tbuckley/cabot-search huggingface dataset:
Bivalirudin during Primary PCI in Acute Myocardial Infarction
Authors: Gregg W. Stone, Bernhard Witzenbichler, Giulio Guagliumi, Jan Z. Peruga, Bruce R. Brodie, Dariusz Dudek, Ran Kornowski, Franz Hartmann, Bernard J. Gersh, Stuart J. Pocock, George Dangas, S. Chiu Wong, Ajay J. Kirtane, Helen Parise, Roxana Mehran
Journal: New England Journal of Medicine (2008)

Treatment with the direct thrombin inhibitor bivalirudin, as compared with heparin plus glycoprotein IIb/IIIa inhibitors, results in similar suppression of ischemia while reducing hemorrhagic complications in patients with stable angina and non-ST-segment elevation acute coronary syndromes who are undergoing percutaneous coronary intervention (PCI). The safety and efficacy of bivalirudin in high-risk patients are unknown.We randomly assigned 3602 patients with ST-segment elevation myocardial infarction who presented within 12 hours after the onset of symptoms and who were undergoing primary PCI to treatment with heparin plus a glycoprotein IIb/IIIa inhibitor or to treatment with bivalirudin alone. The two primary end points of the study were major bleeding and combined adverse clinical events, defined as the combination of major bleeding or major adverse cardiovascular events, including death, reinfarction, target-vessel revascularization for ischemia, and stroke (hereinafter referred to as net adverse clinical events) within 30 days.Anticoagulation with bivalirudin alone, as compared with heparin plus glycoprotein IIb/IIIa inhibitors, resulted in a reduced 30-day rate of net adverse clinical events (9.2% vs. 12.1%; relative risk, 0.76; 95% confidence interval [CI] 0.63 to 0.92; P=0.005), owing to a lower rate of major bleeding (4.9% vs. 8.3%; relative risk, 0.60; 95% CI, 0.46 to 0.77; P<0.001). There was an increased risk of acute stent thrombosis within 24 hours in the bivalirudin group, but no significant increase was present by 30 days. Treatment with bivalirudin alone, as compared with heparin plus glycoprotein IIb/IIIa inhibitors, resulted in significantly lower 30-day rates of death from cardiac causes (1.8% vs. 2.9%; relative risk, 0.62; 95% CI, 0.40 to 0.95; P=0.03) and death from all causes (2.1% vs. 3.1%; relative risk, 0.66; 95% CI, 0.44 to 1.00; P=0.047).In patients with ST-segment elevation myocardial infarction who are undergoing primary PCI, anticoagulation with bivalirudin alone, as compared with heparin plus glycoprotein IIb/IIIa inhibitors, results in significantly reduced 30-day rates of major bleeding and net adverse clinical events. (ClinicalTrials.gov number, NCT00433966 [ClinicalTrials.gov].).
Predictive Value of Biological Markers for Hepatocellular Carcinoma Patients Treated with Orthotopic Liver Transplantation
Authors: Michelangelo Fiorentino, Annalisa Altimari, Matteo Ravaioli, Elisa Gruppioni, Elena Gabusi, Barbara Corti, Marco Vivarelli, Pierre-Paul Bringuier, Jean-Yves Scoazec, Walter Franco Grigioni, Antonia D’Errico-Grigioni
Journal: Clinical Cancer Research (2004)

Abstract Purpose: To help stratify candidates with hepatocellular carcinoma (HCC) for orthotopic liver transplantation (OLT), biomarkers are needed that are capable of predicting recurrence of disease (ROD). We investigated the prognostic role in this setting of immunohistochemical markers reported previously to predict poor prognosis in HCC patients treated with resection. Experimental Design: Eighty-three patients with HCC who underwent OLT between 1987 and 2001 with a minimum clinical follow up of 12 months were included in this retrospective study. We analyzed immunohistochemical expression of the adhesion molecules E-cadherin and β-catenin (membrane/nuclear localization), MIB-1 proliferative index and the cyclin-dependent kinase inhibitor p27, alongside the main clinical-pathological variables. Results: At univariate analysis, vascular thrombosis, high MIB-1 index, lower membrane expression of E-cadherin and β-catenin, and nuclear β-catenin localization were associated with ROD. At multivariate analysis, only MIB-1 index, low equal E-cadherin (with respect to non-neoplastic surrounding tissue), and nuclear β-catenin appeared as independent predictors of ROD. The logistic regression analysis model indicated that detection of any one parameter was associated with at least 88% estimated risk of ROD (up to 99% for all three). Conclusions: We propose these three molecular parameters as an additional tool for rational selection of OLT candidates among HCC patients (stratification according to the risk of ROD might help provide a similar life expectancy for cirrhotic candidates with and without HCC).
Multiple Myeloma in the Very Old: An IASIA Conference Report
Authors: Sascha A. Tuchman, Gary R. Shapiro, William B. Ershler, Ashraf Badros, Harvey J. Cohen, Angela Dispenzieri, Irene Q. Flores, Bindu Kanapuru, Donald Jurivich, Dan L. Longo, Ali Nourbakhsh, Antonio Palumbo, Jeremy Walston, Jerome W. Yates
Journal: JNCI Journal of the National Cancer Institute (2014)

