tbuckley/cabot-search huggingface dataset:
A randomized phase II trial of antithrombin (AT) products in patients with disseminated intravascular coagulation (DIC) associated with sepsis in advanced pancreatic and biliary cancer.
Authors: Takeshi Tamura, Tatsuya Ioka, Hironari Sueyoshi, Ryoji Takada, Nobuyasu Fukutake, Reiko Ashida, Kazuyoshi Ohkawa, Kazuhiro Katayama
Journal: Journal of Clinical Oncology (2015)

423 Background: A randomized phase 2 trial was conducted in order to investigate the most effective administration method of antithrombin (AT) products in patients with disseminated intravascular coagulation (DIC) associated with sepsis during treatment for advanced pancreatic and biliary cancer (aPBC). Methods: Diagnoses of DIC were made according to the criteria of acute DIC of the Japan Association of acute Medicine. We examined 42 patients who were diagnosed with septic DIC and showed a level of AT lower than 70% during treatment for aPBC. The patients were evenly divided into two groups: Group A (21 patients) received continuous infusions of AT products 1500 IU per day for three days, and the group B (21 patients) received intermittent infusions of AT products 500 IU×3 per day for three days. Changes in the coagulation parameters, inflammatory markers, SIRS positive scores, and DIC scores that occurred during treatment were compared between the two groups. Furthermore, the survival outcomes of the patients were evaluated using the Kaplan-Meier method. Results: Before treatment, there were no significant differences between the two groups with respect to their backgrounds. During treatment, statistically significant differences were seen in the platelet counts, D-dimer test results, Fibrinogen levels, and CRP levels between the two groups. However, no differences were observed between the two groups regarding the changes of AT activity levels, SIRS positive scores, and DIC scores. No statistically significant differences were noted between the groups in regards to their survival outcomes (28 day survival rates: 85.7% versus 71.4%, p=0.283). A multivariate analysis indicated that baseline AT activity levels were the sole factor associated with the 28-day survival rates. The survival outcomes didn’t depend on the administration method of AT products. Conclusions: In this trial, we found that baseline AT activity levels were the sole factor associated with the 28-day survival rates. There was no difference in therapeutic effects between the continuous and intermittent infusions of AT products. Clinical trial information: UMIN 000015105.
Bronchial mucosal dendritic cells and VEGF expression in COPD patients
Authors: Andrea Zanini, Sabrina Della Patrona, Federico Gumiero, Maria Majori, Dario Olivieri, Antonio Spanevello, Alfredo Chetta
Journal: European Respiratory Journal (2012)

Introduction : Dendritic cells (DCs) have a pivotal role in the onset and regulation of innate and adaptive immune responses. A decreased number of mature DCs may occur in the airways of COPD patients, thereby reducing their immune response. Moreover, DCs can affect vascularization process in different physiopathological conditions. There are no data concerning the relationship between DCs and vascular endothelial growth factor (VEGF) in COPD patients.  Objectives : We evaluated the relationship between the expression of VEGF and the density of DCs in the bronchial mucosa of COPD patients.  Methods : Twenty patients with moderate to severe COPD (age 76±10 yr, 3 F; FEV1 51±9%, FEV1⁄VC 48±12%) were studied. Eight healthy subjects represented a control group (CS). Bronchial biopsies were evaluated by immunohistochemistry and presence of DCs was investigated by using antibody directed against CD207, to mark immature DCs, and against CD83, to mark mature DCs.  Results : Comparisons are summarized in the table.  Data are presented as mean±SD. In all COPD patients, CD207+ cells were inversely related to FEV1 (r=-0.52, p Conclusions : Our results show that COPD airways were associated with a decrease in mature DCs and that these cells were inversely related to VEGF expression. Additionally, immature DCs were significantly related to airflow obstruction. We speculate that the DCs-VEGF interplay may play a key role both in angiogenesis and in the immune response in COPD patients.
Double-blind, controlled trial of inositol treatment of depression
Authors: J Levine, Y Barak, M Gonzalves, H Szor, A Elizur, O Kofman, R H Belmaker
Journal: American Journal of Psychiatry (1995)

