tbuckley/cabot-search huggingface dataset:
Adjuvant chemotherapy with vincristine, cyclophosphamide, and doxorubicin after radiotherapy in local-regional nasopharyngeal cancer: results of a 4-year multicenter randomized study.
Authors: A Rossi, R Molinari, P Boracchi, M Del Vecchio, E Marubini, M Nava, L Morandi, R Zucali, S Pilotti, C Grandi
Journal: Journal of Clinical Oncology (1988)

To evaluate the effect of adjuvant chemotherapy in patients with local-regional nasopharyngeal carcinoma (NPC) (squamous or undifferentiated) in complete remission at the end of curative radiotherapy (RT) 229 patients were randomized from 1979 to 1983 in a multicenter study to no further therapy (116 patients) or a combination of vincristine, cyclophosphamide, and Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH) (VCA) for six monthly cycles (113 patients). The RT and RT + VCA groups were well balanced for median age (50 v 49 years), histology (undifferentiated carcinoma, 73% v 70%), tumor extent (tumor limited to nasopharynx, 57% v 57%), and nodal extent (negative nodes 26% v 24%, nodes in the lower cervical levels, 17% v 16%). RT was delivered to the nasopharynx, the base of the skull, and bilateral cervical nodes using a split course technique over 10 weeks up to the dose of 60 to 70 Gy in involved sites and 50 Gy to negative nodes. Response to RT was evaluated within 65 days post-RT treatment. Analysis at 48 months did not show significant difference between the two treatment groups in terms of relapse-free survival (RT, 55.8%, RT + VCA, 57.7%, P = .45) and overall survival (RT, 67.3%, RT + VCA, 58.5%, P = .13). The pattern of relapse was similar in the two treatment arms. Distant metastases were the cause of treatment failure in about 50% of relapsing patients. Although the results of the present study did not show any benefit from VCA administered after curative RT, combined systemic chemotherapy should be further explored due to the high incidence of local and distant failure after intensive RT.
Favorable Early-Stage Hodgkin Lymphoma
Authors: Joachim Yahalom
Journal: Journal of the National Comprehensive Cancer Network (2006)

The category of favorable early-stage Hodgkin lymphoma (HL) includes patients with Ann Arbor stages I or II disease with no bulky disease or B symptoms. The precise definition of favorable versus unfavorable early-stage disease may vary among American and European cooperative groups. The overall 10-year survival rate of patients with favorable early-stage HL exceeds 90%. Indeed, effective treatments for this group of patients have been available for more than 4 decades. However, treatment strategies have radically changed over the past 15 years and focus now on maintaining the high cure rate while reducing the risk of treatment-related long-term morbidity. The optimal treatment is still evolving, and more recently, reduction in the total amount of chemotherapy and in radiation field and dose has shown excellent results. Combined modality therapy is the preferred treatment for patients with classical favorable early-stage HL (nodular sclerosis or mixed cellularity histology). Patients with early-stage lymphocyte predominance HL are highly curable using involved-field radiation therapy (IFRT) alone and do not require chemotherapy. Classical favorable HL is also curable with radiotherapy alone or with chemotherapy alone, but larger fields and higher-dose radiation or longer chemotherapy is required compared with combined modality. The freedom from treatment failure rate is significantly better with a combination of short chemotherapy and IFRT than with either chemotherapy or radiotherapy alone. Although combined modality is the standard preferred treatment for favorable disease, radiation therapy alone or chemotherapy alone could be considered under special circumstances or as part of an investigational protocol.
Further Studies on Antibody Status of Mice and Response of Their Litters to Parotid-Tumor (Polyoma) Virus
Authors: L. W. Law, W. P. Rowe, Janet W. Hartley, C. J. Dawe
Journal: JNCI Journal of the National Cancer Institute (1962)

