tbuckley/cabot-search huggingface dataset:
Incidence, annualized cost, and utilization burden in patients with metastatic renal cell carcinoma
Authors: J. P. Burke, Z. Liu, J. Zheng, J. Johnson
Journal: Journal of Clinical Oncology (2009)

e17529 Background: Data on burden of metastatic renal cell carcinoma (MRCC) is scarce. The objectives of this study are to examine the incidence of MRCC and the cost and utilization burden of MRCC over time. Methods: Administrative claims data from a large, US managed care plan were used to identify commercially insured and Medicare enrollees with newly diagnosed MRCC during 01/01/03–12/31/07 and continuous enrollment 12 months prior to and at least 90 days after MRCC diagnosis. Mean (median) costs and utilization during the follow-up period were annualized. Costs were 2007 CPI-adjusted. Results: 1,427 patients were identified with newly diagnosed MRCC (average age: 62.4 years 62.6% male). The annual incidence of MRCC in the managed care plan population was 3.4, 3.8, 2.9, 3.3, and 4.4 per 100,000 enrollees in 2003 through 2007, respectively. The mean (median) annual number of ambulatory visits per patient increased among patients diagnosed in 2003 to those diagnosed in 2007, from 44.9 (33.2) to 63.7 (54.8). Mean (median) annual medical costs per patient increased by year of diagnosis from $70,797 ($33,031) in 2003 to $92,521 ($48,117) in 2007. Pharmacy costs (excluding costs for medications delivered in medical settings) increased from $5,651 ($2,004) to $13,290 ($3,609), and were approximately 7.4%-14.3% of total costs during the time period. Conclusions: This study showed an apparent slight increase in MRCC incidence rates and revealed that treatment costs and health care utilization per patient increased substantially from 2003–2007 among members of this US managed care plan. The increases in health care utilization and cost suggest the evolution in treatment options over time as more therapies become available. No significant financial relationships to disclose.
Abstract P327: Adherence to the Alternative Healthy Eating Index is Associated with a Lower Risk of Acute Myocardial Infarction Among Singapore Chinese Adults
Authors: Nithya Neelakantan, Nasheen Naidoo, Hyungwon Choi, Woon-Puay Koh, Jian Min Yuan, Rob Martinus van Dam
Journal: Circulation (2015)

Introduction: Adherence to the Alternative Healthy Eating Index-2010 (AHEI-2010) has been associated with lower risk of acute myocardial infarction (AMI) in Western populations. It remains unclear if this association is present in Asian populations. Little is known about potential biological mediators of the association between the AHEI-2010 and AMI. Objective: We investigated the association between adherence to the AHEI-2010 and AMI related biomarkers and their potential role as mediators of the association between the AHEI-2010 and risk of AMI in a Chinese population. Methods: We conducted a nested case-control study (subcohort: n=2,198; verified AMI events: n=751) within a large prospective cohort of Singapore Chinese established between April 1993 and December 1998 involving Chinese men and women aged 45-74 years. Habitual diet was assessed with baseline in-person interviews using a validated, semi-quantitative food frequency questionnaire. Cases were ascertained via linkage with nationwide hospital databases and Singapore Birth and Death Registry. We evaluated the association between the AHEI-2010 and several AMI related biomarkers, such as HbA1c, markers of dyslipidemia (low-density lipoprotein, high-density lipoprotein and triglycerides) and inflammation (C-reactive protein), and blood pressure measurements. A conditional logistic regression model was used to estimate the odds ratios and 95% confidence intervals of AMI risk associated with quartiles of AHEI-2010 scores adjusting for potential confounders. Results: We documented 751 incident AMI events (nonfatal AMI=564; fatal AMI = 288). There were 489 AMI events observed in men and 262 AMI events in women. The AHEI-2010 was inversely associated with the risk of AMI (P trend =0.001) in a dose-dependent manner. Compared to the lowest quartile, participants in the highest quartile had a 37% reduction in the AMI risk (OR: 0.63; 95% CI: 0.48, 0.82). Favorable associations were more evident in men (OR: 0.57; 95% CI: 0.40, 0.80) than women (OR: 0.81; 95% CI: 0.51, 1.28). Further adjustments of single biomarkers and their combinations as potential intermediates in the multivariable models did not explain the association between AHEI-2010 and AMI risk (OR: 0.61; 95% CI: 0.44-0.83). Conclusion: In the Singapore Chinese adult population, greater adherence to the AHEI-2010 is associated with a lower risk of AMI. The inverse dose-dependent association between AHEI-2010 and AMI risk was not explained by the potential biological intermediates evaluated in this study.
Clinical factors affecting the late resistance to gefitinib in patients with non-small cell lung cancer (NSCLC)
Authors: Y. Segawa, K. Hotta, S. Umemura, Y. Fujiwara, T. Shinkai, H. Ueoka, N. Takigawa, M. Tabata, K. Kiura, M. Tanimoto
Journal: Journal of Clinical Oncology (2006)

