tbuckley/cabot-search huggingface dataset:
Relationship between respiratory symptoms and medical treatment in exacerbations of COPD
Authors: P. Calverley, R. Pauwels, C-G. Löfdahl, K. Svensson, T. Higenbottam, L-G. Carlsson, E. Ståhl
Journal: European Respiratory Journal (2005)

Exacerbations of chronic obstructive pulmonary disease (COPD) can be defined symptomatically or by healthcare contacts, yet the relationship between these events is unknown. Data were collected during a 1-yr study of the budesonide/formoterol combination in COPD patients, where exacerbations, defined by increases in treatment, were compared with daily records of respiratory symptoms, rescue medication use and peak expiratory flow (PEF). The relationship between changes in these variables and the medical event was examined using different modelling approaches. Data from the first exacerbation treated with oral corticosteroids and/or antibiotics and/or hospitalisation (event based) were available in 468 patients. Patients exacerbating were significantly more breathless and more likely to report cough than healthy patients, but did not differ in baseline spirometry. Exacerbations defined by changes in individual symptoms were only weakly related to event-based exacerbations; however, defined with 63% of such events being predicted from symptom changes. Changes in rescue medication use or PEF were poor predictors of event-based exacerbations. The mean peak change in symptoms was closely related to the onset of therapy. In conclusion, event-based exacerbations are a valid way of identifying acute symptom change in a chronic obstructive pulmonary disease population. However, daily symptom monitoring is too variable using the current diary cards to make individual management decisions.
Posterior sternoclavicular dislocation in a rugby player as a cause of silent vascular compromise: a case report
Authors: A H Mirza, K Alam, A Ali
Journal: British Journal of Sports Medicine (2005)

Background: Approximately 120 cases of posterior sternoclavicular joint (SCJ) dislocation have been documented in the medical literature since it was first described in 1824 by Sir Astley Cooper, a statistic which underlies its relative rarity. It is associated with high energy trauma, and although it may present innocently enough, it is a potentially life threatening injury. Case and Results: We describe a case in which there was no clinical evidence of complication, although CT imaging revealed complete obstruction of the brachiocephalic vein and impingement of the aorta. This required open reduction and a novel fixation technique was employed. The reduction was stable at 8 month follow up appointment as evidenced by CT scan. Conclusions: We acknowledge that this type of complication is well recognised but emphasise that it should not be managed complacently. A high index of suspicion is required to determine the presence of serious complications in this type of injury, which may manifest insidiously.
Early Lymphocyte Recovery Predicts Superior Survival after Autologous Hematopoietic Stem Cell Transplantation for Patients with Primary Systemic Amyloidosis
Authors: Luis F. Porrata, Morie A. Gertz, Mark R. Litzow, Martha Q. Lacy, Angela Dispenzieri, David J. Inwards, Stephen M. Ansell, Ivanna N.M. Micallef, Dennis A. Gastineau, Michele Elliott, William J. Hogan, Suzanne R. Hayman, Ayalew Tefferi, Svetomir N. Markovic
Journal: Clinical Cancer Research (2005)

Abstract Purpose: Absolute lymphocyte count recovery at day 15 (ALC-15) post-autologous stem cell transplantation (ASCT) is a powerful prognostic indicator for survival for multiple hematologic malignancies and metastatic breast cancer. The relationship of ALC-15 with clinical outcomes in primary systemic amyloidosis is unknown. Experimental Design: We evaluated 145 consecutive patients with primary systemic amyloidosis who underwent ASCT at the Mayo Clinic from 1996 to 2003. The ALC-15 threshold was set at 500 cells/μL based on our previous observations. Results: The median patient follow-up was 22 months (range, 3-87 months). Higher hematologic complete response was observed in patients with an ALC-15 ≥ 500 cells/μL compared with patients with an ALC-15 &amp;lt; 500 cells/μL (41% versus 21%, P &amp;lt; 0.0008, respectively). The median overall survival and progression-free survival times were significantly better for the 59 patients that achieved an ALC-15 ≥ 500 cells/μL compared with 86 patients with ALC-15 &amp;lt; 500 cells/μL (not reached versus 53 months, P &amp;lt; 0.0003 and not reached versus 27 months, P &amp;lt; 0.0001, respectively). Multivariate analysis showed ALC-15 to be an independent prognostic factor for overall survival and progression-free survival. Conclusions: ALC-15 ≥ 500 cells/μL is associated with significantly improved clinical outcomes following ASCT in patients with primary systemic amyloidosis.
Association of Urinary Sodium and Potassium Excretion with Blood Pressure
Authors: Andrew Mente, Martin J. O'Donnell, Sumathy Rangarajan, Matthew J. McQueen, Paul Poirier, Andreas Wielgosz, Howard Morrison, Wei Li, Xingyu Wang, Chen Di, Prem Mony, Anitha Devanath, Annika Rosengren, Aytekin Oguz, Katarzyna Zatonska, Afzal Hussein Yusufali, Patricio Lopez-Jaramillo, Alvaro Avezum, Noorhassim Ismail, Fernando Lanas, Thandi Puoane, Rafael Diaz, Roya Kelishadi, Romaina Iqbal, Rita Yusuf, Jephat Chifamba, Rasha Khatib, Koon Teo, Salim Yusuf
Journal: New England Journal of Medicine (2014)

