tbuckley/cabot-search huggingface dataset:
Effects of Health Insurance and Race on Early Detection of Cancer
Authors: R G Roetzheim, N Pal, C Tennant, L Voti, J Z Ayanian, A Schwabe, J P Krischer
Journal: JNCI Journal of the National Cancer Institute (1999)

BACKGROUND: The presence and type of health insurance may be an important determinant of cancer stage at diagnosis. To determine whether previously observed racial differences in stage of cancer at diagnosis may be explained partly by differences in insurance coverage, we studied all patients with incident cases of melanoma or colorectal, breast, or prostate cancer in Florida in 1994 for whom the stage at diagnosis and insurance status were known. METHODS: The effects of insurance and race on the odds of a late stage (regional or distant) diagnosis were examined by adjusting for an individual's age, sex, marital status, education, income, and comorbidity. All P values are two-sided. RESULTS: Data from 28 237 patients were analyzed. Persons who were uninsured were more likely diagnosed at a late stage (colorectal cancer odds ratio [OR] = 1.67, P = .004; melanoma OR = 2.59, P = .004; breast cancer OR = 1.43, P = .001; prostate cancer OR = 1.47, P = .02) than were persons with commercial indemnity insurance. Patients insured by Medicaid were more likely diagnosed at a late stage of breast cancer (OR = 1.87, P <.001) and melanoma (OR = 4.69, P <.001). Non-Hispanic African-American patients were more likely diagnosed with late stage breast and prostate cancers than were non-Hispanic whites. Hispanic patients were more likely to be diagnosed with late stage breast cancer but less likely to be diagnosed with late stage prostate cancer. CONCLUSIONS: Persons lacking health insurance and persons insured by Medicaid are more likely diagnosed with late stage cancer at diverse sites, and efforts to improve access to cancer-screening services are warranted for these groups. Racial differences in stage at diagnosis are not explained by insurance coverage or socioeconomic status.
Screening for hip and knee osteoarthritis in the general population: predictive value of a questionnaire and prevalence estimates
Authors: C H Roux, A Saraux, B Mazieres, J Pouchot, J Morvan, B Fautrel, J Testa, P Fardellone, A C Rat, J Coste, F Guillemin, L Euller-Ziegler
Journal: Annals of the Rheumatic Diseases (2007)

<h3>Objective:</h3> To study the feasibility and validity of a two-step telephone screening procedure for symptomatic knee and hip osteoarthritis (OA) in the general population. <h3>Method:</h3> The screening questionnaire was based on signs and symptoms, previous diagnosis of OA and validated OA criteria. A random sample of telephone numbers was obtained and, at each number, one person aged 40–75 years was included. A physical examination and knee or hip radiographs were offered when the screen was positive. A sample of subjects with negative screens was also examined. The diagnosis of hip/knee OA was based on the American College of Rheumatology criteria for signs and symptoms and Kellgren–Lawrence radiographic stage 2 or greater. Prevalence rates were estimated with correction for the performance of the screening procedure. <h3>Results:</h3> Of 1380 subjects, 479 had positive screens, among whom 109 were evaluated; symptomatic radiographic OA was found in 50 subjects, at the knee (n = 35) or hip (n = 20). Corrected prevalence estimates of symptomatic OA were 7.6% (6.4%–8.8%) for the knee and 5% (3.9%–6.1%) for the hip. The screening procedure had 87% (95% CI 79% to 95%) sensitivity and 92% (95% CI 91% to 93%) specificity for detecting knee OA and respectively 93% (95% CI 86% to 100%) and 93% (95% CI 92% to 94%) for hip OA. <h3>Conclusion:</h3> This study establishes the feasibility of telephone screening for symptomatic knee/hip OA, which could be used for a nationwide prevalence study. Pain and previous OA diagnosis were the best items for detecting symptomatic OA.
Small RNA Overcomes the Challenges of Therapeutic Targeting of Microsomal Triglyceride Transfer Protein
Authors: Kasey C. Vickers, Kathryn J. Moore
Journal: Circulation Research (2013)

