tbuckley/cabot-search huggingface dataset:
C-Reactive Protein and the Risk of Stent Thrombosis and Cardiovascular Events After Drug-Eluting Stent Implantation
Authors: Duk-Woo Park, Sung-Cheol Yun, Jong-Young Lee, Won-Jang Kim, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Jae-Joong Kim, Seong-Wook Park, Seung-Jung Park
Journal: Circulation (2009)

Background— Although C-reactive protein (CRP) has been proposed as a useful biomarker for predicting atherothrombosis, the association between CRP and stent thrombosis after drug-eluting stent implantation has not been defined. Methods and Results— We prospectively evaluated 2691 patients treated with drug-eluting stents who had a baseline CRP measurement. The primary outcome was stent thrombosis; secondary outcomes were death, myocardial infarction (MI), death or MI, and target vessel revascularization. During follow-up (median, 3.9 years), 32 patients had definite or probable stent thrombosis, 137 patients died, 227 had an MI, and 195 underwent target vessel revascularization. In multivariable Cox proportional-hazards models, elevated levels of CRP were significantly associated with increased risk of stent thrombosis (hazard ratio, 3.86; 95% confidence interval, 1.82 to 8.18; P &lt;0.001). Elevated CRP levels also significantly predicted the risks of death (hazard ratio, 1.61; 95% confidence interval, 1.13 to 2.28; P =0.008), MI (hazard ratio, 1.63; 95% confidence interval, 1.25 to 2.12; P =0.001), and death or MI (hazard ratio, 1.61; 95% confidence interval, 1.29 to 2.00; P &lt;0.001) but not target vessel revascularization (hazard ratio, 1.20; 95% confidence interval, 0.90 to 1.61; P =0.21). The incorporation of CRP into a model with patient, lesion, and procedural factors resulted in a significant increase in the C statistic for the prediction of stent thrombosis, MI, and the composite of death or MI. Conclusions— Elevated CRP levels were significantly associated with increased risks of stent thrombosis, death, and MI in patients receiving drug-eluting stents, suggesting the usefulness of inflammatory risk assessment with CRP. Given the relatively infrequent occurrence of stent thrombosis, death, and MI, larger studies with longer-term follow-up are required to confirm the novel relationship.
Dramatic Responses to Therapy in Rare Tumors
Authors: Matías Chacón, Enrique Roca, Eduardo Huertas, Fernando Sanchez Loria, Enzo Domenechini
Journal: Journal of Clinical Oncology (2005)

sarcoma, myeloma, and cachexia syndrome, and is less effective in advanced renal carcinoma.One objective of such therapies is to downregulate the vascular endothelial growth factor.There is no available data on ACC treated with antiangiogenic drugs.This case shows an excellent imaging response with thalidomide in a very resistant tumor (ACC).
Pathophysiology of Cardiogenic Shock
Authors: DANIEL R. ALONSO, STEPHEN SCHEIDT, MARTIN POST, THOMAS KILLIP
Journal: Circulation (1973)

Clinical and pathologic data were correlated in 22 patients with cardiogenic shock and 10 "control" patients who died suddenly after infarction without shock. A pathologic technique of ventricular mapping allowed quantification of recent as well as old infarction. Total left ventricular (LV) damage averaged 51% (range 35-68%) in the shock patients and 23% (range 14-31%) in the control group. Shock was associated with recent infarction (all 22 patients), old infarction (21 patients) and extension of infarction (18 patients). Extension, often in a subepicardial manner, averaged 6% of LV mass (range 3-10%) in 18 patients with shock; it preceded shock in four, coincided with the onset of shock in six, and followed shock in seven patients with shock. In contrast, small extensions averaging 2% of LV mass were found in three, and multiple recent infarctions in two control patients. Although progressive myocardial damage was a common pathologic finding, it was infrequently recognized clinically. The electrocardiogram reflected evidence of recent infarction in 56%, old infarction in 31%, and extension in only 30% of patients. These data suggest that appropriate early therapeutic intervention might limit myocardial damage by preventing extension or reinfarction. Since shock was best correlated with total LV damage, such limitation of infarction might reduce the incidence and mortality of cardiogenic shock.
Enhanced brief lifestyle counseling for obesity was better than usual care for weight loss at 2 years
Authors: Alka M. Kanaya
Journal: Annals of Internal Medicine (2012)

