tbuckley/cabot-search huggingface dataset:
Executive Summary to EDC-2: The Endocrine Society's Second Scientific Statement on Endocrine-Disrupting Chemicals
Authors: A. C. Gore, V. A. Chappell, S. E. Fenton, J. A. Flaws, A. Nadal, G. S. Prins, J. Toppari, R. T. Zoeller
Journal: Endocrine Reviews (2015)

This Executive Summary to the Endocrine Society's second Scientific Statement on environmental endocrine-disrupting chemicals (EDCs) provides a synthesis of the key points of the complete statement. The full Scientific Statement represents a comprehensive review of the literature on seven topics for which there is strong mechanistic, experimental, animal, and epidemiological evidence for endocrine disruption, namely: obesity and diabetes, female reproduction, male reproduction, hormone-sensitive cancers in females, prostate cancer, thyroid, and neurodevelopment and neuroendocrine systems. EDCs such as bisphenol A, phthalates, pesticides, persistent organic pollutants such as polychlorinated biphenyls, polybrominated diethyl ethers, and dioxins were emphasized because these chemicals had the greatest depth and breadth of available information. The Statement also included thorough coverage of studies of developmental exposures to EDCs, especially in the fetus and infant, because these are critical life stages during which perturbations of hormones can increase the probability of a disease or dysfunction later in life. A conclusion of the Statement is that publications over the past 5 years have led to a much fuller understanding of the endocrine principles by which EDCs act, including nonmonotonic dose-responses, low-dose effects, and developmental vulnerability. These findings will prove useful to researchers, physicians, and other healthcare providers in translating the science of endocrine disruption to improved public health.
Non-randomised studies cannot be ignored
Authors: T H Bloomfield
Journal: BMJ (1994)

EDITOR, - James G Thornton and Richard J Lilford's assessment of the components of active management of labour is equivalent of taking a car to pieces and finding that a gearbox left lying in the road goes neither very far nor very fast.1 The strict diagnosis of labour is not the final component of the management of labour - that is delivery of the placenta; rather it is the first component, both in chronological sequence and in …
Giant mediastinal atypical carcinoid tumor
Authors: Recep Demirhan, Hatice Eryigit, Altug Kosar, Mehmet Tukel
Journal: European Respiratory Journal (2011)

Fifty-one years old male with shortness of breath increased by effort since one year. The patient was smoking 30 packs of cigarette per year. Inspiration sounds were decreased on the left hemithorax. Pulmonary function test results were; FEV1: 2.21 L (60%), FVC: 3.22 L (70%), PEF: 3.71 L (42%), FEV 1/FVC: 68.6%. The computerized thorax tomography, showed a 155x127 mm soft tissue mass on the left anterior mediastinal region, pressing vascular structures, and heart, and causing atelectasis on the upper lobe. Incisional biopsy was taken from the mass via mediastinotomy at a differenet hospital; the pathology result was malignant diffuse lymphoma. PET-CT was applied for staging. 2R mediastinum hypermetabolic lymph node station, with 14.5 mm diameter was detected (SUV max: 5.4). The mass SUV max: was 8.7. Chemotherapy was applied to the patient with diagnose of lymphoma. However, due to lack of regression of mass, biopsy slides were reexamined; the diagnosis was changed to be carcinoid tumor. The mass was decided to be surgically removed by median sternotomy. The mass was quite vascular, and had tight adhesions between the lung and pericardium. The result of frozen section of the mass was reported to be atypical carcinoid tumor. The mass was removed totally. Mesh was placed instead of excised pericardium. The mass weight was 1300gr, size was 17.5x 15x 9.5 cm. No tumor was detected within surgical margins. Chromogranin, Synaptofizin, CK, and CD 56 was positive at the immunohistochemical panel. Microscopic findings were confirmed atypical carcinoid tumor. In conclusion, mediastinal carcinoid tumors are very rare. Their origin of tumor is difficult to determine. Surgery is the current treatment method.
Vascular toxicity associated with antineoplastic agents.
Authors: D C Doll, Q S Ringenberg, J W Yarbro
Journal: Journal of Clinical Oncology (1986)

