tbuckley/cabot-search huggingface dataset:
Clinical Characteristics of Women With a History of Childhood Abuse
Authors: Jeanne McCauley, David E. Kern, Ken Kolodner, Laurie Dill, Arthur F. Schroeder, Hallie K. DeChant, Janice Ryden, Leonard R. Derogatis, Eric B. Bass
Journal: JAMA (1997)

<h3>Objectives.</h3> —To determine the prevalence of childhood physical or sexual abuse in women seen in primary care practices; to identify physical and psychologic problems associated with that abuse; and to compare the effects of childhood physical vs sexual abuse and childhood vs adult abuse. <h3>Design.</h3> —Cross-sectional, self-administered, anonymous survey. <h3>Setting.</h3> —Four community-based, primary care internal medicine practices. <h3>Patients.</h3> —A total of 1931 women of varied age and marital, educational, and economic status examined from February through July 1993. <h3>Main Outcome Measures.</h3> —Prevalence of physical and sexual abuse, physical symptoms, psychological symptoms (Symptom Checklist-22), alcohol abuse (CAGE questions), and street drug use. <h3>Results.</h3> —Of the 1931 respondents, 424 (22.0%) reported childhood or adolescent physical or sexual abuse. Compared with women who reported never having experienced abuse (n=1257), women who reported abuse as children but not adults (n=204) had more physical symptoms (mean±SE, 6.2±0.2 vs 4.0±0.9;<i>P</i>&lt;.001) and had higher scores for depression, anxiety, somatization, and interpersonal sensitivity (low self-esteem) (<i>P</i>&lt;.001); were more likely to be abusing drugs (prevalence ratio [PR], 4.7; 95% confidence interval [CI], 2.9-7.6) or to have a history of alcohol abuse (PR, 2.2; 95% CI, 1.5-3.2); were more likely to have attempted suicide (PR, 3.7; 95% CI, 2.6-5.1); and were more likely to have had a psychiatric admission (PR, 3.2; 95% CI, 2.2-4.7). Women abused only as children did not differ from women who reported current, but not childhood, abuse in number of physical symptoms, emotional distress, substance abuse, or suicide attempts. Patients who reported both childhood and adult abuse had higher levels of psychological problems and physical symptoms than those who reported childhood or adult abuse alone. <h3>Conclusions.</h3> —Childhood physical or sexual abuse is associated with adult health problems including physical symptoms, psychological problems, and substance abuse; for many variables, this association is as strong as for patients experiencing current abuse.
Evidence based cardiology: Prevention of ischaemic stroke
Authors: H. J M Barnett, M. Eliasziw, H. E Meldrum
Journal: BMJ (1999)

Stroke is the second most common cause of death worldwide, exceeded only by heart disease.1 Coincident with the emergence of prevention strategies, incidence of stroke is declining dramatically in developed countries. The prevention of stroke is an obligation facing everyone involved with delivering health care.

### Summary points

Managing the risk factors of hypertension, tobacco, and hyperglycaemia reduces the risk of stroke

Managing hyperglycaemia will diminish the severity of strokes

Warfarin prevents stroke in non-valvular atrial fibrillation

Aspirin is the first choice of platelet inhibitors for stroke prevention

Endarterectomy prevents stroke when symptoms are due to severe stenosis;with moderate stenosis the benefit is muted

Endarterectomy is of uncertain benefit for asymptomatic carotid stenosis

Prospective population studies and retrospective case series have identified modifiable risk factors important for ischaemic and haemorrhagic stroke.

The Four Horsemen of the Apocalypse of stroke display the banners of hypertension, tobacco, diabetes mellitus, and hyperlipidaemia.2 All are responsible for cerebral arteriosclerosis. Transient ischaemic events are powerful predictors of stroke. Coronary artery disease and atrial fibrillation increase stroke risk. Compounds lowering cholesterol, the “statins,” reduce the risk of myocardial infarction and stroke.3

At no age and in neither sex is a systolic blood pressure above 160 mm Hg and a diastolic pressure above 90 mm Hg acceptable. Even elderly subjects and heavy smokers reduce the risk of stroke by abandoning cigarettes.4

Control of insulin dependent diabetes has not been shown to reduce stroke.5 A stroke in the presence of hyperglycemia is more disabling.

