tbuckley/cabot-search huggingface dataset:
P211 Exacerbation frequency and maintenance treatment of COPD in UK clinical practice
Authors: M. Thomas, A. Radwan, C. Stonham, S. Marshall
Journal: Thorax (2011)

<h3>Introduction and Objectives</h3> COPD exacerbations are associated with high morbidity, mortality and costs. Prevention of exacerbations is recommended as a key goal of COPD management. Pharmacotherapy shown to reduce exacerbation frequency includes long acting beta agonists (LABA), long acting antimuscarinics (LAMA) and inhaled corticosteroids (ICS). There have been suggestions of a “frequent exacerbator” phenotype across severity. <h3>Methods</h3> Retrospective observational study of 511 patients with COPD diagnosed during or before 2007. Three years9 data per patient on exacerbation frequency, therapies and resource use were collected by trained researchers from routine medical records in 10 general practices in England. COPD severity was defined as: very severe (FEV<sub>1</sub> &lt;30% predicted, n=52), severe (30–49%, n=145) and moderate (50–79%, n=314). Exacerbation frequency was annualised and stratified by: 0/year (“non-exacerbators”), &gt;0&lt;3/year and =3/year (“frequent exacerbators”). <h3>Results</h3> Mean (SD) annual exacerbation frequency: 1.1 (1.1) in moderate, 1.7 (1.6) in severe and 2.2 (2.0) in very severe COPD. 69 (14%) were frequent exacerbators and 97 (19%) were non-exacerbators. The proportion of frequent exacerbators increased with severity (9% moderate, 19% severe, 29% very severe). 14% did not receive any LABA, 25% any LAMA and 12% any ICS medication during the 3-year study period. “Triple therapy” with all three classes was received by only 67% of the frequent exacerbators. The percentage of patients with zero exacerbations/year fell as severity increased (25% moderate, 11% severe, 8% very severe). 61% received a LABA and/or LAMA with ICS (56% moderate, 75% severe and 100% very severe). 32% did not receive ICS during the study period (35% moderate, 25% severe and 0% very severe). The median number of primary care visits was 1.33 for patients with 0, 2.67 for &gt;0&lt;3 and 6.67 for =3 exacerbations/year. <h3>Conclusions</h3> The “frequent exacerbator” phenotype occurs in patients of all levels of severity in community practice in the UK. Health resource use is high in frequent exacerbators. These patients frequently do not receive optimum therapy. The exacerbation history can potentially guide maintenance treatment of patients at all levels of COPD severity.
Complications of Measles
Authors: M. Panikkar
Journal: BMJ (1964)

<b>Background:</b> A very important yet often troublesome element in the conservative management of enterocutaneous fistulae is the protection of the surrounding skin from contact with the effluent. This report describes the successful use of a vacuum assisted closure (VAC) system in dealing with this problem. <b>Methods:</b> The results of using the VAC system were studied in three patients with moderate or high volume output enterocutaneous fistulae where conventional treatment had failed to prevent skin excoriation. <b>Results:</b> The VAC system was found to be highly effective in controlling fistula effluent and in promoting healing of excoriated skin in all three patients. Complete healing of the fistula was also achieved in two of the three patients. <b>Conclusion:</b> The VAC system can be an effective and economically viable method of containing fistula effluent and protecting the skin of patients with enterocutaneous fistulae. Contrary to conventional thought, the VAC system may also actually promote healing of the fistula.
Hyperosmolar Anacidotic Coma in Association With Glucocorticoid Therapy
Authors: Markley H. Boyer
Journal: JAMA (1967)

The syndrome of marked hyperglycemia, coma, and death not associated with keto acidosis has received increasing recognition. Hyperosmolarity of the serum and severe dehydration are important features of this disorder. This report of three patients, two of whom survived, emphasizes the role of prior glucocorticoid therapy in precipitating the syndrome.
Postpartum Septicemia With Mycoplasma hominis
Authors: Joseph G. Tully
Journal: JAMA (1968)

<i>Mycoplasma hominis</i>was recovered from the blood of a woman 24 hours post partum and at the time a febrile illness was in progress. The patient exhibited a significant antibody response to the specific<i>Mycoplasma strain</i>recovered from the blood as well as to other<i>M hominis</i>strains. Additional observations on the role of<i>M hominis</i>and other species of<i>Mycoplasma</i>might play in spontaneous abortions, fetal abnormalities, and postpartum complications are now needed.
Interferons: Rationale for Clinical Trials in Neoplastic Disease
Authors: ERNEST C. BORDEN
Journal: Annals of Internal Medicine (1979)

