tbuckley/cabot-search huggingface dataset:
A multifactorial analysis of melanoma. IV. Prognostic factors in 200 melanoma patients with distant metastases (stage III).
Authors: C M Balch, S J Soong, T M Murad, J W Smith, W A Maddox, J R Durant
Journal: Journal of Clinical Oncology (1983)

A multifactorial analysis of 200 cutaneous melanoma patients with distant metastasis (stage III) was performed on 13 clinical and pathological factors using the Cox regression analysis. There were only three dominant prognostic variables that independently predicted the patient's clinical course: (1) number of metastatic sites (1 vs. 2 vs. greater than or equal to 3, p less than 0.00001), (2) remission duration (less than 12 mo vs. greater than or equal to 12 mo, p = 0.0186), and (3) the location of the metastases (visceral vs. nonvisceral vs. combined, p = 0.0192). Factors that were not significant in the multifactorial analysis included the patients' age and sex, the site of the primary melanoma, the sequence of metastases, and all histopathological features of the primary melanoma (thickness, level of invasion, ulceration, growth pattern, pigmentation, and lymphocyte infiltration). For a single metastatic site, the 1-yr survival rate was 36%, while it was only 13% for 2 sites, and 0% for greater than or equal to 3 sites (p less than 0.00001). The 1-yr survival for patients was 40% for nonvisceral sites (skin, subcutaneous, distant lymph nodes) compared to only 11% for visceral metastases and 8% for combined sites (p less than 0.00001). Pulmonary metastases were associated with a significantly higher survival rate than metastatic melanoma in any other visceral site. The most common first site of distant metastases (either alone or in combination) was skin (38%), lung (36%), liver (20%), and brain (20%). The skin, subcutaneous and distant lymph node group was the first site of metastases in 59% of patients. This finding emphasizes the importance of careful physical exams in routine metastatic evaluations. Only a minority (25%) of stage I patients progressed to stage III disease after a median interval of 2.8 years. In contrast, the majority (75%) of melanoma patients with nodal metastases (stage II) progressed to stage III disease after a median duration of only 11 mo. Of the patients who eventually developed stage III disease, 95% of those who initially presented with stage II disease progressed within 3 yr, while stage I patients who progressed to stage III did not reach a 95% cumulative incidence until 8 yr.
Abstract 4769: Aspirin and Clopidogrel Use in Early Postoperative Period Following On-Pump and Off-Pump Coronary Artery Bypass Grafting
Authors: Dae Hyun Kim, Constantine Daskalakis, Scott C Silvestry, Mital P Sheth, Andrew N Lee, Suzanne Adams, Sam Hohmann, David J Whellan
Journal: Circulation (2008)

Preoperative clopidogrel use increases the risk of bleeding, but the impact of early postoperative clopidogrel use has not been studied. We hypothesized that early postoperative use of clopidogrel ...
Proinflamatory gene polymorphism and fatigue in sarcoidosis
Authors: Tatjana Radjenovic Petkovic, Tatjana Pejcic, Desa Nastasijevic Borovac, Milan Rancic, Ivana Stankovic, Lidija Ristic
Journal: European Respiratory Journal (2012)

Introduction: Fatigue is one of the most prominent symptoms in sarcoidosis patients. Cause of fatigue in sarcoidosis is still unknown. No relationship was found between fatigue and disease activity marker in sarcoidosis. Fatigue can persist many years after disease remission. Proinflammatory cytokines, TNF-α and LT-α, play important role in sarcoidosis pathogenesis. Elevated values of TNF-α and LT-α, are detected in patients with chronic fatigue syndrome of unknown etiology. Aim of our study was to investigate possible association between TNF-α and LT-α gene polymorphism and fatigue in sarcoidosis patients.  Methods: One hundred and twenty eight patients with sarcoidosis were included in study. Fatigue was measured on the Fatigue Assessment Scale (FAS). Genetic tests were performed using the patients9 peripheral blood. Instances of polymorphism were examined by PCR-RFLP (polymorphism detection based on the restriction fragment length) on the DNA isolated from the blood by the commercial kit (Fermentas, Lithuania). Fatigue was present in 71 patients.  Results: Our results showed significantly higher frequency of rare LTα+252 G allele (29,58% vs. 19,30%, p  Conclusion: Based on these results, we concluded that proinflammatory gene polymorphism can predict the occurrence of fatigue in sarcoidosis patients.
Concurrent Paclitaxel and Radiation in the Treatment of Locally Advanced Head and Neck Cancer
Authors: John B. Sunwoo, Laurie L. Herscher, Glenn S. Kroog, Giovana R. Thomas, Frank G. Ondrey, Dianne C. Duffey, Beth I. Solomon, Carol Boss, Paul S. Albert, Linda McCullugh, Susan Rudy, Chris Muir, Suoping Zhai, William D. Figg, John A. Cook, James B. Mitchell, Carter Van Waes
Journal: Journal of Clinical Oncology (2001)

