tbuckley/cabot-search huggingface dataset:
Fluorouracil Plus Leucovorin as Effective Adjuvant Chemotherapy in Curatively Resected Stage III Colon Cancer: Results of the Trial adjCCA-01
Authors: Rainer Porschen, Andreas Bermann, Thomas Löffler, Gregor Haack, Klaus Rettig, Yvonne Anger, Georg Strohmeyer
Journal: Journal of Clinical Oncology (2001)

PURPOSE: Adjuvant postoperative treatment with fluorouracil (5-FU) and levamisole in curatively resected stage III colon cancer significantly reduces the risk of cancer recurrence and improves survival. Biochemical modulation of 5-FU with leucovorin has resulted in increased remission rates in metastatic colorectal cancer, thus reflecting an increased tumor-cell kill. The impact of 5-FU plus leucovorin on survival and tumor recurrence was analyzed in comparison with the effects of 5-FU plus levamisole in the prospective multicentric trial adjCCA-01. PATIENTS AND METHODS: Patients with a curatively resected International Union Against Cancer stage III colon cancer were stratified according to T, N, and G category and randomly assigned to receive one of the two adjuvant treatment schemes: 5-FU 400 mg/m 2 body-surface area intravenously in the first chemotherapy course, then 450 mg/m 2 × 5 days; 12 cycles, plus leucovorin 100 mg/m 2 (arm A), or 5-FU plus levamisole (Moertel scheme; arm B). RESULTS: Six hundred eighty (96.9%) of 702 patients enrolled onto this study were eligible. After a median follow-up time of 46.5 months, the 5-FU plus leucovorin combination significantly improved disease-free survival (P = .037) and significantly decreased overall mortality (P = .0089) in comparison with 5-FU plus levamisole. In a multivariate proportional hazards model, adjuvant chemotherapy emerged as a significant prognostic factor for survival (P = .0059) and disease-free survival (P = .03). Adjuvant treatment with 5-FU plus levamisole as well as with 5-FU plus leucovorin was generally well tolerated; only a minority of patients experienced grade 3 and 4 toxicities. CONCLUSION: After a curative resection of a stage III colon cancer, adjuvant treatment with 5-FU plus leucovorin is generally well tolerated and significantly more effective than 5-FU plus levamisole in reducing tumor relapse and improving survival.
Pulmonary Function: A Guide for Clinicians
Journal: Thorax (1995)

Book noticesrisk of severe adverse event (adjusted RR = 1 0) -that is, increased risk was entirely due to patients with more severe disease being prescribed fenoterol.The possibility that fen- oterol was intermediate in the causal pathway (and thus responsible for an increased ad- mission rate) was addressed by demonstrating that the lower strength preparation of fen- oterol (100 jg in combination with ip- ratropium) was associated with a higher risk of serious adverse event (crude RR = 2-2, 95% CI 0-6 to 10) than the higher strength pre- paration (200 pg) (crude RR= 1-5, 95% CI 0 5 to 6-1), thus demonstrating biological
Abstract 2630: Lower Socioeconomic Status is Associated with Higher Rates of First Hospitalization for Stroke and Subsequent Case Fatality: A Population Study of 5.1 Million People in Scotland 1985–2005
Authors: Pardeep S Jhund, James Lewsey, Michelle Gillies, James Chalmers, Adam Redpath, Laura Kelso, Andrew Briggs, Matthew Walters, Peter Langhorne, Simon Capewell, John McMurray, Kate MacIntyre
Journal: Circulation (2008)

