tbuckley/cabot-search huggingface dataset:
Efficacy of nilutamide as secondary hormonal therapy in androgen-independent prostate cancer (AIPC)
Authors: M. Nakabayashi, M. M. Regan, D. Lifsey, C. P. Evan, P. W. Kantoff, M. E. Taplin, O. Sartor, W. K. Oh
Journal: Journal of Clinical Oncology (2005)

4683 Background: Treatment options are limited for patients with androgen independent prostate cancer (AIPC). Secondary hormonal therapy with antiandrogens has advantages, including low toxicity, oral administration and high patient acceptance. We have evaluated the activity of nilutamide as secondary hormonal therapy in patients with AIPC. Methods: Retrospective study was focused on 45 patients with AIPC who were treated with nilutamide as secondary hormonal therapy in two institutions. All patients had a detectable prostate-specific antigen (PSA) at initiation of nilutamide therapy, but were not required to have radiographic evidence of disease. Any number of prior secondary hormonal therapies and prior history of chemotherapy were allowed. The primary endpoint was to determine the % of evaluable patients who had a ≥ 50% decline in PSA. Adverse effects of treatment, and the relationship between baseline patient characteristics, type and duration of previous therapy and response to nilutamide were also assessed. The majority of patients received nilutamide at a dose of 150 mg/day orally. Results: Median patient age at diagnosis was 64 (range 43–88), and median PSA was 17.0 ng/ml (range 2.5–2356). Thirty of 45 evaluable patients (66.6%; 95% CI 51.1–80.0%) experienced PSA decline of any degree after starting nilutamide therapy, and 18 (40%; 95% CI 25.7–55.7%) had a PSA decline ≥ 50% (Responders). Responders had a median time to progression of 4.4 months (range 0.31+-44.7+). Nilutamide responses were seen whether used as 2nd to 5th line hormonal therapy. No differences in response to nilutamide were observed based on clinical stage, type of local therapy, PSA at diagnosis or initiation of nilutamide, or type of prior antiandrogen therapy. Responders were more likely to have received monotherapy with luteinizing hormone releasing hormone agonist or orchiectomy as first line hormonal treatment than non-responders (p=0.02). The most common reversible adverse effects were mild to moderate visual adaptation alterations (20%). Conclusions: Nilutamide appears to be an effective secondary hormonal therapy in patients with AIPC with a mild toxicity profile. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Aventis
Abstract 11547: Five- Year Outcomes after Sirolimus-Eluting Stent Implantation for Unprotected Left Main Coronary Artery Disease: Insight From the j-Cypher Registry
Authors: Mamoru Toyofuku, Takeshi Kimura, Takeshi Morimoto, Hiromichi Tamekiyo, Masaya Otsuka, Tomokazu Okimoto, Nobuo Shiode, Yasuhiko Hayashi, Kazuaki Mitsudo
Journal: Circulation (2011)

Background This study assessed 5-year outcomes after the treatment with sirolimus-eluting stent (SES) for unprotected left main coronary artery (ULMCA). Methods and Results j-Cypher is a multicente...
New-entrant screening for tuberculosis at port of entry in the U.K.: Is it time to change policy?
Authors: Vikas Punamiya, Heinke Kunst, Martin Dedicoat, Joy Troko
Journal: European Respiratory Journal (2012)

Background:  It is shown that 20% of tuberculosis (TB) cases are diagnosed in persons entering UK within 2 years & in 45% within 5 years of arrival. Therefore the first 2-5 years of arrival in UK presents a period of high risk of reactivation of new-entrants with LTBI. This clearly indicates the importance of early screening & reducing the risk of active TB by giving chemoprophylaxis to patients with LTBI.  UK policy at the moment advocates identification of active TB by chest x-ray for all new arrivals intending to stay for > 6 months from countries with a TB incidence 40 /100,000; however, screening is very arbitrary & not standardised. The results are forwarded to local NHS TB services where new entrants intend to settle for complete screening.   Methods:  A retrospective review was conducted of all new-entrants who were referred to our institution during a 2 year period, from January 2010, with supposedly an abnormal chest x-ray at port of entry. All new-entrants were screened for active & latent TB by TST or IGRA   Results:  103 patients, 51 females & 52 males were referred, however only 42 patients (40.77%) (26 females & 14 males) attended the TB clinic,of which 31(73.8%) were    Conclusion:  Screening new-entrants at port of entry is inadequate. New-entrants often do not attend clinic appointments since they have moved elsewhere or do not understand the necessity of being screened for latent or active TB.
Combination treatment by 10 600 nm ablative fractional carbon dioxide laser and narrowband ultraviolet B in refractory nonsegmental vitiligo: a prospective, randomized half-body comparative study
Authors: J. Shin, J.S. Lee, S-K. Hann, S.H. Oh
Journal: British Journal of Dermatology (2011)

