tbuckley/cabot-search huggingface dataset:
Optimal Duration of Preoperative Therapy in Unilateral and Nonmetastatic Wilms’ Tumor in Children Older Than 6 Months: Results of the Ninth International Society of Pediatric Oncology Wilms’ Tumor Trial and Study
Authors: M. F. Tournade, C. Com-Nougué, J. de Kraker, R. Ludwig, A. Rey, J. M.B. Burgers, B. Sandstedt, J. Godzinski, M. Carli, R. Potter, J. M. Zucker
Journal: Journal of Clinical Oncology (2001)

PURPOSE: To determine the optimal duration of preoperative chemotherapy to further increase the proportion of stage I tumors by comparison of two regimens in the treatment of patients older than 6 months who have unilateral Wilms’ tumor. PATIENTS AND METHODS: Eligible patients (n = 382) initially received four weekly doses of vincristine (VCR) and two courses of actinomycin D (AMD) and were randomized either to be operated on (4-week group [n = 193]) or to receive 4 more weeks of the same chemotherapy regimen (8-week group [n = 189]). The assessment criterion was the observed percentage of stage I tumors. After surgery, patients were assigned according to tumor stage and histology to four different treatment groups: stage I and favorable histology (n = 5) were to have no further treatment (NFT); stage I and standard histology or anaplasia (n = 244), VCR and AMD for 17 weeks (AV); stages II and III and favorable or standard histology, VCR, AMD, and an anthracycline for 27 weeks (AVE) with no abdominal radiotherapy for stage II N0 disease (n = 75) or with a 15-Gy dose of abdominal irradiation (RTH) in case of stages IIN1 and III (n = 56). Anaplastic tumors staged higher than I or clear-cell sarcoma of the kidney (14), AMD, VCR, an anthracycline, and ifosfamide for 36 weeks (DEVI). RESULTS: No advantage was found in favor of prolonged preoperative treatment. The percentages obtained for the 4-week and the 8-week groups, respectively, were as follows: stage I, 64% versus 62%; intraoperative tumor rupture rate, 1% versus 3%; 2-year EFS, 84% versus 83%; and 5-year OS, 92% versus 87%. Two-year EFS and 5-year OS rates, respectively, of the different treatment groups were as follows: NFT, 100% for both EFS and OS; AV, 88% and 93%; AVE, 84% and 88%; AVE RTH, 71% and 85%; and DEVI, 71% and 71%. The rate of abdominal recurrences in stage II N0 nonirradiated patients was 6.6%. CONCLUSION: The 4-week schedule pre-nephrectomy chemotherapy regimen should be considered the standard treatment. Clinical trials should continue to improve the cure rate of high-risk patients and the quality of life of children with a more favorable prognosis.
Outcomes of bedside talc slurry pleurodesis for malignant pleural effusions: A retrospective analysis
Authors: Rina Adhikary, Dipansu Ghosh, Elankumaran Paramasivam, Matthew Callister
Journal: European Respiratory Journal (2013)

Introduction   Current guidelines recommend either administration of talc slurry via an intercostal drain or talc poudrage by thoracoscopy for the treatment of symptomatic malignant pleural effusions. Published success rates for bedside pleurodesis range from 60 - 95%, however anecdotally these rates are more commonly at the lower end of the spectrum in clinical practice. The issue is complicated by lack of standardized definition of “success” making it difficult to compare different studies. We explored the outcomes of talc pleurodesis in our setting.   Methods   All patients undergoing talc pleurodesis from February 2009 to April 2011 were included. A retrospective analysis of their hospital records and thoracic imaging was undertaken. Primary outcomes were fluid recurrence & need for further interventions.   Results   41 patients underwent bedside pleurodesis for malignant pleural effusion; 25 for lung malignancy and 16 for other malignancies. 15 patients required further interventions (repeat drainage, VATS, PleurX drain, etc.) 26 (63%) patients did not require further intervention; however fluid re-accumulation was noted in 21 (51%) patients.   Conclusions   63% of patients required no further intervention; this success rate is comparable with other published studies accepting the difficulty of a direct comparison, but is lower than talc poudrage (80 - 90%). This raises the issue whether thoracoscopic pleurodesis should be the intervention of choice in more patients.
Effectiveness of varenicline as an aid to smoking cessation in primary care: An observational study
Authors: Stefan Andreas, Jean-Francois Chenot, Ruth Diebold, Sarah Peachey, Karl Mann
Journal: European Respiratory Journal (2012)

