tbuckley/cabot-search huggingface dataset:
Relation of health-related quality of life, frequent exacerbation phenotype and circulating systemic biomarkers in stable COPD
Authors: Daiana Stolz, Francesco Blasi, Renaud Louis, Wim Boersma, Alicia Lacoma, Kostantinos Kostikas, Paola Castellotti, Lucas Boeck, Branislava Milenkovic, Tobias Welte, Janko Rakic, Emiel Wouters, Joachim Aerts, Arturo Huerta, Markos Minas, Antoni Torres, Michael Tamm
Journal: European Respiratory Journal (2011)

Background: We have evaluated the impact of the frequent exacerbation phenotype and circulating systemic biomarkers in the HRQL in a well characterized cohort of COPD patients.

Methods: Data of 636 patients with stable COPD (GOLD II-IV) for ≥ 6 weeks seeking care in pulmonary tertiary care hospitals in 10 European centers were analyzed. Assessment included frequency of exacerbations in the previous year, systemic biomarkers (procalcitonin, proANP, copeptin, proadrenomedullin), lung function, SF-36, SGRQ, MMRC dyspnea score, and 6MWD test.

Results: Patients had a mean age of 66 yo ± 11; 74.1% were male; mean FEV1% pred 48.2% ± 18.5. 205 (32.3%) were current smokers and 142 (22.32%) reported frequent exacerbations (≥ 2/y). Median [95% CI] MMRC was 3 [2-3], 6MWD was 390 m [325-445]. The mean SGRQ scores were: total 43.0±38.9; symptoms 48.6±23.1, activity 57.4±23.3, and impact 32.9±19.8. In a linear, univariate regression analysis, frequent exacerbation phenotype, SaO2 at rest, desaturation (< 88%) at exercise, FEV1% pred, MMRC, 6MWD, and Borg scale, but neither current smoking nor circulating biomarkers were associated with the total SGRQ score. In the multivariate analysis, frequent exacerbation phenotype [95%] 6.55 [3.04-10.06], FEV1% pred -0.09 [-0.17–0.003], MMRC 6.46 [4.83-8.00], 6MWD -0.021 [-0.036- -0.006], Borg 1.35 [0.64-2.05] were independently associated with the HRQL as assessed by the SGRQ total score.

Conclusions: Additionally to the variables related to COPD severity, the frequent exacerbation phenotype is independently associated with the HRQL. Conversely, systemic biomarkers are not related to HRQL in COPD at stable state.
Confocal microscopy of recurrent naevi and recurrent melanomas: a retrospective morphological study
Authors: C. Longo, E. Moscarella, P. Pepe, A.M. Cesinaro, A. Casari, M. Manfredini, I. Stanganelli, S. Gardini, C. Cota, G. Argenziano, G. Pellacani, I. Zalaudek
Journal: British Journal of Dermatology (2011)

Repigmentation within a scar after different procedures (shave biopsy, partial excision, cryotherapy, laser) is a challenging diagnostic situation.To determine distinct dermoscopic and confocal microscopic features in a series of histopathologically proven melanocytic proliferations within a scar.Clinical, dermoscopic and confocal microscopic images were acquired before surgical excision in seven patients with repigmentation within a scar. The evaluation of the dermoscopic and confocal features was performed in blind to the final histopathological diagnosis that was obtained in all cases.Dermoscopically, the repigmentation in recurrent naevi (three patients) was confined within the scar while it extended beyond the scar in melanomas. This clue was more evident upon reflectance confocal microscopy (RCM). Confocally, recurrent naevi failed to exhibit prominent pagetoid or lateral spread of melanocytes and atypical nests at the junction, even though some cases showed atypical cells in the junctional component. However, these were few in number and cytologically monomorphous and allowed the diagnosis of a benign neoplasm with confidence. On the other hand, melanomas arising on a scar (four patients) revealed dendritic-shaped melanocytes arranged in sheets, and pagetoid and lateral spread of dendritic cells extending beyond the scar. Those confocal aspects were well correlated with the histopathological findings.The integration of clinical, dermoscopic and RCM aspects offers the possibility to discern reliably the nature in cases of repigmentation on a scar.
A quality assessment of randomized control trials of primary treatment of breast cancer.
Authors: A Liberati, H N Himel, T C Chalmers
Journal: Journal of Clinical Oncology (1986)

