tbuckley/cabot-search huggingface dataset:
Care of the caregiver: Improving caregiver outcomes across the disease trajectory.
Authors: Margaretta Page, Idonah M. Molina, Judy Patt, Susan Marina Chang
Journal: Journal of Clinical Oncology (2014)

82 Background: Caregivers are essential members of the health team, often assuming diverse primary care roles for the cancer patient. Caregiver needs vary across the trajectory of illness and range from informational needs to emotional support to assistance with accessing resources. The needs of caregivers of brain tumor patients are complex not only because of the life threatening nature of the illness but also because of the wide range of neurological and cognitive deficits patients experience, a known risk factor for added stress to the caregiver. To address these challenges and improve caregiver outcomes, the Neuro Oncology Division at UCSF developed a program to provide an additional layer of care that includes information and support to caregivers of brain tumor patients across the trajectory of illness, from diagnosis to death. Methods: The program consists of a medical director and a dedicated nurse practitioner, social worker and coordinator, all focused on the caregiver of the brain tumor patient. The goals of the program are to provide information needed to assist with disease and symptom management, effective communication with the health care team, maximization of use of available resources, and to provide emotional support. Three groups of caregivers were targeted: caregivers of all new patients with a focus on newly diagnosed glioblastoma and caregivers of patients deemed at “high risk,” either identified by the provider, or because of the phase in the illness trajectory. Results: Since June 2013, 13 caregivers reported no needs for the first 4 months from diagnosis. 13 caregivers received care, with over half reporting concerns regarding financial issues and disability as well as need for emotional support around adjusting to the diagnosis, role changes, and care demands. In addition, varying levels of care have been provided to 70 caregivers of patients identified at “high risk” for distress due to disease progression or when transitioning to hospice. Conclusions: This program provides care to caregivers of brain tumor patients at specific time points to improve caregiver outcomes. Challenges include tailoring the information at the right time as well as measuring outcomes with minimal extra burden to the caregiver.
Maintainance of exercise capacity in lung transplant candidates undergoing a pulmonary rehabilitation program
Authors: Leonor Meira, Carla Damas, Manuel Vaz, Margarida Redondo, Paula Martins, Luís Gaspar, Ermelinda Eusébio, Isabel Gomes
Journal: European Respiratory Journal (2014)

Pulmonary transplant (PT) candidates often have to wait in a transplant list for months or years due to shortage of available organs.  To assess the maintenance of exercise capacity (EC) while waiting for PT, in patients undergoing pulmonary rehabilitation (PR).  Retrospective study of PT candidates who attended PR and who had records of the 6 minutes walk test distance (6MWD) at the start of PR, at 12 weeks and before transplant or before this study, if still in the waiting list.  Twenty seven were included, 17 male, median age 52 years. Median FEV1% before PR - 31,9% and BMI-24,2. Seven patients had pneumoconiosis, 6 COPD, 4 hypersensitivity pneumonitis, 3 bronchiectasis, 3 interstitial disease, 1 lymphangioleiomyomatosis, 1 CF and 1 Sjogren syndrome; 19 patients were transplanted. Median duration of the PR until PT/present analysis was 47 wks. They exercised in stationary bicycle, did limbs strength training and education for bronchial cleaning if adequate. Median 6MWD was 400m before PR, remained unchanged at 12 wks and before PT/analysis. Considering patients with lower initial EC (6MWD   In spite of severe lung function impairment, as a whole these patients showed acceptable EC when they were proposed for PR. Those with lower initial EC seemed to benefit more in keeping regular PR while waiting for surgery.
Euthanasia and Palliative Care: Reflections from the Netherlands and the UK
Authors: Zbigniew Zylicz, Ilora G Finlay
Journal: Journal of the Royal Society of Medicine (1999)

