tbuckley/cabot-search huggingface dataset:
Prospective cohort study assessing limb volume change (LVC) and quality of life in breast cancer survivors
Authors: J. N. Cormier, Y. Xing, I. Zaniletti, R. L. Askew, B. R. Stewart, J. M. Armer
Journal: Journal of Clinical Oncology (2008)

9561 Background: The objective of this study was to define the outcomes associated with postoperative limb volume change (LVC) to identify clinically relevant diagnostic criteria for lymphedema following breast cancer treatment and associated findings that could be used to guide risk-reduction practices. Methods: LVC was serially evaluated in 276 women receiving surgical treatment for invasive breast cancer using an optoelectronic volumetry device (perometer). Baseline measures for patients enrolled prior to surgery included ipsilateral limb volume while contralateral limb measurements were used for patients enrolled postoperatively. Symptoms were assessed using the Lymphedema and Breast Cancer Questionnaire (LBCQ). Quality of life (QOL) was assessed at 1 month and 24 months using the Functional Living Index-Cancer (FLIC) and the RAND 36-Item Health Survey (SF-36). Four groups were created based on the maximum LVC: none < 5%, mild 5–9.9%, moderate 10–14.9%, and severe ≥ 15%. Associations between clinical factors, treatment, QOL, and LVC were examined using multivariate regression analyses. Results: With a median follow-up of 29 months, 54 (19.6%) patients did not develop LVC; 120 (43.5%), 50 (18.1%), and 52 (18.8%) developed mild, moderate, and severe LVC, respectively. The frequency of LBCQ-identified symptoms increased and QOL scores decreased as LVC increased. Linear regression analysis demonstrated that increase in body mass index (p = 0.0001) and axillary node dissection (p = 0.046) were associated with increasing LVC, while increasing age had an inverse relationship (p= 0.019). Logistic regression analysis showed that lower QOL scores were significantly associated with a moderate LVC compared to no LVC (odds ratio (OR) =6.7, 95% CI 1.4–32.8, p = 0.018) and postoperative infections (OR = 6.4, 95% CI 2.0–20.1, p = 0.002). Conclusions: LVC at ≥ 5% occurs in up to 80% of breast cancer survivors following treatment and is progressive in most patients. Lymphedema-associated symptoms and decrements in QOL can be detected in patients with even mild LVC (5–9.9%). Risk reduction practices should include post-treatment weight maintenance programs. Cancer surveillance should include postoperative limb monitoring with treatment referral for patients with ≥ 5% LVC. No significant financial relationships to disclose.
Rapid access lung cancer clinic – A patient satisfaction survey
Authors: R. Mustafa, S. Naik, J. Mills, M. Munavvar
Journal: European Respiratory Journal (2011)

Background: Royal Preston Hospital runs a rapid access lung cancer clinic for efficient staging of suspected lung cancer patients. Staging CT-scans and discussion with chest radiologists for planning and scheduling the investigation/s for definitive staging is carried out at first attendance. Moreover management plans are discussed with patients by doctors and reinforced by dedicated lung cancer nurse specialists who also provide ongoing psychological support to suspected cancer patients at first appointment.

Aim: To ascertain if patients were satisfied with the service offered at the rapid access clinic and if this service lead to early diagnostic/& or staging investigations as promised. We also wanted to identify areas which needed further development and aspects of service which were particularly well liked by our patients.

Methods: Survey questionnaires were posted to 35 patients attending the rapid access lung cancer clinic between January 2010 and February 2010.

Results: 42% (n=15) of patients returned the questionnaires.

![Figure][1] 



Conclusion: Rapid access lung cancer clinic at our centre offers prompt investigations to suspected lung cancer patients. Although a large proportion of appointments lasted more than 4 hours, most of our patients had preliminary staging work up completed at first appointment. Our patients reported high levels of satisfaction with the adequacy of information given and degree of privacy observed by health care professionals.

