tbuckley/cabot-search huggingface dataset:
What Is “Appropriate” Care for Ovarian Cancer?
Authors: Donald W. Wiper
Journal: Journal of Clinical Oncology (2004)

time between two modalities.Thus, we favored delivery of both drugs by continuous infusion, simultaneously with radiation.In a pilot study of CCRT for stage IV nasopharyngeal carcinoma (NPC) [2], we used double intravenous lines.However, it is not convenient.In a phase II trial [3], we changed concurrent chemotherapy to a conventional schedule (ie, cisplatin 75 mg/m 2 , 2 hours infusion at day 1, followed by FU 400 mg/m 2 /d, for 96-hour continuous infusion).The compliance to this most acceptable schedule was relatively poor for the first 49 enrolled patients.Three patients interrupted CCRT prematurely after 15, 25, and 55.5 Gy.Three patients interrupted the radiotherapy for 1 to 4.5 weeks, and two patients refused the second cycle of concurrent chemotherapy.Then, we tried the concurrent chemotherapeutic agents in a single-infusion solution for the last 14 patients; we observed good tolerance with similar tumor response.Consequently, we adopted this schedule in our phase III trial [1].Adverse reaction and anticancer activity are two major concerns of admixtures delivery in clinical practice.During more than 10 years experience, we did not observe any color or turbidity changes, or in-dwelling catheter blockage.Although one report showed evidence of substantial loss of cisplatin in the mixture of cisplatin and FU [4], the cisplatin ϩ FU or cisplatin ϩ FU ϩ leucovorin mixtures were shown to be effective in either concurrent/neoadjuvant/adjuvant chemotherapy for advanced NPC, or primary chemotherapy for disseminated disease [1,3,[5][6][7][8].These results support the idea that, except for free forms of each drug in the mixture, a putative platinum-FU adduct is still effective as a cytotoxic agent [9], or may act as a radioenhancer.In comparison with different administration schedules of concurrent chemotherapy for NPC (cisplatin 100 mg/m 2 , every 3 weeks [10]; cisplatin 40 mg/m 2 weekly [11]; or cisplatin 60 mg/m 2 , day 1, followed by FU 600 mg/m 2 /d, 5-day continuous infusion [12]), our mixture in a single-infusion pump seemed to be at least as efficacious as or superior to the other protocols with fewer side effects.In addition, our infusion procedure is the most convenient in clinical practice and can be given as an outpatient procedure.The basic mechanism of drug mixture interaction with radiation is unclear, and deserves to be investigated in the future.
The impact of skin damage due to cutaneous lupus on quality of life
Authors: S.M. Verma, J. Okawa, K.J. Propert, V.P. Werth
Journal: British Journal of Dermatology (2013)

Patients with more severe cutaneous lupus erythematosus (CLE) have a poorer quality of life (QoL). Racial and ethnic disparities have been reported in disease activity and outcomes in systemic lupus erythematosus, but similar information is not available for CLE.To evaluate the impact of lupus-related skin damage on skin-specific QoL, and to analyse differences stratified by ethnic background.Data collected included sex, race, diagnosis and Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) and Skindex-29 scores. These parameters were analysed at the initial and last visits. CLASI damage scores (dyspigmentation and scarring) and activity scores were collected, grouped by ethnicity, and correlated with Skindex-29. Overall, 223 patients were analysed at baseline, with 141 completing more than one study visit.The majority of patients were white (63·7%), followed by African American (29·1%) and Asian American (4·0%). African American patients accounted for a disproportionate percentage of both localized (50%) and generalized discoid lupus erythematosus (DLE) (49%). Median CLASI damage scores differed significantly between the African American, white and Asian American patients, at both the first (8·5, 4·0, 7·0, respectively; P < 0·0001) and last visit (10·0, 6·0, 8·5, respectively; P < 0·01). CLASI damage scores in African Americans correlated with CLASI activity scores (Spearman r = 0·45, P = 0·0003).There was no significant correlation between CLASI damage scores and Skindex domains overall. Individually, dyspigmentation and scarring also did not have a significant effect on QoL. Ethnic differences in patients with CLE were found: African American patients exhibited a high rate of DLE and experienced damage early in their disease course, frequently in conjunction with disease activity.
Bortezomib to Treat the TEMPI Syndrome
Authors: Mary Kwok, Neha Korde, Ola Landgren
Journal: New England Journal of Medicine (2012)

