tbuckley/cabot-search huggingface dataset:
Surgical second look in ovarian cancer: a randomized study in patients with laparoscopic complete remission--a Northeastern Oncology Cooperative Group-Ovarian Cancer Cooperative Group Study.
Authors: M O Nicoletto, S Tumolo, R Talamini, L Salvagno, S Franceschi, E Visonà, G Marin, F Angelini, G Brigato, C Scarabelli, A Carbone, A Cecchetto, A Prosperi, A Rosabian, M Giusto, G P Cima, S Morassut, O Nascimben, O Vinante, M V Fiorentino
Journal: Journal of Clinical Oncology (1997)

PURPOSE The usefulness of extensive and repetitive surgery for patients with ovarian cancer still remains unproven (at least for some conditions). We planned an accurate prospective test of the hypothesis that patients with advanced-stage disease, after they had reached a clinical complete remission (CR), may benefit from surgical second look (SSL). PATIENTS AND METHODS One hundred two patients in CR (as assessed by clinical findings, markers, and visualization by computed tomographic [CT] scan and laparoscopy), after initial debulking and first-line chemotherapy, were randomized to two arms, which were well balanced for predictive criteria such as age, stage at presentation, histology, grading, date of randomization, and residua after first surgery. Forty-eight patients were randomly assigned to receive follow-up evaluation only, while 54 were assigned to receive second surgery (eight of them refused). Of 46 surgical patients, 35 had negative and 11 positive surgical findings (24% clinically false-negative). RESULTS Despite the microscopic residua found at open surgery, and the fact that the patients were then treated with second-line chemotherapy, SSL did not increase the probability of survival in this setting. In an analysis of the results according to the intention-to-treat criteria, after a 60-month follow-up period, the overall survival rates in the two groups of patients (SSL v no SSL) were 65% and 78%, respectively (P = .14). Multivariate analysis according to predictive criteria confirmed there was no significant difference between the two groups (P = .39). CONCLUSION Our study shows the following: (1) our second-line treatment is scarcely effective; (2) SSL accurately defines complete responders to first-line chemotherapy; (3) SSL per se does not prolong survival; and (4) if confirmed, a less invasive procedure could replace SSL as a valuable method in new first-line regimens in ovarian cancer patients with clinical CR confirmed by laparoscopy.
Dynamics of production thyroid-stimulating hormone in patients with multiple-drug resistant tuberculosis (MDR-TB) on the background of prolonged chemotherapy
Authors: Tatiana Morozova, Tatiana Salina
Journal: European Respiratory Journal (2011)

Treatment of patients with pulmonary tuberculosis with MDR-TB requires the use of drugs 2 rows that have a large number of adverse reactions. It is assumed that prolonged simultaneous reception use of protionamide and PASK can reduce thyroid function.  Aim: Evaluation of trends in production of thyroid-stimulating hormone (TSH) in patients with MDR-TB on the background of prolonged combined chemotherapy.  Methods: TSH levels in serum were determined in 102 patients with MDR-TB, initially and after receiving patients 60, 120, 180 doses of a combination of antibacterial drugs (capreomycin, protionamide, pyrazinamide, PASK, ofloxacin, cycloserine) by immunoenzyme method.  Results: The level of TSH in patients with MDR-TB before therapy was low (mean 1,57±0,19 mkME/ml). After receiving 60 and 120 doses of the drugs level of the TSH of patients increased (2,95±0,57, p=0.046 and 3,32±0,41 mkME/ml, p=0.0016, respectively). Significant increase in TSH was observed in 20% of patients without clinical manifestations of hypothyroidism. On the background of receiving of drugs (180 doses) TSH levels decreased slightly (2,38±0,37 mkME/ml). Increased TSH persisted in 13% of patients.  Conclusions: In patients with MDR-TB in the background of the combined reception 6 drugs observed increase in TSH levels in the absence of clinical signs of hypothyroidism. The downward trend in TSH levels with continued therapy without the abolition of drugs (180 doses) may indicate the inclusion of compensatory mechanisms, and at this stage of treatment does not require additional correction of thyroid function.
Impact of an Extensive in Situ Component on the Presence of Residual Disease in Screen Detected Breast Cancer
Authors: I D Campbell, J M Theaker, G T Royle, R Coddington, R Carpenter, A Herbert, I Moore, C Rubin, I Taylor, P B Guyer
Journal: Journal of the Royal Society of Medicine (1991)

