tbuckley/cabot-search huggingface dataset:
Abstract 828: Serum Midkine Predicts Cardiac Events in Chronic Heart Failure Patients
Authors: Tatsuro Kitahara, Yasuchika Takeishi, Tetsuro Shishido, Tetsu Watanabe, Joji Nitoube, Takuya Miyamoto, Takehiko Miyashita, Satoshi Nishiyama, Isao Kubota
Journal: Circulation (2008)

Midkine (MK), a heparin-binding growth factor, has various functions such as migration of inflammatory cell and anti-apoptotic effect. Invasion of inflammatory cells and cardiomyocyte apoptosis are involved in development and progression of heart failure (HF). However, relationship between MK and HF has not been previously examined. Therefore, we examined clinical significance of serum MK levels to determine the prognosis of HF patients. Serum levels of MK were measured at admission in 216 consecutive patients hospitalized for chronic HF and 60 control subjects. Patients were prospectively followed during a median follow-up period of 658 days with the end points of cardiac death and progressive HF requiring re-hospitalization. Serum concentrations of MK were significantly higher in patients with HF than in controls and increased as NYHA functional class rose (fig 1 ). There were 74 cardiac events, including 30 cardiac deaths and 44 re-hospitalization for HF during follow-up period. Patients with cardiac events had significantly higher concentrations of MK than those without cardiac events (539 ± 57 pg/ml vs. 331 ± 17 pg/ml, P &lt; 0.01). Patients were divided into 4 groups based on midkine levels. Risk of cardiac events increased as MK levels rose (fig 2 ). In addition, the Cox multivariate hazard analysis showed that MK was an independent predictor of cardiac events (hazard ratio 1.280, 95% CI 1.027–1.578, P&lt;0.05). Serum MK level is increased in HF patients, and MK is a novel marker for risk stratifying chronic HF patients. Figure 1. Serum Midkine Levels in Study Population Figure 2. Quartile Analysis of Serum Midkine Levels and Relative Risk for All Cardiac Events
Sequential Dose-Intensive Paclitaxel, Ifosfamide, Carboplatin, and Etoposide Salvage Therapy for Germ Cell Tumor Patients
Authors: Robert J. Motzer, Madhu Mazumdar, Joel Sheinfeld, Dean F. Bajorin, Homer A. Macapinlac, Manjit Bains, Lilian Reich, Carlos Flombaum, Tania Mariani, William P. Tong, George J. Bosl
Journal: Journal of Clinical Oncology (2000)

