tbuckley/cabot-search huggingface dataset:
Abstract S2-3: The Impact of Body Mass Index (BMI) on the Efficacy of Adjuvant Endocrine Therapy in Postmenopausal Hormone Sensitive Breast Cancer (BC) Patients; Exploratory Analysis from the TEAM Study
Authors: C Seynaeve, E Hille, A Hasenburg, D Rea, C Markopoulos, Y Hozumi, H Putter, H Nortier, J van Nes, L Dirix, C. van de Velde
Journal: Cancer Research (2010)

Abstract Background: Obesity is associated with an increased risk of breast cancer (BC) recurrence and decreased survival, also in case of adjuvant endocrine therapy. It is still not clear whether the activity of aromatase inhibitors and tamoxifen (T) given as adjuvant therapy is affected by body mass index (BMI), although both drugs are widely prescribed. In this analysis, we explored the outcome of TEAM patients (pts) treated with exemestane (E) versus T (2.75 yrs), and with E versus T followed by E (T/E) (5 yrs) in relation to BMI. Patients and Methods: The TEAM trial is a randomized, international phase III study in postmenopausal hormone sensitive early BC pts comparing the activity and safety of adjuvant E (25 mg daily) or the sequence of T (20 mg daily) followed by E (T/E), both regimens given for five years. WHO BMI definitions were used: normal 18.5-24.9 kg/m2, overweight 25-30 kg/m2, obese &amp;gt;30 kg/m2. Disease-free survival (DFS) and overall survival (OS) were calculated by Kaplan-Meier method; results were compared by using the log-rank test and Cox proportional hazard modelling adjusted for country. Results: Weight and height was known in 4741 pts. Mean BMI was 26.9 kg/m2 (SD 4.9); 39% had a normal BMI, 36.9% overweight, and 23.3% of pts was obese. Underweight pts (n=41, 0.9%) were excluded from further analysis. At 2.75 yrs (E vs T) disease relapse in normal weight, overweight and obese pts using E was observed in 8.1%, 6.8% and 7.5% respectively (p=0.57), and in 9.1%, 8.8%, and 12.5%, respectively (p=0.06) of pts using T. The hazard ratio (HR for risk of relapse on E vs T) in the three subgroups was 0.91 (95%CI 0.66-1.24), 0.78 (95%CI 0.55-1.089), and 0.57 (95%CI 0.39-0.84, p=0.004), respectively. At a median follow-up of 5.1 years, disease relapse in normal weight, overweight and obese pts using E occurred in 14.8%, 15.1% and 15.1%, respectively; and in pts using T in 17.0%, 16.9%, and 18.3%, respectively. Regarding DFS, the HR in normal weight, overweight, and obese pts was 0.87 (95%CI 0.69-1.10), 0.88 (95%CI 0.70-1.11), and 0.75 (95%CI 0.56-1.01, p=0.058), respectively, and with respect to OS 0.87 (95%CI 0.65-1.15, p= 0.32), 0.89 (95%CI 0.67-1.18, p= 0.43), and 0.71 (95% CI 0.51-1.01, p= 0.053), respectively. Conclusions: After 2.75 years more disease events were observed in obese women using tamoxifen, which was not seen in obese exemestane users, whereas at 5 years these differences in disease recurrences disappeared in this group. In contrast to recent reports, there seems to be a difference regarding the influence of a high BMI on recurrence rate between tamoxifen and the aromatase inhibitor exemestane. Further research on this topic is warranted. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr S2-3.
USE OF SODIUM AMYTAL IN STRYCHNINE POISONING
Authors: Bryan C. Fenton
Journal: JAMA (1933)

<h3>To the Editor:</h3> —In a recent edition ofThe JournalI read with interest an article regarding the intravenous use of sodium amytal in the treatment of strychnine poisoning. In the past week I have had the opportunity to put this new treatment into practice with favorable results. I was called to see a man, aged 33, who had taken what I estimated to be 15 grains (1 Gm.) of strychnine sulphate crystals about two hours before my arrival. I base my estimate as to the amount on the fact that the bottle containing the remaining strychnine was one-half empty, the full bottle having contained one-sixteenth ounce, and according to the man's wife, who was present, he had consumed this amount. The patient when first seen was lying quiet but in a few seconds a typical strychnine spasm manifested itself. The position was that of opisthotonos, the spasm lasting for
Birth Size Distribution in 3,705 Infants Born to Mothers With Type 1 Diabetes
Authors: Martina Persson, Dharmintra Pasupathy, Ulf Hanson, Mikael Norman
Journal: Diabetes Care (2011)

