tbuckley/cabot-search huggingface dataset:
Low expectations of pain relief encourage persistence of poor standards
Authors: M. R Gabrielczyk
Journal: BMJ (1995)

patients' satisfaction but, more importantly, outcome.Indeed, anaesthetists and surgeons may also attach greater importance to pain relief and, in particular, regional anaesthesia if the promising results of recent research are borne out by larger controlled studies.'If a combination of new surgical techniques, high quality analgesia, and aggressive rehabilitation can reduce the mean length of stay after major surgery by half, then both providers and purchasers should be interested in the role of regional analgesia in the outcome of surgery.This will require a great change in clinicians' attitudes to postoperative care and an injection of new moneys in the short term.Whether either of these developments occurs remains to be seen.
Should patients with active tuberculosis be routinely screened for chronic viral hepatitis
Authors: J.L. Potter, Z.O. Babiker, H. Kunst, G.R. Foster, V.L.C. White
Journal: European Respiratory Journal (2014)

Background:  Screening for viral hepatitis is not routinely recommended in patients diagnosed with tuberculosis (TB). Co-infection with hepatitis B (HBV) or C (HCV) viruses is a risk factor for hepatotoxicity in patients receiving anti-tuberculous therapy. TB, HBV, and HCV are major imported infections in the United Kingdom.   Objectives:  We determined the prevalence of HBV and HCV among new cases of active tuberculosis in our treatment centre in East London.   Methods:  Patients diagnosed with active TB during 2013 were identified using the London TB register. Data on demographic characteristics, HBV surface antigen (HBsAg), HCV antibody, and human immunodeficiency virus (HIV) were retrospectively analysed.   Results:  In total, 213 new cases of active tuberculosis were notified during 2013. The median age was 35 years (range: 16-90). Males accounted for 61% of our cohort. The ethnic origins of the 81.22% foreign born patients were Bangladeshi 48, Indian 36, Pakistani 28, Black African 31, White 8, Chinese 2, Other 20, and Unknown 1. Overall, 154 patients were screened for HBV, 162 for HCV, and 202 for HIV. HBsAg was detected in 1.95% while HCV antibody was detected in 1.24%. All patients infected with HBV or HCV were foreign born. Patients infected with HIV accounted for 9.78% of our cohort and the proportions of those co-infected with HBV or HCV were 12.5% and 5.88% respectively.   Conclusions:  Routine screening for HBV and HCV on an opt-out basis would be justified in our setting given the high proportion of both foreign born and HIV-infected patients. Further research into the magnitude of HBV/HCV co-infection with active or latent TB and the cost-effectiveness of routine screening is needed.
Autoimmune hepatitis/sclerosing cholangitis overlap syndrome in childhood: A 16-year prospective study
Authors: G Gregorio
Journal: Hepatology (2001)

To investigate whether sclerosing cholangitis with an autoimmune serology characteristic of autoimmune hepatitis (AIH) and AIH are distinct entities, we studied 55 consecutive children with clinical and/or biochemical evidence of liver disease and circulating antinuclear (ANA), anti-smooth muscle (SMA), and/or liver-kidney-microsomal type 1 (LKM1) autoantibodies. They underwent liver biopsy, direct cholangiography, sigmoidoscopy, and rectal biopsy at presentation. Twenty-eight were diagnosed as AIH in the absence and 27 autoimmune sclerosing cholangitis (ASC) in the presence of radiological features of cholangiopathy. Twenty-six ASC and 20 AIH had ANA and/or SMA; 1 ASC and 8 AIH LKM1 autoantibody. Similarities between the 2 conditions included most clinical and biochemical parameters and a lower frequency of HLA DR4. Inflammatory bowel disease and histological biliary changes were more common in ASC; coagulopathy, hypoalbuminemia, lymphocytic periportal hepatitis, and HLA DR3 were more common in AIH. Histological biliary changes were observed in 65% of ASC and 31% of AIH patients. Eighty-nine percent responded to immunosuppression. Follow-up liver biopsies from 17 ASC and 18 AIH patients had similarly reduced inflammatory activity and no progression to cirrhosis. Sixteen follow-up cholangiograms from AIH patients and 9 from ASC patients were unchanged, while 8 ASC patients showed a progressive cholangiopathy. One child with AIH and ulcerative colitis developed sclerosing cholangitis 8 years after presentation. At 2 to 16 years (median, 7 years) from presentation, all patients are alive, including 4 ASC patients who underwent liver transplantation. In conclusion, ASC and AIH are similarly prevalent in childhood; cholangiography is often needed to distinguish between these 2 entities, which are likely to lie within the same disease process.S
Preliminary clinical study using a multiplex real-time PCR test for the detection of bacterial and fungal DNA directly in blood
Authors: F. Wallet, S. Nseir, L. Baumann, S. Herwegh, B. Sendid, M. Boulo, M. Roussel-Delvallez, A.V. Durocher, R.J. Courcol
Journal: Clinical Microbiology and Infection (2009)
Surface Tension Forces in Sleep Apnea: The Role of a Soft Tissue Lubricant
Authors: RUZICA JOKIC, ARTUR KLIMASZEWSKI, JOSEPH MINK, MICHAEL F. FITZPATRICK
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

