tbuckley/cabot-search huggingface dataset:
Do targeted smoking cessation ward rounds increase referrals to smoking cessation services? A survey in a UK district general hospital
Authors: Jessica Maycock, Victoria Foy, Patrick Mulholland, Dilip Nazareth, Simon Twite, Paul Stockton
Journal: European Respiratory Journal (2011)

Background:  NICE (UK) recommends that all smokers should be advised to quit and that individuals who want to stop smoking should be referred to an intensive smoking cessation service (SCS). In a previous study at our institution, 74% of patients had a missed opportunity for referral to the SCS during a hospital admission. A major factor was the lack of knowledge about the service by health care professionals and patients. Subsequently, a “targeted smoking cessation ward round” was introduced at the hospital. This study compares the current utilization of the SCS to that in 2008.   Method:  A voluntary questionnaire surveying the utilization of the SCS was completed by 187 patients (58% smokers past or present of which 69% were current smokers).   Results:  38% (23% in 2008) of current smokers indicated that they would like a referral to the service and were subsequently offered related reading material and an appointment. The table below summarises the results.   Conclusions:  Referral to SCS has improved significantly between the two surveys. The introduction of daily targeted smoking cessation ward rounds and the promotion of the SCS has resulted in improved uptake of the SCS. However, further education of health care professionals in primary and secondary care is needed with regards to the importance of smoking cessation and the need to refer to a specialist smoking cessation service.
Cystic Fibrosis Sputum
Authors: NIEK N. SANDERS, STEFAAN C. DE SMEDT, ELSA VAN ROMPAEY, PAUL SIMOENS, FRANS DE BAETS, JOSEPH DEMEESTER
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Cystic fibrosis (CF) is characterized by the presence of a viscoelastic mucus layer in the upper airways and bronchi. The underlying problem is a mutation in the gene encoding the cystic fibrosis transmembrane conductance regulator protein. Clinical studies of gene transfer for CF are ongoing. For gene delivery to the airways of CF patients to be effective, the mucus covering the target cells must be overcome. We therefore examined the extent to which CF sputum presents a physical barrier to the transport of nanospheres of a size comparable to that of lipoplexes and other transfection systems currently being clinically evaluated for CF gene therapy. We observed that an extremely low percentage of nanospheres ( < 0.3%) moved through a 220- μ m–thick CF sputum layer after 150 min. The largest nanospheres studied (560 nm) were almost completely blocked by the sputum, whereas the smaller nanospheres (124 nm) were retarded only by a factor of 1.3 as compared with buffer. Surprisingly, the nanospheres diffused significantly more easily through the more viscoelastic sputum samples. We hypothesize that the structure of the network in sputum becomes more macroporous when the sputum becomes more viscoelastic. Sputum from a patient with chronic obstructive pulmonary disease retarded the transport of nanospheres to the same extent as did CF sputum. When directly mixed with CF sputum, recombinant human deoxyribonuclease I moderately facilitated the transport of nanospheres through CF sputum.
Idiopathic pulmonary arterial hypertension in the elderly: Data from the French registry
Authors: Frédéric Lador, Olivier Sitbon, Azzedine Yaïci, Emmanuel Bergot, Vincent Cottin, Laurence Rottat, Virginie Gressin, Marc Humbert, Gérald Simonneau
Journal: European Respiratory Journal (2011)

Rationale: Data from recent registries have shown that the mean age of patients with pulmonary arterial hypertension (PAH) is increasing.

Aim: To describe clinical and haemodynamic characteristics of incident (i.e. newly diagnosed) patients >70 yr included in the French Registry with a diagnosis of idiopathic (IPAH), heritable (HPAH) or anorexigen-related (ArPAH) PAH.

Methods: Data from all newly-diagnosed adult patients with IPAH, HPAH or ArPAH included in the French Registry between November 2006 and November 2009 were collected. Patients without right heart catheterization confirmation and those with a pulmonary capillary wedge pressure > 15 mmHg were excluded.

Results: Among the 350 patients who met the inclusion criteria, 100 (28.5%) were >70 yr. Clinical and haemodynamic characteristics at time of diagnosis are shown in the Table. Survival rates at 1, 2 and 3 years were 79%, 60% and 47% in those >70 yr, as compared to 92%, 84% and 76% in the 18-70 yr group, respectively (p<0.01).

