tbuckley/cabot-search huggingface dataset:
Outcomes of external-beam radiation therapy for prostate cancer: a study of Medicare beneficiaries in three surveillance, epidemiology, and end results areas.
Authors: F J Fowler, M J Barry, G Lu-Yao, J H Wasson, L Bin
Journal: Journal of Clinical Oncology (1996)

PURPOSE This study was designed to obtain representative estimates of the quality of life and probabilities of possible adverse effects among Medicare-age patients treated with external-beam radiation therapy for prostate cancer. METHODS Patients treated for local or regional prostate cancer with high-energy external-beam radiation between 1989 and 1991 were sampled from a claims data base of the Surveillance, Epidemiology, and End Results (SEER) program from three regions. Patients were surveyed primarily by mail, with telephone follow-up evaluation of non-respondents. There were 621 respondents (83% response rate). The results were compared with data from a previously published national survey of Medicare-age men who had undergone radical prostatectomy. RESULTS Although they were older at the time of treatment, radiation patients were less likely than surgical patients to wear pads for wetness (7% v 32%) and had a lower rate of impotence (23% v 56% for men &lt; 70 years), while they were more likely to report problems with bowel dysfunction (10% v 4%). Both groups reported generally positive feelings about their treatments. Radiation and surgical patients reported similar rates of additional subsequent treatment (24% v 26% at 3 years after primary treatment). However, radiation patients were less likely to say they were cancer-free, and they reported more worry about cancer than did surgical patients. CONCLUSION The health-related quality of life of radiation and surgical patients, on average, is similar, but the pattern of experience with adverse consequences of treatment differs by treatment.
Twelve Months of Isoniazid Compared with Four Months of Isoniazid and Rifampin for Persons with Radiographic Evidence of Previous Tuberculosis
Authors: ROBERT M. JASMER, DAVID C. SNYDER, DANIEL P. CHIN, PHILIP C. HOPEWELL, STEPHANIE S. CUTHBERT, E. ANTONIO PAZ, CHARLES L. DALEY
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Isoniazid taken daily for 12 mo and isoniazid and rifampin taken daily for 4 mo are both recommended options for patients with radiographic evidence of previous tuberculosis and positive tuberculin skin tests who have not had prior treatment. We compared the completion rates, number of adverse effects, and cost effectiveness of these two regimens. Patients were treated at the San Francisco Tuberculosis Clinic from 1993 through 1996. A Markov model was developed to assess impact on life expectancy and costs. One thousand twenty-two patients, with a mean age of 52 yr, and > 90% foreign born, were treated; 545 received isoniazid and 477 received isoniazid and rifampin. For isoniazid, 79.8% completed 12 mo of therapy and 4.9% had adverse effects versus 83.6% completion, 6.1% adverse effects for isoniazid and rifampin (p > 0.05 for all between-group comparisons). Both regimens increased life expectancy by 1.4–1.5 yr. Compared with isoniazid, isoniazid and rifampin produced net incremental savings of $135 per patient treated. In patients with radiographic evidence of prior tuberculosis who have not been previously treated, isoniazid for 12 mo and isoniazid and rifampin for 4 mo have similar rates of completion and adverse effects, and both increase life expectancy compared with no treatment. Isoniazid and rifampin for 4 mo is cost saving compared with isoniazid alone. This advantage was maintained even when compared with 9 mo of isoniazid, the new American Thoracic Society/Centers for Disease Control (ATS/CDC) recommendation for treatment with isoniazid alone.
Design of the Polish Colonoscopy Screening Program: a randomized health services study
Authors: Michal Kaminski, Ewa Kraszewska, Maciej Rupinski, Milena Laskowska, Paulina Wieszczy, Jaroslaw Regula
Journal: Endoscopy (2015)

