tbuckley/cabot-search huggingface dataset:
Chemotherapy toxicity predicted by baseline nutrition assessment in gastrointestinal (GI) malignancies: A multicenter analysis.
Authors: Kelsey Klute, Julianna Brouwer, Minaxi Jhawer, Hayley Sacks, Anatasia Gangadin, Allyson J. Ocean, Elizabeta C. Popa, Tong Dai, Guojiao Wu, Paul J. Christos, Manish A. Shah
Journal: Journal of Clinical Oncology (2015)

410 Background: Malnutrition is prevalent in GI malignancies and is associated with decreased survival, frequent hospitalizations and increased healthcare costs. Outside the perioperative setting, malnutrition rarely impacts treatment decisions. The subjective global assessment (SGA) is a validated tool that stratifies patients by nutritional status. We hypothesized that malnutrition independently predicts chemotherapy-related toxicity in patients with GI malignancies. Methods: All patients enrolled in the GI Cancer Registry which collects baseline demographic data, comorbid conditions and baseline nutrition status. In patients treated with chemotherapy, we reviewed dosing, schedule and toxicities over the first two months of treatment and compared results between well-nourished (SGA-A) and malnourished (SGA B/C) patients. Two-sample t-test or chi-square tests were used for comparisons as appropriate. Multivariable logistic regression analysis was used to estimate the independent effect of SGA status after controlling for demographic/prognostic factors. Results: We enrolled 184 patients between 5/2012 – 5/2013. The overall rate of malnutrition was 31.0%: 40.4% upper GI, 13.6% lower GI, 50.0% hepatobiliary. Malnourished patients received less chemotherapy (mean 63.9±23.8% vs. 81.4±18.8% of standard dose, p&lt;0.0001) due to toxicity-related dose-reductions, even when stratified by tumor type or treatment type (based on toxicity risk). After controlling for age, gender, ECOG (≥1 vs. 0) and albumin in a multivariable logistic regression model, malnutrition was an independent predictor of receiving less than 80% of the standard dose (adjusted odds ratio = 2.30; 95% confidence interval = 1.07, 4.95, P=0.03). Malnourished patients had a slightly higher rate of hospitalization, not statistically significant (29.8% vs. 22.0%, p=0.26). Conclusions: In patients receiving chemotherapy for GI malignancies, malnutrition (defined by SGA B/C) is an independent predictor of toxicity-related chemotherapy dose-reductions. Prospective studies should evaluate whether nutrition interventions in malnourished patients decrease chemotherapy-related toxicities.
Royal college strengthens its guideline on female genital mutilation
Authors: Ingrid Torjesen
Journal: BMJ (2015)

The Royal College of Obstetricians and Gynaecologists has revised its guideline on female genital mutilation to clarify healthcare professionals’ legal responsibilities, the requirements to notify cases, and the management of women who have undergone mutilation who are pregnant or giving birth.

The update comes after the first attempted UK prosecution of a doctor for female genital mutilation. Dhanuson Dharmasena, a trainee registrar in obstetrics and gynaecology at the Whittington Hospital in north London, was acquitted earlier this year.1

Dharmasena was accused of reinfibulating a Somali woman by sewing her labia together after the birth of her first child in 2012.2 But he told the jury that he had put only a small suture at the top of a cut he had made to deliver the baby, to stop bleeding, in an emergency situation. …
Interferon Adjuvant to Radical Nephrectomy in Robson Stages II and III Renal Cell Carcinoma: A Multicentric Randomized Study
Authors: Giorgio Pizzocaro, Luigi Piva, Maria Colavita, Sonia Ferri, Raffaella Artusi, Patrizia Boracchi, Giorgio Parmiani, Ettore Marubini
Journal: Journal of Clinical Oncology (2001)

