tbuckley/cabot-search huggingface dataset:
Diagnosis, treatment decisions, and follow up in primary gastric lymphoma
Authors: H Boot
Journal: Gut (2002)

Endoscopic ultrasound is inferior to histology for follow up of patients with primary gastric lymphoma after organ conserving strategies

In this issue of Gut , Puspok and colleagues1 highlight the follow up in patients with primary gastric lymphoma after various stomach conserving therapies: Helicobacter pylori eradication, chemotherapy, radiotherapy, or combinations thereof [see page 691]. Endoscopic ultrasound (EUS) findings were compared with histology and showed that a complete histological remission occurred earlier and more often than an EUS defined remission. Were these results to be expected when treatment response is followed? What are the implications of this study for daily practice?

In the recently formalised WHO classification,2 gastric lymphoma is considered as the “disease entity” of marginal zone lymphoma (mucosa associated lymphoid tissue (MALT)-type) with a characteristic morphological spectrum, immunological marker pattern, and discriminative chromosomal aberrations. In the past, these lymphomas were often described as low grade (gastric) MALT lymphomas. High grade (MALT) lymphomas are not a separate entity in the WHO classification but are classified as diffuse large B cell lymphomas (DLBCL) with or without areas of marginal zone lymphoma of the MALT type.

Clinical presentation and endoscopic findings in primary gastric lymphoma may mimic benign and other malignant gastric disorders. The diagnosis of lymphoma can be established on endoscopic biopsies in more than 90% of patients but exact subtyping of the …
Prevalence, incidence and progression of hand osteoarthritis in the general population: the Framingham Osteoarthritis Study
Authors: I. K. Haugen, M. Englund, P. Aliabadi, J. Niu, M. Clancy, T. K. Kvien, D. T. Felson
Journal: Annals of the Rheumatic Diseases (2011)

To describe the prevalence and longitudinal course of radiographic, erosive and symptomatic hand osteoarthritis (HOA) in the general population.Framingham osteoarthritis (OA) study participants obtained bilateral hand radiographs at baseline and 9-year follow-up. The authors defined radiographic HOA at joint level as Kellgren-Lawrence grade (KLG)≥2, erosive HOA as KLG≥2 plus erosion and symptomatic HOA as KLG≥2 plus pain/aching/stiffness. Presence of HOA at individual level was defined as ≥1 affected joint. The prevalence was age-standardised (US 2000 Population 40-84 years).Mean (SD) baseline age was 58.9 (9.9) years (56.5% women). The age-standardised prevalence of HOA was only modestly higher in women (44.2%) than men (37.7%), whereas the age-standardised prevalence of erosive and symptomatic OA was much higher in women (9.9% vs 3.3%, and 15.9% vs 8.2%). The crude incidence of HOA over 9-year follow-up was similar in women (34.6%) and men (33.7%), whereas the majority of those women (96.4%) and men (91.4%) with HOA at baseline showed progression during follow-up. Incident metacarpophalangeal and wrist OA were rare, but occurred more frequently and from an earlier age in men than women. Development of erosive disease occurred mainly in those with non-erosive HOA at baseline (as opposed to those without HOA), and was more frequent in women (17.3%) than men (9.6%).The usual female predominance of prevalent and incident HOA was less clear for radiographic HOA than for symptomatic and erosive HOA. With an ageing population, the impact of HOA will further increase.
Dietary sugars: a fat difference
Authors: Susanna M. Hofmann, Matthias H. Tschöp
Journal: Journal of Clinical Investigation (2009)

Coronary heart disease is a major cause of morbidity and mortality in Western societies. The metabolic syndrome, characterized by obesity, insulin resistance, elevated blood pressure, elevated triglycerides, and low levels of high-density lipoprotein cholesterol, confers substantial risk of coronary heart disease. Current pathogenetic models suggest that postprandial hyperlipidemia is one specific metabolic abnormality that is typically associated with increased morbidity. In this issue of the JCI, Stanhope and colleagues demonstrate that consumption of fructose-sweetened but not glucose-sweetened beverages for 10 weeks increases de novo lipid synthesis, promotes dyslipidemia, impairs insulin sensitivity, and increases visceral adiposity in overweight or obese adults (see the related article beginning on page 1322).
SMAC Mimetic (JP1201) Sensitizes Non–Small Cell Lung Cancers to Multiple Chemotherapy Agents in an IAP-Dependent but TNF-α–Independent Manner
Authors: Rachel M. Greer, Michael Peyton, Jill E. Larsen, Luc Girard, Yang Xie, Adi F. Gazdar, Patrick Harran, Lai Wang, Rolf A. Brekken, Xiaodong Wang, John D. Minna
Journal: Cancer Research (2011)

