tbuckley/cabot-search huggingface dataset:
P128 Practise Patterns in Idiopathic Pulmonary Fibrosis: Results of a UK Physician Survey
Authors: I Kausar, R Cameron, NC Eastmond
Journal: Thorax (2012)

<h3>Introduction and objectives</h3> Idiopathic pulmonary fibrosis (IPF) is a rare, progressive, fibrotic lung disorder that results in reduced lung capacity, disability and ultimately death. Its rarity, and the fact that many of its initial symptoms are common to other lung diseases, mean that it is often mis-diagnosed and patients can experience wide variations in standards of care. We conducted a survey of pulmonary physicians to better understand practise patterns and unmet needs in IPF . <h3>Methods</h3> In December 2010 – January 2011, a structured, quantitative survey was conducted with lung specialists in IPF and non-IPF specialist centres principally in five EU countries (Germany, Italy, Spain, UK, France [5EU]). The survey was extended to a further five countries where fewer physicians were targeted. The survey covered clinical practise patterns over the preceding 12 months. Data from the UK are presented here. <h3>Results</h3> The 5EU sample included 232 participating physicians. Of these, 26 were from the UK, with 15 from specialist IPF centres, and 11 from general lung clinics. Among the UK clinics, 46% of patients had stable IPF, versus 56% with progressive disease (51% versus 49% respectively for 5EU). Triple therapy (steroid + immunosuppressant + N-acetylcysteine [NAC]) was prescribed for 31% of UK patients versus 25% for 5EU. Nineteen percent of UK IPF patients went untreated, and a further 10% received palliative care. Steroid monotherapy was used in another 10% of UK patients, and 11% received steroid + immunosuppressant. NAC + steroids were used in only 5% of patients, and NAC alone in 6%. <h3>Conclusion</h3> IPF is a serious condition, but no standard therapy exists, and many patients receive no treatment or palliative care only. Current therapies are ineffective and unproven. At the time of the survey triple therapy remained prevalent; however, concerns have now been raised regarding AEs and risks of death and hospitalisation. There is therefore an unmet need for effective and well-tolerated therapies to enable a greater range of patients to be treated with agents that have been proven to be safe and effective in clinical trials.
Acquisition of Donor Strains of Cytomegalovirus by Renal-Transplant Recipients
Authors: Sunwen Chou
Journal: New England Journal of Medicine (1986)

