tbuckley/cabot-search huggingface dataset:
Daily low-dose cisplatin plus concurrent high-dose thoracic irradiation in locally advanced unresectable non-small-cell lung cancer: results of a phase II Southwest Oncology Group study.
Authors: M B Hazuka, J J Crowley, P A Bunn, M O'Rourke, T J Braun, R B Livingston
Journal: Journal of Clinical Oncology (1994)

PURPOSE This single-arm phase II trial was designed to evaluate the efficacy and toxicity of continuous-course, high-dose thoracic irradiation (RT) combined with concurrent daily low-dose cisplatin followed by high-dose cisplatin consolidation in patients with locally advanced unresectable non-small-cell lung cancer (NSCLC). The daily chemotherapy regimen was designed to optimize the radiosensitizing properties of cisplatin. PATIENTS AND METHODS Sixty-five patients from 21 participating institutions were entered onto the study between April 1989 and May 1991. Protocol therapy consisted of daily intravenous (i.v.) cisplatin (5 mg/m2) plus concurrent continuous-course RT (61 Gy over 6 1/2 weeks) both delivered Monday through Friday each week. After a 3- to 4-week rest period, this was followed by three 28-day cycles of cisplatin at 100 mg/m2 or subsequently 50 mg/m2 administered i.v. on days 1 and 8 of each cycle. RESULTS Sixty-four patients were eligible; the majority had unresectable stage IIIa (36%) or IIIb (55%) NSCLC. The remaining 9% had recurrent disease confined to the chest (five patients) or stage II disease (one patient). The feasibility of this regimen is demonstrated by the fact that only five patients (8%) were unable to complete daily cisplatin and RT because of toxicity. Esophagitis (16%), leukopenia (14%), nausea (8%), and vomiting (6%) were the most common severe (grade 3) toxicities. There was only one life-threatening toxicity (grade 4 nausea) and no treatment-related deaths. The objective response rate was 39%, and six patients (9%) achieved a radiographic complete response (CR). The median survival duration for all patients was 14 months, and the 1- and 2-year actuarial survival rates were 56% and 24%, respectively. For stage IIIa patients, the median survival duration and 2-year survival rate were 17 months and 38%, as compared with 10 months and 14% for stage IIIb patients, respectively. CONCLUSION Daily low-dose cisplatin plus concurrent high-dose continuous-course RT is a well-tolerated out-patient regimen. The survival results are encouraging and appear to be equivalent to more toxic combined approaches. These results warrant further testing of combined daily platinum analogs with RT.
Comorbidities associated with chronic obstructive pulmonary disease (COPD) – A clinical study
Authors: Gopinathan Vattanatt, Supriya Adiyodi
Journal: European Respiratory Journal (2011)

OPD continues to be one of the commonest causes of increasing morbidity and mortality globally.While cardiovacular (CVD) and cerebrovascular diseases are decreasing over the years,COPD is the fourth leading cause of death,thanks to continuing smoking habits,atmospheric and industrial pollution. Lack of awareness and late diagnosis add insult to injury. Associated comorbidities such as CVD musculoskeletal disorders and infective exacerbations are not often recognised. (Chabra SK et al.Indian J Chest Dis Allied Sci 2010;52:225-238). Recognition of comorbidities associated withCOPD and concurrent management will go a long way in reducing morbidity and even mortality. The situation is worse in developing countries where diabetes,alcoholic liver diseases and human immunodeficient diseases are rampant and hence this communication. All patients with recurrent cough,dyspnea and chest pain exposed to smoking habits and/or other pollutants were screened, They were subjected to spirometry,imaging studies,metabolic/biochemical lab evaluation, and EKG. Diagnosis was established by the GOLD criteria and comorbidities by relevent clinical evaluation and relevat lab studies.   Results:  There were 110 patients in the age group 35-75 years. The majority were males and smokers (95%). Commonest comorbidities were musculoskeletal (30%) and CVD (37%). Infective exacerbations contributed to 20%. More than one was present in few cases.The overall course of the disease was related to patient age,smoking pack year,genetic susceptibility,diabetes and above all treatment compliance.  Mortality in COPD is more often cardiac rather than respiratory causes. Regular physician/community medical education is recommended at regional levels.
Why Use a Pain Clinic? Management of Neurogenic Pain before and after Referral
Authors: Huw T O Davies, Iain K Crombie, William A Macrae
Journal: Journal of the Royal Society of Medicine (1994)

