tbuckley/cabot-search huggingface dataset:
Neural networks as predictors of outcomes in alcoholic patients with severe liver disease
Authors: P Lapuerta, S Rajan, M Bonacini
Journal: Hepatology (1997)

We developed and evaluated neural networks as predictors of outcomes in alcoholic patients with severe liver disease using commonly available clinical and laboratory values. Hospital charts of 144 patients were reviewed. Nine variables (five laboratory, four clinical) were recorded along with in-hospital death or survival. Data were organized into separate development and validation sets. Neural network predictions of survival were compared with those of the Maddrey discriminant function and logistic regression models developed on the same data. Model performance was evaluated by comparing areas under receiver-operating characteristic (ROC) curves and the distributions of model scores. Survivors had significantly different laboratory and clinical characteristics, the most important being a higher prothrombin time, lower bilirubin, and lower incidence of encephalopathy. Neural network performance was significantly better than that of the Maddrey score (ROC areas, 81.5% vs. 73.8%; P = .04). The ROC area for neural networks was similar to that of logistic regression (ROC area 78.2%; P = .3), but the neural networks were more successful in classifying patients into low- and high-risk groups (P < .001). A neural network score with laboratory data from hospital-day 7 improved prognostic accuracy further to 84.3%. After adjusting for baseline risk, the neural network change in illness severity was still a significant predictor of mortality (P = .001). Neural networks using clinical and laboratory data showed a high prognostic accuracy for predicting mortality in alcoholic patients with severe liver disease.
FDG PET/CT in the Detection of Metastases in a Patient With Tg and 131I WBS Negative Follicular Thyroid Cancer
Authors: Anar Aliyev, Sabire Ylmaz, Meftune Ozhan, Sertac Asa, Metin Halac
Journal: Clinical Nuclear Medicine (2013)

After a total or near total thyroidectomy and radioiodine ablation therapy for differential thyroid cancer (DTC), routine follow-up methods are 131I or 123I whole-body scanning (WBS) as well as serum thyroglobulin (Tg) and anti-thyroglobulin (anti-Tg) levels. We describe a case of a 41-year-old woman with follicular thyroid cancer. Although serum Tg level and 131I WBS were negative after radioiodine ablation therapy, she had pain around her left medial clavicle. FDG PET/CT was performed for any undetected metastases. FDG PET/CT showed hypermetabolic bone metastases in the left medial clavicle. Biopsy confirmed metastases of the thyroid follicular carcinoma.
Markers of Myeloproliferative Diseases in Childhood Polycythemia Vera and Essential Thrombocythemia
Authors: Luciana Teofili, Fiorina Giona, Maurizio Martini, Tonia Cenci, Francesco Guidi, Lorenza Torti, Giovanna Palumbo, Angela Amendola, Robin Foà, Luigi M. Larocca
Journal: Journal of Clinical Oncology (2007)

Polycythemia vera (PV) and essential thrombocythemia (ET) can present in pediatric age as sporadic or familial diseases. To define the biologic profile of childhood PV and ET, we evaluated specific markers in a cohort of pediatric patients affected by PV and ET, including cases with familial occurrence.Thirty-eight children with PV and ET were investigated. The control group included 58 adults with PV and ET. Endogenous erythroid colonies, qualitative reverse transcriptase polymerase chain reaction for polycythemia rubra vera-1 (PRV-1) RNA expression, human androgen receptor assay and allele specific polymerase chain reaction for JAK2 V617F mutation were undertaken in all patients. Thrombopoietin, thrombopoietin receptor (c-mpl), and erythropoietin receptor mutation analysis was performed by direct sequencing in familial cases.The JAK2 V617F mutation in children with PV was significantly less frequent than in adult PV. The most common myeloproliferative marker found in these patients was PRV-1 RNA overexpression. Children and adults with sporadic ET showed a similar proportion of patients with PRV-1 RNA overexpression, JAK2 V617F mutation, and clonality, while none of the familial ET showed JAK2 V617F mutation and clonality. Also, PRV-1 RNA overexpression was significantly less common. Furthermore, most patients with familial ET exhibited the dominant-positive activating mutation of c-mpl. Finally, children with PV and ET had a significant lower incidence of thrombosis than adults.This study demonstrates that familial and sporadic ET recognize different pathogenetic mechanisms. Myeloproliferative markers are specific tests for the diagnosis of ET in children with sporadic forms, while a significant proportion of children with PV can prove negative.
Abstract B67: Galectin-1 expression related to hypoxia in primary human melanoma as a driver for metastatic progression. A target to promote anticancer immunotherapy.
Authors: Stephen J. Ralph, Koichi Ito, Bernadette Wachter, Selda Onturk, James Wilmott, Peter Hersey
Journal: Cancer Research (2013)

