tbuckley/cabot-search huggingface dataset:
Abstract P378: Association Between Height-to-Waist Ratio and Cardiovascular Disease Risk Factors in US Adolescents
Authors: Chong-Do Lee
Journal: Circulation (2012)

Background: Although height-to-waist (HtW) ratio is strongly linked to cardiovascular disease (CVD) mortality in adults, the association between HtW and CVD risk factors in children and adolescents remain less unexplored. The purpose of this study was to examine the association between HtW and CVD risk factors in US adolescents (N = 9493), aged 12 to 17 years, from the NHANES (1999-2006). Methods: Waist circumference, body weight, height were assessed with standardized protocols for body composition measurement. High blood pressure (BP) was defined as a value at or above the 90 th percentile for age, sex, and height. Elevated fasting glucose level was defined using the American Diabetes Association guideline of 110 mg/dL or higher. Elevated total cholesterol (TC) level was classified as TC greater than 200 mg/dL. The CVD risk (yes/no) was defined as one or more of these 3 conditions (high BP, elevated glucose, high cholesterol levels). Multivariable logistic regression was used to investigate the association between HtW and CVD risk after adjustment for age, sex, race, physical activity, and dietary habits. We also used the area under a receiver operating characteristic (ROC curve) and a nadir point [(shortest distance from the ROC curve to the perfection (sensitivity = 100% and specificity = 100%)] to define the lowest CVD risk for HtW in boys and girls, respectively. Results: HtW was a strong risk factor for CVD risk in both boys and girls (All P&lt;0.001). There was a strong inverse association between HtW and CVD risk in both boys and girls (All P&lt;0.001), respectively. Minima on the receiver operating characteristics curves for CVD risk in boys and girls were 2.17 and 2.03, respectively. The HtW cutoff points of 2.17 (sensitivity = 67%; specificity = 59%; minimum ROC distance = 0.51) and 2.03 (sensitivity = 64%; specificity = 55%; minimum ROC distance = 0.57) in boys and girls were associated with the lowest CVD risk, respectively. Conclusions: Height-to-waist ratio was strong risk factor for CVD in boys and girls.
Whole lung lavage with PAP in a 12 year old female using ET tube under GA
Authors: Mohankumar Thekkinkattil, Menon A.R. Narendra
Journal: European Respiratory Journal (2012)

Alveolar proteinosis is a rare disease in children as the rare cause of severe respiratory failure. In 2002 report at least 410 cases were reported world-wide. The estimated annual incidence is 0.36 and the prevalence 3.76 cases/million population. In neonates the mortality is 100% Lung transplantation improves survival. In adults, PAP is mainly seen in males at the age of 40-55. In female children PAP is rare. PAP is characterized by intra-alveolar accumulation of proteinaceous material. It is not associated with inflammation and lung architecture is preserved.  Case study: A 12 year girl was admitted with breathlessness, cough, with two weeks duration. She was referred from a private hospital in Salem with X-ray and CT features of? Alveolar Proteinosis. O/E patient restless,Sao2 83%, tachypneic and tachycardia present. CT scan repeated showed features of alveolar proteinosis. After stabilizing her with o2, bronchodilators and antibiotics she was taken up for whole lung lavage on the right side. Since the double lumen catheter of 26 size could not permit insertion of bronchoscope, through 6.5 ET tube under general anaesthesia Right lung was lavaged with about 1700 ml of normal saline. The child tolerated the procedure well. She was kept in the ventilator for one day and extubated. The saturation went up to 90%. The left lung was washed after one week. The saturation and clinical signs and symptoms improved. She is again admitted on 22/12/2011 for the next lavage session.  The treatment for alveolar proteinosis is whole lung lavage in adults. We report the case in a young girl (rarely reported)treated with whole lung lavage using ET tube (rarely tried).
Randomized phase III trial of thalidomide (Th) or placebo (P) for non-metastatic PSA recurrent prostate cancer (PCa) treated with intermittent therapy
Authors: W. D. Figg, J. B. Aragon-Ching, S. M. Steinberg, J. L. Gulley, P. M. Arlen, O. Sartor, D. P. Petrylak, C. S. Higano, M. H. Hussain, W. L. Dahut
Journal: Journal of Clinical Oncology (2008)

