tbuckley/cabot-search huggingface dataset:
NIMG-73PSEUDOPROGRESSION VERSUS PROGRESSION ON GADOLINIUM-ENHANCED MRI IN OLIGODENDROMAS AND MIXED OLIGOASTROCYTOMAS
Authors: Michael White, Andrew Lin, Keith Rich, Jay Huang, Michelle Miller-Thomas, David Tran, Sonika Dahiya
Journal: Neuro-Oncology (2015)

Pseudoprogression is a radiological phenomenon in which tumors develop new areas of contrast enhancement in the 6 months following chemoradiotherapy that is often difficult to distinguish from true disease progression. We hypothesized that in Oligodendrogliomas (OG) and Mixed Oligoastrocytomas (MOA) new early contrast enhancement on MRI was unlikely to be associated with true tumor progression. We retrospectively identified 12 patients with either OG or MOA who had new areas of contrast enhancement and underwent second-look surgery within 6 months of receiving radiation with or without chemotherapy. Among these patients, there were no cases of progression to a higher grade, 9 of 12 had greater than 50% radiation necrosis and the remaining 3 had minimal radiation necrosis. Within this group 6 underwent sub-total resection, 3 had gross-total resection, and 3 had biopsy only. Notably, second-look surgery was associated with significant morbidity. Our findings support the hypothesis that early contrast enhancement following chemo-radiotherapy is frequently pseudoprogression.
A retrospective database analysis of treatment patterns and outcomes for multiple myeloma (MM) patients with malignant bone lesions (BM).
Authors: D. Spencer, J. R. Perez-Torrealba, S. Kaura, H. J. Henk
Journal: Journal of Clinical Oncology (2010)

e18506 Background: For MM pts with BM, skeletal related events (SREs) can be associated with significant morbidity, mortality, and reduced quality of life. ZOL is an IV bisphosphonate (IVBP) proven to reduce and delay incidence of SREs due to BM from several tumor types. The purpose of this study was to examine the use of ZOL to reduce or delay SREs, in the real-world treatment of pts with MM and BM, and to assess the benefit of long-term ZOL use in a real-life setting. Methods: Claims-based analysis of commercial and Medicare data from a large U.S. managed care plan and a 45-health plan database examined the use of ZOL in the treatment of pts with MM and BM between 7/1/03 and 7/31/08. Pts with ≥ 1 claim for ZOL and evidence of MM and BM were included. SRE rates, time from BM to 1st SRE, and mortality in pts treated with ZOL versus no IV BP therapy were compared. Results: The study sample included 4,260 pts enrolled in their health plan for at least one year following ZOL initiation (median follow-up length = 21 mos). Thirty-nine percent men, mean age 60.7 (SD=11.9) years, and average Charlson comorbidity index score of 5.4 (SD=2.2). Pts had an average of 7.01 ZOL admins per person year and approximately 63.5% were still receiving ZOL at one year. In a subsample of pts with greater follow-up (n=1,655), 64% were treated with ZOL and 36% with no IV BP. Incidences of SREs and mortality rates were both greater in the no IV BP group (incidence rate ratio = 1.58; p value<0.001 and mortality rate ratio= 1.71; p value=0.0234) vs. the ZOL groups. Longer persistency with ZOL was associated with lower risk of first SRE compared with no IV BP (Table). Conclusions: According to this retrospective database analysis, the vast majority of pts with MM and BM who initiate ZOL, remained on ZOL treatment after 12 months. Among MM pts with BM, use of ZOL was associated with a lower risk of SREs, including fractures, and lower mortality rates. In addition, longer persistence was found to be associated with lower risk of SREs. Risk per 100-person-years by ZOL persistency Persistency category (days) SRE Fracture No IV BP 32.18 16.90 91-180 24.64 14.03 181-365 23.23 13.21 365-546 22.45 11.58 547+ 18.79 9.18 P value: test for trend 0.0025 0.0037 Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Novartis Novartis
Disruption Of Super Enhancer-Driven Cancer Dependencies In Diffuse Large B-Cell Lymphoma
Authors: Bjoern Chapuy, McKeown Michael, Charles Y. Lin, Stefano Monti, Margaretha GM Roemer, Jun Qi, Peter B. Rahl, Heather Sun, Kelly T. Yeda, Andrew L. Kung, Scott J. Rodig, Richard A. Young, Margaret A. Shipp, James E. Bradner
Journal: Blood (2013)
Expression of Cell-Homologous Genes of Human Herpesvirus-8 in Human Immunodeficiency Virus-Negative Lymphoproliferative Diseases
Authors: Mario Luppi, Patrizia Barozzi, Antonio Maiorana, Raffaella Trovato, Roberto Marasca, Monica Morselli, Katia Cagossi, Giuseppe Torelli
Journal: Blood (1999)
A Newly Recognized Fastidious Gram-Negative Pathogen as a Cause of Fever and Bacteremia
Authors: L N Slater, D F Welch, D Hensel, D W Coody
Journal: New England Journal of Medicine (1990)