This study investigates the histopathological characteristics of a consecutive series of 100 screen detected breast cancers in relation to residual disease. Tumour type, size, grade, resection margins and extent of primary or associated in situ disease were all assessed by one pathologist. Thirty-seven women underwent further surgery (wider excision or mastectomy) and the resected specimen was examined for residual in situ or invasive cancer. In total, 36 cancers had an extensive in situ component, of which 69% were predominantly intraduct carcinoma of comedo type. Of the 37 women who underwent further resection, 21 (57%) women had residual cancer. Of those with initial disease at the resection margin, 16/25 (64%) had residual disease. Five of 12 (42%) with disease close to (within 2-3 mm) but not at the margin had residual disease. Of those with an extensive in situ component, 18/25 (72%) had residual disease, whereas only 2/12 (17%) women with none or some in situ disease had residual cancer. In screen detected breast cancer, residual cancer was present in 72% of women with an extensive in situ component at initial surgery. These women comprise a group in which conservation surgery may be inappropriate if completeness of excision is considered a prerequisite for breast conserving surgery.
An analysis of mRNA and long non-coding RNA (lncRNA) expression during the progression from pre-invasive lesions (PL) to invasive squamous cell carcinoma (SqCC) of the bronchus
Authors: Andre Koper, Leena Joseph, John Gosney, Keith Kerr, Michelle Evison, Phil Crosbie, Mark Lindsay, Richard Booton
Journal: European Respiratory Journal (2013)

Lung cancer has a poor 5-year survival rate often attributed to late diagnosis where curative treatment is uncommon. SqCC account for 40% of non-small cell lung cancer that possess clinically detectable PL. Intervention following early diagnosis of SqCC can reduce mortality. PL of SqCC are classified into squamous metaplasia (M), mild-(MID), moderate-(MOD) and severe dysplasia (SD) as well as carcinoma in-situ(CIS). They are found with varying prevalence, in smokers or individuals exposed to occupational carcinogens. MID and MOD are more frequent but only a minority progress to a SqCC. SD or CIS more commonly progress to SqCC but this is not universal (1,2).  The natural history of PL is not well understood (2). In order to address this, we use exon arrays to profile mRNA and lncRNA in total RNA derived from fixed and wax embedded bronchial biopsies subject to laser microdissection. Three thoracic pathologists (KK, JG, LJ) reviewed all biopsies and agreed the morphological classification. We will report changes in mRNA and lncRNA levels when we compared the expression profiles in 5 categories of PL (see above) and 2 of SqCC (node negative/positive), with those of matched normal bronchial epithelial cells. We believe this analysis will provide novel insights into the molecular events that drive PL towards invasive malignancy, and may identify novel tools for the management of early squamous cell lung cancer.  1. William D. Travis MD, Cancer TIAfRo, & Pathology IAo (2004) Pathology & Genetics: Tumours of the Lung, Pleura, Thymus, and Heart.  2. Banerjee AK (2009). Journal of Thoracic Oncology 4(4):545-551.
Abstract 3163: Association of Pre-PCI TIMI flow grade (TFG) with Subsequent Mortality in Patients Presenting with ST-Elevation Myocardial Infarction (STEMI)
Authors: Michael C Nguyen, Duane S Pinto, Claudia Hochberg, Amjad Almahameed, Yuri Pride, Jo Ellyn Abraham, Paul D Frederick, Sabina A Murphy, C M Gibson
Journal: Circulation (2007)

Background: Pre-procedural TIMI flow grade has been associated with mortality (both in-hospital and long-term) in patients (pts) undergoing percutaneous coronary intervention (PCI) following STEMI in randomized trials. This relationship has not been well characterized in a large heterogeneous real world population. Methods: A cohort of 8,133 patients presenting with STEMI in the National Registry of Myocardial Infarction (NRMI) was studied. Analysis of the relationship between pre-PCI TFG and in-hospital mortality was performed. Results: Of the 8133 patients, 6307 (77.5%) had TFG 0/1, 1178 (14.5%) had TFG 2, and 648 (8.0%) had TFG 3. Patients with TFG 0/1 before PCI (primary, rescue or facilitated) had an in-hospital mortality rate of 3.3% compared with TFG 2 of 1.6% and TFG 3 of 1.2% ( P &lt; 0.001). Pre-PCI TFG was associated with significant differences in mortality in all subgroups including age, gender, and location of infarct (see table ). Among pts with TFG 3 post PCI, mortality was still associated with pre-PCI TFG (pre-TFG 0/1 = 2.7%, pre-TFG 2 = 1.5%, TFG 3 = 1.2%, P = 0.002). Conclusion: Pre-PCI TFG is associated with in-hospital mortality in a heterogeneous group of real world patients presenting with STEMI treated with PCI, including those with TFG 3 following PCI.
Graphs to estimate an individualized risk of breast cancer.
Authors: J Benichou, M H Gail, J J Mulvihill
Journal: Journal of Clinical Oncology (1996)

