tbuckley/cabot-search huggingface dataset:
Abstract OT1-1-04: ALTERNATIVE: safety and efficacy of lapatinib (L), trastuzumab (T), or both in combination with an aromatase inhibitor (AI) for the treatment of hormone receptor-positive (HR+), human epidermal growth factor receptor 2 positive (HER2+) metastatic breast cancer
Authors: S Johnston, S Wroblewski, Y Huang, C Harvey, F Nagi, N Franklin, W Gradishar
Journal: Cancer Research (2012)

Abstract Background: Overexpression of the human epidermal growth factor receptor 2 (HER2) gene in breast cancer is associated with an aggressive phenotype, poor prognosis, and resistance to endocrine therapies. Of HER2+ patients, ∼50% are also hormone receptor-positive (HR+). For patients who are both HER2+ and HR+, combining the AI letrozole with the dual tyrosine kinase inhibitor L has been shown to improve outcomes compared with letrozole alone. The combination of L and T, a humanized monoclonal antibody-targeting HER2, has been shown to improve outcomes compared with L alone. Trial design: The ALTERNATIVE study is a Phase III, randomized, open-label, multicenter trial, which will examine the efficacy of L/T/AI in combination versus T/AI alone. Patients will be randomized to 1 of 3 treatment arms: L 1000 mg po QD plus T (loading dose of 8 mg/kg followed by maintenance with 6 mg/kg IV q3w plus an AI po QD); T plus an AI; or L 1500 mg po QD plus an AI. Choices of AI include letrozole, anastrozole, or exemestane. Eligibility criteria: Postmenopausal female patients with HER2+/HR+ metastatic breast cancer (MBC) who have received neo/adjuvant T and endocrine therapy, are treatment naïve for MBC, and are not candidates for chemotherapy. Specific aims: The primary efficacy endpoint is overall survival (OS), defined as the time from randomization until death due to any cause, for L/T/AI compared with T/AI alone. Secondary efficacy objectives include comparisons of OS between T/AI and L/AI as well as between T/L/AI and L/AI in addition to comparisons of progression-free survival, overall response rate, time to response, and duration of response. The safety objective is to evaluate the safety and tolerability for all 3 treatment groups. A 4-year recruitment is anticipated. More than 200 centers across 37 countries are planned; approximately 110 centers are currently open for enrollment. Statistical methods: The study is powered to detect a 42% reduction in risk of death (hazard ratio=0.70) in patients who receive L/T/AI (median 28.5 months) versus T/AI (median 20 months) using a 1-sided test for superiority with α=0.025. The required number of total events to achieve a power of 80% is 249. Secondary comparisons are not powered and will be based on the intent-to-treat population. Present and target accrual: Twenty-six (26) of 525 patients have been randomized. Patients who have participated in previous neo-/adjuvant trials including a T regimen are eligible, provided they meet all other inclusion criteria. The study is currently recruiting patients, with an anticipated target accrual of 525 patients by March 2016. Clinical trial registry number: NCT01160211 Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr OT1-1-04.
A National Health Program: Northern Light at the End of the Tunnel
Authors: Steffie Woolhandler
Journal: JAMA (1989)

Woolhandler and Himmelstein are members of Physicians for a National Health Policy, a working group that proposes a reform of health care financing in the United States. In this commentary, they describe a national health program (NHP) that would create a single tax-funded comprehensive insurer in each state, federally mandated but locally controlled. The NHP would be similar to the Canadian system of financing health care, which is described here and contrasted with the inflationary, fragmented, bureaucracy-laden system now in place in the United States. Woolhandler and Himmelstein call for a complete overhaul of health care financing in this country that would reduce bureaucratic overhead and intrusion into the physician patient relationship, reduce health care costs, reallocate funds from administration to clinical care, and allow all Americans access to care.
Efficient recombinant hepatitis E virus vaccine: Mission accomplished?
Authors: Frank Tacke, Christian Trautwein, Kris Kowdley, Geoffrey McCaughan, Christian Trautwein
Journal: Hepatology (2007)

