tbuckley/cabot-search huggingface dataset:
Treatment outcomes of obstructive sleep apnoea in obese community-dwelling children: the NANOS study
Authors: María Luz Alonso-Álvarez, Joaquin Terán-Santos, Ana Isabel Navazo-Egüia, Mónica Gonzalez Martinez, María José Jurado-Luque, Jaime Corral-Peñafiel, Joaquin Duran-Cantolla, José Aurelio Cordero-Guevara, Leila Kheirandish-Gozal, David Gozal
Journal: European Respiratory Journal (2015)

The first line of treatment of obstructive sleep apnoea syndrome (OSAS) in children consists of adenotonsillectomy (T&amp;A). The aim of the present study was to evaluate treatment outcomes of OSAS among obese children recruited from the community. A cross-sectional, prospective, multicentre study of Spanish obese children aged 3–14 years, with four groups available for follow-up: group 1: non-OSAS with no treatment; group 2: dietary treatment; group 3: surgical treatment; and group 4: continuous positive airway pressure treatment. 117 obese children (60 boys, 57 girls) with a mean age of 11.3±2.9 years completed the initial (T 0 ) and follow-up (T 1) assessments. Their mean body mass index (BMI) at T 1 was 27.6±4.7 kg·m −2 , corresponding to a BMI Z-score of 1.34±0.59. Mean respiratory disturbance index (RDI) at follow-up was 3.3±3.9 events·h −1 . Among group 1 children, 21.2% had an RDI ≥3 events·h −1 at T 1 , the latter being present in 50% of group 2, and 43.5% in group 3. In the binary logistic regression model, age emerged as a significant risk factor for residual OSAS (odds ratio 1.49, 95% confidence interval 1.01–2.23; p&lt;0.05) in obese children surgically treated, and RDI at T 0 as well as an increase in BMI emerged as significant risk factors for persistent OSAS in obese children with dietary treatment (OR 1.82, 95% CI 1.09–3.02 (p&lt;0.03) and OR 8.71, 95% CI 1.24–61.17 (p=0.03)). Age, RDI at diagnosis and obesity are risk factors for relatively unfavourable OSAS treatment outcomes at follow-up.
Cannabis confusions
Authors: Geoff Watts
Journal: BMJ (2006)

10% of cases of psychosis. 2 6The task of deciding the harms of cannabis involves what Hall and Pacula 23 have described as a "choice of evils" in which the rights of the majority who use cannabis without experiencing problems are balanced against the risks of a minority who may develop serious health consequences.The implications of these findings for both public health policy on cannabis, and the legal status of cannabis, are by no means straightforward or self evident.We need to develop an informed consensus on the risks posed by cannabis and the mechanisms for dealing with such risks.
Phase II study of gemcitabine, oxaliplatin in combination with bevacizumab (GEMOX-B) in patients with unresectable or metastatic biliary tract and gallbladder cancers
Authors: J. W. Clark, J. A. Meyerhardt, D. V. Sahani, S. Namasivayam, T. A. Abrams, K. Stuart, P. Bhargava, L. S. Blaszkowsky, S. R. Jain, A. X. Zhu
Journal: Journal of Clinical Oncology (2007)

