tbuckley/cabot-search huggingface dataset:
Volume and Outcome of Coronary Artery Bypass Graft Surgery
Authors: James M. Wilson
Journal: JAMA (1987)

<h3>To the Editor.—</h3> The recent article entitled "Association of Volume With Outcome of Coronary Artery Bypass Graft Surgery" by Showstack et al<sup>1</sup>was an interesting analysis of coronary artery bypass graft (CABG) surgical results. Several conclusions were drawn from this analysis that require further comment. The major conclusion of this article, based on statistical analysis of the discharge abstracts for 18 986 CABG operations at 77 hospitals, was that the greatest improvement in mortality rates for CABG surgery would result from the closure of low-volume surgery units. To support this premise, the authors reported that CABG surgical programs performing 20 to 100 operations per year had a mortality rate of 5.2%, those programs performing 101 to 200 operations had a mortality rate of 3.9%, and those performing greater than 350 operations per year had a mortality rate of 3.1%. The numbers are certainly suggestive. However, as the authors acknowledge,
A geographic information system for characterizing exposure to Agent Orange and other herbicides in Vietnam.
Authors: Jeanne Mager Stellman, Steven D Stellman, Tracy Weber, Carrie Tomasallo, Andrew B Stellman, Richard Christian
Journal: Environmental Health Perspectives (2002)

Between 1961 and 1971, U.S. military forces dispersed more than 19 million gallons of phenoxy and other herbicidal agents in the Republic of Vietnam, including more than 12 million gallons of dioxin-contaminated Agent Orange, yet only comparatively limited epidemiologic and environmental research has been carried out on the distribution and health effects of this contamination. As part of a response to a National Academy of Sciences' request for development of exposure methodologies for carrying out epidemiologic research, a conceptual framework for estimating exposure opportunity to herbicides and a geographic information system (GIS) have been developed. The GIS is based on a relational database system that integrates extensive data resources on dispersal of herbicides (e.g., HERBS records of Ranch Hand aircraft flight paths, gallonage, and chemical agent), locations of military units and bases, dynamic movement of combat troops in Vietnam, and locations of civilian population centers. The GIS can provide a variety of proximity counts for exposure to 9,141 herbicide application missions. In addition, the GIS can be used to generate a quantitative exposure opportunity index that accounts for quantity of herbicide sprayed, distance, and environmental decay of a toxic factor such as dioxin, and is flexible enough to permit substitution of other mathematical exposure models by the user. The GIS thus provides a basis for estimation of herbicide exposure for use in large-scale epidemiologic studies. To facilitate widespread use of the GIS, a user-friendly software package was developed to permit researchers to assign exposure opportunity indexes to troops, locations, or individuals.
Isolated hevein-like domains, but not 31-kd endochitinases, are responsible for IgE-mediated in vitro and in vivo reactions in latex-fruit syndrome
Authors: Piia Karisola, Annika Kotovuori, Sanna Poikonen, Einari Niskanen, Nisse Kalkkinen, Kristiina Turjanmaa, Timo Palosuo, Timo Reunala, Harri Alenius, Markku S. Kulomaa
Journal: Journal of Allergy and Clinical Immunology (2005)
Do young adults with childhood asthma avoid occupational exposures at first hire?
Authors: O. Dumas, L.A.M. Smit, I. Pin, H. Kromhout, V. Siroux, R. Nadif, R. Vermeulen, D. Heederik, M. Hery, D. Choudat, F. Kauffmann, N. Le Moual
Journal: European Respiratory Journal (2010)

Information on the healthy worker hire effect in relation to asthma is scant. We aimed to assess whether and how childhood asthma-related characteristics (before hire) relate to occupational exposures at first hire. Analyses were conducted in 298 children examined at the first survey of the Epidemiological Study on the Genetics and Environment of Asthma (1991–1995), who reported a training period or a job at follow-up in 2003–2007 (aged 17–29 yrs; 53% males). Exposure likelihood to dust, gases and/or fumes in their first occupation was estimated by the ALOHA job exposure matrix. Asthma before the first occupation and two asthma classifications for severity (Global Initiative for Asthma 2002 guidelines) and symptoms were defined by questionnaire. In their first job, 47% of subjects were exposed. After adjustment (age, sex and education), pre-hire onset asthmatics (59%) were nonsignificantly less likely to be exposed (OR 0.67, 95% CI 0.41–1.11). Associations were stronger when considering those with severe asthma or high symptom score in childhood (OR 0.27 (95% CI 0.11–0.63) and OR 0.49 (95% CI 0.25–0.99), respectively). The association was observed in those who completed a university degree (OR 0.55, 95% CI 0.29–1.04) but not in the others (OR 0.98, 95% CI 0.44–2.22), with consistent results for all asthma characteristics. Results suggest a healthy worker hire effect in subjects with more severe or more symptomatic asthma in childhood. Education may modulate self-selection.
Clinical Management of the NIDDM Patient: Impact of the American Diabetes Association Practice Guidelines, 1985–1993
Authors: Mark W Stolar
Journal: Diabetes Care (1995)