Background: Hepatitis E virus (HEV) is an important cause of viral hepatitis. We evaluated the safety and efficacy of an HEV recombinant protein (rHEV) vaccine in a phase 2, randomized, double-blind, placebo-controlled trial. Methods: In Nepal, we studied 2000 healthy adults susceptible to HEV infection who were randomly assigned to receive three doses of either the rHEV vaccine or placebo at months 0, 1, and 6. Active (including hospital) surveillance was used to identify acute hepatitis and adverse events. The primary end point was the development of hepatitis E after three vaccine doses. Results: A total of 1794 subjects (898 in the vaccine group and 896 in the placebo group) received three vaccine doses; the total vaccinated cohort was followed for a median of 804 days. After three vaccine doses, hepatitis E developed in 69 subjects, of whom 66 were in the placebo group. The vaccine efficacy was 95.5% (95% confidence interval [CI], 85.6 to 98.6). In an intention-to-treat analysis that included all 87 subjects in whom hepatitis E developed after the first vaccine dose, 9 subjects were in the vaccine group, with a vaccine efficacy of 88.5% (95% CI, 77.1 to 94.2). Among subjects in a subgroup randomly selected for analysis of injection-site findings and general symptoms (reactogenicity subgroup) during the 8-day period after the administration of any dose, the proportion of subjects with adverse events was similar in the two study groups, except that injection-site pain was increased in the vaccine group (P=0.03). Conclusions: In a high-risk population, the rHEV vaccine was effective in the prevention of hepatitis E. (ClinicalTrials.gov number, NCT00287469 [www.ClinicalTrials.gov].) Copyright © 2007 Massachusetts Medical Society. All rights reserved.
Hereditary Labile Factor (Factor V) Deficiency
Authors: Irving A. Friedman
Journal: JAMA (1961)

Hereditary labile factor (Factor V) deficiency is transmitted as an autosomal recessive. Only individuals who inherit the defective gene from both parents are bleeders. In the family studied, the father is Greek while the mother is Polish. The diagnosis is made by determining the prothrombin time by the one-stage method, which is completely corrected by the addition of freshly deprothrombinized plasma. Bleeding is mainly purpuric or capillary in type. Epistaxis is common, and menorrhagia is often serious. The important therapeutic agent is a transfusion of fresh plasma or fresh frozen plasma. Administration of vitamin K does not correct the prothrombin time and is ineffective clinically. Because of the hereditary character of the disease, genetic counseling may be helpful.
Oral Contraceptives in Women With Diabetes
Authors: Barbara EK Klein, Scot E Moss, Ronald Klein
Journal: Diabetes Care (1990)

We evaluated the association of oral contraceptive use with the presence and severity of diabetic retinopathy, hypertension, and glycosylated hemoglobin in women of childbearing age who have diabetes. Neither current or past use nor number of years of use of oral contraceptives was associated with severity of retinopathy, hypertension, or current glycosylated hemoglobin. In conclusion, further study of various birth control methods in young women of childbearing age should be considered.
Physical Activity, Physical Fitness, and Health: Time to Act
Authors: Jeffrey P. Koplan
Journal: JAMA (1989)

An increasing body of evidence suggests that physical activity and physical fitness contribute to good health. Studies have demonstrated that physical activity, be it occupational or recreational, is associated with decreased risks of coronary heart disease.<sup>1</sup>Other studies suggest that risks for colon cancer,<sup>2</sup>stroke,<sup>3</sup>and hypertension<sup>4</sup>are reduced and that exercise can assist in management of persons with diabetes,<sup>4</sup>depression,<sup>5</sup>and obesity.<sup>6</sup>Blair et al<sup>7</sup>provide evidence in this issue of<i>JAMA</i>that physical fitness is associated with lower rates of all causes of mortality as well as cardiovascular disease and cancer mortality. Physical fitness is determined by our genetics and our behavior. While we cannot change our genes, we can modify our behavior. Increased physical activity leads to improved physical fitness and to other physiological changes. It is the combination of these changes that leads to improved health. Not only is
Adhesion molecule expression and the inflammatory cell infiltrate in delayed pressure urticaria
Authors: R.J. BARLOW, E.L. ROSS, D. MACDONALD, A.KOBZA BLACK, M.W. GREAVES
Journal: British Journal of Dermatology (1994)

Journal Article Adhesion molecule expression and the inflammatory cell infiltrate in delayed pressure urticaria Get access R.J. BARLOW, R.J. BARLOW St John's Institute of Dermatology. St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH. U.K. Search for other works by this author on: Oxford Academic Google Scholar E.L. ROSS, E.L. ROSS Guy's Hospital, London, U.K. Search for other works by this author on: Oxford Academic Google Scholar D. MACDONALD, D. MACDONALD Guy's Hospital, London, U.K. Search for other works by this author on: Oxford Academic Google Scholar A.KOBZA BLACK, A.KOBZA BLACK St John's Institute of Dermatology. St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH. U.K. Search for other works by this author on: Oxford Academic Google Scholar M.W. GREAVES M.W. GREAVES St John's Institute of Dermatology. St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH. U.K. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 131, Issue 3, 1 September 1994, Pages 341–347, https://doi.org/10.1111/j.1365-2133.1994.tb08521.x Published: 01 September 1994 Article history Accepted: 21 January 1994 Published: 01 September 1994
Radiolabeled Monoclonal Antibody 15 and Its Fragments for Localization and Imaging of Xenografts of Human Lung Cancer
Authors: K. Endo, H. Kamma, T. Ogata
Journal: JNCI Journal of the National Cancer Institute (1988)

