tbuckley/cabot-search huggingface dataset:
Feasibility of conducting a randomized control trial for liver cancer screening: Is a randomized controlled trial for liver cancer screening feasible or still needed?
Authors: Hossein Poustchi, Geoffrey C. Farrell, Simone I. Strasser, Alice U. Lee, Geoffrey W. McCaughan, Jacob George
Journal: Hepatology (2010)

Abstract Screening for hepatocellular carcinoma (HCC) is commonly practiced and recommended in published guidelines, but evidence for its efficacy has been controversial. We tested the feasibility of conducting a randomized controlled trial (RCT) of HCC surveillance in patients with cirrhosis and followed up those offered screening to detect clinical outcomes. Participation was offered to patients with cirrhosis attending liver clinics at three university hospitals. Following discussion, patients received a decision aid (DA) that outlined the risks and benefits of surveillance. The proposed screening program comprised ultrasonography 6-monthly and serum alpha-fetoprotein every 3 months. We envisaged five groups of patients: those who agreed to randomization, those choosing nonrandomized screening, those wanting continuation of usual care, those who were undecided, and those refusing participation. Among 205 patients, 204 (99.5%) declined randomization. Of these, 181 (88%) elected for a nonrandomized screening program, 10% chose usual care (which typically included ad hoc screening), and two were undecided. Among 176 patients fluent in English communication skills, 160 (91%) preferred nonrandomized screening compared with 22/29 (76%) patients needing an interpreter ( P &lt; 0.026). Of 173 patients in nonrandomized screening followed up for a mean 13.5 ± 6.04 months, three developed HCC, two died from nonliver-related causes, and one underwent liver transplantation for liver failure. Eighteen of 21 patients in “usual care” received ad hoc screening. A simultaneous survey on the quality of the DA showed that the majority of participants believed that the information provided was unbiased. Conclusion: Although an RCT is theoretically ideal for determining the efficacy, efficiency, and cost-effectiveness of HCC screening, informed patients prefer surveillance. A randomized study of HCC screening is not feasible when informed consent is imparted. (Hepatology 2011;)
Progress and Prospects on Melanoma: The Way Forward for Early Detection and Reduced Mortality
Authors: Martin A. Weinstock
Journal: Clinical Cancer Research (2006)

Abstract The public health problem of melanoma is difficult. Recent decades have seen substantial efforts directed at primary prevention, yet the incidence of melanoma continues to increase. Substantial efforts have been devoted to improving treatment, yet melanoma retains a poor prognosis if simple surgical excision is not curative. Early detection has made remarkable progress, however. Five-year relative survival has increased from approximately 80% in 1975 to greater than 90% in 1996. Even so, almost 8,000 Americans are projected to succumb to melanoma in 2005. Because most of these fatal melanomas are visible on the skin surface at a curable phase in their evolution, more can and must be done. To improve the early detection practices of clinicians, we have developed an eight-step Basic Skin Cancer Triage algorithm, which forms the core of a curriculum that we have shown can result in improved skills, attitudes, and practices. We are now in the process of attempting to test a Web-based version of that curriculum in a randomized trial. Skin self-examination also has tremendous potential for contributing to early detection of melanoma. We have tested an intervention to encourage thorough skin self-examination in a randomized trial and found it effective in increasing the performance of this procedure, on increase that is sustained for at least a year, while resulting in only short-term increases in surgical procedures on the skin. Early detection has not yet reached its full potential effect on the public health problem of melanoma and is poised to further reduce melanoma mortality.
Mild hypothermia delays the onset of coma and prevents brain edema and extracellular brain glutamate accumulation in rats with acute liver failure
Authors: Christopher Rose, Adrianna Michalak, Marc Pannunzio, Nicolas Chatauret, Andrea Rambaldi, Roger F. Butterworth
Journal: Hepatology (2000)

