tbuckley/cabot-search huggingface dataset:
Abstract 12144: Impact of Left Ventricular Diastolic Dysfunction on Long-Term Outcomes Following Coronary Artery Bypass Grafting: 5-Year Outcomes of the CREDO-Kyoto CABG Registry Cohort-2
Authors: Akira Marui, Noboru Nishiwaki, Tatsuhiko Komiya, Michiya Hanyu, Shiro Tanaka, Takeshi Kimura, Ryuzo Sakata
Journal: Circulation (2014)

Background: Left ventricular (LV) systolic dysfunction (heart failure [HF] with low ejection fraction [EF]) is regarded as an independent risk factor for poor outcomes after coronary artery bypass ...
Abstract A12: Establishing in vitro and in vivo models of pancreatic ductal adenocarcinoma (PDA) utilizing both acinar and ductal lineages
Authors: Jesse Handler, Dafna Bar-Sagi
Journal: Cancer Research (2015)

Abstract As it seems that both acinar and ductal cells can give rise to PDA and that the developmental pathways for these two lineages differ, it is essential that we have models to study the biology of these cells both in vitro and in vivo. To facilitate this, we have developed in vitro organoid models using both acinoductal and ductal cells. These models involve isolation of primary acinar or ductal cells from the mouse pancreas and subsequent 3D culture in Matrigel. Importantly, these models allow us to study both WT, KRAS transformed, or otherwise manipulated primary cells in a physiologically relevant context. We have gone on to perform orthotopic allografts using these cells to study their behavior in vivo. KRAS transformed acinoductal and ductal cells exhibit markedly different phenotypes within these allografts. Ductal cells form large cystic lesions, while acinoductal cells form small, well differentiated ductal lesions within the context of a residual Matrigel plug. Preliminary data suggest that these differences may be due to differential activation of pancreatic stellate cells (PSCs). Citation Format: Jesse Handler, Dafna Bar-Sagi. Establishing in vitro and in vivo models of pancreatic ductal adenocarcinoma (PDA) utilizing both acinar and ductal lineages. [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Innovations in Research and Treatment; May 18-21, 2014; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2015;75(13 Suppl):Abstract nr A12.
Prognostic value of early objective tumor response (EOTR) to first-line systemic therapy in metastatic colorectal cancer (mCRC): Individual patient data (IPD) meta-analysis of randomized trials from the ARCAD database.
Authors: Dirkje Willemien Sommeijer, Qian Shi, Jeffrey P Meyers, Katrin Marie Sjoquist, Paulo Marcelo Hoff, Matthew T. Seymour, James Cassidy, Richard M. Goldberg, Jean-Yves Douillard, J. Randolph Hecht, Herbert Hurwitz, Christophe Tournigand, Niall C. Tebbutt, Enrique Aranda, John Souglakos, Fairooz F. Kabbinavar, Benoist Chibaudel, Aimery De Gramont, Daniel J. Sargent, John Raymond Zalcberg
Journal: Journal of Clinical Oncology (2013)

