tbuckley/cabot-search huggingface dataset:
Alcohol Consumption and Blood Pressure
Authors: Arthur L. Klatsky, Gary D. Friedman, Abraham B. Siegelaub, Marie J. Gérard
Journal: New England Journal of Medicine (1977)

We studied blood pressure in relation to known drinking habits of 83,947 men and women of three races (83.5 per cent white). Using health-check-up questionnaire responses, we classified persons as nondrinkers or according to usual daily number of drinks: two or fewer per day, three to five per day, or six or more per day. As compared to nondrinkers blood pressures of men taking two or fewer drinks per day were similar. Women who took two or fewer drinks per day had slightly lower pressures. Men and women who took three or more drinks per day had higher systolic pressures (P less than 10(-24) in white men, and less than 10(-12) in white women), higher diastolic pressures (P less than 10(-24) in white men, and less than 10(-6) in white women), and substantially higher prevalence of pressures greater than or equal to 160/95 mm Hg. The associations of blood pressure and drinking were independent of age, sex, race, smoking, coffee use, former "heavy" drinking, educational attainment and adiposity. The findings strongly suggest that regular use of three or more drinks of alcohol per day is a risk factor for hypertension.
Multimedia: Injury Prevention: An International Perspective
Authors: Barry Pless
Journal: BMJ (1998)

Peter Barss, Gordon Smith, Susan Baker, Dinesh Mohan


Oxford University Press, £42.50, pp 384 




ISBN 0 19 511982 7

———————

Rating: ★★★★

Several years ago I reviewed this book in draft form at the request of the publisher. I was torn: it was a labour of love and a potentially important book, but it had numerous shortcomings. I conveyed my concerns but stressed that everything possible should be done to bring it to press. Thankfully, publisher and authors agreed. What we now have is a landmark addition to a remarkably small shelf of texts about this subject.

Originally, the book was possibly too ambitious and too thorough and might have benefited only those already persuaded of the topic’s importance. I feared that only they would scratch out the gems buried in it. It is now coherent, well organised, and well written. Although there are now no excuses for not using it, the question remains whether it will be used, and how.

It seems reasonable to ask if books such as this are intended to inform or to foster action. Undoubtedly, it is both in the sense that better information helps equip established or aspiring agents of change. With this in mind, I judge the book a great success because it is difficult to imagine readers, even among the cognoscenti, who are not better informed after a careful read.

This book provides, above all, a truly international perspective, using comparisons as the basis for highlighting problems in prevention in the developing world. These parallel, but differ from in essential ways, those in wealthier countries.

The organisation is exemplary. Six initial chapters lay the foundation by emphasising the importance of injuries worldwide, defining the epidemiological basis for prevention, assessing the health impact in terms of mortality and morbidity and the effect on communities, and thoroughly examining determinants. The next seven chapters are organised around conventional lines by type of injury, with traffic accidents, quite appropriately, receiving the greatest emphasis. One unexpected but laudable chapter is devoted to disasters. The conclusion deals with the choice and development of programmes for prevention and treatment and rehabilitation.

Injury prevention is now well beyond infancy as a specialty and should be of grave concern to policy makers everywhere. I don’t expect health officials to read this book from cover to cover, but browse it they must when facts are needed to support policy initiatives. There is no better compendium and no more thoughtful presentation of this modern epidemic. But, as Foege concludes: “When Thucidides was asked when justice would come to Athens, [he] replied, ‘Justice will come to Athens when those who are not injured are as indignant as those who are injured.’ This book is a roadmap to indignation. It will take action by all of us if the potential power of this book is to be reflected in lives saved and suffering prevented.”
Long Non-Coding RNA Databases in Cardiovascular Research
Authors: Frank Rühle, Monika Stoll
Journal: Genomics Proteomics & Bioinformatics (2016)

