tbuckley/cabot-search huggingface dataset:
THE CLINICAL TEACHER AND THE MEDICAL CURRICULUM
Authors: HARVEY CUSHING
Journal: JAMA (1924)

In a moment of self-communing, Leonardo wrote in his notebook: The supreme misfortune is when theory outstrips performance. This might well be taken as a motto to hang in our several faculty rooms, for  is one thing to sit and theorize about teaching, and quite another to find people capable of carrying out our altogether admirable ideas—or to practice them ourselves. This probably has been so from  beginning— ever since pupils were first assembled in schools; and through  centuries what should be done under  circumstances has puzzled many minds.  Some very wise things, however, have meanwhile been said: that education is a life-long process in which  undergraduate makes only a beginning; that it is  business of  teacher to arouse curiosity, not to satisfy it; that the measure of a teacher's success lies not in his own ideas but in those which radiate from
One-Year Cardiovascular Event Rates in Outpatients With Atherothrombosis
Authors: Ph. Gabriel Steg, Deepak L. Bhatt, Peter W. F. Wilson, Ralph D’Agostino, E. Magnus Ohman, Joachim Röther, Chiau-Suong Liau, Alan T. Hirsch, Jean-Louis Mas, Yasuo Ikeda, Michael J. Pencina, Shinya Goto, for the REACH Registry Investigators
Journal: JAMA (2007)

Few data document current cardiovascular (CV) event rates in stable patients with atherothrombosis in a community setting. Differential event rates for patients with documented coronary artery disease (CAD), cerebrovascular disease (CVD), or peripheral arterial disease (PAD) or those at risk of these diseases have not been previously evaluated in a single international cohort.To establish contemporary, international, 1-year CV event rates in outpatients with established arterial disease or with multiple risk factors for atherothrombosis.The Reduction of Atherothrombosis for Continued Health (REACH) Registry is an international, prospective cohort of 68 236 patients with either established atherosclerotic arterial disease (CAD, PAD, CVD; n = 55 814) or at least 3 risk factors for atherothrombosis (n = 12 422), who were enrolled from 5587 physician practices in 44 countries in 2003-2004.Rates of CV death, myocardial infarction (MI), and stroke.As of July 2006, 1-year outcomes were available for 95.22% (n = 64 977) of participants. Cardiovascular death, MI, or stroke rates were 4.24% overall: 4.69% for those with established atherosclerotic arterial disease vs 2.15% for patients with multiple risk factors only. Among patients with established disease, CV death, MI, or stroke rates were 4.52% for patients with CAD, 6.47% for patients with CVD, and 5.35% for patients with PAD. The incidences of the end point of CV death, MI, or stroke or of hospitalization for atherothrombotic event(s) were 15.20% for CAD, 14.53% for CVD, and 21.14% for PAD patients with established disease. These event rates increased with the number of symptomatic arterial disease locations, ranging from 5.31% for patients with risk factors only to 12.58% for patients with 1, 21.14% for patients with 2, and 26.27% for patients with 3 symptomatic arterial disease locations (P<.001 for trend).In this large, contemporary, international study, outpatients with established atherosclerotic arterial disease, or at risk of atherothrombosis, experienced relatively high annual CV event rates. Multiple disease locations increased the 1-year risk of CV events.
A new animal model for relapsing polychondritis, induced by cartilage matrix protein (matrilin-1)
Authors: Ann-Sofie Hansson, Dick Heinegård, Rikard Holmdahl
Journal: Journal of Clinical Investigation (1999)

