tbuckley/cabot-search huggingface dataset:
A Novel Prognostic Model for Malignant Mesothelioma Incorporating Quantitative FDG-PET Imaging with Clinical Parameters
Authors: Anna K. Nowak, Roslyn J. Francis, Michael J. Phillips, Michael J. Millward, Agatha A. van der Schaaf, Jan Boucek, Arthur W. Musk, Melanie J. McCoy, Amanda Segal, Peter Robins, Michael J. Byrne
Journal: Clinical Cancer Research (2010)

Existing prognostic systems for malignant pleural mesothelioma do not incorporate imaging information. We aimed to identify the contribution of quantitative fluorodeoxyglucose positron emission tomography (FDG-PET) analysis to other prognostic variables in this disease.Patients with malignant pleural mesothelioma underwent helical thoracoabdominal computed tomography and FDG-PET scans at baseline. Patients were treated as clinically indicated and followed for survival. FDG-PET variables derived included total glycolytic volume, a composite of tumor volume and glycolytic activity.Ninety-three patients were accrued from 2003 to 2006. Of 89 eligible assessable patients, 28 had undergone pleurodesis before enrolment. Seventeen patients remained alive at analysis; median survival is 15.4 months. On univariate analysis, significant prognostic factors were: total glycolytic volume on FDG-PET (P = 0.003), sarcomatoid histology (P < 0.0005), weight loss (P = 0.031), computed tomography stage (P = 0.015), and European Organization for Research and Treatment of Cancer good prognostic score (P = 0.049). In patients with epithelioid or biphasic histology, baseline total glycolytic volume remained predictive of survival in patients with (P = 0.01) or without (P = 0.018) previous pleurodesis. In multivariate analysis, no variable other than histology contributed to the model in patients with sarcomatoid histology; total glycolytic volume and weight loss contributed to the models in patients with nonsarcomatoid histology. computed tomography-assessed tumor-node-metastasis stage did not contribute to the model. A nomogram, which incorporates quantitative PET parameters and pleurodesis into prognostic information, is presented.Sarcomatoid histology remains the strongest prognostic factor. In patients with non sarcomatoid disease, volumetric FDG-PET parameters are more predictive of survival than tumor-node-metastasis staging, suggesting that tumor volume and glycolytic activity may be more important determinants of prognosis in malignant pleural mesothelioma than anatomic extent of disease.
Myocardial Laceration Not Demonstrated by Continuous Electrocardiographic Monitoring Occurring during Pericardiocentesis
Authors: Samuel M. Sobol, Harry M. Thomas, Roger W. Evans
Journal: New England Journal of Medicine (1975)

IN 1951 Bishop et al. described the technic of percutaneous pericardiocentesis with continuous electrocardiographic monitoring in which the paracentesis needle serves as an exploring electrode.1 With this procedure, an injury current is detected if the needle contacts the ventricular (ST-segment elevation) or a trial (PR-segment elevation) epicardium. Numerous studies have shown the technic to be of value in preventing inadvertent myocardial puncture and to clarify the site of origin of bloody fluid.1 2 3 4 In the reported exceptions, myocardial penetration and laceration was accompanied by electrocardiographic changes when this technic was used.5 6 7 8 We recently encountered a circumstance in which a definite myocardial laceration occurred without . . .
TCT-160 In-Hospital Switching Of Oral P2Y12 Inhibitor Treatment In Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: Prevalence, Predictors And Short-Term Outcome
Authors: Dimitrios Alexopoulos, Ioanna Xanthopoulou, Spyridon Deftereos, Georgios Sitafidis, Ioannis (John) Kanakakis, Michalis Hamilos, Christos Angelidis, Stylianos petousis, Dimitrios Stakos, Charalambos Parisis, Manolis Vavuranakis, Periklis Davlouros, John Goudevenos, Christodoulos Stefanadis
Journal: Journal of the American College of Cardiology (2013)
Lack of staff and poor organisation blamed for excess deaths in a London hospital
Authors: Susan Mayor
Journal: BMJ (2005)

A shortage of midwives and obstetricians, poor working relationships, and failure to follow clinical guidelines was blamed for maternal deaths at a London hospital in a review published last week by the Healthcare Commission. The review was requested after seven women cared for by North West London Hospitals NHS Trust died in pregnancy or within 42 days of delivery, miscarriage, or termination of pregnancy between April 2002 and December 2003.