Abstract With the rising interest in the regulatory functions of long non-coding RNAs (lncRNAs) in complex human diseases such as cardiovascular diseases, there is an increasing need in public databases offering comprehensive and integrative data for all aspects of these versatile molecules. Recently, a variety of public data repositories that specialized in lncRNAs have been developed, which make use of huge high-throughput data particularly from next-generation sequencing (NGS) approaches. Here, we provide an overview of current lncRNA databases covering basic and functional annotation, lncRNA expression and regulation, interactions with other biomolecules, and genomic variants influencing the structure and function of lncRNAs. The prominent lncRNA antisense noncoding RNA in the INK4 locus (ANRIL), which has been unequivocally associated with coronary artery disease through genome-wide association studies (GWAS), serves as an example to demonstrate the features of each individual database.
Denosumab in patients with resectable giant cell tumor of bone (GCTB): Effect on surgical downstaging in a “real world” experience.
Authors: Giacomo Giulio Baldi, Giovanni Beltrami, Guido Scoccianti, Antonio D'Arienzo, Domenico Campanacci, Filippo Frenos, Alessandro Franchi, Giuliana Roselli, Angelo Di Leo, Rodolfo Capanna
Journal: Journal of Clinical Oncology (2015)

e21505 Background: Pre- surgical treatment with denosumab has been associated with downstaging in patients (pts) with resectable GCTB. Here, we report our “real world” experience with pre-operative denosumab on surgical downstaging in GCTB pts treated at our institution. Methods: We have surgically treated 91 patients with resectable GCTB between 2010 and 2014. Here, we report the outcome of 18 of these patients treated pre-operatively with denosumab 120 mg SC (day 1, 8, 15, 28 and every 4 weeks thereafter) for at least three months and then post-operatively every 4 weeks for 6 months. Timing of surgery was based on clinical and radiological findings. Histologic diagnosis was centrally reviewed by an expert pathologist. Screening for H3F3A mutation is ongoing and will be presented at the meeting. Results: Median age was 36 years (range 19-72). Seventeen pts were treated at first diagnosis and 1 at relapse. Three pts are still on pre-operative treatment. Most had the lesion in the lower limb (n = 5 distal femur, n = 2 proximal femur, n = 3 distal tibia, n = 2 proximal tibia, n = 2 proximal fibula), 3 in the upper limb (n = 1 distal humerus , n = 1 distal radio, n = 1 proximal radio) and 1 in the sacrum. Median time on pre-operative denosumab was 5.7 months (range 3-6). Toxicity was as expected. In 1 case therapy was interrupted due to dental disease found after first dose administration. Out of 14 evaluable pts treated with denosumab, 11 (78%) pts were treated with curettage, 2 (14%) with resection for GCTB of the proximal fibulae and 1 (7%) with resection and prosthetic replacement for GCTB of the proximal radio. Pts without severe morbidity at surgery was 78% and preservation rate of the joint function was 99%. At a median follow-up of 12.3 months, 2 pts are relapsed and are on treatment with denosumab at the same schedule. Conclusions: In our clinical practice experience, we confirm that the use of preoperative denosumab in pts with resectable GCTB is safe and associated with a reduction in invasive surgical procedures and a good preservation rate of joint function.
Umbilical Hernia Secondary to Cirrhosis of the Liver
Authors: Howard C. Baron
Journal: New England Journal of Medicine (1960)

THE surgical treatment of umbilical hernia has undergone only slight variation since the classic procedure of transverse imbrication of fascia and peritoneum was proposed by Charles Mayo1 in 1895. The present report is a critical evaluation of the results of herniorrhaphy in a group of patients in whom the umbilical hernia was a complication of cirrhosis of the liver.The thesis of this study is that the hepatofugal portosystemic collateral pathways in the umbilical area are compromised during the course of umbilical operations in patients with cirrhosis of the liver.The 16 cases that are the basis of this report . . .
Comparison of HMGA2 expression in serous versus endometrioid subtypes of human ovarian carcinoma.
Authors: T. Tagawa, R. Morgan, M. C. Cristea, M. T. Wakabayashi, H. Lin, Y. Wang, P. Chu, X. Liu, D. Ann, Y. Yen
Journal: Journal of Clinical Oncology (2010)

