tbuckley/cabot-search huggingface dataset:
Elevation of Serum NT-Pro BNP Correlates with Asymptomatic Cardiac Dysfunction Induced by Doxorubicin.
Authors: A. Kittiwarawut, Y. Vorasatekarnkit, S. Tanasanwimon, S. Manusnayakorn, V. Sriuranpong
Journal: Cancer Research (2009)

Abstract Background: Cardiac dysfunction is one of the major limitations of anthracycline treatment in cancer patients. Current reliable investigation to detect early cardiac damage from anthracycline is not available. There are several serum cardiac markers useful in other types of cardiomyopathy including NT-pro BNP, Troponin-T, and CK-MB. We chose to investigate potential application of these serum biomarkers in the cancer patients receiving anthracycline.Patients and methods: We prospectively collected data from a cohort of 52 female breast cancer patients who receiving doxorubicin and cyclophosphamide (AC) regimen every 3 weeks for 4 cycles for preoperative or postoperative adjuvant treatment. Cardiac function evaluations by echocardiography were done at baseline and post 4th cycle chemotherapy. Patients' blood samplings were serially measured for cardiac biomarkers at baseline, after 1st cycle, and after 4th cycle chemotherapy.Results: All patients were in good performance status with ECOG scale 0-1.The mean cumulative dose of doxorubicin in this study was 236.69 mg/m2. There was no symptomatic heart failure detected during study period. However, there were significant asymptomatic reductions of left ventricular ejection fraction (LVEF) from 70.73 ± 5.97% at baseline to 66.96 ± 5.48% (p&amp;lt;0.001). The severities of LVEF declination were 17.4% in grade1 and 3.8% in grade 2 by clinical toxicity criteria of NCI version 2. We found significant elevation of serum NT-proBNP (p = 0.044) following the first dose of chemotherapy when compared the measurements in patients who had reduction of LVEF to those with normal LVEF. Measurement of serum Troponin-T and CK-MB showed no significant correlation with changes in LVEF. Generalized-estimating-equations correlation analysis demonstrated that the reduction of fractional shortening (FS) was significantly associated with the elevation NT-pro BNP (r = -0.016, p = 0.014). At cutoff level 45 pg/mL, serum NT-proBNP had 100% sensitivity and 66.67% specificity for the detection of cardiotoxicity in patients under 50 year-old.Conclusion: Asymptomatic reductions in cardiac function are common in patients treated with doxorubicin. NT-pro BNP may serve as a potential convenient serum biomarker for early detection of cardiotoxicity induced by anthracycline. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4003.
Prevalence of Patent Foramen Ovale in Patients with Stroke
Authors: Ph. Lechat, J.L. Mas, G. Lascault, PH. Loron, M. Theard, M. Klimczac, G. Drobinski, D. Thomas, Y. Grosgogeat
Journal: New England Journal of Medicine (1988)

The cause of ischemic stroke in younger adults is undefined in as many as 35 percent of patients. We studied the prevalence of patent foramen ovale as detected by contrast echocardiography in a population of 60 adults under 55 years old with ischemic stroke and a normal cardiac examination. We compared the results with those in a control group of 100 patients. The prevalence of patent foramen ovale was significantly higher in the patients with stroke (40 percent) than in the control group (10 percent, P less than 0.001). Among the patients with stroke, the prevalence of patent foramen ovale was 21 percent in 19 patients with an identifiable cause of their stroke, 40 percent in 15 patients with no identifiable cause but a risk factor for stroke, such as mitral valve prolapse, migraine, or use of contraceptive agents, and 54 percent in 26 patients with no identifiable cause (P less than 0.10). These results suggest that because of the high prevalence of clinically latent venous thrombosis, paradoxical embolism through a patent foramen ovale may be responsible for stroke more often than is usually suspected.
PTH-018 Intravenous Ferric Carboxymaltose (ferinject) Given To Patients Post Endoscopy – Safe And Cost Effective
Authors: AM Verma, D Das, A Dixon, AP Chilton
Journal: Gut (2014)