Higher levels of sodium intake are reported to be associated with higher blood pressure. Whether this relationship varies according to levels of sodium or potassium intake and in different populations is unknown.We studied 102,216 adults from 18 countries. Estimates of 24-hour sodium and potassium excretion were made from a single fasting morning urine specimen and were used as surrogates for intake. We assessed the relationship between electrolyte excretion and blood pressure, as measured with an automated device.Regression analyses showed increments of 2.11 mm Hg in systolic blood pressure and 0.78 mm Hg in diastolic blood pressure for each 1-g increment in estimated sodium excretion. The slope of this association was steeper with higher sodium intake (an increment of 2.58 mm Hg in systolic blood pressure per gram for sodium excretion >5 g per day, 1.74 mm Hg per gram for 3 to 5 g per day, and 0.74 mm Hg per gram for <3 g per day; P<0.001 for interaction). The slope of association was steeper for persons with hypertension (2.49 mm Hg per gram) than for those without hypertension (1.30 mm Hg per gram, P<0.001 for interaction) and was steeper with increased age (2.97 mm Hg per gram at >55 years of age, 2.43 mm Hg per gram at 45 to 55 years of age, and 1.96 mm Hg per gram at <45 years of age; P<0.001 for interaction). Potassium excretion was inversely associated with systolic blood pressure, with a steeper slope of association for persons with hypertension than for those without it (P<0.001) and a steeper slope with increased age (P<0.001).In this study, the association of estimated intake of sodium and potassium, as determined from measurements of excretion of these cations, with blood pressure was nonlinear and was most pronounced in persons consuming high-sodium diets, persons with hypertension, and older persons. (Funded by the Heart and Stroke Foundation of Ontario and others.).
Meetings at the RSM
Authors: Michael Swash
Journal: Journal of the Royal Society of Medicine (2010)

I am in full agreement with Dr Walker.1 While the change from Proceedings of the RSM to JRSM was probably necessary I was opposed and, therefore, somewhat unpopular, at the time. In any case, it was never intended that there should be a complete cessation of reports from Sections or, better, of papers derived from Section proceedings. Dr Walker suggests a partial return to this practice, but an academic institution such as the RSM should publish a full list of papers given at its meetings, with reportage of the more important events and presentations. Such newsworthy items are important for the RSM's standing in the medical world, and not least for the education of the readers of the Journal. Clearly, compromise regarding length and space limitations will be necessary, but no doubt the Editor can deal with such issues.
Progress in Aptamer-Mediated Drug Delivery Vehicles for Cancer Targeting and Its Implications in Addressing Chemotherapeutic Challenges
Authors: Jie Zhu, He Huang, Shiwu Dong, Liang Ge, Yuan Zhang
Journal: Theranostics (2014)

