tbuckley/cabot-search huggingface dataset:
Recommendations for the Care of Individuals With an Inherited Predisposition to Lynch Syndrome
Authors: Noralane M. Lindor, Gloria M. Petersen, Donald W. Hadley, Anita Y. Kinney, Susan Miesfeldt, Karen H. Lu, Patrick Lynch, Wylie Burke, Nancy Press
Journal: JAMA (2006)

About 2% of all colorectal cancer occurs in the context of the autosomal dominantly inherited Lynch syndrome, which is due to mutations in mismatch repair genes. Potential risk-reducing interventions are recommended for individuals known to have these mutations.To review cancer risks and data on screening efficacy in the context of Lynch syndrome (hereditary nonpolyposis colorectal cancer) and to provide recommendations for clinical management for affected families, based on available evidence and expert opinion.A systematic literature search using PubMed and the Cochrane Database of Systematic Reviews, reference list review of retrieved articles, manual searches of relevant articles, and direct communication with other researchers in the field. Search terms included hereditary non-polyposis colon cancer, Lynch syndrome, microsatellite instability, mismatch repair genes, and terms related to the biology of Lynch syndrome. Only peer-reviewed, full-text, English-language articles concerning human subjects published between January 1, 1996, and February 2006 were included. The US Preventive Services Task Force's 2-tier system was adapted to describe the quality of evidence and to assign strength to the recommendations for each guideline.The evidence supports colonoscopic surveillance for individuals with Lynch syndrome, although the optimal age at initiation and frequency of examinations is unresolved. Colonoscopy is recommended every 1 to 2 years starting at ages 20 to 25 years (age 30 years for those with MSH6 mutations), or 10 years younger than the youngest age of the person diagnosed in the family. While fully acknowledging absence of demonstrated efficacy, the following are also recommended annually: endometrial sampling and transvaginal ultrasound of the uterus and ovaries (ages 30-35 years); urinalysis with cytology (ages 25-35 years); history, examination, review of systems, education and genetic counseling regarding Lynch syndrome (age 21 years). Regular colonoscopy was favored for at-risk persons without colorectal neoplasia. For individuals who will undergo surgical resection of a colon cancer, subtotal colectomy is favored. Evidence supports the efficacy of prophylactic hysterectomy and oophorectomy.The past 10 years have seen major advances in the understanding of Lynch syndrome. Current recommendations regarding cancer screening and prevention require careful consultation between clinicians, clinical cancer genetic services, and well-informed patients.
Collagen degrading activity associated with Mycobacterium species
Authors: F Masso, A Paez, E Varela, L Diaz de Leon, E Zenteno, L F Montano
Journal: Thorax (1999)

<h3>BACKGROUND</h3> The mechanism of <i>Mycobacterium tuberculosis</i>penetration into tissues is poorly understood but it is reasonable to assume that there is a contribution from proteases capable of disrupting the extracellular matrix of the pulmonary epithelium and the blood vessels. A study was undertaken to identify and characterise collagen degrading activity of <i>M tuberculosis</i>. <h3>METHODS</h3> Culture filtrate protein extract (CFPE) was obtained from reference mycobacterial strains and mycobacteria isolated from patients with tuberculosis. The collagen degrading activity of CFPE was determined according to the method of Johnson-Wint using <sup>3</sup>H-type I collagen. The enzyme was identified by the Birkedal-Hansen and Taylor method and its molecular mass determined by SDS-PAGE and Sephacryl S-300 gel filtration chromatography using an electroelution purified enzyme. <h3>RESULTS</h3> CFPE from<i>Mycobacterium tuberculosis </i>strain H37Rv showed collagenolytic activity that was four times higher than that of the avirulent strain H37Ra. The 75 kDa enzyme responsible was divalent cation dependent. Other mycobacterial species and those isolated from patients with tuberculosis also had collagen degrading activity. <h3>CONCLUSIONS</h3> <i>Mycobacterium</i>species possess a metalloprotease with collagen degrading activity. The highest enzymatic activity was found in the virulent reference strain H37Rv.
Wound Repair and Regeneration
Authors: Sandra A. Studebaker
Journal: JAMA (1994)