Interferons, cell glycoproteins synthesized in response to viral infections and various nonviral inducers, have proved therapeutically effective for viral infections in experimental models and in humans. Current evidence suggests interferons may also prove effective as antitumor agents in humans. Potent effects on cellular function result from interferons. Cell surface structure and enzyme levels are altered. Immunologic responses thought to be important in tumor immunity are augmented. Interferons have antiproliferative effects on the replication of normal and neoplastic cells. Interferons are effective in animals against tumors of both viral and nonviral origin. Clinical trials in cancer have been limited by the availability and cost of human interferons. However, results in small numbers of patients have been encouraging. This paper reviews experimental and clinical findings regarding the rationale for use of interferons in neoplastic disease.
Spontaneous viral clearance in patients with acute hepatitis C can be predicted by repeated measurements of serum viral load
Authors: Harald Hofer, Thomas Watkins-Riedel, Oskar Janata, Edward Penner, Heidemarie Holzmann, Petra Steindl-Munda, Alfred Gangl, Peter Ferenci
Journal: Hepatology (2003)

Early interferon (IFN) therapy prevents viral persistence in acute hepatitis C, but in view of the resulting costs and morbidity patients who really need therapy have to be identified. Twelve consecutive patients with acute hepatitis C (9 women, 3 men, mean age: 39.5 ± 18.8 y, genotype 1: 7, genotype 3a: 3, 2 could not be genotyped) were studied. The sources of infection were medical procedures in 6, sexual transmission in 3, and intravenous drug abuse in 3 patients. Viral load was measured by Cobas Amplicor HCV Monitor v2.0 (Roche Diagnostic Systems, Branchburg, NY). The time from infection to clinical symptoms was 43.3 ± 8.6 (mean ± SD) days. Eight patients cleared hepatitis C virus (HCV) spontaneously and remained HCV-RNA negative with a follow-up of 9.0 ± 3.9 months. In these patients viral load declined fast and continuously. The time from exposure to HCV-RNA negativity was 77.4 ± 25.3 and from the first symptoms was 34.7 ± 22.1 days. In 4 patients HCV-RNA levels remained high or even increased. Two of them became sustained responders to treatment initiated after a 6-week observation period. The 2 remaining patients were not treated (one because of contraindications for IFN, the other declined therapy) and are still HCV-RNA positive. In conclusion, patients with acute icteric hepatitis C have a high rate of spontaneous viral clearance within the first month after the onset of symptoms. IFN therapy appears only needed in patients who fail to clear the virus within 35 days after onset of symptoms. By this approach, IFN therapy was not necessary in two thirds of patients with acute hepatitis C.
Erysipelothrix Endocarditis
Authors: Edward B. Silberstein
Journal: JAMA (1965)

ERYSIPELOTHRIX insidiosa endocarditis is a rare and usually fatal lesion,<sup>1,2</sup>and occasional survival has been reported only within the last decade.<sup>3</sup>Only one previous case of cerebral infection from<i>Erysipelothrix</i>has been described<sup>4</sup>; there was no heart involvement. The current case is believed to be the first reported of<i>Erysipelothrix</i>endocarditis with cerebral involvement and complete eradication of the organism by penicillin. <h3>Report of a Case</h3> A 41-year-old white carpenter was admitted to the Cincinnati VA Hospital on Nov 7, 1963, with the chief complaints of frontal headache, fever, and arthralgia of both ankles and knees. Paroxysmal nocturnal dyspnea had occurred the night before. One month prior to this admission, the patient had consulted his private physician complaining of myalgia, fever, and chills which had begun a day earlier. He received 600,000 units of procaine penicillin G intramuscularly on two consecutive days with temporary remission of symptoms.
Comparative 5 year incidence of ischemic events for PTCA and CABG in the Bypass Angioplasty Revascularization Investigation (BARI)
Authors: Bernard R. Chaitman, Leonard Schwartz, Gary S. Roubin, Bruce W. Lytle, Regina M. Hardison, George Sopko, David O. Williams, Richard S. Stack, Nicholas T. Kouchoukas, Mirle A. Kellett
Journal: Journal of the American College of Cardiology (1996)
Structure–activity relationships of siRNA carriers based on sequence-defined oligo (ethane amino) amides
Authors: Thomas Fröhlich, Daniel Edinger, Raphaela Kläger, Christina Troiber, Edith Salcher, Naresh Badgujar, Irene Martin, David Schaffert, Arzu Cengizeroglu, Philipp Hadwiger, Hans-Peter Vornlocher, Ernst Wagner
Journal: Journal of Controlled Release (2012)
An Address ON GAS POISONING: Read before the Medical Society of London
Authors: L. Hill
Journal: BMJ (1915)

