tbuckley/cabot-search huggingface dataset:
Methotrexate vs azathioprine in chronic sarcoidosis
Authors: Adriane D.M. Vorselaars, Wim A. Wuyts, Veronique M.M. Vorselaars, Pieter Zanen, Vera H. Deneer, Michiel Thomeer, Jan C. Grutters
Journal: European Respiratory Journal (2012)

Background

Although steroids remain the mainstay of therapy in sarcoidosis, chronic use is associated with toxicity. Evidence is missing on which second line therapy is most appropriate.

Aim

To compare the effect of methotrexate (MTX) and azathriopine (AZA) in second line treatment of chronic sarcoidosis patients regarding steroid use, lung function and side effects.

Methods

This is a retrospective cohort study, reviewing all patients who started MTX or AZA in two Dutch/Belgian tertiary referral centres. Demographic data, steroid use, lung function tests and side effects were noted from initiation until 2 years after or discontinuation. Treatment effect was calculated with a linear mixed model with FEV1, VC, DLCO and prednisone dose changes over time as endpoints. Differences in side effects were calculated with χ2-tests.

Results

200 patients were included, 145 received MTX and 55 received AZA. Prednisone daily dose decreased with 6.32 mg/year (p<0.0001) while on therapy, with no difference between MTX and AZA. FEV1 showed a mean increase of 52 ml/year (p=0.006) and VC of 95 ml/year (p=0.001), with no difference between drugs for both. DLCO (% predicted) increased with a mean of 1.23%/year (p=0.018). Mean DLCO was 5.12% lower in the AZA group (p=0.05), but this difference was constant over time. There were significantly more patients with infections in the AZA group (26.5 vs 16.0% p=0.01). No significant differences were found regarding other side effects.

Conclusions

This is the first study comparing the effect of MTX and AZA in sarcoidosis treatment. Although more infections occurred in the AZA group, this study shows both drugs were equally effective in terms of lung function improvement and had a significant steroid sparing effect.
Sieving and reflection coefficients for sodium salts and glucose during peritoneal dialysis in rats.
Authors: T W Chen, R Khanna, H Moore, Z J Twardowski, K D Nolph
Journal: Journal of the American Society of Nephrology (1991)

The two-part studies reported herein address peritoneal membrane ultrafiltrate (UF) characteristics during peritoneal dialysis exchanges in rats. In the studies of part 1, the sieving coefficients for sodium, chloride, and total solutes during hydrostatic UF after instillation of rat serum into the peritoneal cavity of rats were calculated. Thirty-six rats were divided into six groups (N = 6) according to the following peritoneal dialysis exchange cycle times: 60, 120, 180, 240, 480, and 960 min. Thirty milliliters of pooled rat serum were infused i.p. with the animal being conscious except during infusion and drainage. The study showed in the early phase of exchanges, when oncotic and osmotic pressure gradients were absent, net UF presumably due to capillary hydrostatic pressure and sodium sieving during such UF. Sieving coefficients for sodium (0.72), chloride (0.77) and total solutes (0.73) were determined by using standard formulae. In the second part of these studies, the kinetics of fluid movement after the instillation of 5% dextrose solution into the peritoneal cavity of rats were analyzed. A very low UF rate was observed early in the exchange when the glucose gradient between the dialysis solution and blood was at its peak. The UF rate gradually increased as the sodium entered the dialysis solution from the blood. At the time of low UF rate with high glucose gradient, presumably the osmotic pressure generated by the glucose in the dialysis solution was countered by the osmotic pressure of solutes in plasma, i.e., sodium and its anions.(ABSTRACT TRUNCATED AT 250 WORDS)
Smoking among women: We need a different aproach!
Authors: Cátia Guimarães, Sandra André, Cristina Matos, Fernando Nogueira
Journal: European Respiratory Journal (2013)

