tbuckley/cabot-search huggingface dataset:
Abstract 9683: Acetylcholine-Provoked Diffuse Coronary Spasm is Frequently Observed in Female Patients with Coronary Vasospastic Angina Without Severe Coronary Organic Stenosis
Authors: Koji Sato, Koichi Kaikita, Naoki Nakayama, Eiji Horio, Takamichi Ono, Keisuke Ohba, Kenichi Tsujita, Seiji Hokimoto, Hitoshi Sumida, Seigo Sugiyama, Hiroshige Yamabe, Hisao Ogawa
Journal: Circulation (2011)

Coronary Vasospastic angina (VSA) plays an important role in the pathogenesis of ischemic heart disease. However, the relation between angiographic variation of acetylcholine (ACh)-induced coronary spasm and clinical features in VSA patients is not well understood. We analyzed retrospectively angiographic appearance of coronary vasomotor response induced by ACh injection into left coronary artery (LACh) in 1760 consecutive patients who had rest angina-like chest pain between January 1991 and December 2010. Coronary spasm induced by LACh test was defined as a total or subtotal obstruction (focal spasm), or severe diffuse constriction (diffuse spasm) of left epicardial coronary artery associated with transient myocardial ischemia as evidenced by ischemic ST-segment changes on ECG. Of total 1760 patients, 754 (43%) patients were positive for LACh test on the basis of positive criteria (329 diffuse and 425 focal spasm). Patient characteristics were compared between LACh-positive and -negative groups. Rate of smoking, dyslipidemia, family history of ischemic heart disease (IHD), comorbidity of coronary organic stenosis, and myocardial lactate production were significantly higher in LACh-positive than negative groups (49.7% vs. 42.7%, p=0.005, 48.0% vs. 38.1%, p&lt;0.001, 16.2% vs. 9.6%, p&lt;0.001, 26.9% vs. 14.1%, p&lt;0.001, and 60.9% vs. 13.9%, p&lt;0.001, respectively). Next, we analyzed relation between angiographic variation of LACh-provoked coronary spasm and clinical features in VSA patients. Multiple logistic regression analysis revealed that female gender and low comorbidity rate of coronary organic stenosis were significantly associated with diffuse spasm subtype (OR 2.97; 95%CI: 1.90 to 4.66; p&lt;0.001, and OR 0.60; 95%CI: 0.40 to 0.89; p=0.012, respectively). In conclusions, ACh-provoked diffuse coronary spasm was frequently observed in female VSA patients without severe coronary organic stenosis. These results suggested that angiographic subtypes of ACh-provoked coronary spasm might have different clinical features in VSA patients, indicating the necessity of medical treatment suitable for each subtype of the ACh-provoked coronary spasm.
In atrial fibrillation treated with warfarin, intracranial hemorrhage was associated with ischemic events
Authors: Munther K. Homoud
Journal: Annals of Internal Medicine (2015)

Source Citation Brønnum Nielsen P, Larsen TB, Gorst-Rasmussen A, et al.Intracranial hemorrhage and subsequent ischemic stroke in patients with atrial fibrillation: a nationwide cohort study. Chest. 2015;147:1651-8. 25412369
A restricted clonal T-cell receptor αβ repertoire in Sézary syndrome is indicative of superantigenic stimulation
Authors: L. van der Fits, Y. Sandberg, N. Darzentas, W.H. Zoutman, D. Tielemans, I.L.M. Wolvers-Tettero, M.H. Vermeer, A.W. Langerak
Journal: British Journal of Dermatology (2011)

Sézary syndrome (SS) is a cutaneous T-cell lymphoma characterized by erythroderma, lymphadenopathy and malignant clonal T cells in the skin, lymph nodes and peripheral blood. A role for superantigens in the pathogenesis of SS has been postulated before.To investigate a putative involvement of chronic (super-)antigenic stimulation in driving T-cell expansion in SS.Antigenic specificity of the T-cell receptor (TCR) was assayed by molecular analysis of the TCRA (n=11) and TCRB (n=28) genes, followed by detailed in silico analysis.Sequence analysis of clonally rearranged TCRB genes showed over-representation of Vβ8, Vβ13, Vβ17, Vβ21 and Vβ22, and under-representation of Vβ2 and Jβ1.1 when compared with healthy controls. No similarity was detected in amino acid motifs of the complementarity determining region 3 (CDR3). Analysis of TCRA rearrangements showed that there was no common Vα or Jα gene usage, and that TCRA CDR3 amino acid motifs were not highly similar.The lack of clear stereotypic TCRA and TCRB CDR3 amino acid motifs would argue against involvement of a single common antigen in the pathogenesis of SS. Nevertheless, the skewing of Vβ and Jβ gene usage does seem to point to a restricted TCR repertoire, possibly as a result of superantigenic selection prior to neoplastic transformation.
Template-operated quantitative motor unit potential analysis in diaphragm of patients with myotonic dystrophy
Authors: Lea Leonardis, Simon Podnar
Journal: European Respiratory Journal (2014)