Mild hypothermia is effective in the prevention of brain edema associated with cerebral ischemia and traumatic brain injury. Brain edema is also a serious complication of acute liver failure (ALF). To assess the effectiveness of hypothermia in ALF, groups of rats were subjected to hepatic devascularization (portacaval anastomosis, followed 48 hours later by hepatic artery ligation), and body temperatures were maintained at either 35 degrees C (hypothermic) or 37 degrees C (normothermic). Mild hypothermia resulted in a significant delay in the onset of severe encephalopathy and in reduction of brain water content compared with normothermic ALF rats (control [n = 8] 80.22%; ALF-37 degrees C [n = 8] 81.74%; ALF-35 degrees C [n = 8] 80.48% [P <.01 compared with ALF-37 degrees C]). This protective effect was accompanied by a significant reduction of cerebrospinal fluid (CSF) (but not plasma) ammonia concentrations (CSF ammonia: control: 0.05 mg/dL; ALF-37 degrees C: 1.01 mg/dL; ALF-35 degrees C: 0.07 mg/dL, P <.01 compared with ALF-37 degrees C). In vivo cerebral microdialysis studies revealed that mild hypothermia resulted in a significant reduction of extracellular glutamate concentrations in the brains of rats with ALF (control: 1. 06 micromol/L; ALF-37 degrees C: 2.74 micromol/L; ALF-35 degrees C: 1.49 micromol/L [P <.01 compared with ALF-37 degrees C]). These findings suggest that: 1) mild hypothermia is an effective approach to the prevention of the central nervous system consequences of experimental ALF; and that 2) the beneficial effect of hypothermia is mediated via mechanisms involving reduced blood-brain transfer of ammonia and/or reduction of extracellular brain glutamate concentrations. Mild hypothermia may be an effective approach to delay the onset of brain edema in patients with ALF awaiting liver transplantation.
Exercise and Risk of Major Cardiovascular Events in Adult Survivors of Childhood Hodgkin Lymphoma: A Report From the Childhood Cancer Survivor Study
Authors: Lee W. Jones, Qi Liu, Gregory T. Armstrong, Kirsten K. Ness, Yutaka Yasui, Katie Devine, Emily Tonorezos, Luisa Soares-Miranda, Charles A. Sklar, Pamela S. Douglas, Leslie L. Robison, Kevin C. Oeffinger
Journal: Journal of Clinical Oncology (2014)

Purpose Survivors of Hodgkin lymphoma (HL) are at increased risk of treatment-related cardiovascular (CV) events; whether exercise modifies this risk is unknown. Methods Survivors of HL (n = 1,187; median age, 31.2 years) completed a questionnaire evaluating vigorous-intensity exercise behavior. CV events were collected in follow-up questionnaires and graded according to Common Terminology Criteria for Adverse Events (version 4.03). The primary end point was incidence of any major (grade 3 to 5) CV event. Poisson regression analyses were used to estimate the association between exercise exposure (metabolic equivalent [MET] hours/week −1 ) and risk of major CV events after adjustment for clinical covariates and cancer treatment. Results Median follow-up was 11.9 years (range, 1.7 to 14.3 years). Cumulative incidence of any CV event was 12.2% at 10 years for survivors reporting 0 MET hours/week −1 compared with 5.2% for those reporting ≥ 9 MET hours/week −1 . In multivariable analyses, the incidence of any CV event decreased across increasing MET categories (P trend = .002). Compared with survivors reporting 0 MET hours/week −1 , the adjusted rate ratio for any CV event was 0.87 (95% CI, 0.56 to 1.34) for 3 to 6 MET hours/week −1 , 0.45 (95% CI, 0.26 to 0.80) for 9 to 12 MET hours/week −1 , and 0.47 (95% CI, 0.23 to 0.95) for 15 to 21 MET hours/week −1 . Adherence to national vigorous intensity exercise guidelines (ie, ≥ 9 MET hours/week −1 ) was associated with a 51% reduction in the risk of any CV event in comparison with not meeting the guidelines (P = .002). Conclusion Vigorous exercise was associated with a lower risk of CV events in a dose-dependent manner independent of CV risk profile and treatment in survivors of HL.
Innate Type 2 Immunity Is Associated with Eosinophilic Pleural Effusion in Primary Spontaneous Pneumothorax
Authors: Bo-In Kwon, Seokchan Hong, Kihyuk Shin, Eun-Hye Choi, Jung-Joo Hwang, Seung-Hyo Lee
Journal: American Journal of Respiratory and Critical Care Medicine (2013)

