tbuckley/cabot-search huggingface dataset:
Cancer screening in the United States, 2013
Authors: Robert A. Smith, Durado Brooks, Vilma Cokkinides, Debbie Saslow, Otis W. Brawley
Journal: CA A Cancer Journal for Clinicians (2013)

Abstract Answer questions and earn CME/CNE Each year the American Cancer Society (ACS) publishes a summary of its recommendations for early cancer detection, a report on data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, current ACS cancer screening guidelines are summarized, as are updated guidelines on cervical cancer screening and lung cancer screening with low‐dose helical computed tomography. The latest data on the use of cancer screening from the National Health Interview Survey also are described, as are several issues related to screening coverage under the Patient Protection and Affordable Care Act of 2010. CA Cancer J Clin 2013;. © 2013 American Cancer Society.
Medicine—More Than Molecules and Money-Reply
Authors: Leon Eisenberg
Journal: JAMA (1995)

In Reply.  —I thank Dr Hirsch for bringing Rudolf Virchow's name to the fore. 1 When the faculty of the Johns Hopkins Medical School celebrated Virchow's 70th birthday in 1891, Sir William Osler 2 hailed him as the founder of scientific medicine. An equally strong case can be made for Virchow as the founder of social medicine; his investigation of the role of social factors in the epidemic of relapsing fever in Upper Silesia in 1847 was pathbreaking. 1 Dr Hirsch and I agree that we need more and better science as well as renewed commitment to caring for the patient. 3   Dr Catalona is correct in suggesting that my presentation of the controversy on screening and treatment for prostate cancer was limited. I did not undertake an exhaustive review. When he states that it lacks balance and does not accurately reflect the current literature, I beg to disagree. I
Abstract 997: Oncogenic tyrosine kinases are localized to mitochondria and regulate cancer metabolism by phosphorylating key components of pyruvate dehydrogenase kinase complex
Authors: Jing Chen, Taro Hitosugi, Jun Fan, Sumin Kang, Ting-Lei Gu, Titus Boggon
Journal: Cancer Research (2012)

Abstract The Warburg effect describes the observation that cancer cells take up more glucose than normal tissue and favor aerobic glycolysis. Many tumor cells rely on aerobic glycolysis instead of mitochondrial oxidative phosphorylation for their continued proliferation and survival. This may be, in part, due to attenuated mitochondrial function, which is suggested to be achieved through inhibition of pyruvate dehydrogenase complex (PDC) in cancer cells. Pyruvate dehydrogenase (PDH) is the first and most important enzyme component of PDC, which catalyzes the conversion of pyruvate to acetyl-CoA that subsequently enters into the Krebs cycle to produce ATP and electron donors including NADH. PDH activity is negatively regulated by phosphorylation at several serine sites. Phosphorylation of PDH by PDH kinase (PDHK) results in the inactivation of PDC, while dephosphorylation by pyruvate dehydrogenase phosphatase (PDP) restores PDC activity. Thus, PDHK and PDP coordinate to regulate the phosphorylation and consequently activation status of PDH. In cancer cells, c-Myc and HIF-1alpha are believed to promote inhibition of PDC by, in part, upregulating gene expression of PDHK. However, how oncogenic signals regulate PDH, and/or coordinate PDHK and PDP activity to inhibit PDH and ultimately attenuate PDC activity in cancer metabolism still remains unclear. We recently reported that, surprisingly, functional PDC can form in mitochondria outside of matrix in some cancer cells. Moreover, several oncogenic tyrosine kinases including FGFR1, FGFR1 fusion tyrosine kinase, and FLT3-ITD mutant, as well as BCR-ABL and JAK2 V617F mutants, are localized to different mitochondrial compartments including outer membrane and matrix, respectively, in cancer cells, where they phosphorylate PDHK1, PDP1 and PDHA. Our studies demonstrate that tyrosine phosphorylation enhances PDHK1 kinase activity by promoting ATP and PDC binding, which promotes cancer cell metabolism, proliferation and tumor growth. In consonance with these findings, we found that tyrosine phosphorylation attenuates PDP1 phosphatase activity but inhibits PDHA enzyme activity. These data suggest that mitochondrial oncogenic tyrosine kinases regulate PDC activity by inhibiting PDHA1 enzyme activity directly through tyrosine phosphorylation and indirectly by enhancing and attenuating PDHK1 and PDP1 activity, respectively. These findings represent an acute mechanism underlying the Warburg effect, in addition to the long-term regulation that is believed to be regulated by c-Myc and HIF-1alpha. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 997. doi:1538-7445.AM2012-997
The Macroscopic Classification of Early Neoplasia of the Digestive Tract
Authors: R. J. Schlemper, I. Hirata, M. F. Dixon
Journal: Endoscopy (2002)

