tbuckley/cabot-search huggingface dataset:
Unrelated marrow transplantation for children with acute lymphoblastic leukemia in second remission
Authors: Nancy Bunin, Michael Carston, Donna Wall, Roberta Adams, James Casper, Naynesh Kamani, Roberta King
Journal: Blood (2002)

Abstract Allogeneic bone marrow transplantation (BMT) may be curative for more patients than chemotherapy for the child with relapsed acute lymphoblastic leukemia. This study reviewed the outcomes of 363 children with acute lymphoblastic leukemia in second remission who received unrelated donor BMT from 1988 to 2000 in order to define prognostic factors that affect leukemia-free survival (LFS). Median patient age was 9 years (range, 0-19 years), and median follow-up 29 was months (range, 0-125 months). The median duration of first remission was 24 months (range, 0-109 months). Prognostic factors, including age, duration of first remission, HLA matching, and graft-versus-host (GVH) disease, were analyzed using both univariate and multivariate analyses. Overall survival was 38%, and LFS was 36% at 5 years. LFS was significantly worse for patients 15 years or older (log-rank, P = .009). HLA matching was associated with improved LFS. Acute GVH disease developed in 71%, with 29% having grades III-IV. The incidence of chronic GVH disease was 39% for patients who survived more than 80 days and was significantly higher for female patients receiving marrow from female donors (P = .0009). Transplantation-related mortality was 42% and was associated with HLA mismatches, age 15 years and older, and first remission less than 12 months. The 5-year estimate for relapse was 22%, with first remission at least 6 months associated with a lower risk. Results of unrelated donor BMT appear similar to multi-institutional studies of matched related donor BMT, and this approach appears to be curative for many patients. However, innovative approaches are needed for patients with initial remissions of less than 6 months and for older teenagers.
Microalbuminuria in Patients With Cystic Fibrosis
Authors: Melanie Lind-Ayres, William Thomas, Bonnie Holme, Michael Mauer, Maria Luiza Caramori, Antoinette Moran
Journal: Diabetes Care (2011)

We previously found that microalbuminuria (MA) is present in 14% of patients with long-standing cystic fibrosis-related diabetes (CFRD). However, others have reported much higher rates of MA in CF patients with and without diabetes (32-67%), suggesting this test is not sufficiently specific for diabetic nephropathy screening in CF. We investigated transient (TMA) and persistent (PMA) microalbuminuria in CF patients to resolve these contradictory findings.We reviewed 1,449 outpatient urinary albumin measurements from 467 patients aged ≥10 years, which were collected over a decade. TMA was defined as a single episode of MA that subsequently was resolved. PMA was defined as two consecutive or two out of three consecutive measurements in the MA range.The prevalence of TMA that subsequently was resolved in CF patients was similar to the general population. It was found in 7.6% of patients, including 5% of youth (aged 10-17 years) and 9% of adults. PMA was found in 6.1% of the overall CF population, including 2% of youth and 8% of adults. The odds of PMA were increased sevenfold in patients with CFRD (95% CI 2.5-20, P=0.0002) and 48-fold in patients with both CFRD and organ transplant (95% CI 13-177, P<0.0001). The five patients with PMA in the absence of CFRD or transplant included two youths with presumed benign orthostatic MA and three adults with hypertension.The spot urine albumin-to-creatinine ratio is specific enough to be a valid screening test for diabetic kidney disease in CFRD.
TCT-324 Survival after percutaneous coronary intervention (PCI): Comparison of patients with or without Left Anterior Descending stenosis in elective percutaneous coronary intervention for left main disease and triple vessel disease
Authors: Min Zhao, Heinz Joachim Büttner, Michael Gick, Franz-Josef Neumann, Thomas G. Nuehrenberg, Christian M. Valina
Journal: Journal of the American College of Cardiology (2013)
Alkaline Phosphatase of Mature Neutrophils in Various Polycythemias
Authors: W. J. Mitus, I. B. Mednicoff, W. Dameshek
Journal: New England Journal of Medicine (1959)