View this table:



Conclusions: These results show an increasing proportion of elderly male among patients with IPAH and ArPAH. Patients >70 yr have a worse outcome than younger patients despite a less severe haemodynamic impairment.
CpG Island Methylator Phenotype Is a Strong Determinant of Poor Prognosis in Neuroblastomas
Authors: Masanobu Abe, Miki Ohira, Atsushi Kaneda, Yukiko Yagi, Seiichiro Yamamoto, Yoshihiro Kitano, Tsuyoshi Takato, Akira Nakagawara, Toshikazu Ushijima
Journal: Cancer Research (2005)

Neuroblastoma, one of the most common pediatric solid tumors, is characterized by two extreme disease courses, spontaneous regression and life-threatening progression. Here, we conducted a genome-wide search for differences in DNA methylation that distinguish between neuroblastomas of the two types. Three CpG islands (CGI) and two groups of CGIs were found to be methylated specifically in neuroblastomas with a poor prognosis. By quantitative analysis of 140 independent cases, methylation of all the five CGI (groups) was shown to be closely associated with each other, conforming to the CpG island methylator phenotype (CIMP) concept. The presence of CIMP was sensitively detected by methylation of the PCDHB CGIs and associated with significantly poor survival (hazard ratio, 22.1; 95% confidence interval, 5.3-93.4; P < 0.0001). Almost all cases with N-myc amplification (37 of 38 cases) exhibited CIMP. Even in 102 cases without N-myc amplification, the presence of CIMP (30 cases) strongly predicted poor survival (hazard ratio, 12.4; 95% confidence interval, 2.6-58.9; P = 0.002). Methylation of PCDHB CGIs, located in their gene bodies, did not suppress gene expression or induce histone modifications. However, CIMP was significantly associated with methylation of promoter CGIs of the RASSF1A and BLU tumor suppressor genes. The results showed that neuroblastomas with CIMP have a poor prognosis and suggested induction of silencing of important genes as an underlying mechanism.
An Audit of University Education in Trauma and Orthopaedic Surgery in Great Britain
Authors: J K O'Dowd, J D Spencer
Journal: Journal of the Royal Society of Medicine (1992)

An audit of undergraduate trauma and orthopaedic surgery teaching was carried out in 24 of the 27 medical schools in Great Britain and major differences were found between the medical schools. The range of time spent in teaching trauma and orthopaedic surgery for undergraduates varied from 3 weeks to 12 weeks and in five out of 27 medical schools trauma and orthopaedic surgery tuition was split between various years of the clinical curriculum. In some schools there were 30 students on a firm and in others only one. The opportunity for undergraduates to give feedback to their teachers, the use of objective assessment at the end of such an appointment by the teachers, varied between medical schools. To avoid some of these very basic differences between our medical schools, the teaching of clinical subjects to undergraduates in medicine should be reviewed nationally and minimum standards set.
Virus of Avian Myeloblastosis. XXI. Mechanism of Synthesis of Virus Ribonucleic Acid&lt;xref ref-type="fn" rid="fn1"&gt;2&lt;/xref&gt;
Authors: Lydia Sverak, G. S. Beaudreau, J. W. Beard
Journal: JNCI Journal of the National Cancer Institute (1962)

Journal Article Virus of Avian Myeloblastosis. XXI. Mechanism of Synthesis of Virus Ribonucleic Acid Get access Lydia Sverak, Lydia Sverak Department of Surgery, Duke University-Medical Center, Durham, North Carolina Search for other works by this author on: Oxford Academic PubMed Google Scholar G. S. Beaudreau, G. S. Beaudreau Department of Surgery, Duke University-Medical Center, Durham, North Carolina Search for other works by this author on: Oxford Academic PubMed Google Scholar J. W. Beard J. W. Beard Department of Surgery, Duke University-Medical Center, Durham, North Carolina Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 29, Issue 2, August 1962, Pages 355–373, https://doi.org/10.1093/jnci/29.2.355 Published: 01 August 1962 Article history Received: 23 February 1962 Published: 01 August 1962
Performance of the galactomannan antigen detection test in the diagnosis of invasive aspergillosis in children with cancer or undergoing haemopoietic stem cell transplantation
Authors: E. Castagnola, E. Furfaro, I. Caviglia, M. Licciardello, M. Faraci, F. Fioredda, P. Tomà, R. Bandettini, M. Machetti, C. Viscoli
Journal: Clinical Microbiology and Infection (2010)
Resistance of turkeys to experimental infection with an early 2009 Italian human influenza A(H1N1)v virus isolate
Authors: C Terregino, R De Nardi, R Nisi, F Cilloni, A Salviato, M Fasolato, I Capua
Journal: Eurosurveillance (2009)

