tbuckley/cabot-search huggingface dataset:
Changes in Biliary Lipid Concentrations in Bile Duct Obstruction: An Experimental Study
Authors: Xu Guorong, C J C Kirk, A W Goode
Journal: Journal of the Royal Society of Medicine (1986)

Changes in biliary concentrations of bile acids, phospholipids and cholesterol and biliary pressures were measured in dogs. These parameters were studied during 7-day periods of partial biliary obstruction, of varying degrees, and after 24-hour and 48-hour periods of complete obstruction. The samples were obtained via an exteriorized but intact enterohepatic circulation allowing the introduction of varying degrees of obstruction and bile sampling. Biliary obstruction reduced the concentration of all biliary lipids especially when the obstruction produced pressures in excess of 75% of the maximum biliary secretion pressure. Only immediately after the release of a 48-hour period of complete obstruction did the risk of cholesterol supersaturation of bile occur. However, at that time there was a greatly reduced concentration of lipids in the bile and the amount of cholesterol that could potentially have precipitated was very small. It is suggested that this supersaturation would not play a significant role in the formation of gallstones.
Prevalence of atypical bacterial pathogens in hospitalized patients with community-acquired pneumonia
Authors: I. Gerogianni, C. Neocleous, K. Gourgoulianis, E. Petinaki
Journal: European Respiratory Journal (2013)

Introduction:  The prevalence of atypical pathogens in the pathogenesis of community acquired pneumonia(CAP) in adults varies between studies, whereas there is no such data concerning their role in Greece.   Aims and objectives:  To evaluate whether the causative agents of CAP patients correlated to atypical pathogens permits us to continue with local treatment guidelines including beta-lactams plus macrolides or quinolone monotherapy.   Methods:  Between 2007- 2009, a total of 375 adult patients with CAP were admitted to the emergency department of our hospital. 215 (57.3%) patients were classified as having moderate to high mortality risk according to the patients Outcome Research Team (PORT) pneumonia severity index (PSI) and CURB-65 severity score system and were hospitalized. Among these patients, 152 and 63 were male and female respectively and the mean age was 61 years old (18-80 years). Seventy eight out of the 215 hospitalized patients (36.6%), were found to be positive for any CAP related bacteria. Typical pathogens were detected in 52 out 78 patients (66.6%), while atypical pathogens were found in the remaining 26 patients (33.4%). No significance differences in PSI and CURB-65 scores were observed between patients with typical and atypical pathogens. The three most frequent pathogens was  S. pneumoniae, C. pneumoniae M. pneumoniae . None patient has been found with two pathogens.   Conclusions:  According to our data, the causative agents of one third of CAP patients was correlated to atypical pathogens, and permits us to continue with local treatment guidelines.
Nasal balloon shows promise for otitis media with effusion:
Authors: Jocalyn Clark
Journal: BMJ (2015)

A simple procedure with a nasal balloon can reduce the effect of hearing loss and avoid the unnecessary and ineffective use of antibiotics in children who have otitis media with effusion, a study published in the Canadian Medical Association Journal has found.1

Otitis media with effusion, also known as “glue ear,” can affect hearing development, speech acquisition, and performance at school. In the United Kingdom more than 200 000 children are seen with the condition each year in primary care.

The authors, led by Ian Williamson, of the University of Southampton, UK, …
Tackling fear about exercise produces long term benefit in chronic fatigue syndrome:
Authors: Ingrid Torjesen
Journal: BMJ (2015)

Two treatments for chronic fatigue syndrome that tackle patients’ fears about exercise and that had already been shown to improve fatigue and physical function after a year continue to offer long term benefits in terms of fatigue reduction, a follow-up study of patients involved in the PACE trial has shown.

However, the follow-up findings were complicated by the fact that some of the patients who were randomly assigned to specific treatments in the PACE trial went on to undergo additional treatments.