OBJECTIVE To assess the impact of the American Diabetes Association's (ADA's) standards of care for patients with non-insulin-dependent diabetes mellitus (NIDDM) on practice patterns among university-based endocrine physicians and fellows. RESEARCH DESIGN AND METHODS This study represents a retrospective chart-based review of 790 patients with NIDDM conducted by endocrine fellows in training at 42 academic institutions. By using an ADA guidelines-based questionnaire, patient management and adherence to the guidelines were assessed by reviewing charts dating ≥3 years before, the year of, and 3 years after the guidelines' publication. All calculations were performed using the McNemar test, and all P values are two-sided. RESULTS The ADA standards of care have not had the significant impact in the clinical training setting that was anticipated. Deficiencies were noted in all aspects of the diabetic patient encounter and did not improve significantly following publication of the guidelines, except in the areas of foot care, eye examination, and lipid screening. Major deficiencies exist in areas of quality assurance and chart documentation, and these did not improve over time. CONCLUSIONS New strategies must be devised to increase awareness and implementation of these guidelines, both to enhance patient care and to improve the training of future diabetes caregivers.
Angiosarcoma of the scalp diagnosed by the presence of neck inflammation: a case report
Authors: Rei Karube, Hiroyoshi Sasaki, Keiji Shinozuka, Yasuhiro Fujisawa, Toru Yanagawa, Kenji Yamagata, Kojiro Onizawa, Fujio Otsuka, Hiroki Bukawa
Journal: International Journal of Oral Science (2012)

Angiosarcoma is an uncommon malignancy, which spread out from the endothelial cells of vessels. Scalp angiosarcoma with cervical lymph node metastasis is particularly rare. This article describes a rare case of angiosarcoma of the scalp, presenting as neck inflammation. Imaging procedures such as computed tomography (CT), magnetic resonance image (MRI) and ultrasonography (US) were not sufficient to diagnose this case. A needle biopsy provided an effective and accurate diagnosis of cervical lymph node metastasis. Additional observation and physical examination was required to diagnose the origin of the primary cancerous lesion. Once the angiosarcoma diagnosis was confirmed histologically, sequential weekly and monthly docetaxel (DTX) treatment was effective in preventing reoccurrence. Nonetheless, the optimization of angiosarcoma treatment remains a future goal. Although patients generally describe pain and swelling at the primary lesion site, this patient complained only of painful neck inflammation, without any indication of pain or swelling of the scalp. A revised diagnostic protocol should note that cervical lymph node metastasis of unknown primary origin may result from angiosarcoma of the scalp.
Diaphragmatic Respiration: a Sign of Cervical Cord Lesion in the Unconscious Patient ("Horizontal Paradox")
Authors: F. Sandor
Journal: BMJ (1966)

Transection of the spinal cord is followed by "spinal shock," in which no reflexes are elicited (Aird, 1951; Jamieson and Kay, 1959).Areflexia, however, may also occur in severe concussion associated with brain-stem iniury and in spinal concussion without actual lesion of the cord.
Partially reversible renal tubular damage in patients with obstructive jaundice
Authors: Eleni Bairaktari, George Liamis, Orestes Tsolas, Moses Elisaf
Journal: Hepatology (2001)

