tbuckley/cabot-search huggingface dataset:
British Association of Dermatologists’ guidelines for the management of bullous pemphigoid 2012
Authors: V.A. Venning, K. Taghipour, M.F. Mohd Mustapa, A.S. Highet, G. Kirtschig, J.R. Hughes, J. McLelland, A.J. McDonagh, S. Punjabi, D.A. Buckley, I. Nasr, V.J. Swale, C.E. Duarte Williams, P.M. McHenry, S. Wagle, S. Amin, R. Davis, S.E. Haveron
Journal: British Journal of Dermatology (2012)
Phase I study of paclitaxel as a radiation sensitizer in the treatment of mesothelioma and non-small-cell lung cancer.
Authors: L L Herscher, S M Hahn, G Kroog, H Pass, B Temeck, B Goldspiel, J Cook, J B Mitchell, J Liebmann
Journal: Journal of Clinical Oncology (1998)

PURPOSE To determine the maximum-tolerated dose (MTD) and dose-limiting toxicities of paclitaxel with concurrent thoracic irradiation in patients with malignant pleural mesothelioma and locally advanced non-small-cell lung cancer (NSCLC) using a 120-hour continuous infusion regimen. A secondary objective was to assess the effect of paclitaxel on the cell cycle through serial tumor biopsies. PATIENTS AND METHODS Paclitaxel was administered as a 120-hour (5-day) continuous infusion repeated every 3 weeks during the course of radiation therapy. The starting dose of paclitaxel was 90 mg/m2. Doses were escalated at 15-mg/m2 increments in successive cohorts of three patients. In NSCLC patients, radiation was delivered to the primary tumor and regional lymph nodes for a total tumor dose of 6,120 cGy. In mesothelioma patients, hemithoracic irradiation was delivered as the initial treatment field with a conedown to the tumor volume for a total dose of 5,760 to 6,300 cGy. Tumor biopsies were obtained, if possible, before and during paclitaxel treatment. RESULTS Thirty patients were entered onto this study through three dose levels (from 90 mg/m2 to 120 mg/m2). The MTD was determined to be 105 mg/m2. The dose-limiting toxicity was grade 4 neutropenia (two patients). Grade 2 gastrointestinal (GI) toxicity (nausea and vomiting) was also observed at 120 mg/m2. Three of 30 patients developed a hypersensitivity reaction. Six patients had grade 2 lung injury manifested by a persistent cough that required antitussives. Five patients underwent tumor biopsies. None of the patients showed a significant block of cells in mitosis (G2/M) after paclitaxel infusion. CONCLUSION The MTD of paclitaxel, when administered as a 120-hour continuous infusion with concurrent radiotherapy, was determined to be 105 mg/m2. The dose-limiting toxicity was neutropenia. Continuous infusion paclitaxel administered with large field irradiation of the lung is well tolerated and deserves continued evaluation.
Abstract 4725: Left Ventricular Myocardium Shows Base-to-Apex Deformation Gradient during Isovolumic Relaxation Period in Healthy Subjects
Authors: Adisai Buakhamsri, Zoran B Popovic, Pascal Lim, Neil L Greenberg, James D Thomas
Journal: Circulation (2008)

Introduction: Deformation of LV myocardium during isovolumetric relaxation period (IVR) is not well described. Methods: We performed echocardiography (Vivid 7, GE Medical) in 90 healthy subjects at rest (mean age 38 ±13 years, 34 males). Standard long and short LV axis views were acquired with high frame rate (65–100 fps) and used for strain rate (Sr) measurement by speckle tracking (EchoPac PC) in three directions: longitudinal (SrL), circumferential (SrC) and radial (SrR). Segmental Sr curves were the average Sr in each LV levels, i.e. base (B), mid (M) and apex (A) and normalized by R-R interval duration (Panel A and B). We then calculated Sr gradients during IVR as maximal instantaneous difference between apex-to-base or mid-to-base LV Sr (Sr(A-B) or Sr(M-B), Panel C). Pulsed wave Doppler flow profiles were used to determine cardiac intervals. Results: SrL(A-B), SrC(A-B) and SrR(A-B) were 0.53 ±0.43, 0.67 ±0.46, −1.89± 1.52 s-1. SrL(M-B), SrC(M-B) and SrR(M-B) were 0.37±0.15, 0.5±0.34 and −2.14±1.4 s-1. Both types of gradient were identified for all strains (p&lt;0.001 vs. zero), and were also different from each other (p&lt;0.001, Sr(A-B) vs. Sr (M-B) for similar strain). The gradients were driven by faster relaxation in apical and mid LV segment and brief shortening in basal segment (see Figure inset). Conclusions: Differential deformation of LV exists during IVR. This deformation difference in the base to apex direction may facilitate changes in LV geometry that result in rapid intra-cavitary pressure reduction.
Anemia in COPD patients in Spain: A systematic review
Authors: Jesus Diez-Manglano, Jose Barquero-Romero
Journal: European Respiratory Journal (2011)

