tbuckley/cabot-search huggingface dataset:
The Cutaneous, Net Clinical, and Health Economic Benefits of Advanced Pneumatic Compression Devices in Patients With Lymphedema
Authors: Pinar Karaca-Mandic, Alan T. Hirsch, Stanley G. Rockson, Sheila H. Ridner
Journal: JAMA Dermatology (2015)

The prevalence and clinical burden of lymphedema is known to be increasing. Nevertheless, evidence-based comparative effectiveness data regarding lymphedema therapeutic interventions have been poor.To examine the impact of an advanced pneumatic compression device (APCD) on cutaneous and other clinical outcomes and health economic costs in a representative privately insured population of lymphedema patients.Retrospective analysis of a deidentified private insurance database from 2007 through 2013, and multivariate regression analysis comparing outcomes for the 12 months before and after APCD purchase, adjusting for baseline patient characteristics. Patients with lymphedema who received an APCD who were commercially insured and Medicare managed care enrollees from a large, national US managed care health insurer. The study population was evaluated as cancer-related and non-cancer-related lymphedema cohorts.Receipt of an APCD.Rates of cellulitis, use of lymphedema-related manual therapy, outpatient hospital visits, and inpatient hospitalizations. Lymphedema-related direct costs were measured for home health care, hospital outpatient care, office visits, emergency department use, and inpatient care.The study sample included 718 patients (374 in the cancer cohort and 344 in the noncancer cohort). In both cohorts, use of an APCD was associated with similar reductions in adjusted rates of cellulitis episodes (from 21.1% to 4.5% in the cancer cohort and 28.8% to 7.3% in the noncancer cohort; P < .001 for both), lymphedema-related manual therapy (from 35.6% to 24.9%in the cancer cohort and 32.3% to 21.2% in the noncancer cohort; P < .001 for both), and outpatient visits (from 58.6% to 41.4% in the cancer cohort and 52.6% to 31.4% in the noncancer cohort; P < .001 for both). Among the cancer cohort, total lymphedema-related costs per patient, excluding medical equipment costs, were reduced by 37% (from $2597 to $1642, P = .002). The corresponding decline in costs for the noncancer cohort was 36% (from $2937 to $1883, P = .007).The study found an association between significant reductions in episodes of cellulitis (cancer vs noncancer cohorts) and outpatient care and costs of APCD acquisition within a 1-year time frame in patients with both cancer-related and non-cancer-related lymphedema.
Preparedness explains some differences between Haiti and Nepal's response to earthquake
Authors: P. S. Auerbach
Journal: BMJ (2015)

Paul S Auerbach responded to recent disasters in both countries and reflects on why Nepal saw so many fewer deaths and injuries

On 12 January 2010, a magnitude 7 earthquake struck Haiti 25 km from the capital, Port-au-Prince. Between 160 000 and 200 000 people are estimated to have died and more than 300 000 were injured.

Five years later, on 25 April 2015 a 7.8 magnitude earthquake struck Nepal, its epicentre 77 km from Kathmandu. This was followed on 12 May by a 7.3 magnitude earthquake equidistant from Kathmandu but on the opposite side. So far 8604 people are reported to have died and 16 808 have been injured.1

In both countries, buildings collapsed and enormous numbers of people were displaced and relocated to improvised shelters. The risk of communicable diarrhoeal disease loomed because of crowding and rain. Restricted airport capacity delayed relief workers and supplies. 

The many differences between the two countries help explain why Haiti was far more vulnerable than Nepal to a similar sized earthquake. Both countries are poor, but Haiti is significantly poorer than Nepal. Haiti is considered politically a fragile, if not failed, …
Unifying by binding: Will binding really bind?
Authors: Jörn Diedrichsen, Eliot Hazeltine
Journal: Behavioral and Brain Sciences (2001)

The theory of event coding by Hommel et al. proposes that feature binding is a central component of action planning. To evaluate the binding hypothesis, we consider findings from studies of action-perception interference and bimanual movements. We argue that although binding of action features may be a valuable concept, interference from partial feature overlap does not provide a parsimonious account for the observed phenomena.
Effects of Chemical Carcinogens on Neoplastic Transformation and Morphology of Cells in Culture
Authors: K K Sanford, S L Handleman, C H Fox, J F Burris, M L Hursey, J T Mitchell, J L Jackson, R Parshad
Journal: JNCI Journal of the National Cancer Institute (1974)

