tbuckley/cabot-search huggingface dataset:
Palliative Care Versus Spiritual Care
Authors: Benjamin W. Corn
Journal: Journal of Clinical Oncology (2015)

TO THE EDITOR: The investigators from ENABLE (Educate, Nurture, Advise, Before Life Ends) III extended the rigorous scientific efforts to proactively implement early palliative care programs. Those of us interested in launching palliative care platforms for patients with cancer and their caregivers would be interested to know if spiritual care played a role in the ENABLE III intervention. Were chaplains or pastoral care providers involved? Did the participants— especially the 20% who were not affiliated with organized religion— consider themselves spiritual? Were there correlations between spirituality and outcomes? Was spiritual well-being measured with any of the available tools, such as FACIT-Sp, the Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being Scale? and, can spiritual care even be conveyed in the context of a telehealth environment? Colleagues who aspire to adopt the sacred work of the ENABLE III researchers would value such information.
Blood flow limitations of solute transport across the visceral peritoneum.
Authors: M Kim, J Lofthouse, M F Flessner
Journal: Journal of the American Society of Nephrology (1997)

In a previous study, no limitations to urea transfer across the parietal peritoneum were demonstrated with decreases in local blood flow of 70%. It was hypothesized that the visceral peritoneum would have similar characteristics. To address this problem at the tissue level, diffusion chambers were affixed to the serosal side of the stomach, cecum, or liver of anesthetized rats (n = 6 each tissue), and solutions containing 14C urea were placed in the chamber. During each experiment, the local chamber blood flow was measured with laser Doppler flowmetry, and, simultaneously, the disappearance of the tracer versus time was determined under three conditions: control, after 60 to 70% blood flow reduction, and postmortem (flow = 0). The results showed no difference in the urea mass transfer coefficient (MTC; mean +/- SEM; cm/min x 10[3]) between control and blood flow reduction for the stomach (4.0 +/- 0.4 versus 3.6 +/- 0.3) or for the cecum (4.6 +/- 0.3 versus 4.0 +/- 0.3). However, the MTC was significantly decreased by local blood flow reduction in the liver (5.4 +/- 0.2 versus 2.6 +/- 0.2). Postmortem data demonstrated significant reductions in the MTC with blood flow equal to zero. It is concluded that a 60 to 70% blood flow reduction from control values does not limit solute transperitoneal transfer in the hollow viscera but causes significant changes in the mass transfer across the liver surface. Because the liver makes up only a small portion of the effective exchange area, overall transperitoneal solute transfer should not be greatly affected by significant decreases in blood flow.
Impact of a Family Information Leaflet on Effectiveness of Information Provided to Family Members of Intensive Care Unit Patients
Authors: ELIE AZOULAY, FRÉDÉRIC POCHARD, SYLVIE CHEVRET, MERCÉ JOURDAIN, CAROLINE BORNSTAIN, ANNE WERNET, ISABELLE CATTANEO, DJILALI ANNANE, FRÉDÉRIC BRUN, PIERRE-EDOUARD BOLLAERT, JEAN-RALPH ZAHAR, DANY GOLDGRAN-TOLEDANO, CHRISTOPHE ADRIE, LUC-MARIE JOLY, JEROME TAYORO, THIBAUT DESMETTRE, ETIENNE PIGNE, ANTOINE PARROT, OLIVIER SANCHEZ, CATHERINE POISSON, JEAN-ROGER LE GALL, BENOÎT SCHLEMMER, FRANÇOIS LEMAIRE
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Comprehension and satisfaction are relevant criteria for evaluating the effectiveness of information provided to family members of intensive care unit (ICU) patients. We performed a prospective randomized trial in 34 French ICUs to compare comprehension of diagnosis, prognosis, treatment, and satisfaction with information provided by ICU caregivers, in ICU patient family representatives who did (n = 87) or did not (n = 88) receive a family information leaflet (FIL) in addition to standard information. An FIL designed specifically for this study was delivered at the first visit of the family representative: it provided general information on the ICU and hospital, the name of the ICU physician caring for the patient, a diagram of a typical ICU room with the names of all the devices, and a glossary of 12 terms commonly used in ICUs. Characteristics of the ICUs, patients, and family representatives were similar in the two groups. The FIL reduced the proportion of family members with poor comprehension from 40.9% to 11.5% (p < 0.0001). In the representatives with good comprehension, the FIL was associated with significantly better satisfaction (21 [18 to 24, quartiles] versus 27 [24 to 29, quartiles], p = 0.01). These results indicate that ICU caregivers should consider using an FIL to improve the effectiveness of the information they impart to families.
Standing for two hours a day may benefit heart health, study finds:
Authors: Anna Sayburn
Journal: BMJ (2015)

