tbuckley/cabot-search huggingface dataset:
Melanoma in Children and Teenagers: An Analysis of Patients From the National Cancer Data Base
Authors: Julie R. Lange, Bryan E. Palis, David C. Chang, Seng-Jaw Soong, Charles M. Balch
Journal: Journal of Clinical Oncology (2007)

This study examines the demographics, presentation, and outcomes of children and teenagers with melanoma using a US hospital-based oncology database.Data from the National Cancer Data Base from 1985 through 2003 were examined for demographics, presentation, and survival of patients aged 1 to 19 years, as well as a comparison group of patients aged 20 to 24 years. Two-sided linear and Pearson chi2 tests were calculated to examine associations. Proportions were compared using two-sided z tests. Five-year overall observed survival was evaluated using the Kaplan-Meier method and the log-rank test. Cox proportional hazards regression was used to estimate risk of mortality.Of 3,158 patients aged 1 to 19 years, 96.3% had cutaneous melanoma, 3.0% had ocular melanoma, and 0.7% had an unknown primary tumor. Cutaneous melanoma in patients aged 1 to 19 years was more common in girls (55.5%) and patients older than 10 years (90.5%). The demographics and presentation of cutaneous melanoma were age related; younger children were significantly more likely to be nonwhite and male and more likely to present with a head and neck primary tumors and with regional or distant metastases (linear chi2, P < .001 for sex, race, and extent of disease). Poorer survival was associated with higher stage and younger age. In contrast to patients aged 20 to 24 years, survival was not related to thickness in patients aged 1 to 19 years with localized invasive melanoma.Melanoma in children and teenagers differs from melanoma in young adults in demographics, presentation, and survival. Further investigation is warranted to elucidate possible biologic correlates of the unique aspects of melanoma in children and teenagers.
Clarithromycin Targets Neutrophilic Airway Inflammation in Refractory Asthma
Authors: Jodie L. Simpson, Heather Powell, Michael J. Boyle, Rodney J. Scott, Peter G. Gibson
Journal: American Journal of Respiratory and Critical Care Medicine (2007)

Patients with refractory asthma have persistent symptoms despite maximal treatment with inhaled corticosteroids and long-acting bronchodilators. The availability of add-on therapies is limited, and effective add-on therapies that target noneosinophilic airway inflammation are needed. Macrolide antibiotics, such as clarithromycin, have in vitro efficacy against IL-8 and neutrophils, key inflammatory mediators in noneosinophilic asthma.To determine the efficacy of clarithromycin in patients with severe refractory asthma and specifically in a subgroup of patients with noneosinophilic asthma.Subjects with severe refractory asthma (n = 45) were randomized to receive clarithromycin (500 mg twice daily) or placebo for 8 weeks.The primary outcome for this study was sputum IL-8 concentration. Other inflammatory outcomes assessed included sputum neutrophil numbers and concentrations of neutrophil elastase and matrix metalloproteinase (MMP)-9. Clinical outcomes were also assessed, including lung function, airway hyperresponsiveness to hypertonic saline, asthma control, quality of life, and symptoms. Clarithromycin therapy significantly reduced airway concentrations of IL-8 and neutrophil numbers and improved quality-of-life scores compared with placebo. Reductions in neutrophil elastase and MMP-9 concentrations were also observed. These reductions in inflammation were most marked in those with refractory noneosinophilic asthma.Clarithromycin therapy can modulate IL-8 levels and neutrophil accumulation and activation in the airways of patients with refractory asthma. Macrolide therapy may be an important additional therapy that could be used to reduce noneosinophilic airway inflammation, particularly neutrophilic inflammation, in asthma. Clinical trial registered with the Australian Clinical Trials Registry www.actr.org.au (No. 12605000318684).
Nephrotic Syndrome
Authors: Camille Macé, Sumant S. Chugh
Journal: Journal of the American Society of Nephrology (2014)

