tbuckley/cabot-search huggingface dataset:
Abstract 9690: Does Testosterone Therapy Increase Risk of Cardiovascular Event Among Men? A Meta-Analysis
Authors: nader makki, Wassef Karrowni, Wassef Karrowni
Journal: Circulation (2014)

Background: Testosterone therapy has been increasingly promoted and prescribed over the past decade. However, there is rising concern about its safety, and randomized data adequately powered to assess its effect on cardiovascular outcomes is not available. Aim: We conducted a meta-analysis and systematic review of published randomized and observational studies to examine the overall risk of cardiovascular events associated with testosterone therapy. Methods: We searched Medline (1966-2014), Embase (1966-2014), and Cochrane central (2000-2014). Data was collected and analyzed using random and fixed effect model, as appropriate, with inverse variance weighting. Results: Of 2,800 studies identified, 34 were eligible including 76,270 patients with a mean follow up of 11.7 months. Testosterone therapy was associated with increased risk of cardiovascular events (adjusted HR=1.41, 95% CI = 1.18-1.70, p&lt;0.05), all-cause mortality (adjusted HR=1.51, 95% CI = 1.05-2.18, p&lt;0.05), and ischemic heart disease (adjusted HR=1.32, 95% CI = 1.11-1.57, p&lt;0.05), but not cerebrovascular events (adjusted HR=1.22, 95% CI = 0.98-1.53, p=0.08). Using meta-regression and sensitivity analyses to account for factors such as baseline cardiovascular disease, timing of testosterone collection, and industry funding did not change the results of our main analysis. Conclusions: Our meta-analysis demonstrates that testosterone therapy may be associated with increased risk of all-cause mortality, cardiovascular events, and ischemic heart disease.
Doctor accused of drugging, experimenting on, and sexually exploiting military trainees
Authors: M. McCarthy
Journal: BMJ (2015)

A US physician who provided medical training to troops in the United States and the United Kingdom has had his license suspended after he allegedly had medical students and military officers perform invasive medical procedures on each other without supervision, administered drugs such as ketamine to students, in some cases without their consent, conducted “shock labs” in which blood was withdrawn from students to induce hypovolemia, and exploited at least one student “for personal gain and sexual gratification.”

The allegations, first reported by Reuters, were documented in an order of summary suspension issued in March by the Virginia Board of Medicine.1 The physician, John Henry Hagmann, a former US army doctor, provides training for trauma and medical care in combat situations through his company, Deployment Military International, which is based in Gig Harbor, Washington. The Reuters report said that Hagmann had trained thousands of soldiers and medical personnel on how to treat wounds in combat situations since his retirement in 2000 and that his company has received more than $10.5m (£6.8m; €9.3m) in business from the federal government.

The company’s website says, “The mission of DMI is …
Anti-Angiogenic Therapy Induces T-Lymphocyte Infiltration Associated with Poor Survival in Metastatic Renal Cell Carcinoma Patients
Authors: X. Liu, A. Hoang, L. Zhou, S. Kalra, M. Sun, Z. Ding, S. Bai, P. German, X. Zhang, P. Tamboli, P. Rao, J. Karam, C. Wood, S. Matin, N. Tannir, K. Sircar, E. Jonasch
Journal: Annals of Oncology (2014)
Revisiting the factor structure for positive and negative symptoms: evidence from a large heterogeneous group of psychiatric patients
Authors: R Toomey, W S Kremen, J C Simpson, J A Samson, L J Seidman, M J Lyons, S V Faraone, M T Tsuang
Journal: American Journal of Psychiatry (1997)

The factor structures of individual positive and negative symptoms as well as global ratings were examined in a diagnostically heterogeneous group of subjects.Subjects were identified through a clinical and family study of patients with major psychoses at a VA medical center and evaluated with the Scale for the Assessment of Negative Symptoms and the Scale for the Assessment of Positive Symptoms. For the examination of global-level factor structures (N = 630), both principal-component analysis and factor analysis with orthogonal rotation were used. Factor analysis was used for the examination of item-level factor structures as well (N = 549).The principal-component analysis of global ratings revealed three factors: negative symptoms, positive symptoms, and disorganization. The factor analysis of global ratings revealed a negative symptom factor and a positive symptom factor. The item-level factor analysis revealed two negative symptom factors (diminished expression and disordered relating), two positive symptom factors (bizarre delusions and auditory hallucinations), and a disorganization factor.The generation of additional meaningful factors at the item level suggests that important information about symptoms is lost when only global ratings are viewed. Future work should explore clinical and pathological correlates of the more differentiated item-level symptom dimensions.
Phase III Trial of Gemcitabine Plus Cisplatin Versus Cisplatin Alone in Patients With Locally Advanced or Metastatic Non–Small-Cell Lung Cancer
Authors: A.B. Sandler, J. Nemunaitis, C. Denham, J. von Pawel, Y. Cormier, U. Gatzemeier, K. Mattson, Ch. Manegold, M.C. Palmer, A. Gregor, B. Nguyen, C. Niyikiza, L.H. Einhorn
Journal: Journal of Clinical Oncology (2000)