MANY observers have noted that the alkaline phosphatase content of mature neutrophils is markedly elevated in cases of polycythemia vera.1 2 3 4 In our previous study3 the levels were found to be consistently high, and the therapy given to the patients had no essential effect on the enzyme content.In the present study the levels of the enzyme in mature granulocytes of polycythemia vera were compared with those in other forms of "polycythemia," including the anoxemic erythrocytosis (secondary polycythemia) of congenital heart disease and chronic pulmonary disease and the erythrocytosis occasionally found in association with certain tumors, as well as in a . . .
NAADP links histamine H1 receptors to secretion of von Willebrand factor in human endothelial cells
Authors: Bianca Esposito, Guido Gambara, Alexander M. Lewis, Fioretta Palombi, Alessio D'Alessio, Lewis X. Taylor, Armando A. Genazzani, Elio Ziparo, Antony Galione, Grant C. Churchill, Antonio Filippini
Journal: Blood (2011)
Effects of Reduced Glomerular Filtration Rate on Responsiveness to Chlorothiazide and Mercurial Diuretics
Authors: F. C. REUBI, P. T. COTTIER
Journal: Circulation (1961)

Clearance experiments have been performed in 24 subjects with different levels of glomerular filtration, suffering from renal disease without edema, in order to compare the diuretic, saluretic, and kaliuretic responses to a single intravenous injection of meralluride, chlorothiazide, or both together. The inulin clearances of these patients ranged from 5.9 to 135 ml. per minute. The effects of the drugs were studied under constant loading with saline over 3 hours after injection. Our results indicate that over a wide range (15 to 20 ml. per minute up to normal values) a permanent reduction of the glomerular filtration rate has little influence on the diuretic and saluretic effects of meralluride or chlorothiazide. Below 15 to 20 ml. per minute a further reduction results in a sharp decrease in the diuretic and saluretic actions. This can be best explained by assuming that the diuretic agents block an increasing fraction or the tubular reabsorption of water, sodium, and chloride related to the decrease in glomerular filtration rate. This fraction, however, seems to be limited to 30 to 40 per cent of the filtered load. Some dispersion in the glomerulo-tubular activity may account for the splay of the experimental curves. The kaliuretic effect of chlorothiazide is proportional to the glomerular filtration rate. This effect can be blocked by meralluride. At high levels of glomerular filtration the diuretic and saluretic actions of meralluride and chlorothiazide are additive. At lower levels of filtration, such a summation effect is not demonstrable. Apparently, both drugs given together cannot block the reabsorption of more than 30 to 40 per cent of the filtered load. A single injection of chlorothiazide does not lower the arterial blood pressure of hypertensive subjects, loaded with saline, but produces a slight decrease in the glomerular filtration rate, averaging 7 per cent.
Second-Trimester Ultrasound to Detect Fetuses With Down Syndrome
Authors: Rebecca Smith-Bindman, Wylie Hosmer, Vickie A. Feldstein, Jonathan J. Deeks, James D. Goldberg
Journal: JAMA (2001)

