tbuckley/cabot-search huggingface dataset:
HRT raises risk of rare, treatable breast cancer
Authors: S. Gottlieb
Journal: BMJ (1999)

A study of women using hormone replacement therapy after menopause found that the treatment does not increase the risk of highly malignant breast cancer but does raise the risk of some uncommon forms of the disease that are slow growing and highly treatable.Some previous studies have shown that women who take oestrogen after menopause are more likely to develop breast cancer; others have established no link.In the current study, a research team led by Susan Gapstur, a cancer epidemiologist at Northwestern University Medical School in Chicago, analysed data on 37105 women who were enrolled at ages 55 to 69 years in the Iowa women's health study and followed for 11 years (JAMA 1999;281:2091).They found that women who used hormones for five years or less were 1.8 times more likely to have the slow growing and highly curable medullary, papillary, and mucinous tumours than the women who had never used hormones.Those who had used hormones for more than five years were 2.6 times more likely to have these tumours.Women who took hormones, however, had no difference in their risk of getting the fast growing, life threatening tumours, ductal carcinoma in situ, or invasive ductal or lobular cancer, which together constitute 85% to 90% of all cases of breast cancer.This was the first study of hormone replacement therapy to categorise cases of breast cancer according to whether the tumours were slow or fast growing.Thomas Sellers, an author on the study and associate director of the Mayo Clinic Cancer Center in Rochester, Minnesota, said that the findings showed that the overall benefits of replacement therapy outweighed the risks for women at normal risk of breast cancer, but did not determine the balance for those at high risk.
Injury Coding and Hospital Discharge Data-Reply
Authors: Joseph E. Sniezek
Journal: JAMA (1990)

In Reply.—  We agree that emergency department databases are another valuable source of injury information. These databases can provide information on a broad spectrum of injured persons— those who require hospitalization and those treated in the emergency department and released. Our article high-lighted the usefulness of E-coded hospital discharge data systems in providing information on severe nonfatal injuries.  Because the catchment area population for a single hospital usually is not known, data from a single emergency department may be difficult to interpret. Calculating rates on injury occurrence, therefore, is difficult because persons who present for treatment of injury at one emergency department cannot be linked to a specific population at risk. The injury patients cared for in a single emergency department may not be representative of those cases that occur in the community. By linking emergency department data from all hospitals in a region, we could overcome this problem. Although
Effect of Excessive Weight Gain With Intensive Therapy of Type 1 Diabetes on Lipid Levels and Blood Pressure
Authors: Jonathan Q. Purnell, John E. Hokanson, Santica M. Marcovina, Michael W. Steffes, Patricia A. Cleary, John D. Brunzell
Journal: JAMA (1998)

Context.—Intensive treatment of type 1 diabetes results in greater weight gain than conventional treatment.Objective.—To determine the effect of this weight gain on lipid levels and blood pressure.Design.—Randomized controlled trial; ancillary study of the Diabetes Control and Complications Trial (DCCT).Setting.—Twenty-one clinical centers.Participants.—The 1168 subjects enrolled in DCCT with type 1 diabetes who were aged 18 years or older at baseline.Intervention.—Randomized to receive either intensive (n=586) or conventional (n=582) diabetes treatment with a mean follow-up of 6.1 years.Main Outcome Measures.—Plasma lipid levels and blood pressure in each treatment group categorized by quartile of weight gain.Results.—With intensive treatment, subjects in the fourth quartile of weight gain had the highest body mass index (BMI) (a measure of weight adjusted for height), blood pressure, and levels of triglyceride, total cholesterol, low-density lipoprotein cholesterol (LDL-C), and apolipoprotein B compared with the other weight gain quartiles with the greatest difference seen when compared with the first quartile (mean values for the highest and lowest quartiles: BMI, 31 vs 24 kg/m2; blood pressure, 120/77 mm Hg vs 113/73 mm Hg; triglyceride, 0.99 mmol/L vs 0.79 mmol/L [88 mg/dL vs 70 mg/dL]; LDL-C, 3.15 mmol/L vs 2.74 mmol/L [122 mg/dL vs 106 mg/dL]; and apolipoprotein B, 0.89 g/L vs 0.78 g/L; all P&lt;.001). In addition, the fourth quartile group had a higher waist-to-hip ratio; more cholesterol in the very low density lipoprotein, intermediate dense lipoprotein, and dense LDL fractions; and lower high-density lipoprotein cholesterol and apolipoprotein A-I levels compared with the first quartile. Baseline characteristics were not different between the first and fourth quartiles of weight gain with intensive therapy except for a higher hemoglobin A1c in the fourth quartile. Weight gain with conventional therapy resulted in smaller increases in BMI, lipids, and systolic blood pressure.Conclusions.—The changes in lipid levels and blood pressure that occur with excessive weight gain with intensive therapy are similar to those seen in the insulin resistance syndrome and may increase the risk of coronary artery disease in this subset of subjects with time.
Attitudes of Primary Care Physicians Toward Corporal Punishment
Authors: Kenelm F. McCormick
Journal: JAMA (1992)