<h3>Introduction</h3> Intravenous (IV) iron is established as an effective management for patients with iron deficiency anaemia (IDA) and is indicated in those with severe iron deficiency, malabsorption, intolerance to oral iron and/or those requiring rapid correction of IDA. <sup>1</sup> The use of traditional agents iron dextran (CosmoFer) and iron sucrose (Venofer) are inexpensive in drug cost (£50–60), however they require test doses, slow intravenous infusions (4 h+) and the incidence of hypersensitivity reactions are high. This required a day case attendance which increased the overall cost of an infusion significantly. Then introduction of Ferric Carboxymaltose (FCM) has changed the landscape. Whilst the drug cost is 4 times higher, infusions only take 15 min and are much better tolerated. Also a higher dose of 1 g can be given. This only requires a short hospital appointment and reduces the overall cost of an infusion to less than traditional agents. The majority of patients with IDA undergo endoscopy for investigation +/- management. We trialled the use of IV FCM in patients whom it is indicated during the post-procedure observational time. <h3>Methods</h3> Since January 2013, patients receiving IV FCM post endoscopy had their details recorded in a database. <h3>Results</h3> - 15 patients underwent IV FCM infusion post endoscopy; - 9 women / 6 men, age range 33–83, mean age 64/ median 70; - Mean dose 940mg / median 935.7mg (12 patients received 1g IV); - 13 patients received IV sedation during endoscopy; - 6 had gastroscopy, 9 had colonoscopy; - Indication (s): Intolerant to oral iron 8, severe IDA 9 (GAVE, CRC), malabsorption 1; - Adverse events: 1 patient with bruising post IV cannula removal (not related to FCM). <h3>Conclusion</h3> The safety and cost effectiveness of IV FCM has been established. This study shows that this is also the case for patients who receive IV FCM post endoscopy. The benefits of this approach are significant. Patients are already observed post-endoscopy so giving a short IV infusion is appropriate and does not require extra staff. This is also very convenient for patients, reducing the number of attendances required in addition to the benefits of IV iron for anaemia. Giving IV FCM post endoscopy reduces the costs significantly when compared those of a separate appointment to a day case unit. <h3>Reference</h3> 1 Andrew F Goddard, Martin W James, Alistair S McIntyre, Brian B Scott, on behalf of the British Society of Gastroenterology. Guidelines for the Management of Iron Deficiency Anaemia. <i>Gut</i> 2011:60:1309–1316 <h3>Disclosure of Interest</h3> None Declared.
Late Effects of Total Gastrectomy in Man
Authors: Robert M. MacDonald, Franz J. Ingelfinger, Helen W. Belding
Journal: New England Journal of Medicine (1947)

STUDIES on patients who have survived total gastrectomy for three years or more are few, and contradictory results are reported. For this reason and since total gastrectomy is being practiced with rapidly increasing frequency, we have studied intestinal motor function, intestinal absorption, pancreatic function and the blood picture in 3 patients who have survived total gastrectomy for three, five and ten years, respectively.¶Case ReportsCase 1. E. O., a 58-year-old woman, was admitted to the hospital with a history of anorexia, weight loss and vomiting of 3 years' duration. A total gastrectomy with enteroenterostomy was performed on May 28, . . .
Abstract 5248: Quantum dot multiplexing of prognostic marker and stem cell marker expression in colorectal cancer circulating tumor cells
Authors: Avisnata Das, Joshua E. Allen, David T. Dicker, Kristi L. Peters, Jamal Joudeh, Wafik S. El-Deiry
Journal: Cancer Research (2011)