5016 Background: Th has modest activity in pts with metastatic PCa (CCR 2001; 7:1888 and JCO 2004; 22:2532). LHRH agonist (LHRH-A) therapy is used in PCa pts with PSA recurrence. This trial was undertaken to determine if Th improves progression-free survival (PFS) after limited androgen deprivation therapy in pts with biochemical recurrence. Methods: This was a randomized, double-blind, placebo-controlled, cross-over study in pts with biochemical recurrence after local definitive therapy. Pts were randomized to oral Th or P in blinded fashion following 24 weeks of LHRH-A [designated oral phase A (OPA)]. Baseline and monthly PSA and testosterone (T) were obtained while on Th or P, until rise to baseline PSA or rise of PSA to ≥ 5 ng/mL, whichever occurred first. LHRH-A was then re-initiated after a second 24 weeks of LHRH-A, oral treatment then commenced with the opposite agent (Th to P or P to Th), until PSA progression, designated as [oral phase B (OPB)]. Secondary endpoints included characterization of pharmacokinetics, toxicity and drug effect on T. Results: 159 pts accrued from March 2000 to January 2005; 79 randomized to Th and 80 to P in OPA, of whom 73 and 74 respectively received study drug. Pt characteristics included a median (range) age of 68 (49–87), median Gleason score of 7, median (range) on-study PSA of 5.1 ng/mL (0.9 - 311.8). 46 and 62 pts progressed on Th and P, respectively during OPA. Median PFS during OPA was 15 months (mos) for Th arm compared to 9.6 mos for P arm (P=0.21). 103 pts proceeded to OPB, of whom 51 pts received Th and 38 pts received P. Median PFS during OPB for the Th arm was 17.1 mos versus 6.6 mos for the P arm (P=0.0002). Grade 3 or 4 events occurred in ≤5% of pts on Th. Most common grade 2 toxicites: constipation, fatigue, neurologic (e.g., dizziness, change in consciousness, neuropathy), and dyspnea. T normalization was similar in Th and P arms. Conclusions: Th was associated with improvement in PSA-based PFS after intermittent LHRH-A that was independent of effects on T. Th appears promising in this clinical state. Larger studies are warranted to determine the clinical utility of this approach. No significant financial relationships to disclose.
Comparison of community-onset Staphylococcus argenteus and Staphylococcus aureus sepsis in Thailand: a prospective multicentre observational study
Authors: N. Chantratita, C. Wikraiphat, S. Tandhavanant, G. Wongsuvan, P. Ariyaprasert, P. Suntornsut, J. Thaipadungpanit, N. Teerawattanasook, Y. Jutrakul, N. Srisurat, P. Chaimanee, J. Anukunananchai, S. Phiphitaporn, P. Srisamang, P. Chetchotisakd, T.E. West, S.J. Peacock
Journal: Clinical Microbiology and Infection (2016)

Staphylococcus argenteus is a globally distributed cause of human infection, but diagnostic laboratories misidentify this as Staphylococcus aureus. We determined whether there is clinical utility in distinguishing between the two. A prospective cohort study of community-onset invasive staphylococcal sepsis was conducted in adults at four hospitals in northeast Thailand between 2010 and 2013. Of 311 patients analysed, 58 (19%) were infected with S. argenteus and 253 (81%) with S. aureus. Most S. argenteus (54/58) were multilocus sequence type 2250. Infection with S. argenteus was more common in males, but rates of bacteraemia and drainage procedures were similar in the two groups. S. argenteus precipitated significantly less respiratory failure than S. aureus (5.2% versus 20.2%, adjusted OR 0.21, 95% CI 0.06-0.74, p 0.015), with a similar but non-significant trend for shock (6.9% versus 12.3%, adjusted OR 0.46, 95% CI 0.15-1.44, p 0.18). This did not translate into a difference in death at 28 days (6.9% versus 8.7%, adjusted OR 0.80, 95% CI 0.24-2.65, p 0.72). S. argenteus was more susceptible to antimicrobial drugs compared with S. aureus, and contained fewer toxin genes although pvl was detected in 16% (9/58). We conclude that clinical differences exist in association with sepsis due to S. argenteus versus S. aureus.
Dyspepsia: Current Understanding and Management
Authors: L. Agréus, N. J. Talley
Journal: Annual Review of Medicine (1998)