Wound Repair and Regenerationis the official, peer-reviewed  of the European Tissue Repair Society (ETRS) and the Wound Healing Society (WHS). These societies were incorporated in 1988 and 1989, respectively. As a publication of the latest information on wound healing, repair, and regeneration, this journal fulfills an objective of both the ETRS and the WHS. A thorough review of the first five issues ofWound Repair and Regenerationconfirms the perception that the editors' intent to facilitate production of a greater progress towards the understanding of the process of wound healing is well achieved.  The field of wound healing, previously dominated by surgeons, dermatologists, and pathologists, has widened to include the investigations of other specialists. Consequently, state-of-the-art molecular biology, immunology, and bioengineering join the traditional basic sciences to occupy a prominent place inWound Repair and Regeneration, as manifested by a preponderance of original articles dedicated to the purely
Slipped capital femoral epiphysis
Authors: N M P Clarke, T. Kendrick
Journal: BMJ (2009)

#### Case scenario

A 13 year old boy visited the general practitioner because of a six week history of intermittent limp and pain in the left lower thigh and knee, which was exacerbated by playing sports. On examination he was overweight, but he had no abnormality in the knee. “Knee strain” was diagnosed, and he was advised to take ibuprofen and abstain from sports. Four weeks later he returned with worsening more persistent pain, now in the thigh as well as the knee. Careful examination of the hip elicited a degree of restriction of flexion and rotation, both internal and external, with 2 cm shortening of the affected leg. Radiography of the left hip showed a slipped capital femoral epiphysis.

Slipped capital (or upper) femoral epiphysis occurs during periods of rapid growth in adolescence, when shear forces, particularly in obese children, increase across the proximal femoral growth plate, leading to displacement of the epiphysis. The typical patient is obese. In a recent case study of 54 patients with this condition, all had body mass indexes in the overweight or obese ranges.1 In boys, accompanying hypogonadism implicates possible endocrine causes.2 A chronic slip is the …
Prolactin Concentrations in Patients with Breast Cancer
Authors: S. Franks, D. N. L. Ralphs, V. Seagroatt, H. S. Jacobs
Journal: BMJ (1974)

Basal prolactin levels were measured before operation in 113 patients undergoing surgery for a lump in the breast. Prolactin concentrations were not significantly higher in those patients with breast cancer than in those with benign lumps. Prolactin concentrations were, however, found to be higher in premenopausal women than in postmenopausal ones, regardless of tumour histology.
Fee Setting — The Patient's Ability to Pay
Authors: Neil L. Chayet
Journal: New England Journal of Medicine (1965)

THE Principles of Medical Ethics of the American Medical Association state that "[the physician's] fee should be commensurate with the services rendered and the patient's ability to pay." The law seems to be moving in support of the Principles of Medical Ethics in approving this principle of fee setting for physicians although some courts have been reluctant to do so.The important case of Spencer vs. West 1 is an example of the willingness of courts to approve the principle that the patient's ability to pay should be a very significant factor in fee setting. This case, incidentally, bears out the . . .
Discovery and validation of urinary metabotypes for the diagnosis of hepatocellular carcinoma in West Africans
Authors: Nimzing G. Ladep, Anthony C. Dona, Matthew R. Lewis, Mary M.E. Crossey, Maud Lemoine, Edith Okeke, Yusuke Shimakawa, Mary Duguru, Harr F. Njai, Haddy K.S. Fye, Makie Taal, John Chetwood, Ben Kasstan, Shahid A. Khan, Deborah A. Garside, Anisha Wijeyesekera, Andrew V. Thillainayagam, Edmund Banwat, Mark R. Thursz, Jeremy K. Nicholson, Ramou Njie, Elaine Holmes, Simon D. Taylor-Robinson
Journal: Hepatology (2014)

