tbuckley/cabot-search huggingface dataset:
DSM-III: Problems in Diagnosing Partial Forms of Multiple Personality Disorder: Discussion Paper
Authors: Colin A Ross
Journal: Journal of the Royal Society of Medicine (1985)

Of all the defence mechanisms, only one — Dissociation — is treated as a separate diagnostic category in the third edition of the ‘Diagnostic and Statistical Manual of Mental Disorders’ (DSM-III) (American Psychiatric Association 1980). Delusional marital jealousy, for instance, could be classified as one of the projective disorders, but this is not done. A group of disorders based on dissociation should be easily defined and organized, in comparison with the relatively bewildering array of psychotic disturbances. Yet DSM-III does not provide a conceptually coherent set of dissociative diagnoses. This problem in DSM-III is best illustrated by partial forms of multiple personality disorder (MPD) which at present receive the unsatisfactory diagnosis of atypical dissociative disorder. First, the organization of other sections of DSM-III will be discussed.
Phyllodes Tumors of the Breast: Natural History, Diagnosis, and Treatment
Authors: Melinda L. Telli, Kathleen C. Horst, Alice E. Guardino, Frederick M. Dirbas, Robert W. Carlson
Journal: Journal of the National Comprehensive Cancer Network (2007)

Phyllodes tumors of the breast are unusual fibroepithelial tumors that exhibit a wide range of clinical behavior. These tumors are categorized as benign, borderline, or malignant based on a combination of histologic features. The prognosis of phyllodes tumors is favorable, with local recurrence occurring in approximately 15% of patients overall and distant recurrence in approximately 5% to 10% overall. Wide excision with a greater than 1 cm margin is definitive primary therapy. Adjuvant systemic therapy is of no proven value. Patients with locally recurrent disease should undergo wide excision of the recurrence with or without subsequent radiotherapy.
Time-Series Analyses of Air Pollution and Mortality in the United States: A Subsampling Approach
Authors: Suresh H. Moolgavkar, Roger O. McClellan, Anup Dewanji, Jay Turim, E. Georg Luebeck, Melanie Edwards
Journal: Environmental Health Perspectives (2012)

Hierarchical Bayesian methods have been used in previous papers to estimate national mean effects of air pollutants on daily deaths in time-series analyses.We obtained maximum likelihood estimates of the common national effects of the criteria pollutants on mortality based on time-series data from ≤ 108 metropolitan areas in the United States.We used a subsampling bootstrap procedure to obtain the maximum likelihood estimates and confidence bounds for common national effects of the criteria pollutants, as measured by the percentage increase in daily mortality associated with a unit increase in daily 24-hr mean pollutant concentration on the previous day, while controlling for weather and temporal trends. We considered five pollutants [PM10, ozone (O3), carbon monoxide (CO), nitrogen dioxide (NO2), and sulfur dioxide (SO2)] in single- and multipollutant analyses. Flexible ambient concentration-response models for the pollutant effects were considered as well. We performed limited sensitivity analyses with different degrees of freedom for time trends.In single-pollutant models, we observed significant associations of daily deaths with all pollutants. The O3 coefficient was highly sensitive to the degree of smoothing of time trends. Among the gases, SO2 and NO2 were most strongly associated with mortality. The flexible ambient concentration-response curve for O3 showed evidence of nonlinearity and a threshold at about 30 ppb.Differences between the results of our analyses and those reported from using the Bayesian approach suggest that estimates of the quantitative impact of pollutants depend on the choice of statistical approach, although results are not directly comparable because they are based on different data. In addition, the estimate of the O3-mortality coefficient depends on the amount of smoothing of time trends.
Abstract 4416: IKBKE is a key mediator of Ras activation of NF-κB and Ras oncogenic function
Authors: Donghwa Kim, Jianping Guo, Sridevi Challa, Domenico Coppola, Jin Q. Cheng
Journal: Cancer Research (2014)

