tbuckley/cabot-search huggingface dataset:
National Cluster-Randomized Trial of Duty-Hour Flexibility in Surgical Training
Authors: Karl Y. Bilimoria, Jeanette W. Chung, Larry V. Hedges, Allison R. Dahlke, Remi Love, Mark E. Cohen, David B. Hoyt, Anthony D. Yang, John L. Tarpley, John D. Mellinger, David M. Mahvi, Rachel R. Kelz, Clifford Y. Ko, David D. Odell, Jonah J. Stulberg, Frank R. Lewis
Journal: New England Journal of Medicine (2016)

Concerns persist regarding the effect of current surgical resident duty-hour policies on patient outcomes, resident education, and resident well-being.We conducted a national, cluster-randomized, pragmatic, noninferiority trial involving 117 general surgery residency programs in the United States (2014-2015 academic year). Programs were randomly assigned to current Accreditation Council for Graduate Medical Education (ACGME) duty-hour policies (standard-policy group) or more flexible policies that waived rules on maximum shift lengths and time off between shifts (flexible-policy group). Outcomes included the 30-day rate of postoperative death or serious complications (primary outcome), other postoperative complications, and resident perceptions and satisfaction regarding their well-being, education, and patient care.In an analysis of data from 138,691 patients, flexible, less-restrictive duty-hour policies were not associated with an increased rate of death or serious complications (9.1% in the flexible-policy group and 9.0% in the standard-policy group, P=0.92; unadjusted odds ratio for the flexible-policy group, 0.96; 92% confidence interval, 0.87 to 1.06; P=0.44; noninferiority criteria satisfied) or of any secondary postoperative outcomes studied. Among 4330 residents, those in programs assigned to flexible policies did not report significantly greater dissatisfaction with overall education quality (11.0% in the flexible-policy group and 10.7% in the standard-policy group, P=0.86) or well-being (14.9% and 12.0%, respectively; P=0.10). Residents under flexible policies were less likely than those under standard policies to perceive negative effects of duty-hour policies on multiple aspects of patient safety, continuity of care, professionalism, and resident education but were more likely to perceive negative effects on personal activities. There were no significant differences between study groups in resident-reported perception of the effect of fatigue on personal or patient safety. Residents in the flexible-policy group were less likely than those in the standard-policy group to report leaving during an operation (7.0% vs. 13.2%, P<0.001) or handing off active patient issues (32.0% vs. 46.3%, P<0.001).As compared with standard duty-hour policies, flexible, less-restrictive duty-hour policies for surgical residents were associated with noninferior patient outcomes and no significant difference in residents' satisfaction with overall well-being and education quality. (FIRST ClinicalTrials.gov number, NCT02050789.).
Abstract 5429: Inhibition of LSD1 and HDACs causes synergistic cell death in glioblastoma cells
Authors: Melissa Singh, Christa Manton, Wen-Wei Tsai, Michelle Barton, Joya Chandra
Journal: Cancer Research (2010)

Abstract Glioblastoma multiforme is a particularly aggressive brain tumor and remains a clinically devastating disease. More than 90% of children diagnosed with glioblastoma die within 2 years making it among the leading causes of cancer related morbidity and mortality. Despite innovative therapies for the treatment of glioblastoma, there has not been a significant increase in patient survival over the past decade. Enzymes that control epigenetic alterations have become popular targets for cancer therapy due to their ability to control cellular processes that lead to oncogenesis. Several inhibitors of histone deacetylases (HDACi) have been developed and are in clinical use for cancer therapy. Histone methylation can be modulated by HDACi and here we propose to examine the effect of dually inhibiting deacetylases and demethylases. Specifically, we focused on LSD1, lysine specific demethylase 1, a demethylase known to be in complex with HDAC1/2 and implicated in several high risk cancers. We evaluated apoptosis induction upon knockdown of LSD1 in combination with HDACi in glioblastoma cell lines. Our results demonstrate a greater than two-fold increase in apoptosis in LSD1 knockdown cells treated with increasing doses (1-5 μM) of HDACi for 48 hours as compared to control as measured by DNA fragmentation by propidium iodide staining and analysis by flow cytometry. Furthermore, pretreatment of LSD1 knockdown cells with the general caspase inhibitor zVAD-fmk prior to treatment with vorinostat only partially protects against DNA fragmentation suggesting that cell death proceeds through both caspase-dependent and -independent mechanisms. Similar results were obtained by pharmacologically inhibiting LSD1 with the monoamine oxidase inhibitor tranylcypromine. Treatment of LN-18 cells with combinations of tranylcypromine (100-1000 μM) and vorinostat (1-5 μM) for 72 hours demonstrate that these two agents synergize to promote cell death with 1000 μM tranylcypromine and 5 μM vorinostat showing the most synergistic effect (CI 0.313). Surprisingly, the increase in apoptosis observed upon LSD1 inhibition, by knockdown and pharmacological inhibitors, and HDACi also correlates with an increase in intracellular superoxide as measured by hydroethidum staining and analysis by flow cytometry. These data suggest that reactive oxygen species may play a role in the apoptosis induced by the combination of LSD1 and HDAC inhibition. Further studies aimed at understanding the mechanism by which LSD1 and HDAC inhibition leads to enhanced tumor cell death will substantially increase our knowledge of how epigenetic modifiers interact to control cell survival and may suggest novel options for cancer therapy. 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 5429.
Adrenergic Receptors — Evolving Concepts and Clinical Implications
Authors: Paul A. Insel
Journal: New England Journal of Medicine (1996)

