tbuckley/cabot-search huggingface dataset:
Can infants without epiglottis learn to swallow
Authors: Marco Patrick Lurà, Daniel Trachsel, Jürg Hammer
Journal: European Respiratory Journal (2013)

Background: It is a common notion that the function of the epiglottis is to avoid aspiration during swallowing by occluding the introitus of the larynx. The safety of oral feedings and the risk of recurrent aspiration, respectively, are concerns in neonates with absent epiglottis.  Case: We report a 5 day-old term baby girl with stridor and severe cyanotic episodes during feeding and crying. Besides a significant laryngomalacia of the aryfolds, a cystic mass at the root of the tongue was seen by laryngoscopy. The epiglottis was hypoplastic, deformed, and adhering to the tongue base. The MRI confirmed a lingual cyst of about 1cm diameter in midline. Upon the surgical excision of the cyst most of the adhering rudimentary epiglottis was removed. Histology was consistent with a thyroglossal duct cyst. The neonate was left intubated for 7 days to secure the airway and the healing process. In the first days after extubation, the neonate required nasogastric tube feedings due to repeated aspirations with oral feeds. In the further evolution, however, oral feedings could be cautiously reintroduced. The girl could be discharged home 3 weeks after the intervention, fully breast-fed without noteworthy aspirations.  Conclusion: Our observation supports the notion that the epiglottis is not essential for aspiration-free feeding, even at this young age.
FOLFOXIRI plus bevacizumab versus FOLFIRI plus bevacizumab as initial treatment for metastatic colorectal cancer (TRIBE study): Updated survival results and final molecular subgroups analyses.
Authors: Fotios Loupakis, Chiara Cremolini, Carlotta Antoniotti, Sara Lonardi, Monica Ronzoni, Alberto Zaniboni, Giuseppe Tonini, Lisa Salvatore, Silvana Chiara, Chiara Carlomagno, Chiara Banzi, Francesca Negri, Lorenzo Marcucci, Carlo Barone, Gabriella Fontanini, Nicla Borrelli, Mirella Giordano, Elisabetta Macerola, Luca Boni, Alfredo Falcone
Journal: Journal of Clinical Oncology (2015)

3510 Background: The phase III TRIBE study met its primary endpoint by demonstrating that first-line FOLFOXIRI plus bev significantly prolongs PFS, as compared to FOLFIRI plus bev (Loupakis et al, N Eng J Med 2014). At a median follow-up of 32.2 months a preliminary OS analysis indicated a borderline OS improvement with FOLFOXIRI plus bev (HR = 0.79, p = 0.054) with a consistent effect across RAS (KRAS and NRAS codons 12, 13, 61) and BRAFV600E molecular subgroups. Methods: 508 pts were randomized to either FOLFIRI plus bev (Arm A, N = 256) or FOLFOXIRI plus bev (Arm B, N = 252). On available samples from RAS and BRAF wild-type (wt) pts (N = 129), also KRAS and NRAS codons 59, 117 and 146 were analysed by means of Sequenom MassArray, identifying a new "all wt" population (N = 93). Results: At a median follow-up of 48.1 months, in the ITT population, updated median OS for Arm B vs Arm A was 29.8 vs 25.8 months (HR = 0.80, 95%CI, 0.65-0.98, p = 0.030). Estimated 5-years OS rate were: Arm B, 24.9% vs Arm A, 12.4%. Molecular results were informative for 357 pts (70.3%). All wt patients had longer OS as compared to RAS mutant (HR = 0.70, p = 0.006) and to BRAF mutant (HR = 0.24, p < 0.001). The benefit from FOLFOXIRI plus bev was consistent across all molecular subgroups (Table 1). All wt pts treated with FOLFOXIRI plus bev reported a median OS of 41.7 months as compared to 33.5 months in the FOLFIRI plus bev group (HR = 0.75, 95%CI, 0.45-1.24). Conclusions: FOLFOXIRI plus bev significantly improves survival of metastatic colorectal cancer pts and the OS advantage increases over time. Benefit from FOLFOXIRI plus bev is independent of RAS and BRAF mutational status. All wt pts have a better outcome independently from the treatment arm. Notable results with FOLFOXIRI plus bev are achieved in all wt pts. Clinical trial information: NCT00719797. Arm A FOLFIRI+bev Median PFS (mos) Arm B FOLFOXIRI+bev Median PFS (mos) HR [95%CI] Arm A FOLFIRI+bev Median OS (mos) Arm B FOLFOXIRI+bev Median OS (mos) HR [95%CI] All wt (N = 93) 12.2 13.7 0.82 [0.53-1.26] 33.5 41.7 0.75 [0.45-1.24] RAS mut (N = 236) 9.5 12.0 0.82 [0.63-1.07] 23.9 27.3 0.95 [0.71-1.27] BRAF mut (N = 28) 5.5 7.5 0.56 [0.20-1.14] 10.8 19.1 0.60 [0.27-1.33]
Abstract 9795: Shifting Trends in Incidence and Mortality from Infective Endocarditis Among Medicare Beneficiaries
Authors: Behnood Bikdeli, Yun Wang, Nancy Kim, Mayur Desai, Vincent Quagliarello, Harlan M Krumholz
Journal: Circulation (2012)

