tbuckley/cabot-search huggingface dataset:
L-Arginine metabolism in airways of children with primary ciliary dyskinesia (PCD) or cystic fibrosis (CF)
Authors: Hartmut Grasemann, Nancy McDonald, Sharon Dell, Felix Ratjen
Journal: European Respiratory Journal (2014)

Reduced L-arginine availability for NO synthases (NOS) and increased levels of NOS inhibitor asymmetric dimethylarginine (ADMA) cause airway NO deficiency in CF patients with severe pulmonary exacerbation (PEx), but data for milder CF exacerbation or for PCD are lacking.  Methods: CF and PCD patients with PEx requiring oral AB treatment were studied. Exclusion criteria included infection with  P. aeruginosa  or  B. cepacia . Sputum samples were obtained before (V1) and after (V2) three weeks of oral ABs. L-arginine metabolites were quantified by LC-MS/MS and NO metabolites (NOx) using Griess reagent.  Results: Eleven PCD and 16 CF patients with mean age of 10 yrs (range 7-16 yrs) were studied. Mean (±SD) FEV1 at V1 was not different between groups (63±13.8 % in PCD and 74±18.3 % predicted in CF, p=0.1). FEV1 improved to 71 (±21.2) % in PCD (p  Conclusions: Children with PCD and mild pulmonary exacerbation have reduced arginine availability and airway NOx compared to CF.
Statistical Analysis of Survival Experiments&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: David G. Hoel, H. E. Walburg
Journal: JNCI Journal of the National Cancer Institute (1972)

Final incidences of late-occurring diseases are seriously affected by mortality rates preceding their onset. Meaningful analysis of survival experiments can be obtained by estimations of the net probability of death due to the cause of interest. A comparison of some interval techniques and a noninterval technique developed by Kaplan and Meier suggests that the latter is preferable when the actual ages-at-death are known. This representation can be analyzed for a significant difference between a treated and a control population with a nonparametric test for randomly censored data. The mean age-at-death, a summarized description of the cumulative mortality function, must also be adjusted for competing risks (diseases). Different techniques for correction of incidences of nonlethal diseases must be used, however, since changes in the mortality paHerns for lethal diseases will change the "net probabilities" for nonlethal diseases. Nonlethal diseases can be analyzed by an interval method or a noninterval method similar to the Kaplan-Meier estimate used with lethal diseases.
Does PET-CT predict the results of CT-guided core biopsy in the diagnosis of peripheral lung lesion?
Authors: Kashif Ali Khan, Rita Luddy, J.M. Meaney, Ronan Mcdermott, Finbarr O'Connell
Journal: European Respiratory Journal (2012)

Introduction:   Percutaneous CT-guided transthoracic needle biopsy (CT-Bx) and Positron emission tomographic scanning (PET-CT) aids in the diagnosis of a peripheral pulmonary lesion (PN) where bronchoscopy is unhelpful. Our aim was to evaluate the diagnostic yield of CT-Bx in relation to standardised uptake value (SUV) on PET-CT.   Method:   A retrospective analysis was performed of all patients who had PET-CT and CT-Bx from Jan 2008 to June 2010. CT-Bx was performed with a Temno biopsy needle by an experienced radiologist. The SUV on the PET-CT, size of nodule and diagnosis were recorded.   Results:   95 subjects who had the PET-CT and CT-Bx were included. The mean age was 66.05 years (range 30-90years). 48 (51%) were male. 61 (64%) had diagnostic CT-Bx where as 34 (36%) subjects had non diagnostic CT-Bx. The mean size of lesion was 2.47cm in subjects with diagnostic CT-Bx where as it was 2.38cm in non-diagnostic subjects, the difference which was not statistically significant ( p value 0.37 ). The Mean SUV on PET-CT was higher in subjects where the CT-Bx was diagnostic compared to, where CT-Bx was non-diagnostic ( 12.750 Vs 7.982; p value 0.002 ).   Conclusion:   The SUV on PET-CT may predict the diagnostic yield of CT-Bx. The high value of SUV may result in diagnostic outcome of CT-Bx.
Genitourinary brucellosis: results of a multicentric study
Authors: H. Erdem, N. Elaldi, O. Ak, S. Gulsun, R. Tekin, M. Ulug, F. Duygu, M. Sunnetcioglu, N. Tulek, S. Guler, Y. Cag, S. Kaya, N. Turker, E. Parlak, T. Demirdal, C. Ataman Hatipoglu, A. Avci, C. Bulut, M. Avci, A. Pekok, U. Savasci, S. Kaya, H. Sozen, M. Tasbakan, T. Guven, S. Bolukcu, S. Cesur, E. Sahin-Horasan, E. Kazak, A. Denk, I. Gonen, G. Karagoz, A. Haykir Solay, O. Alici, C. Kader, G. Senturk, S. Tosun, H. Turan, A.I. Baran, D. Ozturk-Engin, F. Bozkurt, O. Deveci, A. Inan, A. Kadanali, M.S. Sayar, B. Cetin, M. Yemisen, H. Naz, L. Gorenek, C. Agalar
Journal: Clinical Microbiology and Infection (2014)
Avoiding the consequences of deep vein thrombosis
Authors: D Gidden, S Kershaw, B. Essex
Journal: BMJ (1999)

