tbuckley/cabot-search huggingface dataset:
Impact of radiotherapy (RT) combined with androgen deprivation (ADT) versus ADT alone for local control in clinically locally advanced prostate cancer.
Authors: N. Mottet, M. Peneau, J. Mazeron, V. Molinie, P. Richaud
Journal: Journal of Clinical Oncology (2010)

4505 Background: In locally advanced disease, the combination of RT with ADT is superior to RT or ADT alone. Clear results with an LHRH analog are still pending. We report a phase III trial in locally advanced PCa, comparing a combined modality and ADT only. Methods: In this multicenter, randomized trial, patients < 80 years, with histologically confirmed PCa, T3- 4, or pT3 (biopsy) N0, M0 were included. They were centrally randomised from March 2000 to December 2003 in 2 parallel groups to either ADT (leuprorelin 11.25 mg SR, 1 sc injection every 3 months for 3 years) or the same ADT combined with RT starting within 3 months: 48 ± 2 Gy (pelvic) and 70 ± 4 Gy (prostate) over 7 weeks. The primary endpoint was PFS either biological (ASTRO definition) or clinical. Secondary end points included clinical progression free survival (Clin PFS). Clinical progression was defined as the first of either: > 50% prostatic volume increase compared to its lowest value (sonography based), new regional lymph nodes ( CT) or distant lesions ( CT or bone scan). Analysis was by intent to treat. Results: 273 patients were included, 263 randomised (130 to ADT, 133 to the combined group). Mean age was 70 years, 93% had a T3 disease, mean baseline PSA: 52 and 42 respectively (p = 0.79). With a minimal and median follow up of 60 and 67 months, the 5 years PFS was 60,9% (combined group) vs 8,5% (ADT group) (RR: 5.9 [4.19; 8.42]; p<0,001). The 5-year Clin PFS was 88.7% (combined group) vs 62.3% (ADT group) (p<0.001). The cumulative incidence of loco-regional progression at 5 years was 9.7% (combined group) versus 29% (ADT group) (p<0.0002) and the cumulative incidence of metastatic progression at 5 years respectively 3% vs 10.8% (p<0.018). Conclusions: In patients with locally advanced prostate cancer, addition of local radiotherapy to ADT with 3 years of LHRH significantly reduces the risk of clinical progression. With a still limited follow up of 5 years the benefit is mainly due to loco regional control. For distant metastases a prolonged follow up is needed to see a larger benefit. This reduction of progression confirm that a combined modality should be the standard for patients with a sigificant life expectancy. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Takeda Takeda Takeda
Abstract 4833: Protective Effect of a Quinazoline-Type Poly(ADP-Ribose)Polymerase Inhibitor Against the Development of Hypertensive Cardiomyopathy and Heart Failure
Authors: Eva Bartha, Klara Magyar, Izabella Solti, Laszlo Kereskai, Tamas Kalai, Kalman Hideg, Balazs Sumegi, Kalman Toth
Journal: Circulation (2008)

