tbuckley/cabot-search huggingface dataset:
Perspectives on Comorbidity and Cancer in Older Patients: Approaches to Expand the Knowledge Base
Authors: Rosemary Yancik, Patricia A. Ganz, Claudette G. Varricchio, Barbara Conley
Journal: Journal of Clinical Oncology (2001)

Not only do persons 65 years and older bear a disproportionate burden of cancer, advancing age is associated with increased vulnerability to other age-related health problems. Newly diagnosed older cancer patients who have lived into later years of life may have concurrent ailments (eg, diabetes, chronic obstructive pulmonary disease, heart disease, arthritis, and/or hypertension) that could affect treatment choice, prognosis, and survival. The clinician must often make cancer treatment decisions in the context of an older individual's pre-existing health problems (ie, comorbidity). Ways to produce reliable information on comorbidity that can be effectively used in evaluation of older cancer patients are urgently needed. What is the nature and severity of the older patient's comorbid health problems? How do other age-related conditions influence treatment decisions and the cancer course? How do already compromised older patients tolerate the stress of cancer and its treatment? How are concomitant comorbid conditions managed? At present, no established, valid way to assess comorbidity in older cancer patients exists. Such technology, with a solid conceptual and scientific base, promises a high positive clinical yield to assure quality cancer care for older patients if reliable and valid instruments can be integrated into oncology practice. Much preliminary scientific work must be performed. A synthesis of viewpoints on what to include in comorbidity assessment of older cancer patients and development approaches were expressed in a multidisciplinary working group convened by the National Institute on Aging and the National Cancer Institute. We share the key issues raised regarding complexities of comorbidity assessment and suggestions for scientific inquiry.
Role of GeneXpert MTB/RIF assay for rapid diagnosis of tuberculosis and detection of rifampacin(R) resistance in patients in high risk DRTB
Authors: Saifullah Baig, Shahina Qayyum, Nausheen Saifullah, Nadeem Ahmed
Journal: European Respiratory Journal (2014)

Introduction  Pakistan ranks 5 th globally in MDR TB. There is urgent need to scale up diagnosis and management of MDR TB. GeneXpert MTB/RIF Assay is being used to detect TB and R resistant. This study was done to evaluate GeneXpert MTB/RIF Assay for Rapid Diagnosis of Tuberculosis and Detection of R Resistance in high risk groups that is Patients requiring retreatment and drug resistant TB contact  Method  Patients requiring retreatment and contact of drug resistant TB visiting outpatient of Ojha institute of chest diseases Karachi during 2013 were screened for tuberculosis by sputum microscopy, GeneXpert MTB/RIF Assay and conventional culture.  Result  560 sputum specimens from 543 patients were tested. 120 were DR-TB contacts and rest were retreatment cases, among them 297, 106 and 01 have received category 1,2and 4 respectively. 19 were others.  Among contacts 29 (24.16) were sputum positive, and 39(32.2%) GeneXpert MTB positive. 02(1.66%) were Rifampacin(R) Resistance.  In patients requiring retreatment 355(83.9%) were sputum positive and 354(83.1%) were GeneXpert MTB positive. 99(23%) were R Resistant.  The results of R Resistance on conventional culture and sensitivity were identical.  Conclusion  GeneXpert MTB detected 8% more cases of TB in DRTB contacts, while the yield was equal in retreatment cases.  R resistance in DRTB contacts was only 1.66% which is not higher than new reported TB cases in any setting in Pakistan. GeneXpert MTB detected R resistance in 23% retreatment cases.
A pleural information programme: For patients and training
Authors: Burhan Khan, Hamid Aminy Raouf
Journal: European Respiratory Journal (2012)

Background:  Pleural effusions usually signify advanced disease, increased symptom load and limited life expectancy when malignant. They need prompt effective management, safely and with least possible inconvenience and discomfort.  choice is key and informed consent is crucial because of possible risks related to the invasive pleural intervention.   Aim:  To develop an interactive tool for healthcare professionals to illustrate and explain the various pleural modalities to patients and trainees.   Method & Results:  We initially used a focus group to determine the key areas, and then piloted it firstly amongst respiratory nurses, then amongst medical and non-medical persons and lastly amongst patients; all the while incorporating feedback into the final version. This was then reviewed and approved by the Trust9s Patient Information Group panel.   Conclusion:  This is an easy to use programme that helps inform patients of the available management options, what they entail and the procedural steps, providing a platform for an open and informed discussion of the pros and cons of each procedure and the possible risks. It has also been proven to be a useful training tool as well.   We hope to demonstrate the programme on tablets or screens at the ERS and disseminate and share amongst colleagues.
BIOLOGY OF BACTERIUM LEPISEPTICUM
Authors: Leslie T. Webster, Oskar Baudisch
Journal: The Journal of Experimental Medicine (1925)