Journal Article Radiolabeled Monoclonal Antibody 15 and Its Fragments for Localization and Imaging of Xenografts of Human Lung Cancer Get access Katsuyuki Endo, Katsuyuki Endo * Department of Surgery, Institute of Clinical Medicine, University of TsukubaTsukuba, Ibaraki, Japan *Correspondence to: Dr. Katsuyuki Endo, Department of Surgery, Institute of Clinical Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki 305, Japan. Search for other works by this author on: Oxford Academic PubMed Google Scholar Hiroshi Kamma, Hiroshi Kamma Department of Pathology, Institute of Basic Medical Sciences, University of TsukubaTsukuba, Ibaraki, Japan Search for other works by this author on: Oxford Academic PubMed Google Scholar Takesaburo Ogata Takesaburo Ogata Department of Pathology, Institute of Basic Medical Sciences, University of TsukubaTsukuba, Ibaraki, Japan Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 80, Issue 11, 3 August 1988, Pages 835–842, https://doi.org/10.1093/jnci/80.11.835 Published: 03 August 1988 Article history Received: 28 December 1987 Revision received: 12 April 1988 Accepted: 02 May 1988 Published: 03 August 1988
Posttransplantation chronic hepatitis in fulminant hepatic failure
Authors: R Mohamed, S G Hubscher, D F Mirza, B K Gunson, D J Mutimer
Journal: Hepatology (1997)

Non-A, non-B or seronegative hepatitis is the leading indication for liver transplantation in patients with fulminant hepatic failure (FHF). We examined protocol annual review liver allograft biopsy specimens in consecutive adult patients transplanted for FHF in an attempt to determine the extent of the histological changes. One hundred eleven biopsy specimens from 41 patients transplanted for fulminant seronegative hepatitis and 34 from a comparison group of 16 patients transplanted for other causes of FHF (11 paracetamol overdose, 2 idiosyncratic drug reaction, 3 Wilson's disease) were available. Specimens were analyzed using standard proforma without knowledge of the original diagnosis. Chronic hepatitis was present in 29 patients (71%) transplanted for fulminant seronegative hepatitis (23 mild, 3 moderate, and 3 severe) compared with 5 patients (31%, all mild) transplanted for other causes of FHF. Twenty-five patients (61%) grafted for seronegative FHF had fibrosis (13 mild, 9 moderate, and 3 severe) in contrast to 4 fibrosis (25%) (all mild) in the comparison group. Excluding early allograft failure because of primary graft nonfunction or vascular complications, six patients with seronegative FHF required retransplantation (2 = chronic rejection; 1 = severe hepatitis with panacinar necrosis, resembling original liver; and 3 = chronic hepatitis with precirrhotic fibrosis and prominent cholestasis of unknown cause). One patient in the comparison group had a second graft (chronic rejection). Posttransplantation chronic hepatitis is more frequent and severe in patients transplanted for seronegative hepatitis. Graft survival may be adversely influenced by the development of chronic hepatitis, which may represent persistent or recurrent disease.
463 SERUM FERRITIN: AN INDEPENDENT PREDICTOR OF MORTALITY IN PATIENTS AWAITING LIVER TRANSPLANTATION IN A COHORT AND VALIDATION STUDY OF PATIENTS FROM AUSTRALIA AND NORTH AMERICA
Authors: N.M. Walker, K.A. Stuart, R.J. Ryan, S. Desai, S. Saab, J.A. Nicol, L.M. Fletcher, D.H.G. Crawford
Journal: Journal of Hepatology (2010)
Contrasting Modes of Evolution Between Vertebrate Sweet/Umami Receptor Genes and Bitter Receptor Genes
Authors: Peng Shi, Jianzhi Zhang
Journal: Molecular Biology and Evolution (2005)