<b>Background and study aims:</b> Colonoscopy screening for colorectal cancer has been implemented without evidence from randomized controlled trials quantifying its benefit and invariably as an opportunistic program, both of which are contrary to the European Union guideline recommendations. The aim of this paper is to describe the rationale and design of the first population-based colonoscopy screening program (PCSP), which was launched in Poland in 2012 as a randomized health services (RHS) study. <b>Methods:</b> The PCSP is a natural extension of opportunistic colonoscopy screening implemented in 2000. It uses colonoscopy capacity, a quality assurance program, and a network of 92 centers built up during the opportunistic screening phase to develop a countrywide PCSP. Within the PCSP, single screening colonoscopy is offered to a target population aged 55 – 64 years. The PCSP uses an RHS design, which means that eligible individuals drawn from population registries are randomly assigned to immediate or postponed invitation to screening. Individuals from birth cohorts that will reach the upper age limit for screening before full implementation of the PCSP are randomly assigned, in a 1:1:1 ratio, to "immediate" screening, "postponed" screening, or a "never invited" control group. The RHS design is a natural platform that will evaluate the effectiveness of screening, and compare different age ranges for screening, invitation procedures, and quality improvement interventions. Up to 2015, 24 centers have been developed, with 34.2 % geographic coverage and 851 535 individuals enrolled. <b>Conclusions: </b>The PCSP sets an example for implementation of population-based colonoscopy screening with experimental design to ensure proper evaluation of its effectiveness. RHS registration number: 007_2015_1_RHS.
Aerobic training performed for short time do not decrease pulmonary allergic disease in mice
Authors: Ronaldo Aparecido da Silva, Rodolfo de Paula Vieira, Francine Maria de Almeida, Clarice Rosa Olivo, Beatriz Mangueira Saraiva, Milton Arruda Martins, Celso Ricardo Fernandes de Carvalho
Journal: European Respiratory Journal (2011)

Background:  Long term aerobic training (AT) seems to decrease airway inflammation in mice with pulmonary allergic disease.   Objective:  Investigate the effect of short on AT in a murine model of asthma.   Methods:  Male Balb/c mice were divided in 4 groups: Control, AT, ovalbumin sensitized (OVA) and OVA+AT. Sensitized groups received OVA i.p. (days 0,14, and 28) and were exposed to inhaled OVA1% (30min/3xweek) after the 21th day. The AT protocol as performed in a treadmill and began in the 28th day and was performed for 7 days (1hr/session, 50% of maximal intensity). Evaluations: In vivo respiratory mechanic (Flexivent), differential cell counting in the BALF, and collagen fibers depositions and smooth muscle thickness airways were evaluated by an image analyzer.   Results:  Physical capacity was increased just in trained groups (AT and OVA+AT; p 0.05); however, it was observed an increase in inflammatory cell migration and collagen fibers, and smooth muscle thickness in OVA and OVA+AT groups (p   Conclusions:  Short term aerobic training seems do not decrease features of pulmonary allergic disease in mice.
Quality of randomised controlled trials in head injury
Authors: C. W P M Hukkelhoven
Journal: BMJ (2000)

Editor—We agree with Dickinson et al1 that larger and better designed randomised controlled trials are necessary to detect benefits of treatment in head injury.2 But increasing the sample size is not the only solution to show efficacy. The statistical power of a study can also be improved by randomising the same number of patients but taking prognostic factors, such as age or Glasgow coma scale, into account.

Firstly, one might limit the inclusion of patients to those with an intermediate prognosis—for example, between 20% and 80% probability of a favourable outcome.3 This leads to a focus on patients for whom treatment effects can be well determined. For the same power, a reduction in sample size of 30% might be achievable.3 After showing efficacy in the intermediate risk group, additional funding may be raised more easily to study patients with a poorer or better prognosis. Note that this reasoning assumes that the relative effect of a treatment is constant across risk groups. This is in contrast to the assumption of an absolute effect of 5% as discussed by Dickinson et al. Such an absolute effect is comparatively large at a baseline incidence of 20%, as indicated by an odds ratio of 0.71 for the comparison of an incidence of 15% versus 20%. In contrast, the odds ratio is 0.82 for the same absolute effect at 50% baseline incidence (45% v 50%). The absolute effect of 5% is more easily detected at a baseline incidence of 20%, while a relative effect such as an odds ratio of 0.71 is more easily detected at an incidence of 50%. So the assumption of an absolute or relative effect is crucial in reasoning about power and inclusion criteria.

Secondly, even if inclusion would be limited to patients at intermediate risk, heterogeneity will remain regarding the probability of a favourable outcome. Predictive characteristics which account for this heterogeneity can be adjusted for in the analysis, which will increase the statistical power to detect a treatment effect.4 In an analysis of patients with acute myocardial infarction, the potential reduction in sample size was 12% by adjustment for age.5

Besides dealing with heterogeneity, we may also consider restricting data collection to the essential variables, such that larger numbers of patients are accrued at the same costs. We hope that the strategies here proposed will be applied in the study of therapy for head injury, together with an increase in funding.
Should General Practitioners Refer More Patients to Hospital?
Authors: M O Roland, C A Green, S O B Roberts
Journal: Journal of the Royal Society of Medicine (1991)

