tbuckley/cabot-search huggingface dataset:
Hormone replacement therapy in cancer survivors: a con opinion
Authors: C. D. Runowicz
Journal: CA A Cancer Journal for Clinicians (1996)

In patients with hormonally sensitive tumors, estrogen replacement therapy carries a theoretical risk of stimulating recurrent disease as well as contributing to an increased risk of other hormonally related cancers. In women with hormone-related cancers, it is unknown if their inherently increased risk for other related cancers can be further increased by the administration of hormones. In genetically susceptible animal models, hormones have been shown to promote growth of hormonally sensitive cancers. The uncertainty and potential risk of hormone replacement therapy demonstrates the need for randomized, prospective trials to provide women with a reasonable basis for therapeutic alternatives. The most prudent approach with this population is to consider alternative treatments until the ongoing, randomized clinical trials have been evaluated with adequate longterm follow-up. Until such time, nonhormonal alternatives to manage symptomatic patients should be employed. It is incumbent on physicians to educate themselves and become adept in their use. Diet and exercise will have to be an essential component of the counseling provided to patients following cancer therapy.
Sibling Correlation of Deficit Syndrome in the Irish Study of High-Density Schizophrenia Families
Authors: David E. Ross, Brian Kirkpatrick, Laura M. Karkowski, Richard E. Straub, Charles J. MacLean, F. Anthony O’Neill, Amelia D. Compton, Bernadette Murphy, Dermot Walsh, Kenneth S. Kendler
Journal: American Journal of Psychiatry (2000)

OBJECTIVE: The deficit syndrome is a subtype of schizophrenia characterized by primary and enduring negative features of psychopathology. It appears to reflect a distinct subtype within the syndrome of schizophrenia. Little is known about the familial or genetic aspects of the deficit syndrome. The purpose of this study was to determine whether deficit versus nondeficit subtypes are correlated in sibling pairs affected with schizophrenia.METHOD: The present study was based on the Irish Study of High-Density Schizophrenia Families. From the earlier study the authors selected a subset of patients who were members of sibling pairs in which both siblings had been diagnosed with "core" schizophrenia, which included schizophrenia, simple schizophrenia, and schizoaffective disorder with poor outcome. The Schedule for the Deficit Syndrome was used to make deficit versus nondeficit diagnoses, which were based on chart examinations by reviewers blind to sibling status. This method resulted in 65 patients being diagnosed with the deficit syndrome and 401 patients diagnosed as nondeficit (prevalence=13.9%). This group included 347 full sibling pairs, which were analyzed for resemblance with respect to deficit versus nondeficit subtype by means of logistic regression.RESULTS: Deficit versus nondeficit subtypes were significantly correlated in sibling pairs concordant for core schizophrenia.CONCLUSIONS: Familial factors contribute significantly to whether a person has the deficit subtype of schizophrenia. This familial contribution could be genetic or environmental.
High Numbers of Differentiated Effector CD4 T Cells Are Found in Patients with Cancer and Correlate with Clinical Response after Neoadjuvant Therapy of Breast Cancer
Authors: Isabelle Péguillet, Maud Milder, Delphine Louis, Anne Vincent-Salomon, Thierry Dorval, Sophie Piperno-Neumann, Suzy M. Scholl, Olivier Lantz
Journal: Cancer Research (2014)

CD4(+) T cells influence tumor immunity in complex ways that are not fully understood. In this study, we characterized a population of human differentiated effector CD4(+) T cells that is defined by low levels of the interleukin (IL)-2 and IL-7 receptors (CD25(-)CD127(-)). We found that this cell population expands in patients with various types of cancer, including breast cancer, to represent 2% to 20% of total CD4(+) blood T lymphocytes as compared with only 0.2% to 2% in healthy individuals. Notably, these CD25(-)CD127(-)CD4 T cells expressed effector markers such as CD244 and CD11b with low levels of CD27, contrasting with the memory phenotype dominating this population in healthy individuals. These cells did not cycle in patients, nor did they secrete IL-10 or IL-17, but instead displayed cytotoxic features. Moreover, they encompassed oligoclonal expansions paralleling an expansion of effector CD8(+) T cells that included tumor antigen-specific T cells. During neoadjuvant chemotherapy in patients with breast cancer, we found that the increase in CD25(-)CD127(-) CD4(+) T cells correlated with tumor regression. This observation suggested that CD4(+) T cells included tumor antigen-specific cells, which may be generated by or participate in tumor regressions during chemotherapy. In summary, our results lend support to the hypothesis that CD4(+) T cells are involved in human antitumor responses.
Facial Palsy accompanying Acute Mastoiditis
Authors: K. R. Ogilvie
Journal: BMJ (1946)