The endogenous catecholamines — norepinephrine and epinephrine — are involved in the regulation of virtually every organ system. Norepinephrine acts as a neurotransmitter at certain sites in the central nervous system and in the sympathetic nervous system at postganglionic neuroeffector junctions. Epinephrine is primarily a circulating hormone produced by the adrenal medulla and other chromaffin tissue. Because norepinephrine comes from chromaffin tissue and overflows from sympathetic-nerve synapses, plasma concentrations of norepinephrine exceed those of epinephrine. Hence, norepinephrine can also act as a circulating hormone.Norepinephrine and epinephrine act through adrenergic receptors (also termed adrenoceptors). In this review, I will summarize . . .
IMPACT OF BRACHIAL-ANKLE PULSE WAVE VELOCITY ON LONG-TERM CARDIOVASCULAR EVENTS: RESULTS FROM IMPACT-ABI REGISTRY
Authors: Yasushi Ueki, Takashi Miura, Wataru Shoin, Kunihiko Shimizu, Mikiko Harada, Tomoaki Motidome, Koji Yoshie, Masatoshi Minamisawa, Yasutaka Oguchi, Naoto Hashizume, Hitoshi Nishimura, Naoyuki Abe, Soichiro Ebisawa, Hirohiko Motoki, Ayako Okada, Yuji Shiba, Atsushi Izawa, Jun Koyama, Uichi Ikeda
Journal: Journal of the American College of Cardiology (2016)
Retail Deli Slicer Cleaning Frequency — Six Selected Sites, United States, 2012
Authors: Laura G. Brown, E. Rickamer Hoover, Danny Ripley, Bailey Matis, David Nicholas, Nicole Hedeen, Brenda Faw
Journal: MMWR Morbidity and Mortality Weekly Report (2016)

Listeria monocytogenes (Listeria) causes the third highest number of foodborne illness deaths (an estimated 255) in the United States annually, after nontyphoidal Salmonella species and Toxoplasma gondii (1). Deli meats are a major source of listeriosis illnesses, and meats sliced and packaged at retail delis are the major source of listeriosis illnesses attributed to deli meat (4). Mechanical slicers pose cross-contamination risks in delis and are an important source of Listeria cross-contamination. Reducing Listeria contamination of sliced meats in delis will likely reduce Listeria illnesses and outbreaks. Good slicer cleaning practices can reduce this foodborne illness risk. CDC's Environmental Health Specialists Network (EHS-Net) studied how often retail deli slicers were fully cleaned (disassembled, cleaned, and sanitized) at the Food and Drug Administration (FDA) Food Code-specified minimum frequency of every 4 hours and examined deli and staff characteristics related to slicer cleaning frequency. Interviews with staff members in 298 randomly-selected delis in six EHS-Net sites showed that approximately half of delis fully cleaned their slicers less often than FDA's specified minimum frequency. Chain-owned delis and delis with more customers, more slicers, required manager food safety training, food safety-knowledgeable workers, written slicer-cleaning policies, and food safety-certified managers fully cleaned their slicers more frequently than did other types of delis, according to deli managers or workers. States and localities should require deli manager training and certification, as specified in the FDA Food Code. They should also consider encouraging or requiring delis to have written slicer-cleaning policies. Retail food industry leaders can also implement these prevention efforts to reduce risk in their establishments. Because independent and smaller delis had lower frequencies of slicer cleaning, prevention efforts should focus on these types of delis.
Abstract 1460: Comparison of radiosensitizing effects of several PARP inhibitors under clinical investigation
Authors: Stephen S. Yoo, David Cerna, Deborah Wilsker, Beverly A. Teicher, C. Norman Coleman
Journal: Cancer Research (2012)