Decreased serum uric acid levels resulting from renal urate wasting have been occasionally encountered in jaundiced patients. However, in these cases, there are no data concerning the underlying renal tubular defects. In the present study, we investigated the renal tubular function in 35 patients with obstructive jaundice of various severity and causes (11 with lithiasis, 17 with carcinoma, and 7 with intrahepatic cholestasis). A detailed study of the renal tubular function was performed. Beyond the conventional methods, 1 H–NMR spectroscopy of urine was used to evaluate noninvasively renal damage by the characteristic perturbation in the excretion pattern of low–molecular weight endogenous metabolites. On admission, patients with obstructive jaundice had significantly lower serum uric acid and phosphate levels and higher bile acid concentrations compared with 40 age– and sex–matched controls. Serum uric acid levels presented a negative correlation with the total and direct bilirubin as well as the fractional excretion of uric acid. Furthermore, a great number of the patients studied developed one or more proximal tubular dysfunction manifestations beyond uricosuria, such as renal glucosuria, phosphaturia, and increased excretion of α 1 –microglobulin. 1 H–NMR spectroscopy of the urine showed decreased levels of citrate and hippurate and increased levels of 3–hydroxybutyrate and acetate. In 12 patients partial or complete remission of jaundice was followed by an improvement of the proximal renal tubular damage. In conclusion, obstructive jaundice can cause a partially reversible generalized proximal tubular dysfunction.
Localization of sphingomyelin during the development of dorsal and tail epidermis of mice
Authors: Y. Yoshida, K. Yoneda, M. Umeda, C. Ide, K. Fujimoto
Journal: British Journal of Dermatology (2001)

Background The water permeability barrier of the stratum corneum seems to be regulated primarily by lamellar bodies situated between the corneocytes; the lamellar bodies originate largely from polar lipid precursors, mainly sphingomyelin (SM), provided by the cells of the stratum granulosum via exocytosis of their lamellar body content. Objectives The aim of our study was to evaluate the cellular distribution of SM during development of the epidermis. Methods In this study, we investigated the expression and localization of SM in both adult and fetal mouse skin by a cytochemical detection method, immunofluorescence microscopy and immunoelectron microscopy, using anti-SM antibody, a specific binding protein to SM (lysenin), and Nile red stain. In addition, we measured transepidermal water loss to estimate the barrier function of the fetal skin. Results We observed that SM was widely distributed from the basal layer to the granular layer in the adult mouse epidermis. An intense cytochemical reaction for SM was observed on embryonic day E14·5 of gestation just before the differentiation of the granular and squamous cells from the intermediate cells. The immunofluorescence indicating SM was detected in two regions, i.e. the most superficial zone of the granular layer and the upper spinous layer after the cell differentiation at the late gestational age. This distribution was not detected by conventional lipid staining, such as with Nile red stain. Immunoelectron microscopy revealed that SM was mainly localized in the intercellular spaces of the adult mouse epidermis and in the intracellular vesicles without a complete lamellar structure in the cytoplasm of epidermal cells of E14·5 fetuses. It is well known that the formation of the structurally mature cornified cell envelope occurs at E15·5 of development. The skin of fetuses at E16·5 showed a definite barrier function. Conclusions These findings suggest that SM dynamics is related to the formation of the lipid envelope, cell differentiation, and epidermal barrier function during development.
Inflammatory Bowel Disease Is Associated With an Increased Risk of Melanoma: A Systematic Review and Meta-analysis
Authors: Siddharth Singh, Sajan Jiv Singh Nagpal, Mohammad H. Murad, Siddhant Yadav, Sunanda V. Kane, Darrell S. Pardi, Jayant A. Talwalkar, Edward V. Loftus
Journal: Clinical Gastroenterology and Hepatology (2013)
Abstract LB-416: Genetic variants in the 53BP1 gene and risk of skin cancer
Authors: Chunyan He
Journal: Cancer Research (2010)

Abstract TP53-binding protein 1 (53BP1) is a central mediator of the DNA damage checkpoint and plays an important role in DNA double-strand break repair. Genetic variation of the 53BP1 gene may interfere the proper repair that would result in genomic instability, leading to cell death or tumorigenesis. We conducted a skin cancer case-control study of Caucasians nested within the Nurses’ Health Study to evaluate whether common genetic variants of the 53BP1 gene are associated with skin cancer risk. We selected and genotyped 8 single nucleotide polymorphisms (SNPs) including potentially functional SNPs and tagging SNPs in the 53BP1 gene region in 218 incident melanoma, 285 incident squamous cell carcinoma (SCC) cases, 300 incident basal cell carcinoma (BCC) cases, and 870 age-matched controls. We found that three tagging SNPs (rs999047, rs2242069, and rs689647) were associated with a significantly decreased risk of BCC (additive multivariate ORs (95% CIs): 0.65(0.46-0.91), 0.67(0.49-0.90), and 0.68(0.48-0.96), respectively). The heterozygous variant of a putatively functional SNP, rs2602141, was significantly associated with an increased risk of melanoma (OR, 1.39; 95% CI, 1.01-1.90). The other two SNPs (rs1869258 and rs560191) highly correlated with rs260214 showed similar associations with melanoma risk. These SNPs (rs2602141, rs1869258 and rs560191) were also associated with lighter hair color and more moles among controls (p for trend, 0.003-0.07). The results suggest that the common genetic variants of 53BP1 are associated with pigmentary phenotypes and different types of skin 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 LB-416.
Characterization of liver T-cell receptor γδ+ T cells obtained from individuals chronically infected with hepatitis C virus (HCV): Evidence for these T cells playing a role in the liver pathology associated with HCV infections
Authors: Chien-Te K. Tseng, Emil Miskovsky, Michael Houghton, Gary R. Klimpel
Journal: Hepatology (2001)