To characterize birth size distribution in infants born to mothers with type 1 diabetes. In particular, the relationship between birth weight (BW) and length (BL) was studied because it may provide information on different causal pathways of fetal macrosomia commonly seen in diabetic pregnancies.This was a population-based cohort study of 3,705 infants of type 1 diabetic mothers (1,876 boys), with a gestational age of 28-43 weeks, born in Sweden between 1998 and 2007. BW and BL were retrieved from the Medical Birth Registry and expressed as SD scores (SDS). Ponderal index (PI) was calculated as BW in g/length in cm³. A BW >90th and a PI ≤ 90th percentile was defined as proportionate large-for-gestational age (LGA), whereas if both BW and PI > 90th percentile, the infant was categorized as disproportionately large. Values are mean (SD).The BW distribution for offspring of type 1 diabetic mothers was bell-shaped, significantly broader, and markedly shifted to the right (BWSDS: 1.27 [1.48]) of the reference. Of the infants born to diabetic mothers, 47% were LGA, and among them, 46% were disproportionately large compared with 35% in nondiabetic LGA infants (P < 0.001). Female offspring of type 1 diabetic mothers had significantly higher BWSDS than males (1.34 vs. 1.20, P < 0.01), and preterm infants had higher BWSDS than term infants (1.41 vs. 1.23, P < 0.01)Fetal macrosomia in type 1 diabetic pregnancies is due to a right-shift and broadening of the entire BW distribution. The large number of disproportionate LGA infants born to type 1 diabetic mothers suggests an underlying metabolic problem. Fetal macrosomia was more pronounced in preterm and female offspring of type 1 diabetic mothers.
Tablets often contain substances in addition to, or instead of, ecstasy..
Authors: A. R Winstock, L. A King
Journal: BMJ (1996)

Ecstasy and neurodegenerationAdvice is that "less is more" EDITOR,-A Richard Green and Guy M Good- win rightly point out that the risk of long term consequences of neurodegeneration associated with the use of ecstasy (3,4-methylene- dioxymethamphetamine) may be greater than the risk of death from acute toxicity.'Having reviewed the compelling evidence linking ecstasy with neurotoxicity in animals, they omit what is perhaps the strongest indication of neurotoxicity in humans.A universal finding of descriptive studies of users of ecstasy is that the first ecstasy tablet is the best and that with subsequent use the desired effects decline and side effects increase.24As ecstasy is pharmacologically active for only a few hours and even frequent users usually limit their use to weekends, neurotoxicity seems a more likely explanation than tolerance through neu- roadaptation.Even newsgroups on the Internet that promote the use of ecstasy are now debating not whether it causes serotoninergic nerve cell damage but whether the result is detrimental, inconsequential, or even beneficial, with general advice to users being that "less is more" and "more than one tablet once a month is an overdose."
Intense FDG Uptake in a Benign Hurthle Cell Adenoma
Authors: Eric M. Rohren
Journal: Clinical Nuclear Medicine (2004)

A 74-year-old man had an 8-mm pulmonary nodule detected as part of a chest computed tomography (CT) screening trial and was referred for positron emission tomography using 2-[F-18]-2-deoxy-D-glucose (FDG-PET). Imaging was performed on a PET/CT scanner (GE Medical Systems, Milwaukee, WI). Although the patient's pulmonary nodule was only minimally FDG-avid, there was a focus of intense FDG activity at the base of the neck anteriorly. PET/CT fusion images localized this uptake to the right lobe of the thyroid gland. Because of concern for an occult thyroid carcinoma, a thyroid ultrasound was performed, confirming a solid and vascular thyroid nodule. A fine-needle aspirate performed at the time of ultrasound revealed Hurthle cell neoplasm. Subsequent right thyroid lobectomy revealed a Hurthle cell adenoma.
THE SHEPPARD-TOWNER ACT IN RELATION TO PUBLIC HEALTH
Authors: ANNA E. RUDE
Journal: JAMA (1922)

The Sheppard-Towner act provides for the current fiscal year (1922) $10,000 for each state accepting the provisions of the act, and an additional sum of $1,000,000.Of this additional amount, not more than $50,000 is to be used for federal administration, and the remainder is to be apportioned to the states and granted if matched dollar for dollar by state appropria- tions\p=m-\$5,000to each state, the remainder to be appor- tioned on the basis of population.After the present fiscal year the authorized annual expenditure is $5,000 unmatched to each state and, to be matched dollar for dollar, an additional $5,000 plus a prorated amount of the remaining $710,000 of the additional $1,000,000, after a maximum of $50,000 has been deducted for federal administration.
Caloric restriction as a mechanism mediating resistance to environmental disease.
Authors: L T Frame, R W Hart, J E Leakey
Journal: Environmental Health Perspectives (1998)

