tbuckley/cabot-search huggingface dataset:
Detection of Dysplasia or Cancer in 3.5% of Patients With Inflammatory Bowel Disease and Colonic Strictures
Authors: Mathurin Fumery, Guillaume Pineton de Chambrun, Carmen Stefanescu, Anthony Buisson, Aude Bressenot, Laurent Beaugerie, Aurelien Amiot, Romain Altwegg, Guillaume Savoye, Vered Abitbol, Guillaume Bouguen, Marion Simon, Jean-Pierre Duffas, Xavier Hébuterne, Stéphane Nancey, Xavier Roblin, Emmanuelle Leteurtre, Gilles Bommelaer, Jeremie H. Lefevre, Francesco Brunetti, Françoise Guillon, Yoram Bouhnik, Laurent Peyrin-Biroulet
Journal: Clinical Gastroenterology and Hepatology (2015)
Mortality and Ratio of Blood Products Used in Patients With Severe Trauma
Authors: Michael T. McCurdy, Alyson Liew-Spilger, Mark Walsh
Journal: JAMA (2015)

To the Editor The PROPPR trial1 confirmed the safety of a 1:1:1 ratio for units of plasma and platelets to RBCs for patients with severe trauma requiring massive transfusion compared with a 1:1:2 ratio. We have 3 questions about the study.
Phase II investigational window using carboplatin, iproplatin, ifosfamide, and epirubicin in children with untreated disseminated neuroblastoma: a Pediatric Oncology Group study.
Authors: R P Castleberry, A B Cantor, A A Green, V Joshi, R L Berkow, G R Buchanan, B Leventhal, D H Mahoney, E I Smith, F A Hayes
Journal: Journal of Clinical Oncology (1994)

PURPOSE Children less than 1 year of age with metastatic neuroblastoma NB are at high risk of death. The need to identify new and effective chemotherapy agents is clear. A study was conducted by the Pediatric Oncology Group (POG) to determine the efficacy and safety of administering two courses of a single phase II agent before conventional treatment as a means to evaluate new agents in this setting. PATIENTS AND METHODS One hundred seventy-three eligible patients more than 1 year of age with disseminated neuroblastoma received two courses of one of the following: ifosfamide (IFOS) 2 g/m2/d for 4 days intravenously (IV) plus mesna; carboplatin (CARB) 560 mg/m2 i.v. over 1 hour; iproplatin (CHIP) 325 mg/m2 IV over 2 hours; or epirubicin (EPIR) 90 mg/m2 i.v. push. Following evaluation for response and toxicity, eligible patients were randomized to receive either cisplatin 90 mg/m2 i.v. on day 1, etoposide 200 mg/m2 i.v. on day 3, cyclophosphamide 150 mg/m2/d orally on days 7 to 13, doxorubicin 35 mg/m2 i.v. on day 14 (CECA), or cisplatin 40 mg/m2 IV on days 1 to 5 and etoposide 200 mg/m2 i.v. on days 2 to 4 alternating at 3-week intervals with cyclophosphamide 150 mg/m2/d orally on days 1 to 7 and doxorubicin 35 mg/m2 IV on day 8 (HDP/VP/CA). An additional 86 patients were randomized to receive either CECA or HDP/VP/CA without initial phase II therapy. RESULTS After phase II therapy, only 20% of patients experienced grade 3/4 hematopoietic toxicity. No toxic deaths occurred. Objective response rates (partial responses [PRs] plus minor responses [MRs]) following IFOS, CARB, CHIP, and EPIR were 70%, 77%, 67%, and 26%, respectively. Following phase III treatment, there was no statistically significant difference in rates of complete response (CR)/PR or progressive disease (PD), or in time to PD of patients who participated in the phase II window versus those who received only CECA or HDP/VP/CA. CONCLUSION IFOS, CARB, and CHIP are efficacious in neuroblastoma, are well tolerated, and should be incorporated into primary treatment regimens. Combination regimens using these agents may be possible, since most repeat courses were given within 2 weeks. Administering phase II therapy to untreated patients with high-risk tumors provides a unique and sensitive method to assess new agents without compromising patient outcome.
Effect of vilanterol trifenatate/fluticasone furoate on parasternal raw EMG in severe COPD: Turns analysis
Authors: Michael Ji, Ron Platt, Jenny Jagers, Malcolm Johnson, Eric Wilde, Paul Easton
Journal: European Respiratory Journal (2014)

Background: Inhaled beta2-agonist and corticosteroid (LABA/ICS), salmeterol-fluticasone propionate (Advair), changes chest wall activity in severe COPD (Chest 2010 137:558-65). To elucidate the inspiratory muscle changes, we examined raw parasternal (PARA) EMG in severe COPD utilizing a frequency domain measure, turns counting analysis, before and after the ultra long acting LABA/ICS vilanterol trifenatate/fluticasone furoate (Relvar, VFF).

