tbuckley/cabot-search huggingface dataset:
Prospective clinical study of endoscopic ultrasound-guided choledochoduodenostomy with direct metallic stent placement using a forward-viewing echoendoscope
Authors: K. Hara, K. Yamao, S. Hijioka, N. Mizuno, H. Imaoka, M. Tajika, S. Kondo, T. Tanaka, S. Haba, O. Takeshi, Y. Nagashio, T. Obayashi, A. Shinagawa, V. Bhatia, Y. Shimizu, H. Goto, Y. Niwa
Journal: Endoscopy (2013)

A prospective clinical study was conducted to evaluate the safety, feasibility, and efficacy of endoscopic ultrasound (EUS)-guided choledochoduodenostomy (CDS) with direct metallic stent placement using a prototype forward-viewing echoendoscope. The indication for EUS – CDS in this study was lower biliary obstruction only, and not failed endoscopic biliary drainage, because the aim was to evaluate EUS – CDS for first-line biliary drainage therapy. The technical and functional success rates were 94 % (17 /18) and 94 % (16 /17), respectively. Early complications (focal peritonitis) were encountered in two patients (11 %). No patients developed late complications. EUS – CDS with direct metallic stent placement using a forward-viewing echoendoscope was generally feasible and effective for malignant distal biliary tract obstruction. The forward-viewing echoendoscope was useful, especially for deploying the metallic stent.
Detection of Familial Primary Pulmonary Hypertension by Genetic Testing
Authors: Jane H. Morse, Robyn J. Barst
Journal: New England Journal of Medicine (1997)

Zhang et al. (Feb. 27 issue) 1 present data confirming the finding of the Study of Osteoporotic Fractures Research Group 2 that increased bone mass in postmenopausal women is associated with an increased risk of subsequent breast cancer.However, I am concerned about the accuracy of the multivariate-adjusted rate ratios that Zhang et al. report.The authors included 10 variables in addition to bone mass in their multivariate model.Since the number of observed events (i.e., cases of breast cancer) was only 91, the ratio of the number of events to the number of variables is less than 10.As a rule of thumb, this ratio should be at least 10 in order to prevent overfitting. 3Models that are overfitted may give results that are numerically unstable and too dependent on the observed data. 4This may be evidenced by overly large coefficients or standard errors.Can the authors allay this concern by indicating the estimated coefficients and standard errors or perhaps by repeating the analysis after omitting some of the less important variables?In addition, perhaps the authors could indicate whether they checked their model for goodness of fit and for conformity to the assumption of proportional hazards.
Assisted Death — A Compassionate Response to a Medical Failure
Authors: H Brody
Journal: New England Journal of Medicine (1992)

Is it ever morally appropriate for physicians to assist a patient's dying, either by providing the means or by directly causing death? What should be the stance of the law toward physician-assisted death?We have usually tried to resolve these questions through appeals to ethical rights, duties, and consequences. This search for a resolution has proved unsatisfactory. In the most difficult and compelling cases, the ethical rights, duties, and consequences seem fairly evenly balanced on both sides of the argument. Any resolution in terms of standard moral principles seems to reject the important moral considerations on one side or the . . .
Abstract 1893: Spectroscopic imaging unveils altered cholesterol metabolism in prostate cancer .
Authors: Shuhua Yue, Junjie Li, Seung Young Lee, Tian Shao, Bing Song, Liang Cheng, Chang-Deng Hu, Xiaoqi Liu, Timothy L. Ratliff, Ji-Xin Cheng
Journal: Cancer Research (2013)

