tbuckley/cabot-search huggingface dataset:
Antimicrobial Resistance for <i>Neisseria gonorrhoeae</i> in the United States, 1988 to 2003: The Spread of Fluoroquinolone Resistance
Authors: Susan A. Wang, Alesia B. Harvey, Susan M. Conner, Akbar A. Zaidi, Joan S. Knapp, William L.H. Whittington, Carlos del Rio, Franklyn N. Judson, King K. Holmes
Journal: Annals of Internal Medicine (2007)

Background: Over the past 60 years, Neisseria gonorrhoeae has acquired clinically significant resistance to sulfonamides, tetracyclines, penicillins, and ciprofloxacin. Objective: To determine U.S. trends in the prevalence of antimicrobial resistance of N. gonorrhoeae from 1988 to 2003. Design: 16-year, multisite, sentinel surveillance for gonococcal isolate susceptibility through the Gonococcal Isolate Surveillance Project (GISP). Setting: Sexually transmitted disease clinics in 37 cities. Patients: Male patients with a total of 82 064 episodes of urethral gonorrhea. Measurements: Primary outcome measures included percentage of gonococcal isolates resistant to antimicrobials used to treat gonorrhea, percentage of patients treated with specific antimicrobials for gonorrhea, and trends of these measures over time. Results: The median age of patients was 26 years, and 74.1% of patients were African American. The proportion of men treated with penicillins for gonorrhea declined from 39.5% in 1988 to 0% in 1994, while the proportion of those receiving fluoroquinolone treatment increased from 0% in 1988 to 42.0% in 2003. Penicillin resistance peaked at 19.6% in 1991, then declined to 6.5% in 2003. Tetracycline resistance peaked at 25.8% in 1997 and declined to 14.4% in 2003. The first fluoroquinolone-resistant isolate was found in 1991. Nationally, 0.4% of isolates were fluoroquinolone-resistant in 1999 and were identified in 39% of GISP cities. By 2003, 4.1% of isolates were fluoroquinolone-resistant and were identified in 70% of GISP cities. Isolates with decreased susceptibility to ceftriaxone, cefixime, azithromycin, and spectinomycin remained rare. In 2001, 3 multidrug-resistant isolates with decreased susceptibility to cefixime were identified. Limitation: Sentinel surveillance may not fully reflect trends for all patients with gonorrhea in the United States. Conclusions: Prevalence of penicillin resistance has declined in the years since gonorrhea treatment with penicillin was discontinued. Fluoroquinolone-resistant N. gonorrhoeae infections continue to increase at a time when fluoroquinolone use has increased. Ongoing nationwide and local antimicrobial susceptibility monitoring is crucial to ensure appropriate treatment of gonorrhea.
“Who's on First?” — Medical Discoveries and Scientific Priority
Authors: Howard Markel
Journal: New England Journal of Medicine (2004)

One afternoon, a brilliant medical investigator unveiled before an eager crowd of physicians a stunning series of experiments that would revolutionize how they understood the human body. Realizing that he was making medical history, the investigator repeatedly reminded his audience that he was the first to conceive of these earth-shaking ideas. Not content merely to declare his originality, the scientist went to great lengths to disparage those competitors who offered differing medical theories. Calling his intellectual rivals “lazy” and “ignorant,” the scientist exclaimed that his work was “as superfluous to them as a tale told to an ass.”I suspect . . .
PROGNOSTIC SIGNIFICANCE OF MICROVASCULAR OBSTRUCTION AND INFARCT SIZE MEASURED BY CARDIOVASCULAR MAGNETIC RESONANCE FOR THE ASSESSMENT OF LEFT VENTRICULAR REMODELING IN PATIENTS WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION: INSIGHT FROM A POOLED ANALYSIS OF INDIVIDUAL PATIENT DATA
Authors: Matthijs van Kranenburg, Tuncay Yetgin, Olivier Manintveld, Dan Atar, Peter Buser, Edwin Wu, Daniel Lee, Vicente Bodi Peris, Peter Bernhardt, Wolfgang Rottbauer, Ronak Delewi, Eric Boersma, Gabriel Krestin, Felix Zijlstra, Robert van Geuns
Journal: Journal of the American College of Cardiology (2014)
Bone Health in Postmenopausal Women Treated with Adjuvant Aromatase Inhibitors for Early Breast Cancer: 12 Months Follow-Up.
Authors: X. Nogués, S. Servitja, M. Peña, M. Martinez, R. Nadal, L. Garrigos, A. Diez Perez, J. Albanell, I. Tusquets
Journal: Cancer Research (2009)