Methods: Fine wire EMG was implanted in PARA muscles of subjects (N=5, mean FEV1 0.68) with severe minimally reversible COPD (no change: FRC, IC). At baseline and 2 hrs after 2 puffs of VFF, we measured pulmonary function, airflow and PARA raw EMG (12Khz sampling). We computed breath-by-breath values for breathing pattern, peak PARA Mavg EMG, and raw EMG total turns and mean amplitude per turn per breath.

Results: For all subjects, minute ventilation, rate and mean inspiratory flow decreased significantly after VFF (P<0.01). Peak PARA Mavg EMG decreased significantly (P<0.01). There was a marked reduction in raw PARA EMG total turns per breath (mean 423 to 267) with significant decrease in mean amplitude per turn (mean 5.2 to 2.5) (P<0.01).

Summary: Vilanterol trifenatate/fluticasone furoate (Relvar) induces significant changes in raw parasternal muscle EMG activity in severe COPD - a fundamental alteration in the population of motor units within this inspiratory muscle.

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Abstract 178: Long-Term Benefit of Using Dual Dispatch in Out-of-Hospital Cardiac Arrest: The Salsa (Saving Lives in Stockholm Area) Trial
Authors: Per Nordberg, Jacob Hollenberg, Tobias Dahlkvist, Hans Pettersson, Mattias Ringh, Emelie Dillenbeck, Mårten Rosenqvist, Leif Svensson
Journal: Circulation (2011)

Introduction: Out-of-hospital cardiac arrest (OHCA) afflicts around 275,000 victims per year across Europe and is accountable for more than 60% of deaths from coronary heart disease. In 2005, a dual dispatch system in OHCA was implemented in Stockholm, Sweden, using CPR-trained fire fighters with automatic external defibrillators as first responders in addition to the emergency medical services (EMS). The pilot study from 2006 showed promising results on improving time intervals and survival rates. Hypothesis: We assessed the hypothesis that reduced pre-hospital response times to shorten the time to CPR and defibrillation and to optimize the quality of CPR would improve survival rates in OHCA. Methods Included in the trial were witnessed out-of-hospital cardiac arrest patients, where resuscitation attempts was initiated, irrespective of first rhythm, from the years 2004 (historical controls) and 2007-2009 (intervention period). In 2007-2009 fire-fighters were dispatched in suspected OHCA in parallel with the EMS. Results and Conclusions In total, 2060 patients were included, 427 controls and 1633 in the intervention group. During the intervention period 2007-2009, fire fighters were first on scene in 39% of cases with dual dispatch. The median time from call to arrival of first responder shortened from 7.5 minutes during the control period to 6.8 minutes among dual dispatch cases in the intervention group. The proportion of patients admitted alive to hospital increased from 27.4% among controls to 33.5% in the intervention group (OR 1.3, p=0.02). The proportion of patients alive after 1 month increased from 5.9% to 12.3 % (OR 2.3, p&lt;0.001). In conclusion, the implementation of a dual dispatch system using fire-fighters as first responders have shortened response times and significantly increased the survival to 1 month, irrespective of the first rhythm in witnessed OHCA. The increase in survival is mainly believed to be associated with improved CPR and shortened time intervals.
Relapse in schizophrenia
Authors: Marvin I. Herz, Charles Melville
Journal: American Journal of Psychiatry (1980)

Although schizophrenia is a chronic illness with exacerbations and remissions, there has been surprisingly little systematic study of early signs of relapse. The authors gave 145 chronic schizophrenic patients and 80 family members a structured interview regarding early signs of relapse and other information related to the relapse period. Most patients and family informants were aware of a prodromal period during which patients experienced such symptoms as having trouble sleeping, having trouble concentrating, loss of appetite, and feeling depressed. The authors discuss the implications of these findings for the treatment of chronic schizophrenic patients.
Choice of adjuvant and first-line metastatic chemotherapy (CT) for colorectal cancer (CRC) treated in the Carolinas
Authors: K. Rowe, M. Patwardhan, J. E. Herndon, M. G. Martin, Y. Zafar, M. Morse, A. P. Abernethy
Journal: Journal of Clinical Oncology (2007)