 [1]: pending:yes
Acute tryptophan depletion and increased food intake and irritability in bulimia nervosa
Authors: T E Weltzin, M H Fernstrom, J D Fernstrom, S K Neuberger, W H Kaye
Journal: American Journal of Psychiatry (1995)

Data suggest that serotonin activity is reduced in women at normal weight who have bulimia nervosa. The authors tested whether acute perturbations in serotonin activity could alter short-term eating behavior and mood.They examined the effect of acute tryptophan depletion in 10 women with and 10 women without bulimia nervosa.Women with bulimia nervosa exhibited an increase in caloric intake and mood irritability after acute tryptophan depletion.These results indicate that women with bulimia nervosa have an exaggerated or pathological response to transient alterations in serotonin activity.
Hypercholesterolemia and Risk of Incident Psoriasis and Psoriatic Arthritis in US Women
Authors: Shaowei Wu, Wen‐Qing Li, Jiali Han, Qi Sun, Abrar A. Qureshi
Journal: Arthritis & Rheumatology (2013)

Psoriasis is a systemic inflammatory disorder associated with an increased risk of cardiovascular disease. Hypercholesterolemia is a major risk factor for cardiovascular disease, and patients with psoriasis or psoriatic arthritis (PsA) have been shown to have elevated cholesterol levels. However, it is not known whether hypercholesterolemia is associated with an increased risk of psoriasis or psoriasis with PsA. We undertook this study to determine whether a history of hypercholesterolemia is associated with the risk of developing incident psoriasis and psoriasis with PsA in a cohort of US women.We included a total of 95,540 participants from the Nurses' Health Study II (1991-2005). Information on personal history of physician-diagnosed hypercholesterolemia and related medication use was collected during the followup period. Clinician-diagnosed psoriasis and psoriasis with PsA were ascertained and confirmed using supplementary questionnaires. Hazard ratios (HRs) were calculated with 95% confidence intervals (95% CIs).During 1,320,765 person-years of followup, we documented 646 participants with incident psoriasis, 165 of whom had concomitant PsA. Hypercholesterolemia was associated with elevated risks of incident psoriasis (HR 1.25 [95% CI 1.04-1.50]) and psoriasis with PsA (HR 1.58 [95% CI 1.13-2.23]) in multivariate-adjusted models. Participants with hypercholesterolemia lasting for ≥7 years were at a higher risk of developing psoriasis (HR 1.29 [95% CI 1.03-1.61]) (P for trend = 0.0002) and psoriasis with PsA (HR 1.68 [95% CI 1.12-2.52]) (P for trend = 0.002). These associations persisted among participants who never took cholesterol-lowering medications. There was no association between cholesterol-lowering drugs and risk of psoriasis or psoriasis with PsA.Our study provides evidence that hypercholesterolemia, a well-known cardiovascular risk factor, is also associated with an elevated risk of psoriasis and psoriasis with PsA.
Focus: who reaps the benefits of biodiversity?
Authors: C Karasov
Journal: Environmental Health Perspectives (2001)

The search for wild plant and animal products of potential value to medicine, agriculture, and other uses has been going on for hundreds, possibly thousands, of years. Many commonly prescribed medicines in the United States include ingredients derived from natural products, and roughly 80% of the world's people rely on natural products for their primary medical needs. Until the past decade, all of these natural products were collected without compensating the source countries. But the rules of collecting changed in 1992 with the establishment of the Convention on Biological Diversity, which offers financial compensation for natural products and seeks to conserve biological diversity, use natural products sustainably, and fairly share products made from gene stocks. Questions remain, however, as to how to share the benefits of biodiversity equitably, as well as whether the lack of both U.S. support for the agreement and enforceability render the convention impotent.
Sympathetic activity in children with OSA evaluated by Poincaré plot analysis and morning urine norepinephrine levels
Authors: Konstantinos Chaidas, Marina Tsaoussoglou, Emmanouel Theodorou, Loukia Lianou, Souzana Hatzinikolaou, Polytimi Panaghiotopoulou-Gartagani, George Chrousos, Athanasios Kaditis
Journal: European Respiratory Journal (2013)

Heart rate variability i.e. the continuous oscillation of the R-R interval around its mean value can be evaluated using Poincare plots. Narrow Poincare scattergrams indicate enhanced sympathetic activity. The aim of this study was to confirm increased sympathetic tone in children with obstructive sleep apnea (OSA) by applying graphic analysis of the Poincare plot. Methods: Subjects with and without OSA were recruited. The width of the plot obtained during overnight polysomnography and the norepinephrine concentration in morning urine specimen were the outcome measures. Results: Fourty four children with OSA (24 with SpO2 nadir ≥90% or mild hypoxemia; 20 with SpO2 nadir
Broadly Neutralizing Antibodies Against HIV: New Insights to Inform Vaccine Design
Authors: Saheli Sadanand, Todd J. Suscovich, Galit Alter
Journal: Annual Review of Medicine (2015)

