tbuckley/cabot-search huggingface dataset:
Psychological comorbidity and length of stay in the general hospital
Authors: S M Saravay, M D Steinberg, B Weinschel, S Pollack, N Alovis
Journal: American Journal of Psychiatry (1991)

As general hospitals search for ways to cut costs without sacrificing efficiency, particular attention has been focused on factors that may prolong hospital stay. The results of prior studies that have reported an association between psychological and psychiatric comorbidity and longer hospital stays have been subject to different interpretations because of methodological design flaws. The current paper reports on a study of psychological comorbidity and length of stay that has been designed to avoid the methodological problems of earlier investigations.The study was performed at a 429-bed tertiary-care, university-affiliated, voluntary, teaching hospital. During hospital days 3 to 5, patients were tested as available with the Mini-Mental State examination, the Zung Depression Inventory, and the SCL-90 and were rated for physical impairment with the Karnofsky Performance Status Scale. Statistical analyses were performed for correlations between length of stay and test scores, rating scales, and demographic and discharge data from the chart.Of 424 patients approached, 321 (76%) agreed to participate and 278 (65.6%) completed the test battery. Depression, anxiety, and organicity, measured by psychological tests, were significantly correlated with longer hospital stay. These correlations remained significant after the authors controlled for degree of physical impairment, emergency versus elective admission, and medical versus surgical service, which were themselves correlated with longer hospital stay.This study confirms a significant correlation between psychological comorbidity and length of stay after correcting for the methodological pitfalls found in earlier studies. The clinical, research, economic, and policy implications of these findings are discussed.
Community-associated methicillin-resistant Staphylococcus aureus: risk factors for infection, and long-term follow-up
Authors: Y. Longtin, P. Sudre, P. François, J. Schrenzel, C. Aramburu, R. Pastore, A. Gervaix, G. Renzi, D. Pittet, S. Harbarth
Journal: Clinical Microbiology and Infection (2009)
Granulocyte-macrophage colony-stimulating factor/interleukin-3 fusion protein versus granulocyte-macrophage colony-stimulating factor after autologous bone marrow transplantation for non-Hodgkin's lymphoma: results of a randomized double-blind trial.
Authors: J M Vose, A N Pandite, R A Beveridge, R B Geller, M W Schuster, J E Anderson, C F LeMaistre, T Ahmed, A Granena, A Keating, J M Fernandez Ranada, P J Stiff, I Tabbara, W Longo, E A Copelan, C Nichols, A Smith, D L Topolsky, P J Bierman, M E Lebsack, M Lange, L Garrison
Journal: Journal of Clinical Oncology (1997)

PURPOSE A phase III trial to compare PIXY321 with granulocyte-macrophage colony-stimulating factor (GM-CSF) following high-dose therapy and autologous bone marrow transplant (ABMT) was conducted to evaluate the time to hematopoietic recovery. PATIENTS AND METHODS One hundred seventy-seven patients with non-Hodgkin's lymphoma (NHL) receiving ABMT were randomized to receive either PIXY321 750 micrograms/m2/d divided into two subcutaneous (SC) doses or GM-CSF 250 micrograms/m2/d as a 2-hour intravenous (IV) infusion starting on day 0 post-ABMT for a maximum of 28 days. RESULTS The median time to reach an absolute neutrophil count (ANC) &gt; or = 500/microL in the PIXY321 group was 17 days versus 19 days in the GM-CSF group (P = .07) and the median time to reach platelet transfusion independence in the PIXY321 group was 25 days versus 23 days in the GM-CSF group (P = .30). The toxicity profiles of the two agents appeared to be equivalent with the exception of more patients in the PIXY321 group with a rash (64%) compared with the GM-CSF group (48%) (P = .028). A logistic regression model identified the use of a non-total-body irradiation (TBI) regimen and/or receipt of unpurged marrow and a body-surface area greater than 2.0 m2 as predictive of faster neutrophil engraftment, and those three factors, as well as the receipt of &lt; or = two prior chemotherapy regimens as predictive for rapid platelet engraftment. CONCLUSION There was a trend toward a slight improvement in neutrophil engraftment post-ABMT with the PIXY321 administered by an SC route compared with GM-CSF administered by an IV route. However, no differences could be identified between the two agents with respect to the time to platelet transfusion independence. Patient, regimen, and graft characteristics were most predictive of the engraftment tempo.
Bacterial etiology of exacerbations of non-cystic fibrosis bronchiectases in young patients
Authors: Natalya Rutenko, Serik Baydurin, Abai Baygenzhin
Journal: European Respiratory Journal (2013)

