tbuckley/cabot-search huggingface dataset:
Efficacy of quinolone prophylaxis in neutropenic cancer patients: a meta-analysis.
Authors: E A Engels, J Lau, M Barza
Journal: Journal of Clinical Oncology (1998)

PURPOSE To perform a meta-analysis to estimate the efficacy of quinolone antibiotics in preventing infections, fevers, and deaths among cancer patients neutropenic following chemotherapy. METHODS We searched MEDLINE to identify randomized trials of quinolone prophylaxis, controlled either with no prophylaxis or trimethoprim/sulfamethoxazole (TMS) prophylaxis. We pooled relative risks for outcomes using a random-effects model. RESULTS Eighteen trials with 1,408 subjects were included. Compared with no prophylaxis, quinolones significantly reduced the incidence of gram-negative bacterial infections (relative risk, 0.21; 95% confidence interval [CI], 0.12 to 0.37), microbiologically documented infections (0.65; 0.50 to 0.85), total infections (0.54; 0.31 to 0.95), and fevers (0.85; 0.73 to 0.99). Quinolone prophylaxis did not alter the incidence of gram-positive bacterial, fungal, or clinically documented infections, or infection-related deaths. Results were similar for trials that used TMS as the control regimen. Among those who received quinolones, the incidence of infections due to quinolone-resistant organisms was 3.0% (95% CI, 1.7% to 5.2%) for gram-negative species and 9.4% (95% CI, 5.3% to 16.3%) for gram-positive species. Based on limited data, the incidence of quinolone-resistant infections was not higher among quinolone recipients than controls. With fever as outcome, blinded trials found quinolones less efficacious than did unblinded trials. CONCLUSION Quinolone prophylaxis substantially reduces the incidence of various infection-related outcomes, but not deaths, in these patients. Although this reduction in infections may translate into a decrease in morbidity, the reduction in fevers (and by extension, use of empiric antibiotics) appears small, and blinded trials provided less evidence for benefit than unblinded trials. Quinolone-resistant infections are uncommon, but continued vigilance is warranted.
The effect of reducing breath holding time to assess diffusion capacity
Authors: Elsa Magro, Barry Kenedy, Sophie Crinion, Orla Cotter, David Curran, Terry O'Connor
Journal: European Respiratory Journal (2012)

The single breath method to measure diffusion capacity requires a subject to inspire a gas mixture followed by a 10 ± 2 second breath hold. However, dyspnoea may preclude measurement in patients with advanced pulmonary disease. We sought to determine if breath hold time reduction had a significant effect on measured D L CO values.  Forced spirometry and CO-diffusion by the single breath method were performed in duplicate with breath-holding for 10 ± 2 seconds, 8 ± 2 seconds and 6 ± 2 seconds in 30 controls (FEV 1  107 ± 12.04% predicted), 30 severe COPD patients (FEV 1  37.2 ± 7.92% predicted), and 30 patients with interstitial lung disease (ILD) (FEV 1  69.5 ± 17.61% predicted).  There was no significant difference between DL CO (SB) and DL CO (VA) measured at 10, 8 and 6 seconds in the control (p=0.4431) and ILD groups (p=0.5915). However, there was a significant difference between DL CO (SB) (p=0.0003) and DL CO (VA) (p=0.0183) measured at 10, 8 and 6 seconds in the COPD group.  In the presence of severe airway obstruction the DL CO  decreases with breath hold time reduction. However, in healthy controls and patients with ILD, there was no significant change in the DL CO  when breath hold time is reduced from 10 to 6 seconds. This could allow for a reduction in breath hold time when measuring the DL CO  in patients with advanced ILD who are unable to breath hold for 10 seconds.
Abstract LB-087: A facilitative role for caspase 3 in promoting genetic instability and carcinogenesis
Authors: XINJIAN LIU, Fang Li, Chuan-yuan Li
Journal: Cancer Research (2015)