There is no clinically applicable biomarker for surveillance of hepatocellular carcinoma (HCC), because the sensitivity of serum alpha-fetoprotein (AFP) is too low for this purpose. Here, we determined the diagnostic performance of a panel of urinary metabolites of HCC patients from West Africa. Urine samples were collected from Nigerian and Gambian patients recruited on the case-control platform of the Prevention of Liver Fibrosis and Cancer in Africa (PROLIFICA) program. Urinary proton nuclear magnetic resonance ((1) H-NMR) spectroscopy was used to metabolically phenotype 290 subjects: 63 with HCC; 32 with cirrhosis (Cir); 107 with noncirrhotic liver disease (DC); and 88 normal control (NC) healthy volunteers. Urine samples from a further cohort of 463 subjects (141 HCC, 56 Cir, 178 DC, and 88 NC) were analyzed, the results of which validated the initial cohort. The urinary metabotype of patients with HCC was distinct from those with Cir, DC, and NC with areas under the receiver operating characteristic (AUROC) curves of 0.86 (0.78-0.94), 0.93 (0.89-0.97), and 0.89 (0.80-0.98) in the training set and 0.81 (0.73-0.89), 0.96 (0.94-0.99), and 0.90 (0.85-0.96), respectively, in the validation cohort. A urinary metabolite panel, comprising inosine, indole-3-acetate, galactose, and an N-acetylated amino acid (NAA), showed a high sensitivity (86.9% [75.8-94.2]) and specificity (90.3% [74.2-98.0]) in the discrimination of HCC from cirrhosis, a finding that was corroborated in a validation cohort (AUROC: urinary panel = 0.72; AFP = 0.58). Metabolites that were significantly increased in urine of HCC patients, and which correlated with clinical stage of HCC, were NAA, dimethylglycine, 1-methylnicotinamide, methionine, acetylcarnitine, 2-oxoglutarate, choline, and creatine. The urinary metabotyping of this West African cohort identified and validated a metabolite panel that diagnostically outperforms serum AFP.
An analysis of fast idioventricular rhythm in the dog.
Authors: M Vassalle, R E Knob, M Cummins, G A Lara, C Castro, J H Stuckey
Journal: Circulation Research (1977)

Fast idioventricular rhythm was studied in dogs with and without recently-induced complete atrioventricular block.The following results were obtained.The fast idioventricular rhythm (1) has an average rate of 92 ± 7.7 beats/min, (2) is either intermittent or continuous, (3) originates from either ventricle, (4) is initiated suddenly by a beat that usually has a different electrocardiogram configuration, (5) may undergo a moderate deceleration before ceasing abruptly, (6) inhibits normal pacemaker activity, (7) when no longer present, can be brought back by a short period of fast driving, (8) can be suppressed by fast driving but the suppression is often preceded by a transient acceleration, (9) requires a longer period of driving than a normal idioventricular rhythm to be suppressed, ( 10) is accelerated by a short period of driving, (11) is "reset" by driving, (12) can be induced at progressively faster rates by repeated periods of driving during recovery from a prolonged overdrive, ( 13) is accelerated by sympathetic stimulation or norepinephrine administration, and ( 14) is accelerated by short periods of driving during submaximal sympathetic stimulation.We conclude that the fast idioventricular rhythm is a form of repetitive activity requiring initiating beats and thus is less sensitive to overdrive suppression.The behavior of this rhythm differs from that of normal idioventricular pacemakers and suggests that this rhythm does not result from an enhancement of a normal pacemaker process but rather from a different mechanism.This mechanism is affected by sympathetic stimulation and by norepinephrine administration and this may result in ventricular tachycardias.
The Free Medical Clinics
Authors: John D. Stoeckle
Journal: JAMA (1972)

The free medical clinics not only provide community-based services for special people, youth, and minorities, in the tradition of special disease clinics in medical practice, but they are also organizational reforms and political acts meant to influence education, care, and treatment. Although their future is uncertain, they have made new groups of patients more visible and now acceptable to regular practices, and some of their reforms (easy access, simplified treatment, peer organizations, less specialized health workers) have been adopted by orthodox clinics. As they acquire public funding to survive, they may lose some of the reforms they initiated.
Angiotensin II plays a pathogenic role in immune-mediated renal injury in mice
Authors: Yutaka Hisada, Takeshi Sugaya, Masaya Yamanouchi, Hiromi Uchida, Hisako Fujimura, Hiroaki Sakurai, Akiyoshi Fukamizu, Kazuo Murakami
Journal: Journal of Clinical Investigation (1999)

Several lines of evidence show the importance of angiotensin II (AII) in renal injuries, especially when hemodynamic abnormalities are involved. To elucidate the role of AII in immune-mediated renal injury, we studied anti-glomerular basement membrane (GBM) nephritis in AII type 1a receptor (AT1a)-deficient homozygous (AT1a-/-) and wild-type (AT1a+/+) mice. A transient activation of the renin-angiotensin system (RAS) was observed in both groups of mice at around day 1. A renal expression of monocyte chemoattractant protein-1 (MCP-1) was transiently induced at six hours in both groups, which was then downregulated at day 1. In the AT1a+/+ mice, after RAS activation, the glomerular expression of MCP-1 was exacerbated at days 7 and 14. Thereafter, severe proteinuria developed, and the renal expressions of transforming growth factor-beta1 (TGF-beta1) and collagen type I increased, resulting in severe glomerulosclerosis and interstitial fibrosis. In contrast, glomerular expression of MCP-1, proteinuria, and tissue damage were markedly ameliorated in the AT1a-/- mice. Because this amelioration is likely due to the lack of AT1a, we can conclude that AII action, mediated by AT1a, plays a pathogenic role in anti-GBM nephritis, in which AII may contribute to the exacerbation of glomerular MCP-1 expression. These results suggest the involvement of AII in immune-mediated renal injuries.
Risk of colorectal cancer seven years after flexible sigmoidoscopy screening: randomised controlled trial
Authors: G. Hoff, T. Grotmol, E. Skovlund, M. Bretthauer
Journal: BMJ (2009)

