tbuckley/cabot-search huggingface dataset:
In juvenile dermatomyositis, cardiac systolic dysfunction is present after long-term follow-up and is predicted by sustained early skin activity
Authors: Thomas Schwartz, Helga Sanner, Ola Gjesdal, Berit Flatø, Ivar Sjaastad
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Objective</h3> To compare systolic cardiac function in patients with juvenile dermatomyositis (JDM) with matched controls and examine associations between systolic and diastolic cardiac function and disease variables. <h3>Methods</h3> Fifty-nine patients, examined at follow-up, median 16.8 years (2–38 years) after disease onset, were compared with 59 age-matched and sex-matched controls. Echocardiography was performed and analysed blinded to patient information. We used mitral annulus displacement to assess the relative long-axis shortening of the left ventricle (long-axis strain) and early diastolic tissue velocity (e′), as markers for systolic and diastolic function, respectively. Disease activity and organ damage were assessed at follow-up by clinical examination and retrospectively by chart review. <h3>Results</h3> Long-axis strain was reduced in patients compared with controls (16.6% (2.5) vs 17.7% (2.0), mean (SD), p=0.001), whereas no difference was seen between patients with active and inactive disease. Disease duration correlated with systolic and diastolic function (r<sub>sp</sub>=−0.50 and r<sub>sp</sub>=−0.73, both p&lt;0.001) and so did Myositis Damage Index (MDI) 1 year (r<sub>sp</sub>=−0.36 and r<sub>sp</sub>=−0.46) and MDI at follow-up (r<sub>sp</sub>=−0.33 and r<sub>sp</sub>=−0.60), all p&lt;0.01. High early disease activity score (DAS) in skin (DAS skin 1 year), but not in muscle, predicted systolic (standardised β=−0.28, p=0.011, R<sup>2</sup>=48%) and diastolic dysfunction (β=−0.36, p&lt;0.001, R<sup>2</sup>=72%) at follow-up. <h3>Conclusions</h3> Long-axis strain was reduced in JDM patients compared with controls, suggesting systolic dysfunction. Impaired systolic and diastolic function was predicted by DAS skin 1 year. This indicates a common pathway to two different cardiac manifestations in JDM, perhaps with similar pathogenesis as skin affection.
Patient Satisfaction With Treatment of Breast Cancer: Does Surgeon Specialization Matter?
Authors: Jennifer F. Waljee, Sarah Hawley, Amy K. Alderman, Monica Morrow, Steven J. Katz
Journal: Journal of Clinical Oncology (2007)

Experience and practice setting vary greatly among surgeons who treat breast cancer patients. However, less is known about how these factors influence patient satisfaction with their care.We surveyed all ductal carcinoma in situ patients and a 20% random sample of invasive breast cancer patients diagnosed in 2002 reported to the Detroit, MI, and Los Angeles, CA, Surveillance, Epidemiology, and End Results registries. Attending surgeons were surveyed, yielding dyad information for 64.6% of patients (n = 1,539) and 69.7% of surgeons (n = 318). Logistic regression was used to examine the associations between surgeon specialization (percentage of practice devoted to breast disease) and hospital cancer program status, with four domains of patient satisfaction: (1) the surgical decision, (2) decision-making process, (3) surgeon-patient relationship, and (4) surgeon-patient communication, adjusting for patient and surgeon demographics and disease stage.In this sample, 34.5% of patients were treated by surgeons who devoted less than 30% (low volume) of their practice to breast disease, 32.5% by surgeons who devoted 30% to 60% (medium volume) of their practice to breast disease, and 33.0% by surgeons who devoted more than 60% (high volume) of their practice to breast disease. Compared to patients treated by low-volume surgeons, patients treated by higher volume surgeons were more satisfied with the decision-making process (medium volume, odds ratio [OR], 1.16; 95% CI, 0.80 to 1.67; high volume: OR, 1.79; 95% CI, 1.14 to 2.80) and with the surgeon-patient relationship (medium volume: OR, 1.13; 95% CI, 0.72 to 1.76; high volume: OR, 1.98; 95% CI, 1.08 to 3.61). Treatment setting was not associated with patient satisfaction after controlling for other factors.Surgeon specialization is correlated with patient satisfaction. Examining the processes underlying these associations can inform strategies to improve breast cancer care.
Effectiveness of Second-Generation Antipsychotics in Patients With Treatment-Resistant Schizophrenia: A Review and Meta-Analysis of Randomized Trials
Authors: Miranda Chakos, Jeffrey Lieberman, Elaine Hoffman, Daniel Bradford, Brian Sheitman
Journal: American Journal of Psychiatry (2001)

