tbuckley/cabot-search huggingface dataset:
Over the counter cough medicines for acute cough
Authors: J. Walmsley
Journal: BMJ (2002)

Road traffic injuries are a global public health problemEditor-Road traffic crashes and their sequelae are a scourge in all societies, both developed and developing.Each year over a million people are killed in road traffic collisions worldwide and some 10 million people are injured or disabled by these events, 1 predominantly in low and middle income countries. 2 Despite what is known about road traffic crashes and their health consequences, policymakers worldwide show little awareness of their contribution to the burden of disease; consequently they are neglected in service and policy.At the same time there has been limited funding, particularly in low and middle income countries, for traffic related research 3 even though these injuries drain developing economies of 1-2% of gross domestic product (about $100 bn) each year, or twice the total development aid received worldwide by developing countries. 4 The critical issue is that road traffic injuries can be prevented.Many effective strategies have been identified in developed countries, but since the type of traffic injuries in developing countries differ greatly from those in developed countries, the prevention strategies, technologies, and policies cannot simply be exported.They require specific testing and appropriate modification to ensure their effectiveness in developing societies.The World Health Organization, as the lead coordinating agency for international public health, is guiding a science based programme of activities in the prevention of road traffic injury.In 2001 its department of injuries and violence prevention, together with partners, developed a multidisciplinary five year global strategy for this (www.who.int/violence_injury_prevention/index.html).This strategy takes into consideration competing needs and expectations, and limited resources in many countries, and addresses long term sustainable goals.The Global Forum for Health Research and the WHO are supporting an initiative to promote appropriate research in Africa, Asia, and Latin America (see www. globalforumhealth.org/pages/index.asp).This North-South collaborative effort is embarking on an ambitious research agenda for the prevention of road traffic injuries.Complementarily, another initiative, led by the Harvard Center for Population and Development Studies and cosponsored by the WHO, addresses the problem of health equity and road traffic injuries.An alliance of partners will help 10 developing countries to develop appropriate policies and interventions over five years.Dedicating an issue of the BMJ to road traffic injuries is a welcome step in the acknowledgement of this global public health problem.It is also a call for partners around the world to confront the growing epidemic and save lives.
Uracil-ftorafur: an oral fluoropyrimidine active in colorectal cancer.
Authors: A Sulkes, S E Benner, R M Canetta
Journal: Journal of Clinical Oncology (1998)

PURPOSE AND DESIGN This review describes the early clinical development of uracil-ftorafur (UFT), an oral fluoropyrimidine, designed in 1978 by adding uracil to ftorafur. The review focuses on the treatment of colorectal cancer and summarizes the Japanese experience and the phase I and II trials performed in the United States and Europe. RESULTS Clinical trials of UFT published in the Western world have included 581 patients with colorectal cancer. UFT has been administered in these trials as a single agent or biomodulated by leucovorin (LV). UFT was administered daily in split doses for periods that ranged from 14 to 28 days. The activity of oral UFT in large-bowel cancer when administered with oral LV (approximately 50 mg/dose) has resulted in objective response rates of approximately 40%. Response rates of approximately 25% (range, 17% to 39%) were reported when UFT was administered as a single agent or with lower doses of LV. The highest dose-intensities of UFT are achieved with 28-day schedules of administration. The maximum-tolerated dose (MTD) of UFT with this schedule, when administered concomitantly with oral LV 150 mg daily, is 300 mg/m2 daily. The dose-limiting toxicity (DLT) of UFT has generally been diarrhea. Other commonly described toxicities include nausea and vomiting, fatigue, and stomatitis. Myelosuppression occurs infrequently. Typically, hand-foot syndrome and neurologic toxicity are lacking. CONCLUSION UFT is a fluoropyrimidine active in colorectal cancer. The oral route of administration and improved safety profile represent important advantages over both conventional and infusional fluorouracil (5-FU) regimens.
Pseudomonas aeruginosa infection in cystic fibrosis caused by an epidemic metallo-β-lactamase-producing clone with a heterogeneous carbapenem resistance phenotype
Authors: S. Pollini, E. Fiscarelli, C. Mugnaioli, V. Di Pilato, G. Ricciotti, A.S. Neri, G.M. Rossolini
Journal: Clinical Microbiology and Infection (2011)
Contributions of the Medullary Raphe and Ventromedial Reticular Region to Pain Modulation and Other Homeostatic Functions
Authors: Peggy Mason
Journal: Annual Review of Neuroscience (2001)

