tbuckley/cabot-search huggingface dataset:
Prognostic Factors for Poor Cognitive Development in Children Born Very Preterm or With Very Low Birth Weight
Authors: Louise Linsell, Reem Malouf, Joan Morris, Jennifer J. Kurinczuk, Neil Marlow
Journal: JAMA Pediatrics (2015)

Cognitive delay is the most common form of impairment among children born very preterm (VPT) at 32 weeks or less or with very low birth weight (VLBW) of 1250 g or less. It is important to identify factors that are robust predictors of long-term outcome because the ability to predict future prognosis will assist in health care and educational service planning and provision.To identify prognostic factors for poor cognitive development in children born VPT or with VLBW.A systematic review was conducted using MEDLINE, EMBASE, and PyscINFO databases to identify studies published between January 1, 1990, and June 1, 2014, reporting multivariable prediction models for neurodevelopment in VPT or VLBW children. Thirty-one studies comprising 98 risk factor models for cognitive outcome were identified. Two independent reviewers extracted key information on study design, outcome definition, risk factor selection, model development, and reporting and conducted a risk-of-bias assessment.There was evidence that male sex, nonwhite race/ethnicity, lower level of parental education, and lower birth weight were predictive of global cognitive impairment in children younger than 5 years. In older children, only the influence of parental education was sustained. Male sex was also predictive of language impairment in early infancy, but not in middle childhood. Gestational age was a poor predictor of cognitive outcome, probably because of a reduced discriminatory power in cohorts restricted to a narrow gestational age range. The prognostic value of neonatal brain injury was unclear; however, studies adopted mixed strategies for managing children with physical or neurosensory disability.The influence of perinatal risk factors on cognitive development of VPT or VLBW children appears to diminish over time as environmental factors become more important. It is difficult to isolate cognitive outcomes from motor and neurosensory impairment, and the strategy for dealing with untestable children has implications for risk prediction.
Sequential high-dose methotrexate and fluorouracil combined with doxorubicin--a step ahead in the treatment of advanced gastric cancer: a trial of the European Organization for Research and Treatment of Cancer Gastrointestinal Tract Cooperative Group.
Authors: J A Wils, H O Klein, D J Wagener, H Bleiberg, H Reis, F Korsten, T Conroy, M Fickers, S Leyvraz, M Buyse
Journal: Journal of Clinical Oncology (1991)

In a prospective phase III multicenter trial, 213 patients with advanced measurable or nonmeasurable gastric cancer were randomized to receive methotrexate (MTX), fluorouracil (5-FU), and Adriamycin (doxorubicin; Farmitalia Carlo Erba, Milan, Italy) (FAMTX) or 5-FU, Adriamycin, and mitomycin (FAM). The results show a significantly superior response rate (41% v 9% [P less than .0001]), and survival (median, 42 weeks v 29 weeks [P = .004]) for FAMTX. There was a cumulative thrombocytopenia in FAM and not in FAMTX. The FAMTX protocol should be the reference treatment in future clinical trials that seek to improve the therapeutic outcome in advanced gastric cancer.
Limitations for the inclusion of patients in the Roflu-2011 study
Authors: Agustín Valido, Concepción Romero, Ana Gómez-Bastero, Patricia Guerrero, Layla Mechbal, Teodoro Montemayor
Journal: European Respiratory Journal (2013)

INTRODUCTION: Chronic Obstructive Pulmonary Disease(COPD) is characterized by the presence of exacerbations that decrease the quality of life and increase the risk of death. Roflumilast is a potent and selective phosphodiesterase type 4(PDE4) inhibitor that has been shown to prevent exacerbations in severe COPD patients.  OBJECTIVE: Assess the most common limitations to begin the treatment with roflumilast.  METHODS: Transversal analysis of the exclusion criteria of COPD patients included in the ROFLU-2011 study. This is a multicenter Andalusian study where the following variables were analyzed: age, gender, FEV1, chronic bronchitis criteria, packs-year,exacerbations in the previous year,clinical stability in last month, pregnancy/breastfeeding,psychiatric,immunologic,rheumatologic,and gastrointestinal comorbidities, so concomitant medication and inability to understand or undertake lung function tests.  RESULTS: 131 patients were analyzed: 128 men(97%). 37 patients did not meet the inclusion criteria. 3.1% refused to participate and 24.5% had been already treated with roflumilast. Among the 68 patients remaining, evaluated the most common limitation was the presence of gastroduodenal ulcer(22%). Other limitations identified were: neoplasia(19.1%) being bladder cancer the most common type, gastroesophageal reflux(13.2%), hiatal hernia(12%), serious psychiatric disorders(5.8%) and inability to carry out lung function tests(6.8%).  CONCLUSIONS: The most common limitations to begin the roflumilast treatment in our patients were gastrointestinal diseases(47%) especially peptic ulcer. Therefore, the gastrointestinal pathology is a limitation for the start of the treatment as well as a frequent cause of treatment discontinuation.
Palliative care for patients with COPD in primary health care sector - An integrative review
Authors: Camilla Askov Mousing, Marit Kirkevold, Helle Timm, Kirsten Lomborg
Journal: European Respiratory Journal (2013)