Nephrotic syndrome is recognized by the presence of proteinuria in excess of 3.5 g/24 h along with hypoalbuminemia, edema, hyperlipidemia (hypertriglyceridemia and hypercholesterolemia), and lipiduria. Each component has been investigated individually over the past four decades with some success. Studies published recently have started unraveling the molecular basis of proteinuria and its relationship with other components. We now have improved understanding of the threshold for nephrotic-range proteinuria and the pathogenesis of hypertriglyceridemia. These studies reveal that modifying sialylation of the soluble glycoprotein angiopoietin-like 4 or changing key amino acids in its sequence can be used successfully to treat proteinuria. Treatment strategies on the basis of fundamental relationships among different components of nephrotic syndrome use naturally occurring pathways and have great potential for future development into clinically relevant therapeutic agents.
Klf6 Is a Zinc Finger Protein Expressed in a Cell-Specific Manner during Kidney Development
Authors: EVELYNE A. FISCHER, MARIE-CHRISTINE VERPONT, LEE ANN GARRETT-SINHA, PIERRE M. RONCO, JEROME A. ROSSERT
Journal: Journal of the American Society of Nephrology (2001)

Abstract. Molecular mechanisms that are responsible for the development of the renal collecting duct system during embryogenesis are still poorly understood. A mouse cDNA encoding a zinc finger protein, called Klf6, which is a member of the Kru[Combining Diaeresis]ppel-like family of transcription factors, has been cloned. Northern blot analyses showed that Klf6 was already expressed in 11.5-d postconception mouse embryos and that its expression persisted after birth. They also disclosed that Klf6 had a restricted pattern of expression. In situ hybridization experiments using mouse embryos showed that during kidney development, Klf6 was expressed selectively in the Wolffian duct and in its derivatives. During mesonephros development, it was expressed in the Wolffian duct but not in the mesonephric mesenchyme. Thereafter, Klf6 was expressed in the ureteric bud and its branches and in the collecting ducts, whereas it was not expressed in tubular structures that derive from the metanephric mesenchyme. Glomeruli were not labeled during early stages of differentiation, and it is only at the capillary stage that a staining of the mesangial area was observed, which persisted after birth. This pattern of expression is strikingly similar to the one of GATA-3, which is another zinc finger protein. It suggests that Klf6 may play a role during kidney development and in particular during the development of the renal collecting duct system, possibly in association with GATA-3.
Autoimmune Disorders Associated with Gain of Function of the Intracellular Sensor MDA5
Authors: Masahide Funabiki, Hiroki Kato, Yoshiki Miyachi, Hideaki Toki, Hiromi Motegi, Maki Inoue, Osamu Minowa, Aiko Yoshida, Katashi Deguchi, Hiroshi Sato, Sadayoshi Ito, Toshihiko Shiroishi, Kunio Takeyasu, Tetsuo Noda, Takashi Fujita
Journal: Immunity (2014)

MDA5 is an essential intracellular sensor for several viruses, including picornaviruses, and elicits antiviral interferon (IFN) responses by recognizing viral dsRNAs. MDA5 has been implicated in autoimmunity. However, the mechanisms of how MDA5 contributes to autoimmunity remain unclear. Here we provide direct evidence that dysregulation of MDA5 caused autoimmune disorders. We established a mutant mouse line bearing MDA5 mutation by ENU mutagenesis, which spontaneously developed lupus-like autoimmune symptoms without viral infection. Inflammation was dependent on an adaptor molecule, MAVS indicating the importance of MDA5-signaling. In addition, intercrossing the mutant mice with type I IFN receptor-deficient mice ameliorated clinical manifestations. This MDA5 mutant could activate signaling in the absence of its ligand but was paradoxically defective for ligand- and virus-induced signaling, suggesting that the mutation induces a conformational change in MDA5. These findings provide insight into the association between disorders of the innate immune system and autoimmunity.
Macrophage microbicidal activity. Correlation between phagocytosis-associated oxidative metabolism and the killing of candida by macrophages
Authors: M Sasada, RB Johnston
Journal: The Journal of Experimental Medicine (1980)

