tbuckley/cabot-search huggingface dataset:
Characteristics of Referrals to an Inpatient Hospice and a Survey of General Practitioner Perceptions of Palliative Care
Authors: David A Seamark, Clive Lawrence, James Gilbert
Journal: Journal of the Royal Society of Medicine (1996)

In order to determine symptoms, drug prescribing and physical problems of patients referred to an inpatient hospice, case notes from 130 consecutive first admissions (95 general practitioner (GP) referrals, 35 consultant referrals) were analysed. GP referrals were more likely to be constipated, require care and be discharged to home. Consultant referrals were more gravely ill, dependent and more likely to die in the hospice. On admission 76 (58%) patients were receiving opiates with co-prescription of opiate and laxative occurring in 41 % (31/76) of the cases. The prescription of laxatives with the symptoms of constipation occurred in 62% (26/42) of the cases on admission. A telephone survey of 79 referring GPs revealed that 37% had attended neither a course nor a lecture relevant to palliative care in the past 3 years. GPs experienced difficulties frequently or always in: (a) managing pain (8/79); (b) managing other symptoms (25/79); (c) helping patients and relatives cope with their emotional distress (18/79); and (d) coping with their own emotional responses to death and dying (5/79). In conclusion, the differences demonstrated between the GP and consultant referrals have implications for purchasers. The high incidence of possible opiate-induced side-effects and the difficulties with symptom control expressed by some GPs indicate a continuing need for effective educational input.
Assessment of public awareness on chronic obstructive pulmonary disease in Slovenia
Authors: Jerneja Farkas, Mitja Lainscak
Journal: European Respiratory Journal (2014)

Background  Chronic obstructive pulmonary disease (COPD) is a major public health problem with implications beyond patients and healthcare system. General public beliefs about chronic disease burden contribute to health policy activities, standards of care and implications of novel management strategies. In this study, we sought to evaluate awareness on COPD in Slovenia.  Methods  In a cross-sectional study performed in 2013, people in several Slovenian cities were invited to complete a 22-item questionnaire about COPD and chronic disease.  Results  Analysis included 1,172 subjects (45±20 years, 43% men, 80% secondary education, 18% and 19% current or former smokers). Overall, 50% reported to have heard about COPD, 19% knew someone with COPD, and 9% believed that COPD is a normal consequence of ageing. Dyspnea (84%), cough (62%), and chest pain (44%) were reported as most common COPD symptoms. Smoking (85%) was most important risk factor, and chronic bronchitis (62%), fibrosis (15%), and lung cancer (10%) were most frequent descriptions for COPD. Overall, 69% believe COPD is treatable with drugs, and 85% would prefer quality of life over life prolongation if diagnosed with COPD. When compared to cancer, myocardial infarction, stroke, heart failure, and diabetes in terms of prevalence, cost, quality of life, and survival, COPD was always considered as least important. Primary care physicians (68%), internet (53%) or specialists (52%) would be primary sources of information about COPD.  Conclusions  Public awareness and knowledge about COPD is low and COPD is not considered as relevant public health problem. Strategies to inform and educate Slovenian public about COPD are urgently needed.
Use of non invasive ventilation (NIV) in a general medical ward (GMW) for the treatment of acute hypercapnic respiratory failure (AHRF) in COPD
Authors: Giovanni Alessandrini, Paolo Onorati, Marcello Di Paolo, Matteo Bonini, Elena Angelici, Francesco Vaccaro, Paolo Palange
Journal: European Respiratory Journal (2013)