PURPOSE: To evaluate the efficacy and toxicity of sequential, dose-intensified chemotherapy with paclitaxel/ifosfamide and carboplatin/etoposide administered plus peripheral blood–derived stem-cell (PBSC) support for patients with germ cell tumors (GCT) who have unfavorable prognostic features in response to conventional-dose salvage programs. Carboplatin was dose escalated by target area under the curve (AUC; in [milligrams per milliliter] × minutes) among patient cohorts, and pharmacokinetic studies were performed for comparison. PATIENTS AND METHODS: Thirty-seven previously treated patients who had cisplatin-resistant GCT and unfavorable prognostic features for response to conventional-dose salvage therapy were treated. Two cycles of paclitaxel 200 mg/m 2 plus ifosfamide 6 g/m 2 were given 2 weeks apart with leukapheresis, followed by three cycles of carboplatin plus etoposide given 14 to 21 days apart with reinfusion of PBSCs. The dose of etoposide was 1,200 mg/m 2 , and the carboplatin target AUC ranged among cohorts from 12 to 32 (mg/mL) × min. Pharmacokinetic studies of carboplatin were performed for comparison of target to measured AUC. RESULTS: Twenty-one patients (57%) achieved a complete response and an additional two patients (5%) achieved a partial response with normal tumor markers; therefore, 23 (62%) achieved a favorable response. Eight patients relapsed, and 15 (41%) of the favorable responses remained durable at a median follow-up of 30 months. Myelosuppression was the major toxicity; 58% of carboplatin/etoposide cycles were associated with hospitalization for nadir fever. The AUC of carboplatin measured in serum was lower than the target AUC; this may be related to underestimation of the glomerular filtration rate used in the dosing formula. CONCLUSION: Dose-intense therapy with sequential, accelerated chemotherapy of paclitaxel/ifosfamide and carboplatin/etoposide administered with PBSC support was relatively well tolerated. The durable complete response proportion was substantial in patients with unfavorable prognostic features for achieving durable complete response to conventional-dose salvage programs. Optimal dosing of carboplatin in the high-dose setting warrants further investigation.
Right Ventricular Failure Following Chronic Pressure Overload Is Associated With Reduction in Left Ventricular Mass
Authors: Maxim Hardziyenka, Maria E. Campian, Herre J. Reesink, Sulaiman Surie, Berto J. Bouma, Maarten Groenink, Christine A. Klemens, Leander Beekman, Carol A. Remme, Paul Bresser, Hanno L. Tan
Journal: Journal of the American College of Cardiology (2011)
Benefit of autologous bone marrow transplantation over sequential chemotherapy in poor-risk aggressive non-Hodgkin's lymphoma: updated results of the prospective study LNH87-2. Groupe d'Etude des Lymphomes de l'Adulte.
Authors: C Haioun, E Lepage, C Gisselbrecht, Y Bastion, B Coiffier, P Brice, A Bosly, B Dupriez, C Nouvel, H Tilly, P Lederlin, P Biron, J Brière, P Gaulard, F Reyes
Journal: Journal of Clinical Oncology (1997)

PURPOSE To update the randomized study that compared consolidative sequential treatment (ifosfamide, etoposide, asporaginase, and cytarabine) versus the high-dose regimen of cyclophosphamide, carmustine, and etoposide (CBV) followed by autotransplantation in patients with aggressive non-Hodgkin's lymphoma in first complete remission and to focus on high-intermediate and high-risk patients identified by the international prognostic index. PATIENTS AND METHODS Nine hundred sixteen patients received induction treatment on the LNH84 protocol with open randomization for the anthracycline. In a subsequent randomization, 541 patients in complete remission were assigned to receive consolidation by either sequential chemotherapy (n = 273) or autotransplant (n = 268). Among the higher risk population (two or three risk factors), 236 patients in complete remission were assessable for the consolidation phase, with 111 in the sequential chemotherapy arm and 125 in the autotransplant arm. RESULTS Among 541 randomized patients, disease-free survival and survival did not differ significantly between the two consolidative treatment arms. In the higher risk population, CBV was superior to sequential chemotherapy, with 5-year disease-free survival rates of 59% (95% confidence interval, 49% to 69%) and 39% (95% confidence interval, 28% to 50%), respectively (P = .01, relative risk = 1.19). The 5-year survival rate was superior in the CBV group at 65% (95% confidence interval, 56% to 74%) compared with 52% in the sequential chemotherapy group (95% confidence interval, 42% to 62%) (P = .06, relative risk = 1.49). CONCLUSION This study shows a superior disease-free survival for higher risk patients in complete remission. Dose-intensive consolidation therapy should be considered for patients at higher risk who achieve complete remission after induction treatment.
Vital prognosis in intrathoracic sarcoidosis with special reference to pulmonary function and radiological stage
Authors: K Viskum, J Vestbo
Journal: European Respiratory Journal (1993)