Background: Patients with bronchiectasis (BE) need frequent courses of antibacterial therapy (ABt) which is appointed empirically. It promotes growth of resistance of microflora.  Aim: To determine a range of microorganisms in young patients with non-SF BE in the period of exacerbation and detect bacterial resistance to ABt.  Methods: 38 patients mean age 19,1 (3,8) years with non-CF BE exacerbations were examined. Potentially pathogenic microorganisms (PPMs) were identified in a sputum and bronchoalveolar lavage (BAL). The PPMs resistance to ABt was detected.  Results: 7/38 (18,4%) of cases bacteriology showed no growth of microflora. Associations of microorganisms were more often found out in a sputum, than in BAL (37,6% vs 22,1%, p=0,04). Sputum was more often contaminated by nasopharyngeal microorganisms. Coincidence of a sputum and BAL results in 17/31 (54,8%) of cases was revealed. In these cases M.catarrhalis (Mc) and S.pneumonia (Sp) showing loads over a 106 sfu/ml were identified more often (4/17 and 5/17). H.influenza (Hi) was isolated in 3/17. Exacerbations on extended BE were associated with P. cepacia in 2/17, P. aeruginosa in 1/17 that was reflected in severity of clinical symptoms. The highest resistance of Sp and Mc is revealed to macrolides (10-36%) mainly to erythromycin (36%) and azitromycin (19%). Resistance to amoxicillin was lower (7,5-12%).  Conclusions: These findings show that in some cases the result of microbiological tests of sputum should be confirmed with BAL analysis. It will provide more objective results of bacteriology. In treatment of exacerbations of bronchiectasis it is necessary to consider high resistance to macrolids.
Prevalence of sleep disordered breathing in middle-aged general population: The HypnoLaus study
Authors: Raphael Heinzer, Daniela Andries, Francois Bastardot, Nadia Tobback, Peter Vollenweider, Mehdi Tafti, José Haba-Rubio
Journal: European Respiratory Journal (2011)

Introduction:  Prevalence of sleep disordered breathing (SDB) in middle-aged general population was reported to be around 9% of women and 27% of men in studies performed in the 809s-909s. Considering the recent improvements in the sensitivity of recording techniques, our aim is to reevaluate the prevalence of SDB in the general population.   Methods:  505 subjects (47.1% women, 50.3±5.6 y.o, BMI 25.7±4.4 kg/m 2 ) participating in an ongoing population-based cohort study (HypnoLaus, Lausanne, Switzerland) underwent complete polysomnographic recordings at home and had an extensive clinical workup including Epworth Score (ESS). Prevalence of SDB was determined according to apnea-hypopnea index (AHI) using two different scoring criteria: AASM 1999 and 2007.   Results:  With AASM 2007 criteria, prevalence of SDB with AHI thresholds of 5/h, 15/h and 30/h was 45.7%, 15,7% and 6.3% respectively in men, and 19.3%,4.2% and 0.8% respectively in women. Mean ESS score was 6.9±4.2 in men and 6.4±3.8 in women. 18% of the men and 12.6% of the women had an ESS >10. The prevalence of ESS>10 and OSA with the same thresholds (5/h, 15/h, 30/h) was 6.3%, 3.4%, and 0.4% respectively in men and 2.1%, 1.3%, and 0% in women. With AASM 1999 criteria, prevalence of OSA with the same thresholds was 77.2%, 37.5% and 14.6% in men and 51.3%, 15.1% and 4.6% in women. Prevalence of OSA and ESS>10 was 12.0%, 6.7% and 2.6% in men and 5.5%, 2.1% and 0.4% in women.   Conclusion:  In HypnoLaus population-based study, prevalence of SDB is higher than previously reported, especially in middle-aged men. This appears to be due to differences in scoring criteria and to a higher sensitivity of nasal pressure sensors compared to thermocouple.
Gall bladder motility after endoscopic sphincterotomy Reply
Authors: B C SHARMA, K SINGH, R K DHIMAN, M SUGIYAMA, Y ATOMI
Journal: Gut (1998)

Editor,—We read with interest the article by Sugiyama and Atomi ( Gut 1996; 39 :856–9) on the effect of endoscopic sphincterotomy (ES) on gall bladder motility. These authors have proved conclusively that ES causes a significant improvement in gall bladder motility in humans. We have assessed gall bladder motility in patients who underwent ES for common bile duct (CBD) stones and compared these with patients with gall bladder calculi but without CBD stones. We found significantly lower fasting and residual gall bladder volumes in the patients who had undergone ES, indicating reduced filling after ES.1 However, the ejection fraction and the rate constant of gall bladder emptying in these patients was increased significantly, suggesting increased gall bladder emptying. In another study2 we found a significant decrease in fasting volume (mean (SD) 18.3 (8.5) v 13.9 (7.3) ml), residual volume (12.0 (8.0) v 4.4 (3.2) ml) and an increase in the ejection fraction (54.3 (9.8) v 83.5 (5.4)) after ES, suggesting decreased stasis and increased gall bladder emptying.