Standing rather than sitting for two hours a day may have a positive effect on biochemical risk markers including fasting blood glucose and lipid profile but not on body mass index (BMI), blood pressure, or HbA1c levels, the results of a cross sectional study have shown.1

The study was intended to investigate the potential benefits of swapping sedentary behaviour with standing. The authors said that the benefits of walking were well known but that the effect of standing (for example, at a standing desk) rather than sitting had …
Toward a Better Understanding of the Complexity of Cancer Drug Resistance
Authors: Michael M. Gottesman, Orit Lavi, Matthew D. Hall, Jean-Pierre Gillet
Journal: The Annual Review of Pharmacology and Toxicology (2015)

Resistance to anticancer drugs is a complex process that results from alterations in drug targets; development of alternative pathways for growth activation; changes in cellular pharmacology, including increased drug efflux; regulatory changes that alter differentiation pathways or pathways for response to environmental adversity; and/or changes in the local physiology of the cancer, such as blood supply, tissue hydrodynamics, behavior of neighboring cells, and immune system response. All of these specific mechanisms are facilitated by the intrinsic hallmarks of cancer, such as tumor cell heterogeneity, redundancy of growth-promoting pathways, increased mutation rate and/or epigenetic alterations, and the dynamic variation of tumor behavior in time and space. Understanding the relative contribution of each of these factors is further complicated by the lack of adequate in vitro models that mimic clinical cancers. Several strategies to use current knowledge of drug resistance to improve treatment of cancer are suggested.
Influences on Oncologists’ Adoption of New Agents in Adjuvant Chemotherapy of Breast Cancer
Authors: Gina M. Buban, Brian K. Link, William R. Doucette
Journal: Journal of Clinical Oncology (2001)

Little is known about how oncologists' adopt new treatments for breast cancer. This study investigated influences on oncologists' adoption of paclitaxel as adjuvant chemotherapy for early-stage breast cancer, 9 months after presentation of phase III data suggesting improved disease-free and overall survival when paclitaxel was added to doxorubicin and cyclophosphamide for such patients.Self-reported data were collected with a mail survey of a random sample of 1,200 oncologists practicing in the United States. Using Rogers' model, we measured four types of influences on adoption of innovation: (1) communication channels, (2) innovation characteristics, (3) a practitioner's social system, and (4) physician characteristics. Multiple regression analysis assessed the associations between oncologist adoption of paclitaxel for early-stage breast cancer patients and variables representing the modeled influences on adoption.On average, respondents (n = 181) reported having adopted paclitaxel for 37% of their early-stage breast cancer patients. The overall model was significant, with seven variables associated (P < or = .05) with adoption of paclitaxel. Significant influences on adoption included use of symposia as a therapy information source, physician experience with paclitaxel to treat late-stage breast cancer, and perceived advantage in efficacy of paclitaxel.As new modalities become available to treat cancer, it is vital to understand what factors influence oncologists and patients when choosing to use them. Those parties interested in fostering the adoption of new breast cancer treatments should address features of communication channels (eg, use of symposia), characteristics of new treatments (eg, perceived advantage in efficacy), physicians' social systems (eg, patient requests), and characteristics of potential adopters (eg, previous experience with the treatment).
Will Biosimilars Gain Momentum?
Authors: Bradford R. Hirsch, Gary H. Lyman
Journal: Journal of the National Comprehensive Cancer Network (2013)

Biosimilars, also known as follow-on biologics, continue to be an area of great interest in oncology because of the potential cost savings and improved access related to their use, yet significant confusion remains regarding their introduction in the United States. The regulatory and legal hurdles remain poorly defined, and companies producing branded products have been battling their introduction. The European Union provided a pathway for approval in 2004, with various agents reaching the market since that time. It is important to understand the nuances of the discussion and experiences and for clinicians and policy makers to take an active part in defining the role of biosimilars. Several outstanding questions remain, including the degree to which physiochemical, biologic, quality, and clinical end points must be demonstrated in clinical trials compared with the use of analytic data for approval; whether off-label indications should be embraced; and the regulatory rules around areas such as marketing and interchangeability. This article highlights tbo-filgrastim, an agent currently marketed as a biosimilar in Europe, because its pending introduction in the US market provides insights into the potential of these agents.
High-Resolution Computed Tomography in Idiopathic Pulmonary Fibrosis
Authors: David A. Lynch, J. David Godwin, Sharon Safrin, Karen M. Starko, Phil Hormel, Kevin K. Brown, Ganesh Raghu, Talmadge E. King, Williamson Z. Bradford, David A. Schwartz, W. Richard Webb
Journal: American Journal of Respiratory and Critical Care Medicine (2005)