Multiple myeloma (MM) in patients aged greater than 80 years poses an increasingly common challenge for oncology providers. A multidisciplinary workshop was held in which MM-focused hematologists/oncologists, geriatricians, and associated health-care team members discussed the state of research for MM therapy, as well as themes from geriatric medicine that pertain directly to this patient population. A summary statement of our discussions is presented here, in which we highlight several topics. MM disproportionately affects senior adults, and demographic trends indicate that this trend will accelerate. Complex issues impact cancer in seniors, and although factors such as social environment, comorbidities, and frailty have been well characterized in nononcological geriatric medicine, these themes have been inadequately explored in cancers such as MM, despite their clear relevance to this field. Therapeutically, novel agents have improved survival for MM patients of all ages, but less so for seniors than younger patients for a variety of reasons. Lastly, both MM- and treatment-related symptoms and toxicities require special attention in senior adults. Existing research provides limited insight into how best to manage these often complex patients, who are often not reflected in typical clinical trial populations. We hence offer suggestions for clinical trials that address knowledge gaps in how to manage very old and/or frail patients with MM, given the complicated issues that often surround this patient population.
Trends in Management for Patients With Localized Prostate Cancer, 1990-2013
Authors: Matthew R. Cooperberg, Peter R. Carroll
Journal: JAMA (2015)

This analysis uses data from the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) national registry to report on changes in the types of treatment patients with low-risk prostate cancer received from 1990 through 2013.
Phosphatidylinositol 3-kinase (PI3K) inhibitors as cancer therapeutics
Authors: Akintunde Akinleye, Parthu Avvaru, Muhammad Furqan, Yongping Song, Delong Liu
Journal: Journal of Hematology & Oncology (2013)

Phosphatidylinositol 3-kinases (PI3Ks) are lipid kinases that regulate diverse cellular processes including proliferation, adhesion, survival, and motility. Dysregulated PI3K pathway signaling occurs in one-third of human tumors. Aberrantly activated PI3K signaling also confers sensitivity and resistance to conventional therapies. PI3K has been recognized as an attractive molecular target for novel anti-cancer molecules. In the last few years, several classes of potent and selective small molecule PI3K inhibitors have been developed, and at least fifteen compounds have progressed into clinical trials as new anticancer drugs. Among these, idelalisib has advanced to phase III trials in patients with advanced indolent non-Hodgkin’s lymphoma and mantle cell lymphoma. In this review, we summarized the major molecules of PI3K signaling pathway, and discussed the preclinical models and clinical trials of potent small-molecule PI3K inhibitors.
SARCOMA OF THE UTERUS
Authors: J. H. Marsh
Journal: BMJ (1913)

RQitiarks.Diiimetih -l. 1 M. 35 Healthy 0 166N 2 M. 31 Healtlhy 0.182N 3 M. 17 Varicocele 0.182N 4 M. 29 Varicocele 0.16SN 6 days af ter opera- tioni, 0.156N. 5M. 20 Varicose veins 0.182N 8 days after opera- tion, 0.182N. 6M. 20 Varicocele 0.16SN 9 days afteropera- tioll, ('.1SSN.7 F. 50 Dyspep3ia 0.165N 8 F. 47 Dyspep3ia 0.182N 9 F. 48 Gall stones 0.182N 10 F. 63 Pernicious anaemiia 0.166N Haeino!lobi, 25 p)2r cent. 11Al. 50Tuberculous hip 0.166N 12 M. 55 Gall stones 0.166N _. 13 M. 42 Varicose veins 0.182N 6 days after opara- tion, 0.182N.14 M. 27 Inguinal hernia 0.182N 15 F. 18 Diabetes 0.166N U r i n e contains di-tcetic acid aul acetone.16 F. 45.Phlebitis 0.166N 17 M. 40 Malaria anid dysentery 0.153N 18 M. 36 Lipolma of hackl 0.182N 19 M. 33 Colitis 0.166N -20 M. 28 App2ndicitis 0.132N 21 F. 32 Endomietritis 0.18 :N Average ... ... 0.173NTABLE III.-Six Doubtfutl Cases
170 HEPATOGENOUS DIABETES MELLITUS IN LIVER CIRRHOSIS: RELATIONSHIP WITH PORTAL PRESSURE AND VARICEAL HEMORRHAGE
Authors: M.Y. Kim, S.K. Baik, C.S. Won, J.W. Byun, H.J. Park, H.J. Choi, Y.O. Jang, S.Y. Park, Y.H. Kwon, D.J. Kim, J.H. Kim, G.J. Cheon, Y.D. Kim, S.J. Lee, D.H. Choi
Journal: Journal of Hepatology (2010)
Cell differentiation in human gastric gland as revealed by nuclear binding of tritiated actinomycin.
Authors: G L Stoffels, A M Preumont, M De Reuck
Journal: Gut (1979)