PURPOSE: To determine the feasibility of an organ preservation regimen consisting of infusional paclitaxel administered concurrently with radiotherapy to patients with locally advanced head and neck squamous cell carcinoma (HNSCC). PATIENTS AND METHODS: Thirty-three previously untreated patients with stage III or IV tumors were enrolled onto the study. Paclitaxel was administered as a 120-hour continuous infusion every 3 weeks during the course of radiation therapy. Sixteen patients received a paclitaxel dose of 105 mg/m 2 , and 17 patients received 120 mg/m 2 . Radiation was delivered in a standard format at 1.8 Gy/d to a total dose of 70.2 to 72 Gy. RESULTS: Three months after therapy, a 76% complete response (CR) at the primary site and a 70% overall CR was achieved. At 36 months, locoregional control was 55.7%, overall survival was 57.8%, and disease-free survival was 51.1%. The median survival duration for all 33 patients was greater than 50 months at the time of this report. Local toxicities including mucositis, dysphagia, and skin reactions were severe but tolerable. All patients retained functional speech, and all but four patients were swallowing food 3 months after treatment. Steady-state plasma concentrations for paclitaxel were not achieved during a 120-hour infusion, suggesting a nonlinear process. Tumor volume quantified by pretreatment computerized tomography imaging was associated with likelihood of response and survival. CONCLUSION: Paclitaxel administered as a 120-hour continuous infusion in combination with radiotherapy is a feasible and promising treatment for patients with advanced HNSCC.
Results of a new questionnaire to assess sleep problems in childhood
Authors: Zsofia Lendvai, Gergely Kiss, Krisztina Pásti, Agnes Prókai, Attila J. Szabo
Journal: European Respiratory Journal (2012)

Screening of sleep disorders in children is of high importance. In Hungary there is no standardized questionnaire for assessing sleep problems.  We evaluated the results of sleep quality scales of our questionnaire and compared the data of healthy and clinical population. We analyzed the correlation between our questionnaire and validated tests and the severity of obstructive sleep apnea (OSA).  Our questionnaire is designed to estimate sleep hygiene and quality in two age groups (8-14 and 15-18 ys.) by nighttime and daytime symptoms score. Two groups of children were analyzed: 1. healthy group (n=2020), 2. children with sleep problems (n=66). The second group filled out two validated tests, Modified Pediatric Epworth Sleepiness Scale (MP-ESS), Conner9s Rating Scales-Revised (CRS-R) and underwent polysomnography. Severity of OSAS was characterized by Apnea-Hypopnea Index (AHI) and Oxigen-Desaturation Index (ODI).  Children underwent polysomnography had significantly higher score both on nighttime and daytime symptoms scale than healthy children. Correlations were: score of nighttime symptoms scale and CRS-R score (r=0.441; p=0.001), score of daytime symptoms scale and MP-ESS score (r=0.389; p=0.001). Children in the highest quartile of nighttime symptoms scale had significantly higher AHI (mean±SD: 0.62±1.07 vs. 5.97±11.39; p=0,04) and ODI (mean±SD: 0.49±0,53 vs. 6.23±12,07; p=0.02) than children in the lowest quartile. The nighttime and daytime score index had higher sensitivity to predict OSA than other tests.  Our questionnaire can be potentially useful in evaluating sleep problems in children and give more information about sleep problems than other tests. However validation of the questionnaire is still needed.
Outcome of endobronchial valve (EBV) placement in lower lobes and in low heterogeneous patients
Authors: Ralf Eberhardt, Daniela Gompelmann, Felix J.F. Herth, Arschang Valipour, Armin Ernst, Gerard J. Criner, Dirk-Jan Slebos
Journal: European Respiratory Journal (2012)

