tbuckley/cabot-search huggingface dataset:
P4-07-01: Circulating Tumor Cells, Disease Recurrence and Survival in Newly Diagnosed Breast Cancer.
Authors: B Franken, Groot MR de, LWMM Terstappen, WJB Mastboom, der Palen J Van, AGJ Tibbe
Journal: Cancer Research (2011)

Abstract Background: The presence of circulating tumor cells (CTC) is an independent prognostic factor for progression-free survival and overall survival (OS) for patients with metastatic breast cancer beginning a new line of systemic therapy. The current study was undertaken to explore whether the presence of CTC at the time of diagnosis was associated with recurrence free survival (RFS) and breast cancer related death. Materials and Methods: In a prospective single center study, CTC were enumerated with the CellSearch system in 4 aliquots of 7.5 ml of peripheral blood of 504 patients before undergoing surgery for breast cancer between September 2003 and January 2009. Four hundred four had stage I-III disease and were followed for 6–90 months (median 48). One hundred had a benign tumor and served as a control group. Results: In the control group 15 (15%) had ≥1 CTC / 30 mL of blood. In stage I-III patients 76 (19%) had ≥1 CTC in 30 mL of blood of whom 16 (21.1%) developed a recurrence. In 328 patients with 0 CTC 38 (11.6%) developed a recurrence. Four year RFS was 88.4% for favorable CTC and 78.9% for unfavorable CTC (p =0.038). Breast cancer related death was 4,3% (14 of 328 patients) for favorable and 14,5% (11 of 76 patients) for unfavorable CTC (p = 0.001). CTC, PR receptor and stage were independent predictors of breast cancer related death in multivariate analysis. The corrected odds ratio after multivariate analysis for breast cancer related death in patiënts with CTC versus patiënts without CTC was 3,47. Discussion: Presence of CTC in breast cancer patients before undergoing surgery with curative intent is associated with an increased risk for recurrence and breast cancer related death. This supports the notion that the presence of CTC is also important in the primary disease setting. In this study the sensitivity of the CellSearch assay was increased by a fourfold increase in blood volume and a threshold for unfavorable of ≥1 CTC in 30 mL of blood, which lead to a relatively high background in the control group. Thus an increase in specificity is desired before initiation of prospective multicenter trials as well as a more practical way to process larger blood volumes. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-07-01.
Colonic hydrogen absorption: quantification of its effect on hydrogen accumulation caused by bacterial fermentation of carbohydrates.
Authors: H F Hammer
Journal: Gut (1993)

The aim of the study was to assess (quantitatively) colonic hydrogen absorption. Hydrogen volumes in flatus and breath were measured over periods of six hours in normal subjects during fasting and after ingestion of the non-absorbable carbohydrate lactulose to simulate the effect of fermentable dietary fibres. If less than 76 ml/6 h of hydrogen accumulated in the colon then all of it was absorbed, as suggested by the intercept of the regression line of the correlation between hydrogen volumes in flatus and breath after ingestion of lactulose. As total flatus volume increased, efficiency of colonic hydrogen absorption decreased from 90% to 20%. The positive correlation between hydrogen volumes of flatus and breath showed that the eightfold interindividual differences in flatus volume after ingestion of 12.5 g of lactulose were caused by differences in bacterial net gas production, not gas absorption. Differences in colonic gas emptying rate are the consequence rather than the cause of interindividual differences in flatus volume. In conclusion: (1) colonic hydrogen absorption is highly effective at low colonic hydrogen accumulation rates, but not at higher accumulation rates; (2) ineffective colonic gas absorption is the consequence and not the cause of high colonic gas accumulation rate after ingestion of non-absorbable carbohydrates; and (3) future therapeutic approaches to the large interindividual variability in colonic gas accumulation after ingestion of poorly absorbable fermentable carbohydrates, such as some kinds of dietary fibres, should be directed towards altering colonic bacterial metabolism.
Prospective Evaluation of HDL Cholesterol Changes After Diet and Physical Conditioning Programs for Patients with Type II Diabetes Mellitus
Authors: Robert M Kaplan, Dawn K Wilson, Sherry L Hartwell, Katherine L Merino, Janet P Wallace
Journal: Diabetes Care (1985)

