T790M mutation in EGFR conferring resistance to reversible EGFR tyrosine kinase inhibitors (TKI), erlotinib was ineffective. In contrast, the combination of an irreversible EGFR TKI (BIBW-2992) with an antibody against EGFR (cetuximab), or a chemically optimized analogue of BIBW-2992 (WZ4002) used alone, was highly effective. All mice treated with the combination or WZ4002 alone had normalization of gait and complete responses by MRI, suggesting that these tumors are dependent upon mutant EGFR. To assess the possible clinical relevance of this mouse model, 2 human middle ear adenocarcinomas and a human ELST were stained for active EGFR using IHC. 3/3 displayed increased EGFR activation. These studies describe a new mouse model for human epithelial ear tumors based on EGFR activation, and raise the possibility that EGFR-based therapies might have clinical efficacy in these rare neoplasms. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2417. doi:10.1158/1538-7445.AM2011-2417
Evaluation of Tamoxifen Doses With and Without Fluoxymesterone in Advanced Breast Cancer
Authors: Douglass C. Tormey, Marc E. Lippman, Brenda K. Edwards, Jane G. Cassidy
Journal: Annals of Internal Medicine (1983)

From a group of 108 female patients with measurable and/or evaluable metastatic breast carcinoma, 52 were randomized to receive tamoxifen and 56 to receive tamoxifen and fluoxymesterone. The fluoxymesterone dose, given orally twice a day, was 7 mg/m2 body surface area. The tamoxifen dose per patient, also given orally twice a day, ranged from 2 to 100 mg/m2 body surface area. Eighty-five percent of the patients had received previous chemotherapy and 60% previous hormone therapy. The complete and partial remission rate was better with the tamoxifen and fluoxymesterone regimen (p=0.016), with remission rates of 15% for tamoxifen alone and 38% for the combination. The tamoxifen and fluoxymesterone regimen appeared to have higher remission rates in all subsets of pretreatment variables. Duration of remission with each regimen was similar, but the overall time to treatment failure for tamoxifen and fluoxymesterone was longer than for tamoxifen alone (180 versus 64 days, p=0.01). Median survival with the combination was 380 days compared to 330 days for tamoxifen. No significant dose-response relationships emerged. Side effects were not different between dose levels or regimens except for the androgen effects in the tamoxifen and fluoxymesterone combination. These results suggest that there is no major dose-response effect for doses ranging from 2 to 100 mg/m2 body surface area given twice daily in this largely (94%) postmenopausal pretreated patient group, and that the tamoxifen and fluoxymesterone regimen is superior to tamoxifen alone.
The ischemic liver—do not resuscitate too much
Authors: Yisrael Isaacson, David H. Van Thiel
Journal: Hepatology (1988)

The interest in liver transplantation has focused more attention on the mechanisms of injury during hepatic ischemia, preservation, and reperfusion. Although the human liver has been successfully maintained under hypothermic conditions for up to 10 hours, organ preservation remains the major obstacle to liver transplantation. With tissue ischemia, cell respiration and oxidative phosphorylation cease, with a decline in high-energy phosphates including adenosine triphosphate (ATP). If oxygen and substrate are made available within a certain period of time, energy stores are regenerated and cells live. However, with irreversible ischemia, ATP stores cannot be regenerated despite the restoration of blood flow, and the cells consequently die. When ATP-MgCl 2 has been given by intravenous infusion, animal survival has been improved in shock, and renal function and histology have been maintained after renal ischemia. The mechanism responsible for this beneficial effect of ATP-MgCl 2 has not been defined, but it is generally presumed that ATP preserves sublethally injured cells by enhancing their repair and recovery after ischemic injury. Although reperfusion is necessary to prevent cell death, it is not without hazard. During the period of ischemia, ATP is broken down to adenosine monophosphate, adenosine, inosine, and finally to hypoxanthine, which can be irreversibly converted by xanthine oxidase to xanthine. The introduction of oxygen into this reaction by reperfusion results in the production of the free radicals superoxide (0 2 ) and hydrogen peroxide (H 2 O 2 ), which are mediators of tissue injury, probably by lipid peroxidation. Protection from these oxidative effects can be achieved by dismutation of superoxide to H 2 O 2 by the enzyme superoxide dismutase (SOD) and reduction of H 2 O 2 by catalase.
Dyslipidemia, Coronary Artery Calcium, and Incident Atherosclerotic Cardiovascular Disease
Authors: Seth S. Martin, Michael J. Blaha, Ron Blankstein, Arthur Agatston, Juan J. Rivera, Salim S. Virani, Pamela Ouyang, Steven R. Jones, Roger S. Blumenthal, Matthew J. Budoff, Khurram Nasir
Journal: Circulation (2013)