Upper airway obstruction in patients with sleep apnea may occur in the absence of a negative intraluminal upper airway pressure. We hypothesized that surface tension forces may play a role in the pathogenesis of obstructive sleep apnea (OSA), and that a topical soft tissue lubricant might reduce the severity of OSA. Ten male patients (age 49 ± 10 yr [mean ± SD]; body mass index [BMI] 31 ± 5 kg/m2) with OSA (apnea–hypopnea index [AHI] 17 ± 9) were studied. The arousal index was lower with the lubricant treatment than with placebo (mean difference 8; 95% CI 4 to 11 arousals/h; p = 0.001). The AHI was lower, in each of the 10 patients, on the lubricant treatment than the placebo (mean change 10, 95% CI 6 to 13; p = 0.0003). The lower AHI with lubricant as compared with placebo was present in both supine (mean difference 13; 95% CI 5 to 20; p = 0.006) and nonsupine (mean difference 6; 95% CI 0 to 12; p = 0.05) positions. There was no significant difference in sleep architecture between the lubricant and placebo treatments. Application of a topical lubricant consistently reduced the severity of OSA. This implies a pathogenetic role for surface tension forces in OSA, and a potential role for surface tension–reducing agents in the treatment of OSA.
Correlation Between Tumor Invasiveness and Content of A-Type Particles in Ehrlich Ascites Tumor: A Model of Quantitative Electron Microscopy
Authors: Toshiko Kodama, Mitsuo Kodama
Journal: JNCI Journal of the National Cancer Institute (1973)

Journal Article Correlation Between Tumor Invasiveness and Content of A-Type Particles in Ehrlich Ascites Tumor: A Model of Quantitative Electron Microscopy Get access Toshiko Kodama, Toshiko Kodama Laboratory of Chemotherapy, Aichi Cancer Center Research Institute, Nagoya, Japan Search for other works by this author on: Oxford Academic PubMed Google Scholar Mitsuo Kodama Mitsuo Kodama Laboratory of Chemotherapy, Aichi Cancer Center Research Institute, Nagoya, Japan Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 50, Issue 3, March 1973, Pages 707–712, https://doi.org/10.1093/jnci/50.3.707 Published: 01 March 1973 Article history Received: 05 July 1972 Revision received: 05 October 1972 Accepted: 14 November 1972 Published: 01 March 1973
Characteristics of the new cases of the tuberculosis according to the method of screening
Authors: Alina Malic, Lilia Tacu
Journal: European Respiratory Journal (2013)

Background. Difficult epidemiological situation, maintance of the worthy social-economic conditions, unfavourable impact of the HIV/SIDA make the investigation of the results in the treatment of the new cases of tuberculosis according to the method of screening necessary.  Objective. Study of the risc factors in the new cases of the tuberculosis according to the method of the investigation.  Methods and materials. There were studied the investigation sheets of 495 patients with the new cases of tuberculosis, revealed in 2011 in the Pneumophthisiology Hospital, Chishinau. The patients were divided into two groups: group I – 207 (41, 8 %), detected by active method, and group II – 288 (58,2%) patients- by passive method.  Results. Limited process was found at 163 (78,7%) patients from group I, extensive process predominated at the ones from group II- 209 (72,6%). At the majority of patients 143 (69,1%)from group I, microscopy and sputum culture were negative, but almost at the half of the patients 126 (43,8%) from group II microscopy and sputum culture were positive. The success of the treatment is high 184 (88,9%) in group I und unsatisfactory in group II - 137 (47,6%).  Conclusions. At passive detecting, extensive forms, forms with bacilli excretion, grave, with complications, with the great number of risk factors (2-3) are revealed and it adversely affects the results of the treatment. The success of the treatment is high in group I und unsatisfactory in group II. To increase the effectiveness of the treatment of the new cases of tuberculosis it is necessary to improve the management of the detecting of the tuberculosis patients.
Cancer-Related Fatigue: Prevalence of Proposed Diagnostic Criteria in a United States Sample of Cancer Survivors
Authors: David Cella, Kimberly Davis, William Breitbart, Gregory Curt
Journal: Journal of Clinical Oncology (2001)