Inorganic iron substances of known chemical structure have been tested for their ability to function as the X factor in the growth of bacteria of the hemophilic, anaerobic) and hemorrhagic septicemia groups. Each iron compound possessing this biocatalytic activity showed oxygen-absorbing and peroxidase properties. The interrelation of these mechanisms is discussed.
Abstract 243: Decreased Adiponectin Levels in Obese Mice with Polygenetic Susceptibility to Type 2 Diabetes Is Linked to Altered miRNA Levels of the ATF3 Gene In Visceral Adipose Tissue
Authors: Nikhil Adi, Jennipher Adi, Danielle Hollar, Paul Kurlansky, Arthur Agatston, Keith A Webster
Journal: Circulation (2008)

INTRODUCTION: Adiponectin encoded by the APMI gene is an adipocyte-expressed protein with insulin sensitizing, antiatherogenic and antiinflammatory properties. Activating transcription factor 3 (ATF3) is a member of the ATF/cAMP responsive element binding family that acts as a stress-inducible transcriptional repressor. ATF3 was recently shown to repress adiponectin gene expression. HYPOTHESIS: High fat diet with genetic susceptibility for T2D alters the miRNA profile for the adiponectin gene in visceral adipose (VA). METHODS: NONcNZO10 (NZ10) mice with polygenic susceptibility to T2D or NONLt controls (60 per group) were subjected to normal chow (NC; 6% fat), Western diet (WD; high fat/carb) or Mediterranean diet (MD; high protein/unsaturated fat) for 25 weeks. After a 16h fast, VA was isolated from all groups (5 mice per group) and subjected to gene-microarray, micro-RNA and protein analyses. RESULTS: NONLt (control) mice retained normal glycemic control and blood chemistry over 25 weeks with all diets. WD-fed NZ10 mice had increased plasma triglycerides (3-fold, p&lt;0.001), insulin (1.8-fold. P&lt;0.01) and severely impaired glucose tolerance relative to the MD or control groups (p&lt;0.01). NZ10 mice on all diets accumulated 2.5-fold more VA than NONLt controls. Body weights of WD-fed NZ10 mice were 18% greater and fat depots were 22±3.1% larger than SB mice at 25 weeks (p&lt;0.01). Serum adiponectin levels decreased &gt;50% at 25–30 weeks in NZ10 mice fed WD compared with NONLt (p&lt;0.01). The ATF3 gene was upregulated (5-fold, p&lt;0.0001) in the NZ10 mice fed WD compared with MD and 2-fold (p&lt;0.001) compared with NC. NONLt mice did not show any diet-related difference of ATF3 expression. Expression of ATF3 was increased 20-fold in NZ10 mice relative to NONLt mice independently of diet (p&lt;0.001). MiR profiling of the ATF3 gene in VA revealed that miR-203, 685, 191 and 29a were markedly downregulated in NZ10-WD mice (all 2.5-fold, p&lt;0.001). MiR expression in NONLt controls was unchanged and similar to that of NZ10 mice fed MD. CONCLUSIONS: Combined T2D susceptibility and a permissive diet cause selective repression of miR-203, 685, 191 and 29a and up-regulation of ATF3 gene expression. The consequences include defective adiponectin production and predisposition to T2D.
Low doses of zidovudine plus didanosine are less effective than higher doses of didanosine monotherapy: a randomized trial in patients pretreated with zidovudine
Authors: Philippe Sudre, Jean Philippe Chave, Christian Ruef, Anne Iten, Heiner C. Bucher, Pietro L. Vernazza, Hansjakob Furrer, Enos Bernasconi, Norberto Ceserani, Manuel Battegay, Jan Von Overbeck, Ignazio Cassis, Adriano Lazzarin, Victor Gabriel, Bernard J. Hirschel
Journal: Clinical Microbiology and Infection (1997)
Abstract 3352: Intracoronary Administration Of Bone Marrow-derived Progenitor Cells Abrogates Progressive Left Ventricular Enlargement After AMI: Insights from the REPAIR-AMI Trial
Authors: Birgit Assmus, Volker Schächinger, Sandra Erbs, Albrecht Elsässer, Werner Haberbosch, Rainer Hambrecht, Hans Hölschermann, Jiangtao Yu, Roberto Corti, Detlef G Mathey, Christian W Hamm, Kerckhoff Klinik, Tim Süselbeck, Torsten Tonn, Stefanie Dimmeler, Andreas M Zeiher
Journal: Circulation (2007)