Abstract Accumulating evidence indicates that the NF-κB transcription factor pathway is important for oncogenic RAS to transform cells and to drive tumorigenesis in animal models. IKBKE has been shown to activate NF-κB through both canonical and non-canonical pathways. Here we show that activating mutations of Ras significantly induce IKBKE kinase activity and that depletion of KRas results in decrease of IKBKE activity only in KRAS mutant but wild-type cells. KRas-induced NF-κB DNA-binding and transcription activity was abrogated by knockdown of IKBKE. In addition, we demonstrated significant decrease of lung tumor development in Ikbke-/-;KRasLA1 mice when compared to Ikbke+/-;KRasLA1 and Ikbke+/+;KRasLA1 animals. Furthermore, depletion of IKBKE selectively reduces cell survival and tumor growth in K-Ras mutant non-small cell lung cancer cells. These data identify IKBKE as a downstream effector of Ras which mediates RAS activation of NF-κB and Ras tumorigenic activity. Citation Format: Donghwa Kim, Jianping Guo, Sridevi Challa, Domenico Coppola, Jin Q. Cheng. IKBKE is a key mediator of Ras activation of NF-κB and Ras oncogenic function. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4416. doi:10.1158/1538-7445.AM2014-4416
Standardization of Allergen Extracts with Appropriate Methods
Authors: K. Aas, A. Backman, L. Belin, B. Weeke
Journal: Allergy (1978)

This paper presents recommendations for standardization of allergen extract by the combined use of skin prick tests and radioallergosorbent tests. These tests provide appropriate means for quantitation of the total allergenic activity of an extract. Advantages and limitations are discussed with reference to the literature.
Stopping routine vaccination for tuberculosis in schools
Authors: Paul Fine
Journal: BMJ (2005)

Brings the UK into line with much of the rest of the world 

F rom autumn 2005 the long running routine programme to vaccinate schoolchildren against tuberculosis with BCG vaccine will stop. This follows a decision by the chief medical, nursing, and pharmaceutical officers in July that there should be selective vaccination of high risk infants and other groups rather than routine vaccination of adolescents negative on tuberculin testing.1 This decision comes after several years of discussion within the Joint Committee on Vaccination and Immunisation, and it closes an important chapter in the complex history of BCG vaccination. It comes as notifications of tuberculosis in England and Wales are at their highest level since 1983. The decision is well justified.

This BCG programme has been unique from its start in the mid-1950s, when a Danish vaccine (later produced by Glaxo) was introduced on the basis of efficacy shown in a trial carried out by the UK Medical Research Council.2 The trial had been carried out in approximately 30 000 adolescents for pragmatic reasons—in order to recruit participants who were still tuberculin negative, but who were about to enter a period of high risk …
Sequential Tamoxifen and Aminoglutethimide Versus Tamoxifen Alone in the Adjuvant Treatment of Postmenopausal Breast Cancer Patients: Results of an Italian Cooperative Study
Authors: F. Boccardo, A. Rubagotti, D. Amoroso, M. Mesiti, D. Romeo, C. Caroti, A. Farris, G. Cruciani, E. Villa, G. Schieppati, G. Mustacchi
Journal: Journal of Clinical Oncology (2001)

PURPOSE: To determine whether switching patients from tamoxifen to antiaromatase treatment would prevent some of the relapses or deaths that we assume would occur if tamoxifen were continued. PATIENTS AND METHODS: Three hundred eighty postmenopausal breast cancer patients receiving adjuvant tamoxifen treatment for 3 years were randomized to either continue tamoxifen for 2 more years or to switch to low-dose aminoglutethimide (250 mg daily) for 2 years. RESULTS: At a median follow-up of 61 months (range, 5 to 94 months), 59 events occurred in the tamoxifen group, and 55 occurred in the aminoglutethimide group. More treatment failures at distant sites, such as viscera (P = .02), were observed in the tamoxifen group. Although no differences in disease-free survival between the two groups have emerged so far, a significant trend favors aminoglutethimide in overall survival (P = .005) and breast cancer–specific survival (P = .06). Even if more patients in the antiaromatase group complained of drug-related side effects and more of them discontinued treatment (P = .0001), the number of cardiovascular events and, in general, of life-threatening adverse events was higher in the tamoxifen arm. CONCLUSION: Switching patients from tamoxifen to aminoglutethimide treatment resulted in comparable event-free survival, but longer overall survival was achieved in patients who were switched to aminoglutethimide as compared with those who continued to receive tamoxifen. Should these preliminary results be confirmed by larger studies with a similar design, which are now testing the effectiveness of the new, more active, and tolerable aromatase inhibitors, sequencing tamoxifen with an aromatase inhibitor could become a preferable alternative to tamoxifen alone in early breast cancer patients.
Abstract 13837: Cardiomyocyte Progenitor Cell and Mesenchymal Stem Cell Exosomes Stimulate the Angiogenic Capacity of Endothelial Cells
Authors: Krijn R Vrijsen, Steven A Chamuleau, Pieter A Doevendans, Joost P Sluijter
Journal: Circulation (2011)

