tbuckley/cabot-search huggingface dataset:
Does This Patient Have a Family History of Cancer?
Authors: Harvey J. Murff, David R. Spigel, Sapna Syngal
Journal: JAMA (2004)

A family history of certain cancers is associated with an increased risk of developing cancer. Both cancer screening and genetic services referral decisions are often based on self-reported pedigree information.To determine the accuracy of self-reported family cancer history information.English-language articles were retrieved by searching MEDLINE (1966-June 2004) using Medical Subject Headings family, genetic predisposition to disease, medical history taking, neoplasm, and reproducibility of results. Additional articles were identified through bibliography searches.Original studies in which investigators validated self-reported family history by reviewing the identified relatives' medical records, death certificate, or cancer registry information were included, as well as studies that evaluated breast, colon, ovarian, endometrial, and prostate cancers.Two of the 3 investigators independently reviewed and abstracted data for estimating the likelihood ratios (LRs) of self-reported family cancer history information. Only data from studies that evaluated both positive and negative family cancer histories were included within the analyses. A total of 14 studies met the search criteria and were included in the review.For patients without a personal history of cancer, the positive and negative LRs of a family history of the following cancers in a first-degree relative were 23.0 (95% confidence interval [CI], 6.4-81.0) and 0.25 (95% CI, 0.10-0.63) for colon cancer; 8.9 (95% CI, 5.4-15.0) and 0.20 (95% CI, 0.08-0.49) for breast cancer; 14.0 (95% CI, 2.2-83.4) and 0.68 (95% CI, 0.31-1.52) for endometrial cancer; 34.0 (95% CI, 5.7-202.0) and 0.51 (95% CI, 0.13-2.10) for ovarian cancer; and 12.3 (95% CI, 6.5-24.0) and 0.32 (95% CI, 0.18-0.55) for prostate cancer, respectively. Positive predictive values tended to be better in articles concerning first-degree relatives compared with second-degree relatives.Patient-reported family cancer histories for first-degree relatives are accurate and valuable for breast and colon cancer risk assessments. Negative family history reports for ovarian and endometrial cancers are less useful, although the prevalence of these malignancies within families is low.
MPs call for Commons committee to examine cost to NHS of missing data
Authors: Z. Kmietowicz
Journal: BMJ (2012)

The government should demand that the £500m (€620m; $810m) it spent in 2009 on stockpiling oseltamivir (Tamiflu) be given back if it was found that the manufacturer withheld trial data that showed it to be no more effective than placebo, say MPs.

Researchers from the Cochrane Collaboration have claimed that the manufacturer, Roche, has conducted over 123 clinical trials but that at least 60% of these are unpublished, which means that they cannot properly assess the effectiveness or risks of oseltamivir. 

Roche agreed in 2009 to make key trial data on oseltamivir available to independent scrutiny, and the BMJ is running an open data …
Endoscopic needle knife treatment of chronic presacral sinus at the anastomosis at an ileal pouch-anal anastomosis
Authors: L. Lian, D. Geisler, B. Shen
Journal: Endoscopy (2010)

A 63-year-old man presented to the clinic with burning sensation, dyschezia, incomplete evacuation, and increased bowel frequency 1 year after total proctocolectomy and ileal pouch-anal anastomosis (IPAA). A pouch endoscopy showed two conjunct presacral sinuses at the anastomosis ([Fig. 1 a]). The decision was made by the patient, the endoscopist (B. S.), and the colorectal surgeon (D. G.) to perform a therapeutic pouch endoscopy, with surgery as the backup plan. The patient was taken to the outpatient endoscopy suite. After sedation, a GIF-H180 gastroscope was applied (Olympus, Tokyo, Japan). Two anastomotic sinuses (both 5 cm in depth), separated by a septum, were identified. The pouch was otherwise normal. The sinuses were treated with an Olympus triple lumen needle knife (Olympus Medical Systems, Tokyo, Japan) at a setting of endoscopic retrograde cholangiopancreatography (ERCP) endocut on ERBE (USA Incorporated Surgical Systems, Marietta, Georgia, USA) ([Fig. 1 b, c], [Video 1]). The entire therapeutic procedure was uneventful and took 10 minutes. The total dose of intravenous meperidine was 100 mg and midazolam 4 mg. The patient tolerated the procedure well and had considerable symptom improvement 1 day later. He has been able to maintain his pouch function to date.
Surgical solution is becoming acceptable, as for birth
Authors: Jacqueline Doyle
Journal: BMJ (2007)

Liao and Creighton refer to idiosyncratic decisions about cosmetic genitoplasty in the absence of local and national guidelines.1 Having worked as a clinical psychologist in women's health for several years, I have seen patients at various stages on the labial surgery pathway, and the reasons for referral to me have been varied.