The Healthcare Commission, which leads investigations into the provision of healthcare by the NHS in England, reviewed the quality of maternity care in detail. This included meeting staff and patients; visiting the trust's two main hospitals, Central Middlesex Hospital, and Northwick Park and St Mark's Hospital; analysing more than 750 documents; and surveying 400 women who had given birth at the trust in the six months leading up to the review.

Nigel Ellis, head of investigations …
Tissue distribution and ontogeny of steroid 5 alpha-reductase isozyme expression.
Authors: A E Thigpen, R I Silver, J M Guileyardo, M L Casey, J D McConnell, D W Russell
Journal: Journal of Clinical Investigation (1993)

The synthesis of dihydrotestosterone is catalyzed by steroid 5 alpha-reductase isozymes, designated types 1 and 2. Mutation of type 2 results in male pseudohermaphroditism, in which the external genitalia are phenotypically female at birth. Two striking and unexplained features of this disorder are that external genitalia of affected males undergo virilization during puberty and that these individuals have less temporal hair regression. The tissue-specific and developmental expression patterns of the 5 alpha-reductase isozymes were investigated by immunoblotting. The type 1 isozyme is not detectable in the fetus, is transiently expressed in newborn skin and scalp, and permanently expressed in skin from the time of puberty. There was no qualitative difference in 5 alpha-reductase type 1 expression between adult balding vs. nonbalding scalp. The type 2 isozyme is transiently expressed in skin and scalp of newborns. Type 2 is the predominant isozyme detectable in fetal genital skin, male accessory sex glands, and in the prostate, including benign prostatic hyperplasia and prostate adenocarcinoma tissues. Both isozymes are expressed in the liver, but only after birth. These results are consistent with 5 alpha-reductase type 1 being responsible for virilization in type 2-deficient subjects during puberty, and suggest that the type 2 isozyme may be an initiating factor in development of male pattern baldness.
Clash in US over methadone treatment
Authors: J. Ciment
Journal: BMJ (1998)

The policy of the mayor of New York in closing methadone treatment centres for heroin users has put the city in direct conflict with officials of the Clinton administration who would like to expand access to methadone.

On 29 September the United States's top drugs official, General Barry McCaffrey, told the American Methadone Treatment Association in Manhattan that doctors would be allowed to prescribe methadone in the privacy of …
Outcomes following colectomy for Clostridium difficile colitis
Authors: Shirley Chan, Mark Kelly, Sophie Helme, James Gossage, Bijan Modarai, Matthew Forshaw
Journal: International Journal of Surgery (2008)

Clostridium difficile associated diarrhoea has become an important health problem in UK hospitals but surgical intervention is rarely required. There is little evidence regarding best practice for patients requiring surgical intervention. The aim of this multicentre study was to review our experience in patients requiring surgery for C. difficile colitis. Patients who underwent surgery for C. difficile colitis in 5 hospitals in Southeast England over a 7-year period (1 teaching hospital and 4 district general hospitals) were identified from histopathology databases. Data were collected regarding the presentation, indication for surgery and post-operative outcomes. 15 patients (9 males; mean age = 71 years (range 35–84 years)) underwent surgery. 46% of patients (n = 7) contracted C. difficile during their hospital admission for other medical reasons and 73% of patients were initially admitted under other medical specialties. Diagnosis was only made preoperatively in 8 patients (53%). Indications for surgery were peritonitis and systemic toxicity (n = 12), failure of medical management (n = 2) and unresolving large bowel dilatation (n = 1). 12 patients underwent total colectomy and the rest underwent segmental resection. All patients were admitted to the intensive care unit post operatively with a mean stay of 6 days. 2 patients needed a second look laparotomy. Mortality rate was 67% (n = 10), with all but 1 patient dying within the 30-day mortality period. The mean length of hospital stay of survivors was 30 days (range 17–72). Surgical intervention for C. difficile colitis remains uncommon. Total colectomy and end ileostomy is the procedure of choice. The outlook for patients requiring surgery remains poor.
Effects of simvastatin on the response to arterial injury in Wild-Type (WT) and apolipoprotein E-deficient (ApoEO) mice
Authors: Robin P. Choudhury, Angela L. Carrelli, Joshua Stern, Raymond Soccio, Igor Chereshnev, Valerie Elmalern, John T. Fallon, Edward A. Fisher, Ernane D. Reis
Journal: Journal of the American College of Cardiology (2002)
Pleural non-Hodgkin's lymphoma arising in a patient with a chronic pyothorax.
Authors: N. Y. Hsu, C. Y. Chen, S. T. Pan, C. P. Hsu
Journal: Thorax (1996)

