nils-herrmann/clean_scirepeval huggingface dataset:
Prognostic factors of unresectable pancreatic cancer treated with nafamostat mesilate combined with gemcitabine chemotherapy.

The aim of this study was to investigate prognostic factors of survival for patients with unresectable pancreatic cancer treated with nafamostat mesilate combined with gemcitabine chemotherapy.



The study included 41 patients who were diagnosed with unresectable pancreatic cancer and eligible for our clinical study of nafamostat mesilate, combined with gemcitabine chemotherapy for unresectable pancreatic cancer between February 2007 and November 2010 at Jikei University Hospital. We retrospectively investigated the relation between patients' characteristics and overall survival using univariate and multivariate analyses.



In univariate analysis, absence of jaundice (p=0.0365), presence of ascites with or without histological diagnosis of carcinomatosis (p=0.0042), lymphocyte count ≥2,000/μl (p=0.0088), serum C-reactive protein ≥1 mg/dl (p=0.014), serum carcinoembryonic antigen ≥5 ng/ml (p=0.0064) and serum CA19-9 ≥500 U/ml (p=0.0164) were significant predictors of poor overall survival. In multivariate analysis, absence of jaundice (p=0.0057), presence of ascites with or without histological diagnosis of carcinomatosis (p=0.0326), lymphocyte ≥2,000/μl (p<0.0001) and CA19-9 ≥500 U/ml (p=0.0198) were independent predictors.



Jaundice, ascites, high lymphocyte count and high serum CA19-9 levels are independent prognostic predictors for poor overall survival of patients with unresectable pancreatic cancer treated with nafamostat mesilate combined with gemcitabine chemotherapy.
ect of RenaGel B , a non-absorbed , calcium-and aluminium-free phosphate binder , on serum phosphorus , calcium , and intact parathyroid hormone in end-stage renal disease patients

hormone (iPTH) levels from 292 pg/ml to 395 pg/ml. iPTH fell to 283 pg/ml after 6 weeks of RenaGel  Control of dietary phosphate absorption in end-stage renal disease patients is essential to prevent treatment despite a persistently lower serum calcium. RenaGel treatment also reduced serum total and LDL the deleterious sequelae of phosphorus retention. Efficacy of currently available calciumand aluminiumcholesterol by 25 mg/dl (0.65 mmol/l ) and 23 mg/dl (0.59 mmol/l ) respectively. containing phosphate binders is constrained by the side-effects associated with the absorption of calcium Conclusions. RenaGel appears to be an effective phosphate binder free of calcium and aluminium. and aluminium. The current study examined the efficacy of RenaGel, a calciumand aluminium-free, polyPhosphorus control with two to four RenaGel capsules per meal appears to result in comparable phosphorus meric phosphate binder, in end-stage renal disease patients. lowering seen with calciumor aluminium-based phosphate binders. RenaGel may offer an alternative for Methods. Administration of calciumor aluminiumcontaining phosphate binders ceased during a 2-week the control of phosphorus retention in end-stage renal disease patients. washout period. RenaGel, at starting doses of one, two, or three 500-mg capsules three times per day with meals, was administered for 8 weeks. RenaGel dose
Troponin T and I assays show decreased concentrations in heparin plasma compared with serum: lower recoveries in early than in late phases of myocardial injury.

Heparinized plasma samples allow more rapid analysis than serum samples, but preliminary studies showed lower cardiac troponin T (cTnT) results in plasma. We undertook a multicenter study to characterize this effect for cTnT and cardiac troponin I (cTnI).



Blood samples were collected with and without heparin at five hospitals. cTnT was measured by a "third generation" assay (Elecsys((R))), and cTnI was measured by a commercial immunoassay (IMMULITE((R))).



Mean cTnT was 15% lower in heparin sampling tubes than in serum. Measured concentrations of cardiac troponins also decreased with increasing heparin concentrations added to sera. Heparin-induced losses were greater in early than in late phases after onset of chest pain. Addition of heparin ( approximately 100 IU/mL) to serial samples from nine acute myocardial infarction patients produced mean cTnT losses of 33% at 1-12 h after onset of chest pain, 17% at 13-48 h, and 7% after 48 h. The changing heparin effects were seen for both cTnT and cTnI during time courses of individual patients with myocardial infarction.