In 1962, in Japan, a macroscopic classification of early gastric carcinoma was established to facilitate discussions between endoscopists, radiologists, surgeons, cytologists and pathologists [1]. The classification into types I, IIa, IIb, IIc, and III has also been applied to superficial esophageal carcinoma since 1972 and to early colorectal neoplasia since 1977 [2] [3]. This classification, based on the extent of elevation and depression, was originally meant to be used only for carcinomas that are limited to the mucosa and submucosa, and it was intended that lesions should be classified on the basis of inspection of surgically resected specimens with the naked eye. It was advocated that the prefix "type 0" (0-I, 0-IIa, etc.) be used to distinguish these early and superficial carcinomas from advanced carcinomas. The latter were classified into type 1 (protuberant), type 2 (ulcerated with clear margin), type 3 (ulcerated with infiltration), type 4 (diffusely infiltrating), and type 5 (unclassifiable). Moreover, it was advocated that the word "like" be appended for lesions clinically suspected to be advanced (IIc-like, IIa-like, etc.), and the word "like" should be omitted only after histological confirmation that the lesion was a carcinoma limited to the mucosa and submucosa (T1 tumor). For the colorectum it has been proposed to append "like" to all lesions for as long as histological confirmation is lacking [3].
Nutrition, Lipids, and Coronary Heart Disease: A Global View; Nutrition in Health and Disease
Authors: William P. Castelli
Journal: JAMA (1979)

I recommend this book to all physicians who eat. As a group we have been careless about something that many of us do three and even more times a day—namely, eat. This is an area that has been genuinely neglected in our medical school and hospital education. Most of us are influenced by awful fads, and the standard books on nutrition have not delved deeply enough into the issues and controversies that abound in this area. Where do we turn for reliable information? Where do we search for the scholarship that would provide us with a background to begin to understand what our patients need to know and frequently ask us about? Is the Senate Select Committee's recommendation to change all American's diet something we should all be for? Read this book before you answer. This book is not perfect, but it is a most unique source to find out
The Role of the Medical School in Health Care in Oklahoma
Authors: James L. Dennis
Journal: JAMA (1967)

The broad and diverse activities associated with a modern university school of medicine are commonly described under the term "medical center." I have been asked to present a "case study" of the evolving relationships of the University of Oklahoma Medical Center to its state community. <h3>Case Presentation</h3> In the fall of 1964, I was introduced to the problems of this 50-year-old "institutional patient." Using the traditional medical approach, I would describe the case as follows: <h3>Chief Complaint.—</h3> Anxiety, fatigue, loneliness, and a sense of having been abandoned by the parent community. <h3>Present Illness.—</h3> The present illness appears to have had its onset about 15 years ago, when a fulltime clinical faculty began to replace the voluntary faculty. Although this transition appears to have been accomplished with a minimum of sibling rivalry, this was at least partially due to an almost passive withdrawal from any major consideration that might have precipitated
Incense Use and Cardiovascular Mortality among Chinese in Singapore: The Singapore Chinese Health Study
Authors: An Pan, Maggie L. Clark, Li-Wei Ang, Mimi C. Yu, Jian-Min Yuan, Woon-Puay Koh
Journal: Environmental Health Perspectives (2014)

Incense burning is common in many parts of the world. Although it is perceived that particulate matter from incense smoke is deleterious to health, there is no epidemiologic evidence linking domestic exposure to cardiovascular mortality.We examined the association between exposure to incense burning and cardiovascular mortality in the Singapore Chinese Health Study.We enrolled a total of 63,257 Singapore Chinese 45-74 years of age during 1993-1998. All participants were interviewed in person to collect information about lifestyle behaviors, including the practice of burning incense at home. We identified cardiovascular deaths via record linkage with the nationwide death registry through 31 December 2011.In this cohort, 76.9% were current incense users, and most of the current users (89.9%) had burned incense daily for ≥ 20 years. Relative to noncurrent users, current users had a 12% higher risk of cardiovascular mortality [multivariable adjusted hazard ratio (HR) = 1.12; 95% CI: 1.04, 1.20]. The HR was 1.19 (95% CI: 1.03, 1.37) for mortality due to stroke and 1.10 (95% CI: 1.00, 1.21) for mortality due to coronary heart disease. The association between current incense use and cardiovascular mortality appeared to be limited to participants without a history of cardiovascular disease at baseline (HR = 1.16; 95% CI: 1.07, 1.26) but not linked to those with a history (HR = 1.00; 95% CI: 0.86, 1.17). In addition, the association was stronger in never-smokers (HR = 1.12; 95% CI: 1.02, 1.23) and former smokers (HR = 1.19; 95% CI: 1.00, 1.42) than in current smokers (HR = 1.05; 95% CI: 0.91, 1.22).Long-term exposure to incense burning in the home environment was associated with an increased risk of cardiovascular mortality in the study population.
STRANGULATED OMENTAL HERNIA WITH FEW SYMPTOMS: REPORT ON THE SPECIMEN FROM MR. A. Z. C. CRESSY'S CASE
Authors: R. Parker
Journal: BMJ (1912)