ContextSecond-trimester prenatal ultrasound is widely used in an attempt to detect Down syndrome in fetuses, but the accuracy of this method is unknown.ObjectiveTo determine the accuracy of second-trimester ultrasound in detecting Down syndrome in fetuses.Data SourcesEnglish-language articles published between 1980 and February 1999 identified through MEDLINE and manual searches.Study SelectionStudies were included if they recorded second-trimester findings of ultrasonographic markers, chromosomal abnormalities, and clinical outcomes for a well-described sample of women. A total of 56 articles describing 1930 fetuses with Down syndrome and 130 365 unaffected fetuses were included.Data ExtractionArticles were independently reviewed, selected, and abstracted by 2 reviewers. Discrepancies in data abstraction were resolved by consensus with a third reviewer. Overall estimates of sensitivity, specificity, and positive and negative likelihood ratios were calculated for the following markers: choroid plexus cyst, thickened nuchal fold, echogenic intracardiac focus, echogenic bowel, renal pyelectasis, and humeral and femoral shortening. Results were stratified by whether markers were identified in isolation or in conjunction with fetal structural malformations.Data SynthesisWhen ultrasonographic markers were observed without associated fetal structural malformations, sensitivity for each was low (range, 1%-16%), and most fetuses with such markers had normal outcomes. A thickened nuchal fold was the most accurate marker for discriminating between unaffected and affected fetuses and was associated with an approximately 17-fold increased risk of Down syndrome. If a thickened nuchal fold is used to screen for Down syndrome, 15 893 average-risk women or 6818 high-risk women would need to be screened for each case of Down syndrome identified. For each of the other 6 markers, when observed without associated structural malformations, the marker had marginal impact on the risk of Down syndrome. Because the markers were detected in only a small number of affected fetuses, the likelihood of Down syndrome did not decrease substantially after normal examination findings (none of the negative likelihood ratios were significant).ConclusionsA thickened nuchal fold in the second trimester may be useful in distinguishing unaffected fetuses from those with Down syndrome, but the overall sensitivity of this finding is too low for it to be a practical screening test for Down syndrome. When observed without associated structural malformations, the remaining ultrasonographic markers could not discriminate well between unaffected fetuses and those with Down syndrome. Using these markers as a basis for deciding to offer amniocentesis will result in more fetal losses than cases of Down syndrome detected, and will lead to a decrease in the prenatal detection of fetuses with Down syndrome.
Pulmonary venous responses to thromboxane A2 analogue and atrial natriuretic peptide in lambs.
Authors: J U Raj, J Anderson
Journal: Circulation Research (1990)

To characterize pulmonary venous vasoactivity and the factors that modulate it, we determined venous responses to a vasoconstrictor agent, thromboxane A2 (TXA2) analogue U46619, and to a vasodilator agent, atrial natriuretic peptide (ANP), in 28 isolated blood-perfused lamb lungs under conditions of varying vascular tone and intraluminal pressures. TXA2 was given in a 5 micrograms/kg bolus followed by a steady infusion of 1 micrograms/kg/min to three groups of lungs: group 1, n = 4, with low vasomotor tone; group 2, n = 8, with moderate vasomotor tone; and group 3, n = 7, with moderate vasomotor tone and high venous intraluminal pressures. Group 3 lungs were reverse-perfused to obtain high venous pressures. ANP was given as two 10 micrograms/kg bolus injections, 5 minutes apart, to three groups of lungs: group 4, n = 4, with low vasomotor tone; group 5, n = 5, with moderate vasomotor tone; and group 6, n = 8, with high vasomotor tone. Group 6 lungs were vasoconstricted with TXA2 infusion. In all lungs, we measured blood flow and pressures in the pulmonary artery and left atrium and partitioned the venous segment by measuring pressures in 20-80-microns venules by micropuncture. We found that the venous constrictor response to TXA2 was greatest in lungs with moderate basal vasomotor tone and low venous intraluminal pressures. In lungs with low vasomotor tone or high venous intraluminal pressures, the venous response to TXA2 was attenuated. The vasodilator response to ANP was negligible in lungs with low vasomotor tone, probably because they were already maximally vasodilated, but similar in lungs with moderate and high vasomotor tone.(ABSTRACT TRUNCATED AT 250 WORDS)
Potent Induction of Tumor Immunity by Combining Tumor Cryoablation with Anti–CTLA-4 Therapy
Authors: Rebecca Waitz, Stephen B. Solomon, Elena N. Petre, Anne E. Trumble, Marcella Fassò, Larry Norton, James P. Allison
Journal: Cancer Research (2011)