Female smoking has increased dramatically over the last century, and currently about 250 million women smoke. Women have a greater risk of developing a smoke related disease and have more difficulty in quitting smoking than men.  Aim: Analysis of women’s follow up (2007-2012) of a Smoking Cessation (SC) Clinic in a Pulmonology Department.  Methods: Retrospective analysis of medical records – SC clinic questionnaire.  Results: 174 women were studied (average age: 46.6 ± 10.7 years). Only 28.7% are graduated. A respiratory disease was identified in 61.5% of patients; 45.4% of patients had a depressing mood and 50.6% had an anxiety disorder. On average, the onset of smoking was at 18 ± 6.0 years and smoking burden was 34.3 ± 19.0 pack-years. Many patients (70.7%) reported prior attempts to quit smoking. The Fagerstrom Test revealed high dependency in 23.5% of patients and the Richmond Test showed high motivation in 5.7%. Pharmacotherapy of patients: nicotine replacement therapy (NRT) to 48.3%; varenicline (V) to 39.7% and bupropion (B) to 10.4%. The SC rate at one year was 12.5% (V 62.5%, NRT 31.3% and B 6.39%) and the drop-out rate was 75.3%.  Conclusions: The SC rate was reduced and the overall drop-out rate was high. The high rates of psychiatric comorbidities, low levels of quitting motivation and education, previous attempts and the lack of a multidisciplinary women-specific health education and quitting program compete for that result. The goal is to understand what motivates women to smoke and what barriers they face when quitting. Women’s tobacco use is a global health problem and linking the specificities of nicotine dependence, smoking pattern, phase of menstrual cycle and external social factors is crucial to succeed.
Health Care Practitioners and Organizations Prepare for Approaching HIPAA Deadlines
Authors: M J Friedrich
Journal: JAMA (2001)

CAMBRIDGE, MASS—A primary aim of the Health Insurance Portability and Accountability Act (HIPAA), enacted by Congress in 1996, is to make health care more efficient through the use of standardized electronic transactions. This approach, adopted by virtually every major business other than health care, simplifies administrative and financial tasks, saving money and time. But while the computerization of medical records may be a necessary step forward for health care, it needs to be done without compromising the privacy of patients. To this end, not only does HIPAA call for national standards and procedures for the electronic storage and transmission of health care information, but the law requires that regulations to ensure privacy and security of health information be instituted and followed. As deadlines draw near for the implementation of HIPAA regulations, the health care community faces the task of responding to this many-faceted law. At the colloquium, Healthcare Transactions and Code Sets, Privacy, Data Security, and HIPAA/GLB Compliance, held here in August, attorneys, policymakers, practitioners, and other experts spoke about HIPAA regulations and what health care providers and organizations need to do to comply with this legislation.
Important Role of Menarche in Development of Estrogen Receptor–Negative Breast Cancer in African American Women
Authors: Christine B. Ambrosone, Gary Zirpoli, Chi-Chen Hong, Song Yao, Melissa A. Troester, Elisa V. Bandera, Pepper Schedin, Traci N. Bethea, Virginia Borges, Song-Yi Park, Dhyan Chandra, Lynn Rosenberg, Laurence N. Kolonel, Andrew F. Olshan, Julie R. Palmer
Journal: JNCI Journal of the National Cancer Institute (2015)

Background:Menarche is a critical time point for diverging fates of mammary cells of origin. African American women have young age at menarche, which could be associated with their high rates of estrogen receptor–negative (ER-) breast cancer.
Phase II Clinical Investigation of Gemcitabine in Advanced Soft Tissue Sarcomas and Window Evaluation of Dose Rate on Gemcitabine Triphosphate Accumulation
Authors: Shreyaskumar R. Patel, Varsha Gandhi, Jan Jenkins, Nicholas Papadopolous, M. Andrew Burgess, Carl Plager, William Plunkett, Robert S. Benjamin
Journal: Journal of Clinical Oncology (2001)

