tbuckley/cabot-search huggingface dataset:
Health-Related Quality of Life in Cancer Patients—More Answers but Many Questions Remain
Authors: Pamela J. Goodwin, Srikala S. Sridhar
Journal: JNCI Journal of the National Cancer Institute (2009)

Patient-reported outcomes, including health-related quality of life, symptoms, and functional status are well established in oncology. They can describe the clinical course of cancer, aid in the selection of optimal treatment, or allow comparison of cancer patient populations with those with other diseases and with the general population. In this issue of the Journal, two reports ( 1 , 2 ) provide new insight into different aspects of health-related quality of life in cancer patients. The Medical Outcomes Survey Short Form 36 (MOS SF-36) ( 3 ) quality-of-life questionnaire was used in both reports; it is a well-validated, reliable, generic quality-of-life instrument that can be used in both medically ill and healthy populations in a valid fashion; it provides information on several aspects of functioning and yields two composite scores — physical and mental. The MOS SF-36 was supplemented with additional patient-reported outcomes in both studies. Reeve et al. ( 1 ) studied individuals aged 65 years or older who did or did not develop cancer during a 2-year period. They evaluated change in these two groups, matching or adjusting for key variables associated with quality of life, including age, comorbidity, education, sex, race or ethnicity, marital status, smoking status, and circumstances of questionnaire administration. Not unexpectedly, those who developed one of several common malignancies (prostate, breast, bladder, colorectal, kidney, and lung cancer and nonHodgkin lymphoma) experienced a statistically signifi cantly greater reduction in physical functioning than those who did not develop cancer. This difference was clinically signifi cant (>0.5 SD) in patients with non-Hodgkin lymphoma and kidney and non – small cell lung cancer. Having cancer was also associated with a reduced ability to perform many activities of daily living, although specifi c impacts differed across cancer types. Only lung cancer patients experienced statistically signifi cant increases in bodily pain and statistically and clinically signifi cant reductions in mental health scores. Reductions in social functioning and vitality were cancer specifi c. The demonstration that a diagnosis of cancer adversely impact quality of life relative to the general population is an important one
Verapamil Restoration of Daunorubicin Responsiveness in Daunorubicin-resistant Ehrlich Ascites Carcinoma
Authors: Lewis M. Slater, Sandra L. Murray, Martha W. Wetzel, Ronald M. Wisdom, Emily M. Duvall
Journal: Journal of Clinical Investigation (1982)

We have studied the influence of verapamil hydrochloride on the in vitro and in vivo effects of daunorubicin in Ehrlich ascites carcinoma. Daunorubicin-sensitive tumor was rendered resistant to daunorubicin by the continuous treatment of sequential generations of tumor-bearing BALB/c mice. The ability of daunorubicin to inhibit [3H]uridine and [3H]thymidine incorporation and the effect of daunorubicin on the mean survival time of host animals bearing daunorubicin-sensitive and daunorubicin-resistant Ehrlich ascites carcinoma were compared. The addition of verapamil to daunorubicin in vitro reduced the concentration of daunorubicin required to inhibit 50% of DNA and RNA synthesis in the daunorubicin-resistant tumor to that required in the daunorubicin-sensitive tumor, from 6 and 4.4 μg/ml to 1.5 and 1.3 μg/ml, respectively. Verapamil also restored drug sensitivity to daunorubicin-resistant Ehrlich ascites carcinoma in vivo. The 21.7±0.7 d mean survival time (MST) of BALB/c mice bearing daunorubicin-resistant tumor treated with daunorubicin alone rose to 44.0±0.7 d when the same tumor was treated with verapamil and daunorubicin, P < 0.001. This in vivo effect is specific for daunorubicin-resistant Ehrlich ascites carcinoma, since there is no alteration in MST of BALB/c mice bearing daunorubicin-sensitive or daunorubicin-resistant tumor when they are treated with verapamil alone or when BALB/c mice bearing daunorubicin-sensitive tumor are treated with daunorubicin and verapamil.
Skeletal muscle utilization of free fatty acids in women with visceral obesity.
Authors: S R Colberg, J A Simoneau, F L Thaete, D E Kelley
Journal: Journal of Clinical Investigation (1995)