Clinicians who counsel women about their risk for developing breast cancer need a rapid method to estimate individualized risk (absolute risk), as well as the confidence limits around that point. The Breast Cancer Detection Demonstration Project (BCDDP) model (sometimes called the Gail model) assumes no genetic model and simultaneously incorporates five risk factors, but involves cumbersome calculations and interpolations. This report provides graphs to estimate the absolute risk of breast cancer from the BCDDP model.The BCDDP recruited 280,000 women from 1973 to 1980 who were monitored for 5 years. From this cohort, 2,852 white women developed breast cancer and 3,146 controls were selected, all with complete risk-factor information. The BCDDP model, previously developed from these data, was used to prepare graphs that relate a specific summary relative-risk estimate to the absolute risk of developing breast cancer over intervals of 10, 20, and 30 years.Once a summary relative risk is calculated, the appropriate graph is chosen that shows the 10-, 20-, or 30-year absolute risk of developing breast cancer. A separate graph gives the 95% confidence limits around the point estimate of absolute risk. Once a clinician rules out a single gene trait that predisposes to breast cancer and elicits information on age and four risk factors, the tables and figures permit an estimation of a women's absolute risk of developing breast cancer in the next three decades.These results are intended to be applied to women who undergo regular screening. They should be used only in a formal counseling program to maximize a woman's understanding of the estimates and the proper use of them.
Adult acute lymphoblastic leukemia: a multicentric randomized trial testing bone marrow transplantation as postremission therapy. The French Group on Therapy for Adult Acute Lymphoblastic Leukemia.
Authors: D Fière, E Lepage, C Sebban, C Boucheix, C Gisselbrecht, J P Vernant, B Varet, A Broustet, J Y Cahn, F Rigal-Huguet
Journal: Journal of Clinical Oncology (1993)

In a prospective multicenter study, we analyzed the benefits of allogeneic bone marrow transplantation (BMT) in a nonselected group of adult patients with acute lymphoblastic leukemia (ALL) and, by a randomized trial, evaluated the effectiveness of autologous BMT over chemotherapy as postremission therapy in patients younger than 50 years who were not candidates for allogeneic BMT.After induction therapy that randomized patients to receive one of two anthracycline-containing regimens, either daunorubicin (DNR) or zorubicin (ZRB), patients were assigned to postremission treatment according to age and results of HLA typing. Patients younger than 40 years with an HLA-identical sibling (group 1) were scheduled to receive cyclophosphamide 60 mg/kg on days 1 and 2, total-body irradiation (TBI), and allogeneic BMT. Patients older than 50 years (group 2) received the chemotherapy arm composed of three monthly consolidation courses (DNR or ZRB, cytarabine, and asparaginase) followed by maintenance chemotherapy (modified L10 regimen). The remaining population (group 3) was randomly assigned to receive, after the three 1-month consolidation courses, either the chemotherapy arm or autologous BMT following a conditioning regimen similar to that of group 1.Of the 572 assessable patients, 436 achieved complete remission (78% +/- 2% for DNR v 74% +/- 3% for ZRB; P = .3). The estimated 3-year disease-free survival (DFS) rate for the 116 patients included in group 1 was 43% +/- 5%. Both autologous BMT (95 patients) and chemotherapy (96 patients) produced comparable 3-year DFS rates (39% +/- 5% v 32% +/- 5%) and survival durations (49% +/- 5% v 42% +/- 5%). However, late relapses after 36 months were mainly observed in the chemotherapy arm.This first interim analysis did not demonstrate a benefit of this autologous BMT procedure over classical maintenance chemotherapy in patients with ALL who received consolidation chemotherapy.
A comparison of lung function and atopy between children with intrauterine growth retardation and normal birth weight in a birth cohort with documented wheeze
Authors: Karthika Jayalal, George D'Souza, Uma Devaraj
Journal: European Respiratory Journal (2012)

RATIONALE: Low birth weight and intra uterine growth retardation has been implicated in lower lung function and a higher incidence of atopy. This was tested in a birth cohort.

AIM: To compare atopic status and lung function between IUGR and normal birth weight children with documented wheeze.