Introduction Small, age or geographically restricted studies suggest that stroke incidence and case fatality increase with lower socioeconomic status (SES). We examined the relationship between SES and stroke incidence and case fatality in a whole country. Methods Linked morbidity and mortality data were used to identify all first hospitalizations in Scotland where stroke was coded in the principal diagnostic position at discharge from 1986 –2005. SES was measured using the quintiles of Carstairs index of deprivation (quintile 1= most affluent, 5=most deprived). Age and sex specific incidence rates by SES were calculated. Cox regression was used to model case-fatality by SES at 30 days, 1 and 5 years adjusted for comorbidities. Results From 1986 –2005 73,676 men and 88,808 women were admitted with a first stroke. In men (women) 11575 (14713) occurred in individuals in deprivation quintile 1 and 15800 (19022) in quintile 5. Rates of stroke were higher in the most deprived vs the most affluent individuals. In 1986, in men aged &lt;55, 55– 64, 65–74, 75– 84 and &gt;85 years, the rate ratios (deprived vs affluent) were 2.05(1.46 –2.87), 1.82(1.38 –2.38), 1.56(1.27–1.92), 1.06(0.87–1.31) and 1.16(0.78 –1.74) respectively. In women the respective ratios were 2.57(1.71–3.87), 2.06(1.50 –2.83), 1.62(1.32–1.99), 1.27(1.09 –1.49) and 1.36(1.07–1.74). These gradients persisted from 1986 to2005 in both men and women and in all ages. Adjusted case fatality did not vary by SES at 30 days,, HR (deprived vs affluent) = 1.01(95%CI 0.96 –1.06) in men, 1.03(0.99 –1.08) in women. However, at 30 days-1 year the HR was 1.17(1.09 –1.24) in men and 1.11 (1.05–1.17) in women. At 1–5 years the HRs were 1.20(1.13–1.26) in men and 1.14(1.09 –1.20) in women. The effect of SES on case fatality and hospitalization rates did not vary by year or stroke subtype (p for interactions &gt;0.05). Conclusion Not only are stroke hospitalization rates highest in the most deprived individuals, but adjusted longer term case fatality after discharge is also higher. There is no evidence that this disparity is decreasing over time.
Phylogeographical analysis of the dominant multidrug-resistant H58 clade of Salmonella Typhi identifies inter- and intracontinental transmission events
Authors: Vanessa K Wong, Stephen Baker, Derek J Pickard, Julian Parkhill, Andrew J Page, Nicholas A Feasey, Robert A Kingsley, Nicholas R Thomson, Jacqueline A Keane, François-Xavier Weill, David J Edwards, Jane Hawkey, Simon R Harris, Alison E Mather, Amy K Cain, James Hadfield, Peter J Hart, Nga Tran Vu Thieu, Elizabeth J Klemm, Dafni A Glinos, Robert F Breiman, Conall H Watson, Samuel Kariuki, Melita A Gordon, Robert S Heyderman, Chinyere Okoro, Jan Jacobs, Octavie Lunguya, W John Edmunds, Chisomo Msefula, Jose A Chabalgoity, Mike Kama, Kylie Jenkins, Shanta Dutta, Florian Marks, Josefina Campos, Corinne Thompson, Stephen Obaro, Calman A MacLennan, Christiane Dolecek, Karen H Keddy, Anthony M Smith, Christopher M Parry, Abhilasha Karkey, E Kim Mulholland, James I Campbell, Sabina Dongol, Buddha Basnyat, Muriel Dufour, Don Bandaranayake, Take Toleafoa Naseri, Shalini Pravin Singh, Mochammad Hatta, Paul Newton, Robert S Onsare, Lupeoletalalei Isaia, David Dance, Viengmon Davong, Guy Thwaites, Lalith Wijedoru, John A Crump, Elizabeth De Pinna, Satheesh Nair, Eric J Nilles, Duy Pham Thanh, Paul Turner, Sona Soeng, Mary Valcanis, Joan Powling, Karolina Dimovski, Geoff Hogg, Jeremy Farrar, Kathryn E Holt, Gordon Dougan
Journal: Nature Genetics (2015)
Anatomical and functional testing did not differ for reducing CV events in suspected obstructive CAD
Authors: Victor Froelicher, Eric R. Bates
Journal: Annals of Internal Medicine (2015)

ACP Journal Club18 August 2015Anatomical and functional testing did not differ for reducing CV events in suspected obstructive CADVictor Froelicher, MD, Eric R. Bates, MDVictor Froelicher, MDStanford University, Palo Alto, California, USA (V.F.)Search for more papers by this author, Eric R. Bates, MDUniversity of Michigan, Ann Arbor, Michigan, USA (E.R.B.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/ACPJC-2015-163-4-011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationDouglas PS, Hoffmann U, Patel MR, et al; PROMISE Investigators. Outcomes of anatomical versus functional testing for coronary artery disease. N Engl J Med. 2015;372:1291-1300. https://pubmed.ncbi.nlm.nih.gov/25773919Clinical Impact RatingsCardiology: Author, Article, and Disclosure InformationAuthors: Victor Froelicher, MD; Eric R. Bates, MDAffiliations: Stanford University, Palo Alto, California, USA (V.F.)University of Michigan, Ann Arbor, Michigan, USA (E.R.B.)This article was published at Annals.org on 4 August 2015. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 18 August 2015Volume 163, Issue 4Page: JC11KeywordsEchocardiographyExerciseHospitalizationsMedical risk factorsMyocardial infarctionNumber needed to harmPharmacologic stress testingStable coronary artery diseaseUnstable angina ePublished: 18 August 2015 Issue Published: 18 August 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Abstract 4650: Comparison Between Balloon-Based Delivery Energy (High Intensity Focused Ultrasound {HIFU}, Laser and Cryoenergy {CRYO} to Perform Pulmonary Vein Isolation
Authors: Charles Dalegrave, Benhur D Henz, Yasuo Okumura, Mark Kolasa, Dylan Miller, Susan B Johnson, Douglas L Packer
Journal: Circulation (2008)
Red Blood Cell Concentrate Storage and Survival After Cardiac Surgery
Authors: Ulrik Sartipy, Martin J. Holzmann, Henrik Hjalgrim, Gustaf Edgren
Journal: JAMA (2015)

