tbuckley/cabot-search huggingface dataset:
Abstract 311: Amplitude Spectrum Area to Guide Defibrillation: A Conclusive Validation in 1,617 Ventricular Fibrillation Patients
Authors: Giuseppe Ristagno, Tommaso Mauri, Giancarlo Cesana, Li Yongqin, Andrea Finzi, Francesca Fumagalli, Gianpiera Rossi, Niccolo' Grieco, Maurizio Migliori, Aida Andreassi, Roberto Latini, Carla Fornari, Antonio Pesenti
Journal: Circulation (2014)

Background:  In a highly populated Region of northern Italy, Lombardia, we validated the capability of amplitude spectrum area (AMSA) to predict defibrillation (DF) success in of out-of-hospital cardiac arrests (CA) due to ventricular fibrillation. We hypothesized that AMSA would be an accurate predictor of DF success so that threshold values of AMSA might be used to guide CPR intervention, i.e. chest compression or DF.   Methods:  ECG data recorded by automated external defibrillators from different manufactures were obtained from CAs occurring in 8 city-areas in Lombardia. A first database, including 2.447 DFs from 1.050 patients, was used as derivation group, while an additional database, including 1.381 DFs from 567 patients, served as validation group. A 2 sec ECG window ending 0.5 sec before DF was analyzed and AMSA was calculated. Univariate and multivariate regression analyses and area under the receiver operating characteristic (ROC) curve were used to determine associations between AMSA and study endpoints, i.e. DF success, sustained ROSC, and long-term survival.   Results:  Among the 2.447 DFs of the derivation database, 26.2% were successful. AMSA was significantly higher prior to a successful DF than a failing one (13±5 vs. 6.8±3.5 mV-Hz) and was an independent predictor of DF success (OR 1.40, 95%CI 1.36-1.44) and sustained ROSC (OR 1.21, 95%CI 1.16-1.25). Area under the ROC curve for DF success prediction was 0.86 (95%CI 0.85-0.88, p  15.5 mV-Hz for DF success and   15.5 predicted DF success with a positive predictive value of 84%, while AMSA    Conclusions:  In this large derivation-validation study, AMSA was proved to be an accurate predictor of DF success. AMSA appeared also as a predictor of short- and long-term survival after cardiac arrest.
Abstract 19881: Low Contrast Technique Significantly Reduces Rate of Contrast-induced Nephropathy (CIN)
Authors: Alexandre Benjo, Sepher Saberian, Girish Nadkarni, John H Lee, Tyrone Collins, Stephen Ramee
Journal: Circulation (2014)

Background:  Contrast induced nephropathy (CIN) after percutaneous cardiovascular procedures is associated with worse short and long term outcomes. A risk score by Mehran et al [incorporating dye amount, age, diabetes, anemia, heart failure, hypotension and intra-aortic balloon pump] is commonly used for predicting CIN risk. However, the minimal amount of contrast used to validate this score was 100 cc. We hypothesized that minimizing the IVC amount utilizing a 3 cc syringe and selected views could decrease CIN rates below the predicted value.   Methods:  We abstracted data from diagnostic and therapeutic (including coronary, peripheral and valve interventions) procedures from 2010-2013 in patients with serum creatinine > 1.5 mg/dl. All coronary and non-coronary diagnostic and interventional procedures were performed utilizing the 3cc low contrast technique and limited, focused views. We documented the occurrence of CIN (Increase in 25% and/or 0.5 mg/dl in serum creatinine at 24-72h post procedure). We then calculated the predicted risk based on the risk score and used the one sample proportion test to compare the actual and predicted CIN rates.   Results:  We had complete data on 67 sequential patients with mean creatinine of 2.1 mg/dl (+/-0.5). The mean amount of contrast used per patient was 26.6 cc (+/-15). In these high-risk patients, the actual incidence of CIN was significantly lower than the predicted incidence [3 patients (4.5%) vs. 23(34%); p   Conclusions:  Thus, aggressive and mindful minimization of contrast utilization using a 3cc syringe and focused angiographic views decreased the rate of CIN by more than 7 fold the predicted rate.
The Clinical Management of Systemic Lupus Erythematosus.
Authors: Peter H. Schur
Journal: Annals of Internal Medicine (1984)

