tbuckley/cabot-search huggingface dataset:
Abstract P6-01-17: AQP3 expression predicts survival in patients with HER2-positive early breast cancer
Authors: Yee Soo Chae, Soo Jung Lee, Jeeyeon Lee, Jin Hyang Jung, Ho Yong Park
Journal: Cancer Research (2015)

Abstract Background: Recent studies have revealed aquaporins (AQPs) as targets for novel anti-tumor therapy, since they likely play a role in carcinogenesis, tumor progression, and invasion. Accordingly, we analyzed the prognostic impact of AQP3 expression and polymorphisms in a number of patients with early breast cancer (EBC). Patients and Methods: AQP3 expression was investigated on the basis of the immunohistochemistry of tissue microarray specimens from 447 EBC patients who underwent surgery between 2003 and 2008. We scored the staining intensity (0 through3) and percentage of positive tumor cells (0 through 4), and the staining score was defined as sum of these scores used to categorize the AQP3 expression as negative (0 through 2), weak (3 through 5), or strong (6 or more). For AQP3 polymorphisms, seven SNPs (rs10813981, rs34391490, rs591810, rs2227285, rs2228332, rs17553719, and rs3860987) were selected using in silico analysis and genotyped using the Sequenom MassARRAY. Results: A total of 180 (40.3%) of the patients were identified as AQP5-positive (staining score &amp;gt;2), including 86 (19.2%) cases of strong expression (stating score &amp;gt;5). In a univariate analysis, AQP3 expression was significantly associated with survival for the patients with HER2-overexpressing EBC. Moreover, a multivariate survival analysis revealed that AQP3 expression was an independent prognostic marker of disease-free survival (DFS: HR=3.137, 95%CI=1.079-9.125, p=0.036; Distant DFS: HR=2.784, 95%CI=0.921-8.414, p=0.070) for the HER2-overexpressing EBC patients. Meanwhile, none of selected AQP3 polymorphisms were related with AQP3 expression in tumor tissue nor survival in the current study. Conclusion: AQP3 expression in tumor tissue may be considered as a potential prognostic marker in patients with HER2-overexpressing EBC after curative surgery. Citation Format: Yee Soo Chae, Soo Jung Lee, Jeeyeon Lee, Jin Hyang Jung, Ho Yong Park. AQP3 expression predicts survival in patients with HER2-positive early breast cancer [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P6-01-17.
Group therapy with the terminally ill
Authors: Irvin D. Yalom, Carlos Greaves
Journal: American Journal of Psychiatry (1977)

The authors describe their four-year experience with a therapy group for patients with metastatic carcinoma. Patients in the group are helped by helping one another, by moving out of a morbid self-absorption, and by finding that they have much of value to share and to teach. The most important aspect of the group experience is the "presence" it offers; patients find support and the opportunity to express their needs and fears openly. The authors believe that group therapy is a valuable modality for the treatment of terminally ill patients and that much can be learned from such groups for the everyday therapy of the living.
The experience of not being able to stop smoking despite having COPD
Authors: Britt-Marie Eklund, Siv Nilsson, Linnea Hedman, Inger Lindberg
Journal: European Respiratory Journal (2011)

Background:  COPD (Chronic Obstructive Pulmonary Disease) is one of the most widespread lung diseases and a growing cause of suffering and mortality worldwide. It is predicted to become the third leading cause of death in the near future. Smoking is the most important risk factor and 50% of smokers develop COPD. Smoking cessation is the most important intervention to improve prognosis for individuals with COPD.   Aim:  To describe the experience of not being able to stop smoking among persons diagnosed with moderate COPD.   Methods:  Ten smokers (5 women) with COPD, GOLD stage II, participated in semi-structured interviews. The data was analysed using qualitative content analysis. The participants were recruited from the OLIN studies in Northern Sweden.   Results:  The analysis resulted in two themes: 1) Life is governed by a long smoking history that is difficult to break and 2) To be aware of and enlightened, but lacking ability to make a decision, and in five categories: That it is the wrong time in life to stop; To break a lifelong pattern is almost impossible; That plans to stop does not lead to results; Being aware of the consequences of continued smoking and to have received help and support but not wanting to be patronized. Although they knew about the harmful effects of smoking, difficulties in everyday life aggravated smoking cessation. To have plans to stop smoking is not enough, it is also necessary to get motivation and support from the social environment at the right time.   Conclusion:  The individual life situations are very important for successful smoking cessation. Health professionals should be even more sensitive and provide an individually tailored support when an individual decides to stop smoking.
Therapeutic Hypothermia in Deceased Organ Donors and Kidney-Graft Function
Authors: Claus U. Niemann, John Feiner, Sharon Swain, Scott Bunting, Melissa Friedman, Megan Crutchfield, Kristine Broglio, Ryutaro Hirose, John P. Roberts, Darren Malinoski
Journal: New England Journal of Medicine (2015)