Red Blood Cell Concentrate Storage and Survival After Cardiac SurgeryBlood undergoes several physiological changes during storage.Observational studies have suggested that transfusion of stored red blood cell (RBC) concentrates may be harmful 1 ; however, the results are inconsistent. 2We performed a nationwide cohort study of RBC storage and adverse outcomes after cardiac surgery.Methods | We identified all patients who underwent coronary artery bypass graft surgery, heart valve surgery, or both between 1997 and 2012 from the SWEDEHEART register, which records information on patients who undergo heart surgery in Sweden. 3Transfusion data were obtained from the SCAN-DAT2 database, a nationwide register of blood transfusions. 4inkage with national health data registers provided vital status and adverse outcomes.Blood services in Sweden are part of the public health care system and follow national guidelines, whereby the oldest available blood unit of the appropriate blood type is allocated first.Storage of RBCs was classified as previously 1,2 with discrete patient groups who had exclusively received blood stored less than 14 days, 14-27 days, or 28-42 days, and a mixed storage category for patients receiving blood of mixed age.Follow-up was completed on December 31, 2013.We used multivariable Cox regression to estimate the 30day, 2-year, and 10-year risk of death in relation to storage of transfused RBCs.We also considered the number of transfused units stored 28-42 days and risk of death.Associations between RBC storage and the risk of complications within 30 days of surgery were assessed using multivariable logistic regression.Both regression models were adjusted for all the factors listed in the footnote for Table 1.Statistical analyses were performed using SAS version 9.4 (SAS Institute Inc).All statistical tests were 2-sided.P values <.05 were considered statistically significant.
Randomized, Double‐Blind, Placebo‐Controlled Trial of the Efficacy and Safety of Rilonacept in the Treatment of Systemic Juvenile Idiopathic Arthritis
Authors: Norman T. Ilowite, Kristi Prather, Yuliya Lokhnygina, Laura E. Schanberg, Melissa Elder, Diana Milojevic, James W. Verbsky, Steven J. Spalding, Yukiko Kimura, Lisa F. Imundo, Marilynn G. Punaro, David D. Sherry, Stacey E. Tarvin, Lawrence S. Zemel, James D. Birmingham, Beth S. Gottlieb, Michael L. Miller, Kathleen O'Neil, Natasha M. Ruth, Carol A. Wallace, Nora G. Singer, Christy I. Sandborg
Journal: Arthritis & Rheumatology (2014)

Objective To assess the efficacy and safety of rilonacept, an interleukin‐1 inhibitor, in a randomized, double‐blind, placebo‐controlled trial. Methods An initial 4‐week double‐blind placebo phase was incorporated into a 24‐week randomized multicenter design, followed by an open‐label phase. Seventy‐one children who had active arthritis in ≥2 joints were randomized (1:1) to the 2 arms of the study. Patients in the rilonacept arm received rilonacept (loading dose 4.4 mg/kg followed by 2.2 mg/kg weekly, subcutaneously) beginning on day 0. Patients in the placebo arm received placebo for 4 weeks followed by a loading dose of rilonacept at week 4 followed by weekly maintenance doses. The primary end point was time to response, using the adapted American College of Rheumatology Pediatric 30 criteria coupled with the absence of fever and taper of the dosage of systemic corticosteroids, using prespecified criteria. Results The time to response was shorter in the rilonacept arm than in the placebo arm (χ 2 = 7.235, P = 0.007). The secondary analysis, which used the same response criteria, showed that 20 (57%) of 35 patients in the rilonacept arm had a response at week 4 compared with 9 (27%) of 33 patients in the placebo arm ( P = 0.016). Exacerbation of systemic juvenile idiopathic arthritis (JIA) was the most common severe adverse event. More patients in the rilonacept arm had elevated liver transaminase levels (including levels more than 3 times the upper limit of normal) compared with those in the placebo arm. Adverse events were similar in the 2 arms of the study. Conclusion Rilonacept was generally well tolerated and demonstrated efficacy in active systemic JIA.
Psychological observations of bank robbery
Authors: D A Johnston
Journal: American Journal of Psychiatry (1978)

