tbuckley/cabot-search huggingface dataset:
Continuous infusion chemotherapy: a critical review.
Authors: N J Vogelzang
Journal: Journal of Clinical Oncology (1984)

With the development of reliable drug pumps and safe long-term venous access catheters, the continuous infusion of chemotherapeutic agents has become clinically feasible. The available studies on infusion therapy with 37 antineoplastic drugs are analyzed. With the majority of agents, infusion studies have either not been performed or the completed studies have failed to demonstrate improved effectiveness over bolus therapy. In some continuous infusion studies, effectiveness has been retained but with no apparent improvement in the therapeutic index. Several other drugs such as bleomycin, cytosine arabinoside, and doxorubicin have apparent improvement in the therapeutic index when given as a continuous infusion. The improved therapeutic index of the fluorinated pyrimidines when given via continuous infusion must be explored in randomized controlled studies using malignancies other than colorectal cancer. The cost effectiveness of such studies must be carefully assessed. Since this method of administration of chemotherapeutic agents offers the potential for less toxicity and retained antineoplastic effect, such investigations are highly desirable for improved patient care.
Randomized trial comparing induction chemotherapy versus induction chemotherapy followed by maintenance chemotherapy in small-cell lung cancer. European Lung Cancer Working Party.
Authors: J P Sculier, M Paesmans, G Bureau, V Giner, J Lecomte, J Michel, M C Berchier, O Van Cutsem, U Küstner, F Kroll, R Sergysels, P Mommen, J Klastersky
Journal: Journal of Clinical Oncology (1996)

PURPOSE AND METHODS The European Lung Cancer Working Party (ELCWP) performed a randomized trial with the primary end point to determine if maintenance chemotherapy with 12 courses of etoposide (120 mg/m2 on days 1 and 3) and vindesine (3 mg/m2 on day 3) could improve progression-free survival in small-cell lung cancer (SCLC) patients who responded to six courses of induction chemotherapy with ifosfamide, etoposide, and an anthracycline (doxorubicin or epirubicin). RESULTS Among 235 eligible patients initially registered, 91 were randomized to receive maintenance therapy, including seven patients who were no longer responding. Among 84 randomized responders, progression-free survival was significantly improved (P = .003) by maintenance therapy, with median durations (maintenance v follow-up) of 25 versus 12 weeks after the second randomization, but survival was not significantly increased (P = .10), with median durations of 48 and 38 weeks. However, in a multi-variate analysis that took into account disease extent, maintenance therapy, Karnofsky performance status (PS), and absolute dose-intensity (ADI) of anthracycline given during induction, limited disease (LD) and maintenance were found to be independent positive predictors of survival. CONCLUSION We conclude that maintenance chemotherapy in responding patients is beneficial in SCLC.
Will India's national health policy deliver universal health coverage?
Authors: M. R. Mathur, K. S. Reddy, C. Millett
Journal: BMJ (2015)

Draft policy is missing some important details

The Union Government of India recently released its draft 2015 national health policy.1 This is the first iteration in India’s national health policy since 2002, catalysed by changes in the central and state governments after 2014 elections. The draft policy comes at an important time. India’s economy is growing quickly, with more money available for public spending. Its private healthcare industry is expanding rapidly, while Indians experience the double burden of infectious and non-communicable disease and high out of pocket expenditure on healthcare. The new policy’s primary goal is “the attainment of the highest possible level of good health and wellbeing, through a preventive and promotive health care orientation in all developmental policies, and universal access to good quality health care services without anyone having to face financial hardship as a consequence.”1

