tbuckley/cabot-search huggingface dataset:
Case 10-1970
Authors: Richard C. Cabot, Benjamin Castleman, Betty U. McNeely, Charles Trey, Benjamin Castleman
Journal: New England Journal of Medicine (1970)

PRESENTATION OF CASE*A seventy-four-year-old woman was admitted to the hospital because of recurrent retinal detachment.Four months previously she underwent a cataract extraction. Two months later she entered the hospital because of loss of vision in the right eye, and retinal detachment was found. A scleral buckling procedure was performed with sodium thiamylal and halothane anesthesia. For the next three days nausea and vomiting occurred; there was no jaundice or fever. She was discharged on the thirteenth hospital day. She was readmitted for another scleral buckling procedure because of recurrent retinal detachment.She had previously been in good health. . . .
High users of outpatient mental health services, II: Implications for practice and policy
Authors: H H Goldman, C A Taube
Journal: American Journal of Psychiatry (1988)

Four assumptions underlie the stereotyped view of use of outpatient mental health services: 1) all use is alike, 2) any use leads to high use, 3) all high use is discretionary, and 4) insurance encourages excessive use. The authors refute the first three assumptions and suggest that different types of treatment episodes vary in their responsiveness to price. Diagnosis appears to be a poor indicator of inpatient needs; some coverage limits outpatient benefits according to type of treatment. The authors favor a combination of pricing strategies, as well as case management and clinical review for high users, which would not impede initial treatment but would limit excessive use of mental health services.
Consumption of Meals Prepared at Home and Risk of Type 2 Diabetes: An Analysis of Two Prospective Cohort Studies
Authors: Geng Zong, David M. Eisenberg, Frank B. Hu, Qi Sun
Journal: PLoS Medicine (2016)

Background There has been a trend towards increased dining out in many countries. Consuming food prepared out of the home has been linked to poor diet quality, weight gain, and diabetes risk, but whether having meals prepared at home (MPAH) is associated with risk of type 2 diabetes (T2D) remains unknown. Methods and Findings We followed 58,051 women (from 1986 to 2012) and 41,676 men (from 1986 to 2010) in two prospective cohort studies of health professionals. Frequencies of consuming midday or evening MPAH were assessed at baseline and during follow-up. Incident T2D was identified through self-report and confirmed using a validated supplementary questionnaire. During 2.1 million person-years of follow-up, 9,356 T2D cases were documented. After adjusting for demographic, socioeconomic, and lifestyle factors, hazard ratios (HRs) and 95% confidence intervals (95% CIs) of T2D were 1 (reference), 0.93 (0.88–0.99), 0.96 (0.90–1.03), and 0.86 (0.81–0.91) for those eating 0–6, 7–8, 9–10, and 11–14 MPAH (p-trend < 0.001) per week, respectively. Participants eating 5–7 midday MPAH had 9% lower T2D risk than those with 0–2 midday MPAH, and participants having 5–7 evening MPAH had 15% lower risk than those with 0–2 evening MPAH (both p-trend < 0.001). In the first 8 y of follow-up, women and men who consumed 11–14 MPAH per week had 0.34 kg (95% CI: 0.15–0.53; p < 0.001) and 1.23 kg (95% CI: 0.92–1.54) less weight gain than those with 0–6 MPAH, respectively. Among participants who were nonobese (body mass index [BMI] < 30 kg/m2) at baseline, pooled HR (95% CI) of developing obesity (BMI ≥ 30 kg/m2) was 0.86 (0.82–0.91; p-trend < 0.001) when extreme MPAH groups (11–14 MPAH versus 0–6 MPAH) were compared. When midday and evening MPAH were analyzed separately, HRs comparing extreme groups (5–7 MPAH versus 0–2 MPAH) were 0.93 (95% CI: 0.89–0.97, p-trend = 0.003) for midday MPAH and 0.76 (95% CI: 0.70–0.83; p-trend < 0.001) for evening MPAH. Further adjusting for BMI during follow-up attenuated the association between MPAH and T2D risk: the HR (95% CI) for participants with 11–14 MPAH was 0.95 (0.89–1.01, p-trend = 0.13). The main limitations of our study were that it lacked assessments on individual foods constituting the MPAH and that the findings were limited to health professionals with a relatively homogeneous socioeconomic status. Conclusions In two large prospective cohort studies, frequent consumption of MPAH is associated with a lower risk of developing T2D, and this association is partly attributable to less weight gain linked with this dining behavior.
Comparison of no-touch multi-bipolar vs. monopolar radiofrequency ablation for small HCC
Authors: Arnaud Hocquelet, Christophe Aubé, Agnès Rode, Victoire Cartier, Olivier Sutter, Anne Frederique Manichon, Jérome Boursier, Gisèle N’kontchou, Philippe Merle, Jean-Frédéric Blanc, Hervé Trillaud, Olivier Seror
Journal: Journal of Hepatology (2016)
Case 27-1973
Authors: Richard C. Cabot, Benjamin Castleman, Robert E. Scully, Betty U. McNeely, Robert C. Leinbach, Robert E. Scully
Journal: New England Journal of Medicine (1973)

