tbuckley/cabot-search huggingface dataset:
A phase II trial of sequential neoadjuvant chemotherapy with ifosfamide, doxorubicin, and gemcitabine (IAG), followed by cisplatin, gemcitabine and ifosfamide (CGI) in locally advanced urothelial cancer (UC): Final results from the M.D. Anderson Cancer Center
Authors: A. O. Siefker-Radtke, R. E. Millikan, A. M. Kamat, Y. Shen, D. L. Williams, H. B. Grossman, C. P. Dinney
Journal: Journal of Clinical Oncology (2008)

5079 Background: Increasing evidence supports the use of neoadjuvant chemotherapy for UC. We report final results of sequential chemotherapy in patients with high risk UC. Methods: Patients with UC received 3 cycles IAG followed by 4 cycles of CGI. Patients had any of the following high-risk features: lymphovascular invasion, or cT3b-4a disease (3-D mass on exam under anesthesia, or invasion into local organs). Patients with G3 upper tract disease, or micropapillary tumors were also eligible. Using a Simon 2-stage design, 65 patients with high-risk UC were enrolled. The primary endpoint was pathologic downstaging to ≤ pT1N0M0. Results: In all, 65 patients received 166 cycles of IAG, and 196 cycles of CGI. With median follow-up of 40.7 months, the 5-year overall survival (OS) and disease-specific survival for all patients was 60% and 67%, respectively (95% CI for 5-yr OS: 0.43–0.74). Downstaging to ≤ pT1 occurred in 30 of 60 (50%) with bladder primaries, and 3 of 5 with renal pelvis primaries. Downstaging was correlated with 5-year OS: ≤pT1, 82%; pT2, 69%; and ≥pT3b, 32% (p=0.001 comparing ≤pT1 vs. ≥ pT2). The presence of any variant histology was also associated with inferior 5-year OS: 48% vs. 67% in pure TCC (p=0.035). All patients who progressed did so within 18 months of their surgery except for one late progression at 53 months. As expected, the most frequent grade 3 toxicities were infection (38%), febrile neutropenia (22%), mucositis (18%) and platelet transfusion (12%). One patient developed G2 neuropathy; there were no cases of G3 neuropathy. Three patients had grade 4 toxicities: MI, vomiting, and platelet transfusion. There was one on study death. Conclusions: Although the benefits of chemotherapy need to be viewed in light of their toxicity, sequential therapy was quite active with curative potential in this high-risk cohort. Pathologic down-staging occurred in a majority of patients. These results reinforce previous experience suggesting that pathologic down-staging to ≤pT1 is a useful surrogate for eventual cure. No significant financial relationships to disclose.
Abstract 17740: Vena Contracta Width as a Predictor of Adverse Outcomes in Patients With Severe Isolated Tricuspid Regurgitation
Authors: Wooin Yang, Woo-Dae Bang, Hee-Sun Mun, Chi-Young Shim, Min-Kyung Kang, In-Jeong Cho, Hyuk-Jae Chang, Yangsoo Jang, Namsik Chung, Seung-Yun Cho, Jong-Won Ha
Journal: Circulation (2010)

Background: The clinical outcome and its predictors of isolated tricuspid regurgitation (TR), which is not associated with left sided heart disease, are poorly defined. We sought to investigate the...
Primary Adenocarcinoma of the Lacrimal Gland
Authors: Rebecca S. Heaps, Neil R. Miller, Daniel M. Albert, W. Richard Green, Susan Vitale
Journal: Ophthalmology (1993)

Primary adenocarcinoma of the lacrimal gland is rare and usually appears in the literature as case reports. The authors retrospectively studied cases of primary adenocarcinoma of the lacrimal gland to determine which of the currently used methods was most effective in treating this tumor.The authors requested cases of primary adenocarcinoma of the lacrimal gland from orbital surgeons and ocular pathologists worldwide. Of the cases referred, 13 examples of primary adenocarcinoma of the lacrimal gland could be confirmed and studied for clinical features, management, and outcome.The authors have follow-up data on all 13 patients. Six patients died of cancer, three are alive with recurrence, and four are alive and disease-free.Based on the results of this study, the authors ascertain that primary adenocarcinoma of the lacrimal gland is not inevitably fatal and should be treated with exenteration and adjuvant radiotherapy as soon as a histologic diagnosis is established. Shorter duration of symptoms before treatment appears to decrease the chance of metastases and increase the chance of long-term survival.
Abstract 3126: Coronary Artery Calcification as a Predictor of Subsequent Coronary Artery Disease Events
Authors: Tina Costacou, Trevor J Orchard
Journal: Circulation (2008)

