tbuckley/cabot-search huggingface dataset:
Quality of life (QOL) and toxicity among patients in CALGB 80405.
Authors: Michelle Joy Naughton, Deborah Schrag, Alan Paul Venook, Donna Niedzwiecki, Roger T. Anderson, Heinz-Josef Lenz, Stephen S. Grubbs
Journal: Journal of Clinical Oncology (2013)

3611 Background: CALGB 80405, a phase III trial, was originally designed to compare toxicity and overall survival of metastatic colorectal patients treated with standard chemotherapy (choice of FOLFOX or FOLFIRI) and either: 1) Bevacizumab; 2) Cetuximab; or 3) both Bevacizumab and Cetuximab. Because Cetuximab causes a prominent acneiform skin rash, adverse effects on QOL were anticipated and assessed in a QOL companion. Methods: The QOL companion enrolled the first 518 consenting patients randomized to CALGB 80405 between 10/2005-9/2007, the majority prior to amendments that eliminated the dual biologic arm and restricted participation to patients with KRAS wttumors. QOL was assessed at baseline, 6 weeks, and 3, 6 and 9 months post-randomization, using the EORTC QLQ-30 and the Dermatology-Specific Quality of Life (DSQL) Scale. We hypothesized that patients receiving Cetuximab would have lower satisfaction with appearance, reduced social functioning and lower overall QOL at 3 months, (a primary assessment point). Results: Patients had a mean age of 59, were predominantly male (58%), performance status 0 (62%), and non-Hispanic White (85%). 83% completed a 3 month assessment. There were no differences in global health functioning (p=0.164) or other items/subscales of the EORTC at 3 months by treatment arm. However, significant differences were found across arms in skin symptoms (p&lt;.0001), limitations in social activities due to skin condition (p=0.008), and concerns about appearance (p&lt;.0001), as measured by the DSQL. Patients randomized to Bevacizumab reported fewer skin symptoms, fewer social limitations and appearance concerns than patients receiving Cetuximab alone or Cetuximab + Bevacizumab. The choice of chemotherapy (FOLFOX or FOLFIRI) had no bearing on these results. Conclusions: Global QOL, as well as physical, role, social and emotional functioning, were not significantly different across treatment arms. However, Cetuximab recipients reported greater symptoms and QOL concerns relating to their skin than those receiving Bevacizumab alone. Interventions to more adequately address skin problems from Cetuximab treatment are warranted. Participants are still being followed to determine survival differences between the biologics. Clinical trial information: NCT00265850.
Hair and Its Disorders: Biology, Pathology and Management
Authors: Barry Monk
Journal: Journal of the Royal Society of Medicine (2001)

Hair has an extraordinary and inexplicable psychological importance. Patients with cancer about to undergo chemotherapy are commonly more concerned about the possibility of hair loss than almost any other aspect of their treatment or diagnosis, whilst hair care is a multibillion pound industry worldwide. Additionally, since hair is such a concern to many, it may be a hair problem that is the first presentation of internal disease; all medical students know of the association between hair loss and myxoedema, even if they have never seen a case. In fact hair disorders—hair loss, hypertrichosis, hirsutism and hair-shaft abnormalities—may be the presenting feature of a wide range of genetic, metabolic, and toxic disorders.

Twenty years ago, a book devoted to hair biology and hair disorders would have been both short and dull. Lately there has been an explosive growth in knowledge which we owe partly to the generous funding of basic research by the cosmetic industry and partly to application of the new techniques of molecular science. Hair and its Disorders brings together a wealth of new and exciting information. The three editors, from Spain, California, and Bradford (UK) have assembled most of the leading experts, both medical and scientific, the 49 contributors coming from four continents. The contributions are well organized and the occasional unevenness of style does not detract from the overall impact. The range of the book is astonishing. For the clinician there are well illustrated and well referenced chapters on hair syndrome recognition and on important genodermatoses, and extensive coverage of alopecia areata. This important disorder is also well covered in terms of our basic immunological understanding. A few chapters are not of immediate practical application but are so well written as to be fascinating in their own right; in this category I would place the contributions on Menke's kinky-hair syndrome (a rare metabolic disorder with lethal consequences) and hair follicle innervation in alopecia areata. The basic biology of the hair is likewise covered in detail, with informative accounts of the hair cycle, androgen effect and so on.