7191 Background: The mechanism of late resistance of NSCLC to gefitinib is unclear. In this study, we assessed clinical factors affecting the late resistance in patients with NSCLC. Methods: Between 2000 and 2004, 197 consecutive patients with NSCLC underwent treatment with gefitinib in our institutions. Of those, 56 patients who had received a prior chemotherapy and continued treatment with gefitinib during at least 6 months were included in this study. The characteristics of these patients were as follows: median age, 62.5 years (range, 28 to 77 years); male/female, 22/34 patients; PS 0/1/2/3/4, 15/31/8/0/2 patients; and adeno/nonadenocarcinoma, 52/4 patients. Thirty-two patients never smoked and 24 were former or current smokers. Nineteen patients underwent surgical resection of NSCLC. Numbers of chemotherapy regimens were one in 31 patients, two in 18, three in 6, four in 1, respectively. Results: Of 56 patients, three achieved a CR and 39 attained a PR, with an overall response rate of 75% (95% CI, 69.2 to 80.8%). The remaining 14 patients had a long SD. At a median follow-up time of 21.6 months (range, 7.7 to 59.7 months), median time to progression was 19.5 months, with progression-free survival rates of 68.5% at 1-year, 33.6% at 2-year, and 21.2% at 3-year, respectively. In a univariate analysis regarding progression-free survival, presences of metastasis to brain (p = 0.008), bone (p = 0.025), liver (p = 0.046), and adrenal (p = 0.008), decreased levels of hemoglobin (p = 0.021) and albumin (p = 0.017), and use of multiple chemotherapy regimens prior to treatment with gefitinib (p = 0.026) were significant factors. In a multivariate analysis using Cox proportional hazard model, presence of brain metastasis was a significant factor clinically affecting the late resistance to gefitinib (hazard ratio, 2.14; 95% CI, 1.10 to 4.17, p = 0.025). In addition, decreased hemoglobin level (p = 0.074) and prior multiple chemotherapy regimens (p = 0.069) were tended to be significant. Conclusions: In patients undergoing treatment with gefitinib, presence of brain metastasis was an important factor indicative of the emergence of late resistance in this study. It is needed to confirm this finding in a large cohort of patients with NSCLC. No significant financial relationships to disclose.
Prevalence and Correlates of DSM-5 Cannabis Use Disorder, 2012-2013: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions–III
Authors: Deborah S. Hasin, Bradley T. Kerridge, Tulshi D. Saha, Boji Huang, Roger Pickering, Sharon M. Smith, Jeesun Jung, Haitao Zhang, Bridget F. Grant
Journal: American Journal of Psychiatry (2016)

Attitudes toward marijuana are changing, the prevalence of DSM-IV cannabis use disorder has increased, and DSM-5 modified the cannabis use disorder criteria. Therefore, updated information is needed on the prevalence, demographic characteristics, psychiatric comorbidity, disability, and treatment for DSM-5 cannabis use disorder.
The effects of phenylethylamine in rhesus monkeys
Authors: J R Tinklenberg, J C Gillin, G M Murphy, R Staub, R J Wyatt
Journal: American Journal of Psychiatry (1978)

In controlled experiments rhesus monkeys that had received phenylethylamine (PEA) demonstrated behavior similar to that reported after the administration of amphetamines, except that tolerance to PEA did not develop. These findings are of psychiatric interest because PEA is found in the human body and is a specific substrate for type B MAO, which is found in decreased quantities in certain schizophrenic patients.
Trends and comparison of female first authorship in high impact medical journals: observational study (1994-2014)
Authors: Giovanni Filardo, Briget da Graca, Danielle M Sass, Benjamin D Pollock, Emma B Smith, Melissa Ashley-Marie Martinez
Journal: BMJ (2016)