ACP Journal Club20 March 2012Enhanced brief lifestyle counseling for obesity was better than usual care for weight loss at 2 yearsAlka M. Kanaya, MDAlka M. Kanaya, MDUniversity of California, San Francisco, San Francisco, California, USA (A.M.K.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-6-201202210-02011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationWadden TA, Volger S, Sarwer DB, et al. A two-year randomized trial of obesity treatment in primary care practice. N Engl J Med. 2011;365:1969-79. https://pubmed.ncbi.nlm.nih.gov/22082239Clinical Impact RatingsGIM/FP/GP: Endocrinology: References1 Digenio AG, Mancuso JP, Gerber RA, Dvorak RV. Comparison of methods for delivering a lifestyle modification program for obese patients: a randomized trial. Ann Intern Med. 2009;150:255-62. [PMID: 19221377] Google Scholar2 Tuomilehto J, Lindström J, Eriksson JG, et al; Finnish Diabetes Prevention Study Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344:1343-50. [PMID: 11333990] Google Scholar3 Knowler WC, Barrett-Connor E, Fowler SE, et al; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393-403. [PMID: 11832527] Google Scholar4 US Preventive Services Task Force. Screening for obesity in adults: recommendations and rationale. Ann Intern Med. 2003;139:930-2. [PMID: 14644896] Google Scholar5 Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA. 2012;307;491-7. [PMID: 22253363] Google Scholar Author, Article, and Disclosure InformationAffiliations: University of California, San Francisco, San Francisco, California, USA (A.M.K.)This article was published at Annals.org on 6 March 2012. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoIn-person or remote behavioral interventions for obesity were better than a self-directed approach Alka M. Kanaya Metrics 20 March 2012Volume 156, Issue 6Page: JC3-11KeywordsBody weightClinical trialsObesityOverweightSubstance abuseTelemedicineType 2 diabetesWeight loss ePublished: 20 March 2012 Issue Published: 20 March 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Endogenous Erythropoietin and Outcome in Heart Failure
Authors: Anne M.S. Belonje, Adriaan A. Voors, Peter van der Meer, Wiek H. van Gilst, Tiny Jaarsma, Dirk J. van Veldhuisen
Journal: Circulation (2010)

Background— Endogenous erythropoietin is increased in patients with heart failure (HF). Previous small-scale data suggest that these erythropoietin levels are related to prognosis. This study aims to analyze the clinical and prognostic value of erythropoietin levels in relation to hemoglobin in a large cohort of HF patients. Methods and Results— In patients hospitalized for HF, endogenous erythropoietin levels were measured at discharge and after 6 months. In anemic patients, the relation between erythropoietin and hemoglobin levels was determined by calculating the observed/predicted ratio of erythropoietin levels. We studied data from 605 patients with HF. Mean age was 71±11 years; 62% were male; and mean left ventricular ejection fraction was 0.33±0.14. Median erythropoietin levels were 9.6 U/L at baseline and 10.5 U/L at 6 months. Higher erythropoietin levels at baseline were independently related to an increased mortality at 18 months (hazard ratio, 2.06; 95% confidence interval, 1.40 to 3.04; P &lt;0.01). In addition, persistently elevated erythropoietin levels (higher than median at baseline and at 6 months) were related to an increased mortality risk (hazard ratio, 2.24; 95% confidence interval, 1.02 to 4.90; P =0.044). The observed/predicted ratio was determined in a subset of anemic patients, 79% of whom had erythropoietin levels lower than expected and 9% had levels higher than expected on the basis of their hemoglobin. Multivariate Cox regression analysis revealed that a higher observed/predicted ratio was related to an increased mortality risk (hazard ratio, 3.52; 95% confidence interval, 1.53 to 8.12; P =0.003). Conclusions— Erythropoietin levels predict mortality in HF patients, and persistently elevated levels have an independent prognostic value. In anemic HF patients, the majority had a low observed/predicted ratio. However, a higher observed/predicted ratio may be related to an independent increased mortality risk.
Autologous immune complex nephritis associated with sickle cell trait: diagnosis of the haemoglobinopathy after renal structural and immunological studies.
Authors: T Ozawa, M F Mass, S Guggenheim, J Strauss, R M McIntosh
Journal: BMJ (1976)