Background: Although the efficacy of NIV treatment in COPD patients with AHRF is well established when applied in Intensive Care Units (ICU), its feasibility in a GMW remains controversial.  Aims: In this study we aimed to assess the occurrence of adverse events (transfer to ICU and in-ward mortality) and to identify related clinical and laboratory markers of potential interest. Furthermore, we evaluated patients’ survival rate after discharge.  Methods: 56 COPD patients (age: 70.4±11.5 years) treated with NIV for AHRF were studied; Pneumonia (Pn) was diagnosed in 31 cases (55.3%). Arterial blood gases, respiratory rate (RR) and Kelly’s scale (Ks) were monitored at baseline and during NIV treatment (at 1 and 48 hour). Adverse events during hospitalization were recorded. After discharge, patients’ survival rate at 1-year was recorded.  Results: A significant (p  Conclusions: Our results support the efficacy and feasibility of NIV treatment in a GMW for COPD patients with AHRF with data similar to those reported in literature in ICU. The presence of pneumonia and low HCO3- levels seems to be negatively related to the occurrence of adverse events. Larger prospective studies are necessary to confirm these findings.
Late-breaking abstract: Epidemiology of IPF in Italy
Authors: Sergio Harari, Fabiana Madotto, Antonella Caminati, Sara Conti, Giancarlo Cesana
Journal: European Respiratory Journal (2014)

Introduction  Despite its clinical relevance, IPF remains an uncommon disorder and few studies have focused on its epidemiology. Aim of the study is to investigate the prevalence and incidence of IPF in Lombardy, an Italian region with universal healthcare coverage for almost 10 million people, during 2005-2010.  Methods  Subjects affected by IPF were identified using healthcare administrative databases of Lombardy Health System: vital status, hospitalizations and outpatient visits. We estimated annual standardized prevalence and incidence rates (100,000 person-years) adopting three different algorithms to identify IPF cases, called generic, broad and narrow case definition (GCD, BCD, NCD).  Results  The mean annual prevalence rate was 35.5, 22.4 and 12.6 using respectively GCD, BCD and NCD. Prevalence increased with age and BCD and NCD showed a significantly higher rate in men. During the study period, we detected a positive trend of the annual prevalence rate. Annual incidence was estimated to 5.3 with GCD, 3.7 with BCD and 2.3 with NCD; like prevalence, incidence was higher among man than women and in elderly. Adopting GCD, we observed a decreasing trend in annual incidence rate (from 6.1 in 2005 to 4.5 in 2010), while the other case definitions detected a stable trend in annual incidence.  Conclusions  In Lombardy, IPF prevalence increased while incidence remained stable in the last years. It is therefore likely that disease duration has lengthened. The IPF prevalence and incidence identified in our population are lower than those reported by American studies and are consistent with those observed in other European studies.
Synthesis and Characterization of a Self-Fluorescent Hyaluronic Acid-Based Gel for Dermal Applications
Authors: Stefano Menegatti, Nino Ruocco, Sunny Kumar, Michael Zakrewsky, Joshua Sanchez De Oliveira, Matthew. E. Helgeson, Gary L. Leal, Samir Mitragotri
Journal: Advanced Healthcare Materials (2015)

Combinations of polymer conjugates affording in situ gelation hold promise for treatment of pathological cavities (e.g., arthritis) and sustained drug release. In particular, hyaluronic acid (HA) functionalized with reactive groups is regarded as an excellent biomaterial due to its tunable cross-linking kinetics and mechanical properties. HA-based reagents, however, can be irritating to surrounding tissues due to the reactivity of pendant groups, and their fast gelation kinetics can result in poor cavity filling. In this study, a biocompatible "click" reaction between cyanobenzothiazole (CBT) and d-cysteine (d-Cys) is employed to produce HA-based conjugates for in situ gelation. Rheological studies conducted on a gel obtained from the combination of HA-CBT and HA-d-Cys indicate optimal gelation time and mechanical properties. Further, in vitro studies on porcine skin demonstrate the ability of the gel to form in situ upon subcutaneous injection or topical application, and to act as a reservoir for sustained release of protein therapeutics. Finally, the safety of the HA-based conjugates is demonstrated on human keratinocytes. The presented results demonstrate the applicability of the binary mixture for in situ gelation and the potential of the proposed system for a variety of biomedical applications.
Calcium Sensing Receptor in Human Colon Carcinoma: Interaction with Ca2+ and 1,25-Dihydroxyvitamin D3
Authors: Subhas Chakrabarty, Hongmei Wang, Lucie Canaff, Geoffrey N. Hendy, Henry Appelman, James Varani
Journal: Cancer Research (2005)