Abstract Metabolic reprogramming allows cancer cells to sustain high proliferative rates and resist cell death. Whereas alterations to glucose and amino acid metabolism have been extensively studied, altered lipid metabolism in cancer is increasingly recognized based on the findings of imbalanced lipid signaling network and dysregulated lipogenic enzymes. Storage of neutral lipids in lipid droplets (LDs), an essential aspect of lipid metabolism, is however long underappreciated until recent advances in LD biology. In human prostate cancer cell lines, neutral lipid accumulation was commonly seen and partially attributed to the up-regulation of fatty acid synthase, a key lipogenic enzyme catalyzing fatty acid biosynthesis and implicated in many human malignancies including prostate cancer. However, because the composition of LDs is not accessible with fluorescence microscopy, the exact role of lipid accumulation in prostate cancer progression remains elusive. By vibration-based spectroscopic imaging of 65 specimens collected from 61 prostate cancer patients and healthy donors, we found for the first time a marked shift from lipofuscin-like autofluorescent granules in normal, benign, and prostatic intraepithelial neoplasia lesions to cholesteryl ester (CE)-rich LDs in high-grade and metastatic prostate cancers. Quantitatively, CE amount was found ∼5 folds higher in high-grade relative to low-grade prostate cancers. Cellular studies demonstrate that the activated PI3K/Akt/mTOR/SREBP pathway accounts for accumulation of CEs via elevated LDL uptake and cholesterol esterification. Blockage of cholesterol esterification with an acetyl-coA cholesterol acyltransferase (ACAT) inhibitor significantly slows the growth and induces apoptosis of prostate cancer both in vitro and in vivo. These findings suggest that CE can be a quantifiable molecular marker for diagnosis of prostate cancer, especially for differentiation between low-grade and high-grade prostate cancers which currently has up to 40% inter-observer discordance. Moreover, targeting the altered cholesterol metabolism opens new opportunities for treating advanced prostate cancer in human patients. Citation Format: Shuhua Yue, Junjie Li, Seung Young Lee, Tian Shao, Bing Song, Liang Cheng, Chang-Deng Hu, Xiaoqi Liu, Timothy L. Ratliff, Ji-Xin Cheng. Spectroscopic imaging unveils altered cholesterol metabolism in prostate cancer . [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1893. doi:10.1158/1538-7445.AM2013-1893 Note: This abstract was not presented at the AACR Annual Meeting 2013 because the presenter was unable to attend.
SAT0437 Meaning and the Prevalence of Different MRI Structural Changes in Knee Osteoarthritis (KOA)
Authors: E. Tsvetkova, N. Ionichenok, P. Karusinov, A. Smirnov, L. Denisov, E. Nasonov
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> OA is a disease with articular cartilage degeneration, synovial and subchondral bone changes, meniscus and ligament pathologies. Bone marrow edema -like lesions (BMLs), with histologically represented bone damage, are predictors of cartilage loss (chondropathy) and pain in KOA. <h3>Objectives</h3> to assess the prevalence of different structural changes in knee OA. <h3>Methods</h3> All pts with available baseline (BL) MRI and X-ray were included. MRI was performed on 1,5T extremity system, including sagittal and axial proton density fat-suppressed and coronal STIR sequences. MRI and X-ray were read by 2 musculkoskeletal radiologists. Plain knee radiographs have been performed by Buckland -Wright. The joint was divided in 5 subregions. Cartilage morphology was scored from 0 (normal cartilage) to IV (uncover subchondral bone). Additionally there were assessed bone cysts, synovitis, meniscal damage, cruciate and collateral ligaments. <h3>Results</h3> 80 knee OA patients (1 knee per person, 5 regions per knee, 400 subregions) were included (women 90%; mean age 57,0; mean BMI - 27,7 kg/m<sup>2</sup>, K-L stage 0-6%; I-25%; II-43,75%; III-25% respectively). Healthy cartilage was noted in X-ray negative knee joints (KJ) in lateral femur and tibia condyles (60% of the whole surface), cartilage softness and edema were estimated in patella and medial femur compartments in 100%. Cartilage cracks and erosions (&gt;50% of surface) were revealed, in patella, medial femur and tibia compartments in spite of X-ray stages. In the same subregions uncovered subchondral bone were seen in I (20%) and II (17%) K-L stages, and significantly more frequent in III stage (75%). Bone cysts were seen only at the III-d stage in the medial femur (41,25%) and tibia (36,25%) condyles; in patella - 13,75%. Bone marrow edema-like lesions was estimated only at the I-st X-ray stage in patella (12,5%), medial femur (18,75%) and tibial (16,25%) subregions under the most damaged cartilage. Synovitis was noted at all stages (0-III) in 60%. Meniscus and cruciated ligaments tears and lesions were found in 59% and 22,5% respectively at the III-d stage only. <h3>Conclusions</h3> Prevalent cartilage damage, incident BMIs in the same subregion are strongly correlated with early KOA. If cartilage damage were targeted in management of knee OA, it might prevent the development of knee OA, the other joint9s structure damages. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.3606
Case 33-2014
Authors: Edwin Choy, Eyal C. Attar, Kevin S. Oh, Ambrose J. Huang, Darcy A. Kerr
Journal: New England Journal of Medicine (2014)

A 60-year-old man was seen in the outpatient cancer center because of bone pain that had lasted for 2 months and the presence of lytic bone lesions on imaging studies. Biopsy specimens of bone marrow and bone lesions showed increased mast cells. A diagnostic procedure was performed.
Rethinking the Role of Tube Feeding in Patients with Advanced Dementia
Authors: M R Gillick
Journal: New England Journal of Medicine (2000)