A renal tubular epithelial antigen (RTE)--anti-RTE autologous immune complex nephritis associated with sickle cell anaemia (SS) has been reported, but immune complex nephritis has never been described in patients with sickle cell trait (SA). During investigation of a child with "asymptomatic proteinuria" cryoprecipitable complexes of RTE-anti-RTE were detected in the serum and granular deposits of RTE, immunoglobulins, and complement localised on the glomerular basement membranes. Morphological and ultrastructural studies showed increased mesangial matrix, sickled red blood cells in the glomeruli and vessels, and tubular and interstitial abnormalities. These findings prompted haemoglobin electrophoretic studies, which showed previously undiagnosed haemoglobin SA in this patient and her family. These observations suggest that nephritis mediated by similar immunopathogenic mechanisms may be associated with SS and SA haemoglobinopathy. Under some conditions patients with sickle cell trait may experience haemodynamic and oxygenation abnormalities, which may be aetiological factors in the immune complex nephritis associated with SS disease.
Epigenetic and genetic loss of Hic1 function accentuates the role of p53 in tumorigenesis
Authors: WenYong Chen, Timothy K. Cooper, Cynthia A. Zahnow, Michael Overholtzer, Zhiquan Zhao, Marc Ladanyi, Judith E. Karp, Nalan Gokgoz, Jay S. Wunder, Irene L. Andrulis, Arnold J. Levine, Joseph L. Mankowski, Stephen B. Baylin
Journal: Cancer Cell (2004)
MILITARY SURGERY IN GREECE.
Authors: N. SENN
Journal: JAMA (1897)

The war between Greece and Turkey is ended. It was a short and in many respects a remarkable combat. After six or seven conflicts little Greece was conquered by an overpowering foe. In a little more than a month the little kingdom found itself trampled under the feet of a fanatic and greedy conqueror. Fate was against Greece from the beginning of the conflict. The scanty resources of the country made it impossible to maintain an army upon a modern war footing and its citizens, the descendants of the proud and warlike Hellenes, are no longer the equals of their forefathers whose daring exploits and victories have been immortalized in prose and poetry. Centuries of subjugation to foreign power and policies have resulted in a loss of confidence and a diminution in the intrinsic resisting power of the nation that once, under the leadership of great statesmen and warriors, constituted
TCT-20 Pressure-controlled Intermittent Coronary Sinus Occlusion (PICSO) in Acute ST-segment Elevation Myocardial Infarction: Final Results of the Prepare RAMSES Study
Authors: Tim P. van de Hoef, Robin Nijveldt, Martin van der Ent, M. Meuwissen, Ahmed Khattab, Wichert J. Kuijt, Joanna J. Wykrzykowska, Jan G. Tijssen, Albert C. van Rossum, Gregg W. Stone, Jan Piek
Journal: Journal of the American College of Cardiology (2014)
886 SOCS3 AND IRS-1 GENE EXPRESSION DIFFERS BETWEEN GENOTYPE 1 AND GENOTYPE 2 HCV- INFECTED HEPG2 CELLS
Authors: M. Persico, R. Roberta, E. Persico, M.F. Svelto, D. Spano, I. Andolfo, V. La Mura, C. Tiribelli, R. Torella
Journal: Journal of Hepatology (2009)
BIVALIRUDIN VERSUS HEPARIN PLUS GLYCOPROTEIN IIB/IIIA INHIBITORS IN PATIENTS UNDERGOING PCI FOR ACUTE CORONARY SYNDROME: A META-ANALYSIS
Authors: Luke Kim, S. Chiu Wong, Hasan Ahmad, Edward Wingfield, Robert M. Minutello, Geoffrey Bergman, Issam Moussa, Dmitriy N. Feldman
Journal: Journal of the American College of Cardiology (2010)
Long-Term Survival After Aortic Valve Replacement Among High-Risk Elderly Patients in the United States
Authors: J. Matthew Brennan, Fred H. Edwards, Yue Zhao, Sean M. O'Brien, Pamela S. Douglas, Eric D. Peterson
Journal: Circulation (2012)