Aptamers are novel oligonucleotides with flexible three-dimensional configurations that recognize and bind to their cognate targets, including tumor surface receptors, in a high-affinity and highly specific manner.Because of their unique intrinsic properties, a variety of aptamer-mediated nanovehicles have been developed to directionally transport anti-cancer drugs to tumor sites to minimize systemic cytotoxicity and to enhance permeation by these tumoricidal agents.Despite advances in the selection and synthesis of aptamers and in the conjugation and self-assembly of nanotechnologies, current chemotherapy and drug delivery systems face great challenges.These challenges are due to the limitations of aptamers and vehicles and because of complicated tumor mechanisms, including heterogeneity, anti-cancer drug resistance, and hypoxia-induced aberrances.In this review, we will summarize current approaches utilizing tumor surface hallmarks and aptamers and their roles and mechanisms in therapeutic nanovehicles targeting tumors.Delivery forms include nanoparticles, nanotubes, nanogels, aptamer-drug conjugates, and novel molecular trains.Moreover, the obstacles posed by the aforementioned issues will be highlighted, and possible solutions will be acknowledged.Furthermore, future perspectives will be presented, including cutting-edge integration with RNA interference nanotechnology and personalized chemotherapy, which will facilitate innovative approaches to aptamer-based therapeutics.
Re: IGF-1 Gene Polymorphism and Risk for Hereditary Nonpolyposis Colorectal Cancer
Authors: Stuart Reeves, Cliff Meldrum, Rodney J. Scott
Journal: JNCI Journal of the National Cancer Institute (2006)

Fig. 1. Kaplan – Meier analysis of time to onset of colorectal cancer for patients with 17 or fewer IGF-1 gene CA repeats ( red ) and patients with 18 or more CA repeats ( green ). The hatched curves represent 95% confi dence intervals. Kaplan – Meier analysis was used to conduct univariate analysis with mutation type and sex along with time to onset of colorectal cancer in regards to CA- repeat length. The age of diagnosis was used as the age of onset in all patients with colorectal cancer. For the unaffected mismatch repair gene mutation carriers, the age at last follow-up was used as the age of onset, and these subjects were censored in the analysis. All proportional hazard assumptions were verifi ed using Schoenfeld residuals, and statistical tests were two-sided and performed using Intercool Stata 8.2 (Stata Corp, College Station, TX).
A Giant Tumor of the Vulva
Authors: Ben J. Tatarowicz
Journal: JAMA (1963)

THE FIBROMAS and mixed fibromas of the vulva are not common. Of 23,000 admissions to the gynecologic service at Johns Hopkins Hospital, Leonard found only six cases of fibroma.<sup>1</sup>In 1938 Hellman et al<sup>2</sup>reported a benign tumor of the vulva which weighed 5,000 gm (11 lb). While such a growth in this region is truly of almost incredible proportions, the tumor weighing 12 kg (26 lb) reported here seems to be unequaled since the classical case reported by Buckner<sup>3</sup>in 1851. <h3>Report of a Case</h3> The patient, a 43-year-old white female, was admitted to the surgical service on June 8, 1955. The nature of her difficulty was not apparent until after she disrobed, when it was found that, with the aid of an ingenious sling, she supported an immense tumor between her thighs. Her history was normal. She was a Gravida II and Para II by
Fulminant Human Herpesvirus 6 Myocarditis in an Immunocompetent Adult
Authors: Golmehr Ashrafpoor, Laurent Andréoletti, Patrick Bruneval, Laurent Macron, Arshid Azarine, Antoine Lepillier, Nicolas Danchin, Elie Mousseaux, Alban Redheuil
Journal: Circulation (2013)
Identification of the first major allergen of a squid (Todarodes pacificus)
Authors: Hiroshi Miyazawa, Hiromi Fukamachi, Yoshimasa Inagaki, Gerald Reese, Carolyn B. Daul, Samuel B. Lehrer, Sakae Inouye, Masahiro Sakaguchi
Journal: Journal of Allergy and Clinical Immunology (1996)
Reference Chart Derived From Post–Stent-Implantation Intravascular Ultrasound Predictors of 6-Month Expected Restenosis on Quantitative Coronary Angiography
Authors: P. J. de Feyter, P. Kay, C. Disco, P. W. Serruys
Journal: Circulation (1999)

