tbuckley/cabot-search huggingface dataset:
PTU-095 A qualitative exploration of inflammatory bowel disease patient perceptions of primary care in the UK
Authors: K Kemp, J Griffiths, S Campbell, K Lovell
Journal: Gut (2012)

<h3>Introduction</h3> Many patients with IBD in the UK are managed primarily in secondary care with minimal General Practitioner (GP) involvement or within a restricted shared care protocol. As UK NHS hospitals face mounting financial and workforce pressures, reconfiguration of hospital services can provide a powerful means of improving the quality of patient care. The issue as to whether GPs should be more involved with IBD care must be addressed and the patient9s attitudes and perceptions of the GP and potential role, should be a focus when restructuring healthcare services. <h3>Methods</h3> 24 in depth qualitative interviews with 24 IBD patients were conducted as part of a larger study to develop a model of follow-up care for patients with IBD. 18 patients had Crohns Disease, 6 ulcerative colitis, age range 27–72 years, disease duration range was 2–40 yrs. Interviews were 40 to 60 min duration. Patients were asked directly about the role of their GP in their diagnosis and ongoing care of their IBD. Thematic analysis of interviews was undertaken using NVivo 9.0. <h3>Results</h3> Many patients experienced years of symptoms prior to diagnosis, in one case diagnosis took 10 years. This misdiagnosis/mistreatment led to a loss of confidence in the GP for future care. This impacted upon the question if they seek help from their GP at times of flares or IBD related problems. All patients reported no they do not seek help from their GP. This loss of confidence at diagnosis promoted views that their GP did not have the level of knowledge nor expertise to manage ongoing care. This was the same for patients with complex and quiescent disease. Patients would be happy to increase the level of input from their GP but this must be under the direction of the IBD team. Patients do not wish to be discharged completely from the IBD team and would accept reduced intervention and face to face contact with their IBD team, such as telephone and virtual clinics, in order to remain under the care of the IBD team. <h3>Conclusion</h3> GPs are the sole carers for a minority of IBD patients. While patients are willing to accept greater involvement from their GP there is general lack of confidence in their expertise to do this effectively. This is reflected by patients expressing a wish to remain under the direct care of the IBD team within secondary care. It is clear from the data that there may be an educational developmental need for the GPs regarding IBD but there is potential for reconfiguration of IBD services in which the GP plays a greater role. <h3>Competing interests</h3> None declared.
P229 Once-daily Tiotropium Respimat(R) As Add-on To At Least Medium- To High-dose Ics, With Or Without Laba, Improves Lung Function In Patients With Symptomatic Asthma, Independent Of Allergic Status
Authors: R. Dahl, T. Casale, E. Pizzichini, M. Vandewalker, J. Virchow, M. Engel, R. Sigmund, P. Moroni-Zentgraf, H. Kerstjens
Journal: Thorax (2014)

<h3>Background</h3> A substantial number of patients have symptomatic asthma despite treatment according to guidelines. Several studies have confirmed that tiotropium Respimat<sup>®</sup>, a once-daily long-acting anticholinergic bronchodilator, improves lung function in symptomatic patients receiving at least medium-dose inhaled corticosteroids (ICS) + long-acting β<sub>2</sub>-agonist (LABA) (Kerstjens <i>et al</i>. NEJM 2012;367:1198–207; Bateman <i>et al</i>. JACI 2011;128:315–22). Here we examine whether the atopic and/or allergic status of patients in these trials influenced their response to tiotropium Respimat<sup>®</sup>. <h3>Method</h3> Two 48-week trials of tiotropium Respimat<sup>®</sup> 5 µg (PrimoTinA-asthma<sup>®</sup>: NCT00776984, NCT00772538) in patients (n = 912) on high-dose ICS + LABA; two 24-week trials of tiotropium Respimat<sup>®</sup> 5 µg and 2.5 µg (MezzoTinA-asthma<sup>®</sup>: NCT01172808, NCT01172821) in patients (n = 2100) on moderate-dose ICS. Pre-planned analyses (pooled populations) were performed in two subgroups defined at baseline as total serum immunoglobulin E (IgE) ≤ or &gt;430 μg/L or blood eosinophils ≤ or &gt;0.6×10<sup>9</sup>/L or clinical judgement of allergic status ('No' or 'Yes'). All tiotropium doses were delivered via the Respimat<sup>®</sup> SoftMist™ inhaler. <h3>Results</h3> Tiotropium Respimat<sup>®</sup> 5 µg or 2.5 µg improved peak and trough forced expiratory volume in 1 second versus placebo (Table) independent of IgE, eosinophil count and clinical judgement. <h3>Conclusion</h3> Once-daily tiotropium Respimat<sup>®</sup> as add-on to ICS or ICS + LABA in patients with moderate to severe symptomatic asthma reduces airflow obstruction, apparently independent of their atopic and/or allergic status.
Increased Cis-to-Trans Urocanic Acid Ratio in the Skin of Chronic Urticaria Leads to the Enhancement of Mast Cell Degranulation
Authors: Young-Min Ye, Duy Le Pham, Hae-Sim Park, Donald Y.M. Leung, Kyung-Min Lim
Journal: Journal of Allergy and Clinical Immunology (2016)
Intravenous Immune Globulin for the Prevention of Nosocomial Infection in Low-Birth-Weight Neonates
Authors: Carol J. Baker, Marian E. Melish, Robert T. Hall, Daniel T. Casto, Ushanalini Vasan, Laurence B. Givner
Journal: New England Journal of Medicine (1992)

