tbuckley/cabot-search huggingface dataset:
Breast cancer and overall mortality following a diagnosis of ductal carcinoma in situ (DCIS) at major community cancer center: A report of 1,014 cases.
Authors: Thomas M. Beck, Dan Sayam Zuckerman, Paul G. Montgomery, Patty Sproat, Mary Winn
Journal: Journal of Clinical Oncology (2016)

e12015 Background: Ductal carcinoma in situ (DCIS), also known as Stage 0 breast cancer, is often treated with surgery, radiation, and hormone therapy to prevent invasive breast cancer. We have reviewed our experience with this entity at a major community cancer center. Methods: From 2000 to 2013, we diagnosed and treated 1014 cases of DCIS. Data were obtained from the National Cancer Data Base. Results: Mean age was 58 years. Mean follow-up is 7.8 years. Three patients developed second breast cancers and died from metastatic breast cancer. Four patients died with advanced aged (89, 91) and extreme comorbid conditions (COPD/lung cancer). All four had persistent, untreated chest wall DCIS. Overall breast cancer specific survival for women diagnosed with DCIS was 99.7%. Overall survival was 99.4%. Conclusions: Breast-cancer specific and overall survival for women diagnosed with DCIS is excellent. It is difficult to define benefit beyond surgical removal. Women with DCIS may be subject to over diagnosis and overtreatment. New terminology for this entity and research focused on identifying those women requiring less or no treatment should be considered. Primary Treatment No. % Mastectomy 225 22% Lumpectomy/ Excision 723 71% Other Treatment Hormonal 100 10% Surgery Only 324 32% Chest Wall Radiation 564 56%
Vitamin D Supplementation and Cancer Risk
Authors: Joan Lappe, Cedric Garland, Edward Gorham
Journal: JAMA (2017)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Number of new HIV infections is rising in Russia
Authors: Sophie Cousins
Journal: BMJ (2017)

The number of new HIV infections in eastern Europe and central Asia rose by 60% between 2010 and 2016, finds a report published by UNAIDS this week.1

There were around 190 000 new infections in the region in 2016, up from 120 000 in 2010, says the report, with Russia accounting for most of these new infections: 62 581 in 2010 and 103 438 in 2016. The executive director of UNAIDS, Michel Sidibe, blamed the rise on the lack of evidence based programmes for harm reduction among injecting drug users in the country.

“We need a political leadership at the top, and we need to face the issue of the shrinking space for civil society—civil society is the structure …
Annals Consult Guys - Let Me Out of Here! How Long to Remain Hospitalized After an MI
Authors: Geno J. Merli, Howard H. Weitz
Journal: Annals of Internal Medicine (2017)