Left ventricular (LV) enlargement is the most important independent determinant of adverse outcome in patients (pts) after AMI. Depressed LV ejection fraction (LVEF) despite successful reperfusion therapy is the single most powerful predictor of progressive LV enlargement after AMI. Therefore, we investigated whether the intracoronary (i.c.) administration of bone marrow-derived progenitor cells (BMC) alters the association between LVEF within 7 days after successful reperfusion therapy for AMI and enddiastolic (EDV) and endsystolic (ESV) volume expansion at 4 months. In the REPAIR-AMI trial paired quantitative LV angiographic data at baseline (4.3 ± 1 days after AMI reperfusion) and at 4 months follow-up were available in 187 pts. 95 pts received i.c. BMC (4.4±1 days post AMI reperfusion therapy), whereas 92 pts received placebo at 4.3 ± 1 days after reperfusion. Baseline LVEF were similar in the BMC (47±10%) and in the placebo group (48±9 %, p = n.s.). At 4 months, ESV increased in the placebo (+6±22ml), but not in the BMC group (−0.6±19ml, p = 0.04 vs. placebo). Baseline LVEF was inversely correlated with ESV expansion at 4 months in the placebo, but not in the BMC group (figure ). Likewise, EDV expansion was closely correlated with baseline LVEF in the placebo (r=−0.36, p&lt;0.001), but not in the BMC group (r=−0.17, p=1.0). Finally, ESV expansion determined changes in NT-proBNP serum levels in the placebo (r=−0.38, p=0.006), but not in the BMC group(r=0.05, p=0.68). Conclusion: I.c. administration of BMC eliminates the correlation between depressed LVEF after reperfusion therapy and LV expansion during follow-up and thereby abrogates progressive LV enlargement after AMI. Change in endsystolic volume (baseline to 4 months , ml)
Impact of protracted venous infusion fluorouracil with or without interferon alfa-2b on tumor response, survival, and quality of life in advanced colorectal cancer.
Authors: M Hill, A Norman, D Cunningham, M Findlay, M Watson, V Nicolson, A Webb, G Middleton, F Ahmed, T Hickish
Journal: Journal of Clinical Oncology (1995)

PURPOSE The aim of this study was to investigate the effects of adding interferon alfa-2b (IFN) to protracted venous infusion fluorouracil (PVI 5-FU) from the start of treatment in patients with advanced colorectal cancer. PATIENTS AND METHODS Patients who attended our unit with histologically confirmed advanced colorectal cancer were randomized to receive either PVI 5-FU 300 mg/m2/d via Hickman line, and IFN 5 MU subcutaneously three times weekly, or PVI 5-FU alone. Treatment was given for a maximum of two 10-week blocks, with a 2-week gap for reassessment of all parameters. Quality of life (QL) was measured by the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) pretreatment and every 6 weeks thereafter. RESULTS A total of 160 patients were randomized, with 155 eligible for assessment. Radiologic response was observed in 43 patients (28%): 17 of 77 (22%) in the 5-FU-plus-IFN arm (all partial responses [PRs]) and 26 of 78 (33%) in the 5-FU-alone group (complete responses [CRs] and 22 PRs) (difference not significant). Symptomatic improvement occurred in the majority of patients, and equally in both arms: 61% to 80% depending on the symptom. There was no significant difference between the two groups in failure-free survival (median, 161 v 193 days) or overall survival (median, 328 v 357 days). However, patients who received IFN did experience significantly more toxicity in the form of leukopenia (P = .001), neutropenia (P = .04), mucositis (P = .008), and alopecia (P = .0002). There were no toxic deaths and few notable differences in QL between the two arms. CONCLUSION This study confirms that PVI 5-FU is effective in treating the symptoms associated with metastatic colorectal carcinoma, with only mild to moderate toxicity and maintenance of QL. IFN 5 MU three times weekly does not enhance these palliative benefits.
Case-Control Study of Intracranial Menigiomas in Women in Los Angeles County, California&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: S Preston-Martin, A Paganini-Hill, B E Henderson, M C Pike, C Wood
Journal: JNCI Journal of the National Cancer Institute (1980)

