tbuckley/cabot-search huggingface dataset:
Home grown asparagus is cheap
Authors: J Heath
Journal: BMJ (1997)

The real ethics of rationing Purchasers, not surgeons, control waiting listsEditor-I applaud the BMJ's efforts to bring the important issue of rationing to the fore, but I cannot allow one aspect of Light's contribution to go without challenge. 1Under the heading "parasitic privatisation" he says, "to top it off, the surgeons control the waiting lists" (to encourage patients into the private sector).I despair that someone of his academic stature should show such a lack of understanding of the purchaser-provider split that we have had in the NHS for the past six years.In the vast majority of cases we as surgeons have a contract with purchasers that places an upper limit on the number of patients on whom we can operate.Thus surgeons have no control over the number of patients having surgery and therefore, by definition, over the waiting list.The role of the surgeon is to prioritise, on clinical grounds, within the contracted number.If surgeons are to operate on more patients then purchasers must contract for more operations.The onus to reduce waiting time, and therefore encourage patients not to use the private sector, lies solely with the purchasers.
Superficial thrombophlebitis (superficial venous thrombosis)
Authors: H. Nasr, J. M. Scriven
Journal: BMJ (2015)

#### The bottom line

Superficial thrombophlebitis (increasingly being called superficial venous thrombosis) is inflammation of the superficial veins associated with venous thrombosis. Traditionally, it has been considered a benign, self limiting disease of the lower extremity. However, it can affect most superficial venous systems in the body and importantly can be associated with deep vein thrombosis and pulmonary embolism. Treatment is aimed at symptomatic control and prevention of these serious and potentially fatal complications. Treatment options are variable and controversial.

The incidence of superficial thrombophlebitis remains unclear but is thought to be higher than that of deep vein thrombosis, which is estimated at about one per 1000.1 Although age is not an independent risk factor, the incidences of other risk factors increase with age, making superficial thrombophlebitis more common in older people, and more common in women (50–70%).2 3 4 However, complications are less likely in those over 60 years old.5

Superficial thrombophlebitis is a clinical diagnosis. Patients usually present with pain and discoloration (redness in the acute phase progressing to a brown, haemosiderin based pigmentation over days to weeks) over the affected superficial veins (fig 1⇓). On palpation, the vein is tender and hard. Extensive limb swelling should raise the suspicion of deep vein thrombosis rather than superficial thrombophlebitis.



Fig 1 Typical superficial thrombophlebitis within …
Factors associated with severity of pulmonary tuberculosis and mortality in TB patients with diabetes mellitus
Authors: Suay Hong Gan, Kyi Win Khin Mar, Yee Tang Wang, Cynthia Bin Eng Chee
Journal: European Respiratory Journal (2014)

Introduction  Diabetics with tuberculosis (TB) have more severe TB disease and poorer clinical outcomes than non-diabetics. We evaluated factors associated with pulmonary TB (pTB) disease severity and outcome among diabetics.  Method:  We performed a retrospective review of case records of TB patients with diabetes mellitus seen at the TB Control Unit (TBCU) in 2010. Age, gender, ethnicity, smoking and HbA1C were evaluated for association with AFB smear positive and cavitary (ie. severe) pTB and all-cause mortality.  Results :  There were 296 diabetic TB patients treated at the TBCU in 2010, of whom 278 had pTB. The median age was 58 years; 69 were newly diagnosed DM; 35.1% had HbA1c of > 10%; 79.4% had culture positive TB; 119 had sputum AFB smear positive and cavitary pTB. 10.5% did not convert their culture after 2 months of treatment. 19 (6.4%) died, one patient acquired drug resistance during treatment, and one patient had disease relapse. There was no treatment failure.  HbA1C > 7% at baseline was significantly associated with smear positive and cavitary disease (p=0.006, OR 3.51), whereas age, ethnicity, gender and smoking were not.  Age > 60 years was significantly associated with all-cause mortality during treatment (p=0.025, OR 6.56) whereas gender, ethnicity, smoking, smear positivity and cavitary disease were not.  Conclusion  Among diabetic TB patients, poor diabetic control was associated with sputum AFB smear positive, cavitary disease at presentation. Age > 60 years old was associated with all-cause mortality.
A comparison of phylogenetic group, virulence factors and antibiotic resistance in Russian and Norwegian isolates of Escherichia coli from urinary tract infection
Authors: N. Grude, N.I. Potaturkina-Nesterova, A. Jenkins, L. Strand, F.L. Nowrouzian, J. Nyhus, B.-E. Kristiansen
Journal: Clinical Microbiology and Infection (2006)
N-terminal pro-brain natriuretic peptide is a useful prognostic marker in patients with pulmonary hypertension and renal insufficiency
Authors: Lars Harbaum, Jan K. Hennigs, Elisabeth Griesch, Nicole Lüneburg, Hans J. Baumann, Hans Klose
Journal: European Respiratory Journal (2013)