Coronary artery calcification (CAC) as measured by electron beam computed tomography (EBCT) can be used as an indicator of atherosclerotic burden. We have previously reported a cross sectional association between the presence of CAC and history of clinical coronary artery disease (CAD) in type 1 diabetes. In this analysis, we assessed the ability of CAC to predict the incidence of CAD events. Participants from the Pittsburgh Epidemiology of Diabetes Complications Study of childhood onset type 1 diabetes who underwent an EBCT screening (1996–98) and were free of clinical CAD were selected for study (n=236). Mean age at EBCT screening was 36.6 years and diabetes duration 28 years. CAC was calculated using the Agatston score and was used both as a continuous variable (after log transformation) and as a categorical variable. CAD was defined as non-fatal MI (n=4), ischemic ECG changes (Minnesota codes 1.3, 4.1, 4.2, 4.3, 5.1, 5.2, 5.3, 7.1) (n=9), hospitalized unstable angina (n=1), new onset angina leading to revascularization (n=2) or fatal CAD (n=4). Glucose disposal rate (eGDR-insulin sensitivity) was estimated by a regression equation derived from hyperinsulinemic euglycemic clamp studies with terms for waist to hip ratio, HbA 1c , and hypertension. During a mean follow-up of 7.4 years, 20 (8.5%) individuals had an incident event. Individuals who had an event were older, with a greater diabetes duration, systolic blood pressure, HbA 1c , and WBC count, a lower eGDR (all p-values &lt;0.05), and a higher CAC score (p&lt;0.0001). Thus, approximately 24% of persons with CAC ≥200 had a subsequent CAD event compared to only 3% of those with a zero score. In multivariable Cox proportional hazard models with backward elimination, a CAC score greater than zero was a significant predictor of CAD incidence (HR=4.07, 95% CI=1.38–11.96). Other significant predictors comprised diabetes duration (HR=1.07, 95% CI=1.01–1.14) and HbA 1c (HR=1.39, 95% CI=1.10–1.76). The area under the ROC curve increased from 0.720 to 0.784 with the inclusion of CAC score. In this cohort of individuals with type 1 diabetes, CAC is a significant predictor of subsequent CAD status and adds to the prediction beyond standard risk factors. Thus, CAC may be used as a screening tool for CAD risk in type 1 diabetes.
Pathological laughing and crying following stroke: validation of a measurement scale and a double-blind treatment study
Authors: R G Robinson, R M Parikh, J R Lipsey, S E Starkstein, T R Price
Journal: American Journal of Psychiatry (1993)

This study was undertaken to test the reliability and validity of the Pathological Laughter and Crying Scale and the effectiveness of nortriptyline treatment for patients with emotional lability following stroke.Eighty-two patients with ischemic brain injury-54 who had been hospitalized with acute stroke and 28 others who requested treatment for pathological laughing and crying--were given standardized psychiatric and neurological assessments and then administered the Pathological Laughter and Crying Scale. The 54 acute stroke patients were used to evaluate the Pathological Laughter and Crying Scale, and the 28 patients with pathological emotional display were randomly assigned to nortriptyline treatment or placebo in a 6-week double-blind trial to assess the efficacy of a tricyclic antidepressant in treatment of this disorder.The interrater reliability on the Pathological Laughter and Crying Scale for a subgroup of 15 patients was 0.93, and the test-retest reliability of the scale was excellent. After 4 and 6 weeks of treatment, scores on the Pathological Laughter and Crying Scale showed significantly greater improvement in the 14 patients given nortriptyline than in the 14 given placebo. Although almost one-half of these patients also had major depression, the improvement in emotional lability was independent of depression status. In addition, response to treatment was not significantly affected by lesion location or time since stroke.The severity of symptoms in pathological emotional display can be reliably quantified with the Pathological Laughter and Crying Scale, and treatment with nortriptyline can effectively ameliorate this emotional disorder.
Abstract 13445: Akt1-Mediated Skeletal Muscle Growth Prevents Left Ventricular Remodeling after Experimental Myocardial Infarction
Authors: Satoshi Araki, Yasuhiro Izumiya, Taku Rokutanda, Kenneth Walsh, Hisao Ogawa
Journal: Circulation (2010)

