tbuckley/cabot-search huggingface dataset:
Weekly cabazitaxel in "unfit" metastatic castration-resistant prostate cancer patients (mCRPC) progressing after docetaxel (D) treatment: Preliminary results of CABASEM-SOGUG phase II trial.
Authors: Ovidio Fernandez Calvo, Eva Fernandez Parra, Begoña Perez-Valderrama, Begoña Mellado, Maria Ochoa de Olza, Daniel E. Castellano, Montserrat Domenech, Susana Hernando Polo, Urbano Anido, Jose Angel Arranz Arija, Cristina Caballero, M Jose Juan, Ignacio Duran, Marc Campayo, Monica Serrano, Miguel Angel Climent
Journal: Journal of Clinical Oncology (2015)

167 Background: Cabazitaxel (C), a novel taxane developed to overcome D resistance, showed an overall survival improvement after D in metastatic castration-resistant prostate cancer (mCRPC) in a three-weekly schedule. Its main toxicity is hematological, especially in unfit patients. We aimed to evaluate efficacy and safety of weekly C/prednisone (P) schedule in "unfit" mCRPC previously treated with D. Methods: Unfit pts defined as ECOG 2, dose reduction due to febrile neutropenia during D treatment or radiation therapy affecting more than 25% of bone marrow reserve, with mCRPC progressing after D treatment with adequate bone marrow, liver and kidney functions were included. C 10 mg/m2 was administered on days 1, 8, 15 and 22 of 5-week cycles with P (5 mg b.i.d.). Radiological and PSA response were evaluated according to the PCWG2 (Scher H, 2008) criteria and toxicity according NCI-CTC AE. Results: To date 70 pts have been enrolled and data are available for 66. Median age was 73 y (range 54-84), 67% pts had ECOG 2, 87% had bone, 14% liver and 11% lung metastases. Half of pts had Gleason &gt;7. Treatment: 271 cycles (median: 3; range: 1-12); 1002 weekly infusions (median 11; range 1-48). Median dose intensity was 93%. Eighteen of 55 pts (32.7%) achieve ≥50% PSA response and 5 (9.1%) ≥80% PSA response. Radiological response was evaluable in 56 pts. PR was observed in 4 pt (7.1%) and SD in 29 pts (51.8%). Median PFS was 3.9 months. Median OS was 14.2 months. Most frequent toxicities of all grades as % of pts were: anemia (71.2%), asthenia (43.9%), thrombocytopenia (15.1%), leukopenia (24.2%), diarrhea (27.3%), nauseas (18.2%), neutropenia (12.1%), peripheral neuropathy (7.6%), and anorexia (18.2%). Grade 3-4: thrombocytopenia (4.5%), anemia (6%), neutropenia (3.0%), asthenia (10.6%), diarrhea (1.5%), anorexia (1.5%), No grade IV diarrhea nor febrile neutropenia were observed. Conclusions: Weekly cabazitaxel (10 mg/m2) plus prednisone administered to unfit pts seems a highly effective treatment and safe, with no grade 4 neutropenia, diarrhea or febrile neutropenia reported. Clinical trial information: NCT01518283.
Clinical and imaging factors associated with severe complications of cervical necrotizing fasciitis
Authors: Hélène Nougué, Anne-Laure Le Maho, Mourad Boudiaf, Jean-Philippe Blancal, Etienne Gayat, Mathieu Le Dorze, Fabrice Vallée, Benjamin Verillaud, Joaquim Mateo, Hakim Kechiche, Claudia Pignataro, Philippe Herman, Alexandre Mebazaa
Journal: Intensive Care Medicine (2015)
Effects of lanreotide autogel/depot (LAN) in patients with neuroendocrine tumors (NETs) age 65 or younger versus older than age 65: Subgroup analyses from the CLARINET study.
Authors: Alexandria T. Phan, Martyn E. Caplin, Marianne E. Pavel, Jaroslaw B Cwikla, Markus Raderer, Eva Sedláčková, Guillaume Cadiot, Edward M. Wolin, Jaume Capdevila, Lucy Wall, Guido Rindi, Alison Langley, Edda Gomez-Panzani, Philippe B. Ruszniewski
Journal: Journal of Clinical Oncology (2015)