PURPOSE: The Hoosier Oncology Group has previously reported the results of its phase II trial of the combination of cisplatin plus gemcitabine. In that study of 27 assessable patients with advanced or metastatic non–small-cell lung cancer (NSCLC), the response rate was 33%, with a median survival of 8.4 months. Based on such favorable results, the Hoosier Oncology Group designed this randomized phase III study of gemcitabine plus cisplatin compared with cisplatin alone in chemotherapy-naive patients with advanced NSCLC. PATIENTS AND METHODS: Patients were randomized to receive either cisplatin (100 mg/m 2 intravenously on day 1 of a 28-day cycle) or the combination of cisplatin (100 mg/m 2 intravenously on day 1) plus gemcitabine (1,000 mg/m 2 administered intravenously on days 1, 8, and 15 of a 28-day cycle). RESULTS: From August 1995 to February 1997, 522 assessable chemotherapy-naive patients were randomized. Toxicity was predominantly hematologic and was more pronounced in the combination arm, with grade 4 neutropenia occurring in 35.3% of patients compared with 1.2% of patients on the cisplatin monotherapy arm. The incidence of neutropenic fevers was less than 5% in both arms. Grade 4 thrombocytopenia occurred in 25.4% of patients on the combination arm compared with 0.8% of patients on the cisplatin monotherapy arm. No serious hemorrhagic events related to thrombocytopenia were reported for either arm. The combination of gemcitabine plus cisplatin demonstrated a significant improvement over single-agent cisplatin with regard to response rate (30.4% compared with 11.1%, respectively; P &lt; .0001), median time to progressive disease (5.6 months compared with 3.7 months, respectively; P = .0013), and overall survival (9.1 months compared with 7.6 months, respectively; P = .004). CONCLUSIONS: For the first-line treatment of NSCLC, the regimen of gemcitabine plus cisplatin is superior to cisplatin alone in terms of response rate, time to disease progression, and overall survival.
In vitro and in vivo activities of piperacillin-tazobactam and meropenem at different inoculum sizes of ESBL-producing Klebsiella pneumoniae
Authors: Y. Harada, Y. Morinaga, N. Kaku, S. Nakamura, N. Uno, H. Hasegawa, K. Izumikawa, S. Kohno, K. Yanagihara
Journal: Clinical Microbiology and Infection (2014)
The Respiratory Epithelium. VII. Epidermoid Metaplasia of Hamster Tracheal Epithelium During Regeneration Following Mechanical Injury&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;&lt;xref ref-type="fn" rid="FN3"&gt;3&lt;/xref&gt;
Authors: E M McDowell, P J Becci, W Schürch, B F Trump
Journal: JNCI Journal of the National Cancer Institute (1979)

Regeneration was studied in female Syrian golden hamster tracheal epithelium. The epithelium was focally removed in vivo by scraping it with a blunt probe. At 2 hours, virtually all cells had sloughed from the injured area leaving a bare basal lamina. At 6 and 12 hours, flattened cells that migrated from adjacent uninjured epithelium partially covered the denuded basal lamina. Increased cell division did not occur at these times. Many of the simple squamous cells contained well-developed endoplasmic reticulum, Golgi apparatus, and mucous granules. Other cells resembled basal cells. At 24 hours the defect was covered by one or two layers of simple squamous cells. At that time, many of those cells were in division, and cell division was also greatly increased in mucous cells and basal cells in the uninjured epithelium distant from the defect. At 48 hours the epithelium was stratified, composed of four or five layers of polygonal to flattened cells, typical of nonkeratinizing epidermoid metaplasia. The cells contained many tonofilament bundles, a large Golgi apparatus, and many tiny mucous granules. Mitoses were seen in all cell layers. At 72 hours, the surface layer of cells was undifferentiated (indifferent cells) overlying an epithelium that otherwise retained its epidermoid character. Indifferent cells were characterized by an electron-lucent cytoplasm and a lack of tonofilament bundles, mucous granules, or cilla. Cells similar in other respects to indifferent cells were seen that possessed mucous granules or early signs of cilla formation. Some cells showed mucous granules and cilla developing in the same cell. By 96 hours, the regenerated epithelium was fully differentiated and was indistinguishable from the normal epithelium. These observations show that mucous cells have a significant role in the regenerative response. Mucous cells have a dual potential; they can undergo epidermoid metaplasia and still retain the ability to secrete mucus. The study explains the universal occurrence of mucosubstances in areas of epidermoid metaplasia and makes more understandable the previously reported fact that many bronchogenic carcinomas are combined epidermoid and adenocarcinomas. In the presence of a carcinogen, the hypothesis has been forwarded that initiation of mucous cells and basal cells occurs, which leads to malignant transformation and produces tumors that show active secretory activity and keratinization, often in the same cell.
Serum apelin 13 levels in patients with pulmonary embolism
Authors: Hadice Selimoglu Sen, Ibrahim Kaplan, Özlem Abakay, Cengizhan Sezgi, Süreyya Yilmaz, Mahsuk Taylan, Abdullah Cetin Tanrikulu, Abdurrahman Abakay
Journal: European Respiratory Journal (2014)

