tbuckley/cabot-search huggingface dataset:
Prognosis and Management after a First Myocardial Infarction
Authors: Arthur J. Moss, Jesaia Benhorin
Journal: New England Journal of Medicine (1990)

PATIENTS who have a first myocardial infarction deserve consideration as a special group. For the most part, the early mortality rate from a first infarction is roughly half the rate found in patients with a second or third infarction,1 , 2 and the long-term survival is considerably better than in patients who have had previous infarctions.3 , 4 The published studies on risk stratification4 5 6 and treatment7 8 9 after an infarction have paid remarkably little attention to patients having their first myocardial infarction. Such patients constitute a majority (60 to 80 percent) of those with acute infarction, yet they are rarely viewed as a special group. . . .
Acute Benign Pericarditis
Authors: Eli R. Movitt, Edwin H. Lennette, Jack F. Mangum, Morris Berk, Murdock S. Bowman
Journal: New England Journal of Medicine (1958)

EVIDENCE incriminating Coxsackie viruses as the causal agents of a variety of human diseases is gradually increasing. Thus, Coxsackie viruses of Group A, which contains at least 19 immunologically different virus types, have definitely been shown to cause herpangina and are strongly suspected to be etiologically involved in meningoencephalitis.1 2 3 Viruses of Group B, which contains 5 immunologically different types, are now generally accepted as etiologically responsible for Bornholm disease (Sylvest's disease, epidemic pleurodynia, epidemic myalgia) and for a proportion of cases classified clinically as aseptic meningitis or meningoencephalitis.More recently the Coxsackie viruses have been causally linked to several cases . . .
Early neoplasia of the common bile duct diagnosed and completely removed using multiple endoscopic modalities
Authors: N. Sirimontaporn, P. Aswakul, P. Junyangdikul, V. Prachayakul
Journal: Endoscopy (2013)

We report the case of a 73-year-old man who presented with a recurrent liver abscess, the second episode occurring after an interval a few months. Blood cultures were positive for Klebsiella pneumoniae on both admissions. He underwent magnetic resonance cholangiopancreatography (MRCP), which revealed a mildly dilated common bile duct (CBD) without any definite cause of obstruction. He was therefore scheduled to undergo further evaluation by endoscopic ultrasound (EUS), for which he was sedated in the endoscopic suite using intravenous propofol. Linear EUS (EG-3870UTK, Pentax, Miyaki, Japan) showed a 5-mm polypoid mass in the mid to distal portion of the CBD ([Fig. 1]). The gallbladder showed evidence of chronic cholecystitis without evidence of gallstones.
Changes in Intestinal Flora of Farm Personnel after Introduction of a Tetracycline-Supplemented Feed on a Farm
Authors: Stuart B. Levy, George B. FitzGerald, Ann B. Macone
Journal: New England Journal of Medicine (1976)

A prospective study was undertaken to determine whether feeding farm animals antibiotics in feed caused changes in the intestinal bacterial flora of farm dwellers and their neighbors. Chickens were fed tetracycline-supplemented feed (tet-feed), and, as expected, within one week their intestinal flora contained almost entirely tetracycline-resistant organisms. Increased numbers of resistant intestinal bacteria also appeared, but more slowly, in farm members, but not their neighbors. Within five and six months, 31.3 per cent of weekly fecal samples from farm dwellers contained greater than 80 per cent tetracycline-resistant bacteria as compared to 6.8 per cent of the samples from the neighbors (P less than 0.001). Seven of the 11 farm members, but only three of the 24 neighbors, had two or more fecal samples containing greater than 80 per cent tetracycline-resistant coliforms (P less than 0.01). These resistant bacteria contained transferable plasmids conferring multiple antibiotic resistances. Selective pressure by tet-feed for antibiotic-resistant bacteria in chickens extends to human beings in contact with chickens and the feed.
P103 Oral contraceptive use does not affect CF disease severity
Authors: N. G. Kernan, P. Cullinan, E. W. F. W. Alton, D. Bilton, U. Griesenbach
Journal: Thorax (2010)