367 Background: The somatostatin analog lanreotide Autogel 120 mg significantly prolonged progression-free survival (PFS) vs. placebo (PBO) in patients with metastatic grade 1 or 2 (Ki-67 &lt;10%) non-functioning enteropancreatic NETs (hazard ratio [HR] for progressive disease [PD]/death: 0.47 [95% CI: 0.30, 0.73]). The large size of the trial (n=204) affords an opportunity to examine treatment effects within subgroups of particular interest. Here, we compare PFS and safety data for patients aged ≤65 years vs. aged &gt;65 years. Methods: In this 96-week randomized double-blind trial, patients received LAN 120 mg or PBO every 4 weeks by deep s.c. injection (NCT00353496). Subgroup analyses were undertaken to investigate only the consistency of treatment effects as the study was not otherwise designed or powered for such analyses. Results: Median age (range) was 57 years (30, 65) for thegroup aged ≤65 years and 71 years (66, 92) for the group aged &gt;65 years. Other baseline characteristics were similar between age groups, including tumor origins (≤65 years: pancreatic 43%, midgut 34%; &gt;65 years: pancreatic 46%, midgut 38%) and hepatic tumor loads (&gt;25%: 30% and 37% for ≤65 and &gt;65 years, respectively). Disease was predominantly stable at baseline (94% vs. 98%, respectively). Therapeutic effects of LAN on PFS were similar for the age groups and there were no consistent differences in tolerabilities between age groups (Table). The most common AE was diarrhea irrespective of age and treatment (≤65 years: LAN 36%, PBO 32%; &gt;65 years: LAN 33%, PBO 40%). Conclusions: The treatment effect with LAN in terms of PFS was consistent across age groups and LAN tolerability/safety was favorable in both cases. Clinical trial information: NCT00353496. [Table: see text]
Intermediary Metabolism of Benzo[&lt;italic&gt;α&lt;/italic&gt;]pyrene in the Rat&lt;xref ref-type="fn" rid="fn1"&gt;2&lt;/xref&gt;
Authors: Hans L. Falk, Ph.D., Paul Kotin, M.D., Sung Suk Lee, B.S., Ann Nathan, B.S.
Journal: JNCI Journal of the National Cancer Institute (1962)

The hepatobiliary system is the primary site of metabolism of polycyclic aromatic hydrocarbons. After administration of C14-benzo[a]pyrene and analysis of bile for metabolites, the metabolic products fell into two main categories—primary and secondary oxidation products. The most significant of the former were 3-hydroxybenzo[a]-pyrene and 6-hydroxybenzo[a]pyrene, and in the secondary oxidation products, 1,6-dihydroxybenzo[a]pyrene and 3,6-dihydroxybenzo[a]pyrene. These metabolites were detectable in several different forms, and under physiologic circumstances underwent either glucuronide or sulfate conjugation. 3-Hydroxybenzo[a]pyrene, though a primary oxidation product, appeared subsequent to several dihydroxy derivatives of 6-hydroxybenzo[a]pyrene. Identification of the F1, X2, and F2 metabolites was partially accomplished, and our findings differed slightly from those published earlier. A labile metabolite could be reconverted to parent benzo[a]pyrene after mild acid treatment. The vehicle used for administration of benzo[a]pyrene significantly modified absorption through the tracheobronchial epithelium. Analysis for radioactivity, paper chromatography, and ultraviolet absorption and fluorescence spectroscopy were used for identification of metabolites. When possible, metabolites in chemically pure form were injected intravenously to establish sequence and site of oxidation.
重症监护治疗学（八）危重病人的转运
Authors: 徐晓峰, Wal., Pgh
Journal: BMJ (2001)