Vitiligo is a common acquired depigmentation disorder caused by the loss of melanocytes. Despite the numerous treatment modalities available for vitiligo, responses to treatment are still unsatisfactory. For this reason, new treatment modalities and approaches are needed.To investigate the effects of fractional carbon dioxide (CO(2) ) laser therapy followed by systemic narrowband ultraviolet B (NB-UVB) phototherapy on nonsegmental vitiligo (NSV) as a prospective and randomized left-right comparative study.Ten patients with NSV who presented symmetrical vitiligo lesions with no further improvement despite more than 1 year of conventional treatment were enrolled. Two sessions of half-body fractional CO(2) laser therapy were performed at a 2-month interval. NB-UVB phototherapy was then administered to the entire body 5 days after each fractional laser treatment twice a week, increasing the dose incrementally by 15% at each session. Objective clinical assessments were made by two blinded dermatologists using a quartile grading scale, and the patients' overall satisfaction was evaluated using a 10-point visual analogue scale.Two months after the last treatment, mean improvement scores, assessed by physicians, were significantly higher for those treated with half-body fractional CO(2) laser therapy followed by NB-UVB phototherapy, compared with those treated with NB-UVB alone (P=0·034). In addition, according to subjective assessment, the half-body laser treatment followed by NB-UVB showed significantly higher improvements compared with NB-UVB treatment alone (P=0·023). Noticeable adverse events, such as infection, scarring and Koebner phenomenon, were not found in any patient.This study suggests that fractional CO(2) laser therapy followed by NB-UVB phototherapy could be used effectively and safely as an alternative modality for the treatment of refractory vitiligo.
Tamoxifen Should be Cost-Effective in Reducing Breast Cancer Risk in High-Risk Women
Authors: Thomas J. Smith, Bruce E. Hillner
Journal: Journal of Clinical Oncology (2000)

To estimate the cost-effectiveness of tamoxifen in the prevention of breast cancer.Clinical trial results of National Surgical Adjuvant Breast Program P-1 compared tamoxifen versus placebo in the prevention of breast cancer, and direct medical care costs were estimated from the Agency for Health Care Policy and Research and local sources. The base estimate of effectiveness included all women on the trial.For every 100 women treated for 5 years, 1.665 expected cancers would not be detected. If breast cancer death is fully prevented by this strategy, then the cost-effectiveness of tamoxifen compared with no intervention is $8,479 per additional year of life gained. If lifetime prevention of the risk of death from breast cancer exceeded 17%, then the cost-effectiveness ratio would be less than $50,000 per year of life gained (a common benchmark).Tamoxifen for breast cancer prevention should be cost-effective under nearly all circumstances. Its use will require additional resources because it is not cost saving, but it fits within accepted guidelines.
High-density preculture of PBMCs restores defective sensitivity of circulating CD8 T cells to virus- and tumor-derived antigens
Authors: Julia Wegner, Stephan Hackenberg, Claus-Jürgen Scholz, Sergey Chuvpilo, Dmitry Tyrsin, Alexey A. Matskevich, Götz Ulrich Grigoleit, Stefan Stevanović, Thomas Hünig
Journal: Blood (2015)
Andrew Michael Peter Hamilton
Authors: R. D. Hamilton
Journal: BMJ (2015)

Andrew Michael Peter Hamilton, known to friends and family as Peter, was born in London, son of William Hamilton, professor of anatomy and embryology at Charing Cross Hospital, whose books were used by a generation of medical students. As consultant at Moorfields Eye Hospital and associate lecturer at the Institute of Ophthalmology, London, Peter pioneered the treatment for diabetic retinopathy and maculopathy and became a world leader in laser therapy for retinal diseases.