HIV-1 poses immense immunological challenges to the humoral immune response because of its ability to shield itself and replicate and evolve rapidly. Although most currently licensed vaccines provide protection via the induction of antibodies (Abs) that can directly block infection ( 1 ), 30 years of HIV-1 vaccine research has failed to successfully elicit such Abs against globally relevant HIV strains. However, mounting evidence suggests that these broadly neutralizing antibodies (bNAbs) do emerge naturally in a significant fraction of infected subjects, albeit after years of infection, indicating that these responses can be selected naturally by the immune response but take long periods of time to evolve. We review the basic structural characteristics of broadly neutralizing antibodies and how they recognize the virus, and we discuss new vaccination strategies that aim to mimic natural evolution to guide B cells to produce protective Abs against HIV-1.
Influence of posture and gender on breathing pattern in healthy subjects: A three-compartmental analysis
Authors: Danielle Vieira, Liliane Mendes, Nathalia Elmiro, Letícia Gabriel, Guilherme Fregonezi, Rencio Florencio, Armèle Dornelas, Catarina Rattes, Veronica Parreira
Journal: European Respiratory Journal (2014)

Background:  It is well known that posture influences breathing pattern, however a three-compartmental analysis is not yet available. The effect of gender is still controversial.  Aims:  To investigate the effects of posture and gender on breathing pattern during quiet breathing in three postures: sitting, supine and supine with trunk inclination of 45°, in healthy.  Methods:  29 subjects(18 men and 11 women), aged 24±2 yrs, body mass index of 24±3 kg/m 2  and normal pulmonary function were studied. Evaluation was performed by optoelectronic plethysmography(BTS-Italy) in three different postures(59 each). The following variables were analysed: Chest wall tidal volume–V CW , respiratory rate-RR and contribution of the pulmonary rib cage–V rcp% , of abdominal rib cage-V rca%  and of abdomen–V ab%  to tidal volume. Statistical analysis was performed by Friedman test or ANOVA for repeated measures(postures). For the comparison between gender unpaired Student9s t or Mann-Whitney were performed, according to distribution. α was set at 5%. This study was approved by the Ethic Committee and subjects gave written consent form. Results: Table 1 shows the comparisons among postures.  For gender, men showed higher V CW than women in supine position. Women showed higher V rcp  %  in sitting position while men presented higher V ab  %  in trunk at 45°.  Conclusions:  Our results showed that posture influence breathing pattern as well as gender.
Interleukin-11 Attenuates Nephrotoxic Nephritis in Wistar Kyoto Rats
Authors: PING-CHIN LAI, H. TERENCE COOK, JENNIFER SMITH, JAMES C. KEITH, CHARLES D. PUSEY, FREDERICK W. K. TAM
Journal: Journal of the American Society of Nephrology (2001)

Interleukin-11 (IL-11) is a multifuctional cytokine with anti-inflammatory activity. The effect of IL-11 was studied in an experimental model of necrotizing glomerulonephritis induced in Wistar Kyoto rats by an injection of anti—glomerular basement membrane antibody (nephrotoxic serum). Intraperitoneal injection was chosen as the route of IL-11 administration in all experiments. In experiment 1, recombinant human IL-11 (1360 μg) was given 2 h before nephrotoxic serum, then once daily until day 6. In experiment 2, a lower dose of IL-11 (800 μg/d) was used. Rats were treated either with IL-11 400 μg twice daily intraperitoneally or with 800 μg once daily intraperitoneally for 6 d. In experiment 3, the lower dose of IL-11 was given 2 h before nephrotoxic serum, then twice daily until day 2. In experiment 1, IL-11 significantly reduced proteinuria (13.2 ± 3.3 versus 63.2 ± 4.3 mg/24 h), fibrinoid necrosis (0.58 ± 0.08 versus 1.52 ± 0.06 quadrants/glomerular cross section [gcs]), macrophage infiltration (ED1-positive cells, 24.4 ± 1.8 versus 39.3 ± 1.9 cells/gcs), apoptosis (1.11 ± 0.1 versus 2.39 ± 0.2 apoptotic bodies/gcs), and proliferating cell nuclear antigen—positive cells (24.4 ± 2.0 versus 37.3 ± 2.3 cells/gcs). Inducible nitric oxide synthase—positive cells were significantly increased (3.1 ± 0.3 versus 2.0 ± 0.2 cells/gcs). In experiment 2, a lower dose of IL-11 significantly reduced proteinuria and fibrinoid necrosis. Macrophage infiltration was similar in treated and control groups, although the number of sialoadhesin-positive macrophages (ED3+) was significantly reduced in the IL-11—treated rats. In experiment 3, quantitative competitive reverse transcriptase—polymerase chain reaction showed that the mRNA ratio of IL-1β/β-actin in the treated rats was reduced compared with controls. By the use of probes designed from mouse IL-11 receptor α-chain sequence, it was also shown that rat mesangial cells and macrophages expressed IL-11 receptor α-chain, demonstrating that they were capable of responding to IL-11. In this model of necrotizing glomerulonephritis, high-dose IL-11 treatment markedly reduced both proteinuria and fibrinoid necrosis. At the lower dose, there was a reduction in glomerular injury and macrophage sialoadhesin expression, but without an alteration of macrophage numbers, suggesting that IL-11 may be acting in part to reduce macrophage activation.
Point: Justification for Lynch Syndrome Screening Among All Patients With Newly Diagnosed Colorectal Cancer
Authors: Heather Hampel
Journal: Journal of the National Comprehensive Cancer Network (2010)