17039 Background: CT choice is influenced by many factors including published evidence, guidelines, cost, reimbursement, patient considerations, key opinion leaders, and anecdote. Substantial locoregional variation in practice patterns can exist, and therefore studies of locoregional practice provide important information on local drivers of care. Methods: Using a population-based strategy, we identified CRC patients who developed metastatic disease since 6/1/03 from 9 Duke Oncology Network community practices and 1 academic practice in North and South Carolina. Demographic, comorbidity, diagnostic, stage, initial treatment, and metastatic treatment data were abstracted by retrospective chart review, double-entered and verified for accuracy. Results: Of the first 743 charts screened, 306 were eligible (mean age 61 (SD 13), 49% male; 65% white; 22% black; 77% colon cancer and 19% rectal; stages II 8%, III 16%, IV 64%). 26 earlier stage rectal cancer patients received neoadjuvant treatment, 50% infusional fluorouracil (5FU) and 42% capecitabine (Cap). 46 colon cancer patients received adjuvant CT, including 5FU/leucovorin (LVN; 54%), 5FU/LVN/oxaliplatin (21%), Cap (9%), and 5FU/LVN/irinotecan (7%). First-line CT for metastatic colon cancer (n=149) included FOLFOX+-bevacizumab (Bev; 42%), Cap/oxaliplatin +- Bev (23%), 5FU/LVN + Bev (9%), FOLFIRI +- Bev (7%), IFL +- Bev (7%), clinical trial (7%), Cap (3%), and unknown (1%). 54% of patients received Bev overall, reflecting 49% usage before 6/05 and 69% after 6/05. CT was not offered for 25 (8%) at initial diagnosis. Conclusion: Locoregional practice patterns in the Carolinas suggest that for adjuvant treatment of CRC, oxaliplatin has been used in 21% of adjuvant and 75% of first-line metastatic colon CT regimens, and that bevacizumab use has increased to 69% of first-line metastatic CRC patients. No significant financial relationships to disclose.
Upper pole kidney tumors: Open or laparoscopic partial nephrectomy?
Authors: Ramkishen Narayanan, Rebecca Leigh O'Malley, Diana Mehedint, Thomas Schwaab
Journal: Journal of Clinical Oncology (2012)

429 Background: Partial nephrectomy in upper pole kidney tumors represents a distinct surgical challenge. Data on minimally invasive nephron sparing surgery in this context are scarce. We set out to investigate the role of laparoscopic and open approaches to partial nephrectomy in these tumors. Methods: The Roswell Park Cancer Institute prospective, IRB-approved kidney surgery database was reviewed containing 690 patients. Only patients completing a radical or partial nephrectomy for unilateral, localized, non-metastatic tumors &lt; 7cm were included. The resulting cohort contained 400 patients. Average patient age at surgery was 59.9 ± 13.2 years (range: 22-88). Tumor stages included benign (13.5%), T1a (53.0%), T1b (25.0%), T2 (1.5%), T3a (7.0%). Upper pole tumors (n=128; 27%) and lower pole/ mid-pole tumors (n=270; 67.5%) were recorded. Intraoperative complications were recorded; postoperative complications were tabulated as low or high grade per Clavien-Dindo classification. SPSS (version 19.0) software was used to analyze the dataset. Results: Total intraoperative complication rate was 11.3% (45/400 cases). After stratification by tumor location and partial vs. radical nephrectomy, intraoperative complication rates were higher for laparoscopic/robotic partial nephrectomies involving upper pole tumors (72.7% of all intraoperative complications) compared to lower pole tumors (27.3%, p=0.04), in Chi-Square test. In the delayed postoperative period, total low-grade Clavien complication rate was 97.8% (391/400 cases); high-grade complication rate was 2.3% (9/400). After controlling for tumor location and nephrectomy extent, the high-grade delayed complications were present only in the open nephrectomies involving upper-pole tumors. However, laparoscopic/robotic partial nephrectomies involving upper-pole tumors had significantly more delayed low-grade complications (92.4% of all delayed complications) compared to lower-pole tumors (7.6%, p&lt;0.01), in Chi-Square. Conclusions: Upper pole kidney tumors represent a challenging surgical situation. We here demonstrate that minimally invasive partial nephrectomy in this context requires significant surgical expertise and an open approach could be considered.
Randomized trial of cyclophosphamide, methotrexate, and fluorouracil chemotherapy added to tamoxifen as adjuvant therapy in postmenopausal women with node-positive estrogen and/or progesterone receptor-positive breast cancer: a report of the National Cancer Institute of Canada Clinical Trials Group. Breast Cancer Site Group.
Authors: K I Pritchard, A H Paterson, S Fine, N A Paul, B Zee, L E Shepherd, H Abu-Zahra, J Ragaz, M Knowling, M N Levine, S Verma, D Perrault, P L Walde, V H Bramwell, M Poljicak, N Boyd, D Warr, B D Norris, D Bowman, G R Armitage, H Weizel, R A Buckman
Journal: Journal of Clinical Oncology (1997)