India’s current health profile reflects the combined effects of multiple transitions (demographic, epidemiological, and nutritional) overlaid by uneven economic development, an under-resourced public health system, and inadequate multisectoral action on the determinants of health. Striking inequalities in health indicators are present across very diverse states and heterogeneous population groups. The new policy advocates action on the social determinants …
Reverse-Thrust Ventilation in Hypercapnic Patients with Acute Respiratory Distress Syndrome
Authors: NICOLA ROSSI, GUIDO MUSCH, FABIO SANGALLI, MURIEL VERWEIJ, NICOLO PATRONITI, ROBERTO FUMAGALLI, ANTONIO PESENTI
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Section:ChooseTop of pageAbstract <<METHODSRESULTSDISCUSSIONCONCLUSIONSReferencesCITING ARTICLES
Cell-Substrate Interactions: Tuning of Collagen Scaffold Properties Modulates Embedded Endothelial Cell Regulatory Phenotype in Repair of Vascular Injuries In Vivo (Adv. Healthcare Mater. 15/2015)
Authors: Shimon Unterman, Alina Freiman, Margarita Beckerman, Eytan Abraham, James R. L. Stanley, Ela Levy, Natalie Artzi, Elazer Edelman
Journal: Advanced Healthcare Materials (2015)

Biomaterials exhibit dramatically varying behavior and efficacy in different tissue microenvironments. On p. 2220, S. Unterman, N. Artzi, and co-workers describe how tuning material properties can enhance efficacy of implanted endothelial cells in the injured perivascular environment. The rational design of materials for optimal in vivo efficacy is dependent on real-time monitoring of tissue, material (red), and implanted cell (green) state using live animal fluorescent imaging.
A simple, robust and rapid approach to detect carbapenemases in Gram-negative isolates by MALDI-TOF mass spectrometry: validation with triple quadripole tandem mass spectrometry, microarray and PCR
Authors: C. Vogne, G. Prod'hom, K. Jaton, L.A. Decosterd, G. Greub
Journal: Clinical Microbiology and Infection (2014)
Proposal for classifying the acute emetogenicity of cancer chemotherapy.
Authors: P J Hesketh, M G Kris, S M Grunberg, T Beck, J D Hainsworth, G Harker, M S Aapro, D Gandara, C M Lindley
Journal: Journal of Clinical Oncology (1997)

PURPOSE To propose a classification of the acute emetogenicity of antineoplastic chemotherapy agents, and to develop an algorithm to define the emetogenicity of combination chemotherapy regimens. METHODS A Medline search was conducted to identify (1) clinical trials that used chemotherapy as single-agent therapy, and (2) major reviews of antiemetic therapy. The search was limited to patients who received commonly used doses of chemotherapy agents, primarily by short (&lt; 3 hours) intravenous infusions. Based on review of this information and our collective clinical experience, we assigned chemotherapy agents to one of five emetogenic levels by consensus. A preliminary algorithm to determine the emetogenicity of combination chemotherapy regimens was then designed by consensus. A final algorithm was developed after we analyzed a data base composed of patients treated on the placebo arms of four randomized antiemetic trials. RESULTS Chemotherapy agents were divided into five levels: level 1 (&lt; 10% of patients experience acute [&lt; or = 24 hours after chemotherapy] emesis without antiemetic prophylaxis); level 2 (10% to 30%); level 3 (30% to 60%); level 4 (60% to 90%); and level 5 (&gt; 90%). For combinations, the emetogenic level was determined by identifying the most emetogenic agent in the combination and then assessing the relative contribution of the other agents. The following rules apply: (1) level 1 agents do not contribute to the emetogenic level of a combination; (2) adding &gt; or = one level 2 agent increases the emetogenicity of the combination by one level greater than the most emetogenic agent in the combination; and (3) adding level 3 or 4 agents increases the emetogenicity of the combination by one level per agent. CONCLUSION The proposed classification schema provides a practical means to determine the emetogenic potential of individual chemotherapy agents and combination regimens during the 24 hours after administration. This system can serve as a framework for the development of antiemetic guidelines.
Effects of latex avoidance on latex sensitization, atopy and allergic diseases in patients with spina bifida
Authors: K. Blumchen, P. Bayer, D. Buck, T. Michael, R. Cremer, C. Fricke, T. Henne, H. Peters, U. Hofmann, T. Keil, M. Schlaud, U. Wahn, B. Niggemann
Journal: Allergy (2010)

