tbuckley/cabot-search huggingface dataset:
Head and neck cancers in Kano, Nigeria
Authors: A. D. Salisu, A. A. Aluko, A. Z. Mohammed
Journal: Journal of Clinical Oncology (2008)

17553 Background: The therapeutic options for cancers of the Head and Neck are expensive in developing countries and attention needs to be directed at prevention. Knowledge of the pattern of the disease is thus imperative for the proper planning of preventive strategy. This study is to determine the pattern of head and neck cancer as seen in otolaryngology practice in a tertiary institution in Kano, north-western Nigeria. Methods: A retrospective study of all patients with histological confirmation of malignancy who attended the ENT department of Aminu Kano Teaching Hospital, Kano between January 2001 and December 2005 was carried out. Informations were retrieved from patients record folders and records in histopathology department. Results: There were One hundred and eighteen patients, mean age 46.2 years (range 10years to 85years). There were 92 males and 26 females (M:F ratio of 3.5:1). Nasopharyngeal cancer was the most common 39%, cancer of larynx 17% and sino-nasal cancers 16%, otologic cancers 4.2%. Squamous cell carcinoma predominated histologically (76%). Conclusions: The pattern seen in this study is similar to that reported from other centres in Nigeria. Viral infections such as Epstein-Barr virus which is associated with nasopharyngeal cancers and Human papilloma virus type 16 infections which are associated with several head and neck cancers may be responsible. Further research to determine factors responsible for occurrence of these cancers in our environment is recommended. No significant financial relationships to disclose.
PTU-241 A pragmatic approach to investigation of iron deficiency anaemia in the elderly
Authors: J L Hulley, M Gunn, J Robertson
Journal: Gut (2012)

<h3>Introduction</h3> Recent British Society of Gastroenterology (BSG) guidelines<sup>1</sup> recommend all post-menopausal women and all men with confirmed iron deficiency anaemia (IDA) should be considered for upper and lower gastrointestinal investigation. Increasing demands on limited resources mean a straight-to-test approach is commonly adopted in busy gastrointestinal units. In the elderly this may result in poor attendance and inappropriate endoscopic investigations in high-risk patients. <h3>Methods</h3> We looked at one year9s experience of a nurse-led one-stop IDA service which offered an initial clinic visit to discuss the most appropriate mode of investigation in patients aged 75 years and older. Four options were considered: bi-directional endoscopy, OGD and CT colonography with faecal tagging, plain CT scan of abdomen/pelvis or treatment of anaemia without investigation. Data were collected retrospectively for the period of April 2010 to April 2011 for this group of patients. <h3>Results</h3> 244 patients were referred over the year. Ninety-six were 75 and over: 67 female, 30 male. Age range of 75–97. Fifty-nine patients had confirmed IDA based on the haemoglobin level, mean corpuscular volume (MCV) and ferritin. Twenty-seven patients were iron deficient without anaemia. Ten patients had normocytic anaemia. In the IDA group: 25/59 (42.3%) patients qualified for bi-directional endoscopy. 16/59 (27%) patients opted for alternative investigations and 18/59 (30.5%) either were not suitable, chose not to be investigated or did not attend their appointments. In the iron-deficient group: 6/27 (22%) underwent bi-directional endoscopy. 7/27 (26%) had alternative investigations and 14/27 (51.8%) were not investigated for reasons as outlined in the IDA group. In the normocytic anaemia group: 4/10 (40%) had IDA, 1/10 (10%) underwent bi-directional endoscopy. Only 32/96 (33%) patients initially referred to the IDA service underwent bi-directional endoscopy. <h3>Conclusion</h3> Only a third of elderly patients referred for investigation of IDA were appropriate for bi-directional endoscopy. A straight-to-test approach in this group of patients is likely to result in inefficiencies in endoscopy slots and inappropriate investigations in a high-risk group. We recommend a one-stop initial clinic assessment in this group of patients. <h3>Competing interests</h3> None declared. <h3>Reference</h3> 1. <b>Goddard AF</b>, James MW, McIntyre AS, <i>et al.</i> Guidelines for the management of iron deficiency anaemia. <i>Gut</i> 2011;<b>60</b>:1309–16.
Referred itch (Mitempfindungen).
Authors: P R Evans
Journal: BMJ (1976)

