tbuckley/cabot-search huggingface dataset:
Patient-controlled analgesia for chronic cancer pain in the ambulatory setting: a report of 117 patients.
Authors: G Swanson, J Smith, R Bulich, P New, R Shiffman
Journal: Journal of Clinical Oncology (1989)

Patient-controlled analgesia (PCA) represents a drug-delivery system in which patients self-administer predetermined doses of opiate analgesics. We have taken advantage of recent advances in pump technology and developed a system in which patients with severe pain received a continuous narcotic infusion, along with the capability of PCA bolus for breakthrough pain. All patients were experiencing chronic pain related to cancer and were unable to obtain adequate pain control with either intermittent parenteral, oral, or rectal narcotics. Sixty-nine percent of patients were treated in the home setting, and the majority received morphine sulfate subcutaneously (SQ). Admixture stability studies using high-pressure liquid chromatography (HPLC) showed that dexamethasone, metoclopramide, and haloperidol could be added to the morphine solutions and remain stable for 1 week at room temperature. Of 117 patients entered, 95% received excellent pain control, and side effects were rare, consisting of subcutaneous needle site infection and respiratory depression. Progressive pain due to either advancing disease or development of drug tolerance could be controlled by increasing opiate infusion rates. We conclude that (1) continuous infusion opiate with PCA bolus capability can be initiated and administered safely in the home setting; (2) patients with pain related to malignancy can be managed well with this system; and (3) pain control programs can be designed, implemented, and evaluated in the private practice setting.
MICROCOCCUS TETRAGENUS INFECTION
Authors: Hobart A. Reimann
Journal: Journal of Clinical Investigation (1935)

The appearance of only two or three reports (Greiwe, et al. (1), Steele (1)) of Micrococcus tetragenus infection in American medical literature would lead one to believe the disease to be rare and of little importance.It is probably quite common, but often disregarded or unrecognized in this country.More than 170 cases have been reported in Italian, French, German, English and Spanish journals.Micrococcus tetragenus, after its discovery in
Developmental Airway Cell Biology
Authors: JONATHAN GRIGG, JOSEF RIEDLER
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

There is increasing awareness in the research community that events in early childhood have a profound influence on the expression of respiratory disease in later life, but is there any value in studying airway cells from healthy children? Why not use the extensive body of information about airway cells derived from adult volunteers? Adults are easy to recruit, whereas ingenious and time-consuming ways of sampling the lower airways of children must be devised to overcome ethical problems. Even if there are developmental changes, could these be defined in animal models? There are several reasons why children must be studied. First, research published within the last 5 yr clearly shows that there are major changes in immunocompetent and inflammatory cells during normal human development. Second, there are significant species differences in the release of mediators by immunocompetent cells. Third, age-associated changes in human airway cells are a result of complex interactions between genetic and environmental factors. It is therefore impossible to model the combination of even a handful of potential variables, for example, frequency of colds, exposure to lipopolysaccharide, nutritional state, and age. The technique of bronchoalveolar lavage (BAL) before elective surgery, initially developed to overcome the ethical problems of sampling cells from normal children, is uniquely suited to studying large numbers of individuals (the mean number of children per study is currently more than 50). It is now possible to tease out the independent effects of environmental stimuli on airway cell function. Clues to the relevant factors have been provided by epidemiological research. For example, having older siblings reduces the risk of aeroallergen sensitization (1). This association, if true, must also be associated with an effect on immune function at the cellular level. The goal of pediatric airway cell research is therefore not just to generate normal values for comparison with established disease, but to focus on the critical functional mechanisms that protect the normal lung from developing disease. Although the lung of the young child may seem to be particularly vulnerable to a range of environmental insults (2), this does not necessarily reflect immaturity of airway cell function. Young children may have more respiratory infections not because of a defect in microbial killing by cells, but because their immunoglobulin repertoire is not fully developed. Similarly, early childhood may seem to be the vulnerable period for antigen sensitization, not because of a possible immaturity in the ability of alveolar macrophages (AMs) to suppress pulmonary immune cells (3), but because it is the period when the lung is first exposed to antigen. These considerations are important, because a true developmental immaturity of airway cell function may be amenable to accelerated maturation by exposure to an appropriate environmental factor (e.g., exposure to traditional farms) (4), or an anthroposophic lifestyle (5).
A comparative study of criteria for subgrouping alcoholics: the primary/secondary diagnostic scheme versus variations of the type 1/type 2 criteria
Authors: R M Anthenelli, T L Smith, M R Irwin, M A Schuckit
Journal: American Journal of Psychiatry (1994)