Twenty-two patients with skin problems were identified on the basis that their general practitioner was satisfied with their management and had no intention of referring them to hospital. These patients were reviewed by one of two dermatologists who made treatment recommendations in 14 cases, and these suggestions were taken up by 11 patients. Six patients reported definite subjective improvement in their skin condition six weeks later. The general practitioners found the consultation valuable in 17 cases. Although these patients might have improved without the dermatologists' intervention, a group of patients may exist who would benefit from specialist advice, even though that advice has not been sought. Restriction on hospital referrals could therefore be detrimental to patient care. Controlled trials could be conducted to determine the benefit of specialist advice on patients not currently seen in hospital.
Reliability and reproducibility of arterial stiffness by pulse wave velocity (PWV) in stable COPD patients
Authors: Isabelle Vivodtzev, Clémence Minet, Renaud Tamisier, François Arbib, Jean-Christian Borel, Jean-Philippe Baguet, Patrick Lévy, Jean-Louis Pépin
Journal: European Respiratory Journal (2012)

Background : Pulse wave velocity, a validated method for assessment of arterial stiffness, is widely used in studies evaluating cardiovascular risk and/or efficacy of new bronchodilators for improving arterial stiffness in COPD patients. However, PWV reproducibility studies are lacking in this population.   Methods : 38 stable COPD patients (79% men, 63 ± 8 years; FEV 1  = 53 ± 17 % of predicted values) were included. Using the Complior™ device, the carotido-femoral PWV was measured at baseline (d0), after 2 weeks (d15) and 6 weeks (d42). Pearson or Spearman correlation coefficients and between-sessions Interclass Coefficient Correlation (ICC) allowed comparing PWV at d0 vs. d15 (short-term reproducibility) and d42 (middle-term reproducibility). The relationship between PWV and inflammatory status (CRP, TNF and IL6) were also investigated.   Results:  Mean PWV values were 11.10 ± 1.91, 11.05 ± 2.17 and 11.24 ± 2.25 m/s at d0, d15 and d42, respectively. For short-term reproducibility (d0 vs. d15), Spearman coefficient was r = 0.78, p    Conclusion : Using the Complior™ method, PWV measurements had good reproducibility in stable COPD patients. Such assessment of arterial stiffness can be properly used as objective outcome for randomized trials.
Russian advisory telephone line of help for smoking cessation
Authors: Olga Sukhovskaya, Petr Yablonskiy
Journal: European Respiratory Journal (2012)

Effective assistance in stop smoking must include behavioral and medical therapy, a behavioral stereotype plays an important role in maintenance of nicotine dependence.  Aim. To describe the prevalence and intensity of different symptoms in relation to tobacco abstinence, personal9s abilities and demand of telephone psychological and medical counseling.  Methods. 3840 smokers (18-78 years) who rang the Russian advisory telephone line of help for smoking cessation (ATL) were interviewed about smoking (nicotine dependence, smoking behavior, motivation to quit smoking, earlier cessation experience), respiratory symptoms, personal9s traits and social status.  Results. There were men (69,4%) and women (30,9%) among the respondents (63,9% - people 18-34 years). 31,4% had high education.43% were married. The most of respondents had high motivation to quit smoking (71%). In 85% of cases smokers had experience in smoking cessation (including 8% were treated with nicotine dependence) and in 48% of cases had high intensity of withdrawal symptoms (4 and more scores) of withdrawal symptoms (more two symptoms). Frequency of respiratory symptoms among smokers was 39%, chronic disiases - 41%. 63% respondents are needed in consultation only; 31,4% received the consultative psychological and medical support during 1 month; 5,6% were sent to the hospital doctor to quit smoking. After 1-3 sessions ATL 28,4% of smokers stopped tobacco consumption.  Conclusion. Consultative telephone line helps change behavioral patterns and contributes to effective smoking cessation.
Failure of orally administered dipyridamole to enhance the antineoplastic activity of fluorouracil in combination with leucovorin in patients with advanced colorectal cancer: a prospective randomized trial.
Authors: C H Köhne, W Hiddemann, J Schüller, J Weiss, H P Lohrmann, U Schmitz-Hübner, H Bodenstein, C Schöber, H Wilke, J Grem
Journal: Journal of Clinical Oncology (1995)

