tbuckley/cabot-search huggingface dataset:
Rudolf Virchow
Authors: Lytt I. Gardner
Journal: New England Journal of Medicine (1955)

ON the night of March 18, 1848, a young man burst into the office of Dr. Schleich, a physician of Berlin, asking:"Schleich, have you any weapons?" "Only this old gun and a rusty sabre." "Out with them! Off to the barricade!"1 Thus, Rudolf Virchow, twenty-seven years of age, rushed off to build barricades and to oppose, with only a pistol, the soldiers of a king. The short range of his weapon limited his effectiveness, since, as he regretfully wrote to his father, "The soldiers shot mostly from too great a distance..."Only three years later the young revolutionary postulated . . .
Effect of diagnostic criteria on the ratio of male to female schizophrenic patients
Authors: R Lewine, D Burbach, H Y Meltzer
Journal: American Journal of Psychiatry (1984)

Contrary to earlier epidemiological data, recent evidence points to a significantly greater proportion of men than women among schizophrenic patients diagnosed by current restrictive criteria. In this study, the authors analyzed the effect of using six different diagnostic systems (varying in their stringency) on the male to female ratio of schizophrenia among 387 inpatients. Diagnostic criteria representing a broad conceptualization of schizophrenia, such as the New Haven Schizophrenia Index, consistently yielded equal rates of schizophrenia among men and women. Those diagnostic systems representing more stringently defined schizophrenia, such as the Research Diagnostic Criteria, consistently yielded a male to female ratio significantly greater than the male to female ratio of the total sample.
Stomach Cancer
Authors: Janet M. Torpy
Journal: JAMA (2010)

Stomach Cancer Cancer of the stomach, also known as gastric cancer, often goes unnoticed until the cancer has reached a late stage.For many individuals, stomach cancer has already metastasized (spread to other body organs) before it is discovered.For these reasons, stomach cancer has a lower survival rate than many other types of cancers.However, during the last decade, the incidence (number of new cases) of stomach cancer has decreased for most population groups, and a person' s chance of dying from stomach cancer has also declined.The May 5, 2010, issue of JAMA contains several articles about stomach cancer.
Characterization of Circulating Monoclonal B Lymphocytes in Patients with HCV Infection
Authors: Korenori Ohtsubo, Takashi Okamura, Michio Sata, Takumi Kawaguchi, Satoshi Morishige, Yuka Takata, Eijiro Oku, Rie Imamura, Ritsuko Seki, Michitoshi Hashiguchi, Koichi Osaki, Kazuaki Yakushiji, Taisuke Kanaji, Kohji Yoshimoto, Takato Ueno
Journal: Blood (2008)
Pathology of congenital Zika syndrome in Brazil: a case series
Authors: Roosecelis Brasil Martines, Julu Bhatnagar, Ana Maria de Oliveira Ramos, Helaine Pompeia Freire Davi, Silvia D'Andretta Iglezias, Cristina Takami Kanamura, M Kelly Keating, Gillian Hale, Luciana Silva-Flannery, Atis Muehlenbachs, Jana Ritter, Joy Gary, Dominique Rollin, Cynthia S Goldsmith, Sarah Reagan-Steiner, Yokabed Ermias, Tadaki Suzuki, Kleber G Luz, Wanderson Kleber de Oliveira, Robert Lanciotti, Amy Lambert, Wun-Ju Shieh, Sherif R Zaki
Journal: The Lancet (2016)
Correlation of different CT densities of untreated dedifferentiated liposarcoma (ddLPS) with rate of growth.
Authors: Sree Harsha Tirumani, Andrew J. Wagner, Harika Tirumani, Jyothi Priya Jagannathan, Atul B. Shinagare, Jason L. Hornick, Nikhil H. Ramaiya
Journal: Journal of Clinical Oncology (2014)