3520 Background: EOTR has been suggested as a potential surrogate for overall survival (OS) in patients (pts) with mCRC and allows early assessment of treatment efficacy, facilitating adaptive trial design. We assessed at the individual patient level, the correlation between EOTR (complete or partial response) at 6, 8 and 12 weeks (wk), OS and progression free survival (PFS) in pts with mCRC treated with 1 st line chemotherapy with or without a targeted agent as a first step in a surrogacy demonstration. Methods: IPD from 13,949 pts enrolled on 15 randomized Phase III trials in 1 st line mCRC were used; 8 trials included targeted (anti-angiogenic and anti-EGFR) agents. EOTR prognostic value was assessed by landmark analyses using Cox models stratified by treatment assignment. P-values &lt;0.01 were considered statistically significant to account for multiple comparisons. Results: Of 13,949 pts, 11,987 had sufficient response data to be included in the analysis. Median OS was 21.7 months (mo) in pts with an EOTR vs. 16.5 mo without EOTR at 6 wk (p&lt;.0001, Hazard Ratio [HR] 0.64, 95% confidence interval [CI] 0.58-0.70, c statistic [c] 0.55). HRs were similar whether pts were treated with targeted therapies (p&lt;.0001, HR 0.68, 95% CI 0.58-0.80, x 0.54) or non-targeted therapies (p&lt;.0001, HR 0.61, 95% CI 0.55-0.69, x 0.55). Median PFS was 8.4 mo in pts with EOTR at 6 wk vs. 7.0 mo in pts without EOTR (p&lt;.0001, HR 0.79, 95% CI 0.73-0.85). EOTR at 8 and 12 wks were also significantly associated with longer OS and PFS. The prognostic value of EOTR at 6, 8 and 12 wks remained significant (p&lt;0.0001) after adjusting for age, gender, performance statusand location of metastatic disease (lung or liver). Overall tumor response (to 26 wk) however provided superior OS prediction (p&lt;.0001, HR 0.51, 95% CI, 0.47-0.56, CS 0.61) vs. EOTR. Conclusions: Early response measured at 6, 8 or 12 wk after starting 1 st line treatment was a strong and independent predictor of both OS and PFS in patient with mCRC and warrants further consideration as a potential endpoint for future trials, particularly randomized phase II trials.
Abstract 16825: Increased Pericardial Adipose Tissue Volume is Associated with Adverse Left Ventricular Remodeling After Acute Myocardial Infarction
Authors: Julia K Steiner, Lena Noh, Iris Burck, Volker Schachinger, Birgit Assmus, Thomas Vogl, David M Leistner, Andreas M Zeiher
Journal: Circulation (2012)

Background: Pericardial adipose tissue (PAT) has been shown to predict the prevalence and progression of coronary artery disease. However there are no data on the potential role of PAT on left vent...
Early discharge after surgery for breast cancer
Authors: D W England, L. Hopkins, A. D Spigelman, R. Ackroyd, M. W R Reed, N. J Bundred, A. D Baildam, L. Barr, P. Maguire, J. Reynolds, L. Thomson, J. Grimshaw, J. Morris
Journal: BMJ (1999)

Editor—We too have found the positive effects of early discharge of patients with breast cancer. Of our last 100 operations for breast cancer, 23 patients were suitable for and accepted early discharge with the axillary drain in situ. Interestingly, 41 patients were deemed fit enough for early discharge and to have adequate social support but declined for various reasons, including feeling safer in hospital, needing the rest, and problems associated with the husband’s employment. Two patients who had paid into the hospital’s “Saturday fund” were anxious to stay in hospital as payments are related to the number of days in hospital.

The unit in Bundred et al’s1 study had a policy of daily phone calls and daily visits by a breast nurse after early discharge. Few breast units are likely to be able to afford to employ highly skilled breast care nurses for this purpose. Our policy is to give full oral and written information relating to management of the drain and a 24 hour contact number; during the week after discharge the patient is brought to the clinic once and phoned at home once. The general practitioner is also informed of the patient’s discharge with the drain in situ. With this policy we have not experienced any problems related to the drain and have found patient satisfaction to be high.

The most important aspect of Bundred et al’s study is that 73% of patients were unable to be discharged early, even with a high level of support. The significance of this is brought out in Fallowfield’s editorial.2 Clearly, two days after breast surgery patients do not require the full input of a surgical ward with its attendant high costs. The early discharge of patients after breast surgery in the United States is well known to most hospital managers, but they may not appreciate the problems that the three quarters of patients who do not return home early have.

The advent of sentinel lymph node biopsy may well shorten the average stay after surgery for breast cancer. An appreciable number of patients will still not be able to be discharged early. A good compromise would be to discharge patients to a halfway house with low level nursing input, such as a patient hotel. We would encourage managers to look carefully at the introduction of such facilities.
Increased Specificity of Liver Scanning with the Use of<sup>67</sup>Gallium Citrate
Authors: Frederick Lomas, Pablo E. Dibos, Henry N. Wagner
Journal: New England Journal of Medicine (1972)