We performed an experimental infection of 21- and 70-day-old meat turkeys with an early human isolate of the 2009 pandemic H1N1 influenza virus exhibiting an alpha-2,3 receptor binding profile. Virus was not recovered by molecular or conventional methods from blood, tracheal and cloacal swabs, lungs, intestine or muscle tissue. Seroconversion was detected in a limited number of birds with the homologous antigen only. Our findings suggest that in its present form, the pandemic H1N1 influenza virus is not likely to be transmitted to meat turkeys and does therefore not represent an animal health or food safety issue for this species.
David Lawrence Sackett, MD, MSc (Epidemiology), 1934–2015
Authors: R. Brian Haynes
Journal: Annals of Internal Medicine (2015)

ACP Journal Club18 August 2015David Lawrence Sackett, MD, MSc (Epidemiology), 1934–2015R. Brian Haynes, MD, MPH, MACP, Editor, ACP Journal ClubR. Brian Haynes, MD, MPH, MACP, Editor, ACP Journal ClubMcMaster University (R.H.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/ACPJC-2015-163-4-002 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationDavid Lawrence Sackett, MD, MSc (Epidemiology)References1. A proposal for more informative abstracts of clinical articles. Ad Hoc Working Group for Critical Appraisal of the Medical Literature. Ann Intern Med 1987;106:598–;604. [PMID: PMID: 3826959] Google Scholar2. The James Lind Library. www.jameslindlibrary.org/acp-journal-club-1991/ (accessed 22 Jun 2015). Google Scholar3. Goodreads. www.goodreads.com/quotes/535242-the-farther-back-you-can-look-the-farther-forward-you (accessed 22 Jun 2015). Google Scholar4. David Sackett: Interview in 2014 and 2015. http://fhs.mcmaster.ca/ceb/docs/David_L_Sackett_Interview_in_2014_2015.pdf. Google Scholar5. Unsigned editorial. Evidence based medicine, in its place. Lancet. 1995;346: 785. [PMID: PMID: 7674736] Google Scholar6. Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn't. BMJ. 1996;312:71-2. [PMID: PMID: 8555924] Google Scholar Author, Article, and Disclosure InformationAffiliations: McMaster University (R.H.)This article was published at Annals.org on 4 August 2015. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 18 August 2015Volume 163, Issue 4Page: JC2KeywordsClinical epidemiologyEpidemiologyEvidence based medicineGraduate medical educationHealth careHealth services researchMedical servicesNephrologyResearch designResidency ePublished: 18 August 2015 Issue Published: 18 August 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Stanford-Kaiser Permanente G1 study for clinical stage I to IIA Hodgkin's disease: subtotal lymphoid irradiation versus vinblastine, methotrexate, and bleomycin chemotherapy and regional irradiation.
Authors: S J Horning, R T Hoppe, J Mason, B W Brown, S L Hancock, D Baer, S A Rosenberg
Journal: Journal of Clinical Oncology (1997)

PURPOSE We have demonstrated that a relatively mild chemotherapy regimen, vinblastine, methotrexate, and bleomycin (VBM), and involved-field radiotherapy (IFRT) could substitute for extended-field radiotherapy in patients with favorable Hodgkin's disease (HD) who have been laparotomy-staged. The purpose of this study is to determine if VBM and regional radiotherapy can substitute for extended-field radiotherapy in favorable clinical stage (CS) I and II HD. PATIENTS AND METHODS Seventy-eight patients with favorable CS I to II HD were randomly assigned to subtotal lymphoid irradiation (STLI) or VBM chemotherapy and regional radiotherapy. Randomization was stratified on the basis of age, sex, number of Ann Arbor sites, histology, and institution. Patients were evaluated for freedom from progressive HD, survival, and toxicity. Results were compared with the predecessor trial in pathologically staged patients. RESULTS With a median follow-up period of 4 years, the rate of freedom from progressive HD was 92% (95% confidence interval [CI], 88% to 96%) for patients treated with STLI and 87% (95% CI, 81% to 93%) for patients treated with VBM and regional radiotherapy. Six of seven patients who relapsed are alive and in remission following successful second-line therapy. CONCLUSION Given the caveat of a small number of patients, the results of extended-field radiotherapy and VBM and regional radiotherapy are comparable with a median follow-up period of 4 years. VBM serves as a paradigm to reduce late effects in favorable early-stage HD. We do not advocate its routine use in clinical practice, but instead encourage participation in clinical trials with the objective of maintaining efficacy while reducing toxicity in CS I and II HD.
Standardized RT-PCR analysis of fusion gene transcripts from chromosome aberrations in acute leukemia for detection of minimal residual disease
Authors: JJM van Dongen, EA Macintyre, JA Gabert, E Delabesse, V Rossi, G Saglio, E Gottardi, A Rambaldi, G Dotti, F Griesinger, A Parreira, P Gameiro, M González Diáz, M Malec, AW Langerak, JF San Miguel, A Biondi
Journal: Leukemia (1999)
Evaluation of antimicrobial susceptibility of bacteria containing the qnr gene and FOX-5 β-lactamase by four automated systems
Authors: J.M. Rodríguez-Martinez, M.C. Conejo, L. Martínez-Martínez, M.E. Cano, C. Velasco, A. Pascual
Journal: Clinical Microbiology and Infection (2005)
A competence framework to support the development of the workforce to deliver improved outcomes for patients with COPD and asthma
Authors: Anne Moger, Sue Hill, Kevin Holton, Matt Kearney
Journal: European Respiratory Journal (2012)