PURPOSE: Because interferon gave promising results in the management of metastatic renal cell carcinoma in the 1980s, a multicentric randomized controlled trial was planned to compare adjuvant recombinant interferon alfa-2b (rIFNα2b) with observation after radical nephrectomy in patients with Robson stages II and III renal cell carcinoma. Overall and event-free survival were to be evaluated together with prognostic factors. PATIENTS AND METHODS: Overall and event-free survival curves for 247 patients (124 controls and 123 treated) were estimated by the Kaplan-Meier method and compared using the log-rank test. Cox’s multiple regression models were adopted to perform a joint analysis of treatment and prognostic factors. RESULTS: The 5-year overall and event-free survival probabilities were 0.665 and 0.671, respectively, for controls and 0.660 and 0.567, respectively, for the treated group; the differences were not statistically significant (2P = .861 for overall and 2P = .107 for event-free survival with the log-rank test). Regarding prognostic factors, only grade, pT, and pN demonstrated a significant prognostic role. First-order interactions of treatment with pT and pN category were investigated; a significant interaction was found between pN and treatment. A harmful effect of rIFNα2b in the 97 treated pN0 patients and a protective effect in the 13 treated pN2/pN3 patients were statistically significant. CONCLUSION: Adjuvant rIFNα2b is not indicated after radical nephrectomy for renal cell carcinoma. The protective effect in the small group of pN2/pN3 patients requires further investigation.
Influences of smoking on FEV1 remain over the long-term after cessation
Authors: Shinobu Osanai, Mie Aoki, Toshiyuki Ogasa
Journal: European Respiratory Journal (2011)

Backgrounds and objectives: Natural course of forced expiratory volume in on second (FEV1) after smoking cessation is still unclear. We sought to assess influences of smoking habits to FEV1 in subjects without obstructive pulmonary disorders.

Subjects and methods: Subjects were recruited from patients who attended to rural primary care clinics except for respiratory disorders. Each participant was asked to answer a questionnaire including smoking history and measure forced vital capacity (FVC) and FEV1. Results are presented as mean ± SD.

Results: In the present study, 408 of male (61.2±13.7 years-old) and 500 of female (60.2±15.6 years-old) were analyzed. There was no significant difference in smoking duration between current smokers (28.1±23.9 pack/year) and ex-smokers (31.3±30.8 pack/year). In the ex-smokers, duration after smoking cessation was 14.3±13.0 yr. Both %FEV1 (measured FEV1/predicted FEV1 (%)) in current smokers (95.3±14.8, n=253) and %FEV1 in ex-smokers (93.7±15.4, n=269) were lower than %FEV1 in non-smokers (103.2±16.5, n=386) (P<0.01). There was no difference in%FEV1 among the subgroups divided by age both in current smokers and ex-smokers. Also, there was no difference in %FEV1 among the subgroups divided by duration of smoking cessation in ex-smokers. The ex-smokers under 40 years-old had lower %FEV1 comparing to non-smokers under 40 years-old. The ex-smokers who stopped smoking more 20 years had still lower %FEV1 than that in non-smokers.

Conclusion: In conclusion, influence of smoking on FEV1 starts under 40 year-old, and decrease of FEV1 remain over 20 years after cessation in subjects without obstructive pulmonary disorders.
Prevention of Second Primary Tumors by an Acyclic Retinoid, Polyprenoic Acid, in Patients with Hepatocellular Carcinoma
Authors: Yasutoshi Muto, Hisataka Moriwaki, Mitsuo Ninomiya, Sadashi Adachi, Akiko Saito, Ken Takeshi Takasaki, Takuji Tanaka, Kaito Tsurumi, Masataka Okuno, Eiichi Tomita, Toshiyuki Nakamura, Takao Kojima
Journal: New England Journal of Medicine (1996)

In patients with hepatocellular carcinoma (hepatoma), the rate of recurrent and second primary hepatomas is high despite surgical resection and percutaneous ethanol-injection therapy. We developed an acyclic retinoid, polyprenoic acid, that inhibits hepatocarcinogenesis in the laboratory and induces differentiation and apoptosis in cell lines derived from human hepatoma. In a randomized, controlled study, we tested whether the compound reduced the incidence of recurrent and second primary hepatomas after curative treatment.
Abstract 1782: Alcohol Septal Ablation in Symptomatic Patients with Hypertophic Cardiomyopathy at High-Risk for Surgical Myectomy: Data on Long-term Outcomes
Authors: Deborah H Kwon, Carmel Halley, Samir R Kapadia, Ronan Curtin, Maran Thamilarasan, E M Tuzcu, Harry Lever, Milind Y Desai
Journal: Circulation (2007)
Abstract 2659: Effect of an Automated Ventilator and the Impedance Threshold Device on Coronary Perfusion Pressure and Cerebral Blood Flow During Cardiopulmonary Resuscitation in Pigs
Authors: Jing-quan Zhong, Xudong Hu, Gregory M Hare, C D Mazer, Petsy P So, Donna Debicki, Paul Dorian
Journal: Circulation (2006)

The impedance threshold device (ITD) increases coronary perfusion during CPR by lowering intrathoracic pressure during decompression. The effect of an automatic ventilator which cycles when expirat...
Study was not sufficiently rigorous
Authors: N J Everitt
Journal: BMJ (1996)

EDITOR,—Cornelia S Carr and colleagues have added to the evidence that enteral nutrition may be started soon after gastrointestinal surgery.1 The importance of anticipating the need for postoperative nutritional support cannot be underestimated, particularly when postoperative complications may delay oral intake. The content of this paper fails, however, to support its title and the key points listed.