Purpose: Spontaneously hypertensive rat (SHR) is a suitable model for studies of hypertension and consequential left ventricular (LV) hypertrophy and heart failure. It is known, that activation of poly(ADP-ribose)polymerase enzyme (PARP) plays a role in the development of postinfarction myocardial remodeling. In our work we examined the effect of a PARP inhibitor (L-2286) against the development of hypertensive cardiopathy and heart failure in SHRs. Methods: Male 6-week-old SHR rats were treated with L-2286 (n=32, SHR-L) or placebo (n=32, SHR-C) for 50 weeks. Male CFY rats were used as aged-matched, normotensive controls (n=7, CFY). The phosphorylation state of signal transduction proteins were monitored by Western blotting. To detect the extent of fibrosis, histologic samples were stained with Masson’s trichrome. Plasma BNP activity was also determined. Before the study, after 24 weeks, and at the end of the treatment period echocardiography was performed. Results: L-2286 treatment enhanced the phosphorylation of the prosurvival factors Akt-1/GSK-3β and PKC ϵ (p&lt;0.01), while phosphorylation of JNK, p-38 MAPK, PKC pan (p&lt;0.01), PKC α/β, δ (p&lt;0.05) were significantly ameliorated in SHR-L group. Interstitial collagen accumulation and plasma BNP activity were significantly elevated (p&lt;0.05) in SHR-L and SHR-C groups compared to the CFY group. These parameters were improved due to L-2286 treatment (p&lt;0.01 and p&lt;0.05, respectively). Echocardiography showed that the measured parameters did not differ significantly among the three groups at baseline. After 24 weeks, LV end-diastolic and end-systolic volumes and LV wall thickness increased (p&lt;0.05 SHR-L and SHR-C vs. CFY). All these parameters decreased by L-2286 treatment (p&lt;0.05 SHR-L vs. SHR-C). At the end of the study in SHR-L group LV hypertrophy with preserved LV ejection fraction, however in the SHR-C group an excentric hypertrophy with poor systolic function was observable. As a hard endpoint, the survival rate was significantly better in SHR-L group (p&lt;0.05) compared to SHR-C group. Conclusions: We demonstrated that PARP inhibition has a beneficial effect against the development of LV hypertrophy and heart failure in SHRs, due to the activation of PKC ϵ, and Akt-1/GSK-3β signaling pathways.
The ICU-HELICS programme: Towards European surveillance of hospital-acquired infections in intensive care units
Authors: C Suetens, A Savey, J Labeeuw, I Morales
Journal: Eurosurveillance (2002)

The creation of a database intended for the comparative analysis of the rates of hospital-acquired infections in the 15 countries of the European Union is among the objectives of the HELICS network (Hospitals in Europe Link for Infection Control through Surveillance).
Abstract 2636: Magnetic Resonance Angiography Measurement of Carotid Stenosis Underestimates Plaque Burden Identified by Magnetic Resonance Imaging
Authors: Li Dong, Tom Hatsukami, Hideki Ota, Wei Yu, Hunter Underhill, Tianli Gao, Zhaoqi Zhang, Zhuo Zhang, Miao Guo, Zixu Yan, Minako Oikawa, Xihai Zhao, Chun Yuan
Journal: Circulation (2008)

Measurement of carotid stenosis using NASCET criteria, where the minimum lumen diameter is compared to the normal distal artery, is often used as an indicator of atherosclerotic disease. However, s...
Exposure to atrocities and severity of chronic posttraumatic stress disorder in Vietnam combat veterans
Authors: R Yehuda, S M Southwick, E L Giller
Journal: American Journal of Psychiatry (1992)

The authors' objective was to explore aspects of trauma associated with severity of posttraumatic stress disorder (PTSD) in Vietnam veterans.Several ratings of stress exposure and symptom severity were administered to 40 patients with combat-related PTSD.A significant relationship was observed between exposure to atrocities and the impact of PTSD on veterans' lives, as measured by the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder. Exposure to atrocities was also significantly correlated with current symptom severity. In contrast, combat exposure alone was not significantly associated with overall symptom severity. Both atrocity and combat exposure, however, were significantly related to reexperiencing symptoms.The data suggest that the enduring effect and severity of PTSD symptoms on an individual are associated more with exposure to brutal human death and suffering than the threat of death associated with combat.
Endothelial Function in Human Immunodeficiency Virus-Infected Antiretroviral-Naive Subjects Before and After Starting Potent Antiretroviral Therapy
Authors: Francesca J. Torriani, Lauren Komarow, Robert A. Parker, Bruno R. Cotter, Judith S. Currier, Michael P. Dubé, Carl J. Fichtenbaum, Mariana Gerschenson, Carol K.C. Mitchell, Robert L. Murphy, Kathleen Squires, James H. Stein
Journal: Journal of the American College of Cardiology (2008)
Clinical problem solving and the biopsychosocial model
Authors: J Z Sadler, Y F Hulgus
Journal: American Journal of Psychiatry (1992)