Rationale   It is estimated that over 3 million people in the UK are living with COPD or related respiratory disease, with less than one third diagnosed and treated. With better awareness and clearer pathways of care focused on improving outcomes, there are implications for planning and developing the workforce. This competence framework identifies the skills, knowledge and attitudes required to deliver improvements. The framework consists of a menu of National Occupational Standards where evidence of competence will ensure practitioners are equipped to deliver respiratory services and promote patient self care and management within their scope of practice, role and responsibility.   Method and results   In collaboration with Skills for Health, the agency responsible for developing National Occupational Standards in healthcare, a respiratory disease Competence Framework based on functional and performance standards has been developed, that describes what is needed to deliver patient-centred respiratory care. This was informed by an expert group of stakeholders focused on delivery of care across the spectrum of respiratory disease from prevention, detection and diagnosis, through acute and chronic care to end of life care.   Conclusion   This resource is being used by commissioners, service providers, local networks and workforce planners to inform service and workforce design, thereby supporting the shift of service delivery by a competent workforce, from acute settings into the community.
Spontaneous regression of lymphoproliferative disorders in patients treated with methotrexate for rheumatoid arthritis and other rheumatic diseases.
Authors: E Salloum, D L Cooper, G Howe, J Lacy, G Tallini, J Crouch, M Schultz, J Murren
Journal: Journal of Clinical Oncology (1996)

PURPOSE To determine the clinicopathologic features of lymphoproliferative disorders (LPD) that occur in the setting of methotrexate (MTX) therapy for rheumatic diseases (RD) and to define the relationship between the presence of Epstein-Barr virus (EBV) in tumor cells and the response of LPD to MTX withdrawal. PATIENTS AND METHODS In addition to nine new cases, we analyzed 28 cases previously reported in the literature of LPD in patients receiving MTX for RD. In addition to MTX, immunosuppressive therapy included corticosteroids in 19 patients, azathioprine in three, and cyclosporine in one. Extranodal disease was identified in 16 patients, but none had CNS involvement. Pathologic findings included five cases of Hodgkin's disease and seven low-grade lymphomas. The remaining patients had intermediate or aggressive lymphomas. In situ hybridization studies (ISHS) for EBV-RNA transcripts were positive in 12 of 27 patients (44%). RESULTS Among 37 patients, 16 were initially observed after MTX withdrawal without additional antitumor therapy. Six achieved a spontaneous complete remission (CR), three had a partial response (PR), one had a minimal response, and six had no response to MTX withdrawal. Of 10 responding patients, EBV was detected by ISHS (n = 6) or polymerase chain reaction (PCR) (n = 2); one patient had a CR despite the absence of EBV by PCR and one had a CR but did not have viral assays performed. Only one of six patients with negative EBV by ISHS or PCR responded to MTX withdrawal. CONCLUSION MTX withdrawal and observation for a short period should be considered in the initial management of patients who develop LPD while on MTX therapy. Responses were consistently observed, but not limited to patients in whom EBV was detected by ISHS or PCR. Further studies are required to confirm these findings and to evaluate the role for EBV in LPD that occur in patients receiving MTX.
Pulmonary hypertension in the newborn GTP-cyclohydrolase 1 deficient mouse is unrelated to endothelium-dependent vasorelaxation potential
Authors: Jaques Belik, Brendan McIntyre, Jingyi Pan, Jeannette Vasquez-Vivar
Journal: European Respiratory Journal (2011)

