tbuckley/cabot-search huggingface dataset:
Cancer statistics, 2015
Authors: Rebecca L. Siegel, Kimberly D. Miller, Ahmedin Jemal
Journal: CA A Cancer Journal for Clinicians (2015)

Abstract Each year the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States in the current year and compiles the most recent data on cancer incidence, mortality, and survival. Incidence data were collected by the National Cancer Institute (Surveillance, Epidemiology, and End Results [SEER] Program), the Centers for Disease Control and Prevention (National Program of Cancer Registries), and the North American Association of Central Cancer Registries. Mortality data were collected by the National Center for Health Statistics. A total of 1,658,370 new cancer cases and 589,430 cancer deaths are projected to occur in the United States in 2015. During the most recent 5 years for which there are data (2007‐2011), delay‐adjusted cancer incidence rates (13 oldest SEER registries) declined by 1.8% per year in men and were stable in women, while cancer death rates nationwide decreased by 1.8% per year in men and by 1.4% per year in women. The overall cancer death rate decreased from 215.1 (per 100,000 population) in 1991 to 168.7 in 2011, a total relative decline of 22%. However, the magnitude of the decline varied by state, and was generally lowest in the South (∼15%) and highest in the Northeast (≥20%). For example, there were declines of 25% to 30% in Maryland, New Jersey, Massachusetts, New York, and Delaware, which collectively averted 29,000 cancer deaths in 2011 as a result of this progress. Further gains can be accelerated by applying existing cancer control knowledge across all segments of the population. CA Cancer J Clin 2015;65:5–29. © 2015 American Cancer Society.
Microalbuminuria, Cardiovascular, and Renal Risk in Primary Hypertension
Authors: Roberto Pontremoli, Giovanna Leoncini, Maura Ravera, Francesca Viazzi, Simone Vettoretti, Elena Ratto, Denise Parodi, Cinzia Tomolillo, Giacomo Deferrari
Journal: Journal of the American Society of Nephrology (2002)

ABSTRACT. Microalbuminuria is defined as abnormal urinary excretion of albumin between 30 and 300 mg/d. It can be measured accurately by several widely available and sensitive methods. This abnormality can be found in 8 to 15% of nondiabetic patients with primary hypertension, although its prevalence varies greatly in the literature, likely due to differences in the methods used to detect it and to the criteria applied in the selection of patients. The pathogenetic mechanisms leading to the development of microalbuminuria are still not completely known. BP load and increased systemic vascular permeability, possibly due to early endothelial damage, seem to play a major role. Increased urinary albumin excretion has been associated with several unfavorable metabolic and nonmetabolic risk factors and subclinical hypertensive organ damage. In fact, a higher prevalence of concentric left ventricular hypertrophy and subclinical impairment of left ventricular performance, as well as the presence of carotid atherosclerosis, have been reported in patients with microalbuminuria. These associations might per se justify a greater incidence of cardiovascular events. Long-term longitudinal studies have recently confirmed the unfavorable prognostic significance of microalbuminuria in hypertensive patients. It has also been hypothesized that microalbuminuria might be a forerunner of overt renal damage in primary hypertension. Clinical studies, however, have shown conflicting results, and this hypothesis has to be considered tempting but speculative at present. In conclusion, microalbuminuria is a specific, integrated marker of cardiovascular risk and target organ damage in primary hypertension and one that is suitable for identifying patients at higher global risk. A wider use of this test in the diagnostic work-up of hypertensive patients is recommended. E-mail; [email protected]
Expression of thrombospondin-1 and its receptor CD36 in human osteoarthritic cartilage
Authors: D. Pfander
Journal: Annals of the Rheumatic Diseases (2000)