Presentation of CaseA 70-year-old woman was admitted to the hospital because of pain in the left hip.Forty years previously she had bilateral pulmonary tuberculosis, which was treated with pneumothorax followed by a right thoracoplasty. Ten years later a diagnosis of bronchiectasis of the right lower lobe was made. Repeated examinations of sputum for acid-fast bacilli were negative. Fourteen years before admission an abdominoperineal resection was performed because of carcinoma of the rectum. Two years thereafter isoniazid was begun and was continued for two years. Five years before entry an x-ray film of the chest (Fig. 1) disclosed a . . .
Website of the week: Low fat diets
Authors: Rhona MacDonald
Journal: BMJ (2001)

So, it's official: low fat diets don't do much to improve cardiovascular morbidity and mortality (p 757). This conclusion is both surprising and counterintuitive and no doubt will send health promoters into a spin.

In general we in the West are obsessed with fat and with low fat diets. But in true form we still want to have our cake and eat it—so we have invented low fat junk food and pills that allow us to take in as much as we want then excrete a lot of it. Anything to avoid making an effort and actually having to eat healthily. A search on “fat and diet” at www.google.com confirms this: there are over 800 000 sites devoted to lotions, potions, and notions that claim to burn, flush, and remove fat from your system while you continue eating whatever you want. I will not give them free advertising by mentioning them here, but I'm sure you know the sort of thing I mean.

In light of this, thank goodness for www.dietfraud.com, whose mission is to inform the public about diet scams. If you type “fat and diet” into its search engine you will find a list of dodgy sites and what is wrong with them. Obviously, the list is limited, but this site makes a good attempt at naming and shaming some of the culprits.

If you want to stay healthy the old fashioned way or are looking for a site that your patients can turn to, www.hebs.scot.nhs.uk is worth a look. The Health Education Board for Scotland has had much experience in trying to change the dietary habits of a nation that has one of the worst diets in the world. You can find an animated list of the top 10 tips for healthy eating (www.hebs.scot.nhs.uk/02/intro.htm). There is also a carrot telling you that it is “brill to grill” and “good to wok.”
Abstract 13415: Is Late Gadolinium Enhancement by Cardiac Magnetic Resonance Really Helpful for Risk Stratification in Patients With Stable Heart Failure in Comparison With Usual Prognostic Factors ?
Authors: Marie Fertin, Frederic Mouquet, Christophe Lions, Celine Goeminne, Nicolas Lamblin, Christophe Bauters, Jean-Paul Beregi, Pascal de Groote
Journal: Circulation (2010)