High-density lipoprotein (HDL) cholesterol is known to be low in patients with diabetes mellitus. Low HDL levels are correlated with premature cardiovascular mortality in several major epidemiologic studies and many investigators believe increases in HDL cholesterol may reduce the risk of coronary heart disease. We evaluated dietary and exercise interventions in relation to HDL cholesterol in patients with type II diabetes mellitus. Sixty-five volunteers were randomly assigned to one of four experimental conditions: diet, exercise, diet plus exercise, or education control. Three months after entering the program, those exposed to the dietary intervention had significant increases in HDL cholesterol. HDL increases for the other two treatment groups did not differ significantly from the education control.
Eastern Equine Encephalomyelitis in Massachusetts
Authors: Henry de F. Webster
Journal: New England Journal of Medicine (1956)

VITRAL diseases of the nervous system, except mumps, poliomyelitis and herpes zoster, are extraordinarily rare in New England. Although patients on the wards of general hospitals are frequently suspected of having viral meningitis or encephalitis, such diagnoses are seldom confirmed by appropriate laboratory tests or post-mortem examination.During the summer of 1955, at the peak of the poliomyelitis epidemic, 2 cases with a clinical picture consistent with a viral meningoencephalitis were observed on the Neurology Service of the Massachusetts General Hospital. They differed from the usual cases of poliomyelitis and were suspected of being some other type of neurotropic viral . . .
Reply to Christopher Chee Kong Ho, Siew Eng Ho, Srijit Das’ Letter to the Editor re: Giorgio Gandaglia, Alberto Briganti, Graham Jackson, et al. A Systematic Review of the Association Between Erectile Dysfunction and Cardiovascular Disease. Eur Urol 2014;65:968–78
Authors: Giorgio Gandaglia, Alberto Briganti, Francesco Montorsi, Charalambos Vlachopoulos
Journal: European Urology (2014)
Rapid Method for Tzanck Preparations
Authors: Ronald J. Barr
Journal: JAMA (1977)

Use of the Paragon Multiple Stain for Frozen Sections (PMS) for Tzanck preparations of herpetic lesions has several distinct advantages over procedures previously described; the method is rapid, simple, inexpensive, and results in hematoxylin-eosin-like staining. This enables a diagnosis to be made from a single, affected cell.
Best books on neurology: a personal choice
Authors: J Greene
Journal: BMJ (1994)

Neurology still tends to be perceived as difficult and esoteric by students and clinicians alike, which perhaps partly explains the plethora of books available. This is unfortunate as it is one of the most logical specialities in terms of reaching a diagnosis. In perhaps no other specialty is a knowledge of the basic anatomy and physiology such a prerequisite for the beginner.

Books for the undergraduate

Essential Neurology. 2nd edn. I M S Wilkinson. (pounds sterling 15.95.) Blackwell Scientific, 1993. ISBN 0-632-03516-1.

\***|Neurological Differential Diagnosis. 2nd edn. J Patten. (pounds sterling 40.) Springer-Verlag, 1988. ISBN 0-287-66988-2.

**Essentials of Neurology. 6th edn. John Walton. (pounds sterling 19.50.) Churchill Livingstone, 1989. ISBN 0-443-03986-0.

**Neurology and Neurosurgery Illustrated. 2nd edn. K W Lindsay, I Bone, R Callander. (pounds sterling 26.50.) Churchill Livingstone, 1986. ISBN 0-443-04345-0.

**Aids to the Examination of the Peripheral Nervous System. 3rd edn. Ed M D O'Brien. (pounds sterling 6.50.) Bailliere-Tindall, 1986. ISBN 0-7020-1165-7.

