tbuckley/cabot-search huggingface dataset:
Clinical utility of EGFR gene mutation analysis with cytological materials from bronchoscopy not histological materials
Authors: Kyosuke Nakata, Yoshikazu Kotani, Yukihisa Hatakeyama, Nanako Tomita, Nobuko Hazeki, Akihiro Sakashita, Kazuyuki Kobayashi, Yasuhiro Funada, Yoshihiro Nishimura
Journal: European Respiratory Journal (2011)

Rationale: Epidermal growth factor receptor (EGFR) gene mutation analysis becomes essential in medical cares for non-small-cell lung cancer after the report of the effectiveness of Gefitinib for non-small-cell lung cancer patients who have EGFR gene mutations. Although most of materials for EGFR gene mutation analysis in the past reports or clinical practice is submitted from lung tissue, we must sometimes diagnose patients as lung cancer with cytological materials because it is sometimes difficult to get enough tissue materials in clinical practice.

Method: In our hospital, after we take cytological materials from bronchoscopy, we wash devices with saline in the microcentrifuge tube and store this tube in a deep freezer immediately. When the patient is diagnosed as non-small-cell lung cancer with cytological materials, we analize the frozen materials for EGFR gene mutation with a PCR clamp method.

Result: One hundred and seventy eight patients were diagnosed as non-small-cell lung cancer with cytological materials from December 16, 2008 to August 5, 2010. We could diagnose histological materials only half of cases. The number of non-small-cell lung cancer patients who had EGFR gene mutations was 36 (20.2%). Especially 34.4% of adenocarcinoma patients had EGFR gene mutation, so there was no great difference with the rate of past reports that used tissue diagnosis. The response rate of EGFR-tyrosine kinase inhibitor for the patients who had EGFR gene mutations was 83%, similar to that of past reports.

Conclusion: Cytological materials from bronchoscopy are useful enough for EGFR mutation gene analysis.
Abstract 9237: Spectrum of Constrictive Pericarditis: 10-Year Experience
Authors: Alexander Mayer, M. Fuad Jan, Naoyo Mori, Louie Kostopoulos, David C Kress, Leonard H Kleinman, Suhail Allaqaband, Tanvir Bajwa, Timothy E Paterick, A. Jamil Tajik, Bijoy K Khandheria
Journal: Circulation (2011)

Introduction: Contemporary data on clinical presentation and outcomes of constrictive pericarditis (CP) in a community setting is lacking. We investigated the clinical spectrum of CP in a real-world setting. Hypothesis: Diagnosis of CP in contemporary clinical practice is difficult and frequently requires multimodality testing, with possible impact on clinical outcomes. Methods: A retrospective cohort of patients with surgically proven CP from January 2000 to December 2009 was studied. Baseline characteristics, clinical presentation, radiological imaging, cardiac catheterization and echocardiographic examinations were reviewed. Results: A total of 43 patients (median age 67; 76.7% male) were identified during the 10-year period. The majority presented with dyspnea (91%) and peripheral edema (72%), while anasarca and ascites were present in 33% of patients. Calcification on chest X-ray was present in 17% (5 of 29 cases), while catheterization hemodynamics suggested CP in 81% (25 of 31 cases). Computed tomography and/or magnetic resonance imaging showed pericardial thickening in 67% (20 of 30 studies). A specific etiology was found in 67% of the cohort (figure). Combined pericardiectomy with other cardiac surgery was undertaken in 35%. The perioperative 30-day mortality rate was 16%. At a median follow-up of 9 months, survival rate excluding perioperative mortality was 72%. Depressed ejection fraction (&lt;40%) was a predictor of perioperative mortality (odds ratio: 8.27, 95% confidence interval [CI]: 1.41-48.54; p=0.019), while prior cardiac surgery was associated with reduced long-term survival (odds ratio: 6.82, 95% CI: 1.47-31.61; p=0.014). Conclusions: Our findings reaffirm the complexity of diagnosing constrictive pericarditis in contemporary medical practice. Early suspicion in clinical groups at risk for constrictive pericarditis and prompt surgical intervention prior to systolic dysfunction may improve outcomes.
Abstract 15235: High-Dose Plasmid VEGF Gene Transfer in Patients with Severe Coronary Artery Disease: Final Results of the First Latin American Trial of Gene Therapy in Myocardial Ischemia
Authors: Oscar Mendiz, Liliana Favaloro, Mirta Diez, Leon Valdivieso, Andres Bercovich, Marcelo Criscuolo, Gustavo Vera Janavel, Alberto Crottogini
Journal: Circulation (2011)

