tbuckley/cabot-search huggingface dataset:
New Standards and Implications for Improving the Quality of Supportive Oncology Practice
Authors: Betty Ferrell, Judith Paice, Marianna Koczywas
Journal: Journal of Clinical Oncology (2008)

The purpose of this article is to review current guidelines and national initiatives to improve the quality of supportive oncology care. Review of the literature in this area has documented important advances in supportive oncology. This article focuses on work by the National Consensus Project for Quality Palliative Care and the National Quality Forum. The mandate to improve the quality of care in oncology has been the focus of several national reports, including those by the Institute of Medicine addressing end-of-life care in cancer and cancer survivorship. Patients with cancer face significant needs for support in areas such as pain and symptom management and psychosocial and spiritual support, as well as diverse quality-of-life concerns. These reports recommending changes in practice have been reinforced by clinical practice guidelines developed by the National Consensus Project for Quality Palliative Care and preferred practices defined by the National Quality Forum. This article applies these national mandates and guidelines to the field of supportive care in oncology. Improving the quality of supportive oncology will require commitment by oncology professionals in areas of education, clinical practice, and research.
Co-trimoxazole and typhoid fever.
Authors: Z Farid, A Hassan
Journal: BMJ (1972)

August, p. 329) should have mentioned co-trimoxazole as an alternative drug to chloramphenicol in the treatment of typhoid fever.To date we have successfully treated over 30 patients with acute typhoid or paratyphoid A fever with this drug.'But in addition we have found co-trimoxazole to be very useful in the treatment of chronic salmonellosis where antibiotic treatment usually has to be given for at least four to six weeks.2In patients with irreparably damaged urinary tracts due to schistosomiasis and persistent salmonella urinary excretion prolonged suppressive therapy with co- trimoxazole has successfully maintained the urine s:erile for over a year.4-Weare, etc.,
Abstract 3026: miR-203 and miR-205 expression profiles are predictive of high grade non-invasive urothelial carcinoma progression
Authors: Kimberly M. Rieger-Christ, Sheaumei Tsai, Sara M. Lenherr, Cara B. Cimmino, Jason R. Gee, John A. Libertino, Ian C. Summerhayes
Journal: Cancer Research (2010)

Abstract Introduction: MicroRNA (miRNA) has been shown to play a role in regulating the expression of genes involved in tumor suppression and oncogenesis. High-grade, non-muscle-invasive urothelial carcinoma of the bladder (UCB) harbors a significant risk of progression to muscle invasion. In this study, we sought to identify miRNAs differentially expressed in non-progressive high-grade non-muscle-invasive UCB as compared to pathologically identical lesions that progress to muscle invasion. Methods: Total RNA was extracted from formalin fixed paraffin-embedded tissue (FFPE) of high-grade non-muscle-invasive (TaG3/T1G3) UCB lesions. Patients were categorized into two groups: non-progressors with at least 3 years follow-up or progressors advancing to ≥T2. Exclusion criteria were previous tumors of the upper tract, prior systemic chemotherapy or previous pelvic irradiation. Total RNA was pooled for microarray analysis from a subset of the non-progressor and progressor groups. Data was analyzed using the LOWESS normalization method. Expression profiles of miRNAs were verified with qRT-PCR on 89 high-grade non-muscle-invasive UCB (68 non-progressors and 21 progressors). Logistic regression analysis was performed to identify miRNAs predictive of tumor progression. Results: MicroRNA microarray data identified a panel of miRNAs (25) with potential involvement in the progression to invasion of high-grade non-muscle-invasive UCB. 36% of these miRNAs were upregulated and 64% were downregulated in the progressor samples. To validate differential expression of these miRNAs, qRT-PCR was performed on the 89 FFPE tissue samples. Logistic regression analysis of qRT-PCR data revealed decreased expression of miR-203 and miR-205 as predictive of progression (p = 0.031 and p = 0.045, respectively). Subsequent qRT-PCR with miR-203 and miR-205 on 31 muscle-invasive tumor samples (≥T2) showed expression profiles that were similar to those of the non-invasive progressors. Conclusions: In this study, we have shown that miR-203 and miR-205 can identify patients with non-muscle- invasive UCB at high risk to progress to muscle-invasive disease. Our findings also suggest that such tumors have a biomolecular profile similar to muscle-invasive lesions. Further validation studies are underway to investigate additional miRNAs and determine the mechanism by which these miRNAs promote tumor invasion and progression. These results provide an important tool that can be used to prognosticate the clinical behavior of a very challenging subset of tumors. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3026.
TRICHINOSIS WITH LIVER DYSFUNCTION, HYPOALBUMINEMIA, AND TYPHOID AGGLUTININS
Authors: Samuel D. Kushlan
Journal: JAMA (1953)

