tbuckley/cabot-search huggingface dataset:
FRI0254 Prognosis factors for survival and progression-free survival in systemic sclerosis–associated interstitial lung disease
Authors: N. Le Gouellec, J.-B. Faivre, A.-L. Hachulla, E. Hachulla, T. Perez, S. Morell-Dubois, P.-Y. Hatron, M. Remy-Jardin, D. Launay
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Systemic sclerosis-associated interstitial lung disease (SSc-ILD) is one of the leading cause of morbi-moratlity in SSc. Progression of ILD is variable among patients and some prognosis factors of mortality and progression have been suggested such as the extension of ILD on HRCT or the cutaneous extension of the disease. However, to date, there is no available study which assessed the prognostic information provided both by HRCT/pulmonary function tests (PFT) at baseline and clinical/biological characteristics of SSc. <h3>Objectives</h3> To assess the prognosis value of ILD and SSc baseline date on the survival and progression-free survival. <h3>Methods</h3> We restrospectively collected data of 75 consecutive SSc patients with ILD on HRCT and with a regular follow up with PFT. Progression of ILD was defined by a decrease of FVC≥10% and/or DLCO≥15% or the introduction of an immunosuppressive treatment. Each baseline HRCT was reviewed by 2 independent radiologists in order to assess the extension of disease and the proportion of ground-glass opacities and reticular pattern. <h3>Results</h3> Overall survival was 97, 94, 90 and 85% at 1, 3, 5 and 10 years respectively. Significant prognosis factors were FVC, DLCO, age at ILD diagnosis, left ventricular ejection fraction, CRP, hemoglobin level and presence of anticentromere antibodies. Conversely, neither the subtypes of SSc, nor the sex, 6 minute walk test or the extension of ILD on the HRCT were significant prognosis factors for survival. DLCO was the independent prognosis factor of survival. Progression-free survival was 78, 50, 43 and 24% at 1, 3, 5 and 10 years respectively. Significant prognosis factors of progression-free survival were only NYHA functional class and the extension of ILD on the baseline HRCT whatever the proportion of ground-glass opacities or reticular pattern <h3>Conclusions</h3> This study shows a good long term survival of patients with SSc-ILD in our center. However, the progression-free survival was much worse. The two prognosis factors of progression-free survival were the NYHA functional class and the extension of ILD on the baseline HRCT. Neither the subtype of SSc nor the subtype of autoantibodies were prognosis factor for progression-free survival. <h3>Disclosure of Interest</h3> None Declared
Lasting Remissions in Hairy-Cell Leukemia Induced by a Single Infusion of 2-Chlorodeoxyadenosine
Authors: Lawrence D. Piro, Carlos J. Carrera, Dennis A. Carson, Ernest Beutler
Journal: New England Journal of Medicine (1990)

2-Chlorodeoxyadenosine is a simple purine nucleoside that has previously been shown to be effective in the treatment of low-grade malignant disorders of lymphoid tissue, including chronic lymphocytic leukemia and non-Hodgkin's lymphoma. Because of these encouraging results, we treated 12 patients with another low-grade B-cell neoplasm, hairy-cell leukemia. The patients received 2-chlorodeoxyadenosine (0.1 mg per kilogram of body weight per day) by continuous infusion for seven days.
Surgical bleeding and calcium antagonists
Authors: J. Ohman
Journal: BMJ (1995)

Incidence of bleeding may be lower than suggested

EDITOR,--In L E Wagenknecht and colleagues' prospective randomised placebo controlled study of nimodipine in patients undergoing cardiac valve surgery an interim analysis of 149 patients suggested that nimodipine was associated with bleeding complications leading to increased mortality.1 In two out of three patients treated with nimodipine who died because of blood …
Identification of genomic DNA signatures predicting relapse in low- and intermediate-risk neuroblastoma using a case control design and high-density SNP genotyping: A Children's Oncology Group (COG) study
Authors: E. F. Attiyeh, Y. P. Mosse, S. Diskin, C. Hou, M. A. Attiyeh, D. Baker, D. Strother, M. Schmidt, W. B. London, J. M. Maris
Journal: Journal of Clinical Oncology (2007)

