tbuckley/cabot-search huggingface dataset:
[<sup>18</sup>F]Fluorodeoxyglucose Positron Emission Tomography for Detection of Bone Marrow Involvement in Children and Adolescents With Hodgkin's Lymphoma
Authors: Sandra Purz, Christine Mauz-Körholz, Dieter Körholz, Dirk Hasenclever, Antje Krausse, Ina Sorge, Kathrin Ruschke, Martina Stiefel, Holger Amthauer, Otmar Schober, W. Tilman Kranert, Wolfgang A. Weber, Uwe Haberkorn, Patrick Hundsdörfer, Karoline Ehlert, Martina Becker, Jochen Rössler, Andreas E. Kulozik, Osama Sabri, Regine Kluge
Journal: Journal of Clinical Oncology (2011)

Purpose Currently, a routine bone marrow biopsy (BMB) is performed to detect bone marrow (BM) involvement in pediatric Hodgkin's lymphoma (HL) stage greater than IIA. [ 18 F]fluorodeoxyglucose positron emission tomography (FDG-PET) is increasingly used for the initial staging of HL. The value of using FDG-PET to detect BM involvement has not been sufficiently defined. We compared the results of BMBs and FDG-PET for the diagnosis of BM involvement in a large pediatric group with HL. Patients and Methods The initial staging of 175 pediatric patients with newly diagnosed classical HL stage greater than IIA was determined by using BMB, FDG-PET, chest computed tomography (CT), and magnetic resonance imaging (MRI) or CT of the neck, abdomen, and pelvis. Staging images were prospectively evaluated by a central review board. Skeletal regions that were suggestive of BM involvement by either method were re-evaluated by using different imaging modalities. In suspicious cases, bone scintigraphy was performed. If follow-up FDG-PET scans were available, the remission of skeletal lesions during treatment was evaluated. Results BMB results were positive in seven of 175 patients and were identified by FDG-PET. FDG-PET scans showed BM involvement in 45 patients. In addition, the lesions of 32 of these 45 patients had a typical multifocal pattern. In 38 of 39 follow-up positron emission tomography scans, most of the skeletal lesions disappeared after chemotherapy. There was no patient with skeletal findings suggestive of BM involvement by MRI or CT with a negative FDG-PET. Conclusion FDG-PET is a sensitive and specific method for the detection of BM involvement in pediatric HL. The sensitivity of a BMB appears compromised by the focal pattern of BM involvement. Thus, FDG-PET may safely be substituted for a BMB in routine staging procedures.
Free Radicals in Ischemic and Reperfusion Myocardial Injury: Is this the Time for Clinical Trials?
Authors: Michael V. Cohen
Journal: Annals of Internal Medicine (1989)

An increasing number of studies in cell cultures, isolated perfused hearts, and intact animal preparations purport to show the significance of free radical production in the pathophysiology of myocardial injury and necrosis of ischemic and reoxygenated or reperfused tissue. Additionally an impressive array of therapeutic approaches has been developed to interfere with the generation of free radicals and to thereby salvage jeopardized myocardium. Based on these data clinical trials are now being conducted or planned. However, a critical examination of the experimental data raises questions that undermine total acceptance of the conclusions of the investigators and the enthusiastic extrapolations to the clinical arena. Issues such as endotoxin contamination of infused free radical scavenger enzymes, incorrect dosing, possibly improper selection of control conditions, species specificity, inadequate consideration of the dependence of infarct size on coronary collateral blood flow, and the possibly transient nature of any benefits of anti-free radical interventions cast doubt on some of the accumulated data and their general applicability to humans. These issues must be satisfactorily addressed before this experimental approach can be fully embraced by the clinical cardiologist. Additionally, uniformity in the experimental model and conditions might eliminate some of the confusion and make it easier to compare the results of different studies. Free radical mechanisms may be important in the heart, but more data are needed to rigorously document an unequivocal effect of therapeutic interventions in experimental models before clinical trials are appropriate.
The Use of Child Restraint Devices in Vehicles
Authors: Angela E. Fuller
Journal: JAMA (1986)

