tbuckley/cabot-search huggingface dataset:
Tuberculosis in London: a decade and a half of no decline in tuberculosis epidemiology and control
Authors: S. R Anderson, H. Maguire, J. Carless
Journal: Thorax (2006)

London accounts for nearly half of the national burden of tuberculosis. The incidence of tuberculosis has more than doubled in London in the past 15 years.Data from the enhanced tuberculosis surveillance 1999-2003, the national tuberculosis surveys of 1993 and 1998, and tuberculosis notifications were compared and analysed.In 2003, 3048 patients with tuberculosis were reported in London, 45% of the national total. This represents an incidence of 41.3/100,000, five times higher than the rest of England and Wales, and in parts of London the incidence of tuberculosis is nine times the national average. 75% of people with tuberculosis in London are born abroad; nearly half have lived in the UK for <5 years, but a third for >10 years. 86% are from an ethnic minority group, and the incidence is highest in black Africans at 283/100,000 compared with 141, 141 and 8/100,000 for Pakistanis, Indians and whites, respectively. In absolute terms, a third of patients with tuberculosis in London are from Africa and nearly a third from the Indian subcontinent. Specific groups affected also include the homeless, prisoners, and hard drug and alcohol users as well as the immunosuppressed.London reflects the worldwide rise in tuberculosis, with increasing incidence in ethnic minorities. Work has been carried out to combat this rise, but more is needed. Tuberculosis control and prevention strategies should be mindful of the changing epidemiology of tuberculosis in London, and provide information, diagnosis and treatment tailored to the specific needs of the capital and its at-risk groups.
Abstract 16990: First In-Human Implantations of a New Fully Resorbable Antibiotic Envelope During Cardiac Implantable Electronic Device (CIED) Procedures
Authors: Francois Philippon, Jean Champagne, Gilles O'Hara, Franck Molin, Louis Blier, Isabelle Nault, Jean-Francois Sarrazin, John M Rothschild
Journal: Circulation (2013)

Background: Infection at time of CIED implantation or replacement is associated with significant morbidity, mortality and costs. The observed infection rate is 1.6% to 2.4% and increasing with majo...
A Q-TWiST analysis of adjuvant chemotherapy in non-small cell lung cancer (NSCLC) in the NCIC CTG JBR.10 trial
Authors: R. W. Jang, A. Le Maître, K. Ding, T. L. Winton, A. Bezjak, L. Seymour, F. A. Shepherd, N. B. Leighl
Journal: Journal of Clinical Oncology (2008)

6535 Background: NCIC CTG JBR.10 was a North American Intergroup phase III trial of adjuvant vinorelbine/cisplatin after resection of stage IB or II NSCLC, that demonstrated improved disease-free and overall survival with chemotherapy. However many patients are either not referred for chemotherapy or decline treatment. To aid in treatment decision-making, quality-adjusted survival estimates of the JRB.10 trial were derived using a Quality-Adjusted Time Without Symptoms or Toxicity (Q-TWiST) analysis. Methods: Survival curves for treatment (N=242) and observation groups (N=240) were partitioned into three health states: time with grade >=2 (early or late) chemotherapy-related toxicity (TOX), time in relapse (REL), and time without toxicity or relapse (TWiST). Q-TWiST = uTOX*TOX + uTWiST*TWIST + uREL*REL, where utilities uTOX, uTWIST, and uREL range from 0 to 1. Utilities were derived in an exploratory fashion using different methods, (not prospectively collected but predefined). Method 1 arbitrarily defined uTOX=0.75, uREL=0.5, and uTWIST=1 based on previous studies. Methods 2 and 3 derived utilities from the EORTC QLQ-C30 quality of life data prospectively collected in JBR.10 (N=186 chemotherapy, N=173 observation). Method 2 averaged the two QLQ-C30 global assessment responses and method 3 averaged the symptom-related QLQ-C30 responses. Method 4 used utilities (EQ-5D) collected from early stage NSCLC patients post-resection (non-trial patients) surveyed at the Princess Margaret Hospital (N=70), with discounting of 10% for uTOX, and 20% for uREL. Results: The adjuvant chemotherapy group had better Q-TWiST, (5 to 6 additional months), which was statistically significant using methods 3 and 4 (p 0.016, p 0.006), and trended to significance with methods 1 and 2 (p 0.058, p 0.144). Threshold utility analysis revealed that adjuvant chemotherapy was preferred for all possible values of uREL and uTOX, although the quality-adjusted survival improvement was not always statistically significant. The Q-TWiST gain function showed that the benefit of chemotherapy became apparent 2 to 3 years after chemotherapy, and may decrease after 5 years. Conclusions: Adjuvant chemotherapy in early stage NSCLC improves quality-adjusted survival despite chemotherapy toxicity. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration GlaxoSmithKline GlaxoSmithKline, Pierre Fabre GlaxoSmithKline
Verbal abuse and other violence types against doctors in chest diseases polyclinic
Authors: Sinem Berik, Fatih Alasan, Peri Arbak
Journal: European Respiratory Journal (2012)

