tbuckley/cabot-search huggingface dataset:
P31 A retrospective analysis of interstitial lung disease screening in a regional centre for patients with scleroderma
Authors: L Chenciner, F Pearce, PC Lanyon, SR Johnson
Journal: Thorax (2015)

<h3>Background</h3> Interstitial Lung Disease (ILD) and Pulmonary Arterial Hypertension (PAH) are the major sources of morbidity and mortality amongst patients with Scleroderma. Specific autoantibodies, anti-Scl70 and anti-centromere (ACA), are associated with ILD and PAH respectively. Screening for ILD and PAH using annual pulmonary function testing (PFT), High Resolution Computed Tomography (HRCT) and Echocardiography respectively, is recommended by the BTS ILD Guidelines, 2008. However, the predictive value of autoantibodies and clinical screening for ILD and PAH, remains unclear in regional centres managing patients with Scleroderma. We hypothesised that an objective scoring system would elucidate lung phenotypes amongst the cohort and confirm original radiology reports for these patients, whilst patients autoantibody profiles would serve a clinical purpose in management. We retrospectively compared identification of ILD by a specialist ILD radiologist, against the use of predictive autoantibody profiling, for the detection of ILD. <h3>Methods</h3> 99 patients with Scleroderma, managed in Nottingham, were identified from clinic lists (n = 68) or the pathology database, for positive anti-Scl70 and ACA results (n = 31). Autoantibody profiles (n = 77), including Extractable Nuclear Antigens (ENA) and Myositis Immunoblot, were accessed using the Nottingham University Hospitals Trust pathology database. Existing and accessible HRCT scans (n = 69), were evaluated, by a radiologist with a special interest in connective tissue disease-ILD. The Scleroderma Lung Study scoring system was employed, evaluating ground glass opacity, fibrosis, bronchiectasis and honeycombing in three anatomical zones. A binary logistic regression model evaluated the role of autoantibodies in ILD diagnosis. <h3>Results</h3> On re-evaluation of HRCT (n = 69), eight scans had no evidence of ILD. 49 scans had evidence of ILD (NSIP = 41; UIP = 5; non-specific pattern of ILD = 3). Following comparison with the initial reporting radiologists’ reports, twelve patients, with no previous diagnosis of ILD, were identified with the NSIP phenotype. The autoantibody model, using positive ACA and anti-Scl70 status, correctly classified 64.5% of cases overall (n = 62; p = 0.05). <h3>Conclusions</h3> The role of objective HRCT evaluation, by a specialist radiologist, is superior in the detection of ILD, even in the ubiquitous NSIP phenotype, when compared to general radiology review and predictive autoantibody profiling of the same patients.
Screening for Prostate Cancer with Prostate-Specific Antigen — An Examination of the Evidence
Authors: Steven H. Woolf
Journal: New England Journal of Medicine (1995)

After lung cancer, prostate cancer is the leading cause of deaths from cancer among men in the United States. It will claim 40,000 lives in 1995.1 Studies in the early 1990s demonstrated that levels of prostate-specific antigen (PSA), a serine protease, are elevated in most men with clinically important prostate cancer and that measuring them is the best means for early detection of the disease.25 In 1993, the American Cancer Society recommended that clinicians measure PSA in all men 50 years of age and older as part of an annual prostate examination and that PSA screening should begin at . . .
Diagnosis of Massive Pulmonary Embolism in Man by Radioisotope Scanning
Authors: Henry N. Wagner, David C. Sabiston, John G. McAfee, Donald Tow, Howard S. Stern
Journal: New England Journal of Medicine (1964)

THE diagnosis of massive pulmonary embolism is frequently difficult and always uncertain, primarily because the symptoms and signs may mimic those of some other diseases, such as myocardial infarction or pneumonia. Ancillary examinations, including x-ray study of the chest and electrocardiography, are rarely definitive. The diagnosis can be suspected when sudden dyspnea, pleural pain, hemoptysis, syncope or a bloody pleural effusion occurs in patients who are predisposed to pulmonary embolism — that is, those who are suffering from congestive heart failure or polycythemia, or who are bedridden, as during the postoperative or postpartum state.A high degree of suspicion is . . .
ATCT-05OBJECTIVE RESPONSE (OR) TO NEOADJUVANT TREATMENT IN GLIOBLASTOMA AND ITS IMPACT ON OVERALL SURVIVAL (OS). A META-ANALYSIS OF NEOADJUVANT TRIALS OF THE SPANISH GROUP FOR RESEARCH IN NEUROONCOLOGY (GEINO)
Authors: Carmen Balana, Miguel Gil Gil, Oscar Gallego, Alfonso Berrocal, Juan Sepulveda, Ramon de las Penas, Ana Herrero, Gaspar Reynes, Raquel Luque
Journal: Neuro-Oncology (2015)

