tbuckley/cabot-search huggingface dataset:
Relations of Long-Term and Contemporary Lipid Levels and Lipid Genetic Risk Scores With Coronary Artery Calcium in the Framingham Heart Study
Authors: Connie W. Tsao, Sarah Rosner Preis, Gina M. Peloso, Shih-Jen Hwang, Sekar Kathiresan, Caroline S. Fox, L. Adrienne Cupples, Udo Hoffmann, Christopher J. O'Donnell
Journal: Journal of the American College of Cardiology (2012)

This study evaluated the association of timing of lipid levels and lipid genetic risk score (GRS) with subclinical atherosclerosis.Atherosclerosis is a slowly progressive disorder influenced by suboptimal lipid levels. Long-term versus contemporary lipid levels may more strongly impact the development of coronary artery calcium (CAC).Framingham Heart Study (FHS) Offspring Cohort participants (n = 1,156, 44% male, 63 ± 9 years) underwent serial fasting lipids (low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein, and triglycerides), Exam 1 (1971 to 1975) to Exam 7 (1998 to 2001). FHS Third Generation Cohort participants (n = 1,954, 55% male, 45 ± 6 years) had fasting lipid profiles assessed, 2002 to 2005. Computed tomography (2002 to 2005) measured CAC. Lipid GRSs were computed from significantly associated single-nucleotide polymorphisms. The association between early, long-term average, and contemporary lipids, and lipid GRS with elevated CAC was assessed using logistic regression.In FHS Offspring, Exam 1 and long-term average as compared with Exam 7 lipid measurements, including untreated lipid levels, were strongly associated with elevated CAC. In the FHS Third Generation, contemporary lipids were associated with CAC. The LDL-C GRS was associated with CAC (age-/sex-adjusted odds ratio: 1.14, 95% confidence interval: 1.00 to 1.29, p = 0.04). However, addition of the GRS to the lipid models did not result in a significant increase in the odds ratio or C-statistic for any lipid measure.Early and long-term average lipid levels, as compared with contemporary measures, are more strongly associated with elevated CAC. Lipid GRS was associated with lipid levels but did not predict elevated CAC. Adult early and long-term average lipid levels provide important information when assessing subclinical atherosclerosis and cardiovascular risk.
Bullous Skin Lesions in Barbiturate Overdosage and Carbon Monoxide Poisoning
Authors: Michael M. Baden
Journal: JAMA (1970)

<h3>To the Editor.—</h3> Mandy and Ackerman (<b>213</b>:253,1970) noted a lack of recognition in the United States of bullous skin lesions in persons with drug- or carbon-monoxide-induced coma. The authors overlooked the excellent description and photographs of these lesions in<i>Legal Medicine: Pathology and Toxicology</i>by Gonzales et al (New York, Appleton-Century-Crofts, 1954), and similar descriptions in other forensic pathology texts. Gonzales et al in this leading text attributed the lesions to hypoxia and pressure as have Doctors Mandy and Ackerman in their recent article. Unfortunately, in this country there is such great separation between the many physicians who study natural disease and death (at medical centers) and the few who study unnatural death (in medical examiners offices) that much knowledge obtained from investigation of death due to drugs, carbon monoxide, suicide, accidents, battered children, lead poisoning, etc, is not known to the medical community at large. This failing is
Structured Advance Planning
Authors: Linda Emanuel
Journal: JAMA (1995)

IF THERE is one striking thing about the advance directives movement, it is the contrast between the overwhelming endorsement of advance directives from all corners of society and their virtual nonuse. Why do they meet with simultaneous deference and diffidence? One possible explanation is that the whole paradigm is wrong—perhaps the autonomy model that motivates the advance directives movement is mistaken. Another possible explanation is that the basis for the movement is right but too much was expected too fast. Perhaps "doing advance directives" is not so simple, and like other medical interventions, advance planning has to develop and find its appropriate place before it is trustworthy. <h3>An Argument for Slow Ripening</h3> There is not much ground for the more radical explanation that the model of autonomy on which advance directives are founded is flawed. Recently, commentators have pointed out that people are not atomistic. Certainly, if people are like
Photodynamic therapy with methyl-aminolevulinic acid for paucilesional mycosis fungoides: A prospective open study and review of the literature
Authors: Gaelle Quéreux, Anabelle Brocard, Mélanie Saint-Jean, Lucie Peuvrel, Anne-Chantal Knol, Rémy Allix, Amir Khammari, Jean-Jacques Renaut, Brigitte Dréno
Journal: Journal of the American Academy of Dermatology (2013)
Intracoronary Doppler Assessment of Moderate Coronary Artery Disease
Authors: Louis I. Heller, Christopher Cates, Jeffrey Popma, Lawrence I. Deckelbaum, James D. Joye, Seth T. Dahlberg, Bernard J. Villegas, Anita Arnold, Robert Kipperman, W. Carter Grinstead, Sharon Balcom, Yunsheng Ma, Michael Cleman, Richard M. Steingart, Jeffrey A. Leppo
Journal: Circulation (1997)