Introduction and Aim   A variety of adipokines has been reported in recent years that contribute to many different systemic processes. One of these novel adipokines, apelin, has become popular in the past decades. mRNA expression and peptide immunoreactivity have been described in a variety of tissues, including: gastrointestinal tract, adipose tissue, brain, kidney, liver, cardiovascular system and lungs. This study aimed to investigate the possible involvement of the endogenous apelin–APJ system in the pathophysiological events that occur in patients with pulmonary embolism (PE).   Materials and Methods   In total, 53 PE patients and 35 healthy volunteers, were included the study. Patient9s with pulmonary embolism were prospectively randomized from patients diagnosed in a tertiary care university hospital. The control group was created from healthy volunteers who were admitted to hospital for the purpose of a routine health maintenance exam. Serum apelin 13 levels were measured in both groups and the results were compared.   Results   The mean ages were 56.75 ± 19.70, 52.25 ± 12.45 and female/male ratios were 30/23, 20/15, in the PE and control groups, respectively. The mean serum apelin 13 levels were 76.74±93.89 ng/mL and 50.99±26.56 ng/mL, in the PE and control groups, respectively. The difference was statistically significant (p= 0.003).   Conclusion   This study demonstrated that levels of apelin 13 are elevated in patients with PE. The study findings provided novel evidence for the possible regulatory role of apelin in PE. These results suggest that apelin may be a novel biomarker and a potential therapeutic target in patients with acute PE in the future.
Breath alkanes as an index of lipid peroxidation
Authors: A Van Gossum, J Decuyper
Journal: European Respiratory Journal (1989)

Formation of free radicals and lipid peroxidation are mechanisms that are involved in many conditions including cellular damage. In a human body, there are many antioxidant systems likely to limit the production of free radicals and to reduce their deleterious effect. The peroxidation of polyunsaturated fatty acids, such as linoleic acid and linolenic acid which are cell membrane components, induces the formation of volatile alkanes that are excreted in the breath. The determination of breath alkanes (pentane and ethane) is considered to be a valuable and elegant method to assess lipid peroxidation. The method for collecting a breath sample and the chromatographic analysis of the collected gas require a strict methodology. Moreover, we must take into consideration some factors, such as the hepatic function, which may influence the pentane metabolism itself. We critically describe the results of breath alkane determination obtained in humans in different clinical conditions.
Neurological Presentations of AIDS-when to Test for HIV
Authors: G N Fuller, R J Guiloff, B Gazzard, J N Harcourt-Webster, F Scaravilli
Journal: Journal of the Royal Society of Medicine (1989)

Nine of 122 patients dead from AIDS in central London presented with neurological disease, confirmed pathologically in seven. Seven had no other major systemic manifestations. AIDS needs to be considered in the differential diagnosis of meningitis, dementia, diffuse and focal encephalopathies, brainstem syndromes, myelopathy, visual failure and peripheral nerve syndromes. As AIDS becomes more widespread there will be an increasing need for diagnostic HIV testing in many neurological syndromes.
Four-step high-dose sequential chemotherapy with double hematopoietic progenitor-cell rescue for metastatic breast cancer.
Authors: F Patrone, A Ballestrero, F Ferrando, F Brema, L Moraglio, M Valbonesi, P Basta, R Ghio, M Gobbi, M Sessarego
Journal: Journal of Clinical Oncology (1995)