Abstract Recent studies show that the human parathyroid calcium sensing receptor (CaSR) is expressed in human colon epithelium and functions to regulate epithelial proliferation and differentiation. In this study, we show that the cells of the colon crypt acquire CaSR expression as they differentiate and migrate towards the apex of the crypt. CaSR expression was weak in colon carcinomas with a more-differentiated histologic pattern, whereas CaSR expression was undetectable in less-differentiated tumors. We found that Ca2+ and/or 1,25(OH)2D3 stimulated CaSR promoter activity and CaSR protein expression in the human colon carcinoma CBS cells, which possessed a functional CaSR. Both agents concomitantly induced a series of changes in the CBS cells that influence proliferation and differentiation, but cellular responses to the two agents were not identical. Ca2+ strongly induced E-cadherin expression and inhibited the expression of the nuclear transcription factor, TCF4. 1,25(OH)2D3 was weaker in its effect on E-cadherin and was not able to inhibit TCF4 expression. 1,25(OH)2D3 was as strong or stronger than Ca2+ in its induction of the cyclin-dependent kinase inhibitors, P21 and p27. It is concluded that CaSR may function in the colon to regulate epithelial differentiation and that loss of CaSR expression may be associated with abnormal differentiation and/or malignant progression. Extracellular Ca2+ and 1,25(OH)2D3 are potential candidates involved in regulating CaSR expression in the colon and the chemopreventive actions of Ca2+ and 1,25(OH)2D3 in colon cancer may be mediated, in part, through the CaSR.
Leisure time physical activity and cancer risk: evaluation of the WHO's recommendation based on 126 high-quality epidemiological studies
Authors: Li Liu, Yun Shi, Tingting Li, Qin Qin, Jieyun Yin, Shuo Pang, Shaofa Nie, Sheng Wei
Journal: British Journal of Sports Medicine (2015)

The WHO has concluded that physical activity reduces the risk of numerous diseases. However, few systemic reviews have been performed to assess the role of leisure time physical activity (LTPA) in lowering the risk of cancer in a dose-dependent manner and furthermore the suitability of recommendation of physical activity by the WHO.A systematic review and meta-analysis was designed to estimate cancer risk by LTPA in binary comparison and in a dose-dependent manner. MEDLINE and Web of Science were searched up to 30 December 2014 without language restrictions. Reference lists were reviewed for potential articles.A total of 126 studies were recruited into the meta-analysis. Overall, the total cancer risk was reduced by 10% in people who undertook the most LTPA as compared with those who did the least. Dose-response meta-analysis indicated that the current WHO recommendation (equal to an average of 10 metabolic equivalents of energy hours per week) induced a 7% (95% CI 5% to 9%) cancer reduction. Moreover, the protective role of LTPA against cancer becomes saturated at 20 metabolic equivalents of energy hours per week, with a relative risk of 0.91 (95% CI 0.88 to 0.93). Subanalyses results based on cancer types showed that LTPA only exhibited significant protection against breast cancer and colorectal cancer.Our meta-analysis indicates that the current WHO recommendation of physical activity can result in a 7% reduction in cancer risk, which is mainly attributed to its protective role against breast cancer and colorectal cancer. Furthermore, two-fold of current recommendation level is considered to give its saturated protection against cancer.
Dietary habits and leisure-time physical activity in relation to adiposity, dyslipidemia, and incident dysglycemia in the pathobiology of prediabetes in a biracial cohort study
Authors: Andrew B Boucher, E A Omoluyi Adesanya, Ibiye Owei, Ashley K Gilles, Sotonte Ebenibo, Jim Wan, Chimaroke Edeoga, Samuel Dagogo-Jack
Journal: Metabolism (2015)
Inhibition of c-Myc Expression and Function in Hematologic Malignancies
Authors: Ghayas C Issa, Jake E Delmore, Michael R McKeown, Madeleine E Lemieux, Peter B Rahl, Hannah M. Jacobs, Efstathios Kastritis, Timothy Gilpatrick, Ronald M Paranal, Jun Qi, Junwei Shi, Marta Chesi, Anna C. Schinzel, Christopher R. Vakoc, P.Leif Bergsagel, Paul G. Richardson, Richard Young, William C. Hahn, Irene M. Ghobrial, Kenneth C Anderson, Andrew L. Kung, Constantine S. Mitsiades, James E Bradner
Journal: Blood (2011)
Common Mental Disorders, Explanatory Models and Consultation Behaviour among Indian Women Living in the UK
Authors: K S Jacob, D Bhugra, K R Lloyd, A H Mann
Journal: Journal of the Royal Society of Medicine (1998)