CSF levels of inositol have been reported to be lower than normal in depressed subjects. The authors administered inositol to depressed patients in a double-blind, controlled trial.Under double-blind conditions, 12 g/day of inositol (N = 13) or placebo (N = 15) was administered to depressed patients for 4 weeks.The overall improvement in scores on the Hamilton Depression Rating Scale was significantly greater for inositol than for placebo at week 4. No changes were noted in hematology or in kidney or liver function.This may be the first use of the precursor strategy for a second messenger rather than a neurotransmitter in treating depression. Although inositol had a significant antidepressant effect in this study, replication is crucial.
P-167 Risk factors for febrile neutropenia in patients with unresectable pancreatic cancer receiving FOLFIRINOX as the first-line treatment
Authors: M. Sasaki, H. Ueno, A. Kuchiba, F. Koga, S. Shiba, Y. Sakamoto, S. Kondo, C. Morizane, T. Okusaka
Journal: Annals of Oncology (2015)
Weekly clinico-pathological meetings: Utility or futile exercise?
Authors: D. Gupta, L. Kumar, A. Sharma
Journal: Journal of Clinical Oncology (2008)

17518 Background: The histopathological diagnosis is the backbone of oncology diagnosis. Errors in these reports can critically affect patient care. At our institute, weekly clinico-pathological meetings are held and attended by faculty and residents of pathology and medical oncology. We analyzed consecutive cases of lymphoma which were discussed in these meetings over a period of 16 months from September 2005 to December 2006 to assess the impact of these meetings in improving diagnostic accuracy. Methods: We retrieved the medical case records of those lymphoma cases discussed in these meetings over the specified time period. Primary pathological diagnosis was compared with diagnosis after discussion. Change in diagnosis was categorized as major if it caused change in treatment plan and as minor if it caused no change in treatment plan. Results: We analyzed fifty cases of lymphoma out of which thirty five cases were of Non- Hodgkin lymphoma and fifteen cases were of Hodgkin disease. Reason for listing for discussion in thirty two cases was for confirmation of pathological diagnosis, for sub typing or grading in fourteen cases and four cases were discussed as no diagnosis was given in primary pathological report. In thirty three (66%) cases, there was no change in diagnosis after discussion, eight (16%) cases had minor changes regarding sub typing or grading not leading to any change in treatment plan and nine (18%) cases had major changes. Among nine major changes we could establish diagnosis in four cases (three Hodgkin disease and one Non Hodgkin lymphoma) for which no diagnosis was available in primary pathology report. Five diagnosis were changed, one from Hodgkin disease to Anaplastic large cell lymphoma, one from T cell non Hodgkin lymphoma to Hodgkin disease, two from diffuse large B cell lymphoma to low grade follicular lymphoma and one diagnosis was amended from B cell NHL to low grade MALT lymphoma. Conclusions: Weekly clinico-pathological meetings allow early revision and refinement of patient diagnosis and management. The process facilitates interaction between clinicians and pathologists and also provides a valuable educational forum. No significant financial relationships to disclose.
Microscopic Hematuria
Authors: Robert A. Cohen, Robert S. Brown
Journal: New England Journal of Medicine (2003)

An otherwise healthy 48-year-old woman is found to have microscopic hematuria (5 red cells per high-power field) on a urinalysis performed by a life insurance company. No other laboratory abnormalities are identified; the serum creatinine concentration is 0.8 mg per deciliter (70.7 μmol per liter). The woman reports no symptoms and is a nonsmoker. Her blood pressure is 118/74 mm Hg, and the findings on physical examination are normal. How should she be evaluated?
A retrospective analysis of lymph node sampling methods in patients with TB lymphadenitis
Authors: Kieran Zucker, Paul Whitaker, Hugh McGann, Timothy Collyns, John Watson
Journal: European Respiratory Journal (2013)

Aims and Background:  Only a limited body of literature exists on how best to investigate suspected  Mycobacterium tuberculosis  (TB) lymphadenopathy. We aimed to identify if any method of lymph node sampling had greater sensitivity in TB diagnosis.  Methods:  Records for all adult patients that were treated for extrapulmonary TB lymphadenitis between 2006 and 2010 were examined. The method of lymph node sampling, the rates of culture positivity, and the timescale of culture positivity were documented.  Results:  133 patients received treatment for extrapulmonary TB lymphadenitis. Blind fine needle aspiration (FNA) was performed in 61 (46%) of patients, ultrasound guided FNA in 17 (13%), TRUCUT biopsy in 10 (8%) and complete surgical excision in 15 (11%). Overall 39% of these patients were either microscopy or culture positive for TB.  The sensitivities of the sampling methods were 61% for blind FNA, 32% for ultrasound guided FNA, 40% for TRUCUT biopsy and 33% for surgical excision. Chi square analysis revealed no significant difference between sampling methods. If a blind FNA sample were to become culture positive this happened by week 2 in 76% of patients and week 3 in 86%.  Conclusions:  Our data suggests that blind FNA yields results that are of equal diagnostic accuracy to alternative methods. The data suggests that week 3 post sampling might represent a suitable time to consider further sampling methods, as most will be positive by this time, if they are to become positive.
Hepatotoxicity of antituberculosis chemotherapy in patients with liver cirrhosis
Authors: Hong Joon Shin, Chan Woo Park, Sung Chul Lim, In Jae Oh, Kyu Sik Kim, Yu Il Kim, Young Chul Kim, Jong Pil Jung, Young Chun Ko, Yong Soo Kwon
Journal: European Respiratory Journal (2012)

