tbuckley/cabot-search huggingface dataset:
Screening, Case-Finding, and Outcomes for Adults With Unrecognized COPD
Authors: Fernando J. Martinez, George T. O’Connor
Journal: JAMA (2016)

Chronic obstructive pulmonary disease (COPD) is a common chronic disease of middle-aged and older adults, with an estimated prevalence of diagnosed COPD of almost 14 million individuals in the United States. 1 This condition leads to substantial morbidity, disability, impaired quality of life, increased health care costs, and mortality. 2In addition to persons with diagnosed COPD, it has been estimated that 60% of individuals living in the United States with obstructive lung disease have not been diagnosed 3 ; these individuals appear to experience impaired health status, 4 activities of daily living, 4 and outcomes. 3t is understandable that COPD, which has been defined as "a common preventable and treatable disease… characterized by persistent airflow limitation that is usually progressive," 2 may remain unrecognized.The irreversible airflow obstruction (ie, airflow obstruction that persists after inhalation of an inhaled bronchodilator) develops gradually over many years.A person with only mild airflow obstruction may truly be asymptomatic, especially if a sedentary lifestyle does not include vigorous exertion that might provoke dyspnea.A person with moderately advanced airflow obstruction might attribute gradually reduced exercise tolerance, such as dyspnea climbing stairs, to growing older or being "out of shape" and might not seek medical attention or think to mention reduced exercise tolerance to a physician seen for other reasons.In this context, the US Preventive Services Task Force (USPSTF) has undertaken a thorough systematic review 5 to update its 2008 report, assessing published evidence on the benefits and risks of screening for COPD among asymptomatic adults.This Evidence Report, 5 which supports the USPSTF Recommendation Statement, 6 both of which are published in this issue of JAMA, considers the accuracy of various screening tools, including screening questionnaires and prebronchodilator spirometry; whether screening for COPD improves the delivery and uptake of targeted preventive services or leads to benefits in terms of morbidity, mortality, or health-related quality of life; and the possible harms of screening for and treatment of mild to moderate COPD.This review and synthesis of the available evidence leads the USPSTF to recommend "against screening for COPD in asymptomatic adults" and to classify this as a D recommendation, indicating that "there is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits." 7The USPSTF notes that this recommendation applies only to asymptomatic adults who do not recognize or report respiratory symptoms to their clinician.Critical
Effect of PCI on Long-Term Survival in Patients with Stable Ischemic Heart Disease
Authors: Steven P. Sedlis, Pamela M. Hartigan, Koon K. Teo, David J. Maron, John A. Spertus, G.B. John Mancini, William Kostuk, Bernard R. Chaitman, Daniel Berman, Jeffrey D. Lorin, Marcin Dada, William S. Weintraub, William E. Boden
Journal: New England Journal of Medicine (2015)

Percutaneous coronary intervention (PCI) relieves angina in patients with stable ischemic heart disease, but clinical trials have not shown that it improves survival. Between June 1999 and January 2004, we randomly assigned 2287 patients with stable ischemic heart disease to an initial management strategy of optimal medical therapy alone (medical-therapy group) or optimal medical therapy plus PCI (PCI group) and did not find a significant difference in the rate of survival during a median follow-up of 4.6 years. We now report the rate of survival among the patients who were followed for up to 15 years.We obtained permission from the patients at the Department of Veterans Affairs (VA) sites and some non-VA sites in the United States to use their Social Security numbers to track their survival after the original trial period ended. We searched the VA national Corporate Data Warehouse and the National Death Index for survival information and the dates of death from any cause. We calculated survival according to the Kaplan-Meier method and used a Cox proportional-hazards model to adjust for significant between-group differences in baseline characteristics.Extended survival information was available for 1211 patients (53% of the original population). The median duration of follow-up for all patients was 6.2 years (range, 0 to 15); the median duration of follow-up for patients at the sites that permitted survival tracking was 11.9 years (range, 0 to 15). A total of 561 deaths (180 during the follow-up period in the original trial and 381 during the extended follow-up period) occurred: 284 deaths (25%) in the PCI group and 277 (24%) in the medical-therapy group (adjusted hazard ratio, 1.03; 95% confidence interval, 0.83 to 1.21; P=0.76).During an extended-follow-up of up to 15 years, we did not find a difference in survival between an initial strategy of PCI plus medical therapy and medical therapy alone in patients with stable ischemic heart disease. (Funded by the VA Cooperative Studies Program and others; COURAGE ClinicalTrials.gov number, NCT00007657.).
AB0550 Etiologic Profile of Interstitial Lung Disease in Internal Medecine
Authors: S. Toujani, F. Ajili, N. Ben Abdelhafidh, N. Boussetta, L. Metoui, I. Gharsallah, B. Louzir, S. Othmani
Journal: Annals of the Rheumatic Diseases (2014)