e15528 Background: The human high mobility group A2 (HMGA2) gene is located at chromosomal locus 12q14-15 where it is subjected to chromosomal rearrangements, resulting in deregulation of its expression and truncation or generation of fusion genes. HMGA2 protein is a multifunctional transcriptional factor that regulates gene transcription and interferes with DNA repair. Overexpression of HMGA2 has been observed in 65% of human ovarian carcinoma (OC) and is rarely expressed in normal ovarian epithelial cells. Given serous OC is known to carry a poorer prognosis compared to nonserous OC, the objective of this study is to compare the expression of HMGA2 in serous OC with endometrioid OC. Methods: Paraffin blocks of consecutive serous or endometrioid OC surgical specimens were collected between November 2008 and September 2009. The five-micron-thickness slides were used for immunohistochemical (IHC) staining with an anti-HMGA2 polyclonal antibody (Abnova; 1:500). The nuclear HMGA2 staining was visualized with a pan-IgG secondary antibody. The degree of HMGA2 expression was scored by pathologist as a categorical measure based on intensity of IHC staining. Results: 23 paraffin blocks, (12 serous and 11 endometrioid) were evaluated for IHC staining with HMGA2 antibody. The results are described below (Table). Conclusions: In this study, serous OC had greater HMGA2 expression compared to endometrioid OC. Evaluation of clinical outcomes may reveal HMGA2 expression to be a predictive or prognostic marker. Furthermore, HMGA2 may serve as a possible target for therapeutic intervention in OC, specifically in the poor prognosis subtype of serous OC. HMGA2 expression in ovarian cancer Degree of HMGA2 expression Endometrioid carcinoma (n=12) Serous carcinoma (n=11) − 8 3 + 1 2 ++ 2 0 +++ 1 6 Chi-square Likelihood ratio=9.92, p=0.019 Pearson=8.67, p=0.034 OR 5.3* (95% CI=0.89-31.92; p value=0.0667) * Reference is endometrioid adenocarcinoma. Serous carcinoma is 5.3 times more likely to stain positively than endometrioid carcinoma. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Abbott Laboratories
Case 36-1990
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, Homayoun Kazemi, Eugene J. Mark
Journal: New England Journal of Medicine (1990)

Presentation of CaseA 42-year-old woman was admitted to the hospital because of chylous ascites, lymphadenopathy, and weight loss.The patient was well until three years earlier, when she was evaluated elsewhere because of a right pleural effusion. A thoracentesis yielded fluid that was believed to be consistent with an exudate; no malignant-tumor cells or acid-fast bacilli were seen; microscopical examination of a pleural-biopsy specimen was reported to show nonspecific findings. Bronchoscopic examination was said to be negative. A test for antinuclear antibodies was positive in a titer of 1:1280; the results of tests of renal function were normal. A . . .
PTH-059 Faecal calprotectin identifies non responders to anti-tnfΑ therapy when measured after induction in inflammatory crohn’s disease
Authors: P Pavlidis, A Cavazza, N Siddique, P Stamoulos, J Tumova, L Medcalf, G Chung-Faye, P Dubois, I Bjarnason, B Hayee
Journal: Gut (2015)

<h3>Introduction</h3> Poor response to anti-TNFα treatment in patients with Crohn’s disease (CD) is not infrequent. As new biologic therapies targeting other immune pathways of the intestinal inflammation are becoming available in routine clinical practice early prognostic markers of treatment failure are urgently needed. Faecal calprotectin (fcal) has been shown to be a useful prognostic marker of relapse in CD correlating well with both endoscopic and magnetic resonance imaging scores. Furthermore, a recently published study utilising gene expression profiling by micro arrays to detect prognostic markers of early response to anti-TNFα therapy identified the two genes coding for the calprotectin subunits (S100A8, S100A9) to be among the most highly expressed gene transcripts in non-responders. <h3>Method</h3> This is a retrospective observational study of a prospectively kept database testing the hypothesis that a faecal calprotectin measurement after anti-TNFα induction (infliximab: 8–12 weeks, adalimumab: 6-weeks) reflects response to treatment. CD patients, who commenced anti-TNFα therapy for active, inflammatory disease and had serial fcal measurements before and after induction were identified. Remission was assessed at 6 months and defined as the composite of Harvey Bradshaw Index (HBI &lt; 5) and fcal &lt;250 μg/g. <h3>Results</h3> We identified 26 patients who started either infliximab (16) or adalimumab (10) and had serial fcal at the set time points [median age: 32, disease duration: 5 (3, 8), location: 17 ileocolonic, 8 colonic and 1 ileal]. Patients on infliximab received 5mg/kg doses at 0, 2, 6 and then 8 weekly. Those on adalimumab had one dose of 160mg followed by 80 mg after two weeks and then received 40 mg doses fortnightly. At 6 months, 15/26 (58%) patients were in remission. Fcal post induction in those in remission at 6 months was lower compared to those with persistently active disease [65 (38, 118) vs. 269 (161, 542)]. Receiver operator characteristic curve analysis shows that fcal &gt;150 has 93% sensitivity and 91% specificity in predicting non responders (likehood ratio: 10.27, area under curve: 0.98, p &lt; 0.0001). HBI and fcal levels before anti-TNFα induction did not differ between patients with the two different outcomes. <h3>Conclusion</h3> Fcal measurement soon after anti-TNFα induction predicts non-response providing the opportunity to identify those patients who require further treatment tailoring early. <h3>Disclosure of interest</h3> None Declared.
Scaling-up treatment of depression and anxiety: a global return on investment analysis
Authors: Dan Chisholm, Kim Sweeny, Peter Sheehan, Bruce Rasmussen, Filip Smit, Pim Cuijpers, Shekhar Saxena
Journal: The Lancet Psychiatry (2016)