Family history of stroke requires the Four Horsemen be sought and managed in the early decades of life. Fatalistic attitudes are wrong. Genetics deals the cards. The play can be determined by environmental influences.

Coagulation abnormalities and homocysteinaemia add to the likelihood of early stroke but are manageable.6

Seven randomised trials …
Notch1, Notch2, and Epstein-Barr virus–encoded nuclear antigen 2 signaling differentially affects proliferation and survival of Epstein-Barr virus–infected B cells
Authors: Hella Kohlhof, Franziska Hampel, Reinhard Hoffmann, Helmut Burtscher, Ulrich H. Weidle, Michael Hölzel, Dirk Eick, Ursula Zimber-Strobl, Lothar J. Strobl
Journal: Blood (2009)
Delayed Tumor Onset in Transgenic Mice Fed a Low-Folate Diet
Authors: N. D. Bills, S. H. Hinrichs, R. Morgan, A. J. Clifford
Journal: JNCI Journal of the National Cancer Institute (1992)

Background : Transgenic mice carrying the human T-lymphotropic virus type 1 tax 1 (transactivator) gene develop peripheral nerve sheath tumors with well-characterized times of onset and tissue involvement. Purpose and Methods: To evaluate the effect of dietary folic acid on age at tumor onset and on the concentration of folate in tissues and tumors, we bred heterozygous transgenic mice and systematically assigned their offspring at weaning (within litters) to a 2 × 2 × 2 factorial arrangement. The three variables studied were 1) the tax, gene (presence or absence), 2) gender (male or female), and 3) dietary level of folic acid (0. 11 or 11.34 μmol folic acid per kilogram of controlled amino acid-based diet). Blood and tissues were collected from tumor-bearing transgenic mice (prior to cachexia) and from non-transgenic littermates, matched whenever possible for gender and diet. Results: Transgenic mice fed a diet containing 0. 11 μmol of folic acid per kilogram developed tumors significantly later (92. 8 ± 6. 4 days) than did those fed a diet containing 11. 34 μmol of folic acid per kilogram (71. 9 ± 3. 9 days). Fo-late concentrations in tumors of mice fed the low-folate diet were approximately one third those in tumors of mice fed the higher folate diet. Brain folate concentrations in mice fed the low-folate diet were less than one half those in mice fed the higher folate diet. Conclusion: Results show that the onset of spontaneous tumors can be delayed by feeding mice the lowest level of folate adequate to meet nutritional requirements for normal growth. Implication: Transgenic animal models of human disease offer great potential for evaluating the role of micronutrients in human carcinogenesis. [J Natl Cancer Inst 84: 332–337, 1992]
A profile of medical education.
Authors: M Ryan
Journal: BMJ (1981)

Whatever the quality of higher education available in the Soviet Union, there can be no question about the massive expansion in the number of places that has occurred over the years. By the start of the academic year 1979-80, students following advanced courses totalled 5 186 000, which represented an all-time record. In the same year the various establishments of higher education which catered for those students with day, evening, or correspondence courses had increased to a new high level of 870. Although it appears that courses are available in more than 400 specialist fields, the regularly published statistical series gives the number of students for only 22 broad occupational groupings. One of these is health service and physical culture. Like higher education in general, this category had reached a peak in 1979-80, with a total of 372 800 students undergoing training and an output of 57 500. Although medicine will account for a very substantial proportion of these aggregates, unfortunately the exact figures are not available and a reliable estimate cannot be calculated at all easily.
Desensitization and Flooding (Implosion) in Treatment of Phobias
Authors: M. Z. HUSSAIN
Journal: American Journal of Psychiatry (1971)

A controlled cross-over trial of desensitization and flooding therapy assisted by intravenous thiopental or saline infusion was carried out in 40 patients with agoraphobia or social phobias. Patients showed gradual symptom improvement with desensitization treatment, whether it was assisted by saline or thiopental, and continued to improve after cross-over. Patients receiving thiopental-assisted flooding showed marked and faster improvement, while those receiving saline-assisted flooding treatment showed slight improvement. The author concludes that desensitization and flooding produce the best results with phobic patients but could also prove useful in general psychiatric management.
Extraosseous Uptake of Technetium-99m MDP in Secondary Deposits of Neuroblastoma
Authors: GERALD A. MANDELL, SYDNEY HEYMAN
Journal: Clinical Nuclear Medicine (1986)