Abstract Targeting tumor DNA repair is an attractive strategy in selectively killing tumors while sparing normal tissues. Inhibiting Poly (ADP-ribose) polymerase (PARP) in cancers with BRCA1 and BRCA2 mutations has been shown to be a promising approach either as a single agent or in combination therapy with chemotherapeutics or ionizing radiation. To systematically compare the radiosensitizing efficacy of various PARP inhibitors we have evaluated the long-term cytotoxicity of ABT-888, AZD2281, MK4827, and BSI-201 in clonogenic survival assays in combination with ionizing radiation. For these studies we used the breast cancer cell lines MDA-MB 231 BR, a subline of MDA-MB-231 selected for its tendency to metastasize to brain (BRCA1+/−) and MX-1 (BRCA1 deletion and BRCA2 mutation). Furthermore, we have evaluated PARP inhibitors under normoxic and hypoxic conditions (21% O2 versus 0.1% O2). In MDA-MB 231 BR cells, at a clinically relevant and achievable concentration for ABT-888 (J Clin Oncol. 2009; 27(16)) and AZD2281(N Engl J Med. 2009; 361(2)), and at 1 uM MK4827 showed radiosensitizing effects under both normoxic and hypoxic conditions. BSI-201 at a clinically achievable concentration (ASCO 2010, Abstract 2012) did not exhibit radiosensitizing effects under the same conditions. When MX-1 cells were treated with BSI-201 under hypoxic conditions (0.1% O2) the cytotoxicity of BSI-201 was evident. Taken together, the results show that ABT-888, AZD2281 and MK4827 show promising radiosensitizing effects under both normoxic and hypoxic conditions whereas the cytotoxicity of BSI-201 was observed only under hypoxic conditions in BRCA1/2 mutant carrier MX-1cells. 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 1460. doi:1538-7445.AM2012-1460
Alleviating Distress For Children In Treatment
Authors: J. Burklow
Journal: JNCI Journal of the National Cancer Institute (1989)

Journal Article Alleviating Distress For Children In Treatment Get access John Burklow John Burklow Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 81, Issue 10, 22 May 1989, Pages 731–732, https://doi.org/10.1093/jnci/81.10.731 Published: 22 May 1989
Phase II Study of Interferon- and Interleukin-2: Tachyphylaxis of Toxicity to the Liver During Increasing Immune Enhancement
Authors: J. W. BAARS, J. WAGSTAFF, C. J. VAN GROENINGEN, J. B. VERMORKEN, E. M. BUVANK, H. M. PINEDO, J. J. P. NAUTA
Journal: JNCI Journal of the National Cancer Institute (1993)
Molecular Imaging in the Management of Adrenocortical Cancer
Authors: Ka Kit Wong, Barbra S. Miller, Benjamin L. Viglianti, Ben A. Dwamena, Paul G. Gauger, Gary J. Cook, Patrick M. Colletti, Domenico Rubello, Milton D. Gross
Journal: Clinical Nuclear Medicine (2016)