_ZIA J__A _I_ Othier causes are too early removal of stitclles, and too great lhurry In gettinig the patient up after operation.SirAlfred Pearce Gould:2 has drawn attention to this latter danger, and lhas pointed out that the integrity of the abdoimiinal wall caninct be jtudged by the mere appear- ailce -of the skin uniLn.In onie case I saw the prolapse occurred about lhalf ani holur after tlhe-removal of the stitches on the tentlh day, although at the tinme of removal thle union was apparently firm.It is ratlher surprising that in nine cases which I have come across the accident hlas usually occurred 'in the second week, andc lnot in the days inulmediately followinig operation, the average being OIn the tentlh day.
Exudate Macrophages Attenuate Lung Injury by the Release of IL-1 Receptor Antagonist in Gram-negative Pneumonia
Authors: Susanne Herold, Tannaz Shafiei Tabar, Hermann Janßen, Katrin Hoegner, Maciej Cabanski, Peter Lewe-Schlosser, Jens Albrecht, Frank Driever, Istvan Vadasz, Werner Seeger, Mirko Steinmueller, Juergen Lohmeyer
Journal: American Journal of Respiratory and Critical Care Medicine (2011)

Rationale: Exudate macrophages are key players in host defense toward invading pathogens. Their antiinflammatory and epithelial-protective potential in gram-negative pneumonia, however, remains elusive.Objectives: We investigated whether exudate macrophages contributed to preservation of alveolar epithelial barrier integrity and analyzed the molecular pathways involved.Methods: We evaluated the antiinflammatory and epithelial-protective effects of exudate macrophages in a model of LPS- and Klebsiella pneumoniae–induced lung injury comparing wild-type and CC-chemokine receptor 2 (CCR2)-deficient mice with defective lung macrophage recruitment and in in vitro studies using primary alveolar epithelial cells.Measurements and Main Results: CCR2−/− mice exhibited enhanced alveolar epithelial cell apoptosis and lung leakage on intratracheal LPS treatment, which could be attributed to lack of exudate macrophage recruitment from the circulating pool as demonstrated in a model of wild-type/CCR2−/− bone-marrow chimeric mice. Among various antiinflammatory and proliferative mediators analyzed, the endogenous counterpart of resident macrophage–expressed IL-1β, IL-1 receptor antagonist (IL-1ra), was highly up-regulated in flow-sorted exudate macrophages in LPS-treated wild-type mice. LPS/IL-1β–induced impairment of alveolar epithelial cell integrity was antagonized by IL-1ra in vitro. Finally, intratracheal substitution of IL-1ra or intravenous adoptive transfer of IL-1ra+/+ but not IL-1ra−/− blood mononuclear cells attenuated alveolar inflammation, epithelial apoptosis, and loss of barrier function in LPS-challenged or K. pneumoniae-infected CCR2−/− mice and enhanced survival after K. pneumoniae infection.Conclusions: We conclude that recruited lung macrophages attenuate IL-1β–mediated acute lung injury in gram-negative pneumonia by release of IL-1ra.
Roles of FcγRIIB in Nasal Eosinophilia and IgE Production in Murine Allergic Rhinitis
Authors: Tohru Watanabe, Mitsuhiro Okano, Hisashi Hattori, Tadashi Yoshino, Nobuaki Ohno, Nobuo Ohta, Yuji Sugata, Yorihisa Orita, Toshiyuki Takai, Kazunori Nishizaki
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