Abstract Circulating tumor cells (CTCs) reflect disease burden in metastatic colorectal cancer (mCRC) and show reduced numbers in patients who are responding to chemotherapy. Current analysis is limited to counting CTCs and little additional marker analysis. We sought to develop methodology to allow multiplexing of marker detection in individual CTCs to assess tumor cell heterogeneity and to gain insight into relationships of prognostic and therapy response markers. This ongoing study is evaluating expression of up to 8 markers in a single CTC by a multispectral multiplex imaging technique using nano-particle type quantum dot (Q-Dot) dyes. We hypothesize that CTCs that are extremely rare (∼ 1 in 10 million RBCs) in the blood of cancer patients play an important role in metastasis. In view of the small number of such cells in the blood of mCRC patients (prognostication based on &amp;lt;3 versus &amp;gt;3 CTCs/7.5 ml of blood) there is a need to derive more molecular correlations from single CTCs. We designed a clinical protocol to collect blood from mCRC patients receiving chemotherapy with the intent to evaluate multiplexed molecular marker expression in CTCs in responders versus non-responders using the FDA-approved Veridex CellSearch technology. We are evaluating CD26, CD133, EGFR, Ki 67, p27, c-Myc, ALDH1, Bcl-Xl, Mcl-1, phosho-Akt, phospho-ERK, TRAIL receptors, IAPs, and p53 using antibodies conjugated to different Q-Dots. Ongoing studies include prognostic marker, stem cell marker, and cell proliferation/death response marker analysis in human tumor xenografts of HCT116, p53-null HCT116, DLD1, SW620, and SW480. Initial profiling of tumor cell lines revealed that mutant p53 and KRAS-expressing SW620 derived from a patient with mCRC has CD26 and CD133 expression including a sub-population of tumor cells that co-express these two stem cell markers. HCT116 showed positive EGFR, CD26, but little or no CD133 expression. We are evaluating correlations between the primary tumors in mice as compared to the CTCs in mice and similar experiments are part of the clinical protocol. The studies should unravel the complexity of CTC heterogeneity, and define informative subsets of markers that can be routinely included in studies to assess prognosis and response to therapy. The ease with which CTCs can be isolated makes these studies of comparisons with primary tumors critical in order to establish and validate new methods for assessing tumor behavior and response to therapy in the clinic through this CTC “liquid biopsy” technique. 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 5248. doi:10.1158/1538-7445.AM2011-5248
AB1338 Substantial subclinical cardiovascular dysfunction in inflammatory arthritis
Authors: I. Meek, H. Vonkeman, M. van de Laar
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Chronic rheumatic and cardiovascular (CV) diseases share common pathophysiological factors; immobility, obesity, inflammation and smoking. Previous studies consistently found increased CV morbidity and mortality in patients with rheumatoid arthritis (RA) and gout. Cardiovascular events are more likely to be fatal in RA patients, possibly due to delayed recognition of CV symptoms. Echocardiographic and vascular function studies suggest subclinical CV dysfunction in RA patients. Appropriate non-invasive screening tests are needed to identify patients at increased risk of cardiovascular events due to subclinical CV dysfunction. <h3>Objectives</h3> to evaluate the prevalence of -subclinical CV dysfunction by ECG and NT-proBNP in patients with RA and gout compared to patients with noninflammatory rheumatic diseases. <h3>Methods</h3> Comparison of prevalences of ECG abnormalities, elevated NT-proBNP and previously documented CV disease (myocardial infarction, coronary artery disease, cardiac arrhythmia, heart failure, cerebrovascular event) between patients with RA (673) and gout (202) versus noninflammatory rheumatic disease (NRD; osteoarthritis and chronic pain syndromes, 458) in a cohort of consecutive patients the Arthritis Center Twente (ACT), a large rheumatology department in The Netherlands. Data were collected in 2009. Subclinical cardiovascular dysfunction was defined as the finding of ECG abnormalities and/or elevated NT-proBNP in patients without previously documented CV disease. Logistic regression analysis of potential predictors of subclinical CV dysfunction, i.e. traditional CV risk factors, ESR, disease specific medication (DMARDs or urate lowering therapy in RA and gout respectively), and DAS-28 disease activity scores (RA only), within patient groups. Analyses were controlled for age and sex. <h3>Results</h3> 9.8% of patients had previously documented CV disease (RA 7.6%, gout 17.3% vs. NRD 5.7%, p&lt;0.05). ECG recordings were available for 1164 patients (RA 590, gout 183, NRD 391), NT-proBNP levels for 1331 (RA 672, gout 201, NRD 458). For 1163 patients both measurements were present (RA 589, gout 183, NRD 391). Subclinical ECG abnormalities were significantly more frequent in RA (18.3%) and gout (24.0%) compared with NRD (12.0%, p&lt;0.05). Elevated NT-proBNP was also significantly more frequent in RA (29.5%) and gout (38.3%) vs. NRD (19.0%, p&lt;0.05). Subclinical CV dysfunction occured significantly more often in RA (30.7%) and gout (31.1%) compared with NRD (20.2%, p&lt;0.05). Age was the only predictor of suspected CV dysfunction in both RA and gout. <h3>Conclusions</h3> Subclinical CV disease is highly prevalent in rheumatoid arthritis and gout compared to noninflammatory rheumatic disease. <h3>Disclosure of Interest</h3> None Declared
Central-Airway Necrosis after Stereotactic Body-Radiation Therapy
Authors: Michael N. Corradetti, Andrew R. Haas, Ramesh Rengan
Journal: New England Journal of Medicine (2012)

Stereotactic body-radiation therapy is a novel technique that aims to deliver higher doses of radiation to cancers in a more focused way. However, adjacent tissues also get higher doses and fatal toxicities can emerge, as in one patient.
World could be declared free of polio by 2018
Authors: A. Gulland
Journal: BMJ (2013)

