tbuckley/cabot-search huggingface dataset:
Abstract 15185: Risk Factors for Sudden Death in Chagas Cardiomyopathy
Authors: Giselle L Peixoto, Sérgio Siqueira, Silvana Nishioka, Anísio Pedrosa, Ricardo Teixeira, Roberto Costa, Martino Martinelli
Journal: Circulation (2015)

Introduction: Sudden death (SD) is an important cause of death in Chagas Cardiomyopathy patients. We aim to identify associated factors for its occurrence in Chagas Cardiomyopathy patients requiring pacemaker (PM). Methods: We prospectively evaluated 527patients included in the PACINCHAGAS Study - Risk Stratification in Pacemaker Patients with Chagas Cardiomyopathy, which primary objective is to create a risk score to predict death in this population.The patients are submitted to an extent questionnaire which included clinical (NYHA class, symptoms, comorbidities and medications) functional (electrocardiography, holter and echocardiography) and electronic variables (burden of pacing and arrhythmias).Patients withat least 6 months of follow-up were included in this analysis. Results: The cohort included 337 (63.9%) females, the mean age was 62.6±12.0 years and 64.3% were in NYHA class I. Indication for PM implantation was atrioventricular block, sick sinus syndrome, atrial fibrillation with slow ventricular response and unknown in 72.7%; 20.7%; 4.7% and 1.9%, respectively. The mean time of PM was 11.6±9.0years. During a mean follow-up of 1.8±0.6 years, 74 (14.0%) patients died; 25 deaths (33.8%) were due to heart failure, 23 (31.0%)weresudden (9.7%), 8(10.9%) were due to other cardiovascular causes, and 11 (14.8%) were due to non-cardiovascular causes. The cause of death could not be determined in seven patients (9.5%).Univariate analysis shows that patients with SD were younger (57.1 versus 62.8years, P=0.033), have higher duration of QRS (172.8 versus 155.8msec, P=0.013), lower ejection fraction (38.7% versus 48.7%, P=0.002), higher left ventricular diastolic diameter (60.0 versus 48.7mm, P=0.001), higher systolic arterial pulmonary pressure (41.8 versus 34.9mmHg, P=0.038) and higher rate of segmental wall-motion abnormality (57.9% versus 23.3%, P=0.002. Advanced functional class and non-sustained ventricular tachycardia were not associated to SD. Conclusions: We found that lower age, higher QRS duration and presence of echocardiographic abnormalities were associated to sudden death in PM users with Chagas Cardiomyopathy.
Evaluation of immunochromatographic tests for the rapid detection of the emerging GII.17 norovirus in stool samples, January 2016
Authors: Lucie Théry, Maxime Bidalot, Pierre Pothier, Katia Ambert-Balay
Journal: Eurosurveillance (2016)

A novel GII.17 norovirus emerged in Asia in the winter of 2014/15. A worldwide spread is conceivable and norovirus diagnostic assays need to be evaluated to investigate if they adequately detect this emerging genotype. Seven immunochromatographic kits commercially available in Europe were evaluated on ten stool samples where GII.17 virus had been quantified by real-time reverse transcription-polymerase chain reaction. All the kits detected GII.17 with various sensitivities, partly depending on the virus titre.
Significance of myocardial tenascin‐C expression in left ventricular remodelling and long‐term outcome in patients with dilated cardiomyopathy
Authors: Tetsuro Yokokawa, Yasuo Sugano, Takafumi Nakayama, Toshiyuki Nagai, Taka‐aki Matsuyama, Keiko Ohta‐Ogo, Yoshihiko Ikeda, Hatsue Ishibashi‐Ueda, Takeshi Nakatani, Satoshi Yasuda, Yasuchika Takeishi, Hisao Ogawa, Toshihisa Anzai
Journal: European Journal of Heart Failure (2016)