BACKGROUND: Neoadjuvant therapy (NA: treatment administered before radiation) is barely accepted in clinical trial methodology. Nevertheless, it could be an effective way to test de activity of new agents. In this study we analyzed the impact of objective response to NA therapy on the final outcome of patients included in three neoadjuvant trials carried on by GEINO: GENOM 99 (39p: Phase II cisplatin and temozolomide), GENOM 008 (12p: Phase II sunitinib) an GENOM 09 (93p: randomized phase II temozolomide versus temozolomide and bevacizumab). METHODS: We merged data bases of the 3 studies (SPSS program), and studied their characteristics, treatment response and prognostic factors related to OS. RESULTS: One hundred and forty-four patients were included: male/female: 45.1%/79%; PS: 0,1,2: 20.8%, 47.2%, 31.9%; MMS: <27/ ≥27/no data : 38.1% / 41.6%/20.3%, Neurological deficit: 59%; Basal dexametasone treatment ≥2mg/d: 71.1%; More than one lesion: 14.6%; MGMT status: Met 25.7%, Unmet 29.2%, Unk or invalid 45.1%; RPA classification: III (4.2%), III (14.6%), V (81.3%); Anticonvulsants: 52.1%, Biopsy only: 71.5%, Craniotomy with minimal resection: 28.5%. For evaluable pts: ORs were 1.5%complete response (CR), 22.3% partial response(PR). Clinical benefit (CB= CR & PR & SD): 48.4%. OS was: 10.3 months (95%CI 8.7-12.0). Patients with OR had a median OS of 16.4 months vs. 8.4 for non responders, p = 0.0001; HR 95%CI: 2.1 (1.4-3.3), p = 0.0001. Patients with CB: 13.8 vs. 6.4 p = 0.001; HR 95%CI: 0.42 (0.29-0.60), P = 0.0001). Methylation status (79) p = 0.001, bevacizumab at recurrence (27) P = 0.000, RPA II/IV vs V p = 0.05. In multivariate analyses: only MGMT status, CB or OR and bevacizumab at recurrence were independent factors for better survival either for all patients (144) or only-biopsied (103) patients. CONCLUSIONS: OR and CB are related with better OS in NA trials.
Malignant Hypertension with Unilateral Renal-Artery Occlusion
Authors: Herbert L. Goodman
Journal: New England Journal of Medicine (1952)

AS A result of Goldblatt's studies on experimental hypertension, reported in 1937,1 there has been a revival of interest and investigation in renal-artery occlusion as a cause of hypertension in man. In a small number of cases the occlusion has been limited to one renal artery. Although it is true that the majority of these cases cannot be diagnosed during life, autopsy study has revealed such lesions. The following case is presented as an example of malignant hypertension initiated in a young woman by occlusion of the right renal artery.Case ReportCase 1. C. J., a 22-year-old woman, was . . .
lmmunohistochemical Detection of the Ca Antigen in Normal and Tumor Tissues of Humans by Use of Cal Monoclonal Antibody&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;&lt;xref ref-type="fn" rid="FN3"&gt;3&lt;/xref&gt;
Authors: C S Woodhouse, C Seiler, A C Morgan, R K Oldham
Journal: JNCI Journal of the National Cancer Institute (1985)

The Ca1 monoclonal antibody was used to detect Ca antigen in paraffin sections with the use of a two-stage indirect immunoperoxidase technique. A range of normal and malignant human tissues was examined. The antibody reacted with squamous cell carcinomas, small cell carcinomas, adenocarcinomas, ductal carcinomas, and anaplastic carcinomas from gastrointestinal, lung, and breast tissues. Melanomas were negative. Reactivity was also observed against normal tissues: urinary transitional epithelium, fallopian tube epithelium, breast ducts, sweat glands, sebaceous glands, alveolar epithelium, bile duct, gallbladder, kidney tubules, and some digestive tract epithelial cells. Although the study confirms earlier reports that Ca1 is a marker for some normal, nonciliated epithelial cells and for epithelial and some other cancers, a more widespread distribution for normal tissues was found.
Adrenocortical Hypoplasia in the Newborn Infant
Authors: R. William Provenzano
Journal: New England Journal of Medicine (1950)

