tbuckley/cabot-search huggingface dataset:
Sino-MONICA Project
Authors: Zhaosu Wu, Chonghua Yao, Dong Zhao, Guixian Wu, Wei Wang, Jing Liu, Zhechun Zeng, Yingkai Wu
Journal: Circulation (2001)

The Sino-MONICA project is a 7-year study monitoring trends and determinants of cardiovascular disease (CVD) in geographically defined populations in different parts of China.The study is a community-based prospective disease surveillance that uses the methodology and criteria of the World Health Organization's Monitoring Trends and Determinants in Cardiovascular Disease (WHO MONICA) project, with slight modifications for local use. After a pilot study of 2 years (1985 through 1986), data collection started formally on January 1, 1987, and ended on December 31, 1993. The main results were as follows. By international standards, both the incidence and mortality rate of coronary heart disease in Chinese populations were low. The highest incidence was 108.7 of 100,000 (1987 to 1989), and the lowest was 3.3 of 100,000 for men 35 to 64 years of age, a 33-fold difference. Both the incidence and mortality rate of cerebrovascular disease were high. The highest incidence was 553.3 of 100,000 (1987 to 1989), and the lowest was 33.0 of 100,000 for men 35 to 64 years of age, a 17-fold difference. There were significant geographic variations in both CVD incidence and mortality rate, with higher rates in the north and lower rates in the south. During 1987 to 1993, increasing trends were found in CVD rates in some populations, whereas decreasing trends were found in others. The trends were not significant statistically in most cases.Monitoring CVD with international standardized methods in China is feasible and urgently needed in view of the rapid socioeconomic development and transition of disease patterns taking place in China. The results are of significance in combating CVD both at home and abroad.
The Newcastle exercise project: a randomised controlled trial of methods to promote physical activity in primary care
Authors: J. Harland, M. White, C. Drinkwater, D. Chinn, L. Farr, D. Howel
Journal: BMJ (1999)

To evaluate the effectiveness of combinations of three methods to promote physical activity.Randomised controlled trial. Baseline assessment with post-intervention follow up at 12 weeks and 1 year.One urban general practice, 1995-7.523 adults aged 40 to 64 years, randomised to four intervention groups and a control group.Brief (one interview) or intensive (six interviews over 12 weeks) motivational interviewing based on the stages of change model of behaviour change, with or without financial incentive (30 vouchers entitling free access to leisure facilities).Physical activity score; sessions of moderate and vigorous activity in the preceding four weeks.Response rate was 81% at 12 weeks and 85% at one year. More participants in the intervention group reported increased physical activity scores at 12 weeks than controls (38% v 16%, difference 22%, 95% confidence interval for difference 13% to 32%), with a 55% increase observed in those offered six interviews plus vouchers. Vigorous activity increased in 29% of intervention participants and 11% of controls (difference 18%, 10% to 26%), but differences between the intervention groups were not significant. Short term increases in activity were not sustained, regardless of intensity of intervention.The most effective intervention for promoting adoption of exercise was the most intensive. Even this did not promote long term adherence to exercise. Brief interventions promoting physical activity that are used by many schemes in the United Kingdom are of questionable effectiveness.
Large volume spacer devices and the influence of high dose beclomethasone dipropionate on hypothalamo-pituitary-adrenal axis function.
Authors: P H Brown, A P Greening, G K Crompton
Journal: Thorax (1993)

