tbuckley/cabot-search huggingface dataset:
Capsule endoscopic detection of bleeding Meckel’s diverticulum, with capsule retention in the diverticulum
Authors: Y. Tanaka, Y. Motomura, K. Akahoshi, N. Nakama, T. Osoegawa, Y. Kashiwabara, T. Chaen, N. Higuchi, M. Kubokawa, K. Nishida, T. Yukaya, M. Oya, K. Nakamura
Journal: Endoscopy (2010)

A 20-year-old man was admitted to hospital with episodes of passing painless bloody stools and syncope. When he arrived, he was in a state of shock with severe dehydration. Laboratory data showed a hemoglobin (Hb) level of 8.6 g/dL. Esophagogastroduodenoscopy and colonoscopy did not show the cause of bleeding.
P61 The Prevalence Of Hypercapnia In Patients With Alpha-1-anti-trypsin Deficiency (aatd)
Authors: C. Dave, A. Turner, T. Spruell
Journal: Thorax (2014)

<h3>Introduction</h3> Hypercapnia in the acute phase of COPD exacerbation is common, with CO<sub>2</sub> &gt;6 kPA in 44% of patients at some point during their admission. Little data exists on the prevalence of hypercapnia in stable COPD patients, and even less in those with AATD. As emphysema is more predominant in the lower lobes of AATD patients, this is likely to contribute to hyperinflation and hence potentially increase CO<sub>2</sub> levels. <h3>Methods</h3> The Birmingham AATD database (ADAPT) is a registry of with over 1000 patients with AATD. The registry has basic demographics, detailed spirometric parameters as well as baseline blood gases. Hypercapnia is defined as CO<sub>2</sub> greater than 5.5 kPa. <h3>Results</h3> The blood gas results of 766 (PiZZ genotypes) individual patients were available for analysis. 93 patients (12.14%) had a type 1 respiratory failure, defined as a PO<sub>2 </sub> &lt;8 kPa, 69 had hypercapnia (9.01%) and 16 (2.09%) patients fulfilled both criteria. There is a statistically significant difference seen in the hypercapnic vs non-hypercapnic population with regards to FEV<sub>1</sub> (1.07 vs 1.46, p = 0.01), FVC (3.45(CI 3.1–3.81) vs 3.82, p = 0.02) and BMI (27.1 vs 24.9, p = 0.02). There is no difference in the amount of upper zone emphysema (29.54 vs 30.50 (CI 29.12–33.01)) or lower zone emphysema (40.66 vs 49.13 (CI 42.64–47.32)). Chi-squared analysis of lower zone predominance (lower zone – upper zone) showed no statistical difference either (p = 0.76). Factors clinically significant in univariate analysis were taken forward to logistic regression analysis where BMI was the only clinically significant (p = 0.008) predictor. <h3>Conclusion</h3> Hypercapnia is relatively common amongst AATD patients, but Type 2 respiratory failure is uncommon. There is an increased risk of hypercapnia with worse FEV<sub>1</sub>, FVC and higher BMI. The presence or location of emphysema did not seem to influence the CO<sub>2</sub> levels.
Adjuvant Systemic Therapy in Women With Early-Stage Breast Cancer at High Risk for Relapse
Authors: N. E. Davidson, M. D. Abeloff
Journal: JNCI Journal of the National Cancer Institute (1992)

Considerable progress has been made in the appropriate application of adjuvant chemotherapy or endocrine therapy for certain subsets of women with stages I and II breast cancers.In fact, meta-analysis of all adjuvant therapy trials as performed by the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) clearly demonstrates that the use of systemic adjuvant treatments results in a 20%-25% reduction in the annual mortality rate for specific patient populations, e.g., premenopausal, node-positive women who receive combination chemotherapy (7).Nonetheless, a substantial number of women die of metastatic breast cancer despite administration of adjuvant systemic therapy.One of the most challenging issues in contemporary medical oncology is the development of new adjuvant treatment to improve the outcome for women with high-risk, early-stage breast cancers.In this commentary, we explore the difficulties in defining high-risk breast cancer and review previous treatment results as well as potential new therapeutic approaches.
P18.03 * PATIENT FEEDBACK INTERVIEWS FOR DEVELOPMENT OF DISCHARGE PROCEDURES
Authors: P. Hansen, A. Meldgaard
Journal: Neuro-Oncology (2014)