Background: Infective endocarditis (IE) is the most serious cardiovascular infection in adults. The AHA guidelines in 2007 narrowed the indications for antibiotic prophylaxis for IE. Yet, little is known about recent IE trends among older adults (age≥65 years), who are a growing at-risk population in the United States. Methods: We used the Inpatient Medicare standard analytic files to identify 100% of fee-for-service (FFS) patients aged ≥65 with a primary or secondary diagnosis of IE from 1999 to 2010. We built a denominator file from Medicare administrative data to report IE hospitalizations per 100,000 beneficiary-years. Thirty-day and 1-year mortality rates were determined using the vital status files from the Centers for Medicare &amp; Medicaid Services. Results: Annually, over 20,000 FFS Medicare beneficiaries were hospitalized with IE. IE incidence was 84 per 100,000 patient-years in 1999, rose gradually to 103 per 100,000 patient years in 2005, and has had a slight decline thereafter (Table 1). From 1999 to 2007, 30-day and 1-year mortality rates remained high, ~15% and ~ 35% respectively. Mortality rates during 2008 were at 16% and 37% respectively; however, risk-adjusted analysis did not show a consistent rise in mortality rates from 2008 onwards. Conclusion: Although endocarditis is frequently cited as a rare condition with stable incidence, our findings signify the high burden of IE in older adults. We did not observe a major rise in IE hospitalizations or mortality rates after publication of AHA guidelines in 2007. Our observational study supports the safety of these recommendations.
Results of a pilot trial of fludarabine, mitoxantrone and rituximab in mantle cell lymphoma
Authors: A. Mohrbacher, A. U. Khan, A. Tulpule, B. M. Espina, N. Berman, L. Mark, D. Douer, D. I. Feinstein, A. Levine
Journal: Journal of Clinical Oncology (2004)

6697 Background: Mantle cell lymphoma is an aggressive disease not curable with standard chemotherapy. Median age is 65 years, and patients often cannot tolerate intensive regimens. Better therapies are needed. Methods: Patients with newly diagnosed or relapsed mantle cell lymphoma with no prior exposure to fludarabine and mitoxantrone were studied. Treatment consisted of fludarabine, 25 mg/m2 (F), IV days 1–3; mitoxantrone (M) 10 mg/m2 IV day 1, and Rituxan (R) 375 mg/m2 on day 1 (cycles 2–6 only). Therapy was given every 28 days. After completion of 6 cycles of FMR, 3 weekly maintenance doses of Rituxan were given. Results: To date, 14 male and 6 female patients with a median age of 60 years (range 41–87) have been accrued. Four patients (25%) relapsed from prior systemic chemotherapy including stem cell transplantation in 1. Stage III (n=2) or IV disease (n=17) was present in 95%, with bone marrow involvement in 14 (70%). Eight patients (40%) had an intermediate or high IPI score. Treatment has been well tolerated; the most common side effect was transient grade 3 or 4 neutropenia reported in 15 (75%) patients; transient grade 3 or 4 thrombocytopenia in 6 patients; and anemia observed in 5 patients. No grade 3 or 4 non-hematologic toxicity has been reported. Of 17 evaluable patients, complete remissions (CR) have been documented in 15 (88%, 95% CI=65–98%). Three patients are too early to evaluate for response. The CR rate was 67% for relapsed patients (2/3 evaluable) and was 93% (13/14 evaluable) for newly diagnosed patients. The median duration of complete remission is 14.6+ months (range 1.8+-33.2+). Six patients have relapsed after 12.8 to 33.5 months in CR. Three of these have been re-induced with FMR, with subsequent response. All 20 patients remain alive after a median follow-up of 16.4+ mos (range 1.0–39.6+). Conclusions: Combination therapy with fludarabine, mitoxantrone, and Rituxan (FMR) is a well tolerated regimen, even in older patients. FMR is highly active in patients with both newly diagnosed and relapsed mantle cell lymphoma. Larger studies of this regimen are warranted. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Berlex Inc.
Does it matter who requests HRCT scans
Authors: William Kent, Alexander Youzguin
Journal: European Respiratory Journal (2011)

Introduction: High resolution computerised tomography scanning (HRCT) is widely used for the investigation of interstitial lung disease (ILD) and bronchiectasis. If significant numbers of inappropriate scans were requested it could be argued that its use should be restricted to senior chest physicians only.