Historical Perspective and Changing History General Symptomology Immunopathology of Lupus Serology Musculoskeletal Manifestations Cutaneous Lupus Erythematosus Cardiac Aspects Pulmonary Manifestations Hematologic Manifestations Renal Disease Gastrointestinal Manifestations Neurologic Manifestations of Lupus Psychiatric Aspects of Lupus Pregnancy Lupus-Like Syndromes Related to Drugs and Environmental Factors Systemic Lupus Erythematosus in Children and Adolescents Antiphospholipid Syndrome Clinical Monitoring Medications Treatment Subject Index
Elevation of Plasma Neurotensinlike Immunoreactivity after a Meal
Authors: Robert A. Hammer, Robert E. Carraway, Susan E. Leeman
Journal: Journal of Clinical Investigation (1982)

The detection of an elevation in neurotensinlike immunoreactivity in peripheral plasma for several hours after a meal has been confirmed and shown to be primarily due to the presence of aminoterminal fragments of neurotensin (NT) rather than to NT itself. We have developed a procedure to separate and characterize these N-terminal cross-reacting substances, and to estimate the contributions of these constitutents to plasma neurotensinlike immunoreactivity. Gel chromatography of pooled plasma extracts on Sephadex G-25 followed by reverse-phase high pressure liquid chromatography indicated that peptides coeluting with NT and its N-terminal partial sequences NT(1-8) and NT(1-11) were present in plasma. Comparison of plasmas collected before and 1 h after a defined meal, in five experiments, demonstrated no change in C-terminal immunoreactivity and an 8- to 10-fold rise in N-terminal immunoreactivity. Chromatographic analysis of pooled pre- and postmeal plasma in four experiments showed that essentially all of this elevation in neurotensinlike immunoreactivity measured with an N-terminal directed antiserum was due to increases in NT(1-8) and NT(1-11), while NT itself, measured using a C-terminal directed antiserum, did not increase appreciably in peripheral plasma 1 h after the meal. Generation of tritiated substances with the same elution times as NT(1-8) and NT(1-11) did occur after incubation of [3H]NT with whole blood in vitro, providing supporting evidence that these fragments are metabolites of NT. The marked elevation in the circulating levels of these fragments reflects that an increased secretion of NT occurred in response to the test meal. The secreted NT may have acted as a hormone before it was metabolized, or it may only have had a local (paracrine) effect.
Emergence and spread of vancomycin resistance among enterococci in Europe
Authors: G Werner, T M Coque, A M Hammerum, R Hope, W Hryniewicz, A Johnson, I Klare, K G Kristinsson, R Leclercq, C H Lester, M Lillie, C Novais, B Olsson-Liljequist, L V Peixe, E Sadowy, G S Simonsen, J Top, J Vuopio-Varkila, R J Willems, W Witte, N Woodford
Journal: Eurosurveillance (2008)

Nowadays, six types of acquired vancomycin resistance in enterococci are known; however, only VanA and to a lesser extent VanB are widely prevalent. Various genes encode acquired vancomycin resistance and these are typically associated with mobile genetic elements which allow resistance to spread clonally and laterally. The major reservoir of acquired vancomycin resistance is Enterococcus faecium; vancomycin-resistant Enterococcus faecalis are still rare. Population analysis of E. faecium has revealed a distinct subpopulation of hospital-acquired strain types, which can be differentiated by molecular typing methods (MLVA, MLST) from human commensal and animal strains. Hospital-acquired E. faecium have additional genomic content (accessory genome) including several factors known or supposed to be virulence-associated. Acquired ampicillin resistance is a major phenotypic marker of hospital-acquired E. faecium in Europe and experience has shown that it often precedes increasing rates of VRE with a delay of several years. Several factors are known to promote VRE colonisation and transmission; however, despite having populations with similar predispositions and preconditions, rates of VRE vary all over Europe.
Abstract 566: The clinicopathological features and prognostic impact of ALK-positivity in resected gastric or gastro-esophageal cancer patients
Authors: Hongjae Jeon, HyeRyun Kim, Sung Hoon Noh, Hyun Cheol Chung, Sun Young Rha
Journal: Cancer Research (2014)