<h3>To the Editor.—</h3> Motor vehicle accidents are the leading cause of death in childhood.<sup>1</sup>Physicians generally agree that many highway casualties are preventable with the use of child restraint devices. The medical profession played a significant role in the implementation of child restraint legislation in the majority of the states. In 1976, Williams<sup>2</sup>observed that 90% of children ride unprotected in automobiles. The US Department of Transportation estimates that two thirds (67%) of infants and 44% of children between the ages of 1 and 4 years are placed in safety seats.<sup>3</sup> On a 360-mile trip through north central Florida and southern Georgia, the authors undertook a preliminary investigation to determine actual child restraint usage in rural areas. One hundred consecutive motor vehicles with small children were studied. The authors directly observed and ascertained whether or not the children were riding in safety restraint devices. Poorly visualized and questionable
Letter by Testa et al Regarding Article, “Presence of Older Thrombus Is an Independent Predictor of Long-Term Mortality in Patients With ST-Elevation Myocardial Infarction Treated With Thrombus Aspiration During Primary Percutaneous Coronary Intervention”
Authors: L. Testa, F. Bedogni, Giuseppe G.L. Biondi Zoccai
Journal: Circulation (2009)
Communication from centres of excellence
Authors: C. Barber
Journal: BMJ (1985)

fever, myalgia, anorexia, and weight loss but in our case the finding was incidental.Interstitial nephritis has also been reported in a patient with glomerulonephritis who was concurrently taking cimetidine.3Determining the cause of deteriorating renal function may therefore be difficult, and, on present evidence, ranitidine should be used in preference to cimetidine in people with impaired renal function who need an H. antagonist, although there is one reported case of the use of steroids to control the cimetidine induced interstitial nephritis.4In our case, as in another,5 substitution of ranitidine for cimetidine permitted recovery of renal function.N ALI
Abstract 3827: Interferons induce CXCR3-cognate chemokine production by melanoma
Authors: Amanda T. Lucht, Eleanor Clancy-Thompson, Lynn T. Dengel, Robert M. Strieter, Craig L. Slingluff, David W. Mullins
Journal: Cancer Research (2010)

Abstract Immune-mediated cancer regression requires tumor infiltration by Ag-specific effector T cells, but lymphocytes are commonly sparse in melanoma metastases. Activated T cells express CXCR3, whose cognate chemokines are CXCL9/MIG, CXCL10/IP-10 and CXCL11/I-TAC. Little is known about expression of these chemokines in lymph node (LN) metastases of melanoma. We evaluated whether metastatic melanoma induces these CXCR3-cognate chemokines in human LN-derived tissues. Also, because these chemokines can be induced by interferon (IFN), we evaluated whether type I or II IFNs (IFN-α or IFN-γ, respectively) can modulate chemokine expression in an in vitro model of the human tumor microenvironment. Production of CXCL9-11 by melanoma-infiltrated nodes (MIN) was no different than tumor-free nodes (TFN); both produced less than activated LN (sentinel immunized nodes, SIN). These data suggest melanoma infiltration into LN neither induces nor reduces CXCL9-11. Stimulation with IFN-α or IFN-γ increased production of CXCL10-11 from MIN, but not TFN or SIN. IFN-γ also increased production of CXCL9 in MIN. In IFN-treated MIN, the primary source of CXCL9-11 was melanoma cells themselves, whereas CD14+ cells were the source of these molecules in SIN. Melanoma cell lines expressed IFN receptors and produced CXCL9-11 in response to IFN treatment. Treatment of melanoma cell lines or primary melanomas in vitro with IFN-γ induced the migration of CXCR3+ T cells in transwell assays, whereas T cell did not significantly migrate in response to resting melanoma cells. Thus, melanoma infiltration of LN is insufficient to induce the production of CXCL9-11, but melanoma may be a significant source of IFN-induced chemokines. Collectively, these data suggest that IFN-α or IFN-γ may act in the tumor microenvironment to increase the chemotactic gradient for CXCR3+ T cells, thus enhancing the capacity of therapeutic vaccines to mediate clinical efficacy. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3827.
NHS should adopt new ways of working, such as joint ventures and collaboratives with private providers, Dalton report says
Authors: M. Limb
Journal: BMJ (2014)

