tbuckley/cabot-search huggingface dataset:
A phenotype of onset of adult asthma with co-morbid rhinitis
Authors: Hiroyuki Sano, Katsuyuki Tomita, Osamu Taguchi, Kazuto Hirata, Akiko Sano, Takashi Iwanaga, Hiroaki Kume, Yuji Toda
Journal: European Respiratory Journal (2013)

Background:  Asthma is heterogeneous with respect to onset of the disease but there is limited data on the proportions of patients with varying phenotypes. We hypothesized that onset of asthma might be associated with onset of rhinitis   Methods:  A cross sectional, multicentre survey including 1,617 questionnaire responses was conducted in doctor-diagnosed asthma. The data were collected using a pre-designed structured questionnaire concerning self-reported rhinitis, and a clinical examination for atopic status. This categorization was compared to one in which patients were grouped using a K-means clustering technique with log linear modelling and cross-tabulation.   Results:  1,303 (80.6%) of the 1,617 subjects had adult asthma. The total prevalence of self-reported rhinitis was 50.3% in the adult asthmatics. This clinical categorization was validated by comparison with a categorization in which patients were grouped by unsupervised k-means cluster analysis. Seven clusters were further identified: cluster 1 (10.6%): child-onset asthma existing 14-year before rhinitis; cluster 2 (14.0%): rhinitis existing 4-year before adult-onset in their twenties; cluster 3 (15.3%): rhinitis existing 8-year before adult-onset in their forties; cluster 4 (10.4%): rhinitis existing 12-year before adult-onset in their sixties; cluster 5 (14.4%): child-onset asthma without rhinitis; cluster 6 (18.0%): adult-onset asthma in their forties without rhinitis, and cluster 7 (17.3 %): adult-onset asthma in their sixties.   Conclusion:  Patients with adult asthma show different phenotypes of the onset. This approach to categorization more appropriately reflects the likely multiple pathophysiological processes involved in adult asthma.
Well-Differentiated Neuroendocrine Tumors with a Morphologically Apparent High-Grade Component: A Pathway Distinct from Poorly Differentiated Neuroendocrine Carcinomas
Authors: Laura H. Tang, Brian R. Untch, Diane L. Reidy, Eileen O'Reilly, Deepti Dhall, Lily Jih, Olca Basturk, Peter J. Allen, David S. Klimstra
Journal: Clinical Cancer Research (2015)

Most well-differentiated neuroendocrine tumors (WD-NET) of the enteropancreatic system are low-intermediate grade (G1, G2). Elevated proliferation demonstrated by either a brisk mitotic rate (>20/10 high power fields) or high Ki-67 index (>20%) defines a group of aggressive neoplasms designated as high-grade (G3) neuroendocrine carcinoma (NEC). High-grade NEC is equated with poorly differentiated NEC (PD-NEC) and is associated with a dismal outcome. Progression of WD-NETs to a high-grade neuroendocrine neoplasm very rarely occurs and their clinicopathologic and molecular features need to be characterized.We investigated 31 cases of WD-NETs with evidence of a component of a high-grade neoplasm. The primary sites included pancreas, small bowel, bile duct, and rectum. Histopathology of the cases was retrospectively reviewed and selected IHC and gene mutation analyses performed.The high-grade component occurred either within the primary tumor (48%) or at metastatic sites (52%). The clinical presentation, radiographic features, biomarkers, and the genotype of these WD-NETs with high-grade component remained akin to those of G1-G2 WD-NETs. The median disease-specific survival (DSS) was 55 months (16-119 months), and 2-year and 5-year DSS was 88% and 49%, respectively-significantly better than that of a comparison group of true PD-NEC (DSS 11 months).Mixed grades can occur in WD-NETs, which are distinguished from PD-NECs by their unique phenotype, proliferative indices, and the genotype. This phenomenon of mixed grade in WD-NET provides additional evidence to the growing recognition that the current WHO G3 category contains both WD-NETs as well as PD-NECs.
Subclinical Thyroid Dysfunction, Cardiac Function, and the Risk of Heart Failure
Authors: Nicolas Rodondi, Douglas C. Bauer, Anne R. Cappola, Jacques Cornuz, John Robbins, Linda P. Fried, Paul W. Ladenson, Eric Vittinghoff, John S. Gottdiener, Anne B. Newman
Journal: Journal of the American College of Cardiology (2008)
Nontuberculous mycobacterial lung disease caused by Mycobacterium parascrofulaceum in an immunocompetent patient
Authors: Jae Seok Park, Wonmok Lee, Young June Jeon
Journal: European Respiratory Journal (2014)