The low-affinity IgG Fc receptor, FcγRIIB, displays inhibitory potential in experimental models such as autoimmune diseases. However, whether this receptor is involved in the onset of allergic diseases remains unknown. This study examines the role of FcγRIIB in the initiation of allergic rhinitis in mice. Repeated intranasal sensitization with Schistosoma mansoni egg antigen (SEA) induced SEA-specific IgE and marked nasal eosinophilia in high-responder BALB/c mice. FcγRIIB gene-deficient (−/−) BALB/c mice displayed severe eosinophilia compared with that of wild-type counterparts. However, FcγRIIB −/− mice conversely produced less SEA-specific IgE. The production of interleukin (IL)-4 but not of IL-5 or IFN-γ by nasal mononuclear cells was also decreased in FcγRIIB −/− mice, suggesting that the exacerbation of nasal eosinophila in FcγRIIB −/− mice is independent of the local IL-5 levels. The findings in low responder C57BL/6 mice were similar. In addition, nasal eosinophilia in FcγRIIB −/− mice passively sensitized with SEA was exacerbated, and conversely, specific IgE production was inhibited after a nasal challenge. These results suggest that FcγRIIB plays a regulatory role in the initiation of allergic rhinitis that is independent of either mouse strain or type of sensitization.
Microtubules Modulate the Stiffness of Cardiomyocytes Against Shear Stress
Authors: Satoshi Nishimura, Shinya Nagai, Masayoshi Katoh, Hiroshi Yamashita, Yasutake Saeki, Jun-ichi Okada, Toshiaki Hisada, Ryozo Nagai, Seiryo Sugiura
Journal: Circulation Research (2005)

Although microtubules are involved in various pathological conditions of the heart including hypertrophy and congestive heart failure, the mechanical role of microtubules in cardiomyocytes under such conditions is not well understood. In the present study, we measured multiple aspects of the mechanical properties of single cardiomyocytes, including tensile stiffness, transverse (indentation) stiffness, and shear stiffness in both transverse and longitudinal planes using carbon fiber–based systems and compared these parameters under control, microtubule depolymerized (colchicine treated), and microtubule hyperpolymerized (paclitaxel treated) conditions. From all of these measurements, we found that only the stiffness against shear in the longitudinal plane was modulated by the microtubule cytoskeleton. A simulation model of the myocyte in which microtubules serve as compression-resistant elements successfully reproduced the experimental results. In the complex strain field that living myocytes experience in the body, observed changes in shear stiffness may have a significant influence on the diastolic property of the diseased heart.
Activation of chemokine and inflammatory cytokine response in hepatitis C virus–infected hepatocytes depends on toll-like receptor 3 sensing of hepatitis C virus double-stranded RNA intermediates
Authors: Kui Li, Nan L. Li, Dahai Wei, Susan R. Pfeffer, Meiyun Fan, Lawrence M. Pfeffer
Journal: Hepatology (2011)

Chemokines and inflammatory cytokines are key regulators of immunity and inflammation during viral infections. Hepatitis C virus (HCV) is a hepatotropic RNA virus frequently associated with chronic liver inflammation and hepatocellular carcinoma. Intrahepatic levels of chemokines and cytokines are elevated in chronic HCV infections, but the underlying mechanisms remain unclear. We found that Toll-like receptor-3 (TLR3) senses HCV infection in cultured hepatoma cells, leading to nuclear factor kappa B (NF-κB) activation and the production of numerous chemokines and inflammatory cytokines, such as regulated on activation normal T cell expressed and secreted (RANTES), macrophage inflammatory protein (MIP)-1α, MIP-1β, IP-10, and interleukin-6. The chemokine/cytokine induction occurred late in HCV infection and was abrogated when HCV was ultraviolet-inactivated before infection, indicating a dependence on the cellular recognition of HCV replication products. Gel-shift and chromatin immunoprecipitation assays revealed that NF-κB plays a pivotal role in HCV-induced chemokine/cytokine transcription. Mutations specifically disrupting the double-stranded RNA (dsRNA)-binding activity of TLR3 ablated the chemokine/cytokine response to HCV infection, indicating that HCV dsRNA was the pathogen-associated molecular pattern triggering TLR3 signaling. In vitro synthesized HCV dsRNAs, with a minimal length of ˜80-100 base pairs, activated TLR3-dependent chemokine expression, regardless of the genome position from which they derived. In contrast, HCV single-stranded RNAs, including those derived from the structured 3'nontranslated region highly potent for RIG-I activation, failed to do so. Moreover, robust production of chemokines and inflammatory cytokines was also observed in primary human hepatocytes after stimulation with extracellular poly-I:C, a TLR3 ligand. Conclusion : Our data suggest that TLR3-mediated chemokine and inflammatory cytokine responses may play an important role in host immune responses to HCV and the pathogenesis of HCV-associated liver diseases.
Effects of Upright Posture and Exercise on Pulmonary Hemodynamics in Patients with Central Cardiovascular Shunts
Authors: ROBERT A. BRUCE, GREGORY G. JOHN, Curt A. Wiederhielm, Charlotte Hamilton, Claire Morgan, Elizabeth Kendall
Journal: Circulation (1957)

