tbuckley/cabot-search huggingface dataset:
Circulating testosterone and prostate-specific antigen in nipple aspirate fluid and tissue are associated with breast cancer.
Authors: Edward R Sauter, David S Tichansky, Inna Chervoneva, Eleftherios P Diamandis
Journal: Environmental Health Perspectives (2002)

Preliminary evidence has associated testosterone and prostate-specific antigen (PSA) with breast cancer. Our objective was to determine whether a) testosterone levels in nipple aspirate fluid (NAF), serum, or breast tissue are associated with breast cancer; b) testosterone levels in serum are associated with levels in NAF; c) PSA in NAF, serum, or breast tissue is associated with breast cancer; and d) serum PSA is associated with NAF PSA levels. We obtained 342 NAF specimens from 171 women by means of a modified breast pump. Additionally, we collected 201 blood samples from 99 women and 51 tissue samples from 41 subjects who underwent surgical resection for suspected disease. Women currently using birth control pills or hormone replacement therapy were excluded from the study. Controlling for age and menopausal status, serum testosterone was significantly increased in women with breast cancer (p = 0.002). NAF and serum testosterone levels were not associated. Neither NAF nor tissue testosterone was associated with breast cancer. Controlling for menopausal status and age, NAF PSA was significantly decreased in women with breast cancer (p < 0.001). We did not find serum PSA to be associated with breast cancer, although we found an indication that, in postmenopausal women, its levels were lower in women with cancer. Serum PSA was associated with NAF PSA in postmenopausal women (p < 0.001). PSA levels in cancerous tissue were significantly lower than in benign breast specimens from subjects without cancer (p = 0.011), whereas levels of PSA in histologically benign specimens from subjects with cancer were intermediate. Our results suggest that serum testosterone is increased and NAF PSA is decreased in women with breast cancer, with PSA expression being higher in normal than in cancerous breast tissues. NAF and serum PSA levels in postmenopausal women are correlated, suggesting that as laboratory assessment of PSA becomes more sensitive, serum PSA may become useful in identifying women with breast cancer.
Does food intolerance have any role in the aetiology and management of rheumatoid disease?
Authors: L G Darlington
Journal: Annals of the Rheumatic Diseases (1985)

Dietary therapy for rheumatoid disease has been used by patients for decades. Until recently, orthodox medical opinion has tended to ignore the subject, but interesting results from recent studies suggest that further investigation would now be appropriate. It is possible that food (which consists of many antigens regularly entering the body) could be responsible for altering immunological function. Be that as it may, it would seem logical, particularly in view of recent uncertainty about the efficacy and/or safety of various drugs used in the management of rheumatoid disease, to determine scientifically whether dietary manipulation has any value in the management of these rheumatoid patients.
The many faces of epidermolysis bullosa acquisita after serration pattern analysis by direct immunofluorescence microscopy
Authors: J.J.A. Buijsrogge, G.F.H. Diercks, H.H. Pas, M.F. Jonkman
Journal: British Journal of Dermatology (2011)

The inflammatory variant of epidermolysis bullosa may mimic a form of pemphigoid.To estimate the frequency of epidermolysis bullosa acquisita (EBA) and bullous systemic lupus erythematosus (bSLE) among patients with subepidermal autoimmune bullous disease (sAIBD), and to correlate the isotype of in vivo antibody depositions to the clinical phenotype.Patients with EBA or bSLE were systematically identified using serration pattern analysis by direct immunofluorescence microscopy in a prospective cohort of 364 patients with sAIBD. Correlation of the clinical phenotype to the isotype of the in vivo antibody depositions was investigated for 38 prospective and retrospective cases.The frequency of EBA or bSLE was 5·5% (n = 20), defined by the u-serration pattern, and reached only 1·9% (n = 7) when serological reactivity was the only criterion. The clinical phenotype of EBA was mechanobullous in 14 (37%) and inflammatory in 24 (63%) patients. Pure IgG-mediated cases (67%) were associated with the mechanobullous phenotype, whereas pure IgA-mediated cases (91%) were found more often in the inflammatory phenotype. Mucous membrane involvement was present in 22 (58%) patients, and neither correlated with IgG or IgA depositions, nor with a mechanobullous (64%) or inflammatory (54%) phenotype.The frequency of EBA is about one in 18 among patients with sAIBD. The clinical phenotype in two of three cases is inflammatory, thus mimicking other sAIBDs, e.g. bullous pemphigoid, mucous membrane pemphigoid, or linear IgA disease. The yield of diagnosed EBA cases almost triples when serration pattern analysis is used by direct immunofluorescence microscopy on skin biopsy.
Cardiorespiratory Fitness and Metabolic Syndrome in Older Men and Women
Authors: Maija Hassinen, Timo A. Lakka, Leena Hakola, Kai Savonen, Pirjo Komulainen, Hannu Litmanen, Vesa Kiviniemi, Reija Kouki, Harri Heikkilá, Rainer Rauramaa
Journal: Diabetes Care (2010)