A 69 year old man with a chronic left pyothorax was treated by decortication. Although the treatment rapidly improved respiratory function, histopathological examination revealed a diffuse large B cell non-Hodgkin's lymphoma. Subsequent bone marrow biopsy samples disclosed bone marrow involvement. It is possible that non-Hodgkin's lymphoma may develop from a chronic pyothorax.
Hematologic Depression Following Therapy with Strontium-89 Chloride
Authors: ROBERT J. COWAN, HENRY M. CHILTON, M ROBERT COOPER, CAROLYN R. FERREE, EVELYN E. WATSON, RALPH G. ROBINSON
Journal: Clinical Nuclear Medicine (1986)

Initial clinical trials using strontium-89 (Sr-89) chloride for the treatment of painful skeletal metastases have observed minimal or no hematological depression secondary to the radiostrontium. A patient with marked bone marrow depression temporally related to the administration of the Sr-89 is reported, and the need for close hematological monitoring is emphasized. Bone marrow tumor replacement may predispose patients to marrow depression from radiostrontium, and such patients should be treated with caution.
Lymph Node Count as a Quality Measure for Gastric Cancer Surgery—Reply
Authors: John W. Morgan, Liang Ji, Sharon S. Lum
Journal: JAMA Surgery (2015)

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Scrofuloderma (tuberculosis colliquativa cutis)
Authors: E. TUR, S. BRENNER, Y. MEIRON
Journal: British Journal of Dermatology (1996)

A 16-year-old girl presented with long-standing purulent sinuses to the skin overlying the lacrimal ducts, which had evolved into ulcers and resulted in hypertrophic scarring. The ulcers were serpiginous, with an uneven soft floor, and undermined edges. Histological examination revealed non-caseating tuberculoid granulomas in the dermis. Cultures for Mycobacterium tuberculosis were positive. Chest X-ray did not show pulmonary involvement. Antituberculous therapy with isoniazid 300 mg/day and rifampicin 600 mg/day achieved a great improvement within 5 weeks of being started. A further improvement was seen at 4 months and complete resolution had occurred by 9 months. To the best of our knowledge, there are no other documented cases of scrofuloderma over the lacrimal system. The delay in the diagnosis emphasizes the importance of maintaining a high level of awareness.
Cardiac Tumors and Associated Arrhythmias in Pediatric Patients, With Observations on Surgical Therapy for Ventricular Tachycardia
Authors: Christina Y. Miyake, Pedro J. Del Nido, Mark E. Alexander, Frank Cecchin, Charles I. Berul, John K. Triedman, Tal Geva, Edward P. Walsh
Journal: Journal of the American College of Cardiology (2011)
Percutaneous delivery of the gax gene inhibits vessel stenosis in a rabbit model of balloon angioplasty
Authors: L Maillard, E Van Belle, R C Smith, A Le Roux, P Denéfle, G Steg, J J Barry, D Branellec, J M Isner, K Walsh
Journal: Cardiovascular Research (1997)