Extraosseous uptake of radiophosphate compounds i well recognized in primary neural crest tumors. In a review of 32 cases of neuroblastoma presenting over a three-year period at Children's Hospital of Philadelphia, nine patients were noted to have secondary lesions in eleven different sites accumulating radiotracer. The extraosseous uptake in metastases included: ascites, liver, lung, anterior mediastinum, and posterior mediastinum. These cases are reported to emphasize the ability of bone imaging to detect the presence of extraosseous soft tissue metastases and primary lesions.
Hypoxic pulmonary blood flow redistribution and arterial oxygenation in endotoxin-challenged NOS2-deficient mice
Authors: Roman Ullrich, Kenneth D. Bloch, Fumito Ichinose, Wolfgang Steudel, Warren M. Zapol
Journal: Journal of Clinical Investigation (1999)

Sepsis and endotoxemia impair hypoxic pulmonary vasoconstriction (HPV), thereby reducing arterial oxygenation and enhancing hypoxemia. Endotoxin induces nitric oxide (NO) production by NO synthase 2 (NOS2). To assess the role of NO and NOS2 in the impairment of HPV during endotoxemia, we measured in vivo the distribution of total pulmonary blood flow (QPA) between the right (QRPA) and left (QLPA) pulmonary arteries before and after left mainstem bronchus occlusion (LMBO) in mice with and without a congenital deficiency of NOS2. LMBO reduced QLPA/QPA equally in saline-treated wild-type and NOS2-deficient mice. However, prior challenge with Escherichia coli endotoxin markedly impaired the ability of LMBO to reduce QLPA/QPA in wild-type, but not in NOS2-deficient, mice. After endotoxin challenge and LMBO, systemic oxygenation was impaired to a greater extent in wild-type than in NOS2-deficient mice. When administered shortly after endotoxin treatment, the selective NOS2 inhibitor L-NIL preserved HPV in wild-type mice. High concentrations of inhaled NO attenuated HPV in NOS2-deficient mice challenged with endotoxin. These findings demonstrate that increased pulmonary NO levels (produced by NOS2 or inhaled at high levels from exogenous sources) are necessary during the septic process to impair HPV, ventilation/perfusion matching and arterial oxygenation in a murine sepsis model.
Two Unusual Cases of Metastatic Osteosarcoma Detected by Tc-99m MDP Bone Scintigraphy
Authors: ANDREW HEINLE, JORGE A. CARRASQUILLO, RONALD D. NEUMANN
Journal: Clinical Nuclear Medicine (1989)

Tc-99m MDP bone scintigraphy is widely used for initial staging and subsequent follow-up of patients with osteosarcoma. Two unusual cases are presented here, one with diffuse pleural metastases and one with diffuse peritoneal metastases. In one case, an abnormal bone scan was the first indication of metastatic disease. Both the metastatic pattern of osteosarcoma and the indications for bone scintigraphy are reviewed.
GW25-e5221 The Characters of Myocardial Mechanics in Chinese Patients with Primary Cardiac Amyloidosis and Hypertrophic Cardiomyopathy
Authors: Zhang Lu, Wang Ye, Cheng Liuquan, Wang Jing, Zhou Xiao, Liu Miao, Zhang Bo, Chen Yundai, Zhi Guang
Journal: Journal of the American College of Cardiology (2014)
Community-Acquired Methicillin-Resistant &lt;EMPH TYPE="ITAL"&gt;Staphylococcus aureus&lt;/EMPH&gt; in a Rural American Indian Community
Authors: Amy V. Groom
Journal: JAMA (2001)