Nosocomial infection is a major risk for premature infants with very low birth weights. One reason for their susceptibility to infection may be antibody deficiency, since there is little transfer of maternal IgG to the fetus before 32 weeks' gestation.
Intravenous Use of Diphenylhydantoin Sodium
Authors: H. Kutt
Journal: JAMA (1967)

<h3>To the Editor:—</h3> Two fatalities have been reported inThe Journal(<b>200</b>:335, 1967) in association with intravenous administration of diphenylhydantoin (Dilantin) sodium for the treatment of cardiac arrythmias. Amounts administered were 250 mg and were reported as being given over a period of two to three minutes. We have used diphenylhydantoin sodium intravenously to treat status epilepticus in 36 patients and cardiac arrythmias in 75 patients. It was effective in stopping seizures in about half of the patients. It was also predictably effective in abolishing premature ventricular contractions, but it did not usually correct sino-auricular arrythmias. The dose given ranged from 500 to 1,000 mg administered at a rate of not over 100 mg/min, and usually the rate of administration was less, 10 to 50 mg/min. Of the 111 patients treated, 105 have shown little or no changes of blood pressure and respirations. In one patient who received 1,000
Economic evaluation of adjuvant chemotherapy in Stage III (SIII) colon cancer: Capecitabine versus 5FU/LV
Authors: K. Virik, C. Skedgel, T. Younis
Journal: Journal of Clinical Oncology (2006)

6046 Background: Adjuvant chemotherapy for SIII colon cancer is an accepted standard of care. Oral Capecitabine (C) has been shown to be at least equivalent and possibly superior to 5FU/LV (F) with a superior relapse free survival (RFS). This new option is associated with a higher drug cost. An economic analysis was undertaken to compare these two alternatives. Methods: A cost minimisation analysis was performed in Canadian $ ($) using C and F given as per the X-ACT (X) trial. The direct costs including chemotherapy drug acquisition, supportive medications, laboratory investigation and health resources utilisation were examined based in Nova Scotia. Indirect costs included travel and opportunity cost based on the average provincial wage and participation rates. Complete drug delivery was assumed. A direct payer perspective was used. A cost-effectiveness (CE) model was also constructed to estimate the required lower risk of cancer recurrence for C to be cost effective compared to F at a commonly used CE threshold. The Markov model developed used a hypothetical cohort of 1,000 patients with SIII colon cancer and projected costs and outcomes over 5 years (discounted 3% and in $2,005). All recurrences were modeled to death. Recurrence rates, median survival with recurrent disease, costs and utility scores were derived from the literature. Estimates of background mortality without recurrence were obtained from Canadian Life Tables. Sensitivity analysis (SA) was performed using a range of recurrence risk hazard ratios (HR) including that reported in the X trial. Results: Compared to F, C is associated with higher direct costs, principally reflecting the higher drug cost (difference: $5,589/patient) but less resources utilisation cost (difference: - $1,804/patient). The total indirect costs favour C (difference: - $2,464/patient). For C to be potentially CE compared to 5FU/LV, a ≥ 9% lower relative recurrence risk (HR = 0.91) with C would be required. At the reported RFS HR 0.86, the CE of C relative to F is $15,844 per disease free survival years gained and $22,097 per quality adjusted life years gained. Conclusions: C has more direct costs but has indirect cost savings. It has the potential to be cost effective as seen in the SA and is a CE alternative to F at the HR for RFS reported in the X trial. No significant financial relationships to disclose.
QUALITY CONTROL METHOD FOR REPRODUCABLE CAMERA/SOURCE ALIGNMENT AND MEASUREMENTS
Authors: S. M. Leonard, M. W. Groch, S. Bello, A. Balinao, W. G. Spies, S. M. Spies
Journal: Clinical Nuclear Medicine (1996)