PURPOSE A randomized trial was performed to investigate the ability of the nucleoside transport inhibitor dipyridamole (DP) to enhance the antitumor activity of fluorouracil (5-FU)/leucovorin (folinic acid [FA]). PATIENTS AND METHODS One hundred eighty-one untreated patients with advanced colorectal cancer were randomized to receive 5-FU 600 mg/m2 plus FA 300 mg/m2 on days 2 to 4 with or without DP 75 mg orally three times daily on days 1 to 5. Cycles were repeated every 3 weeks. Only patients with documented tumor progression before therapy were eligible. 5-FU pharmacokinetics using high-performance liquid chromatography (HPLC) were assessed in 11 nonrandomized patients receiving paired cycles with or without DP. RESULTS One hundred seventy-four patients were assessable for toxicity and response. There was no significant difference in toxicity, except DP-related headache in 24% of patients. An objective response rate of 15% (one complete response [CR] and 13 partial responses [PRs]) for 5-FU/FA and 13% (two CRs and nine PRs) for 5-FU/FA/DP was observed. The dose-intensity of 5-FU delivered was significantly higher (1.09- to 1.16-fold) for the DP-containing arm. Pharmacokinetic parameters of 5-FU did not differ significantly, except for a prolonged half-life (t1/2) induced by DP. The median time to progression (P = .8) and the median survival time (11.6 months for 5-FU/FA v 9.3 months for 5-FU/FA/DP; P = .14, log-rank test) were not different between treatment arms. CONCLUSION Orally administered DP did not improve the antineoplastic activity of 5-FU/FA in patients with advanced colorectal cancer when used at this dose and schedule. The observed increase in 5-FU dose-intensity for FU/FA/DP was not clinically relevant.
A survey on the use in clinical practice of noninvasive positive pressure ventilation (NPPV) as a first-line intervention for acute respiratory distress syndrome (ARDS)
Authors: Tomoya Katsuta, Toshimitu Suwaki, Takashi Ninomiya, Haruhito Kamei
Journal: European Respiratory Journal (2013)

BACKGROUND: Few studies have investigated non-invasive positive pressure ventilation (NPPV) in acute respiratory distress syndrome (ARDS).  OBJECTIVE: To investigate variables predictive of NPPV success and prognosis factor in patients with ARDS.  DESIGN: prospective, three hospitals cohort study.  METHOD: Predictive factor of NPPV success were analyzed with logistic regression. Prognostic factor in patients with ARDS analyzed with Cox proportional hazard model. Prognostic factor of NPPV was examined using with Cox proportional model (CPHM). Two models were examined. Namely  Model1: all prognostic factors were time-independent factors  Model2: Respiratory care was time-dependent factor and others were time-independent factors  RESULTS: NPPV failed in 51% (19/37) of patients. Stepwise analysis identified arterial pH (OR 1.94, 95% CI 1.21-3.11) and respiratory rate (OR 0.86, 95% CI 0.78-0.96). Stepwise analysis in model 1 indentified arterial pH(0.1unit) (HR 5.96, 95%CI 2.03-17.5) a simplified acute physiologic score (SAPS II) (HR 1.15 95%CI 1.05-1.26) and arterial pCO 2  (HR1.10 95%CI 1.01-1.21). However the interaction between pCO 2  and arterial pH are significant at 0.05 level. Stepwise analysis in model 2 indentified respiratory care (HR 5.44 95%CI 1.19-24.9), arterial pH(0.1 unit) (HR 3.04 95%CI 1.19-7.81),and SAPS II(HR1.12 95%CI 1.03-1.22). There is no interaction of these factors.  CONCLUSION: Time-dependents covariates are useful for examining the prognostic factors of ARDS. We decide prognostic factors of ARDS in first-line NPPV are SAPS II and arterial pH.
Non-invasive determination of alveolar pressure during mechanical ventilation
Authors: T Nicolai, C Lanteri, N Freezer, PD Sly
Journal: European Respiratory Journal (1991)