Intravascular ultrasound (IVUS)-guided stent implantation and the availability of a reference chart to predict the expected in-stent restenosis rate based on operator-dependent IVUS parameters may interactively facilitate optimal stent placement. The use of IVUS guidance protects against undue risks of dissection or rupture.IVUS-determined post-stent-implantation predictors of 6-month in-stent restenosis on quantitative coronary angiography (QCA) were identified by logistic regression analysis. These predictors were used to construct a reference chart that predicts the expected 6-month QCA restenosis rate. IVUS and QCA data were obtained from 3 registries (MUSIC [Multicenter Ultrasound Stenting in Coronaries study], WEST-II [West European Stent Trial II], and ESSEX [European Scimed Stent EXperience]) and 2 randomized in-stent restenosis trials (ERASER [Evaluation of ReoPro And Stenting to Eliminate Restenosis] and TRAPIST [TRApidil vs placebo to Prevent In-STent intimal hyperplasia]). In-stent restenosis was defined as luminal diameter stenosis >50% by QCA. IVUS predictors were minimum and mean in-stent area, stent length, and in-stent diameter. Multiple models were constructed with multivariate logistic regression analysis. The model containing minimum in-stent area and stent length best fit the Hosmer-Lemeshow goodness-of-fit test. This model was used to construct a reference chart to calculate the expected 6-month restenosis rate.The expected 6-month in-stent restenosis rate after stent implantation for short lesions in relatively large vessels can be predicted by use of in-stent minimal area (which is inversely related to restenosis) and stent length (which is directly related to restenosis), both of which can be read from a simple reference chart.
Specific Regulation of Noncanonical p38α Activation by Hsp90-Cdc37 Chaperone Complex in Cardiomyocyte
Authors: Asuka Ota, Jun Zhang, Peipei Ping, Jiahuai Han, Yibin Wang
Journal: Circulation Research (2010)

p38 is an important stress activated protein kinase involved in gene regulation, proliferation, differentiation, and cell death regulation in heart. p38 kinase activity can be induced through canonical pathway via upstream kinases or by noncanonical autophosphorylation. The intracellular p38 kinase activity is tightly regulated and maintained at low level under basal condition. The underlying regulatory mechanism for canonical p38 kinase activation is well-studied, but the regulation of noncanonical p38 autophosphorylation remains poorly understood.We investigated the molecular basis for the regulation of noncanonical p38 autophosphorylation and its potential functional impact in cardiomyocytes.Using both proteomic and biochemical tools, we established that heat shock protein (Hsp)90-Cdc37 chaperones are part of the p38alpha signaling complex in mammalian cells both in vitro and in vivo. The Hsp90-Cdc37 chaperone complex interacts with p38 via direct binding between p38 and Cdc37. Cdc37 expression is both sufficient and necessary to suppress noncanonical p38 activation via autophosphorylation at either basal state or under TAB1 (TAK1 binding protein-1) induction. In contrast, Cdc37 expression has no impact on p38 activation by canonical upstream kinase MKK3 or oxidative stress. Furthermore, Hsp90 inhibition results in p38 activation via autophosphorylation, and p38 activity contribute to apoptotic cell death induced by Hsp90 inhibition.Our study has revealed a so far uncharacterized function of Hsp90-Cdc37 as an endogenous regulator of noncanonical p38 activity.
P154 The improving lung cancer outcomes project: a study of the feasibility of a national reciprocal peer review and facilitated quality improvement programme
Authors: S. Jimenez, L. Martin, E. Aveling, G. Martin, I. Woolhouse
Journal: Thorax (2011)