Both cells recently explanted and long-term lines derived from fetal tissues of the mouse, Syrian hamster, and rat and adult tissue of the Chinese hamster were given either single, short (1–2 1/2 hr) exposure to the carcinogen 4-nitroquinoline-l-oxide (NQO) (1 µM) or repeated, short exposures to NQO or 1 mm N-methyl-N-nitrosourea. Cultures were assayed for neoplastic transformation by implantation in syngeneic and/or X-irradiated hosts. Although “spontaneous” neoplastic transformations occurred in mouse and Chinese hamster cells, these carcinogens neither induced neoplastic transformation nor enhanced the spontaneous change. Secondary and tertiary cultures of Syrian hamster embryo cells were treated several times for longer periods (48–72 hr) with either 1 µM NQO or 1 µg 3-methylcholanthrene/ml. Both carcinogens seemed to promote establishment of continuous cell lines and to induce neoplastic transformation. To correlate morphologic changes with neoplastic transformation in vitro, cytologic criteria previously used for mouse cells were applied to coded preparations. Immediately after carcinogen treatment, some cultures contained fusiform cells growing in random crisscross pattern, morphologically a marker of carcinogen-induced transformations. These cultures did not form tumors in untreated hosts, whereas most of the carcinogen-treated cell lines that later grew as sarcomas showed neither fusiform shape nor crisscross growth pattern. Although no single morphologic event cold be definitely associated with neoplastic transformation, combinations of morphologic features showed a high correlation with tumor production in vivo.
Management of Seizures in the Elderly: A Survey of UK Geriatricians
Authors: Iwona H Stolarek, Adam F Brodie, Martin J Brodie
Journal: Journal of the Royal Society of Medicine (1995)

The incidence and prevalence of epilepsy increase substantially with old age. Despite this, the investigation and management of this patient population remains a grey area. Four hundred and eleven (53%) consultant geriatricians responded to a questionnaire exploring their approach to seizures in the elderly in order to establish an overview of current clinical practice. Between one and five patients presenting with seizures, predominantly aged between 75-85 years, were reviewed monthly. Seventy per cent of geriatricians undertook to investigate the patients themselves with biochemical and haematological profiles performed by most. Electroencephalography and computerized tomographic scanning were routinely requested by a quarter of responders. Only 58% would themselves initiate therapy with antiepileptic drugs, with 16% of consultants starting treatment following the first seizure, 59% after a second and 5% after a third. Phenytoin was first choice for generalized tonic-clonic seizures with carbamazepine preferred for partial seizures. If good control was not obtained, 67% would substitute another first line drug, while 27% would add in a second. Less than 3% would use the new anticonvulsants lamotrigine or vigabatrin. Sixty per cent monitored anticonvulsant concentrations in patients with poor control or suspected toxicity. A wide variability was seen in the current approach to seizures in the elderly, which reflects a lack of established practice. Epilepsy clinics for the elderly would encourage structured research into the many unanswered questions affecting the care of older people with seizures.
Lobular Carcinoma in Situ: A 29-Year Longitudinal Experience Evaluating Clinicopathologic Features and Breast Cancer Risk
Authors: Tari A. King, Melissa Pilewskie, Shirin Muhsen, Sujata Patil, Starr K. Mautner, Anna Park, Sabine Oskar, Elena Guerini-Rocco, Camilla Boafo, Jessica C. Gooch, Marina De Brot, Jorge S. Reis-Filho, Mary Morrogh, Victor P. Andrade, Rita A. Sakr, Monica Morrow
Journal: Journal of Clinical Oncology (2015)

Purpose The increased breast cancer risk conferred by a diagnosis of lobular carcinoma in situ (LCIS) is poorly understood. Here, we review our 29-year longitudinal experience with LCIS to evaluate factors associated with breast cancer risk. Patients and Methods Patients participating in surveillance after an LCIS diagnosis are observed in a prospectively maintained database. Comparisons were made among women choosing surveillance, with or without chemoprevention, and those undergoing bilateral prophylactic mastectomies between 1980 and 2009. Results One thousand sixty patients with LCIS without concurrent breast cancer were identified. Median age at LCIS diagnosis was 50 years (range, 27 to 83 years). Fifty-six patients (5%) underwent bilateral prophylactic mastectomy; 1,004 chose surveillance with (n = 173) or without (n = 831) chemoprevention. At a median follow-up of 81 months (range, 6 to 368 months), 150 patients developed 168 breast cancers (63% ipsilateral, 25% contralateral, 12% bilateral), with no dominant histology (ductal carcinoma in situ, 35%; infiltrating ductal carcinoma, 29%; infiltrating lobular carcinoma, 27%; other, 9%). Breast cancer incidence was significantly reduced in women taking chemoprevention (10-year cumulative risk: 7% with chemoprevention; 21% with no chemoprevention; P &lt; .001). In multivariable analysis, chemoprevention was the only clinical factor associated with breast cancer risk (hazard ratio, 0.27; 95% CI, 0.15 to 0.50). In a subgroup nested case-control analysis, volume of disease, which was defined as the ratio of slides with LCIS to total number of slides reviewed, was also associated with breast cancer development (P = .008). Conclusion We observed a 2% annual incidence of breast cancer among women with LCIS. Common clinical factors used for risk prediction, including age and family history, were not associated with breast cancer risk. The lower breast cancer incidence in women opting for chemoprevention highlights the potential for risk reduction in this population.
The Control of Prostate-Specific Antigen Expression and Gene Regulation by Pharmacological Agents
Authors: Shannon C. Dixon, Kevin B. Knopf, William D. Figg
Journal: Pharmacological Reviews (2001)