Introduction: Modern organization of health care services lead to more specialized tasks in the primary sector. The literature suggests that patients with COPD are underserviced in the primary sector and receive less palliative care than patients with other diseases with comparable symptoms and prognoses.  Aim: To identify, integrate and interpret the existing body of knowledge on the role and function of the health care professional in their work with palliative COPD patient care in primary sector.  Methods: An integrative review of existing literature was conducted. The systematic review included: problem identification, literature search, data evaluation, analysis, synthesis, and presentation of the results. 332 original papers addressed the health care professionals’ experience of palliative approaches to patients with COPD. After detailed review of the abstracts 19 papers were selected for in depth quality assessment and analysis.  Results: Professionals in primary care experience several barriers to palliative approaches, including vague definition of palliative care, unpredictability of the illness, uncertainty regarding their professional role, lack of knowledge and access to advice from COPD specialists, fear of patients’ reaction and limited time to talk with patients.  Conclusions: A strong association between palliative care and death may be an obstacle for the adoption of a palliative approach to care. Death taboo, lack of knowledge and inadequate communication skills may affect the role and function of the health professional, as these barriers affect the ability to identify, initiate and evaluate palliative needs and interventions.
Protection of Mice Against Syngeneic C1300 Neuroblastoma Challenge by Immunization With Membranes of C1300 Neuroblastoma Cells&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: G Lauro, R Businaro, R H Butler, R Revoltella
Journal: JNCI Journal of the National Cancer Institute (1980)

Male A/J mice 2-3 months old were inoculated sc with membranes from syngeneic C1300 neuroblastoma cells (clone NB6R) in complete Freund's adjuvant. Significant immunoprophylaxis was noted in the sensitized mice upon sc challenge with viable NB6R cells. During the experiment (60 days from viable cell challenge), each control mouse developed a palpable tumor and died within 50 days. Complete protection was obtained with a program of 4 inoculations of NB6R cell membranes. Each mouse given only 1 inoculation of NB6R cell membranes developed a palpable tumor, but afer 60 days only 1 mouse in 7 had died, which indicated a significant degree of protection. With in vitro tests of lymphocyte proliferation, rosette formation, and complement fixation, it was shown that these mice had mounted both cellular and humoral immune response against the tumor cells.
Adaptational changes in renal vacuolar H(+)-ATPase in the rat remnant kidney.
Authors: B Bastani, S Gluck
Journal: Journal of the American Society of Nephrology (1997)

After 7/8 nephrectomy, the remnant kidney exhibits an adaptive increase in acid secretion per nephron. We studied the role of the kidney vacuolar H(+)-ATPase in this adaptational response by anti-H(+)-ATPase immunocytochemistry in kidneys from rats subjected to 7/8 nephrectomy or a sham procedure at 1, 2, and 3 wk after surgery. No changes in H(+)-ATPase staining were apparent in the proximal tubule, thick ascending limb, or distal convoluted tubule. In the cortical collecting ducts, the percentage of intercalated cells with well-polarized apical and well-polarized basolateral H(+)-ATPase staining was significantly higher in the remnant kidneys at 1, 2, and 3 wk. In the medullary intercalated cells of the sham-operated kidneys, relatively few cells had predominant plasma membrane H(+)-ATPase staining. In the remnant kidneys, the percentage of medullary intercalated cells with predominant plasma membrane H(+)-ATPase staining was increased significantly at 1 and 2 wk after surgery, returning to sham-operated values at 3 wk. The results indicate that intercalated cells in the collecting ducts of both cortex and medulla participate in the adaptation to reduction in renal mass by changing the steady-state distribution of H(+)-ATPase, similar to changes that occur with chronic acid administration.
Phase I Trial of Radiation Dose Escalation With Concurrent Weekly Full-Dose Gemcitabine in Patients With Advanced Pancreatic Cancer
Authors: Cornelius J. McGinn, Mark M. Zalupski, Imad Shureiqi, John M. Robertson, Frederic E. Eckhauser, David C. Smith, Diane Brown, Gwen Hejna, Myla Strawderman, Daniel Normolle, Theodore S. Lawrence
Journal: Journal of Clinical Oncology (2001)