The methodology of randomized control trials (RCTs) of the primary treatment of early breast cancer has been reviewed using a quantitative method. Sixty-three RCTs comparing various treatment modalities tested on over 34,000 patients and reported in 119 papers were evaluated according to a standardized scoring system. A percentage score was developed to assess the internal validity of a study (referring to the quality of its design and execution) and its external validity (referring to presentation of information required to determine its generalizability). An overall score was also calculated as the combination of the two. The mean overall score for the 63 RCTs was 50% (95% confidence interval [CI] = 46% to 54%) with small and nonstatistically significant differences between types of trial. The most common methodologic deficiencies encountered in these studies were related to the randomization process (only 27 of the 63 RCTs adopted a truly blinded procedure), the handling of withdrawals (only 26 RCTs included all patients in the analyses), the description of the follow-up schedule (only 12 RCTs reported adequately), the report of side effects (adequate information given in 33 RCTs), and the description of the patient population (satisfactory in 29 RCTs). Telephone calls to the principal investigators improved the quality scores by seven points on a scale of 100, indicating that some of the deficiencies lay in reporting rather than performance. There was evidence that quality has improved over time and that the increasing tendency of involving a biostatistician in the research team was positively associated with the improvement of the internal validity but not with the external.
A 12-year survey of methicillin-resistant Staphylococcus aureus infections in Greece: ST80-IV epidemic?
Authors: E. Drougka, A. Foka, A. Liakopoulos, A. Doudoulakakis, E. Jelastopulu, V. Chini, A. Spiliopoulou, S. Levidiotou, T. Panagea, A. Vogiatzi, E. Lebessi, E. Petinaki, I. Spiliopoulou
Journal: Clinical Microbiology and Infection (2014)
The optimal timing of autologous bone marrow transplantation in Hodgkin's disease patients after a chemotherapy relapse.
Authors: C E Desch, M R Lasala, T J Smith, B E Hillner
Journal: Journal of Clinical Oncology (1992)

PURPOSE The optimal sequence of salvage chemotherapy (SC) and autologous bone marrow transplantation (ABMT) for Hodgkin's disease (HD) patients who relapse after primary chemotherapy is unknown. We created a decision analysis model to determine the optimal treatment strategy and the most cost-effective approach. METHODS The decision tree simulated a 25-year-old HD patient who relapsed less than 12 months after mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) chemotherapy. Four strategies used ABMT in some sequence with SC; the final strategy considered SC alone. Clinical data were derived from 17 published reports chosen by explicit criteria. Costs of care were estimated from the published literature and institutional experience. RESULTS The optimal strategy was ABMT in second relapse, which was superior to the SC-only option by 1.9 years at an incremental cost of $26,200 per each year of life saved. When the probabilities of complete remission and disease-free survival were reduced for SC, similar to the clinical expectation of SC after a seven- or eight-drug regimen like MOPP/doxorubicin, bleomycin, and vinblastine with or without dacarbazine (MOPP/ABV[D]), ABMT in first relapse was the preferred strategy and provided 6 additional months. However, when the data from favorable (or unfavorable) SC and ABMT reports were compared head-to-head in this model, SC followed by ABMT in second relapse was always optimal. CONCLUSIONS All relapsed HD patients should plan to use ABMT in some sequence with SC, if necessary. In most situations the optimal strategy is ABMT in second relapse. This analysis will assist clinicians in planning treatment for relapsed HD patients. It could be refined if historical series were updated to report the incidence and outcomes of SC relapse from seven- or eight-drug regimens.
Effects of subinhibitory concentrations of antibiotics on the biofilm formation of pseudomonas aeruginosa
Authors: Handong Jiang, Junjuan Li
Journal: European Respiratory Journal (2011)

