tbuckley/cabot-search huggingface dataset:
Abstract 17184: Is Acute Myopericarditis a Bening Pericarditic Syndrome?
Authors: Rosa MJiménez, Jose MSerrano, CarmenCristÓbal, Pedro LTalavera, AlejandroCurcio, CatherineGraupner, JoaquÍn JAlonso
Journal: Circulation (2012)

Acute pericarditis is a clinical syndrome of benign course. Cardiac troponin I has been considered a marker of poor prognostic in this setting. However, data regarding prognostic value of troponin I are lacking.The purpose of this study was to evaluate prognostic value of troponin I in acute myopericarditis (AM). Methods: From July 2004 to December 2011 were included 103 consecutive patients (pts) with AM. Clinical data, ECG and echocardiographic parameters as well as development of complications during hospitalization [arrhythmias, left ventricular dysfunction (LVD), acute heart failure (AHF), pericardial effusions and mortality] were collected. Results: Mean age was 33±14 years, 84% were males. Mean follow-up was 72±14 months. Thirty three pts (32%) developed complications: Eighteen pts(17%) developed LVD, 4 pts (3.8%) AHF, 12 pts(11.6%) presented mild pericardial effusions and 17(16.5%) had arrhythmias. Levels of myocardial damage markers and inflammatory parameters were associated with the development...
A phase I study of adoptive immunotherapy in melanoma using allogeneic cytotoxic T-lymphocytes transfected with a MART-1 receptor-encoding gene
Authors: L. Duval, H. Schmidt, J. J. Jensen, S. M. Soerensen, H. Von der Maase
Journal: Journal of Clinical Oncology (2004)

2587 Background: Cytotoxic T lymphocytes and their recognition of tumor cells play key roles in the immunotherapeutic response against metastatic malignant melanoma (MMM). However, previous treatment approaches using T cells have been limited by lack of specificity as well as the amount of available T cells. We report here the first clinical experience with an allogeneic T cell-line, C CURE 709, a cytotoxic T lymphocyte transfected with a T cell receptor-encoding gene, which recognizes the melanoma associated antigen MART-1 together with the HLA-A2 complex. Methods: Toxicity and efficacy of C CURE 709 administered intra-tumorally in patients with MMM was investigated in a Phase I study. 3–6 patients per dose level were treated at one of 4 levels. Criteria of eligibility were HLA-A2 tissue type, expression of MART-1 antigen, no cerebral metastases, ECOG Performance status 0–2 and accessible sites of disease. The National ethical committee and health authorities approved the study, and a written consent was obtained from all patients. Injections were given ultrasonically guided at days 1,4,7,10,14 and 28. Evaluation was performed at day 38. In the absence of progressive disease a total of 3 cycles could be administered.Results: 13 patients, AJCC IV, received 19 treatment cycles. None of the patients achieved an overall systemic response. Three patients obtained a local response in injected lesions. Toxicity was minor to moderate and most commonly fever, reaction at site of injection, nausea, and fatigue. Side effects remised in general within 24 hours. Toxicity was apparently not dose dependent.Conclusions: This new immunotherapeutic approach is feasible and safe in the treatment of patients with MMM. Local responses and tolerability of treatment hold promise for further investigation in a Phase II study. No significant financial relationships to disclose.
Hemodialysis in a Healthy Patient—A Case of an Erroneous Laboratory Result
Authors: Megan E. Himmel, Kenneth Lam, Michael Fralick
Journal: JAMA Internal Medicine (2016)

This case of a 49-year-old woman who was admitted for presumed methanol poisoning highlights the importance of ordering appropriate investigations and considering an unexpected laboratory value in the context of the patient’s clinical signs and symptoms.
Randomized controlled trial of gemcitabine in combination with UFT versus gemcitabine alone in patients with advanced pancreatic cancer
Authors: S. Ohkawa
Journal: Journal of Clinical Oncology (2004)