Abstract Inhibitors of apoptosis proteins (IAP) are key regulators of apoptosis and are inhibited by the second mitocondrial activator of caspases (SMAC). Previously, a small subset of TNF-α–expressing non–small cell lung cancers (NSCLC) was found to be sensitive to SMAC mimetics alone. In this study, we determined if a SMAC mimetic (JP1201) could sensitize nonresponsive NSCLC cell lines to standard chemotherapy. We found that JP1201 sensitized NSCLCs to doxorubicin, erlotinib, gemcitabine, paclitaxel, vinorelbine, and the combination of carboplatin with paclitaxel in a synergistic manner at clinically achievable drug concentrations. Sensitization did not occur with platinum alone. Furthermore, sensitization was specific for tumor compared with normal lung epithelial cells, increased in NSCLCs harvested after chemotherapy treatment, and did not induce TNF-α secretion. Sensitization also was enhanced in vivo with increased tumor inhibition and increased survival of mice carrying xenografts. These effects were accompanied by caspase 3, 4, and 9 activation, indicating that both mitochondrial and endoplasmic reticulum stress-induced apoptotic pathways are activated by the combination of vinorelbine and JP1201. Chemotherapies that induce cell death through the mitochondrial pathway required only inhibition of X-linked IAP (XIAP) for sensitization, whereas chemotherapies that induce cell death through multiple apoptotic pathways required inhibition of cIAP1, cIAP2, and XIAP. Therefore, the data suggest that IAP-targeted therapy using a SMAC mimetic provides a new therapeutic strategy for synergistic sensitization of NSCLCs to standard chemotherapy agents, which seems to occur independently of TNF-α secretion. Cancer Res; 71(24); 7640–8. ©2011 AACR.
Carcinoma of the ampulla of Vater: prognostic factors after curative surgery: a series of 45 cases.
Authors: A Dorandeu, J L Raoul, F Siriser, N Leclercq-Rioux, M Gosselin, E D Martin, M P Ramee, B Launois
Journal: Gut (1997)

BACKGROUND: Some adjuvant or neoadjuvant therapy could be important for patients operated on for tumours of the ampulla of Vater, especially for those having a higher risk of recurrence. AIM: To evaluate prognostic factors after curative surgery based on a series of 45 cases of malignant tumours of the Oddi sphincter. PATIENTS: From 1970 to 1992, a curative resection was performed in 45 patients (age 62.8 (SD 10.1) years) with adenocarcinoma of the ampulla. Surgical procedures included pancreatoduodenectomy (n = 42) and resection of the ampulla (n = 3). Actuarial survival was 44 (SD 9)% at five years. METHODS: Various prognostic variables were studied: clinical manifestations, macroscopic aspect, differentiation, noninvasive adenomatous component, mucin histochemistry, immunohistochemistry (CEA, CA19.9, p53, Ki67), and accepted classifications (Blumgart and Kennedy, Martin, Yamaguchi and Enjoji, Talbot et al, pTNM). RESULTS: Variables with prognostic power, in order of importance were: Classification of Talbot et al; CA19.9; pTNM; sialomucins; classification of Yamaguchi and Ejoji; Martin classification; sulphomucins; non-invasive adenomatous component (positive &gt; negative); jaundice; tumour localisation. CONCLUSIONS: This series confirmed the prognostic power of former classifications and showed the prognostic power of other variables (mucin, non-invasive adenomatous component, CA19.9).
Phase II Trial of Bevacizumab in the Treatment of Persistent or Recurrent Squamous Cell Carcinoma of the Cervix: A Gynecologic Oncology Group Study
Authors: Bradley J. Monk, Michael W. Sill, Robert A. Burger, Heidi J. Gray, Thomas E. Buekers, Lynda D. Roman
Journal: Journal of Clinical Oncology (2009)