Thrombospondin-1 (TSP-1), a trimeric glycoprotein, is involved in cell-matrix interactions of various tissues, particularly in cartilage. Biochemical analyses show expression of TSP-1 in human cartilage, but its cellular source as well as the presence of its main surface receptors CD36 and CD51 in normal and osteoarthritic cartilage remain unknown. Therefore, to localise TSP-1 and its receptors immunohistochemistry and in situ hybridisation were used.Radioactive in situ hybridisations with an RNA probe that encodes TSP-1 combined with immunostaining were carried out to investigate the expression patterns of TSP-1, CD36, and CD51 in seven normal and 23 osteoarthritic human cartilage samples.In normal cartilage TSP-1 was present mainly in the middle and upper deep zone. RNA expression was predominantly seen over chondrocytes of the middle zone. CD36 was found in chondrocytes of the superficial and upper middle zone. In mild and moderate osteoarthritic cartilage an increased number of TSP-1 expressing chondrocytes were seen and an increased pericellular staining close to the surface. In severe osteoarthritic cartilage a decrease in the number of TSP-1 synthesising chondrocytes and a strong reduction in matrix staining were observed. Most of these severe osteoarthritic samples showed a strongly enhanced number of CD36 positive chondrocytes.The cellular source of TSP-1 in normal cartilage is mainly mid-zone chondrocytes, which also express CD36. In early osteoarthritic cartilage lesions an increase of TSP-1 was seen, whereas reduced TSP-1 synthesis is paralleled by a strong decrease in TSP-1 protein staining in severe osteoarthritis. Furthermore, in severe osteoarthritic cartilage the number of CD36 immunostained chondrocytes is significantly increased.
Clinical evidence: Urinary tract infection in children
Authors: J. Larcombe
Journal: BMJ (1999)

This review of the effects of treatment for urinary tract infection in children and of preventive interventions is one of over 60 chapters in the first issue of Clinical Evidence , published by the BMJ Publishing Group.

#### Key messages

Definition: Urinary tract infection is defined by the presence of a pure bacterial growth >105 colony forming units/ml. Lower counts of bacteria may be clinically important, especially in boys and in specimens obtained by urinary catheter. Any growth of typical urinary pathogens is considered clinically important if obtained by suprapubic aspiration. In practice, three age ranges are usually considered on the basis of differential …
Complete Long-Term Recovery of β-Cell Function in Autoimmune Type 1 Diabetes After Insulin Treatment
Authors: Beate Karges, Ivana Durinovic-Belló, Eberhard Heinze, Bernhard O. Boehm, Klaus-Michael Debatin, Wolfram Karges
Journal: Diabetes Care (2004)

rogressive loss of ␤-cell mass in type 1 diabetes results from CD4 ϩ and CD8 ϩ T-cell autoimmunity targeting insulin and other islet cell antigens.After initial treatment of type 1 diabetes, partial disease remission is found in 18 -80% of patients, with a mean duration of only 6 -10 months (1). ␤-Cell function in autoimmune type 1 diabetes
A case of recurrent squamous cell carcinoma of the vulva successfully treated by combination therapy with cetuximab and paclitaxel
Authors: M. Matsuzawa, T. Inozume, S. Sano, N. Ando, T. Onuma, K. Harada, T. Kawamura, S. Shimada
Journal: British Journal of Dermatology (2015)

Funding sources: none. Conflicts of interest: none declared. Dear Editor, Cetuximab is a monoclonal antibody that binds to epidermal growth factor receptor (EGFR) and blocks signalling, thereby inhibiting downstream intracellular signals.1 Recently, combination therapy with cetuximab and paclitaxel has been used as the standard therapy for squamous cell carcinoma (SCC) of the head and neck because of its high response rates and low toxicity in phase II studies.2 We report a case of recurrent SCC of the vulva that was resistant to radiotherapy and conventional chemotherapies, but was successfully treated by combination therapy with cetuximab and paclitaxel. A 52‐year‐old woman presented to our hospital complaining of a large tumour of the vulva. She was diagnosed with vulvar SCC with vaginal invasion, and multiple metastases to the inguinal lymph nodes. Administration of 5‐fluorouracil and cisplatin was not effective. Next she was treated with peplomycin (115 mg total) and radiotherapy (70 Gy total). After this therapy, her vulvar tumour and metastatic lymph nodes were regressed. However, 2 years later the vulvar tumour recurred. The tumour was found to have rapidly grown into the pelvis, in spite of administration of irinotecan (100 mg m−2 weekly). Based on the efficacy and tolerability of the combination therapy with cetuximab and paclitaxel for head and neck SCC, we initiated cetuximab (initial dose of 400 mg m−2, followed by 250 mg m−2) and paclitaxel (80 mg m−2), on a weekly basis. We confirmed high EGFR expression in the primary tumour (data not shown).
Tumor pseudoprogression following radiosurgery for vestibular schwannoma
Authors: C. Hayhurst, G. Zadeh
Journal: Neuro-Oncology (2011)

