tbuckley/cabot-search huggingface dataset:
THE Mitchell Banks Memorial Lecture ON THE ANATOMY OF THE PANCREAS IN RELATION TO ITS DISEASES: Delivered at the Liverpool University, November 27th, 1907
Authors: A. W. M. Robson
Journal: BMJ (1908)

<b>631</b> <b>Objectives: </b>To evaluate the efficacy of FDG-PET in cancer screening for early detection of cancer and to decrease deaths due to cancer. <b>Methods: </b>We started a prospective cancer screening trial with 1197 healthy volunteers aged 35 years and over (46.8±7.7y.o.), who underwent initial cancer screening between August 2003 and July 2004. The study design is for all participants to receive screening tests annually for 5 years and be followed thereafter for many years. The screening tests included whole-body FDG-PET, chest and abdominal CT, brain and pelvic MRI, blood tumor markers (CEA, CA19-9, PSA, CA125), and fecal occult blood test. Of the 1197, 1160 subjects underwent the second screening and 1116 completed the third one. We made contact with those subjects who did not receive the tests for each year to check the occurrence of cancers. <b>Results: </b>As of the end of 2006, 22 primary cancers were confirmed. Seventeen cancers (6 thyroid, 4 lung, 3 breast, 2 prostate, 1 uterus, 1 ectopic thymus in the thyroid gland) were positive on the initial screening. Thirteen of the 17 were treated in the year following the initial screening, but 4 with small lesions needed 1 to 2 years for follow-up and re-examination before final diagnosis. Two prostate cancers were detected on the second screening and no cancers on the third one. Eleven of the 19 detected by the screening were stage I. Three subjects who were negative at the screening developed gastric lymphoma, gastric cancer or malignant lymphoma of the kidney. FDG-PET was positive in 11 of the 22 cancers (6 thyroid, 2 breast, 1 prostate, 1 uterus and 1 ectopic thymus). Sensitivity of the cancer screening protocol as a whole and FDG-PET alone were 86.4% (19/22) and 50.0% (11/22), respectively. Positive and negative predictive values and specificity of FDG-PET on the initial screening were 12.1% (11/91), 99.0% (1095/1106), and 94.1% (1106/1175), respectively. <b>Conclusions: </b>Cancer screening including FDG-PET showed reasonable accuracy and could detect a wide variety of cancers at early stages. This prospective study will clarify the details of efficacy and suitable interval of FDG-PET for cancer screening.
Quality indicators in rheumatoid arthritis care: using measurement to promote quality improvement
Authors: Claire Bombardier, Samra Mian
Journal: Annals of the Rheumatic Diseases (2012)

Quality of care improvement has become a priority for decision-makers. Important variations in the quality and cost of care are being documented often without evidence of improved outcomes. Therapeutic advances are not consistently applied to practice despite efforts from professional organisations to create guidelines. The quality movement emerged following increasing evidence that the creation and measurement of quality indicators can improve quality of care and health outcomes. Quality indicators can measure healthcare system performance across providers, system levels and regions. In rheumatology, early efforts to develop quality measures have focused on examining all aspects of care while more recent efforts have focused on disease course monitoring. The American College Rheumatology has recently endorsed seven quality indicators for rheumatoid arthritis (RA) that are evidence based and measurable for use in routine rheumatology practices. This review provides an overview on quality indicators in rheumatology with a focus on RA, and discusses the application of quality measures into routine rheumatology practices to improve quality of care for RA.
Effects of leg resistance training on arterial function in older men
Authors: S Maeda, T Otsuki, M Iemitsu, M Kamioka, J Sugawara, S Kuno, R Ajisaka, H Tanaka
Journal: British Journal of Sports Medicine (2006)

