tbuckley/cabot-search huggingface dataset:
Diazepam treatment of socially isolated monkeys
Authors: A B Noble, W T McKinney, C Mohr, E Moran
Journal: American Journal of Psychiatry (1976)

Four rhesus monkeys were reared for the first eight months of life in total social isolation. One animal died during this period; the three remaining subjects were treated with diazepam in an isolation chamber, in their home cages, and in a playroom testing situation. Diazepam significantly decreased the self-disturbance behaviors of two subjects, and there was even the appearance of some social behaviors, although they were limited and not of the same quality as in nonisolated subjects. The authors discuss the implications of the data for understanding the significance of the social isolation syndrome in monkeys as a model for human psychoses.
Viral vs bacterial community-acquired pneumonia: Radiologic features
Authors: Alejandro Robles, Anna San Gil, Vanesa Pascual, Esther Calbo, Eugenia Viladot, Susana Benet, Bienvenido Barreiro, Eva Cuchi, Juan Torres, Lydia Canales, Jose Angel De Marcos, Josefa Perez, Javier Garau
Journal: European Respiratory Journal (2011)

Background:  Radiologic findings in the viral community-acquired pneumonia (CAP) are poorly characterized.   Aims and objectives:  To describe and compare the radiologic findings of patients with bacterial (BP) vs those with viral pneumonia (VP).   Methods:  Adults with CAP admitted for at least 24h in a 500-bed acute care hospital from November 2009 to October 2010 were included. Diagnostic methods were blood and sputum cultures, antigen urinary detection, sputum analysis by polimerase chain reaction for 4 respiratory bacteria and 15 respiratory viruses. Initial chest radiographs (CR) were reviewed by a team of radiologists. We defined consolidation as not well-defined opacities with aerial bronchogram, multifocal distribution as more than 1 separated areas affected and diffuse distribution as >60% of the parenchyma affected.   Results:  125 patients with CAP were included. 43 (34.4%) were BP, 23 (18.4%) VP and 21 (16.8%) co infection (BP and VP). 40.3% of patients had bilateral infiltrates. Consolidation pattern was seen in 90.3%; the rest presented with interstitial affectation. 47.2% presented multifocal distribution, 43.4% focal distribution and 9.4% diffuse distribution. Pleural effusion was seen in 14.1%. No statistical significant differences were found in the comparison of the CR according to the etiology (BP vs VP).   Conclusions:  Viral CAP presented frequently with a consolidation in the initial CR. Unilateral, multifocal and consolidation pattern without pleural effusion was the most frequent radiologic finding. CR is not a good tool to discriminate between BP and VP.
Study of thoracoscopic pleural biopsy for nondiagnostic pleural effusion
Authors: YuJin Kim, Sun Young Kyung, Sang Pyo Lee, Sung Hwan Jeong, Shin Myung Kang, Sang Min Lee, Jeong-Woong Park
Journal: European Respiratory Journal (2012)

Background: We performed thoracentesis and pleural biopsy by cope needle to find cause of exudative pleural effusion. Usually about 20% of them can9t find cause. We study thoracoscopic biopsy for nondianostic patients and charateristics of diseases.  Method: We enrolled patients from April 2004 to May 2010. We included patients with nondiagnostic pleural effusion through sputum study, thoracentesis, washing microbiologic study and cytology by bronchoscopy. Twenty-six patients were performed thoracoscopic pleural biopsy.  Result: Twenty-four patients were identified. Their mean age was 60.5±15.3years, and 16(66.7%) of the patients were men. Four patients weren9t performed thoracentesis. Charateristics of pleural effusion were lymphodominent (15; 75%), poly-dominent(2;10%), eosinophil dominant (1;5%) and unknown(2;10%). Final diagnosis of patients with undiagnostic pleural effusion were malignant effusion (n=14, 58.3%), Tb pleuray(n=3, 12.5%), chronic inflammation and fibrosis(n=5, 20.8%) and hemorrhagic effusion and eosinophilic effusion (n=2, 8.3%). The most common cause of malignant effusion was secondary not primary lung cancer. Metastatic effusion were 5 patients (35.7%). Malignant mesothelioma were 3patients (21.4%). adenocarcinoma of unknown origin were 2patients (14.3%). Primary lung cancer were 4patients (25.8%).  Conclusion: Fifteen patients(58.3%) of nondianostic effusion were diagnosed malignant effusion. In These 15 patients, secondary malignant effusion were 10.  patients(74.3%). In Conclusion, we consider thoracoscopic biopsy and systemic  examination to identified nondianostic pleural effusion.
Abstract 191: Community Uptake of a Smartphone Application to Recruit Bystander Basic Life Support for Victims of Out-of-Hospital Cardiac Arrest
Authors: Steven C Brooks
Journal: Circulation (2012)