Women of Indian origin are said to have a lower rate of recognized common mental disorders and a higher frequency of consultation in primary care than white British. The aim of this study was to evaluate factors, including explanatory models (patient perspectives) of illness, associated with common mental disorders and with frequency of consultation among women of Indian origin in primary care. The investigation was conducted in a general practice in West London with a large Indian population. Consecutive woman attenders of Indian descent were screened with the General Health Questionnaire-12 to identify probable cases of psychiatric morbidity. 100 patients were interviewed with the Revised Clinical Interview Schedule (CIS-R), a specific tool for the diagnosis of common mental disorders, and the Short Explanatory Model Interview, which elicits the individual's conceptualization of his or her illness. Those patients who satisfied CIS-R criteria were classified as ‘cases’, the others as ‘controls’. Common mental disorders were documented in 30% of patients. The general practitioner's diagnosis of common mental disorders had a sensitivity of 17% and a specificity of 91%. Individuals with common mental disorders had a higher frequency of consultation (P=0.017), were less likely to see depression as an indication for medical intervention and were more likely to withhold some of their concerns from the general practitioner. Incorrect diagnosis by the GP was most likely to occur when patients did not disclose all their complaints. These associations were all statistically significant after adjustment for possible confounders by multiple linear and logistic regression. Women of Indian origin in this sample had rates of common mental disorders similar to those in other UK populations. Differing conceptualizations of common mental disorders may contribute to their underrecognition in women of Indian origin.
Does histology influence outcome in childhood Hodgkin's disease? Results from the United Kingdom Children's Cancer Study Group.
Authors: A G Shankar, S Ashley, M Radford, A Barrett, D Wright, C R Pinkerton
Journal: Journal of Clinical Oncology (1997)

PURPOSE Histology has been identified as an important prognostic factor in Hodgkin's disease (HD) in adults. Information regarding the impact of histology on outcome in childhood HD is scarce. This study determines the effect of histology on the overall survival (OS) or progression-free survival (PFS) in a national series of children treated in a standardized manner. PATIENTS AND METHODS The results of treatment of 331 assessable patients, treated between January 1, 1982 and June 30, 1992, in the United Kingdom Children's Cancer Study Group (UKCCSG) Hodgkin's study I were reviewed to evaluate OS, PFS, and deaths according to stage and histology. Treatment was either involved-field radiation alone (stage IA) or chlorambucil, vinblastine, procarbazine, and prednisolone (ChlVPP) chemotherapy with or without mediastinal radiation. All were clinically staged at diagnosis. RESULTS Nodular sclerosing (NS) HD was the most common histologic subtype (155 of 331 patients [47%]) and was uniformly distributed through all stages. Lymphocyte-depletion (LD) HD was extremely uncommon (&lt; 1%). Mixed-cellularity (MC) HD had the highest relapse rate, but this was only significant (P &lt; .05) in stage I patients who received local irradiation alone. There was no other statistically significant difference in OS and PFS between the various histologic subtypes. Multivariate analysis for PFS and OS confirmed that stage was the most important prognostic factor and that histology did not have an effect after stratification by stage. CONCLUSION This study demonstrates that with effective multiagent chemotherapy, histologic subtype does not influence outcome. The high relapse rates in stage I MC subtype indicates that MC HD is biologically aggressive and systemic treatment with or without local irradiation may be indicated. The high relapse rate in stage IV patients appeared to be independent of histology.
Primary CNS lymphoma treated with osmotic blood-brain barrier disruption: prolonged survival and preservation of cognitive function.
Authors: E A Neuwelt, D L Goldman, S A Dahlborg, J Crossen, F Ramsey, S Roman-Goldstein, R Braziel, B Dana
Journal: Journal of Clinical Oncology (1991)

