tbuckley/cabot-search huggingface dataset:
Patient preferences concerning the trade-off between the risks and benefits of routine radiation therapy after conservative surgery for early-stage breast cancer.
Authors: J A Hayman, D L Fairclough, J R Harris, J C Weeks
Journal: Journal of Clinical Oncology (1997)

To assess patients' preferences regarding the trade-off between risks and benefits of radiation therapy after conservative surgery for early-stage breast cancer.Utilities (measures of preference) of 97 early-stage breast cancer patients treated with conservative surgery and radiation therapy and 20 medical oncology nurses were assessed for five health states using standard gambles.Patients had the highest mean utility for treatment with conservative surgery and radiation therapy without a local recurrence (0.92), intermediate utilities for treatment with conservative surgery alone followed either by no local recurrence or by a local recurrence salvaged by conservative surgery and radiation therapy (0.88 and 0.87, respectively), and the lowest utilities for treatment with or without radiation therapy followed by a local recurrence salvaged by mastectomy and reconstructive surgery (0.82 and 0.81, respectively). All differences between health states' utilities were significant (P < .0001), except between the two intermediate and two lowest rated health states. None of the clinical or sociodemographic factors examined explained more than 5% of the variability in the patients' utilities or their differences. Nurses' utilities were similar to those of the patients.These results strongly suggest that fear of a local recurrence and an actual local recurrence leading to mastectomy have such a negative impact on quality of life that patients are willing to accept the risks and inconvenience of radiation therapy to avoid them. There is also considerable interpatient variability that was not explained by the clinical or sociodemographic factors examined.
Cardiovascular mortality and chronotropic incompetence in systolic heart failure: the importance of a reappraisal of current cut‐off criteria
Authors: Damiano Magrì, Ugo Corrà, Andrea Di Lenarda, Gaia Cattadori, Antonello Maruotti, Annamaria Iorio, Alessandro Mezzani, Pantaleo Giannuzzi, Valentina Mantegazza, Erica Gondoni, Gianfranco Sinagra, Massimo F. Piepoli, Cesare Fiorentini, Piergiuseppe Agostoni
Journal: European Journal of Heart Failure (2013)
Rituximab Therapy in Hematologic Malignancy Patients With Circulating Blood Tumor Cells: Association With Increased Infusion-Related Side Effects and Rapid Blood Tumor Clearance
Authors: John C. Byrd, Jamie K. Waselenko, Thomas J. Maneatis, Timothy Murphy, Frank T. Ward, Brian P. Monahan, Melissa A. Sipe, Sarah Donegan, Christine A. White
Journal: Journal of Clinical Oncology (1999)

PURPOSE: Rituximab was recently approved for use in relapsed, low-grade non-Hodgkin's lymphoma; however, few data exist regarding the safety of this agent in patients with a high number of tumor cells in the blood. METHODS AND RESULTS: After the observation at our institution of a rapid reduction of peripheral-blood tumor cells with associated severe pulmonary infusion-related toxicity in two patients with refractory hematologic malignancies, data on three additional cases were collected from physician-submitted reports of adverse events related to rituximab treatment. Five patients with hematologic malignancies possessing a high number of blood tumor cells were treated with rituximab and developed rapid tumor clearance. The median age was 68 years (range, 26 to 78 years). Patients were diagnosed with B-cell prolymphocytic leukemia (n = 2), chronic lymphocytic leukemia (n = 2), or transformed non-Hodgkin's lymphoma (n = 1). All of these patients had bulky adenopathy or organomegaly. All five patients developed a unique syndrome of severe infusion-related reactions, thrombocytopenia, rapid decrement in circulating tumor cell load, and mild electrolyte evidence of tumor lysis, and all required hospitalization. In addition, one patient developed ascites. These events resolved, and four patients were subsequently treated with rituximab without significant complications. CONCLUSION: Rituximab administration in patients who have a high number of tumor cells in the blood may have an increased likelihood of severe initial infusion-related reactions. These data also suggest that rituximab may have activity in a variety of other lymphoid neoplasms, such as chronic lymphocytic leukemia and B-cell prolymphocytic leukemia.
Clinical Trial Design Principles and Endpoint Definitions for Transcatheter Mitral Valve Repair and Replacement: Part 1: Clinical Trial Design Principles
Authors: Gregg W. Stone, Alec S. Vahanian, David H. Adams, William T. Abraham, Jeffrey S. Borer, Jeroen J. Bax, Joachim Schofer, Donald E. Cutlip, Mitchell W. Krucoff, Eugene H. Blackstone, Philippe Généreux, Michael J. Mack, Robert J. Siegel, Paul A. Grayburn, Maurice Enriquez-Sarano, Patrizio Lancellotti, Gerasimos Filippatos, Arie Pieter Kappetein
Journal: Journal of the American College of Cardiology (2015)
Importance of the initial behaviour of patients in avoiding late recovery from COPD exacerbations
Authors: Takashi Motegi, Takeo Ishii, Kumiko Hattori, Yuji Kusunoki, Ryuko Furutate, Akihiko Gemma, Kozui Kida
Journal: European Respiratory Journal (2013)