I doubt that there is a better book on this subject, and warmly recommend Hair and its Disorders to all dermatologists. It is also likely to become indispensable to geneticists, developmental paediatricians and endocrinologists; and skin biologists, whether in the cosmetic industry or not, will find much to interest them.
Impact of a new bedside thoracic ultrasound service in a large district general hospital: A service evaluation
Authors: Helen Stanworth, Paul Marsden, Matthew Evison, Graham Hoadley, Tarek Saba
Journal: European Respiratory Journal (2011)

Background:  In 2008, the UK National Patient Safety Agency (NPSA) issued an alert recommending the use of thoracic ultrasound to aid chest drain insertion (NPSA/2008/RRR003).Our institution is a large district general hospital in North-West England, serving a local population of approximately 330,000 people and a further 12 million holidaymakers who visit the area each year. In 2009, a Physician-Led Ultrasound Service (PL-US) was launched, in addition to the existing Radiology-Led Ultrasound Service (RL-US).   Aim:  To investigate the demand for PL-US and the impact on workload and training.   Methods:  We audited the number of procedures performed by physicians and radiologists from May-July 2008, 2009 and 2010.   Results:  The total number of procedures increased from 24 (all RL-US) in 2008 to 66 (29 RL-US and 32 PL-US). The proportion of RL-US procedures requested by respiratory medicine fell from 46% (11/24) in 2008 to 17% (4/24) in 2009 and 14% (4/29) in 2010, with the remaining RL-US procedures requested by other specialities. In addition, in 2010 a total of 24 thoracic ultrasounds were performed on respiratory patients, 20 of these 24 were performed by the PL-US, with only the remaining 4 by the RL-US.   Conclusions:  Overall demand for thoracic ultrasound has risen by 275% since the UK NPSA alert in 2008. Since introduction of the PL-US, the total number of chest medicine referrals to the RL-US has fallen by 64%. In addition, 83% of thoracic ultrasounds in respiratory patients are now performed by physicians. Importantly, training opportunities for radiologists have not diminished as a result of this service.
Proteases During the Growth of Ehrlich Ascites Tumor. II. The KallikreinKinin System23
Authors: Pierre P. LeBlanc, Nathan Back
Journal: JNCI Journal of the National Cancer Institute (1975)

Ascitic fluid and ascites tumor cells from Swiss mice bearing Ehrlich ascites tumor were assayed for components of the kallikrein-kinin system at various times during tumor growth. Changes in component levels were correlated with those in the plasma. Ascitic fluid contained an acetone-activated prekallikrein that increased in concentration during tumor growth and reached peak levels during the 7th-10th day post transplant. No free kinin activity was present in the ascitic fluid. During tumor growth, kininogen levels increased in parallel with prekallikrein levels. The ascitic fluid also contained a kinin-destroying activity that was initially high during the early phase of tumor growth. Tumor cell fractions, prepared by ultracentrifugal techniques, had no kinin-forming activity while possessing kinin-destroying activity that was localized in the soluble protoplasmic protein and nuclear fractions. The kinin-forming activity of the ascitic fluid resembled that of the plasma with respect to pH optima, kinetics of kinin formation, and effect of protease inhibitors. The kininase activity of both ascitic fluid and plasma differed from that of the tumor cell fractions.
Diversity in VIM-2-encoding class 1 integrons and occasional blaSHV2a carriage in isolates of a persistent, multidrug-resistant Pseudomonas aeruginosa clone from Tunis
Authors: S. Hammami, V. Gautier, R. Ghozzi, A. Da Costa, S. Ben-Redjeb, G. Arlet
Journal: Clinical Microbiology and Infection (2009)
Sight tests to detect glaucoma
Authors: P. G Griffiths, M. Cole
Journal: BMJ (1997)