PURPOSE: To evaluate the efficacy, toxicity, and optimal dose rate of gemcitabine in adult patients with advanced soft tissue sarcomas (STS) by comparing levels of gemcitabine triphosphate (GTP) in peripheral-blood mononuclear cells (PBMCs) of patients receiving two different dose rates. PATIENTS AND METHODS: Fifty-six assessable patients with STS (17 gastrointestinal [GI] leiomyosarcomas and 39 other histologies) were treated on a two-arm phase II study. Gemcitabine was given at 1 g/m 2 as a 30-minute infusion weekly for up to 7 weeks followed by 1 week of rest and reassessment of tumor. Subsequent cycles were given at 1 g/m 2 weekly for 3 weeks followed by 1 week of rest. Nine patients underwent cellular pharmacologic studies at two different dose rates (1 g/m 2 over a standard 30-minute infusion on week 1 and over pharmacologically based infusion of 150 minutes on week 2) to evaluate GTP levels in PBMCs. RESULTS: Seven partial responses were noted among 39 patients, for an overall response rate of 18% (95% confidence interval, 7% to 29%). Median duration of response was 3.5 months (range, 2 to 13 months). Four of 10 patients with non-GI leiomyosarcomas achieved a partial response. No objective responses were noted in 17 patients with GI leiomyosarcomas. One patient had a mixed response. Median time to progression for all patients (both arms) was 3 months; median survival was 13.9 months. Treatment was generally well tolerated. Comparison of cellular pharmacology demonstrated a significant 1.4-fold increase in the concentration of GTP with the 150-minute infusion. CONCLUSION: Given the limited therapeutic armamentarium for STS, the activity of gemcitabine is encouraging. Its potential for combination therapy in the salvage setting should be studied with pharmacologically guided fixed dose-rate infusion.
Characterisation of human outbreaks of brucellosis and sporadic cases by the use of hyper-variable octameric oligonucleotide fingerprint (HOOF) variable number tandem repeats
Authors: S. Valdezate, I. Cervera, P. Hernandez, A. Navarro, J. A. Saéz Nieto
Journal: Clinical Microbiology and Infection (2007)
The use of two substrates to improve the sensitivity of indirect immunofluorescence in the diagnosis of pemphigus
Authors: K.E. Harman, M.J. Gratian, B.S. Bhogal, S.J. Challacombe, M.M. Black
Journal: British Journal of Dermatology (2000)

Abstract The aim of this study was to re-evaluate indirect immunofluorescence (IIF) comparing two substrates, normal human skin (HS) and monkey oesophagus (MO) using serum from 29 pemphigus patients classified according to the presence of serum autoantibodies to either desmoglein (Dsg) 1 or Dsg3 detected by enzyme-linked immunosorbent assay (ELISA). Overall, the sensitivity of IIF was 83% on HS and 90% on MO. When data from both substrates were combined, the sensitivity increased to 100%. When sera from pemphigus foliaceus (PF) patients were studied, which contained Dsg1 antibodies only, the sensitivity of IIF was greatest on HS and titres were on average 4·8 doubling dilutions higher than on MO. In contrast, when sera containing autoantibodies only to Dsg3 from pemphigus vulgaris (PV) patients was studied, the sensitivity was greatest on MO and titres were on average 4·4 doubling dilutions higher than on HS. There was a significant correlation between Dsg1 antibody levels and IIF titres on HS and between Dsg3 antibody levels and IIF titres on MO. The investigation of immunobullous disorders in the future is likely to move towards antigen-specific techniques such as the Dsg ELISAs used in this study. However, in laboratories which currently rely on IIF for detecting pemphigus autoantibodies, the data presented in this study strongly suggest that two substrates should be used for IIF screening: one rich in Dsg1, such as HS, and the other rich in Dsg3, such as MO. This combination of substrates should not only increase the sensitivity of detecting pemphigus antibodies, but will aid in the differentiation of PV from PF. It is also possible that the data might be more useful for disease monitoring.
A randomized placebo-controlled trial of recombinant human interleukin-11 in cancer patients with severe thrombocytopenia due to chemotherapy
Authors: Isidore Tepler, Laurence Elias, John W. Smith, Mohamad Hussein, Gerald Rosen, Alex Y.-C. Chang, Joseph O. Moore, Michael S. Gordon, Bernice Kuca, Kathleen J. Beach, John W. Loewy, Marc B. Garnick, James A. Kaye
Journal: Blood (1996)
Adjuvant radiation versus observation: a cost analysis of alternate management schemes in early-stage testicular seminoma.
Authors: N N Sharda, T J Kinsella, M A Ritter
Journal: Journal of Clinical Oncology (1996)