Introduction  VENT and Chartis studies showed clinical benefit when EBV9s (PulmonX, CA, USA) are placed to achieve lobar occlusion in patients with complete fissures/absent collateral ventilation. There was no restriction on site of valve placement and patients with a range of heterogeneity scores were treated.  Objective  To evaluate clinical outcomes in patients treated with EBV in lower lobes and in patients with low heterogeneity.  Methods  Analysis of the VENT subgroup with complete fissures with lobar occlusion and analysis of patients in the Chartis study with absent collateral ventilation and who achieved target lobe volume reduction of > 350ml.  Results  In the Chartis subgroup, 12 patients were treated in left lower lobe (LLL) with a % improvement in FEV 1  at 30 days of 17.5% ±20.8 and SGRQ of -14.6 points ±14.4. Five patients were treated in right lower lobe (RLL) with a Δ FEV 1  of 40.7% ±27.4 and a Δ SGRQ of -18.6 points ±15.2. In the VENT subgroup, 11 patients were treated in LLL, resulting in a ΔFEV 1  at 6 and 12 months of 18.1% ±20.0 and 13.1% ±20.2 respectively. In the 4 RLL patients, ΔFEV 1  was 22.9% ±22.8 and 23.6% ±15.8. Δ SGRQ was -7.5 points ±19.1 and -7.5 ±15.0 at 6 months in LLL and RLL respectively.  In the VENT subgroup, 26 patients had heterogeneity score of ≤15% with a mean change in FEV 1  at 12 months of 15.4% ±25.1 compared to 31.1 ±28.8 in the 35 patients with a score > 15%. In the Chartis subgroup, 14 had a score of ≤15% and showed a mean change in FEV 1  of 15.9% ±16.1 at 30 days compared to 26.4% ± 27.9 in the 20 patients with a score > 15%.  Conclusion  A clinical relevant response can be obtained after EBV in lower lobes and in patients who are not highly heterogeneous.
The role of radiation therapy in the management of stage III follicular lymphomas.
Authors: S B Paryani, R T Hoppe, R S Cox, T V Colby, H S Kaplan
Journal: Journal of Clinical Oncology (1984)

Between 1961 and 1982, 66 patients with stage III follicular small cleaved (FSC) and follicular mixed small cleaved and large cell (FM) lymphoma were treated at Stanford University. Treatment consisted of total-lymphoid irradiation (TLI) to a total dose of about 4,000 rad in 61 patients or whole-body irradiation (WBI) followed by boost irradiation to sites of involvement in five patients. In addition, 13 patients treated with TLI received adjuvant chemotherapy, consisting of six cycles of cyclophosphamide, vincristine, and prednisone (CVP). Median follow-up was 9.6 years. Kaplan-Meier actuarial survival at five, ten, and 15 years was 78%, 50%, and 37%, respectively. Freedom from relapse at five and ten years was 60% and 40% with no relapses after ten years. In a prospective randomized study of 16 patients who all underwent staging laparotomy comparing TLI with or without adjuvant chemotherapy with CVP, there was no significant difference in either survival or freedom from relapse between the two groups. Patients with limited stage III disease (without B symptoms, less than five sites of involvement, and maximum size of disease less than 10 cm) had an excellent prognosis with a 15-year survival and freedom from relapse of 100% and 88%, respectively. Radiation therapy may be a potentially curative modality in patients with stage III follicular lymphomas.
Abstract 108: Implementation and Benefit of the Pediatric Emergency Warning Score in a Community Hospital System
Authors: Samuel L Zuckerman, Daniel J Sedillo, Jeanie Tamayo, Jodi Koenig
Journal: Circulation (2011)

Introduction: In-hospital cardiac arrest has a high mortality that has not shown significant improvement despite advances in cardiopulmonary resuscitation techniques. Rapid response teams (RRTs) ha...
COPD phenotypes according to high resolution CT scan findings
Authors: Arpan Shah, Umang Shah, T.K. Jayalakshmi, Lavina Mirchandani, Aparna Iyer, Girija Nair
Journal: European Respiratory Journal (2014)