Mycobacterium parascrofulacum , a new species of nontuberculous mycobacterium (NTM) belonging to group II, was first described in 2004. However, infection from this species is rare and infrequently reported. We report a lung disease caused by  M. parascrofluceum  in an immunocompetent patient with bronchiectasis. A 65-year-old man was referred to our hospital due to recurrent hemoptysis and sputum. A computed tomography scan of the chest showed bronchiectasis with peribronchial infiltration and centrilobular nodule in right middle lobe and left lower lobe. Nontuberculous mycobacteria were isolated twice from three expectorated sputum specimens. Both isolates were identified as  M. parascrofulaceum  by  hsp65  gene sequencing analysis. In vitro drug susceptibility tests showed that the organism was sensitive to amikacin, ciprofloxacin, clarithromycin, moxifloxacin, rifampicin, trimethoprime/sulfamethoxazole and linezolid. We consider to long-term antibiotic therapy if symptoms and chest image of the patient are aggravated. As treatment and prognosis depend on the recognition of species, identification of the pathogen was important but complex. Little information on  M. parascrofulaceum  infection or therapies for treating this organism is available. Our experience of pulmonary infection caused by  M. parascrofulaceum  was discussed here to improve the current knowledge of infection caused by this bacterium.
Frankincense and Myrrh as Remedies in Children
Authors: C A Michie, E Cooper
Journal: Journal of the Royal Society of Medicine (1991)

Two cases of therapy with frankincense and myrrh in children are presented. The long history of this unusual treatment is outlined, demonstrating that for several millenia such agents have been employed in a number of medical contexts, as well as in the perfume and incense industries. Myrrh has found recent pharmacological application in the reduction of cholesterol and triglycerides, as predicted by several traditional therapies.
Gemcitabine-capecitabine in platinum-refractory patients with thymic epithelial tumors
Authors: G. Palmieri, C. Merola, L. Petillo, G. Merola, P. Federico, D. Leopardo, M. Marino, L. Montella
Journal: Journal of Clinical Oncology (2009)

7590 Background: Platinum based combination chemotherapy is the actual standard of care for advanced and recurrent Thymic epithelial tumours-TET (thymoma and thymic carcinoma). Additional agents are needed in this setting. We have designed a pilot study, phase II multicenter, to evaluate the efficacy and safety of no tested schedule gemcitabine-capecitabine in patients refractory to platinum based chemotherapy. Methods: Eligible patients had pathologically confirmed TET and were treated with at least 2 lines of chemotherapy, one of this being a platinum based schedule. From January 2007 to September 2008 twelve pts were enrolled. Treatment Schedule: Gemcitabine 1,000 mg/m2 by 30-minute infusion on days 1 and 8 every 3 weeks plus oral capecitabine 650 mg/m2 twice daily on days 1 to 14. Response was evaluated at 3 and 6 cycles. Results: Pts Characteristics: 12 pts (7 M-5F, Median Age 51,3 yrs,range 27–76). 7 pts had received Thymectomy and 4 of this had received also surgery for metastatic disease. 5 pts have received only thymic biopsy. Performance status sec. Karnofsky was 90% (range 80–100). Site of disease: liver, lung, bone, nodal, pleural and pericardium. All pts were staged IVB sec. Masaoka. Tumors were classified by WHO classification as follows: 4-B2, 8-B2/B3. All pts were evaluated as concerns performance status and all had Karnofcky 90% (range 80–100). Sites of metastatic disease were: liver,lung,bone,nodal, pleural and pericardium. Associated paraneoplastic syndromes were: myasthenia in 7 pts, B-lymphopenia 11 pts. The minimum number of cycles administered on study was 3 (range 3–8).Among the 12 enrolled pts there were 10 objective response: 2 CR, 8 PR. 2 pts had SD. Prolonged maintenance of absence of disease was obtained in the 2 pts reporting a CR (more than 6 months in 1 patient). Treatment was well tolerated, no grade 4 toxicities was registered. Conclusions: The combination schedule gemcitabine-capecitabine have an high activity in Thymic malignancies in pts heavily pretreated with advanced recurrent TET and appears to be a safe option in platinum-refractory TET pts. This schedule must be proposed to be used also in randomized clinical trial compared with platinum based treatment. No significant financial relationships to disclose.
Folate, vitamin B12, and homocysteine in major depressive disorder
Authors: M Fava, J S Borus, J E Alpert, A A Nierenberg, J F Rosenbaum, T Bottiglieri
Journal: American Journal of Psychiatry (1997)