Introduction:  The effectiveness and safety of varenicline have been well established in randomized controlled trials. In the primary care setting, in which varenicline is commonly prescribed, only limited information is available on its use in patients with smoking-related comorbidities.   Objective:  To assess the efficacy and safety of varenicline in a large sample of patients seeking smoking cessation treatment through their general practitioners.   Methods:  This was a 12-week, prospective, observational, non-comparative phase IV trial conducted in Germany. The primary endpoint was the 7-day point prevalence of abstinence rate at Week 11–12, evaluated by verbal report using the nicotine use inventory.   Results:  Overall 1391 subjects were enrolled; 1177 received study medication and were evaluated for efficacy and safety. A total of 66.7% participants had at least one concurrent comorbidity, chronic obstructive pulmonary disease (35.5%), hypertension (29.6%), depression (10.4%), diabetes mellitus (8.2%), and asthma (7.9%) being the most commonly reported. In the 7-day period between Weeks 11 and 12, 837 of 1177 subjects (71.1%; 95% confidence interval: 68.5, 73.7) were abstinent. A total of 205 all-causality adverse events were reported in 130 subjects (11.0%), of which 189 (in 122 participants [10.4%]) were considered treatment-related, and 2.2% were classified as serious or severe. There were no fatal adverse events.   Conclusion:  These real-world data indicate that even in a setting outside of the clinical trial environment, and in patients with smoking-related comorbidities, varenicline is an effective smoking cessation aid with an acceptable safety profile.
Effectiveness of smoking cessation skills building workshops in educating smoking cessation techniques to Pakistani physicians
Authors: Ahmed Suleman Haque, Muhammad Irfan, Zeeshan Waheed, Javaid Khan
Journal: European Respiratory Journal (2012)

Introduction: Physician advice to quit smoking is an effective component of a smoking cessation strategy. Published data indicates that teaching/training smoking cessation skills to physicians improves their smoking cessation practices and increases quit rates among their patients.   Objective:  To determine the effectiveness of smoking cessation skills building workshops (SCW) among local physicians.   Methods:  Five one-day SCW were arranged across Pakistani cities. A validated questionnaire assessing attitude and knowledge related to smoking was administered pre-workshops (PRW) and immediately post-workshops (POW) attendance.   Results:  113 physicians completed the SCW. 90 were men. Age range was 22-61 years (mean age ±SD 37±11 yrs). 72 were GPs, 11 chest physicians, 11 cardiologists, 8 consultant internist and 11 trainee physicians.  Post workshop the physicians felt 9very confident9 about their knowledge to treat nicotine dependence- 15.9% (PRW) vs. 64.6% (POW); they felt 9very confident9 in discussing the smoking cessation issues with their patients- 52.2% (PRW) vs. 80.9% (POW); their knowledge regarding pharmacotherapy improved- 9.7% (PRW) vs. 49.1% (POW). The 5As approach was answered correctly by 17.7% (PRW) vs. 69.9% (POW). Appropriate prescribing of Nicotine Replacement Therapy improved - 39.8% (PRW) vs. 61.1% (POW). Awareness of possible adverse effects of medications enhanced - 46.9% (PRW) vs. 71.1% (POW).   Conclusion:  After attending a one-full day smoking cessation skills building workshop, physician9s felt more confident in discussing anti-smoking issues with their patients and their smoking cessation knowledge improved significantly.
Ten Years of Progress in Head and Neck Cancers
Authors: Shrujal Baxi, Matthew Fury, Ian Ganly, Shyam Rao, David G. Pfister
Journal: Journal of the National Comprehensive Cancer Network (2012)

Squamous cell carcinoma of the head and neck (HNSCC) is a heterogenous disease characterized by complex clinical and pathologic presentations constituting approximately 90% of all head and neck cancers.The past decade has seen important advances in our understanding of the epidemiology, pathogenesis, and management of HNSCC.It is a disease increasingly managed by a multidisciplinary team of providers, as reflected in the updates of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Head and Neck Cancers (to view the most recent version of these guidelines, visit NCCN.org).
Transplantation Technique for Acceleration of Carcinogenesis by Benz[&lt;italic&gt;a&lt;/italic&gt;]anthracene or 3,4,9,10-Dibenzpyrene [Benzo (rst) penta-phene]&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: F. Homburger, A. Treger
Journal: JNCI Journal of the National Cancer Institute (1970)

