tbuckley/cabot-search huggingface dataset:
Pre- and post-treatment circulating tumor cell counts (CTCc) and overall survival (OS) in castration-resistant prostate cancer (CRPC): The Royal Marsden Hospital (RMH) experience
Authors: G. Attard, D. Olmos, H. T. Arkenau, I. Ledaki, C. P. Carden, A. H. Reid, J. Ang, P. C. Fong, C. Parker, J. S. De Bono
Journal: Journal of Clinical Oncology (2008)

5072 Background: Recent studies have shown that CTCc predict OS in patients (pts) with CRPC. Methods: CTC were collected at baseline and after 1 and 2 cycles of treatment in CPRC pts starting a new line of systemic treatment in phase I/II clinical trials at the RMH. Enumeration of CTC was performed using the CellSearch System. Results: 119 pts were studied. Prior chemotherapy was significantly associated with a higher median CTCc (Spearman rank p=0.008). Pts with bone metastasis had significantly more CTC (median 9; range 0 -545) than patients with solely lymph node involvement (median 0; range 0–5) (Mann-Whitney p= 0.001). Utilising a Cox Regression model, a CTCc >5 was associated with a worse OS than a CTCc <5 at baseline (median OS 19.5 vs >30 months, p<0.0001), after 1 cycle (10 vs 27.6 months, p<0.0001) and after 2 cycles of treatment (8.4 vs 26.7 months, p<0.0001). A CTCc decline by >30% after 2 cycles of treatment in pts with >5 CTC at baseline significantly predicted improved OS (median: 23 months vs 7.7 months, p=0.04). In multivariate analysis which included ALP, LDH, hemoglobin, lines of prior treatment, performance status, albumin, baseline PSA, PSA doubling time, age, Gleason score and CTCc, only a CTCc >5 (HR: 3.25; 95% CI: 1.4–7.4; p=0.005) and an elevated LDH (HR 2.44, CI-95% 1.2–4.9; p=0.012) were independently significant prognostic factors. In sub-group analysis of pts (n=60) who received the novel hormonal treatment, abiraterone acetate, a decline in CTCc preceded and predicted declines in PSA and radiological responses and a rise in CTCc was associated with tumor progression. Finally, rearrangements involving the ERG gene, could be detected by fluorescent hybridisation assays on CTC. Conclusions: Our data confirm the results of the IMMC38 study, showing a CTCc >5 at baseline and after treatment predicts a worse OS in CPRC pts. These data also suggest that CTC kinetics can be used to identify pts who are benefiting from hormonal or cytotoxic treatment after 2 cycles of treatment. The evaluation of CTCc as a surrogate of OS in large phase III randomised studies is now required. No significant financial relationships to disclose.
Cluster of cases of hepatitis A with a travel history to Egypt, September-November 2008, France
Authors: E Couturier, A M Roque-Afonso, M J Letort, E Dussaix, V Vaillant, H de Valk
Journal: Eurosurveillance (2009)

Since September 2008, 26 cases of hepatitis A with a history of travel to Egypt have been reported in France. Investigations indicate that a common source of contamination linked to Nile river cruises is the most likely explanation of the increase in the number of cases reported in France as well as in several other European Union countries.
Abstract 2680: Electrocardiographic Recognition of Ventricular Tachycardia With Successful Endocardial Catheter Ablation in Patients With Non-Ischemic Cardiomyopathy
Authors: Satoshi Nagase, Nobuhiro Nishii, Shigeki Hiramatsu, Masato Murakami, Takeshi Tada, Masamichi Tanaka, Koji Nakagawa, Hiroshi Morita, Kengo Kusano, Hiroshi Ito
Journal: Circulation (2009)
Abstract 3289: Vortex Formation Index in Heart Failure: Novel Non-invasive Assessment Of Fluid Dynamics using Transthoracic Echocardiography
Authors: Li Ching Lee, Yee-Leng Tan, Huay Cheem Tan, Abdul Razakjr Omar, Ping Chai, Tiong Cheng Yeo, Adrian Fatt Hoe Low, James WL Yip, Boon Lock Chia, Kian Keong Poh
Journal: Circulation (2007)

