tbuckley/cabot-search huggingface dataset:
Predicting and communicating prognosis in palliative care
Authors: P. Glare
Journal: BMJ (2011)

Prognostic tools can help, but should not be applied blindly

When Abdelbaset Ali al-Megrahi, convicted of the Lockerbie bombing, was released from a Scottish prison in August 2009, he was freed on compassionate grounds. His doctors pronounced that he was terminally ill with prostate cancer and thought he had only a few months to live. He is still alive today. How Meghari’s prognosis was formulated is not known, but its accuracy may have been improved if his doctors had had access to a tool like the one developed in the linked study by Gwilliam and colleagues (doi:10.1136/bmj.d4920).1

Diagnosis, prognosis, and therapeutics are the three essential clinical skills and prognosis is the least well done. Doctors are rarely trained in formulating prognoses, an nor do they like doing it, so they try to avoid it.2 But in the 21st century much of clinical practice involves caring for patients with advanced, progressive, life limiting illness. Prognosis needs to be restored as a core clinical skill, to optimise the patient’s treatment and planning.

A new science of prognosis is emerging in palliative care. There are two components to the skill of prognosis—formulating the …
Clinical and subclinical HSV infection resulting from exposure to asymptomatic patients
Authors: L. Aurelian, M. Wachsman, J.W. Burnett
Journal: British Journal of Dermatology (1990)

Journal Article Clinical and subclinical HSV infection resulting from exposure to asymptomatic patients Get access L. Aurelian, L. Aurelian Virology/Immunology Laboratories, Department of Pharmacology and Experimental Therapeutics, School of Medicine Baltimore, MD 21201Divisions of Comparative Medicine, The John Hopkins Medical Institutions, Baltimore, MD 21205, U.S.A.Divisions of Biophysics, The John Hopkins Medical Institutions, Baltimore, MD 21205, U.S.A. Search for other works by this author on: Oxford Academic Google Scholar M. Wachsman, M. Wachsman Virology/Immunology Laboratories, Department of Pharmacology and Experimental Therapeutics, School of Medicine Baltimore, MD 21201 Search for other works by this author on: Oxford Academic Google Scholar J.W. Burnett J.W. Burnett Division of Dermatology, Department of Medicine, School of Medicine Baltimore, MD 21201 Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 122, Issue 1, 1 January 1990, Pages 117–119, https://doi.org/10.1111/j.1365-2133.1990.tb08252.x Published: 01 January 1990
The Natural History of Alcoholism Revisited
Authors: Jack H. Mendelson
Journal: JAMA (1996)

In 1983 Dr George Vaillant reported a study,<i>The Natural History of Alcoholism</i>, based upon a research program of adult development at the Harvard Medical School. The original study carried out from 1940 through 1980 involved 660 men during their maturation from adolescence to late middle life. Of the 660 subjects, 204 were college students with excellent social and economic resources. A total of 456 young men were selected from less fortunate inner-city environments, and 100 alcohol-dependent men and women who were in treatment for alcohol detoxification were also evaluated on a longitudinal basis. In<i>Natural History of Alcoholism Revisited</i>Dr Vaillant notes that "rather than alter the original text I have chosen to add data collected and literature reviewed since 1980 in new sections under headings marked<i>revisited</i>." He also states that "one purpose of using separate sections for new material is to underscore the relativity that time imposes
Clinical and Prognostic Features of Infiltrating Lobular Carcinoma of the Breast in a Korean Series.
Authors: J. Lee, B. Park, S. Park
Journal: Cancer Research (2009)

