tbuckley/cabot-search huggingface dataset:
Acute hypersensitivity reactions to etoposide in a VEPA regimen for Hodgkin's disease.
Authors: M M Hudson, H J Weinstein, S S Donaldson, C Greenwald, L Kun, N J Tarbell, W A Humphrey, C Rupp, N M Marina, J Wilimas
Journal: Journal of Clinical Oncology (1993)

We report an unexpectedly high incidence of hypersensitivity to etoposide among 45 patients with newly diagnosed Hodgkin's disease treated with vinblastine, etoposide, prednisone, and doxorubicin (VEPA) plus radiation.Twenty-three of 45 patients (51%) had one or more acute hypersensitivity reactions to etoposide administration. The 23 patients were 8 to 18 years of age (median, 15 years); 12 were males. Four patients had experienced prior allergic reactions to antibiotics or intravenous contrast media.Hypersensitivity reactions followed the first or second dose of VEPA in most cases. The reactions occurred at a median time of 5 minutes (range, 3 to 120) from the start of the etoposide infusion. Fifteen patients reacted early (within 10 minutes), four midway through the infusion, and four after completion of the infusion. Signs and symptoms included flushing, respiratory problems, changes in blood pressure, and abdominal pain with or without nausea and vomiting. Respiratory problems included dyspnea, chest pain/tightness, bronchospasm, and cyanosis. Symptoms were alleviated by discontinuing the etoposide infusions and administering diphenhydramine and/or hydrocortisone; epinephrine was required to reverse bronchospasm in three cases. All 23 patients recovered without adverse sequelae and were rechallenged with etoposide. Fifteen patients tolerated subsequent etoposide infused at a slower rate, with antihistamine and/or corticosteroid premedication; five had recurrent hypersensitivity despite these measures. Three of these five developed similar symptoms when teniposide was substituted for etoposide. Three patients who had isolated episodes of hypotension on completion of the etoposide infusion successfully received subsequent infusions without premedication or change in infusion rate or concentration.Despite this unexpectedly high incidence of hypersensitivity among Hodgkin's disease patients treated with etoposide, rechallenge with the drug was successful in 78% of cases.
Correction
Authors: J.P. Casas, E. Ninio, A. Panayiotou, J. Palmen, J.A. Cooper, S.L. Ricketts, R. Sofat, A.N. Nicolaides, J.P. Corsetti, F.G.R. Fowkes, I. Tzoulaki, M. Kumari, E.J. Brunner, M. Kivimaki, M.G. Marmot, M.M. Hoffmann, K. Winkler, W. Maerz, S. Ye, H.A. Stirnadel, S.M. Boekholdt, K.T. Khaw, S.E. Humphries, Sandhu, A.D. Hingorani, P.J. Talmud
Journal: Circulation (2010)
Late-breaking abstract: Erythropoietin (EPO) inhibits the immunohistochemical expression of Tumor Necrosis Factor-a (TNF-a) in bleomycin (BLM)-induced pulmonary fibrosis (PF) in rats
Authors: Drosos Tsavlis, Anna Tzoumaka, Anastasia Tektonidou, Afroditi Papadopoulou, Evaggelia Spandou
Journal: European Respiratory Journal (2014)

AIM: The cytokine TNF-a is well known to participate in the fibrotic pathway with inflammatory and apoptotic actions.Erythropoietin, on the other hand, is a multiple functional cytokine with anti-inflammatory and anti-apoptotic properties.Aim of this study was to investigate the role of EPO on the expression of TNF-a in BLM-induced PF in rats.  METHODS: Fifty Wistar rats (300gr) were divided into five groups of 10 animals each: 1)control animals, 2)intratracheal (i.t) and intraperitoneal (i.p) injection of saline (0.5ml/kg), 3)BLM hydrochloride (7.5mg/kg) i.t injection, 4)BLM hydrochloride (7.5mg/kg) i.t injection followed by EPO i.p injection (2000 iu/kg), 5)saline (0.5ml/kg) i.t injection followed by EPO i.p injection (2000 iu/kg). All rats were sacrified after 14 days.The expression of TNF-a was immunohistochemically measured and a scale of four grades (A:0-25%, B:25-50%, C:50-75%, D:75-100%) was used to evaluate it.  RESULTS: In groups 1,2 and 5 (control groups), TNF-a was expressed only in the two lower grades of the scale (A:80% and B:20%).In group 3, TNF-a was expressed in the high grades (C:30% and D:70%).Finally, in group 4, the cytokine in question was expressed only in the low grades (A:80% and B:20%).The expression of TNF-a took place in the high grades for group 3 (BLM group) and in the lower grades for group 4 (BLM+EPO group) (p  CONCLUSIONS: Treatment with EPO significantly ameliorated the extent and severity of the BLM-induced toxicity in lung tissue.TNF-a had a significantly lower expression in the group of animals which were administrated with EPO, compared with the group of BLM.
Review of the Treatment of Mycosis Fungoides and Sézary Syndrome: A Stage-Based Approach
Authors: Steven M. Horwitz, Elise A. Olsen, Madeleine Duvic, Pierliugi Porcu, Youn H. Kim
Journal: Journal of the National Comprehensive Cancer Network (2008)