Taste reception is fundamental to diet selection in many animals. The genetic basis underlying the evolution and diversity of taste reception, however, is not well understood. Recent discoveries of T1R sweet/umami receptor genes and T2R bitter receptor genes in humans and mice provided an opportunity to address this question. Here, we report the identification of 20 putatively functional T1R genes and 167 T2R genes from the genome sequences of nine vertebrates, including three fishes, one amphibian, one bird, and four mammals. Our comparative genomic analysis shows that orthologous T1R sequences are relatively conserved in evolution and that the T1R gene repertoire remains virtually constant in size across most vertebrates, except for the loss of the T1R2 sweet receptor gene in the sweet-insensitive chicken and the absence of all T1R genes in the tongueless western clawed frog. In contrast, orthologous T2R sequences are more variable, and the T2R repertoire diverges tremendously among species, from only three functional genes in the chicken to 49 in the frog. These evolutionary patterns suggest the relative constancy in the number and type of sweet and umami tastants encountered by various vertebrates or low binding specificities of T1Rs but a large variation in the number and type of bitter compounds detected by different species. Although the rate of gene duplication is much lower in T1Rs than in T2Rs, signals of positive selection are detected during the functional divergences of paralogous T1Rs, as was previously found among paralogous T2Rs. Thus, functional divergence and specialization of taste receptors generally occurred via adaptive evolution.
NONINVASIVE DIAGNOSIS OF SARCOIDOSIS: RECOGNITION OF DISTINCT PATTERNS OF Ga-67 DISTRIBUTION
Authors: S B Sulavik, D A Weed, R P Spencer, H R Shapiro, S T Shiue, R J Castriotta
Journal: Clinical Nuclear Medicine (1990)

Sulavik, S. B.; Weed, D. A.; Spencer, R. P.; Shapirn, H. R.; Shiue, S. T.; Castriotta, R. J. Author Information
Randomized, Controlled Trial of Clonidine for Smoking Cessation in a Primary Care Setting
Authors: Peter Franks
Journal: JAMA (1989)

Clonidine hydrochloride has been reported to reduce tobacco withdrawal symptoms and facilitate smoking cessation. We enrolled 185 subjects, 92 receiving clonidine and 93 receiving placebo, in a randomized, double-blind study of clonidine for smoking cessation in a primary care setting. Clonidine had no demonstrable effect on withdrawal (8 of 11 measures favoring placebo). At 4 weeks, 17 (18%) subjects receiving clonidine had quit compared with 13 (14%) receiving placebo (χ<sup>2</sup>= 0.7; 90% confidence interval of benefit from clonidine, —4% to 13%). At 4 weeks, the mean number of cigarettes smoked was 17.7 for those receiving clonidine and 17.5 for those receiving placebo (<i>t</i>=0.1; 90% confidence interval of benefit from clonidine, —4.1 to 3.7 cigarettes per day). These results provide little support for a beneficial effect of clonidine on tobacco withdrawal symptoms, quitting, or smoking reduction in a primary care setting. (<i>JAMA</i>. 1989;262:3011-3013)
A Good Man
Authors: John McClenahan
Journal: Annals of Internal Medicine (2005)

On Being a Doctor7 June 2005A Good ManJohn McClenahan, MDJohn McClenahan, MDFrom Richmond, VA 23220.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-11-200506070-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail At Ain Z'halta, a village in the Lebanese boondocks, a mosquito bit me on the wrist. I slapped it, brushed away a smear of blood, and returned to my guidebook. That evening, the bite itched. I scratched it and awoke the next morning with a welt the size of an almond at the base of my right thumb, a tender elbow, and disquieting red streaks running up to my armpit. President Coolidge's son had died a year or 2 previously from an infected blister despite the most advanced medical treatment of the time: hot soaks of Epsom salt, antiphlogistine, and ... Author, Article, and Disclosure InformationAffiliations: From Richmond, VA 23220.Corresponding Author: John McClenahan, MD, 413 Stuart Circle, Apartment B2, Richmond, VA 23220. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 7 June 2005Volume 142, Issue 11Page: 944-945KeywordsAlcoholsAnestheticsBloodBreadCheesesChildrenElbowRunningSulfonamideTea ePublished: 7 June 2005 Issue Published: 7 June 2005 CopyrightCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Medical Student Interest in Internal Medicine
Authors: Mark D. Schwartz, Mark Linzer, David Babbott, George W. Divine, Eugene Broadhead
Journal: Annals of Internal Medicine (1991)

