tbuckley/cabot-search huggingface dataset:
Prognostic factors in aggressive malignant lymphomas: description and validation of a prognostic index that could identify patients requiring a more intensive therapy. The Groupe d'Etudes des Lymphomes Agressifs.
Authors: B Coiffier, C Gisselbrecht, J M Vose, H Tilly, R Herbrecht, A Bosly, J O Armitage
Journal: Journal of Clinical Oncology (1991)

The objectives of this study were to determine prognostic factors for response to treatment, freedom-from-relapse (FFR) survival, and overall survival of 737 aggressive malignant lymphoma patients treated with the doxorubicin, cyclophosphamide, vindesine, bleomycin, methylprednisolone, methotrexate with leucovorin, ifosfamide, etoposide, asparaginase, and cytarabine (LNH-84) regimen; to construct a prognostic index with factors isolated by multivariate analyses; and to validate this prognostic index with another set of patients. Complete response (CR) was reached in 75% of LNH-84 patients, and 30% of them relapsed. With a median follow-up of 36 months, median FFR survival and median overall survival were not reached. Low serum albumin level, high tumoral mass, weight loss, bone marrow involvement, greater than or equal to 2 extranodal sites, and increased lactic dehydrogenase (LDH) level were associated with a low response rate. Advanced stage, increased LDH level, and nonlarge-cell histologic subtypes (diffuse mixed, lymphoblastic, and small non-cleaved) were statistically associated with a high relapse rate and short FFR survival. Increased LDH level, low serum albumin level, tumoral mass larger than 10 cm, greater than or equal to 2 extranodal sites, advanced stage, and age older than 65 years were statistically associated with short overall survival. Four of these parameters, namely, LDH level, stage, number of extranodal sites, and tumoral mass, were put together to construct a prognostic index. This index partitioned LNH-84 patients into three subgroups of good, intermediate, and poor prognosis (P less than .00001): CR rates of 93%, 83%, and 61%; relapse rates of 12%, 25%, and 45%; 3-year FFR survival of 87%, 73%, and 53%, and 3-year survival of 88%, 71%, and 41%, respectively. This prognostic index was applied to a test set of patients: 155 patients treated on protocols of the Nebraska Lymphoma Study Group. Using this index, these patients had 3-year FFR survival of 70%, 40%, and 22% (P = .0002) and 3-year survival of 79%, 52%, and 31% (P = .005). In patients with aggressive lymphomas, this simple prognostic index could distinguish between patients requiring intensive treatment such as autologous bone marrow transplantation in first complete remission and those who could be treated with standard regimens.
Abstract 17434: Shelterin Complex Influenced by Pim-1 Preserves Telomeres in Cardiac Progenitor Cells
Authors: Christopher T Cottage, Balaji Sandararaman, Lauren E Neidig, Mark A Sussman
Journal: Circulation (2010)

Telomere shortening has been implicated in the pathogenesis of heart disease associated with myocardial aging. Telomeres are the distal ends of chromosomes that consist of nucleotide repeats that f...
Clinical impact of the relationship between low bone mineral density and peripheral muscle strength in patients with COPD
Authors: Glenn Leemans, Kris M.H. Ides, Lieve De Backer, Hilde Vaerenberg, Kevin De Soomer, Dirk Vissers, Wilfried De Backer
Journal: European Respiratory Journal (2012)

Introduction   COPD is a respiratory disease with systemic consequences such as osteoporosis. It is known that this impaired bone mineral density (BMD) correlates with physical inactivity. If physical inactivity does depend on muscle strength, a correlation between muscle strength and osteoporosis must exist.   Objective   To evaluate how strong peripheral muscle strength is related to the loss of BMD in our COPD population.   Methods   Data of 11 patients in a pulmonary rehabilitation program is analysed. BMD at the lumbar spine and hip is determined by dual-energy X-ray absorption (DXA). DXA is performed based upon the patient9s risk profile (long history of corticosteriods). The BMD is expressed as a T score. Isometric quadriceps force (IQF) is assessed by a computerized dynamometer during a voluntary maximal isometric contraction with the hip at 90° and the knee at 60° flexion. The highest value is taken.   Results   A significant correlation is found between T score lumbar spine and IQF in % predicted of the normal value (R=0.627; p=0.039). IQF is not related to the T score of the hip (p=0.385).   Conclusions   Lower BMD in the lumbar spine seems to relate with lower IQF in our COPD population. Strengthening of those quadriceps muscles in this specific COPD patients must therefore best be done in an upright, weight-bearing position during closed chain exercises to stabilise or increase the BMD of the lumbar spine.
Wood smoke COPD: a new description of a COPD phenotype?
Authors: Mauricio González-García, Carlos Torres-Duque
Journal: European Respiratory Journal (2014)