Telangiectasias, erythrocytosis, monoclonal gammopathy, perinephric-fluid collection, and intrapulmonary shunting are characteristic of the TEMPI syndrome. A case report documents improvement with bortezomib, a drug used in the treatment of myeloma.
Transforming healthcare: necessary but difficult
Authors: C. Kaplan, E. Moody, S. Gee
Journal: BMJ (2014)

<h3>Purpose</h3> The Trellix (Shape Memory Medical, Inc., Santa Clara, CA) is a new generation shape memory polymer coated coil designed to expand for increased volume filling after implantation. The purpose of this study was to compare the efficacy of the Trellix coil in the rabbit aneurysm model. <h3>Methods</h3> Trellix and bare platinum coils were implanted in rabbit elastase-induced aneurysms and followed up at 30 days (n=10 for each group) and 90 days (n=5 for each group). Angiographic aneurysm occlusion was rated as stable, progressive or recanalization. Aneurysm specimen were harvested and subjected to histological studies (H and E staining). Comparisons of angiographic outcome, histologic healing score and neointimal thickness between two groups were performed. <h3>Results</h3> The angiographic stable or progressive aneurysm occlusion rate in Trellix group was 4 vs 4 at 30 days and 1 vs 3 at 90 days compared to control group. Mean histologic healing score was not significant between Trellix and control group at 30 days (5.5±2.3 vs 5.9±2.2), but 70% higher in Trellix group at 90 days (7.8±2.1 vs 4.5±2.4). Mean neointima thickness covering the neck was significantly higher in Trellix group at both follow up time points (0.16±0.06 vs 0.05±0.04 mm, p=0.0001 at 30 days; and 0.13±0.02 vs 0.03±0.01 at 90 days, p=0.00001). Microscopic evaluation demonstrated Trellix group at 90 day had high level of connective tissue filled in the aneurysm cavity compared to other groups (figure 1). <h3>Conclusion</h3> Trellix coil can promote neointima formation along aneurysm neck, which might be helpful for long term aneurysm healing. <h3>Disclosures</h3> <b>Y. Ding:</b> None. <b>D. Dai:</b> None. <b>S. Herting:</b> None. <b>A. Boyle:</b> None. <b>L. Nash:</b> None. <b>S. Asnafi:</b> None. <b>D. Jakaitas:</b> None. <b>C. Johnson:</b> None. <b>D. Maitland:</b> None. <b>D. Kallmes:</b> None. <b>R. Kadirvel:</b> None.
At what blood alcohol concentration should drink-driving be illegal?
Authors: A Guppy
Journal: BMJ (1994)

steps to improve surgical technique.Procedures can also be recorded and replayed.In neurosurgery researchers are trying to combine live video information with three dimensional computer images of the brain to help in planning operations (W Lorensen et al, proceedings of medicine meets virtual reality II, San Diego, Jan 1994).This procedure uses off the shelf video products and a computer to combine the images of both signals.The surgeon sees a computed tomography scan or magnetic resonance imaging scan projected over the actual patient.The result is an intraoperative blend ofvideo and computer data.Volumetric stereotaxis is another method of planning neurosurgery (P Kelly, proceedings of medicine meets virtual reality II, San Diego, Jan 1994).This technique also uses datasets obtained with computed tomography and magnetic resonance imaging.The patient and the scan are linked by the technology of frameless stereotaxis.Magnetic field digitisers (tracking devices using magnetic forces) and computers are used to show where the instruments are.The intraoperative computer uses the information from the intraoperative micro- scope to update the surgeon continuously on the position of the surgical instrument.These methods of planning neuro- surgical procedures are useful both preoperatively and perioperatively.They can help a surgeon to plan the best site for a skin incision, craniotomy, and brain incision.Such accuracy would minimise the injury to normal brain tissue.Perioper- atively the procedure could pinpoint the site of the lesion, indicating in real time where the abnormal tissue ends and normal tissue begins.But, while these methods are promising, they have so far proved difficult to use.Hopefully, as the technology improves and becomes more user friendly neurosurgeons will be able to use these systems on patients with previously inoperable tumours.Telepresence surgery is performed on a patient in an operating theatre containing a stereoscopic camera and a robot.At a separate location the surgical control workstation has a three-dimensional monitor the surgical input-output devices closely resembling the instruments that would be used in an operation.2This system allows a surgeon to operate on patients in remote locations and has been developed for use in battlefields.It could, however, enable specialised surgeons to operate on patients at a distance.Although all of these systems are still being developed, they hold great promise for future training and planning and performance of surgical procedures.Cine'-Med is researching and developing virtual clinic surgical simulation.
Endoglin (CD105) Up-regulation in Pulmonary Microvasculature of Ventilated Preterm Infants
Authors: Monique E. De Paepe, Chintan Patel, Amy Tsai, Sravanthi Gundavarapu, Quanfu Mao
Journal: American Journal of Respiratory and Critical Care Medicine (2008)