Abstract Background:The use of aromatase inhibitors (AI) in the adjuvant setting for postmenopausal women with receptor-positive breast cancer is well established. The AI treatment has been associated with decline in bone mineral density (BMD), and increased bone turnover markers. We designed a prospective study to evaluate the effect of oral bisphosphonates (BP) on vertebral and non vertebral fractures (VF), bone turnover markers (bTM), BMD, and quality of life (QoL) in postmenopausal women receiving adjuvant AI for hormone receptor positive early breast cancer.Material and methods:Postmenopausal, receptor-positive breast cancer women treated with AI as initial therapy [Letrozol (LET)] or after 2 or 5 years of tamoxifen [switched to exemestane (EXE)] were included. Patients were stratified by lumbar spine, femoral neck and total hip BMD to receive open-label treatment with BP, alendronate or risedronate, (if osteoporosis [T-score&amp;lt;-2,5] or osteopenia [T-score&amp;lt;-2.0] and 1 major risk factor, defined as group of high risk of fracture) or calcium and vitamin D supplementation (if normal BMD or T-score&amp;gt;-2.0 and no major risk factor). Levels of 25-OH vitamin D, N-telopeptide (NTx), bone alkaline phosphatase (bALP) and osteocalcin (OC) were measured at baseline, 3, 12 and 24 moths, and BMD and thoracic and lumbar spine X-rays were assesed at baseline, 1 and 2 years. QoL was evaluated by ECOS-16 questionnaire and a visual analogue scale used to evaluate arthralgia. Results:from 03/2006 to 03/2009, 261 patients have been included and 117 have completed &amp;gt;12 month follow up. All the bTM increased after 12 months of AI treatment and a significant decrease on BMD was also observed (Table 1). This effect is reverted with oral BP treatment, maintaining the BMD level and reducing the bTM. With the AI introduction QoL of patients became worse, and the BP treatment did not improve neither arthralgia nor bone pain. Osteoporotic fractures were recorded at baseline in 12.3% of women (4.2% VF and 7.7% non VF).Conclusions:AI treatment increased bone turnover, decreased BMD and QoL. Of note, BP use decreased bone turnover, has neutral effect in BMD and does not improve QoL. This study suggests that the current recommendation of the use of BP should be revisited to consider including all postmenopausal women treated with adjuvant AI to avoid increased bone turnover and bone mass decrease.Table 1. BMD at baseline, 12 months and changes Without BP (n=76) With BP (n=41) BMD value (g/cm2)AIBasal12 month% change / pBasal12 month% change / pFemoral NeckLET0.7650.751- 1.96 / 0.020.6480.657+ 1.61 / NS EXE0.7560.749- 0.6 / NS0.6260.644+ 2.63 / 0.013Lumbar spineLET0.9900.969- 2.36 / 0.00010.8150.813- 0.17 / NS EXE0.9570.940- 1.57 / 0.0430.8110.814+ 0.86 / NS Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3175.
Examination of the Role of Cigarette Smoke in Lung Carcinogenesis Using Multistage Models1
Authors: M. Gaffney, B. Altshuler
Journal: JNCI Journal of the National Cancer Institute (1988)

The widely used multistage model of Armitage and Doll is fit to the British physician lung cancer data of Doll and Hill under the assumption that cigarette smoke induces the initial and penultimate changes. It is shown that the best fit of this model in continuing smokers gives predictions not in accordance with incidence in ex-smokers and dose-response. A better global fit can be obtained by increasing the number of stages, but this de-emphasizes initiation and is inconsistent with the rise of incidence in nonsmokers. Thus, one should look to other models. A two-stage model with clonal growth in which smoking initiates normal target cells and promotes the clonal growth of just the smoke-initiated cells is proposed. This model is shown to agree with the Doll and Hill data and thus it has empirical plausibility that should encourage biological studies of clonal growth in carcinogenesis.
STUDIES IN INTRAVASCULAR COAGULATION. III. THE PATHOGENESIS OF SERUM-INDUCED VENOUS THROMBOSIS 12
Authors: Stanford Wessler, Kathleen Ward, Carol Ho
Journal: Journal of Clinical Investigation (1955)