Visceral obesity is strongly associated with insulin resistance. One potential cause is increased availability of FFA. Alternatively, it has been proposed that there is impaired oxidation of lipid in individuals at risk for obesity. The extent to which either concept involves skeletal muscle is uncertain. To examine these opposing hypotheses, 17 healthy lean and obese premenopausal women, among whom cross-sectional area of visceral fat ranged from 18 to 180 cm2, participated in leg balance studies for measurement of FFA and glucose utilization during basal and insulin-stimulated conditions. A metabolic profile of skeletal muscle, based on enzyme activity, was determined in vastus lateralis muscle obtained by percutaneous biopsy. Visceral fat content was negatively correlated with insulin sensitivity (rates of leg glucose uptake and storage), but insulin resistance was not caused by glucose-FFA competition. During hyperinsulinemia, neither leg FFA uptake nor oxidation was increased in women with visceral obesity. During fasting conditions, however, rates of FFA uptake across the leg were negatively correlated with visceral adiposity as were activities of muscle carnitine palmitoyl transferase and citrate synthase. In summary, visceral adiposity is clearly associated with skeletal muscle insulin resistance but this is not due to glucose-FFA substrate competition. Instead, women with visceral obesity have reduced postabsorptive FFA utilization by muscle.
Monitoring anti-TNF treatment in rheumatoid arthritis: responsiveness of magnetic resonance imaging and ultrasonography of the dominant wrist joint compared with conventional measures of disease activity and structural damage
Authors: E A Haavardsholm, M Ostergaard, H B Hammer, P Boyesen, A Boonen, D van der Heijde, T K Kvien
Journal: Annals of the Rheumatic Diseases (2008)

<h3>Objectives:</h3> To evaluate the responsiveness of magnetic resonance imaging (MRI) and ultrasonography (US) compared with conventional measures of disease activity and structural damage in patients with rheumatoid arthritis (RA) during the first year of treatment with anti-tumour necrosis factor α (TNFα). <h3>Methods:</h3> A cohort of patients with RA (N = 36, median age 53 years, disease duration 7.6 years and disease activity score (DAS28) 5.7) was evaluated by core measures of disease activity, US (one wrist), MRI (one wrist) and conventional radiography (CR, both hands and wrists) at initiation of treatment with anti-TNFα agents and after 3, 6 and 12 months. Responsiveness was assessed by standardised response means (SRM). Accepted thresholds were applied to classify responsiveness as trivial, low, moderate or good. <h3>Results:</h3> MRI synovitis (SRM between −0.79 and −0.92) and the MRI total inflammation score comprising synovitis, tenosynovitis and bone marrow oedema (SRM between −1.05 and −1.24) were highly responsive. Moderate to high responsiveness was found for MRI tenosynovitis and bone marrow oedema, all the composite indices (DAS28, simplified disease activity index (SDAI) and clinical disease activity index (CDAI)) and the 28-swollen joint count. US displayed low to moderate responsiveness. The MRI erosion score displayed low responsiveness but was more responsive than CR measures at 3 and 6 months follow-up. MRI and CR measures of annual progression rates of damage performed similarly and were highly responsive. <h3>Conclusions:</h3> The most responsive measure of inflammation when evaluating anti-TNFα medication was a composite measure comprising MRI synovitis, tenosynovitis and bone marrow oedema, and this may be a promising outcome measure in clinical studies.
Pistorius ineligible for the Olympic Games: the right decision
Authors: Giuseppe Lippi, Camilla Mattiuzzi
Journal: British Journal of Sports Medicine (2008)

All his life, Oscar Pistorius has had to battle adversity. Born 21 years ago in South Africa without fibulas, he was only 11 months old when his legs were amputated below the knee. What he did not lack, however, was tenacity and five years ago he began running competitively using prosthetic racing blades (J-shaped carbon-fibre “Cheetah” extensions, see fig 1). Nine months later he won the 200 metres at the 2004 Paralympic Games in Athens. 