We have shown that high dose intramyocardial injection of a plasmid coding VEGF165 (pVEGF) in pig and sheep models of myocardial ischemia induces angio-arteriogenesis and cardiomyogenesis with no s...
Efficacy of BiPAP AutoSV advanced in subjects with congestive heart failure and central apnea
Authors: Winifried J. Randerath, D. Banerjee, M. Treml, W. Galetke, C. Priegnitz, A. Ali, S. Taheri
Journal: European Respiratory Journal (2011)

Introduction:  Auto-Servo Ventilation effectively suppresses Sleep Disordered Breathing (SDB) in patients with Congestive Heart Failure (CHF). This study compared the efficacy of a new mode of ASV that incorporates an automatic EPAP (ASV-Advanced), with and without its Bi-Flex comfort feature, to manually titrated ASV (ASV) in patients with central SDB and CHF.   Methods:  Following diagnostic PSG and titration, patients underwent 3 consecutive treatment nights in a random order: ASV, ASV-Advanced and ASV-Advanced with Bi-Flex. For the ASV night, EPAP was set to the level determined during the titration night and IPAP set at EPAP+20cmH 2 O. For the ASV-Advanced nights, the device was set to automatically determine EPAP and IPAP pressures with a maximum pressure support of 20cmH 2 O. When activated, Bi-Flex was set to its maximum expiratory pressure relief. Data were analyzed with ANOVA and Bonferroni.   Results:  10 males participated (mean ± SD: age 67.4±11.7 y, BMI 28.4±5.5 kg/m 2 , LVEF 25.7±5.7%). Sleep time and efficiency were similar.   Conclusion:  ASV-Advanced treats central SDB as effectively as ASV in patients with CHF.
Prognostic factors and survival in malignant pleural mesothelioma
Authors: T Van Gelder, RA Damhuis, HC Hoogsteden
Journal: European Respiratory Journal (1994)

Malignant pleural mesothelioma is a lethal disease and little is known about prognostic factors. The prognostic significance of age, stage of disease, gender and histological subtype was studied in 167 new cases of cytologically (15%) or histologically (85%) proven malignant pleural mesothelioma in the Rotterdam area, during the period 1987-1989. Median survival of all patients was 242 days. Univariate analysis identified age, stage and histopathological subtype as significant prognostic factors, which was confirmed in multivariate analysis. Median survival rates for patients < 65, 65-74 and > or = 75 yrs were 359, 242 and 131 days, respectively. Patients with Stage I disease had a median survival of 359 days compared to 147 and 112 days, respectively, for patients with Stage II and the combination of Stages III and IV. Mixed histopathological subtype (190 days) was less favourable than sarcomatous (207 days) and epithelial (252 days) subtypes. Using a Cox proportional hazard model in patients with malignant pleural mesothelioma, age, histological subtype and stage were identified as independent prognostic factors. These prognostic factors should be taken into account when starting or evaluating treatment studies.
Identification of a second locus for progressive intrahepatic familial cholestasis on chromosome 2q24.
Authors: RJ Thompson, Etienne Sokal, SS Strautnieks, AF Kagalwalla, Tanner, AS Knisely, LN Bull, NB Freimer, SA Kocoshis, N Dahl, H Arnell, RM Gardiner
Journal: Hepatology (1997)
Fiber Content of the Fornix in Schizophrenia: Lack of Evidence for a Primary Limbic Encephalopathy
Authors: Steven A. Chance, J. Robin Highley, Margaret M. Esiri, Timothy J. Crow
Journal: American Journal of Psychiatry (1999)