Trichinosis appears to be one of the commonest and most important parasitic diseases in this country.<sup>1</sup>Routine postmortem examination of diaphragms, using the improved technique of the peptic digest method, has revealed the presence of Trichinella spiralis cysts in about 37%.<sup>2</sup>Infestation with this roundworm is commonly the result of ingestion of partially cooked or raw pork containing the encysted larvae, and the disease is endemic wherever pork is eaten. The diagnosis of trichinosis is obvious in the presence of a history of pork ingestion, edema of the eyelids, muscle pain, fever, nausea, vomiting, diarrhea, abdominal pain, and respiratory symptoms. Eosinophilia is probably the most valuable laboratory diagnostic aid, although it may fluctuate widely.<sup>3</sup>The widespread dissemination of the larvae<sup>4</sup>accounts for the common confusion of trichinosis with acute respiratory infection, acute nephritis, rheumatism, various gastrointestinal disorders, undulant fever, and tuberculosis. A mistaken diagnosis of primary
Where are the guidelines for treating hypertension in elderly patients?
Authors: K. O'Malley, E. O'Brien
Journal: BMJ (1992)

three months after myoblast transfer in 18 subjects showed an increase in 30 of the 69 muscle groups measured, no change in 26, and a reduction in 13.Interpreting these results is difficult given the uncontrolled nature of the study and the short period of follow up.Blau and colleagues studied the tibialis anterior muscle from eight patients with Duchenne dystrophy, with a docu- mented deletion in the dystrophin gene, one month after the injection of lOOm cultured myoblasts into up to 100 injection sites.'Using the polymerase chain reaction they showed that in three patients dystrophin messenger RNA derived from the donor myoblast DNA was being expressed.Given the extreme sensitivity of this technique, this result presumably reflects the persistence of donor DNA from a few of the implanted myoblasts.The number of dystrophin positive fibres was only about 10 per 1000 fibres-no greater than the frequency of spontaneously occurring dystrophin positive "revertant" fibres in muscles on the control side.Despite being hailed by Nature as a transplant success it was an unequivocal clinical failure.So where do we stand in relation to myoblast transfer in Duchenne dystrophy?Could the essentially negative results merely reflect the birth pangs reminiscent of earlier transplantation procedures such as kidney, bone marrow, and heart?Simple technical problems may explain the failure, which further studies could resolve.Alternatively, cell transfer may turn out to be a non-starter in the treatment of muscular dystrophy, and other experimental approaches, such as introducing gene constructs either directly into the muscle" 12 or using viral vectors, may need to be pursued further.Meanwhile, it is imperative that the Duchenne boys are given optimal supportive care, including the provision of orthoses to maintain ambulation.We should also continue the search for drugs to influence the course of the disease.'3
Treatment Failure and Mortality Factors in Patients Receiving Second-Line HIV Therapy in Resource-Limited Countries
Authors: Mar Pujades-Rodríguez
Journal: JAMA (2010)