Delayed graft function, which is reported in up to 50% of kidney-transplant recipients, is associated with increased costs and diminished long-term graft function. The effect that targeted mild hypothermia in organ donors before organ recovery has on the rate of delayed graft function is unclear.We enrolled organ donors (after declaration of death according to neurologic criteria) from two large donation service areas and randomly assigned them to one of two targeted temperature ranges: 34 to 35°C (hypothermia) or 36.5 to 37.5°C (normothermia). Temperature protocols, which were initiated after authorization was obtained for the organ to be donated and for the donor's participation in the study, ended when organ donors left the intensive care unit for organ recovery in the operating room. The primary outcome was delayed graft function in the kidney recipients, which was defined as the requirement for dialysis during the first week after transplantation. Secondary outcomes were the rates of individual organs transplanted in each treatment group and the total number of organs transplanted from each donor.The study was terminated early, on the recommendation of an independent data and safety monitoring board, after the interim analysis showed efficacy of hypothermia. At trial termination, 370 organ donors had been enrolled (180 in the hypothermia group and 190 in the normothermia group). A total of 572 patients received a kidney transplant (285 kidneys from donors in the hypothermia group and 287 kidneys from donors in the normothermia group). Delayed graft function developed in 79 recipients of kidneys from donors in the hypothermia group (28%) and in 112 recipients of kidneys from donors in the normothermia group (39%) (odds ratio, 0.62; 95% confidence interval, 0.43 to 0.92; P=0.02).Mild hypothermia, as compared with normothermia, in organ donors after declaration of death according to neurologic criteria significantly reduced the rate of delayed graft function among recipients. (Funded by the Health Resources and Services Administration; ClinicalTrials.gov number, NCT01680744.).
Future Directions for Cardiovascular Disease Comparative Effectiveness Research
Authors: Mark A. Hlatky, Pamela S. Douglas, Nakela L. Cook, Barbara Wells, Emelia J. Benjamin, Kay Dickersin, David C. Goff, Alan T. Hirsch, Elaine M. Hylek, Eric D. Peterson, Véronique L. Roger, Joseph V. Selby, James E. Udelson, Michael S. Lauer
Journal: Journal of the American College of Cardiology (2012)
Non-surgical and drug treatments
Authors: Stuart Enoch, Joseph E Grey, Keith G Harding
Journal: BMJ (2006)

Despite great strides in technological innovations and the emergence of a wide range of treatments for wounds, non-healing wounds continue to perplex and challenge doctors. Various non-surgical approaches have been developed and numerous drugs have been introduced to aid the management of such wounds.



Fig 1 
Left: Components of four layer bandage system. Right: Four layer bandage system to treat venous ulcer (note class II compression stocking on right leg for prevention of ulceration)



View this table:

Single layer compression bandages



### Bandages and hosiery

Compression bandages are used to treat lower limb ulcers secondary to venous insufficiency (venous leg ulcers) and lymphoedema. Single layer compression bandages (elastic) are classified into four groups according to the predetermined levels of compression they provide at the ankle. Inelastic compression bandages (short stretch), when applied at full extension, improve the calf muscle pump action and exert higher pressures when the patient is upright (and walking) and lower pressures at rest. They are useful in patients who are adequately mobile. An elasticated tubular bandage (one to three layers) may be useful to treat and prevent venous leg ulcers.