Objective: The aim of this study was to compare the prognostic value of late gadolinium enhancement (LGE) by cardiac magnetic resonance, B-type natriuretic peptide (BNP) and exercise capacity in patients (pts) with stable systolic heart failure (HF). Background: Previous studies have demonstrated that these parameters are useful for risk stratification but no study has compared their respective prognostic value. Methods: Pts (n=421) were consecutively included if they had a left ventricular ejection fraction (LVEF) ≤ 45% and received optimal medical therapy. All the pts underwent coronary angiography to assess etiology, cardiac magnetic resonance to assess the presence and extent of LGE, BNP measurement and cardiopulmonary exercise test. The endpoint was a composite of cardiovascular mortality, hospitalization for HF or non urgent heart transplantation. Results: Mean age was 55 ± 13 years, mean LVEF was 36 ± 12%, 99.5% were receiving renin-angiotensin inhibitors and 94% beta-blockers. LGE was detected in ...
Esophageal Adenocarcinoma: Screening, Surveillance, and Management
Authors: Nabil M. Mansour, Shawn S. Groth, Sharmila Anandasabapathy
Journal: Annual Review of Medicine (2016)

Esophageal adenocarcinoma (EAC) is a growing problem with a rapidly rising incidence. Risk factors include gastroesophageal reflux disease, central obesity, and smoking. The prognosis of EAC remains poor because it is usually diagnosed late, and many efforts have been made to improve prevention, early detection, and treatment. Acid suppression, nonsteroidal antiinflammatory drugs (NSAIDs), and statins may play a role in chemoprevention. Screening for Barrett's esophagus (BE), the only known precursor lesion of EAC, is indicated for individuals with increased risk. Endoscopic surveillance of patients with BE likely improves overall outcomes. Endoscopic ablation and resection is highly effective for treating dysplastic BE and early EAC, whereas esophagectomy is indicated for patients with locally advanced disease. This review covers epidemiology, staging, screening, and prevention of EAC as well as endoscopic and surgical management.
P-165 Efficacy and toxicity of FOLFIRI / aflibercept in second line colorectal cancer in real life population, retrospective study. Does first line matter?
Authors: A. Fernandez Montes, N. Martinez Lago, M. Covela Rúa, J. De la Cámara Gómez, J.C. Méndez Méndez, P. Gonzalez Villarroel
Journal: Annals of Oncology (2016)
Dissection and Aneurysm in Patients With Fibromuscular Dysplasia
Authors: Daniella Kadian-Dodov, Heather L. Gornik, Xiaokui Gu, James Froehlich, J. Michael Bacharach, Yung-Wei Chi, Bruce H. Gray, Michael R. Jaff, Esther S.H. Kim, Pamela Mace, Aditya Sharma, Eva Kline-Rogers, Christopher White, Jeffrey W. Olin
Journal: Journal of the American College of Cardiology (2016)
The ClC-K2 Chloride Channel Is Critical for Salt Handling in the Distal Nephron
Authors: J. Christopher Hennings, Olga Andrini, Nicolas Picard, Marc Paulais, Antje K. Huebner, Irma Karen Lopez Cayuqueo, Yohan Bignon, Mathilde Keck, Nicolas Cornière, David Böhm, Thomas J. Jentsch, Régine Chambrey, Jacques Teulon, Christian A. Hübner, Dominique Eladari
Journal: Journal of the American Society of Nephrology (2016)