Several studies using a variety of in vitro models indicate that sex hormones such as oestrogen can alter ion transport across epithelial cells by either directly affecting CFTR or altering the activity of alternative chloride channels; such effects may in part explain the gender-difference in disease severity observed in some studies. However, published data are inconsistent with several studies postulating beneficial and others detrimental effects of oestrogen on CF ion transport abnormalities. A large proportion of women with CF regularly use oral contraceptives (OC), but the effect of OC use on disease severity has not been systematically studied. Here, we assessed the effects of OC use in a retrospective study. The data included annual follow-up information from 681 women born between 1937 and 1992 of whom 42% have taken OC for varying periods of time. Data regarding OC use is currently available from 1981 to 2010. We performed an <i>inter-patient</i> analysis comparing average yearly changes in %FEV<sub>1</sub> and body mass index (BMI) and total days of intravenous (IV) antibiotic use over a 5-year period between matched cohorts of OC users (n=57), (median age at start of study period: 23 (16–45), median %FEV<sub>1</sub> at start of study period: 56.2 (20.4–111.1)), and OC non-users (n=57) (median age at start of study period: 22 (17–44), median %FEV<sub>1</sub> at start of study period: 48.4 (12.8–119.6)). We found no differences between the groups (median change in %FEV<sub>1</sub>: users: −1.87 (−11.5 to 10.4), non-users: −1.03 (−11.8 to 17.9); median change in BMI: users: 0.051 (−1.1 to 1.6), non-users: −0.065 (−1.5 to 3.3); median total days on antibiotics: users: 49 (0–308), non-users: 42 (0–378)). We next performed an <i>intra-patient</i> analysis of the same outcomes over a 3-year period on and a 3-year period off OC in the same patient (n=23–27), but again did not detect any differences in any of the clinical outcomes studied. In conclusion, OC use in CF females did not affect %FEV<sub>1</sub>, BMI or intravenous antibiotic usage in this study; our findings suggest that there is no evidence of a clinically significant effect on CF outcomes.
Abstract 1824: Sun exposure and the risk of malignant lymphoma in an Asian population: The Singapore Lymphoma Study
Authors: Kin-Yoke Wong, Sin-Eng Chia, Ponnudurai Kuperan, Khai-Mun Lee, Soon-Thye Lim, Susan Loong, Benjamin Mow, Siok-Bian Ng, Suat-Hoon Tan, Leonard Tan, Soo-Yong Tan, Miriam Tao, Alvin Wong, Gee-Chuan Wong, Adeline Seow
Journal: Cancer Research (2010)

Abstract INTRODUCTION Recent epidemiological studies have reported an inverse association between sun exposure and Non-Hodgkin lymphoma (NHL) which may be related to vitamin D or other factors, but these studies have been conducted almost exclusively in the Western countries, and in temperate locations. METHODS The Singapore Lymphoma Study is a hospital-based, case-control study conducted in Singapore between Feb 2005 and Dec 2008. Singapore residents (men and women, ethnic Chinese/Malays/Indians) aged 18 to 90 formed the study population. Detailed information on outdoor activities under sun (for recreational or occupational purposes) during childhood and in adulthood, skin colour and sun sensitivity, and other information on other possible risk factors were collected in personal interviews. A total of 543 incident malignant lymphomas including 74 Hodgkin's lymphoma (HL), 403 B-cell and 61 T and NK-cell NHL and 5 others, and 830 controls were recruited. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression analysis, adjusted for age, gender, ethnicity, and housing types as surrogate for social economic status. RESULTS Skin colour and sun sensitivity did not show any association with risk of malignant lymphoma, after adjusting for ethnicity. We observed a reduced overall risk of NHL (but not HL) among subjects who reported spending time outdoors regularly, especially on weekends/rest days. A lower risk of NHL was associated with recreational sun exposure in childhood non-school days (OR 0.7, 95% CI 0.5-0.9) and in adulthood weekends/rest days (OR 0.8, 95%CI 0.6-1.0), and the observed association was significant in females when stratified by gender. In addition, occupational sun exposure in males was inversely associated with the risk of NHL (OR 0.7, 95%CI 0.5-1.0). Cumulative working time outside under sun appeared unrelated to NHL overall. The associations were more consistently observed in B-cell NHL subtypes (OR 0.6, 95%CI 0.5-0.8), in diffuse large B-cell lymphoma (OR 0.6, 95%CI 0.5-0.9) and mucosal-associated lymphoid tissue lymphoma (OR 0.5, 95%CI 0.2-1.0), than in T-cell NHL. CONCLUSION As the first case-control lymphoma study in Asia, our data are consistent with an inverse association between intermittent sun exposure and NHL in this study population. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1824.
INTERSTUDY REPRODUCIBILITY OF QUANTITATIVE MYOCARDIAL PERFUSION AND FIBROSIS BY CARDIAC MAGNETIC RESONANCE
Authors: Promporn Suksaranjit, Devavrat Likhite, Imran Haider, Ganesh Adluru, Lowell Chang, Brent Wilson, Christopher McGann, Edward DiBella
Journal: Journal of the American College of Cardiology (2015)
647 TISSUE DOPPLER IMAGING ANALISYS IMPROVES THE SENSBILITY AND SPECICIFITY IN THE DIAGNOSIS OF DIASTOLIC DYSFUNCTION IN CIRRHOTIC CARDIOMYOPATHY
Authors: V. Barghini, L. Marzano, V. Bonasia, D. Cappello, A. Carnelutti, L. De Luca, F. Cugini, C. Catena, L. Sechi, G. Soardo
Journal: Journal of Hepatology (2012)
Rethinking Health Care Labor
Authors: Robert Kocher, Nikhil R. Sahni
Journal: New England Journal of Medicine (2011)