The pathogenic mechanisms involved in viral hepatitis are not completely understood. Evidence suggests that the pathology associated with hepatitis C virus (HCV) and hepatitis B virus (HBV) infections are a result of the immune response in the liver to these viruses. The livers of patients with viral hepatitis have been shown to contain elevated numbers of T cells expressing the γ/δ form of the T–cell receptor for antigen (TCRγδ). In this study, we investigated whether liver biopsy specimens obtained from individuals with viral (HCV and/or HBV) or nonviral hepatitis contained TCRγδ + T cells that could be expanded in vitro by cytokines. A high percentage of liver biopsy specimens obtained from HCV– and/or HBV–infected individuals contained high numbers of TCRγδ + T cells. In contrast, T–cell lines generated from liver biopsy tissues obtained from individuals with nonviral hepatitis or from normal controls had no preferential expansion of TCRγδ + T cells. Liver TCRγδ + T–cell lines from HCV–infected individuals had high levels of non-major histocompatibility complex (MHC)-restricted cytotoxic activity against different targets including primary hepatocytes and produced interferon gamma (IFN–γ), tumor necrosis factor α (TNF–α), and interleukin 8 (IL–8) following activation by anti–CD3. Surprisingly, none of these liver TCRγδ + T–cell lines could recognize any of the structural or nonstructural proteins of HCV and had no cytotoxic activity against cells infected with recombinant vaccinia viruses expressing different HCV proteins. However, the crosslinking of CD81, which has been shown to bind HCV particles and E2, resulted in significant levels of IFN–γ and TNF–α production by liver TCRγδ + T cells. These results suggest that TCRγδ + T cells may play a role in the liver pathology of HCV infections. (Hepatology 2001;33:1312–1320.)
Examining the Homosexual Male for Sexually Transmitted Diseases
Authors: Yehudi M. Felman
Journal: JAMA (1977)

Homosexual men may be deterred from seeking an examination for sexually transmitted diseases because it would require an open admission of sexual preference. For these diseases to be controlled, gay men must be motivated to be examined for sexually transmitted diseases. If a medical or health professional feels unable to respond to a gay patient's needs, he should refer the patient to someone who deals well with gay patients. Health care services must be offered in a way that minimizes the anxiety many homosexuals associate with examination and treatment for sexually transmitted diseases. (<i>JAMA</i>238:2046-2047, 1977)
X-RAY THERAPY IN LEUKEMIA.A PRELIMINARY REPORT. WITH SPECIAL REFERENCE TO LYMPHATIC LEUKEMIA.
Authors: JOSEPH A. CAPPS
Journal: JAMA (1904)

The first recorded utilization of the<i>x</i>-ray for the treatment of leukemia was by Pusey,<sup>1</sup>who observed no effect whatever in a case of the splenomyelogenic type, but in one of the lymphatic type he noticed a marked diminution in the size of the glands. More recently a fresh interest in the subject has been aroused by the favorable reports of Senn,<sup>2</sup>Brown<sup>3</sup>and others.<sup>4</sup> In all we have seen reports of 11 cases of well-verified leukemia treated in this way. All but one of these belonged to the splenomyelogenic type. In every instance the splenic tumor decreased in size, in 3 cases becoming barely palpable. The leucocytes in all cases excepting Pusey's diminished in number. Four reporters record a white count under 10,000, with entire disappearance of the myelocytes. An improvement in the hemoglobin and red corpuscles always took place, but was
Selecting outcome measures in sports medicine: a guide for practitioners using the example of anterior cruciate ligament rehabilitation
Authors: N P Bent, C C Wright, A B Rushton, M E Batt
Journal: British Journal of Sports Medicine (2009)