In Sugiyama and Atomi’s this study, all patients in whom gall bladder motility was assessed before ES had CBD stones; all stones were extracted before …  Dr Sugiyama.
Ventricular enlargement in schizophrenia: relationship to positive and negative symptoms
Authors: Nancy C. Andreasen, Scott A. Olsen, James W. Dennert, Michael R. Smith
Journal: American Journal of Psychiatry (1982)

The authors explored the clinical correlates of ventricular enlargement in schizophrenia by comparing 16 patients with "large" ventricles (ventricles more than I SD above the control mean) with 16 patients with the smallest ventricles from a sample of 52 schizophrenic patients. Patients with ventricular enlargement showed some impairment in the sensorium and had a preponderance of "negative" symptoms (e.g., alogia, affective flattening, avolition, anhedonia), while those with small ventricles were characterized by "positive" symptoms (e.g., delusions, hallucinations, positive formal thought disorder, bizarre behavior). These findings suggest that combining a measure of brain structure with the clinical picture may provide a useful new approach to the classification of schizophrenia.
Intensive remission consolidation therapy in the treatment of acute nonlymphocytic leukemia.
Authors: H D Preisler, A Raza, A Early, J Kirshner, M Brecher, A Freeman, Y Rustum, N Azarnia, R Priore, A Sandberg
Journal: Journal of Clinical Oncology (1987)

A pilot study was conducted to determine the possible efficacy and the toxicities associated with the administration of four courses of intensive consolidation chemotherapy to patients with acute nonlymphocytic leukemia in remission. All therapy was completed within 6 months. The median duration of remission was 22 months, with 45+% of patients in remission at 3 years and few relapses to date thereafter. Sixty percent of patients experienced significant side effects after each course of therapy. The therapy appeared to be particularly efficacious for patients less than 45 years of age, since 65% are alive at 3 years and there is no projection for a median duration of remission as yet. The cytogenetic characteristics of the leukemic cells, the percentage of S phase cells, and the height of the WBC count were the most important prognostic characteristics at diagnosis.
CEREBRAL DAMAGE IN HYPOGLYCEMIA
Authors: A. B. BAKER
Journal: American Journal of Psychiatry (1939)

1. The literature on those studies describing cerebral damage in hypoglycemia is reviewed. 2. Four sources of material underly this study—namely, insulin shock in diabetics, spontaneous hypoglycemia secondary to neoplasm or functional overactivity of the islands of Langerhans, insulin shock therapy in mental disorders, and experimental hypoglycemia in animals. 3. Four personal cases are reported, three of whom are still alive but handicapped by varying neurological and psychiatric disabilities. 4. From a review of the literature and a study of our own cases it seems very apparent that continued repeated hypoglycemia may definitely produce a depression of the cerebral function and even an irreversible degeneration of the brain tissue and cells, resulting in long continued or permanent functional damage or even death. 5. The factors behind the different individual responses to hypoglycemic insults are at present unknown, hence making it impossible to predict or adequately control the more severe reactions or the resulting brain damage.
Circumferentially aligned fibers guided functional neoartery regeneration in vivo
Authors: Meifeng Zhu, Zhihong Wang, Jiamin Zhang, Lina Wang, Xiaohu Yang, Jingrui Chen, Guanwei Fan, Shenglu Ji, Cheng Xing, Kai Wang, Qiang Zhao, Yan Zhu, Deling Kong, Lianyong Wang
Journal: Biomaterials (2015)
Detection of relapse in early-stage Hodgkin's disease: role of routine follow-up studies.
Authors: M J Torrey, J C Poen, R T Hoppe
Journal: Journal of Clinical Oncology (1997)

