tbuckley/cabot-search huggingface dataset:
ICU and twelve-month mortality of patients with acute respiratory failure admitted to the ICU: What is the role of comorbidities?
Authors: Huriye Berk Takir, Zuhal Karakurt, Cuneyt Salturk, Feyza Kargin, Merih Balci, Bunyamin Burunsuzoglu, Esra Akkutuk, Ozlem Mocin, Nalan Adiguzel, Gokay Gungor
Journal: European Respiratory Journal (2014)

Objective:We aimed to evaluate the effect of comorbidities and long term mortality predictors of acute problems.  methods:This is a retrospective observational cohort study performed in a 22-bed tertiary ICU. All patients who were admitted to the ICU in one-year period were included. Demographics, comorbidities, ICU data were recorded. ICU mortality and at least 12-month mortality after ICU discharge were analysed by Cox regression and Kaplan Meier survival analysis.  Results:In study period, 1022 patients(362 female) were admitted to the ICU. ICU and 12 month mortality rates were 20.8%(n=223) and 44.5%(n=360) respectively. Tables show the ICU and long term mortality risk factors of patients with ARF.  Conclusion:The first year mortality after ICU discharge of patients with ARF admitted to the ICU is higher than ICU mortality. In this group of patients, presence of COPD decreases mortality while malignancy increases.
Pseudomonas aeruginosa counteracts the host defense functions of MIG/CXCL9
Authors: Sandra Jovic, Mathias Mörgelin, Arne Egetsen
Journal: European Respiratory Journal (2012)

Pseudomonas aeruginosa  is a frequent colonizer and cause of exacerbations in cystic fibrosis (CF) and other chronic pulmonary diseases. CF is a monogenic disease caused by mutations in the CF transmembrane conductance regulator (CFTR) gene. One feature of the disease is a reduction or absence of chloride transport and dysregulation of sodium transport to the airway epithelium surface. In this study, we show that the antibacterial chemokine MIG/CXCL9 (monokine induced by IFN-γ) is expressed by bronchial epithelial cells and could be detected in sputum from patients suffering from CF. MIG/CXCL9 showed high bactericidal activity against  P. aeruginosa  in vitro, also at salt concentrations similar to those seen in CF.  P. aeruginosa  strains equipped with efflux-pumps, showed a high degree of resistance to MIG/CXCL9. Elastase from  P. aeruginosa  and neutrophils respectively, both cleaved of a distinct fragment from the MIG/CXCL9 holoprotein. Taken together, our data indicates that the activity of antimicrobial proteins, as exemplified by MIG/CXCL9, is not foremost hampered by salt but rather efflux-pumps and proteases. The latter released both by the bacteria and neutrophils.
A 25-Year Prospective Study of Modified Radical Mastectomy (Patey) in 193 Patients
Authors: M D Staunton, D M Melville, A Monterrosa, J M Thomas
Journal: Journal of the Royal Society of Medicine (1993)

The results of a prospective study over 20 years of 193 patients with breast carcinoma treated by Patey mastectomy are presented together with details of the operative technique employed. One hundred and twenty-eight cases (66%) were stage 1 (T1/T2 N0), 46 (24%) were stage 2 (T1/T2 N1), 18 (9%) were stage 3 (T3 N0/N1), and one was stage 4 (M1). The probability of survival together with 95% confidence intervals for stage 1 (T1/T2 N0) at 10 years was 79% (71-88); and at 15 years 74% (61-87). For stage 2 (T1/T2 N1), the probability of survival at 10 years was 64% (48-79), and at 15 years 60% (44-76). For stage 3 (T3 N0/N1), the probability of survival at 10 years was 70% (45-95) and nobody survived at 15 years. These differences between the clinical stages lacked significance [Log-rank test: chi 2 = 3.44 df = 2 P = 0.18]. There were nine patients (5%) who developed local recurrence without systemic metastases. There was no postoperative mortality, and morbidity was low. Axillary node metastases depressed survival with probability of survival at 10 years 43% (29-57) in contrast to those without it 90% (84-96) [log-rank test: chi 2 = 39.42 df = 1 P < 0.0001]. Patey mastectomy should be considered for patients with T1 or T2 tumours who choose mastectomy rather than breast conservation. It is an effective local treatment which is of particular relevance in countries where radiotherapy is not available.
David Richard Firth
Authors: Dorothy Cullen
Journal: BMJ (2015)