Background: PulsePoint is a smartphone application that links bystanders with the 911 response to cardiac arrest. The application facilitates bystander basic life support while EMS personnel are en route. After community members download the free software to their smartphones, they can receive automated alerts directing them to nearby public location out-of-hospital cardiac arrests and public AED locations. Objective: To quantify the uptake of the PulsePoint application in two Californian communities. Methods: PulsePoint was launched in San Ramon December 2011 and in San Jose February 2012. Promotional efforts in both communities included mass media campaigns, public service announcements in theatres and the use of social media outlets (e.g. Twitter and Facebook). Data from iTunes, Android Market and the PulsePoint enterprise server were collected to document uptake. Results: As of May 27, 2012 there were 23,069 PulsePoint application downloads (18,000 iOS, 5,069 Android). Figure 1 shows the cumulative installations of the PulsePoint application over time. The number of devices registered on the PulsePoint server is 11,167, accounting for users who removed the application from their device after installation. Of those devices registered, only 30% (3,350/11,167) have settings configured to receive cardiac arrest alerts. To date, there have been 64 suspected cardiac arrest incidents associated with a PulsePoint alert. Conclusion: There has been significant uptake of the PulsePoint application in San Ramon and San Jose with an increasing number of users over time. Future work should focus on methods to maximize the number of users configuring the cardiac arrest alerts feature to be active, to encourage retention of the application and determining the effectiveness of the application with respect to increasing bystander CPR, AED use and survival for out-of-hospital cardiac arrest victims in the community.
Procalcitonin use in acute exacerbations of COPD
Authors: Thomas Medveczky, Mark Jackson
Journal: European Respiratory Journal (2011)

Background:  Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) contribute to a rising number of hospital admissions in United Kingdom [1]. This study investigates the role of procalcitonin (PCT) essay in antibiotic prescribing in AECOPD.   Methods:  A prospective study of 30 patients admitted with acute exacerbation of COPD in Winter 2010. All patients were assessed with routine Xray,bloods, CRP and Procalcitonin essay. Decisions to treat with antibiotics were made using clinical impression and a standard PCT protocol [2]. Antibiotic use was discouraged if initial PCT level    Results:  From 30 cases in our study 7/30 (23%) had antibiotics stopped on admission with PCT    Discussion:  Procalcitonin significantly reduced the use of antibiotics in acute exacerbation of COPD. This means reduction in stay, antibiotic side effects,savings without increased rate in readmissions.Our data suggests the use of the PCT essay may improve clinical care in exacerbations of COPD.Further studies on a larger number of patients are needed.   References:   1Hospital admission rates AECOPD 2004-2008 National Library for Health, UK.  2Schuetz et al. Procalcitonin guided antibiotic therapy (...)  BMC HS Research  2007.
F-18 FDG PET scan 20 years after talc pleurodesis: Report of 3 cases
Authors: Thomas Vandemoortele, Sophie Laroumagne, Olivier Bylicki, Herve Dutau, Philippe Astoul
Journal: European Respiratory Journal (2012)