<b>Objective</b> To determine the risk of colorectal cancer after screening with flexible sigmoidoscopy. <b>Design</b> Randomised controlled trial. <b>Setting</b> Population based screening in two areas in Norway—city of Oslo and Telemark county (urban and mixed urban and rural populations). <b>Participants</b> 55 736 men and women aged 55-64 years. <b>Intervention</b> Once only flexible sigmoidoscopy screening with or without a single round of faecal occult blood testing (n=13 823) compared with no screening (n=41 913). <b>Main outcome measures</b> Planned end points were cumulative incidence and mortality of colorectal cancer after 5, 10, and 15 years. This first report from the study presents cumulative incidence after 7 years of follow-up and hazard ratio for mortality after 6 years. <b>Results</b> No difference was found in the 7 year cumulative incidence of colorectal cancer between the screening and control groups (134.5 <i>v</i> 131.9 cases per 100 000 person years). In intention to screen analysis, a trend towards reduced colorectal cancer mortality was found (hazard ratio 0.73, 95% confidence interval 0.47 to 1.13, P=0.16). For attenders compared with controls, a statistically significant reduction in mortality was apparent for both total colorectal cancer (hazard ratio 0.41, 0.21 to 0.82, P=0.011) and rectosigmoidal cancer (0.24, 0.08 to 0.76, P=0.016). <b>Conclusions</b> A reduction in incidence of colorectal cancer with flexible sigmoidoscopy screening could not be shown after 7 years' follow-up. Mortality from colorectal cancer was not significantly reduced in the screening group but seemed to be lower for attenders, with a reduction of 59% for any location of colorectal cancer and 76% for rectosigmoidal cancer in per protocol analysis, an analysis prone to selection bias. <b>Trial registration</b> Clinical trials NCT00119912.
A Coursebook in Health Care Delivery
Authors: Phil R. Aaron
Journal: JAMA (1976)

The type and amount of treatment a patient receives is controlled in a large part by our health care delivery system. This "coursebook," resulting from courses taught at the Universities of Pittsburgh and Wisconsin, addresses the manner in which our health care system has been constructed to make medical services available. It also delineates responsibility for making medical decisions. The authors believe there is an inadequate supply of health care resources, making us incapable of providing total care for every patient. Therefore, we must better allocate our health resources. There must be planning of the access, availability, cost, and quality of medical care so that the rich and the poor do not receive different levels of care. Consumers and providers are involved in developing new modalities of health care delivery to provide a better product. It remains to be seen, however, whether the physician's role in the alphabet maze is
Ischemic preconditioning and T4 pretreatment have additive cardioprotective effects against ischemia probably mediated by incremental p38 MAPK attenuation
Authors: Ioannis Paizis, Costas Pantos, Vassiliki Malliopoulou, Evangelia Karamanoli, Panagiotis Moraitis, Dennis Varonos, Dennis V. Cokkinos
Journal: Journal of the American College of Cardiology (2003)
Office Work Exposures and Adult-Onset Asthma
Authors: Maritta S. Jaakkola, Jouni J.K. Jaakkola
Journal: Environmental Health Perspectives (2007)

