tbuckley/cabot-search huggingface dataset:
Chemotherapy in elderly patients with non-small-cell lung cancer in Tunisian respiratory department
Authors: Hela Kamoun, Dorra Greb, Soraya Fenniche, Leila Fekih, Hager Ben Abdelghaffar, Hanen Smadhi, Ines Akrout, Hela Hassen, Mohamed Lamine Megdiche
Journal: European Respiratory Journal (2013)

Old people affected by lung cancer are an increasingly common problem faced by oncologist. More than 50% of cases of advanced non-small-cell lung cancer (NSCLC) are diagnosed in patients aged over 65 years.  Elderly patients have more co-morbidity and tend to tolerate toxic medical treatments less than young people.  We followed 42 elderly men with NSCLC treated with chemotherapy to identify therapeutic difficulties and complications occurring during treatment.  The average age of our patients was 68 years. We had 69% of adenocarcinoma and 31% of squamous cell carcinoma. The most impotant co-morbidities wee: hypertension 26%, chronic obstructive pulmonary disease 24%, dyslipidemia 14%, diabetes 12%, and coronary heart disease 7%. For 84% of patients, chemotherapy was palliative.  Among the 16% of patients who were operated 86% received adjuvant chemotherapy and 28% received neoadjuvant chemotherapy.  71% of patients received one line of chemotherapy, 22% received 2 lines and 7% received 3 lines of chemotherapy.  In 58% of cases, patients received single-agent chemotherapy (third-generation molecule) and in 42% of cases they received a combined therapy involving platinum.  Side effects were observed in 78,5% of patients including neutropenia(35%), anemia(11%), thrombocytopenia(4%), bronchopulmonary infection (14%), pneumonia(4%), pulmonary abscess(2%) and renal insufficiency(4%).  The median survival was 18 months. Elderly are at risk of both empirical under-treatment resulting in poor survival or excessive toxicity from standard therapy. Clinical data obtained in a younger population cannot be automatically extrapolated to the great majority of non-selected elderly patients with NSCLC.
Shift in serotype distribution of Shigella species in China, 2003–2013
Authors: S Qiu, X Xu, C Yang, J Wang, B Liang, P Li, H Li, S Yi, H Liu, X Cui, Z Wu, J Xie, L Jia, L Wang, R Hao, H Jin, Y Wang, Y Sun, H Song
Journal: Clinical Microbiology and Infection (2014)
Malfolded Protein Structure and Proteostasis in Lung Diseases
Authors: William E. Balch, Jacob I. Sznajder, Scott Budinger, Daniel Finley, Aaron D. Laposky, Ana Maria Cuervo, Ivor J. Benjamin, Esther Barreiro, Richard I. Morimoto, Lisa Postow, Allan M. Weissman, Dorothy Gail, Susan Banks-Schlegel, Thomas Croxton, Weiniu Gan
Journal: American Journal of Respiratory and Critical Care Medicine (2013)

Recent discoveries indicate that disorders of protein folding and degradation play a particularly important role in the development of lung diseases and their associated complications. The overarching purpose of the National Heart, Lung, and Blood Institute workshop on "Malformed Protein Structure and Proteostasis in Lung Diseases" was to identify mechanistic and clinical research opportunities indicated by these recent discoveries in proteostasis science that will advance our molecular understanding of lung pathobiology and facilitate the development of new diagnostic and therapeutic strategies for the prevention and treatment of lung disease. The workshop's discussion focused on identifying gaps in scientific knowledge with respect to proteostasis and lung disease, discussing new research advances and opportunities in protein folding science, and highlighting novel technologies with potential therapeutic applications for diagnosis and treatment.
Health improvement and the RSM
Authors: D D Hine
Journal: Journal of the Royal Society of Medicine (2000)

Dame Deidre Hine, who takes office as President of the Royal Society of Medicine this autumn, qualified at the Welsh National School of Medicine in 1961. After junior hospital posts and a period in general practice she obtained the dph and was appointed to a combined clinical and administrative post in community child health with the Glamorgan County Council. In 1974 she became a specialist in community medicine (child health) to the South Glamorgan Health Authority. In 1980 she took up the post of senior lecturer in the Department of Geriatric Medicine in her former medical school (now the University of Wales College of Medicine), combining this with continued work as a specialist in community medicine. In 1993 she was appointed to the post of Deputy Chief Medical Officer in the Welsh Office. Five years later she left the Civil Service to become director of the Welsh Breast Cancer Screening Service. In 1990 she returned to the Welsh Office as Chief Medical Officer, a post from which she retired in 1997. Some of her thoughts on the National Health Service will be known to JRSM readers from her Jephcott Lecture last year (July 1999 JRSM, pp. 332-338). In August last year she was appointed to chair the Commission for Health Improvement (CHI). She is interviewed here by Robin Fox.
Quantitative Fluorescent Microassay for Identification of Antiproliferative Compounds&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: Ikuo Saiki, Corazon D. Bucana, Jerry Y. Tsao, Isaiah J. Fidler
Journal: JNCI Journal of the National Cancer Institute (1986)