Praise of a colleague's book might be looked on with some suspicion, but we have to confess that Wilkinson's book is in fact the best undergraduate text available. Its structure leads to a clearheaded approach to the subject. It has been pared to the essentials and is a model of lucidity. It expounds perfectly the two stage method of diagnosis: firstly, where is the lesion and, secondly, what …
A PRELIMINARY STUDY OF POSTSHOCK AMNESIA BY AMYTAL INTERVIEW
Authors: SAMUEL BOGOCH
Journal: American Journal of Psychiatry (1954)

1. A preliminary study of 21 patients suffering postshock amnesia is reported. 2. In 17 patients, much of the amnesia was relieved during interview with sodium amytal. The 4 patients showing no improvement in recall were still acutely psychotic at the time of interview. 3. A reappraisal of the postshock amnestic syndrome is suggested, and a simple technique is described for its study. 4. Possibilities for the therapeutic use of the improvement in recall are discussed.
Regulation of α-Fetoprotein by Nuclear Factor-κB Protects Hepatocytes from Tumor Necrosis Factor-α Cytotoxicity during Fetal Liver Development and Hepatic Oncogenesis
Authors: Lakita G. Cavin, Manickam Venkatraman, Valentina M. Factor, Swayamjot Kaur, Insa Schroeder, Frank Mercurio, Amer A. Beg, Snorri S. Thorgeirsson, Marcello Arsura
Journal: Cancer Research (2004)

Abstract Nuclear factor-κB (NF-κB) plays a critical role during fetal liver development and hepatic oncogenesis. Here, we have assessed whether NF-κB activity is required for murine hepatocellular carcinoma cell survival. We show that adenoviral-mediated inhibition of inhibitor of NF-κB kinase-β (IKK-2) activity in hepatocellular carcinomas derived from transforming growth factor (TGF)-α/c-myc bitransgenic mice leads to inhibition of NF-κB and promotes tumor necrosis factor (TNF)-α–mediated cell death of malignant hepatocytes but not the surrounding peritumorous tissue. Induction of apoptosis is accompanied by inhibition of Bcl-XL and XIAP, two pro-survival NF-κB target genes. In addition, we have identified the α-fetoprotein (AFP) as a novel downstream target of NF-κB. We show that repression of IKK-2 activity in hepatocellular carcinomas promotes down-regulation of AFP gene expression. Likewise, genetic disruption of the RelA subunit results in reduced AFP gene expression during embryonic liver development, at a time in which fetal hepatocytes are sensitized to TNF-α–mediated cell killing. In this regard, we show that AFP inhibits TNF-α–induced cell death of murine hepatocellular carcinomas through association with TNF-α and inhibition of TNFRI signaling. Thus, NF-κB-mediated regulation of AFP gene expression during liver tumor formation and embryonic development of the liver constitutes a potential novel mechanism used by malignant and fetal hepatocytes to evade immune surveillance.
Exclusive Lymphatic Drainage from a Melanoma on the Back to Intraabdominal Lymph Nodes
Authors: ROGER F. UREN, ROBERT HOWMAN-GILES, JOHN F. THOMPSON, WILLIAM H. MCCARTHY
Journal: Clinical Nuclear Medicine (1998)

Preoperative lymphoscintigraphy with Tc-99m antimony sulphide colloid was performed for a patient with a cutaneous melanoma on the left back. There was direct lymphatic drainage to retroperitoneal and paravertebral nodes but no drainage whatsoever to the axillary, inguinal, or triangular intermuscular space node fields, which would normally be expected to drain this area of the skin. Any attempt at sentinel lymph node biopsy in the axilla, groin, or triangular intermuscular space would have failed in this patient.
Oral contraceptives and benign liver tumours.
Authors: M P Vessey, C R Kay, J A Baldwin, J A Clarke, I B Macleod
Journal: BMJ (1977)

An oral contraceptive study by the Royal College of General Practitioners recorded 216000 woman-years of observation.  116000 of these were related to takers or ex-takers of oral contraceptives.  No case of liver tumor was found in women of childbearing age.  The Oxford Family Planning Association follow-up study of women using different methods of contraception recorded 83000 woman-years of observation of which 40% related to oral contraceptive users.  No case of liver tumor was identified.  The Oxford Linkage study for the years 1970-1975 found no benign liver tumors in women of childbearing age in a population of over a million.  The Scottish National Diagnostic Index for the years 1968-1974 recorded no liver tumors in women of childbearing age.  However 1 consultant recalled seeing 1 such case which had been improperly recorded as a hematoma.  Thus the authors have identified only 1 case of benign liver tumor in a woman of childbearing age.  Therefore benign tumors of the liver are considered to be rare in both users and nonusers of oral contraceptives.  Some reports have indicated that the risk of such tumors has increased with the duration of use of oral contraceptives.
Duty to refer to larger hospital
Authors: A. R. Holder
Journal: JAMA (1973)

