tbuckley/cabot-search huggingface dataset:
Patient and colonoscopy factors influencing adenoma detection in patients undergoing colonoscopy in the NHS bowel cancer screening programme
Authors: T. J. W. Lee, C. J. Rees, R. G. Blanks, S. M. Moss, C. Nickerson, K. C. Wright, P. W. James, R. J. Q. McNally, J. Patnick, M. D. Rutter
Journal: Gut (2011)

<h3>Introduction</h3> The aim of screening colonoscopy is twofold: Firstly to detect colorectal cancer, secondly to detect and remove adenomas. This study examines the influence of both patient factors (age, gender, body mass index (BMI), smoking, alcohol use, deprivation, geographical location) and colonoscopy factors (withdrawal time, bowel preparation quality, rectal retroversion, colonoscopist, intravenous antispasmodic use, sedation use, time of procedure) on the risk of detecting one or more adenomas, advanced adenomas and right sided adenomas during screening colonoscopy. <h3>Methods</h3> All patients undergoing colonoscopy in the NHS Bowel Cancer Screening Programme (BCSP) between August 2006 and August 2009 were included in this study. Demographic, lifestyle, procedural and histological data were retrieved from the national database. The relationships between patient and colonoscopy factors with adenoma detection were examined using univariable and multivariable analysis. <h3>Results</h3> 31 088 patients undergoing screening colonoscopy were included in the analysis. 14 423 had one or more adenomas (46.7%). The following factors increased the relative risk of adenoma detection at screening colonoscopy in both univariable and multivariable analysis (p value &lt;0.001 in multivariable analysis unless otherwise stated): male gender, increasing age, current or previous smoking, current alcohol use, increasing withdrawal time, higher quality bowel preparation, intravenous antispasmodic use, earlier procedure start time (p=0.018) and increasing colonoscopist experience. Increasing level of deprivation was associated with a reduced risk of adenoma detection (p=0.007). Similar results are demonstrated for the effect of these factors on advanced adenoma and right sided adenoma detection. Rectal retroversion did not increase adenoma detection or rectal adenoma detection. <h3>Conclusion</h3> This is the largest study to examine the effect of both patient and colonoscopy factors on adenoma detection at colonoscopy following a positive FOB test. The known impact of smoking, alcohol use, and male gender on adenoma risk is also observed in this setting. The relative effect of colonoscopy factors is also demonstrated with caecal intubation, bowel preparation quality, withdrawal time, intravenous antispasmodic use, colonoscopist experience and earlier sessional start time significantly affecting the risk of adenoma detection. This study demonstrates the need for high quality colonoscopy to optimise adenoma detection.
The Canadian Familial Adenomatous Polyposis Registry: Past, Present and Future
Authors: Hartley S Stern
Journal: Journal of the Royal Society of Medicine (1996)

The advent of the molecular world opening up for familial adenomatous polyposis and other genetically predisposed cancers has now provided us with wonderful tools to study these diseases. The challenges, however, clearly remain to transfer discoveries in the laboratory to improvements in the care of these patients.
Marimastat as First-Line Therapy for Patients With Unresectable Pancreatic Cancer: A Randomized Trial
Authors: S. R. Bramhall, A. Rosemurgy, P. D. Brown, C. Bowry, J. A.C. Buckels
Journal: Journal of Clinical Oncology (2001)

PURPOSE: The prognosis for unresectable pancreatic cancer remains dismal (1-year survival rate, &lt; 10%; 5-year survival rate, &lt; 5%). Recent advances in conventional chemotherapy and novel molecular treatment strategies warrant investigation. This, the largest randomized study in pancreatic cancer performed to date, compares marimastat, the first of a new class of agents, with gemcitabine. PATIENTS AND METHODS: Four hundred fourteen patients with unresectable pancreatic cancer were randomized to receive marimastat 5, 10, or 25 mg bid or gemcitabine 1,000 mg/m 2 . The primary end point was survival. Progression-free survival, patient benefit, and safety were also assessed. RESULTS: There was no significant difference in survival between 5, 10, or 25 mg of marimastat and gemcitabine (P = .19). Median survival times were 111, 105, 125, and 167 days, respectively, and 1-year survival rates were 14%, 14%, 20%, and 19%, respectively. There was a significant difference in survival rates between patients treated with gemcitabine and marimastat 5 and 10 mg (P &lt; .003). Both agents were well tolerated, although grade 3 or 4 toxicities were reported in 22% and 12% of the gemcitabine- and marimastat-treated patients, respectively. The major toxicity of marimastat was musculoskeletal (44% of marimastat patients, compared with 12% of gemcitabine patients; musculoskeletal toxicity was severe in only 8% of marimastat patients). CONCLUSION: The results of this study provide evidence of a dose response for marimastat in patients with advanced pancreatic cancer. The 1-year survival rate for patients receiving marimastat 25 mg was similar to that of patients receiving gemcitabine. In view of the manageable tolerability of marimastat and its ease of administration, further studies are warranted.
The Importance of Trust and the Importance of Trustworthiness
Authors: Sabine Salloch, Sebastian Wäscher, Jochen Vollmann, Jan Schildmann
Journal: The American Journal of Bioethics (2015)