Background : N-terminal pro-brain natriuretic peptide (NT-proBNP) is a routinely used prognostic parameter in patients with pulmonary hypertension (PH). As it accumulates in patients with renal insufficiency the clinical value of NT-proBNP in PH patients with renal insufficiency remains unclear.  Methods : Ninety five PH patients (WHO class I and IV) with and without renal insufficiency (defined as glomerular filtration rate (GFR) ≤60 ml/min/1.73m2) were retrospectively matched regarding hemodynamic parameters. Correlations of NT-proBNP with demographic, hemodynamic and prognostic parameters (Time to clinical worsening, TTCW) were evaluated.  Results : Patients with renal insufficiency (n=39, GFR 45±11) were older and showed shorter 6-minute walking distances than patients with normal renal function (n=56, GFR 78±13). GFR correlated inversely with NT-proBNP (r=-.35, p=.001). Overall, GFR was the strongest predictor of NT-proBNP in a multivariate regression model including hemodynamic parameters. In patients with renal insufficiency, NT-proBNP correlated with pulmonary vascular resistance, right atrial pressure and cardiac index (r>.35, p Conclusion : In a retrospective cohort study we showed that, although NT-proBNP levels are affected by renal function, this marker correlated with hemodynamic parameters and predicted clinical outcome in patients with renal insufficiency.
Disseminated Scopulariopsis brevicaulis infection in an allogeneic stem cell recipient: case report and review of the literature
Authors: A. Salmon, A. Debourgogne, M. Vasbien, L. Clément, J. Collomb, F. Plénat, P. Bordigoni, M. Machouart
Journal: Clinical Microbiology and Infection (2010)
Feeling of a Lump in the Throat: Thoughts of a Radiologist
Authors: G M Ardran
Journal: Journal of the Royal Society of Medicine (1982)

Radiological examination of over 300 patients complaining of feeling a lump in the throat and difficulty in swallowing, but in whom there was no visible lump, showed that in most cases there was no significant abnormality above the thoracic inlet. Oesophageal examination revealed no abnormality in one-third; definite gastric reflux with or without hiatus hernia in one-third; and impaired clearance of fluid in the horizontal position in the remainder. Reflux and impaired clearance were either seen spontaneously or were induced after the ingestion of hydrochloric acid of the same pH as gastric juice.
Phase I and Pharmacokinetic Study of the Oral Farnesyl Transferase Inhibitor SCH 66336 Given Twice Daily to Patients With Advanced Solid Tumors
Authors: Ferry A.L.M. Eskens, Ahmad Awada, David L. Cutler, Maja J.A. de Jonge, Gré P.M. Luyten, Marije N. Faber, Paul Statkevich, Alex Sparreboom, Jaap Verweij, Axel-R. Hanauske, Martine Piccart
Journal: Journal of Clinical Oncology (2001)

A single-agent dose-escalating phase I and pharmacokinetic study on the farnesyl transferase inhibitor SCH 66336 was performed to determine the safety profile, maximum-tolerated dose, and recommended dose for phase II studies. Plasma and urine pharmacokinetics were determined.SCH 66336 was given orally bid without interruption to patients with histologically or cytologically confirmed solid tumors. Routine antiemetics were not prescribed.Twenty-four patients were enrolled onto the study. Dose levels studied were 25, 50, 100, 200, 400, and 300 mg bid. Pharmacokinetic sampling was performed on days 1 and 15. At 400 mg bid, the dose-limiting toxicity (DLT) consisted of grade 4 vomiting, grade 4 neutropenia and thrombocytopenia, and the combination of grade 3 anorexia and diarrhea with reversible grade 3 plasma creatinine elevation. After dose reduction, at 300 mg bid, the DLTs consisted of grade 4 neutropenia, grade 3 neurocortical toxicity, and the combination of grade 3 fatigue with grade 2 nausea and diarrhea. The recommended dose for phase II studies is 200 mg bid, which was found feasible for prolonged periods of time. Pharmacokinetic analysis showed a greater than dose-proportional increase in drug exposure and peak plasma concentrations, with increased parameters at day 15 compared with day 1, indicating some accumulation on multiple dosing. Plasma half-life ranged from 4 to 11 hours and seemed to increase with increasing doses. Steady-state plasma concentrations were attained at days 7 through 14. A large volume of distribution at steady-state indicated extensive distribution outside the plasma compartment.SCH 66336 can be administered safely using a continuous oral bid dosing regimen. The recommended dose for phase II studies using this regimen is 200 mg bid.
Effect of arachidonic acid on hypoxia-induced VEGF expression of mouse embryonic stem cells; involvement of Wnt, Notch1, HIF1-α
Authors: Sang Hun Lee, Yun Hee Kim, Han Na Suh, Yu Jin Lee, Mi Ok Kim, Jung Min Ryu, Seung Pil Yun, Jae Hong Park, Ho Jae Han
Journal: Clinical Cancer Research (2007)