Although the presynaptic protein α-synuclein is a recognized player in neurodegeneration, its precise physiologic function(s) and/or role in human disease remains unclear. An emerging consensus from previous studies in lower-order systems is that α-synuclein interferes with vesicle-trafficking pathways; however putative neuronal correlates are unknown. Here we explore consequences of α-synuclein modulation in cultured mouse hippocampal neurons; coupling α-synuclein overexpression and knock-out model-systems with contemporary imaging paradigms. Our studies reveal an unexpected role of α-synuclein in attenuating the mobility of recycling pool (RP) vesicles between presynaptic boutons—called “superpool” trafficking—and also in maintaining the overall size of RPs at synapses. While an excess of α-synuclein led to smaller RPs and inhibited intersynaptic trafficking, an absence of α-synuclein triggered converse changes with larger RPs and enhanced intersynaptic trafficking. The data collectively suggest a model where α-synuclein maintains RP homeostasis by modulating intersynaptic vesicular dynamics, and provide a putative neuronal correlate of α-synuclein-induced impairments in vesicle-trafficking previously reported in lower-order systems.
AB0219 Association between elevated serum levels of soluble e-cadherin and renal dysfunction in female patients with systemic lupus erythematosus
Authors: T. Jin, K. Almehed, H. Carlsten, H. Forsblad-d’Elia
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Epithelial (E)-cadherin is a homophilic adhesion molecule that plays major role in epithelial cell adhesion. E-cadherin can be cleaved from the cell surface by proteolytic enzymes, resulting in the generation of soluble E-cadherin (sE-cad). Serum levels of sE-cad are elevated in patients with several types of cancer, bacterial infections, organ failure, and primary Sjögren’s syndrome. However, the sE-cad levels in SLE have not been examined. <h3>Objectives</h3> To study the levels and the potential roles of sE-cad in SLE. <h3>Methods</h3> The present study was undertaken to assess the serum levels of sE-cad in 150 female SLE patients and 31 healthy women by ELISA. Correlations between sE-cad levels and diseases-related variables were analyzed in the SLE patients. <h3>Results</h3> Serum levels of sE-cad were significantly increased in SLE patients compared with levels in healthy controls (93 ng/ml vs. 80 ng/ml; <i>p</i> &lt;0.05). Importantly, increased sE-cad levels were only observed in SLE patients who had pathologically elevated levels of serum creatinine (105 ng/ml, <i>p</i>&lt;0.001), but not in those with normal serum creatinine (82ng/ml, ns). Also, significantly higher levels of sE-cad were found in patients with calculated GFR less than 50 ml/min than ones with over 50ml/min (<i>p</i>&lt;0.001), and in patients defined as kidney affection ever by SLE than in ones without kidney affection by SLE (<i>p</i>&lt;0.001). sE-cad levels correlated positively with serum creatinine (r=0.65, <i>p</i>&lt;0.001), SLICC/ACR damage index (r=0.24, <i>p</i>&lt;0.001), and inversely with calculated glomerular filtration rate (r=-0.53, <i>p</i>&lt;0.001). In addition, significant correlation (r=0.37, <i>p</i>&lt;0.001) was observed between sE-cad and erythrocyte sedimentation rate. <h3>Conclusions</h3> This study demonstrates a close association between elevated serum levels sE-cad and kidney dysfuntion in female SLE patients, suggesting that sE-cad might be involved in pathogenesis of decreased kidney function in SLE patients. <h3>Disclosure of Interest</h3> None Declared
Abstract 2655: Esophagectomy with extended 2-field lymph node dissection for patients with thoracic esophageal carcinoma
Authors: Hengchuan Xue, Changrong Wu, Zonghai Zhu, Zhenbin Zhang, Zhenkai Ma, Jie Gao
Journal: Cancer Research (2012)