Pre-operative facial palsy occurs in about 2% of all cases of otitis media, acute and chronic, but is a much more common complication of chronic or acute-on-chronic otitis media than of acute otitis media ab initio (Kettel').Presumably, therefore,' this complication of acute mastoiditis is colnparatively rare.Apart from the four cases now presented, I have only once previously seen a similar case of facial palsy resulting from an acute mastoiditis, but have met with the condition three times following an exacerbation of chronic otitis media.Reports of Four Cases Case 1.-This patient was a girl aged 51 years.On Sept. 12, 1945,
On the Medicinal Leech: (Sanguisuga Officinalis, Sav.)
Authors: T. Brightwell
Journal: BMJ (1846)

extracted in a more direct line.In this case, through the stone being of a large size, and exceedingly rouglh upon its surface, the extraction was rendered very, difficult, but by gentle and sustained traction it was safely removed.Thje case proceeded favourably, and the patient had, at the date of Mr. May's observations, nearly recovered from the operation.Mr. Field (whose recent retirement from the Society I will here take occasion to notice with regret,) presented a morbid specimen taken frotu a girl who died from wlhat he considered to be acute stricture of the cesophagus, and fromii the history of the synptoms, it would appear that such had been the case.On examination after death, an enlarged tuberculous bronchial gland was discovered lying on the right side of the tracchea, a little above its bifurcation; another longer than this, and also tuberculous, situated imtne- diately below the right bronchus, was so placed that it pressed on the esophagus and closed its canal, which was slightly dilated above this point, and contracted below it, leaving no doubt that death resulted from this cause.A section of one of these tumours disRlayed a nmass of tubercuilouis matter, containing two or three cells filled with pus, and some streaks of carbonaceous matter, the whole being enveloped in a tolerably firmn capsule.The base of the right Ilung contained several small tubercles, one of wvhiielWas rapidly advancing to suppuration.In the course of the discussion wlhich followed, Dr. Cowan tookoccasion to observe, that a tumour simiilar to that of the bronclhial gland existed in the lorver lobe of the lung, while-there wvas no tubercular degenerescence in the uipper lobe, and said lie thouight the case came under what the French called bronchial plhthisis,
Biomarker analysis by tissue microarray technology of Bik, Bcl-2, Bax, ER-α, ER-β, Her2/neu, PCNA, P53, pRB proteins and apoptotic index (by TUNEL) in breast cancer Mexican biopsies.
Authors: N Garcia-Hernandez, D Arenas, B Murillo-Ortiz, A Meneses, D Muñoz, E Ruiz-Garcia, H Astudillo-de la Vega
Journal: Cancer Research (2009)

Abstract Abstract #4043 Background: &amp;#x2028; The development and progression of epithelial cancers are the results of changes in many genetic networks. Through massive analysis techniques various prognostic factors have been studied to determine proteins implicated in cancer. A new technology used is tissue microarray (TMAs), which allows the assessment of several patients at different stages in a single slide.&amp;#x2028; Methods:&amp;#x2028; TMA blocks with up to 128 cylinders were made by using 1.5-mm diameter tissue cores from each paraffin block. In a series of 70 formalin-fixed carcinomas, we analyzed the immuno-expression of Bik, Bcl-2, Bax, ER-α, ER-β, Her2, PCNA, P53 and RB proteins. For apoptosis detection the TUNEL technique was used. Expression profiles for these tumors were generated with an unsupervised clustering and a T Test analysis.&amp;#x2028; Results:&amp;#x2028; We developed TMAs with samples from Mexican women with breast cancer at different stages (type I, II and III) and compared these with those of non affected breast tissue of the same women's samples. Through a hierarchical cluster we found three subgroups of tumors according to protein expression behavior. The apoptotic process was found in low grade 4.28%; moderate grade 90% and high grade 5.71% of samples. Statistical analysis revealed that Bax gene (p=0.000) expression was significantly increased in samples stage I and underexpressed in samples stage IIIA. The Bcl-2 gene was under-expressed in the majority of samples of the stage II. Even when the Bik gene was detected the protein level was over-expressed in 44.29% of the cases with noa significant correlation with apoptosis (TUNEL) (p=0.006). The samples where there were more alterations of the studied proteins were understood in the stages IIA (T2N0M0) and IIB (T2N1M0).&amp;#x2028; &amp;#x2028; Conclusions:&amp;#x2028; The analysis of specimens of several patients in different stages of the disease turns out to be useful to establish a better diagnosis and prognosis. Differential regulation of these genes, especially Bik and Bax, may contribute to the biological nature of a clinically more aggressive and highly proliferative breast cancers. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4043.
Blood to brain to the rescue
Authors: Richard L. Proia, Yun-Ping Wu
Journal: Journal of Clinical Investigation (2004)