A reproducible and convenient microassay was developed by us to measure the antiproliferative activity of biological materials and anticancer drugs. The assay involved the labeling of target cells after their incubation with anticancer agents with the fluorescent vital dye hydroethidine at a dose of 28 μg/ml for 30 minutes. Once internalized into live cells, hydroethidine is dehydrogenated to ethidium, which then intercalates into DNA. Hydroethidine labeled the cells uniformly. The cells were lysed with detergent, and the relative fluorescence of this dye was monitored in a microfluorimeter at the speed of 30 seconds per 96-well plate. Because this assay is accurate and reproducible, does not present problems of disposal of labeling agents, and is extremely rapid, it should prove very useful for the screening of many potential anticancer agents with antiproliferative activity.
Abstract 13: Relations of Midlife Exercise Blood Pressure, Heart Rate and Fitness to Late Life Brain Structure and Function
Authors: Nicole L Spartano, Jayandra J Himali, Alexa S Beiser, Charles DeCarli, Ramachandran S Vasan, Sudha Seshadri
Journal: Circulation (2015)

Background: Exaggerated blood pressure (BP) and vascular stiffness have been associated with lower cognitive performance and brain atrophy in older age. The brain is a high-flow, low impedance organ that is susceptible to fluctuation in BP. Poor cardiovascular (CV) fitness is also emerging as a factor associated with cognitive decline in older age. The BP and heart rate (HR) response to exercise are impacted by CV fitness; and exercise BP is also highly determined by vascular stiffness. The objective of this investigation was to examine whether poor fitness and exaggerated BP and HR response to exercise in midlife are associated with worse brain morphology in later life. Methods: A subset of Framingham Offspring Study participants (n=1340, 54.5% F) free from dementia and CV disease underwent an exercise treadmill test (the modified Bruce protocol) in midlife [mean age of 41±9 y] and continued until exhaustion or until 85% HR maximum (age- and sex- predicted) was reached. Exercise test duration was used to estimate VO2max. BP and HR were measured during stage 2. MRI scans of the brain and neurocognitive tests (Trail Making Tests [Trails] B-A) were administered in later life [mean age of 59±9 y]. Results: A greater exercise systolic (S)BP and HR response at midlife was associated with smaller total cerebral brain volume (TCBV) in later life (β=-0.09 ±0.04, p=0.042; β=-0.10 ±0.05, p=0.033) after adjustment models including resting SBP and HR; an effect equal to approximately 0.5 y brain aging for every 11.1 mm Hg increase in SBP or 10 beats per min increase in HR. Higher estimated VO2max at midlife was associated with larger TCBV in later life (β=0.03 ±0.01, p=0.014). Additionally, greater exercise HR response at midlife was associated with smaller frontal lobe volume in later life (β=-0.012 ±0.05, p=0.002). Exercise diastolic (D)BP at midlife was associated with poorer performance on Trails B-A in later life (β=-0.009 ±0.004, p=0.017) and the achievement of target HR during exercise was associated with better performance on Trails B-A in later life (β=0.03 ±0.01, p=0.044). Resting SBP at midlife was associated with greater white matter hyperintensity volume in later life (β=0.05 ±0.02, p=0.031); and resting SBP and DBP at midlife were also associated with smaller frontal lobe volume in later life (β=-0.17 ±0.07, p=0.011; β=-0.21 ±0.10, p=0.030). Conclusion: Our investigation provides new evidence that lower midlife fitness and worse exercise BP and HR responses are associated with smaller brain volumes and poorer cognitive performance nearly two decades later. Promotion of midlife physical fitness may be an important step towards ensuring healthy brain aging in the population.
Remission of childhood asthma in adolescence – A longitudinal study
Authors: Martin Andersson, Linnea Hedman, Sigrid Sundberg, Anders Bjerg, Bertil Forsberg, Eva Rönmark
Journal: European Respiratory Journal (2011)

Background: Few population-based studies have prospectively evaluated remission of childhood asthma and factors related to remission.

Aims: To investigate remission and determinants of asthma remission from the age of 7-8 years to 19.