David Richard Firth was the son of a general practitioner in Oxford. He attended the Dragon School Oxford and Radley College. He did his military service at Bovington Camp, Dorset, as medical officer in the tank regiment, mainly with the junior leaders.

From 1963 to 1994 he was a singlehanded GP in the Devon village of Shaldon, familiar …
Cholesterol Emboli Syndrome—Uncommon or Unrecognized?
Authors: S P Bell, A Frankel, E A Brown
Journal: Journal of the Royal Society of Medicine (1997)

Cholesterol emboli syndrome is a multisystem disorder that can be precipitated by angiographic procedures. We report 5 cases in which the presentation was renal failure. All patients had undergone angiography, but the temporal relation of the procedure to the clinical presentation was highly variable, the interval ranging from one day to four months. With the increase in diagnostic and therapeutic uses of angiography, the cholesterol emboli syndrome is likely to become more frequent and needs to be recognized.
Abstract 17091: High Saturated Fat Intake Improves Survival in Genetic Cardiomyopathy Compared to a High Polyunsaturated Fat Diet or a Low Fat Diet
Authors: Tatiana Galvao, Peter Hecker, Bethany Brown, Kelly O'Connell, Karen O'Shea, William Stanley
Journal: Circulation (2011)

Surprisingly, a high fat diet comprised mainly of saturated fatty acids improves LV function and survival in rat models of heart failure induced by hypertension or myocardial infarction. The mechanism for this effect is not clear, nor is it known if a similar effect occurs with a high fat diet composed of plant derived polyunsaturated fatty acids (PUFA), or in genetic cardiomyopathies. We determined if survival in cardiomyopathic hamsters (Bio TO-2 strain) is prolonged by a high fat diet compared to a low fat diet (see table). Further, we compared the effect of high fat diets enriched with either saturated fat (palmitate and stearate), or PUFAs from plant sources(primarily linoleic and α-linolenic acids). Cardiomyopathic hamsters (6 wks old) were fed either a Low Fat diet; a High PUFA diet, or a High Saturated Fat diet. Survival was assessed (n=30/group), and subgroups were evaluated at 30 wks of age (n=12/group) for LV and mitochondrial function. The diet has no effect on LV function as assessed by echocardiography, and there was no difference in body weight or LV mass. Since there is impaired mitochondrial function in heart failure and dietary lipid composition might positively impact mitochondrial function, isolated mitochondria were assessed. Respiration and Ca 2+ -induced mitochondrial permeability transition were unaffected by diet. On the other hand, the high PUFA diet increased fat pad mass compared with the two other cardiomyopathic groups and elevated plasma free fatty acid concentration (p&lt;0.05). Importantly, there was a significant increase in survival in the high saturated sat group compared to the either the low fat or the high PUFA groups after 16 months of treatment (p&lt;0.0001). These results show that a high fat diet comprised largely of long chain saturated fatty acids increase survival in cardiomyopathic hamsters compared to either a low fat diet or a high fat diet comprised of PUFA from plant sources. The effect was independent of improved mitochondrial function.
Identification of causative bacteria in the airways of COPD by a novel semi-quantitative PCR method
Authors: Shohei Minezaki, Hidetoshi Nakamura, Takashi Hirama, Ayako Shiono, Akiko Kawashima, Makoto Nagata, Koichi Hagiwara, Minoru Kanazawa
Journal: European Respiratory Journal (2013)

