tbuckley/cabot-search huggingface dataset:
Blasts in CSF with a normal cell count do not justify alteration of therapy for acute lymphoblastic leukemia in remission: a Childrens Cancer Group study.
Authors: D G Tubergen, J W Cullen, J M Boyett, G S Gilchrist, R T O'Brien, P F Coccia, M J Waskerwitz
Journal: Journal of Clinical Oncology (1994)

PURPOSE The Childrens Cancer Group (CCG) requires both a CSF WBC count of more than five cells per microliter and demonstration of blast cells in the cytocentrifuge specimen to support a diagnosis of CNS relapse. We reviewed the CSF examinations of patients with intermediate-risk acute lymphoblastic leukemia (ALL) to determine the clinical significance of blast cells reported in the cytocentrifuge when the total CSF cell count was normal. PATIENTS AND METHODS Children treated on CCG-105 for ALL had CSF examinations every 12 weeks during maintenance therapy. The outcome of children who had a positive CSF cytocentrifuge examination without an elevated CSF WBC count was compared with that of children who did not have any CSF blast cells observed. RESULTS Sixty-four patients had 81 CSF examinations with blast cells and a normal cell count. By Cox life-table regression analysis, patients with blasts had a different disease-free survival (DFS) distribution, with relapses tending to occur earlier (P = .008). However, the DFS for these patients was 63% +/- 9.6% at 5 years from the time of the abnormal cytocentrifuge result as compared with 69% +/- 1.5% for 1,490 children who did not have blasts in their CSF. This difference is not significant. CONCLUSION Blast cells were infrequently identified in cytocentrifuge preparations of CSF when the cell count was normal. The majority of patients in whom such an event was observed have not experienced a subsequent relapse as measured by life-table analysis at 5 years. The data do not justify changing or augmenting therapy based on cytocentrifuge results alone.
Preferential metabolic involvement of visual cortical areas in a subtype of Alzheimer's disease: clinical implications
Authors: Pietro Pietrini, Maura L. Furey, Neill R. Graff-Radford, Ulderico Freo, Gene E. Alexander, Cheryl L. Grady, Alessio Dani, Marc J. Mentis, Mark B. Schapiro
Journal: American Journal of Psychiatry (1996)

A subgroup of patients with Alzheimer's disease present with visual disturbances at onset. This study investigated whether specific cortical networks associated with visual processes are preferentially affected in this subgroup and determined the clinical implications of such abnormalities.Regional cerebral glucose metabolic rates were assessed with positron emission tomography and [18F]2-fluoro-2-deoxy-D-glucose, and general intellectual functions, memory, and visual skills were measured with cognitive tests in patients with probable Alzheimer's disease-10 with and 22 without prominent visual symptoms-and in 25 healthy comparison subjects.Both patient groups showed reduced glucose metabolism in parietal regions and in middle and superior temporal regions in comparison with the healthy subjects. The Alzheimer's disease patients without visual symptoms also showed reductions in inferior temporal, frontal, and limbic structures, as is typical of Alzheimer's disease. In contrast, the patients with visual symptoms had larger metabolic deficits than the patients without visual symptoms in the parietal and occipital cortices (including the primary visual cortex), with a relative sparing of inferior temporal, frontal, and limbic regions. Consistently, the patients with visual symptoms had significantly greater visuospatial deficits and less severe memory impairments than the patients without visual symptoms.Alzheimer's disease patients with visuospatial deficits who are studied while alive have a distinctive regional distribution of cerebral metabolic impairment that is related to specific cognitive deficits and that distinguishes them from patients with typical Alzheimer's disease. These findings imply that regional variations in brain dysfunction can occur in Alzheimer's disease, with differential involvement of cortical systems resulting in distinctive clinical subgroups.
Effects of respiratory (RS) and electrical (ES) stimulation on mechanical parameters of the isolated upper airway (UAW) in the pig: The significance of neck structures
Authors: Alexander Brodsky, Yaniv Dotan, Alan Schwartz, Arie Oliven
Journal: European Respiratory Journal (2014)

Rationale : We have previously found that in contrast to ES, even intense RS of the genioglossus (GG) during flow limitation in OSA patients fails to prevent pharyngeal collapse.