We sought to characterize vestibular schwannoma (VS) pseudoprogression after radiosurgery to assess its incidence, causative factors, and association with radiation-induced adverse effects. We performed a retrospective study of VS treated with Gamma Knife radiosurgery during 2005-2009. Seventy-five patients had at least 24 months of clinical and radiographic follow-up (median, 29 months) and were included. Tumor response was calculated volumetrically using Gamma plan software on consecutive MRIs. All treatment plans were reviewed for dosimetry characteristics. Forty-nine VS (65%) were stable or regressed after treatment. Seventeen (23%) underwent pseudoprogression, with onset of enlargement at 6 months. Seven (9%) remained larger than initial treatment volume at last follow-up. Nine (12%) had persistent growth. Three patients underwent subsequent microsurgery. One patient required intervention at 3 months for cystic enlargement; otherwise, all patients with progressive enlargement had stable VS until at least 24 months. Twenty-six patients (34.7%) developed nonauditory adverse radiation effects after treatment, including cranial neuropathy, ataxia, and hydrocephalus. There was no statistical association between onset of clinical deterioration and tumor response. Volume changes in the first 24 months after radiosurgery rarely herald treatment failure. Any volume change after 24 months is indicative of treatment failure. Pseudoprogression does not appear to be independently linked to radiation-induced morbidity, and there are no patient-related or radiosurgical parameters that predict tumor response.
Identification and Survival of Carriers of Mutations in DNA Mismatch-Repair Genes in Colon Cancer
Authors: Rebecca A. Barnetson, Albert Tenesa, Susan M. Farrington, Iain D. Nicholl, Roseanne Cetnarskyj, Mary E. Porteous, Harry Campbell, Malcolm G. Dunlop
Journal: New England Journal of Medicine (2006)

The identification of mutations in germ-line DNA mismatch-repair genes at the time of diagnosis of colorectal cancer is important in the management of the disease.Without preselection and regardless of family history, we recruited 870 patients under the age of 55 years soon after they received a diagnosis of colorectal cancer. We studied these patients for germ-line mutations in the DNA mismatch-repair genes MLH1, MSH2, and MSH6 and developed a two-stage model by multivariate logistic regression for the prediction of the presence of mutations in these genes. Stage 1 of the model incorporated only clinical variables; stage 2 comprised analysis of the tumor by immunohistochemical staining and tests for microsatellite instability. The model was validated in an independent population of patients. We analyzed 2938 patient-years of follow-up to determine whether genotype influenced survival.There were 38 mutations among the 870 participants (4 percent): 15 mutations in MLH1, 16 in MSH2, and 7 in MSH6. Carrier frequencies in men (6 percent) and women (3 percent) differed significantly (P<0.04). The addition of immunohistochemical analysis in stage 2 of the model had a sensitivity of 62 percent and a positive predictive value of 80 percent. There were 35 mutations in the validation series of 155 patients (23 percent): 19 mutations in MLH1, 13 in MSH2, and 3 in MSH6. The performance of the model was robust among a wide range of cutoff probabilities and was superior to that of the Bethesda and Amsterdam criteria for hereditary nonpolyposis colorectal cancer. Survival among carriers was not significantly different from that among noncarriers.We devised and validated a method of identifying patients with colorectal cancer who are carriers of mutations in DNA repair genes. Survival was similar among carriers and noncarriers.
Clinical course of perianal fistulas in Crohn's disease.
Authors: F Makowiec, E C Jehle, M Starlinger
Journal: Gut (1995)

