tbuckley/cabot-search huggingface dataset:
Abstract 202: Fast Hypothermia Induced by Continuous Renal Replacement Therapy Alleviates Systemic Inflammation and Intestinal Injury After Cardiopulmonary Resuscitation in Swine
Authors: Jiefeng Xu, Qijiang Chen, Xiaohong Jin, Chunshuang Wu, Zilong Li, Mao Zhang
Journal: Circulation (2018)

Introduction: Systemic inflammation and intestinal injury contribute to post-resuscitation multiple organ dysfunction and death in cardiac arrest victims, and they can be partly alleviated by therapeutic hypothermia. Recently, continuous renal replacement therapy (CRRT) was shown to be an effective cooling method to induce fast hypothermia. In this study, we investigated the effects of CRRT cooling (CRRT-C) on systemic inflammation and intestinal injury after cardiopulmonary resuscitation (CPR) in swine. Hypothesis: Fast hypothermia induced by CRRT-C would alleviate post-resuscitation systemic inflammation and intestinal injury better than surface cooling (SC). Methods: Twenty-seven male domestic swine weighing 36 ± 2 kg were utilized. Ventricular fibrillation was induced for 8 mins while defibrillation was attempted after 5 mins of CPR. At 5 mins after resuscitation, the animals were randomized to receive either CRRT-C, SC or normotherma (NT). In the two hypothermic groups, the animals were cooled by either the combination of 8-hr CRRT and 16-hr SC or the whole 24-hr SC. In animals treated with CRRT-C, a higher rate of 180 ml/min of blood flow was initially set with the infusion line submerged in 4 °C of ice water. The temperature was normally maintained in the NT group. Results: After resuscitation, the rate of temperature decrease was significantly faster in the CRRT-C group than in the SC group (9.8±1.6 vs. 1.5±0.4 °C/h, p &lt;0.01). The serum levels of tumor necrosis factor-α, interleukin-6, intestinal fatty acid binding protein and diamine oxidase after resuscitation were significantly lower in the two hypothermic groups compared with the NT group. However, post-resuscitation systemic inflammation and intestinal injury were further significantly alleviated in the CRRT-C group compared to the SC group (Table). Conclusion: Fast hypothermia induced by CRRT-C was superior to SC in alleviating post-resuscitation systemic inflammation and intestinal injury.
Patterns of care for patients with non-metastatic castration-resistant prostate cancer: Population-based study in Ontario, Canada.
Authors: Shawn Malone, Christopher J.D. Wallis, Richard M. Lee-Ying, Naveen S. Basappa, Ilias Cagiannos, Robert James Hamilton, Ricardo Fernandes, Cristiano Ferrario, Geoffrey Gotto, Scott Carlyle Morgan, Chris Morash, Tamim Niazi, Krista Noonan, Ricardo A. Rendon, Sebastien J. Hotte, Fred Saad, Anousheh Zardan, Brendan Osborne, Katherine Chan, Bobby Shayegan
Journal: Journal of Clinical Oncology (2022)

53 Background: To describe patterns of practice of PSA testing and imaging for Ontario men receiving continuous androgen deprivation therapy (ADT) for the treatment of non-metastatic castration-resistant prostate cancer (nmCRPC). Methods: This was a retrospective, longitudinal, population-based study of administrative health data from 2008 to 2019. Men &gt; 65 years old receiving continuous ADT with documented CRPC were included. An administrative proxy definition was applied to capture patients with nmCRPC patients and excluded those with metastatic disease. Patients were indexed upon progression to CRPC and were followed until death or end of study period to assess frequency of monitoring with PSA tests and conventional imaging. A 2-year look-back window was used to assess patterns of care leading up to CRPC, as well as baseline covariates. Results: At a median follow-up of 40 months, 944 patients with CRPC were identified. Their median time from initiation of ADT to CRPC was 26 months, 61% of patients had their PSA measured twice or fewer in the year prior to index and 71% patients did not receive any imaging in the year following progression to CRPC. Almost all patients (98%, n = 921/944) in the study progressed to high-risk CRPC (HR-CRPC) during the study period, of which more than half received fewer than 3 PSA tests in the year prior to progression to HR-CRPC, and 31% received no imaging in the subsequent year. Conclusions: PSA testing and imaging studies are under-utilized in a real-world setting for the management of nmCRPC, including those at high-risk of developing metastatic disease. Infrequent monitoring impedes proper risk stratification, disease staging, detection of treatment failure and/or metastases, likely delaying necessary treatment intensification with life-prolonging therapies. Adherence to guideline recommendations and the importance of timely staging should be reinforced to optimize patients’ outcome.
Lecture on National Health
Authors: H. W. Acland
Journal: BMJ (1871)