View this table:

Caution in use of compression bandages



Multilayer compression bandaging, such as the four layer method, is well established in the management of venous leg ulcers. It consists of four layers—padding, a crepe bandage, and classes 3a and 3b (UK classification) compression bandages—applied from the base of the toes to knee. Ideally, it should be left in place for four to seven days. Although effective, the bulkiness of these layers may lead to non-compliance in some patients. Its use is limited in heavily exuding ulcers as repeated dressing changes may be needed.

This is …
The role of thromboxane in allergen-induced asthmatic responses
Authors: PJ Manning, WH Stevens, DW Cockcroft, PM O'Byrne
Journal: European Respiratory Journal (1991)

In this study we evaluated the role of thromboxane in causing allergen-induced early and late asthmatic responses and airway hyperresponsiveness in asthmatic subjects. Twelve atopic subjects with stable asthma and documented early and late asthmatic responses to an inhaled allergen were treated with placebo or CGS 13080, a specific thromboxane synthetase inhibitor, given orally (200 mg four times daily) for two days before, the day of, and the day after allergen inhalation. Treatments were administered in a double-blind, placebo-controlled, crossover fashion. The effect of pretreatment with CGS 13080 was examined on serum TxB2 levels and the magnitude of the asthmatic responses after inhaled allergen. Serum TxB2 levels increased significantly from 96 ng.ml-1 (SEM 29) 3 h after diluent to 151 ng.ml-1 (SEM 27) 3 h after allergen (p = 0.008). CGS 13080 pretreatment markedly inhibited the levels of TxB2 at all time points before and after inhaled allergen (p = 0.0001) and had a small but significant effect on the magnitude of the early asthmatic responses after allergen (p = 0.0009). CGS 13080 did not alter either late asthmatic responses, baseline airway responsiveness, or the increase in histamine airway responsiveness after allergen. These results suggest that allergen-induced early asthmatic responses, but not late responses or allergen-induced airway hyperresponsiveness, are partly caused by thromboxane release.
Abstract 2871: Correlation between number and sites of metastases and differential pretreated EBV DNA load profiles and their effects on outcomes in patients with metastatic nasopharyngeal carcinoma
Authors: Hung-Ming Wang, Kai-Ping Chang, Tung-Liang Lin, Shiang-Fu Huang, Ngan-Ming Tsang, Sheng-Chieh Chan, Cheng-Lung Hsu
Journal: Cancer Research (2014)

Abstract Background: To investigate the relationship between pretreatment plasma EBV DNA copy number and sites and numbers of metastases in patients with nasopharyngeal carcinoma (NPC). Methods: One hundred and thirty-three patients with metastatic NPC were treated at outpatient department. Their plasma EBV DNA concentrations were determined by real-time quantitative PCR. Results: The overall patient response rate after 3-6 months of treatment was 48.1%. Pretreatment plasma EBV DNA concentrations were lower in patients with solitary nodule (≤5,000 copies/mL, 18/25 [72%] vs. multiple nodules, 49/128 [45.4%], P=0.025) or pure lung metastases (≤5,000 copies/mL, 19/21 [90.5%] vs. not lung metastases alone 48/112 [42.9%], P&amp;lt;0.001) and higher in patients with liver involvement, alone or combined with other organs (≤5,000 copies/mL, 18/54 [33.3%] vs. non-liver metastases 49/79 [62%], P=0.001); and bone related metastases (≤5,000 copies/mL, 33/83 [39.8%] vs. non-bone metastases 34/50 [68%], P=0.002). Moreover, plasma EBV DNA concentration was correlated with overall survival (OS) (≤5,000 vs. &amp;gt;5,000 copies/mL, median OS, 26 vs. 10 months; HR, 2.852; P&amp;lt;0.001). Conclusions: Pretreatment plasma EBV DNA copy number correlated with number and sites of metastases and with OS in patients with metastatic NPC. Citation Format: Hung-Ming Wang, Kai-Ping Chang, Tung-Liang Lin, Shiang-Fu Huang, Ngan-Ming Tsang, Sheng-Chieh Chan, Cheng-Lung Hsu. Correlation between number and sites of metastases and differential pretreated EBV DNA load profiles and their effects on outcomes in patients with metastatic nasopharyngeal carcinoma. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2871. doi:10.1158/1538-7445.AM2014-2871
Personal paper: Disclosure of clinical audit records in law: risks and possible defences
Authors: C. Womack, S. Roger, M. Lavin
Journal: BMJ (1997)

