tbuckley/cabot-search huggingface dataset:
Single agent gemcitabine or docetaxel in the second-line therapy for patients with non-small cell lung cancer previously treated with platin-based chemotherapy
Authors: Ahmet Yurdakul, Fatma Yildirim, Ayse Baha, Can Öztürk
Journal: European Respiratory Journal (2013)

Purpose:  To compare the efficacy and toxicity of gemcitabine versus docetaxel in the second-line setting of the NSCLC patients who previously treated with platin-based combination chemotherapy.   Patients and Methods:  We retrospectively evaluated the medical records of 57 patients treated with single agent gemcitabine or docetaxel in second-line setting of advanced NSCLC who received one prior a platinum-based therapy.   Results:  Fifty-seven patients were included in this study. The mean age of patients was 56.72±8.39 years. There were 55 (96.5%) male patients and 2 (3.5%) female patients. Forty of them received docetaxel and 17 of them received gemcitabine. The mean number of chemotherapy cycles was 6.8±4.0 in the gemcitabine group, 4.6±3.0 cycles in the docetaxel group. Overall response rates were 8% and 12% for gemsitabine and docetaxel, respectively (p=0.02). The median time to progression was 8 and 5 months gemcitabine and docetaxel, respectively. The median survival time was 22 versus 21 months for gemcitabine and docetaxel, respectively. There was no difference in overall survival between two groups. In addition, there was no difference between two groups in terms of incidence of the adverse effects. All of the hematological side effects were in grade 1/2. No major toxicity was encountered to stop the drug for both groups.   Conclusion:  Treatment with gemcitabine demonstrated clinically equivalent efficacy and safety profile compared with docetaxel treatment in the second-line setting for patients with NSCLC.
Use of ICD-10 diagnoses in Danish psychiatric hospital-based services in 2001-2007
Authors: POVL MUNK-JØRGENSEN, MALENE NAJARRAQ LUND, AKSEL BERTELSEN
Journal: World Psychiatry (2010)

The Danish version of the ICD-10 chapter on mental and behavioural disorders has 380 different diagnoses when three digits are used. This study examines how many of the available diagnoses were used and to what extent in Danish psychiatric hospital-based services in the period from 2001 to 2007, through an analysis of the total number of diagnoses reported to the Danish Psychiatric Central Research Register (n=1,260,097). The 50th percentile (50.1%) was reached by using 16 diagnoses (4.2% of 380 available). The three most frequently registered diagnoses were paranoid schizophrenia, alcohol dependence and adjustment disorder, used 10.2%, 8.3% and 5.9% of the times, respectively. Seven diagnoses (1.8%) were used between 1 and 4 times during the 7-year period. One hundred nine (28.7% of available diagnoses) were used less than 100 times each. These data suggest that it may be sensible to reconsider the number of diagnoses needed in the revision of the ICD-10 chapter on mental and behavioural disorders.
The effect of initial management of hyperleukocytosis on early complications and outcome of children with acute lymphoblastic leukemia.
Authors: H S Maurer, P G Steinherz, P S Gaynon, J Z Finklestein, H N Sather, G H Reaman, W A Bleyer, G D Hammond
Journal: Journal of Clinical Oncology (1988)