About one person in four or five is conscious that scratching an irritation may produce an itch elsewhere. The sensation is well localised, comes and goes quickly, and recurs when scratching is repeated a short while later. Scratch and referred itch are ipsilateral; scratching the site of the referred itch does not cause the original spot to itch. Scatching face, palms, or soles does not produce referred itching. Different people stimulated in the same region do not necessarily feel referred itch in the same place. The mechanism of the phenomenon is unknown, though it may be thalamic.
Results of intensive therapy in children with localized alveolar extremity rhabdomyosarcoma: a report from the Intergroup Rhabdomyosarcoma Study.
Authors: R Heyn, M Beltangady, D Hays, W Lawrence, W Newton, W Crist, M Tefft, H M Maurer
Journal: Journal of Clinical Oncology (1989)

Preliminary analyses of treatment results and prognostic factors from the first Intergroup Rhabdomyosarcoma Study (IRS I) suggested that alveolar histology and extremity site were among factors associated with an adverse outcome in clinical group I patients whose tumors had been completely resected. A high incidence of alveolar histology among the extremity tumors compounded the problem. These findings prompted an amendment to IRS II shortly after the study opened. Therapy for patients with alveolar extremity tumors in groups I and II was changed to more intensive repetitive pulse vincristine, dactinomycin, and cyclophosphamide (VAC) for 2 years. The outcome of 44 patients who received intensive therapy on IRS II is compared with a control series of 30 patients who were treated on IRS I. The control patients received standard VAC therapy for 2 years or VA for 1 year. Half of group I control patients received local radiotherapy, whereas none was given to group I intensive therapy patients. In both studies group II patients received radiotherapy to the primary tumor site and to identified positive regional lymph nodes. Compared with the control group, patients given more intensive therapy had a longer disease-free survival (DFS) (69% v 43% at 3 years), but this was of marginal significance (P = .06). The overall survival difference (77% v 57% at 3 years) was not significant (P = .23). Despite the limited statistical evidence, there is some indication that intensive therapy improved the prognosis of children with localized alveolar rhabdomyosarcoma (RMS).
How I Am
Authors: Chauncey D. Leake
Journal: The Annual Review of Pharmacology and Toxicology (1976)

Heme oxygenases (HO) catabolize free heme, that is, iron (Fe) protoporphyrin (IX), into equimolar amounts of Fe2+, carbon monoxide (CO), and biliverdin. The stress-responsive HO-1 isoenzyme affords protection against programmed cell death. The mechanism ...Read More
Absorption studies in patients with `intraabdominal ileostomy reservoirs' and in patients with conventional ileostomies
Authors: R. Jagenburg, G. Dotevall, J. Kewenter, N. G. Kock, B. Philipson
Journal: Gut (1971)

Twenty patients with ileostomy were studied concerning the absorption of d-xylose, fat, l-phenylalanine, and vitamin B<sub>12</sub>. Ten patients had a conventional ileostomy, whereas 10 others were provided with an intraabdominal intestinal ileostomy reservoir resulting in faecal continence. No remarkable differences in the absorption of d-xylose, fat, or l-phenylalanine were found between the two groups of ileostomy patients. Most of the absorption values were within normal or borderline ranges. In the reservoir group the Schilling test gave subnormal values in six out of 10 patients, whereas only one patient in the group with a conventional ileostomy had a subnormal value. The reason for this finding is briefly discussed.
Donor-type CD4+CD25+ Regulatory T Cells Suppress Lethal Acute Graft-Versus-Host Disease after Allogeneic Bone Marrow Transplantation
Authors: Petra Hoffmann, Joerg Ermann, Matthias Edinger, C. Garrison Fathman, Samuel Strober
Journal: The Journal of Experimental Medicine (2002)

Acute graft-versus-host disease (aGVHD) is still a major obstacle in clinical allogeneic bone marrow (BM) transplantation. CD4+CD25+ regulatory T (Treg) cells have recently been shown to suppress proliferative responses of CD4+CD25− T cells to alloantigenic stimulation in vitro and are required for ex vivo tolerization of donor T cells, which results in their reduced potential to induce aGVHD. Here we show that CD4+CD25+ T cells isolated from the spleen or BM of donor C57BL/6 (H-2b) mice that have not been tolerized are still potent inhibitors of the alloresponse in vitro and of lethal aGVHD induced by C57BL/6 CD4+CD25− T cells in irradiated BALB/c (H-2d) hosts in vivo. The addition of the CD4+CD25+ Treg cells at a 1:1 ratio with responder/inducer CD4+CD25− T cells resulted in a &amp;gt;90% inhibition of the mixed leukocyte reaction and marked protection from lethal GVHD. This protective effect depended in part on the ability of the transferred CD4+CD25+ T cells to secrete interleukin 10 and occurred if the Treg cells were of donor, but not host, origin. Our results demonstrate that the balance of donor-type CD4+CD25+ Treg and conventional CD4+CD25− T cells can determine the outcome of aGVHD.
Psychosocial Concerns and Interventions for Cancer Survivors
Authors: Annette L. Stanton
Journal: Journal of Clinical Oncology (2006)

