tbuckley/cabot-search huggingface dataset:
Management of nodular thyroid disease
Authors: M K. Jones
Journal: BMJ (2001)

Thyroid nodules are found in 5% of middle aged women and are commoner in women than in men. A nodule raises concerns about malignant disease, but thyroid cancer is rare, accounting for about 1000 new cases in England and Wales each year. The main aim of management is to identify the small proportion of patients with thyroid cancer who require treatment and avoid unnecessary testing and treatment for the majority.

Nodules are more likely to be malignant in men, particularly men aged over 70.1 A history of neck irradiation, rapid tumour growth, or a family history of thyroid cancer increases risk. Physical signs associated with increased risk include firm, non-tender nodules, local lymphadenopathy, and recurrent laryngeal nerve palsy in the absence of previous surgery. The incidence of cancer in those with clinical features strongly suggestive of malignancy is high,2 but most patients do not have these features.

Solitary nodules are more common than multinodular goitres clinically, and solitary nodules used to be considered more likely to harbour malignant disease. This view …
Abstract 9142: Post Procedural Changes of P-wave Duration can Predict Recurrence of Atrial Fibrillation after Circumferential Pulmonary Vein Isolation
Authors: Yasuyuki Egami, Masami Nishino, Masayuki Taniike, Nobuhiko Makino, Hiroyasu Kato, Ryu Shutta, Hisaki Morita, Jun Tanouchi, Yoshio Yamada
Journal: Circulation (2011)

Background: It has been reported that the significant shortening of P-wave duration after pulmonary vein isolation was related to successful outcome. However, the impact of the clinical outcomes after circumferential pulmonary vein isolation (CPVI) on the serial changes of P-wave characteristics is not clear. We hypothesized that the recurrence of atrial fibrillation (AF) prolonged P-wave duration and the recurrence of AF after CPVI affected the P-wave parameters by P-wave signal averaged electrocardiogram (P-SAECG). Methods: Fifty-nine patients (65±7years, 41 male) with AF (paroxysmal AF : n=44, persistent AF : n=15) who underwent CPVI alone and received P-SAECG at 2 days, 2 weeks, and 4weeks after CPVI were enrolled in this study. By using P-SAECG, the filtered P-wave duration (FPD) and root mean square voltage for the last 20msec (RMS20) were measured and the serial changes of FPD and RMS20 were calculated. AF recurrence was defined as patient's symptom and any episode of AF lasting &gt; 30 seconds on surface 12-leads ECG or 24-hour Holter ECG during follow-up periods except for 2 months post CPVI. Results: The patients were followed for 6±3 months. The recurrences of AF occurred in 18 of 59 patients (31%). The results of P-SAECG parameters were shown as table. The FPD of 2 days, 2weeks and 4weeks after CPVI in AF recurrence group was significantly longer than that in sinus rhythm (SR) maintenance group and the ΔFPD 4weeks in AF recurrence group was significantly prolonged than that in SR maintenance group. Using FPD 4weeks as cutoff value of &gt; 130.5 msec to predict AF recurrence, the sensitivity and specificity were 65% and 61%, respectively. Using ΔFPD 4weeks as cutoff value of &gt; 3.5 msec to predict AF recurrence, the sensitivity and specificity were 71% and 63%, respectively. Conclusion: The longer FPD and prolongation of FPD for one month after CPVI can predict the recurrence of AF after CPVI.
Abstract 18108: Critical Cysteine Oxidation is Reduced During Ischemia-Reperfusion Injury via S-nitrosothiol Formation
Authors: Mark J Kohr, Junhui Sun, Angel Aponte, Marjan Gucek, Elizabeth Murphy, Charles Steenbergen
Journal: Circulation (2010)