OBJECTIVE We studied the association of maximum oxygen uptake (Vo2max) with the development and resolution of metabolic syndrome (MetS) for 2 years in older individuals. RESEARCH DESIGN AND METHODS Subjects were a population sample of 1,226 men and women aged 57–78 years. We assessed Vo2max directly by respiratory gas analysis during maximum exercise testing and used dichotomous and continuous variables for MetS. RESULTS One SD increase in baseline Vo2max associated with 44% (95% CI 24–58) decreased risk of developing MetS. Individuals in the highest third of baseline Vo2max were 68% (37–84) less likely to develop MetS than those in the lowest third. One SD increase in Vo2max increased the likelihood to resolve MetS 1.8 (1.2–2.8) times. Individuals in the highest Vo2max third were 3.9 (1.5–9.9) times more likely to resolve MetS than those in the lowest third. CONCLUSIONS Higher levels of cardiorespiratory fitness protect against MetS and may resolve it in older individuals.
Placebo Response in Studies of Major Depression
Authors: B. Timothy Walsh, Stuart N. Seidman, Robyn Sysko, Madelyn Gould
Journal: JAMA (2002)

ContextIntense debate persists about the need for placebo-controlled groups in clinical trials of medications for major depressive disorder (MDD). There is continuing interest in the development of new medications, but because effective antidepressants are already available, ethical concerns have been raised about the need for placebo groups in new trials.ObjectiveTo determine whether the characteristics of placebo control groups in antidepressant trials have changed over time.Data Sources and Study SelectionWe searched MEDLINE and PsychLit for all controlled trials published in English between January 1981 and December 2000 in which adult outpatients with MDD were randomly assigned to receive medication or placebo. Seventy-five trials met our criteria for inclusion.Data ExtractionData were extracted from the articles by 2 of the authors and discrepancies were resolved via discussion and additional review by a third author.Data SynthesisThe mean (SD) proportion of patients in the placebo group who responded was 29.7% (8.3%) (range, 12.5%-51.8%). Most studies examined more than a single active medication, and, in the active medication group with the greatest response, the mean (SD) proportion of patients responding was 50.1% (9.0%) (range, 31.6%-70.4%). Both the proportion of patients responding to placebo and the proportion responding to medication were significantly positively correlated with the year of publication (for placebo: n = 75; r = 0.45; 95% confidence interval [CI], 0.25-0.61; P&lt;.001; for medication: n = 75; r = 0.26; 95% CI, 0.03-0.46; P = .02). The association between year of publication and response rate was more statistically robust for placebo than medication.ConclusionsThe response to placebo in published trials of antidepressant medication for MDD is highly variable and often substantial and has increased significantly in recent years, as has the response to medication. These observations support the view that the inclusion of a placebo group has major scientific importance in trials of new antidepressant medications and indicate that efforts should continue to minimize the risks of such studies so that they may be conducted in an ethically acceptable manner.
Reaction to Hepatitis B Virus Vaccine
Authors: S. DAVID FELDSHON
Journal: Annals of Internal Medicine (1984)