A byproduct of the aging of the population has been a dramatic rise in the rate of Alzheimer's disease and other types of dementia. A conservative estimate is that there are currently 4 million people in the United States with dementia.1 In the final stage of dementia, patients are typically unable to walk or to feed themselves, they are incontinent and aphasic, and they have lost the capacity to have relationships with other people. Family members or other surrogate decision makers must make difficult and often painful decisions about limiting care.2 Should they authorize surgery, hospitalization, intravenous medication? Is a . . .
PARE0010 The Relationship between Musculoskeletal Diseases and Ageing
Authors: P. Stannett, J. Cumming
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Musculoskeletal conditions (MSKs) are one of the largest causes of physical disability in the UK and, while it affects people of all ages including children, it particularly affects older people. Although large numbers of people are affected by MSKs, there is little specific data which show how people are affected by age, type of MSK and what support they seek. We felt an analysis of these issues could be examined. <h3>Objectives</h3> We analysed all contacts reporting to a national helpline during 2013 with the aim of exploring how people with MSKs are affected in different age groups, their additional health problems (AHPs) and the type of support requested. <h3>Methods</h3> Every contact by telephone, email, letter or online forum received by the helpline was anonymised and logged onto a secure, confidential database, complying with the UK Data Protection Act. Where age was self-reported, it was analysed in conjunction with the type of arthritis and the support sought. <h3>Results</h3> 86.8% of 6,141 had self-reported MSKs. Of all the callers with an MSK, there were 10.1% in the 26-44 age group, 40.2% in the 45-64 group, 14.5% in the 65-69 group, 9.9% in the 70-74 group, 8.5% in the 75-79 group, 6.8% in the 80-84 group, 4.6% in the 85-89 group, 1.8% in the 90-94 group and 0.3% in the 95-99 group. 1,089 (20.4%) of the callers with arthritis had AHPs. Of these, 0.6% were in the 18-25 age group, 7% in the 26-44 group, 39.4% in the 45-64 group, 13.6% in the 65-69 group, 12.2% in the 70-74 group, 9.0% in the 75-79 group, 8.1% in the 80-84 group, 6.9% in the 85-89 group, 2.0% in the 90-94 group and 0.2% in the 95-99 age group. 3,886 (44.4%) of all contacts wanted information were about pain: 0.5% were in the 18-25 age group, 4.6% in the 26-44 group, 17.3% in the 45-64 group, 6.4% in the 65-69 group, 4.4% in the 70-74% group, 3.9% in the 75-79 group, 3.3% in the 80-84 group, 2.2% in the 85-89 group, 1% in the 90-94 group and 0.1% in the 95-99 age group. Next, 2,469 (28.2%) requested information about types of arthritis: 0.4% in the 18-25 group, 2.8% in the 26-44 group, 11.2% in the 45-64 group and 4.3% in the 65-69 group, 2.5% in the 70-74 group, 2.3% in the 75-79 group, 2.1% in the 80-84 group, 1.2% in the 85-90 group, 0.5% in the 90-94 group, and 0.1% in the 95-99 age group. Thirdly, 2,113 (24.2%) requested emotional support: 3.6% in the 26-44 group, 10.4% in the 45-64 group, 2.6% in the 65-69 group, 2.0% in the 70-74 group, 1.7% in the 75-79 group, 1.4% in the 80-84 group, 0.9% in the 85-89 group, 0.3% in the 90-94 group and 0.1% in the 95-99 age group. <h3>Conclusions</h3> 1. The incidence of co-morbidities increases with age from the 26-44 group to the 45-64 age group and declines thereafter. 2. As people with MSKs get older their need for print information on pain declines. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.4308
Can Congress Regulate “Inactivity” (and Make Americans Buy Health Insurance)?
Authors: Timothy Stoltzfus Jost
Journal: New England Journal of Medicine (2011)

On January 31, 2011, federal judge Roger Vinson declared the entire Patient Protection and Affordable Care Act (ACA) unconstitutional.1 Judge Vinson concluded that Congress had no authority to enact one provision of the law that requires uninsured individuals who can afford health insurance to purchase it. Since that provision is the cornerstone of the entire edifice, Vinson opined, the rest of the law also must fall.The states have broad authority to adopt laws that protect the public health and safety. But the powers of Congress are limited to those delegated by the Constitution. The federal government argued that the . . .
Abstract 5130: Src and Caveolin-1 reciprocally regulate metastasis via Rho Kinase
Authors: Shibu Thomas, Jonathan B. Overdevest, Mathew Nitz, Paul Williams, Martin A. Schwartz, Dan Theodorescu
Journal: Cancer Research (2010)