It has been observed that susceptibility to many degenerative diseases increases concurrently with industrialization and rising living standards. Although epidemiologic studies suggest that specific environmental and dietary factors may be important, caloric intake alone (as reflected in body size) may account for much of the differential risk observed among diverse human populations. It has been suggested from animal studies that caloric intake may be the primary effector for many hormonal, metabolic, physiologic, and behavioral responses that coordinate reproductive strategy to apparent availability of food. When caloric intake is excessive, particularly at critical developmental stages, physiologic priorities are set for body growth and fecundity rather than for endurance and longevity. The converse occurs during periods of famine, thus increasing the probability that sufficient individuals survive to restore the population when conditions improve. Calorically restricted rodents have significantly longer reproductive and total life spans than their ad libitum-fed controls and exhibit a spectrum of biochemical and physiologic alterations that characterize their adaptation to reduced intake. These include reduced stature, hypercorticism in the absence of elevated adrenocorticotropic hormone levels, increased metabolic efficiency, decreased mitogenic response coupled with increased rates of apoptosis, reduced inflammatory response, induction of stress proteins and DNA repair enzymes, altered drug-metabolizing enzyme expression, and modified cell-mediated immune function. The overall profile of these changes is one of improved defense against environmental stress. This has been suggested as the mechanistic basis for the protective effects of low body weight on radiation and chemically induced cancers in experimental animals. It may also explain the significantly higher thresholds of acute toxicity observed when calorically restricted rodents are exposed to certain test compounds.
Aphorisms and Facetiae of Bela Schick
Authors: G. Dunea
Journal: BMJ (2008)

“Meetings are for meeting people—the scientific sessions are of secondary importance,” declared the professor to his retinue, commenting on an issue rekindled in recent years by the advent of video teleconferencing. On another occasion he wistfully reflected: “After 20 years one is no longer quoted in the medical literature. Every 20 years one sees a republication of the same ideas.”

The professor, Bela Schick, was born in Hungary, studied in Austria, and from 1923 to 1942 was director of paediatrics at Mount Sinai Hospital in New York. At his retirement he suggested that every chief should have a dog and leave …
Endoscopic Mucosal Resection in the Esophagus with a New Rigid Device: an Animal Study
Authors: A. Radu, P. Grosjean, C. Fontolliet, P. Monnier
Journal: Endoscopy (2004)

: There is a growing trend toward the use of minimally invasive endoscopic methods to treat early esophageal cancers. Although there is continuing controversy regarding the management of Barrett's esophagus and the value of surveillance programs continues to be debated, the ultimate goal is to eradicate all of the foci of intestinal metaplasia and hence the risk of developing an adenocarcinoma. A number of ablative techniques have so far been applied, but none has yet been shown to be superior and entirely satisfactory. The present study evaluates the feasibility, efficacy, and safety of a promising new method of endoscopic mucosal resection (EMR) in a sheep model, based on the use of a modified rigid esophagoscope.The resectoscope consists of a rigid esophagoscope with a distal transparent window through which the mucosa and part of the submucosa are sucked in and then resected with a wire loop. The sheep model was chosen because of its similarities to human anatomy with regard to the thickness and histological structure of the esophagus. Fifty-five separate hemicircumferential resections and 11 circumferential resections were carried out in 21 and 11 animals, respectively. Mitomycin C, an agent inhibiting fibroblast proliferation, was administered at different time intervals after eight circumferential resections to prevent the development of esophageal strictures.All of the specimens of hemicircumferential resections were obtained as single distinct pieces and were easily examined histologically. The surface of the specimen correlated with the size of the window and ranged from 6 to 12 cm (2). In circumferential resections, the specimens were obtained in two pieces. An accurate resection depth through the submucosa was achieved in 58 of 65 resected specimens. No complications occurred after hemicircumferential resections. Complications after circumferential resections (stenosis or perforation, or both) were minimized after appropriate timing of mitomycin C administration.This EMR method offers a promising approach in comparison with other options currently available. It appears to be superior in terms of the size of the resected specimen, the precision and regularity of the resection depth, and the accuracy of histological diagnosis with safety margins. Hemicircumferential EMRs have been shown to be safe in the sheep model. This new technique warrants further animal studies before being used for circumferential EMR in humans.
The Country Doctor on the Maine Coast
Authors: Mary Ellen Chase
Journal: New England Journal of Medicine (1948)

