tbuckley/cabot-search huggingface dataset:
The role of an all-oral chemotherapy containing capecitabine and etoposide in advanced, progressive metastatic disease: A patient-friendly palliative option that can result in long-term disease control—A study from India.
Authors: A. Chandra
Journal: Journal of Clinical Oncology (2010)

e19689 Background: Chemotherapeutic treatment prolongs survival in comparison with placebo in patients with advanced progressive metatstatic cancer. Nevertheless, the impact of chemotherapy on quality of life and in patients with poor prognosis is unknown. Current chemotherapeutic regimens are associated with significant side effects and only limited activity in metastatic progressive disease. Methods: The subjects were 50 patients with severe disseminated cancer (breast, lung, gastrointestinal, etc.) who were treated with oral chemotherapy. The treatment schedule comprised daily administration of capecitabine (1,000 mg) for 2 weeks and etoposide (50 mg) for 21 days. Next cycle was administered on 28 days. This continued until disease progression. Results: The median survival time was 400 days, (range 90-720 days) and the median progression-free survival was 250 days. Of the 50 patients with measurable lesions, 19% patients had progressive disease, 41% achieved a partial response and 40% had stable disease. Ascites volume decreased markedly in 14 (54%) of the 26 patients with ascites. Grade 3 neutropenia was observed in 20% of the patients and anemia was observed in 45%. 4 patients had febrile neutropenia. The grade 3 nonhematological toxicities were vomiting (6%) and fatigue (40%). Early death, within 30 days of the last administration of occurred due to disease progression in 2 patients, but there were 1 treatment-related deaths. Conclusions: Oral chemotherapy may be effective in treating disseminated cancer and might improve the patient's condition, economic and patient friendly regime in limited resource countries. Well-designed, controlled trials are needed to further evaluate the risks and benefits of different chemotherapeutic schedules in patients with advanced cancer. No significant financial relationships to disclose.
Combining molecular analysis, chemo sensitivity testing in vitro, and therapy monitoring in vivo on disseminated tumor cells in breast cancer patients.
Authors: K. Pachmann, O. Camara, T. Kroll, S. Carl, N. Rüdiger, C. Rabenstein, A. Plaschke-Schluetter
Journal: Journal of Clinical Oncology (2010)

e21116 Background: Most breast cancer patients do not die of their primary tumor but from metastases developing sometimes years after the primary tumor has been removed. Cells from the tumor seem to be disseminated continuously during tumor growth and the first spread of tumor cells detectable with conventional methods is in the lymph nodes. Patients with lymph node positive disease have a poorer disease free survival than patients without affected lymph nodes. An increase in circulating epithelial tumor cell (CETC) numbers during adjuvant therapy is correlated with an 11 to 16-fold increase in hazard of relapse indicating increasing resistance to the applied drugs. Therefore, it would be desirable to better characterize these cells, test them for alternate drugs and monitor the actual response to the therapy decided on. Methods: For this purpose we have developed a test system comprising isolation of individual CETC from lymph nodes and blood from breast cancer patients for molecular characterization, chemo sensitivity testing of cells from the same sample defining the effectivity of the drugs as percentage of cells killed and measurement of the response of the CETC to the drugs in these patients treated according to guide lines. Results: The molecular characteristics and the sensitivity to the applied drugs of the tested cells and the response of the CETC were subsequently compared to clinical outcome. Conclusions: The response of CETC to therapy correlated highly with the previously tested chemo sensitivity and the molecular characteristics of these cells. Correlation to relapse or progression free survival is under investigation. No significant financial relationships to disclose.
Plasma IGFBP-2 for prediction of clinical outcomes of patients with gliomas
Authors: Y. Lin, T. Jiang, S. Song
Journal: Journal of Clinical Oncology (2008)