The plasma level of apolipoprotein B (apoB) is among the strongest risk factors for coronary artery disease. Microsomal triglyceride transfer protein (MTP) plays a key role in the lipidation of nascent apoB and the secretion of apoB-containing lipoproteins enriched with triglycerides and is thus a promising target for the treatment of hyperlipidemia. Yet, the development of MTP inhibitors to lower plasma lipid concentrations has been hindered by adverse effects on hepatic steatosis. A study recently published in Nature Medicine identifies microRNA-30c (miR-30c) as a potent repressor of MTP that controls plasma apoB-containing lipoprotein levels, in addition to decreasing hepatic lipid synthesis through direct targeting of lysophosphatidylglycerol acyltransferase 1 (LPGAT1). These findings identify miR-30c as a novel therapeutic target that coordinately reduces lipid biosynthesis and lipoprotein secretion to suppress circulating apoB lipoproteins, while sparing the liver from steatosis.
Book Review: The Body in the Library: A Literary Anthology of Modern Medicine
Authors: Tom Marrs
Journal: Journal of the Royal Society of Medicine (2004)

The National Health Service is morphing before our very eyes, as change after change is introduced in the name of patient benefit. Will these changes improve the patients’ well-being? One of their consequences is a downgrading of the doctor–patient relationship; for example, in primary care we are seeing the end of the ‘personal doctor’. The Body in the Library—a collection of writings about doctors from the early nineteenth century to the present day—sheds light on this relationship by broadening ‘our conceptual grasp of how medicine and society aid and abet each other’.

The largest share of the older writing comprises ‘stories’—some real, others fiction. Whilst we may doubt the specifics of individual accounts, their breadth illustrates the awesome scope of medical services needed. There are contributions, for example, from itinerant Portuguese general practitioners, wartime surgeons conducting post-trauma salvage operations and doctors treating the TB-stricken poor of Paris. Medicine is as eclectic as the people it treats. Do doctors need to show empathy? This was a point of discussion as long as 100 years ago, as illustrated by Valery’s angry piece questioning a doctor’s right to remain aloof and simply move onto the next patient. Virginia Woolf, however, thinks empathy can be taken too far, arguing that to show full empathy is to share in the passivity of illness, thus rendering the doctor ineffective. Full empathy? The notion that this is even possible is dismissed by the poet Gunn as supreme arrogance. Patients are not all alike, and their reactions are mutable; these conflicting views retain their relevance today.

Other contributors delve into medical morality and politics. Leiris tells the story of a boy who was deceived into thinking he was on a trip to the circus when he was on his way to having an adenoidectomy. Some present-day writers suggest that the dictates of the General Medical Council cause doctors to neglect their personal responsibility to patients. Telling of his father’s death, Bert Keizer contributes a tirade against those who investigate near-terminal patients with cutting-edge technology; today’s medical practice, he declares, allows neither living well nor dying well. His anecdote certainly illustrates the perils of ‘guideline medicine’.

The Body in the Library elegantly portrays the personal nature of good clinical medicine. Changes to the NHS that undermine this characteristic are not likely to increase the sum of happiness.
Regulatory T Cells Limit Vascular Endothelial Injury and Prevent Pulmonary Hypertension
Authors: Rasa Tamosiuniene, Wen Tian, Gundeep Dhillon, Lijuan Wang, Yon K. Sung, Lajos Gera, Andrew J. Patterson, Rani Agrawal, Marlene Rabinovitch, Kelly Ambler, Carlin S. Long, Norbert F. Voelkel, Mark R. Nicolls
Journal: Circulation Research (2011)

Pulmonary arterial hypertension (PAH) is an incurable disease associated with viral infections and connective tissue diseases. The relationship between inflammation and disease pathogenesis in these disorders remains poorly understood. To determine whether immune dysregulation due to absent T-cell populations directly contributes to the development of PAH. Vascular endothelial growth factor receptor 2 (VEGFR2) blockade induced significant pulmonary endothelial apoptosis in T-cell-deficient rats but not in immune-reconstituted (IR) rats. T cell-lymphopenia in association with VEGFR2 blockade resulted in periarteriolar inflammation with macrophages, and B cells even prior to vascular remodeling and elevated pulmonary pressures. IR prevented early inflammation and attenuated PAH development. IR with either CD8 T cells alone or with CD4-depleted spleen cells was ineffective in preventing PAH, whereas CD4-depleting immunocompetent euthymic animals increased PAH susceptibility. IR with either CD4(+)CD25(hi) or CD4(+)CD25(-) T cell subsets prior to vascular injury attenuated the development of PAH. IR limited perivascular inflammation and endothelial apoptosis in rat lungs in association with increased FoxP3(+), IL-10- and TGF-β-expressing CD4 cells, and upregulation of pulmonary bone morphogenetic protein receptor type 2 (BMPR2)-expressing cells, a receptor that activates endothelial cell survival pathways. PAH may arise when regulatory T-cell (Treg) activity fails to control endothelial injury. These studies suggest that regulatory T cells normally function to limit vascular injury and may protect against the development of PAH.
Cross-Sectional and Prospective Study of Lung Function in Adults With Type 2 Diabetes: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: John G. Teeter, Richard J. Riese
Journal: Diabetes Care (2008)