A follow-up of 254 patients with intrathoracic sarcoidosis has been carried out after a median of 27 yrs from the diagnostic admission. All patients could be traced. At the end of follow-up there was no excess mortality (80 deaths observed versus 65.5 expected). However, during the first 20 yrs of follow-up a slight excess mortality was seen. Thirty three out of the 80 deaths were related to sarcoidosis. No excess number of deaths from lung cancer or lymphoma was observed. Erythema nodosum was of no prognostic significance concerning survival. X-ray stage was related to survival with a significant excess mortality for stage 3. Early clearing of X-ray changes gave a favourable vital prognosis. Survival was related to lung function, and for forced expiratory volume in one second (FEV1), FEV1/forced vital capacity (FVC) index and total lung capacity (TLC) this relationship reached levels of statistical significance. In multivariate Cox regression models, with age and sex entered as covariates, the same parameters were found to be significant predictors of mortality. Patients with FEV1 &lt; or = 50% predicted had an increased mortality risk of 4.2 (95% confidence interval 1.8-9.6) when compared to patients with FEV1 &gt; 80% predicted. Likewise, patients with TLC &lt; or = 80% predicted had a mortality risk of 2.6 (1.5-4.5) when compared to patients with TLC &gt; 80% predicted. In conclusion, a modest excess mortality was observed during the first 20 yrs of follow-up. Furthermore, both X-ray staging and lung function at the time of diagnosis influenced long-term mortality in patients with intrathoracic sarcoidosis.
The Futility of Arguing About Medical Futility in Anorexia Nervosa: The Question Is How Would You Handle Highly Specific Circumstances?
Authors: Joel Yager
Journal: The American Journal of Bioethics (2015)

Dr. Geppert (2015) is to be commended for thoughtfully presenting the challenging considerations of “medical futility” in the treatment of cases of severe and enduring anorexia nervosa, and I'm hap...
The role of increased pulmonary blood flow in pulmonary arterial hypertension
Authors: M. E. van Albada, R. G. Schoemaker, M. S. Kemna, A. H. Cromme-Dijkhuis, R. van Veghel, R. M. F. Berger
Journal: European Respiratory Journal (2005)

Chronic increased pulmonary blood flow is considered a pre-requisite for the induction of advanced vascular lesions in pulmonary arterial hypertension in congenital heart defects. The aim of the present study was to characterise the effects of increased pulmonary flow induced by an aortocaval shunt in the monocrotaline rat model for pulmonary hypertension in terms of survival, haemodynamics, pathology and histology. Male Wistar rats were injected with monocrotaline followed by the creation of an abdominal aortocaval shunt. Animals were sacrificed when displaying symptoms of weight loss or dyspnoea, 4-5 weeks after the creation of the shunt. Echocardiography identified increased ventricular dimensions in shunted rats and right ventricular hypertrophy in monocrotaline-treated rats. At similar pulmonary artery pressures, shunted monocrotaline rats displayed higher morbidity and mortality, increased pulmonary-to-systemic artery pressure ratios and increased right ventricular hypertrophy compared with nonshunted monocrotaline rats. Histological assessment demonstrated increased number and diameter of pre-acinar pulmonary arteries. Intra-acinar vessel remodelling and occlusion occurred to a similar extent in shunted and nonshunted monocrotaline rats. In conclusion, increased pulmonary blood flow in monocrotaline-induced pulmonary hypertension is associated with increased morbidity, mortality, and unfavourable haemodynamic and cardiac effects. These effects could be attributed to more pronounced right heart failure rather than to altered intra-acinar pulmonary vessel remodelling.
The budesonide/formoterol inhaler as maintenance and reliever therapy in Maori asthmatics
Authors: Janine Pilcher, Mitesh Patel, Ann Smith, Cheryl Davies, Justin Travers, Mark Weatherall, Richard Beasley, Matire Harwood
Journal: European Respiratory Journal (2013)