Abstract Galectin-1 is a major protein secreted by the majority of cancer types which is induced by HIF and plays important roles in the tumor microenvironment protecting against anticancer immune cell attack and from reactive oxygen species production. We have shown this protein to be more highly expressed within hypoxic regions of primary melanoma. Galectin-1 expression is critical for protecting endothelial cells in tumor angiogenesis and for promoting tumor metastasis. More recently, we have shown that inhibiting this protein using small drug molecules significantly enhances chemotherapeutic access inside tumors by promoting leakiness and facilitates TIL access inside tumors to kill cancer cells. When galectin-1 blocking drugs are used in combination as a triple therapy with modified whole cancer cell vaccines plus anti-CTLA4 Ig, this provides synergistic enhancements increasing CD8+ CTL anticancer TIL responses to inhibit cancer growth in a range of different mouse tumor models. Citation Format: Stephen J. Ralph, Koichi Ito, Bernadette Wachter, Selda Onturk, James Wilmott, Peter Hersey. Galectin-1 expression related to hypoxia in primary human melanoma as a driver for metastatic progression. A target to promote anticancer immunotherapy. [abstract]. In: Proceedings of the AACR Special Conference on Tumor Immunology: Multidisciplinary Science Driving Basic and Clinical Advances; Dec 2-5, 2012; Miami, FL. Philadelphia (PA): AACR; Cancer Res 2013;73(1 Suppl):Abstract nr B67.
Simulated Systemic Lupus Erythematosus From Degraded Tetracycline
Authors: Stanley R. Sulkowski, John R. Haserick
Journal: JAMA (1964)

RECENT REPORTS describe a Fanconi-like syndrome that has developed in patients after the ingestion of a degraded tetracycline.<sup>1,2</sup>This report is of a case of gross aminoaciduria and photosensitivity, which, at onset, simulated systemic lupus erythematosus and implicates a degraded tetracycline as the etiological agent. <h3>Report of a Case</h3> An 8-year-old girl was admitted to the Cleveland Clinic Hospital on June 26, 1963, because of a persistent illness of two weeks' duration. The illness began as a bilateral otalgia, and the child was examined by a physician who prescribed four 250-mg capsules daily of tetracycline hydrochloride (Achromycin V). The tetracycline hydrochloride was given directly from the physician's own office supply. Three days after the initiation of antibiotic therapy, the mother noted an erythema over the child's knuckles and dorsa of the hands. In the following two days, the erythema occurred also on the forearms and as a butterfly-like eruption
Continuous Intravenous Vasopressin in Active Upper Gastrointestinal Bleeding
Authors: MICHAEL R. FOGEL
Journal: Annals of Internal Medicine (1982)

Sixty patients with active upper gastrointestinal bleeding were randomized to receive either continuous intravenous infusions of vasopressin (29 patients) or placebo (31 patients) at a rate of 40 U/h. Six hours after beginning the study, 13 patients in the vasopressin group and 11 in the placebo group had ceased bleeding (p=0.46). By 24 hours, 17 patients in the vasopressin group and 14 in the placebo group had stopped bleeding (p=0.30). Restriction of the analysis to patients bleeding from varices showed no advantage with vasopressin treatment after 6 or 24 hours. No consistent trend favoring use of vasopressin to stop hemorrhage was noted during the 30-month study period. There was little difference between the two groups in the number of patients needing surgery (13 on vasopressin, 18 on placebo; p=0.30) or the number of deaths (eight on vasopressin, 11 on placebo; p=0.51); the transfusion requirement was the same. In our patients, a continuous intravenous infusion of vasopressin neither controlled bleeding nor altered outcome.
Assessment of urine analysis for the diagnosis of tuberculosis
Authors: E. Mortier, J. Pouchot, L. Girard, Y. Boussougant, P. Vinceneux
Journal: BMJ (1996)

CommentSystolic blood pressure was not indicative of blood cyanide levels and oxyhaemoglobin saturation gradient did not parallel decreases in blood cyanide concen- trations.Concentration decay curves suggest that plasma lactate concentration is closely related to blood cyanide concentration before and after hydroxoco- balamin treatment.If this is confirmed in other cases of pure cyanide intoxication serial plasma lactate concen- trations could be used as a marker of the evolution of cyanide toxicity and perhaps of the adequacy of treatment.
Living Hungry In America
Authors: Anne R. Somers
Journal: JAMA (1990)