Pain arising from damage or malfunction of the nervous system (for example postherpetic neuralgia, peripheral nerve injuries and the neuropathies) is often severe and resistant to standard analgesics. These patients are commonly seen in pain clinics where they receive a variety of treatments including psychotropic drugs (such as antidepressants and anticonvulsants), nerve blocks and stimulation. There is concern that the management of these difficult patients may be less than optimal where they are not seen by pain specialists. We examined a cohort of 703 patients with long-established nerve-damage pain seen in ten outpatient pain clinics. We compared their use of treatments prior to referral with the management given in the pain clinic. The majority of patients (79%) had had their pain for over 1 year before being seen in the pain clinic, yet many had not tried simple and effective treatments prior to referral. Less than a quarter had received an adequate trial of antidepressants; only one in seven had been appropriately treated with anticonvulsants; and only one in 10 had tried a nerve stimulator. All these treatments were frequently provided in the pain clinic. Referral of patients with nerve-damage pain to a pain clinic may greatly increase their access to therapies of proven value.
Environmental Microbial Exposure and Protection against Asthma
Authors: Patrick G. Holt, Peter D. Sly
Journal: New England Journal of Medicine (2015)

Lipopolysaccharide levels in household dusts are inversely related to the prevalence of allergy in urban children, a finding consistent with the protective effect of exposure to lipopolysaccharides. A new study describes a molecular pathway that may underpin this effect.
CD123 immunostaining patterns in systemic mastocytosis: differential expression in disease subgroups and potential prognostic value
Authors: A Pardanani, K K Reichard, D Zblewski, R A Abdelrahman, E A Wassie, W G Morice II, C Brooks, K L Grogg, C A Hanson, A Tefferi, D Chen
Journal: Leukemia (2015)
Adoptive immunotherapy for AML with CD123-engager T cells
Authors: Challice Bonifant, David Torres, Nicholos Joseph, Carolyn Arber Barth, Mireya Velasquez, Xiao-Tong Song, Michele Redell, Stephen Gottschalk
Journal: Journal for ImmunoTherapy of Cancer (2015)

Meeting abstracts T cell immunotherapy is one promising approach to improve outcomes for patients with AML; however, infused T cells do not redirect resident T cells to tumors. To overcome this, we have genetically modified T cells to produce a secretable, bispecific T cell engager (ENG-T cells).
Exploring the evidence base for national and regional policy interventions to combat resistance
Authors: Osman A Dar, Rumina Hasan, Jørgen Schlundt, Stephan Harbarth, Grazia Caleo, Fazal K Dar, Jasper Littmann, Mark Rweyemamu, Emmeline J Buckley, Mohammed Shahid, Richard Kock, Henry Lishi Li, Haydar Giha, Mishal Khan, Anthony D So, Khalid M Bindayna, Anthony Kessel, Hanne Bak Pedersen, Govin Permanand, Alimuddin Zumla, John-Arne Røttingen, David L Heymann
Journal: The Lancet (2015)
The Nottingham Prognostic Index (NPI) applied to 467 patients (pts) with a long-term follow-up that were treated in a single institution
Authors: C. T. Vallejo, J. A. Lacava, P. M. Cabaleiro, P. Butín, M. Cari, S. E. Albornoz, J. R. Castro, A. Novoa, M. Mac Donnell, B. A. Leone
Journal: Journal of Clinical Oncology (2004)