High-resolution computed tomography (HRCT) is an integral aspect of the evaluation of patients with suspected idiopathic pulmonary fibrosis (IPF). However, few studies have evaluated its use in a large cohort.To describe HRCT features in patients with mild to moderate IPF, compare diagnostic evaluations by a radiology core (three thoracic radiologists) with those by study-site radiologists, correlate baseline clinical and physiologic variables with HRCT findings, and evaluate their association with mortality.We assessed HRCT scans from patients with IPF (n = 315) enrolled in a randomized controlled study evaluating IFN-gamma1b.There was concordance between study-site and core radiologists regarding the diagnosis of IPF in 86% of cases. Diffusing capacity of carbon monoxide (DLCO) was the physiologic characteristic most highly correlated with HRCT findings. Multivariate analysis identified three independent predictors of mortality: a higher extent of fibrosis score increased the risk of death (p < 0.0001), whereas a higher percent-predicted DLCO (p = 0.004) and treatment assignment to IFN-gamma1b rather than placebo (p = 0.04) reduced the risk of death.A study-site diagnosis of IPF on HRCT was regularly confirmed by core radiologists. Extent of reticulation and honeycombing on HRCT is an important independent predictor of mortality in patients with IPF.
Conversion of a Poorly Differentiated Human Adenocarcinoma to Ascites Form With Invasion and Metastasis in Nude Mice: Brief Communication
Authors: Seiichi Takahashi, Yoichi Konishi, Katsunori Nakatani, Shoji Inui, Kiyohide Kojima, Tsuneo Shiratori
Journal: JNCI Journal of the National Cancer Institute (1978)

Cells (1 X 10(7)/0.5 ml) from a Borrmann type III poorly differentiated adenocarcinoma of the human stomach were injected ip into nude mice. The injection resulted in ascites carcinoma with invasion (carcinomatous peritonitis) and liver metastasis. The inoculum was obtained from subcutaneous tumors at passage 9 in nude mice that had received serial transplants from the patient with Borrmann type III poorly differentiated adenocarcinoma of the stomach. Serial transfers of 1.5 X 10(6) dispersed cancer cells/0.5 ml into the peritoneal cavity of nude mice converted this adenocarcinoma to an ascites form. Hemorrhagic ascites accumulated within 3 weeks at the first passage and 4-6 weeks in serial passages. Carcinomas peritonitis occurred consistently and was observed in the diaphragm, mesenteries, omentum, and pancreas; metastases were seen in the liver and spleen. Subsequently, iv injection of ascites at passage 3 (6 X 10(5) cells/0.2 ml) into nude mice produced metastatic lesions in the lung and the heart. The histology of the invasive and metastatic lesions in the nude mice was similar to that of the original tumor in the patient with stomach carcinoma.
Multivariate analysis of prognostic factors in stage IV follicular low-grade lymphoma: a risk model.
Authors: J E Romaguera, P McLaughlin, L North, D Dixon, K B Silvermintz, L A Garnsey, W S Velasquez, F B Hagemeister, F Cabanillas
Journal: Journal of Clinical Oncology (1991)

