tbuckley/cabot-search huggingface dataset:
Case 19-1993
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, Peter M. Mauch, Judith A. Ferry
Journal: New England Journal of Medicine (1993)

Case Records of the Massachusetts General Hospital from The New England Journal of Medicine — Case 19-1993 — A 39-Year-Old Man with Bilateral Renal Masses a Few Months after Treatment for Hodgkin's Disease, Stage IIA
P206 The Acceptability of Starting Non-Invasive Ventilation at Home to Patients with COPD and Their Carers
Authors: M Jawad, NK Gale, AM Turner
Journal: Thorax (2012)

<h3>Introduction</h3> Home non-invasive ventilation (NIV) is prescribed to patients suffering from severe chronic obstructive pulmonary disease (COPD) with chronic respiratory failure. Uncertainty exists regarding clinical efficacy and the effect on a patient’s quality of life (QOL) during long term use. This qualitative study aimed to explore the perceptions and experiences of healthcare professionals (HCPs) involved in the management of COPD patients, COPD patients themselves and the patient’s carers regarding the use of home NIV, with the aim of understanding decision making processes and improving its future use. <h3>Method</h3> 15 HCPs including doctors, nurses, physiotherapists and physiologists, 20 COPD patients with moderate to very severe disease and 4 carers (3 patient spouses and 1 patient sibling) were recruited to participate in a semi-structured interview from a tertiary NIV hospital, a hospital providing home NIV services and the community. All interviews were transcribed verbatim and analysed using framework analysis. <h3>Results</h3> Two major themes emerged from the interviews. The need for ‘adapting to home NIV’ was reported by all patients. This corresponds to the need for acceptance of the NIV and the ability to overcome NIV specific problems. Patients expressed that this change was forced upon them by their HCPs. It was evident from the interviews that carers also experienced this need for adaptation. Another theme that emerged from the interviews was of ‘negotiating the evidence’. HCPs reported that due to the lack of evidence and guidance available for home NIV use, they encountered difficulties when deciding which patients to start or continue on home NIV. Patients faced a dilemma of whether to accept the doctor’s ‘orders’ to use home NIV, despite distressing NIV experiences at hospital. Nevertheless improvements in the patient’s QOL, particularly in their day-to-day functions, were reported. <h3>Conclusion</h3> This study demonstrated that patients find the use of home NIV acceptable once they have adapted to it. Recommendations include providing patients with greater technical NIV support, a better experience of NIV at hospital and improving communication between HCPs and patients to allow for greater understanding of the patient’s perspective.
Abstract 123: Hormonal and genetic risk factors of soft tissue sarcoma in Sweden.
Authors: Philippe Wagner, Susanne Magnusson, Håkan Olsson
Journal: Cancer Research (2013)

Abstract BACKGROUND AND METHODS. The aetiology of soft tissue sarcoma (STS) is largely unknown. Merely a handful putative risk factors such as certain genetic syndromes, a positive family history of cancer/STS, specific chemical exposures and exposure to ionizing radiation have been identified. With respect to the genetic aetiology, most STS patients do not have a clear family history of cancer. Only in rare cases heritable or germline genetic abnormalities associated with cancer predisposition syndromes that manifest as STS have been identified. We study STS and cancer morbidity in first degree relatives (FDR) together with hormone related factors in the Swedish population in the years between the years 1988 and 2009 using a population-based case-control design. RESULTS. Our study is the largest on this topic to date, including 855 cases and 2024 controls. It identified protective effects of being shorter than your peers at age eleven with a relative risk (RR) of 0.5 (0.4 - 0.7). Having used oral contraceptives (OC), RR 0.6 (0.4 - 1.0), and high parity, RR 0.6 (0.3 - 0.9) comparing three or more children to none, also appeared to reduce the risk for STS. The reduction increased further comparing use for eleven years or more to use for three years or less, RR 0.2 (0.1 - 0.6). Those with an FDR with STS and with those with an FDR with cancer had increased risks, RR 5.16 (1.03 - 25.9) and 1.31 (1.05 - 1.65), respectively. The latter varied with sex and histological subtype. In men, the familial risk was significant for malignant fibrous histiocytoma/undifferentiated pleomorphic sarcomas (MFH), RR 2.21 (1.23 - 3.97) and was higher in younger men (P=0.015). In women, there was a significant overall familial risk when stratifying on OC use, RR 1.55 (1.06 - 2.26). This risk seemed to derive from a group of rare and unclassified tumours present mainly in retroperitoneum and visceral organs, RR 6.19 (0.54 - 71.2). CONCLUSIONS. STS are a heterogeneous group of tumours with possibly very different aetiologies. However, the genesis of sarcoma seems to be influenced by both sex and growth hormones as well as genetic factors. Studies are on the way of the molecular genetic background of these associations. Citation Format: Philippe Wagner, Susanne Magnusson, Håkan Olsson. Hormonal and genetic risk factors of soft tissue sarcoma in Sweden. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 123. doi:10.1158/1538-7445.AM2013-123
A Qualitative Analysis of Brain SPECT for Prognostication of Gross Motor Development in Children With Cerebral Palsy
Authors: S Y Yim, I Y Lee, C H Park, O H Kim
Journal: Clinical Nuclear Medicine (2000)

