tbuckley/cabot-search huggingface dataset:
Chemotherapy Use for Hormone Receptor–Positive, Lymph Node–Negative Breast Cancer
Authors: Michael J. Hassett, Melissa E. Hughes, Joyce C. Niland, Stephen B. Edge, Richard L. Theriault, Yu-Ning Wong, John Wilson, W. Bradford Carter, Douglas W. Blayney, Jane C. Weeks
Journal: Journal of Clinical Oncology (2008)

To describe the frequency of chemotherapy use for hormone receptor (HR)-positive, lymph node (LN)-negative breast cancer from 1997 to 2004 at eight National Comprehensive Cancer Network institutions, to explore whether chemotherapy use varied over time and between institutions, and to identify factors associated with the decision to forego chemotherapy.Among women younger than age 70 years with HR-positive, LN-negative breast cancer measuring more than 1 cm, we analyzed the frequency of chemotherapy use on a yearly basis. A multivariable logistic regression model assessed the relationship between receipt of chemotherapy and year of diagnosis, institution, tumor features, and patient characteristics. Interaction terms were added to the model, and stratified analyses were conducted to further explore the determinants of chemotherapy use.Fifty-five percent of 3,190 women received chemotherapy. Chemotherapy use was less common for patients with 1.1- to 2-cm tumors than for patients tumors greater 2 cm (47% v 87%, respectively; P < .01) and for women age 60 to 69 years versus women younger than age 50 years (24% v 76%, respectively; P < .01). On multivariable analysis, predictors independently associated with receiving chemotherapy included larger tumor size, higher grade, human epidermal growth factor receptor 2 overexpression, younger age, and institution (P < .01 for all). Institutions exhibited dramatically different rates of chemotherapy use (from 46% to 65%) and patterns of change in chemotherapy use over time (from a 79% relative increase to a 22% relative decrease).Although institutions seemed to agree that not all women with HR-positive, LN-negative breast cancer need chemotherapy, there did not seem to be consensus regarding which women should get chemotherapy. Only prospective randomized controlled trials will conclusively establish which subtypes of HR-positive, LN-negative breast cancer benefit from chemotherapy.
Effect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis
Authors: K. Ker, P. Edwards, P. Perel, H. Shakur, I. Roberts
Journal: BMJ (2012)

<b>Objective</b> To assess the effect of tranexamic acid on blood transfusion, thromboembolic events, and mortality in surgical patients. <b>Design</b> Systematic review and meta-analysis. <b>Data sources</b> Cochrane central register of controlled trials, Medline, and Embase, from inception to September 2011, the World Health Organization International Clinical Trials Registry Platform, and the reference lists of relevant articles. <b>Study selection</b> Randomised controlled trials comparing tranexamic acid with no tranexamic acid or placebo in surgical patients. Outcome measures of interest were the number of patients receiving a blood transfusion; the number of patients with a thromboembolic event (myocardial infarction, stroke, deep vein thrombosis, and pulmonary embolism); and the number of deaths. Trials were included irrespective of language or publication status. <b>Results</b> 129 trials, totalling 10 488 patients, carried out between 1972 and 2011 were included. Tranexamic acid reduced the probability of receiving a blood transfusion by a third (risk ratio 0.62, 95% confidence interval 0.58 to 0.65; P&lt;0.001). This effect remained when the analysis was restricted to trials using adequate allocation concealment (0.68, 0.62 to 0.74; P&lt;0.001). The effect of tranexamic acid on myocardial infarction (0.68, 0.43 to 1.09; P=0.11), stroke (1.14, 0.65 to 2.00; P=0.65), deep vein thrombosis (0.86, 0.53 to 1.39; P=0.54), and pulmonary embolism (0.61, 0.25 to 1.47; P=0.27) was uncertain. Fewer deaths occurred in the tranexamic acid group (0.61, 0.38 to 0.98; P=0.04), although when the analysis was restricted to trials using adequate concealment there was considerable uncertainty (0.67, 0.33 to 1.34; P=0.25). Cumulative meta-analysis showed that reliable evidence that tranexamic acid reduces the need for transfusion has been available for over 10 years. <b>Conclusions</b> Strong evidence that tranexamic acid reduces blood transfusion in surgery has been available for many years. Further trials on the effect of tranexamic acid on blood transfusion are unlikely to add useful new information. However, the effect of tranexamic acid on thromboembolic events and mortality remains uncertain. Surgical patients should be made aware of this evidence so that they can make an informed choice.
Bioresorbable Vascular Scaffolds Versus Metallic Stents in Patients With Coronary Artery Disease
Authors: Runlin Gao, Yuejin Yang, Yaling Han, Yong Huo, Jiyan Chen, Bo Yu, Xi Su, Lang Li, Hai-Chien Kuo, Shih-Wa Ying, Wai-Fung Cheong, Yunlong Zhang, Xiaolu Su, Bo Xu, Jeffery J. Popma, Gregg W. Stone
Journal: Journal of the American College of Cardiology (2015)
Low frequency of paleoviral infiltration across the avian phylogeny
Authors: Jie Cui, Wei Zhao, Zhiyong Huang, Erich D Jarvis, M Thomas P Gilbert, Peter J Walker, Edward C Holmes, Guojie Zhang
Journal: Genome biology (2014)