Of the $2.6 trillion spent in 2010 on U.S. health care, 56% consisted of wages for health care workers. Health care, as currently designed and delivered, is very labor-intensive. Yet unlike other sectors, health care has seen no recent gains in labor productivity.
AB0778 A longitudinal study of the clinical effects of conventional and biologic disease modifying anti-rheumatic drugs in australian rheumatology practice
Authors: L. Roberts, K. Tymms, J. de Jager, G. Littlejohn, H. Griffiths, D. Nicholls, P. Bird, J. Hill, P. McCloud, J. Zochling
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> The treat-to-target approach in Rheumatoid Arthritis (RA) is broadly accepted, however, outside of trial settings, little is known of the therapeutic impact that a new DMARD/bDMARD prescription has on moving patients from a high/moderate disease activity (HMDA) state to low disease activity or remission. <h3>Objectives</h3> To observe the effect of a change in DMARD/bDMARD prescription on disease outcome. <h3>Methods</h3> The CEDAR Study is a longitudinal observational study conducted by the OPAL QUMI (Optimising Patient outcomes in Australian rheumatoLogy–Quality Use of Medicines Initiative) consortium. Using a clinical audit program, de-identified and routinely collected clinical data from routine practice was sourced from 20 participating rheumatology practices comprising 42 rheumatologists from across Australia. Patients were included if they had baseline and 6 month (4.5-7.5 month) DAS28-ESRs following the initiation of a DMARD/bDMARD either as monotherapy or in addition to their stable previous therapy. A linear mixed model was used determine the change over time and all medications with adequate sample sizes were included. The percentage reduction of patients in the HMDA category was summarized. <h3>Results</h3> Of the 9570 screened RA patients, 3103 met the inclusion criteria; 73% female, mean age 62 years, median disease duration 7 years, and 30% had used a bDMARD. All 7 medications were significantly associated with clinically modest reductions in mean DAS28 (Table) with the range of mean DAS reduction being 0.20-0.78. At 6 months, the percentage of patients who moved from a HMDA category to low disease activity or remission ranged from 7% for etanercept &amp; adalimumab to 19% for tocilizumab. <h3>Conclusions</h3> In a large cohort of unselected community RA patients sourced from across Australia, the initiation of a DMARD/bDMARD was associated with a small but significant reduction in disease activity after 6 months. Improvements in disease activity were substantially smaller than improvements reported in randomized controlled trials of the same medications. Possible explanations include: that community patients, in comparison to trial patients, have more refractory disease; are less adherent; are treated less aggressively perhaps because of comorbidities; and/or have less rigorous follow up. Selection bias may be present in this observational study making inferences drawn from medication comparisons unreliable. Nevertheless, leflunomide and tocilizumab appeared to confer the largest benefit amongst the studied DMARDs and bDMARDs respectively. <h3>Acknowledgements</h3> OPAL QUMI is supported by Roche Products Pty Ltd (Australia). Medical writing provided by Dr Joseline Ojaimi from Roche Products. <h3>Disclosure of Interest</h3> None Declared
Full-thickness laparoendoscopic stapled excision of colonic lesion in a porcine ex vivo model
Authors: A. Brigic, A. Southgate, P. Sibbons, S. Clark, C. Fraser, R. Kennedy
Journal: Endoscopy (2013)