Some women have had labial surgery and request further interventions, thus causing …
The Molecular Basis of Leukemia
Authors: Franklin H. Epstein, Martin J. Cline
Journal: New England Journal of Medicine (1994)

Genes involved in the pathogenesis of cancer are thought to act by two general mechanisms. The first involves the structural alteration of a normal gene (a proto-oncogene) to generate a novel gene (an oncogene) whose protein product acts on the host cell to induce characteristics of malignancy. This protein product is usually involved in cellular proliferation, differentiation, or survival. The second mechanism involves the loss or inactivation of genes whose proteins suppress cancer. Genes of this class are known as tumor-suppressor genes or anti-oncogenes.Alterations in members of specific gene families are consistently associated with some types of leukemia. Table 1 lists . . .
Hard Cases Make Bad Law
Authors: Edwin J. Holman
Journal: JAMA (1973)

Medicine is largely self-governed. This is so because the public, the citizens of the state, have permitted it. Professional self-government does not result from natural or constitutional right. It is a privilege. Society believes it lacks the knowledge and expertise needed to review the quality of professional service or to evaluate professional judgments. But beliefs can and do change. The public can be stampeded into believing (1) its rights are being impinged upon (2) medicine isn't policing its own ranks (3) the privilege of self-government should be restricted or curtailed, or (4) the public should participate with the profession in administering self-government.  Medical societies appear to have been reluctant to tackle tough problems relating to questionable actions by their members. It is amazing how many excuses can be found for not conducting an investigation or for not taking action. One common excuse is that if the medical society becomes involved
Abstract 2619: Sulfation of toremifene: Individual variability, isoform specificity, and contribution to toremifene pharmacogenomics
Authors: Vineetha Koroth Edavana, Suzanne Williams, Marjorie L. Beggs, Kelly Mercer, Xinfeng Yu, Xuemei Zhang, David B. Caldwell, Fred Kadlubar, Susan Kadlubar
Journal: Cancer Research (2010)

Abstract Toremifene (TOR) is a selective estrogen receptor modulator (SERM) used in adjuvant therapy for breast cancer, and more recently is in clinical trials for prostate cancer prevention in patients with high grade PIN. The chemical structure of TOR differs from tamoxifen (TAM) only by the presence of a chlorine atom in the ethyl side chain. That difference results in distinct breakdown products of the two drugs, which may provide for a more favorable toxicity spectrum with TOR compared to TAM. TOR has a similar mechanism of action to that of TAM, in that its 4-hydroxy metabolites bind specifically to estrogen receptors and, as an estrogen receptor-TOR complex, to chromatin. Interestingly, studies have indicated that a subset of patients who fail on TAM therapy benefit from high-dose TOR therapy, indicating that pharmacogenomics could be an important determinant of response to treatment with TOR. Several studies have indicated that functional genetic variants in the TAM metabolic pathway influence response to therapy, but to date, pharmacogenomic studies of patients treated with TOR are lacking. In order to perform candidate gene association studies, it is necessary to identify the enzymes involved in TOR metabolism. While the Phase I metabolism of TOR has been well-characterized, Phase II metabolism of the active 4-OH-TOR is not well-defined. In this study, we examined individual variability in sulfation of TOR, and found 20-fold variation in human liver cytosols from 100 subjects. Examination of recombinant sulfotransferases revealed that SULT1A1, SULT1E1, and to a lesser extent, SULT2A1 catalyzed the sulfation of TOR. SULT1A1 is the most highly expressed hepatic sulfotransferase, and there was a significant association between SULT1A1*1/*2 genotype and TOR sulfation in human liver cytosols (p=0.001). Since target tissue metabolism is also a critical determinant of clinical efficacy, we also examined the presence of sulfotransferase isoforms in normal prostate (n= 8), BPH tissue (n= 12), and prostate cancer (n=4). Quantitative RT-PCR analysis showed the presence of SULT1A1 and SULT2B1b in BPH and Prostate cancer tissues. These results indicate that variability in sulfation, in terms of both first-pass metabolism and target tissue metabolism, contributes to response to TOR for prostate cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2619.
A Point-of-Care Platelet Function Assay and C-Reactive Protein for Prediction of Major Cardiovascular Events After Drug-Eluting Stent Implantation
Authors: Duk-Woo Park, Seung-Whan Lee, Sung-Cheol Yun, Hae-Geun Song, Jung-Min Ahn, Jong-Young Lee, Won-Jang Kim, Soo-Jin Kang, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park
Journal: Journal of the American College of Cardiology (2011)
Natural History of Polycythemia Vera
Authors: Ofer Shpilberg
Journal: Annals of Internal Medicine (1996)