4131 Background: GEM is a standard drug for chemotherapy in patients with APC. But they should be offered better therapy aimed more effective response and prolonging survival. UFT is also available for treatment of APC. In order to evaluate the efficacy of GEM in combination with UFT, we performed following study. Methods: Eligibility: no pretreatment (chemotherapy and irradiation), good performance status (50–100 in Karnofsky Performance Status) and less than 75 years old in APC patients such as locally advanced or with distant metastasis. The study is randomized trial comparing two arms, arm A in which patients are treated by GEM plus UFT (day 1, 8, 15: gemcitabine 1000 mg/m2, d.i.v./30min; everyday: UFT 300 mg/day, oral; every 4 weeks as 1 course), arm B in which patients are treated by GEM alone (day 1, 8, 15: gemcitabine 1000 mg/m2, div/30min; every 4 weeks as 1 course). Primary endpoints are response rate (RR) and survival time (MST). Time to progression (TTP) and Clinical benefit response (CBR) were also evaluated. Results: During July in 2001 to March in 2003, 19 patients (A : B=10 : 9) were randomized from two centers.depends on document reviewPretreatment characteristics were well balanced between the two groups; A vs B as median age, 60.5 vs 58.4, stage (locally advanced : metastatic), 3:7 vs 2:7, sex difference (male : female), 7:3 vs 7:2. RR (0/10 vs 3/9) and MST (5.0±0.6 months vs 7.6±2.1) were not significant (NS). CBR (25 % vs 33.3 %) was NS. But TTP (1.9±0.5 months vs 5.0±1.5) was significantly different (p=0.0408, Logrank). So, from a point of ethics, the study has already stopped. Toxicity (NCI-CTC grade 3/4); leucocytes (20.0%:33.3%), neutrophils (10.0%:11.1%), platelets (10.0%:0%), diarrhea (10.0%:0%), anorexia (40.0%:11.1%) Conclusions: The chemotherapy by GEM plus UFT in this method may not be effective compared with GEM alone. No significant financial relationships to disclose.
The role of androgen ablation with low dose rate brachytherapy in the treatment of prostate cancer
Authors: A. B. Jani, A. Shoushtari, J. Feinstein
Journal: Journal of Clinical Oncology (2006)

14546 Background: We report a single-institution analysis of the role of androgen ablation (AA) with low-dose rate brachytherapy. Methods: A cohort of 189 consecutive patients (AA: n = 68, no-AA: n = 121) receiving brachytherapy (iodine-125: n = 125; palladium-109: n = 64) at our institution who had demographic (age), disease (T-stage [T1–70%, T2–28%, T3–2%], Gleason Score [median score 6], PSA [median-7.7 ng/mL]), and treatment (isotope, dosimetric endpoints, use of supplemental external beam radiotherapy [EBRT, administered as 45 Gy/1.8 Gy to the pelvis using 4-field technique with isocentric prescription]) information available, and a minimum of 2 years of follow-up available, constitute the analysis study group (median follow-up - 4.0 years). This cohort was divided into 2 major groups based on the use of AA (leuprolide 22.5 mg IM injection(s) 3–6 months [mean 4.0 months] prior to brachytherapy). Using 2 successive PSA rises &gt; 1 ng/mL as the failure definition, biochemical failure-free survival (BFFS) curves were constructed and compared using the logrank test; additionally, multivariate analysis of all major patient and treatment factors was performed using the Cox proportional hazards model. These analyses were done for the whole cohort as well as for subgroups defined by the use of EBRT and for subgroups of patients with low-, intermediate-, and high-risk prognostic factors (defined as the basis of 0, 1, or ≥ 2 prognostic factors [PSA &gt; 10 ng/mL, Gleason score &gt; 6, T-stage &gt; T2a], repectively). Results: The 4-year BFFS in the AA vs no-AA groups was 76 vs 70% (p = 0.230) for the whole cohort, 75 vs 62% (p = 0.182) for EBRT patients, and 75 vs 82% (p = 0.764) for no-EBRT patients. For the whole cohort, the use of EBRT was the only factor reaching significance on multivariate analysis (p = 0.040). When analyzing the EBRT and no-EBRT subgroups separately, no factor, including AA, reached significance on multivariate analysis. 4Y-BFFS of the AA vs no-AA subgroups were 82 vs 76% (p = 0.236) for the low-risk, 76 vs 70% (p = 0.437) for the intermediate-risk, and 75 vs 70% (p = 0.185) for the high-risk subgroup. Conclusions: In our study, short-course AA conferred no significant biochemical control advantage when added to low-dose rate brachytherapy overall or for any subgroup based on prognostic risk. No significant financial relationships to disclose.
Randomized controlled trial to evaluate splenectomy in total gastrectomy for proximal gastric carcinoma (JCOG0110): Final survival analysis.
Authors: Takeshi Sano, Mitsuru Sasako, Junki Mizusawa, Hiroshi Katayama, Hitoshi Katai, Takaki Yoshikawa, Hiroshi Yabusaki, Seiji Ito, Masahide Kaji, Hiroshi Imamura, Norimasa Fukushima, Kazumasa Fujitani, Yoshiaki Iwasaki, Taira Kinoshita
Journal: Journal of Clinical Oncology (2015)