Introduction:  As the SMART regimen (combination budesonide/formoterol inhaler for maintenance and relief) may have a favourable risk/benefit profile in asthma, it may confer specific benefits for ethnic groups with a disproportionate burden of disease, such as Maori (the indigenous population of New Zealand).  Aim:  To investigate outcomes for Maori versus non-Maori in a randomised controlled trial (RCT) investigating the SMART regimen.  Methods:  In a multicentre 24 week RCT in 303 adult asthma patients (including 44 Maori), electronic inhaler monitoring data and clinical outcomes were analysed in patients randomised to SMART or a Standard (combination budesonide/formoterol inhaler for maintenance and salbutamol for relief) regimen. Differences in Maori versus non-Maori were analysed via an interaction term for ethnicity.  Results:  With adjustment for ethnicity, SMART resulted in improvement in the following outcomes: days of high inhaler use (>12 actuations/day of budesonide/formoterol in SMART or >16 actuations/day of salbutamol for Standard) (Relative Rate (95%CI) 0.57(0.38-0.85)), days of maintenance inhaler non-adherence, days of high inhaler use without medical review and number of severe exacerbations. The benefits of SMART were similar in magnitude for Maori and non-Maori. Independent of treatment regimen, Maori had increased rates of high inhaler use, inhaler non adherence and high inhaler use without medical review.  Conclusions:  The SMART regimen has favourable outcomes in Maori with asthma, which may be generalisable to other ethnic populations with increased asthma burden.  Funding:  Health Research Council of New Zealand.
Prevention of monocrotaline-induced pulmonary vascular and myocardial remodeling by the selective neutrophil elastase inhibitor BAY 85-8501
Authors: Martina Delbeck, Volkhart Li, Franz Von Nussbaum, Daniel Meibom, Stefan Golz, Klemens Lustig, Hubert Truebel, Stefan Schaefer
Journal: European Respiratory Journal (2014)

Excess of neutrophil elastase activity has been implicated in the pathogenesis of pulmonary arterial hypertension (PAH). Neutrophil elastase acts as a mediator of tissue remodeling by degradation of extracellular matrix (ECM) structures, the release of growth factors, and increased deposition of ECM proteins such as tenascin-C, which amplify the proliferative response to growth factors.  We therefore investigated the novel selective neutrophil elastase inhibitor BAY 85-8501 in a rat model of PAH. Four weeks after a single subcutaneous injection of monocrotaline (MCT), rats displayed severely elevated right ventricular (RV) systolic pressure and marked RV hypertrophy and dysfunction with a concomitant increase in RV remodeling (e.g tenascin-C, Osteopontin) markers. Furthermore there was an increase in lung Osteopontin, TIMP-1 and IL-8 expression. Treatment with BAY 85-8501 from day 14-28 significantly reduced RV pressure and RV hypertrophy with an improvement of RV dysfunction. Furthermore, BAY 85-8501 significantly reduced lung as well as RV remodeling markers.  Conclusion: MCT-induced PAH is linked to upregulation of enhancers of matrix production and endothelial and smooth muscle cell proliferation. Selective inhibition of neutrophil elastase by BAY 85-8501 significantly improves these biomarkers, indicating substantial anti-remodeling and anti-inflammatory effects.
Long-term follow-up of a phase III intergroup study of cisplatin alone or in combination with methotrexate, vinblastine, and doxorubicin in patients with metastatic urothelial carcinoma: a cooperative group study.
Authors: S B Saxman, K J Propert, L H Einhorn, E D Crawford, I Tannock, D Raghavan, P J Loehrer, D Trump
Journal: Journal of Clinical Oncology (1997)