Abstract Apoptosis and apoptotic caspases are generally considered tumor-suppressive since there are involved in the elimination of unwanted or damaged cells. However, the relationship between caspases and carcinogenesis has not been thoroughly examined. In this study, we sought to determine the role of caspase 3 in chemical- and radiation-induced genetic instability and carcinogenesis. By use of a non-invasive caspase 3 reporter, we found that that a significant fraction of mammalian cells treated with ionizing radiation could survive, despite caspase 3 activation. Moreover, this sublethal activation of caspase 3 promoted persistent DNA damage, chromosome aberrations and oncogenic transformation. In addition, chemically-induced skin carcinogenesis was significantly reduced in mice genetically deficient in caspase 3. We provided strong evidence that activated caspase 3 can indeed promote oncogenic transformation in human cells and in mice by inducing persistent genetic instability. Since a wide array of environmental and endogenous stressors can trigger caspase 3 activation, our findings suggest that rather than acting as a broad inhibitor of carcinogenesis, caspase 3 activation may contribute to genome instability and play a pivotal role in tumor formation following damage. Citation Format: XINJIAN LIU, Fang Li, Chuan-yuan Li. A facilitative role for caspase 3 in promoting genetic instability and carcinogenesis. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr LB-087. doi:10.1158/1538-7445.AM2015-LB-087
Asthma and allergies among children in West and East Germany: a comparison between Munster and Greifswald using the ISAAC phase I protocol. International Study of Asthma and Allergies in Childhood
Authors: H Duhme, SK Weiland, P Rudolph, A Wienke, A Kramer, U Keil
Journal: European Respiratory Journal (1998)

The study aim was to compare the prevalence of asthma, rhinitis and eczema in children living in Munster, western Germany, and Greifswald, eastern Germany, and to investigate associations of several characteristics and exposures with atopic disease symptoms. In 1994 and 1995, questionnaire information was gathered on 5-8 yr old children (n=3,741 in Munster and n=2,857 in Greifswald) and 12-15 yr olds (n=4,003 and n= 3,153, respectively) using the phase I protocol of the International Study of Asthma and Allergies in Childhood (ISAAC). The 12 month period prevalences of reported atopic disease symptoms in 5-8 yr olds were generally higher in Munster than in Greifswald, whereas only a few prevalence differences were observed in 12-15 yr olds. In both age groups the reported lifetime prevalences of asthma, hay fever and eczema were lower in Greifswald. Indoor exposures such as wood or coal heating and feather bedding were negatively associated with symptoms, whereas exposures such as truck traffic in a residential street or active smoking were positively associated with symptoms. Wood or coal heating could partly explain the prevalence difference of allergic rhinitis symptoms among 5-8 yr olds between Munster and Greifswald. The findings provide additional evidence for a role of several characteristics and exposures as potential determinants of asthma and allergies in children.
Minimizing Hypoglycemia in Diabetes
Authors: S.A. Amiel, P. Aschner, B. Childs, P.E. Cryer, B.E. de Galan, S.R. Heller, B.M. Frier, L. Gonder-Frederick, T. Jones, K. Khunti, L.A. Leiter, Y Luo, R. Vigersky, S. Zoungas
Journal: Diabetes Care (2015)

Hypoglycemia caused by treatment with a sulfonylurea, a glinide, or insulin coupled with compromised defenses against the resulting falling plasma glucose concentrations is a problem for many people with diabetes. It is often recurrent, causes significant morbidity and occasional mortality, limits maintenance of euglycemia, and impairs physiological and behavioral defenses against subsequent hypoglycemia. Minimizing hypoglycemia includes acknowledging the problem; considering each risk factor; and applying the principles of intensive glycemic therapy, including drug selection and selective application of diabetes treatment technologies. For diabetes health-care providers treating most people with diabetes who are at risk for or are suffering from iatrogenic hypoglycemia, these principles include selecting appropriate individualized glycemic goals and providing structured patient education to reduce the incidence of hypoglycemia. This is typically combined with short-term scrupulous avoidance of hypoglycemia, which often will reverse impaired awareness of hypoglycemia. Clearly, the risk of hypoglycemia is modifiable.
Direct identification of pathogens from positive blood cultures using matrix-assisted laser desorption-ionization time-of-flight mass spectrometry
Authors: B. Rodríguez-Sánchez, C. Sánchez-Carrillo, A. Ruiz, M. Marín, E. Cercenado, M. Rodríguez-Créixems, E. Bouza
Journal: Clinical Microbiology and Infection (2013)
The combined therapy of HGF and G-CSF for pulmonary hypertension in rats
Authors: Yinghua Guo, Longxiang Su, Yinghui Li, Na Guo, Changting Liu
Journal: European Respiratory Journal (2012)