Vascular complications associated with antineoplastic agents are being reported with increasing frequency. Such vascular toxicity is clinically heterogeneous, ranging from asymptomatic arterial lesions to a fatal thrombotic microangiopathic syndrome. Mitomycin is most commonly implicated in the thrombotic microangiopathic syndrome, while bleomycin, either alone or in combination with a vinca alkaloid or cisplatin, appears to be an important cause of Raynaud's phenomenon. Acute arterial ischemic events, ie, myocardial infarction and cerebrovascular accidents, occur most frequently after cisplatin-based combination chemotherapy. Putative mechanisms for such toxicity include drug-induced endovascular damage, perturbation of the clotting system, platelet activation, an abnormality of thromboxane-prostacyclin homeostasis, autonomic dysfunction, vasculitis, and stimulation of fibroblasts. More than one mechanism may be operative in an individual patient. Better documentation of the incidence and types of vascular toxicity and studies to help elucidate the pathogenesis and management of such toxicity are needed.
Abstract 1180: Protection Against Lipopolysaccharide-Induced Myocardial Dysfunction in Mice by Cardiac-Specific Expression of Soluble Fas
Authors: Jianli Niu, Asim Azfer, Pappachan E Kolattukudy
Journal: Circulation (2007)

The mechanisms responsible for myocardial dysfunction in the setting of sepsis remain undefined. Fas ligation with its cognate ligand (FasL) induces apoptosis and activates cellular inflammatory responses associated with tissue injury. We determined whether interruption of Fas/FasL interaction by cardiac-specific expression of soluble Fas (sFas), a competitive inhibitor of FasL, would rescue myocardial dysfunction and inflammation in a lipopolysaccharide (LPS)-induced mouse model of sepsis. Wild-type (WT) and sFas transgenic mice were injected intraperitoneally with 10mg/kg LPS or with an equivalent volume of saline. At 18 hours after LPS administration, echocardiographic evaluation revealed a significant decrease in left ventricular fractional shortening in the WT mice, whereas it was preserved in the sFas mice (WT versus sFas, 27.5 ± 4.2% versus 43.3 ± 3.8%, P &lt; 0.05). The increase in the transcript levels of proinflammatory cytokines, tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6 resulting from LPS treatment were attenuated in the myocardium of sFas mice. sFas expression also caused a decrease in myocardial Toll-like receptor 4 (TLR-4) mRNA and protein expression. Myocardial inducible nitric oxide synthase (iNOS) expression and formation of peroxynitrite as well as apoptotic cell death were suppressed in sFas mice compared with WT mice after LPS administration. LPS-induced lung injury and increase in lung water content were also significantly reduced in sFas mice compared with WT mice (4.3 ± 0.15 versus 4.7 ± 0.88, P &lt; 0.05). These observations indicate that neutralization of FasL by expression of sFas significantly preserved cardiac function and reduced inflammatory responses in the heart, suggesting that Fas/FasL signaling pathway is important in mediating the deleterious effects of LPS on myocardial function associated with sepsis.
Use of Life-Sustaining Therapies for Patients With Ebola Virus Disease
Authors: Jeffrey T. Berger
Journal: Annals of Internal Medicine (2015)

Letters7 July 2015Use of Life-Sustaining Therapies for Patients With Ebola Virus DiseaseJeffrey T. Berger, MDJeffrey T. Berger, MDFrom Winthrop University Hospital, Mineola, New York.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5106 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Halpern and Emanuel (1) state that “cardiopulmonary resuscitation (CPR) for most patients with Ebola … carries a highly unfavorable risk–benefit ratio” and that a default policy of not routinely providing CPR is preferable. This reasoning should also apply to patients who do not have Ebola virus disease who have a similarly remote prospect of surviving CPR, yet few advocate for such a policy. Because attempting CPR regardless of medical utility is the default in contemporary practice, arguments to withhold expectedly ineffective CPR in patients with Ebola, to be consistent, must ignore inefficacy and rest solely on risks ...References1. Halpern SD, Emanuel EJ. Ethical guidance on the use of life-sustaining therapies for patients with Ebola in developed countries. Ann Intern Med. 2015;162:304-5. [PMID: 25545099] doi:10.7326/M14-2611 LinkGoogle Scholar2. Iserson KV, Heine CE, Larkin GL, Moskop JC, Baruch J, Aswegan AL. Fight or flight: the ethics of emergency physician disaster response. Ann Emerg Med. 2008;51:345-53. [PMID: 17950487] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Jeffrey T. Berger, MDAffiliations: From Winthrop University Hospital, Mineola, New York.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterest Forms.do?msNum=L15-0194. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEthical Guidance on the Use of Life-Sustaining Therapies for Patients With Ebola in Developed Countries Scott D. Halpern and Ezekiel J. Emanuel Use of Life-Sustaining Therapies for Patients With Ebola Virus Disease Scott D. Halpern and Ezekiel J. Emanuel Metrics 7 July 2015Volume 163, Issue 1Page: 69-70KeywordsCardiopulmonary resuscitationConflicts of interestDisclosureEbola virusPatient advocacyPersonal protective equipmentReasoning ePublished: 7 July 2015 Issue Published: 7 July 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Rituximab maintenance after R-CHOP in the first-line treatment of follicular lymphoma: A GOTEL phase II trial
Authors: A. Rueda, M. Provencio, M. Abrio, J. Gómez-Codina, M. Llanos, J. Delgado, J. Rifá, P. Sabin, E. Vélez de Mendizabal, V. Baz
Journal: Journal of Clinical Oncology (2009)