<b>Objective</b>&nbsp;To examine changes in representation of women among first authors of original research published in high impact general medical journals from 1994 to 2014 and investigate differences between journals. <b>Design</b>&nbsp;Observational study. <b>Study sample</b>&nbsp;All original research articles published in <i>Annals of Internal Medicine</i>, <i>Archives of Internal Medicine, The BMJ, JAMA, The Lancet,</i> and the <i>New England Journal of Medicine (NEJM)</i> for one issue every alternate month from February 1994 to June 2014. <b>Main exposures</b>&nbsp;Time and journal of publication. <b>Main outcome measures</b>&nbsp;Prevalence of female first authorship and its adjusted association with time of publication and journal, assessed using a multivariable logistic regression model that accounted for number of authors, study type and specialty/topic, continent where the study was conducted, and the interactions between journal and time of publication, study type, and continent. Estimates from this model were used to calculate adjusted odds ratios against the mean across the six journals, with 95% confidence intervals and P values to describe the associations of interest. <b>Results</b>&nbsp;The gender of the first author was determined for 3758 of the 3860 articles considered; 1273 (34%) were women. After adjustment, female first authorship increased significantly from 27% in 1994 to 37% in 2014 (P&lt;0.001). The <i>NEJM</i> seemed to follow a different pattern, with female first authorship decreasing; it also seemed to decline in recent years in <i>The BMJ</i> but started substantially higher (approximately 40%), and <i>The BMJ</i> had the highest total proportion of female first authors. Compared with the mean across all six journals, first authors were significantly less likely to be female in the <i>NEJM</i> (adjusted odds ratio 0.68, 95% confidence interval 0.53 to 0.89) and significantly more likely to be female in <i>The BMJ</i> (1.30, 1.01 to 1.66) over the study period. <b>Conclusions</b>&nbsp;The representation of women among first authors of original research in high impact general medical journals was significantly higher in 2014 than 20 years ago, but it has plateaued in recent years and has declined in some journals. These results, along with the significant differences seen between journals, suggest that underrepresentation of research by women in high impact journals is still an important concern. The underlying causes need to be investigated to help to identify practices and strategies to increase women’s influence on and contributions to the evidence that will determine future healthcare policies and standards of clinical practice.
Risk of Subsequent Infection Among Patients Receiving Tumor Necrosis Factor Inhibitors and Other Disease‐Modifying Antirheumatic Drugs
Authors: Neil A. Accortt, Machaon M. Bonafede, David H. Collier, Jan Iles, Jeffrey R. Curtis
Journal: Arthritis & Rheumatology (2015)

To describe the incidence of subsequent serious infections in patients who received systemic drug therapy after an initial serious infection. Patients with rheumatic conditions (rheumatoid arthritis [RA], psoriatic arthritis, ankylosing spondylitis) or psoriasis who experienced a serious infection between January 1, 2006 and December 31, 2011 were identified in a claims database. Patients were required to be continuously enrolled in the Truven Health Analytics MarketScan Research Database for 12 months prior to and at least 60 days after the date of discharge or the end of intravenous antibiotic therapy for the index serious infection. Subsequent serious infection incidence rates per 100 patient-years with 95% confidence intervals (95% CIs) were calculated for up to 18 months post-index, starting 60 days post-index. Cox proportional hazards models were used to adjust for baseline demographic and clinical characteristics, treatment duration, and changes during followup. Among the 21,699 patients who met the inclusion criteria, the majority (84.3%) had RA. Patients who received tumor necrosis factor (TNF) inhibitor therapy after their index infection had a lower rate of subsequent serious infections (18.1 per 100 patient-years for those treated with a TNF inhibitor alone and 17.3 per 100 patient-years for those treated with a TNF inhibitor plus a nonbiologic disease-modifying antirheumatic drug [DMARD]) compared with those treated with a nonbiologic DMARD alone (21.4 per 100 patient-years). Etanercept, either alone (adjusted hazard ratio [HR] 0.87, 95% CI 0.77-0.99) or in combination with a nonbiologic DMARD (adjusted HR 0.76, 95% CI 0.66-0.88), and infliximab (only in combination with a nonbiologic DMARD) (adjusted HR 0.80, 95% CI 0.67-0.95) were associated with a significantly lower risk of subsequent serious infections compared with a nonbiologic DMARD alone. We did not observe an increased risk of subsequent infection in patients who received TNF inhibitor treatment following a serious infection. The risk of a subsequent serious infection was lower in patients treated with both a TNF inhibitor and a nonbiologic DMARD compared with that in patients treated with a nonbiologic DMARD alone.
Marek's Disease in Immunosuppressed Chickens: Growth of a Transplantable Lymphoma and Development of the Disease by Natural Exposure&lt;xref ref-type="fn" rid="fn2"&gt;2&lt;/xref&gt;&lt;xref ref-type="fn" rid="fn3"&gt;3&lt;/xref&gt;
Authors: P F Cotter, R M Jakowski, T N Fredrickson, L W Schierman, R A McBride
Journal: JNCI Journal of the National Cancer Institute (1975)