Methods: To evaluate mechanisms of this phenomenon we studied mechanical parameters of the isolated, sealed UAW in pigs breathing through a tracheostomy. Video-pharyngoscopy was used to obtain the pressure-area relationship of the collapsible segment (lower velopharynx) of the UAW under 3 conditions: baseline (BL), RS and ES of the hypoglossus (HG). All parameters were obtained before and after transection of neck muscles and the trachea, to assess the relevance of coordination of forces acting to protect UAW patency.

Results : No phasic GG-EMG was present during BL. RS induced by partial obstruction of the inspiratory port at the tracheostomy was associated with high phasic GG-EMG activity, and significantly lowered closing pressure (Pcl) from -4.8±2.2 to -9.8±2.9 cmH2O, p<0.05, by reducing compliance from 0.22±0.03 to 0.18±0.03 cm2, p<0.05. HG-ES lowered Pcl more effectively, by significantly reducing external pressure from 11.5±3.4 to 7.5±5.8 cmH2O, p<0.05. After transection of the neck structures, all mechanical parameters worsened significantly. Under this condition, only the changes during HG-ES, but not during RS, reached statistical significance.

Conclusions : RS and HG-ES have different mechanical effects on the UAW. After removing the mechanical support of the tracheal tag and neck muscles, the mechanical effectiveness of RS is markedly reduced, despite intense activation of the GG-EMG.
Abstract 15438: Cardiac Myosin-Binding Protein C (cMyBPC) as a Potential New Serum Biomarker of Myocardial Infarction
Authors: James O Baker, Renuka Devaraj, Johannes Reinhold, Gajen Kanaganayagam, Sakthivel Sadayappan, Mathias Gautel, Simon Redwood, Michael Marber
Journal: Circulation (2010)

cMyBPC is a sarcomeric thick filament protein involved in modulating contractility. Previous work in our laboratory identified cMyBPC as a potential marker for MI by LC-MS/MS of coronary effluent from buffer perfused isolated mouse hearts. As cMyBPC dissociates from the sarcomere under acidic conditions it is possibly released earlier following ischaemic injury than other cardiac specific sarcomeric proteins. This preliminary study examined the temporal serum concentration profile of a novel biomarker of myocardial infarction (MI) in a mouse model of ischaemia/reperfusion and patients with STEMI. Left anterior descending coronary artery ligation was performed for thirty minutes and mice sacrificed at 30 seconds and 30, 45, 60 or 120 minutes of reperfusion and serum collected. Sham operated mice served as negative controls. In humans with STEMI undergoing primary PCI, 2 hourly serial serum samples were collected up to 18 hours from symptom onset and then daily to day 3. Healthy volunteers acted as negative...
Abstract P112: Changes in Lifestyle Behavior to Reduce Uncontrolled Blood Pressure in the Faith Trial
Authors: Kristie J Lancaster, Antoinette M Schoenthaler, William Chaplin, Gbenga Ogedegbe
Journal: Circulation (2015)

