tbuckley/cabot-search huggingface dataset:
Retrospective Assessment of Menstrual Cycle Length in Patients With Breast Cancer, in Patients With Benign Breast Disease, and in Women Without Breast Disease&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: H Olsson, M Landin-Olsson, B Gullberg
Journal: JNCI Journal of the National Cancer Institute (1983)

Journal Article Retrospective Assessment of Menstrual Cycle Length in Patients With Breast Cancer, in Patients With Benign Breast Disease, and in Women Without Breast Disease Get access Håkan R. Olsson, Håkan R. Olsson Search for other works by this author on: Oxford Academic PubMed Google Scholar Mona Landin-Olsson, Mona Landin-Olsson Search for other works by this author on: Oxford Academic PubMed Google Scholar Bo Gullberg Bo Gullberg Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 70, Issue 1, January 1983, Pages 17–20, https://doi.org/10.1093/jnci/70.1.17 Published: 01 January 1983 Article history Received: 01 December 1981 Revision received: 26 July 1982 Accepted: 17 August 1982 Published: 01 January 1983
The Role of Bile-Acid Derivatives in the Seroflocculation Reaction. II. Clinical Evaluation&lt;xref ref-type="fn" rid="fn1"&gt;2&lt;/xref&gt;,&lt;xref ref-type="fn" rid="fn2"&gt;3&lt;/xref&gt;
Authors: Hall, George C., Dowdy, Andrew H., Penn, Harry S., Bellamy, Albert W.
Journal: JNCI Journal of the National Cancer Institute (1955)

Journal Article The Role of Bile-Acid Derivatives in the Seroflocculation Reaction. II. Clinical Evaluation, Get access George C. Hall, M.D., George C. Hall, M.D. Director Search for other works by this author on: Oxford Academic PubMed Google Scholar Andrew H. Dowdy, M.D., Andrew H. Dowdy, M.D. Professor and Chairman Department of Radiology, University of California Medical Center and Consultant, Radiology, Veterans Administration Hospital Center Search for other works by this author on: Oxford Academic PubMed Google Scholar Harry S. Penn, M.D., Harry S. Penn, M.D. Associate Professor of Radiology (Oncology) University of California Medical Center Search for other works by this author on: Oxford Academic PubMed Google Scholar Albert W. Bellamy, Ph.D. Albert W. Bellamy, Ph.D. Professor of Biophysics University of California Medical Center, Los Angeles, Calif4 Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 16, Issue 1, August 1955, Pages 237–253, https://doi.org/10.1093/jnci/16.1.237 Published: 01 August 1955 Article history Received: 25 June 1954 Published: 01 August 1955
Mood disorders in the psychoneurologic borderland: three cases of responsiveness to carbamazepine
Authors: A J Kessler, N E Barklage, J W Jefferson
Journal: American Journal of Psychiatry (1989)

Three patients with affective disorders with psychotic features were refractory to various combinations of psychotropic agents (antipsychotics, antidepressants, and lithium). Closer scrutiny revealed a seizure history in two patients and unusual neuropsychiatric features in the third patient. Subsequent substitution of carbamazepine for the antipsychotic resulted in control of the patients' psychoses. The authors describe clinical features that may identify the patient who may respond to carbamazepine. The mechanism of carbamazepine's psychotropic effects through its hypothesized ability to inhibit limbic system kindling is discussed. The case reports emphasize the need for careful neuropsychiatric assessment of patients who are refractory to conventional treatments.
NIMG-57QUANTITATION OF 18F-DOPA UPTAKE ON PET PREDICTS TUMOR GRADE WITH HIGH SENSITIVITY AND SPECIFICITY IN NEWLY-DIAGNOSED GLIOMA: UCLA EXPERIENCE
Authors: Chirag Patel, Huytram Nguyen, Jasmine Manoukian, Benjamin Ellingson, Johannes Czernin, Timothy Cloughesy, Phioanh Nghiemphu, Albert Lai
Journal: Neuro-Oncology (2015)