Transplantation of multiple pooled injection sites of 25 μg of benzo(rst)pentaphene (DBP) or 500 μg of benz[a]anthracene (BA) in tricaprylin (glycerol trioctanoate) from 4 C57BL/6 J male mice into 1 secondary host of the same strain and sex yielded palpable tumors in approximately half the time required for development of similar tumors after single subcutaneous injection of the same dose of these carcinogens. When BA was left in situ, 2 tumors developed among 48 mice 52 weeks following the original injection, whereas significant tumor incidences occurred within 24 weeks after the original injection when site transfers had been made 8, 12, 16, or 24 weeks after the administration of carcinogen. Site transfers made 8 weeks after the original injection yielded 67% tumors 24 weeks after injection of the carcinogen. Following site transfers made 12 weeks after the first injection there were 80% tumors 12 weeks later. More delayed site transfers gave lower tumor yields. With DBP, the first tumor appeared 12 weeks after single injection, whereas, following transplantation of injection site 6 weeks later, the first tumor appeared 9 weeks after the original injection.
Do characteristic airway epithelial change precede the development of lung fibrosis? Ectopic epithelial marker protein expression in bleomycin induced fibrosis replicates that seen in bronchiolized epithelium in IPF
Authors: Colin Bingle, Bianca Araujo, Helen Marriott, William Wallace, Nikhil Hirani, Lynne Bingle
Journal: European Respiratory Journal (2012)

The cause Idiopathic Pulmonary Fibrosis (IPF) remains elusive but there is support for the view that epithelial cell damage within the peripheral lung initiates the process that ultimately results in fibrosis. Unfortunately, markers of this process remain elusive due in part to most human studies being performed with tissues from end-stage disease. Ectopic expression of the gel forming mucin, MUC5B was recently described as a specific marker for the bronchiolized epithelium seen in IPF and we have shown that it is co-expressed in this region with LPLUNC1 but not with other airway submucosal gland proteins, including Zinc-alpha2-glycoprotein and Proline-rich protein 4. To shed light on a temporal association of expression of these markers with fibrosis development we studied mice exposed to the pro-fibrotic agent bleomycin (Bleo). MUC5B and LPLUNC1 were co-expressed in a population of goblet cells in the airways of mice within 3-7 days of Bleo exposure, prior to the onset of a fibrosis. Continued expression is seen during the development of fibrosis between 14-21 days post treatment. In contrast, in mice treated with PBS neither protein was seen (due to mouse airways being essentially free of goblet cells). Staining was absent from the fibrotic regions and the lung parenchyma, as is the case in IPF. Our data show that the ectopic expression seen in human IPF is mirrored by that seen in the Bleo mouse model. Furthermore it suggests that these epithelial remodeling events precede the development of lung fibrosis and these can be studied in mice.
Demonstration of Cellular Immunity Against Urethan-Induced Lung Adenomas of Mice&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: Maria I. Colnaghi, Sylvie Ménard, Giuseppe Della Porta
Journal: JNCI Journal of the National Cancer Institute (1971)

The tumor-specific antigenicity of urethan-induced murine lung adenomas was studied with an in vitro microassay for cell-mediated cytotoxicity. SWR mice were immunized with pooled adenomas from syngeneic animals that had been treated in infancy with 5 doses of urethan, 0.2 mg/g body weight, alone or combined with cortisone or cyclophosphamide. Direct tests on target cells from the same tumors used for immunization of the donors of effector cells were positive in 5 of 6 tumors from mice treated with urethan plus an immunodepressor, and negative in the 3 tumors from mice given urethan only. In the cross-reaction combinations, when target cells were from tumors of animals treated with urethan plus immunodepressor and effector cells from animals immunized with tumors of the same experimental group, 9 of 13 tests were positive, whereas the 4 tests with effector cells from animals immunized with tumors induced in mice given urethan only were negative. The 6 tests on tumors from mice administered urethan only, and effector cells from animals immunized with tumors from all the 3 experimental groups, were negative. In addition, the time of subcutaneous take of adenomas from the immunodepressed groups was significantly longer than that of adenomas from animals treated with urethan only. These results show that urethan-induced lung adenomas had an in vitro detectable cross-reacting antigenicity that depended on the immunological status of the tumor donors, suggesting an immunoselective process in the animals without the immunodepressive treatment.
Use of simple advice and behavioural support
Authors: Tim Coleman
Journal: BMJ (2004)