Aim Dilated cardiomyopathy ( DCM ) has a variety of causes, and no useful approach to predict left ventricular ( LV ) remodelling and long‐term outcome has yet been established. Myocardial tenascin‐C ( TNC ) is known to appear under pathological conditions, possibly to regulate cardiac remodelling. The aim of this study was to clarify the significance of myocardial TNC expression in LV remodelling and the long‐term outcome in DCM . Methods and results One hundred and twenty‐three consecutive DCM patients who underwent endomyocardial biopsy for initial diagnosis were studied. Expression of TNC in biopsy sections was analysed immunohistochemically to quantify the ratio of the TNC ‐positive area to the whole myocardial tissue area ( TNC area). Clinical parameters associated with TNC area were investigated. The patients were divided into two groups based on receiver operating characteristic analysis of TNC area to predict death: high TNC group with TNC area ≥2.3% (22 patients) and low TNC group with TNC area &lt;2.3% (101 patients). High TNC was associated with diabetes mellitus. Comparing echocardiographic findings between before and 9 months after endomyocardial biopsy, the low TNC group was associated with decreased LV end‐diastolic diameter and increased LV ejection fraction, whereas the high TNC group was not. Survival analysis revealed a worse outcome in the high TNC group than in the low TNC group ( P &lt; 0.001). Multivariable Cox regression analysis revealed that TNC area was independently associated with poor outcome ( HR = 1.347, P = 0.032). Conclusions Increased myocardial TNC expression was associated with worse LV remodeling and long‐term outcome in DCM .
Identification of actionable targets in chromophobe renal cell carcinoma detected by multiplatform molecular analysis.
Authors: Philip Abbosh, Daniel M. Geynisman, Nancy Doll, ADAM Hauben, Sandeep K. Reddy, Sherri Z. Millis, Robert G. Uzzo
Journal: Journal of Clinical Oncology (2015)

451 Background: Chromophobe renal cell carcinoma (chRCC) is a rare kidney cancer subtype that infrequently metastasizes or recurs after definitive local therapy. Limited biomarker data exists to prognosticate outcome or predict response to therapy. We explored the utility of multiplatform tumor profiling, which uses immunohistochemistry (IHC) and targeted next generation sequencing (tNGS) to identify druggable targets, with the intent of developing targeted therapy protocols in patients with (chRCC). Because of the non-aggressive nature of small chRCCs, we excluded T1a tumors. Methods: Cases were identified from 65,000+ tumors submitted for commercial testing at Caris Life Sciences. All tissues were internally reviewed by a dedicated genitourinary pathologist to confirm diagnosis. Markers were analyzed on tumor tissue removed during partial or radical nephrectomy. IHC was performed on 19 proteins. FISH was performed on EGFR, HER2, and TOP2A. tNGS was performed on 47 genes. Results: Twelve patients with chRCC were profiled. Five patients had metastatic disease. Median age was 54 years old; 50% of patients were male. One patient had a T1b tumor, two patients had T2 tumors, 8 patients had T3 tumors, and one had a T4 tumor. Thymidylate synthase (TS), ribonucleotide reductase M1 (RRM1), and O-6-methylguanine-DNA methyltransferase (MGMT) expression was absent in 12/12, 11/12 and 11/12 tumors, respectively. PTEN expression was absent in 7/12 of tumors. cKIT and PDGFR was expressed in 6/9 and 0/4 tumors, respectively. Lastly, point mutations in APC and TP53 were detected in 1/7 and 3/7 tumors, respectively. No mutations were identified in the other 45 genes tested and no changes in copy number were identified. Conclusions: Biomarker analysis showed that advanced chRCC might be amenable to chemotherapy with 5-fluorouracil, gemcitabine, or temozolamide because of absent TS, RRM1, and MGMT expression, respectively. Such rationale has been used successfully in targeted treatment of other cancers. In addition, sunitinib or imatinib but not sorafenib might be preferred tyrosine kinase inhibitors, as cKIT but not PDGFR was detected.
Pharmacologic Control of Thromboembolic Complications of Cardiac-Valve Replacement
Authors: Jay M. Sullivan, Dwight E. Harken, Richard Gorlin
Journal: New England Journal of Medicine (1971)

Continued experience with the use of dipyridamole as an antithrombotic agent confirmed earlier impressions of the clinical effectiveness of this agent. Dipyridamole (400 mg daily) or a placebo was given to 163 patients surviving prosthetic cardiac-valve replacement. All patients received anticoagulation with warfarin sodium. Eighty-four patients entered the placebo group. Within one year, 11.9 per cent died, 14.3 per cent suffered arterial emboli, and 9.5 per cent discontinued their medication because of possible side effects. The dipyridamole group contained 79 patients, of whom 13.9 per cent died; arterial emboli developed in 1.3 per cent and 15.2 per cent discontinued their medication. The frequency of embolization in the dipyridamole group was significantly lower than that in the placebo group. There was no significant difference between the death rates or between the drug discontinuation rates of the two groups.
Clinical features and neuroimaging (CT and MRI) findings in presumed Zika virus related congenital infection and microcephaly: retrospective case series study
Authors: Maria de Fatima Vasco Aragao, Vanessa van der Linden, Alessandra Mertens Brainer-Lima, Regina Ramos Coeli, Maria Angela Rocha, Paula Sobral da Silva, Maria Durce Costa Gomes de Carvalho, Ana van der Linden, Arthur Cesario de Holanda, Marcelo Moraes Valenca
Journal: BMJ (2016)