The mechanisms by which macrophages kill ingested microorganisms were explored using Candida albicans and Candida parapsilosis. The results indicate that efficient macrophage candidacidal activity depends upon the generation of oxygen metabolites by the phagocytic cell: (a) peritoneal macrophages from mice infected with bacillus Calmette-Guerin (BCG) or injected intraperitoneally with lipopolysaccharide (LPS) released more superoxide anion (0(2)(-)) during phagocytosis of candida and killed candida better than did resident macrophages; (b) cells of the macrophage-like line J774.1, which released negligible amounts of O(2)(-), could ingest the candida normally but not kill them; (c) killing of candida by resident, LPS- elicited, and BCG-activated macrophages was inhibited by agents that scavenge O(2)(-), hydrogen peroxide (H(2)0(2)), hydroxyl radical (x OH), and singlet oxygen; and (d) all three macrophage types killed C. parapsilosis more effectively than C. albicans, and (7. parapsilosis stimulated a more prompt and vigorous burst of macrophage oxygen consumption and 0(2)(-) release than did C. albicans. Macrophages ingested C. parapsilosis slightly more quickly than C. albicans, but phagocytosis of both strains was equivalent by 60 min of incubation. Although C. albicans contained higher concentrations of the oxygen-metabolite scavengers superoxide dismutase and catalase, neither fungal species scavenged 0(2)(-) or H(2)0(2) effectively; and C. albicans was killed more easily than C. parapsilosis by a xanthine oxidase system that generates primarily H(2)O(2) at pH 7, or 0(2)(-) and x OH at pH 10. Thus, the decreased killing of C. albicans appears to result primarily from the capability of this species to elicit less vigorous stimulation of macrophage oxidative metabolism. This capability may have general relevance to the pathogenicity of microorganisms.
Metoprolol does not attenuate atherosclerosis in lipid-fed rabbits exposed to environmental tobacco smoke.
Authors: Y P Sun, B Q Zhu, R E Sievers, S A Glantz, W W Parmley
Journal: Circulation (1994)