Ten years ago, avoidance measures such as the performance of latex-free operations were implemented in children with spina bifida. Since then, latex sensitization and latex allergy have decreased in this high-risk group.To study the effect of primary latex-free prophylaxis on the prevalence of allergic diseases and atopy as a marker for sensitization spreading in children with spina bifida.One hundred and twenty children with spina bifida born after the introduction of latex-free prophylaxis and operated on under latex-free conditions ('current group') were examined for latex sensitization, latex allergy, sensitization to aero- and food allergens and allergic diseases. Results were compared to a 'historic' (not latex-free operated) group of children with spina bifida and comparable age (n = 87) and to a recent sample of children from the general population (n = 12,403).In comparison with the 'historic group', latex sensitization (55% vs 5%, P < 0.001) and latex allergy (37% vs 0.8%, P < 0.001) were significantly reduced in the 'current group'. Furthermore, a significant reduction could be demonstrated for sensitization to aeroallergens (41.4% vs 20.8%, P = 0.001) and for allergic diseases (35% vs 15%, P = 0.001). The prevalence for atopy, sensitization to aero-/foodallergens and for allergic diseases in children of the 'current group' was similar to those in children of the weighted population sample.Latex avoidance in children with spina bifida prevents latex sensitization and latex allergy. Additionally, it also seems to prevent sensitization to other allergens and allergic diseases which might be explained by the prevention of sensitization spreading.
Four year efficacy of prophylactic human papillomavirus quadrivalent vaccine against low grade cervical, vulvar, and vaginal intraepithelial neoplasia and anogenital warts: randomised controlled trial
Authors: Joakim Dillner, Susanne K. Kjaer, Cosette M. Wheeler, Kristján Sigurdsson, Ole Erik Iversen, Mauricio Hernandez-Avila, Gonzalo Perez, Darron R. Brown, Laura A. Koutsky, Eng Hseon Tay, Patricia García, Kevin A. Ault, Suzanne M. Garland, Sepp Leodolter, Sven Eric Olsson, Grace W.K. Tang, Daron Gale Ferris, Jorma Paavonen, Matti Lehtinen, Marc Steben, F. Xavier Bosch, Elmar A. Joura, Slawomir Majewski, Nubia Muñoz, Evan R. Myers, Luisa L. Villa, Frank J. Taddeo, Christine Roberts, Amha Tadesse, Janine T. Bryan, Roger Maansson, Shuang Lu, Scott Vuocolo, Teresa M. Hesley, Eliav Barr, Richard Haupt
Journal: BMJ (2010)

Objectives To evaluate the prophylactic efficacy of the human papillomavirus (HPV) quadrivalent vaccine in preventing low grade cervical, vulvar, and vaginal intraepithelial neoplasias and anogenital warts (condyloma acuminata).
Factors Associated With Interhospital Variability in Inpatient Costs of Liver and Pancreatic Resections
Authors: Howard Nelson-Williams, Faiz Gani, Arman Kilic, Gaya Spolverato, Yuhree Kim, Doris Wagner, Neda Amini, Aslam Ejaz, Timothy M. Pawlik
Journal: JAMA Surgery (2015)