Background Interstitial lung disease (ILD) is a heterogeneous group of disorders that are classified together because of similar clinical and radiographic manifestations. However, prognosis and therapeutic response are influenced by the presence of an underlying cause. Objectives The aim is to study the etiologic profile of ILD in internal medicine. Methods A retrospective analysis of patients with ILD hospitalized in internal medicine department of military hospital from 2000 to 2013. Results We evaluated 44 patients (30 women, 14 men) with a mean age of 57 years. Among them, 32% were smokers. The most common symptom was progressive dyspnea occurring in 83% of cases. All the patients had abnormal chest radiographs, mainly confluent reticular infiltrates or diffuse reticulonodular shadowing. Pulmonary function tests were restrictive in pattern in 54% of the subjects. The most frequent disease was connective tissue disorders (CTD) - associated ILD (64% of all cases): Sjogren's syndrome (20%), systemic sclerosis (16%), systemic lupus erythematosus (11%), rheumatoid arthritis (9%), antisynthetase syndrome (5%) and dermatomyositis in one case. The diagnostic of both CTD and ILD was made at the same time in 57% of cases. ILD induced by drugs was observed in 16% followed by sarcoidosis in 11% of cases. Idiopathic pulmonary fibrosis was observed in 3 cases and Churg–Strauss syndrome in one case. Corticosteroid therapy was prescribed in 68% of variable dosage depending on the cause and severity of lung disease. Immunosuppressive treatment with cyclophosphamide was indicated in only 4 cases. The response to therapy was favorable in 48% of cases and not satisfactory in 25% of the cases. Conclusions Collagen and vascular diseases are more common than previously appreciated. A multi-disciplinary evaluation of patients with DPLD can enhance diagnosis, improve prognosis and quality of care. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.2378
Abstract 2875: Ceramide suffocates cancer cells to death: Regulation of mitophagy by ceramide signaling
Authors: Besim Ogretmen, David Sentelle, Can E. Senkal
Journal: Cancer Research (2011)

Abstract Sphingolipid ceramide is a bioeffector molecule involved in the regulation of cell death. Endogenous ceramides contain different fatty acid chain lengths varying between C12-C26-ceramides. Ceramide synthase 1 (CerS1) selectively regulates the generation of C18-ceramide, which is down-regulated in the majority of tumors obtained from patients with head and neck squamous cell carcinomas (HNSCC). Reconstitution of C18-ceramide generation using a tetracycline inducible vector system for stable expression of CerS1 inhibits the growth of HNSCC cells and xenografts in culture and SCID mice, respectively. In this study, our goal was to determine mechanisms by which CerS1/C18-ceramide inhibits HNSCC tumor growth. Data revealed that reconstitution of C18-ceramide generation by wt-CerS1 induction, but not its catalytically inactive mutant, induces autophagy as detected by various techniques in HNSCC cells. Interestingly, soft agar studies showed that CerS1/C18-ceramide induction inhibits HNSCC cell growth, which is prevented by addition of the autophagy inhibitor 3-methyladenine. In addition, knockdown of Atg3 and Atg7 in HNSCC cells protected against cell death induced by exogenous addition of the C18-ceramide therapeutic analog, C18-pyridinium-ceramide (C18-Pyr-Cer). Additionally, Atg5-/- MEFs showed resistance to cell death when compared to wild type MEFs upon C18-Pyr-Cer exposure. Taken together these results suggest that autophagy is required for cell death. Electron microscopy showed that addition of C18-Pyr-Cer to UM-SCC-22A cells induced autophagosome formation and fusion with mitochondria. Mechanistically, our studies showed that CerS1/C18-ceramide-induced cell death/inhibition of tumor growth are mediated by mitochondrial damage and inhibition of respiration via induction of mitophagy. Inducible expression of CerS1/C18-ceramide and C18-Pyr-Cer treatment resulted in significant decreases in mitochondrial oxygen consumption rates. Furthermore, live and fixed cell imaging with mitochondrial markers MitoTracker Red colocalized with lysosomal marker LysoTracker Red upon C18-Pyr-Cer treatment and CerS1/C18-ceramide induction indicating mitochondrial fusion with lysosomes. Conversely, ceramide-mediated mitophagy was inhibited using LC3B siRNA, suggesting that mitochondria might be targeted to autophagosomes by ceramide signaling. In conclusion, we provide novel evidence here which suggest that C18-ceramide targets autophagosomes to mitochondria (mitophagy), which results in the modulation of respiration/oxygen consumption, leading to HNSCC growth inhibition and tumor suppression. 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 2875. doi:10.1158/1538-7445.AM2011-2875
Severe duodenojejunitis in a case of adult-onset Henoch–Schönlein purpura
Authors: H. Matsumoto, N. Oshitani, K. Aomatsu, I. Suwa
Journal: Endoscopy (2011)