Chloride transport by the renal tubule is critical for blood pressure (BP), acid-base, and potassium homeostasis. Chloride uptake from the urinary fluid is mediated by various apical transporters, whereas basolateral chloride exit is thought to be mediated by ClC-Ka/K1 and ClC-Kb/K2, two chloride channels from the ClC family, or by KCl cotransporters from the SLC12 gene family. Nevertheless, the localization and role of ClC-K channels is not fully resolved. Because inactivating mutations in ClC-Kb/K2 cause Bartter syndrome, a disease that mimics the effects of the loop diuretic furosemide, ClC-Kb/K2 is assumed to have a critical role in salt handling by the thick ascending limb. To dissect the role of this channel in detail, we generated a mouse model with a targeted disruption of the murine ortholog ClC-K2. Mutant mice developed a Bartter syndrome phenotype, characterized by renal salt loss, marked hypokalemia, and metabolic alkalosis. Patch-clamp analysis of tubules isolated from knockout (KO) mice suggested that ClC-K2 is the main basolateral chloride channel in the thick ascending limb and in the aldosterone-sensitive distal nephron. Accordingly, ClC-K2 KO mice did not exhibit the natriuretic response to furosemide and exhibited a severely blunted response to thiazide. We conclude that ClC-Kb/K2 is critical for salt absorption not only by the thick ascending limb, but also by the distal convoluted tubule.
Phase I trial of fractionated-dose <sup>177</sup>lutetium radiolabeled anti-prostate-specific membrane antigen (PSMA) monoclonal antibody J591 (<sup>177</sup>Lu-J591) in patients (pts) with metastatic castration-resistant prostate cancer (metCRPC).
Authors: S. T. Tagawa, S. Vallabhajosula, J. Osborne, S. J. Goldsmith, K. Petrillo, L. Tyrell, G. S. Dhillon, H. Beltran, N. H. Bander, D. M. Nanus
Journal: Journal of Clinical Oncology (2010)

4667 Background: A phase II trial of single-dose 177Lu-J591 radioimmunotherapy (RIT) in pts with metCRPC demonstrated efficacy with acceptable toxicity and an apparent dose-response relationship [Tagawa et al, ASCO 2008]. Dose fractionation of RIT may decrease toxicity while maintaining or increasing efficacy [DeNardo et al, 2002]. Methods: In this phase I study, cohorts of 3-6 pts with progressive metCRPC received 2 fractionated doses of 177Lu - J591 2 weeks apart: Cohort 1 (20 mCi/m2 x2), dose escalation 5 mCi/m2 per dose per cohort up to 45 mCi/m2 x2. The primary endpoint is to determine dose limiting toxicity (DLT) and the cumulative maximum tolerated dose (MTD) of fractionated 177Lu -J591 RIT and secondary endpoints of efficacy; 177Lu-J591 scans with semi-quantitative scoring were performed. Results: 27 pts have been enrolled, receiving up to 45 mCi/m2 x2 (highest anticipated dose). Median age is 71 (range 57-86), median baseline PSA 47.7 (2 – 517.3). 89% had bone mets and 48% extra-osseous visceral mets (lung, liver). All pts had progressed after 1-3 hormonal therapies and 37% progressed on 1-4 lines of chemotherapy including docetaxel. Despite achieving cumulative doses exceeding the single-dose maximum tolerated dose (70 mCi/m2, a dose at which 40% require platelet transfusions), to date only 3 pts experienced Gr 4 thrombocytopenia (1 requiring a transfusion). 2 pts experienced Gr 4 neutropenia without fever; no growth factors were needed. There has been no Gr >1 non-heme toxicity or DLT to date. Targeting of known sites of PC metastases was seen in the majority of pts. 9 of 22 (41%) evaluable pts thus far have experienced PSA declines. Conclusions: Fractionated dose 177Lu-J591 is well tolerated, with reversible myelosuppression. With dose-fractionation, pts are able to tolerate higher cumulative doses than with single-dose 177Lu-J591. Building upon these data, a phase I fractionated-dose 177Lu-J591 plus docetaxel study has begun enrollment, utilizing improved tolerability of fractionated dose RIT plus the radiosensitizing and debulking properties of docetaxel. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration BLZ Biologics
An ongoing phase IIIb/IV safety trial of nivolumab (NIVO) in patients (pts) with advanced or metastatic non-small-cell lung cancer (NSCLC) who progressed after receiving 1 or more prior systemic regimens.
Authors: Todd Michael Bauer, Michael McCleod, Jason Claud Chandler, George R. Blumenschein, Lee Steven Schwartzberg, Howard Burris, David Waterhouse, Robert M. Jotte, Maen Hussein, David R. Spigel, Dana Shelton Thompson, Xuemei Li, Craig H. Reynolds
Journal: Journal of Clinical Oncology (2015)