Introduction: Modifying lifestyle behaviors is a key method for controlling hypertension. This strategy is extremely important for hypertensive Black Americans, as they are more likely to have uncontrolled blood pressure (BP), have a higher risk of complications, and poorer outcomes. To address this need, we conducted a cluster-randomized controlled trial to reduce BP through lifestyle modification that was delivered by lay health advisors in Black churches. The Faith-based Approaches in the Treatment of Hypertension (FAITH) trial was designed to evaluate the effectiveness of a 12-week faith-based lifestyle intervention and subsequent 3-month motivational interviewing vs. health education control on BP reduction among hypertensive Black adults. This study examines the change in lifestyle behaviors during the trial from baseline to 6 months. Methods: We recruited 373 Black Americans with uncontrolled hypertension from 32 urban churches. BP was considered to be uncontrolled if systolic BP (SBP)≥140 mmHg or diastolic BP (DBP)≥90 mmHg, or DBP≥130 mmHg or DBP≥80 mmHg for participants with self-reported diabetes or kidney disease The primary outcome was within-participant change in BP from baseline to 6 months. Lifestyle data collected included the NCI fruit/vegetable intake screener and % calories from fat screener, the International Physical Activity Questionnaire (IPAQ), medication adherence, and measured height and weight. Results: Participants’ mean age was 63.4 y, 76.4% were female, and 96.1% reported being of African descent. The mean BMI was 32.1 kg/m2. At 6 months, the intervention was associated with significant reduction in SBP but not DBP compared with the control group (-16.0 mmHg vs -10.3 mmHg, p=0.017). There was no significant change in number of servings of fruits and vegetables consumed, minutes walked per day, or weight for either group. However, the intervention group had a slight but significantly greater decrease of 1.08 % calories from fat over time compared with the control (p=0.018), but that change was not related to change in SBP. Most notably, there was a significant months x treatment interaction on medication adherence the intervention group had a greater decrease in non-adherence score than the control (-0.84 vs -0.30, p=0.28). This improvement in adherence was related to decrease in SBP (p=0.019). Conclusion: Community-based lifestyle modification program led to significantly reduced systolic BP; and this intervention effect was mediated by improved medication adherence. However, the 12-week intervention resulted in little change in key diet and physical activity behaviors found in other trials to positively affect BP.
Paracetamol in pregnancy and risk of wheezing in offspring: Causation or bias?
Authors: Franca Rusconi, Lorenzo Richiardi, Enrica Migliore, Daniela Zugna, Claudia Galassi, Tiziana Nannelli
Journal: European Respiratory Journal (2012)

Background: Many but not all studies have suggested an association between paracetamol (P) use in pregnancy and wheezing in childhood.  Objective: To assess the relationship between P use in pregnancy and wheezing in offspring, in an Italian mother and child cohort (NINFEA cohort, www.progettoninfea.it). To evaluate the potential role of confounding by indication of P use.  Methods: Infants born from 1076 mothers who used P were contrasted with those born from mothers with no use of P (701) with respect to wheezing at 6-18 months of life. P use was assessed during pregnancy and 6 months after delivery, while wheezing was assessed 18 months after delivery.  Results: The overall prevalence of wheezing was 25% and it was more common among infants exposed to P in pregnancy (Relative risk (RR)=1.23, 95% confidence interval (CI): 0.98-1.54). Adjustment for ever diagnosis of maternal asthma (prevalence: 7.6%) did not change the association. After further adjustment for maternal respiratory diseases in pregnancy (asthma episodes, influenza like illness, bronchitis), maternal smoking and education, child sex and siblings, the RR for wheezing was 1.06 (CI: 0.84-1.34). When we analyzed women who suffered from headache, migraine or backache versus all the others, the risk of wheezing in offspring was similar for mothers who used and for those who did not use P in pregnancy for these diseases (RR 1.28; CI: 0.85-1.91 versus 1.35; 1.03-1.76).  Conclusions: The weak association found between P use in pregnancy and wheezing in offspring disappeared after adjustment, raising a problem of confounding. A non-causal relationship is also suggested by the lack of increased risk of wheezing for P use in non-respiratory diseases.
NHS cancer diagnosis system is under strain and not meeting demand, experts warn
Authors: Adrian O’Dowd
Journal: BMJ (2015)

Experts claim that the current NHS system for diagnosing cancer in England is under serious strain and not prepared for an inevitable growth in demand in the next few years.

The charity Cancer Research UK published two new reports on 6 September both warning that NHS services for diagnosing cancer are underfunded and understaffed and that crucial waiting time targets are being missed.