e19502 Background: Rituximab maintenance have demonstrated improvements in progression-free and overall survival in relapsed patients with follicular lymphoma (FL). Ongoing trials are evaluating the benefit of rituximab maintenance following treatment of therapy-naive patients (pts) treated with rituximab-containing chemoinmunotherapy induction regimens. Methods: The current study evaluated the activity and toxicity of rituximab maintenance after chemoinmunotherapy in the first line treatment of advanced-stage FL. Pts with advanced stage FL were eligible. The induction treatment consisted in 8 courses of chemoinmunotherapy with R-CHOP (rituximab 375 mg/m 2 ; cyclophosphamide 750 mg/m 2 ; doxorubicin 50 mg/m 2 and vincristine 2 mg). Pts entering a complete (CR) or partial remission (PR) received maintenance with 6 doses of rituximab (375 mg/m 2 /d) to be given every two months after the end of induction therapy. Results: From December 2004 to November 2006, 52 pts were included. Median age was 52 years (range, 36–85) and 26 pts were women. At baseline 32 (62%) pts had stage IV and 20 (38%) stage III. According to the Follicular Lymphoma International Prognostic Index (FLIPI), 8 pts (15%) had low risk disease, 24 pts (46%) intermediate risk, and 20 pts (39%) high risk disease. Six (12%) pts did not receive maintenance (3 pts progressed during induction, 2 pts refused maintenance and 1 pt had severe toxicity to induction). Of the 46 pts included in the maintenance phase, 32 (69%) were in CR/CRu and 14 pts (31%) in PR after induction therapy. Rituximab was well tolerated in the maintenance phase. Only 5 pts didn´t receive the 6 scheduled courses (toxicity: 1; progressive disease: 2; cardiovascular events: 2). Grade 3–4 toxicity occurred as follow: neutropenia in 4 pts (9%), and fever in 1 pt (2%). No severe infections were seen. After maintenance, 40 (87%) pts were in CR/CRu, 4 pts (9%) in PR and 2 (4%) progressed. With a median follow-up of 27 months, progression-free and overall survival at 30 months were 82% and 92%, respectively. Conclusions: Rituximab maintenance after first-line R-CHOP is safe and increase the complete remission rate obtained in the induction phase. No significant financial relationships to disclose.
Abstract 14633: Longer Period of Atrial Fibrillation Persistence was Associated with Higher Prevalence of Triggers from the Non-Pulmonary Vein Foci
Authors: Koichi Inoue, Ryusuke Kimura, Yuko Toyoshima, Masaharu Masuda, Atsushi Doi, Yohei Sotomi, Katsuomi Iwakura, Atsunori Okamura, Yasushi Koyama, Motoo Date, Yoshiharu Higuchi, Hiroyuki Nagai, Makito Ozawa, Takashi Takagi, Shigemiki Omiya, Daisuke Morisawa, Shimpei Nakatani, Kenshi Fujii
Journal: Circulation (2011)

Background:  The recurrence rate of atrial fibrillation (AF) is relatively high after catheter ablation (CA) for long-lasting persistent AF (LLAF), because of the advanced AF substrate in atria. We assessed the possibility that the progression of AF trigger was also the cause of higher recurrence rate.   Method;  Consecutive 263 patients who underwent CA to persistent AF (PeAF) were included in this study. Patients were divided into 2 groups based on the period AF persisted; PeAF-group (persisted    Result:  The prevalence of AF-Triggers was almost same in these groups (LLAF-group vs. PeAF-group, 26.7% vs. 26.5%, p=0.97). However, the prevalence of PV AF-Triggers was significantly higher in PeAF-group (31% vs. 94%, p=0.012). To the contrary, the prevalence of Non-PV AF Triggers was significantly higher in LLAF-group (51% vs. 14%, p=0.0019). Though successful ablation of AF-Triggers were highly associated with success in maintenance of sinus rhythm (OR=16.3, p   Conclusion:  The progression of AF trigger from Non-PV foci was also the cause of the higher recurrence rate after CA for LLAF.
Importance of clinical staging in limited small-cell lung cancer: a valuable system to separate prognostic subgroups. The University of Toronto Lung Oncology Group.
Authors: F A Shepherd, R J Ginsberg, R Haddad, R Feld, U Sagman, W K Evans, G DeBoer, E Maki
Journal: Journal of Clinical Oncology (1993)