10580 Background: The biologic behavior of ddLPS is spatially and temporally heterogeneous. On imaging, untreated ddLPS shows widely varied CT densities. In this study, we retrospectively analyzed tumor growth rate as a function of tumor density. Methods: We identified 44 patients (pts) with ddPLS (35M, 18F; mean age at diagnosis= 59 years, range, 35 – 82 years) who had one or more resections and no intervening chemo or radiotherapy. Two radiologists reviewed CT imaging immediately obtained before the surgical resection (pre-surgery) and up to a maximum of one year before the surgery (baseline) to note the density of the nonlipomatous elements and the rate of growth during that period. Clinical and histopathological data were extracted from the electronic medical records. Results: We observed three distinct densities of the nonlipomatous components in our study: soft tissue density (SD) (>20HU), fluid density (FD) (-10 to +20HU), and mixed density (MD) (combination of soft tissue, fluid or fat). Tumors were of intermediate grade (36 SD, 9 MD, 5 FD) or high grade (18 SD, 2 MD, 1FD). Grade was unavailable for 1 tumor. Pre-surgery scans showed 72 tumors including 55 SD, 11 MD, and 6 FD. Baseline scans were available for 35 of the 72 lesions and included 26 SD, 5 MD, and 4 FD. The respective median growth rates per month were 40% (SD), 28% (MD), and 72% (FD). There was a change in density in 1/ 5 MD lesions (to SD) and 3/4 FD lesions (to SD). Conclusions: ddLPS has three distinct densities on imaging. Fluid density lesions have rapid growth rate and often convert to soft tissue density. Whether fluid density lesions need more aggressive management given their rapid growth rate needs further evaluation.
Brief Communication: Familial Medullary Thyroid Carcinoma and Pheochromocytoma: Epidemiologic Investigations
Authors: Frederick P. Li, Kenneth E. W. Melvin, Armen H. Tashjian, Paul H. Levine, Joseph F. Fraumeni
Journal: JNCI Journal of the National Cancer Institute (1974)

Epidemiologic studies were made of familial medullary thyroid carcinoma-pheochromocytoma syndrome occurring in an autosomal dominant pattern in 20 members of a kindred, including 13 with occult tumors diagnosed by laboratory surveillance. Parathyroid hyperfunction, neurocutaneous lesions, dermatoglyphic aberrations, serologic hyperreactivity to Epstein-Barr virus, and increased in vitro viral transformation of skin fibroblasts were detected in some family members; the significance of these findings may be clarified by careful evaluation of these indIviduals for new tumors.
Abstract P309: Prevalence of Low Ankle-Brachial Index among Individuals with Non-High Risk for Coronary Heart Disease: Data from the National Health and Nutrition Examination Survey 1999–2004
Authors: Hongyan Ning, Donald Lloyd-Jones
Journal: Circulation (2012)

Background: Abnormal ankle-brachial index (ABI) is prospectively associated with coronary heart disease (CHD) independent of traditional Framingham risk scores (FRS) variables. Two-thirds of CHD events occur in individuals with lower FRS (&lt;20%). Evaluating the role of supplemental risk assessment with ABI among those subjects may have significant public health impact. We explore prevalence of abnormal ABI among the low-intermediate risk US population according to sex, age and race. Methods: We included 5035 cardiovascular disease-free, nonpregnant, nondiabetic individuals aged from 40 to 79 years from the National Health and Nutrition Examination Survey 1999–2004, representing approximately 75 million US adults. FRS was used to estimate participants’ 10-year risk for CHD, and two risk categories were defined as low (&gt; 6%) and intermediate (6% – &lt; 20%). Individuals with risk estimates ≥ 20% were excluded from this analysis. Abnormal ABI was defined as ABI &lt; 0.9. Participants were categorized into younger ages (40–64) and older ages (65–79). The number needed to screen (NNS), which is the number of people within each stratum that needed to be screened to detect one person with abnormal ABI was used to assess the yield of screening for ABI. Results: Mean age was 53.1 years, with 45% (2261/5035) male, 19% (978/5035) non-Hispanic Black. Weighted prevalence of an abnormal ABI was 1.63% (61/2261) in men and 3.78% (138/2774) in women, corresponding to 2.1 million US adults aged 40 and above. Abnormal ABI was observed in 0.4% (2/714) and 2.4% (59/1488) in men (NNS=357 and 26) of those with low and intermediate risk, and 2.8% (85/2248) and 9.4% (53/526) in women (NNS=26 and 10), respectively. Older participants have higher prevalence of abnormal ABI than younger both in men (4.4% (29/435) vs. 1.8% (32/1826), NNS=15 and 57) and women (7.5% (63/748) vs. 2.9% (75/2026), NNS=12 and 27). Non-Hispanic Blacks have higher prevalence of abnormal ABI than other races in men (Black: 3.1% (21/458) vs. White: 1.6% (29/1144) and others: 0.9% (11/659)) as well as in women (Black: 7.1% (40/520) vs. White: 3.7% (64/1379) and others: 2.3% (34/875)). Conclusions: Among individuals at low-intermediate predicted 10-year CHD risk in US population, we observed concordance between abnormal ABI prevalence and FRS risk strata. The yield of screening and possibility of identifying abnormal ABI cases is highest in those with intermediate risk, especially older ages, non-Hispanic blacks and females.
Case 69-1963
Authors: Oliver Cope, Austin L. Vickery
Journal: New England Journal of Medicine (1963)