The nuclear binding of H3 actinomycin, which is closely linked to the differentiation phenomenon, was studied in human normal gastric mucosa. Actinomycin binding decreases in cells which differentiate and becomes very low in fully differentiated cells. In the gastric pits, there is a decreasing gradient of labelling from the deeper stem cells to the well-differentiated superficial cells. This indicates that migration and renewal of the surface epithelium occurs following a 9pipe-line9 system. All the undifferentiated stem cells are labelled. Where the parietal cells are concerned all degrees of labelling are observed at various levels with a decreasing proportion of labelling from the surface to the bottom of the gland. With mucous cells and chief cells in the upper part of the gland a great number of poorly labelled mucous neck cells is observed. In the middle and lower part of the gland there is a new growth of heavily labelled cells. This means that in the normal human stomach chief cells probably do not originate from mucous cells.
An effect of extrarenal beta adrenergic stimulation on the release of renin
Authors: Ian A. Reid, Robert W. Schrier, Laurence E. Earley
Journal: Journal of Clinical Investigation (1972)

The present study was undertaken to examine whether the beta adrenergic agonist, isoproterenol, increases plasma renin activity (PRA) by activation of intrarenal or extrarenal pathways. The effects of intravenous (i.v.) and renal arterial infusion of isoproterenol on PRA and renin secretion rate (RSR) were compared in anesthetized dogs. In 12 studies in 9 dogs i.v. infusion of isoproterenol (0.009-0.018 mug/kg per min) was associated with an increase in PRA from 14.7 to 35.7 ng/ml per 3 hr (P < 0.001). PRA decreased to 19.4 ng/ml per 3 hr (P < 0.001) after cessation of the infusion. In innervated kidneys RSR increased from 1640 to 5062 U/min (P < 0.02) and decreased to 2132 U/min after cessation of the infusion (P < 0.05). In denervated kidneys the control RSR was significantly lower (455 U/min) but still increased during i.v. infusion of isoproterenol to 2762 U/min (P < 0.001) and decreased to 935 U/min (P < 0.001) after the infusion was stopped. These changes in PRA and RSR were associated with an increase in cardiac output averaging 49% and a large decrease in total peripheral resistance. These effects of i.v. isoproterenol to increase RSR were not mediated by changes in renal perfusion pressure since this was held constant by adjusting a suprarenal aortic clamp. In addition, there were no changes in glomerular filtration rate, renal plasma flow, or electrolyte excretion in either denervated or innervated kidneys during i.v. infusion of isoproterenol, and the concentration of potassium in plasma was unchanged. Prior hypophysectomy abolished the antidiuretic effect of i.v. isoproterenol but did not prevent the effect on RSR. In contrast, renal arterial infusion of isoproterenol at the same dose had no apparent effect on PRA and RSR in seven studies in five dogs and also did not produce changes in cardiac output, peripheral resistance or renal hemodynamics. These results do not provide evidence for a role of intrarenal beta adrenergic receptors in the control of renin release and indicate that the effect of beta adrenergic stimulation with isoproterenol to increase the release of renin is mediated by an extrarenal mechanism. Since the effect of i.v. isoproterenol occurred in the absence of changes in plasma potassium concentration, renal perfusion pressure, glomerular filtration rate, renal plasma flow, and electrolyte excretion and was not abolished by renal denervation, the possibility must be considered that the effect on renin secretion is mediated by circulatory factors. The changes in systemic hemodynamics which occurred with i.v. but not renal arterial infusion of isoproterenol may be involved in the initiation of such a pathway.
Mortality and morbidity of reusing dialysers. A report by the registration committee of the European Dialysis and Transplant Association.
Authors: A J Wing, F P Brunner, H O Brynger, C Chantler, R A Donckerwolcke, H J Gurland, C Jacobs, N H Selwood
Journal: BMJ (1978)