The charity said that early diagnosis was vital in improving cancer outcomes and was a priority area in the new NHS cancer strategy announced in July.1 That strategy set the aim that, by 2020, 95% of patients referred for testing by a GP should get a definitive diagnosis of cancer or have …
Reliability and Validity of Prostate-Specific Antigen
Authors: Matti Hakama, Anssi Auvinen
Journal: JAMA (2003)

To the Editor: Dr Eastham and colleagues found that many men with abnormal levels of prostate-specific antigen (PSA) were found to have normal levels when retested 1 year later. The authors thus concluded that PSA lacks specificity and that a single PSA test is unreliable. They recommend confirmatory assessment before undergoing further testing. We disagree with this logic. Specificity can only be improved by more stringent test criteria, not by further testing. Because the proposed ancillary evaluation includes biopsy, the interval of a few weeks is unnecessary for establishing a diagnosis or reducing adverse effects, but the delay is likely to increase the patient’s anxiety and fear. We also believe that the evidence of Eastham et al was insufficient to make these claims. Assessment of the validity of a screening test requires knowledge of the true disease status; this was not available in the study by Eastham et al. On the basis of such data, we found a single PSA determination to have a test sensitivity of 86% at a specificity level of 94% for a 5-year follow-up period. For patients aged 65 years or younger, the values were even higher—93% and 96%, respectively. Thus, the specificity of the PSA test appears superior to the specificities for the Papanicolaou smear and mammography used in screening for cervical and breast cancer, respectively. Furthermore, the assessment of the PSA test did not rely on cross-sectional evaluation with biopsy (thus inevitably detecting indolent cancers and missing some small carcinomas), but on clinically relevant disease as it was based on serum-bank study with clinical cancer diagnosis in the pre-PSA era. The large fluctuations and low specificity reported by Eastham et al may reflect insufficient reliability, perhaps related to laboratory problems, rather than poor validity of the test itself. The effect of such fluctuations cannot be assessed only by follow-up of those patients with high levels of PSA, but also require follow-up of those with low levels. Without examining the entire distribution, the conclusions are subject to regression toward the mean. The specificity of a test can be improved by using a higher cutoff value. Because prostate biopsy cannot definitively establish or rule out clinically relevant prostate cancer, a meaningful evaluation of test validity would require a design with follow-up for cancer either retrospectively nested within the serum bank study or prospectively after PSA testing. This design also allows for random sampling of controls within the study base or, ideally, random allocation to PSA testing in the context of an experimental study. However, we are not advocating routine screening for prostate cancer because this decision requires knowledge of mortality effects. Our ongoing randomized trial 3 may yield the evidence for decisions about routine screening.
Availability and affordability of cardiovascular disease medicines and their effect on use in high-income, middle-income, and low-income countries: an analysis of the PURE study data
Authors: Rasha Khatib, Martin McKee, Harry Shannon, Clara Chow, Sumathy Rangarajan, Koon Teo, Li Wei, Prem Mony, Viswanathan Mohan, Rajeev Gupta, Rajesh Kumar, Krishnapillai Vijayakumar, Scott A Lear, Rafael Diaz, Alvaro Avezum, Patricio Lopez-Jaramillo, Fernando Lanas, Khalid Yusoff, Noorhassim Ismail, Khawar Kazmi, Omar Rahman, Annika Rosengren, Nahed Monsef, Roya Kelishadi, Annamarie Kruger, Thandi Puoane, Andrzej Szuba, Jephat Chifamba, Ahmet Temizhan, Gilles Dagenais, Amiram Gafni, Salim Yusuf
Journal: The Lancet (2015)
The Proportion of Ph+ CD34+CD38neg Leukemic Stem Cells In the Bone Marrow of Newly Diagnosed Patients with Chronic Myeloid Leukemia (CML) In Chronic Phase (CP) Is Variable and Correlates with High Sokal Risk, High Leukocyte Count, Low Hemoglobin Concentration, Splenomegaly and Increased Hematological Toxicity During Initial TKI-Therapy. Data From a Randomized Phase II NordCML006 Study
Authors: Satu Mustjoki, Johan Richter, Gisela Barbany, Ingunn Dybedal, Thoas Fioretos, Tobias Gedde-Dahl, Bjorn T. Gjertsen, Randi Hovland, Sari Jalkanen, Dag Josefsen, Perttu Koskenvesa, Carin Lassen, Kirsi Latvala, Waleed Majeed, Claes Malm, Berit Markevärn, Ali Moshfegh, Lotta Ohm, Tor Olofsson, Ulla Olsson-Strömberg, Katrin Rapakko, Kari Remes, Jesper Stentoft, Leif Stenke, Merja Suominen, Sara Thunberg, Ole Weiss Bjerrum, Bengt Simonsson, Kimmo Porkka, Henrik Hjorth-Hansen
Journal: Blood (2010)
Neuropsychologic effects of chemotherapy on children with cancer: a longitudinal study.
Authors: D R Copeland, B D Moore, D J Francis, N Jaffe, S J Culbert
Journal: Journal of Clinical Oncology (1996)

