tbuckley/cabot-search huggingface dataset:
THE HEART IN PERNICIOUS ANEMIA
Authors: WILLIAM D. REID
Journal: JAMA (1923)

The death of a patient ill with pernicious anemia, a few hours after a transfusion of blood, with symptoms reported to be those of acute heart failure, brought home to me how little I knew of the heart in this disease. The patient referred to had only 660,000 red corpuscles per cubic millimeter of blood. A series of three blood transfusions was given, resulting in some improvement with the first, a moderate upset with the second, and a severe reaction after the third. This reaction was described by the physician in attendance as being characterized by dyspnea and the disappearance of the pulse at the wrist; the heart sounds remained audible. It began before the transfusion was complete, and persisted until the death of the patient about five hours later. What was the cause of the attack and subsequent death? Could there have been an embolus to the coronary artery,
P5-01-13: High Levels of Nuclear Heat Shock Factor 1 (HSF1) Are Associated with Poor Prognosis in Breast Cancer: Results from the Nurses' Health Study.
Authors: S Santagata, R Hu, NU Lin, ML Mendillo, LC Collins, SE Hankinson, SJ Schnitt, L Whitesell, S Lindquist, RM Tamimi, TA Ince
Journal: Cancer Research (2011)

Abstract Purpose: Heat shock factor 1 (HSF1) is the master transcriptional regulator of the cellular response to heat and a wide variety of other stressors. We previously reported that HSF1 promotes the survival and proliferation of malignant cells. At this time, however, the clinical and prognostic significance of HSF1 in cancer is unknown. Patients and methods: Breast cancer samples from 1,841 participants in the Nurses’ Health Study (NHS) were scored for levels of nuclear HSF1. Associations of HSF1 status with clinical parameters and survival outcomes were investigated by Kaplan-Meier analysis and Cox proportional hazard models. The associations were further delineated by Kaplan-Meier analysis using publicly available mRNA expression data. Results: Nuclear HSF1 levels were elevated in ∼80% of in situ and invasive breast carcinomas. In invasive carcinomas, HSF1 expression was associated with high histologic grade, larger tumor size, and nodal involvement at diagnosis (P&amp;lt;0.0001). Overall, in multivariate analysis, high-HSF1 levels were associated with increased breast cancer-specific mortality (HR, 1.62; 95% CI, 1.21−2.17). This association was seen in the ER-positive population (HR, 2.10; 95% CI, 1.25−2.47), even in early-stage lymph node negative cases (HR, 1.98; 95% CI, 1.17−3.33). In public expression profiling data, high-HSF1 mRNA levels were also associated with an increase in ER-positive breast cancer-specific mortality. Conclusions: Increased HSF1 is associated with reduced survival in breast cancer. The findings indicate that HSF1 should be evaluated prospectively as an independent prognostic indicator in ER-positive breast cancer and that HSF1 may provide a useful therapeutic target. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-01-13.
Biopersistence of respirable synthetic fibers and minerals: the point of view of the epidemiologist.
Authors: P Boffetta
Journal: Environmental Health Perspectives (1994)

Biopersistence of fibers and minerals in human respiratory tissues is an important aspect of the toxicity of these agents. However, few data are available from human studies. Although a number of studies have measured the lung burden of asbestos and other minerals in exposed humans, few presented information relevant to biopersistence of these agents. The studies analyzing asbestos lung burden in workers at different intervals following cessation of exposure suggest a linear decrease in concentration over time, that is independent of duration of exposure. However, the available evidence on asbestos is too sparse to allow a firm conclusion; almost no data are available on other minerals.
Borderline Thrombocytopenia or Mild Idiopathic Thrombocytopenic Purpura?
Authors: Jacques Zimmer, François Hentges, Emmanuel Andres
Journal: PLoS Medicine (2006)

I read the paper by Chi et al. with interest.The authors found a greater hypoxia response gene expression in carcinomas than stromal cells grown in vitro, but were not sure of the underlying explanation (see Discussion in [1]).The underlying explanation may be the difference in mitotic activity and hence metabolic activity between these two cell types, such that hypoxia may be present within cancer cells, although the surrounding culture media may have similar oxygen levels as the stromal cultures.The differences in mitotic activity could also explain greater hypoxia-related gene expression in clear-cell carcinoma compared with chromophobe carcinoma, normal tissue, or oncocytoma, as clear-cell carcinomas are more active mitotically.Did the authors compare the hypoxia gene expression with mitotic activity in various tumors?
Associations among Race/Ethnicity, ApoC-III Genotypes, and Lipids in HIV-1-Infected Individuals on Antiretroviral Therapy
Authors: Andrea S Foulkes, David A Wohl, Ian Frank, Elaine Puleo, Stephanie Restine, Megan L Wolfe, Michael P Dube, Pablo Tebas, Muredach P Reilly
Journal: PLoS Medicine (2006)