Su ci-being the general conception of the foundations ofnational health, At would at first seem to be an easy task to describe the causes which may sap them.It wouldl be easy if we were dealing with a social tabnitz r-asa.In an old coun-try, however, growing with unprecedented rapidity on a limited area, the questions involved touch every point of political econiomy.Theories conicerinii-g population, religion, liberty, existing privileges, and niatuiral rights, are to be met, accepted, or denied, at every point.Ignoranice and prejudice have to be dealt with among lhonest persoins; self-interest with the unpatriotic.The haste to be rich among the unwise, the intolerance among the cultivated of opinions counted narrow, and inadequate appreciation of the extent to which our w%vorld lies ulnder law (binding eveni the seeming free agency of man), all check the progress of lpopular knowledge as to the foundation of
HIV-1 antibody reactivity in inner-city alcoholics
Authors: S. J. Schleifer
Journal: JAMA (1989)

<h3>To the Editor.—</h3> Human immunodeficiency virus (HIV) infection in substance abusers is a major public health concern, with intravenous (IV) drug users in urban centers such as New York, NY,<sup>1</sup>and Newark, NJ,<sup>2,3</sup>having an estimated prevalence of HIV seropositivity of 50% to 60%. Alcohol abusers, especially in inner-city areas, represent a large secondary at-risk population owing to geographic and social proximity to the primary high-risk groups, compounded by their being less likely than nonabusers to use safe-sex practices. The prevalence of antibody to HIV type 1 in alcoholics who deny the use of other substances has not, to our knowledge, been described. We conducted an anonymous screening for HIV type 1 antibody on discarded samples from routine blood analyses of 99 patients in an inner-city alcohol treatment center. Sixty-eight percent of samples were from patients reporting alcohol use exclusively and 27% were from those with an additional
Malaria Prophylaxis
Authors: M. G. Phillips
Journal: BMJ (1954)

this; but rather that a man who reports one accident will report another, while another man would treat both himself and report neither to the doctor.The accident-prone are illness-prone.-Thefigures given do not prove the above contention, but rather confirm my view that there are doctor-conscious patients who report every bruise or cold and self-reliant patients who do not trouble the doctor over trivialities.Sex ratio of patients.-Acardinal factor affecting the reporting of accidents is the need for a certificate.Since Dr. McGregor does not confine his figures to insured per- sons, and since there is a much higher proportion of men insured than women, Dr. McGregor's conclusion regarding the sex ratio of accidents is invalidated.Change in sex ratio of accidents over 45 years of age.-May this not be apparent rather than real ?I would suggest that many women under 45 have young children, and con- sequently ignore their minor accidents so that they can carry on their domestic responsibilities, whereas women over 45 have reached a stage in life where their duties are less onerous and they can indulge in the luxury of a little fuss, sympathy, and a trip to the doctor.-Iam, etc.,
Abstract 214: Basic Life Support Instructors Overestimate Their Own Ability to Perform Cardiopulmonary Resuscitation
Authors: Mathilde Stærk, Lauge Vammen, Camilla Hansen, Kristian Krogh, Bo Løfgren
Journal: Circulation (2018)