Dyspepsia, defined as “pain or discomfort centered in the upper abdomen” is reported by one in four adults in Western societies. The most important causes are non-ulcer (functional) dyspepsia, peptic ulcer, gastroesophageal reflux, and, rarely, gastric cancer. Persons with heartburn alone are not considered to have dyspepsia. The division of dyspepsia into symptom-based subgroups (ulcer-like, dysmotility-like, reflux-like, and unnspecified dyspepsia) has proven to be of doubtful value for the clinician, as it has a low predictive value for identifying the causes of dyspepsia. Upper endoscopy remains the “gold standard” test; ultrasound and blood tests have a low yield. The role of Helicobacter pylori in peptic ulcer disease is well known, but the clinical role of the infection in non-ulcer dyspepsia remains very controversial. In uninvestigated dyspeptic patients who are H. pylori infected based on a non-invasive test, empiric anti–H. pylori therapy is a reasonable and probably cost-effective option. In documented non-ulcer dyspepsia, prokinetics are superior to placebo while antisecretory therapy is of less certain efficacy.
Diversity of Melanoma Plasma Membrane Proteinases: Inhibition of Collagenolytic and Cytolytic Activities by Minocycline&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: S Zucker, R M Lysik, N S Ramamurthy, L M Golub, J M Wieman, D P Wilkie
Journal: JNCI Journal of the National Cancer Institute (1985)

The tissue-destructive proteinases of B16-BL6 melanoma cells from C57BL/6 mice and subcellular fractions were examined. Cancer cell organelles were isolated following nitrogen cavitation with the use of sucrose density gradient centrifugation. Serine, cysteine, and metalloproteinases were assayed with the use of radiolabeled proteins and synthetic substrates. Tumor-induced red blood cell lysis was quantitated by measurement of the release of isotope from 59Fe-labeled red blood cells (RBC) cocultivated with melanoma cells; the RBC were from Wistar rats. Enzyme inhibitors with specificity toward different classes of proteinases were used in the above assays to categorize the enzymes responsible for substrate degradation. Results indicated that intact melanoma cells, cell organelles, and cytosol contain proteinases that can degrade collagen and gelatin and lyse normal RBC. Melanoma plasma membranes are highly enriched in collagenase, gelatinase, cysteine proteinase, plasminogen activator, and cytolytic activity. The inhibition of tumor collagenolytic, gelatinolytic, and cytolytic activities by EDTA and 1,10-phenanthroline but not by diisopropyl fluorophosphate and Nα-p-tosyl-L-lysine chloromethyl ketone indicates that metalloproteinases are the active enzymes in these assays. Minocycline, a synthetic tetracycline with demonstrable inhibitory activity with other mammalian collagenases, also inhibited melanoma collagenolytic and cytolytic activities.
Imatinib mesylate is effective in the treatment of polycythemia vera: A multi-institutional clinical trial
Authors: E. J. Feldman, J. L. Spivak, S. Lee, M. Rivera, S. M. Fruchtman, A. Salvado, R. T. Silver
Journal: Journal of Clinical Oncology (2006)

6532 Background: We previously reported that the erythrocytosis of polycythemia vera (PV) was controlled with imatinib mesylate in a cohort of patients. This effect may involve inhibition of tyrosine phosphorylation of c-Kit, the stem cell factor receptor essential for erythroid progenitor cell proliferation. Methods: We report treating an expanded cohort of 37 PV patients with imatinib in a multi-institutional phase II trial. All patients had an increased 51 Cr RBC mass determination at diagnosis and fulfilled the stipulated criteria for the diagnosis of PV. Men were initially phlebotomized to a hematocrit (HCT) ≤ 45%; women to HCT ≤ 42%. Imatinib was started at 400 mg qd escalating 100 mg every 2 weeks to a maximum of 800 mg for persistent phlebotomy (PHL) requirements or for platelet counts &gt; 600 × 10 9 /L. All patients received 81 mg of aspirin qd. Results: There were 21 men, 16 women, median age 51 years, range 29–83. Prior to imatinib, mean disease duration was 60.2 mos; average number of PHLs per year ranged from 0–23 (mean=9). After 1 year of imatinib, PHLs ranged from 0 to 9 (mean=2). There were 9 complete remissions (PHL-free, platelets ≤ 600 × 10 9 /L, no splenomegaly) and 10 partial remissions (PHL and/or splenomegaly decreased by 50% of initial values with platelets ≤ 600 × 10 9 /L, or platelets &gt; 600 × 10 9 /L but no PHL requirements or splenomegaly); 1 patient, protocol violation. Thus, of 36 evaluable patients, 19 (53%) responded. Of the remaining 17, 10 failed due to disease progression: myelofibrosis (n=2); platelets &gt; 1,000 × 10 9 /L with PHL and/or splenomegaly (n=2); repeated PHLs (n=1); cytogenetic abnormalities (n=1); increasing thrombocytosis (n=1); and a TIA (n=1). Seven of 17 with no remission developed toxicity: grade 3 dermatologic (n=2); grade 3 diarrhea (n=2); grade 3 bone pain (n=1), liver (n=1); heart failure (n=1). Median treatment duration: 17.2 months. Conclusions: We conclude that imatinib is useful for treating erythrocytosis and controlling splenomegaly in a significant proportion of PV patients, but is less effective for controlling thrombocytosis or splenomegaly in others. These data suggest heterogeneity of hematopoietic stem cell proliferation in PV or patient variability with respect to imatinib metabolism. [Table: see text]
Effect of the degree of nodularity on the survival of patients with nodular lymphomas.
Authors: E Z Ezdinli, W G Costello, O Kucuk, C W Berard
Journal: Journal of Clinical Oncology (1987)