Objectives: The expression of gax, an anti-proliferative homeobox gene, is rapidly downregulated in vascular smooth muscle cells (VSMCs) following arterial injury. Here we performed percutaneous adenovirus-mediated gene transfer into the iliac arteries of normal rabbits using a channel balloon catheter to assess the effects of gax overexpression on neointima formation, lumen diameter, reendothelialization and functional vasomotion. Methods: A channel balloon catheter was used to perform both the arterial injury and local gene delivery. In each animal both iliac arteries were randomly assigned to receive either an adenovirus expressing the gax gene (Ad-Gax) or the β-galactosidase gene (Ad-βgal). In a second group of animals arteries were randomly assigned to receive either Ad-βgal or saline. Results: At one month, angiography revealed 36% less luminal narrowing in the Ad-Gax-treated arteries relative to the Ad-βgal-treated control arteries. Histological analysis revealed that the intimal/medial ratio (I/M) was reduced by 56% in the Ad-Gax group. Endothelium-dependent vasomotion was not affected by the gax gene transfer. In the second group, no statistically significant differences were found between the saline and the Ad-βgal-treated vessels for any of these parameters. Conclusions: Percutaneous adenovirus delivery of the gax gene to rabbit iliac arteries following endothelial denudation and vessel wall injury reduces neointimal hyperplasia and luminal stenosis, but does not affect endothelium-dependent vasomotion. This study demonstrates that a VSMC transcription factor can potentially be utilized for the development of a molecular therapy for vascular disorders.
Neglect of children in councilcare exposed in England
Authors: J. Warden
Journal: BMJ (1998)

Widespread neglect of children in the care of local authorities in England has been exposed by the House of Commons health committee. Beyond the question of abuse, the care system is failing such children in terms of their education, health, and aftercare.

The neglect starts at the top, with the Department of Health for years disregarding its …
Oral tolerization to adenoviral antigens permits long-term gene expression using recombinant adenoviral vectors.
Authors: Y Ilan, R Prakash, A Davidson, . Jona, G Droguett, M S Horwitz, N R Chowdhury, J R Chowdhury
Journal: Journal of Clinical Investigation (1997)

Recombinant adenoviruses (Ads) efficiently transfer foreign genes into hepatocytes in vivo, but the duration of transgene expression is limited by the host immune response which precludes gene expression upon readministration of the virus. To test if this immune response can be abrogated by oral tolerization, we instilled protein extracts of a recombinant adenovirus type-5 via gastroduodenostomy tubes into bilirubin-UDP-glucuronosyltransferase-1 (BUGT1)-deficient jaundiced Gunn rats. Control rats received BSA. Subsequent intravenous injection 5 x 10(9) pfu of a recombinant adenovirus-expressing human BUGT1 (Ad-hBUGT1) resulted in hepatic expression of human BUGT1 (hBUGT1) with reduction of serum bilirubin levels by 70%. After 2 mo serum bilirubin increased gradually. In orally tolerized rats, but not in controls, a second dose of the virus on day 98 markedly reduced serum bilirubin again. In the tolerized rats, the development of antiadenoviral neutralizing antibodies and cytotoxic lymphocytes were markedly inhibited, and transplantation of their splenocytes into naive Gunn rats adoptively transferred the tolerance, indicating a role for regulatory cells. Lymphocytes from the tolerized rats hyperexpressed TGFbeta1, IL2, and IL4 upon exposure to viral antigens, whereas IFNgamma expression became undetectable. Thus, oral tolerization with adenoviral antigens permits long-term gene expression by repeated injections of recombinant adenoviruses.
Effect of Deregionalized Care on Mortality in Very Low-Birth-Weight Infants With Necrotizing Enterocolitis
Authors: Zachary J. Kastenberg, Henry C. Lee, Jochen Profit, Jeffrey B. Gould, Karl G. Sylvester
Journal: JAMA Pediatrics (2014)

There has been a significant expansion in the number of low-level and midlevel neonatal intensive care units (NICUs) in recent decades. Infants with necrotizing enterocolitis represent a high-risk subgroup of the very low-birth-weight (VLBW) (<1500 g) population that would benefit from focused regionalization.To describe the current trend toward deregionalization and to test the hypothesis that infants with necrotizing enterocolitis represent a particularly high-risk subgroup of the VLBW population that would benefit from early identification, increased intensity of early management, and possible targeted triage to tertiary hospitals.A retrospective cohort study was conducted of NICUs in California. We used data collected by the California Perinatal Quality Care Collaborative from 2005 to 2011 to assess mortality rates among a population-based sample of 30 566 VLBW infants, 1879 with necrotizing enterocolitis, according to the level of care and VLBW case volume at the hospital of birth.Level and volume of neonatal intensive care at the hospital of birth.In-hospital mortality.There was a persistent trend toward deregionalization during the study period and mortality rates varied according to the level of care. High-level, high-volume (level IIIB with >100 VLBW cases per year and level IIIC) hospitals achieved the lowest risk-adjusted mortality. Infants with necrotizing enterocolitis born into midlevel hospitals (low-volume level IIIB and level IIIA NICUs) had odds of death ranging from 1.42 (95% CI, 1.08-1.87) to 1.51 (95% CI, 1.05-2.15, respectively). In the final year of the study, just 28.6% of the infants with necrotizing enterocolitis were born into high-level, high-volume hospitals. For infants born into lower level centers, transfer to a higher level of care frequently occurred well into the third week of life.These findings represent an immediate opportunity for local quality improvement initiatives and potential impetus for the regionalization of important NICU resources.
Assessment and management of medically unexplained symptoms
Authors: Simon Hatcher, Bruce Arroll
Journal: BMJ (2008)