Prostate-specific antigen is a serine protease that is a member of the kallikrein family. It is widely used as an indicator of tumor burden and as a surrogate marker for disease progression in men with androgen-independent prostate cancer. It has been shown that the expression and/or secretion of this glycoprotein can be regulated by pharmacological agents. The effects of these agents on PSA may be independent of their effects on cell growth. For example, a pharmacological agent may down-regulate PSA expression/secretion but have no effect on tumor cell growth. In this case, a patient receiving this therapeutic agent might be falsely considered as having a clinical response. Alternatively, an agent might up-regulate PSA expression/secretion and have an inhibitory effect on cell growth. A patient receiving this therapeutic agent might be diagnosed with progressive disease unless an alternative method for assessing tumor burden is used. Thus, when an agent is to be evaluated in a clinical trial utilizing PSA as a marker for disease progression, it is important to prospectively test whether the agent has an effect on PSA expression and/or secretion. In addition, it is equally important to understand how these regulatory effects relate to cell growth. The purpose of this review is to describe several agents that have been tested for their regulatory effects on PSA and to discuss potential mechanisms of by which this regulation may occur. The implications of these findings in the evaluation of new agents in androgen-independent prostate cancer will be considered.
Phonation performance in chronic stroke patients with inspiratory muscle training
Authors: Myung Jin Huh, Hea Mi Park, Nan Soo Kim, Ju Hyeon Jung
Journal: European Respiratory Journal (2014)

Background: Stroke patients have several degrees of respiratory muscle dysfunction and produce a weak voice and short speech at phonation duration.  Purpose: The aim of this study was to find the phonation performance capacity of chronic stroke patients (CSP) through inspiratory muscle training.  Method: Nine patients, between 52 and 65 years of age (5 experimental group, 4 control group), with chronic stroke participated in this study. All patients were engaged in inspiratory muscle training to increase their phonation capacity individually and their phonation capacity was measured using various test situations including MPT(Maximum Phonation Time), Counting, and DDK(diadochokinetic rate) at pre- and post-training.  Results: The MPT of the experimental group showed a significantly longer improvement than that of the control group. The differences between the pre-training and the post-training results for each group are as follows(Table 1).  Conclusion: Our results suggest that inspiratory muscle training could improve phonation performance in stroke patients and could be used as one of the most effective speech treatment strategies.
Are we effectively monitoring and treating vitamin D deficient patients with tuberculosis
Authors: James Murray, Lara Wood, Ajitha Jayaratnam
Journal: European Respiratory Journal (2013)

INTRODUCTION  Hypovitaminosis D is associated with active tuberculosis (TB). It is controversial whether the condition predisposes to TB infection or is a result of it.  AIMS  Following release of local guidelines on vitamin D replacement, the aim was to examine if vitamin D replacement was effective in TB patients prior to this.  METHODS  TB cases from March 2011 - March 2012 treated at King George Hospital were identified via London TB Register. The hospital pathology database identified patients that had vitamin D levels measured and if this had been rechecked following supplementation. Levels were classified as replete; insufficient; deficient. Chronic kidney disease patients were excluded.  RESULTS  124 patients had vitamin D levels measured and commenced on supplementation. Of these, 97 were deficient, 25 had insufficient levels and 2 were replete. 30 patients had vitamin D levels re-checked (mean interval of 184 days). Initial tests in this group showed that 7 patients had insufficient levels and 23 were deficient. Following supplementation, 6 patients had insufficient levels, 21 were deficient and 3 were replete. 12 patients had lower vitamin D levels than at diagnosis. 3 were unchanged.  CONCLUSIONS  Results suggest vitamin D supplementation was ineffective in TB patients. Causative mechanism(s) remain unclear but could be due to disease process, indicate lack of patient compliance or a need for local guidelines (primary and secondary care). Re-audit in line with local guidelines and anticipated NICE guidelines may add clarity as to the causative mechanism(s).
The effect of pirfenidone with patients with idiopathic pulmonary fibrosis in one university hospital
Authors: Yasunori Ichimura, Kenji Tsushima, Takuma Matsumura, Ayako Yokota, Jiro Terada, Ken Iesato, Seiichiro Sakao, Yuji Tada, Nobuhiro Tanabe, Koichiro Tatsumi
Journal: European Respiratory Journal (2014)