BACKGROUND: The systemic effects of the inhaled corticosteroid beclomethasone dipropionate are reduced if the drug is inhaled through a large volume spacer. Use of spacers may therefore permit higher doses to be given without causing hypothalamo-pituitary-adrenal suppression. METHODS: Randomised, double blind, double dummy, parallel group study was carried out in adults with chronic asthma to determine the dose of beclomethasone dipropionate causing hypothalamo-pituitary-adrenal suppression when the drug was administered by metered dose aerosol with and without a large volume spacer. After a four week run in taking 1.5 mg beclomethasone daily 50 patients underwent tests of hypothalamo-pituitary-adrenal function (measurement of 0900 h serum cortisol concentration and 24 hour urinary free cortisol excretion and the short tetracosactrin test). Six patients had hypothalamo-pituitary-adrenal suppression (results of at least two tests subnormal) and asthma was well controlled in six others. Thirty eight patients received increasing doses of beclomethasone with (group S) or without (group MDI) a 750 ml spacer. The daily dose was increased by 0.5 mg at monthly intervals until hypothalamo-pituitary-adrenal suppression developed or a dose of 5 mg/day was achieved. Asthma symptoms and peak expiratory flow were recorded daily. RESULTS: Twenty three patients completed the study, one (group S) reaching a dose of 5 mg beclomethasone dipropionate daily without hypothalamo-pituitary-adrenal suppression. Reasons for withdrawal were poor compliance (n = 10), the patient's decision (n = 3), and asthma that was too unstable (n = 2). "Intention to treat" analysis showed that the median dose of beclomethasone causing hypothalamo-pituitary-adrenal suppression was similar in the two groups (3.25 mg in S v 3.0 mg in MDI; 95% confidence interval (CI) for difference -1.0 to 1.0 mg). At 2 mg/day of beclomethasone most patients in both groups had well controlled asthma and there were no differences in symptoms or peak flow between the groups. Good control at this dose did not permit conclusions to be drawn about the efficacy of higher doses. CONCLUSIONS: There is wide interindividual variation in the dose of beclomethasone dipropionate causing hypothalamo-pituitary-adrenal suppression. Whether or not a spacer is used, doses higher than the currently accepted maximum of 2 mg/day can be taken by many adults with asthma without causing subnormal function of the hypothalamo-pituitary-adrenal axis. Whether these higher doses are more effective in controlling asthma remains to be established.
Success of Reentry Into Anesthesiology Training Programs by Residents With a History of Substance Abuse
Authors: Emil J. Menk
Journal: JAMA (1990)

To determine incidence and outcome of reentry into anesthesiology training programs by residents with histories of substance abuse, a survey was sent to the 159 US anesthesiology training programs. One hundred thirteen (71%) responded, with 82 (73%) submitting at least one case report of substance abuse. A total of 180 case reports were submitted, including 26 in which the resident died as a result of substance abuse. The prevalence of substance abuse among trainees was 2%. Sixty-one (74%) of the responding training programs submitted a total of 113 case reports of resident reentry into anesthesiology training. The success rate of reentry in the parenteral opioid abuser group was 34% (27/79). The success rate of reentry for the nonopioid abuser group was 70% (16/23). There were 14 cases of suicide or lethal overdose among trainees who were allowed to reenter anesthesiology training. Death as the initial relapse symptom occurred in 16% (13/79) of the parenteral opioid abusers who were allowed to reenter anesthesiology training. This study suggests that drug rehabilitation followed by redirection into another specialty may be the most prudent course for the anesthesiology trainee who abuses parenteral opioids. (<i>JAMA</i>. 1990;263:3060-3062)
Improvement in Exercise Capacity in Asymptomatic and Mildly Symptomatic Adults After Atrial Septal Defect Percutaneous Closure
Authors: Marie-Claude Brochu, Jean-François Baril, Annie Dore, Martin Juneau, Pierre De Guise, Lise-Andrée Mercier
Journal: Circulation (2002)

Controversy exists as to whether secundum atrial septal defects (ASDs) in asymptomatic or mildly symptomatic New York Heart Association (NYHA) class I or II adult patients should be closed.Thirty-seven patients (24 females; mean age 49.4 years, range 19 to 76) with a mean pulmonary to systemic flow ratio (Qp:Qs) of 2.1 (1.2 to 3.4) had a maximal oxygen uptake (VO2max) determination and echocardiographic measurement of right ventricular dimensions before and 6 months after elective percutaneous closure of ASD. At baseline, mean VO2max was 23.5+/-6.4 mL/kg per minute and was higher in the 15 NYHA I patients than in the 22 NYHA II patients (27+/-6.9 versus 20.8+/-4.6 mL/kg per minute; P=0.0015). VO2max increased significantly at 6 months (23.5+/-6.4 to 26.9+/-6.9 mL/kg per minute; P<0.0001). Improvement was as marked in NYHA I (+22%; P<0.0001) as in NYHA II patients (+12%; P<0.0001), in patients with Qp:Qs 1.2 to 2.0 (+16%; P<0.0001) as in those with Qp:Qs >2 (+12%; P<0.0001), and in patients > or =40 years of age (+14%; P<0.0001) as in those <40 years of age (+16%; P<0.0001). Compared with 15 of 37 patients before closure, 35 of 37 patients were in NYHA I at 6 months. Right ventricular dimensions decreased significantly (P<0.0001).Adult ASD patients significantly increase their functional capacity after percutaneous defect closure. This is observed even in patients classified as asymptomatic, in those with lesser shunts, and in older patients. These findings suggest that ASD closure in an adult population should be considered even in the absence of symptoms.
462 HEPATITIS C VIRUS LOAD AND EXPRESSION OF A UNIQUE SUBSET OF CELLULAR GENES IN LYMPHOID CELLS DIFFERENTIATE NONRESPONDERS FROM RESPONDERS TO PEGYLATED INTERFERON ALPHA-RIBAVIRIN TREATME
Authors: T.N. Pham, D.M. Lin, P.M. Mulrooney-Cousins, N.D. Churchill, A. Kowala-Piaskowska, I. Mozer-Lisewska, A. Machaj, M. Pazgan-Simon, M. Zalewska, K. Simon, D. King, S.B. Reddy, T.I. Michalak
Journal: Journal of Hepatology (2011)
Abstract 1287: Mutations in the CBL gene among breast cancer patients in an Asian clinic-based population
Authors: Edward Wong, Yoon Sim Yap, Ying Ying Cheng, Delia Chua, Lewis Zuocheng Hong, William F. Burkholder, Gay Hui Ho, Min Han Tan, Peter Ang, Ann S.G. Lee
Journal: Cancer Research (2014)

