tbuckley/cabot-search huggingface dataset:
Lymphopenia and monocytopenia versus MASCC score system in patients with febrile neutropenia
Authors: M. Baykara, A. Demirkazik, A. Elhan, B. Yalcin, A. Buyukcelik, M. Dogan, G. Utkan, I. Tek, H. Doruk, H. Akan, F. Icli
Journal: Journal of Clinical Oncology (2006)

18622 Background: The purpose of this study was determine the clinical significance of lymphopenia and monocytopenia in terms of its duration and depth in patients with febrile neutropenia (FEN) and MASCC scores parametres. Methods: Sixty-six patients with FEN were prospectively analysed. Recurrent FEN episodes were excluded in this trial. Twenty-four patients had solid tumors, 42 patients had lymphoma-leukemia. Patients with MASCC-scores ≥21 evaluated as low-risk (LR) and the ones with their scores &lt;21 were high-risk (HR). Results: Thirty-six patients had HR and the rest had LR. Lymphocyte count &lt;700/mm3 and monocyte count &lt;100/mm3 were found as 91.6% and 86.6% in HR and in LR groups, respectively.The rate of refractory fever(RF) in HR patients was clearly high.Patients with protracted neutropenia (PN) had higher rate of RF (p = 0.007). Patients with longer duration of neutropenia and monocytopenia tended to have RF (p = 0.052, p = 0.018). The rate of administered AFT was significantly high in HR patients (p = 0.005). AFT was administered to one third of HR patients, but no patient received AFT in LR-group (p &lt; 0.001). In group with neutropenia duration (ND) &lt;10 days, one patient received AFP (p &lt; 0.001). AFT was given to most of the patients who had longer duration of lymphopenia or monocytopenia (respectively; p = 0.002, p = 0.001), and who had leukemia (p = 0.001). The most important parameters effecting the duration of antibiotic therapy (DAT) was found to be ND. DAT &gt;14 days was found more than fourfold in patients PN (p = 0.007). Fifty-five percent out of patients with solid tumor or lymphoma were given &lt;14 days antibiotic therapy. But, most of patients with leukemia had antibiotics &gt;14 days (p = 0.002).The rate of antibiotic therapy &gt;14 days was higher in patients with longer duration of lymphopenia and monocytopenia (respectively; p = 0.073, p = 0.062). The most important parameter that influences on antibiotic modification (AM) was severity of monocytopenia on the first day of FEN. The rate of AM was found in aproximately nine-fold in patients that had monocyte counts ≤100/ mm3 as compared to monocyte ≥100/ mm3 (p = 0.01). Conclusions: The depth of monocytopenia and durations of lymphopenia and monocytopenia were the important parameter influencing antibiotic modification in FEN. No significant financial relationships to disclose.
Clinical competence in ambulatory electrocardiography
Authors: Suzanne B. Knoebel, None Task Force Member, Sankey V. Williams, James L. Achord, William A. Reynolds, Charles Fisch, Gottlieb C. Friesinger, Francis J. Klocke, Masood Akhtar, Thomas J. Ryan, Robert C. Schlant
Journal: Journal of the American College of Cardiology (1993)
The Reproducibility of a Method to Identify the Overuse and Underuse of Medical Procedures
Authors: Paul G. Shekelle, James P. Kahan, Steven J. Bernstein, Lucian L. Leape, Caren J. Kamberg, R.E. Park
Journal: New England Journal of Medicine (1998)