We suggest that binding of heparin to troponins decreases immunoreactivity, especially in early phases of myocardial injury. The resulting losses may depend on the antibodies used in each troponin assay.
Favourable prognosis with modified dosing of docetaxel and cisplatin in Japanese patients with ovarian cancer.

The long-term efficacy and safety of docetaxel/cisplatin as first-line chemotherapy in Japanese patients was evaluated in order to find an optional regimen for ovarian cancer.



Women with surgically resected stage Ic-IV epithelial ovarian cancer were treated with docetaxel 70 mg/m2 and cisplatin 60 mg/m2 every 4 weeks.



Ninety women were enrolled of whom 89 (median age, 54 years) received a median of 6 cycles (range 1 to 9). With a median 38 months'follow-up, median progression-free survival was 28 months (95% lower confidence interval, 24 months) in 60 patients with stage III-IV disease. The overall response rate for 20 patients was 45%. Neutropenia was the most common (67%) grade 3/4 toxicity. Major grade 3/4 nonhaematological toxicities were gastrointestinal toxicities (< or = 11%) and fatigue (8%). No grade 3/4 neurotoxicity was observed.



The combination of docetaxel/cisplatin is a regimen with favourable progression-free survival for ovarian cancer.
Baseline characteristics of the omega-3 fatty acids (Fish oils) and Aspirin in Vascular access OUtcomes in REnal Disease (FAVOURED) study.

The Fish oils and Aspirin in Vascular access OUtcomes in REnal Disease (FAVOURED) trial investigated whether 3 months of omega-3 polyunsaturated fatty acids, either alone or in combination with aspirin, will effectively reduce primary access failure of de novo arteriovenous fistulae. This report presents the baseline characteristics of all study participants, examines whether study protocol amendments successfully increased recruitment of a broader and more representative haemodialysis cohort, including patients already receiving aspirin, and contrasts Malaysian participants with those from Australia, New Zealand and the United Kingdom (UK).



This international, randomized, double-blind, placebo-controlled trial included patients older than 19 years with stage 4 or 5 chronic kidney disease currently receiving, or planned within 12 months to receive haemodialysis.



Participants (n = 568) were overweight (28.6 ± 7.3 kg/m(2) ), relatively young (54.8 ± 14.3 years), and predominantly male (63%) with a high prevalence of diabetes mellitus (46%) but low rate of ischaemic heart disease (8%). Sixty one percent were planned for lower arm arteriovenous fistula creation. Malaysian participants (n = 156) were younger (51.8 ± 13.6 years vs 57.1 ± 14.2 years, P < 0.001) with a higher prevalence of diabetes mellitus (65% vs 43%, P < 0.001), but less ischaemic heart disease (5% vs 14%, P < 0.01) compared with the combined Australian, New Zealand and UK cohort (n = 228). Protocol modifications allowing for inclusion of patients receiving aspirin increased the prevalence of co-morbidities compared with the original cohort.



The FAVOURED study participants, while mostly similar to patients in contemporary national registry reports and comparable recent clinical trials, were on average younger and had less ischaemic heart disease. These differences were reduced as a consequence of including patients already receiving aspirin.
Hippocampal volume changes in healthy subjects at risk of unipolar depression.