Abstract In human bladder cancer, overexpression of Caveolin-1 (Cav-1) and downregulation of Src expression and kinase activity correlate with aggressive behavior suggesting they may have causal and perhaps interactive roles in this process. Here we show that Cav-1 and Src are reciprocally expressed in the same tumors, suggesting they act on a similar pathway. RNAi mediated Cav-1 depletion or expression of constitutively active Src in invasive human urothelial cancer cells UMUC-3 and KU-7 resulted in loss of stress fibers and reduced capacity to migrate. Cav-1 depletion was associated with loss of pY14 Cav-1 while increased p190RhoGAP was seen with Src over-expression while both led to a significant reduction in RhoA and RhoC levels and activity. Conversely, expression of Cav-1 but not the non-phosphorylatable mutant of Cav-1 or suppression of Src using PP2 or Src RNAi in noninvasive human urothelial RT4 cancer cells, increased RhoA and RhoC GTP and cell migration. Use of ROCK inhibitor Y27632 in RT4 cells completely abolished enhanced migration induced by Cav-1 expression or that associated with Src inhibition. Furthermore, metastatic lung colonization of UMUC-3 cells expressing constitutively active Src or depleted of Cav-1 was significantly reduced while having marginal effect on subcutaneous tumor growth. Moreover, ROCK inhibitor prevented bladder cancer lung metastasis in vivo. Our findings indicate Src is metastasis suppressor protein in bladder cancer and describe a novel relationship between Cav-1 and Src in regulating RhoA and RhoC providing a unifying molecular mechanism for prior descriptive studies suggesting a role for these proteins in bladder cancer progression. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 5130.
AT-13 * R9802: PHASE III STUDY OF RADIATION THERAPY (RT) WITH OR WITHOUT PROCARBAZINE, CCNU, AND VINCRISTINE (PCV) IN LOW-GRADE QLIOMA: RESULTS BY HISTOLOGIC TYPE
Authors: J. Buckner, E. Shaw, S. Pugh, M. Gilbert, G. Barger, S. Coons, P. Ricci, D. Bullard, P. Brown, K. Stelzer, D. Brachman, J. Suh, C. Schultz, J.-P. Bahary, B. Fisher, H. Kim, A. Murtha, M. Won, M. Mehta, W. Curran
Journal: Neuro-Oncology (2014)

BACKGROUND: Recent results of R9802 (Buckner et al; J Clin Oncol 32:5s, 2014 (suppl; abstr 2000)) demonstrated that PCV given with RT at the time of initial diagnosis prolongs both progression-free survival (PFS) and overall survival (OS) for all patients enrolled in the trial. Herein, we report the impact of treatment on PFS and OS based upon specific histologic type. METHODS: Eligibility criteria included age <40 years with subtotal resection or biopsy, age >40 with any extent of resection, and supratentorial grade ll oligodendroglioma (O), oligo-astrocytoma (OA), or astrocytoma (A). Patients were stratified by age, histology, Karnofsky Performance Status, and presence versus absence of contrast enhancement on the preoperative imaging study and randomized to RT alone (54 Gy in 30 fractions) or RT followed by 6 cycles of PCV chemotherapy. In an exploratory analysis, we used the log rank test to compare survival and progression free survival (PFS) distributions for each histologic type. RESULTS: 251 eligible patients were accrued from 1998 to 2002: 107 had O, 79 had OA, and 65 had A. In total, 67% have progressed and 55% have died. Median PFS (RT vs. RT + PCV) overall, O, OA, and A, respectively, are 4.0 vs 10.4 (p < 0.001); 6.0 vs not reached (NR) (p < 0.001); 3.0 vs 8.9 (p = 0.01); and 1.8 vs 3.7 (p = 0.06) years. Median survival times (RT vs. RT + PCV) overall, O, OA, and A, respectively, are 7.8 vs 13.3 (p = 0.002); 10.8 vs NR (p = 0.008); 5.9 vs 11.4 (p = 0.05); and 4.4 vs 7.7 (p = 0.31) years. CONCLUSIONS: For grade 2 glioma patients with less than gross total tumor resection or >40 years of age, PCV + RT prolongs both OS and PFS compared with RT alone. The observed benefit is most definitive for O and OA patients.
258 CONNECTION BETWEEN WNT/β-CATENIN AND TGF-β/SMADS PATHWAYS IN HEPATOCELLULAR CARCINOMA (HCC): INTERFERON-α2B (IFN) AND TRANSFORMING GROWTH FACTOR-β1 (TGF) TREATMENT EFFECTS ON HCC CELL LINES
Authors: M.P. Ceballos, J.P. Parody, M.D.L. Alvarez, P.I. Ingaramo, C.E. Carnovale, M.C. Carrillo
Journal: Journal of Hepatology (2012)
AB1321 Extra-articular calcifications around the pelvis are highly prevalent and associated with bone mineral density and osteoarthritis
Authors: D. Sluiter, H.J. Kerkhof, B. Hofman, F. Rivadeneira, A. Uitterlinden, S. Bierma-Zeinstra, E. Oei, J. van Meurs
Journal: Annals of the Rheumatic Diseases (2013)