THE reprobation of the use of poison gases by the G'ermans in war does niot lie so muclh in their acttual use as in the fact that the German Government broke, in this as in so nmaniy otlher respects, tlheir word, andl secretly prepared before the war this method of offence.All the propellants now in use set free enormons volumes of gases.Thie late Professor Vivian Lewes calculated thlat one of tlle 15in.guns on a super-dreadnought, witlh its charge of 400 lb. of cordite, gives off about 2.500 cubic feet of carbon monoxidle gas each time tlle big gun is fired.In every battle liundreds of tlhousands of cubic feet of this gas mlust be produced, and yet so great is the diffusive Power of the atmosplhere that no poisoning from it can be traced.Nevertheless, carbon monoxide is a gas so poisonous that the breathing of 1 per cent.quickly renders a man unconscious.The high explosive nitre compounds stuelh as picric acid and tri-nitro-toluLol set free, when ex- plodel, not only carbon monoxide but nitric oxide gas, and the latter when broathed lhas an irritative effect on the lungs closely comparable to that of clhlorine.The fumes of high explosives set free in close spaces, suchl as cellars and thle initerior of warshlsips, where the ventilating7 power of the atmosphere iN aSbsent, may poison those whAo are not actually put oult of action by explosive violence.Gas, poisoning, thlen, to a limitedl extent, occurred in modern warfare before drift gases and asphyxiating shells were introduced by the GermansI.Muich has been said of
Good at what we know: doctors are rationed too
Authors: K. Patel
Journal: BMJ (2010)

We’re all good at different things. Eighteen months ago I had never picked up an endoscope. Now I spend 12 hours a week—10% of my waking hours—with one in my hand. And although there is undoubtedly an element of skill to it, I must admit that most of the ability comes with practice and repetition.

The same goes for understanding patients with gastroenterological problems, from irritable bowel syndrome to inflammatory bowel disease. We all learn by seeing and doing and are much better at dealing with the familiar …
Pathogenesis of neurotropic murine coronavirus is multifactorial
Authors: Judith M. Phillips, Susan R. Weiss
Journal: Trends in Pharmacological Sciences (2010)

Although coronavirus tropism is most often ascribed to receptor availability, increasing evidence suggests that for the neurotropic strains of the murine coronavirus mouse hepatitis virus (MHV), spike-receptor interactions cannot fully explain neurovirulence. The canonical MHV receptor CEACAM1a and its spike-binding site have been extensively characterized. However, CEACAM1a is poorly expressed in neurons, and the extremely neurotropic MHV strain JHM.SD infects ceacam1a(-/-) mice and spreads among ceacam1a(-/-) neurons. Two proposed alternative MHV receptors, CEACAM2 and PSG16, also fail to account for neuronal spread of JHM.SD in the absence of CEACAM1a. It has been reported that JHM.SD has an unusually labile spike protein, enabling it to perform receptor-independent spread (RIS), but it is not clear if the ability to perform RIS is fully responsible for the extremely neurovirulent phenotype. We propose that the extreme neurovirulence of JHM.SD is multifactorial and might include as yet unidentified neuron-specific spread mechanisms.
ROS-Responsive Activatable Photosensitizing Agent for Imaging and Photodynamic Therapy of Activated Macrophages
Authors: Hyunjin Kim, Youngmi Kim, In-Hoo Kim, Kyungtae Kim, Yongdoo Choi
Journal: Theranostics (2014)

The optical properties of macrophage-targeted theranostic nanoparticles (MacTNP) prepared from a Chlorin e6 (Ce6)-hyaluronic acid (HA) conjugate can be activated by reactive oxygen species (ROS) in macrophage cells.MacTNP are nonfluorescent and nonphototoxic in their native state.However, when treated with ROS, especially peroxynitrite, they become highly fluorescent and phototoxic.In vitro cell studies show that MacTNP emit near-infrared (NIR) fluorescence inside activated macrophages.The NIR fluorescence is quenched in the extracellular environment.MacTNP are nontoxic in macrophages up to a Ce6 concentration of 10 µM in the absence of light.However, MacTNP become phototoxic upon illumination in a light dose-dependent manner.In particular, significantly higher phototoxic effect is observed in the activated macrophage cells compared to human dermal fibroblasts and non-activated macrophages.The ROS-responsive MacTNP, with their high target-to-background ratio, may have a significant potential in selective NIR fluorescence imaging and in subsequent photodynamic therapy of atherosclerosis with minimum side effects.
Comparing Respiratory Gated With Delayed Scans in the Detection of Colorectal Carcinoma Hepatic and Pulmonary Metastases With 18F-FDG PET-CT
Authors: Stéphanie Hassler, Fabrice Hubele, André Constantinesco, Christian Goetz
Journal: Clinical Nuclear Medicine (2013)