Unipolar depression is moderately heritable. It is unclear whether structural brain changes associated with unipolar depression are present in healthy persons at risk of the disorder. Here we investigated whether a genetic predisposition to unipolar depression is associated with structural brain changes. A priori, hippocampal volume reductions were hypothesized. Using a high-risk study design, magnetic resonance imaging brain scans were obtained from 59 healthy high-risk subjects having a co-twin with unipolar depression, and 53 healthy low-risk subjects without a first-degree family history of major psychiatric disorder. High-risk twins had smaller hippocampal volumes than low-risk twins (p<0.04). The finding was most pronounced in DZ twins. Groups did not differ on global brain tissue volumes or regional tissue volumes assessed in exploratory voxel-wise whole cerebrum analyses. In conclusion, hippocampal volume reduction may index a predisposition to develop depression and thus may be predictive of future onset of the disorder. Further studies are needed to elucidate the role of (shared) environmental and genetic factors.
Views of emergency physicians working in university and state hospitals in Turkey regarding the use of analgesics in patients with acute abdominal pain.

Use of narcotic analgesics in patients with acute abdominal pain does not cause delayed misdiagnosis, increases patient comfort and does not suppresses physical examination. The purpose of this study was to determine attitudes anddaily practices of emergency medicine (EM) specialists, residents and faculty members in Turkey on the use of analgesics in patients with acute abdominal pain and factors affecting their decisions on the use of analgesics.



A cross-sectional study was performed between November 15, 2013 and January 25, 2014 by conducting a questionnaire to EM physicians working in University Hospitals, Education and Research Hospitals of the Ministry of Health, State Hospitals, and Private Hospitals in Turkey.



A total of 803 questionnaires (participation rate: 47%) were completed. 59.3% (n=470) of the participants were research assistants. 49.5% of the participants reported that analgesic drugs "suppressed'' physical examination findings. They stated that 90% of the patients "always'' and "often'' requested analgesics and that 34.6% of surgery consultant physicians "rarely" recommended the use of analgesics, while 28.7% "never" recommended, and that there was no common policy established together with surgical departments (79.1%). According to the comparison between the EM specialists and residents, residents in the group stating that they would "never'' use analgesics were higher than specialists in number (p=0.002); residents reported that they administered analgesics "upon surgical intervention decision", while specialists reported that they administered analgesics "after patient's examination and treatment plan" (p=0.021); residents reported that analgesics "suppressed'' physical examination findings, while specialists reported that analgesics "clarified'' physical examination findings (p<0.0001); residents reported that they did not administer analgesics "before examination by surgeon'', while specialists reported otherwise (p=0.0001). Senior residents (>24 months) reported that they administered analgesics "often'' compared to junior residents (p=0.034) and that junior residents believed that the use of analgesics would "suppress physical examination findings'' at a higher percentage (p=0.002).



The rates of use of analgesics in patients with acute abdominal pain by EM physicians are very low. The rates of use of analgesics by EM residents are much lower compared to EM specialists, and they highly believe that analgesic drugs suppress physical examination findings. Residents tend to administer analgesic drugs at a later stage. As seniority of residents increases, the rate of analgesics use and the opinion that analgesic drugs have no effect on physical examination findings increases.
Busulfex (i.v. BU) and CY regimen before SCT: Japanese-targeted phase II pharmacokinetics combined study

To evaluate the toxicity and efficacy of an i.v. preparation of BU (12.8 mg/kg), combined with CY (120 mg/kg), a prospective study was performed on 30 Japanese patients (median age, 30 years) with hematologic malignancies undergoing hematopoietic SCT (28 allogeneic transplants from an HLA-matched donor and 2 autologous transplants). There were no significant toxicities, and all but one patient showed evidence of granulocyte engraftment at a median of 14 days for allogeneic and 11 days for autologous transplantation. Grades II–IV acute and chronic GVHD occurred in 9 (9/27, 33%) and 16 patients (16/27, 59%), respectively. Non-relapse mortality at days 100 and 365 was 3 and 17%, respectively. The pharmacokinetics of i.v. BU showed close inter- and intrapatient consistency; the area under the plasma concentration–time curve of the first administration remained at less than 1500 μmol min/l in 27 of the 29 patients (93%), and between 900 and 1350 μmol min/l in 22 patients (73%). As all of the profiles overlap with data from non-Japanese patients, we conclude that racial factors may not seriously influence the bioactivity of i.v. BU.
Can a cure be achieved with taxane-based chemotherapy plus surgery in patients with primary mediastinal non-seminomatous germ cell tumors and progression or relapse despite first-line chemotherapy?

