tbuckley/cabot-search huggingface dataset:
Screening men for abdominal aortic aneurysm: 10 year mortality and cost effectiveness results from the randomised Multicentre Aneurysm Screening Study
Authors: S G Thompson, H A Ashton, L Gao, R A P Scott
Journal: BMJ (2009)

To assess whether the mortality benefit from screening men aged 65-74 for abdominal aortic aneurysm decreases over time, and to estimate the long term cost effectiveness of screening.Randomised trial with 10 years of follow-up.Four centres in the UK. Screening and surveillance was delivered mainly in primary care settings, with follow-up and surgery offered in hospitals.Population based sample of 67 770 men aged 65-74.Participants were individually allocated to invitation to ultrasound screening (invited group) or to a control group not offered screening. Patients with an abdominal aortic aneurysm detected at screening underwent surveillance and were offered surgery if they met predefined criteria.Mortality and costs related to abdominal aortic aneurysm, and cost per life year gained.Over 10 years 155 deaths related to abdominal aortic aneurysm (absolute risk 0.46%) occurred in the invited group and 296 (0.87%) in the control group (relative risk reduction 48%, 95% confidence interval 37% to 57%). The degree of benefit seen in earlier years of follow-up was maintained in later years. Based on the 10 year trial data, the incremental cost per man invited to screening was pound100 (95% confidence interval pound82 to pound118), leading to an incremental cost effectiveness ratio of pound7600 ( pound5100 to pound13,000) per life year gained. However, the incidence of ruptured abdominal aortic aneurysms in those originally screened as normal increased noticeably after eight years.The mortality benefit of screening men aged 65-74 for abdominal aortic aneurysm is maintained up to 10 years and cost effectiveness becomes more favourable over time. To maximise the benefit from a screening programme, emphasis should be placed on achieving a high initial rate of attendance and good adherence to clinical follow-up, preventing delays in undertaking surgery, and maintaining a low operative mortality after elective surgery. On the basis of current evidence, rescreening of those originally screened as normal is not justified. Trial registration Current Controlled Trials ISRCTN37381646.
TCT-727 First Report of Two-Year Outcomes With the Repositionable Lotus Aortic Valve Replacement System: Results From the REPRISE I Feasibility Study
Authors: Ian T. Meredith, Stephen G. Worthley, Robert J. Whitbourn, Paul Antonis, Joseph Montarello, Andrew E. Newcomb, Paul Underwood, Keith D. Dawkins
Journal: Journal of the American College of Cardiology (2014)
Is normobaric simulation of hypobaric hypoxia accurate in chronic airflow limitation?
Authors: M T Naughton, P D Rochford, J J Pretto, R J Pierce, N F Cain, L B Irving
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Hypobaric hypoxemia is experienced by passengers during commercial aircraft flight. In order to assess the extent of hypoxemia and to test whether hypobaric hypoxia can be accurately estimated at sea level, the results of the normobaric hypoxia altitude simulation test (N-HAST) were compared with those of the hypobaric hypoxia altitude simulation test (H-HAST) in six normal control subjects and nine patients with chronic airflow limitation (CAL) at simulated cabin altitudes of 6,000 ft (1,829 m) and both at rest and during exercise at 8,000 ft (2,438 m). Serial arterial blood samples were drawn during the breathing of 15.1 and 16.3% inspired oxygen at sea level (N-HAST) at rest and during light exercise, and during the breathing of room air at simulated cabin altitudes (H-HAST) of 609 mm Hg (6,000 ft) and 565 mm Hg (8,000 ft) at rest and during light exercise. As measured with the H-HAST technique, the mean (+/- SD) PaO2 of the normal group fell from 96.2 +/- 6.2 mm Hg (sea level) to 70.1 +/- 6.0 mm Hg (6,000 ft), and to 61.7 +/- 1.6 mm Hg (8,000 ft at rest) and 54.8 +/- 7.1 mm Hg (8,000 ft during exercise) (p < 0.005 by analysis of variance [ANOVA]). In the CAL group, the mean (+/- SD) PaO2 fell from 75.8 +/- 8.2 mm Hg (sea level) to 57.0 +/- 6.3 mm Hg (6,000 ft), and 49.5 +/- 6.1 mm Hg (8,000 ft at rest), and 38.6 +/- 7.5 mm Hg (8,000 ft during exercise) (p < 0.005 by ANOVA).(ABSTRACT TRUNCATED AT 250 WORDS)
Functional Status and Quality of Life After Transcatheter Aortic Valve Replacement
Authors: Caroline A. Kim, Suraj P. Rasania, Jonathan Afilalo, Jeffrey J. Popma, Lewis A. Lipsitz, Dae Hyun Kim
Journal: Annals of Internal Medicine (2014)