BACKGROUND: Discharging patients from the hospital is a complex process. A survey revealed that about one-third of dismissed neurosurgical patients did not have a concluding consultation (32 %), an accurate discharge medication list (28 %), or an updated information on relevant symptoms requiring a follow-up (28 %). Improving the quality of hospital discharges may prevent re-hospitalization and has the potential to improve the quality-of-life for patients. PURPOSE: To highlight the priorities and experiences of patients and next of kin at discharge after intracranial neurosurgery in order to improve discharge procedures with incorporation of major key elements. METHODS: Direct staff-to-patient feedback discussions were based on a semi-structured interview template presented to patient discharged within two month after intracranial neurosurgery. Patients and next of kin were grouped with independent interviewers and instructed to elaborate lists of priorities regarding 1) good-experience events, 2) things that went wrong, 3) experience of discharge process, 4) reconciliation with discharge, 5) quality of post-discharge care. RESULTS: The response of patients and next of kin could be categorized into three main themes: 1) in-hospital information and patient involvement in the process of discharge, 2) post-discharge support and plans, 3) reconciliation with discharge. Typical discontent focused on not to be informed of test results (i.e. simple blood pressure measurements), being asked the same questions over again, and lack of advise concerning treatment opportunities. Also more involvement of next of kin and a follow-up consultation at about two weeks after discharge was warranted. In addition, patients felt that provisions for follow-up care were often inadequate. PERSPECTIVES: Responses from the interviews suggest that development of discharge checklists may favorably focus on 1) univocal in-hospital information about procedures, tests and medication, 2) involvement of patient and next of kin in individualized discharge plans, 3) determination of the need and site of post-discharge care. Development of personalized discharge checklists may improve patient outcome and diminish rate of re-hospitalization.
Long-Term Survival of a Cohort of Community Residents with Asthma
Authors: Marc D. Silverstein, Charles E. Reed, Edward J. O'Connell, L. Joseph Melton, W. Michael O'Fallon, John W. Yunginger
Journal: New England Journal of Medicine (1994)

Reports of an increase in asthma-related mortality have been based on studies of death certificates from the general U.S. population on which asthma was listed as an underlying cause of death. We addressed the issue in a different way by analyzing long-term survival in a defined, population-based cohort of patients with asthma.
Correlation of tumor burden, liver and bone metastasis with serum extracellular domain HER2 expression in front-line metastatic breast cancer.
Authors: S Johnston, L O'Rourke, W Wang, M Pegram, MF Press, J Maltzman
Journal: Cancer Research (2009)

Abstract Abstract #3146 Background: Although serum extracellular domain (sECD) HER2 levels can be easily measured by enzyme immunoassays, the potential clinical utility of HER2 extracellular domain protein shed in the serum is not established. High serum protein levels may be indicative of metastatic disease to the liver or perhaps greater tumor burden. EGF30008 is a double-blind, placebo-controlled phase III trial evaluating the effect of letrozole with/without lapatinib in previously untreated postmenopausal women with hormone receptor-positive metastatic breast cancer. Levels of sECD HER2 were collected on all 1,286 women at baseline and every 4 weeks on study including at disease progression.&amp;#x2028; Methods: Baseline serum levels and tumor characteristics were collated in blinded fashion for all 1,286 patients in the trial (data cut off 12May08). Patients with baseline serum protein levels ≥ 15 ng/mL were defined as sECD HER2+. Correlations were assessed between baseline serum protein levels and baseline liver disease and bone-only disease and total tumor burden (as defined by number of metastatic sites). Chi-square test was applied to assess the correlation between serum protein levels and liver disease or bone-only disease. Wilcoxon rank-sum test using normal approximation was used to compare total tumor burden and baseline protein levels.&amp;#x2028; Results: Among sECD HER2+ patients, 42% had at least one liver metastasis, whereas 20% of sECD HER2-negative patients had at least one liver metastasis (P &amp;lt; 0.0001). No correlation exists between baseline serum protein level and bone-only disease (P = 0.64). Patients who were sECD HER2+ had a greater total tumor burden (mean metastatic sites = 5.4; standard deviation = 3.2; median = 5) compared with patients who were sECD HER2-negative (mean metastatic sites = 4.4; standard deviation = 3.1; and median = 4; P &amp;lt; 0.0001).&amp;#x2028; Conclusion: High baseline sECD HER2 strongly correlates with tumor burden. There was also a significant correlation between sECD and liver metastases, but no correlation at all with bone-only disease. These analyses will be repeated after the database is finalized and unblinded. Our analysis is limited to detection of the number of metastatic sites and is not sensitive to the individual sizes of metastases. In addition, another potential explanation for the low sensitivity of HER2 detection by sECD is that small metastatic deposits that are HER2+ in situ do not shed enough sECD into the serum to be detected by the assay. Conversely, some very large HER2-negative tumors do in fact shed measurable sECD if the tumor bulk is very high, even though in situ they may be nonamplified. A future analysis will take the sum of the longest diameters of all known lesions and compare it to sECD HER2 levels. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3146.
Old Traumatic Ventricular Septal Defect Seen on Myocardial Perfusion Imaging
Authors: SURJIT S. WADHWA, ROBERT MANSBERG, VIVIAN B. FERNANDES
Journal: Clinical Nuclear Medicine (1999)