ContextUntil recently, methicillin-resistant Staphylococcus aureus (MRSA) infections have been acquired primarily in nosocomial settings. Four recent deaths due to MRSA infection in previously healthy children in the Midwest suggest that serious MRSA infections can be acquired in the community in rural as well as urban locations.ObjectivesTo document the occurrence of community-acquired MRSA infections and evaluate risk factors for community-acquired MRSA infection compared with methicillin-susceptible S aureus (MSSA) infection.DesignRetrospective cohort study with medical record review.SettingIndian Health Service facility in a rural midwestern American Indian community.PatientsPatients whose medical records indicated laboratory-confirmed S aureus infection diagnosed during 1997.Main Outcome MeasuresProportion of MRSA infections classified as community acquired based on standardized criteria; risk factors for community-acquired MRSA infection compared with those for community-acquired MSSA infection; and relatedness of MRSA strains, determined by pulsed-field gel electrophoresis (PFGE).ResultsOf 112 S aureus isolates, 62 (55%) were MRSA and 50 (45%) were MSSA. Forty-six (74%) of the 62 MRSA infections were classified as community acquired. Risk factors for community-acquired MRSA infections were not significantly different from those for community-acquired MSSA. Pulsed-field gel electrophoresis subtyping indicated that 34 (89%) of 38 community-acquired MRSA isolates were clonally related and distinct from nosocomial MRSA isolates found in the region.ConclusionsCommunity-acquired MRSA may have replaced community-acquired MSSA as the dominant strain in this community. Antimicrobial susceptibility patterns and PFGE subtyping support the finding that MRSA is circulating beyond nosocomial settings in this and possibly other rural US communities.
Neoplasms of Bone and Related Conditions: Etiology, Pathogenesis, Diagnosis, and Treatment
Authors: W. G. Brandstadt
Journal: JAMA (1960)

This second edition appears about 11 years after the first and is completely revised and largely rewritten. New entities described include chondromyxoid fibroma, aneurysmal bone cyst, juxtacortical low-grade osteosarcoma, and malignant angioblastoma. "Emphasis has again been placed on the role of radiation therapy, not only as a palliative agent or for inoperable tumors but under certain conditions even as a preferred method of treatment." The various sections deal with classification, etiology, and diagnosis; benign tumors and tumorlike lesions of bone; primary malignant tumors of bone; tumors involving bone by extension; metastatic tumors involving bone; tumors of bone in special localities; surgical treatment; radiation therapy; constitutional therapy; and lesions of the skeletal system that may simulate neoplasms of bone. This list indicates the completeness of the coverage. Microscopic pathology has purposely been given little space as this aspect of the subject is well covered in other texts. The book is profusely
Sociologic Influences on Decision-Making by Clinicians
Authors: JOHN M. EISENBERG
Journal: Annals of Internal Medicine (1979)

Recent articles on clinical decision-making have proposed sophisticated quantitative methods for improving the physician's clinical judgment. Actual clinical decisions, however, are influenced by interactions between the clinician, the patient, and the sociocultural milieu as well as by biomedical considerations. This paper explores these sociologic influences on the decision-making process. Four types of sociologic factors influence the clinician's judgment: the characteristics of the patient; the characteristics of the clinician; the clinician's interaction with his profession and the health care system; and the clinician's relationship with the patient. To illustrate sociologic influences on clinical decision-making, this paper presents observations from the literature of sociology, clinical psychology, psychiatry, and medicine. Further studies are needed to provide additional empirical information.
Pituitary adenylate cyclase activating peptides relax human pulmonary arteries by opening of KATP and KCa channels
Authors: L. Bruch, S. Rubel, A. Kastner, K. Gellert, M. Gollasch, C. Witt
Journal: Thorax (1998)

Pituitary adenylate cyclase activating peptides (PACAPs) are potent endothelium independent dilators of human coronary arteries; however, their effects on human pulmonary arteries are unknown.The vasorelaxant effects of PACAP27 on human pulmonary segmental arteries were studied and the specific potassium (K+) channel regulatory mechanisms in the vasorelaxant effects were tested by means of isometric contraction experiments.PACAP27 produced dose dependent relaxations of 10 microM rings preconstricted with prostaglandin F2 alpha (PGF2 alpha) with half maximal relaxation (IC50) at 17 nM. Pretreatment of the vessels with the ATP sensitive K+ (KATP) channel blocker glibenclamide (1 microM) or with the Ca2+ activated K+ (KCa) channel blocker iberiotoxin (100 nM) inhibited the PACAP27 induced relaxation.These results provide evidence that PACAPs are potent vasodilators of human pulmonary arteries and that this relaxation might be mediated by opening of KATP and KCa channels.
Diagnosis and management of gallstone disease: summary of NICE guidance
Authors: S. Warttig, S. Ward, G. Rogers
Journal: BMJ (2014)