Backgroud:  We compared liver cirrhosis (LC) and control patients who were received standard short-course antituberculous (TB) therapy to evaluate the risk of drug induced hepatotoxicity (DIH) in LC patients.   Methods:  Forty two LC patients with newly diagnosed active TB who were received isoniazid, rifampin, ethambutol, and/or pyrazinamide were included in the study. One hundred forty eight patients were selected as control subjects. DIH was defined as a liver transaminase level ≥ 120 IU/L.   Results:  Of all LC patients, the etiology of LC consisted of alcoholic in 31 (74%), hepatitis B in 8 (19%), and hepatitis C in 3 (7%). Mean Child-Pugh score of all LC patients was 7.1±1.2 and Child9s A and B were 16 (38%) and 26 (62%), respectively. Pyrazinamide containing regimens were more commonly used in control patients (24 of 42 LC patients [57%] vs. 138 of 148 control patients [93%], p=0.001). Elevated liver enzyme including transient elevation of transaminase was more frequently found in LC patients (31 of 42 LC patients [74%] vs. 69 of 148 control patients [47%], p=0.002). DIH was also more frequently found in LC patients (6 of 42 LC patients [14%] vs. 6 of 148 control patients [4%], p=0.016). In 5 out of 6 LC patients showed DIH, isoniazid and rifampin were successfully rechallenged and maintained until the end of treatment.   Conclusion:  Our data suggested that LC patients with active TB should be closely monitored liver function tests due to more frequent hepatotoxicity during anti-TB treatment including insoniazid and rifampin.
Salvage Treatment With Paclitaxel, Ifosfamide, and Cisplatin Plus High-Dose Carboplatin, Etoposide, and Thiotepa Followed by Autologous Stem-Cell Rescue in Patients With Relapsed or Refractory Germ Cell Cancer
Authors: O. Rick, C. Bokemeyer, J. Beyer, J. T. Hartmann, N. Schwella, D. Kingreen, S. Neureither, B. Metzner, J. Casper, H. Wandt, F. Hartmann, H. J. Schmoll, G. Derigs, A. Gerl, W. E. Berdel, L. Kanz, W. Siegert
Journal: Journal of Clinical Oncology (2001)

PURPOSE: To study feasibility and efficacy of a new salvage regimen in patients with relapsed and/or refractory germ cell tumors. PATIENTS AND METHODS: Between May 1995 and February 1997, 80 patients were entered onto a phase II study. Conventional-dose salvage treatment with three cycles of paclitaxel 175 mg/m 2 , ifosfamide 5 × 1.2 g/m 2 , and cisplatin 5 × 20 mg/m 2 (TIP) was followed by one cycle of high-dose chemotherapy (HDCT) with carboplatin 500 mg/m 2 × 3, etoposide 600 mg/m 2 × 4, and thiotepa 150 to 250 mg/m 2 × 3 (CET). In 23 patients, one additional cycle of paclitaxel 175 mg/m 2 and ifosfamide 5 g/m 2 (TI) was given immediately before TIP to improve stem-cell mobilization. RESULTS: Fifty-five (69%) of 80 patients responded to TIP, 24 (30%) of 80 patients had stable disease (n = 5) or tumor progression (n = 19), and one patient died. Only 62 (78%) of 80 patients received subsequent HDCT. Among those, 41 (66%) of 62 patients responded and 20 (32%) of 62 patients had stable disease (n = 3) or tumor progression (n = 17). One patient died after HDCT from multiorgan failure. Survival probabilities at 3 years were 30% for overall and 25% for event-free survival. Peripheral neurotoxicity with sensorimotor impairment grade 2 through 4 in 29%, paresthesias grade 2 through 4 in 24%, and skin toxicity grade 2 through 3 in 15% of patients were the most relevant side effects. CONCLUSION: Treatment with TIP followed by high-dose CET is feasible and can induce long-term remissions in 25% of patients with relapsed or refractory germ cell tumors. Peripheral nervous toxicity in approximately one third of patients is a disadvantage of this salvage strategy.
Obesity as the most considerable risk factor for death due to influenza A/H1N1-09 viral infection
Authors: Natalia Lareva, Elena Luzina
Journal: European Respiratory Journal (2012)