Web Exclusives18 July 2017Annals Consult Guys - Let Me Out of Here! How Long to Remain Hospitalized After an MIFREEGeno J. Merli, MD and Howard H. Weitz, MDGeno J. Merli, MDSearch for more papers by this author and Howard H. Weitz, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/W17-0007 SectionsSupplemental MaterialAboutVisual Abstract ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Annals Consult Guys brings a new perspective to the art and science of medicine with lively discussion and analysis of real-world cases and situations. They address medically relevant topics—whether they be poignant, thought-provoking, or just plain entertaining.For more videos from and information on Annals Consult Guys, visit go.annals.org/ConsultGuys. Comments0 CommentsSign In to Submit A Comment Yaseer Muhammad Tareq KhanMinistry of Health, Oman5 January 2018 post thrombolysis hospital stay Sir,I work in a hospital where there is no cath lab facility. Hence all STEMI we are managing by thrombolysis with reteplase. My question is , is there any guideline/recommendation for the duration of hospital stay in uncomplicated post thrombolysis MI patients?RegardsDr Khan Author, Article, and Disclosure InformationAffiliations: Disclosures: Geno J. Merli, MD, reports the following: Research grants/contracts: Bristol-Myers Squibb, Janssen, Portola; Consultancies: Bristol-Myers Squibb, Janssen. Howard H. Weitz, MD, reports that he has no financial relationships or interests to disclose. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 18 July 2017Volume 167, Issue 2Page: CG1KeywordsDisclosureResearch grantsResearch reporting guidelines ePublished: 18 July 2017 Issue Published: 18 July 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.Loading ...
Global patterns of care in advanced stage mycosis fungoides/Sezary syndrome: a multicenter retrospective follow-up study from the Cutaneous Lymphoma International Consortium
Authors: P. Quaglino, M. Maule, H.M. Prince, P. Porcu, S. Horwitz, M. Duvic, R. Talpur, M. Vermeer, M. Bagot, J. Guitart, E. Papadavid, J.A. Sanches, E. Hodak, M. Sugaya, E. Berti, P. Ortiz-Romero, N. Pimpinelli, O. Servitje, A. Pileri, P.L. Zinzani, T. Estrach, R. Knobler, R. Stadler, M.T. Fierro, S. Alberti Violetti, I. Amitay-Laish, C. Antoniou, C. Astrua, S. Chaganti, F. Child, A. Combalia, S. Fabbro, P. Fava, V. Grandi, C. Jonak, E. Martinez-Escala, M. Kheterpal, E.J. Kim, C. McCormack, T. Miyagaki, D. Miyashiro, S. Morris, C. Muniesa, V. Nikolaou, G. Ognibene, F. Onida, S. Osella-Abate, S. Porkert, C. Postigo-Llorente, C. Ram-Wolff, S. Ribero, K. Rogers, M. Sanlorenzo, R. Stranzenbach, N. Spaccarelli, A. Stevens, D. Zugna, A.H. Rook, L.J. Geskin, R. Willemze, S. Whittaker, R. Hoppe, J. Scarisbrick, Y. Kim
Journal: Annals of Oncology (2017)
Estimates of Soil Ingestion in a Population of Chinese Children
Authors: Chunye Lin, Beibei Wang, Xiaoyong Cui, Dongqun Xu, Hongguang Cheng, Qin Wang, Jin Ma, Tuanyao Chai, Xiaoli Duan, Xitao Liu, Junwei Ma, Xuan Zhang, Yanzhong Liu
Journal: Environmental Health Perspectives (2017)

China's soil pollution poses serious health risks. However, data regarding the soil ingestion rate (SIR) of the Chinese population, which is critical to assessing associated health risks, are lacking.We estimated soil ingestion of 177 Chinese children from Guangdong, Hubei, and Gansu Provinces.We conducted this investigation by employing a tracer mass-balance method. We collected a duplicate of all food consumed and all feces and urine excreted on 1 d (n=153) and over 3 consecutive d (n=24), as well as soil samples from play areas and drinking-water samples. We analyzed concentrations of the tracer elements Al, Ba, Ce, Mn, Sc, Ti, V, and Y in these samples using ICP-AES and ICP-MS and estimated the SIR for each subject.The estimated SIR data based on each tracer element were characterized by a skewed distribution, as well as higher inter-tracer and inter-subject variation, with several outliers. After removing the outliers, daily SIR median (range) values in milligrams per day were Al, 27.8 (−42.0 to 257.3); Ba, 36.5 (−230.3 to 412.7); Ce, 35.3 (−21.2 to 225.8); Mn, 146.6 (−1259.4 to 1827.7); Sc, 54.8 (−4.5 to 292.0); Ti, 36.7 (−233.7 to 687.0); V, 92.1 (10.4 to 308.0); and Y, 59.1 (−18.4 to 283.0). Daily SIR median/95th percentile (range) values based on the best tracer method (BTM) were 51.7/216.6 (−9.5 to 297.6) mg/d.Based on the BTM, recommended SIR values for the general population of Chinese children (2.5 to 12 years old) are 52 mg/d for the central tendency and 217 mg/d for the upper percentile. We did not differentiate between outside soil and indoor dust. Considering the lower concentration of tracer elements in indoor dust than outside soil, actual soil and dust ingestion rates could be higher. https://doi.org/10.1289/EHP930.
Abstract P258: Effect of MicroRNA-223 on Hypoxic Pulmonary Hypertension
Authors: Lei Shi, Bhola Kumar, Beate Fisslthaler, Ralph T Schermuly, Ingrid Fleming
Journal: Circulation Research (2011)

