tbuckley/cabot-search huggingface dataset:
Pap Hub: A system to improve compliance with pap smear screening guidelines in a large health care system.
Authors: Deanna Gek Koon Teoh, Lisa A. Fall, Erin A. Beitelspacher, Charles W. Lais
Journal: Journal of Clinical Oncology (2013)

193 Background: Cervical cancer is the most prevalent gynecologic cancer worldwide, but is third in the U.S. due to pap smear screening. However, American Society for Colposcopy and Cervical Pathology (ASCCP) guidelines are complex and frequently changed, resulting in guideline adherence as low as 33-44%. We describe a centralized pap smear tracking system (“pap hub”) and report preliminary results. Methods: On 1/1/13 we implemented the pap hub, routing all screening pap smear results to a dedicated OB/Gyn nursing staff with a new Epic workbench. Epic Health Maintenance Modifier updated to recommend pap smears for women age 21-65 years (not younger or older per guidelines). Screening Pap/HPV results auto routed to Pap Pool Epic inbasket (not to individual providers). Centralized nurse reviews results alongside past pap results on Pathology flowsheet in Epic If normal Normal history -&gt; appropriate follow-up interval per screening guidelines If abnormal history -&gt; repeat pap as determined by previous history and treatment If abnormal -&gt; manage per ASCCP guidelines Document plan in Epic Result Note Update Epic problems list If Normal: document “Pap Hub Normal History” If Abnormal: document “Pap Hub Abnormal History” with specifics in Overview History Communicate results/plan to the patient. Update Health Maintenance Modifier with next step. Review abnormal results to ensure proper follow-up, with reminders as indicated. Results: Guideline recommendations against pap smears for patients &lt;21 years and &gt;65 years have not changed since 2009. Comparison of first-quarter data for 2010 (pre-Pap Hub) to 2013 (post-Pap Hub) have shown a 63.86% reduction in pap smears in women &lt;21 years. Pap smears in women &gt;65 years has always been low, but has decreased slightly from 2.4% of all pap smears in 2010 to 1.5% of all pap smears in 2013. The 2012 ASCCP guidelines have changed recommended pap smear frequency and abnormal pap smear follow-up, and compliance with these new recommendations is being collected. Conclusions: Pap smear screening has decreased the incidence of invasive cervical cancer in the United States. The Pap Hub, a centralized pap smear tracking system, improves compliance with pap smear screening guidelines.
Interferon- Before Allogeneic Bone Marrow Transplantation in Chronic Myelogenous Leukemia Does Not Affect Outcome Adversely, Provided It Is Discontinued at Least 90 Days Before the Procedure
Authors: Rüdiger Hehlmann, Andreas Hochhaus, Hans-Jochem Kolb, Jörg Hasford, Alois Gratwohl, Hermann Heimpel, Wolfgang Siegert, Jürgen Finke, Gerhard Ehninger, Ernst Holler, Ute Berger, Markus Pfirrmann, Alexander Muth, Axel Zander, Axel A. Fauser, Axel Heyll, Christoph Nerl, Dieter K. Hossfeld, Helmut Löffler, Hans Pralle, Wolfgang Queißer, and Andreas Tobler
Journal: Blood (1999)
Accuracy of Reagent Strip Testing for Urinary Tract Infection in the Elderly
Authors: P J Evans, B R Leaker, W R McNabb, R R Lewis
Journal: Journal of the Royal Society of Medicine (1991)

The accuracy of reagent strip testing for urinary tract infection (UTI) was assessed in 100 elderly patients (50 acute patients admitted to hospital and 50 attending the day hospital). Reagent strip sensitivities were: acute patients-urinary nitrite 83%, blood 67%, protein 72% and leucocytes 72%, and day hospital patients-urinary nitrite 90%, blood 65%, protein 30% and leucocytes 60%. Urinary nitrite specificities were 100% for both groups of patients. Only 28% of patients with a UTI had specific symptoms of the infection; pyrexia and a raised WBC also proved poor indicators. Urinary nitrite was thus the most accurate immediate indicator of UTI.
Major depression following smoking cessation
Authors: L S Covey, A H Glassman, F Stetner
Journal: American Journal of Psychiatry (1997)