A prospective study was conducted to assess the effects of chemotherapy for cancer on children's long-term neuropsychologic status.Ninety-nine children who received no cranial radiation therapy (CRT) completed four annual neuropsychologic assessments. Fifty-one patients received intrathecal (IT) chemotherapy (ITC); 48 received no CNS treatment. These two groups were compared using repeated-measures analysis of variance on IQ, memory, language, freedom from distractibility, academic achievement, executive functions, and fine-motor, perceptual-motor, and tactile-spatial skills. In addition, 51 of the sample of 99 patients had been examined 5 to 11 years after diagnosis. Their data were analyzed to evaluate the longer-term effects of chemotherapy. The predictability of demographic and medical variables on neuropsychologic outcome at 3-year and long-term follow-up study were assessed using multiple regression techniques.Overall, the effects of chemotherapy in the absence of CRT appear to be slight. Patients who received ITC and intravenous (IV) methotrexate declined slightly on perceptual-motor skills, but were still well within the normal range. Both groups, regardless of treatment, declined on academic achievement tests, although not to a statistically significant degree. Age effects were found on performance IQ (PIQ) and perceptual-motor skills. Socioeconomic status (SES) correlated with a large number of variables. Sex effects were not significant.The present results are largely consistent with previous findings for nonirradiated groups. Treatment effects from ITC are slightly more apparent 5 to 11 years after diagnosis than at 3-year follow-up evaluation but this does not constitute a clinically meaningful difference. More noticeable are academic declines among all groups, regardless of treatment.
Global AIDS Epidemic Worsens
Authors: Joan Stephenson
Journal: JAMA (2004)

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Improved survival in medically-treated chronic thromboembolic pulmonary hypertension
Authors: Rintarou Nishimura, Nobuhiro Tanabe, Yasunori Ichimura, Ayumi Sekine, Toshihiko Sugiura, Takayuki Jujo, Ayako Shigeta, Seiichiro Sakao, Yasunori Kasahara, Yuichi Takiguchi, Koichiro Tatsumi
Journal: European Respiratory Journal (2011)

Background:  Although the key for the successful treatment of patients with chronic thromboembolic pulmonary hypertension (CTEPH) is pulmonary endarterectomy (PEA), the patients who are not indicated for surgical intervention and/or have comorbiditiies must therefore be medically treated. Recent new medical therapies (newTx), such as bosentan and sildenafil, may thus be able to improve the outcome of Japanese patients with CTEPH.   Purpose:  To clarify the improved survival in CTEPH cases administered new Tx.   Methods:  Between 1986 and 2010, 202 patients were diagnosed to have CTEPH at Chiba University Hospital. Ninety-nine patients underwent PEA, while 103 patients were medically treated. 56.5% of the patients diagnosed from 2005-2010 were treated by new Tx., 19.4% of those from 1999-2004, and 8.7% of those from 1986-1998 (p   Results:  The patients diagnosed from 2005-2010 showed a significantly improved survival (5-year survival: 87.8%) compared with those from 1999-2004 (72.2%) and from 1986-1998 (56.5%) (p=0.02). The 5-year survival from the initiation of bosentan (n=15) and sildenafil (n=24) was 90.0%, 84.2%, respectively. A multivariate analysis revealed a lower pulmonary vascular resistance (p   Conclusion:  The survival in medically treated CTEPH cases was found to have improved due to the administration of new medical therapies.