103 Background: We conducted a RCT to compare splenectomy and spleen preservation in total gastrectomy and reported higher morbidity and larger blood loss in splenectomy at 2010 ASCO Annual Meeting. Survival analysis after 5-year follow-up is now complete. Methods: Proximal gastric adenocarcinoma of T2-4/N0-2/M0 not invading the greater curvature was eligible. During operation surgeons confirmed that R0 resection was possible with negative lavage cytology, and the patient was randomized into splenectomy or spleen-preserving arm. The primary endpoint was OS. The trial was designed to confirm non-inferiority of spleen preservation to splenectomy in OS with a non-inferiority margin of the hazard ratio (HR) as 1.21. The planned sample size was 500 pts with a power of 70% and a one-sided alpha of 5%. Results: Between June 2002 and March 2009, 505 patients (splenectomy 254, spleen-preservation 251) were enrolled from 36 institutions. The first 319 patients were treated without adjuvant therapy by protocol, but after the S-1 adjuvant effect was established in 2006, patients with pathological stage II and III tumors received adjuvant S-1 by amended protocol. The 5-year survivals were 75.1% and 76.4% in the splenectomy and spleen-preserving arms, respectively. The HR was 0.88 [90.7% CI 0.67-1.16] (&lt;1.21); thus the non-inferiority of spleen preservation was confirmed (p=0.025). The 5-year RFS was 68.4% in splenectomy arm and 70.5% in spleen-preserving arm. The HR was 0.87 [95% CI 0.65-1.17]. Subset analyses showed slightly better survival of spleen preservation in patients having deeper tumors (T3/T4), lymph node metastases, tumors located mainly in the middle stomach, and in those enrolled in the first study period of no-adjuvant protocol. Conclusions: This is the largest RCT of splenectomy in gastric cancer, and demonstrated significant non-inferiority of spleen preservation for the first time. In total gastrectomy for proximal gastric cancer which does not invade the greater curvature, prophylactic splenectomy should be avoided not only for operative safety but also for survival benefit. Clinical trial information: NCT00112099.
Feasibility and safety of mannitol challenge in pre-school children using forced oscillations
Authors: Afaf Albloushi, Shannon Simpson, Stephen Stick, Graham Hall
Journal: European Respiratory Journal (2012)

Background: The mannitol dry powder challenge is used to identify exercise induced bronchoconstriction (EIB) in adults and school-age children. The forced oscillation technique (FOT) is suitable for assessing lung function in pre-school children and can be combined with inhaled challenge testing in this age group.

Aims: This study aimed to assess the safety and the feasibility of a mannitol challenge using FOT in young children with asthma and in healthy controls.

Methods: Healthy children and children with exercise induced symptoms (EIS group) aged 3-7 years were recruited. A mannitol challenge (Aridol, Pharmaxis, Australia) was performed. A positive response to mannitol was defined as wheeze on auscultation, persistent cough, SpO2   50% from control. The mannitol challenge was considered successful if the child completed the challenge to the final dose or a positive response was noted.

Results: To date, 6 healthy and 10 EIS children have been studied. 14 children successfully completed the mannitol challenge with no adverse events. Two healthy children aged 3 years did not complete the test due to lack of cooperation. Three children with reported EIS responded to the challenge with symptoms, and three children responded by an increase in the Rrs8 by >50% from the control measurement.

Conclusion: These preliminary results suggest that a mannitol challenge test is feasible in young children and can be performed safely.

Funded by: ANZSRS Research Grant, Asthma Foundation WA.
Reclassification of genetic-based risk predictions as GWAS data accumulate
Authors: Joel Krier, Richard Barfield, Robert C. Green, Peter Kraft
Journal: Genome Medicine (2016)