Euthanasia, though formally still illegal, is a broadly accepted practice in the Netherlands. In the UK it is widely discussed, but the background issues are radically different from those in the Netherlands. One difference is that care for the terminally ill in the UK has a long tradition, while this type of care is just emerging in the Netherlands. Is it the only difference? In this paper we explore experiences with people who request euthanasia but are cared for in a Dutch hospice. Is hospice an answer to the needs of terminally ill patients? Holland is the subject of interest to many because, in 1984, the Royal Dutch Medical Association drew up guidelines on voluntary euthanasia which resulted in the non-prosecution of doctors who actively and intentionally terminated life at the patient's request. The guidelines stipulate that the patient's request must be voluntary; that the patient must be suffering 'unbearably' with no prospect of improvement; and that the doctor has sought the opinion of a colleague. Fifteen years' experience has provided some important quantitative and qualitative data on the practice of voluntary euthanasia. Many patients admitted to hospices in the Netherlands have considered euthanasia. A review of their motivation provides useful qualitative information about euthanasia in the Netherlands, and also reveals that suffering in terminal illness is far more complex than simply distress from unrelieved symptoms. Doctors are influenced by the society into which they are born and in which they are trained. They are members of the wider community in which they live and work. The Netherlands, sandwiched between other nations, has mastered the art of compromise to maintain peace on all sides, making a desire for consensus something of a national characteristic. Moreover, religious/spiritual life in Holland was dominated by Calvinism, whose emphasis on personal responsibility helps to account for the importance attached to selfdetermination in contemporary, secular Holland. Meantime, in the Western world, while religious observance has declined the goals of health and an improved 'quality of life' are pursued with a quasi-religious fervour; suffering is widely seen as meaningless and social values are ostensibly increasingly utilitarian.
Women in Metabolism: Part I
Authors: Barbara Kahn, M. Celeste Simon, Bei B. Zhang, Juleen R. Zierath, Deborah M. Muoio, Kathryn J. Moore, Barbara Cannon, Marcia Haigis, Kristina Schoonjans, Susanne Mandrup, Karine Clement, Nancy C. Andrews
Journal: Cell Metabolism (2015)
Efficacy of Prostate-Specific Antigen Screening
Authors: Jonathan Shoag, Joshua Halpern, Brian Eisner, Richard Lee, Sameer Mittal, Christopher E. Barbieri, Daniel Shoag
Journal: JAMA Oncology (2015)

confirm the study results of the PLCO trial that biopsy at a PSA threshold of 4.0 ng/mL did not decrease prostate cancerspecific or overall mortality.For prostate cancer-specific mortality, the trend was toward increased mortality at the cutoff, which is opposite of what would be expected if there were a benefit to screening.Interpreting clinical data using RD has many potential applications in medicine since treatment decisions are often based on discrete cutoffs in continuous data.
Assessing physiological benefit from domiciliary nebulized bronchodilators in severe airflow limitation
Authors: JF Morrison, PC Jones, MF Muers
Journal: European Respiratory Journal (1992)

In steroid resistant chronic obstructive pulmonary disease (COPD) we assessed the effect of q.i.d. domiciliary nebulized fenoterol (F) 1.25 mg and ipratropium (I) 0.5 mg for three weeks in a placebo-controlled, randomized, double-blind, crossover study. The twenty patients studied (mean forced expiratory volume in one second (FEV1) 0.8 l) all showed less than 20% increase in FEV1 to 200 micrograms inhaled salbutamol (S) and less than 20% increase in peak expiratory flow rate (PEFR) after 2 weeks prednisolone therapy. Respiratory function tests, 5 min walking distance (5 MWD), visual analogue scales (VAS) for breathlessness, oxygen cost diagrams and reversibilities were performed weekly for three weeks with patients on their usual therapy, after three weeks domiciliary F+I, after three weeks saline and, finally, after a further three weeks on usual therapy again. Primary end-points, selected prior to unblinding, were mean home twice daily PEFR, trapped gas volume, FEV1 and 5 MWD. Home PEFR rose from 164 l.min-1 on saline to 196 l.min-1 on F+I (p = 0.0001). Secondary end-point analysis revealed a fall in home inhaler usage and a rise in VAS. Using the criterion of +15% and greater than 20 l.min-1 increase in home PEFR, 11 out of 20 patients had a "positive" trial. We suggest that such patients, but not others, benefit from long-term, nebulized beta 2-agonist and ipratropium. Trials using home PEFR recordings should be used to identify them.
Continuation drug therapy for major depressive episodes: how long should it be maintained?
Authors: Robert F. Prien, David J. Kupfer
Journal: American Journal of Psychiatry (1986)