The survival of patients with favorable lymphoma entered on various Eastern Cooperative Oncology Group (ECOG) studies was analyzed according to the degree of nodularity. A pure nodular pattern (NN), defined as nodularity involving 75% or more of the cross-sectional area, was found to be an important favorable prognostic indicator as compared with a nodular-diffuse pattern (ND). The median survival in 336 patients with NN of 68.2 months was significantly better than the 39.6 months in 87 patients with ND (P less than .003). The median survival in NN-lymphocytic poorly differentiated (LPD) was 77.2 months v 44.3 months for ND-LPD. NN-M median survival of 56.4 months contrasted with only 25.5 months for ND-mixed lymphocytic and histiocytic (M). The degree of nodularity as defined in this study appears to have significant prognostic implication and should be more widely used by pathologists.
A Galician Lung Cancer Group phase II study of bevacizumab (B), cisplatin, and vinorelbine in chemotherapy-naive patients (p) with non-squamous non-small cell lung cancer (NSCLC).
Authors: L. Leon, S. Vazquez, J. Gracia, J. Casal, M. Lázaro, J. L. Fírvida, M. Amenedo, L. Santomé, J. V. Cardona, S. Maciá
Journal: Journal of Clinical Oncology (2010)

e18052 Background: Bevacizumab, an anti-VEGF monoclonal antibody, improves response rates and prolongs survival in p with non squamous NSCLC when combined with carboplatin-paclitaxel and PFS when combined with cisplatin-gemcitabine. This single-arm, open-labeled phase II trial aims to evaluate the efficacy and safety profile of B in combination with another widely used chemotherapy doublet for NSCLC: cisplatin and vinorelbine. Methods: Chemotherapy-naïve p diagnosed with stage IIIB or IV non-squamous NSCLC received cisplatin (80 mg/m2), vinorelbine (25 mg/m2 IV days 1 and 8) and B (15 mg/kg IV) on day 1 every 3 weeks for up to 6 cycles followed by B 15 mg/kg alone every 3 weeks until disease progression. Main eligibility criteria were: PS 0-1, no brain metastases, no history of hemoptysis, stable cardiac condition and no full dose anticoagulation Primary endpoint was progression-free survival and secondary endpoints were RR, duration of response, OS, 1-year survival and safety profile of the combination. Results: From September 07 to May 09 a total of 50 p have been enrolled in the study and data of 49 p have been included in this analysis. P characteristics were: male 73.5%; median age 59 years (range 36-75); ECOG PS 0/1 (%) 33.3/66.7; adenocarcinoma/other (%) 78.1/21.9; stage IIIB/IV (%) 19.1/80.9. Median number of cycles for B/cisplatin/vinorelbine was 6.0 (range 1-6) and median number of cycles for B maintenance was 4 (range 1-9). 45 p were evaluable for response according to RECIST criteria: PR 28.9% and SD 44.4%. With a median follow-up of 8.8 months (range 0.9-22.3), median PFS was 6 months (95% CI: 4.5-7.5) and median OS 14.7 months (95% CI: 8.4-21.0). Most frequent grade ≥ 3 toxicities were: leucopenia 6.1%, neutropenia 28.6%, high blood pressure 8.2%, vomiting 10.2%, febrile neutropenia 14.3% and asthenia 6.1%. Of interest, 10 p presented grade < 3 epistaxis, 3 p grade 1 and 1 p grade 4 hemoptysis and 9 p grade < 3 proteinuria. Conclusions: This analysis shows that B in combination with cisplatin and vinorelbine followed by B until disease progression is safe and well tolerated and has a promising activity in chemonaïve p with non-squamous NSCLC. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Roche
Fish Consumption, Brain Mercury, and Neuropathology in Patients With Alzheimer Disease and Dementia
Authors: Edeltraut Kröger, Robert Laforce
Journal: JAMA (2016)