Background: In clinical heart failure (HF), inefficient propagation of blood through the left ventricle (LV) may result from suboptimal vortex formation (VF) ability of the LV during early diastole. We aim to validate echocardiographic-derived VF index (VFI) in normal subjects and examine its utility in both systolic and diastolic HF. Method: Echocardiography was performed in 100 normals and 155 pts admitted with HF (110, systolic and 45, isolated diastolic failure). In additon to biplane LV ejection fraction (EF) and conventional parameters, the Tei index and tissue Doppler (TD) indices were measured. VFI was obtained using: 4 X (1-β) / πX α 3 X LVEF where β is the fraction of total transmitral diastolic stroke volume contributed by atrial contraction (assessed by time velocity integral of the mitral E and A waves) and α is the biplane end diastolic volume (EDV) 1/3 divided by mitral annular diameter during early diastole. Results: Mean VFI was 2.75 ± 0.7 in control subjects; reduced in heart failure, diastolic, 2.21 ± 0.8; systolic, 1.24 ± 0.5 (P&lt;0.001, Fig 1 ). It correlated positively with TD early diastolic myocardial velocities (E, septal, r =0.58; lateral, r =0.58), inversely with LV filling pressure (E/E’ septal, r =−0.42; lateral, r =−0.41) and the Tei index (r =−0.57, curvilinear relation, Fig 2 ); all Ps &lt;0.001. In comparison with age, sex and LVEF-matched controls, only VFI, but not all other echo indices, remained significantly different (attenuated) in diastolic HF patients (2.01 ± 0.7 vs 2.74 ± 0.8, P=0.005). Conclusion: VFI, a novel, dimensionless index, incorporating LV geometry, systolic and diastolic contributions to fluid dynamics, may be useful in heart failure.
Abstract 3225: Ablation Of The Pulmonary Veins Using An Irrigated Tip Rf Ablation Catheter Reduces Cerebral Microemboli Versus A Non-irrigated-tip Rf Ablation Catheter.
Authors: Loes Sauren, Luc De Roy, Laurent Pison, Mark la Meir, Erik van der Veen, Werner Mess, Harry Crijns, Jos Maessen
Journal: Circulation (2007)

Background Pulmonary vein isolation (PVI) has become an established treatment for patients with atrial fibrillation (AF). But post-intervention complications like, TIA, stroke and cognitive decline, might occur. In this study the incidence of microembolic signals (MES) was determined during percutaneous PVI; non-irrigated tip radiofrequency (RF) ablation versus irrigated tip RF ablation. Methods and Results Twelve patients underwent PV catheter RF ablation. Two patient groups were selected; Group NON-IRRIGATED RF: a non-irrigated RF ablation catheter (temperature&lt; 55°, power&lt; 30 W) was used in 7 patients, Group IRRIGATED RF: an irrigated tip RF ablation catheter (temperature&lt; 43°, power&lt; 25 W) was used in 5 patients. Transcranial Doppler (TCD) was used to detect microembolic signals in the middle cerebral arteries. The duration of the procedure, the number of applications and the total ablation time was not different between both groups. In the IRRIGATED RF group versus the NON-IRRIGATED group less cerebral MES were detected during the complete procedure (1570 vs. 3515) and per 1 minute of ablation (4 vs.89). Conclusions Ablation of the pulmonary veins in a percutaneous endocardial approach causes a significant number of cerebral MES during the procedure. The cerebral MES detected during ablation are most likely gas bubbles and solid emboli due to overheating of the tissue and blood. Because a positive association between the number of cerebral MES and the risk of stroke and neurological impairment has been reported, the RF irrigated tip ablation catheter might be preferable in an effort to reduce the stroke risk. Number of MES during irrigated and non-irrigated PVI
Abstract 554: Measurement of Heart-Type Fatty Acid Binding Protein Identifies High Risk Patients among Those with Suspected Acute Coronary Syndrome Who Are Troponin Negative
Authors: Karthik Viswanathan, Christine Morrell, Susan J Thistlethwaite, Taj B Hassan, Julian H Barth, Alistair S Hall
Journal: Circulation (2008)

