tbuckley/cabot-search huggingface dataset:
Micrometastatic cancer cells in lymph nodes, bone marrow, and blood: Clinical significance and biologic implications
Authors: Stanley P.L. Leong, William W. Tseng
Journal: CA A Cancer Journal for Clinicians (2014)

Abstract Answer questions and earn CME/CNE Cancer metastasis may be regarded as a progressive process from its inception in the primary tumor microenvironment to distant sites by way of the lymphovascular system. Although this type of tumor dissemination often occurs in an orderly fashion via the sentinel lymph node (SLN), acting as a possible gateway to the regional lymph nodes, bone marrow, and peripheral blood and ultimately to distant metastatic sites, this is not a general rule as tumor cells may enter the blood and spread to distant sites, bypassing the SLN. Methods of detecting micrometastatic cancer cells in the SLN, bone marrow, and peripheral blood of patients have been established. Patients with cancer cells in their SLN, bone marrow, or peripheral blood have worse clinical outcomes than patients with no evidence of spread to these compartments. The presence of these cells also has important biologic implications for disease progression and the clinician's understanding of the process of cancer metastasis. Further characterization of these micrometastatic cancer cells at each stage and site of metastasis is needed to design novel selective therapies for a more “personalized” treatment. CA Cancer J Clin 2014;64:195–206. © 2014 American Cancer Society.
Final Results of a Randomized Phase III Trial of Sequential High-Dose Methotrexate, Fluorouracil, and Doxorubicin Versus Etoposide, Leucovorin, and Fluorouracil Versus Infusional Fluorouracil and Cisplatin in Advanced Gastric Cancer: A Trial of the European Organization for Research and Treatment of Cancer Gastrointestinal Tract Cancer Cooperative Group
Authors: Udo Vanhoefer, Philippe Rougier, Hansjochen Wilke, Michel P. Ducreux, Angel J. Lacave, Eric Van Cutsem, Manfred Planker, José Guimaraes Dos Santos, Pascal Piedbois, Bernard Paillot, Heinrich Bodenstein, Hans-Jochen Schmoll, Harry Bleiberg, Bernard Nordlinger, Marie-Laure Couvreur, Benoit Baron, Jacques A. Wils
Journal: Journal of Clinical Oncology (2000)

PURPOSE: To compare the efficacy and tolerability of etoposide, leucovorin, and bolus fluorouracil (ELF) or infusional fluorouracil plus cisplatin (FUP) with that of the reference protocol of fluorouracil, doxorubicin, and methotrexate (FAMTX) in advanced gastric cancer. PATIENTS AND METHODS: A total of 399 patients with advanced adenocarcinoma of the stomach were randomized and analyzed for toxicity, tumor response, and progression-free and overall survival. Only reviewed and confirmed responses were considered. The analysis of remission was based on assessable patients with documented measurable lesions. The intent-to-treat principle, log-rank test, and Cox regression model were used for the statistical analysis of time-to-event end points. RESULTS: The overall response rate for 245 eligible patients with measurable disease was 9% with ELF, 20% with FUP, and 12% with FAMTX, with no significant differences. One hundred twelve patients were eligible for efficacy in assessable, nonmeasurable disease. No change was observed in 66% of patients treated with ELF, 56% with FUP, and 55% with FAMTX. Two patients achieved a complete tumor regression (one each for ELF and FAMTX). With a median follow-up time of 4.5 years, the median survival times were 7.2 months with ELF, 7.2 months with FUP, and 6.7 months with FAMTX, respectively, with no significant differences. Nonhematologic and hematologic toxicities of ELF, FUP, and FAMTX were acceptable, with neutropenia being the major toxicity for all three regimens. Seven treatment-related deaths occurred (two with FUP and five with FAMTX). CONCLUSION: All three investigated regimens demonstrate modest clinical efficacy and should not be regarded as standard treatment for advanced gastric cancer. New strategies should be considered to achieve a better clinical efficacy in the treatment of advanced gastric cancer.
Disease Relapse After TKI Discontinuation In CML Is Related Both To Low Number and Impaired Function Of NK-Cells:Data From Euro-SKI
Authors: Mette Matilda Ilander, Ulla Olsson-Strömberg, Hanna Lähteenmäki, Tiina Kasanen, Perttu Koskenvesa, Stina Söderlund, Martin Hoglund, Berit Markevärn, Anders Själander, Kourosh Lofti, Claes Malm, Anna Lubking, Marja Ekblom, Elena Holm, Mats Björeman, Sören Lehmann, Leif Stenke, Lotta Ohm, Henrik Hjorth-Hansen, Susanne Saussele, Francois-Xavier Mahon, Kimmo Porkka, Johan Richter, Satu Mustjoki
Journal: Blood (2013)
The relationship between sleep quality and the control and severity of bronchial asthma
Authors: Caroline Becker, Carlos Martinez Rivera, Jorge Abad Capa, Maria Luisa Martinez, Laura Rodriguez Pons, Nuria Bruguera Ávila, Zoran Stojanovic, Juan Ruiz Manzano
Journal: European Respiratory Journal (2013)

