tbuckley/cabot-search huggingface dataset:
Abstract 315: Influence of Previous Comorbidities on Hospital Outcome After Cardiac Arrest
Authors: Florence Dumas, Audrey Paoli, Marine Paul, Jean-Francois Llitjos, Guillaume Savary, Paul Jaubert, Richard Chocron, Olivier Varenne, Julien Charpentier, Jean-Paul Mira, Alain Cariou
Journal: Circulation (2018)

Introduction: Despite improvements, overall survival after out-of-hospital cardiac arrest (OHCA) remains low, even in those with return of spontaneous circulation (ROSC). In addition to usual prognostic characteristics, patients’ medical history may also influence the outcome. This study aimed to investigate the role of comorbidities on hospital mortality, neurological outcome and mode of death in OHCA patients with successful ROSC. Methods: From Jan 2012 to Sep 2017, all consecutive non-traumatic OHCA adults with stable ROSC admitted in ICU were included. Utstein characteristics, circumstances and in-hospital interventions were prospectively recorded. Comorbidities were measured using Charlson Comorbidity Index (CCI), divided into 3 groups (CCI=0,CCI=1-3,CCI&gt;3).The influence of CCI on mortality and poor neurological outcome at discharge (with a Cerebral Performance Categories level&gt;2) was assessed using logistic regression and association with mode of death (withdrawal of life sustaining treatments (WLST) or other causes) using multinomial regression. Results: During the study period, among 777 patients admitted alive and analyzed, 504 (65%) pts were discharged as CPC&gt;2 and 484 (62%) died in ICU with 48%, 61% and 70% in CCI-0, CCI 1-3 and CCI&gt;3 respectively. After adjustment, an increase in CCI was associated with poor neurological outcome (ORadj 2.22 [1.21-4.08] for CCI=1-3 and ORadj=2.86 [1.50-5.45] for CCI&gt;3; ref CCI=0). Other independent predictors were an initial non shockable rhythm (OR=3.70[2.38-5.88]), absence of bystander cardiopulmonary resuscitation (CPR) (OR=1.96[1.20-3.22]), higher dose of epinephrine (OR= 5.88 [3.70-9.09]), longer resuscitation (CA-CPR, OR=1.69 [1.10-2.63] and CPR-ROSC, OR=2.43 [1.56-3.85]). Using multinomial regression, an increased CCI was associated with all modes of death, but particularly with WLST (RRadj=2.43 [1.25-4.71] for CCI=1-3 and 4.27[2.15-8.48] for CCI&gt;3, ref CCI=0). Conclusion: A high number of comorbidities, as assessed by CCI, was associated with a worse neurological and a higher mortality in patients admitted alive after cardiac arrest. Presence and burden of comorbidities should be considered in the evaluation of the prognosis in patients admitted after cardiac arrest
Brigatinib Effective in ALK+ NSCLC
Journal: Cancer Discovery (2016)

Results from a phase I/II trial indicate that the investigational ALK inhibitor brigatinib is active in patients with ALK-rearranged non-small cell lung cancer. Patients who had previously received crizotinib-as well as those who hadn't-responded to the drug, which was also active in patients with brain metastases.
Angiotensin
Authors: D I HIGTON, D W JAMES
Journal: BMJ (1964)

Intrauterine Transfusion: Dr. C. A. Holman and Mrs. Jadwiga Karnicki describe five infants in whom intrauterine transfusion was done for haemolytic disease of the newborn, in one infant twice (p.594).Leader at p. 585.Leakage of Liquor: Dr. A. D. Bain and colleagues suggest that prolonged leakage causes anomalies of the face, hands, and feet similar to those in bilateral renal agenesis (p. 598).Gastric Secretion: Dr. S. Ardeman and colleagues report studies on the secretion of intrinsic factor.After histamine
Rheumatoid arthritis disease activity assessed by patient-reported outcomes and flow cytometry before and after an additional dose of COVID-19 vaccine
Authors: Sara K Tedeschi, Jacklyn Stratton, Jack Elias Ellrodt, Mary Grace Whelan, Keigo Hayashi, Kazuki Yoshida, Lin Chen, Ifeoluwakiisi Adejoorin, Kathryne Elizabeth Marks, A. Helena Jonsson, Deepak A Rao, Daniel H Solomon
Journal: Annals of the Rheumatic Diseases (2022)
The prognostic role of sarcopenia and albumin in locally advanced renal cell carcinoma with IVC tumor thrombus.
Authors: Eric Midenberg, Dattatraya H Patil, Alexandra Medline, Michelle Higgins, Milton Williams, Bassel Nazha, Jacqueline T Brown, Kenneth Ogan, Sarah P. Psutka, Mehmet Asim Bilen, Viraj A. Master
Journal: Journal of Clinical Oncology (2022)

