tbuckley/cabot-search huggingface dataset:
PWE-232 Indications for intestinal and multivisceral transplantation at addenbrooke–s hospital, cambridge
Authors: CS Rutter, LM Sharkey, NK Russell, AJ Butler, SJ Middleton
Journal: Gut (2015)

<h3>Introduction</h3> Small intestinal transplantation was first undertaken in Cambridge in 1991. All patients are discussed at the National Adult Intestinal Transplantation Forum (NASIT) and indications for transplantation agreed prior to listing. We present the indications for intestinal and multivisceral transplantation in patients referred to our unit over the last 8 years. <h3>Method</h3> A prospectively maintained database records the indications for all patients listed for intestinal and multivisceral transplantation. This database was used to identify indications for patients transplanted between January 2006 and December 2014. NASIT and International Transplant Registry indications were reviewed. <h3>Results</h3> 56 transplant procedures were performed on 50 patients - 27 (48%) multivisceral (MV); 6 (11%) liver/small intestine (LSB); 8 (14%) modified multivisceral and 15 (27%) small intestine. 6 patients were re-transplanted due to acute cellular rejection not amenable to medical therapy (n = 3), intestinal graft ischaemia (n = 2) and primary non-functioning liver graft (n = 1). The predominant NASIT indications for transplantation were intestinal failure associated liver disease (IFALD) (29%); need for multi-organ transplant (liver with portomesenteric venous thrombosis) (20%); loss of venous access for HPN (14%); widespread mesenteric arterial insufficiency (11%); FAP/desmoids (5%); catheter-related blood stream infections (5%) and acute cellular rejection (5%). 54% of patients had short bowel, the causes of which were ischaemia (57%), Crohn’s disease (27%), volvulus (3%), trauma (3%) and other (10%). <h3>Conclusion</h3> Cambridge is the only UK centre performing adult multivisceral transplants. IFALD remains the predominant indication for multivisceral transplantation but the number of referrals for this indication is not increasing year on year. This may reflect improved management of patients with Type 3 intestinal failure on home parenteral nutrition, with a focus on quality outcomes and reducing complications. We have observed an increase in patients referred with portomesenteric venous thrombosis which precludes an isolated liver graft. Subsequently we have performed more MV or LSB transplants over the last 2 years in a group of patients with multiple co-morbidities, whose management is more complex. Another emerging indication is widespread mesenteric arterial insufficiency, resulting in 5 urgent transplants during the last 2 years (6 in total). Treatment options for these patients have been very limited in the past and MV transplantation offers a potential new management strategy. <h3>Disclosure of interest</h3> None Declared.
Jeremy Hunt interview: Still a safe pair of hands?
Authors: Gareth Iacobucci
Journal: BMJ (2016)

Jeremy Hunt is a health secretary under pressure. In this exclusive interview with<i> The BMJ</i>’s editor in chief Fiona Godlee, the man who could soon become the longest serving health secretary insists he has more to give.<b><i> Gareth Iacobucci</i></b> reports
Headline writers find sweet spot with sugar tax
Authors: Anne Gulland
Journal: BMJ (2016)

The Times was the only UK newspaper to offer unqualified support to George Osborne’s unveiling of a sugar tax in last week’s budget.1

Under the headline “Osborne sugars the pill,” next to the traditional shot of the chancellor holding aloft his red budget briefcase, the newspaper declared its support for the tax. The columnist Tim Montgomerie welcomed it because it will reduce spending on health in the long term. He wrote, “Just as measures to tax and restrict tobacco changed public attitudes and encouraged important innovations such as life-saving e-cigarettes, so a progressive public policy …
Radioautographic Analysis of 7,12-Dimethylbenz[&lt;italic&gt;a&lt;/italic&gt;]anthracene-&lt;sup&gt;3&lt;/sup&gt;H Incorporation and Cell Survival of Syrian Hamster Embryo Cells During Exposure to Nucleic Acid Inhibitors
Authors: D I Connell, L A Riechers, J A DiPaolo
Journal: JNCI Journal of the National Cancer Institute (1971)
A clinical report of thymoleptic-responsive atypical paranoid psychoses
Authors: H S Akiskal, G W Arana, R J Baldessarini, P J Barreira
Journal: American Journal of Psychiatry (1983)