HYPOFUNCTION of the adrencortical tissue in the newborn infant presents a characteristic clinical syndrome. The manifestations that may result from temporary deficiency of this gland have been suggested by several authors.1 2 3 4 5 6 7 8 No report has been found in the pediatric literature of such manifestations, however, with response on replacement therapy and confirmation of the diagnosis of simple hypoplasia of the adrenocortical tissue. It is the purpose of this paper to present the case of a newborn infant that demonstrates clinically hypofunction of the adrenocortical tissue and in which post-mortem examination established the existence of this condition.My interest in the use . . .
Predictive role of carcinoembryonic antigen (CEA) for therapeutic efficacy of angiogenesis-targeting therapy in colorectal cancer: Novel clinical observation based upon recently discovered CEA biology.
Authors: K. H. Bramswig, G. W. Prager, A. Martel, G. Heinze, B. R. Binder, T. Brodowicz, G. Kornek, W. Scheithauer, C. Zielinski
Journal: Journal of Clinical Oncology (2010)

3574 Background: Angiogenesis represents a key element in the pathogenesis of malignancy. Recently, we have shown that CEA acts as a major mediator of angiogenesis independently from VEGF. We were interested whether plasma levels of CEA would predict therapeutic response towards anti-VEGF therapy by Bevacizumab in metastatic colorectal cancer (mCRC). Methods: We now retrospectively analyzed data of 275 patients with mCRC, who were treated with bevacizumab plus chemotherapy consisting of fluorouracil and leukovorin or capecitabine in combination with oxaliplatin (FOLFOX, XELOX) or irinotecan (FOLFIRI, XELIRI) (n = 149) or – as control – chemotherapy (FOLFOX or FOLFIRI) plus cetuximab, an anti EGFR antibody (n = 126). It was analyzed whether baseline CEA correlated with the overall response rate (ORR) consisting of complete remission (CR), partial remission (PR) or stable disease (SD) for at least three months according to RECIST (Response Evaluation Criteria In Solid Tumors). Patient cohorts depending on CEA plasma levels (< 5 ng/mL, 63 patients; 6-30 ng/mL, 78 patients; 31-100 ng/mL, 47 patients; > 100 ng/mL, 87 patients) were generated. Results: Baseline CEA plasma levels inversely correlated with therapeutic response in patients receiving bevacizumab-based treatment (P for trend i < 0.001: OR = 0.52, 95% C.I. 0.36, 0.74). No such association was found in patients receiving cetuximab-based therapy. ORR (%) in patients with mCRC receiving bavacizumab- based treatment were in dependence upon CEA plasma levels < 5 ng/mL ORR 92.7%, 6-30 ng/mL ORR 80.4%, 31-100 ng/mL ORR 60.9%, > 100 ng/mL ORR 59.0%. Conclusions: CEA has been shown by our group to induce angiogenesis in vitro and in mouse models in vivo. To our knowledge, this is the first clinical observation expanding our experimental models, in that the response to the VEGF-targeting antibody bevacizumab in patients with mCRC depended on CEA plasma levels which inversely correlated with therapeutic response. We propose that CEA might act as angiogenesis-inducing protein in humans and thus predict therapeutic efficacy to bevacizumab. No significant financial relationships to disclose.
EFFECT OF SAMPLING SITE ON THE EARLY KINETICS OF BLOOD RADIOIODIDE AND PERTECHNETATE.
Authors: Marguerite T. Hays, Lawrence J. Carr, Jane M. Turrel, Michael R. Broome
Journal: Clinical Nuclear Medicine (1986)

Hays, Marguerite T.; Carr, Lawrence J.; Turrel, Jane M.; Broome, Michael R. V. A. Author Information
Residency curriculum in forensic psychiatry
Authors: J D Bloom, J D Kinzie, J H Shore
Journal: American Journal of Psychiatry (1980)

The authors describe the development of a curriculum in forensic psychiatry in a general psychiatric residency training program. Educational objectives for both knowledge and skills are presented. The authors detail training experiences at each level of psychiatric residency, including electives available for fourth-year residents. They encourage other training programs to share similar reports with a view toward the development of standards in the training of residents in forensic psychiatry.
Treatment of Ostial Renal-Artery Stenoses with Vascular Endoprostheses after Unsuccessful Balloon Angioplasty
Authors: U Blum, B Krumme, P Flügel, A Gabelmann, T Lehnert, C Buitrago-Tellez, P Schollmeyer, M Langer
Journal: New England Journal of Medicine (1997)