Bank robbery has been only partially examined in the psychiatric literature. It has been publicly considered an act of men of strong will to obtain money. According to the author's observations in a federal penitentiary, bank robbery more often is a symptomatic act with psychological meaning. The author describes several of the unconscious motives and defense aspects of bank robbery in the hope that this will assist in demythologizing the bank robber.
Neuropathy and Celiac Disease—When a Gluten-Free Diet is Not Enough
Authors: Maurizio Mennini, Ilaria Baglivo, Federica Ferrari
Journal: JAMA Neurology (2015)

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Outcome of clear cell sarcoma of the kidney (CCSK) treated on the National Wilms Tumor Study-5 (NWTS)
Authors: N. L. Seibel, J. Sun, J. R. Anderson, N. E. Breslow, E. J. Perlman, M. L. Ritchey, P. R. Thomas, M. J. Coppes, P. E. Grundy, D. M. Green
Journal: Journal of Clinical Oncology (2006)

9000 Background: CCSK was initially described by its bone metastasizing tendencies and propensity for late recurrences. Outcome for patients with CCSK has improved from NWTS 1–4. On NWTS 4 patients were randomized to treatment for 15 months vs 6 months. Their overall 8 year relapse free survival was 88% vs 61%, respectively. NWTS-5 was designed to improve the event free survival (EFS) and overall survival (S) for patients with CCSK by incorporating cyclophosphamide and etoposide. Methods: Prospective single-arm study conducted between August, 1995 and June, 2002. Patients less than 16 years of age with a centrally confirmed pathological diagnosis of CCSK were eligible. Staging consisted of CT scans of chest, abdomen, pelvis, bone scan, skeletal survey, and CT or MRI of head. Patients were treated with vincristine/doxorubicin/cyclophosphamide alternating with cyclophosphamide/etoposide for 24 weeks and XRT (10.8 cGy). Results: 110 eligible patients were enrolled on study. Median age was 22 months, 69% were males, and 63% white. Stage distribution was: stage I, 14; II, 41; III, 46; IV, 9 [metastatic sites: lung (3), bone (1), brain (1), liver (1), bone and bilateral lung (1) and other (2)] Median follow-up is 4.6 years. 5-year EFS and S were 79% (95% CI, 69% to 86%) and 89% (95% CI, 80% to 94%). All but one of 21 recurrences occurred within 3 years of initial treatment. The most common site of recurrence was brain (11/21). 5-year EFS for Stage I-IV was 100%, 87%, 74% and 36% respectively. Adverse prognostic factors for patients with Stage II/III disease were white race, and lymph node involvement. Conclusions: Outcome for patients with CCSK treated on NWTS-5 is similar to that seen on NWTS-4 and recent SIOP and UKCCSG trials. Stage is highly predictive of outcome. Brain recurrence was higher than that seen on NWTS-4; lung recurrences were lower. The next Childrens Oncology Group (COG) protocol will use the same treatment for patients with Stages I-III; therapy for patients with Stage IV disease will incorporate carboplatin. The role of XRT in CCSK needs to be evaluated. No significant financial relationships to disclose.
Respiratory muscle assessment in Guillain-Barré-syndrome
Authors: Stephan Walterspacher, André Kirchberger, David Walker, Anja Schwörer, Johann Lambeck, Wolf-Dirk Niesen, Wolfram Windisch, Farsin Hamzei, Hans-Joachim Kabitz
Journal: European Respiratory Journal (2013)

Introduction 

Guillain-Barre-Syndrome (GBS) is a potentially life-threatening situation due to respiratory muscle involvement and paralysis.

Objectives 

This study aimed to objectively assess the course of respiratory muscle function in GBS patients within the first week of intensive care treatment using neurological scoring systems, spirometry and indices of (non)volitional assessed respiratory and peripheral muscle strength.

