tbuckley/cabot-search huggingface dataset:
Marital Status and Postoperative Functional Recovery
Authors: Mark D. Neuman, Rachel M. Werner
Journal: JAMA Surgery (2015)

A multidisciplinary review may lead to the comprehensive implementation of diagnostic modalities that better identify patients most likely to benefit from therapeutic resection.Recent data suggest that the engagement of surgical oncologists in tumor boards results in higher rates of curativeintent surgery for patients with early-stage non-small cell lung cancer. 4Owing to the limited scope of the present study, the effect of therapeutic resection on stage migration or survival was not evaluated.In light of the National Lung Screening Trial and the 8 million individuals at risk, an estimated 3.1 million lung abnormalities will be identified in the first 3 years of a national computed tomographic screening program. 1,5Assuming a benign rate exceeding 20%, at least 24 000 operations in the first 3 years would be performed for patients with benign lesions.Reducing benign rates will ease the cost and prevent unnecessary morbidity and mortality resulting from evaluating lesions found during lung cancer screening.The benign rate has recently been proposed as a quality metric for the management of patients with indeterminate lung lesions. 3Implementation of a preoperative multidisciplinary review may help us to better target institutional resources while minimizing the potential harm caused by invasive diagnostic and therapeutic techniques.
Sensory stimulation in dementia
Authors: E. Moniz-Cook
Journal: BMJ (2003)

Editor—Burns et al urge caution in prescribing neuroleptic drugs for agitation in dementia and advance the cause of psychosocial alternatives, citing good evidence in support of bright light and aromatherapy.1

A conceptual problem remains. It is analogous to reflex prescription of neuroleptics (although with less risk of side effects) to attempt standard psychosocial cures before assessing causes of the behaviour—well beyond essential screening for physiological aetiology such as infections or drug interactions. For example, sleep disturbance in nursing homes is commonly caused by staff waking residents up.2 It would be ludicrous to start bright light therapy without first assessing the behaviour of night staff.

Most incidents of aggression are not random but occur in personal care.3 It would be naive to apply some standard psychosocial therapy without first observing and adjusting how personal care is implemented.

Case specificity extends even to what causes behaviour to become “challenging” and thus labelled behavioural and psychological symptoms of dementia. It is idiosyncratic to the individual carer, staff member, or nursing home.3,4 Not surprisingly, aromatherapy can have mixed effects, depending on the person, staff, or nursing home.5

In a recent controlled trial the most common interventions were not named therapies but changing the behaviour and attitudes of carers or staff by using emotional support and case specific education.3 Overall, a careful assessment, followed by tailored psychosocial or pharmacological interventions, enabled all patients to be managed in place, took less time, and produced far fewer drug side effects than a control group where drug treatment was the frontline treatment.

Effective alternative drugs or adjuncts to drugs certainly include standard approaches such as aromatherapy, but they are not drugs and cannot be conceptualised as such. Each case needs a diagnostic work up, investigating both physiological and psychosocial causes before any treatment is applied—including, we suggest, psychopharmacology. In this framework we agree it is important for clinicians to have evidence based treatment such as aromatherapy and bright light in the toolkit.
Atenolol Once Daily in Essential Hypertension
Authors: C.L. Alicandri, E. Agabiti-Rosei, B. Cerri, L. Corea, P. Innocenti, G. Levi, F. Mantero, C. Porcellati, E. Solinas, M. Toso, C. Vaori, O. Visioli, G. Muiesan
Journal: Drugs (1983)
Humoral Immunity to Dietary Antigens in Atopic Dermatitis
Authors: S. Husby, F. Schultz Larsen, S. Ahlstedt, S‐E. Svehag
Journal: Allergy (1986)

IgG subclass antibodies to two dietary antigens, ovalbumin (OA) and beta‐lactoglobulin (BLG) were measured with quantitative ELISA‐techniques in 16 patients with atopic dermatitis (AD) (6‐21 years old) and closely matched controls. In addition, IgE‐antibodies to OA, BLG and milk were determined with RAST. IgG subclass antibodies were frequently detected in IgG1 and IgG4 for both AD‐patients and controls, quantitatively dominated by IgG4. The IgG4 anti‐BLG antibody levels were significantly higher ( P &lt; 0.001) in AD‐patients (median: 1.1 μg/ml, range: 0‐24.0 μg/ml) than in controls (median: 0.05 μg/ml, range: 0‐1.05 μg/ml). No relation was found between IgG4 anti‐BLG antibody levels, levels of IgE antibodies to milk or BLG, or severity of disease.
Hormonal treatment of endometrial stromal sarcomas (ESS): A possible indication for aromatase inhibitors
Authors: T. Lindner, D. Pink, A. Kretzschmar, A. Mrozek, P. C. Thuss-Patience, P. Reichardt
Journal: Journal of Clinical Oncology (2005)