9657 Background: The Nottingham Prognostic Index (NPI) is a validated prognostic tool, based on breast tumour size, node involvement and Scarff-Bloom-Richardson (SBR) grading, that is able to predict survival in pts with breast cancer, and allows their stratification into three different prognostic groups. Methods: The purpose of this retrospective study was to verify, according to our experience with a long-term follow-up, the effect of some prognostic variables on overall survival (OS) and to establish the independent influence of each of them by means of a survival regression analysis. Then we applied the NPI to the same group of pts in order to assess the predictive power and reproducibility of the index. 467 women with stages I or II treated from November 1979 to March 2002 were evaluated. The follow-up was complete for all pts, with a median of 66 months (range 12–280 m). Results: : OS for all pts at 10 years was 74.6%. A significant difference in OS was demonstrated for lymph node involvement, tumor size, histological grade, age and ER status in the univariate analysis. In multivariate analysis (Cox proportional hazard model), lymph node involvement, tumor size, histological grade and age remained as independent prognostic factors. The OS curves obtained after applying the NPI are similar to those for the factors with independent prognostic significance derived from our multivariate analysis. Pts with NPI 3.4 or less had survival rate at 10 years of 92%, pts with NPI 3,5–5,4 had 73% and 52 % of those with an index sum >5.5, respectively. Similarly, mean NPI was higher in patients ≤ 40 years old, compared with those > 40 years (p< 0.02). Conclusions: In addition to the variables used to elaborate NPI score, age emerged as an important predictor both for time to relapse and survival. Future investigations should consider if its inclusion can aid to the developing of a more exact prognostic tool. No significant financial relationships to disclose.
Abstract P6-06-01: Studies on tumor heterogeneity using a preclinical model of breast cancer caused by genetic alteration of the ATX-LPA axis
Authors: Lorenzo Federico, Kang Jin Jeong, Dong Zhang, Zhenlin Ju, Zechen Chong, Jennifer B Dennison, Gordon B Mills
Journal: Cancer Research (2015)

Abstract Targeted alterations of the ATX/LPA signaling axis in mice creates a tumorigenic environment from which mammary neoplasias can develop. Using mammary tumors derived from this model, we have established a transplantation procedure in which fragments of different tumors are orthotopically transplanted in syngeneic mice. Under these conditions, primary murine tumors displayed a wide spectrum of growth rates suggesting that alteration of ATX/LPA signaling axis engenders a variety of different breast cancer subtypes with distinctive propensity to progress, which is similarly observed in human neoplastic disease. Comprehensive analysis of high-throughput RNAseq and Reverse Phase Protein Array (RPPA) data revealed that despite being passaged multiple times, tumors retained their distinct growth profiles and also maintained surprisingly stable molecular characteristics. The remarkable consistency in terms of growth, transcriptional landscape, and protein expression demonstrates that in this model a small fragment randomly taken from any region of the tumor can accurately and reproducibly regenerate an entire developmental program when grown in vivo. It follows that each consistent molecular change detected in the tumor likely represents either a marker of the tumor or its mechanistic oncodriver. Using unbiased multidimensional scaling analysis of RNAseq data we have identified tumors that were strictly related to normal mammary tissue in terms of gene expression as well as individual gene signatures that differentiate slow- vs fast-growing tumors. Furthermore, we have identified several stable alterations at a protein level that are commonly found in human breast cancers including cMYC, BRCA2, PARP1, Claudin-7, Her3, and E-Cadherin. These results demonstrate that an orthotopic transplantation procedure in immunocompetent hosts represents a relevant preclinical platform to probe human breast cancer heterogeneity and pinpoint molecular alterations that are mechanistically responsible for malignant behavior. Citation Format: Lorenzo Federico, Kang Jin Jeong, Dong Zhang, Zhenlin Ju, Zechen Chong, Jennifer B Dennison, Gordon B Mills. Studies on tumor heterogeneity using a preclinical model of breast cancer caused by genetic alteration of the ATX-LPA axis [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P6-06-01.
Earlier detection of drug resistant mutations in small bowel/multivisceral transplant recipients with CMV infection using next generation sequencing
Authors: Yanjun Diao, Jane Greatorex, Hongyi Zhang, Suzanne English, Heather White, Kim Brugger, Tim Ambrose, Andrew Butler, Neil Russell, Dunecan Massey, Stephen Middleton, Effrossyni Gkrania-Klotsas
Journal: Journal of Infection (2015)
Ethical debate: Certifying fitness for corporal punishment White lies Innocents abroad Deception demands compelling arguments Individuals need clear policy guidance Response
Authors: A. Thorns, G. Lloyd, G. Szmukler, J. Welsh, A. Thorns
Journal: BMJ (1998)

# Certifying fitness for corporal punishment {#article-title-2}

Junior doctors seeking work experience abroad can find themselves in difficult situations. Here one doctor, who was working in rural Africa, describes what he did when he was asked to certify that a young man was medically fit for a beating. A philosopher, a psychiatrist, and a representative from Amnesty International give their views.