Mammalian genomes commonly harbor endogenous viral elements. Due to a lack of comparable genome-scale sequence data, far less is known about endogenous viral elements in avian species, even though their small genomes may enable important insights into the patterns and processes of endogenous viral element evolution.
Activation Studies following Experimental Hemiblock in the Dog
Authors: John J. Gallagher, Andres R. Ticzon, Andrew G. Wallace, Jackie Kasell
Journal: Circulation Research (1974)

Electrocardiograms (ECG), McFee vectorcardiograms (VCG), and ventricular activation data were collected from 25 anesthetized dogs before, immediately after, and 4 weeks after surgically induced discrete left anterior divisional block. Left anterior divisional block resulted in minor ECG changes: small S waves developed in leads II, III, and aVF and the QRS complex was prolonged 5-15 msec (mean 9 ± 2.7 [SD] msec). Prominent VCG changes also occurred: maximal and terminal forces were shifted posteriorly, superiorly, and slightly leftward, the duration of the loop was increased 5-15 msec (mean 9.8 ± 2.8 msec), and the terminal portions of the loop were slurred. Epicardial surface mapping revealed a consistent area of 5-20-msec delay (mean 12 ± 5.1 msec) confined to the lateral-basal surface of the left ventricle. Transmural activation studies in this area invariably revealed 6-20-msec (mean 12.8 ± 4.8 msec) delays in Purkinje and 3-25-msec (mean 12.4 ±5.6 msec) delays in endocardial activation. The wave front propagated across the wall with normal velocity. Q waves developed due to a "window effect" in the area of delay. Combining division of the septal fibers with left anterior divisional block resulted in surface delays of greater magnitude with marked axis shifts toward the left. Despite the extensive interconnections of the left ventricular conduction system, discrete proximal left anterior divisional block resulted in a significant alteration in the sequence of ventricular activation, confirming the fascicular nature of the left ventricular conduction system. The septal division appears to be an integral part of this system. The methodology described in this paper can be used to readily differentiate between epicardial delay due to conduction delay and that due to intramural myocardíal delay.
Endothelin-1 and interleukin-8 in high altitude pulmonary oedema
Authors: Y Droma, T Hayano, Y Takabayashi, T Koizumi, K Kubo, T Kobayashi, M Sekiguchi
Journal: European Respiratory Journal (1996)

We present a case of high altitude pulmonary oedema (HAPE) with pulmonary hypertension and polymorphonuclear leucocyte (PMN) accumulation in bronchoalveolar lavage fluid (BALF), which occurred in a 21 year old man. Plasma endothelin-1 (ET-1) and interleukin-8 (IL-8) concentration in BALF were elevated on admission, and returned to normal level at recovery, when the pulmonary artery pressure and the PMN counts in BALF were normal. In addition, E-selectin and intercellular adhesion molecule-1 (ICAM-1) in BALF were also slightly increased on admission. These findings suggest that endothelin-1 is a vasoconstrictor which contributes to the pulmonary hypertension in high altitude pulmonary oedema, and that some of the inflammatory mediators play an important role in chemotaxis and accumulation of polymorphonuclear leucocytes in the development of high altitude pulmonary oedema.
Patient outcome and factors influencing lack of histology in patients with clinical diagnosis of lung cancer
Authors: Nicola Hunt, Laura Watkins, Lorraine Creech, Marta Babores
Journal: European Respiratory Journal (2013)