Introducing the postoperative care team Effective postoperative care remains surgeons' roleEditor-I am concerned that the suggestions made by David R Goldhill might be taken too seriously rather than remain a point for discussion. 1 Goldhill is right in his assertion that patients can fare badly in their postoperative course because of lack of attention by their attendants and lack of understanding of common postoperative complications.I believe, however, that he has missed the opportunity to lay the blame at the correct door.Surely it is the surgeons' role to carry out preoperative assessment, surgery, and effective postoperative care.If they choose to emphasise their importance in the operating theatre, delegating their other responsibilities to their trainees, the nurse practitioners, and the anaesthetists, why should we encourage this path?Undoubtedly, anaesthetists are fast becoming the new generalists, with an increasing role outside the operating theatre.These new skills and responsibilities include pain control, intensive care, and transoesophageal echocardiography, to name but a few.Some of my professional colleagues may relish even more diversification and abhor my comments.Goldhill implies that anaesthetists and postoperative care nurses will lead the postoperative care team; indeed, this is already happening in North America, where they have been sent to run preoperative assessment clinics by surgeons based in the operating room.If the surgical ward round in your hospital has become a quick look through the laboratory results and a glance at the chest radiograph before a rush to the changing rooms then I suggest that waiting for the confidential inquiry into perioperative deaths to point out the obvious is not the solution.
Impact of diabetes mellitus on clinical parameters and treatment outcomes of diagnosed pulmonary tuberculosis patients
Authors: Jihen Ben Amar, Bouthaina Ben Safta, Besma Dhahri, Saloua Azzabi, Mohamed Ali Baccar, Hichem Aouina, Hend Bouacha
Journal: European Respiratory Journal (2014)

Tuberculosis (TB) is an infectious disease which is still a major cause of morbidity and mortality throughout the world. People with diabetes have a three times higher risk of developing active TB than people without diabetes.  Aim: The aim of this study is to determine the impact of diabetes on clinical and radiological manifestations and treatment outcome of pulmonary TB (PTB) patients.  Methods: We have retrospectively analyzed clinical features in 30 diabetic patients treated for TB; this group was compared to a control group of 65 non-diabetic tuberculosis patients.  Results: In the diabetic group, the mean age is 52 years (22-74); 52% of patients had type I diabetes. The duration of diabetes course at the time of PTB diagnosis varied from 1 month to 16 years. The most frequent symptom was weight loss found in 85% of cases. Haemoptysis was noted in 50% and fever in 61% of patients. Radiographic abnormalities were bilateral in 74 % of patients; lower lung lesion was observed in 52% of patients. The percentage of patients with cavities was higher in the patients with diabetes (74%) than in those without (38%; P  The diagnosis of PTB was made by microscopic sputum examination and sputum culture in all patients. Five patients had extrapulmonary TB: liver (2 cases), blood (2 cases) and bone in one case.  Therapy length is similar between two groups. No drug resistance was noted. Insulin was required in all patients with type II diabetes. Diabetes is associated with a higher frequency of lung after-effects compared with non-diabetic (52% vs 20%; p  Conclusion: PT seems to aggravate diabetes course and diabetes seems to increase radiological after-effects.
Interactions between Calciotropic Hormones
Authors: J N Bradbeer
Journal: Journal of the Royal Society of Medicine (1987)

The metatarsal cytochemical bioassay (CBA) for parathyroid hormone (PTH) was adapted to study interactions between PTH and certain vitamin D metabolites. Thus, while they had no effect in the system alone, both 1,25(OH)2D3 and 25(OH)D3 caused a dose-dependent potentiation of PTH-stimulated glucose 6-phosphate dehydrogenase activity in the hypertrophic chondrocytes of the rat metatarsal. 1,25(OH)2D3 was about 1000 times more potent than 25(OH)D3. Specificity is indicated by the lack of a similar effect when either oestradiol or 1,24,25(OH)3D3 or a lactone derivative of 1,25(OH)2D3 was used. Furthermore, the rapidity of the effect of 1,25(OH)2D3 and 25(OH)D3, within 8 minutes, favours a membranophilic mechanism rather than the conventional nuclear mechanism of steroid hormone action.
Clinical characteristics and prognostic factors of pulmonary embolism in different age groups
Authors: Jihen Ben Amar, Eya Tangour, Leila El Gharbi, Besma Dhari, Saloua Azzabi, Mohamed Ali Baccar, Hichem Aouina, Hend Bouacha
Journal: European Respiratory Journal (2013)