In 2011 the PACE trial found that patients randomised to receive cognitive behavioural therapy or graded exercise therapy in addition to specialist medical care showed less fatigue and improved physical functioning after one year when compared with patients who were randomised to receive adaptive pacing therapy or specialist medical care alone.1 In graded exercise therapy the patient undertakes a personalised and gradually increasing exercise programme delivered by a physiotherapist, whereas in adaptive pacing therapy the patient adapts …
Clinical outcomes in patients with ST-segment elevation myocardial infarction treated with everolimus-eluting stents versus bare-metal stents (EXAMINATION): 5-year results of a randomised trial
Authors: Manel Sabaté, Salvatore Brugaletta, Angel Cequier, Andrés Iñiguez, Antonio Serra, Pilar Jiménez-Quevedo, Vicente Mainar, Gianluca Campo, Maurizio Tespili, Peter den Heijer, Armando Bethencourt, Nicolás Vazquez, Gerrit Anne van Es, Bianca Backx, Marco Valgimigli, Patrick W Serruys
Journal: The Lancet (2015)
Impact of African immigration on drug resistance to Mycobacterium tuberculosis in Portugal
Authors: Carina Gaspar, Carlos Gomes, Nelson Diogo
Journal: European Respiratory Journal (2011)

Background: Several works pointed immigration as a risk factor for drug resistance in Western countries. In Portugal immigration is responsible for 13,6% of tuberculosis cases, 75% of those cases being originated from Sub-Saharan African countries.

Aim: To evaluate the role of immigration from African countries in drug resistance to Mycobacterium tuberculosis (Mt) in Portugal.

Methods: Comparative retrospective study between African immigrants (I) and native (N) patients with positive-culture to Mt and who realized susceptibility tests, admitted in a Pneumology unit from 2000 to 2010. Clinical-demographic characteristics, aetiopathogenic factors, drug resistance profiles and inhospital outcomes were evaluated.

Results: 1328 patients were enrolled, 240 (18,1%) being immigrants, most of them from Portuguese spoken countries. Statistically significant differences were found on the following variables: drug addition (I:6,7% vs N:28,8%); WHO classification; number of previous treatments (I:0,21 vs N:0,37); duration of previous treatments (I:0,88 vs N:1,83); inhospital mortality (I:4,2% vs N:8,5%).The variables with predictive value for resistance in this population were HIV co-infection, number of previous treatments and chronic TB infection.The total incidence of drug resistance was similar in both groups (I:20,8% vs N:21,0%), but secondary resistances were less frequent in immigrants (I:5,4% vs N:9,7%).

Conclusion: African immigration was not associated with increased prevalence of drug resistance to Mt. These findings can be explained by the reduced access to antituberculosis drugs in Sub-Saharan countries.
Obesity Hypoventilation Syndrome
Authors: Amanda J. Piper, Ronald R. Grunstein
Journal: American Journal of Respiratory and Critical Care Medicine (2010)

Section:ChooseTop of pageAbstract <<WHICH PATIENTS ARE LIKELY...CLINICAL CONSEQUENCES OF ...SCREENING AND IDENTIFYING...WHAT IS THE BEST THERAPY ...CONCLUSIONS AND FUTURE RE...ReferencesCITING ARTICLES
High prevalence of altered cardiac repolarization in patients with COPD
Authors: Noriane Sievi, Christian Clarenbach, Giovanni Camen, Valentina Rossi, Arnoldus van Gestel, Malcolm Kohler
Journal: European Respiratory Journal (2013)

Background: Chronic obstructive pulmonary disease (COPD) is associated with an increased risk of cardiovascular morbidity and mortality. Previous studies suggested that patients with COPD have an increased risk of sudden cardiac death (SCD). In the general population altered cardiac repolarization has been identified as independent risk factor for SCD. However, the prevalence of altered cardiac repolarization has not been defined in patients with COPD.  Methods: In 91 COPD patients (GOLD I-IV, mean age 62.0 (SD 7.1)), 31 control subjects matched for age, cardiovascular risk factors (Pocock score) and medication, and 41 healthy subjects, measures of cardiac repolarization (QT interval, Tpeak-to-Tend (TpTe) interval) were derived from 12-lead electrocardiography. The prevalence rates of heart rate corrected QT (QTc) >450ms and TpTe (TpTec) >110ms were determined to assess the number of subjects at risk for SCD.  Results: QTc was significantly longer in COPD patients compared to matched controls and healthy subjects respectively (438.0 ± 29.6 vs. 425.7 ± 27.9 ms, p=0.046 and vs. 405.4 ± 20.7 ms, p  Conclusion: A third of all COPD patients seem to have disturbed cardiac repolarization. Thus disturbed cardiac repolarization may be a mechanism contributing to the risk of SCD in patients with COPD.
Multicenter Randomized Trial Evaluating the Efficacy of Cilostazol on Ischemic Vascular Complications After Drug-Eluting Stent Implantation for Coronary Heart Disease
Authors: Jung-Won Suh, Seung-Pyo Lee, Kyung-Woo Park, Hae-Young Lee, Hyun-Jae Kang, Bon-Kwon Koo, Young-Seok Cho, Tae-Jin Youn, In-Ho Chae, Dong-Ju Choi, Seung-Woon Rha, Jang-Ho Bae, Taek-Geun Kwon, Jang-Whan Bae, Myeong-Chan Cho, Hyo-Soo Kim
Journal: Journal of the American College of Cardiology (2011)
The aetiology of pharyngotonsillitis in adolescents and adults – Fusobacterium necrophorum is commonly found
Authors: K. Hedin, L. Bieber, M. Lindh, M. Sundqvist
Journal: Clinical Microbiology and Infection (2014)