Letters15 September 1996Natural History of Polycythemia VeraOfer Shpilberg, MD and Avner Shahar, MDOfer Shpilberg, MDUniversity of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15261Search for more papers by this author and Avner Shahar, MDUniversity of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15261Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-6-199609150-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The highly informative article from the Gruppo Italiano Studio Policitemia [1] has increased our knowledge of the course of polycythemia vera. Although we endorse most of the author's conclusions, we believe the study has several limitations inherent in its retrospective design.Although the diagnostic criteria established by the group are useful in the research setting, they tend to be restrictive and may exclude as many as one third of patients who have polycythemia vera but incomplete presentations [2]. In interpreting the Italian group's findings, it seems plausible that some or most of the patients who previously had ...References1. Polycythemia vera: the natural history of 1213 patients followed for 20 years. Gruppo Italiano Studio Policitemia. Ann Intern Med. 1995; 123:656-64. Google Scholar2. Cohen-Goldenberg N, Shpilberg O, Modan B, Chetrit A, Ramot B. Long term follow up in polycythemia vera. Harefuah. 1995; 128:673-6. Google Scholar Author, Article, and Disclosure InformationAuthors: Ofer Shpilberg, MD; Avner Shahar, MDAffiliations: University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15261 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byErythrocyte Deformability is Reduced and Fragility increased by Iron Deficiency 15 September 1996Volume 125, Issue 6Page: 514KeywordsMyocardial infarctionPolycythemia veraRetrospective studiesThrombosis ePublished: 15 August 2000 Issue Published: 15 September 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Human parvovirus B19: Hard to differentiate from infectious mononucleosis
Authors: J W Jones, J V S Pether, R W P Frost, J A Snowden, W I Ali-Wali
Journal: BMJ (1994)

Supporting local ethics committees is a responsibility of purchasers.2Lambeth, Southwark and Lewisham Health Commission is reviewing the organisation of the local committees and will be meeting their chairpersons to discuss how the problems discussed can best be tackled.Given the problems mentioned above and the fact that many hospital ethics committees are already overloaded, the answer may lie in setting up a local ethics committee dedicated to primary care and community research.
ANTIGENICITY OF POLYPEPTIDES (POLY ALPHA AMINO ACIDS)
Authors: Paul H. Maurer, Bernard F. Gerulat, Paul Pinchuck
Journal: The Journal of Experimental Medicine (1964)

A new group of synthetic random polymers of alpha-L-amino acids has been studied for immunogenicity. With the glutamic acid and alanine copolymers, those consisting of almost equimolar amounts of the two (G(60)A(40) and G(40)A(60)) were effective antigens in rabbits whereas those with higher glutamic acid contents (G(75)A(25), G(90)A(10)) were poor antigens. The substitution of alanine by valine or leucine (G(75)V(25) and G(80)Leu(20)) produced copolymers which were poor antigens in rabbits but effective in guinea pigs. L(70)A(30), although capable of "non-specifically" precipitating serum proteins, was shown not to be antigenic in either rabbits or guinea pigs. The introduction of alanine into glutamic acid and lysine polymers (GLA series) enhanced the immunogenicity of the terpolymers, i.e., GLA30 > GLA20 > GLA10 > GL. The mechanism by which this may be accomplished is discussed as possibly being related to the reduction of the interactions between glutamyl and lysyl residues which allows the carboxyl groups to act as strong immunogenic determinants.
Abstract A5: Lenalidomide inhibits hypoxia-induced HIF-1α production and prevents the invasive phenotype in epithelial solid tumor cells
Authors: Ling Lu, Peter H. Schafer, J. Blake Bartlett
Journal: Clinical Cancer Research (2010)