The authors examined the relationships between levels of three metabolites (folate, vitamin B12, and homocysteine) and both depressive subtype and response to fluoxetine treatment in depressed patients.Fluoxetine, 20 mg/day for 8 weeks, was given to 213 outpatients with major depressive disorder. At baseline, depressive subtypes were assessed, and a blood sample was collected from each patient. Serum metabolite levels were assayed. Response to treatment was determined by percentage change in score on the 17-item Hamilton Depression Rating Scale.Subjects with low folate levels were more likely to have melancholic depression and were significantly less likely to respond to fluoxetine. Homocysteine and B12 levels were not associated with depressive subtype or treatment response.Overall, the results are consistent with findings linking low folate levels to poorer response to antidepressant treatment. Folate levels might be considered in the evaluation of depressed patients who do not respond to antidepressant treatment.
Use of Serogroup B Meningococcal Vaccines in Adolescents and Young Adults: Recommendations of the Advisory Committee on Immunization Practices, 2015
Authors: Jessica R. MacNeil, Lorry Rubin, Temitope Folaranmi, Ismael R. Ortega-Sanchez, Manisha Patel, Stacey W. Martin
Journal: MMWR Morbidity and Mortality Weekly Report (2015)

At its June 2015 meeting, the Advisory Committee on Immunization Practices (ACIP) recommended that adolescents and young adults aged 16–23 years may be vaccinated with a serogroup B meningococcal (MenB) vaccine to provide short-term protection against most strains of serogroup B meningococcal disease. This report summarizes the deliberations of ACIP, the rationale for its decision, and recommendations for use of MenB vaccines in adolescents and young adults. Two MenB vaccines have recently been licensed by the Food and Drug Administration (FDA) for use in the United States and approved for use in persons aged 10–25 years: MenB-FHbp (Trumenba, Wyeth Pharmaceuticals, Inc.) and MenB-4C (Bexsero, Novartis Vaccines). Both MenB vaccines were licensed based on statutory regulations for accelerated approval, which enabled FDA to approve the MenB vaccines for serious or life-threatening diseases based on safety and demonstration that vaccine effectiveness, as measured by bactericidal antibody responses with assays using several MenB test strains that were representative of prevalent strains in the United States, is reasonably likely to predict clinical benefit. As a requirement for accelerated approval, confirmatory studies in the postmarketing period will be conducted to verify and further describe the effectiveness of the vaccines against an extended number of MenB strains that represent a broader diversity of endemic disease. Additional postlicensure safety data are also needed and will be reviewed by ACIP as they become available.
Informed Consent: What Do Patients Want to Know?
Authors: Patrick J D Dawes, Pauline Davison
Journal: Journal of the Royal Society of Medicine (1994)

Informed consent is an important aspect of surgery, yet there has been little inquiry as to what patients want to know before their operation. This study has questioned 50 patients within 3 months of an ENT (ear, nose and throat) operation. We found that most were happy to allow doctors to determine their treatment but they wanted to know about their condition, the treatment, and the important side effects. Fifty per cent of patients admitted worrying about some aspect of their recent surgery. More than two-thirds thought signing a consent form primarily signified agreement to undergo treatment and that it was a legal document; 54% thought there was an important medico-legal aspect. Over half thought information sheets would be reassuring, one-third thought they would provoke anxiety and 8% thought they would frighten them from having surgery. Closer examination of the answers to our questions showed that those who were most worried about aspects of their surgery had a higher mean anxiety score, as did those who thought an information sheet would be either frightening or anxiety provoking. However, a higher anxiety score was not associated with a desire to know less about the proposed treatment.
Serum tissue polypeptide antigen in bladder cancer as a tumor marker: a prospective study.
Authors: C Maulard-Durdux, M E Toubert, C Hennequin, M Housset
Journal: Journal of Clinical Oncology (1997)