Methods: In 1996, a questionnaire about asthma and related conditions was distributed to all children 7-8 years old in three municipalities in Northern Sweden, and 3430 (97%) participated. After a validation study, 248 (7.2%) of the children were defined as having current asthma. The 248 children were reassessed by annual questionnaires until the age of 19 years where 205 (83%) participated. During the follow-up period spirometry, bronchial challenge testing and skin prick tests were performed.

Results: At the age of 19 years, 76 out of the 205 participants (37%) were in remission defined as no wheeze and no use of asthma medication during the last 12 months. A negative skin prick test at age 7-8y and male sex were significant predictors for remission, OR 2.1 (CI 95% 1.1-4.2) and 2.3 (CI 95% 1.2-4.1), respectively. Having rhinitis or eczema at age 7-8 years was negatively associated with remission. Neither heredity for asthma nor parental smoking or rural living was associated with remission.

Conclusion: Remission of childhood asthma in late teenage was common and related to absence of allergic sensitization and other allergic diseases. The higher rate of remission among boys contribute to the switch in boy-to-girl prevalence ratio, from asthma being more common among boys in childhood to being more common among girls/women later in life.
Reproducibility of mRECIST in assessing response to transarterial radioembolization therapy in hepatocellular carcinoma
Authors: Adeel R. Seyal, Fernanda D. Gonzalez‐Guindalini, Atilla Arslanoglu, Carla B. Harmath, Robert J. Lewandowski, Riad Salem, Vahid Yaghmai
Journal: Hepatology (2015)

The purpose of our study was to evaluate the reproducibility of Modified Response Evaluation Criteria in Solid Tumors (mRECIST) in hepatocellular carcinoma (HCC) lesions undergoing transarterial radioembolization (TARE) therapy and to determine whether mRECIST reproducibility is affected by the enhancement pattern of HCC. One hundred and three HCC lesions from 103 patients treated with TARE were evaluated. The single longest diameter of viable tumor tissue was measured by two radiologists at baseline; response to therapy was evaluated according to mRECIST. The enhancement pattern of HCC lesions was correlated with their mRECIST response. The response rate between mRECIST and RECIST 1.1 was compared. Wilcoxon signed-rank test, paired t test, Lin's concordance correlation coefficient (ρc ), Bland-Altman plot, kappa statistics, and Fisher's exact test were used to assess intra- and interobserver reproducibilities and to compare response rates. There were better intra- than interobserver agreements in the measurement of single longest diameter of viable tumor tissue (bias = 0 cm intraobserver versus bias = 0.3 cm interobserver). For mRECIST, good intraobserver (ĸ = 0.70) and moderate interobserver (ĸ = 0.56) agreements were noted. The mRECIST response for HCC lesions with homogeneous enhancement at both baseline and follow-up imaging showed better intra- and interobserver agreements (ĸ = 0.77 and 0.60, respectively) than lesions with heterogeneous enhancement at both scans (ĸ = 0.54 and 0.40, respectively). In the early follow-up period mRECIST showed a significantly higher response rate than RECIST (40.8% versus 3.9%; P = 0.025). In HCC patients treated with TARE, mRECIST captures a significantly higher response rate compared with RECIST; it also demonstrates acceptable intra- and interobserver reproducibilities for HCC lesions treated with TARE, and mRECIST reproducibility may be lower for HCC lesions with heterogeneous distribution of the viable tumor tissue.
A 55 year old man with bilateral pulmonary nodules, neuropathy and renal nodules
Authors: Vikas Pathak, Govinda Aryal, Lawrence Clouse
Journal: European Respiratory Journal (2011)

Case description: A 55-year-old previously healthy male presented with complaints of bilateral chest wall pain for the last 4 weeks. Patient denied any history of cough, fever, dyspnea, hoarseness, or any rash. He had smoked a half pack per day for about 30 years. Physical examination was normal as were laboratory studies. Chest CT scan demonstrated a 2.5 cm mass adjacent to the left diaphragm with small satellite nodules. Open lung biopsy did not yield any definite diagnosis. Further workup with MRI of spine, CSF analysis and a para-neoplastic antibody panel were negative. A nerve conduction study demonstrated an axonal polyradiculoneuropathy. Almost a year later a repeat chest and abdominal CT scan showed innumerable bilateral lung nodules and masses. It also showed peculiar mottling of the kidneys. A repeat thoracotomy and lung biopsy showed finding consistent with pulmonary lymphomatoid granulomatosis (EBV positive diffuse large B-cell lymphoma of the lungs).

