tbuckley/cabot-search huggingface dataset:
The interaction of scientific evidence and politics in debates about preventing malaria in 1925
Authors: Gabriel Gachelin
Journal: Journal of the Royal Society of Medicine (2013)

Malaria parasites were identified by Laveran in Algeria in 1883, their cycle largely elucidated by Ross in India in 1895 and transmission of malaria by Anopheles was identified by Grassi in Italy in 1899.1–3 Very soon after the transmission of malaria had been elucidated, the first science-based approaches to preventing the disease were designed and implemented by Celli in Italy.4,5

Italy had had a tradition of draining marshes going back to Etruscan times. In 1883, this strategy was officially implemented by an Italian Royal law and named Bonifica. Because of the role of water in the breeding of Anopheles, Bonifica was not unnaturally assumed to be a way of controlling malaria. Although anti-malaria prophylaxis based on intervening in the biology of Anopheles or on extensive land drainage could be seen as complementary procedures, they were curiously seen to be in opposition. The efficacy of Bonifica as an anti-malaria measure was challenged by experts in malaria prophylaxis and epidemiology. However, in 1925 the Italian government chose to favour Bonifica, and this shaped Italian anti-malaria campaigns for the next 15 years. In selecting Bonifica as the ‘official’ Italian policy of malaria prophylaxis, conflicts within the fascist movement6 played a more significant role than that of science and medicine.
Amphiregulin is an estrogen-responsive gene which predicts recurrence-free survival in patients with estrogen receptor positive breast tumors.
Authors: PA Kenny
Journal: Cancer Research (2009)

Abstract Abstract #3039 Estradiol is a potent growth factor in estrogen receptor positive breast disease. Activated estrogen receptors have been reported to activate many hundreds of genes, yet the key effector genes for breast cancer cell proliferation remain poorly understood. Here, we have focused on one such target gene, Amphiregulin, which encodes a ligand for the Epidermal Growth Factor Receptor. We report that Amphiregulin is induced by estrogens and repressed by estrogen receptor antagonists in several breast cancer cell lines (MCF7, ZR75B and T47D), and that it promotes breast epithelial cell proliferation. Using microarray analysis of primary tumors, we find that Amphiregulin and ER-alpha expression are highly positively correlated in human breast cancer cases (n = 295). Additionally, in a cohort of women with ER+ breast tumors (n = 60), high levels of Amphiregulin predicted response to tamoxifen. We further demonstrate that Amphiregulin production can be blocked by inhibiting TACE/ADAM17, a metalloproteinase which regulates the shedding of Amphiregulin from the cell surface.&amp;#x2028; Collectively, these data suggest that Amphiregulin may be a key transcriptional target of estrogen receptor signaling and a marker for Estrogen Receptor positive tumors that are especially dependent on estrogen and, therefore, particularly sensitive to tamoxifen. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3039.
TIME TO DISCOVERY OF LEFT VENTRICULAR THROMBUS AFTER ANTERIOR WALL ST ELEVATION MYOCARDIAL INFARCTION WITH REDUCED EJECTION FRACTION TREATED WITH PERCUTANEOUS CORONARY INTERVENTION AND DUAL ANTIPLATELET THERAPY
Authors: Kipp Slicker, Ola Oyetayo, Wesley Lane, Dane Langsjoen, Ryan Mack, Lisa De La Rosa, Chhaya Patel, Christopher Chiles
Journal: Journal of the American College of Cardiology (2015)
DAMAGING CARDIAC GENE VARIANTS DETERMINE RESPONSE TO LVAD THERAPY
Authors: Eric Rome, Kajari Dhar, Alexandra Moulton, Junhan Zhao, Jeff Kittrell, James Eudy, Eugenia Raichlin, John Um, Michael Moulton, Geoffrey Thiele, Ronald Redder, Daniel Anderson, Brian Lowes
Journal: Journal of the American College of Cardiology (2015)
Computed Tomographic Findings in Microcephaly Associated with Zika Virus
Authors: Adriano N. Hazin, Andrea Poretti, Danielle Di Cavalcanti Souza Cruz, Marli Tenorio, Ana van der Linden, Lindomar Jose Pena, Carlos Brito, Laura H. Vega Gil, Demócrito de Barros Miranda-Filho, Ernesto Torres de Azevedo Marques, Celina M. Turchi Martelli, João G. Bezerra Alves, Thierry A. Huisman
Journal: New England Journal of Medicine (2016)