Presentation of Case First admission. A seventy-one-year-old woman entered the hospital because of pain and swelling in the left leg.The patient had been well until one year previously, when fatigue, anorexia and weight loss developed. Two months before admission the left calf became painful, and a diagnosis of cellulitis was made. The pain subsided but recurred two weeks before entry, together with persistent heat and swelling of the calf.Pneumonia and empyema had occurred at the age of nine years, and she had experienced several attacks of bronchitis in recent years. A sister had anemia of unknown cause. . . .
P242 The order effect of experimental oesophageal acidification on cough reflex sensitivity in chronic cough patients and healthy volunteers: Abstract P242 Table 1
Authors: D Valdramidou, H Sumner, E Hilton, S Whiteside, JA Smith
Journal: Thorax (2015)

<h3>Background</h3> One of the mechanisms thought to be involved in the triggering of chronic cough is gastroesophageal reflux. We aimed to compare the effects of oesophageal acid infusion on cough reflex sensitivity in chronic cough (CC) patients with healthy volunteers (HV). <h3>Method</h3> In a randomised, double–blind, placebo-controlled, crossover study, 0.15 M hydrochloric acid/saline was infused in the distal oesophagus of each subject. Each infusion treatment was separated by a washout period of at least 7 days. Single dose inhalation capsaicin challenge (C<sub>5</sub>) was used to measure cough reflex sensitivity before (baseline), immediately after (t = 0 mins) and 90 min, 180 min and 24 hrs post infusion. Data were analysed using Generalised Estimating Equation (GEE) models. <h3>Results</h3> Ten CC patients (mean age 56.0 ± 11.0 years, 8 females) and twelve HV (mean age 26 ± 8.3 years, 7 females) completed the study. Overall, CC patients had a more sensitive cough reflex than HV (geometric mean ratio 0.46; ratio 0.05, Table 1). Furthermore, there was a significant order effect (acid-saline vs saline-acid); CC patients appeared to be sensitised to acid infusion when given first (p-value = 0.039), but not second (p-value = 0.245), whereas HV cough responses were not influenced by the infusion order (all p-values &gt; 0.05). <h3>Conclusions</h3> In our experience, distal oesophageal acid infusion did not sensitise the cough reflex in either CC patients or HV. Notably, the order of the infusions heavily influenced the cough responses of CC patients compared to HV. Future study designs need to be cognisant of order effects and if cross-over designs are used, test for the presence of these.
The HIV prevention cascade: integrating theories of epidemiological, behavioural, and social science into programme design and monitoring
Authors: James R Hargreaves, Sinead Delany-Moretlwe, Timothy B Hallett, Saul Johnson, Saidi Kapiga, Parinita Bhattacharjee, Gina Dallabetta, Geoff P Garnett
Journal: The Lancet HIV (2016)
Small-Bowel Tumors Diagnosed by Wireless Capsule Endoscopy: Report of Five Cases
Authors: M.  N.  G.  de Mascarenhas-Saraiva, L.  M.  da Silva Araújo Lopes
Journal: Endoscopy (2003)

Tumors of the small bowel, both benign and malignant, are relatively uncommon. As the symptoms are vague and conventional diagnostic tests are unsatisfactory, these tumors often present a clinical, radiological, and endoscopic challenge. We report here on five patients in whom small-bowel tumors were diagnosed using wireless capsule endoscopy. The indications for capsule endoscopy were: obscure gastrointestinal bleeding in four patients (one jejunal capillary hemangioma, one ileal hemangiosarcoma, and two jejunal gastrointestinal stromal tumors) and chronic abdominal pain in one patient (ileal carcinoid). Wireless capsule endoscopy, a new endoscopic method, promises to improve the diagnosis of deep small-bowel pathology.
Pembrolizumab (MK-3475) plus 5-fluorouracil (5-FU) and cisplatin for first-line treatment of advanced gastric cancer: Preliminary safety data from KEYNOTE-059.
Authors: Charles S. Fuchs, Atsushi Ohtsu, Josep Tabernero, Eric Van Cutsem, Jiang Dian Wang, Baohoang Lam, Minori Koshiji, Yung-Jue Bang
Journal: Journal of Clinical Oncology (2016)