A case-control study was conducted among women in Los Angeles County to investigate possible causes of intracranial meningiomas. Questionnaires sought information from patients and from a neighbor of each one on characteristics and past experiences that might be associated with the development of this disease. Information was obtained on 188 matched patient-neighbor pairs. Three primary factors appeared to be associated with meningioma occurrence: 1) a history of head trauma (odds ratio = 2.0, P = 0.01), 2) consumption of certain cured meats (odds ratio = 2.8, P less than 0.01), and 3) exposure to medical and dental diagnostic X-rays to the head. For diagnostic X-rays, the strongest association was with early exposure (less than 20 yr old) to full-mouth dental X-ray series (odds ratio = 4.0, P less than 0.01).
Systemic inflammatory repercussions after pleurodesis in an experimental model of pneumothorax
Authors: Evaldo Marchi, Tiago Ventureli, Ariane Lazaro, Debora Careta, Marcus Carvalho, Andre Fruchi, Milena Acencio, Richard Light
Journal: European Respiratory Journal (2013)

Introduction: Thoracoscopy (VATS) is used for recurrent pneumothorax (PTX) to remove blebs and create pleurodesis. However, little is known about the systemic effects of different forms of VATS pleurodesis.

Aim: To evaluate in an experimental model the systemic inflammatory effects produced by VATS pleurodesis.

Methods: Four groups of rabbits were submitted to VATS pleurodesis. Blood samples were collected pre-operatively and after 24, 48 hours and 28 days, and assayed for total leukocyte (WBC), neutrophils, and the serum levels of IL-8, TGFb and VEGF. After 28 days the animals were sacrificed for macroscopic evaluation of pleurodesis.

Results: No difference was found in WBC and neutrophils. TGFb and VEGF serum levels were undetectable. Serum IL-8 increased acutely and decreased after 28 days except in the pleurectomy group.

View this table:

Serum levels of IL-8 after VATS pleurodesis in an experimental model of PTX.





After 28 days, the pleurectomy group had significantly higher pleural adhesions (2.1 ± 0.3) than the gauze and plastic mesh abrasion groups (0.7 ± 0.5 and 0.7 ± 0.3; p< 0.001).

Conclusions: Apical pleurectomy group had more effective adhesions than gauze and plastic mesh abrasion groups. Serum IL-8 was the only parameter found elevated in all groups, peaking at 48 hours and decreasing along time, except in the pleurectomy group, showing a more persistent pleural inflammation in this particular group in comparison to the lesser invasive forms of pleural irritation (gauze and plastic mesh abrasion).
Abstract 16013: Annexin-A1 Interacts With NF-KappaB Inhibiting Its Activation: Cardioprotection in vivo and in vitro
Authors: Zhiquan Zhang, Qing Ma, G B Mackensen, Mihai V Podgoreanu
Journal: Circulation (2011)

Background: Annexin-A1 (ANXA1), a mediator of the anti-inflammatory action of glucocorticoids, is cardioprotective in multiple preclinical models of myocardial ischemia-reperfusion (I/R), but under...
Phase III trial of lenalidomide plus high-dose dexamethasone versus lenalidomide plus low-dose dexamethasone in newly diagnosed multiple myeloma (E4A03): A trial coordinated by the Eastern Cooperative Oncology Group
Authors: S. V. Rajkumar, S. Jacobus, N. Callander, R. Fonseca, D. Vesole, M. Williams, R. Abonour, D. Siegel, P. Greipp
Journal: Journal of Clinical Oncology (2007)

LBA8025 Background: We compared lenalidomide plus high (standard) dose Dex (R+HighD) versus lenalidomide plus low dose Dex (R+LowD) in newly diagnosed MM. Methods: Pts with untreated, symptomatic MM were eligible. Pts in both arms received lenalidomide 25 mg/day PO days 1–21 every 28 days. In addition, pts in the R+HighD arm received Dex 40 mg days 1–4, 9–12, and 17–20 PO every 28 days; pts in the R+LowD arm received Dex 40 mg days 1, 8, 15, and 22 PO every 28 days. The primary null hypothesis was that response rates at 4 months on the 2 arms are equivalent. Planned sample size was 196 eligible pts per arm with one-sided 0.10 Type I and 0.05 Type II error rate. Pre-planned interim analysis is performed by an independent DMC when full information is available on 25%, 50% and 75% of accrual. All analysis were intent to treat. Results: 445 pts (median age, 65 yrs) were accrued; 223 randomized to R+HighD, 222 to R+LowD. Arms were well balanced for age, gender, stage, bone lesions, hemoglobin, beta-2 microglobulin, performance status, bone marrow plasma cells, and M protein levels at baseline. Major grade 3 or higher toxicities included thromboembolism (22.1% with R+HighD vs 6.1% in R+LowD), infection/pneumonia (15.7% vs 7.5%) and hyperglycemia (9.7% vs 6.6%). Grade 3 or higher non-hematologic toxicities occurred in 65.9% (R+HighD) versus 54.9% (R+LowD) respectively; corresponding grade 4 or higher rates were 20.3% vs 13.1% respectively. Overall survival (OS) at first interim analysis was significantly superior with R+LowD, P&lt;0.001; one year survival 96.5% (R+LowD) versus 86% (Rev+HighD). OS differences in favor of R+LowD were seen in pts &lt;65 (P=0.015; one year rate 98% vs 90%) and pts 65 and older (P=0.004; one year rate 95% vs 83%), respectively. DMC recommended release of survival results, and recommended switching all pts to R+LowD. DMC also recommended closure of an expansion phase trial of R+HighD investigating optimal thromboprophylaxis. Conclusions: Lenalidomide plus low-dose dexamethasone is associated with superior OS compared to lenalidomide plus high-dose dexamethasone. This study has major implications for future use of high-dose dexamethasone in the treatment of MM. No significant financial relationships to disclose.
A case of pulmonary capillary haemangiomatosis (PCH) diagnosed by lung biopsy
Authors: Nesrin Mogulkoc, Aysin Sakar Coskun, Paul Bishop
Journal: European Respiratory Journal (2013)