OBJECTIVE: There have been claims that schizophrenia is a disease of the limbic circuit and that the volume of the hippocampus and its content of neurons are low in schizophrenia. The fornix is a major pathway through which neurons project to and from the hippo­campus. The authors investigated whether the fiber number or structure of the fornix is abnormal in schizophrenia, as was suggested by an earlier MRI study. METHOD: A section of fornix was removed from each hemisphere of postmortem brains of 16 male and 13 female schizophrenic patients and a comparison group of 19 men and 14 women. Cross-sectional area, fiber density, and total fiber number were examined for differences between diagnostic groups and between genders. RESULTS: The men had a lower fiber density in the fornix than the women. Fiber density on the left side was greater in the schizophrenic men than in the comparison men. For total fiber number (density multiplied by area) there were no differences between groups. Density was found to decrease with increasing area, suggesting that these measures may be affected by degree of myelination. CONCLUSIONS: The fornix does not show the abnormalities in cross-sectional area or total fiber number that would be expected if the primary impact of schizophrenia is on the hippocampus and limbic system. The greater density on the left in schizophrenic men suggests an effect of schizophrenia on myelination related to sex and asymmetry, which may reflect one aspect of a global delay in brain development.
"Chest pain---please admit": is there an alternative?
Authors: S. Capewell
Journal: BMJ (2000)

The approach to teaching employed in the Dictionary of Medical Ethics (1) provides a model which might be adopted in other media. Most of the 150 authors were medical, but many represented other disciplines, and they wrote for similar professionals and for the general public. Medical ethics is derived from medical science and practice, moral philosophy, sociology, theology, the law and other disciplines, all of which make essential, distinctive and complementary contributions to knowledge and to teaching. Medical practitioners must play the primary role, because they are responsible for clinical ethical decisions, but they need the co-operation and guidance of others. All who are concerned should work towards the development of a general moral consensus among the profession and public, which keeps abreast of scientific and technical advances and to which all are committed.
A reevaluation of nonhormonal cytotoxic chemotherapy in the treatment of prostatic carcinoma.
Authors: M A Eisenberger, R Simon, P J O'Dwyer, R E Wittes, M A Friedman
Journal: Journal of Clinical Oncology (1985)

The palliative role of nonhormonal cytotoxic chemotherapy in the treatment of endocrine-resistant prostatic carcinoma has not been established. Conventional means of quantifying tumor response are most frequently not applicable in this disease because of the lack of measurable objective parameters to allow for a reliable estimation of antitumor effects. While this problem is not unique to prostatic carcinoma, this review illustrates its magnitude in this disease. Only approximately 5% of patients studied fulfill the various criteria for complete response (CR), partial response (PR), or both, while the vast majority of patients reported as responders are actually in the stable disease category. Stable disease is highly questionable as an indicator of antitumor response and should not be used as a criterion for response in conventional phase II studies unless it is convincingly demonstrated that it occurs as a result of treatment. A study design that may allow a more reliable assessment of the value of the stable disease category is described in the text. More effective means for assessing tumor responses and better instruments to measure aspects of quality of life are needed. Review of several prospective randomized clinical trials showed that no treatment program tested during the last decade resulted in a survival advantage when compared with a concurrently treated control group. Furthermore, in two such trials, four different single chemotherapeutic agents widely used in the treatment of this disease (cyclophosphamide, 5-fluorouracil, estramustine phosphate, and streptozocin) either alone or in combination, did not produce any prolongation of survival when compared to a no chemotherapy (standard treatment) control arm. Survival curves for endocrine-resistant patients fall within a relatively narrow and possibly predictable range that may be used as an additional endpoint in conjunction with response (CRs and PRs only) in phase II trials. More definitive evidence of therapeutic efficacy in this disease should derive from phase III trials using survival as one of the major endpoints. Because of the poor results observed with chemotherapy thus far, we suggest that the appropriate control arm for phase III testing in endocrine-resistant patients continues to be a no chemotherapy control arm consisting of a best symptomatic care or a uniformly applied second-line endocrine manipulation.
Cephalosporin and fluoroquinolone combinations are highly associated with CTX-M β-lactamase-producing Escherichia coli: a case–control study in a French teaching hospital
Authors: P. Cassier, S. Lallechère, S. Aho, K. Astruc, C. Neuwirth, L. Piroth, P. Chavanet
Journal: Clinical Microbiology and Infection (2010)
RAINBOW: A global, phase III, randomized, double-blind study of ramucirumab (RAM) plus paclitaxel (PTX) versus placebo (PL) plus PTX in the treatment of metastatic gastroesophageal junction and gastric adenocarcinoma (mGC) following disease progression on first-line platinum- and fluoropyrimidine-containing combination therapy—Efficacy analysis in Japanese and Western patients.
Authors: Shuichi Hironaka, Yasuhiro Shimada, Naotoshi Sugimoto, Yoshito Komatsu, Tomohiro Nishina, Kensei Yamaguchi, Yoshihiko Segawa, Yasushi Omuro, Takao Tamura, Toshihiko Doi, Seigo Yukisawa, Hirofumi Yasui, Fumio Nagashima, Masahiro Gotoh, Taito Esaki, Michael Emig, Kumari Chandrawansa, Kei Muro, Hansjochen Wilke, Atsushi Ohtsu
Journal: Journal of Clinical Oncology (2014)