Abstract Background: In hematological malignancies lenalidomide (len) exerts tumoricidal and immunomodulatory effects and may also influence the tumor cell microenvironment by blocking the proangiogenic and proinvasive effects of growth factors and/or hypoxia. In solid tumor models len is antimetastatic but lacks overt tumoricidal activity. These observations led us to explore the effect of len on hypoxic solid tumor cells, in particular the expression of HIF-α and its upstream regulators p53 and HDM-2. Methods: Eighteen solid tumor cell lines were tested for the effect of len on the response to hypoxia (1 % O2, 5% CO2, 94% N2; Invivo2 400 hypoxic workstation). Cell lysates from three cell lines (HCT-15, MDA-MB-231 and SKOV-2) were assessed for HIF-1α, p53 and HDM-2 proteins by immunoblot. We also performed immunoprecipitation studies to explore the effect of len on the interaction of these proteins. The effect of len on HIF-1α was assessed in p53 siRNA transfected HCT-15 cells and on HIF-1 α mRNA in transfected Luc-HIF NIH 3T3 cells. Len effects on hypoxia-induced trans-well invasion of three cell lines were also assessed. Results: Len (1 µM) significantly inhibited hypoxia-induced HIF-1 a protein levels dose-dependently in the majority of tumor cell lines tested; breast (by 68%, MDA-MB-231; 65%, MCF-7), colorectal (76%, HCT-116; 65%, HCT-15; 82% HT-29), ovarian (71%, OVCAR-3; 66%, SKOV-3), renal (83%, 786-O; 57%, HEK293), prostate (54%, DU- 145) and pancreatic (45%, MiaPaca-3)(all p&amp;lt;0.05). Len had no effect on HIF-1 α in SW480 (colorectal), Panc-1, BxPC3 (pancreatic), SW579 (thyroid), NCI-H446 (SCLC) or Caki-1 (Renal) cell lines or on HCT-15 cells transfected with p53 siRNA. In addition to inhibition of HIF-1 α protein len also inhibited hypoxia-induced HIF-1α mRNA expression (p&amp;lt; 0.01). Len enhanced p53 levels in hypoxic HCT-15 cells (by 2-fold; p&amp;lt;0.05), SKOV-3 cells (by 4-fold; p&amp;lt;0.01) and MDA-MB-231 cells (by almost 2-fold; p&amp;lt;0.05) but had little apparent effect on the interaction of these proteins. Len totally inhibited the 2-fold hypoxic induction of HDM-2 levels in HCT-15 (p&amp;lt;0.05) and SKOV-3 (p&amp;lt;0.01) cells but had no effect on HDM-2 in p53 mutant MDA-MB-231 cells. Tumor cell invasiveness was enhanced in response to hypoxia by ~3- fold in all three lines and was blocked by 50-80% by len treatment (all p &amp;lt; 0.05). Conclusions: These results suggest that len inhibits the proinvasive hypoxic response in multiple, diverse tumor lines and may exert antimetastatic effects within the hypoxic solid tumor microenvironment. Citation Information: Clin Cancer Res 2010;16(14 Suppl):A5.
THE ROLE OF EYESTRAIN IN CIVILIZATION
Authors: G. M. Gould
Journal: BMJ (1903)