FDG PET scan is used with increasing frequency to investigate pleural abnormalities and determine the possibility of neoplastic invasion. Talc pleurodesis has been reported to cause hypermetabolic pleural thickenings and masses, up to 5 years after the procedure.  We report 3 cases of patients who required talc pleurodesis for pneumothoraces in 1989 and 1990 with satisfying results, and who were investigated in 2010-2011 for pleural abnormalities, with positive TEP results, which were deemed secondary to the pleurodesis.  Talc pleurodesis functions by creating inflammation, therefore promoting pleural adhesions. The metabolism surrounding this inflammatory reaction could decrease with time, as in other inflammatory processes. However, the fact that talc itself is not metabolized by the body would explain the positive FDG PET scan, possibly as a foreign body reaction.  We discuss radiological differences that can be used to differentiate between hypermetabolic talcoma and neoplastic disease.  Conclusion  Talc pleurodesis can induce an inflammatory reaction, even 20 years after being performed. In patients with pleural abnormalities, it is important to question such procedures and mention them to colleagues interpreting metabolic imaging.
Ventilation inhomogeneity (VI) and spirometry in response to intravenous antibiotics (IVab) in cystic fibrosis (CF)
Authors: Noor Al-Khathlan, Erol Gaillard, Caroline Beardsmore
Journal: European Respiratory Journal (2013)

Introduction: The value of Lung Clearance Index (LCI) in assessing CF lung disease is not established. One study found improvement in LCI and FEV1 with IVab.1 Another found improvement in FEV1 only, after inhaled antibiotics.2 Our aim was to compare changes in indices from multi-breath N2 washout (MBNW), including VI in the lung periphery(Sacin, Scond) with changes in FEV1 after 2 weeks antibiotics. Method: Children did spirometry and MBNW in triplicate at start and end of routine IVab. Differences were analysed by paired t-test. Results: Eight children (9-17y) completed all tests. Overall there were no statistically significant changes.

View this table:

Mean(SD) measurements pre(A) and post(B) antibiotics





No individual changes in FEV1>10% were seen. Taking a change in LCI >5% as clinically significant1, LCI worsened in 4 children and improved in 1. The clinical significance of change in Sacin and Scond is unknown but both increased in 5 and decreased in 3, without concordance. When changes in FEV1 were compared with those in VI indices there was no consistency in the direction or size of change. Conclusion: We found no concordance between FEV1 and MBNW indices after IVab . The changes were small; bigger changes might have led to concordance. In contrast with others, our patients did not improve after antibiotics, perhaps because they were stable at the start and, being younger, had less advanced disease. Ref: 1) Robinson P et al 2009 PedPulm ; 44:733. (2) Horsley, A. 2009. PhD thesis .
Fertility after chemotherapy for testicular germ cell cancers.
Authors: H Lampe, A Horwich, A Norman, J Nicholls, D P Dearnaley
Journal: Journal of Clinical Oncology (1997)

PURPOSE To analyze the probability of recovery of spermatogenesis after orchidectomy and cisplatin-based chemotherapy (CT) for testicular germ cell cancer. PATIENTS AND METHODS One hundred seventy-eight patients treated between 1979 and 1991 were selected by the requirement of sperm count both pre-CT and post-CT. Counts were classified as normospermic (NS) if more than 10 x 10(6)/mL, oligospermic (OS) if 1 to 9 x 10(6)/mL, and azoospermic (AS) if less than 1 x 10(6)/mL. The median follow-up time after CT before sperm analysis was 30 months. RESULTS Analysis of 170 patients whose spermatogenesis was reassessed at least 1 year after CT showed that of 89 patients whose pre-CT counts were NS, the post-CT count was NS in 64%, OS in 16%, and AS in 20%. There was clear evidence for continued recovery beyond 1 year; the probability of spermatogenesis increased to 48% by 2 years and 80% by 5 years. There was a significantly higher probability of recovery to OS and NS count levels in the 54 patients treated with carboplatin-rather than cisplatin-based therapy. There was an independent and similar effect of normal pre-CT count. There was a reduced probability to recover to OS in the 26 patients treated with more than four cycles of CT. A prognostic model identified three groups with 25%, 45%, and 82% probabilities of recovering spermatogenesis by 2 years after CT. CONCLUSION Analysis of pre-CT sperm count together with details of planned treatment can be used to predict recovery of spermatogenesis following germ cell CT.
Off-the-Cuff Cellular Phone Consultations in a Family Practice
Authors: Roni Peleg
Journal: Journal of the Royal Society of Medicine (2001)