Cardiac cell therapy results in increased capillary density, however only a small percentage of cells successfully engraft the myocardium. This suggests that paracrine factors are involved. These paracrine factors can include e.g. soluble proteins, growth factors and exosomes. Exosomes are small membrane vesicles which can facilitate communication between cells. Here, we focused on the effect of cardiomyocytes progenitor cell (CMPC) and mesenchymal stem cell (MSC) exosomes on the angiogenic capacity of endothelial cells (ECs). In addition, we studied the role of extracellular matrix metalloproteinase inducer (EMMPRIN) on exosomes. Exosomes were isolated from conditioned medium (CM) by centrifugation at 100.000xg or separated on a sucrose gradient. These exosomes were used in scratch wound, spheroid, and matrigel assays. In addition, exosomes were or were not treated with an extracellular matrix metalloproteinase inducer antibody. CMPCs and MSCs are able to produce exosomes of approximately 100 nm in size ...
Cancer outcomes at end-of-life in Michigan
Authors: J. W. Finn, P. Nelson, M. Yassine, K. Presby, J. Towns, S. Affholter
Journal: Journal of Clinical Oncology (2006)

8575 Background: End-of-life care (EOLC) is an important focus of comprehensive cancer control, yet little data is formally collected and no central repository exists across all cancer sites. Collaboration by the MI Department of Community Health, the MI Public Health Institute, and the Institute for Public Policy and Social Responsibility (IPPSR) in 2004 produced an end-of-life module, which was added to a caregiver survey designed to track cancer screening already in use: the Michigan Special Cancer Behavioral Risk Factor Survey (MSCBRFS). Methods: A population-based sample of caregivers, age 40 and older, including minorities, were contacted by trained IPPSR staff (bilingual) using computer-assisted telephone interviews. Results: 761 respondents constituted the sample size of caregivers who reported having cared for a family member or friend who died of cancer in the preceding 5 years, including 196 African Americans, 92 American Indians, 51 Hispanic Americans, 49 Arab Americans and 73 Asian Americans. The average pain level in the final 3 months was severe to excruciating for 44.7%. Pain medications had been prescribed for 93.5%; however, not used as directed for 30.3%. The most frequent reason given for this was fear of addiction/side effects (32.7%). The proportion who died at home was 44.3%. In general terms, Caucasians tended to die outside the hospital, whereas African and Asian Americans tended to die in the hospital and Native and Hispanic Americans at home. 68.2% of cancer decedents died with the support of hospice care (no racial variance). The median length of stay on hospice was short, 17.5 days (2003 MHPCO data). The main reason given why hospice was not chosen was that death occured before hospice enrollment (55.2%). Conclusions: Cancer outcomes data at end-of-life is an important part of state-wide comprehensive cancer control. Specific progress markers are presently established for the Michigan Cancer Consortium. Baselines measurements include the prevalence of severe pain in the final 3 months (44.7%), proportion of those who died at home (44.3%), percent of those who used hospice services (68.2%) and median hospice length of stay (17.5 days). These outcome measures will be trended over the next five years for purposes of cancer care quality improvement, public and professional education and system change. No significant financial relationships to disclose.
Association of Model for End-Stage Liver Disease Score and Mortality in Trauma Patients With Chronic Liver Disease
Authors: Allan Peetz, Ali Salim, Reza Askari, Marc A. De Moya, Olubode A. Olufajo, Tracey G. Simon, Fiona K. Gibbons, Kenneth B. Christopher
Journal: JAMA Surgery (2015)