The aim of this study was to assess the complications of A/H1N1-09 viral infection in died patients in dependence of body mass. Methods. We reviewed medical records and postmortem examination reports of 33 pts who died in 2009 in Zabaikalsky region of RF. A/H1N1-09 viral infection was confirmed by transcription-polymerase chain reaction method. Results. 14 men and 19 women (average age 39,8±12,5 years) were included. All patients were divided into 2 groups: 22 patients with BMI 32,2±1,08 (the 1st group) and 11 patients with BMI
Excess ventilation and ventilatory constraints during exercise in patients with chronic obstructive pulmonary disease
Authors: Elisabetta Teopompi, Panagiota Tzani, Marina Aiello, Maria Rosaria Gioia, Emilio Marangio, Alfredo Chetta
Journal: European Respiratory Journal (2014)

Purpose: Excess minute ventilation (VE) for a given metabolic rate (VCO2) and ventilatory limitation occur in patients with chronic obstructive pulmonary disease (COPD) during exercise. The aim of the study was to investigate in COPD patients the relationship between VE/VCO2 and dynamic hyperinflation as well as tidal volume (VT) constraints during a cardiopulmonary exercise testing (CPET).  Methods: Fifty-two (13 females) COPD patients performed a CPET. Slope and intercept of the VE/VCO2 linear relationship and changes in inspiratory capacity/total lung capacity (IC/TLC) as well as the ratios of VT at peak of exercise over vital capacity (VTpeak/VC) and IC (VTpeak/IC), as indices of volume excursion, and over forced expiratory volume at 1st second (VTpeak/FEV1), as exercise index of emphysema severity, were measured. The difference peak-rest in end-tidal pressure of CO2 (PETCO2) was also measured.  Results: VE/VCO2 intercept increased as more as the dynamic hyperinflation was severe, by showing a negative correlation with IC/TLC peak (p  Conclusions: In COPD patients, VE/VCO2 slope and intercept may provide different and complementary information on the ventilatory limitation to exercise, as assessed by the changes in the end-expiratory lung volume and in the tidal volume excursion. The combined analysis of the excess ventilation and the ventilatory constraints during exercise may better define the COPD phenotypes.
A Systematic Comparison of 18F-C-SNAT to Established Radiotracer Imaging Agents for the Detection of Tumor Response to Treatment
Authors: Timothy H. Witney, Aileen Hoehne, Robert E. Reeves, Ohad Ilovich, Mohammad Namavari, Bin Shen, Frederick T. Chin, Jianghong Rao, Sanjiv S. Gambhir
Journal: Clinical Cancer Research (2015)

Abstract Purpose: An early readout of tumor response to therapy through measurement of drug or radiation-induced cell death may provide important prognostic indications and improved patient management. It has been shown that the uptake of 18F-C-SNAT can be used to detect early response to therapy in tumors by positron emission tomography (PET) via a mechanism of caspase-3–triggered nanoaggregation. Experimental Design: Here, we compared the preclinical utility of 18F-C-SNAT for the detection of drug-induced cell death to clinically evaluated radiotracers, 18F-FDG, 99mTc-Annexin V, and 18F-ML-10 in tumor cells in culture, and in tumor-bearing mice in vivo. Results: In drug-treated lymphoma cells, 18F-FDG, 99mTc-Annexin V, and 18F-C-SNAT cell-associated radioactivity correlated well to levels of cell death (R2 &amp;gt; 0.8; P &amp;lt; 0.001), with no correlation measured for 18F-ML-10 (R2 = 0.05; P &amp;gt; 0.05). A similar pattern of response was observed in two human NSCLC cell lines following carboplatin treatment. EL-4 tumor uptake of 99mTc-Annexin V and 18F-C-SNAT were increased 1.4- and 2.1-fold, respectively, in drug-treated versus naïve control animals (P &amp;lt; 0.05), although 99mTc-Annexin V binding did not correlate to ex vivo TUNEL staining of tissue sections. A differential response was not observed with either 18F-FDG or 18F-ML-10. Conclusions: We have demonstrated here that 18F-C-SNAT can sensitively detect drug-induced cell death in murine lymphoma and human NSCLC. Despite favorable image contrast obtained with 18F-C-SNAT, the development of next-generation derivatives, using the same novel and promising uptake mechanism, but displaying improved biodistribution profiles, are warranted for maximum clinical utility. Clin Cancer Res; 21(17); 3896–905. ©2015 AACR.
Safety and efficacy of MPDL3280A (anti-PDL1) in combination with bevacizumab (bev) and/or FOLFOX in patients (pts) with metastatic colorectal cancer (mCRC).
Authors: Johanna C. Bendell, John D. Powderly, Christopher Hanyoung Lieu, S. Gail Eckhardt, Herbert Hurwitz, Howard S. Hochster, Janet E. Murphy, Roel Peter Funke, Cheryl Rossi, Jeffrey Wallin, Daniel Waterkamp, Michael J. Pishvaian
Journal: Journal of Clinical Oncology (2015)

