tbuckley/cabot-search huggingface dataset:
Abstract 13461: Risks for Heart Failure Readmission within 90 days - A Meta-Analysis of 1,640,014 Subjects
Authors: Makoto Saito, Kazuaki Negishi, Thomas H Marwick
Journal: Circulation (2014)

Background: Heart failure (HF) readmissions are a common and serious problem of heterogeneous etiology. A better understanding of the risks for readmission may permit more effective targeting of disease management strategies. We performed a meta-analysis of risk factors for the prediction of HF readmission to identify the highest risk pts. Methods: Electronic databases were systematically searched for studies reporting risk factors for HF readmission within 90 days of discharge using the following key MeSH terms heart failure, congestive, “risk, and patient  The primary outcome was a composite of all-cause death or readmission. Relative risk (RR) of each risk variable was extracted. RR and 95% confidence intervals (CIs) were computed for each risk variable using a random-effects model weighted by inverse variance. Results: Forty studies (1,640,014 pts) were included and 23 factors were reported more than twice. The significant associations of 90-day readmission were chronic obstructive pu...
Functional and psychological correlates to exercise dyspnea in patients with abnormal ventilatory impedance due to COPD or interstitial lung disease or obesity
Authors: Olivier Sanchez, Aurore Caumont-Prim, Brigitte Chevalier-Bidaud, Bruno Mahut, Christophe Delclaux
Journal: European Respiratory Journal (2011)

The ATS consensus stated that spirometry and lung volume measurements may be useful in the assessment of dyspnea, together with the evaluation of psychologic status. Our objectives were to assess these statements in non overlapping groups of patients with an abnormal impedance (obesity, COPD and interstitial lung disease [ILD]), and to provide cut-off values for defects that explain moderate/severe dyspnea.

Patients with severe obesity (BMI≥35) or COPD (GOLD definition) or ILD underwent spirometry, lung volume and psychologic status (Hospital Anxiety-Depression [HAD], Fatigue Impact Scale [FIS], SGRQ and SF-36 scores) assessments. Patients with mild dyspnea (MRC score 1-2) were compared with those with moderate/severe dyspnea (MRC score ≥ 3).

Three hundred and twenty-height patients were prospectively enrolled, of whom 107 (33%) exhibited moderate/severe dyspnea (45/128 COPD, 28/78 ILD, 34/122 obeses). Severe dyspnea was related to airflow limitation and lung hyperinflation in COPD, to the restrictive defect in ILD and to the only increase in resistance in obese patients. Principal component analysis demonstrated that anxiety and depression fatigue exhibited no effect on dyspnea because they were related to the mental component of SF-36, while dyspnea was related to its physical component only. In non obese patients, a FEV1 < 31% predicted exhibited a 92% positive predictive value for severe dyspnea (99% specificity).

In conclusion, only very severe impairment of FEV1 can predict moderate to severe dyspnea in patients with either COPD or ILD. Exertional dyspnea is not affected by psychologic status in these patients.
Documentation of normal stratum corneum scaling in an average population: features of differences among age, ethnicity and body site
Authors: M. Chu, N. Kollias
Journal: British Journal of Dermatology (2010)

Scaling skin involves an imbalance between cell proliferation and desquamation, resulting in partially detached corneocytes at the stratum corneum (SC) surface that become visible as they scatter light.The purpose of this study was to document scaling skin with no associated pathology, to estimate the range of normal corneocyte detachment in the average population, and to determine if age, pigmentation and/or body sites of different exposures contribute to differences observed in the SC.Healthy African-American and Caucasian female subjects (n = 151) from a typical central New Jersey population, aged between 14 and 75 years, were evaluated on the dorsal forearm and upper inner arm. Dermatoscopy and adhesive tape were used to evaluate the appearance and adhesion of surface corneocytes. Transepidermal water loss and conductivity were measured to assess water-handling properties of the SC. Measurements were conducted during the winter.Corneocyte detachment observed with dermatoscopy became more prevalent with age and was more severe on the dorsal forearm and in Caucasian subjects. The distribution of the amount of corneocyte removal with adhesive tape increased with age. The range of values was larger in the dorsal forearm than the upper inner arm and was greater in Caucasian subjects than African-American subjects. Minimal changes were observed for water-handling properties.The architecture of the outer SC appears different between ages, body sites of different exposures, and individuals of different pigmentation groups, but minimal differences in water-handling properties are observed.
Brief Report: Nonsteroidal Antiinflammatory Drug–Sparing Effect of Tumor Necrosis Factor Inhibitors in Early Axial Spondyloarthritis: Results From the DESIR Cohort
Authors: Anna Moltó, Benjamin Granger, Daniel Wendling, Maxime Breban, Maxime Dougados, Laure Gossec, Alain Saraux
Journal: Arthritis & Rheumatology (2015)