Sixty-one patients with focal defects on colloid liver scan and two with infrahepatic mass lesions were studied with 67gallium citrate. Definite accumulation of the radionuclide was noted in the lesions of 23 of 30 patients with hepatic cancer –11 of 12 with hepatocellular carcinoma, four of nine with metastatic adenocarcinoma, two with squamous-cell carcinoma, two with malignant melanoma, two with Hodgkin's disease, one with undifferentiated carcinoma and one with hepatoblastoma. The tracer was poorly taken up by five metastatic adenocarcinomas and one malignant carcinoid. Four of six patients with liver abscess and one with cirrhosis also had appreciable accumulation of gallium in the liver lesions. Twenty-six other patients with benign conditions producing focal defects on the colloid liver scan did not have appreciable uptake of gallium. The gallium studies were helpful in the detection of hepatoma in patients with cirrhosis and in differentiating cancer and abscess from more benign causes of an abnormal liver scan.
Studies of Immune Functions of Patients with Systemic Lupus Erythematosus
Authors: Tsuyoshi Sakane, Alfred D. Steinberg, J. Patton Reeves, Ira Green
Journal: Journal of Clinical Investigation (1979)

Patients with systemic lupus erythematosus (SLE) produce excessive amounts of autoantibodies. It has also been demonstrated in several systems that such patients have a relative loss of suppressor thymus-derived (T) cells that inhibit the immune response. This loss of suppressor cells has been suggested as one of the causes of the excessive production of antibodies in patients with SLE. In the present report we have tested the hypothesis that anti-T-cell antibodies found in the plasma of some patients with SLE preferentially kill suppressor cells. T cells from normal individuals can be activated by concanavalin A to develop suppressor cell activity. We therefore cultured normal T cells together with concanavalin A in the presence of plasma or plasma fractions from patients with SLE. We found that plasma from patients with active SLE, in which anti-T-cell antibodies were present, inhibited the development of suppressor activity in such cultures. In contrast, plasma from other active patients and patients with inactive SLE, in which no anti-T-cell antibodies could be detected, failed to block the development of such suppressor activity. Absorption of the plasma that contained anti-T-cell antibodies with T cell, but not non-T cells, could eliminate the suppressor-inhibiting activity of the SLE plasma that contained anti-T-cell antibodies. The immunoglobulin (Ig)M, but not the IgG, fraction of the plasma was shown to possess the inhibiting property and complement was found to be necessary for the effect of such anti-T-cell antibodies. We also demonstrated that exposure of normal T cells to such anti-T-cell antibodies and complement did not affect another population of T cells that could proliferate in response to mitogens.Thus, certain patients with SLE have in their plasma an antibody of the IgM class that can selectively eliminate a population of T cells capable of developing suppressor function. The loss of suppressor T cells in patients with SLE may be the result of the effects of such antibody activity in vivo.
Abstract 13966: High Cardiorespiratory Fitness Attenuates Carotid Intima Media Thickening In Men With Metabolic Syndrome
Authors: Sae Young Jae, Kevin S Heffernan, Bo Fernhall, Yoon-Ho Choi
Journal: Circulation (2010)

Introduction:  High levels of cardiorespiratory fitness (fitness) provide a strong protective effect against CVD mortality in men with the metabolic syndrome (MetS), but the underlying mechanisms are not fully understood. Carotid intima media thickness has been associated with increased risk of CVD and is increased with metabolic syndrome. We evaluated whether high fitness attenuates carotid intima media thickness in 8104 men (mean age 51 ± 7 yrs) who participated in a medical screening program.   Methods:  We measured common carotid artery intima media thickness (CIMT) using B-mode ultrasound. Fitness was directly measured by peak oxygen uptake using expired gas analysis during maximal treadmill testing and was classified as low fit (  or =60%) categories based on age-specific peak oxygen uptake percentiles.   Results:  The prevalence of the MetS defined by NCEP criteria was 8.4% (n=684). Men with MetS had significantly higher mean CIMT than men without MetS (0.94±0.2 vs. 0.89±0.2mm, p   Conclusion:  These results demonstrate that high cardiorespiratory fitness is inversely associated with CIMT in men with and without MetS and increased CIMT in the metabolic syndrome is attenuated by high cardiorespiratory fitness.
The use of collagen-based scaffolds to simulate prostate cancer bone metastases with potential for evaluating delivery of nanoparticulate gene therapeutics
Authors: Kathleen A. Fitzgerald, Jianfeng Guo, Erica G. Tierney, Caroline M. Curtin, Meenakshi Malhotra, Raphael Darcy, Fergal J. O'Brien, Caitriona M. O'Driscoll
Journal: Biomaterials (2015)
Study is based on unproved assumptions
Authors: A. House, T. Sheldon, N. Freemantle
Journal: BMJ (1995)