Abstract Objective: To summarize the surgical effect and clinical application of esophagectomy with extended 2- field lymph node dissection for patients with thoracic esophageal carcinoma. Methods: From June, 1987 to December, 2008, 1690 patients with thoracic esophageal cancer underwent esophagectomy with extended 2-field (thoracic and abdominal) dissection of lymph nodes were recruited and followed up. Patients with the middle and lower thoracic esophageal cancer underwent Ivor-Lewis esophagectomy, while patients with upper thoracic esophageal cancer underwent Akiyama esophagectomy. Both thoracic and abdominal lymph node metastases were recorded. Survival rates on 1, 3, 5, and 10 years were analyzed respectively. Results: Totally, 1690 eligible patients were recruited and successfully followed. Lymph node metastases were found in 713 patients, with the proportion of 42.2%(713/1690). Thoracic lymph node metastasis rate was 39.3%(665/1690), of which 20.7%(349/1690) were found in the right apical pleural para-tracheal triangle, 26.3%(444/1690) were found in the posterior upper mediastinum, and 18.2%(307/1690) were found in the lower mediastinum. Abdominal lymph node metastasis rate was 20.1%(339/1690). Out of 1690 patients underwent esophagectomy, 278 patients were reported postoperative complications, among which the pulmonary complication was ranked as the first one (43.6%). The death rate due to operation was 0.2%.The l-year, 3-year, 5-year and 10-year survival rates were 88.2%, 63.5%, 54.8% and 30.8%, respectively. Patients without lymph node metastasis had higher 5-year survival rate (76.2%), as compared to those with lymph node metastases (36.8%). Conclusion: Findings from this study demonstrated that Ivor-Lewis and Akiyarna esophagectomy with 2-field lymph node dissection could expose the operation fields clearly and make radical lymphadenectomy thoroughly, which was useful for observing the lymph nodes in the posterior upper mediastinum around the recurrent laryngeal nerve and in the right pleural apical para-tracheal triangle. We believe that esophageal cancer patients with potential lymph node metastases could benefit from esophagectomy with extended 2-field dissection of lymph nodes. 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 2655. doi:1538-7445.AM2012-2655
IMPACTO DE LA ECOENDOSCOPIA (USE) Y DE LA PUNCIÓN ASPIRATIVA GUIADA POR USE (USE-PAAF) EN EL MANEJO DE LAS LESIONES QUÍSTICAS DEL PÁNCREAS: RESULTADOS PRELIMINARES
Authors: A Rodriguez-D'jesus, G Fernández-Esparrach, J Boadas, J Busquets Barenys, L Fernández-Cruz, J Ferrer, E Vaquero, X Molero, S Navarro, S Sánchez, A Ginés
Journal: Endoscopy (2013)

Introducción: USE y USE-PAAF son útiles en el diagnóstico de las lesiones quísticas pancreáticas, pero no existe información acerca de su impacto en el manejo de estos pacientes. Objetivo: El objetivo de este estudio es determinar con qué frecuencia USE y USE-PAAF cambian el manejo de estas lesiones. Material y Método: 4 gastroenterólogos y 4 cirujanos de 4 hospitales de tercer nivel emitieron de forma independiente un diagnóstico así como la recomendación terapéutica en 49 pacientes con lesiones quísticas del páncreas. La información se presentó escalonadamente: 1. clínica y resultados de la TC; 2. hallazgos de la USE y 3. resultado de la USE-PAAF (citología y bioquímica). Los encuestados tenían que aconsejar el manejo en cada uno de estos niveles de información. Resultados: Las lesiones quísticas eran: TMPI (41,9%), cistoadenoma mucinoso (22,5%), cistoadenoma seroso (11,7%), pseudoquiste (10%); tumor neuroendocrino (2,3%), quiste inespecífico (11,6%). Patrón oro: pieza quirúrgica/citología. Los resultados de la USE indujeron un cambio en el diagnóstico y manejo en 32% y 20% de casos respectivamente. El cambio fue hacia una actitud más intervencionista (de vigilancia a cirugía) en 50% de casos. USE-PAAF provocó un cambio adicional en el diagnóstico y manejo de 41% y 21% de casos respectivamente. La concordancia entre los especialistas fue baja tanto en el diagnóstico como en el tratamiento (kappa = 0,32 y 0,21). La concordancia diagnóstica mejoró con la adición de la USE-PAAF (kappa = 0,43). y fue mayor entre digestólogos (paso 1: 0,47; paso 2: 0,47; paso 3: 0,51) que entre cirujanos (paso 1: 0,21; paso 2: 0,35; paso 3: 0,39). Conclusiones: USE y USE-PAAF tienen un impacto significativo en el manejo de las lesiones quísticas pancreáticas. La concordancia entre especialistas es baja, aunque aumenta con el resultado de la PAAF. Estos resultados demuestran la necesidad de crear documentos de consenso sobre este tipo de lesiones.
TCTAP A-135 Predilation with Scoring Balloon Optimized Cobalt-Chromium Stent Expansion Analyzed with Optical Coherent Tomography
Authors: Kentaro Jujo, Gaku Nakazawa, Jun-ichi Yamaguchi, Katsumi Saito, Nobuhisa Hagiwara
Journal: Journal of the American College of Cardiology (2015)