4625 Background: Patients (Pts) with unresectable or metastatic biliary tract cancer (BTC) and gallbladder cancer (GBC) have a poor prognosis. Vascular endothelial growth factor (VEGF) expression has been detected in BTC and GBC. Increased angiogenesis has been correlated with advanced stage of disease and poor prognosis. Given reported activity of gemcitabine (GEM) and oxaliplatin (OX) in BTC/GBC and potential benefits of targeting the VEGF pathway with bevacizumab (B), we performed a study to examine the efficacy and tolerability of GEM, OX and B (GEMOX-B) in unresectable or metastatic BTC/GBC. Methods: Eligibility criteria included unresectable or metastatic measurable BTC/GBC, 0–1 prior chemotherapy regimens, performance status = 2, and adequate organ function. No clinically significant cardiovascular disease or history of active bleeding. Pts were treated with all 3 drugs intravenously on days 1 and 15 every 28 days (one cycle): B was given first at 10 mg/kg, followed by GEM at 1000 mg/m 2 as dose rate infusion at 10 mg/m 2 /minute, and OX at 85 mg/m 2 . Whole body FDG-PET scan was obtained at baseline and after cycle 2. The primary endpoint of the study was progression-free survival (PFS). Results: 19 pts (10 BTC and 9 GBC) have been enrolled since May 17, 2006: median age = 69 (25–82), M/F = 13/6, ECOG 0/1/2 = 7/10/2. Treatment has been well tolerated with no grade 4–5 toxicities seen. Treatment related grade 3 toxicities included (number of pts): hypertension (2), neutropenia (1), transient SGPT elevation (1), proteinuria (1), neuropathy (1), and fatigue (1). Of 11 pts followed for at least 4 months, 3 had confirmed partial responses (PR), 5 had stable disease (SD) of at least 4 cycles, and 3 had progressive disease (PD) per RECIST criteria. Five pts had more than 50% decrease in CA19–9 levels. Of 16 PET studies analyzed, changes in SUV values from baseline to after 2 cycles of treatment were: 11 PRs, 4 SDs, 1 PD per EORTC criteria. Conclusions: GEMOX-B can be safely administered with tolerable safety profiles in patients with advanced BTC/GBC. Early evidence of antitumor activity was seen. A decreased SUV in FDG-PET following GEMOX-B treatment was observed in the majority of patients. No significant financial relationships to disclose.
Prevalence, incidence rates and persistence of contact allergy and allergic contact dermatitis in The Odense Adolescence Cohort Study: a 15-year follow-up
Authors: C.G. Mortz, C. Bindslev-Jensen, K.E. Andersen
Journal: British Journal of Dermatology (2012)

Background A cohort of 1501 unselected 8th grade schoolchildren was established 15 years ago with the aim to follow the course of contact allergy and allergic contact dermatitis (ACD) from school age into adult life. To date no studies have evaluated incidence rates and persistence of contact allergy and ACD in an unselected population from adolescence to adulthood. Objectives To estimate the incidence rates and persistence of contact allergy and ACD from adolescence to adulthood, and the point prevalence in adulthood. Methods In total, 1206 young adults from the cohort were contacted and asked to complete a questionnaire and participate in a clinical examination including patch testing with TRUE Test®. The questionnaire was answered by 899 (74.6%), however, only 442 (36·7%) of those invited participated in patch testing. Results Over the 15‐year period the incidence rates of contact allergy and ACD were 13·4% and 7·8%, respectively. The point prevalence of contact allergy was 20·1%, and present or past ACD was found in 12·9% of those followed. Nickel was the most common contact allergen (11·8%), followed by cobalt (2·3%), colophony (2·0%), thiomersal (1·4%) and p‐phenylenediamine (1·1%). Most nickel reactions were persistent, and a significant number of new nickel sensitizations were found. Fragrance mix I reactions from adolescence could not be reproduced. Conclusions From adolescence to adulthood the incidence rates of contact allergy and ACD were high. Nickel was still the most common contact allergen, and new sensitizations occurred despite the European Union nickel regulation. Fragrance mix I was a poor marker for history of eczematous skin reaction to perfumed products.
An Italian, observational, multicenter trial to describe the therapeutic approach according to COPD GOLD guidelines during three years of observation: The MISTRAL study
Authors: Walter Castellani, Maria Laura Frilli, Marta Bartezaghi, Evren Karayel, Francesco Sergio
Journal: European Respiratory Journal (2014)

Introduction  The GOLD strategy standardizes the diagnostic and treatment approaches for patients (pts) with COPD, whilst recent findings point out poor adherence to these guidelines(1). The aim of this study is to characterize patient pharmacological treatment pathways, with a particular focus on GOLD 2011 guidelines(2), in two cohorts which differ in frequency of exacerbation history (frequent: ≥2 and non-frequent: up to 1 exacerbation).  Method  This 3-year, observational, longitudinal, prospective and multicentre Italian study (FPFV May 2013) will enroll pts with COPD in two cohorts (1:1) according to the history of exacerbations, into frequent and non-frequent exacerbators. This study has 1 enrollment and 6 follow up visits, and is including pts aged ≥40 yrs with diagnosis of COPD (GOLD 2011) and smoking history of ≥10 pack-yrs. The primary objective is to describe the therapeutic approach in the 2 cohorts of pts with COPD during 3-year observation. Secondary outcomes are to evaluate, in the 2 cohorts, changes in COPD treatment management, clinical outcomes (CAT questionnaire, respiratory function and exacerbations), treatment persistence, cost of illness and aspects related to gender differences on therapeutic approach, comorbidities, symptoms and treatment compliance.  Conclusion  This is one of the largest real word evidence trials on the whole COPD patient population conducted in Italy tailored to describe the treatment pathways in two different cohorts according to exacerbation rate, as per GOLD 2011.  Reference  (1) Asche CV. Int J COPD 2012; 7:201-9, (2) GOLD 2011. http://www.goldcopd.com
Late-breaking abstract: The level of markers of endothelial dysfunction in men with chronic obstructive pulmonary disease and osteopenic syndrome
Authors: Evgenia Kochetkova, Ludmila Ugay, Yulia Maistrovskaya, Vera Nevzorova
Journal: European Respiratory Journal (2014)