OBJECTIVE: The authors conducted a review and meta-analysis of studies that compared the efficacy and tolerability of typical and second-generation antipsychotics for patients with treatment-resistant schizophrenia. METHOD: A systematic search revealed 12 controlled studies (involving 1,916 independent patients), which were included in the review. For the seven studies that compared clozapine to a typical antipsychotic, a meta-analysis was performed to examine clozapine's effects on overall psychopathology, response rate, extrapyramidal symptoms, and tardive dyskinesia. RESULTS: The meta-analysis confirmed that treatment-resistant schizophrenic patients have more favorable outcomes when treated with clozapine rather than a typical antipsychotic, as reflected by Brief Psychiatric Rating Scale total score, categorical response rate, Scale for the Assessment of Negative Symptoms score, Simpson-Angus Rating Scale score, and compliance rate. Clozapine also conferred benefits on the sickest treatment-resistant schizophrenic patients. Patients treated with olanzapine also had more favorable outcomes with regard to categorical response and compliance rates. CONCLUSIONS: In the aggregate, the results of a meta-analysis indicated that clozapine exhibits superiority over typical antipsychotics in terms of both efficacy (as measured by improvement in overall psychopathology) and safety (in terms of reduced extrapyramidal side effects). However, the magnitude of the clozapine treatment effect was not consistently robust. Efficacy data for other second-generation antipsychotics in the treatment of patients with refractory schizophrenia were inconclusive. There is, therefore, a growing need to consider new and different treatment strategies, whether they be adjunctive or monotherapeutic, for schizophrenia that continues to be resistant or only partially responsive to treatment.
Deaths after elective repair of abdominal aortic aneurysm fall to all time low
Authors: Z. Kmietowicz
Journal: BMJ (2015)

Survival rates among patients undergoing elective surgery for abdominal aortic aneurysm in England and Wales have improved substantially in the past few years, a national audit has found.1

Of the 12 000 patients who had an elective operation to repair an aneurysm from 2012 to 2014, the proportion who died in hospital after surgery was 1.5%. From 2010 to 2012, 2.4% of patients died after surgery to repair an aneurysm; the rate 10 …
Adjuvant Imatinib for High-Risk GI Stromal Tumor: Analysis of a Randomized Trial
Authors: Heikki Joensuu, Mikael Eriksson, Kirsten Sundby Hall, Annette Reichardt, Jörg T. Hartmann, Daniel Pink, Giuliano Ramadori, Peter Hohenberger, Salah-Eddin Al-Batran, Marcus Schlemmer, Sebastian Bauer, Eva Wardelmann, Bengt Nilsson, Harri Sihto, Petri Bono, Raija Kallio, Jouni Junnila, Thor Alvegård, Peter Reichardt
Journal: Journal of Clinical Oncology (2015)

Three years of adjuvant imatinib therapy are recommended for patients with GI stromal tumor (GIST) with high-risk features, according to survival findings in the Scandinavian Sarcoma Group XVIII/AIO (Arbeitsgemeinschaft Internistische Onkologie) trial. To investigate whether the survival benefits have persisted, we performed the second planned analysis of the trial.Eligible patients had macroscopically completely excised, KIT-positive GIST with a high risk of recurrence, as determined by using the modified National Institutes of Health criteria. After surgery, the patients were randomly assigned to receive imatinib for either 1 or 3 years. The primary objective was recurrence-free survival (RFS), and the secondary objectives included survival.A total of 400 patients were entered onto this open-label study between February 4, 2004, and September 29, 2008. During a median follow-up of 90 months, 171 recurrences and 69 deaths were detected. Patients assigned to the 3-year group had longer RFS than those assigned to the 1- year group; 5-year RFS was 71.1% versus 52.3%, respectively (hazard ratio [HR], 0.60; 95% CI 0.44 to 0.81; P < .001), and survival was 91.9% versus 85.3% (HR, 0.60; 95% CI, 0.37 to 0.97; P = .036). Patients in the 3-year group survived longer in the subset with centrally confirmed GIST and without macroscopic metastases at study entry (93.4% v 86.8%; HR, 0.53; 95% CI, 0.30 to 0.93; P = .024). Similar numbers of cardiac events and second cancers were recorded in the groups.Three years of adjuvant imatinib therapy results in longer survival than 1 year of imatinib. High 5-year survival rates are achievable in patient populations with high-risk GIST.
Childhood tuberculosis in Israel: epidemiological trends and treatment outcomes, 1999–2010
Authors: Zohar Mor, Noa Cedar, Galia Pinsker, Haim Bibi, Itamar Grotto
Journal: European Respiratory Journal (2012)

