Miracle-dz/UniFAR-FTUs huggingface dataset:
Allogeneic hematopoietic stem-cell transplantation for patients 50 years or older with myelodysplastic syndromes or secondary acute myeloid leukemia.

PURPOSE This study was performed to examine the characteristics of transplant activity for patients with myelodysplastic syndromes (MDS) older than 50 years within the European Group for Blood and Marrow Transplantation, and to evaluate the factors predicting outcome within this group of patients. PATIENTS AND METHODS We performed a retrospective multicenter analysis of 1,333 MDS patients age 50 years or older who received transplantation within the EBMT since 1998. The median recipient age was 56 years, with 884 patients (66%) age 50 to 60 years and 449 (34%) patients older than 60 years. There were 811 HLA-matched sibling (61%) and 522 (39%) unrelated donor transplants. Five hundred patients (38%) received standard myeloablative conditioning (SMC), and 833 (62%) received reduced intensity conditioning (RIC). RESULTS The 4-year estimate for overall survival of the whole cohort was 31%. On multivariate analysis, use of RIC (hazard ratio [HR], 1.44; 95% CI, 1.13 to 1.84; P < .01) and advanced disease stage at transplantation (HR, 1.51; 95% CI, 1.18 to 1.93; P < .01) were associated with an increased relapse rate. In contrast, advanced disease stage at transplantation (HR, 1.43; 95% CI, 1.13 to 1.79; P = .01), use of an unrelated donor (P = .03), and RIC (HR, 0.79; 95% CI, 0.65 to 0.97; P = .03) were independent variables associated with nonrelapse mortality. Advanced disease stage at transplantation (HR, 1.55; 95% CI, 1.32 to 1.83; P < .01) was the major independent variable associated with an inferior 4-year overall survival. CONCLUSION Allogeneic hematopoietic stem-cell transplantation remains a potential curative therapeutic option for many older patients with MDS. In this analysis, disease stage at time of transplantation, but not recipient age or the intensity of the conditioning regimens, was the most important factor influencing outcomes.
Effects of Thermotherapy Combined with Aromatherapy on Pain, Flexibility, Sleep, and Depression in Elderly Women with Osteoarthritis

Purpose: This study examined the effects of heat therapy combined with aromatherapy on pain, flexibility, sleep, and depression in elderly women with osteoarthritis. Methods: This study was designed as a nonequivalent control group quasi-experimental study based upon data acquired through a pre-post test. The experimental group (n=21) was treated using an aroma-permeated hot compress applied to the knee. The cotton towel was heated in a microwave to , and 2~3 drops of lavender were applied on it. The towel was wrapped with plastic bag to prevent aroma leakage and retain heat. The treatment was applied the towel for 20 minutes, three times a day for 3 weeks. The control group (n=24) was not given any treatment. Data were collected using a VAS(100mm) for pain, questionnaire for sleep and depression, and a goniometer for knee flexibility. The data were analyzed with -test and t-test using SPSS/Win18.0. Results: There were significant differences in knee pain (p=.001) and flexibility (p
Techniques for Ventricular Repolarization Instability Assessment From the ECG

Instabilities in ventricular repolarization have been documented to be tightly linked to arrhythmia vulnerability. Translation of the information contained in the repolarization phase of the electrocardiogram (ECG) into valuable clinical decision-making tools remains challenging. This work aims at providing an overview of the last advances in the proposal and quantification of ECG-derived indices that describe repolarization properties and whose alterations are related with threatening arrhythmogenic conditions. A review of the state of the art is provided, spanning from the electrophysiological basis of ventricular repolarization to its characterization on the surface ECG through a set of temporal and spatial risk markers.
Cytokines and Reperfusion in Ischemic Stroke