Introduction  The Department of Health recommends 75% of patients diagnosed with lung cancer should have histology confirmed(1). We review patients in our area with clinical diagnosis to determine factors influencing lack of tissue diagnosis and outcome  Methods  Data review of patients diagnosed with lung cancer 1/1-31/12/2010. Somerset cancer registry was data source. We assess factors leading to lack of tissue diagnosis, treatment offered and patient survival time.  Results  122 patients were diagnosed with lung cancer in 2010. 38(31%) had no histological diagnosis. 17(45%) were male. 26(68%) were aged over 75. 35(92%) had CT chest. 3 didn9t: 1 was investigated out of area(OOA), 1 refused and 1 was unfit  Of the 18 unfit for investigation, 10(56%) survived   Conclusion  The DoH target for histological diagnosis wasn9t met in our area but there were justifiable reasons for this in the majority. Viewing patients holistically must take precedence. Poor PS predicts poor outcome and hence reasons for focusing on supportive care not aggressive investigation.  Reference  1. National Lung Cancer Audit Report for the audit period 2010. 2011www.ic.nhs.uk/webfiles/Services/NCASP/audits%20and%20reports/NHS_IC_Lung_Cancer_AUDIT_2011_Interactive_PDF_V1.0.pdf.
Murine Concanavalin A–Induced Hepatitis Is Prevented by Interleukin 12 (IL-12) Antibody and Exacerbated by Exogenous IL-12 Through an Interferon-γ–Dependent Mechanism
Authors: Ferdinando Nicoletti, Roberto Di Marco, Paola Zaccone, Antonio Salvaggio, Gaetano Magro, Klaus Bendtzen, PierLuigi Meroni
Journal: Hepatology (2000)

Concanavalin A (ConA)-induced hepatitis is a cell-mediated immunoinflammatory condition similar to human autoimmune hepatitis. We investigated the role of interleukin 12 (IL-12) in hepatitis induced in NMRI and C57/BL6 mice by a single injection of ConA. Recombinant murine IL-12 administered 24 hours and 1 hour prior to ConA exacerbated both transaminase activities in plasma and histologic signs of hepatitis. These markers of liver injury were significantly reduced by prophylactic, but not therapeutic treatment with anti-IL-12 monoclonal antibody (mAb). The disease-modulatory effects of IL-12 and anti-IL-12 mAb were associated with profound and reverse modifications of a ConA-induced increase in the circulating levels of IL-4, IL-6, interferon gamma (IFN-γ) and tumor necrosis factor (TNF). Relative to control animals receiving ConA alone, the plasma levels of these cytokines were all augmented in IL-12/ConA-treated mice and diminished in anti-IL-12 mAb/ConA-treated mice. Anti-IFN-γ mAb also impeded the appearance of IL-12/ConA-induced hepatitis. Thus, IL-12-induced production of IFN-γ might play a role in mediating the hepatitis-inducing effect of ConA. However, IL-12p40-deficient C57/BL6 mice were as susceptible as wild-type controls to the hepatitis-inducing effect of ConA.
Adherence issues in sport and exercise: Edited by S Bull. John Wiley and Sons, 2001, pound42.50, pp 305. ISBN 0471988480
Authors: J Waterfield
Journal: British Journal of Sports Medicine (2002)

The contents of this softback edition of a book first published in 1999 remain pertinent, as there is a continued focus on improving and maintaining health by lifestyle, rather than medical, interventions. Four key factors, which impact on adherence to physical activity, are identified early in the book—the client, the setting, the practitioner, …
Stand-Patism Versus Change in Psychiatric Clinic Practice
Authors: RACHEL A. LEVINE
Journal: American Journal of Psychiatry (1966)

A number of factors appear to retard the implementation of new clinic practices designed to cope more effectively with widespread, multi-faceted disorders. To remove these deterrents to change, the author offers three premises: more and better knowledge of the community, broadening of the treatment concept to embrace direct and indirect services including help in regard to housing, education, etc., and adding to professional training the concept of the need for a constant search for new knowledge and skills.
Pyk2 promotes tumor progression in multiple myeloma
Authors: Yu Zhang, Michele Moschetta, Daisy Huynh, Yu-Tzu Tai, Yong Zhang, Wenjing Zhang, Yuji Mishima, Jennifer E. Ring, Winnie F. Tam, Qunli Xu, Patricia Maiso, Michaela Reagan, Ilyas Sahin, Antonio Sacco, Salomon Manier, Yosra Aljawai, Siobhan Glavey, Nikhil C. Munshi, Kenneth C. Anderson, Jonathan Pachter, Aldo M. Roccaro, Irene M. Ghobrial
Journal: Blood (2014)
Neuroleptic malignant syndrome
Authors: G A Chaimowitz, U Gomes, S S Maze
Journal: JAMA (1986)