In light of the increasing population living with a history of cancer in the United States, it is important to attend to quality of life and health in this group, and to develop effective interventions to address psychosocial and physical concerns across the course of the cancer trajectory. The goals of this article are to document the need for attention to psychosocial domains; offer a brief overview of the current status of the empirical literature on effects of psychosocial interventions with cancer survivors, relying on systematic reviews and meta-analyses conducted in the last decade; highlight recent examples of randomized, controlled psychosocial intervention trials directed toward cancer survivors after the completion of primary medical treatments (ie, the re-entry phase and beyond); and identify directions for application and research.
Age-Related Prognostic Impact of Different Types of <i>DNMT3A</i> Mutations in Adults With Primary Cytogenetically Normal Acute Myeloid Leukemia
Authors: Guido Marcucci, Klaus H. Metzeler, Sebastian Schwind, Heiko Becker, Kati Maharry, Krzysztof Mrózek, Michael D. Radmacher, Jessica Kohlschmidt, Deedra Nicolet, Susan P. Whitman, Yue-Zhong Wu, Bayard L. Powell, Thomas H. Carter, Jonathan E. Kolitz, Meir Wetzler, Andrew J. Carroll, Maria R. Baer, Joseph O. Moore, Michael A. Caligiuri, Richard A. Larson, Clara D. Bloomfield
Journal: Journal of Clinical Oncology (2012)

Purpose To determine the frequency of DNMT3A mutations, their associations with clinical and molecular characteristics and outcome, and the associated gene- and microRNA-expression signatures in primary cytogenetically normal acute myeloid leukemia (CN-AML). Patients and Methods Four hundred fifteen previously untreated adults were analyzed for DNMT3A mutations and established prognostic gene mutations and expression markers. Gene- and microRNA-expression profiles were derived using microarrays. Results Younger (&lt; 60 years; n = 181) and older (≥ 60 years; n = 234) patients had similar frequencies of DNMT3A mutations (35.3% v 33.3%). Missense mutations affecting arginine codon 882 (R882-DNMT3A) were more common (n = 92; 62%) than those affecting other codons (non–R882-DNMT3A). DNMT3A-mutated patients did not differ regarding complete remission rate, but had shorter disease-free survival (DFS; P = .03) and, by trend, overall survival (OS; P = .07) than DNMT3A–wild-type patients. In multivariable analyses, DNMT3A mutations remained associated with shorter DFS (P = .01), but not with shorter OS. When analyzed separately, the two DNMT3A mutation types had different significance by age group. Younger patients with non–R882-DNMT3A mutations had shorter DFS (P = .002) and OS (P = .02), whereas older patients with R882-DNMT3A mutations had shorter DFS (P = .005) and OS (P = .002) after adjustment for other clinical and molecular prognosticators. Gene- and microRNA-expression signatures did not accurately predict DNMT3A mutational status. Conclusion DNMT3A mutations are frequent in CN-AML, and their clinical significance seems to be age dependent. DNMT3A-R882 mutations are associated with adverse prognosis in older patients, and non–R882-DNMT3A mutations are associated with adverse prognosis in younger patients. Low accuracy of gene- and microRNA-expression signatures in predicting DNMT3A mutation status suggested that the role of these mutations in AML remains to be elucidated.
Advancing Cervical Cancer Prevention Initiatives in Resource-Constrained Settings: Insights from the Cervical Cancer Prevention Program in Zambia
Authors: Mulindi H. Mwanahamuntu, Vikrant V. Sahasrabuddhe, Sharon Kapambwe, Krista S. Pfaendler, Carla Chibwesha, Gracilia Mkumba, Victor Mudenda, Michael L. Hicks, Sten H. Vermund, Jeffrey S. A. Stringer, Groesbeck P. Parham
Journal: PLoS Medicine (2011)