To the Editor: 

We read with interest the article by Camp et al. [1] published in the European Respiratory Journal . In this study, based on both qualitative and quantitative computed tomography (CT) scan measures, the authors established that women exposed to biomass smoke had less emphysema than women exposed to tobacco smoke with similar obstruction observed by spirometry [1]. In addition, they described the presence of bronchiectasis in 14% of the biomass-exposed women compared to 0% of the tobacco-exposed women, without differences between the groups in the quantitative measures of air trapping or airway thickness on the inspiratory scans [1]. Finally, the authors concluded that this is the first study showing differences in chronic obstructive pulmonary disease (COPD) phenotypes in living women with biomass- versus tobacco-smoke exposure [1 …
Abstract 13466: Mutations in Cytoplasmic Loops are Associated with Increased Risk for Cardiac Events in Type-1 Long QT Syndrome
Authors: Alon Barsheshet, Ilan Goldenberg, Jin O-Uchi, Arthur J Moss, Christian Jons, Scott McNitt, Wojciech Zareba, Jennifer L Robinson, Coeli M Lopes
Journal: Circulation (2010)

Background: Exercise and consequent β-adrenergic stimulation are the main triggers for cardiac events in type-1 Long QT syndrome (LQT1). Accordingly, β-blockers is the treatment of choice in LQT1, ...
Inhibition of Natural Killer Cell Cytotoxicity by Interleukin‐6: Implications for the Pathogenesis of Macrophage Activation Syndrome
Authors: Loredana Cifaldi, Giusi Prencipe, Ivan Caiello, Claudia Bracaglia, Franco Locatelli, Fabrizio De Benedetti, Raffaele Strippoli
Journal: Arthritis & Rheumatology (2015)

Systemic juvenile idiopathic arthritis (JIA) is associated with high levels of interleukin-6 (IL-6) in the serum and synovial fluid, and impairment of natural killer (NK) cell function is often observed. This study was undertaken to evaluate a possible link between these 2 biologic findings and whether they may be associated with the development of macrophage activation syndrome, a condition frequently observed in systemic JIA.Splenocytes from wild-type (WT) or IL-6-transgenic (Tg) mice were evaluated for NK cell cytotoxicity using a (51) Cr-release assay. Numbers of NK cells and expression of perforin, granzyme B, CD69, and CD107a were evaluated by flow cytometry. Human peripheral blood mononuclear cells (PBMCs) isolated from healthy donors were treated with IL-6 and cultured in the presence or absence of tocilizumab (TCZ), an IL-6 receptor blocker. Human polyclonal NK cells from healthy donor PBMCs were evaluated for cell cytotoxicity and expression of perforin, granzyme B, and CD107a. PBMCs harvested from patients with systemic JIA during periods of active or inactive disease were left untreated or treated with IL-6 in combination with soluble IL-6 receptor and analyzed for the expression of perforin and granzyme B.Splenic NK cell cytotoxicity was reduced in IL-6-Tg mice compared to WT mice. Levels of CD69 and CD107a showed no significant differences, whereas expression of perforin and granzyme B was impaired in NK cells from IL-6-Tg mice. Exposure of human peripheral blood NK cells to IL-6 led to reduced expression of perforin and granzyme B. Culturing human polyclonal NK cells in the presence of TCZ significantly increased cell cytotoxicity, and also increased expression of perforin and granzyme B. In patients with systemic JIA, a reduction in IL-6 plasma levels during disease remission correlated with the rescue of perforin and granzyme B expression in NK cells from these patients.In both mice and humans, IL-6 down-modulated the cytotoxic activity of NK cells. This decrease was associated with reduced perforin and granzyme B levels in the absence of altered granule exocytosis.
Differences Between Early and Late Readmissions Among Patients
Authors: Kelly L. Graham, Edward R. Marcantonio
Journal: Annals of Internal Medicine (2015)