To evaluate the proposed cancer-related fatigue (CRF) diagnostic criteria in a sample of cancer survivors. More accurate prevalence estimates of CRF may result in improved diagnosis and management of one of the most common symptoms associated with cancer and its treatment.Three hundred seventy-nine individuals who had been treated with chemotherapy, either alone or in combination with radiation therapy, were surveyed. Patients were asked background questions about their current condition, their medical history, and the frequency of fatigue during their chemotherapy. Additionally, patients who reported experiencing fatigue at least a few days each month during treatment were asked a series of questions about the impact of fatigue on their daily functioning.One hundred forty-one (37%) individuals reported at least 2 weeks of fatigue in the previous month. Of the respondents who had received their last treatment more than 5 years ago, 33% still reported at least a 2-week period of fatigue in the month before the interview. Evaluation of the proposed criteria revealed that 17% of respondents met at least two criteria for CRF.The prevalence of diagnosable CRF in the individuals in this sample, most of whom had completed treatment more than 1 year ago, was 17%-lower than expected based on previous reports that have used less-strict criteria. In a sizable number of people, CRF persists well beyond active treatment and should be a focus of intervention. Although they will require replication in other samples and clinical validation, these formal diagnostic criteria can be a step toward common language and a better understanding of the severity range and persistence of CRF.
QuantiFERON-TB Gold in-tube test for diagnosis of latent tuberculosis (TB) infection among immunocompromised adults
Authors: Monica Sane Schepisi, Mario Pasquale Parracino, Alessia Mammone, Rita Bellagamba, Carmen Pinetti, Stefania Cicalini, Alessandro Sampaolesi, Adriana Ammassari, Delia Goletti, Enrico Girardi
Journal: European Respiratory Journal (2013)

Background Current evidence suggests that IGRAs perform similarly to the tuberculin skin test at identifying HIV-infected individuals who could benefit from LTBI treatment.

Aims To evaluate the use of an IGRA in screening for latent TB in a cohort of patients with HIV infection.

Methods . A retrospective study of one time use of an interferon-gamma release assay - QuantiFERON-TB Gold In-Tube (QFT-GIT; Cellestis, Carnegie, Australia)- was carried out in Rome, Italy. 606 infected patients with HIV-AIDS attending the HIV outpatient clinic at the National Institute for Infectious Diseases from January 2006 until December 2012 were enrolled in the study, excluding those being investigated or treated for active TB. Subsequent incidence of active TB was ascertained until February 2013.

Results. 

QFT-GIT was positive in 64 cases (10.6%) and indeterminate in 28 cases (4.6%).In multivariable analysis, factors associated with being QFT-GIT positive were CD4 cells count > 200 (OR 3.1; p=0.01), being born in a country of TB incidence rate > 100/100,000 (OR 6.9; p <0.001) or between 15 and 99/100,000 (OR 3.7; p<0.001), male gender (OR 2.4 p=0.03) and age (0.6 OR for each 10 year increase, p=0,008). Two of the 64 positive patients (3.1%) and 2 among the 514 negative (0.4%) developed active TB over a median follow-up time of 3.1 years.

Conclusions. The probability of being QFT-GIT positive among persons with HIV in a low prevalence country was associated with CD4, country of birth and age. Positivity appears to be associated with an increased risk of developing active disease.
A phase I toxicity, pharmacology, and dosimetry trial of monoclonal antibody OKB7 in patients with non-Hodgkin's lymphoma: effects of tumor burden and antigen expression.
Authors: D A Scheinberg, D J Straus, S D Yeh, C Divgi, P Garin-Chesa, M Graham, K Pentlow, D Coit, H F Oettgen, L J Old
Journal: Journal of Clinical Oncology (1990)