Journal Article Further Studies on Antibody Status of Mice and Response of Their Litters to Parotid-Tumor (Polyoma) Virus Get access L. W. Law, L. W. Law Laboratory of Biology and Laboratory of Pathology, National Cancer Institute, and Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases,5Bethesda, Maryland Search for other works by this author on: Oxford Academic PubMed Google Scholar W. P. Rowe, W. P. Rowe Laboratory of Biology and Laboratory of Pathology, National Cancer Institute, and Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases,5Bethesda, Maryland Search for other works by this author on: Oxford Academic PubMed Google Scholar Janet W. Hartley, Janet W. Hartley Laboratory of Biology and Laboratory of Pathology, National Cancer Institute, and Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases,5Bethesda, Maryland Search for other works by this author on: Oxford Academic PubMed Google Scholar C. J. Dawe C. J. Dawe Laboratory of Biology and Laboratory of Pathology, National Cancer Institute, and Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases,5Bethesda, Maryland Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 28, Issue 3, March 1962, Pages 629–647, https://doi.org/10.1093/jnci/28.3.629 Published: 01 March 1962 Article history Received: 05 September 1961 Published: 01 March 1962
Relationship between exacerbation frequency and survival post MI in COPD patients
Authors: Jennifer Quint, Emily Herrett, Adam Timmis, Harry Hemingway, Jadwiga Wedzicha, Liam Smeeth
Journal: European Respiratory Journal (2012)

COPD patients are at increased risk of myocardial infarction (MI),1 particularly after an exacerbation.2 COPD patients have shorter survival after MI compared to the general population. We investigated whether COPD patients with frequent exacerbations (FE) had shorter survival post MI than patients with infrequent exacerbations (IE).  All COPD patients with a first MI between 1/1/03 and 31/12/08 as recorded in MINAP, who had no previous evidence of MI in GPRD or MINAP were included. Patients under 35, not registered with GPRD at the time of MI, or with less than 1 year of follow-up before their MI were excluded. Exacerbations were defined using pre-defined READ codes and prescription of pre-specified antibiotics and/or steroids. FE had ≥2 exacerbations in the year preceding MI and IE   1063 patients were identified with a first STEMI or NSTEMI. 111 (10.4%) FE and 952 (89.6%) IE. The unadjusted mortality rate in FE was 285.7 deaths (95%CI 222.3-367.2) per 1000 person years and in IE 152.4 deaths (95% CI 138.1-168.1) per 1000 person years. Adjusting for confounding by smoking and gender and stratifying by age, mortality was greater in FE compared to IE; HR 1.61(95%CI 1.23-2.11);p=0.001. Mortality was greater in patients who exacerbated in the 2 months preceding the MI; HR 3.88(2.70-5.56):p  Conclusions: FE have shorter survival after a first MI than IE. There appears to be an association between timing of exacerbations, exacerbation frequency and survival after 1st MI.  1. Feary et al Thorax 2011  2. Donaldson et al Chest 2010.
Dyspnoea and fat free mass are major determinants of reduced physical activity in COPD patients
Authors: Francesco Costa, Gianna De Cusatis, Laura Malagrinò, Sandra Antonelli, Claudia De Simone, Sabrina Santerini, Barbara Vagaggini, Pierluigi Paggiaro
Journal: European Respiratory Journal (2011)

Background:  Physical activity is reduced in patients with chronic obstructive pulmonary disease (COPD), and this has been associated with systemic inflammation and left cardiac disfunction (Magnussen et al, AJRCCM 2008)   Aim:  To assess the predictors of physical activity, expressed as daily steps, in COPD patients.   Subject and methods:  In a cross sectional study 45 COPD (FEV1%: 52±17.1, 34 male) underwent: physical activity evaluation by Armband (as a mean of a 7-day monitoring period), pulmonary function tests (PFT), cardiopulmonary exercise test (CPET) with assessment of dynamic hyperinflation, arterial blood analysis, Saint George9s Respiratory Questionnaire (SGRQ), comorbidity index (CIRS), dyspnea scale (MRC), body composition by bioelectrical impedance analysis, Pro-BNP, inflammatory cells in blood and sputum.   Results:  Multivariate linear regression analysis stepwise method were performed using daily steps as dependent variable.  The severity of dyspnea (MRC) and the free fat mass (FFM%) explained 43% of the variance of the physical activity, while other physiologic and biologic markers did not have additive effects.   Conclusion:  Dyspnea and nutritional status are extra-pulmonary parameters that play a relevant role in the limitation of the physical activity level in COPD patients.
ABC of allergies: Adverse reactions to drugs
Authors: D. Vervloet, S. Durham
Journal: BMJ (1998)

An adverse reaction to a drug has been defined as any noxious or unintended reaction to a drug that is administered in standard doses by the proper route for the purpose of prophylaxis, diagnosis, or treatment. Some drug reactions may occur in everyone, whereas others occur only in susceptible patients. A drug allergy is an immunologically mediated reaction that exhibits specificity and recurrence on re-exposure to the offending drug.