9057 Background: ESS are a rare disease with probably less than 250 new cases in the US or EU per year often incidentally discovered after hysterectomy (Hy). ESS usually express steroidal receptors and are regarded to be hormone sensitive. A higher risk in women receiving estrogen replacement therapy (ERT) or tamoxifen (T) has been suspected and remissions following treatment with progestins have been reported in case studies. Aromatase inhibitors represent an interesting new treatment option. Methods: Our institutional sarcoma data bank was screened for cases of advanced ESS since 1999. All corresponding files and radiographs were reviewed retrospectively. Results: 9 patients (age 39 - 67 years, median 47) were identified. Diagnosis was established before or by Hy (5), by local recurrence (LR) after previous Hy for nonmalignant disease (3) or by pulmonary metastases (PM) with no primary tumor found so far (1). 4/9 pts were on ERT and 2/9 on T at the time of diagnosis of advanced disease. 6/9 pts presented with LR or peritoneal spread and 8/9 with PM. Treatment and Outcome: 7/9 pts are alive 33 - 251 months after Hy (median 99). Survival since diagnosis of advanced disease is 8 - 66 months (median 30). Treatment strategies consisted of stopping ERT/T or initiation of MPA or Letrozole. Conclusions: Although this is a small and retrospective study, we could confirm that ESS is steroidal hormone responsive as 6 cases of advanced disease were diagnosed in pts under ERT/T and withdrawl was partially effective. MPA and Letrozole are active with probable lack of cross resistance inducing durable stabilisations and remissions in the majority of patients. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Novartis Novartis Novartis
Primary lymphoma of bone in children: analysis of treatment results with adriamycin, prednisone, Oncovin (APO), and local radiation therapy.
Authors: J S Loeffler, N J Tarbell, H Kozakewich, J R Cassady, H J Weinstein
Journal: Journal of Clinical Oncology (1986)

Primary lymphoma of bone is an unusual extranodal presentation of pediatric non-Hodgkin's lymphoma (NHL). Treatment with radiotherapy alone has resulted in a disease-free survival rate of approximately 50% in most adult series. Between January 1973 and April 1985, 11 children with biopsy-proven NHL of bone were seen and treated at our institutions. The minimal clinical staging included chest and bone radiographs, a radionuclide bone scan, complete blood cell counts and serum chemistries, and a bone marrow aspirate and biopsy. The age range was 9 to 17 years with a median age of 14 years. Histology included diffuse lymphoblastic lymphoma in four patients and diffuse histiocytic lymphoma in seven. Each patient was treated with the Adriamycin/prednisone/Oncovin (APO) protocol and ten patients received concomitant radiation to the whole bone when possible and a boost to the primary lesion(s). The median tumor dose was 5,000 rad (range, 3,600 to 5,600). The median follow-up was 8 years. There have been no relapses, but two patients have developed second bone tumors 5 and 7 1/2 years after beginning therapy. Each second tumor arose directly in the radiation field. The overall 8-year actuarial survival is 83%. We conclude that APO and local radiation results in excellent overall survival for children with primary NHL of bone. The occurrence of two second bone tumors, however, raises questions regarding dose and/or the role of radiation for this disease.
Utility of PET scan in predicting chemotherapeutic response in soft tissue sarcoma patients
Authors: D. M. Mintzer, J. J. King, A. Alavi, A. P. Staddon, R. D. Lackman, L. Hartner, E. J. Fox, C. M. Ogilvie
Journal: Journal of Clinical Oncology (2007)