The introduction of the National Bowel Cancer Screening Programme in the United Kingdom has resulted in an increasing number of patients requiring hemicolectomy for endoscopically unresectable benign colonic polyps [1] [2]. Laparoscopic hemicolectomy with en bloc mesenteric resection is a morbid intervention as death (2 %), anastomotic leakage (7 %), and other complications (34 – 46 %) can occur [3]. These patients derive no additional benefit from removal of the mesentery and a new, less invasive treatment option is required. We report a modified version of the previously published Full-thickness Laparoendoscopic EXcision (FLEX) technique [4].
SAT0473 Defining cut-off values for disease activity states and improvement scores for patient-reported outcomes: the example of the rheumatoid arthritis impact of disease (RAID)
Authors: M. Dougados, Y. Brault, I. Logeart, D. van der Heijde, L. Gossec, T. Kvien
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> The Rheumatoid Arthritis Impact of Disease (RAID) is a patient-reported outcome measure evaluating the impact of rheumatoid arthritis (RA) on patient quality of life. It comprises 7 domains that are evaluated as continuous variables from 0 (best) to 10 (worst).[1,2] <h3>Objectives</h3> To define/identify cut-off values for disease activity states and improvement scores in order to present results at the individual level (<i>e.g.</i> patient in acceptable state, improved patient). <h3>Methods</h3> Patients with definite active RA requiring anti-TNF therapy were seen at screening, baseline and after 4 and 12 weeks of etanercept therapy. Answers to “Gold standard” questions on improvement (MCII: Minimum Clinically Important Improvement) and an acceptable status (PASS: Patient Acceptable Symptom State) were collected as well as the RAID score and DAS28-ESR. Cut-offs were defined by different techniques (<i>e.g.</i> empirical, measurement error and gold standard anchors). The external validity of these cut-offs was evaluated using the positive likelihood ratio (LR) based on the patient’s perspective (<i>e.g.</i> patient’s global) and on low disease activity status (<i>e.g.</i> DAS28-ESR). <h3>Results</h3> Ninety-seven (97) of the 108 recruited patients (age: 54±13 years old, female gender: 75%, rheumatoid factor positive: 81%, disease duration: 8±7 years, CRP: 18±30 mg/l, DAS28-ESR: 5.4±0.8) completed the 12 weeks of the study. The different techniques suggested thresholds ranging from 0.2 to 3 (absolute change) and from 6 to 50% (relative change) for defining MCII and thresholds from less than 1 to less than 5.6 for defining PASS. The evaluation of external validity (LR+) showed the highest LR+ was obtained with thresholds of 3 for absolute change; 50% for relative change and less than 2 for an acceptable status. <h3>Conclusions</h3> This study showed that thresholds defined for continuous variables are closely depend on the methodological technique, justifying a systematic evaluation of their validity. Our results suggested that a change of at least 3 points (absolute) or 50% (relative) in the RAID score should be used to define a MCII and that a maximal value of 2 defines an acceptable status. <h3>References</h3> Gossec L, Dougados M, Rincheval N, et al. Elaboration of the preliminary Rheumatoid Arthritis Impact of Disease (RAID) score: a EULAR initiative. Ann Rheum Dis 2009;68:1680-5. Gossec L, Paternotte S, Aanerud GJ, et al. Finalisation and validation of the rheumatoid arthritis impact of disease score, a patient-derived composite measure of impact of rheumatoid arthritis: a EULAR initiative. Ann Rheum Dis 2011;70:935-42. <h3>Disclosure of Interest</h3> None Declared
ER-α36, a variant of ER-α, is the estrogen receptor that mediates mitogenic estrogen signaling in breast cancer cells.
Authors: L Ding, X Zhang, Z Wang
Journal: Cancer Research (2009)

Abstract Abstract #18 The role of endogenous estrogens in breast cancer etiology has been well established. Dysregulated estrogen signaling increases the rate of cell proliferation and thus the risk of breast cancer. However, despite widespread agreement that estrogens are involved in breast cancer etiology, the molecular mechanisms of estrogen action, especially those by which estrogen signaling stimulates mammary tumorigenesis and breast cancer progression have not been well established.&amp;#x2028; Recently, we have identified and cloned a 36-kDa novel isoform of estrogen receptor α (ER-α36) that is generated from a promoter located in the first intron of the original 66-kDa ER-α (ER-α66) gene. The ER-α36 differs from the ER-α66 by lacking both transcriptional activation domains (AF-1 and AF-2) but retains the DNA-binding, dimerization and most of the ligand-binding domains. ER-α36 is mainly expressed on the plasma membrane and mediates membrane-initiated estrogen signaling that activates the MAPK/ERK pathway and stimulates cell proliferation. ER-α36 inhibits the genomic estrogen signaling mediated by the AF1 and AF2 domains of ER-α66 and ligand-dependent and -independent transactivation activities of ER-β. We designed and constructed shRNA expression vectors to express shRNAs specific for ER-α36 or ER-α66. We found that ER-positive breast cancer cells MCF7 and T47D expressing ER-α36 shRNA that successfully knockdown about 90% ER-α36 expression failed to respond to estrogen stimulation. However, estrogen strongly stimulated cell growth in MCF7 and T47D cells with ER-α66 knockdown. We found that some estrogen responsive genes such as c-Myc, CyclinD1 and progesterone receptor (PR) were induced through the extra-nuclear estrogen signaling pathway while pS2 was induced by the nuclear pathway. Our results for the first time demonstrated that ER-α36, not the original ER-α36 is the estrogen receptor that actually mediates estrogen-stimulated cell proliferation in breast cancer cells.&amp;#x2028; Among 800 cases of human breast cancer specimens examined, ER-α36 is expressed in most of the breast cancer specimens, and even in 40% of ER-negative breast cancer cases that lack expression of ER-α66. In addition, ER-α36 expressing patients responded poorly to anti-estrogen Tamoxifen treatment. In vitro study revealed that breast cancer cells that highly express ER-α36 exhibited estrogen hypersensitivity and Tamoxifen resistance, consistent with the clinical evidence that breast cancers expressing ER-α36 exhibit higher degree of malignancy and poorer survival rate.&amp;#x2028; Taken together, our results demonstrated that ER-α36 is a novel player in mitogenic estrogen signaling that plays an important role in estrogen stimulated mammary carcinogenesis. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 18.
Abstract DDT01-02: CH5424802: A selective ALK inhibitor
Authors: Hiroshi Sakamoto, Nobuhiro Oikawa, Takuo Tsukuda, Nobuo Shimma, Nobuya Ishii, Yuko Aoki
Journal: Cancer Research (2011)