Methods: All HRCT scans performed over an eight month period between January - August 2009 at our hospital were identified and only those that had been performed as an initial investigation into suspected ILD/bronchiectasis were included. The xray card and clinic letters were analyzed to see who had requested them.

Results: 82 HRCT scans were eligible for inclusion. 30/43 (69.8%) of the scans requested by respiratory physicians confirmed the suspected diagnosis compared with 24/39 (61.5%) by non-respiratory physicians (p = 0.4892). 12/17 (70.6%) of the scans requested by respiratory trainees confirmed the diagnosis compared with 42/65 (64.6%) requested by consultant physicians (p = 0.7774).

![Figure][1] 



Conclusion: There was no significant difference in the number of negative scans requested by non-respiratory and respiratory physicians or between respiratory trainees and Consultants. We therefore suggest that the use of HRCT scanning should not be restricted to senior respiratory specialists.

 [1]: pending:yes
Social media could provide early warning of virus outbreaks
Authors: N. Hawkes
Journal: BMJ (2015)

Outbreaks of norovirus infection may be detected earlier through study of the hashtags used on Twitter by tweeters who have fallen ill, a project backed by the Food Standards Agency has found.

In an echo of the celebrated use of Google searches to predict the advance of flu epidemics, the agency has found that following the activity of tweeters complaining they have fallen ill can anticipate clinical evidence of the outbreak by two weeks. Last week the development work won first prize in the UK government’s Digital Awards, the chief scientist at the Food Standards Agency, Guy Poppy, told a briefing at the Science Media Centre in London on 11 November.

So far the technique has been tested only retrospectively, not for predicting future outbreaks. But Poppy suggested that if it can be developed it …
An Electron Microscope Study of the Cytophagocytosis of Sarcoma I Cells by Alloimmune Macrophages In Vitro 2
Authors: Velma C. Chambers, Russell S. Weiser
Journal: JNCI Journal of the National Cancer Institute (1973)

Journal Article An Electron Microscope Study of the Cytophagocytosis of Sarcoma I Cells by Alloimmune Macrophages In Vitro Get access Velma C. Chambers, Velma C. Chambers Search for other works by this author on: Oxford Academic PubMed Google Scholar Russell S. Weiser Russell S. Weiser Department of Microbiology, School of Medicine, University of Washington, Seattle, Wash. 98195 Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 51, Issue 4, October 1973, Pages 1369–1375, https://doi.org/10.1093/jnci/51.4.1369 Published: 01 October 1973 Article history Received: 29 June 1973 Accepted: 17 July 1973 Published: 01 October 1973
Abstract 13342: Patient Demographics, Clinical Characteristics, Medication Utilization, Medical Resource Use and Outcomes Associated with Patients with Symptomatic Peripheral Artery Disease
Authors: Monica Reed Chase, Prakash Navaratnam, Howard Friedman, Kim Heithoff, Ross J Simpson
Journal: Circulation (2014)