Objective: To determine the factors that attract students toward and push students away from a career in internal medicine. Design: National survey of senior U.S. medical students using a stratified random cluster sampling of medical schools. Participants: The survey included 1650 U.S. senior students from 16 medical schools, of whom 1244 (76%) responded. Measurements and Main Results: A survey instrument was developed and pilot tested at 17 medical schools. Twenty-four percent of the respondents to the final survey chose a career in general internal medicine (9%) or subspecialty internal medicine (15%). A career in internal medicine had been "seriously considered" by 608 respondents (50%) who finally chose a career other than internal medicine (the "switchers"). Compared with other specialties, internal medicine was perceived as being more stressful to residents, more demanding of time and workload as a career and a residency, and as an easier residency to enter. Internal medicine was also seen as providing less satisfaction for residents, having lower income potential, and allowing less leisure time. For the 608 switchers, the most important influences leading to their decision to switch were the type of patient seen in internal medicine (for example, chronically ill, alcohol and drug abusing patients) as well as dissatisfaction and stress among internal medicine residents. Factor analysis showed that three factors, "intellectual challenge of internal medicine," "primary care interests," and "the medicine clerkship" attracted students toward internal medicine, whereas three others, "taking care of chronically ill patients," "level of satisfaction among internists and medical residents," and "workload and stress" pushed students away from internal medicine. Factors pushing students away from internal medicine were significantly more negative with regard to a career in general as opposed to subspecialty internal medicine (P < 0.001). Conclusion: Medical students have serious reservations about internal medicine as a career choice. Perceptions about the medical residency, the patients they expect to see, and the dissatisfaction among residents and internists are foremost in their thinking. Changes to improve the attractiveness of internal medicine should address these adverse perceptions while building on the positive influences identified by the respondents.
Diagnostic Pathology of Parasitic Infections With Clinical Correlations
Authors: Rául A. Marcial-Rojas
Journal: JAMA (1990)

This book represents a genuine and successful attempt to serve many purposes. It handles the subject of parasitic diseases in a concise but accurate fashion, thus keeping the price of the book down and promoting its accessibility to students, technologists, and physicians interested in this field. At the same time, keeping its size reasonably small (slightly over 500 pages) makes it easily manageable as a parasitology diagnostic manual in routine clinical and laboratory procedures as well as in diagnostic pathological anatomy. The book presents an excellent coverage of practically all the parasitic diseases of some importance to mankind, keeping an adequate balance between their incidence, prevalence, biologic complexity, and available diagnostic tools. The illustrations, for the most part, have been well selected and are purposeful and of good quality. The bibliographyat is up-to-date and selective, thus limiting itself to truly helpful, valuable, and recent information. This book should prove itself
Potent topical steroid obtained from a Chinese herbalist
Authors: J. O'Driscoll, A.D. Burden, T.P. Kingston
Journal: British Journal of Dermatology (1992)

Journal Article Potent topical steroid obtained from a Chinese herbalist Get access J. O'Driscoll, J. O'Driscoll The Skin Hospital, Chapel Street, Manchester M60 9EP, U.K. Search for other works by this author on: Oxford Academic Google Scholar A.D. Burden, A.D. Burden The Skin Hospital, Chapel Street, Manchester M60 9EP, U.K. Search for other works by this author on: Oxford Academic Google Scholar T.P. Kingston T.P. Kingston The Skin Hospital, Chapel Street, Manchester M60 9EP, U.K. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 127, Issue 5, 1 November 1992, Pages 543–544, https://doi.org/10.1111/j.1365-2133.1992.tb14859.x Published: 01 November 1992
Corrigendum to “Epidemiological profile of 806 Italian children with hepatitis C virus infection over a 15-year period” [J Hepatol 46 (2007) 783–790]
Authors: Flavia Bortolotti, Raffaele Iorio, Massimo Resti, Calogero Cammà, Matilde Marcellini, Raffaella Giacchino, Maria Grazia Marazzi, Garbriella Verucchi, Lucia Zancan, Cristiana Barbera, Giuseppe Maggiore, Pietro Vajro, Antonietta Giannattasio, Samuela Bartolacci
Journal: Journal of Hepatology (2007)
Commentaries on the end of year editorial on the definition of ischaemia in last December's issue
Authors: E. Murphy
Journal: Cardiovascular Research (1995)

Commentaries on the end of year editorial on the definition of ischaemia in last December's issue Get access Elizabeth Murphy, Dr Elizabeth Murphy, Dr NIH, Laboratory of Molecular Biophysics, Research Triangle Park, North Carolina, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 29, Issue 2, February 1995, Pages 283–284, https://doi.org/10.1016/S0008-6363(95)90004-7 Published: 01 February 1995