Worldwide clinical practice guidelines for dyslipidemia emphasize allocating statin therapy to those at the highest absolute atherosclerotic cardiovascular disease (CVD) risk.We examined 5534 Multi-Ethnic Study of Atherosclerosis (MESA) participants who were not on baseline medications for dyslipidemia. Participants were classified by baseline coronary artery calcium (CAC) score (>0, ≥ 100) and the common clinical scheme of counting lipid abnormalities (LA), including low-density lipoprotein cholesterol ≥ 3.36 mmol/L (130 mg/dL), high-density lipoprotein cholesterol <1.03 mmol/L (40 mg/dL) for men or <1.29 mmol/L (50 mg/dL) for women, and triglycerides ≥ 1.69 mmol/L (150 mg/dL). Our main outcome measure was incident CVD (myocardial infarction, angina resulting in revascularization, resuscitated cardiac arrest, stroke, cardiovascular death). Over a median follow-up of 7.6 years, more than half of events (55%) occurred in the 21% of participants with CAC ≥ 100. Conversely, 65% of events occurred in participants with 0 or 1 LA. In those with CAC ≥ 100, CVD rates ranged from 22.7 to 29.5 per 1000 person-years across LA categories. In contrast, with CAC=0, CVD rates ranged from 2.7 to 5.9 per 1000 person-years across LA categories. Individuals with 0 LA and CAC ≥ 100 had a higher event rate compared with individuals with 3 LA but CAC=0 (22.7 versus 5.9 per 1000 person-years). Similar results were obtained when we classified LA using data set quartiles of total cholesterol/high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, or low-density lipoprotein particle concentration and guideline categories of low-density lipoprotein cholesterol or non-high-density lipoprotein cholesterol.CAC may have the potential to help match statin therapy to absolute CVD risk. Across the spectrum of dyslipidemia, event rates similar to secondary prevention populations were observed for patients with CAC ≥ 100.
OBSERVATION OF A PATIENT DURING A CEREBRAL ANGIOSPASM
Authors: Benjamin Finesilver
Journal: JAMA (1924)

The occurrence of a transient hemiplegia, monoplegia or aphasia, appearing in cases of advanced arteriosclerosis, during a spasm of the cerebral vessels, is not very uncommon. The physical signs and symptoms present in such patients are varied and interesting. Textbooks and the literature have made mention of such occurrences, but fail to give a vivid picture of the patient during such attacks. These spasms, with their ensuing signs and symptoms, are very characteristic, often brief, at times lasting a day or two, and at times disappearing within a few hours. However, few physicians have been fortunate enough to observe the onset, disappearance and subsequent findings presented by spasm and relaxation of the cerebral vessels. Many even doubt their occurrence, for any and all information obtained is most frequently derived from the description of the attack given by the lay observer. The present case, from the service of Dr. S. P.
S17 A prothrombotic state is associated with increased mortality in idiopathic pulmonary fibrosis: Abstract S17 Table 1.
Authors: V Navaratnam, A Fogarty, T McKeever, N Thompson, RG Jenkins, SR Johnson, G Dolan, M Kumaran, K Pointon, RB Hubbard
Journal: Thorax (2013)