Discussion: Pulmonary lymphomatoid granulomatosis is an uncommon multi-organ systemic disease with predilection to lungs and characterized by multiple pulmonary nodular lesions with lymphocytic invasion of vascular walls on biopsy. The skin, kidney, and neurologic system may be affected concurrently or independently. Cough and dyspnea are the most common presenting symptoms in patients with lung involvement. Physical examination and laboratory studies are generally non-diagnostic. Chest radiography typically reveals multiple poorly defined nodules and/or masses in the mid- and lower-lung zones; diffuse reticular abnormalities may also be present. Therapy ranges from observation to treatment with prednisone or chemotherapy.
Error in Calculating Main Outcome in Gamma Ventral Capsulotomy for Obsessive-Compulsive Disorder Randomized Clinical Trial
Authors: Christopher Baethge
Journal: JAMA Psychiatry (2015)

Antonio C. Lopes, MD, PhD; Benjamin D. Greenberg, MD, PhD; Miguel M. Canteras, MD; Marcelo C. Batistuzzo, PsyD; Marcelo Q. Hoexter, MD, PhD; André F. Gentil, MD; Carlos A. B. Pereira, PhD; Marinês A. Joaquim, RN; Maria E. de Mathis, PsyD; Carina C. D’Alcante, PsyD, MSc; Anita Taub, PsyD, MSc; Douglas G. de Castro, MD; Lucas Tokeshi, MD; Leonardo A. N. P. C. Sampaio, MD; Cláudia C. Leite, MD, PhD; Roseli G. Shavitt, MD, PhD; Juliana B. Diniz, MD, PhD; Geraldo Busatto, MD, PhD; Georg Norén, MD, PhD; Steven A. Rasmussen, MD, PhD; Eurípedes C. Miguel, MD, PhD
Garibaldi and the Surgeons
Authors: Ornella Moscucci
Journal: Journal of the Royal Society of Medicine (2001)

The illnesses of politicians and military leaders are interesting from a historical point of view not only because they impinge on government business and the conduct of war: since they are usually well documented, they can also provide useful insights into medical practice and belief in the past. In the case of Giuseppe Garibaldi (1807-1882), the leading force in the unification of Italy, there was controversy over the treatment of the bullet wound he had received during his abortive march on Rome in the summer of 1862—the detection of the bullet being particularly difficult at a time before X-rays were available. Furthermore, delicate questions of medical etiquette arose against the backdrop of nationalistic interests, as clinicians from four countries, including Britain and France, became involved. Finally, the dispute was settled thanks to a new surgical instrument, ‘Nelaton's probe’, named after the French surgeon who invented it. These circumstances and Garibaldi's enormous popularity meant that the case received extensive coverage in the British medical press, providing a minutely detailed account of a surgical dilemma of the nineteenth century.
Breast MRI as a Screening Tool: The Appropriate Role
Authors: Huong T. Le-Petross
Journal: Journal of the National Comprehensive Cancer Network (2006)

Magnetic resonance imaging (MRI) can detect breast cancer that is occult on mammography or ultrasound. However, although the high sensitivity of this imaging modality is desirable, its lower specificity, higher cost, variable technique and interpretation among institutions, exclusion criteria, and unproven effect on survival rate make it a less desirable screening test for the general population. Several studies have shown that using more than one imaging tool, such as MRI and mammography, increases cancer yield in high-risk patients, such as those with inherited BRCA1 and BRCA2 mutations. Recent studies show improved specificity of MRI, likely related to advances in technique and the development of interpretive guidelines.
Real-time optical biopsy and analysis of breast cancer using clinical optical coherence tomography
Authors: S. A. Boppart, A. M. Zysk, F. T. Nguyen, E. J. Chaney, F. J. Bellafiore, J. G. Kotynek, P. A. Johnson, K. M. Rowland
Journal: Journal of Clinical Oncology (2007)