Introduction

Few studies have comprehensively assessed the quality of sleep in patients with bronchial asthma by full polysomnographic parameters and validated questionnaires.

Material and methods

We performed full polysomnography in 26 selected patients with asthma.We gathered data on their sleep quality through the Pittsburgh sleep quality index (PSQI), the Epworth test, and the Insomnia Severity Index (ISI), and we collected data on asthma control using ACT, health resource utilization in the previous year, pulmonary function, and previous treatment. The Hospital Anxiety and Depression (HAD) test, the Nijmegen questionnaire, and the Sidney Asthma Quality of Life Questionnaire (AQLQ Sidney) were handed out. We divided patients into partially or poorly controlled if the ACT score was <20, and into well controlled if the ACT ≥20. Patients with ≥15 were classified as clinical insomnia, and if they had a PSQI score ≥ 5, as poor sleep quality.

Results

The ACT medium was 18.5 and FEV1 74%. In patients with ACT <20 sleep latency was higher with no significant difference (33 vs.20, p = 0.28), they had the worse PSQI (12 vs.3, p = 0.03) and the worse score in ISI (13.67 vs 2.26, p = 0.020). Patients with clinical insomnia had worse ACT score (19.4 vs. 13.8, p=0.08), hyperventilation (Nijmegen 29 vs 8.7, p = 0.057), worse AQLQ (5.9 vs. 1.7, p = 0.005), anxiety (HDA 16 vs. 5, p = 0.001), depression (HDA 12 vs. 2.6, p = 0.004), and more exacerbations (2.2 vs. 0.7, p=0.07).

Conclusions

There is probably a bidirectional relation between asthma control and poor quality of sleep. We found poor correlation between polysomnographic parameters, sleep quality questionnaires and characteristics of asthma.
A 50-year-old woman with a recurrent oesophageal stricture
Authors: Tahir Akbar, Adnan Al Badri, John N Gordon
Journal: Gut (2015)

A 50-year-old woman presented with a 4-month history of progressive dysphagia and associated weight loss. Her medical history was unremarkable, and she was not taking any medication. Gastroscopy revealed a tight impassable stricture at 30 cm (figure 1A) confirmed on barium swallow (figure 1B). Biopsies from the stricture were reported as consistent with reflux oesophagitis with no evidence of malignancy. The stricture was dilated revealing a short segment of normal distal oesophagus above a small hiatus hernia. She was started on a high-dose proton pump inhibitor. She re-presented 3 months later with recurrent dysphagia and …
Emergency oxygen use and monitoring in the pre-hospital and acute hospital setting - The significance of a common problem
Authors: Jamie Johnstone, Lucy Malpas, Fenella Johnstone, Mike Malpas
Journal: European Respiratory Journal (2012)