Background: Symptomatic peripheral artery disease (SPAD) [defined as intermittent claudication (IC) and/or critical limb ischemia requiring peripheral revascularization (PRV)] is associated with significant CV and PAD-related morbidity and mortality. However, the real world impact of SPAD has not been well characterized to date. Methods: An algorithm that selectively identifies SPAD patients using a combination of PAD related ICD-9 diagnostic and DRG codes, PRV CPT-4 procedure codes, and IC medication NDC codes was used to select study eligible patients from the MarketScan Commercial and Encounters database from 01/01/06 to 06/30/10. The earliest date of a record of SPAD was the index date and a period of 1 year pre- and 3 years post-index was the study time frame. Patients with stroke/TIA, with bleeding complications and contraindications to anti-platelet therapy were excluded. Descriptive statistics comparing patient demographics, clinical characteristics, medication utilization, medical resource utilization and outcomes (event risk estimates for MI, any stroke, revascularization (coronary and peripheral), limb amputation, acute ischemic event hospitalizations and costs) were generated. Results: A total of 16,663 patients (58.0% male; mean age (± SD) 67.2 ± 12.9 years) were identified with SPAD. SPAD patients had significant comorbidities with 31.5% CAD, 36.0% diabetes, 31.0% hyperlipidemia and 53.1% hypertension. Twenty percent (20%) of SPAD patients were on clopidogrel in the pre-index. Pre-index use of beta-blocker, ACE, ARB and statin use was 42.1%, 37.1%, 21.1% and 48.5% respectively. SPAD patients experienced CV events such as any stroke (8.9%), NSTEMI (4.1%), STEMI (4.8%) and UA (7.5%) in the post-index. SPAD patients also experienced a limb amputation (11.5%), endovascular PRV (17%), and open PRV (14.6%) in the post-index. Annualized SPAD-related hospitalization rates, inpatient costs and outpatients costs were significantly higher in the post-index (0.1 vs 0.01, $2,073 vs $175, $1,313 vs $936; all p&lt;0.0001). Conclusion: In an insured population, SPAD patients have low utilization of preventive medications, high rates of major vascular events (both CV and PAD related) and high costs.
Peripheral T-cell lymphomas have a worse prognosis than B-cell lymphomas: A prospective study of 361 immunophenotyped patients treated with the LNH-84 regimen
Authors: B. Coiffier, N. Brousse, M. Peuchmaur, F. Berger, C. Gisselbrecht, P.A. Bryon, J. Diebold
Journal: Annals of Oncology (1990)
Association between deficient mismatch repair system and efficacy to irinotecan containing first-line chemotherapy in patients with sporadic metastatic colorectal cancer.
Authors: J. Kim, Y. Hong, J. Lee, M. Ryu, H. Chang, S. Jang, M. Kim, C. Yu, T. Kim
Journal: Journal of Clinical Oncology (2010)

3579 Background: Colorectal cancer with deficient mismatch repair system (dMMR) has been associated with favorable prognosis in early-stage disease. The influence of dMMR on response to chemotherapy in metastatic colorectal cancer (mCRC) has not been fully defined yet. The aim of our study was to investigate the association between dMMR and efficacy outcomes to irinotecan-based first-line chemotherapy in patients (pts) with mCRC. Methods: Between January 2004 and April 2008, about 297 pts with sporadic mCRC received irinotecan-containing regimen as their first-line chemotherapy. Paraffin-embedded tissues were available in 200 pts and were included in this study. Expression of mismatch repair proteins was examined by immunohistochemistry and treatment outcomes were retrospectively reviewed. The tumors were defined dMMR if at least one of the MLH1 or MSH2 showed negative expression and others defined proficient MMR (pMMR). Response rate (RR), disease control rate (DCR), and progression-free survival (PFS) were compared between pts with dMMR and pMMR. Results: Deficient mismatch repair was found in 23 (11.5%) out of 200 evaluable pts of which 8 showed negative MLH1 expression, 11 showed negative MSH2, and 4 showed negative expressions in two of all. The overall RR was 47%; 45.8% (81/177) in pMMR and 56.5% (13/23) in dMMR, respectively, and there was no statistical difference between two groups (Table). The median PFS tended to be longer with 8.85 months (mo) (95% confidence interval [CI], 7.06-10.64) in pts with dMMR tumors compared to 6.82 mo (95% CI, 6.15-7.49) in pts with pMMR tumors, but the difference was not statistically significant (p=0.092). Conclusions: Efficacy outcomes to first-line irinotecan-based chemotherapy were not statistically different in mCRC pts either with pMMR or dMMR, but a trend toward longer PFS was observed in patients with dMMR. pMMR (n = 177) dMMR (n = 23) P value ORR 81 (45.8%) 13 (56.5%) 0.110 DCR (PR + SD) 138 (78.0%) 20 (87.0%) 0.145 PFS (mo) 6.82 mo 8.85 mo 0.092 No significant financial relationships to disclose.
Swedish ovarian cancer patients are found with a high frequency of human leucocyte antigen (HLA) A2, -B7, -B12, -B15 -B44 and -DRB1–4 haplotypes
Authors: K. Bergfeldt, Z. Gamzatova, B. Tholander, M. Bergdahl, B. Nordström, E. Hjerpe, G. Masucci
Journal: Journal of Clinical Oncology (2006)