Vascular endothelial growth factor is a key promoter of tumor progression in cervical carcinoma. The Gynecologic Oncology Group (GOG) conducted a phase II trial to assess the efficacy and tolerability of bevacizumab, a recombinant humanized anti-vascular endothelial growth factor monoclonal antibody.
Type, Rather Than Number, of Mental and Physical Comorbidities Increases the Severity of Symptoms in Patients With Irritable Bowel Syndrome
Authors: Jeffrey M. Lackner, Chang–Xing Ma, Laurie Keefer, Darren M. Brenner, Gregory D. Gudleski, Nikhil Satchidanand, Rebecca Firth, Michael D. Sitrin, Leonard Katz, Susan S. Krasner, Sarah K. Ballou, Bruce D. Naliboff, Emeran A. Mayer
Journal: Clinical Gastroenterology and Hepatology (2013)
Dendritic Cells Pulsed with Polyomavirus BK Antigen Induce Ex Vivo Polyoma BK Virus–Specific Cytotoxic T-Cell Lines in Seropositive Healthy Individuals and Renal Transplant Recipients
Authors: Patrizia Comoli, Sabrina Basso, Alberta Azzi, Antonia Moretta, Riccardo De Santis, Francesco Del Galdo, Raffaele De Palma, Umberto Valente, Arcangelo Nocera, Francesco Perfumo, Franco Locatelli, Rita Maccario, Fabrizio Ginevri
Journal: Journal of the American Society of Nephrology (2003)

ABSTRACT. Polyoma BK virus (BKV)-associated interstitial nephritis has emerged as a relevant complication of immunocompromise after kidney transplantation, leading to reduced survival of the renal allograft. The limitations of current antiviral treatment and the high probability of rejection in kidney graft recipients when control of viral replication is attempted by reduction of immunosuppression warrant further efforts to develop alternative therapeutic tools. Cellular immunotherapy has proved to be a successful approach for prevention and/or treatment of other viral complications in the immunocompromised host. For assessing the feasibility of translating this strategy to the prevention of BKV-associated disease, a procedure for ex vivo reactivation of BKV-specific cytotoxic T cells (CTL) was developed from BKV-seropositive healthy donors and allograft recipients through stimulation with dendritic cells pulsed with inactivated BKV. The CTL lines thus obtained showed BKV specificity, as an efficient lysis of BKV-infected targets was accompanied by little or no reactivity against mock-infected autologous or allogeneic targets. In vitro killing of allogeneic BKV-infected targets, likely as a result of populations of TCRγδ+/CD3+ displaying MHC class I unrestricted cytotoxicity, was also displayed. Application of this culture system may allow a preemptive therapy approach to BKV-related complications in transplant recipients, based on CTL treatment guided by BKV DNA levels.
Prostate Cancer in the Elderly Patient
Authors: Chunkit Fung, William Dale, Supriya Gupta Mohile
Journal: Journal of Clinical Oncology (2014)

Treatment for prostate cancer (PCa) has evolved significantly over the last decade. PCa is the most prevalent non-skin cancer and the second leading cause of cancer death in men, and it has an increased incidence and prevalence in older men. As a result, physicians and patients are faced with the challenge of identifying optimal treatment strategies for localized, biochemical recurrent, and advanced PCa in the older population. When older patients are appropriately selected, treatment for PCa results in survival benefits and toxicity profiles similar to those experienced in younger patients. However, underlying health status and age-related changes can have an impact on tolerance of hormonal therapy and chemotherapy in men with advanced disease. Therefore, the heterogeneity of the elderly population necessitates a multidimensional assessment to maximize the benefit of medical and/or surgical options. Providing clinicians with the requisite health status data on which to base treatment decisions would help ensure that older patients with PCa receive optimal therapy if it will benefit them and/or active surveillance or best supportive care if it will not. We provide a review of the existing evidence to date on the management of PCa in the older population.
IL-6 induces PI 3-kinase and nitric oxide-dependent protection and preserves mitochondrial function in cardiomyocytes
Authors: N SMART, M MOJET, D LATCHMAN, M MARBER, M DUCHEN, R HEADS
Journal: Cardiovascular Research (2005)