Kelley and colleagues plead for a “collaborative approach to the governance of research on medical practices that addresses core values of trust, transparency and partnership” (Kelley et al. 2015, ...
Treatment of nonmetastatic osteosarcoma of the extremity with preoperative and postoperative chemotherapy: a report from the Children's Cancer Group.
Authors: A J Provisor, L J Ettinger, J B Nachman, M D Krailo, J T Makley, E J Yunis, A G Huvos, D L Betcher, E S Baum, C T Kisker, J S Miser
Journal: Journal of Clinical Oncology (1997)

PURPOSE The specific aims of this study were to improve event-free survival (EFS) in patients with newly diagnosed nonmetastatic osteosarcoma of an extremity using the histologic response to neoadjuvant chemotherapy to determine postoperative chemotherapy; to evaluate a uniform histologic grading system that measures tumor response; and to identify patient characteristics that might influence EFS and survival. PATIENTS AND METHODS Two hundred sixty-eight patients with nonmetastatic osteosarcoma of the extremity were entered between August 1983 and October 1986. Preoperative chemotherapy consisted of four courses of high-dose methotrexate (MTX) and one course of bleomycin, cyclophosphamide, and dactinomycin (BCD). Histologic response to preoperative chemotherapy was determined by morphometric analysis. Good histologic responders (&lt; 5% residual viable tumor) were treated postoperatively with MTX, BCD, and doxorubicin (DOX); poor histologic responders were treated with BCD, DOX, and cisplatin (CDDP). RESULTS The 8-year EFS and survival rates were 53% and 60%, respectively. Two hundred six patients had their tumors assessed for histologic response: 28% displayed a good histologic response to preoperative chemotherapy. Good histologic responders had an 8-year postoperative EFS rate of 81% and survival rate of 87%; those with a poor histologic response had an 8-year postoperative EFS rate of 46% and survival rate of 52%. A primary tumor site in the proximal humerus or proximal femur and an elevated serum alkaline phosphatase level were associated with an increased risk of an adverse event, whereas the type of surgical procedure was not. CONCLUSION EFS and survival appear to be directly related to histologic response to neoadjuvant chemotherapy.
Second malignancies in patients treated for childhood acute lymphoblastic leukemia.
Authors: V M Kimball Dalton, R D Gelber, F Li, M J Donnelly, N J Tarbell, S E Sallan
Journal: Journal of Clinical Oncology (1998)

PURPOSE Second malignant neoplasms (SMN) are devastating late complications of childhood acute lymphoblastic leukemia (ALL) and its treatment. We evaluated the incidence and type of SMN diagnosed before leukemic relapse in a large series of patients with ALL. PATIENTS AND METHODS We reviewed the outcome of all patients treated for childhood ALL between 1972 and 1995 on Dana-Farber Cancer Institute (DFCI) and DFCI ALL Consortium protocols. The follow-up time from diagnosis of ALL to induction failure, relapse, remission death, or SMN, whichever occurred first, ranged from 0 to 24.0 years (median, 7.6 years; mean, 6.7 years). RESULTS Thirteen SMNs were diagnosed among 1,597 patients. Eight tumors occurred in a radiation field (five in the CNS and three in the head and neck), two occurred outside of a radiation field (one adenocarcinoma of the sigmoid colon and one epithelioid sarcoma of the chest wall), and three were hematopoietic malignancies. The median time to occurrence was 6.7 years (range, 1.0 to 17.2 years) and the cumulative incidence of second malignancy before another first event was 2.7% (95% confidence interval, 0.7 to 4.7). The risk of a first event, which included induction failure, relapse, or remission death, was 31.0% (95% confidence interval, 28.5 to 33.5). CONCLUSION We found a more than 10-fold risk of other first events when compared with SMN. Thus, we conclude that SMN before first relapse is a relatively uncommon occurrence among survivors of childhood ALL. Future therapeutic regimens must focus on reducing leukemia relapse and enhancing quality of life, as well as preventing SMNs.
Surgical treatment of hydatid disease at the modern stage
Authors: Shuhrat Hudaybergenov, Georgy Pahomov, Rustem Hayaliev, Maksudjon Shermatov
Journal: European Respiratory Journal (2013)

