tbuckley/cabot-search huggingface dataset:
Empirical Use of Fluconazole in Critically Ill Patients: Good Study, but What Was the Hold-up?
Authors: Samuel A. Shelburne
Journal: Annals of Internal Medicine (2009)

Letters6 January 2009Empirical Use of Fluconazole in Critically Ill Patients: Good Study, but What Was the Hold-up?Samuel A. Shelburne, MDSamuel A. Shelburne, MDFrom the University of Texas MD Anderson Cancer Center, Houston, TX 77030.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-1-200901060-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I would like to thank Schuster and colleagues (1) for the excellent article on the empirical use of fluconazole in critically ill patients at high risk for disseminated candidiasis. Their investigation provides valuable data to a broad array of clinicians and addresses an important but understudied area of biomedical research. However, I was troubled to see that, whereas the study was published in 2008, the last patient was enrolled in 1999 and follow-up was completed in 2000 (1). This leads me to ask: What led to an 8-year delay in publication of such critical data? Given that ...References1. Schuster MG, Edwards JE, Sobel JD, Darouiche RO, Karchmer AW, Hadley S, et al. Empirical fluconazole versus placebo for intensive care unit patients: a randomized trial. Ann Intern Med. 2008;149:83-90. [PMID: 18626047] LinkGoogle Scholar2. U.S. Food and Drug Administration. US Food and Drug Administration New and Generic Drug Approvals: 1998–2004. Accessed at www.fda.gov/Cder/Approval/index.htm on 18 November 2008. Google Scholar3. Fekete T. The answer is in: fluconazole prophylaxis is not beneficial for intensive care unit patients without neutropenia [Editorial]. Ann Intern Med. 2008;149:140-1. [PMID: 18626054] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From the University of Texas MD Anderson Cancer Center, Houston, TX 77030.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEmpirical Fluconazole versus Placebo for Intensive Care Unit Patients Mindy G. Schuster , John E. Edwards Jr. , Jack D. Sobel , Rabih O. Darouiche , Adolf W. Karchmer , Susan Hadley , Gus Slotman , Helene Panzer , Pinaki Biswas , and John H. Rex The Answer Is In: Fluconazole Prophylaxis Is Not Beneficial for Intensive Care Unit Patients without Neutropenia Thomas Fekete Empirical Use of Fluconazole in Critically Ill Patients: Good Study, but What Was the Hold-up? Mindy Schuster , Helene Panzer , and John Edwards Empirical Use of Fluconazole in Critically Ill Patients: Good Study, but What Was the Hold-up? Dong Heun Lee Metrics 6 January 2009Volume 150, Issue 1Page: 58-59KeywordsCandidiasisConflicts of interestDatabasesForecastingInformation storage and retrieval ePublished: 6 January 2009 Issue Published: 6 January 2009 CopyrightCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Quantitation of HIV-1 RNA in Plasma Predicts Outcome after Seroconversion
Authors: John W. Mellors
Journal: Annals of Internal Medicine (1995)

To investigate the relation between the quantity of human immunodeficiency virus type 1 (HIV-1) RNA in plasma and the risk for the acquired immunodeficiency syndrome (AIDS) or a decline in the CD4+ T-cell count after seroconversion.Prospective study.62 homosexual men with documented HIV-1 seroconversion.University outpatient setting.Clinical status, CD4+ T-cell counts, and plasma and serum samples were obtained every 6 months. Human immunodeficiency virus RNA in plasma was quantitated with a branched-DNA (bDNA) assay. Serum samples were assayed for neopterin, beta 2-microglobulin, and immune complex dissociated HIV-1 p24 antigen.18 of 62 (29%) men developed AIDS; 21 (34%) had a significant decline in the CD4+ T-cell count without AIDS; and 23 (37%) had a stable CD4+ T-cell count. For each participant, HIV-1 RNA results were categorized into one of four groups: 1) detection of HIV-1 RNA (> 1 x 10(4) genome equivalents/mL [Eq/mL]) in all samples; 2) detection in most samples (> or = 50%); 3) detection in fewer than 50% of samples; and 4) detection in none of the samples. Detection of HIV-1 RNA in all or most samples was strongly associated with AIDS (16 of 18 patients) and a decline in the CD4+ T-cell count (13 of 21 patients) compared with a stable CD4+ T-cell count (4 of 23 patients; P < 0.001). Conversely, the absence of HIV-1 RNA (< 1 x 10(4) Eq/mL) in all or most samples was associated with stable CD4+ T-cell counts (19 of 23 patients) and a lower risk for AIDS or decline in the CD4+ T-cell count (10 of 39 patients; P < 0.001). In multivariate analysis of all laboratory values at the seroconversion visit, a plasma HIV-1 RNA level greater than 1 x 10(5) Eq/mL was the most powerful predictor of AIDS (odds ratio, 10.8; P = 0.01).Plasma HIV-1 RNA is a strong, CD4+ T-cell-independent predictor of a rapid progression to AIDS after HIV-1 seroconversion.
Percutaneous Transhepatic Cholangiography with the "Skinny" Needle
Authors: RAUL PEREIRAS
Journal: Annals of Internal Medicine (1977)