Letters20 October 2015Differences Between Early and Late Readmissions Among PatientsKelly L. Graham, MD, MPH and Edward R. Marcantonio, MD, SMKelly L. Graham, MD, MPHFrom Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts. and Edward R. Marcantonio, MD, SMFrom Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5149-2 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We apologize if our text was unclear. When we stated that the cut point of 5 days used in our sensitivity analysis was "not substantially different," we meant relative to the 7-day results, not that the results were no longer significant. In fact, we performed this sensitivity analysis specifically to determine whether our findings were robust enough to justify the specific cut point used. The results show that whether 5 or 7 (or, we suspect, 6 or 8) days is used as the cutoff, the message is still the same: Early readmissions differ from late readmissions.There is ... Author, Article, and Disclosure InformationAffiliations: From Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-2159. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDifferences Between Early and Late Readmissions Among Patients Kelly L. Graham , Elissa H. Wilker , Michael D. Howell , Roger B. Davis , and Edward R. Marcantonio Differences Between Early and Late Readmissions Among Patients Ronald L. Hirsch Differences Between Early and Late Readmissions Among Patients Ronald L. Hirsch Metrics Cited byPrivate choices, public costs: Evaluating cost-shifting between private and public health sectors in New ZealandReadmission to hospital of medical patients – A cohort study 20 October 2015Volume 163, Issue 8Page: 650KeywordsDisclosure ePublished: 20 October 2015 Issue Published: 20 October 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Microparticle-associated tissue factor activity is increased in late stage lung cancer
Authors: Federica Martino, Marcella Zurlo, Tommaso Neri, Stella Cini, Antonio Chella, Antonio Palla, Elena Mariancini, Alessandro Celi, Laura Maria Tavanti
Journal: European Respiratory Journal (2011)

Background:  Microparticles (MP) are small (.05-1 μm) vesicles shed by cells upon activation or during apoptosis. MP are rapidly gaining importance as a new family of physiologically relevant mediators. Tissue factor (TF) is the transmembrane receptor for factor VII(a) essential in the activation of blood coagulation; TF is also involved in several pathways relevant to tumor growth and metastasis including angiogenesis, and it has been postulated that it contributes to cancer progression. Recent evidences indicate that TF circulates associated with MP. Preliminary data indicate that MP-associated TF is increased in lung cancer (LC) patients.   Aim:  To investigate whether MP-associated TF correlates with disease stage in LC patients.   Methods:  Plasma MP-TF activity was measured in 33 patients with LC of different stages. Blood was collected at the time of inclusion; MP were collected by ultracentrifugation; TF activity was measured with a one stage clotting assay. Informed consent was obtained from all patients.   Results:  The blood of patients with stage IV LC had a higher MP-associated TF activity compared to stage III (45.56 [14.88-143.70] vs. 9.45 [3.47-16.23] arbitrary U/mL) (median [interquartile range]); p   Conclusions:  MP-associated TF activity increases in late stage LC. This observation is consistent with the hypothesis that MP-associated TF is involved in LC progression.
Prospective Validation of Renal Function–Based Carboplatin Dosing in Children With Cancer: A United Kingdom Children’s Cancer Study Group Trial
Authors: Huw Thomas, Alan V. Boddy, Martin W. English, Rachel Hobson, John Imeson, Ian Lewis, Bruce Morland, Andrew D. J. Pearson, Ross Pinkerton, Lisa Price, Michael Stevens, David R. Newell
Journal: Journal of Clinical Oncology (2000)