20100 Background: There is an increased interest on the association between HLA markers and prognostic outcome in several cancer forms. We have previously reported that the high prevalence of the A2 allele in Scandinavia, which decreases with latitude in Europe, correlates to a similar decrease in ovarian cancer mortality among European countries. We have also published the association of this allele with severe prognosis in serous adenocarcinoma of the Ovary in stage III-IV. We now present a complete distribution of the HLA- A, -B -C and DRB1 alleles and haplotypes in relation to histology and clinical stage. Methods: An unbiased selection of epithelial ovarian cancer patients (n = 56) recorded by age, histology, stage and treatment were analyzed for HLA-A, -B, -C and -DRB1 genotypes by PCR/sequence-specific oligonucleotide hybridization procedure (PCR/SSOP). HLA frequencies from healthy Swedish bone marrow donors were used as comparison. Results: HLA-A2, -B7, -B15, -B44 as well as the A2, -B15, -DR4 haplotypes frequency are significantly higher than in the healthy Swedish population. We noticed a high concentration of this haplotypes among the serous adenocarcinomas. Seven patients were homozygotes for A2 allele (23%), two times the healthy Swedish population (12%), and 3 times the median frequency in Europe (8%). Six of these had the haplotype -A2, -B7. Conclusions: HLA-A2 homozygotes and some HLA-A2 -B and -DRb1 haplotypes are higher expressed than in healthy individuals. These observations corroborate the relevance of HLA in association with ovarian cancer, previously partially investigated. Ongoing studies consider the relationship of HLA-A2 and its haplotypes to possible oncogenes and prognosis in ovarian cancer. No significant financial relationships to disclose.
Should social psychologists create a disciplinary affirmative action program for political conservatives?
Authors: Richard A. Shweder
Journal: Behavioral and Brain Sciences (2015)

Abstract Freely staying on the move between alternative points of view is the best antidote to dogmatism. Robert Merton's ideals for an epistemic community are sufficient to correct pseudo-empirical studies designed to confirm beliefs that liberals (or conservatives) think deserve to be true. Institutionalizing the self-proclaimed political identities of social psychologists may make things worse.
Inhaled black carbon in the lower airways of London cyclists
Authors: Chinedu Nwokoro, Naseem Mushtaq, Clare Harrison, Mubin Ibrahim, Iain Dickson, Omar Hussain, Zoya Manzoor, Clare Ewin, Isobel Dundas, Jonathan Grigg
Journal: European Respiratory Journal (2011)

Background: Inhalable elemental black carbon (BC) from fossil fuel combustion impairs lung health. We recently developed a novel method for assessing internal dose of BC using the amount of BC phagocytosed by airway macrophages (AM). To date, the determinants of AM carbon in healthy individuals living in urban areas remain unclear. Personal external monitoring indirectly suggests that cyclists have high levels of BC exposure.

Aim: To compare AM carbon in healthy adult cycling (cyclist) and non-cycling (pedestrian) London commuters.

Methods: AM carbon was assessed in non-smoking urban commuters aged 18 to 40 yr. AM were sampled using sputum induction, imaged under light microscopy (x60) and the area of carbon in 50 random AM determined using image analysis (mean AM carbon, μg/m2).

Results: Cyclists and pedestrians had similar lung function and home-main road distance. Cyclists reported more weekly exercise but this difference did not reach significance (Table 1).

View this table:

Table 1. Demographics and baseline data





Cyclists had significantly more AM carbon than pedestrians (Chart 1).

![Figure][1] 

Chart 1. Alveolar macrophage carbon in cyclists vs pedestrians.





Conclusion: Cycling in London is associated with a higher internal dose of BC. These data suggest a need for low-pollution cycling routes.

 [1]: pending:yes
Clinical and Chemical Studies in Human Lactation.--IX
Authors: F. E. Hytten
Journal: BMJ (1954)

Although most studies in this country show that the proportion of women leaving hospital fully breast- feeding is between 80 and 90%, it is generally recognized that such statistics give almost no indication of the number of women who will be breast-feeding after, say, two or three months, since there is a rapid decline in the incidence of breast-feeding soon after leaving hospital.Nevertheless, hospital records provide information which is useful in elucidating many of the medical causes of difficulty in breast-feeding.Later on the picture be- comes much more complex owing to the intervention of "social " influences.Breast-feeding in hospital is relatively easy.The baby's nutritional demands are small during the first week or two, particularly in a well-heated hospital, and the mother, resting, with no domestic responsibilities, and with the reassuring presence of the medical and nursing staff, has ample time to devote to it and to cope with minor difficulties.The proportion of women who leave hospital "fully breast-feeding" depends to a considerable extent on the zeal with which breast-feeding is insisted upon by the medical and nursing staff.Read (1949), for example, reported 98% of 480 women leaving hospital on the twelfth day to be " entirely breast-feeding," but 15% were classified as " breast-feeding-poor and 26% as " breast-feeding-fair"; furthermore, 46% of the babies had not regained their birth weight.Hospital returns covering the whole of England and Wales showed that 84.9% of about 350,000 infants were wholly breast-fed when they left hospital (Ministry of Health, 1951). Dummer (1949) reported an incidence of 83.8% from a Hertfordshire hospital during 1946 and