9500 Background: Neuroblastoma (NB) is a childhood malignancy with a heterogeneous clinical course. Clinical and genomic markers are powerful predictors of outcome and are used to stratify cases for treatment intensity, but imprecision remains. Methods: We identified all disease recurrences from the recently closed COG low- (P9641: 903 eligible, 63 events) and intermediate-risk (A3961: 467 eligible, 40 events) NB phase III trials. To date, tumor DNA from 35 cases and 90 controls (P9641/A3961 patients without event) was used for whole genome copy number and genotype evaluation on the Illumina HumanHap550 (550K SNPs) array. An in-house algorithm was developed to assign genomic copy number and loss of heterozygosity based on probe intensity (log R ratio) and degree of allelic imbalance (B allele frequency). Results: A total of 988 chromosomal aberrations were identified; 231 (23.4%) were whole chromosome (WC) copy number aberrations (CNA). Unsupervised hierarchical clustering identified 10 tumor subsets, with 2 highly enriched with cases showing progression events (13/21; 61%), and 2 dominated by WC gains (chromosomes 2, 6, 7 and 18) with only 2/20 events. Regional aberrations most highly associated with EFS included loss of 11q14-qter (p=0.036), and gain of 11p (p=0.003), 11q13 (p=0.020), and 17q23-qter (p=0.005). Other regional CNAs at borderline univariate significance for EFS included partial gain at 2p, 2q, 6q, 7q, 12q and 13q. The pattern 11p and proximal 11q gain associated with loss of distal 11q was associated with relapse and death (p=0.006 and p=0.023). Conclusion: Whole genome SNP genotyping detects patterns of chromosomal CNAs predictive of EFS, even in situations where events are rare such as low- and intermediate- risk NB. These data support chromosomal 11 and 17 structural CNAs as being most highly predictive of relapse in otherwise favorable NBs, but also suggest that other CNAs likely cooperate and may improve precisions for risk prediction. These data can be used to identify patients eligible for chemotherapy reduction/elimination, and perhaps others for intensification. Ongoing analyses of the remaining samples will extend these conclusions. No significant financial relationships to disclose.
Case 10-1992
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, H.M. Goodman, B.A. Centeno
Journal: New England Journal of Medicine (1992)

Presentation of CaseA 41-year-old woman was admitted to the hospital because of a pelvic mass and bilateral hydronephrosis.The patient was well until 19 days earlier, when she twisted her left ankle while on a cruise to the Bahamas. Immediately thereafter progressive swelling developed in the left leg. Two weeks before entry the patient noticed a mass in the lower left side of the abdomen. Six days before admission she consulted a physician. An ultrasonographic examination of the left leg, performed on the following day, was reported to show no evidence of thrombi. A computed tomographic (CT) scan of . . .
Incentive Spirometry to Prevent Acute Pulmonary Complications in Sickle Cell Diseases
Authors: Paul S. Bellet, Karen A. Kalinyak, Rakesh Shukla, Michael J. Gelfand, Donald L. Rucknagel
Journal: New England Journal of Medicine (1995)

This study was designed to determine the incidence of thoracic bone infarction in patients with sickle cell diseases who were hospitalized with acute chest or back pain above the diaphragm and to test the hypothesis that incentive spirometry can decrease the incidence of atelectasis and pulmonary infiltrates.
Early Inhaled Glucocorticoid Therapy to Prevent Bronchopulmonary Dysplasia
Authors: Cynthia H. Cole, Theodore Colton, Bhavesh L. Shah, Soraya Abbasi, Brenda L. MacKinnon, Serkalem Demissie, Ivan D. Frantz
Journal: New England Journal of Medicine (1999)

The safety and efficacy of inhaled glucocorticoid therapy for asthma stimulated its use in infants to prevent bronchopulmonary dysplasia. We tested the hypothesis that early therapy with inhaled glucocorticoids would decrease the frequency of bronchopulmonary dysplasia in premature infants.
RAC Ponders Its Purpose: To Be or Not to Be
Authors: S. Jenks
Journal: JNCI Journal of the National Cancer Institute (1993)