This study was designed to compare costs of adjuvant radiation versus observation in the management of early-stage testicular seminoma after inguinal orchiectomy.A line-by-line inspection of the charges generated during a course of adjuvant pelvic and paraaortic radiotherapy and of three cycles of bleomycin, etoposide, and platinum salvage chemotherapy was performed for five patients who received irradiation and five patients who received salvage chemotherapy. The average charge for either treatment was then calculated. Only those charges directly associated with the diagnosis of seminoma were included in the analysis. Follow-up charges were also generated from the patients' billing records. The optimum follow-up regimen for either management option was derived from a synthesis of the international literature. A 5% rate of failure was assumed if adjuvant irradiation was administered, and a 15% rate of failure was assumed if observation was the option chosen. Charges were truncated at 5 years.The total charge generated over 5 years based on following a policy of observation is $27,223 per patient versus $19,557 if the option of adjuvant irradiation in chosen. Using University of Wisconsin institutional reimbursement rates, the estimated costs were $20,487 and $14,722 for the option of observation and adjuvant radiation, respectively. The cost equivalence point between the two options occurs at 2.5 years, when the initial cost of adjuvant radiotherapy is matched by the cost generated during the period of observation. The maximum cost difference is achieved by 5 years.Following a policy of observation postorchiectomy for early-stage testicular seminoma generates 39% more medical costs per patient over a 5-year follow-up period than does following the standard policy of adjuvant irradiation to the pelvic and paraaortic regions, with no reported difference in outcome.
Consolidation docetaxel after paclitaxel-carboplatin chemotherapy in stage Ic-IV ovarian cancer.
Authors: R. Matsumoto, S. Isonishi, M. Suzuki, H. Nagano, K. Takagi, K. Ochiai, T. Tanaka
Journal: Journal of Clinical Oncology (2010)

e15536 Background: To test the concept of taxane sequencing in combined-modality therapy, this feasibility trial evaluated consolidation docetaxel after paclitaxel/carboplatin combination chemotherapy in patients with pathologically documented stage Ic-IV ovarian cancer. Methods: All the patients received debulking surgery and primary treatment consisted of carboplatin AUC 6 and paclitaxel 180 mg/m2 on day 1. Prior to consolidation chemotherapy, confirmation of no evidence of residual tumor was established by computed tomography scan, magnetic resonance imaging, or ultrasound sonography. Consolidation docetaxel started 4 to 6 weeks after the last chemotherapy at an initial dose of 70 mg/m2and repeated every 4 weeks for no less than 6 cycles. All patients were informed of the investigational nature of this study and signed a written informed consent in accordance with local institutional review board and administrative guidelines. Primary endpoint of this study was the evaluation of toxicities and the secondary endpoint was progression-free survival. Results were compared with those of the previous study with identical eligibility, staging criteria, and treatment, excepting for docetaxel consolidation. Results: Stage subsets in 18 eligible patients were as follows: T1, 1 patient (5.6%), T2, 1 patient (5.6%), T3, 11 patients (61.1%), and T4, 5 patients (27.8%). Paclitaxel-carboplatin combination chemotherapy was generally well tolerated and severe adverse events were not observed in this cohort. Neutropenia during consolidation docetaxel was common (22.2 % with grade 3 or 4) and was most frequent during second cycle. Median progression-free survival was 14.0 months with median follow up period of 15.0 months and 1-year survival rate was 66.7%. In historical control, median survival was 14.1 months and 1-year survival rate was 52.2%. Conclusions: Consolidation docetaxel after paclitaxel/carboplatin combination chemotherapy in ovarian cancer is feasible and generally tolerable. Nevertheless, this study does not provide definitive evidence of the survival benefit of this approach. Phase III trials evaluating the docetaxel consolidation regimen have been initiated to validate these results. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration sanofi-aventis sanofi-aventis
Studying the control of breathing in man
Authors: H Folgering
Journal: European Respiratory Journal (1988)

The control system of breathing can be considered as a closed-loop system, consisting of two subsystems: the controlling system and the controlled system. Both subsystems are defined by their input-output relationships. In the controlling system the input is the blood gas value; the output is some parameter of ventilation. The controlled system is characterized by an input of ventilation, and an output of blood gas values. In the closed-loop situation the control of breathing can be influenced by outside "disturbances", threatening to disrupt the regulation of the constancy of the internal environment. When studying the control of breathing, and therefore studying the strengths or defects of this homeostatic system, one has to decide whether one intends to investigate the closed-loop or the open-loop situation, and which defect in a subsystem may be the cause of a disrupted homeostasis. What non-feedback stimuli may be active at the moment of the investigation? How can they be kept constant or eliminated? What possible effects from drugs, beverages, nutrients (possibly consumed hours earlier) may still be present? In particular, the output parameters of the controlling system should be carefully chosen to represent that part of the system that one intends to investigate. Disruptions of the control of breathing may have serious consequences for several categories of patients, e.g. those with chronic obstructive pulmonary disease (COPD), asthma, sleep apnoea, sudden infant death syndrome, several neurological syndromes, and the hyperventilation syndrome. Adequate investigation of the control of breathing in these patients is of great importance for their treatment.
Does eosinophil cationic protein (ECP) predict asthma outcome and response to treatment in asthmatic patients
Authors: Elena Bacci, Silvana Cianchetti, Manuela Latorre, Lorenza Melosini, Antonella Di Franco, Federico Dente, Pier Luigi Paggiaro
Journal: European Respiratory Journal (2012)