Depression and anxiety disorders are highly prevalent and disabling disorders, which result not only in an enormous amount of human misery and lost health, but also lost economic output. Here we propose a global investment case for a scaled-up response to the public health and economic burden of depression and anxiety disorders.In this global return on investment analysis, we used the mental health module of the OneHealth tool to calculate treatment costs and health outcomes in 36 countries between 2016 and 2030. We assumed a linear increase in treatment coverage. We factored in a modest improvement of 5% in both the ability to work and productivity at work as a result of treatment, subsequently mapped to the prevailing rates of labour participation and gross domestic product (GDP) per worker in each country.The net present value of investment needed over the period 2016-30 to substantially scale up effective treatment coverage for depression and anxiety disorders is estimated to be US$147 billion. The expected returns to this investment are also substantial. In terms of health impact, scaled-up treatment leads to 43 million extra years of healthy life over the scale-up period. Placing an economic value on these healthy life-years produces a net present value of $310 billion. As well as these intrinsic benefits associated with improved health, scaled-up treatment of common mental disorders also leads to large economic productivity gains (a net present value of $230 billion for scaled-up depression treatment and $169 billion for anxiety disorders). Across country income groups, resulting benefit to cost ratios amount to 2·3-3·0 to 1 when economic benefits only are considered, and 3·3-5·7 to 1 when the value of health returns is also included.Return on investment analysis of the kind reported here can contribute strongly to a balanced investment case for enhanced action to address the large and growing burden of common mental disorders worldwide.Grand Challenges Canada.
Abstract 17617: Post-cardiac Arrest Mortality Rates With Different Levels of Targeted Temperature Management within Patient Illness Severity Categories
Authors: Jon C Rittenberger, Patrick Coppler, Francis X Guyette, Clifton W Callaway, Jonathan Elmer, Ankur A Doshi, Daniel Slowey
Journal: Circulation (2015)

Introduction: There are 380,000 out-of-hospital cardiac arrests (OHCA) in the United States each year. Controlling temperature improves outcome. It is unknown if different illness severity may require different goal temperatures. Hypothesis: When controlling for Pittsburgh Cardiac Arrest Category (PCAC), there is no difference in mortality between treatment at 33°C or 36°C. Methods: Review of existing QI database between 12/2013 and 12/2014. We abstracted location of arrest, primary rhythm, initial illness severity (PCAC), survival, presence of fever and neurologic outcome. We defined four categories of PCAC: I) awake, II) coma + mild cardiopulmonary dysfunction, III) coma + moderate-severe cardiopulmonary dysfunction, and IV) coma without brainstem reflexes. Good neurologic outcome was defined as a CPC of 1-2 or mRS of 0-2. Chi-squared analysis compared the cohorts. Logistic regression was used to determine factors associated with survival and good neurologic outcome. Candidate variables included age, primary rhythm of arrest, PCAC, development of fever in the first 48 hours and goal temperature. Results: Of 165 patients studied, 102 (62%) were male, with a mean age of 58 (SD = 18). The most common primary rhythm was VF/VT (53; 32%). Goal temperature of 36°C was used in 92 (56%), temperature of 33°C was used in 60 (36%), and no temperature management was used in 13 (36%). Fever was more common in patients treated with goal temperature of 36°C (28% vs. 7%; p=0.004). Survival did not differ between temperature management strategies (PCAC II 33°C: 2 (50%), PCAC II 36°C 24 (80%); PCAC III 33°C: 3 (75%), PCAC III 36°C: 6 (43%); PCAC IV 33°C: 4 (8%), PCAC IV 36°C: 7 (18%). In the multivariate analysis, only PCAC was associated with survival (OR 0.35; 95% CI 0.23, 0.55), good CPC (OR 0.30; 95% CI 0.15, 0.61) and good mRS (OR 0.33; 95% CI 0.16, 0.67). Conclusions: After accounting for PCAC, survival and good neurologic do not differ between temperature management strategies of 33°C or 36°C. Fever is more common in patients treated at goal temperature of 36°C. We noted a systematic trend towards application of 33°C to higher illness severity patients. This bias needs to be robustly controlled for in future observational work to prevent confounding by indication.
Survival rates of patients with glioblastoma multiforme treated with combined radiochemotherapy at first line
Authors: W. Wagner, A. Radmard, D. Hatami, U. Niewöhner-Desbordes, G. J. Wiedemann
Journal: Journal of Clinical Oncology (2005)