Introduction: It is well known that aerobic endurance exercise can attenuate unfavorable myocardial remodeling post myocardial infarction (MI). In contrast, little is known about the effect of resi...
Trends in HIV, gonorrhoea, and syphilis
Authors: C. Solaro
Journal: BMJ (2002)

Are trust doctors the new lost tribe?Editor-The number of trust doctors (doctors in non-training grades) in the United Kingdom is rising as trusts try to meet both service and hours requirements and are unable to employ more doctors in training.The Department of Health has no code for trust doctors so its annual census cannot show how many there are.We surveyed the human resource departments in each acute trust in Yorkshire by postal questionnaire; nine out of 10 replied.We found that the number of trust doctor posts has increased at least fivefold over the past four years, and the current number will more than double in the near future on the basis of trusts' stated plans (figure).We sent separate questionnaires to 63 of a sample of 81 trust doctors in the region; 36 (57%) replied.They were asked questions about educational provision and supervision, reasons for being in the post, previous clinical experience, career aspirations, work patterns, and pay.With regard to education and training, 16 trust doctors reported that they had an educational supervisor and only six had appraisals.Although 32 trust doctors had been granted study leave, only 25 received funding for this.Surprisingly, 15 trust doctors rated their work as equivalent to that of a senior house officer and 21 as equivalent to a specialist registrar.Most of the doctors were United Kingdom graduates ( 16), with eight being from the Indian subcontinent, five from Africa and the Middle East, and one from the European Economic Area.The most common career aim was a consultant post in the United Kingdom (21 doctors), and the main reasons for taking a post as a trust doctor were as a "stop gap" or to gain
Abstract P339: Cardiovascular Preventive Care In Patients Using Psychotropes: Impact On Primary Care
Authors: Rajeev Sudhakar, Arun Muthusamy, Diane Levine
Journal: Circulation (2012)

Background Patients on psychotropic medications are at higher cardiometabolic risk compared to the general population because of obesity, diabetes, hypertension and hyperlipidemia making primary prevention important. We sought to assess preventative strategies in primary care setting for this population. Methods We conducted a cross sectional analysis using the limited access dataset of National Ambulatory Medical Care Survey from year 2000-2009. Patients between 18-85 years who visited primary care clinics were included. Demographics including age, gender, race, region and type of insurance were analyzed. Psychotropes included in our analysis were typical and atypical anti- psychotics, selective serotonin reuptake inhibitors, serotonin - norepinephrine reuptake inhibitors, norepinephrine reuptake inhibitors, monoamine oxidase inhibitors and tricyclic antidepressants. Multivariate logistic regression model was used to compute the adjusted odds ratio to compare the health conditions and its preventative care with and without psychotrope use. Results There were a total of 279,819 patient visits. Psychotropic medication use was documented in 6% of visits. The use of psychotropes was higher among middle age persons (45%), women (67%) and Southern regions(35%). Obesity (41% Vs 29% P = 0.02), hyperlipidemia (18.5% Vs 15.2% P = &lt;0.0001) and smoking (17% Vs 10% P = &lt;0.0001) were reported more often in visits for patients with psychotropes use compared to patients without psychotrope use. There was no difference in the prevalence of hypertension (P = 0.1) or diabetes (P= 0.3). Patients on psychotropes had a higher rate of aspirin use(8% Vs 3%), statin use(48% Vs 36%), antihypertensive use (69% Vs 48%) and stress-management counseling (28% Vs 5%) but a proportionally similar rate of smoking cessation advice (25% Vs 19%) compared to those not on psychotropes. Despite a higher prevalence of obesity and hyperlipidemia, adequate preventive counseling was not provided to patients on psychotropes for diet /nutrition (10.8 Vs 10.4 P = 0.5), exercise (10.1 Vs 8.7 P = 0.8) and weight reduction (9 Vs 6.6 P = 0.1 Conclusion In this large cohort,patients on psychotropes were found to be at increased cardiovascular risk and were treated aggressively with medications. Yet, this at-risk population received lesser degree of counseling for lifestyle modification. It is important for primary care physicians who see nearly one third of this high risk population, to understand this association and focus on preventive and lifestyle counseling.
Obesity—time to wake up
Authors: David Haslam, Naveed Sattar, Mike Lean
Journal: BMJ (2006)