2036 Background: Insulin-like growth factor binding protein-2 (IGFBP-2) has been suggested to be related to the initiation and progression of gliomas. An elevated IGFBP-2 level in tumor tissue was found in glioblastoma multiforme (GBM), the most malignant form of gliomas, and was associated with shortened survival of GBM patients. To investigate a possibility of IGFBP-2 as a plasma surrogate marker for clinical outcomes in glioma patients, we retrospectively examined the IGFBP-2 level in plasma of patients with different grades of glioma before surgery and its association with clinical outcomes of glioma patients. Methods: We identified 200 glioma cases and 30 normal controls, and measured the plasma IGFBP-2 level with the ELISA assay. Clinical data (e.g., tumor response, progression-free survival PFS, and overall survival OS) were collected from medical records or follow-ups. We compared the plasma IGFBP-2 level in the different glioma subtypes and controls, and assessed the potential correlation of the plasma IGFBP-2 level before surgery with tumor response to adjuvant therapy (radiation therapy and chemotherapy), PFS and OS in GBM patients. We also examined any changes of the plasma IGFBP-2 level before surgery and after recurrence and an association of the changed plasma IGFBP-2 level with clinical outcomes. Results: 1) The plasma IGFBP-2 level before surgery was significantly higher in the high-grade glioma (grade III and GBM) than in the low-grade one (grade II) and the normal controls (p=0.000), and was significantly higher in the grade II gliomas than the controls (p=0.010), but no differences were observed between the grade III glioma and GBM. 2) In patients with the high-grade glioma, the plasma IGFBP-2 level before surgery was significantly correlated with PFS (r=-0.307, p=0.046), and the plasma IGFBP-2 level before surgery showed an association with tumor response. 3) The plasma IGFBP-2 level in GBM patients was significantly increased after recurrence compared with that before surgery (p=0.000) and the plasma IGFBP-2 level after recurrence was associated with PFS. Conclusions: The plasma IGFBP-2 has a potential to be used as a surrogate biomarker for diagnosis and prognosis in glioma, which deserves a large-scale validation study. No significant financial relationships to disclose.
Low plasma gamma-aminobutyric acid levels during the late luteal phase of women with premenstrual dysphoric disorder
Authors: U Halbreich, F Petty, K Yonkers, G L Kramer, A J Rush, K W Bibi
Journal: American Journal of Psychiatry (1996)

Plasma gamma-aminobutyric acid (GABA) levels have been reported to be low in some patients with major depressive disorder. Premenstrual dysphoric disorder is often associated with major depressive disorder. Therefore, the authors sought to determine whether women with premenstrual dysphoric disorder with or without prior major depressive disorder also had low plasma GABA levels.Plasma GABA levels were measured in 27 women with premenstrual dysphoric disorder and 21 comparison women during the the mid-follicular and late luteal phases of the menstrual cycle.In comparison women, plasma GABA levels increased from the mid-follicular to the late luteal phase. Women with premenstrual dysphoric disorder and a past history of major depressive disorder had low plasma GABA levels during both phases. In women with premenstrual dysphoric disorder but no past major depressive disorder, plasma GABA levels decreased from the nonsymptomatic, mid-follicular phase to the symptomatic, late luteal phase.Decreased GABA function may represent a common biological link between subtypes of depressive and premenstrual dysphoric disorders. A trait in major depressive disorder and a state-dependent decrease in premenstrual dysphoric disorder might imply a possible continuum between the two disorders.
A family history study of schizophrenia-related personality disorders
Authors: Kenneth S. Kendler, Catherine C. Masterson, Roseann Ungaro, Kenneth L. Davis
Journal: American Journal of Psychiatry (1984)

This study examined whether the family history method can be used to detect cases of schizophrenia-related personality disorder in the families of schizophrenic patients. After proposing specific family history criteria for this diagnosis, the authors applied these criteria in a blind family history study and found that schizophrenia-related personality disorders were significantly more common in the first-degree relatives of schizophrenic patients than in the relatives of medically ill controls.
Abstract 2028: Right Ventricular Infarction is Associated with a High Rate of Atrial Fibrillation and Ventricular Arrhythmias in Patients with Inferior ST-Elevation Myocardial Infarction
Authors: Khung Keong Yeo, Reginald I Low, Ezra Amsterdam, Lori Parsons, William French
Journal: Circulation (2008)