This study compared three methods for identifying type 1 and type 2 alcoholism to determine how well the methods agree. It also evaluated the comparability of each of these schemes to the primary/secondary approach to subgrouping alcoholics.Fifty male alcoholic inpatients were given diagnoses of primary alcoholism without antisocial personality disorder or primary antisocial personality disorder with secondary alcoholism on the basis of data from structured interviews. Operationalized criteria for type 1 and type 2 alcoholism from three groups of researchers (Gilligan et al., von Knorring et al., and Sullivan et al.) were also used to designate subgroups of the same subjects.Subgroups of subjects classified as having type 1 or type 2 alcoholism according to the criteria of von Knorring et al. and of Sullivan et al. showed good levels of agreement, but the criteria of Gilligan et al. yielded poor agreement with those of the other two schemes. Subgroups with type 1 or type 2 alcoholism according to the criteria of Sullivan et al. showed significant overlap with subgroups diagnosed according to the primary/secondary alcoholism scheme: there was 73% concordance between the type 1 subgroup and the subgroup with primary alcoholism and 73% concordance between the type 2 subgroup and the subgroup with primary antisocial personality disorder and secondary alcoholism.There is variability in assigning diagnoses of type 1 and type 2 alcoholism with the use of current methods. Also, type 1/type 2 classifications based primarily on age-at-onset factors significantly overlap with the primary/secondary classifications of alcoholics.
The dopaminergic system in pulmonary hypertension
Authors: Pierdonato Bruno, Carmine Dario Vizza, Alberto Ricci, Davide Scozzi, Maria Cristina Esposito, Emanuela Cherubini, Giorgia Amira Osman, Silvia Papa, Martina Nocioni, Mario Mezzapesa, Salvatore Mariotta
Journal: European Respiratory Journal (2013)

The purpose was to investigate the possible role of dopamine in the regulation of the pulmonary circulation in patients with pulmonary hypertension (PH).We enrolled 40 patients with PH (24 M/16 F; mean age 65) and 5 patients without PH (3 M/2 F; mean age 74); divided into groups according to the severity of PH as measured by pulmonary artery pressure (PAP) [severe=20 pts, moderate=10 pts, mild=10 pts]. 30 ml of blood from pulmonary artery and from peripheral arterial blood were taken out during each right heart catheterization for the determination of circulating catecholamines, receptors (D1DR-D5DR) and transporters (Mat-V-1, V-2-Mat, h-Dat) of dopamine. In patients (40 pts) with PH the increase of PAP was correlated (p0.05) with a decrease in transmembrane transporters of dopamine (HDAT), with an increase of the concentration of adrenaline in the peripheral circulation (p0.05), and with a decrease of the difference between lung and peripheral dopamine (p0.05). In patients with mild PH (10 pts) the increase in right atrial pressure (PAD) and cardiac output (PO) is correlated (p0.01) with an increase of dopamine receptors (D4R). From these observations, it might be theorized a decrease in the availability of dopamine in patients with pulmonary hypertension, which could cause an up regulation of its receptors and a reduction of its carriers; the decrease in the availability of dopamine may be a compensation to adrenergic hypertonia, given the correlation between PAP and circulating levels of adrenaline. The reduction of availability could be explained by an increased metabolism in the pulmonary circulation (inverse correlation between PAP and difference between lung and peripheral dopamine). Further studies are necessary.
Meropenem Versus Ceftazidime in the Treatment of Cancer Patients With Febrile Neutropenia: A Randomized, Double-Blind Trial
Authors: Ronald Feld, Ben DePauw, Steven Berman, Armand Keating, Winston Ho
Journal: Journal of Clinical Oncology (2000)