In this report, the authors assessed the clinical significance of decreased regional cerebral blood flow (rCBF) in the thalamus or cerebellar hemispheres in relation to gross motor performance in the children with cerebral palsy.Thirty-six children with bilateral spastic cerebral palsy (BSCP) underwent brain SPECT. Visual analysis was used for the brain SPECT interpretation. The rCBF in the thalamus or cerebellum was graded as normal, mildly decreased, or severely decreased. A marked decrease or near absence of rCBF in the thalamus or cerebellum was considered as severely decreased.All 36 children with BSCP had hypoperfusion in the thalamus or cerebellar hemispheres. Eight of 20 children (40%) with mildly decreased rCBF on brain SPECT had mild developmental delays. On the other hand, only 1 of 16 children (6.3%) with severe hypoperfusion in the thalamus or cerebellum had a mild developmental delay, and the remaining 15 of 16 children (93.8%) had severe developmental delays. There was good correlation between the degree of developmental delay and the severity of hypoperfusion in the thalamus or cerebellum (P = 0.023).The measurement of rCBF by Tc-99m ethyl cysteinate dimer brain SPECT appears to be valuable in prognostication of gross motor development in children with BSCP.
Abstract LB-24: Molecular subtypes of pancreatic adenocarcinoma with different biological characteristics and therapeutical responses
Authors: Anguraj Sadanandam, Eric A. Collisson, Peter Olson, William J. Gibb, Morgan Truitt, Adam Olshen, Margaret A. Tempero, Paul T. Spellman, Douglas Hanahan, Joe W. Gray
Journal: Cancer Research (2011)

Abstract Pancreatic ductal adenocarcinoma (PDAC) is an invariably lethal disease. Due to its late clinical presentation, surgical cure is attempted in only a minority, and resected patients usually recur quickly with incurable, metastatic disease. These attributes may reflect the variable and often disappointing responses seen when deploying the standard treatment, gemicitabine alone or in combination with other chemotherapeutic agents in unselected PDAC populations. Studies in other solid tumors have shown that heterogeneity in therapeutic responses can be anticipated by molecular differences between tumors, and targeting drugs specific to tumor subtypes in which they are predicted to be selectively effective can indeed improve treatment. Seeking to extend this new paradigm of personalized medicine to PDAC, we performed an integrative analysis of transcriptional profiles of human primary PDAC tumors (n = 143) and cell lines (n = 35). We have defined 62 gene (PDAssigner) signature that classifies the human PDAC tumors into three subtypes (classical, QM-PDAC and exocrine-like tumors) and present evidence that two (classical and QM-PDAC) of these three are present in human and mouse PDAC cell lines. Interestingly, we found that PDAC subtype classification is an independent predictor of overall survival, and patients with classical PDAC subtype tumors have significantly better survival than those with QM-PDA tumors. In addition, the expression of GATA6 (a transcriptional factor involved in the embryonic pancreas development) and KRAS (mutated in majority of PDACs) are functionally associated with classical PDAC subtype relative to QM-PDAC subtype. Intriguingly, treatment of PDAC cell lines with gemcitabine or erlotinib shows significantly differential and opposing responses between classical and QM-PDAC subtypes. Overall, we describe here a broadly integrative approach to PDAC subtype discovery and analysis that identifies gene expression signature with prognostic significance in primary patient samples and couples them with biological information and subtype specific drug responses. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr LB-24. doi:10.1158/1538-7445.AM2011-LB-24
NOVEL DEGRADABLE HYDROGEL CONTAINING HEPARIN IMPROVES THE THERAPEUTIC EFFECT OF MESENCHYMAL STROMAL CELLS FOR THE TREATMENT OF MYOCARDIAL INFARCTION
Authors: Giuseppe Malpasso, Maria Chiara Ciuffreda, Francesco Copes, Kyle Goetsch, Deon Bezuidenhout, Manuela Mura, Federica Pisano, Neil H. Davies, Massimiliano Gnecchi
Journal: Journal of the American College of Cardiology (2015)
Impact of PET-CT on initial staging and treatment of breast cancer
Authors: I. Sachelarie, K. Kerr, S. K. Boolbol, S. N. Gettinger, R. H. Blum
Journal: Journal of Clinical Oncology (2005)