The diaphragm is the main inspiratory muscle. Template-operated quantitative motor unit potential (MUP) analysis (qEMG) has been shown to be useful in the diagnosis of myopathy in limb muscles. Diaphragmatic MUPs in a healthy population are much smaller than in limb muscles and due to the waxing and waning respiratory EMG pattern, MUP sampling is difficult.

The aim of our study was to evaluate feasibility and utility of the quantitative MUP analysis in the diagnosis of myopathy of the diaphragm.

qEMG of the diaphragm and the biceps brachii muscles, phrenic nerve conduction studies and respiratory function tests were performed in 30 patients with myotonic dystrophy (DM) type 1 (DM1) and 17 patients with DM type 2 (DM2). Findings in both disorders were compared to reference ranges and correlated with respiratory function studies.

Low diaphragm MUP amplitude precluded MUP analysis in 21% of DM1 patients. Only a single DM1 patient had qEMG findings consistent with myopathy. In this patient, and another 4 DM1 and 3 DM2 patients, findings consistent with neuropathy were demonstrated. By contrast, in the biceps brachii muscles of the same DM population, 67% of patients had MUPs consistent with myopathy. Phrenic compound motor action potential amplitudes correlated with respiratory function tests, whereas diaphragm MUP parameters did not.

Diaphragm myopathic MUPs are very small and as such they skip from qEMG analysis. Template-operated quantitative MUP analysis is therefore inadequate for sampling diaphragm MUPs in patients with DM.
Postnatal and Prenatal Transmission of the Bovine Leukemia Virus Under Natural Conditions&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: C E Piper, J F Ferrer, D A Abt, R R Marshak
Journal: JNCI Journal of the National Cancer Institute (1979)

Cattle in a well-characterized multiple-case leukemia herd (herd BF) were examined for bovine leukemia virus (BLY) infection and BLY antibodies from birth to adulthood. According to standard husbandry practices for dairy herds, the BF calves were separated from the adult herd after they were weaned up to the ages of 14–16 months. The results showed that after the age of 30 months all cattle in the herd were infected with BLY and had antiviral antibodies. However, only 18% of the BF calves were positive at birth and before their first colostral meal. Thus prenatal transmission of BLY was relatively infrequent. Several observations indicated that prenatal transmission occurred only through the placenta. After ingestion of colostrum and for the first 3–5 months of life, all the BF calves had passively acquired maternal antibodies to BLY. During this time and until the ages of 7–10 months, the incidence of BLY infection among the BF calves did not change significantly. Subsequently, the incidence increased rapidly, and when the calves reached 2 years of age, it was 93%. By contrast, BLY infection was detected in only 3 of 17 BF calves of similar ages that were virus-free at birth and kept in isolation after weaning from their BLY-infected dams. These data indicate that the large majority of the BF cattle were infected with BLY by contact following exposure to the adult herd and that, during the first weeks of life, they were protected against milk-borne or contact infection by passively acquired maternal antibodies. The results also indicate that BLY infection in cattle persisted despite the presence of actively produced or passively acquired BLY-neutralizing antibodies.
Methscopolamine Inhibition of Sleep-Related Growth Hormone Secretion
Authors: Wallace B. Mendelson, Natarajan Sitaram, Richard Jed Wyatt, J. Christian Gillin, Laurence S. Jacobs
Journal: Journal of Clinical Investigation (1978)