The clinical course of perianal fistulas and associated abscesses was evaluated prospectively in 90 patients with Crohn's disease. Fistula type, rectal disease, faecal diversion, and immunosuppression were examined as prognostic indicators for fistula healing and recurrence. Median follow up was 22 months. The outcome was evaluated with life table analysis. Prognostic factors were analysed by multiple regression. Inactivation was achieved in all patients. The risks of recurrent fistula activity were 48% at one year and 59% at two years. Fistulas were healed in 51% after two years but reopened in 44% within 18 months of healing. Faecal diversion and absence of rectal disease decreased recurrence rates (p = 0.019/0.04) and increased healing rates (p = 0.005/0.017). The outcome in patients with trans-sphincteric fistulas was better than that in those with ischiorectal fistulas but worse than in patients with subcutaneous fistulas (p = 0.015 for healing; p = 0.007 for recurrent fistula activity). After initial treatment about 20% of the patients were symptomatic and about 10% had painful events per six month period. Incontinence was rare and did not increase during the study period. Perianal fistulas and associated abscesses can be controlled safely by simple drainage of pus collections. Frequent reinfection and re-opening after healing of fistulas are characteristic. Fistula type, rectal disease, and stool contamination influence the clinical course. Only a few patients, however, have continuous symptoms from perianal fistulas.
Response to Letter Regarding Article, “Retrograde Ascending Aortic Dissection During or After Thoracic Aortic Stent Graft Placement: Insight from the European Registry on Endovascular Aortic Repair Complications”
Authors: Holger Eggebrecht, Raimund Erbel, Matt Thompson, Hervé Rousseau, Martin Czerny, Lars Lönn, Rajendra H. Mehta
Journal: Circulation (2010)
Validity of ECSC prediction equations for spirometric indices in Dutch conscripts
Authors: WH Stevens, JH van Hartevelt, PE The, HA Smink, PH Quanjer
Journal: European Respiratory Journal (1994)

A study was performed to determine whether prediction equations issued by the European Community for Steel and Coal (ECSC) and the European Respiratory Society (ERS) fit spirometric data in young adult males. The study comprised 246 randomly selected Dutch conscripts, who participated in the study on the basis of informed consent. A questionnaire was used to assess respiratory symptoms and smoking habits. Maximal expiratory flow-volume curves were obtained with a rolling seal spirometer, and summary statistics selected according to ECSC/ERS recommendations. In addition, standing height and body weight were obtained. We analysed the data of 100 conscripts of European descent, with no history of respiratory symptoms. They were all life-long nonsmokers. Their mean (SD) age was 18 (0.12) yrs (range 17.9-19.0 yrs), with a mean (SD) standing height of 1.84 (0.06) m (range 1.68-2.00 m). The data for forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and maximal mid-expiratory flow (MMEF) agreed well with ECSC predictions; 95% confidence intervals (95% CI) of differences between measured and predicted values were -0.174 to 0.044 l, -0.012 to 0.174 l.s-1 and -0.114 to 0.302 l.s-1, respectively. Peak expiratory flow was systematically larger than predicted, as was FEV1 % FVC (95% CI 0.74 to 1.31 l.s-1 and 2.50 to 5.24%, respectively), due to the intercept being inappropriate. The residual standard deviation in the conscripts was somewhat less than in the ECSC/ERS predictions equations, except for peak expiratory flow (PEF).(ABSTRACT TRUNCATED AT 250 WORDS)
A–Z of nutritional supplements: dietary supplements, sports nutrition foods and ergogenic aids for health and performance: Part 40: Table 1
Authors: D E Larson-Meyer, L M Burke, S J Stear, L M Castell
Journal: British Journal of Sports Medicine (2012)

As mentioned before, micronutrients, including vitamin supplements, are widely used in the general population and by athletes, and have a variety of clinical applications. Similar to Part 39, we have again devoted an entire part of our A–Z series to vitamin supplementation—this time to vitamin D. Vitamin D was first discussed in our A–Z series in an earlier article on calcium and other bone health nutrients in 20101. In Part 40, the topic of vitamin D has been discussed anew by our current author in the context of more recent literature.