To report radiological findings observed in computed tomography (CT) and magnetic resonance imaging (MRI) scans of the first cases of congenital infection and microcephaly presumably associated with the Zika virus in the current Brazilian epidemic.Retrospective study with a case series.Association for Assistance of Disabled Children (AACD), Pernambuco state, Brazil.23 children with a diagnosis of congenital infection presumably associated with the Zika virus during the Brazilian microcephaly epidemic.Types of abnormalities and the radiological pattern of lesions identified on CT and MRI brain scans.Six of the 23 children tested positive for IgM antibodies to Zika virus in cerebrospinal fluid. The other 17 children met the protocol criteria for congenital infection presumably associated with the Zika virus, even without being tested for IgM antibodies to the virus--the test was not yet available on a routine basis. Of the 23 children, 15 underwent CT, seven underwent both CT and MRI, and one underwent MRI. Of the 22 children who underwent CT, all had calcifications in the junction between cortical and subcortical white matter, 21 (95%) had malformations of cortical development, 20 (91%) had a decreased brain volume, 19 (86%) had ventriculomegaly, and 11 (50%) had hypoplasia of the cerebellum or brainstem. Of the eight children who underwent MRI, all had calcifications in the junction between cortical and subcortical white matter, malformations of cortical development occurring predominantly in the frontal lobes, and ventriculomegaly. Seven of the eight (88%) children had enlarged cisterna magna, seven (88%) delayed myelination, and six each (75%) a moderate to severe decrease in brain volume, simplified gyral pattern, and abnormalities of the corpus callosum (38% hypogenesis and 38% hypoplasia). Malformations were symmetrical in 75% of the cases.Severe cerebral damage was found on imaging in most of the children in this case series with congenital infection presumably associated with the Zika virus. The features most commonly found were brain calcifications in the junction between cortical and subcortical white matter associated with malformations of cortical development, often with a simplified gyral pattern and predominance of pachygyria or polymicrogyria in the frontal lobes. Additional findings were enlarged cisterna magna, abnormalities of corpus callosum (hypoplasia or hypogenesis), ventriculomegaly, delayed myelination, and hypoplasia of the cerebellum and the brainstem.
A penicillin- and metronidazole-resistant Clostridium botulinum strain responsible for an infant botulism case
Authors: C. Mazuet, E.-J. Yoon, S. Boyer, S. Pignier, T. Blanc, I. Doehring, D. Meziane-Cherif, C. Dumant-Forest, J. Sautereau, C. Legeay, P. Bouvet, C. Bouchier, S. Quijano-Roy, M. Pestel-Caron, P. Courvalin, M.R. Popoff
Journal: Clinical Microbiology and Infection (2016)
S36 Weekly audiograms pre-emptively identify amikacin related ototoxicity in MDR-TB
Authors: A Abbara, S Lang, OM Kon, SM Collin, D Pan, T Hansel, R Ravindran, R Holder, L John, RN Davidson
Journal: Thorax (2015)

<h3>Introduction and objectives</h3> Updated WHO guidance recommends at least 8 months of aminoglycoside (AG) for MDR-TB but provides no definitions or monitoring strategies for otoxocity. Most UK centres perform 2–4 weekly audiograms; we perform weekly audiograms. We retrospectively investigated whether this strategy pre-emptively identifies ototoxicity before significant hearing loss (HL) is evident. <h3>Methods</h3> Patients we treated with amikacin for MDR-TB from 2002–2015, with at ≥4 weekly pure tone audiograms, were included. Audiograms, treatment duration, symptoms, creatinine clearance and outcome were obtained from clinical records. All patients received amikacin at 15 mg/kg per day and had weekly amikacin levels and renal function. Definition of HL was defined as per the ASHA as &gt;20 dB loss of pure tone threshold from baseline at one frequency or &gt;10 dB at two adjacent frequencies. <h3>Results</h3> 31 MDR-TB patients fulfilled selection criteria; 15 female, median age 36 years (IQR: 24–43) and median weight 61.5 kg (IQR: 52–65.) 22/31 (70.9%) patients had their first audiogram within 10 days; median 5.5 (IQR:4–7.) The median duration of amikacin treatment was 79.5 days (IQR: 61.75–94) and median total dose of 70.8 g (IQR:44.4–97.75.) 4/31 (12.9%) had moderate-severe baseline hearing loss (HL). A total of 17 (54.8%) patients met the ASHA definition of HL: 7 at 4 kHz, 10 at 6 kHz and 17 at 8 kHZ. The median time to meeting ASHA definition of HL among these patients was 59 days (IQR: 41–84.75). 16/31 (51.6%) patients stopped amikacin earlier than planned and 1 continued; 2 (6.5%) due to symptoms of deafness, 2 (6.5%) due to tinnitus and 12 (38.7%) due to asymptomatic high frequency HL on audiograms. Creatinine clearance and trough amikacin levels remained within range for all patients. Regarding outcomes, 17 (54.8%) completed TB treatment, 5 (16.1%) remain on treatment, 4 (12.9%) transferred, 3 (9.7%) were lost to follow up and 1 (3.2%) died. <h3>Conclusions</h3> AGs are important in the treatment strategy of MDR-TB but this must be balanced with the long-term side effects. The ototoxicity of AG is unrelated to elevated drug levels or contributing factors and is a common adverse effect. Weekly audiograms led to earlier detection of pre-symptomatic amikacin ototoxicity and cessation in 38.7% of patients.
Pituitary Function in Hand-Schüller-Christian Disease
Authors: Glenn D. Braunstein, Peter O. Kohler
Journal: New England Journal of Medicine (1972)