Background: Reduced forced expiratory volume in 1 second (FEV1), long-term oxygen therapy (LTOT), and frequent exacerbations are considered as risk factors for late recovery (LR) from exacerbations of chronic obstructive pulmonary disease (E-COPD). However, few studies have investigated whether initial behaviour or education status affects recovery from E-COPD.  Aim: To test the hypothesis that initial behaviour or education status affects recovery period.  Methods: We conducted an observational study of E-COPD patients (n = 115) divided into 2 groups: usual recovery (  Results: Of the 201 E-COPD episodes observed, 112 occurred in the LR group. Characteristics of the LR group were as follows: increased deterioration in the BODE index and use of systemic steroids during E-COPD (p   Conclusions: Initial behaviour of patients during the early onset of E-COPD was correlated with LR. To avoid LR, each COPD patient should be educated to begin early action in E-COPD.
Risk factors of hypercapnia in patient with obstructive sleep apnea
Authors: Jihen Ben Amar, Leila El Gharbi, Besma Dhahri, Mohamed Ali Baccar, Saloua Azzabi, Hichem Aouina, Hend Bouacha
Journal: European Respiratory Journal (2012)

The severe obesity sometimes leads to a chronic alveolar hypoventilation: obesity hypoventilation syndrome (OHS). The association with OSAS is frequent.   AIM:  The aim of the present study is to specify favorisants factors that lead to hypoventilation in a population of obese persons with SAS and to deduct the type of association between OHS and SAS.   Methods:    62 patients were enrolled. We excluded patient with bronchial obstruction and we have compared anthropometric, functional, gazometric and polysomnographic details of the groupe1 (G1): OHS=9 and of the groupe2 (G2): obesity without hypoventilation=53.   Results:    We haven9t identify a difference between the two groups concerning age, sex, frequency of smokers, nasopharynx region abnormalities, AHI,SAS severity and the respiratory functional exploration.We noted that there is a positive interrelationship between BMI and Paco2. We identify severe gazometric perturbation in G1 (Pao2=61±9 mmHg, Paco2=50±7 mmHg) versus G2 we noted a moderate hypoxemia. Patients of the group1 make minimal desaturation of 63±17% and a Sao2 average of 81±20% what is meaningfully important than in the G2.   Conclusion:    The alveolar hypoventilation in SAS seems to be in correlation with the degree of obesity. The hypercapnie in the OHS is in relation neither with the SAOS nor with its severity.The OHS-SAS association is usual but not synonym; the OHS is an autonomous disease.
Association Between RECIST Changes and Survival in Patients with Metastatic Castration-resistant Prostate Cancer Receiving Docetaxel
Authors: Guru Sonpavde, Gregory R. Pond, Arnoud J. Templeton, Abderrahim Fandi, Bertrand Tombal, Mark Rosenthal, Andrew J. Armstrong, Daniel P. Petrylak
Journal: European Urology (2015)
Use of a learning tool to enhance the ability of residents to diagnose pneumonia on chest radiographs
Authors: Takahiro Mastuo, Atsushi Kitamura, Naoki Nishimura, Genta Ishikawa, Sachiko Ohde, Yutaka Tomishima, Torahiko Jinta, Naohiko Chonabayashi
Journal: European Respiratory Journal (2014)