Introduction  Evidence shows that oxygen (O 2 ) can cause decompensated type 2 respiratory failure (T2RF) increasing morbidity and mortality in COPD patients.  Aim  To review pre-hospital and emergency hospital use of O 2  in COPD patients.  Methods  All COPD admissions in January 2011 to Worcester Royal Hospital were audited against BTS guidelines.  Results  Ambulance documentation showed no record of previous NIV or O 2  alert card. There is no box to record FiO2 on the ambulance data form. O 2  dose (51.6%) and mask (48.4%) recordings were suboptimal. 60% of patients were given 28% venturi masks and 13.3% non-rebreathe masks. 45.8% of patients were given O 2  with adequate saturations (sats). 72% of patients given O 2  had sats > 92%.  In hospital, 9.5% of clerkings contained a history of prior NIV. 2/3 of patients with adequate sats were given O 2 . 80% of those on O 2  had sats above 92. 36.7% of patients had O 2  prescribed with 45% having correct sats ranges. 15 patients had T2RF; 5 with sats > 92%. 3 patients met the criteria of NIV; all had sats > 92%. Mean length of stay (LOS) was 6 days longer in those who had NIV. 90.5% of discharge letters did not contain an ABG result.  Conclusions  There is still a major issue with O 2  use and monitoring in COPD patients. Patients are being given too much O 2 , it is not prescribed and not being documented accurately. This causes increased morbidity and cost, evidenced by those with hyperoxia developing T2RF and longer LOS. We recommend the ambulance data form includes an FiO 2  box, O 2  prescription is mandatory, documentation is improved and discharge letters include an ABG. Doctors, nurses and paramedics should all be regularly educated in O 2  therapy.
Activity of 2-fluoro-5-methylarabinofuranosyluracil against mouse leukemias sensitive to and resistant to 1-beta-D-arabinofuranosylcytosine.
Authors: Burchenal Jh, Chou Tc, Lokys L, Smith Rs, Watanabe Ka, Su Tl, Fox Jj
Journal: Cancer Research (1982)

A new pyrimidine nucleoside, 2'-fluoro-5-methyl-1-beta-D-arabinofuranosyluracil, previously has been shown to be active against the herpes group of viruses in vitro and in vivo. It is also active against mouse and human leukemic cells in culture and against mouse leukemias L1210, P388, and P815 in vivo. In contrast to other 1-beta-D-arabinofuranosylcytosine (ara-C) derivatives, 2'-fluoro-5-methyl-1-beta-D-arabinofuranosyluracil, when given either i.p. or p.o., is highly active against lines of leukemias P815 and L1210 made resistant to ara-C. Against P815/ara-C and L1210/araC, it is more effective than is 5-azacytidine, a drug which has shown definite effectiveness in patients with acute leukemia whose disease has become resistant to ara-C. For these reasons, 2'-fluoro-5-methyl-1-beta-D-arabinofuranosyluracil would seem to merit clinical trial in patients with acute nonlymphocytic leukemia whose disease has become resistant to ara-C.
High risk of leukemia after short-term dose-intensive chemotherapy in young patients with solid tumors.
Authors: B H Kushner, G Heller, N K Cheung, N Wollner, K Kramer, D Bajorin, T Polyak, P A Meyers
Journal: Journal of Clinical Oncology (1998)