Aim: to investigate the role of markers of endothelial dysfunction in formation of osteoporosis in COPD.  Materials : Soluble E-selectin, endotheline 1 (ET-1), vitamin D, VEGF, MMP-9, vascular cell adhesion molecule (VCAM-1), osteoprotegerin (OPG), the receptor activator of nuclear factor-kB ligand (RANKL) and bone markers were determined in 73 COPD men. BMD was measured by DEXA at the lumbar spine (LS) and left femur neck (FN).  Results: bone formation markers (procollagen type 1 amino-terminal propeptide P1NP), N-terminal midmolecule fragment osteocalcin (N-MID OC), bone specific alkaline phosphatase were lower in COPD than in controls. Type 1 collagen C-telopeptide (CTx-resorption marker) was higher in lung group and related to FN and had a relationship with P1NP. E-selectin, ET-1, VEGF, RANKL, MMP-9, VCAM-1 were higher; Vitamin D, OPG were low in lung groupe. Compared to the lung group with osteopenia, E-selectin, ET-1, MMP-9 and VEGF were the highest in COPD with osteoporosis. There was positive correlation between vitamin D, OPG and negative between MMP-9 and BMD in FN and LS ; inverse correlation between ET-1, VEGF in L2-L4; negative correlation of VCAM-1 with BMD in FN. OPG was correlated with N-MID OC, RANKL in lung patients. No correlations were found between VCAM-1 and markers of bone metabolism. ET-1, MMP-9 and VEGF positively correlated with parameters of bone resorption and negatively associated with P1NP and N-MID OC.  Conclusion: we observed a significant association between parameters of bone metabolism and endothelial dysfunction markers in COPD, which suggests possible role of endothelial dysfunction in the increasing of bone loss in COPD.
Improvement in clinical outcome of <i>FLT3</i> ITD mutated acute myeloid leukemia patients over the last one and a half decade
Authors: Talha Badar, Hagop M. Kantarjian, Graciela M. Nogueras‐Gonzalez, Gautam Borthakur, Guillermo Garcia Manero, Michael Andreeff, Marina Konopleva, Tapan M. Kadia, Naval Daver, William G. Wierda, Raja Luthra, Keyur Patel, Betul Oran, Richard Champlin, Farhad Ravandi, Jorge E. Cortes
Journal: American Journal of Hematology (2015)

AML with FLT3 ITD mutations are associated with poor outcome. We reviewed outcomes of patients with FLT3 ITD mutated AML to investigate trends over time. We analyzed 224 AML patients (excluding patients with core binding factor and acute promyelocytic leukemia) referred to our institution between 2000 and 2014. Patients were divided into five cohorts by era: 2000-2002 (Era 1, n = 19), 2003-2005 (Era 2, n = 41), 2006-2008 (Era 3, n = 53), 2009-2011 (Era 4, n = 55), and 2012-2014 (Era 5, n = 56) to analyze differences in outcome. The baseline characteristics were not statistically different across Eras. The response rate (CR/CRp) from Era 1-5 was 68%, 49%, 72%, 73%, and 75%, respectively. The overall response rate (all Eras) with chemotherapy alone versus chemotherapy plus FLT3 inhibitor was 67% and 72.5%, respectively (P = 0.4). The median time to relapse was 6, 3.6, 7.9, 8.1 months and not reached from Eras 1 through 5, respectively (P = 0.001). The median OS has improved: 9.6, 7.6, 14.4, 15.7, and 17.8 month from Eras 1-5, respectively (P = <0.001). Stem cell transplant as a time-dependent variable, showed better OS in the univariate analysis (HR: 0.57, 95% CI: 0.39-0.84, P = 0.004) but did not retained its significance in multivariate analysis (HR: 0.75, 95% CI: 0.50-1.13, P = 0.16). Our data suggest improvement in outcome of FLT3 ITD mutated AML patients over the last 15 years. This is probably due to improvement in treatment strategies, including but not limited to integration of FLT3 inhibitors and increased use of SCT.
Leading journal questions Public Health England’s stance on e-cigarettes
Authors: Adrian O’Dowd
Journal: BMJ (2015)

An editorial in the Lancet has questioned the stance taken by Public Health England (PHE) on electronic cigarettes, claiming that it had “fallen short of its mission” to always rely on the highest quality evidence.