The mechanisms involved in the initiation, prop- agation, and dissemination of intravascular clots remain obscure.The identification of each new clotting factor has raised the possibility that ab- normalities in these factors might be found among patients with thromboembolism.Data have yet to be presented, however, demonstrating a causal relationship between intravascular thrombosis and an alteration in any of these clotting factors.Our efforts to uncover such a relationship proceeded from two observations.One was the impressive evidence that stasis plays an important role in the development of intravascular clotting.The other was the significant fact first established by Alex- ander, deVries, and Goldstein (1) and later con- firmed by Owren (2) and Koller, Loeliger, and Duckert (3) that there is normally present in hu- man serum a stable factor which accelerates pro- thrombin conversion.This factor has been vari- ously called SPCA, Converting and factor VII.It has been repeatedly stated that blood stag- nating in a vein included between two ligatures will remain liquid for weeks (4, 5).We have found, however, that although clot formation was never observed in such vein segments of dogs within 20 minutes of their isolation, fibrin clots XThis study was supported by the Medical Research and Development Board, Office of the Surgeon General, Department of the
Researcher didn't get ethical approval for 68 studies, investigators say
Authors: C. Dyer
Journal: BMJ (2011)

Joachim Boldt, a German anaesthetist who published widely, failed to obtain ethical approval for much of his research, show the preliminary results of an investigation by the medical association of the Rheinland-Palatinate.

The findings were given in a joint statement on 4 February by the editors in chief of 11 major journals that carried Professor Boldt’s work, published on the website of each journal.

One of the journals is Anesthesia and Analgesia , which in October 2010 retracted an article by him that compared the use of a high dose balanced hydroxyethyl starch preparation with an albumin based regimen as a priming solution for cardiopulmonary bypass ( BMJ 2010;341:c7026, …
GAS6 expression identifies high-risk adult AML patients: potential implications for therapy
Authors: S P Whitman, J Kohlschmidt, K Maharry, S Volinia, K Mrózek, D Nicolet, S Schwind, H Becker, K H Metzeler, J H Mendler, A-K Eisfeld, A J Carroll, B L Powell, T H Carter, M R Baer, J E Kolitz, I-K Park, R M Stone, M A Caligiuri, G Marcucci, C D Bloomfield
Journal: Leukemia (2013)
Review of drug subsidy scheme delayed as test case looms
Authors: Bob Burton
Journal: BMJ (2006)

A review of the pharmaceuticals provisions of the Australia-United States free trade agreement has been deferred until after the announcement of the outcome of a landmark appeal. 

The appeal by Eli Lilly Australia against the decision not to include the osteoporosis drug teriparatide (Forteo) in the Australian government's Pharmaceutical Benefits Scheme will be decided upon by an independent reviewer and is expected early next year. 

The decision is seen by the drug industry as a test case on the effectiveness of concessions won when the agreement was concluded in 2004 ( BMJ 2004;328:604). On four occasions, the company's …
Incidence, Risk Factors, and Outcome of Traumatic Tricuspid Regurgitation After Percutaneous Ventricular Lead Removal
Authors: Frédéric Franceschi, Franck Thuny, Roch Giorgi, Islem Sanaa, Eric Peyrouse, Xavier Assouan, Sébastien Prévôt, Emilie Bastard, Gilbert Habib, Jean-Claude Deharo
Journal: Journal of the American College of Cardiology (2009)
Atopic disease and dermatitis herpetiformis
Authors: M.G. DAVIES, R. FIFIELD, R. MARKS
Journal: British Journal of Dermatology (1979)

Patients with dermatitis herpetiformis were found to have an increased incidence of atopic disorders compared to an age and sex matched control group. The increase in incidence was statistically significant for atopic eczema and any atopic disorder. Serum immunoglobulins (including IgE) were estimated in forty-five dermatitis herpetiformis patients and no significant abnormalities were found.
Academic medicine: time for reinvention: Academic research should wind down, not up
Authors: D. P Kernick
Journal: BMJ (2004)

Editor—Clark and Smith announce a crisis in academic medicine and call for an international campaign to re-establish its credentials.1 This assertive policy marks a turning point for a discipline that has to date adopted a defensive posture in the developing healthcare environment.2

Unlike healthcare research, where the impact on service delivery has been minimal, research in academic medicine has delivered many important innovations. But, unfortunately, academic research still reflects a store in which researchers are busy filling shelves with a comprehensive set of all possible relevant studies that a decision maker might some day drop by to purchase.3 The endeavour is characterised by a voluminous literature, invariably driven by the dictates of funding spirals and accreditation exercises and, in many cases, irrelevant to the efficient production of health against a background of limited public resources.​resources.