Protease inhibitors (PIs) are associated with hypertriglyceridemia and atherogenic dyslipidemia. Identifying HIV-1-infected individuals who are at increased risk of PI-related dyslipidemia will facilitate therapeutic choices that maintain viral suppression while reducing risk of atherosclerotic diseases. Apolipoprotein C-III (apoC-III) gene variants, which vary by race/ethnicity, have been associated with a lipid profile that resembles PI-induced dyslipidemia. However, the association of race/ethnicity, or candidate gene effects across race/ethnicity, with plasma lipid levels in HIV-1-infected individuals, has not been reported.A cross-sectional analysis of race/ethnicity, apoC-III/apoA-I genotypes, and PI exposure on plasma lipids was performed in AIDS Clinical Trial Group studies (n = 626). Race/ethnicity was a highly significant predictor of plasma lipids in fully adjusted models. Furthermore, in stratified analyses, the effect of PI exposure appeared to differ across race/ethnicity. Black/non-Hispanic, compared with White/non-Hispanics and Hispanics, had lower plasma triglyceride (TG) levels overall, but the greatest increase in TG levels when exposed to PIs. In Hispanics, current PI antiretroviral therapy (ART) exposure was associated with a significantly smaller increase in TGs among patients with variant alleles at apoC-III-482, -455, and Intron 1, or at a composite apoC-III genotype, compared with patients with the wild-type genotypes.In the first pharmacogenetic study of its kind in HIV-1 disease, we found race/ethnic-specific differences in plasma lipid levels on ART, as well as differences in the influence of the apoC-III gene on the development of PI-related hypertriglyceridemia. Given the multi-ethnic distribution of HIV-1 infection, our findings underscore the need for future studies of metabolic and cardiovascular complications of ART that specifically account for racial/ethnic heterogeneity, particularly when assessing candidate gene effects.
Bizarre gastric ulcer related to betel quid use: report of two cases
Authors: H. Lu, H. Huang, A. Li, H. Lin, F. Chang, S. Lee
Journal: Endoscopy (2008)

A 47-year-old gentleman, who had chewed 20 betel quids daily for 25 years, presented with a 3-day history of melena. Esophagogastroduodenoscopy (EGD) disclosed an ulcerated tumor 3 cm in size in the antrum ([Fig. 1]). Biopsy of the tumor revealed acute and chronic inflammation. The patient quit chewing betel quids. Because of a strong suspicion of malignancy, EGD was repeated 5 days later. It showed ulcers, from 0.5 to 2 cm in diameter, in the antrum. Biopsy again disclosed acute and chronic inflammation. Hence, betel-quid-related gastric injury was suspected. EGD 1 month later showed only a scar in the antrum ([Fig. 2]) and the histology again proved benign.
EXPERIMENTAL OBSERVATIONS ON IRRADIATED, NORMAL, AND PARTIALLY PARATHYROIDECTOMIZED RABBITS
Authors: Frederick L. Gates, J. H. B. Grant
Journal: The Journal of Experimental Medicine (1927)

The experiments described in the three papers of this series were undertaken to determine if possible the significance of the parathyroid hypertrophy that has repeatedly been found in rabbits after exposure to ultra-violet light. The fact that the hypertrophy was not accompanied by a corresponding increase in blood calcium led us to infer that the upper level of blood calcium concentration is governed by factors independent of parathyroid control, and that the gland hypertrophy under the influence of ultra-violet light might represent a potential functional capacity, or increased factor of safety, to protect the calcium level under conditions of stress or emergency. Partial parathyroidectomy in irradiated rabbits, compared with the same operation in normal controls, resulted in a similar immediate drop in blood calcium; but a more rapid restoration of the calcium level in the irradiated rabbits indicated a more prompt and active response to the emergency on the part of the remaining glands. In the second group of experiments no significant differences were found in the reactions of irradiated, normal, or partially parathyroidectomized rabbits to injections of calcium chloride or of disodium hydrogen phosphate. All three groups of rabbits rapidly eliminated the excess calcium from the blood. Their reactions to large doses of sodium phosphate, given subcutaneously, appeared to be related to phosphate elimination or retention in the individual animals. Those in each group which had phosphate retention in the blood died in acute tetany. So also in the fasting experiments, reported in this paper, no distinctions could be drawn between normal, irradiated, and partially parathyroidectomized rabbits on the basis of their calcium and phosphorus metabolism. Blood calcium was reduced in a similar manner in all three groups of rabbits, and wide individual variations in serum phosphorus levels preclude significant deductions. But the irradiated rabbits suffered disproportionate losses of weight during the fasting period and four of five of them died during the course of the experiment. The deaths of these rabbits are attributed to this more rapid consumption of their own tissues and possibly also to suprarenal injury caused both by fasting and by exposure to ultra-violet light.
Pathognomonic Is Hardly Euphonic
Authors: Martin A. Shearn
Journal: New England Journal of Medicine (1963)