10021 Background: The response to chemotherapy in soft tissue sarcomas (STS) is often used to guide the further management of these neoplasms. The goal of this study was to determine if an overall metabolic response assessed by PET scan can be used to predict survival. Methods: Records of 12 STS patients (10m, 2f) who underwent pre- and post-chemotherapy PET scans were retrospectively renewed. PET scans were evaluated by a senior nuclear medicine physician and the response was compared to patient survival. Disease progression on PET was defined as a SUV increase in any lesion, appearance of new lesions, or presence of extended areas of disease activity during chemotherapy. A stable response was defined as a decrease in SUV &lt;40% of the initial value of over half the lesions. A partial response was defined as a =40% decrease in SUV compared to the initial value in over half of the lesions. Patient survival was measured from the date of the post-treatment PET to the date of death or last follow-up. Results: Of the 12 patients, 6 had disease progression (all with metastases before treatment), 1 had stable disease with metastasis before treatment, and 5 had partial(4) or complete(1) responses of which 2 had metastases on presentation. The 6 patients who had progressive disease during treatment had a mean survival of 4 months (range 1.5–10.9 months, 0 alive at last follow-up). The patient with stable disease died at 13 months post-treatment. The 5 patients with partial to complete responses had a mean survival of 19 months (range 1.9–37.4, 3 alive). Patients with a partial or complete response had a longer mean survival than did patients with progression during chemotherapy, although this was not significant (p=0.49, Wilcoxon). When considering only patients with metastatic disease, the 3 patients without progression during chemotherapy had a longer mean survival (20 months, range 13–24, 1 alive) than the 6 patients with progression during chemotherapy, although this was not significant (p=0.17, Wilcoxon). Conclusions: A trend of decreased survival was seen in patients who had disease progression seen on PET during chemotherapy. Further studies with larger numbers of subjects need to be conducted to evaluate the correlation between the metabolic response to chemotherapy seen on PET to patient outcome in STS. [Table: see text]
Abstract 339: Long-term AAV6-{beta}ARKct Myocardial Gene Therapy Improves Cardiac Function Via Restoration Of {beta}-Adrenergic Receptor Signaling And Neurohormonal Status Of The Failing Heart
Authors: Giuseppe Rengo, Anastasios Lymperopoulos, Carmela Zincarelli, Maria Donniacuo, Stephen Soltys, Joseph E Rabinowitz, Walter J Koch
Journal: Circulation (2008)
Depressive Symptoms and Impaired Physical Function after Acute Lung Injury
Authors: Oscar J. Bienvenu, Elizabeth Colantuoni, Pedro A. Mendez-Tellez, Victor D. Dinglas, Carl Shanholtz, Nadia Husain, Cheryl R. Dennison, Margaret S. Herridge, Peter J. Pronovost, Dale M. Needham
Journal: American Journal of Respiratory and Critical Care Medicine (2011)

Survivors of acute lung injury (ALI) frequently have substantial depressive symptoms and physical impairment, but the longitudinal epidemiology of these conditions remains unclear.To evaluate the 2-year incidence and duration of depressive symptoms and physical impairment after ALI, as well as risk factors for these conditions.This prospective, longitudinal cohort study recruited patients from 13 intensive care units (ICUs) in four hospitals, with follow-up 3, 6, 12, and 24 months after ALI. The outcomes were Hospital Anxiety and Depression Scale depression score greater than or equal to 8 ("depressive symptoms") in patients without a history of depression before ALI, and two or more dependencies in instrumental activities of daily living ("impaired physical function") in patients without baseline impairment.During 2-year follow-up of 186 ALI survivors, the cumulative incidences of depressive symptoms and impaired physical function were 40 and 66%, respectively, with greatest incidence by 3-month follow-up; modal durations were greater than 21 months for each outcome. Risk factors for incident depressive symptoms were education 12 years or less, baseline disability or unemployment, higher baseline medical comorbidity, and lower blood glucose in the ICU. Risk factors for incident impaired physical function were longer ICU stay and prior depressive symptoms.Incident depressive symptoms and impaired physical function are common and long-lasting during the first 2 years after ALI. Interventions targeting potentially modifiable risk factors (e.g., substantial depressive symptoms in early recovery) should be evaluated to improve ALI survivors' long-term outcomes.
Assessment of the Impact of Cancer on Work, Recreation, Home Management and Sleep Using a General Health Status Measure
Authors: Margaret Malone, Adrian L Harris, David K Luscombe
Journal: Journal of the Royal Society of Medicine (1994)