The raphe magnus is part of an interrelated region of medullary raphe and ventromedial reticular nuclei that project to all areas of the spinal gray. Activation of raphe and reticular neurons evokes modulatory effects in sensory, autonomic, and motor spinal processes. Two physiological types of nonserotonergic cells are observed in the medullary raphe and are thought to modulate spinal pain processing in opposing directions. Recent evidence suggests that these cells may modulate stimulus-evoked arousal or alerting rather than pain-evoked withdrawals. Nonserotonergic cells are also likely to modulate spinal autonomic and motor circuits involved in thermoregulation and sexual function. Medullary serotonergic cells have state-dependent discharge and are likely to contribute to the modulation of pain processing, thermoregulation, and sexual function in the spinal cord. The medullary raphe and ventromedial reticular region may set sensory, autonomic, and motor spinal circuits into configurations that are appropriate to the current behavioral state.
The relationship between surfactant protein D and respiratory functions in COPD
Authors: Elif Sen, Fatma Ciftci, Gokcen Arkan, Duygu Acar, Sevgi Saryal
Journal: European Respiratory Journal (2014)

INTRODUCTION:Surfactant protein D(SPD) is a glycoprotein synthesized in type-2 pneumocytes,modulates surfactant homeostasis, and plays an important role as a defence mechanism aganist various infections and allergens. In COPD patients serum SPD levels may be high.The aim of this study is to compare serum SPD levels between COPD patients and healthy controls, to define the relationship between SPD level and respiratory functions.

METHODS:Sixty-four(5F, 59M) COPD subjects(mean age of 63,67±9,16 years) and 25(8F, 17M) healthy control subjects(mean age of 53,80±8,23 years) were enrolled.Medical history, smoking history, comorbidities were recorded.Arterial blood gases, pulmonary function tests (spirometry, diffusion test, lung volumes),six minute walking test(6MWT) were performed.

RESULTS:Subjects were classified according to GOLD spirometric classification as stage 1(1 (1,7%)patient, stage 2(41(68,3%) patients),stage 3(12 (20%)patients), stage 4(6(10%)patients). Mean serum SPD level was higher in COPD group (171,85±113,00) than control group (106,80±46,68)(p<0.05).Serum SPD level was not related to age,BMI,smoking status. There was a significant positive correlation between SPD and pCO2(r:0,325;p:0,02).SPD was negatively correlated with FEV1(L) (r:-0,266, p:0,042),FEV1(%) (r:-0,324;p:0,013), FEV1/FVC (r:-0,343;p:0,008) and diffusion capacity (r:-0,283; p:0,034).

CONCLUSION: In conclusion, serum Surfactant protein D level was higher in COPD patients compared to healthy controls. Serum SPD levels was negatively correlated with FEV1 and diffusion capacity in COPD patients. The pathopysiologic changes may have effects on the circulating SPD levels in COPD.
Communication Between Primary Care Physicians and Radiation Oncologists Regarding Patients With Cancer Treated With Palliative Radiotherapy
Authors: Elizabeth A. Barnes, John Hanson, Catherine M. Neumann, Cheryl L. Nekolaichuk, Eduardo Bruera
Journal: Journal of Clinical Oncology (2000)