684 Background: In patients (pts) with breast cancer, PET-CT is increasingly being used for staging, multimodality treatment planning, monitoring response to therapy, and follow-up. Our goal was to determine the utility of PET-CT for initial staging and treatment planning of pts with breast cancer. Methods: We performed a retrospective study of 32 breast cancer pts who underwent integrated PET-CT for initial staging between May 2003 and November 2004. Evidence of disease was determined clinically and histopathologically. Results: Thirty-two patients (age 30 to 73 years, mean 51) were included in this analysis. Clinical stage prior to PET-CT: stage 0 (2 pts), stage I (1 pt), stage II (18 pts), and stage III (11 pts). In detecting the primary breast mass, PET-CT had a false negative rate of 13%. A breast mass was not identified in 4 pts: 2 with DCIS, 1 with invasive ductal carcinoma < 1cm in size, and 1 with invasive lobular carcinoma 3 cm in size. Axillary lymph node (ALN) metastases were evident in 21 pts (66%), 17 by histopathology and 4 by clinical exam alone. For ALN metastases, PET-CT had an overall sensitivity of 91% (19/21 pts), specificity of 55% (6/11 pts), accuracy of 78% (25/32 pts), positive predictive value of 79% (19/24 pts), and negative predictive value of 75% (6/8 pts). Abnormal FDG uptake was also found in internal mammary nodes (3/32 pts) and supraclavicular lymph nodes (3/32 pts). PET-CT indicated unsuspected distant metastases in 5 pts (16%): 2 with liver metastases and 4 with bone metastases. PET-CT up-staged 11 pts (34%) and altered treatment planning in 12 (38%). Of these 12 pts, 4 had primary rather than adjuvant chemotherapy, 3 had palliative chemotherapy for metastatic disease, 2 had delayed treatment pending further work up, 2 had a change in surgical procedure, and 1 had a change in radiotherapy planning. Conclusions: In our retrospective study of newly diagnosed breast cancer, PET-CT up-staged 34% of pts and resulted in a change in multi-modality treatment planning in 38%. Prospective studies are necessary to further assess the utility of PET-CT compared to other imaging techniques in the staging and management of breast cancer. No significant financial relationships to disclose.
The Clinical Evaluation of Phenylindandione as an Anticoagulant
Authors: Oscar R. Kruesi, Fred J. Schilling
Journal: New England Journal of Medicine (1954)

IN 1944 indandione derivatives were reported by Kabat, Stohlman and Smith1 to be capable of producing hypoprothrombinemia in laboratory animals. These workers studied several compounds with different side chains, but only 2-phenyl-l, 3-indandione was found to have a hypoprothrombinemic effect comparable to that of Dicumarol. In their experience compounds with 3 ketone groups were more effective in producing hypoprothrombinemia than those with 2 ketone groups. In 1947 Meunier, Mentzer and Molho,2 during a study of chemical structures possessing activity against vitamin K, reported phenyl indandione or 2-phenyl-l, 3-indandione to be effective in its hypoprothrombinemic action in laboratory animals; its formula . . .
Abstract 4539: Selection of non-phophorylated peptide inhibitors of BRCA1.
Authors: E. Railey White, Zhong Ma, David E. Hacker, Jason M. Beckta, Melissa B. Huie, David C. Williams, Kristoffer Valerie, Matthew C. Hartman
Journal: Cancer Research (2013)