In order to test whether sputum Eosinophil Cationic Protein (ECP) predicts asthma outcome and response to treatment, we studied 119 mild/moderate, steroid-naive asthmatic patients. All patients underwent spirometry, methacholine test, induced sputum analysis before and after treatment, and recorded symptom score and rescue beta2-agonist use on a diary card throughout the study. In patients with high (≥75 mcg/L) sputum ECP, baseline FEV1 was lower (high-ECP: 85±17%; low-ECP: 96±14%, p
Antitumor Antibody Synthesis In Vitro Induced in Mouse Spleen Cells by Xenogeneic Immune RNA 2
Authors: David H. Kern, Yosef H. Pilch
Journal: JNCI Journal of the National Cancer Institute (1978)

Journal Article Antitumor Antibody Synthesis In Vitro Induced in Mouse Spleen Cells by Xenogeneic Immune RNA Get access David H. Kern, David H. Kern Search for other works by this author on: Oxford Academic PubMed Google Scholar Yosef H. Pilch Yosef H. Pilch 4 4Address reprint requests to Dr. Pilch at his present address: Division of Oncology, Department of Surgery, University of California at San Diego, School of Medicine, University Hospital, 225 West Dickinson St., San Diego, Calif. 92103. Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 60, Issue 3, March 1978, Pages 599–603, https://doi.org/10.1093/jnci/60.3.599 Published: 01 March 1978 Article history Received: 14 February 1977 Revision received: 21 September 1977 Accepted: 14 October 1977 Published: 01 March 1978
Is Increased Use of Mechanical Circulatory Support Devices Justified?
Authors: Prakash Deedwania, Tushar Acharya
Journal: JAMA Internal Medicine (2015)

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Prognostic value of outcome variables at follow-up in patients with PAH
Authors: Christine Brodherr, Carolin Schild, Tobias Meis, Gregor Zimmermann, Andrea Waelde, Jürgen Behr, Claus Neurohr
Journal: European Respiratory Journal (2014)

Background:

Current treatment goals in patients with pulmonary arterial hypertension (PAH), correlating with long-term outcome are WHO functional class (FC) I or II, hemodynamic assessment with right atrial pressure (RA)   2.5 l/min/m², 6-min walk distance (6-MWD) >380 m and BNP within normal limits.

Methods:

We performed a retrospective analysis of 76 consecutive patients with PAH class I (49 female, age 52.7 ± 19.0 years , WHO FC II-IV) were followed up for 5.6 ± 4.4 years.

All patients were started on monotherapy (PDE-5-inhibitors, ERA, prostacyclines p.i.) and follow up assessment including right heart catheterization was performed after 6.8 ± 3.9 months.

Baseline characteristics were as follows: mean pulmonary-artery pressure was 51.8±13.2 mmHg, RA 8.8±5.0 mmHg, BNP 322.2±398.0 ng/l, 6-MWD 364.5±120.4 m.

During follow-up 21 patients died (27.6%).

For the survival analysis was performed using the Kaplan-Meier method. Ap-value < 0,05 was considered statistically significant.

Results:

Survival analysis revealed a significant better survival in patients reaching FC class I or II (p=0,012), BNP within normal limits (p=0,001) and 6-MWD >380m (p=0,007). Hemodynamic parameters were not significantly correlated with survival (p>0,05).

At baseline 5 patients (6,6%) and under therapy 18 patients (23,7%) reached FC class I or II.

42 patients (55,3%) under therapy in comparison to 30 patients (39,5%) at baseline reached an 6-MWD > 380m.

25 patients (32,9%) without and 29 patients with monotherapy (38,2%) reached BNP values within normal limits.

Conclusions:

Our data suggest that reaching predefined therapeutic goals in PH patients improves overall long-term survival.