Introduction: High-quality cardiopulmonary resuscitation (CPR) increases survival from cardiac arrest. Laypeople attend basic life support (BLS) courses to learn CPR, but unfortunately, skill quality and retention are often poor. BLS instructors teach by demonstrating CPR skills. However, BLS instructors’ ability to correctly demonstrate CPR remains to be investigated. Aim: To determine BLS instructors’ competence in demonstrating CPR skills. Methods: Certified BLS instructors were asked to demonstrate CPR on a resuscitation manikin (AMBU ® Man, AMBU) in a simulated teaching setting but without verbal explanations. Data on CPR quality was collected from the manikin and the first three cycles of CPR were analyzed. Correct CPR was defined according to the European Resuscitation Council 2015 Guidelines: chest compression (CC) depth of 50-60 mm, CC rate of 100-120 min -1 , and rescue breath volume of 500-600 mL. Instructors were asked to rate their own ability to perform CPR on a 5-point Likert scale before the demonstration and after receiving a performance report thereof. Results: Data from 125 certified instructors were analyzed. Median instructor age was 45 years (Q1;Q3: 30;56), 72% were male, and instructor experience was 8 years (3;14) with a median of 14 courses/year (6;44)). Mean CC depth was 64 mm (SD: 7.3). In total, 22% of chest compressions were performed within guideline recommendations (72% were too deep and 5% were too shallow). Mean CC rate was 115 min -1 (10.8). Full recoil was achieved in 86% of CCs. Of all attempted rescue breaths, 94% resulted in any amount of air registered (mean volume: 499 mL (291)). Only 11% of rescue breaths were within guideline recommendations (52% were too shallow and 37% were excessive). Instructors rated their ability to perform CCs lower after receiving a performance report (p=0.02). Similarly, ratings of rescue breathing ability were lower after receiving a performance report (p=0.01). Conclusion: Certified and experienced BLS instructors performed CC with excessive depth, but with acceptable CC rate and recoil. Instructors were unable to correctly demonstrate rescue breathing. Instructors overrated their ability to demonstrate correct CPR even when provided with their own CPR performance report.
Social Network–Based Strategies to Improve Uptake of HIV Testing and Linkage to Care Among Men Who Have Sex With Men in Sub-Saharan Africa
Authors: Carey Farquhar, Sarah Masyuko, Peter Mugo
Journal: JAMA Network Open (2022)

Robert Garofalo, MD, MPH; Adedotun Adetunji, MBChB, MSCI; Lisa M. Kuhns, PhD, MPH; Olayinka Omigbodun, MBBS, MPH; Amy K. Johnson, PhD, MSW; Kehinde Kuti, MBBS, MSCI; Olutosin A. Awolude, MBBS, MSc; Baiba Berzins, MPH; Patrick Janulis, PhD; Ogochukwu Okonkwor, MPH; Bibilola Oladeji, MBBS, MSc; Abigail L. Muldoon, MA; Oluwaseun P. Amoo, MPH; Hannah Atunde, MPH; Bill Kapogiannis, MD; Babafemi O. Taiwo, MBBS
Expression of immune checkpoint molecules programmed death protein 1, programmed death‐ligand 1 and inducible T‐cell co‐stimulator in mycosis fungoides and Sézary syndrome: association with disease stage and clinical outcome*
Authors: Cosimo Di Raimondo, Belen Rubio‐Gonzalez, Joycelynne Palmer, Dennis D. Weisenburger, Jasmine Zain, Xiwei Wu, Zhen Han, Steven T. Rosen, Joo Y. Song, Christiane Querfeld
Journal: British Journal of Dermatology (2022)

The relationship between immune checkpoint status and disease outcome is a major focus of research in cutaneous T-cell lymphoma (CTCL), a disfiguring neoplastic dermatological disorder. Mycosis fungoides (MF) and Sézary syndrome (SS) are the two most common types of CTCL.The aim was to evaluate the immune checkpoint markers programmed death protein 1 (PD1), inducible T-cell co-stimulator (ICOS) and programmed death-ligand 1 (PD-L1) in skin biopsies from patients with CTCL relative to disease stage and overall survival.This consecutive case series enrolled 47 patients: 57% had stage IA-IIA disease and 43% had stage IIB-IVA2 disease (including seven with SS).PD1, PD-L1 and ICOS expression was seen in all biopsies. Notably, PD-L1 was predominantly expressed on histiocytes/macrophages, but focal expression on CTCL cells was seen. High expression of either ICOS or PD-L1 was associated with advanced-stage disease (P = 0·007 for both) and with the appearance of large-cell transformation (LCT), a histopathological feature associated with a poor prognosis (ICOS: P = 0·02; PD-L1: P = 0·002). PD1 expression was not significantly associated with disease stage (P = 0·12) or LCT (P = 0·49), but expression was high in SS biopsies. A high combined checkpoint marker score (PD1, PD-L1 and ICOS) was associated with advanced-stage disease (P = 0·001), LCT (P = 0·021) and lower overall survival (P = 0·014).These findings demonstrate the existence of a complex immunoregulatory microenvironment in CTCL and support the development of immunotherapies targeting ICOS and PD-L1 in advanced disease.
The osteogenesis of Ginsenoside Rb1 incorporated silk/micro-nano hydroxyapatite/sodium alginate composite scaffolds for calvarial defect
Authors: Yuqiong Wu, Jiahui Du, Qianju Wu, Ao Zheng, Lingyan Cao, Xinquan Jiang
Journal: International Journal of Oral Science (2022)