BACKGROUND We previously demonstrated that exposure to environmental tobacco smoke (ETS) increases the development of atherosclerosis in lipid-fed rabbits. Clinical studies have suggested a protective effect of beta-blockers in smokers. Accordingly, we evaluated the effects of metoprolol in this animal model to see whether this beta-blocker would block the atherogenic effects of ETS. METHODS AND RESULTS Thirty-two New Zealand White male rabbits on a 0.3% cholesterol diet were randomly divided into four groups: ETS-metoprolol (ETS-M), ETS-control (ETS-C), and non-ETS with metoprolol (NETS-M) and without metoprolol (NETS-C). The two metoprolol-treated groups received metoprolol at a dose of 0.4 mg.kg-1.h-1 administered subcutaneously by an osmotic pump. Rabbits in the ETS groups were exposed to sidestream smoke from four Marlboro cigarettes per 15 minutes, 6 hours a day, for 10 weeks. Average air carbon monoxide (CO), nicotine, and total particulates (TP) in the exposure chambers were 67.2 +/- 3.1 (SEM) ppm, 1133.7 +/- 78.4 micrograms/m3, and 37.7 +/- 3.0 mg/m3, respectively. Plasma nicotine was significantly higher in ETS-exposed rabbits than in nonexposed rabbits (7.1 +/- 1.9 versus 0.5 +/- 0.1 ng/mL, P &lt; .01). Blood carbon monoxide hemoglobin (COHb) in the ETS-M group was significantly higher than that in the NETS-M group (4.0 +/- 0.2% versus 1.3 +/- 0.1%, P &lt; .0001). The lipid lesions in the aorta and pulmonary artery were 57.2 +/- 7.6% and 33.1 +/- 6.4% (ETS-M), 62.8 +/- 8.4% and 58.4 +/- 6.1% (ETS-C), 38.7 +/- 9.4% and 24.8 +/- 7.7% (NETS-M), and 49.8 +/- 8.7% and 32.7 +/- 7.1% (NETS-C). There were significant differences in lipid deposits of the arteries between the controls and the ETS-exposed rabbits (37 +/- 1% versus 53 +/- 1%, P = .004) and between the controls and metoprolol-treated rabbits (51 +/- 1% versus 38 +/- 1%, P = .027). The benefit of metoprolol was independent of ETS exposure (ETS x metoprolol interaction, P = .595). CONCLUSIONS Exposure to ETS significantly accelerated and metoprolol decreased the development of atherosclerosis in lipid-fed rabbits, but there was no interaction between the effects of ETS exposure and metoprolol. Metoprolol did not protect against the effects of ETS on atherosclerosis, suggesting that the beta-adrenergic system is not the mechanism of ETS-induced atherosclerosis.
DEFECTS IN CONTINUOUS AMBULATORY PERITONEAL DIALYSIS EQUIPMENT
Authors: G. Seyffart, A. Colombi, R. Gokal, J. Manos, N.P. Mallick, D.C. Schohn, H.A. Jahn, Marie-Josée Kopp, W.K. Stewart, LauraW. Fleming, M.G. Bamber
Journal: The Lancet (1982)
Effect of telomere length on survival in patients with idiopathic pulmonary fibrosis: an observational cohort study with independent validation
Authors: Bridget D Stuart, Joyce S Lee, Julia Kozlitina, Imre Noth, Megan S Devine, Craig S Glazer, Fernando Torres, Vaidehi Kaza, Carlos E Girod, Kirk D Jones, Brett M Elicker, Shwu-Fan Ma, Rekha Vij, Harold R Collard, Paul J Wolters, Christine Kim Garcia
Journal: The Lancet Respiratory Medicine (2014)
Syncope Evaluation in the Emergency Department Study (SEEDS)
Authors: Win K. Shen, Wyatt W. Decker, Peter A. Smars, Deepi G. Goyal, Ann E. Walker, David O. Hodge, Jane M. Trusty, Karen M. Brekke, Arshad Jahangir, Peter A. Brady, Thomas M. Munger, Bernard J. Gersh, Stephen C. Hammill, Robert L. Frye
Journal: Circulation (2004)

Background— The primary aim and central hypothesis of the study are that a designated syncope unit in the emergency department improves diagnostic yield and reduces hospital admission for patients with syncope who are at intermediate risk for an adverse cardiovascular outcome. Methods and Results— In this prospective, randomized, single-center study, patients were randomly allocated to 2 treatment arms: syncope unit evaluation and standard care. The 2 groups were compared with χ 2 test for independence of categorical variables. Wilcoxon rank sum test was used for continuous variables. Survival was estimated with the Kaplan-Meier method. One hundred three consecutive patients (53 women; mean age 64±17 years) entered the study. Fifty-one patients were randomized to the syncope unit. For the syncope unit and standard care patients, the presumptive diagnosis was established in 34 (67%) and 5 (10%) patients ( P &lt;0.001), respectively, hospital admission was required for 22 (43%) and 51 (98%) patients ( P &lt;0.001), and total patient-hospital days were reduced from 140 to 64. Actuarial survival was 97% and 90% ( P =0.30), and survival free from recurrent syncope was 88% and 89% ( P =0.72) at 2 years for the syncope unit and standard care groups, respectively. Conclusions— The novel syncope unit designed for this study significantly improved diagnostic yield in the emergency department and reduced hospital admission and total length of hospital stay without affecting recurrent syncope and all-cause mortality among intermediate-risk patients. Observations from the present study provide benchmark data for improving patient care and effectively utilizing healthcare resources.
Silencing of TESTIN by dense biallelic promoter methylation is the most common molecular event in childhood acute lymphoblastic leukaemia
Authors: Robert J Weeks, Ursula R Kees, Sarah Song, Ian M Morison
Journal: Molecular Cancer (2010)