Groesbeck Parham and colleagues describe their Cervical Cancer Prevention Program in Zambia, which has provided services to over 58,000 women over the past five years, and share lessons learned from the program's implementation and integration with existing HIV/AIDS programs.
Maternal Depressive Symptoms and Children’s Emotional Problems
Authors: Catherine M. Herba, Richard E. Tremblay, Michel Boivin, Xuecheng Liu, Chantal Mongeau, Jean R. Séguin, Sylvana M. Côté
Journal: JAMA Psychiatry (2013)

Maternal depression is a major risk factor for the development of children's mental health problems. No population-based study to date has examined whether early child care spanning the full preschool period from infancy onward is protective for children of depressed mothers.To examine whether early child care moderates associations between maternal depressive symptoms (MDSs) and child internalizing problems (emotional problems [EPs], separation anxiety symptoms, and social withdrawal symptoms [SWSs]) during the preschool period.Population-based prospective cohort study within the Québec Longitudinal Study of Child Development.Québec Longitudinal Study of Child Development participants (n = 1759) assessed repeatedly between ages 5 and 60 months.High-level trajectories of EPs, SWSs, and separation anxiety symptoms between ages 17 and 60 months.Child care age at entry moderated associations between MDSs and child internalizing problems. Among children of mothers with elevated MDSs, reduced odds ratios for EPs and SWSs were found for those entering child care early (0.24; 95% CI, 0.09-0.66 for EPs and 0.29; 95% CI, 0.09-0.92 for SWSs) or late (0.29; 95% CI, 0.11-0.77 for EPs and 0.21; 95% CI, 0.07-0.65 for SWSs) compared with those remaining in maternal care. Child care type moderated the association between MDSs and child EPs; children of mothers with elevated MDSs who received group-based child care had lower odds ratios for EPs than those who remained in maternal care (0.21; 95% CI, 0.09-0.48) or those who were cared for by a relative or babysitter (0.40; 95% CI, 0.17-0.94).Regulated early child care services reduced the risks for internalizing problems for children of mothers with elevated MDSs. Regulated child care services may be used as a public health intervention to buffer the negative effect of maternal depression on children's internalizing problems.
Chemokine:Receptor Structure, Interactions, and Antagonism
Authors: Samantha J. Allen, Susan E. Crown, Tracy M. Handel
Journal: Annual Review of Immunology (2007)

Chemokines are critical mediators of cell migration during routine immune surveillance, inflammation, and development. Chemokines bind to G protein–coupled receptors and cause conformational changes that trigger intracellular signaling pathways involved in cell movement and activation. Although chemokines evolved to benefit the host, inappropriate regulation or utilization of these proteins can contribute to or cause many diseases. Specific chemokine receptors provide the portals for HIV to get into cells, and others contribute to inflammatory diseases and cancer. Thus, there is significant interest in developing receptor antagonists. To this end, the structures of ligands coupled with mutagenesis studies have revealed mechanisms for antagonism based on modified proteins. Although little direct structural information is available on the receptors, binding of small molecules to mutant receptors has allowed the identification of key residues involved in the receptor-binding pockets. In this review, we discuss the current knowledge of chemokine:receptor structure and function, and its contribution to drug discovery.
Reproducibility of spirometrically controlled CT lung densitometry in a clinical setting
Authors: RJ Lamers, GJ Kemerink, M Drent, JM van Engelshoven
Journal: European Respiratory Journal (1998)

The aim of this study was to assess the reproducibility of quantitative, spirometrically gated computed tomographic (CT) lung densitometry at defined levels of inspiration in hospitalized patients. On two consecutive days, spirometrically gated CT sections were obtained from 20 hospitalized patients at 5 cm above and 5 cm below the carina, and at 90 and 10% of the vital capacity (VC). The mean, modal and median lung densities were calculated, the cut-off points of the frequency distribution of Hounsfield units (HU) defining the lowest and the highest 10th percentile, as well as the histogram full width at half maximum. The lung density parameters of corresponding CT sections of both studies were compared. Reproducibility was expressed as the standard deviation of the signed difference between the results of Day 1 and Day 2 divided by the square root of 2. Reproducibility data were correlated with results of airflow limitation. At 90% VC, reproducibility was of the order of 3-14 HU in both lung zones. At 10% VC, reproducibility was worse by approximately a factor of three. No relationship was found between reproducibility and results of airflow limitation. In conclusion, objective measurement of lung density at spirometrically controlled levels of inspiration is a reproducible method in assessing pulmonary density. Reproducibility of lung density measurements is not influenced by severe respiratory insufficiency. The most reproducible computed tomographic lung density measurements can be obtained at 90% vital capacity.
Predictors of Oral Mucositis in Patients Receiving Hematopoietic Cell Transplants for Chronic Myelogenous Leukemia
Authors: Kim Robien, Mark M. Schubert, Barbara Bruemmer, Michele E. Lloid, John D. Potter, Cornelia M. Ulrich
Journal: Journal of Clinical Oncology (2004)