Previous hemodynamic studies of patients with septal defects, or patent ductus arteriosus, have been made with the patient recumbent in the horizontal posture. Our studies indicate unexpected changes in pulmonary blood flow with the upright posture, and often further increments in flow during walking that are different from those reported for exercise in recumbency. It is suggested that such defects reveal the complexity of factors regulating preferential flow under these circumstances.
Traumatic Cranial Nerve Palsy
Authors: Christopher Baker, Jeremy Cannon
Journal: New England Journal of Medicine (2005)

A 19-year-old man sustained a crush injury to his skull from a piece of heavy machinery. Although on initial assessment he readily followed commands, his mental status deteriorated and he required intubation for airway protection. He was rapidly transferred to our level 1 trauma center. An examination of his pupils at his arrival showed ptosis (Panel A) and anisocoria (Panel B), which aroused concern that there was uncal herniation. A high-resolution computed tomographic scan of his head did not show uncal herniation but, rather, revealed a complex fracture of the sella turcica (Panel C, arrow) and of the skull base . . .
Correction: Colorectal Cancer Screening for Average-Risk North Americans: An Economic Evaluation
Authors: Steven J. Heitman, Robert J. Hilsden, Flora Au, Scot Dowden, Braden J. Manns
Journal: PLoS Medicine (2012)

Background: Colorectal cancer (CRC) fulfills the World Health Organization criteria for mass screening, but screening uptake is low in most countries.CRC screening is resource intensive, and it is unclear if an optimal strategy exists.The objective of this study was to perform an economic evaluation of CRC screening in average risk North American individuals considering all relevant screening modalities and current CRC treatment costs.Methods and Findings: An incremental cost-utility analysis using a Markov model was performed comparing guaiac-based fecal occult blood test (FOBT) or fecal immunochemical test (FIT) annually, fecal DNA every 3 years, flexible sigmoidoscopy or computed tomographic colonography every 5 years, and colonoscopy every 10 years.All strategies were also compared to a no screening natural history arm.Given that different FIT assays and collection methods have been previously tested, three distinct FIT testing strategies were considered, on the basis of studies that have reported ''low,'' ''mid,'' and ''high'' test performance characteristics for detecting adenomas and CRC.Adenoma and CRC prevalence rates were based on a recent systematic review whereas screening adherence, test performance, and CRC treatment costs were based on publicly available data.The outcome measures included lifetime costs, number of cancers, cancer-related deaths, quality-adjusted life-years gained, and incremental cost-utility ratios.Sensitivity and scenario analyses were performed.Annual FIT, assuming mid-range testing characteristics, was more effective and less costly compared to all strategies (including no screening) except FIT-high.Among the lifetimes of 100,000 average-risk patients, the number of cancers could be reduced from 4,857 to 1,782 and the number of CRC deaths from 1,393 to 457, while saving CAN$68 per person.Although screening patients with FIT became more expensive than a strategy of no screening when the test performance of FIT was reduced, or the cost of managing CRC was lowered (e.g., for jurisdictions that do not fund expensive biologic chemotherapeutic regimens), CRC screening with FIT remained economically attractive.Conclusions: CRC screening with FIT reduces the risk of CRC and CRC-related deaths, and lowers health care costs in comparison to no screening and to other existing screening strategies.Health policy decision makers should consider prioritizing funding for CRC screening using FIT.
Intraosseous Fat Necrosis and Infarction Associated With Pancreatitis
Authors: FERNANDO BAYO, JAMES D. MASSIE, JENO SEBES
Journal: Clinical Nuclear Medicine (1993)

A case of trauma-induced pancreatitis with subsequent intraosseous fat necrosis and infarction is presented. The young patient demonstrated multiple cortical lytic lesions of the lower extremities and bilateral sterile joint effusions. Several radiographic modalities were employed in the workup of his disease. Related findings and pathophysiologic considerations are reviewed.