A major problem for the practitioner is the lack of satisfactory guidelines as to how long continuation drug treatment of depressive episodes must be maintained to ensure that the episode is over. This often leads to either premature withdrawal of the drug and subsequent relapse or unnecessarily prolonged treatment. Results from a collaborative project of the National Institute of Mental Health provide the first study-derived guidelines on the length of continuation therapy. Findings indicate that withdrawal of such therapy is safe only after the patient has been free of significant symptoms for 16 to 20 weeks and that focusing on mild as well as severe symptoms is critical in this decision.
A review of major implications of the O'Connor v. Donaldson decision
Authors: L E Kopolow
Journal: American Journal of Psychiatry (1976)

Although the Supreme Court's decision in O'Connor v. Donaldson is narrow from the legal perspective, it will have wide clinical applications for psychiatry if it reflects a trend in future court decisions. The author assesses the impact of this decision on the mental health profession in terms of the issue of dangerousness as grounds for involuntary commitment for psychiatric treatment, the principle of least restrictive alternative to hospitalization, the question of adequacy of treatment in light of the absence of nationally defined standards, and the personal liability of physicians for their professional actions.
Changes in left ventricular ejection fraction during REM sleep and exercise in chronic obstructive pulmonary disease and sleep apnoea syndrome
Authors: PA Levy, C Guilleminault, D Fagret, JM Gaio, P Romand, C Bonnet, CM Pison, JE Wolf, B Paramelle
Journal: European Respiratory Journal (1991)

Nine patients, 4 with chronic obstructive pulmonary disease (COPD) and 5 with obstructive sleep apnoea syndrome (OSAS) were monitored during sleep, rest and exercise. Left ventricular ejection fraction (LVEF) was investigated using gated equilibrium 99mtechnetium ventricular scintigraphy during rapid eye movement (REM) sleep, during exercise, and during wakeful rest. Control wakeful rest periods used for comparison with a study state (either REM sleep or exercise) were always selected during the same circadian segment as that state. Myocardial stress thallium-201 scintigraphy was performed during, and 4 h after, exercise, and results were compared to a daytime rest period. Several patients had myocardial hypoperfusion despite a normal electrocardiographic (ECG) treadmill test. During REM sleep, all patients exhibited a significant change in LVEF (greater than 5%) compared to wakefulness. During exercise, 5 subjects increased their LVEF normally (greater than 5%) and 4 (1 COPD, 3 OSAS) decreased it. All patients had a similar change (increase or decrease) during REM and at maximal exercise. Our results suggest that REM sleep in COPD and in OSAS can produce a myocardial stress as great as that produced by exercise. We conclude that REM sleep, like exercise, is a state in which morbidity may become higher and that it may account for mortality in COPD and OSAS patients with compromised myocardial circulation.
Medroxyprogesterone acetate antiandrogen treatment of hypersexuality in a pedophiliac sex offender
Authors: O A Cordoba, J L Chapel
Journal: American Journal of Psychiatry (1983)

A hypersexual pedophiliac sex offender was treated with the antiandrogen medroxyprogesterone acetate for 500 days. During the treatment, his testosterone blood levels significantly decreased, nearly to female values. Pituitary gonadotropin and urinary steroid metabolite levels diminished initially. Medroxyprogesterone therapy resulted in decreased libido, few side effects, and no recurrence of sex offenses, but there was no change in the patient's sexual orientation.
Routine Iron Supplementation and Screening for Iron Deficiency Anemia in Pregnancy
Authors: Robert C. Kane
Journal: Annals of Internal Medicine (2015)