Adrenocortical cancer (ACC) is an uncommon primary neoplasm of the adrenal cortex with dismal prognosis. It often presents with symptoms and signs of adrenal cortical hormone hypersecretion and abdominal mass effect or is incidentally detected as an adrenal mass on imaging performed for other indications. Endocrine evaluation, comprehensive staging, and meticulous resection are crucial to ensure the best possible outcome. Despite extensive initial surgical resection, local and distant metastases are not uncommon with disappointing 5-year survival, although progress is being made at high-volume centers. Accurate restaging of recurrent disease is important to guide further management. Mitotane, external beam radiation and chemotherapy, and newer anticancer systemic treatments are used as adjunctives for inoperable disease and distant metastases. Contrast-enhanced CT and MRI are first-line imaging modalities for evaluation of ACC to characterize adrenal masses and to determine tumor resectability. Emerging literature supports F-FDG PET/CT use to determine the malignant potential of adrenal masses. In patients with a diagnosis of ACC, FDG PET/CT is sensitive for detecting metastatic disease, and its tumor accumulation has been correlated to pathology, Weiss scores, and prognosis. Metomidate, labeled with C for PET or with I for SPECT/CT, allows characterization of an adrenal mass as being of adrenocortical origin with high specificity. Taking advantage of its adrenocortical avidity, metomidate has been labeled with I for radionuclide therapy in a subset of ACC. In this review, we describe how nuclear medicine imaging, and specifically PET, can assist surgical management of ACC.
Early Detection of Intra-abdominal Abscesses with Tc-99m (V) DMSA Scanning and Comparison with Ga-67 Imaging
Authors: Wan-Yu Lin, Te-Hsin Chao, Shyh-Jen Wang
Journal: Clinical Nuclear Medicine (2002)

From the Departments of Nuclear Medicine* and Surgery,† Taichung Veterans General Hospital, Taichung, Taiwan Received for publication December 3, 2001. Accepted January 10, 2002. Correspondence: Wan-Yu Lin, Department of Nuclear Medicine, Taichung Veterans General Hospital, 160 Taichung Harbor Road, Section 3, Taichung 40705, Taiwan. E-mail: [email protected]
Endocardial Fibroelastosis in Infants Associated with Thrombosis and Calcification of Arteries and Myocardial Infarcts
Authors: Wilbur A. Thomas, Kyu Taik Lee, Malcolm H. McGavran, Erwin R. Rabin
Journal: New England Journal of Medicine (1956)

CALCIFIC arterial disease of infants with myocardial infarcts is uncommon, but at least 50 cases have been reported in the medical literature.1 , 2 The etiology has remained a complete mystery. It has been suggested that the arterial changes result from a basic defect in calcium metabolism.1 , 2 However, no such defect has been demonstrated, and the general distribution of the lesions is not that of diseases known to result from abnormalities of calcium metabolism. Another possibility is that the disease results from a defect in the formation of elastic tissue and that the calcium deposition is a secondary feature.1 2 3 The nature of . . .
PTH-181 Bile Acid Malabsorption: Prevalence Comparable to Coeliac Disease in Patients with Chronic Diarrhoea: Abstract PTH-181 Table 1
Authors: M Kurien, J McConnell, J S Leeds, D S Sanders
Journal: Gut (2013)

<h3>Introduction</h3> Chronic watery diarrhoea is a common referral, with a host of possible aetiologies. To help establish a diagnosis a number of international guidelines have been created, defining diagnostic pathways. Bile acid malabsorption (BAM) is a potential cause, with high prevalence previously demonstrated by our group in patients with Diarrhoea predominant Irritable Bowel Syndrome (D-IBS).<sup>1</sup> This study determines the prevalence of BAM and other organic conditions in patients referred with chronic diarrhoea (Group A), with findings compared to our previously published D-IBS cohort (Group B). <h3>Methods</h3> A total of 92 consecutive patients referred to a tertiary referral centre with chronic diarrhoea, defined as more than 3 loose or liquid bowel movements a day for at least 4 weeks were evaluated (Group A). Demographic data, subsequent investigations and diagnostic yields of these tests were collected. All patients underwent haematological, biochemical and immunological testing prior to subsequent investigations. Statistical analysis was performed using SPSS with Fisher’s exact test used to compare categorical data. <h3>Results</h3> Medical records were identified in 89 of the 92 patients referred (mean age 50 years, range 18–86 years). Of these patients, 23 (26%) had an organic cause for their diarrhoea identified (Table 1), with 6 having dual pathology. Inflammatory bowel disease was the most prevalent condition identified, with the prevalence of BAM being comparable to that seen for coeliac disease (p = 0.72). When evaluating diagnostic yields for BAM in Groups A and B, prevalence was significantly higher in the D-IBS Cohort (42% vs 6%, p &lt; 0.001). <h3>Conclusion</h3> In this study organic causes for chronic diarrhoea were identified in 26%. Given that BAM had similar prevalence to coeliac disease in patients with chronic diarrhoea, we would advocate BAM investigations early within the diagnostic pathway. <h3>Disclosure of Interest</h3> None Declared. <h3>Reference</h3> Kurien M<i> et al.</i> Bile acid malabsorption: an under-investigated differential diagnosis in patients presenting with diarrhoea predominant irritable bowel syndrome type symptoms. Scand J Gastroenterol. 2011 Jul; 46(7–8):818–22
Endoscopic treatment of difficult bile duct stones by using a double-lumen basket for laser lithotripsy – a case series
Authors: J. Lee, J. Moon, H. Choi, A. Song, E. Jung, Y. Cheon, Y. Cho, J. Lee, M. Lee
Journal: Endoscopy (2009)