PURPOSE AND METHODS By the mid 1980s, tamoxifen alone was considered standard adjuvant therapy for postmenopausal women with node-positive, estrogen receptor (ER)- or progesterone receptor (PgR)-positive breast cancer. From 1984 through 1990, 705 eligible postmenopausal women with node-positive, ER- or PgR-positive breast cancer were randomized to a National Cancer Institute of Canada Clinical Trials Group (NCIC CTG) study that compared tamoxifen 30 mg by mouth daily for 2 years (TAM) versus TAM plus chemotherapy with all-intravenous cyclophosphamide 600 mg/m2, methotrexate 40 mg/m2, and fluorouracil 600 mg/m2 given every 21 days for eight cycles (CMF). RESULTS There were no significant differences in overall survival, recurrence-free survival, locoregional recurrence-free survival, or distant recurrence-free survival between the two treatment arms. However, there was significantly greater severe toxicity, which included leukopenia (P &lt; .0001), nausea and vomiting (P &lt; .0001), and thromboembolic events (P &lt; .0001), as well as significantly more mild or greater toxicity, which included thrombocytopenia (P = .04), anemia (P = .02), infection (P = .0004), mucositis (P = .0001), diarrhea (P = .0001), and neurologic toxicity (P = .006), in women who received TAM plus CMF. CONCLUSION The addition of CMF to TAM adds no benefit and considerable toxicity in this group of women.
Abstract 3282: Optimizing Cardiac Resynchronization Therapy Using Acoustic Cardiography and AV/VV Delay Maps
Authors: Stefan Toggweiler, Michel Zuber, Richard Kobza, Markus Roos, Peiman Jamshidi, Patricia Arand, Paul Erne
Journal: Circulation (2007)

Introduction: In cardiac resynchronization therapy (CRT), AV and VV delays are frequently optimized using echocardiography. For efficiency, the optimal AV and VV delays are usually determined seria...
Subgroup analysis of a phase III trial of doxorubicin vs doxorubicin plus tesmilifene in advanced breast cancer (ABC): Tesmilifene survival benefit focused on patients with more aggressive disease
Authors: M. D. Vincent, P. Keane, H. Chen, K. Pritchard
Journal: Journal of Clinical Oncology (2005)

756 Background: Tesmilifene (DPPE), a novel chemopotentiating small molecule, conferred a substantial (50%+) increase in median survival in MA.19, a 305 patient randomized trial in ABC (doxorubicin alone, 15.6 m; doxorubicin + DPPE, 23.6 m; p<0.03; J Clin Oncol 22: 269–276, 2004). Response rates and median progression free survival (PFS) were not different, however. Methods: YM Biosciences conducted an unplanned subgroup analysis of the MA.19 database to determine whether some subsets of patients might benefit differentially from the addition of DPPE. Results: Tally of post-trial treatments revealed minimal differences in exposure to a range of chemotherapy (CT) including taxanes; therefore, post-trial treatments do not explain the large survival (OS) difference. The only important prognostic factor maldistribution was the disease free interval (DFI) from original diagnosis to entry on trial, median 20 m (doxorubicin) vs 26 m (doxorubicin + DPPE). Although independently prognostic this DFI difference could not account for the OS difference (Cox proportional hazards, J Clin Oncol, ibid). By tertiles, only patients with a DFI >36 m were maldistributed and this subgroup actually demonstrated no survival benefit. A very large survival benefit (MST doxorubicin 12.2 m; doxorubicin + DPPE 29.7 m, p=0.0016) was evident in the two thirds of patients with DFI ≤36 m. Furthermore, a large, highly significant, OS benefit was seen in ER negative (p=0.003) but not ER positive patients, and in the ±80% of chemotherapy responders (CR, PR) and stabilizers (SD) (p<0.007) but not in chemorefractory (PD) patients; additionally, these CR/PR/SD patients exhibited a significant improvement in time to disease progression (p= 0.0204). Conclusions: These subset analyses, although unplanned, raise interesting hypotheses including the suggestions that a differential effect on a minority population of mdr+ cells explains the late (survival) benefit in the absence of an early (response, PFS) benefit for DPPE. This hypothesis is being further explored in a currently ongoing trial of EC vs EC plus DPPE in ABC patients with early recurring disease. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration YM Biosciences Pfizer, YM Biosciences YM Biosciences YM Biosciences YM Biosciences
Does tobacco use cause psychosis? Systematic review and meta-analysis
Authors: Pedro Gurillo, Sameer Jauhar, Robin M Murray, James H MacCabe
Journal: The Lancet Psychiatry (2015)