PURPOSE Tissue polypeptide antigen (TPA) is a differentiation and proliferation tissue marker of epithelia. Increased serum levels were found in some patients with invasive bladder cancer. We present the results of a prospective study that evaluated the role of serum TPA (S-TPA) in bladder carcinoma. PATIENTS AND METHODS The series included 167 patients treated for invasive bladder cancer between 1989 and 1996. S-TPA concentrations were measured by radioimmunoassay before treatment, at the end of treatment, and during follow-up evaluation. The upper normal limit of the test was set at 80 UI/L. RESULTS With a specificity of 100%, the diagnostic sensitivity was 46%. Pretherapeutic S-TPA levels were significantly correlated with tumor stage (T2 v T3 and T4; P = .02), with nodal stage (N0 v N1 and N2; P = .00001), and with metastatic stage (M0 v M1; P = 10[-6]), but not with histologic grading (grade 1 and 2 v 3). In the subset of patients with normal pretherapeutic S-TPA levels, 95% had no residual disease at the end of treatment, compared with 53% of patients with initial elevated S-TPA (P = 10[-8]). Among patients who achieved a complete response, 27% experienced a relapse, with an increase of S-TPA in 72% of cases. The mean follow-up time was 20 +/- 17 months. For patients with normal pretherapeutic S-TPA levels, 3-year overall survival and disease-free survival rates were 76% and 67% respectively. These were 46% (P = .001) and 25% (P = 10[-7]), respectively, for patients with high pretherapeutic S-TPA. Multivariate analysis showed that S-TPA was an independent prognostic factor for survival (P = .03). CONCLUSION In invasive bladder cancer, S-TPA level is correlated with initial tumor stage. It is a valuable parameter for follow-up evaluation and appears to be a prognostic factor in multivariate analysis.
Changing the way pharmacy only drugs are supplied would be unwise
Authors: Claire Anderson
Journal: BMJ (2015)

The move to change diclofenac from a pharmacy only drug to a prescription only one was based on safety issues, not poor advice being given by pharmacists.1 People’s expectations of pharmacies vary—from wanting in depth advice to selecting a product, buying it, and leaving with no questions asked. This takes place in an environment rooted in both health and commerce.2 There is an …
A family cluster of giardiasis with variable treatment responses: refractory giardiasis in a family after a trip to India
Authors: A. Requena-Méndez, P. Goñi, S. Lóbez, I. Oliveira, E. Aldasoro, M.-E. Valls, A. Clavel, J. Gascón, J. Muñoz
Journal: Clinical Microbiology and Infection (2013)
Dermacentor-borne necrosis erythema and lymphadenopathy: clinical and epidemiological features of a new tick-borne disease
Authors: J.A. Oteo, V. Ibarra, J.R. Blanco, V. Martínez de Artola, F.J. Márquez, A. Portillo, D. Raoult, P. Anda
Journal: Clinical Microbiology and Infection (2004)
Differences in symptoms between patients with and without PCD: Data from a PCD diagnostic referral centre
Authors: Laura Behan, Samantha Packham, Amanda Harris, Sin Tung Mak, Hazel J. Evans, Karen Lock, Woolf T. Walker, Jane S. Lucas
Journal: European Respiratory Journal (2014)

Background: Primary Ciliary Dyskinesia (PCD) is an inherited condition characterised by pulmonary infections, rhinosinusitis and situs abnormalities (∼50%). Symptoms are mostly non-specific thus guidance on who needs testing is lacking.  Method: From 2006 to 2013, data was prospectively collected using a proforma from 947 consecutive patients referred for PCD testing. Information included neonatal symptoms, respiratory, ENT and cardiac history, symptoms at time of assessment, situs abnormalities and family history. Patients were deemed PCD positive following a portfolio of tests including nasal nitric oxide, ciliary beat analysis, electron microscopy +/- culture at air liquid interface.  Results: 775 patients had sufficient data for inclusion, 47% male and 53% female. 90 (11%) were PCD positive. The median age at assessment was 6 years (range: 0-80 years). The rates of neonatal symptoms (72% vs. 18%; p  Conclusion: Significant differences exist in the clinical history, current condition and symptoms of patients with a positive diagnosis of PCD compared to those found to be negative. Symptoms starting in early life were particularly suggestive of PCD. This data may improve predication of who to test for PCD.
Media coverage had shortlived effect on beef consumption by pregnant women
Authors: S. Wilson, S. Mcleod, A. Gillies, Y. Carter
Journal: BMJ (1996)

EDITOR,—K D Gunasekera and colleagues comment on the public recognition of scientific uncertainty about the risk of developing Creutzfeldt-Jakob disease after eating beef.1 Their conclusion is supported by our data, which indicate that although almost three quarters of women stopped eating beef in the week after the media coverage of the scare, this reaction was short lived.