Abstract INTRODUCTION Although mutations in BRCA1 and BRCA2 are associated with familial hereditary breast and ovarian cancer, mutations are only found in 20 to 25% of these patients. This suggests that additional genes may be mutated. The Casitas B-lineage lymphoma (CBL) gene encodes a RING finger E3 ubiquitin ligase. Recent studies have shown that mutations in the CBL gene occurs in human acute myeloid leukemia and lung cancers. The relationship of the CBL gene with breast cancer, however, is not well characterized. The aim of this study was to identify mutations in the CBL gene in Asian patients with familial or early-onset breast cancer. METHODS All patients (n=75) were accrued at the risk assessment clinic at the National Cancer Centre Singapore, and presented with a family history of breast and/or ovarian cancer or early-onset breast cancer. Screening for mutations in the BRCA1 and BRCA2 genes was performed using Sanger sequencing and Multiplex Ligation-dependent Probe Amplification (MLPA). Next generation sequencing was done using the Agilent SureSelect target-enrichment technology on the Illumina MiSeq platform, followed by validation using Sanger sequencing. RESULTS Two mis-sense variants in the CBL gene were identified. They are CBL c. 560C&amp;gt;T (p. A187V) and c. 1858C&amp;gt;T (p.L620F) occurring in 2/75 (3%) and 8/75 (11%) of the patients, respectively. Both mis-sense mutations were predicted to be damaging using Polyphen-2 and SIFT. The p.A187V alteration was predicted to interrupt the N-terminal tyrosine kinase binding domain (TKB) that is important for ligand-induced ubiquitination of receptor tyrosine kinases (RTKs). The CBL c. 1858C&amp;gt;T variant has previously been reported in the NCBI database (rs2227988). Three individuals, who carried this mutation, had early-onset breast cancer. In addition, the p.L620F alteration within the proline-rich region, may disrupt the interactions of binding partners to the c-CBL protein, which are required to recruit c-CBL to RTKs. All patients, except one, with germline CBL mutations were negative for BRCA1 and BRCA2 mutations. CONCLUSION This preliminary study has identified damaging CBL mutations in an Asian population with breast cancer and warrants further investigations in other breast cancer populations. Citation Format: Edward Wong, Yoon Sim Yap, Ying Ying Cheng, Delia Chua, Lewis Zuocheng Hong, William F. Burkholder, Gay Hui Ho, Min Han Tan, Peter Ang, Ann S.G. Lee. Mutations in the CBL gene among breast cancer patients in an Asian clinic-based population. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1287. doi:10.1158/1538-7445.AM2014-1287
THE PRACTICE OF MEDICINE IN THE NEW ENGLAND COLONIES.
Authors: FRANCIS R. PACKARD
Journal: JAMA (1898)

I propose to glance in a cursory manner at a few of the many interesting and curious facts concerning medical practice in the early days of the settlement of New England. It is a subject about which not much has been written and of which our knowledge is very scanty, compared with the thoroughness with which we know every other detail of the lives of the colonists. The truth is that our medical forefathers left but little literary material upon which to work in an investigation of their methods or experiences. But few of them devoted themselves to purely professional work, and their lives were too largely occupied with the battle against the difficulties which lay in the way of developing the new country to afford much chance for scientific or literary labor, had any of them the inclination for it. In the records of the settlements of the New
1,2-Dimethylhydrazine-Induced Colon Carcinoma and Lymphoma in msh2-/- Mice
Authors: C. Colussi, S. Fiumicino, A. Giuliani, S. Rosini, P. Musiani, C. Macri, C. S. Potten, M. Crescenzi, M. Bignami
Journal: JNCI Journal of the National Cancer Institute (2001)