704 Background: Cancers can mediate immune evasion via upregulation of PD-L1; blocking PD-L1 may restore tumor-specific T-cell immunity. MPDL3280A, a human anti-PD-L1 mAb containing an engineered Fc domain, prevents PD-L1 binding to its receptors PD-1 and B7.1 on activated T cells. Single-agent MPDL3280A has shown clinical activity in various indications, including NSCLC, bladder cancer, RCC and CRC. VEGF blockade has shown immunomodulatory properties, and certain chemotherapies may have immunogenic effects. Therefore we examined the safety and efficacy of MPDL3280A + bev with or without FOLFOX. Methods: MPDL3280A + bev in refractory mCRC pts (Arm A) and MPDL3280A + bev + FOLFOX in oxaliplatin-naive mCRC pts (Arm B) were evaluated in an open-label, multicenter Phase Ib study. Arm A pts received MPDL3280A 20 mg/kg q3w and bev 15 mg/kg q3w. Arm B pts received MPDL3280A 14 mg/kg q2w, bev 10 mg/kg q2w and mFOLFOX6 at standard doses. Responses were assessed by RECIST v1.1. Potential biomarkers were assessed in pre- and on-treatment liver biopsies. The clinical data cutoff was July 7, 2014. Results: 14 mCRC pts in Arm A and 30 in Arm B were evaluable for safety. In Arm A, median age was 56 y, 29% were male and all had ≥3 prior systemic regimens. In Arm B, median age was 57 y, 53% were male and 70% had no prior systemic therapy. In Arm A, grade 3-4 AEs regardless of attribution were 64%, including abdominal pain, hyperbilirubinemia and pneumonia (14% each). 73% of Arm B pts had grade 3-4 AEs, including neutropenia (40%), diarrhea (13%), increased ALT (10%) and increased AST (10%). Grade ≥3 MPDL3280A-related AEs were 7% in Arm A and 20% in Arm B. For pts with ≥1 tumor assessment, the unconfirmed ORR was 8% (1/13) in Arm A and 36% (9/25) in Arm B. The unconfirmed ORR was 44% (8/18) for Arm B first-line pts. Minimum follow-up was 1.9 mo in Arm A and 2.2 mo in Arm B. Updated data, including biomarkers, will be presented. Conclusions: MPDL3280A + bev with or without FOLFOXwas well tolerated with no unexpected toxicities. Clinical activity was observed with both treatment combinations. Longer follow-up and randomized studies will be needed to estimate the potential benefit of adding MPDL3280A to chemotherapy. Clinical trial information: NCT01633970.
Thirty-Month Outcome in Patients With Anorexia or Bulimia Nervosa and Concomitant Obsessive-Compulsive Disorder
Authors: Andreas Thiel, Markus Züger, Georg E. Jacoby, Gerhard Schüáler
Journal: American Journal of Psychiatry (1998)

The present study examines whether concomitant obsessive-compulsive disorder (OCD) indicates a poorer prognosis for patients with anorexia or bulimia nervosa.Seventy-five female inpatients who met DSM-IV criteria for anorexia or bulimia nervosa took part in the follow-up study; 29 of these patients met criteria for concomitant OCD. All patients were investigated twice: during inpatient treatment and at follow-up 30 months after discharge. A semistructured diagnostic interview was used as well as the Eating Disorder Inventory and the Hamburg Obsession-Compulsion Inventory--Short Form.At follow-up, 51% (N = 38) of the patients no longer fulfilled DSM-IV criteria for anorexia or bulimia nervosa, but this improvement was not significantly correlated with the earlier presence of concomitant OCD. Analysis of variance for repeated measures revealed significant improvement over time on six of the eight Eating Disorder Inventory subscales for all patients regardless of OCD presence. Furthermore, no significant group effects or group-by-time interactions were identified. Clinically significant change, as reflected by improvement in scores on the Eating Disorder Inventory, was seen somewhat more often in patients without concomitant OCD, but this trend was not statistically significant. The patients whose eating disorders were most improved at follow-up also showed the highest reduction of obsessions and compulsions.The results suggest that concomitant OCD does not indicate a significantly poorer prognosis for patients with anorexia or bulimia nervosa.