This report describes the characteristics of infants who were exposed to the Zika virus in utero and were born with abnormalities of the central nervous system, as seen on computed tomography.
Abstract P5-12-02: Long Term Cardiac Toxicity after Adjuvant Trastuzumab for Early Breast Cancer: Implications for Life-Expectancy and Cost-Effectiveness
Authors: PS Hall, C McCabe, CJ Plummer, DA. Cameron
Journal: Cancer Research (2010)

Abstract Introduction: Trastuzumab has significantly improved survival outcomes for women with HER2 over-expressing early breast cancer. Observed short term cardiac toxicity appears reversible in the majority of cases and confidence in the long term safety is growing. Despite this, reported follow-up from adjuvant trastuzumab clinical trials does not extend beyond six years. If trastuzumab causes myocardial cell death with loss of cardiac reserve in addition to reversible myocardial stress alone, this may lead to an increased long term risk of congestive heart failure (CHF). The future incidence of this possible late cardiac toxicity remains uncertain. The aim of this study is to quantify the consequences of scenarios of late cardiac toxicity on the survival benefit and cost-effectiveness of adjuvant trastuzumab for women treated for HER2 over-expressing early breast cancer. Methods: A cost-utility analysis was performed using a discrete-state time-dependent semi-Markov model to calculate expected costs and benefits over the lifetime of an average cohort of women with HER2 over-expressing early breast cancer when treated with or without one year of adjuvant trastuzumab. The perspective was the UK NHS. Scenarios across the full range of possibility were explored along with estimates based on expert opinion to determine the impact of possible long-term cardiac toxicity on life-expectancy, quality of life and treatment costs. Probabilistic sensitivity analysis was used to characterise uncertainly around expected outcomes. Results: With a willingness-to-pay threshold of £30,000 (GBP) per quality adjusted life-year, trastuzumab is cost-effective if the lifetime increased risk of CHF is no more than three times the average level expected in an anthracycline treated population of women diagnosed with HER2 overexpressing early breast cancer (figure 1). Life-expectancy gains from using adjuvant trastuzumab persist even if there is a high consequent lifetime risk of congestive cardiac failure (figure 2). Conclusion: The use of adjuvant trastuzumab remains the optimal clinical and economic treatment strategy even if its use leads to moderately increased levels of cardiac disease in later life. This study supports current confidence in its cost-effectiveness and safety. Long-term follow-up after current and future adjuvant breast cancer trials is essential in to reduce the uncertainty around these estimates. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-12-02.
882 GENETIC VARIATIONS IN proprotein convertase subtilisin/kexin type 9 (PCSK9) GENE ARE ASSOCIATED WITH RESPONSE TO PEGYLATED INTERFERON/RIBAVIRIN IN HEPATITIS C VIRUS GENOTYPE 3-INFECTED PATIENTS
Authors: K. Neukam, A. Caruz, A. Rivero-Juárez, P. Labarga, M. Márquez, L.M. Real, R. Herrero, A. Rivero, V. Soriano, J.A. Pineda
Journal: Journal of Hepatology (2013)
P17.76 * LOW-DOSE RATE STEREOTACTIC IODINE-125 BRACHYTHERAPY FOR THE TREATMENT OF INOPERABLE PRIMARY AND RECURRENT GLIOBLASTOMA: SINGLE-CENTER EXPERIENCE WITH 201 CASES
Authors: P. Kickingereder, C. Hamisch, B. Suchorska, N. Galldiks, V. Visser-Vandewalle, R. Goldbrunner, M. Kocher, H. Treuer, J. Voges, M. I. Ruge
Journal: Neuro-Oncology (2014)