Relapsing polychondritis (RP) differs from rheumatoid arthritis (RA) in that primarily cartilage outside diarthrodial joints is affected. The disease usually involves trachea, nose, and outer ears. To investigate whether the tissue distribution of RP may be explained by a specific immune response, we immunized rats with cartilage matrix protein (matrilin-1), a protein predominantly expressed in tracheal cartilage. After 2–3 weeks, some rats developed a severe inspiratory stridor. They had swollen noses and/or epistaxis, but showed neither joint nor outer ear affection. The inflammatory lesions involved chronic active erosions of cartilage. Female rats were more susceptible than males. The disease susceptibility was controlled by both MHC genes (f, l, d, and a haplotypes are high responders, and u, n, and c are resistant) and non-MHC genes (the LEW strain is susceptible; the DA strain is resistant). However, all strains mounted a pronounced IgG response to cartilage matrix protein. The initiation and effector phase of the laryngotracheal involvement causing the clinical symptoms were shown to depend on αβ T cells. Taken together, these results represent a novel model for RP: matrilin-1–induced RP. Our findings also suggest that different cartilage proteins are involved in pathogenic models of RP and RA.
Constitutive Activation of PKA Catalytic Subunit in Adrenal Cushing's Syndrome
Authors: Felix Beuschlein, Martin Fassnacht, Guillaume Assié, Davide Calebiro, Constantine A. Stratakis, Andrea Osswald, Cristina L. Ronchi, Thomas Wieland, Silviu Sbiera, Fabio R. Faucz, Katrin Schaak, Anett Schmittfull, Thomas Schwarzmayr, Olivia Barreau, Delphine Vezzosi, Marthe Rizk-Rabin, Ulrike Zabel, Eva Szarek, Paraskevi Salpea, Antonella Forlino, Annalisa Vetro, Orsetta Zuffardi, Caroline Kisker, Susanne Diener, Thomas Meitinger, Martin J. Lohse, Martin Reincke, Jérome Bertherat, Tim M. Strom, Bruno Allolio
Journal: New England Journal of Medicine (2014)

Corticotropin-independent Cushing's syndrome is caused by tumors or hyperplasia of the adrenal cortex. The molecular pathogenesis of cortisol-producing adrenal adenomas is not well understood.
Early versus deferred antiretroviral therapy for children older than 1 year infected with HIV (PREDICT): a multicentre, randomised, open-label trial
Authors: Thanyawee Puthanakit, Vonthanak Saphonn, Jintanat Ananworanich, Pope Kosalaraksa, Rawiwan Hansudewechakul, Ung Vibol, Stephen J Kerr, Suparat Kanjanavanit, Chaiwat Ngampiyaskul, Jurai Wongsawat, Wicharn Luesomboon, Nicole Ngo-Giang-Huong, Kea Chettra, Theshinee Cheunyam, Tulathip Suwarnlerk, Sasiwimol Ubolyam, William T Shearer, Robert Paul, Lynne M Mofenson, Lawrence Fox, Matthew G Law, David A Cooper, Praphan Phanuphak, Mean Chhi Vun, Kiat Ruxrungtham
Journal: The Lancet Infectious Diseases (2012)
'Sexual behavior in an abnormal situation'
Authors: Phil Gunby
Journal: JAMA (1981)

Even the session's title provoked controversy as experts gathered at the American Medical Association's conference on health care in jails to discuss "Abnormal Sexual Behavior in the Correctional Facility." The title was termed "pejorative" by David Rothenberg, executive director of the Fortune Society, "a nonprofit organization of ex-convicts and other interested persons" with headquarters in New York City. What was being discussed, he said, was sexual behavior in an abnormal situation. In general, postulated Peter L. Nacci, PhD, director of the US Department of Justice's Federal Prison System Staff Training Center, Atlanta, same-sex activity occurs in prison because the inmate: wants to participate; complies with the desires of others but does not genuinely wish to do so; is manipulated into participation through gifts, persuasion, or trickery; or is sexually assaulted. The environment also plays a role, he said, because of the crowding, idle time, difficult living
Phosphorylation of the <i>I</i> <sub>Ks</sub> Channel Complex Inhibits Drug Block
Authors: Tao Yang, Hideaki Kanki, Dan M. Roden
Journal: Circulation (2003)

IKs, an important repolarizing current in heart, is an antiarrhythmic drug target and is markedly increased by activation of protein kinase A (PKA; eg, by beta-adrenergic stimulation). Because beta-adrenergic stimulation is a frequent trigger of arrhythmias, we hypothesized that PKA stimulation inhibits drug block.CHO cells were transfected with KCNQ1 cDNA (encoding the pore-forming subunit) with or without the ancillary subunit KCNE1. IC50 for quinidine block of basal IKs was 5.8+/-1.2 micromol/L, versus 19.9+/-3.2 micromol/L (P<0.01) for PKA-stimulated current. A similar >3-fold shift was apparent in the absence of KCNE1 and with the IKs-specific blocker chromanol 293B. The first current recorded after channels were held at rest and exposed to the drug was reduced approximately 40%, and further depolarizations increased the block with a time constant (tau) of 181+/-27 seconds. By contrast, PKA-stimulated channels displayed a <5% first-pulse block and much slower block development (tau=405+/-85 seconds). Alanine substitution at 3 potential PKA target sites (S27, S468, and T470) generated an IKs that did not increase with PKA stimulation; this mutant retained wild-type drug sensitivity that was unaffected by PKA.Activation of this key intracellular signaling pathway blunts drug block. The onset of block and the data with the PKA-resistant mutant support the concept that phosphorylation of the KCNQ1 subunit directly modulates drug access to a binding site on the channel. These data identify a novel mechanism for modulation of drug-channel interactions that may be especially important during beta-adrenergic stimulation.
Cholera in a Vaccinated American
Authors: E. ABRUTYN
Journal: Annals of Internal Medicine (1971)