Data were collected from 124 patients with newly diagnosed acute lymphoblastic leukemia (ALL) and WBC greater than 200,000/microL seen at institutions affiliated with the Children's Cancer Study Group (CCSG) from April 1981 to May 1983. The presenting characteristics, initial management, early complications, and outcome were reviewed. All the children received vigorous intravenous (IV) hydration, alkalinization of the urine, and allopurinol. Thirty-two patients were started on full therapy with no additional measure. One or more special measures believed to reduce the complications of leukostasis and blast cell lysis were administered to 92 patients as follows: small initial doses of prednisone, 63; emergency cranial irradiation, 26; exchange transfusion, 21; and leukopheresis, 19. The incidence of CNS hemorrhage was only 3% (4/124). Seven patients expired during induction and four failed to achieve a remission by day 28. Nineteen patients (15%) had documented bacterial or fungal sepsis. Mild to moderate electrolyte abnormalities occurred in 29 patients: three patients required renal dialysis. Pretreatment with small doses of prednisone did not decrease the incidence of electrolyte abnormalities in those patients when compared with patients who received full chemotherapy. The event-free survival (EFS) for the 106 patients treated on one of the three intensive pilot studies is 55% at 36 months. On multivariate analysis the two significant adverse prognostic factors were massive splenomegaly (P = .02) and WBC count greater than 600,000/microL (P = .05). In conclusion, in patients with hyperleukocytosis the complications of blast cell lysis and leukostasis were manageable with acceptable morbidity and minimal mortality in a group of patients treated with vigorous hydration, allopurinol, and alkalinization of the urine before beginning chemotherapy. Selected patients with severe hyperuricemia and renal dysfunction may benefit from leukopheresis. No beneficial role was demonstrated for the use of small initial doses of prednisone or emergency cranial irradiation.
Effects of supplemental O2 on PCO2 and ventilation in people with obesity hypoventilation syndrome
Authors: Carly Hollier, Alison Harmer, Lyndal Maxwell, Collette Menadue, Gunnar Unger, Grant Willson, Amanda Piper
Journal: European Respiratory Journal (2012)

Breathing 100% O2 increases PCO2 in some people with obesity hypoventilation syndrome (OHS). It is not known how lower concentrations of O2 affect people with OHS. This study investigated the effect of clinically relevant O2 concentrations on PCO2, pH and minute ventilation (VE) in stable OHS patients pre and post treatment with positive airway pressure (PAP), and in controls. In a double-blind randomised crossover study, 14 subjects with OHS and 14 age- and gender-matched controls breathed inspired O2 fractions (FiO2) of 0.28 and 0.5, each for 20min, separated by a 45min washout. The OHS group were retested after 3 months of nocturnal PAP. Arterialised-venous PCO2 and pH, and VE were measured every 5min. Data were analysed with repeated measures ANOVA. In OHS pre-PAP, small rises in PCO2 of 2.0±1.7mmHg; 3.7±3.2mmHg (both p<0.01) occurred after 20min of breathing FiO2 0.28 and 0.5, respectively, with no significant difference between concentrations. pH fell accordingly, with FiO2 0.5 inducing mild acidaemia (7.346±0.030, p<0.01). VE fell below the room air baseline for both FiO2 0.28 (-5±11%, p<0.01) and FiO2 0.5 (-7±20%, p<0.01). The controls' responses differed significantly from the OHS group (p<0.01). PCO2 and pH did not change significantly with either FiO2 and mild hyperventilation occurred (VE +1.3±19%, FiO2 0.28; +12±17%, FiO2 0.5). In OHS, O2-induced PCO2 rises tended to be smaller after PAP (1.3±2.3mmHg, FiO2 0.28; and 0.9±1.7mmHg, FiO2 0.5). Commonly used concentrations of O2 caused hypoventilation, small PCO2 rises and mild acidaemia in stable OHS. When providing supplemental O2 for people with stable OHS, close monitoring and targeting of O2 saturations is recommended.
Stearate inhibits breast cancer cell spreading, motility, and invasion
Authors: Arig Ibrahim Hashim, Stephanie Cowey, Manuel Pallero, Joanne Murphy-Ullrich, Chuanyu Li, Jun-Lin Guan, Gene P. Siegal, Robert W. Hardy
Journal: Cancer Research (2006)