In Israel the public tends to make use of informal medicine alongside organized health services, and cellular phones now allow contact with physicians at almost any time or place. For three months in 1999 a family physician documented all consultations on medical subjects conducted by cellular phone, the phone being available 24 hours a day. There were 94 cellular phone medical consultations, of mean duration 5.8 min (range 2-18). Only 11 took place over the weekend, and 63 took place while the clinic was open. The most common reasons for consultation were advice on treatment (29%) and a second opinion (28%). In 48 cases the consultation was for a close relative rather than the caller. In 42 cases the request for consultation came while the physician was busy with other patients. The results of this small personal study confirm that the practice of informal consultations now extends to the cellular phone. Technologies of this sort demand new rules of conduct, if we are to avoid the various hazards of off-the-cuff medicine.
Treatment of Fear of Flying
Authors: LESLIE SOLYOM, RICHARD SHUGAR, SHIRLEY BRYNTWICK, CAROL SOLYOM
Journal: American Journal of Psychiatry (1973)

In a study of treatment efficacy for 40 patients with air travel phobia, three behavior therapy techniques—aversion relief, systematic desensitization, and habituation—proved equally effective in significantly reducing the phobia, while group psychotherapy was ineffective. However, at follow-up the difference between the two approaches was no longer significant. The authors suggest that the behavior therapy techniques achieved a more immediate result because they were more directly symptom-oriented. In addition, prior extensive flying experience tended to reduce the benefits from treatment.
Abstract 3374: Four Year Survival in 1285 Patients Undergoing Cardiac Resynchronization Therapy (CRT): The Importance of Atrioventricular Junction Ablation in Patients with Permanent Atrial Fibrillation
Authors: Maurizio Gasparini, A Auricchio, B Lamb, M Metra, A Curnis, C Klersy, J Vogt, F Regoli, E Gronda
Journal: Circulation (2006)

Aim: To investigate the long-term effects of cardiac resynchronization therapy on all-cause survival of heart failure (HF) patients with permanent atrial fibrillation (AF). Methods: From the experi...
Use of Phosphodiesterase Type 5 Inhibitors for Erectile Dysfunction and Risk of Malignant Melanoma
Authors: Stacy Loeb, Yasin Folkvaljon, Mats Lambe, David Robinson, Hans Garmo, Christian Ingvar, Pär Stattin
Journal: JAMA (2015)