PURPOSE: The aims of this study were to determine whether quantifying the amount of 18F-DOPA uptake in newly-diagnosed gliomas predicted tumor grade and was more accurate than qualitative reporting. METHODS: A retrospective study was performed at UCLA Medical Center to identify patients with pathology-proven glioma who underwent 18F-DOPA PET scanning ≤6 weeks prior to biopsy/resection. Tumor grade was obtained by standard pathology assays. 18F-DOPA uptake was quantified by determining maximum standardized uptake value (SUVmax) based on the injected radiotracer dose per patient's body weight in the region corresponding to the MRI-based lesion (tumor SUVmax). Tumor-to-normal-brain tissue (T/N) ratio was defined as dividing the tumor SUVmax by the SUVmax of the contralateral normal tissue at the level of the centrum semiovale, and tumor-to-basal ganglia (T/BG) ratio was also determined. Patient demographics, tumor grade, and imaging metrics were tabulated and analyzed. RESULTS: 982 18F-DOPA PET scans from January 2003 through February 2015 in 523 individual patients were reviewed, and scans in 23 patients (n = 9 female, n = 14 male with age 46.3 ± 16.4 years; n = 9 grade II, n = 7 grade III, n = 7 grade IV) were eligible for study. T/N ratio was 1.5 ± 0.6, 1.8 ± 0.4, and 3.0 ± 1.0 for grade II, III, and IV gliomas, respectively. Grade IV T/N ratio was significantly greater than that in grade II (p = 0.008) and grade III (p = 0.02) gliomas. Applying T/N ratio cut-offs of 1-1.69/1.7-2.39/ ≥ 2.4 for grade II/III/IV gliomas, the respective sensitivity/specificity were 88.9%/100%, 85.7%/87.5%, and 71.4%/93.8%. This is in contrast to the diagnostic accuracy (based on the qualitative report in the chart) of 66.7%, 85.7%, and 100%, respectively. CONCLUSIONS: The results demonstrate the utility of quantitative T/N ratio cut-offs in predicting glioma grade. Additionally, a population of grade II/III gliomas that was not diagnosed based on the qualitative report was identified. Future work will correlate 18F-DOPA uptake with survival and tumor molecular profile.
Evaluation of High-Sensitivity Cardiac Troponin I Levels in Patients With Suspected Acute Coronary Syndrome
Authors: Edward Carlton, Jaimi Greenslade, Louise Cullen, Richard Body, Martin Than, John W. Pickering, Sally Aldous, Simon Carley, Christopher Hammett, Jason Kendall, Brian Keevil, Sarah Lord, William Parsonage, Kim Greaves
Journal: JAMA Cardiology (2016)

Low concentrations of high-sensitivity cardiac troponin I determined on presentation to the emergency department (ED) have been shown to have an excellent negative predictive value (NPV) for the identification of acute myocardial infarction. The sensitivity, and therefore clinical applicability, of such testing strategies is unknown.To determine the diagnostic performance of low concentrations of high-sensitivity cardiac troponin I in patients with suspected cardiac chest pain and an electrocardiogram showing no ischemia as an indicator of acute myocardial infarction.A pooled analysis of 5 international (Australia, New Zealand, and England) prospective, observational cohort studies with blinded outcome assessment and 30-day follow-up was conducted. A total of 3155 patients presenting with symptoms suggestive of cardiac ischemia were included in the analysis. Eligible patients had a nonischemic electrocardiogram determined and high-sensitivity troponin I measured at presentation. The lower limit of detection (1.2 ng/L) as well as cutoff concentrations rounded to the nearest integer for a high-sensitivity troponin I assay were used in the analysis. Recruitment was undertaken from November 1, 2007, to August 10, 2013.The primary outcome was fatal or nonfatal acute myocardial infarction occurring within 30 days of ED presentation, adjudicated with serial troponin testing. The secondary outcome was the proportion of patients potentially suitable for early discharge at each cutoff concentration.Of the 3155 eligible patients, 1771 were male (56.1%), and mean (SD) age was 57.4 (13.3) years. Acute myocardial infarction developed in 291 individuals (9.2%). The 1.2-ng/L limit of detection gave a sensitivity of 99.0% (95% CI, 96.8%-99.7%) and an NPV of 99.5% (95% CI, 98.4%-99.9%). This cutoff level would allow for early discharge of 594 patients (18.8%). All higher rounded cutoff values had sensitivities less than 98.0%. Diagnostic performance of the limit of detection was maintained when patients were stratified by age, sex, risk factors, presence of coronary artery disease, and early presentation.High-sensitivity troponin I concentrations determined at presentation to the ED that were below the limit of detection identified 18.8% of patients potentially suitable for discharge, with a high sensitivity for acute myocardial infarction. Rounded cutoff values above the limit of detection may not have the required sensitivity for clinical implementation.
Unproved Hypotheses
Authors: Thomas R. Dawber
Journal: New England Journal of Medicine (1978)