Chronic hypoxia plays a key role in pulmonary hypertension and remodeling by inducing marked changes in gene expression. However, the regulatory effect of chronic hypoxia on microRNA (miR) expression in the lung has not yet been investigated. The purpose of this study was to determine which miRs are regulated by chronic hypoxia in the mouse lung and to determine their functional significance. We identified miRs altered in mouse lung after 3 weeks chronic hypoxia (10% O 2 (10 in 100) ) treatment by Microarray screening, verified miR target genes by reporter gene assays and Western blotting. Furthermore, we analyzed in vitro and in vivo functional significance for mouse pulmonary vascular artery smooth muscle cells. Among the miRs regulated, miR-223 was the most significantly decreased, a phenomenon verified by RT-qPCR. The insulin-like growth factor 1 receptor (IGF1R) is a known target of miR-223 and the binding of miR-223 to the 3’UTR of IGF1R was demonstrated. We found that IGF1R protein levels (but not RNA) were increased in lungs from hypoxic mice via a mechanism involving HIF1α/2α and reduced C/EBPα expression and transcription activity. Moreover, the expression of IGF1R was decreased following introduction of pre-mir-223 into pulmonary artery smooth muscle cells, an phenomenon coupled to attenuated IGF1-induced Akt phosphorylation, cell migration and proliferation. Decreasing endogenous miR-223 levels using a specific antagomir (3 weeks), increased pulmonary artery pressure and vessel muscularization. A similar phenomenon was observed in miR-223 -/y mice, which also demonstrated a more severe response to hypoxia than wild-type mice. In lungs from primary pulmonary hypertension (PPH) patients we also detected a decrease in miR-223 and increase in IGF1R expression. These data indicate that the downregulation of miR-223 may contribute to the IGF1-induced pulmonary smooth muscle migration by regulating the expression of its receptor and thus contributing to pulmonary remodeling and the development of pulmonary hypertension.
Progress Toward Measles Elimination — Bangladesh, 2000–2016
Authors: Sudhir Khanal, Rajendra Bohara, Stephen Chacko, Mohammad Sharifuzzaman, Mohammad Shamsuzzaman, James L. Goodson, Alya Dabbagh, Katrina Kretsinger, Deepak Dhongde, Jayantha Liyanage, Sunil Bahl, Arun Thapa
Journal: MMWR Morbidity and Mortality Weekly Report (2017)

In 2013, at the 66th session of the Regional Committee of the World Health Organization (WHO) South-East Asia Region (SEAR), a regional goal was established to eliminate measles and control rubella and congenital rubella syndrome* by 2020 (1). WHO-recommended measles elimination strategies in SEAR countries include 1) achieving and maintaining ≥95% coverage with 2 doses of measles-containing vaccine (MCV) in every district, delivered through the routine immunization program or through supplementary immunization activities (SIAs)†; 2) developing and sustaining a sensitive and timely measles case-based surveillance system that meets targets for recommended performance indicators; and 3) developing and maintaining an accredited measles laboratory network (2). In 2014, Bangladesh, one of 11 countries in SEAR, adopted a national goal for measles elimination by 2018 (2,3). This report describes progress and challenges toward measles elimination in Bangladesh during 2000-2016. Estimated coverage with the first MCV dose (MCV1) increased from 74% in 2000 to 94% in 2016. The second MCV dose (MCV2) was introduced in 2012, and MCV2 coverage increased from 35% in 2013 to 93% in 2016. During 2000-2016, approximately 108.9 million children received MCV during three nationwide SIAs conducted in phases. During 2000-2016, reported confirmed measles incidence decreased 82%, from 34.2 to 6.1 per million population. However, in 2016, 56% of districts did not meet the surveillance performance target of ≥2 discarded nonmeasles, nonrubella cases§ per 100,000 population. Additional measures that include increasing MCV1 and MCV2 coverage to ≥95% in all districts with additional strategies for hard-to-reach populations, increasing sensitivity of measles case-based surveillance, and ensuring timely transport of specimens to the national laboratory will help achieve measles elimination.
Abstract 148: Sterol Regulatory Element-Binding Protein-1 Is Involved in the Development of Angiotensin II-Induced Cardiac Fibrosis
Authors: Satoshi Sakai, Yoshimi Nakagawa, Nobutake Shimojo, Taizo Kimura, Kazuko Tajiri, Kuga Keisuke, Satoshi Homma, Takashi Miyauchi, Kazutaka Aonuma, Hitoshi Shimano
Journal: Circulation Research (2012)