To determine the source of post-transplantation cytomegalovirus (CMV) infection in renal-transplant recipients, viral isolates were collected from pairs of patients who received kidneys from the same cadaver. Among 36 pairs of recipients, CMV viruria or viremia occurred in both members of 4 pairs and in one member of 11 pairs. Restriction-enzyme analysis of viral DNA revealed 15 distinct strains of CMV among viral isolates from these 19 patients. In all four pairs in which both members shed CMV, both recipients shed the same strain, suggesting that the virus was of donor origin. In three of these pairs, one member had been seropositive for CMV before transplantation. One seropositive recipient was simultaneously shedding two strains of CMV after transplantation; one strain was of donor origin. Two patients who had CMV viruria before receiving grafts from a seropositive donor shed a different CMV strain two months after grafting. These findings indicate that cadaveric grafts can transmit an identifiable strain of CMV to recipients, and that seropositive recipients can be reinfected by a new CMV strain from the donor after transplantation.
AB0521 Differences in disease characteristics of patients with active psoriatic arthritis prior to adalimumab treatment who failed at least two antitnf-therapies in comparison to those who failed conventional dmards only
Authors: M. Koehm, F. Behrens, D. Thaci, B. Krummel-Lorenz, G. Greger, B. Wittig, H. Burkhardt
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> For the treatment of patients with active psoriatic arthritis (PsA) only antiTNF biologics are licensed. Therefore, failures to anti-TNF are often switched to another antiTNF treatment. In this study, characteristics of patients switching from conventional DMARDs to antiTNF (DMARD failures) are compared to those switching from previous antiTNF to Adalimumab (ADA) (anti-TNF failures). <h3>Methods</h3> A multicentre, prospective observational study included patients (n=2651) with moderate to severe PsA treated with ADA. Treatment response of ADA therapy when used as first-, second- or third/fourth line antiTNF-therapy regimen in clinical routine care in Germany was measured. Demographic Data previous to therapy was documented. Disease characteristics of those with DMARD inadequate response (n=2546) and those who failed antiTNF agents (two or more) (n=105) were compared. <h3>Results</h3> In both groups, the duration of PsA (9 vs. 10 years of disease duration) as well as the mean ages at start of ADA-therapy (49.3 to 48.7 years respectively) are comparable. Additionally, the value of body mass index (BMI) shows similarity (28.2 vs. 28.8 kg/m<sup>2</sup>). Patients who failed two or more biologicals prior to ADA show differences in disease duration of skin manifestations and in onset of the diseases: patients who failed biologicals have a younger age at onset of PsA (37.8 vs. 40.3 years), an earlier onset of psoriasis (28.3 vs. 31.7 years) and a longer disease duration of psoriasis (20.5 vs. 17.6 years). While disease activity of the musculoskeletal system is comparable in both groups (swollen joint count 8.5 vs. 8.7, DAS28 4.74 vs. 4.71, presence of enthesitis 27.5 vs. 27.7 %), skin disease activity is higher in patients who failed previous biological treatment (Target Lesion Score 8.0 vs. 6.1, Body Surface Area 11.2 vs. 8.9%). In addition, a higher systemic inflammation is seen in the group with antiTNF-failures (ESR 29.4 vs. 23.4 mm/h, CRP 18.8 vs. 13.9 mg/dL). <h3>Conclusions</h3> No significant differences in patient characteristics (Age, Sex, BMI) of DMARD failures and anti-TNF failures prior to ADA treatment are seen. By trend, an earlier onset of both, psoriasis and psoriatic arthritis, and higher levels of systemic inflammation are detectable in the anti-TNF failure group. <h3>Disclosure of Interest</h3> M. Koehm Grant/research support from: Abbott, F. Behrens Grant/research support from: Abbott, Consultant for: Abbott, D. Thaci Grant/research support from: Abbott, Consultant for: Abbott, B. Krummel-Lorenz Grant/research support from: Abbott, Consultant for: Abbott, G. Greger Employee of: Abbott, B. Wittig Employee of: Abbott, H. Burkhardt Grant/research support from: Abbott, Consultant for: Abbott
Tubulo-Interstitial Nephritis Associated with Polyomavirus (BK Type) Infection
Authors: Seymour Rosen, William Harmon, Alan M. Krensky, Paul J. Edelson, Billie L. Padgett, Brian W. Grinnell, Michael J. Rubino, Duard L. Walker
Journal: New England Journal of Medicine (1983)