To assess the overuse and underuse of medical procedures, various methods have been developed, but their reproducibility has not been evaluated. This study estimates the reproducibility of one commonly used method.We performed a parallel, three-way replication of the RAND-University of California at Los Angeles appropriateness method as applied to two medical procedures, coronary revascularization and hysterectomy. Three nine-member multidisciplinary panels of experts were composed for each procedure by stratified random sampling from a list of experts nominated by the relevant specialty societies. Each panel independently rated the same set of clinical scenarios in terms of the appropriateness of the relevant procedure on a risk-benefit scale ranging from 1 to 9. Final ratings were used to classify the procedure in each scenario as necessary or not necessary (to evaluate underuse) and inappropriate or not inappropriate (to evaluate overuse). Reproducibility was measured by overall agreement and by the kappa statistic. The criteria for underuse and overuse derived from these ratings were then applied to real populations of patients who had undergone coronary revascularization or hysterectomy.The rates of agreement among the three coronary-revascularization panels were 95, 94, and 96 percent for inappropriate-use scenarios and 93, 92, and 92 percent for necessary-use scenarios. Agreement among the three hysterectomy panels was 88, 70, and 74 percent for inappropriate-use scenarios. Scenarios involving necessary use of hysterectomy were not assessed. The three-way kappa statistic to detect overuse was 0.52 for coronary revascularization and 0.51 for hysterectomy. The three-way kappa statistic to detect underuse of coronary revascularization was 0.83. Application of individual panels' criteria to real populations of patients resulted in a 100 percent variation in the proportion of cases classified as inappropriate and a 20 percent variation in the proportion of cases classified as necessary.The appropriateness method is far from perfect. Appropriateness criteria may be useful in comparing levels of appropriate procedures among populations but should not by themselves be used to direct care for individual patients.
Metabolic responses to cardiac hypoxia. Increased production of succinate by rabbit papillary muscles.
Authors: H Taegtmeyer
Journal: Circulation Research (1978)

In oxygen-deprived heart muscle tissue, alanine levels increase, whereas levels of glutamate and aspartate decline, and it is therefore postulated that free tissue amino acids participate in the metabolic response to cardiac hypoxia.Succinate is a hypothetical end product of anaerobic metabolism of glutamate and aspartate.To test this hypothesis in vitro isolated right ventricular papillary muscles from rabbits were individually incubated under oxygenated and hypoxic conditions.Lack of oxygen significantly augmented succinate, lactate, and alanine production, while levels of glutamate fell.Increased succinate production also was seen when various metabolic precursors were present in the oxygenated incubation medium.In hypoxic muscles, succinate production could be enhanced further when these precursors were present.The aminotransferase inhibitor, aminooxyacetate, reduced succinate production by hypoxic papillary muscles.This finding demonstrated a close relationship between transamination of amino acids and succinate production.In addition, it is suggested that anaerobic metabolism of the amino acids glutamate and aspartate, anaerobic glycolysis, and alanine production are quantitatively related.Moreover, the two reactions responsible for succinate production during hypoxia, 2-oxoglutarate dehydrogenase and fumarate reductase, are in oxidation-reduction balance and lead to substrate level phosphorylation in the citric acid cycle.Anaerobic mitochondrial metabolism, resulting in increased synthesis of succinate, must be considered when one estimates the energy production by oxygen-deprived heart muscle.
Guided Homing of Cells in Multi‐Photon Microfabricated Bioscaffolds
Authors: Mark A. Skylar‐Scott, Man‐Chi Liu, Yuelong Wu, Atray Dixit, Mehmet Fatih Yanik
Journal: Advanced Healthcare Materials (2016)

Tissues contain exquisite vascular microstructures, and patterns of chemical cues for directing cell migration, homing, and differentiation for organ development and function. 3D microfabrication by multi‐photon photolithography is a flexible, high‐resolution tool for generating 3D bioscaffolds. However, the combined fabrication of scaffold microstructure simultaneously with patterning of cues to create both geometrically and chemically defined microenvironments remains to be demonstrated. This study presents a high‐speed method for micron‐resolution fabrication of scaffold microstructure and patterning of protein cues simultaneously using native scaffold materials. By the simultaneous microfabrication of arbitrary microvasculature geometries, and patterning selected regions of the microvasculature with the homing ligand P‐selectin, this study demonstrates adhesion, rolling, and selective homing of cells in defined 3D regions. This novel ability to generate high‐resolution geometries replete with patterned cues at high speed enables the construction of biomimetic microenvironments for complex 3D assays of cellular behavior.
Chlorambucil/prednisone vs. CHOP in symptomatic low-grade non-Hodgkin's lymphomas: A randomized trial from the Lymphoma Group of Central Sweden
Authors: E Kimby, M Björkholm, G Gahrton, B Glimelius, H Hagberg, B Johansson, H Johansson, G Juliusson, M Järnmark, E Löfvenberg
Journal: Annals of Oncology (1994)
CLINICAL AND ECHOCARDIOGRAPHIC PREDICTORS OF EXERCISE CAPACITY FOLLOWING MITRAL VALVE SURGERY FOR MITRAL REGURGITATION
Authors: Nicholas M. Furiasse, Todd Kiefer, Sanjiv Shah, Bonnie Kane, Nishath Quader, Hamorabi Mkrdichian, Lauren Nelson, Laila Payvandi, Adin-Cristian Andrei, Andrew Wang, Vera Rigolin
Journal: Journal of the American College of Cardiology (2016)
Unilateral Acute Renal Cortical Necrosis
Authors: S Lantsberg, I Rachinsky, L Lupu, D Tovbin, Y Hertzanu
Journal: Clinical Nuclear Medicine (2000)