BACKGROUND: Resident doctors must gain skills in reading chest radiographs. There have been few studies of the effectiveness of resident education, especially in diagnosing radiographic signs of pneumonia, even though this condition is common. We examined the effectiveness of our educational method for radiographic interpretation.  METHODS: The study (November 2012 to January 2013) was performed at St. Luke9s International Hospital, Tokyo, Japan. We selected 50 hospital chest radiographs in which community-acquired pneumonia had been diagnosed. Of these, we chose 30 in which there was consensus between two pulmonary specialists regarding the presence and location of signs of pneumonia. Twenty-four residents were asked to locate signs and locations of pneumonia on the radiographs. Between the pre-education and post-education tests they were taught to interpret the radiographs by our method, which emphasized lobe anatomy and detection of the “silhouette sign” in examples from the hospital database. Wilcoxon matched-pairs tests were used for statistical analysis.  RESULTS: Pre-study, 60% of all interpretations were correct, whereas post-study 70% were correct ( P  l 0.001). The mean correct percentage location of signs of pneumonia in the left lower lobe was 61%±26.1% pre-study and 86%±17.4% post-study ( P  l 0.05).  CONCLUSION: Our method was effective in training residents to detect pneumonia radiographically. Residents had difficulty detecting signs in the left lower lobe pre-test because of the presence of large numbers of over- or underlying structures in radiographs of this area. Our education program increased the accuracy of detection of signs in this lobe.
Clinic-roentgenologic and morphologic features of sarcoma of lungs, results of treatment
Authors: Yaroslav Voloshyn
Journal: European Respiratory Journal (2013)

Aim: To study clinic, diagnosis of lungs sarcoma.  Methods: Retrospective analysis of 72 cases of s. of lung (65), pleura (7) for the last 20 years. Men - 49, women - 23, age of majority - 40-70 years. Before clinic 27 treated mistakenly of: pneumonia - 15, infiltrative tuberculosis - 6, intercostal neuralgia - 6. Complains: pain on the side of lesion - 64, increase of body temperature - 58, dispnea - 45, loss of weight - 37, caugh - 34, weekness - 63, hemoptysis - 10. Roentgen: formation in right (47), left (25) lung, in upper (39), lower (33) lobe round intensive homogenous shadow with clear eneven contour (diameter 4-15 sm), atelectasis of lobe - 15. Blood analysis: anemia, BSR increased - 18 - 72 mm, fibrinogen - 7,5-37,5 mmol/l - 59, dysproteinemia - 44. Oncotest of blood drop, worked out in the Institute - positive in 21 of 25.  Results: Quick growth of formation and clinical sympthoms let suspect s. (47). Transthoracic punctio, brash biopsy, cyto-histologyc study of bioptates (25). Atypical cells - 67. Endotracheal anesthesia: wide lobectomy - 27, bilobectomy - 8, pneumonectomy - 32, explorative thoracotomy - 5. Morphologically dominated: fibrosarcoma - 31, angiosarcoma - 9, s. of pleura - 7.  Complications - 12. 3 died of tromboembolia of lung artery. Clinical effect - 59. 17 lived 1,5 - 2 years, 11 - 2-3 years of 28.  Conclusions: S. of lungs more often in men in age 40-70. Quick growth of clinical symptoms and big intensive formation in lung with uneven clear contour let suspect s. Instrumental methods of examination with cyto-histologic study, oncotest of blood drop important in diagnosis. Timely diagnosis, complex therapy, surgical treetment let prolong lives.
Magnitude and Time Course of Changes Induced by Continuous-Flow Left Ventricular Assist Device Unloading in Chronic Heart Failure
Authors: Stavros G. Drakos, Omar Wever-Pinzon, Craig H. Selzman, Edward M. Gilbert, Rami Alharethi, Bruce B. Reid, Abdulfattah Saidi, Nikolaos A. Diakos, Sandi Stoker, Erin S. Davis, Matthew Movsesian, Dean Y. Li, Josef Stehlik, Abdallah G. Kfoury
Journal: Journal of the American College of Cardiology (2013)
A Young Woman With Blurred Vision and Distal Paresthesias
Authors: Nathan H. Kung, Nancy L. Bartlett, Nabeel R. Yaseen, Gregory P. Van Stavern, Robert C. Bucelli
Journal: JAMA Neurology (2015)

A 29-year-old woman presented with blurred vision and distal paresthesias. Her initial evaluation revealed severe bilateral optic disc edema with distal lower-extremity sensory and motor deficits and electrodiagnostic evidence of a length-dependent mixed demyelinating and axonal polyneuropathy. The results of routine diagnostic testing, including laboratory tests, magnetic resonance imaging, and lumbar puncture, were nondiagnostic. A targeted biopsy was ultimately required for diagnosis. In this article, we discuss the differential diagnosis and outline the clinical evaluation indicated for a patient presenting with demyelinating polyneuropathy and concurrent papilledema.
Whooping cough in cystic fibrosis (CF)
Authors: Marlène Murris, Nicole Guiso, Elisabeth Njamkepo, Laurent Tetu, Alain Didier
Journal: European Respiratory Journal (2011)