Combination chemotherapy with or without radiotherapy has had only modest efficacy in the treatment of primary CNS lymphoma. Median survival of these patients, treated primarily with radiotherapy, is 13 months; 5-year survival is less than 5%. Thirty consecutive non-acquired immune deficiency syndrome patients with primary CNS lymphoma were treated with barrier-dependent chemotherapy using intraarterial mannitol to open the blood-brain barrier (BBB). Follow-up included extensive neuropsychologic testing of all patients. Thirteen patients received cranial radiation 1 to 9 months before referral (group 1). Seventeen patients received initial BBB disruption chemotherapy with subsequent radiation only for tumor progression or recurrence (group 2). The difference in median survivals from diagnosis--17.8 months for group 1 and 44.5 months for group 2--was statistically significant (P = .039). Group 1 survival is comparable with the 20-month median survival of a historical series of patients (n = 208) treated with radiotherapy with or without chemotherapy. Group 2 patient survival represents an advance in the survival of CNS lymphoma and was associated with preservation of cognitive function in six of seven nonirradiated complete responders observed for 1 to 7 years. Patient toxicity was manageable in this intensive therapeutic regimen. In this series, a plateau in survival curves suggests that a major portion of these patients may be cured without the neuropsychologic sequelae associated with cranial radiation.
Role of Cationic Proteins in the Airway
Authors: Anthony J. Coyle, Derek Uchida, Steven J. Ackerman, Wayne Mitzner, Charles G. Irvin
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

Major basic protein (MBP) is a highly cationic protein found in the granules of eosinophils. It has been postulated that MBP may participate in the pathogenesis of airway hyperresponsiveness exhibited by asthmatic patients. Accordingly, we have employed a rat system to investigate the effect of human MBP instillation on airway responsiveness and the possible role of cationic charge in the determination of this effect. Major basic protein caused a significant increase in airway responsiveness to inhaled methacholine. Two polycations, poly-L-arginine and poly-L-lysine, also increased airway responsiveness to inhaled methacholine. Moreover, two other very different cationic proteins, platelet factor 4 (PF4) and cathepsin G were also capable of inducing airway hyperresponsiveness. These effects were dependent on their positive charge, since the charge — and, hence the effect — of these proteins was neutralized with low molecular weight heparin. In addition, other polyanions, such as low molecular weight heparin, albumin, or dextran sulfate, were also effective. We investigated whether two synthetic cationic proteins, poly-L-arginine and poly-L-lysine, could modify epithelial-dependent responses using a perfused guinea pig tracheal tube preparation. With an intact epithelium, methacholine was some 150 times less potent when applied intraluminally than when applied extraluminally. Perfusion of the luminal surface with cationic proteins increased the potency of intraluminally applied methacholine without modifying the responses to extraluminally applied methacholine. Cationic proteins also attenuated the relaxant effects of intraluminally applied KCI. These effects occurred in the absence of any overt epithelial cell damage. Our data demonstrates that cationic proteins can modify epithelial-dependent responses in the airways. While the precise mechanisms are unclear, a role is suggested for a charge-mediated interaction with the respiratory epithelium, resulting in airway smooth muscle dysfunction. Lastly, we suggest that it is the total cationic load formed by all of the inflammatory cells that may have importance in the pathogenesis of asthma.