Disease risk assessments based on common genetic variation have gained widespread attention and use in recent years. The clinical utility of genetic risk profiles depends on the number and effect size of identified loci, and how stable the predicted risks are as additional loci are discovered. Changes in risk classification for individuals over time would undermine the validity of common genetic variation for risk prediction. In this analysis, we quantified reclassification of genetic risk based on past and anticipated future GWAS data. We identified disease-associated SNPs via the NHGRI GWAS catalog and recent large scale genome-wide association study (GWAS). We calculated the genomic risk for a simulated cohort of 100,000 individuals based on a multiplicative odds ratio model using cumulative GWAS-identified SNPs at four time points: 2007, 2009, 2011, and 2013. Individuals were classified as Higher Risk (population adjusted odds >2), Average Risk (between 0.5 and 2), and Lower Risk (<0.5) for each time point and we compared classifications between time points for breast cancer (BrCa), prostate cancer (PrCa), diabetes mellitus type 2 (T2D), and cardiovascular heart disease (CHD). We estimated future reclassification using the anticipated number of undiscovered SNPs. Risk reclassification occurred for all four phenotypes from 2007 to 2013. During the most recent interval (2011-2013), the degree of risk reclassification ranged from 16.3 % for CHD to 24.4 % for PrCa. Many individuals classified as Higher Risk at earlier time points were subsequently reclassified into a lower risk category. From 2011 to 2013, the degree of such downward risk reclassification ranged from 24.9 % for T2D to 55 % for CHD. The percent of individuals classified as Higher Risk increased as more SNPs were discovered, ranging from an increase of 5 % for CHD to 9 % for PrCa from 2007 to 2013. Reclassification continued to occur when we modeled the discovery of anticipated SNPs based on doubling current sample size. Risk estimates from common genetic variation show large reclassification rates. Identifying disease-associated SNPs facilitates the clinically relevant task of identifying higher-risk individuals. However, the large amount of reclassification that we demonstrated in individuals initially classified as Higher Risk but later as Average Risk or Lower Risk, suggests that caution is currently warranted in basing clinical decisions on common genetic variation for many complex diseases.
Drugs for smoking cessation
Authors: Jamie Hartmann-Boyce, Paul Aveyard
Journal: BMJ (2016)

#### What you need to know

A 49 year old woman who smokes attends the general practitioner for help with troubling menopausal symptoms. During the course of the consultation, the doctor offers her help to stop smoking. She has tried stopping smoking previously without help and found it intolerable. She asks if she can use drug therapy this time.

Of the drugs available for smoking cessation, three are widely licensed and have proved efficacy:

Cochrane reviews give strong evidence that all three drugs are effective. Compared with placebo, the relative risks of abstinence are 1.60 (95% confidence interval 1.53 to 1.68) for NRT, 1.62 (1.49 to 1.76) for bupropion, and 2.27 (2.02 to 2.55) for varenicline.1 2 3 These relative risks seem to be constant over time from early in the quitting process to the long term and do not depend on …
Abstract 18268: Development of First Patient-Specific Computational Model to Analyze Wall Stress in Ascending Thoracic Aortic Aneurysms
Authors: Liang Ge, Andrew D Wisneski, Michael D Hope, Sam Chitsaz, Julius M Guccione, Victor Barocas, Elaine E Tseng
Journal: Circulation (2013)

Background: Ascending thoracic aortic aneurysms (aTAA) can rupture or dissect and rapidly become a lethal cardiovascular emergency. Peak aTAA wall stress may be a better predictor of rupture risk than diameter. However, in vivo models have never been validated and require zero-stress geometry, regional material properties, and residual stress. The goal of this study was to develop the first patient-specific computational models of aTAAs associated with bicuspid vs. tricuspid aortic valve using surgical specimens to accurately determine wall stress magnitudes. Methods: High-resolution micro-computed tomography of aTAA surgical specimens was used to construct zero-stress geometry. Bi-axial stretch testing of aTAAs in 4 quadrants provided stress-strain data to describe regional mechanical properties. Opening angle was used to determine residual stress. Finite element analyses were performed with LS-DYNA. Results: Elevated wall stress was seen in pockets in the anatomic left and right regions of bicuspid aTAA, primarily towards the sino-tubular junction, and in the left face of the inner lumen of the tricuspid aTAA more distally (Figure 1). Magnitudes of peak and mean wall stresses were similar between the bicuspid and tricuspid aTAAs. Conclusions: Wall stress magnitudes were relatively similar for these two aTAAs from bicuspid and tricuspid valve patients. Maximal wall stress areas may indicate sites more prone to rupture. Development of patient-specific aTAA models from surgical specimens is essential to determine true wall stress and to validate any in vivo -derived models. Such understanding is required to uncover the relationship between wall stress and rupture risk.
Effectiveness of Condoms in Preventing V.D.
Authors: N Sharrock, R K Kalkhoff, C A Ferrou
Journal: New England Journal of Medicine (1971)