Introduction: Exacerbation and comorbid pneumonia in COPD are critical events associated with disease progression and mortality. However, causative pathogens often remain unidentified despite clinical manifestations of airway infection. Although commensal organisms are frequent causes of these events, they may exist merely as colonizers. PCR method is quick and sensitive to detect microorganisms but is difficult in discriminating pathogens from colonizers. We have recently developed a semi-quantitative PCR method, HIRA-TAN, to detect microorganisms using an organism-to-human cell DNA copy number ratio as an index for their pathogenic role (2011 PLoS One).  Aim: To identify pathogenic bacteria in the airways of COPD by HIRA-TAN.  Methods: Between October 2009 and September 2010, sputum culture and HIRA-TAN analyses were performed in 254 patients suggestive of airway infection at Saitama Medical University Hospital. In this study we compared bacteria detected by the two methods in 107 patients who had airflow limitation (FEV 1 %  Results: Sputum culture detected pathogenic bacteria in 51 cases (48%) out of 107, while HIRA-TAN identified those in 46 cases (43%). It was noted that the results were matched only in 21 cases between the two methods. HIRA-TAN detected  S. pneumoniae  in 22 cases whereas it was detected only in one and seven cases by sputum culture and the urine antigen test, respectively. In contrast sputum culture detected  Haemophilus spp.  other than  H. influenzae  in 16 cases.  Conclusions: These observations suggest that HIRA-TAN is useful to identify bacteria responsible for comorbid airway infections in COPD.
Autotransplants for Hodgkin's Disease in Patients Never Achieving Remission: A Report From the Autologous Blood and Marrow Transplant Registry
Authors: By Hillard M. Lazarus, Philip A. Rowlings, Mei-Jie Zhang, Julie M. Vose, James O. Armitage, Philip J. Bierman, James L. Gajewski, Robert Peter Gale, Arm Keating, John P. Klein, Carole B. Miller, Gordon L. Phillips, Donna E. Reece, Kathleen A. Sobocinski, Koen van Besien, Mary M. Horowitz
Journal: Journal of Clinical Oncology (1999)

Hodgkin's disease patients who never achieve complete remission with conventional chemotherapy (i.e., those with primary induction failure) have a poor prognosis. Some subjects who receive high-dose therapy with autologous hematopoietic progenitor-cell infusion experience prolonged progression-free survival.Detailed records from the Autologous Blood and Marrow Transplant Registry (ABMTR) on 122 Hodgkin's disease patients who failed to achieve complete remission after one or more conventional therapy regimens and subsequently received an autotransplant between 1989 and 1995 were reviewed.Median age was 27 years (range, 7 to 57 years). Median time from diagnosis to transplantation was 14 months (range, 5 to 38 months). Most patients received high-dose chemotherapy without radiation for pretransplantation conditioning (n = 107). The regimen most frequently used was cyclophosphamide, carmustine, and etoposide (n = 47). Fifteen patients received total-body irradiation (n = 15). The graft consisted of bone marrow (n = 86), blood stem cells (n = 25), or both (n = 11). The 100-day mortality was 12% (95% confidence interval, 7% to 19%). Sixty patients (50%) were considered to have achieved complete remission after autotransplantation; 37 of these had negative imaging studies, whereas scan abnormalities of unknown significance persisted in 23 patients. Twenty-seven patients (22%) had no response or progressive disease after transplantation. Probabilities of progression-free and overall survival at 3 years were 38% (95% confidence interval, 28% to 48%) and 50% (95% confidence interval, 39% to 60%), respectively. In multivariate analysis, "B" symptoms at diagnosis and poor performance score at transplantation were adverse prognostic factors for outcome.Autotransplants should be considered for patients with Hodgkin's disease who do not achieve complete remission with conventional therapy.
Complement-Fixing Antigen of Human Sarcomas2
Authors: Jitender Sethi, Yashar Hirshaut
Journal: JNCI Journal of the National Cancer Institute (1976)