If we fuse the data thus gained into a composite clinical photograph the lessons become more clear and strik- inig.The diseases, or rather the symptoms of the one disease common to all, were headachle, " biliousness," sick headache, " nervousness," indescribable suffering, inability to do literary work without producing these symiptoms, and relief of the symptoms whenever, even for a day or a few hours, literary work was stopped; entire cessation of the character- istic syilmptoms at about 6o years of age.Here we have a definite clinical picture that differentiates the fundamenital pathologic condition from that of any other disease.The symptoms were briefly, and without quotation marks, as follow:Of De Quincey.-Pain in the head beginninig at I4; violent twitchings of the stomach during sleep, at 17; neuralgic affection at i8 or I9 ; nervous horror, irritation of the stomach, gastralgia, illiless, dejectedness, biliousness, wretchledness, dizziness, a nervous malady of a very peculiar character, inisomniia.The digestional difficulty was pre- dominant.Of Carlyle.-Dyspepsia,torture as of a rat gnawing at the pit of the stomach, bad hlealth, nervous disorders, insomnia, biliousness, melancholy, cardiac symptoms.Tlle dyspepsia was the leading complaint.Of Mrs. Carlyle.-Sickheadache, nervous sufferings, insomnia.Hers was a case of life-long sick headlacle.Of Darvin.-Dispiritment,pain and palpitation about the heart, sea-sickness, illness, iniability to do literary work, disordered stomach, prostratioii of strength, sick headache, vomiting, insominia, headache, great weakness.The diges- tive organis were those principally affected.Of Hulaley.-Hypochondriacaldyspepsia, cardiac sym- ptoms; unaccountable prostration; liver; headache: flatulent dyspepsia; mental depression-a case, again, of almost typical sick headache.Of Broivniuq.-Headache,confused cerebral symptoms, depression, dizziness, deranged liver, nervous excitability.This is a case of almost simple headache.Of Wagner.-Feeblestomach, sick headaches, extreme de- pression, cardiac symptoms, insomnia, shattered nerves, intense irritability, violent headache.A martyr to sick headache.Of Parkman.-Dyspepsia,stirred-up head, photophobia, the greatest inability to use the eyes in literary work, in- somnia, insanity feared on the part of friends and physicians.Mental, ocular, and cerebral symptoms dominant.Of Whittier.-Delicatehealth, great weakness, depression, palpitation of the heart, influenza, headache, weariness, rheumatism, cerebral symptoms, neuralgia, insomnia.Headache, physical weakness and sensitiveness were continuous from early manlhood to the completion of presbyopia.Of Herbert Spencer.-Insomnia,inability to use the eyes
Accurate Case Counts: The Problem and a Proposal
Authors: ELIAS ABRUTYN
Journal: Annals of Internal Medicine (1986)

Editorials1 July 1986Accurate Case Counts: The Problem and a ProposalELIAS ABRUTYN, M.D.ELIAS ABRUTYN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-105-1-132_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe reporting of identical cases in two otherwise different papers can confuse some readers as to case identity, notably when the cases are not cross-referenced in both articles. A letter to the editor (1) in this issue illustrates this problem. A problem far more important than just confusion arises when accurate total case counts are vital to epidemiologic judgments, as in the assessment of the risk of adverse drug effects, and to judgments on drug efficacy.In even a casual search of case reports in older journals, one finds that patients were often identified with extraordinary precision. First names or...References1. HENRY K. Reports of DHPG treatment of cytomegalovirus retinitis [Letter]. Ann Intern Med. 1986:105:144-5. LinkGoogle Scholar2. ABRUTYN E. Better reporting of adverse drug reactions [Editorial]. Ann Intern Med. 1985; 102:264-5. LinkGoogle Scholar3. PALESTINESTEVENSLANE AGH. Treatment of cytomegalovirus retinitis with dihydroxy propoxymethyl guanine. Am J Ophthalmol. 1986;101:95-101. CrossrefMedlineGoogle Scholar4. MASURPALESTINESTEVENS HAG. Reports of DHPG treatment of cytomegalovirus retinitis [Letter]. Ann Intern Med. 1986; 105:145. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 July 1986Volume 105, Issue 1Page: 132-132KeywordsDrugsEpidemiology Issue Published: 1 July 1986 PDF downloadLoading ...
Stability of IgE Levels during Acute Asthma: Implications for Initiation of Omalizumab Therapy after the Emergency Department Visit
Authors: C.J. Ahn, B.M. Baumann, R.F. Kysia, M.S. Radeos, K. Stiffler, C.A. Camargo
Journal: Journal of Allergy and Clinical Immunology (2007)