387 Background: Indicators of body composition and nutritional status, such as lumbar skeletal muscle index (SMI, cm 2 /m 2 ) and hypoalbuminemia, are associated with adverse outcomes following surgery for localized renal cell carcinoma (RCC) but have yet to be described in patients with RCC and venous tumor thrombus. We hypothesize that preoperative sarcopenia, a severe deficit in lean muscle mass, and hypoalbuminemia will be associated with decreased overall survival (OS) and cancer specific survival (CSS) in nonmetastatic RCC patients undergoing radical nephrectomy and tumor thrombectomy. Methods: We retrospectively analyzed 103 nonmetastatic RCC patients who underwent radical nephrectomy and tumor thrombectomy from 2005 to 2020. Optimally fit BMI (kg/m 2 ) and sex-stratified sarcopenia thresholds were calculated (BMI&lt;30: SMI&lt;47 for males, SMI&lt;38 for females; BMI≥30: SMI&lt;54 for males, SMI&lt;47 for females). Sarcopenia and albumin risk groups were created based on their individual hazard ratios on univariable analysis and defined as low-risk (non-sarcopenic, normal albumin), medium-risk (non-sarcopenic, hypoalbuminemia), high-risk (sarcopenic, normal albumin), and very high-risk (sarcopenic, hypoalbuminemia). Associations between independent and combined sarcopenia and hypoalbuminemia (albumin&lt;3.5 g/dL) with OS and CSS were evaluated using multivariable and Kaplan-Meier analyses. Results: Prevalence of sarcopenia and hypoalbuminemia were 51.2% and 44.7%, respectively. Median follow up time was 24.8 months and median time from preoperative imaging to surgery was 21 days. Sarcopenia was an independent predictor of OS (p=0.003) and CSS (p=0.006) whereas hypoalbuminemia was not (OS: p=0.096; CSS: p=0.718). When analyzing sarcopenia and albumin in combination, the high and very high-risk groups were significantly associated with decreased OS (high-risk: p=0.011; very high-risk: p&lt;0.001) and CSS (high-risk: p=0.011; very high-risk: p=0.017). Kaplan-Meier curves showed a stepwise decline in median OS (p=0.0071) and CSS (p=0.0068) times with increasing risk. Conclusions: Simultaneous sarcopenia and hypoalbuminemia were associated with nearly a seven-fold decrease in OS and CSS in patients undergoing surgery for nonmetastatic RCC with IVC tumor thrombus.[Table: see text]
Validation of the STAR-CAP clinical prognostic system for predicting biochemical recurrence after radical prostatectomy in a Japanese cohort.
Authors: Noriyoshi Miura, Yuki Miyauchi, Tadahiko Kikugawa, Akihiro Oka, Yuichiro Sawada, Ryotaro Tomida, Masafumi Matsumura, Katsuyoshi Hashine, Yutaka Yanagihara, Iku Ninomiya, Masaharu Kan, Akira Yano, Takatoshi Tacho, Takahiro Yanagaki, Hajime Takeda, Yuichi Watanabe, Takashi Saika
Journal: Journal of Clinical Oncology (2022)