Journal Article Complement-Fixing Antigen of Human Sarcomas Get access Jitender Sethi, Ph.D., Jitender Sethi, Ph.D. Search for other works by this author on: Oxford Academic PubMed Google Scholar Yashar Hirshaut, M.D. Yashar Hirshaut, M.D. Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 57, Issue 3, September 1976, Pages 489–493, https://doi.org/10.1093/jnci/57.3.489 Published: 01 September 1976 Article history Received: 04 November 1975 Accepted: 27 February 1976 Published: 01 September 1976
Abstract 872: APE1/Ref-1 as a serological biomarker for the detection of bladder cancer
Authors: Sunga Choi, Ju Hyun Shin, Yu Ran Lee, Myoung Soo Park, Chang Nam Yim, Young Gil Na, Jae Sung Lim, Byeong Hwa Jeon
Journal: Cancer Research (2014)

Abstract Apurinic/apyrimidinic endonuclease1/redox factor-1 (APE1/Ref-1) is a DNA repair enzyme whose expression is increased in several forms of cancerous cells. We investigated whether serum APE1/Ref-1 is elevated in patients with bladder cancer. Tumor tissue and serum from patients with bladder cancer who had not received chemotherapy or radiotherapy (n=51) and non-tumor healthy controls (n=55) was used. In immunohistochemistry, and immunoblot analysis, the APE1/Ref-1 protein level of bladder tissues was increased in patients with bladder cancer. The serum APE1/Ref-1 levels were significantly elevated in bladder cancer patients than in those of non-tumor healthy controls and its levels were correlated with tumor staging and grading. The ROC curve of APE1/Ref-1 showed an excellent area under the ROC curve of 0.824. In this study, the optimal combination of sensitivity and specificity were determined as 93% and 59% for a cut-off value of serum APE1/Ref-1 of 2.83 ng/100 μl, respectively. The serum APE1/Ref-1 levels are increased in patients with bladder cancer with recurrence. These data indicate serum APE1/Ref-1 may help to identify patients with bladder cancer and it can be used as a serological marker of bladder cancer. Citation Format: Sunga Choi, Ju Hyun Shin, Yu Ran Lee, Myoung Soo Park, Chang Nam Yim, Young Gil Na, Jae Sung Lim, Byeong Hwa Jeon. APE1/Ref-1 as a serological biomarker for the detection of bladder cancer. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 872. doi:10.1158/1538-7445.AM2014-872
Surgery or steroids?:
Authors: Richard Mathew Thomson
Journal: BMJ (2015)

<h3>Abstract</h3> <h3>Background</h3> Accurate methods of identifying patients with COVID-19 who are at high risk of poor outcomes has become especially important with the advent of limited-availability therapies such as monoclonal antibodies. Here we describe development and validation of a simple but accurate scoring tool to classify risk of hospitalization and mortality. <h3>Methods</h3> All consecutive patients testing positive for SARS-CoV-2 from March 25-October 1, 2020 within the Intermountain Healthcare system were included. The cohort was randomly divided into 70% derivation and 30% validation cohorts. A multivariable logistic regression model was fitted for 14-day hospitalization. The optimal model was then adapted to a simple, probabilistic score and applied to the validation cohort and evaluated for prediction of hospitalization and 28-day mortality. <h3>Results</h3> 22,816 patients were included; mean age was 40 years, 50.1% were female and 44% identified as non-white race or Hispanic/Latinx ethnicity. 6.2% required hospitalization and 0.4% died. Criteria in the simple model included: age (0.5 points per decade); high-risk comorbidities (2 points each): diabetes mellitus, severe immunocompromised status and obesity (body mass index≥30); non-white race/Hispanic or Latinx ethnicity (2 points), and 1 point each for: male sex, dyspnea, hypertension, coronary artery disease, cardiac arrythmia, congestive heart failure, chronic kidney disease, chronic pulmonary disease, chronic liver disease, cerebrovascular disease, and chronic neurologic disease. In the derivation cohort (n=16,030) area under the receiver-operator characteristic curve (AUROC) was 0.82 (95% CI 0.81-0.84) for hospitalization and 0.91 (0.83-0.94) for 28-day mortality; in the validation cohort (n=6,786) AUROC for hospitalization was 0.8 (CI 0.78-0.82) and for mortality 0.8 (CI 0.69-0.9). <h3>Conclusion</h3> A prediction score based on widely available patient attributes accurately risk stratifies patients with COVID-19 at the time of testing. Applications include patient selection for therapies targeted at preventing disease progression in non-hospitalized patients, including monoclonal antibodies. External validation in independent healthcare environments is needed.
Abstract 14968: Switching Elderly Patients With High On-treatment Platelet Reactivity From Clopidogrel to Prasugrel
Authors: Thibault Lhermusier, Simon Mejean, Sophie Voisin, Vincent Bataille, Thomas Chollet, Sylvain Sayir, Pierre Sié, Didier Carrié
Journal: Circulation (2014)

