tbuckley/cabot-search huggingface dataset:
Squamous cell carcinoma of the head and neck (SCCHN) in patients reporting human immunodeficiency virus (HIV) infection: A retrospective case series
Authors: M. Haigentz, G. Jung, M. Garg, R. Owen, B. Schiff, R. V. Smith
Journal: Journal of Clinical Oncology (2006)

5570 Background: Although Squamous Cell Carcinoma of the Head and Neck (SCCHN) is a non-AIDS defining malignancy, its risk is greater in HIV-positive populations for unclear reasons. Very limited data exist on the clinical presentation, treatment toxicities and outcomes of HIV infected pts with SCCHN, a population frequently excluded from participation in clinical trials. Methods: We present a large case series of HIV infected pts with SCCHN who were recently treated at a single institution. Retrospective chart reviews were performed by treating physicians. Results are reported with descriptive statistics. Results: Thirty individuals with SCCHN reporting HIV infection have been treated by the collaborating physicians from 1997–2005; all were smokers. The average age at diagnosis of SCCHN was 49.3 years (range 33–62), and interestingly, a relatively large number were female (13 of 30, 43%). The median CD4 count of pts was 374/μL, and most pts reported a history of antiretroviral therapy. The most frequent sites of primary disease were the larynx (13 pts, 43%, mostly supraglottic) and oropharynx (13 pts, 43%). Although most patients (87%) presented with advanced (stage III and IV) disease, a few (4 pts, 13%) had stage II disease. Although 12 pts underwent surgical resections for primary treatment, 16 pts underwent primary nonsurgical therapy, including 8 pts treated with chemoradiotherapy. Therapy related toxicities were expected and did not appear different from those observed in immunocompetent individuals. Eight pts had recurrence (7 locoregional/1 distant), and 5 pts died from recurrent/metastatic disease. Three pts had second primary cancers. Conclusions: HIV-infected individuals with SCCHN are generally young smokers, both male and female, receiving active treatment against HIV. The detection of a proportion of pts with early stage disease further supports the role for aggressive smoking cessation counseling and screening efforts for SCCHN in HIV infected populations. Additionally, HIV infection is not a contraindication to aggressive organ-preserving regimens for SCCHN pts with otherwise good functional status. A case-control clinical and pathologic study of SCCHN in HIV infection is planned. No significant financial relationships to disclose.
Abstract 3813: Hemodynamic Characterizations in Patients with Diastolic Heart Failure and Hypertension
Authors: Naoki Fujimoto, Kaoru Dohi, Masaki Tanabe, Takeshi Takamura, Tairo Kurita, Masaaki Ito, Naoki Isaka, Katsuya Onishi
Journal: Circulation (2006)

Background: Hypertension is thought to play an important role in diastolic heart failure (DHF); however, DHF has different underlying pathophysiologic mechanisms. Hemodynamic characterizations in D...
Abstract 14939: Reverse Left Ventricular remodelling 6 months post-Transcatheter Aortic Valve Implantation compared to Surgical Aortic Valve Replacement. A Cardiovascular Magnetic Resonance Study.
Authors: Timothy A Fairbairn, Christopher D Steadman, Adam N Mather, Manish Motwani, Daniel J Blackman, Gerry P McCann, Sven Plein, John P Greenwood
Journal: Circulation (2011)

Introduction  Transcatheter Aortic Valve Implantation (TAVI) for patients with severe aortic stenosis at unacceptably high surgical risk has been shown to improve survival compared to medical therapy. Our aim was for the first time to use the ‘reference standard’ technique, Cardiovascular Magnetic Resonance (CMR) to accurately demonstrate serial changes in left ventricular (LV) function and mass post TAVI compared to surgical aortic valve replacement (SAVR).   Methods  Forty patients (20 TAVI, 20 SAVR) completed baseline and 6 month follow-up 1.5T CMR scans. Patient characteristics were matched for gender (male 10 vs 15, p=0.1) and BMI (27 ±3 vs 27 ±4, p=0.88) but due to TAVI selection criteria not for age (80 ±7 vs 75 ±7, p=0.01) or EuroSCORE (20 ±11 vs 6.7 ±3, p   Results  TAVI resulted in a significant reduction in LV end-systolic volume (ESV) and mass and an increase in ejection fraction (EF). Post SAVR LV end-diastolic volume (EDV), ESV and mass significantly reduced with no significant change in EF (Table 1). EDV was significantly lower (p=0.03) in the SAVR group at 6 months when compared to TAVI. Multivariate analysis identified diabetes as an independent predictor of poor LV mass regression (B 7.6, p=0.02). Gender, CAD, Renal failure and AF had no association to remodelling when controlled for baseline parameters. In SAVR, CABG was associated with higher EDV and stroke volume at 6 months (B 11.7, p=   Conclusion  In high risk patients, TAVI resulted in comparable levels of LV reverse remodelling to lower risk SAVR patients. TAVI significantly improved LV ESV, mass and EF at 6 months. No specific variable predicted reverse remodelling although LV mass reduction was less pronounced in diabetic patients. These changes in ventricular remodelling may be responsible for the reported improved prognosis post TAVI.
Predictive value for relapse of variation in alpha-fetoprotein (AFP) levels in patients who are in remission from germ cell cancer.
Authors: P. Patel, R. R. Balise, S. Srinivas
Journal: Journal of Clinical Oncology (2010)