Abstract Ginsenoside Rb1, the effective constituent of ginseng, has been demonstrated to play favorable roles in improving the immunity system. However, there is little study on the osteogenesis and angiogenesis effect of Ginsenoside Rb1. Moreover, how to establish a delivery system of Ginsenoside Rb1 and its repairment ability in bone defect remains elusive. In this study, the role of Ginsenoside Rb1 in cell viability, proliferation, apoptosis, osteogenic genes expression, ALP activity of rat BMSCs were evaluated firstly. Then, micro-nano HAp granules combined with silk were prepared to establish a delivery system of Ginsenoside Rb1, and the osteogenic and angiogenic effect of Ginsenoside Rb1 loaded on micro-nano HAp/silk in rat calvarial defect models were assessed by sequential fluorescence labeling, and histology analysis, respectively. It revealed that Ginsenoside Rb1 could maintain cell viability, significantly increased ALP activity, osteogenic and angiogenic genes expression. Meanwhile, micro-nano HAp granules combined with silk were fabricated smoothly and were a delivery carrier for Ginsenoside Rb1. Significantly, Ginsenoside Rb1 loaded on micro-nano HAp/silk could facilitate osteogenesis and angiogenesis. All the outcomes hint that Ginsenoside Rb1 could reinforce the osteogenesis differentiation and angiogenesis factor’s expression of BMSCs. Moreover, micro-nano HAp combined with silk could act as a carrier for Ginsenoside Rb1 to repair bone defect.
Annals Graphic Medicine - A Metamorphosis
Authors: Christopher H. Schifeling
Journal: Annals of Internal Medicine (2020)

Web Exclusives17 March 2020Annals Graphic Medicine - A MetamorphosisFREEChristopher H. Schifeling, MDChristopher H. Schifeling, MDUniversity of Colorado School of Medicine, Denver, Colorado (C.H.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/G19-0031 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Download figure Download PowerPoint Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: University of Colorado School of Medicine, Denver, Colorado (C.H.S.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=G19-0031.Author/Illustrator Information: Christopher H. Schifeling, MD (e-mail, chris.[email protected]com).This article was published at Annals.org on 10 March 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 17 March 2020Volume 172, Issue 6Page: W85-W86KeywordsConflicts of interestDisclosureHealth care ePublished: 10 March 2020 Issue Published: 17 March 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
The role of sabizabulin in phase 1b/2 clinical trials of men with metastatic castration-resistant prostate cancer who progressed on androgen receptor-targeting agents.
Authors: Mark Christopher Markowski, Mario A. Eisenberger, Christopher Michael Pieczonka, Robert H. Getzenberg, Domingo Rodriguez, K. Gary Barnette, Mitchell S. Steiner, Daniel R. Saltzstein, Emmanuel S. Antonarakis, Ronald F. Tutrone
Journal: Journal of Clinical Oncology (2022)