Abstract Recent development of targeted protein kinase inhibitors provides new opportunity in cancer treatment. On the other hand, there are some cases limiting the efficacy of cancer therapies, owing to narrow therapeutic index by inhibiting multiple kinase, and the emergence of resistant mutants. Thus, the development of kinase inhibitors with more potent and selective properties and effectiveness to resistant mutants is needed. Anaplastic lymphoma kinase (ALK) is a tyrosine kinase that is constitutively activated in some cancers, due to gene alterations such as chromosomal translocation, amplification, or point mutation. Here we have identified CH5424802, a potent, selective and orally available ALK inhibitor with a new chemical scaffold. CH5424802 showed preferential antitumor activity against cancers with gene alterations of ALK, such as non-small cell lung cancer (NSCLC) cells expressing EML4-ALK fusion, anaplastic large-cell lymphoma (ALCL) cells expressing NPM-ALK fusion, and neuroblastoma with gene amplification of ALK in vitro and in vivo. Also, CH5424802 could inhibit ALK L1196M, which corresponds to the gatekeeper mutation conferring common resistance to kinase inhibitors, and block the growth of EML4-ALK L1196M-driven cells. CH5424802 is currently being investigated in phase I/II clinical trials for patients with ALK-positive NSCLC. 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 DDT01-02. doi:10.1158/1538-7445.AM2011-DDT01-02
The Migration of Physicians to the United States
Authors: Thomas D. Dublin
Journal: New England Journal of Medicine (1972)

Abstract The physician supply in the United States now includes over 63,000 foreign medical graduates. They comprise 1/5 of the active physicians, about 1/3 of hospital interns and residents, and a similar proportion of newly licensed physicians. In the past 10 years the number of foreign medical graduates entering the country has increased at a faster rate than domestic production. Developing countries, particularly in the Far East, have become the prinipal sources of supply. Many exchange visitor physicians may now remain permanently in the United States. Basic training received in many countries is not equivalent to that acquired in American schools, nor is the graduate training offered in this country appropriate to the needs of the majority of foreign medical graduates. Although "push factors" condition many foreign graduates to leave their own countries, sound policy dictates that we discontinue the active recruitment of such physicians to meet domestic needs, particularly for hospital services.
Mosaic loss of chromosome Y is associated with common variation near TCL1A
Authors: Weiyin Zhou, Mitchell J Machiela, Neal D Freedman, Nathaniel Rothman, Nuria Malats, Casey Dagnall, Neil Caporaso, Lauren T Teras, Mia M Gaudet, Susan M Gapstur, Victoria L Stevens, Kevin B Jacobs, Joshua Sampson, Demetrius Albanes, Stephanie Weinstein, Jarmo Virtamo, Sonja Berndt, Robert N Hoover, Amanda Black, Debra Silverman, Jonine Figueroa, Montserrat Garcia-Closas, Francisco X Real, Julie Earl, Gaelle Marenne, Benjamin Rodriguez-Santiago, Margaret Karagas, Alison Johnson, Molly Schwenn, Xifeng Wu, Jian Gu, Yuanqing Ye, Amy Hutchinson, Margaret Tucker, Luis A Perez-Jurado, Michael Dean, Meredith Yeager, Stephen J Chanock
Journal: Nature Genetics (2016)