Aim: There are a few studies focused on unexpected patient-doctor relationship such as verbal abuse and the other types of violence.  Materials and Methods: Two hundred thirty one patients (134 male, 97 female) who accepted filling out the forms and admitted to Chest Diseases Polyclinic between September and December 2011, were included in the study.  Results: The mean age of the patients was 53.6 ± 16.7 (15-85) years. The mean duration for anamnesis was 10.1 ± 4.2 minutes. Forteen patients used verbal abuse or other types of violence (6.1%). Mostly, patients used violence by themselves (78.6%). Seven patients ridiculed (50%), two patients abused (14.3%), two patients threated (14.3%) and three patients tried to enter free of turn (21.4%). Negative interaction mostly occured in examination room (64.3%) and before the beginning of anamnesis (64.3%). The mean duration from the anamnesis to the final diagnosis was 41.7 ± 75.2 minutes (min:0-max:180). The mean admittance rates of verbal abusers to university hospital (27.9 ± 24.6, Median= 25) were significantly higher than the others (8.7 ± 12.7, p=0.007, Median=5). The mean number of households of verbal abusers (2.8 ± 2.0, Median=2) was significantly lower than the others (3.8 ± 1.7, p=0.041, Median=4).  Conclusion: Verbal abuse is the most seen form of the negative relationships between patient and doctor. Making realistic changes in referral system can satisfy the expectations of patients. The positive relationship rights are necessary not only for patients but also for doctors.
Chromosomes of 14 Hematopoietic Cell Lines Derived From Peripheral Blood of Persons With and Without Chromosome Anomalies&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: C C Huang, G E Moore
Journal: JNCI Journal of the National Cancer Institute (1969)

The chromosome constitutions of 14 hematopoietic cell lines derived from peripheral blood of 11 normal persons and 3 persons with chromosome anomalies (46 + 1 minute, XYY, and XXY) were studied. Of the 11 normal lines, 8 had normal diploid karyotypes when first examined at culture ages varying from 3–23 months. Of the remaining 3 normal lines, 2 had hyperdiploid modes of 47, and 1 had a mixed mode of diploid and pseudodiploid when first examined, all at culture ages greater than 15 months. Four of the originally diploid lines changed to pseudodiploid modes when they were reexamined 20–33 months after initiation. The line with a mixed diploid and pseudodiploid mode had shifted to a hypodiploid mode of 45 at later examinations. This line and its 2 sublines all exhibited high incidences of cells with chromosome attenuation at the centromeric regions of #1, #16, and one chromosome of group G The 3 lines derived from persons with chromosome anomalies have maintained the donors' karyotypes for 10–12 months in vitro. No C chromosome with a subterminal secondary constriction, as has been reported to occur in some Burkitt cell lines, was observed in the lines studied, whether positive or negative for herpes-type virus. It is apparent that human hematopoietic cell lines can maintain the donors' chromosome constitutions as well as rapid growth rates for long periods and hundreds of cell generations in vitro. When chromosome changes finally do occur, they are minor and fairly consistent within each line.
Effects of endurance on strength, fatigue and quality of life in bronchiectasis
Authors: Deniz Inal Ince, Sulenur Subasi, Melda Saglam, Ebru Calik Kutukcu, Naciye Vardar Yagli, Hulya Arikan, Lutfi Coplu
Journal: European Respiratory Journal (2014)

Aim: Bronchiectasis is a chronic pulmonary disease causing extrapulmonary symptoms in addition to its effects on pulmonary system. Endurance is one of the most vulnerable physical parameter to chronic process of chronic disease. The aim of this study was to investigate the effects of endurance levels on skeletal muscle strength, fatigue and quality of life in adult patients with bronchiectasis.

Methods: Forty-one patients (27 females, 14 males) participated in the study. Subjects' demographics and physical characteristics were recorded. Pulmonary function testing was performed. Peripheral muscle strength (knee extensor muscle strength), quality of life (Leicester Cough Questionnaire, LCQ; Saint George Respiratory Questionnaire, SGRQ), and fatigue perception (Fatigue Severity Scale, FSS) were evaluated. To evaluate endurance levels, endurance shuttle walk test (ESWT) was performed.