PURPOSE: To compare meropenem, a carbapenem antibiotic, with ceftazidime for the empirical treatment of patients with febrile neutropenia. PATIENTS AND METHODS: A prospective, double-blind, randomized clinical trial was conducted at medical centers in North America and the Netherlands. A total of 411 cancer patients (196 treated with meropenem and 215 treated with ceftazidime), who had 471 episodes of fever, participated in the trial. For each neutropenic episode, patients were allocated at random to receive intravenous administration of meropenem (1 g every 8 hours) or ceftazidime (2 g every 8 hours). Treatment could be modified at any time. Key end points were clinical and bacteriologic outcomes, eradication of infecting organism, and adverse events. RESULTS: The rate of successful clinical response at the end of therapy was significantly higher for patients treated with meropenem than for those on ceftazidime for all episodes (54% v 44%, respectively) and for episodes of fever of unknown origin (62% v 46%, respectively), but differences between groups were not statistically significant for clinically defined or microbiologically defined infections. Meropenem was significantly more effective than ceftazidime in severely neutropenic (≤ 100 cells/μL) patients (55% v 43%, respectively), bone marrow transplant patients (73% v 27%, respectively), and patients given antibiotic prophylaxis before study entry (71% v 52%, respectively). Common adverse effects of meropenem and ceftazidime therapy were rash, diarrhea, and nausea and vomiting. CONCLUSION: Monotherapy with meropenem represents a suitable choice for initial empirical antibiotic therapy for febrile episodes in neutropenic cancer patients.
Exercise ventilatory inefficiency, age and peak oxygen consumption as postoperative mortality and complications predictors in surgery for lung cancer
Authors: Claudio Ciacco, Marco Guglielmo, Roberto Giardino, Alessandra Mazzucco, Daniele Giuliani, Filippo Patrucco, Francesco Ardissone, Roberto Torchio
Journal: European Respiratory Journal (2014)

AIM of this study was to investigate in a large sample of patients the role of respiratory functional parameters at rest and during exercise as predictors of postoperative death or complications after lung surgery for cancer.

PATIENTS AND METHODS: a retrospective analysis was performed on 264 consecutive patients with lung cancer (213 males, 51 females), mean aged 65+8years, operable according to current standards (ERS/ESTS) in which lung resection was performed after complete preoperative study with cardiopulmonary exercise test.

RESULTS: Thirty-nine (14.8%) had serious complications, 12 (4.5%) died within 30 days from surgery. 187 patients had lobectomy or bilobectomy with 27/187 (14.4%) serious complications and 7/187 (3.7%) postoperative deaths; 77 had pneumonectomy with 12/77 (15.6%) serious complications and 5/77 (6.5%) deaths.

Considering all preoperative and predicted post operative parameters a logistic regression analysis individuated age [Odds ratio(OR): 1.19 z= 2.89 p<0.004], V'E/V'C02 slope [Odds ratio(OR): 1.14 z= 2.85 p<0.005] and V'02peak (%predicted) (OR: 0.92 z= 2.68 p<0.007) as independent mortality predictors.

Best predictors for the occurrence of severe cardiopulmonary post-operative complications were instead V'02peak (mL/Kg/min) (OR: 0.96 z= 2.25 p<0.025) and V'E/V'C02 slope [Odds ratio(OR): 1.06 z= 2.00 p<0.04).