Methods and Measurements 

Patients were included immediately after establishing the diagnosis of GBS according to recent guidelines. Within the first week of treatment spirometry, peripheral (vigorimetry) and respiratory muscle function (respiratory drive: P0.1, global inspiratory/exspiratory muscle strength: PImax/PEmax, sniff nasal pressure: SnPna) and neuromuscular scores (MRC Sum Score) were evaluated twice and the GBS Disability Score assessed once daily. On day one and seven non-volitional tests on respiratory muscle function (twitch mouth pressure during bilateral magnetic phrenic nerve stimulation: TwPmo) were added.

Main Results 

Nine patients were included. MRC-Scoring (38.6SD18.3 vs 42.3SD16.3; p=0.08), vigorimetry (44.3SD40.6 vs 59.8SD49.5; p=0.003), PImax (5.8SD1.7 vs 7.2SD2.5; p=0.07) and SnPna (5.2SD2.2 vs 7.1SD2.0; p<0.001) increased. GBS-Scoring, spirometry and TwPmo (0.6SD0.3 vs 0.8SD0.2, p=0.14) remained unaltered. Only SnPna correlated closely with MRC-Scoring on day1 (r=0.77, p=0.02) and day7 (r=0.74, p=0.02).

Conclusions 

Respiratory muscle strength is limited in acute GBS. SnPna proved as a reliable and easy to assess parameter of respiratory muscle function and was the only parameter that correlated with disease specific indices.
A phase I trial of a bi-weekly combination of capecitabine/irinotecan (XELIRI) then capecitabine/irinotecan/oxaliplatin (XELIRINOX) in solid tumors
Authors: E. Assenat, A. Kramar, S. Poujol, C. Gestin-Boyer, P. Senesse, E. Samalin, F. Portales, S. Thezenas, J. Bleuse, M. Ychou
Journal: Journal of Clinical Oncology (2009)

e15075 Background: Oral fluoropyrimidines, notably capecitabine, are increasingly replacing IV 5-FU/LV as the backbone of therapy for metastatic colorectal cancer. The bi-weekly combination of capecitabine/irinotecan warrants further examination. Methods: We conducted a phase I trial, in metastatic cancer patients treated for solid tumors, to determine the recommended dose of capecitabine administered orally bid from day 1 to 8 in combination with a bi-weekly fixed-dose of IV irinotecan 180 mg/m 2 delivered on day 1 and 14 (FIRST STAGE: XELIRI); and + a bi-weekly fixed-dose of IV oxaliplatin (L-OHP) 85 mg/m 2 delivered on day 1 and 14 (Second STAGE: XELIRINOX). Five increasing dose levels (DL1–5) of capecitabine were planned: 1000, 1250, 1500, 1750, and 2000 mg/m 2 bid. A pharmacokinetic study of this association was performed. Results: In the first stage, a total of 17 patients were enrolled, with a median age of 60 (range 52–73) years. All patients had an ECOG PS of either 0 (59%), 1 (35%), or 2 (6%). Four patients experienced dose-limiting toxicity: 2 developed grade 4 neutropenia (at DL 1 and 4) and 2 others grade 4 febrile neutropenia (at DL3 and 4). One toxicity-related death occurred following febrile neutropenia (DL4). Maximal tolerated dose (MTD) was DL4, and the recommended dose regimen was bi-weekly irinotecan 180 mg/m 2 combined with capecitabine 1500 mg/m 2 bid (administered from days 1 to 8). In the second stage, the starting dose level of capecitabine in the bi- weekly association with irinotecan and L-OHP was defined as two dose levels below the MTD level reached in the first stage of the study (DL4 - 2 = DL2). Height patients were enrolled with a median age of 56 (35–75) and ECOG 0 for 62%, ECOG 1 for 38%. Chemotherapy is ongoing for three of them. Three patients experienced dose-limiting toxicity: 1 grade 4 neutropenia ( DL2), 1 grade 4 febrile neutropenia ( DL3) and 1 grade 4 pneumopathy ( DL3). The MTD of XELIRINOX was DL3, and the recommended dose regimen will be presented at the meeting. Conclusions: Bi-weekly combination of capecitabine/irinotecan/oxaliplatin (XELIRI / XELIRINOX) is feasible and could be tested in patients with metastatic colorectal cancer in combination with a targeted therapy. [Table: see text]