The purpose of this study was to assess the satisfaction and information needs of primary care physicians (PCPs) regarding communication with radiation oncologists (ROs), with respect to patients who receive palliative radiotherapy (RT). A selected objective was to evaluate the agreement between PCPs' expectations and the content of the RO letter sent after completion of RT. PCPs' knowledge of the role of palliative RT and their awareness of available patient support services were also determined.The PCPs of patients discharged from the Cross Cancer Institute after receiving palliative RT were surveyed using a mail-out questionnaire. Questions regarding communication, RT knowledge, and awareness of support services were asked. The corresponding RO letter was reviewed.A total of 148 PCPs were identified and were mailed questionnaires, with 114 (77%) responding. Overall, 80% (87 of 109) of PCPs found the RO letter to be useful in patient management. However, there was poor (< 53%) agreement between PCPs' expectations and the actual content of the RO letter. Knowledge of the indications and effectiveness of palliative RT was limited, with PCPs obtaining a median score of 4 of a possible 8. Only 27% (31 of 114) of PCPs were aware of all five of the patient support services listed.Results show that although the majority of PCPs found the RO letter useful, they believed that the letter lacked important information while containing unnecessary details. Communication between PCPs and ROs needs improvement, especially considering that PCPs seem to have limited knowledge of palliative RT.
Relationship between heterogeneous bronchoconstriction and impulse oscillometry resistance: A simulation study
Authors: Rafel Bordas, Sherif Gonem, Wim Vos, Ruth Hartley, Joe Pitt-Francis, Jan De Backer, Chris Brightling, John Owers-Bradley, David Kay, Salman Siddiqui, Kelly Burrowes
Journal: European Respiratory Journal (2014)

Rationale: Impulse oscillometry (IOS) is a common clinical technique to probe airway structure. The IOS parameter R5-R20 is believed to be a measure of heterogeneous small airways constriction (Gonem et al. ERJ 2012, Gonem et al . CEA 2013). We test this hypothesis using a computational model.

Methods: A complete airway model was created by first segmenting the lobes and central airways (to generation 8) from CT data of a healthy adult male (25yo, 27.7 BMI). A volume filling branching algorithm was applied to extrapolate the remaining airway tree to generation 24. Random airway constriction patterns of varying severity and heterogeneity were applied to three groups of airways: the large conducting airways (generations 4-7), the small conducting airways (8-15) and the intra-acinar airways (16-24). An acoustic impedance model was used to simulate IOS resistance parameters using the resulting models.

Results: Mean R5-R20 showed little change over baseline after severe constriction of the large conducting airways (+10% homogenous, -15% heterogeneous). Mean R5-R20 increased with homogeneous constriction of both the small conducting airways (+186%) and the intra-acinar airways (+197%). Mean R5-R20 increased further with heterogeneous constriction of the small conducting airways (+270%) and increased markedly after heterogeneous constriction of the intra-acinar region (+440%).

Conclusions: Simulations support the hypothesis that increased R5-R20 is a measure of airways constriction in the small conducting and intra-acinar airways. Further, R5-R20 is seen to depend strongly on increasing constriction heterogeneity in the intra-acinar region.
What Time of Day Should a Urethral Catheter be Removed?
Authors: A Wyman
Journal: Journal of the Royal Society of Medicine (1987)

Patients who had undergone bladder neck surgery were randomized to having their urethral catheters removed either early in the morning or late at night. There was no difference in the incidence of urinary retention between these two groups of patients. However, patients who presented with acute urinary retention had a higher incidence of postoperative urinary retention. This study suggests that a urethral catheter may be safely removed in the evening without increasing the risk of urinary retention. There also seems to be no greater chance of the patient having to be recatheterized at an unsocial hour.
Quality-of-life in a long-term multicentre trial in chronic nonspecific lung disease: assessment at baseline. The Dutch CNSLD Study Group
Authors: AA Kaptein, PL Brand, FW Dekker, HA Kerstjens, DS Postma, HJ Sluiter
Journal: European Respiratory Journal (1993)

Quality-of-life (QOL) in patients with respiratory illness is a topic of increasing interest to clinicians and researchers. In a multicentre trial, which studies the long-term effects of three medication regimens (beta-agonist plus either placebo, anticholinergic agent or corticosteroid, all by inhalation) in patients with chronic nonspecific lung disease ((CNSLD): asthma and chronic obstructive pulmonary disease (COPD)), quality-of-life was included as an additional outcome measure. We wanted to provide a baseline assessment of quality-of-life in 274 adult patients with a mild to moderate degree of CNSLD. Quality-of-life was measured using a set of six standardized tests: Anxiety, Depression and Sleep Disorders, Optimism and Stigma, and Activities of Daily Living were assessed via scales with adequate validity and reliability, as established in previous work in Dutch patients with CNSLD. We found that quality-of-life was mildly impaired in these patients. Although differences with a reference group were present throughout, these were not significant, probably due to selection of relatively young, clinically stable, and highly motivated patients for our study. Quality-of-life scores showed higher correlation coefficients (0.20 < r < 0.38) to symptom scores than did results of pulmonary function tests (r < 0.015). In logistic regression models, absence from work and hospitalizations due to CNSLD were partly determined by quality-of-life scores.(ABSTRACT TRUNCATED AT 250 WORDS)
Myeloablative combination chemotherapy without total body irradiation for neuroblastoma.
Authors: B H Kushner, R J O'Reilly, L R Mandell, S C Gulati, M LaQuaglia, N K Cheung
Journal: Journal of Clinical Oncology (1991)