In an attempt to assess the response to treatment and survival of a group of patients treated with standard chemotherapy and radiotherapy, we undertook a retrospective review of small-cell lung cancer (SCLC) patients treated by the University of Toronto Lung Oncology Group.We reviewed the records of 264 patients with limited SCLC who were treated from 1976 to 1985. Based on radiologic review and physical examination, patients were assigned to three prognostic groups: group 1 (very limited SCLC), negative mediastinoscopy and/or no evidence of mediastinal nodes on radiologic review; group 2, x-ray evidence of mediastinal node involvement or a positive mediastinoscopy; group 3, supraclavicular adenopathy or x-ray evidence of pneumonic consolidation, pleural effusion, or atelectasis. All patients received combination chemotherapy, radiotherapy to the primary site, and prophylactic cranial irradiation.Complete response was seen in 52% of patients and partial response in 29%. Response rates did not differ among the three prognostic subgroups. The median survival time for patients in group 1 was 15.7 months, compared with 12 months for group 2 and 11 months for group 3 (P = .0175). Projected 5-year survival for group 1 was 18%, compared with only 6% and 2% for groups 2 and 3, respectively. There was no difference among the prognostic subgroups with respect to either local or distant recurrence rates.Using simple clinical staging techniques, we were able to identify a subgroup of patients with very limited SCLC who had a significantly better prognosis. We recommend that randomized clinical trials stratify patients according to the presence or absence of clinically detectable mediastinal lymphadenopathy.
Outcome of candidates for liver transplantation suffering from portopulmonary hypertension
Authors: Caroline Sattler, Romain Magnier, Hélène Bouvaist, Xavier Jais, Elise Artaud Macari, Sven Gunther, David Montani, Marc Humbert, Gerald Simonneau, Olivier Sitbon, Laurent Savale
Journal: European Respiratory Journal (2013)

Background: Outcome of candidates for LT suffering from PoPH remains hazardous.  Objective: To analyze outcomes of patients who were candidate for LT and referred to the French reference centre for pulmonary arterial hypertension (PAH) for management of PoPH.  Methods: Candidates for LT suffering from PoPH were retrospectively analyzed. Assessments included: hemodynamics at time of PoPH diagnosis, effects of PAH therapies and outcome after LT.  Results: Forty-seven patients (30 males) were analyzed (mean age 48±8 years). At baseline, 11 patients had mPAP 3 WU and 5 had mPAP>50 mmHg. Thirty patients were treated with PAH specific therapies resulting in significant decrease of mPAP and PVR after a median of 3 months on therapy (mPAP 34±7 vs 44±9 mmHg, p  Conclusion: PAH specific therapies should be proposed to candidates for LT suffering from PoPH in order to reduce the risk of postoperative mortality due to PoPH. Interestingly, LT may be beneficial in highly selected patients with PoPH. A prospective study is warranted to identify predictive factors of resolution of PoPH after LT.
Tumor Antigen ROR1 Targeted Delivery Of FTY720 Derivative OSU-2S Prolongs Survival In ROR1 Engineered Mouse Model Of Chronic Lymphocytic Leukemia
Authors: Rajeswaran Mani, Yicheng Mao, Frank W Frissora, Chi-ling Chiang, Jiang Wang, Yuan Zhao, Yun Wu, Bo Yu, Ribai Yan, Xiaokui Mo, Sivasubramanian Baskar, Christoph Rader, Mitch A. Phelps, Robert J. Lee, Ching-Shih Chen, James Lee, John C. Byrd, Natarajan Muthusamy
Journal: Blood (2013)
Countdown to 2015: a decade of tracking progress for maternal, newborn, and child survival
Authors: Cesar G Victora, Jennifer Harris Requejo, Aluisio J D Barros, Peter Berman, Zulfiqar Bhutta, Ties Boerma, Mickey Chopra, Andres de Francisco, Bernadette Daelmans, Elizabeth Hazel, Joy Lawn, Blerta Maliqi, Holly Newby, Jennifer Bryce
Journal: The Lancet (2015)
Usefulness of selective neutrophil elastase inhibitor, sivelestat, in ALI patients with SIRS
Authors: Seigo Miyoshi, Ryoji Ito, Hitoshi Katayama, Kazunori Irifune, Hironobu Hamada, Toshimitsu Suwaki, Norihiko Nakanishi, Takanori Kanematsu, Kentaro Dote, Mayuki Aibiki, Jitsuo Higaki
Journal: European Respiratory Journal (2012)