The primary objective of this phase I trial was to determine the maximum-tolerated dose of radiation that could be delivered to the primary tumor concurrent with full-dose gemcitabine in patients with advanced pancreatic cancer.Thirty seven patients with unresectable (n = 34) or incompletely resected pancreatic cancer (n = 3) were treated. Gemcitabine was administered as a 30-minute intravenous infusion at a dose of 1,000 mg/m(2) on days 1, 8, and 15 of a 28-day cycle. Radiation therapy was initiated on day 1 and directed at the primary tumor alone, without prophylactic nodal coverage. The starting radiation dose was 24 Gy in 1.6-Gy fractions. Escalation was achieved by increasing the fraction size in increments of 0.2 Gy, keeping the duration of radiation constant at 3 weeks. A second cycle of gemcitabine alone was intended after a 1-week rest.Two of six assessable patients experienced dose-limiting toxicity at the final planned dose level of the trial (42 Gy in 2.8-Gy fractions), one with grade 4 vomiting and one with gastric/duodenal ulceration. Two additional patients at this dose level experienced late gastrointestinal toxicity that required surgical management.The final dose investigated (42 Gy) is not recommended for further study considering the occurrence of both acute and late toxicity. However, a phase II trial of this novel gemcitabine-based chemoradiotherapy approach, at a radiation dose of 36 Gy in 2.4-Gy fractions, is recommended on the basis of tolerance, patterns of failure, and survival data.
Protein intake in renal disease.
Authors: C A Pollock, L S Ibels, F Y Zhu, M Warnant, R J Caterson, D A Waugh, J F Mahony
Journal: Journal of the American Society of Nephrology (1997)

The dietary protein intake (DPI) of 766 patients (aged 7 to 88 yr) was determined from 24-h urinary urea and protein excretion by urea kinetic modelling. Five hundred sixty-five patients had a normal serum creatinine concentration, and of these 565, 385 patients had no dietary modification advised and 180 were advised to follow a low-protein diet. The remaining 201 patients had an increased serum creatinine concentration; 148 of these 201 patients had been advised to restrict their DPI. Patients with a normal serum creatinine concentration who had no dietary restriction had a significantly higher DPI than those advised to restrict their protein intake (1.08 +/- 0.01 versus 0.96 +/- 0.02 g/kg per day (mean +/- SEM), P < 0.01). Similarly, patients with abnormal renal function who were advised to follow a low-protein diet had a reduced DPI (0.93 +/- 0.01 versus 0.87 +/- 0.02 g/kg per day; P < 0.05). A lower DPI correlated with level of renal dysfunction, independent of dietary advice (P < 0.0001). In the overall population, DPI correlated with body mass index (BMI; P < 0.0001) and serum albumin (P < 0.0001), and inverse correlations were evident between age (P < 0.0001), blood glucose level (P < 0.01), serum cholesterol level (P < 0.0001), and triglyceride levels (P < 0.0001) independently of renal function. Fifty-two patients were assessed within the 3 months before the commencement of dialysis, and 47 were reassessed within 3 months after the commencement of dialysis. Despite advice regarding an increase in dietary protein after the commencement of dialysis, this increase failed to occur within the 3 months of commencement of dialytic therapy (0.79 +/- 0.04 versus 0.82 +/- 0.03 g/kg per day); P = 0.64). However, 6 to 9 months after the commencement of dialysis, a significant increase in protein intake was evident (1.04 +/- 0.04 g/kg per day; P < 0.005 versus both prior measurements). Hence a low DPI in renal impairment occurs independently of dietary advice, but compliance with such advice is evident because patients advised to consume a low-protein diet had significantly lower protein intake than did patients receiving no dietary advice. Adaptation to a high-protein diet after instigation of dialysis is unsuccessful in the short term, irrespective of whether or not advice is given regarding a low-protein diet before dialysis is initiated. However, 6 to 9 months after the commencement of dialysis, a significant increase in protein intake occurs, which in the hemodialysis population correlates with dialysis delivery.
China sends in medical teams to cope with casualties of Tianjin blast
Authors: Michael Woodhead
Journal: BMJ (2015)

China’s health authorities have activated disaster response plans to send in medical teams to help treat hundreds of casualties from the massive Tianjin chemical explosion on Wednesday 12 August.