Figure 1



Credit: ST BARTHOLOMEW'S/SPL




This retail perspective on research overlooks two important economic insights.

Firstly, life is lived on an exponential curve. The law of diminishing marginal returns means that increments in benefit become smaller with additional increments of resource allocation. As the pharmaceutical sector is beginning to discover, the flat portion of the curve may have been reached in medical research.

Secondly, the principle of opportunity costs means that an investment should be valued in terms of its next best opportunity forgone. Although medical science has had many spectacular successes, its contribution is secondary when compared with behavioural and environmental factors.4,5

The resources that Smith and Clark argue for so passionately may produce greater health gain if diverted into areas other than health care. We need to start winding down investment in academic medicine, not talking it up.
Treating asthma in preschool children.
Authors: J. O. Warner
Journal: BMJ (1988)

which the statutory dose limit (equivalent to 50 mGy in a year) is rarely exceeded.In a survey ofBritish exposures the highest dose rate in any exposed medical staff was 23 mGy a year, corresponding to 4 mGy in the most sensitive eight week period if the radiation was received at a constant rate during a pregnancy.'
S65 Interim data from a randomised controlled trial of average volume-assured pressure support (AVAPS) versus spontaneous-timed (ST) pressure support in Obesity Hypoventilation Syndrome (OHS)
Authors: P. Murphy, A. C. Davidson, A. J. Williams, J. Moxham, A. Simonds, M. Hind, M. I. Polkey, N. Hart
Journal: Thorax (2010)

<h3>Introduction</h3> The obesity epidemic is leading to an increase in respiratory morbidity including sleep disordered breathing (SDB). The optimal ventilatory strategy in OHS is yet to be characterised. Changes in the respiratory system compliance through sleep and positional variations could compromise the effectiveness of fixed level pressure support thus the idea of varying pressure support to maintain tidal volume is appealing. Published data show improvements in nocturnal control of SDB in OHS using AVAPS mode ventilation (Storre <i>et al</i>, 2006) but also concerns regarding sleep fragmentation (Janssens <i>et al</i>, 2009). Data from these studies have been difficult to interpret as patient set up has not been set out to minimise the differences between modes. <h3>Method</h3> Consecutive patients admitted for setup of domiciliary NIV were randomised to either ST or AVAPS mode (BiPAP Synchrony, Philips-Respironics, Murrysville, USA). NIV was titrated to improve nocturnal oximetry-capnometry using a standard setup protocol. Patients had baseline investigations including anthropometrics, health related quality of life and gas exchange. A subset of patients had sleep disruption monitored via actigraphy (AW64, Philips-Respironics, Murrysville, USA) in the week following discharge. <h3>Results</h3> 50 patients were enrolled, mean age 55±11 years, 53% male, BMI 50±7 kg/m<sup>2</sup>, PaCO<sub>2</sub> 6.85±0.81 kPa, PaO<sub>2</sub> 8.91±1.55 kPa, ESS 12±6 with preliminary data available at 6 weeks for 43 patients, 13 were initiated acutely and 30 were elective admissions. No significant between group differences (Abstract S65 Table 1). Actigraphy analysis (AVAPS n=16, ST n=17) during 1st week of NIV showed total sleep time of 347±80 min in AVAPS and 348±78 min in ST with sleep efficiency of 81±6% in AVAPS and 79±12% in ST. Arterial blood gas analysis at 6 weeks showed no between group differences. However, significant improvement occurred in PaCO<sub>2</sub> in AVAPS patients, mean difference 0.63 kPa (p=0.013), that did not reach significance in ST, mean difference 0.55 kPa (p=0.053). <h3>Conclusion</h3> The preliminary data indicate no significant sleep disruptive effect of AVAPS mode compared to ST following initiation of NIV for OHS. There was no clinically significant difference between groups in the primary outcome of change in PaCO<sub>2</sub>, although there was only a significant fall in PaCO<sub>2</sub> in the AVAPS group. 3 months data are awaited.
Abstract 1110: Colorectal liver metastases induce a systemic phase shift of the biological clock
Authors: Sander A. Huisman, F. Tamanini, A. Ahmadi, J.N.M. IJzermans, G.T.J. van der Horst, R.W.F. de Bruin
Journal: Cancer Research (2014)