# White lies {#article-title-3}

The BMJ issue highlighting the problems of torture brought back memories of my own relatively minor experience. Before completing my hospital training in England I took some time out to work in a remote African hospital. My role included that of local police surgeon. I remember a young boy, probably in his teens, being brought to me by the police. I forget what he was accused of, but the punishment was to be a beating with a stick. As police surgeon I was required to sign a document certifying that he was fit enough to receive the punishment. It seemed very barbaric and he looked very frightened, but my inadequacy with the language and the presence of two policemen made it impossible to find out his views on the issue.

I was in a dilemma. On one hand, I could not let the boy go through this brutal punishment as it went against what I considered right, and I felt that by signing the piece of paper I would be condoning the action; on the other hand, I could not show disrespect for local law.

In the end I listened to his chest and lied. I said that he had a chest infection and was not fit enough to be beaten. The young man received a course of unnecessary amoxicillin and—I hope, although I cannot be sure—no beating. Nor can I be certain what the alternative punishment was … probably some time in jail. I wonder which …
Male rape victims: noninstitutionalized assault
Authors: A Kaufman, P Divasto, R Jackson, D Voorhees, J Christy
Journal: American Journal of Psychiatry (1980)

Fourteen male rape victims treated in a county hospital emergency room over a 30-month period are compared with 100 randomly selected female victims treated over the same period. The male victims as a group sustained more physical trauma, were more likely to have been a victim of multiple assaults from multiple assailants, and were more likely to have been held captive longer. They were more reluctant to reveal initially the genital component of their assault and were more likely to use denial and control their emotions in reaction to the assault. Proper diagnosis and treatment of male rape victims requires a high index of suspicion and sensititivty to the likelihood of major, hidden trauma.
Opposite associations between alanine aminotransferase and γ-glutamyl transferase levels and all-cause mortality in type 2 diabetes: Analysis of the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study
Authors: Kathryn H. Williams, David R. Sullivan, Geoffrey C. Nicholson, Jacob George, Alicia J. Jenkins, Andrzej S. Januszewski, Val J. Gebski, Patrick Manning, Yong Mong Tan, Mark W. Donoghoe, Christian Ehnholm, Simon Young, Richard O'Brien, Luke Buizen, Stephen M. Twigg, Anthony C. Keech
Journal: Metabolism (2015)
AB0830 Concordance of the Pase Questionnaire (Psoriatic Arthritis Screening Evaluation) for the Screening and Assessment of Clinical Practice in Psoriatic Arthritis
Authors: V. Torrente-Segarra, D. Reina, D. Roig, D. Cerdà, P.V. Estrada, V. Navarro, L. Peramiquel, S. García-Díaz, R. Fíguls, D. Vidal, H. Corominas
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> The presence of Psoriasis (PSO) can help you to identify patients with psoriatic arthritis (PsA) at earlier stages of the disease. Early diagnosis in inflammatory arthropathies is crucial to optimize the clinical evolution of our patients. The Psoriatic arthritis screening questionnaire Evaluation (PASE) could help us to accurately identify these patients. <h3>Objectives</h3> To assess the concordance of the PASE questionnaire in the screening of PsA in clinical practice and its relationship with the PsA activity measures. <h3>Methods</h3> During the 2014 the Dermatology Department has referred all patients with PSO, consecutively, to the Rheumatology Department to evaluate the utility of screening questionnaires PASE for the diagnosis of PsA and to detect articular activity. A score &gt;47 in questionnaire PASE has been shown as a good 'cut-off' score for the suspiction of PsA. Dermatology performed the cutaneous assessment and the PASE. Rheumatology performed the articular assessment, CASPAR criteria completion, PsA diagnosis, DAS28 and BASDAI. We recorded sociodemographics (age, gender) and serological markers (ESR [0-20mmHg], PCR [&lt;3 mg/L]). <h3>Results</h3> 75 patients with PSO were referred, 49/45.3% women, mean age 48.9 years. Three patients were diagnosed of PsA (4%), all peripheral disease (2 oligoarticular and 1 monoarticular) and all of them met the CASPAR criteria. Average ESR 9.42 mmHg, average CRP 1.85 mg/L. Seventeen patients (22.6%) had score pass &gt;47, average 55.4 (47-75). A patient (33.3%) with PsA showed PASE&lt;47. Three patients were diagnosed by a rheumatologist of having PsA (sensitivity 17.6%) from those having PASE &gt;47. DAS28 and ANKYLOSING scores: mean DAS28 2.36 (1.6-3.6), mean ANKYLOSING 2.64 (0.08-10). Of these, 7 patients showed DAS28 &gt;2.6, and 7 patients an ANKYLOSING &gt;4 (41.1%). The 3 patients with diagnosis of PsA had BASDAI &gt;4. <h3>Conclusions</h3> The PASE questionnaire, pending of expanding the study with a larger number of included patients, did not show as a useful tool particularly in detectin PsA, showing a lower sensitivity than published. The presence of a high PASE, the realization of measures of activity until there be a diagnostic confirmation of APSO by a rheumatologist is not recommended. CASPAR criteria were met in all patients with PsA. As limitation for our findings we might point out: the low prevalence of PsA shown by patients (may be due to the low number of patients included yet) and the clinical practice setting. <h3>Disclosure of Interest</h3> None declared
CpG-DNA enhances the tight junction integrity of the bronchial epithelial cell barrier
Authors: Terufumi Kubo, Paulina Wawrzyniak, Hideaki Morita, Kazunari Sugita, Kerstin Wanke, Jeannette I. Kast, Can Altunbulakli, Beate Rückert, Bogdan Jakiela, Marek Sanak, Mübeccel Akdis, Cezmi A. Akdis
Journal: Journal of Allergy and Clinical Immunology (2015)
Natural decline in FEV1 and FVC: Self versus reference equations
Authors: Maureen P. Swanney, Josh D. Stanton, Andrew O'Reilly-Nugent
Journal: European Respiratory Journal (2013)