The NCCN Clinical Practice Guidelines in Oncology: Non-Hodgkin's Disease were recently revised to include recommendations for treating mycosis fungoides and Sézary syndrome. These uncommon lymphomas require a specialized evaluation and use a unique TNMB staging system. Unlike the other forms of non-Hodgkin's lymphomas, stage overwhelmingly determines prognosis and defines radically different treatment approaches. For patients with early-stage disease, initial treatment with skin-directed therapies is preferred, and many patients never require systemic therapy. For patients with refractory or advanced-stage disease, biologic therapies are often the first choices, whereas chemotherapies are reserved for later in the disease course. Many milder therapies may be repeated several times in the disease course, and maintenance and tapering strategies are common. This article also discusses the emerging role of allogeneic stem cell transplantation.
A dose-finding study of liposomal daunorubicin with CVP (COP-X) in advanced NHL
Authors: I.W. Flinn, S.N. Goodman, L. Post, J. Jamison, C.B. Miller, S. Gore, L. Diehl, C. Willis, R.F. Ambinder, J.C. Byrd
Journal: Annals of Oncology (2000)

Standard therapy for lymphoma consists of a cyclophosphamide (C), doxorubicin, vincristine (V), and prednisone (P) (CHOP) combination regimen. Liposomal daunorubicin (DaunoXome) is an alternative to doxorubicin for patients with lymphoma because of its more favorable safety profile and potentially more selective uptake in lymphoma. The objectives of this study were to determine the maximum tolerated dose (MTD) of liposomal daunorubucin with CVP (COP-X) and the tolerability of the regimen in patients with indolent lymphoma.Patients with low-grade and intermediate-grade lymphoma having adequate cardiac, hepatic, and renal function were enrolled. Patients received C 750 mg/m2, V 1.4 mg/m2 (maximum 2.0 mg), and liposomal daunorubicin 50-100 mg/m2 i.v. on day 1 and P 100 mg p.o. on days 1-5. MTD was the liposomal daunorubicin dose associated with 20% dose-limiting toxicity (ANC < 500/mm3 for > 5 days or febrile neutropenia).Twenty patients, median age 59 years, were treated. The liposomal daunorubicin MTD combined with CVP was 70-80 mg/m2, depending on patient population. No significant non-hematologic toxicity occurred. Response rate was 44% (2 complete and 5 partial responses).A liposomal daunorubicin dose of 80 mg/m2 in the COP-X regimen was well tolerated with little nonhematologic toxicity.
An audit of oxygen prescribing practices in a district general hospital
Authors: Anna Szulc, Richard Berry, S. Fayyaz Hussain
Journal: European Respiratory Journal (2012)

Introduction: Oxygen is a drug and should be prescribed. Yet the attitudes about oxygen prescription are extremely different to that of other prescription only medications. We wished to evaluate that a) correct prescription was filled out for patients receiving oxygen in hospital and b) in patients with COPD oxygen saturation (SpO2) was maintained at 88-92%(1).  Methods: On a single day in January 2012 all patients on 14 wards (medical and surgical) were observed for supplemental oxygen therapy. All patients receiving oxygen therapy had their prescription charts and clinical notes assessed for quality of the oxygen prescription and presence of COPD.  Results: Out of a total of 259 patients seen, 51 (19.6%) were on oxygen. Of these 21 (41%) patients had the oxygen prescribed correctly. Thirteen patients were diagnosed to have COPD; in 6 (46%) the actual bedside oxygen saturations matched the correct safe target set by BTS guideline, but in only 3 (23%) the target oxygen saturations was correctly specified.  Conclusions: This audit highlights significant gaps in oxygen prescribing in secondary care. Almost half of COPD patients receiving supplemental oxygen remain at risk of oxygen toxicity. Education of doctors and nurses on oxygen prescription should be reinforced regularly.  1) BTS guideline for emergency oxygen use in adult patients. B R O9Driscoll et al. British Thoracic Society. Thorax 2008;63(Suppl VI):vi1–vi68.
Recurrent neuroblastoma: Randomized treatment with topotecan + cyclophosphamide (T+C) vs. topotecan alone(T). A POG/CCG Intergroup Study
Authors: C. N. Frantz, W. B. London, L. Diller, R. Seeger, K. Sawyer
Journal: Journal of Clinical Oncology (2004)