C9   Vascular endothelial growth factor (VEGF), a potent angiogenic growth factor, has been implicated in this embryo development. Hypoxia has been shown to stimulate the expression of vascular endothelial growth factor (VEGF) which is a major mediator for angiogenesis and vasculogenesis. Hypoxia induced cytosolic phospholipase A2 (cPLA2) plays a role in angiogenesis. Moreover, Wnt or Notch are important mediators of cell fate during embryogenesis, but their role in postnatal angiogenesis, remains unknown. Thus, in this study, we examined effect of arachidonic acid on hypoxia-induced VEGF expression and its related signal pathways in mouse embryonic stem (ES) cells. In process of hypoxic condition, mouse ES cells were incubated with fresh culture medium supplemented with 5% FBS without LIF (leukemia inhibitory factor) in a modular incubator chamber gassed with 5.5% CO 2 , 2.2% O 2 , and 92.3% N 2 . The hypoxia increased VEGF expression in a time-dependent manner. In this hypoxic condition, Wnt-1 and Notch1 were increased in a time-dependent manner. The increases of HIF-1α activity under hypoxic conditions were inhibited by L-685,458 (Notch inhibitor, 10 -7  M) but were not inhibited by AACOCF 3 , mepacrine (phospholipase A 2  inhibitor, 10 -5  M) or indomethacin (COX inhibitor, 10 -7 M). Moreover, cells were transfected with a pool of HIF-1α specific siRNAs (100 nmol/L) or non-targeting siRNAs (100 nmol/L). In this experiment, HIF-1α siRNA inhibited the hypoxia-induced increase in the VEGF expression level. Furthermore, the treatment of arachidonic acid (10 -7  M) increased HIF-1α, VEGF expression level in hypoxia. In conclusion, synergistic effect of hypoxia and arachidonic acid on VEGF expression was induced by Wnt, Notch, cPLA 2  and HIF1-α in mouse embryonic stem cells.  Key words : mouse embryonic stem cell, Wnt, Notch, VEGF, HIF-1α
SOME PROPERTIES OF THE LACTIC DEHYDROGENASE AGENT OF MICE
Authors: Herman G. du Buy, Martin L. Johnson
Journal: The Journal of Experimental Medicine (1965)

The lactic dehydrogenase agent was obtained in quantities sufficient for purification studies by growing the virus in Ehrlich ascites tumor-bearing mice. A rapid method of titration of the agent is described. Subsequent to the standard procedure of concentration of virus by treatment with hyaluronidase and centrifugation, lipids were removed by extraction with PE, without major loss of infectivity. Electron microscopic sections of purified preparations contained particles consisting of a dense inner ring of about 25 mµ and a less dense ring extending to about 50 mµ. The particles occur frequently in single-membraned vesicles of varying size, and occasionally in large double-membraned bodies. The purified LDH agent did not stimulate the formation of neutralizing antibodies in rabbits and guinea pigs. The crude LDH agent was found to be a low interferon producer. Increased interferon, produced by secondary inoculation with Newcastle disease virus temporarily decreased the titer of the LDH agent. The results of others regarding the nature and the size of the LDH agent are interpreted in regard to the findings presented, and the role of interferon in permanently LDH agent infected mice is discussed.
Donor leukocyte infusions in 140 patients with relapsed malignancy after allogeneic bone marrow transplantation.
Authors: R H Collins, O Shpilberg, W R Drobyski, D L Porter, S Giralt, R Champlin, S A Goodman, S N Wolff, W Hu, C Verfaillie, A List, W Dalton, N Ognoskie, A Chetrit, J H Antin, J Nemunaitis
Journal: Journal of Clinical Oncology (1997)