Objective:  To study the effects of the subinhibitory concentrations of four antibiotics on the biofilm formation of pseudomonas aeruginosa.   Methods:  2 types of culture media of 1-broth (LB) and mueller–hinton broth (MHB) were used with the application of static biofilms model of pseudomonas aeruginosa.   Results:  (1) The results of the static-made biofilm were as follows: in the MHB media, azithromycin could induce the biofilm formation of PAO1 when the concentrations were more than 16ug/ml, but inhibited the biofilm formation when the concentrations were less than 8ug/ml.When the PAO1 was cultured in LB, azithromycin would induce the bioflim formation at the sub-MIC concentrations. Ciprofloxacin and ceftazidime could inhibited the biofilm formation at the sub-mic concentration. Amikacin could induce biofilm formation at the concentration of 0.125 and 0.25ug/ml cultured in MHB and LB respectively. All the results above had statistical diference compared with the blank. The Furanone C-30 was added in the static biofilm model with the azithromycin concentration 8ug/ml and 4ug/ml;the results had no statistical difference. (3) Silver staining results: when the concentration of azithromycin was 8ug/ml,the formation of the biofilm was the most, the second was blank and the the lest was 256ug/ml.   Conclusions:  The sensitivity of the azithromycin to the POAI was different with changing of the environment. Azithromycin could induce the biofilm formation at the subinhibitory concentration. Ciprofloxacin and ceftazidime could inhibit the biofilm formation; amikacin could induce the biofilm formation at the concentration of 0.125ug/ml and 0.25ug/ml.
Novel population‐based study finding higher than reported hepatocellular carcinoma incidence suggests an updated approach is needed
Authors: Thai P. Hong, Paul Gow, Michael Fink, Anouk Dev, Stuart Roberts, Amanda Nicoll, John Lubel, Ian Kronborg, Niranjan Arachchi, Marno Ryan, William Kemp, Virginia Knight, Helen Farrugia, Vicky Thursfield, Paul Desmond, Alexander J. Thompson, Sally Bell
Journal: Hepatology (2015)

Hepatocellular carcinoma (HCC) incidence is rising rapidly in many developed countries. Primary epidemiological data have invariably been derived from cancer registries that are heterogeneous in data quality and registration methodology; many registries have not adopted current clinical diagnostic criteria for HCC and still rely on histology for classification. We performed the first population‐based study in Australia using current diagnostic criteria, hypothesizing that HCC incidence may be higher than reported. Incident cases of HCC (defined by American Association for the Study of Liver Diseases diagnostic criteria or histology) were prospectively identified over a 12‐month period (2012‐2013) from the population of Melbourne, Australia. Cases were captured from multiple sources: admissions to any of Melbourne's seven tertiary hospitals; attendances at outpatients; and radiology, pathology, and pharmacy services. Our cohort was compared to the Victorian Cancer Registry (VCR) cohort (mandatory notified cases) for the same population and period, and incidence rates were compared for both cohorts. There were 272 incident cases (79% male; median age: 65 years) identified. Cirrhosis was present in 83% of patients, with hepatitis C virus infection (41%), alcohol (39%), and hepatitis B virus infection (22%) the commonest etiologies present. Age‐standardized HCC incidence (per 100,000, Australian Standard Population) was 10.3 (95% confidence interval [CI]: 9.0‐11.7) for males and 2.3 (95% CI: 1.8 to 3.0) for females. The VCR reported significantly lower rates of HCC: 5.3 (95% CI: 4.4 to 6.4) and 1.0 (95% CI: 0.7 to 1.5) per 100,000 males and females respectively ( P &lt; 0.0001). Conclusions: HCC incidence in Melbourne is 2‐fold higher than reported by cancer registry data owing to under‐reporting of clinical diagnoses. Adoption of current diagnostic criteria and additional capture sources will improve registry completeness. Chronic viral hepatitis and alcohol remain leading causes of cirrhosis and HCC. (H epatology 2016;63:1205–1212)
After 6 years with Xolair; a 3‐year withdrawal follow‐up
Authors: A. Nopp, S. G. O. Johansson, J. Adédoyin, J. Ankerst, M. Palmqvist, H. Öman
Journal: Allergy (2009)

Abstract Background: This study reports the clinical and immunological state of patients 3 years after a 6‐year period of Xolair treatment for severe allergic asthma. Methods: The patient’s cat allergen sensitivity, measured as CD‐sens, IgE and IgE‐ and IgG4 antibodies, was analysed and compared with asthma severity evaluated from FEV 1 and a questionnaire. Results: Three years after treatment with Xolair was stopped, 12/18 patients reported improved or unchanged asthma compared with ongoing Xolair treatment. Most of the patients were in a stable clinical condition, 16/18 had not increased nightly asthma attacks and 14/18 little or no increase in medication. The CD‐sens to cat was still significantly lower ( P &lt; 0.02) than untreated patients with allergic asthma and lower than expected from their serum IgE antibody levels. Conclusion: Most of the patients in this study had, still 3 years after closing of 6 years Xolair treatment, a surprisingly mild and stable asthma. Interestingly, the observed, considerable, downregulation of basophil allergen sensitivity, CD‐sens, most likely representing mast cell allergen sensitivity, contributed to the clinical results.
Aminoglycoside ototoxicity monitoring in multidrug resistant tuberculosis: How much is enough?
Authors: Veronica Melchionda, Harry Wyatt, Raul Garcia Medina, Angelita Solamali, Sotira Katiri, Susan Hopkins, Ian Cropley, Marc Lipman
Journal: European Respiratory Journal (2012)

