tbuckley/cabot-search huggingface dataset:
Intensive weekly chemotherapy for the treatment of extensive-stage small-cell lung cancer.
Authors: N Murray, A Shah, D Osoba, R Page, H Karsai, C Grafton, K Goddard, R Fairey, N Voss
Journal: Journal of Clinical Oncology (1991)

The regimen of cisplatin, vincristine, doxorubicin, and etoposide (CODE) was designed to double the dose intensity of these drugs in comparison with a standard regimen (alternating cyclophosphamide, doxorubicin, and vincristine [CAV] and etoposide-cisplatin [EP]) for extensive-stage small-cell lung cancer (SCLC). The dose intensity was increased by more frequent treatments rather than by increasing the dose size. The structure of this outpatient protocol includes weekly administration of chemotherapy, alternation of myelosuppressive and nonmyelosuppressive treatments, supportive corticosteroids, gastroprotective agents, and prophylactic antibiotics. Although the duration of chemotherapy was brief (9 to 12 weeks), the total cumulative doses of drugs delivered were similar to the standard regimen. Patients with no residual disease outside the chest after chemotherapy received thoracic irradiation, and patients with complete responses (CRs) received prophylactic cranial irradiation. Eligible extensive-stage SCLC patients were ambulatory, younger than 66 years of age, and free of brain metastasis. Forty-eight extensive-stage SCLC patients were treated. Forty-five (94%) responded to chemotherapy, with 19 (40%) attaining CR. After consolidative thoracic irradiation, the CR rate was 56%. The median time to progression was 43 weeks, and the median survival was 61 weeks. The 2-year survival rate was 30%. The most common site of first relapse was brain (38%). Although two patients (4%) died of toxicity, overall toxicity was acceptable for an outpatient regimen. We conclude that the CODE regimen reliably produces palliative remissions for selected extensive-stage SCLC patients, and it may be associated with durable remissions for some patients. The results of this pilot study are sufficiently promising to justify a phase III trial of CODE versus standard (alternating CAV and EP) chemotherapy.
Double intensive consolidation chemotherapy in adult acute myeloid leukemia.
Authors: J L Harousseau, N Milpied, J Briere, B Desablens, P Y Leprise, N Ifrah, B Gandhour, P Casassus
Journal: Journal of Clinical Oncology (1991)

Of 115 adult patients with de novo acute myeloid leukemia (AML), 87 (75.5%) achieved complete remission (CR) after induction treatment with zorubicin and conventional doses of cytarabine (Ara-C). Patients under age 45 years with histocompatibility locus antigen-identical sibling underwent bone marrow transplantation (BMT). The others were treated with two courses of intensive consolidation chemotherapy (ICC): course 1 with 4 days of high-dose Ara-C and 3 days of amsacrine (m-AMSA); course 2 with carmustine (BCNU), Ara-C, cyclophosphamide, and etoposide. Forty-two patients received both planned courses, 15 received only the first, and 13 patients could only support conventional maintenance therapy. Four patients died during consolidation. With a median follow-up of 60 months, the disease-free survival (DFS) after ICC at 5 years is 40.3% (+/- 6.5%), with no statistically significant difference between patients receiving one or two courses. The DFS for the 17 transplanted patients is comparable (P = .72) and is lower for the 13 excluded patients (23% +/- 11.5%, P = .046). Age did not influence the probability of remaining in CR. In univariate analysis, three parameters had a negative impact on the 5-year DFS: a high initial WBC count (52% for patients with less than 30 x 10(9) WBC/L v 12% for patients with greater than 30 x 10(9) WBC/L, P = .01), a long delay between induction treatment and course 1 (+/- 60 days; 63% v 29%, P = .01), and a long delay between course 1 and course 2 (+/- 60 days, 61.5% v 28.5%, P = .05). In multivariate analysis (Cox model), only the WBC count remained significant. This study confirms the value of intensive postremission chemotherapy, which can be compared in AML with allogeneic or autologous BMT. It also demonstrates the prognostic value of the initial WBC count. The optimal modalities of ICC remain to be defined by further studies.
Cost-Effectiveness of Herpes Zoster Vaccine for Persons Aged 50 Years
Authors: Phuc Le, Michael B. Rothberg
Journal: Annals of Internal Medicine (2015)