e15119 Background: Germ cell cancer is highly curable even with advanced disease. Serum markers aid in diagnosis and prognosis and can indicate a relapse. Significant variations in the normal level of AFP exist and create anxiety among patients and physicians during surveillance or therapy. We assessed whether AFP level variations within the normal range predict for relapse in patients with germ cell cancer. Methods: We conducted a retrospective review of all patients with germ cell tumors who were in clinical remission and followed with surveillance AFP at our center from 1991 to 2009. Seventy-four patients with a median follow up of 50 months were identified. Baseline characteristics including age, date of diagnosis, histology, and treatments (orchiectomy, surveillance, chemotherapy, retroperitoneal lymph node dissection, radiation) were documented. We included patients with seminoma in our analysis to serve as a control group as elevations in AFP levels are not expected in this histology. Both patients on surveillance and those treated with chemotherapy were included. We evaluated the variance of AFP levels within normal. Results: Of the seventy-four patients, 78% had non-seminomatous germ cell histology and 22% had seminomas. Thirty-four percent of patients were stage I, 27% were stage II and 34% were stage III. Seventy patients underwent orchiectomy and 50 patients received systemic chemotherapy. Four patients had extragonadal primaries. Three patients required hematopoietic stem cell transplant. The mean age of patients at diagnosis was 30.5 years. The mean AFP value was 3.27ng/ml (range: 2.27ng/ml and 5.31ng/ml) with a standard deviation (SD) of 1.35ng/ml. Five patients relapsed on surveillance with rising AFP levels. Their average AFP pattern prior to relapse was not predictive of relapse. There was no evidence of a difference in the mean AFP values between patients with seminonas (N = 15) 2.96ng/ml and those with non-seminomatous germ cell tumors (N =57) 3.3ng/ml with a SD of 1.01ng/ml. Conclusions: Significant variations in normal serum AFP exists. Rising AFP levels within normal limits did not predict for relapse in our cohort of patients with extended follow up. No significant financial relationships to disclose.
Abstract 6193: Renal Flow Reserve after Successful Percutaneous Renal Angioplasty Predicts Renal Functional Recovery
Authors: Yoji Neishi, Hiroyuki Okura, Tetsuo Tsuchiya, Yoshinori Miyamoto, Ryotaro Yamada, Teruyoshi Kume, Akihiro Hayashida, Takahiro Kawamoto, Kiyoshi Yoshida
Journal: Circulation (2008)
Quantification of Survival Gain From Cardiac Resynchronization Therapy
Authors: Judith A. Finegold, Claire E. Raphael, Wayne C. Levy, Zachary Whinnett, Darrel P. Francis
Journal: Journal of the American College of Cardiology (2013)