Letters and Corrections1 January 1984Reaction to Hepatitis B Virus VaccineS. DAVID FELDSHON, M.D., RICHARD E. SAMPLINER, M.D.S. DAVID FELDSHON, M.D.Search for more papers by this author, RICHARD E. SAMPLINER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-100-1-156_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: To date, five "serious" reactions in patients have been attributed to administration of hepatitis B virus vaccine (1). In this letter, we describe one of those reactions.A 31-year-old physician at the Arizona Health Sciences Center who did not have antibody to hepatitis B surface antigen (anti-HBs) received a standard initial dose of 20 µg of hepatitis B virus vaccine intramuscularly in November 1982. By 48 hours after the injection, he noted the onset of malaise and low-grade fever. At approximately 60 hours, he awoke with a generalized urticarial reaction. Over the next 5 days, the rash...References1. The safety of hepatitis B virus vaccine. MMWR. 1983;32:134-6. MedlineGoogle Scholar2. ALPERT E, ISSELBACHER K, and SCHUR P. The pathogenesis of arthritis associated with viral hepatitis. N Engl J Med. 1971;285:185-9. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: S. DAVID FELDSHON, M.D.; RICHARD E. SAMPLINER, M.D.Affiliations: Veterans Administration Medical Center Arizona Health Sciences Center Tucson, AZ 85718 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byBullous lichen planus with nail involvement induced by Hepatitis B vaccine in a childBullous lichen planus with nail involvement induced by Hepatitis B vaccine in a childArthus Reaction to Recombinant Hepatitis B Virus VaccineHepatitis and hepatitis immunisationRecombinant hepatitis B vaccination of neonates and infants: emerging safety data from the Vaccine Adverse Event Reporting SystemERYTHEMA MULTIFORME FOLLOWING HEPATITIS B VACCINESerious hepatitis B vaccine adverse reactions, are they immune-mediated?Hepatitis B vaccine side-effectErythema multiforme associated with hepatitis B vaccineErythema multiforme following diphtheria and tetanus toxoid vaccinationHepatitis B and vaccination in emergency physiciansImmunobiological preparationsLetters to the Editor 1 January 1984Volume 100, Issue 1Page: 156-157KeywordsFeversHepatitis B surface antigenHepatitis B virusRashesVaccines ePublished: 1 December 2008 Issue Published: 1 January 1984 PDF downloadLoading ...
Variant IRF4/MUM1 associates with CD38 status and treatment-free survival in chronic lymphocytic leukaemia
Authors: J M Allan, N J Sunter, J R Bailey, A R Pettitt, R J Harris, C Pepper, C Fegan, A G Hall, L Deignan, C M Bacon, J C Pointon, R S Houlston, P Broderick, T Mainou-Fowler, G H Jackson, G Summerfield, P A Evans, J C Strefford, A Parker, D Oscier, G Pratt, D J Allsup
Journal: Leukemia (2010)
Sex-Selective QT Prolongation During Rapid Eye Movement Sleep
Authors: Paola A. Lanfranchi, Abu S.M. Shamsuzzaman, Michael J. Ackerman, Tomas Kara, Pavel Jurak, Robert Wolk, Virend K. Somers
Journal: Circulation (2002)

We examined the effects of the various sleep stages on RR and QT intervals in healthy subjects and tested the hypothesis that there is a differential effect of sleep stage on QT interval in women compared with men.Eighteen healthy subjects (9 women, age 22 to 45 years) underwent polysomnography and simultaneous recording of ECG, blood pressure, and respiration. RR interval, RR variability, and QT values were measured in stable conditions (no abrupt changes of heart rate or blood pressure, stable breathing pattern) during inactive wakefulness during stages 2 and 3 to 4 of non-REM sleep and during REM sleep. The absolute QT interval was normalized for variations of RR (QTc). In men, RR interval and RR variability increased through all sleep stages. The QTc remained stable from wakefulness through all sleep stages. In women, however, RR interval increased only during non-REM and was virtually identical in wakefulness and in REM. RR variability remained very stable from wakefulness through all stages of sleep. Also, during REM in women, both absolute QT interval and QTc, regardless of the correction maneuver used, increased compared with wakefulness.The influence of sleep on RR, RR variability, and QTc is sex-dependent. We speculate that these differential sex effects on cardiac rate and repolarization may have important implications for sleep-selected cardiac arrhythmias in women.
1174 LOW VITAMIN D SERUM LEVEL IS RELATED TO RAPID, EARLY AND SUSTAINED VIROLOGICAL RESPONSE TO IFN-BASED THERAPY IN GENOTYPE 1 CHRONIC HEPATITIS C
Authors: S. Petta, D. Ferrara, C. Scazzone, D. Cabibi, C. Cammà, V. Di Marco, R. Di Stefano, A. Mazzola, A. Bono, A. Craxì
Journal: Journal of Hepatology (2011)
THE PRESENT POSITION OF ULTRA-VIOLET LIGHT THERAPY
Authors: C. B. Heald
Journal: BMJ (1929)