253 Background: An international staging collaboration for cancer of the prostate (STAR-CAP) was recently established and used for predicting oncological outcomes for patients with prostate cancer. However, the validation of STAR-CAP has not yet been performed in the Japanese cohort. Our study aimed to assess the STAR-CAP prognostic model for Japanese patients with prostate cancer and compare it to the CAPRA score for the prediction of biochemical recurrence (BCR) after radical prostatectomy. Methods: We retrospectively analyzed data from a multi-institution database of 1,645 patients who underwent radical prostatectomy between 2010 and 2020. We excluded patients with inadequate follow-up duration ( &lt; 1 year), missing or incomplete perioperative clinical parameters relevant for STAR-CAP, and patients who received neoadjuvant therapy. BCR was defined as two consecutive prostate-specific antigen values ≥ 0.2 ng/mL. The 3-year BCR-free survival was assessed by Kaplan-Meier analyses and log-rank test. The performance of both models to predict 3-year BCR-free survival was assessed using the area under the curve (AUC). Results: The 3-year BCR-free survival ranged from 47.3% (high risk) to 93.5% (low risk) in the STAR-CAP classification ( p&lt; 0.001) and from 62.5% (high risk) to 94.6% (low risk) in the CAPRA classification ( p&lt; 0.001). AUCs for the 3-year BCR prediction were 0.756 and 0.784 for STAR-CAP and CAPRA, respectively. Conclusions: In Japanese patients, both STAR-CAP and CAPRA prognostic systems provide sufficient stratification and their predictive ability for 3-year BCR-free survival is comparable, with a small advantage for CAPRA (2.8%).
Bamlanivimab plus Etesevimab in Mild or Moderate Covid-19
Authors: Michael Dougan, Ajay Nirula, Masoud Azizad, Bharat Mocherla, Robert L Gottlieb, Peter Chen, Corey Hebert, Russell Perry, Joseph Boscia, Barry Heller, Jason Morris, Chad Crystal, Awawu Igbinadolor, Gregory Huhn, Jose Cardona, Imad Shawa, Princy Kumar, Andrew C Adams, Jacob Van Naarden, Kenneth L Custer, Michael Durante, Gerard Oakley, Andrew E Schade, Timothy R Holzer, Philip J Ebert, Richard E Higgs, Nicole L Kallewaard, Janelle Sabo, Dipak R Patel, Matan C Dabora, Paul Klekotka, Lei Shen, Daniel M Skovronsky
Journal: New England Journal of Medicine (2021)

BackgroundPatients with underlying medical conditions are at increased risk for severe coronavirus disease 2019 (Covid-19). Whereas vaccine-derived immunity develops over time, neutralizing monoclonal-antibody treatment provides immediate, passive immunity and may limit disease progression and complications.MethodsIn this phase 3 trial, we randomly assigned, in a 1:1 ratio, a cohort of ambulatory patients with mild or moderate Covid-19 who were at high risk for progression to severe disease to receive a single intravenous infusion of either a neutralizing monoclonal-antibody combination agent (2800 mg of bamlanivimab and 2800 mg of etesevimab, administered together) or placebo within 3 days after a laboratory diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The primary outcome was the overall clinical status of the patients, defined as Covid-19–related hospitalization or death from any cause by day 29.ResultsA total of 1035 patients underwent randomization and received an infusion of bamlanivimab–etesevimab or placebo. The mean (±SD) age of the patients was 53.8±16.8 years, and 52.0% were adolescent girls or women. By day 29, a total of 11 of 518 patients (2.1%) in the bamlanivimab–etesevimab group had a Covid-19–related hospitalization or death from any cause, as compared with 36 of 517 patients (7.0%) in the placebo group (absolute risk difference, −4.8 percentage points; 95% confidence interval [CI], −7.4 to −2.3; relative risk difference, 70%; P<0.001). No deaths occurred in the bamlanivimab–etesevimab group; in the placebo group, 10 deaths occurred, 9 of which were designated by the trial investigators as Covid-19–related. At day 7, a greater reduction from baseline in the log viral load was observed among patients who received bamlanivimab plus etesevimab than among those who received placebo (difference from placebo in the change from baseline, −1.20; 95% CI, −1.46 to −0.94; P<0.001).ConclusionsAmong high-risk ambulatory patients, bamlanivimab plus etesevimab led to a lower incidence of Covid-19–related hospitalization and death than did placebo and accelerated the decline in the SARS-CoV-2 viral load. (Funded by Eli Lilly; BLAZE-1 ClinicalTrials.gov number, NCT04427501.) Visual Abstract Bamlanivimab plus Etesevimab in Mild or Moderate Covid-19
Aspects of the Circulation's Economy.--I
Authors: K. J. Franklin
Journal: BMJ (1951)