Eosinophilic pleural effusion (EPE) is characterized by greater than 10% eosinophilia and is frequently associated with air and/or blood in the pleural cavity. Primary spontaneous pneumothorax (PSP), defined as the spontaneous presence of air in the pleural space, is one of the most common causes of EPE. Recent studies have shown that type 2 immune responses play important roles in eosinophilic airway inflammation resulting in pleural pathology.To determine the predominant immune responses associated with PSP in humans, and to examine whether IL-33, thymic stromal lymphopoietin (TSLP), or type 2 innate lymphoid cell (ILC2)-mediated immune responses are associated factors.Eosinophil-associated cytokines were measured in the pleural fluid of patients with PSP and control subjects. Th2 cell and ILC2 responses in the pleural cavity and peripheral blood were also evaluated by in vitro restimulation and intracellular cytokine staining of T cells and ILC2s in patients with PSP (n = 62) and control subjects (n = 33). IL-33-mediated IL-5 production by ILC2s was also evaluated.Significantly higher concentrations of IL-5 and eotaxin-3 were detected in the pleural fluid of patients with PSP, in addition to significantly higher concentrations of IL-33 and TSLP. Although IL-5 production was induced by IL-33 treatment of ILC2s, other Th2 cell-mediated immune responses were not detected.Our results indicate that innate immune responses characterized by the production of IL-33, TSLP, and IL-5 are associated with the development of EPE in PSP by an ILC2-dependent and Th2-independent mechanism.
Usefulness of Aqueous Humor Analysis for the Diagnosis of Posterior Uveitis
Authors: Aniki Rothova, Joke H. de Boer, Ninette H. ten Dam-van Loon, Gina Postma, Lenneke de Visser, Stephanie J. Zuurveen, Margje Schuller, Annemarie J.L. Weersink, Anton M. van Loon, Jolanda D.F. de Groot-Mijnes
Journal: Ophthalmology (2007)
Posttraumatic Stress Following Pediatric Injury
Authors: Nancy Kassam-Adams, Meghan L. Marsac, Aimee Hildenbrand, Flaura Winston
Journal: JAMA Pediatrics (2013)

After pediatric injury, transient traumatic stress reactions are common, and about 1 in 6 children and their parents develop persistent posttraumatic stress (PTS) symptoms that are linked to poorer physical and functional recovery. Meta-analytic studies identify risk factors for persistent PTS, including preinjury psychological problems, peritrauma fear and perceived life threat, and posttrauma factors such as low social support, maladaptive coping strategies, and parent PTS symptoms. There is growing prospective data indicating that children's subjective appraisals of the injury and its aftermath influence PTS development. Secondary prevention of injury-related PTS often involves parents and focuses on promoting adaptive child appraisals and coping strategies. Web-based psychoeducation and targeted brief early intervention for injured children and their parents have shown a modest effect, but additional research is needed to refine preventive approaches. There is a strong evidence base for effective psychological treatment of severe and persistent PTS via trauma-focused cognitive behavioral therapy; evidence is lacking for psychopharmacological treatment. Pediatric clinicians play a key role in preventing injury-related PTS by providing "trauma-informed" pediatric care (ie, recognizing preexisting trauma, addressing acute traumatic stress reactions associated with the injury event, minimizing potentially traumatic aspects of treatment, and identifying children who need additional monitoring or referral).
Unsuitable hepatitis C testing kit being used in India
Authors: R. Sharma
Journal: BMJ (2001)

Hepatitis C virus is emerging as a major public health challenge in India, specialists said at a conference in New Delhi last week.

“Seroprevalence of hepatitis C virus in the Indian population is around 1.5-2%,” said Dr Subrata Kumar Panda of the All India Institute of Medical Sciences.

Every year between 1.5 million and two million Indians die from chronic liver disease. “If you take all chronic liver disease cases in India, nearly 15% are due to hepatitis C virus and 45% are due to hepatitis …
CASE OF SCIRRHUS OF THE PANCREAS AND STOMACH
Authors: J. S. Bartrum
Journal: BMJ (1855)

OUGNMAL XMN0A?IONB.l an 't y ibly prove of &icient interet for publica.T, e ough the practice recorded, that of leaving the g of the limb, to the patient's " feeling of animal con-; eiousne,s", after the fashion of Abernethy's monkey, be not in accordance with the " rules laid down by the warmest promoters of excision".P.S.-The case of "successful excision of the knee- joint", reported in the AssocIATIoir JOURNAL of August 4th, 1854, has been honoured by a far from complimentary cTitical notice in the Edinburgh Jfedica and Surical Journal of October 1854.It will not perhaps be uninter- esting to the authorities of that periodical to learn that t.heir predictions, as to permanency of cure, have not been realised; as the boy, now upwards of twenty months after the operation (as was reported in Mr. Butcher's excellent mono-
Pituitary Expression of CTLA-4 Mediates Hypophysitis Secondary to Administration of CTLA-4 Blocking Antibody
Authors: Shintaro Iwama, Alessandra De Remigis, Margaret K. Callahan, Susan F. Slovin, Jedd D. Wolchok, Patrizio Caturegli
Journal: Science Translational Medicine (2014)