Either microsatellite instability testing or immunohistochemical staining for the 4 mismatch repair proteins (MLH1, MSH2, MSH6, and PMS2) should be performed on all newly diagnosed colorectal cancers. This testing will identify tumors that are microsatellite unstable, which has implications for patient prognosis and possibly treatment. In addition, it will identify patients who are more likely to have Lynch syndrome. Of every 35 colorectal cancer patients, 1 has Lynch syndrome, the most common hereditary cause of colorectal and endometrial cancers. Diagnosis of Lynch syndrome affects the medical management of the patient and their relatives, with potentially life-saving ramifications. Although screening only a subset of patients with colorectal cancer based on age at diagnosis, family history, or histologic criteria will reduce the number of screening tests necessary, it will miss a significant proportion of patients with microsatellite unstable colorectal cancer and many patients with Lynch syndrome. Given that universal screening of all patients with newly diagnosed colorectal cancer using immunohistochemistry as the initial test was recently shown to be cost-effective and comparable with other widely accepted preventive services, it is not necessary to try to reduce costs by restricting screening to a subset of patients, which leads to a reduction in the efficacy of the screening program.
Congenital heart disease after surgery: benefits, residua, sequelae
Journal: Thorax (1984)

Cavernoscopic evacuation of an intrapulmonary asper- gilloma causing appreciable haemoptysis appears to offer a useful alternative approach in high risk patients such as those with ankylosing spondylitis.It appears to be a rela- tively safe procedure with low morbidity and may be re- peated as necessary.It avoids the risks of surgical resection in patients with poor respiratory function and is preferable to open drainage.
Age-Related Geriatric Medicine: Relevance of Special Skills of Geriatric Medicine to Elderly People Admitted to Hospital as Medical Emergencies
Authors: Kalman Kafetz, Jeanne O'Farrell, Anthea Parry, Vinitha Wijesuriya, Geraldine McElligott, Brian Rossiter, Myriam Lugon
Journal: Journal of the Royal Society of Medicine (1995)

This study was carried out to find out how many patients aged 75 and over admitted to hospital as medical emergencies had features appropriate to care by physicians in geriatric medicine and to examine the extent of use of specialist facilities by these patients. The purpose was to examine criticisms of age-related admission policies which have focused on misplacement of patients with single diagnoses and lack of access to specialist care. An analysis was made of admission, process and discharge characteristics relevant to the special skills of geriatric medicine, multiple pathology and use of specialist services by 554 patients aged 75 and over. These were collected prospectively, consecutively admitted as medical emergencies via the accident and emergency department of a large district general hospital with an age-related (75 and over) medical admissions policy. 84 patients (15%) had single pathology and no characteristics suggesting the need for specialist geriatric care. 177 (32%) had single pathology and one or more specialized characteristics. 66 (12%) had multiple pathology alone. 227 (41%) had multiple pathology and specialized characteristics. There were 142 specialist referrals in 121 patients (22% of the whole sample). We concluded that the special skills of general physicians specializing in the medical and associated community problems of elderly people are highly relevant to patients aged 75 and over presenting as medical emergencies. There was no evidence of lack of involvement of specialists in their care.
Evaluation of human glioma radiosensitization using a combination of caffeine and phenylbutyrate (a histone deacetylase inhibitor)
Authors: Joseph M. Herman, Mukesh K. Nyati, Mary A. Davis, Susan M. Hiniker, Chris Chang, Mats Ljungman
Journal: Cancer Research (2004)