Editor—In his editorial on avoiding the consequences of deep vein thrombosis1 McCollum suggests that ischaemia in the legs as a result of elevated calf compartment pressure secondary to deep vein thrombosis should be treated by high elevation and thrombolysis. High elevation is likely to induce reflex vasospasm and reduce perfusion further. It has been shown in tibial fracture that a perfusion pressure (compartment pressure minus diastolic blood pressure) of 30 mm Hg is safe to observe without the risk of acute compartment syndrome developing.2 The management of ischaemia of the leg resulting from compartment syndrome induced by deep vein thrombosis should include measurement of compartment pressures with a four compartment fasciotomy if limb perfusion pressure is inadequate.

In our experience young adults with ischaemia of the leg have amputations above the knee not for the lack of elevation but because they are managed as if they had chronic vascular insufficiency. The presence of foot and skin perfusion does not exclude ischaemia of the deep muscles and nerves, and reliance on these findings often leads to a delay in appropriate surgical management.3
Early lymphopenia after cytotoxic chemotherapy as a risk factor for febrile neutropenia.
Authors: J Y Blay, F Chauvin, A Le Cesne, B Anglaret, D Bouhour, C Lasset, G Freyer, T Philip, P Biron
Journal: Journal of Clinical Oncology (1996)

PURPOSE Febrile grade four (ie, &lt; or = 500/microL) neutropenia (FN) is a frequent life-threatening complication of cancer chemotherapy. Although its incidence correlates to the dose of chemotherapy, FN may occur after almost any cytotoxic regimen. At present, there is no predictive method to identify patients who will experience FN. PATIENTS AND METHODS Univariate and multivariate analyses of risk factors for FN were performed on a retrospective cohort of 112 consecutive patients treated with various chemotherapy regimens. Two independent risk factors were identified by the logistic regression and used to create a risk model for FN. The validity of the model was tested in three distinct groups of patients: two prospective groups of patients treated in two institutions (Centre Léon Berard [CLB] and Institut G. Roussy [IGR]) and the group of patients with intermediate- or high-grade non-Hodgkin's lymphoma (NHL) treated with the doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisone (ACVBP) regimen between 1988 and 1992 at CLB. RESULTS Within the retrospective group, 23 of 47 (49%) patients with lymphocyte counts &lt; or = 700/microL at day 5 after chemotherapy experienced FN compared with seven of 65 (11%) of other patients (P = .00002). The type of chemotherapy (high dose v others) was also significantly correlated to FN (48% v 11%, P = .0003). Age, performance status, the number of previous chemotherapy cycles, or polymorphonuclear leukocyte (PMN) counts, were not significantly correlated to the incidence of FN in univariate analyses. Two independent risk factors were identified in the logistic regression: day 5 lymphocyte counts (beta = 1.97 +/- 0.53) and the type of chemotherapy regimen (beta = 1.91 +/- 0.53). The calculated probability to experience FN in patients with none, one, and both of these risk factors was 4.3%, 24.0%, and 68.8%, respectively. The validity of this model was tested in the three groups of patients used as validation samples. The observed incidences of FN in the above defined risk subgroups were 3%, 19%, and 67%, respectively, within the CLB prospective series and 6%, 19%, and 75% within the IGR prospective series. In the ACVBP group, the incidence of FN was 33% and 72%, respectively, in patients from the intermediate- and high-risk groups. In the two prospective groups and in the ACVBP series, the observed numbers of FN in the different risk groups did not differ significantly from those calculated by the model (P = .89, P = .86, and P = .72 for these three groups, respectively). CONCLUSION Day 5 lymphocyte counts &lt; or = 700/microL and the type of chemotherapy regimen enable oncologists to define subgroups of patients treated with chemotherapy as those with a high intermediate, and low risk of FN. These criteria could be used to select subjects in whom prophylactic measures for FN, in particular hematopoietic growth factors, should be proposed.
Spindle cell liposarcoma of the face: case report and literature review
Authors: T. Agostini, C. Catelani, A. Acocella, A. Franchi, R. Bertolai, R. Sacco, D. Lazzeri, K. Shokrollahi
Journal: British Journal of Dermatology (2010)