Oral mucositis is a nearly universal and often severe complication following hematopoietic cell transplantation (HCT). The objective of this study was to evaluate factors predicting oral mucositis severity among 133 patients undergoing allogeneic HCT for chronic myelogenous leukemia.All patients were transplanted between 1992 and 1999, were >or= 18 years of age, received either cyclophosphamide/total-body irradiation (TBI) or busulfan/cyclophosphamide conditioning regimens, and received four doses of methotrexate for graft-versus-host disease prophylaxis post-transplant. Oral mucositis was measured by a trained examiner every 2 to 3 days using the Oral Mucositis Index (OMI). Multiple linear regression analysis was used to identify predictors of mean OMI during days 6 to 12, 1 to 18, and the maximum OMI score between days 1 to 18.TBI containing conditioning regimens, body mass index >or= 25, and methylenetetrahydrofolate reductase 677 TT genotype were found to be predictive of higher mean OMI scores (P <.05). Pretransplant multivitamin supplement use was associated with lower mean OMI scores compared to those who did not use supplements. Smoking status, race, pretransplant treatment with interferon-alfa or hydroxyurea, and patient/donor ABO compatibility were not associated with mean OMI scores.Patients who are scheduled to receive conditioning regimens containing TBI, have a pretransplant body mass index >or= 25, or carry the methylenetetrahydrofolate reductase 677 TT genotype should be considered at greater risk of developing oral mucositis following HCT. Future studies should investigate whether multivitamin supplementation before HCT could reduce mucositis severity.
Significance of Increasing Levels of Minimal Residual Disease in Patients With Philadelphia Chromosome–Positive Chronic Myelogenous Leukemia in Complete Cytogenetic Response
Authors: Hagop M. Kantarjian, Jianqin Shan, Daniel Jones, Susan O'Brien, Mary Beth Rios, Elias Jabbour, Jorge Cortes
Journal: Journal of Clinical Oncology (2009)

Purpose The aim of this study was to evaluate the clinical relevance of increases in quantitative polymerase chain reaction (QPCR) levels in patients with chronic myelogenous leukemia (CML) who are in complete cytogenetic response (CGCR) on therapy. Patients with Philadelphia chromosome (Ph)–positive CML receiving tyrosine kinase inhibitors (TKIs) are frequently monitored for response by QPCR studies for minimal molecular disease. The clinical significance of increasing levels of QPCR in patients in CGCR is uncertain. Patients and Methods One hundred sixteen patients in durable CGCR, and on imatinib therapy for at least 18 months, had increases in QPCR levels (documented at least twice consecutively) as defined by literature reports. These were further analyzed by the achievement of major molecular response (MMR) defined as QPCR ≤ 0.05%, as well as by the degree of increase in QPCR. Results Only 11 (9.5%) of 116 patients with increases in QPCR had CML progression; 10 of them were among 44 patients (23%) who either lost a MMR or never had a MMR, and had more than 1 log increase of QPCR. Conclusion Most patients with increases in QPCR remain in CGCR. Patients who lose a MMR or never achieve a MMR, and have more than 1 log increase of QPCR, should be monitored more closely, and may be evaluated for mutations of BCR-ABL kinase domain and considered for investigational therapeutic interventions.
Ethics of clinical trials from bayesian perspective: Randomisation to clinical trials may solve dilemma of treatment choice in prostate cancer
Authors: F. C Hamdy
Journal: BMJ (2003)

EDITOR—Lilford uses the example of the ProtecT study to raise concerns about recruitment to clinical trials, taking quotations out of context from Donovan et al.1 2 Lilford asserts that in this study men are simply told that the best treatment for localised prostate cancer is “uncertain” that they are not given enough information or time to question the recruiter about essential details about treatments and side effects; and that …