The practice of reusing dialysers in renal units in the UK was surveyed by examining the patient questionnaires returned to the EDTA registration committee for 1976 and by a special questionnaire sent to all UK renal units. Altogether 65.6% of the 1785 patients treated with non-disposable dialysers and 49.6% of the 1109 treated with disposable dialysers reused their equipment. Reuse of dialysers caused some morbidity but no mortality. Most centres where disposable dialysers were used accepted that their reuse was necessary because of financial constraints and was ethically defensible.
On the Treatment of Empyema by Lister's Antiseptic Method
Authors: E. M. Skerritt
Journal: BMJ (1876)

THERE. have been, I believe, not more than three or four cases recorded in which Lister's antiseptic method has been applied to the treatment of empyema; and I cannot but think that its more extended use would result in substantial evidence of its value.Mly object in, relating the details of this case is to call attention specially to the antiseptic treat- ment of this disease, and to point out what appear to me to be its peculiar advantages.The patient was a boy, eight years of age, admitted on December Ist, 1874, into one of the children's wards in University College lbos- pital, under Dr. Sydney Ringer, who has kindly placed the notes of the case at my disposal.During the month of October previously, pus had been twice withdrawn from the left side of the chest by aspiration, with much temporary benefit.On admission, the ordinary signs of left pleuritic effusion were well marked ; the heart's apex was at the epigastrium, the side was enlarged andl dull throughout, and mucous rdldhs and weak breath-sounds were faintly audible.Evening temperature, 98 deg.Next day, December 2nd, I inserted the aspirator-trocar in the sixth interspace in the anterior axillary line, and withdrew twenty-eight ounces of greenish-yellow sweet pus.The apex of the heart came back to its normal position, the breath-sounds returned, and the boy was much relieved.The evening temperature was 98.4 deg.In two or three days, however, the temperature became irregular, and examination of the chest showed that fluid was reaccumulating; and on the 23rd, three weeks after the previous aspiration, the heart's apex was to the right of the ensiform cartilage, and the whole left side was again enla'rged and dull on-percussion.On that day, I removed thirty ounces of pus by aspiration, and the heart returned to its normal position.The boy was much relieved, but it was soon evident that the pleural cavity was filling again, and symptoms of hectic became marked; on several occasions there was a difference of about 4 deg.between the morning and evening temperatures, the highest temperature being 104.2 deg. on the evening of the 31st.By January 6th, the heart's apex was again to the right of the epigastrium, and the side was as full as ever.Accordingly, on the gth, at Dr. Ringer's visit, the patient was put under chloroform, and I inserted a drainage-tube in the sixth inter- * Read before the Glasgow Medico-Chirurgical Society.t A chart, showing Lhe temperature, pulse, and general course of the case, was handed round in the society.
The Exposure of Health Care Workers to Ribavirin Aerosol
Authors: B. Joseph Guglielmo
Journal: JAMA (1989)

<h3>To the Editor. —</h3> We would like to report the experience at the University of California, San Francisco, with aerosolized ribavirin. Ribavirin is a virostatic agent approved for the treatment of respiratory syncytial virus (RSV) in infants who do not require mechanical ventilation. While the drug currently is not approved for use in intubated patients, it has been administered via this route. However, considering the tendencies of the drug to crystallize in respiratory equipment, special care must be taken to ensure patency of the airway in these patients.<sup>1</sup> Morbidity and mortality secondary to RSV primarily occurs in premature infants and in those with underlying cardiopulmonary abnormalities.<sup>2</sup>The early trials with ribavirin suggest subjective improvement in severity of illness. Some studies report improved arterial oxygen tension and a decrease in viral shedding in patients who receive ribavirin.<sup>3</sup>The drug has not been found to alter the mortality associated
Immunoglobulin A nephropathy. Quantitative immunohistomorphometry of the tonsillar plasma cells evidences an inversion of the immunoglobulin A versus immunoglobulin G secreting cell balance.
Authors: M C Bene, G Faure, B Hurault de Ligny, M Kessler, J Duheille
Journal: Journal of Clinical Investigation (1983)