Defective mismatch repair (MMR) in humans is particularly associated with familial colorectal cancer, but defective repair in mice is generally associated with lymphoma in the absence of experimental exposure to carcinogens. Loss of MMR also confers resistance to the toxic effects of methylating agents. We investigated whether resistance to methylation contributes to increased susceptibility to colorectal cancer in mice by exposing mice with defects in the MMR gene msh2 to a methylating agent.Tumor incidence and time of death in msh2(+/+), msh2(+/-), and msh2(-/-) mice were analyzed after weekly exposure (until tumor appearance) to the methylating agent 1,2-dimethylhydrazine (DMH). Chemically induced and spontaneous tumors were characterized by frequency, type, and location. The tumor incidence in untreated and treated mice of each genotype was compared by a Mann-Whitney U test. Carcinogen-induced apoptosis in histologic sections of small and large intestines was also determined. All statistical tests were two-sided.Homozygous inactivation of the msh2 gene statistically significantly accelerated (P<.0001) death due to the development of DMH-induced colorectal tumors and lymphomas. Rates of death from DMH-induced colorectal adenocarcinoma were similar in msh2 heterozygous and wild-type mice, but only msh2 heterozygotes (msh(+/-)) developed additional, noncolorectal malignancies (notably trichofolliculoma [two of 21], angiosarcoma of the kidney capsule [two of 21], and lymphoma [one of 21]), suggesting that heterozygosity for msh2 slightly increases DMH susceptibility. DMH induced apoptosis in small intestinal and colonic epithelial crypts that was dependent on active msh2.Inactivation of msh2 allows the proliferation of gastrointestinal tract cells damaged by methylating agents. Furthermore, MMR constitutes a powerful defense against colorectal cancer induced by DNA methylation.
Bacteriuria in Sodium-Losing Nephritis
Authors: Herman Falsetti, Arthur S. Kunin
Journal: New England Journal of Medicine (1963)

PATIENTS with renal disease occasionally lose the ability to conserve sodium adequately. Although first reported by Peters et al.1 in 1929, sodium-losing nephritis was not a well defined clinical syndrome until 1944, when it is described by Thorn and his associates.2 Since then several case reports have been published.3 4 5 6 7 8 9 10 11 12 It is well known that micro-organisms may vary in the abnormality that they produce, and since this defect in its most extreme form is found in pyelonephritis, it is possible that the anatomic lesion has a bearing on the functional defect. It is perhaps significant that some species, notably Proteus mirabilis . . .
Intraindividual Comparison of 123I-mIBG SPECT/MRI, 123I-mIBG SPECT/CT, and MRI for the Detection of Adrenal Pheochromocytoma in Patients With Elevated Urine or Plasma Catecholamines
Authors: Thorsten Derlin, Jasmin D. Busch, Christian Wisotzki, Bjoern P. Schoennagel, Peter Bannas, László Papp, Susanne Klutmann, Christian R. Habermann
Journal: Clinical Nuclear Medicine (2012)

To determine the diagnostic performance of ¹²³I-metaiodobenzylguanidine (mIBG) SPECT/MRI fusion, ¹²³I-mIBG SPECT/CT and adrenal MRI for the detection of pheochromocytoma in patients with elevated urine or plasma catecholamines.Twenty-two consecutive patients underwent both a whole-body ¹²³I-mIBG scan with SPECT/CT of the adrenal region and MRI of the adrenal glands. Fused SPECT/MRI, SPECT/CT, and MRI scans were evaluated. Imaging results were analyzed both on a per-patient and on a per-lesion basis. Histopathology and/or clinical and radiological follow-up served as the reference standard.Sixteen adrenal tumors were found in thirteen patients. On a per-lesion basis, SPECT/CT had a sensitivity of 87.5%, a specificity of 93.8%, and an overall accuracy of 92.5%. MRI had a sensitivity of 87.5%, a specificity of 96.9%, and an overall accuracy of 95.0%. On a per-patient basis, both SPECT/CT and MRI had a sensitivity of 85.7%, a specificity of 93.3%, and an overall accuracy of 90.9%. SPECT/CT was concordant with MRI in 81.8% of cases. SPECT/MRI fusion was superior to both SPECT/CT and MRI and had a sensitivity of 100% on both a per-lesion and a per-patient basis.¹²³I-mIBG SPECT/MRI has the highest sensitivity and accuracy for the detection and localization of pheochromocytomas. SPECT/CT and MRI of the adrenal glands are equivalent diagnostic procedures. However, MRI offers the advantage of fully diagnostic assessment of adrenal lesions other than pheochromocytoma undetectable by ¹²³I-mIBG.
Better: A surgeon’s notes on performance
Authors: Ara Darzi, Oliver Warren
Journal: Journal of Clinical Investigation (2007)

