tbuckley/cabot-search huggingface dataset:
Geographic variation in the conduct of patient surveillance after lung cancer surgery.
Authors: F E Johnson, K S Naunheim, M A Coplin, K S Virgo
Journal: Journal of Clinical Oncology (1996)

PURPOSE Considerable variation among surgeons exists in the current practice of patient surveillance after lung cancer treatment. We evaluated whether geographic factors are responsible for this observed variation. METHODS Profiles of hypothetical patients suitable for postoperative surveillance and a detailed questionnaire based on the profiles were mailed to the 3,700 members of the Society of Thoracic Surgery (STS). The influence of the geographic location of the respondents on practice patterns was assessed among eight large metropolitan statistical areas (MSAs) with sufficient numbers of respondents, among nine broad geographic areas (United States census regions), and by the population size of the MSA from which the respondents reported. RESULTS There were 2,009 responses (54% return rate); 768 of those respondents both operate on and provide long-term follow-up care for lung cancer patients. There were sizeable effects of tumor-node-metastasis (TNM) stage and year postsurgery on practice patterns. Respondents from the Los Angeles/Long Beach MSA consistently had the highest frequency of follow-up test usage and those from the Tampa/St Petersburg MSA usually had the lowest. This held true for most testing modalities and was consistent across TNM stages I to III and years 1 to 5 postsurgery. Follow-up strategy was generally most intensive in the largest MSAs (population size, 2.5 to 10 million). The STS respondents from the Pacific US census region generally used the most intensive follow-up strategies and those from the East North Central and Mountain regions often used the least intensive. The differences disclosed in all three analyses were small. CONCLUSION There is marked variation among STS members in surveillance strategy, and the determinants of testing intensity are complex and interrelated. TNM stage and year postsurgery clearly affect follow-up practice; this analysis provides the first evidence that geographic setting has rather little effect on the surveillance strategies of clinicians.
Screening colonoscopy in adults with cystic fibrosis
Authors: Susanne Naehrig, Rudolf M. Huber, Veit Gülberg, Juergen Behr
Journal: European Respiratory Journal (2014)

Introduction: As the risk for gastrointestinal cancers is increased in CF patients, it might be necessary to screen before the recommended age for the general population (in Germany 55 years). In our center the first screening colonoscopy is recommended after the age of forty, as well as a yearly control of CEA.

Method: We retrospectively analysed the results of patients undergoing colonoscopy.

Results: We have 56 patients over 40 years. Until February 2014 19,6% (11 pat.) underwent colonoscopy, mean age was 45,3 years. There were 2 adenocarcinomas (18,1%), 3 tubulovillous adenomas (27,3%), 1 inflammatory polyp (9,1%). One macroscopic polyp revealed a normal histology of colonic mucosa (9,1%). 3 patients had an insufficient preparation. Only 1 Patient had no finding at all. CEA was only positive in the male patient with adenocarcinoma. An update will be presented at the conference.

View this table:

Table 1: Patients undergoing colonoscopy





Conclusion: Colonoscopy seems to be a reasonable procedure to screen for adenomas, and may be warranted earlier in CF patients. The likelihood to find an adenoma or carcinoma is high (45%). Preparation has to be done carefully.
Late-breaking abstract: BAFF: A self-perpetuating mechanism of B cell activation in COPD
Authors: Francesca Polverino, Jaime Pons, Amanda Iglesias, Angel Rios, Sergio Scrimini, Catalina Crespi, Jaume Sauleda, Caroline Ann Owen, Bartolome Celli, Alvar Agustí, Borja Cosio
Journal: European Respiratory Journal (2014)