The target for the oral erectile dysfunction drugs, phosphodiesterase type 5 (PDE5) inhibitors, is part of a pathway implicated in the development of malignant melanoma. An increased risk of melanoma in sildenafil users was recently reported.To examine the association between use of PDE5 inhibitors and melanoma risk, including data on specific PDE5 inhibitors, number of prescriptions, and melanoma stage.Nationwide, population-based, nested case-control study in the Swedish Prescribed Drug Register, the Swedish Melanoma Register, and other health care registers and demographic databases in Sweden, including 4065 melanoma cases diagnosed from 2006 through 2012 and 5 randomly selected controls per case with matching year of birth.Number of filled prescriptions for the PDE5 inhibitors sildenafil and vardenafil or tadalafil.Risk of melanoma; overall and by stage and risk of basal cell carcinoma in multivariable logistic regression analyses.Of 4065 melanoma cases, 435 men (11%) had filled prescriptions for PDE5 inhibitors, as did 1713 men of 20,325 controls (8%). In multivariable analysis, there was an increased risk of melanoma in men taking PDE5 inhibitors (OR, 1.21 [95% CI, 1.08-1.36]). The most pronounced increase in risk was observed in men who had filled a single prescription (OR, 1.32 [95% CI, 1.10-1.59]; exposure rate, 4% for cases vs 3% for controls), but was not significant among men with multiple filled prescriptions (for 2-5 prescriptions: OR, 1.14 [95% CI, 0.95-1.37], 4% for cases and 3% for controls; for ≥6 prescriptions: OR, 1.17 [95% CI, 0.95-1.44], 3% for cases vs 2% for controls). PDE5 inhibitors were significantly associated with melanoma stage 0 (OR, 1.49 [95% CI, 1.22-1.83], 13% for cases vs 8% for controls) and stage I (OR, 1.21 [95% CI, 1.02-1.43], 12% for cases vs 10% for controls), but not stage II through IV (OR, 0.83 [95% CI, 0.63-1.09], 6% for cases vs 7% for controls). The risk estimates were similar for sildenafil and vardenafil or tadalafil. PDE5 inhibitor use was also associated with an increased risk of basal cell carcinoma (OR, 1.19 [95% CI, 1.14-1.25], 9% for cases vs 8% for controls). Men taking PDE5 inhibitors had a higher educational level and annual income, factors that were also significantly associated with melanoma risk.In a Swedish cohort of men, the use of PDE5 inhibitors was associated with a modest but statistically significant increased risk of malignant melanoma. However, the pattern of association (eg, the lack of association with multiple filled prescriptions) raises questions about whether this association is causal.
Review: In acute ischemic stroke, adding endovascular therapy to t-PA improves functional independence at 90 days
Authors: Katie Lin, Eddy Lang
Journal: Annals of Internal Medicine (2015)

Source Citation Sardar P, Chatterjee S, Giri J, et al.Endovascular therapy for acute ischaemic stroke: a systematic review and meta-analysis of randomized trials. Eur Heart J. 2015;Jun 12. Epub ahead of print. 26071599
Hematological toxicity associated with gemcitabine/cisplatin in elderly non-small cell lung cancer patients
Authors: Nevena Secen, Danica Sazdanic-Velikic, Daliborka Bursac, Branislava Mendebaba, Aleksandar Tepavac, Gordana Popovic, Zoran Potic
Journal: European Respiratory Journal (2011)

Introduction: Chemotherapy regimen gemcitabin/cisplatin is indicated in the treatment of non-small cell lung cancer (NSCLC), stage IIIb and IV with good performance status (according to leading National Comprehensive Cancer Network (NCCN) guideline).

Aim of the study: To compare the hematological toxicity of gemcitabine/cisplatin between elderly and patients younger than 65 years of age.

Patients and methods: In our study we observed 253 chemotherapy-naive patients divided into two groups according to their ages: younger then 65 years of age (194 patients) and patients older then 65 years of age (59 patients). Both groups of patients had received chemotherapy regimen: gemcitabine (1000mg/m2 iv. day 1. and day 8.),and cisplatin (50mg/m2 iv. day 1. and day 8.) in three weeks regimen-four cycles.

Results: Hematological toxicity were register in 26/194 (13,4%) younger patients compared to 15/59 (25,3%) older patients. Statistical analysis showed significant difference in apperance of hematological toxicity in elderly patients (p=0,046). Anemia occurred in 36 (87,8%)patients. Statistically, there is no significant difference between these two group in appearance of anemia (p=0,591). We found leukopenia in 17 (41,5%) patients, but without statistically significant differences between two groups (p=0,854). Thrombocytopenia were register in 16 (39%) patients, again without statistically significance between the two groups (p=0,274).