110 Background: Sabizabulin is a novel oral cytoskeleton disruptor being developed for use in metastatic castration resistant prostate cancer (mCRPC). A phase 1b/2 clinical study was conducted to establish the maximum tolerated dose (MTD) and evaluate the preliminary efficacy in men with mCRPC resistant to androgen receptor targeting agents (ARTAs). Methods: The phase 1b portion of the study in 39 men utilized escalating and expanding dose and duration. The phase 2 portion studied 41 men with mCRPC at the recommended phase 2 dose (RP2D) of 63 mg daily. Based upon the phase 1b/2 data, sabizabulin appears to have both cytotoxic and cytostatic activity. A analysis was conducted evaluating the best clinical response (BCR) defined as either an objective response assessed by PCWG3 criteria and/or stable disease defined as ≥5 cycles (≥15 weeks) of continuous treatment. Results: Of the combined 80 patients in the phase 1b/2 portions of the study, the BCR was 37.5% (30/80) and 5 of the responders remain on study with the longest being treated for more than 30 months. Of the patients with measurable disease at study entry, the BCR was 59% (17/29). Prior to study entry, 11/30 (37%) of those with a BCR had previously been treated with and subsequently progressed on a minimum of 2 ARTAs. The remaining 19/30 (63%) had progressed on a single ARTA agent. 11 (37%) were previously treated with enzalutamide or apalutamide and 8 (27%) with abiraterone as single agents. 8 (27%) received enzalutamide and abiraterone and 3 (10%) patients received more than two ARTAs. As described previously, the safety profile continues to be favorable with no clinically relevant neutropenia or neurotoxicity. Conclusions: In this analysis, sabizabulin has demonstrated not only cytotoxic, but also significant cytostatic activity with similar responses in men that have progressed on a single or multiple ARTA agents. Sabizabulin is a novel agent with the potential provide men with mCRPC a well-tolerated chronic treatment cytostatic option after progressing on an ARTA and is being tested in the open phase 3 VERACITY trial. Clinical trial information: NCT03752099.
Early identification of patients admitted to hospital for covid-19 at risk of clinical deterioration: model development and multisite external validation study
Authors: Fahad Kamran, Shengpu Tang, Erkin Otles, Dustin S McEvoy, Sameh N Saleh, Jen Gong, Benjamin Y Li, Sayon Dutta, Xinran Liu, Richard J Medford, Thomas S Valley, Lauren R West, Karandeep Singh, Seth Blumberg, John P Donnelly, Erica S Shenoy, John Z Ayanian, Brahmajee K Nallamothu, Michael W Sjoding, Jenna Wiens
Journal: BMJ (2022)

To create and validate a simple and transferable machine learning model from electronic health record data to accurately predict clinical deterioration in patients with covid-19 across institutions, through use of a novel paradigm for model development and code sharing.Retrospective cohort study.One US hospital during 2015-21 was used for model training and internal validation. External validation was conducted on patients admitted to hospital with covid-19 at 12 other US medical centers during 2020-21.33 119 adults (≥18 years) admitted to hospital with respiratory distress or covid-19.An ensemble of linear models was trained on the development cohort to predict a composite outcome of clinical deterioration within the first five days of hospital admission, defined as in-hospital mortality or any of three treatments indicating severe illness: mechanical ventilation, heated high flow nasal cannula, or intravenous vasopressors. The model was based on nine clinical and personal characteristic variables selected from 2686 variables available in the electronic health record. Internal and external validation performance was measured using the area under the receiver operating characteristic curve (AUROC) and the expected calibration error-the difference between predicted risk and actual risk. Potential bed day savings were estimated by calculating how many bed days hospitals could save per patient if low risk patients identified by the model were discharged early.9291 covid-19 related hospital admissions at 13 medical centers were used for model validation, of which 1510 (16.3%) were related to the primary outcome. When the model was applied to the internal validation cohort, it achieved an AUROC of 0.80 (95% confidence interval 0.77 to 0.84) and an expected calibration error of 0.01 (95% confidence interval 0.00 to 0.02). Performance was consistent when validated in the 12 external medical centers (AUROC range 0.77-0.84), across subgroups of sex, age, race, and ethnicity (AUROC range 0.78-0.84), and across quarters (AUROC range 0.73-0.83). Using the model to triage low risk patients could potentially save up to 7.8 bed days per patient resulting from early discharge.A model to predict clinical deterioration was developed rapidly in response to the covid-19 pandemic at a single hospital, was applied externally without the sharing of data, and performed well across multiple medical centers, patient subgroups, and time periods, showing its potential as a tool for use in optimizing healthcare resources.
Endoscopic closure of cecal fistula using purse-string suture after plombage with polyglycolic acid sheets and fibrin glue
Authors: Fumiaki Kawara, Akihiro Minami, Kazuya Hara, Kodai Yamanaka, Takanori Matsuura, Mitsuko Mimura, Chiharu Nishioka
Journal: Endoscopy (2022)

An 86-year-old man with a postappendectomy abscess and fistula was treated with antibiotics and percutaneous drainage for 5 weeks, but the fistula did not close ([Fig. 1], [Fig. 2 a]). We report successful fistula closure using a modified endoscopic closure technique ([Video 1]).
Higher Risk of Mortality for Individuals Diagnosed With Autism Spectrum Disorder or Attention-Deficit/Hyperactivity Disorder Demands a Public Health Prevention Strategy
Authors: Russell A. Barkley, Geraldine Dawson
Journal: JAMA Pediatrics (2022)

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