<h3>Importance</h3> In an era of accountable care, understanding variation in health care costs is critical to reducing health care spending. <h3>Objective</h3> To identify factors associated with increased hospital costs and quantify variations in costs among individual hospitals in patients undergoing liver and pancreatic surgery in the United States. <h3>Design, Setting, and Participants</h3> Retrospective analysis of total costs among 42 480 patients undergoing hepatopancreaticobiliary surgery from January 1, 2002, through December 31, 2011, using a nationally representative data set (Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project). Analysis was conducted in May 2015. <h3>Main Outcomes and Measures</h3> Total inpatient costs and proportional variation in inpatient costs among individual hospitals. <h3>Results</h3> Among the 42 480 patients who underwent liver or pancreatic resection, the median age was 62 years, 52.4% were female, and 72.9% had a Charlson Comorbidity Index of 2 or higher. The median cost for the entire cohort was $21 535 (interquartile range, $15 373-$31 104), varying from $3320 to $279 102 among individual hospitals. On multivariable analysis, increasing patient comorbidity (coefficient, 2000.30; 95% CI, 1363.33-2637.27;<i>P</i> &lt; .001) and operative characteristics (total pancreatectomy: coefficient, 12 742.31; 95% CI, 10 063.66-15 420.94;<i>P</i> &lt; .001; lobectomy: coefficient, 6336.42; 95% CI, 3934.61-8737.24;<i>P</i> &lt; .001) were associated with higher hospital costs. The development of postoperative complications, such as sepsis (coefficient, 30 571.25; 95% CI, 29 308.96-31 833.54;<i>P</i> &lt; .001) or stroke (coefficient, 8925.34; 95% CI, 2801.38-15 049.30;<i>P</i> = .004), and a longer length of stay were most strongly predictive of higher inpatient cost (length of stay &gt;14 days: coefficient, 44 162.24; 95% CI, 43 125.56-45 198.92;<i>P</i> &lt; .001). After adjusting for patient and hospital characteristics, the overall cost of hepatopancreaticobiliary surgery varied by $9000 among individual hospitals. <h3>Conclusions and Relevance</h3> Significant variability was noted in hospital costs among patients undergoing pancreatic and liver surgery. Future policies should focus on reducing variations in costs by promoting payment paradigms that support a better quality of care and lower costs.
Abstract P359: A Sickle Cell Variant Associates With Urine Albumin Excretion in Genome Wide Association Study of Hispanics: The HCHS/SOL Study
Authors: Nora Franceschini, Adrienne Stilp, Christina L Wassel, Holly J Mattix-Kramer, Michael F Flessner, Rebekah S Rasooly, Jianwen Cai, Cathy C Laurie
Journal: Circulation (2015)

Introduction: Genome wide association studies have identified genetic variants in the Cubillin gene ( CUBN ) that explain inter-individual variation in urine albumin-to-creatinine excretion (UACR) in populations. These studies have not included Hispanics/Latinos, the fast growing minority population in the U.S., who has also high prevalence of chronic kidney disease and its risk factors. Hypothesis: By leveraging on population admixture of Hispanics and using a genome wide association approach, we hypothesized that novel loci associated with UACR would be identified. Methods: We used data from 12,212 self-identified Hispanic individuals recruited in a community-based study, aged 18-74 years at screening (2008-2011), and randomly selected from households in four U.S. field centers (Chicago, IL; Miami, FL; Bronx, NY; San Diego, CA). Urine albumin (mg/dl) and creatinine (g/dl) were measured at the baseline exam. UACR was log-transformed for analysis. Individuals were excluded if reporting to have end-stage renal disease. Genotyping was performed using a custom Illumina Omni2.5M array. Imputation of variants was performed using 1000 Genome Project data from cosmopolitan HapMap samples. After quality control of imputed data, we performed mixed linear regression analyses that accounted for the sampling strategy and family relatedness, for variants with minor allele frequency (MAF) &gt; 0.01 and imputation quality &gt; 0.3. We used additive genetic models and adjusted for age, sex, and principal components which were estimated from the data. In a secondary analysis, we also examine the association of significant variants with kidney function using estimated glomerular filtration rate (eGFR) equations. Results: Among 12,212 participants, 41% were men, and mean age was 46 (SD =13). There was little evidence for genome wide inflation (lambda =1.024). We identified significant associations of single nucleotide polymorphisms (SNPs) with UACR at two loci: CUBN and HBB . The CUBN SNP (chr10:16966414, p=2.1x10-8) is an indel variant with MAF of 0.14, which was not in linkage disequilibrium with previously reported SNP rs1801239 (rsq=0.38, p=1.3x10-4) identified in individuals of European ancestry. The HBB SNP is a missense variant which results in an E [Glu] ⇒ A [Ala] substitution in the beta-globin chain of hemoglobin and a cause of the Mendelian disorder sickle cell anemia (rs334, T allele frequency =0.01, beta=0.44, SE=0.06, p=7.6x10-12). rs344 was not associated with eGFR in our data (p&gt;0.05). Conclusion: This study identified a novel association of a sickle cell missense variant with UACR in Hispanics, and provided evidence for allelic heterogeneity at the CUBN locus. Our findings suggest a role for Mendelian gene variants in increased albuminuria in Hispanic populations with admixture.
Man's Ancestors
Authors: R A IRVINE, W B ROBERTSON
Journal: BMJ (1964)