Leonard, S.; Groch, M. W.; Bello, S.; Balinao, A.; Spies, W. G.; Spies, S. M. Author Information
Endoscopic Sclerotherapy as Compared with Endoscopic Ligation for Bleeding Esophageal Varices
Authors: Greg V. Stiegmann, John S. Goff, Patrice A. Michaletz-Onody, Jacob Korula, David Lieberman, Zahid A. Saeed, R. Matthew Reveille, John H. Sun, Steven R. Lowenstein
Journal: New England Journal of Medicine (1992)

Endoscopic sclerotherapy is an accepted treatment for bleeding esophageal varices, but it is associated with substantial local and systemic complications. Endoscopic ligation, a new form of endoscopic treatment for bleeding varices, may be safer. We compared the effectiveness and safety of the two techniques.
Photodynamic therapy of intraductal papillary mucinous neoplasm
Authors: M. Topazian, N. Zhong, T. Baron, S. Vege, K. Wang
Journal: Endoscopy (2012)

Intraductal papillary mucinous neoplasm (IPMN) of the main pancreatic duct is usually treated by surgical excision of the affected pancreas. Nonoperative ablative therapies have not been described. We treated IPMN of the pancreatic duct with photodynamic therapy (PDT) in a patient who was a poor operative candidate. Porfimer sodium was administered intravenously, and laser light was delivered by a diffusing catheter placed in the pancreatic duct during endoscopic retrograde cholangiopancreatography (ERCP). Imaging and biopsy findings of IPMN resolved after PDT, and symptoms also resolved. Metastatic cancer was diagnosed 2 years after PDT had been initiated. Pancreatic PDT was well tolerated in this case, and may be a therapeutic option for selected patients with IPMN of the main pancreatic duct.
DOES RENAL HAEMODYNAMICS RELATE WITH CARDIAC AND AORTIC HAEMODYNAMICS IN THE EARLY STAGES OF ESSENTIAL HYPERTENSION?
Authors: Konstantinos P. Tsioufis, Konstantinos Kintis, Dimitris Konstantinidis, Eirini Andrikou, Panagiotis Vasileiou, Alexandros Kasiakogias, Anastasios Milkas, Theodoros Kalos, Dimitris Tousoulis
Journal: Journal of the American College of Cardiology (2016)
What does article on investigating suspected heart failure add to current practice?
Authors: C. Broughton, J. Rigby, D. Satchithananda
Journal: BMJ (2013)

After reading this practice article,1 which was based on 2010 National Institute for Health and Care Excellence (NICE) guidance, we would like to comment, particularly on the use of electrocardiography (ECG) in primary care for diagnosing heart failure.

ECG is a poor discriminator for the diagnosis of left ventricular systolic dysfunction.2 The European Society of Cardiology (ESC) guidelines 2012 state that …
Synergistic Interaction Betweem Olaparib, a Parp Inhibitor, and Cytotoxic Agent in Triple Negative Breast Cancer
Authors: J. Hashimoto, Y. Kitamura, Y. Takashima, Y. Kodera, S. Shimma, A. Hamada, Y. Fujiwara, F. Koizumi, K. Tamura
Journal: Annals of Oncology (2013)
Anemia and Symptoms
Authors: SUSANNE E. LARSH
Journal: Annals of Internal Medicine (1967)

Editorial Notes1 January 1967Anemia and SymptomsSUSANNE E. LARSH, M.D.SUSANNE E. LARSH, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-66-1-234 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe folklore of health often carries on medical notions long beyond their tenancy in the profession. Popular belief in fatigue and dizziness as indicators of anemia persists and is abetted by peddlers of over-the-counter remedies containing iron for "tired blood." Most modern hematologists are skeptical, however, in regard to symptoms specific for iron deficiency and its concomitant anemia. A very recent text (1) notes, for example:Complaints are relatively non-specific and can be attributed to anemia; that is, weakness, ease of fatigue, tachycardia, and exertional dyspnea.What is not clear to many physicians, however, is to what degree of anemia...References1. LINMAN JW: Principles of Hematology. The Macmillan Co., New York, 1966, p. 173. Google Scholar2. WOODELWOOD MMPC: Symptoms of iron deficiency in anaemia. A Community Survey. Brit. J. Prev. Soc. Med. 20: 117, 1966. MedlineGoogle Scholar3. JUDYPRICE HENB: Hemoglobin level and red blood cell count findings in normal women. JAMA 167: 567, 1958. MedlineGoogle Scholar4. SPROULEMITCHELLMILLER BJJHWE: Cardiopulmonary physiological responses to heavy exercise in patients with anemia. J. Clin. Invest. 39: 378, 1960. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 January 1967Volume 66, Issue 1Page: 234-235KeywordsAnemiaBloodDyspneaFatigueHematology and oncologyIron deficiencyIron deficiency anemiaTachycardia Issue Published: 1 January 1967 PDF DownloadLoading ...
S116 Systemic Chemotherapy And The Risk Of Pleural Infection With Indwelling Pleural Catheters (ipcs)
Authors: S. Gunatilake, R. Mercer, S. Babu, L. Bishop, A. Chauhan
Journal: Thorax (2014)