Objective To evaluate the effect of tumor necrosis factor (TNF) inhibitors on nonsteroidal antiinflammatory drug (NSAID) intake in a cohort of patients with early axial spondyloarthritis (SpA) over the first 2 years of followup. Methods The Devenir des Spondylarthropathies Indifférenciées Récentes (DESIR) cohort is a prospective, multicenter, observational study cohort of patients with early inflammatory back pain. The management and treatment of these patients were decided by their treating rheumatologists. Data regarding NSAID intake (yes/no) and the Assessment of SpondyloArthritis international Society NSAID score were collected at each visit over 2 years of followup. Patients receiving a TNF inhibitor were matched with those receiving usual care, based on a propensity score. The NSAID‐sparing effect of TNF inhibitors was estimated by comparing the percentage of patients reaching several end points (e.g., a decrease in the NSAID score to &lt;10 over 2 years) and by modeling NSAID intake using mixed models. Results Among the 627 patients who were followed up, 181 (28.9%) received a TNF inhibitor, and these patients were matched to 181 patients who received usual care. The baseline characteristics of the patients in the 2 groups were comparable (∼40% of the patients were male, and the mean age was 34 years). Initially, 90.2% of patients receiving TNF inhibitors and 90.0% of those receiving usual care had been treated with NSAIDs during the previous 6 months. The number of patients who received an NSAID decreased over time in both groups, but the decrease was greater in the group receiving TNF inhibitors ( P = 0.04). The decrease in the median NSAID score was significantly greater in the TNF inhibitor group (54.9 versus 41.9), and the percentage of patients in whom the NSAID score decreased by &gt;50% or to &lt;10 or in whom NSAID treatment was discontinued was greater in the TNF inhibitor group (67.6% versus 46.2%). Conclusion Treatment with TNF inhibitors was associated with a decrease in the proportion of patients taking NSAIDs and with a rapid and sustained decrease in NSAID intake. This study is the first to confirm the NSAID‐sparing effect of TNF inhibitors in patients with early axial SpA in a real‐life clinical setting.
Glutathione <i>S</i>-Transferase Polymorphisms and Outcome of Chemotherapy in Childhood Acute Myeloid Leukemia
Authors: Stella M. Davies, Leslie L. Robison, Jonathan D. Buckley, Tom Tjoa, William G. Woods, Gretchen A. Radloff, Julie A. Ross, John P. Perentesis
Journal: Journal of Clinical Oncology (2001)

PURPOSE: Glutathione S-transferase theta (GSTT1) and mu (GSTM1) genes are polymorphic, the genes being absent in approximately 15% and 50% of the population, respectively. Because glutathione S-transferases may be involved in the metabolism of chemotherapy drugs, we hypothesized that presence or absence of the genes may influence the outcome of treatment for childhood acute myeloid leukemia (AML). PATIENTS AND METHODS: We genotyped GSTT1 and GSTM1 in 306 children with AML receiving chemotherapy on Children’s Cancer Group therapeutic studies. Outcomes were compared in those with and without GSTT1 and GSTM1 genes. RESULTS: Patients with the GSTT1-negative genotype had reduced survival compared with those with at least one GSTT1 allele (GSTT1 positive) (52% v 40% at 5 years; log-rank P = .05). A multivariate model of survival adjusted for age group, sex, WBC count, chloroma, CNS involvement, and French-American-British group confirmed the increased risk of death in the GSTT1-null cases (relative risk,AQ 1.6; P = .02). The frequency of death in remission was increased in GSTT1-negative cases compared with GSTT1-positive cases (24% v 12%, log-rank P = .05). The frequency of relapse from end of induction was similar in GSTT1-negative and GSTT1-positive cases (38% v 35%, log-rank P = .5). CONCLUSION: Children who lacked GSTT1 had greater toxicity and reduced survival after chemotherapy for AML compared with children with at least one GSTT1 allele. If confirmed in further studies, GSTT1 genotype might be useful in selecting appropriate chemotherapy regimens for children with AML.
PROTAMINE INSULIN AS A CONTRIBUTING FACTOR IN THE DEATH OF A DIABETIC PATIENT WITH CEREBRAL ARTERIOSCLEROSIS
Authors: Janvier W. Lindsay, E. Clarence Rice, Maurice A. Selinger, K. Hammond Mish
Journal: Annals of Internal Medicine (1937)