affected than men, and the sex difference was most marked in the fifth decade of life.More recently B. S. Tynes and J. P. Utz' confirmed these correlations of the carrier state with age and sex and drew attention to the similar age and sex distribution of gall-stones.Treatment of clinical typhoid with chloramphenicol does not seem to have reduced the incidence of the chronic-carrier state.Treatment of the carrier state is notoriously difficult.Chloramphenicol is often ineffective either alone'2 or in combination with other antibiotics.'3There is some evidence that large doses of penicillin''" or of penicillin in con- junction with other agents'" 16 may be helpful.More recently, success has been reported with ampicillin."7This antibiotic, combined with cholecystectomy when there is evidence of disease of the gall-bladder,' may be the treatment of choice for carriers at present.To detect entry of cooling-water into tins of corned beef Dr. Mair Thomas suggests in our correspondence columns (page 1571) that a dye should be added to it.This would seem worth following up.
Evaluation of Deferasirox (Exjade®, ICL670) Therapy in Patients with Transfusional Iron Overload Who Achieve Serum Ferritin (SF) ≤1000 ng/mL in Long-Term Studies.
Authors: Maria Domenica Cappellini, Elliott Vichinsky, John M. Ford, Bertrand Rabault, John Porter
Journal: Blood (2007)
Immunity to pneumococcal surface proteins in children with community-acquired pneumonia: a distinct pattern of responses to pneumococcal choline-binding protein A
Authors: K.M. Posfay-Barbe, A. Galetto-Lacour, S. Grillet, M.M. Ochs, R.H. Brookes, J.D. Kraehenbuhl, M. Cevey-Macherel, M. Gehri, A. Gervaix, C.-A. Siegrist
Journal: Clinical Microbiology and Infection (2010)
Psychosocial Treatment Prescriptions for Generalized Anxiety Disorder, Panic Disorder, and Social Phobia, 1991–1996
Authors: Robert M. Goisman, Meredith G. Warshaw, Martin B. Keller
Journal: American Journal of Psychiatry (1999)

Pharmacologic prescriptions for anxiety disorders have changed significantly in the last decade. This article investigates whether psychosocial treatments, as reported by 362 subjects in the Harvard/Brown Anxiety Disorders Research Program from 1991 to 1996, changed as well.Subjects were interviewed in 1991 and 1995-1996 to determine which psychosocial treatments (behavioral, cognitive, dynamic, or relaxation or meditation) they had received.The percentage of subjects who received each type of psychosocial treatment either declined or remained the same from 1991 to 1995-1996. Dynamic psychotherapy remained the most frequently used method of these four. The percentage of subjects receiving any such method declined.Behavioral and cognitive treatment, two empirically validated forms of psychotherapy, were less frequently used than dynamic psychotherapy, which lacks such validation. All use of verbal treatment methods declined from 1991 to 1995-1996.
Abstract 247: Therapeutic Neovascularization by AAV2/9 Based Gene Transfer of hVEGF-A and hPDGF in Chronic Ischemia (rabbit model)
Authors: Achim Pfosser, Chiraz El-Aouni, Franziska Globisch, Claudia Dinges, Andrea Fritz, Shahana Sultana, Rabea Hinkel, Corinna Lebherz, Andrea Banfi, Peter Boekstegers, Christian Kupatt
Journal: Circulation (2008)