Background: The incidence of arrhythmic complications after inferior ST-elevation myocardial infarction (STEMI) and right ventricular (RV) myocardial infarction (MI) in comparison to anterior MI re...
Abstract 60: Dexmedetomidine Administration During CPR Improves Stroke Volume During the Early Postresuscitation Period
Authors: Srinivasarao Badugu, Andre Shih, Giridhar Kaliki Venkata, Ikram Haque, Arno Zaritsky, Jai P Udassi
Journal: Circulation (2011)

Introduction: Elevated sympathetic response after CPR worsens myocardial dysfunction and cardiac output. Dexmedetomodine has sympatholytic effects both in animal and human studies. Hypothesis: Dexmedetomidine given during CPR improves stroke volume (SV) after ROSC compared with standard CPR. Methods Sixteen anesthetized &amp; ventilated (2 months old) farm pigs (UF Research Swine) of either sex were blindly randomized (8/group) after induction of ventricular fibrillation (VF; via direct right ventricular current) to receive either dexmedetomidine (2 mcg/kg) or placebo after the first minute of chest compressions per AHA CPR guidelines. Chest compressions were delivered at 100/min by a pneumatic compressor device (Thumper, Michigan instruments, USA) and 21% FiO 2 was used for ventilation. SV was measured at 15, 30, 60, 90 and 120 minutes after ROSC using a Pressure-Volume (P-V) catheter in the left ventricle (Millar instruments, Michigan, USA). Cardiac output was calculated from SV and heart rate. Outcome (mean±SD) was analyzed using mixed linear model (SAS Proc MIXED). We used an unpaired t-test for the differences between groups at each time point; p-value ≤0.05 was considered significant. Results Dexmedetomidine group had significantly higher stroke volume (% change from baseline) at 15 minutes (97±24 vs. 44±19, p =0.0006) and 30 minutes (87±26 vs. 51±21 p =0.0153). CO (% change from baseline) was higher in Dex group at 15 minutes (141±53 vs. 61±23, p =0.0061) and at 30 minutes (115±44 vs. 55±17 p =0.0122). SV and CO were higher, but not significantly after 30 minutes. The study group had significantly higher CO (% change from baseline) across all time points combined compared with the control group (89.3±6.14 vs. 60.1±7.15, p=0.0033). End-diastolic volume trended higher in Dexmedetomidine group but was not significant. HR was not different between the two groups. Conclusions Dexmedetomidine, when given during the initial cycle of chest compressions during CPR, increases SV and CO early post ROSC. Further studies are needed to evaluate the appropriate dose, continuous infusion and time of administration.
Lesson of the Week: Obstructive uropathy without dilatation: a potential diagnostic pitfall
Authors: K. Lyons, P. Matthews, C. Evans
Journal: BMJ (1988)

A propos de 3 observations: l'insuffisance renale avec oligurie ou anurie due a une obstruction des voies urinaires peut ne pas s'accompagner d'hydronephrose, ce qui rend difficile le diagnostic. Interet de l'urographie i.v. a haute dose
人乳头瘤病毒检测对宫颈低度细胞学异常的寿命效应、成本和成本效益的影响：模拟研究
Authors: Rosa, Legood, Alastair, Gray, Jane, Wolstenholme, Sue, Moss, 王瑾晖（译）, 潘凌亚（校）
Journal: BMJ (2006)