Diagnosis of pulmonary embolism (PE) remains difficult and is often missed in the elderly due to nonspecific and atypical presentation. Diagnostic algorithms able to rule out PE and validated in young adult patients may have reduced applicability in elderly patients, which increases the number of diagnostic tools use and costs.  To assess the particularities of PE in the elderly, we report a comparative study including 100 patients managed for a PE from which 40 were aged over 65 years (G1) and 60 were aged less than 65 years (G2). The 2 group were similar in terms of sex-ratio and smoking exposure. Comorbidities were significantly more frequent in the G1 (dominated by COPD and cardiovascular pathologies) p=0.02. Chest pains and hemoptysis were significantly less frequent in the elderly (respectively 17% vs 73%; p=0.001 and 2% vs 16% ; p=0.04). There was no difference between the two groups concerning the frequency of fever, polypnea, tachycardia or signs of right heart failure. Radiological data showed that atelectasis were more frequent in elderly (42% vs 8 13%; p=0.03). Hypoxemia were significantly more frequent and more severe in the elderly (85% versus 75%; p= 0.09 ; average PO2 at 66 mm Hg versus 77 mm Hg; p=0.001). There was no difference concerning HCO2 or ECG. PE was confirmed by CT scan or Doppler sonography in the same proportions between the 2 groups. The death rate was similar in both group.The wells score was significantly higher in the first group (p=0.01). The Geneva score was similar in the 2 groups. PE in elderly is associated with less clinical symptoms, more chest x-ray abnormalities and more frequent and severe hypoxemia and a higher wells probability score.
Cytomegalovirus as predisposing agent to respiratory infections in heart transplant patients
Authors: Filipe Leite, Tiago Nogueira, Jorge Vale, Manuel Batista, David Prieto, João Bernando, Luis Eugénio, Manuel Antunes
Journal: European Respiratory Journal (2013)

Introduction: Cytomegalovirus (CMV) is a known cause of allograft rejection, decreased graft and patient survival, and malignancies. Its immunomodulatory effects have been suggested to account for a higher predisposition to develop other infections. Aims and objectives: To establish a relationship between pre-heart transplant CMV status and post-transplant respiratory infections. Methods: Review of records of 221 heart transplant patients operated between November 2003 and December 2012. The preoperative and postoperative CMV status, antiviral treatments and respiratory infections were recorded. Results: 129 patients were IgG positive for CMV and 92 were negative. 196 respiratory infection episodes were recorded, 80 in CMV positive patients and 116 in CMV negative patients. The relative risk for a pre-transplant CMV negative patient to develop a respiratory infection was 1.034. 120 risk patients for development of CMV infection were treated with antiviral agents. Of these, 65 developed pulmonary infection. There was a relationship between a CMV infection and a respiratory infection in 19 patients, and 101 were treated for CMV with no relationship to respiratory infection. The relative risk for a patient who received treatment for a CMV infection to develop a respiratory infection was 0.347. Conclusion: No relationship between pre-transplant CMV status and development of respiratory infection was found, but there was a relationship between post-transplant CMV infection and development of respiratory infection, suggesting the importance of treating CMV infections to reduce respiratory infections, while denying pre-operative CMV status as early predictor of risk of infection.
Expanded access program (EAP) to investigational drugs
Authors: L. Talarico, R. Pazdur
Journal: Journal of Clinical Oncology (2004)

6001 Background: Title 21 part 312.34 of the Code of Federal Regulations provides for use of unapproved drugs to treat patients with serious or immediately life-threatening diseases ineligible for clinical trials and without available alternative therapy. EAPs can provide drugs to individual patients under "single patient Investigational New Drug (IND)" and to larger numbers under "treatment IND". EAPs are implemented while sponsors are actively pursuing marketing approval. Reasonable evidence of clinical usefulness for the indication and sufficient safety information from ongoing or completed trials are required. EAPs are voluntarily initiated by the drug sponsor. FDA and IRB approvals and safety monitoring are required. Methods: Review of data reported from EAPs for the following drugs (indications): imatinib (chronic myelogenous leukemia), trastuzumab (breast cancer), temozolomide (malignant gliomas), oxaliplatin (colorectal cancer), gemcitabine (pancreatic cancer), gefitinib (non-small cell lung cancer). Results: The number of patients in each EAP ranged from 168 to 24,261, total 42,828, median 5182 (169, 11965). No new safety concerns were raised in the EAPs. For example, the incidence of interstitial lung disease in patients receiving gefitinib was about 2% in the Japanese post-marketing experience and 0.3% in about 24.000 patients in the U.S. EAP. Efficacy outcomes were consistent with registration trials. Selected EAPs provided additional information, such as tolerability of gefitinib in elderly, identification of factors predictive of response to oxaliplatin-based treatment. Conclusions: Disseminated information on new drugs in clinical development encourages patients without available treatments to seek new therapeutic options. Patients with common tumors comprise large EAP populations. EAPs are effective mechanisms to provide investigational drugs to patients and obtain additional safety information from larger, more heterogeneous populations. While providing investigational drugs to all patients who may benefit, EAPs could be designed to provide additional clinical information such as subpopulation analyses of outcome, dose ranging, drug combinations. No significant financial relationships to disclose.
The impact of teratogenic factors in the development of pulmonary hypoplasia in children
Authors: Tatiana Macovei, Svetlana Sciuca, Rodica Selevestru, Rodica Eremciuc
Journal: European Respiratory Journal (2013)