Engel's biopsychosocial model, while unifying the sciences relevant to medicine under general systems theory, is of limited utility in organizing bedside clinical problem solving. The authors consider this issue in light of the structure and goals of the clinical encounter. The biopsychosocial model is a model for organizing the sciences relevant to medicine; however, medical/psychiatric practice poses problems both within and outside the scientific realm. Since the biopsychosocial model cannot account for clinical problems to which the methods of science do not apply, the authors seek to facilitate biopsychosocial problem solving by proposing a clinical decision-making model that complements the biopsychosocial model. Their model directs the clinician's attention to three core aspects of the clinical encounter: problems of knowledge, ethics, and pragmatics. The authors reconsider Engel's case of Mr. Glover to demonstrate the anticipatory emphasis of the model. Other clinical examples are used to demonstrate the difficulties arising from mistaking one kind of aspect of medicine for another. When these three aspects of medicine are respected equally, a biopsychosocial practice is unavoidable.
Abstract 5281: Bioluminescence Imaging of X-Ray Visible Microencapsulated Mesenchymal Stem Cells for Cell Based Therapy of Peripheral Arterial Disease
Authors: Dorota A Kedziorek, Piotr Walczak, Yingli Fu, Nicole Azene, Aravind Arepally, Jeff W Bulte, Dara L Kraitchman
Journal: Circulation (2008)

Introduction: Therapeutic angiogenesis in Peripheral Arterial Disease (PAD) using stem cell therapy is potentially complicated by immunorejection. To overcome this problem, microen-capsulation using the alginate-poly-L-lysine (PLL)-alginate (APA) method was developed to provide a protective porous bubble to block antibodies but allow exchange of small molecules. Recently, we have developed a method to enable X-ray detection of these capsules. However, cell survival within the capsules could not be determined. Plus PLL can be mildly cytotoxic. In the present study, we combined reporter gene methods to verify cell survival with X-ray detection of the microcapsules in a rabbit PAD model and studied the PLL impact on cell viability. Methods: Rabbit mesenchymal stem cells (MSCs) were transfected with triple fusion (TF) reporter gene for bioluminescence (firefly luciferase), fluorescence (red fluorescent protein) and PET (truncated thymidine kinase). TF-MSCs were encapsulated in the perfluorooctyl bromide (PFOB) capsules to enable computed tomographic detection. Capsule crosslinking was performed with three PLL concentrations, i.e., 0.005%, 0.025% and 0.05%. Bioluminescent imaging (BLI) was used to monitor cells survival for one week in vitro and after intramuscular injection in vivo . Results: Serial in vitro BLI enabled the detection of viable encapsulated MSCs without detrimental signal degradation (~13% decrease of BLI signal intensity after PFOB encapsulation comparing to equal number of naked MSCs). PLL did not result in cell death; higher PLL concentrations were correlated with stronger BLI signal. BLI signal production was only slightly reduced by second layer of alginate (~80% for 0.05% PLL). In vivo BLI demonstrated the detection of naked, APA, and PFOB-encapsulated TF-MSCs. X-ray imaging enabled PFOB microcapsules detection relative to vasculature. Conclusion: BLI allows monitoring of encapsulated cells survival. PLL concentrations ≤ 0.05% appear safe for encapsulated cells with higher concentration being associated with enhanced crosslinking and capsule stability. MSCs expressing TF reporter in PFOB microcapsules enables dual monitoring of cell delivery/capsule tracking by X-ray imaging and cell viability with BLI.
Abstract 17497: Ischemic Grade on the Admission ECG of a First St-Elevation Myocardial Infarction Predicts Microvascular Damage and Impaired Functional Recovery
Authors: Philippe Timmermans, Jan Bogaert, Steven Dymarkowski, Tom Adriaenssens, Mark Coosemans, Christophe Dubois, Bert Ferdinande, Peter Sinnaeve, Ann Belmans, Jens-Uwe Voigt, Walter Desmet, Stefan Janssens
Journal: Circulation (2011)