Abstract Circadian clock genes drive cyclic expression of 10-15% of the transcriptome. Disruption of the circadian clock may deregulate the cell's normal functions and can lead to carcinogenesis, indicating that clock genes also act as tumor suppressor genes. In previous work, we have shown that circadian rhythmicity is disrupted in C26 colon carcinoma cell-derived hepatic metastases, as compared to the non-cancerous tissue of the liver. It has been suggested that neoplastic tissue can influence the circadian clock of adjacent tissues, causing a tissue specific phase shift. A better understanding of how tumors affect the circadian system may help elucidate the role of the clock in cancer patients suffering from fatigue and sleep disorders. Therefore, we have examined the circadian clock in liver and kidney tissue of mice carrying hepatic C26 colon carcinoma cell metastases. Male BALB/c mice were divided into two groups. In group 1, hepatic metastases were induced by injecting C26 colorectal carcinoma cells into the spleen. Group 2 was sham operated. Three weeks after (sham) surgery, animals were sacrificed over a 24-hour period (6 time points, n=4 per time point) and liver and kidneys were collected to compare circadian rhythmicity in control and tumor bearing animals. RNA was isolated and qRT-PCR was performed to determine the expression levels of 5 clock genes (Rev-Erbα, Per1, Per2, Bmal1, Cry1) and 3 clock controlled genes (Dbp, p21 and Wee1). Liver and kidney tissue of healthy control mice showed normal 24-hour oscillations of all clock genes, consistent with normal circadian rhythmicity. Liver and kidney tissue of tumor-bearing mice, as compared to control mice, showed a marked phase difference in clock rhythms. In the liver we observed a 4-hour phase advance for Bmal1, Rev-Erbα and Dbp. In contrast in the kidney, there was a 4-hour phase delay for Bmal1, Rev-Erbα, Cry1 and DBP, and a 8 hour delay for Per2. These data show that colorectal liver metastases induce a phase advance in the liver, and a phase delay in the kidney . This suggests a systemic effect of the tumor on peripheral clocks. This difference in clock phase between tumor-bearing mice and healthy controls may provide new clues to further understand the role of the clock for fatigue and sleep problems in cancer patients, but may also give opportunities to administer chemotherapeutic treatment in a chronotherapeutical setting . Citation Format: Sander A. Huisman, F. Tamanini, A. Ahmadi, J.N.M. IJzermans, G.T.J. van der Horst, R.W.F. de Bruin. Colorectal liver metastases induce a systemic phase shift of the biological clock. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1110. doi:10.1158/1538-7445.AM2014-1110
The Complexities of Compassion in Patient Care
Authors: Teresa Gilewski
Journal: JAMA Oncology (2015)

Kimberson Tanco, MD; Wadih Rhondali, MD; Pedro Perez-Cruz, MD; Silvia Tanzi, MD; Gary B. Chisholm, MS; Walter Baile, MD; Susan Frisbee-Hume, RN, MS, CCRC, OCN; Janet Williams, MPH, CCRP; Charles Masino, BA, MS; Hilda Cantu, BS; Amy Sisson, MS, MLS; Joseph Arthur, MD; Eduardo Bruera, MD
Respiratory disease in cork workers (`suberosis')
Authors: J. C. Pimentel, R. Avila
Journal: Thorax (1973)

<b>Pimentel, J. Cortez, and Avila, Ramiro (1973).</b><i>Thorax</i>, <b>28</b>, 409-423. <b>Respiratory disease in cork workers (`suberosis9).</b> A clinical, immunological, and histological study of 63 workers in the cork industry with bronchopulmonary manifestations is described. From this study, it was possible to recognize three types of reaction to the inhalation of cork dust: asthma-like syndromes, extrinsic allergic alveolitis, and chronic bronchitis with bronchiectasis. The place of histological (lung biopsy and scalene node biopsy) and immunological methods in the diagnosis of these different forms of the disease is evaluated. The high incidence of precipitins to <i>Penicillium frequentans</i> is stressed because the antigens produced by this fungus seem to be more pathogenic than those produced by the mouldy cork itself. The histological studies have demonstrated extrapulmonary foci of disease and have also revealed for the first time, abnormalities in the lungs of symptomless subjects. Pathological changes present in the lungs of patients with the chronic form of extrinsic allergic alveolitis, long after removal from exposure to cork dust, are also described. The experimental material of Horta and Cancella (1956) is reviewed in the light of present knowledge, and the similarity between the lesions produced in animals and those found in cork workers is noted. Finally, especial importance is attached to the finding of cork dust within the lesions, the technique for its identification and staining being described.