<h3>Introduction</h3> Indwelling pleural catheters (IPCs) are an alternative method for controlling recurrent, symptomatic malignant pleural effusions, currently reserved for cases of known trapped lung, or after an initial unsuccessful talc pleurodesis.<sup>1</sup> A 2.8% pleural infection rate has been observed in patients with an IPC<sup>2</sup> leading to the concern that this risk of infection may increase further with systemic chemotherapy. <h3>Objectives</h3> Determine whether systemic chemotherapy increased the number of IPC related pleural infections. Whether the risk was related to the interval between chemotherapy and IPC insertion. <h3>Methods</h3> A detailed retrospective review was performed of the first 100 patients treated with an IPC from February 2011 to December 2013 at Queen Alexandra Hospital, Portsmouth. <h3>Results</h3> 11 of the 100 IPC insertions developed pleural infection (11%), four of whom had received chemotherapy (see table). Overall 15 patients received chemotherapy after IPC insertion with an interval varying from 0 days (same day) to 43 days, with a median of 9 days. The 2 × 2 table compared the proportion of patients developing pleural infection with and without chemotherapy. Further analyses assessed the interval from chemotherapy to IPC insertion and whether it influenced the numbers of pleural infections, using cut-off points at 7, 14, 21 and 28 days. There was no significant difference at any of these time-points (p=NS). <h3>Conclusions</h3> The pleural infection rate with an IPC was slightly higher than previous published series. There was however no significant increase in pleural infection in those receiving chemotherapy, although these analyses did not account for variability in tumour type, tumour stage, performance, co-morbidity and leucopenia at time of insertion. While the analyses were not significant, this needs to be retested in larger or combined registries of patients treated with IPCs for pleural malignancy. <h3>References</h3> Roberts ME, Neville E, Berrisford RG, Antunes G, Ali NJ. BTS Pleural Disease Guideline Group. Management of a malignant pleural effusion: British Thoracic Society Pleural Disease Guideline 2010. <i>Thorax.</i> 2010;65 Van Meter ME, McKee KY, Kohlwes RJ. Efficacy and safety of tunneled pleural catheters in adults with malignant pleural effusions: a systematic review. J <i>Gen Intern Med</i>. 2011;26(1):70–76
Toxicity Assessment of Intratumoral Injection of the Herpes Simplex Type I Thymidine Kinase Gene Delivered by Retrovirus in Patients with Refractory Cancer
Authors: Sandeep Singh, Casey Cunningham, Angela Buchanan, Doug J Jolly, John Nemunaitis
Journal: Molecular Therapy (2001)

Introduction of the herpes simplex type I thymidine kinase (HSV-TK) gene into tumor tissue, followed by ganciclovir, initiates a phosphorylation cascade that induces formation of a toxic ganciclovir triphosphate. Animal trials suggest that this ganciclovir triphosphate has antitumor activity. Here we report application of the HSV-TK transfection approach using a retroviral construct. Sixteen patients (median age 61.5 years) with refractory carcinoma (13 melanoma, 1 breast cancer, 1 nonsmall-cell lung cancer, and 1 osteogenic sarcoma) received intratumoral injection of HSV-TK retroviral vector at escalating doses (0.2×107 cfu per injection ×5 daily doses) and we evaluated them for toxicity and activity. We observed grade III pain associated with cellulitis in one patient following injection. Analysis of blood samples drawn between 3 and 28 weeks from 14 patients for replication-competent retrovirus by PCR analysis of the amphotrophic envelope revealed no replication-competent retrovirus. We injected 21 lesions. We identified no tumor responses of the injected lesions. Of 13 patients with advanced melanoma, 6 survived over one year. Thus, injection of retroviral delivered HSV-TK in patients with refractory cancer was well-tolerated.
P5-02-04: Disruption of Endothelial Cells Barrier Integrity by Invasive Breast Cancer Cells.
Authors: M Haidari, W Zhang, Z Chen, A Mortazavi, R Dixon
Journal: Cancer Research (2011)