<h3>ABSTRACT</h3> Intracellular trafficking pathways control residency and bioactivity of integral membrane proteins at the cell surface. Upon internalisation, surface cargo proteins can be delivered back to the plasma membrane via endosomal recycling pathways. Recycling is thought to be controlled at the metabolic and transcriptional level, but such mechanisms are not fully understood. In yeast, recycling of surface proteins can be triggered by cargo deubiquitination and a series of molecular factors have been implicated in this trafficking. In this study, we follow up on the observation that many subunits of the Rpd3 lysine deacetylase complex are required for recycling. We validate ten Rpd3-complex subunits in recycling using two distinct assays and developed tools to quantify both. Fluorescently labelled Rpd3 localises to the nucleus and complements recycling defects, which we hypothesised were mediated by modulated expression of Rpd3 target gene(s). Bioinformatics implicated 32 candidates that function downstream of Rpd3, which were over-expressed and assessed for capacity to suppress recycling defects of <i>rpd3Δ</i> cells. This effort yielded 3 hits: Sit4, Dit1 and Ldb7, which were validated with a lipid dye recycling assay. Additionally, the essential phosphatidylinositol-4-kinase Pik1 was shown to have a role in recycling. We propose recycling is governed by Rpd3 at the transcriptional level via multiple downstream target genes.
A Wrinkle in Time
Authors: Sigall Kassutto, Marshall A. Wolf
Journal: New England Journal of Medicine (2003)

An 86-year-old man presented with abdominal discomfort and fever. His medical history was notable for long-standing hypertension, mild chronic renal insufficiency, coronary-artery bypass surgery, repair of an abdominal aortic aneurysm seven years earlier, gout, diverticulitis, and prostatitis.
Abstract 1039: High Prevalence of Lower-Extremities Peripheral Artery Disease in Central Africa
Authors: Maelenn Guerchet, Victor Aboyans, Alain M Mouanga, Pascal M'Belesso, Johanna Salazar, Andre Tabo, Bebene Bandzouzi, Philippe Lacroix, Pierre-Marie Preux
Journal: Circulation (2009)

Background: A high prevalence of lower-extremities peripheral artery disease (LE-PAD) is reported among African Americans, but little is known about the epidemiology of LE-PAD in Africa. We sought ...
Dyskinetic movements, cognitive impairment, and negative symptoms in elderly neuropsychiatric patients
Authors: C N Karson, H S Bracha, A Powell, L Adams
Journal: American Journal of Psychiatry (1990)

The presence or absence of tardive dyskinesia, cognitive status, and psychopathology were assessed in a group of elderly male psychiatric patients (N = 49) in a nursing home setting. Twenty-five patients were found to have tardive dyskinesia, which was associated with a greater degree of cognitive impairment and negative symptoms. This finding was not related to obvious macroscopic organic pathologies, which were less prevalent in the dyskinetic patients. In fact, patients with frontal lesions (primarily lobotomies) had a significantly lower prevalence of tardive dyskinesia.
The United Kingdom public health response to an imported laboratory confirmed case of a novel coronavirus in September 2012
Authors: R  G Pebody, M A Chand, H L Thomas, H K Green, N L Boddington, C Carvalho, C S Brown, S R Anderson, C Rooney, E Crawley-Boevey, D J Irwin, E Aarons, C Tong, W Newsholme, N Price, C Langrish, D Tucker, H Zhao, N Phin, J Crofts, A Bermingham, E Gilgunn-Jones, K E Brown, B Evans, M Catchpole, J  M Watson
Journal: Eurosurveillance (2012)

On 22 September 2012, a novel coronavirus, very closely related to that from a fatal case in Saudi Arabia three months previously, was detected in a previously well adult transferred to intensive care in London from Qatar with severe respiratory illness. Strict respiratory isolation was instituted. Ten days after last exposure, none of 64 close contacts had developed severe disease, with 13 of 64 reporting mild respiratory symptoms. The novel coronavirus was not detected in 10 of 10 symptomatic contacts tested.
Abstract 15197: Adventitial Lymph Vessels are Instrumental in Regulating T Cell Influx in Atherosclerosis In Apoe-/- Mice
Authors: Timo Rademakers, Isabelle T Daissormont, Saskia C de Jager, Ilze Bot, Peter J van Santbrink, Marc A van Zandvoort, Sylvia Heeneman, Erik A Biessen
Journal: Circulation (2011)