PURPOSE High-dose chemotherapy produces high complete remission (CR) rates and some survival advantage in patients with metastatic breast cancer (BC). A current issue is the possibility that these patients may have an even better prognosis with multiple high-dose treatments. In this study, we evaluated the feasibility of a four-step, high-dose sequential chemotherapy (HDSC) with double autologous hematopoietic progenitor-cell rescue. We also tested the hypothesis that peripheral-blood progenitor cells (PBPCs) harvested following a single recruitment with cyclophosphamide (CY) and granulocyte-macrophage colony-stimulating factor (GM-CSF) allow the safe administration of the whole HDSC with closely timed repeated courses of several non-cross-resistant agents. PATIENTS AND METHODS The treatment plan included CY 7 g/m2, followed by GM-CSF 5 to 7 micrograms/kg/d administered by continuous intravenous (i.v.) infusion on days 2 to 14; PBPCs with or without bone marrow (BM) harvest; mitoxantrone (NOV) 60, 75, or 90 mg/m2 plus melphalan (L-PAM) 140 to 180 mg/m2 with hematopoietic rescue; methotrexate (MTX) 8 g/m2 plus vincristine (VCR) 1.4 mg/m2; and etoposide (VP-16) 1.5 g/m2 plus carboplatin (PP) 1.5 g/m2 with hematopoietic rescue. RESULTS All 15 patients enrolled completed the entire treatment and there were no toxic deaths. Hematologic reconstitution was good at each step. The median number of days with an absolute neutrophil count (ANC) less than 100/microL and platelet count less than 20,000/microL were 8 and 3, respectively, after NOV plus L-PAM, and 7 and 4, respectively, after VP-16 plus PP. The main non-hematologic toxicity was mucositis, while organ toxicity was mild and reversible. CONCLUSION This regimen is feasible, with acceptable toxicity. GM-CSF and PBPCs have a pivotal role, as they hasten hematologic reconstitution, abate toxicity, and allow rapid recycling.
Abstract 13284: In-Hospital ADP Receptor Inhibitor Switching in Myocardial Infarction Patients Treated With Percutaneous Coronary Intervention: Insights From the National Cardiovascular Data Registry®
Authors: Akshay Bagai, Yongfei Wang, Tracy Y Wang, Jeptha Curtis, Hitinder S Gurm, Eric D Peterson, Jorge F Saucedo, Christopher B Granger, Matthew T Roe, Deepak L Bhatt, Robert L McNamara, Karen P Alexander
Journal: Circulation (2013)

Background:  With several ADP receptor inhibitors now available, little is known regarding patient characteristics associated with in-hospital drug switching.   Methods:  We studied 47,040 PCI-treated ACS patients who received either clopidogrel or prasugrel within 24 hours of hospital admission using the ACTION - Get With the GuidelinesTM and CathPCI® registries at 362 U.S. hospitals from July 2009 to June 2011. Hierarchical logistic regression modeling was used to determine factors independently associated with in-hospital ADP receptor inhibitor switching.   Results:  Among 40,531 patients treated with clopidogrel at admission, 2,125 (5.2%) were switched in-hospital and discharged on prasugrel, while among 6,509 patients treated with prasugrel at admission, 751 (11.5%) were discharged on clopidogrel. Among those treated initially in-hospital with clopidogrel, switching to prasugrel was associated with clinical (diabetes, home clopidogrel or prasugrel use, in-hospital reinfarction), angiographic (bifurcation lesion, multivessel PCI) and socioeconomic (private health insurance) factors; continuation and discharge on clopidogrel was associated with bleeding risk (older age, prior stroke or TIA, in-hospital CABG) (Figure). Among those treated initially in-hospital with prasugrel, switching to clopidogrel was associated with bleeding risk or observed bleeding events; continuation and discharge on prasugrel was associated with STEMI presentation, treatment with drug eluting stent and private health insurance.   Conclusion:  ADP receptor inhibitors are switched in-hospital in approximately 5-10% of ACS patients undergoing PCI. Drug switching appears to be associated with bleeding risk, lesion complexity and socioeconomic considerations. Future studies will assess implications of in-hospital ADP receptor inhibitor switching on clinical outcomes.
Resistant hypertension and obstructive sleep apnea
Authors: Nadia M.L. Amorim, Luciene S. Araujo, Julia F.R. Fernandes, Maria L.G. Rodrigues, Debora C.T. Valenca, Fabiana B. Bassan, Marcia R.S. Torres, Antonio F. Sanjuliani
Journal: European Respiratory Journal (2013)