Background: Little information is available on the effect of strength training on vascular function, particularly in older people. Objective: To determine the effect of resistance training on arterial stiffness and endothelial function in older adults. Method: Eleven healthy men (mean (SEM) age 64 (1) years) performed 12 weeks of resistance training involving knee flexion and extension (three sets a day, two days a week). Results: Resistance training increased maximal muscle power by 16% (p&lt;0.0001). Arterial stiffness as assessed by aortic pulse wave velocity did not change with resistance training. Plasma concentration of nitric oxide (NO), measured as its stable end product (nitrite/nitrate), had increased (p&lt;0.05) after resistance training (61.2 (10.4) v 39.6 (3.2) μmol/l). There was no change in plasma concentration of endothelin-1. Conclusion: The results suggest that short term resistance training may increase NO production without stiffening central arteries in healthy older men.
Glimepiride increases high-density lipoprotein cholesterol via increasing adiponectin levels in type 2 diabetes mellitus
Authors: Takahiro Araki, Masanori Emoto, Toshiaki Konishi, Yoshiko Ikuno, Eiko Lee, Megumi Teramura, Koka Motoyama, Hisayo Yokoyama, Katsuhito Mori, Hidenori Koyama, Tetsuo Shoji, Yoshiki Nishizawa
Journal: Metabolism (2009)
Plasma cortisol and cortisone concentrations in normal subjects and patients with adrenocortical disorders
Authors: Hiroyuki Morita, Yukinori Isomura, Tomoatsu Mune, Hisashi Daido, Rieko Takami, Noriyoshi Yamakita, Tatsuo Ishizuka, Noriyuki Takeda, Keigo Yasuda, Celso E Gomez-Sanchez
Journal: Metabolism (2003)
Estimating Risk of Cancer Associated With Radiation Exposure From 64-Slice Computed Tomography Coronary Angiography
Authors: Andrew J. Einstein, Milena J. Henzlova, Sanjay Rajagopalan
Journal: JAMA (2007)

ContextComputed tomography coronary angiography (CTCA) has become a common diagnostic test, yet there are little data on its associated cancer risk. The recent Biological Effects of Ionizing Radiation (BEIR) VII Phase 2 report provides a framework for estimating lifetime attributable risk (LAR) of cancer incidence associated with radiation exposure from a CTCA study, using the most current data available on health effects of radiation.ObjectivesTo determine the LAR of cancer incidence associated with radiation exposure from a 64-slice CTCA study and to evaluate the influence of age, sex, and scan protocol on cancer risk.Design, Setting, and PatientsOrgan doses from 64-slice CTCA to standardized phantom (computational model) male and female patients were estimated using Monte Carlo simulation methods, using standard spiral CT protocols. Age- and sex-specific LARs of individual cancers were estimated using the approach of BEIR VII and summed to obtain whole-body LARs.Main Outcome MeasuresWhole-body and organ LARs of cancer incidence.ResultsOrgan doses ranged from 42 to 91 mSv for the lungs and 50 to 80 mSv for the female breast. Lifetime cancer risk estimates for standard cardiac scans varied from 1 in 143 for a 20-year-old woman to 1 in 3261 for an 80-year-old man. Use of simulated electrocardiographically controlled tube current modulation (ECTCM) decreased these risk estimates to 1 in 219 and 1 in 5017, respectively. Estimated cancer risks using ECTCM for a 60-year-old woman and a 60-year-old man were 1 in 715 and 1 in 1911, respectively. A combined scan of the heart and aorta had higher LARs, up to 1 in 114 for a 20-year-old woman. The highest organ LARs were for lung cancer and, in younger women, breast cancer.ConclusionsThese estimates derived from our simulation models suggest that use of 64-slice CTCA is associated with a nonnegligible LAR of cancer. This risk varies markedly and is considerably greater for women, younger patients, and for combined cardiac and aortic scans.
Insights into PBDE Uptake, Body Burden, and Elimination Gained from Australian Age–Concentration Trends Observed Shortly after Peak Exposure
Authors: Tenzing Gyalpo, Leisa-Maree Toms, Jochen F. Mueller, Fiona A. Harden, Martin Scheringer, Konrad Hungerbühler
Journal: Environmental Health Perspectives (2015)

Population pharmacokinetic models combined with multiple sets of age-concentration biomonitoring data facilitate back-calculation of chemical uptake rates from biomonitoring data.We back-calculated uptake rates of PBDEs for the Australian population from multiple biomonitoring surveys (top-down) and compared them with uptake rates calculated from dietary intake estimates of PBDEs and PBDE concentrations in dust (bottom-up).Using three sets of PBDE elimination half-lives, we applied a population pharmacokinetic model to the PBDE biomonitoring data measured between 2002-2003 and 2010-2011 to derive the top-down uptake rates of four key PBDE congeners and six age groups. For the bottom-up approach, we used PBDE concentrations measured around 2005.Top-down uptake rates of Σ4BDE (the sum of BDEs 47, 99, 100, and 153) varied from 7.9 to 19 ng/kg/day for toddlers and from 1.2 to 3.0 ng/kg/day for adults; in most cases, they were--for all age groups--higher than the bottom-up uptake rates. The discrepancy was largest for toddlers with factors up to 7-15 depending on the congener. Despite different elimination half-lives of the four congeners, the age-concentration trends showed no increase in concentration with age and were similar for all congeners.In the bottom-up approach, PBDE uptake is underestimated; currently known pathways are not sufficient to explain measured PBDE concentrations, especially in young children. Although PBDE exposure of toddlers has declined in the past years, pre- and postnatal exposure to PBDEs has remained almost constant because the mothers' PBDE body burden has not yet decreased substantially.
P89 Attendance Of Secondary Care Respiratory Outpatient Appointments In Illicit Drug Users With Recurrent Hospital Admissions With 'copd' At A City Centre Teaching Hospital
Authors: R. Huang, A. Collins, N. Williams, N. Garner, T. Perry, H. Burhan
Journal: Thorax (2014)