Using examples from the field of anterior cruciate ligament rehabilitation, this review provides sports and health practitioners with a comprehensive, user-friendly, guide to selecting outcome measures for use with active populations. A series of questions are presented for consideration when selecting a measure: is the measure appropriate for the intended use? (appropriateness); is the measure acceptable to patients? (acceptability); is it feasible to use the measure? (feasibility); does the measure provide meaningful results? (interpretability); does the measure provide reproducible values? (reliability); does the measure assess what it is supposed to assess? (validity); can the measure detect change? (responsiveness); do substantial proportions of patients achieve the worst or best scores? (floor and ceiling effects); is the measure structured and scored correctly? (dimensionality and internal consistency); has the measure been tested with the types of patients with whom it will be used? (sample characteristics). Evaluation of the measure using these questions will assist practitioners in making their judgements.
An Ethical Debate: The legal background
Authors: M. A Jones
Journal: BMJ (1995)

The legal difficulty arising from elective ventilation concerns the legal basis for providing lawful treatment to patients who are unable to give a valid consent because they are incompetent. The consent of a competent adult provides the doctor's defence to a civil action for the tort of battery and, potentially, the crime of assault. But in the most common setting in which elective ventilation is contemplated the donor will be incompetent and not have made any advance declaration about treatment, in contrast with what may be done with his or her organs after death (which is the position governed by donor cards). As long as the patient is alive the legal justification for providing treatment is the principle of necessity. Relatives cannot give a valid consent on behalf of an incompetent adult. Treatment is “necessary” provided that it is in the “best interests” of the patient, and this occurs …
Abstract 1227: Anti-oncogenic role of Peroxisome proliferator-activated receptor- β/Δ (Pparβ/Δ) involves regulation of viral Hras1 (v-Hras1)-induced senescence and endoplasmic reticulum (ER) stress in mouse primary keratinocytes
Authors: Bokai Zhu, Combiz Khozoie, Moses Bility, Nicholas Blazanin, Adam B. Glick, Frank J. Gonzalez, Jeffrey M. Peters
Journal: Cancer Research (2011)

Abstract Pparβ/Δ-null mice exhibit enhanced chemically-induced skin tumorigenesis compared to wild-type counterparts. Since an oncogenic mutation of Harvey sarcoma ras virus gene (v-Hras1) is a critical event in chemical carcinogenesis, the role of PPARβ/Δ in mouse primary keratinocytes infected with a retrovirus encoding viral Hras1 (v-Hras1) gene was examined. While v-Hras1 induced senescence in wild-type mouse primary keratinocytes, the level of v-Hras1-induced senescence was significantly reduced in Pparβ/Δ-null keratinocytes, which was due in part to decreased phospho-MEK and phospho-ERK during the early stage of v-Hras1 expression. In addition, while total v-Hras1 protein level was comparable between wild-type and Pparβ/Δ-null keratinocytes, the level of the GTP-bound form of v-Hras1 was significantly decreased in Pparβ/Δ-null keratinocytes from 4 day to 7 day post v-Hras1 infection. Surprisingly, the decreased activity of v-Hras1 did not lead to a decreased level of phospho-AKT in Pparβ/Δ-null keratinocytes. However, Pparβ/Δ-null keratinocytes were more dependent upon PI3K-AKT pathway for maintenance of proliferation and evasion of senescence. Differentially expressed genes between wild-type and Pparβ/Δ-null keratinocytes that are involved in the regulation of senescence were determined by cDNA microarray analysis. Differential expressions of both positive and negative regulators of RAS pathway were observed between wild-type and Pparβ/Δ-null keratinocytes following v-Hras1 infection. Notably, the mRNA encoding CDK inhibitor p27Kip1 was lower in Pparβ/Δ-null keratinocytes, In addition, Pparβ/Δ-null keratinocytes showed enhanced endoplasmic reticulum (ER) stress and unfolded protein response (UPR) post v-Hras1 infection, characterized by enhanced vacuolation and higher levels of major ER stress markers. However, the enhanced ER stress did not lead to apoptosis in Pparβ/Δ-null keratinocytes. These results suggest an anti-oncogenic role of PPARβ/Δ in v-Hras1-transformed mouse primary keratinocytes that involves both the promotion of anti-tumorigenic senescence and attenuation of pro-tumorigenic ER stress and UPR. (Supported by CA124533) Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1227. doi:10.1158/1538-7445.AM2011-1227