Bilateral acute cortical necrosis is a rare form of acute renal failure characterized by necrosis of the renal cortex and sparing of the medulla. Little information on the imaging presentation of bilateral acute renal cortical necrosis is available. The enhanced CT appearance is pathognomonic and diagnostic. The unilateral presentation of acute cortical necrosis is extremely rare, and no imaging methods have been described. The authors chose to apply scintigraphic evaluation to this unique condition complementary to CT to confirm the diagnosis. Mercaptoacetylglycine (T3) was selected to assess tubular damage, in contrast to the pure glomerular agent DTPA. Evidence of some tubular function and clear delineation of the shrunken kidney was found. Conversely, in the DTPA study the kidney was not visualized. A DMSA scan was performed for assessment of viability of the renal cortex and showed a photopenic halo around the small area of the viable cortex of the upper pole. The halo sign represents a cortical loss. The visualization of the upper pole as evidence of cortical viability as a consequence of collateral blood flow from capsular vessels was seen on angiography. Radiographic and scintigraphic correlation of this rare condition may be an effective means to confirm the diagnosis and to establish the extent of involvement. However, contrast CT remains the preferred method in the diagnosis of acute cortical necrosis.
Case 4-2012
Authors: Eugene P. Rhee, James A. Scott, Anand S. Dighe
Journal: New England Journal of Medicine (2012)