Sore throat is common in primary healthcare. Aetiological studies have focused on the presence of a limited number of pathogens. The aim of the present study was to investigate the presence of a wide range of bacteria and viruses, including Fusobacterium necrophorum, in patients with pharyngotonsillitis and in asymptomatic controls. A prospective case control study was performed in primary healthcare in Kronoberg County, Sweden. Patients (n=220) aged 15 to 45 years with a suspected acute pharyngotonsillitis, and controls (n=128), were included. Nasopharyngeal and throat swabs were analysed for β-hemolytic streptococci, F. necrophorum, Mycoplasma pneumoniae, and Chlamydophila pneumoniae, and 13 respiratory viruses. Serum samples were analysed for antibodies to Epstein-Barr virus. The patient history and symptoms, including Centor score, were analysed in relation to pathogens. In 155/220 (70.5%) of the patients, as compared to 26/128 (20.3%) of the controls (p <0.001), at least one microorganism was found. Group A streptococci, F. necrophorum, and influenza B virus were the three most common findings, and all significantly more common in patients than in controls (p <0.001, p 0.001, and p 0.002, respectively). Patients with F. necrophorum only (n=14) displayed a lower Centor score than patients with Group A streptococcus only (n=46), but a higher score than patients with influenza B, other viruses, or no potential pathogen (Kruskal-Wallis p <0.001). A pathogen was detected in 70% of the patients, displaying a wide range of pathogens contributing to the aetiology of pharyngotonsillitis. This study supports F. necrophorum as one of the pathogens to be considered in the aetiology of pharyngotonsillitis.
Some Factors Affecting Nerve Regeneration in Relation to Radiotherapy
Authors: Michael Stearns
Journal: Journal of the Royal Society of Medicine (1983)

The effect of delay and irradiation, both separately and combined, on regeneration of rat sciatic nerve was evaluated in adult Wistar rats. Those animals which had received irradiation at some stage fared significantly worse than those which had immediate division and reanastomosis of the sciatic nerve without irradiation. The possible relevance of these findings to nerve regeneration in patients treated by surgery and radiotherapy for parotid cancer is discussed.
A randomized phase II trial of a new anticoagulant, apixaban, in metastatic cancer
Authors: M. N. Levine, D. Deitchman, J. Julian, H. Liebman, C. Escalante, M. C. O'Brien, L. Ramirez, L. Weise-Kelly, S. Solymoss
Journal: Journal of Clinical Oncology (2009)