The purpose of this study was to determine whether or not family physicians and pediatricians support the use of corporal punishment. The frequency with which these physicians offer anticipatory guidance on discipline was also studied.Self-report survey, mailed to study participants.The sample for this study was 800 family physicians and 400 pediatricians, randomly selected from the Ohio State Medical Board's roster of family physicians and pediatricians. Physicians with a subspecialty were excluded. Participants who did not return their surveys received a second, and if necessary, a third mailing of the survey. After three mailings, a total of 619 physicians (61%) completed a survey.Participants were considered to support corporal punishment if they would tell a parent in their medical practice that spanking would be an appropriate response to any one of a series of childhood misbehaviors presented in the survey.Of family physicians, 70% (95% confidence interval [CI], 66% to 75%) support use of corporal punishment. Of pediatricians, 59% (95% CI, 52% to 66%) support corporal punishment. Of pediatricians, 90% (95% CI, 86% to 94%) indicated that they include discipline issues either always or most of the time when providing anticipatory guidance to parents. Significantly fewer family physicians (52%; 95% CI, 47% to 57%) indicated that they discuss discipline either always or most of the time when providing anticipatory guidance (P less than .01).Most family physicians and pediatricians support the use of corporal punishment in spite of evidence that it is neither effective nor necessary, and can be harmful. Pediatricians offer anticipatory guidance on discipline more often than family physicians.
905 A UNIQUE HUMAN MODEL OF EPITHELIAL TO MESENCHYMAL TRANSITION REVEALS AXL AS A KEY REGULATOR OF HEPATOCELLULAR CARCINOMA PROGRESSION
Authors: F. van Zijl, S. Mall, G. Machat, T. Bauer, C. Pirker, H. Strobl, W. Berger, M. Bilban, W. Mikulits
Journal: Journal of Hepatology (2010)
Respiratory Muscle Blood Flow Distribution during Expiratory Resistance
Authors: Charles H. Robertson, William L. Eschenbacher, Robert L. Johnson
Journal: Journal of Clinical Investigation (1977)

When work load on the respiratory system is increased the relative increase in blood flow to each of the muscles of breathing provides an index of how the augmented effort of breathing is partitioned among the different muscles. We have used a radio-active microsphere technique to measure blood flow to each of the muscles of respiration in supine dogs during unobstructed respiration and breathing against graded expiratory threshold loads. 79% of the augmented flow went to expiratory muscles; of this increased flow to expiratory muscles 74% went to abdominal wall muscles and 26% to internal intercostals. In our earlier studies of hyperventilation induced by CO2 rebreathing where expiratory work loads were low, 44% of the increase in flow went to expiratory muscles; of this, only 39% went to abdominal wall muscles and 61% to internal intercostals. During inspiratory resistance which produced small increases in expiratory work, 27% of the increase in blood flow went to expiratory muscles; of this, only 37% went to abdominal wall muscles and 63% to internal intercostals. These results suggest that the internal intercostals are predominantly used for expiration when expiratory work loads are low, whereas the abdominal wall muscles are predominantly used when loads are high.
Survival Following Biochemical Recurrence After Radical Prostatectomy and Adjuvant Radiotherapy in Patients With Prostate Cancer: The Impact of Competing Causes of Mortality and Patient Stratification
Authors: Firas Abdollah, Stephen Boorjian, Cesare Cozzarini, Nazareno Suardi, Maxine Sun, Claudio Fiorino, Nadia di Muzio, Pierre I. Karakiewicz, Francesco Montorsi, R. Jeffrey Karnes, Alberto Briganti
Journal: European Urology (2013)
The Physician's Role in Preventing Alcohol-Related Injuries
Authors: Julian R. Waller
Journal: JAMA (1988)