Background: Prediction of recovery of systolic function after STEMI remains challenging. Microvascular obstruction (MVO) is a known predictor of negative remodeling after reperfusion therapy, but can only be diagnosed on cardiovascular magnetic resonance (CMR). We sought to evaluate the relationship between ischemic grade on the presentation ECG on MVO severity at baseline and functional recovery after 4 months. Methods: We prospectively enrolled 134 patients with a first STEMI undergoing successful PCI followed by state-of-the-art postinfarction medical treatment, and quantified MVO at day 3-4, and LV functional and structural remodeling after 4 mo follow-up using 1.5 T CMR and TTE. Ischemic grade was defined as ST elevation with distortion of the terminal portion of the QRS on ECG. Grade 2 and 3 ischemia represented the ST J amplitude greater or smaller than 50% criterion or presence or absence of an S wave or any Q in V2 and V3. Results: Patients with grade 2 (n=77) and 3 (n=57) ischemia had comparable pre- and peri-procedural medication and cardiovascular risk profiles, except for age. Patients with gr 3 ischemia were older than those with gr 2 (60±12 vs 57±11y, P&lt;0.05), had a longer delay between symptom onset and PCI (4.7±2.7 vs 4.1±3.1 hours, P&lt;0.05) and a trend for a greater proportion of TIMI 0 flow before PCI (p=0.058). Infarct-related artery and TIMI flow after PCI were similar. Troponin and CK levels at admission were similar, but significantly higher after 24 h in patients with gr 3 ischemia (P&lt;0.001). Patients with gr 3 ischemia had significantly more MVO (4±6 vs 10±13 g, P&lt;0.01), greater area at risk (44±23 vs 34±20 g, P&lt;0.01) and larger infarct volumes both at baseline and at 4 mo (23±14 vs 14±10%LV mass and 15±13 vs 11±7% respectively, P&lt;0,001 for both), and smaller myocardial salvage index (p&lt;0.003). LVEF at admission and after 4 mo measured by TTE was lower in gr 3 ischemia (52±12 vs 54±11, P&lt;0.01 and 53±11 vs 61±9, P&lt;0.001). Serial CMR confirmed impaired global LV systolic function recovery in patients with gr 3 ischemia (P&lt;0.001). Conclusion: Gr 3 ischemia in STEMI is a valuable predictor of extensive myocardial microvascular damage on CMR imaging, and is closely associated with impaired functional and structural recovery after successful PCI for STEMI.
Abstract 2004: Usefulness of Coronary CT Angiography in the Early Triage of Patients with Acute Chest Pain
Authors: Udo Hoffmann, Fabian Bamberg, Claudia U Chae, Ian S Rogers, Sujith K Seneviratne, Quynh S Truong, Ricardo S Cury, Sunhy Abbara, Michael Shapiro, Jamaluddin Moloo, Javed Butler, Maros Ferencik, David F Brown, James E Udelson, Stephan Achenbach, Thomas J Brady, John T Nagurney
Journal: Circulation (2008)