Introduction:  Despite advances in therapy of PAH, the treatment and prognosis remain poor.  Objectives:  This study was to investigate whether expression of HGF through the transplantation of genetically modified MSCs combined with G-CSF could offer therapeutic benefit.  Methods:  Three weeks after monocrotaline, SD rats were randomly divided into PAH (n=10), MSCs (transplantation of 5×10 6  MSC transfected with an empty adenovirus vector,n=10), HGF (transplantation of 5×10 6  MSCs transfected with Ad-HGF,n=10), G-CSF group (100μg/kg daily for 5 days,n=10),and HGF+G-CSF group (transplantation of 5×10 6  MSCs transfected with Ad-HGF and G-CSF, 100μg/kg daily for 5 days,n=10). Three weeks later, hemodynamic, histomorphology, endothelial and angiogenesis function were detected, involving serum levels of TGF-β, ET-1 and protein level of VCAM-1and MMP-9.  Results:  Compared with HGF, G-CSF and PAH group, HGF and HGF+G-CSF group have significantly less right ventricular hypertrophy, PASP and mPAP (p Conclusion:  Transplanted HGF-MSCs combined with G-CSF could offer synergistic therapeutic benefit for the treatment of pulmonary hypertension. This study illustrate mechanisms underlying the synergistic effect of G-CSF and HGF combination.
Rehabilitation of patients with breast cancer with lung post-beam injuries
Authors: Tatiana Grushina, Fedor Mukharlyamov, Marina Sycheva
Journal: European Respiratory Journal (2013)

Purpose. Assessment of medical rehabilitation of patients with breast cancer with post-beam injuries of lungs. Material and methods. 92 patients with primary breast cancer, earlier transferred the combined treatment - surgery and remote beam therapy, were observed: 36 patients with beam bronchitis (BB), 47 - beam pneumonitis (BP), 9 - beam fibrosis (BF). 25 patients the magnetotherapy, 48 patients - magneto-and aerosoltherapy, 19 patients - drugs were carried out. Results. Magnetotherapy at patients with BB authentically increased indicators of VC, PEF, FEF75, approaching them to the normal; at patients with BP - authentically increased indicators of VC, FVC, PEF, FEF75, and MVV; at patients with BF the insignificant increase in indicators of VC, PEF, FEF75,50,25 was noted. As a result magneto-and aerosoltherapy at patients with BB also increased all main indicators, but only VC authentically increased at decrease in ERV; at patients with BP VC, FVC authentically increased; at patients with BF the increase in VC, FVC, PEF, FEF75 and MVV were noted. As a result of drug treatment all the indicators changed not authentically. Conclusions. Magnetotherapy authentically reduces restrictive violations, improves indicators of passability of bronchial tubes as small and average (approaching them to normal), and large (restoring them completely). The magnetotherapy in combination with an aerosoltherapy increases the vital capacity of lungs.
Compliance for domiciliary NIV in Indian patient's “issues and practices”
Authors: Mir Shad Ali, Deepak Talwar
Journal: European Respiratory Journal (2014)

INTRODUCTION:Patients with Respiratory Failure are using domiciliary NIV worldwide. However,issues faced by patient's affecting compliance are not being explored in India and we looked into these aspects prospectively.

OBJECTIVES:To study issues related to compliance in domiciliary NIV use by Indian patients.

METHODS:65 patients using domiciliary NIV after discharge from hospital during OPD follow up were asked regarding various aspects of compliance to PAP therapy in ethics approved pre-structured performa and data downloaded from machine regarding usage in each patient.Result were recorded and analyzed.

RESULTS: Two third participants using NIV at home were males and 31 patients 47.7%were using it for more than 2yrs with19 patients 29.2% using it for less than 3 months. Only 12 patients 18.5% were using nasal mask while rest all preferred oro-nasal masks.Re-titration of pressures in lab was required in 78.5% cases. Only 15.3% used humidifier,though dryness of mouth was complained by 38.4% of patients.Data showed that 50% used it for ≥6 hrs daily and for >70% days of month. Two patients complained of uncomfortable pressures,60% of patients admitted no problems when not using machine, but 79.5% of them continued to use, being advised by physician. About 20% changed machines and 16.9% changed masks, but mask related problems were encountered in 64.6%. Although, NIV was given for respiratory failure,but 40% patients reported improved sleep quality and 15.4% had improved breathing. Only 18.5% patients data was downloaded from machine to check compliance