This excellent little book deserves high marks for several reasons. It deals with a very important subject—so important and so widespread that it sometimes escapes professional attention. It is exceptionally well written and readable. It is not a government document, not a statistical analysis. Most of the book consists of interviews with the poor themselves and those trying to help them—physicians, other health professionals, and administrators of food stamp offices, day-care centers, and other local programs. In this respect, Living Hungry follows in the time-honored clinical approach to problem solving. It is part of another important American tradition—the recurrent plea for social justice that has contributed so greatly to progress in America. Brown and Pizer's indictment of poverty, hunger, and malnutrition in this affluent society brings to mind Harriet Beecher Stowe on slavery and John Steinbeck on rural poverty in the Great Depression. Unlike Uncle Tom's Cabin
Lectures on the History of Medicine
Authors: A. Henry
Journal: BMJ (1860)

tions to the Study, Reasons for Cultivating a Knowledge of Mlledical History.Imitportance of the Stutdy.M1ode of following it.GENTLEMEN,-I have the honour of appearing before you, by the k;ind consent of the lecturers of this school, for the purpose of delivering a brief course of lectures on the History of Medi- cine.And, while the honour attached to the duty entrusted to me is great, I approach the task with fear, lest I should fail in the performance.You will at once appreciate how much room there is for anxiety, when you reflect how ex- tensive is the subject.What a vast mass of ideas is comprehended in the term " historical records of medical science!"What names it calls to our recollection!What a space of time it includes!There are, in fact, few records more ancient or more interesting than those of medicine; and none in which greater names appear, or in which deeds more worthy of man are narrated.Yet, strange though it may seem, the teachinig of the history of medicine is a novelty in England.The greatest pains are taken to shew the student what are the approved views in medi- cine of this our day, and what new springs of medical know- ledge may have burst forth in the time that is, or within the personal memory of the present race of men; but to bear his mind back to the time that has been-to direct his attention to the prime sources of his knowledge-is a duty which is very generally neglected.Tllus the majority of the profession in this country are comparatively uniniformed of everything that relates to the rise and progress of the science whose disciples they are, or of the art which they practise.A few names of men great in medicine, as Hippocrates, Galen, Areteus, Har- vey, Haller, may now and then be mentioned: nay, they may be "familiar in our mouths as household words"; but merely as entities in connection with history, much as Plato, Aristotle, and Bacon, are known to the general reader.And some of us, more advanced, may even have an acquaintance with some leading facts of the labours and doctrirnes of these men; and we may even have perused with care and interest their writings.But estimates of the influence they have really exerted on the progress of medicine are seldom made; and, instead of our having before us a general history of the rise and
PD05-05: Meta Analysis of Discordant HER2 Status in Matched Primary and Metastatic Breast Cancer.
Authors: S Richter, A Zandvakili
Journal: Cancer Research (2011)

Abstract Background: The status of HER2 amplification in breast cancer is an important prognostic and predictive indicator. Only those tumors exhibiting HER2 overamplification are candidates for HER2 targeted therapy. It remains controversial how accurately HER2 status of primary tumors reflects HER2 status in distant metastases. Discordance between primary and metastatic tumors can impact significantly on patient management and suitability for HER2 targeted therapies in the setting of recurrent distant disease. Methods: A literature search of the PubMed database was performed to identify all primary studies comparing HER2 status in matched primary and distant metastatic tumors between January 2005 and February 2011. Review and data extraction was performed by two independent reviewers. Eligible studies evaluated HER2 status by current ASCO guidelines. Studies comparing paired primary and axillary lymph nodes or synchronous primaries and metastases were excluded. Weighted pooled estimates were calculated. Results: The original search strategy retrieved 1703 studies for which there were 62 eligible studies for full evaluation. Metastatic sites included bone, brain, lung and liver. Traztuzumab was received in three studies. Weighted summary estimate for negative to positive discordance was 23% (95% CI, 16.0-28%). Positive to negative discordance had a weighted summary estimate of 4% (95% CI, 0.0-6%). Discussion: Meta analysis of studies adhering to ASCO guidelines for HER2 status determination revealed a significant rate of change to HER2 positive metastatic disease in HER2 unamplified primary breast cancers. This data suggests that nearly one quarter of patients may be denied the benefit of HER2 targeted therapy if HER2 primary status alone is used a the sole measure in determining therapeutic options upon distant recurrence. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr PD05-05.
David Livingstone Wilson
Authors: N. I. L. Wilson
Journal: BMJ (2010)