重症病人无论是在院内转运如送至影像室 ,还是由于床位短缺或试图获得进一步的治疗而转送其他医院 ,其原则是相似的。本文重点介绍医院间病人的转运。尽管英国的重症监护学会和麻醉学会建议成立专门的救护小组。但 90 %的病人是由转出医院的医护人员陪同转运的。英国每年要转运 1万多名重症病人 ,但大多数医院每年转运不足 2 0例 ,因此各个医院在转运病人方面既缺乏经验 ,又几乎没有人受过专门培训。大多数病人由值班的麻醉实习医师陪同转运 ,这不仅导致医院值班人员不足 ,且陪同人员常缺乏经验。 转运途中的危险重症病人常存在生理紊乱 ,需进行有创监测和器官支持 ,尤其在转运途中 ,其病情更易恶化。车内不利
The novel receptor targeted (CD206) 99mTc-labeled tilmanocept versus the currently employed Tc99m-sulfur colloid in intraoperative lymphatic mapping (ILM) on key performance metrics breast cancer.
Authors: Frederick Oliver Cope, Wendy Metz, Beth Potter, Bonnie Abbruzzese, Michael Blue, Jo Shuping, Lori Christman, Dennis King
Journal: Journal of Clinical Oncology (2012)

e21066 Background: ILM is a key diagnostic component for solid tumor excision. ILM utilizes the injection of a color agent and/or a radiopharmaceutical agent (RPA) which may be tracked intraoperatively w/ a γ-probe. ILM is designed to aid the surgeon in tracing lymph nodes that may have a connection to the tumor bed. ILM in the U.S. employs a non-standard RPA, S-colloid (TcSC). This agent was recently approved by the FDA for breast cancer ILM using a literature review. In contrast, CD206-targeted Tc99m-tilmanocept (TCP) was studied in 2 prospective Ph-3 trials. These trials compared TCP to blue dye, the same dye utilized in the FDA review of TcSC. Methods: For a statistical review and contrast of TCP vs TcSC, we used a meta-analysis and pooled analysis based on the FDA-review of TcSC. We focused on the functional endpoints: 1] Localization rate (% of pts w/ a found hot node) and 2] degree of localization (# of found hot nodes/pt). Both metrics define the potential for agent performance for ILM and nodal metastasis. Results: The contrast of the localization rate/pt for TcSC at 94% was based on TcSC’s reviewed value. The results for the proportion of TCP patients were localization rates of 99.91% by meta-analysis and 98.65% by pooled analysis; p<0.0001 and p<0.008, repsectively (1-sided test, H0 p=/< 0.94). The contrast of the # hot nodes/pt. This value was benchmarked at 1.6 nodes/pt based on TcSC’s review value. The results for the nodes/pt of TCP patients were 2.08 by meta-analysis and 2.16 by pooled analysis; p<0.0001 and p<0.0001, repsectively (1-sided test, H0 p=/< 1.6). Conclusions: TCP provided significantly greater performance in key metrics, node localization/pt, and degree of localization (nodes found/pt) in breast cancer. All values are highly statistically significant for the key clinical performance parameters. These data suggest that receptor targeted TCP may provide improved diagnostic ILM over the currently employed nonspecific RPA lymphatic mapping agent TcSC.
Abstract P362: Validation of a Simple Method to Estimate Populational 24-h Urinary Sodium Excretion Based on a Casual Urine Specimen in an Adult Danish Population
Authors: Ulla Toft, Charlotte Cerquira, Torben Jørgensen
Journal: Circulation (2012)