Anterior and posterior pituitary function was evaluated in 13 patients with Hand–Schuller–Christian disease, including eight with growth retardation. Growth-hormone reserve, determined by insulin-induced hypoglycemia, arginine tolerance test or pyrogen stimulation, was deficient in seven of the eight short patients and in three of the patients whose disease developed after adult height had been attained. Tests of gonadotropin secretion and adrenocortical and thyroid function gave normal results. A dehydration test demonstrated complete diabetes insipidus in eight patients and incomplete diabetes insipidus in two. Growth-hormone deficiency was usually found when diabetes insipidus was present. Both abnormalities may be accounted for by a single hypothalamic lesion. The short stature frequently observed in patients with this disease may be in part secondary to quantitative growth-hormone deficiency.
One-Year Risk of Stroke after Transient Ischemic Attack or Minor Stroke
Authors: Pierre Amarenco, Philippa C. Lavallée, Julien Labreuche, Gregory W. Albers, Natan M. Bornstein, Patrícia Canhão, Louis R. Caplan, Geoffrey A. Donnan, José M. Ferro, Michael G. Hennerici, Carlos Molina, Peter M. Rothwell, Leila Sissani, David Školoudík, Philippe Gabriel Steg, Pierre-Jean Touboul, Shinichiro Uchiyama, Éric Vicaut, Lawrence K.S. Wong
Journal: New England Journal of Medicine (2016)

Previous studies conducted between 1997 and 2003 estimated that the risk of stroke or an acute coronary syndrome was 12 to 20% during the first 3 months after a transient ischemic attack (TIA) or minor stroke. The TIAregistry.org project was designed to describe the contemporary profile, etiologic factors, and outcomes in patients with a TIA or minor ischemic stroke who receive care in health systems that now offer urgent evaluation by stroke specialists.We recruited patients who had had a TIA or minor stroke within the previous 7 days. Sites were selected if they had systems dedicated to urgent evaluation of patients with TIA. We estimated the 1-year risk of stroke and of the composite outcome of stroke, an acute coronary syndrome, or death from cardiovascular causes. We also examined the association of the ABCD(2) score for the risk of stroke (range, 0 [lowest risk] to 7 [highest risk]), findings on brain imaging, and cause of TIA or minor stroke with the risk of recurrent stroke over a period of 1 year.From 2009 through 2011, we enrolled 4789 patients at 61 sites in 21 countries. A total of 78.4% of the patients were evaluated by stroke specialists within 24 hours after symptom onset. A total of 33.4% of the patients had an acute brain infarction, 23.2% had at least one extracranial or intracranial stenosis of 50% or more, and 10.4% had atrial fibrillation. The Kaplan-Meier estimate of the 1-year event rate of the composite cardiovascular outcome was 6.2% (95% confidence interval, 5.5 to 7.0). Kaplan-Meier estimates of the stroke rate at days 2, 7, 30, 90, and 365 were 1.5%, 2.1%, 2.8%, 3.7%, and 5.1%, respectively. In multivariable analyses, multiple infarctions on brain imaging, large-artery atherosclerosis, and an ABCD(2) score of 6 or 7 were each associated with more than a doubling of the risk of stroke.We observed a lower risk of cardiovascular events after TIA than previously reported. The ABCD(2) score, findings on brain imaging, and status with respect to large-artery atherosclerosis helped stratify the risk of recurrent stroke within 1 year after a TIA or minor stroke. (Funded by Sanofi and Bristol-Myers Squibb.).
Phenotypic characteristics of triple negative breast cancer in a rural population
Authors: M. Howard-McNatt, H. Hazard, A. Jaime, L. Vona-Davis
Journal: Journal of Clinical Oncology (2007)