David Livingstone Wilson was born in Chitambo, Northern Rhodesia, where his father, a grandson of David Livingstone, was a medical missionary. The mission station at Chitambo was not far from where the explorer died in 1873. David qualified from Glasgow in 1948, followed by the diploma in tropical medicine and hygiene in Liverpool as preparation for medical missionary work. He was …
Systolic time interval as index of schedule--dependent doxorubicin cardiotoxicity in patients with acute myelogenous leukaemia.
Authors: S Al-Ismail, J A Whittaker
Journal: BMJ (1979)

The ratio of the pre-ejection period to the left ventricular ejection time (PEP:LVET) was measured in two groups of patients with acute myeloblastic leukaemia (AML) receiving the anthracycline antibiotic doxorubicin (DXR). Patients receiving high doses of DXR per course (about 90 mg/m2) showed a significant increase in the PEP:LVET ratio irrespective of the total cumulative dose. At a lower dose per course (less than 50mg/m2) only patients who had a total cumulative dose of over 450 mg/m2 showed significant increases in ratio. ECG changes were seen in both groups of patients but did not correlate significantly with the dosage. These findings, which suggest that DXR cardiotoxicity is schedule dependent, are important in the design of schedules of DXR for treating cancer and in interpreting the changes in systolic time intervals (STIs) observed with different schedules. Measurement of the STI is a simple and convenient method of assessing DXR cardiotoxicity. While a total DXR dose of 550 mg/m2 should not normally be exceeded, by carefully monitoring the STI the recommended total dose may be exceeded safely in selected patients.
POSTTHYMECTOMY WASTING ASSOCIATED WITH AUTOIMMUNE PHENOMENA
Authors: Edmond J. Yunis, Richard Hong, Mary Alice Grewe, Carlos Martinez, Eugene Cornelius, Robert A. Good
Journal: The Journal of Experimental Medicine (1967)

1. Mice of A and C(57)BL/6 Ks strains, thymectomized at birth acquire wasting disease in 84.1% (A) and 77.1% (C(57)BL/6 Ks) of the cases. There is no sex predelection. 2. Anemia in these animals is characterized by shortened red cell survival and increased fragility to hypotonic salt solutions. Among thymectomized A mice reticulocytosis is absent and extramedullary hematopoiesis is found in the spleen in the presence of bone marrow hypoplasia for the erythroid and lymphocyte series. 3. Positive antiglobulin tests of the red cells were observed in all the thymectomized C(57)BL/6 Ks (7/7) and 71.2% of the A strains (62/87). Normal mice do not show positive Coombs' tests. 4. The globulin coat on the A strain consists of IgM, whereas beta(1C) and IgG are not detectable. By contrast, red cell coats of NZB mice developing spontaneous autoimmune hemolytic anemia show IgM and beta(1C), but these erythrocytes do not react with anti-gamma chain antibodies. Another difference in the globulin coats of the two types of erythrocytes is that the IgM on NZB red cells has available light chain determinants but these are apparently hidden or absent in the case of sensitized erythrocytes. The difference in antibody coating, association with a component of complement in one but not the other, suggests a different mechanism for the immune surface phenomenon in each instance. 5. Anemia in NZB mice is associated with reticulocytosis while that in thymectomized A mice is not. 6. Thymectomy appears to initiate a chain of events leading to a series of autoimmune phenomena which may be due to alteration in host response consequent to loss of thymic tissue and thymic dependent functions or alternatively to infection to which increased susceptibility exists as a result of thymic extirpation.
COMPARISONS OF THE CHARACTERISTICS AND OUTCOMES BETWEEN AORTIC DISSECTION AND INTRAMURAL HEMATOMA: FIVE YEAR EXPERIENCE OF SINGLE TERTIARY CENTER
Authors: Kye Hun Kim, Hyun Ju Yoon, Young Joon Hong, Youngkeun Ahn, Myung Ho Jeong, Jeong Gwan Cho, Jong Chun Park, Jung Chaee Kang
Journal: Journal of the American College of Cardiology (2011)
Adoptive T-cell Transfer and Chemotherapy in the First-line Treatment of Metastatic and/or Locally Recurrent Nasopharyngeal Carcinoma
Authors: Whay-Kuang Chia, Marissa Teo, Who-Whong Wang, Bernett Lee, Soo-Fan Ang, Wai-Meng Tai, Chit-Lai Chee, Joanna Ng, Rebecca Kan, Wan-Teck Lim, Sze-Huey Tan, Whee-Sze Ong, Yin-Bun Cheung, Eng-Huat Tan, John E Connolly, Stephen Gottschalk, Han-Chong Toh
Journal: Molecular Therapy (2013)