Preterm infants exposed to mechanical ventilation and oxygen are at risk for bronchopulmonary dysplasia (BPD), a multifactorial chronic lung disorder characterized by arrested alveolar development. Studies have described disruption of microvascular development in BPD, characterized by primitive angioarchitectural patterns reminiscent of the canalicular/saccular stages of lung development. The molecular regulation of this BPD-associated dysangiogenesis remains undetermined. Endoglin (CD105), a hypoxia-inducible transforming growth factor-beta coreceptor, has been implicated as an important regulator of angiogenesis in various neoplastic and nonneoplastic conditions. The aim of this study was to investigate the expression of endoglin and other angiogenesis-related factors in ventilated preterm human lungs. We have studied endoglin protein and mRNA expression in postmortem lungs of short-term and long-term ventilated preterm infants. Control subjects were age-matched infants who had lived for less than 1 hour. Lungs of short-term ventilated preterm infants showed significant upregulation of endoglin mRNA and protein levels, immunolocalized to the microvasculature. Similar but more variable endoglin upregulation was noted in lungs of long-term ventilated infants with BPD. The mRNA levels of vascular endothelial growth factor, angiopoietin-1, and their respective receptors were significantly lower in ventilated lungs than in age-matched nonventilated control lungs. BPD is associated with a shift from traditional angiogenic growth factors (vascular endothelial growth factor, angiopoietin-1) to alternative regulators such as endoglin, which may contribute to BPD-associated microvascular dysangiogenesis.
Abstract 1200: Characterization of a novel radiation-induced sarcoma cell line
Authors: Julie E. Lang, Brandon Nokes, Grishma Sheth, Petr Novak, Laura Fuchs, George S. Watts, Bernard W. Futscher, Neal Mineyev, Weizhu Zhu, Lauren LeBeau, Ray Nagle, Lee Cranmer
Journal: Cancer Research (2014)

Abstract Background: Radiation-induced sarcoma (RIS) is a potential complication of cancer treatment. No widely available cell line models currently exist to facilitate studies of RIS. Methods: We derived a primary human cell line, UACC-SARC1, from a RIS. Short tandem repeat (STR) genotyping was used to confirm that this cell line was propagated from the tumor. Further characterization of this cell line involved comparing 24 markers using immunocytochemistry (ICC) to immunohistochemistry (IHC) of the tumor, a Matrigel invasion assay, karyotyping of the cell line, comparative genomic hybridization (CGH), DNA sequencing using the Ion AmpliSeq Cancer panel and in vivo mouse xenografts after subcutaneous injection of UACC-SARC1 in immunodeficient mice. Results: STR profiling of UACC-SARC1 was virtually identical to its parental tumor. IHC analysis of the tumor and ICC analysis of UACC-SARC1 revealed shared expression of vimentin, osteonectin, CD68, Ki67 and PTEN but tumor-restricted expression of the histiocyte markers α1-antitrypsin and α1-antichymotrypsin. Karyotyping of the tumor demonstrated aneuploidy. CGH provided direct genetic comparison between the tumor and UACC-SARC1. Sequencing of 740 mutation hotspots revealed no mutations in UACC-SARC1 nor in the tumor. SCID mice xenografts exhibited tumor formation but resulting tumors failed to metastasize. Further xenografts with NOD SCID gamma (NSG) mice are planned. The doubling time of UACC-SARC1 was 28.3 hours. Conclusion: Our novel RIS strain constitutes a useful tool for pre-clinical studies of this rare, aggressive disease. Citation Format: Julie E. Lang, Brandon Nokes, Grishma Sheth, Petr Novak, Laura Fuchs, George S. Watts, Bernard W. Futscher, Neal Mineyev, Weizhu Zhu, Lauren LeBeau, Ray Nagle, Lee Cranmer. Characterization of a novel radiation-induced sarcoma cell line. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1200. doi:10.1158/1538-7445.AM2014-1200
Interpretation of Serum Calcium in Patients with Abnormal Serum Proteins
Authors: R. B. Payne, A. J. Little, R. B. Williams, J. R. Milner
Journal: BMJ (1973)