The nature …
India sees 31% fall in open defecation over past 25 years, finds WHO
Authors: Cheryl Travasso
Journal: BMJ (2015)

An estimated 94% of India’s population now has access to safe drinking water, but about 44% still practises open defecation, a new report has found.

Published by the World Health Organization and Unicef, the report looked at the worldwide improvements in access to water and sanitation, as defined by the millennium development goals set in 2000.1

One of the proposed targets of the millennium development goals was to reduce by half the proportion of the global population without “sustainable access to safe drinking water and basic sanitation” by 2015. Thus 77% and 88% of the population should have …
Assessing spatial heterogeneity of multidrug-resistant tuberculosis in a high-burden country
Authors: Helen E. Jenkins, Valeriu Plesca, Anisoara Ciobanu, Valeriu Crudu, Irina Galusca, Viorel Soltan, Aliona Serbulenco, Matteo Zignol, Andrei Dadu, Masoud Dara, Ted Cohen
Journal: European Respiratory Journal (2012)

Multidrug-resistant tuberculosis (MDR-TB) is a major concern in countries of the former Soviet Union. The reported risk of resistance among tuberculosis (TB) cases in the Republic of Moldova is among the highest in the world. We aimed to produce high-resolution spatial maps of MDR-TB risk and burden in this setting. We analysed national TB surveillance data collected between 2007 and 2010 in Moldova. High drug susceptibility testing coverage and detailed location data permitted identification of subregional areas of higher MDR-TB risk. We investigated whether the distribution of cases with MDR-TB risk factors could explain this observed spatial variation in MDR-TB. 3447 MDR-TB cases were notified during this period; 24% of new and 62% of previously treated patients had MDR-TB. Nationally, the estimated annual MDR-TB incidence was 54 cases per 100 000 persons and &gt;1000 cases per 100 000 persons within penitentiaries. We identified substantial geographical variation in MDR-TB burden and hotspots of MDR-TB. Locations with a higher percentage of previously incarcerated TB cases were at greater risk of being MDR-TB hotspots. Spatial analyses revealed striking geographical heterogeneity of MDR-TB. Methods to identify locations of high MDR-TB risk and burden should allow for better resource allocation and more appropriate targeting of studies to understand local mechanisms driving resistance.
Occurrence, recognition, and outcome of psychological disorders in primary care
Authors: B G Tiemens, J Ormel, G E Simon
Journal: American Journal of Psychiatry (1996)

The authors' goal was to cross-validate the earlier finding of the Groningen Primary Care Study that recognition of psychological disorders was associated with better patient outcomes.The 12-item General Health Questionnaire was used to screen 1,271 consecutive primary care patients. A stratified sample of 340 of these patients participated in the second-stage baseline series of interviews, which included the Composite International Diagnostic Interview, the occupational role section of the Social Disability Schedule, the 28-item General Health Questionnaire, and the SCL-90. Three months later 209 of the patients completed the 28-item General Health Questionnaire and the SCL-90, and 12 months later 213 of the patients completed the second-stage baseline series of interviews. The study was carried out in six primary care practices (11 general practitioners) in the northern part of The Netherlands.Recognition of psychological disorders was associated with higher initial severity of psychopathology and occupational disability and with a psychological reason for the medical encounter. Recognition rates were higher for anxiety than for depression. Patients whose psychological disorders were recognized did not have better outcomes than those whose psychological disorders were not recognized.Recognition of psychological disorders was not associated with better outcome. Recognition is a necessary but not a sufficient condition for delivery of treatment according to clinical guidelines. Increasing recognition is likely to improve outcomes only if general practitioners have the skills and resources to deliver adequate interventions.
Lymph Node Staging by Positron Emission Tomography in Patients With Carcinoma of the Cervix
Authors: Perry W. Grigsby, Barry A. Siegel, Farrokh Dehdashti
Journal: Journal of Clinical Oncology (2001)