3013 Background: NIVO, a fully human IgG4 programmed death-1 (PD-1), immune checkpoint inhibitor antibody, has demonstrated durable responses and tolerability in heavily pretreated pts with advanced NSCLC. Conducted mostly in community-based oncology centers, this ongoing trial explores the safety of NIVO in previously treated NSCLC pts. Methods: Eligible pts are enrolled in 4 subgroups: 1) squamous cell (SQ), performance status (PS) 0–1, ≥2 prior therapies; 2) SQ, PS 0–1, 1 prior therapy; 3) nonsquamous (NSQ), PS 0–1, ≥1 prior therapy; and 4) SQ or NSQ, PS 2, ≥1 prior therapy. Pts receive NIVO 3 mg/kg IV (60 min) Q2W either until progressive disease (PD)/unacceptable toxicity (Cohort A) or for 1 year with the possibility of retreatment upon disease progression (Cohort B). Primary objective is to estimate incidence of high grade (CTCAE v4.0 Grade 3–4 and 5) select treatment-related adverse events (TRAEs); exploratory efficacy assessments include ORR, PFS and OS. Results: From 4/16/14 to 8/15/14, 226 pts were treated and have demographic and safety data available; 179 remain on study as of 8/15. 51 pts had evaluable radiographic tumor assessments at week 9. Conclusions: Safety and tolerability are consistent with prior NIVO experience and no new safety signals have been identified in this trial. Immune-related toxicities are manageable in a community practice setting using previously developed safety algorithms. Early data from this large multicenter trial suggests that pts with pretreated advanced NSCLC benefit from NIVO therapy. Clinical trial information: NCT02066636. N=226 % male, female 55, 45 Median age (range), yrs 67 (33–91) % SQ, NSQ 26, 74 % PS 0–1, 2 90, 9 % 1, 2, ≥3 prior therapies 21, 28, 47 Select TRAEs, % all grade, grade 3–4 Any 13.3, 1.8 Skin 5.3, 0.4 GI 9.7, 0.9 Pulmonarya 1.3, 0.4 Endocrinopathies 2.7, 0 Hepatic 1.8, 0 Infusion reaction 0.9, 0 Renal 1.3, 0 1st tumor evaluation N=51 CR 0% PR 7 (13.7%) SD 22 (43.1%) a1 fatal drug-related respiratory failure was reported in the setting of known lymphangitic tumor spread, recurrent pulmonary embolus, bacteremia, pleural effusion and tumor progression; death classified as "Other-Multifactorial" by investigator.
Case 80-1962
Authors: Kurt J. Isselbacher, Robert E. Scully
Journal: New England Journal of Medicine (1962)

Presentation of CaseA sixty-year-old man was referred to the hospital for evaluation of abdominal discomfort and weight loss.Seven years before admission the patient began to experience episodes of severe, burning epigastric pain that was occasionally relieved by antacids, but was not associated with melena, hematemesis, nausea, vomiting or abnormal bowel habits. Two years before entry abdominal exploration at another hospital revealed a ruptured duodenal ulcer, which was repaired. One month later a subtotal gastrectomy was performed; the pathological diagnosis was chronic gastritis. Subsequently, he experienced occasional episodes of vague epigastric discomfort with intermittent burning pain not related to . . .
Best research
Authors: Allyson M Pollock, Nick McNally, Sue Kerrison
Journal: BMJ (2006)