Purpose In patients experiencing colorectal carcinoma, exhaustive analysis of indicates extent of hepatic and pulmonary surgery that prolongs survival of patients. Patients and Methods To localize metastasis, we compared 2 18F-FDG PET-CT imaging protocols, early respiratory gated scan, and delayed scan, to standard PET imaging procedure. SUVmax and lesion–to–healthy tissue ratio were measured in 60 pulmonary and 21 hepatic lesions by each of the 2 imaging protocols. Results In the liver, metastatic lesion–to–healthy tissue ratios significantly increased on delayed scans as compared with early scans (P < 0.001). Better ratios could not be obtained when using respiratory gated scans, whereas more lesions were detected on delayed scans. In the lungs, metastatic lesion– to–healthy tissue ratio increased significantly on delayed scans for largest lesions (P < 0.001). Ratios were not better when exploring smallest metastatic lesions or when using respiratory gated scans. Factors interfering with 18F-FDG PET-CT sensitivity are discussed, such as respiratory motion and high FDG physiological uptake in healthy liver parenchyma. Conclusions Our studies indicate that routine acquisitions should use delayed hepatic scans for all patients referred for evaluation, recurrence check, or monitoring of colorectal adenocarcinoma. Delayed pulmonary scans are useful for the largest metastatic lesions and should be used in addition to early scan. In our experience, respiratory gated scans seem to be less convenient because of a low sensitivity in detection, as compared with the delayed technique; in addition, this technique is currently complicated by some technical issues, although these might be overcome with new gated protocols.
Abstract 4621: Downregulation of Protein Kinase D1 in hepatocellular carcinoma (HCC): Potential as a diagnostic/prognostic molecular marker
Authors: Preethi Prakash, Matt Freiz, Teresa Bohlmeyer, Micheal R.D Koch, Subhash C. Chauhan, Meena Jaggi
Journal: Cancer Research (2010)

Abstract OBJECTIVE: Protein Kinase D1 (PKD1) plays an important role in several cellular processes such as cell proliferation, oxidative stress signaling, adhesion and motility. PKD1 is of particular interest in diagnosis, prognosis and treatment of human diseases because of its enzymatic activity and susceptibility to successful therapeutic targeting. In our earlier study we have demonstrated suppression of PKD1 expression in advance stage prostrate cancer. This led us to analyze PKD1 expression patterns in various other cancer tissue samples. MATERIAL AND METHODS: Tissue microarrays containing various cancer samples with corresponding normal tissues were used to investigate the expression profile of PKD1 using immunohistochemistry (Biocare Medical, Concord, CA). Further studies on PKD1 expression profile in hepatocellular carcinoma (HCC) were carried out using tissue microarray (TMA) containing HCC samples (n=70) with normal tissues (n=4) and a HCC TMA with hepatitis B viral history (HBV) containing HCC samples (n=100) with normal tissues (n=4) (AccuMax Array). Immunostaining was graded by two independent pathologists. Intensity and extent of staining scores were multiplied to obtain the composite score (CS) of each sample. RESULT: Differential expression pattern of PKD1 was observed in brain, skin, lung, kidney, thyroid and ovarian cancer samples. Along with stomach and colon cancer, HCC samples showed a marked downregulation of PKD1 expression compared to their respective normal tissues. PKD1 expression profile was further evaluated in a large cohort of HCC samples. Overall, HCC samples showed a significant (p&amp;gt;0.05) downregulation (Mean CS=6.0) of PKD1 expression compared to normal liver samples (Mean CS=11.4). Among cancer samples, advanced stage samples showed a relatively lower PKD1 expression (Mean CS=5.4) compared to early stage (Mean CS=6.6) HCC samples. Similarly, advance stage HCC samples with HBV showed a lower PKD1 expression (Mean CS=6.9) compared to early stage samples (Mean CS=9.6) and non neoplastic samples (Mean CS=12). CONCLUSION: The results of this study suggest suppression of PKD1 expression in HCC. In view of the limitations of the available diagnostic/prognostic studies for detection of HCC, the aberrant expression of PKD1 may serve as a novel biomarker for the diagnosis/prognosis of hepatocellular carcinoma. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4621.
BMA meeting: Doctors urge government to lower age limit for cervical cancer screening
Authors: D. Cohen
Journal: BMJ (2009)

Representatives at the BMA’s annual conference have urged the government to lower the age limit for screening for cervical cancer to 20 years.