BACKGROUND: Treatment options for inoperable glioblastoma are limited. Low-dose-rate stereotactic iodine-125 brachytherapy (SBT) has been reported as an effective and low-risk treatment option for circumscribed low-grade gliomas and brain metastases. The present study evaluates this treatment approach for patients with inoperable glioblastoma. METHODS: Between 1990 and 2012, 201 patients with histologically proven glioblastoma were treated with SBT (iodine-125 seeds; median cumulative surface dose, 60Gy; median dose-rate, 6cGy/h; median gross-tumor-volume, 17ml) either as primary treatment (n = 103) or at recurrence (n = 98). In addition to SBT, 90.3% of patients in the primary treatment group received external boost radiotherapy (median dose, 25.2Gy). Adjuvant chemotherapy was added for 30.8% of patients following SBT and consisted of temozolomide for the majority of cases (88.7%). Procedure-related complications, clinical outcome, progression-free and overall survival (PFS, OS) were evaluated. Median follow-up was 9.8 months. RESULTS: The procedure-related mortality was zero. During follow-up, transient and permanent procedure-related morbidity was observed in 7.5% and 2.0%, respectively. Calculated from the time of SBT, median OS and PFS rates were 10.5 and 6.2 months, with no significant differences among primary and recurrent tumors (11.1 vs.10.4 months for OS and 6.2 vs. 5.9 months for PFS). For OS, multivariate analysis revealed Karnofsky performance score, age, and adjuvant chemotherapy as independent prognostic factors (all p < 0.01). CONCLUSION: Low-dose-rate SBT is a safe and effective local treatment option for patients with circumscribed inoperable glioblastoma initially or at recurrence. It deserves prospective validation since it may potentially improve the outcome for a subset of patients with inoperable GBM.
PWE-187 Colonic biopsies to detect microscopic colitis in patients with diarrhoea and “normal” colonoscopy: worth the effort?
Authors: P S Sidhu, F Khan, J Hebden, M Donnelly
Journal: Gut (2012)

<h3>Introduction</h3> Patients investigated for diarrhoea often have macroscopically normal colonoscopies. Biopsies are, however, required in order to diagnose microscopic colitis (MC). Obtaining colonoscopic biopsies for persistent diarrhoea is an auditable JAG standard. The aim of this study, carried out in a single large NHS Teaching Hospitals Trust was (1) To measure the incidence of MC in patients with diarrhoea who had a “normal” colonoscopy. (2) To examine whether the discipline of the colonoscopist affected whether biopsies were taken in this situation or not. (3) To assess which biopsy protocols were being used. <h3>Methods</h3> An analysis was performed of all colonoscopies with the indication of diarrhoea, with normal findings, undertaken in 2010. Interrogation of the endoscopy recording system (ERS), looked at endoscopist discipline, if biopsies were taken, biopsy sites and histology results. <h3>Results</h3> A total of 4753 colonoscopy records were examined, of which 750 (15.8%) were performed for diarrhoea. 313/750 (41.7%) were described as being entirely normal. Of the 313 “normal” colonoscopies, 132 (42.2%) were performed by physicians; 40 (12.8%) surgeons; 124 (39.6%) nurses; 17 (5.4%) not specified. 294 (93.9%) colonoscopies had biopsies taken and MC was confirmed histologically in 14 (4.8%). Among the different professional groups, there was variation in the frequency of obtaining biopsy specimens: physicians 126/132 (95.5%), surgeons 35/40 (87.5%) and nurses 118/124 (95.2%). The difference between physicians and surgeons was not statistically significant (χ<sup>2</sup>=3.55, p=0.06). Positive biopsy for MC was similar between the different groups: physicians 5 (3.8%), surgeons 2 (5.0%), nurses 5 (4.0%) (p=NS). Of the patients who did have biopsies performed, 274/294, (93%) had both right and left colon sampled. <h3>Conclusion</h3> The vast majority (93.9%) of patients presenting with diarrhoea and a normal colonoscopy in our unit are having colonic biopsies performed to exclude a diagnosis of microscopic colitis. The histology positivity rate was 5%, comparable to similar published series. A majority of all professional colonoscopists perform colonic biopsies appropriately in the setting of diarrhoea and normal colonoscopy. There is variability, but this is not statistically significant. <h3>Competing interests</h3> None declared.
SAT0086 Rapid Access Rheumatology Consultation (RAC) – an Office-Based Pilot Project
Authors: R. Puchner, W. Kaiser, R. Tremetsberger, M. Steininger, F. Linkesch, R. Janetschko, K. Machold
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Objectives</h3> Waiting times for first appointments are a major obstacle to timely Rheumatology care. In order to improve access, a cooperative of office based Rheumatologists established an immediate access network offering brief initial assessments for patients with musculoskeletal problems. <h3>Methods</h3> Patients were assessed at presentation in the offices and followed up after 6 months. Data regarding demographics, diagnostic accuracy, clinical parameters such as pain levels, and care at baseline and after 6 months were analysed. <h3>Results</h3> From October 2012 to March 2013 335 patients were assessed in the 6 cooperating practices during dedicated office hours (each office opening once a week for this service). 124 patients (38%) had a symptom duration less than 3 months, for rheumatoid arthritis (RA) patients this proportion was 42%. In the 271 patients available for reassessment after 6 months, initial suspected diagnosis was confirmed in 88%. Initial tentative diagnosis of RA (60 patients) was confirmed in 93%, of spondyloarthritis (46 patients) in 83%. At follow up, the visual analogue scale for pain in RA patients had significantly decreased from a median (IQR) of 70 (56 - 80) to a median (IQR) of 26 (20 - 42), for patients with spondyloarthritis from 50 (36 - 80) to 30 (20 - 40). <h3>Conclusions</h3> The RAC resulted in a substantial waiting time reduction for rheumatology assessment. More than one third of the patients were seen before 3 months disease duration. Suspected diagnoses of inflammatory rheumatic diseases were correct in almost 90%. This initiative demonstrates the feasibility of a rapid access service and indicates high diagnostic accuracy in such a setting as well as the effectiveness of treatments recommended by the Rheumatologists. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.4746
A memorable event: New doctors
Authors: R. M Kirby
Journal: BMJ (2000)