<h3>Introduction</h3> Non-attendance at outpatient appointments (OPA) costs the NHS an estimated £600 m a year, with over 94,000 missed (first) OPAs in England from 2013 to 2014.<sup>1</sup> We reviewed the arrangement and attendance of OPAs for illicit drug smokers, after hospital re-admission with an ‘exacerbation of chronic obstructive pulmonary disease (COPD)’. <h3>Methods</h3> All illicit drug smokers re-admitted between January 2009 and September 2011 with a presumptive diagnosis of ‘exacerbation of COPD’ were included. Planned respiratory OPAs were reviewed retrospectively from our COPD admission database to determine the number attended or unattended. Unattended OPAs were classified as (a) hospital cancellation (b) patient cancellation (c) patient did not attend (DNA) or (d) ‘unknown’. <h3>Results</h3> Of 89 patients, no OPA was arranged in 28 (31.5%). 334 respiratory appointments were made for 61 patients (mean = 5.5 per patient); of these, only 86 (25.7%) were attended (see Table). <h3>Conclusion</h3> High recurrent admission rates suggests that these patients should all have specialist respiratory OPAs arranged at discharge, with the aim of preventing re-admission and improving their respiratory health. In our cohort we noted poor OPA attendance with a DNA rate of 52.0% compared with around 8.6% for first OPAs overall in England in 2012.<sup>2</sup> This suggests alternative approaches are needed in order to engage with these patients such as community based secondary care outreach services. We will now study the effects of an intensive community-based secondary care outreach services; involving smoking cessation, targeted pulmonary rehabilitation, specialist respiratory (consultant and nurse) involvement, vaccination, inhaler technique reviews, medication concordance checks/ prescription and health trainers. <h3>References</h3> Department of Health (2014). Referrals and Attendances for Outpatient Appointments: Hospital Activity Statistics. London: DH Department of Health (2013). NHS inpatient elective admission events and outpatient referrals and attendances, quarter ending December 2012. Available from: http://www.england.nhs.uk/statistics/2013/02/22/nhs-inpatient-elective-admission-events-and-outpatient-referrals-and-attendances-quarter-ending-december-2012
Biopsy Misidentification Identified by DNA Profiling in a Large Multicenter Trial
Authors: Michael Marberger, John D. McConnell, Ivy Fowler, Gerald L. Andriole, David G. Bostwick, Matthew C. Somerville, Roger S. Rittmaster
Journal: Journal of Clinical Oncology (2011)

The Reduction by Dutasteride of Prostate Cancer Events (REDUCE) prostate cancer risk reduction study randomly assigned 8,231 men to dutasteride or placebo for 4 years. Protocol-mandated biopsies were obtained after 2 and 4 years. After the discovery of three cases of biopsy sample misidentification in the first 2 years, all protocol-mandated biopsy samples were DNA tested to verify biopsy identity.Biopsy and blood DNA profiling was performed retrospectively for the year 2 scheduled biopsies and prospectively for the year 4 scheduled biopsies. Toward the end of year 2, multiple changes were made to improve sample handling and chain of custody.Of the 6,458 year 2 and 4,777 year 4 biopsies, 26 biopsies reflecting 13 sample handling errors at year 2 (0.4%) and one biopsy reflecting one sample handling error at year 4 (0.02%) were confirmed to be mismatched to the patient for whom they were originally submitted. Of 6,733 reference blood samples profiled, 31 (0.5%) were found to be mismatched to the patient's verified identity profile. Sample identification errors occurred at local research sites and central laboratories.Biopsy misidentification is a potential problem in clinical laboratories and clinical trials. Until now, biopsy misidentification has not been studied in the setting of a large, multinational clinical trial. In the REDUCE study, process improvement initiatives halfway through the trial dramatically reduced biopsy mismatches. The potential for biopsy mismatches in clinical trials and clinical practice is an under-recognized problem that requires rigorous attention to details of chain of custody and consideration of more widespread DNA identity testing.
The Ron/STK receptor tyrosine kinase is essential for peri-implantation development in the mouse
Authors: Rebecca S. Muraoka, William Y. Sun, Melissa C. Colbert, Susan E. Waltz, David P. Witte, Jay L. Degen, Sandra J. Friezner Degen
Journal: Journal of Clinical Investigation (1999)