A case of clinical cholera in an American physician and his serologic response to cholera vaccine and the illness are described. In July 1968 he participated in a study evaluating monovalent Inaba vaccine. Initially his vibriocidal antibody titers were lower than the geometric mean titers of the other nine study participants, but at 6 months his titer was comparable with titers of other Americans at 6 months after immunization. In December 1968 he traveled to East Pakistan from Atlanta, Georgia, and in January he had clinical cholera. Although the reciprocal vibriocidal antibody titer in the acute and convalescent serum specimens was unchanged (320), the reciprocal toxin neutralizing antibody titer rose from less than 1 on the day the illness began to 8 on the ninth day and 13 on the fifteenth day after onset. Whereas IgM vibriocidal antibody was detectable in sera collected before and after the illness, IgG vibriocidal antibody was detectable only in serum collected 15 days after onset. This case emphasizes that healthy persons inoculated with vaccine of proved efficacy can still develop clinical cholera when exposed to it.
Re: David Brix, Bruno Allolio, Wiebke Fenske, et al. Laparoscopic Versus Open Adrenalectomy for Adrenocortical Carcinoma: Surgical and Oncologic Outcome in 152 Patients. Eur Urol 2010;58:609–15
Authors: Sebastien Gaujoux, Stephane Bonnet, Bertrand Dousset
Journal: European Urology (2010)
The teaching of communication skills may be misguided
Authors: Richard Smith
Journal: BMJ (2004)

Each day in Britain there are some two million consultations between doctors and patients and around 100 million decisions about patient care. Any fundamental reform of health care will depend on influencing those consultations and decisions, and they are, I suggest, so far largely untouched. “Thank God,” I hear many doctors say, but who could disagree that much of what goes on in those consultations is capable of considerable improvement?

One method of improving what happens in consultations is through teaching doctors communication skills, but a paper from Liverpool …
High-dose radiotherapy with short-term or long-term androgen deprivation in localised prostate cancer (DART01/05 GICOR): a randomised, controlled, phase 3 trial
Authors: Almudena Zapatero, Araceli Guerrero, Xavier Maldonado, Ana Alvarez, Carmen Gonzalez San Segundo, Maria Angeles Cabeza Rodríguez, Victor Macias, Agustí Pedro Olive, Francesc Casas, Ana Boladeras, Carmen Martín de Vidales, Maria Luisa Vazquez de la Torre, Salvador Villà, Aitor Perez de la Haza, Felipe A Calvo
Journal: The Lancet Oncology (2015)
Abstract 1705: 14-3-3ζ is an androgen-regulated gene that activates the androgen receptor signaling and facilitates cell survival in prostate cancer
Authors: Taro Murata, Ken-ichi Takayama, Tomohiko Urano, Tetsuya Fujimura, Jinpei Kumagai, Kuniko Horie-Inoue, Kazuhiro Ikeda, Satoru Takahashi, Yasuyoshi Ouchi, Yukio Homma, Satoshi Inoue
Journal: Cancer Research (2010)

Abstract The 14-3-3 proteins are a family of regulatory molecules that modulate the functions of their binding partners. They are involved in many processes including protein synthesis/degradation, cell cycle regulation, apoptosis, and tumor development. We have identified one of 14-3-3 protein isoforms 14-3-3zeta as a novel androgen target gene by chromatin immunoprecipitation (ChIP) coupled with microarray analysis. The expression of 14-3-3zeta was upregulated in LNCaP prostate cancer cells at both mRNA and protein levels by androgen stimulation. We generated LNCaP cells stably expressing 14-3-3zeta or control empty vector, and found that less etoposide-induced cell death was observed in 14-3-3zeta-expressing cells compared with control cells. Cell proliferation and motility were increased in 14-3-3zeta-expressing cells. Imunoprecipitation study showed that 14-3-3zeta binds to androgen receptor (AR) in these cells. Luciferase assay showed that androgen-dependent PSA promoter activity was significantly increased in 14-3-3ζ-expressing cells. Androgen-dependent PSA expression was also increased in 14-3-3ζ-expressing cells. siRNA-dependent 14-3-3zeta knockdown revealed that androgen-dependent AR transactivation was reduced in LNCaP cells. Taken together, the present study indicates that 14-3-3ζ is a bona-fide androgen-regulated gene that plays an important role in activating AR-dependent signaling, thereby promoting cell growth, motility and acquirement of apoptosis resistance in prostate cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1705.
Impact of Fasting Plasma Glucose Levels on Gastric Cancer Incidence in a General Japanese Population
Authors: Hajime Yamagata, Yutaka Kiyohara, Shotaro Nakamura, Michiaki Kubo, Yumihiro Tanizaki, Takayuki Matsumoto, Keiichi Tanaka, Isao Kato, Tomoko Shirota, Mitsuo Iida
Journal: Diabetes Care (2005)