It was set to be a wasted day. The postgraduate dean's office had decided that all house officer appointments in the region should be made using a regional matching plan. We had been given a list of possible candidates to interview and the date. I had to cancel my planned sessions for the whole day.

Our interviewees had all just started their final year of training. Some had been interviewed already for house officer posts elsewhere, but others had probably not had an interview since applying for medical school. They were refreshingly honest in answering questions. They were telling us what they thought of what they were learning at the moment and what they were gaining from their training. They told us what they felt, rather than a politically correct version more applicable to a job interview. They were all bright and enthusiastic about the prospect of being a doctor this time next year. They all wanted to come to a busy district general hospital, which is why they were applying to us, and they all wanted to work hard and gain a lot of experience. There was no cynicism about the NHS, and no real worries about the future—apart from a few examinations. Few had any real idea what they wanted after house jobs; that was the only target in sight at present.

These students had recently returned from electives. They all had fascinating stories to tell about their experiences. Between them they had helped orphans in South America, backpacked around Sri Lanka, visited Indian hospitals, explored the borders of Pakistan, gone through jungles, and visited centres in north America and Australia. We learnt about the priorities between getting in the harvest or losing the sight of an eye in the Third World. It was a good day. I was buoyed up by the enthusiasm of these young people who wanted to come and work with us. There was not a single candidate that we would have even considered rejecting. I had been fascinated by their amazing experiences. What goes wrong later? Why are we losing this enthusiasm once they achieve their first goals? Not only did I enjoy the day, but I realised that it is partially up to us to try and keep the fires of enthusiasm burning. I am already looking forward to next year's interviews.
SYMPTOM ONSET TO BALLOON TIME, ST-SEGMENT RESOLUTION AND IN-HOSPITAL MORTALITY IN ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION PATIENTS UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION IN CHINA
Authors: Fei Song, YueJin Yang, Jingang Yang, Mengyue Yu, Yanyan Zhao
Journal: Journal of the American College of Cardiology (2016)
Tips for a Physician in Getting the Right Job, Part X
Authors: Jay A. Harolds
Journal: Clinical Nuclear Medicine (2014)

Preparation for a job interview is very helpful in building up the applicant's self-confidence and having the interview go well. One aspect of interviewing is the appearance of the applicant. Appearance is a very important factor in the overall impression the candidate makes on the interviewers. This article gives a number of pointers about preparation and discusses the subject of interviewee appearance in depth.
Abstract 4426: Preclinical development of a rare tumor model: Establishment and characterization of a patient-derived collecting duct carcinoma
Authors: Amalraj Thangasamy, Francis Nieves, Kyriakos Papadopoulos, Amita Patnaik, Anthony Tolcher, Michael J. Wick
Journal: Cancer Research (2011)