Background: Tanaka et al (J Hum Hypert 2002; 16: 97-103) developed a simple method to estimate populational 24-h urinary sodium excretion using a casual urine specimen. However, this method was developed and validated in a Japanese population and thus this method might not be valid in populations that differ markedly from this population. Hypothesis: We assessed the hypothesis that the 24 hour urinary sodium excretion can be estimated from a casual spot urine using the Tanaka prediction method in a Danish general population. Methods: Overall 473 Danish individuals provided both a 24h urine collection and a spot urine sample. Data were collected in the Danthyr study (248 women aged 25-30 years and 60-65 years) and the Inter99 study (102 men and 113 women aged 30-60 years), respectively. Only participants with complete 24h urine collection (validated by the PABA method) were included. We compared the estimated daily sodium excretion through 24h urine (the gold standard) with the predicted 24 h sodium excretion from a causal urine specimen, using the Tanaka prediction method. Results: The predicted median 24 h sodium excretion (median [5 and 95 percentile]) was 8.6 gram [3.7;17.5] compared with a median measured 24 h sodium excretion of 8.9 [5.4; 13:1]. The mean (sd) residual (measured minus predicted 24 h sodium excretion) was 0.08 (3.7). The correlation (Spearman) between predicted and measured 24 h sodium excretion was 0.39 and the R 2 was 0.17. The proportion of individuals classified in the same or adjacent quintiles was 67%. Gross misclassification was found for 3% of the individuals. However, a Bland-Altman plot indicated a tendency of underestimation the sodium excretion for individuals with a high level of sodium excretion (&gt;14 g per day). Conclusion: The Tanaka prediction model gives a reasonable estimate of sodium intake in a Danish population using casual spot urines. However, the validation study showed a tendency of underestimation of the sodium intake for individuals with a high sodium excretion (&gt;14 g per day).
Modified Chemotherapy With Carmustine, Cytarabine, Cyclophosphamide, and 6-Thioguanine (BACT) and Autologous Bone Marrow Transplantation in 24 Poor-Risk Patients With Acute Lymphoblastic Leukemia&lt;xref ref-type="fn" rid="FN1"&gt;1&lt;/xref&gt;
Authors: J L Pico, O Hartmann, D Maraninchi, F Beaujean, E Benhamou, B Mascret, G Novakovitch, R Ghalie, C Kalifa, M Hayat
Journal: JNCI Journal of the National Cancer Institute (1986)

Twenty-four poor-risk patients with acute lymphoblastic leukemia received a modified regimen of carmustine, cytarabine, cyclophosphamide, and 6-thioguanine (BACT) followed by autologous bone marrow transplantation (ABMT). Nineteen patients were in second or subsequent complete remission (CR) when treated with this regimen; 3 died early, 2 died of pneumonia in CR, 11 relapsed within 3 months (median), and 3 remain in CR with no maintenance therapy 14-24 months after ABMT. Of the 5 patients with measurable disease who were treated, 3 had CR and 1 remains in CR without maintenance therapy more than 28 months after ABMT. The toxicity of this regimen was acceptable, but late pulmonary toxic effects remain a major concern. These results are poor in terms of efficacy, and new effective methods of eradicating acute lymphoblastic leukemia in patients with poor prognosis should be investigated.
Response of Proguanil-resistant Strain of P. Falciparum to Pyrimethamine
Authors: S. A. Jones
Journal: BMJ (1953)

The morphological and cultural characteristics of the organism are described, and are compared with those reported by other workers.A morphologically similar organism found in the normal vagina, which must not be mistaken for fusi- formis, is briefly mentioned.With suitable antibiotic treatment, and surgical drainage where indicated, the prognosis in infection with these organisms is regarded as good.I wish to thank both Dr.
Selective internal radiation therapy (SIRT) as salvage therapy for uveal melanoma (UM) hepatic metastases
Authors: C. F. Gonsalves, D. J. Eschelman, K. L. Sullivan, P. R. Anne, L. Doyle, T. Sato
Journal: Journal of Clinical Oncology (2009)