ONE of the few advantages of becoming a senior citizen in the Medical Society is the privilege of being allowed to philosophize about various aspects of our field of endeavor. Although previous orators addressing the Society have not all been elderly in years, all have had wide experience that made their comments noteworthy on the varied subjects on which they chose to discourse. One thread runs through the cloth of these dissertations — a desire to improve medical knowledge and the level of medical care and practice proceeding from it.Medicine is not a pure science, and its successful practice . . .
PWE-189 Helicobacter Pylori, HIV and Gastric Hypochlorhydria in the malawian population
Authors: J Geraghty, A Thumbs, A Kankwatira, T Andrews, A Moore, R Malamba, N Mtunthama, K Hellberg, L Kalongolera, S Sarkar, P O’Toole, A Varro, DM Pritchard, M Gordon
Journal: Gut (2015)

<h3>Introduction</h3> HIV and Helicobacter pylori are common chronic infections in sub-Saharan Africa. Both conditions can predispose to gastric hypochlorhydria that may be a risk factor for enteric infections and reduced drug absorption. We have investigated to what extent HIV and H. pylori infections are associated with hypochlorhydria in a Malawian cohort of patients undergoing endoscopy. <h3>Method</h3> 104 sequential symptomatic adults referred for gastroscopy at Queen Elizabeth Central Hospital, Blantyre, Malawi, had blood taken for rapid HIV testing and fasting serum gastrin analysis. Gastric fluid was aspirated for pH testing, and gastric biopsies were taken. <h3>Results</h3> After 9/104 HIV-infected patients who were already established on antiretroviral therapy were excluded, 17/95 (25.0%) were seropositive for untreated HIV, and 68/95 (71.6%) patients were H. pylori positive by histology. Hypochlorhydria (fasting gastric pH &gt;4.0) was present in 55.8% (53/95) of patients. H. pylori infection was significantly associated with hypochlorhydria (OR 2.91, [1.02–7.75], p = 0.046). While single infection with HIV was not significantly independently associated with hypochlorhydria. H. pylori and HIV co-infection was more strongly associated with hypochlorhydria (OR 6.25, [1.33–29.43], p = 0.020) than either infection alone, suggesting an additive effect of co-infection. HIV infection was associated with higher serum gastrin levels (91.3pM vs. 53.1pM, p = 0.040), while H. pylori infection was not (63.1pM vs. 55.1pM, p = 0.610). Irrespective of H. pylori and HIV status, most patients (&gt;90%) exhibited pangastritis. Only three patients had histological evidence of gastric atrophy, of which only one was HIV-infected. <h3>Conclusion</h3> H. pylori infection was associated with fasting hypochlorhydria, while HIV was not independently associated. HIV and H. pylori co-infection, however, was more strongly associated with hypochlorhydria than H. pylori infection alone. The mechanism of this apparent additive effect between HIV and H. pylori remains unclear, but appears to be related to chronic pangastritis rather than gastric atrophy, and associated with hypergastrinaemia in HIV-infected individuals. <h3>Disclosure of interest</h3> None Declared.
PWE-257 Establishing a tertiary referral service for patients with locally advanced and recurrent rectal cancer
Authors: A Karim, V Cubas, H Ibrahim, M Goldstein, D Bowley, D McArthur
Journal: Gut (2015)