Journal Article RAC Ponders Its Purpose: To Be or Not to Be Get access Susan Jenks Susan Jenks Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 85, Issue 19, 6 October 1993, Pages 1544–1546, https://doi.org/10.1093/jnci/85.19.1544 Published: 06 October 1993
A6.24 Does the altered expression of micro-RNA-155 and micro-146A in synovial fluid of rheumatoid arthritis patients correlate with the ultrasound scores for active synovitis?
Authors: R Shumnalieva, D Kachakova, S Monov, R Kaneva, Kolarov Zl, R Rashkov
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Micro-ribonucleic acids (microRNAs) comprise a class of non-coding small microRNA that regulates gene expression on posttranscriptional level. Altered expression profile of certain microRNAs has been found in the peripheral blood (PB), synovial fluid (SF) and synovial fibroblasts of rheumatoid arthritis (RA) patients. The use of microRNAs as biomarkers for RA in the clinical practice is based on correlation between their expression levels and scores for disease activity and progression. We found that altered expression of certain microRNAs in SF of RA patients correlate with the ultrasound scores for active synovitis. <h3>Materials and methods</h3> 46 RA patients according to the 1987 ACR criteria were included in the study. Before an arthrocentesis we performed ultrasound assessment and scoring of the joint inflammation by using both grey scale and power Doppler technic for defining the synovial thickening and degree of vascularisation. MicroRNA-155 and -146a expression levels in paired PB and SF samples were investigated through PCR (SYBR Green technology) and compared to healthy controls (HCs). <h3>Results</h3> SF in 80,43% and in 69,55% (p &lt; 0.05, T-test) of RA patients showed overexpression of microRNA-155 and microRNA-146a, respectively, when compared to the HCs. There was a good correlation of microRNA-155 expression level and the ultrasound score for active synovitis grade ≥ 2 (Spearman's correlation coefficient 0.313, p &lt; 0.016) and for microRNA-146a (Spearman's correlation coefficient 0.241, p &lt; 0.066). The levels of microRNA-155 and -146a correlated with the presence of erosions (Spearman's correlation coefficient 0.373, p &lt; 0.004 and 0.318, p &lt; 0.014, respectively) and the imaging score (Spearman's correlation coefficient 0.412, p &lt; 0.001 and 0.341, p &lt; 0.008, respectively). <h3>Conclusion</h3> The laboratory and imaging data showed correlation between the expression levels of the chosen microRNAs with the active joint inflammation and destruction. Differences could be explained by the different disease stage and progression characterised by higher erosion score and tendency to lesser synovial thickened and vascularisation as well as by the possibility of different expression levels of microRNA though the disease course. Further analysis with higher number of patients is needed to confirm if these microRNAs could be used in the clinical practice as local biomarkers for both disease activity and progression. <h3>Acknowledgement</h3> The study was supported by Grant 55/2013 funded by Medical University – Sofia, Bulgaria
PWE-138 The incidence and management of cystic duct stones: the intra-operative cholangiogram is more than just a diagnostic tool
Authors: R Dave, N Yeomans, A Cockbain, G Toogood
Journal: Gut (2012)