A 37-year-old man was admitted to this hospital because of 12 hours of muscle pain and weakness, resulting in the inability to rise from bed. Brief episodes of similar symptoms had occurred during the past month. He reported blurred vision, gynecomastia, and weight loss.
THU0353 The prevalence of vitamin D deficiency in 55 new patients diagnosed with fibromyalgia at first visit to rheumatology outpatient clinics in cork, ireland
Authors: O.E. Hussein, W.J. Tee, M.J. Regan
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Fibromyalgia (FM) is a chronic hypersensitivity pain syndrome with altered central pain processing. Whether vitamin D deficiency contributes to this pain syndrome has not been clearly defined. <h3>Objectives</h3> From among all new patients referred over a three-year period to our clinics by G.P.s, our aims were to identify the new patients diagnosed with FM and to analyse their vitamin D levels. <h3>Methods</h3> At first visit to our clinics, we record patients' demographics, their musculoskeletal diagnosis and pre-determined clinical data in a database which is continually updated at follow-up visits. We performed a retrospective database review of all new patients seen between 1/1/2009 – 31/12/2011 to identify patients diagnosed anew with FM. Using ACR 1990 FM criteria, the diagnosis was confirmed by chart review and their vitamin D levels were recorded. Vitamin D deficiency was defined as a 25 hydroxy-vitamin D level of &lt;75 nmol/L (&lt;30ng/mL); severe deficiency as &lt;25 nmol/L. <h3>Results</h3> Between 1/1/2009 – 31/12/2011, 696 new patients were seen: 62 (9%) had FM of which 60 (97%) were female, 2 were male. The average age was 43 years (range 18 - 72). Race: 60 Caucasian (97%), one African (1.5%), one Asian (1.5%). In 54 of the FM patients, FM was the only musculoskeletal diagnosis. Eight patients had FM and another musculoskeletal condition at presentation (5 osteoarthritis, 1 gout and osteoarthritis, 1 psoriatic arthritis, 1 shoulder capsulitis). Vitamin D levels were available for 55 of these FM patients (89%) with results as follows: &lt;75 nmol/L in 42 (76%), &lt;25 nmol/L in 12 (22%) and ≥75 nmol/L in 13 (24%) patients. <h3>Conclusions</h3> Three-quarters of newly diagnosed FM patients had hypovitaminosis D and more than 1 in 5 had severe deficiency. This could reflect background vitamin D deficiency which is prevalent in Ireland. Another postulate is that some non-specific pain syndromes are caused by subclinical osteomalacia misdiagnosed as FM. Should vitamin D deficiency be corrected before we label patients as having FM? More research is needed in this area. <h3>References</h3> The prevalence of vitamin D deficiency in consecutive new patients seen over a 6-month period in general rheumatology clinics. Haroon M, Bond U, Quillinan N, Phelan MJ, Regan MJ. Fibromyalgia–should we be testing and treating for vitamin D deficiency? Daniel D, Pirotta MV. Correlation of symptoms with vitamin D deficiency and symptom response to cholecalciferol treatment: a randomized controlled trial. Arvold DS, Odean MJ, Dornfeld MP, Regal RR, Arvold JG, Karwoski GC, Mast DJ, Sanford PB, Sjoberg RJ. <h3>Disclosure of Interest</h3> None Declared
AB0106 Serum and synovial interleukin-15 (IL-15) in rheumatoid arthritis (RA)
Authors: S.M. Rashad, S.A. Mohamed, S.H. Ghomaa, Z.A. Aboeleuon
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> IL-15 is a proinflammatory cytokine that contributes to local inflammation and joint damage in RA. A locally overproduced IL-15 may be responsible for the activation and proliferation of T cells in situ, reflected by significantly increased number of activated T cells in RA possibly contributing to the pathogenesis of RA (Kuca-Warnawin, 2011). <h3>Objectives</h3> The aim of the study was to evaluate the clinical significance of serum (S) and synovial fluid (SF) interleukin (IL)-15 measurements in relation to laboratory and clinical measures of disease activity of patients with rheumatoid arthritis (RA). <h3>Methods</h3> Forty-four patients with RA (22 in activity) and (22 in remission) and 12 patients with osteoarthritis (OA) were included in this study. RA activity was determined using the Disease Activity Score (DAS) 28 index. Concentrations of IL-15 were measured by ELISA. Serum C-reactive protein (CRP) levels were also determined. Cross-sectional correlations between S and SF levels of cytokine and values of DAS 28 index were calculated. <h3>Results</h3> The results have shown that IL-15 levels in S and SF of patients with RA were significantly higher than the levels obtain from patients with OA (p&lt;0.001). S IL-15 level was higher in active group than remission group (P&lt;0.05). Significantly higher S and SF levels of IL-15 and serum CRP values were found in RA patients with high disease activity (DAS 28&gt;5.1) compared to those with mild (DAS 28&gt;3.2) and low disease activity (DAS 28&gt;2.6) (p&lt;0.01). S IL-15 was higher in RA with positive RF (P&lt;0.05). Positive correlation between SF IL-15 and RF in active RA was found (P&lt;0.01). Serum and SF concentrations of IL-15 positively correlated with DAS 28 index values, i.e., disease activity. ESR and duration of morning stiffness were correlated with S and SF IL-15 in active RA (P&lt;0.05), but no correlation with duration of the disease. Serum IL-15 was found to be positively correlated with SF IL-15 in RA patients in activity. <h3>Conclusions</h3> In conclusion, SF IL-15 levels in RA patients are good indicators of disease activity. The results obtained support the contribution of its use in clinical practice as a reliable method in assessing disease activity in RA patients. <h3>References</h3> Elevated number of recently activated T cells in bone marrow of patients with rheumatoid arthritis: a role for interleukin 15? Kuca-Warnawin E, Ann Rheum Dis 01-JAN-2011; 70(1): 227-33. <h3>Disclosure of Interest</h3> None Declared
Most patients have less pain and disability after bariatric surgery
Authors: Jacqui Wise
Journal: BMJ (2016)

In a three year follow-up of severely obese patients undergoing bariatric surgery, 50% to 70% experienced significant improvements in pain, physical function, and walking capacity. The research, published in JAMA , also found that roughly three quarters of patients with severe knee and hip pain or disability before surgery experienced clinically significant improvements in symptoms.1

The study, which was funded by the National Institutes of Health, included 2221 adults with severe obesity undergoing bariatric surgery at 10 US hospitals. The median body mass index was 45.9, the median age was 47 years, and 79% of …
Dexamethasone suppression test as a prognostic tool: two case reports
Authors: J D Amsterdam, A Winokur, S Caroff
Journal: American Journal of Psychiatry (1981)