Percutaneous transluminal renal angioplasty is a safe and effective treatment for nonostial stenoses of the renal arteries, but it has proved to be disappointing for ostial stenoses. Therefore, we prospectively studied the use of intravascular stents for the treatment of critical ostial stenoses after unsuccessful balloon angioplasty.Stainless-steel endoprostheses were placed across 74 renal-artery stenoses located within 5 mm of the aortic lumen in 68 patients with hypertension. Twenty patients had mild or severe renal dysfunction. The indications for stent placement were elastic recoil (63 arteries) or dissection (1 artery) of the vessel after angioplasty, or restenosis after initially successful balloon angioplasty (10 arteries). Patients were followed for a mean of 27 months with measurements of blood pressure and serum creatinine, duplex sonography, and intraarterial angiography.Initial technical success was achieved in all patients. Minor complications (local hematomas) occurred in only three patients; there were no major complications. Eighty-four percent of the patients were free of primary occlusion 60 months after the procedure. Restenosis of more than 50 percent of the vessel diameter occurred in 8 of 74 arteries (11 percent). Reintervention resulted in a secondary patency rate of 92 percent. Long-term normalization of blood pressure was achieved in 11 patients (16 percent). Serum creatinine levels did not change significantly after successful stent implantation in patients with previously impaired renal function.Accurate placement of renal-artery stents is technically feasible without major complications. The favorable early and long-term results suggest that primary stent placement is an effective treatment for renal-artery stenosis involving the ostium.
Reaction to Tetanus Toxoid
Authors: A. H. Eisen, J. J. Cohen, B. Rose
Journal: New England Journal of Medicine (1963)

TETANUS toxoid has been of inestimable value in the prophylaxis of tetanus infection. Active immunization is generally regarded as effective and safe, with few or no side effects. Because of the rarity of delayed reaction to tetanus toxoid1 , 2 the following case is presented.Case ReportOn June 5, 1962, P.H. and D.E. both received a booster injection of 1 ml. of tetanus toxoid¶ subcutaneously in the deltoid region of the right arm for palmar lacerations sustained during handling of an animal cage. Four days later P.H., a 20-year-old healthy laboratory technician, noted pain, heat and swelling of the right upper . . .
A Long-Term Study of Hepatitis C Virus Replication in Non-A, Non-B Hepatitis
Authors: Patrizia Farci, Harvey J. Alter, Doris Wong, Roger H. Miller, James W. Shih, Betsy Jett, Robert H. Purcell
Journal: New England Journal of Medicine (1991)

Although antibodies to the hepatitis C virus (HCV) are known to be associated with non-A, non-B hepatitis, little is known about the pattern of HCV replication, its relation to antibody levels, and the clinical course of non-A, non-B hepatitis.We measured HCV RNA in serial serum samples from five patients with post-transfusion non-A, non-B hepatitis who were followed for 10 to 14 years after transfusion. We also studied four chimpanzees that were experimentally infected with serum from four of these patients. Serum HCV RNA was detected by a "nested" polymerase-chain-reaction (PCR) assay that used two sets of primers derived from the third (NS3) and fourth (NS4) non-structural gene regions of the HCV genome.HCV sequences were detected by PCR in only two of the five patients and two of the four chimpanzees with the set of primers corresponding to the NS3 region, but in all five patients (and in all four chimpanzees) with the primers from the NS4 region. Serum HCV RNA was first detected within three weeks of transfusion in all five patients and within one week in three patients. The viremia lasted less than 4 months in the patient (and two chimpanzees) with acute, self-limited hepatitis, whereas it persisted for 10 to 14 years in the four patients (and for 1 and 3 years in two chimpanzees) with chronic non-A, non-B hepatitis. Antibodies to HCV were first detected at week 12 to 14; they disappeared after nine years in the patient with self-limited disease and became borderline after five years in one of the patients with chronic disease.During the early phase of primary HCV infection, there is a period of several months of sero-negativity during which HCV RNA is the only diagnostic marker of infection. The disappearance of HCV RNA from serum appears to correlate with the resolution of non-A, non-B hepatitis, whereas viremia persists in patients whose disease progresses to chronic hepatitis. In contrast, antibody levels do not necessarily remain elevated in patients with chronic disease.
Is there a survival difference between clear cell and serous carcinoma of the endometrium? A stage and age-matched cohort study
Authors: B. M. Slomovitz, R. L. Coleman, P. T. Soliman, L. M. Ramondetta, J. Wolf, C. C. Sun, D. M. Gershenson, T. W. Burke, K. H. Lu
Journal: Journal of Clinical Oncology (2005)