Proc Amer Assoc Cancer Res, Volume 47, 2006

1812 

Morphological changes in cells are known to affect cell differentiation, tissue remodeling, mitosis and possibly cancer cell metastasis. Stearate is a long chain saturated fatty acid (C18:0) found in red meat and chocolate. There is in vitro and in vivo evidence that it inhibits cancer cell proliferation and tumor growth, as well as promotes breast cancer cell morphological changes, however the mechanism(s) underlying these effects are unclear. We demonstrate that physiological concentrations of stearate induce cell rounding, but not detachment, in ∼60-70% (p≤.02) of human breast cancer cells (MDA-MB-435 and Hs578t cells) within 24 hrs of treatment, while normal mammary epithelial cells (Hs578Bst) are not significantly affected (p>.22). Trypan blue staining and lack of caspase activation indicate that the rounded cells (<1 process) are neither necrotic, nor apoptotic. In addition, actin stress fibers are reduced in stearate treated breast cancer cells. Interference reflection microscopy (IRM) revealed that 5 min of stearate treatment, decreased the number of adherent cells with greater than 5 focal adhesions by 30% (p<0.007), without causing cell rounding. Focal adhesion kinase (FAK) is necessary for focal adhesion formation. Our data shows that 12 hrs following stearate treatment of human breast cancer cells (Hs578t) FAK protein expression was unchanged, but phosphorylation on tyrosine 397 and 925 was decreased. Immunoprecipitation of FAK revealed that its association with FAK interacting protein-200 (FIP200), an endogenous inhibitor of FAK, was increased after 3 hrs of stearate treatment, although FAK’s association with other proteins was unchanged. These data are consistent with FAK, and possibly the interaction of FIP200 and FAK, being important in focal adhesion site turnover. Cell invasion and scratch assays demonstrated that treatment with stearate inhibits both invasion (98% + 1% inhibition, n=3) and migration (58% + 1% inhibition, n=2) in Hs578t cells. Thus, physiological concentrations of stearate profoundly inhibit breast cancer cell spreading, focal adhesion formation, cell migration and cell invasion. We are currently performing dietary studies using mouse metastasis models to explore our hypothesis that stearate will inhibit breast cancer metastasis in vivo.
Abstract 15107: Increase in Ventricular Stiffness in Patients with Systemic Autoimmune Disease without Accompanied Ventricular Concentric Remodeling
Authors: Qing Shang, Lai-Shan Tam, Jing-Ping Sun, John E Sanderson, Qing Zhang, Edmund K Li, Cheuk-Man Yu
Journal: Circulation (2011)

Background: Remodeling is the accepted cause of left ventricular (LV) stiffness which contributes to myocardial diastolic dysfunction. The aim of this study was to determine whether early remodelin...
Randomized comparison of cisplatin, methotrexate, bleomycin and vincristine (CABO) versus cisplatin and 5-fluorouracil (CF) versus cisplatin (C) in recurrent or metastatic squamous cell carcinoma of the head and neck
Authors: M. Clavel, J.B. Vermorken, F. Cognetti, P. Cappelaere, P.H.M. de Mulder, J.H. Schornagel, E.A. Tueni, J. Verweij, J. Wildiers, M. Clerico, O. Dalesio, A. Kirkpatrick, G.B. Snow
Journal: Annals of Oncology (1994)