In the 1990s, there has been a slow steady resurgence of pertussis with an increased proportion of cases reported among adolescents and adults in absence of vaccine or natural boosters. CF is the commonest genetically inherited disease, leading to bronchiectasis. Cough is a non specific symptom in CF patients and whooping could cause lung function worsening,  We report a retrospective, monocentric study, on whopping in adult CF patients.  64 sera samples from patients (median age 26 years old) were analysed by ELISA (Enzyme-Linked Immunosorbent Assay) to detect anti-pertussis toxin (PT) antibodies. In all patients with a positive detection of anti-PT IgG, clinical and functional data were collected all around the date of the serum sample.  Among the 64 sera analysed, 57 had no IgG. Seven were positive with a titre of anti-PT IgG ranging from 35UI to 198UI/ml. None of them has a history of vaccination the years preceding the sample. Among the 7 patients, 4 had a severe lung disease which was progressing since several months. Two of them described a change in their cough. Patients with low levels IgG received daily azithromycin as anti-inflammatory treatment. Among the 3 patients with moderate disease, only one returned to baseline after 6 months. One patient wasn9t known as a CF patient but as an asthmatic. Persistent new cough induced a new advice and the diagnosis of CF.  These results underline several aspects that clinicians should be aware: the difficulty to make the diagnosis of whopping when patients chronically cough, the potential impact of whopping cough on severe respiratory disease, the need to optimize vaccination coverage in adults at risk, the potential role of chronic azithromycin to reduce the duration and severity of illness.
Urinary mitochondrial DNA is a biomarker of mitochondrial disruption and renal dysfunction in acute kidney injury
Authors: Ryan M. Whitaker, L. Jay Stallons, Joshua E. Kneff, Joseph L. Alge, Jennifer L. Harmon, Jennifer J. Rahn, John M. Arthur, Craig C. Beeson, Sherine L. Chan, Rick G. Schnellmann
Journal: Kidney International (2015)
Variant von Willebrand's Disease
Authors: Zaverio M. Ruggeri, Theodore S. Zimmerman
Journal: Journal of Clinical Investigation (1980)

We have examined the multimeric composition of factor VIII/von Willebrand factor in plasma and platelet lysates by means of sodium dodecyl sulfate agarose electrophoresis followed by staining with (125)I-labeled affinity-purified antibody. In normal plasma and platelet lysates, factor VIII/von Willebrand factor displayed 10 distinct multimers that ranged in apparent molecular weight from 0.86 to 9.9 x 10(6). The molecular weight difference between adjacent bands was 0.8-1.1 x 10(6). Larger material, not resolved into discrete bands, was also present with an average M(r) of 14.5 x 10(6). Though the dimer (apparent M(r) = 0.48 x 10(6)) and the monomer (apparent M(r) = 0.28 x 10(6)) generated by reduction of disulfide bonds were readily identified in this system, they were not detected in normal plasma or platelets. No differences were observed between fresh plasma prepared without anticoagulant and fresh or frozen plasma anticoagulated with either citrate or heparin. "Variant" (type II) von Willebrand's disease could be divided into two subtypes. In subtype IIA, factor VIII/von Willebrand factor in plasma consisted predominantly of the five smaller multimers with traces of the sixth and seventh (M(r) up to 4.5 x 10(6)). In subtype IIB, all these multimers were easily detected and, in addition, bands of intermediate size (M(r) = 8.5 x 10(6) and smaller) were present. In contrast, the multimeric composition of IIB platelet factor VIII/von Willebrand factor was identical to normal, whereas in subtype IIA the larger multimers were absent from platelets as well as from plasma. In subtype IIB, binding of factor VIII/von Willebrand factor to platelets occurred at lower concentrations of ristocetin than required for normal and multimers of smaller size than in normal bound. On the contrary, in subtype IIA, binding was minimal, as was true of normal factor VIII/von Willebrand factor of equivalent size. Thus, physical as well as functional differences in the two subtypes of variant von Willebrand's disease described suggest that different pathogenetic mechanisms underlie the factor VIII/von Willebrand factor abnormalities in these patients.
A comparison of induction and maintenance therapy for acute nonlymphocytic leukemia in childhood: results of a Pediatric Oncology Group study.
Authors: C P Steuber, C Civin, J Krischer, S Culbert, A Ragab, F B Ruymann, Y Ravindranath, B Leventhal, R Wilkinson, T J Vietti
Journal: Journal of Clinical Oncology (1991)