BACKGROUNDS: Pirfenidone and acetylcysteine monotherapy are anti-fibrotic drugs used for the treatment of idiopathic pulmonary fibrosis: IPF. Pirfenidone has been approved in some Asian and European countries recently, but usage experience in practical clinics is still limited.  METHODS: We retrospectively analyzed general information and clinical characteristics in 70 consecutive patients with IPF treated with pirfenidone in one university hospital.  RESULTS: The study comprised 70 patients (77% male) with an average age of 68.1 ± 7.4 years old. The baseline forced vital capacity: FVC and percentage predicted FVC were 2.28 ± 0.81L and 71.3 ± 21.0%. Pirfenidone administration doses were 600mg in 11 cases (16%), 1200mg in 36 cases (51%), 1600mg in 1 case (1%), and 1800mg in 22 cases (32%). Average administration period was 355 days. Deterioration of respiratory status was defined as 10% or greater decline in percentage predicted value of FVC after 6-month treatment. Stable pulmonary function was showed in 64% cases. As adverse effects, appetite loss (43%), diarrhea (10%), general fatigue (13%), rash (5%), headache (8%) and stupor (3%) were seen, and adverse effects was main reason of pirfenidone withdrawal.  Conclusion: More than half of patients treated with pirfenidone showed stable respiratory status. To continue pirfenidone administration, it was important to control adverse effects.
Low‐molecular‐weight fibroblast growth factor 2 attenuates hepatic fibrosis by epigenetic down‐regulation of Delta‐like1
Authors: Ruo‐Lang Pan, Li‐Xin Xiang, Ping Wang, Xiao‐Yuan Liu, Li Nie, Wendong Huang, Jian‐Zhong Shao
Journal: Hepatology (2014)

Liver fibrosis, a major cause of end-stage liver diseases, is closely regulated by multiple growth factors and cytokines. The correlation of fibroblast growth factor 2 (FGF2) with chronic liver injury has been reported, but the exact functions of different FGF2 isoforms in liver fibrogenesis remain unclear. Here, we report on the differential expression patterns and functions of low- and high-molecular-weight FGF2 (namely, FGF2(lmw) and FGF2(hmw) , respectively) in hepatic fibrogenesis using a CCl4 -induced mouse liver fibrosis model. FGF2(hmw) displayed a robust increase in CCl4 -induced hepatic fibrosis and promoted fibrogenesis. In contrast, endogenous FGF2(lmw) exhibited a slight increase in hepatic fibrosis and suppressed this pathological progression. Moreover, exogenous administration of recombinant FGF2(lmw) potently ameliorated CCl4 -induced liver fibrosis. Mechanistically, we showed that FGF2(lmw) treatment attenuated hepatic stellate cell activation and fibrosis by epigenetic down-regulation of Delta-like 1 expression through the p38 mitogen-activated protein kinase pathway.FGF2(lmw) and FGF2(hmw) have distinct roles in liver fibrogenesis. These findings demonstrate a potent antifibrotic effect of FGF2(lmw) administration, which may provide a novel approach to treat chronic liver diseases.
Concurrent chemoradiation in stage III NSCLC: High eligilbility and high rates of overall and progression-free survival with acceptable toxicity
Authors: Frans Krouwels, Patricia de Haan, Max Dahele, Bita Hajian, Ivo van der Lee
Journal: European Respiratory Journal (2013)

Introduction: In fit patients with stage III NSCLC treatment with radical intent is recommended with concurrent chemo-radiation (CRT). Expected median and 2-year overall survival (OS) is about 18 months and 35% respectively, at the expense of significant rates of toxicity, and low eligibility (40%).

Aim: To evaluate the efficacy and toxicity of concurrent CRT for stage III NSCLC in routine clinical practice and compare these with published results.