Coronary angiography may not reliably predict whether a stenosis causes exercise-induced ischemia. Intracoronary Doppler ultrasound may enhance diagnostic accuracy by providing a physiological assessment of stenosis severity. The goal of this study was to compare intracoronary Doppler ultrasound with both 201Tl imaging and coronary angiography.Fifty-five patients with 67 stenotic coronary arteries underwent coronary angiography with intracoronary Doppler ultrasound and had exercise 201Tl testing within a 1-week period. Coronary flow reserve was measured, and analyses were performed by independent core laboratories. The mean stenosis was 59+/-12%; 51 of 67 stenoses were intermediate in severity (40% to 70%). A coronary flow reserve < 1.7 predicted the presence of a stress 201Tl defect in 56 of 67 stenoses (agreement=84%; kappa=0.67; 95% CI=0.48 to 0.86). In the patients who achieved 75% of their predicted maximum heart rate, the Doppler and 201Tl imaging data agreed in 46 of 52 stenoses (agreement=88%; kappa=0.77; 95%CI=0.57 to 0.97). Scatter was evident when angiography was compared with coronary flow reserve (r=.43), and the angiogram did not reliably predict the results of the 201Tl stress test (kappa=0.21; agreement=57% to 63%).Doppler-derived coronary flow reserve accurately predicts the presence of exercise-induced ischemia on stress 201Tl imaging, and coronary angiography does not reliably assess the physiological significance of an intermediate coronary stenosis.
The Pig-Faced Lady of Manchester Square &amp; other Medical Marvels
Authors: Sue Weir
Journal: Journal of the Royal Society of Medicine (2004)

For those interested in the anomalies of the human body Dr Bondeson's latest work offers many examples—a treasure trove of the morbid and unusual and, for the medically inclined, some intriguing case histories. Bondeson has written at least four other books on the bizarre, and the Pig-faced Lady is a tour de force—highly researched, well illustrated where possible and bringing to life the people affected.

Was the early-nineteenth-century pig-faced lady in the title real or just a hoax? The author's meticulous research cannot find the answer. Her predecessor Tannakin Skinker from Holland, who made her first appearance in London in 1639 where she was hoping to find a husband, was much featured in ballads and songs but she too may have been more legend than fact. Similar stories are explored concerning hairy maidens, one of whom, Julia Pastrana, was reported in a Lancet of 1857. Conjoined twins are another area explored. Sometimes these were put on show to provide a living for themselves and their families; thus we have newspaper reports, advertisements and articles in medical journals to substantiate the claims for one body supporting two persons. Probably it is the story of Daniel Lambert from Leicestershire that will appeal most to the medical world—especially in the light of today's obsession with obesity. An entire chapter is devoted to the 'English fat man', illuminated by the author's own experiences as a senior registrar dealing with primary obesity. Bondeson also tells with enthusiasm the stories of two eighteenth-century giants, the Swede Daniel Cajanus and the Irishman Charles Byrne (whose skeleton is in the Hunterian Museum at the Royal College of Surgeons of England). With clever marketing these men made substantial amounts of money by exploiting their extreme condition as showmen, though both contrived to lead relatively normal lives. Cajanus was a prudent intelligent man; Byrne's intellect was not helped by his habit of drinking at least one large bottle of gin or whisky every day. These chapters on the fat and tall are the most interesting and readable in the book; in his accounts of the King of Poland's Court Dwarf and the Sicilian Fairy (whose skeleton and clothes are likewise at the Royal College of Surgeons of England), Bondeson tells us more about the person behind the abnormality, and does so with great skill. The Dwarf does not emerge as an endearing character.