PURPOSE To help fill the gap in knowledge about the risk of leukemia from repetitive high-dose use of alkylating agents and topoisomerase-II inhibitors in young patients with solid tumors. METHODS Poor-risk solid tumors were treated with four courses of cyclophosphamide (4,200 mg/m2)/ doxorubicin (75 mg/m2), and three courses of ifosfamide (9,000 mg/m2)/etoposide (500 mg/m2). The cumulative incidence of treatment-related myelodysplasia/ leukemia (t-AML) was calculated using the method of competing risks. The expected number of leukemic events was calculated by applying national incidence rates to person-years classified by age and sex. RESULTS Among 86 patients (median age, 17 years) monitored for 6 to 88 months (median, 24), five cases of t-AML were detected at 10 to 37 months (median, 17). The expected number of leukemic events in this cohort was .001. Clinical and cytogenetic findings implicated prior alkylator therapy in three cases and prior treatment with topoisomerase-II inhibitors in two. At 40 months, the cumulative incidence of t-AML was 8% (SE 7%). CONCLUSION Repetitive high-dose use of alkylating agents given with topoisomerase-II inhibitors is strongly leukemogenic, even with modest cumulative doses of each drug. This finding is notable for the following reasons: (1) it undermines predictions that limited use of high-dose chemotherapy might be minimally leukemogenic, and (2) it contrasts strikingly with the previously reported low risk of t-AML following treatment of pediatric solid tumors with chemotherapy lacking the alkylator dose-intensity and prominence of etoposide that are hallmarks of current regimens.
Early evaluation of combined fluorouracil and leucovorin as a radiation enhancer for locally unresectable, residual, or recurrent gastrointestinal carcinoma. The North Central Cancer Treatment Group.
Authors: C G Moertel, L L Gunderson, J A Mailliard, P J McKenna, J A Martenson, P A Burch, S S Cha
Journal: Journal of Clinical Oncology (1994)

PURPOSE To develop a tolerable regimen of fluorouracil (5-FU), low-dose leucovorin, and radiation, and to obtain an early estimate of therapeutic effectiveness. PATIENTS AND METHODS Forty patients with locally unresectable or recurrent gastrointestinal carcinoma were studied (pancreas, n = 22; rectum and sigmoid, n = 10; gastric, n = 6; other, n = 2). Irradiation therapy was administered in 1.8-Gy fractions 5 days per week, with total doses ranging from 45 to 54 Gy. 5-FU 400 mg/m2/d plus leucovorin 20 mg/m2/d, both by rapid intravenous injection, were administered for 3 or 4 days during the first and fifth weeks of radiation. 5-FU 425 mg/m2/d plus leucovorin 20 mg/m2/d were administered for 4 days at 4 weeks following radiation and for 5 days at 9 weeks. RESULTS Major toxicities with upper abdominal treatment were nausea, vomiting, weight loss, and leukopenia. A tolerable dosage regimen was radiation at 45 Gy with 4 days of 5-FU plus leucovorin during the first week and 3 days during the last week with postradiation chemotherapy. Major toxicities with pelvic radiation were diarrhea and leukopenia. A tolerable regimen was 54 Gy with 4 days of 5-FU plus leucovorin during the first and fifth week followed by the postradiation chemotherapy. Median survival durations for pancreatic and rectal/sigmoid carcinomas are 13 months and 31 months, respectively. Five patients have no evidence of disease from 38 to 50 months after the onset of therapy (rectal, n = 2; stomach, n = 2; pancreas, n = 1). CONCLUSION We have developed patient-tolerable regimens for combined 5-FU plus leucovorin followed by radiation to the abdomen and to the pelvis. The favorable results observed in locally unresectable disease allow cautious optimism for possible effectiveness in the surgical adjuvant setting, a possibility currently being tested in national trials of rectal and gastric carcinoma.
Obstructive sleep apnea in patients with idiopathic pulmonary fibrosis
Authors: Ahmed Sh. Mohamed, Ibrahim Ibrahim, Mohamed Hantera
Journal: European Respiratory Journal (2012)