Background: The adaptive immune response, including the recruitment and activation of lymphocytes, may contribute to emphysema pathogenesis. B cell Activating Factor (BAFF) promotes B cell tolerance and homeostasis, and is overexpressed in COPD lymphoid follicles. However, it is not know whether BAFF is expressed in lymphocytes in the blood or BAL compartments in COPD.  Methods: 1) BAFF expression in B and T cells in bronchoalveolar lavage (BAL) and blood samples was quantified by flow cytometry in 38 COPD patients (GOLD I-IV), and 17 smokers (SC) and 20 non-smokers (NSC) with normal lung function. 2) Immunostaining for BAFF was performed on BAL leukocytes from COPD patients (n=4), SC (n=4), and NSC (n=4). 3) Blood mononuclear cells from 4 NSC were cultured with 3% or 7% CS-extract (CSE) or PBS, and BAFF-positive B cells were quantified by flow cytometry.  Results: 1) BAFF expression was increased in B but not T BAL cells and, to a lesser extent, in blood samples from COPD patients compared with cells from SC which, in turn, had higher BAFF expression than NSC cells. Also, BAFF levels in BAL B cells were inversely correlated with the severity of airflow limitation. 2) COPD had 2-fold higher BAFF levels in BAL B cells than SC and NSC, and SC had higher BAFF levels in BAL B cells than NSC. 3) Stimulation with 3% CSE increased BAFF expression in blood B cells, which was increased even more with 7% CSE vs. PBS-treated cells.  Conclusions: BAFF levels were increased in blood and lung B cells in COPD patients. Also, CSE exposure in vitro increased BAFF expression in B cells in a dose-dependent manner. These results suggest that B lymphocyte expansion, mediated by BAFF, is a critical event in the pathogenesis of COPD.
Mastectomy or Lumpectomy? Helping Women Make Informed Choices
Authors: Timothy Whelan, Mark Levine, Amiram Gafni, Kenneth Sanders, Andrew Willan, Douglas Mirsky, Denise Schnider, David McCready, Susan Reid, Anna Kobylecky, Kenneth Reed
Journal: Journal of Clinical Oncology (1999)

PURPOSE: To develop an instrument to help clinicians inform their patients about surgical treatment options for the treatment of breast cancer and to evaluate the impact of the instrument on the clinical encounter. METHODS: We developed an instrument, called the Decision Board, to present information regarding the benefits and risks of breast-conserving therapy (lumpectomy plus radiation therapy) and mastectomy to women with early-stage breast cancer to enable them to express a preference for the type of surgery. Seven surgeons from different communities in Ontario administered the instrument to women with newly diagnosed clinical stage I or II breast cancer over an 18-month period. Patients and surgeons were interviewed regarding acceptability of the instrument. The rates of breast-conserving surgery performed by surgeons before and after the introduction of the instrument were compared. RESULTS: The Decision Board was administered to 175 patients; 98% reported that the Decision Board was easy to understand, and 81% indicated that it helped them make a decision. The average score on a true/false test of comprehension was 11.8 of 14 (84%) (range, 6 to 14). Surgeons found the Decision Board to be helpful in presenting information to patients in 91% of consultations. The rate of breast-conserving surgery decreased when the Decision Board was introduced (88% v 73%, P = .001) CONCLUSION: The Decision Board is a simple method to improve communication and facilitate shared decision making. It was well accepted by patients and surgeons and easily applied in the community.
Correlation between Genotype and Phenotype in Patients with Cystic Fibrosis
Authors: Augarten A, Kerem Bs, Kerem E, Gazit E, Yahav Y
Journal: New England Journal of Medicine (1993)

Cystic fibrosis is the most common lethal autosomal recessive disorder among whites. Seventy-two percent of patients with this disease are homozygotes or compound heterozygotes for eight mutations of the cystic fibrosis transmembrane conductance regulator gene on chromosome 7: delta F508, G542X, R553X, W1282X, N1303K, 621 + 1G-->T, 1717-1G-->A, and R117H. We studied the relation between genotype and phenotype in patients from 14 countries.Each of 399 patients who were compound heterozygotes for delta F508 and one other mutation was matched with the delta F508 homozygote of the same sex who was the closest in age from the same center. A paired analysis was performed of the following outcome variables: age at diagnosis, sweat chloride concentration, growth percentiles, pulmonary-function values, chest-film score, pseudomonas colonization, nasal polyps, pancreatic sufficiency, pancreatitis, diabetes mellitus, meconium ileus, distal intestinal obstruction syndrome, rectal prolapse, cirrhosis, and gallbladder disease.The compound heterozygotes having the genotype R117H/delta F508 clearly differed from the age- and sex-matched delta F508 homozygotes: they more often had pancreatic sufficiency (87 percent vs. 4 percent, P < 0.001), were older when the diagnosis was first made (mean [+/- SD] age, 10.2 +/- 10.5 vs. 2.5 +/- 4.3 years; P = 0.002), and had lower sweat chloride concentrations (80 +/- 18 vs. 108 +/- 14 mmol per liter, P < 0.001). There were no statistically significant differences between delta F508 homozygotes and other compound heterozygotes with regard to any variable tested.Prenatal and prognostic counseling for patients with the R117H/delta F508 genotype should include the likelihood that they will have long-term pancreatic sufficiency. Patients with the other genotypes should expect the early onset of pancreatic insufficiency. For none of the genotypes studied can predictions be made about the occurrence of common complications or the severity or course of pulmonary disease.
Relationship between rpoB mutations and minimum inhibitory concentrations of rifampicin in multi drug resistant strains of mycobacterium tuberculosis
Authors: Shashikant Vaidya, Vidyagouri Shinde, Rupendra Jadhav, Shreyasi Mulye, Abhay Chowdhary, Mohan Kulkarni, Geeta Koppikar
Journal: European Respiratory Journal (2011)