To evaluate the role of heart-type fatty acid binding protein (H-FABP) in risk stratifying patients with suspected acute coronary syndrome (ACS), especially those identified as ‘troponin negative’. We recruited a consecutive cohort of 1080 consenting patients admitted with ‘suspected ACS’ over 10 months. Additional serum samples were collected 12–24 hours from symptom onset (same time as routine troponin test). H-FABP results, measured using the Randox assay, were available in 1047 patients. ‘Positive H-FABP’ was defined as ≥5.8μg/l (= 99th centile value in healthy adults with the Randox assay). Follow-up for mortality was for minimum of 12 months (for the last patient recruited). 1) 253/1080 (23.4%) were adjudged ‘troponin positive’(Siemens ultraTnI +ve). HFABP was positive (HFABP +ve) in 206/1047 (19.7%). All-cause mortality was 5.56% (64/1080). Mortality within sub-groups: TnI+ve 12.3% vs TnI −ve 4%; HFABP+ve 18% vs HFABP −ve 3.1%. 2) Among TnI −ve patients, 54/803 (6.7%) were HFABP +ve. Unadjusted mortality in TnI =−ve, ‘HFABP +ve’ patients was 18.5% vs 3.1% in TnI −ve, ‘HFABP −ve’ patients (HR 6.74 {95% CI = 2.8–16.6}, p &lt;0.001) -see Figure. 3) After adjusting for age, serum creatinine, troponin and hsCRP in a multivariate model, elevated H-FABP was an independent predictor of all-cause mortality across the entire cohort [HR 2.38 (95% CI = 1.23–4.63), p=0.01]. Elevated H-FABP is an independent prognostic marker in patients with suspected acute coronary syndrome. H-FABP identifies high-risk ‘troponin-negative’ chest pain patients reliably and would be a useful adjunct when risk stratifying these patients.
Abstract 16677: Allogeneic Cardiospheres Boost Cardiac Function and Attenuate Adverse Remodeling Without Eliciting Immune Reactions Post-Myocardial Infarction in Immunologically-Mismatched Rat Strains
Authors: Eleni Tseliou, Konstantinos Malliaras, John Terrovitis, Daniel Luthringer, Linda Marban, Eduardo Marban
Journal: Circulation (2011)

BACKGROUND: Autologous cardiospheres, 3-dimensional heart-derived multicellular structures that form spontaneously in suspension culture, have been shown to ameliorate remodeling and improve global function after intramyocardial (IM) injection in infarcted pig hearts. However, autologous tissue processing is fraught with considerable expense, delays to treatment and potential complications.The possible role of allogeneic cardiospheres in restoring ischemic heart tissue has not been studied. OBJECTIVES: We evaluated the immunologic profile of syngeneic and allogeneic cardiospheres in vitro and their in vivo efficacy after IM injection in a rat model of acute myocardial infarction. METHODS: Cardiospheres expanded from male Wistar Kyoto (WKY) rat hearts were injected in the peri-infarct zone of WKY female (syngeneic group, n=18) or Brown Norway female rats (allogeneic group, n=20). Brown Norway female rats (n=12) injected with normal saline served as controls. RESULTS: In vitro, cardiospheres expressed only MHC I antigens on their outer layer, while MHC II were only gradually expressed after stimulation with γ-interferon over a course of 7 days. In vivo, cell engraftment was equivalent in the two treated groups 1 week (syngeneic 4.5% vs allogeneic 3%, p&gt;0.05) and 3 weeks after injection (&lt;0.5% in both groups). At the same time points, infarct size was significantly and equally reduced in the two cardiosphere-treated groups compared with the vehicle-treated group by quantitative morphometry. Echocardiography revealed similar functional improvement in both cardiosphere-treated groups at one week (EF syngeneic 45.5±2.9, allogeneic 46.4 ± 1.7 vs control 33.4±1.7, p&lt;0.05 ) and three weeks of follow up (EF syngeneic 51.5±1.9, allogeneic 50.5±2.2 vs control 31.9±0.7, p&lt;0.05). Histopathologic evaluation of the infarct site and the peri-infarct zone, where the allogeneic cardiospheres were injected, showed no signs of rejection. CONCLUSION: Allogeneic cardiospheres engraft in the infarcted heart, improve cardiac function and limit infarct size, to the same extent as syngeneic ones, without evident immune reaction. Cardiospheres may serve as an effective off-the-shelf cell product for regeneration after acute myocardial infarction.
Legionnaires’ disease cluster linked to a metal product aqueous pre-treatment process, Staffordshire, England, May 2008
Authors: N Coetzee, W K Liu, N Astbury, P Williams, S Robinson, M Afza, H V Duggal
Journal: Eurosurveillance (2009)