PCH is a rare cause of pulmonary hypertension. We report histologically confirmed PCH in a 18-yr-old male student. He presented with progressive exertional dyspnoea of two years’ duration. He had no significant past medical or family history, never smoked and had no occupational or environmental inhalational history. Coarse crackles were present in both lungs. Biochemistry showed a raised LDH, otherwise normal. Arterial blood gas analysis in room air showed hypoxaemia (PaO2 43.2 mmHg) and hypocapnia (PaCO2 20.9 mmHg). Serum brain-type natriuretic polypeptide was elevated at 3840 pg/mL. Pulmonary function tests revealed normal forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and FEV1/FVC, but diffusion capacity for carbon monoxide (DLCO) was markedly reduced at 4.83 mL/mmHg /min, 39% of predicted. ECG showed cor pulmonale and incomplete right bundle branch block. Echocardiography showed a pericardial effusion, marked right atrial and ventricular enlargement with severe tricuspid regurgitation and an estimated systolic pulmonary artery pressure of 80 mmHg. Right heart catheterisation was not performed. Chest radiography and high-resolution computed tomography demonstrated marked cardiomegaly, dilated main pulmonary artery, ground-glass opacities, thickening of the septal lines, and hilar and mediastinal lymphadenopathy. A surgical biopsy showed features of PCH. Diuretics and the intravenous prostacyclin iloprost were used with caution but to no avail. Lung transplantation was considered. He died soon thereafter. PCH is a rare condition of adults and children, related to veno-occlusive disease, which may be idiopathic or complicate connective tissue diseases.
Impact of long-term target-volume noninvasive positive pressure ventilation on sleep quality
Authors: Jan Hendrik Storre, Elena Matrosovich, Emelie Ekkernkamp, Michael Dreher, Claudia Schmoor, Wolfram Windisch
Journal: European Respiratory Journal (2012)

Objective: Target-volume noninvasive positive pressure ventilation (TV-NPPV) was introduced to combine the advantages of volume- and pressure-preset NPPV. However, diverging results have been reported regarding a deterioration of sleep quality due to pressure variation.

Methods: 12 COPD-patients on long term high-intensity NPPV (HI-NPPV) were switched to TV-NPPV for 10 weeks. Sleep quality and overnight gas exchange were analyzed at run-in during HI-NPPV and after 10 weeks of TV-NPPV. Two TV-NPPV-settings were tested overnight in a randomized order: 8ml/kg ideal body weight (TV1) versus 110% of individual tidal volume analyzed during familiar HI-NPPV (TV2). Inspiratory pressures were set to -5mbar (of HI-NPPV) up to 35mbar. TV-NPPV-settings reflecting the lower overnight transcutaneous PCO2-values (PtcCO2) were chosen for long-term TV-NPPV.

Results: 10 patients completed the study, 2 patients refused to complete the trial using TV2-NPPV at home. Mean overnight PtcCO2 was similar during HI-NPPV and TV-NPPV (both 45±5mmHg), p=0.75. In addition, no difference was found comparing sleep quality by polysomnography regarding sleep efficiency, sleep stages, total sleep time, arousal index, apnoe-hypopnea index or oxygen saturation.

Conclusion: After 10 weeks of TV-NPPV at home no differences regarding sleep quality or overnight PtcCO2 were observable compared to conventional HI-NPPV.