Objective: To determine the prevalence of anemia in COPD patients in Spain and the consequences of it.

Material and methods: We have conducted an electronic search in PubMed and Embase, a hand-made search of the main Spanish journals of COPD (Archivos de Bronconeumologia, Revista Clinica Espanola and Medicina Clinica) and its references and a hand-made search from 2005 to 2010 of proceedings of annual congresses of European Respiratory Society, Spanish Society of Respiratory Pathology (SEPAR) and Spanish Society of Internal Medicine.

Results: We have obtained 11 studies, 2 journal papers and 9 congress abstracts. 7 studies were conducted in Internal Medicine departments, 3 in Pneumology departments and one in both. All studies used spirometric criteria for COPD diagnose. Six studies defined anemia with WHO criteria and there was significant heterogeneity in exclusion criteria. The studies included 1669 patients, with a mean age of 74.4 years and 537 (32.2%) had anemia. Patients of Internal medicine departments were older (75.8 vs 70.7 years) There was no difference in prevalence by study department (Pneumology 30.2%, Internal Medicine 32.8%; p=0.32) but prevalence was lower with different of WHO diagnose criteria (24.5% vs 34.9%, p=0.001). Anemia was not associated with readmission or mortality after three months in one study but there was association with readmission in the next year in one study and with one year-mortality in two studies. In one study anemia was associated with mortality during a median follow up of 531 days.

Conclusion: A third of Spanish patients with COPD had anemia. Anemia is associated with more long-term readmissions and mortality.
Role of transthoracic sonography in diagnosis and follow up of community acquired pneumonia in emergency department
Authors: Gamal Agmy, Yasser Ahmed
Journal: European Respiratory Journal (2013)

Background: The diagnosis of community-acquired pneumonia (CAP) is based mainly on history and physical examination. However, in severe cases a further evaluation may be necessary.  The aim was to define the accuracy of transthoracic ultrasound (TUS) in the diagnosis and follow up of CAP.  Setting: The emergency department (ED) of Assiut University Hospital.  Methods: A prospective study included 284 patients with suspected CAP. During admission to ED, history, examination, laboratory testing, TUS, chest radiograph (CXR) in two planes and CT scan were performed. In patients with CAP, follow-up was arranged.  Results: CAP was confirmed in 260 patients. For CAP TUS revealed a sensitivity of 97% and 98% for specificity, positive predictive or negative predictive value. In patients with CAP,TUS demonstrated subpleural consolidation in 85%, air bronchogram, in 82%, B lines in 70% and pleural effusion in 50% of cases. CXR clarified CAP with sensitivity of 85%, specificity of 94%, positive predictive value of 85% and negative predictive value of 90%.CXR missed pleural effusion in 15% of cases. During follow-up, C-reactive protein decreased from 157 mg/dL to 5 mg/dL at days 10 to 15 as did signs of CAP.  Conclusions: TUS is a simple and reliable imaging tool, superior to CXR in identifying CAP in ED. During the course of CAP, TUS allows a radiation-free follow-up.  Clinical Implication: TUS is an excellent imaging tool in diagnosis and follow up of CAP with excellent sensitivity and specificity exceeding that of CXR. It has the advantages of simplicity, loss of ionizing radiation, bedside availability and both diagnosis and treatment can be established immediately.
Cardiological management
Authors: Peter Henriksen, Nicholas Boon
Journal: BMJ (2006)

Mrs Patel's case shows the challenge of assessing young patients with possible cardiac chest pain.1 The location of her chest discomfort may be considered atypical, but Marin Marinovic correctly notes that the close relation with exertion raises the possibility that it is cardiac in origin.2 Overlap in the location of symptoms between patients presenting with cardiac and non-cardiac chest pain makes discrimination difficult using this factor alone.3

Several respondents on bmj.com flag the possibilities of pulmonary embolism or pneumothorax as causes of chest pain in the postnatal period.2 However, the absence of dyspnoea and the non-pleuritic nature of the pain points away from these diagnoses. Acute coronary syndromes do occur infrequently during pregnancy when a prothrombotic state and changes in haemodynamic forces can lead to occlusive coronary thrombosis or arterial dissection respectively. Mrs Patel's presentation seven months after giving birth was not so dramatic, perhaps indicating a subacute process.​process.