We analyzed the records of 96 previously untreated patients with stage IV follicular low-grade lymphoma (FLGL) uniformly treated with cyclophosphamide, doxorubicin, vincristine, prednisone, and bleomycin (CHOP-Bleo) chemotherapy from 1972 to 1982. The overall complete remission (CR) rate was 77%. At a median follow-up of 138 months, the 10-year cause-specific survival rate was 42% with a median survival of 100 months. Failure-free survival (FFS) was 15% at 10 years with a median FFS of 30 months. Multivariate analysis showed peripheral lymph node size (LN), degree of marrow involvement, and sex, in that order, to be important for FFS, while the number of extranodal sites (#ENS), LN, sex, and degree of marrow involvement were important for cause-specific survival. We devised a tumor burden (TB) model, incorporating #ENS, LN, and degree of marrow involvement. Three groups were identified with statistically significant differences in cause-specific survival and FFS. Those with low TB (one ENS exclusive of extensive marrow and nodal disease less than 5 cm) had a 10-year cause-specific survival of 73% compared with 24% for patients with high TB (greater than or equal to two ENS and nodal disease greater than or equal to 5 cm) (P less than .001) and 40% for those with intermediate TB (either greater than or equal to 2 ENS, or extensive marrow only, or nodal disease greater than 5 cm) (P = .050). Patients with low TB had a 10-year FFS rate of 32%, while the intermediate and high TB groups had 10% and 9% FFS, respectively (P = .003). Because sex was a very strong prognostic variable, we created a risk model for survival and FFS based on TB and sex. Females with low TB had the best prognosis (92% survival and 50% FFS at 10 years) and males with high TB had the worst outlook (median survival and FFS, 43 and 12 months, respectively). Other TB-sex combinations defined two groups with statistically significant differences in survival but comparable FFS. This model should aid in the design and analysis of future trials.
Characterization of Bone Marrow Laminins and Identification of 5-Containing Laminins as Adhesive Proteins for Multipotent Hematopoietic FDCP-Mix Cells
Authors: Yuchen Gu, Lydia Sorokin, Madeleine Durbeej, Tord Hjalt, Jan-Ingvar Jönsson, Marja Ekblom
Journal: Blood (1999)
The Liver Catalase Activity of Tumor-Bearing Rats and the Effect of Extirpation of the Tumors
Authors: P Greenstein Jesse, V Jenrette Wendell, White Julius
Journal: JNCI Journal of the National Cancer Institute (1941)

The Liver Catalase Activity of Tumor-Bearing Rats and the Effect of Extirpation of the Tumors Jesse P. Greenstein, Jesse P. Greenstein research fellow National Cancer Institute, National Institute of Health, United States Public Health Service Search for other works by this author on: Oxford Academic PubMed Google Scholar Wendell V. Jenrette, Wendell V. Jenrette junior physiologist National Cancer Institute, National Institute of Health, United States Public Health Service Search for other works by this author on: Oxford Academic PubMed Google Scholar Julius White Julius White research fellow National Cancer Institute, National Institute of Health, United States Public Health Service Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 2, Issue 3, December 1941, Pages 283–291, https://doi.org/10.1093/jnci/2.3.283 Published: 01 December 1941
Outcomes of Patients With Acute Type B (DeBakey III) Aortic Dissection
Authors: Rana O. Afifi, Harleen K. Sandhu, Samuel S. Leake, Mina L. Boutrous, Varsha Kumar, Ali Azizzadeh, Kristofer M. Charlton-Ouw, Naveed U. Saqib, Tom C. Nguyen, Charles C. Miller, Hazim J. Safi, Anthony L Estrera
Journal: Circulation (2015)

Aortic dissection remains the most common aortic catastrophe. In the endovascular era, the management of acute type B aortic dissection (ATBAD) is undergoing dramatic changes. The aim of this study is to evaluate the long-term outcomes of patients with ATBAD who were treated at our center over a 13-year period.We reviewed patients with ATBAD between 2001 and 2014, analyzing variables based on status (complicated [c] versus uncomplicated [u]) and treatment modalities. We defined cATBAD as rupture, expansion of diameter on imaging during the admission, persistent pain, or clinical malperfusion leading to a deficit in cerebral, spinal, visceral, renal, or peripheral vascular territories at presentation or during initial hospitalization. Postoperative outcomes were defined as deficits not present before the intervention. Outcomes were compared between the groups by use of Kaplan-Meier and descriptive statistics. We treated 442 patients with ATBAD. Of those 442, 60.6% had uATBAD and were treated medically, and 39.4% had cATBAD, of whom 39.0% were treated medically to 30.0% with open repair, 21.3% with thoracic endovascular aortic repair, and 9.7% with other open peripheral procedures. Intervention-free survival at 1 and 5 years was 84.8% and 62.7% for uATBAD, 61.8% and 44.0% for cATBAD-medical, 69.2% and 47.2% for cATBAD-open, and 68.0% and 42.5% for cATBAD-thoracic endovascular aortic repair, respectively (P=0.001). Overall survival was significantly related primarily to complicated presentation.In our experience, early and late outcomes of ATBAD were dependent on the presence of complications, with cATBAD faring worse. Although uATBAD was associated with favorable early survival, late complications still occurred, mandating radiographic surveillance and open or endovascular interventions. Prospective trials are required to better determine the optimal therapy for uATBAD.
Gebelik Sırasında Pirozisin Gastroözofagal Reflü Hastalığı Riski ile İlişkisi
Authors: Serhat Bor, Gul Kitapcioglu, Peter Dettmar, Izmir, Technostics, Kingston upon Hull, East Yorkshire, Dansom Lane Hull, United Kingdom
Journal: Clinical Gastroenterology and Hepatology (2007)
Prognostic significance of HER-2 oncoprotein expression in breast cancer: a 30-year follow-up.
Authors: S Toikkanen, H Helin, J Isola, H Joensuu
Journal: Journal of Clinical Oncology (1992)