To the Editor: The current epidemic of gonorrhea in the United States and in Massachusetts has prompted many physicians to ask us about the effectiveness of the condom as a prophylactic against this disease.  The answer to this question is theoretically yes but the effectiveness of the condom is such as to make it completely useless as a prophylactic.  The condom is effective against gonorrhea provided there is no preliminary sex play the condom is intact before use the condom is intact after use the condom is put on correctly and the condom is taken off correctly.  However the male population has never been able to fulfill the very first requisite.  Even if all these five conditions are fulfilled a condom incompletely protects against syphilis because it protects only the parts that covers.  It covers the glans It does not cover and the shaft of the penis and that is all.  It does not cover the base of the penis the symphysis or the thighs and these are the areas that are bathed with the secretion of the female during the sex act.  In summary then its effectiveness makes the condom useless as a prophylactic against gonorrhea and even under ideal conditions against syphilis.(Full text)
Oncogenic Association of Specific Human Papillomavirus Types With Cervical Neoplasia&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: A T Lorincz, G F Temple, R J Kurman, A B Jenson, W D Lancaster
Journal: JNCI Journal of the National Cancer Institute (1987)

Molecular hybridization analysis of human papillomavirus (HPV) DNA from 190 cervical biopsy specimens from women in the United States, Brazil, and Peru revealed viral sequences in 2 (9%) of 23 biopsy specimens of normal mature squamous epithelium, 7 (44%) of 16 biopsy specimens of metaplastic squamous epithelia, 60 (77%) of 78 cervical intraepithelial neoplasia (CIN), 57 (89%) of 64 invasive squamous carcinomas, and 8 (89%) of 9 endocervical adenocarcinomas. HPV typing by DNA hybridization revealed HPV 6 and HPV 11 sequences in metaplastic squamous epithelia, CIN I, and CIN II, but not in CIN III lesions or invasive carcinomas. HPV 16 was detected in metaplastic epithelium and in nearly half of the invasive squamous carcinomas and adenocarcinomas. It was present in 31% of CIN lesions, increasing in frequency with the severity of CIN from 20% of CIN I to 50% of CIN III. HPV 16 showed a striking difference in geographic distribution, being detected in 36% of the carcinomas from the United States compared to 64% of the carcinomas from Brazil and Peru. HPV 18 was found in metaplastic epithelia and in 17% of carcinomas but in only 1% of CIN lesions. HPV 31 was not found in metaplastic epithelium but was present in 6% of carcinomas and in 18% of CIN lesions. In addition, a group of uncharacterized HPVs, not corresponding to any of the probes used, was found in 5% of normal and metaplastic epithelia and in 18% of CIN and 19% of invasive cancers. These results suggest that individual HPV types that infect the cervix have varying degrees of oncogenic association. HPV 6 and HPV 11 appear to have very little oncogenic association, HPV 31 has low oncogenic association, and HPV 16 and HPV 18 have high oncogenic association.
Abstract 16014: Combining an Innovative Health Class With PE Reduces Weight and Increased Performance in High School Students
Authors: Erica Irvin, Amy Barras, Shawn G Hayes
Journal: Circulation (2014)

Introduction:  Traditional PE programs have not necessarily resulted in reduction in obesity rates in school age children. In recent years, schools have eliminated or reduced the time or frequency of PE to provide space in the school schedule for academic requirements. HealthCorps and the school staff developed and implemented the Fit2Live and Learn (F2LL) program, an integrative approach to health and PE. The goal was to demonstrate whether there was an impact on weight loss from restructuring existing freshman PE.   Hypothesis:  Combining PE and health classes into an extended daily model will result in weight loss and behavioral change.   Methods:  Benson Polytechnic HS in Portland, where HealthCorps runs a wellness program, implemented the new F2LL program. The prior PE program was changed from meeting every other day to a class that met daily for 90 minutes. Students received credits for both Health and Physical Education. The program combined its traditional Health and PE classes into an experiential integrative approach to health concepts. The F2LL program was a year-long practice of optimal exercise, healthy eating and mental strength habits for students. We measured weight loss, health knowledge and behavioral change using pre- and post- surveys.   Results:  In the first three months, the 240 students lost a combined 860 pounds, (mean 3.5 pounds). By the end of the school year (8 months) student combined weight loss was 1233 pound (mean 5.1 pounds/student; p   Conclusion:  The F2LL program combined with HealthCorps’ program emphasizing nutrition, mental resilience and physical activity, resulted in significant weight loss in the freshman PE class at one Portland public high school. Increases in knowledge and modest improvements in subsequently behavior were also seen.
A beacon of hope in stroke therapy—Blockade of pathologically activated cellular events in excitotoxic neuronal death as potential neuroprotective strategies
Authors: Ashfaqul Hoque, M. Iqbal Hossain, S. Sadia Ameen, Ching-Seng Ang, Nicholas Williamson, Dominic C.H. Ng, Anderly C. Chueh, Carli Roulston, Heung-Chin Cheng
Journal: Pharmacology & Therapeutics (2016)