The Ron/STK receptor tyrosine kinase is a member of the c-Met family of receptors and is activated by hepatocyte growth factor–like protein (HGFL). Ron activation results in a variety of cellular responses in vitro, such as activation of macrophages, proliferation, migration, and invasion, suggesting a broad biologic role in vivo. Nevertheless, HGFL-deficient mice grow to adulthood with few appreciable phenotypic abnormalities. We report here that in striking contrast to the loss of its only known ligand, complete loss of Ron leads to early embryonic death. Embryos that are devoid of Ron (Ron–/–) are viable through the blastocyst stage of development but fail to survive past the peri-implantation period. In situ hybridization analysis demonstrates that Ron is expressed in the trophectoderm at embryonic day (E) 3.5 and is maintained in extraembryonic tissue through E7.5, compatible with an essential function at this stage of development. Hemizygous mice (Ron+/–) grow to adulthood; however, these mice are highly susceptible to endotoxic shock and appear to be compromised in their ability to downregulate nitric oxide production. These results demonstrate a novel role for Ron in early mouse development and suggest that Ron plays a limiting role in the inflammatory response.
Stomach as a source of colonization of the respiratory tract during mechanical ventilation: association with ventilator-associated pneumonia
Authors: A Torres, M El-Ebiary, N Soler, C Monton, N Fabregas, C Hernandez
Journal: European Respiratory Journal (1996)

The aetiopathogenesis of ventilator-associated pneumonia (VAP) requires abnormal oropharyngeal and gastric colonization and the further aspiration of their contents to the lower airways. VAP develops easily if aspiration or inoculation of microorganisms occur in patients with artificial airways, in whom mechanical, cellular and/or humoral defences are altered. Well-known risk factors for gastric colonization include: alterations in gastric juice secretion; alkalinization of gastric contents; administration of enteral nutrition; and the presence of bilirubin. However, the role of the colonized gastric reservoir in the development of VAP remains debatable. Evidence in favour of the role of the stomach in the development of VAP comes mainly from randomized, controlled trials of selective gut decontamination and stress ulcer prophylaxis in the intensive care unit (ICU), in which reducing the bacterial burden of the stomach decreases the incidence of nosocomial respiratory infections. However, at least three studies of flora have found an absence of stomach origin of pneumonia occurring during mechanical ventilation. Prophylactic measures suggested to prevent VAP in relation to the gastric reservoir include: treatment for stress ulcers with sucralfate; prevention of duodenal reflux with metoclopramide; reduction of gastric burden and bacterial translocation by selective digestive decontamination; acidification of enteral feeding; and jejunal feeding. Gastro-oesophageal reflux can be prevented by using small bore nasogastric tubes and jejunal feeding. The aspiration of gastric contents can be reduced by positioning patients in a semirecumbent position, checking the patency of the tube cuff, and aspiration of subglottic secretions. The role of the stomach as a reservoir for microorganisms causing ventilator-associated pneumonia is still controversial but despite the debate, there is major evidence in the literature in favour of the gastric origin of part of these pulmonary infections.
Diagnosing COPD in non-smokers: splitting not lumping
Authors: E. R. Chilvers, D. A. Lomas
Journal: Thorax (2010)

Chronic obstructive pulmonary disease (COPD) is the diagnostic label given to patients with chronic airflow obstruction that is poorly reversible.1 As such, it is a non-specific disease entity and, like stroke or atrial fibrillation, can be the end result of multiple and often very differing conditions. A diagnosis of COPD based on spirometry alone should therefore trigger further investigation to identify the underlying cause and the application, if possible, of a more appropriate and specific diagnostic label. Hence while sarcoidosis, chronic asthma, organ-specific autoimmune disease, cystic fibrosis and multiple other pathologies can all cause COPD (and in a technical sense allow all such patients to be labelled as having COPD) most would recognise this as diagnostic duplicity.