A 54-year-old woman with a 2-week history of left upper abdominal pain was admitted to our hospital. Joint pain was not reported. Abdominal CT scan revealed wall thickening from the third portion of the duodenum to the upper jejunum, with surrounding lymphadenopathy. Single-balloon endoscopy (SBE) showed edema, hyperemia, and ulcers from the second portion of the duodenum to the upper jejunum, while the third portion of the duodenum showed more severe damage ([Fig. 1]).
P1-07-15: The Reliability of Ki-67 Expression Assessment Using Core Needle Biopsy and Surgical Specimens of Invasive Breast Cancer: Can Ki-67 Change Predict Benefits of Preoperative Endocrine Therapy?
Authors: Y Mizuno, H Takayanagi, K Sato
Journal: Cancer Research (2011)

Abstract Background: The use of Ki-67 change as a predictive marker in breast cancer has been widely investigated in patients treated with preoperative endocrine therapy. It has been assumed that Ki-67 expression determined using core needle biopsy and surgical specimens of invasive breast cancer is concordant. Many studies have suggested the concordance of the results obtained using core needle biopsy and surgical specimens for expression of the estrogen receptor (ER), progesterone receptor (PgR), and human epidermal growth factor receptor type2 (HER2) status in early-stage breast cancer. However, there was few study to compare Ki-67 expression in the core needle biopsy and surgical specimens. We conducted a retrospective study of Ki-67 expression assessment between the two types of specimens to answer this question. Methods: A total of 269 patients underwent primary operations for early-stage breast cancer at Tokyo-West Tokushukai Hospital from August 2008 to May 2011. Among these patients, 169 patients who received core needle biopsy prior to operation were enrolled. Patients with ductal carcinoma in situ and those with neoadjuvant chemotherapy were excluded. A cutoff value of 20% was used for Ki-67-positive criteria. We also examined ER, PgR, and HER2 expression and compared it with Ki-67 expression. Statistical significance for concordance rates between the two types of specimens was evaluated by Wilcoxon t-test. To evaluate the consequence of formalin and genetic heterogeneity, parameters such as operative method and tumor size were analyzed by χ2 analysis. Results: The concordance rate between the two types of specimens for Ki-67 expression was 76%, and this was significantly lower than that for ER expression, which was 96%. The concordance rates for PgR and HER2 expression were 88% and 91%, respectively, and they were not significantly different from the rate for Ki-67 expression. 45 patients(34.6%) had received mastectomy in the Ki-67 concordant group, and 14 patients(34.1%) in the discordant group. 55 patients(42.0%) showed T2∼ tumor size in the concordant group, 13 patients(31.7%) in the discordant group. No significant differences of parameters such as operative method (mastectomy vs breast conserving surgery) and tumor size (T1 vs T2∼) were observed between the two patient groups. Conclusion: The reliability of Ki-67 concordance rate assessment using core needle biopsy specimens was significantly lower than that of ER expression. A standard pathological assessment of Ki-67 expression might be needed for the possible use of Ki-67 as a predictive marker for preoperative endocrine therapy. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-07-15.
Spontaneous in Vitro Reduction of Nitroblue Tetrazolium by Neutrophils of Adult Patients with Bacterial Infection
Authors: George Matula, Philip Y. Paterson
Journal: New England Journal of Medicine (1971)

The spontaneous reduction of colorless nitroblue tetrazolium (NBT) to intracellular blue-black formazan deposits by neutrophils of 192 adult subjects was evaluated as a rapid, laboratory aid in the diagnosis of bacterial infection. Sixty-one of 65 patients with bacterial infection had more than 10 per cent formazan-positive neutrophils. Conversely, 101 of 102 subjects without bacterial infection, the majority of whom had inflammatory disease on some other basis, showed NBT responses of less than 10 per cent formazan-positive neutrophils. Elevated NBT responses were associated with a wide variety of infectious diseases due to classic pyogenic bacteria as well as nocardia and malarial parasites. Elevated positive responses soon returned to negative after initiation of effective therapy. Positive NBT responses could be induced in vitro with bacterial culture filtrates or high concentrations of endotoxin.
Championing Effectiveness Before Cost-Effectiveness
Authors: Sanket S. Dhruva, Harlan M. Krumholz
Journal: JACC Heart Failure (2016)