Abstract Thermal ablation to destroy tumor tissue may help activate tumor-specific T cells by elevating the presentation of tumor antigens to the immune system. However, the antitumor activity of these T cells may be restrained by their expression of the inhibitory T-cell coreceptor CTLA-4, the target of the recently U.S. Food and Drug Administration–approved antibody drug ipilumimab. By relieving this restraint, CTLA-4–blocking antibodies such as ipilumimab can promote tumor rejection, but the full scope of their most suitable applications has yet to be fully determined. In this study, we offer a preclinical proof-of-concept in the TRAMP C2 mouse model of prostate cancer that CTLA-4 blockade cooperates with cryoablation of a primary tumor to prevent the outgrowth of secondary tumors seeded by challenge at a distant site. Although growth of secondary tumors was unaffected by cryoablation alone, the combination treatment was sufficient to slow growth or trigger rejection. In addition, secondary tumors were highly infiltrated by CD4+ T cells and CD8+ T cells, and there was a significant increase in the ratio of intratumoral T effector cells to CD4+FoxP3+ T regulatory cells, compared with monotherapy. These findings documented for the first time an effect of this immunotherapeutic intervention on the intratumoral accumulation and systemic expansion of CD8+ T cells specific for the TRAMP C2–specific antigen SPAS-1. Although cryoablation is currently used to treat a targeted tumor nodule, our results suggest that combination therapy with CTLA-4 blockade will augment antitumor immunity and rejection of tumor metastases in this setting. Cancer Res; 72(2); 430–9. ©2011 AACR.
DIPHTHERIA AND DIPHTHERIA CARRIERS IN ARMY CAMPS
Authors: CAREY P. McCORD
Journal: JAMA (1918)

The number of admissions to the base hospital at Camp Sherman has on several occasions taxed its bed capacity. This has necessitated the overcrowding of wards and the placing of patients in close contact in aisles and otherwise. The inadvisability of this procedure was clearly and early demonstrated in the frequency of new infections and reinfections. To meet the demands made on the hospital for the care of patients, a survey was instituted to determine the means available for increasing the number of vacant beds without resorting to ward overcrowding. It developed in this survey that the desired end in part might be obtained by the prompt and intensive treatment of the trivial conditions causing large numbers of hospital admissions to the end that the average days in hospital be lessened. This plan contemplated the acquiring of the needed bed space in hospital and, what is of greater significance, making
Detection of Bone Marrow Metastases by FDG-PET and Missed by Bone Scintigraphy in Widespread Melanoma
Authors: Aysel Aydin, Jian Q. Yu, Hongming Zhuang, Abass Alavi
Journal: Clinical Nuclear Medicine (2005)

The optimal management of patients with melanoma requires accurate imaging techniques that can screen the entire body for metastases. One of the most used tests for this purpose is bone scintigraphy. PET has been reported to be more sensitive than bone scintigraphy in some malignancies. In our case, FDG-PET was also superior to bone scintigraphy in detecting the extent of skeletal disease in a patient with melanoma. This is likely the result of the fact that metastasis to bone marrow may not result in bone reaction in certain conditions and therefore bone scans may remain negative despite skeletal involvement.
Desperate Diseases and Plasmapheresis
Authors: Edward W. Campion
Journal: New England Journal of Medicine (1992)

For any disease there is a limited number of treatments that are known to be effective. When those fail, the physician has to consider alternatives that are either new and unproved or ancient and of uncertain benefit. After enduring a chronic disease and failing to respond to the standard therapies, patients can become desperate. Some discouraged patients visit a number of physicians or consider unorthodox alternatives. When the patient still asks, "What else is there?" the physician may be tempted to offer an experimental medication, a surgical procedure of uncertain benefit, or some other major but unproved intervention. For many . . .
Improved Overall Survival in Postmenopausal Women With Early Breast Cancer After Anastrozole Initiated After Treatment With Tamoxifen Compared With Continued Tamoxifen: The ARNO 95 Study
Authors: Manfred Kaufmann, Walter Jonat, Jörn Hilfrich, Holger Eidtmann, Günther Gademann, Ivan Zuna, Gunter von Minckwitz
Journal: Journal of Clinical Oncology (2007)