EDITORS frequently remind authors to avoid polysyllabic words when smaller ones will serve the same purpose. Despite this advice, the five-syllable word "pathognomonic" enjoys wide use in medical writings. Even Demosthenes would have tripped over the awkward gn sequence in the middle of this dissonant monstrosity. To what virtues, then, does this word owe its unusual popularity?Physicians are well aware of the rapidly changing state of medical knowledge. With burgeoning research the pigeonholes called "diseases" change more rapidly than classifiers can reclassify them. What is read and believed today is often recognized as fiction tomorrow. The physician thus finds . . .
Genetic disruption of γ-melanocyte–stimulating hormone signaling leads to salt-sensitive hypertension in the mouse
Authors: Xi-Ping Ni, David Pearce, Andrew A. Butler, Roger D. Cone, Michael H. Humphreys
Journal: Journal of Clinical Investigation (2003)

The γ-melanocyte-stimulating hormone (γ-MSH) is a natriuretic peptide derived from the N-terminal region of proopiomelanocortin (POMC). Evidence suggests that it may be part of the coordinated response to a low-sodium diet (LSD). We tested the effect of the HSD (8% NaCl) compared with LSD (0.07%) on mean arterial pressure (MAP) in mice with targeted disruption of the PC2 gene (PC2–/–), necessary for processing of POMC into γ-MSH, or the melanocortin receptor 3 gene (Mc3r–/–; the receptor for MSH). In wild-type mice, HSD for 1 week did not alter MAP versus LSD mice, but plasma γ-MSH immunoreactivity was more than double the LSD value. In contrast, in PC2–/– mice, MAP on the LSD was not greater than in wild-type mice, but plasma γ-MSH was reduced to one-seventh the wild-type value. On the HSD, MAP rose to a markedly hypertensive level while plasma γ-MSH concentration remained severely depressed. Intravenous infusion of γ-MSH (0.2 pmol/min) for 30 min to PC2–/– mice after 1 week of HSD lowered MAP from hypertensive levels to normal; infusion of α-MSH at the same rate had no effect. Injection of 60 fmol of γ-MSH into the lateral cerebral ventricle of hypertensive mice also lowered MAP to normal. Administration of a stable analogue of γ-MSH intra-abdominally by microosmotic pump to PC2–/– mice prevented the development of hypertension when ingesting the HSD. In mice with targeted disruption of the Mc3r gene, the HSD also led to marked hypertension accompanied by elevated plasma levels of γ-MSH; infusion of exogenous γ-MSH to these mice had no effect on MAP. These results strongly suggest that PC2-dependent processing of POMC into γ-MSH is necessary for the normal response to the HSD. γ-MSH deficiency results in marked salt-sensitive hypertension that is rapidly improved with exogenous γ-MSH through a central site of action. α-MSH infused at the same rate had no effect on MAP, indicating that the hypertension is a specific consequence of impaired POMC processing into γ-MSH. Absence of Mc3r produces γ-MSH resistance and hypertension on the HSD. These findings demonstrate a novel pathway mediating salt-sensitivity of blood pressure.
P80 Antibiotic usage as a risk factor for non-tuberculous mycobacterium infection in children with cystic fibrosis
Authors: JL Bowker, MF Thomas, CJ O'Brien
Journal: Thorax (2013)