The paranoid disorders of five patients remitted after treatment with thymoleptic agents despite the absence of a full affective syndrome. Their clinical symptoms at admission included suspiciousness, hypervigilance, ideas of reference, hostility, belligerence, and delusions of persecution or of infidelity. Some had phasic disturbances with somatic complaints or prominent phobic anxiety symptoms, a family history of affective disorder, or prior responses to thymoleptic drugs. These observations suggest that some patients with paranoid psychosis who do not have a full DSM-III affective syndrome may respond to antidepressant pharmacotherapy alone, i.e., without neuroleptics. Systematic, prospective studies of this phenomenon would help to ascertain diagnostic criteria for such patients and the range of therapeutic responses.
Novel Long-Term Co-Culture Approach Identifies Prognostically Important Heterogeneity Of Stem/Progenitor Cell Involvement In Human Acute Myeloid Leukemia
Authors: George S. Laszlo, Jack M. Lionberger, Kimberly H. Harrington, Chelsea J. Gudgeon, Megan Othus, Frederick R. Appelbaum, Irwin D. Bernstein, Roland B. Walter
Journal: Blood (2013)
Determination of the Activity Profile of Bosutinib, Dasatinib and Nilotinib against 18 Imatinib Resistant Bcr/Abl Mutants
Authors: Sara Redaelli, Rocco Piazza, Roberta Rostagno, Marianna Sassone, Vera Magistroni, Pietro Perini, Manuela Marega, Frank Boschelli, Carlo Gambacorti
Journal: Blood (2008)
News
Authors: Gail McBride
Journal: BMJ (1990)

Some of the legal prerogatives in Cyprus and Britain for protection of childrens interests from parental rights are highlighted.  Several cases are discussed e.g. a case involving a 2-year old leukemia patient who was treated with a blood transfusion in Cyprus after her parents who were Jehovahs Witnesses refused to grant permission for the transfusion.  The child had been made a ward of the High Court prior to the transfusion when her parents had removed her from the Hospital for Sick Children in Britain after her diagnosis.  The justification for the action was the protection of the childs best interests.  The law permits anyone including doctors and social workers who believes the parents are not acting in the childs best interests to make the child a ward of the court.  Wardship is granted as soon as the summons is issued.  2 other cases mentioned relate to sanctions or stopping medical treatment.  In 1 case a Down syndrome newborn had a duodenal atresia and the parents would not approve life-saving surgery.  A High Court agreed that the child should be allowed to die but the Court of Appeals authorized the operation because it felt that the girls life would not be so demonstrably awful that she should die.  Another case involved an 11-year old girl with Sotos syndrome whose parents wanted her sterilized.  The High Court judge ruled that the operation was neither medically indicated nor necessary.  The childs best interests would be served by not having it performed and her future prospects were unpredictable.  An informed choice was indeed possible in the future.  Even a temporary stay in England is sufficient to bring about wardship.  In 1956 an American child was made a ward of the court during a stopover in London.  The judge decided that when the child was old enough to decide herself whether to live in Russia or America she would make the decision.  Another American child of US Air Force parents was made a ward of the court and placed in English foster care due to parental mistreatment.
Clinical phenotypes in adult patients with bronchiectasis
Authors: Stefano Aliberti, Sara Lonni, Simone Dore, Melissa J. McDonnell, Pieter C. Goeminne, Katerina Dimakou, Thomas C. Fardon, Robert Rutherford, Alberto Pesci, Marcos I. Restrepo, Giovanni Sotgiu, James D. Chalmers
Journal: European Respiratory Journal (2016)

Bronchiectasis is a heterogeneous disease. This study aimed at identifying discrete groups of patients with different clinical and biological characteristics and long-term outcomes. This was a secondary analysis of five European databases of prospectively enrolled adult outpatients with bronchiectasis. Principal component and cluster analyses were performed using demographics, comorbidities, and clinical, radiological, functional and microbiological variables collected during the stable state. Exacerbations, hospitalisations and mortality during a 3-year follow-up were recorded. Clusters were externally validated in an independent cohort of patients with bronchiectasis, also investigating inflammatory markers in sputum. Among 1145 patients (median age 66 years; 40% male), four clusters were identified driven by the presence of chronic infection with Pseudomonas aeruginosa or other pathogens and daily sputum: “ Pseudomonas ” (16%), “Other chronic infection” (24%), “Daily sputum” (33%) and “Dry bronchiectasis” (27%). Patients in the four clusters showed significant differences in terms of quality of life, exacerbations, hospitalisations and mortality during follow-up. In the validation cohort, free neutrophil elastase activity, myeloperoxidase activity and interleukin-1β levels in sputum were significantly different among the clusters. Identification of four clinical phenotypes in bronchiectasis could favour focused treatments in future interventional studies designed to alter the natural history of the disease.
Treatment of afferent limb syndrome: novel approach with endoscopic ultrasound-guided creation of a gastrojejunostomy fistula and placement of lumen-apposing stent
Authors: Ashish Shah, Lauren Khanna, Amrita Sethi
Journal: Endoscopy (2015)