The editorial,1 published on 28 August, said that the conclusions of a recent evidence review published by PHE on 19 August,2 which said that e-cigarettes were 95% less harmful than normal cigarettes, were based on an “extraordinarily flimsy foundation” of evidence. On the basis of the review’s findings PHE has said that NHS stop smoking services …
Balance of Matrix Metalloprotease-9 and Tissue Inhibitor of Metalloprotease-1 from Alveolar Macrophages in Cigarette Smokers
Authors: SAM LIM, NICOLAS ROCHE, BRIAN G. OLIVER, WALDO MATTOS, PETER J. BARNES, K. FAN CHUNG
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

An imbalance between proteases and antiproteases may play a role in emphysema, which is characterized by increased degradation of extracellular matrix, and in airway remodeling in chronic bronchitis and asthma, in which there is increased collagen deposition. We assessed the effect of smoking on release of matrix metalloprotease-9 (MMP-9) and of its inhibitor, tissue inhibitor of metalloprotease-1 (TIMP-1), from alveolar macrophages, and determined the effects of proinflammatory (interleukin [IL]-1 β and lipopolysaccharide [LPS]) and antiinflammatory (IL-10) stimuli on the release of MMP-9 and TIMP-1. We performed bronchoalveolar lavage in 11 smokers and 11 nonsmokers, and cultured airway macrophages in the presence of control medium, IL-1 β , and LPS. Airway macrophages from smokers released greater amounts of MMP-9 and TIMP-1 at baseline and in response to IL-1 β and LPS than did those of nonsmokers. Airway macrophages from smokers produced more TNF- α and IL-10. IL-10 increased TIMP-1 release without modifying that of MMP-9, leading to a decrease in the MMP-9 to TIMP-1 ratio. Anti-IL-10 antibody had no effect on MMP-9 production induced by LPS. We conclude that the release of proteases and antiproteases by airway macrophages is increased in cigarette smokers, and can be regulated by exogenous IL-10.
Force feeding of Ian Brady declared lawful
Authors: Clare Dyer
Journal: BMJ (2000)

Ian Brady, who has been in prison for over 30 years for murdering three children, last week lost his fight to stop doctors force feeding him through a nasogastric tube, when a High Court judge ruled that their decision to do so was “lawful, rational, and fair.”

Brady, who is detained in Ashworth special hospital near Liverpool, was probably “playing the system” in undertaking his hunger strike, said Mr Justice Kay at the High Court in Liverpool.

The judge accepted the …
EXCESSIVE SELF-ADMINISTERED DOSAGES OF THYROID EXTRACT
Authors: D GOLDFINGER
Journal: Annals of Internal Medicine (1946)