Figure 1 Oscar Pistorius.

Oscar, world record holder in the 100, 200 and 400 m Paralympic events, had a dream—to compete in the Beijing Olympics by qualifying for South Africa. In mid-January, however, his dream was dashed when the International Association of Athletics Federations (IAAF) outlawed his prosthetic racing blades; the International Olympic Committee upheld that decision.

The IAAF decision was based on the statement of German Professor Gert-Peter Brueggemann, who conducted tests on the prosthetic limbs and concluded that the blades might …
Getting to the Heart of HIV and Myocardial Infarction
Authors: Patrick W. G. Mallon
Journal: JAMA Internal Medicine (2013)

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An 83-year-old female with worsening dyspnoea and bleeding from a cavernostomy
Authors: M. Scharitzer, G. Dekan, L. Stiebellehner, A. A. Bankier
Journal: European Respiratory Journal (2005)

An 83-yr-old female presented with a history of worsening dyspnoea.In 1952, the patient had undergone surgical treatment for progressive pulmonary tuberculosis (TB) of the left-upper lobe.Treatment had consisted of an artificial pneumothorax and a cavernostomy via incision and drainage of a tuberculous cavity.Since surgery, the patient had cared for the cavernostomy herself by occasionally draining secretions using a plastic tube prescribed by a general practitioner.There had been no other post-surgical surveillance over almost 50 yrs.The patient had no history of smoking.
Computer Modeling and Simulation of Human Movement
Authors: Marcus G. Pandy
Journal: Annual Review of Biomedical Engineering (2001)

▪ Abstract Recent interest in using modeling and simulation to study movement is driven by the belief that this approach can provide insight into how the nervous system and muscles interact to produce coordinated motion of the body parts. With the computational resources available today, large-scale models of the body can be used to produce realistic simulations of movement that are an order of magnitude more complex than those produced just 10 years ago. This chapter reviews how the structure of the neuromusculoskeletal system is commonly represented in a multijoint model of movement, how modeling may be combined with optimization theory to simulate the dynamics of a motor task, and how model output can be analyzed to describe and explain muscle function. Some results obtained from simulations of jumping, pedaling, and walking are also reviewed to illustrate the approach.
White Matter Anisotropy in Post-Treatment Childhood Cancer Survivors: Preliminary Evidence of Association With Neurocognitive Function
Authors: Pek-Lan Khong, Lucullus H.T. Leung, Amy S.M. Fung, Daniel Y.T. Fong, Deqiang Qiu, Dora L.W. Kwong, Gaik-Cheng Ooi, Grainne McAlanon, Guang Cao, Godfrey C.F. Chan
Journal: Journal of Clinical Oncology (2006)

We aim to determine if the loss of white matter fractional anisotropy (FA), measured by diffusion tensor magnetic resonance imaging (DTI), in post-treatment childhood medulloblastoma (MED) and acute lymphoblastic leukemia (ALL) survivors correlate with intelligence quotient (IQ) scores.MED and ALL survivors (n = 30; 20 male, 10 female; age range, 6.0 to 22.1 years; mean, 13.1 years) were recruited for DTI and IQ tests. In this cross-sectional study, age-matched normal control (n = 55; 32 male, 23 female; age range, 6.0 to 23 years; mean, 12.1 years) DTI was obtained to compute percentage difference in white matter FA (DeltaFA%) for each patient compared with the age-matched control group. Multivariate regression analysis was performed to determine the relationships between DeltaFA%, age at treatment, irradiation dose, time interval from treatment, and full-scale IQ (FSIQ), verbal IQ (VIQ), and performance IQ (PIQ). Receiver operating characteristics curves were used to determine the best DeltaFA% cutoffs for predicting FSIQ, VIQ, and PIQ of less than 85.DeltaFA% had a significant effect on FSIQ (adjusted r2 = 0.439; P < .001), VIQ (adjusted r(2) = 0.237; P = .028), and PIQ (adjusted r(2) = 0.491; P < .001) after adjusting for the effects of age at treatment, irradiation dose, and time interval from treatment. The best DeltaFA% value to predict less than 85 scores in FSIQ, VIQ, and PIQ was -3.3% with specificities of 100% and sensitivities ranging from 77.8% to 87.5%.Our preliminary findings suggest that white matter FA may be a clinically useful biomarker for the assessment of treatment-related neurotoxicity in post-treatment childhood cancer survivors.
What factors predict differences in infant and perinatal mortality in primary care trusts in England? A prognostic model
Authors: N. Freemantle, J Wood, C Griffin, P Gill, M J Calvert, A Shankar, J Chambers, C MacArthur
Journal: BMJ (2009)