THIDiEBii did nlot possess before.In cases wiherie a dirop in blood pressure is to be feared-as, for examiiple, in the collapse from hacmorrhage or in bad caridiac cases-I lhave, in addition, employed adreiialine, and, latterl, vasopressin.At this point I would make it clear that onlce tlle toxaemia passes over into an eclamiiptic sCizuret1 any active intervention is to be rigidly avoided, and the platient mliust bo treated along such lines of expectancy as tlhose laid down by Stiroganoff anid otliers.On two occasiolis it is true, I have carried out Caesareani section) unider spinial anaesthesia wlhere the patients imiade a goo(d imimiie(liate recovery under tlhe Stroganoff treatmiienit, but whiere, several days afterwards, there was a suddeii and alarming recruidescenco of the cliniical featur es -riise in blood pressuire, fall in uriniary secretion, etc.The operative delivery was carriied out witlh the idea that the risk of delay was greatel thani the risk of terminating the labour with the help of the spinal aniaesthesia.A furltlher inidica- tion in these cases was the continued intr-auterI.hinesur- vival of tlle child, which I regard as a featurc adding greatly to tlle gr-avity of the prognosis.The Question of Future le ourll1tiacis.Among the lessonis to be ddrawni from time (lata asselmibled in an earlier paint of this paper thter c is ono wi-hiiel is of profound importanice.It is that the risk of toxaeiiiia in
Effect of bacterial products on neutrophil migration in vitro.
Authors: G Ras, R Wilson, H Todd, G Taylor, P Cole
Journal: Thorax (1990)

Chronic bronchial inflammation is associated with migration of large numbers of granulocytes into the bronchial tree. A study was designed to find out whether products of bacteria commonly isolated in chronic bronchial infection stimulate neutrophil migration in vitro. Neutrophils from healthy donors were studied by a modified Boyden chamber technique. Bacterial culture filtrates stimulated neutrophil migration over a wide dilution range and the chemotactic activity was heat stable. Culture filtrates derived from Pseudomonas aeruginosa, Streptococcus pneumoniae, and Haemophilus influenzae were significantly chemokinetic and directionally chemotactic, whereas filtrates from Staphylococcus aureus were only chemotactic. Gel filtration of S aureus and P aeruginosa culture filtrates yielded high, medium, and low molecular weight fractions showing chemotactic activity. S pneumoniae and H influenzae yielded fractions with only low molecular weight chemotactic activity. Neutrophil chemotactic responses, occurring in response to all bacterial species tested, appear to represent a defence mechanism by the host. Chemoattractant activity may, however, contribute to bronchial damage mediated by products released from continuously attracted, activated neutrophils.
A molecular signature in blood identifies early Parkinson’s disease
Authors: Leonid Molochnikov, Jose M Rabey, Evgenya Dobronevsky, Ubaldo Bonuccelli, Roberto Ceravolo, Daniela Frosini, Edna Grünblatt, Peter Riederer, Christian Jacob, Judith Aharon-Peretz, Yulia Bashenko, Moussa BH Youdim, Silvia A Mandel
Journal: Molecular Neurodegeneration (2012)

Abstract Background The search for biomarkers in Parkinson’s disease (PD) is crucial to identify the disease early and monitor the effectiveness of neuroprotective therapies. We aim to assess whether a gene signature could be detected in blood from early/mild PD patients that could support the diagnosis of early PD, focusing on genes found particularly altered in the substantia nigra of sporadic PD. Results The transcriptional expression of seven selected genes was examined in blood samples from 62 early stage PD patients and 64 healthy age-matched controls. Stepwise multivariate logistic regression analysis identified five genes as optimal predictors of PD: p19 S-phase kinase-associated protein 1A (odds ratio [OR] 0.73; 95% confidence interval [CI] 0.60–0.90), huntingtin interacting protein-2 (OR 1.32; CI 1.08–1.61), aldehyde dehydrogenase family 1 subfamily A1 (OR 0.86; 95% CI 0.75–0.99), 19 S proteasomal protein PSMC4 (OR 0.73; 95% CI 0.60–0.89) and heat shock 70-kDa protein 8 (OR 1.39; 95% CI 1.14–1.70). At a 0.5 cut-off the gene panel yielded a sensitivity and specificity in detecting PD of 90.3 and 89.1 respectively and the area under the receiving operating curve (ROC AUC) was 0.96. The performance of the five-gene classifier on the de novo PD individuals alone composing the early PD cohort (n = 38), resulted in a similar ROC with an AUC of 0.95, indicating the stability of the model and also, that patient medication had no significant effect on the predictive probability (PP) of the classifier for PD risk. The predictive ability of the model was validated in an independent cohort of 30 patients at advanced stage of PD, classifying correctly all cases as PD (100% sensitivity). Notably, the nominal average value of the PP for PD (0.95 (SD = 0.09)) in this cohort was higher than that of the early PD group (0.83 (SD = 0.22)) , suggesting a potential for the model to assess disease severity. Lastly, the gene panel fully discriminated between PD and Alzheimer’s disease (n = 29). Conclusions The findings provide evidence on the ability of a five-gene panel to diagnose early/mild PD, with a possible diagnostic value for detection of asymptomatic PD before overt expression of the disorder.
Human Values and the Medical Curriculum
Authors: Edmund D. Pellegrino
Journal: JAMA (1969)