Recent reports have suggested that the dexamethasone suppression test (DST) may be useful as a prognostic tool, providing information on the longterm clinical course of patients with primary depression. Carroll and associates (1) showed that the “early escape” ofcontisol after the DST gradually normalized with clinical improvement. Gneden and associates (2) reported that continued abnormal cortisol nonsuppression distinguished those patients who relapsed after treatment was discontinued from those who remained well. If this promising finding can be replicated, it might prove to be an important application of a neumoendocrine test for the treatment of depression. Here we report on two cases that pertain to the significance of the DST as a prognostic tool. The first case supports the potential value of the DST as a prognostic indicator, and the second case underscores the variability that may be encountered in attempting to apply this type of neuroendocnine evaluation to patients with depression.
Reexcision — The Other Breast Cancer Epidemic
Authors: Hiram S. Cody, Kimberly J. Van Zee
Journal: New England Journal of Medicine (2015)

Overviews of randomized clinical trials have established that the survival rate after breast-conserving surgery (partial mastectomy) is equivalent to that after mastectomy1 and that local control of disease and breast cancer–specific survival rates are related: strategies that reduce the rates of local recurrence at 5 years and 10 years translate into an improved breast cancer–specific survival rate at 15 years.2 This year in the United States, nearly 270,000 women will receive a diagnosis of operable breast cancer; a substantial majority of these women will be suitable candidates for breast-conserving surgery, and approximately two thirds (180,000 women) will choose this option. . . .
Murine Studies With 5-Fluorouracil and Leucovorin
Authors: A. J. WEISS
Journal: JNCI Journal of the National Cancer Institute (1989)

Journal Article Murine Studies With 5-Fluorouracil and Leucovorin Get access ARTHUR J. WEISS ARTHUR J. WEISS Department of Medicine, Thomas Jefferson University, School of MedicinePhiladelphia, PA 19107 Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 81, Issue 6, 15 March 1989, Pages 459–460, https://doi.org/10.1093/jnci/81.6.459-a Published: 15 March 1989
AB0229 Senescence associated β-galactosisdase expression in systemic sclerosis skin and fibroblasts
Authors: F. Ogawa, H. Tomita, Y. Koike, Y. Kuwatsuka, A. Utani
Journal: Annals of the Rheumatic Diseases (2013)

Background Systemic sclerosis (SSc) is connective tissue disease characterized by fibrosis and vascular changes in the skin and internal organs with autoimmune background. However, the mechanism is still unknown. Recently, it is reported that cellular senescence is associated with fibrosis and its amelioration in several diseases. Senescence associated β-galactosidase (SA-β-gal) is one of the histological marker for the cellular senescence. Objectives To determine association of cellar senescence in SSc skin and fibroblast. Methods SA-β-gal expression was investigated in skin samples from SSc patients and age- and sex- matched healthy control. SA-β-gal activity was also compared in SSc patients between sclerosis lesion (forearm) and non-sclerotic lesion (upper arm). In addition, SA-β-gal expression was also investigated in fibroblasts from SSc patients and healthy control. Senescent fibroblast established by successive subculture was used for SA-β-gal staining control. Results Senescence fibroblast showed large-scaled shape and nucleus with SA-β-gal staining. SA-β-gal expression was higher in SSc skin than control. SA-β-gal activity was observed mainly in upper dermis. Furthermore, SA-β-gal expression was observed in sclerotic skin lesion of SSc patients, however, its expression was not detected in non-sclerotic lesion of SSc patients. Furthermore, fibroblast from SSc patients showed higher SA-β-gal expression than control fibroblast. Conclusions These results suggest that cellular senescence in SSc fibroblast may contribute to disease development in patients with SSc 1. Coppe, J.P., et al., Senescence-associated secretory phenotypes reveal cell-nonautonomous functions of oncogenic RAS and the p53 tumor suppressor. PLoS Biol, 2008. 6(12): p. 2853-68. 2. Jun, J.I. and L.F. Lau, Cellular senescence controls fibrosis in wound healing. Aging (Albany NY), 2010. 2(9): p. 627-31. 3. Leontieva, O.V. and M.V. Blagosklonny, DNA damaging agents and p53 do not cause senescence in quiescent cells, while consecutive re-activation of mTOR is associated with conversion to senescence. Aging (Albany NY), 2010. 2(12): p. 924-35. 4. Frippiat, C., et al., Subcytotoxic H2O2 stress triggers a release of transforming growth factor-beta 1, which induces biomarkers of cellular senescence of human diploid fibroblasts. J Biol Chem, 2001. 276(4): p. 2531-7. Disclosure of Interest None Declared