In Better: a surgeon’s notes on performance, Atul Gawande, best-selling author of Complications: a surgeon’s notes on an imperfect science, general and endocrine surgeon at Brigham and Women’s Hospital, and assistant professor at Harvard Medical School and Harvard School of Public Health, investigates human performance in medicine. He takes the reader to courtrooms, clinics, war zones, and execution chambers to demonstrate the incredible environments in which doctors care for and treat patients. While drawing on a vast array of sources, including his own personal experience, Gawande interweaves into nearly every chapter fascinating vignettes about the most important person in his view of medicine: the patient. By ensuring that every message is personalized in this manner, he brings a warm, humane touch to this superb book.
Longitudinal Analysis of Blood Pressure, Lipid, and Glycemic Control in Diabetic Patients With Nephropathy Attending a Hospital Outpatient Clinic and Their Relationship to Renal Function, Mortality, and Cardiovascular Morbidity
Authors: Shahid T. Wahid, Laura A. Baines, Leo Savopoulos, Vincent M. Connolly, William F. Kelly, Rudy W. Bilous
Journal: Diabetes Care (2001)

Clinical trials have shown that optimal blood pressure (BP) control slows the deterioration of renal function in diabetic nephropathy (1), with specific renoprotection from ACE inhibition therapy (2). The benefit of glycemic control is less well established (3). Studies have demonstrated the efficacy of lipid control in the primary and secondary prevention of coronary heart disease in diabetic and nondiabetic people (4,5). Therefore, it is important that patients with diabetic nephropathy use a multiple risk-factor approach (6). Few data are available on BP, lipid, and glycemic control in the nontrial setting. We recently audited the use of therapies proven beneficial in a high-risk group of diabetic patients with overt nephropathy and completed a retrospective analysis of putative renal-failure progression factors from 1992 to 1999.

Data were extracted from our Diabetic Nephropathy Database (Microsoft Access 1997). Mean systolic BP (SBP), diastolic BP (DBP), HbA1c, total serum cholesterol (TC), …
Diagnosis of Atrial Tumors by Ultrasound
Authors: STANLEY B. WOLFE, RICHARD L. POPP, HARVEY FEIGENBAUM
Journal: Circulation (1969)

A rapid, harmless, noninvasive technic using ultrasound to diagnose intra-atrial mass lesions is described. The technic permits detection of those tumors which pass through the atrioventricular orifice. Two patients with left atrial myxomata and one with a right atrial myxoma were studied with pulsed, reflected ultrasound, cardiac catheterization, and cineangiography. The diagnosis in each case was confirmed at surgery. The ultrasound technic for detecting atrial tumors was based on recording a mass of echoes immediately behind the echoes originating from the mitral or tricuspid valve leaflets. The mass held the leaflet open during diastole, causing abnormal valve motion. In one case of left atrial myxoma, the tumor plop sound, clinically confused with an opening snap, was shown to occur at a different time in the ultrasound cycle than the true opening snap. This examination is simple enough to be considered as a screening examination for the detection or exclusion of this rare but potentially dangerous abnormality.
Functional expression of a pseudohypoaldosteronism type I mutated epithelial Na+ channel lacking the pore-forming region of its α subunit
Authors: Olivier Bonny, Ahmed Chraibi, Jan Loffing, Nicole Fowler Jaeger, Stefan Gründer, Jean-Daniel Horisberger, Bernard C. Rossier
Journal: Journal of Clinical Investigation (1999)

The autosomal recessive form of type I pseudohypoaldosteronism (PHA-I) is an inherited salt-losing syndrome resulting from diminution-of-function mutations in the 3 subunits of the epithelial Na+ channel (ENaC). A PHA-I stop mutation (αR508stop) of the ENaC α subunit is predicted to lack the second transmembrane domain and the intracellular COOH-terminus, regions of the protein involved in pore function. Nonetheless, we observed a measurable Na+ current in Xenopus laevis oocytes that coexpress the β and γ subunits with the truncated α subunit. The mutant α was coassembled with β and γ subunits and was present at the cell surface at a lower density, consistent with the lower Na+ current seen in oocytes with the truncated α subunit. The single-channel Na+ conductance for the mutant channel was only slightly decreased, and the appearance of the macroscopic currents was delayed by 48 hours with respect to wild-type. Our data suggest novel roles for the α subunit in the assembly and targeting of an active channel to the cell surface, and suggest that channel pores consisting of only the β and γ subunits can provide significant residual activity. This activity may be sufficient to explain the absence of a severe pulmonary phenotype in patients with PHA-I.