The clinical syndrome known as ischemic stroke, secondary to the occlusion of an intracranial artery, once considered an ineluctably catastrophic event, may be susceptible of being improved through the application of newly developed therapeutic interventions. The evidence favoring this optimistic outlook is based on three separate but probably interrelated observations: (1) There exists a lapse of hours, perhaps days, between the ictus (i.e., the appearance of a focal neurologic deficit or stroke) and the time when irreversible tissue injury (i.e., widespread pannecrosis) becomes demonstrable. This time interval, generally known as the therapeutic window, may be measured in hours or days depending on the degree or severity of the post occlusive ischemia. (2) Reopening the artery, within a reasonable period of time, has beneficial effects in terms of: (a) improving the neurologic function, and (b) decreasing the numbers of necrotic neurons as well as preventing the appearance of pannecrosis or infarction. (3) The progression from the early ischemic changes (potentially reversible) to the development of an infarct may be influenced by the effects of selected cytokines, in particular those of interleukin 1 (IL‐1).
Conditional survival and the choice of conditioning set for patients with colon cancer: an analysis of NSABP trials C-03 through C-07.

PURPOSE Colon cancer overall survival (OS) is usually computed from the time of diagnosis. Survival gives the initial prognosis but does not reflect how prognosis changes with changing hazard rates over time. Conditional survival (probability of surviving y additional years given they have survived x years [CS or OS|OS]) is an alternative measure that accounts for elapsed time since diagnosis, providing more relevant prognostic information. We extend the concept of CS to condition on the set of patients alive, recurrence-free, and second primary cancer-free (disease-free survival [OS|DFS]). PATIENTS AND METHODS Using data from National Surgical Adjuvant Breast and Bowel Project trials C-03 through C-07, 5-year OS|DFS was calculated on patients who were disease free up to 5 years after diagnosis, stratified by age, stage, nodal status, and performance status (PS). RESULTS For stage II, OS|DFS improved from 87% to 92% at 5 years. For stage III, OS|DFS improved from 69% to 88%. Patients younger than 50 years showed OS|DFS improvement from 79% to 95%; those older than 70 years showed no sustained increase in OS|DFS. Node-negative patients with > or = 12 nodes resected showed little change (89% to 94%); those with more than four positive nodes showed an improvement (57% to 86%). Patients with a PS of 0 or 1 demonstrated a small improvement; those with a PS of 2 did not (64% to 58%). CONCLUSION Prognosis improves over time for almost all groups of patients with colon cancer, especially those with positive nodes. OS|DFS is a more relevant measure of prognosis for those who have already survived disease free a period of time after diagnosis.
Molecular predictors of progression-free and overall survival in patients with newly diagnosed glioblastoma: a prospective translational study of the German Glioma Network.

PURPOSE The prognostic value of genetic alterations characteristic of glioblastoma in patients treated according to present standards of care is unclear. PATIENTS AND METHODS Three hundred one patients with glioblastoma were prospectively recruited between October 2004 and December 2006 at the clinical centers of the German Glioma Network. Two hundred fifty-eight patients had radiotherapy, 199 patients had temozolomide, 189 had both, and seven had another chemotherapy as the initial treatment. The tumors were investigated for TP53 mutation, p53 immunoreactivity, epidermal growth factor receptor, cyclin-dependent kinase CDK 4 or murine double minute 2 amplification, CDKN2A homozygous deletion, allelic losses on chromosome arms 1p, 9p, 10q, and 19q, O(6)-methylguanine methyltransferase (MGMT) promoter methylation, and isocitrate dehydrogenase 1 (IDH1) mutations. RESULTS Median progression-free (PFS) and overall survival (OS) were 6.8 and 12.5 months. Multivariate analysis revealed younger age, higher performance score, MGMT promoter methylation, and temozolomide radiochemotherapy as independent factors associated with longer OS. MGMT promoter methylation was associated with longer PFS (relative risk [RR], 0.5; 95% CI, 0.38 to 0.68; P < .001) and OS (RR, 0.39; 95% CI, 0.28 to 0.54; P < .001) in patients receiving temozolomide. IDH1 mutations were associated with prolonged PFS (RR, 0.42; 95% CI, 0.19 to 0.91; P = .028) and a trend for prolonged OS (RR, 0.43; 95% CI, 0.15 to 1.19; P = .10). No other molecular factor was associated with outcome. CONCLUSION Molecular changes associated with gliomagenesis do not predict response to therapy in glioblastoma patients managed according to current standards of care. MGMT promoter methylation and IDH1 mutational status allow for stratification into prognostically distinct subgroups.
Are the most distressing concerns of patients with inoperable lung cancer adequately assessed? A mixed-methods analysis.