<h3>Introduction</h3> Use of the Intraoperative cholangiogram (IOC) was introduced by Mirizzi in 1931, who recommended its routine use. Currently, routine IOC during laparoscopic cholecystectomy (LC) remains a controversial issue. Unsuspected common bile duct (CBD) stones are reported in only between 2% and 3% of cases, whereas “post-cholecystectomy syndrome (PCS),” is reported in 10% - 40%. A potential cause of this is retained stones within the cystic duct (CD) remnant. We aimed to identify the intra-operative incidence of CD stones and the incidence of post-operative complications following routine IOC. <h3>Methods</h3> We analysed a prospectively maintained database of all LC and routine IOC performed by the senior author. Since 7 April 2010, the incidence of CD stones/sludge was prospectively recorded—once the incision on the CD had been made, the CD and the CBD were “milked” in a retrograde fashion to remove any debris prior to introduction of the catheter for IOC. Impacted CD stones were crushed laproscopically. We also analysed the entire database prospectively collected since 1999 for the incidence of CBD stones. T-test (continuous) and Chi<sup>2</sup> (categorical) tests were used to analyse predictors of CD stones. <h3>Results</h3> 248 LC with IOC had been recorded from 7 April 2010. In this cohort, the incidence of CD stones was 13% (N=33/248) and CD sludge was 6% (N=15/248). The presence of CD stones was not significantly associated with raised liver function tests (ALT&gt;100, ALT&gt;350) nor with pre-operative diagnoses of cholecystitis, pancreatitis, jaundice or cholangitis. Out of the 248 patients, 4% of patients presented with pain post operatively (N=11). &lt;1% (N=2/248) presented with CBD stones post-operatively despite a negative IOC. No patients presented with pancreatitis or cholangitis post-operatively. In addition, out of a larger cohort of 1957 LC performed by the senior author, 4.5% of cases had CBD stones detected on IOC. <h3>Conclusion</h3> The incidence of CD stones is not well reported in published literature—the data that exists is mainly following repeat cholecytectomy for PCS rather than intraoperative detection. PCS is widely reported and can cause a therapeutic and diagnostic challenge. The presence of stones in the CD or within a retained gall bladder remnant may be the cause of residual symptoms, but are difficult to diagnose. We propose that the IOC is not only a diagnostic tool for identification of CBD stones and to delineate anatomy, but also serves a therapeutic purpose, allowing “milking” of the CD to remove any stones/debris which in our cohort has resulted in low rates of post-operative pain. <h3>Competing interests</h3> None declared.
Underserved Topics in Oncology: The Role of Physical Activity in Improving Quality of Life and Decreasing Recurrence Risk in Patients With Cancer
Authors: Robert J. Morgan
Journal: Journal of the National Comprehensive Cancer Network (2014)

Amy: "I'm glad that I'm here getting my chemotherapy.My doctor told me that the chemo will decrease the chances of my breast cancer recurring by about 2%, but I want to do everything that I can."Christina: "Me too.My doctor told me to keep active also.I wonder if being more active will help.I really just want to sit and sleep all the time."Amy: "Oh, all of that stuff is just complementary medicine.I don't believe in those things.Just like acupuncture
A memorable patient: Informed consent
Authors: I Tiwari
Journal: BMJ (2001)

I first met Ivy three years ago when she came for her 29th oesophageal dilatation. She was an 86 year old spinster, deaf without speech from childhood, and the only sign language she knew was thumbs up, which she would use for saying good morning or for showing happiness. She had no next of kin and had lived in a residential home for the past 50 years. She developed a benign oesophageal stricture in 1992 and came to the endoscopy unit for repeated dilatations. The carers in the residential home used to say that she enjoyed her “days out” at the endoscopy unit.

We would explain the procedure to her in sign language. She would use the thumbs up sign and make a cross on the dotted line on the consent form. She would enter the endoscopy room smiling, put her left arm out to be cannulated, turn to her left side for endoscopy, and when fully awake would show her thumbs up again. Every time after her dilatation the nursing staff would question why an expandable oesophageal stent was not being considered. We would conclude that the indications for an expandable stent in benign strictures are not well established.

Her need for dilatation was becoming more frequent, and so on her 46th dilatation we decided to refer her to our regional centre for the insertion of a stent. She had an expandable stent inserted, and in his report the endoscopist mentioned the risk of the stent migrating down in the stomach beyond the stricture. Six weeks later she developed a bolus obstruction. At endoscopy it was noted that the stent had indeed migrated down. She consented to another stent. Four weeks later she had another bolus obstruction that could not be completely removed at the first attempt, and she was brought back the following day for removal of the bolus by endoscopy.

She came to the endoscopy room but did not have her familiar smile. She looked around for a minute, got off her trolley, and walked out. Everyone in the endoscopy room understood that she was trying to say, “I've had enough.”