Liposarcoma is a common soft tissue sarcoma accounting for approximately 20% of all mesenchymal tumours across all ages. Recently, collaborative research in the specialties of pathology and genetics has led to the delineation of several tumour variants with different behaviours and prognoses, one of which includes the very rare spindle cell liposarcoma (SCL) subtype. We present the first case of an SCL arising in the subcutaneous tissue of the forehead of a 78-year-old man. In light of the rarity of this tumour, we describe the tumour and its clinical and pathological characteristics and undertake a literature review to clarify the surgical management and prognosis of SCL, and increase awareness to avoid misdiagnosis of a benign soft tissue neoplasm.
Antimetastatic Effects of N-Diazoacetyl-glycine Derivatives in C57BL Mice
Authors: T. Giraldi, C. Nisi, G. Sava
Journal: JNCI Journal of the National Cancer Institute (1977)

When three diazoacetyl-glycine derivatives, N-diazoacetyl-glycine amide (DGA), N-diazoacetyl-glycine hydrazide (DGI), and N-diazoacetyl-glycine ethyl ester (DGE), were tested against Lewis lung carcinoma in C57BL mice, DGA reduced sharply the number and weight of pulmonary metastases; the effects of DGI and DGE were less pronounced. The growth of the primary tumor was reduced slightly by DGA, but the greater effect was produced by DGI. The absence of correlation between the reduction of the growth of the primary implant and the number of lung secondary tumors for the tested compounds indicated that DGA possesses antimetastatic properties.
Celebrating the ACP Centennial: From the <i>Annals</i> Archive—Malaria Treatment
Authors: Deborah Cotton
Journal: Annals of Internal Medicine (2015)

Editorials6 October 2015Celebrating the ACP Centennial: From the Annals Archive—Malaria TreatmentDeborah Cotton, MD, MPHDeborah Cotton, MD, MPHSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-1073 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail During the 2015 centennial year of the American College of Physicians, publisher of Annals of Internal Medicine, Annals editors will link an article in each issue with an earlier paper from our archives addressing the same disease or clinical question. We hope our readers find this interesting and we welcome comments, especially from physicians who were practicing at the time of publication of the original paper who might offer insight into the impact of the earlier paper on their knowledge or practice.Quinidine is a stereoisomer of quinine and, although still a mainstay of oral malaria treatment, has substantial adverse ...References1. Mackie TT. Malaria in the army. Ann Intern Med. 1944;20:655-60. doi:10.7326/0003-4819-20-4-655 LinkGoogle Scholar2. Blount RE. Acute falciparum malaria: field experience with quinine/pyrimethamine combined therapy. Ann Intern Med. 1969;70:142-7. doi:10.7326/0003-4819-70-1-142 LinkGoogle Scholar3. Twomey PS, Smith BL, McDermott C, Novitt-Moreno A, McCarthy W, Kachur SP, et al. Intravenous artesunate for the treatment of severe and complicated malaria in the United States: clinical use under an investigational new drug protocol. Ann Intern Med. 2015;163:498-506. doi:10.7326/M15-0910 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMALARIA IN THE ARMY THOMAS T. MACKIE Acute Falciparum Malaria ROBERT E. BLOUNT JR. Intravenous Artesunate for the Treatment of Severe and Complicated Malaria in the United States: Clinical Use Under an Investigational New Drug Protocol Patrick S. Twomey , Bryan L. Smith , Cathy McDermott , Anne Novitt-Moreno , William McCarthy , S. Patrick Kachur , and Paul M. Arguin Metrics 6 October 2015Volume 163, Issue 7Page: 559KeywordsArchivesArmed forcesArrhythmiaArtesunateDrugsMalariaMorbidityMortalityPyrimethamineQuinine ePublished: 6 October 2015 Issue Published: 6 October 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Using Sound To Separate Circulating Tumor Cells:
Authors: Vijay Shankar Balakrishnan
Journal: JNCI Journal of the National Cancer Institute (2015)