PURPOSE Standardized questionnaires for patient-reported outcomes are generally composed of specified predetermined items, although other areas may also cause patients distress. We therefore studied reports of what was most distressing for 343 patients with inoperable lung cancer (LC) at six time points during the first year postdiagnosis and how these concerns were assessed by three quality-of-life and symptom questionnaires. PATIENTS AND METHODS Qualitative analysis of patients' responses to the question "What do you find most distressing at present? " generated 20 categories, with 17 under the dimensions of "bodily distress," "life situation with LC," and "iatrogenic distress. " Descriptive and inferential statistical analyses were conducted. RESULTS The majority of statements reported as most distressing related to somatic and psychosocial problems, with 26% of patients reporting an overarching form of distress instead of specific problems at some time point. Twenty-seven percent reported some facet of their contact with the health care system as causing them most distress. While 55% to 59% of concerns reported as most distressing were clearly assessed by the European Organisation for Research and Treatment for Cancer Quality of Life Questionnaire Core-30 and Lung Cancer Module instruments, the Memorial Symptom Assessment Scale, and the modified Distress Screening Tool, iatrogenic distress is not specifically targeted by any of the three instruments examined. CONCLUSION Using this approach, several distressing issues were found to be commonly reported by this patient group but were not assessed by standardized questionnaires. This highlights the need to carefully consider choice of instrument in relation to study objectives and characteristics of the sample investigated and to consider complementary means of assessment in clinical practice.
Fatigue in the Superficial and Deep Digital Flexor Muscles During Exercise in Thoroughbred Horses

Introduction One of the causes of injury to the superficial digital flexor tendon (SDFT) is assumed to be repeated high intensity loading of the tendon. Earlier fatigue of the deep digital flexor muscle (DDFM) in comparison to the time of fatigue of the superficial digital flexor muscle (SDFM) is also assumed to increase load on the SDFT during long distance running. This study evaluated the fatigue of SDFM and DDFM with maximal exercise. Methods Two wire electrodes were inserted into the SDFM and DDFM of 6 Thoroughbred horses (461–557 kg). Electromyogram (EMG) and hoof strain gauge signals were recorded at 2,500 Hz with horses on an inclined treadmill (6%), and filter processing was applied (high-pass 10 Hz for EMG and low-pass 200 Hz for strain gauge). Integrated EMG (iEMG), the median frequency (MF) of EMG, and the stride frequency (SF) were compared using paired t-test during 100–105% heart rate max exercise and trotting before and after maximal exercise. Results The SF significantly decreased and iEMG of SDFM tended to decrease during maximal exercise (P = 0.055), while MF of EMG in SDFM and DDFM did not change. The iEMG of SDFM and DDFM significantly decreased and MF of EMG in DDFM tended to decrease at a trot after maximal exercise (P = 0.063). Conclusions The DDFM may fatigue earlier than SDFM during long distance running. Further study is needed to evaluate the relationship between the decrease in iEMG of SDFM and DDFM during maximal exercise and the injury to SDFT. Ethical Animal Research The study was approved by the Animal Welfare and Ethics Committee of the Japan Racing Association Equine Research Institute. Sources of funding: Japan Racing Association. Competing interests: none.
Preoperative radiotherapy for colorectal cancer.

: In a prospective randomized trial, 700 patients with a confirmed histological diagnosis of adenocarcinoma of the rectum or rectosigmoid were randomized to receive radiotherapy prior to operation (2000 to 2500 rads in two weeks) or surgery alone. Five year observed survival in the 453 patients on whom "curative" resection was possible was 48.5% in the X-ray treated group compared with 38.8% in controls, while in the 305 having low lying lesions requiring abdominoperineal resection, survival in the treated group was 46.9% compared with 34.3% in controls. Although suggestive of a treatment benefit, neither is considered statistically significant. Histologically positive lymph nodes were found in 41.2% of the control group and in only 27.8% of the patients receiving radiotherapy. Reveiw of all patients who died during the study shows a consistently lower death rate from cancer in the radiotherapy group. Although this study suggests a treatment benefit from preoperative radiotherapy, further studies now in progress by this group and others are necessary to determine the optimal dose regimen.
Prevalence of Human Immunodeficiency Virus among tuberculosis patients in Kano, Nigeria