One hundred thirty-one cases of cholestasis were evaluated by "skinny" needle percutaneous transhepatic cholangiography. The biliary tree was seen in 129 patients (98.5%). When the biliary tree was dilated, a success rate of 100% was obtained. In the 45 patients with nondilated ducts, visualization was achieved in 95.6%. There was no mortality, early operation, or transfusion requirement associated with the procedure. This form of cholangiography is a simple, reliable, and extremely high-yield technique for evaluating patients with cholestasis.
Procainamide-Induced Psychosis-Reply
Authors: Ivan D. McCrum
Journal: JAMA (1979)

We appreciate Dr Menken's comments and the opportunity to respond. We were not suggesting that this patient's behavior was due to a functional psychosis but only that his mental status examination was consistent with such a state. By this we meant that schizo-affective disorders are occasionally similar and that disorientation and impairment of memory, information, and ability to calculate were never such that would be inconsistent with manicdepressive illness or schizophrenia. Alterations in motor activity, sleep patterns, attention span, affect, social restraint, and judgment were present but were nonspecific findings and did not help clarify the diagnosis. We believe that this episode of aberrant behavior was drug induced (organic) but that delirium was absent. Because organic mental disorders can occur without evidence of delirium, they can imitate a variety of psychiatric syndromes. Perhaps the best known example of this is reserpine-induced depression. We described this patient as having
Abstract 4512: Super-enhanced permeability and retention (SUPR) effect induced by photo-immunotherapy (PIT) can accommodate massive nano-sized reagents deep into tumors.
Authors: Hisataka Kobayashi, Kohei Sano, Takahito Nakajima, Peter L. Choyke
Journal: Cancer Research (2013)

Abstract A major barrier to cancer treatment is the inability to deliver sufficient concentrations of drug to the interior of tumors without incurring systemic toxicities. Nanomaterials are appealing because they can carry a large drug payload, however, tumor delivery is limited by modest leakage and retention in most tumors. Photo-immunotherapy (PIT) is a newly developed therapy involving the injection of a conjugate composed of an armed monoclonal antibody (mAb) and a near infrared phthalocyanine dye, IR700 [Mitsunaga M. Nature Med 2011;17:1685]. When exposed to NIR light, the conjugate induces a highly-selective necrotic cell death only in mAb-IR700 bound cancer cells. This target-specific necrotic cell death occurs within 10 minutes of exposure to NIR light and results in rapid morphologic changes including cellular swelling, bleb formation, and rupture of vesicles indicating necrotic cell death. Meanwhile, immediately adjacent receptor-negative cells are unharmed. Because it damages cells immediately adjacent to the tumor vasculature, PIT results in marked increases in vascular permeability leading to 12- to 25-fold enhanced nano-particle delivery into cancer tissue, an effect termed “super-enhanced permeability and retention (SUPR)” to differentiate it from inherent enhanced permeability and retention (EPR). Of particular interest is that nano-sized reagents including macromolecules (dendrimers), particles (quantum dots, iron oxide nano-particles), and liposomes up to 300 nm in diameter rapidly enter and are retained within the tumor space following PIT. Therefore, although PIT might not be able to eliminate all cancer cells due to heterogeneity of tumor antigen expression, SUPR allows the delivery of extremely high concentrations of nano-sized anti-cancer reagents such as daunorubicin containing liposome (Daunoxome), resulted in significantly synergic therapeutic effects of PIT and nano-sized agents. In conclusion, target-selective PIT can induce a SUPR effect leading to the accumulation of relatively high concentrations of nano-sized reagents into the tumor bedthus improving effectiveness of PIT.. Citation Format: Hisataka Kobayashi, Kohei Sano, Takahito Nakajima, Peter L. Choyke. Super-enhanced permeability and retention (SUPR) effect induced by photo-immunotherapy (PIT) can accommodate massive nano-sized reagents deep into 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 4512. doi:10.1158/1538-7445.AM2013-4512
Abstract LB-59: ERG induces taxane resistance in castration-resistant prostate cancer.
Authors: Giuseppe Galletti, Himisha Beltran, Alexandre Matov, Jacqueline Fontugne, Juan Miguel Mosquera, Ladan Fazli, Scott Tagawa, David Nanus, Martin Gleave, Mark Rubin, Paraskevi Giannakakou, David S. Rickman
Journal: Cancer Research (2013)