Objective: Interleukin-6 (IL-6) is a pro-inflammatory cytokine which is a prognostic marker associated with left ventricular contractile dysfunction and heart failure. On the other hand, IL-6 activates signalling pathways which mediate delayed ischemic preconditioning. We have therefore studied the cellular mechanisms of IL-6-induced cardioprotection.
Impact of Medicare Coverage on Basic Clinical Services for Previously Uninsured Adults
Authors: J. Michael McWilliams
Journal: JAMA (2003)

Uninsured adults receive less appropriate care and have more adverse health consequences than insured adults. Longitudinal studies would help to more clearly define the effects of health insurance on health care and health.To assess the differential effects of gaining Medicare coverage on use of basic clinical services and medications by previously insured and uninsured adults.Household survey data from the nationally representative Health and Retirement Study were used to analyze differences in receipt of basic clinical services by adults in 1996 and 2000, before and after becoming eligible for Medicare at age 65 years.A total of 2203 adults aged 60 to 64 years in 1996 who were classified as continuously uninsured (n = 167), intermittently uninsured (n = 216), or continuously insured (n = 1820) in 1994 and 1996, prior to Medicare eligibility.Individuals' reports of receiving cholesterol testing, mammography (in women), prostate examination (in men), and treatment of arthritis and hypertension in the prior 2 years.The difference in cholesterol testing between continuously insured and continuously uninsured adults was significantly reduced after Medicare eligibility (35.4% vs 17.7%; change of -17.7% [95% CI, -29.3% to -6.2%]; P =.003), and the reduction was substantially greater among those with hypertension or diabetes than among other adults (29.2% vs 7.7%; difference of 21.5% [95% CI, 0.2% to 42.9%]; P =.048). Differences in use were similarly reduced after Medicare eligibility for mammography in women (30.3% vs 15.0%; change of -15.3% [95% CI, -29.9% to -0.7%]; P =.04) and prostate examination in men (45.2% vs 20.0%; change of -25.2% [95% CI, -45.4% to -5.1%]; P =.01). Continuously uninsured adults with arthritis reported significantly greater increases in arthritis-related medical visits and limitations of activity than continuously insured adults after Medicare eligibility, but not greater increases in arthritis treatments. Among adults with hypertension, differences in use of antihypertensive medications between continuously uninsured and insured adults were essentially unchanged after Medicare coverage.Previously uninsured adults substantially increased their use of covered basic clinical services but not medications after gaining Medicare coverage. An affordable option through which near-elderly uninsured adults could purchase Medicare coverage might have similar effects.
Novel <i>SCN5A</i> Mutation Leading Either to Isolated Cardiac Conduction Defect or Brugada Syndrome in a Large French Family
Authors: Florence Kyndt, Vincent Probst, Franck Potet, Sophie Demolombe, Jean-Christophe Chevallier, Isabelle Baro, Jean-Paul Moisan, Pierre Boisseau, Jean-Jacques Schott, Denis Escande, Hervé Le Marec
Journal: Circulation (2001)

The SCN5A gene encoding the human cardiac sodium channel alpha subunit plays a key role in cardiac electrophysiology. Mutations in SCN5A lead to a large spectrum of phenotypes, including long-QT syndrome, Brugada syndrome, and isolated progressive cardiac conduction defect (Lenègre disease).In the present study, we report the identification of a novel single SCN5A missense mutation causing either Brugada syndrome or an isolated cardiac conduction defect in the same family. A G-to-T mutation at position 4372 was identified by direct sequencing and was predicted to change a glycine for an arginine (G1406R) between the DIII-S5 and DIII-S6 domain of the sodium channel protein. Among 45 family members, 13 were carrying the G1406R SCN5A mutation. Four individuals from 2 family collateral branches showed typical Brugada phenotypes, including ST-segment elevation in the right precordial leads and right bundle branch block. One symptomatic patient with the Brugada phenotype required implantation of a cardioverter-defibrillator. Seven individuals from 3 other family collateral branches had isolated cardiac conduction defects but no Brugada phenotype. Three flecainide test were negative. One patient with an isolated cardiac conduction defect had an episode of syncope and required pacemaker implantation. An expression study of the G1406R-mutated SCN5A showed no detectable Na(+) current but normal protein trafficking.We conclude that the same mutation in the SCN5A gene can lead either to Brugada syndrome or to an isolated cardiac conduction defect. Our findings suggest that modifier gene(s) may influence the phenotypic consequences of a SCN5A mutation.
Estrogen receptor alpha (ESR1) gene amplification is frequent in breast cancer
Authors: Frederik Holst, Phillip R Stahl, Christian Ruiz, Olaf Hellwinkel, Zeenath Jehan, Marc Wendland, Annette Lebeau, Luigi Terracciano, Khawla Al-Kuraya, Fritz Jänicke, Guido Sauter, Ronald Simon
Journal: Nature Genetics (2007)
Influence of anchoring ligands and particle size on the colloidal stability and in vivo biodistribution of polyethylene glycol-coated gold nanoparticles in tumor-xenografted mice
Authors: Guodong Zhang, Zhi Yang, Wei Lu, Rui Zhang, Qian Huang, Mei Tian, Li Li, Dong Liang, Chun Li
Journal: Biomaterials (2009)
Management of a malignant pleural effusion: British Thoracic Society pleural disease guideline 2010
Authors: M. E. Roberts, E. Neville, R. G. Berrisford, G. Antunes, N. J. Ali
Journal: Thorax (2010)