目的：对宫颈刮片结果处于临界或者轻度核异常状态的妇女进行人乳头瘤病毒（HPV）检测以确定是否马上行阴道镜检查。预测该做法对寿命效应、成本及成本效益的影响。设计：模拟研究。研究机构：3个研究中心参与了这项英国国家医疗卫生服务体系（NHS）的引导性研究。人群：25-64岁的宫颈刮片结果处于临界或者轻度核异常状态妇女。干预：采用传统细胞学、液基细胞学以及4种不同年龄截取点和随访次数的策略进行筛查。该策略结合了液基细胞学和HPV检测（辅助的HPV检测）。结果：该模拟研究提示与没有进行HPV检测的传统细胞学方法相比，液基细胞学与HPV检测的联合应用，对于年龄≥35岁宫颈刮片结果处于临界或者轻度核异常状态的妇女，每延长生命年花费为英镑（￡）3735（欧元5528；美元6474），对于年龄处于25-34岁的妇女则延长每生命年需要额外花费￡4233。HPV检测可能减少一生中重复的宫颈刮片检查次数52％-86％，但是会增加阴道镜检查次数64％-138％。结论：对宫颈刮片结果处于临界或者轻度核异常状态的所有妇女均进行HPV检测有可能具有一定的成本效益。然而，预示一生中阴道镜检查的次数增加，需给予慎重考虑。
The biology and prognostic value of lymphatic vessel density (LD) and lymphatic invasion (LI) in regression in melanoma
Authors: S. Yun, P. Gimotty, W. Hwang, P. Dawson, P. VanBelle, D. Elder, R. Elenitsas, D. Guerry, L. Schuchter, X. Xu
Journal: Journal of Clinical Oncology (2009)

9017 Background: Regression in melanoma is characterized by increased vascularity, lymphocytic infiltrate and fibroplasia in the papillary dermis, accompanied by the absence (complete regression, CoR) or presence (partial regression, PaR) of melanoma cells in the epidermis. The prognostic value of regression is controversial. We noticed that LD and LI were increased in the areas of regression (AR) or areas with brisk lymphocytic infiltration (AB). Our goal was to clarify the prognostic value of regression in melanoma. Methods: Dual immunohistochemical staining was done using antibodies to podoplanin (lymphatic vessels) and S100 (melanoma cells) on paraffin tissues from 321 patients with vertical growth phase (VGP) primary melanomas who had 10 years or more of follow-up. LD in AR (both CoR and PaR) was compared with that of normal dermis adjacent and distant, as well as LD in the AB. LI in these areas was also scored. Unadjusted and adjusted hazard rates were obtained from univariate and multivariate Cox models for time to melanoma-specific death using established melanoma prognostic factors. Results: 116 patients (36%) had regression: 75 CoR (23%) and 41 PaR (13%). LD significantly decreased stepwise from CoR (mean ± se, 23.7 ± 2.7) to PaR (15.5 ± 1.1), adjacent normal dermis (7.3 ± 0.28) and distant normal dermis (5.4±0.31) and it was significantly elevated in the AB (18.5±0.78). Melanomas with CoR had the highest percentage of LI in both AR and AB. In addition, the percentage of LI in AB was highest for men and for those with VGP tumor infiltrating lymphocytes (TILs). Both high LD in AR and more LI in AB were associated with poor prognosis (p=0.004 and p=0.002, respectively). Six factors were significant in the final multivariate model: LI in AB (HR=2.3), LD in AR (HR=1.04), thickness (HR=1.44), axial (HR=7.7), ulceration (HR=2.5) and no VGP TILs (HR=2.8). Conclusions: AR and AB were associated with increased LD and higher incidence of LI in primary melanomas. LD and LI in AR or AB are independent prognostic factors. Our data suggest that the effects of regression on prognosis are mediated at least in part through lymphangiogenesis and LI. No significant financial relationships to disclose.
Abstract 15511: Age Adjusted Health-Related Quality of Life in an ACHD Cohort
Authors: Michelle Gurvitz, Kara Western, Russell Gongwer, Matthew Minahan, Adrienne Kovacs, Michael Landzberg, Kathy Jenkins
Journal: Circulation (2013)