Evidence indicated that treatment of chickens with Cytoxan at hatching (bursectomy) had little effect on the development of transplantable Marek's disease (md) lymphoma. Cytoxan treatment of chickens at 2 and 3 weeks of age, however, apparently reduced the incidence of visceral tumors in chickens naturally exposed to MD. Amelioration of MD in immunosuppressed chickens was possibly mediated through suppression of MD-induced T-cell proliferation.
Early sirolimus immunosuppression is safe in lung transplantation
Authors: Jacek Wojarski, Slawek Zeglen, Marek Ochman, Wojtek Karolak, Marian Zembala
Journal: European Respiratory Journal (2012)

BACKGROUND: Sirolimus based immunosuppression administered de-novo after LTx has been shown to be associated with bronchial anastomosis healing complications. We hypothesized that, in select LTx recipients, sirolimus due to its antiproliferative properties and minimal side effect profile when began within the first post-operative month is safe and associated with a favourable short and long term outcome.  MATERIALS AND METHODS: Between December 2004 and October 2011, 62 LTx were performed at a single institution. Ten patients (16.1%) mean age 46.9 ± 11.9 years old were selected to received early sirolimus based immunosuppression regime along with cyclosporine and prednisone with all receiving induction immunosuppression. Patients were selected to receive early sirolimus based on an uncomplicated post-operative course and decisively after bronchoscopic assessment.  RESULTS: Sirolimus was begun on mean POD 20.5 ± 5.4 (14-32). In-hospital / 30-day mortality was 0%. On long-term follow up 3 patients died, 2 due to bacterial infection and in one patient PCP infection. Mean survival was 3.6 ± 1.9 years (1.1 – 6.9), 1-year survival was 90% and 5-year survival was 75%. In 4 patients (40%) sirolimus was stopped, in 3 due to infection and in one because of re-transplant. None of the patients displayed BOS based on FEV1. In the patients still taking sirolimus renal function was within normal range. The study patients did not suffer increased rate of bacterial, PCP or CMV infection when compared to standard immunosuppression patients.  CONCLUSION: Contradictive to previously published studies, our results show that early sirolimus based immunosuppression is safe and is associated with a beneficial side-effect profile.
Primary prevention and risk factor reduction in coronary heart disease mortality among working aged men and women in eastern Finland over 40 years: population based observational study
Authors: Pekka Jousilahti, Tiina Laatikainen, Markku Peltonen, Katja Borodulin, Satu Männistö, Antti Jula, Veikko Salomaa, Kennet Harald, Pekka Puska, Erkki Vartiainen
Journal: BMJ (2016)

<b>Objective</b>&nbsp;To estimate how much changes in the main risk factors of cardiovascular disease (smoking prevalence, serum cholesterol, and systolic blood pressure) can explain the reduction in coronary heart disease mortality observed among working aged men and women in eastern Finland. <b>Design</b>&nbsp;Population based observational study. <b>Setting</b>&nbsp;Eastern Finland. <b>Participants</b>&nbsp;34 525 men and women aged 30-59 years who participated in the national FINRISK studies between 1972 and 2012. <b>Interventions</b>&nbsp;Change in main cardiovascular risk factors through population based primary prevention. <b>Main outcome measures</b>&nbsp;Predicted and observed age standardised mortality due to coronary heart disease. Predicted change was estimated with a logistic regression model using risk factor data collected in nine consecutive, population based, risk factor surveys conducted every five years since 1972. Data on observed mortality were obtained from the National Causes of Death Register. <b>Results</b>&nbsp;During the 40 year study period, levels of the three major cardiovascular risk factors decreased except for a small increase in serum cholesterol levels between 2007 and 2012. From years 1969-1972 to 2012, coronary heart disease mortality decreased by 82% (from 643 to 118 deaths per 100 000 people) and 84% (114 to 17) among men and women aged 35-64 years, respectively. During the first 10 years of the study, changes in these three target risk factors contributed to nearly all of the observed mortality reduction. Since the mid-1980s, the observed reduction in mortality has been larger than predicted. In the last 10 years of the study, about two thirds (69% in men and 66% in women) of the reduction could be explained by changes in the three main risk factors, and the remaining third by other factors. <b>Conclusion</b>&nbsp;Reductions in disease burden and mortality due to coronary heart disease can be achieved through the use of population based primary prevention programmes. Secondary prevention among high risk individuals and treatment of acute events of coronary heart disease could confer additional benefit.
Fever in an intravenous drug user
Authors: Jennifer van Griethuysen, Simon W Dubrey
Journal: BMJ (2016)