PURPOSE: The aim of this study was to compare the results of computed tomography (CT) and positron emission tomography (PET) with [ 18 F]-fluoro-2-deoxy-d-glucose (FDG) for lymph node staging in patients with carcinoma of the cervix and to evaluate the relationship of the imaging findings to prognosis. PATIENTS AND METHODS: We retrospectively compared the results of CT lymph node staging and whole-body FDG-PET in 101 consecutive patients with carcinoma of the cervix. Patients were treated with standard irradiation and chemotherapy (as clinically indicated) and observed at 3-month intervals for a median of 15.4 months (range, 2.5 to 30 months). Progression-free survival was evaluated by the Kaplan-Meier method. RESULTS: CT demonstrated abnormally enlarged pelvic lymph nodes in 20 (20%) and para-aortic lymph nodes in seven (7%) of the 101 patients. PET demonstrated abnormal FDG uptake in pelvic lymph nodes in 67 (67%), in para-aortic lymph nodes in 21 (21%), and in supraclavicular lymph node in eight (8%). The 2-year progression-free survival, based solely on para-aortic lymph node status, was 64% in CT-negative and PET-negative patients, 18% in CT-negative and PET-positive patients, and 14% in CT-positive and PET-positive patients (P &lt; .0001). A multivariate analysis demonstrated that the most significant prognostic factor for progression-free survival was the presence of positive para-aortic lymph nodes as detected by PET imaging (P = .025). CONCLUSION: This study demonstrates that FDG-PET detects abnormal lymph node regions more often than does CT and that the findings on PET are a better predictor of survival than those of CT in patients with carcinoma of the cervix.
Carbamazepine and Folic Acid in Trigeminal Neuralgia Patients
Authors: A A Al-Musaed, J M Zakrzewska, B J Bain
Journal: Journal of the Royal Society of Medicine (1992)

The effect of carbamazepine monotherapy on the red cell folate level of 133 patients with trigeminal neuralgia was evaluated. The patient group had a significantly lower mean value of red cell folate levels compared with 110 controls. No significant correlation was found between the red cell folate levels and the mean cell volume or haemoglobin values in either the carbamazepine or control group. In addition no significant correlation was found between the red cell folate levels and drug dosage. Administration of folic acid supplements raised the mean value of red cell folate significantly. Dietary folate intake was assessed in 43 trigeminal neuralgia patients and 33 matched control patients and there was no significant difference between the groups. Patients taking carbamazepine should be advised on a well-balanced diet rich in folate as opposed to being given a routine prescription of folic acid.
Comparison of two strategies using pedometers to counteract physical inactivity in smokers
Authors: Juliana Zabatiero, Demétria Kovelis, Karina Couto Furlanetto, Leandro Cruz Mantoani, Mahara Proença, Fabio Pitta
Journal: European Respiratory Journal (2012)

Objective:  To compare the effects of two different 5-month protocols using pedometers and informative booklets to increase physical activity in daily life (PADL) in smokers who reach or not 10000 steps/day in daily life.  Methods:  PADL level was assessed at baseline (A1), and subjects were randomly assigned to two groups: booklet+pedometer (GB+P; n=13), which started the protocol receiving a booklet with encouragement to walk as much as possible in everyday life; or pedometer+booklet (GP+B; n=18) which started the protocol wearing a pedometer aiming to achieve 10000 steps/day; both for 1 month. PADL was re-assessed (A2), and the interventions were crossed-over for 1 month, followed by PADL reassessment (A3). After A3, both groups used pedometers for 3 months aiming to reach 10000 steps/day, and final PADL assessment was performed (A4). For the analysis, each group was subdivided according to baseline PADL as physically active or inactive, according to have reached or not 10000 steps/day at baseline.  Results:  The physically active subgroups of GB+P and GP+B showed no change in steps/day. The physically inactive subgroup of GP+B significantly increased steps/day at A2 and maintained this increase until A4. The physically inactive subgroup of GB+P initially increased to a lesser extent, reaching borderline statistical significance at A2 and A3 (p=0.06) and statistically significant increase only at A4 (p=0.02).  Conclusions:  Both strategies were effective in increasing the number of steps/day in physically inactive smokers after 5 months, although the increase was more quickly obtained in smokers who used pedometers as the first intervention.
Conflict and health: Peace building through health initiatives
Authors: G. MacQueen
Journal: BMJ (2000)

This is the last of four articles Edited by 

War affects human health through the direct violence of bombs and bullets, the disruption of economic and social systems by which people use to address their health needs, the famine and epidemics that follow such disruptions, and the diversion of economic resources to military ends rather than health needs.1–8 In recent years war has been framed as a public health problem.9 This highlights the role of health workers in preventing and mitigating destructiveness but also raises questions regarding the constraints to their achievement of such objectives.