Abstract Collecting duct carcinoma (CDC) is a rare type of renal tumor accounting for approximately 2% of all renal cell carcinomas (RCC). Unlike common RCC that arises from the convoluted tubules of the renal cortex, this aggressive tumor is derived from the renal medulla, possibly from the distal collecting duct of Bellini. Clinically this aggressive tumor is shown to have a poor response to therapy and the majority of patients when diagnosed are in the metastatic phase. While several agents have been recently approved for standard RCC, lack of useful preclinical models of CDC have limited drug screening for potential therapies. To this end we have established a patient-derived model of CDC and characterized mutational status and target expression. In addition, we have evaluated in vivo drug sensitivity to agents approved for standard RCC including sorafenib and sunitinib as well as the chemotherapies irinotecan and gemcitabine and targeted therapy temsirolimus. For model establishment a core biopsy was collected and engrafted into an immune-deficient mouse; once take was confirmed tumor tissue was passaged until model stabilization at which point tissue was taken for characterization and in vivo drug sensitivity evaluated. For model characterization, mutation status and expression of target molecules in proliferation pathways were examined by PCR and immunohistochemistry. In the drug sensitivity study, targeted RCC therapies and gemcitabine reported modest tumor growth inhibition while irinotecan was active with significant inhibitory effects. Some activity was reported with the mTOR inhibitor temsirolimus but its effect was not found statistically significant. Overall we have established and characterized a rare patient-derived tumor model of RCC and demonstrated its use as a tool for screening potentially useful agents for patients with collecting duct carcinoma. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 4426. doi:10.1158/1538-7445.AM2011-4426
Army medical staff plug shortages in accident and emergency department at Stafford Hospital
Authors: C. Dyer
Journal: BMJ (2011)

Army doctors and nurses have been brought in temporarily to plug staff shortages threatening safety at Stafford Hospital, in what is thought to be the first such instance in the NHS in England.

Two emergency doctors and four nurses from the Defence Medical Services have been drafted into the hospital’s accident and emergency department, which has only four of its complement of six consultants.

A national shortage of accident and emergency consultants and bad publicity arising …
TCT-691 Clinical Impact of the Presence of Aortic Regurgitation Following Transcatheter Aortic Valve Replacement:Insights into the Degree and Acuteness of Presentation
Authors: Marina Urena, Miguel Jerez-Valero, Webb John, Corrado Tamburino, Antonio J. Munoz-Garcia, Asim Cheema, Antonio E. Dager, Vicenç Serra, Ignacio J. Amat-Santos, Marco Barbanti, Sebastiano Immè, Juan Alonso Briales, Hatim Al Lawati, Luis M. Benitez, Angela Maria Cucalon, Bruno Garcia del Blanco, Ana Revilla, Eric Dumont, Henrique B. Ribeiro, Luis Nombela-Franco, Sébastien Bergeron, Philippe Pibarot, Josep Rodes-Cabau
Journal: Journal of the American College of Cardiology (2014)
Parotid Swelling, Alcoholism and Cirrhosis
Authors: Stanley J. Wolfe, W. H. J. Summerskill, Charles S. Davidson
Journal: New England Journal of Medicine (1957)

CHRONIC, noninflammatory enlargement of the parotid glands has been noted in populations whose food supplies are inadequate and in this country has been reported in persons suffering from malnutrition1 and certain chronic diseases.2 , 3 Chronic alcoholism is frequently responsible for severe malnutrition, and both conditions are widely considered fundamental in the etiology of Laënnec's cirrhosis of the liver. It is relevant that parotid enlargement also has been observed in alcoholic patients with hepatic cirrhosis in Italy and France.4 5 6 This report presents clinical and laboratory observations on 16 patients with hepatic cirrhosis associated with chronic alcoholism who had bilateral, symmetrical parotid swelling. . . .
Effects of Therapy in X-Linked Hypophosphatemic Rickets
Authors: Charles F. Verge, Albert Lam, Judy M. Simpson, Christopher T. Cowell, Neville J. Howard, Martin Silink
Journal: New England Journal of Medicine (1991)

Patients with X-linked hypophosphatemic rickets, which is clinically manifested by growth failure and bowing of the legs, are usually treated with phosphate and a vitamin D preparation. However, the efficacy of this treatment has been disputed, and nephrocalcinosis is a recognized complication of therapy.