Background Tuberculosis (TB) is a major public health problem worldwide with an estimated one third of the world's population being infected by the agent Mycobacterium tuberculosis . The TB problem has escalated in the last two decades in the developing countries because of the recent pandemic of human immunodeficiency virus (HIV) infection. Previous studies have shown a high prevalence of HIV in TB patients. However, there is no documented study from Kano, Nigeria. Aims Therefore, this study is aimed at establishing current prevalence of HIV infection in TB patients attending Aminu Kano Teaching Hospital, Kano, Nigeria. Methods All confirmed pulmonary TB were screen for HIV. Pulmonary TB was diagnosed by microscopic examination of acid-alcohol fast bacilli stained sputum smear using the Ziel- Neelsen method. HIV was determined using Genscreen plus HIV Ag-Ab EUSA technique and confirmed by immunoconfirm technique. Results Among the 200 tuberculosis patients studied, 41(20.5%) were positive for antibodies to HIV. The highest prevalence rate was found in th age group 31 to 40 years (12%) Conclusion This study has confirmed high prevelance of HIV in patients with tuberculosis. The result shows a high HIV seroprevalence in TB patients in Kano, Nigeria. It is suggested that patients with TB should be tested for routinely for HIV. Key-words: Human Immunodeficiency Virus, Tuberculosis, Prevalence, Kano, Nigeria
Brainstem Level Test Results Following Head Injury

* Chief, Division of Audiology and Speech Pathology, Letterman Army Medical Center, Presidio of San Francisco, CA † Department of Communication Disorders, University of Minnesota-Twin Cities, Minneapolis, MN As described earlier in the article by Mueller in this issue of Seminars, the brainstem-level auditory battery of the Vietnam Head Injury Study (VHIS) consisted of four different tests. The results of the auditory brainstem response measures will be summarized in this article which will focus on the results for the acoustic reflex, the masking level difference (MLD) test, and the synthetic sentence identification (SSI) test. It is important to distinguish between the pathologic groups studied in other investigations and the subjects of the VHIS using this test battery. Much of the research that has supported the classification of these tests as sensitive to auditory brainstem pathologic conditions is based on subjects with space-occupying lesions or, in some instances, multiple scleroses. The subjects of the VHIS, however, all had penetrating head injury. Because of the nature of a penetrating head injury, most subjects with severe injury to the brainstem did not survive, or could not participate in the study, (see the article by Vance in this issue of Seminars.) This article, therefore, centers more on the specificity than the sensitivity of these brainstem-level tests. That is, the test results for subjects with injury to the primary auditory areas of the cortex, rather than the brainstem, are reported. If tests such as the acoustic reflex and the MLD are unaffected by auditory neural pathology above the level of the superior olivary complex, then normal findings for this corticallevel pathologic group would be expected.
Phase III, randomized, open-label study of daily imatinib mesylate 400 mg versus 800 mg in patients with newly diagnosed, previously untreated chronic myeloid leukemia in chronic phase using molecular end points: tyrosine kinase inhibitor optimization and selectivity study.

PURPOSE To evaluate the safety and efficacy of initial treatment with imatinib mesylate 800 mg/d (400 mg twice daily) versus 400 mg/d in patients with newly diagnosed chronic myeloid leukemia in chronic phase. PATIENTS AND METHODS A total of 476 patients were randomly assigned 2:1 to imatinib 800 mg (n = 319) or 400 mg (n = 157) daily. The primary end point was the major molecular response (MMR) rate at 12 months. RESULTS At 12 months, differences in MMR and complete cytogenetic response (CCyR) rates were not statistically significant (MMR, 46% v 40%; P = .2035; CCyR, 70% v 66%; P = .3470). However, MMR occurred faster among patients randomly assigned to imatinib 800 mg/d, who had higher rates of MMR at 3 and 6 months compared with those in the imatinib 400-mg/d arm (P = .0035 by log-rank test). CCyR also occurred faster in the 800-mg/d arm (CCyR at 6 months, 57% v 45%; P = .0146). The most common adverse events were edema, gastrointestinal problems, and rash, and all were more common in patients in the 800-mg/d arm. Grades 3 to 4 hematologic toxicity also occurred more frequently in patients receiving imatinib 800 mg/d. CONCLUSION MMR rates at 1 year were similar with imatinib 800 mg/d and 400 mg/d, but MMR and CCyR occurred earlier in patients treated with 800 mg/d. Continued follow-up is needed to determine the clinical significance of earlier responses on high-dose imatinib.
Consolidation radiotherapy in patients with advanced Hodgkin's lymphoma: survival data from the UKLG LY09 randomized controlled trial (ISRCTN97144519).