We studied viral injury to the kidney in a six-year-old boy with hyperimmunoglobulin M immunodeficiency who presented with irreversible acute renal failure and eventually died after five months of dialysis. Renal biopsy at the time of his presentation revealed a predominantly tubulo-interstitial process with numerous viral inclusions that were identified as polyomavirus. Urine cultures showed a massive viruria with BK-type, polyomavirus. The kidney disease was end stage, with persistence of BK virus identified by morphologic techniques and by culture. DNA hybridization analysis showed virus in low concentration in the lymph nodes, spleen, and lungs. The marked viruria, the high concentration of BK virus, and the extensive distribution of viral antigen throughout the kidney all suggest that infection with BK virus was the basis of the severe renal parenchymal injury.
THU0406 Histological Findings of Spleen Affected by Adult Onset Still's Disease: an Analysis of 3 Cases
Authors: T. Sakairi, S. Okabe, Y. Ohishi, N. Sakurai, H. Ikeuchi, Y. Kaneko, A. Maeshima, K. Hiromura, Y. Nojima
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Diagnosis of adult onset Still9s disease (AOSD) is based on sets of several clinical and laboratory criteria, because no specific test is available. The differential diagnosis includes malignant lymphoma and infection. A recent case-series study using positron emission tomography/computed tomography (PET/CT) have shown that injected 18F-fluoro-deoxyglucose (FDG) accumulates in spleens of AOSD patients with high frequency up to 90.9%, along with bone marrow (100%) [1]. It is currently unknown which cell types contribute to the FDG retention in spleens of AOSD patients, while granulocytic hyperplasia in bone marrow reported as a common feature of AOSD may be responsible for the FDG uptake by bone marrow [2]. <h3>Objectives</h3> We aimed to present AOSD cases that underwent spleen biopsies to rule out malignant lymphoma. <h3>Methods</h3> Three AOSD patients (aged 31, 40 and 48 years) with high FDG accumulation in spleens and bone marrow (mean max SUV, 5.46 and 4.70, respectively) were subjected to percutaneous spleen and bone marrow biopsies, and specimens were histologically analyzed. The diagnosis of AOSD was made according to Yamaguchi criteria. <h3>Results</h3> Severe infiltration of neutrophils into red pulps was observed in all spleen biopsies (shown in image), which resembled acute splenitis caused by sepsis [3]. Plasmacytic hyperplasia was found in 1 among the 3 biopsies. In addition, we identified mild eosinophilic infiltration in each biopsy. Bone marrow examination revealed hypercellular bone marrow with granulocytic hyperplasia and histiocytic hemophagocytosis in 1, and normocellular bone marrow with normal myeloid/erythroid ratio in 2 among the 3 biopsies, which is inconsistent to the previous report [2]. <h3>Conclusions</h3> Our results indicate that neutrophils infiltrating in red pulps are relevant to the FDG-uptake by spleens among AOSD patients. Spleen biopsies are useful to differentiate AOSD from malignant lymphoma, but unable to exclude sepsis. <h3>References</h3> Yamashita, H., et al., Clinical value of F-fluoro-dexoxyglucose positron emission tomography/computed tomography in patients with adult-onset Still9s disease: A seven-case series and review of the literature. Mod Rheumatol, 2013. [Epub ahead of print] Min, J.K., et al., Bone marrow findings in patients with adult Still9s disease. Scand J Rheumatol, 2003. 32(2): p. 119-21. Feig, J.A. and S.J. Cina, Evaluation of characteristics associated with acute splenitis (septic spleen) as markers of systemic infection. Arch Pathol Lab Med, 2001. 125(7): p. 888-91. <h3>Disclosure of Interest</h3> : None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.1443
Clinical Importance of near-Diploid Tumor Stem Lines in Patients with Osteosarcoma of an Extremity
Authors: A T Look, E C Douglass, W H Meyer
Journal: New England Journal of Medicine (1988)

We determined the clinical value of flow-cytometric measurement of tumor-cell DNA content, which reflects the chromosome number (ploidy), in patients with osteosarcoma of an extremity. Hyperdiploid stem lines were identified in 25 of 26 tumor samples obtained at diagnosis from patients who did not have clinically overt metastases. Near-diploid tumor stem lines coexisted with hyperdiploid lines in 15 of these 25 cases; an isolated near-diploid line was present in the 26th case. All 26 patients underwent definitive surgery and then were treated uniformly with intensive adjuvant combination chemotherapy. Kaplan–Meier analysis of both relapse-free and overall survival times showed that the presence of a near-diploid tumor stem line was associated with improved outcome (P = 0.003 for each comparison). After a median follow-up time of three years, pulmonary metastases developed in only 2 patients in the group with near-diploid lines, in contrast to 7 of the 10 with hyperdiploid lines exclusively. Near diploidy remained significantly associated with improved relapse-free survival after adjustment for the influence of age, the only clinical variable that showed prognostic strength in this analysis (P<0.01; relative risk, 0.08; 95 percent confidence interval, 0.02 to 0.48). Our findings demonstrate the usefulness of flow-cytometric determination of tumor-cell ploidy for predicting the sensitivity of histologically high-grade osteosarcoma to chemotherapeutic agents. Patients with a near-diploid tumor stem line can be expected to respond favorably to adjuvant chemotherapy as used in this study, whereas those with only hyperdiploid lines should be considered as candidates for alternative therapy. (N Engl J Med 1988; 318:1567–72.)
Lack of Effect of Long-Term Supplementation with Beta Carotene on the Incidence of Malignant Neoplasms and Cardiovascular Disease
Authors: Charles H. Hennekens, Julie E. Buring, JoAnn E. Manson, Meir Stampfer, Bernard Rosner, Nancy R. Cook, Charlene Belanger, Frances LaMotte, J. Michael Gaziano, Paul M. Ridker, Walter Willett, Richard Peto
Journal: New England Journal of Medicine (1996)