METHODS: Children aged 3-7 yrs from a birth cohort with documented wheezing or a parental history of child wheezing and a doctors prescription for bronchodilators were studied. IUGR was defined as birth weight of less than 2.5kg. All the children underwent spirometry and skin prick test.

Spirometry was done before and after bronchodilator according to ATS guidelines. Skin prick test was done using 10 antigens. Positive test was defined as wheal of more than 3mm of that of the negative control.

RESULTS: A total of 92 children who were comparable were studied,out of which 36 (33%) were low birth weight and 56 (51.52%) were normal birth weight.

IUGR children had a lower FEV1 / FVC ratio (FEV1 / FVC 87.26±11.55) than children with normal birth weight (FEV1 / FVC 93.74±7.62) p value - FEV1/FVC-0.002.They also had a lower FVC % value when compared to normal birth weight children.FVC% in IUGR -81.46±10.97and that of normal birthweight children were-86.91±10.92 with a p value of 0.025.The skin prick test positivity in both groups were comparable(15.7% in normal birth weight and 16.7 % in IUGR children, p value -0.92)

CONCLUSION: IUGR had lower FEV1/FVC ratio and FVC% as compared to normal birth weight children. Atopic status was comparable in both groups.
Complete tissue coverage achieved by scaffold-based tissue engineering in the fetal sheep model of Myelomeningocele
Authors: Miho Watanabe, Haiying Li, Aimee G. Kim, Aaron Weilerstein, Anteneta Radu, Marcus Davey, Stavros Loukogeorgakis, Melissa D. Sánchez, Kazutaka Sumita, Naoki Morimoto, Masaya Yamamoto, Yasuhiko Tabata, Alan W. Flake
Journal: Biomaterials (2015)
A new approach for assessing regional distribution of within-breath chest wall (CW) mechanical properties
Authors: Raffaele Dellaca, Alessandro Bertini, Amedeo Bussi, Ilaria Milesi
Journal: European Respiratory Journal (2014)

Few studies demonstrated the presence of spatial heterogeneities in CW mechanics and its relevant contribution to respiratory mechanics. Nowadays, there are no technologies able to simultaneously measure regional CW mechanics and the CW motion due to breathing.

Recently, we developed a CW scanning system based on laser interferometers (LI) that allows measuring high-frequency skin vibrations and, when combined with (FOT) Forced Oscillation Technique, also mechanical impedance CW maps. Unfortunately, this technology cannot provide absolute 3D positions, making it impossible to measure the pressure propagation speed and its dependence on lung volume.

We developed a new device by combining the LI with a self-made 3D optical tracking system based on two webcams (WCTRK) able to measure the 3D position of the LI spots on the skin (Figure, left) .

The WCTRK was compared to a commercial 3D tracker (OEP system, BTS, Italy) in 3 healthy subjects during quiet breathing. Ten LI spots placed along two horizontal imaginary lines (one at the angle of Louis and the other at the umbilicus) were considered. The overall regression line between the commercial tracker and the WCTRK was y=1.00*x+0.13 mm, r2=0.99, mean error 0.5±0.31 mm. The combination of LI and WCTRK systems, both based on low-cost technologies, was able to accurately measure regional within-breath oscillatory pressure propagation speed (

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).

 [1]: pending:yes
Evaluation of aerobic exercise program during hospitalization in quality of life and in exercise capacity after one month of discharge in exacerbated COPD patients
Authors: Caroline Knaut, Carolina B. Mesquita, Stephania S. Margotto, Talita J. Cezare, Simone S. Vale, Liana S. Coelho, Ilda Godoy, Irma Godoy, Suzana E. Tanni
Journal: European Respiratory Journal (2014)

Introduction: Acute exacerbation causes deterioration in quality of life, pulmonary and muscle functions and survival of COPD patients. Exercise taken during an acute exacerbation can improve quality of life and physical ability. Objective: Pilot study to evaluate the associations of aerobic exercise program on length of stay, quality of life and exercise capacity after one month of discharge. Methods: 11 patients (81.8% female, FEV1:42.4±18.3% and age:67±9.4years) hospitalized for COPD exacerbation were randomized in two groups, the control group and the intervention group who performed aerobic exercise during hospitalization. All patients were evaluated for physical capacity determined by the 6-minute walk test (6MWT) and quality of life estimated by the Saint George Respiratory Questionnaire (SGRQ). Aerobic exercise program was performed diary with mean velocity 1,1±1,0 Km/h and inclination 0,5± 1,3o, twice a day with a treadmill during 15 minutes. Results:- 

