tbuckley/cabot-search huggingface dataset:
Abstract 309: High Incidences of Postshock Asystole in VF with Low AMSA Values
Authors: Yongqin Li, Bihua Chen, Mi He, Weilun Quan, Ulrich Herken
Journal: Circulation (2014)

Purpose:  Early defibrillation is critical to survival from cardiac arrest. However, defibrillation is often followed by asystole or pulseless electrical activity (PEA) in the pre-hospital setting. These non-perfusing post-shock rhythms have been demonstrated to have a worse prognosis than primary asystole or PEA. In the present study, we used registry data of out-of-hospital cardiac arrests (OHCA) to investigate the relationship between pre-shock amplitude spectrum area (AMSA) value and incidence of post-shock asystole.   Materials and Methods:  A total of 543 patients treated by emergency providers following OHCA with VF as presenting rhythm were included in this study. All defibrillation shocks were attempted with ZOLL automated external defibrillators that employ rectilinear biphasic waveform. The sampling rate of the ECG was 250 Hz and only the initial shocks (120J) were analyzed. AMSA were calculated from a waveform episode of 2.05 seconds ending at 0.5 seconds before each shock attempt. Post-shock rhythms were annotated as VF, asystole/PEA and tROSC. tROSC was defined as an organized rhythm that was present for a minimum of 30 seconds, started within 60 seconds after the shock, and had a rate of 40 beats per minute or greater.   Results:  The post-shock rhythms and associated AMSA readings are displayed in the Figure. The occurrence of post-shock asystole was exponentially decreased as AMSA value increased. Among those cases with AMSA   Conclusions:  In this patient population, for VF with very low AMSA (
An international prospective study of the psychometric properties of the EORTC Satisfaction With Care Measure (EORTC QLQ SAT-32)
Authors: A. Brédart, A. Bottomley, J. Blazeby, T. Conroy, W.-C. Chie, E. Hammerlid, J. Arraras, M. Costantini, S. Schraub, C. Fleissner
Journal: Journal of Clinical Oncology (2005)

6030 Background: Little is known on patients perception of the quality of care received in oncology hospitals across various cultural contexts. Within the EORTC, we developed a standardised 32-item satisfaction with care questionnaire to evaluate the competence of hospital doctors and nurses, as well as aspects of care organisation and hospital environment. This study aimed to assess the psychometric robustness of the EORTC QLQ-SAT32 in a large cross-cultural group of patients. Patients and Methods: Cancer patients (pts) discharged from a surgery or medical ward of oncology hospitals in 9 countries were invited to complete the EORTC QLQ-SAT32 at home and return it in a self-addressed envelope. Results: Of 762 pts recruited, 15% failed to return the questionnaire. 63% completed the questionnaires within 15 minutes and 82% requested no help. Multitrait scaling analysis provided excellent internal consistency and convergent validity estimates. However scales were highly inter-correlated. The EORTC QLQ-SAT32 did not correlate with the EORTC QLQ-C30, providing evidence of quality of life being an independent concept of satisfaction with care. Besides, the various scales of EORTC QLQ-SAT32 were able to discriminate between patients in terms of care expectations or intention to recommend the ward. Test-retest on 113 patients showed high reliability on all scales, with intraclass correlation coefficients above 0.70 for most scales. Conclusions: This study provides evidence of the validity, reliability and sensitivity of the EORTC QLQ-SAT32 scales. This questionnaire should help foster improved response to cancer patients care needs across oncology settings from various cultural contexts. No significant financial relationships to disclose.
Effect of Daily Chlorhexidine Bathing on Hospital-Acquired Infection
Authors: Michael W. Climo, Deborah S. Yokoe, David K. Warren, Trish M. Perl, Maureen Bolon, Loreen A. Herwaldt, Robert A. Weinstein, Kent A. Sepkowitz, John A. Jernigan, Kakotan Sanogo, Edward S. Wong
Journal: New England Journal of Medicine (2013)

Results of previous single-center, observational studies suggest that daily bathing of patients with chlorhexidine may prevent hospital-acquired bloodstream infections and the acquisition of multidrug-resistant organisms (MDROs).
ERA 223: A phase 3 trial of radium-223 dichloride (Ra-223) in combination with abiraterone acetate (abiraterone) and prednisone in the treatment of asymptomatic or mildly symptomatic chemotherapy-naïve patients (pts) with bone predominant metastatic castration-resistant prostate cancer (mCRPC).
Authors: Matthew Raymond Smith, Chris Parker, Bertrand F. TOMBAL, Kurt Miller, Fred Saad, Fang Fang, Amily Zhang, Martin Kornacker, Celestia S. Higano
Journal: Journal of Clinical Oncology (2015)