Observational studies suggest that people who consume more fruits and vegetables containing beta carotene have somewhat lower risks of cancer and cardiovascular disease, and earlier basic research suggested plausible mechanisms. Because large randomized trials of long duration were necessary to test this hypothesis directly, we conducted a trial of beta carotene supplementation.In a randomized, double-blind, placebo-controlled trial of beta carotene (50 mg on alternate days), we enrolled 22,071 male physicians, 40 to 84 years of age, in the United States; 11 percent were current smokers and 39 percent were former smokers at the beginning of the study in 1982. By December 31, 1995, the scheduled end of the study, fewer than 1 percent had been lost to follow-up, and compliance was 78 percent in the group that received beta carotene.Among 11,036 physicians randomly assigned to receive beta carotene and 11,035 assigned to receive placebo, there were virtually no early or late differences in the overall incidence of malignant neoplasms or cardiovascular disease, or in overall mortality. In the beta carotene group, 1273 men had any malignant neoplasm (except nonmelanoma skin cancer), as compared with 1293 in the placebo group (relative risk, 0.98; 95 percent confidence interval, 0.91 to 1.06). There were also no significant differences in the number of cases of lung cancer (82 in the beta carotene group vs. 88 in the placebo group); the number of deaths from cancer (386 vs. 380), deaths from any cause (979 vs. 968), or deaths from cardiovascular disease (338 vs. 313); the number of men with myocardial infarction (468 vs. 489); the number with stroke (367 vs. 382); or the number with any one of the previous three end points (967 vs. 972). Among current and former smokers, there were also no significant early or late differences in any of these end points.In this trial among healthy men, 12 years of supplementation with beta carotene produced neither benefit nor harm in terms of the incidence of malignant neoplasms, cardiovascular disease, or death from all causes.
DISCORDANCE BETWEEN EXERCISE ECHOCARDIOGRAPHY AND FRACTIONAL FLOW RESERVE IN A PATIENT WITH MULTI VESSEL CORONARY ARTERY DISEASE, A DIAGNOSTIC DILEMMA FOR THE PERCUTANEOUS INTERVENTION: SHOULD WE HAVE FIXED THE RCA?
Authors: Peyman Naji, Nishant Sethi, Hani Kozman
Journal: Journal of the American College of Cardiology (2015)
Abstract 4112: De novo EGFR T790M mutation modifies outcome to second-line erlotinib in non-small cell lung cancer (NSCLC) according to metastatic site and upfront chemotherapy
Authors: Rafael Rosell, Miguel Angel Molina, Jose Javier Sanchez, Miquel Taron, Susana Benlloch, Teresa Moran, Enric Carcereny, Felipe Cardenal, Bartomeu Massuti, Ignacio Magri
Journal: Cancer Research (2011)

Abstract EGFR T790M mutation is associated with shorter progression-free survival (PFS) (12 months [m] vs 18 m; P=0.02). We hypothesized that the site of metastases (mets) and/or prior chemotherapy could also influence outcome in these p. Methods: The T790M mutation was assessed in 129 advanced NSCLC p by TaqMan assay in the presence of a peptide-nucleic acid designed to inhibit the amplification of the wild-type allele. Results: De novo T790M mutations were identified in 35% (45 of 129) of EGFR-mutant p before receiving erlotinib. The T790M mutation was detected more frequently in p with bone mets (35.6% vs 16.7%; P=0.03). PFS was 20 m for 58 p with a deletion in EGFR exon 19 (del 19) but without the T790M mutation vs 12 m for 23 p with both del 19 and the T790M mutation (P=0.03), but with no difference in MS between these two groups (31 m vs 29 m; P=0.56). PFS was 15 m for 26 p with the L858R mutation but without the T790M mutation vs 16 m for 22 p with both the L858R and T790M mutations (P=0.83), with no difference in MS between these two groups (27 m vs 21 m; P=0.81). When p with T790M were divided according to the presence of brain mets, PFS was 1 m for 4 p with brain mets vs 13 m for 41 p without brain mets (P=0.002), while MS was 6 m for p with brain mets vs 36 m for those without (P=0.009). No effect on PFS or MS was observed in p with the T790M mutation according to lung, liver, pleura or bone mets. In the multivariate analysis, the presence of the T790M mutation did not increase the risk of short MS (HR, 1.3; P=0.49), while having received prior chemotherapy was associated with longer MS (HR, 0.48; P=0.02). Conclusions: The de novo T790M mutation is a marker for poor prognosis in p with brain mets. Upfront chemotherapy can play a role in the management of NSCLC p with the de novo T790M mutation. 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 4112. doi:10.1158/1538-7445.AM2011-4112
Liver Morphology and Biochemistry in Eight Obese Patients Treated with Jejunoileal Anastomosis
Authors: Erik Juhl, Per Christoffersen, Helge Baden, Flemming Quaade
Journal: New England Journal of Medicine (1971)