PURPOSE This study analyzed the outcomes of nonrandomized consolidation radiotherapy (RT) given after chemotherapy in the initial treatment of advanced Hodgkin's lymphoma (HL). The results were collected prospectively within a randomized controlled trial of induction chemotherapy. PATIENTS AND METHODS Patients were randomly assigned between doxorubicin, bleomycin, vinblastine, and dacarbazine and one of two prespecified multidrug regimens. At least six cycles of chemotherapy were planned, with up to eight for patients showing slower response. Involved-field RT was recommended for incomplete response to chemotherapy or bulk disease at presentation. The primary outcome measure was progression-free survival (PFS), landmarked from the end of chemotherapy. RESULTS Among 807 patients randomly assigned, 702 achieved objective response. Postchemotherapy RT for consolidation was reported in 300 (43%). With median follow-up of 6.9 years, 161 PFS events and 83 deaths were reported. Baseline characteristics showed more patients with bulk disease having RT (190 [63%] v 111 [28%]) and only partial response after chemotherapy (150 [50%] v 36 [9%]). Other baseline characteristics were similar. PFS was superior for patients having RT (hazard ratio [HR], 0.43; 95% CI, 0.30 to 0.60) with 5-year PFS 71% without RT, 86% with RT. A similar advantage was seen for overall survival (HR, 0.47; 95% CI, 0.29 to 0.77). There was no evidence of heterogeneity of treatment effect across subgroups. CONCLUSION Patients who received consolidation RT apparently had better outcomes, consistently across all prognostic groups which persisted in multivariate analysis. This suggests that RT contributes significantly to the cure rate for advanced HL, although patient selection for combined modality treatment requires better definition in prospective trials.
Phase I and pharmacologic study of SNS-032, a potent and selective Cdk2, 7, and 9 inhibitor, in patients with advanced chronic lymphocytic leukemia and multiple myeloma.

PURPOSE SNS-032 is a highly selective and potent inhibitor of cyclin-dependent kinases (Cdks) 2, 7, and 9, with in vitro growth inhibitory effects and ability to induce apoptosis in malignant B cells. A phase I dose-escalation study of SNS-032 was conducted to evaluate safety, pharmacokinetics, biomarkers of mechanism-based pharmacodynamic (PD) activity, and clinical efficacy. PATIENTS AND METHODS Parallel cohorts of previously treated patients with chronic lymphocytic leukemia (CLL) and multiple myeloma (MM) received SNS-032 as a loading dose followed by 6-hour infusion weekly for 3 weeks of each 4-week course. RESULTS There were 19 patients with CLL and 18 with MM treated. Tumor lysis syndrome was the dose-limiting toxicity (DLT) for CLL, the maximum-tolerated dose (MTD) was 75 mg/m(2), and the most frequent grade 3 to 4 toxicity was myelosuppression. One patient with CLL had more than 50% reduction in measurable disease without improvement in hematologic parameters. Another patient with low tumor burden had stable disease for four courses. For patients with MM, no DLT was observed and MTD was not identified at up to 75 mg/m(2), owing to early study closure. Two patients with MM had stable disease and one had normalization of spleen size with treatment. Biomarker analyses demonstrated mechanism-based PD activity with inhibition of Cdk7 and Cdk9, decreases in Mcl-1 and XIAP expression level, and associated CLL cell apoptosis. CONCLUSION SNS-032 demonstrated mechanism-based target modulation and limited clinical activity in heavily pretreated patients with CLL and MM. Further single-agent, PD-based, dose and schedule modification is warranted to maximize clinical efficacy.