Abstract A growing body of literature suggests Breast Cancer-Associated Protein 1 (BRCA1) is important not only as a cause, but also as a target in the quest for cancer treatment. BRCA1 deficient cells treated with radiation as well as PARP inhibitors and other chemotherapeutics demonstrate a greater sensitivity than cells with wild type BRCA1. Inhibitors of BRCA1 would take advantage of this synthetic lethality and represent a significant advance in cancer treatment as well as an understanding of the biology of DNA repair. Despite significant study of BRCA1 protein and function, it is a large protein (208 KDa) that is still largely uncharacterized, but its N- and C-terminal domains have been described by significant structural data. The BRCT (BRCA1 C-Terminal) Domain is a phosphoprotein binding domain that is commonly mutated or lost in cancers and has a binding cleft seemingly very suitable for drug design. Small molecule screens have been conducted against this domain, but the resulting hits with moderate affinity have not been shown to induce BRCA1 deficient phenotypes. Phosphopeptides have also been studied as potential BRCA1 inhibitors, yet despite some having affinities in the mid-nanomolar range the presence of a phosphate is not without its pharmacologic challenges. We generated an mRNA display library with 1.3 x 10ˆ13 cyclized peptides covalently attached to the mRNA that encoded them. Eight rounds of selection exposing the library to a GST-BRCT fusion resulted in non-phosphorylated peptides that bind to a BRCT domain of BRCA1. The sequences resulting from the selection have common homologies and initial characterization has shown that these peptides may be the first viable non-phosphoserine containing inhibitors of BRCA1. Citation Format: E. Railey White, Zhong Ma, David E. Hacker, Jason M. Beckta, Melissa B. Huie, David C. Williams, Kristoffer Valerie, Matthew C. Hartman. Selection of non-phophorylated peptide inhibitors of BRCA1. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4539. doi:10.1158/1538-7445.AM2013-4539
The Japanese Experience with Vaccinating Schoolchildren against Influenza
Authors: Thomas A. Reichert, Norio Sugaya, David S. Fedson, W. Paul Glezen, Lone Simonsen, Masato Tashiro
Journal: New England Journal of Medicine (2001)

Influenza epidemics lead to increased mortality, principally among elderly persons and others at high risk, and in most developed countries, influenza-control efforts focus on the vaccination of this group. Japan, however, once based its policy for the control of influenza on the vaccination of schoolchildren. From 1962 to 1987, most Japanese schoolchildren were vaccinated against influenza. For more than a decade, vaccination was mandatory, but the laws were relaxed in 1987 and repealed in 1994; subsequently, vaccination rates dropped to low levels. When most schoolchildren were vaccinated, it is possible that herd immunity against influenza was achieved in Japan. If this was the case, both the incidence of influenza and mortality attributed to influenza should have been reduced among older persons.
F-18 Fluorodeoxyglucose Positron Emission Tomographic Imaging
Authors: CONSTANTIN DRAGOIESCU, EMILE F. I. COMANS, ANNEMARIE VAN RIEL, OTTO S. HOEKSTRA
Journal: Clinical Nuclear Medicine (2000)

Epithelioid sarcoma is a rare tumor that occurs almost exclusively in the distal extremities. The primary site in this case was seen with F-18 fluorodeoxygluclose (FDG) positron emission tomography (PET). This tumor exhibits various histologic growth patterns and diverse clinical presentations, and thus the diagnosis is often delayed for months or years. They have a tendency to spread to noncontiguous areas of skin, subcutaneous tissue, fat, and bone. Many case reports have suggested a causal relation to trauma. Treatment includes wide surgical excision, often involving amputation of the extremity, and regional lymph node dissection.
Jury awards $28bn to former smoker
Authors: Fred Charatan
Journal: BMJ (2002)

A Los Angeles jury has awarded $28bn (£18bn; €29bn) punitive damages to Betty Bullock, aged 64, of Newport Beach, California, a former smoker with lung cancer, against tobacco giant Philip Morris. It is the largest punitive damage amount ever awarded to an individual in a smoking case, and is likely to be reduced on appeal.

Michael Piuze, the lawyer who represented Ms Bullock, had won the previous record, $3bn, in California last year . 

In September the jury awarded Ms Bullock $750000 in economic damages and $100000 for pain and suffering. Mr Piuze said the jury had seen company documents that proved Philip Morris had engaged in a 50 year conspiracy to hide the harmful effects of its products.