Figure 1

Stress echocardiography isn't widely available in the UK
Depression in medically ill hospitalized older adults: prevalence, characteristics, and course of symptoms according to six diagnostic schemes
Authors: H G Koenig, L K George, B L Peterson, C F Pieper
Journal: American Journal of Psychiatry (1997)

The purpose of this study was to examine and compare rates of depression, correlates, and course of symptoms in medically ill hospitalized elders through use of six diagnostic schemes (inclusive, etiologic, exclusive-inclusive, exclusive-etiologic, substitutive-inclusive, and substitutive-etiologic).A consecutive series of 460 cognitively unimpaired patients aged 60 or over who were admitted to the medical inpatient services of Duke Hospital underwent a structured psychiatric evaluation administered by a psychiatrist. Patients with depression were contacted by telephone at 12-week intervals after discharge to assess weekly change in depressive symptoms (median follow-up time = 47 weeks).The prevalence of major depression varied from 10% to 21% depending on diagnostic scheme; similarly, minor depression varied from 14% to 25%. Diagnostic strategy made little difference in known psychological and health characteristics of patients with depression (predictive validity) or severity of depressive symptoms (convergent validity). The diagnostic strategy that best distinguished a severe and persistent major depression was the exclusive-etiologic approach; however, this strategy missed 49% of patients with major depression identified by the inclusive approach, almost 60% of whom continued to experience persistent symptoms of depression many weeks after discharge.Diagnostic strategy affects rates of major and minor depression, with about a twofold difference between the extremes. There is little reason, however, to choose one diagnostic scheme over another in all cases. Diagnostic strategy should be chosen on the basis of the specific goals and purposes of the examiner. While the exclusive-etiologic approach identifies the most severe and persistent depressions, the inclusive approach is the most sensitive and reliable approach and is an intermediate predictor of persistent depression.
Gender difference in the perception of dyspnea in former smokers with COPD
Authors: Vladimir Koblizek, Sarka Pracharova, Petr Papousek
Journal: European Respiratory Journal (2011)

Rationale:  Considerable number of COPD patients (pts) suffers from dyspnea and exercise limitation. These symptoms are not in close relation with FEV 1  nor GOLD severity. In addition there is apparent individual susceptibility to dyspnea sensation.   Aim:  We measured dyspnea (MRC dyspnea scale) and prognostic indexes (ADO, classical BODE 2004, modified BODE 2009) of stable COPD pts and compared these parameters in male and female subgroups.   Methods:  We used data from observational crossectional assessment (Ciliary Study) of stable ex-smokers with mild (n 23), moderate (n 25), severe (n 25) and very severe (n 25) COPD. All 98 pts (79 males, 65.1 years, FEV 1  55.5% ±22.7) were randomly recruited from all our out-patients (n 620).   Results:  Severity of bronchial obstruction (FEV 1 %) was idenical in both subgroups.  The mean values of MRC in males and females subgroups were 1.84 and 2.42 respectively. The mean values of MRC were higher for women in all stages of the disease (stage I- males 1.24 and females 2.50, II- 1.41 and 2.33, III – 1.86 and 2.33, IV – 2.89 and 3.29). Inter-gender difference was statistically significant (p=0.028 chi square test). Although we did not find any significant difference between the prognostic parameters (ADO, classical and modified BODE) in males and females, women achieved a higher score in all three indexes.   Conclusion:  We confirmed gender difference in the perception of dyspnea among ex-smokers with COPD. We did not show significant gender difference in values of prognostic indexes.  Supported by Czech Ministry of Education, Youth and Sports - MSM 002 162 0820.
Effects of megakaryocyte growth and development factor on platelet production, platelet life span, and platelet function in healthy human volunteers
Authors: Laurence A. Harker, Lorin K. Roskos, Ulla M. Marzec, Richard A. Carter, Judith K. Cherry, Birgitta Sundell, Ellen N. Cheung, Dixon Terry, William Sheridan
Journal: Blood (2000)
Anticoagulation for patients with atrial fibrillation and risk factors for stroke
Authors: S. J Connolly
Journal: BMJ (2000)

