tbuckley/cabot-search huggingface dataset:
An Epidemiologic Test of the “Spectrum of Disease” Concept in Cervical Neoplasia&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: Barbara S. Hulka, Lawrence L. Kupper
Journal: JNCI Journal of the National Cancer Institute (1971)

To provide an epidemiologic test of the “spectrum of disease” concept in cervical neoplasia, a sample of invasive cancer, in situ cancer, severe dysplasia, and mild-to-moderate dysplasia cases and matched controls was drawn from the women examined through a cervical cancer screening program for medically indigent women. All women with the appropriate histologic diagnoses comprised the case groups and, from the pool of women with normal smears, 4 controls per case were selected, so that 4 controls matched each case on age, race, and time period of examination. Among the variables for which cases and controls were compared, an abnormal cervix identified at the screening examination was more frequent among all categories of cases than among controls. Postcoital and postmenopausal bleeding differentiated invasive cancer cases from controls, and both categories of cancer (in situ and invasive) differed from controls on the basis of lack of postnatal care and need for referral for medical care, as identified at the screening examination. Both categories of dysplasia patients differed from their controls in terms of the increased frequency with which the patients were receiving public welfare. From these associations, the demonstrated lack of association with other variables, and the lack of a gradient in the strength of association for individual variables from the least to the most severe category of neoplasia, the spectrum of disease hypothesis can neither be confirmed nor refuted by the current study.
Characterization of High-Altitude Pulmonary Hypertension in the Kyrgyz
Authors: Almaz A. Aldashev, Akpay S. Sarybaev, Akyl S. Sydykov, Bolot B. Kalmyrzaev, Elena V. Kim, Lira B. Mamanova, Rashid Maripov, Baktybek K. Kojonazarov, Mirsaid M. Mirrakhimov, Martin R. Wilkins, Nicholas W. Morrell
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Previous studies have suggested a genetic component in susceptibility to hypoxia-induced pulmonary hypertension. We therefore estimated the prevalence of high-altitude pulmonary hypertension (HAPH) in a Kyrgyz population and whether the insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene associates with HAPH. An electrocardiographic survey of 741 highlanders demonstrated electrocardiogram signs of cor pulmonale in 14% of subjects. Pulmonary artery hemodynamics measured in an independent group of 136 male highlanders with symptoms of dyspnea at altitude revealed established pulmonary hypertension (mean pulmonary artery pressure [MPAP] ≥ 25 mm Hg) in 20%. However, 26% of the normal subjects demonstrated an exaggerated response (twofold or greater increase in MPAP) to inhalation of 11% oxygen, and were classified as hyperresponsive. Ten-year follow-up of this group revealed increases in the MPAP, but not in normal subjects. Comparison of ACE I/D genotypes in the catheterized group revealed a threefold higher frequency of the I/I genotype in highlanders with HAPH, compared with normal highlanders (χ2 = 11.59, p = 0.003). In addition, MPAP was higher in highlanders with the I/I genotype (26.9 ± 4.0 mm Hg) compared with the I/D genotype (20.6 ± 1.2 mm Hg) or the D/D genotype (18.3 ± 0.9 mm Hg) (p < 0.05). We conclude that HAPH is associated with ACE I/D genotype among Kyrgyz highlanders and the development of HAPH in this population and may be predicted by hyperresponsiveness to acute hypoxia.
Frequency and severity of exacerbations reflect COPD severity, but not COPD phenotype as determined by quantitative CT
Authors: Francesca Bigazzi, Alessio Garcea, Matteo Vannini, Elena Torricelli, Valentina Luzzi, Matteo Paoletti, Stefano Diciotti, Gianna Camiciottoli, Massimo Pistolesi
Journal: European Respiratory Journal (2014)

COPD exacerbations worsen lung function, quality of life and prognosis. We investigated the relationship between characteristics of COPD exacerbations and lung pathologic changes as assessed by quantitative CT.  133 COPD outpatients underwent clinical examination, whole pulmonary function and CT scan. Frequency, severity and clinical presentation of exacerbations occurring within the year prior to visit were collected by standardized questionnaire. Hospitalization or access to emergency department indicated more severe events. We considered  exacerbators patients with ≥2 episodes/year and distinguished exacerbations with only dyspnea and only sputum from those with both symptoms. From original CT scan values of parenchymal destruction (%LAA-950) and airway wall thickness (AWT-Pi10) we derived by principal component analysis two novel parameters, CT1 and CT2, which are the expression of COPD phenotype and severity, respectively (ERJ 2013;42:626-635). Phenotypic characteristics range progressively from airway predominant (CT1-) to emphysema predominant (CT1+). Severity of disease increases progressively from CT2- to CT2+.  Characteristics, frequency and severity of exacerbations did not differ between patients with predominant airway disease (CT1-) and those with predominant emphysema (CT1+). Patients with more severe lung CT changes (CT2+), more severely impaired function, and higher BODE score had more frequent and severe exacerbations. In conclusion, frequency and severity of exacerbations could be a reliable index of COPD severity, but not of the predominant pathophysiologic mechanism of airflow limitation as determined by CT quantitative analysis.
A novel nurse-led approach improves treatment completion rates for latent tuberculosis infection (LTBI) treatment
Authors: Nigel Clerk, Rajarajan Anandavelu, Wendy Dibble, George Antunes
Journal: European Respiratory Journal (2014)