<h3>Background</h3> Our previous case-control study demonstrated that a prothrombotic state was almost five times more common in people with idiopathic pulmonary fibrosis (IPF) than general population controls. We followed up the incident cases of IPF to determine if a prothrombotic state altered prognosis in terms of survival. <h3>Methods</h3> People with IPF were recruited from five teaching and eight district general hospitals in England and Wales. All participants were asked for details of medical history, medication and smoking habit. Venous blood samples were taken to test for inherited and acquired clotting defects. We also collected high resolution computed tomography (HRCT) scans and pulmonary function tests done as part of routine care. All HRCT scans were reviewed by two thoracic radiologists to confirm the diagnosis of IPF. A prothrombotic state was defined as having at least one of the inherited or acquired clotting defects tested. Cox regression modelling was used to investigate the association between a prothrombotic state and survival amongst people with IPF, adjusting for age, sex, highly sensitive C Reactive Protein (hsCRP), smoking habit and baseline pulmonary function indices. <h3>Results</h3> There were 211 incident cases of definite or probable IPF with a median follow up of 2 years (IQR: 1.2 to 2.5). During this time, 86 out of the 211 (40.8%) cases died, which equates to an overall mortality rate of 220.5 per 1000 person years (95% CI: 178.2 to 272.7). 78 out of the 86 deaths (90.7%) were in individuals with a prothrombotic state (see Table 1). The proportion of the IPF cohort surviving at 2 years was 84.7% in patients without any clotting defects and 61.1% in patients with a prothrombotic state (p = 0.0035). <h3>Conclusions</h3> A prothrombotic state is associated with increased mortality amongst people with IPF. Further research into manipulation of the clotting cascade to improve the outlook of people with IPF is warranted.
PTH-161 Outcome of Investigations Performed following a Positive Faecal Calprotectin: a Nine Month Pilot Study from a District General Hospital: Abstract PTH-161 Table 1
Authors: P T Rajasekhar, R Bevan, C Parker, C Rees, S Panter
Journal: Gut (2013)

<h3>Introduction</h3> Faecal calprotectin (FCP) is a neutrophil degradation product used to detect inflammation within the gastrointestinal tract. It can aid differentiation of inflammatory bowel disease (IBD) from functional disorders and in the monitoring of IBD. We evaluated the outcome of investigations performed following a positive FCP at South Tyneside District Hospital. <h3>Methods</h3> All positive FCP results (values &gt; 60microg/g) were identified (1/1/12 and 30/9/12). Endoscopy and radiological results were reviewed in addition to clinic letters to understand clinician interpretation of results when necessary. Patients were categorised by age and FCP result. Outcomes in patients without IBD were categorised as: new IBD, non-specific inflammation/ulceration (NSI), peptic ulcer disease (PUD), cancer, colorectal adenoma (CRA), coeliac disease, other (including irritable bowel syndrome, bile salt malabsorption) or unknown where no additional information was available. <h3>Results</h3> 147 positive (of 391, 37.6%) FCP results were identified. 11 were excluded, as investigations were ongoing. The outcome of investigations per category are summarised in Table 1. <h3>Conclusion</h3> The use of FCP is increasing. In our unit, the majority are used for assessment in patients with known IBD. In patients in whom FCP was used to aid diagnosis, those with a result &lt; 100 had a ‘benign’ diagnosis following investigation in both age categories suggesting a considered approach in this group may be reasonable. <h3>Disclosure of Interest</h3> None Declared.
Psychotherapy in Patients with Poorly Controlled Type 1 (Insulin-Dependent) Diabetes
Authors: Heimo Viinamäki, Leo Niskanen
Journal: Psychotherapy and Psychosomatics (1991)

We studied a group of 9 poorly controlled type 1 diabetic patients who were referred to the metabolic ward for a 10-day intensive patient education and treatment period and followed thereafter for 1 year. The psychodynamically and phase-specifically oriented intensive psychotherapy was prescribed. In terms of mental coping ability assessed by an index constituting the attitude towards diabetes, the family support and the expectations from the psychotherapy, the final outcome was classified as good or moderate in 7 of 9 patients. The complexities of different personality characteristics and their interaction with metabolic control are issues that require further exploration.
How Well Has Canada Contained the Costs of Doctoring?
Authors: John S. Hughes
Journal: JAMA (1991)

Canada's provinces have had varying success at containing the costs of physician services through the use of fee schedules and expenditure targets. This article examines the wide variation in the increases in the costs of physician services among Ontario, Quebec, and British Columbia between 1975 and 1987. Cost increases during that time resulted from various combinations of increases in prices (fees) and utilization, stimulated by an increased supply of physicians. Differences among the three provinces resulted from differences in the aggressiveness of fee schedule controls and whether expenditure targets were imposed. Regardless of the degree of expenditure increases, utilization increased steadily in all three provinces and was associated most consistently with growth in the supply of physicians. This was most dramatically illustrated in Quebec, which noted the most rapid rise in physician-to-population ratio. Cost containment may ultimately require constraints on the number of new physicians in addition to controls on fees and utilization.