TPS5082 Background: Ra-223, a first-in-class alpha-emitting radiopharmaceutical targeting bone metastases, reduced risk of death by 30% and delayed time to first symptomatic skeletal event (SSE) versus placebo (15.6 vs 9.8 mo; HR = 0.66) in phase 3 ALSYMPCA (Parker et al. NEJM 2013, Sartor et al. Lancet Oncol 2014). Ra-223 favorable safety profile and lack of significant toxicity support combining it with other agents. Abiraterone improved radiologic progression-free survival (rPFS) and overall survival (OS) (Ryan et al. NEJM 2012) in chemotherapy-naïve men with mCRPC; it has no overlapping toxicity with Ra-223. This study investigates efficacy and safety of Ra-223 + abiraterone versus abiraterone alone in chemotherapy-naïve pts with mCRPC to bone. Methods: This phase 3, double-blind, placebo-controlled, multinational trial (ERA 223, NCT02043678) will randomize ~ 800 pts with asymptomatic or mildly symptomatic chemotherapy-naïve, bone-predominant mCRPC 1:1 to receive abiraterone (oral 1000 mg daily) and prednisone (oral 5 mg twice daily) + Ra-223 (50 kBq/kg IV) q 4 wk for 6 cycles or matching placebo until an SSE or death. Stratification is by geographic region, concurrent use of denosumab or bisphosphonates, and total alkaline phosphatase. The primary end point is SSE-free survival. Secondary end points include OS; time to opiate use for cancer pain, pain progression, and cytotoxic chemotherapy; rPFS; and acute and long-term safety. Pts are assessed at each treatment visit for efficacy, safety, and health-related quality of life, and every 3 months for progression and long-term safety. Pts who complete all study treatment and have no SSE enter active follow-up. Long-term follow-up begins after pts experience an SSE and ends 7 years after the last Ra-223 dose or at death, loss to follow-up, or withdrawal. SSE-free survival will be analyzed using a stratified log-rank test, accounting for stratification. Kaplan-Meier estimates will be produced for both treatment groups. As of January 15, 2015, 118 pts were screened. Clinical trial information: NCT02043678.
The Science and Practice of Surgery
Journal: JAMA (1935)

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Randomized phase III study of weekly <i>nab</i>-paclitaxel plus gemcitabine versus gemcitabine alone in patients with metastatic adenocarcinoma of the pancreas (MPACT).
Authors: Daniel D. Von Hoff, Thomas J. Ervin, Francis P. Arena, E. Gabriela Chiorean, Jeffrey R. Infante, Malcolm J. Moore, Thomas E. Seay, Sergei Tjulandin, Wen Wee Ma, Mansoor N. Saleh, Marion Harris, Michele Reni, Ramesh K. Ramanathan, Josep Tabernero, Manuel Hidalgo, Eric Van Cutsem, David Goldstein, Xinyu Wei, Jose Luis Iglesias, Markus Frederic Renschler
Journal: Journal of Clinical Oncology (2013)