Eighteen patients with relapsed non-Hodgkin's lymphoma (NHL) were infused with escalating doses of monoclonal antibody (mAb) OKB7, trace-labeled with iodine-131 (131I), in order to study toxicity, pharmacology, antibody localization, and dosimetry of radioiodine. OKB7 is a noncytotoxic mouse immunoglobulin G2b (IgG2b) mAb reactive with B cells and most B-cell NHL. Three patients each were treated at six dose levels ranging from 0.1 mg to 40 mg. All patients had radionuclide imaging and counting daily, had serial blood sampling to study pharmacokinetics, human antimouse antibody (HAMA), and circulating antigen, and had a biopsy of accessible lymphoma to determine delivery of isotope to tumors and assess the effect of tumor antigen expression on mAb delivery. Bone marrow biopsies were also done in the majority of patients. There was no toxicity. Serum clearance showed a median early phase half-life of 1.9 hours and a later phase half-life of 21.7 hours. Median total body clearance half-life was 22 hours. Pharmacokinetics were not dose-related. HAMA was detected in five patients. Circulating blocking antigen was detected in the serum of four patients, but at levels that were of pharmacologic consequence only in one. Biopsied tumor tissue from five patients did not express OKB7 antigen. No significant uptake of antibody was seen in these tumor sites. Mean total uptake of isotope into lymphoma measured in biopsies correlated linearly over the 400-fold increase in injected mAb dose. However, the percent of injected dose found per gram of tumor was unrelated to dose, but correlated inversely with tumor burden. In two patients with minimal tumor burden, 1.0 mg and 5.0 mg doses of OKB7 resulted in tumor to body radioisotope dose ratios of 22 and 7, which would theoretically permit tolerable delivery of 4,400 and 1,400 rads to these tumors, respectively, if OKB7 were conjugated with higher doses of 131I.
PD-1 Blockade in Tumors with Mismatch-Repair Deficiency
Authors: Dung T. Le, Jennifer N. Uram, Hao Wang, Bjarne R. Bartlett, Holly Kemberling, Aleksandra D. Eyring, Andrew D. Skora, Brandon S. Luber, Nilofer S. Azad, Dan Laheru, Barbara Biedrzycki, Ross C. Donehower, Atif Zaheer, George A. Fisher, Todd S. Crocenzi, James J. Lee, Steven M. Duffy, Richard M. Goldberg, Albert de la Chapelle, Minori Koshiji, Feriyl Bhaijee, Thomas Huebner, Ralph H. Hruban, Laura D. Wood, Nathan Cuka, Drew M. Pardoll, Nickolas Papadopoulos, Kenneth W. Kinzler, Shibin Zhou, Toby C. Cornish, Janis M. Taube, Robert A. Anders, James R. Eshleman, Bert Vogelstein, Luis A. Diaz
Journal: New England Journal of Medicine (2015)

Somatic mutations have the potential to encode "non-self" immunogenic antigens. We hypothesized that tumors with a large number of somatic mutations due to mismatch-repair defects may be susceptible to immune checkpoint blockade.We conducted a phase 2 study to evaluate the clinical activity of pembrolizumab, an anti-programmed death 1 immune checkpoint inhibitor, in 41 patients with progressive metastatic carcinoma with or without mismatch-repair deficiency. Pembrolizumab was administered intravenously at a dose of 10 mg per kilogram of body weight every 14 days in patients with mismatch repair-deficient colorectal cancers, patients with mismatch repair-proficient colorectal cancers, and patients with mismatch repair-deficient cancers that were not colorectal. The coprimary end points were the immune-related objective response rate and the 20-week immune-related progression-free survival rate.The immune-related objective response rate and immune-related progression-free survival rate were 40% (4 of 10 patients) and 78% (7 of 9 patients), respectively, for mismatch repair-deficient colorectal cancers and 0% (0 of 18 patients) and 11% (2 of 18 patients) for mismatch repair-proficient colorectal cancers. The median progression-free survival and overall survival were not reached in the cohort with mismatch repair-deficient colorectal cancer but were 2.2 and 5.0 months, respectively, in the cohort with mismatch repair-proficient colorectal cancer (hazard ratio for disease progression or death, 0.10 [P<0.001], and hazard ratio for death, 0.22 [P=0.05]). Patients with mismatch repair-deficient noncolorectal cancer had responses similar to those of patients with mismatch repair-deficient colorectal cancer (immune-related objective response rate, 71% [5 of 7 patients]; immune-related progression-free survival rate, 67% [4 of 6 patients]). Whole-exome sequencing revealed a mean of 1782 somatic mutations per tumor in mismatch repair-deficient tumors, as compared with 73 in mismatch repair-proficient tumors (P=0.007), and high somatic mutation loads were associated with prolonged progression-free survival (P=0.02).This study showed that mismatch-repair status predicted clinical benefit of immune checkpoint blockade with pembrolizumab. (Funded by Johns Hopkins University and others; ClinicalTrials.gov number, NCT01876511.).
Gastro-oesophageal reflux disease, upper gastro-intestinal motility and autonomic function in adult asthmatics
Authors: D. Lakmali Amarasiri, Arunasalam Pathmeswaran, H. Janaka de Silva, Channa D. Ranasinha
Journal: European Respiratory Journal (2011)