The other medical marvels will await the reader to be amazed, repulsed or mildly amused; this is a book to dip into and some of the evidence to be taken lightly. If you are fascinated by congenital abnormalities you will be excited. If you are revolted by the whole scene, spare yourself a trip to the bookshop.
Characteristics and management of chronic destructive pneumonia.
Authors: E W Cameron, P C Appelbaum, D Pudifin, W S Hutton, S A Chatterton, J Duursma
Journal: Thorax (1980)

In 12 years 627 patients presented to Wentworth Hospital, Natal with chronic destructive pneumonia (CDP). Common symptoms were haemoptysis, the production of foul-smelling sputum, and chest pain. The disease pursued a chronic course with acute exacerbations which may be lethal. The majority of patients were African men aged between 20 and 50 years who were free from other significant disease apart from dental infection. Radiographically and pathologically CDP had the characteristics of a necrotising pneumonia, and microbiological investigation showed mixed aerobic and anaerobic flora in the lower respiratory tract. Gram-positive aerobic cocci and Bacteroides species were the predominant organisms. In 120 patients treatment regimens were based on chloramphenicol, in 429 cephalosporins, and in 78 on combination therapy with cephalosporins, penicillin, and metronidazole. One hundred and seventy patients also required operative management in an attempt to control progress of the disease. The overall inpatient mortality rate from CDP was 7.8%. In the group of patients treated with combination therapy the mortality rate was 1.3%.
Replacement of unfractionated heparin by low-molecular-weight heparin for postorthopedic surgery antithrombotic prophylaxis lowers the overall risk of symptomatic thrombosis because of a lower frequency of heparin-induced thrombocytopenia
Authors: Andreas Greinacher, Petra Eichler, Theresia Lietz, Theodore E. Warkentin
Journal: Blood (2005)
Rates of gout continue to rise in UK, but GP care has not improved
Authors: I. Torjesen
Journal: BMJ (2014)

Although the prevalence of gout in the United Kingdom has risen by about two thirds over the past 15 years, the care provided by GPs for the condition has “remained essentially the same” and of a poor standard, says a study in the Annals of the Rheumatic Diseases .

The research found that the UK now had the highest prevalence of gout in Europe, with one in 40 people having been given a diagnosis.1 However, the proportion of patients with gout being treated with urate lowering drugs has remained constant over the past 15 years, at just a third.

Researchers from the University of Nottingham used the Clinical Practice Research Datalink to estimate the prevalence …
Human Bronchoalveolar (BAL) Cells Secrete Increased Amounts of Monocyte Chemoattractant Protein 1 (MCP-1) During an Experimental Rhinovirus (RV) Infection
Authors: M. Bates, N.L. Korpi, D.J. Hall, R.L. Heuser, M. Aga, W.W. Busse, P.J. Bertics
Journal: Journal of Allergy and Clinical Immunology (2006)
Building Measurement and Data Collection into Medical Practice
Authors: Eugene C. Nelson
Journal: Annals of Internal Medicine (1998)

Clinicians can use data to improve daily clinical practice. This paper offers eight principles for using data to support improvement in busy clinical settings: 1) seek usefulness, not perfection, in the measurement; 2) use a balanced set of process, outcome, and cost measures; 3) keep measurement simple (think big, but start small); 4) use qualitative and quantitative data; 5) write down the operational definitions of measures; 6) measure small, representative samples; 7) build measurement into daily work; and 8) develop a measurement team. The following approaches to using data for improvement are recommended. First, begin with curiosity about outcomes or a need to improve results. Second, try to avoid knee-jerk, obstructive criticism of proposed measurements. Instead, propose solutions that are practical, goal-oriented, and good enough to start with. Third, gather baseline data on a small sample and check the findings. Fourth, try to change and improve the delivery process while gathering data. Fifth, plot results over time and analyze them by using a control chart or other graphical method. Sixth, refine your understanding of variation in processes and outcomes by dividing patients into clinically homogeneous subgroups (stratification) and analyzing the results separately for each subgroup. Finally, make further changes while measuring key outcomes over time. Measurement and improvement are intertwined; it is impossible to make improvements without measurement. Measuring and learning from each patient and using the information gleaned to test improvements can become part of daily medical practice in local settings.
Radon and Smoking Status
Authors: R. T. Ravenholt
Journal: JAMA (1989)