The EORTC Head and Neck Cancer Cooperative Group conducted a randomized comparison of cisplatin, methotrexate, bleomycin and vincristine (CABO) versus cisplatin and 5-fluorouracil (CF) versus cisplatin (C) in chemotherapy naive patients with recurrent or metastatic squamous cell carcinoma of the head and neck. The primary objectives of this study were to investigate whether the CF regimen was in anyway superior to the CABO regimen and to detect any superiority of these two combinations over cisplatin alone.Three hundred eighty-two patients were randomized to one of three treatments: (1) methotrexate (40 mg/m2) days 1 and 15, bleomycin (10 mg) and vincristine (2 mg) days 1, 8 and 15, cisplatin (50 mg/m2) day 4, repeated every 21 days, (2) cisplatin (100 mg/m2) and 5-FU (1 g/m2 x 4), repeated every 21 days, and (3) cisplatin (50 mg/m2) days 1 and 8, repeated every 28 days. After 3 cycles, all responding and stable disease patients in the three arms of the study continued with cisplatin alone.The overall response rates to CABO (34%) and CF (31%) were superior to C (15%) (p < 0.001, p = 0.003, respectively). In addition, complete response rate to CABO (9.5%) was superior to that of C (2.5%) (p = 0.02), and also superior to that of CF (1.7%) (p = 0.01). Response was associated with performance status and prior treatment, but by multivariate analysis treatment type was the important determinant of response (p = 0.0006). Although CABO and CF were superior to C with respect to time to progression within the first 6 to 8 months after randomization, there was no overall difference in progression-free survival or survival between the three arms of the study. Both hematologic and non-hematologic toxicity were worse in the combination chemotherapy arms.We conclude that the CF regimen has no advantage over the CABO regimen, which in fact showed a higher complete response rate. Both combinations showed improved response rates but also more toxicity and no improvement in overall survival in comparison with cisplatin alone.
Approaching tuberculosis in a vulnerable group
Authors: Elmira Ibraim, Nicoleta Cioran, Nicoleta Popescu, Florentina Ligia Furtunescu
Journal: European Respiratory Journal (2012)

Introduction: The homeless represents a high risk group for TB, with poor access to health care services. TB prevalence among the around 5,000 homeless estimated to live in Bucharest is not known.  Aims and objectives: To detect active TB cases in homeless population in Bucharest.  Methods: A screening program was developed based on partnership between the National TB Programme and Samusocial Romania (NGO providing medical, psychological and social support to homeless people). Persons coming to the surgery service of Samusocial have been screened for TB in TB facilities. Any homeless giving a positive informed consent has been included and only exclusion criterion was having another chest X-ray in the previous 6 months.  Results: In the 248 cases registered from January to June 2011, 83.9% were males, mean age was 43.9 years (from 18 to 73 years old), 30.2% didn9t have any ID document and half were at first medical consultation. TB has been suspected in 44.4% by clinical criteria, but from eligible persons only 48% were screened by chest X-ray, 14.1% refused and 35.5% didn9t come back for screening. Active TB has been found in 8 cases (6.7% from the screened persons), 2 of them negative to clinical examination. None was previously examined even though they have free access to TB services. All cases were admitted in long-stay hospitals for treatment and monitoring.  Conclusions: In this project the prevalence of active TB was found very high in the homeless population (6,700%ooo). Providing free access to TB services is not sufficient to detect TB cases in this high risk group and active screening programs are necessary.
Clinical, epidemiological and evolving profile of miliary tuberculosis: Study of 48 cases
Authors: Nahid Zaghba, Abdelaziz Bakhatar, Najiba Yassine, Abdelkrim Bahlaoui
Journal: European Respiratory Journal (2011)