The goal of this study was to examine the impact of calculation-window duration on lifespan gain (as observed in trials) and on who gains most. The landmark trials of biventricular pacing (cardiac resynchronization therapy [CRT]) typically ran for <1 device battery life, and they may therefore underestimate lifespan benefit over longer durations. We conducted a meta-analysis of biventricular pacing trials to calculate lifespan gained: first, within the duration of randomized controlled trial data up to 2 years; second, over a 5-year typical battery life; and third, over >1 battery life. Importantly, we applied the Gompertz method for age-related increase in mortality from non–CRT-preventable causes. Five landmark trials (COMPANION [Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure], CARE-HF (CArdiac REsynchronization–Heart Failure), MADIT-CRT [Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy], REVERSE [Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction], RAFT (Resynchronization–Defibrillation for Ambulatory Heart Failure)) provided data for 2 years (6,561 patients), with an average hazard ratio of 0.71. Lifespan gained across all trials increased nonlinearly with time from 0.1 month at 1 year, to 0.5 month at 2 years, and a projected 6.5 months at 5 years (65 times more than at 1 year). After multiple devices, it reached 14 months, involving on average 1.6 devices (i.e., 8.8 months per device implanted). Moreover, while over a short window (e.g., 2 years), lower-mortality patients may gain less than higher-mortality patients (1.4 vs. 2.3 months), their positions reverse by 15 years (16.0 vs. 13.7 months). Lifespan gain from biventricular pacing rises nonlinearly with time. Early on, higher-risk patients exhibit more gain, but later, lower-risk patients exhibit more gain. Quantifying gain over less than a patient's lifetime underestimates lifespan gain. Over the first 1 or 2 years, lower-risk patients may seem to gain less, although they may ultimately be the ones who gain the most.
Abstract 2865: Ventricular Rate Control using the Adenosine Receptor Agonist CVT510 in the Goat Model of Atrial Fibrillation: Efficacy During Exercise and Synergistic Effects with Metoprolol
Authors: Sunniva de Haan, Sander Verheule, Arvinder Dhalla, Luiz Belardinelli, Maurits Allessie, Ulrich Schotten
Journal: Circulation (2007)
Black twins are born to white parents after treatment mix-up
Authors: Owen Dyer
Journal: BMJ (2002)

The case of black twins being born to a white couple receiving infertility treatment, which became public this week, looks set to become a matter for the courts. The Official Solicitor has been granted injunctions forbidding the release of the identity of any of the parents, the children, or the clinic concerned.

It is not known if the incident involved a black man's sperm being introduced into Mrs A's eggs, or complete fertilised embryos from a black couple being implanted in her womb. The error took place before 2001 so the children may now be over 1 year old. The white couple, known as Mr and Mrs A, are apparently determined to keep the children.

Preliminary legal hearings will begin in October. Experts say these are likely to focus on the issue of legal paternity. Dr Vivienne Nathanson, head of science and ethics at the BMA, said the law was clear on maternity, acknowledging that motherhood applies to the woman who carried the child, irrespective of genes. The position of the two prospective fathers is less clear.

According to the Human Fertilisation and Embryology Act 1990, the husband in the couple who received infertility treatment should be regarded as the father if he gave consent to the placement of the embryos. It could be argued that Mr A did not give informed consent as he did not know the true nature of the embryos.
Effects of blood pressure lowering on cerebral white matter hyperintensities in patients with stroke. The PROGRESS MRI Substudy
Authors: C. Dufouil, J. P. Chalmers, O. Coskun, V. Besancon, M. G. Bousser, P. Guillon, Stephen MacMahon, B. Mazoyer, B Neal, Mark Woodward, N. Tzourio-Mazoyer, C. Tzourio, Progress Mri Substudy Investigators
Journal: Circulation (2005)
Abstract 6096: Long-Term Survival of Patients with Chest Pain Syndrome and Angiographically Normal or Near Normal Coronary Arteries: The Additional Prognostic Value of Coronary Flow Reserve
Authors: Rosa Sicari, Fausto Rigo, Sonia Gherardi, Lauro Cortigiani, Maurizio Galderisi, Eugenio Picano
Journal: Circulation (2008)

It has been demonstrated that in the low risk subset of patients with angiographically normal coronary arteries, 1 out of 10 shows wall motion abnormalities during dipyridamole echocardiography tes...
Recognition and treatment of rabbit syndrome, an uncommon complication of neuroleptic therapies
Authors: R Todd, S Lippmann, M Manshadi, A Chang
Journal: American Journal of Psychiatry (1983)

Rabbit syndrome is an uncommon, tongue-sparing, orofacial movement disturbance, rapid and regular in nature and associated with prolonged use of neuroleptics. Two cases reports illustrate how anticholinergic agents successfully treat the disorder. The syndrome is distinguished from tardive dyskinesia, which tends to be exacerbated by anticholinergic agents.
Abstract 15394: Insulin Induced Uncoupling of Nitric Oxide Synthase and Generation of Reactive Oxygen Species Underlie Cerebrovascular Insulin Resistance
Authors: Prasad V Katakam, James A Snipes, Mesia M Steed, David W Busija
Journal: Circulation (2011)