Sterol Regulatory Element Binding Protein (SREBP)-1 is a transcription factor for triglyceride synthesis. SREBP-1 is shown to contribute to the organ damages such as pancreatic beta cell, liver, and kidney; however, it is unclear whether SREBP-1 also contributes to the cardiac pathogenesis. We made cardiac dysfunction and fibrosis model by 2-week infusion of angiotensin II (A-II, 1.44 mg/kg BW/day). Mice were divided into followings (n=5∼6 in each group): wild with vehicle (WC), wild with A-II (WA), SREBP-1 knockout mice (SREBP-KO) with vehicle (SC), and SREBP-KO with A-II (SA). WA clearly demonstrated cardiac dysfunction and severe perivascular fibrosis compared to WC; however, these findings were not observed in SA compared to SC. We analyzed gene expression by DNA microarray using the software DAVID and quantitative RT-PCR to find gene clusters mostly illustrative for these phenotypes. Gene expression of extracellular matrix (Col1a, 3a, periostin) was increased in WA. Highly scored annotations in WA were chemokines (CCL5, CXCL10) and their receptors (CCR5, CXCR3), and Th2 cytokines (IL-13 and TGFb), suggesting that chronic inflammatory and repairing responses occurred. These changes were normalized in SA compared to SC. Expression of NOX4, a component of NADPH oxidase, was significantly increased in WA and SA compared to each control in a similar extent, suggesting that the Ang II-induced oxidative stress to the heart did not differ. To elucidate why the cardiac fibrosis differed between WA and SA, we analyzed the expression of transcription factors. Nrf2, a transcription factor for detoxification and anti-oxidant gene against to reactive oxygen species (ROS), was significantly decreased in WA compared to WC; however, it did not differ between in SA and SC. Furthermore, expression of the Nrf2-inducible genes HO-1 and NQO1, antioxidant genes, was significantly decreased in WA compared to WC; meanwhile, there were no differences between in SA and SC. [Conclusion] SREBP-1 may positively contribute to the A-II-induced cardiac fibrosis via the involvement of chronic inflammatory responses, which is induced partly by the reduction of antioxidant activity.
Investigating the impact of the English health inequalities strategy: time trend analysis
Authors: Ben Barr, James Higgerson, Margaret Whitehead
Journal: BMJ (2017)

<b>Objective</b>&nbsp;To investigate whether the English health inequalities strategy was associated with a decline in geographical health inequalities, compared with trends before and after the strategy. <b>Design</b>&nbsp;Time trend analysis. <b>Setting</b>&nbsp;Two groups of lower tier local authorities in England. The most deprived, bottom fifth and the rest of England. <b>Intervention</b>&nbsp;The English health inequalities strategy—a cross government strategy implemented between 1997 and 2010 to reduce health inequalities in England. Trends in geographical health inequalities were assessed before (1983-2003), during (2004-12), and after (2013-15) the strategy using segmented linear regression. <b>Main outcome measure</b>&nbsp;Geographical health inequalities measured as the relative and absolute differences in male and female life expectancy at birth between the most deprived local authorities in England and the rest of the country. <b>Results</b>&nbsp;Before the strategy the gap in male and female life expectancy between the most deprived local authorities in England and the rest of the country increased at a rate of 0.57 months each year (95% confidence interval 0.40 to 0.74 months) and 0.30 months each year (0.12 to 0.48 months). During the strategy period this trend reversed and the gap in life expectancy for men reduced by 0.91 months each year (0.54 to 1.27 months) and for women by 0.50 months each year (0.15 to 0.86 months). Since the end of the strategy period the inequality gap has increased again at a rate of 0.68 months each year (−0.20 to 1.56 months) for men and 0.31 months each year (−0.26 to 0.88) for women. By 2012 the gap in male life expectancy was 1.2 years smaller (95% confidence interval 0.8 to 1.5 years smaller) and the gap in female life expectancy was 0.6 years smaller (0.3 to 1.0 years smaller) than it would have been if the trends in inequalities before the strategy had continued. <b>Conclusion</b>&nbsp;The English health inequalities strategy was associated with a decline in geographical inequalities in life expectancy, reversing a previously increasing trend. Since the strategy ended, inequalities have started to increase again. The strategy may have reduced geographical health inequalities in life expectancy, and future approaches should learn from this experience. The concerns are that current policies are reversing the achievements of the strategy.
Patients harmed by mesh implants address emotional parliamentary meeting
Authors: Rebecca Coombes
Journal: BMJ (2017)

Women with life changing side effects after transvaginal mesh implants led a call in the UK parliament last week for a suspension of the devices pending a full public inquiry.