Proc Amer Assoc Cancer Res, Volume 45, 2004

1288 

Sodium Phenylbutyrate (PB) is a histone deacytalase (HDAC) inhibitor which has been reported to have differentiating and cytotoxic effects on cultured tumor cells and has demonstrated promising results in Phase I/II clinical trials. We have previously reported that at clinically achievable doses, PB attenuates the expression of Bcl-XL, DNA-PK, caveolin and VEGF in prostate cancer cells (1). Furthermore, PB blocks the invasive properties of metastatic prostate and breast cancer cells (2) and can act in synergy with ionizing radiation and chemotherapy to induce apoptosis in prostate cancer (1) and normal human fibroblasts (3). However, this synergy was only observed when PB was added after irradiation. Since PB induces high expression of the Cdk inhibitor p21 (WAF1/Cip1), it is possible that the lack of radiosensitisation when PB was added prior to irradiation was due to p21-mediated G1 arrest. To test whether ablation of p21 expression will lead to increased radiosensitisation by PB, we selected three human glioma cell lines: U87, D54 (p53 WT) and SK-MG3 (p53 heterozygous mutant/EGFR vIII overexpression). Treatment of cells with PB (2 mM) prior to irradiation resulted in dose-dependent inhibition of glioma cell proliferation and induction of apoptosis; however, pre-treatment with PB failed to yield significant radiosensitisation in these cell lines. Our preliminary data indicated that p21 expression in these cell lines was enhanced by a 24-hour pre-treatment with PB. It is known that caffeine inhibits p21 induction and increases the sensitivity of cells to radiation, independent of p53. Thus, we pretreated cells with 2 mM each of PB and caffeine for 24 hours before irradiation and found significant G1 arrest and enhanced radiosensitization. Western blot analysis showed increased p21 production with PB alone and repression of p21 at 24 hours after the addition of caffeine. Currently, experiments are underway to investigate if other inhibitors of the PI 3-kinase-PKC signaling pathway such as LY294002 and Calphostin C as well as p21 specific inhibition by siRNA yield similar effects. These results suggest that specific inhibition of p21 following PB induction could lead to enhanced synergy with ionizing radiation and other chemotherapeutic agents in the treatment of malignant gliomas. 1. Goh, M., et al. Neoplasia, 3: 331-338, 2001. 2. Dyer, E. S., et al. Int. J. Cancer, 101: 496-499, 2002. 3. Chung, D. H., et al. Radiat. Res., 149: 187-194, 1998.
A randomized trial of etoposide + cisplatin versus vinblastine + bleomycin + cisplatin + cyclophosphamide + dactinomycin in patients with good-prognosis germ cell tumors.
Authors: G J Bosl, N L Geller, D Bajorin, S P Leitner, A Yagoda, R B Golbey, H Scher, N J Vogelzang, J Auman, R Carey
Journal: Journal of Clinical Oncology (1988)

Standard chemotherapy for disseminated germ cell tumors (GCT) cures most patients but causes considerable acute toxicity, including treatment-related death due to septicemia during neutropenia and pulmonary fibrosis. In addition, chronic and delayed toxicities, particularly Raynaud's phenomenon, have been reported in 6% to 37% of treated patients. In an attempt to minimize the acute and chronic effects of treatment which are related primarily to vinblastine and bleomycin, a randomized trial comparing the efficacy and toxicity of vinblastine + bleomycin + cisplatin + cyclophosphamide + dactinomycin (VAB-6) and etoposide + cisplatin (EP) was conducted on 164 eligible patients with good-prognosis GCT. Seventy-nine of 82 (96%) patients receiving VAB-6 and 76/82 (93%) receiving EP achieved a complete remission (CR) with or without adjunctive surgery. Similar proportions of patients in both arms were found at surgery to have necrosis/fibrosis or mature teratoma. With a median follow-up of 24.4 months in the VAB-6 arm and 25.9 months in the EP arm, the total, relapse-free, and event-free survival distributions were similar in the two arms. Patients receiving EP experienced less emesis (P = .05), higher nadir WBC (P = .06) and platelet counts (P = .01), less magnesium wasting (P = .0001), less mucositis (P = .09), and no pulmonary toxicity. No treatment-related mortality was observed. EP is an efficacious and less toxic regimen and is recommended for good-prognosis patients with disseminated GCT.