Aberrant promoter DNA methylation has been reported in childhood acute lymphoblastic leukaemia (ALL) and has the potential to contribute to its onset and outcome. However, few reports demonstrate consistent, prevalent and dense promoter methylation, associated with tumour-specific gene silencing. By screening candidate genes, we have detected frequent and dense methylation of the TESTIN (TES) promoter. Bisulfite sequencing showed that 100% of the ALL samples (n = 20) were methylated at the TES promoter, whereas the matched remission (n = 5), normal bone marrow (n = 6) and normal PBL (n = 5) samples were unmethylated. Expression of TES in hyperdiploid, TEL-AML+, BCR-ABL+, and E2A-PBX+ subtypes of B lineage ALL was markedly reduced compared to that in normal bone marrow progenitor cells and in B cells. In addition TES methylation and silencing was demonstrated in nine out of ten independent B ALL propagated as xenografts in NOD/SCID mice. In total, 93% of B ALL samples (93 of 100) demonstrated methylation with silencing or reduced expression of the TES gene. Thus, TES is the most frequently methylated and silenced gene yet reported in ALL. TES, a LIM domain-containing tumour suppressor gene and component of the focal adhesion complex, is involved in adhesion, motility, cell-to-cell interactions and cell signalling. Our data implicate TES methylation in ALL and provide additional evidence for the involvement of LIM domain proteins in leukaemogenesis.
Adipose tissue in obesity and obstructive sleep apnoea
Authors: M.R. Bonsignore, W.T. McNicholas, J.M. Montserrat, J. Eckel
Journal: European Respiratory Journal (2011)

A European Respiratory Society research seminar on “Metabolic alterations in obstructive sleep apnoea (OSA)” was jointly organised in October 2009 together with two EU COST actions (Cardiovascular risk in the obstructive sleep apnoea syndrome, action B26, and Adipose tissue and the metabolic syndrome, action BM0602) in order to discuss the interactions between obesity and OSA. Such interactions can be particularly significant in the pathogenesis of metabolic abnormalities and in increased cardiovascular risk in OSA patients. However, studying the respective role of OSA and obesity is difficult in patients, making it necessary to refer to animal models or in vitro systems. Since most OSA patients are obese, their management requires a multidisciplinary approach. This review summarises some aspects of the pathophysiology and treatment of obesity, and the possible effects of sleep loss on metabolism. OSA-associated metabolic dysfunction (insulin resistance, liver dysfunction and atherogenic dyslipidaemia) is discussed from the perspective of both obesity and OSA in adults and children. Finally, the effects of treatment for obesity or OSA, or both, on cardio-metabolic variables are summarised. Further interdisciplinary research is needed in order to develop new comprehensive treatment approaches aimed at reducing sleep disordered breathing, obesity and cardiovascular risk.
Prognostic factors influencing clinical outcome of allogeneic hematopoietic stem cell transplantation following imatinib-based therapy in BCR–ABL-positive ALL
Authors: S Mizuta, K Matsuo, T Maeda, T Yujiri, Y Hatta, Y Kimura, Y Ueda, H Kanamori, N Usui, H Akiyama, S Takada, A Yokota, Y Takatsuka, S Tamaki, K Imai, Y Moriuchi, Y Miyazaki, S Ohtake, K Ohnishi, T Naoe
Journal: Blood Cancer Journal (2012)