Direct cardiac trauma can cause complex valvular and myocardial injuries. The findings on myocardial perfusion scans of a repaired ventricular septal defect, a repaired anterior wall defect, and right ventricular hypertrophy secondary to a previous industrial accident are described.
Abstract P2-14-11: Vitamin D Deficiency in Post-Menopausal Breast Cancer Survivors
Authors: CF Friedman, A DeMichele, HI Su, R Feng, S Kapoor, K Desai, JJ. Mao
Journal: Cancer Research (2010)

Abstract Background: Breast cancer patients on aromatase inhibitors (AIs) are at an increased risk for decreased bone density and fractures. Given the important role vitamin D plays in bone metabolism, vitamin D deficiency may place these patients at an additional risk. Our objective was to examine the prevalence of and risk factors for vitamin D deficiency in post-menopausal breast cancer survivors (BCS) with current or past AI use. Materials and Methods: We conducted a cross-sectional study. Vitamin D levels were obtained utilizing the Diasorin radioimmunoassay using sera. Multiple logistic regression analyses were performed to identify independent risk factors associated with vitamin D deficiency. Results: In our cohort of 391 post-menopausal women with stage I to III breast cancer on AI therapy, the mean vitamin D level was 35 ng/mL, S.D. 12.49. Vitamin D levels were normally distributed in the cohort. Thirty five percent of women were vitamin D deficient, defined as a level less than 30 ng/mL. In our cohort, 73.4% of the participants had vitamin D supplementation documented in their chart; 26.8% of these women were still vitamin D deficient despite supplementation. Adjusting for demographic and clinical variables, non-white patients were more likely to be vitamin D deficient, adjusted odds ratio (AOR) of 2.00, 95% confidence interval (CI) 1.14-3.51, p=.004. Overweight (AOR 3.07, 95% CI 1.77-5.33, p&amp;lt;.001) and obese (AOR 2.88, 95% CI 1.64-5.06, p&amp;lt;.001) women were also at higher risk. In a second model, adjusting for the same covariates and chart-documented vitamin D supplementation, vitamin D supplementation was associated with lower risk for vitamin D deficiency (AOR .29, 95% CI .17-.48, p&amp;lt;.001). The risk for non-white women (AOR 2.19, 95% CI 1.22-3.89, p=.009) and obese women (AOR 3.21, 95% CI 1.79-5.78, p&amp;lt;.001) were increased after adjusting for vitamin D supplementation. Discussion: Hypovitaminosis D is common in BCS, and those who are non-white or have a BMI greater than 25 are at a higher risk of deficiency. When adjusting for vitamin D supplementation, the discrepancy between normal weight patients and obese patients became even more pronounced, suggesting that standard vitamin D supplementation may not be sufficient for these patients. In light of data linking hypovitaminosis D and bone health, oncologists should consider routine testing with particular attention to non-white or overweight patients, and repleting those patients who are deficient. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-14-11.
P151 HEPADNAVIRAL REPLICATION IN HBV-TRANSGENIC MICE LACKING THE SURFACE ANTIGEN IS ACCOMPANIED BY TOLL-LIKE RECEPTOR 3 MEDIATED INTERFERON RESPONSES
Authors: C.I. Real, R. Broering, K. Jahn-Hofmann, L. Ickenstein, M. John, K. Kleinehr, S. Driftmann, M. Lutterbeck, T. Kemper, H.-P. Vornlocher, R. Schirmbeck, M. Lu, G. Gerken, J.F. Schlaak
Journal: Journal of Hepatology (2014)
La brosse Infinity® améliore les résultats du brossage cytologique des sténoses biliaires malignes
Authors: T Barrioz, M Wangermez, P Levillain, M Beauchant
Journal: Endoscopy (2013)