In May 2008, a report of two workers from the same construction equipment manufacturing plant who were admitted to hospital with Legionnaires disease confirmed by urine antigen prompted an outbreak investigation. Both cases were middle aged men, smokers, and with no travel, leisure or other common community exposure to Legionella sources. There were no wet cooling towers at the plant or in the surrounding area. No increase in respiratory disease or worker absenteeism occurred at the plant during the preceding month. Wider case ascertainment including alerts to hospitals and medical practitioners yielded no further cases. The environmental investigation (and sampling of water systems for Legionella) identified a Legionella pneumophila serogroup1 (Mab 2b) count of >3.0x10(4)cfu/l in water samples from an aqueous metal pre-treatment tunnel, which generates profuse water aerosol. Drainage, cleaning and biocide treatment using thiazalone eliminated Legionella from the system.
Abstract 15889: High Glucose Leads to Increased Inflammatory Gene Expression via Epigenetic Histone H3 Lysine 9 Methylation in Cardiomyocyte
Authors: Xi-Yong Yu, Yong-Jian Geng, Qiu-Xiong Lin, Hui-Su Xia, Zhi-Xin Shan, Min Yang, Shu-Guang Lin, Yangxin Li
Journal: Circulation (2010)

Diabetic patients continue to develop inflammation and cardiovascular complications even after achieving glycemic control. The poorly understood “metabolic memory” phenomenon poses major challenges in treating diabetes. Also, the mechanism by which high levels of glucose (HG) causes inflammation and diabetic cardiomyopathy are not known. Recent studies demonstrate a link between epigenetic changes such as chromatin histone methylation and gene expression. Thus, we tested whether histone 3 lysine-9 tri-methylation (H3K9me3), a key epigenetic chromatin marker, was involved in HG-induced inflammation and metabolic memory. Incubating H9C2 rat ventricular cells in high glucose (25 mM) resulted in increased inflammatory cytokine IL-6 mRNA levels (3.3 ± 0.4 fold at 72 h, p
Fondaparinux versus Enoxaparin in Acute Coronary Syndromes
Authors: David T. Majure, Scott K. Aberegg
Journal: New England Journal of Medicine (2006)

To the Editor: The authors of the Fifth Organization to Assess Strategies in Acute Ischemic Syndromes (OASIS-5) study (April 6 issue)1 point out that despite the presence or absence of administration of unfractionated heparin, bleeding rates were significantly lower with fondaparinux than with enoxaparin in patients with acute coronary syndromes. However, the authors do not fully evaluate the significant difference between patients who received unfractionated heparin after randomization in the enoxaparin group and those who did so in the fondaparinux group (31.2 percent and 22.0 percent, respectively; P<0.001) (Table 1 in the article). Of the patients who underwent percutaneous coronary intervention (PCI), 55.5 percent of those in the enoxaparin group and 20.8 percent of those in the fondaparinux group received unfractionated heparin. Notably, the rate of major bleeding at nine days among patients undergoing percutaneous coronary intervention was 5.1 percent for patients in the enoxaparin group and 2.3 percent in the fondaparinux group. By comparison, in the Superior Yield of the New Strategy of Enoxaparin, Revascularization, and Glycoprotein IIb/IIIa Inhibitors (also known as SYNERGY) trial, among patients receiving enoxaparin, the rate of major bleeding, defined according to Thrombolysis in Myocardial Infarction (TIMI) criteria, that was not related to coronary-artery bypass grafting was 2.4 percent, and according to the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (also known as GUSTO) criteria, the rate of severe bleeding was 2.7 percent.2 Although the authors of the OASIS-5 study give a P value of less than 0.001 for the comparison of rates of bleeding between groups, regardless of the presence or absence of heparin therapy during PCI, a more complete evaluation is needed. Given the significant difference between groups in the number of patients who were treated with unfractionated heparin, the authors should present the relative risk of bleeding in each group stratified according to the use of unfractionated heparin during PCI and provide an interaction term.3 David T. Majure, M.D., M.P.H.
Abstract 9116: Ultrasound Speckle Tracking System Using Radiofrequency Data for Simultaneous Computation of Strain and Strain Rate: Validation Against Sonomicrometry
Authors: Muhammad Ashraf, Max Carlson, Colleen Newey, Shiza Ashraf, Karen Li, Sarah K Yang, Jamie Hamilton, David J Sahn
Journal: Circulation (2010)