PURPOSE: Carboplatin dosing in adults with cancer is based on renal function. The purpose of the current study was to validate a previously developed pediatric carboplatin-dosing formula. PATIENTS AND METHODS: Thirty-eight pediatric patients were randomized to receive a carboplatin dose calculated according to surface area or a renal function–based dosing formula. On the next course of therapy, the alternative dosing method was used for each patient. Carboplatin pharmacokinetics (based on free plasma platinum concentrations) were measured after both courses. RESULTS: The mean observed areas under the carboplatin concentration–versus-time curve (AUCs) after renal function– and surface area–based dosing were 98% and 95% of the target AUCs, respectively. The variation in the observed AUC was significantly less after renal function–based dosing (F test, P = .02), such that 74% of courses had an observed AUC within ± 20% of the target value, versus 49% for courses after dosing according to surface area. Only one of 22 courses at the center with the most experience with renal function–based dosing was associated with an AUC outside ± 20% of the target value, versus nine of 22 courses after surface area–based dosing in the same center. There was a relationship (r 2 = .71) between carboplatin AUC and thrombocytopenia in 10 neuroblastoma patients treated with a combination of carboplatin, vincristine, etoposide, and cyclophosphamide. CONCLUSION: Renal function–based carboplatin dosing in children results in more consistent drug exposure than surface area–based drug administration.
Abstract P80: Short-term Outcomes of Vasopressin Administerd with Epinephrine versus Epinephrine Alone in ED for Out-of-hospital Cardiac Arrest
Authors: Tae Yun Kim, Sun Woo Lee, Kyuseok Kim, Joong Eui Rhee, Sung Koo Jung
Journal: Circulation (2008)

Introduction: Out-of-hospital cardiac arrest (OOHCA) victims are increasing, but emergency medical service system (EMSS) is not ready for them in Korea. A previous randomized, controlled clinical trial has suggested that vasopressin followed epinephrine was superior to epinephrine in patients with asystole. According to the Korean national registry of OOHCA, patients with asystole were more than two thirds of them. In Korean EMSS, no drugs are permitted to administer in the prehospital phase by law. Thereafter epinephrine or vasopressin cannot be administered until patients are transported to emergency departments (EDs). This study was to evaluate whether the combined administration of vasopressin and epinephrine in ED for OOHCA patients would increase the return of spontaneous circulation (ROSC) and survival discharge. Methods: From October 2007 to May 2008, we changed the CPR protocol in adult, nontraumatic OOHCA that 40 U of vasopressin was administered as soon as possible after the first dose of epinephrine (the after group). Cardiac arrest data were collected using the Utstein template. Data from January to September 2007, when vasopressin has not been used, were also collected for comparative analysis (the before group). These two groups were compared in terms of ROSC, and survival discharge Results: There were 45 and 50 patients in the before and after groups, respectively. There was no significant differences in the initial ECG rhythm of asystole (67% vs 78%), witnessed arrest (73% vs 72%), bystander CPR (16% vs 10%), time from collapse to BLS time (6 min vs 8.5 min), and time from collapse to study drugs (23 min vs 26.5 min). The rate of sustained ROSC was similar between the before and after groups (53% vs 48%, P=0.604) as was the survival discharge (27% vs 14%, P=0.123). Conclusions: Vasopressin with administerd with epinephrine does not increase the rate of ROSC nor the survival discharge.
Interactions of neutrophils with epithelial cells
Authors: C A Parkos, S P Colgan, J L Madara
Journal: Journal of the American Society of Nephrology (1994)

Active inflammatory processes in organs lined by columnar epithelial cells are often characterized by abundant neutrophil migration. To reach an epithelial surface, neutrophils must leave the vasculature and cross the interstitium where signals may be generated that influence migration and/or epithelial function. Subsequently neutrophils migrate across epithelial linings by impaling intercellular junctions between epithelial cells and, in doing so, diminish the ability of epithelial linings to serve as a barrier. Decreased barrier function brought about by neutrophil migration across epithelia appears to be a reversible process after the removal of the chemotactic stimulus. The molecular events underlying neutrophil-epithelial interactions are at present poorly understood. With recent information regarding neutrophil-endothelial interactions, it has been possible to better understand issues of neutrophil interactions with epithelial cells. In general, there appear to be different rules governing the interaction of neutrophils with endothelial cells as compared with epithelial cells. Neutrophil migration across endothelial monolayers involves a series of at least three steps, each regulated by glycoproteins expressed on the cellular surface. In considering neutrophil-epithelial interactions, the single common denominator is the requirement for surface expression of neutrophil beta 2 integrins, and specifically CD11b/18, as shown by functional inhibition through the use of antibodies to neutrophil beta 2 integrins and the use of neutrophils from patients lacking the beta-chain of this integrin. An understanding of the regulation of neutrophil-epithelial interactions, although in its infancy, appears to involve inflammatory cytokines. Recent in vivo evidence suggests that interferon-gamma production at the level of the intestine may correlate with the regulation of neutrophil-epithelial interactions in vitro by interferon-gamma. Finally, considerable evidence exists that neutrophils may contribute significantly to fluid transport during inflammatory diseases such as secretory diarrhea. When placed in contact with epithelial monolayers, activated neutrophils bring about the transport of ions, with concomitant water loss across epithelial surfaces. This transport process brought about by the presence of neutrophils is generated by a metabolite produced and secreted from neutrophils. This metabolite was originally termed neutrophil-derived secretagogue and has recently been identified as 5'-AMP. The mechanism of 5'-AMP action on epithelial cell ion transport is discussed.
Abstract 18506: Relief of Myocardial Edema in Advanced Decompensated Heart Failure is Associated with Improved Left Ventricular Systolic and Diastolic Function
Authors: Frederik H Verbrugge, Endry Willems, Philippe B Bertrand, Ellen Gielen, Wilfried Mullens, Shivraman Giri, Subha V Raman, David Verhaert
Journal: Circulation (2014)