Official reports have said that at least 112 people were killed, 95 were missing, and 722 were admitted to hospital for treatment of injuries from the blast, which destroyed a wide area around a container storage area in the northeastern port city of Tianjin.

Many of the dead and wounded people were firefighters sent to tackle the blaze that triggered the huge explosion at around midnight on 12 August.

Doctors treating casualties at the nearby Taida Hospital said that most of the injuries were blast injuries such as burns and fractures, although hundreds of nearby residents were also …
Inhibition of RAF Isoforms and Active Dimers by LY3009120 Leads to Anti-tumor Activities in RAS or BRAF Mutant Cancers
Authors: Sheng-Bin Peng, James R. Henry, Michael D. Kaufman, Wei-Ping Lu, Bryan D. Smith, Subha Vogeti, Thomas J. Rutkoski, Scott Wise, Lawrence Chun, Youyan Zhang, Robert D. Van Horn, Tinggui Yin, Xiaoyi Zhang, Vipin Yadav, Shih-Hsun Chen, Xueqian Gong, Xiwen Ma, Yue Webster, Sean Buchanan, Igor Mochalkin, Lysiane Huber, Lisa Kays, Gregory P. Donoho, Jennie Walgren, Denis McCann, Phenil Patel, Ilaria Conti, Gregory D. Plowman, James J. Starling, Daniel L. Flynn
Journal: Cancer Cell (2015)
European recommendations for musculoskeletal pain.
Authors: E Ernst
Journal: Annals of the Rheumatic Diseases (2004)

The article by Woolf et al 1 yields plenty of fascinating information. I was particularly interested to see the national differences in recommendations for acupuncture or herbal medicine (incidentally, herbal treatments are pharmacological by nature despite the affirmation to the contrary in fig 1 of the article). Throughout Europe, few doctors issue such recommendations, despite the fact that the evidence for both approaches is perhaps not conclusive but encouraging.2 Generally, acupuncture …
Comparable effectiveness of budesonide/formoterol combination and fluticasone for the treatment of cough variant asthma
Authors: Saori Kirishi, Etsuko Tagaya, Masanobu Ishii, Kiyoshi Takeyama, Kazuo Isono, Mitsuko Kondo, Fumiaki Shinya, Jun Tamaoki
Journal: European Respiratory Journal (2013)

Background: Cough variant asthma (CVA) is defined as asthma with cough as the predominant or sole symptom, and one of the most common causes of chronic persistent cough, in which eosinophilic airway inflammation may play an important role. Although current guidelines recommend bronchodilators and anti-inflammatory drugs for the treatment, comparison of the efficacy of these medications has not been investigated.

Objective: To evaluate the effectiveness of inhaled budesonide/formoterol combination (BFC) and inhaled fluticasone propionate (FP) in the treatment of CVA.

Methods: The study was a randomized, controlled, parallel-group, multicenter trial. After a 4-week run-in period, 45 patients with newly diagnosed CVA were assigned to receive BFC (160/4.5 μg, 1 inhalation twice daily) or FP (200 μg, 1 inhalation twice daily) for 8 weeks. Primary outcome measure was cough symptom assessed by CASA-Q and secondary outcome measures were pulmonary function and eosinophilic airway inflammation.

Results: Treatment with BFC and FP each decreased cough symptom scores and cough impact scores, where the values decreased from baseline levels significantly more rapid and greater in the BFC group than in the FP group. FEV1 and PEF increased in both groups, the effects that were more pronounced with BFC compared with FP. Eosinophil counts and eosinophil cationic protein contents in the induced sputum decreased in the two treatment groups with the same magnitudes.