We identified a motile, curved, gram-negative bacillus as the cause of persistent fever and bacteremia in two patients with symptomatic human immunodeficiency virus infection. The same organism was subsequently recovered from a bone marrow—transplant recipient with septicemia and from two immunocompetent persons with week-long febrile illnesses. All the patients recovered after antimicrobial therapy.
The Repair of Cranial Defects with Special Reference to the Use of Cancellous Bone
Authors: John T. B. Carmody
Journal: New England Journal of Medicine (1946)

THE treatment of defects of the cranial bones is a problem as old as cranial surgery. All types of material have been used, and the search for a completely satisfactory substance continues. The war has stimulated such endeavor, and there is no doubt that vast strides have been made. There has been a strong tendency toward the use of metal. Almost all metals have been tried in one form or another, each having its advocates and showing advantages over the others, but each possessing distinct disadvantages. Formerly, the most successful and most popular materials were silver and vitallium,1 but other . . .
SURGICAL PATHOLOGY OF THE SPLEEN
Journal: BMJ (1939)

The indications for splenectomy in haematological and myeloproliferative disorders are now wider than before. An increased understanding of the concept of hypersplenism and a developing appreciation of the value of splenectomy in chronic leukaemia has been partially responsible for the increase. The principal factor, however, has been the advent of routine splenectomy as an integral part of the diagnostic process in Hodgkin's disease. This paper discusses these indications and their surgical pathology.
Lactation and a Reduced Risk of Premenopausal Breast Cancer
Authors: Polly A. Newcomb, Barry E. Storer, Matthew P. Longnecker, Robert Mittendorf, E. Robert Greenberg, Richard W. Clapp, Kenneth P. Burke, Walter C. Willett, Brian MacMahon
Journal: New England Journal of Medicine (1994)

The evidence of an association of lactation with a reduction in the risk of breast cancer among women has been limited and inconsistent. The effect of lactation appears to be confined to premenopausal women with a history of long lactation, but most studies of this relation have been limited in statistical power. We conducted a multicenter, population-based, case-control study with a sample large enough for us to describe more precisely the association between lactation and the risk of breast cancer.
AB0619 Isotypes of Anti-Beta 2- Glycoprotein I in Systemic Lupus Erythematosus Patients: Correlation with Clinical Manifestations, Laboratory Features and Association with Antiphospholipid Syndrome
Authors: D. Attia, T.A. Gheita, A. El Awar, A. Abd Alaal, M. Ayoub
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by the production of autoantibodies to the components of the cell nucleus. Antiphospholipid antibodies of IgA isotype though excluded from antiphospholipid syndrome (APS) classification criteria were yet considered of importance in the development of the disease. <h3>Objectives</h3> The aim of the study was to clarify the significance of the different anti-β2GPI isotypes among Egyptian lupus patients with associated APS. <h3>Methods</h3> The study included 54 SLE patients (27 with APS and another 27 without). Patients with other known causes of thrombophilia were excluded. The mean age of the patients in those with APS was 27.06±5.825 years while in those without was 29.09±7.46 years. The disease duration was also comparable. The patietns were fully examined and disease activity (SLEDAI) and damage index (SLICC) assessed. The anti-β2GPI isotypes were assessed. <h3>Results</h3> In those without APS, the most specific antibodies were in the following order: LA (81.5%), aCL (62.96%) and lastly anti-β2-GPI (48.1%). Regarding sensitivity of aPL among SLE patients with APS, anti-β2GPI antibodies were the most sensitive (59.3%) followed by LA (40.7%) and aCL (22.2%).Among anti-β2-GPI isotypes, the most sensitive isotype was IgA (48.1%) followed by IgG and IgM (14.8% for each). Among aCL isotypes, the most sensitive isotype was IgG (14.8%) followed by IgM (11.1%) and lastly IgA (0%). Anti-β2GPI antibodies and LA seem to contribute to APS pathogenesis more than aCL antibodies. In patients with positive anti-B2GPI IgA, there was a significantly increased dural sinus thrombosis (P=0.025), Autoimmune thrombocytopenia (P=0.03) and leukopenia (P=0.017). <h3>Conclusions</h3> Although anti-β2GPI, including its IgA isotype, is less specific than LA and aCL, it seems to contribute to the pathogenesis of thrombotic and non thrombotic manifestations of SLE and APS including DVT, dural sinus thrombosis, pregnancy morbidity, leucopenia and autoimmune thrombocytopenia. <h3>Disclosure of Interest</h3> None declared
Therapeutic monoclonal antibodies target phenotypically-differing human breast cancer
Authors: S. E. Hahn, L. A. da Cruz, D. Sayegh, A. Ferry, K. O’Reilly, D. S. Pereira, D. B. Rubinstein, H. Findlay, D. S. Young
Journal: Journal of Clinical Oncology (2007)