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Detection and Treatment of Ductal Carcinoma In Situ of the Breast
Authors: Daniel B. Kopans
Journal: JAMA (1996)

To the Editor.  —The article by Dr Ernster and colleagues 1 raises important questions concerning the diagnosis and treatment of a group of lesions that have been characterized as ductal carcinoma in situ (DCIS). Unfortunately, some of the statements contained in the article could be misconstrued and were misrepresented by the media. The unjustified suggestion that mammography is the cause of the disfiguring surgery that results from the diagnosis of DCIS distracted from the clear need to develop a much greater understanding of the significance of DCIS.  Mammographic screening is the only method that has been proved to reduce mortality from breast cancer. It is unfortunate the article by Ernster et al could be interpreted as discouraging the use of this screening. I'm sure the authors would agree that the harm of the anxiety that may be caused by an abnormal mammogram report or even a breast biopsy is not
Mental health services in England fail to meet children's needs, commissioner says
Authors: H. Adcock
Journal: BMJ (2008)

Around one in 10 trusts providing mental health services in England are failing to follow recommendations designed to meet children’s and young people’s needs and keep them safe, warns a report. It found that many children were still being treated on adult psychiatric wards despite a government commitment to end this practice by April 2010. 

To accurately assess the situation, Al Aynsley-Green for the first time used powers granted to him as children’s commissioner to force primary care trusts and mental health trusts to disclose how young people are being cared for. He asked trusts to report their progress in …
Paromomycin and neomycin B derived cationic lipids: Synthesis and transfection studies
Authors: Mathieu Mével, Matthieu Sainlos, Benoît Chatin, Noufissa Oudrhiri, Michèle Hauchecorne, Olivier Lambert, Jean-Pierre Vigneron, Pierre Lehn, Bruno Pitard, Jean-Marie Lehn
Journal: Journal of Controlled Release (2011)
Publishers' copyright policy
Authors: J. Dobbing
Journal: BMJ (1995)

EDITOR,—In my retirement I have completed a bibliography of research on infant feeding for distribution to doctors and others professionally interested in the subject. The bibliography is on a floppy disk and contains about 3200 references, with their published abstracts in most cases, together with built in software for making computer searches and for adding users' own references. My intention is that it should be distributed at nominal charge to cover postage and packing etc, especially to colleagues out of reach of library services, including those working in underprivileged communities around the world. I have a commercial sponsor, which has defrayed most of the expense, but neither the sponsor nor I will make any money …
Coronary Arteriographic Appearances in Patients with Left Bundle-Branch Block
Authors: C. MICHAEL LEWIS, GILLES R. DAGENAIS, GOTTLIEB C. FRIESINGER, RICHARD S. ROSS
Journal: Circulation (1970)

Left bundle-branch block (LBBB) was found to be associated with an unusually short left main coronary artery in 11 of 12 patients studied by selective coronary arteriography. The average length of the left coronary artery in this group of 12 patients with LBBB was 4.5 ± 1.7 mm as compared to 12.8 ± 0.8 mm in a control group. Four of the 12 had evidence of ischemic heart disease, one had mild aortic regurgitation, one had myocardiopathy, and one had a patent ductus arteriosus. No etiology was discovered for the LBBB in the remaining five patients. Mechanical and hemodynamic explanations for this association of a particular pattern of coronary anatomy with LBBB are proposed.
More Problems than just Fits
Authors: J. Bowe
Journal: BMJ (1972)

This short book provides a good survey of the present position in regard to the principal forms of total replacement hip arthroplasty, a development in which British orthopaedic surgeons have been pre-eminent.There can be no doubt that this method of managing the cruel affliction of hip arthritis will be of great importance for many years.It has proved clinically successful beyond any reasonable expectation, and even if break-
Effects of Gap Geometry on Conduction Through Discontinuous Radiofrequency Lesions
Authors: Francisco J. Pérez, Mark A. Wood, Christine M. Schubert
Journal: Circulation (2006)