The Model for End-Stage Liver Disease (MELD) score is predictive of trauma outcomes.To determine whether a decrease in MELD score is associated with improved mortality in critically ill trauma patients.We performed a retrospective registry study of critically ill trauma patients 18 years or older with chronic liver disease treated between August 3, 1998, and January 5, 2012, at 2 level I trauma centers in Boston, Massachusetts. The consecutive sample included 525 patients (male, 373 [71.0%]; white, 399 [76.0%]; mean [SD] age, 55.0 [12.4] years).Change in MELD score from intensive care unit (ICU) admission to 48 to 72 hours later.Thirty-day all-cause mortality.The mean (SD) MELD score at ICU admission was 19.3 (9.7). The 30-day mortality was 21.9%. The odds of 30-day mortality with a change in MELD score of less than -2, -2 to -1, +1 to +4, and greater than +4 were 0.23 (95% CI, 0.10-0.51), 0.30 (95% CI, 0.10-0.85), 0.57 (95% CI, 0.27-1.20), and 1.31 (95% CI, 0.58-2.96), respectively, relative to a change in MELD score of 0 and adjusted for age, sex, race, Charlson/Deyo Index, sepsis, number of acute organ failures, International Classification of Diseases, Ninth Revision-based injury severity score, and ICU admission MELD score.A decrease in MELD score within 72 hours of ICU admission is associated with improved mortality.
Value of immunophenotype in intensively treated adult acute lymphoblastic leukemia: cancer and leukemia Group B study 8364.
Authors: Myron S. Czuczman, Richard K. Dodge, Carleton C. Stewart, Stanley R. Frankel, Frederick R. Davey, Bayard L. Powell, Ted P. Szatrowski, Charles A. Schiffer, Richard A. Larson, Clara D. Bloomfield
Journal: Blood (1999)
Does an Increase in the Sensitivity of Serum Thyrotropin Assays Reduce Diagnostic Costs for Thyroid Disease in the Community?
Authors: M P J Vanderpump, R H Neary, K Manning, R N Clayton
Journal: Journal of the Royal Society of Medicine (1997)

Many authorities now advocate that the first-line assessment of thyroid function should be measurement of thyrotropin (TSH). The latest serum TSH assays (third generation) are more sensitive than the second generation but the reagents are more costly. We have examined whether overall assay reagent costs would be higher or lower with a third-generation assay, in a laboratory that serves a population of almost 500,000. In a prospective study over six weeks, 505 samples with a second-generation serum TSH less than 0.5 mU/L (303 for screening and 202 for monitoring thyroxine therapy) had an additional third-generation TSH analysis. With a second-generation assay for screening, 11% more free thyroxine (FT4) measurements were required to exclude thyrotoxicosis but there was a 42% saving on the reagent budget compared with a third-generation assay. In patients taking thyroxine, 33% more FT4 measurements were required to exclude over-replacement but the calculated saving in reagent costs was 53%. The costs of all other aspects of the two methods were similar. In this community-based sample, the improvement in sensitivity yielded by the third-generation assay at the lower end of the normal range reduced the number of confirmatory FT4 levels required to exclude thyrotoxicosis or over-replacement with thyroxine, but reagent costs were nevertheless higher than for second-generation assays. In financial terms, there is little justification for use of assays with sensitivity greater than the second generation (0.1 mU/L).
Spontaneous tearing of a duodenal metallic stent: a rare adverse event
Authors: Takeshi Ogura, Wataru Takagi, Saori Onda, Daisuke Masuda, Toshihisa Takeuchi, Shinya Fukunishi, Kazuhide Higuchi
Journal: Endoscopy (2015)

Duodenal metallic stent placement is one of the options for the palliative treatment of malignant duodenal obstruction [1]. However, this palliative procedure is associated with several adverse events; stent migration, bleeding, and perforation have been reported [2] [3] [4] [5]. If the site of obstruction is in the duodenal bulb, the duodenal stent should be placed from the stomach to the duodenum across the pylorus. At this site, stent injury may be caused by pyloric spasm. Herein, we describe a rare adverse event – duodenal metallic stent tearing due to pyloric spasm – and our successful re-intervention.
Interstitial Chemotherapy with Drug Impregnated Polymer Implants to Treat Brain Tumors: Pre-Clinical and Clinical Studies
Authors: Alessandro Olivi, Abraham Domb, Doris Lenartz, Rafael Tamargo, Henry Brem
Journal: Neuro-Oncology (1991)