Case Reports1 June 1937PROTAMINE INSULIN AS A CONTRIBUTING FACTOR IN THE DEATH OF A DIABETIC PATIENT WITH CEREBRAL ARTERIOSCLEROSISJANVIER W. LINDSAY, M.D., F.A.C.P., E. CLARENCE RICE, M.D., F.A.C.P., MAURICE A. SELINGER, M.D., K. HAMMOND MISH, M.D.JANVIER W. LINDSAY, M.D., F.A.C.P.Search for more papers by this author, E. CLARENCE RICE, M.D., F.A.C.P.Search for more papers by this author, MAURICE A. SELINGER, M.D.Search for more papers by this author, K. HAMMOND MISH, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-10-12-1892 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptProtamine insulin was first used in the United States during 1935 by Root,1 Joslin2 and their associates and since then its use has been extended to diabetic patients in other parts of the country under the direction of physicians with considerable experience in the treatment of diabetes mellitus. The number under treatment at present in the United States is probably about 3,000 persons.By means of its use it has been possible to convert the severe diabetes of a number of patients not easily controlled by the simpler or regular insulin to a relatively mild form due to the prolonged...References1. ROOTWHITEMARBLESTOTZ HFPAEH: Clinical experience with protamine insulinate, Jr. Am. Med. Assoc., 1936, cvi, 180. CrossrefGoogle Scholar2. JOSLINROOTMARBLEWHITEJOSLINLYNCH EPHFAPAPGW: Protamine insulin, New Eng. Jr. Med., 1936, ccxiv, 1079. CrossrefGoogle Scholar3. BOWENBECK BDG: Insulin hypoglycemia, ANN. INT. MED., 1933, vi, 1412. LinkGoogle Scholar4. TERPLAN K: Changes in the brain in a case of fatal insulin shock, Arch. Path., 1932, xiv, 131. Google Scholar5. WHITE P: Diabetes in childhood and adolescence, 1932, Lea & Febiger, Philadelphia. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Washington, D. C.*Received for publication January 16, 1937.From the Garfield Memorial Hospital, Washington, D. C. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byIntoxikationenHypoglycæmia in DiabeticsKrankheiten des KohlenhydratstoffwechselsDer Diabetes mellitusProbleme der experimentellen und klinischen Pathologie und Therapie der Zuckerkrankheit 1 June 1937Volume 10, Issue 12Page: 1892-1900KeywordsDiabetes mellitusInsulinInsulin-like growth factorsProtamines ePublished: 1 December 2008 Issue Published: 1 June 1937 PDF downloadLoading ...
Patterns of Antibodies to Epstein-Barr Virus-Induced Early Antigens in Burkitt's Lymphoma. Comparison of Dying Patients With Long-Term Survivors 2
Authors: Werner Henle, Gertrude Henle, Peter Gunvén, George Klein, Peter Clifford, Surjit Singh
Journal: JNCI Journal of the National Cancer Institute (1973)