<h3>Background</h3> There is a growing incidence of Non-Tuberculous Mycobacterium (NTM) in children with Cystic Fibrosis. This audit aimed to determine relevant risk factors for NTM acquisition in paediatric cystic fibrosis patients. <h3>Methods</h3> Data was obtained from clinical notes for 66 patients aged 5–18 years old in a North-East CF clinic who had sputum or bronchoalveolar lavage screened for NTM between 2011 and 2012. <h3>Results</h3> Patients who isolated NTM had higher exposure to intravenous antibiotic courses than comparison group: 53 vs. 21% having 3 or more courses per year (p-value 0.039). 77% of NTM positive patients vs. 47% of non-NTM were taking long-term azithromycin (p-value 0.07). <h3>Conclusion</h3> Higher exposure to intravenous antibiotics courses is a risk factor for isolation of NTM in CF children. This highlights the importance of close monitoring until more is known about the long term health implications of this group of pathogens.
COMPARATIVE EVALUATION OF ADIPOKINES, INFLAMMATORY MARKERS AND CARDIOVASCULAR OUTCOMES IN ASIAN INDIANS VS. EUROPEAN WHITES WITH CORONARY HEART DISEASE: RESULTS FROM THE PRACTICE REGISTRY
Authors: Milan Gupta, Michelle Tsigoulis, Sheriar Hirjikaka, Mahesh Kajil, Mohammad Mamdani, Subodh Verma
Journal: Journal of the American College of Cardiology (2011)
What the educators are saying
Authors: Richard Hays
Journal: BMJ (2005)

The baby boomer generation (born between 1945 and about 1960) still provides the largest proportion of the medical and nursing workforce, and they work longer hours than younger health professionals. However, a survey of doctors and nurses shows that baby boomers are feeling worn out, are looking forward to retirement soon, and are likely to retire at a rate faster than health professionals can be trained. Younger professionals show little sign of wanting to work as hard, or for as long, as the baby boomers. Perhaps society needs to keep baby boomers working for longer, even if only part time, to prevent a collapse of the healthcare system. Medical Journal of Australia2005;183:80–3 [OpenUrl][1][PubMed][2] In an effort to address workforce shortages, the expansion of undergraduate medical education is pushing full time professional medical education to district and smaller hospitals, which traditionally have been run as service, rather than academic, facilities. According to a questionnaire survey of doctors, the good news is that medical staff in … [1]: {openurl}?query=rft.jtitle%253DMedical%2BJournal%2Bof%2BAustralia%26rft.stitle%253DMedical%2BJournal%2Bof%2BAustralia%26rft.aulast%253DSchofield%26rft.auinit1%253DD.%2BJ.%26rft.volume%253D183%26rft.issue%253D2%26rft.spage%253D80%26rft.epage%253D83%26rft.atitle%253DBaby%2Bboomer%2Bdoctors%2Band%2Bnurses%253A%2Bdemographic%2Bchange%2Band%2Btransitions%2Bto%2Bretirement.%26rft_id%253Dinfo%253Apmid%252F16022613%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=16022613&link_type=MED&atom=%2Fbmj%2F331%2F7516%2F561.atom
CMV serostatus still has an important prognostic impact in de novo acute leukemia patients after allogeneic stem cell transplantation: a report from the Acute Leukemia Working Party of EBMT
Authors: Martin Schmidt-Hieber, Myriam Labopin, Dietrich Beelen, Liisa Volin, Gerhard Ehninger, Jürgen Finke, Gerard Socié, Rainer Schwerdtfeger, Nicolaus Kröger, Arnold Ganser, Dietger Niederwieser, Emmanuelle Polge, Igor W. Blau, Mohamad Mohty
Journal: Blood (2013)
F-18 Fluorodeoxyglucose Positron Emission Tomography in the Evaluation of Distant Metastases From Renal Cell Carcinoma
Authors: Navneet S. Majhail, Jean-Luc Urbain, Justin M. Albani, Mangesh H. Kanvinde, Thomas W. Rice, Andrew C. Novick, Tarek M. Mekhail, Thomas E. Olencki, Paul Elson, Ronald M. Bukowski
Journal: Journal of Clinical Oncology (2003)

We conducted a study to evaluate the role of F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) in the detection of distant metastases from renal cell carcinoma (RCC).Twenty-four patients with histologically proven clear-cell RCC undergoing surgical evaluation for possible resection of recurrent disease were investigated. All patients had suspected distant metastases based on conventional anatomic imaging techniques (computed tomography and magnetic resonance imaging). A total of 36 distant metastatic sites were identified. Pathology for all sites was obtained by biopsy or after surgical resection.Histologically documented distant metastases from RCC were present in 33 sites (21 patients). Overall sensitivity, specificity, and positive predictive value of FDG-PET for the detection of distant metastases from RCC was 63.6% (21 of 33), 100% (three of three), and 100% (21 of 21), respectively. The mean size of distant metastases in patients with true-positive FDG-PET was 2.2 cm (95% CI, 1.7 to 2.6 cm) compared with 1.0 cm in patients with false-negative FDG-PET (95% CI, 0.7 to 1.4 cm; P =.001).FDG-PET is not a sensitive imaging modality for the evaluation of metastatic RCC and may not adequately characterize small metastatic lesions. However, positive FDG-PET is predictive for the presence of RCC in lesions imaged, may complement anatomic radiologic imaging modalities, and may alleviate the need for a biopsy in selected situations. A negative FDG-PET, however does not rule out active malignancy.
Letter by Tsikas and Rossi Regarding Article, “Nitrite Anion Provides Potent Cytoprotective and Antiapoptotic Effects as Adjunctive Therapy to Reperfusion for Acute Myocardial Infarction”
Authors: Dimitrios Tsikas, Ranieri Rossi
Journal: Circulation (2009)