Letters1 September 2015Routine Iron Supplementation and Screening for Iron Deficiency Anemia in PregnancyRobert C. Kane, MDRobert C. Kane, MDFrom U.S. Food and Drug Administration, Silver Spring, Maryland.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5132 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:To interpret the results of the trials included in Cantor and colleagues' review (1), we need to know 1 additional fact: Did the women in fact take the iron pills during pregnancy? If that fact is not known, the trials cannot be interpreted. Although I have no firsthand experience, I have been told that taking iron pills during pregnancy is a daunting task. At best, using the intention-to-treat population, we could conclude that the trials as designed and conducted did not show a benefit. It does not mean that none exists.Another issue arises when this same ...Reference1. Cantor AG, Bougatsos C, Dana T, Blazina I, McDonagh M. Routine iron supplementation and screening for iron deficiency anemia in pregnancy: a systematic review for the U. S. Preventive Services Task Force. Ann Intern Med. 2015;162:566-76. [PMID: 25820661] doi:10.7326/M14-2932 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From U.S. Food and Drug Administration, Silver Spring, Maryland.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L15-0319. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRoutine Iron Supplementation and Screening for Iron Deficiency Anemia in Pregnancy: A Systematic Review for the U.S. Preventive Services Task Force Amy G. Cantor , Christina Bougatsos , Tracy Dana , Ian Blazina , and Marian McDonagh Routine Iron Supplementation and Screening for Iron Deficiency Anemia in Pregnancy Amy G. Cantor , Christina Bougatsos , and Marian McDonagh Routine Iron Supplementation and Screening for Iron Deficiency Anemia in Pregnancy Amy G. Cantor , Christina Bougatsos , and Marian McDonagh Metrics 1 September 2015Volume 163, Issue 5Page: 399-400KeywordsConflicts of interestDisclosureDrugsIron deficiency anemiaObservational studiesPregnancy ePublished: 1 September 2015 Issue Published: 1 September 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
The role of flexible bronchoscopy in the evaluation of fever in immunocompromised haematological patients
Authors: Elena Karampini, Theodora Vatopoulou, Andrew Creamer, Geoffrey Warwick
Journal: European Respiratory Journal (2014)

Introduction/aim:  Respiratory infection is a leading cause of morbidity and death in febrile immunocompromised patients, despite the introduction of prophylactic strategies and advances in diagnosis and treatment. We aimed to evaluate the safety, diagnostic yield and therapeutic implications of flexible bronchoscopy (FB) with bronchoalveolar lavage (BAL) and transbronchial biopsy (TBB) in immunocompromised haematological patients, who present with a fever and pulmonary infiltrates.  Method:  We retrospectively reviewed the medical records of all such patients, who were evaluated by FB over 5 years (August 2008 - August 2013) in our hospital.  Results:  102 patients with fever and pulmonary infiltrates were identified (male 59, female 43; median age 55 years). 42 patients (41.2%) had significant neutropenia ( 9 /L), The median time from hospital admission to FB was 10.5 days. 100 patients (98%) underwent chest computed tomography (CT) prior to FB. 86 patients (84.3%) had been on antibiotics (median course duration: 12 days) and 59 (57.8%) on antifungals prior to FB. FB (102 BAL and 3 TBB) was performed safely with only 4 patients experiencing complications (respiratory failure, pneumothorax or significant bleeding). The diagnostic yield of FB was 46%. The bronchoscopic findings resulted in management changes (confirmation of diagnosis/treatment, change of treatment agent or proceeding to further investigations) in 34.3% of patients.  Conclusion:  FB as a component of the septic screen in febrile patients with pulmonary infiltrates is both useful and safe. The majority of febrile immunosuppressed haematological patients are empirically treated prior to FB.
Drug survival rates for tumour necrosis factor-α antagonists in psoriasis
Authors: A.D. Burden
Journal: British Journal of Dermatology (2011)