The discovery of malignant cells in pleural fluid and/or parietal pleura signifies disseminated or advanced disease and a reduced life expectancy in patients with cancer.1 Median survival following diagnosis ranges from 3 to 12 months and is dependent on the stage and type of the underlying malignancy. The shortest survival time is observed in malignant effusions secondary to lung cancer and the longest in ovarian cancer, while malignant effusions due to an unknown primary have an intermediate survival time.2–6 Historically, studies showed that median survival times in effusions due to carcinoma of the breast are 5–6 months. However, more recent studies have suggested longer survival times of up to 15 months.7–10 A comparison of survival times in breast cancer effusions in published studies to 1994 calculated a median survival of 11 months.9

Currently, lung cancer is the most common metastatic tumour to the pleura in men and breast cancer in women.4 11 Together, both malignancies account for 50–65% of all malignant effusions (table 1). Lymphomas, tumours of the genitourinary tract and gastrointestinal tract account for a further 25%.2 12–14 Pleural effusions from an unknown primary are responsible for 7–15% of all malignant pleural effusions.3 13 14 Few studies have estimated the proportion of pleural effusions due to mesothelioma: studies from 1975, 1985 and 1987 identified mesothelioma in 1/271, 3/472 and 22/592 patients, respectively, but there are no more recent data to update this in light of the increasing incidence of mesothelioma.4 13 14

View this table:

Table 1 
Primary tumour site in patients with malignant pleural effusion



Attempts have been made to predict survival based on the clinical characteristics of pleural fluid. None has shown a definite correlation: a recent systematic review of studies including 433 patients assessing the predictive value of pH concluded that low pH does not reliably predict …
New insights into<i>Chlamydia</i>and arthritis. Promise of a cure?
Authors: Henning Zeidler, Alan P Hudson
Journal: Annals of the Rheumatic Diseases (2013)

<i>Chlamydia trachomatis</i> and <i>Chlamydia pneumoniae</i> together comprise the most frequent causative pathogens that elicit reactive arthritis (ReA). Advances in our understanding of the molecular biology/molecular genetics of these organisms have improved significantly the ability to detect chlamydiae in the joint for diagnostic purposes, as well as extending our current understanding of the pathogenic processes they elicit in the joint and elsewhere. An important aspect of the latter is that synovial chlamydiae infect the joint in an unusual but metabolically active state. While some standard treatments can provide a palliative effect on the ReA disease phenotype, many reports have indicated that standard antibiotic treatment does not provide a cure. Of critical importance, however, two recent reports of controlled clinical trials demonstrated that <i>Chlamydia</i>-ReA can be treated successfully using combination antibiotic therapy. These observations offer the opportunity of a cure for this disease, thereby increasing the practical importance of awareness and diagnosis of the spondyloarthritis caused by <i>Chlamydia</i>. In this viewpoint, we provide an overview of recent key findings in the epidemiology, pathophysiology, clinical manifestations, diagnosis and treatment of <i>Chlamydia</i>-induced arthritis. Our intention is for these insights to be translated rapidly into clinical practice to overcome misdiagnosis and underdiagnosis of the disease, and for them to stimulate the continued development of a cure.