Although the association between psychotic illness and cigarette smoking is well known, the reasons are unclear why people with psychosis are more likely to smoke than are the general population. We aimed to test several hypotheses. First, that daily tobacco use is associated with an increased risk of psychotic illness in both case-control and prospective studies. Second, that smoking is associated with an earlier age at onset of psychotic illness. Finally, that an earlier age at initiation of smoking is associated with an increased risk of psychosis. We also aimed to derive an estimate of the prevalence of smoking in patients presenting with their first episode of psychosis.
Clinical characteristics and treatment outcome of childhood acute lymphoblastic leukemia with the t(4;11)(q21;q23): a collaborative study of 40 cases [see comments]
Authors: CH Pui, LS Frankel, AJ Carroll, SC Raimondi, JJ Shuster, DR Head, WM Crist, VJ Land, DJ Pullen, CP Steuber
Journal: Blood (1991)
Margaret McCartney: Second use patents--why do we have to prescribe branded Lyrica for pain?
Authors: M. McCartney
Journal: BMJ (2015)

You say Lyrica; I say pregabalin. Branded Lyrica is licensed for pain, anxiety, and epilepsy; generic pregabalin is cheaper. But Pfizer has a second use patent on Lyrica for pain (granted 2003-17), which trumps generic use in this condition. So pregabalin can be prescribed generically for epilepsy and anxiety, but for pain, the only licence is prescription as Lyrica.

Pfizer wrote to pharmacists this year to tell them that generic prescribing of pregabalin for pain would be “unlawful” and would be contrary to government policy “of rewarding additional research by the granting of a second use patent.”1 NHS England then told all GPs to prescribe the branded drug for pain.2 Pfizer said that it does “not wish” to take legal action3—but prescribing data may identify individual doctors. Should pharmacists check the drug’s …
D-dimer testing and pre-test probability scoring in the diagnosis of venous thromboembolism
Authors: Pooja Arora, Asad Ali, Shiva Bikmalla, Vikas Punamiya, Gareth Ebbon, Rahul Mukherjee
Journal: European Respiratory Journal (2011)

Introduction:  With easy availability of bedside markers of venous thromboembolism (VTE) like D-dimer, widespread use of these tests often without pre-test probability scoring (PTPS) has become common practice in the diagnostic pathway of VTE.   Aims:  We set out to assess how effective D-dimer testing is in predicting the likelihood of VTE and whether PTPS adds any further value to D-dimer testing.   Method:  Consecutive patients with suspected VTE were included for a 3 week period - 90 records were analysed where a D-dimer test (Roche Test kit) was performed as part of the diagnostic pathway in the admissions unit of a teaching hospital providing acute medical services to a population of 450000.   Results:  Out of the 90 patients: 40 D-dimer tests were positive, 50 negative; 14 with positive tests had radiological confirmation of VTE (CT Pulmonary Angiogram, Ventilation-Perfusion scan or Doppler Ultrasound Scan of the legs), 8 with negative tests still went to have radiological imaging because of high clinical suspicion but all were negative. Thus sensitivity was 100%, specificity 65.79%. Only 31 patients had PTPS; 18 had high or intermediate PTPS with positive D-dimer but only 8 had VTE (44.4%); 1 with low PTPS and positive D-dimer had VTE; 5 with high or intermediate PTPS but negative D-dimer had no VTE. The remaining had low PTPS with no VTE.   Conclusions:  D-dimer is a very sensitive and reasonably specific tool to aid VTE diagnosis in appropriate clinical presentation, PTPS further aids to rule out the possibility of VTE with a negative D-dimer but does not seem to add any further value in patients with a positive D-dimer, hence PTPS should be included in the interest of patient safety.
Abstract 13525: Acute Surgical Conversion during Transcatheter Aortic Valve Implantation (TAVI) - A Weighted Meta-Analysis of 9,251 Patients from 46 Studies
Authors: Holger Eggebrecht, Axel Schmermund, Thomas Voigtlander, Rajendra H Mehta
Journal: Circulation (2012)

Background. Transcatheter aortic valve implantation (TAVI) is a novel treatment option for high surgical risk patients (pts) with severe symptomatic aortic valve (AV) stenosis. During TAVI, some pt...