4005 Background: RAINBOW, a global phase III trial, demonstrated significant improvements in overall survival (OS), progression-free survival (PFS), and objective response rate (ORR) in patients (pts) with mGC receiving RAM, a human IgG1 VEGF-receptor-2 targeted antibody, plus PTX compared with PL plus PTX. In global trials for mGC, regional differences in survival outcomes have been reported. Here, we analyzed clinical outcomes of Japanese (JP) pts and Western (Europe, US, Australia) pts. Methods: Eligibility included Eastern Cooperative Oncology Group performance status ≤1, adequate organ function, and disease progression during or within 4 months of the last dose of first-line therapy. OS and PFS were compared using a stratified log-rank test. ORR was analyzed using a Cochran-Mantel-Haenszel test. Results: Of 665 patients randomized worldwide, 140 were JP pts and 398 were Western pts. Efficacy results are shown in the Table. Conclusions: Benefit was seen in PFS, ORR, and the 6-mos OS rate in the JP population, which was consistent with the Western population. Prolonged post-progression survival in JP pts may be due to higher use of post-discontinuation treatment (PDT) and may have masked the potential OS benefit. Clinical trial information: NCT01170663. Japanese Western RAM+PTX n=68 PL+PTX n=72 RAM+PTX n=198 PL+PTX n=200 mPFS, mos 5.6 2.8 4.2 2.8 HR, 95% CI 0.503 (0.348-0.728) P=0.0002 0.631 (0.506-0.786) P<0.0001 mOS, mos 11.4 11.5 8.6 5.9 HR, 95% CI 0.880 (0.603-1.284) P=0.5113 0.726 (0.580-0.909) P=0.0050 6-mos OS, % 94.1 71.4 66.0 49.0 12-mos OS, % 47.1 48.6 34.8 21.7 Post-progression survival (mOS – mPFS), mos 5.8 8.7 4.4 3.1 ORR, % 41 19 27 13 Odds ratio, 95% CI 3.29 (1.46-7.44) P=0.0035 2.51 (1.49-4.23) P=0.0004 PDT, % 75 75 38 36 Pts w/o PDT, n 17 18 122 128 mOS, mos 9.6 4.3 5.6 4.1 HR, 95% CI 0.338 (0.124-0.922) P=0.0298 0.685 (0.518-0.906) P=0.0076 Abbreviations: CI, confidence interval; HR, hazard ratio; m, median; mos, months; PDT, postdiscontinuation therapy.
Expert criticises report that said UK's maternal death rate was twice that of Belarus
Authors: N. Hawkes
Journal: BMJ (2015)

The charity Save the Children has found in a report that women in the United Kingdom are more than twice as likely to die in pregnancy and childbirth as those in Poland or Belarus.1 The claim was reported in all major British newspapers, and the Scotsman devoted a leader to the subject, under the title A shocking indictment. 

Jasmine Whitbread, chief executive of Save the Children International, said, “We urgently need to close the gap in life chances for mothers and children so that no matter where they live, everyone has a fair chance to survive and fulfil their potential.”

The source for the charity’s data was a report by United Nations agencies and the World Bank called Trends in Maternal Mortality: 1990-2013 ,2 which was an authoritative attempt to measure maternal deaths across the world. It showed huge gaps …
β-arrestin 2 regulates Aβ generation and γ-secretase activity in Alzheimer's disease
Authors: Amantha Thathiah, Katrien Horré, An Snellinx, Elke Vandewyer, Yunhong Huang, Marta Ciesielska, Gerdien De Kloe, Sebastian Munck, Bart De Strooper
Journal: Nature Medicine (2012)
Right lung ischemia induces development of contra-lateral pulmonary vasculopathy
Authors: Edouard Sage, Olaf Mercier, Philippe Dartevelle, Saadia Eddahibi, Elie Fadel
Journal: European Respiratory Journal (2011)