populations, with variable doses and durations, which creates further difficulty in interpreting such data.We therefore conclude that it is not possible to state with certainty which of the seven most commonly prescribed non-steroidal antiinflammatory drugs is the safest; six of these seven have similar profiles of adverse events.
MR Imaging of Carotid Plaque Composition During Lipid-Lowering Therapy
Authors: Xue-Qiao Zhao, Li Dong, Tom Hatsukami, Binh An Phan, Baocheng Chu, Andrew Moore, Trevor Lane, Moni B. Neradilek, Nayak Polissar, Duane Monick, Colin Lee, Hunter Underhill, Chun Yuan
Journal: JACC. Cardiovascular imaging (2011)
探讨以“单位”为形式的全科医学服务
Authors: 吴海云
Journal: BMJ (2011)

欧美国家的大量研究表明，全科医学服务可改善医疗服务质量，提高服务效率，降低医疗费用。但如何搭建全科医学服务的平台，却是一个值得深入考虑、不断探索的问题。近10年来，我国致力于发展城镇“社区卫生服务”，但其发展却一直不如人意，居民接受其服务的比例远未达到政策设计水平。很多人将这种现象归咎于社区卫生服务水平、服务态度及环境设施等因素，但我认为，其中的关键因素，是我国城镇居民对“社区”的认同感低。
Abstract 4405: Sequence Variant for Atrial Fibrillation on Chromosome 4q25 near the PITX2 Gene Increases Risk for Recurrent AF
Authors: Jeffrey Gulcher, Hilma Holm, Daniel Gudbjartsson, David Arnar, Anna Helgadottir, Solveig Gretarsdottir, Unnur Thorsteinsdottir, Kari Stefansson
Journal: Circulation (2008)

Introduction. We have previously reported a strong association between two sequence variants on chromosome 4q25 and atrial fibrillation (AF) as the result of a genome-wide association study in Icelandic patients. This association has been replicated in three populations of European descent. About 35% of individuals of European descent have at least one of the variants and the risk of AF increases by 1.72 and 1.39 per copy for the two variants, rs 2200733 and rs10033464, respectively. The purpose of our current analysis was to examine the phenotypes of Icelandic AF patients in relation to the stronger sequence variant, rs2200733. Methods. The patients had received the diagnosis of AF at Landspitali University Hospital in Iceland. A genome-wide association scan with 316,000 SNPs on a Illumina BeadChip was performed and medical records were utilized for phenotypic data collection. Results. Our data set contained 719 cases with confirmed AF and detailed phenotypic/genotypic data, 435 men and 284 women. Thirty four were homozygous for the stronger genetic variant and 190 heterozygous. The mean age at diagnosis was 69.9 years in the non-carrier group and decreased by 1.9 years for each risk allele (p=0.018). There was a significantly stronger association with lone AF than with AF associated with hypertension or structural heart disease (p=0.042, OR 1.35). There was also a significantly stronger association with recurrent AF as opposed to single episode only (p=0.045, OR 1.47). There was no differential association with stroke but the incidence of stroke diagnosed at time of first presentation with atrial fibrillation was equal in the three groups of homozygous, heterozygous and non-carriers (5.9%, 5.3% and 5.3% respectively) despite younger age of the homozygous individuals. Conclusions. Previous analysis demonstrates that the sequence variant rs2200733 is a strong risk factor for AF. This analysis shows that carriers are diagnosed at a younger age and are less likely to have other common AF risk factors such as hypertension and structural heart disease, although the variant increases the risk of AF in all sub-phenotypes. Furthermore, carriers appear more prone to develop recurrent AF.
United States reviews smallpox vaccination policy.
Authors: Fred Charatan
Journal: BMJ (2002)

US public health doctors and preventive medicine specialists met in Atlanta, Georgia, last week to consider whether to continue the policy of prohibiting vaccinations against smallpox unless a smallpox bioterrorist attack takes place or whether to allow smallpox vaccination for anyone who wants it.