Miliary tuberculosis is a rare but severe form of TB often due to hematogenous spread of Mycobacterium tuberculosis. It represents less than 2% of tuberculosis in our context. We conducted a retrospective study of 48 cases collected in our Respiratory Diseases department between 2003 and 2010. Female cases were predominant with 60%. The mean age was 35 years old. The history of tuberculosis and tuberculosis contagion were found in 10 cases each, the postpartum in 3 cases, trisomy-21 in 1 case, diabetes and HIV seropositivity in 3 cases each. The clinical setting was dominated by health impairment in all the cases and fever in 40 cases (83%). Chest X-ray spotted out miliary aspect in all the cases, cardiomegaly in 2 cases, pyopneumothorax in 5 cases, and excavated opacities in 4 cases. The intradermal tuberculin test performed for all the cases was positive in 20 cases. Bascilloscopies were positive in 15 cases. The spread assessment found out a cerebro-meningeal affection in 5 cases with cerebral tuberculomas in 1 case, pericarditis in 3 cases, mediastinal and peripheral lymph nodes in 6 cases; choroidal tubercle was found in 5 cases and a medullar affection in 2 cases. Antibacillary treatment according to the 2SRHZ/7RH regimen was started in emergency in 32 cases, 2RHZE/7RH in 3 cases and according to 2RHZE/4RH regimen in 5 cases. Evolution was good in 36 cases (75%), 9 patients were lost for follow up, and 3 deaths were deplored. Throughout this work we emphasize the severity of miliary tuberculosis and the need for urgent and early therapeutic management.
Abstract 3295: Enoxaparin is Superior to Unfractionated Heparin in Patients with STEMI Undergoing Fibrinolysis Regardless of the Choice of Lytic-type: ExTRACT-TIMI 25 Analysis
Authors: Roberto R Giraldez, Jose C Nicolau, Michelle O'Donoghue, Ramon Corbalan, Enrique P Gurfinkel, Ursulo Juarez, Jacqueline L Buros, Satishkumar Mohanavelu, David A Morrow, Elliott M Antman, Eugene Braunwald
Journal: Circulation (2006)
A woman with upper and lower airway symptoms
Authors: J. Capps, C. Chrysochou, W. Flight
Journal: BMJ (2015)

A 65 year old woman presented with a four week history of lethargy, cough, and feeling generally unwell. She had recently been treated for an ear infection and had occasional epistaxis but had no other medical history. She had never smoked. On examination she was did not have a fever and had crepitations in the base of her right lung. A chest radiograph showed right basal consolidation. Her blood tests showed: white blood cell count 17.5×109 cells/L (reference range 4-11), C reactive protein 3171 nmol/L (<47.6), urea 9.8 mmol/L (2.5-7.8), and creatinine 98 µmol/L (62-124). A diagnosis of community acquired pneumonia was made.

After seven days of treatment with antibiotics her symptoms had not improved. A repeat chest radiograph showed worsening bilateral inflammatory changes. Sputum and blood cultures were negative, as were tests for Legionella and Pneumococcus urinary antigens. Urine dipstick was positive for blood. At bronchoscopy, bloodstained mucus was found within the airways. Bronchial washings were negative for cancer cells and pathogens.

Her renal function then deteriorated (urea 10.6 mmol/L, creatinine 178 µmol/L) and intravenous fluids were started. A further chest radiograph showed progression of the inflammatory changes and a new left pleural effusion. A contrast enhanced computed tomogram of the chest was considered but not performed owing to worsening renal function. Further blood tests showed that she was positive for cytoplasmic antineutrophil cytoplasmic antibodies (c-ANCA).



### 1. What is the likely diagnosis?

#### Answer

Granulomatosis with polyangiitis (previously known as Wegener’s granulomatosis), a small vessel vasculitis that predominantly affects the kidneys and respiratory tract. Other possible differentials (before the positive cytoplasmic antineutrophil cytoplasmic antibody (c-ANCA) result) included atypical pneumonia, a complication …
Hepatic arterial infusion of floxuridine in patients with liver metastases from colorectal carcinoma: long-term results of a prospective randomized trial.
Authors: P Rougier, A Laplanche, M Huguier, J M Hay, J M Ollivier, J Escat, R Salmon, M Julien, J C Roullet Audy, D Gallot
Journal: Journal of Clinical Oncology (1992)