13510 Background: CD44 (an adhesion molecule and stem cell antigen), CD59 (a complement-inhibitory molecule), MCSP (an adhesion and cell-cell interactions), and Trop-2 (EpCam a related signaling molecule) represent a group of biologically-significant cancer proteins acting through distinct mechanisms. We have described Abs with in vitro and in vivo cancer suppressive activity to this group of targets. However, their effectiveness depends on the phenotype of malignant cells; cell response should correlate with expression of its Ag, and tumor cells represent a heterogeneous group of non-synchronous cells. The present study describes the efficacy of those antibodies in breast cancer models and the prevalence of their antigen targets in a survey of human breast cancer tissues. Methods: In vivo activity of antibodies ARH460–16–2 (anti-CD44), AR36A36.11.1 (anti-CD59), AR11BD-2E11–2 (anti-MCSP), and AR47A6.4.2 (anti-Trop-2) in estrogen-dependent and hormone sensitive xenograft models of human breast cancer was examined. In addition, distribution of the antigens in breast cancer was determined by immunohistochemistry using tumor tissue arrays of breast cancer sections from distinct patients. Results: Treatment of an established breast cancer model with ARH460–16–2 resulted in 51% median tumor xenograft suppression (p&lt;0.05), as well as increased survival in an MDA-MB-231 (breast cancer) grafted model. 63% of human breast cancer sections expressed the CD44 antigen. Treatment with anti-CD59 antibody AR36A36.11.1 resulted in 68% xenograft tumor suppression (p&lt;0.005). AR47A6.4.2 anti-Trop-2 antibody bound to 100% of human breast cancer sections tested, and showed efficacy in the estrogen- dependent MCF-7 breast cancer model. Anti-MCSP antibody AR11BD-2E11–2 demonstrated 80% tumor growth inhibition (p&lt;0.001), increased survival in an estrogen-dependent model of breast cancer, and was found to stain 62% of breast cancer tissues examined. Conclusions: The heterogeneity of breast cancer cell phenotypes in in vitro and in vivo studies and variable composite cellular antigen targets is the basis for the therapeutic use of multiple antibodies, each with independent mechanisms of action, and offers a rationale for combined antibody therapy in selected patients. [Table: see text]
P86 Spirometric values of Greek healthy people and comparison with ECSC values in COPD people
Authors: N Tatsis, S Kakavas, E Balis, N Koulouris, K Hadjistavrou, G Tatsis
Journal: Thorax (2015)