We have examined the effects of cholinergic blockade with 0.5 mg methscopolamine bromide, intramuscularly, on sleep-related and insulin-induced growth hormone (GH) secretion. 17 normal young men were studied; 8 had sleep studies, and 12 (including 3 who also had sleep studies) had insulin tolerance tests (ITT) with 0.1 U/kg of regular insulin. After an adjustment night in the sleep laboratory, saline control night and methscopolamine night studies were done in random sequence; study procedures included electroencephalographic, electromyographic, and electrooculographic recordings, and blood sampling every 20 min for hormone radioimmunoassays. Prolactin levels were also measured during sleep. For methscopolamine night studies, the mean overall control GH level of 2.89±0.44 ng/ml and the mean peak control GH level of 11.09±3.11 ng/ml were dramatically reduced to 0.75±0.01 and 1.04±0.25 ng/ml, respectively (P<0.0001 and <0.001). Despite virtual absence of GH secretion during the night in every study subject, no measured sleep characteristic was affected by methscopolamine, including total slow-wave sleep (12.1±2.6% control vs. 10.3±2.5% drug, P>0.2). Sleep prolactin levels were not changed by methscopolamine. In contrast to the abolition of sleep-related GH secretion, administration of methscopolamine had only a marginal effect on the GH response to insulin hypoglycemia. None of nine time points differed significantly, as was also the case with peak levels, mean increments, and areas under the curves (P>0.2). Analysis of variance did, however, indicate that the lower GH concentrations achieved during ITT after methscopolamine (average 31.7% below control) were significantly different than control concentrations. We conclude that the burst of GH secretion which normally occurs after sleep onset is primed by a cholinergic mechanism which does not influence slow-wave sleep. Cholinergic mechanisms do not appear to play an important role in sleep-related prolactin secretion. The contrast between the complete suppression of sleep-related GH release and the relatively small inhibitory effect on ITT-induced GH secretion suggests that the neurotransmitter mechanisms, and presumably the pathways, which subserve sleep-related GH secretion in man may be different from those which mediate the GH response to pharmacologic stimuli such as insulin.
Secondary leukemia following high cumulative doses of etoposide in patients treated for advanced germ cell tumors.
Authors: C Kollmannsberger, J Beyer, J P Droz, A Harstrick, J T Hartmann, P Biron, A Fléchon, P Schöffski, M Kuczyk, H J Schmoll, L Kanz, C Bokemeyer
Journal: Journal of Clinical Oncology (1998)

PURPOSE High cumulative epipodophyllotoxin dosages are reported to be associated with an elevated risk for secondary acute myeloid leukemia (s-AML). This study examined the risk of s-AML following cumulative etoposide doses greater than 2 g/m2 in patients with metastatic germ cell tumors (GCT). PATIENTS AND METHODS The incidence of s-AML was retrospectively assessed in patients treated within clinical trials between January 1986 and February 1996 at four university centers. All patients received high-dose chemotherapy (HDCT) plus autologous stem-cell support for metastatic GCT, including high cumulative etoposide doses (&gt; 2 g/m2). Minimum patient follow-up was 12 months. Standardized morbidity ratio (SMR) was calculated to estimate the risk associated with high cumulative etoposide doses, as compared with the general population. RESULTS A total of 302 patients with a median age of 29 years (range, 15 to 55) received a median cumulative etoposide dose of 5 g/m2 (range, 2.4 to 14 g/m2). Four cases of s-AML were observed, which resulted in a cumulative incidence of 1.3% (95% confidence interval [CI], 0.38% to 3.59%) at 52 months of median follow-up (range, 12 to 198). Two cases of secondary myelodysplasia (s-MDS) developed in patients with primary mediastinal GCT. Based on the observed four cases of AML, which are most likely etoposide-related, the risk for developing s-AML (SMR, 160 [95% CI, 43.7 to 411.2]) is significantly increased in comparison to the age-matched general population. CONCLUSION Due to the low incidence of AML in the general population, the significantly elevated risk for developing s-AML affects only 1.3% of all patients who receive etoposide doses greater than 2 g/m2. HDCT, including etoposide doses greater than 2 g/m2, is associated with an acceptably low incidence of s-AML in patients with advanced GCT.
Update on food allergy
Authors: A. Carrard, D. Rizzuti, C. Sokollik
Journal: Allergy (2015)