CTLA-4 blocking antibody induces secondary hypophysitis by binding to CTLA-4 antigen and initiating a type II hypersensitivity reaction.
Telemedicine: a cautious welcome
Authors: R. Wootton
Journal: BMJ (1996)

Telemedicine is a major new development. Having become technically and economically feasible, it deserves proper investigation. Rushing into equipment purchase, however, is almost certain to prove counterproductive. Face to face contact is fundamental to health care and enthusiasts of telemedicine should recognise that it is not as good as the real thing (and unlikely ever to be). However, constraints on time and resources will make face to face consultation increasingly expensive, and telemedicine has the potential to produce major efficiencies in the diagnostic process. The goal of current research is therefore to marry medicine with technology, capitalising on the advantages of telemedicine and producing a robust system that delivers an acceptable service at an appropriate price.
Fibrinolysis
Authors: Stanley N. Cohen, Henry G. Kupfer
Journal: New England Journal of Medicine (1958)

NORMAL blood contains the mechanism of fibrinolysis that is responsible for the dissolution of blood clots. The fibrinolytic process has attracted extensive interest because of both its physiologic activity in the human organism and its abnormal activity in various clinical states. The purposes of the case report and discussion that comprise this presentation are twofold: to emphasize that a deficiency in factor V as well as fibrinogen exists during extensive fibrinolysis in the human being; and to suggest that therapy in hypofibrinogenemia due to fibrinolysis differs from that in conditions associated with intravascular coagulation and defibrination.Case ReportA 63-year-old . . .
Acute effects of cadmium on the pregnant rat and embryo-fetal development.
Authors: G P Samarawickrama, M Webb
Journal: Environmental Health Perspectives (1979)

In rats, of the Wistar-Porton strain, a single intravenous injection of 1.25 mg Cd2+ between days 9 and 15 of gestation results in a high incidence (80% of hydrocephalus, together with other malformations in the fetuses, examined on day 20. This dose is critical, since 1.1 mg Cd2+/kg is not teratogenic, while 1.35 mg Cd2+/kg kills all the embryos. Intravenous injection of Cd2+ to the pregnant rat on day 12 causes a dose-dependent inhibition of placental Zn2+ transport. At the teratogenic dose, Zn2+ transport is inhibited by about 75% at 4 hr. Thereafter, inhibition decreases with time but is still significant at 48 hr. At 20 hr after administration of Cd2+ the embryonic concentration of Zn2+ is depressed by 33%. In the whole embryo the activity of the Zn2+-dependent thymidine kinase is inhibited by about 60% at 4 hr and at 20 hr the DNA concentration is reduced significantly. Placental transport of 14C-leucine and 14C-uridine, as well as the embryonic incorporation of these precursors into protein and RNA is unaffected at least at short times after the administration of Cd2+. It is possible therefore, that the teratogenic effects of Cd2+ may be related to the inhibition of DNA synthesis in the embryo.
p16 INK4a andp15INK4b gene methylations in plasma cells from monoclonal gammopathy of undetermined significance
Authors: Gaëlle Guillerm, Emmanuel Gyan, Darius Wolowiec, Thierry Facon, Hervé Avet-Loiseau, Kazimierz Kuliczkowski, Francis Bauters, Pierre Fenaux, Bruno Quesnel
Journal: Blood (2001)
Quadrilateral Peripheral Vascular Disease in the Young Adult
Authors: FALLS B. HERSHEY, MORTON D. PAREIRA, ROBERT C. AHLVIN
Journal: Circulation (1962)

Seven cases of quadrilateral chronic occlusive arterial disease different from other known chronic occlusive arterial diseases as evidenced by arteriography, pathology, and clinical manifestations are reported. They resemble some of the cases originally described by Buerger.
Localization of Ryanodine Receptors in Smooth Muscle
Authors: Ryan E. Lesh, Graeme F. Nixon, Sidney Fleischer, Judith A. Airey, Andrew P. Somlyo, Avril V. Somlyo
Journal: Circulation Research (1998)