Journal Article Patterns of Antibodies to Epstein-Barr Virus-Induced Early Antigens in Burkitt's Lymphoma. Comparison of Dying Patients With Long-Term Survivors Get access Werner Henle, Werner Henle The Virus Laboratories at the Children's Hospital of Philadelphia and the School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; the Department of Tumor Biology, Karolinska Institute Medical School, Stockholm, Sweden; and the Kenyatta National Hospital, Nairobi, Kenya Search for other works by this author on: Oxford Academic PubMed Google Scholar Gertrude Henle, Gertrude Henle The Virus Laboratories at the Children's Hospital of Philadelphia and the School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; the Department of Tumor Biology, Karolinska Institute Medical School, Stockholm, Sweden; and the Kenyatta National Hospital, Nairobi, Kenya Search for other works by this author on: Oxford Academic PubMed Google Scholar Peter Gunvén, Peter Gunvén The Virus Laboratories at the Children's Hospital of Philadelphia and the School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; the Department of Tumor Biology, Karolinska Institute Medical School, Stockholm, Sweden; and the Kenyatta National Hospital, Nairobi, Kenya Search for other works by this author on: Oxford Academic PubMed Google Scholar George Klein, George Klein The Virus Laboratories at the Children's Hospital of Philadelphia and the School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; the Department of Tumor Biology, Karolinska Institute Medical School, Stockholm, Sweden; and the Kenyatta National Hospital, Nairobi, Kenya Search for other works by this author on: Oxford Academic PubMed Google Scholar Peter Clifford, Peter Clifford The Virus Laboratories at the Children's Hospital of Philadelphia and the School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; the Department of Tumor Biology, Karolinska Institute Medical School, Stockholm, Sweden; and the Kenyatta National Hospital, Nairobi, Kenya Search for other works by this author on: Oxford Academic PubMed Google Scholar Surjit Singh Surjit Singh The Virus Laboratories at the Children's Hospital of Philadelphia and the School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; the Department of Tumor Biology, Karolinska Institute Medical School, Stockholm, Sweden; and the Kenyatta National Hospital, Nairobi, Kenya Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 50, Issue 5, May 1973, Pages 1163–1173, https://doi.org/10.1093/jnci/50.5.1163 Published: 01 May 1973 Article history Received: 12 October 1972 Accepted: 12 January 1973 Published: 01 May 1973
A randomized comparison of once weekly epoetin alfa to extended schedule epoetin or darbepoetin in chemotherapy‐associated anemia
Authors: David P. Steensma, Shaker R. Dakhil, Paul J. Novotny, Jeff A. Sloan, David B. Johnson, Daniel M. Anderson, Bassam I. Mattar, Dennis F. Moore, Daniel Nikcevich, Charles L. Loprinzi
Journal: American Journal of Hematology (2015)

Erythropoiesis‐stimulating agents (ESAs) epoetin alfa (EA) and darbepoetin alfa (DA) increase hemoglobin (Hb) levels and reduce red blood cell (RBC) transfusion requirements in patients with cancer chemotherapy‐associated anemia (CAA). Extended‐interval ESA dosing (administration less than once weekly) is common with DA, but previous studies suggested that EA might also be administered less often than weekly. In this multicenter prospective trial, 239 CAA patients with Hb &lt;10.5 g/dL were randomized to receive EA 40,000 U subcutaneously once weekly (“40K” arm), EA 80,000 U every 3 weeks (“80K”), EA 120,000 U every 3 weeks (“120K” arm), or DA 500 mcg every 3 weeks (“DA”), for 15 weeks. The primary endpoint was the proportion of patients achieving Hb ≥ 11.5 g/dL or increment of Hb &gt; 2.0 g/dL from baseline without transfusion. Secondary endpoints included transfusion requirements, adverse events (AEs), and patient‐reported outcomes (PROs). There were no significant differences between treatment arms in the proportion of patients achieving Hb response (68.9% for 40K, 61.7% for 80K, 65.5% for 120K, and 66.7% for DA; P &gt; 0.41 for all comparisons) or requiring RBC transfusion, but the median Hb increment from baseline was higher in the 40K and DA arms compared to the two extended dosing EA arms, and Hb response was achieved soonest in the weekly EA arm. There were no differences in PROs or AEs. The FDA‐approved schedules tested—weekly EA 40,000 U, and every 3 week DA 500 mcg—are reasonable standards for CAA therapy. Am. J. Hematol. 90:877–881, 2015. © 2015 Wiley Periodicals, Inc.
Glycemic control paradox: Poor glycemic control associated with higher one-year and eight-year risks of all-cause hospitalization but lower one-year risk of hypoglycemia in patients with type 2 diabetes
Authors: Tsai-Chung Li, Sharon L.R. Kardia, Chia-Ing Li, Ching-Chu Chen, Chiu-Shong Liu, Sing-Yu Yang, Chin-Shin Muo, Patricia A. Peyser, Cheng-Chieh Lin
Journal: Metabolism (2015)
Issues of Imatinib and Pregnancy Outcome
Authors: Jane Apperley
Journal: Journal of the National Comprehensive Cancer Network (2009)