The study of Yeh et al. (1) raises awareness of the pulmonary dysfunction associated with type 2 diabetes. Prospective 2-year controlled lung function data regarding subjects with type 2 diabetes from the inhaled insulin (Exubera) development program have recently been published (2,3) and extend the results reported by Yeh et al. The subjects enrolled in these studies were predominantly middle-aged, type 2 diabetic Caucasian men and women who had never smoked or who had stopped smoking and who had normal or near-normal lung function at study entry. Barnett et al. (2) observed mean annualized declines in forced expiratory volume in 1 s (FEV1) and carbon …
Sulfhydryl Redox State Affects Susceptibility to Ischemia and Sarcoplasmic Reticulum Ca <sup>2+</sup> Release in Rat Heart
Authors: Riccardo Zucchi, Gongyuan Yu, Paola Galbani, Mario Mariani, Giovanni Ronca, Simonetta Ronca-Testoni
Journal: Circulation Research (1998)

Abstract —We investigated the effect of sulfhydryl and disulfide reagents on ischemic preconditioning and on sarcoplasmic reticulum Ca 2+ release. Isolated working rat hearts were subjected to ischemic preconditioning (three 3-minute periods of global ischemia) or to control aerobic perfusion, which was followed by 30 minutes of global ischemia and 120 minutes of retrograde reperfusion. Necrosis was evaluated on the basis of lactate dehydrogenase release and triphenyltetrazolium chloride staining. In parallel experiments, sarcoplasmic reticulum Ca 2+ release and [ 3 H]-ryanodine binding were determined before the sustained ischemia. Ischemic preconditioning was associated with protection versus ischemic injury, decreased Ca 2+ release and reduced [ 3 H]-ryanodine binding. The disulfide reducing agent dithiothreitol (1 mmol/L) removed the protection provided by ischemic preconditioning, if added to the perfusion buffer either before or after the preconditioning procedure. In preconditioned hearts, dithiothreitol increased sarcoplasmic reticulum Ca 2+ release and ryanodine binding, whereas in control hearts it had no effect on either tissue injury or sarcoplasmic reticulum function. Perfusion of control hearts with the sulfhydryl blocking agents 4,4′-dithiodipyridine (25 μmol/L) and N-ethylmaleimide (16 μmol/L) increased the resistance to ischemia and reduced sarcoplasmic reticulum Ca 2+ release and [ 3 H]-ryanodine binding. These effects were not additive with those induced by preconditioning. Sulfhydryl and disulfide reagents produced similar effects on Ca 2+ release and [ 3 H]-ryanodine binding if added in vitro to preparations obtained from control and preconditioned hearts. We conclude that ischemic preconditioning is associated with the oxidation of sulfhydryl groups involved in the modulation of sarcoplasmic reticulum Ca 2+ release.
Influence on the Health of the Partner Affected by Tumor Disease in the Wife or Husband Based on a Population-Based Register Study of Cancer in Sweden
Authors: Katarina Sjövall, Bo Attner, Thor Lithman, Dennis Noreen, Barbro Gunnars, Bibbi Thomé, Håkan Olsson
Journal: Journal of Clinical Oncology (2009)