Background: Early triage of patients with acute chest pain in the emergency department (ED) may be improved by rapid noninvasive assessment of coronary artery disease (CAD) by coronary computed tomography angiography (CTA). We sought to determine the usefulness of coronary CTA for the early triage of patients with acute chest pain but an inconclusive initial ED evaluation. Methods: Single center, double-blinded observational cohort study in the ED of a large tertiary academic hospital enrolling 368 consecutive patients with acute chest pain and inconclusive initial ED evaluation (normal initial troponin and an initial ECG without evidence of myocardial ischemia) who were awaiting hospital admission between May 2005 and May 2007. All patients underwent 64-slice contrast-enhanced coronary CTA prior to hospital admission with caregivers and patients blinded to the results of the examination. Diagnostic accuracy and discriminatory power of coronary CTA findings (coronary plaque and stenosis [&gt;50% luminal narrowing]) for acute coronary syndrome (ACS) during index hospitalization and major adverse cardiac events (MACE) during 6- month follow-up. Results: Among 368 patients (mean age 53±12 years, 61% male) 31 (8%) developed ACS but no MACE occurred during follow-up. Fifty percent (n=183) of the study population had neither plaque nor stenosis, a finding which had 100% negative predictive value (95% confidence interval [CI]: 98 to 100%) for ACS. In adjusted analysis, the extent of coronary plaque and presence of stenosis were associated with an increased risk for ACS (OR: 1.28, 95% CI: 1.14 to 1.43 and OR: 11.69, 95% CI: 4.4 to 31.0; respectively). Coronary CT findings (no CAD, plaque but no stenosis, and stenosis) discriminated patients at low, intermediate, or high risk of ACS (OR: 8.65, 95% CI: 3.69 to 20.26; AUC: 0.91). Conclusion : Half of the patients with acute chest pain and low to intermediate likelihood of ACS have no CAD and may be safely discharged directly from the ED. Coronary CT has excellent discriminatory power in defining patient risk for ACS.
Abstract 16129: Low-Energy Three-Stage Electrotherapy Delivered Through Implantable Leads Significantly Reduces the Cardioversion Threshold in a Canine Model of Persistent Atrial Fibrillation
Authors: Ajit Janardhan, Wenwen Li, Sarah R Gutbrod, Yoshiyuki Watanabe, Toshinobu Kazui, Timo Weimar, Michael Yeung, Qun Sha, Phillip S Cuculich, Richard B Schuessler, Igor R Efimov
Journal: Circulation (2011)

BACKGROUND: Previous attempts to apply implantable defibrillation therapy to atrial fibrillation (AF) were severely limited by the pain associated with high-energy biphasic (BP) shocks. Recently, w...
The Sea-Blue Histiocyte Syndrome
Authors: R Etcheverry, A Daiber, E Boris, N Durán
Journal: New England Journal of Medicine (1970)

The sea-blue histiocyte syndrome, similar to Niemann-Pick disease, is a congenital, hereditary histiolipidosis due to an inborn enzymatic error. Accumulation of non saturated, oxidated, polymerized lipids is observed; ceroids of lipofuscin, glycophospholipids and sphingomyelin, like bulky granules 1 to 3 u in diameter, turn blue with May Grunwald staining, orange reddish with PAS and black with Sudan III and osmic acid. The sea-blue histiocytes are preferably located at the bone marrow, liver and spleen and less frequently in lymph nodes, lungs and some other organs. The prognosis is variable: fatal in the central nervous system location, relatively mild in cases of spleen and bone marrow location. The possibility of complicating hepatic cirrhosis and/or pulmonary fibrosis is always present. Seven cases are described in this paper, 4 of them family related. Acute myelomonocytic leukemia in one case and histioimmunoblastic lymphoma in another were complications not yet reported in the literature.
Testing for Helicobacter pylori in dyspeptic patients
Authors: A. Jacobs, A. Williams, K. E L McColl, L. S Murray, R. Sultana, C. F Weijnen, M. E Numans, N. J de Wit, K. G M Moons, T. J M Verheij, A. W Hoes, A. J P M Smout
Journal: BMJ (2001)