Background:  The outcome of patients with idiopathic pulmonary fibrosis (IPF) is poor. Breathlessness and coughing are usually progressive and about 50% of the patients die within 3 years after diagnosis. The role sleep disordered breathing in IPF should be investigated.  Objective:  The aim of this study was to investigate obstructive sleep apnea and associated daytime sleepiness in IPF patients and investigate the correlation between IPF and OSA.  Subjects and Methods:  28 patients with IPF and 10 control subjects matched on age and BMI were included in the study. Sleep quality and its daytime consequences were assessed by the Epworth Sleepiness Scale and all-night polysomnography.  Results:  23 patients had an abnormal ESS (82.1 %). 24 IPF patients (85.71%) had OSA; 21 patients(75%) had mild-to-moderate OSA, and 3 patients(10.71%) had severe OSA. AHI was statistically significant correlated with, ESS, FVC, and TLC.  Conclusion:  Patienta with IPF are at high risk for OSA that may account for reversible daytime fatigue, possibly wrongly ascribed to IPF. Further, without treatment the sleep deprivation and lack of oxygen caused by sleep apnea increases health risks that have a significant negative effect on prognosis of IPF that already carries a poor prognosis.  Recommendation:  sleep evaluation should be extended to IPF patients routinely and the scientific work should focus on the improvement of sleep quality during sleep in these patients.   Ref. Aydogdu M, Firat GS, et al . Assessment of sleep with polysomnography in patients with interstitial lung disease.Tuberk Toraks 2006; 54:213-221.
Protective effect of transcription factor PAX-5 (BSAP) on asthma severity
Authors: Lada Sorokina, Valery Mineev, Michael Nyoma, Vasily Ivanov, Vasily Trofimov
Journal: European Respiratory Journal (2011)

The aim is to evaluate the association of B-cell specific transcription factor PAX-5 amount in patients with different bronchial asthma (BA) courses.   Materials and methods:  Peripheral blood lymphocytes derived from 12 BA patients and healthy were examined before and after 30-minutes IL-4 action. To estimate the mRNA quantity of PAX-5, reverse transcription PCR followed by electrophoresis on agarose gel was performed. PhosphoSTAT6 analyzed by Western blot. Western blotting was performed through standard procedure using antyphosphoSTAT6-antibody (Cell Signaling, USA).   Results:  PAX-5 mRNA levels have trend to increase in patients with mild BA, in comparison with those with moderate and severe BA (data not shown). We revealed important positive correlations of PAX-5 with some characteristics of PFT probably defining severity of BA (%FEV1/FVC after bronchodilator: R=0,755; p=0,031; n=8; PEF%pred. before bronchodilator: R=0,623; p=0,041; n=11; MMEF50% exp. after bronchodilator: R=0,69; p=0,02; n=11) and the level of phosphoSTAT6 that is crucial for Th2-activity (R=0,724; p=0,027; n=9; after IL-4 action: R=0,87; p=0,025; n=6). PAX-5 mRNA levels correlate negatively with serum IgE at the end of exacerbation (r=-1,0; p=0,042; n=4) and with IFN-γmRNA levels (r=-0,511; p=0,004; n=10).   Conclusion:  We revealed the association of PAX-5 and asthma severity. It probably may be explained by the fact of PAX-5 inhibiting B-cell differentiation to IgE-secreting plasmacells that may lead to decreased serum IgE level. IFNγhaving Th2-supressing activity may cause decreasing of PAX-5 amount through additional inhibiting of B-cell activation.  The work was supported by Saint-Petersburg government grant 28-04/17 (Certif. PSP080591).
Cardiovascular Phenotype in HFpEF Patients With or Without Diabetes
Authors: Brian R. Lindman, Victor G. Dávila-Román, Douglas L. Mann, Steven McNulty, Marc J. Semigran, Gregory D. Lewis, Lisa de las Fuentes, Susan M. Joseph, Justin Vader, Adrian F. Hernandez, Margaret M. Redfield
Journal: Journal of the American College of Cardiology (2014)
Pilot telemedicine program for COPD patients based on Kinect® system
Authors: David Bravo, Patricia Sobradillo, Jose Luis Lobo, Maria Ángeles Segura, Marta Inchausti, Verónica S. Hernandez, Julia A. García, Xabi Ribas
Journal: European Respiratory Journal (2013)

New emerging Technologies can help us control our COPD patients.

AIMS: 1. To test the acceptability and usability of a Kinect ® based system in patients with COPD. 2. To describe the interventions derived from the generated alarms.

METHODS: COPD patients with at least one ECOPD were included. A fist information session was performed in groups of 5 patients and carer. Those who accepted to participate received as many formation sessions as necessary. They were equipped with a TV adapted to the necessities of Kinect. They daily answered a symptom questionnaire, sent data on pulsioximetry and temperature and performed upper arms exercises controlled by kinect®.