MOST persons in my profession, which is the teaching of English Literature, cherish a devotion to the ancient Greeks of the fifth century B.C., that golden age of poetry and drama. I share that devotion. My freshmen at Smith College always read with me a play or two of Euripides or of Sophocles, and I take great pleasure in reading to them the Apology, the Crito and the Phaedo of Plato so that they may know at least something about the life, the noble thoughts, and the death of Socrates.But there is one Greek writer of this great . . .
Prediction of Physical Indisposition with the Help of a Questionnaire for Measuring Denial and Overcompensation
Authors: R.W. Trijsburg, J.A. Bal, W.P. Parsowa, R.A.M. Erdman, H.J. Duivenvoorden
Journal: Psychotherapy and Psychosomatics (1989)

A questionnaire for assessing feelings of 'weakness' (the feeling of resentment, dependency, anxiety and vital exhaustion) as well as aggression and activity was presented to two groups of healthy men (n = 202 and 178, respectively). One group underwent self-evaluation by means of questionnaires and an interview. In the other group self-evaluation and evaluation by the partner were measured using questionnaires during two assessments with an interval of 6 months. The construct validity of the scales corresponded to that of an earlier study on acute myocardial infarct (AMI) patients. The reliability (internal consistency) of the scales was less satisfactory compared to the study on AMI patients. The congruent validity of the scales measuring experience of weakness appeared to be good. The method of score comparison for assessing denial of weakness and overcompensation (by means of aggression and activity) turned out to be reasonably valid, at least for the scales measuring weakness. Analysis of the predictive value of the derived scores for denial and overcompensation led to the finding that the men who reported more physical complaints 6 months after completion of the defence list had a higher mean denial score than the men who reported fewer somatic complaints after 6 months. This confirms the hypothesis that denial of one's own emotional condition in the long run leads to an increase in (reporting) somatic complaints.
Home Graduates Only
Authors: M. U. Din
Journal: BMJ (1974)

Two hundred and ten patients with coeliac disease previously reported from this unit were reviewed at the end of 1985 after a further 11 years of follow up. The initial review at the end of 1974 could not demonstrate that a gluten free diet (GFD) prevented these complications, probably because the time on diet was relatively short. The same series has therefore been kept under surveillance with the particular aim of assessing the effects of diet on malignancy after a further prolonged follow up period. Twelve new cancers have occurred: of which one was a carcinoma of the oesophagus and two lymphomas. Thirty nine cancers developed in 38 patients and of 69 deaths, 33 were the result of malignancy. A two-fold relative risk (RR) of cancer was found and was because of an increased risk of cancer of the mouth and pharynx (RR = 9.7, p less than 0.01, 95% confidence interval (CI) = 2.0-28.3), oesophagus (RR = 12.3, p less than 0.01, CI = 2.5-36.5), and of non-Hodgkin9s lymphoma (RR = 42.7, p less than 0.001, CI = 19.6-81.4). The results indicate that for coeliac patients who have taken a GFD for five years or more the risk of developing cancer over all sites is not increased when compared with the general population. The risk is increased, however, in those taking a reduced gluten, or a normal diet, with an excess of cancers of the mouth, pharynx and oesophagus (RR = 22.7, p &lt; 0.001), and also of lymphoma (RR = 77.8, p &lt; 0.001). A significant decreasing trend in the excess morbidity rate over increasing use of a GFD was found. The results are suggestive of a protective role for a GFD against malignancy in coeliac disease and give further support for advising all patients to adhere to a strict GFD for life.
CAN PEMPHIGUS BE PROVOKED BY A BURN?
Authors: T. CHORZELSKI, S. JABLONSKA, E. H. BEUTNER, M. KOWALSKA
Journal: British Journal of Dermatology (2006)