Identifying potential areas for successful patient counseling to prevent or reduce high-risk behavior is one of the ongoing goals of the medical profession. Three steps are required. First, a predictive relationship between a given behavior and a harmful outcome must be documented. Second, there must be an easy way to communicate this information to the patient within the context and constraints of the typical medical practice. Third, there must be evidence that such communication can reduce risk effectively. The article by Anda et al in this issue ofTHE Journal<sup>1</sup>clearly fulfills the first of these requirements. Prospective analysis of deaths over a nine-year period among more than 13 000 adults revealed that for both men and women, self-reported heavy consumption of alcohol is predictive of a greater likelihood of subsequent death from injury. Persons who initially reported consuming five or more drinks per occasion as their usual quantity
Thermal Injury of the Esophagus
Authors: Sudhir K. Dutta, Ki Young Chung, Belur S. Bhagavan
Journal: New England Journal of Medicine (1998)

To the Editor: We report two cases in which the appearance of the esophageal mucosa and histologic abnormalities in the esophagus were indicative of reversible thermal injury. A 66-year-old man with a history of coronary artery disease presented to the emergency room for the second time in one month with retrosternal chest pain, mild dysphagia, and odynophagia. A 72-year-old woman presented with episodic melena of three weeks' duration associated with chest and epigastric discomfort. Both patients underwent initial and follow-up upper endoscopic studies along with multiple mucosal biopsies. Upper endoscopy in each patient showed bands of thin, white, pseudomembranous mucosa . . .
Sclerosis of lytic bone metastases after disodium aminohydroxypropylidene bisphosphonate (APD) in patients with breast carcinoma.
Authors: A. R. Morton, J. A. Cantrill, G. V. Pillai, A. McMahon, D. C. Anderson, A. Howell
Journal: BMJ (1988)

for supplying the chicks, and the staff in the five public health laboratories for their cooperation. 1
Mesenteric and renal vascular effects of diadenosine polyphosphates (APnA)
Authors: Gert Gabriëls, Karl Heinz Rahn, Eberhard Schlatter, Martin Steinmetz
Journal: Cardiovascular Research (2002)

Diadenosine polyphosphates (APnA) are endogenous dinucleoside molecules consisting of two adenosine moieties linked via their 5′-ribose positions by a variable number of phosphate groups. APnA have been shown to be present in different cell types and to be released from platelets as well as co-released with catecholamines and ATP from bovine adrenal medulla. Candidate metabolites of APnA are ATP, ADP, AMP and adenosine. Vascular effects induced by APnA and their metabolites in several models have been reported to be mediated by A1- and A2-adenosine receptors as well as P2-purinoceptors. APnA have been demonstrated to differentially affect regional perfusion, to influence cardiac output and blood pressure as well as the reactivity of isolated blood vessels and vascular beds. Vascular effects of APnA vary with the number of phosphate groups linking the adenosine molecules. This review outlines the effects of APnA on mesenteric and renal circulation. The effects of the antagonists varying with the type of vascular bed and the heterogeneous and dynamic vascular effects of diadenosine polyphosphates indicate a regionally different distribution of P2X and of P2Y purinoceptors in resistance arteries from different vascular beds. Although APnA have vasoconstrictor effects on the local level, it was repeatedly confirmed that systemically applied APnA induce hypotensive effects. The vasoconstrictor effects of APnA in isolated vessels are most prominent under resting tone conditions. In vivo, the vasculature exhibits a vasotone which makes dilatory effects more likely. Information on effects of APnA in vivo is still limited despite the fact that these compounds already have been used in man.
Assessment of the intrapulmonary ventilation-perfusion distribution after the Fontan procedure for complex cardiac anomalies: Relation to pulmonary hemodynamics
Authors: Tohru Matsushita, Hikaru Matsuda, Minoru Ogawa, Kiyoshi Ohno, Tetsuya Sano, Susumu Nakano, Yasuhisa Shimazaki, Kazuya Nakahara, Jun Arisawa, Takahiro Kozuka, Yasunaru Kawashima, Hyakuji Yabuuchi
Journal: Journal of the American College of Cardiology (1990)
No clear benefit of parent initiated oral steroids in preschool children with viral wheeze
Authors: S S Birring
Journal: Thorax (2004)