8512 Background: In Phase I/II studies, T and the combination of T+C each demonstrated promising activity against recurrent neuroblastoma, so a randomized study was performed. Methods: Eligible patients were <21 yrs with evaluable disease at first recurrence after a first regimen of aggressive chemotherapy. 73 patients had prior stem cell transplants. 13 patients received “therapeutic window” deferoxamine for 3–6 weeks as part of the study. T+C received T 0.75mg/m2+C 250mg/m2+MESNA 150 mg/m2 daily×5d q21d. T received T 2.4mg/m2/d×5d q21d. Best response according to the International Neuroblastoma Response Criteria was analyzed in a two-stage sequential design. In the calculation of time to progressive disease, patients taken off study for stem cell transplant, refusal, or unrelated death were censored at that time. Results: Target accrual 118, accrual 123, eligible 119 patients (1996–2001). Hematopoietic toxicity was the same in both arms. Deferoxamine had no effect on outcome. There were 11 (19%) CR+PR on T, 18 (31%) on T+C; 19 (32%) CR+PR+MR on T, 26 (45%) on T+C. At least eight more responders in T+C than in T were required by the two-stage design in order to conclude superiority of T+C; with only seven, there is insufficient evidence to reach such a conclusion. For both EFS and S treatment comparisons, the curves were not significantly different. However, the time to disease progression was significantly longer for T+C. The 2-year Progression-Free Survival rates (+/- standard error) were 16%+/-6% (T) vs. 36%+/-9% (T+C), p=0.0379. Conclusions: There is a trend toward better results with T+C than T. Incorporation of the combination into front line treatment plans deserves further exploration. No significant financial relationships to disclose.
Did Medicare Part D Affect National Trends in Health Outcomes or Hospitalizations?
Authors: Becky A. Briesacher, Jeanne M. Madden, Fang Zhang, Hassan Fouayzi, Dennis Ross-Degnan, Jerry H. Gurwitz, Stephen B. Soumerai
Journal: Annals of Internal Medicine (2015)

Medicare Part D increased economic access to medications, but its effect on population-level health outcomes and use of other medical services remains unclear.To examine changes in health outcomes and medical services in the Medicare population after implementation of Part D.Population-level longitudinal time-series analysis with generalized linear models.Community.Nationally representative sample of Medicare beneficiaries (n = 56,293 [unweighted and unique]) from 2000 to 2010.Changes in self-reported health status, limitations in activities of daily living (ADLs) (ADLs and instrumental ADLs), emergency department visits and hospital admissions (prevalence, counts, and spending), and mortality. Medicare claims data were used for confirmatory analyses.Five years after Part D implementation, no clinically or statistically significant reductions in the prevalence of fair or poor health status or limitations in ADLs or instrumental ADLs, relative to historical trends, were detected. Compared with trends before Part D, no changes in emergency department visits, hospital admissions or days, inpatient costs, or mortality after Part D were seen. Confirmatory analyses were consistent.Only total population-level outcomes were studied. Self-reported measures may lack sensitivity.Five years after implementation, and contrary to previous reports, no evidence was found of Part D's effect on a range of population-level health indicators among Medicare enrollees. Further, there was no clear evidence of gains in medical care efficiencies.
Professional and frequent driving habits detected in the European Sleep Apnea Database (ESADA) - Call for a safety alert
Authors: Mahssa Karimi, Jan Hedner, Ludger Grote
Journal: European Respiratory Journal (2012)