<h3>To the Editor.—</h3> We read with interest the recent article by Friedman et al entitled "A Neuroleptic Malignantlike Syndrome due to Levodopa Therapy Withdrawal."<sup>1</sup>The authors speculate that the dysfunction underlying the neuroleptic malignant syndrome (NMS) occurs at more than one level of the neuraxis, on the ground that the multiple symptoms and signs cannot be reconciled to the pathophysiology of one anatomic area. We would like to suggest, however, that the key factor to the pathophysiology of the NMS is a dysregulation in the activity of endorphins at the diencephalic level. Our hypothesis is based on the following evidence and rationale. First, it is understood that the hypothalamus regulates temperature,<sup>2</sup>level of consciousness,<sup>3</sup>and motor activity.<sup>4</sup>The hypothalamus is rich in endorphins and dopamine, the former being implicated in both hypothermia and hyperthermia. Dopaminergic pathways link the hypothalamus with the substantia nigra.<sup>5</sup> Recent studies
Interrelation between some indices of polysomnography and nasal flows in severe COPD patients
Authors: Ludmila Iashyna, Yra Feshchenko, Viktiria Ignatieva, Sveta Ishyk, Natalia Kramarskya, Natalia Dyachenko
Journal: European Respiratory Journal (2013)

Aim of study: to study interrelation between indices of polysomnography (PSG) and rhinometry in severe COPD patients patients.

Methods of study : 60 severe COPD patients (Post BD FEV1 – (41,6 ± 2,1) %), 45 male and 15 female at the age 41 -- 79 years) were investigated with the use of anterior active rhinomanometry, spirometry, PSG (SomnoStar Pro, Cardinal Health (Germany), statistics.

Results: complications with nasal breathing were revealed in 50 (83,3%) of patients. In 49 (81,7%) patients was diagnosed vasculomotor rhinitis, accompanied by hypertrophy of maxilloturbinal bone in 44 (81,7%) cases, in 30 % of patients had deviated septum.

Correlation analysis revealed significant direct connection of medium strength between left inspiratory nasal flow (LINF) and apnea index (AI) – (r = 0,428, p < 0,05), between LINF and awakenings/hour (r = 0,493, p < 0,05), between right inspiratory nasal flow (RINF) and AI (r = 0,575, p < 0,05), between LINF and apnea-hypoapnea index (AHI) (r = 0,494, p < 0,05).

Conclusion: in severe COPD patients aerodynamic impairments of upper airways due to vasomotor rhinitis complicated by hypertrophy of the maxilloturbinal bone and deviation of nasal septum conditioned appearance and severity of respiratory disorders during sleep.
Right ventricular global strain and right ventricular dyssynchrony can predict success to pulmonary vasodilators therapy in PH patients
Authors: Bouchra Lamia, Luis-Carlos Molano, Catherine Viacroze, Antoine Cuvelier, Jean-Francois Muir
Journal: European Respiratory Journal (2012)

Background   Transthoracic echocardiography (TTE) is used to evaluate right ventricular (RV) function in pulmonary hypertension (PH) patients. RV function is assessed using TAPSE or RV end-diastolic area/ LV end-diastolic area ratio (RVEDA/LVEDA). RV speckle tracking strain can quantify regional contraction. Pulmonary vasodilators can improve functional status and prognosis but their effects on RV function are poorly described. The aim of our study is to test whether response to pulmonary vasodilators can be predicted by change in RV regional strain.   Methods   16 patients were prospectively included. They underwent right heart catheterization, usual and 2D strain TTE at baseline and after 3 months of pulmonary vasodilators: PDE5 inhibitors,endothelin receptors antagonists,prostacyclin (single or combination therapy). Success or failure to pulmonary vasodilators were defined according to the guidelines.   Results   At baseline:MPAP was 44±11 mmHg, PAPO 11± 3 mmHg, cardiac index 3.06± 0.73 L/min/m 2 , RVEDA/LVEDA 1.03 ± 0.43, RV global strain: 12.29± 5.34% and RV dyssynchrony: 124± 78 msec. A change in global RV strain higher than 70% (-100 to 122%) could predict success to pulmonary vasodilators with a specificity of 100%, a change in RV dyssynchrony of 96 msec could predict success to treatment with a sensitivity of 100%. Change in TAPSE or RVEDA/LVEDA were not accurate enough to predict response to pulmonary vasodilators.  Conclusion  Success to pulmonary vasodilators therapy in PH patients can be predicted by changes in regional right ventricular contraction using longitudinal right ventricular strain and right ventricular dyssynchrony analysis.
Quantification of ortholog losses in insects and vertebrates
Authors: Stefan Wyder, Evgenia V Kriventseva, Reinhard Schröder, Tatsuhiko Kadowaki, Evgeny M Zdobnov
Journal: Genome biology (2007)