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Feasibility and economic viability of home-based supportive care
Authors: C. A. Cerny, A. Mutti, D. M. Ferreira, D. P. Jardini, K. Z. Cecyn, E. Suzuki, P. C. Ceschim
Journal: Journal of Clinical Oncology (2009)

e20741 Background: Oncological treatment is becoming more complex and more costly. When their symptoms worsen, many patients seek an Emergency Room and arrive without a good performance-status. This causes insecurity to the attending physician, and it also represents a huge chance that this patient would receive an avoidable admission. With the appropriate home-support it is possible to attend the majority of patient's demands, offering a good quality clinical support.Home administration of some drugs is more comfortable and helps to eliminate some taxes that are commonly charged by private clinics. Methods: We performed an analysis of a private healthcare company's database.To avoid seasonality and high impact on costs of terminally ill patients occurring at an analyzed month, we selected a six months interval, from January to June 2008. Results: About 500 patients are active each month at the home-care program. They received from simple monitoring to 24 hour home nursing support. Hematological malignancies, as expected, require more resources.Home based supportive care could prevent the majority of avoidable hospital admissions. Conclusions: Home based supportive care can meet the basic needs of clinical support during chemotherapy and the demands of comfort at the end of life, in order to reduce avoidable hospital admissions. This contributes to reducing the cost of treatment. [Table: see text]
Science Selections August 2003
Authors: JR Barrett
Journal: Environmental Health Perspectives (2003)

Diagnosing Effects Decades LaterTwo decades after contaminated cooking oil caused widespread sickness in Spain, patients with so-called toxic oil syndrome (TOS) continue to report neurologic symptoms.Accurately assessing these symptoms-which include headache, insomnia, and muscle weakness-has been challenging, because the symptoms are numerous and tend to be vague.Standard clinical examinations have detected few or no problems, and patients have sometimes been accused of exaggerating or malingering.This month, a team led by Manuel Posada de la Paz of the Instituto de Salud Carlos III in Madrid provides the first quantitative evidence that TOS patients do indeed experience neurologic abnormalities [EHP 111:1326-1334].In May 1981, Spanish health officials were puzzled and alarmed by the emergence of a severe, possibly novel respiratory illness.The outbreak, which occurred in Madrid and the northwestern Spanish provinces, affected 10,000 people and claimed at least 80 lives in the first month.Initial symptoms included fluid in the lungs, shortness of breath, fever, headache, rash, muscle pain, and a proliferation of eosinophils (a type of white blood cell).An infectious agent seemed implicated, but by mid-June epidemiologic studies revealed the cause to be cooking oil derived from aniline-denatured rapeseed oil.This oil had been produced for industrial uses but was illegally refined to remove the aniline and sold as pure olive oil.The Spanish government acted quickly to remove all suspect oil from the market, but TOS eventually affected at least 20,000 people and caused more than 300 deaths.Even after the cause was identified, the crisis continued.TOS comprises three phases: the early acute phase, an intermediate phase involving neurologic complaints and intense muscle pain, and, for
Unusual causes of peritonitis in patients undergoing continuous peritoneal dialysis with emphasis on Listeria monocytogenes.
Authors: N M Lunde, J M Messana, R D Swartz
Journal: Journal of the American Society of Nephrology (1992)

Peritonitis remains a significant cause of morbidity in ESRD patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Staphylococcus species, Streptococcus species, and less commonly, gram-negative rods comprise the majority of isolated organisms. Other organisms, including unusual bacteria, fungi, and mycobacteria, comprise 5% or less of cases. Many of the uncommon causes of CAPD peritonitis have been reviewed, with special emphasis on antimicrobial therapy and whether catheter removal was required. The presumed third case of CAPD-associated peritonitis caused by Listeria monocytogenes is also described. In contrast to two other reported cases, our patient was not overtly immunosuppressed. L. monocytogenes infection should therefore be considered in CAPD patients with gram-positive rod peritonitis, even if immunocompetence is presumed.