Background:   Neutrophil elastase is known to be an important mediator of acute lung injury (ALI) in systemic inflammatory response syndrome (SIRS). Sivelestat is a neutrophil elastase inhibitor, but the clinical efficacy of sivelestat in patients with ALI associated with SIRS is now controversial.    Methods:   A retrospective data analysis of 110 ALI patients with SIRS was conducted to investigate the effects of sivelestat. The clinical efficacy of sivelestat was evaluated based on the survival rate and ventilator free days (VFD) and changes between before and 7 days after administration of sivelestat in PaO 2 /F I O 2  (P/F) ratio, white blood cell count, levels of C-reactive protein and procalcitonin (PCT).    Results:   Sivelestat group included 70 patients, and control group included 40 patients without administration of sivelestat. VFD was significantly higher, and P/F ratio significantly improved in the sivelestat group compared to the control group. Univariate analysis showed that administration of sivelestat is not an independent predictor of survival of ALI patients with SIRS. In non-septic patients, there was no significant efficacy of administration of sivelestat on the survival rate, VFD and changes in P/F ratio. In septic patients, the survival rate was significantly higher in the sivelestat group than in the control group (p=0.008). Administration of sivelestat significantly increased VFD and P/F ratio, and reduced the levels of PCT in septic patients.    Conclusion:   Our results suggest that sivelestat might have beneficial effect on the respiratory condition of the ALI patients with SIRS. Furthermore, sivelestat administration tends to associate with survival in patients with ALI with sepsis.
Repeated lung infections. Scimitar syndrome
Authors: D Ziora, J Kozielski, J Glowacki, M Rycaj, G Niepsuj
Journal: European Respiratory Journal (1994)

Case historyA 25 year old, nonsmoking white male was admitted to the Emergency Department following suicidal aspirin poisoning.After gastric lavage and X-ray examination, he was transferred to the Pulmonology Department with suspicion of right lung partial atelectasis, probably due to aspiration of a foreign body.He had a history of repeated bronchial infections with dyspnoea, since early childhood.There was no available medical documentation from a period of hospitalization at the age of 12 yrs.On admission to the Pulmonology Department, the patient was in good general condition.He complained of cough and dyspnoea on exercise.His body temperature was 37.6°C.Physical examination revealed a narrow right hemithorax, and wheezes and rhonchi, especially in the right
A questionnaire survey on information to cancer patients in Northern Italy
Authors: G. Aprile, E. Zanon, R. Perlazzi, F. Puglisi, O. Belvedere, R. Bracci, R. Cellerino, A. Piga
Journal: Journal of Clinical Oncology (2004)

8252 Background: Communication to cancer patients is central in establishing a strong patient-physician relationship. However, the way communication is realized is not standardized, is subjected to cultural influences, and largely varies in different countries. Methods: From June 2003 to August 2003, we invited 200 consecutive cancer patients to answer a 26-item questionnaire in order to verify if information on diagnosis and prognosis was correct and adequate. The questionnaire was derived from that used for a similar survey in Central Italy (Proc ASCO 1998; Abs 210), and enquired also information on treatment and other communication aspects. M/F ratio was 1:2, the median age was 60 yrs; 59 patients had metastatic disease, 11 locally advanced disease, 130 had no evidence of disease (NED). The majority had breast cancer (42%) or gastrointestinal malignancy (37%). Results: We found that 85 % of patients were aware of their diagnosis. Age < 60 yrs (p= 0.004), breast cancer (p= 0.002), NED-status (p= 0.002) and higher education (p= 0.025) were significantly associated to adequate information on diagnosis. Perception of prognosis was adequate in 47% of patients. Female patients (p= 0.003), breast cancer patients (p< 0.001) and patients with NED-status (p<0.001) had a significantly more adequate perception of their prognosis. Only 46% of the patients who desired complete information on prognosis had an adequate knowledge about expected outcome. Thirty-six percent of patients stated they desired a complete information about their disease (open information about diagnosis and prognosis), and 59% were satisfied with the information received (complete information about diagnosis, partial information about prognosis); 5% did not want to know anything about cancer. Conclusions: The results are different from what was previously reported in a similar survey in Central Italy (ASCO 1998; Abs 210). Whether the improvement in overall information on diagnosis (85 vs 60%), prognosis (47 vs 10%) and other aspects is related to change of attitude with time or geographic/cultural differences is presently matter of investigation, with extension of the survey to other parts of Italy. No significant financial relationships to disclose.