LBA148 Background: nab-Paclitaxel (nab-P, 130 nm albumin-bound paclitaxel) provides tumor selective localization via transcytosis across the endothelium, potential tumor uptake via macropinocytosis, and improved pharmacokinetics vs cremophor-paclitaxel. In vitro, nab-P increased tumoral gemcitabine (G) levels, and in a phase I/II study in metastatic pancreatic cancer (mPC) nab-P + G showed promising activity. Methods: Patients (pts) with mPC were randomized to nab-P 125 mg/m 2 , followed by G 1000 mg/m 2 on days 1, 8, and 15 every 4 weeks or G 1000 mg/m 2 weekly for 7 weeks (cycle 1), then on days 1, 8, and 15 every 4 weeks (≥ cycle 2). For the primary endpoint of overall survival (OS), 608 events from 842 patients provided a power of 0.9 to detect a HR of 0.769 (2-side α = 0.049). Results: 861 pts received therapy. Baseline pt characteristics were well balanced. Median age was 63 years, Karnofsky performance status was 90-100 in 60% and ≤80 in 40% of pts, 43% had head of pancreas lesions, 84% had liver and 39% had lung metastases, and 52% of pts had CA19-9 ≥59 x ULN. Treatment duration was 4 vs 3 months in nab-P + G vs G. The relative protocol G dose was 75% vs 85% in nab-P + G vs G; nab-P dose was 81%. OS, progression-free survival (PFS), time to treatment failure (TTF), and overall response rate (ORR) were significantly improved in the nab-P + G arm (Table). Most common grade ≥3 AEs were neutropenia (38% vs 27%), fatigue (17% vs 7%), and neuropathy (17% vs 1%) in the nab-P + G vs G arms. Grade ≥3 neuropathy improved to grade ≤1 in 29 days. Febrile neutropenia was reported in 3% (nab-P + G) vs 1% (G) pts. Conclusions: In this multinational, multiinstitutional study, nab-P + G was well tolerated and superior to G with statistically significant and clinically meaningful results in all endpoints and across subgroups. Clinical trial information: NCT00844649. [Table: see text]
Development of HER2-specific chimeric antigen receptor T cells for the treatment of breast-to-brain metastasis
Authors: Saul Priceman, Brenda Aguilar, Renate Starr, Dileshni Tilakawardane, Anthony Park, Ethan Gerdts, Wen-Chung Chang, Sarah Wright, Stephen J Forman, Christine E Brown
Journal: Journal for ImmunoTherapy of Cancer (2015)

Meeting abstracts Adoptive transfer of chimeric antigen receptor (CAR)-engineered T cells has demonstrated robust and durable clinical efficacy in patients with CD19+ B cell malignancies. Broader application of this approach to brain and other advanced solid tumors is an immediate goal for the
Antineuroblastoma activity of triterpenoids involves induction of apoptosis through inhibition of Akt/NF-κB prosurvival pathways
Authors: Xiaohua Gao, Yongbo Liu, Scott A. Dulchavsky, Subhash C. Gautam
Journal: Cancer Research (2007)

AACR Annual Meeting-- Apr 14-18, 2007; Los Angeles, CA

4877 

Neuroblastomas are high-risk primary brain tumors that are generally unresponsive or only weakly responsive to the currently available antineoplastic agents. The current median survival for glioblastoma patients is approximately one year, thus novel therapeutic agents are urgently needed. Oleanolic acid and ursolic acid are naturally occurring triterpenoids that have been used in traditional Asian medicine as anti-inflammatory and anti-cancer agents. Recently, synthetic oleanolic acid derivatives: 2-cyano-3,12-dioxooleana-1,9(11)-dien-28-oic acid (CDDO) and its C-28 methyl ester (CDDO-Me) and C-28 imidazole (CDDO-Im) have been shown to exhibit potent antitumor activity against diverse types of tumor cell lines, including leukemia, multiple myeloma, osteosarcoma, breast, lung, and pancreatic cancer cell lines; however, anticancer activity of these agents for brain tumors has not been reported. In the present study, we investigated the apoptosis-inducing activity of CDDOs in neuroblastoma cell lines U87MG, U251MG, and SK-N-MC. Cell growth/viability (MTS) and cytotoxicity (LDH release) assays demonstrated that neuroblastoma cell lines are least sensitive to the parent synthetic oleanolic acid triterpenoid (CDDO), but are highly sensitive to CDDO-Me and CDDO-Im at concentrations of 2.5-10 μM. CDDO-Me and CDDO-Im were equipotenent in their growth inhibitory activity. The primary mode of tumor cell destruction was apoptosis as demonstrated by significant increase in the number of hypo-diploid (sub-G1) and annexin V-binding cells. Induction of apoptosis was associated with activation of procaspases -3, -8, and -9, mitochondrial depolarization and the release of cytochrome c from the mitochondria. Furthermore, CDDO-Me inhibited the levels of anti-apoptotic and prosurvival p-Akt, NF-κB (p65) and Notch1 signaling molecules. These studies provide preliminary evidence for the potential use of these novel triterpenoids for clinical management of lethal brain neoplasms.
Reply
Authors: Amil M. Shah, Elisabeth Kraigher-Krainer, Deepak K. Gupta, Angela Santos, Brian Claggett, Burkert Pieske, Michael R. Zile, Adriaan A. Voors, Marty P. Lefkowitz, Milton Packer, John J.V. McMurray, Scott D. Solomon
Journal: Journal of the American College of Cardiology (2014)
Mutations in CACNA2D4 Cause Distinctive Retinal Dysfunction in Humans
Authors: Rola Ba-Abbad, Gavin Arno, Keren Carss, Kathleen Stirrups, Christopher J. Penkett, Anthony T. Moore, Michel Michaelides, F. Lucy Raymond, Andrew R. Webster, Graham E. Holder
Journal: Ophthalmology (2015)
Association of IL4 gene polymorphisms with asthma phenotype
Authors: Maria Vakharlovskaya, Maria Petrova, Tatyana Ivashchenko
Journal: European Respiratory Journal (2011)