Abstract —The ryanodine receptor (RyR) in aortic and vas deferens smooth muscle was localized using immunofluorescence confocal microscopy and immunoelectron microscopy. Indirect immunofluorescent labeling of aortic smooth muscle with anti-RyR antibodies showed a patchy network-like staining pattern throughout the cell cytoplasm, excluding nuclei, in aortic smooth muscle and localized predominantly to the cell periphery in the vas deferens. This distribution is consistent with that of the sarcoplasmic reticulum (SR) network, as demonstrated by electron micrographs of osmium ferrocyanide–stained SR in the two smooth muscles. Immunoelectron microscopy of vas deferens smooth muscle showed anti-RyR antibodies localized to both the sparse central and predominant peripheral SR elements. We conclude that RyR–Ca 2+ -release channels are present in both the peripheral and central SR in aortic and vas deferens smooth muscle. This distribution is consistent with the possibility that both regions are release sites, as indicated by results of electron probe analysis, which show a decrease in the Ca 2+ content of both peripheral and internal SR in stimulated smooth muscles. The complex distribution of inositol 1,4,5-trisphosphate and ryanodine receptors (present study) is compatible with their proposed roles as agonist-induced Ca 2+ -release channels and origins of Ca 2+ sparks, Ca 2+ oscillations, and Ca 2+ waves.
Therapeutic Blood Lidocaine Concentrations after Local Anesthesia for Cardiac Electrophysiologic Studies
Authors: Stanley Nattel, Robert L. Rinkenberger, Linda L. Lehrman, Douglas P. Zipes
Journal: New England Journal of Medicine (1979)

CLINICAL cardiac electrophysiologic studies are performed to evaluate mechanisms of arrhythmias and their response to therapy.1 2 3 4 5 6 7 8 9 10 Lidocaine, injected to provide local anesthesia before insertion of the electrode catheter, can affect the results of such studies if substantial blood concentrations are achieved. This study was designed to measure lidocaine concentrations in patients undergoing cardiac electrophysiologic studies.Materials and MethodsSeventeen patients were studied after written informed consent was obtained. Lidocaine solution (1 per cent, without epinephrine) was injected subcutaneously into one or both groins before insertion of two to four transvenous electrode catheters. Intravascular injection was avoided by aspiration before each . . .
Abstract LB-116: Immunodeficient pigs as a large animal model for human tumors
Authors: Sivasai Balivada, Matthew T. Basel, Marla Pyle, Amanda P. Beck, Ada G. Cino-Ozuna, Maureen A. Kerrigan, Jennifer L. Hill, Carol R. Wyatt, Robert R. R. Rowland, Deryl L. Troyer
Journal: Cancer Research (2012)

Abstract Currently, SCID mice are the major biomedical model for the study of human cancer and other diseases; however, they can be a poor model because there is a large discrepancy in body size and physiology between rodents and humans. Since most new anticancer drugs are first evaluated in rodents, most fail in phase I and phase II clinical trials. Thus, there is a tremendous demand for more sophisticated animal models, which may improve the translation efficiency from preclinical to clinical studies. We recently identified pigs that are severely immunocompromised. Here we tested these pigs as a model for human tumors. Three immunodeficient (ID) pigs and three normal (WT) pigs, six weeks of age, were tested for their ability to allow xenotransplanted human tumors to grow. Each pig was transplanted with 4 million A375 human malignant melanoma cells subcutaneously into the left ear and 4 million PANC-1 human pancreatic carcinoma cells subcutaneously into the right ear on day 0. The ID pigs were euthanized 6, 14, or 23 days after cell transplantation, based on their health condition. Palpable melanoma tumors were identified on day 13 after cell transplantation in the two remaining ID pigs. After euthanasia, full necropsy was performed on all pigs; tissues were collected from ears and other organs for histopathological analysis. Melanoma and pancreatic tumor xenotransplants were identified histologically in all three ID pigs. The presence of human cancer cells in these pigs was further verified with anti-human mitochondrial immunohistochemistry. No transplanted tumors were found, grossly, histologically, or immunohistochemically, in the WT pigs. We propose that this genetic line of ID pigs may prove to be a useful large animal model for human tumors. 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 LB-116. doi:1538-7445.AM2012-LB-116