To study retrospectively the long-term prognostic significance of HER-2 oncoprotein expression in breast cancer (BC).Two hundred nine consecutive female patients with invasive operable BC from a defined urban population were observed for a median of 30 years. Tissue expression of HER-2 oncoprotein was demonstrated by using an immunoperoxidase procedure.Fifty-five (26%) patients had cancer and a positive HER-2 oncoprotein stain reaction. They had significantly worse 10- and 25-year survival rates than those patients who had a negative stain reaction in their cancer (31% v 48% and 31% v 39%, respectively; P = .004). HER-2 expression was also associated with a poorer survival among patients who had axillary nodal metastases (P = .003; n = 104), but not among those patients who did not have metastases. HER-2 expression was related to the ductal histologic type, poor histologic grade, and high mitotic count, but not to tumor size, axillary nodal status, DNA ploidy, or S-phase fraction (SPF). In a multivariate analysis among patients with nodal metastases, HER-2 expression was an independent prognostic factor (P = .04) that predicted poor survival. However, if the entire series was entered onto the analysis, it did not emerge as an independent factor.HER-2 oncoprotein expression has long-term prognostic significance for predicting poor survival in BC, and it has an independent prognostic value among patients who presented with axillary nodal metastases. This result is contradictory to the argument that HER-2 expression is only a marker for drug resistance because the patients were not given adjuvant drug therapy.
Gemcitabine in leukemia: a phase I clinical, plasma, and cellular pharmacology study.
Authors: R Grunewald, H Kantarjian, M Du, K Faucher, P Tarassoff, W Plunkett
Journal: Journal of Clinical Oncology (1992)

PURPOSE Phase I clinical and in vitro studies of gemcitabine (2',2'-difluorodeoxycytidine; dFdC) have demonstrated that the accumulation rate of dFdC 5'-triphosphate (dFdCTP) in mononuclear and leukemia cells is saturated when plasma or extracellular dFdC levels exceed 15 to 20 mumol/L. Thus, we designed a phase I study to maximize the accumulation of dFdCTP by leukemia cells by administering dFdC at 10 mg/m2/min, a dose rate calculated to produce steady-state plasma dFdC levels that exceed 15 to 20 mumol/L. PATIENTS AND METHODS The treatment intensity was increased in patients (n = 22) with relapsed or refractory acute leukemia or chronic myelogenous leukemia (CML) in blast crisis by prolonging the infusion duration but maintaining the same rate. Doses of dFdC between 1,200 mg/m2 and 6,400 mg/m2 were administered weekly for 3 weeks. RESULTS The maximum-tolerated dose was 4,800 mg/m2 infused over 480 minutes. The mean steady-state dFdC level in plasma of all infusions was 26.5 +/- 9 mumol/L (n = 19). The accumulation rates of dFdCTP in circulating leukemia cells varied greatly among patients but remained linear in eight patients infused for 120 to 240 minutes, and up to or beyond 360 minutes in five of eight additional patients. Elimination of dFdCTP was significantly related to its cellular concentration: blasts with greater than 450 mumol/L dFdCTP exhibited biphasic elimination, whereas blasts with lower dFdCTP concentrations exhibited linear kinetics. Biphasic elimination was associated with higher dFdCTP areas under the concentration-times-time curve (AUCs) and greater inhibition of DNA synthesis. CONCLUSION Studies of the cellular pharmacology and pharmacodynamics of dFdC may be useful in optimizing protocol designs for leukemia.