[BACKGROUND]  High Resolution Computed Tomography Scan (HRCT) is now being used as an important diagnostic test in COPD patients.  In present study, we have evaluated various HRCT features to identify morphological patterns and correlated with clinical features.  [METHODS]  50 patients (42 males and 8 females) of stable COPD attending a tertiary referral hospital were included. According to HRCT findings, 3 predominant patterns were identified as Emphysema, Bronchial wall thickening and Bronchiectasis. This was correlated with smoking status, Body Mass Index, 6 min walk test (6MWT), frequency of exacerbations, and spirometry parameters including bronchodilator reversibility.  [RESULTS]  COPD patients with Emphysema phenotype on HRCT were more severely affected i.e. they had severe COPD as per GOLD guidelines (55%) with lower (  52% COPD patients with bronchial wall thickening phenotype predominantly had severe COPD as per GOLD guidelines with lower (  52% COPD patients with bronchiectasis phenotype predominantly had moderate COPD as per GOLD guidelines. They had better (>250m) 6MWT values (73.68%) with good bronchodilator reversibility (68.42%) on spirometry. However, these patients had higher frequency of infective exacerbation compared with other two groups (52.63%).  When 6MWT is compared among emphysema, bronchial wall thickening, bronchiectasis. P value is 0.016 (significant) and F value is 4.341.  [CONCLUSION]  Morphological phenotypes as assessed by HRCT scan may help in identifying patients who will benefit from bronchodilator treatment and can also help to predict severity of COPD.
Suitability of Rat Mammary Adenocarcinoma 13762 as a Model for BCG Immunotherapy2
Authors: John W. Kreider, Gerald L. Bartlett, Dallas M. Purnell
Journal: JNCI Journal of the National Cancer Institute (1976)

We determined the optimal conditions for conducting experiments with the solid and ascites sublines of the 13762 rat mammary adenocarcinoma and examined the response of the tumor growth rate to BCG administered in admixture with tumor cells or separately at a remote site. Versene dissociation of the 13762 solid tumor produced better growth rates than did pronase-DNase, but the former decreased cell viability and yields. A dose of 106 or 105 tumor cells produced 100% growth by the sc and iv routes. Both sublines grew slower but produced metastases slightly sooner in the intradermal than in the sc site. The frequency of axillary lymph node metastases from the sc site increased as a function of the duration of the time interval between tumor implantation and surgical excision. Both solid and ascites tumors were weakly immunogenic. Administration of BCG in a split adjuvant protocol did not improve tumor immunity. Admixture of tumor cells with BCG suppressed tumor growth but when given at a remote site, BCG was ineffective. We concluded that the 13762 rat mammary adenocarcinoma is a useful system for BCG immunotherapy.
Minimal toxicity and mortality in high-risk breast cancer patients receiving high-dose cyclophosphamide, thiotepa, and carboplatin plus autologous marrow/stem-cell transplantation and comprehensive supportive care.
Authors: H K Holland, S P Dix, R B Geller, S M Devine, L T Heffner, D G Connaghan, C D Hillyer, L L Hughes, R L Miller, M R Moore, E F Winton, J R Wingard
Journal: Journal of Clinical Oncology (1996)

To assess the clinical toxicity and outcome associated with a comprehensive supportive care approach in poor-risk breast cancer (BrCA) patients with high-dose chemotherapy (HDC).One hundred twenty-five consecutive patients with stages II, III or metastatic breast cancer received HDC between February 1992 and June 1994. Recipients received 4 days of continuous infusion of cyclophosphamide 1.5 g/m2/d, thiotepa 125 mg/m2/d, and carboplatin 200 mg/m2/d followed by infusion of bone marrow or peripheral-blood stem cells (PBSC) and recombinant human growth factor (rhu-GF) support. Patients received similar supportive care that included administration of prophylactic antibiotics, management of neutropenic fevers, and transfusion support.There were 38 women with stage II or III (27 patients with > or = 10 lymph nodes), four with stage IIIB, and 83 with metastatic breast cancer. The median age was 44 years (range, 27 to 61). Grade II or greater nonhematologic toxicities included diarrhea (66%), stomatitis (33%), hepatic venoocclusive disease (VOD) (5%), and pulmonary toxicity (4%). Myeloid and platelet engraftment was comparable between bone marrow and PBSC recipients (P > .1). Infectious complications were rare and consisted of gram-negative bacteremia (1.6%), gram-positive bacteremia (1.6%), fungemia (1.6%), and documented or suspected aspergillosis infection (3%). There was one treatment-related death secondary to severe VOD.A comprehensive supportive care approach was associated with a low treatment-related mortality rate of less than 1%. With the observed reduction in treatment-related mortality, it is reasonable to evaluate the efficacy of HDC in women with less than 10 positive nodes and stage II disease in well-designed clinical trials.
Studying Cancer-Related Fatigue: Report of the NCCN Scientific Research Committee
Authors: Joanne E. Mortimer, Andrea M. Barsevick, Charles L. Bennett, Ann M. Berger, Charles Cleeland, Shannon R. DeVader, Carmen Escalante, Jeffrey Gilreath, Arti Hurria, Tito R. Mendoza, Hope S. Rugo
Journal: Journal of the National Comprehensive Cancer Network (2010)