Objectives:  Concordance to prophylactic chemotherapy is essential for the success of any LTBI control policy and innovative approaches are required to improve this. Concordance and treatment completion rates vary widely in the literature for any recognised LTBI therapeutic regimen. The study9s objective was to determine treatment completion rates using a nurse-led assisted treatment approach.  Methods:  A retrospective cohort study design was utilised and patients treated for LTBI were recruited from a pre-existing database (2009 to 2012). Case notes were reviewed to obtain further data if necessary.  The assisted approach consisted of an initial, monthly and post treatment completion contact by a TB nurse specialist and regular telephone support if needed.  Patients were given the choice of either a 6 month (Isoniazid alone), 3 month treatment regimen (Isoniazid and Rifampicin) or advice and education.  Results:  A total of 146 cases were identified over the 4 year period (61% were male and 39% female). The majority were in the 16-34 year age group (n=77) and the largest group were asylum seekers (n=45). 132 (89%) chose the three month regimen.  120 (82%) patients completed treatment, 11 stopped treatment because of side effects (none worse than grade 2 toxicity), 9 were lost to follow up and 6 declined drug therapy.  Conclusion:  The findings demonstrate that a high treatment completion rate over 80% can be achieved with a nurse led assisted approach for LTBI treatment.
Smoking, changes in smoking habits, and rate of decline in FEV1: new insight into gender differences
Authors: X Xu, ST Weiss, B Rijcken, JP Schouten
Journal: European Respiratory Journal (1994)

We wanted to test the hypothesis that gender differences in effects of smoking on the rate of decline in pulmonary function may be related to gender differences in the frequency of smoking. Data from the Vlagtwedde-Vlaardingen study in The Netherlands were analysed, to investigate the rate of decline in forced expiratory volume in one second (delta FEV1) in relation to smoking status and gender. 4,554 participants, initially aged 15-54 yrs, provided 16,900 pairs of observations at 3 yr intervals over 24 yrs of follow-up. Lifetime nonsmokers accounted for 11% of male participants and 45% of female participants. Compared with lifetime nonsmokers, estimated excess delta FEV1 for light, moderate, and heavy continued smokers was 4.4, 9.5 and 13.5 ml.yr-1 for men and 6.1, 10.8 and 18.8 ml.yr-1 for women, respectively. Female former smokers had a significantly more rapid delta FEV1 (beta = 4.4, SE = 1.6 ml.yr-1) than lifetime nonsmokers; but male former smokers had a slower rate of decline (beta = 4.1, SE = 2.3 ml.yr-1) than lifetime nonsmokers. Overall gender difference in smoking effects on delta FEV1 was statistically significant. Among subjects who smoked an identical amount at the beginning of the study period those who quit smoking during the period had a significantly slower delta FEV1 than those who continued smoking, for both men (beta = 20.6, SE = 3.9 ml.yr-1) and women (beta = 15.7, SE = 3.4 ml.yr-1). Younger quitters (< 45 yrs) benefited significantly more from smoking cessation than older quitters (> or = 45 yrs).(ABSTRACT TRUNCATED AT 250 WORDS)
Detection of antibodies against Pseudomonas aeruginosa in the sputum of cystic fibrosis patients: A pilot study
Authors: Krisztina Kelemen, Eszter Csiszér, Imre Barta, Balázs Antus
Journal: European Respiratory Journal (2012)