Abstract Despite its critical role in cancer metastasis the molecular mechanisms regulating breast cancer cells transendothelial migration are poorly understood, but clearly depend on the invasive capacity of tumor cells and their ability to breach the endothelial cell barrier. Vascular endothelial-cadherin (VE-cadherin) is found specifically in the endothelial cell adherens junction and has been implicated in playing a fundamental role in controlling the transport across the endothelial barrier. Tyrosine phosphorylation of VE-cadherin has been implicated in the disruption of endothelial cells adherens junctions and diapedesis of metastatic cancer cells. We tested this hypothesis that interaction of breast cancer cells with endothelial cells initiates the signal transductions that disrupt the endothelium barrier integrity. Our studies demonstrated that the attachment of MDA-MB-231 human breast cancer cells to Human Umbilical Vein Endothelial Cells (HUVECs) leads to tyrosine phosphorylation of VE-cadherin and the formation of gaps between endothelial cells. These were accompanied by activation of two tyrosine kinases, Src and proline rich tyrosine kinase (Pyk-2). In addition, immunoprecipitation studies indicated that the endothelial cells adherens junction structure was disrupted through MDA-MB-231-induced dissociation of VE-cadherin and β-catenin complex. Activation of RhoA and HRas by over expression of constitutively active forms of the genes leads to tyrosine phosphorylation of VE-cadherin and Pyk-2 in HUVECs. Over expression of dominant negative forms of RhoA, HRas, Raf and ERK2 but not Rac1 and Cdc42 attenuated breast cancer cell-induced tyrosine phosphorylation of VE-cadherin and Pyk-2 in HUVECs. Indicating that breast cancer cell-induced VE-cadherin tyrosine phosphorylation and disruption of adherens junction in endothelial cells is mediated by RhoA and HRas\Raf\MEK\ERK signaling cascade. Understanding the precise molecular mechanisms that facilitate breast cancer cells transendothelial migration could develop novel therapeutic strategies targeting cancer cell metastasis by improving the protective role of endothelial cells. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-02-04.
Abstract P3-01-03: The Predictive Value of Serum Serum Her-2/neu for Response to Anthracycline-Based and Trastuzumab-Based Neoadjuvant Chemotherapy of Advanced Primary Breast Cancer
Authors: C Jeon, JS Lee, W Min
Journal: Cancer Research (2010)

Abstract Background:There excists little information about a possible influence of serum Her-2/neu on response to chemotherapy. We aimed that the assessment of serum Her-2/neu in pretreatment serum sample can be useful in predicting response to neoadjuvant chemotherapy. Methods: All breast cancers were tested by immunohistochemical stain and FISH for Her-2/neu before treatment. Serum Her-2/neu was twice measured by Chemiluminescence immunoassay (ADVIA centaur®TMsystem) before neoadjuvant chemotherapy and before operation. The cutoff value was 10.2 mg/ml according to previous study. Pathologic complete response (pCR) was considered as no residual tumor or remnant ductal carcinoma in situ, partial response (PR) was less than 50% decrease in maximal diameter in pathologic tumor size.The measurements for the change of serum Her-2/neu were defined as pretreatment Her-2/neu — preoperation Her-2/neu. We compared the change of serum Her-2/neu between 1) before prechemotherapy and after chemotherapy 2) pathologic complete response and partial response 3) trastuzumab (H) group and anthracyline (A) group. Results: Serum Her-2/neu was decreased after neoadjuvant chemotherapy. Mean of serum Her-2/neu in prechemotherapy was 15.4±9.0 ng/mL, that of postchemotherapy was 10.5± 2.0 ng/mL (p= 0.04). Pathologic response was correlated with the change of serum Her-2/neu (PR: 6.1 ng/ml vs. pCR: 42.0 ng/ml, p= 0.014). Serum Her-2/neu of trastuzumab group was more decreased than of anthracyline group (H=12.9 ± 14.5 ng/mL ; A= 2.2 ± 1.2 ng/mL; p=0.024). In trastuzumab group, pCR was boreline significantly correlated with change of serum Her-2/neu (PR: 0.8 ± 0.84 ng/ml vs. pCR: 21.1 ± 13.2 ng/ml, p= 0.08). Conclusions: Prechemotherapy serum Her-2/neu was to be a significant predictor of pathologic response to neoadjuvant chemotherapy. Serum Her-2/neu levels during treatment were associated with pathologic response in patients receiving neoadjuvant chemotherapy, particularly, in trastuzumab-based regimen. Serum Her-2/neu levels may serve to monitoring neoadjuvant therapy in Her-2/neu overexpressed breast cancer. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-01-03.