Background Extra-articular calcifications are calcified deposits in soft tissue structures outside the joint and are visible on radiographs. Not much is known about the prevalence and aetiology of these extra-articular calcifications, but it is thought that these calcifications develop as a consequence of traumatic events that trigger calcifications of tendons. Objectives The objective of this study was to determine the prevalence of extra-articular calcifications of the pelvis in an elderly general population and to assess whether these calcifications are associated with hip pain, hip osteoarthritis (OA), osteophytosis and bone mineral density (BMD). Methods We developed a scoring system for the calcifications, which were scored at five positions around the pelvis: spina iliaca anterior inferior (SIAI), greater trochanter, lesser trochanter, os pubis and tuber ischiadicum. Scores from the calcifications on all 5 locations were added up to make a sumscore variable where a sumscore ≥4 was considered as a case. In 947 subjects, a selection of participants from the Rotterdam Study (a large population-based cohort study of subjects aged ≥55 years), linear regression was used to study the associations between calcifications and lumbar spine (ls) BMD and femoral neck (fn) BMD. To determine the relation between calcifications and hip pain, hip OA and hip osteophytosis, we used a logistic regression model with general estimating equations (GEE). Results 24% of the subjects had at least one extra-articular calcification around the pelvis. Prevalence was highest at the greater trochanter (12%). We observed that subjects with calcifications had a 7.5% higher ls-BMD ( P =5×10-5) and 4.5% higher fn-BMD ( P =0.01) compared to subjects without a calcification. Calcifications around the greater trochanter were more frequently present in subjects with hip OA (OR 2.04 (95%CI 1.05-3.96), P=0.04) and in subjects with hip osteophytosis (OR 1.50 (95%CI 1.01-2.22), P=0.04). We observed no association between calcifications and hip pain. Conclusions The prevalence of calcifications around the pelvis is high in an elderly general population. We showed that extra-articular calcifications of the pelvis are related to BMD, hip osteophytosis and hip osteoarthritis. These results might indicate that these extra-articular calcifications are a reflection of bone forming capacity. Disclosure of Interest None Declared
The Effect of a Supportive Companion on Perinatal Problems, Length of Labor, and Mother-Infant Interaction
Authors: Roberto Sosa, John Kennell, Marshall Klaus, Steven Robertson, Juan Urrutia
Journal: New England Journal of Medicine (1980)

We studied the effects of a supportive lay woman ("doula") on the length of labor and on mother-infant interaction after delivery in healthy Guatemalan primigravid women. Initial assignment of mothers to the experimental (doula) or control group was random, but controls showed a higher rate (P less than 0.001) of subsequent perinatal problems (e.g. cesarean section and meconium staining). It was necessary to admit 103 mothers to the control group and 33 to the experimental group to obtain 20 in each group with uncomplicated deliveries. In the final sample, the length of time from admission to delivery was shorter in the experimental group (8.8 vs. 19.3 hours, P less than 0.001). Mothers who had a doula present during labor were awake more after delivery (P less than 0.02) and stroked (P less than 0.001), smiled at (P less than 0.009), and talked to (P less than 0.002) their babies more than the control mothers. These observations suggest that there may be major perinatal benefits of constant human support during labor.
Multidrug-resistant tuberculosis in Uzbekistan: results of a nationwide survey, 2010 to 2011
Authors: D J Ulmasova, G Uzakova, M N Tillyashayhov, L Turaev, W van Gemert, H Hoffmann, M Zignol, K Kremer, T Gombogaram, J Gadoev, P du Cros, N Muslimova, A Jalolov, A Dadu, P de Colombani, O Telnov, A Slizkiy, B Kholikulov, M Dara, D Falzon
Journal: Eurosurveillance (2013)

Binary file ES_Abstracts_Final_ECDC.txt matches