Abstract Introduction: Infiltrating lobular carcinoma (ILC) is the second most common histological type of invasive breast cancer (IBC) and accounts for 10% of all IBCs. ILC differs from IDC in many respects including age of patients, tumor size and increased frequency of multifocality and bilaterality. But, the outcome of ILC remains unclear. Therefore, we studied the clinical features and prognosis of patients with ILC and infiltrating ductal carcinoma (IDC). Methods: We analyzed data from 3716 breast cancer pts who were were treated at the Yonsei University Health System between 1984 and 2005. Median follow time is 74 months. The patients were categorized as having ILC or IDC. Results: 95(2.3%) tumors were classified as ILC, 3621 (89.4%) as IDC. In analysis there were no differences of age, tumor size, nodal status and stage between ILC and IDC. However, patients with ILC were significantly more likely to have estrogen positive (79.7% for ILC vs 62.6% for IDC, p=0.003) and HER-2 negative tumors (83.6% for ILC vs 70.8% for IDC, p=0.038) compared to patients with IDC. The frequency of bilateral breast cancers was higher for patients with ILC than for patients with IDC (ILC: 6.8% vs. IDC: 3.5%, p=0.013). The systemic recurrence and local recurrence rates for ILC were similar to IDC. However, the sites of systemic recurrence were different. IDC more commonly metastasized lung than IDC (36.5% for IDC vs 9.1% for ILC). ILC more commonly metastasized to bone and the ovaries than IDC (bone: 72.7% for ILC vs 36.5 % for IDC, ovary: 18.2% for ILC vs 0% for IDC). there were no statistically significant differences in DFS and OS between ILC and IDC. The 5-year DFS was 87.6% for ILC and 78.7% for IDC.(p=0.174) The 5-year OS was 93.6% for ILC and 85.5% for IDC.(p=0.104) Conclusion: In the results of this study, the incidence of ILC was quite low in Korean breast cancer patients. ILC showed different histologic features as bilateral involvement, ER positivity, HER-2 negativity and systemic recurrence sites compared to IDC. But the prognosis of ILC was similar to that of IDC. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3036.
What causes cryptogenic fibrosing alveolitis? A case-control study of environmental exposure to dust.
Authors: J Scott, I Johnston, J Britton
Journal: BMJ (1990)

OBJECTIVE--To investigate the role of occupational and domestic exposure to dust in the aetiology of cryptogenic fibrosing alveolitis. DESIGN--Matched case-control study. SUBJECTS--40 Patients with cryptogenic fibrosing alveolitis and 106 community controls matched for age and sex who responded to a questionnaire. MAIN OUTCOME MEASURE--Responses to self administered questionnaire asking about lifetime exposure to dust, animals, and smoke at home and at work. RESULTS--The patients with cryptogenic fibrosing alveolitis were more likely to report occupational exposure to metal dust (matched odds ratio 10.97 (95% confidence interval 2.30 to 52.4), p less than 0.001) or wood dust (2.94 (0.87 to 9.90), p = 0.08), to have worked with cattle (10.89 (1.24 to 96.0), p = 0.01), and to have lived in a house heated by a wood fire (12.55 (1.04 to 114), p = 0.009). A history of smoking and social class based on occupation were not significantly related to disease state. CONCLUSION--Environmental exposure to dust may be an important factor in the aetiology of cryptogenic fibrosing alveolitis.
Bilateral Thyrotomy for Carcinoma of the Larynx
Authors: Joseph I. Kemler
Journal: New England Journal of Medicine (1951)

THYROTOMY for carcinoma of the larynx has been practiced since 1870 with varied success. The results were very discouraging at first, as, for instance, in Billroth's Clinic, where eight cases were operated on between 1870 and 1884, and only one patient survived less than three years without recurrence of the condition. Paul Bruns recorded nineteen cases in the same period, with only two survivals of one year. From these statistics it was then concluded by such men as Morrell Mackenzie, Butlin, Semon and Moure that thyrotomy is an undesirable operation, and should not be attempted in cases of cancer of . . .
Irritable bowel syndrome: relationship of disorders in the transit of a single solid meal to symptom patterns.
Authors: P A Cann, N W Read, C Brown, N Hobson, C D Holdsworth
Journal: Gut (1983)

The time taken for a solid meal to pass through the stomach, small intestine, and colon was measured in 61 patients with irritable bowel syndrome, subdivided according to their presenting symptoms, and in 53 healthy volunteers. Small bowel transit times were significantly shorter in patients who complained predominantly of diarrhoea (3.3 +/- 0.3 vs 4.2 +/- 0.2 h; p = 0.01; n = 21) and significantly longer in patients who complained predominantly of constipation (5.4 +/- 0.3 vs 4.2 +/- 0.2 h; p less than 0.01; n = 23) or pain and distension (5.4 +/- 0.4 vs 4.2 +/- 0.2 h; p less than 0.01; n = 17) compared with controls. Whole gut transit times were shorter in patients who complained of diarrhoea (35 +/- 5 vs 53 +/- 4 h; p less than 0.01), and longer in patients with constipation (87 +/- 13 vs 53 +/- 4 h; p less than 0.05) compared with controls. No significant differences in gastric emptying rates were shown between any of the patient groups and normal controls. Thirty-four patients reported pain, particularly in the right iliac fossa, during the meal transit test, and in 25 of these (74%), the onset of the pain was associated with the arrival of residues of the test meal in the caecum. Our results indicate that irritable bowel syndrome should be considered a disease of the small intestine as well as the colon.
Discordant effects of anti–VLA-4 treatment before and after onset of relapsing experimental autoimmune encephalomyelitis
Authors: Bradley E. Theien, Carol L. Vanderlugt, Todd N. Eagar, Cheryl Nickerson-Nutter, Remederios Nazareno, Vijay K. Kuchroo, Stephen D. Miller
Journal: Journal of Clinical Investigation (2001)