Introduction:  Rifampicin (RF) resistance serves as a surrogate marker for detection of multi drug resistant (MDR) strains of Mycobacterium tuberculosis (MTB). Among many mutations identified in rpoB gene, the target gene for detection of RF resistance, few were verified by molecular genetic methods.   Aim:  To detect and characterize mutations in rpoB region of MDR MTB strains by automated DNA sequencing.  To study the relationship between in vitro Minimum Inhibitory Concentrations (MIC) for RF and rpoB mutations   Methods:  Absolute concentration method was used to determine MIC of RF for 20 MDR MTB strains.  DNA sequencing was carried out in an ABI sequencer.   Results:  We could detect point mutations in the 81 bp section of a “hot spot” region of the rpoB gene of all the MDR strains.  Mutations were detected in positions 516,526 and 531, with frequencies of 30%, 40%, and 55%, respectively.  It was found that mutations in positions 526 and 531 conferred high-level resistance to RF (MIC9s ≥ 128μg/ml).  Mutations in positions 516 relate to low-level resistance. (MIC9s ≤ 64μg/ml).  Double point mutations in 2 isolates in positions 526 & 531 and 1 isolate in position 516 & 531 relate to high level resistance (MIC9s ≥ 128μg/ml), while 2 isolates in position 516 & 526 relate to low level resistance (MIC9s ≤ 64μg/ml).   Conclusion:  A relationship between susceptibility to RF and alterations in rpoB gene is observed. However, relationship between gene alteration and drug-resistant phenotype is still unclear, further analysis of the relationship between MICs and gene alteration is necessary.
High-risk multiple myeloma treated with high-dose melphalan.
Authors: H M Lokhorst, O J Meuwissen, L F Verdonck, A W Dekker
Journal: Journal of Clinical Oncology (1992)

This study was undertaken to evaluate the efficacy and toxicity of high-dose melphalan (HDM) 140 mg/m2 in poor-risk multiple myeloma (MM).Thirteen patients were previously untreated, and 13 had been pretreated with vincristine, Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), and dexamethasone (VAD) for refractory or relapsed MM.All 11 fully assessed, untreated patients responded, and six achieved a complete response. Remissions were of excellent quality, but response duration--a median of 16 months--was short. This was probably due to the high incidence of unfavorable prognostic signs, like a high beta 2-microglobulin (B2M) and/or a high plasma cell labeling index (LI). None of the nine pretreated patients with a measurable M component had more than 50% reduction of M component after HDM, indicating that intensive treatment has no effect on a residual tumor population. The relapse-free period after HDM in this group of patients (median, 9 months) was not better than in a historical control group of patients treated with VAD alone. The major complications due to the prolonged myelosuppression were severe infections. After primary HDM, median time to recovery to greater than 0.5 x 16(9) granulocytes was 30 days; in previously treated patients, the recovery period was even longer. There were three toxic deaths. Fulminant relapses with features of J-chain disease were frequently observed, indicating a dedifferentiated tumor, probably induced or selected by the HDM.HDM is an effective treatment resulting in good remissions for untreated MM. However, other therapy strategies should be explored first, focusing on the reduction of toxicity and prolongation of the relapse-free period, before HDM can be recommended as first-line treatment for the younger MM patient.
The Fellows Presentations Evaluation Survey (FPES) is a reliable educational method to assess the Hematology-Oncology Fellows (HOFs) presentation skills
Authors: A. A. Eid, M. Safar, L. F. Hutchins, L. Ray, C. Mercado, M. Petty
Journal: Journal of Clinical Oncology (2008)