Background: There is no widely accepted protocol to monitor for potentially irreversible ototoxicity in aminoglycoside treated patients with multidrug resistant tuberculosis (MDR-TB). Experience suggested that we should perform audiometric assessments every 2-4 weeks when using these drugs. This is a more intensive protocol than generally described.  Aim: To evaluate the use of frequent audiometric assessments in MDR-TB patients receiving extended-duration aminoglycosides and to describe their influence on subsequent clinical management.  Methods: Retrospective review of audiometrical and clinical records of MDR-TB patients treated with amikacin at single site London MDR TB service 2009-2011. Hearing loss was graded using the NCI criteria recommended by the American Academy of Audiologists.  Results: 12 patients were assessed. The median dose of amikacin received was 98.3 grams (IQR, 80.8-111.2) over a median period of 122 (92-144) days. Patients had a median of 8.5 (5.5-10) audiograms at 2.3 weekly intervals. 3 (25%) developed grade 1 hearing loss during amikacin therapy at a median time of 116 (95-148) days. All progressed to grade 2 or 3 loss after treatment cessation. 9 (75%) stopped amikacin treatment earlier than originally planned due to audiological complaints (8 with significant tinnitus and 4 with abnormal audiograms).  Conclusion: Aminoglycoside associated ototoxicity appears common despite frequent audiological assessments and often leads to early treatment discontinuation. Other ototoxic agents should be avoided if possible. The optimal type and frequency of audiometric assessments need to be determined within a prospective study.  VM & HW are joint first authors.
Predictive Role of Interphase Cytogenetics for Survival of Patients With Multiple Myeloma
Authors: Robert Königsberg, Niklas Zojer, Jutta Ackermann, Elisabeth Krömer, Harald Kittler, Elke Fritz, Hannes Kaufmann, Thomas Nösslinger, Lucia Riedl, Heinz Gisslinger, Ulrich Jäger, Ingrid Simonitsch, Renate Heinz, Heinz Ludwig, Heinz Huber, Johannes Drach
Journal: Journal of Clinical Oncology (2000)

PURPOSE: Recent metaphase cytogenetic studies suggested that specific chromosomal abnormalities are of prognostic significance in patients with multiple myeloma (MM). Because the true incidence of chromosomal abnormalities in MM is much higher than that detected by metaphase analysis, we used interphase fluorescence in situ hybridization (FISH) to determine the prognostic value of specific chromosomal aberrations. PATIENTS AND METHODS: Bone marrow plasma cells from 89 previously untreated patients with MM were studied consecutively by FISH to detect the deletions of 13q14, 17p13, and 11q and the presence of t(11;14)(q13;q32). FISH results were analyzed in the context of clinical parameters (response to treatment and survival after conventional-dose chemotherapy), and a multivariate analysis of prognostic factors was performed. RESULTS: By FISH, the deletion of 13q14 occurred in 40 patients (44.9%), deletion of 17p13 in 22 (24.7%), and 11q abnormalities in 14 (15.7%; seven with t(11;14)). Deletions of 13q14 and 17p13 were associated with poor response to induction treatment (46.9% v 77.3% in those without deletions, P = .006 and 40.0% v 73.2%, P = .008, respectively) and short median overall survival (OS) time (24.2 v 88.1 months, P = .008 and 16.2 v 51.3 months, P = .008, respectively). Short median OS time was also observed for patients with 11q abnormalities (13.1 v 41.6 months, P = .02). According to the number of unfavorable cytogenetic features (deletion of 13q14, deletion of 17p13, and aberrations of 11q) that were present in each patient (0 v 1 v 2 or 3), patients with significantly different OS times could be discriminated from one another (102.4 v 29.6 v 13.9 months, P &lt; .001, respectively). CONCLUSION: For patients with MM who were treated with conventional-dose chemotherapy, interphase FISH for 13q14, 17p13, and 11q provides prognostically relevant information in addition to that provided by standard prognostic factors. This observation may be considered for risk-adapted stratifications of MM patients in future clinical trials.
Low prevalence and severity of COPD in the Canary Islands: A temperate climate effect?
Authors: Carlos Cabrera-Lopez, Cristina Cabrera-Lacalzada, Angeidi Martin-Medina, Gabriel Julia-Serda, Pedro Cabrera-Navarro
Journal: European Respiratory Journal (2012)