Two hundred consecutive specimens received in this laboratory for “liver function tests” showed a wide range of abnormal protein concentrations. Calcium concentration correlated closely with albumin (r = 0·867) but less closely with total protein (r = 0·682). A simple formula for adjusting calcium concentration was derived from the regression equation of calcium on albumin. Adjusted calcium = calcium - albumin + 4·0, where calcium is in mg/100 ml and albumin in g/100 ml. Low calcium concentrations were found in 49 (24·5%) and raised concentrations in six (3%) of the 200 blood specimens taken for liver function tests. After adjustment, the 95% limits of the observed range were identical with the 95% limits of the normal range determined in this laboratory. Unlike adjustments based on total protein or specific gravity, the adjustment on albumin in 39 specimens which showed hypergammaglobulinaemia on electrophoresis gave normal calcium concentrations.
Cutaneous Graft-Versus-Host Disease on Tc-99m Leukocyte Scintigraphy
Authors: Erik Mittra, I Ross McDougall
Journal: Clinical Nuclear Medicine (2009)

Leukocyte scintigraphy has previously been used to evaluate gastrointestinal graft-versus-host disease (GVHD). No reports have described their utility in cutaneous GVHD or the ability of leukocyte scintigraphy to evaluate treatment response at any site. This case shows significant radiolabeled leukocyte uptake in a man with extensive cutaneous GVHD, with subsequent near complete resolution after therapy. As such, leukocyte scintigraphy may provide an alternate way to assess the burden of GVHD and response to treatment.
Endoscopic Aspect of Cronkhite-Canada Syndrome
Authors: M. Classen, W. Rösch
Journal: Endoscopy (1971)

The endoscopic findings in a 67 year old patient with Cronkhite-Canada syndrome after partial gastrectomy are reported. In the gastric remnant and duodenum the mucosa was covered by numerous hydatiforme polyps which on histological examination proved to be most probably of inflammatory origin showing groups of mucoid glands with marked cystic dilation and extensive edema of the tunica propria. During rectosigmoidoscopy only a few glassy polyps were seen which increased in number towards the descending colon. Follow-up studies after one year of conservative treatment with how residue diet revealed a regression of the polyps in regard to size and number.
Ventricular function in cirrhosis and portasystemic shunt: A two-dimensional echocardiographic study
Authors: Helmut Keller, Vera Bezjak, Beatrice Stegaru, Jan Buss, Eggert Holm, Dieter L. Heene
Journal: Hepatology (1988)

Cardiovascular alterations such as increased heart rate, high cardiac output, reduced systemic vascular resistance, and in most of the cases, increased contractility parameters have been recognized in patients with advanced liver disease. Some investigators define a cirrhotic cardiomyopathy as a hyperdynamic failure of the heart. Consequently, in patients with cirrhosis, the risk of developing further circulatory deterioration may be increased in situations which stress the cardiovascular system. After opening a portocaval shunt, it is expected that a large amount of blood will be distributed from the splanchnic to the pulmonary circulation and put a strain on the heart. This two-dimensional echocardiographic study was made in 30 patients with cirrhosis and in 20 patients who were chronically treated (range: 16 to 156 months) with portasystemic shunt for prevention of hemorrhage from esophageal variceal bleeding. Patients with portasystemic shunts revealed a change in hemodynamic pattern. There was a significant increase in the left ventricular end-diastolic volume index and also a slight increase in the left ventricular end-systolic index. Cardiac output remained high despite a significant decrease in heart rate due to an elevated left ventricular stroke volume index. The parameters of systolic ventricular performance were normal. In contrast to the acute opening of the portacaval shunt, the chronic shunt volume put no strain of clinical significance on the heart.
Examination of the Larynx-Reply
Authors: Harold C. Klein
Journal: JAMA (1982)