Objective. Insulin resistance (IR) accompanied by hyperinsulinemia is an independent risk factor for stroke. However, the cerebrovascular actions of insulin in IR or diabetes have never been examin...
Lesson of the Week: Thyrotoxicosis in a patient with multiple trauma: value of "AMPLE" history taking
Authors: J. Fitz-Henry, B. Riley
Journal: BMJ (1996)

Globally, grain yields are not falling, but their percentage rate of increase is seriously slowing * If grain yields are to match future population growth they will need to double or triple-sustainably * Like China, demographically trapped communities may need one child families * If we are to encourage any community to have one child families we should have them ourselves * The Cairo population conference in 1994 evaded local demographic entrapment and global food security and needs to be recalled demographic entrapment-much more seriously, deal- ing as they do with the distribution of wealth and power and who eats what.It will also need to remind us that, if not physically tightening out belts, we need to eat a
Guidelines on appropriate indications for upper gastrointestinal endoscopy
Authors: A T R Axon, G D Bell, R H Jones, M A Quine, R F McCloy
Journal: BMJ (1995)

between scarce units of resource, will paradoxically lead to a reaffirmation that the professional's duty is to the individual patient.The specialist's role at the margin ofknowledge What characterises specialists is, to borrow an economic concept, their ability at the margin of knowledge.This cannot be replaced by semitrained nurses or physician assistants or by championing generalists as economic gatekeepers.The scenario that I have sketched may not happen.Most empirical evidence suggests that it would be an expensive way to provide health care.But consumerism and ever more information about the potential benefits of medical intervention will forge an alliance directly between physicians and patients (real rather than proxy purchasers), resulting in pressure for increased specialist care.Technical advance will drive demand, and the priests that tend the machines will increase in number, as will the number of their sects.Alternatives of course do exist.My treatment of the ethics of a humane medicine owes much to the ideas advanced in Science and Human Values (Hutchinson, London 1961
Abstract 3628: Serum Macrophage Inflammatory Protein 1 Beta as a Predictor for Cerebro-Cardiovascular Events in Hypertensive Patients
Authors: Yuji Tatara, Mitsuru Ohishi, Minako Terai, Norihisa Ito, Takashi Takagi, Norihiro Hayashi, Atsushi Shiota, Hiromi Rakugi, Toshio Ogihara
Journal: Circulation (2006)

Background: We designed hospital-based cohort study to evaluate prognostic effects of NOn-invasive Atherosclerotic evaluation in Hypertension (NOAH study). Macrophage inflammatory protein-1β (MIP-1...
Abstract 9434: A Specific IKK Inhibitor Suppresses Experimental Autoimmune Myocarditis in Rats
Authors: Ryo Watanabe, Jun-Ichi Suzuki, Masahito Ogawa, Susumu Muto, Akiko Itai, Yasunobu Hirata, Ryozo Nagai, Mitsuaki Isobe
Journal: Circulation (2011)

Introduction: Nuclear factor-kappa B (NF-κB), which is regulated by the inhibitor NF-κB kinase (IKK), plays a critical role in the development of myocarditis. However, little is known about the role of IKK in its pathophysiology. Hypothesis: We assessed the hypothesis that IKK inhibition could attenuate cardiac inflammation in the progression of myocarditis. Methods: Lewis rats were immunized with porcine cardiac myosin to induce experimental autoimmune myocarditis (EAM). We administered the IKK inhibitor (IMD-0354, 15mg/kg/day, n=6) to EAM rats daily; the drug-free vehicle was used as untreated EAM control (n=7). We analyzed the therapeutic effects of IKK inhibition against EAM using echocardiography and pathological examination. Cytokine expression in the hearts and cell proliferation by myosin restimulation were also analyzed. Results: Echocardiogram revealed that the IKK inhibitor improved left ventricular fractional shortening (52.7±4.5%) in comparison to the untreated group (37.3±3.1%, p&lt;0.05). Pathologically, severe myocardial cell infiltration was observed in the untreated EAM group (affected area per whole heart, 55.8±6.1%), while the IKK inhibitor treated group showed to suppress these changes (26.3±4.2%, p&lt;0.05). In the IKK inhibitor treated group, mRNA expression of IFN-gamma (3.9 ±0.7 fold vs. untreated group, p&lt;0.05) and MCP-1 (17.1±0.8 fold vs. untreated group, p&lt;0.05) was significantly suppressed in comparison to the untreated EAM group (IFN-gamma: 14.5±2.7 fold, MCP-1: 51.4±3.9 fold). Moreover, the IKK inhibitor suppressed production of IL-2 and T cell proliferation in a dose dependent manner in vitro. Conclusion: In conclusion, the IKK inhibitor ameliorated EAM by suppressing cytokine production and attenuating inflammatory cell infiltration. IKK regulation is a promising treatment of clinical myocarditis.
"Folk" explanations of mental illness in rural laos
Authors: Joseph Westermeyer, Ronald Wintrob
Journal: American Journal of Psychiatry (1979)