Chronic thromboembolic pulmonary hypertension is due to mechanical obstruction by unresolved clots and vasculopathy in the non obstructed vascular lung regions. We tested whether flow induced vascular lesions or endocrine factors released by the ischemic lung account for development of vasculopathy in non obstructed regions.  3 groups of 5 piglets were studied 5 weeks after right pulmonary artery (PA) ligation (PAL group), right pneumonectomy (RP group) or right PA dissection (Sham group). We measured pulmonary vascular resistance, pulmonary arterial vasoreactivity and morphometry, and quantified gene expression of factors involved in vascular smooth muscle cell proliferation IGF, PDGF, VEGF and endothelium-dependent vasoreactivity pathways ET-1, ETAr, ETBr and eNOS.  As compared to RP, PAL animals developed pulmonary vasculopathy in the left lung as assessed by increase in pulmonary vascular resistances (p=0.0006), medial hypertrophy of the distal PA (p  Pulmonary vasculopathy is absent in the remaining lung 5 weeks after pneumonectomy and developed in the non obstructed pulmonary territories 5 weeks after right PA ligation suggesting that factors released by the ischemic lung induced vascular remodelling in the contra-lateral lung. This endocrine regulation might implicate release of factors involved in vascular smooth muscle cell proliferation.
Public acceptance of smoking ban in Greece
Authors: Eythymios Zervas, Nikolaos Papandonis, Dimos Fotopoulos, Eleni Litsiou, Eleni Ischaki, Spyridon Zakynthinos, Paraskevi Katsaounou
Journal: European Respiratory Journal (2014)

INTRODUCTION: Unlike most countries smoking ban in closed public places in Greece has been ineffective since its enactment in 2009.  AIM: This study aims to assess the degree of public acceptance of the recent smoking ban in Greece and analyze the parameters influencing its acceptance.  METHODS: This research is based on 540 valid questionnaires collected between February and April 2011 in Athens area and suburbs. Respondents have been chosen as a representative human sample from the last census of Greece.  Statistical analysis was initially based on the mean values of the responses concerning smoking habits and opinions about smoking ban. Comparison of responses and correlation with respondents9 personal data have been made.  RESULTS:  • 42% of the respondents were smokers with 20% among them being highly addicted (FTND: Fangestrom Test Of Nicotine Dependence).  • 65% of the respondents agree with a smoking ban in all closed public places.  • 50% believe that smoking restrictions could not be sustainably implemented.  • 66% consider that the smoking ban will not have an impact on the overall number of cigarettes that is consumed.  • 65% do not consider smoking ban as a social discrimination against smokers.  • 75% consider that smoking ban will have an impact on entertainment.  The degree of acceptance of smoking restrictions is:  o Lower in smokers compared to non-smokers  o Correlates with smokers9s addiction.  o Higher in high educated respondents.  CONCLUSIONS:  There is a high willingness, in the Greek society (smokers included) to accept reinforced smoking ban in designated public places. However, the lack of robustness in the governmental policy is an inhibitor to effective implementation of targeted measures.
Very-high-dose cisplatin and etoposide in children with untreated advanced neuroblastoma.
Authors: O Hartmann, C R Pinkerton, T Philip, J M Zucker, F Breatnach
Journal: Journal of Clinical Oncology (1988)

Between January and December 1985, 17 children with advanced neuroblastoma who were greater than 1 year old (16 stage IV, one stage III) were administered cisplatin (CPDD, 200 mg/m2) and etoposide (VP-16, 500 mg/m2) as a pilot study of toxicity and response rates for the European Neuroblastoma Study Group (ENSG). The study was designed to assess toxicity of two courses of treatment, and evaluate response rates after this short therapy. The creatinine clearance declined in seven of 15 patients. No patient experienced clinically significant hearing loss, but formal audiometric assessment of nine children revealed characteristic high tone loss in seven patients. Peripheral neuropathy was not seen. Asymptomatic hypomagnesemia (less than 0.7 microEq/L) was frequent, despite routine supplementation. Asymptomatic electrolyte imbalances occurred frequently, but were generally transient. Myelosuppression was severe, but brief. Seven patients required platelet transfusions and seven were readmitted between courses due to febrile episodes while neutropenic. There were no treatment-related deaths. According to strictly defined criteria, 12 of 17 patients showed a partial response (PR), and extensive marrow evaluation showed complete clearing of disease in six of 15 patients. This high-dose regimen, if carefully supervised, is associated with acceptable toxicity, comparable to that seen when the dose of CPDD is spread over several months. The rapidity and degree of response was encouraging and merits further evaluation.