Abstract Food allergies are a global health issue with increasing prevalence. Allergic reactions can range from mild local symptoms to severe anaphylactic reactions. Significant progress has been made in diagnostic tools such as component‐resolved diagnostics and its impact on risk stratification as well as in therapeutic approaches including biologicals. However, a cure for food allergy has not yet been achieved and patients and their families are forced to alter eating habits and social engagements, impacting their quality of life. New technologies and improved in vitro and in vivo models will advance our knowledge of the pathogenesis of food allergies and multicenter‐multinational cohort studies will elucidate interactions between genetic background, lifestyle, and environmental factors. This review focuses on new insights and developments in the field of food allergy and summarizes recently published articles.
Specific characteristics of selfmanagement are associated with asthma control, quality of life and lung function
Authors: Thijs Beerthuizen, Jiska B. Snoeck, Johanna L. van Gaalen, Moira J. Bakker, Richard H. Osborne, Jacob K. Sont
Journal: European Respiratory Journal (2013)

Rationale: Web-based self-management support can improve asthma outcomes (Van der Meer, Ann Int Med, 2009) . However, it is unknown which self-management characteristics contribute to this improvement. We hypothesized that specific self-management characteristics are associated with asthma control, quality of life and lung function.

Methods: Asthma control (ACQ), asthma related quality of life (AQLQ) and lung function (FEV1 % pred) was assessed in 24 adults with doctor diagnosed asthma (>3 mo ICS prescribed in the past year). Self-management characteristics were assessed by using the de Health Education Impact Questionnaire (HeiQ), The association between these clinical outcomes and 8 domains of HeiQ was assessed by using Spearman's rank (rho) correlation.

Results 

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Favourable outcomes on the domains of emotional distress, monitoring and skills were found to correlate best with favourable asthma outcomes in terms of asthma control, quality of life and lung function.

Conclusion: Our findings suggest that identifying and targeting specific self-management domains in the individual patient does allow for tailoring self-management support to the individual patient’s need and thereby contributes to improved clinical asthma related outcomes. Future research is warranted on tailoring self-management support.
Breaking the cycle in abusive families
Authors: Rosemary S. Hunter, Nancy Kilstrom
Journal: American Journal of Psychiatry (1979)

The tendency for the cycle of abusive and neglectful parenting to be transmitted across generations has been well documented. The authors report on 40 families who broke this family pattern. The mechanisms for change used in these families included reliance on a broad network of resources, a degree of self-differentiation, an attitude of realistic optimism, and the ability to marshall extra resources to meet crisis situations. The authors recommend further study of such exceptions and a more hopeful approach to the problem of abusive families.
Early-Stage Hodgkin’s Disease: To Mantle or Not to Mantle?
Authors: Mahmut Ozsahin
Journal: Journal of Clinical Oncology (2001)

Article Tools SPECIAL DEPARTMENTS Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2001.19.13.3298 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 11432902 Early-Stage Hodgkin’s Disease: To Mantle or Not to Mantle? Mahmut OzsahinxMahmut OzsahinSearch for articles by this author Show More Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland https://doi.org/10.1200/JCO.2001.19.13.3298 First Page Full Text PDF Figures and Tables © 2001 by American Society of Clinical Oncology
Self-adjuvanted mRNA vaccination in advanced prostate cancer patients: a first-in-man phase I/IIa study
Authors: Hubert Kübler, Birgit Scheel, Ulrike Gnad-Vogt, Kurt Miller, Wolfgang Schultze-Seemann, Frank vom Dorp, Giorgio Parmiani, Christian Hampel, Steffen Wedel, Lutz Trojan, Dieter Jocham, Tobias Maurer, Gerd Rippin, Mariola Fotin-Mleczek, Florian von der Mülbe, Jochen Probst, Ingmar Hoerr, Karl-Josef Kallen, Thomas Lander, Arnulf Stenzl
Journal: Journal for ImmunoTherapy of Cancer (2015)