Since 2010, Tony Huang, Ph.D., from the Acoustofluidics laboratory at Penn State University in University Park, Penn.; Ming Dao, Ph.D., from the Massachusetts Institute of Technology in Cambridge; and Subra Suresh, Ph.D., now president of Carnegie Mellon University in Pittsburgh, came up with the idea of using sound waves to tweeze out pathological cells from normal blood cells. Four years later, they showed that their sound-based device, named Acoustic Tweezers (AT), could separate MCF-7 breast cancer cells from normal white blood cells. This first-generation, dime-sized cell sorting device recovered about 71% of the MCF-7 cells from the white blood cells with 84% purity (Proc. Natl. Acad. Sci. USA 2014;111:12992–7). Now their second-generation AT has been scaled up for performance, and it efficiently tweezed out circulating tumor cells (CTCs) from normal blood cells in patient samples with a higher throughput and recovery rate, recovering more than 83% of the CTCs (Proc. Natl. Acad. Sci. USA 2015;112:4970–5).

CTCs are shed by a tumor, which then may lead to metastasis. They are rare cells: A 7.5mL sample of blood may contain only 1–100 cells. “Looking for them in a blood sample is like looking for a needle in a haystack,” Huang said. But separating and culturing CTCs for analysis may serve as a “liquid biopsy,” allowing clinicians to screen for various biological signatures of cancer, such as probing mutations in tumor cells or examining their drug susceptibility.
Preliminary analysis of ECOG 3303: Concurrent radiation (RT), cisplatin (DDP) and cetuximab (C) in unresectable, locally advanced (LA) squamous cell carcinoma of the head and neck (SCCHN)
Authors: C. J. Langer, J. W. Lee, U. A. Patel, D. M. Shin, A. E. Argiris, H. Quon, J. A. Ridge, A. A. Forastiere
Journal: Journal of Clinical Oncology (2008)

6006 Background: Randomized trials and meta-analyses have demonstrated therapeutic superiority for concurrent platinum-based chemoradiation vs. RT alone in unresectable LA-SCCHN. More recently, Bonner et al (NEJM, 2006) reported a survival advantage for (C) plus RT vs RT alone. We report toxicity and response data from an ECOG trial of concurrent chemo-RT and C in LA-SCCHN. Methods: Unresectable, newly diagnosed patients with LA-SCCHN, PS 0–1 and adequate physiologic indices received C 400 mg/m2 d1, then 250 mg/m2 Q wk, in combination with definitive RT (70 Gy/2Gy/d x 7 wks) starting d 15 and DDP 75 mg/m2 days 15, 36 and 57. In the absence of disease progression (PD) or untoward toxicity, pts could continue C weekly for > 6 mos. Results: 69 pts were accrued between 12/21/04 and 7/20/06. 5 were ineligible; 3 never started treatment. Of the remaining 61, median age was 56 (range 42–79); 85% were male, 44% PS 0; 61% had < 5% weight loss. 98% were Stage IV: 43% T4; 75% N2, 15% N3. Most common primary sites included base of tongue (34%), tonsil (21%) and other oropharynx (13%). 87% received all planned doses of C prior to and concurrent with DDP-RT. 74% received all 3 doses of cisplatin; 93% received > 2 doses. 3 pts (5%) were switched to carboplatin. Median RT dose was 70 Gy. 8 pts (13%) received < 50 Gy. 41 (67%) received maintenance therapy with C; 19 (31%) completed > 6 mos. 10 pts (16%) proved inevaluable for response. Three (5%) had PD; 31% had stable disease; 23% and 25% had CR and PR respectively. One clearly attributable Grade (gr) 5 event (neutropenic fever) was recorded. Among 65 evaluable pts, 97% had gr >3 toxicity, including neutropenia in 17 (26%), fatigue in 15 (23%), acneiform rash in 18 (28%), and radiation dermatitis in 10 (15%). Gr ≥3 mucositis was registered in 35 (54%); Gr ≥3 hyponatremia in 13 (20%). Two late Gr 4 toxicities were observed; (1) laryngeal edema, (2) pain in larynx/pharynx. Conclusions: Weekly C225, in combination with concurrent DDP and full dose RT, is feasible in fit pts with unresectable LA-SCCHN. Unique toxicities included acneiform rash and possible increase in Gr ≥3 mucositis. Longer follow-up is needed for determination of local-regional control and survival endpoints. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Amgen, Bristol-Myers Squibb, ImCLone, sanofi-aventis Bristol-Myers Squibb, ImClone Amgen, AstraZeneca, Bristol-Myers Squibb, Domantis, Ltd, ImClone, Pfizer
Inflammatory Bowel Disease: From Bench to Bedside, 2nd edn
Authors: S Ghosh
Journal: Gut (2004)