Summary.— The authors describe a case of pemphigus, confirmed histologically (acantholysis) and by immunofluorescence studies (circulating pemphigus autoantibodies in the titre of 1:1280, and in vivo bound immunoglobulins IgG, and complement in the intercellular substance of the epidermis). The symptoms developed 10 months after a burn which refused to heal and involved the site of the burn and other skin areas. The possible connection between the development of pemphigus and the burn is discussed in the light of reports of pemphigus-like antibodies in burns, which normally appear temporarily in some patients and are never bound in vivo.
Single administration of stem cell factor, FLT-3 ligand, megakaryocyte growth and development factor, and interleukin-3 in combination soon after irradiation prevents nonhuman primates from myelosuppression: long-term follow-up of hematopoiesis
Authors: Michel Drouet, Frédéric Mourcin, Nancy Grenier, Valérie Leroux, Josianne Denis, Jean-François Mayol, Philippe Thullier, Jean-Jacques Lataillade, Francis Herodin
Journal: Blood (2003)
Cytoskeletal Protein 4.1R Affects Repolarization and Regulates Calcium Handling in the Heart
Authors: Mark A. Stagg, Edward Carter, Nadia Sohrabi, Urszula Siedlecka, Gopal K. Soppa, Fiona Mead, Narla Mohandas, Pamela Taylor-Harris, Anthony Baines, Pauline Bennett, Magdi H. Yacoub, Jennifer C. Pinder, Cesare M.N. Terracciano
Journal: Circulation Research (2008)

The 4.1 proteins are a family of multifunctional adaptor proteins. They promote the mechanical stability of plasma membranes by interaction with the cytoskeletal proteins spectrin and actin and are required for the cell surface expression of a number of transmembrane proteins. Protein 4.1R is expressed in heart and upregulated in deteriorating human heart failure, but its functional role in myocardium is unknown. To investigate the role of protein 4.1R on myocardial contractility and electrophysiology, we studied 4.1R-deficient (knockout) mice (4.1R KO). ECG analysis revealed reduced heart rate with prolonged Q-T interval in 4.1R KO. No changes in ejection fraction and fractional shortening, assessed by echocardiography, were found. The action potential duration in isolated ventricular myocytes was prolonged in 4.1R KO. Ca(2+) transients were larger and slower to decay in 4.1R KO. The sarcoplasmic reticulum Ca(2+) content and Ca(2+) sparks frequency were increased. The Na(+)/Ca(2+) exchanger current density was reduced in 4.1R KO. The transient inward current inactivation was faster and the persistent Na(+) current density was increased in the 4.1R KO group, with possible effects on action potential duration. Although no major morphological changes were noted, 4.1R KO hearts showed reduced expression of NaV1.5alpha and increased expression of protein 4.1G. Our data indicate an unexpected and novel role for the cytoskeletal protein 4.1R in modulating the functional properties of several cardiac ion transporters with consequences on cardiac electrophysiology and with possible significant roles during normal cardiac function and disease.
The Right Test: A Physician's Guide to Laboratory Medicine
Authors: Donald S. MacNair
Journal: JAMA (1990)

This small text fits neatly into the pocket of a lab coat or suit coat and seems to be designed for everyday use rather than as a library book. There is a table of reference ranges for common laboratory tests on the inside covers. In the introduction, Dr Speicher refers to his 1983Choosing Effective Laboratory Tests, which devotes about 100 pages to the problem-solving approach to medicine. His current work also uses that approach.  The book has 10 chapters, which generally correspond to what were called clinical subproblems in the earlier text. The organization scheme for all chapters is spelled out in the introduction. There are a list of which tests to choose, explanations of how to evaluate the tests, how to interpret positive and negative test results, and how to monitor the patient's disorder, additional abnormal test results, and references. The chapters' titles are Screening, General and Miscellaneous
The Use of Apexcardiography in the Assessment of Left Ventricular Diastolic Pressure
Authors: GUSTAV C. VOIGT, GOTTLIEB C. FRIESINGER
Journal: Circulation (1970)

A total of 58 observations of simultaneous left ventricular pressure and apex-cardiograms (ACG) was made on 18 patients. An a wave percentage amplitude (aWPA) of greater than 15% of the total deflection of the ACG indicated an increase in left ventricular end-diastolic pressure (LVEDP). In 12 observations on six patients, an aWPA of less than 15% was associated with a high LVEDP. Patients with high LVEDP and aWPA of less than 15% had a high early left ventricular diastolic pressure with further rise in pressure prior to atrial contraction. These patients had small LV a waves ("atrial kick"). The aWPA of the ACG correlated better with the magnitude of the LV a wave than the absolute level of LVEDP in all patients. Correlation was good between changes in aWPA and changes in LVEDP in individual patients; but the ACG as an indirect means of evaluating left ventricular function is limited by the fact that elevations in LVEDP can exist in the presence of a normal aWPA. The ACG is a complex tracing reflecting not only intracardiac pressures, but changes in left ventricular volume, compliance, position, and perhaps left atrial function as well.