Initial migration of encephalitogenic T cells to the central nervous system (CNS) in relapsing experimental autoimmune encephalomyelitis (R-EAE), an animal model of multiple sclerosis (MS), depends on the interaction of the α4 integrin (VLA-4) expressed on activated T cells with VCAM-1 expressed on activated cerebrovascular endothelial cells. Alternate homing mechanisms may be employed by infiltrating inflammatory cells after disease onset. We thus compared the ability of anti–VLA-4 to regulate proteolipid protein (PLP) 139-151–induced R-EAE when administered either before or after disease onset. Preclinical administration of anti–VLA-4 either to naive recipients of primed encephalitogenic T cells or to mice 1 week after peptide priming, i.e., before clinical disease onset, inhibited the onset and severity of clinical disease. In contrast, Ab treatment either at the peak of acute disease or during remission exacerbated disease relapses and increased the accumulation of CD4+ T cells in the CNS. Most significantly, anti–VLA-4 treatment either before or during ongoing R-EAE enhanced Th1 responses to both the priming peptide and endogenous myelin epitopes released secondary to acute tissue damage. Collectively, these results suggest that treatment with anti–VLA-4 Ab has multiple effects on the immune system and may be problematic in treating established autoimmune diseases such as MS.
Disease activity and risk of lymphoma in patients with rheumatoid arthritis: nested case-control study
Authors: E. Baecklund, A. Ekbom, P. Sparen, N. Feltelius, L. Klareskog
Journal: BMJ (1998)

maxilla that might predispose to retropalatal upper airway narrowing.Since facial structure is at least partly inherited, this may provide the familial link in the sudden infant death syndrome, although larger studies are required to confirm these findings.These results also provide a further link between the sudden infant death and obstructive sleep apnoea/hypopnoea syndromes, as the facial changes are similar in both conditions.Our study indicates that a retrognathic facial structure should be considered as an additional risk factor for the sudden infant death syndrome, and the suggested mechanism for upper airway narrowing could also contribute to the posture dependence of the syndrome and to the association with upper respiratory tract infections, which predispose to obstructive apnoeas by increasing nasal resistance.We suggest there is a need to assess whether prevention of obstructive apnoeas, such as by continuous positive airway pressure, prevents the sudden infant death syndrome in high risk infants.
Transport and biodistribution of dendrimers across human fetal membranes: Implications for intravaginal administration of dendrimer-drug conjugates
Authors: Anupa R. Menjoge, Raghavendra S. Navath, Abbas Asad, Sujatha Kannan, Chong Jai Kim, Roberto Romero, Rangaramanujam M. Kannan
Journal: Biomaterials (2010)
Cryptic ins(2;11) with clonal evolution showing amplification of 11q23–q25 either on hsr(11) or on dmin, in a patient with AML-M2
Authors: I Vazquez, I Lahortiga, X Agirre, M J Larrayoz, J L Vizmanos, M T Ardanaz, N J Zeleznik-Le, M J Calasanz, M D Odero
Journal: Leukemia (2004)
DIURETIC DRUGS IN ACUTE EXPERIMENTAL NEPHRITIS
Authors: HENRY A. CHRISTIAN
Journal: JAMA (1913)

The term "diuretic drug" is used in this paper to indicate drugs which are used frequently by physicians for the purpose of causing diuresis. How they act, whether or not they are actually diuretics, and questions of this nature lie beyond the scope of this paper, and are left for discussion by pharmacologists. Since the abstract of this paper was prepared a portion of the work has been published,<sup>1</sup>and this I shall review briefly. In that paper we described experiments with theobromin sodium salicylate in rabbits having severe nephritis produced by uranium nitrate. In half of the animals theobromin sodium salicylate was given by stomach-tube, and in half it was given intravenously. In all eighty-two rabbits were used, half of which, not receiving theobromin sodium salicylate, served as controls. In order to have the animals which received theobromin sodium salicylate and the controls under the same conditions of experiment
Extracellular signal-regulated kinase activation differentially regulates platelet-derived growth factor's actions in hepatic stellate cells, and is induced byIn Vivo liver injury in the rat
Authors: Fabio Marra, Maria Cristina Arrighi, Marilena Fazi, Alessandra Caligiuri, Massimo Pinzani, Roberto G. Romanelli, Eva Efsen, Giacomo Laffi, Paolo Gentilini
Journal: Hepatology (1999)