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We identified statistical difference in length of stay between intervention group and control group (6,8± 3,0 vs 8,1± 4,4 days, p=0,007). Conclusion: This study showed that patients who underwent an aerobic exercise during hospitalization had better quality of life and exercise capacity after one month of discharge.
Severity of psychiatric symptoms as a predictor of benefits from psychotherapy: the Veterans Administration-Penn study [published erratum appears in Am J Psychiatry 1989 Dec;146(12):1651]
Authors: George E Woody, A. T. McLellan, L. Luborsky, C. P. O'Brien, J. Blaine, S. Fox, I. Herman, A. T. Beck
Journal: American Journal of Psychiatry (1984)

One hundred ten nonpsychotic opiate addicts were randomly assigned to receive paraprofessional drug counseling alone, counseling plus cognitive-behavioral psychotherapy, or counseling plus supportive-expressive psychotherapy. Patients were classified low-severity, mid-severity, or high-severity on the basis of the number and severity of their psychiatric symptoms. Overall, the addition of professional psychotherapy was associated with greater benefits than was drug counseling alone. Low-severity patients made considerable and approximately equal progress with added psychotherapy or with counseling alone. Mid-severity patients had better outcomes with additional psychotherapy than with counseling alone, but counseling did effect numerous significant improvements. High-severity patients made little progress with counseling alone, but with added psychotherapy made considerable progress and used both prescribed and illicit drugs less often.
Cholecystectomy: Safe or Not Safe to Drain?
Authors: S G Mellor, M H Thomas, B S Donnellan
Journal: Journal of the Royal Society of Medicine (1988)

The aim of this study was to determine whether drains influenced the size of subhepatic collections following cholecystectomy, and if these had any affect on complications. Eighty-five patients undergoing cholecystectomy had either no drain, a narrow bore suction drain or an open corrugated drain. Subhepatic fluid collections were measured by real time ultrasound on the first and fifth postoperative days, and thereafter if necessary. The volumes of fluid drained were also measured and clinical complications recorded. The subhepatic collections were, on average, the same whether a drain was used or not. Drains produced volumes considerably in excess of any subhepatic collection measured, but they did not appear to warn of biliary leakage. More complications (28%) were seen in the drained group compared with the undrained group (10.5%), and furthermore, the complications did not seem to occur in relation to the larger collections. One patient who had had a corrugated drain correctly placed developed biliary peritonitis. We suggest that drainage of simple cholecystectomy is unnecessary and, if an open drain is used, potentially dangerous.
Diarrhoea in general practice: when should a Clostridium difficile infection be considered? Results of a nested case-control study
Authors: M.P.M. Hensgens, O.M. Dekkers, A. Demeulemeester, A.G.M. Buiting, P. Bloembergen, B.H.B. van Benthem, S. Le Cessie, E.J. Kuijper
Journal: Clinical Microbiology and Infection (2014)
Combined Heart Failure Device Diagnostics Identify Patients at Higher Risk of Subsequent Heart Failure Hospitalizations
Authors: David J. Whellan, Kevin T. Ousdigian, Sana M. Al-Khatib, Wenji Pu, Shantanu Sarkar, Charles B. Porter, Behzad B. Pavri, Christopher M. O'Connor
Journal: Journal of the American College of Cardiology (2010)
Hypertension management in general practice
Authors: Michael Whitfield, Anthony Hughes
Journal: Journal of the Royal Society of Medicine (1997)

The views of 542 general practitioners (GPs) and 64 consultant physicians about the management of patients with hypertension in general practice were sought by postal questionnaire. 325 (60%) of the GPs and 45 (70%) of the consultant physicians completed the questionnaire. For a 40-year-old man with no other cardiovascular risk factors most general practitioners would intervene with drugs at blood pressure levels specified in published guidelines, whereas many local consultants and older GPs would consider drug treatment at lower levels. About 75% of GPs, compared with 87% of consultants, would suggest drug treatment in a woman of 70 years with a BP of 180/ 100 mmHg. Although consultants tended to expect GPs to order more tests when investigating a patient with hypertension than the GPs actually did, both GPs and consultants would order similar types of investigations apart from imaging. Consultants had different expectations about the frequency with which general practitioners should record patients' blood pressure and the GPs' ability to prevent cardiovascular events in hypertensive patients. Many older GPs and consultants seem to have unrealistic expectations of the value of treating patients with hypertension.