Edited by S R Targan, F Shanahan and L C Karp. Dordrecht: Kluwer Academic Publishers, 2003, £219, pp 903. ISBN 1 40200 713 2

Few diseases can lay claim to four large multiauthor textbooks in addition to numerous more concise handbooks and monographs. This is certainly unique in gastroenterology where inflammatory bowel disease (IBD) has attracted eager basic scientists, clinicians, and the pharmaceutical industry with a frenzy of translation from bench to bedside. The concept of “boundary less”, so effectively developed by Jack Welch as the CEO of General Electric Co, aptly describes current IBD research, where geneticists, epidemiologists, immunologists, microbiologists, and molecular biologists interact seamlessly with gastroenterologists, physicians, health economists, and nurse specialists.

Three additional questions posed in …
Attributes of an effective trainer: implications of the views of U.K. dermatology trainees
Authors: P. Farrant, S.N. Cohen, S.M. Burge
Journal: British Journal of Dermatology (2008)

Trainers have a critical influence on the education of specialist registrars (SpRs) and the quality of training programmes.This study gathered the opinions of U.K. dermatology SpRs on the attributes they felt were important in a trainer.The questionnaire was sent to all U.K. dermatology SpRs (n=216). It comprised the stem: 'A good trainer (supervising consultant or educational supervisor)', followed by statements such as '...has realistic expectations of the trainee'. Respondents ranked each statement in importance using a five-point Likert scale. A free-text box was also included for respondents to list the least desirable attributes.Completed questionnaires were received from 146 trainees (68%). Four attributes were identified as most important: having an encouraging and supportive attitude, using feedback to identify specific areas for attention, being approachable, and being willing to answer questions. Least important attributes included openness to criticism of teaching skills, auditing of own clinical practice, sense of humour and place of work (district general vs. teaching hospital). Eighty-seven respondents indicated the least desirable attributes of a trainer. Most comments related to being uninterested in training, being unapproachable or unavailable, or undermining the trainee and using unconstructive criticism.The results highlight the importance to trainees of constructive feedback, and dialogue with trainers. Some of the stated undesirable characteristics in a trainer appeared to derive from personal experience. This is of serious concern, and ways in which the trainer-trainee relationship can be improved are discussed.
A randomized study of a patient narrative (storytelling) medical education process for third year medical students compared to standard clinical experience in an academic oncology practice
Authors: C. M. Anderson, J. Floyd, M. Cunningham, T. Reeder, K. Hoffman, S. Boren
Journal: Journal of Clinical Oncology (2005)

8265 Background: Allowing patients to tell their stories is thought to benefit them. In medical education, however, the role of patient narratives is historically unexplored and understudied. Methods: A prospective study is being conducted randomizing 20 third year medical students to a patient narrative experience or standard group. Students in the standard group participate in the medical oncology clinic by observing the attending physician and fellow’s evaluation and interactions while participating in history-taking and physical examination to the extent that their comfort and skills allow. In addition to duties of the standard group, the students randomized to the narrative group are allotted additional time in a medical oncology clinic to illicit and listen to narrative from patients pertaining to their disease and/or life circumstances. Six or more of the stories are documented and presented to the principal investigator and peers during and after the rotation month. Students from both arms undergo the same evaluation process consisting of standard evaluation of rotation bv the student and an evaluation of the student by the attending. Additionally, students fill out a clinical rotation questionnaire (CRQ) targeting their comfort with patient interaction and an information input scale (IIS). Finally, patients fill out a satisfaction survey (PSS) after each interaction with a student from the narrative arm. Data from the CRQ, IIS, PSS, and additional subjective data will be statistically analyzed in an attempt to identify a measurable impact on the learner and the patient. Results: To date, six students have been enrolled in the study and have been randomized. Four students have completed their evaluations. An additional 14 students will be randomized prior to preliminary data analysis. Conclusions: Randomized studies evaluating the utility of patient narratives as an educational tool are needed. Our study design and implementation demonstrate the feasibility of such studies. Preliminary data will be available for presentation. No significant financial relationships to disclose.