<h3>ABSTRACT</h3> Deep neural networks offer a promising approach for capturing complex, non-linear relationships among variables. Because they require immense sample sizes, their potential has yet to be fully tapped for understanding complex relationships between gene expression and human phenotypes. Encouragingly, a growing number of diseases are being studied through consortium efforts. Here we introduce a new analysis framework, namely MD-AD (<b>M</b>ulti-task <b>D</b>eep learning for <b>A</b>lzheimer’s <b>D</b>isease neuropathology), which leverages an unexpected synergy between deep neural networks and multi-cohort settings. In these settings, true joint analysis can be stymied using conventional statistical methods, which (1) require “harmonized” phenotypes (i.e., measured in a highly consistent manner) and (2) tend to capture cohort-level variations, obscuring the subtler true disease signals. Instead, MD-AD incorporates multiple related phenotypes sparsely measured across cohorts, and learns complex, non-linear interactions between genes and phenotypes not discovered using conventional expression data analysis methods (e.g., component analysis and module detection), enabling the model to capture subtler signals than cohort-level variations. Applied to the largest available collection of brain samples (N=1,758), we demonstrate that MD-AD learns a truly generalizable relationship between gene expression program and AD-related neuropathology. The learned program generalizes in several important ways, including recapitulation of the disease progress in animal models and across tissue types, and we show that such generalizability is not achieved by previous statistical paradigms. Its ability to identify genes with high non-linear relevance to neuropathology enabled us to identify a sex-specific relationship between neuropathology and immune response across microglia, providing a nuanced context for association between inflammatory genes and AD.
QOF as Trojan horse
Authors: D. J Jeffries
Journal: BMJ (2009)

I have mistrusted the quality and outcomes framework (QOF) from the start, and its true Trojan horse characteristics are becoming increasingly obvious.1

Generally, as each target is attained so it is removed from the equation and a new one introduced. More clinical and non-clinical areas are added, but of course no new resources are offered to …
Reduced somatostatin (SS) tone in liver cirrhosis: Normalization byinsulin-like growth factor-I (IGF-I)
Authors: M.A. Aliaga, I. Castilla Cortázar, C. Chocarro, M. García, G. Delgado, S. González-Barón, J. Quiroga, J. Prieto
Journal: Journal of Hepatology (2000)
Impact of markedly elevated serum lipoprotein(a) levels (≥100 mg/dL) on the risk of coronary heart disease
Authors: Toshio Murase, Minoru Okubo, Michiyo Amemiya-Kudo, Takaki Hiraga, Junko Oka, Masako Shimada, Tomio Igarashi
Journal: Metabolism (2007)
Peripheral Arterial Disease Is Associated With Higher Rates of Hip Bone Loss and Increased Fracture Risk in Older Men
Authors: Tracie C. Collins, Susan K. Ewing, Susan J. Diem, Brent C. Taylor, Eric S. Orwoll, Steven R. Cummings, Elsa S. Strotmeyer, Kristine E. Ensrud
Journal: Circulation (2009)

Peripheral arterial disease (PAD) and osteoporosis are chronic illnesses that increase in prevalence with aging and certain metabolic disorders. The association between PAD, rates of bone loss, and fracture risk in older men is uncertain.We sought to test the hypothesis that PAD is associated with higher rates of bone loss and increased fracture risk. We analyzed data from a prospective cohort study involving 6 US centers and 5781 men at least 65 years of age. We assessed ankle-brachial index and hip bone mineral density, followed up prospectively for changes in hip bone mineral density and fractures. PAD was defined as a baseline ankle-brachial index <0.9. Hip bone mineral density was measured with dual x-ray absorptiometry at baseline and again an average of 4.6 years later. Incident nonspine fractures were ascertained by self-report and confirmed with radiography reports during an average of 5.4 years of follow-up. At baseline, the prevalence of PAD was 6.2%. After adjustment for age, race, site, and baseline bone mineral density, the mean annualized rate of bone loss at the total hip was -0.66% per year (95% confidence interval -0.78 to -0.54) in men with PAD compared with -0.34% per year (95% confidence interval -0.36 to -0.31) in men without PAD (P<0.001). After further adjustment for multiple potential confounders, the difference was attenuated (-0.49% in men with PAD versus -0.35% in men without PAD) but remained significant (P=0.02). Findings were similar at hip subregions. Twelve percent of men with PAD and 7.9% of those without PAD experienced an incident nonspine fracture (hazard ratio adjusted for age, race, and site=1.47, 95% confidence interval 1.07 to 2.04); this association was not altered substantially by further adjustment for multiple confounders.In community-dwelling older men, PAD was associated with higher rates of hip bone loss and increased risk of nonspine fractures. Further research should examine the biological mechanisms underlying the association between reduced limb blood flow and fractures.
FDG-PET Imaging in Primary Bilateral Adrenal Lymphoma: A Case Report and Review of the Literature
Authors: Rakesh Kumar, Yan Xiu, Ayse Mavi, Ghassan El-Haddad, Hongming Zhuang, Abass Alavi
Journal: Clinical Nuclear Medicine (2005)