17554 Background: Evaluation of didactic sessions presented by fellows is a continuing challenge for many fellowship programs. The lack of a standardized assessment tool to evaluate the fellows’ presentation skills throughout the fellowship training period is affecting this important aspect of the fellows training. Our hypothesis is that the PFES is a reliable method to assess and improve the fellows’ presentation skills. Methods: We designed a 9-item survey to evaluate the following aspects: 1) the presentation (length, organization, and audience's scientific benefit), 2) the content (relationship to objectives, currency, clarity and logic), 3) the quality of the audiovisuals and 4) the presenting fellow (effort made gathering the data, presentation skills). Each item is scored from one to five where one is “strongly disagree” and five is “strongly agree”. The subjects were the Hematology- Oncology fellows (HOFs) and the study was conducted over a full academic year. Three time periods were defined: fall period (from August to November 2006), winter period (from November to March 2007) and spring period (from March to June 2007). The fellows were evaluated anonymously by their peers and the faculty of the department. At the end of each period, a feedback from an educator faculty member was planned. This feedback was based on the fellows PFES scores, comments and the educator's personal evaluation of the fellows’ presentation skills. Results: Nine HOFs participated in the educational study between August 2006 and June 2007. Two hundred and eighty two surveys were filled: 108 in the fall period, 100 in the winter period and 74 in the spring period. Thereliability was >0.93 for all 3 periods and for the aggregated data. There was a trend toward better use of the scale in the spring period. Generally, the means for the questions dropped for the spring period. A feedback session was done after the fall period when the fellows were given the feedback and were educated about the need to use the scale in a more objective way. Conclusions: In our study, the PFES is a reliable method to assess but not to improve the HOFs presentation skills. The fellows tend to overrate their peers initially and education about the objective use of the survey is needed. No significant financial relationships to disclose.
No Evidence of Association Between Prothrombotic Gene Polymorphisms and the Development of Acute Myocardial Infarction at a Young Age
Authors: P. M. Mannucci, P. A. Merlini, D. Ardissino, C. Barzuini, F. Bernardi, L. Bernardinelli, C. Cavallini, P. Celli, G. Corsini, M. Ferrario, R. Fetiveau, M. Galli, A. Piazza, F. Ribichini, E. Sacchi, M. Tubaro, P. Zonzin, C. Berzuini, L. Foco, L. Tagliabue, M. Menegatti, F. Peyvandi, A. Repetto, U. Canosi, V. Cucci, S. Buratti, S. Fondazione, M. Ponzetta, M. Rinuncini, M. Spolverato, A. Vetrano, M. Lamponi, L. Cacciavillani, C. Castelli, A. Colizzi, N. Pagnoni, E. Colombi, D. Covini, G. Fantini, C. Dodi, P. Paoloni, I. Maoddi, G. Bardelli, M. Azzarito, M. Beciani, F. Tettamanti, M. E. Caccia, P. Massoli, R. Pozzi, F. Pecchio, P. Barberis, M. Giudice, R. Di Giovanbattista, B. Mazzocco, G. Gaeta, M. Margaglione, P. Diotallevi, A. Salvioni, S. Biancoli, A. Rosi, E. Milanesi, S. Span, A. C M Saccà, A. C. Maugeri, D. Scorzoni, M. Maffi, G. A. Dei Tos, P. P. Cannarozzo, R. Vandelli, M. Fici, A. Tempesta, G. R. Lucchi, G. Ricci, D. Baragli, D. Laiso, L. Garzaro, R. Vaninetti, G. Cattadori, A. Picozzi, R. Petacchi, C. Berardi, V. Guiducci, O. Gaddi, N. Franco, E. Buia, F. Fedeli, F. Barillà, L. Irace, S. Sarracino, N. De Giorgio, G. Scalera, M. Elia, P. Sabella, A. Previtera, G. Di Tano, B. Francaviglia, G. Contini, F. Del Nevo, P. Agricola
Journal: Circulation (2003)

We investigated the association between 9 polymorphisms of genes encoding hemostasis factors and myocardial infarction in a large sample of young patients chosen because they have less coronary atherosclerosis than older patients, and thus their disease is more likely to be related to a genetic predisposition to a prothrombotic state.This nationwide case-control study involved 1210 patients who had survived a first myocardial infarction at an age of <45 years who underwent coronary arteriography in 125 coronary care units and 1210 healthy subjects matched for age, sex, and geographical origin. None of the 9 polymorphisms of genes encoding proteins involved in coagulation (G-455A beta-fibrinogen: OR, 1.0; CI, 0.8 to 1.2; G1691A factor V: OR, 1.1; CI, 0.6 to 2.1; G20210A factor II: OR, 1.0; CI, 0.5 to 1.9; and G10976A factor VII: OR, 1.0; CI, 0.8 to 1.3), platelet function (C807T glycoprotein Ia: OR, 1.1; CI, 0.9 to 1.3; and C1565T glycoprotein IIIa: OR, 0.9; CI, 0.8 to 1.2), fibrinolysis (G185T factor XIII: OR, 1.2; CI, 0.9 to 1.6; and 4G/5G plasminogen activator inhibitor type 1: OR, 0.9; CI, 0.7 to 1.2), or homocysteine metabolism (C677T methylenetetrahydrofolate reductase: OR, 0.9; CI, 0.8 to 1.1) were associated with an increased or decreased risk of myocardial infarction.This study provides no evidence supporting an association between 9 polymorphisms of genes encoding proteins involved in hemostasis and the occurrence of premature myocardial infarction or protection against it.
EXPERIMENTAL SYPHILIS IN THE RABBIT
Authors: Wade H. Brown, Louise Pearce
Journal: The Journal of Experimental Medicine (1920)