The authors examined the incidence and predictors of major depression following successful smoking cessation treatment, with special attention to the influence of past major depression.Three-month follow-up data were obtained from 126 subjects who successfully completed a 10-week smoking cessation program.The 3-month incidence of new major depression following treatment for nicotine dependence was 2%, 17%, and 30% among subjects with histories of no major depression, single major depression, and recurrent major depression, respectively. A history of major depression and persistent withdrawal symptoms independently predicted posttreatment major depression.Continued patient care beyond the 2-4-week period associated with the nicotine withdrawal syndrome is indicated when abstinence is attempted by smokers with prior major depression.
Severe infantile lower respiratory tract illness may be characterised by a reduced, rather than increased, immune response
Authors: J Carter
Journal: Thorax (2007)

▴ Welliver T, Garofalo R, Hosakote Y, et al . Severe human lower respiratory tract illness caused by respiratory syncytial virus and influenza virus is characterized by the absence of pulmonary cytotoxic lymphocyte responses. J Infect Dis2007;195:1126–36.

[OpenUrl][1][Abstract/FREE Full Text][2]



The pathogenesis of severe infantile respiratory illness due to respiratory syncytial virus (RSV) and influenza virus is not fully understood. Some evidence suggests there is an increased T lymphocyte and cytokine response to infection. However, this cross-sectional study found otherwise. …

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Abstract 3547: FoxD3-regulated microRNA-137 suppresses tumour growth and metastasis in human hepatocellular carcinoma by targeting AKT2
Authors: Li-Li Liu, Shi-Xun Lu, Min Li, Jia Fu, Chris Zhiyi Zhang, Jing-Ping Yun
Journal: Cancer Research (2014)

Abstract Background and Aims: microRNAs, which are frequently deregulated in human cancer, have been implicated in the progression of hepatocarcinogenesis. Our study aims to investigate the role of miR-137 in cell proliferation and metastasis of hepatocellular carcinoma and the underlying molecular mechanisms. Methods: Real-time PCR and western blot were used to examine the expressions of miR-137, Akt2 and FoxD3 in HCC tissues and cells. The in vitro and in vivo effects of miR-137 were determined. Luciferase reporter assay was conducted to confirm the association of miR-137 and AKT2. CHIP assay was performed to test the regulation of miR-137 by FoxD3. Results: We show that microRNA (miR)-137 is significantly down-regulated in hepatocellular carcinoma (HCC), and its decreased expression is associated with vein invasion, incomplete Involucrum, and tumour metastasis. Multivariate analysis suggests that miR-137 is an independent indicator for poor survival. To determine its role in HCC development, we showed that overexpression of miR-137 suppresses cell proliferation, invasion and metastasis in vitro. Conversely, miR-137 inhibition promoted HCC cell growth. We also identified AKT2 as a key target of miR-137 in this context. Statistical data revealed a reverse correlation of AKT2 and miR-137 expression in HCC patients. Silencing of AKT2 phenotypically copied miR-137-induced phenotypes, whereas re-expression of AKT2 reversed the suppressive effects of miR-137. Further investigation showed that miR-137 exerted its anti-tumour activity via inhibiting the AKT2/mTOR pathway. Moreover, we demonstrated that FoxD3 binds to the promoter of miR-137 and activates its transcription. In vivo studies confirmed that FoxD3-regulated miR-137 inhibition of HCC growth and metastasis via directly targeting AKT2. Conclusions: Our findings indicated that miR-137 is a valuable biomarker for HCC prognosis and demonstrated that the FoxD3/miR-137/AKT2 regulatory network plays an important role in HCC progression. Citation Format: Li-Li Liu, Shi-Xun Lu, Min Li, Jia Fu, Chris Zhiyi Zhang, Jing-Ping Yun. FoxD3-regulated microRNA-137 suppresses tumour growth and metastasis in human hepatocellular carcinoma by targeting AKT2. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3547. doi:10.1158/1538-7445.AM2014-3547
Carriage of methicillin-resistant Staphylococcus aureus on admission to European rehabilitation centres-a prospective study
Authors: E. Bilavsky, Y. Lerman, J. Salomon, C. Lawrence, A. Rossini, A. Salvia, J.V. Samso, J. Fierro, M. Hochman, M. Kazma, A. Klein, M.J. Schwaber, Y. Carmeli
Journal: Clinical Microbiology and Infection (2012)
Factors associated with severe disease in hospitalized adults with pandemic (H1N1) 2009 in Spain
Authors: D. Viasus, J.R. Paño‐Pardo, J. Pachón, A. Campins, F. López‐Medrano, A. Villoslada, M.C. Fariñas, A. Moreno, J. Rodríguez‐Baño, J.A. Oteo, J. Martínez‐Montauti, J. Torre‐Cisneros, F. Segura, F. Gudiol, J. Carratalà
Journal: Clinical Microbiology and Infection (2010)
The prognostic value of comorbidity assessed using the Cumulative Illness Rating Scale for Geriatrics (CIRS-G) in patients with advanced non-small cell lung cancer (NSCLC)
Authors: B. H. Gronberg, M. Jordhoy, S. Sundstrom
Journal: Journal of Clinical Oncology (2008)