9066 Background: The liver is the first site of metastasis in &gt;80% of patients with UM. Transarterial chemoembolization (TACE) has been used to control hepatic metastases, however, patients eventually progress through or experience complications related to TACE. We report our results using SIRT as salvage therapy for patients with UM liver metastases who are no longer candidates for TACE. Methods: Patients with UM liver metastases previously treated with TACE were treated with SIRT. Patients were followed 1-month post-SIRT for acute toxicity then every 3 months for tumor response evaluation and for complications of delayed toxicity. Common Toxicity Criteria 3.0 (CTC) was used for toxicity assessment. Best radiographic tumor response was determined by MRI using RECIST criteria. Results: Five men and 7 women, ages 48–81 (median 65) with UM liver metastases were treated with SIRT after tumor progression post-TACE (n=9), complications of TACE (n=1) or patient preference (n=2). Pretreatment whole liver tumor burdens were as follows: &lt;25% (n=10), 25–50% (n=1) and &gt;50% (n=1). Patients had both hepatic lobes treated on separate occasions (n=7), one lobe (n=3) or whole liver (n=2) therapy. Treatment dose per patient was reduced by 25% due to prior TACE procedures. The mean total SIRT dose delivered was 1.0 GBq (0.62–1.47 GBq). Five patients had an increase in hepatic enzymes (Grade 1–4) at 1-month follow-up. No procedure related deaths or serious adverse events were experienced. Best tumor response was as follows: CR (n=0), PR (n=0), SD (n=8), PD (n=4), with a median follow-up of 7.8 months (1.0–16.0). The median time to liver progression was 7.0 months (1.0- 15.5). Nine of the 12 patients, including 2 patients with &gt;25% pretreatment tumor burden, died due to progression of liver disease (n=6), extrahepatic disease (n=1) or both (n=2). Post-SIRT, median overall patient survival was 10.8 months (1.0–19.0). Three patients (ECOG 0 performance status) are still alive at 13.5–19.0 months (median 16.2 months) following SIRT. Conclusions: SIRT was safely used and showed a potential clinical benefit for patients previously treated with TACE. Further investigation is warranted to determine if SIRT should be employed as a first line therapy for patients with UM liver metastases. No significant financial relationships to disclose.
Effectiveness of continuity in “World Day of COPD” awareness campaign on case finding for COPD in target population
Authors: Florin Mihaltan, Roxana Nemes, Amelia Ionescu
Journal: European Respiratory Journal (2011)

Background and aim:  To evaluate effectiveness of continuity in awareness disease campaign on case-finding for COPD in a target population: over 35, smokers/ex-smokers, at least one respiratory symptom.   Methods:  1-week marketing campaign was conducted 2009-2010 in WCD, using different marketing tools. Target population had open access to spirometry. Population was encouraged to visit COPD web-site to inform and take on-line COPD risk-test. In 2009 – high visibility posters, leaflets within medical offices, press conference on World COPD Day. In 2010 – media campaign, press conference precede COPD Week, leaflets as personal letters from President of Romanian Society of Pneumology, distributed directly to population,through telephony companies. Primary outcome was number of COPD diagnosed. Secondary outcomes measures: unique site visitors, number of persons who perform on-line COPD risk test.   Results:  In 2009, 3494 persons were tested, 847 diagnosed (24%). In 2010, 4298 persons were tested, 1259 diagnosed (29%) – see Table 1.  Web-site access: 804 in 2009, with 245 on-line test (30%); 5006 in 2010, with 2367 on-line test (46%) – see Table 2.   Conclusion:  Continuity in awareness disease campaign on COPD case-finding increased presentation and interest about COPD. Awareness campaign in media, more personalized messages, directly addressed to potential patients, increased effectiveness of social marketing models.
The clinical relevance of epidemiology: An overview
Authors: C. La Vecchia, S. Franceschi
Journal: Annals of Oncology (1991)

Epidemiology is one of the areas of medical research which by definition should have immediate clinical implications, since its inferences are based on and apply to humans and should in theory be directly transferable to clinical and preventive measures. However, interchange of information has not always been easy, and this has constituted a substantial drawback to both the epidemiologist and the clinician. This review paper will provide some points for discussion, with special emphasis on cancer epidemiology and aspects of specific interest to the clinician, i.e., quantification and risk assessment for primary prevention and cost/benefit evaluation for secondary prevention and cancer treatment. Quantitative assessment is of major importance for the oncologist in at least three areas: cancer trends (descriptive epidemiology), cancer risks (analytical epidemiology), and preventive and therapeutic measures (clinical epidemiology).
Short-term effects of airborne pollen on emergency department visits for asthma in three Swedish cities
Authors: Kadri Meister, Bertil Forsberg
Journal: European Respiratory Journal (2014)