Objective: Studies measuring health related quality of life (HRQOL) with SF-36v2 in adult congenital heart disease (ACHD) patients have shown results similar to or worse than the general population...
Abstract 14611: Phenotypic Modulation of SMCs and Related Inflammation in the Development of Experimental Obstructive Pulmonary Vasculopathy
Authors: Shoichiro Otsuki, Hirofumi Sawada, Noriko Yodoya, Tsutomu Shinohara, Taichi Kato, Hiroyuki Ohashi, Erquan Zhang, Kyoko Yoshida-Imanaka, Hideto Shimpo, Kazuo Maruyama, Yoshihiro Komada, Yoshihide Mitani
Journal: Circulation (2013)

Shoichiro Otsuki, 2013 Finalist and Presenting Author
The prognostic and predictive value of CA-125 regression during neoadjuvant chemotherapy for advanced ovarian or primary peritoneal carcinoma.
Authors: N. Vasudev, I. Trigonis, D. A. Cairns, G. Hall, D. Jackson, T. Perren
Journal: Journal of Clinical Oncology (2010)

5070 Background: The selection of patients with ovarian cancer for interval debulking surgery (IDS) following neoadjuvant chemotherapy (NAC) is an important clinical goal. We have examined the significance of CA-125 regression as a prognostic indicator and predictor of optimal cytoreduction at IDS in women with ovarian or primary peritoneal carcinoma receiving NAC. Methods: 63 women treated between 2004 and 2007 with neoadjuvant platinum-based chemotherapy followed by IDS were studied retrospectively. Preoperative CA-125 values were used to calculate a regression coefficient (CA-125r) using exponential regression analysis. Outcome endpoints were overall survival (OS), time to CA-125 progression by Rustin criteria (TTC) and time to second-line treatment (TTS). Results: On multivariable analysis, CA-125r was an independent predictor of OS (HR 1.18 [per 1% change in CA-125r], 95% CI: 1.00-1.38, p = 0.048). CA-125r was independently predictive of TTC and TTS (HR 1.16, p ≂̃F 0.03 for both). CA-125r was also predictive of achieving optimal cytoreduction at IDS (AUC 0.756, p < 0.001). Conclusions: CA-125 regression rate during preoperative NAC is of independent prognostic value. CA-125 regression rate strongly predicts for optimal cytoreduction. No significant financial relationships to disclose.
Doctors' autonomy
Authors: D. Orchard
Journal: BMJ (1998)

It was 1947. As the door closed behind Lord Moran, Nye Bevan turned to his permanent secretary, who was pouring generous measures of pre-war whisky. “Rotten negotiators, doctors. I would have given consultants twice that salary if he'd asked.”

Sir Bartholomew sat down before replying doubtfully, “He certainly seemed anxious to conclude negotiations, even if it meant accepting a rather low offer.” He paused. “Minister, what were you hoping to achieve?”

“Keep down expenses in this new National Health Service, obviously.”

“Hmm.” Sir Bartholomew frowned. “Minister, no doubt you recall the proportion of costs that will go on doctors' salaries.” He slid a sheet of foolscap in front of the minister and tapped a column of figures. Bevan scanned them quickly and registered surprise.

Sir Bartholomew smiled. “Not much, is it, Minister ? The real expense is here.” He pointed to a different column. “Drugs, investigations, other treatments. It all mounts up. And who tells patients they need these things?”

“The doctors, naturally. That's their job.”

“precisely. Negotiating a small salary for consultants will do little to contain healthcare expenditure. What you should have done, Minister, was to negotiate away their power. It is not inconceivable that Lord Moran's …
Abstract 1244: Lipid Goals among Patients with Diabetes or the Metabolic Syndrome: The Lipid Treatment Assessment Project (L-TAP) 2
Authors: J W Jukema, Roger S Blumenthal, Raul D Santos, David D Waters, Michael Messig, Lisa Tarasenko
Journal: Circulation (2008)