The introduction of tyrosine kinase inhibitors into clinical practice now offers most patients with chronic myelogenous leukemia lengthy remissions and the possibility of normal life expectancies. These improved survivals have resulted in the need to address issues relating to quality of life, including fertility and procreation. Treatment may require lifelong daily therapy with drugs that might inhibit proteins essential to gonadal function, implantation, and embryogenesis. Animal data suggest that imatinib at standard dosages is unlikely to impair fertility in either adult male or female animals. However, human data remain limited, particularly in children and adolescents. Children born to men who are actively taking imatinib at conception seem healthy, and current advice is not to discontinue treatment. In contrast, data are less encouraging for children born to women exposed to imatinib during pregnancy. Although numbers are small, a disturbing cluster of rare congenital malformations has prevented imatinib from being recommended safely, particularly during the period of organogenesis. Alternative strategies for managing pregnancy in chronic myelogenous leukemia include one or both of regular leukapheresis and interferon-α. Pregnancy in advanced-phase disease presents particular problems.
Fatigue and somatic symptoms
Authors: Russell Viner, Deborah Christie
Journal: BMJ (2005)

Fatigue, headache, stomach ache, and backache are common. Large international surveys show that about 8% of adolescents report daily headaches, 10% daily backache, and 16% daily sleepiness in the mornings. Fatigue is even more common—about a third of both boys and girls have substantial fatigue four or more times a week.



Frequency of headache in the previous six months in 11-17 year olds in Europe. Adapted from: World Health Organization. Health behaviour in school-aged children, 1997-1998 . Calverton, MD: Macro International, 2002



Most adolescents with these symptoms do not seek help from their doctor. They can present diagnostic dilemmas when they do, however. In most cases, the symptoms reflect not an organic disorder but an imbalance between the increasing educational, social, and sports demands on young people and physiological “debts” owed to rapid growth and sexual development. Adolescents, for example, need more sleep than children and adults, yet social and educational demands often mean that they sleep less. Adolescents may also have a physical hypersensitivity to changes in the growing body. For a minority, these symptoms may represent a functional or somatoform disorder, where psychological problems are expressed through physical symptoms rather than through language. Unexplained abdominal pain is a common example of this in early adolescents, with older adolescents more likely to have headaches or fatigue.

Signs or symptoms suggestive of more serious somatoform disorder include the co-occurrence of multiple symptoms (such as headaches with fatigue and muscle aches), chronicity (symptoms lasting more than three months), diminishing school attendance, and social isolation, together with a history of recent family, school, or psychological problems.



Prevalence of somatic symptoms (other than headache) in the previous six months in 11-17 year olds in Europe. Adapted from Health behaviour in school-aged children, 1997-1998 (see above)



When pain or symptoms remain unexplained, they should …
The Effects of Inhaled Fluticasone on Airway Inflammation in Chronic Obstructive Pulmonary Disease
Authors: Keith L. Hattotuwa, Mariusz J. Gizycki, Tareq W. Ansari, Peter K. Jeffery, Neil C. Barnes
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Inhaled corticosteroids (ICS) are effective in the treatment of asthma and markedly reduce the numbers of inflammatory cells in bronchial biopsies. However, the effect of ICS on the inflammatory profile of biopsies in smokers with chronic obstructive pulmonary disease (COPD) is unknown. We have performed a double-blind, placebo-controlled, randomized study to compare fluticasone propionate (FP) 500 μg twice daily via a dry powder inhaler and placebo (P) over a 3-month period in subjects with COPD. Fiberoptic bronchoscopy and bronchial biopsy was carried out at baseline and after the 3 months of treatment. Thirty-one subjects completed the trial and 30 paired biopsies were available for analysis. Compared with P (n = 14), subjects on inhaled FP (n = 16) had no significant reductions in the primary endpoints: CD8+, CD68+ cells, or neutrophils, considered to be of importance in COPD. However, there was a reduction in the CD8:CD4 ratio in the epithelium and of the numbers of subepithelial mast cells in the FP group. CD4+ cells were significantly raised in the P group in both subepithelium and epithelium. Symptoms significantly improved, and there were significantly fewer exacerbations in subjects on FP, compared to subjects on P. The data indicate that inhaled fluticasone does affect selected aspects of airway inflammation in COPD, and this may explain, in part, the decrease in exacerbations seen in long-term studies with fluticasone propionate.