Upon liver injury, hepatic stellate cells (HSC) show increased proliferation, motility, and extracellular matrix (ECM) production. The extracellular signal-regulated kinases (ERK) control different functions in a cell-specific manner. In this study, we evaluated the role of ERK activation in cultured HSC stimulated with platelet-derived growth factor (PDGF) and after induction of liver injury in vivo . HSC were isolated from normal human liver tissue, cultured on plastic, and used in their myofibroblast-like phenotype. In in vivo experiments, HSC were isolated from normal rats or at different time points after a single intragastric administration of CCl 4 . Nontoxic concentrations of PD98059, a specific inhibitor of ERK activation, reduced PDGF-induced activation of ERK in a dose-dependent fashion. Suppression of ERK activation was associated with complete inhibition of HSC proliferation and with a 57% reduction in chemotaxis. In the presence of the ERK inhibitor, binding of the AP-1 complex and of STAT1 to the related regulatory elements was inhibited. The inhibition of the DNA binding activity of STAT1 was mediated by a reduction in PDGF-induced tyrosine phosphorylation. Expression of c-fos in response to PDGF was also reduced, but not suppressed, by treatment with PD98059. In HSC isolated from CCl 4 -treated rats, ERK activity increased as early as 6 hours following liver damage, and declined thereafter. The results of this study indicate that ERK activation regulates proliferation and chemotaxis of HSC, and modulates nuclear signaling. Acute liver damage in vivo leads to activation of ERK in HSC.
Abstract P6-08-10: Disease Specific Survival of Breast Cancer Patients Is Not Associated with Expression of Inactive or Even Partially Activated Src Kinase
Authors: B Elsberger, BA Tan, SF Brown, EA Mallon, J. Edwards
Journal: Cancer Research (2010)

Abstract Background: c-Src is implicated as a regulator of cell proliferation and survival (1). Recent work has demonstrated that c-Src and fully activated Y419Src expression in breast cancer specimens was associated with poor clinical outcome of breast cancer patients (2). c-Src is activated by a number of pathways. Known as the classical activation pathway, dephosphorylation of Y530 is needed to initiate a configuration change of the protein allowing full activation by autophosphorylation of tyrosine site 419. Phosphorylation of the tyrosine residual 530 on the c-terminal tail by Csk tyrosine kinase acts as a negative regulatory protein binding site, keeping Src kinase in a closed confirmation (3). The aim of this translational study was to assess associations between inactivate and partially activated Src expression to clinic-pathological features of the cohort and if different stages of c-Src activation equally influences breast cancer patients’ disease specific survival. Methods: Tissue microarray technology was used to analyse tissue taken from 165 breast cancer patients taken at time of surgical resection. Immunohistochemistry was performed using anti-Clone 28 and Clone 28 antibody. To investigate those different stages of Src kinase activation, Clone 28 antibody was employed to recognise the semi-active form of Src. To evaluate protein expression of inactive Src kinase, anti-Src family negative regulatory [pY] site (anti-Clone 28= AC28) antibody was utilised for detecting phosphorylated tyrosine site 530. Expression was assessed using the weighted histoscore method by two independent scorers. Results: Using those antibodies, 50% of AC28 and Clone28 expression was observed in the nucleus and 44% AC28 and 46% Clone28 expression in the cytoplasm. Only 3.6% of AC28 was detected in the membrane, compared to Clone28 with 53% in the membrane and 55 % perinuclear. Nuclear expression of AC28 correlated negatively with ER status (chi square P&amp;lt;0.001), whereas cytoplasmic AC28 and Clone28 correlated negatively with membrane c-Src expression (chi square p=0.008, chi square P&amp;lt;0.001). On univariate and multivariate analysis there was no significant association noticed between AC28 and Clone28 expression and disease specific survival at any cellular location. Conclusions: ER negative breast cancers patients were more likely to express inactive Src in the nucleus. Breast cancer patients with higher cytoplasmic expression of inactive or partially activated Src were more likely not to express c-Src at the membrane (site of activation). Inactive and partially activated Src are not associated with patients’ survival. References: 1) Frame MC. Biochim Biophys Acta 2002; 1602: 114-130. 2) Elsberger B, et. al: Am J Path (2009);175(4):1389-97. 3) Roskoski R Jr. Biochem Biophys Res Commun. 2005 May 27;331(1):1- 14. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P6-08-10.
A PREVIOUSLY VALIDATED PERIPHERAL GENE EXPRESSION SCORE IS MOSTLY DETERMINED BY NON-CALCIFIED PLAQUE AND LUMINAL STENOSIS AS ASSESSED BY QUANTITATIVE, 3-DIMENSIONAL MEASUREMENTS BY CT ANGIOGRAPHY IN THE MULTI-CENTER, PROSPECTIVE COMPASS STUDY
Authors: Szilard Voros, Gregory Thomas, Alexandra Lansky, John McPherson, Michael Elashoff, Sarah Rinehart, Andrea Johnson, Steven Rosenberg
Journal: Journal of the American College of Cardiology (2012)
A possible explanation for the increased referral of atopic dermatitis from the Asian community in Leicester
Authors: S. GEORGE, J. BERTH-JONES, R.A.C. GRAHAM-BROWN
Journal: British Journal of Dermatology (1997)