The increasing number of sequenced insect and vertebrate genomes of variable divergence enables refined comparative analyses to quantify the major modes of animal genome evolution and allows tracing of gene genealogy (orthology) and pinpointing of gene extinctions (losses), which can reveal lineage-specific traits.To consistently quantify losses of orthologous groups of genes, we compared the gene repertoires of five vertebrates and five insects, including honeybee and Tribolium beetle, that represent insect orders outside the previously sequenced Diptera. We found hundreds of lost Urbilateria genes in each of the lineages and assessed their phylogenetic origin. The rate of losses correlates well with the species' rates of molecular evolution and radiation times, without distinction between insects and vertebrates, indicating their stochastic nature. Remarkably, this extends to the universal single-copy orthologs, losses of dozens of which have been tolerated in each species. Nevertheless, the propensity for loss differs substantially among genes, where roughly 20% of the orthologs have an 8-fold higher chance of becoming extinct. Extrapolation of our data also suggests that the Urbilateria genome contained more than 7,000 genes.Our results indicate that the seemingly higher number of observed gene losses in insects can be explained by their two- to three-fold higher evolutionary rate. Despite the profound effect of many losses on cellular machinery, overall, they seem to be guided by neutral evolution.
Reviewing Potential Malpractice Cases
Authors: J. Terrence Coyle
Journal: JAMA (1992)

<h3>To the Editor.</h3> —The article by Hirshfeld<sup>1</sup>on practice parameters in malpractice litigation that appeared in the November 27,1991, issue of<i>JAMA</i>prompted me to submit my approach to the review of potential malpractice cases. Over the last 20 years I have reviewed approximately 40 proposed malpractice cases. About one third of those were without merit. Part of the problem in dropping such cases is cost. Attorneys spend many hours obtaining records, analyzing their content, and interviewing plaintiffs. They then must summarize their findings and submit their observations and questions, together with pertinent records, to a medical expert for his or her analysis. I, as the physician expert, will spend several hours reviewing the data and the literature and then compose a letter or verbal communication that defines my opinion. If my time is worth $200 an hour, then a bill of $600 to $1000 is easily generated. If
Relationship between lung function impairment and incidence or recurrence of cardiovascular events in a middle-aged cohort
Authors: A K Johnston, D M Mannino, G W Hagan, K J Davis, V A Kiri
Journal: Thorax (2008)

<h3>Introduction:</h3> Lung function impairment may be a risk factor for cardiovascular disease (CVD) events. <h3>Objective:</h3> To determine the relationship between the severity of airflow obstruction based on modified Global Initiative on Obstructive Lung Disease (GOLD) criteria and the prevalence and incidence or recurrence of CVD in a cohort of US adults, aged 45–64 years, from 1987 to 2001. <h3>Methods:</h3> We analysed data from 14 681 adults using logistic regression to determine the cross sectional association between lung function impairment and prevalent CVD at baseline and Cox regression to examine the prospective association of lung function impairment at baseline with CVD over 15 years of follow-up. Models were adjusted for age, sex, race, smoking, comorbid hypertension and diabetes, cholesterol levels and fibrinogen level. <h3>Results:</h3> At baseline, the crude prevalence of CVD was higher among subjects with GOLD 2 (OR 2.9, 95% CI 2.4 to 3.6) and GOLD 3 or 4 chronic obstructive pulmonary disease (COPD) (OR 3.0, 95% CI 2.0 to 4.5), compared with normal subjects. These relative risks were greatly reduced after adjusting for covariates (OR 1.4, 95% CI 1.1 to 1.8 for GOLD 2 and OR 1.3, 95% CI 0.8 to 2.1 for GOLD 3 or 4). Similarly, the association between COPD and risk of incident or recurrent CVD was much stronger in the unadjusted models (hazard ratio (HR) 2.4, 95% CI 2.1 to 2.7 for GOLD 2 and 2.9, 95% CI 2.2 to 3.9 for GOLD 3 or 4) than in the adjusted ones (HR 1.2, 95% CI 1.03 to 1.4 for GOLD 2 and 1.5, 95% CI 1.1 to 2.0 for GOLD 3 or 4). <h3>Conclusion:</h3> We observed a crude association between lung function impairment and prevalent and incident or recurrent CVD that was greatly reduced after adjusting for covariates, including age, sex, race, smoking, comorbid hypertension and diabetes, cholesterol levels and fibrinogen level. These data suggest that this association may be, in part, mediated through established CVD risk factors included in our adjusted models.