RESULTS: 29 Patients included. Main characteristics are described in Table 1. Number of formation sessions: 3±1.34. Mean stay in the program was 109.34±38.3 (21-224) days. No patient was unable to learn how to use the technology. Daily adherence was over 97%. Mean punctuation given by the patients: 8.8.

Interventions: Treated at home: 23, Primary Care: 11, Emergency Room: 4, Hospitalization: 11 (Mean stay: 4.4±1.7). Domiciliary Service: 2. Severity of the exacerbations: mild: 61, moderate: 38 and severe: 13.

CONCLUSIONS: A program based on Kinect technology is viable and very well accepted by patients. Exacerbations are mainly treated at home.

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Spontaneous respiratory activity during mechanical ventilation of term born infants
Authors: Olie Chowdhury, Stephanie Kayode, Silke Lee, Simon Hannam, Gerrard F. Rafferty, Anne Greenough
Journal: European Respiratory Journal (2011)

Aim:  Prematurely born infants frequently breathe while being mechanically ventilated and the pattern of the respiratory interaction influences outcome. The different interactions seen are the result of stimulation of respiratory reflexes (Head9s and the Hering-Breuer reflexes). Respiratory reflexes may be weaker in term born compared to prematurely born infants and thus may not influence the outcome of the former. The aim, therefore, of this study was to characterise any spontaneous respiratory efforts of mechanically ventilated infants born at term.   Methods:  To date, ten infants (median gestational age 38 weeks) have been studied at a median postnatal age of five days: five infants on intermittent positive pressure ventilation (IPPV) and five on synchronised intermittent mandatory ventilation (SIMV). Oesophageal, gastric and airway pressures, flow and volume were simultaneously recorded for at least 20 minutes, 100 consecutive breaths were analysed for each baby.   Results:  All the infants breathed during mechanical ventilation. Four patterns of interaction were noted: synchrony, augmented inspiration, active expiration, prolongation of expiration:  Active expiration was significantly more common in the SIMV group (p   Conclusions:  Respiratory reflexes are provoked in term born infants by mechanical inflations. SIMV does not prevent active expiration, this may relate to trigger delay.
Treatment of malignancy-associated hypercalcemia with intravenous aminohydroxypropylidene diphosphonate.
Authors: J J Body, A Borkowski, A Cleeren, O L Bijvoet
Journal: Journal of Clinical Oncology (1986)

Treatment of malignancy-associated hypercalcemia remains unsatisfactory. We have prospectively treated 26 consecutive hypercalcemic cancer patients with intravenous (IV) aminohydroxypropylidene diphosphonate (APD). The drug was administered daily as a 15-mg two-hour IV infusion until both serum and urinary calcium had been normalized for 48 hours. Twenty-four patients were fully evaluable (eight head and neck tumors, seven breast cancers, three epidermoid tumors of the lung, and six miscellaneous neoplasms). Whereas rehydration had only inconsistent effects, APD normalized serum calcium in all patients after a mean of three daily doses: serum calcium decreased from 13.3 +/- 0.4 mg/dL (mean +/- SEM) before APD to 8.0 +/- 0.1 mg/dL at the end of treatment. Ionized calcium declined in parallel to total calcium. APD was as effective in hypercalcemia due to bone metastases as in paraneoplastic hypercalcemia. The drug was tolerated without toxicity and had a prolonged effect: serum calcium remained normal during 3+ weeks (1 + to 8 +) in 17 patients who did not receive or did not respond to antitumoral treatment. APD normalized serum calcium by inhibiting bone resorption, as evidenced by the dramatic decrease in urinary excretion of calcium and hydroxyproline. Inhibition of bone resorption was probably also responsible for the decrease in serum phosphorus from 2.9 +/- 0.2 to 2.0 +/- 0.1 mg/dL. In summary, IV APD constitutes a major advance in the treatment of malignancy-associated hypercalcemia: it is very effective, well tolerated, and has a prolonged efficacy.