<b>An electronic nose does not simply detect the concentrations of selected VOCs in the exhaled air, but verifies the cumulative signature, reflecting the overall VOC concentration. This technology is novel but promising.</b>http://ow.ly/IPCt30mbIBV
Managing cleft lip and palate
Authors: M J Timmons
Journal: BMJ (1995)

Editorial proves controversialED1ToR,-In their two year Medline search for studies on the results of cleft surgery Tony Markus and Peter Ward Booth found just one British study, and they criticise the lack of British studies.'Six studies on primary and secondary surgery and outcome analysis are noteworthy,2-7 as is a book on speech.8Citing just the Eurocleft study, which included two British centres, Markus and Ward Booth state that British results are poor.This is not true in other British studies.910The authors neglect to mention that the two centres with the best results in the Eurocleft study used different surgical techniques (none like Markus's) and high volume operators (none of them maxillofacial surgeons).On high volume operators Markus and Ward Booth are incoherent.They move from implying that specialist high volume operators are preferable to stating that high volume operators and large, centralised units do not guarantee good results, while high volume maxillofacial surgery exists in district hospitals, which are well placed to provide a comprehensive service.European countries, including Britain, have made advances in cleft surgery."Continental Europe may do it better"'-or it may not.
The interface between borderline personality disorder and affective disorder
Authors: John G. Gunderson, Glen R. Elliott
Journal: American Journal of Psychiatry (1985)

The authors review the available literature on the interface between borderline personality disorder and affective disorder. Three competing hypotheses have been offered to explain the substantial overlap between these diagnostic categories; they postulate that borderline disorder arises from affective disorder, that affective disorder arises from borderline disorder, or that the two are independent and overlap coincidentally. None of these hypotheses satisfactorily explains the existing data. The authors propose a fourth hypothesis focusing on the multiple etiologies of the signs and symptoms used to diagnose both affective and borderline disorders and suggesting that some patients in the resulting heterogeneous population have symptom clusters that fit both syndromes.
Abstract 14717: Double-blind, Randomized Comparison of Zofenopril vs. Ramipril in MI Patients Treated With ASA: The SMILE 4 Study and Subgroup Analysis
Authors: Claudio Borghi, Ettore Ambrosioni
Journal: Circulation (2011)

Background. ACE-inhibitors (ACEI's) are largely used for the treatment of patients with left ventricular dysfunction (LVD). Their efficacy has reported as unfavorably affected by the concomitant ad...
Abstract 176: Early Hyperglycemia Following Resuscitation From Cardiac Arrest Does Not Affect 72 Hour Neurologic Outcome in the Swine Model
Authors: Scott Youngquist, John P Rosborough, James T Niemann
Journal: Circulation (2010)

Background: Hyperglycemia is common following resuscitation from cardiac arrest and has been shown to be a predictor of neurologic outcome in retrospective studies. The purpose of this study was to...
Psychoactive substance use disorders in adults with attention deficit hyperactivity disorder (ADHD): effects of ADHD and psychiatric comorbidity
Authors: J Biederman, T Wilens, E Mick, S Milberger, T J Spencer, S V Faraone
Journal: American Journal of Psychiatry (1995)

The authors evaluated the association between attention deficit hyperactivity disorder (ADHD) and psychoactive substance use disorders in adults with ADHD, attending to comorbidity with mood, anxiety, and antisocial disorders. It was hypothesized that psychiatric comorbidity would be a risk factor for psychoactive substance use disorders.Findings for 120 referred adults with a clinical diagnosis of childhood-onset ADHD were compared with those for non-ADHD adult comparison subjects (N = 268). All childhood and adult diagnoses were obtained by structured psychiatric interviews for DSM-III-R.There was a significantly higher lifetime risk for psychoactive substance use disorders in the ADHD adults than in the comparison subjects (52% versus 27%). Although the two groups did not differ in the rate of alcohol use disorders, the ADHD adults had significantly higher rates of drug and drug plus alcohol use disorders than the comparison subjects. ADHD significantly increased the risk for substance use disorders independently of psychiatric comorbidity. Antisocial disorders significantly increased the risk for substance use disorders independently of ADHD status. Mood and anxiety disorders increased the risk for substance use disorders in both the ADHD and comparison subjects, but more demonstrably in the comparison subjects.Although psychiatric comorbidity increased the risk for psychoactive substance use disorders in adults with ADHD, by itself ADHD was a significant risk factor for substance use disorders. More information is needed to further delineate risk and protective factors mediating the development of substance use disorders in persons with ADHD.
MMP-3 serum levels and MMP3 -1171insA promoter polymorphism in patients with COPD
Authors: Dimo Dimov, Tanya Tacheva, Mateusz Kurzawski, Vasil Dimitrov, Marek Drozdzik, Tatyana Vlaykova
Journal: European Respiratory Journal (2014)