A general health status measure (the UK Sickness Impact Profile) was used to assess health-related quality of life in 212 cancer patients [143 women, mean (SD - standard deviation) age 55.3 (11.7) years] compared to 105 age-sex matched control subjects [71 women, mean (SD) age 54.7 (12.2) years]. The four main areas of impairment in the cancer patient group were work, recreation and pastimes, home management and sleep and rest. The majority of patients were unable to work or working shorter hours due to their disease. A diagnosis of cancer was likewise found to have a major impact on active leisure pursuits and led to reduced participation in social and community activities. Patients had particular problems in carrying out household chores and maintenance or repair work in the house. Many patients had difficulty sleeping at night and tended to sleep during the day or rest for much of the day. The majority of studies of quality of life in oncology patients concentrate upon alterations in symptoms, such measures would fail to detect impairment in the aspects described above. Greater attention should be directed towards addressing issues such as changes in employment status and the need for help in the home to improve the overall care of cancer patients.
US initiatives to boost organ donation have had little effect, study finds
Authors: M. McCarthy
Journal: BMJ (2015)

<h3>Background</h3> Urogenital <i>Chlamydia trachomatis</i> infection (“chlamydia”) remains highly prevalent and causes significant reproductive morbidity. Earlier randomised chlamydia treatment trials comparing azithromycin 1g versus a 7-day regimen of doxycycline 100mg twice daily reported high cure rates, but used less sensitive diagnostics and results may have been confounded by chlamydia re-exposure or doxycycline nonadherence. Recent studies have raised concern about azithromycin efficacy for chlamydia. <h3>Methods</h3> We conducted a randomised trial comparing azithromycin versus doxycycline for chlamydia in males and females in youth correctional facilities (YCFs) to evaluate for noninferiority of azithromycin compared to doxycycline. Treatment was directly observed and participants had no furloughs from the YCF throughout the study. The primary endpoint was treatment failure at 28 days after treatment initiation, determined by nucleic acid amplification test results, sexual history, and <i>C. trachomatis</i> OmpA genotyping. <h3>Results</h3> Of 567 participants enrolled, 284 were randomised to azithromycin and 283 to doxycycline. There were 155 participants in each treatment arm comprising the per protocol population: 65% male and 35% female. No treatment failures occurred in the doxycycline arm. In the azithromycin arm, five treatment failures occurred (3.2%; 95% CI: 0.4–7.4%): four were males (3.9%; 95% CI: 1.1–9.7%) and one female (1.9%; 95% CI: 0.0–10.1%). The observed failure rate difference in the treatments was 3.2%, with a 90% upper CI of 5.9%, exceeding the predetermined 5% cutoff for establishing azithromycin noninferiority. <h3>Conclusion</h3> Doxycycline had a 100% cure rate for chlamydia. Noninferiority of azithromycin to doxycycline was not established in this study, although azithromycin treatment failures occurred infrequently and the high azithromycin cure rate was consistent with earlier chlamydia treatment trials. Because of possible chlamydia treatment failures when azithromycin is used, further surveillance is needed and doxycycline might be considered for persons with suspected chlamydia treatment failure following azithromycin treatment. <h3>Disclosure of interest statement</h3> Nothing to Declare.
Association of plasma adiponectin level with pulmonary function in a general Japanese population
Authors: Kento Sato, Yoko Shibata, Shuichi Abe, Sumito Inoue, Akira Igarashi, Keiko Yamauchi, Yasuko Aida, Keiko Nunomiya, Hiroshi Nakano, Masamichi Sato, Tomomi Kimura, Takako Nemoto, Isao Kubota
Journal: European Respiratory Journal (2014)

Introduction : Adiponectin is an anti-inflammatory and cardio-protective cytokine. However, several studies demonstrated an increase in adiponectin levels in patients with chronic obstructive pulmonary disease. It is still unclear whether adiponectin plays a pulmo-protective or pulmo-destructive role. The aim of this study was to investigate the association of adiponectin with pulmonary function in a general Japanese population.   Methods : Spirometry and blood sampling including adiponectin measurement was performed on 3,253 subjects aged 40 years or older,who participated in a community-based annual health-check in Takahata, Japan, from 2004 to2006. In 2011, spirometry was re-performed for 872 subjects (men, 405; women, 467).   Results : Plasma adiponectin levels were significantly associated with age, body mass index (BMI), alanine aminotransferase (ALT), triglyceride (TG), and high-density lipoprotein-cholesterol (HDL-c) among male and female subjects. In men only, plasma adiponectin level was associated with lifetime consumption of cigarettes (Brinkman index, BI). Plasma adiponectin level was inversely associated with the FEV 1  /FVC in both men and women. In addition, annual change in FEV 1  was inversely associated with plasma adiponectin levels in both men and women. Multiple linear regression analysis demonstrated that this association was independent of other confounding factors such as age, BMI, BI, ALT, TG and HDL-c.   Conclusions : Plasma adiponectin levels were inversely associated with FEV 1 /FVC and annual change in FEV 1 , in a general Japanese population. The results suggest that adiponectin levels is predictive for decline in FEV 1 .
Use of Protamine for Anticoagulation During Carotid Endarterectomy
Authors: Karina A. Newhall, Elizabeth C. Saunders, Robin J. Larson, David H. Stone, Philip P. Goodney
Journal: JAMA Surgery (2015)