We read with interest the work by Gonzalez et al, 1 which reports that nitrite infusion may enhance the efficacy of reperfusion therapy for acute myocardial infarction and have potential clinical impact.Gonzalez et al 1 concluded that nitrite but not other nitric oxide (NO)-related species is the bioactive intravascular NO metabolite that accounts for cardioprotection.In our opinion, this conclusion lacks proof because of potential analytic and methodological shortcomings; in particular, the results shown in Figures 2A and2B of the article 1 deserve comment.Considering the hematocrit (Hct), the relation between nitrite concentration in blood (C B ), plasma (C P ), and erythrocytes (C E ) is described by the equation: C B ϭ(1ϪHct)ϫC P ϩHctϫC E .For dog, 1 the Hct value is Ϸ50%, and C E can be calculated from the reported C B and C P as C E ϭ2ϫC B ϪC P .Before nitrite infusion, the enrichment factors for nitrite (ie, the respective molar ratios of C E :C P ) are 13:1 and 12:1 for the erythrocytic compartment.The data displayed in
Bent Needles: Another Problem in Glycemic Control
Authors: Antonio C. Bossi, Eunice O. Ansah
Journal: Diabetes Care (2008)

Achieving and maintaining tight glycemic control has been the aim of modern diabetologists in the bid to prevent long-term complications of diabetes. In spite of advancement in insulin therapy and devices for its administration (syringes, pens, and needles) making insulin more acceptable to patients, there still remain a few setbacks to treatment efficacy. We report two cases of bent needles as a major contributor to poor glycemic control in patients on insulin therapy (1,2).

B.S., a 51-year-old male truck driver with type 2 diabetes, was on oral hypoglycemics …
How the internet could help Cuba more in health research
Authors: Rodolfo J Stusser, Robert L Kriel, Richard A Dickey, Linda E Krach
Journal: BMJ (2004)

Emigration of talented professionals from resource poor to resource rich countries is a serious and increasing problem. We think that the internet could be used to address some of the root causes of this emigration, substituting collaboration between countries for competition.

Our ideas arose from a detailed review of Cuba's disappointing history of research collaboration with other countries, especially the United States. While Cuba modelled its educational, scientific, and technological systems on those of the United States and embarked on research programmes of US relevance, since 1959 contact between Cuban and US professionals and students has been limited, owing to travel restrictions and limited funds.

Despite these handicaps, Cuban professionals still assimilated overseas knowledge. Cuba has developed a substantial biomedical network …
Antiglobulins in Nigerians with rheumatoid disease.
Authors: G O Okafor, M W Turner, B M Greenwood
Journal: Annals of the Rheumatic Diseases (1975)

The levels of IgG and IgM antiglobulins in the sera of Nigerian patients with seropositive rheumatoid arthritis, seronegative arthritis, and Reiter's syndrome have been studied using an immunosorbent of glutaraldehyde insolubilized human IgG. No conclusion could be reached in the case of IgM antiglobulins because of the relatively high threshold of detectability in the quantitation procedure, but all groups of patients had significantly higher levels of IgG antiglobulins than did a group of healthy Nigerians.
Veterans Who Return to Hospitals Again and Again
Authors: Edward W. Campion
Journal: New England Journal of Medicine (1994)

A report in this issue of the Journal documents that some men are admitted to multiple Veterans Affairs (VA) hospitals with remarkable regularity.1 Using a central data base, Pankratz and Jackson found that in 1991, for example, 810 patients were admitted to four or more VA hospitals and had an average of 8 admissions plus 28 outpatient visits. It is hard to know what was troubling or motivating these patients, but many of their admissions were for psychiatric reasons and they often left the hospital against medical advice. Within this group, no doubt, were some men with medically necessary admissions . . .