She did not come back for a repeat endoscopy, and she stayed nil by mouth on intravenous fluids. Two weeks later she died of an aspiration pneumonia. We think she understood all the procedures she had agreed to. We also think it was informed consent. I hope we were right. She gave us a very clear message without saying a word on her last visit to the endoscopy room.

Do we really understand what aphasic patients are trying to tell us when we get informed consent for invasive procedures? We should try to read the non-verbal messages very carefully.
Abstract 4980: Myocardin functions as an effective inducer of growth arrest and differentiation in human leiomyosarcoma cells
Authors: Yasunori Kimura, Tsuyoshi Morita, Ken'ichiro Hayashi, Tsuneharu Miki, Kenji Sobue
Journal: Cancer Research (2010)

Abstract Myocardin is an important transcriptional regulator in smooth and cardiac muscle development. We noticed that the expression of myocardin was markedly downregulated in human uterine leiomyosarcoma cells. Restoration of myocardin expression induced the re-expression of smooth muscle marker proteins and the formation of well-developed actin fibers. A concomitant increase in the expression of a CDK inhibitor, p21, led to a significant slowing of cell proliferation, via p21's inhibition of the G1/S transition. A p21 promoter-reporter assay showed that myocardin markedly increased p21's promoter activity. Furthermore, a serum response factor (SRF)-binding cis-element CArG-box in the p21 promoter region was required for this myocardin effect. Chromatin immunoprecipitation and DNA-protein binding assays showed that myocardin indirectly bound to the CArG-box in the p21 promoter through an interaction with SRF. Furthermore, immunohistochemistry revealed that the levels of myocardin and p21 were both lower in leiomyosarcoma samples than in normal smooth muscle tissue. Taken together, our results indicate that the downregulation of myocardin expression facilitates cell-cycle progression via the reduction of p21 expression in human leimyosarcomas, and suggest that myocardin could be a useful therapeutic target for this disease. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4980.
Effect of Prenatal Ultrasound Screening on Perinatal Outcome
Authors: Bernard G. Ewigman, James P. Crane, Fredric D. Frigoletto, Michael L. LeFevre, Raymond P. Bain, Donald McNellis
Journal: New England Journal of Medicine (1993)

Many clinicians advocate routine ultrasound screening during pregnancy to detect congenital anomalies, multiple-gestation pregnancies, fetal growth disorders, placental abnormalities, and errors in the estimation of gestational age. However, it is not known whether the detection of these conditions through screening leads to interventions that improve perinatal outcome.
An Inherited Defect in Aldosterone Biosynthesis Caused by a Mutation in or near the Gene for Steroid 11-Hydroxylase
Authors: Hadas Globerman, Ariel Rösler, Rachel Theodor, Maria I. New, Perrin C. White
Journal: New England Journal of Medicine (1988)

The final step in aldosterone biosynthesis, an oxidation at position 18 of 18-hydroxycorticosterone, is catalyzed by an enzymatic activity termed corticosterone methyl oxidase II (CMO II). This activity is mediated in vitro by P450c11 (steroid 11-hydroxylase), a cytochrome P-450 enzyme that also catalyzes the preceding two steps of 11-hydroxylation and 18-hydroxylation. CMO II deficiency, an inherited defect in the 18-oxidation step, impairs aldosterone biosynthesis and thus leads to a clinical syndrome of salt wasting. To test the hypothesis that CMO II deficiency results from a mutation affecting the structural gene for P450c11, we examined 11 affected and 21 unaffected members of six families with this disorder. After DNA samples were digested with the restriction endonuclease MspI thereby cutting the DNA at specific sites) and hybridized with a P450c11 DNA probe, a unique DNA fragment in the P450c11 structural gene was detected in subjects with the deficiency. The DNA fragment and the disease trait were inherited together in each family, demonstrating that CMO II deficiency is caused by a mutation in or very near the structural gene for P450c11 on chromosome 8. We conclude that the metabolic diseases of CMO II and 11-hydroxylase deficiency, which have distinct clinical symptoms, may be caused by different mutations in the single gene for a multifunctional enzyme. (N Engl J Med 1988;319:1193–7.)