Introduction:  In the subgroup of elderly patients (pts) from the TRITON-TIMI 38 (TRial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet InhibitioN with Prasugrel-Thrombolysis In Myocardial Infarction 38) study, prasugrel 10 mg reduced ischemic events versus clopidogrel 75 mg, but increased bleeding leading to a controversial overall benefit of the prasugrel 10 mg dose in this population.   Hypothesis:  The study aimed to assess the consequences on platelet inhibition and clinical outcomes of switching elderly pts with high on-treatment platelet reactivity (HTPR) from clopidogrel to prasugrel after an acute coronary syndrome (ACS).   Methods:  Platelet reactivity was measured at discharge with the VerifyNow P2Y12 assay (Accumetrics, San Diego, California) in 59 elderly ACS pts (age > 75 years) treated with clopidogrel (tailored group). Patients with HTPR were switched from clopidogrel 75 mg to prasugrel 10 mg. The rate of pts with HTPR (P2Y12 reaction units (PRU) > 235, and low on-treatment platelet reactivity (LPR) (PRU   Results:  On a regimen of clopidogrel 75 mg, the rate of patients with HTPR was 33.9 % (n=20/59), whereas 13.6 % (n=8) had LPR. Among the 33 patients switched to prasugrel, on-treatment platelet reactivity decreased from 287± 35 on a regimen of clopidogrel to 116±71 on a regimen of prasugrel. After switching, the rate of patients with HTPR was 10% whereas the rate of LPR was 41%. In the taylored group, incidence rates (for 100 person-years) of major ischemic events and (major or minor) bleeding events were respectively 26.1 and 39.9 and were not significantly different compared with incidence rates observed in patients from the standard treatment cohort (respectively p=0.59 and p=0.08).   Conclusions:  HTPR is frequent in elderly patients treated with clopidogrel 75 mg. Early switching from clopidogrel 75 mg to prasugrel 10 mg reduces the number of patients with HTPR but also lead to increase the number of patients with LPR with unknown consequences on clinical outcome.
Chronology of Use of Ticlopidine to Prevent Stent Occlusion
Authors: Marie-Claude Morice
Journal: Circulation (1998)