A 44-year-old woman, with recurrent pancreatic cancer after a Whipple procedure, presented with afferent limb syndrome that manifested as sepsis secondary to cholangitis thought to be due to obstruction of the Roux limb by tumor recurrence.
Abstract 296: Determinants of Incidence of Ventricular Fibrillation as First Recorded Rhythm During Out-of-Hospital Cardiac Arrest and Association with Long-Term Neurological Outcomes: Observations from a Large Randomized Clinical Study
Authors: Demetris Yannopoulos, Richard Holcomb, Ralph J Frascone, Brian D Mahoney, Marvin A Wayne, Robert A Swor, Robert M Domeier, Michael L Olinger, David E Tupper, Tom P Aufderheide
Journal: Circulation (2012)

Background: We sought to identify the factors that were associated with higher incidence of VF and survival with good neurological function in the ResQ Trial patients that compared standard cardiopulmonary resuscitation (S-CPR) versus active compression decompression CPR with an inspiratory impedance threshold device (ACD+ITD) in patients with out of hospital cardiac arrest (OHCA). Methods: A retrospective analysis of a randomized multicenter clinical study of 1655 patients with OHCA. 88.3% (106/120) of the patients discharged with good neurological function [Modified Rankin Score (MRS)≤3] had a first recorded rhythm of ventricular fibrillation/pulseless ventricular tachycardia (VF). The first rhythm was recorded in 99.4% (1645/1655) of the cases about 9.5 minutes after 911 call, on average 3 minutes after the arrival of EMS on the scene and after CPR was performed for at least 2 minutes. Results: A total of 32.8% of the patients had VF as presenting rhythm and 42.8% received bystander CPR. Presence of bystander CPR was associated with a higher VF incidence only in the S-CPR group (40.8% versus 23.1% with no bystander, p=0.001) but survival was 7.6% versus 4.6% p=0.09. Presence or absence of bystander CPR let to similar VF incidence and survival in the ACD+ITD group 36.1% versus 33.9% and 9.0% versus 8.9% respectively, p&gt;0.2. After propensity adjustment for witnessed arrest, age &lt;67, gender, public location, bystander CPR lost significance. In the absence of bystander CPR, ACD+ITD significantly increased the incidence of first recorded VF compared to S-CPR from 106/459 (23.1%) to 164/484 (33.9%) [OR 1.71, 95% CI (1.27, 2.30), p&lt;0.001], and in patients with VF, return of spontaneous circulation increased from 65/459 (14.2%) to 104/484 (21.5%) [OR 1.66, 95% CI (1.16, 2.37), p=0.004], leading to an overall doubling of survival with MRS≤3 from 21/455 (4.6%) to 43/482 (8.9%) [OR 2.02, 95% CI (1.15, 3.65), p=0.009]. After propensity adjustment ACD+ITD remained a significant predictor of an MRS≤3, (p= 0.02). Conclusions: VF was the most important predictor of survival with MRS≤3. In the absence of bystander CPR, ACD+ITD increased VF incidence as the first recorded rhythm and doubled survival to hospital discharge with MRS≤3 compared to S-CPR.
Studies of Experimental Bladder Carcinoma in Fischer 344 Female Rats. II. Characterization of 3 Cell Lines Drived From Induced Urinary Bladder Carcinomas&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: P Lavin, L G Koss
Journal: JNCI Journal of the National Cancer Institute (1971)
<i>MET</i> Exon 14 Alterations in Lung Cancer: Exon Skipping Extends Half-Life
Authors: Alexander Drilon
Journal: Clinical Cancer Research (2016)

MET exon 14 alterations are a diverse group of mutations, many of which disrupt splice acceptor or donor sites leading to exon 14 skipping, impaired receptor degradation, and oncogenic transformation. These alterations are clinically targetable with MET-directed therapy. Clin Cancer Res; 22(12); 2832-4. ©2016 AACRSee related article by Tong et al., p. 3048.
Calgb/Swog 80405: Analysis of Patients Undergoing Surgery As Part of Treatment Strategy
Authors: A. Venook, D. Niedzwiecki, H. Lenz, M. Mahoney, F. Innocenti, B. O'Neil, H. Hochster, R. Goldberg, R. Schilsky, R. Mayer, B. Polite, J. Atkins, J.E. Shaw, M. Bertagnolli, C. Blanke
Journal: Annals of Oncology (2014)
Meta-analysis: The fashion of summing-up evidence
Authors: R.D. Gelber, A. Goldhirsch
Journal: Annals of Oncology (1991)