Introduction: Asthmatics have increased prevalence of gastro-oesophageal reflux disease (GORD). Oesophageal hypomotility, delayed gastric emptying (GE) and autonomic hypofunction increase GOR. Our aim was to study the relationship of GOR with autonomic function, oesophageal motility and GE in adult asthmatics.

Methods: Thirty consecutive mild, stable asthmatics (American Thoracic Society criteria) and 30 healthy volunteers underwent stationary oesophageal manometry, GE by real-time ultrasonography and autonomic function testing (cardiovascular reflex tests). GORD was assessed by symptom assessment and 24-hour pH monitoring.

Results: The asthmatics (40% male; mean age 34.8 years (SD 8.4)) and controls (50% male; mean age 30.9 years (SD 7.7)) were comparable. Twenty two (73.3%) asthmatics had increased reflux on pH monitoring. Asthmatics with higher GOR symptom scores had lesser peristaltic contractions (p=0.032), prolonged acid contact times (p<0.001), delayed GE (p=0.097) and decreased antral motility (p<0.001) than those with lower scores and controls. 69% of asthmatics showed hypervagal activity, rest had normal autonomic function, none had a hyperadrenergic response. There was no association between vagal function, oesophageal or gastric motility parameters in asthmatics.

Conclusions: A cohort of mild, stable adult asthmatics had increased GOR, decreased oesophageal motility and delayed GE. This was not associated with autonomic hypofunction, but with a hypervagal response. Our findings support the hypothesis that vagal hyperreactivity induced acid secretion leads to a reflex decrease in gastric motility, inducing GOR and secondary reduction in oesophageal motility.
Restrictive treatment policy for pulmonary tuberculosis in a low prevalence country
Authors: J Norregaard, G Grode, K Viskum
Journal: European Respiratory Journal (1993)

In Denmark, treatment of tuberculosis is generally recommended only if the diagnosis is confirmed bacteriologically. This policy may cause a delay in treatment, if the patients are smear negative. We investigated the duration of the treatment delay, and whether the delay would cause any serious health problems for the individual, or risk of contact infections, in a retrospective examination of 324 cases of pulmonary tuberculosis. The mean treatment delay was longer in the oldest age group. Concerning death due to delay, we found no risk for those patients who were not weakened by other disease or old age. Only 11 patients (3.6%) over the age 10 yrs were treated without bacteriological confirmation (1% for Danes). The infection risk from the smear negative but culture positive patients was minimal, as only one subject was definitely infected from a smear negative patient. However, a risk of transmission exists from patients who are initially culture negative but later become smear positive. In conclusion, we find the epidemiological and individual risks sufficiently low to continue our rather restrictive treatment policy.
Action of Cytotoxic Agents on the Erythroid System of the Mouse
Authors: P. R. Twentyman, N. M. Blackett
Journal: JNCI Journal of the National Cancer Institute (1970)

Dose-response curves were obtained for the effects of 5 cytotoxic agents on the repopulating and maturing cells of the erythroid system in the mouse. The curves were determined both in normal animals and animals in which cellular proliferation had been modified by 2 weeks' exposure to continuous γ-irradiation. It was found that X rays and dimethylmyleran had similar effects on maturing and repopulating cells, and continuous irradiation made no difference in the response. Methotrexate, vinblastine, and actinomycin D, however, had considerably greater effect on the maturing than on the repopulating cells in normal mice, although, in irradiated animals, the sensitivity of repopulating cells was considerably increased. This difference in the sensitivity of the two stages of maturation appears to be largely a consequence of their different rates of proliferation. The possible implications of these results for chemotherapy are discussed with particular reference to regimens of fractionation and drug combinations.