Abstract Taxanes are the only chemotherapies to prolong survival for patients with metastatic castration-resistant prostate cancer (CRPC), and both docetaxel (doc) and cabazitaxel (cab) are FDA approved for this indication. Despite the initial efficacy of taxanes in treating CRPC, all patients ultimately fail due to the development of drug resistance. In this study we show that ERG over-expression, which occurs in roughly 50% of prostate cancers, is associated with both doc and cab resistance using in vitro and in vivo models of CRPC. Using either tetracycline-inducible or constitutively active expression systems in multiple prostate cancer cell lines, we found that ERG over-expression leads to at least a 10 fold increase in IC50 doses of doc or cab based on cell viability assays and inhibition of taxane-induced apoptosis. Similarly, ERG over-expressing prostate cancer xenografts were reproducibly more resistant to cab compared to the cab-sensitive control xenografts. Based on a biochemical and cell biological characterization, we observed that ERG binds directly to tubulin in the cytoplasm of prostate cancer cells, as well as in circulating tumor cells from patients treated with doc, and prevents taxane-induced microtubule stabilization. ERG over-expression affects several parameters of microtubule dynamics and inhibits effective drug-target engagement of doc or cab with tubulin, either directly via its tubulin interaction or indirectly by affecting transcription of genes that modulate microtubule homeostasis. In addition, ERG induces and binds to clusterin, a molecular chaperone also associated with taxane resistance. Clusterin knock-down with siRNA abrogates ERG-induced taxane resistance. Altogether, this data suggests that ERG, an oncogenic transcription factor, plays a novel role beyond regulating gene expression and functions outside the nucleus to cooperate with clusterin and tubulin in promoting taxane resistance. Determining ERG status in patient tumors may aid in patient selection for doc or cab therapy and/or influence co-targeting approaches using the clusterin antisense inhibitor OGX-011. Citation Format: Giuseppe Galletti, Himisha Beltran, Alexandre Matov, Jacqueline Fontugne, Juan Miguel Mosquera, Ladan Fazli, Scott Tagawa, David Nanus, Martin Gleave, Mark Rubin, Paraskevi Giannakakou, David S. Rickman. ERG induces taxane resistance in castration-resistant prostate cancer. [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 LB-59. doi:10.1158/1538-7445.AM2013-LB-59
Abstract 2660: Racial Disparities in the Rate of Bystander CPR
Authors: Robert E O'Connor, Diane McGinnis-Hainsworth, Ross E Megargel, Melissa Bollinger, David Zamara
Journal: Circulation (2006)

Purpose: Disparities in health care are widely documented. We conducted this study to test the hypothesis that there were no differences in the frequency of bystander CPR when the victim of out-of-...
Language shares neural prerequisites with non-verbal capacities
Authors: Georg Goldenberg
Journal: Behavioral and Brain Sciences (2003)

Based on neuropsychological evidence of nonverbal impairment accompanying aphasia, I propose that the neural prerequisites for language acquisition are shared with a range of nonverbal capacities. Their commonality concerns the ability to recognize a limited number of finite elements in manifold perceptual entities and to combine them for constructing manifold entities.
Changes in breathing and ventilatory muscle recruitment patterns induced by lung volume reduction surgery.
Authors: J O Benditt, D E Wood, F D McCool, S Lewis, R K Albert
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