In postmenopausal women with estrogen receptor-positive early breast cancer, surgery is usually followed by a 5-year course of tamoxifen. This report presents results of a prospective, open-label, randomized study, designed to evaluate the benefits of switching to anastrozole after 2 years of tamoxifen treatment, compared with continuing on tamoxifen for 5 years.After receiving tamoxifen treatment for 2 years, eligible patients (n = 979) were randomly assigned to switch to anastrozole (1 mg/d) or continue tamoxifen (20 or 30 mg/d) for an additional 3 years. Patients were monitored every 6 months during years 1 to 3 and annually thereafter. The primary efficacy variable was disease-free survival, including local or distant recurrence, new contralateral breast cancer, or death. Secondary variables were overall survival and assessment of safety.Switching to anastrozole resulted in a significant reduction in the risk of disease recurrence (hazard ratio [HR], 0.66; 95% CI, 0.44 to 1.00; P = .049), and improved overall survival (HR, 0.53; 95% CI, 0.28 to 0.99; P = .045) compared with continuing on tamoxifen. Fewer patients who switched to anastrozole reported serious adverse events (22.7% v 30.8%) compared with those who continued on tamoxifen, mainly due to more patients in the tamoxifen group with endometrial events. The overall safety profile for anastrozole was consistent with previous reports and no new safety issues were identified.Postmenopausal women who have taken tamoxifen for 2 years as adjuvant therapy are less likely to experience a recurrence of breast cancer and have improved overall survival if they switch to anastrozole compared with continuing to receive tamoxifen.
Barbiturate and Aspirin Poisoning
Authors: T. J. Thomson, S. Alstead
Journal: BMJ (1955)

The summons, " Come at once: Mr. Smith has poisoned himself," may be the prelude to a medical emergency.How to deal with it depends to a large extent on circum- stances of time and place.For example, Mr. Smith is, in fact, an employee of a general hospital, and, being on duty when the incident occurred, he is already on his way to a well-staffed and well-equipped medical ward.On the other hand, Mr. Smith may be a crofter 20 miles from the doctor's house and 100 miles from the nearest hospital.Most cases of poisoning, however, are seen in town practices, and it is against this background that the general practitioner is called upon to deal with the emergency.
Abortion pill is approved for sale in United States
Authors: S. Gottlieb
Journal: BMJ (2000)

Amid bitter opposition from antiabortion groups, federal authorities announced that the abortion pill RU-486 has been approved for sale in the United States. The pill should be available there within four to six weeks, according to Planned Parenthood.

The Food and Drug Administration (FDA) approved RU-486 (mifepristone) for the termination of early pregnancy, defined as 49 days or less, counting from the beginning of the last menstrual period. The administration said it based its approval of mifepristone on data about safety and effectiveness from clinical trials in the United States and France. It is estimated that more than half a million women in Europe have used mifepristone since …
Study Findings Offer Conflicting Views on Future Role of Carotid Artery Stenting
Authors: Mike Mitka
Journal: JAMA (2010)

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New Perspectives for Diagnosis of Nodular Goiter by Technetium-Thallium Subtraction Scanning
Authors: MAKOTO KATAGIRI, TANEKAZU HARADA, MASAO FUKUNAGA, JUNKOU FURUKAWA, YASUHIKO YAMANE, KENTAROU YASUDA, SHINICHI YANAGIMOTO, TATSUSHI TOMOMITSU, NOBUAKI OTSUKA, RIKUSHI MORITA
Journal: Clinical Nuclear Medicine (1989)

To improve the scintigraphic differential diagnosis of thyroid nodules, Tc-99m pertechnetate-TI-201 Cl subtraction scintigraphy (Tc-TI subtraction scanning) was performed in 106 patients with various histologically proven thyroid nodules. Results were evaluated by comparison with surgical findings and preoperative ultrasonographic results. Thyroid nodules were more successfully detected by Tc-TI subtraction scanning than by either Tc-99m pertechnetate or TI-201 Cl scintigraphy alone. Detection of nodules was further improved when images recorded by the three methods were integrally observed (sensitivity 83%, accuracy 89%), with detectability approaching that of ultrasonography. False-positive or -negative Tc-TI subtraction scans were obtained principally when multiple nodules were present (7 cases) or when no discrepancy existed between the accumulations of Tc-99m pertechnetate and TI-201 Cl (18 cases). Most colloid nodules exhibited irregular margins, heterogeneous internal accumulations of TI-201 Cl, and distorted shapes on Tc-TI subtraction scans, while the majority of adenoma were oval-shaped with smooth margins. Carcinoma were characterized by homogeneous internal accumulation of TI-201 Cl and distorted shapes.