PURPOSE To examine the costs and benefits of routine follow-up evaluation in patients treated with radiation therapy for early-stage Hodgkin's disease. PATIENTS AND METHODS We retrospectively examined patterns of follow-up evaluation and methods of relapse detection among 709 patients with stage I and II Hodgkin's disease treated with primary radiotherapy between 1969 and 1994. We determined the probability of relapse detection for seven routine follow-up procedures, compared their relative costs, and determined the impact of each procedure on the likelihood of survival following salvage therapy. RESULTS Relapse has occurred in 157 patients (22%) at a median 1.9 years (range, 0 to 13 years) posttreatment. Relapse was suspected primarily by history (Hx) in 55% of patients, physical examination (PE) in 14%, chest x-ray (CXR) in 23%, and abdominal x-ray (KUB) in 7%. Only one relapse (1%) was identified by a routine laboratory study. The rate of relapse detection was highest for a combination of Hx and PE (78 of 10,000 examinations) followed by CXR (26 of 10,000 examinations). The projected charges (1995 dollars) per relapse detected by routine follow-up Hx and PE were $11,000 compared with $68,000 for CXR and $142,000 for KUB. The 10-year actuarial survival rate following salvage therapy was 65% overall, 65% for patients in whom relapse was detected by Hx or PE, and 69% for patients in whom relapse was detected by radiographs (P = not significant). CONCLUSION The majority of relapses occurred within 5 years of treatment and were identified by Hx and PE. CXR was useful during the first 3 years of follow-up evaluation. KUB, CBC, and laboratory studies accounted for nearly half of all follow-up charges and rarely led to the detection of relapse. Their routine use as a method of relapse detection is questionable. In general, the method of relapse detection did not have a significant impact on the likelihood of successful salvage therapy.
Tumor-Associated Transplantation Antigens of Myelomas Induced in BALB/c Mice2
Authors: Winston H. Williams, Robert G. Krueger
Journal: JNCI Journal of the National Cancer Institute (1972)

Journal Article Tumor-Associated Transplantation Antigens of Myelomas Induced in BALB/c Mice Get access Winston H. Williams, Winston H. Williams Search for other works by this author on: Oxford Academic PubMed Google Scholar Robert G. Krueger Robert G. Krueger Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 49, Issue 6, December 1972, Pages 1613–1620, https://doi.org/10.1093/jnci/49.6.1613 Published: 01 December 1972 Article history Received: 16 May 1972 Revision received: 16 August 1972 Accepted: 30 August 1972 Published: 01 December 1972
Banning heading in soccer would have limited effect on concussions, study finds
Authors: Jacqui Wise
Journal: BMJ (2015)

Banning heading the ball in soccer would have limited effectiveness in preventing concussion injuries, as most are caused by player to player contact, researchers have found.

The retrospective analysis, published in JAMA Pediatrics , was based on data from a nationally representative sample of high schools in the United States from 2005 to 2014.1 Soccer has increased in popularity in the United States over the past three decades and is played widely by both boys and girls at …
Introduction of highly resistant bacteria into a hospital via patients repatriated or recently hospitalized in a foreign country
Authors: G. Birgand, L. Armand-Lefevre, M. Lepainteur, I. Lolom, C. Neulier, F. Reibel, Y. Yazdanpanah, A. Andremont, J.C. Lucet
Journal: Clinical Microbiology and Infection (2014)
Potentiation of a Dendritic Cell Vaccine for Murine Renal Cell Carcinoma by CpG Oligonucleotides
Authors: Fanny Chagnon, Simon Tanguay, Ozdem Levent Ozdal, Meng Guan, Zeynep Z. Ozen, Jean-Sébastien Ripeau, Mario Chevrette, Mostafa M. Elhilali, Lu Ann Thompson-Snipes
Journal: Clinical Cancer Research (2005)

An ideal vaccine therapy for tumors should activate both effector and memory immune responses against tumor-specific antigens. Here we investigated the effect of CpG oligodeoxynucleotides (CpG-ODN) for their ability to potentiate the activity of tumor antigen-pulsed bone marrow-derived dendritic cells (DC) in a vaccine model for the treatment of murine renal cell carcinoma (RENCA).First we evaluated the effects of a murine renal cell carcinoma (RENCA) on immune cell activity in a mouse model using in vitro assays for T-cell proliferation and natural killer cell activation. To overcome the immune suppression of the tumor, we s.c. injected groups of 10 mice with dendritic cells and tumor cells. We compared the effect of different conditioning regimens of the DCs with RENCA antigen and/or CpG-ODNs before injection by measuring tumor size twice a week.Tumor growth was shown to negatively affect spleen cell and T-cell proliferation, IFN-gamma production, natural killer cell activity, and NF-kappaB activation in T cells. In this model, we have shown that RENCA-pulsed CpG-ODN-treated DCs were able not only to significantly reduce tumor growth but also to prevent tumor implantation in 60% of mice. Tumor-free mice were resistant to tumor challenge and the immunity conferred by the vaccine was transferable and tumor specific.This data show that RENCA down-modulates the immune response, and DC vaccine therapy, in conjunction with CpG-ODN, can restore tumor-specific immunity.
Randomized study of paclitaxel-cisplatin versus cisplatin-teniposide in patients with advanced non-small-cell lung cancer. The European Organization for Research and Treatment of Cancer Lung Cancer Cooperative Group.
Authors: G Giaccone, T A Splinter, C Debruyne, G S Kho, P Lianes, N van Zandwijk, M C Pennucci, G Scagliotti, J van Meerbeeck, Q van Hoesel, D Curran, T Sahmoud, P E Postmus
Journal: Journal of Clinical Oncology (1998)