To the Editor.—  The generally excellent study entitled Lung Cancer Mortality Among Nonsmoking Uranium Miners Exposed to Radon Daughters 1 is flawed in two ways. First, the investigators failed to validate the lifelong non-smoking status of the 14 lung cancer decedents by discussions with surviving relatives, coworkers, and physicians. Such specific validation is needed because of workers' compensation implications and because of the many years' lapse from ascertainment of smoking status (1950 through 1969) to death as late as 1984.  Second, the investigators entirely ignored the key issue of what proportion of radon daughter—α-particle exposure was due not to uranium in mine ore but to tobacco smoke—polonium 210 in mines, bars, and home environments, generated by associates. 2 Furthermore, the authors did not define nonsmoking status, eg, never smoked a cigarette, pipe, or cigar; never smoked 100 such; or never smoked regularly. 3
DIFFERENTIAL PERFORMANCE OF THE GLOBAL REGISTRY OF ACUTE CORONARY EVENTS (GRACE) RISK SCORE AMONG ASIAN ETHNIC GROUPS: A GRACE MODEL DISCRIMINATION AND CALIBRATION STUDY OF 13,041 ASIAN SUBJECTS
Authors: Mark Y. Chan, Bimal R. Shah, Fei Gao, Ling Ling Sim, Terrance Chua, Huay Cheem Tan, Tiong Cheng Yeo, Hean Yee Ong, Keng Thye Ho, Ping Ping Goh, Soondal K. Surrun, Tian Hai Koh, Karen S. Pieper, E Shyong Tai
Journal: Journal of the American College of Cardiology (2010)
FTA-ABS Test
Authors: Peter E. Dans
Journal: JAMA (1976)

<h3>To the Editor.—</h3> Burns reported spontaneous reversion of FTA-ABS reactions in patients undergoing preemployment examination. His conclusion was that "serologic tests for syphilis in individuals without physical evidence or history of disease and with negative VDRL and weakly fluorescent FTA-ABS tests should be followed up for about a year before the diagnosis of syphilis is made." In fact, as noted by Dans et al (unpublished data), biologic false-positive results comprise a large percentage of FTAABS reactive sera when such a lowprevalence population is sampled, and the test should not be performed in such patients. When syphilis is suspected, the patient need only be followed up for two to three months. If the VDRL and other treponemal tests remain nonreactive, without any other basis for the diagnosis, the FTA-ABS test should be considered biologically false-positive. In the QUESTION AND ANSWER section (234:975, 1975), a physician reported a patient with varicella and a
The Vital Balance: The Life Process in Mental Health and Illness
Authors: Melvin Sabshin
Journal: JAMA (1964)

Karl Menninger is one of this generation's best-known physicians as well as the most famous member of his medical specialty. Indeed, for millions the name "Menninger" has come to symbolize the psychiatric profession in its most vital, enlightened sense. While geographical boundaries have not limited his fame, Karl Menninger is an American psychiatrist. His career not only typifies American psychiatry's evolution over half a century but also represents American humanism, courage, intelligence, and faith.<i>The Vital Balance</i>represents Menninger's appraisal of what psychiatry is becoming as well as constituting a review of where it has been. It is a deeply personal book since the author has been so much a part of the "becoming" process. Like Menninger's conception of the richness, heterogeneity, and yet uniqueness of individual life, the book is both encyclopedic and sharply focused. The title reflects the central theme. It refers to lifetime organismic tendencies in health
Leukocytes and the kidney contribute to interstitial inflammation in lupus nephritis
Authors: L. Adalid-Peralta, A. Mathian, T. Tran, L. Delbos, I. Durand-Gasselin, D. Berrebi, M. Peuchmaur, J. Couderc, D. Emilie, S. Koutouzov
Journal: Kidney International (2007)
Employment Spectrum of IDDM
Authors: Thomas J Songer, Ronald E LaPorte, Janice S Dorman, Trevor J Orchard, Dorothy J Becker, Allan L Drash
Journal: Diabetes Care (1989)