Results: The ESWT was significantly correlated with SGRQ total score (r=-0.45, p<0.003), SGRQ impact score (r= -0.421, p<0.006), SGRQ activity score (r=-0.460, p<0.002), FSS score (r=-0.384, p<0.013), and knee extensor muscle strength (r= 0.407, p<0.01).The SGRQ activity score explained 25.4% of variance in the ESWT distance (r=0.504, r2=0.254, F(1-37)=12.597, p<0.001).

Conclusion: Knee extensor muscle strength, FSS and SGRQ are associated with lower endurance capacity in patients with bronchiectasis. As an indicator of disturbances to daily physical activity, SGRQ activity score independently predicted endurance level in bronchiectasis. Changing perception of disease's negative daily efffects may affect patient's endurance capacity positively. Optimal rehabilitation management should include this important factor.
Cetuximab as first-line monotherapy in patients with unresectable squamous cell carcinoma of the skin: Preliminary results of a phase II multicenter study
Authors: E. Maubec, P. Petrow, P. Duvillard, A. Certain, X. Duval, D. Kerob, M. Bagot, S. Faivre, F. Mentré, M. Avril
Journal: Journal of Clinical Oncology (2008)

9042 Background: Patients (pts) with advanced squamous cell carcinoma of the skin (SCCS) have a poor prognosis. Cetuximab (C), an IGg1 monoclonal antiboby that blocks the epidermal growth factor receptor (EGFR) is active in the treatment of squamous cell carcinoma of the head and neck (SCCHN), a tumor type with high EGFR expression. SCCS is also known to express the EGFR. The objective of the study was therefore to evaluate C in the treatment of unresectable SCCS. Methods: Pts who had advanced or metastatic EGFR expressing SCCS, with an ECOG performance status (PS) of ≤ 2 were eligible for this study. No prior chemotherapy was allowed. C was kindly provided by Merck KGaA and administered iv weekly (400 mg/m2 initial dose followed by 250 mg/m2). Evaluations by MRI or CT were performed every 6 weeks and were independently reviewed. The primary endpoint was the disease control rate at 6 wks (RECIST criteria). It was planned to include 28 evaluable pts who would receive C in the first 6 weeks, and to follow them for one year. Results: Twenty eight pts were recruited between October 2005 and October 2007, of which 19 were male. Median age was 70 yrs; 63% of patients were PS 1 and 20 were AJCC stage 3. Median follow-up was 4.7 mths. At the most recent follow up, 22 pts were evaluable for tumor response and 28 for toxicity. Disease control rate at 6 wks in the ITT population was 61 % (95% CI: 41–78%) and, in evaluable pts, 77% (17/22, 95% CI: 55–92%) corresponding to 15 stabilisations (S) and 2 partial responses (PR). Best responses were 6 PR (22%) and 11 S (41%). 3 pts underwent a surgical excision after treatment with C: histologically the resection was complete in 2 pts and there was no residual disease in 1 pt. Eleven pts died: 6 deaths were related to disease progression including 2 sudden deaths; 3 were considered as NOS and 2 were unrelated to disease or C. Three pts discontinued C, 2 due to grade 4 infusion-related reactions and 1 due to a grade 3 worsening of an epidermolysis bullosa. A grade 3 paronychia related to C occurred in 1 pt. Acneiform rash of grade 1–2 occurred in 71% of pts. Conclusion: These preliminary data suggest that cetuximab is active as a single-agent in the 1st-line treatment of pts with unresectable SCCS, and may be considered a therapeutic option in this setting. No significant financial relationships to disclose.
Evaluation of potentially excessive plasma gemcitabine (dFdC) concentrations produced by 30-minute dFdC infusions
Authors: J. W. Fisher, J. A. Florian, R. S. Parker, A. P. Venook, M. J. Ratain, M. J. Egorin
Journal: Journal of Clinical Oncology (2004)