Chronic Pseudomonas aeruginosa (Pa) infection plays a pivotal role in disease progression in patients with cystic fibrosis (CF). The aim of this cross-sectional study was to test whether anti-Pa antibodies can be detected in the sputum using common serological methods.  During routine ambulatory visits blood and spontaneously expectorated sputum samples were obtained from 29 adult CF patients (11 chronically infected with Pa [Pa+], 10 non-infected [Pa-] and 8 intermittently infected [Pa+/-]). Anti-Pa antibodies (IgA and IgG) in serum and in sputum supernatant were measured with ELISA originally developed for measuring anti-Pa antibodies in serum (Genesis Diagnostics). Data are presented as means±SEM.  As expected serum IgA levels were elevated in Pa+ as compared to Pa- patients (20.3±9.5 vs. 6.0±1.5 pg/ml, respectively, p 0.05). In all subjects serum and sputum IgA levels showed a close correlation (r=0,525, p  In conclusion, sputum anti-Pa IgA antibody levels are elevated in patients with chronic Pa infection. The sensitivity of the assay is even greater in sputum than in serum raising the possibility that sputum could be material of choice for the early detection of Pa.
Systematic Psychiatric Evaluation: A Step-by-Step Guide to Applying the Perspectives of Psychiatryby ChisholmMargaret S., M.D., and LyketsosConstantine G., M.D., M.H.S., Baltimore, Md., Johns Hopkins University Press, 2012, 246 pp., $30.00 (paper).
Authors: Renato D. Alarcón
Journal: American Journal of Psychiatry (2013)
Effects of endoscopic lung volume reduction on the distribution of pulmonary perfusion and ventilation
Authors: Carmen Pizarro, Hojjat Ahmadzadehfar, Markus Essler, Izabela Tuleta, Georg Nickenig, Dirk Skowasch
Journal: European Respiratory Journal (2014)

Introduction: 

Endoscopic lung volume reduction (ELVR) using endobronchial valves represents an established therapy for emphysematous COPD. However, any resulting changes in lung perfusion and ventilation remain unknown.

Objectives: 

The aim was to investigate, by means of pulmonary scintigraphy, adaptations in lung perfusion and ventilation that follow ELVR.

Methods: 

We enrolled 19 patients (65±8.7yrs, 60.9% male) with COPD heterogeneous emphysema undergoing ELVR with endobronchial valves (Zephyr®, PulmonX Inc.). Mean baseline FEV1 and RV were 33.1% and 253.2% predicted, respectively. Baseline 6 min. walk test distance (6MWD) was 289.1±126.1 m. Ventilation/perfusion lung scintigraphy was conducted prior to ELVR and six weeks thereafter. Pre- and post-procedural analyses of regional and whole lung perfusion and ventilation shifts were performed and complemented by correlation measurements (Spearman's rho) between paired analyzed lobes.

Results: 

After ELVR, the target lobe perfusion showed a mean reduction of 6.8% (p<0.0001) and was significantly associated with a simultaneous perfusion decrease in the ipsilateral, non-treated lobe (rho=0.49, p=0.017). Ventilation of the emphysematous target lobe was also reduced (p=0.009) and correlated proportionally with the correspondent perfusional adaptations (rho=0.54). Contralateral whole lung perfusion exhibited a significant increase post-ELVR (p=0.027). These effects occurred independently of clinical responsiveness to ELVR, stated by changes in 6MWD.

Conclusions: 

ELVR induces a relevant reduction in perfusion and ventilation of the treated lobe that corresponds with compensatory perfusional increases in the contralateral lung.
Correlation Between Tumor-Specific Systemic and In Situ Immunity as Manifested by the Delayed Hypersensitivity Response&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;&lt;xref ref-type="fn" rid="FN2"&gt;3&lt;/xref&gt;
Authors: L A Radov, J S Haskill, J H Korn, J W Fett
Journal: JNCI Journal of the National Cancer Institute (1979)

The delayed hypersensitivity response (DHR) to the transplanted murine mammary adenocarcinoma (T1699) was studied by means of both direct challenge of tumor-bearing DBA female mice and adoptive transfer of DHR to normal DBA/2 female mice with the use of immunocompetent cells. Specific effector cells for DHR were demonstrable in both the host inflammatory cell fraction of the solid tumor and in the peripheral lymph nodes. A significant proportion, but not all of these in situ effector cells, appeared to be derived from thymus cells. The kinetics and specificity of the DHR were studied with both intact tumor cells and a soluble antigen preparation. The DHR’s seen appeared to be tumor-specific. A similar approach was used to investigate the DHR in a series of early passages of spontaneous C3H mammary tumors. As in the T1699 model, DHR effector cells isolated from the host inflammatory cell fraction of the tumor masses and the draining lymph nodes were capable of transferring DHR. There was considerable variation, however, among the different C3H tumors in the relationship between in situ DHR and DHR in the regional lymph nodes. The activity of the in situ effector cells was equivalent to that of the cells from the lymph nodes in 5 of the 12 tumor groups studied. The remaining 7 groups demonstrated a lack of correlation; depending on the tumor line tested, the activity of cells from one site was significantly different from the activity of cells from another site. The pattern of reactivity for a given tumor was consistent following in vivo passage.
Segmentectomy for second lung cancer after lobectomy
Authors: Thomas Krbek, Uldis Kopeika, Joachim Kolb, Petar Traykov, Kato Kambartel, Thomas Voshaar
Journal: European Respiratory Journal (2013)