Therapeutic neovascularization by several growth factors is a concept well established in multiple animal models, albeit lacking clearcut clinical success to date. Therefore, we modified our therapeutic approach by combining the potent angiogenic agent hVEGF-A with hPDGF, a growth factor known for attracting pericytes and smooth muscle cells for arterial vessel maturation. In order to enhance efficacy, we utilized adeno-associated virus (AAV) 2/9, allowing for prolonged transgene expression. A lower hVEGF-AAV-concentration was used to avoid hemangiomaformation. 7 days after femoral artery excision, 1×10e11 hVEGF-A-AAV alone or in combination with 1×10e12 hPDGF-AAV particles were retroinfused into the anterior tibial vein of rabbits (n=5/group, p&lt;0.05). LacZ-AAV2 was used as reporter-gene controls. At d7 and 35 angiography of both hindlimbs was performed for collateral quantification (% of d7 level) and frame count score (cinedensitometry, % of d7 level). Capillary density (Capillary muscle fiber ratio, CM/F) was assessed at d35 by PECAM-1 and alkaline-phosphatase-staining of the ischemic gastrocnemic and tibial anterior muscles, pericyte-quantification was assessed by NG2-staining. LacZ-expression was detected at d35 in control animals. hVEGF-A-AAV retroinfusion strongly induced angiogenesis (CM/F 1,32+0,07 vs. 0.96+0,08, controls), but failed to enhance collateral growth (125+7 vs. 95+6%, controls, p&lt;0.05) or perfusion (frame count score: 136+12% vs. 107+9%, p=0.07). hVEGF-A/hPDGF co-application, however, enhanced perfusion (163+8%, p&lt;0.05) via an increased collateral growth (146+9%, p&lt;0.01) at a similar capillary density (1,44+0,10). We conclude, that efficacy of hVEGF-A-transfection is increased by hPDGF-co-transfection with a long-acting AAV. Utilizing this approach, the main target of hPDGF appears to be the collateral vasculature, complementary to the capillary growth induced by hVEGF-A. Thus, the combination of hVEGF-A and hPDGF combined with a long-acting AAV-vector is a promising tool in the quest of efficient therapeutic neovascularization.
Incidence, clinical characteristics and 30-day mortality of enterococcal bacteraemia in Denmark 2006–2009: a population-based cohort study
Authors: M. Pinholt, C. Østergaard, M. Arpi, N.E. Bruun, H.C. Schønheyder, K.O. Gradel, M. Søgaard, J.D. Knudsen
Journal: Clinical Microbiology and Infection (2013)
Clinical characteristics of respiratory infections in patients with cancer
Authors: Gino Fuentes, Carmen Venegas, Jorge Dreyse, Ricardo Rabagliati, Fernando Saldías
Journal: European Respiratory Journal (2014)

INTRODUCTION   Infections are common in oncology. Aim: To characterize respiratory infections in hospitalized adult cancer patients.   METHODS   Prospective, descriptive study of febrile adult patients in oncology at the Hospital Clinico Universidad Catolica, between April 2008 and April 2009.   RESULTS   187 episodes were evaluated. Clinical infection was recognized in 70% and 33 episodes (25%) were respiratory focus. Neoplastic disease corresponded to solid organ cancer in 77% of cases and 33% were admitted with febrile neutropenia. The upper respiratory tract infection accounted for 36% and low respiratory tract infection 65% of cases; 55% was pneumonia. Etiology of these was isolated in 39% ( S. pneumoniae  2 cases,  S. bovis  1,  E. faecalis 1,  P. jirovecii  2,  S. maltophilia  1 and  A. fumigatus  1)  . Hospital mortality for pneumonia was 22% and overall mortality 12%.   CONCLUSIONS   Respiratory infections are a major focus in adult cancer patients, highlighting pneumonia. It carries high mortality and varied etiology.