Dr D A Henderson, who led the worldwide smallpox eradication programme in the 1970s, and is now an adviser to Tommy Thompson, US secretary of health and human services, cited many problems if the smallpox vaccine were to be offered to all Americans. People with compromised immune systems, such as people with AIDS, and those with a history of eczema or atopic dermatitis are at risk from vaccination. A recipient of smallpox vaccine can infect another person by transfer of the virus by hand or through bathing. Other complications include post-vaccination encephalitis.

But Dr William Bicknell, professor of international health, sociomedical sciences, and community medicine at Boston University's School of Public Health, emphasised that relying on containment, tracing contacts, and isolation as the primary strategy to manage a malicious release of smallpox virus was very risky. He urged the CDC to seriously reassess its current policy.
Abstract 11447: Transcatheter Aortic Vavle Replacement: Outcome of Patients with Moderate or Severe Mitral Regurgitation
Authors: Stefan Toggweiler, Robert H Boone, Karin Humphries, May Lee, Jasmine Grewal, Rodrigo Bagur, Alexander B Willson, Ronald K Binder, Gurvitch Ronen, Robert Moss, Christopher R Thompson, David A Wood, Josep Rodes-Cabau, John G Webb
Journal: Circulation (2011)

Background Mitral regurgitation (MR) is present in most patients with severe aortic stenosis. Concomitant mitral valve repair or replacement is usually performed in patients with moderate or severe...
Urinary Tryptophan Metabolites in Rheumatoid Arthritis and Some Other Diseases
Authors: I. M. Bett
Journal: Annals of the Rheumatic Diseases (1966)

Previous studies from this laboratory have shown that a majority of patients with rheumatoid arthritis excrete abnormally high amounts of 3-hydroxy- anthranilic acid and kynurenine (Bett, 1962a, b).A more striking finding was the rise in kynurenine output after tryptophan loading in rheumatoid arthritis.Administration of large doses of pyri- doxine over a short period caused a temporary fall in kynurenine output which increased again when the test was repeated after pyridoxine had been with- drawn for a week.Urinary tryptophan metabolites have been studied in a variety of diseases including rheumatoid arthritis and it is known that abnormalities in the metabolism of this amino acid are not specific to this particular disease.Flinn, Price, Yess, and Brown (1964) refer to studies in which increased amounts of several metabolites were found in the urine of patients with bladder cancer, scleroderma, acrosclerosis, por- phyria and lupus erythematosus, and in pregnant women.No abnormalities were found in patients with psoriasis, atopic dermatitis, hyperthyroidism, muscular dystrophy, Friedrich's ataxia, or diabetes mellitus.These authors also measured kynurenic acid, xanthurenic acid, indoxyl sulphate, anthranilic acid glucuronide, o-aminohippuric acid, N-a-acetyl kynurenine, kynurenine, 3-hydroxykynurenine, and pyridone in the urines of fifteen female and five male patients with rheumatoid arthritis.After trypto- phan loading they found significantly raised levels of one or more of the metabolites measured in twelve of the fifteen female patients and in four of the five male patients.Kynurenine and 3-hydroxykynurenine were most frequently elevated.Pyridoxine restored metabolism to normal in eleven female patients studied, although it had been shown pre- viously that excretion of 4-pyridoxic acid was normal in these patients.Spiera (1963) and Spiera and Plotz (1964) found that a significant number of
BMA council agrees structure for devolution Doctors welcome public health green paper NHS needs occupational health service NHS complaints must be speeded up BMA annual report
Authors: Linda Beecham
Journal: BMJ (1998)

# BMA council agrees structure for devolution {#article-title-2}

The BMA council has agreed a structure for the association to operate when devolution comes into force next year.

A working party, which was set up some months ago to consider the impact of devolution on its democratic structure, has proposed amendments to the powers of the Scottish council to consider and deal with all matters specially concerning Scotland, subject to decisions made by the annual representative meeting (ARM) and the adjourned annual general meeting. The proposals will have to be ratified by the ARM in Cardiff in July.

The Welsh and Northern Ireland councils have been asked to submit proposals to change their constitutions along similar lines in time for the 1999 ARM.

# Doctors welcome public health green paper {#article-title-3}

The BMA has welcomed the government's public health green paper for England, Our Healthier Nation , in particular the health secretary's statement, “Now we want to see far more attention and government action concentrated on the things which damage people's health which are beyond the control of the individual.” …