Aim: To establish the potential role of teratogenic factors in the development of pulmonary hypoplasia associated with multisystemic anomalies in children.  Methods: HRCT scans with MPR and 3D reconstructions were used for the assessment of the lung malformations, ECG and EchoCG Doppler – for cardiac pathology confirmation, and USG revealed the renal anomalies.  Results: The diagnosis of pulmonary hypoplasia was suspected in the neonatal period after clinical and X-ray examination, but the complex multisystemic malformation was confirmed at 8 months of age. On CT scans, pulmonary hypoplasia was presented by diminished size of the right hemithorax, rised right diaphragm cupola, hyperinflated and hyperlucent left lung, complete mediastinal displacement to the right side. 3D reconstructions revealed narrowing of the right bronchus situated in the left hemithorax and hypoplasia of the right pulmonary artery- 4mm. ECG showed characteristic signs of dextrocardia: negative P wave and positive T wave in I standard deviation, negative P wave in aVR and deep Q wave in aVL. EchoCG Doppler revealed a narrowing of right pulmonary artery of 4,6mm, USG showed the right kidney with increased size(80x35mm) and the absence of the left one. The data concerning fetus exposure to some chemical toxic substances during the pregnancy due to mother’s professional condition, could explain this complex malformation in pulmonary hypoplasia.  Conclusions: Pulmonary hypoplasia is associated with malformations of the urinary tract, cardiovascular and nervous systems. The teratogenic influence during the embryonic period trigger the malformative changes with renal agenesia that could cause the immaturity of the embryonic lung.
Abstract 215: Effect of Adipose Tissue-derived Stromal Cell Transplantation in Mouse Model of Acute Myocardial Infarction
Authors: Long-Hao Yu, Moo H Kim, Dong S Kum, Tae H Park, Kwang S Cha, Young D Kim, Soo Y Seo, Jin S Jung
Journal: Circulation (2007)

Background: Adipose tissue has been identified as a source of multipotent cells that have the capacity to differentiate into cardiac myocytes, endothelial cells, similar to bone marrow cells. We sought to investigate the effect of adipose tissue-derived stromal cells (ADSCs) therapy on cardiac contractility and remodeling in C57BL/6 mouse model of acute myocardial infarction (AMI). Materials and Methods: Total 30 adult male C58BL/6 mice (12 weeks of age, 28~30g body weight) were used for the study. Mice were randomized into two groups (MI + media, n = 15 and MI + ADSCs, n= 15) after producing AMI by ligation of left anterior descending coronary artery. Intramyocardial injection of 1 × 10 6 ADSCs cells was compared to the injection of media alone. Ten animals were excluded from further analyses because of death. Most of them died 7 to 10 days after AMI, a mouse died duing surgical procedure following LAD ligation. All survived mice (n = 20) were received echocardiograpic analysis before and 2 weeks after cell transplantation, and then sacrificed for histologic analysis. Results: The fractional shortening and left ventricular ejection fraction improved significantly in ADSCs transplant group at 2 weeks compared to control group ( 20.9 ± 3.48% vs 29.9 ± 8.6%, p = 0.006 and 46.4 ± 7.6% vs 63.1 ± 12.8%, p = 0.002 ). Left ventricular end dialstolic dimension in ADSCs transplant group showed a little decrease from 4.65 ± 0.63 mm (control) to 4.14 ± 0.53 mm (ADSC), but there was no statistical difference ( p &lt; 0.072), whereas left ventricle end-systolic diameter decreased significantly in cell transplantation group ( p &lt; 0.05). Also, there were significant difference in injury size, infarct area, wall thickness or scar formation in ADSC group. In histochemical analysis, ADSCs have been shown to migrate into the injured sites and to integrate into the scar areas with some of transplanted ADSCs expressing endothelial marker. Conclusion: ADSCs improved left ventricular function and showed favorable effect on remodeling. They could be a good candidate for the source of cell therapy after myocardial injury.