9506 Background: More than 40% of patients (pts) with NSCLC are >70 years, but elderly are reported to be under- represented in clinical trials and under-treated compared with younger pts. One reason may be fear of intolerance to chemotherapy due to comorbidity - which increases with age and has been reported to be an independent prognostic factor in stage I & III NSCLC. The aim of the study was to explore correlations between comorbidity and overall survival (OS), toxicity (tox) and Quality of Life (QoL) in advanced NSCLC. Methods: Data from a trial comparing pemetrexed/carboplatin vs gemcitabine/carboplatin as first-line therapy in stage IIIB/IV NSCLC were analysed. Comorbidity was accepted provided pts had WHO Performance Status 0 - 2 and adequate kidney/liver/bone-marrow function. Chemotherapy-doses were reduced by 25% for pts ≥75 years. Main endpoints: global QoL, fatigue, nausea-vomiting & dyspnea reported on EORTC QLQ C30. No differences in QoL or OS (7.3 vs 7.0 months, log-rank; p=0.63) were observed. Median age 65 [#7517, ASCO 2007]. Comorbidity was assessed from hospital charts using the CIRS-G manual in 408/436 pts. A score 0 - 4 was set on 14 scales (organ- systems) for all pts. Total score (0 - 56) = Sum of score for all scales. Severity Index (SI) = [total score]/[no. of scales >0]. Results: No significant correlations were found between comorbidity (CIRS-G total score / any score 3 - 4 / SI > 2) and OS, grade 3 - 4 hematological tox or neutropenic fever. Pts with any CIRS-G score 3 - 4 (n=179) reported poorer QoL - but not significantly different mean change of QoL - than other pts during therapy. Pts ≥75 years (n=76) had more comorbidity - median total score 8 vs 6 (Mann-Whitney; p=.001), median no. of scales >0 4.5 vs 3.0 (M-W; p=.001), SI >2 (20% vs 13%, Fischers exact test; p=.15), any score 3–4 (54% vs 42%, Fischers; p=.055). Median OS (7.1 vs 7.3 months, log-rank; p=.99), hematological tox and QoL was similar as for younger pts. Conclusions: No significant correlations were found between comorbidity and OS, tox or impact of chemotherapy on QoL. More comorbidity in pts ≥75 years did not result in worse OS, tox or QoL. Comorbidity should not necessarily prevent otherwise fit pts with advanced NSCLC from receiving chemotherapy. No significant financial relationships to disclose.
Patients as partners in managing chronic disease
Authors: H. Holman
Journal: BMJ (2000)

General practice p 550 Education and debate p 569

When acute disease was the primary cause of illness patients were generally inexperienced and passive recipients of medical care. Now that chronic disease has become the principal medical problem the patient must become a partner in the process, contributing at almost every decision or action level. This is not just because patients deserve to be partners in their own health care (which, of course, they do) but also because health care can be delivered more effectively and efficiently if patients are full partners in the process.