Patients with chronic obstructive pulmonary disease have abnormal breathing and ventilatory muscle recruitment patterns at rest and during exercise, and these alterations may contribute to the limited exercise capacity seen in this disease. Lung volume reduction surgery (LVRS), a recently described treatment for emphysema, is reported to improve exercise performance. We studied the breathing and ventilatory muscle recruitment (VMR) patterns in eight patients with severe chronic obstructive lung disease (median FEV1 = 0.79 L, range 0.46 to 1.13 L) by measuring esophageal and gastric pressure measurements as well as tidal volumes (VT), respiratory rates (f), inspiratory (TI) and expiratory (TE) times, and watts at rest and during maximal exercise, before and 3 mo after lung volume reduction surgery. Maximal exercise capacity increased a median of 49% (median increase 17 watts, range 6 to 44 watts, p < 0.05) and maximal minute ventilation (VEmax) increased by a median of 22% (median increase 6.5 L/min, range 3 to 25 L/min, p < 0.05). At isowatt exercise after surgery, VT increased 0.31 L (range 0.07 to 0.69 L) and f decreased four breaths/min (range +0.5 to -15 breaths/min). Dyspnea scores as measured by a visual analog scale (VAS) decreased significantly at rest and at peak exercise after surgery. End-expiratory esophageal (Pes) and gastric (Pga) pressures at rest and at isowatt exercise decreased. A rightward shift in the slope of the Pes versus Pga plot was also observed suggesting increased use of the diaphragm after surgery. Our data indicate that LVRS improves the mechanics of breathing both at rest and during exercise.
Pregnancy in kidney transplant recipients seems successful, but...
Authors: John Henahan
Journal: JAMA (1983)

Well managed, the great majority of pregnancies in kidney transplant recipients have apparently successful outcomes, although gestation and delivery are not necessarily complication-free, according to the results of a large international survey reported at the Second European Meeting on Renal Diseases in Milan. (These findings are fairly consistent with those of a much smaller Canadian study [<i>Am J Obstet Gynecol</i>1983;145:193].) An analysis of 1,068 pregnancies that occurred in 717 transplant recipients seen at 64 centers worldwide shows that after the first trimester, the success rate is 90%, stated John M. Davison, MB, of the Medical Research Council's Human Reproduction Group at Newcastle-upon-Tyne, England. He warned, however, that long-term effects of immunosuppressant drugs on the fetus are not known. The first-trimester spontaneous abortion rate, 13%, was no higher than in the normal population. However, the incidence of therapeutic abortions in the same period was about 28%, Davison noted, commenting: "These
Exercise reduces persistent ductus arteriosus shunting in piglets
Authors: D. SEABERG, E. LORENZ, G. LUND, J. RYSAVY, M. E. PIERPONT, S.-L. ZHANG, S. EINZIG
Journal: Cardiovascular Research (1987)

Journal Article Exercise reduces persistent ductus arteriosus shunting in piglets Get access DAVID SEABERG, DAVID SEABERG **From the Department of Paediatrics, University of Minnesota, Minneapolis, Minnesota, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar ELIZABETH LORENZ, ELIZABETH LORENZ **From the Department of Paediatrics, University of Minnesota, Minneapolis, Minnesota, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar GUNNAR LUND, GUNNAR LUND †From the Department Radiology, University of Minnesota, Minneapolis, Minnesota, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar JOSEPH RYSAVY, JOSEPH RYSAVY †From the Department Radiology, University of Minnesota, Minneapolis, Minnesota, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar MARY ELLA PIERPONT, MARY ELLA PIERPONT **From the Department of Paediatrics, University of Minnesota, Minneapolis, Minnesota, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar SHU-LUN ZHANG, SHU-LUN ZHANG **From the Department of Paediatrics, University of Minnesota, Minneapolis, Minnesota, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar STANLEY EINZIG STANLEY EINZIG **From the Department of Paediatrics, University of Minnesota, Minneapolis, Minnesota, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 21, Issue 11, November 1987, Pages 847–855, https://doi.org/10.1093/cvr/21.11.847 Published: 01 November 1987 Article history Received: 14 January 1987 Accepted: 01 June 1987 Published: 01 November 1987
Limited heterogeneity of T cell receptor BV usage in aplastic anemia
Authors: Weihua Zeng, Jaroslaw P. Maciejewski, Guibin Chen, Neal S. Young
Journal: Journal of Clinical Investigation (2001)