Myeloablative treatment intensification in 25 patients diagnosed when older than 12 months of age with stage IV neuroblastoma included sequential delivery of cisplatin 120 mg/m2 x 1, hyperfractionated radiation (2,100 cGy) to the primary site and adjacent lymph nodes, carmustine (BCNU) 200 mg/m2 x 1, melphalan 60 mg/m2/d x 3 (n = 13) or thiotepa 300 mg/m2/d x 3. (n = 12), and etoposide (VP 16) 300 mg/m2/d x 3. Seventy-two hours after the last dose of VP 16, histologically tumor-free and 4-hydroperoxycyclophosphamide (4-HC; 100 mumol/L)-purged autologous bone marrow (ABMT) was infused. Acute toxicities included grade 3 to 4 oral mucositis, grade 1 to 2 diarrhea, and fevers. No patient required infusion of unpurged reserve autografts. At ABMT, 16 patients (group I) were progression-free 6.5 months to 14 months (median, 9 months) from diagnosis: seven remain progression-free 20 months to 46 months (median, 39 months) off therapy, six relapsed 4 months to 17 months post-ABMT, and three died of toxicity (candidiasis, metabolic derangement, and venoocclusive disease [VOD]). The event-free survival of group I patients is 44% at 24 months post-ABMT. Nine patients (group II) were in second remission at ABMT, including three who had relapsed after other transplant procedures: two are progression-free 24 months and 41 months off therapy, four relapsed 3 months to 12 months post-ABMT, and three died of toxicity (aspergillosis, hemorrhagic cystitis, VOD). Only one of 10 relapses involved a primary site, suggesting a beneficial effect of local radiation. In terms of survival or toxicity, an advantage for melphalan or thiotepa was not evident. Regimens such as this may prolong the survival of selected patients with poor-risk neuroblastoma, but concerns over late relapses and toxicity mandate continuing efforts to devise alternative, less risky, and more clearly beneficial approaches for definitive ablation of neuroblastoma.
Comparison of Visual and Quantitative Florbetapir F 18 Positron Emission Tomography Analysis in Predicting Mild Cognitive Impairment Outcomes
Authors: Stefanie Schreiber, Susan M. Landau, Allison Fero, Frank Schreiber, William J. Jagust
Journal: JAMA Neurology (2015)