Many people present with medically unexplained symptoms. For example, more than a quarter of primary care patients in England have unexplained chronic pain, irritable bowel syndrome, or chronic fatigue,1 and in secondary and tertiary care, around a third of new neurological outpatients have symptoms thought by neurologists to be “not at all” or only “somewhat” explained by disease.2 This is not a problem just in developed countries—in Bangladesh, only a third of women with abnormal vaginal discharge had evidence of infection.3 These disorders are important because they are common and they cause similar levels of disability as symptoms caused by disease.4 If not treated properly they can result in large amounts of resources being wasted5 and iatrogenic harm.

#### Sources and selection criteria 

We did a Medline search over the past 10 years using the keywords “somatoform disorders”, “medically unexplained symptoms”, and “randomised controlled trials”. We consulted Clinical Evidence and the Cochrane Collaboration for relevant articles. Most of the content of this article is based on the findings of systematic reviews and randomised controlled trials. Drawing conclusions is difficult because of the various definitions of the disorders used by different authors and the wide variety of symptom severity experienced by people with the same disorder.

This is a clinically, conceptually, and emotionally difficult area. Clinical presentations vary greatly—from people who frequently attend the general practitioner with minor symptoms to people with chronic fatigue who are bed bound. What unites them, however, is the difficulty in explaining the presenting symptoms on the basis of any known pathology. Strong feelings are common, with patients often referred to in pejorative terms as “frequent fliers,” “heart sink patients,” “thick folder patients,” or “somatisers.” Doctors may feel that their competence is challenged by their inability to explain the symptoms, and patients may feel that they …
Correlation of In Vitro Autofluorescence Endoscopy Images with Histopathologic Findings in Stomach Cancer
Authors: None Abe, None Izuishi, None Tajiri, None Kinoshita, None Matsuoka
Journal: Endoscopy (2000)

Background and Study Aims: There is increasing interest in the use of autofluorescence endoscopic imaging systems for the detection of malignancies in the gastrointestinal tract. The purpose of this study was to investigate the autofluorescent color of cancer lesions, and the detection rate of cancer areas using an autofluorescence endoscopic imaging system. Concurrent histopathologic examination was used for comparison.
Preoperative FDG PET/CT in Adrenocortical Cancer Depicts Massive Venous Tumor Invasion
Authors: Constantin Lapa, Rudolf A. Werner, Joachim Brumberg, Takahiro Higuchi
Journal: Clinical Nuclear Medicine (2014)

A 79-year-old woman presented with abdominal pain. Ultrasound revealed an intra-abdominal mass in the left renal region. Comprehensive endocrine workup was unremarkable. The patient was referred for further diagnostic workup. FDG PET/CT revealed a hypermetabolic mass in the left adrenal region. In addition, pathologically increased tracer uptake of 2 renal veins (the upper vein crossing in front of the aorta the lower one crossing behind the aorta) and the inferior vena cava raised the concern for malignant venous infiltration. Adrenalectomy, nephrectomy, and thrombectomy were carefully planned and performed. Adrenocortical carcinoma with tumor thrombus and caval extension was proven by histopathology.
Liposomes and immunoliposomes for controlled release or site specific delivery of anti-parasitic drugs and cytostatics
Authors: D.J.A. Crommelin, W.M.C. Eling, P.A. Steerenberg, U.K. Nässander, G. Storm, W.H. De Jong, Q.G.C.M. Van Hoesel, J. Zuidema
Journal: Journal of Controlled Release (1991)