Le diagnostic étiologique des sténoses biliaires reste difficile. La technique la plus utilisée reste le brossage cytologique endobiliaire réalisé lors du cathétérisme rétrograde, mais l'efficacité n'est que de 10 à 30%. Les biopsies endobiliaires sous contrôle cholangioscopique à l'aide d'un pince dédiée ou l'endomicroscopie permettent des résultats nettement supérieur de 70 à 90%, mais ces techniques très coûteuses ne sont disponibles que dans de rares centres experts.
Abstract P1-05-24: Pharmacologic reversion of epigenetic silencing of the <i>PRKD1</i> promoter blocks breast tumor cell invasion and metastasis.
Authors: S Borges, H Doppler, CA Andorfer, EA Perez, Z Sun, PZ Anastasiadis, AE Thompson, XJ Geiger, P Storz
Journal: Cancer Research (2012)

Abstract Epigenetic silencing of tumor suppressing genes by promoter-specific DNA methylation is common in many types of cancer. As an early event, this process has been well shown to promote tumor initiation and progression; however little is known how such epigenetic silencing can contribute to tumor metastasis. The PRKD1 gene encodes Protein Kinase D1 (PKD1), a serine/threonine kinase expressed in epithelial cells of the normal mammary gland that maintains the epithelial phenotype of normal breast cells and prevents epithelial-to-mesenchymal transition (EMT). PKD1 is also a critical suppressor of tumor cell invasion and is silenced in expression and activity during breast tumor progression. Here, we show that aberrant methylation of PRKD1 promoter region is not only correlated with the silencing of its expression but is also associated with invasiveness of breast cancer cell lines and with aggressiveness of breast tumors. Using the highly invasive MDA-MB-231 cells, we show that the inhibition of PRKD1 promoter methylation with the DNA methyltransferase inhibitor decitabine restores PKD1 expression and significantly decreases their invasive abilities in vitro. More importantly, in a tumor xenograft model it dramatically blocks tumor spread and metastasis to the lung in a PKD1-dependent fashion. Our data suggest that the status of epigenetic regulation of the PRKD1 promoter can provide valid information on the invasiveness of breast tumors, and therefore could serve as an early diagnostic marker. Moreover, targeted upregulation of PKD1 expression may be used as a therapeutic approach to reverse the invasive phenotype of breast cancer cells. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P1-05-24.
1126 IDENTIFICATION OF p90RSK AS A NOVEL THERAPEUTIC TARGET FOR LIVER FIBROSIS
Authors: O. Morales-Ibanez, S. Affò, C. Millán, M. Coll, V. Arroyo, P. Ginès, J. Caballería, P. Sancho-Bru, R. Bataller
Journal: Journal of Hepatology (2013)
A Population-Based Study of Seizures after Traumatic Brain Injuries
Authors: John F. Annegers, W. Allen Hauser, Sharon P. Coan, Walter A. Rocca
Journal: New England Journal of Medicine (1998)

The risk of seizures is increased after traumatic brain injury, but the extent and duration of the increase in risk are unknown. The purpose of this study was to identify the characteristics of brain injuries that are associated with the development of seizures.
Abstract 4330: Transcriptional regulation of gp170 by YY1 and prognostic significance in childhood acute lymphoblastic leukemia (ALL)
Authors: Gabriela Andres-Antonio, Jesus Rangel-Santiago, Ana B. Tirado-Rodriguez, Elisa Dorantes-Acosta, Mario I. Vega, Guillermo Aquino-Jarquin, Briseida Lopez, Elba Jimenez, Rosana Pelayo, Benjamin Bonavida, Aurora Medina-Sanson, Sara Huerta-Yepez
Journal: Cancer Research (2012)