Peter was a giant in the area of retinal vascular disease at a time when two major advances occurred. He was a leading light in the fields of both fluorescein angiography and lasers. His major contributions happened at a time when there was much more flexibility in the introduction of new devices and techniques. His was the approach of the true pioneer: “In the absence of a database, let’s try this, and if that doesn’t work, let’s do it in a different way.” Peter would have found the framework of today’s rigid clinical trials an almost impossible barrier to …
Transurethral Radiofrequency Heating or Thermotherapy for Benign Prostatic Hypertrophy: A Prospective Trial on 65 Consecutive Cases
Authors: Aswin H.P. Meier, Ernest H.J. Weil, Ernst S.C. van Waalwijk van Doom, Gerard T.C.M. Verhaegh, Ruud A. Janknegt
Journal: European Urology (1992)
Clinical manifestations of primary ciliary dyskinesia: A review of the literature
Authors: Myrofora Goutaki, Elisabeth Maurer, Philipp Latzin, Carmen Casaulta, Claudia Kuehni
Journal: European Respiratory Journal (2013)

Aim   Data on clinical manifestations of Primary Ciliary Dyskinesia (PCD) are scarce. We aimed to review all publications that describe prevalence and severity of PCD related morbidity and to show changes in morbidity with age.   Methods   We searched PubMed to identify studies published since 1990, describing prevalence and severity of signs and symptoms in PCD patients. We identified 488 original papers. We excluded studies presenting only data on diagnostic evaluations or imaging, studies with    Results   12 studies met our inclusion criteria. Together, they described 440 patients (mean per study 37, range 17-58). 7 came from pulmonary departments, mostly pediatric, 5 from ENT clinics. 4 included children, 5 children and young adults and 3 individuals of all ages. Only 1 study presented results stratified by age, allowing to investigate age-related changes. Clinical manifestations commonly described were: rhinitis, cough, otitis media, sinusitis, pulmonary infections and neonatal respiratory distress; none was assessed in all studies. There was a great heterogeneity in type of data (patient reported vs. chart reviews). Symptom prevalence varied between studies, many of which included highly selected populations (e.g. prevalence of sinusitis: 23-54% in pulmonary units, 59-100% in ENT clinics). Few studies described manifestations affecting other than the respiratory system (e.g. infertility).   Conclusion   This review underlines the necessity to study PCD in large unselected groups of patients, to allow to describe the natural history of the disease.   Funding   FP7 grant 305404, SNF 32003B-144068,Lungenliga Bern.
Standardization and quality assurance for antimicrobial resistance surveillance of Streptococcus pneumoniae and Staphylococcus aureus within the European Antimicrobial Resistance Surveillance System (EARSS)†
Authors: W. Goettsch, S.L.A.M. Bronzwaer, A.J. de Neelin, M.C.J. Wale, H. Aubry-Damon, B. Olsson-Liljequist, M.J.W. Sprenger, J.E. Degener
Journal: Clinical Microbiology and Infection (2000)
Adjuvant active specific immunotherapy for human colorectal cancer: 6.5-year median follow-up of a phase III prospectively randomized trial.
Authors: H C Hoover, J S Brandhorst, L C Peters, M G Surdyke, Y Takeshita, J Madariaga, L R Muenz, M G Hanna
Journal: Journal of Clinical Oncology (1993)

Patients with colon or rectal cancer were entered onto a prospectively randomized, controlled clinical trial of active specific immunotherapy (ASI) with an autologous tumor cell-bacillus Calmette-Guérin (BCG) vaccine. We investigated whether ASI could improve disease-free status and survival.Ninety-eight patients with Dukes' stage B2-C3 colon or rectal cancer were randomized into groups treated by resection alone or resection plus ASI. Eighty patients met all eligibility criteria. All patients with rectal cancer were to receive 50 Gy of pelvic irradiation. Analysis of distribution of survival and disease-free survival was made on all eligible patients until December 31, 1990.As a single study, no statistically significant differences were detected in survival or disease-free survival for all 80 eligible patients. However, since it was recognized at the outset that there were treatment differences, in that rectal cancer patients were to receive postimmunotherapy radiation, it was considered that a cohort analysis of the colon and rectal cancer patients might be informative. With a median follow-up of 93 months, there is a significant improvement in survival (two-sided P = .02; hazards ratio, 3.97) and disease-free survival (two-sided P = .039; hazards ratio, 2.67) in all eligible colon cancer patients who received ASI. With a median follow-up of 58 months, no benefits were seen in patients with rectal cancer who received ASI.This study suggests that ASI may be beneficial to patients with colon cancer.
Editorial contained specious arguments
Authors: T. F G Esmonde
Journal: BMJ (1996)

EDITOR,—I find it reprehensible that the editor of the BMJ has decided to support the lobby for the legalisation of drugs.1 His specious arguments will be interpreted as the view of the medical profession as a whole precisely because they have come from the editor of the journal.