▴ Oommen A, Lambert PC, Grigg J. Efficacy of a short course of parent-initiated oral prednisolone for viral wheeze in children aged 1–5 years: randomised controlled trial. Lancet2003;362:1433–8 [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] Asthma in children aged 1–5 years is characterised by recurrent transient episodes of wheeze triggered by viral colds. This is labelled “preschool viral wheeze” and is commonly treated with inhaled bronchodilators and oral corticosteroids. Persistent wheeze is associated … [1]: {openurl}?query=rft.jtitle%253DLancet%26rft.stitle%253DLancet%26rft.aulast%253DOommen%26rft.auinit1%253DA.%26rft.volume%253D362%26rft.issue%253D9394%26rft.spage%253D1433%26rft.epage%253D1438%26rft.atitle%253DEfficacy%2Bof%2Ba%2Bshort%2Bcourse%2Bof%2Bparent-initiated%2Boral%2Bprednisolone%2Bfor%2Bviral%2Bwheeze%2Bin%2Bchildren%2Baged%2B1-5%2Byears%253A%2Brandomised%2Bcontrolled%2Btrial.%26rft_id%253Dinfo%253Adoi%252F10.1016%252FS0140-6736%252803%252914685-5%26rft_id%253Dinfo%253Apmid%252F14602435%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1016/S0140-6736(03)14685-5&link_type=DOI [3]: /lookup/external-ref?access_num=14602435&link_type=MED&atom=%2Fthoraxjnl%2F59%2F2%2F99.atom [4]: /lookup/external-ref?access_num=000186356600007&link_type=ISI
Debate on sale of donor organs shows equal division of opinion
Authors: G. Watts
Journal: BMJ (2010)

At the end of a meeting held on 11 October to debate the cautiously worded motion “Paying for blood and organs is not so bad,” an audience at the Wellcome Trust’s headquarters in London voted 44% in favour and 44% against. But this dead heat could be viewed as a moral victory by the team proposing the motion. A vote taken at the beginning of the evening had shown just 33% to be in favour, with 50% against.

The University of Auckland professor of political studies, Martin Wilkinson, opened the debate, which was organised by the Centre for the Study of Incentives in Health. He prefaced his argument for the motion by making an audacious bid to seize the moral high ground. In ruling the sale of organs a criminal offence, he declared, you are preventing people from …
A PROTEIN POISON THEORY: Its Application to the Treatment of Headache and Especially Migraine
Authors: R. Curtis-Brown
Journal: BMJ (1925)

intermission from the onset of the attack, she did not think it had differed in character after the end of the first hour.At no time had she any feeling of air hunger.She lay in a dazed, apathetic condition, and was markedly pale, but of a fawny white rather than the ashy grey coloiir of secondary anaemia.The pulse was 108 and the temperature 980 F. The abdomen was greatly distended and gave a senlsation of hard tenseness.This distension was chiefly localized in the upper segmenit anid passed under the costal margins.No sounlds could be lhear d on auscultation, nor could any movemeni's be recognized on inspection or palpation.The tenderness she complained of couild not be described as severe.No blood was found in the vagina, -nor was there any staining of lher clothliiig.The os was dilated (2 cm.), with distenided membranes bulgingf tlhrougih.Concealed accidental haemoi rriage was diagnosed and Caesarean section recommended.This her husband agreed to, bu-t requested that the uterus should be preserved if found possible.She was emnoved to Loington Hospital.At 7.30 p.m. on January 1st, 1924, under a general anaesthetic, the abdomen was opened through a mid-line incision extending fr om 1 inchi above the umbilicus to 1 inch above the pubes.A little free sanguinieous fluid escaped from the peritoneal cavity.OIn attempting to centralize the uter us it was found impossible to insinuate the hand between it and the costal margins.The distensioni of the uterus was definitely limited to the bodv, which was of a slaty grey colour with purplish mottling, while the lower uter-ine segment, below the anterior peritoneal reflection which was r-aised to the level of the umbilicus, was elongated and showed neither grey coloration nor mottling.A longitudinal
THE SURGEON OF THE NINETEENTH CENTURY.
Authors: FREDERICK TREVES
Journal: JAMA (1900)

The surgeon of one hundred years ago was but a sorry element in social life. In the great towns and cities there were a few practitioners of surgery who were eminent by reason of their scientific work and successful practice. London was then the center of surgical activity, and the prominent exponents of the art were John Abernethy, Henry Cline, Sir William Blizard, Sir Everard Home, Sir Astley Cooper, William Lawrence and Charles Aston Key. The great John Hunter had died in 1793, having accomplished a work which marks an epoch in British surgery. In the provinces the most conspicuous surgeons were Edward Alanson, of Liverpool, and William Hey, of Leeds, while in Edinburgh the position of the leading operator was held for many years by John Bell. A little later in the century we find among the names of prominent men in England those of Sir Charles Bell, Sir
SUBDURAL FLUID ACCUMULATIONS FOLLOWING HEAD INJURY
Authors: HOWARD C. NAFFZIGER
Journal: JAMA (1924)