#### Summary points

Health work in zones of conflict can initiate and spread peace through conflict management, solidarity with indigenous health workers, strengthening of the social fabric, public dissent and restriction of the destructiveness of war

Evaluation tools need refinement, but there is preliminary evidence of effectiveness for some health-peace initiatives

The transition towards peace in war-affected zones will often improve health care and health status of populations. But do health workers have a role in expanding peace? Progress towards more peaceful relationships, between large entities such as nations or blocs, or small entities like community groups, requires multitrack actions at several levels. Does health care offer one such track? Only empirical data will answer this question, but our preliminary analysis of information suggests that health initiatives have indeed been successfully used as peace initiatives.10–12

This paper seeks to briefly elaborate on the linkage between health and peace in the hope that others will see useful applications of this linkage. We use the term “health-peace initiative” to refer to any initiative that is intended to improve the health of a population and to simultaneously heighten that population's level of peace and security.

The five peace building mechanisms described below have been …
Late-breaking abstract: Serum concentrations of new factors (IL-20, galectin 3, IL-29 and IL-33) involved in angiogenesis in patients with advanced non-small cell lung cancer (NSCLC)
Authors: Wojciech Naumnik, Maria Ossolinska, Katarzyna Niewiarowska, Elzbieta Chyczewska
Journal: European Respiratory Journal (2011)

There are several factors involved in angiogenesis, not tested yet, whose role is not clear in patients with lung cancer. Our pilot study was carried out to analyze the serum IL-20, Galectin 3, IL-29 and IL-33 (ELISA) in patients with non-small cell lung cancer (45 NSCLC) before chemotherapy, 15 sarcoidosis (BBS), 8 hypersensitivity pneumonitis (HP) and 15 healthy controls (H). Serum concentration of IL-20 was highest in NSCLC, lower in BBS and H, and lowest in HP (45,1±2 vs 41,88±11 vs 40±5,5 vs 36,09±2,7 pg/ml; p=0,01). The levels of Galectin 3 was highest in HP, lower in BBS, NSCLC, lowest in H (2,5±0,3 vs 1,2±0,4 vs 0,9±0,5 vs 0,8±0,1 pg/ml; p=0,03). The highest level of IL-29 was in HP, lower in NSCLC and H, the lowest in BBS (85,70±12 vs 53,65±2,8 vs 45,22±2,5 vs 38,68±1,7 pg/ml; p=0,003). Serum levels of IL-33 was lowest in H, higher in NSCLC and BBS, the highest in HP (3,57±0,9 vs 4,1±0,5 vs 5,56±3,7 vs 7,24±1,5 pg/ml; p= 0,02). Serum levels of IL-29 and IL-33 were lower in patients with metastases of NSCLC (IL-29: 85,19±18 vs 48,33 pg/ml; p=0,03; IL-33: 4,54±4,2 vs 3,61±2,1 pg/ml; p=0,04). There were no significant differences in serum IL-20, Galectin 3, IL-29 and IL-33 in relation to a response to a therapy.A correlations were found between IL-33 and Galectin 3 concentrations (R= 0.60). Summing up, serum concentrations of IL-20, Galectin 3, IL-29 and IL-33 were higher in patients with NSCLC than in healthy people. Their clinical usefulness in the diagnosis of cancer seems to be weak, but this requires further investigation.
Hematopoietic Stem Cells with High Proliferative Potential
Authors: Dane R. Boggs, Sallie S. Boggs, Debra F. Saxe, Lora A. Gress, Don R. Canfield
Journal: Journal of Clinical Investigation (1982)

This study was designed to approach two primary questions concerning hematopoietic stem cells (HSC) in mice: what is the concentration of HSC with extensive proliferative potential in marrow, and how long can an HSC continue to function in an intact animal? The assay system was the W/Wv mouse, a mouse with an inherited HSC defect, reflected in a reduction in all myeloid tissue and most particularly in a macrocytic anemia.