Each year, herpes zoster (HZ) affects 1 million U.S. adults, many of whom develop postherpetic neuralgia (PHN). Zoster vaccine is licensed for persons aged 50 years or older, but its cost-effectiveness for those aged 50 to 59 years is unknown.To estimate the cost-effectiveness of HZ vaccine versus no vaccination.Markov model.Medical literature.Adults aged 50 years.Lifetime.Societal.HZ vaccine.Number of HZ and PHN cases prevented and incremental cost per quality-adjusted life-year (QALY) saved.For every 1000 persons receiving the vaccine at age 50 years, 25 HZ cases and 1 PHN case could be prevented. The incremental cost-effectiveness ratio (ICER) for HZ vaccine versus no vaccine was $323 456 per QALY.In deterministic and scenario sensitivity analyses, the only variables that produced an ICER less than $100 000 per QALY were vaccine cost (at a value of $80) and the rate at which efficacy wanes. In probabilistic sensitivity analysis, the mean ICER was $500 754 per QALY (95% CI, $93 510 to $1 691 211 per QALY). At a willingness-to-pay threshold of $100 000 per QALY, the probability that vaccination would be cost-effective was 3%.Long-term effectiveness data for HZ vaccine are lacking for 50-year-old adults.Herpes zoster vaccine for persons aged 50 years does not seem to represent good value according to generally accepted standards. Our findings support the decision of the Advisory Committee on Immunization Practices not to recommend the vaccine for adults in this age group.None.
T cell receptor reversed polarity recognition of a self-antigen major histocompatibility complex
Authors: Dennis X Beringer, Fleur S Kleijwegt, Florian Wiede, Arno R van der Slik, Khai Lee Loh, Jan Petersen, Nadine L Dudek, Gaby Duinkerken, Sandra Laban, Antoinette Joosten, Julian P Vivian, Zhenjun Chen, Adam P Uldrich, Dale I Godfrey, James McCluskey, David A Price, Kristen J Radford, Anthony W Purcell, Tatjana Nikolic, Hugh H Reid, Tony Tiganis, Bart O Roep, Jamie Rossjohn
Journal: Nature Immunology (2015)
Impact of infant pneumococcal vaccination on invasive pneumococcal diseases in France, 2001-2006
Authors: A Lepoutre, E Varon, S Georges, L Gutmann, D Lévy-Bruhl
Journal: Eurosurveillance (2008)

Vaccination with the 7-valent pneumococcal conjugate vaccine (PCV) has been recommended in France since 2003 for children under the age of two years who are at risk due to medical or living conditions. From 2006, the recommendation has been extended to all children under two years. The impact of PCV introduction on the incidence of pneumococcal meningitis and bacteraemia and on the serotype distribution in French children and other age-groups was assessed using laboratory surveillance data. The coverage with three doses of PCV was 44% in children aged 6-12 months in 2006. From 2001/2002 to 2006, the incidence of pneumococcal meningitis decreased from 8.0 to 6.0 cases per 100,000, and the incidence of pneumococcal bacteraemia decreased from 21.8 to 17.5 cases per 100,000 in children under the age of two years. For the vaccine strains, the incidence of pneumococcal meningitis and bacteraemia decreased from 20,4 to 6.0 cases per 100,000, while the incidence of pneumococcal meningitis and bacteraemia due to non-vaccine strains increased from 9.4 to 17.5 cases per 100,000 in this time period. The incidence in older children and adults did not decrease. Further expansion of PCV coverage is expected to increase the impact of the vaccination in both children and adults. However, the fact that cases caused by vaccine serotypes have been partially substituted by cases of non-vaccine serotypes is likely to reduce the overall benefit of PCV in France, should this early observation be confirmed in the future.
Comparison of PD20 with two alternative measures of response to histamine challenge in epidemiological studies
Authors: S Chinn, PG Burney, None Britton, AE Tattersfield, BG Higgins
Journal: European Respiratory Journal (1993)