Myocardial ischemic preconditioning (IPC) yields an increase in protein S-nitrosothiol (SNO) formation. Furthermore, inhibition of GSNO-reductase has been shown to increase protein SNO and is cardi...
Validation of ThermoFisher's Papspin for human papillomavirus detection in cervicovaginal specimens using PCR with GP5+/GP6+ primers and the Hybrid Capture II assay
Authors: B. Weynand, P. Delvenne, R. Polet, Y. Guiot, M. Arafa, J. Somja, C. Galant
Journal: Clinical Microbiology and Infection (2009)
Patients promised online access to their medical records by 2018
Authors: Gareth Iacobucci
Journal: BMJ (2015)

Variations of diaphragm thickness (DT) during different respiratory maneuvers can be measured by B-mode ultrasonography (US). In order to verify if this parameter provides useful insights for functional assessment in DMD, we measured DT by a 7.5 MHz US linear probe in the 9th or 10th right intercostal space in 39 DMD patients (age 16.3±4.4 yrs, FVC 53.2±24.8%pred) in supine position at rest (end-expiration during quiet breathing, QB) and maximal inspiratory pressure (MIP) at residual volume. The contribution of the abdominal compartment to tidal volume (Vab%) was assessed by optoelectronic plethysmography during QB and an inspiratory capacity (IC) maneuver. Patients were subdivided into 3 groups according to age (G1: n=11, age&lt;14; G2: n=13, 14&lt;age&gt;18; G3: n= 15, age&gt;18 yrs). MIP was significantly higher in G2 compared to both G1 and G3 (fig., left). The variation of DT during the MIP maneuver, expressed as % change of DT at rest, was significantly greater in G3 compared to G1. Patients belonging to G3 group were also characterized by lower Vab% during IC. In conclusion, in DMD patients&gt;18 yrs MIP decreases and maximal variation of DT increases. These results suggest that diaphragm impairment is expressed as a dissociation between muscle drive and muscle developed force. Measurements of DT by US allow a detailed noninvasive assessment on how alterations in diaphragm function progress in DMD.
Tadalafil in idiopathic or heritable pulmonary arterial hypertension compared to pulmonary arterial hypertension associated with connective tissue disease
Authors: Nazzareno Galie, Robyn Barst, Bruce Brundage, Hossein A. Ghofrani, Ronald Oudiz, Gerald Simonneau
Journal: European Respiratory Journal (2011)

Patients (pts) with PAH associated with connective tissue disease (APAH-CTD) have a worse prognosis compared to idiopathic (I) or heritable (H)PAH. Our objective was to evaluate the clinical outcomes in these two subgroups.  In a 16 week (wk), double-blind, placebo (PBO) controlled trial with blinded 52 wk extension, pts were randomized to PBO, 20 or 40mg tadalafil (Tad) qd (APAH-CTD: n=16, 21 and 19, respectively; I/HPAH: n=54, 50 and 46, respectively); subgroup efficacy analyses included six-minute walk test (6MWT, 40mg) at Wk16 (assessed by rank permutation tests) and clinical worsening (CW, PBO and 40mg) at Wk16 and up to 68wks (20 and 40mg). Pts on 20mg without CW at 16wks remained on 20mg; all others received 40mg in the extension.  Mean changes in 6MWT from baseline to Wk16 were 32m in APAH-CTD and 38m in I/HPAH for 40mg Tad dose. PBO-corrected treatment effects on 6MWT at Wk 16 were 49m in APAH-CTD (P=0.03) and 22m in I/HPAH (P=0.04). The% of pts with CW in the Tad 40mg and PBO subgroups at Wk16 were 11 and 25% in APAH-CTD, respectively; and 4 and 15% in I/HPAH, respectively. In pts who received Tad 20 or 40mg up to 68wks, CW was 35% in APAH-CTD (n=40) and 24% in I/HPAH (n=96).  Tad 40mg improves 6MWT at Wk16 in APAH-CTD and I/HPAH; however, with PBO 6MWT decreased in APAH-CTD but not in I/HPAH pts. In addition, CW was numerically less with Tad in both subgroups at Wk16 compared to PBO. At Wk68, CW was numerically higher in APAH-CTD vs. I/HPAH. These latter data are consistent with a worse prognosis in APAH-CTD. Whether more aggressive therapy earlier in APAH-CTD pts would be efficacious requires further study.
Methicillin-resistant Staphylococcus aureus producing Panton–Valentine leukocidin as a cause of acute osteomyelitis in children
Authors: G. Sdougkos, V. Chini, D.A. Papanastasiou, G. Christodoulou, G. Tagaris, G. Dimitracopoulos, I. Spiliopoulou
Journal: Clinical Microbiology and Infection (2007)
The use of bethanechol chloride with tricyclic antidepressants
Authors: H C Everett
Journal: American Journal of Psychiatry (1975)