A 29 year old intravenous drug user presented to the acute medical unit feeling generally unwell. On clinical examination he was found to be in septic shock with a fever of 39.2°C. A septic screen was performed and broad spectrum antibiotics started empirically. Staphylococcus aureus was grown in both blood culture bottles after one day. An echocardiogram showed a large irregular mass on …
Abstract 17023: Endoplasmic Reticulum Stress Regulates Protein-Tyrosine Phosphatase 1B Expression and Cellular Glucose Uptake in Obesity
Authors: Evgeniy Evgeniy Panzhinskiy, Yinan Hua, Bruce Culver, Jun Ren, Sreejayan Nair
Journal: Circulation (2012)

Obesity is associated with an increased risk of developing insulin resistance and type-2 diabetes. Sustained obesity overwhelms the capacity of endoplasmic reticulum (ER) for the folding of protein...
Prevalence of Venous and Arterial Thrombosis Among 268 Heterozygous and 111 Homozygous Factor V Leiden Carriers: a Single-Center Cross-Sectional Study
Authors: Juliana Perez Botero, Wayne D. Ormsby, Aneel A Ashrani, Robert D McBane, Waldemar E Wysokinski, Mrinal M. Patnaik, Rajiv K Pruthi, John A. Heit
Journal: Blood (2014)
Age and Breed Effects on Induction of Fibrosarcomas by Dibenz[&lt;italic&gt;a,h&lt;/italic&gt;]anthracene in Pigeons&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: Prichard, R. W., Eubanks, J. W., Hazlett, C. C.
Journal: JNCI Journal of the National Cancer Institute (1964)

Journal Article Age and Breed Effects on Induction of Fibrosarcomas by Dibenz[a,h]anthracene in Pigeons Get access R. W. Prichard, M.D., R. W. Prichard, M.D. Department of Pathology and the Vivarium, Bowman Gray School of Medicine of Wake Forest College, Winston-Salem, North Carolina Search for other works by this author on: Oxford Academic PubMed Google Scholar J. W. Eubanks, D.V.M., J. W. Eubanks, D.V.M. Department of Pathology and the Vivarium, Bowman Gray School of Medicine of Wake Forest College, Winston-Salem, North Carolina Search for other works by this author on: Oxford Academic PubMed Google Scholar C. C. Hazlett C. C. Hazlett Department of Pathology and the Vivarium, Bowman Gray School of Medicine of Wake Forest College, Winston-Salem, North Carolina Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 32, Issue 4, April 1964, Pages 905–915, https://doi.org/10.1093/jnci/32.4.905 Published: 01 April 1964 Article history Received: 26 September 1963 Published: 01 April 1964
Zika virus may be linked to several birth defects, expert warns
Authors: Anne Gulland
Journal: BMJ (2016)

The Zika virus may be linked to other congenital malformations, not just microcephaly, a Brazilian public health expert has warned.

Paulo Buss, director of the global health centre at the Oswaldo Cruz Foundation in Rio de Janeiro, told a press conference that scientists were still not “aware of all the consequences” of infection with the virus. “The extent to which the epidemic will affect pregnant mothers is not known, nor what the outcome of their babies will be,” he said. “Other manifestations may emerge.”

Buss said that initial findings from a cohort of pregnant women being studied showed that the virus, spread by the Aedes …
A man with COPD, fever, and leucocytosis
Authors: R. Murthy, K. Kernstine
Journal: BMJ (2015)

A 68 year old man with severe chronic obstructive pulmonary disease (COPD), who was on home oxygen and still smoked, presented to the emergency room with fever, fatigue, and leucocytosis (14×109 white blood cells/L). Computed tomography was performed (fig 1⇓). What is the diagnosis?



Fig 1 Sagittal computed tomography image



An infection within a giant bulla.

### Discussion

Infections within a …