Background:  Obstructive sleep apnea (OSA) is considered an independent risk factor for cardiovascular disease and reported as the most common secondary cause of high blood pressure (BP) maintenance.   Objective:  To determine the prevalence of OSA and verify its association with endothelial function behavior and anthropometric parameters in patients with resistant hypertension (RHG) and BP controlled by medication (CHG).   Methods:  Cross-sectional study involving 40 hypertensive patients (20 in RHG and 20 in CHG), aged between 18 and 75 years. Endothelial function and OSA were assessed by peripheral arterial tonometry.   Results:  Patients were late middle-aged (RHG: 54.9±2.4  vs  CHG: 56.1±2.4; mean±SE). The prevalence of OSA in CHG was 76.5% (apnea-hypopnea index=20.74±4.69), reaching 85% in RHG (AHI=12.39±1.89). In general, OSA was more frequent in men (93.7%  vs  75%; p=0.0455,  OR =3.86; 95% IC 0.99 to 5.09) and was correlated with weight (p=0.0007), BMI (p=0.0078) and waist (WaC) (p=0.0246). In hypertensive patients overall, OSA also presented an independent association with endothelial function (p=0.0297;  OR =0.17; 95% CI 0.03 to 0.72). Both groups presented similar (p > 0.05) BMI (RHG: 31.3±1.26  vs  CHG: 32.6±1.27 kg/m2), as well as WaC (RHG: 103±3.4  vs  CHG: 100.1±2.7cm) and neck circumference (RHG: 38.9±0.7  vs  CHG: 38±0.8 cm). Endothelial function evaluated by reactive hyperemia index was similar in both groups (RHG: 1.88±0.44  vs  CHG: 2.03±0.43; p=0.47) as well as minimum saturation (RHG: 87.8±3.8  vs  CHG: 83.3±10.6%).   Conclusions:  The findings of the present study suggest that, in hypertensive subjects, OSA occurs more frequently in men, being associated with endothelial dysfunction and correlated positively with weight, BMI and WaC.
Somatic symptoms after a natural disaster: a prospective study
Authors: J I Escobar, G Canino, M Rubio-Stipec, M Bravo
Journal: American Journal of Psychiatry (1992)

The authors prospectively examined the prevalence of somatization symptoms among community respondents after a natural disaster in Puerto Rico. Exposure to the disaster was related to a higher prevalence of medically unexplained physical symptoms, particularly gastrointestinal ones (abdominal pain, vomiting, nausea, excessive gas) and pseudoneurological ones (amnesia, paralysis, fainting, unusual spells/double vision).
Pharmacogenetic influence of eNOS gene variant on endothelial and glucose metabolism responses to L-arginine supplementation: Post hoc analysis of the L-arginine trial
Authors: Lucilla D. Monti, Elena Galluccio, Barbara Fontana, Serena Spadoni, Mauro Comola, Massimiliano M. Marrocco Trischitta, Roberto Chiesa, Giancarlo Comi, Emanuele Bosi, Piermarco Piatti
Journal: Metabolism (2015)
Is performance during pre-operative cardiopulmonary exercise testing (CPET) related to post-operative outcome?
Authors: Robert Green, Louise Peers, Christine O'Brien, Clara Green
Journal: European Respiratory Journal (2014)

Introduction 

CPET assesses the response of the cardiovascular and pulmonary systems to exercise. (1) Oxygen uptake at the onset of blood lactate accumulation is known as the anaerobic threshold (AT). AT is used as a measure of exercise capacity. (1) An AT of < 11ml/min/kg identifies patients with poor exercise capacity. (2) We hypothesised that AT was associated with post-operative ITU admissions and length of stay in a district general hospital.

Methods 

All patients who underwent a CPET at George Eliot Hospital from 1/2/2012-31/3/2013 were selected. The hospital electronic system was used to obtain the AT and clinical information for each patient.

Results 

33 patients were identified. All patients had comorbidities and none died. 13/14 (92.9%) of patients with an AT ≥ 11 had surgery. A significantly smaller proportion of patients with an AT <11 had surgery [9/19 (47.4%); p = 0.009]. ITU admission and length of stay details were available for 19/22 patients. 6/11 (54.5%) patients with AT ≥ 11 were admitted to ITU. A greater proportion of patients with AT <11 were admitted to ITU 6/8 (75%), but this did not reach statistical significance (p= 0.633). There was a positive correlation (r=0.337) between AT and length of stay which was not significant (p= 0.112).

Conclusions 

Patients with a pre-operative AT ≥11 are more likely to have surgery. Patients with an AT <11 may be more likely to receive ITU care post-operatively, but a larger cohort of patients would be needed to confirm this. AT does not appear to be related to length of stay after surgery.

References 

1. Older P, et al. Chest. 1999. 116 :355-362

2. Moyes, LH et al. Ann R Coll Surg Engl .2013. 95 :125-30.