Objective. We retrospectively reviewed our experience of surgical resection for second primary lung cancer (SPLC).  Methods. From January 2009 to December 2012, a total of 11 patients underwent anatomical segmentectomy for second primary lung cancer after completed lobectomy. Median time between surgical interventions was 1765 (591 till 4915) days.  Results. There were 8 men and 3 women. The average age at the 2nd operation was 76 year. The initial pulmonary resection was lobectomy. The average tumor size was 2.5 cm (0.5-5.5 cm). Postoperative stage of the 2nd primary lung cancer was IA in 5, IB in 6 cases. Adenocarcinoma and planozellcarcinoma were observed each in 5 cases, in 1 case there was large cell carcinoma with focal neuroendocrine differentiation. Histological types were different between primary and second lung cancer in 5 patients. 5 patients died during follow up. Cause of death in 1 case war local recurrence (survival 1601 day), in 4 cases cause of death was distant metastases (survival 913+/- 433 days). Median survival since primary lung cancer diagnosis was 2321 +/- 1302 days. Local recurrence was observed in 1 case (9%), in this case tumor has involved the visceral pleura. Postoperative complications occurred in 2 cases, but there were no perioperative deaths.  Conclusions. We conclude that an anatomical segmentectomy for a 2nd primary lung cancer is safe and is linked with low local recurrence rate.
International multi-centre randomised Phase II/III study of Capecitabine (Cap), bevacizumab (Bev) and mitomycin C (MMC) as first-line treatment for metastatic colorectal cancer (mCRC): Final safety analysis of the AGITG MAX trial
Authors: T. J. Price, V. Gebski, G. A. van Hazel, B. A. Robinson, A. Broad, V. Ganju, D. Cunningham, K. Wilson, V. Tunney, N. C. Tebbutt
Journal: Journal of Clinical Oncology (2008)

4029 Background: Fluoropyrimidine (FU) monotherapy combined with Bev has activity and is less toxic than standard combination chemotherapy. MMC also has the potential to improve efficacy of FU monotherapy. MAX is a randomised phase II/III trial designed to evaluate Cap alone compared with Cap in combination with Bev±MMC aiming to develop an active but low toxicity combination regimen, potentially suitable for a broad range of patients. Patients with mCRC considered suitable for single agent FU chemotherapy were randomised to Cap, CapBev or to CapBev + MMC (MCapBev). The primary outcome is PFS, with safety an important secondary outcome. Methods: Patients with mCRC who had not received prior chemotherapy or for whom 6 mths had elapsed since adjuvant chemotherapy, ECOG PS<2 were randomised to either Arm A (Cap 2,000 or 2,500 mg/m2 in 2 divided doses, 14 days, q3w), Arm B (Cap+Bev 7.5mg/kg q3w) or Arm C (MMC 7 mg/m2, capped at 14mg and limit 4 doses, q6w + CapBev). Randomisation was stratified by centre, PS and Cap dose. Final safety analysis of 471 patients is presented. Results: Recruitment was from 7/05 to 7/07. Sex, ECOG status, median age and Cap dose was balanced. Two thirds of patients received Cap dose 2,000 mg/m2. 60 day all-cause mortality was Arm A 4.5%, Arm B 5.7%, Arm C 2.5%. Rates of stomatitis, hepatic toxicity, febrile neutropenia & thrombocytopenia were < 5% in all 3 arms. Grade 3/4/5 AEs are summarised in table below. There were 2 patients in Arm C who had manageable, but delayed onset (10 & 11 mths after last dose MMC) haemolytic ureamic syndrome. Conclusions: All treatment arms were well tolerated and addition of either Bev or Bev and MMC to Cap was associated with little additional grade 3/4 toxicity, apart from higher rates of grade 3 HFS in the CapBev & MCapBev arms. Acceptable rates of grade 3/4 HT, VTE, haemorrhage & perforation was seen in the Bev arms. Efficacy results will be presented ASCO 2009. Toxicity %Gd 3/4/5 Arm A (156) Arm B (157) Arm C (158) Diarrhoea 11% 15% 14% Nausea/Vomiting 5%/5% 5%/5% 4%/3% Fatigue 9% 10% 13% Hand foot syndrome (HFS) 15% 25% 26% Proteinuria/HT <1%/<1% 3%/3% 7%/5% Venous thromboembolic (VTE) 8% 8% 10% Cardiac/arterial event 0/0 3%/0 1%/2% Haemorrhage 3% 1% 4% Perforation <1% 2% 0 Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Roche Roche Roche Roche
Clusters of patients with candidaemia due to genotypes of Candida albicans and Candida parapsilosis: differences in frequency between hospitals
Authors: L.J. Marcos-Zambrano, P. Escribano, M. Sanguinetti, E. Gómez G. de la Pedrosa, E. De Carolis, A. Vella, R. Cantón, E. Bouza, J. Guinea
Journal: Clinical Microbiology and Infection (2015)
Angiogenic growth factors potential new treatment for acute myocardial infarction?
Authors: L Gonçalves
Journal: Cardiovascular Research (2000)