Background— Surgical aortic valve replacement (AVR) remains the standard of care for the treatment of operable, symptomatic aortic valve disease; however, to date, there are limited national data on the contemporary long-term outcomes after AVR in older individuals. Methods and Results— We examined long-term survival among 145 911 AVR patients ≥65 years of age undergoing AVR at 1026 centers with participation in the Society of Thoracic Surgeons Adult Cardiac Surgery Database from 1991 to 2007. In-hospital complications and long-term survival were stratified by age, Society of Thoracic Surgeons perioperative risk of mortality, and several comorbidities. The median patient age was 76 years; 16% had chronic lung disease, 6% had preoperative renal failure, 38% had heart failure, and 12% had prior cardiac surgery. The median survival in patients 65 to 69, 70 to 79, and ≥80 years of age undergoing isolated AVR was 13, 9, and 6 years, respectively. For AVR plus coronary artery bypass graft procedures, median survival was 10, 8, and 6 years, respectively. Although only 5% of isolated AVR patients had a high Society of Thoracic Surgeons perioperative risk of mortality (≥10%), their median survival was 2.5 to 2.7 years. Severe lung disease and renal failure were each associated with a ≥50% reduction in median survival among all age groups compared with those who did not have these comorbidities, whereas left ventricular dysfunction and prior cardiac operation were associated with a 25% reduction in median survival. Conclusion— Long-term survival after surgical AVR in the elderly is excellent, although patients with a high Society of Thoracic Surgeons perioperative risk of mortality and those with certain comorbidities carry a particularly poor long-term prognosis.
High Serum Lactate Dehydrogenase Level as a Marker for Drug Resistance and Short Survival in Multiple Myeloma
Authors: Meletios A. Dimopoulos, Bart Barlogie, Terry L. Smith, Raymond Alexanian
Journal: Annals of Internal Medicine (1991)

Objective: To evaluate serum lactate dehydrogenase (LDH) as a prognostic factor in previously untreated patients with multiple myeloma. Design: Study of 391 consecutive patients with uniformly treated multiple myeloma, followed until death in 63% of patients. Setting: Tertiary, referral cancer center. Patients: A total of 391 consecutive, previously untreated, symptomatic patients with various stages of multiple myeloma. Intervention: Various chemotherapy regimens that included doxorubicin or glucocorticoids, or both, with a consistent response rate (53%). Measurements: Outcomes included clinical response based on a 75% reduction of calculated tumor load and survival time from treatment. Univariate and multivariate analyses were used. Main Results: Eleven percent of patients showed a high serum LDH level of more than 5.0 µkat/L (300 U/L). An elevated LDH level was seen more frequently with a rise in the tumor load; an increased level was present in 26% of patients with high tumor mass. A high LDH level was associated with plasma cell leukemia or lymphoma-like clinical features (43%) and with plasma cell hypodiploidy (17%). Only 20% of patients with elevated LDH levels responded to chemotherapy compared with a response rate of 57% for patients with low levels of LDH. Using multivariate analysis, LDH was a significant independent predictor of response (P = 0.001), with an odds ratio of 0.25 (95% Cl, 0.11 to 0.57). A high LDH level was associated with a short median survival (9 months) and showed the highest relative risk (2.63; Cl, 1.75 to 3.95; P = 0.001). Conclusions: Elevation of the LDH level suggests the presence of occult extraosseous disease and high tumor mass. The LDH level is a predictor of a poor prognosis in selected patients who should be considered for early intensive treatment.
Assessing the Competence of Persons With Alzheimer’s Disease in Providing Informed Consent for Participation in Research
Authors: Scott Y. H. Kim, Eric D. Caine, Glenn W. Currier, Adrian Leibovici, J. Michael Ryan
Journal: American Journal of Psychiatry (2001)

OBJECTIVE: The capacity of persons with Alzheimer's disease or other neuropsychiatric disorders for giving consent to participate in research has come under increasing scrutiny. While instruments for measuring abilities related to capacity have been developed, how they should be used to categorize subjects as capable or incapable is not clear. A criterion validation study was carried out to help address this question. METHOD: The authors measured the ability of 37 subjects with mild-to-moderate Alzheimer's disease and 15 elderly comparison subjects to provide consent for participation in a hypothetical clinical trial. Using the judgment of three experts as the criterion standard, the authors performed a receiver operator characteristic analysis for the capacity ability measures from the MacArthur Competence Assessment Tool—Clinical Research Version. The results were compared with categorizations of capacity status that were based on normative values. RESULTS: While most comparison subjects scored perfectly on all measures of the competence assessment tool, the majority of the group with Alzheimer's disease showed significant decision-making impairment. Thresholds based on normative values resulted in 84% (N=31) of the Alzheimer's disease subjects being rated as incapable on at least one ability; thresholds based on expert judgment resulted in 62% (N=23) failing to meet cutoff scores on at least one ability. CONCLUSIONS: Even relatively mild Alzheimer's disease significantly impairs consent-giving capacity. But differentiating capable from incapable subjects remains an issue despite the aid of standardized tools. More research is needed to understand the relationship between subject factors (performance on ability measures) and categorical judgments about their capacity.
Volume regulation by human lymphocytes. Identification of differences between the two major lymphocyte subpopulations.
Authors: R K Cheung, S Grinstein, E W Gelfand
Journal: Journal of Clinical Investigation (1982)