17060 Background: Triple negative breast tumors are a basal-like subtype of breast cancer associated with the poorest clinical outcomes. Typically they are found in younger patients, African-American women, and patients with the BRCA mutation. To date, however, the epidemiology of triple negative breast cancers in a rural, Caucasian population has not been described. Methods: 96 breast cancer patients presenting with a basal-like subtype of breast cancer had tumor biopsies and demographic and epidemiologic information were collected. Standard histologic and immunohistochemical analysis was done for ER, PR, HER-2/neu status for all high nuclear grade tumors from January 2000 to December 2005 at West Virginia University Hospital. The tumor registry was reviewed to determine tumor size, stage at diagnosis, age at diagnosis, race, menopausal status, body mass index (BMI) and BRCA1/BRCA2 status. Variables in the triple negative group were then compared to all patients who were diagnosed with infiltrating ductal carcinoma between 1999–2004. Results: The basal-like breast cancer subtype was more prevalent among the 40–59 year old group (52%, 50/96) versus women &lt;40 years (12.5%, 12/96) (p= 0.01). Most patients presented with T2 tumors (57%) and the majority had stage II disease (61%, p-value = 0.01). 67% of the population was postmenopausal and were more likely to be overweight or obese (73%, p-value = 0.03). Only one African-American patient met all criteria (2.8%). Of the 7 patients with triple negative tumors who received BRCA testing, four were BRCA1 positive. Age, tumor stage and BMI were similar between the populations of triple negative tumors and infiltrating ductal carcinoma. Conclusions: The demographic and phenotypic characteristics of basal-like breast cancers are still being defined. In contrast to previous findings, triple negative tumors in a rural area were found in middle aged, postmenopausal Caucasian women with Stage II disease and a higher BMI. This analysis will help to identify possible risk factors such as obesity in triple negative cancer subtypes and may prompt further research into differences in breast cancer survival in obese populations from rural areas. No significant financial relationships to disclose.
A Multi-Institutional Randomized Phase 2 Trial of the Oncolytic Virus Reolysin in the First Line Treatment Metastatic Adenocarcinoma of the Pancreas (Map)
Authors: T. Bekaii-Saab, A.M. Noonan, G. Lesinski, S. Mikhail, K. Ciombor, S. Pant, S. Aparo, S. Tahiri, A. Thompson, J. Sexton, J.L. Marshall, T. Mace, C. Wu, B. El-Rayes, C. Timmers, S. Geyer, J. Zwiebel, M.A. Villalona-Calero
Journal: Annals of Oncology (2014)
Spontaneous Expectoration of a Prosthetic Graft Nine Years after a Blalock-Taussig Shunt Procedure
Authors: T. Carrel, H. Winklehner, M. Pasic, M. Turina
Journal: New England Journal of Medicine (1993)

To the Editor: The modified Blalock-Taussig operation, now performed by inserting a polytetrafluoroethylene graft between the subclavian and pulmonary arteries, is considered to be the palliative procedure of choice in infants with cyanosis who are less than three months of age. The operation is associated with a low mortality rate, excellent patency, and a low rate of long-term complications1,2. We report on a child born with cyanosis in 1983 who had a congenitally corrected L-transposition of the great arteries with a large ventricular septal defect, pulmonary atresia, and a cleft mitral valve with moderate regurgitation. In the first . . .
Herpes Simplex Virus Corneal Dendrite
Authors: T A Ciulla, K Johnson
Journal: New England Journal of Medicine (1995)

Figure 1. A herpes simplex virus corneal dendrite is revealed by slit-lamp examination with fluorescein (upper panel) and fluorescein plus rose bengal (lower panel, high power) in a 70-year-old man who reported two days of pain and redness in his right eye. His visual acuity was minimally diminished. The lids (A) are normal; the conjunctiva (B) is injected; the diagnostic dendrite (C) results from a branching pattern of desquamation of infected corneal epithelial cells. Desquamated cornea stains with fluorescein, whereas the remaining infected epithelial cells at the margin of the dendrite stain brilliantly with rose bengal. This epithelial infection differs . . .