Abstract Background: To determine the frequency and prognostic impact of ALK-rearrangements in gastric cancer patients who underwent curative surgical resection with extensive (D2) lymph node dissection. Patients and methods: We concurrently analyzed the ALK-rearrangements and HER2 overexpression in whole tumor sections of 455 curatively resected gastric cancers. We performed immunohistochemistry (IHC) and fluorescent in situ hybridization (FISH), and analyzed the relationship between ALK positivity and clinical survival outcome. Results: Of the 455 tumors that were screened, 38 (8.4%) were ALK+ by IHC, which consisted of 1+ (24, 7.5%), 2+ (3, 0.7%), and 3+ (1, 0.2%), but no cases were confirmed by FISH. ALK+ patients were significantly younger (57 vs. 61 years, P=0.02) and showed similar patterns of ALK+ lung adenocarcinoma. ALK+ patients were significantly more likely to have abundant signet ring cells (defined as ≥ 10% of tumor cells). Moreover, as the ALK intensity (measured by IHC) increased, so did the density of signet ring cell in tumors (Ptrend = 0.02). Also, the disease free survival (DFS) and overall survival (OS) of ALK+ patients in stages were shorter than ALK- patients (DFS: 21.2 vs.100.5 months; P = 0.007, OS: 34.3 months vs. median survival time unattainable; P=0.016) Conclusions: ALK+ is an independent negative prognostic factor in surgically resected gastric cancers and is associated with signet ring cell histology. Furthermore ALK+ might be a relevant therapeutic target in gastric cancer patients. Citation Format: Hongjae Jeon, HyeRyun Kim, Sung Hoon Noh, Hyun Cheol Chung, Sun Young Rha. The clinicopathological features and prognostic impact of ALK-positivity in resected gastric or gastro-esophageal cancer patients. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 566. doi:10.1158/1538-7445.AM2014-566
Book: Core Values in Primary Care
Authors: R. Jones
Journal: BMJ (1998)

Ed Mike Pringle BMJ Books, £25, pp 128 ISBN 0 7279 1268 2 Rating:![Graphic][1]</img>![Graphic][2]</img> Twenty years ago the US Institute of Medicine enunciated, perhaps a little ironically, the four fundamental principles of primary care:accessibility, comprehensiveness, coordination, and continuity. These principles represent an enduring framework for considering and evaluating the contribution that a primary care sector makes to a healthcare system. In this edited collection of essays from the BMJ an international cast of contributors explores these and other aspects of primary … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif
CHRONIC ARTHRITIS, A GENERAL DISEASE REQUIRING INDIVIDUALIZED TREATMENT
Authors: Ernest E. Irons
Journal: Annals of Internal Medicine (1936)

Article1 June 1936CHRONIC ARTHRITIS, A GENERAL DISEASE REQUIRING INDIVIDUALIZED TREATMENTERNEST E. IRONS, F.A.C.P.ERNEST E. IRONS, F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-9-12-1658 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptHundreds of discussions and scores of books have been written about arthritis—and still they come, largely because this condition occasions more disability than any other disease in temperate climates, and its care presents a greater multitude of difficulties. In presuming to bring to you so age-worn a subject, I plead as excuse the request of your President, and the fact, expressed in my title, that in recent years there has come a great change in the general conception of the relation of disease of the joints to disease of the rest of the body. This altered viewpoint makes easier the... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Chicago, Illinois*Presented at the Detroit meeting of the American College of Physicians, March 2, 1936. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1936Volume 9, Issue 12Page: 1658-1663KeywordsArthritisDisabilities ePublished: 1 December 2008 Issue Published: 1 June 1936 PDF downloadLoading ...
Incidence and long term prognosis of papillary renal cell carcinoma
Authors: A. J. Schrader, S. Rauer-Bruening, P. J. Olbert, A. Hegele, J. Rustemeier, R. Hofmann
Journal: Journal of Clinical Oncology (2009)

e16020 Background: Papillary renal cell carcinoma (pRCC) represents the largest subgroup of non clear-cell kidney cancer. In this study we assessed tumour characteristics and long-term prognosis of patients with pRCC in comparison with conventional clear-cell cancer (ccRCC). Methods: We evaluated 744 patients who had undergone renal surgery for RCC between 1990 and 2005. The mean follow-up was 5.6 years. Results: Both groups pRCC and ccRCC were alike concerning age, body mass index, and the incidence of regional lymph node or distant metastasis at diagnosis. The percentage of male patients was higher in pRCC than in ccRCC (73.8 vs. 60.3%, p = 0.006). Even though patients with pRCC presented more often with smaller (p = 0.039) and low grade tumours (p = 0.006), there was no statistically significant difference in tumour recurrence or tumour related death. Moreover, looking at the whole cohort Kaplan-Meier curves revealed no differences regarding tumour specific survival between pRCC and ccRCC (p = 0.94; 5-year survival 78% vs. 77%). However, we observed a trend towards an improved outcome for organ confined (pT1–2) cancer, but a significantly inferior prognosis for locally advanced stage (pT3–4) and/or metastatic papillary tumours at the time of renal surgery. However, applying multivariate analysis including age, sex, and tumour grade, histology could neither be retained as a significant independent prognostic marker in the metastatic setting (p = 0.068, cox regression analysis) nor in a subgroup analysis focussing on patients with advanced cancer (pT3–4 and/or N+/M+; p = 0.064, cox regression analysis). Conclusions: Even though pRCC and ccRCC differ significantly in many aspects including histology and genetic alterations, in all, their long term prognosis is comparable. As we could not confirm a favourable clinical course for pRCC in general, standardized aftercare programmes and - if necessary - systemic treatment, especially in the era of novel targeted drugs, are also needed for this common RCC subtype. In addition, routine histologic subtyping of pRCC is strongly recommended. No significant financial relationships to disclose.
Abstract 13131: The Priority of Coronary Arteriography and Therapeutic Hypothermia After Return of Spontaneous Circulation in Patients With Out-of-hospital Cardiac Arrest. the Result of Sos-kanto 2012 Study
Authors: Shuichi Hagiwara, Kiyohiro Oshima, Masato Murata, Makoto Aoki, Kei Hayashida, Atsushi Sakurai, Ken Nagao, Arino Yaguchi, Naoto Morimura
Journal: Circulation (2014)