To examine health care use and health care costs among partners of persons with cancer.Partners of patients with colon, rectal, lung, breast, and prostate cancer (N = 11,076) were identified via linked data from the Tumor Registry of Southern Sweden and Census Registry of Sweden. Health care use, total costs of health care, and diagnosis of the partner were studied before and after diagnosis of the cancer patient.Health care use for partners increased in terms of in-patient care after the cancer diagnosis. A significant increase was seen the second year for partners of patients with colon cancer (risk ratio [RR], 1.55; 95% CI, 1.28 to 1.87) and lung cancer (RR, 1.50; 95% CI, 1.26 to 1.79). Psychiatric diagnoses increased after the cancer diagnosis in the total sample, with a significant increase for partners of colon (RR, 2.66; 95% CI, 1.71 to 4.22), lung (RR, 3.16; 95% CI, 2.23 to 4.57), and prostate cancer patients (RR, 1.68; 95% CI, 1.32 to 2.15). Costs of care increased more than the consumer price index the two years after the cancer diagnosis. Costs of care increased most for male partners and especially for younger male partners (age 25 to 64 years) of patients with colon, rectal, and lung cancers.The results showed increased health care costs and an increase in psychiatric diagnoses after the cancer diagnosis among partners of cancer patients. Further research is needed to learn more about the situation of the partner and to identify persons at risk of psychiatric morbidity. Knowledge is also needed on how to support the partner in the most efficient way.
Endothelial Health and Diversity in the Kidney
Authors: Mark S. Segal, Chris Baylis, Richard J. Johnson
Journal: Journal of the American Society of Nephrology (2006)

The endothelial cells that line all blood vessels are essential in maintaining vascular tone, largely through the production of the vasodilators nitric oxide (NO) and prostacyclin, and antithrombogenic properties, via the production of the tissue-type plasminogen activator (t-PA) and glycocalyx.
Urinary excretion of bile acid glucosides and glucuronides in extrahepatic cholestasis
Authors: Hubertus Wietholtz, Hanns-Ulrich Marschall, Regina Reuschenbach, Heidrun Matern, Siegfried Matern
Journal: Hepatology (1991)

Recently the formation of bile acid glucosides has been described as a novel conjugation mechanism in vitro and in vivo. In 10 patients with extrahepatic cholestasis caused by carcinoma of the head of the pancreas we investigated excretion rates and profiles of urinary bile acid glucosides. Urinary bile acid glucosides and, for comparison, bile acid glucuronides were extracted and characterized according to established methods. In controls total urinary bile acid glucoside excretion was 0.22 +/- 0.03 mumol/24 hr (mean +/- S.E.M.)-in the range of bile acid glucuronide excretion (0.41 +/- 0.06 mumol/24 hr; mean +/- S.E.M.). A gas chromatography-mass spectrometry-characterized trihydroxy bile acid glucoside of still-unknown hydroxyl positions accounted for 65% of total urinary bile acid glucosides. In extrahepatic cholestasis total urinary bile acid glucoside excretion was 0.52 +/- 0.13 mumol/24 hr (mean +/- SEM), yet significantly lower than bile acid glucuronide excretion (1.53 +/- 0.13 mumol/24 hr; mean +/- SEM; p less than 0.001). In cholestasis the primary bile acid derivatives cholic and chenodeoxycholic acid glucosides amounted to 90%, whereas the trihydroxy bile acid glucoside had decreased to 5% of total bile acid glucoside excretion, indicating its alteration during enterohepatic circulation. The data establish the composition and quantity of urinary bile acid glucosides in healthy controls and cholestasis and constitute a quantitative comparison with another glycosidic conjugation reaction, bile acid glucuronidation.
Oral tolerance and Treg cells are induced in BALB/c mice after gavage with bovine β-lactoglobulin
Authors: K. Adel-Patient, S. Wavrin, H. Bernard, N. Meziti, S. Ah-Leung, J.-M. Wal
Journal: Allergy (2011)