Gallstone disease is common—10-15% of adults in Western populations are thought to have the condition.1 2 Concerns about inappropriate variation in the management of gallstones have led to the development of recommendations on the diagnosis and management of cholelithiasis, cholecystitis, and choledocholithiasis in an attempt to improve patient outcomes and promote effective use of resources. This article summarises the most recent recommendations on the management of gallstone disease from the National Institute for Health and Care Excellence (NICE).3 NICE recommendations are based on systematic reviews of best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on the Guideline Development Group’s experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets. ### Diagnosis ### Treating asymptomatic gallbladder stones
Paxillin Is a Target for Somatic Mutations in Lung Cancer: Implications for Cell Growth and Invasion
Authors: Ramasamy Jagadeeswaran, Hanna Surawska, Soundararajan Krishnaswamy, Varalakshmi Janamanchi, A. Craig Mackinnon, Tanguy Y. Seiwert, Sivakumar Loganathan, Rajani Kanteti, Trevor Reichman, Vidya Nallasura, Stuart Schwartz, Leonardo Faoro, Yi-Ching Wang, Luc Girard, Maria S. Tretiakova, Salman Ahmed, Osvaldo Zumba, Lioubov Soulii, Vytas P. Bindokas, Livia L. Szeto, Gavin J. Gordon, Raphael Bueno, David Sugarbaker, Mark W. Lingen, Martin Sattler, Thomas Krausz, Wickii Vigneswaran, Viswanathan Natarajan, John Minna, Everett E. Vokes, Mark K. Ferguson, Aliya N. Husain, Ravi Salgia
Journal: Cancer Research (2008)

Abstract Lung cancer is characterized by abnormal cell growth and invasion, and the actin cytoskeleton plays a major role in these processes. The focal adhesion protein paxillin is a target of a number of oncogenes involved in key signal transduction and important in cell motility and migration. In lung cancer tissues, we have found that paxillin was highly expressed (compared with normal lung), amplified (12.1%, 8 of 66) and correlated with increased MET and epidermal growth factor receptor (EGFR) gene copy numbers, or mutated (somatic mutation rate of 9.4%, 18 of 191). Paxillin mutations (19 of 21) were clustered between LD motifs 1 and 2 and the LIM domains. The most frequent point mutation (A127T) enhanced lung cancer cell growth, colony formation, focal adhesion formation, and colocalized with Bcl-2 in vitro. Gene silencing from RNA interference of mutant paxillin led to reduction of cell viability. A murine in vivo xenograft model of A127T paxillin showed an increase in tumor growth, cell proliferation, and invasion. These results establish an important role for paxillin in lung cancer. [Cancer Res 2007;68(1):132–42]
Overcoming Treatment Resistance in Chronic Depression: A Pilot Study on Outcome and Feasibility of the Cognitive Behavioral Analysis System of Psychotherapy as an Inpatient Treatment Program
Authors: Eva-Lotta Brakemeier, Martina Radtke, Vera Engel, Johannes Zimmermann, Brunna Tuschen-Caffier, Martin Hautzinger, Elisabeth Schramm, Mathias Berger, Claus Normann
Journal: Psychotherapy and Psychosomatics (2014)

The Cognitive Behavioral Analysis System of Psychotherapy (CBASP), initially developed as an outpatient treatment for chronic depression (CD), has been adapted as a multidisciplinary 12-week inpatient program for CD.Seventy inpatients with CD and treatment resistance were included in a noncontrolled trial. The Hamilton Depression Rating Scale served as the primary outcome measure. Prospective naturalistic follow-up assessments were conducted 6 and 12 months after discharge.Dropout rate was 7.1%; 90.4% perceived the program as helpful. Pre-post comparisons yielded strong effect sizes; 75.7% of the intention-to-treat sample responded, and 40.0% remitted. Nonremission was associated with experiencing temporary deterioration of symptoms during treatment. After 6 months 75.0% and after 12 months 48.0% of patients sustained response.The CBASP program appears as a feasible acute treatment for treatment-resistant CD inpatients with promising outcome. However, the continuation of treatment after discharge should be optimized especially for patients with subjective deterioration during treatment.