Primary mediastinal non-seminomatous germ cell tumors (NSCGTs) have a poor prognosis in the International Germ Cell Cancer Collaborative Group (IGCCCG) classification. There is no clear standard of treatment at relapse. Between 1995 and 2005, 13 patients experienced progression or relapse, and 1 patient was cured with a taxane-based chemotherapy plus surgical resection at our institution.
Around-the-clock, controlled-release oxycodone therapy for osteoarthritis-related pain: placebo-controlled trial and long-term evaluation.

Although opioid analgesics have well-defined efficacy and safety in treatment of chronic cancer pain, further research is needed to define their role in treatment of chronic noncancer pain.



To evaluate the effects of controlled-release oxycodone (OxyContin tablets) treatment on pain and function and its safety vs placebo and in long-term use in patients with moderate to severe osteoarthritis pain.



One hundred thirty-three patients experiencing persistent osteoarthritis-related pain for at least 1 month were randomized to double-blind treatment with placebo (n = 45) or 10 mg (n = 44) or 20 mg (n = 44) of controlled-release oxycodone every 12 hours for 14 days. One hundred six patients enrolled in an open-label, 6-month extension trial; treatment for an additional 12 months was optional.



Use of controlled-release oxycodone, 20 mg, was superior (P<.05) to placebo in reducing pain intensity and the interference of pain with mood, sleep, and enjoyment of life. During long-term treatment, the mean dose remained stable at approximately 40 mg/d after titration, and pain intensity was stable. Fifty-eight patients completed 6 months of treatment, 41 completed 12 months, and 15 completed 18 months. Common opioid side effects were reported, several of which decreased in duration as therapy continued.



Around-the-clock controlled-release oxycodone therapy seemed to be effective and safe for patients with chronic, moderate to severe, osteo-arthritis-related pain. Effective analgesia was accompanied by a reduction in the interference of pain with mood, sleep, and enjoyment of life. Analgesia was maintained during long-term treatment, and the daily dose remained stable after titration. Typical opioid side effects were reported during short- and long-term therapy.
Antidepressant effects after short-term and chronic stimulation of the subgenual cingulate gyrus in treatment-resistant depression

Deep brain stimulation (DBS) of the subcallosal cingulate gyrus (SCG) is an experimental approach in treatment-resistant depression (TRD). Apart from its potential long-term antidepressant effects acute stimulation effects have been described. We investigated putative neuroanatomical clusters in which such acute effects accumulate and followed patients over the long-term.



We assessed safety and efficacy of DBS in six patients with TRD receiving bilateral DBS with electrodes implanted in the SCG. First, high intensity 130 Hz stimulation was applied on five consecutive days after surgery for 24 h comprising a sham condition in a double-blind, randomized design. Acute stimulation was conducted at all four homologous electrode contacts on both sides. Afterwards, chronic stimulation was initiated and the clinical effect was evaluated at 24-36 weeks compared to baseline (50% reduction in HAMD scores). The primary outcome criterion was depression severity as assessed with the Hamilton Depression Rating Scale (HAMD-24); secondary outcome parameters were the Montgomery-Åsberg Rating-Scale and Beck Depression Inventory following DBS. The clinical effect over the three scores was compared to sham stimulation and was correlated to the anatomical localization of active contacts by stereotactically delimiting the cluster of most effective contacts in responding patients.



Acute 24 h of stimulation showed only moderate reductions in mean HAMD-24, MADRS and BDI scores. At the last observation (24-36 weeks), two patients were remitters (HAMD-24 < 10) and the four other patients were non-responders.



Our results confirm that stimulation of the SCG is capable of exerting moderate acute and chronic antidepressant effects. The predictive value of these findings needs to be addressed in future studies.
The impact of healing touch on pediatric oncology patients.

HYPOTHESES
Healing Touch (HT) is an energy therapy that has been shown to lower stress, pain, and fatigue in adult oncology patients. This study evaluated the feasibility of administering HT in pediatric oncology inpatient and outpatient units at Kapi'olani Medical Center for Women and Children.