Abstract Leukemia is the most common cancer among children under the age of 15 years in the United States and many developed countries. In recent years, there has been the emergence of novel therapeutic drugs for this disease. However, the development of drug resistance by the tumor cells remains the most important obstacle in the treatment of leukemia. A widely studied mechanism of tumor resistance to chemotherapeutic drugs is through the expression of the multi-drug resistance (MDR) genes. P-glycoprotein 170 (gp170) is an MDR1 gene product which serves as an ATP-dependent cell membrane transporter; it facilitates the efflux of xenobiotics from the cells to prevent damage for prolonged drug activity, including chemotherapeutics agents. In addition to MDR1, several reports in different cancers have indicated that the transcription factor Yin Yang 1 (YY1) is over-expressed and regulates tumor cell response to chemotherapeutic drugs. TESS analysis demonstrated that the gp170 proximal promoter contains four putative binding sites for the YY-1 protein. We also hypothesized that the YY1 may too be over-expressed in ALL and that its expression may be correlated with the expression of gp170. These hypotheses were examined first by reporter systems analyze, the gp170 protein was cloned and we developed a luciferase reporter assay. Examination of the putative YY1 binding sites that were individually mutated (deleted), showed revealed that mutation at the site –1860 abolished the activity. Mutation at the site –1920 abolished approximately 50% and mutation at –1230 site abolished approximately 25%. Further, CHIP analysis demonstrated that YY1 transcription factor binds directly to the gp170 gene MDR1 promoter. In addition, we examined the expression of YY1 and gp170 in childhood ALL (n= 84). The expression of YY1 and gp170 was determined evaluated by IHC in tumor tissues and the frequency of positive cells was determined. For comparison, normal controls were also analyzed (n=53). The findings demonstrate that were a significant increase in the frequency of positive cells in ALL compared to controls for both YY1 (38% vs. 8%, p=0.001) and for gp170 (42% vs. 12%, p=0.001). There was a good correlation between the expression of YY1 and gp170 (Pearson's test, r=0.4, p=0.001). The findings suggest that YY1 transcriptionally regulates the mdr1 and may be a therapeutic target in MDR positive ALL and its inhibition may reverse resistance to chemotherapeutic drugs. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4330. doi:1538-7445.AM2012-4330
Tips for Leaders, Part I
Authors: Jay A. Harolds
Journal: Clinical Nuclear Medicine (2011)

There are many important leadership skills that can be learned from experience, mentoring, reading, discussions, lectures, etc. The subjects include not only business topics and communication skills but also a variety of tips on what to do and what not to do. These include desirable styles of leadership, how to gain the trust of others in the organization, the significance of the appropriate delegation of tasks, the importance of teams, how to manage change, how to win during a crisis, what to do in the early days of becoming a new leader, preventing the loss of one's practice to a rival organization, improving quality, and others. There are also many important attributes of leaders, including having a strong moral compass. Although each of these topics could be a book in of itself, this short series of articles will briefly examine these issues and others.
The Landlady Confirms the Diagnosis
Authors: G E Thibault
Journal: New England Journal of Medicine (1992)

A 43-year-old man with a long but poorly characterized psychiatric history presented to the emergency room complaining of nausea, vomiting, shortness of breath, and hearing things.The age of the patient, the available history, and the major symptoms lead one to think about several categories. Assuming that the patient has an organic as opposed to a psychiatric illness, I'd worry about whether metabolic derangements could create these symptoms. Given his psychiatric history, I'd be con-cerned about abnormalities in sodium or calcium balance and acid–base abnormalities. The reason for thinking about these metabolic derangements is that the patient may consume excessive . . .
Cardiovascular Effects of Glucagon in Man
Authors: William W. Parmley, Gerald Glick, Edmund H. Sonnenblick
Journal: New England Journal of Medicine (1968)

Because glucagon in animals has positive inotropic and chronotropic effects in the presence of beta-adrenergic blockade, catecholamine depletion or full digitalization, its cardiovascular effects in man were studied during diagnostic cardiac catheterization. In 11 patients 3 to 5 mg intravenously significantly increased cardiac index, mean arterial pressure, heart rate and maximum rate of left ventricular pressure development, but left ventricular end-diastolic pressure and systemic vascular resistance did not change significantly. Action after a single dose began in one to three, reached a maximum in five to seven and lasted for 10 to 15 minutes. In six patients given only 1 mg the only significant changes were increased cardiac index and decreased systemic vascular resistance. Glucagon benefits cardiac performance in man, and with its demonstrated action in the absence of catecholamines and in the presence of full digitalization, may be useful to treat acute heart failure.