<h3>Background</h3> CV9103 is a prostate-cancer vaccine containing self-adjuvanted mRNA (RNActive®) encoding the antigens PSA, PSCA, PSMA, and STEAP1. This phase I/IIa study evaluated safety and immunogenicity of CV9103 in patients with advanced castration-resistant prostate-cancer. <h3>Methods</h3> 44 Patients received up to 5 intra-dermal vaccinations. Three dose levels of total mRNA were tested in Phase I in cohorts of 3–6 patients to determine a recommended dose. In phase II, 32 additional patients were treated at the recommended dose. The primary endpoint was safety and tolerability, the secondary endpoint was induction of antigen specific immune responses monitored at baseline and at weeks 5, 9 and 17. <h3>Results</h3> The most frequent adverse events were grade 1/2 injection site erythema, injection site reactions, fatigue, pyrexia, chills and influenza-like illness. Possibly treatment related urinary retention occurred in 3 patients. The recommended dose was 1280&nbsp;μg. A total of 26/33 evaluable patients treated at 1280&nbsp;μg developed an immune response, directed against multiple antigens in 15 out of 33 patients. One patient showed a confirmed PSA response. In the subgroup of 36 metastatic patients, the Kaplan-Meier estimate of median overall survival was 31.4&nbsp;months [95 % CI: 21.2; n.a]. <h3>Conclusions</h3> The self-adjuvanted RNActive® vaccine CV9103 was well tolerated and immunogenic. The technology is a versatile, fast and cost-effective platform allowing for creation of vaccines. The follow-up vaccine CV9104 including the additional antigens prostatic acid phosphatase (PAP) and Muc1 is currently being tested in a randomized phase IIb trial to assess the clinical benefit induced by this new vaccination approach. <h3>Trial registration</h3> EU Clinical Trials Register: EudraCT number 2008-003967-37, registered 27 Jan 2009.
Optimizing adherence of full-thickness skin grafts to the wound bed of the nasal ala with the ‘sandwich suture’
Authors: W. Hussain, J. Hafiji, P. Salmon
Journal: British Journal of Dermatology (2012)

Funding sources: none. Conflicts of interest: none declared. Madam, Skin cancers on the nose are common.1 Following surgical excision of a lesion on the nasal ala, many reconstructive surgeons will utilize a full‐thickness skin graft (FTSG), harvested from a number of potential donor sites, to repair such a defect.2 In order to maximize adherence of the graft to the wound bed, minimize movement and reduce shearing forces, the use of a tie‐over bolster dressing is common practice when performing FTSGs.3, 4 The ‘nasal ala FTSG’ is challenging for the reconstructive surgeon in that any form of external pressure, such as a bolster, collapses the nasal vestibule. Not only is this uncomfortable for the patient but also does not maximize the adherence of the undersurface of the graft to the wound bed. The use of Merocel® (Medtronic Xomed Inc., Jacksonville, FL, U.S.A.) nasal packing with airway5 or a ‘D.I.Y. nasal plug’6 has previously been proposed to provide a form of rigid support inside the nasal vestibule and thus maximize the potential for graft uptake, while not impeding airflow into the nostril. With both the aforementioned nasal plugs, however, the pressure within the nostril is uniform including the medial nostril where it is essentially not required. Furthermore, both these devices are secured in place only by virtue of their ‘tight fit’ and sterile adhesive tapes. Thus the potential for them to be simply pulled out either intentionally or inadvertently remains.
Screening healthcare workers for Mycobacterium TB: Is QFT-G now the test of choice?
Authors: Robert Smyth, Parthiban Nadarajan, Anne Gileece, Liam Cormican
Journal: European Respiratory Journal (2012)

Introduction  Quantiferon-Gold (QFT-G) is FDA approved for the diagnosis of infection with Mycobacterium tuberculosis. CDC guidelines have supported the use of QFT-G in all cases where Tuberculin Skin Test (TST) is used, including screening of healthcare workers (HCWs). We sought to establish the benefits of QFT-G in HCW screening within our own hospital practice.  Methods  In June 2010 we consecutively screened, by TST all newly employed HCWs. 41 patients over the period had full data for analysis. Country of origin and evidence of prior distant history of BCG vaccination on examination, were also documented. A TST of ≥10mm was considered a positive result and was followed by a QFT-G.  Results  41 TST were performed, 35/41 (85.4%) had a BCG scar. TST was positive in 23/41 (56.1%). QFT-G was positive in 15/23 (65.2%). Significantly 8/23 (34.8%) TST proved to be false positives on the basis of a subsequent negative QFT-G.  Conclusion  HCWs are identified as a cohort at risk of Mycobacterium TB infection. As a lab based assay QFT-G is not subject to biases or the errors of TST placement or reading. It also negates the need for a return visit in 48-72 hours for interpretation. 34.8% of our cohort had a false positive TST leading us to question the sensitivity of the test in this cohort. QFT-G has proved itself to approach 98% sensitivity1 and 89% specificity1 and is a suitable replacement for TST in HCW screening.  References  1. Mori T, Sakatani M, Yamagishi F, et al. Specific detection of tuberculosis infection: an interferon-g--based assay using new antigens. Am J Respir Crit Care Med 2004;170:59--64.