The most effective methods of helping smokers to quit smoking combine pharmacotherapy (such as nicotine or bupropion) with advice and behavioural support. These two components contribute about equally to the success of the intervention. Doctors and other health professionals should therefore be familiar with what these strategies offer, encourage smokers to use them, and be able at least to provide simple advice and behavioural support to smokers. They also need to be familiar with other sources of support, such as written materials, telephone helplines, and strategies for preventing relapses. This article focuses on non-pharmacological interventions.

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The Cochrane Tobacco Addiction Group defines brief advice against smoking as “verbal instructions to stop smoking with or without added information about the harmful effects of smoking.” All the published guidelines on managing smoking cessation recommend that all health professionals should give simple brief advice routinely to all smokers whom they encounter. The success rate of brief advice is modest, achieving cessation in about 1 in 40 smokers, but brief advice is one of the most cost effective interventions in medicine. The previous article in this series gave tips on how to take account of smokers' motivation to stop, but the key point is that only one or two minutes are needed for effective brief advice to be delivered in routine consultations.



Cost effectiveness of brief advice versus common medical interventions



Advice along these lines is probably most effective in smokers with established smoking related disease. It is also more effective if more time is spent discussing smoking and cessation and if a follow up visit is arranged to review progress. More intensive advice (taking more than 20 minutes at the initial consultation), inclusion of additional methods of reinforcing advice (such as self …
The incidence of interstitial and vascular kidney rejection after pancreas-kidney transplantation.
Authors: J G Boonstra, J A Bruijn, J Hermans, H H Lemkes, J Ringers, H van der Pijl, F J van der Woude
Journal: Journal of the American Society of Nephrology (1995)

Several groups have reported that recipients of a simultaneous pancreas-kidney transplantation suffer from more kidney rejection episodes than do recipients of a kidney transplantation (1-6). However, it is not known whether this is interstitial rejection, vascular rejection, or both. In this study, the renal biopsies and transplantectomies of 45 pancreas-kidney and 48 kidney transplant recipients were evaluated for the presence of interstitial and vascular rejection. Furthermore, the influence of OKT3 induction therapy on rejection after pancreas-kidney transplantation was studied. Of the 45 pancreas-kidney recipients. 4 patients did not suffer from rejection during follow-up, 28 suffered only from interstitial rejection, and 13 suffered from vascular (with or without interstitial) rejection, whereas 12, 19, and 14 of the 48 kidney transplant patients had no rejection, interstitial rejection, or vascular (with or without interstitial) rejection, respectively. Three patients with a kidney transplant were treated for rejection although no biopsy was taken. In the pancreas-kidney group, 38 of the total of 149 biopsies and transplantectomies taken contained no rejection, 92 had interstitial rejection, and 19 had vascular rejection. In the kidney group, these values were 13, 41, and 25, respectively, of 79 biopsies and transplantectomies taken (P = 0.002). Five-year renal graft survival was 79% in the kidney group and 60% in the pancreas-kidney group. Renal graft survival rates differed significantly (P = 0.02). Renal graft survival and occurrence of rejection did not reach significance between pancreas-kidney recipients treated with OKT3 induction therapy and pancreas-kidney recipients receiving conventional triple therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
Structural lung disease, pulmonary infection and inflammation in infancy is associated with reduced spirometry at school-age in children with cystic fibrosis (CF)
Authors: Kathryn Ramsey, Sarath Ranganathan, Billy Skoric, Barry Linnane, Peter Franklin, Peter Sly, Stephen Stick, Graham Hall
Journal: European Respiratory Journal (2013)