Childhood tuberculosis (TB) poses a high risk for morbidity and death. This study describes the characteristics of childhood TB in Israel and examines treatment outcomes. Data sources were the National TB Registry and the National Civil Census. Between 1999 and 2010, 416 children (aged <18 years) had TB, averaging 1.5 per 100 000 children (range 0.6-3.2), demonstrating a declining trend. The average proportion of all TB cases reported annually that were in children was 8.4% (range 5.4-11.8%). Most (n=320, 79%) of the childhood TB cases were pulmonary. TB rates were highest for the 0-4-year age group and lowest for the 10-14-year age group. Of all childhood TB cases, 236 (56.7%) were born in countries with high prevalence of TB: 214 were Israeli citizens who were Ethiopian-born and 22 were non-Israeli citizens. The overall childhood TB incidence in 2010 was 1.05 cases per 100 000 children. The incidence of TB for Israeli-born children, children whose parents were Ethiopian-born and children of migrant workers was 0.55 per 100 000, 7.5 per 100 000 and 50-100 per 100 000, respectively. Cultures were taken from 60% of all childhood TB cases. Most children (97.8%) achieved treatment success, while three children (0.7%) died. Overall, rates of childhood TB rates in Israel are decreasing. However, children of parents born in countries with a high prevalence of TB are still at high risk of developing TB. Bacteriological confirmation should be encouraged to improve control of childhood TB.
Basal Ganglia Circuits as Targets for Neuromodulation in Parkinson Disease
Authors: Mahlon R. DeLong, Thomas Wichmann
Journal: JAMA Neurology (2015)

The revival of stereotactic surgery for Parkinson disease (PD) in the 1990s, with pallidotomy and then with high-frequency deep brain stimulation (DBS), has led to a renaissance in functional surgery for movement and other neuropsychiatric disorders.To examine the scientific foundations and rationale for the use of ablation and DBS for treatment of neurologic and psychiatric diseases, using PD as the primary example.A summary of the large body of relevant literature is presented on anatomy, physiology, pathophysiology, and functional surgery for PD and other basal ganglia disorders.The signs and symptoms of movement disorders appear to result largely from signature abnormalities in one of several parallel and largely segregated basal ganglia thalamocortical circuits (ie, the motor circuit). The available evidence suggests that the varied movement disorders resulting from dysfunction of this circuit result from propagated disruption of downstream network activity in the thalamus, cortex, and brainstem. Ablation and DBS act to free downstream networks to function more normally. The basal ganglia thalamocortical circuit may play a key role in the expression of disordered movement, and the basal ganglia-brainstem projections may play roles in akinesia and disturbances of gait. Efforts are under way to target circuit dysfunction in brain areas outside of the traditionally implicated basal ganglia thalamocortical system, in particular, the pedunculopontine nucleus, to address gait disorders that respond poorly to levodopa and conventional DBS targets.Deep brain stimulation is now the treatment of choice for many patients with advanced PD and other movement disorders. The success of DBS and other forms of neuromodulation for neuropsychiatric disorders is the result of the ability to modulate circuit activity in discrete functional domains within the basal ganglia circuitry with highly focused interventions, which spare uninvolved areas that are often disrupted with drugs.
Gestational Diabetes Mellitus Upsets the Proportion of Fatty Acids in Umbilical Arterial but Not Venous Plasma
Authors: Henar Ortega-Senovilla, Gioia Alvino, Emanuela Taricco, Irene Cetin, Emilio Herrera
Journal: Diabetes Care (2008)