Dexterous hands, used to manipulate food, tools, and other objects, are one of the hallmarks of primate evolution. However, the neural substrate of fine manual control necessary for these behaviors remains unclear. Here, we describe the functional organization of parietal cortical areas 2 and 5 in the cebus monkey. Whereas other New World monkeys can be quite dexterous, and possess a poorly developed area 5, cebus monkeys are the only New World primate known to use a precision grip, and thus have an extended repertoire of manual behaviors. Unlike other New World Monkeys, but much like the macaque monkey, cebus monkeys possess a proprioceptive cortical area 2 and a well developed area 5, which is associated with motor planning and the generation of internal body coordinates necessary for visually guided reaching, grasping, and manipulation. The similarity of these fields in cebus monkeys and distantly related macaque monkeys with similar manual abilities indicates that the range of cortical organizations that can emerge in primates is constrained, and those that emerge are the result of highly conserved developmental mechanisms that shape the boundaries and topographic organizations of cortical areas.
P-224 Locally advanced rectal cancer: a single institution experience
Authors: N. Dueñas Cid, M. Tobeña, C. Pernas Juan, D. Hernandez, M. Menso Maria, J. Szafranska, A. Sebio, D. Paez, A. Virgili, C. Vethencourt Andrea, P. del Carpio Luis, M. Andrés, J. Balart, M. Martin
Journal: Annals of Oncology (2016)
대한간학회지 제8차 춘계학술대회 초록집 : 포스터 발표 ; 간경변증에 의한 복수를 지닌 환자에서 결핵성 복막염 진단을 위한 복수 Adenosine Deaminase 측정의 임상적 유용성
Authors: 이준성 ( Lee Jun Seong ), 김경아 ( Kim Gyeong A ), 이우진 ( Lee U Jin ), 전영빈 ( Jeon Yeong Bin ), 이정환 ( Lee Jeong Hwan ), 김유선 ( Kim Yu Seon ), 문정섭 ( Mun Jeong Seob )
Journal: Clinical and Molecular Hepatology (2002)
FOxTROT: Randomized phase II study of neoadjuvant chemotherapy (CT) with or without an anti-EGFR monoclonal antibody for locally advanced, operable colon cancer: Planned interim report.
Authors: D. Morton, L. Magill, K. Handley, G. Brown, D. R. Ferry, Z. b. Gray, P. Quirke, M. T. Seymour, B. Warren, R. G. Gray
Journal: Journal of Clinical Oncology (2011)

3568 Background: Preoperative CT and radiotherapy are surprisingly more effective than postoperative treatment in rectal and other cancers, perhaps because micrometastases are more readily eradicated by neoadjuvant CT than CT given after the delay and immunological stress of surgery. Or, shrinking tumours before surgery may reduce the risk of incomplete excision and tumour cell shedding during surgery. Pre-operative CT also provides a unique opportunity to identify tumour markers predictive of response to CT and anti-EGFR therapy. Methods: The FOxTROT pilot study randomised 150 patients with potentially curative locally advanced colon cancer from 35 UK centres between neoadjuvant and standard CT. Patients with radiologically staged high-risk T3 (invasion ≥5mm beyond the muscularis propria) or T4 cancer received three 2-week cycles of OxMdG (oxaliplatin 85 mg/m2, l-folinic acid 175mg, 5-FU 400 mg/m2 bolus then 2400 mg/m2 by 46h infusion) followed by surgery and a further nine cycles of post-operative CT, or surgery followed by 12 cycles of the same CT (randomised 2:1). KRAS wildtype patients were also randomised 1:1 to receive panitumumab (6 mg/kg; 2-weekly) with the first 6 weeks of CT or control. Results: Neoadjuvant CT was delivered to schedule in 85% of patients with grade 34 toxicity in <10% of patients. Only one had surgery delayed (neutropenia) and there were no significant differences in post operative morbidity or hospital stay compared to the control group. There were 2 pathological complete responses (pT0) and 6 pT2 tumours in 88 neoadjuvant CT patients compared to one pT2 in 43 controls. 2% vs 17% of apical nodes were positive (p=0.003) and tumour regression was graded as moderate or more for 22% vs 0% (p<0.0001). Conclusions: Neoadjuvant CT for primary colon cancer can be delivered with acceptable toxicity and perioperative morbidity and an encouraging pathological response. The ongoing phase III trial will determine whether long term benefits are realisable.