Introduction: Pulmonary inflammation, infection and structural lung disease occur early in life in children with CF leading to lung function decline. We aimed to determine if these markers of CF lung disease in infancy altered spirometry outcomes at school-age. Methods: Infants (0-2 years) with CF diagnosed following newborn screening had annual bronchoalveolar lavage fluid collected to assess infection and inflammation and computed tomography (CT) scans to assess structural lung disease. Ninety-four children were followed up with lung function (FEV0.5) at 6-8 years of age and 59 children had lung function measured at both infancy and school-age. Results: Children with CF who were pancreatic insufficient had 9.6% (n=80) lower FEV0.5 compared with sufficient children (n=14; p = 0.03). The presence of air trapping on CT in infancy was associated with 14.5% lower FEV0.5 at school-age (p = 0.03). In children with longitudinal measurements of lung function infection with P. aeruginosa or H. influenzae in infancy was associated with a lower FEV0.5 (15.8% and 18.2%; respectively) compared with never infected (p = 0.04). The presence of free neutrophil elastase (NE) during infancy (n=23) was associated with a 13.5% reduction in FEV0.5 compared with CF children without NE (n=36; p = 0.01). Conclusions: In children with CF the presence of air trapping on CT, lower airway infection and free NE during infancy was associated with clinically-significant reductions in lung function in the early school years, highlighting the need for targeted interventions during infancy.
Antigenic Properties of Lymphomas Induced by the Moloney Agent&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: Eva Klein, George Klein
Journal: JNCI Journal of the National Cancer Institute (1964)

Mouse lymphomas induced by the Moloney agent were strongly antigenic in isologous hosts, as indicated by transplantation and serologic tests. Specific transplantation resistance was established by pretreatment of the recipients with homografts of other Moloney lymphomas, small isografts of the same lymphoma, or virus-containing lymphoma homogenates. Extensive cross-resistance was demonstrated between different Moloney lymphomas, while there were no certain cross-reactions between Moloney lymphomas and lymphomas induced by the Gross virus, or between Moloney lymphomas and a number of long-transplanted lymphomas. Total-body X irradiation with 400 r reduced the minimum number of cells required for the take and growth of Moloney lymphoma cells after inoculation into untreated isologous recipients. Establishment of specific transplantation resistance by one of the procedures mentioned was paralleled by the appearance of humoral antibodies in the serum, detectable by the indirect fluorescent-antibody reaction and by cytotoxicity in the presence of complement. The fluorescence test was specific for Moloney, while the cytotoxic test indicated certain cross-reactions. Moloney target cells were killed only by anti-Moloney sera, but some hyperimmune anti-Moloney sera also killed cells of Gross lymphomas and some long-transplanted lymphomas. Preliminary absorption tests indicated efficient and complete removal of the activity directed against the Moloney lymphomas by absorption with Moloney cells and no removal, or partial removal, with the cross-reacting lymphomas of other types. Thus, all experiments indicated that lymphomas induced by the Moloney agent differ from lymphomas of other types with regard to their antigenic specificity, but the possibility that the difference may be quantitative rather than qualitative cannot be excluded.
Acupuncture for vulvodynia
Authors: J Powell, F Wojnarowska
Journal: Journal of the Royal Society of Medicine (1999)

Vulvodynia is the sensation of burning and/or pain of the vulva in the absence of abnormal clinical findings. We offered acupuncture to twelve patients with this syndrome. All had experienced severe distress and impairment of sexual function and usual treatments had failed. The patients attended weekly for acupuncture and progress was monitored at each visit by enquiry, a questionnaire and a visual analogue scale for pain. Half had treatment for the first five weeks only, the other half for the second five weeks only. Side-effects were negligible. Two patients felt so much improved that they declared themselves 'cured'; three believed their symptoms had improved and wished to continue acupuncture; four felt slightly better and judged acupuncture more effective than any other treatment; and three noted no effect at all. Acupuncture is time-consuming and a large part of its beneficial effect in this study may have come from the regular specialist contact. However, in view of the patients' lack of response to other measures their satisfaction with the acupuncture was surprisingly high.
In Vivo Demonstration of Frail Neointimal Tissue Embolization After Angioplasty With a Drug-Coated Balloon Confirmed by Optical Coherence Tomography and Histology
Authors: Sungsoo Cho, Hoguen Kim, Jung-Sun Kim, Byeong-Keuk Kim, Yangsoo Jang, Myeong-Ki Hong
Journal: Circulation (2015)