In models of hind-limb ischemia and progressive coronary artery occlusion, angiogenic growth factor proteins and genes expressing growth factors have been shown to induce the development of collateral vessels and remodeling of existing collaterals. The therapeutic potential of growth factors in the setting of acute myocardial infarction may be related to non-angiogenic properties of growth factors as well, and is the focus of this review.
Economic and policy implications of adopting paclitaxel as first-line therapy for advanced ovarian cancer: an Ontario perspective.
Authors: L M Elit, A Gafni, M N Levine
Journal: Journal of Clinical Oncology (1997)

To determine the potential economic and policy implications that result from incorporating paclitaxel into first-line therapy for stage 3 and 4 ovarian cancer patients in the province of Ontario, Canada.A cost-effectiveness analysis was conducted to compare cisplatin/cyclophosphamide (CC), a standard therapy, with cisplatin/paclitaxel (CT). Based on survival curves from a clinical trial, mean costs and survival were calculated. Sensitivity analyses were conducted based on altering the duration of paclitaxel infusion, discount rates, and efficacy of paclitaxel.The mean survival duration is prolonged from 2.06 years with the standard therapy to 2.44 years with the paclitaxel combination. The paclitaxel therapy is more expensive, with a mean cost of $17,469 (Canadian) per patient treated with CT compared with $5,228 per patient with CC. The incremental cost-effectiveness ratio is $32,213 per year gained. Sensitivity analyses show that the conclusions remain unchanged. The use of CT as first-line treatment for advanced ovarian cancer patients in Ontario requires an additional $9 million per year over and above the present costs to treat this patient population.Although paclitaxel-based therapy prolongs survival, it comes at an increased cost. It may not be possible to fund paclitaxel treatment using resources presently allocated to first-line chemotherapy for advanced ovarian cancer. The policy implications for absorbing the cost of paclitaxel in the context of a publicly funded health care system are discussed.
Decreasing Late Mortality Among Five-Year Survivors of Cancer in Childhood and Adolescence: A Population-Based Study in the Nordic Countries
Authors: Torgil R. Möller, Stanislaw Garwicz, Lotti Barlow, Jeanette Falck Winther, Eystein Glattre, Gudridur Olafsdottir, Jörgen H. Olsen, Roland Perfekt, Annukka Ritvanen, Risto Sankila, Hrafn Tulinius
Journal: Journal of Clinical Oncology (2001)

PURPOSE: To assess the risk of death in patients who survive more than 5 years after diagnosis of childhood cancer and to evaluate causes of death in fatal cases. PATIENTS AND METHODS: This was a population-based study in the five Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) using data of the nationwide cancer registries and the cause-of-death registries. The study cohort included 13,711 patients who were diagnosed with cancer before the age of 20 years between 1960 and 1989 and who survived at least 5 years from diagnosis. By December 31, 1995, 1,422 patients had died, and death certificates were assessed in 1,402. Standardized mortality ratios (SMRs) for validated causes of death were calculated based on 156,046 patient-years at risk. RESULTS: The overall SMR was 10.8 (95% confidence interval [CI], 10.3 to 11.5), mainly due to high excess mortality from the primary cancer. SMR for second cancer was 4.9 (95% CI, 3.9 to 5.9) and was 3.1 (95% CI, 2.8 to 3.5) for noncancer death. The pattern of causes of death varied markedly between different groups of primary cancer diagnoses and was highly dependent on time passed since diagnosis. Overall late mortality was significantly lower in patients treated during the most recent period of time, 1980 to 1989, compared with those treated from 1960 to 1979 (hazard ratio, 0.61; 95% CI, 0.54 to 0.70), and there was no increase in rates of death due to cancer treatment. CONCLUSION: Long-term survivors of childhood cancer had an increased mortality rate, mainly dying from primary cancers. However, modern treatments have reduced late cancer mortality without increasing the rate of therapy-related deaths.