Obstructive sleep apnea (OSA) is associated with an increased risk for motor vehicle accidents. Treatment of OSA leads to a reduced risk. Many, but not all, EU countries associate untreated OSA with impaired capability to drive. The strategy to improve traffic safety for sleep centers has not been well addressed. This study captured driving habits in the multinational ESADA cohort.  The ESADA database includes subjects with suspected OSA referred to 23 sleep centers in 16 EU countries. Reported parameters were obtained at regular clinic visits in association with an overnight sleep study in 8087 subjects (5789 males and 2298 females). Driving license status (no or A to E) was defined and mean yearly driving distance was recorded.  AB license was reported by 4676 subjects (58.8% in men, 55.4% in women), CDE license by 923 (15.0% in men, 2.3% in women) and no driving license by 2488. Men reported a higher yearly driving distance than women (21847±478 km vs. 10681±347 km). 63% of subjects with severe OSA (AHI ≥30/h) were license holders. CDE license holders tended to be younger, less morbid and used fewer medications. Central obesity, OSA severity and daytime sleepiness were similar in AB and CDE drivers. 43.3% of all license holders were frequent drivers (>15.000 km/yr) and 35.4% (14.7%) of male (female) frequent drivers had severe OSA.  Information from the ESADA confirms that professional and frequent driving is common in patients with OSA. Classification of driving habits should be included in the clinical routine at sleep centers and prospective outcome studies are warranted.  The ESADA study is supported by the EU COST Action B 26, RESMED and PHILIPS RESPIRONICS.
Lung Volumes before and after Lung Volume Reduction Surgery
Authors: MURRAY D. BECKER, YAHYA M. BERKMEN, JOHN H. M. AUSTIN, IN K. MUN, BENJAMIN M. ROMNEY, ANNA ROZENSHTEIN, PATRICIA A. JELLEN, CHUN K. YIP, BYRON THOMASHOW, MARK E. GINSBURG
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

The volume and severity of pulmonary emphysema in individual lungs were measured by means of quantitative computed tomography (CT) studies in 28 patients (14 women, 14 men, median age 65 yr) who underwent either bilateral (n = 15) or unilateral (n = 13) lung volume reduction surgery (LVRS). Spirometric, total body plethysmographic, and CT data (at TLC and RV) were correlated before and after LVRS. Lung volumes determined by CT correlated well with volumes obtained by total body plethysmography (p < 0.0001). For individual lungs after LVRS, CT-derived mean lung capacity decreased 13% and residual volume 20% (p < 0.00001 for each), while mean total functional lung volume (TFLV, defined as the volume of lung with CT attenuation greater than -910 Hounsfield units) increased 9% (p < 0.01), and the mean ratio of the air space to tissue space volume (V(AS)/V(TS)) decreased more at RV (23%) than at TLC (14%) (p < 0.0005 for each). In contrast, unilateral LVRS did not affect exhalation from the unoperated lung (2% reduction in RV, p = NS). The magnitude of the postoperative response (CT-derived TLC, RV, TFLV, V(AS)/V(TS)) of each operated lung was comparable for unilateral and bilateral LVRS. Thus, a lung's response to LVRS was independent from that of the contralateral lung. Moreover, postoperative alterations in TFLV and FEV1 correlated significantly (r = 0.80, p < 0.0001), which suggests that the expansion of functioning tissue may contribute to the mechanism by which LVRS palliates airway obstruction.
Painful Extremities and Neurological Disorder in Essential Thrombocythaemia
Authors: Edward A Martin, Patrick J Lavin, Alan J Thompson
Journal: Journal of the Royal Society of Medicine (1984)

Six of 20 patients with essential thrombocythaemia had neurological features and 8 had peripheral vascular symptoms. Four had cerebrovascular ischaemia or stroke and 3 had gangrene. Pain in the extremities may be a striking symptom in this disorder.
Prognostic value of the Charlson Comorbidity Index in patient with COPD
Authors: Nina Karoli, Andrey Rebrov
Journal: European Respiratory Journal (2012)

Few studies show patient outcomes over time in chronic obstructive pulmonary disease (COPD). The traditional pulmonary function test assessed by tge FEV1 is known to correlate poorly with dyspnea, health status and exercise intolerance.  In the present study we evaluated by Charlson Comorbidity Index (CCI) as a predictive marker of death in patients with COPD.  A total 77 patients with COPD (mean age 54,93±0,63 yrs) was monitored over 5 years in our study. COPD was diagnosed according GOLD criteria. During follow-up 18 patients (23.4%) died: 17 patients due to respiratory insufficiency and/or heart failure and 1 pts due to cancer.  Died patients with COPD had higher CCI than alive (4,50±0,46 and 2,44±0,17, p 3 score more frequently than alive patients. We noted correlations between baseline CCI and time before patients died (r=-0.54, p  The Charlson Comorbidity Index has demonstrated good predictive validity in our study. In our opinion, the CCI represents the optimal balance between ease of use and prognostic ability. CCI> score was associated was poor prognoses in patients with COPD.
Glycemic Variability and Diabetes Complications: Does It Matter? Simply Put, There Are Better Glycemic Markers!
Authors: Richard M. Bergenstal
Journal: Diabetes Care (2015)