PURPOSE Recipients of allogeneic bone marrow transplants (BMTs) who have relapsed may attain complete remissions when treated with transfusions of leukocytes obtained from the original bone marrow donor. We performed a retrospective study to characterize better this new treatment modality. PATIENTS AND METHODS We surveyed 25 North American BMT programs regarding their use of donor leukocyte infusions (DLI). Detailed forms were used to gather data regarding the original BMT, relapse, DLI, response to DLI, complications of DLI, and long-term follow-up evaluation. Reports of 140 patients were thus available for analysis. RESULTS Complete responses were observed in 60% (95% confidence interval [CI], 51.9% to 68.1%) of chronic myelogenous leukemia (CML) patients who received DLI and did not receive pre-DLI chemotherapy; response rates were higher in patients with cytogenetic and chronic-phase relapse (75.7%; 95% CI, 68.2% to 83.2%) than in patients with accelerated-phase (33.3%; 95% CI, 19.7% to 46.9%) or blastic-phase (16.7%; 95% CI, 1.9% to 31.9%) relapse. The actuarial probability of remaining in complete remission at 2 years was 89.6%. Complete remission rates in acute myelogenous leukemia (AML) (n = 39) and acute lymphocytic leukemia (ALL) (n = 11) patients who had not received pre-DLI chemotherapy were 15.4% (95% CI, 9.6% to 21.2%) and 18.2% (95% CI, 6.6% to 29.8%), respectively. Complete remissions were also observed in two of four assessable myeloma patients and two of five assessable myelodysplasia patients. Complications of DLI included acute graft-versus-host disease (GVHD) (60%; 95% CI, 51.4% to 68.6%), chronic GVHD (60.7%; 95% CI, 50.3% to 71.1%), and pancytopenia (18.6%; 95% CI, 12.2% to 25.0%). Pre-DLI characteristics predictive of complete response in CML patients were post-BMT chronic GVHD, pre-DLI disease status of chronic phase, and time interval between BMT to DLI less than 2 years. Acute and chronic GVHD post-DLI were highly correlated with disease response (P &lt; .00001). CONCLUSION DLI results in complete remissions in a high percentage of patients with relapsed chronic-phase CML. Complete remissions are observed less frequently in patients with advanced CML and acute leukemia. GVHD and pancytopenia occur commonly; GVHD is highly correlated with response.
Health economics of COPD: First results of the new German COSYCONET cohort compared to population-based controls from KORA
Authors: Margarethe Wacker, Matthias Hunger, Holger Schulz, Joachim Heinrich, Annette Peters, Armin Koch, Rudolf A. Jörres, Claus Vogelmeier, Rolf Holle
Journal: European Respiratory Journal (2014)

Background  The new German multicenter COPD cohort COSYCONET is studying health economic questions of COPD in terms of healthcare utilization, absence from work and health-related quality of life (HRQL). We present first results comparing patients from the clinical cohort to population-based controls and analyze the influence of disease severity.  Methods  Self-reported data on healthcare utilization, work absence and on HRQL (measured by EQ-5D-3L) from the baseline examination were compared across patients in four COPD grades (GOLD definition, % predicted values according to ECSC) and to controls without airflow limitation from two pooled studies from the KORA research platform.  Results  Descriptive analysis of a partial dataset (60% of study sample, n=1383 cases, 1610 controls, mean age 64.8 yrs, 54% males) showed that patients with COPD grade 1-4 reported on average 1.9/2.2/1.8/1.9 times more physician visits and 2.1/2.8/4.1/6.5 times more hospital days than controls without COPD. The number of taken medications and of days with work absence was also considerably higher for COPD patients than for controls and increased with disease stage (up to factor 2.7/7.5 compared to controls). Mean EQ-5D utility values decreased from 0.90 in controls to 0.83/0.84/0.81/0.74 in patients with COPD grades 1-4. Full adjusted results based on the complete study sample will be available at the conference.  Conclusion  Patients with COPD show extensive healthcare utilization, work absence and limitations in HRQL even for COPD grade 1. Prevention programs and interventions aiming at delaying disease progression are needed to reduce the burden of COPD on patients and healthcare systems.
Cisplatin combination chemotherapy versus chlorambucil in advanced ovarian carcinoma: mature results of a randomized trial.
Authors: C J Williams, G M Mead, F R Macbeth, J Thompson, J M Whitehouse, H MacDonald, V J Harvey, M L Slevin, T A Lister, J H Shepherd
Journal: Journal of Clinical Oncology (1985)