The population of the city of Leicester contains, in addition to the 'native' population, a large immigrant 'Asian' community originating from the Indian subcontinent. Among referrals to our department, atopic dermatitis (AD) was 3,3 times more common in Asians. We therefore performed a study based on a cohort of consecutive births in Leicester hospitals to investigate the possible ethnic difference in prevalence and to examine possible reasons for an ethnic difference in referral pattern. Parents of 1,800 children were asked at the time of the birth to allow their child to be entered on a register. A year later, parents of a sample of 499 of these children, 158 Asian and 341 non-Asian, were invited for interview and for examination of the children. A total of 413 children were examined. The overall point prevalence of AD was 10.7% (95% confidence interval, 7.7%-13.7%). There was no significant ethnic difference. However, a history of eczema in a first degree relative was found in 14.2% of Asian subjects and 35.1% of non-Asians (P < 0.0001, chi-square test). The data suggest the increased referrals to our clinic from the Asian community may result from a lower level of familiarity with AD.
The Effect of Exercise on Intrinsic Myocardial Performance
Authors: WILLIAM G. WINTERS, DAVID M. LEAMAN, RICHARD A. ANDERSON
Journal: Circulation (1973)

Systolic time intervals were performed on 49 male subjects. Twenty-eight subjects were inactive with respect to a continuing exercise program and were classified as a sedentary group. Twenty-one subjects were physically active and were classified as an active group. The active group was composed of 12 members who were moderately active and nine members of a college track team. Using analysis of covariance no significant difference was found in the total duration of electromechanical systole (QS 2 ), left ventricular ejection time (LVET), or the preejection period (PEP) between the moderately active subgroup and the members of the track team. However, a highly significant difference was found between the sedentary and the active group in the QS 2 and PEP. The LVET was not significantly different. The results of this study appear to be consistent with the hypothesis that an increase in intrinsic myocardial performance is associated with physical conditioning. In addition, it is suggested that published equations for the QS 2 interval and the PEP may be applicable only to sedentary individuals.
Radioactive Isotope Therapy for Ovarian Carcinoma
Authors: Irving M. Ariel
Journal: JAMA (1961)

THIS REPORT describes an unusual instance in which a 22-year-old woman with extensive inoperable ovarian carcinomatosis was treated with a large dose of radioactive isotopes administered intra-abdominally. She became pregnant after the administration of 75 millicuries of radioactive gold and 20 millicuries of radioactive chromic phosphate. One month after gestation, and, of course, without the realization that the patient was pregnant, she was given another course of 20 millicuries of radioactive chromic phosphate intra-abdominally. She delivered a normal child by cesarean section.  Report of a Case  The patient had suffered pain in the region of the left side of the abdomen and had had the sensation of a large mass involving the left side of the abdomen for approximately 6 weeks. The abdomen had become distended. Her appetite remained good, and her bowel and bladder functions were normal. At the time she presented herself, on July 2, 1959, she had
FDA approves heart laser treatment
Authors: D. Josefson
Journal: BMJ (1998)

A laser treatment for refractory angina known as transmyocardial revascularisation has won cautious approval from a Food and Drug Administration advisory panel. Last year the technique was rejected.

The treatment is an experimental procedure in which 20­40 holes, each 1 mm in diameter, are drilled by a laser into a beating left ventricle. PLC Systems, the manufacturer of the laser, had applied for FDA approval of its heart laser system and of the technique.

Proponents of the procedure believe that the holes promote angiogenesis and mature into blood vessels, which subsequently feed oxygen rich blood to ischaemic myocardium. But little evidence exists that this …
Rituximab treatment of idiopathic membranous nephropathy
Authors: F.C. Fervenza, F.G. Cosio, S.B. Erickson, U. Specks, A.M. Herzenberg, J.J. Dillon, N. Leung, I.M. Cohen, D.N. Wochos, E. Bergstralh, M. Hladunewich, D.C. Cattran
Journal: Kidney International (2007)