161 Background: Standard first-line treatment for advanced gastric cancer includes combination chemotherapy with a platinum agent and a fluoropyrimidine. The anti–PD-1 humanized monoclonal antibody pembrolizumab (pembro) has shown promising antitumor activity as monotherapy in patients (pts) with advanced gastric cancer. We report preliminary safety data for pts with advanced gastric cancer treated with pembro + cisplatin and 5-FU in the multicohort, phase 2 KEYNOTE-059 study (NCT02335411). Methods: Eligible pts were aged ≥ 18 y and had HER2 – relapsed or metastatic gastric or gastroesophageal junction adenocarcinoma, ECOG PS 0-1, and no prior therapy for metastatic disease. Pts received pembro 200 mg + 5-FU 800 mg/m 2 (or capecitabine 1000 mg/m 2 in Japan) + cisplatin 80 mg/m 2 Q3W for 6 cycles followed by pembro + 5-FU for up to 2 y or until confirmed progression, intolerable toxicity, or investigator decision. Primary end point was safety and tolerability of the combination. Results: Of the 17 pts enrolled (10 from Asia, 7 from outside Asia), 70.6% were men, and median age was 58.0 y. Three pts (17.6%) had a prior gastrectomy—2 total, 1 partial. As of the Aug 12, 2015, data cutoff date, median follow-up duration was 3.6 mo (range 2.6-5.4), and pts received a median of 5 treatment cycles (range 3-7). Only 1 pt (5.9%) discontinued treatment (due to progressive disease). There were no treatment-related deaths or discontinuations. Twelve pts (70.6%) experienced treatment-related adverse events (AEs) of any grade, most commonly neutropenia/decreased neutrophils (n = 7, 41.2%), stomatitis (n = 6, 35.3%), and decreased appetite (n = 5, 29.4%). Eight pts (47.1%) experienced ≥ 1 grade 3-4 treatment-related AE; only neutropenia/decreased neutrophils (n = 4 [23.5%] grade 3, n = 3 [17.6%] grade 4) occurred in &gt; 1 pt. AEs of interest based on immune etiology, regardless of attribution by investigator, were grade 2 infusion-related reaction and grade 2 pruritus (n = 1 [5.9%] each). Conclusions: Preliminary data from KEYNOTE-059 suggest the combination of pembro, cisplatin, and 5-FU has a manageable safety profile as first-line therapy in pts with advanced gastric cancer. Clinical trial information: NCT02335411.
Nivolumab in Combination With Platinum‐Based Doublet Chemotherapy for First-Line Treatment of Advanced Non–Small-Cell Lung Cancer
Authors: Naiyer A. Rizvi, Matthew D. Hellmann, Julie R. Brahmer, Rosalyn A. Juergens, Hossein Borghaei, Scott Gettinger, Laura Q. Chow, David E. Gerber, Scott A. Laurie, Jonathan W. Goldman, Frances A. Shepherd, Allen C. Chen, Yun Shen, Faith E. Nathan, Christopher T. Harbison, Scott Antonia
Journal: Journal of Clinical Oncology (2016)

Nivolumab, a fully human immunoglobulin G4 programmed death-1 immune checkpoint inhibitor antibody, has demonstrated improved survival in previously treated patients with advanced non-small-cell lung cancer (NSCLC). CheckMate 012, a phase I, multicohort study, was conducted to explore the safety and efficacy of nivolumab as monotherapy or combined with current standard therapies in first-line advanced NSCLC. Here, we report results for nivolumab plus platinum-based doublet chemotherapy (PT-DC).Patients (N = 56) received nivolumab (intravenously) plus PT-DC concurrently every 3 weeks for four cycles followed by nivolumab alone until progression or unacceptable toxicity. Regimens were nivolumab 10 mg/kg plus gemcitabine-cisplatin (squamous) or pemetrexed-cisplatin (nonsquamous) or nivolumab 5 or 10 mg/kg plus paclitaxel-carboplatin (all histologies). The primary objective was to assess safety and tolerability. Secondary objectives included objective response rate and 24-week progression-free survival rate (per Response Evaluation Criteria in Solid Tumors version 1.1); exploratory objectives included overall survival (OS) and response by tumor programmed death ligand-1 expression.No dose-limiting toxicities occurred during the first 6 weeks of treatment. Forty-five percent of patients (25 of 56 patients) reported grade 3 or 4 treatment-related adverse events (AEs); 7% of patients (n = 4) had pneumonitis. Twenty-one percent of patients (n = 12) discontinued all study therapy as a result of treatment-related AEs. Objective response rates for nivolumab 10 mg/kg plus gemcitabine-cisplatin, nivolumab 10 mg/kg plus pemetrexed-cisplatin, nivolumab 10 mg/kg plus paclitaxel-carboplatin, and nivolumab 5 mg/kg plus paclitaxel-carboplatin were 33%, 47%, 47%, and 43%, respectively; 24-week progression-free survival rates were 51%, 71%, 38%, and 51%, respectively; 2-year OS rates were 25%, 33%, 27%, and 62%, respectively. Responses were achieved regardless of tumor programmed death ligand-1 expression.The safety profile of nivolumab plus PT-DC was consistent with that expected for individual agents; however, treatment discontinuation related to AEs was greater with the combination. Encouraging activity was observed, especially for the nivolumab 5 mg/kg plus paclitaxel-carboplatin group, with a 2-year OS rate of 62%.
Soundings: Personal statement syndrome
Authors: Trisha Greenhalgh
Journal: BMJ (2004)