#### Classification of adverse reactions to drugs

##### Reactions that may occur in anyone

##### Reactions that occur only in susceptible subjects

Adverse reactions to drugs are very common in everyday medical practice. A French study of 2067 adults aged 20-67 years attending a health centre for a check up reported that 14.7% gave reliable histories of systemic adverse reactions to one or more drugs. In a Swiss study of 5568 hospital inpatients, 17% had adverse reactions to drugs. Fatal drug reactions occur in 0.1% medical inpatients and 0.01% of surgical inpatients. The main drugs implicated are antibiotics and non-steroidal anti-inflammatory drugs. Adverse reactions to drugs occurring during anaesthesia (muscle relaxants, general anaesthetics, and opiates), although less common (1 in 6000 patients receiving anaesthesia), are life threatening, with a mortality of about 6%.

Numerous mechanisms have been implicated in adverse reactions to drugs. …
Induction of Malignant Vascular Tumors of the Liver in Guinea Pigs Treated With 2,2′-Dihydroxy-di-n-propylnitrosamine
Authors: M. S. Rao, J. K. Reddy
Journal: JNCI Journal of the National Cancer Institute (1977)

The effect of chronic administration of 2,2'-dihydroxy-di-n-propylnitrosamine (DHPN) was studied in randombred guinea pigs. DHPN, dissolved in olive oil, was injected sc into 40 animals at a dose of 250 mg/kg body weight/week for 30 weeks, and the animals were observed until their death or termination of the experiment at the end of 40 weeks. Of the 32 guinea pigs that survived more than 20 weeks of DHPN treatment, 23 developed angiosarcoma of the liver between 22 and 40 weeks. Metastases to lungs, spleen, and peripancreatic lymph nodes were observed in 8 animals. Other tumors included hepatocellular carcinoma (1 animal), cholangiocarcinoma (1 animal), chronic myeloid leukemia (1 animal), acinar cell adenoma of pancreas (1 animal), and acinar cell carcinoma of pancreas (1 animal). In addition, megalocytic change of hepatic cells with intranuclear inclusions, pelliosis hepatis, and cholangiomatous lesions were also encountered frequently in the livers.
Quantitation of a Murine Leukemia Virus With a Spleen Colony Assay&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: Dov H. Pluznik, Leo Sachs
Journal: JNCI Journal of the National Cancer Institute (1964)

A method is described for the rapid quantitation of the Rauscher leukemia virus with a spleen colony assay. Virus-induced cell colonies in the spleen can be scored macroscopically at 6 to 8 days after virus inoculation into adult mice, and the colonies consist predominantly of nucleated erythrocytes in various stages of differentiation. It was shown that there was a linear relationship between virus concentration and number of colonies in the spleen. The serial isolation of virus from single colonies thus provides a method for the production of genetically homogeneous lines of this virus. Six strains of mice were tested for susceptibility to the colony-forming unit (CFU) assay. The highest CFU titers were obtained with SWR and Swiss, somewhat lower titers with BALB/c, DBA/2, and C3H, and the lowest with C57BL/6 mice. Intravenous inoculation gave an average of 10 times higher CFU titers than intraperitoneal inoculation. Virus titers expressed as endpoint for leukemia in an observation period of 150 days were higher than virus titers expressed as CFU in an observation period of 7 days, by a factor of 13 and 71 in two experiments with spleen extracts, and by a factor of 6 when plasma was used as the source of virus. With the use of the CFU assay, the half-life of the Rauscher virus at 37° C was found to be about 70 minutes.
Megestrol acetate and aminoglutethimide/hydrocortisone in sequence or in combination as second-line endocrine therapy of estrogen receptor-positive metastatic breast cancer: a Southwest Oncology Group phase III trial.
Authors: C A Russell, S J Green, J O'Sullivan, H E Hynes, G T Budd, J E Congdon, S Martino, C K Osborne
Journal: Journal of Clinical Oncology (1997)