Long-term antiretroviral therapy (ART) use in resource-limited countries leads to increasing numbers of patients with HIV taking second-line therapy. Limited access to further therapeutic options makes essential the evaluation of second-line regimen efficacy in these settings.To investigate failure rates in patients receiving second-line therapy and factors associated with failure and death.Multicohort study of 632 patients > 14 years old receiving second-line therapy for more than 6 months in 27 ART programs in Africa and Asia between January 2001 and October 2008.Clinical, immunological, virological, and immunovirological failure (first diagnosed episode of immunological or virological failure) rates, and mortality after 6 months of second-line therapy use. Sensitivity analyses were performed using alternative CD4 cell count thresholds for immunological and immunovirological definitions of failure and for cohort attrition instead of death.The 632 patients provided 740.7 person-years of follow-up; 119 (18.8%) met World Health Organization failure criteria after a median 11.9 months following the start of second-line therapy (interquartile range [IQR], 8.7-17.0 months), and 34 (5.4%) died after a median 15.1 months (IQR, 11.9-25.7 months). Failure rates were lower in those who changed 2 nucleoside reverse transcriptase inhibitors (NRTIs) instead of 1 (179.2 vs 251.6 per 1000 person-years; incidence rate ratio [IRR], 0.64; 95% confidence interval [CI], 0.42-0.96), and higher in those with lowest adherence index (383.5 vs 176.0 per 1000 person-years; IRR, 3.14; 95% CI, 1.67-5.90 for < 80% vs > or = 95% [percentage adherent, as represented by percentage of appointments attended with no delay]). Failure rates increased with lower CD4 cell counts when second-line therapy was started, from 156.3 vs 96.2 per 1000 person-years; IRR, 1.59 (95% CI, 0.78-3.25) for 100 to 199/microL to 336.8 per 1000 person-years; IRR, 3.32 (95% CI, 1.81-6.08) for less than 50/microL vs 200/microL or higher; and decreased with time using second-line therapy, from 250.0 vs 123.2 per 1000 person-years; IRR, 1.90 (95% CI, 1.19-3.02) for 6 to 11 months to 212.0 per 1000 person-years; 1.71 (95% CI, 1.01-2.88) for 12 to 17 months vs 18 or more months. Mortality for those taking second-line therapy was lower in women (32.4 vs 68.3 per 1000 person-years; hazard ratio [HR], 0.45; 95% CI, 0.23-0.91); and higher in patients with treatment failure of any type (91.9 vs 28.1 per 1000 person-years; HR, 2.83; 95% CI, 1.38-5.80). Sensitivity analyses showed similar results.Among patients in Africa and Asia receiving second-line therapy for HIV, treatment failure was associated with low CD4 cell counts at second-line therapy start, use of suboptimal second-line regimens, and poor adherence. Mortality was associated with diagnosed treatment failure.
Lipoprotein macroaggregates in bronchoalveolar lavage fluid from patients with diffuse interstitial lung disease: comparison with idiopathic alveolar lipoproteinosis.
Authors: P L Haslam, D A Hughes, A Dewar, C F Pantin
Journal: Thorax (1988)

Lipoprotein macroaggregates were present in cytocentrifuge preparations of bronchoalveolar lavage fluid from four patients with diffuse lung diseases other than idiopathic alveolar lipoproteinosis. In three patients the primary diagnosis was cryptogenic fibrosing alveolitis and in one sarcoidosis. We confirmed the presence of large multilamellar aggregates of lipoprotein by ultrastructural examination in patients with both interstitial lung disease and idiopathic alveolar lipoproteinosis. The small lamellar bodies and amorphous debris found in idiopathic alveolar lipoproteinosis were rare in the patients with interstitial lung disease. The lavage fluid from patient with interstitial lung disease did not show the substantial alterations in phospholipid composition that were seen in lavage fluid in idiopathic alveolar lipoproteinosis. These ultrastructural and biochemical features may help to distinguish idiopathic from other causes of alveolar lipoproteinosis, particularly at an early stage, when differential diagnosis may be difficult.
Crossmodal Associative Memory Representations in Rodent Orbitofrontal Cortex
Authors: Paul A Lipton, Pablo Alvarez, Howard Eichenbaum
Journal: Neuron (1999)

Firing patterns of neurons in the orbitofrontal cortex (OF) were analyzed in rats trained to perform a task that encouraged incidental associations between distinct odors and the places where their occurrence was detected. Many of the neurons fired differentially when the animals were at a particular location or sampled particular odors. Furthermore, a substantial fraction of the cells exhibited odor-specific firing patterns prior to odor presentation, when the animal arrived at a location associated with that odor. These findings suggest that neurons in the OF encode cross-modal associations between odors and locations within long-term memory.
Prophylactic sclerotherapy for esophageal varices: Long-term results of a single-center trial
Authors: David R. Triger, Howard L. Smart, Shorland W. Hosking, Alan G. Johnson
Journal: Hepatology (1991)