The outcomes for patients with metastatic or locally recurrent Epstein–Barr virus (EBV)-positive nasopharyngeal carcinoma (NPC) remain poor. Adoptive immunotherapy with EBV-specific cytotoxic T lymphocytes (EBV-CTLs) has proven clinical efficacy, but it has never been evaluated in the first-line treatment setting in combination with chemotherapy. To evaluate the safety and efficacy of a chemotherapy in combination with adoptive EBV-CTL transfer, we conducted a phase 2 clinical trial consisting of four cycles of gemcitabine and carboplatin (GC) followed by up to six doses of EBV-CTL. Thirty-eight patients were enrolled, and 35 received GC and EBV-CTL. GC-CTL therapy resulted in a response rate of 71.4% with 3 complete responses and 22 partial responses. With a median follow up of 29.9 months, the 2-year and 3-year overall survival (OS) rate was 62.9 and 37.1%, respectively. Five patients did not require further chemotherapy for more than 34 months since initiation of CTL. Infusion of CTL products containing T cells specific for LMP2 positively correlated with OS (hazard ratio: 0.35; 95% confidence interval: 0.14–0.84; P = 0.014). Our study achieved one of the best survival outcomes in patients with advanced NPC, setting the stage for a future randomized study of chemotherapy with and without EBV-CTL. The outcomes for patients with metastatic or locally recurrent Epstein–Barr virus (EBV)-positive nasopharyngeal carcinoma (NPC) remain poor. Adoptive immunotherapy with EBV-specific cytotoxic T lymphocytes (EBV-CTLs) has proven clinical efficacy, but it has never been evaluated in the first-line treatment setting in combination with chemotherapy. To evaluate the safety and efficacy of a chemotherapy in combination with adoptive EBV-CTL transfer, we conducted a phase 2 clinical trial consisting of four cycles of gemcitabine and carboplatin (GC) followed by up to six doses of EBV-CTL. Thirty-eight patients were enrolled, and 35 received GC and EBV-CTL. GC-CTL therapy resulted in a response rate of 71.4% with 3 complete responses and 22 partial responses. With a median follow up of 29.9 months, the 2-year and 3-year overall survival (OS) rate was 62.9 and 37.1%, respectively. Five patients did not require further chemotherapy for more than 34 months since initiation of CTL. Infusion of CTL products containing T cells specific for LMP2 positively correlated with OS (hazard ratio: 0.35; 95% confidence interval: 0.14–0.84; P = 0.014). Our study achieved one of the best survival outcomes in patients with advanced NPC, setting the stage for a future randomized study of chemotherapy with and without EBV-CTL.
Pulsatile peptide secretion: encoding of brain messages regulating endocrine and reproductive functions.
Authors: A Negro-Vilar, M D Culler, M M Valença, T B Flack, G Wisniewski
Journal: Environmental Health Perspectives (1987)

Neuropeptides are defined chemical messengers produced by the brain to modulate its own activity and also to regulate the function of every organ system. These neuropeptides can be viewed as coded chemical signals produced by the brain and secreted into the blood or into other fluids, such as the cerebrospinal fluid, to be transported and to act at a distant site. The signals arrive to the target organ or sometimes to an intermediary station, such as the pituitary gland, where they are decoded, transformed into a more powerful signal, and sent again through the general circulation to reach their final target. Our work has characterized the episodic or pulsatile pattern of secretion of a number of peptide hormones produced by the brain or the pituitary gland and analyzed the brain mechanisms involved in the generation of such a pulsatile pattern of hormone secretion. Molecular biology approaches have provided information on the synthesis, processing, and secretion of these brain messengers. In addition, using computer-assisted perifusion systems, we have been able to reproduce in vitro some of the signals produced by the brain and are currently trying to decode the message carried by those signals, as well as determining the intracellular messengers involved in the signal process. The importance of the neuropeptides and of the messages carried by the pulsatile signal is underlined by experiments in which animals treated with a neurotoxin were rendered infertile.(ABSTRACT TRUNCATED AT 250 WORDS)