The emotionally charged meeting, organised by a shadow cabinet member, Owen Smith, was also supported by doctors, surgeons, academics, and more than 20 MPs.

More than a dozen women testified to how mesh had left them disabled, in chronic and debilitating pain, needing a bladder or bowel removed where the mesh had shrunk and sliced into them, unable to have sex, or with psychological problems. The implants include vaginal mid-urethral tapes used to treat stress urinary incontinence, as well as mesh used to treat pelvic organ prolapse, made of polypropylene.

Since 2006 more than 126 000 women have had mesh implants and tapes for incontinence and prolapse in England. The implants are subject to an ongoing inquiry in Scotland, where mesh for women with pelvic organ prolapse is currently suspended.

A report by a working party set up by NHS England is due to report this week. An initial …
Urinary Extracellular Vesicles of Podocyte Origin and Renal Injury in Preeclampsia
Authors: Sarwat I. Gilani, Ulrik Dolberg Anderson, Muthuvel Jayachandran, Tracey L. Weissgerber, Ladan Zand, Wendy M. White, Natasa Milic, Maria Lourdes Gonzalez Suarez, Rangit Reddy Vallapureddy, Åsa Nääv, Lena Erlandsson, John C. Lieske, Joseph P. Grande, Karl A. Nath, Stefan R. Hansson, Vesna D. Garovic
Journal: Journal of the American Society of Nephrology (2017)

Renal histologic expression of the podocyte-specific protein, nephrin, but not podocin, is reduced in preeclamptic compared with normotensive pregnancies. We hypothesized that renal expression of podocyte-specific proteins would be reflected in urinary extracellular vesicles (EVs) of podocyte origin and accompanied by increased urinary soluble nephrin levels (nephrinuria) in preeclampsia. We further postulated that podocyte injury and attendant formation of EVs are related mechanistically to cellfree fetal hemoglobin (HbF) in maternal plasma. Our study population included preeclamptic ( n =49) and normotensive ( n =42) pregnant women recruited at delivery. Plasma measurements included HbF concentrations and concentrations of the endogenous chelators haptoglobin, hemopexin, and α 1- microglobulin. We assessed concentrations of urinary EVs containing immunologically detectable podocyte-specific proteins by digital flow cytometry and measured nephrinuria by ELISA. The mechanistic role of HbF in podocyte injury was studied in pregnant rabbits. Compared with urine from women with normotensive pregnancies, urine from women with preeclamptic pregnancies contained a high ratio of podocin-positive to nephrin-positive urinary EVs (podocin + EVs-to-nephrin + EVs ratio) and increased nephrinuria, both of which correlated with proteinuria. Plasma levels of hemopexin, which were decreased in women with preeclampsia, negatively correlated with proteinuria, urinary podocin + EVs-to-nephrin + EVs ratio, and nephrinuria. Administration of HbF to pregnant rabbits increased the number of urinary EVs of podocyte origin. These findings provide evidence that urinary EVs are reflective of preeclampsia-related altered podocyte protein expression. Furthermore, renal injury in preeclampsia associated with an elevated urinary podocin + EVs-to-nephrin + EVs ratio and may be mediated by prolonged exposure to cellfree HbF.
The microvascular niche instructs T cells in large vessel vasculitis via the VEGF-Jagged1-Notch pathway
Authors: Zhenke Wen, Yi Shen, Gerald Berry, Farhad Shahram, Yinyin Li, Ryu Watanabe, Yaping Joyce Liao, Jörg J. Goronzy, Cornelia M. Weyand
Journal: Science Translational Medicine (2017)

Microvascular endothelial cells in the arterial adventitia have immunoregulatory function and build an instructive tissue niche for the induction of pathogenic T cells in giant cell arteritis.
Large case series documents chronic brain damage in players of American football
Authors: Michael McCarthy
Journal: BMJ (2017)

Chronic traumatic encephalopathy (CTE), a form of brain damage associated with repetitive head trauma, was common in players of American football whose brains had been donated to a brain bank dedicated to the study of the condition, a new study has found.1

In the study Ann C McKee, from the Boston University CTE Center and VA Boston Healthcare Systems, and colleagues examined the brains of 202 football players for neuropathological signs of CTE and other neurological disorders, such as Alzheimer’s disease.

They also gathered information about possible clinical signs …