The author describes the use of bethanechol chloride to relieve side effects, including salivary inactivation, constipation, and bladder inhibition, which result from the anticholinergic action of tricyclic antidepressants. He suggests that the use of cholinergic medication during antidepressant therapy may extend the use of the tricyclics to patients who find anticholinergic side effects especially troublesome.
Elevated CSF corticotropin-releasing factor concentrations in posttraumatic stress disorder
Authors: J Bremner, Julio Licinio, Adam Darnell, John Krystal, Michael Owens, Steven Southwick, Charles Nemeroff, Dennis Charney
Journal: American Journal of Psychiatry (1997)

Corticotropin-releasing factor (CRF) and somatostatin both play important roles in mediating responses to acute and chronic stress. The purpose of this study was to measure CSF concentrations of CRF and somatostatin in patients with chronic combat-related post-traumatic stress disorder (PTSD) and comparison subjects.Lumbar punctures for collection of CSF were performed in Vietnam combat veterans with PTSD (N = 11) and comparison subjects (N = 17). CSF concentrations of CRF and somatostatin were compared between the two groups.CSF concentrations of CRF were higher in the PTSD patients than in the comparison subjects (mean = 29.0 pg/ml, SD = 7.8, versus mean = 21.9 pg/ml, SD = 6.0). This group difference remained significant after covariance for age. CSF somatostatin concentrations in PTSD patients were higher than those of the comparison subjects (mean = 19.9 pg/ml, SD = 5.4, versus mean = 13.7 pg/ml, SD = 8.0). However, covarying for age reduced the level of significance.Higher CSF CRF concentrations in patients with PTSD may reflect alterations in stress-related neurotransmitter systems. The higher CSF CRF concentrations may play a role in disturbances of arousal in patients with PTSD.
Impact of age and comorbidity on presentation, aetiology and outcome in patients with community-acquired pneumonia
Authors: Catia Cilloniz, Eva Polverino, Santiago Ewig, Stefano Aliberti, Albert Gabarrus, Rosario Menéndez, Josep Mensa, Francesco Blasi, Antoni Torres
Journal: European Respiratory Journal (2012)

Background : Community-acquired pneumonia (CAP) is currently undergoing re-evaluation. The aim of the study was to determine the influence of age and comorbidity on microbial patterns in elderly patients with community-acquired pneumonia (CAP).   Methods:  In a prospective observational study of adult patients with CAP, excluding those residing in nursing homes, we compared patients aged 65 -74 years, 75 - 84 years and 85 years or older for potential differences in clinical presentation, comorbidities, severity on admission, microbial investigations, aetiologies, antimicrobial treatment, and outcomes.   Findings : We studied a total of 2149 patients. The number of patients in each age group was as follows: 759 (35·3%) patients aged 65-74 years, 941 (43·7%) aged 75-84 years, and 449 (20·8%) patients aged 85 years or older. At least one comorbidity was present in 1710 (79·6%) patients.  Streptococcus pneumoniae  was the most frequent pathogen in all age groups, regardless of comorbidity. Pathogens such as  S. aureus (including MRSA),  H. influenzae , enterobacteriaceae, and  P. aeruginosa  were present in 15% and were found almost exclusively in patients with comorbidities. Increasing CAP severity on admission and mortality but decreasing ICU admission rates and use of mechanical ventilation suggested an increasing frequency of treatment restrictions across age groups.   Interpretation:  Age did not significantly affect pathogen patterns. Potential multidrug-resistant (MDR) pathogens were not frequent and were found almost exclusively in patients with comorbidities. Excess mortality in the elderly was not related to aetiology but to age and disability.
Emergence of Ciprofloxacin Resistance in Nosocomial Methicillin-Resistant Staphylococcus Aureus Isolates
Authors: L.R. Peterson, J.N. Quick, B. Jensen, S. Homann, S. Johnson, J. Tenquist, C. Shanholtzer, R.A. Petzel, L. Sinn, D.N. Gerding
Journal: JAMA Internal Medicine (1990)
Introduction of human papillomavirus (HPV) vaccination in Belgium, 2007-2008
Authors: C Simoens, M Sabbe, P Van Damme, P Beutels, M Arbyn
Journal: Eurosurveillance (2009)