My friend's 12 year old son wanted to give up music lessons. Sure, said his dad, but tell me why. Didn't he like the teacher? Was there too much pressure? Had he stopped enjoying the violin? “Dad,” replied the child, “I never liked music, but I reckon I'm good enough now to put it on my CV.”

Last month, I attended a school concert and heard a 17 year old play a concerto by Liszt. He played by ear—faultlessly and passionately. The young man's face was contorted with concentration; his forehead dripped sweat. In the tough allegro section he bit his lip so hard I thought it might bleed.

Profoundly talented as he undoubtedly was, this level of performance was the result of years of practice and, I mused, considerable self sacrifice in the face of the usual adolescent temptations. But it was more than that. The boy played the piano for the sheer love of it. After his ovation, he had gently closed the piano lid, unfolded a handkerchief, and discreetly wiped tears from his eyes.

I recently helped interview a group of 17 year old hopefuls who were applying to do medicine. Their personal statements were uniformly perfect. As well as the expected row of A grades at GCSE, every one of them boasted excellence in at least three of the Big Four: music, sport, drama, and community service.

They had all done their homework—identifying the subconscious benchmarks that ageing professors use when evaluating the achievements of the young, and ensuring that they scored above the line. I asked one multitalented individual what she had got out of playing in an orchestra. Her measured reply—that the experience had taught her teamwork and commitment, and had provided balance in her timetable while taking five science A levels—gained her top marks on our assessment sheet.

We are now admitting cohorts of medical students who, like my friend's son, have been constructing their CVs since the age of 9. With a few radiant exceptions, their very identities are a pastiche of academic and personal achievements, carefully constructed for viewers like you and me. Surely we owe it to our children to change the system that is requiring them to become so hollow?
Accelerated telomere attrition in children and teenagers with α<sub>1</sub>-antitrypsin deficiency
Authors: Amparo Escribano, Sara Pastor, Ana Reula, Silvia Castillo, Silvia Vicente, Francisco Sanz, Francisco Casas, María Torres, Estrella Fernández-Fabrellas, Pilar Codoñer-Franch, Francisco Dasí
Journal: European Respiratory Journal (2016)

Numerous studies have shown that oxidative stress accelerates telomere shortening in several lung pathologies. Since oxidative stress is involved in the pathophysiology of α 1 -antitrypsin deficiency (AATD), we hypothesised that telomere shortening would be accelerated in AATD patients. This study aimed to assess telomere length in AATD patients and to study its association with α 1 -antitrypsin phenotypes. Telomere length, telomerase activity, telomerase reverse transcriptase ( hTERT ) expression and biomarkers of oxidative stress were measured in 62 children and teenagers (aged 2–18 years) diagnosed with AATD and 18 controls (aged 3–16 years). Our results show that intermediate-risk (MZ; SZ) and high-risk (ZZ) AATD patients have significantly shorter telomeres and increased oxidative stress than controls. Correlation studies indicate that telomere length was related to oxidative stress markers in AATD patients. Multiple hypothesis testing revealed an association between telomere length, telomerase activity, hTERT expression and AATD phenotypes; high-risk patients showed shorter telomeres, lower hTERT expression and decreased telomerase activity than intermediate-risk and low-risk patients. AATD patients show evidence of increased oxidative stress leading to telomere attrition. An association between telomere and α 1 -antitrypsin phenotypes is observed suggesting that telomere length could be a promising biomarker for AATD disease progression.
Abstract 20265: Myocardial Blood Flow Quantification with Rubidium-82 Cardiac PET has Incremental Prognostic Value in Patients with Known or Suspected Coronary Artery Disease
Authors: Hoshang Fahrad, Vincent Dunet, Vincent Soubeyran, Fabrice Camus, Gilles Allenbach, John O Prior
Journal: Circulation (2010)

Aim: Cardiac PET allows non-invasively assessment of myocardial blood flow (MBF) and myocardial flow reserve (MFR). The impact of MBF and MFR in predicting major adverse cardiovascular events (MACE...