<h3>Background</h3> Variation exists in lung cancer outcomes in the UK, which does not appear to be wholly explained by differences in case mix. The Improving Lung Cancer Outcomes Project aims to address this via a 2 year programme of national reciprocal peer review and facilitated quality improvement. We describe the feasibility and acceptability of delivering this programme over the first year. <h3>Methods</h3> All NHS trusts in England were invited to take part. Those who agreed were paired on the basis of contrasting results in four headline indicators from the national lung cancer audit. 15 pairs were randomised to the intervention arm and the remaining pairs acted as controls. The intervention group were invited to participate in workshops, reciprocal site visits, patient experience surveys and facilitated quality improvement (QI) work. Evaluation of this activity was performed using anonymous feedback, interviews with participants and observations of programme activities by external researchers. <h3>Results</h3> 92 of 156 (59%) trusts agreed to participate. The site visits for the 15 pairs in the intervention arm took 6 months to complete and were attended by a total of 210 MDT members. The visits were seen as supportive yet opened up the possibility of legitimate challenge to existing ways of working. All 30 trusts in the intervention group were represented in the first patient survey, which had an overall response rate of 49%. However returns for individual trusts were low which reduced perceived credibility in some cases. 71 QI plans were submitted by 29 of the 30 trusts. These focused on a range of areas including data collection, diagnostics, and access to clinical nurse specialists. Considerable revision of the QI plans was required to ensure alignment with the overall project aims. <h3>Conclusions</h3> We have demonstrated that reciprocal peer review and facilitated quality improvement planning is both feasible and acceptable as part of a national lung cancer improvement project. Organising timely site visits, providing credible patient feedback and maintaining the focus of quality improvement plans is challenging and requires considerable resource. The overall effect of the programme on patient experience and outcomes is awaited with interest.
Use of Intra-aortic Balloon Pump in a Japanese Multicenter Percutaneous Coronary Intervention Registry
Authors: Taku Inohara, Hiroaki Miyata, Ikuko Ueda, Yuichiro Maekawa, Keiichi Fukuda, Shun Kohsaka
Journal: JAMA Internal Medicine (2015)

of JAMA Internal Medicine.The authors used California Medicaid data to identify patients who were prescribed an antipsychotic medication.They then assessed what percentage of the patients had some form of glucose screening, a recommendation by the American Diabetes Association 2 for persons taking antipsychotic medications, in a yearlong period.Overall, 30.1% of individuals were screened.It would be fair to point out that the efficacy of screening for diabetes has not been well established.However, that less than one-third had such screening for a known adverse effect of antipsychotic medication use suggests opportunities for improvement in integrated health care.Among those who had at least 1 primary care visit during the year, the proportion screened was significantly higher at 35.6% vs 19.8% for those who had no primary care visit.To improve care for persons with serious mental illness, it will be necessary to break down the silos that separate the mental health and physical health care systems.Integrated care (care provided by a team of physical and mental health clinicians)-or at least colocated care (care provided by physical and mental health clinicians in the same place)-offers the promise of improving the physical health of individuals with mental illness, as well as the mental health of those seeking physical health services.
Hypoxia-Inducible Factor-1 Target Genes as Indicators of Tumor Vessel Response to Vascular Endothelial Growth Factor Inhibition
Authors: Duyen T. Dang, Sang Y. Chun, Kyunghee Burkitt, Masako Abe, Shaowei Chen, Pamela Havre, Nicola J. Mabjeesh, Elisabeth I. Heath, Nicholas J. Vogelzang, Marcia Cruz-Correa, Douglas W. Blayney, William D. Ensminger, Brad St. Croix, Nam H. Dang, Long H. Dang
Journal: Cancer Research (2008)

Antiangiogenic therapy improves survival in patients with advanced stage cancers. Currently, there are no reliable predictors or markers for tumor vessel response to antiangiogenic therapy. To model effective antiangiogenic therapy, we disrupted the VEGF gene in three representative cancer cell lines. HCT116 xenografts had low proportions of endothelial tubes covered by pericytes that stained with alpha-smooth muscle actin (SMA) antibody. Upon disruption of VEGF, HCT116(VEGF-/-) xenografts had significantly decreased tumor microvessel perfusion compared with their parental counterparts. Furthermore, HCT116(VEGF-/-) xenografts mounted a tumor-reactive response to hypoxia, characterized by the induction of hypoxia-inducible factor-1 (HIF-1) target genes. One highly induced protein was DPP4, a measurable serum protein that has well-described roles in cancer progression. In contrast, LS174T and MKN45 tumor xenografts had high proportion of endothelial tubes that were covered by SMA+ pericytes. Upon disruption of VEGF, LS174T(VEGF-/-) and MKN45(VEGF-/-) xenografts maintained tumor microvessel perfusion. As such, there were no changes in intratumoral hypoxia or HIF-1 alpha induction. Together, these data show that the extent of tumor vessel response to angiogenic inhibition could be correlated with (a) the preexisting coverage of tumor endothelial tubes with SMA+ pericytes and (b) differential tumor induction of HIF-1 target genes. The data further show that DPP4 is a novel marker of HIF-1 induction. Altogether, these preclinical findings suggest novel clinical trials for predicting and monitoring tumor vessel responses to antiangiogenic therapy.