# Did paper have statistical discrepancies? {#article-title-2} EDITOR—I am confused by Weijnen et al's description of the statistical methods used in their study and how they fit with the data presented.1 The methods section states that all variables found to be univariate predictors of peptic ulcer with P<0.25 were entered in the multivariate regression model. However, the results section says that age was included in the model, although table 2 shows that it was not predictive (P=0.67). Table 2 also shows that P=0.24 for both hiatal hernia and pain after meal, so these should have been included in the multivariate model, but neither of them was. Are these discrepancies due to a typing mistake, or is there another explanation? 1. 1.↵1. Weijnen CF, 2. Numans ME, 3. de Wit NJ, 4. Smout AJPM, 5. Moons KGM, 6. Verheij TJM, 7. et al .Testing for Helicobacter pylori in dyspeptic patients suspected of peptic ulcer disease in primary care: cross sectional study.BMJ2001;323: 71–75. (14 July.) [OpenUrl][1][Abstract/FREE Full Text][2] # Authors' suggestion muddies waters in debate {#article-title-4} EDITOR—Weijnen et al suggest that we should test and treat patients at high risk of peptic ulceration.1 This seems to muddy the waters in the debate about testing for Helicobacter pylori infection in primary care. Of the 38 patients they identified as having a peptic ulcer, only 22 gave a positive result to a non-invasive H pylori test, although the rate of detection overall was increased from 31% to 41% by using invasive tests of culture or histology, which suggests that serological testing is not as sensitive. Agreus and Talley reported that the sensitivity of H pylori enzyme linked immunosorbent assay (ELISA) kits had an average sensitivity of 85% (low and high extremes 49% and 99% respectively).2 Why are the rates of detection so low in Weijnen et al's study (33 of the 38 patients … [1]: {openurl}?query=rft.jtitle%253DBMJ%26rft.stitle%253DBMJ%26rft.issn%253D0007-1447%26rft.aulast%253DWeijnen%26rft.auinit1%253DC.%2BF%26rft.volume%253D323%26rft.issue%253D7304%26rft.spage%253D71%26rft.epage%253D75%26rft.atitle%253DTesting%2Bfor%2BHelicobacter%2Bpylori%2Bin%2Bdyspeptic%2Bpatients%2Bsuspected%2Bof%2Bpeptic%2Bulcer%2Bdisease%2Bin%2Bprimary%2Bcare%253A%2Bcross%2Bsectional%2Bstudy%26rft_id%253Dinfo%253Adoi%252F10.1136%252Fbmj.323.7304.71%26rft_id%253Dinfo%253Apmid%252F11451780%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=bmj&resid=323/7304/71&atom=%2Fbmj%2F323%2F7320%2F1066.atom
Abstract 392: Estimated Radiation Dose of Coronary Computed Tomography Angiography Using Adaptive Statistical Iterative Reconstruction: A Multicenter Study
Authors: Troy M LaBounty, James Earls, Jonathon Leipsic, Brett Heilbron, GB John Mancini, Fay Y Lin, James K Min
Journal: Circulation (2009)

Introduction: Methods to reduce radiation exposure during coronary computed tomography angiography (CCTA) are important. Hypothesis: In contrast to filtered backprojection (FBP), adaptive statistic...
Abstract 19414: Influence of Diabetes on Post-Myocardial Infarction Left Ventricular Remodeling and RAAS Inhibition with Aliskiren
Authors: Amil Shah, Sung Hee Shin, Hicham Skali, Akshay S Desai, Lars Kober, Aldo P Maggioni, Jean L Rouleau, Roxzana Y Kelly, Allen Hester, Deborah Keefe, John J McMurray, Marc A Pfeffer, Scott D Solomon
Journal: Circulation (2010)

Background: Diabetes mellitus (DM) is associated with worse outcomes following MI. We assessed the effect of DM on post-MI remodeling and whether DM modifies the effect of aliskiren on top of stand...
First autochthonous malaria case due to Plasmodium vivax since eradication, Spain, October 2010
Authors: P Santa-Olalla Peralta, M C Vazquez-Torres, E Latorre-Fandós, P Mairal-Claver, P Cortina-Solano, A Puy-Azón, B Adiego Sancho, K Leitmeyer, J Lucientes-Curdi, M J Sierra-Moros
Journal: Eurosurveillance (2010)

In October 2010, one case of autochthonous malaria due to Plasmodium vivax was diagnosed in Spain. The case occurred in Aragon, north-eastern Spain, where the vector Anopheles atroparvus is present. Although the source of infection could not be identified, this event highlights that sporadic autochthonous transmission of vector-borne diseases in continental Europe is possible and calls for enhanced surveillance and vector control measures.