PURPOSE A previously reported randomized intergroup trial demonstrated that combination chemotherapy with methotrexate, vinblastine, doxorubicin, and cisplatin (M-VAC) was superior to single-agent cisplatin in patients with advanced urothelial carcinoma. We conducted a long-term analysis of patients included in the intergroup trial to examine factors associated with long-term survival. PATIENTS AND METHODS Two-hundred fifty-five assessable patients with urothelial carcinoma were randomized to receive either single-agent cisplatin (70 mg/m2 on day 1) or combination chemotherapy with methotrexate (30 mg/m2 on days 1, 15, and 22), vinblastine (3 mg/m2 on days 2, 15, and 22), doxorubicin (30 mg/m2 on day 2), and cisplatin (70 mg/m2 on day 2). Courses were repeated every 28 days. The association between patient characteristics and survival was assessed using Cox proportional hazards models. RESULTS With long-term follow-up evaluation, survival in the M-VAC arm continues to be superior to cisplatin (P = .00015, log-rank test). Predictors of survival include performance status, histology, and the presence of liver or bone metastasis. Only 3.7% of the patients randomized to M-VAC are alive and continuously disease-free at 6 years. CONCLUSION Long-term follow-up evaluation of the intergroup trial confirms that M-VAC is superior to single-agent cisplatin in patients with advanced urothelial carcinoma; however, durable progression-free survival is rare. Patients with non-transitional-cell histology, poor performance status, and/or bone or visceral involvement fare poorly and are unlikely to benefit significantly from M-VAC chemotherapy.
Counseling and Interventions to Prevent Tobacco Use and Tobacco-Caused Disease in Adults and Pregnant Women: U.S. Preventive Services Task Force Reaffirmation Recommendation Statement
Journal: Annals of Internal Medicine (2009)

Description: Reaffirmation of the 2003 U.S. Preventive Services Task Force (USPSTF) recommendation on counseling to prevent tobacco use. Methods: The USPSTF reviewed new evidence in the U.S. Public Health Service's 2008 clinical practice guideline and determined that the net benefits of tobacco cessation interventions in adults and pregnant women remain well established. Recommendations: Ask all adults about tobacco use and provide tobacco cessation interventions for those who use tobacco products. (Grade A recommendation) Ask all pregnant women about tobacco use and provide augmented, pregnancy-tailored counseling for those who smoke. (Grade A recommendation)
Glycaemia as an outcome predictor in respiratory failure due to COPD exacerbation in an intensive care unit
Authors: Ana Tavares e Castro, Carina Gaspar, Luis Telo, Filipe Froes, Fernanda Paula
Journal: European Respiratory Journal (2013)

Rationale: Hyperglycaemia has been associated with poor outcomes during non-invasive ventilation in severe Chronic Obstructive Pulmonary Disease Acute Exacerbation (COPDAE).

Aim: Ascertain hyperglycaemia as an outcome predictor of COPDAE requiring IMV in an ICU.

Methods: Patients admitted to Pulido Valente’s Hospital Respiratory ICU over a period of 7 years for COPDAE demanding IMV were retrospectively accessed and analyzed. Random blood glucose levels were determined within the last 24h prior to IMV. Hyperglycaemia was defined as ≥126mg/dL. Poor outcome was defined as death, permanent tracheostomy or need to reintubate.

Results: A total of 89 patients (median±IQR, 70.0±15 years, 83.3% men) with COPDAE (median baseline FEV1 34.5±26.5% of predicted) were invasively ventilated due to respiratory failure (median pH 7.25±0.13, median PaO2/FiO2 103.0±143.0). Median BMI was 24.0±6.0 kg/m2, 15.7% of the patients were under systemic corticosteroids and 20.2% were diabetic. Median blood glucose level was 128.0±50.0 mg/dL. Hyperglycaemia was not significantly correlated to the APACHE score, respiratory failure severity, systemic corticotherapy or BMI. Also, hyperglycaemia and poor outcome did not show a significant correlation (p 200mg/dL (p=0.1).

Conclusions: Hyperglycaemia did not predict a poor outcome in respiratory failure due to COPDAE. However, data from a small sample retrospectively collected and blood glucose levels randomly determined may have misled the results. Further studies are needed to elucidate the positive trend between hyperglycaemia and mortality.
Abstract 1985: Increased Plaque Mass, but not Relative Plaque Composition, Distinguishes Culprit Coronary Artery Lesions in Patients with Acute Coronary Syndrome: A Lesion Analysis by Intravascular Ultrasound Histology
Authors: Andrew Frutkin, Sameer K Mehta, Justin R McCrary, John House, Steven P Marso
Journal: Circulation (2007)