Primary IgA nephropathy (Berger's disease) is characterized by renal deposits of IgA, the origin of which is still unknown. However, several clinical and biological findings suggest that these immunoglobulins might have a mucosal origin, and that such patients should present mucosal abnormalities. This paper reports the results of the immunohistomorphometrical analysis of tonsillar plasma cells from seven patients suffering from Berger's disease and seven controls also with recurrent tonsillitis. IgG, IgA, and IgM-secreting cells were enumerated after immunofluorescent staining of serial frozen-cut sections from 20 tonsils. In controls, a predominance of the IgG-secreting population, similar to this reported in the literature was observed (65% of IgG secreting cells and 29% of IgA plasma cells), while an inversion in the patients' plasma cells percentages was evidenced (IgG:37%, IgA:56%). This increment in the IgA population was paralleled by an augmentation of the number of dimeric IgA-secreting cells (75% of IgA plasma cells), stained both for cytoplasmic IgA and J chain. In controls, the latter cells were in similar proportions as previously reported by others (45% of IgA plasma cells). These results demonstrate an imbalance in the IgA-producing system of patients with Berger's disease, which is in keeping with the hypothesis favoring a mucosal origin for the mesangial IgA present in their kidneys.
TAP, a novel T cell-activating protein involved in the stimulation of MHC-restricted T lymphocytes.
Authors: K L Rock, E T Yeh, C F Gramm, S I Haber, H Reiser, B Benacerraf
Journal: The Journal of Experimental Medicine (1986)

Five mAbs have been generated and used to characterize TAP (T cell activating protein) a novel, functional murine T cell membrane antigen. The TAP molecule is a 12-kD protein that is synthesized by T cells. By antibody crossblocking, it appears to be closely associated with a 16-kD protein on the T cell membrane also identified with a novel mAb. These molecules are clearly distinct from the major well-characterized murine T cell antigens previously described. Antibody binding to TAP can result in the activation of MHC-restricted, antigen-specific inducer T cell hybridomas that is equivalent in magnitude to maximal antigen or lectin stimulation. This is a direct effect of soluble antibody and does not require accessory cells or other factors. The activating anti-TAP mAbs are also mitogenic for normal heterogeneous T lymphocytes in the presence of accessory cells or IL-1. In addition, these antibodies are observed to modulate specific immune stimulation. Thus, the activating anti-TAP mAbs synergise with antigen-specific stimulation of T cells, while a nonactivating anti-TAP mAb inhibits antigen driven activation. These observations suggest that the TAP molecule may participate in physiologic T cell activation. The possible relationship of TAP to known physiologic triggering structures, the T3-T cell receptor complex, is considered. TAP is expressed on 70% of peripheral T cells and therefore defines a major T cell subset, making it perhaps the first example of a murine subset-specific activating protein.
Long-term Health Outcomes and Medical Effects of Torture Among US Navy Prisoners of War in Vietnam
Authors: D S Nice, C F Garland, S M Hilton, J C Baggett, R E Mitchell
Journal: JAMA (1996)

<h3>Objective.</h3> —To characterize incidence of illnesses and injuries from 1979 to 1993 in former naval aviator prisoners of war (POWs) from the Vietnam War and a comparison group of naval aviators from the same war. <h3>Design.</h3> —Cohort analytic study. <h3>Setting.</h3> —A US Navy primary care clinic. <h3>Participants.</h3> —Volunteer sample consisting of 70 former naval aviator POWs (white men, aged 47 to 69 years in 1993) and a comparison group of 55 naval aviators who served in Vietnam but were not POWs, matched on race, age, marital status, education, rank, year of entry into the navy, and pilot status. Subjects participated in an annual health screening program. This study reports data sampled on a biennial basis from subjects screened both in 1979 and 1993. <h3>Main Outcome Measure.</h3> —Medically diagnosed incidence of illness and injury based on a standard protocol. <h3>Results.</h3> —POWs had higher incidence rates than the comparison group did of disorders of the peripheral nervous system (relative risk [RR], 8.4; 95% confidence interval [CI], 2.7-25.9;<i>P</i>&lt;.001), joints (RR, 1.5; 95% CI, 1.2-2.0;<i>P</i>&lt;.006), and back (RR, 1.8; 95% CI, 1.0-3.0;<i>P</i>&lt;.037). These findings also were statistically significant according to Kaplan-Meier survival analyses that included 131 (95%) of 138 POWs and 115 (83%) of the 138 members of the comparison group. Survival analyses revealed that, in addition to these disorders, POWs had higher hazard rates of peptic ulcer (<i>P</i>&lt;.01). <h3>Conclusions.</h3> —During captivity, ropes, ratchet handcuffs, leg irons, or stocks were used to put tightly constrictive pressure around the extremities of POWs as a means of torture, resulting in painful ischemia and subsequent neuropathies. Being a former POW was associated with increased cumulative incidence rates of chronic disorders of the peripheral nervous system, joints, and back and an increased hazard rate of peptic ulcer.