CONCLUSIONS: High V'E/V'C02 slope and low V'02peak are predictors of death and complications after lung surgery. Advanced age is an additional risk factor for death.
Letter by Lazaros et al Regarding Article, “Clinical Profile and Influences on Outcomes in Patients Hospitalized for Acute Pericarditis”
Authors: George Lazaros, Massimo Imazio, Dimitrios Tousoulis
Journal: Circulation (2015)

Kytö et al 1 published in a recent issue of Circulation.In this work, the authors provide data on incidence, epidemiology, and mortality in hospitalized adolescent and adult patients with acute pericarditis.Some key points need to be addressed in the interpretation of the findings of this valuable work in which 670 409 individuals were screened.First, this survey provides a selected view of acute pericarditis because only hospitalized patients were included (probably the worst cases and those patients whom the physician decided to admit according to local protocols) in a specific setting with a low prevalence of tuberculosis.Moreover, cases with postpericardiotomy syndrome and postinfarction pericarditis were excluded, for reasons that were not reported in the article.The above limitations probably explain the difference observed in the incidence of acute pericarditis in the context of Western Europe, namely 3.3 per 100 000 in Finland 1 versus 27.7 per 100 000 2 in an Italian urban metropolitan area.Another issue that may account for such discrepancies is the lack of standardized means for the diagnosis of acute pericarditis, which is based on purely clinical criteria. 3 Our group and other experts in the field have proposed the presence of at least 2 of the following as criteria for the diagnosis of acute pericarditis: pleuritic chest pain, pericardial friction rub, widespread ST-segment elevation in the ECG, and newly appearing or worsening pericardial effusion. 3Particular attention should be paid to C-reactive protein levels at the first medical contact, which, in the Finnish national registry, is reported among the main diagnostic findings in acute pericarditis. 1Indeed, we have recently shown that high-sensitivity C-reactive protein elevation may be absent in as many as 22% of cases at presentation, rendering this biomarker, according to the current view, a confirmatory rather than a diagnostic tool. 4 Another important issue is that mortality data in this registry should be considered in the specific context of the studied population and not generalized to the entire population of patients with acute pericarditis because it is the underlying pathogenesis that has been correlated with the long-term prognosis. 5 Finally, we wish to emphasize that there is a compelling need for updated guidelines with respect to pericardial disease in which a universally accepted definition of acute pericarditis should be reported and used as a common denominator in future studies.
Differential in vitro activity of anidulafungin, caspofungin and micafungin against Candida parapsilosis isolates recovered from a burn unit
Authors: M.A. Ghannoum, A. Chen, M. Buhari, J. Chandra, P.K. Mukherjee, D. Baxa, A. Golembieski, J.A. Vazquez
Journal: Clinical Microbiology and Infection (2009)
Abstract 2071: The utility of FDG uptake as a surrogate biomarker to monitor tumor cell metabolism in response to anticancer therapy
Authors: Nanni Huser, Wenlin Li, Maruja Lira, Patrick Lappin, Erick Kindt, Valeria Fantin, Gary Li, Cathy C. Zhang
Journal: Cancer Research (2014)

Abstract [18F]FDG-PET imaging has been emerging as a powerful clinical tool for tumor diagnosis, staging and monitoring anticancer therapy. Due to some physiologic variants and technical artifacts, one of the limitations for [18F]FDG-PET imaging is the potential to show negative scans despite the presence of malignant tumors. In this report, we aimed to gain insights into the FDG tracer biology in different tumor models and subsequently to validate the use of FDG tracer uptake for monitoring targeted therapy. To measure the FDG tracer uptake in tumor cells, a LC/MS method was established to monitor the FDG monophosphate; these results were compared with the outcome of [18F]FDG-PET imaging. In a subset tumor models including patient derived xenografts, not all growing tumors showed high FDG tracer avidity. RT-PCR and IHC assays were performed to understand the potential physiological factors that could impact the FDG tracer avidity including the intrinsic glucose level, the exposure and distribution of FDG, as well as the expressions of glucose transporters and hexokinase. The results indicated that LC/MS analysis of FDG monophosphate served as a cost-effective tool to provide a surrogate measure of [18F]FDG-PET imaging. By using FDG tracer avid tumor models, several anticancer agents including the PI3K/mTOR dual inhibitor PF-04691502, crizotinib and the γ-Secretase inhibitor PF-03084014 demonstrated suppression in FDG tracer uptake after treatment, which predicted their antitumor efficacies in the corresponding models. This work provides insights into the FDG tracer biology and the utility of [18F]FDG-PET imaging as a non-invasive biomarker for anticancer drug discovery. Citation Format: Nanni Huser, Wenlin Li, Maruja Lira, Patrick Lappin, Erick Kindt, Valeria Fantin, Gary Li, Cathy C. Zhang. The utility of FDG uptake as a surrogate biomarker to monitor tumor cell metabolism in response to anticancer therapy. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2071. doi:10.1158/1538-7445.AM2014-2071
Oral chemotherapy: rationale and future directions.
Authors: M D DeMario, M J Ratain
Journal: Journal of Clinical Oncology (1998)