Meta-analysis is the process of formally combining the quantitative results of separate studies in order to increase the statistical precession of estimated effects. It has become fashionable when individual studies fail to yield conclusive results. A recent update of a meta-analysis (overview) for treatments of patients with early breast cancer motivated this commentary to discuss the rationale, principles of conduct, statistical methods, and graphical display for summing up results. In part II we will approach the issue of interpretation and use of overview data.
PP-003 Endoscopic retrograde cholangiopancreatography in renal patients: a case control study of complication rates
Authors: S Pattni, A Dhar, K J Monahan, P Vlavianos, D Westaby
Journal: Gut (2010)

<h3>Introduction</h3> Endoscopic retrograde cholangiopancreatography (ERCP) remains a high-risk procedure with a significant incidence of procedure related complications. Endoscopy in patients with renal disease has additional associated morbidity. The aim of the study was to determine the incidence of procedure related complications following ERCP in a cohort of patients with end stage renal disease receiving dialysis (ESRD) and renal transplant recipients (RT). <h3>Methods</h3> A retrospective analysis of patients under the care of the largest renal unit in Europe, who underwent ERCP during a 36-month period. A cohort of patients without renal disease, matched for age, sex, comorbidities, indication, procedural intervention and results were used for comparison. <h3>Results</h3> 51 ERCPs were performed on ESRD and RT patients, and 100 case control matched ERCPs were randomly selected retrospectively over the study period. 35 ERCPs were performed on ESRD patients (median age 66.7, M/F ratio 1.9:1). Sphincterotomies were performed in 65.7% (23/35) of procedures. There was a significant increased risk of post-sphincterotomy bleeding in the ERSD group vs the control group (6/23 vs 2/56, p&lt;0.01) and a significant increased risk of post ERCP pancreatitis (9/35 vs 9/100, p&lt;0.05). 16 ERCPs were performed on RT patients (median age 64.5; M/F ratio 1.3:1). Sphincterotomies were performed in 50.0% (8/16) of procedures. There was a significant increase in the risk of post sphincterotomy bleeding in the RT group vs the control group (3/8 vs 2/56, p&lt;0.05) and a significant increased risk of post ERCP pancreatitis (5/15 vs 9/100, p&lt;0.05). No patient related factors were related to the incidence of post ERCP pancreatitis in ESRD nor RT patients, and the absence of a sphincterotomy was the only procedural related factor significantly related to the incidence of post ERCP pancreatitis in either group (OR 1.46, 95% CI 1.06 to 2.00). ERSD patients had a significant increase in 30-day procedural related morbidity vs control group (17/35 vs 17/100, p&lt;0.001, OR 4.05, 95% CI 1.74 to 9.46). There was no significant increase in 30-day procedure related morbidity in RT patients vs the control group. No significant increase in 30-day mortality was demonstrated between the ESRD nor the RT group and the control group. <h3>Conclusion</h3> ERCP in both ESRD and RT patients is a high-risk procedure with a significant added incidence of post ERCP pancreatitis and post sphincterotomy bleeding. These findings suggest that ERCP and sphincterotomy should be approached with caution in this select group of patients, and measures targeted to minimise the risk of these complications should be employed.
Prognosis of patients with metastatic hepatocellular carcinoma (HCC)
Authors: H. Ishii, J. Furuse, M. Nagase, M. Yoshino, S. Takahashi, T. Nakagohri, M. Konishi, T. Kinoshita
Journal: Journal of Clinical Oncology (2004)

4127 Background: There has been no study regarding the long-term survival of a large number of metastatic HCC patients. The current study was conducted to clarify their prognostic factor. Methods: We surveyed 196 consecutive patients with metastatic HCC admitted to our hospital. We divided patients into subgroups according to their backgrounds, and compared survival times to determine favorable prognostic factors. We also analyzed relationship between the cause of death and site of metastasis. Results: The top 4 sites of the first metastasis were the lung in 78 patients, the bone in 69, an abdominal lymph node in 42, and the adrenal gland in 22. The first additional treatment after metastasis was observation in 58, surgery in 35, systemic chemotherapy in 14, transcatheter arterial chemoembolization in 41, and radiotherapy in 48. The median survival time and 1-, 3-, and 5-year survival rates were 4.5 months, and 31.1%, 9.7%, and 3.8%, respectively. Good performance status, good hepatic reserve, low alpha-fetoprotein, no bone metastasis, and low T factor were shown to be favorable significantly in survival time. Although 84% of the patients died of hepatic cause, patients with lung and bone metastasis tended to die due to lung metastasis and cachexia, respectively. Conclusion: The prognosis of metastatic HCC patients was generally poor, however, there were long survivors among them. Their prognosis corresponded well to intrahepatic factors, i.e., primary cancer status and hepatic reserve. No significant financial relationships to disclose.
The role of high-dose therapy and autologous hematopoietic stem cell transplantation for mantle cell lymphoma
Authors: D.A. Stewart, J.M. Vose, D.D. Weisenburger, J.R. Anderson, E.I. Ruby, M.A. Bast, P.J. Bierman, A. Kessinger, J.O. Armitage
Journal: Annals of Oncology (1995)