Ms Bullock started smoking when she was 17. Her lawyer said she was in the final stages of her cancer and would “never see a penny” of the damages award.
AB0537 Rhupus: Myth or an Overlooked Fact. an Indian Perspective
Authors: N. Kulkarni, N. Nahar, M. Saluja, A. Venugopalan, A. Chopra
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Rhupus; is it an overlap or a distinct entity? First Described in 1960<sup>1</sup>, it has received scant attention. There are no diagnostic biomarkers. <h3>Objectives</h3> To study the clinical phenotype of RHUPUS <h3>Methods</h3> Subjects of RHUPUS were identified retrospectively from database maintained at Centre For Rheumatic Diseases, Pune maintained since 1996 and currently with records of over 35000 patients. The diagnosis was clinical and made by Rheumatologist. Clinical and investigations data, with focus on serology, was extracted pertaining to initial examination and follow up. Study Period 2000-2013. Auto antibodies reported were RF (Nephlometry, cut off 40IU/ml, Anti CCP (Second generation ELISA, cut off 5RU/ml), Anti dsDNA (ELISA, cut off 24IU/ml) and screening of ENA (ELISA, Western Blot) <h3>Results</h3> 114 patients with RHUPUS were identified. 57% satisfied 1987 ACR criteria for RA and 44% satisfied 1999 ACR criteria for SLE while 33% satisfied both. The onset was RA like in 50% patients. 56% had symmetrical small and large joint arthritis; 21% were erosive (XRay hands), 5% had subcutaneous nodules. 17% patients presented first as SLE with 7% having renal involvement, 26% neurological, 10% with discoid rash, 2% having serositis, 5% with cytopenias (none AIHA) and 7% had Raynaud9s (with digital gangrene). 67% patients were seropositive for Rheumatoid Factor, 42% for ACCP, 58% for ANA and 47% for Anti dsDNA. 50% patients with Predominant RA had serological ANA positivity while 30% with predominant SLE phenotype were detected to have ACCP. During follow up lesser systemic complications were recorded. Overall it appeared to have a better prognosis compared to aggressive RA or SLE. Articular deformities were usually mild. <h3>Conclusions</h3> This is probably the largest RHUPUS series reported. The phenotype is heterogenous with several overlap features (RA &amp; SLE) and merits detail immunogenetic exploration to endorse its distinct phenotype if any. It also suggests a relook at the new Classification Criteria9s for RA and SLE. <h3>References</h3> Toone et al. The American Journal Of Medical Sciences, 1960 <h3>Acknowledgements</h3> Arthritis Research &amp; Care Foundation – Center for Rheumatic Diseases. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.2891
PTH-021 Magnetic Anal Sphincter – a Novel Surgical Option for Management of Faecal Incontinence
Authors: R Tevlin, A Hanly, J Larkin, R O’Connell
Journal: Gut (2013)

<h3>Introduction</h3> Faecal incontinence (FI) is a common and distressing problem with diverse aetiology and a significant economic burden<sup>1,2</sup>. First-line therapy includes dietary modification, medication and biofeedback. Surgical options include sphincteroplasty, artificial bowel sphincter insertion, sacral nerve stimulation and stoma formation<sup>3</sup>. Recently, magnetic sphincter augmentation has been used successfully in gastro-oesophageal reflux disease<sup>4</sup>. A magnetic anal sphincter (MAS)(Torax Medical, Mn, USA) have been developed to reinforce an incompetent anal sphincter in FI. The MAS device consists of magnetic cores hermetically sealed within a series of titanium beads interlinked on independent titanium wires, forming a ring that rests around the external anal sphincter. The force required to separate the beads is approximately 100g, equivalent to normal defaecatory force<sup>5</sup>. <h3>Methods</h3> Three multiparous females (47–54 years) with severe FI had MAS devices implanted under general anaesthesia. Two had failed neuromodulation, one had a failed sphincteroplasty and one incontinence after neo-chemoradiotherapy and colo-anal anastomosis for cancer. A curved, anterior perineal incision allowed creation of an extrasphincteric circumanal tunnel. Under fluoroscopic guidance and with fastidious antiseptic technique, the appropriate size MAS was inserted. All were discharged the same day. <h3>Results</h3> Two patients with obstetric aetiologies reported significant improvement in continence at 6 weeks (St. Mark’s Score 19 to 4 and 14 to 5 (24 = max worst score). The third patient, with anterior resection syndrome, developed a recalcitrant wound infection with subsequent device extrusion and explantation. <h3>Conclusion</h3> MAS insertion is a novel, promising technique for management of FI. Further study is required prior to making definitive conclusions. <h3>Disclosure of Interest</h3> None Declared. <h3>References</h3> Mellgren A. Fecal Incontinence. <i>Surgical Clinics of North America</i> 2010; 90:185–194. Wald A. Fecal Incontinence in Adults. <i>New England Journal of Medicine</i> 2007; 356:1648–55. Lehur PA, Mc Nevin S, Buntzen S, Mellgren AF, Laurberg S, Madoff RD. Magnetic Anal Sphincter Augmentation for the Treatment of Fecal Incontinence: A Preliminary Report From a Feasibility Study. <i>Diseases of the Colon and Rectum</i> 2010; 53:1604–1610. Use of a magnetic sphincter for the treatment of GERD: a feasibility study. <i>Gastrointestinal Endoscopy</i> 2008; 67(2):287–294. Bharucha AE, Croak AJ, Gebhart JB, <i>et al.</i> Comparison of recto-anal axial forces in health and functional defecatory disorders. <i>American Journal of Physiology – Gastrointestinal and Liver Physiology</i> 2006; 290:1164–1169.