Office exposures have been linked to symptoms of sick building syndrome, but their relation to the development of asthma has not been studied previously. These exposures have increasing importance because an increasing proportion of the workforce is working in office environments.The aim of this study was to assess the relations of exposure to carbonless copy paper (CCP), paper dust, and fumes from photocopiers and printers to adult-onset asthma.We conducted a population-based incident case-control study of adults 21-63 years of age living in the Pirkanmaa District in South Finland. All new clinically diagnosed cases (n = 521) of asthma were recruited during a 3-year study period. A random sample of the source population formed the controls (n = 1,016). This part focused on 133 cases and 316 controls who were office workers according to their current occupation classified by the 1988 International Standard Classification of Occupations. All participants answered a questionnaire on health, smoking, occupation, and exposures at work and home. Subjects with previous asthma were excluded.Exposures to paper dust [adjusted odds ratio (OR) = 1.97; 95% confidence interval (CI), 1.25-3.10] and CCP (OR = 1.66; 95% CI, 1.03-2.66) were related to significantly increased risk of adult-onset asthma. An exposure-response relation was observed between exposure to paper dust and risk of asthma.This study provides new evidence that exposures to paper dust and CCP in office work are related to increased risk of adult-onset asthma. Reduction of these exposures could prevent asthma in office workers. Clinicians seeing asthma patients should be aware of this link to office exposures.
Bullous eruption of systemic lupus erythematosus: a clinicopathological study of four cases
Authors: N.P. BURROWS, B.S. BHOGAL, M.M. BLACK, M.H.A. RUSTIN, A. ISHIDA-YAMAMOTO, G. KIRTSCHIG, R. RUSSELL JONES
Journal: British Journal of Dermatology (1993)

We describe the clinical, histological and immunopathological features of four female patients with the bullous eruption of systemic lupus erythematosus (bullous SLE). Three patients had circulating anti-basement membrane zone (BMZ) antibodies, and Western blot analysis in two cases revealed binding to type VII collagen. Immunoelectron microscopy in one of these patients demonstrated deposition of antibody in the lamina densa and sublamina densa regions, thus sharing immunopathological features with epidermolysis bullosa acquisita (EBA). The vesiculobullous lesions developed 8 months to 6 years after the initial symptoms of SLE, and cleared promptly with dapsone treatment.
Retroperitoneal fibrosis after treatment with atenolol.
Authors: M J Asbury
Journal: BMJ (1979)

Retroperitoneal fibrosis after treatment with atenolol SIR,-The report from Belfast City Hospital (23-30 December, p 1786) implying that atenolol may have been the cause of retroperitoneal fibrosis in a 68-year-old woman deserves comment.There are several reasons for supposing that the suspicion of a cause- and-effect relationship is not well founded.The authors state that this case was reported "because of the established relationship between the earlier beta-blocker practolol and similar types of sclerosing fibroblastic reaction."However, in more than 200 cases of
Effect of shock polarity on ventricular defibrillation threshold using a transvenous lead system
Authors: S.Adam Strickberger, John D. Hummel, Laura E. Horwood, John Jentzer, Emile Daoud, Mark Niebauer, Omar Bakr, K.Ching Man, Brian D. Williamson, William Kou, Fred Morady
Journal: Journal of the American College of Cardiology (1994)
The Number of Postsynaptic Currents Necessary to Produce Locomotor-Related Cyclic Information in Neurons in the Neonatal Rat Spinal Cord
Authors: Morten Raastad, Bruce R Johnson, Ole Kiehn
Journal: Neuron (1996)

To understand better how synaptic signaling contributes to network activity, we analyzed the potential contribution of putative unitary postsynaptic currents (PSCs) to locomotor-related information received by spinal interneurons in neonatal rats. The average cyclic modulation of the whole-cell current in 13 neurons was quantified as the difference between the current integral (charge) during the first and second halves of the cyclic locomotor network output. Between 7.6 and 303 average unitary PSCs per second were needed to produce the cyclic modulation. This number is so low that very few (1–5) of the synapses contributing to the cyclic information need to be active simultaneously. This suggests that individual presynaptic cells in a central locomotor network can have a powerful influence on other neurons.
Some Remarks in Reply to Dr. H. A. Kelly's Article on "Ureteral Calculus."
Authors: F. Kreissl
Journal: JAMA (1900)

<h3>To the Editor:</h3> —InThe Journalof March 3, Dr. H. A. Kelly reports, as entirely new, the diagnosis of a ureteral calculus by means of a wax-tip bougie, and he closes with the words: "I am not aware that ureteral calculus has ever been assisted to escape in this way before." I am ready to admit that the removal of a stone from the ureter is not an old practice, that the literature on the subject is of more recent date, and does not cover a great many cases, but the practice is not unique and the ease is not a singular one, and I am very much surprised to see the statement propounded by a gentleman as well read as H. A. Kelly. Kolischer presented the first case of this kind to the Vienna Medical Society, about two years ago. The stone was found impacted in the left