This article has been corrected. The original version (PDF) is appended to this article as a Supplement. Background: The functional and quality-of-life benefits of transcatheter aortic valve replacement (TAVR) have not been established. Purpose: To evaluate the changes in functional status and quality of life after TAVR. Data Sources: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials from 1 January 2002 to 30 September 2013. Study Selection: Studies of TAVR that reported the New York Heart Association (NYHA) class, Short Form-12/36 Health Survey physical and mental component summary (points), or other measures of functional status. Data Extraction: Two reviewers independently extracted the mean change (follow-up minus baseline) in primary outcomes. Because of substantial heterogeneity, data were not pooled; the range of mean change was summarized. Data Synthesis: We identified 60 observational studies (56 pre–post comparison and 4 head-to-head comparative studies) and 2 randomized, controlled trials (11 205 patients). Most studies showed a clinically important decrease in NYHA class at 6 to 11 months (range, −0.8 to −2.1 classes) and 12 to 23 months (range, −0.8 to −2.1 classes). The improvement in the Short Form-12/36 Health Survey physical component score was clinically important over 12 months (range, 4.9 to 26.9 points), and the change in mental component score was smaller (range, 1.0 to 8.9 points). Clinically important improvements were seen in other disease-specific measures but were less consistently seen in general health measures. Limitations: Comparative evidence is limited by few head-to-head studies. Survivor bias may have overestimated the benefits. Conclusion: Transcatheter aortic valve replacement provides clinically important benefits in physical function and disease-specific measures of quality of life but modest benefits in psychological and general health measures. More comparative studies on functional status and quality of life are needed for informed treatment decision making. Primary Funding Source: Health Resources and Services Administration and Health Resources in Action.
Consultants must not be compulsorily resident
Authors: D. Carnall, L. Beecham, a. J. Smith
Journal: BMJ (1995)

The conference agreed overwhelmingly that consultants should never be compulsorily resident on call, but it backed away from agreeing that limits should be set on the total number of hours that they could work.

Dr Bob Buckland, a consultant anaesthetist in Winchester, argued that trainees' problems should not be passed on to consultants, though trusts were increasingly using this option as a short term solution when juniors were on holiday or sick leave. He called on the conference to produce guidance for consultants' …
Medical emergencies in conflict areas are too often ignored, says aid agency
Authors: Sally Hargreaves
Journal: BMJ (2007)

The impact of tuberculosis and the devastation caused by wars in the Central African Republic and Chechnya are among the top 10 most under-reported medical emergencies of 2006, as rated in a list released online this week by the international aid charity Medecins Sans Frontieres (MSF). 

“The violence and suffering that MSF medical staff witness is too often seen as a norm that does not merit media attention,” said Jean-Michel Piedagnel, executive director of MSF UK, London. He added, “Yet the media is crucial in bringing humanitarian issues into the public consciousness and is often a precondition for increased …
Abstract 3: HER2 gene-amplified human breast cancer cells harboring a gatekeeper T768M mutation in HER2 overexpress EGFR ligands and are sensitive to dual therapeutic blockade of EGFR and HER2
Authors: Ritwik Ghosh, Archana Narasanna, Anindita Chakrabarty, Jeffrey A. Engelman, Carlos L. Arteaga
Journal: Cancer Research (2012)