Conclusion: According to our results, there is no statistically significant differences between this two group of patients in appearance of anemia, leukopenia, thrombocytopenia, but generally hematological toxicity is more often in elderly patients.
Treatment of metastatic osteosarcoma at diagnosis: a Pediatric Oncology Group Study.
Authors: M B Harris, P Gieser, A M Goorin, A Ayala, S J Shochat, W S Ferguson, T Holbrook, M P Link
Journal: Journal of Clinical Oncology (1998)

PURPOSE To estimate the duration of survival (S) of patients with metastatic osteosarcoma (MOS) at diagnosis treated with a multiagent, ifosfamide-containing chemotherapeutic and surgical regimen and to evaluate the toxicity of this regimen. PATIENTS AND METHODS Thirty patients aged younger than 30 years received two courses of ifosfamide followed by surgery on the primary tumor and metastatic sites. Patients then received a postsurgical multiagent chemotherapeutic regimen that consisted of high-dose methotrexate (HDMTX), ifosfamide, doxorubicin, and cisplatin. RESULTS The 5-year event-free survival (EFS) rate was 46.7% (95% confidence interval [CI]; 28.5 to 64.9) and 5-year S rate was 53.3% (95% CI; 35.1 to 71.5). Three patients with bone metastases and one patient with lymph node metastases died. Twenty-six patients presented with pulmonary metastatic nodules only. Eight of these patients had at least eight nodules at diagnosis and had an estimated 5-year EFS rate of 25.0% compared with 66.7% for the 18 patients with less than eight nodules (P=.06). Fourteen patients presented with bilateral lung metastases and had a 5-year EFS rate of 35.7% compared with the 12 patients who presented with unilateral involvement and had a 5-year EFS rate of 75.0% (P=.03). The hematopoietic toxicity experienced by the patients during the entire regimen was relatively mild. Seven patients had renal toxicity characterized by hypophosphatemia and/or hypokalemia. CONCLUSION This ifosfamide-containing regimen is tolerable and effective in the treatment of patients with osteosarcoma (OS) who present with lung metastases. However, better regimens are required for this group of patients.
Factors affecting compliance in OSA patients treated with APAP
Authors: Sriram Chandramouli, Jennifer Furlong, Dorothy Price, Mohammed Haris, Justine Hadcroft
Journal: European Respiratory Journal (2011)

Introduction:  Continuous positive airway pressure (CPAP) is an effective treatment for symptomatic moderate-severe obstructive sleep apnoea (OSA). More recently, automatic positive airway pressure (APAP) devices are being used instead on the premise that variability in device pressure would improve compliance although this has not been proven.   Aims:  Evaluate 3 month compliance in OSA patients treated with APAP  Identify factors affecting short and medium term compliance   Methods:  Symptomatic patients with OSA [Apnoea hypopnoea index (AHI) >10 and Epworth Sleep Score (ESS) >10]were offered APAP therapy and monitored prospectively for 3 months. Their APAP data was downloaded at 2 weeks and 3 months.Data was analysed using Spearman9s test and multiple regression.   Results:  APAP therapy was initiated in 26 patients (22 men) with a mean (SD) age of 51 (11.7) years. Mean AHI was 44.5 (25.5) and mean ESS was 12 (4.7).  Mean compliance at 3 months and 2 weeks was 307 (130) and 330 (96) minutes respectively. Median (range) number of consultations over 3 months was 2 (1-9).  Compliance at 2 weeks was significantly correlated to compliance at 3 months (p  Other factors such as age, sex BMI, initial AHI and mean APAP did not influence compliance on multiple regression.   Conclusions:  Mean short and medium term compliance is very good in our cohort. Compliance at 2 weeks predicts 3 month compliance which is in keeping with other studies.  Compliance was also found to be related to intensity of technical support suggesting that careful follow up will improve compliance.