<h3>Introduction</h3> There have been always controversies whether, there is a hypo or hyper diagnosis of COPD according GOLD criteria with parameters driven many years ago, around many countries. <h3>Purpose</h3> The purpose of our study is the use of mathematical models for the comparison of Greek patients with COPD, according GOLD criteria versus normal values of our country. <h3>Methods</h3> Using spirometry results from a pool of healthy local population (n = 500, age range 18–89 years) we fitted regression models, separately for men and women, for FEV1 and FEV1/FVC ratio. The set of healthy individuals consisted of 261 women (52.2%) and 239 men (47.8%). Their mean age (SD) was 48.20 ± 17.19 and 46.92 ± 16.16 years respectively. The corresponding heights were 162.7 ± 7.2 and175.8 ± 7.3 cm. Predicted normal FEV1 was also calculated using the European Coal and Steel Community (ECSC) equations. Also 124 subjects, with a history of COPD were studied (age range 25–91 years). <h3>Results</h3> A positive and linear association with height was apparent in women whereas for men, a guadratic height term was also statistically significant. Predicted FEV1 of healthy individuals, based on either the ECSC or the locally derived equations, was excellent with the concordance correlation coefficients being 0.986 for women and 0.991 for men (p &lt; 0.001 in both cases). Using the GOLD 2008b staging definitions and the ECSC predicted FEV1, the obstructive individuals were classified as having mild (17; 13.71%), moderate (48; 38.71%), severe (40; 32.26%) and very severe (19; 15.32%) COPD. The corresponding figures for the same classification, based on our derived equations for FEV1, were 17 (13.71%), 44 (35.48%), 42 (33.87%) and 21 (16.94%), respectively. The overall agreement between the two classifications was 97.85% with the kappa coefficient of agreement indicating a very good agreement (kappa = 0.936; p &lt; 0.001). Out of the 124 obstructive individuals, 4 (3.2%) were found to have an FEV1/FVC ratio which was above the LLN as predicted from our equations. <h3>Conclusion</h3> The statistical analysis has shown a high correlation between the parameters already used and those locally derived.
Implementation of digital technology solutions for a lung health trial in rural Malawi
Authors: Blessings Chisunkha, Hastings Banda, Rachael Thomson, S. Bertel Squire, Kevin Mortimer
Journal: European Respiratory Journal (2016)

There is a global epidemic of non-communicable disease including chronic lung disease [1–3]. In the case of chronic lung disease, this challenge plays out in the context of a high burden of communicable diseases and pulmonary tuberculosis in particular. Digital technology solutions pave the way for a lung health trial in rural Malawi <http://ow.ly/107F5s> Sincere gratitude to the entire project team from both REACH Trust (Malawi) and Liverpool School of Tropical Medicine (UK), with expertise in Health and Medicine, Data Management, Computer Science, Research and Health Economics, for their insightful technical contributions and comments . Our thanks to the field team and the respondents.
The standard of care of patients with ARDS: ventilatory settings and rescue therapies for refractory hypoxemia
Authors: Thomas Bein, Salvatore Grasso, Onnen Moerer, Michael Quintel, Claude Guerin, Maria Deja, Anita Brondani, Sangeeta Mehta
Journal: Intensive Care Medicine (2016)