Food allergy is considered as resulting from an impaired development or a breakdown of oral tolerance. We aimed to induce oral tolerance to the major cow's milk allergen bovine β-lactoglobulin (BLG) or corresponding trypsin hydrolysates (BLG-Try) and to investigate the mechanisms involved.Wild-type BALB/cJ mice were gavaged on days 1-3 and 8-10 with different doses of native BLG (nBLG) or with nBLG-Try and were then sensitized on day 14 by i.p. administration of BLG in alum. Sensitization was assessed by measurement of BLG-specific antibodies in sera and of cytokines secreted by BLG-reactivated splenocytes. Elicitation of the allergic reaction was assessed by measurement of cytokines and mMCP-1 in sera collected 35 min after an oral challenge. Cellular and biochemical markers of the allergic reaction were also analysed in bronchoalveolar lavage fluids (BAL) collected 24 h after intra-nasal challenge. Analysis of the CD4(+) CD25(+) Foxp3(+) cells in different organs obtained 3 days after gavage and in vivo depletion of CD25(+) cells before oral tolerance induction were then performed.Systemic sensitization and elicitation of the allergic reaction were totally inhibited in mice gavaged with 2 mg of nBLG whereas nBLG-Try was far less efficient. A high percentage of CD4(+) Foxp3(+) cells were observed in BAL from tolerant mice, and a negative correlation between the number of eosinophils and the percentage of Foxp3(+) cells was evidenced. Efficient induction of CD4(+) CD25(+) Foxp3(+) cells after nBLG gavage and impaired oral tolerance induction after in vivo depletion of CD25 cells were then demonstrated.For the first time, allergen-induced Treg cells that inhibited both the sensitization and the elicitation of the allergic reaction were evidenced in gavaged wild-type mice.
Glomerular and vascular atrial natriuretic factor receptors in cardiomyopathic hamsters: correlation with the peptide biological effects
Authors: V. Cachofeiro, E. L Schiffrin, M. Cantin, R. Garcia
Journal: Cardiovascular Research (1990)

Journal Article Glomerular and vascular atrial natriuretic factor receptors in cardiomyopathic hamsters: correlation with the peptide biological effects Get access Victorio Cachofeiro, Victorio Cachofeiro Laboratory of Experimental Hypertension and Vasoactive Peptides, Clinical Research Institute of Montreal, 110 Pine Avenue West, Montreal, Quebec, Canada H2W 1R7 Correspondence to: Dr Garcia Search for other works by this author on: Oxford Academic PubMed Google Scholar Ernesto L Schiffrin, Ernesto L Schiffrin Laboratory of Experimental Hypertension and Vasoactive Peptides, Clinical Research Institute of Montreal, 110 Pine Avenue West, Montreal, Quebec, Canada H2W 1R7 Search for other works by this author on: Oxford Academic PubMed Google Scholar Marc Cantin, Marc Cantin Laboratory of Experimental Hypertension and Vasoactive Peptides, Clinical Research Institute of Montreal, 110 Pine Avenue West, Montreal, Quebec, Canada H2W 1R7 Search for other works by this author on: Oxford Academic PubMed Google Scholar Raul Garcia Raul Garcia Laboratory of Experimental Hypertension and Vasoactive Peptides, Clinical Research Institute of Montreal, 110 Pine Avenue West, Montreal, Quebec, Canada H2W 1R7 Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 24, Issue 10, October 1990, Pages 843–850, https://doi.org/10.1093/cvr/24.10.843 Published: 01 October 1990 Article history Received: 12 February 1990 Accepted: 08 June 1990 Published: 01 October 1990
Developmental and Neurological Status of Children at 4 Years of Age After Heart Surgery With Hypothermic Circulatory Arrest or Low-Flow Cardiopulmonary Bypass
Authors: David C. Bellinger, David Wypij, Karl C. K. Kuban, Leonard A. Rappaport, Paul R. Hickey, Gil Wernovsky, Richard A. Jonas, Jane W. Newburger
Journal: Circulation (1999)

Background —It is not known whether developmental and neurological outcomes in the preschool period differ depending on whether the predominant vital organ support strategy used in infant heart surgery was total circulatory arrest (CA) or low-flow cardiopulmonary bypass. Methods and Results —Infants with D-transposition of the great arteries who underwent an arterial-switch operation were randomly assigned to a support method consisting predominantly of CA or low-flow cardiopulmonary bypass. Developmental and neurological status were evaluated blindly at 4 years of age in 158 of 163 eligible children (97%). Neither IQ scores nor overall neurological status were significantly associated with either treatment group or duration of CA. The CA group scored lower on tests of motor function (gross motor, P =0.01; fine motor, P =0.03) and had more severe speech abnormalities (oromotor apraxia, P =0.007). Seizures in the perioperative period, detected either clinically or by continuous electroencephalographic monitoring, were associated with lower mean IQ scores (12.6 and 7.7 points, respectively) and increased risk of neurological abnormalities (odds ratios, 8.4 and 5.6, respectively). The performance of the full cohort was below expectations in several domains, including IQ, expressive language, visual-motor integration, motor function, and oromotor control. Conclusions —Use of CA to support vital organs during open heart surgery in infancy is associated, at the age of 4 years, with worse motor coordination and planning but not with lower IQ or with worse overall neurological status.