Subdural fluid accumulation after head injury seems to have escaped the comment of pathologists and surgeons.  This pathologic condition is one found with or without fissured fracture of the skull, and has not been noted in association with depressed fractures or penetrating wounds. It is an accumulation of subdural but extra-arachnoid fluid.  When a brain injury occurs, the immediate effects of damage are soon complicated by an increase in the fluid content within the skull. This fluid may be present as extravasated blood, as edema in which the fluid is more or less fixed in the swollen brain tissue, or as free fluid of other types. When present in considerable amounts, intracranial pressure results.  For the surgeon, a practical pathologic classification includes three groups: (1) The extradural hemorrhages—chiefly of middle meningeal origin. (2) The swollen, contused and edematous brains, which in appearance vary from the small petechial hemorrhages to the
Effect of recombinant human granulocyte macrophage-colony stimulating factor in long-term marrow cultures from patients with aplastic anemia
Authors: Guadalupe Mart�nez-Jaramillo, Enrique G�mez-Morales, Hector Mayani
Journal: American Journal of Hematology (1999)

The hematopoietic system in patients with aplastic anemia (AA) shows both quantitative and qualitative deficiencies, i.e., reduced numbers of hematopoietic progenitor cells (HPC) and impaired HPC proliferation in long-term marrow cultures (LTMC). Since recombinant human granulocyte macrophage-colony stimulating factor (rhGM-CSF) has been shown to be a potent stimulator of normal hematopoiesis, both in vivo and in vitro, in the present study we wanted to assess the possibility of stimulating hematopoiesis in LTMC from 17 patients with AA, by weekly addition of rhGM-CSF (10 ng/ml). In LTMC from 11 patients (group of responders), rhGM-CSF induced a significant increase (4.8-fold, compared with untreated cultures) in the levels of myeloid progenitor cells; in contrast, in six patients (group of nonresponders), myeloid progenitors were refractory to this cytokine. In the group of responders, rhGM-CSF also induced a pronounced increment in the levels of nonadherent and adherent cells (5.99- and 5.18-fold, respectively, compared with untreated cultures). Among the different myelopoietic lineages, rhGM-CSF preferentially stimulated the macrophagic lineage; this was evident both at the progenitor and mature cell levels. Interestingly, the effect of rhGM-CSF in LTMC from AA patients was only transient. Indeed, the effects mentioned above were observed only during the first three weeks of culture; afterwards, myeloid progenitor and nonadherent cell levels in treated cultures declined, practically reaching the levels observed in untreated cultures. At the moment, we do not know whether this transient stimulatory effect is due to the production of inhibitory cytokines, by macrophages generated in response to rhGM-CSF, or to the exhaustion of the HPC pool in AA cultures. In all 17 patients, rhGM-CSF had no effect on the kinetics of erythroid or multipotent progenitor cells. These results are in keeping with clinical studies in which it has been observed that most AA patients treated with rhGM-CSF show increments in circulating monocytes and granulocytes, as well as in bone marrow cellularity. However, little or no effect is observed on erythropoiesis. The actual mechanisms involved in the in vitro effects of rhGM-CSF on myeloid progenitor cells from AA bone marrow are still not completely understood. Future studies on this issue should be encouraged, since they may help to understand the in vivo (clinical) effects of this cytokine. Am. J. Hematol. 61:107–114, 1999. © 1999 Wiley-Liss, Inc.
Gamma interferon enhances macrophage transcription of the tumor necrosis factor/cachectin, interleukin 1, and urokinase genes, which are controlled by short-lived repressors.
Authors: M A Collart, D Belin, J D Vassalli, S de Kossodo, P Vassalli
Journal: The Journal of Experimental Medicine (1986)

Exposure of mouse resident and thioglycollate-elicited peritoneal macrophages to IFN-gamma leads to a marked increase in the TNF-alpha (tumor necrosis factor/cachectin), IL-1 and u-PA (urokinase-type plasminogen activator) mRNA levels. Nuclear run-on experiments show that IFN-gamma acts by enhancing the transcription of these three genes. Transcription of these three genes is also rapidly and transiently induced by cycloheximide, an inhibitor of protein synthesis, indicating that they are under the control of short-lived repressors.
240 MEASUREMENT OF LIVER STIFFNESS IN CHRONIC LIVER DISEASES VIA SHEAR WAVE ELASTOGRAPHY (AIXPLORER®): A VALID SUBSTITUTION FOR TRANSIENT ELASTOGRAPHY (FIBROSCAN®)?
Authors: P. Salzl, T. Reiberger, M. Peck-Radosavljevic, A. Ferlitsch
Journal: Journal of Hepatology (2013)