In epidemiological studies that examine associations between air pollution and aggravation of asthma is information on airborne pollen not always incorporated, ignoring their role and potential bias. Our aim was to study the short-term effects of two major types of allergenic pollen in Sweden, birch and grass, on daily emergency department visits for asthma (ICD10: J45-J46) ,  in the three largest cities in Sweden (Stockholm, Gothenburg and Malmo). Focus was on daily total visits and visits in separate age classes (children and adults). Data from 2001 through 2008 were collected. To study the effect of pollen at different pollen concentrations, pollens were categorized into concentration intervals defined on the basis of the standard scale for forecast of daily pollen levels. We used additive Poisson regression models. Lag 01 of birch and grass pollen and air pollution variables (PM 10 , O 3  and NOx) were simultaneously included in the model. We found that the birch pollen was positively associated with emergency department visits for asthma in Stockholm. For example, we estimated the increase of 3 % (95% CI 2.5 to 3.5%) in daily visits for all ages and 2 % (95% CI 1.5 to 2.9 %) among children per 100 grains/m 3  increase in highest interval (> 100 grains/m 3 ), respectively. In Gothenburg we found a tendency for birch pollen to be positively associated with asthma visits among children and grass pollen among adults, respectively. In Malmo, no statistically significant effects of any studied pollen on daily visits for asthma were found. There seem to be regional differences in effects of different types of pollen. The representativity of pollen measurements may be one explanation.
一个“不爱学习”的军官
Authors: 曾昭耆
Journal: BMJ (2007)

50多年前，我刚毕业不久，在军医大学附属医院内科进修学习。那时，刚开始设立神经科，但在这个医院还没有形成独立的科室，由内科医生兼管。一天晚上我值急诊，两个军队干部送来了一个20多岁的患者，要我查查他到底有什么病。我一般性地问了病史，查体，做了常规化验，没有发现什么问题。陪送的人私下告诉我说，他们来自基层野战部队，患者是一个连级干部，他作战时非常英勇，平时带领战士训练、劳动表现也很突出，但最近部队动员学文化，他就闹情绪，拿起书看一会儿就说“头痛”，不愿学习。到野战医院检查过，医生说没有病，所以首长指示让到上级医院再查，如果没有病，就要对其进行批评教育。
Clinical and genotypic pattern of multidrug resistant tuberculosis isolated from extrapulmonary tuberculosis cases in tertiary care hospitals in northern India
Authors: Anand Kumar Maurya, Surya Kant, Vijaya Lakshmi Nag, Ram Awadh Singh Kushwaha, Tapan N. Dhole
Journal: European Respiratory Journal (2011)

Background:  Extra-pulmonary tuberculosis (EPTB) is an important clinical problem in India as well as worldwide. The diagnosis of EPTB in its different clinical presentations remains a true challenge. The emergence and widespread dissemination of multidrug resistant (MDR) strains of Mycobacterium tuberculosis pose a serious threat to EPTB.   Objectives:  To compare clinical pattern of MDRTB patients and genotypic pattern of these Mycobacterium tuberculosis isolates from EPTB cases.   Methods:  A total of 789 specimens from patients of EPTB cases with varied presentation were studied. A total of 123 M. tuberculosis isolates recovered during the period Jan 2008-Dec2010 were tested for drug susceptibility against SHRE using the proportion method on Radiometric BACTEC. MDR isolates were sequenced in rpoB, katG and inhA for mutation analysis.   Results:  165 (20.7%) of 797 patients clinically suspected to have EPTB were BACTEC culture positive for mycobacteria. Out of 123/165 (74.5%) were M. tuberculosis cases, 94 (77%) were newly diagnosed and 29 (23%) retreated cases. Based on the phenotypic drug susceptibility testing results, 15 (12.1%) was MDR-TB. On basis of genotypic characterization of 15 MDR isolates, Rifampicin resistance related mutations in the rpoB gene were detected in 13/15 (86.7%). Isoniazid resistance-related mutations in the katG and inhA genes were detected in 12/15 (80%) of the MDR isolates.   Conclusions:  Our study provides incidence of MDR-TB has been increasing in the clinical isolates of EPTB in Northern India. Genotypic pattern of MDR could be offer necessary information for improved TB control in the future.