PURPOSE To compare two cisplatin based chemotherapy schedules in patients with advanced non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS A total of 332 patients with advanced NSCLC were randomized to receive cisplatin 80 mg/m2 on day 1 either in combination with teniposide 100 mg/m2 on days 1, 3, and 5 (arm A) or paclitaxel 175 mg/m2 by 3-hour infusion on day 1 (arm B); cycles were repeated every 3 weeks. RESULTS Fifteen patients were ineligible; patient characteristics were well balanced between the two arms: 71% were male, 71% had less than 5% weight loss, 89% had a World Health Organization (WHO) performance status of 0 to 1, 51% had adenocarcinoma, and 61% had stage IV disease. Hematologic toxicity was significantly more severe in arm A (leukopenia, neutropenia, and thrombocytopenia grade 3 or 4: 66% v 19%, 83% v 55%, 36% v 2% in arms A and B, respectively), which resulted in more febrile neutropenia (27% v 3% in arms A and B, respectively), dose reductions, and treatment delays. There were a total of nine toxic deaths, six due to neutropenic sepsis: five in arm A and one in arm B. In contrast, arthralgia/myalgia (grade 2 or 3, 4% v 17%), peripheral neurotoxicity (grade 2 or 3, 6% v 29%), and hypersensitivity reactions (1% v 7%, all grades) were significantly more frequent in arm B. The frequency and severity of other toxicities were comparable between the two arms. Responses were one complete and 44 partial on arm A (28%) and two complete and 61 partial (41%) on arm B (P = .018). There was no significant difference in survival, with median and 1-year survivals 9.9 versus 9.7 months and 41% versus 43%, respectively in arm A and B. Progression-free survival was 4.9 and 5.4 months in arm A and B, respectively. Selected centers participated in a quality-of-life (QoL) assessment, which was performed by the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and LC-13 administered at baseline and every 6 weeks thereafter. Arm B achieved a better score at week 6 for emotional, cognitive and social functioning, global health status, fatigue, and appetite loss, which was lost at 12 weeks. In conclusion, arm B appears superior to arm A with regard to response rate, side effects, and QoL. CONCLUSION Although survival was not improved, arm B offers a better palliation for advanced NSCLC patients than arm A.
Redefining leadership
Authors: N. Dudley
Journal: BMJ (2002)

Successful leadership requires range of stylesEditor-Treasure's views and comments after the NHS Confederation's leadership conference make interesting reading. 1 The leadership style of consultants covers a broad spectrum that could be described as ranging from "huggy touchy feely" all the way up to "Attila the Hun meets Genghis Khan."A similar spectrum exists in managers.The British government's own Cabinet Office expert report on public service leadership indicates that successful leaders need to adopt a range of styles depending on the situation. 2That may include having to resort at times to coercive, browbeating styles.Many consultants would perhaps choose to operate in the lower or middle range of the style spectrum.At times when managers do not listen to consultants' reasonable concerns about the delivery of safe, effective, high quality services there may be no option but reluctantly to wheel out Attila and Genghis to protect both patients and consultants.Treasure is very fortunate to be in a specialty that is comparatively rich in resources and having its concerns addressed by major
Obesity, diabetes mellitus, atherosclerosis and chronic periodontitis: a shared pathology via oxidative stress and mitochondrial dysfunction?
Authors: Pedro Bullon, Hubert N. Newman, Maurizio Battino
Journal: Periodontology 2000 (2013)

Abstract As many diseases have been shown to have several or indirect causes (i.e. are multifactorial) the question is what is the relative importance of each factor in a given disease? Also, what happens when some diseases, although apparently disparate, share causative factors and/or tissue pathologies? Host inflammation response mechanisms are largely shared by the body’s different tissues and systems and only recently has special attention been paid to the possible linkages among chronic periodontitis and other chronic systemic diseases. The aim of this review was to consider and discuss the mounting evidence that the basis for the inter‐relationships between chronic periodontitis and atheromatous disease and diabetes lie at a fundamental intracellular level, namely oxidative stress and mitochondrial dysfunction, as a meeting background among such chronic diseases and periodontitis.