We investigated prognostic factors for the clinical outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) following imatinib-based therapy. Among 100 adult patients who were prospectively enrolled in the JALSG Ph+ALL202 study, 97 patients obtained complete remission (CR) by imatinib-combined chemotherapy, among whom 60 underwent allo-HSCT in their first CR. The probabilities of overall survival (OS) and disease-free survival (DFS) at 3 years after HSCT were 64% (95% CI, 49-76) and 58% (95% CI, 43-70), respectively. Prognostic factor analysis revealed that the major BCR-ABL transcript was the only unfavorable predictor for OS and DFS after HSCT by both univariate (HR, 3.67 (95% CI 1.49-9.08); P=0.005 and HR, 6.25 (95% CI, 1.88-20.8); P=0.003, respectively) and multivariate analyses (HR, 3.20 (95% CI, 1.21-8.50); P=0.019 and HR, 6.92 (95% CI, 2.09-22.9); P=0.002, respectively). Minimal residual disease status at the time of HSCT had a significant influence on relapse rate (P=0.015). Further study of the BCR-ABL subtype for the clinical impact on outcome of allo-HSCT in Ph+ALL is warranted.
Randomized Controlled Trial of Combined 5-Fluorouracil and Low-Molecular-Weight Heparin in the Management of Unselected Rhegmatogenous Retinal Detachments Undergoing Primary Vitrectomy
Authors: L. Wickham, C. Bunce, D. Wong, D. McGurn, D.G. Charteris
Journal: Ophthalmology (2007)
Combined Use of Clinical and Pathologic Staging Variables to Define Outcomes for Breast Cancer Patients Treated With Neoadjuvant Therapy
Authors: Jacqueline S. Jeruss, Elizabeth A. Mittendorf, Susan L. Tucker, Ana M. Gonzalez-Angulo, Thomas A. Buchholz, Aysegul A. Sahin, Janice N. Cormier, Aman U. Buzdar, Gabriel N. Hortobagyi, Kelly K. Hunt
Journal: Journal of Clinical Oncology (2007)

Neoadjuvant chemotherapy is being used with increasing frequency for operable breast cancer. We hypothesized that by using clinical and pathologic staging parameters, in conjunction with biologic tumor markers, a novel means of determining prognosis for patients treated with neoadjuvant chemotherapy could be facilitated.A prospective database of patients treated with neoadjuvant chemotherapy from 1997 to 2003 was reviewed, and 932 patients meeting inclusion criteria were identified. Clinical and pathologic tumor characteristics, treatment regimens, and patient outcomes were recorded. Cox proportional hazards models were used to create two prognostic scoring systems. American Joint Committee on Cancer (AJCC) clinical and pathologic staging parameters and biologic tumor markers were investigated to devise the scoring systems.Median follow-up time was 5 years (range, 0.4 to 9.4 years). Five-year disease-specific survival rate was 96% for patients who experienced a pathologic complete response (pCR; n = 130) compared with 87% for patients who did not have a pCR (n = 802; P = .001). Two scoring systems, based on summing binary indicators for clinical substages >/= IIB and >/= IIIB, pathologic substages >/= ypIIA and >/= ypIIIC, negative estrogen receptor status, and grade 3 pathology, were devised to predict 5-year patient outcomes. These scoring systems facilitated separation of the study population into more refined subgroups by outcome than the current AJCC staging system.The scoring systems derived in this work provide a novel means for evaluating prognosis after neoadjuvant therapy. Future work will focus on prospective validation of these scoring systems and refinement of the scoring systems through addition of new biologic markers.
Experts call for larger PCTs and clinician led bodies to boost commissioning
Authors: A. O'Dowd
Journal: BMJ (2010)

Commissioning in the NHS will start to work effectively only if radical changes are made that put clinicians far more in control of the process, say two new reports from health policy experts.

Clinician led “integrated care organisations” and more powerful primary care trusts are needed to boost commissioning in the NHS, claim the two reports published on 30 March by the health policy think tanks the Nuffield Trust and the King’s Fund.

Growing demand for care and a prolonged period of constrained budgets for the NHS mean that the way care is commissioned, organised, and delivered needs to change drastically, say the reports.

The first report, Where Next for Commissioning …