From a study of the reaction to scrotal inoculation with Treponema pallidum in alarge series of rabbits, it was found that the specific reaction presented the following characteristics. In general, the reaction in the scrotum became apparent within 7 to 14 days after inoculation but was subject to considerable variation. The early reaction took the form of an edematous swelling and congestion associated with a new growth of vessels or of an infiltration with more or less proliferation of fixed tissue cells. These reactions were either confined to a small circumscribed area of the scrotum or were of a diffusely spreading character, and as the infection advanced, the infiltration and proliferation together with such secondary changes as exfoliation, necrosis, and ulceration became the most conspicuous features of the reaction. The course of the reaction in the scrotum was essentially the same as that in the testicle; that is, it was periodic in character and was marked by a phase of active progression followed by quiescence or regression and renewed activity. The scrotal reaction resembled that in the testicle also in the varying character of the reaction, appearing at times as a circumscribed focus of reaction and later becoming diffuse, or first as a diffuse reaction which subsequently became more localized. The lesions produced in consequence of this reaction were of two general types -one a circumscribed indurated granulomatous lesion closely resembling the human chancre, the other a diffuse infiltration more analogous to the secondary skin lesions of man. Both groups of lesions presented the greatest degree of individual variations and possessed no fixed status but were subject to frequent and marked transformations. After a period of from a few weeks to many months, the lesions in the scrotum disappeared spontaneously.
Use of retinoic acids in the treatment of peripheral T-cell lymphoma: a pilot study.
Authors: A L Cheng, I J Su, C C Chen, H F Tien, J D Lay, B R Chen, Y S Pu, R L Hong, M C Shen, C H Wang
Journal: Journal of Clinical Oncology (1994)

We have systemically analyzed, both in vitro and in vivo, the effect of 13-cis-retinoic acids (RA) on non-Hodgkin's lymphoma (NHL).The in vitro growth-inhibitory effect of 13-cis-RA was examined in 11 (T cell, five; B cell, six) lymphoma cell lines by a tetrazolium colorimetric assay. A pilot clinical trial with oral 13-cis-RA 1 mg/kg/d was conducted in a selected group of 18 lymphoma patients, of whom 16 had failed to respond to at least one regimen of intensive chemotherapy. The in vitro and in vivo effects of 13-cis-RA were correlated with immunophenotypes, RA-induced changes of morphology, and patterns of DNA fragmentation of the lymphoma cells.Four of five T-lymphoma cell lines and none of six B-lymphoma cell lines were sensitive (concentration of 50% growth inhibition [IC50] < 1.5 microns) to 13-cis-RA (P = .015). In the clinical trial, five (two Ki-1, one angioinvasive type, one diffuse mixed cell, and one diffuse large cell) complete remissions and one (Ki1) partial remission were observed in 12 patients with peripheral T-cell lymphoma (PTCL), while none of six patients with B-cell lymphoma responded to 13-cis-RA. 13-cis-RA-induced cellular differentiation and apoptosis, as evidenced by the more mature morphology, characteristic nuclear condensation, and DNA ladder pattern signifying internucleosomal fragmentation, were demonstrated in the sensitive cell lines, as well as in the remitting lymphoma tissues.The 13-cis-RA appears to be active on lymphomas of T-lineage and their therapeutic indication may be extended to include some subtypes of PTCL. The mechanisms of action are related to differentiation and apoptosis of lymphoma cells. There appears to be no cross-resistance between 13-cis-RA and conventional chemotherapy.
Thought Disorder in Depression
Authors: BENJAMIN M. IANZITO, REMI J. CADORET, DANIEL D. PUGH
Journal: American Journal of Psychiatry (1974)

The authors investigated abnormalities in the thinking of depressed patients and present some preliminary data on the prognostic value of thought disorder in unipolar depressive illness. They conclude that both content disturbances and formal thought disorder may occur in primary depressive illness during episodes severe enough to require hospitalization. They also conclude that formal thought disorder at the time of admission seems to predict a more severe episode of depression and may help create a subdivision of depressive illness analagous to that proposed for schizophrenia.