Clinical audit records have some degree of protection. The BMA recommends that access to audit information should be limited “to only those individuals, within the organisation, with a legitimate interest,” the organisation having further privilege” to control and restrict anonymised audit information for external organisations or individuals.”1 The code of practice on openness in the NHS aims to ensure, among other things, that people “have access to available information about the services provided by the NHS,” including “quality standards.”2It does not, however, propose publishing information about the performance of an individual clinician or the quality and outcome of the care of individual patients.2 The code also detailsinformation that may be withheld, and clinical audit records may fall into one or more of the four following exempt categories:

Strict guidelines in this clinical audit department cover security, dissemination, and disposal of audit information, over and above the trust employees' obligation and the Data Protection Act.

#### Summary points

Clinical audit assesses clinical practice against agreed standards—it is an educational process that aims to improve patient care

Audit may uncover activities that fall short of the standard, and to encourage participation and enable uninhibited discussion and resolution of these problems, clinical audit is protected by restricted access and anonymised patient and …
Exposure of the Fetus, Neonate, and Nursed Infant to Nicotine and Cotinine from Maternal Smoking
Authors: W Luck, H Nau
Journal: New England Journal of Medicine (1984)

The adverse effects of maternal cigarette smoking on the prenatal and postnatal development of the fetus and infant have been well documented.  Greenberg et al. (April 26 issue) have shown that saliva and urine from infants exposed as  smokers contained measurable amounts of nicotine and cotinine.  Our results indicate that nicotine concentrations in amniotic fluid placental tissue and fetal serum all exceed corresponding maternal serum concentrations probably because of ion trapping of this basic substance in the more acidic compartments.  Cotinine which is a weak base did not accumulate in the gestational fluids and tissues.  On the other hand in spite of elevated concentrations of nicotine in breast milk only very small amounts of this substance were found in serum and urine from nursed infants.  Passive smoking was minimized for these infants since the mothers were not allowed to smoke in the nursery.  The continine concentrations in these samples were also low.  Our results as well as those of Greenberg et al. indicate that measurable albeit low concentrations of nicotine and cotinine--transferred by passive smoking or in breast milk--can be detected in the infants serum saliva and urine.  However much higher concentrations of these toxins were present in fetal blood amniotic fluid and placental tissue.  Thus perinatal exposure to nicotine and cotinine by diaplacental and possibly paraplacental transfer appears to be quantitatively much more important than postnatal exposure by means of breast milk or inhaled air.  (full text)
Treatment takes precedence over monitoring
Authors: J. Clear, M. Yeoh, S. Cockroft
Journal: BMJ (1995)

teaching, intraosseous access may be secured without difficulty and should be considered in any paediatric emergency in which intravenous access cannot be secured promptly.Bolus and infusion doses of adrenaline can be given safely by this route, as can other pharmacological agents recommended in anaphylaxis.In children with signs of upper airway ob- struction caused by laryngeal mucosal oedema, nebulised adrenaline may lead to prompt resolution of stridor.5It should be given as a dose of either 0 05 ml of a 2-25% (racemic) solution/kg diluted to 2 ml with normal saline or, more conveniently, as 0 5 ml of a 1/1000 solution/kg (to a maximum of 5 ml).The child whose clinical history prompted Fisher's review would probably have benefited from this treatment.Finally, in both his article and the summary in "This week in BMY" Fisher states that oxygen should be given in severe anaphylaxis.We prefer the recommendations of the Association of Anaes- thetists of Great Britain and Ireland that oxygen should be given in all cases ofanaphylaxis regardless of the initial severity.3Hypoxaemia will develop quickly if a patient suddenly develops airway obstruction as a late complication of an initially mild attack.
Primary hormonal therapy with exemestane in patients with breast tumors &gt;3 cm in diameter: Results of a Spanish multicenter phase II trial
Authors: M. J. Gil Gil, A. Barnadas, L. Cirera, I. Tusquets, M. Muñoz, A. Arcusa, L. Prieto, A. Moreno, J. Graupera, M. Margeli
Journal: Journal of Clinical Oncology (2004)