5081 Purpose Clear cell carcinoma of the endometrium (CCC) and uterine papillary serous carcinoma (UPSC) are uncommon and collectively account for 10% of epithelial endometrial cancers. However, greater than 50% of disease-specific recurrences and deaths occur in patients with these histologies. While the prognostic impact is well known, typically, CCC and UPSC are grouped together in translational and clinical studies. The purpose of this study was to compare overall survival (OS) in patients with CCC and UPSC in a matched cohort study. Methods The medical records of all patients with CCC evaluated at our cancer center between 1990–2003 were ascertained for evaluation. The comparative cohort consisted of age- and stage-matched patients with UPSC evaluated during the same time period. Clinical, pathologic, and treatment information were obtained. Results We identified 100 patients with high-risk endometrial cancer (50 with CCC and 50 with UPSC). The median age was 68.9 yrs for the CCC patients and 70.5 yrs for the UPSC patients. Complete surgical staging was performed at diagnosis (88% of the CCC and 94% of the UPSC, p=ns). Stage distribution for each group was the following: 24 patients had stage I disease, 2 stage II, 19 stage III, and 5 stage IV. The 5-yr OS for CCC was 53% (stage I /II - 70%; stage III/IV - 39%). The 5-yr OS for UPSC was 49% (stage I/II - 63%; stage III/IV - 33%). There was no significant difference in OS between CCC and UPSC. 66% of CCC and 34% of UPSC patients received adjuvant radiation (p=0.01). 22% of CCC and 38% of UPSC patients received chemotherapy (p=ns). Among all patients, stage (p=0.02) and lymph node status (p=0.03) were the only factors associated with OS when compared with traditional pathologic criteria (mixed histology, lymph vascular invasion, myometrial invasion). Conclusion This cohort represents a large series of patients with these two distinct, rare, and aggressive histologic subtypes. CCC often presents with high stage disease (48% stage III or IV). CCC and UPSC have a similar OS when matched for age and stage. Stage (including lymph node status) remains an accurate predictor of OS in patients with these tumors. The poor survival reflects accuracy of a high-risk pathology. No significant financial relationships to disclose.
Catheter-Based Radiotherapy to Inhibit Restenosis after Coronary Stenting
Authors: Paul S. Teirstein, Vincent Massullo, Shirish Jani, Jeffrey J. Popma, Gary S. Mintz, Robert J. Russo, Richard A. Schatz, Erminia M. Guarneri, Stephen Steuterman, Nancy B. Morris, Martin B. Leon, Prabhakar Tripuraneni
Journal: New England Journal of Medicine (1997)

In animal models of coronary restenosis, intracoronary radiotherapy has been shown to reduce the intimal hyperplasia that is a part of restenosis. We studied the safety and efficacy of catheter-based intracoronary gamma radiation plus stenting to reduce coronary restenosis in patients with previous restenosis.Patients with restenosis underwent coronary stenting, as required, and balloon dilation and were then randomly assigned to receive catheter-based irradiation with iridium-192 or placebo. Clinical follow-up was performed, with quantitative coronary angiographic and intravascular ultrasonographic measurements at six months.Fifty-five patients were enrolled; 26 were assigned to the iridium-192 group and 29 to the placebo group. Angiographic studies were performed in 53 patients (96 percent) at a mean (+/-SD) of 6.7+/-2.2 months. The mean minimal luminal diameter at follow-up was larger in the iridium-192 group than in the placebo group (2.43+/-0.78 mm vs. 1.85+/-0.89 mm, P=0.02). Late luminal loss was significantly lower in the iridium-192 group than in the placebo group (0.38+/-1.06 mm vs. 1.03+/-0.97 mm, P=0.03). Angiographically identified restenosis (stenosis of 50 percent or more of the luminal diameter at follow-up) occurred in 17 percent of the patients in the iridium-192 group, as compared with 54 percent of those in the placebo group (P= 0.01). There were no apparent complications of the treatment.In this preliminary, short-term study of patients with previous coronary restenosis, coronary stenting followed by catheter-based intracoronary radiotherapy substantially reduced the rate of subsequent restenosis.