<h3>The Student Challenge</h3> Our students this morning have cogently and feelingly detailed a damaging case against contemporary medical education and practice. They have also literally pleaded for us, their older colleagues, to listen to this case. Their sincerity and their urgency demand not only that we listen, but that we<i>hear</i>and that we<i>respond</i>responsibly and with a concern at least equal to theirs. It is my delicate task to attempt such a response. I speak as one member of the educational establishment who shares their interest in change, relevance, and the primacy of human values in medicine. I must, however, underline the personal nature of this response. I disclaim any role as an official representative, but I hope some of my thoughts are representative of those entertained by other concerned educators and practitioners. The students have used commendable clarity and brevity to detail the deficiencies in human values
The two week wait pathway: Is it used appropriately?
Authors: Jemima Robinson, Aidan Hulbert, Susannah Paul, Timothy Howell
Journal: European Respiratory Journal (2014)

Introduction 

In England, suspected cancer patients are referred from primary to secondary care and must be seen within two weeks of referral; called the two week wait (2WW) pathway. In our centre there has been a progressive increase in referrals to this service. In 2006 we received 9.6 referrals a week, this increased by 50% to 15.4 referrals a week in 2012. Despite this increase the number of patients diagnosed with malignancy has remained fairly static.

Aim 

To review the 2WW referrals and see if the pathway is used appropriately.

Methods 

We reviewed all primary care referrals to the 2WW service from January to March 2013 recording reason for referral, imaging reports and end diagnosis. We looked at reasons for referral based on NICE guidelines.

Results 

There were 143 referrals to the pathway, an average of 11 referrals per week. All patients had imaging prior to referral. 28% of patients referred had a malignancy with 17% having primary lung cancer. The commonest reason for referral was chest x-ray suggestive of malignancy. 49% of referrals made had imaging recommending referral on 2WW pathway, 41% of these had cancer. For the 51% of referrals where the report did not suggest a 2WW referral 18% had cancer. 13% of referrals were for other important respiratory diagnoses such as TB or lung abscess.

Conclusions 

There is a marked increase in the number of referrals, however the proportion of patients with cancer has decreased from 42% to 28% since 2006. This study shows the high accuracy of radiologists' reports suggesting cancer. In an image led referral system is there a way of prioritising the referrals and standardising radiology terminology to meet the targets and reduce operational pressures enforced by the 2WW pathway?
Robust In Vivo Transduction of Nervous System and Neural Stem Cells by Early Gestational Intra Amniotic Gene Transfer Using Lentiviral Vector
Authors: David H Stitelman, Masayuki Endo, Archana Bora, Nidal Muvarak, Philip W Zoltick, Alan W Flake, Timothy R Brazelton
Journal: Molecular Therapy (2010)

Presently, in vivo methods to efficiently and broadly transduce all major cell types throughout both the central (CNS) and peripheral adult nervous system (PNS) are lacking. In this study, we hypothesized that during early fetal development neural cell populations, including neural stem cells (NSCs), may be accessible for gene transfer via the open neural groove. To test this hypothesis, we injected lentiviral vectors encoding a green fluorescent protein (GFP) marker gene into the murine amniotic cavity at embryonic day 8. This method (i) efficiently and stably transduced the entire nervous system for at least 80% of the lifespan of the mice, (ii) transduced all major neural cell types, and (iii) transduced adult NSCs of the subventricular zone (SVZ) and subgranular zones (SGZs). This simple approach has broad applications for the study of gene function in nervous system development and adult NSCs and may have future clinical applications for treatment of genetic disorders of the nervous system.
1116-32 Getting risk factors to goal: Lifestyle intervention is worth the effort in patients with hypertension, hyperlipidemia, and/or hyperglycemia
Authors: Neil F Gordon, Richard D Salmon, William E Saxon, Kevin S Reid, George C Faircloth, Ivan Levinrad, Brenda S Mitchell, Richard F Leighton, Laurence S Sperling, William L Haskell, Barry A Franklin
Journal: Journal of the American College of Cardiology (2004)