Method: We retrospectively identified all patients with stage III NSCLC in 2005-11, and those treated with CRT. Staging included PET/CT and brain MRI.. Treatment: 1x chemotherapy with cisplatin (C) 75 mg/m2 and either gemcitabine 1250 mg/m2 or pemetrexed 500 mg/m2. Three weeks later:2 cycles of C with etoposide 100 mg/m2 in combination with radiotherapy (aim 66Gy) with 4-dimensional CT for planning,

Results: Of all 89 patients with stage III NSCLC, 63% were treated with CRT, mean age: 64 yrs (range 46-84); median OS: 27 months, OS and PFS: Figure 1. Site of recurrence: local 30%, distant 48%, and both 21%. Neutropenic fever: 25%, eneteral feeding for radiation esophagitis:18%, steroids for radiation pneumonitis 9%.

![Figure][1] 



Conclusion: Most patients with stage III NSCLC received CRT. OS and PFS rates were higher than expected (Figure 1), with acceptable toxicity. The high PFS suggests that this was not due to 2nd line treatment.

 [1]: pending:yes
Influence of lung infection on the course and outcome in patients with stroke
Authors: Dragana Ristic, Sinisa Ristic, Ivana Marinkovic, Ines Veselinovic
Journal: European Respiratory Journal (2012)

Purpose: Occurance of acute bacterial lung infectuns affects the course of disease and outcome in stroke patients. Aim of the study was to explore the frequency of hypostatic and aspiration pneumonia, their risk factor and their effect on outcome in patinets with acute stroke.  Metods: In this retrospective study, we evaluated patients with stroke who were hospitalized at the Department of Neurology in Nis, between January- December 2011.There were a total of 1312 patients with stroke. 824(62,80%) had ischaemic stroke, and 488 (37,20%) had haemorrhagic. Patients were evaluated and had the same investigations with anamnestic, clinical, neurological, biochemical analisys, physical examination by a specialist for pulmonary diseases, lung X-ray, Color-Doppler of the neck blood vessels, EEG, CT of lung, CT/MRI of brain, MRA angiography.  Results: Of a total of 1312 patients with stroke, 59 patients (4,49%) of them had pulmonary complications within 10 day from the event. There were 36 male and 23 female patients, age from 41 to 82 years. Pulmonary infections in all of the patients was confirmed by x-ray imaging and biochemical analisys. 28(47,46%) patients had lobar pneumonia, 23(38,98%) had bilateral bronchopneumonic changes and 8(13,56%) had pleural effusion. All of the patients were higly febrile, with increased sedimentation and leucocitosys with dominant neutrophiles. Despite the intensive antibiotic treatment, using two or more antibiotics in combination, 14 patients has died.  Conclusion: Hypostatic and aspiration pneumonia are frequent complications of stroke associated with poor outcome. Regading to this fact, an intensive prevention of complications is necessary immediately after hospitalization.
Multiple Marker Evaluation in Human Prostate Cancer With the Use of Tissue-Specific Antigens&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;&lt;xref ref-type="fn" rid="FN3"&gt;3&lt;/xref&gt;
Authors: M. Kuriyama, M. C. Wang, C. L. Lee, C. S. Killian, L. D. Papsidero, H. Inaji, R. M. Loor, M. F. Lin, T. Nishiura, N. H. Slack, G. P. Murphy, T. M. Chu
Journal: JNCI Journal of the National Cancer Institute (1982)

Serum prostate-specific antigen and prostatic acid phosphatase were simultaneously evaluated in 22 healthy males, 29 patients with benign prostatic hypertrophy, and 192 patients with prostate cancers at various stages as well as in 30 patients with cancers other than prostate cancer. Both markers were quantitated by specific sandwich-type, enzyme-linked, immuno-sorbent assays with the use of specific antiserum reagents. Serum assays revealed a discordance between these two markers; thus expressions of these two biochemically and immunologically distinct prostate-specific proteins may reflect different aspects in the biology of prostate cancer. A combination test with the use of 7.5 ng of prostate antigen and 15.5 ng of prostatic acid phos-phatase/ml of serum, respectively, as cutoff values resulted in a positive detection rate of 58% for prostate cancers of stages A (7/12) and B (21/36) each, 68% for prostate cancer of stage C (19/28), 92% for prostate cancer of stage D (106/116), and only 10% for benign prostatic hypertrophy (3/29). None of 52 other cancers or healthy controls was registered as positive. This study demonstrates that a multiple marker test of tissue-specific antigens can be of an additive value in the immunodiagnosis of cancer and may be a logical and effective approach at this time, in light of the unavailability of human tumor-specific markers.