Neonates of women with gestational diabetes mellitus (GDM) have reduced levels of arachidonic acid (AA) (20:4 n-6) and docosahexaenoic acid (DHA) (22:6 n-3). To assess whether this is the result of impaired placental transfer or endogenous fetal metabolism, fatty acids in umbilical venous and arterial plasma were analyzed in neonates of GDM women.Fatty acids were analyzed by gas chromatography in the plasma of 15 subjects with GDM and 30 healthy control subjects undergoing elective cesarean section and in vein and artery cord blood collected separately.The percentages of AA (20:4 n-6), DHA (22:6 n-3), and total n-6 or n-3 polyunsaturated fatty acids (PUFAs) as well as total PUFAs were lower in umbilical arterial but not in venous plasma of neonates of the GDM versus the control group.An altered handling or metabolism of long-chain PUFAs by the fetus rather than impaired placental transfer seems to be responsible for the lower proportion of those fatty acids in the plasma of neonates of GDM mothers.
Efficacy and safety of seven-valent conjugate pneumococcal vaccine in American Indian children: group randomised trial
Authors: Katherine L O'Brien, Lawrence H Moulton, Raymond Reid, Robert Weatherholtz, Jane Oski, Laura Brown, Gaurav Kumar, Alan Parkinson, Diana Hu, Jill Hackell, Ih Chang, Robert Kohberger, George Siber, Mathuram Santosham
Journal: The Lancet (2003)
Anti-Aromatase Activity of Phytochemicals in White Button Mushrooms (<i>Agaricus bisporus</i>)
Authors: Shiuan Chen, Sei-Ryang Oh, Sheryl Phung, Gene Hur, Jing Jing Ye, Sum Ling Kwok, Gayle E. Shrode, Martha Belury, Lynn S. Adams, Dudley Williams
Journal: Cancer Research (2006)

Abstract White button mushrooms (Agaricus bisporous) are a potential breast cancer chemopreventive agent, as they suppress aromatase activity and estrogen biosynthesis. Therefore, we evaluated the activity of mushroom extracts in the estrogen receptor–positive/aromatase-positive MCF-7aro cell line in vitro and in vivo. Mushroom extract decreased testosterone-induced cell proliferation in MCF-7aro cells but had no effect on MCF-10A, a nontumorigenic cell line. Most potent mushroom chemicals are soluble in ethyl acetate. The major active compounds found in the ethyl acetate fraction are unsaturated fatty acids such as linoleic acid, linolenic acid, and conjugated linoleic acid. The interaction of linoleic acid and conjugated linoleic acid with aromatase mutants expressed in Chinese hamster ovary cells showed that these fatty acids inhibit aromatase with similar potency and that mutations at the active site regions affect its interaction with these two fatty acids. Whereas these results suggest that these two compounds bind to the active site of aromatase, the inhibition kinetic analysis indicates that they are noncompetitive inhibitors with respect to androstenedione. Because only conjugated linoleic acid was found to inhibit the testosterone-dependent proliferation of MCF-7aro cells, the physiologically relevant aromatase inhibitors in mushrooms are most likely conjugated linoleic acid and its derivatives. The in vivo action of mushroom chemicals was shown using nude mice injected with MCF-7aro cells. The studies showed that mushroom extract decreased both tumor cell proliferation and tumor weight with no effect on rate of apoptosis. Therefore, our studies illustrate the anticancer activity in vitro and in vivo of mushroom extract and its major fatty acid constituents. (Cancer Res 2006; 66(24): 12026-34)
Erythrocyte Sedimentation Rate Predicts Early Relapse and Survival in Early-Stage Hodgkin Disease
Authors: Michel Henry-Amar, Samuel Friedman, Marcel Hayat, Reinier Somers, Jokobus H. Meerwaldt, Patrice Carde, J. M. V. Burgers, José Thomas, M. Monconduit, E. M. Noordijk, D. Bron, René Regnier, B. E. de Pauw, Alain Tanguy, Jean-Marc Cosset, Noëlle Dupouy, Maurice Tubiana
Journal: Annals of Internal Medicine (1991)