This paper documents the progress of human papillomavirus (HPV) vaccine introduction in Belgium. Information on vaccine use is based on sales statistics and reimbursement claims. From November 2007 to November 2008, the National Institute for Health and Disability Insurance reimbursed the HPV vaccine for girls aged between 12-15 years. In December 2008, the age limit was extended to include girls up to the age of 18. In November 2008, the total number of HPV vaccines sold exceeded 530,000 doses. The number of vaccines reimbursed in Belgium, for the period November 2007-November 2008, corresponds to the amount required to fully vaccinate 44% of all girls aged between 12-15 years. However, the trend was decreasing over the last 10 months. By the current reimbursement policy, we can expect that maximum half of the target population can be reached. In Flanders (one of the three Communities in Belgium), the intention is to start, from September 2010, with a free school-based HPV immunisation for girls in the first year of secondary school (12 years of age), complemented with vaccination by a physician of choice. This strategy ensures a higher HPV vaccine coverage which is expected to be as high as the current coverage in the hepatitis B vaccination programme (approximately 80%) offered to boys and girls in the same age group and under the same circumstances.
Induced CD8+FoxP3+ Treg Cells in Rheumatoid Arthritis Are Modulated by p38 Phosphorylation and Monocytes Expressing Membrane Tumor Necrosis Factor α and CD86
Authors: Shawn D. P. Ellis, Jenny L. McGovern, André van Maurik, David Howe, Michael R. Ehrenstein, Clare A. Notley
Journal: Arthritis & Rheumatology (2014)

Objective Limiting the severity of inflammation and promoting its eventual resolution are vital for protecting host tissues both in autoimmunity and chronic infection. The aim of this study was to determine the suitability of repurposing anti‐CD3 monoclonal antibody (mAb) therapy for rheumatoid arthritis (RA) by analyzing its ability to induce CD8+FoxP3+ Treg cells from peripheral blood mononuclear cells (PBMCs). Methods Anti‐CD3 mAb was cultured with RA PBMCs to induce CD8+FoxP3+ Treg cells, which were analyzed by flow cytometry to determine their phenotype. Treg cell induction was investigated via neutralization or blocking antibodies, cellular depletion, or ImageStream technology. Blotting was used to determine the signaling pathways involved in CD8+FoxP3+ Treg cell induction. Suppression of CD4+ T cell effector responses was assessed by Treg cell suppression assays and Mosaic enzyme‐linked immunosorbent assay. Results Potent CD8+FoxP3+ Treg cells were induced from RA PBMCs by anti‐CD3 mAb. Unlike their CD4+ counterparts, CD8+FoxP3+ Treg cells inhibited Th17 responses in a contact‐dependent manner, thereby functioning to limit a wider range of inflammatory pathways. CD8+FoxP3+ Treg cell induction was supported both by p38 phosphorylation intrinsic to naive CD8+ T cells and by monocytes via CD86 and membrane tumor necrosis factor α (TNFα). Artificially increasing monocyte membrane TNFα or inhibiting CD8+ T cell p38 phosphorylation drove FoxP3 expression in a subset of initially unresponsive CD8+ T cells. Conclusion These data define an unknown mechanism of CD8+FoxP3+ Treg cell induction by anti‐CD3 mAb, which could be combined with a p38 inhibitor to improve therapeutic efficacy in RA patients and resolve chronic inflammation via the restoration of tolerance.
Abstract 231: Edaravone Preserves Coronary Microvascular Nitric Oxide Availability and Myocardial eNOS Expression on Ischemia/Reperfusion Injury in Canine Heart
Authors: Renan Sukmawan, Toyotaka Yada, Eiji Toyota, Yoji Neishi, Teruyoshi Kume, Yoshisuke Haruna, Naoki Kashihara, Hidezo Mori, Yoshiro Shinozaki, Yasuo Ogasawara, Hiroyuki Okura, Kiyoshi Yoshida
Journal: Circulation (2006)