The proliferation of costly therapies has led to an increased focus on value. In the treatment of patients with advanced heart failure (HF), one such expensive intervention, CardioMEMS (CardioMEMS Heart Failure System, St. Jude Medical Inc., Atlanta, Georgia), is a permanently implanted device to
GE-26 * ASSOCIATION BETWEEN FLUORESCENCE IN SITU HYBRIDISATION (FISH) PROBE RATIO SCORES AND SURVIVAL IN 1p/19q CO-DELETED GLIOMAS
Authors: M. Pinkham, C. McBain, D. DuPlessis, N. Telford, F. O'Neill, R. Gattamaneni, A. Tran, G. Whitfield
Journal: Neuro-Oncology (2014)

BACKGROUND: 1p/19q co-deletion is associated with improved overall survival (OS) and considered a binary result. Our objective was to assess if OS varies according to FISH probe ratio. METHODS: Consecutive patients with gliomas undergoing 1p/19q analysis from 2006-2014 were included. Minimum required follow-up was 6 months, unless death occurred sooner. Using FISH, a dual locus-specific probe ratio of ≤0.8 indicated chromosome deletion. Patients were stratified by ratios ≤0.6, 0.6 to ≤0.8, 0.8 to ≤1.0 and >1.0 for both chromosomes. Kaplan Meier survival curves were compared using the Log Rank test. RESULTS: There were 298 patients; 127 WHO grade II, 110 grade III, 34 grade IV (including 15 with oligodendroglial features) and 27 grade unknown. Median age was 46 years and median follow-up 28 months (range 0.5-93). Co-deletion was present in 138 (46%) patients. Median 1p and 19q ratios were 0.60 (IQR 0.57-0.64) and 0.59 (IQR 0.57-0.62) for the co-deleted population and 1.01 (IQR 0.97-1.05) and 0.99 (IQR 0.81-1.02) for the non-co-deleted population, respectively. The 5 year OS was 78% (95%-CI 68.0%-87.6%) for co-deleted and 43% (95%-CI 29.2%-52.0%) for non-co-deleted populations (p < 0.0001). There was no significant OS difference between patients with deletion of only 1p, only 19q or neither chromosome (p = 0.51). Within the co-deleted group, 5 year OS did not differ significantly for those with one or both ratios >0.6 (p = 0.62), but was significantly worse for those with both ratios ≤0.6 than for the rest combined (63.2%, 95%-CI 43.6%-77.6% versus 90.7%, 95%-CI 76.7%-96.5%, p = 0.005). CONCLUSIONS: This large single-institution series confirms a strong association between 1p/19q co-deletion and improved OS using ≤0.8 as probe ratio threshold. Isolated deletion of 1p or 19q did not confer better prognosis. Although unexpected, variability in survival within the co-deleted population may relate to tumour cell density. Collection of relevant prognostic factors is ongoing to explore this.
SP0160 What?s new in rehabilitation of systemic sclerosis?
Authors: A. Schouffoer
Journal: Annals of the Rheumatic Diseases (2013)

In patients with systemic sclerosis, physical disability may be a result of fibrosis in the internal organs as well as the musculoskeletal system. In recent years clinical studies evaluating effectiveness of rehabilitation demonstrated promising results (1). Rehabilitation modalities aiming to improve musculoskeletal impairment include heat application, range of motion and stretching exercise, massage and joint manipulation and splints. In order to improve functional capacity other brehabilitation programs contained aerobic exercise and strength or resistive exercises (2,3). This lecture aims to provide an overview of the safety and effectiveness of rehabilitation regiments in systemic sclerosis. <h3>References</h3> Poole JL. Musculoskeletal rehabilitation in the person with scleroderma. Curr Opin Rheumatol 2010; 22(2):205-12. Pinto AL, Oliveira NC, Gualano B, Christmann RB, Painelli VS, Artioli GG et al. Efficacy and safety of concurrent training in systemic sclerosis. J Strength Cond Res 2011; 25(5):1423-8. Schouffoer AA, Ninaber MK, Beaart-van de Voorde LJ, van der Giesen FJ, de JZ, Stolk J et al. Randomized comparison of a multidisciplinary team care program with usual care in patients with systemic sclerosis. Arthritis Care Res (Hoboken) 2011; 63(6):909-17. <h3>Disclosure of Interest</h3> None Declared
Hepatitis B Virus Infection in Dentists
Authors: James W. Mosley, Virginia M. Edwards, Gerard Casey, Allan G. Redeker, Edward White
Journal: New England Journal of Medicine (1975)