<b>Objective</b> To identify predictors of perinatal and infant mortality variations between primary care trusts (PCTs) and identify outlier trusts where outcomes were worse than expected. <b>Design</b> Prognostic multivariable mixed models attempting to explain observed variability between PCTs in perinatal and infant mortality. We used these predictive models to identify PCTs with higher than expected rates of either outcome. <b>Setting</b> All primary care trusts in England. <b>Population</b> For each PCT, data on the number of infant and perinatal deaths, ethnicity, deprivation, maternal age, PCT spending on maternal services, and "Spearhead" status. <b>Main outcome measures</b> Rates of perinatal and infant mortality across PCTs. <b>Results</b> The final models for infant mortality and perinatal mortality included measures of deprivation, ethnicity, and maternal age. The final model for infant mortality explained 70% of the observed heterogeneity in outcome between PCTs. The final model for perinatal mortality explained 80.5% of the between-PCT heterogeneity. PCT spending on maternal services did not explain differences in observed events. Two PCTs had higher than expected rates of perinatal mortality. <b>Conclusions</b> Social deprivation, ethnicity, and maternal age are important predictors of infant and perinatal mortality. Spearhead PCTs are performing in line with expectations given their levels of deprivation, ethnicity, and maternal age. Higher spending on maternity services using the current configuration of services may not reduce rates of infant and perinatal mortality.
Reputation and Precedent in the Bevacizumab Decision
Authors: Daniel Carpenter, Aaron S. Kesselheim, Steven Joffe
Journal: New England Journal of Medicine (2011)

In February 2008, the U.S. Food and Drug Administration (FDA) granted accelerated approval to bevacizumab (Avastin) in combination with paclitaxel as first-line treatment for HER-2 negative metastatic breast cancer. Approval was based on the results of E2100, a cooperative-group randomized trial that showed a 5.5-month increase in progression-free survival associated with the addition of bevacizumab to paclitaxel therapy.1,2 Confirmatory studies by Genentech, the manufacturer, however, showed that bevacizumab's benefits for progression-free survival may be appreciably smaller than those shown in E2100 and have demonstrated convincingly that the addition of bevacizumab to the chemotherapy agents they have tested offers no . . .
North America has new outbreaks of antibiotic associated C difficile
Authors: Janice Tanne
Journal: BMJ (2005)

Outbreaks of severe Clostridium difficile diarrhoea with a high death rate have occurred among hospital patients in Quebec and in at least 16 US states. In the United States people at low risk in the community have also been affected. Use of fluoroquinolones and cephalosporins has been implicated.

Although the infection usually affects hospital patients or elderly people in long term care facilities, the US Centers for Disease Control and Prevention (CDC) reported severe C difficile disease among healthy people in the community and among peripartum women ( Morbidity and Mortality Weekly Report 2005;54:1201-5).

Ten cases among peripartum women and 23 cases among people in the community were reported from four states between February 2003 and June 2005. The patients in the community ranged in age from 6 months to 72 years. One person, one of the peripartum women, died.