NCCN convened a committee of experts to make recommendations for future studies of cancer-related fatigue (CRF). The committee reviewed the current data on the incidence, clinical measurement, and treatment of CRF. The assessment of fatigue is largely derived from self-report questionnaires that address the symptom of fatigue, and do not correlate the presence of fatigue with change in physical activity. The committee developed a self-report questionnaire, NCCN Fatigue and Contributing Factors Inventory, which incorporates assessments of fatigue, pain, difficulty sleeping, distress, physical activity, and concurrent medications. A clinical research study using this measure in conjunction with the NCCN Breast Cancer Outcomes Database Project is planned. The committee noted a strong interaction among fatigue, pain, difficulty sleeping, and distress and recommended that future clinical research address these interactions.
Heterogeneity of findings in exercise induced inspiratory stridor (EIIS)
Authors: Hege Clemm, Magnus Hilland, Thomas Halvorsen, John-Helge Heimdal, Ola Røksund
Journal: European Respiratory Journal (2013)

Introduction  EIIS has been attributed to inappropriate adduction of the vocal cords (VCD), often without laryngoscopic verification. Some researchers have argued that VCD may be diagnosed from a medical history or symptoms alone, and that laryngoscopy is difficult and unnecessary. This strongly contradicts our experience, with EIIS being associated with a broad spectrum of abnormalities in more than 500 patients tested since 1998, without adverse events.   Aim  To demonstrate the heterogeneity of findings from continuous laryngoscopy performed during maximal exercise (CLE-test) during 2012 at our institution.   Method  Patients presenting with EIIS at our institution during the past 15 years have been offered diagnostic examination with the CLE-test, according to our published method; in 2012 performed in 64 new referrals.   Results  Sixty-three successful tests were performed (72% female; age range 7-62 years of whom 65% range 13-18). Despite similar symptoms, laryngeal findings varied widely. Inappropriate movements of supraglottic structures were the primary obstructing event in 60%, severely impeding the laryngeal inlet in 10% with corresponding severe respiratory distress. In 36% epiglottic abnormalities were observed, seemingly disturbing airflow. Secondary adduction of vocal folds was observed in a large proportion, while primary vocal fold adduction was rare (9%). Extra-laryngeal abnormalities were suspected in seven (11%).   Conclusion  EIIS has different origins. Adduction of supraglottic structures and not the vocal folds was the inciting event in a majority. EIIS should not be linked to VCD without laryngoscopic verification, which is a safe procedure revealing findings of therapeutic consequences.
Unresectable Liver Metastases from Colorectal Cancer: Methodology and Prognosis with Radiofrequency Ablation
Authors: Junji Machi
Journal: Liver Cancer (2009)

Liver metastases from colorectal cancer, although it is a stage 4 disease, has more treatment options and has better prognosis than liver metastases from other cancers. Multimodality treatment is required for colorectal liver metastases, including local and systemic treatment. Systemic treatment is mainly chemotherapy, that is described in detail in other chapters of this book. Local treatment includes surgical resection, ablation, and hepatic artery infusion therapy. Surgical resection is the established curative local therapy; however, only 10–20% of patients with colorectal liver metastases have resectable tumors at the time of diagnosis. Resection cannot be performed even in patients with liver only metastases because of various reasons including multiple bilobar tumors, invasion or close proximity to major blood vessels or bile ducts, limited liver function, or high surgical risk due to comorbidity. Ablation therapy was introduced initially in the hope of achieving local control of unresectable liver tumors; however, more lately it has been used for curative intent. Chemical ablation such as ethanol injection is effective for hepatomas, but not for metastatic tumors. Cryoablation was extensively investigated in 1980s to early 1990s. Although less invasive than resection and applicable for unresectable metastases, cryoablation is associated with various complications and usually requires laparotomy. Thermal ablation is a newer modality, which can be achieved by various methods: microwave, laser, and high-intensity ultrasound are under investigation, but sufficient clinical data are not available. On the other hand, radiofrequency ablation (RFA) has been increasingly used during the last decade, and has almost replaced cryoablation.