Ideally, serial measures of lung function should be compared using data from the person when young and healthy. In practice reference equations are the best substitute.

Aim: To compare the natural decline in spirometry in respiratory scientists using measured values and their reference value z-scores.

Methods: Serial measures of FEV1 and FVC from respiratory scientists were obtained. We calculated the annual decline in measured values and compared with z-scores using ECSC/ERS'93, Hankinson and GLI2012 equations.

Results: 2044 data points were available for 26 scientists (13 female) starting from 20-39 years up to 31-60 years. The data time-span was 5 to 33 years. The average fall in FEV1 was 29 mL/year and FVC 23 mL/year.

View this table:

Average Annual Decline in Spirometry Values





Age-related FEV1 and FVC z-scores for the equations are shown in Figure 1.

![Figure][1] 



Discussion: The horizontal z-score trends using GLI2012 equations demonstrate they virtually match the rate of decline in FEV1 and FVC in our group of respiratory scientists. ECSC/ERS'93 elevates the z-score, and Hankinson shows a decreasing trend suggesting these equations are a poorer match for our longitudinal data.

Conclusion: This study suggests that the GLI2012 equations are more appropriate for monitoring lung function over time.

 [1]: pending:yes
Risk factors for anti-TB drug resistance in Poland
Authors: Maria Korzeniewska-Kosela
Journal: European Respiratory Journal (2013)

Aims: To find out factors associated with resistance to isoniazid (IR) and multidrug resistance (MDR).  Methods: Data on cases with drug susceptibility testing results registered in the Central TB Register from 2002 to mid-2012 were analyzed (11391). Chi-squared test to assess statistical significance (SS), bivariate and multivariate analyses (MVA) were used.  Results: IR (352) was in higher proportion (SS) in retreatment cases (5.4% v 3.0%; p  MDR (88) was in higher proportion (SS) in cases with the history of previous treatment (2,9 % v 0,5%; p  Conclusions: The main determinant of anti-TB drug resistance in Poland is history of previous treatment.
P0740 : Usefulness of interferon LAMBDA4-, HLA class II-polymorphism and killer-immunglobulin -like receptor-2DL3:C1/C1 to predict spontaneous clearance of acute hepatitis C virus infection
Authors: S. Beinhardt, M. Mandorfer, B.A. Payer, A.F. Stättermayer, C. Datz, A. Maieron, F. Huber, E. Dulic-Lakovic, R. Stauber, G. Fischer, M. Gschwantler, P. Ferenci, H. Hofer
Journal: Journal of Hepatology (2015)