Abstract Intrinsic or acquired mutations in receptor tyrosine kinases (RTKs) can confer resistance to RTK-targeted therapies. A previous study reported that a ‘gatekeeper’ T768M mutation in HER2 confers resistance to the tyrosine kinase inhibitor (TKI) lapatinib. We generated BT474 cells stably expressing either T768M HER2 or GFP. Treatment with lapatinib disrupted HER3-p85 complex and blocked phosphorylation of HER2, HER3, AKT and Erk1/2 in BT474-GFP but not in BT474-T768M cells. BT474-T768M cells were also resistant to other anti-HER2 therapies such as trastuzumab. BT474-T768M cells were sensitive to the PI3K inhibitor BKM120 but not the MEK inhibitor CI1040, suggesting they still depend on the PI3K pathway for survival. Treatment with the irreversible HER2/EGFR inhibitor BIBW2992 (afatinib) eliminated P-HER2 and inhibited growth of cells expressing the mutant, suggesting they still depend on the ErbB receptor network to activate PI3K. Indeed, like in BT474-GFP (control) cells, BIBW2992 disrupted the association of p85 (PI3K) with HER3 and blocked phosphorylation of AKT. A co-culture experiment with varying proportions of BT474-GFP and BT474-T768M cells revealed that lapatinib-resistant acini emerge when as low as 5% of the population has T768M HER2. Moreover, we found that only 3.2% of the HER2 alleles had the T768M mutation in the BT474-T768M cells. This result suggests that allelic dilution will render it difficult to identify this drug resistant mutation with conventional sequencing techniques (i.e., Sanger) in patients with HER2 gene-amplified breast cancer. Next, we stably expressed either wild-type or T768M HER2 in MCF10A cells. Both WT and T768M HER2 resulted in increased phosphorylation of HER3 and AKT. MCF10A-HER2 but not MCF10A-T768M cells were sensitive to growth inhibition by lapatinib. Lapatinib blocked HER2, HER3 and tyrosine phoshorylation in MCF10A-HER2 but not in MCF10A-T768M cells. Quantitative PCR indicated that the BT474-T768M cells produce more EGFR ligands (EGF, TGFα, amphiregulin and HB-EGF) compared to BT474-GFP cells. Treatment with cetuximab, an EGFR antibody that blocks ligand binding, restored sensitivity of BT474-T768M cells to trastuzumab. Further, the BT474-T768M cells were sensitive to a combination of trastuzumab and lapatinib both in vitro and in vivo. Hence, dual blockade of HER2 and EGFR might be effective at trumping the development of HER2-overexpressing cancers bearing a gatekeeper mutation in T768M. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3. doi:1538-7445.AM2012-3
Growth and Development in Children with Sickle-Cell Trait
Authors: Michael S. Kramer, Yolanda Rooks, Howard A. Pearson
Journal: New England Journal of Medicine (1978)

To ascertain if sickle-cell trait (Hb AS) impairs physical growth and cognitive development, we prospectively investigated 50 matched pairs of black children. For each child with Hb AS, an Hb AA child was matched at birth for sex, birth date, birth weight, gestational age, five-minute Apgar score and socio-economic status. Between the ages of three and five years, the members of each matched pair were evaluated, within one month of one another, by persons "blind" to the hemoglobin genotype. Twelve outcome measurements were obtained at evaluation: height, weight, head circumference, skinfold thickness, cross-sectional area of arm muscle, bone age, five scores of the McCarthy Scales of Children's Abilities, and the Peabody Picture Vocabulary Test. There were no statistically significant differences in these measurements favoring the AA group. The results show that children with sickle-cell trait in this age group have no deficits in standard measurements of growth and development and emphasize the importance of rigorous methods when clinical groups are assembled and compared. (N Engl J Med 299:686–689, 1978)
Waiting with time
Authors: G. McLeay
Journal: BMJ (2000)

Waiting lists. Waiting rooms. Sorry to keep you waiting. Until recently the word “waiting” interfered little with my day to day thoughts. Usually apologetic to patients who had spent too long in the waiting room; guilty of medical “be with you in a minute” reassurances which frequently extended to half an hour. Chambers dictionary defines waiting as “to keep watch, be on guard; to remain in expectation or readiness.” But what it means to wait.

Recently, or was it years ago, my wife found a breast lump which turned out to be malignant. She's 36. Since then, time has become distorted, the objective measures of calendars and clocks becoming meaningless as appointments, results, operations, and treatments …
Enhancement of basophil chemotaxis in vitro by virus-induced interferon.
Authors: M A Lett-Brown, M Aelvoet, J J Hooks, J A Georgiades, D O Thueson, J A Grant
Journal: Journal of Clinical Investigation (1981)