Background: Achievement of lipid targets is particularly important in individuals with diabetes mellitus (DM) and the metabolic syndrome (MS) because their cardiovascular (CV) risk is high. This analysis of the L-TAP 2 population compared goal attainment by DM status and number of MS components. Methods: In L-TAP 2, patients aged ≥20 years with dyslipidemia on stable lipid lowering therapy were assessed at investigation sites in 9 countries (US, Spain, Canada, Netherlands, Korea, France, Taiwan, Mexico, and Brazil) between September 2006 and April 2007. Lipid levels were determined once in each patient at time of enrollment. Achievement of LDL-C success (according to National Cholesterol Education Program Adult Treatment Panel III guidelines), triglycerides (TG) goals (&lt;150 mg/dL), and HDL-C success (&gt;40 mg/dL in men or &gt;50 mg/dL in women) was compared using logistic regression by DM status and number of MS components (BMI ≥30 kg/m 2 , TG ≥150 mg/dL, HDL-C &lt;40 mg/dL in men or &lt;50 mg/dL in women, blood pressure ≥130/≥85 mm Hg, fasting glucose ≥110 mg/dL). Lipid and CRP levels were compared by DM status using ANOVA. Results: A total of 9955 patients were evaluated. Patients with DM, compared with those without DM, had significantly lower achievement of LDL-C success (67% vs 75%), TG goals (55% vs 64%), and HDL-C success (62% vs 75%; P &lt;0.0001 for all comparisons). However, significantly more DM patients had LDL-C &lt;70 mg/dL (28% vs 16%; P &lt;0.0001). As the number of MS components increased, success rates significantly decreased for both LDL-C (81%, 75%, 71%, 69%, 69%, and 69% for 0, 1, 2, 3, 4, and 5 MS components respectively; P &lt;0.0001) and HDL-C (91%, 74%, 50%, and 24% for 1, 2, 3, and 4 MS components respectively; P &lt;0.0001). Patients with DM, compared with those without DM, had significantly higher CRP levels (1.86 vs 1.52 mg/L), significantly lower total cholesterol (175 vs 188 mg/dL), LDL-C (91 vs 104 mg/dL), HDL-C (49 vs 54 mg/dL), and non-HDL-C (125 vs 134 mg/dL), and higher TG (177 vs 155 mg/dL; P &lt;0.0001 for all comparisons). Conclusions: This analysis indicates that despite their increased CV risk, patients with DM remain undertreated. Furthermore, as the number of MS components increases, lipid goal success rates decrease.
Maintenance Therapy With Alternating Azacytidine and Lenalidomide Cycles In Elderly (≥ 60) Fit Patients (Pts) With Poor Prognosis AML In First Complete Remission (CR) After Lia Induction. A Phase II Multicentric Goelams Trial
Authors: Mathilde Hunault-Berger, Edouard Randriamalala, Aline Schmidt-Tanguy, Chantal Himberlin, Bachra Choufi, Caroline Bonmati, Jean Yves Cahn, MD marie-Anne Couturier, Eric Deconinck, Jean Pierre Marolleau, Frederique orisni-Piocelle, Jacques Delaunay, Emmanuelle Tavernier, Christian Recher, Severine Lissandre, Mario Ojeda-Uribe, Laurence Sanhes, Laurent Sutton, Anne Banos, Bruno Lioure, Thierry Lamy, Didier Bouscary, Alain Saad, Valérie Rouille, Philippe Guardiola, Isabelle Luquet, MD marie-Christine Bene, Francois Dreyfus, Norbert Ifrah, Arnaud Pigneux
Journal: Blood (2013)
Abstract 5418: Deficiency of Glutathione-S-transferase P (GSTP)-mediated Detoxification of Lipid Peroxidation Products Increases Myocardial Ischemia-Reperfusion Injury
Authors: Daniel J Conklin, Bradford G Hill, Karin Kaiserova, Yiru Guo, Roberto Bolli, Aruni Bhatnagar
Journal: Circulation (2008)

Myocardial ischemia-reperfusion (I/R) results in the generation of oxygen-derived free radicals. An increase in myocardial antioxidant defenses ameliorates I/R injury and stunning. Nevertheless, th...