A study collecting information about folic acid supplementation by pregnant women is also collecting dietary information,2 asking about food eaten in the past week; information is collected …
<i>MGMT</i> promoter methylation and <i>IDH1</i> mutation as prognostic markers for a favorable clinical outcome in patients with glioblastoma multiforme.
Authors: A. Wozniak, E. Van Mieghem, H. Ardon, S. De Vleeschouwer, J. Menten, R. Sciot, F. Van Calenbergh, S. Van Gool, M. Debiec-Rychter, P. M. Clement
Journal: Journal of Clinical Oncology (2010)

2053 Background: Glioblastoma multiforme (GBM) is a highly malignant, and the most common primary tumor of the central nervous system. Hypermethylation of MGMT promoter region can silence its expression and results in MGMT- mediated DNA repair deficiency that may be responsible for better outcome of GBM patients treated with temozolomide. In addition, recent studies suggest that somatic mutations in NADP+-dependent isocitrate dehydrogenase encoded by IDH1 and IDH2 occur in small fraction of GBMs and that patients with such tumors have a better outcome than those with wild-type IDH1/2. Methods: DNA was isolated from fresh frozen primary tumor biopsies from 115 adult patients with histologically proven GBM. Direct sequencing of mutational “hot spots” (exon 4) of IDH1 and IDH2 was performed. The methylation-specific polymerase chain reaction (MSP) was used to detect epigenetic silencing of MGMT. The clinical outcome of patients was correlated with the observed molecular changes. Results: The IDH1 mutations were identified in 5/115 (4.3%) samples the mutation in while the IDH2 mutations were not found. All mutations affected codon R132 of IDH1: p.R132H (c.395G > A) in four tumors, and p.R132C (c.394C > T) in one sample. Among patients whose tumors carried mutation, two died after 21 and 46 months, respectively. Three others remain free of disease with a follow up of 18 to 65 months. The median survival time of patients with a tumor not carrying IDH1 mutation was 11.6 months. Methylation of MGMT was found in 44.3% (51/115) of samples and the presence of the promoter methylation correlated with better survival in the studied cohort (median of 14.4 vs. 11.57 months respectively, p = 0.045). All tumors carrying IDH1 mutation also exhibited methylation of the MGMT promoter. Conclusions: Our study confirms that although mutations in IDH1 are rare events (< 5%) in primary glioblastoma, they represent a strong prognostic biomarker for a good clinical outcome of patients with GBM, and seem to be associated with MGMT promoter methylation. No significant financial relationships to disclose.
Evaluation of the relationship between intention to quit and not smoking at home
Authors: Vahid Moosavi, Ali Abdolahinia, Mohammadreza Masjedi
Journal: European Respiratory Journal (2012)

Objective: This study aimed at evaluating the correlation between not smoking at home and intention to quit.  Methods: This descriptive cross-sectional study was carried out in Tehran in 2011, on 2,020 smokers. Information were collected by interviewers through a standardized questionnaire such as age of smoking onset, daily rate of smoking, price of cigarettes, using labeled or non-labeled tobacco products, history of quit attempts, cessation intention, water-pipe consumption, and knowledge about anti-tobacco laws.  Findings: In our sample (2020 smokers), the mean number of cigarettes smoked daily was 14.4±10.9. This figure was 15.5±11.0 in married people and 12.6±10.5 in singles. A total of 433 (21.4%) smokers had adequate knowledge about anti-tobacco laws. In addition, 1,081 (53.5%) smokers had history of quit attempts and 729 (46.1%) reported water-pipe consumption. Rate of water-pipe consumption among singles was twice the rate in married individuals. Among our understudy subjects, 673 (33.3%) reported smoking at home; of which, 355 (52.7%) expressed their intention for quitting smoking. Meanwhile, out of 1,330 (65.8%) smokers who did not smoke at home, 834 (62.7%) stated that they would like to quit smoking. Chi-Square test revealed a significant association between tobacco smoking at home and intention to quit.  Discussion: As this study and some other studies have shown, restrictions on tobacco smoking at home can motivate smokers to quit smoking. Family has a considerable role in increasing the intention of its members for smoking cessation and not smoking at home. Family members can have a positive role in encouraging other members to quit smoking or sustain their abstinence.