Today in the United States chronic disease is the major cause of disability, is the main reason why people seek health care, and consumes 70% of healthcare spending. The differences between acute and chronic diseases are seen in the box on the BMJ 's website. With acute disease, the treatment aims at return to normal. With chronic disease, the patient's life is irreversibly changed. Neither the disease nor its consequences are static. They interact to create illness patterns requiring continuous and complex management. Furthermore, variations in patterns of illness and treatments …
Explaining, not just predicting, drives interest in personal genomics
Authors: Susanne F. Meisel, Deanna Alexis Carere, Jane Wardle, Sarah S. Kalia, Tanya A. Moreno, Joanna L. Mountain, J. Scott Roberts, Robert C. Green
Journal: Genome Medicine (2015)

There is a widespread assumption that risk prediction is the major driver of customer interest in personal genomic testing (PGT). However, some customers may also be motivated by finding out whether their existing diseases have a genetic etiology. We evaluated the impact of an existing medical diagnosis on customer interest in condition-specific results from PGT. Using a prospective online survey of PGT customers, we measured customer interest prior to receiving PGT results for 11 health conditions, and examined the association between interest and personal medical history of these conditions using logistic regression. We analyzed data from 1,538 PGT customers, mean age 48.7 years, 61 % women, 90 % White, and 47 % college educated. The proportion of customers who were 'very interested' in condition-specific PGT varied considerably, from 28 % for ulcerative colitis to 68% for heart disease. After adjusting for demographic and personal characteristics including family history, having a diagnosis of the condition itself was significantly associated with interest in genetic testing for risk of that condition, with odds ratios ranging from 2.07 (95 % CI 1.28-3.37) for diabetes to 19.99 (95 % CI 4.57-87.35) for multiple sclerosis. PGT customers are particularly interested in genetic markers for their existing medical conditions, suggesting that the value of genetic testing is not only predictive, but also explanatory.
Prognostic value of the expression of p53, bcl-2, and bax oncoproteins, and neovascularization in patients with radically resected non-small-cell lung cancer.
Authors: R M Apolinario, P van der Valk, J S de Jong, W Deville, J van Ark-Otte, A M Dingemans, J C van Mourik, P E Postmus, H M Pinedo, G Giaccone
Journal: Journal of Clinical Oncology (1997)

PURPOSE To assess the prognostic value of p53, bcl-2, bax, and neovascularization in radically resected non-small-cell lung cancer (NSCLC) patients. PATIENTS AND METHODS Tumors from 116 patients were assessed by immunohistochemistry for expression of p53 (DO7 and PAb1081), bcl-2, and the quantification of microvessel density (CD-31). In addition, the expression of bax was assessed in 61 stage I tumors. The median levels of expression of each marker were used as cutoff points. RESULTS p53 was not correlated to any patient or tumor characteristic, whereas bcl-2 showed higher expression in squamous cell carcinomas (P &lt; .001). bax expression was significantly related with male sex (P = .006) and adenocarcinoma type (P = .0013). p53 status, assessed with one monoclonal antibody (MoAb), was not predictive for survival; however, the combination of staining results obtained with two MoAbs identified the DO7-/PAb1801+ tumors as those with the worst prognosis. bcl-2 expression was associated with longer survival in stage I patients (P = .0169). The combined group expressing p53+(PAb1801)/bcl-2- had the worst survival in stage I patients (P = .034) and in the whole series in comparison with the other combinations of the two oncoproteins. bax expression alone had no influence on survival of stage I patients, but patients with bax+/bcl-2- tumors had the worst prognosis (P = .02 in comparison with bax+/bcl-2+). Tumor neovascularization was not related with other factors, and patients with CD-31+ tumors had a shorter survival duration than those with CD-31- tumors only in stage II (P = .0283). By multivariate analysis including all patients, the presence of p53+/ bcl-2- tumor expression and large tumor diameter (&gt; or = 4cm) were independent prognostic factors for shorter survival duration. For stage I, only the presence of bax+/ bcl-2- tumor expression had a significant negative influence on survival. CONCLUSION The interaction and the regulation of new biologic markers, such as those involved in the apoptotic pathway, are complex. Combinations of the expression of several of them may give more valuable information than the study of just one. Prognostic influence of p53 staining varied depending on the choice of antibody and the combination of bcl-2- together with p53+ (PAb1801) or with bax+ had the worst influence on survival for patients with stage I NSCLC.
Renal and hepatic concentrations of platinum: relationship to cisplatin time, dose, and nephrotoxicity.
Authors: D J Stewart, N Z Mikhael, A A Nanji, R C Nair, S Kacew, K Howard, W Hirte, J A Maroun
Journal: Journal of Clinical Oncology (1985)