1576 Background: The prognosis of malignant glioma remains poor. Standard therapy consists of radical resection and postoperative irradiation. The median survival rates lay in the range between 6 and 13 months. Chemotherapy using PCV was not able to improve the results significantly. Since 1999, a new oral alkylating agent called temozolomide (TMZ) was introduced in the therapy of gliomas. In this study temozolomide was analysed regarding efficacy and tolerability. Methods: 42 patients with histologically proven glioblastoma multiforme were treated postoperatively with concomitant radiochemotherapy. All tumours had been completely resected. The median age of all patients was 54 years (25–60 years). Patients older than 60 years or patients with a Karnofsky-Index < 80 were not included in the study. Irradiation was performed conventionally with total doses between 54 Gy and 60 Gy specified to the resected tumour area. Temozolomide was given during the complete course of irradiation orally with a daily application of 100 mg absolutely without any supportive therapy. After finalisation of irradiation temozolomide therapy was stopped. Patients were evaluated and controlled every 6–8 weeks using MRI. Results: Median survival of all patients was 14 months. The 1-year overall survival rate was 72%, the 2-year overall survival rate was 30%. Side effects of this minor aggressive therapy were small. In only 4 cases a leuco-thrombozytopenia > Grad III WHO was documented. All patients developed alopecia caused by radiotherapy. No motoric, sensitive or mental deficits were documented related to therapy. Conclusions: In conclusion the 2-year overall survival rate of 30% and the median survival time of 14 months are encouraging and the data are comparable with the EORTC- Study results gained by Roger Stupp. It must be mentioned that the prognosis of the involved patients concerning survival time was a priori better in this study compared to other trials, as only patients with good prognostic factors were included. No significant financial relationships to disclose.
Abstract 08: The Impact of Food Taxation and Subsidy Policies on Cardiometabolic Disparities in the US
Authors: Jose L Penalvo, Fred Cudhea, Renata Micha, Ashkan Afshin, Colin Rehm, Parke Wilde, Masha Shulkin, Eve Bishop, Jonathan Pearson-Stuttard, Martin O’Flaherty, Thomas Gaziano, Laurie Whitsel, Simon Capewell, Dariush Mozaffarian
Journal: Circulation (2016)

Background: Food taxes and subsidies are promising strategies for improving diets and reducing cardiometabolic diseases (CMD). Both dietary habits and CMD burdens are unequally distributed in the US, with major disparities by socioeconomic status (SES). Information on impacts of national food price policies on disparities is lacking. Aim: To estimate the impact on CMD deaths and health disparities in US adults of price interventions (taxes, subsidies) targeting 7 key dietary factors. Methods: Using nationally representative data, we conducted comparative risk assessment analysis to estimate the impact of a 10% price subsidy on fruits, vegetables, whole grains, and nuts and a 10% tax on processed meat, unprocessed red meat, and sugar-sweetened beverages, on CMD deaths and disparities in SES subgroups. We evaluated 18% (based on global price elasticity data) and 50% (based on recent experience from soda taxes in Mexico) greater price responsiveness in lowest vs. highest SES groups. Results: Each separate price intervention would reduce CMD deaths (Figure). Jointly subsidizing and taxing these 7 dietary factors (10% price change each) and assuming 18% greater price-responsiveness in lowest vs. highest SES, this intervention would prevent 5.27% of CMD deaths in those with &lt;high school education (&lt;HS), 6.27% among HS graduates and those with some college (SC), and 5.11% among college graduates (COL). Effects in each group were dependent on both baseline (current) diet and price responsiveness. Applying a 50% greater price-responsiveness, the corresponding values were 5.91% (&lt;HS), 6.27% (SC), and 4.58% (COL). Conclusions: Introducing modest price changes on key dietary factors could reduce CMD burdens and improve disparities in the US. Policy-based strategies targeting disparities will require considering both baseline dietary habits as well as price responsiveness in specific population subgroups.