Case Reports1 April 1946EXCESSIVE SELF-ADMINISTERED DOSAGES OF THYROID EXTRACTDAVID GOLDFINGER, M.D.DAVID GOLDFINGER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-24-4-701 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThere are numerous reports in the literature regarding the effects of thyroid feeding in animals. There are only a few reports dealing with the effect of large doses of thyroid in man. The following case report is of interest because of the huge doses of thyroid extract consumed over a period of one year, by an individual subsequently proved unstable, for the concealed purpose of self-destruction.CASE REPORTOn December 4, 1941, a white, married, 28 year old woman presented herself for weight reduction. The past history revealed the usual childhood diseases, a tonsillectomy at age 5, but no serious...Bibliography1. DANIEL WW: The deleterious effects of indiscriminate use of thyroid preparations in obesity, Jr. Med. Assoc. Georgia, 1928, xvii, 192. Google Scholar2. HOFFMAN A: Die Electrokardiographie, 1914, J. F. Bergmann, Wiesbaden, p. 108. Google Scholar3. KRUMBHAAR EB: Electrocardiographic observations in toxic goiter, Am. Jr. Med. Sci., 1918, cxcv, 175. CrossrefGoogle Scholar4. WHITEAUB ODJC: The electrocardiogram in thyroid disease, Arch. Int. Med., 1918, xxii, 766. CrossrefGoogle Scholar5. PARDEE HE: Clinical aspects of the electrocardiogram, 1924, Paul B. Hoeber, p. 162. Google Scholar6. LEWIS T: Clinical electrocardiography, Ed. iii, p. 117, 1925, Shaw, London. Google Scholar7. WILLIUS FA: Clinical electrocardiograms—their interpretation and significance, 1929, W. B. Saunders Co., Philadelphia, p. 159. Google Scholar8. HAMBURGERLEVPRIESTHOWARD WWMWWSHC: Changes in T-waves of the human electrocardiogram following iodine medication, and thyroidectomy, Arch. Int. Med., 1929, xliii, 35. CrossrefGoogle Scholar9. DOWLANGLEY CSG: Some aspects of the electrocardiogram in toxic goiter, Quart. Jr. Med., 1932, i, 9. Google Scholar10. MCGUIREFOULGER JM: Influence of thyroid extract and hyperthyroidism on the electrocardiogram with special reference to the T-waves, Am. Heart Jr., 1932, viii, 114. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Chicago, Illinois*Received for publication April 5, 1945.From the Department of Medicine, Chicago Medical School. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byFACTITIAL THYROTOXIC CRISIS INDUCED BY DEXTROAMPHETAMINE SULFATE AND THYROID*JOHN B. ATKINSON, M.D.Thyrotoxicosis factitia masked as heart disease 1 April 1946Volume 24, Issue 4Page: 701-704KeywordsThyroidWeight loss ePublished: 1 December 2008 Issue Published: 1 April 1946 PDF downloadLoading ...
Adenosis-Like Lesions and Other Cervicovaginal Abnormalities in Mice Treated Perinatally With Estrogen&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: L Plapinger, H A Bern
Journal: JNCI Journal of the National Cancer Institute (1979)

Female mice from three inbred strains (BALB/cCrgl, C3H/Crgl, and C57BL/Crgl) and one noninbred stock [RU:NCS (RU)] were treated perinatally with estradiol benzoate (EB), diethylstilbestrol (DES), or sesame oil and were killed on postnatal days 30--36. A combined prenatal and neonatal regime of EB injections resulted in the abnormal presence of columnar epithelium in the vaginal fornices of some of the mice from each strain or stock. The same epithelial abnormalities were also present in the vaginal fornices of 30-day-old RU:NCS(RU) mice that had been treated only neonatally with EB or DES. The incidence of these lesions was 40--67% in the mice treated prenatally and neonatally with EB, 68% in the neonatal EB treatment group, and 100% in the neonatal DES treatment group. The columnar cells were arranged either as single layers in areas of the fornical lining epithelium or as glandlike or cystic structures in the subepithelial stroma. No cells of this type were detected in any of the samples from sesame oil-inoculated control mice. No comparable epithelial lesions were detected in the common cervical canal of the perinatally estrogen-treated animals, but this treatment consistently resulted in gross structural abnormalities at this site.
PROTEIN-BOUND DYE AND PURINE-CATABOLYZING ENZYMES IN PARENCHYMAL AND NONPARENCHYMAL CELLS OF RATS FED 4-DIMETHYLAMINOAZOBENZENE.
Authors: Gaston de Lamirande
Journal: Cancer Research (1964)

The binding of 4-dimethylaminoazobenzene to proteins and the enzymatic activities of some purine-catabolyzing enzymes during feeding of the carcinogen have been investigated by analysis of two liver fractions differing in their cytological composition. At an early stage of feeding dye binding occurred at a faster rate in nonparenchymal cells than in parenchymal cells. Binding in nonparenchymal cells reached a maximum after 1 week of feeding and decreased afterward, whereas maximum binding in the parenchymal cells was observed after 4 weeks. The decrease in the amount of bound dye in parenchymal cell that followed was accompanied by a second peak in nonparenchymal cells.

The results on the activities of the purine-catabolyzing enzymes show that a decrease in 5′-nucleotidase, inosine phosphorylase, and uricase activities occurred in both parenchymal and nonparenchymal cells of the liver at early stages of the carcinogenic process— i.e., before liver cells become cancerous. The decreases in these enzyme activities were still more pronounced in the primary tumor. The possible relation between the decreased activities and the induction of tumors is discussed.

These studies reveal the possibility of characterizing biochemically parenchymal and nonparenchymal cells of the liver in normal and pathological processes, irrespective of the alterations in the proportions of cell types that may occur during these pathological processes.