Background During plaque progression, the adventitia has been shown to be progressively enriched in inflammatory cells like T and B cells, mast cells and dendritic cells, as well as cytokines and c...
A randomized study of erythropoietin and granulocyte colony-stimulating factor (G-CSF) versus placebo and G-CSF for patients with Hodgkin's and non-Hodgkin's lymphoma undergoing autologous bone marrow transplantation
Authors: NJ Chao, JR Schriber, GD Long, RS Negrin, M Catolico, BW Brown, LL Miller, KG Blume
Journal: Blood (1994)
Abstract 214: Sphingosine Kinase-1 Knockout Mice Have Increased Cardiac Arrest Mortality That is Rescued by Sphingosine-1-Phosphate Lyase Inhibition
Authors: Evgeny V Berdyshev, Irina A Gorshkova, Jonathan Goya, David G Beiser, Huashan Wang, Gerasim Orbelyan, Viswanathan Natarajan, Terry L Vanden Hoek
Journal: Circulation (2010)

Introduction: Sphingosine-1-phosphate (S1P) is an important regulator of pro-survival signaling. Two sphingosine kinases (SK), SK1 and SK2, form S1P in cells while S1P lyase irreversibly degrades S...
Bone-Marrow Transplantation
Authors: Thomas E, Storb R, Clift Ra, Fefer A, Johnson Fl, Neiman Pe, Lerner Kg, Glucksberg H, Buckner Cd
Journal: New England Journal of Medicine (1975)

THE modern era of bone-marrow transplantation was ushered in by the experiments of Jacobsen, Lorenz and their colleagues, who showed that mice could be protected against otherwise lethal irradiation by shielding of the spleen1 or by intravenous infusion of marrow.2 At first it was thought that this protective effect was due to a humoral factor.3 By 1956, however, several laboratories, using a variety of blood genetic markers, demonstrated that the protective effect against lethal irradiation was due to the colonization of the recipient marrow by donor cells.4 5 6 7An article on clinical marrow transplantation that appeared in . . .
Abstract 16675: Invasive Hemodynamic Measurements Predict 1-Year Survival After Cardiac Resynchronization Therapy
Authors: Patrick Houthuizen, Margot D Bogaard, Frank A Bracke, Pieter A Doevendans, Frits W Prinzen, Berry M van Gelder, Mathias Meine
Journal: Circulation (2010)

Introduction:  The acute hemodynamic response to Cardiac Resynchronization Therapy (CRT) can be assessed by the maximum rate of left ventricular (LV) pressure rise (dP/dt max ). The correlation between acute dP/dt max  and long-term outcome is yet unknown.   Hypothesis:  We assessed the hypothesis that acute dP/dt max  predicts long-term prognosis after CRT implantation.   Methods:  In 286 patients from 2 centers dP/dt max  was measured invasively to optimize atrioventricular and interventricular delays during CRT implantation. Four indices were evaluated: baseline dP/dt max  before CRT, maximal dP/dt max  during optimized CRT, and absolute and relative increase in dP/dt max  achieved by CRT. The composite endpoint consisted of all-cause mortality, heart transplantation (HTX) and LV assist device (LVAD) implantation within a year after implantation. Multivariate Cox regression models included a dP/dt max  variable, etiology, QRS ≥/   Results:  Thirty-four events occurred after a mean follow-up of 160 days (range 21–359). Patients with event had lower baseline dP/dt max  (705±194 vs 801±222 mmHg/s, p=0.017) and lower maximal dP/dt max  (894±224 vs 986±244 mmHg/s, p=0.039). After adjustment, baseline and maximal dP/dt max  predicted the endpoint (HR 0.977 [0.960–0.995, p=0.014] and HR 0.982 [0.967–0.998, p=0.027] per 10 mmHg/s increase, respectively). Increase in dP/dt max  achieved by CRT did not significantly predict outcome. Patients with dP/dt max  above the median value of baseline (757 mmHg/s) or maximal dP/dt max  (964 mmHg/s) had better cumulative survival (both: Log-rank p=0.028; Figure). Corresponding hazard ratio9s were 0.438 (0.212–0.906, p=0.026) and 0.421 (0.204–0.869, p=0.019), respectively.   Conclusions:  LV dP/dt max  before and during optimized CRT independently predict 1-year survival after CRT implantation free from all-cause mortality, HTX or LVAD implantation.