PURPOSE A phase III randomized trial was performed to determine whether combination hormonal therapy with aminoglutethimide (AG) and hydrocortisone (HC) plus megestrol acetate (MA) improved response rates, response duration, or increased survival over the sequential use of each hormone in women with estrogen receptor-positive metastatic breast cancer (MBC) who had maintained stable disease for at least 6 months or responded to tamoxifen. PATIENTS AND METHODS Two hundred eighty-eight postmenopausal women with progressive estrogen receptor-positive MBC were randomly selected to receive MA 40 mg four times daily (arm I), AG 250 mg four times daily with HC 40 mg daily in divided doses (arm II), versus the combination of MA plus AG given at the same dosages (arm III). Patients on arms I and II who progressed after an adequate trial were crossed over to the other treatment arm. RESULTS Two hundred thirty-five eligible patients were evaluated for response, time to treatment failure, and survival. Response was only reported for patients with measurable disease and was not statistically different among the three arms. There were two partial responses (PRs) on MA (6%), four complete responses (CRs) and six PRs on AG (24%), and eight PRs and three CRs on MA plus AG (23%) in 32, 42, and 48 measurable patients, respectively. Median times to treatment failure were also similar at 5, 4, and 7 months. Survival was also not statistically different among the three arms at 26, 27, and 26 months for arms I, II, and III, respectively. Toxicity was greater in the two AG arms with respect to fatigue, nausea and vomiting, and rash. CONCLUSION With the exception of toxicity, there is no response, time to treatment failure, or survival benefit for any one group when comparing MA, AG, or the combination at their stated doses in women with estrogen receptor-positive MBC who had previously responded to or stabilized with tamoxifen.
Activation of the coagulation system following exposure of mice to chlorine
Authors: Sadis Matalon, Sotirios Zarogiannis, Naseem Anjun, Karen Iles, Jean-Francois Pittet
Journal: European Respiratory Journal (2012)

Chlorine (Cl2) is a highly irritant and reactive gas produced in large quantities throughout the world. The accidental release of large amounts of Cl2 in 30 large cities world-wide, caused significant mortality and morbidity to humans and animals. Our previous findings show that exposure of rodent to Cl2 causes both pulmonary and systemic injury (Zarogiannis et al. Am J Respir Cell Mol Biol. 2011;45(2):386-92; Honavar et al.Am J Respir Cell Mol Biol. 201145(2):419-25.) Herein we tested the hypothesis that exposure to Cl2 activates intraalveolar and systemic coagulation cascades which in turn may contribute to the development of lung and other end-organ injury. Male C57Bl/6 mice (6-8 weeks) were exposed to either Cl2 (600 ppm for 45 minutes in environmental chambers) or air (0 ppm). Mice were returned to room air and sacrificed immediately or at 1 h post-exposure and their lungs were lavaged. Mice exposed to Cl2 had much higher levels of Thrombin/anti-Thrombin (TAT) complexes (measured by ELISA) as compared to those exposed to air both in the BAL (10 ± 2 ng/ml vs. 0.5 + 0.1; mean + SE; n=6; p<0.01) and plasma (25±0.1 ng/ml vs. 0.1±0.05; mean + SE; n=6; p<0.01) at 1 h post exposure. In addition clotting time in the blood (measured by thromboelastometry) was significantly prolonged in Cl2 exposed mice as compared with air controls (275 ± 25 sec. vs. 150 2±10; mean + SE; n=6; p<0.01). In contrast, there was no significant change in the clotting time blood taken from mice immediately after Cl2. Taken together, these data demonstrates a strong activation of the coagulation within the airspaces as well as the development of a systemic disseminated intravascular coagulation after Cl2 exposure in mice.
Clustered Tuberculosis Cases
Authors: Henk van Deutekom, Susan P. Hoijng, Petra E. W. de Haas, Miranda W. Langendam, Alice Horsman, Dick van Soolingen, Roel A. Coutinho
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