Conclusion: Although BFC and FP have equipotent effects for suppressing eosinophilic airway inflammation, treatment with BFC provided improvements in cough symptoms to a greater extent than did FP in patients with CVA.
Anti-G(D2) antibody treatment of minimal residual stage 4 neuroblastoma diagnosed at more than 1 year of age.
Authors: N K Cheung, B H Kushner, I Y Cheung, K Kramer, A Canete, W Gerald, M A Bonilla, R Finn, S J Yeh, S M Larson
Journal: Journal of Clinical Oncology (1998)

PURPOSE To eradicate minimal residual disease with anti-G(D2) monoclonal antibody 3F8 in stage 4 neuroblastoma (NB) diagnosed at more than 1 year of age. PATIENTS AND METHODS Thirty-four patients were treated with 3F8 at the end of chemotherapy. Most had either bone marrow (n=31) or distant bony metastases (n=29). Thirteen patients were treated at second or subsequent remission (group I) and 12 patients in this group had a history of progressive/persistent disease after bone marrow transplantation (BMT); 21 patients were treated in first remission following N6 chemotherapy (group II). RESULTS Before 3F8 treatment, 23 patients were in complete remission CR, eight in very good partial remission (VGPR), one in partial remission (PR), and two had microscopic foci in marrow. Twenty-five had evidence of NB by at least one measurement of occult/minimal tumor (iodine 131[(131)I]-3F8 imaging, marrow immunocytology, or marrow reverse-transcriptase polymerase chain reaction [RT-PCR]). Acute self-limited toxicities of 3F8 treatment were severe pain, fever, urticaria, and reversible decreases in blood counts and serum complement levels. There was evidence of response by immunocytology (six of nine), by GAGE RT-PCR (seven of 12), and by (131)I-3F8 scans (six of six). Fourteen patients are alive and 13 (age 1.8 to 7.4 years at diagnosis) are progression-free (40 to 130 months from the initiation of 3F8 treatment) without further systemic therapy, none with late neurologic complications. A transient anti-mouse response or the completion of four 3F8 cycles was associated with significantly better survival. CONCLUSION Despite high-risk nature of stage 4 NB, long-term remission without autologous (A)BMT can be achieved with 3F8 treatment. Its side effects were short-lived and manageable. The potential benefits of 3F8 in consolidating remission warrant further investigations.
Effects of Mutant Steel Alleles on Leukemogenesis and Life-Span in the Mouse2
Authors: Edwin D. Murphy
Journal: JNCI Journal of the National Cancer Institute (1977)

Mutant alleles at the steel locus produce the pleiotropic effects of congenital anemia, sterility, and lack of hair pigmentation. Strain (WC/Re × C57BL/6)F1Sl/Sld mice lived only half as long as heterozygotes and homozygous normal controls, differing only at the steel locus. Lymphocytic leukemia developed spontaneously in 37% of mice of the Sl/Sld genotype at an average age of 370±25 days and In 5% of heterozygotes and homozygous normal controls at 965±41 days. Severe ulcerative dermatitis occurred in 56% of Sl/Sld mice at an average age of 441±21 days and in 20% of heterozygotes and homozygous normal controls at 722±50 days. The mutant steel alleles provided an opportunity for study of the role of chronic anemia in life shortening and of a mechanism of gene action in spontaneous leukemogenesis.
Recurrence of sarcoid granulomas in lung transplant recipients is common and does not affect overall survival
Authors: Hans Henrik Schultz, Claus Andersen, Daniel Steinbrüchel, Michael Perch, Jørn Carlsen, Martin Iversen
Journal: European Respiratory Journal (2013)

Background  Sarcoidosis represent 2.5% of all indications for lung transplantation. Recurrence of granuloma has earlier been proved to derive from recipient immune cells, but its role in relation to lung function and overall survival after lung transplantation remains uncertain.  Objective  To identify patients with re-occurence of granuloma in transplanted lungs, and compare these patients with other patients transplanted for sarcoidosis without re-occuring granulomas. We compared these patients on survival and lung function  Design  A total of 620 patients were transplanted in Copenhagen from 1992 until august 2012. This study comprised all patients (n=25) transplanted due to end-stage pulmonary sarcoidosis. We reviewed all lung functions and trans-bronchial biopsies and lung functions until today. Granuloma was defined as formation of epitheloid giant cells without presence of infection.  Results  A total of 7 (28%) patients had re-occurence of granuloma and 18 (72%) did not. Recurrent granuloma were persistent in 9/17 biopsies (53%) after first definite finding. There was no difference in best obtained FEV 1  (P=0,458), and last FEV 1  recorded (P=0,389). There was no difference in survival (Log Rank test P=0,399).  Conclusions  Approximately 30% of lung transplant recipients due to endstage sarcoidosis have recurrence of sarcoid granulomas. Recurrence of granulomas does not affect overall survival or lung function.