Survival after prophylactic sclerotherapy was assessed in a single-center study involving 99 cirrhotic (41 alcoholic) patients enrolled over 8-yr. The wedged hepatic vein pressure gradient was measured; those with pressure greater than or equal to 12 mm Hg were randomized to receive sclerotherapy or no treatment. The rest were not randomized. Patients in all three groups who bled were treated with emergency endoscopy and sclerotherapy. Stratification according to presence of ascites was also undertaken. Median follow-up was 61 mo (range = 14 to 107 mo). Survival among unrandomized patients was significantly longer than among randomized patients (p less than 0.006), but there was no significant difference between those treated by sclerotherapy and the controls (p = 0.27). Alcoholic cirrhotic patients undergoing sclerotherapy had better 2-yr survival than did the controls (80% vs. 43%; p = 0.09), but this benefit was not sustained at 5 yr. Survival in the nonalcoholic patient groups was identical. Only 10 of 50 deaths were caused by variceal bleeding. Forty-eight percent of patients with large varices bled, compared with 20% of patients with small varices. Wedged hepatic vein pressure less than 12 mm Hg accurately identified alcoholic patients at low risk of variceal bleeding but not nonalcoholic patients. Only four episodes of variceal bleeding were attributable to elective sclerotherapy. We conclude that in our population, prophylactic sclerotherapy alone does not improve survival. The discrepancy in survival between alcoholic and nonalcoholic cirrhotic patients suggests that factors other than variceal hemorrhage may be responsible for the difference.
Elective operations for left ventricular asynergy
Authors: F. Gerbode, W. J. Kerth, J. D. Hill, S. Banerjee, C. Marcelletti
Journal: Thorax (1974)

<b>Gerbode, F., Kerth, W. J., Hill, J. D., Banerjee, S., and Marcelletti, C. (1974).</b><i>Thorax</i>, <b>29</b>, 282-286. <b>Elective operations for left ventricular asynergy.</b> Operative results in 45 patients with symptomatic left ventricular asynergy are reviewed. The main symptoms were congestive heart failure in 77·7%, angina in 31·1%, arrhythmias in 11·1%, and systemic thromboembolism in 2·2% of the patients. All patients had left heart catheterization, 40 had left ventricular angiography, and 27 had selective coronary arteriography. The last myocardial infarction occurred within three months preoperatively in 15 patients and more than 13 months prior to surgery in 27 patients. The cardiac index was 1·5 1/m<sup>2</sup>/min or less in six patients and the left ventricular end diastolic (LVED) pressure was 25 mmHg or higher in 15 patients. All patients were operated upon electively with the use of cardiopulmonary bypass. Excision of the left ventricular aneurysm was performed in 39 cases and plication in six. The immediate survival rate was 66·6%. The lowest mortality rate was among patients with angina (12·5%) and the highest in those with association of congestive heart failure and angina (66·6%). The mortality rates among patients with recent or old myocardial infarction were 46·6 and 22·2% respectively. One of the six patients with a cardiac index of 1·5 1/m<sup>2</sup>/min or less and seven of the 15 patients with LVED pressure of 25 mmHg or higher were discharged from hospital. It is concluded that ventricular aneurysmectomy has to be considered an elective procedure in order to obtain predictable results and that ideal indications for operation are angina or congestive heart failure refractory to medical treatment, associated with acceptable haemodynamics, a cardiac index of 2·0 1/m<sup>2</sup>/min or higher, and a LVED pressure below 25 mmHg.
Random walk type models for indicator-dilution studies: comparison of a local density random walk and a first passage times distribution
Authors: J M BOGAARD, J R C JANSEN, E A VON RETH, A VERSPRILLE, M E WISE
Journal: Cardiovascular Research (1986)