Background: Coronary ischemia/reperfusion (I/R) leads to a burst of free radicals generation. Nitric oxide (NO) plays an important role to maintain the tissue level perfusion after I/R. We examined...
Soluble mesothelin as a monitoring tool in the management of malignant mesothelioma patients
Authors: Kevin Hollevoet, Eliane Kellen, Kristiaan Nackaerts, Lionel Bosquee, Paul Germonpre, Joris Delanghe, Catherine Legrand, Jan P. van Meerbeeck
Journal: Journal of Thoracic Oncology (2009)
Issues critical to the survival of community mental health
Authors: J F Borus
Journal: American Journal of Psychiatry (1978)

The author delineates some of the critical issues that face community mental health, with the opportunity for either growth and further development or regression into a decentralized type of custodial care. These issues include clarifying boundaries and priorities, caring for chronically ill deinstitutionalized patients, providing differentiated care, collaborating with the community, relating to the rest of psychiatry and medicine, defining the community psychiatrist's role, maintaining psychiatric manpower, undertaking evaluation research, and achieving stable funding. Psychiatry's response to these issues will help determine the resolution of this crisis and the future viability and direction of community mental health.
Loose cough as sign of hyper secretion and inflammation in airways in relation to smoking index
Authors: Dragana Sumrak, Vladimir Jakovljevic, Tomislav Dokic
Journal: European Respiratory Journal (2012)

Cough may be considered as a symptom of disease, an indicator of environmental pollution. In addition, the subject may produce cough through voluntary control. The aim of this study was to determine the quality and humidness of voluntary cough as a sign of inflammatory bronchial alterations leading to hyper secretion in patients chronic obstructive bronchitis (COB) in relation to “Smoking Index” (years x cigarettes per day). Evaluation of lung function included clinical examination, electrocardiogram, estimation of blood, urine and function of the lung. The diagnosis of a disease as a basis for cough can be established with measurements of indirect tests (forced expiratory flow in first second (FEV1), maximal expiratory flow at 25% and 50% of FVC (MEF 25%FVC, MEF 50% FVC), and direct tests by measurement of airway resistance to flow. The results presented in this study were done on 147. patients with COB. The control groups consisted 132. subjects, and none of these subjects had symptoms or a history of pulmonary or cardiac diseases. Beside the questionnaire MRC, there was obligation to each subject to perform the test of cough, which is established on the base that in healthy subjects with normal bronchial mucosa provoked voluntary cough is dry, while in patients with inflammation in bronchial mucosa, the cough is humid assessed by auscultation. In smokers with COB the presence of chronic productive cough was in a positive correlation with increase of “Smoking Index”. In smokers with COB were negative correlation between “Smoking Index” and positive test of humid cough. Increase of “Smoking Index” was followed with decrease of the incidence of humid cough in patients with COB.
Treatment of bone and joint infections caused by Gram-negative bacilli with a cefepime–fluoroquinolone combination
Authors: L. Legout, E. Senneville, R. Stern, Y. Yazdanpanah, C. Savage, M. Roussel-Delvalez, B. Rosele, H. Migaud, Y. Mouton
Journal: Clinical Microbiology and Infection (2006)
Gender differences in patients with aspirin-induced asthma (AIA)
Authors: Grazyna Bochenek, Joanna Kuschill-Dziurda, Krystyna Szafraniec, Tomasz Stachura, Ewa Nizankowska-Mogilnicka
Journal: European Respiratory Journal (2013)