CONCLUSION: Domiciliary NIV compliance is poor in Indian patients (50%). Repeated compliance checks and advise by the physician is effective in improving usage.
Reliability and validity of the Functional Assessment of Cancer Therapy-melanoma (FACT-M)
Authors: J. N. Cormier, K. Webster, D. Cella, M. I. Ross, J. E. Gershenwald, J. E. Lee, P. F. Mansfield, K. B. Kim, L. H. Camacho, J. L. Palmer
Journal: Journal of Clinical Oncology (2007)

8554 Background: Our group has developed a disease-specific module for the Functional Assessment of Cancer Therapy (FACT) instrument to assess quality of life (QOL) in melanoma patients. The purpose of this study was to assess the reliability and validity of the melanoma subscale (MS) and melanoma surgery subscales (MSS) as well as the total FACT-M, which includes the FACT combined with the MS and MSS. Methods: 273 melanoma patients (stages I-IV) attending an outpatient melanoma clinic completed a battery of questionnaires at baseline assessment. The scores from the MS, MSS, and total FACT-M were compared to patient performance status (ECOG and Karnofsky scales), disease stage, treatment status, and other instruments with related domains including the Profile of Mood States, Marlowe-Crowne Social Desirability Scale, and the EORTC Quality of Life Questionnaire - melanoma module. Patients were assessed 1 week after baseline to assess test-retest reliability, and 163 patients completed assessments at 3 months to evaluate the responsiveness to change in performance status. Results: Internal consistency and test-retest reliability for the MS (Cronbach's a = 0.85, r = 0.81), MSS (a = 0.85, r = 0.82), and the total FACT-M (a = 0.95, r = 0.90) were excellent. Overall, the scales correlated with other measures and correlations were in the hypothesized direction. As predicted, FACT-M, MS, and MSS scores were lower for patients with advanced (stage III/IV) melanoma, patients with poor performance status, and patients who were receiving active treatment. In addition, total FACT-M, MS, and MSS scores were highly sensitive to changes in performance status (p = 0.0012, 0.0004, and 0.0006, respectively). Conclusions: The FACT-M is a reliable and valid QOL assessment tool for patients with melanoma. This disease-specific instrument should be utilized for melanoma QOL assessment in clinical trials. No significant financial relationships to disclose.
Attachment Disorders in Infancy and Early Childhood: A Preliminary Investigation of Diagnostic Criteria
Authors: Neil W. Boris, Charles H. Zeanah, Julie A. Larrieu, Michael S. Scheeringa, Sheryl S. Heller
Journal: American Journal of Psychiatry (1998)

OBJECTIVE: The primary purpose of this study was to compare the reliability of differing sets of criteria for attachment disorders by using a retrospective case review. METHOD: Forty-eight consecutive clinical case summaries from an infant behavior clinic were reviewed by four experienced clinicians. Attachment disorders were coded as present or absent by using competing criteria and were scored by using a continuous scale of relationship functioning. RESULTS: The reliability of alternative criteria was acceptable, but the reliability of DSM-IV criteria in diagnosing attachment disorders was marginal. Preliminary validity for the criteria was demonstrated by the fact that more severe relationship disturbances were seen in infants diagnosed with attachment disorders than in infants diagnosed with other disorders. CONCLUSIONS: Standardized assessments of at-risk populations should be used to replicate these preliminary results; revision of DSM-IV criteria may be necessary to obtain adequate reliability for diagnosing attachment disorders. (Am J Psychiatry 1998; 155:295–297)
Late-breaking abstract: Improvements in compliance of resuscitation bundles and achievement of end points after an educational program on the management of severe sepsis and septic shock
Authors: Yousnag Ko, So Yeon Lim, Gee Young Suh, Kyeongman Jeon
Journal: European Respiratory Journal (2011)

Purpose: The objectives of this study were to determine whether an educational program could improve compliance with resuscitation bundles and the outcomes of patients with severe sepsis or septic shock and to evaluate which resuscitation bundle end points were associated with in-hospital mortality.

Materials and methods: This was a retrospective observational study of 366 patients with severe sepsis or septic shock who presented to the emergency department between May 2007 and July 2009. Compliance with resuscitation bundles and achievement of the corresponding end points were compared before and after the three-month educational program.