Oliver's objects in founding these lectures in memory of Professor William Sharpey were "to pro- mote physiological research by observation and experi- ment, and encourage the application of physiological knowledge to the prevention and cure of disease and the prolongation of life."With these objects I find myself to be in sympathy; they are, indeed, very much the basis of my own outlook, as they were of that of one of my heroes, Richard Lower (1631-91), Harvey's greatest follower in circulation studies in the seven- teenth century.I would particularly stress physiological research by observation, much as I value and have indulged in its counterpart; for experiments too often disturb unduly the normal conditions and render diffi- cult the assessment, from their results, of what naturally happens.Direct acquisition of knowledge by observa- tion has been a feature of our science throughout the two millennia of its story, and it has become possible in recent times, as I shall describe more fully later, to extend such " zooscopy " (Franklin, 1933, 1949b) to many of the internal activities, including the blood's circulation, of the living body.My choice of subject for these lectures would, I think, have appealed to both Sharpey and Oliver, for the latter's interest in the blood and its circulation is manifest in the titles of his book (Oliver, 1895) and of the papers which he published in the Journal of Physiology (Anon., 1928), while the former's main research contribution was on ciliary action, and the movement of mucus by cilia is part of the circulation in the extended connotation of that term which I shall mention below.tLiterature The blood's circulation and the cardiovascular system within which it is effected have been my major research interests for nearly 30 years, and I have deemed it right to study the associated literature with some thoroughness, whatever the date of publication of any particular contribution may have been.This is not any purpose- less devotion to medical history as such, but an attempt to " take out of the past all that is noble and good, and *The first Oliver-Sharpey Lecture, given at the Royal College of Physicians of London on March 13, 1951.tCarl Ludwig introduced the kymographic recording of blood pressure in 1847, and Sharpey used to show students and others how it was done by turning his top-hat round and imitating the movement of the float with a finger.The hat used to be preserved at University College, but I have not seen it since the recent war.
Aflatoxin
Authors: A. Coady
Journal: BMJ (1964)

1~~~~~~~~~~MEDICAL JOURNAL uterine haemorrhage in several instances of chorioncarcinoma.Toxic effects with this form of treatment are usually slight or absent, and it lacks the finality of hysterectomy on the patient's child-bearing capacity.The risks and unpleasantness of systemic chemotherapy are not to be underestimated, but when it offers a substantial expectation of cure and of further normal pregnancies it would be unfortunate if serious delays in its application result from any impression that it is a fate wores than death.-Iam, etc.,
THE DIET OF THE PRECIBICULTURISTS
Authors: H. Campbell
Journal: BMJ (1905)