Ten patients were treated for obesity with jejunoileal shunt operation. Liver biopsies were performed in seven both during and 10 to 27 months after operation. The degree of fatty infiltration showed no distinct trend. Steatosis increased in three, decreased in three and remained unchanged in one. Two liver specimens were entirely normal at follow-up examination. Serum aspartate transaminase and sulfobromophthalein retention tests showed a transient deterioration after surgery, but later improved as compared with preoperative values. Prothrombin values decreased, but remained within normal limits. All other liver-function tests were unchanged. The present investigation does not support the contention that jejunoileal shunt for obesity should be abandoned for fear of severe liver damage.
Adjuvant Therapy of Node-Negative Breast Cancer: Another Point of View
Authors: W. L. MCGUIRE
Journal: JNCI Journal of the National Cancer Institute (1988)

Journal Article Adjuvant Therapy of Node-Negative Breast Cancer: Another Point of View Get access WILLIAM L. MCGUIRE WILLIAM L. MCGUIRE Department of Medicine, The University of Texas, Health Science Center7703 Floyd Curl Drive, San Antonio, TX 78284 Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 80, Issue 13, 7 September 1988, Pages 1075–1076, https://doi.org/10.1093/jnci/80.13.1075 Published: 07 September 1988
<sup>99m</sup>Tc-anti-TNF-α antibody for the imaging of disease activity in pulmonary sarcoidosis
Authors: Roeland Vis, Gaurav Malviya, Alberto Signore, Jan C. Grutters, Bob Meek, Ewoudt M.W. van de Garde, Ruth G.M. Keijsers
Journal: European Respiratory Journal (2016)

Infliximab, a monoclonal antibody directed against tumour necrosis factor (TNF)-α, is used in the treatment of refractory sarcoidosis. However, the clinical response is variable and a tool to select responders beforehand is highly desirable. In this study we evaluated scintigraphy with technetium-99m ((99m)Tc)-labelled infliximab for the imaging of disease activity in patients with pulmonary sarcoidosis.10 patients were studied using single photon emission computed tomography/computed tomography (CT) 6 h and 20 h after intravenous administration of 370 MBq of(99m)Tc-infliximab. Correlation analysis was performed between tissue accumulation of(99m)Tc-infliximab and laboratory parameters (including soluble interleukin-2 receptor and angiotensin-converting enzyme), lung function parameters (including forced expiratory volume in 1 s and the diffusing capacity of the lung for carbon monoxide) and(18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT.Analysis showed selective and variable accumulation of(99m)Tc-infliximab in the target tissue. Accumulation correlated positively with all four laboratory parameters and negatively with all four lung function parameters, yielding better correlations than serum TNF-α levels or(18)F-FDG PET/CT.(99m)Tc-infliximab accumulation reflects thein situTNF-α expression in an individual patient and therefore provides valuable information on the presence of the biological target for anti-TNF-α therapy.
A Comparison of Magnesium Sulfate with Phenytoin for the Prevention of Eclampsia
Authors: Michael J. Lucas, Kenneth J. Leveno, F. Gary Cunningham
Journal: New England Journal of Medicine (1995)

Magnesium sulfate is used widely to prevent eclamptic seizures in pregnant women with hypertension, but few studies have compared the efficacy of magnesium sulfate with that of other drugs. Anticonvulsant prophylaxis with phenytoin for eclampsia has been recommended, but there are virtually no data to support its efficacy. Our objective was to compare magnesium sulfate with phenytoin in preventing seizures in hypertensive women during labor.