2019 Background: The phosphorylation of dFdC to active metabolites is saturable, whereas its deamination to the inactive metabolite, 2'2'-difluorodeoxyuridine (dFdU) is not. 30-min dFdC infusions produce plasma concentrations greater than the 10–15 μM that saturate intracellular phosphorylation. We utilized data from patients given 30-min infusions of dFdC to evaluate the percentage of plasma AUC associated with dFdC concentrations ≥ 10–15 μM. Methods: 31 patients with varying degrees of renal and hepatic function were enrolled in CALGB 9565 and underwent intensive pharmacokinetic sampling after being treated with 30-min dFdC infusions at doses of 650–950 mg/m2. Plasma concentrations of dFdC and dFdU were determined by HPLC. Plasma dFdC and dFdU concentration vs. time data were modeled using a 5-compartment model in ADAPT II and additional mathematical methods were developed using MATLAB. AUC was calculated using Simpson's rule and patient-specific pharmacokinetic parameters so as to calculate the total AUC (TAUC) and excessive AUC (EAUC). The fraction of each patient's dFdC AUC spent above 10 and 15 μM was then calculated from the ratio EAUC / TAUC. Results: 4 patients received 650 mg/m2, 17 patients received 800 mg/m2, and 10 patients received 950 mg/m2 of dFdC. The percentages of total dFdC AUC spent above the 10 μM threshold were 68 ± 16, 49 ± 15 and 57 ± 11% for doses of 650, 800, and 950 mg/m2, respectively. The percentages of total dFdC AUC spent above the 15 μM threshold were 58 ± 21, 35 ± 16, and 43 ± 13% for doses of 650, 800, and 950 mg/m2, respectively. Conclusions: Administering dFdC by 30-min infusion resulted in approximately half of the plasma drug exposure (as measured by AUC) occurring above dFdC concentrations that saturate its phosphorylation to active metabolites. This excessive drug may be clinically inconsequential because of its inactivation through deamination to dFdU. The data argue for studying additional patients with normal organ function and other schedules of dFdC delivery. Support: U10 CA44691, National Cancer Institute and a Whitaker Foundation Graduate Student Fellowship (JAF). Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Eil Lilly Corp. Eli Lilly Corporation
Abstract 15707: Fluorescence Voltage Recordings From Stem Cell-Derived Cardiomyocytes Enable High-Throughput Screening for Cardiotoxicity
Authors: Jordan S Leyton-Mange, Robert W Mills, Min-Young Jang, Xaio Ling, Patrick T Ellinor, David J Milan
Journal: Circulation (2014)

Introduction: The lack of high quality predictive models for drug-induced QT prolongation continues to be a significant problem in pharmaceutical development. While human pluripotent stem cell derived-cardiomyocytes (hPSC-CMs) hold promise to be a valuable tool for drug discovery, efforts have been frustrated by the labor-intensive nature of electrophysiological recordings and the heterogeneity of hPSC-CMs populations. Methods: Using lentivirus, we introduced the genetically encoded fluorescent voltage reporter, A242-Arclight, into hPSC-CM monolayers in multi-well plates. An inverted fluorescence microscope was fit with an environmentally controlled enclosure and automated stage. High speed imaging with a Photometrics Evolve 128 EMCCD camera was performed at baseline and after administration of test compounds. Optical traces were processed using a custom program and composite AP durations, APD80, were compared before and after drug application (Figures A &amp; B). Results: Baseline APD80 values displayed high degree of consistency between wells: 483±59 msec. High-throughput data acquisition demonstrated dose dependent APD80 increases from all QT-prolonging agents tested as well as dose dependent APD80 decrease from pinacidil. In contrast, negative control compounds caused no significant changes in APD80. Results from a representative plate are shown (Figure C). Conclusions: Optical measurements provide rapid recordings of drug-induced AP duration changes, and offer a strategy to non-invasively screen hPSC-CMs in high-throughput. Recording from cell monolayers as opposed to single cells and using paired comparisons may be beneficial in addressing the heterogeneity amongst hPSC-CM preparations.
A Microtest Radioimmunoassay for Noncytotoxic Tumor-Specific Antibody to Cell-Surface Antigens2
Authors: Lester T. Goldstein, Norman R. Klinman, Lionel A. Manson
Journal: JNCI Journal of the National Cancer Institute (1973)

A radioimmunoassay capable of measuring cytolytic and noncytolytic antibodies directed against cell-surface antigens was developed. Cells of the murine lymphoma L-5178Y grown in culture were used as a solid-phase immunoadsorbent to which the antibodies in the sera were bound. These bound antibodies were then detected by reacting the treated cells with a purified 125I-labeled, anti-mouse- Fab antibody. Specific antibody was found in a serum from DBA/2J mice (syngeneic host) hyperimmunized against the L-5178Y tumor. This serum was not cytolytic in a complement-dependent assay.
临床证据（14）——急性肾衰竭
Authors: 陈旻, 王海燕
Journal: BMJ (2003)