Hydatid disease - a serious parasitic disease of humans, which is often found in countries with livestock and is endemic to the Central Asian republics, including Uzbekistan. The number of operations performed per year now exceeds 1.5 thousand.  Materials and methods: our department has large material of treatment of hydatid disease - 3464 patients. With unilateral pulmonary echinococcosis treated 2297 patients. 1112 were men (48.6%), women -1185 (51.4%). Most of the patients were young, and most persons of working age - 1237 (53.8%).  Results and Discussion: Of the 2297 patients with unilateral pulmonary hydatid cyst in 837 (36.4%) observed complicated forms of pulmonary hydatidosis. Among the complicated forms of the disease in 81.8% of cases showed a breakthrough hydatid cysts in the bronchus, and 2.6% in the pleural cavity, purulent cysts - in 15.6%. 2275 (99%) operations had organ-saving character, 30 operations were performed with videoassisted minitorakotomy access. Lung resection was performed in 22 patients.  Of the 489 patients with bilateral echinococcosis operated 460 (94.07%) patients, of which 217 (44.37%) patients underwent staged procedure with an interval of 2 weeks to 1 year. 243 (49.69%) patients underwent one-stage operation. 29 (5.93%) patients with endovisual technique performed 33 operations. In this organ-saving operations were used in 421 (86.1%) and different in terms of resection in 68 (13.9%) patients. For one reason or another are not operated 29 (5.93%) patients. Of non-operated patients, 14 - cases were considered inoperable and the patients were discharged for further outpatient treatment with recommendations for further receiving albendazole 2.5% 10 mg per 1 kg of patient weight.
Inhaled Nitric Oxide as a Preoperative Test (INOP Test I)
Authors: David T. Balzer, Henry W. Kort, Ronald W. Day, Howard M. Corneli, John P. Kovalchin, Bryan C. Cannon, Stephen F. Kaine, D. Dunbar Ivy, Steven A. Webber, Abraham Rothman, Robert D. Ross, Sanjeev Aggarwal, Masato Takahashi, J. Deane Waldman
Journal: Circulation (2002)

This study was performed to determine whether a preoperative hemodynamic evaluation with oxygen and inhaled nitric oxide identifies patients with pulmonary hypertension who are appropriate candidates for corrective cardiac surgery or transplantation more accurately than an evaluation with oxygen alone.At 10 institutions, 124 patients with heart disease and severe pulmonary hypertension underwent cardiac catheterization to determine operability. The ratio of pulmonary and systemic vascular resistance (Rp:Rs) was determined at baseline while breathing approximately 21% to 30% oxygen, and in approximately 100% oxygen and approximately 100% oxygen with 10 to 80 parts per million nitric oxide to evaluate pulmonary vascular reactivity. Surgery was performed in 74 patients. Twelve patients died or developed right heart failure secondary to pulmonary hypertension following surgery. Rp:Rs<0.33 and a 20% decrease in Rp:Rs from baseline were chosen as 2 criteria for operability to determine, in retrospect, the efficacy of preoperative testing in patient selection. In comparison to an evaluation with oxygen alone, sensitivity (64% versus 97%) and accuracy (68% versus 90%) were increased by an evaluation with oxygen and nitric oxide when Rp:Rs<0.33 was used as the criterion for operability. Specificity was only 8% when a 20% decrease in Rp:Rs from baseline was used as the criterion for operability.By using a combination of oxygen and inhaled nitric oxide, a greater number of appropriate candidates for corrective cardiac surgery or transplantation can be identified during preoperative testing when a specific value of Rp:Rs is used as a criterion for operability.
Pragmatic Randomized Trials Without Standard Informed Consent?
Authors: Rahul K. Nayak, David Wendler, Franklin G. Miller, Scott Y.H. Kim
Journal: Annals of Internal Medicine (2015)