603 Background: Primary hormonal therapies have demonstrated great activity in elderly women with locally advanced and hormone-dependent breast tumors. Exemestane, a steroidal aromatase inactivator, is effective in a metastatic setting. The primary aim of this study was to analyze the efficacy of exemestane as a neoadjuvant treatment. Methods: 55 patients (p) were recruited. Inclusion criteria were histologic diagnosis of infiltrating breast carcinoma, no metastatic disease, tumor >3 cm (T2, T3, T4a-b), >50% ER+, and no previous hormonal treatment/chemotherapy. At baseline, all p were considered noneligible for breast-conserving surgery. Treatment: oral exemestane 25 mg/d for 6 months. Response was estimated by mammography and breast ultrasound every 2 months (RECIST criteria). Secondary endpoints were rate of breast-conserving surgery, time to progression, duration of response, and toxicity. To date, 50 p have been evaluated for response and 5 remain under treatment. Results: Patient characteristics: median age 77 (67–88); tumor stage: T2: 25, T3: 7 and T4a-b: 23; nodal status: N0: 30, N1: 20 and N2: 5; tumor grade I: 3, II: 24, III: 6 and unknown: 22. Responses were CR: 1, PR: 24, SD: 24 and PD: 1. Overall clinical response: 25 of 50 evaluable p (45% ITT) (95% CI 36.1%–63.8%). Median time to surgery: 7 months. Surgery type: conservative 21 p, mastectomy 17 p, no operation 12 p (various reasons). Pathologic complete response was observed in the breast and axilla in 3 p; partial pathologic remission was seen in 14 p. Grade I-II toxicity: hot flushes, nausea, dizziness, and pain. No patient was withdrawn for toxic events. Conclusions: Exemestane was found to be a well-tolerated and effective neoadjuvant treatment in elderly patients with a breast cancer tumor >3 cm in diameter. Conservative surgery was possible in most responding patients. No severe treatment-related adverse events were detected. No significant financial relationships to disclose.
Sexual health of homosexual men and women
Authors: G. Brook, R. Bell
Journal: BMJ (1999)

Trust wants help in formulating system to recognise performance of salaried GPsEditor-General practitioners (academic and non-academic) are still excluded from the merit award arrangements for consultants.We are therefore asking readers to help us formulate a system to recognise progress and performance for salaried general practitioners in our trust.We currently employ several general practitioners on the NHS consultant salary scale.They take part in the discretionary points system, but we would like now to develop detailed proposals by which they could progress through enhanced payments-wholly funded by the trustagainst meritorious criteria, which would be widely recognised and acknowledged.This would give them similar opportunities for recognition to those
A current view of the interface between borderline personality disorder and depression
Authors: J G Gunderson, K A Phillips
Journal: American Journal of Psychiatry (1991)

The recent and dramatic expansion in studies about borderline and depressive disorders is reviewed with respect to the implications about their interface. Revisiting this subject 6 years after an earlier review reveals that intervening research has altered the conclusions that should be drawn. Growing evidence from family history, comorbidity, phenomenology, psychopharmacology, biological markers, and a new domain, pathogenesis, indicates that a surprisingly weak and nonspecific relationship exists between these disorders. Implications are drawn with respect to classification, therapeutics, and defining the borderline construct.
Abstract 87: Obstacles of Prompt Deployment of Mechanical CPR Devices During ED Resuscitation: a Video-Recording and Time-Motion Study
Authors: Edward P Huang, Chia-Ming Fu, Jiun-Wei Chen, Yen-Chen Liao, Hunag-Chieh Liu, Hui-Chih Wang, Wen-Chu Chiang, Patrick C Ko, Matthew H Ma, Shyr-Chyr Chen
Journal: Circulation (2010)

Background: Quality of CPR is important to survival. Mechanical CPR can provide constant CPR, especially during prolonged resuscitation, but the contribution of the device may be affected by deploy...