e20514 Background: Cancer patients receiving chemotherapy, biologic, and molecular targeted therapies are at increased risk of venous thromboembolism (VTE). Currently available anticoagulants (ACs) are not well suited to prevent VTE in such patients. Vitamin K antagonist oral ACs require frequent lab monitoring and low molecular weight heparins require daily subcutaneous injection. There is concern for bleeding with ACs. Apixaban (A) is a new antithrombotic agent which inhibits activated coagulation Factor X, is taken orally, and does not require lab monitoring. Trials to prevent post-operative VTE in orthopedic surgery showed that A was effective and safe. We wanted to assess the feasibility of A in cancer. Methods: In a randomized phase II trial, patients with metastatic cancer on 1 st or 2 nd line chemotherapy received study drug once daily for 12 weeks; either 5, 10 or 20 mg of A, or placebo. The primary outcome measure was the proportion of patients remaining free of major bleeding (MB), clinically relevant non-major bleeding (CRNMB), VTE, and grade ≥3 adverse events considered to be probably/definitely related to study drug (AE*). After 125 patients were recruited, the sponsor eliminated further randomization to the 10 and 20 mg arms, to add experience with the 5 mg dose currently under evaluation for VTE prevention in other conditions. Data on the first 125 patients are reported. Results: The study population was 50% male; 88% had ECOG performance status 0 or 1. The most common cancers were breast, colon, pancreas, and myeloma. 23% had liver metastases. Approximately 80% of A patients completed 12 weeks of treatment. The numbers of patients with events were: Conclusions: Apixiban was well tolerated in patients with advanced cancer on chemotherapy. Major bleeding, thrombosis, and drug-related SAEs were very low. These results support further study of A in phase III trials for VTE prevention in cancer patients. [Table: see text] [Table: see text]
Respiratory symptoms associated with cannabis and tobacco use in a north Edinburgh primary care population
Authors: Jim McKenzie, Lorraine Copeland, John MacLeod, Reid Peter
Journal: European Respiratory Journal (2011)

Cannabis is usually inhaled and is most commonly taken in a joint containing both cannabis and tobacco. We are conducting a cross-sectional study of cannabis and tobacco smokers recruited from a primary care population in North Edinburgh. One aim of this study is to investigate whether cannabis smokers report a greater number of respiratory symptoms compared with an age and sex matched group of regular tobacco smokers. The quantification of cannabis and tobacco use is assessed by the Avon Longitudinal Study of Parents and Children and the reported respiratory symptoms by NHANES III.  We have recruited 119 subjects (Group 1) who smoke tobacco as either branded cigarettes and/or roll-your-own tobacco cigarettes) and 117 subjects (Group 2) who smoke cannabis. Tobacco smokers are generally older median age men = 47 (range 24-73) and women 42.50 (range 22-63) than the cannabis smokers median age men 41 (range 22-63) and for women median 38.5 (range 22-58). The majority (>90%) of cannabis smokers employ unfiltered single skinned joints with 8% using bongs and a minority using other methods. The predominant form of cannabis used is resin (78%) with 22% smoking grass. Unadjusted data suggest that the prevalence of respiratory symptoms are greater at all ages and in both sexes for persons using cannabis and tobacco compared with persons using tobacco only. In North Edinburgh the majority of cannabis users smoke cannabis resin rolled with tobacco in a single skinned unfiltered joint. Respiratory symptoms typical of chronic obstructive pulmonary disease are more frequently reported by cannabis smokers than tobacco smokers and women report a greater number of symptoms than men.
Skin equivalents for studying the secrets of skin: from development to disease
Authors: J.A. Hardman
Journal: British Journal of Dermatology (2015)

Journal Article Skin equivalents for studying the secrets of skin: from development to disease Get access J.A. Hardman J.A. Hardman Faculty of Medical and Human Sciences Centre for Dermatology Research Institute of Inflammation and Repair University of Manchester Manchester U.K https://orcid.org/0000-0002-1653-7908 Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 173, Issue 2, 1 August 2015, Pages 320–321, https://doi.org/10.1111/bjd.13970 Published: 01 August 2015
More US men with low risk prostate cancer opt for watchful waiting
Authors: Michael McCarthy
Journal: BMJ (2015)