The relative merits of the local density random walk and the first passage times distributions were compared with respect to their practical applicability in cardiovascular research and clinical practice. Open indicator-dilution curves of varying shape were used, and reference values for area and mean transit times were calculated numerically. Curves not perturbed by recirculation were obtained in two different ways. Thermodilution curves were obtained in an animal model at the left and the right side of the heart respectively and conductivity curves with 0.5% NaCl solution as indicator were obtained in a hydrodynamic circulation model. The fits of the two types of distribution were equally accurate for the more symmetrical curves; for very skewed curves the local density random walk fit proved to be more accurate. This result could be related to the greater difference in shape between the first passage times and local density random walk distribution for a large degree of asymmetry. For this reason the local density random walk distribution for fitting indicator-dilution curves was used in a variety of other experimental conditions.
Future Forum tries to influence two key government documents
Authors: N. Hawkes
Journal: BMJ (2011)

The NHS Future Forum, in its second coming, is calling on England’s health secretary to provide better information to patients, including online access to their health records, and financial incentives for commissioning groups that promote integrated care.

Recognising that the NHS operating framework for 2012-13 and also further details about how public health will be organised are likely to emerge before it can produce a full report, the forum has sent Andrew Lansley interim recommendations in the hope of influencing the shape of both these documents.

The forum was originally set up to get the coalition government out of political difficulty by acting as a lightning conductor for complaints about the Health and …
Use of Micro Partial Thromboplastin Time Test-Reply
Authors: John B. Miale
Journal: JAMA (1964)

Dr. Britten's points are well taken. I felt I had made a strong plea for preoperative testing<i>plus</i>careful history taking and clinical studies. I doubt whether a test useful primarily in screening for hemophilia and hemophiloid diseases would be taken as a substitute for clinical history and examination. I would dissent from Dr. Britten's opinion that the clinical history alone will adequately screen potential bleeders. He quotes a 95% reliability from the paper of Nye et al, but this figure requires interpretation. First, the 618 patients studied by Nye and associates were persons<i>suspected</i>of being bleeders (because of personal history, previous clotting tests, or family history). Of these, 242 (39.2%) were found to have a bleeding diathesis, 102 (16.5%) had no diagnosis, and 274 (44.3%) were found to be normal. Second, of the 242 with a bleeding diathesis, 164 had a history of abnormal bleeding; the accuracy of
Exclusion of the alpha 1(II) collagen structural gene as the mutant locus in type II Ehlers-Danlos syndrome.
Authors: P Wordsworth, D Ogilvie, R Smith, B Sykes
Journal: Annals of the Rheumatic Diseases (1985)

We have used a high frequency site polymorphism within the human pro-alpha 1(II) collagen gene (COL2A1) in order to examine the segregation of this gene within a large pedigree with type II Ehlers-Danlos syndrome (EDS). The EDS gene and the collagen gene segregate independently within the pedigree and therefore COL2A1 can be excluded as the mutant locus.
Presentation by a major histocompatibility complex class I molecule of nucleoprotein peptide expressed in two different genes of an influenza virus transfectant.
Authors: H Isobe, T Moran, S Li, A Young, S Nathenson, P Palese, C Bona
Journal: The Journal of Experimental Medicine (1995)

Major histocompatibility (MHC) class I glycoproteins are specialized to present to CD8+ T cells, peptides that originate from proteins synthesized within the cytoplasm. Conventional killed vaccines are unable to get into the cell cytoplasm and therefore fail to expand the CD8+ T cell population. We have created a novel influenza transfectant virus, R10, which carries an immunogenic peptide from the nucleoprotein (NP) of PR8 influenza virus in its hemagglutinin (HA) and another similar peptide in its HK influenza virus NP. The two peptides are both presented by H-2Db and bind with approximately equal affinity. They can compete with one another for binding to H-2Db. Yet in cells infected with R10, both peptides are presented efficiently enough to expand the respective cytotoxic T lymphocyte (CTL) precursors in vivo and to serve as targets for CTL lysis in vitro. It has been proposed that proteins bearing signal sequences may be processed by a transporter-independent pathway. To investigate this, we infected the transporter-deficient cell line RMA-S with the R10 virus to see if the NP peptide expressed by the HA would be presented. The result shows that even the presence of a signal peptide in the HA does not overcome the lack of a transporter function, suggesting that the presentation of both peptides is dependent on functional transporter proteins. Our data also suggest the feasibility of creating by genetic engineering, recombinant vaccines expressing multiple epitopes that can effectively stimulate a cellular immune response.