Clustered tuberculosis cases with Mycobacterium tuberculosis isolates showing identical restriction fragment length polymorphism patterns are assumed to be the result of disease transmission. In a prospective, population-based study in the province of North Holland, The Netherlands, we combined molecular methods with highly detailed epidemiologic information to determine why many clustered cases are not detected at an early stage. Of 481 patients, 138 (29%) fell into 43 clusters, suggesting recent transmission in 20%. Of 155 patients in clusters occurring within 2 years before or after the diagnosis of the disease, 21 (14%) had no epidemiologic links with other patients. Independent predictors of the absence of such links were female sex and Turkish, Moroccan, or other African ethnicity. Of 47 patients with a clear epidemiologic link, 37 (24% of 155) were identified early, e.g., by contact tracing, and 10 (6%) were missed. In 85 (55%) patients, an epidemiologic link was likely but undetected when using conventional contact tracing. Compared with clearly linked patients, only male sex was independently associated with presence in this last group. Our results indicate that 86% of clustered study patients had epidemiologic links and that opportunities for earlier identification using conventional tuberculosis control strategies are limited.
Prevalence of chronic kidney disease (CKD) in the UK COPD population
Authors: David Price, Emily Davis, Anna Gilchrist, Daniel West, Marjan Kerklof, Dermot Ryan
Journal: European Respiratory Journal (2014)

Estimates suggest 8.5% of the UK adult population may have CKD stages 3-5 ( Stevens, P.E. et al, Kidney International 2007;72: 92-99 ), though this may be higher among COPD patients(pts). The introduction of quality outcomes framework guidelines requiring renal function data to be captured presents a unique opportunity to assess CKD prevalence in the UK COPD population.   Methods:  Retrospective, observational study using Optimum Patient Care Research Database. COPD pts aged ≥40 years with ever recorded FEV1/FVC    Results:  Of 31,107 COPD patients; 16,314 had renal function data available (of this sub-group: 48.3% male, median age [IQR]:68[61-75]). GOLD and CKD stage data presented below. Of our total COPD population, 18.2% had CKD stage 3-5.   Conclusion:  CKD may be more common among the UK COPD population than the total adult population.
Further concerns about the Shape of Training proposals
Authors: V. J. Gokani, P. J. McElnay, A. J. Beamish, R. L. Harries
Journal: BMJ (2015)

We would like to add our concerns to those of Dean regarding the recommendations made by Greenaway.1 Of primary concern is that the review risks introducing a subconsultant grade, which would be detrimental to patient care and the NHS.

We would also urge caution that levels of competence should not be reduced nor …
Diagnostic value and prognostic significance of pleural C-reactive protein in lung cancer with malignant pleural effusions
Authors: Hak-Ryul Kim, Ki-Eun Hwang, Hwi-Jung Kim, Eun-Taik Jeong
Journal: European Respiratory Journal (2012)

C-reactive protein (CRP) has been implicated in various inflammatory and advanced malignant states. Increased serum CRP levels have been shown in associated with independent prognostic factor for survival in patients with advanced lung cancer. However, only few studies have focused on the role of CRP in pleural effusions. This study aimed to evaluate the diagnostic value of pleural CRP to discriminate lung cancer with MPE from benign effusion and its prognostic role in lung cancer patients with MPE. Pleural effusion samples were collected from patients with MPE (68 lung cancers; 12 extrathoracic tumors), and from 68 with various benign conditions. Concentrations of pleural (p) and serum (s) CRP were measured by ELISA. The expression profile of CRP in pleural fluid, and its association with survival were investigated. P-CRP levels correlated with s-CRP levels ( P  = 0.0028). The area under the ROC curve (AUC) of p-CRP (0.86) in their diagnostic accuracy to differentiate lung cancer with MPE from benign pleural effusion was greater than those of s-CRP (0.77). High p-CRP expression was significantly correlated with shorter overall survival ( P  = 0.0001). In a multivariate Cox regression analysis, p-CRP was independent prognostic factor significantly associated with overall survival ( P  = 0.0001). The relative risk of overall survival for lung cancer patients with high p-CRP was 3.909 (95% CI, 2.000–7.639). In conclusion, P-CRP is superior to s-CRP in determining the pleural fluid etiology. Quantitive assay of CRP in pleural effusion might be useful complementary test both in diagnosis and prognosis for lung cancer patients with MPE.