Primary adrenal lymphoma is an extremely rare entity. Only 70 cases have been reported in the English literature. Most of the patients are elderly men with bilateral adrenal masses without extraadrenal involvement. The most common presenting symptoms are fever, weight loss, lumbar pain, and/or symptoms of adrenal insufficiency. Of the cases reported, CT, ultrasound, and MRI were the imaging modalities used to describe the lesions. FDG PET has been used successfully to differentiate benign and malignant adrenal masses. The authors report a 67-year-old man diagnosed as having primary bilateral adrenal lymphoma and having no evidence of extraadrenal spread who was evaluated from the time of diagnosis to complete remission with FDG PET scanning. The literature of this unusual neoplasm is reviewed in detail.
MELD Scores of Liver Transplant Recipients According to Size of Waiting List
Authors: James F. Trotter, Michael J. Osgood
Journal: JAMA (2004)

The Model for Endstage Liver Disease (MELD) score serves as the basis for the distribution of deceased-donor (DD) livers and was developed in response to "the final rule" mandate, whose stated principle is to allocate livers according to a patient's medical need, with less emphasis on keeping organs in the local procurement area. However, in selected areas of the United States, organs are kept in organ procurement organizations (OPOs) with small waiting lists and transplanted into less-sick patients instead of being allocated to sicker patients in nearby transplant centers in OPOs with large waiting lists.To determine whether there is a difference in MELD scores for liver transplant recipients receiving transplants in small vs large OPOs.Retrospective review of the US Scientific Registry of Transplant Recipients between February 28, 2002, and March 31, 2003. Transplant recipients (N = 4798) had end-stage liver disease and received DD livers.MELD score distribution (range, 6-40), graft survival, and patient survival for liver transplant recipients in small (<100) and large (> or =100 on the waiting list) OPOs.The distribution of MELD scores was the same in large and small OPOs; 92% had a MELD score of 18 or less, 7% had a MELD score between 19 and 24, and only 2% of listed patients had a MELD score higher than 24 (P =.85). The proportion of patients receiving transplants in small OPOs and with a MELD score higher than 24 was significantly lower than that in large OPOs (19% vs 49%; P<.001). Patient survival rates at 1 year after transplantation for small OPOs (86.4%) and large OPOs (86.6%) were not statistically different (P =.59), and neither were graft survival rates in small OPOs (80.1%) and large OPOs (81.3%) (P =.80).There is a significant disparity in MELD scores in liver transplant recipients in small vs large OPOs; fewer transplant recipients in small OPOs have severe liver disease (MELD score >24). This disparity does not reflect the stated goals of the current allocation policy, which is to distribute livers according to a patient's medical need, with less emphasis on keeping organs in the local procurement area.
Bimedial Lobotomy
Authors: Julius Levine, Milton Greenblatt, Harry C. Solomon
Journal: New England Journal of Medicine (1951)

LOBOTOMY investigations at the Boston Psychopathic Hospital during the last two years have centered about a comparative evaluation of three different types of frontal-lobe surgery—bilateral, bimedial and unilateral lobotomy. A pilot study of bimedial and unilateral lobotomy in 1950 by Bockoven and Greenblatt1 indicated that these two modifications of the standard operation had definite potentialities for improving chronically ill mental patients. The investigations here reported are part of a larger project that over eight years has had two essential aims: to develop an operation that would accomplish the most benefit for the patient with the least personality and brain damage . . .
Tobacco Use Out of Step With US Armed Forces
Authors: Phil Gunby
Journal: JAMA (1994)

IT'S NO LONGER "smoke 'em if you've got 'em" in the US military, which hopes to be tobacco-free early next century. Many an enlisted service member has heard a noncommissioned officer use the phrase in giving permission to smoke a cigarette during a break in military activity. Now, with stronger emphasis than ever, the armed forces are urging members not to smoke or chew tobacco. The US Department of Defense is expected to issue a clean air policy that may further strengthen the services' antitobacco efforts. In the meantime, the surgeons general of the US Navy (which provides medical support for the US Marine Corps), US Army, and US Air Force are emphasizing that ceasing to use tobacco is a step in taking responsibility for one's own health, improving productivity, and allowing more efficient and cost-effective use of military medical resources. Donald F. Hagen, MD, vice admiral and surgeon general
Prevalence of Helicobacter pylori Antibodies in the Serum of Gastroenterologists in Austria
Authors: H. Pristautz, A. Eherer, R. Brezinschek, M. Truschnig-Wilders, W. Petritsch, F. Schreiber, H. F. Hammer, H. Wenzl, T. Hinterleitner, G. Reicht, G. P Tilz, G. J. Krejs
Journal: Endoscopy (1994)