INTRODUCTION Intravascular ultrasound Virtual Histology (IVUS-VH) uses radiofrequency analysis to measure coronary artery plaque geometry and classify plaque components into one of four categories: fibrous, fibrofatty, necrotic or calcified. We hypothesized that patients with acute coronary artery syndrome (ACS) would have atherosclerotic plaque geometry and composition that differs from patients with stable, obstructive coronary artery disease. METHODS In a crossectional study we used IVUS-VH to image 38 culprit lesions of 28 ACS patients and 104 lesions of 71 non-ACS patients prior to intervention. In both ACS and non-ACS patients, culprit lesions were defined as the site of percutaneous coronary intervention with at least 3 contiguous frames of &gt; 40% percent plaque burden (100 × [external elastic membrane (EEM ) area − lumen area]/EEM area ) and a neointimal thickness &gt; 600 um subtending an arc of &gt; 10% vessel circumference. Plaque geometry and composition were measured with IVUS-VH software (pcVH v.2.2, Volcano Corp). A remodeling index was calculated as the ratio of the EEM area at the frame of the minimal lumen area to the EEM area of a reference frame (within 10 mm of MLA). RESULTS Lesions of ACS patients were longer and had greater plaque volume than non-ACS patients (Table ). The proportions of IVUS-derived plaque components were similar in both ACS and non-ACS culprit lesions (Table ). CONCLUSION Culprit coronary artery lesions in ACS patients have greater plaque mass than in non-ACS patients, but relative plaque composition is similar between these patient populations. Measurements of atherosclerotic plaque mass may discriminate better than plaque composition as to which patients with severe, obstructive coronary artery disease are at greatest risk of coronary artery thrombosis. Longitudinal studies using IVUS-VH will best resolve which IVUS-VH measurements of plaque geometry and composition have greatest predictive value.
Local-regional failure in patients treated with adjuvant chemotherapy for breast cancer.
Authors: D Stefanik, R Goldberg, P Byrne, F Smith, W Ueno, L Smith, L Bachenheimer, C Beiser, A Dritschilo
Journal: Journal of Clinical Oncology (1985)

Risk factors for local-regional recurrence of breast cancer were analyzed in a retrospective review of 117 patients treated with adjuvant CMF (Cytoxan [Mead Johnson &amp; Co, Evansville, Ind], methotrexate, 5-fluorouracil) after radical or modified radical mastectomy at the Vincent T. Lombardi Comprehensive Cancer Center (Washington, DC). The median follow-up time was 50 months after mastectomy. The median time to recurrence was 23 months. The actuarial local-regional failure rate was 19% at five years. Risk of local failure correlated with size of primary (27% for T3 v 15% for T1) and axillary node status (36% for four or more positive nodes v 9% for three or fewer positive nodes). These findings suggest a rationale for the addition of postoperative radiation therapy in high-risk patients treated with adjuvant chemotherapy.
Rib fracture caused by coughing in a young patient
Authors: Safak Yildiz, Kuthan Kavakli
Journal: European Respiratory Journal (2012)

Introduction: 

A cough is a voluntary or involuntary explosive expiration that protects the lungs against aspiration and promotes the movement of secretions and other airway constituents upward toward the mouth. Rib fracture which is caused by coughing usually occurred due to underlying pathologic factors such as osteoporosis, renal failure, metastatic tumors. We presented a young patient with rib fracture caused by coughing.

Case Report: 

A 33- year old man has admitted with the complaint of immediate onset and localized left sided chest pain which was occurred due to coughing induced by upper airway infection. The history of patient was not significant and he had no injury to his chest. The crepitation and tenderness were determined on his physical examination. The thorax computed tomography was revealed a rib fracture on the left tenth rib. When we evaluate him for an endocrihnopathy, we did not find any abnormality. We decided that his rib fracture was occurred due to coughing.

![Figure][1] 



Conclusion: 

A rib fracture should be considered in mind in a patient who admitted with immediate onset and localized chest pain.

 [1]: pending:yes