It is well established that viral infections may precipitate or worsen attacks of bronchial asthma. Furthermore, in symptomatic atopic subjects, the local accumulation of basophils and the production of a basophil chemotactic factor have been reported. We have investigated the effect of cell-free supernates from viral stimulated cultures of human mononuclear cells on the in vitro migration of human basophils. Our results show the presence of a factor in these culture supernates that enhances the migration of basophils toward two separate chemoattractants, a peptide from C5 and a lymphokine. The enhancing activity, while affecting basophil migration, did not change the response of monocytes. The enhancing activity resembled viral-induced interferon when (a) pH 2 stability, (b) heat resistance, (c) trypsin sensitivity, and (d) species-specificity were compared. Finally, the enhancing activity for basophil chemotaxis and the interferon titer were highly correlated in preparations with a 10(4)-fold difference in interferon specific activity. Our studies show that viral-induced interferon can augment the in vitro chemotactic response of basophils. Because mediators present in basophils may be involved in the pathogenesis of immediate hypersensitivity, the modulation of basophil movement by interferon suggests a possible mechanism for the association between viral infections and atopic disorders.
Study finds that anticancer effect of "5 a day" is less than expected
Authors: A. Sayburn
Journal: BMJ (2010)

People who eat more fruit and vegetables than average may have a slightly reduced risk of getting cancer, a big study concludes, but the benefit is much smaller than previous studies suggested.

The European Prospective Investigation Into Cancer and Nutrition (EPIC), a 9 year prospective study of nearly 500 000 European men and women, has concluded that the protective effect of eating fruit and vegetables is “very small” ( J Natl Cancer Institute 2010; doi:10.1093/jnci/djq072).

The international study recruited people aged 25 to 70 from 10 Western European countries who filled in detailed questionnaires about their diet and lifestyle. Researchers then used their medical records to find out whether they were diagnosed with cancer during the next 9 years. 

Overall, there were 7.9 cancers annually per 1000 men, and 7.1 cancers …
TCT-154 Platelet inhibition after a loading dose of three different antiplatelet drugs in patients with STEMI/NSTEMI: Comparison between a loading dose of Prasugrel, Ticagrelor and Clopidogrel. PraTiClo LD Study
Authors: Alessio Mattesini, Rossella Marcucci, Marco Chiostri, Mary Zucchini, Giorgio Jacopo Baldereschi, Critistina Giglioli, Francesco Meucci, Rosanna Abbate, Gian Franco Gensini, Serafina Valente
Journal: Journal of the American College of Cardiology (2013)
HIV and hepatitis C among injecting drug users
Authors: R A Coutinho
Journal: BMJ (1998)

Papers p 433

Injecting drug users have been capable of reducing their risky behaviour in the face of the HIV-AIDS epidemic.1 To many this risk reduction, shown in numerous studies from different parts of the world, was unexpected as drug users are often regarded as self destructive. Nevertheless, because of the decrease in risky behaviour, the incidence of HIV infection among drug users in most industrialised countries has declined over the years. Thus, in this issue, van Beek et al report that among young injecting drug users in Sydney the incidence of HIV infection in 1992-5 was only 0.2 per 100 person years (p 433).2 Not so good is their finding that the incidence of infection with hepatitis C virus (HCV) was extremely high: 21 per 100 person years; among those aged under 20 the rate was 76 per 100 person years. Other groups from different countries have also reported a continuing high prevalence and incidence of hepatitis C virus among injecting drug users,3 though not as high as in this study; this may be to do with the young …
A Risk Score to Predict Bleeding in Patients With Acute Coronary Syndromes
Authors: Roxana Mehran, Stuart J. Pocock, Eugenia Nikolsky, Tim Clayton, George D. Dangas, Ajay J. Kirtane, Helen Parise, Martin Fahy, Steven V. Manoukian, Frederick Feit, Magnus E. Ohman, Bernard Witzenbichler, Giulio Guagliumi, Alexandra J. Lansky, Gregg W. Stone
Journal: Journal of the American College of Cardiology (2010)
Endogenous Activation in Blastomycosis
Authors: Warren Laskey, George A. Sarosi
Journal: Annals of Internal Medicine (1978)

Recent work established the fact that the portal of entry in blastomycosis is the lung. After the initial exposure to the fungus, a pneumonic process develops that may heal spontaneously or progress locally or at distant sites, or both. Frequently, however, patients present with disseminated disease, whose chest roentgenograms do not show any lesions We have recently seen three patients with disseminated blastomycosis with negative chest roentgenograms at the time of diagnosis. Past history showed a pneumonic illness 33, 32, and 4 months before diagnosis. Chest roentgenograms from the time of the original illness showed a pneumonic process compatible with blastomycosis in all three. Examination of postbronchoscopy sputa showed the characteristic yeasts of Blastomyces dermatitidis. These three patients document for the first time apparent endogenous activation in blastomycosis. A possible explanation for this apparent endogenous activation may reside in the histopathologic similarity between blastomycosis and other chronic granulomatous diseases, especially tuberculosis.
Promoting Public Trust: ESCROs Won't Fix the Problem of Stem Cell Tourism
Authors: Zubin Master, David B. Resnik
Journal: The American Journal of Bioethics (2013)