Background: AIA is characterized by a predilection for female gender, which was revealed in two large cohort studies carried out in Europe and in the United States. Females (F) differed from males (M) only in several clinical features.  Aims: To assess possible gender differences in a cohort of patients with confirmed AIA, diagnosed in our Department.  Methods: Clinical data of 201 AIA patients were collected by means of specifically structured questionnaire. Demographics and detailed medical history concerning the course of asthma, upper airways symptoms, presence of nasal polyps, history of polypectomies were taken. Patients were asked about allergies, asthma-related emergency department (ED) visits, hospitalizations. Asthma severity and control were assessed according NAEPP EPR3 guideline and ACT, respectively. Spirometry, skin tests, total IgE, blood eosinophilia were also evaluated.  Results: F outnumbered M twice (134 vs 67). F differed from M by longer asthma duration, younger age of asthma onset and appearance of aspirin hypersensitivity. F had more NSAIDs induced asthma attacks per patient and asthma related hospitalizations but less asthma-related ED visits. Nasal polyps were diagnosed more often in M but the frequency of polypectomies was comparable in both genders. There were no differences as regards asthma severity and control levels. Positive skin prick tests to mites and seasonal allergens were found more often in F. No differences were found in the other variables studied.  Conclusions: Despite the females predominance in AIA, no substantial clinical and laboratory differences existed between both genders. The actual effect of gender on the course of AIA is far from clear and awaits further explanation.
Analysis of clinical course after pulmonary resection for mycobacterium avium complex lung disease in our hospital
Authors: Mitsuhiro Tada, Shuichi Yano, Kanako Kobayashi, Emiko Nishikawa, Shinichi Iwamoto, Toru Kadowaki, Hibiki Kanda, Masahiro Kimura, Toshikazu Ikeda, Yasuaki Kubouchi, Yoshin Adachi, Hiroyuki Metsugi, Takeshi Tokushima
Journal: European Respiratory Journal (2014)

Background  The localization of lesions is an important factor in determining operability of patients with  Mycobacterium avium complex  ( MAC )  lung  disease. If multilocular small lesions are present, it is difficult to surgically resect all of these lesions. In such a case, residual lesions can become a problem after surgery.  Aim  The aim of this study is to focus on residual lesions after surgery and to examine the postoperative outcomes.  Methods  This study retrospectively analyzed 39 patients with MAC lung disease who were surgically treated between 1999 and 2012 at our hospital. The study evaluated patients for two years after surgery, and the therapeutic effects were assessed mainly using chest CT.  Results  The 39 patients consisted of 13 men and 26 women. The mean age was 57 years (range: 24-77 years). The main lesions were cavitary lesions in 22 patients, bronchiectatic  lesions in 12 patients, and lesions with granular or nodular pattern in 5 patients. Neoadjuvant and adjuvant chemotherapy regimens were mainly a combination of  rifampicin, clarithromycin, and ethambutol.  Eighteen patients were thought to have achieved total excision and 21 patients had residual lesions. There were 8 patients whose opacities clearly worsened. All 8 patients had residual lesions, of whom 7 patients had cavitary or  bronchiectatic  lesions. The presence of residual cavitary or  bronchiectatic  lesions was associated with significant worsening of opacities compared with the presence of residual  lesions with granular or nodular pattern.  Conclusion  Postoperative worsening of opacity was associated with the presence of postoperative residual  cavitary or  bronchiectatic  lesion.