<h3>Introduction</h3> The management of patients with locally advanced rectal cancer (LARC) and recurrent rectal cancer (RRC) (collectively referred to as Beyond TME rectal cancer) presents particular surgical challenges. It has been shown that, in carefully selected patients in centres specialising in their treatment, surgical resection can result in good outcomes. We present results from our unit, establishing a tertiary referral centre for LARC and RRC in the West Midlands, UK. The team, set up after a number of its members had worked in other high volume units, comprises specialist colorectal surgeons, radiologists, pathologists, urologists, oncologists and full MDT staff. Referrals are received through the MDT from other units within the West Midlands. <h3>Method</h3> A prospective database was set up to collect data on all referrals received for LARC and RRC. Demographic, radiological and histological data was recorded. Length of stay, short and medium term morbidity, and long-term outcome, including recurrence, were all analysed. <h3>Results</h3> A total of 34 referrals were received from October 2011 to December 2014. 7 patients were declined surgery based upon anatomical factors (e.g. extensive pelvic sidewall involvement), whilst 25 patients went on to have surgery (2 further patients' surgery pending). Of those operated, M: F ratio 19:6 and median age was 60 years old. Surgery was for LARC (n = 11) and RRC (14). Surgery involved multi-visceral resection, according to the anatomical distribution of disease. Histology results for resection margins showed R0=19, R1=5, and R2=1. Median length of stay was 11 days. Median follow up was 12 months with 5 patients found to have further recurrence (2 R1 and 3 R0). Post-op complications were limited to 2 patients with wound infections managed with dressings, and one patient who developed hospital acquired pneumonia. One patient required nephrostomy in the post op period for ureteric stenosis on the contralateral side to a re-implanted ureter. 4 patients died within the follow up period and were all known to have recurrence. <h3>Conclusion</h3> Our initial results have shown acceptable outcomes for patients in terms of short-term morbidity and recurrence when compared to more established centres. The management of patients with LARC and RRC involves complex decision-making processes and challenging surgery. We believe this requires specialist input. As such, establishing a specialist referral unit for these cases is achievable and important in improving outcomes for this group of patients. <h3>Disclosure of interest</h3> None Declared.
Facial Muscle Electromyography in Depressed and Nondepressed Hospitalized Subjects: A Partial Replication
Authors: Donald Oliveau, Ragon Willmuth
Journal: American Journal of Psychiatry (1979)

Imagining happy events, sad events, and the events of a typical day led to measurable electromyographic (EMG) changes in the corrugator muscle of the face in both depressed and nondepressed subjects. The depressed and nondepressed subjects could not be differentiated on the basis of muscle activity, whether depression was defined by a self-rating scale, an adjective checklist, or research criteria. Previous investigators have observed differences in the facial EMG patterns of depressed and nondepressed subjects who were not hospitalized; the authors suggest that such changes are a consequence of a general psychological stress state rather than of depression specifically.
PTU-121 Monitoring changes in hepatic architecture and haemodynamics with quantitative magnetic resonance imaging (MRI) following directly-acting antiviral therapy in hepatitis C patients with decompensated cirrhosis
Authors: N Palaniyappan, E Cox, C Bradley, R Scott, IN Guha, S Ryder, S Francis, W Irving, GP Aithal
Journal: Gut (2015)

<h3>Introduction</h3> Directly-acting antiviral (DAA) therapy achieves sustained virological response (SVR) in over 90% of those with chronic hepatitis C (CHC), but even in those with SVR, the risk for liver related morbidity and mortality persists albeit at a lower level. It is hypothesised that the residual risk of liver related outcome in those with SVR is related to the progression or non-regression of structural and haemodynamic changes of advanced liver disease at the time of HCV therapy. Here, we investigate the effect of DAAs on the hepatic architecture and splanchnic haemodynamics in patients with decompensated cirrhosis, using quantitative MRI techniques. <h3>Method</h3> We prospectively recruited patients receiving DAAs for CHC related decompensated cirrhosis from the East Midlands hub of the Early Access Programme commissioned by NHS England. MRI was performed before and at the end of a 12-week treatment with Daclatasvir, Sofosbuvir and Ribavarin. A respiratory-triggered inversion recovery scheme was used to measure the longitudinal (T1) relaxation time of the liver employing a fat suppressed Echo Planar Imaging-acquisition. Phase-contrast (PC)-MRI was used to assess the velocity, area and bulk flow in the splanchnic circulation without any intravenous contrast agents. <h3>Results</h3> 9 patients have undergone baseline and post-treatment MR scans and end-of-treatment response (EOTR) was achieved in all 9 patients, but one patient has had virologic relapse. There was a significant reduction in the T1 relaxation time in patients with SVR (baseline T1: 765 ± 112 ms; post-treatment 737 ± 118 ms; p = 0.043) (Figure 1). There were no significant changes in the hepatic artery, portal vein, superior mesenteric artery and splenic artery flow. The changes in the Model for End-Stage Liver Disease (MELD) and United Kingdom Model for End-Stage Liver Disease (UKELD) score are shown in Table 1. <h3>Conclusion</h3> Treatment of decompensated CHC related cirrhosis with DAA is associated with early improvement in the MR markers of liver architecture. These early changes are likely to reflect the reduction in the inflammation associated with EOTR and is evident before any improvement in conventional liver function tests. This novel quantitative MR methodology will allow us to non-invasively monitor HCV related liver disease. <h3>Disclosure of interest</h3> None Declared.
Surgery of the Esophagus
Authors: Earle W. Wilkins, David B. Skinner
Journal: New England Journal of Medicine (1968)