This study was a 1-year randomized prospective study consisting of 2 study arms. The HT arm was considered the treatment group, and reading/play activity was designated as the control group. Participants were randomly assigned to each arm on enrollment in the study.



They were recruited by the pediatric oncology social worker. Interested participants were asked to provide informed consent and were randomized to either the HT arm or the reading/play activity arm of the study. They received their designated intervention for 30 minutes at each inpatient or outpatient encounter. Participants, parents, and care providers were asked to complete preintervention and postintervention assessments.



In all, 15 participants, aged 3 to 18 years old, were approached about the study between July 2009 and June 2010. A total of 9 participants enrolled (recruitment rate of 60%); 6 patients were randomized to receive HT sessions, and 3 patients received reading/play activities; 2 participants dropped out of the study because of prolonged hospitalizations and complicated treatments. An additional participant expired while in the study because of disease progression. Those in the HT group showed significant decreases in the scores for pain, stress, and fatigue for participants, parents, and caregivers. Furthermore, parents' perception of their children's pain decreased significantly for the HT group when compared with the group receiving reading/play activity.



This study demonstrates the feasibility of using energy therapy in the pediatric oncology patient population. There also seems to be an interest in this treatment modality for this patient population. Furthermore, these findings suggest that HT has a positive impact on pain, stress, and fatigue related to oncology treatment.
Mortality and its risk factors in Malawian children admitted to hospital with clinical pneumonia, 2001-12: a retrospective observational study.

Few studies have reported long-term data on mortality rates for children admitted to hospital with pneumonia in Africa. We examined trends in case fatality rates for all-cause clinical pneumonia and its risk factors in Malawian children between 2001 and 2012.



Individual patient data for children (<5 years) with clinical pneumonia who were admitted to hospitals participating in Malawi's Child Lung Health Programme between 2001 and 2012 were recorded prospectively on a standardised medical form. We analysed trends in pneumonia mortality and children's clinical characteristics, and we estimated the association of risk factors with case fatality for children younger than 2 months, 2-11 months of age, and 12-59 months of age using separate multivariable mixed effects logistic regression models.



Between November, 2012, and May, 2013, we retrospectively collected all available hard copies of yellow forms from 40 of 41 participating hospitals. We examined 113 154 pneumonia cases, 104 932 (92·7%) of whom had mortality data and 6903 of whom died, and calculated an overall case fatality rate of 6·6% (95% CI 6·4-6·7). The case fatality rate significantly decreased between 2001 (15·2% [13·4-17·1]) and 2012 (4·5% [4·1-4·9]; ptrend<0·0001). Univariable analyses indicated that the decrease in case fatality rate was consistent across most subgroups. In multivariable analyses, the risk factors significantly associated with increased odds of mortality were female sex, young age, very severe pneumonia, clinically suspected Pneumocystis jirovecii infection, moderate or severe underweight, severe acute malnutrition, disease duration of more than 21 days, and referral from a health centre. Increasing year between 2001 and 2012 and increasing age (in months) were associated with reduced odds of mortality. Fast breathing was associated with reduced odds of mortality in children 2-11 months of age. However, case fatality rate in 2012 remained high for children with very severe pneumonia (11·8%), severe undernutrition (15·4%), severe acute malnutrition (34·8%), and symptom duration of more than 21 days (9·0%).



Pneumonia mortality and its risk factors have steadily improved in the past decade in Malawi; however, mortality remains high in specific subgroups. Improvements in hospital care may have reduced case fatality rates though a lack of sufficient data on quality of care indicators and the potential of socioeconomic and other improvements outside the hospital precludes adequate assessment of why case-fatality rates fell. Results from this study emphasise the importance of effective national systems for data collection. Further work combining this with data on trends in the incidence of pneumonia in the community are needed to estimate trends in the overall risk of mortality from pneumonia in children in Malawi.



Bill & Melinda Gates Foundation.