Background: Asthma is a major chronic disease, and a lot of studies indicate that it is on the rise worldwide. The implication genes responsible for this disease may indicate pathways for therapeutic intervention and information about the prognosis of children from asthma's family. Genetic risk factors may be useful for identifying subtypes of asthma. Several lines of evidence suggest that the IL-4 gene is involved in the development of atopic asthma.

Objective: The objective of this study was to analyze the polymorphism -590 C/T IL-4 in the subgroups of patients with early-onset asthma (defined as asthma developing before 16 years of age) and later-onset asthma and in the group of population control.The genetic polymorphisms –590 C/T were studied by PCR-RFLP analysis

Results: The frequency of -590 C allele of the IL-4 gene was significantly higher in the group of patients with asthma (p = 0.0366) as compared to the population group. The analysis of distribution of the -590 C/- genotype showed significant increasing of the frequency of this genotype in the group of patients with later-onset asthma (p = 0.0231) as compared to the early-onset asthma group of patients. According to odds ratio value (OR=4.2 [CI:1.658-11.014]) -590 C/- genotype of the IL-4 could be responsible for 4-fold increase in the risk of later-onset asthma.

Conclusions: Asthma is caused by genetic and environmental factors and this chronic disease is genetically heterogeneous. Our data show that -590 C/T IL-4 polymorphism plays a role in disease formation and could be treated as a prognostic genetic marker of the risk of later-onset asthma.
Producing nitric oxide by pulsed electrical discharge in air for portable inhalation therapy
Authors: Binglan Yu, Stefan Muenster, Aron H. Blaesi, Donald B. Bloch, Warren M. Zapol
Journal: Science Translational Medicine (2015)

Generating nitric oxide from air by pulsed electrical discharge produces therapeutic levels of nitric oxide for inhalation and provides effective pulmonary vasodilation.
Increased Aortic Valve Calcification in Familial Hypercholesterolemia
Authors: Gert-Jan R. ten Kate, Sven Bos, Admir Dedic, Lisan A. Neefjes, Akira Kurata, Janneke G. Langendonk, Anho Liem, Adriaan Moelker, Gabriel P. Krestin, Pim J. de Feyter, Jeanine E. Roeters van Lennep, Koen Nieman, Eric J. Sijbrands
Journal: Journal of the American College of Cardiology (2015)
Modulation of chemically induced renal carcinogenesis by Chrysin via inhibition of oxidative stress, hyper-proliferation and inflammation at preclinical stage
Authors: Summya Rashid, Sarwat Sultana
Journal: Journal for ImmunoTherapy of Cancer (2015)

Meeting abstracts The present study was planned to investigate the chemopreventive efficacy of Chrysin (CH) against renal carcinogenesis in Wistar rats. Ferric nitrilotriacetate (Fe-NTA) is a potent nephrotoxicant and known renal carcinogen. CH is a natural flavonoid found in honey, propolis, blue
Enriching Careers in General Practice: Could the right contract improve morale?
Authors: S Handysides
Journal: BMJ (1994)

Many general practitioners still blame the 1990 contract for the problems in general practice, claiming it has reduced morale to levels of the 1950s and 1960s.The contract was introduced to improve the quality of care and to provide some measures of standards, but the government failed to convince general practitioners that the contract was what the profession needed.Further change seems inevit- able.Ideally a contract should improve efficiency, enable rationale planning, and ensure public accountability.This article gives the history of the 1990 contract and discusses changes which could be made towards reaching this ideal.
Exhaled breath condensate pH in exercise-induced bronchoconstriction
Authors: Andras Bikov, Gabriella Galffy, Lilla Tamasi, Dora Bartusek, Balazs Antus, Gyorgy Losonczy, Ildiko Horvath
Journal: European Respiratory Journal (2014)