Neurodegeneration occurs in the majority of the more than 40 known lysosomal storage diseases. Since the nervous system in these disorders can be globally affected, effective treatment would require persistent widespread correction. Biffi et al. show such correction is possible in a mouse model of metachromatic leukodystrophy by the transplantation of hematopoietic cells genetically modified to overexpress the missing lysosomal enzyme. The results reveal a nervous system damage-response pathway that can be harnessed to provide therapy to the nervous system in these serious disorders.
Lords recommend “passive immunisation” if bird flu reaches UK
Authors: Michael Day
Journal: BMJ (2006)

In the event of an avian influenza pandemic, doctors may have to collect and pool antibodies from the blood of survivors to treat the seriously ill, says a House of Lords science and technology committee report. Such “passive immunisation” might also slow the spread of infection while the world waits anxiously for a pandemic vaccine, said Lord May, a committee member and former government chief scientific adviser, at the launch of the report on 15 December.

But prompt use of this makeshift vaccination would require ministers to relax the rules on blood products designed to protect the public …
Prevalence and Risk Factors of Bisphosphonate-Associated Osteonecrosis of the Jaw in Prostate Cancer Patients with Advanced Disease Treated with Zoledronate
Authors: Christian Walter, Bilal Al-Nawas, Knut A. Grötz, Christian Thomas, Joachim W. Thüroff, Viktoria Zinser, Heinold Gamm, Joachim Beck, Wilfried Wagner
Journal: European Urology (2008)
Learning from low income countries: Thalassaemia screening in Iran provides evidence for programme in Lancashire
Authors: Peter Elton
Journal: BMJ (2005)

Learning from low income countries Experience in low income countries should count towards specialist registrar trainingEditor-Richards and Tumwine ask for discussion on the subject of poor countries making the best teachers. 1When will the postgraduate tutors and royal colleges recognise that medical experience in developing countries should be counted towards specialist registrar training?I recently spoke to a specialist registrar whose 12 months in the main teaching hospital in Malawi counted for nothing towards his training.As a specialist registrar training in chest medicine, he will have seen more tuberculosis than most chest physicians working in provincial England will see in a lifetime.This is particularly frustrating as the numbers of cases of tuberculosis are rising progressively in the United Kingdom, and training in the diagnosis and management of this disease needs to be improved as much as possible.
Modification of Therapy From Insulin to Chlorpropamide Decreases HDL Cholesterol in Patients With Non-Insulin-Dependent Diabetes Mellitus
Authors: James K Schmitt, Karen Harriman, Joel R Poole
Journal: Diabetes Care (1987)

In 27 patients with non-insulin-dependent diabetes mellitus, we determined fasting serum glucose, hemoglobin A,, body weight, serum triglycerides, cholesterol, low-density lipoprotein cholesterol (LDL-chol), high-density lipoprotein cholesterol (HDL-chol), and very-low-density lipoprotein cholesterol during treatment with insulin and several months after changing treatment to chlorpropamide. In five patients, diabetic control deteriorated to the point where insulin was reinitiated. In the remaining 22 patients, despite a significant decrease in weight (122 ± 5 vs. 114 ± 5% ideal body wt; P &amp;lt; .025) on chlorpropamide, HDL-chol fell from 49 ± 4 to 40 ± 4 mg/dl (P &amp;lt; .01) when therapy was modified from insulin to the sulfonylurea. There was a concomitant increase in LDL-chol:HDL-chol from 3.6 ± 0.3 to 4.4 ± 0.5 (P &amp;lt; .05). In the 5 patients in whom insulin was reinstituted, HDL-chol increased to its previous level on insulin (P &amp;lt; .05). Changing antidiabetic medication from insulin to sulfonylureas may alter the lipoproteins in a manner that increases cardiovascular risk.
388 Race, insulin resistance, visceral adiposity and hepatic steatosis in genotype 1 patients with chronic hepatitis C
Authors: H CONJEEVARAM, D KLEINER, N AFDHAL, R BROWN, M FRIED, C HOWELL, L JEFFERS, N TERRAULT, T WILEY, C CHERRY
Journal: Hepatology (2003)