Most patients in the CDC reports said they had not used …
Antigenic variants of rabies virus
Authors: TJ Wiktor, H Koprowski
Journal: The Journal of Experimental Medicine (1980)

Antigenic variants of CVS-11 strain of rabies virus were selected after treatment of virus populations with monoclonal antibodies directed against the glycoprotein antigen of the virus. These variants resisted neutralization by the hybridoma antibody used for their selection. Two independently mutating antigenic sites could be distinguished when five variants were tested with nine hybridoma antibodies. The frequency of single epitope variants in a cloned rabies virus seed was approximately 1:10,000. Animals were not or only partially protected when challenged with the parent virus or with another variant, but were fully protected against challenge with the virus used for immunization. Variants were also detected among seven street viruses obtained from fatal cases of human rabies. Animals immunized with standard rabies vaccine were protected against challenge with some but not all street rabies variants. A comparative antigenic analysis between vaccine strain and challenge virus by means of monoclonal antiglycoprotein antibodies showed a slightly closer degree of antigenic relatedness between vaccine and challenge strain in the combinations where vaccination resulted in protection. It remains unknown, however, whether these apparently minor antigenic differences in the glycoproteins account for the varying degrees of protection. The results of this study clearly indicate that the selection of vaccine strains and the methods used to evaluate the potency of rabies vaccines need to be revised.
Prospective comparison of faecal incontinence grading systems
Authors: C J Vaizey, E Carapeti, J A Cahill, M A Kamm
Journal: Gut (1999)

Background Existing scales for assessing faecal incontinence have not been validated against clinical assessment, or with regard to reproducibility. They also fail to take into account faecal urgency, and the use of antidiarrhoeal medications. Aims To establish the validity, and sensitivity to change, of existing scales and a newly designed incontinence scale. Methods (1) Twenty three patients (21 females, median age 57 years) were prospectively evaluated by two independent clinical observers, using three established scales (Pescatori, Wexner, American Medical Systems), a newly devised scale which also includes details about urgency and antidiarrhoeal drugs, and by a 28 day diary. (2) A further 10 female patients were assessed by the same scales before and after surgery for faecal incontinence. Results (1) Assessments by two independent clinicians correlated well. All four scales and a diary card correlated highly and significantly with the clinical impression, with the new scale reaching the highest correlation ( r =0.79, p&lt;0.001). (2) All except one score changed significantly in response to surgical treatment; the new scale showed the greatest change, at the highest level of significance (p=0.004), and correlated best with the clinicians’ assessment of change ( r =0.94, p&lt;0.001). Conclusions Existing scales for the assessment of faecal incontinence correlate well with careful clinical impression of severity, and serve as useful and reproducible measures for comparison of patients and treatments. A newly devised scale has shown high clinical validity and utility.
Phase I–II study of amrubicin and cisplatin in previously untreated patients with extensive-stage small-cell lung cancer
Authors: Y. Ohe, S. Negoro, K. Matsui, K. Nakagawa, T. Sugiura, Y. Takada, Y. Nishiwaki, S. Yokota, M. Kawahara, N. Saijo, M. Fukuoka, Y. Ariyoshi
Journal: Annals of Oncology (2005)
Prospective comparison of two Sengstaken tubes in the management of patients with variceal haemorrhage.
Authors: K Mitchell, D B Silk, R Williams
Journal: Gut (1980)

To compare the efficacy of two oesophageal tamponade tubes, 28 patients with endoscopically proven actively bleeding varices were randomly allocated to be intubated with either a newly available 4-lumen tube incorporating an extra lumen for oesophageal suction, or the modified 3-lumen Sengstaken tube. The patients and the nursing staff preferred using the 4-lumen tube and both aspiration pneumonias and balloon dysfunction occurred less frequently. Variceal haemorrhage was successfully controlled for the first 12 hours in most patients in the two treatment groups, although the incidence of re-bleeding at 48 hours after the tube had been deflated was high.
The effect of various corticosteroids on the release of β-glucuronidase from human leukocytes challenged with zymosan
Authors: BRIAN WATSON, E.L. RHODES, B.B.J. MAJEWSKI
Journal: British Journal of Dermatology (1979)

Seven corticosteroids were tested for their effect on the release of beta-glucuronidase when human white cells were challenged with zymosan. Stabilization was noted in two areas of dilution with every steroid but destabilization occurred at high concentrations. However, those steroids that stabilized effectively at low concentrations were also those which were the most potent vasoconstrictors.