<h3>Importance</h3> The applicability of β-amyloid peptide (Aβ) positron emission tomography (PET) as a biomarker in clinical settings to aid in selection of individuals at preclinical and prodromal Alzheimer disease (AD) will depend on the practicality of PET image analysis. In this context, visual-based Aβ PET assessment seems to be the most feasible approach. <h3>Objectives</h3> To determine the agreement between visual and quantitative Aβ PET analysis and to assess the ability of both techniques to predict conversion from mild cognitive impairment (MCI) to AD. <h3>Design, Setting, and Participants</h3> A longitudinal study was conducted among the Alzheimer's Disease Neuroimaging Initiative (ADNI) sites in the United States and Canada during a 1.6-year mean follow-up period. The study was performed from September 21, 2010, to August 11, 2014; data analysis was conducted from September 21, 2014, to May 26, 2015. Participants included 401 individuals with MCI receiving care at a specialty clinic (219 [54.6%] men; mean [SD] age, 71.6 [7.5] years; 16.2 [2.7] years of education). All participants were studied with florbetapir F 18 [<sup>18</sup>F] PET. The standardized uptake value ratio (SUVR) positivity threshold was 1.11, and one reader rated all images, with a subset of 125 scans rated by a second reader. <h3>Main Outcomes and Measures</h3> Sensitivity and specificity of positive and negative [<sup>18</sup>F] florbetapir PET categorization, which was estimated with cerebrospinal fluid Aβ1-42 as the reference standard. Risk for conversion to AD was assessed using Cox proportional hazards regression models. <h3>Results</h3> The frequency of Aβ positivity was 48.9% (196 patients; visual analysis), 55.1% (221 patients; SUVR), and 64.8% (166 patients; cerebrospinal fluid), yielding substantial agreement between visual and SUVR data (κ = 0.74) and between all methods (Fleiss κ = 0.71). For approximately 10% of the 401 participants in whom visual and SUVR data disagreed, interrater reliability was moderate (κ = 0.44), but it was very high if visual and quantitative results agreed (κ = 0.92). Visual analysis had a lower sensitivity (79% vs 85%) but higher specificity (96% vs 90%), respectively, compared with SUVR. The conversion rate was 15.2% within a mean of 1.6 years, and a positive [<sup>18</sup>F] florbetapir baseline scan was associated with a 6.91-fold (SUVR) or 11.38-fold (visual) greater hazard for AD conversion, which changed only modestly after covariate adjustment for apolipoprotein ε4, concurrent fludeoxyglucose F 18 PET scan, and baseline cognitive status. <h3>Conclusions and Relevance</h3> Visual and SUVR Aβ PET analysis may be equivalently used to determine Aβ status for individuals with MCI participating in clinical trials, and both approaches add significant value for clinical course prognostication.
Current Evaluation Research on Mental Health Services
Authors: GERALD KLERMAN
Journal: American Journal of Psychiatry (1974)

Historically, the status of mental health services in the United States has depended upon the economic stability of the nation; much of the financial support of these programs has come from government sources. Since current budget reductions have somewhat curtailed NIMH-supported community and mental health center programs, it becomes increasingly important to systematically evaluate the changing relationship between the mental health professions and the society at large. The need for better administrative and fiscal supervision of community-based mental health service units as well as professional assessment of such centers is evident; unless evaluative data are gathered, social and professional growth may be stifled.
Longitudinal analysis of lung function decline with eosinophilic clustering in severe asthma
Authors: Chris Newby, Josh Agbetile, Beth Hargadon, Peter Bradding, Andrew Wardlaw, Ian Pavord, Ruth Green, Chris Brighling, Salman Siddiqui
Journal: European Respiratory Journal (2011)

Background: Lung function decline over time is an important variable for patients with severe/difficult asthma and it is unclear how granulocytic cell counts in sputum are associated with this variable as few longitudinal studies include both biomarkers.

Aims and objectives: To analyse lung decline, post bronchodilator FEV1 was recorded over time in order to determine the best fitting mixed effect model to determine the role of granulocytes.

Methods: Data was collected form the Glenfield Hospital Severe asthma clinic, the mean duration of follow up and number of visits were 6 years and 2.7/years. A mixed effect model was applied to the data. Using individual patient mean and standard deviation over time, a statistical mixture/cluster analysis was implemented.

Results: For the best fitting mixed effects model FEV1 decline was -25.7ml/year, p=0.0001. The significant independent fixed effects included exacerbations, age of onset, log eosinophils (p<0.001). Three clusters were found in the log eosinophil cluster analysis. Cluster 1 described a low grade eosinophilic group. Cluster 2, a hyper eosinophilic group and cluster 3, a neutrophilic/non-eosinophilic group. The clusters differed in their frequency of exacerbation/decline.

Conclusions: Eosinophils were found to be a significant predictor for FEV1 decline. Clustering eosinophil variables found that patients are either consistently eosinophilic over time, consistently non eosinophilic over time or have a large amount of eosinophilic variation.
Unmasking masked depression in children and adolescents
Authors: Gabrielle A. Carlson, Dennis P. Cantwell
Journal: American Journal of Psychiatry (1980)

The authors examined depressive symptoms and behavior disorders in 102 systematically interviewed children aged 7 to 17 years to elucidate the category of masked depression. They found that it was possible to diagnose these children using adult research criteria and that more children with depression were identified using a systematic interview than were identified using standard evaluation procedures. Although children with a depressive disorder may also exhibit behavior disorders that overshadow the depression, an alert clinician conducting a thorough interview should be able to identify the "masked" depression.