Autopsy tissues were obtained from 30 patients who had received cisplatin antemortem; the tissues were assayed for platinum by flameless atomic absorption spectrometry. Patients with antemortem evidence of renal toxicity had higher renal cortical platinum concentrations than did patients without evidence of kidney damage. In addition, patients with nephrotoxicity were more likely than patients without toxicity to have renal cortical platinum concentrations that were higher than renal medullary platinum concentrations. Overall, the two variables most closely associated with an increase in serum creatinine with treatment were renal cortical platinum concentration (P less than .02) and cumulative dose of cisplatin (P less than .05). These two variables were important independently of one another. Renal cortex platinum concentrations correlated inversely with time from last treatment until death, whereas hepatic platinum concentrations did not. In contrast, hepatic platinum concentrations correlated with dose of cisplatin while renal platinum concentrations did not. Our results suggest the following: (1) cisplatin-induced renal toxicity is tissue-platinum-concentration dependent and cisplatin-dose dependent; and (2) cisplatin may be handled differently at the molecular level in liver and kidney.
Goethe's Ottilie: An early 19th century description of anorexia nervosa
Authors: S Bhanji, F E F Jolles, R A S Jolles
Journal: Journal of the Royal Society of Medicine (1990)

The view that the prevalence of anorexia nervosa is influenced by social attitudes and customs is a popular one. Unfortunately the scarcity of medical accounts prior to the later decades of the last century make it difficult if not impossible to estimate the prevalence of anorexia nervosa at various periods in history. The authors present the history of one of Goethe's literary heroines and suggest that similar studies could throw some light on the epidemiology of anorexia nervosa in the past.
The phylogenetic affinities of the chaetognaths: a molecular analysis.
Authors: M J Telford, P W Holland
Journal: Molecular Biology and Evolution (1993)

The chaetognaths, or arrowworms, constitute a small and enigmatic phylum of marine invertebrates whose phylogenetic affinities have long been uncertain. A popular hypothesis is that the chaetognaths are the sister group of the major deuterostome phyla: chordates, hemichordates, and echinoderms. Here we attempt to determine the affinities of the chaetognaths by using molecular sequence data. We describe the isolation and nucleotide sequence determination of 18S ribosomal DNA from one species of chaetognath and one acanthocephalan. Extensive phylogenetic analyses employing a suite of phylogenetic reconstruction methods (maximum parsimony, maximum likelihood, evolutionary parsimony, and two distance methods) suggest that the hypothesized relationship between chaetognaths and the deuterostomes is incorrect. In contrast, we propose that the lineage leading to the chaetognaths arose prior to the advent of the coelomate metazoa.
An Ambystoma mexicanum EST sequencing project: analysis of 17,352 expressed sequence tags from embryonic and regenerating blastema cDNA libraries.
Authors: Bianca Habermann, Anne-Gaelle Bebin, Stephan Herklotz, Michael Volkmer, Kay Eckelt, Kerstin Pehlke, Hans Henning Epperlein, Hans Konrad Schackert, Glenis Wiebe, Elly M Tanaka
Journal: Genome biology (2004)

Abstract Background The ambystomatid salamander, Ambystoma mexicanum (axolotl), is an important model organism in evolutionary and regeneration research but relatively little sequence information has so far been available. This is a major limitation for molecular studies on caudate development, regeneration and evolution. To address this lack of sequence information we have generated an expressed sequence tag (EST) database for A. mexicanum . Results Two cDNA libraries, one made from stage 18-22 embryos and the other from day-6 regenerating tail blastemas, generated 17,352 sequences. From the sequenced ESTs, 6,377 contigs were assembled that probably represent 25% of the expressed genes in this organism. Sequence comparison revealed significant homology to entries in the NCBI non-redundant database. Further examination of this gene set revealed the presence of genes involved in important cell and developmental processes, including cell proliferation, cell differentiation and cell-cell communication. On the basis of these data, we have performed phylogenetic analysis of key cell-cycle regulators. Interestingly, while cell-cycle proteins such as the cyclin B family display expected evolutionary relationships, the cyclin-dependent kinase inhibitor 1 gene family shows an unusual evolutionary behavior among the amphibians. Conclusions Our analysis reveals the importance of a comprehensive sequence set from a representative of the Caudata and illustrates that the EST sequence database is a rich source of molecular, developmental and regeneration studies. To aid in data mining, the ESTs have been organized into an easily searchable database that is freely available online.