Bronchial responsiveness to histamine or methacholine provides a useful objective measure for epidemiological studies of airways disease, but most people in a community population do not have a 20% fall in forced expiratory volume in one second (FEV1) with the highest dose administered. Histamine challenge data were analysed to compare the repeatability. Normality and separation of symptom groups of the early dose-response slope with provocative dose producing a 20% fall in FEV1 (PD20). Tests were continued until a 20% fall in FEV1 occurred, or 4 mumol had been given. Data were available for 510 randomly selected subjects, and for an additional 283 with wheeze. A repeat test was obtained in 104 individuals. PD20 was estimated by curve fitting, with extrapolation to 8 mumol. Least-squares slope of percentage decline in FEV1 on histamine dose was calculated, using all the measured points and two-point slope as the fall from the post-saline measurement to the maximum cumulative dose divided by the maximum dose. Log transformation of PD20 and shifted reciprocal transformations of slope produced constant variance. Over all subjects the three measures had similar repeatability; in subjects with PD20 > 8 mumol the intraclass correlation for two-point slope was only 0.26, but was 0.66 for least-squares slope. Neither measure of slope was normally distributed, but the distribution of log(PD20) was consistent with a censored normal distribution. In conclusion, least-squares slope is preferable to two-point slope for epidemiological studies.(ABSTRACT TRUNCATED AT 250 WORDS)
Reduction of Neuropathic and Inflammatory Pain through Inhibition of the Tetrahydrobiopterin Pathway
Authors: Alban Latremoliere, Alexandra Latini, Nick Andrews, Shane J. Cronin, Masahide Fujita, Katarzyna Gorska, Ruud Hovius, Carla Romero, Surawee Chuaiphichai, Michio Painter, Giulia Miracca, Olusegun Babaniyi, Aline Pertile Remor, Kelly Duong, Priscilla Riva, Lee B. Barrett, Nerea Ferreirós, Alasdair Naylor, Josef M. Penninger, Irmgard Tegeder, Jian Zhong, Julian Blagg, Keith M. Channon, Kai Johnsson, Michael Costigan, Clifford J. Woolf
Journal: Neuron (2015)
Abstract 16711: Contemporary Treatment and Outcomes of Peripheral Vascular Interventions for Symptomatic Lower Extremity Peripheral Arterial Disease: Insights From the National VA Clinical Assessment, Reporting and Tracking (VA-CART) Program Peripheral Registry
Authors: Thomas T Tsai, Philip B Dattilo, Jeremy Warner, Darcy Donaldson, Allison Virchow, Maggie A Stanislawski, Colin I O'Donnell, R. Kevin Rogers, Kendrick A Shunk, William S Jones, Scott Kinlay, Emmanouil S Brilakis, Andrew P Klein, Ivan P Casserly, John S Rumsfeld
Journal: Circulation (2011)

Background: The numbers of peripheral vascular interventions (PVI) have exploded over the last decade. The contemporary indications, treatments and outcomes in clinical practice are not well defined. Methods: We studied a convenience sample of 358 patients treated in 33 VA catheterization laboratories between August 2005 and August 2010. Patients were stratified by their PVI indication: Claudication vs. Critical limb ischemia (CLI). Kaplan-Meier curves were constructed and Cox proportional hazards analysis was performed to identify independent predictors of follow-up amputation and mortality. Results: The median follow-up was 2.37 years, the mean age was 64.9 +/- 8.7 years, and 97.8% have a history of hypertension. Of the 358 patients, 71 (19.8%) underwent PVI for CLI. The superficial femoral artery was the most common target lesion for both claudicants (41.2%) and CLI patients (46.7%). Self expanding stents (46.7%) were the most common treatment strategy for patients with claudication whereas angioplasty (34.7%) was the most common stand alone treatment in CLI patients. Three year survival for patients treated for claudication versus CLI was 89.4 ± 2.4% and 67.3 ± 7.2% respectively (log-rank p&lt;0.001) (Figure). Independent predictors of follow-up mortality included age (hazard ratio[HR], 1.05; 95% CI, 1.02 to 1.08; P&lt;0.001), diabetes mellitus (HR, 2.52; 95% CI, 1.21 to 5.24; P=0.013), and CLI as an indication (HR, 2.54; 95% CI, 1.36 to 4.75; P=0.004). Three year amputation rates for patients treated for claudication or CLI was 1.7 ± 0.9% and 13.8 ± 4.6% respectively (log-rank p&lt;0.001). CLI was a strong independent predictor of amputation (HR, 10.0; 95% CI, 3.0 to 33.3; P&lt;0.001) (Figure). Conclusions: Contemporary follow-up mortality and amputation rates in patients undergoing PVI for critical limb ischemia are high, approaching 1 in every 3 patients for mortality and 1 in every 8 patients needing amputation at 3 years.
Peanut Allergy
Authors: Hugh A. Sampson
Journal: New England Journal of Medicine (2002)