In order to maximize the delivery of chemotherapeutic agents to brain tumors, while minimizing the systemic toxicity, we have developed a new local sustained-release system consisting of biocompatible polymers impregnated with anticancer drugs. These polymers are surgically implanted into the tumor site. Two biodegradable polymers have been studied in our laboratory: the polyanhydride PCPP:SA (polycarboxyphenoxy propane and sebacic acid) and the polyanhydride P(FAD):SA (poly fatty acid dimer and sebacic acid). Biocompatibility studies of the brain have shown that these materials do not cause systemic or local toxicity. The local inflammatory response to the polymer is comparable to standard neurosurgical implants currently in use. The efficacy of the local sustained release of two classes of agents (nitrosoureas and platinum based drugs) from these polymers has been tested in vivo against experimental brain tumors with encouraging results. A phase I-II clinical study with PCPP:SA-BCNU polymers for the treatment of recurrent gliomas has been completed and no adverse reaction of this form of treatment has been observed. A Phase III randomized, placebo-controlled study is underway.
Contrasting cardiopulmonary responses to incremental exercise in patients with schistosomiasis-associated and idiopathic pulmonary arterial hypertension with similar resting hemodynamic impairment
Authors: Fabricio Valois, Roberta Ramos, Eloara Ferreira, Jaquelina Arakaki, José Alberto Neder, Luiz Eduardo Nery
Journal: European Respiratory Journal (2011)

Schistosomiasis is the most common cause of pulmonary arterial hypertension (PAH) worldwide. It has been reported that schistosomiasis-associated PAH (Sch-PAH) has better hemodynamic profile at diagnosis and a more benign clinical course as compared with idiophatic PAH (IPAH) [Fernandes, C.J.C.S. et al. JACC 2010; 59:715-20]. We hypothesized that Sch-PAH subjects have better physiological responses to incremental cardiopulmonary exercise test (CPET) than IPAH patients, even at similar resting pulmonary hemodynamic impairment. We performed CPET and hemodynamic study in 8 Sch-PAH and 9 IPAH patients. None of them had received any PAH therapy. There were no significant between-group differences on cardiac index (2.1±0.3 vs 2.4±0.7 L/min, p=0.21), pulmonary vascular resistance (p=0.32) and mean pulmonary artery pressure (p=0.48). However, the peak oxygen uptake (V'O2) was greater in Sch-PAH (75±21 vs 54±16%pred, p=0.016), as well as the ratio of increases of V'O2 to work rate (8.2±1.1 vs 6.8±1.8 mL/min/W, p=0.024). Also, the slope of the ventilatory response as a function of CO2 output was lower in Sch-PAH (41±4 vs 59±18 L2/min2, p= 0.04), with a shallower heart rate response for a given change in V'O2 (80±21 vs 123±39 beats.ml/min2, p=0.02), and a greater peak oxygen pulse (p<0.05). In conclusion, Sch-PAH patients had better physiological responses to exercise than IPAH subjects at similar resting hemodynamic profile. Our data suggest a more preserved hemodynamic response to exercise in Sch-PAH, that might explain its better clinical course as compared with IPAH.
Incidentally Discovered Intraperitoneal Masses
Authors: Mersadies Martin, Hiromichi Ito
Journal: JAMA Surgery (2015)

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Allan St John Dixon
Authors: Anthony Clarke
Journal: BMJ (2015)

In his time as a consultant in Bath from 1966 to 1986, Allan St John Dixon, one of the major figures in British rheumatology, helped raise the reputation of the Royal National Hospital for Rheumatic Diseases to that of one of the premier rheumatology centres in the world, with an outstanding research programme and a reputation for postgraduate training that attracted young doctors, nurses, and therapists from around the globe. These activities were based on the excellent clinical care that drew patients from all over Britain and abroad.

Dixon was born in east London, within the sound of Bow Bells, to Percival Dixon, a mining engineer, and Florence, who was a member of the Devonian Lidstone family, who were prominent in the humanism movement. It was from this branch of the family that he developed two important interests of his life: humanism and carpentry.

He went to Bedales School on a violin scholarship and then to the Regent Street Polytechnic to study physics and organic chemistry. He then moved to Chelsea Polytechnic before attending Guy’s Hospital, where he …