To evaluate viral hepatitis as a hazard in general dentistry, we surveyed participants in an annual health-screening program at the 1972 American Dental Association session. Of 1245 practitioners, 0.9 per cent were positive for hepatitis B surface antigen, and 12.7 per cent were antibody positive. Of those who had had clinical hepatitis while studying or practicing dentistry, 43 per cent were seropositive. The frequency of evidence for prior infection with hepatitis B virus increased uniformly with increasing years of professional experience. The proportion of seropositive dentists did not vary with geographic region of the United States, or size of community. Only 10.5 per cent recognized illicit self-injection among patients, and their infection rate was not increased. These data indicate an increased frequency of infection with hepatitis B virus among general dentists, and are compatible with relatively uniform endemicity of subtype/ad strans of that agent in the general population for several decades.
Abstract 1311: Expression and activity of nuclear factor TOX3 in breast cancer
Authors: Akop Seksenyan, Asha Kadavallore, Brian de la Torre, Parinaz Aliahmad, Ananthi Asirvatham, Ann E. Walts, Shikha Bose, Dror Berel, Samuel Strom, Vincent Funari, William Audeh, Jonathan Kaye
Journal: Cancer Research (2012)

Abstract Our laboratory has shown that thymocyte selection-associated HMG-box protein (TOX) is a member of a small subfamily of DNA binding factors, and a key regulator of multiple aspects of immune system development. Recently, genome wide association studies have mapped a breast cancer susceptibility locus to the gene encoding the TOX-family member TOX3. However, little is known concerning the pattern of expression or biological functions of TOX3 in breast cancer and normal mammary epithelial cells. We find that TOX3 is specifically expressed in estrogen receptor (ER+) mammary luminal epithelial cells. Interestingly, using a TOX3 monoclonal antibody developed by our laboratory, we identify a subset of breast tumors that highly express TOX3. Moreover, using the MCF-7 breast cancer cell line, we find that TOX3 regulates a subset of ER target genes in an estrogen independent but ER dependent manner, potentially revealing a novel mechanism of ER target gene activation. In addition, TOX3 enhances cell migration. Together, these studies lend support to the idea of altered TOX3 expression influencing breast cancer development and/or progression. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 1311. doi:1538-7445.AM2012-1311
Meningitis Due to the Group B Beta-Hemolytic Streptococcus
Authors: J. M. Lazarus, Dilworth P. Sellers, W. M. Marine
Journal: New England Journal of Medicine (1965)

MENINGITIS due to the Lancefield Group B beta-hemolytic streptococcus has rarely been reported.Case ReportR.L., a 56-year-old obese diabetic woman with chronic pyelonephritis, had an intense headache on the morning of May 12, 1964, and was admitted to Henry Grady Memorial Hospital in a semistuporous state with a temperature of 103.8°F. For several months she had had a "bad toe." The diabetes was controlled by diet.Positive physical findings included nuchal rigidity, a draining erosion on the 2nd toe of the left foot and a leiomyomatous uterus.Lumbar puncture yielded purulent cerebrospinal fluid with 20,000 white cells per cubic . . .
Rectal perforation from cholesterol embolization syndrome
Authors: H. Mori, H. Kobara, M. Kobayashi, A. Muramatsu, T. Nomura, T. Yachida, K. Izuishi, Y. Suzuki, J. Gong, T. Masaki
Journal: Endoscopy (2010)

Cholesterol embolization syndrome (CES) is a rare syndrome with a high incidence of morbidity and mortality [1]. Because of the variability in clinical presentations, the diagnosis is often difficult. CES presents as multiorgan dysfunction and should be considered in the differential diagnosis of the symptom complex after vascular thrombolytic therapy [2]. Skin and renal involvement are the most common presentations, such as livedo reticularis and rash [3]. CES of the digestive systems is not uncommon, with rates varying from 18 % to 48 % [4] [5]. We encountered a rare case of rectal perforation due to CES, which was diagnosed only after the patient had died.