The statement on "Phytochemicals and Cardiovascular Disease" published in the June 3, 1997, issue of Circulation 1 focuses attention on the vast therapeutic possibilities found in plants.One of the 3 groups of substances mentioned, the flavonoids, is found in great abundance in standardized special extracts of Hawthorn leaves with flowers.This extract has been studied extensively in Germany and is currently being used as a treatment modality in NYHA class II heart failure.Clinical studies (double-blind and placebo controlled) have been published in German and other languages 2,3 along with pharmacological and chemical studies.In a recent article, 4 136 patients (NYHA class II heart failure) were randomized (double-blind) to either 160 mg Hawthorn special extract WS 1442 per day or placebo.The difference between the pressure/heart rate product (PHRP) at a 50-W load versus rest was measured before and after treatment, and the change in this parameter was defined as the primary target parameter.The group receiving active medication showed a significant improvement in the PHRP, whereas, in the placebo group, this parameter tended to deteriorate.Other surrogate parameters (patients' subjective assessment of symptoms and quality of life) also improved.The medication was excellently tolerated.The cardioprotective qualities of Hawthorn extract WS 1442 have been demonstrated by Krzeminski and Chatterjee. 5 They used the ischemia/reperfusion model in 2 groups of rats, 1 receiving 100 mg ⅐ kg Ϫ1 ⅐ d Ϫ1 of the standardized Hawthorn extract WS 1442 orally for 6 days before induction of ischemia and the other serving as a control group.Active treatment effectively protected the animals from reperfusion-induced arrhythmia, mortality, and hypotensive crisis, as observed in the control animals after 7 minutes of coronary occlusion.A better understanding of the pharmacological working principles of WS 1442 is offered by Chatterjee et al. 6 They fractionated the Hawthorn extract and demonstrated that a subgroup of the flavonoids, namely, the oligomeric procyanidins, possess potent radical scavenging and human neutrophil elastase inhibitory activities.Further research is being carried out with this special Hawthorn extract to investigate its pharmacological properties and its clinical significance, not only in early but also in advanced stages of heart failure and for secondary prevention after myocardial infarction.
Chemotherapy-related amenorrhea in women with early breast cancer: The effect of paclitaxel or dose density
Authors: M. E. Abusief, S. A. Missmer, E. S. Ginsburg, J. C. Weeks, E. P. Winer, A. H. Partridge
Journal: Journal of Clinical Oncology (2006)

10506 Background: The effect of the addition of paclitaxel (T) to adriamycin and cyclophosphamide (AC), or dose density (DD, q2wk) on menstrual functioning in women with early breast cancer remains uncertain. Methods: We reviewed data from premenopausal women treated at Dana-Farber Cancer Institute and Brigham and Women’s Hospital who received adjuvant chemotherapy with either AC or AC-T from 1997–2005 for whom pre- and post-treatment menstrual data were available. A multivariable logistic regression model evaluating amenorrhea at 6 months or greater follow-up was conducted. Results: Of the 403 patients eligible for analysis, average age at diagnosis was 41 years (range 25–50); average weight was 67kg; 10% were smokers, 53% had never smoked; 24% were nulliparous. 60% of women received AC, 40% AC-T; 20% of women received DD therapy (either AC or AC-T); 72% received tamoxifen. The multivariable model adjusting for age, weight, gravity, parity, smoking, alcohol use, and tamoxifen use, revealed that risk of amenorrhea was not statistically different in patients receiving AC-T versus AC (OR = 1.45, 95% CI 0.78–2.69) or in patients receiving DD therapy versus standard (OR = 1.61, 95% CI 0.74–3.49). However, a planned future analysis including data from an additional 200+ patients may yield significant differences. Age directly correlated with risk of amenorrhea, OR = 1.40, 95% CI 1.30–1.50) for every year increase in age, and women receiving tamoxifen were more likely to be amenorrheic (OR = 1.99, 95% CI 1.05–3.79). Conclusions: The addition of T to AC or use of DD therapy does not appear to increase the likelihood of amenorrhea in follow-up. These findings may assist premenopausal women with breast cancer when making decisions at diagnosis and in follow-up. No significant financial relationships to disclose.
Epidemiology, risk factors and impact on long-term pancreatic function of infection following pancreas-kidney transplantation
Authors: J.M. Herrero-Martínez, C. Lumbreras, A. Manrique, R. San-Juan, A. García-Reyne, F. López-Medrano, M. Lizasoain, B. de Dios, A. Andrés, C. Jiménez, E. Gutiérrez, E. Moreno, J.M. Aguado
Journal: Clinical Microbiology and Infection (2013)