Following exposure to hypotonic media, human peripheral blood lymphocytes swell initially but restore their isotonic volume within minutes. In contrast, tonsillar lymphocytes demonstrate a similar initial phase of swelling but fail to restore their isotonic volume. We have studied the ionic basis for this second or regulatory volume decrease (RVD) phase using lymphocytes from peripheral blood, tonsil, and thymus. RVD was characterized by 86Rb efflux and a decrease in K+ content. The increase in K+ permeability in response to hypotonic challenge was characteristic for T lymphocytes obtained from peripheral blood, tonsil, or thymus. B lymphocytes showed only a modest increase in K+ permeability and consequently little RVD. The data confirm that the response of peripheral blood and tonsillar lymphocytes to a hypotonic environment can be accounted for by differences in the proportions of T and B cells, and the differential behaviour of B and T lymphocytes is based on differences in membrane permeability to K+ upon swelling.
Abstract 3976: PD-1 blockade combined with TEGVAX (TLR agonists-enhanced GVAX) can induce regression of established palpable tumors.
Authors: Ian-James Malm, Juan Fu, Drew Pardoll, Young J. Kim
Journal: Cancer Research (2013)

Abstract Background: Cell-based vaccines have been developed for several types of tumors, but these vaccines have two critical shortcomings that weaken their clinical efficacy. The first of which is a limited capability to activate antigen presenting cells. Second, they fail to address critical immune checkpoint molecules that dampen the subsequent T-cell response against the established tumor. In order to optimize the activation of antigen presenting cells capable of marshaling both an innate and adaptive immune response against the tumor, we formulated a GM-CSF secreting tumor cell vaccine with multiple TLR agonists. To address the immune checkpoint signaling pathway, we combined our formulated vaccine with a blocking αPD-1 antibody in two mouse models of established tumor - one with melanoma and the other with tongue cancer. Methods: To optimize in vivo efficacy of anti-tumor T-cell response, we engineered TEGVAX, a GM-CSF secreting cell-based tumor vaccine formulated with GLA (TLR4 agonist) and R848 (TLR7/8 agonists), molecules that are amenable for clinical translation. We then combined TEGVAX with αPD-1 blocking antibody (G4 clone) in the murine B16 melanoma and SCCFVII tongue cancer model. Furthermore, we studied immunological parameters that correlated with in vivo anti-tumor response. Results: In both B16 and SCCFVII treatment models, TEGVAX demonstrated statistically significantly (p&amp;lt;0.01) enhanced anti-tumor responses in comparison to the parental cell vaccine in vivo. For tumor bearing mice treated with TEGVAX, these potent anti-tumor responses were correlated with a statistically significant increase in CD4+ and CD8+ T-cells that secrete IFNγ in the tumor microenvironment. TEGVAX treated mice also had significantly higher levels of tumor antigen p15E-specific cell mediated killing in vivo. Blockade of the PD-1 immune checkpoint pathway further augmented the therapeutic potential of TEGVAX and induced the regression of established B16 and SCCFVII tumors. Conclusion: When combined with αPD-1 antibody, TEGVAX was able to induce regression of established B16 and SCCFVII tumors. Our results with these combinatorial immunotherapeutic strategies provide preclinical evidence to support the translation of these reagents for HNSCC or melanoma patients that are refractory to standard treatment modalities. Citation Format: Ian-James Malm, Juan Fu, Drew Pardoll, Young J. Kim. PD-1 blockade combined with TEGVAX (TLR agonists-enhanced GVAX) can induce regression of established palpable tumors. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3976. doi:10.1158/1538-7445.AM2013-3976