Two hundred fifty-six children with previously untreated acute nonlymphocytic leukemia (ANLL) were evaluated on a Pediatric Oncology Group (POG) phase III randomized trial of both induction and continuation chemotherapies. Induction therapy compared vincristine, cytarabine, and dexamethasone (VADx) with daunorubicin, cytarabine, and thioguanine (DAT). The complete remission (CR) rate using DAT was superior (82% v 61%, P = .02). Postremission therapy consisted of either "standard" two-cycle therapy or a more intensive four-cycle regimen given for 2 years. Overall, there was no difference in outcome for patients randomized to either continuation regimen. The overall complete continuous remission rate (CCR) for the "best" induction/continuation therapy combination at 2 years was .50 (SE = .06), at 3 years was .35 (.04), and at 4 years was .34 (.05). Analysis of selected clinical and laboratory parameters demonstrated differences in induction responses favoring DAT induction but did not impact eventual disease-free survival. There were two subgroups of patients who responded better to four-cycle continuation therapy. These were patients with French-American-British (FAB) M1/M2 (2-year CCR was .20 v .44, P = .01) and patients older than 10 years at diagnosis (.32 v .62, P = .004).
An occult cause of dyspnoea
Authors: A. S. Bates, S. Al-Hamali
Journal: BMJ (2015)

A 69 year old man presented with severe dyspnoea. After respiratory arrest and emergency intubation, computed tomography of the neck was performed (fig 1⇓). What is the diagnosis based on the results of computed tomography?



The diagnosis is compressive cervical goitre.

### Discussion

A 69 year old man presented to the emergency department with severe dyspnoea. His medical history included adult …
Development of Novel Adenoviral Vectors to Overcome Challenges Observed With HAdV-5–based Constructs
Authors: Julio Alonso-Padilla, Tibor Papp, Győző L Kaján, Mária Benkő, Menzo Havenga, Angelique Lemckert, Balázs Harrach, Andrew H Baker
Journal: Molecular Therapy (2015)

Recombinant vectors based on human adenovirus serotype 5 (HAdV-5) have been extensively studied in preclinical models and clinical trials over the past two decades. However, the thorough understanding of the HAdV-5 interaction with human subjects has uncovered major concerns about its product applicability. High vector-associated toxicity and widespread preexisting immunity have been shown to significantly impede the effectiveness of HAdV-5-mediated gene transfer. It is therefore that the in-depth knowledge attained working on HAdV-5 is currently being used to develop alternative vectors. Here, we provide a comprehensive overview of data obtained in recent years disqualifying the HAdV-5 vector for systemic gene delivery as well as novel strategies being pursued to overcome the limitations observed with particular emphasis on the ongoing vectorization efforts to obtain vectors based on alternative serotypes.
Conduct of phase I trials in children with cancer.
Authors: M Smith, M Bernstein, W A Bleyer, J D Borsi, P Ho, I J Lewis, A Pearson, F Pein, C Pratt, G Reaman, R Riccardi, N Seibel, R Trueworthy, R Ungerleider, G Vassal, T Vietti
Journal: Journal of Clinical Oncology (1998)

Future progress in the care of children with cancer requires appropriate evaluations of promising new agents for pediatric indications, beginning with well-conducted phase I trials. This report summarizes current guidelines for the conduct of pediatric phase I trials and represents a consensus between American and European investigators. The primary objective of pediatric phase I trials is to define safe and appropriate doses and schedules of new agents that can subsequently be used in phase II trials to test for activity against specific childhood malignancies. Prioritization of agents for evaluation in children is critical, since many more investigational agents are evaluated in adult patients than can be systematically evaluated in children. Considerations used in prioritizing agents include activity in xenograft models, novel mechanism of action, favorable drug-resistance profile, and activity observed in adult trials of the agent.Distinctive characteristics of pediatric phase I trials, in comparison to adult phase I trials, include the necessity for multiinstitutional participation and their higher starting dose (typically 80% of the adult maximum-tolerated dose [MTD]), both of which reflect the relative unavailability of appropriate patients. The application of uniform eligibility criteria and standard definitions for MTD and dose-limiting toxicity (DLT) help to assure that pediatric phase I trials are safely conducted and reliably identify appropriate doses and schedules of agents for phase II evaluation. Where possible, pediatric phase I trials also define the pharmacokinetic behavior of new agents in children.