Despite an independent committee having recently concluded that earlier screening could do more harm than good ( BMJ 2009;338:b2583, doi:10.1136/bmj.b2583), representatives voted 68% for and 25% against lowering the age, with the remaining doctors abstaining. 

Mary McCarthy, a GP in Shrewsbury, argued that the best age to start cervical screening was 20 years, as it currently is in Scotland and Wales and as it used to be in England until it was raised to 25 in 2005.

She said, “The reasons given [for raising the age] were …
Heartbeat Evoked Potentials during Sleep and Daytime Behavior in Children with Sleep-disordered Breathing
Authors: Sarah A. Immanuel, Yvonne Pamula, Mark Kohler, James Martin, Declan Kennedy, Eugene Nalivaiko, David A. Saint, Mathias Baumert
Journal: American Journal of Respiratory and Critical Care Medicine (2014)

Rationale: Event-related brain potentials allow probing of cortical information processing, but when evoked with externally induced stimuli may disrupt sleep homeostasis and do not provide insight into intrinsic cortical information processing. To investigate if cortical processing of intrinsic information in children with sleep-disordered breathing (SDB) is different from healthy children and, if so, whether it resolves with treatment, we used heartbeat as a source of interoceptive event-related brain potentials.Objectives: To investigate heartbeat evoked potentials (HEP) during sleep in healthy children and in children with SDB before and after treatment and to explore if there are any associations between HEP and daytime behavioral deficits in children with SDB.Methods: Heartbeat-aligned EEG was assessed for presence of HEP within stage 2, slow-wave sleep, and REM sleep in 40 children with primarily mild to moderate SDB before and after adenotonsillectomy and in 40 matched control subjects at similar time points.Measurements and Main Results: In both groups, nonrandom HEP were present in all sleep stages analyzed; however, amplitude of HEP were significantly lower in children with SDB during non-REM sleep (stage 2: P = 0.03; slow-wave sleep: P = 0.001). This between-group difference was not significant post adenotonsillectomy. Significant negative associations between HEP and daytime behavioral scores were observed at baseline.Conclusions: Children with SDB displayed reduced HEP amplitude during sleep, which might be indicative of changes in afferent sensory inputs to the brain and/or signify differences in sensory gating of cardiac-related information in the insular cortex. Adenotonsillectomy appears to reverse this effect.
COMPUTER ASSISTED V/Q ASSESSMENT FOR DIRECTING PULMONARY ANGIOGRAPHY
Authors: M. Tulchinsky, R. P.M. Mahraj, J. F. Cardella, B. M. Rank, M. A. Tulli, P. S. Fox, D. F. Eggli
Journal: Clinical Nuclear Medicine (1996)

Tulchinsky, M.; Mahraj, R. P.M.; Cardella, J. F.; Rank, B. M.; Tulli, M. A.; Fox, P. S.; Eggli, D. F. Author Information
Watermelon Stomach Seen by Wireless-Capsule Endoscopy
Authors: M. Mascarenhas-Saraiva, L. Lopes, A. Mascarenhas-Saraiva
Journal: Endoscopy (2003)

Figure 1 A 51-year-old man with iron-deficiency anemia underwent an upper digestive endoscopy which revealed a watermelon stomach, i. e. linear red streaks running longitudinally in the gastric antrum.
Impaired Function of Cloth-Covered Starr-Edwards Mitral Valve Prosthesis
Authors: ERNEST CRAIGE, PETER HUTCHIN, RICHARD SUTTON
Journal: Circulation (1970)

Malfunction of a cloth-covered Starr-Edwards mitral valve prosthesis (6300 series) was suspected because of phonocardiographic abnormalities. A prolonged interval from aortic closure to opening of the mitral ball suggested an impediment to movement of the ball. This was confirmed by catheterization and cinefluorography. At autopsy the impaired ball movement was found to be due to thrombus buildup on the outflow face of the mitral valve orifice. It is suggested that frequent postoperative phonocardiographic observations may be useful in detecting malfunction of valvular prostheses.