Gaps of sufficient cross-sectional dimensions within linear radiofrequency (RF) lesions may allow conduction through the lesion. The purpose of this study was to examine the effects of different gap geometries on conduction through discontinuous RF lesions.Radiofrequency lesions were created in isolated, perfused rabbit right ventricular (RV) free wall preparations to produce gaps with 3 different lesion geometries: straight, bifurcated, and angled (n=10 each group). Angled preparations contained 2 right angles within the conduction path. Optical mapping was used to assess bidirectional conduction through the myocardium before and after gap formation during pacing at 1000-, 400-, and 200-ms cycle lengths. Histological analysis was performed on each preparation after optical mapping. After lesion formation, 9 of 10 straight gap preparations and 1 of 10 angled gap preparations demonstrated bidirectional conduction (P<0.001) at all cycle lengths. Nine of 10 bifurcated gap preparations demonstrated bidirectional conduction and 1 demonstrated unidirectional conduction at all cycle lengths. Two bifurcated gap preparations showed rate-dependent unidirectional 2:1 conduction. All unidirectional and rate-dependent block occurred during impulse propagation in the direction of diverging arms of the bifurcation. The occurrence of bidirectional conduction in the gaps was associated with the gap geometry (P<0.0001). Histological analysis confirmed the continuity of viable myocardium transmurally throughout the length of the gap in each preparation. The sites of conduction block were demonstrated to be just after the first angle in the conduction path for angled gaps and at the branch point of a bifurcated gap. The predominant myofiber orientation was changed relative to the conduction path at angulations of the gaps. Flecainide (0.1 micromol/L) produced bidirectional conduction block in straight and bifurcated gap preparations with bidirectional conduction at baseline.Conduction through discontinuities in RF lesions is associated with gap geometry. Complex gap geometry may allow for unidirectional and/or rate-dependent block. Gaps within RF lesions are susceptible to pharmacological blockade.
Platelet Reactivity and Cardiovascular Outcomes After Percutaneous Coronary Intervention
Authors: Matthew J. Price, Dominick J. Angiolillo, Paul S. Teirstein, Elizabeth Lillie, Steven V. Manoukian, Peter B. Berger, Jean-François Tanguay, Christopher P. Cannon, Eric J. Topol
Journal: Circulation (2011)

In the Gauging Responsiveness With A VerifyNow P2Y12 Assay: Impact on Thrombosis and Safety (GRAVITAS) trial, 6 months of high-dose clopidogrel did not reduce cardiovascular events compared with standard-dose clopidogrel in patients with high on-treatment platelet reactivity (OTR) after percutaneous coronary intervention, defined as OTR ≥230 P2Y12 reaction units according to the VerifyNow P2Y12 platelet function test. The aim of this analysis was to examine the relationship between outcomes and OTR over the course of the trial.OTR was measured at 12 to 24 hours and 30±7 days after percutaneous coronary intervention. Cox proportional hazards models with OTR as a time-varying covariate were used to determine the association between OTR and the primary end point of cardiovascular death, myocardial infarction, and stent thrombosis. Of the 2800 enrolled patients, 2796 (99.98%) had evaluable platelet function data. OTR <208 P2Y12 reaction units was significantly associated with a lower risk of the primary end point at 60 days (hazard ratio, 0.18; 95% confidence interval, 0.04 to 0.79; P=0.02) and at 6 months (hazard ratio, 0.43; 95% confidence interval, 0.23 to 0.82; P=0.01). After adjustment for other significant predictors of outcome, OTR <208 P2Y12 reaction units remained independently associated with the primary end point at 60 days (hazard ratio, 0.23; 95% confidence interval, 0.05 to 0.98; P=0.047) and tended to be associated at 6 months (adjusted hazard ratio, 0.54; 95% confidence interval, 0.28 to 1.04; P=0.065).In the GRAVITAS trial, achievement of on-clopidogrel reactivity <208 P2Y12 reaction units at 12 to 24 hours after percutaneous coronary intervention or during follow-up was associated with a lower risk for cardiovascular events. The efficacy of an individualized strategy to target a level of OTR below this threshold merits investigation. Clinical Trial Registration- http://www.clinicaltrials.gov. Unique identifier: NCT00645918.