Eighty-eight endoscopists (mean age 41 years, range 29-76 years) and a control group of 100 persons of similar ages were investigated for the prevalence of antibodies (ABs) to Helicobacter pylori, using a quantitative enzyme-linked immunosorbent assay (ELISA) to IgG, two semiquantitative ELISAs to IgG and IgA, and a latex test to IgG and IgM antibodies. The prevalence of antibodies to H. pylori in endoscopists was 48% (quantitative ELISA), 56% (semiquantitative ELISA to IgG), 62% (latex test), and 57% by combined evaluation of semiquantitative ELISAS to IgG and IgA. The respective numbers in the control group were 47%, 48%, 48% and 51%. None of the differences was significant. In both groups, endoscopists and controls, there was a significantly higher H. pylori positivity in older subjects compared to younger persons, but there was no difference between the two groups. The prevalence of ABs was independent to the number of endoscopies previously performed, and independent of protective measures taken, such as wearing gloves during the procedures. Antibody titers as measured with quantitative ELISA showed a positive correlation with the length of time the subject had been active as an endoscopist, but no correlation with the total number of endoscopies performed. In conclusion, the prevalence of ABs to H. pylori in endoscopists follows the age-dependent pattern known from the general population. The regular performance of gastrointestinal endoscopies poses no additional risk of infection with H. pylori in Austria.
How Superstition Won and Science Lost: Popularizing Science and Health in the United States
Authors: Michael D. Oppenheim
Journal: JAMA (1988)

Describing astrology, telepathy, UFOs, or creation science, most<i>JAMA</i>readers might use terms varying from "unproven" to "fallacious" to just plain "silly." This is not the attitude of most laypersons—or even a majority of my own family. Scientists may not enjoy the lofty status they did half a century ago, but Americans still look on them as powerful—if dangerous—authority figures. The products of science, from lasers to computed tomography, seem magical. Those of us who smile at this naïveté do not realize the harm it has caused. If science is magic, anything is possible. When some "authorities" claim that laetrile cures cancer while others dismiss it as quack medicine, laypersons see this as an exciting turf battle between establishment magicians and a rebel group trying to break in. This, of course, is how the media portray it. It was not always this way. Victorian scientists knew that they were uncovering
FDA Steps Up Efforts to Find, Remove Violators of Clinical Trial Regulations
Authors: Bridget M. Kuehn
Journal: JAMA (2009)

RESEARCHERS WHO FLOUT REGULAtions for the conduct of clinical trialsorwhocommitcrimesrelated toclinicalresearchmayfaceswifterrepercussionsastheUSFoodandDrugAdministration (FDA) intensifies its efforts to identify and remove violators from the drug and device development process. Since the 1960s, the FDA has had the authority to disqualify or remove from FDA-regulated trials any clinical investigatorswhohave“repeatedlyordeliberately”ignoredregulationsdesignedtoprotecthumanresearchparticipantsorwho have repeatedly or deliberately submitted false informationto theagencyor the sponsoroftheirresearch.Butthisprocess often took years to complete. In1992,CongressgrantedtheFDAthe additionalauthoritytobarresearcherswho havebeenconvictedof feloniesrelatedto drug development from working in the pharmaceuticalindustry.Italsoauthorized theagencytobargenericdrugcompanies convictedoffeloniesfromsubmittingdrug applications to the FDA. The legislation followedascandal inwhichsomegeneric drugcompanieshadbribedFDAstaffers ormanipulated thedata in their abbreviateddrugapplications.Yet a2008report by minority members of the Committee on Energy and Commerce found that theagencyhadneverdebarredacompany and had inconsistently debarred clinical investigators convicted of wrongdoing andalso that theagencymight takeyears to carry out such actions.
Results of a randomized prospective trial of intraaortic balloon counterpulsation and intravenous nitroglycerin in patients with acute myocardial infarction
Authors: John T. Flaherty, Lewis C. Becker, James L. Weiss, Jeffrey A. Brinker, Bernadine H. Bulkley, Gary Gerstenblith, Clayton H. Kallman, Myron L. Weisfeldt
Journal: Journal of the American College of Cardiology (1985)