<h3>Importance</h3> Protamine sulfate can be administered at the conclusion of carotid endarterectomy (CEA) to reverse the anticoagulant effects of heparin and to limit the risk for postoperative bleeding. Protamine use remains controversial owing to concern for increased thrombotic complications with its use. <h3>Objective</h3> To review the evidence for and against protamine use, both in its association with increased thrombotic complications and with decreased bleeding. <h3>Data Sources</h3> We searched Medline (1946-2014), EMBASE (1966-2014), Cochrane Library (1972-2014), clinical trial registries (World Health Organization International Clinical Trials Registry and clinicaltrials.gov), and abstracts from conferences of the Society of Vascular Surgery (2002-2014) and American Heart Association Scientific Sessions (1980-2014) in November 2014. No language restrictions were applied. <h3>Study Selection</h3> We included clinical trials and observational studies comparing reversal of heparin with protamine sulfate vs no reversal in patients undergoing carotid revascularization and reporting stroke during hospitalization. Of 360 records screened, 12 studies (3%) of CEA were eligible for data pooling. <h3>Data Extraction and Synthesis</h3> Two reviewers extracted data and assessed quality. Random-effects models were used to summarize relative risks (RRs). <h3>Main Outcome and Measure</h3> Stroke after CEA. <h3>Results</h3> We included 12 observational studies involving 10 621 patients in the meta-analysis. Event rates did not differ significantly between patients who received protamine vs those who did not for the following outcomes: stroke (RR, 0.84; 95% CI, 0.55-1.29;<i>I</i><sup>2</sup> = 15%; 9 studies), myocardial infarction (RR, 0.89; 95% CI, 0.53-1.51;<i>I</i><sup>2</sup> = 0%; 3 studies), or mortality (RR, 0.9, 95% CI, 0.62-1.29;<i>I</i><sup>2</sup> = 0%; 7 studies). The use of protamine was associated with a significant decrease in major bleeding complications requiring reoperation (RR, 0.57; 95% CI, 0.39-0.84;<i>I</i><sup>2</sup> = 32%; 10 studies). <h3>Conclusions and Relevance</h3> Based on available evidence, the use of protamine following CEA is associated with a reduction in bleeding complications, without increasing major thrombotic outcomes, including stroke, myocardial infarction, or death.
Human vaccinia infection after contact with a raccoon rabies vaccine bait - Pennsylvania, 2009.
Authors: V. Dato, C. Moose, G. Fraser, J. Seiders, C. Rittle, V. Urdaneta, S. Ostroff, C. Encarnacion, M. Reynolds, I. Damon, K. Karem, Y. Li, W. Davidson, K. Wilkins, E. McDowell, C. E. Rupprecht, L. Orciari, M. Niezgoda, S. Smith, A. Roess
Journal: MMWR Morbidity and Mortality Weekly Report (2009)
Evaluation of four real-time PCR assays for detection of influenza A(H1N1)v viruses
Authors: J Ellis, M Iturriza, R Allan, A Bermingham, K Brown, J Gray, D Brown
Journal: Eurosurveillance (2009)

The sensitivity and specificity of four real-time PCR assays (HPA A(H1)v, CDC A (H1)v, HPA A(N1)v and NVRL S-OIV assays) was evaluated for detection of influenza A(H1N1)v viruses. Nose and throat swab samples containing influenza A(H1N1)v viruses, seasonal influenza AH3N2, AH1N1, influenza B viruses, or negative for influenza viruses were tested by the four assays. Specificity was also analysed using influenza A viruses of different subtypes and non-related respiratory viruses. The sensitivities and specificities of the four assays were in a similar range and suitable for diagnostic use. The HPA (H1)v and the S-OIV assays were the most sensitive assays for use as a first line test, but the S-OIV assay was less specific, detecting all avian subtypes of influenza A viruses tested. The results of this study demonstrate that the concurrent use of primary diagnostic and confirmatory assays provides rapid and accurate assessment of confirmed cases, and allows appropriate management of patients.