Severe ARDS is often associated with refractory hypoxemia, and early identification and treatment of hypoxemia is mandatory. For the management of severe ARDS ventilator settings, positioning therapy, infection control, and supportive measures are essential to improve survival. A precise definition of life-threating hypoxemia is not identified. Typical clinical determinations are: arterial partial pressure of oxygen < 60 mmHg and/or arterial oxygenation < 88 % and/or the ratio of PaO2/FIO2 < 100. For mechanical ventilation specific settings are recommended: limitation of tidal volume (6 ml/kg predicted body weight), adequate high PEEP (>12 cmH2O), a recruitment manoeuvre in special situations, and a 'balanced' respiratory rate (20-30/min). Individual bedside methods to guide PEEP/recruitment (e.g., transpulmonary pressure) are not (yet) available. Prone positioning [early (≤ 48 hrs after onset of severe ARDS) and prolonged (repetition of 16-hr-sessions)] improves survival. An advanced infection management/control includes early diagnosis of bacterial, atypical, viral and fungal specimen (blood culture, bronchoalveolar lavage), and of infection sources by CT scan, followed by administration of broad-spectrum anti-infectives. Neuromuscular blockage (Cisatracurium ≤ 48 hrs after onset of ARDS), as well as an adequate sedation strategy (score guided) is an important supportive therapy. A negative fluid balance is associated with improved lung function and the use of hemofiltration might be indicated for specific indications. A specific standard of care is required for the management of severe ARDS with refractory hypoxemia.
AB0772 Color Doppler Ultrasonography Can be Used to Detect the Changes of Sacroiliitis and Peripheral Enthesitis in Patients with Ankylosing Spondylitis During the Treatment of Adalimumab
Authors: Z. Hu, M. Xu, Z. Lin, Z. Liao, Q. Lv, J. Gu
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Adalimumab is a TNF-α blocking agent that it is effective in patients with ankylosing spondylitis (AS). Ultrasonography can be used to detect sacroiliitis and peripheral enthesitis. <h3>Objectives</h3> To investigate whether color Doppler ultrasonography (CDUS) can be used to detect the effect of adalimumab on sacroiliitis and peripheral enthesitis in patients with AS. <h3>Methods</h3> AS patients (n=41) received 40 mg adalimumab every other week for 24 weeks. BASDAI, BASFI, CRP, MRI examinations of the sacroiliac joints (SIJs) and CDUS examinations of both SIJs and 10 peripheral entheseal sites were taken at baseline, week 12, and week 24. We scored the MR images by SPARCC method. We recorded the resistive index (RI) value of SIJs and graded the blood signal on a semi quantitative 0-3 scale. We also scored lesions of peripheral entheses seen by CDUS. We analyzed the associations between the results of CDUS and clinical indices and MRI data. <h3>Results</h3> Significant reduction in mean CDUS score of SIJs and peripheral enthesitis and increase in mean RI value were observed in AS patients treated with adalimumab for 12 weeks and 24 weeks as compared with baseline (all p&lt;0.05). The CDUS scores of SIJs and peripheral enthesitis positively related with clinical assessments (including BASDAI, BASFI, and CRP), while the RI value negatively related with them at all visits (all p&lt;0.05). The results of CDUS also correlated well with the MRI data (all p&lt;0.05) during the treatment of adalimumab in AS patients. <h3>Conclusions</h3> Our study found that CDUS could be used to detect the changes of sacroiliitis and peripheral enthesitis in AS patients under the therapy of adalimumab. <h3>References</h3> Schueller-Weidekamm C, Mascarenhas VV, Sudol-Szopinska I, et al. Imaging and interpretation of axial spondylarthritis: the radiologist9s perspective–consensus of the Arthritis Subcommittee of the ESSR. Semin Musculoskelet Radiol. 2014;18:265-79. Mohammadi A, Ghasemi-rad M, Aghdashi M, et al. Evaluation of disease activity in ankylosing spondylitis; diagnostic value of color Doppler ultrasonography. Skeletal Radiol. 2013;42:219-24. Kelly S, Taylor P, Pitzalis C. Ultrasound imaging in spondyloathropathies: from imaging to diagnostic intervention. Curr Opin Rheumatol. 2008;20:408-15. <h3>Disclosure of Interest</h3> None declared
Chemotherapy Hypersensitivity Reactions in Ovarian Cancer
Authors: Matthieu Picard, Ursula A. Matulonis, Mariana Castells
Journal: Journal of the National Comprehensive Cancer Network (2014)

Ovarian cancer is the fifth leading cause of cancer death among women in the United States. Chemotherapy using a taxane and platinum combination is key in improving survival in patients with newly diagnosed advanced ovarian cancer and is also used to treat recurrent platinum-sensitive disease. However, hypersensitivity reactions (HSRs) to chemotherapeutic agents are increasingly common and can greatly limit their use. Moreover, because of the frequent lack of equally effective alternative agents, chances of survival can be compromised. Therefore, physicians caring for these patients must be familiar with the management of HSRs to chemotherapy, and major advancements have recently been made in this field. Most HSRs implicate mast cell and basophil activation either through an IgE-mediated (ie, platinum agents) or nonspecific (ie, taxanes) mechanism. Therefore, these reactions have the potential to lead to anaphylaxis, at which time they should be treated with intramuscular epinephrine. Serum tryptase, which is released alongside histamine after mast cell activation, may be measured after an acute HSR to document mast cell involvement. After an HSR, the decision to re-treat with the same agent or a closely related one will vary depending on the causative drug, the type of HSR, and its severity. Drug desensitization has emerged as a safe and effective way of reintroducing a chemotherapeutic agent or monoclonal antibody responsible for an HSR in a patient who is expected to benefit from its continued use and for whom alternatives are considered less effective and/or more toxic. Currently, candidates for desensitization are preferably evaluated in academic settings with expertise in those procedures, because their use is still limited. Efforts are now needed to increase awareness about desensitization procedures so that more patients may benefit. This challenge will require the close collaboration of patients, nurses, oncologists, and allergists.