Significant debate surrounds the issue of whether written consent is necessary for pragmatic randomized, controlled trials (RCTs) with low risk.To assess the U.S. public's views on alternatives to written consent for low-risk pragmatic RCTs.National experimental survey (2 × 2 factorial design) examining support for written consent versus general notification or verbal consent in 2 research scenarios.Web-based survey conducted in December 2014.2130 U.S. adults sampled from a nationally representative, probability-based online panel (response rate, 64.0%).Respondent's recommendation to an ethics review board and personal preference as a potential participant on how to obtain consent or notification in the 2 research scenarios.Most respondents in each of the 4 groups (range, 60.3% to 71.5%) recommended written informed consent, and personal preferences were generally in accord with that advice. Most (78.9%) believed that the pragmatic RCTs did not pose additional risks, but 62.5% of these respondents would still recommend written consent. In contrast, a substantial minority in all groups (28.5% to 39.7%) recommended the alternative option (general notification or verbal consent) over written consent.Framing effects could have affected respondents' attitudes, and nonrespondents may have differed in levels of trust toward research or health care institutions.Most of the public favored written informed consent over the most widely advocated alternatives for low-risk pragmatic RCTs; however, a substantial minority favored general notification or verbal consent.Time-sharing Experiments for the Social Sciences and Intramural Research Program of the National Institutes of Health Clinical Center.
Psychiatric Side Effects of Interferon Therapy: Prevalence, Proposed Mechanisms, and Future Directions
Authors: Peter C. Trask, Peg Esper, Michelle Riba, Bruce Redman
Journal: Journal of Clinical Oncology (2000)

ABSTRACT: The increasing use of interferon (IFN) in treating a variety of disorders including, malignant melanoma and hepatitis C, has resulted in the identification and increasing concern about the psychiatric side effects that can result from treatment. These effects can occur either shortly after beginning IFN therapy or later as a result of continued treatment. Studies have reported the incidence of later side effects, which include symptoms of depression, anxiety, and occasional suicidal ideation, to be from 0% to 70%. Case studies have demonstrated that pharmacologic interventions are beneficial in reducing iatrogenic psychiatric symptoms while allowing patients to maintain IFN therapy. The present article provides an overview of the psychiatric effects of IFN therapy, the proposed mechanisms of these side effects, and case studies that provide mechanistic support. In addition, limitations of the current literature are provided with suggestions for treating physicians and a discussion of possible future research directions.
Modifications in the smoking habits of 200 regular smokers experimenting the electronic-cigarette focusing on smoking reduction and smoking abstinence
Authors: Pasquale Caponnetto
Journal: European Respiratory Journal (2012)

Background:  Cigarette smoking is a tough addiction to break. Therefore, improved approaches to smoking cessation are necessary. The electronic-cigarette, a battery-powered electronic nicotine delivery device resembling a cigarette, may help smokers to remain abstinent during their quit attempt or to reduce cigarette consumption. (1).   Aim and objectives:  We designed a prospective study to monitor possible modifications in the smoking habits of 200 regular smokers, not intending to quit, experimenting the most popular marketed e-Cigarette in Italy (9Categoria9) focusing on smoking reduction and smoking abstinence.   Methods: . Study participants were invited to attend a total of six study visits: at baseline, week-4, week-8, week-12, week-24 and week-52. Product use, number of cigarettes smoked, and exhaled carbon monoxide levels were measured at each visit. Smoking reduction and abstinence rates were calculated. Adverse events and product preferences were also reviewed.   Results:  Sustained 50% reduction in the number of cig/day at week-52 was shown in 16% of participants. Sustained smoking abstinence at week-52 was observed in 9,75% of participants. Participants9 perception and acceptance of the product was good.   Conclusion:  The use of e-Cigarette substantially decreased cigarette consumption without causing significant side effects in smokers not intending to quit.
Activation of TLR7 increases CCND3 expression via the downregulation of miR-15b in B cells of systemic lupus erythematosus
Authors: Deshan Ren, Fei Liu, Guanjun Dong, Ming You, Jianjian Ji, Yahong Huang, Yayi Hou, Hongye Fan
Journal: Cellular and Molecular Immunology (2015)
Docetaxel in patients with metastatic breast cancer: a phase II study of the National Cancer Institute of Canada-Clinical Trials Group.
Authors: M E Trudeau, E A Eisenhauer, B P Higgins, F Letendre, W S Lofters, B D Norris, T A Vandenberg, F Delorme, A M Muldal
Journal: Journal of Clinical Oncology (1996)