Fatigue is the most frequent and often debilitating symptom of chronic hepatitis C. It is unclear whether successful therapy of hepatitis C leads to its clinical improvement. In the Virahep-C study, patients with hepatitis C virus (HCV) genotype 1 infection were treated with peginterferon alfa-2a and ribavirin for up to 48 weeks while undergoing assessment of viral kinetics and clinical symptoms.Fatigue measurements were conducted, before, during and after therapy, as ‘presence’ (yes/no) and ‘severity’ (visual analog scale: 0–100 mm). The clinical, histologic, and virologic features that correlated with the presence and degree of fatigue were assessed focusing upon changes associated with sustained virological response (SVR).At baseline, 52% (n = 401) of participants reported having fatigue, which was more common in women than men (59% vs. 48%, p = 0.02) and slightly more severe (30 vs. 22 mm, p = 0.056). Fatigue was frequent and worse in cirrhotics versus those with lesser fibrosis (66% vs. 49%; 34 vs. 24 mm). Fatigue did not correlate with other parameters. The proportion of patients and median fatigue scores increased on treatment (52–78%; 25–40 mm, p <0.0001) with higher fatigue noted amongst those who ultimately achieved SVR (p <0.0001). On achieving SVR, there was a significant decrease in both frequency and severity of fatigue compared to their baseline (53–33%; 27–13 mm, both p <0.0001).Fatigue is common in patients with chronic hepatitis C but is poorly associated with biochemical parameters. Sustained response is accompanied by substantial improvement of fatigue.
Restraints in Use of Statistics
Authors: Jack R. Harnes
Journal: JAMA (1978)

<h3>To the Editor.—</h3> The BRIEF REPORT, "Amebiasis: An Increasing Problem Among Homosexuals in New York City" (238:1386, 1977), was a shrewd piece of research that will undoubtedly be of value to many physicians. In an era in which research physicians use statistically significant associations as conclusive evidence of etiologic relations, it is gratifying that the authors did not conclude, as they had every right to do, that overseas travel to areas in which amebiasis is endemic is less frequently undertaken by homosexual men than by heterosexual men.
An anesthetized model of lethal canine galactosamine fulminant hepatic failure
Authors: Timothy D. Sielaff, Michael Y. Hu, Mark D. Rollins, Joseph R. Bloomer, Bruce Amiot, Wei-Shou Hu, Frank B. Cerra
Journal: Hepatology (1995)

A reproducible large animal model of fulminant hepatic failure was developed in the anesthetized dog by the administration of the amino sugar D-galactosamine. Galactosamine in 5% dextrose in water (D5W), was given as an intravenous bolus to 10 young male dogs weighing 27 to 30 kg. Three dogs that received an equal volume of D5W alone served as controls. Galactosamine at 0.5 g/kg (n = 5) produced significant biochemical evidence of liver injury with 100% survival at 48 hours. Galactosamine 1.0 g/kg (n = 5) yielded in 100% 48-hour mortality resulting from fulminant liver failure characterized by a progressive increase in liver enzymes, total bilirubin, ammonia, and lactate and associated coagulopathy, hypoglycemia, coma, and increased intracranial pressure. Necropsy showed liver pallor, ascites, and brain swelling. Liver histology showed significant hepatocellular necrosis. This clinically relevant large animal model will enable the quantitative evaluation of new technologies, such as the bioartificial liver, for the support of hepatic failure in humans.
Expected Rates and Modes of Evolution of Enhancer Sequences
Authors: S. MacArthur
Journal: Molecular Biology and Evolution (2004)