Prohibition is not “working,” but it was never meant to be the measure that would solve society's dependence on drugs, only a way of making it more difficult to become dependent. The trouble with …
Enriching Careers in General Practice New roles for general practitioners
Authors: S Handysides
Journal: BMJ (1994)

General practice is likely to change greatly over the next few years. Increases in care in the community and day surgery will lead to more work, and the demand for better data on practice activity will mean the development of audit and epidemiological work. To make time general practitioners will have to learn to delegate work that does not require a doctor. Fundholding has already stimulated some practices to bring services to patients rather than send patients to hospital, and this trend seems set to continue. It is important to pool resources, not only within practices but among other practices in the area--joint action will increase the ability to improve the services for patients. If general practitioners take the opportunity to gain control of the changes the morale of the profession should improve.
Public must be made aware of need for research in children, report says
Authors: E. Parish
Journal: BMJ (2015)

A new report by the UK Nuffield Council on Bioethics calls for researchers to be trustworthy and open and to have courage when designing and conducting clinical research involving children and teenagers.1

The report, by a working group set up in 2013 and chaired by Bobbie Farsides, professor of clinical and biomedical ethics at Brighton and Sussex Medical School, outlines the main ethical challenges in conducting research with children and gives key recommendations to improve the involvement of young people, with the aim of broadening the evidence base for care in this age group.

After a two year review that engaged with over 500 stakeholders in the United Kingdom and internationally, the working party made recommendations for individual researchers and the main organisations that govern research or advocate for children’s health needs. The recommendations include balancing child and parental …
A Simple Stratification Factor Prognostic for Survival in Advanced Cancer: The Good/Bad/Uncertain Index
Authors: Jeff A. Sloan, Charles L. Loprinzi, John A. Laurine, Paul J. Novotny, Delfino Vargas-Chanes, James E. Krook, Michael J. O’Connell, John W. Kugler, Maria Tria Tirona, Carl G. Kardinal, Martin Wiesenfeld, Loren K. Tschetter, Alan K. Hatfield, Paul L. Schaefer
Journal: Journal of Clinical Oncology (2001)

This article summarizes the third step of a research program to identify variables that supplement the predictive power of the the Eastern Cooperative Oncology Group (ECOG) performance status (PS) for survival. The objective was to produce a simple, practical, stratification factor for phase III oncology clinical trials involving patients with advanced malignant disease.A questionnaire was administered to 729 patients with metastatic colorectal or lung cancers. Patients provided a Karnofsky index and appetite rating while physicians provided a survival estimate and the ECOG-PS. Scores for each item were categorized as having a positive, neutral, or negative indication for survival. A patient was classified as having a relatively good prognosis if three or more of the four items showed a positive indication, a bad prognosis if three or more items were negative, and an uncertain prognosis otherwise (Good/Bad/Uncertain [GBU] index).The GBU index improved on the prognostic power of a Cox model quartile index and PS alone and increased the accuracy of survival classification estimates by 5% to 10% more than ECOG-PS alone. For patients with PS of 0 or 1, significant survival patterns exist between GBU groups (P=.002 and.0001, respectively).The GBU index may be recommended as a supplementary stratification factor for certain future phase III trials in metastatic lung or colorectal cancer where patient heterogeneity is a particular concern. The GBU represents a relatively modest increase to the cost and patient burden of a clinical trial given the additional control that is achieved over the potentially confounding concomitant to the treatment variable.
Ambulatory management of spontaneous pneumothorax with pigtail catheters
Authors: Fanny Voisin, Laurent Sohier, Yann Rochas, Mallorie Kerjouan, Charles Ricordel, Chantal Belleguic, Benoit Desrues, Stéphane Jouneau
Journal: European Respiratory Journal (2013)