Aim: To evaluate the priority of coronary angiography (CAG) and therapeutic hypothermia therapy (TH) after return of spontaneous circulation (ROSC) in patients with out-of-hospital cardiac arrest (OHCA). Patients and Methods: SOS-KANTO 2012 study is a prospective, multicenter (69 emergency hospitals) and observational study and includes 16,452 patients with OHCA. Among the cases with ROSC in that study, we intended for patients treated with both CAG and TH within 24 hours after arrival. Those patients were divided into two groups; patients in whom TH was firstly performed (TH group), and the others in whom CAG was firstly done (CAG group). We statistically compared the prognosis between the two groups. SPSS Statistics 22 (IBM, Tokyo, Japan) was used for the statistical analysis. Statistical significance was assumed to be present at a p value of less than 0.05. Result: 233 patients were applied in this study. There were 86 patients in the TH group (M/F: 74/12, mean age; 60.0±15.2 y/o) and 147 in the CAG group (M/F: 126/21, mean age: 63.4±11.1 y/o) respectively, and no significant differences were found in the mean age and M/F ratio between the two groups. The overall performance categories (OPC) one month after ROSC in the both groups were as follows; in the TH group, OPC1: 21 (24.4%), OPC2: 3 (3.5%), OPC3: 7 (8.1%), OPC4: 8 (9.3%), OPC5: 43 (50.0%), unknown: 4 (4.7%), and in the CAG group, OPC1: 38 (25.9%), OPC2: 13 (8.8%), OPC3: 15 (10.2%), OPC4: 18 (12.2%), OPC5: 57 (38.8%), unknown: 6 (4.1%). There were no significant differences in the prognosis one month after ROSC between the two groups. Conclusion: The results which of TH and CAG you give priority to over do not affect the prognosis in patients with OHCA.
Abstract P2-16-01: Discovery of fully human monoclonal antibodies as therapeutic candidates for the treatment of HER2-negative breast cancer
Authors: Christy Boozer, Paul Algate, Aurelio Bonavia, Mark Branum, Po-Ying Chan-Hui, Alison Fitch, Brad Greenfield, Claire Sutherland, Kristine Swiderek
Journal: Cancer Research (2015)

Abstract Unlike HER2-positive breast cancer, there are limited treatment options for patients diagnosed with triple negative and endocrine resistant HER2-negative breast cancer, and as such HER2-negative breast cancer represents a significant unmet medical need. The goal of this work is to use Theraclone’s proprietary I-STAR platform to mine the memory B cell immune repertoire of breast cancer patients for the discovery of therapeutically relevant monoclonal antibodies (mAbs) and targets that may be exploited as candidates for treatment of HER2-negative breast cancer. Matched serum and PBMC samples were collected from breast cancer patients at multiple clinical sites. The selected patient populations included, but were not limited to, patients who were treatment naïve, those who had received immunotherapy or adjuvant chemotherapy, and patients who had an exceptional clinical response to treatment and/or disease. Serum antibody binding to a diverse panel of 5 well characterized breast cancer-derived cell lines of luminal and basal sub-types was determined. Utilizing this approach, patients with a robust serological profile across multiple breast cancer cell lines were identified and prioritized for memory B cell repertoire analysis via the I-STAR platform. Using a high throughput and miniaturized, multiplex flow cytometry assay, the secreted IgG antibodies from over 85,000 individually enriched and expanded B cell clones were screened for binding to the tumor cell line panel and a large number of positive B cell clones were identified. The screening hits can be binned into several unique binding profiles, many of which were confirmed to be shared across multiple patient samples. Deep sequence analysis of the variable regions of the antibodies produced by the B cell clones demonstrated that several of the screening hits were derived from clonally related B cells; the majority of the screening hits represented antibodies derived from unique B cell clones. A representative set of these antibodies was expressed recombinantly for further in vitro characterization. Citation Format: Christy Boozer, Paul Algate, Aurelio Bonavia, Mark Branum, Po-Ying Chan-Hui, Alison Fitch, Brad Greenfield, Claire Sutherland, Kristine Swiderek. Discovery of fully human monoclonal antibodies as therapeutic candidates for the treatment of HER2-negative breast cancer [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-16-01.
Vitamin D deficiency: time for action
Authors: J E Compston
Journal: BMJ (1998)