Introduction: Cardiac magnetic resonance (CMR) imaging with quantitative T2-mapping allows identi[[Unable to Display Character: &amp;#64257;]]cation of myocardial edema, improving risk-stratification in acute coronary syndromes and myocarditis. Hypothesis: Global myocardial edema contributes to left ventricular (LV) dysfunction in advanced decompensated heart failure (ADHF). Methods: CMR with quantitative T2-mapping was performed in consecutive ADHF patients (n=17) undergoing right heart catheterization for worsening dyspnea and volume overload. Patients received vasodilators and diuretics to achieve pulmonary capillary wedge pressure (PCWP) ≤18 mmHg and central venous pressure (CVP) ≤10 mmHg, while maintaining mean arterial pressure ≥65 mmHg. After reaching hemodynamic targets, the pulmonary arterial catheter was removed and CMR imaging repeated. Changes in LV T2-values, hemodynamics, and CMR volumetric measurements were compared. Results: Study patients (64±11 years, male 88%, LV ejection fraction 23±8%, ischemic cardiomyopathy 50%) received decongestive treatment during 5±2 days. PCWP and CVP decreased from 25±7 to 17±4 mmHg and 13±6 to 7±3 mmHg, respectively (p&lt;0.001 for both), while cardiac index increased from 2.14±0.60 to 2.58±0.49 L/min/m 2 (p=0.012). LV T2-values dropped consistently from 59.6±4.9 ms to 56.3±5.2 ms after decongestion (p=0.002; Figure). Decreasing LV T2-values correlated well to both decreasing PCWP (r=0.75; p=0.001) and increasing cardiac index (r=0.58; p=0.023). Although LV end-diastolic volume index (142±31 to 135±34 mL/m 2 ; p=0.033) and end-systolic volume index (110±29 to 99±33 mL/m 2 ; p=0.001) both decreased significantly, the extent of these changes were not correlated to changing T2-values (r=0 and 0.11, respectively; p=ns). Conclusions: Global LV myocardial edema is observed in ADHF and reversible with successful decongestive therapy. Relief of myocardial edema strongly correlates with improvements in systolic and diastolic function.
In future, cardiac arrest teams may require current evidence of their skills
Authors: N Bradbury, T M Cook, J Handel, T M Craft
Journal: BMJ (1995)

for trainees to acquire the necessary skills.It remains to be seen if the proficiency in resuscitation skills among those taking anaesthetic examinations is higher than that among candidates taking the examination for membership of the Royal College of Physicians.The resuscitation training officer has a valuable role in ensuring that these skills are retained.
Overview of depression and psychosis in Alzheimer's disease
Authors: R E Wragg, D V Jeste
Journal: American Journal of Psychiatry (1989)

The authors reviewed 30 studies on Alzheimer's disease to determine the prevalence and phenomenology of affective and psychotic symptoms in patients with this disorder. Depressive and psychotic symptoms occurred in 30%-40% of the Alzheimer's disease patients. Isolated symptoms were two to three times as frequent as diagnosable affective or psychotic disorders. Paranoid delusions were the most common psychotic symptoms reported. Implications of the relationship of psychiatric symptoms to the clinical presentation of Alzheimer's disease, patterns of cognitive dysfunction, clinical management, and areas for future research are discussed.