PURPOSE A multicentric randomized study that compared patients who received intrahepatic arterial infusion (HAI) to a group of patients who did not receive HAI (control group) was performed for unresectable hepatic metastases from primary colorectal carcinoma. PATIENTS AND METHODS One hundred sixty-six patients were assigned randomly to HAI of floxuridine (5 fluoro-2'deoxyuridine [FUDR]) 0.3 mg/kg/d for 14 days every 4 weeks or to the control group; this latter group, depending on the investigator's choice, was either under observation or received systemic fluorouracil (5-FU). The same regimen of systemic 5-FU also was administered to the HAI group in the event of extrahepatic progression. No crossover from the control group to the HAI group was permitted. The mean duration of follow-up was 54 months (range, 31 to 72), and 163 patients were analyzed. RESULTS A significant improvement was observed in the survival rate for the 81 patients assigned to HAI group (P less than .02) with a 1-year survival rate of 64% versus 44% in the control group (82 patients). The 2-year survival rate was 23% versus 13%. The median survival was 15 months versus 11 months for the HAI group and the control group, respectively. Survival was better for patients with a less than 30% liver involvement, and for those treated in more specialized centers. The hepatotoxic effects of HAI were observed in 47 patients (chemical hepatitis [n = 28], and biliary sclerosis [n = 19]). The 1-year rate of sclerosing cholangitis was equal to 25%. Gastrointestinal toxicity was infrequent and consisted of gastritis or diarrhea. CONCLUSIONS Therapy with HAI of FUDR improves the survival of patients with liver metastases over colorectal carcinoma. However, the methods that are used to diminish the toxicity of HAI and efficient systemic chemotherapy, such as a combination of 5-FU and leucovorin, are required to prevent extrahepatic metastases.
Class-level relationships in the phylum Cnidaria: molecular and morphological evidence.
Authors: D Bridge, C W Cunningham, R DeSalle, L W Buss
Journal: Molecular Biology and Evolution (1995)

The evolutionary history of cnidarian life cycles has been debated since the 1880s, with different hypotheses favored even by current textbooks. Contributing to the disagreement is the fact that the systematic relationships of the four cnidarian classes have received relatively little examination using modern systematic methods. Here we present analyses of class-level relationships based on 18S ribosomal DNA (rDNA) sequence, mitochondrial 16S rDNA sequence, mitochondrial genome structure, and morphological characters. DNA sequences were aligned using a repeatable parsimony-based approach incorporating a range of alignment parameters. Analyses of individual data sets and of all data combined are unanimous in grouping the classes possessing a medusa stage, leaving the holobenthic Anthozoa basal within the phylum.
Validation of the Epworth sleepiness scale, Berlin, STOPBANG questionnaires and American Society of Anesthesiologists checklist as screening tools for obstructive sleep apnea in patients with chronic obstructive pulmonary disease, asthma and cardiovascular diseases
Authors: Hamdy Ali Mohammadien Mahmoud, Suzan Said Ahmid Sallama, Azza Mahmoud Ahmad
Journal: European Respiratory Journal (2013)

Background: 

Obstructive sleep apnea is a common medical condition and may lead to life threatening problems if it is left undiagnosed. This study was conducted to evaluate the Epworth Sleepiness Scale (ESS), Berlin, STOP-Bang questionnaires and the American Society of Anesthesiologists (ASA) checklist for screening OSA in patients with COPD,asthma and CVD.

Material and methods : 

The study was performed on 180 patients, 60 COPD, 60 asthmatics and 60 patients with CVD without previously diagnosed OSA were recruited Subjects completed the Questionnaires. The scores from the ESS, Berlin, STOPBANG questionnaires, and ASA checklist were evaluated.

Results: Of 180 screened patients, (30, 70, 20 and15% of COPD), (32,55,37,&35% of asthmatic) and (70,35,60 &49% of CVD) were respectively classified as being at high risk of OSA by the ESS, STOP BANG, Berlin questionnaires, and ASA checklist. The STOPBANG questionnaire& ESS demonstrate significant difference in the cardiac patients in comparison to the COPD and asthmatic patients.The risk of OSA increased up to age 65 years. A significant number of obese individuals (58%) were at high risk for OSA. Those whose questionnaire scores indicated a high risk for OSA were more likely to report subjective sleep problems, a negative impact of sleep on quality of life, and a chronic medical condition than those who were at lower risk.

Conclusions: Berlin & STOP-Bang Questionnaires are quite reliable to determine which patient need further evaluation of OSA followed by ASA checklist then ESS.