Vitamin D is both a vitamin and a hormone and has diverse actions. The major biologically active metabolite, 1,25-dihydroxyvitamin D, plays a central part in maintaining calcium and phosphate homoeostasis and also has antiproliferative, prodifferentiation, and immunosuppressive effects; its receptors are distributed in various tissues, including bone, pancreas, stomach, gonads, brain, skin, and breast.1 Vitamin D is essential for skeletal health, and severe deficiency is associated with defective mineralisation resulting in rickets or its adult equivalent, osteomalacia. More subtle degrees of insufficiency lead to secondary hyperparathyroidism and increased bone turnover, which play an important part in age related bone loss and osteoporotic fractures.

Over recent decades a wealth of evidence has accumulated documenting vitamin D deficiency in elderly populations in Europe and elsewhere. 2 3 A recent study from the United States has added further evidence that vitamin D deficiency continues to be neglected and also raised questions about how best to combat it.4

Vitamin D status is most commonly assessed by measuring serum concentrations of 25-hydroxyvitamin D (25-OHD), the major circulating form of …
Effects of Xanthine Oxidase Inhibition in Hyperuricemic Heart Failure Patients
Authors: Michael M. Givertz, Kevin J. Anstrom, Margaret M. Redfield, Anita Deswal, Haissam Haddad, Javed Butler, W.H. Wilson Tang, Mark E. Dunlap, Martin M. LeWinter, Douglas L. Mann, G. Michael Felker, Christopher M. O’Connor, Steven R. Goldsmith, Elizabeth O. Ofili, Mitchell T. Saltzberg, Kenneth B. Margulies, Thomas P. Cappola, Marvin A. Konstam, Marc J. Semigran, Steven E. McNulty, Kerry L. Lee, Monica R. Shah, Adrian F. Hernandez
Journal: Circulation (2015)

Background— Oxidative stress may contribute to heart failure (HF) progression. Inhibiting xanthine oxidase in hyperuricemic HF patients may improve outcomes. Methods and Results— We randomly assigned 253 patients with symptomatic HF, left ventricular ejection fraction ≤40%, and serum uric acid levels ≥9.5 mg/dL to receive allopurinol (target dose, 600 mg daily) or placebo in a double-blind, multicenter trial. The primary composite end point at 24 weeks was based on survival, worsening HF, and patient global assessment. Secondary end points included change in quality of life, submaximal exercise capacity, and left ventricular ejection fraction. Uric acid levels were significantly reduced with allopurinol in comparison with placebo (treatment difference, –4.2 [–4.9, –3.5] mg/dL and –3.5 [–4.2, –2.7] mg/dL at 12 and 24 weeks, respectively, both P &lt;0.0001). At 24 weeks, there was no significant difference in clinical status between the allopurinol- and placebo-treated patients (worsened 45% versus 46%, unchanged 42% versus 34%, improved 13% versus 19%, respectively; P =0.68). At 12 and 24 weeks, there was no significant difference in change in Kansas City Cardiomyopathy Questionnaire scores or 6-minute walk distances between the 2 groups. At 24 weeks, left ventricular ejection fraction did not change in either group or between groups. Rash occurred more frequently with allopurinol (10% versus 2%, P =0.01), but there was no difference in serious adverse event rates between the groups (20% versus 15%, P =0.36). Conclusions— In high-risk HF patients with reduced ejection fraction and elevated uric acid levels, xanthine oxidase inhibition with allopurinol failed to improve clinical status, exercise capacity, quality of life, or left ventricular ejection fraction at 24 weeks. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00987415.