Results: Compliance with central line insertion and monitoring of central venous pressure (CVP) (29% vs. 67%, p < 0.001) and central venous oxygen saturation (ScvO2) (25% vs. 68%, p < 0.001) was significantly improved after the educational program. The achievement of target ScvO2 within the first six hours was significantly improved (62% vs. 88%, p < 0.001). In-hospital mortality was independently associated with adequate fluid challenge (OR, 0.161; 95% CI, 0.046 – 0.559) and the achievement of target mean arterial pressure (MAP) (OR 0.056; 95% CI, 0.008 – 0.384) and ScvO2 (OR, 0.251; 95% CI, 0.072 – 0.875) among the five sepsis resuscitation bundles.

Conclusion: An educational program can improve compliance with resuscitation bundles and achievement of their corresponding end points.
Sentinel Lymph Node Biopsy for Melanoma: Controversy Despite Widespread Agreement
Authors: Kelly M. McMasters, Douglas S. Reintgen, Merrick I. Ross, Jeffrey E. Gershenwald, Michael J. Edwards, Arthur Sober, Neil Fenske, Frank Glass, Charles M. Balch, Daniel G. Coit
Journal: Journal of Clinical Oncology (2001)

ABSTRACT: Although sentinel lymph node (SLN) biopsy for melanoma has been adopted throughout the United States and abroad as a standard method of determining the pathologic status of the regional lymph nodes, some controversy still exists regarding the validity and utility of this procedure. SLN biopsy is a minimally invasive procedure, performed on an outpatient basis at the time of wide local excision of the melanoma, with little morbidity. Numerous studies have documented the accuracy of this procedure for identifying nodal metastases. There are four major reasons to perform SLN biopsy. First, SLN biopsy improves the accuracy of staging and provides valuable prognostic information for patients and physicians to guide subsequent treatment decisions. Second, SLN biopsy facilitates early therapeutic lymph node dissection for those patients with nodal metastases. Third, SLN biopsy identifies patients who are candidates for adjuvant therapy with interferon alfa-2b. Fourth, SLN biopsy identifies homogeneous patient populations for entry onto clinical trials of novel adjuvant therapy agents. Overall, the benefit of accurate nodal staging obtained by SLN biopsy far outweighs the risks and has important implications for patient management.
Of White Coats and StethoscopesON THE COVER1999 Frank Netter Arts Contest for Medical StudentsSerpents, Staffs, and the Emblems of MedicineAesculapius: A Modern TaleThe White Coat: Why not Follow Suit?Rejuvenating the Symbols of Medicine
Authors: Mark D. Hiatt
Journal: JAMA (1999)

A WHITE COAT. THE COUNTRY DOCTOR’S BLACK BAG. A STETHOSCOPE. A snake-entwined staff. The oath of Hippocrates. The clinical acumen of Osler and the compassionate service of Schweitzer. These are the symbols and personifications of our chosen profession. One symbol of medicine since antiquity has been the Aesculapian staff. A glance through this journal will uncover the staff in the American Medical Association’s emblem, depicting a snake coiled around the rough, knotty staff of the Greek physician Aesculapius. In this issue of MSJAMA, Nathan W. Williams explores the connection between snakes and the art of healing across cultures; Judith Anne Stanton introduces us to Aesculapius. Williams reveals that the serpent can represent the forces of both healing and destruction. Stanton demonstrates that society’s alternating praise and distrust of the medical profession have been present throughout time and suggests that such ambivalence will continue. Valerie A. Jones turns her attention to another Greek healer, Hippocrates, who bestowed on modern medicine a legacy of ethical thought embodied in his famous oath. This pledge has become part of a new ceremony that Jones describes in her discussion of a second inherited symbol of the profession—the physician’s white coat. Timothy Lahey, MD, argues that we must preserve the purity of the meaning behind such symbols as the white coat by always acting in the best interest of our patients. By exploring the symbols that form and influence the culture of medicine, we hope to come closer to the heart of what it means to be a physician.
Studies in Porphyria
Authors: Shigeru Sassa, Gregory L. Zalar, Attallah Kappas
Journal: Journal of Clinical Investigation (1978)

A 50% reduction in the activity of uroporphyrinogen-I (URO) synthase in liver, erythrocytes, and cultured skin fibroblasts characterizes all patients with clinically active acute intermittent porphyria (AIP). The same enzyme defect has also been demonstrated in the erythrocytes and skin fibroblasts of completely latent gene carriers of this disorder and presumably exists in the liver as well.