OBJECTIVE—Several studies have shown associations between diabetes and various types of cancer other than gastric cancer. The aim of this cohort study was to evaluate the impact of fasting plasma glucose (FPG) levels on gastric cancer occurrence. RESEARCH DESIGN AND METHODS—A total of 2,466 Japanese subjects aged ≥40 years were stratified into three groups according to FPG tertiles (&amp;lt;5.3 mmol/l, low FPG; 5.3–5.8 mmol/l, modest FPG; &amp;gt;5.8 mmol/l, high FPG) and followed up prospectively for 9 years. RESULTS—During the follow-up, 66 subjects experienced gastric cancer. In men, the age-adjusted incidences were significantly higher in the modest-FPG (7.0 per 1,000 person-years, P &amp;lt; 0.05) and high-FPG (7.2, P &amp;lt; 0.05) groups than in the low-FPG group (2.2). In women, the high-FPG group also had a significantly higher age-adjusted incidence of gastric cancer compared with the low-FPG group (2.5 vs. 0.8, P &amp;lt; 0.05). The multivariate analysis with Cox’s proportional hazards model revealed that the risks of gastric cancer in the modest-FPG (relative risk [RR] 2.3 [95% CI 1.1–5.0]) and high-FPG (3.1 [1.5–6.4]) groups were significantly higher than that in the low-FPG group, even after adjusting for other comprehensive risk factors, including Helicobacter pylori status, smoking, and dietary factors. However, this FPG-cancer association was observed only among H. pylori–seropositive subjects. CONCLUSIONS—Our findings suggest that a modest increase in FPG is a risk factor for gastric cancer and that hyperglycemia is a possible cofactor increasing the risk posed by Helicobacter pylori infection.
Association of Metabolic Syndrome and Hidradenitis Suppurativa
Authors: Iben Marie Miller, Christina Ellervik, Gabrielle Randskov Vinding, Kian Zarchi, Kristina Sophie Ibler, Kim Mark Knudsen, Gregor B. E. Jemec
Journal: JAMA Dermatology (2014)