To obtain "folk" explanations of specific cases of mental illness the authors interviewed 35 baa(insane) Laotian individuals and their relatives and neighbors. They obtained 54 explanations; 15 focused on supernatural causes, 15 on physical causes, 14 on social problems, and 10 on psychological states. Although 31 theories (57%) focused on etiologic factors familiar to clinical psychiatrists, many self-evident factors (such as familial prevalence) were not mentioned. Except for 3 cases, responsibility for the illness was attributed to factors outside the subject's control. This view of mental illness absolves the baa person from blame and ensures support from the social group.
Multiple personality disorder in Switzerland
Authors: J Modestin
Journal: American Journal of Psychiatry (1992)

There are no reliable data on the prevalence of multiple personality disorder. The objective of the study was to determine whether and, if so, how frequently patients with multiple personality disorder are encountered and diagnosed in Switzerland.All qualified Swiss psychiatrists were sent a questionnaire on multiple personality disorder along with the DSM-III description of multiple personality disorder and three case examples. A total of 836 psychiatrists (66%) answered after two mailings, and 770 questionnaires qualified for evaluation. In addition, a random sample of nonresponders were contacted by telephone.Three percent of the psychiatrists indicated that, at the time of the inquiry, they were treating or examining one or more patients who met DSM-III criteria for multiple personality disorder, and 10% indicated that they had seen multiple personality disorder at least once during their professional career. The patients were not equally distributed among the psychiatrists; three colleagues reported that they had seen much higher numbers of patients with multiple personality disorder. The point prevalence of multiple personality disorder among patients seen by psychiatrists in Switzerland amounts to 0.05%-0.1%.Multiple personality disorder appears to be a disorder that genuinely exists, even though it occurs relatively rarely.
Concurrent cisplatin-based chemoradiation for figo stage 1b<sub>2</sub> cervical carcinoma
Authors: B. P. Goksedef, C. Kunos, J. Belinson, P. G. Rose
Journal: Journal of Clinical Oncology (2008)

16595 Background: There is controversy over the appropriate treatment for stage IB2 cervical cancer. Among 3 randomized GOG trials the highest survival reported is in patients treated with concurrent chemoradiation and adjuvant hysterectomy. This study was conducted to assess the effectiveness of primary chemoradiation therapy alone for stage 1B2 cervical carcinoma. Methods: A retrospective study of patients diagnosed stage 1B2 cervical carcinoma and treated with primary chemoradiation at Cleveland area hospitals from 1992 to 2006 was performed. Patients with evidence of regional or distant metastasis on imaging were excluded. All patients underwent treatment with external beam radiation therapy to the pelvis with weekly concurrent Cisplatin 40 mg/m2 and high or low dose rate brachytherapy. Results: Forty nine patients with a median age of 51 years were identified. The majority of patients were Caucasian (81.6%), had squamous cell carcinomas (81.6%). Median tumor diameter was 5 cm (range 4.1–10 cm). At a median duration of follow up of 35 months, recurrence was seen in 18.3%. Median recurrence time was 22 months (4–57). Conclusions: For stage 1B2 cervical cancer primary chemoradiation has a local recurrence rate, PFS and OS which is similar to concurrent chemoradiation and adjuvant hysterectomy. Summary of recurrence rates and survival rates in two different treatment modalities Local and local and distant recurrence Distant only recurrence Progression-free survival Overall survival GOG 123 ChemoRT/hysterectomy 11% 10% 79% 83% ChemoRT alone 12% 6% 75% 89.4% No significant financial relationships to disclose.