Click to increase image sizeClick to decrease image size Acknowledgments We thank Professor Timothy Caulfield for helpful suggestions. This work was partially supported by the Cancer Stem Cell Consortium and the Canadian Stem Cell Network. Zubin Master is also affiliated with the Health Law and Science Policy Group at the University of Alberta. This article is the work product of an employee or group of employees of the National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH). However, the statements, opinions, or conclusions contained herein do not necessarily represent the statements, opinions, or conclusions of NIEHS, NIH, or the U.S. government.
Regulation of corticotropin receptor number and messenger RNA in cultured human adrenocortical cells by corticotropin and angiotensin II.
Authors: M C Lebrethon, D Naville, M Begeot, J M Saez
Journal: Journal of Clinical Investigation (1994)

The regulation of ACTH receptor binding sites and mRNA by ACTH and angiotensin II (A-II) was studied using cultured human adrenal fasciculata reticularis cells (HAC). These cells expressed two major ACTH receptor transcripts of 1.8 and 3.4 kb and three minor ones of 4, 7, and 11 kb. ACTH increased the levels of all these transcripts in a time- and dose-dependent manner. At a maximal concentration of 10(-8) M, ACTH enhanced 21- and 4-fold the level of ACTH receptor mRNA and the number of receptors per cell, respectively. Pretreatment of HAC with A-II produced a dose-dependent enhancement of ACTH receptor mRNA that was associated with an increase of both ACTH receptor number and responsiveness to this hormone. The effects of A-II were completely blocked by an AT1 receptor subtype antagonist but not by an AT2 antagonist. The effects of ACTH together with A-II on ACTH receptor mRNA were greater than those induced by each hormone alone. These results show that ACTH receptor number and mRNA are positively regulated by the two main hormones (ACTH and A-II) which, in vivo, regulate adrenocortical functions. In addition, they also show that HAC are a target for A-II. Thus, regulation of ACTH receptors may be one mechanism by which ACTH and A-II regulate adrenocortical functions under both normal and pathological conditions.
Guidelines of care for warts: Human papillomavirus
Authors: None Committee on Guidelines of Care, Lynn A Drake, Roger I Ceilley, Raymond L Cornelison, William L Dobes, William Dorner, Robert W Goltz, Charles W Lewis, Stuart J Salasche, Maria L Chanco Turner, Barbara J Lowery, None Task Force, Steven K Shama, Elliot J Androphy, Wesley King Galen, Charles L Heaton, Peter J Lynch, Maria L Chanco Turner
Journal: Journal of the American Academy of Dermatology (1995)
M.I.F. test in halothane jaundice.
Authors: W J Williams, E Pioli, J N Horton, A Waldron
Journal: BMJ (1972)

sharply.Indeed there was one fewer in 1963 than in 1953, though there had been some increase in 1961 and 1962.The 10 years' operative mortality was 0-87 % and the morbidity due to chest infection, wound infection, and deep venous thrombosis was 9-8%.I can confirm the finding of a high proportion of stones at operation (97 4% in 1960), whereas only 29% had been demonstrated radiologically preoperatively in tiat year.The most striking feature of 1960 was that there were no operative cholangiograms carried out.Indeed, 1961 was the first year they were done at Frenchay, though only 11 were done in the subsequent three years.This led to 37-6% of all common bile ducts being explored, half of these unnecessarily.As operative cholangiography is now routine during all cholecystectomies at that hospital it would be interesting to compare the 1960 and 1970 total figures with special reference to the problem of recurrent common-bile-duct stones.-Iam, etc.,
Cardiac Performance Capacity and the Effect of Exercise on Renal Plasma Flow in Aortic Insufficiency
Authors: THOMAS B. GIBBONS, AUSTIN HENSCHEL, HENRY LONGSTREET TAYLOR, CARLETON B. CHAPMAN
Journal: Circulation (1950)

Maximal oxygen intake and renal plasma flow at rest and in work were measured in normal subjects and patients with aortic valve insufficiency; the tests measure some aspects of cardiovascular function. The lower maximal oxygen intake and renal plasma flow at rest and in work in these cardiac patients indicate a decreased cardiovascular performance capacity even though the patients were asymptomatic and their daily physical activity was not restricted.