The evolution of new functions takes place partially through changes in the way transcription is controlled. Transcriptional control is brought about by the interactions of transcription factors with short target motifs in the DNAs of promoters and enhancers. One way in which changes in gene expression can evolve is through the acquisition of new transcription factor targets in enhancer sequences. Since such target sites are simple, they can be produced rapidly from random DNA by mutation and selection. Here we consider a population of organisms that finds itself in an ecological situation where bringing a particular target gene under the control of a particular transcription factor would be favored by natural selection. What will be the time required for such a process, as a function of the selection for the new target, the mutation rate, and the population size? The starting sequences considered are either real enhancers from the Drosophila melanogaster genome, or randomized versions of these. We find that the time required to find binding sites is strongly dependent on the existence in the starting sequence of sites that differ from binding sites by single substitutions (presites). The process of converting presites to binding sites is driven by natural selection, and thus the time required typically reduces with the strength of selection. However, if there is a strongly distorted G:C ratio in the starting sequence, presites will typically be absent, and the finding of binding sites will be preceded by a long time period of neutral evolution, however strong is the selection favoring sites. The positions of presites largely determine where binding sites will evolve. One result of this is that any incremental selective benefits that result from the relative positioning of sites have a surprisingly small impact on the final binding-site positions.
Critical Body Weight in Anorexia Nervosa
Authors: Ann Johanson
Journal: New England Journal of Medicine (1974)

Anorexia nervosa is a disorder that has been known to physicians for centuries; yet an understanding of its pathophysiology and successful treatment has been elusive. Studies of the hypothalamic-pituitary axis have demonstrated that pituitary responsiveness to hypothalamic releasing factors and hypothalamic responsiveness to feedback stimuli are normal except that gonadotropin release does not result from clomiphene citrate administration. The latter, with other evidence (abnormal thermoregulatory responses, partial diabetes insipidus and insulin insensitivity1), implicates hypothalamic dysfunction as an integral part of the disease. It is not clear whether this dysfunction is secondary to the malnutrition that results from the disease, . . .
Addressing Alcohol Problems in Primary Care: A Cluster Randomized, Controlled Trial of a Systems Intervention: The Screening and Intervention in Primary Care (SIP) Study
Authors: Richard Saitz, Nicholas J. Horton, Lisa M. Sullivan, Mark A. Moskowitz, Jeffrey H. Samet
Journal: Annals of Internal Medicine (2003)

Background: Screening and intervention for alcohol problems can reduce drinking and its consequences but are often not implemented. Objective: To test whether providing physicians with patients' alcohol screening results and simple individualized recommendations would affect the likelihood of a physician's having a discussion with patients about alcohol during a primary care visit and would affect subsequent alcohol use. Design: Cluster randomized, controlled trial. Setting: Urban academic primary care practice. Participants: 41 faculty and resident primary care physicians and 312 patients with hazardous drinking. Interventions: Providing physicians with alcohol screening results (CAGE questionnaire responses, alcohol consumption, and readiness to change) and recommendations for their patients at a visit. Measurements: Patient self-report of discussions about alcohol use immediately after the physician visit and alcohol use 6 months later. Results: Of 312 patients, 240 visited faculty physicians, 301 (97%) completed the outcome assessment after the office visit, and 236 (76%) were followed for 6 months. Faculty physicians in the intervention group tended to be more likely than faculty physicians in the control group to give patients advice about drinking (adjusted proportion, 64% [95% CI, 47% to 79%] vs. 42% [CI, 33% to 53%]) and to discuss problems associated with alcohol use (74% [CI, 59% to 85%] vs. 51% [CI, 39% to 62%]). Resident physicians' advice and discussions did not differ between groups. Six months later, patients who saw resident physicians in the intervention group had fewer drinks per drinking day (adjusted mean number of drinks, 3.8 [CI, 1.9 to 5.7] versus 11.6 [CI, 5.4 to 17.7]). Conclusions: Although effects seem to differ by physician level of training, prompting physicians with alcohol screening results and recommendations for action can modestly increase discussions about alcohol use and advice to patients and may decrease alcohol consumption.
Comparison of Mortality in All Patients on Dialysis, Patients on Dialysis Awaiting Transplantation, and Recipients of a First Cadaveric Transplant
Authors: Robert A. Wolfe, Valarie B. Ashby, Edgar L. Milford, Akinlolu O. Ojo, Robert E. Ettenger, Lawrence Y.C. Agodoa, Philip J. Held, Friedrich K. Port
Journal: New England Journal of Medicine (1999)

The extent to which renal allotransplantation — as compared with long-term dialysis — improves survival among patients with end-stage renal disease is controversial, because those selected for transplantation may have a lower base-line risk of death.