<h3>Background</h3> The aim of preparticipation cardiac screening of athletes is to detect cardiovascular disease at an early stage to prevent sudden cardiac death and sudden cardiac arrest. Few studies focus on consequences of false negative findings. <h3>Objective</h3> The main objective of this study was to identify cardiovascular incidents in a cohort of male professional football players with negative screening results. <h3>Design</h3> Retrospective eight years follow-up study. <h3>Setting</h3> Follow-up of systematic preparticipation cardiac screening completed prior to the 2008 football season of 604 players cleared for full participation in the Norwegian professional leagues, including player and family history, electrocardiography and echocardiography. <h3>Patients (or Participants)</h3> All players who suffered severe cardiovascular incidents during 8 years of follow-up. <h3>Interventions (or Assessment of Risk Factors)</h3> Media search with key words football and cardiovascular incidents in Norway from January 1st 2008 until February 13th 2016. We collected medical records from players with disease and compared preparticipation cardiac screening results with outcome. <h3>Main Outcome Measurements</h3> Players from the original cohort who suffered sudden cardiac death or arrest, angina pectoris or myocardial infarction, transitory ischemic attack, cerebral haemorrhage or infarction, atrial flutter or fibrillation, blood clot, myocarditis or pericarditis. <h3>Results</h3> Six players with negative screening results, median age 30 years (27–36), had experienced cardiovascular incidents during follow-up. Three players had suffered sudden cardiac arrest, one myocardial infarction, one transitory ischemic attack and one atrial flutter. Four of the incidents happened during or straight after a match, and one during training. <h3>Conclusions</h3> More than 1 in 100 players with negative screening results suffered severe cardiovascular incidents, included three sudden cardiac arrests, within 8 yrs of follow up. Mandatory preparticipation cardiovascular screening of professional soccer teams in Norway was not able to prevent this.
Dissemination of Chest Compression–Only Cardiopulmonary Resuscitation and Survival After Out-of-Hospital Cardiac Arrest
Authors: Taku Iwami, Tetsuhisa Kitamura, Kosuke Kiyohara, Takashi Kawamura
Journal: Circulation (2015)

Background— The best cardiopulmonary resuscitation (CPR) technique for survival after out-of-hospital cardiac arrests (OHCAs) has been intensively discussed in the recent few years. However, most analyses focused on comparison at the individual level. How well the dissemination of bystander-initiated chest compression–only CPR (CCCPR) increases survival after OHCAs at the population level remains unclear. We therefore evaluated the impact of nationwide dissemination of bystander-initiated CCCPR on survival after OHCA. Methods and Results— A nationwide, prospective, population-based, observational study covering the whole population of Japan and involving consecutive OHCA patients with resuscitation attempts was conducted from January 2005 through December 2012. The main outcome measure was 1-month survival with favorable neurological outcome. The incidence of survival with favorable neurological outcome attributed to types of bystander CPR (CCCPR and conventional CPR with rescue breathing) was estimated. Among 816 385 people experiencing OHCAs before emergency medical services arrival, 249 970 (30.6%) received CCCPR, 100 469 (12.3%) received conventional CPR, and 465 946 (57.1%) received no CPR. The proportion of OHCA patients receiving CCCPR or any CPR (either CCCPR or conventional CPR) by bystanders increased from 17.4% to 39.3% ( P for trend &lt;0.001) and from 34.6% to 47.3% ( P for trend &lt;0.001), respectively. The incidence of survival with favorable neurological outcome attributed to CCCPR per 10 million population significantly increased from 0.6 to 28.3 ( P for trend=0.010), and that by any bystander-initiated CPR significantly increased from 9.0 to 43.6 ( P for trend=0.003). Conclusion— Nationwide dissemination of CCCPR for lay-rescuers was associated with the increase in the incidence of survival with favorable neurological outcome after OHCAs in Japan.
Dealing with our losses.
Authors: B M Mount
Journal: Journal of Clinical Oncology (1986)

The repeated losses experienced by a clinical oncologist may constitute a significant source of personal stress. Studies documenting high stress levels on oncology services and the prevalence among physicians of alcoholism, cirrhosis, suicide, and marital discord lend urgency to the need to examine etiologic factors, clinical manifestations, and strategies for the management of job-related stress. Significant etiologic factors include death as an existential fact emphasizing our finite nature, the cumulative grief associated with repeated unresolved losses, the pressure of a health care system fueled by the medical information explosion, the inability to achieve the idealistic goals embraced by holistic medical care, stresses inherent in working as a "team," and an undermined context of meaning as an outcome of treatment failures. Clinical manifestations of stress are reviewed as an aid to early diagnosis. Strategies useful in the prevention and management of stress include the encouragement of increased awareness of stress in self and colleagues, the clarification of appropriate goals and priorities, encouragement of appropriate limit setting, the mobilization of collaborative input, the clarification of team roles and organizational patterns, the establishment of team support meetings and favorable working conditions, exercise, and the clarification and working through of previously unresolved personal psychodynamic issues. Differences between the work-related stress involved in clinical oncology as compared with hospice care are examined.