PURPOSE AND METHODS The expanding role of oral chemotherapy in oncology is suggested by the abundance of orally formulated agents currently in development. The pharmacoeconomic principles that drive oral drug formulation are discussed. Patient preference for oral therapy is identified as a second major impetus for the design of oral cytotoxics. While the rationale for oral formulations is apparent, substantial patient compliance and pharmacokinetic limitations have been identified for this route of administration. Specific aspects of bioavailability limitations and patient compliance are discussed. Relevant pharmacokinetic data for each orally formulated chemotherapy agent are compared and selected novel oral cytotoxics and cytotoxic modulators are discussed. RESULTS A review of pharmacokinetic literature suggests substantial variability in bioavailability for many orally formulated cancer cytotoxics. While these findings are observed for all classes of oral drugs, the issue is especially critical for cancer chemotherapy, in which a narrow therapeutic index is frequently observed. Improved bioavailability and reduced interpatient biovariability are therefore desirable for new cytotoxic formulations. Pharmacologic manipulations to improve bioavailability and reduce costs are examined. CONCLUSION Oral chemotherapy represents a fundamental change in contemporary oncology practice, driven by pharmacoeconomic issues, patient convenience, and the potential for improved patient quality of life. Novel cytostatic therapies that require protracted drug administration periods will also favor an oral formulation. While the use of oral chemotherapy may initially be limited to metastatic disease palliation, demonstration of equivalent efficacy would allow for its subsequent use in adjuvant settings. This efficacy is contingent on circumventing bioavailability limitations and patient noncompliance. The development of specific, low-toxicity inhibitors of CYP3A4, P-glycoprotein (P-gp), and other drug metabolizing enzymes such as dihydropyrimidine dehydrogenase represents a major innovative step in the successful formulation of oral chemotherapy.
Scoliosis as cause of pulmonary atelectasis
Authors: P M ter Wee, W J Luth, A C van der Schee, J Stam
Journal: European Respiratory Journal (1991)

We present a patients with persistent position-dependent productive cough and intermittent fever. He was first examined at 38 yrs of age. Chest X-ray showed a severe thoracic lordoscoliosis and an atelectasis of the right lower lobe. Bronchography revealed a total stenosis of the right lower lobe bronchus. Five years later had increased symptoms. Spirometry showed total lung capacity (TLC) 3.8 l (predicted value 6.7 l), forced vital capacity (FVC) 2.6 l (4.8 l) and forced expiratory volume in one second (FEV1) 1.7 l (3.9 l). Bronchoscopy demonstrated a smooth stenosis of the right lower lobe bronchus but the stenosis could be passed through with a brush. Computed tomographic scanning demonstrated compression of the right lower lobe bronchus and the atelectasis. After surgical removal of the right lower lobe, all symptoms disappeared. Histological examination of the right lower lobe revealed fibrosis and chronic inflammation.
The CAGE Questionnaire: Validation of a New Alcoholism Screening Instrument
Authors: DEMMIE MAYFIELD, GAIL MCLEOD, PATRICIA HALL
Journal: American Journal of Psychiatry (1974)

The CAGE questionnaire, a new brief alcoholism screening test, was administered to all patients (N = 366; 39 percent alcoholic) admitted to a psychiatric service over a one-year period. The authors indicate that the CAGE questionnaire is not a sensitive alcoholism detector if a four-item positive response is the criterion; however, if a two- or three-item criterion is used, it becomes a viable rapid alcoholism screening techniquefor large groups.