THE Botocudos, Paris, and Caraodos are wild tribes inbabiting the western parts of Brazil between the Parahiba and Coutas rivers.In the early part of the nineteenth century they naked nomad hunters, using stone axes and living in tem- poTary dwellings made after some primitive method, as driving a few palm branches circlewise into the ground inclining them so as to meet at the top.Until recently were wholly ignorant of agriculture, and even to this day retain, in spite of their contact with the European settlers, many of their pristine customs.The Botocudos have loDg the irreconcilable foes of the settlers and the dread of neighbouring tribes, and it is to them rather than to Puris and Caraodos that this account applies.They are a dolichocephalic people, who roam naked in woods in quest of roots, berries, fraits, palm-cabbage, honey, froge, snakes, grubs, "man, and other large game," canni- balism being at one time rife among them; with the exception of serpents, all kinds of animal food are acceptable.Larvae are eagerly sought for, eseecially in the decayed parts of trees and in bamboo trunks.They possess the domesticatedThe women, to whom-as is usual with primitive peoples- falls all the drudgery, dig up edible roots.Thus, Martius writes, " All the household work falls upon the women, even sometimes the building of the huts"; Maximilian, Prince of Neuwied, describes how he eaw number of Botocudos women, each laden with a heavy sack, marching in single file after their day's labour.Game is grilled on a spit, or cooked in underground ovens, as is also vegetable food.Maximilian came upon a band these people grouped round a large oven fire and enveloped in a cloud of smoke.Food is also cooked in ashes and bamboo stems.Vegetables are sometimes boiled "in schleeht gebrantaten Topne," which is often a bamboo stem which, with great care, water can, it appears, be boiled.Von Martiun, to whom we are chiefly indebted for our know- ledge of the Botocudos and neighbouring tribes, gives aboriginal method of preparing wholesome meal from poisonous manioc, and then goes on to describe a shorter which consists in cutting the roots into slices, or long pieles, spreading them out to dry, and finally cooking them in ashes or underground ovens.The chief weapons employed are the bow and arrow, spear and thestone axe.The Diet of the Fuegians.
Cost effectiveness of adjuvant pembrolizumab after nephrectomy for RCC: Insights for patient selection from a Markov model.
Authors: Vidit Sharma, Kevin M Wymer, Daniel D. Joyce, James P. Moriarty, Bijan J Borah, R. Houston Thompson, Brian Addis Costello, Bradley C. Leibovich, Stephen A. Boorjian
Journal: Journal of Clinical Oncology (2022)

321 Background: KEYNOTE-564 demonstrated that adjuvant pembrolizumab after nephrectomy for high-risk clear cell renal cell carcinoma (RCC) decreased the risk of disease progression and – albeit with immature follow-up (2 years) – found a signal of improved overall survival as well. Herein, we used extrapolations from a Markov-model, accounting for the costs and toxicities of pembrolizumab relative to its efficacy, to investigate its utility at a population level. Methods: A decision-analytic Markov Model was used to conduct a cost-utility analysis of adjuvant pembrolizumab versus placebo after nephrectomy for high risk RCC, using data from KEYNOTE-564 to inform model probabilities. Transition probabilities not found in KEYNOTE-564, in addition to utility values, were extracted from the literature. Base case analyses were conducted with 5-year and 15-year time horizons (using extrapolations from 2-year outcomes), and 3-week time cycles. Primary outcomes were Quality-adjusted life years (QALYs), 2021 US Medicare costs, and Incremental cost-effectiveness ratios (ICERs). The willingness-to-pay threshold was set at $100,000/QALY. One-way sensitivity analyses were used to identify cost-effectiveness thresholds of individual parameters while probabilistic sensitivity analyses with 100,000 Monte-Carlo simulations were used to simultaneously vary all model inputs. Results: Pembrolizumab was associated with higher QALYs and costs relative to placebo (Table). Pembrolizumab was not cost-effective at a 5-year time horizon but was cost-effective at 15 years and beyond. One-way sensitivity analysis noted that pembrolizumab became cost-effective at 5-years if: 1) its administration cost was less than $5,064 (base = $10,278) or 2) if the 5-year risk of progression was 18.8% higher in placebo vs pembrolizumab (base = 9%). Using pembrolizumab’s reported hazard ratio of 0.68 for progression from KEYNOTE-564, we estimated that pembrolizumab would be cost-effective at 5-years for all patients with a Mayo Progression Free Survival Score of 10 or higher. Probabilistic sensitivity analysis found that pembrolizumab was cost-effective for 29% and 58% of microsimulations at 5 and 15 years, respectively. Conclusions: At current prices, adjuvant pembrolizumab was not cost-effective for all trial patients at a population level at 5-years after treatment but may be cost-effective for time horizons over 15 years. Instead, adjuvant pembrolizumab was found to be cost-effective only for the highest risk subsets of RCC at 5-years. Longer term trial data of progression-free survival and overall survival are necessary to confirm these extrapolations.[Table: see text]
Der Rücken des Menschen, die Erkennung und Behandlung seiner Erkrankungen: Eine Anleitung für Studierende der Medizin und praktische Aerzte
Journal: JAMA (1941)

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