The development of inadvertent positive end-expiratory pressure (PEEPi) in ventilated infants is of clinical relevance and difficult to measure non-invasively. A method for estimating end-expiratory alveolar pressure by applying a multiple regression analysis to airway opening pressure, flow and volume recordings during mechanical ventilation was evaluated. In eight open-chested, paralysed and mechanically ventilated mongrel dogs, alveolar pressure was measured directly with "alveolar capsules". Alteration of ventilation patterns and addition of a resistive element were used in three dogs to induce different levels of PEEPi. End-expiratory alveolar pressure measured directly and determined from multilinear regression of airway opening pressure correlated well (mean error 0.06 +/- 0.53 (+/- SD) hPa, limits of agreement -1.16 to +1.04 hPa). The other five dogs received inhalation challenges, two with histamine, two with hypertonic saline and one with methacholine resulting in a mean increase of respiratory system resistance of 230% (range 141-489%) of the baseline values. The mean error in determining PEEPi was 0.54 +/- 0.37 hPa, the limits of agreement were -0.20 to 1.28 hPa. The method was then applied to seven mechanically-ventilated children (aged 2 months to 8 yrs, weight 4.9-23.5 kg) and the results were compared to the pressure at which inspiration began (equalling PEEPi). Seventy eight measurements were performed during open heart surgery, while compliance changed by between 3 and 186% of baseline values due to the surgical procedures. PEEPi estimated by multiple regression agreed well with the pressure at which inspiration began (mean difference 0.25 +/- 0.68 hPa, limits of agreement -1.12 to 1.62 hPa).(ABSTRACT TRUNCATED AT 250 WORDS)
A follow-up of a randomized study comparing two chemotherapy treatments for advanced diffuse histiocytic lymphoma.
Authors: M Todd, E Cadman, P Spiro, J Bertino, L Farber, J Waldron, D Fischer
Journal: Journal of Clinical Oncology (1984)

In 1976 we began a randomized study for the treatment of patients with stage III and IV diffuse histiocytic lymphoma. The therapy was either ACOMLA (doxorubicin, cyclophosphamide, vincristine [oncovin], methotrexate with leucovorin rescue, and cytarabine) or CHOP-B (cyclophosphamide, doxorubicin [hydroxydaunorubicin], vincristine [oncovin], prednisone, and bleomycin). A complete response (CR) was achieved in 13 (65%) of 20 patients treated with ACOMLA and in 20 (71%) of the 28 patients treated with CHOP-B. Four patients achieving CR with ACOMLA and three patients treated with CHOP-B have relapsed for an overall relapse rate of 21%. Partial response (PR) was obtained in four patients treated with ACOMLA and five patients treated with CHOP-B. Median follow-up time is 36 months for the combined treatment groups. Multiple regression analysis demonstrated that those patients who were classified by the Lukes-Collins criteria as having histiocytic lymphoma not of follicular center-cell origin (combined T- and B-cell immunoblastic sarcoma) had a significantly worse survival as compared to patients classified with follicular center-cell origin lymphoma (large cell noncleaved, large cell cleaved, and large cell unclassified) with a 40% five-year survival versus an 80% five-year survival (P = .011). The CR rate however for these two large categories of patients was 63% v 73% respectively, and the relapse rates were equivalent. The increased survival in the follicular center-cell origin lymphomas may be related to a longer survival of PRs and relapsed patients as compared to the patients with nonfollicular center-cell lymphomas.
Abstract 3339: Treatment of Choice for Severe Cardiac Amyloidosis: Heart Transplantation Combined with Chemotherapy and Stem Cell Transplantation for Patients with AL-Amyloidosis and Heart and Liver Transplantation for Patients with ATTR-Amyloidosis
Authors: Falk-Udo Sack, Arnt Kristen, Hartmut Goldschmidt, Philipp A. Schnabel, Thomas Dengler, Achim Koch, Matthias Karck
Journal: Circulation (2006)

Objective: Cardiac amyloidosis (CA) is associated with a poor prognosis and a survival rate of less than 30% 2 years after clinical manifestation. Considered as a semi-malignant disease, CA is often a contraindication for HTx; however, depending on the type of CA, there are excellent treatment regimes that can be combined with HTx. In AL-amyloidosis, chemotherapy and stem cell transplantation are necessary and in TTRamyloidosis, where the liver is the source of the pathologic protein, liver transplantation is recommended after HTx. Methods and Results: More than 60 patients with AL-amyloidosis and more than 25 patients with ATTR-amyloidosis have been investigated at our centre. Eighteen patients showed signs of end-stage heart failure. Four patients died within 1 month after listing for HTx. Seven patients with AL (mean age 41.8 years) and fivepatientswith ATTR-amyloidosis(mean age42.6years)were successfully transplanted withan actualsurvivalrate of91.6%. Onepatientdied8 months after HTx due to infection. Five AL patients received chemotherapy and SCT and one ATTR patient was liver transplanted. Three AL patients showed complete remission of amyloidosis. Conclusions: Cardiac amyloidosis is a potentially curative disease after HTx when combined with either chemotherapy and SCTor LiverTx depending on the type of the amyloidosis. Due to the natural course of the disease, urgent HTx after cardiac manifestation is mandatory. With this approach, excellent survival rates and even remission of the underlying disease is possible. # 2007 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.