背景知识 定义 急性肾衰竭(ARF)是指肾小球滤过率突然和持续性下降,导致尿素和其他化学物质在血液中堆积。目前还没有清晰一致的生化学定义,但多数研究的定义为血清肌酐(Scr)2～3mg/dL(200-250 μmol/L),在Scr基础值小于2 mg/dL(170μmol/L)时,升高0.5 mg/dL(45μmol/L)
Cancer center improvement through practice-based clinical leadership team infrastructure.
Authors: Mary Coniglio, Regina Cunningham, Dawna Gillespie
Journal: Journal of Clinical Oncology (2013)

180 Background: A practice based clinical leadership team (PBCL) was created in the outpatient cancer center to identify, evaluate, and implement initiatives to improve safety, quality, and patient satisfaction. A quality leader facilitates the team which includes nursing, physician leaders, as well as subject matter experts from throughout the cancer service line. Methods: Key focus areas include data review/analysis, facilitating performance improvement teams to enhance patient satisfaction and patient safety; and to reduce variations in care. PBCL members participate in Performance Improvement in Action (PIIA) program that includes just-in-time process improvement training while completing projects in a 90-day period. The PIIA approach embeds quality/lean tools in the organization. The training provides structure, common terminology, and stresses the use of data to make decisions, relying on the voice of the customer and clear articulation of the problem statement before jumping to solutions. The methodology incorporates six sigma/lean tools and plan-do-check-act. Results: The PBCL structure has resulted in several specific improvement projects. The patient throughput project team implemented recommendations that increased the percentage of patients who arrived and completed lab tests before their scheduled appointment time by 36%. In addition, a simulation model was created which quantified a 28 minute reduction in total time in the department by increasing the number of patients seen independently by advanced practice providers and removing the room assignment constraint by assigning providers to a “pod of rooms” rather than a specified room(s). An infusion fast track program was implemented for selected medications to expedite patient throughput resulted in an 18 minute (52%) reduction of time in the department. Conclusions: Incorporating clinical leadership in a structured framework for quality improvement increases the buy-in to change while maintaining an objective, data driven approach. The team approach and use of performance metrics provides the opportunity to expedite pilot project testing while raising awareness of key metrics to inform of additional opportunities.
Editorial
Journal: Cardiovascular Research (1999)

In recent years we commented on several aspects of the higher than during the years 1992-1996.Fig. 1 shows the handling of manuscripts, such as submission [1], geo-monthly submission rate, which is now close to 90 graphical trends in submission [2,3], the impact factor of manuscripts per month, a 50% increase compared to 1995.Cardiovascular Research [1,4,5] and the reviewer's related Elsevier Science has provided us with more staff to meet features of the process [6].At the onset of this last year of the administrative consequences of this increase.We have the Millennium we present an update of these data.also extended our number of reviewers to over 2,400.Finally, we have increased the number of published papers by 10% in 1998.
Phase I trial of a mouse monoclonal antibody against GD3 ganglioside in patients with melanoma: induction of inflammatory responses at tumor sites.
Authors: S Vadhan-Raj, C Cordon-Cardo, E Carswell, D Mintzer, L Dantis, C Duteau, M A Templeton, H F Oettgen, L J Old, A N Houghton
Journal: Journal of Clinical Oncology (1988)

Twenty-one patients were entered into a phase I trial to evaluate toxicity, antitumor effects, and biological responses at tumor sites during treatment of R24, an immunoglobulin G3 (IgG3) mouse monoclonal antibody (mAb) against GD3 ganglioside. Toxicity was related to dose of R24. Urticaria and pruritus were the most prominent side effects, with nausea, vomiting, and diarrhea occurring at the highest dose levels. Partial responses were observed in four patients lasting from 6 to 46 weeks, and mixed responses were seen in two patients. Responses occurred as early as 4 weeks and as late as 10 weeks after beginning treatment. Twenty of the 21 patients developed human IgG antibodies against R24. Antimouse Ig antibodies were first detected at a median of 14 days after starting treatment, but three of the four patients who had a partial response developed the antimouse Ig responses later than 20 days. Peak serum levels of R24 were related to dose and ranged from a mean of 0.9 micrograms/mL at the lowest dose level (1 mg/m2/d) to 44 micrograms/mL at the highest dose (50 mg/m2/d). The amount of R24 reaching tumor sites corresponded to the dose administered, and R24 could be detected in tumors as late as 30 days after finishing treatment. Inflammation at tumor sites was observed during treatment. Biopsies of tumors taken before, during, and after treatment revealed that R24 induced deposition of complement components, increased numbers of mast cells with mast cell degranulation, and infiltration of T lymphocytes. These results suggest that treatment with R24 can produce a localized inflammatory response at tumor sites that is capable of producing tumor regression.