Introduction: COPD prevalence varies widely depending on the geography. Two epidemiological studies in Spain showed a 9-10% COPD prevalence in population older than 40 years. However, none of them included the Canary Islands, a very interesting area for its climate characteristics and high smoking prevalence.  Methods: 1353 people from 40 to 70 years old were randomly selected from a sample of 596,478 individuals. Subjects participating in the study completed a long questionnaire which mainly included items about respiratory health and performed spirometry with broncodilatation test if obstruction was observed.  COPD was diagnosed if FEV1/FVC was lower than 0.7 after a broncodilator test.  Results: COPD prevalence in the Canary islands was 7.3% (IC 95%, 5.5-9.5%) being higher in male than female (8.7% CI 95%, 5.8-12.7% vs 6.3% CI 95%, 4.7-8.4% p  Conclusions: The Canary Islands have a lower COPD prevalence than the rest of Spain as a whole, with a lower severity in spite of having a high smoking prevalence. This finding could be related to the special climate characteristics of the Canaries.
Local and systemic inflammation in chronic obstructive pulmonary disease (COPD)
Authors: Jie Ji, Ida von Schéele, Barbro Dahlén, Jan Bergström, Bo Billing, Ann-Sofie Lantz, Kejll Larsson, Lena Palmberg
Journal: European Respiratory Journal (2013)

Background   The aim of the study was to explore to what extent local inflammatory processes in the mouth (saliva, clinical assessment of periodontitis) and the respiratory tract (sputum, bronchoalveolar lavage (BAL), lung function) are associated with systemic inflammatory responses (blood) in smokers with and without COPD.   Method   Healthy controls (n=23), smokers with (n=28) and without (n=29) COPD performed spirometry and dental examinations. Saliva, induced sputum, BAL fluid and serum were collected. Inflammatory mediators were measured using ELISA. Soluble and cell bound tumor necrosis factor receptors (TNFR) in sputum, BAL fluid and serum were detected by flow cytometry. The mRNA-expression of tumor necrosis factor-α (TNF-α) and its receptors on BAL macrophage were analyzed by real-time PCR.   Result   A negative correlation between lung function and saliva IL-8/MMP-9 was found in smokers with COPD (p   Conclusion   Inflammatory markers in saliva, which is easy to collect, seem to reflect disease severity in COPD patients. Shedding of TNFR is similarly regulated locally and systemically, both in healthy subjects and in smokers, irrespective of airflow limitation.
Fifteen-year results of breast-conserving surgery and definitive breast irradiation for the treatment of ductal carcinoma in situ of the breast.
Authors: L J Solin, J Kurtz, A Fourquet, R Amalric, A Recht, B A Bornstein, R Kuske, M Taylor, W Barrett, B Fowble, B Haffty, D J Schultz, I T Yeh, B McCormick, M McNeese
Journal: Journal of Clinical Oncology (1996)

PURPOSE To determine the 15-year outcome for women with ductal carcinoma in situ (DCIS, intraductal carcinoma) of the breast treated with breast-conserving surgery followed by definitive breast irradiation. PATIENTS AND METHODS An analysis was performed of 270 intraductal breast carcinomas in 268 women from 10 institutions in Europe and the United States. In all patients, breast-conserving surgery included complete gross excision of the primary tumor followed by definitive breast irradiation. When performed, pathologic axillary lymph node staging was node-negative (n=86). The median follow-up time was 10.3 years (range, 0.9 to 26.8). RESULTS The 15-year actuarial overall survival rate was 87%, and the 15-year actuarial cause-specific survival rate was 96%. The 15-year actuarial rate of freedom from distant metastases was 96%. There were 45 local recurrences in the treated breast, and the 15-year actuarial rate of local failure was 19%. The median time to local failure was 5.2 years (range, 1.4 to 16.8). A number of clinical and pathologic parameters were evaluated for correlation with local failure, and none were predictive for local failure (all P &gt; or = .15). CONCLUSION The results from the present study demonstrate high rates of overall survival, cause-specific survival, and freedom from distant metastases following the treatment of DCIS of the breast using breast-conserving surgery and definitive breast irradiation. These results support the use of breast-conserving surgery and definitive breast irradiation for the treatment of DCIS of the breast.