Background: There is significant interest in speckle tracking echo derived mechanical indices to assess myocardial deformation and contractility. Current commercial B-mode feature tracking packages...
Abstract 8547: Patient-Specific Cellular Therapy (Ixmyelocel-T) is Safe and Improves Time to Treatment Failure in Patients with Critical Limb Ischemia and No Revascularization Options
Authors: William Marston, Richard Powell, Carlo Dall'Olmo, Raul Guzman, Scott Berceli, Colleen J Moore, Jeff Martinez, Brian Halloran, Peter Henke, Patrick Stiff, Anthony Comerota, Omaida Velazquez, Edith Tzeng, Farrell Mendelsohn, Tim Henry, W T Bohannon, Jorge Saucedo, Ronnda Bartel, Amy Longcore, Theresa Stern, Sharon Watling
Journal: Circulation (2011)

Background: Critical limb ischemia (CLI) represents the most severe degree of peripheral arterial disease and is associated with significant morbidity and mortality. Cellular therapy offers the potential to promote tissue remodeling, immuno-modulation, and angiogenesis. This Phase 2 study assessed the safety and efficacy of patient-specific, expanded bone marrow cells (ixmyelocel-T) in a no-option CLI population followed for 12 months. Methods: This randomized (2:1), double-blind, placebo-controlled, multicenter study compared one-time treatment of ixmyelocel-T with placebo, administered via 20 IM lower extremity injections. Bone marrow aspirates from patients in the ixmyelocel-T group were processed over 12 days to generate ixmyelocel-T mixed cell product. The primary objective was safety. A composite treatment failure efficacy endpoint (major amputation on treated limb, death, doubling of wound size from baseline, or de novo gangrene) and amputation-free survival (major amputation or death) were also evaluated. Results: Of the 72 patients who received injections (mean age 69 years, 67% male, 50% diabetic, 84% current or past smokers, 63% with baseline wounds), 48 received ixmyelocel-T and 24 placebo. No major safety concerns were evident (Table 1). The time to first occurrence of treatment failure was significantly longer in ixmyelocel-T-treated patients compared with placebo-treated patients (Figure 1, logrank test, p = 0.0032). Amputation-free survival showed a clinically meaningful 32% reduction in event rate but did not reach statistical significance (p = 0.3880). Conclusions: Ixmyelocel-T was safe and increased time to treatment failure.
Abstract 15464: Serum CXCL12 Levels Decrease Following Acute Myocardial Infarction - Data from the Pakistan Risk of Myocardial Infarction Study (PROMIS)
Authors: Samira S Farouk, Weang K Ho, Asif Rasheed, Sara Vanorman, Megan Wolfe, Nehal N Mehta, Philippe Frossard, Muredach P Reilly, John Danesh, Daniel J Rader, Danish Saleheen
Journal: Circulation (2011)

Introduction: Genome-wide association studies have identified common polymorphisms near the CXCL12 gene that are significantly associated with myocardial infarction (MI). Variants associated with i...
Y-Nitinol Airway Stent for Management of Central Airway Compression Due to Metastatic Colon Cancer
Authors: R W Hauck, P Born, H Helmberger, S Bülau, R M Lembeck, T Rösch
Journal: Endoscopy (2003)