A 19-year-old woman is brought to the emergency room because of the acute onset of dyspnea, wheezing, vomiting, and generalized flushing. She has well-controlled asthma as well as a history of atopic dermatitis as an infant and urticaria after ingesting peanut butter at the age of five years. According to friends she ate a chocolate-chip cookie from a vending machine just before her symptoms developed. The ingredients listed on the cookie wrapper do not include peanuts. Nevertheless, how should this patient's condition be treated?
Survival Advantage From Higher-Dose Radiation Therapy for Clinically Localized Prostate Cancer Treated on the Radiation Therapy Oncology Group Trials
Authors: Richard Valicenti, Jiandong Lu, Miljenko Pilepich, Sucha Asbell, David Grignon
Journal: Journal of Clinical Oncology (2000)

PURPOSE: We evaluated the effect of external-beam radiation therapy on disease-specific survival (death from causes related to prostate cancer) and overall survival in men with clinically localized prostate cancer. METHODS: From 1975 to 1992, 1,465 men with clinically localized prostate cancer received radiation therapy on four Radiation Therapy Oncology Group phase III randomized trials and were pooled for this analysis. No one received androgen-deprivation therapy with his initial treatment. All original histology had central pathologic review for grading using the Gleason classification system. Total delivered radiation dose ranged from 60 to 78 Gy (median, 68.4 Gy). The median follow-up time was 8 years. RESULTS: A Cox regression model revealed that Gleason score was an independent predictor of disease-specific survival and overall survival. The 10-year disease-specific survival rates by Gleason score were as follows: score of 2 through 5, 85%; score of 6, 79%; score of 7, 62%; and score of 8 through 10, 43%. Stratifying outcome by this important prognostic factor revealed that higher radiation dose was a significant predictor for improved disease-specific survival and overall survival only for those patients whose cancers had Gleason scores of 8 through 10 (P &lt; .05). After adjusting for clinical T stage, nodal status, and age, treating with a higher radiation dose was associated with a 29% lower relative risk of death from prostate cancer and 27% reduced mortality rate (P &lt; .05). CONCLUSION: These data demonstrate that higher-dose radiation therapy can significantly reduce the risk of dying from prostate cancer in men with clinically localized disease. This survival benefit is restricted to men with poorly differentiated cancers.
Effect of aclidinium bromide on dyspnoea and health status in patients with stable COPD: Phase III data by GOLD 2013 classification
Authors: Robert M. Mróz, Maria Pilar Ausin, Rosa Lamarca, Esther Garcia Gil
Journal: European Respiratory Journal (2014)

Background 

Current GOLD guidelines classify patients with COPD into groups (A–D) in terms of less or more symptoms and low or high risk. Long-acting muscarinic antagonists, such as aclidinium, are now recommended as first-choice option for Group B–D patients and as an alternative choice for Group A patients.

Aim 

To assess the effect of aclidinium 400 µg twice daily (BID) on dyspnoea and health status in patients with COPD stratified by GOLD group.

Methods 

Data from the placebo and aclidinium arms of three, 6-month, placebo-controlled studies evaluating aclidinium mono- or combination-therapy in patients with moderate-to-severe COPD were analysed. Breathlessness was assessed using the Transitional Dyspnoea Index (TDI) and health status using the St George's Respiratory Questionnaire (SGRQ). Health status assessment was based on two studies due to a treatment interaction by study (p<0.05).

Results 

In total, 1787 patients were included: baseline characteristics (mean ranges) age 62.4–63.9 years, mean FEV1 % predicted 54–57%, percentage of patients in each group was A: 7.9%, B: 48.4%, C: 3.1%, D: 40.6 %. At Week 24, aclidinium significantly improved TDI and SGRQ total scores vs placebo (overall and Groups A+C and B+D; see Table).

Conclusions 

Aclidinium improved dyspnoea and health status regardless of GOLD Group.

![Figure][1]  [1]: pending:yes
A conversation with Craig Thompson
Authors: Ushma S. Neill
Journal: Journal of Clinical Investigation (2015)

Craig Thompson, President and CEO of Memorial Sloan Kettering Cancer Center, is a medical oncologist and immunologist who has made fundamental contributions to our understanding of how cells — from B and T cells to stem cells and cancer cells — survive and replicate. See the full interview at https://www.jci.org/videos/cgms to hear Thompson’s (Figure 1) stories about being a remedial reader, the future of cancer research and therapy, and leadership lessons learned from Watership Down.
Adjunct treatment of pneumonia in children 6-18 years old using a hand held sputum induction device
Authors: Mary Aimee Uson, Anjanette De Leon, Bobby Balete, Leslie Mae Domagas, Joyce Raymond Punzalan
Journal: European Respiratory Journal (2012)