IMPORTANCE An association between the metabolic syndrome (MetS) and chronic inflammatory diseases, such as psoriasis or rheumatoid arthritis, has been suggested.Hidradenitis suppurativa (HS), a more localized chronic inflammation of the skin, has been speculated to have a similar association. Hidradenitis suppurativa is a substantial burden for the individual and a socioeconomic burden globally. Information about the burden of possible comorbidities is scarce.OBJECTIVE To investigate the possibility of an association between HS and MetS.DESIGN, SETTING, AND PARTICIPANTS Cross-sectional population- and hospital-based study of HS and MetS.We identified 32 patients with physician-verified HS from the outpatient clinic at the Department of Dermatology, Roskilde Hospital, and 326 patients with HS and 14 851 individuals without HS from the general population. Individuals with HS were younger,predominantly female, and more often smokers compared with the non-HS group.EXPOSURE Hidradenitis suppurativa.MAIN OUTCOMES AND MEASURES Metabolic syndrome and its components of diabetes mellitus, hypertension, dyslipidemia, and obesity.RESULTS When compared with the non-HS group, the odds ratios (ORs) for the hospital HS and population HS groups were 3.89 (95%CI, 1.90-7.98) and 2.08 (95%CI, 1.61-2.69),respectively, for MetS; 5.74 (95%CI, 1.91-17.24) and 2.44 (95%CI, 1.55-3.83), respectively, for diabetes mellitus; 6.38 (95%CI, 2.99-13.62) and 2.56 (95%CI, 2.00-3.28), respectively, for general obesity; and 3.62 (95%CI, 1.73-7.60) and 2.24 (95%CI, 1.78-2.82), respectively, for abdominal obesity. With regard to dyslipidemia, significant results were found for decreased levels of high-density lipoprotein cholesterol, with ORs of 2.97 (95%CI, 1.45-6.08) and 1.94(95%CI, 1.52-2.48) for the hospital HS and general population HS groups, respectively, when compared with the non-HS group. With regard to increased triglyceride levels, only the result for the population HS group compared with the non-HS group was significant, with an OR of1.49 (95%CI, 1.18-1.87). The OR for hypertension, which was only significant for the hospital HS group compared with the non-HS group, was 2.14 (95%CI, 1.01-4.53). Obesity and inflammation acted as possible confounders. The ORs were higher for the hospital HS group compared with the population HS group. The association between HS and MetS was not influenced by the degree of HS severity.CONCLUSIONS AND RELEVANCE As with more systemic inflammatory diseases, HS appears to be associated with MetS, indicating substantial comorbidities. Because this study is cross-sectional, causality remains to be explored.
Mortality related to chronic hepatitis B and chronic hepatitis C in France: Evidence for the role of HIV coinfection and alcohol consumption
Authors: Patrick Marcellin, Françoise Pequignot, Elisabeth Delarocque-Astagneau, Jean-Pierre Zarski, Nathalie Ganne, Patrick Hillon, Denise Antona, Martine Bovet, Murielle Mechain, Tarik Asselah, Jean-Claude Desenclos, Eric Jougla
Journal: Journal of Hepatology (2007)
COMPARISON BETWEEN ORAL RAPAMYCIN PLUS BARE METAL STENT VERSUS DRUG ELUTING STENT FOR THE PREVENTION OF RESTENOSIS IN THE TREATMENT OF CORONARY DISEASE WITH PCI: FIVE–YEARS FINAL RESULTS FROM THE ORAR III TRIAL
Authors: Alfredo Eduardo Rodriguez, Carlos Fernandez–Pereira, Juan Mieres, Alfredo M. Rodriguez–Granillo, Gustavo Risau, Ricardo Pauletto, Leonardo Solorzano, David Antoniucci, Patrick W. Serruys
Journal: Journal of the American College of Cardiology (2013)
External Validation of Urinary PCA3-Based Nomograms to Individually Predict Prostate Biopsy Outcome
Authors: Marco Auprich, Alexander Haese, Jochen Walz, Karl Pummer, Alexandre de la Taille, Markus Graefen, Theo de Reijke, Margit Fisch, Paul Kil, Paolo Gontero, Jacques Irani, Felix K.-H. Chun
Journal: European Urology (2010)
Prospective assessment of donor blood screening for antibody to hepatitis C virus and high-titer antibody to HBcAg as a means of preventing posttransfusion hepatitis
Authors: Susumu Takano, Masao Omata, Masao Oht, Yoichi Satomura
Journal: Hepatology (1993)

Since December 1989, the Japan Red Cross Blood Bureau has screened blood donors for hepatitis C virus antibody on the basis of enzyme-linked immunosorbent assay and high titers of antibody to HBc antigen. To elucidate the effectiveness of the new screening tests in preventing posttransfusion hepatitis, the incidence of posttransfusion hepatitis after the introduction of the new tests (December 1989 to December 1990) was compared with the incidence before their introduction (January 1982 to December 1988). The incidence of posttransfusion hepatitis was 9.8% (219 of 2240), with a mean transfusion volume of 10.2 units, before the screening and 3.7% (12 of 326), with a mean transfusion volume of 14.7 units, after the introduction of the new tests. Statistical analysis revealed a significant decrease of incidence of posttransfusion non-A, non-B hepatitis after the introduction of the new tests (x2 = 10.9, p < 0.01). Posttransfusion hepatitis B occurred in 3 of 2,240 recipients (0.13%) before the introduction of HBc antibody testing. No cases of posttransfusion B viral hepatitis developed after the introduction of the new tests. Hepatitis C virus antibody status was investigated in 7 of 12 posttransfusion hepatitis patients who contracted the disease after the new screening tests were initiated. Hepatitis C virus antibody seroconversion occurred in three of the seven cases (43%), as detected on first- and second-generation hepatitis C virus antibody assays and reverse-transcription polymerase chain reaction. (HEPATOLOGY 1993;18:235–239).
Child and Adolescent Health—A Call for Papers
Authors: Jody W. Zylke
Journal: JAMA (2008)

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