There is no argument that improving mean levels of glycemic control as judged by assays for glycated hemoglobin (HbA1c) reduces the risks of microvascular complications and cardiovascular disease events in patients with type 1 and type 2 diabetes. However, observations in some trials have suggested that targeting HbA1c to suggested targets may not always result in improved outcomes for people with long-standing type 2 diabetes. The reasons why the glycemic control strategies that primarily use HbA1c in these studies did not have predicted outcomes are not clear. Thus, controversy remains as to whether there are glycemic metrics beyond HbA1c that can be defined as effective measures that can be used in addition to HbA1c to help in assessing the risk of an individual developing diabetes complications. In this regard, the concept of “glycemic variability” (GV) is one metric that has attracted a lot of attention. GV can be simply defined as the degree to which a patient’s blood glucose level fluctuates between high (peaks) and low (nadir) levels. The best and most precise way to assess GV is also one that is still debated. Thus, while there is universal agreement that HbA1c is the current gold standard for the primary clinical target, there is no consensus as to whether other proposed glycemic metrics hold promise to provide additional clinical data or whether there should be additional targets beyond HbA1c. Therefore, given the current controversy, we provide a Point-Counterpoint debate on this issue. In the preceding point narrative, Dr. Hirsch provides his argument that fluctuations in blood glucose as assessed by GV metrics are deleterious and control of GV should be a primary treatment target. In the counterpoint narrative below, Dr. Bergenstal argues that there are better markers to assess the risk of diabetes than GV and provides his consideration of other concepts. —William T. Cefalu Editor in Chief, Diabetes Care
Mood and clinical status in patients with multiple myeloma.
Authors: P M Silberfarb, K M Anderson, A C Rundle, J C Holland, M R Cooper, O R McIntyre
Journal: Journal of Clinical Oncology (1991)

Two hundred ninety patients with a recent diagnosis of multiple myeloma were studied psychologically at the time of initial treatment. Physician- and patient-completed psychosocial scales were correlated with physical variables used to measure tumor load and physical status. A logistic regression model was used to analyze objective response to treatment. Indirect measures of response to treatment were obtained, and factors influencing survival duration were studied using a Cox regression model. If physical variables were controlled, there were no significant correlations between psychologic scores on entry and response to treatment or survival duration. Thus, the notion that mood influences disease outcome once the disease process has begun in patients with multiple myeloma is not supported by this data set.
Specific detection by real-time reverse-transcription PCR assays of a novel avian influenza A(H7N9) strain associated with human spillover infections in China
Authors: V M Corman, M Eickmann, O Landt, T Bleicker, S Brünink, M Eschbach-Bludau, M Matrosovich, S Becker, C Drosten
Journal: Eurosurveillance (2013)

In response to a recent outbreak in China, detection assays for a novel avian influenza A(H7N9) virus need to be implemented in a large number of public health laboratories. Here we present real-time reverse-transcription polymerase chain reaction (RT-PCR) assays for specific detection of this virus, along with clinical validation data and biologically-safe positive controls.
Adenocarcinoma of the Kidney. I. Ultrastructure of Renal Adenocarcinomas Induced in Rats by N-(4′-Fluoro-4-biphenylyl)acetamide23
Authors: Jane Howard Dees, Melvin D. Reuber, Benjamin F. Trump
Journal: JNCI Journal of the National Cancer Institute (1976)

The ultrastructure of tumors induced in kidneys of F344 rats by the carcinogen N-(4′-fluoro-4-biphenylyl)acetamide appeared similar in many aspects to that described in humans and other animal models. The neoplastic cells exhibited microvilli resembling brush border and other adaptations of the cell membrane. Tumor lobules were surrounded by basement membranelike material, which also extended into the tumor mass between individual cells. The ultrastructure appeared to reflect a proximal tubular origin of these lesions.