Background:  Tetrahydrobiopterin (BH4) is an endothelial nitric oxide (NO) synthase (eNOS) cofactor. Its absence results in eNOS uncoupling and a shift from NO to reactive oxygen species (ROS) generation. The hph-1 mouse is deficient in GTP-cyclohydrolase 1 (GCH1) production, resulting in lowered BH4 tissue content. The adult hph-1 mouse has pulmonary hypertension secondary to eNOS uncoupling, yet whether similar changes are evident in the newborn is presently unknown. Thus, we evaluated 1-3 day old newborn hph-1 pups and compared them to wild-type mice (C57BL/6xCBA).   Methods and results:  Lung morphometry, BH4 and its oxidized metabolite BH2 content were measured and near-resistance pulmonary arteries were studied. In control and hph-1 mice, the BH4 lung content is inversely proportional with age, but significantly lower in the mutated animals (P   Conclusion:  Pulmonary hypertension is present from birth in the GCH1 deficient mice, not as a result of vasoconstriction, but secondary to pulmonary vascular remodeling.
Effect of exercise training on ventilation in patients with COPD or chronic heart failure
Authors: Marta Gudjonsdottir, Egill Thoroddsen, Arna E. Karlsdottir, Asdis Kristjánsdottir, Magnus R. Jonasson, Magdalena Asgeirsdottir
Journal: European Respiratory Journal (2012)

Ventilatory efficiency is reduced in patients (pts) with COPD or chronic heart failure (CHF) resulting in abnormal dyspnoea during exercise. The aim of the study was to evaluate the effect of exercise training on ventilation in these pts.

Methods: 25 COPD pts (11 males; 64±9 years old, GOLD 3-4) and 25 CHF pts (23 males, 55±10 years old, NYHA class II-III, ejection fraction ≤ 35%) underwent maximal exercise test pre and post rehabilitation programme (RP) measuring oxygen uptake (V'O2), carbon dioxide output (V'CO2) and ventilation (V'E). The ventilatory efficiency was evaluated using the V'E/V'CO2 slope. Breathing pattern was evaluated using iso-ventilation, i.e. maximal V'E, tidal volume (VT) and respiratory rate (RR) pre RP compared to the same parameters during iso-V'O2 post RP. Exercise training in the RP consisted of endurance and strength training 5 days a week for six weeks.

Results: Exercise endurance increased and ventilatory requirements reduced post RP. Breathing pattern was improved in COPD pts but ventilatory efficiency was unchanged in both groups (Table 1).

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Table 1





Conclusion: Exercise training did not improve ventilatory efficiency but reduced ventilatory requirements during heavy exercise giving prospect of less dyspnoea during effort in these pts.
Risk of adverse events in children completing treatment for acute lymphoblastic leukemia: St. Jude Total Therapy studies VIII, IX, and X.
Authors: C H Pui, R K Dodge, A T Look, S L George, G K Rivera, M Abromowitch, J Ochs, W E Evans, W M Crist, J V Simone
Journal: Journal of Clinical Oncology (1991)

We studied the frequency, causes, and predictors of adverse events in 624 patients who had completed treatment for acute lymphoblastic leukemia (ALL) in three consecutive total therapy studies (VII, IX, and X, 1972 to 1983). Event-free survival in study X was significantly better overall than that in studies VIII and IX (P less than .0001 by the log-rank test). In study X, 75% of the patients were electively taken off therapy, compared with 54% in studies VIII and IX. However, the risks of having an adverse event during the first 5 years after completion of therapy were remarkably similar: 22% (95% confidence interval, 17% to 29%) in study X versus 24% (20% to 29%) in studies VIII and IX. Bone marrow, testicular, and CNS relapses accounted for the majority of failures in both groups (85% in study X and 92% in studies VIII and IX). Late adverse events consisted largely of hematologic relapses and the development of solid tumors. Black race (P = .001) and leukemia without an anterior mediastinal mass (P = .05) were associated with an increased risk of failure after completion of treatment in the two earlier clinical trials, whereas a lower leukemic cell DNA content (DNA index less than 1.16) was the only predictor of late treatment failure in the more recent trial (P = .019). None of the other presenting features that were examined (eg, age, leukocyte count, and sex) had value as predictors of late failure. Thus, improved treatment altered the impact of specific prognostic factors and the distribution of sites of relapse, but it did not significantly affect the risk of delayed failure.