The aim of the current study was to elucidate the possible effect of the insertion/deletion promoter polymorphism at position -1171 in MMP3 gene (-1171 5A>6A, ) on the risk for COPD and on the serum levels of the enzyme and to explore the association of serum enzyme concentration with clinical parameters of the disease. We genotyped for MMP3 -1171insA (5A>6A) 162 patients with COPD and 172 control individuals using PCR-RFLP. The serum levels of MMP3 were measured by ELISA method. The genotype and allele frequencies of MMP3 -1171 5A>6A did not show significant differences between patients and controls (p=0.553). However, the serum levels of MMP3 were significantly higher in the patients (9.90± 7.03 ng/ml) than in controls (4.99± 3.82 ng/ml, p=0.004). The patients who carry 6A/6A genotype had higher serum MMP-3 levels than the carriers of other genotypes (6A/6A- 13.54±5.64 ng/ml vs. 5A/6A- 9.30±7.11 ng/ml, p=0.029; vs. 5A/5A- 5.20±6.07 ng/ml, p=0.001). Moreover, MMP-3 serum levels were significantly lower in patients with COPD GOLD II ( 8.41± 6.87 ng/ml) than in those with COPD GOLD III and IV (12.23± 1.41 ng/ml, p= 0,041). In addition, current (14.35±6.23 ng/ml) and ex-smokers (9.56±7.06 ng/ml) appeared to have enhanced enzyme concentration than non-smokers (7.89± 6.74, p= 0.022, ANOVA test). Based on our results we suggest that the MMP3 -1171insA promoter polymorphism does not affect the risk for COPD, but may influence the serum levels of the enzyme. Moreover, due to the obtained association of the serum MMP-3 levels with GOLD stages and smoking habits, we may propose MMP-3 as a serum biomarker for severity of the diseases and possibly to be applied for following the progression of COPD.
Personality disorder and parietal lobe dysfunction
Authors: Paul C. Horton
Journal: American Journal of Psychiatry (1976)

An inability to relate transitionally is a major feature of personality disorder. The developmental independence of transitional relatedness from verbal-symbolic growth, its orienting function, and the nature of its visual and tactile components support the conclusion that it is a function of the nondominant parietal lobe. Therefore it can be hypothesized that dysfunction of this area is the cerebral analogue of personality disorder. The fact that unawareness of illness ("anosognosia") in conjunction with grossly intact intellectual function is common to both personality disorder and minor parietal lobe dysfunction further supports this hypothesis.
A MURINE VIRUS (JHM) CAUSING DISSEMINATED ENCEPHALOMYELITIS WITH EXTENSIVE DESTRUCTION OF MYELIN
Authors: F. Sargent Cheever, Joan B. Daniels, Alwin M. Pappenheimer, Orville T. Bailey
Journal: The Journal of Experimental Medicine (1949)

The isolation of a murine virus causing disseminated encephalomyelitis accompanied by extensive destruction of myelin in the central nervous system, and focal necrosis of the liver has been described. Young mice can be infected by a number of parenteral routes. Both encephalitic and paralytic signs can be observed. After intracerebral inoculation the virus has been isolated from brain, spinal cord, liver, lung, spleen, and kidney, but not from blood or from intestinal walls and contents. Hamsters, cotton rats, and Hisaw rats can be infected by the intracerebral route. Guinea pigs and rabbits appear to be insusceptible. Attempts to infect chick embryos have so far met with failure. Under proper conditions the agent can pass through the usual bacterial filters. No inclusion bodies have been seen. No serological relationship to other neurotropic viruses has been demonstrated as yet.