10508 Background: Advances in high-resolution, real-time, optical imaging have enabled optical coherence tomography (OCT) for non-excisional optical biopsies of breast tissue. OCT is the optical analogue to ultrasound imaging, with resolution approaching that of histology. In breast tissue, regions of tumor, tumor margins, abnormal ducts, and foci of tumor cells can be identified based on increased scattering and morphological appearance. We have developed a portable clinical OCT system along with image criteria for identifying breast cancer in real-time during needle-biopsy and surgical-biopsy procedures. Methods: Over 4,000 depth-resolved OCT axial scans were extracted from over 50 cross-sectional OCT images from 9 ex vivo specimens of ductal carcinoma in situ (DCIS) of the human breast. OCT image data was acquired in real-time within 6 hours of surgical resection using a state-of-the-art OCT system with micron resolution. Imaged sites were marked for registration with hematoxylin and eosin-stained histology. Axial scan data was analyzed using frequency-domain analysis techniques to classify regions as tumor, stroma, or adipose tissue. OCT images of tissue types were compared with histological observations. Results: Real-time OCT images of microscopic breast cancer morphology showed strong correlations with corresponding histology, including regions of tumor, tumor margins, ducts, and adipose tissue. Computational frequency-domain analysis of depth-resolved axial scan data classified tissue types as tumor, stroma, and adipose with 91% sensitivity and 87% specificity. Conclusions: Optical biopsy of breast cancer with OCT is feasible for imaging at resolutions approaching histology. Frequency- domain analysis of axial scan data can be used to classify breast tissue types with a sensitivity and specificity that are comparable to or surpasses that of conventional mammography and ultrasound imaging of human DCIS. Clinical OCT imaging has the potential for real-time guidance and diagnostics in needle- or surgical-biopsy of breast cancer. No significant financial relationships to disclose.
Tracheo-esophageal phistula: The role of bronchology
Authors: Vitezslav Kolek, Stanislav Losse, Petr Jakubec, Helena Bartosova
Journal: European Respiratory Journal (2011)

Tracheo-esophageal phistula (TEP) is a complex condition with different etiology and prognosis. Present study evaluates a series of patients (pts) with TEP according to etiology, complications, survival and endobronchial treatment. Among 50 pts there were 41 (82%) men and 9 (18%) women, mean age was 62.2 years. Tracheobronchoscopy was the diagnostic method of choice, other methods were anamnesis, chest X ray, 3Dimensional CT and esophagoscopy. Malignant disease was the cause of TEP in 33 (66%) pts, benign disease in 17 (34%) pts. There were 17 pts with esophageal carcinoma, 8 pts with bronchial/tracheal cancer, 8 pts with other tumours, 9 cases with tracheostomy or tracheal intubation, 8 traumatic cases and 7 consequences with endoscopic therapy (laser, esophageal stent, brachytherapy). Phistula was covered by tracheal or Y tracheobronchial stent in 19 (38%) pts, esophageal stent in 8 (16%) pts and doublestenting in 4 (8%) pts. Median of overall survival (MOS) was 14.3 m. It was 8.8 m in men and 29.3 m in women (p 0.0441). MOS in malignant diseases was 5.6 m, in benign disease 34.8 m (p 0.04). Pts with endotracheal/bronchial stents survived non significantly longer than those without stents: MOS 13.7 m vs 11.3 m (p 0.949). The difference was not significant in benign processes (39.6 m vs 22.1 m, p 0.523) and in malignant diseases as well (5.0 m vs 5.6 m, p 0.484). Endobronchial/endotracheal treatment brings substantial symptomatic relief, but sometimes can be a cause of TEP as well. Other survival determinants could not be analyzed in present study due to small number of patients.
Anaphylactoid reactions in children receiving high-dose intravenous cyclosporine for reversal of tumor resistance: the causative role of improper dissolution of Cremophor EL.
Authors: J G Theis, M Liau-Chu, H S Chan, J Doyle, M L Greenberg, G Koren
Journal: Journal of Clinical Oncology (1995)

PURPOSE An unusually high incidence of anaphylactoid reactions was observed during a phase I/II trial of high-dose intravenous cyclosporine (CsA) therapy to attenuate tumor multidrug resistance (MDR). Five of 21 children experienced severe anaphylactoid reactions shortly after initiation of the first or second CsA infusion. We hypothesized that improper dissolution of the vehicle Cremophor EL may have been a cause for these anaphylactoid reactions. METHODS All nurses who had administered intravenous CsA were interviewed regarding their technique of preparing the infusion and the occurrence of an anaphylactoid reaction. The responses were statistically analyzed. The effect of various mixing techniques on the distribution of Cremophor EL in the infusion was experimentally evaluated. Different mixing techniques were used to assess their effect on the distribution of Cremophor EL in the solution. RESULTS Analysis of the preparation techniques of the CsA infusion showed significant correlation between suboptimal mixing of CsA by nurses and the occurrence of anaphylactoid reactions (P = .02). Experimental simulation showed that suboptimal mixing results in an uneven distribution of Cremophor EL, which subsequently sinks to the bottom of the vial. CONCLUSION Improper mixing of high-dose CsA infusions causes nonsolubilized Cremophor EL to sink to the outflow area of the bottle. An initial bolus infusion of highly concentrated Cremophor EL may produce an anaphylactoid-like response. This mechanism of toxicity is important to recognize, because it is easily preventable by proper preparation of the infusion, thus reducing the incidence of potentially life-threatening anaphylactoid reactions.