Pneumonia is consistently a leading cause of mortality and morbidity in the Philippines; treatment is mainly antimicrobial. Lung Flute is a safe, hand held device that helps effective induction of sputum. The objective of this study is to evaluate the effectiveness of Lung Flute in sputum induction for relief of cough in children 6-18 years old admitted for Pediatric Community Acquired Pneumonia (PCAP) PCAP B and PCAP C. Children ages 6-18 years old admitted with a diagnosis of PCAP B or PCAP C were included. Patients diagnosed with PCAP A, PCAP D and hyperreactive airway were excluded. Each subject was enrolled to Lung Flute group or Control group by systematic randomization. Patients in the Lung Flute group used Lung Flute 3x a day in addition to the treatment provided by the physician. Pretested questionnaire on cough was answered by both groups. McNemar test was used. Of the 35 subjects (CI 80%, alpha error .05), there were more males than females with a mean age of 9 years old. Majority admitted were diagnosed with PCAP B in Lung Flute group (73.4%) and Control group (85%). There was significant decrease in the frequency of cough on Day 2 (p value .048954) and significant improvement on the quality of cough on Day 2 (p value .002627) and Day 3 (p value .022961). Significant improvement on the quality of life on Day 1 and Day 2 was seen (p value .0004883, p value .002, p value .0000002384). Effective sputum induction was noted in both groups but earlier improvement was seen in the Lung Flute group. Lung Flute is an effective device in sputum induction and may someday be used as adjunct treatment of pneumonia.
Pulmonary oedema in healthy persons during scuba-diving and swimming
Authors: M Pons, D Blickenstorfer, E Oechslin, G Hold, P Greminger, U K Franzeck, E W Russi
Journal: European Respiratory Journal (1995)

The prevalence of pulmonary oedema during scuba-diving is unknown. In our referral centre for diving accidents we have observed several episodes of pulmonary oedema in four previously healthy persons while scuba-diving or swimming. Four events were documented by physical findings, typical chest radiographic changes, and arterial hypoxaemia. Four additional episodes were identified in one of the individuals by a suggestive history. No technical problems with the diving equipment were detectable and none of the individuals reported aspiration of water. In order to gather information about the incidence of pulmonary oedema, we carried out a survey among 1,250 divers. To elucidate possible underlying mechanisms of this complication we investigated forearm vascular resistance, levels of vasoreactive hormones, and left ventricular function by Doppler echocardiography, at room temperature and during cold exposure, in four patients and in healthy control subjects. We found only one additional person with a history suggestive of pulmonary oedema among 460 responders to the survey. We found no differences in forearm vascular resistance, left ventricular systolic and diastolic function, and plasma levels of epinephrine, norepinephrine, cortisol, aldosterone, renin and atrial natriuretic peptide between the patients with a history of pulmonary oedema and the control subjects. We conclude that the occurrence of pulmonary oedema during scuba-diving or swimming is an extremely rare event in healthy individuals. The mechanisms responsible remain unclear.
Clinical differentiation between lethal catatonia and neuroleptic malignant syndrome
Authors: E Castillo, R T Rubin, E Holsboer-Trachsler
Journal: American Journal of Psychiatry (1989)

Lethal catatonia, a syndrome described several decades before the advent of neuroleptic drugs, has been regarded by many investigators as clinically similar to, and perhaps indistinguishable from, neuroleptic malignant syndrome. However, published case reports of the two syndromes indicate differences in mode of onset, signs and symptoms, and outcome. Lethal catatonia often begins with extreme psychotic excitement, which, if persistent, can lead to fever, exhaustion, and death. Neuroleptic malignant syndrome begins with severe extrapyramidally induced muscle rigidity. Because lethal catatonia often requires neuroleptic treatment and neuroleptic malignant syndrome necessitates immediate cessation of neuroleptics, their early clinical differentiation is important.
Action of Bacterial Polysaccharide on Tumors. I. Reduced Growth of Sarcoma 37, and Induced Refractoriness, by &lt;italic&gt;Serrafia&lt;/italic&gt; Morcescens Polysaccharide
Authors: W. Edward O'Malley, Betty Achinstein, Murray J. Shear
Journal: JNCI Journal of the National Cancer Institute (1962)

The growth rate of Sarcoma 37 in mice given the tumor-necrotizing polysaccharide from Serratia marcescens was compared with that in untreated mice. Tumor growth was retarded by a single dose of microgram quantities of this polysaccharide. Subsequent doses, however, failed to interrupt growth a second time. Possible mechanisms for the induction of this refractoriness are discussed.