<h3>In Reply.—</h3> I am grateful for the stimulating letters from Drs Deeb, Toohill, and Flaum. In answer to Dr Deeb, I do believe that expecting to resolve the issue via a return to rotating internships in our medical training is wistful thinking. In our reported survey, we found that the physicians trained in the old rotational system were as ill-equipped and as unwilling to undertake laryngoscopy as their younger counterparts. The problem is not how much exposure the student gets, but, rather, to what he is exposed. The mirror cannot work for us. The telescope at least is within our capability. Dr Toohill's comment is well taken because it certainly has to take time and many examinations of the larynx to become familiar with its vagaries and variances. Just as putting a stethoscope in the ears of a novice does not qualify him as a cardiologist, so the telescope does
Cardiovascular response to acute hypoxemia in adult rats hypoxemic neonatally
Authors: C Rohlicek
Journal: Cardiovascular Research (2002)

Objective: To determine the effects of chronic hypoxemia neonatally on the cardiovascular response to acute hypoxemia in adulthood. Methods: Experiments were conducted on adult rats (82±2 days) which had been made chronically hypoxemic (hypobaric hypoxia equivalent to FiO2=0.14) during the first ten days of life but raised in room air (Neonatally Hypoxemia) as well as on adult rats never previously hypoxemic (Control). The animals were instrumented with catheters in the right common carotid artery and superior vena cava for measurements of mean systemic arterial pressure (MAP), central venous pressure, heart rate (HR), arterial blood gases, and arterial as well as mixed venous O2 saturation. Oxygen consumption (O2) was measured allowing calculation of cardiac index (CI), stroke volume index (SVI) and systemic vascular resistance index (SVRI). The rats were made acutely hypoxemic by exposure to FiO2=0.10 for 20 min. Results: HR increased and MAP decreased to similar extents in both groups during acute hypoxemia. However, SVI and CI increased significantly (P<0.05) during acute hypoxemia in the Neonatally Hypoxemic group (24±6%, 41±8%) but respectively decreased and did not change in the Control animals (−13±6%, 2±6%). SVRI fell significantly more during hypoxemia in the Neonatally Hypoxemic animals than in the Control group (36±4% vs. 14±5%). Conclusions: Hypoxemia experienced in early life has long-term effects on the cardiovascular response to acute hypoxemia at maturity. This may have important implications for individuals hypoxemic in early life due to congenital cyanotic heart defects or pulmonary disease secondary to prematurity.
Evidence from convergent evolution and causal reasoning suggests that conclusions on human uniqueness may be premature
Authors: Alex H. Taylor, Nicola S. Clayton
Journal: Behavioral and Brain Sciences (2012)

Abstract We agree with Vaesen that there is evidence for cognitive differences between humans and other primates. However, it is too early to draw firm conclusions about the uniqueness of the cognitive mechanisms underlying human tool use. Tests of causal understanding are in their infancy, as is the study of animals more distantly related to humans.
Improving surveillance of MRSA bacteraemia
Authors: Anthony P Morton
Journal: BMJ (2005)

Improving surveillance of MRSA bacteraemiaData from north west England support Oxfordshire findings Editor-Wyllie et al conclude that admission cultures accounted for 24% of total hospital methicillin resistant Staphylococcus aureus (MRSA) bacteraemia episodes over seven years to March 2004. 1 Data collected from five district general hospitals and one university hospital in Cheshire and Merseyside and one district general hospital in greater Manchester support this view.This group of hospitals has collected enhanced MRSA bacteraemia surveillance data using published case definitions from the Department of Health since April 2004.Anonymised data are collected on paper forms and analysed using the FORMIC data capture system.In all, 534 cases of S aureus bacteraemia were identified between April 2004 and March 2005, 334 being methicillin sensitive S aureus bacteraemia and 200 MRSA bacteraemia.Sixty six of the MRSA bacteraemia cases occurred within 48 hours of arrival in hospital, 16 being related to a previous hospital admission, 25 in patients known to have been colonised with MRSA, and 13 in patients admitted from nursing or residential homes.Thirty five cases were admitted as medical specialties, 25 of them in patients over 65.Our results support the suggestion by Wyllie et al that anti-MRSA treatment should be considered for patients with possible staphylococcal sepsis who have previously been admitted or known to be colonised with MRSA.In a predominantly district general hospital setting, anti-MRSA treatment should also be considered for possible staphylococcal sepsis in elderly medical admissions and admissions from nursing homes.