Occupational issues in 158 insulin-dependent diabetes mellitus (IDDM) individuals and 158 matched nondiabetic siblings were examined in a case-control design to evaluate the role of diabetes in the employability of people with IDDM. Overall, the IDDM cases were more likely to report refusal for a job at some point in their lives (56 vs. 42%, P = .02) than were the nondiabetic control siblings. Surprisingly, individuals who told job interviewers about their diabetes were more likely to report job refusal than their siblings (64 vs. 42%, P = .005), whereas individuals who did not mention their diabetes reported rates of refusal similar to their siblings (44 vs. 41%). IDDM cases were also less likely to be employed full time compared with siblings (55 vs. 73%, P = .001). Reduced employment in IDDM respondents was related to work disability. Reported work disability was more than seven times greater in the IDDM than the sibling group. The presence of diabetic complications was the primary factor related to work disability. Although 13% of IDDM respondents were unable to work because of disability, absenteeism among IDDM cases currently working did not differ from that of the nondiabetic siblings. Diabetes was not significantly associated with career levels or household income levels reported by the IDDM group. Disability, however, had a strong detrimental influence on these variables. The results suggest that hiring practices by employers may still be discriminatory toward individuals with IDDM. Once hired, the employment experiences of the IDDM population appear to be similar to the experiences of the nondiabetic population, provided thedevelopment of disabling diabetic complications has not taken place.
Abstract P5-04-06: Loss of the E3 ubiquitin ligase HACE1 plays a critical role in transformation of mammary cells and clinical progression of human breast cancer via accumulation of active Rac1
Authors: ET Goka, ME Lippman
Journal: Cancer Research (2013)

Abstract Invasive ductal breast cancer arises when the immediate precursor, ductal carcinoma in situ (DCIS), breaches the basement membrane of the ductal lumen and invades into the surrounding tissue. Although this transition has been implicated as a crucial step in the progression of breast cancer, the specific alterations responsible for this transition have yet to be identified. HER2/neu, a member of the epidermal growth family receptor (EGFR) family, is frequently overexpressed in non-invasive lesions (50-60%) but is significantly less common in invasive breast cancer (20-30%). This suggests that while HER2/neu may be partially transformative, additional alterations are required for mammary epithelial cells to achieve full malignant transformation. To identify novel genes capable of cooperating with HER2, we performed an insertional mutagenesis screen for genes whose alteration induces anchorage-independent growth on primary mouse mammary epithelial cells isolated from MMTV-neu transgenic mice. We identified HECT domain and ankyrin repeat containing E3 ubiquitin-protein ligase 1 (HACE1) as a putative breast tumor suppressor gene whose loss contributes to the transformative process. Loss of HACE1 expression is commonly seen in publicly available breast cancer patient data sets as well as in established breast cancer cell lines supporting the role of HACE1 as a breast cancer tumor suppressor gene. Knockdown of HACE1 in HER2 overexpressing human mammary epithelial cells (HMECs) enhanced colony formation over HER2 overexpressing HMEC controls cells. Moreover, knockdown of HACE1 alone was sufficient to allow anchorage-independent growth in soft agar in the HMECs while the overexpression of HACE1 in breast cancer cell lines diminishes clonogenic capacity in soft agar. We confirmed recent studies that have shown that HACE1 is capable of tagging the Rho GTPase Rac1 for ubiquitin-mediated proteasomal degradation. In mammary epithelial cells, the loss of HACE1 leads to enhanced levels of active Rac1 resulting in increased clonogenicity, migration and invasion. Importantly, we show that targeting Rac1 can rescue the effects of HACE1 loss in mammary epithelial cells. Our results establish HACE1 as a breast cancer tumor suppressor gene by attenuating active Rac1 signaling. Our work supports the role of Rac1 as a critical signaling node in breast cancer and that loss of HACE1 leads to enhanced Rac1 signaling resulting in driving cancer progression. Furthermore, our results suggest the role of HACE1 loss as a biomarker for tumor progression and may identify patients vulnerable to Rac1 or Rac effector targeted therapies. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P5-04-06.
The Genetics of Speech and Language Impairments
Authors: Karin Stromswold
Journal: New England Journal of Medicine (2008)

Without instruction, most children master the complexities of spoken language by the age of 6 or 7 years. About 5% of apparently healthy children, however, struggle to acquire basic competence in one or more aspects of spoken language and are classified as having specific language impairment.Genetic factors have an important role in many such cases.1,2 Children with specific language impairment are four times as likely to have a family history of the disorder as are children who do not have such an impairment,3 and the concordance rate for the disorder is almost twice as great for monozygotic twins . . .