Although mantle cell lymphoma (MCL) is a distinct disease entity with well described clinical and pathological features, little information exists regarding its therapy. This paper will evaluate patients with MCL receiving either induction therapy with an anthracycline or high-dose chemotherapy and autologous hematopoietic stem cell transplantation for relapsed disease.The cases of 14 previously untreated patients with MCL who received an anthracycline-containing combination chemotherapy regimen on Nebraska Lymphoma Study Group protocols from 3/83 to 2/92 were reviewed. During the same time period, a different set of nine patients with recurrent MCL were referred for high-dose chemoradiotherapy and autologous stem cell rescue as salvage therapy.The five year overall (OS) and failure-free (FFS) survivals from the initiation of chemotherapy for the patients receiving an induction therapy with an anthracycline containing regimen were 23% and 8%, respectively. At the time of this analysis, three of the nine transplant patients remain progression-free 7, 12, and 25 months post-transplant. Two year overall and FFS for all nine patients was 34%.Longer follow-up of greater patient numbers is required to determine whether high-dose therapy can overcome the chemoresistance and increase the cure rate of MCL. Since most patients with this disease have minimal chance of cure with standard chemotherapy, the optimal timing for high dose therapy may be as part of front-line treatment. Further clinical trials are required to investigate the potential benefits of high-dose therapy for patients with MCL.
Adjuvant high-dose chemotherapy with autologous hematopoietic stem cell transplantation for breast cancer with &gt; 9 positive nodes: 15-year results from the Italian registry
Authors: P. Pedrazzoli, A. M. Gianni, G. Da Prada, A. Ballestrero, M. V. Martino, G. Rosti, M. Bregni, M. Aglietta, C. Bengala, G. Martinelli
Journal: Journal of Clinical Oncology (2008)

592 Background: High-dose chemotherapy (HDC) with autologous hematopoietic stem cell transplantation (HSCT) for the treatment of primary poor risk breast cancer (BC) pts has lost favor over recent years in the oncology community. This is mainly due to the worrisome high mortality and morbidity of the procedure and the lack of a clear survival benefit in early randomized studies. Recently reported trials have demonstrated that this approach could still have a role in selected pts, namely with >9 positive axillary nodes and with HER2-tumors. Aim of this study is to retrospectively evaluate toxicity and efficacy of HDC with HSCT in a large cohort of pts receiving HDC in Italy between 1990 and 2005. Methods: 1,294 BC pts receiving HDC for poor risk BC were identified in the Italian registry (GITMO). In 835 patients with >9 LN, a thorough data set including biological characteristics, toxicity and follow-up was available. Median age was 46 years (24–66), 59% of pts were premenopausal at treatment, 73% had an endocrine responsive tumors and 42% had a HER2+ tumor. One third of pts had ≥20 LN+. 76% received alkylating agents-based HDC as a single procedure while 24% received epirubicin or mitoxantrone-containing HDC, usually within a multitransplant program. Source of stem cells was peripheral blood in 99% of pts. Results: Transplant-related mortality (TRM) at 100 days was 0.7%, while late cardiac and secondary tumor-related mortality were around 1% overall. With a median follow-up of 79 months, median disease-free survival (DFS) and overall survival (OS) in the entire population were 101 and 134 months, respectively. Subgroup analysis demonstrated that OS was significantly better in endocrine responsive tumors (p=0.0009), while menopausal or HER-2 status did not affect survival. Median OS was significantly better (p=0.0000) in pts receiving multiple transplant procedures. Conclusions: In our series of poor risk pts HDC with HSCT has low TRM and high efficacy. Multiple transplants seem more active than single HDC procedures. This analysis could be useful in selecting well-defined patient populations in which to re-address the role of HDC as adjuvant treatment. No significant financial relationships to disclose.