Tumors in the mediastinum, in the area between the esophagus and the tracheobronchial tree, can cause several complications, but mainly may lead to strictures in one or both organs [1]. This results in dysphagia and dyspnea, the latter due to airway compression. Further reasons for the same problems can be post-radiation strictures of both organs which sometimes have to be distinguished from the original tumor stenosis. However, another important cause of airway compression is the insertion of metal stents or plastic tubes in patients with stenosing proximal esophageal cancers [2]. So far, this complication has been mostly treated by implantation of a bifurcating dynamic Y-stent or a Dumon silicone stent, procedures which have to be performed with the patient under general anesthesia [3] [4] [5].
Nosocomial outbreak of disseminated orf infection in a burn unit, Gaziantep, Turkey, October to December 2012
Authors: K Midilli, A Erkılıç, M Kuşkucu, H Analay, S Erkılıç, N Benzonana, M S Yıldırım, K Mülayim, H Acar, O Ergonul
Journal: Eurosurveillance (2013)

We report the first outbreak of nosocomial orf infection in a hospital burn unit in Gaziantep, Turkey. The outbreak lasted from October to December 2012 and involved a total of thirteen cases. It demonstrates the risk of introduction of orf virus to a burn unit, and the potential for extensive transmission among patients with compromised skin integrity. The importance of hygiene measures and infection control are highlighted and possible transmission routes of the virus discussed.
Abstract 3027: The Pocket Protector Study: Use of D-Stat <sup>®</sup> Flowable Hemostat in Pulse Generator Pectoral Pockets Reduces the Rate of Clinically Relevant Hematomas
Authors: David Slotwiner, Stuart Alder, Charles Fuenzalida, Ronald McCowan, Craig McPherson, Theofanie Mela, Andrew Merliss, Sameh Mobarek, Hemal Nayak, Fawwah Shoukfeh
Journal: Circulation (2007)

Background : Patients who are anti-coagulated following pulse generator implantation have a 20% risk of hematoma development in the pre-pectoral pocket. In general, hematomas are correlated with patient discomfort &amp; pain, lead to increased risk of infections, &amp; may require surgical drainage leading to longer hospitalization. Objectives : This investigation was conducted to evaluate safety &amp; effectiveness associated with use of D-Stat ® Flowable Hemostat following implantation of a pulse generator compared to standard of care. Safety endpoint evaluated the incidence of major study-related adverse events &amp; effectiveness endpoint evaluated the incidence rate of clinically significant hematomas. Clinically relevant hematoma was defined as alteration in the standard of care. Methods : Two hundred sixty nine anticoagulated patients were enrolled at ten sites &amp; followed through 8 weeks post-procedure. Patients undergoing implantation were randomized to either D-Stat Flowable Hemostat or standard of care. Results : No statistical differences were observed in the baseline demographics between treatment groups. The D-Stat Flowable group presented with 65.4% males compared to 71.4% in the control group. Mean age was 73.3 years in the D-Stat Flowable group vs 72.2 years in the control group. Pulse generator distribution between the study groups was 54.4% pacemakers &amp; 45.5% ICDs in the D-Stat Flowable group vs 54.9% pacemakers &amp; 45.1% ICDs in the control group. The safety of the D-Stat Flowable was successfully demonstrated as the incidence rate of major complications experienced in both groups (D-Stat Flowable: 21.3%; Control: 27.8%) was equivalent (p value 0.0008). The effectiveness of D-Stat Flowable was successfully demonstrated as the overall rate of clinically relevant hematomas experienced in the D-Stat Flowable group (11.8%) was significantly less than that of the control group (22.6%) (p-value 0.0231). Conclusions : The findings from this investigation demonstrate the use of D-Stat Flowable within the pre-pectoral pocket in anti-coagulated patient population undergoing placement of a pulse generator is safe and effective. Use of D-Stat Flowable resulted in a 48% reduction in the rate of clinically relevant hematomas in the target population.