Immune mediation of aplastic anemia (AA) has been inferred from clinical responsiveness to immunosuppressive therapies and a large body of circumstantial laboratory evidence. However, neither the immune response nor the nature of the antigens recognized has been well characterized. We established a large number of CD4 and CD8 T cell clones from a patient with AA and analyzed their T cell receptor (TCR) usage. Most CD4 clones displayed BV5, whereas most CD8 clones displayed BV13. We found sequence identity for complementarity determining region 3 (CDR3) among a majority of CD4 clones; the same sequence was present in marrow lymphocytes from four other patients with AA but was not detected in controls. The dominant CD4 clone showed a Th1 secretion pattern, lysed autologous CD34 cells, and inhibited their hematopoietic colony formation. In three of four patients, successful immunosuppressive treatment led to marked decrease in clones bearing the dominant CDR3 BV5 sequence. These results suggest surprisingly limited heterogeneity of the T cell repertoire in an individual patient and similarity at the molecular level of the likely pathological lymphocyte response among multiple patients with AA, consistent with recognition of limited numbers of antigens shared by individuals with the same HLA type in this disease.
Vascular Endothelial Growth Factor-B Acts as a Coronary Growth Factor in Transgenic Rats Without Inducing Angiogenesis, Vascular Leak, or Inflammation
Authors: Maija Bry, Riikka Kivelä, Tanja Holopainen, Andrey Anisimov, Tuomas Tammela, Jarkko Soronen, Johanna Silvola, Antti Saraste, Michael Jeltsch, Petra Korpisalo, Peter Carmeliet, Karl B. Lemström, Masabumi Shibuya, Seppo Ylä-Herttuala, Leena Alhonen, Eero Mervaala, Leif C. Andersson, Juhani Knuuti, Kari Alitalo
Journal: Circulation (2010)

Background— Vascular endothelial growth factor-B (VEGF-B) binds to VEGF receptor-1 and neuropilin-1 and is abundantly expressed in the heart, skeletal muscle, and brown fat. The biological function of VEGF-B is incompletely understood. Methods and Results— Unlike placenta growth factor, which binds to the same receptors, adeno-associated viral delivery of VEGF-B to mouse skeletal or heart muscle induced very little angiogenesis, vascular permeability, or inflammation. As previously reported for the VEGF-B 167 isoform, transgenic mice and rats expressing both isoforms of VEGF-B in the myocardium developed cardiac hypertrophy yet maintained systolic function. Deletion of the VEGF receptor-1 tyrosine kinase domain or the arterial endothelial Bmx tyrosine kinase inhibited hypertrophy, whereas loss of VEGF-B interaction with neuropilin-1 had no effect. Surprisingly, in rats, the heart-specific VEGF-B transgene induced impressive growth of the epicardial coronary vessels and their branches, with large arteries also seen deep inside the subendocardial myocardium. However, VEGF-B, unlike other VEGF family members, did not induce significant capillary angiogenesis, increased permeability, or inflammatory cell recruitment. Conclusions— VEGF-B appears to be a coronary growth factor in rats but not in mice. The signals for the VEGF-B–induced cardiac hypertrophy are mediated at least in part via the endothelium. Because cardiomyocyte damage in myocardial ischemia begins in the subendocardial myocardium, the VEGF-B–induced increased arterial supply to this area could have therapeutic potential in ischemic heart disease.
Voice Rehabilitation After Total Laryngectomy and Postoperative Radiation Therapy
Authors: William M. Mendenhall, Christopher G. Morris, Scott P. Stringer, Robert J. Amdur, Russell W. Hinerman, Douglas B. Villaret, K. Thomas Robbins
Journal: Journal of Clinical Oncology (2002)

PURPOSE: The purpose of this study was to evaluate voice rehabilitation after laryngectomy and postoperative irradiation for patients with squamous cell carcinoma of the larynx and hypopharynx. PATIENTS AND METHODS: Between December 1983 and December 1998, 173 patients underwent a total laryngectomy and postoperative irradiation and had follow-up from 3 to 188 months (median, 38 months). Three patients were lost to follow-up at 63, 39, and 4 months after treatment. All other living patients had follow-up for 2 years or longer. Twelve (7%) patients had incomplete data pertaining to voice rehabilitation. RESULTS: Data pertaining to voice rehabilitation were available at 2 to 3 years and longer and 5 years and longer after treatment for 118 and 69 patients, respectively. The methods of voice rehabilitation at 2 to 3 years and longer and 5 years and longer were as follows: tracheoesophageal, 27% and 19%; artificial larynx, 50% and 57%; esophageal, 1% and 3%; nonvocal, 17% and 14%; and no data, 5% and 7%, respectively. CONCLUSION: The most common form of voice rehabilitation after total laryngectomy and postoperative radiation therapy is the artificial larynx. Although the tracheoesophageal puncture is a technique frequently promoted by clinicians as a superior method, a relatively small subset of patients are successfully rehabilitated long-term. However, of those who undergo a tracheoesophageal puncture, approximately half will use this method of voice rehabilitation long term.