Recent studies have highlighted the apparently high proportion of patients with COPD who have never smoked. Collectively, these studies suggest that even in developed countries cigarette smoking causes COPD in only 50–70% of patients. Indeed, the Swedish OLIN and US NHANES III studies reported that the population-attributable risk of COPD from smoking in these countries was …
Meningitis and Cephalothin Therapy
Authors: CHARLES E. TURNER
Journal: Annals of Internal Medicine (1973)

Comments and Corrections1 July 1973Meningitis and Cephalothin TherapyCHARLES E. TURNER, M.D.CHARLES E. TURNER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-79-1-135_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The development of meningitis during cephalothin therapy was recently reported in your pages (Ann Intern Med 78:347-351, 1973). The authors described five patients of their own and mentioned three other cases. I wish to add the case of another patient who developed this complication in a clinical setting different from those described.In the spring of 1971 a 34-year-old woman with a 2-year history of chronic granulomatous colitis was admitted with an exacerbation of her illness and a possible perforation of the colon. She had been treated with daily single-dose prednisone therapy for several months, which resulted... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByMeningitis Developing during Cephalothin Therapy of SepticaemiaCephalothin and Cephaloridine Therapy for Bacterial Meningitis An EvaluationLARRY S. FISHER, M.D., ANTHONY W. CHOW, M.D., F.R.C.P.(C), THOMAS T. YOSHIKAWA, M.D., LUCIEN B. GUZE, M.D., F.A.C.P. 1 July 1973Volume 79, Issue 1Page: 135-135KeywordsColitisColonMeningitis Issue Published: 1 July 1973 PDF DownloadLoading ...
Novel Glioblastoma Markers with Diagnostic and Prognostic Value Identified through Transcriptome Analysis
Authors: Sreekanth P. Reddy, Ramona Britto, Katyayni Vinnakota, Hebbar Aparna, Hari Kishore Sreepathi, Balaram Thota, Arpana Kumari, B.M. Shilpa, M. Vrinda, Srikantha Umesh, Cini Samuel, Mitesh Shetty, Ashwani Tandon, Paritosh Pandey, Sridevi Hegde, A.S. Hegde, Anandh Balasubramaniam, B.A. Chandramouli, Vani Santosh, Paturu Kondaiah, Kumaravel Somasundaram, M.R. Satyanarayana Rao
Journal: Clinical Cancer Research (2008)

Abstract Purpose: Current methods of classification of astrocytoma based on histopathologic methods are often subjective and less accurate. Although patients with glioblastoma have grave prognosis, significant variability in patient outcome is observed. Therefore, the aim of this study was to identify glioblastoma diagnostic and prognostic markers through microarray analysis. Experimental Design: We carried out transcriptome analysis of 25 diffusely infiltrating astrocytoma samples [WHO grade II—diffuse astrocytoma, grade III—anaplastic astrocytoma, and grade IV—glioblastoma (GBM)] using cDNA microarrays containing 18,981 genes. Several of the markers identified were also validated by real-time reverse transcription quantitative PCR and immunohistochemical analysis on an independent set of tumor samples (n = 100). Survival analysis was carried out for two markers on another independent set of retrospective cases (n = 51). Results: We identified several differentially regulated grade-specific genes. Independent validation by real-time reverse transcription quantitative PCR analysis found growth arrest and DNA-damage–inducible α (GADD45α) and follistatin-like 1 (FSTL1) to be up-regulated in most GBMs (both primary and secondary), whereas superoxide dismutase 2 and adipocyte enhancer binding protein 1 were up-regulated in the majority of primary GBM. Further, identification of the grade-specific expression of GADD45α and FSTL1 by immunohistochemical staining reinforced our findings. Analysis of retrospective GBM cases with known survival data revealed that cytoplasmic overexpression of GADD45α conferred better survival while the coexpression of FSTL1 with p53 was associated with poor survival. Conclusions: Our study reveals that GADD45α and FSTLI are GBM-specific whereas superoxide dismutase 2 and adipocyte enhancer binding protein 1 are primary GBM-specific diagnostic markers. Whereas GADD45α overexpression confers a favorable prognosis, FSTL1 overexpression is a hallmark of poor prognosis in GBM patients.