To assess the value of an elevated (greater than 30 mm/h) Westergren erythrocyte sedimentation rate (ESR) for predicting early relapse and survival after therapy in patients with clinical stage I or II Hodgkin disease.We studied 772 patients with early-stage Hodgkin disease who had participated in two separate multicenter clinical trials. Both trials used modern field radiotherapy and, in some patients, multi-agent chemotherapy.The ESR patterns were based on pretherapy and post-therapy assessments: pattern 1, always normal (n = 261); pattern 2, elevated before therapy but normal immediately after therapy (n = 121); pattern 3, elevated before therapy but normal within 3 months after therapy (n = 89); pattern 4, always elevated (n = 48); pattern 5, normal before therapy but oscillating between normal and elevated after therapy (n = 150); pattern 6, elevated before therapy but oscillating between normal and elevated after therapy (n = 130). By multivariate analysis, independent of whether or not patients received chemotherapy in the initial therapy protocol, ESR patterns 4, 5, and 6 were shown to be the best predictors for early relapse and survival when patients were stratified according to the type of chemotherapy received and the number of involved nodal areas. Patients with ESR pattern 4 had a relative risk for death seven times that of patients with patterns 1, 2, or 3. Early relapse was the second most important factor predicting death, irrespective of ESR; patients with early relapse and ESR patterns 1, 2, or 3 had a relative risk for death of 4.5, and those with early relapse and ESR patterns 4, 5, or 6 had a relative risk for death of 15. Whether or not chemotherapy was given initially did not change the relative risk, which shows that ESR, not initial therapy, was the predictor for early relapse and death due to Hodgkin disease.An unexplained elevated ESR after therapy, especially after modern radiotherapy, independent of other factors, strongly suggest the presence of aggressive and resistant Hodgkin disease. An elevated ESR is predictive of early relapse and poor prognosis; its presence justifies early aggressive therapy.
Renal interstitial fibrosis: Remembrance of things past?
Authors: Doris Herzlinger
Journal: Journal of Clinical Investigation (2002)

The decline in renal function seen in a variety of pathological states is associated with an increase in the number and changes in the protein synthetic activity of tubular interstitial cells.However, the relationship between expansion of the interstitial compartment (interstitial fibrosis) and loss of renal epithelial tubules and capillaries remains unclear.Interstitial pathologies accompanying renal failure may merely be coincident with tubular degeneration.Alternatively, interstitial pathologies may cause tubular degeneration.Finally, it is possible that "pathological" changes in the interstitial compartment reflect the kidney's attempts to repair damaged tubules.Discriminating among these possibilities has been difficult, in part because the function of interstitial cells in the healthy kidney remains poorly understood.A new study by Iwano et al. in this issue of the JCI (1) suggests that recent advances in the field of kidney development may provide insight into this important clinical problem.
Extended evolutionary theory makes human culture more amenable to evolutionary analysis
Authors: Alex Mesoudi
Journal: Behavioral and Brain Sciences (2007)

Abstract Jablonka &amp; Lamb's (J&amp;L's) extended evolutionary theory is more amenable to being applied to human cultural change than standard neo-Darwinian evolutionary theory. However, the authors are too quick to dismiss past evolutionary approaches to human culture. They also overlook a potential parallel between evolved genetic mechanisms that enhance evolvability and learned cognitive mechanisms that enhance learnability.
Fibroblasts of Recipient Origin Contribute to Bronchiolitis Obliterans in Human Lung Transplants
Authors: Verena Bröcker, Florian Länger, Tariq G. Fellous, Michael Mengel, Mairi Brittan, Martin Bredt, Simone Milde, Tobias Welte, Matthias Eder, Axel Haverich, Malcolm R. Alison, Hans Kreipe, Ulrich Lehmann
Journal: American Journal of Respiratory and Critical Care Medicine (2006)

The participation of circulating precursor cells in the development of experimental pulmonary fibrosing lesions in mice has been recently demonstrated.This study analyzes whether circulating, bone marrow-derived, fibroblastic precursor cells contribute to the development of fibrosing lesions in human lungs, especially bronchiolitis obliterans.The occurrence of in situ microchimerism in bronchiolitis obliterans lesions of human lung allografts (n = 12) as well as of autologous lung tissue from patients post-bone marrow transplantation (n = 2) was analyzed using laser-assisted microdissection after immunohistochemical labeling of leukocytes followed by short tandem repeat-polymerase chain reaction-based genotyping. Combined immunofluorescence and fluorescence in situ hybridization for sex chromosomes was performed for independent confirmation in cases with appropriate sex mismatch (n = 2).The bronchiolitis obliterans lesions of all 12 lung transplant patients contained considerable numbers of recipient-derived fibroblasts (mean, 32%). The fibrosing pulmonary lesions of the two bone marrow-transplanted patients also displayed clear in situ microchimerism. The in situ detection methodology confirmed these results, although to a lower degree (6-16%).These data clearly demonstrate the involvement of circulating fibroblastic precursor cells in the development of human fibrosing lung lesions and provide evidence that these cells are most probably bone marrow derived. These results may open new venues regarding the prevention of fibrosis in lung transplants and potentially in other organs.