### Vitamin D

#### D E Larson-Meyer

It is well recognised that vitamin D plays an important role in calcium regulation and bone health. Emerging evidence, however, also suggests that vitamin D plays important roles in immune and inflammatory modulation and skeletal muscle function, and therefore has the potential to impact upon the health, training and performance of athletes. This paper provides an overview of the potential importance of vitamin D and vitamin D supplementation on the health and performance of athletes, and offers guidelines for appropriate supplementation.

### Vitamin D synthesis and sources

Although vitamin D is thought of as a ‘'vitamin’, required amounts can be obtained entirely from cutaneous synthesis via exposure to ultraviolet-B (UVB) radiation in sunlight.2 Cutaneous synthesis of vitamin D, however, is dependent on factors including time of exposure, season, latitude, cloud cover, smog, skin pigmentation, sunscreen coverage and age. Vitamin D is not synthesised during the winter at latitudes greater than 35–37° north or south because insufficient UVB photons reach the earth's surface during these months.2 ,3

Vitamin D is also obtained in the diet from limited natural and fortified sources (table 1). Dietary vitamin D includes vitamin D3 (cholecalciferol, derived from animal sources) and vitamin D2 (ergocalciferol, derived from UVB exposure of fungi and yeast ergosterols).2 Both …
Voriconazole-induced photosensitivity: photobiological assessment of a case series of 12 patients
Authors: A.K. Haylett, S. Felton, D.W. Denning, L.E. Rhodes
Journal: British Journal of Dermatology (2012)

Voriconazole, a broad-spectrum triazole antifungal agent increasingly used to treat aspergillosis, has been linked with acute photosensitivity and skin carcinogenesis. The action spectrum of the photosensitivity is unknown, while an indirect retinol effect secondary to the antifungal's impact on CYP450 enzymes has been proposed to contribute to the underlying mechanism.To perform a detailed photobiological assessment of the photosensitivity presenting in a series of 12 patients treated with voriconazole.Minimal erythemal dose thresholds (MED) to narrow wavebands of ultraviolet (UV) A, UVB and visible light were determined. Provocation testing was performed to broadband UVA (310-400 nm) and to solar-simulated radiation (SSR) (290-400 nm). Patients underwent routine photopatch testing and laboratory investigations including serum vitamin A (retinol).Patients (eight men, four women; median age 54years, range 40-63) experienced moderate-severe cutaneous erythema (n = 12), burning pain (n=5), itching (n=3), scaling (n=5), vesiculation (n=5) and oedema (n=1) following sunlight exposure; increased lentigines (n=4) and actinic cheilitis (n = 4) were also observed. While the majority (n=8) of patients showed normal MED thresholds to monochromator phototesting to UVB, UVA and visible light, a low MED to UVA was observed in four patients. Repeated provocation testing with broadband UVA and SSR provoked an abnormal erythema in eight and 10 patients, respectively. Serum retinol levels were mildly elevated in two patients but normal in the majority. UVA sensitivity is the predominant finding in acute voriconazole-induced photosensitivity. We found little evidence of elevated circulating retinol as the causal factor. Patients with voriconazole-induced photosensitivity require education in appropriate UVA protective measures in addition to consideration of skin surveillance for malignant sequelae.
Important Differences Between Nocturnal Urine Production and Nocturnal Voiding Frequency
Authors: Ilse Hofmeester, Marco H. Blanker
Journal: JAMA Surgery (2015)

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