A randomized study to compare the efficacy of combination chemotherapy (cisplatin, doxorubicin, cyclophosphamide: PACe) with chlorambucil (CB) in International Federation of Gynecology and Obstetrics (FIGO) stage III and IV ovarian carcinoma was conducted between May 1979 and October 1983. Patients failing initial CB were subsequently eligible for treatment with PACe. Eighty-nine patients were randomized and 85 were eligible for analysis; as of date, 72 of these patients have died. The majority of patients in this study had bulky residual disease after their initial laparotomy (76%). Complete response (CR) was documented by a second laparotomy after five cycles of combination therapy or 6 to 12 months alkylating agent therapy. The overall response rate (CR plus partial response [PR]) for the combination (PACe, 68%) was significantly higher (P = .0004) than that for the chlorambucil (CB, 26%). However, the median survival was not improved (PACe, 13 months; CB, 11 months) and the survival curves were not significantly different (log rank test P = .25). The results of this study are comparable to preliminary data reported from other similar randomized studies. PACe, as administered in this study, is not indicated as routine therapy in patients with bulky residual ovarian carcinoma.
Characteristics of a New Inbred Strain of Mice (PBA) With a High Tumor Incidence: Preliminary Report&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: Paul C. Bailey, William B. Leach, Marshall W. Hartley
Journal: JNCI Journal of the National Cancer Institute (1970)

A new inbred strain (PBA) of mice is described. Emphasis is on 3 spontaneous neoplasms in the animals: lymphomas developing in 100% of the animals at an average age of 35 weeks; primary mammary tumors developing in 74.3% of the breeding females at an average age of 38 weeks; and pulmonary adenomas with an incidence of 77% in animals a year old or older. The lymphomas characteristically involved the peripheral lymph nodes and spleen, which had an increased proliferation of plasma cells often containing Russell bodies. Electrophoretic studies showed an increase in the serum globulins in a large percentage of animals with lymphomas. The mammary tumors were adenocarcinomas with differentiation ranging from mature glandular patterns to anaplastic sheets of pleomorphic epithelial cells. The pulmonary lesions were adenomas with the usual glandular and papillary structure.
Mechanism of Action of BCG-Tumor Cell Vaccines in the Generation of Systemic Tumor Immunity. II. Influence of the Local Inflammatory Response on Immune Reactivity&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;&lt;xref ref-type="fn" rid="FN3"&gt;3&lt;/xref&gt;
Authors: M E Key, M G Hanna
Journal: JNCI Journal of the National Cancer Institute (1981)

The intradermal injection of a vaccine composed of 10(7) X-irradiated syngeneic hepatocarcinoma line 10 (L10) cells admixed with 10(8) Mycobacterium bovis strain BCG into inbred Sewall Wright strain 2 guinea pigs induces a local inflammatory reaction and effectively immunizes against a contralateral challenge with viable L10 cells. The relationship between the local inflammatory reaction and the generation of tumor immunity was studied. Immunization against L10 was most effective when both L10 cells and BCG were injected into the same site, less effective when they were injected into separate sites with common lymphatic drainage, and not effective when they were injected at totally separate sites. Enzymatic dissociation of dermal vaccination sites revealed that vaccination with BCG and L10 cells combined induced a significantly greater inflammatory response than did vaccination with BCG alone or L10 cells alone; the inflammatory response was also greater than the combination of these individual responses, suggesting that BCG and L10 cells interacted synergistically in the elicitation of an inflammatory response. Sites receiving a combined vaccine of BCG and L10 cells were infiltrated rapidly by inflammatory cells, and surgical excision of these sites as early as 24 hours after vaccine administration did not affect significantly the development of immune responsiveness. However, vaccination sites induced by the injection of BCG and L10 cells at separate but adjacent sites were slowly infiltrated by inflammatory cells, and surgical removal of these sites within 96 hours of vaccination inhibited later immune responsiveness. Quantitative cellular analysis of these inflammatory reactions showed that inflammation was related to tumor-reactive immunity such that the greater the initial inflammatory process, the greater the resistance to tumor challenge.
Atypical (Endometrial) Carcinoma of the Prostate
Authors: W A Jurewicz, R H Whitaker, W A Brough, T K Wheeler
Journal: Journal of the Royal Society of Medicine (1983)

Three cases of atypical (endometrial) carcinoma of the prostate are reported. In the light of the uncertain response to oestrogen therapy, all three patients were treated with radical radiotherapy.