Background: There is no consensus in the management of large spontaneous pneumothorax (PTX). Guidelines recommend either manual aspiration or chest tube drainage and most patients are hospitalized. We assessed the efficiency of an ambulatory management of spontaneous PTX with pigtail catheter.  Methods: From February 2007 to January 2011, all spontaneous primary (PSP) and secondary (SSP) large PTXs from Lorient’s hospital (France) were managed (by respiratory physicians) with pigtail catheter and one-way valve. They were discharged immediately and were evaluated every two days according to a specific algorithm.  Findings: Out of the 132 patients (included) (110 PSP, 22 SSP), 103 were exclusively managed as outpatients and cured at day 2 or day 4, which represents an ambulatory success rate of 78%. Mean time of drainage was 3.4±1.8 days. Total success rate was 83%, seven patients were initially hospitalized, discharged and cured at day 2 or 4. Total success rate of PSP and SSP were not different for the first episode: 84% vs 67% (p=0.15); and for the relapse: 89% vs 86% (p=1.00). One year recurrence-rate was 26%. Use of analgesics was low. This management was cost-effective: for 132 large spontaneous PTXs, 445,676 € with chest tube drainage and hospitalization vs 117,510 € with our protocol.  Interpretation: In our opinion, ambulatory management with pigtail catheter associated to one-way valve should be the first-line treatment in all large spontaneous PTX. Compared to literature, it is as efficient as manual exsufflation and as chest tube drainage, painless, without hospitalization and cost effective.
Private companies behave differently from NHS providers
Authors: N. Mann
Journal: BMJ (2015)

Appleby states that “if rates of [average?] growth . . . continue over the next 20 years . . . non-NHS providers could account for one in five of all outpatient attendances.”1 This is a surprising interpretation of the data. If the trend as shown continues, non-NHS providers would account for 20% of the total within five, not 20, …
Abstract 15463: Pioglitazone Enhances Cholesterol Efflux From Macrophages by Increasing ABCA1/ABCG1 Expressions via LXR{alpha}/PPAR{gamma} Pathway: Findings From in vitro and ex vivo Studies
Authors: Hideki Ozasa, Makoto Ayaori, Masatsune Ogura, Shun-ichi Takiguchi, Kazuhiro Nakaya, Yoshio Terao, Harumi Uto-Kondo, Emi Yakushiji, Maki Iizuka, Makoto Sasaki, Tomohiro Komatsu, Katsunori Ikewaki
Journal: Circulation (2010)
Antiangiogenic therapy for granulosa cell tumors of the ovary
Authors: X. Tao, A. K. Sood, M. T. Deavers, K. M. Schmeler, A. M. Nick, R. L. Coleman, D. M. Gershenson, J. Brown
Journal: Journal of Clinical Oncology (2009)

5574 Background: Sex-cord stromal ovarian tumors (SCSTs) tend to respond poorly to chemotherapy agents. Therefore, we examined the clinical efficacy of bevacizumab with or without concurrent chemotherapy and evaluated the angiogenic characteristics of these patients’ tumors. Methods: We conducted an IRB-approved retrospective review of all patients with SCSTs seen at our institution from February 2004 to October 2008. Eligible patients underwent pathologic confirmation and clinical evaluation, and received bevacizumab. VEGF and CD31 immunohistochemical staining (IHC) was performed when tissue was available; microvessel density (MVD) was measured based on CD31 counts. Results: We identified 8 eligible patients treated with bevacizumab. Of these, 7 had adult granulosa cell tumors (GCT) and one had a juvenile GCT. Of the 8 patients, 4 had early stage disease (I or II), 2 had advanced stage disease (III), and 2 were unstaged. All patients were treated for recurrent disease and had been previously treated with cytotoxic chemotherapy, with a median of 3.5 prior regimens (range, 1–6). Of the 8 patients, one patient had a complete clinical response, 2 patients had a partial response, 2 patients had stable disease, and 3 patients progressed, yielding a response rate of 38% and a clinical benefit rate of 63%. The median progression-free survival (PFS) was 7.2 months and the overall survival (OS) was not reached at a median follow-up after starting bevacizumab of 23.6 months. Of the 8 patients, 5 had tissue available for IHC. VEGF expression was noted at some level in all samples; overexpression was present in 1 of the 5 patients (upper tertile of score), and moderate expression was observed in 3 of the 5 patients (middle tertile). VEGF overexpression correlated with shorter PFS (p = 0.006) and shorter overall survival (p = 0.02). High MVD (&gt;12.3 per previous data based on ROC analysis) was present in 3 of the 5 patients, and correlated with VEGF overexpression (p = 0.007) and shorter overall survival (p = 0.004). Conclusions: Anti-VEGF therapy is highly effective in patients with ovarian granulosa cell tumors. On the basis of these observations, a prospective trial has now been initiated using single agent bevacizumab in patients with recurrent disease. No significant financial relationships to disclose.