The Lower Esophageal RingIt is now clear that the lower esophageal ring (Schatzki) itself is the anatomic boundary of limited distensibility marking the esophagogastric junction. This fact is demonstrated by radiographic-manometric technics and operative observation. Heitmann et al.46 have shown that esophageal peristaltic waves stop at the ring. In 15 cases Wilkins and Bartlett47 found the ring at the exact mucosal junction by direct transgastric or transesophageal exposure. Rinaldo and Gahagan48 likewise found the ring at the mucosal junction in seven patients.These rings are of symptomatic consequence only if small enough to cause obstruction; 13 mm is apparently . . .
Psychological States as Factors in the Development of Malignant Disease: A Critical Review&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: L LESHAN
Journal: JNCI Journal of the National Cancer Institute (1959)

The literature concerning the effect of personality structure on the etiology and development of neoplasms was reviewed. In the eighteenth and nineteenth century, publications repeatedly indicated the belief of their writers that emotional states had an important effect on the development of cancer. In the past 10 years a large number of studies in this area has been done with the modern techniques of psychiatry and clinical psychology. By and large, recent studies have come to the same conclusions as the eighteenth- and nineteenth-century oncologist. At present the data seem to justify 4 conclusions: 1) There seems to be a correlation between neoplastic disease and certain types of psychological situations. 2) The most consistently reported, relevant psychological factor has been the loss of a major emotional relationship prior to the first-noted symptoms of the neoplasm. 3) There appears to be some relationship between personality organization and the length of time between the appearance of a neoplasm and the death of the patient. 4) There may be some relationship between personality organization and the type or location of a cancer.
Damage Induced in Sarcoma 37 with Chemical Agents, III. Colchicine Derivatives Related to Trimethylcolchicinic Acid and to Colchinol&lt;xref ref-type="fn" rid="fn1"&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/xref&gt;
Authors: J LEITER, V DOWNING, J L HARTWELL, M J SHEAR
Journal: JNCI Journal of the National Cancer Institute (1952)
Systematic Population Screening, Using Biomarkers and Genetic Testing, Identifies 2.5% of the U.K. Pediatric Diabetes Population With Monogenic Diabetes
Authors: Maggie Shepherd, Beverley Shields, Suzanne Hammersley, Michelle Hudson, Timothy J. McDonald, Kevin Colclough, Richard A. Oram, Bridget Knight, Christopher Hyde, Julian Cox, Katherine Mallam, Christopher Moudiotis, Rebecca Smith, Barbara Fraser, Simon Robertson, Stephen Greene, Sian Ellard, Ewan R. Pearson, Andrew T. Hattersley
Journal: Diabetes Care (2016)

Monogenic diabetes is rare but is an important diagnosis in pediatric diabetes clinics. These patients are often not identified as this relies on the recognition of key clinical features by an alert clinician. Biomarkers (islet autoantibodies and C-peptide) can assist in the exclusion of patients with type 1 diabetes and allow systematic testing that does not rely on clinical recognition. Our study aimed to establish the prevalence of monogenic diabetes in U.K. pediatric clinics using a systematic approach of biomarker screening and targeted genetic testing.We studied 808 patients (79.5% of the eligible population) <20 years of age with diabetes who were attending six pediatric clinics in South West England and Tayside, Scotland. Endogenous insulin production was measured using the urinary C-peptide creatinine ratio (UCPCR). C-peptide-positive patients (UCPCR ≥0.2 nmol/mmol) underwent islet autoantibody (GAD and IA2) testing, with patients who were autoantibody negative undergoing genetic testing for all 29 identified causes of monogenic diabetes.A total of 2.5% of patients (20 of 808 patients) (95% CI 1.6-3.9%) had monogenic diabetes (8 GCK, 5 HNF1A, 4 HNF4A, 1 HNF1B, 1 ABCC8, 1 INSR). The majority (17 of 20 patients) were managed without insulin treatment. A similar proportion of the population had type 2 diabetes (3.3%, 27 of 808 patients).This large systematic study confirms a prevalence of 2.5% of patients with monogenic diabetes who were <20 years of age in six U.K. clinics. This figure suggests that ∼50% of the estimated 875 U.K. pediatric patients with monogenic diabetes have still not received a genetic diagnosis. This biomarker screening pathway is a practical approach that can be used to identify pediatric patients who are most appropriate for genetic testing.