PURPOSE The National Cancer Institute of Canada-Clinical Trials Group (NCIC-CTG) conducted a phase II study to assess the efficacy and toxicity of docetaxel as first-line chemotherapy in metastatic breast cancer (MBC). PATIENTS AND METHODS Fifty-one patients with measurable MBC were studied. Three patients were ineligible and were excluded from analysis. The planned dose of docetaxel was 100 mg/m2 intravenously (i.v.) every 3 weeks. Prior adjuvant chemotherapy was allowed if at least 12 months had elapsed from completion of treatment to recurrence. RESULTS The most severe toxicity was granulocytopenia. Ten patients (20.8%) were hospitalized for febrile neutropenia. The protocol was amended to a starting dose of 75 mg/m2 for the last 16 patients. Sixty percent of patients experienced hypersensitivity reactions (HSRs). After two protocol amendments, the use of a premedication regimen of oral dexamethasone and i.v. H1 and H2 blockers prevented significant HSRs. Edema developed in 62% of patients and was cumulative, was present in 50% who received greater than 400 mg/m2, and was not improved by premedication regimens. Following an independent radiology review, 22 partial remissions and four complete responses in 47 assessable patients were confirmed (response rate, 55%; 95% confidence interval [CI], 40% to 69%). The response rate for 15 assessable patients registered at 75 mg/m2 was 40% (95% CI, 16% to 67%); for 32 assessable patients registered at 100 mg/m2, the response rate was 63%, (95% CI, 43% to 78%). CONCLUSION Docetaxel is an active agent in MBC. Its activity as a single agent is comparable to many combination chemotherapy regimens and is not affected by prior adjuvant chemotherapy. Studies are ongoing to improve its therapeutic index and to incorporate docetaxel in combination chemotherapy regimens.
Wheezing in morbidly obese patients is not always due to asthma
Authors: Astrid van Huisstede, Arjan Rudolphus, Hans Zengerink, Gert-Jan van de Geijn, Pieter Hiemstra, Gert-Jan Braunstahl
Journal: European Respiratory Journal (2011)

Background: Morbid obesity is becoming a world wide epidemic. Morbidly obese patients are at risk for asthma.

Aim of the study: To investigate the differences in symptoms and lung function test in morbidly obese patients with and without asthma.

Methods: A group of 93 morbidly obese patients (BMI>35 kg/m2, age 18-50y) was studied. Asthma was defined as the presence of reversible airway obstruction (ΔFEV1≥12%) and/or PC20 methacholine of <8 mg/ml. Patients with a physician diagnosis asthma, but not fulfilling the criteria of asthma after stopping ICS were defined as “asthma-like symptoms” (asthma-l.s.).

Results: 29 patients fulfilled the criteria of asthma, 14 had asthma-l.s., and 50 control group patients. Sex, age, BMI, smoking, abdominal circumference, atopy, FeNO, FVC, DLCO, Eppworth Sleepiness Scale score, GERD questionnaire and steps a day did not differ between the groups. Patients with asthma or asthma-l.s. had significantly more symptoms (wheezing [p<0.001], coughing [p<0.001]), and significant worse AQLQ-scores (mean 5.7 points [p=0.004], 5.5 points [p=0.002] respectively) and ACT-scores (mean 1.1 points [p=0.000] and 1.0 points [p=0.015] respectively) compared to controls (AQLQ 6.5 points, ACT 0.3 points). Patients with asthma had a significantly lower FEV1 (86% pred) and FEV1/FVC (76%pred) than the group with asthma-l.s. (102%pred [p<0.001], and 83%pred [p=0.001] respectively) and the control group (97%pred [p=0.001], and 81%pred [p=0.001] respectively).

Conclusion: A significant proportion of the patients with morbid obesity and a history of asthma does not fulfill the criteria of asthma. These patients have the same symptom scores as “asthma-like symptoms” asthmatics, despite supranormal lung function parameters.
Candida species distribution and antifungal susceptibility testing according to European Committee on Antimicrobial Susceptibility Testing and new vs. old Clinical and Laboratory Standards Institute clinical breakpoints: a 6-year prospective candidaemia survey from the fungal infection network of Switzerland
Authors: C. Orasch, O. Marchetti, J. Garbino, J. Schrenzel, S. Zimmerli, K. Mühlethaler, G. Pfyffer, C. Ruef, J. Fehr, R. Zbinden, T. Calandra, J. Bille
Journal: Clinical Microbiology and Infection (2013)