Background  Exercise-induced bronchoconstriction (EIB) is the temporary narrowing of the airways caused by physical exercise. Its exact pathophysiology is unclear; however acute changes in airways pH may play a role. Exhaled breath condensate (EBC) pH was suggested as a surrogate indicator for airway acid-base status, but its value is also affected by volatile molecules and respiratory droplet dilution.   Objective  The aim of the study was to assess changes in EBC pH during exercise-induced bronchoconstriction.   Methods  Twenty-two asthmatic patients who reported breathlessness following exercise and sixteen healthy individuals participated in the study. Lung function test was performed and exhaled breath samples were collected for pH, dilution factor and volatile compound pattern measurements (Cyranose 320) pre-exercise and at 0, 10, 20 and 30 minutes after physical exercise challenge. FE NO  was also measured before exercise.   Results  EIB developed in 13 asthmatic subjects. In these patients, but not in the EIB-negative asthmatics (p=0.51), EBC pH reduced significantly during exercise (p=0.01). In addition, changes in EBC pH were related to the degree of bronchospasm only in the EIB-positive group (p=0.01, r=0.68). Exhaled volatile pattern altered (p 0.05).   Conclusions  The development of EIB was related to acute changes of EBC pH which suggest the role of airway pH decrease in the pathophysiology of EIB. Exercise-induced changes in exhaled biomarkers suggest methodological precautions to avoid physical exercise before performing exhaled breath tests.
Contrast-Enhanced Magnetic Resonance Imaging as the Newest Tool to Detect Transplant Coronary Artery Disease⁎⁎Editorials published in the Journal of the American College of Cardiology reflect the views of the authors and do not necessarily represent the views of JACC or the American College of Cardiology.
Authors: Pascal J. Goldschmidt-Clermont, Chunming Dong
Journal: Journal of the American College of Cardiology (2008)
High blood pressure is linked to increased risk of diabetes
Authors: Jacqui Wise
Journal: BMJ (2015)

<b>2402</b> <h3><b>Objectives</b></h3> Nuclear Medicine lung images are ordered to diagnose pulmonary embolism (PE). To do this, a perfusion and ventilation study is performed. If perfusion is normal, pulmonary embolism can be ruled out. If abnormal, a ventilation study is necessary for the diagnosis of PE. Most Nuclear Medicine departments use both ventilation and perfusion for every patient; however, Froedtert Hospital performs perfusion first on every patient, and only if abnormal, ventilation is done. This research compares the different radiation exposures between the two approaches. <h3><b>Methods</b></h3> Patients were acquired over the past year at Froedtert Hospital. The number of ventilations needed was compared to the total number of perfusions. Exposure (rad) of Tc99m MAA, Tc99m Aerosol and Xenon-133 was obtained for the lungs, liver, and kidneys, as well as total exposures when using a ventilation and perfusion study together. <h3><b>Results</b></h3> For MAA only, the exposure to the lungs, kidneys, and liver is 0.880 rad, 0.044 rad, and 0.072 rad, respectively. For an Aerosol and MAA study, the exposure is 0.976 rad, .080 rad, and 0.107 rad, respectively. For a Xe-133 and MAA study, the exposure is 0.996 rad, 0.115 rad, and 0.143 rad, respectively. The percent increase exposure for an Aerosol study was calculated to be 9.8% to the lungs, 45.0% to the kidneys, and 32.5% to the liver. The percent increase using Xenon is 11.6% to the lungs, 61.6% to the kidneys, and 49.5% to the liver. A graph of the kidneys and liver exposures can be seen below. <h3><b>Conclusions</b></h3> Recently, radiation exposure has been a huge concern. Those exposed to radiation are always taught to follow the ALARA principle. The results show that with ventilation there is a large increase in radiation exposure to the kidneys and liver, as well as the lungs. Also, the radiation exposure is much higher for Xenon than Aerosol. Froedtert Hospital follows ALARA by only doing necessary scans on patients. Last year, only 17% of patients were vented, and therefore 83% did not get unnecessary exposure. Less radiation is given to the patients, as well as less exposure to the technologists