Laser lithotripsy is an effective and safe method for difficult common bile duct (CBD) stones. However, radiolucent laser fibers make accurate fragmentation difficult and require continuous visual control or an accessory for effective targeting. The newly developed double-lumen basket may promote effective laser lithotripsy after stone capture. We performed laser lithotripsy using a double-lumen basket in 14 patients with CBD stones refractive to conventional endoscopic treatment, and evaluated the feasibility and efficacy of this procedure. Stones were successfully fragmented in 13 of 14 patients, and 13 patients eventually became stone-free. Mechanical lithotripsy was applied in two patients with biliary strictures. Minor complications were noted in three patients, including transient hemobilia in one patient. For a selected group of patients with difficult CBD stones, laser lithotripsy using a double-lumen basket appears to be an effective and safe method. However, continuous development of basket protocols to increase the success rate of lithotripsy is needed.
Ectopic Cushing's Syndrome
Authors: Felix Flohr, Helene Geddert
Journal: New England Journal of Medicine (2011)

A 23-year-old man presented with a 1-year history of diabetes mellitus, hypertension, and hypogonadism and a weight gain of 22 kg. Abdominal striae were present on physical examination (Panel A). An endocrine evaluation showed a corticotropin-dependent hypercortisolism: his morning cortisol level after an overnight dexamethasone suppression test was 38 μg per deciliter (1048 nmol per liter) (reference range, <1.8 μg per deciliter [<49.7 nmol per liter]) and his corticotropin level was 287 pg per milliliter (63.2 pmol per liter) (reference range, <46 pg per milliliter [<10.1 pmol per liter]). Endogenous cortisol production could not be suppressed with the administration of . . .
Abstract SY18-04: Next-generation screens for cancer genes.
Authors: David J. Adams
Journal: Cancer Research (2013)

Abstract In humans diverse mutagenic processes contribute to tumor development and drive tumor evolution. We have been performing genetic screens in mouse models of cancer engineered to carry known driver mutations. Using exome sequencing, whole genome sequencing, and transposons in these models we have identified genes that can promote tumorigenesis and regulate response to therapy. I will talk about our latest progress with these screens and the genes we have discovered. Citation Format: David J. Adams. Next-generation screens for cancer genes. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr SY18-04. doi:10.1158/1538-7445.AM2013-SY18-04
Dehydroepiandrosterone Replacement in Women with Adrenal Insufficiency
Authors: Wiebke Arlt, Frank Callies, Jan Christoph van Vlijmen, Ines Koehler, Martin Reincke, Martin Bidlingmaier, Doris Huebler, Michael Oettel, Michael Ernst, Heinrich Maria Schulte, Bruno Allolio
Journal: New England Journal of Medicine (1999)

The physiologic role of dehydroepiandrosterone in humans is still unclear. Adrenal insufficiency leads to a deficiency of dehydroepiandrosterone; we therefore investigated the effects of dehydroepiandrosterone replacement in patients with adrenal insufficiency.
Expanded Medicaid coverage boosted visits to emergency departments, finds study
Authors: M. McCarthy
Journal: BMJ (2014)

Patients newly insured under an expansion of the Medicaid program increased their visits to hospital emergency departments by 40%, a new study has shown. 

The findings challenge the claim that providing uninsured people with health insurance will, by giving them access to more appropriate primary care services, reduce their use of costly emergency room care.

In the study, published in Science,1 Sarah Taubman, of the National Bureau of Economic Research in Cambridge, Massachusetts, and colleagues looked at changes in use of emergency departments after the state of Oregon implemented a limited expansion of its Medicaid program in 2008.

To determine who would get access to expanded coverage, the state used …