Journal Article Drug survival rates for tumour necrosis factor‐α antagonists in psoriasis Get access A.D. Burden A.D. Burden Western Infirmary, Glasgow G11 6NT, U.K. E‐mail: david.burden@ggc.scot.nhs.uk Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 164, Issue 5, 1 May 2011, Pages 940–941, https://doi.org/10.1111/j.1365-2133.2011.10355.x Published: 01 May 2011
Sirolimus- Versus Paclitaxel-Eluting Stents for the Treatment of Coronary Bifurcations
Authors: Young Bin Song, Joo-Yong Hahn, Seung-Hyuk Choi, Jin-Ho Choi, Sang Hoon Lee, Myung-Ho Jeong, Hyo-Soo Kim, In-Whan Seong, Ju-Young Yang, Seung Woon Rha, Yangsoo Jang, Jung Han Yoon, Seung-Jea Tahk, Ki Bae Seung, Seung-Jung Park, Hyeon-Cheol Gwon
Journal: Journal of the American College of Cardiology (2010)
Treatment of refractory mycobacterium avium complex lung disease with a moxifloxacin-containing regimen
Authors: Goohyeon Hong, Su-Young Kim, Byeong-Ho Jeong, Hye Yun Park, Kyeongman Jeon, O. Jung Kwon, Seung-Heon Lee, Chang Ki Kim, Sung Jae Shin, Won-Jung Koh
Journal: European Respiratory Journal (2013)

Moxifloxacin (MXF) has  in vitro  and  in vivo  activity against  Mycobacterium avium  complex (MAC) in experimental models. However, no data are available concerning its treatment effect in patients with MAC lung disease. The aim of this study was to evaluate the clinical efficacy of an MXF-containing regimen for the treatment of refractory MAC lung disease. Patients with MAC lung disease who were diagnosed between January 2002 and December 2011 were identified from our hospital database. We identified 41 patients who received MXF for ³4 weeks for the treatment of refractory MAC lung disease. A total of 41 patients were treated with an MXF-containing regimen because of a persistent positive culture after at least 6 months of clarithromycin-based standardized antibiotic therapy. The median duration of antibiotic therapy before MXF administration was 410 days (interquartile range [IQR], 324-683 days). All patients had culture-positive sputum when MXF treatment was initiated. The median duration of MXF administration was 332 days (IQR, 146-547 days). The overall treatment success rate was 29% (12/41) and the median time to sputum conversion was 91 days (IQR, 45-190 days). A positive sputum acid-fast bacilli smear at the start of treatment with MXF containing-regimens was an independent predictor of an unfavorable microbiologic response. Our results indicate that MXF may improve treatment outcomes in about one-third of patients with persistently culture-positive MAC lung disease who fail to respond to clarithromycin-based standardized antibiotic treatment. Prospective studies are required to assess the clinical efficacy of MXF treatment for refractory MAC lung disease.
Exercise capacity and limitations in long-term post-pneumonectomy patients
Authors: Baruch Vainshelboim, Milton Saute, Alexander Sagie, Liora Yohoshua, Benjamin Fox, Mordechai Kramer
Journal: European Respiratory Journal (2013)

Post-pneumonectomy patients have impaired pulmonary function and exercise intolerance associated with respiratory limitations. However, little is known regarding the limiting factors in exercise. The aims of the present study were to assess exercise tolerance and functional capacity in post-pneumonectomy patients and to identify the limiting factors in exercise.   Methods:  Seventeen post-pneumonectomy patients (6±4 years post operation) (9 males and 8 females) aged 59 ±13 were prospectively studied. Pulmonary function  (PFT), cardiopulmonary exercise test (CPET), Doppler-echocardiography, 6MWT and senior fitness tests were conducted for all patients.   Results:  Exercise tolerance during CPET was moderately reduced (peak VO 2 - 11.5±3.3 ml/kg/min, 48±17 % predicted). Most patients (n=13) did not use all the breathing reserve (17±12 L) and were primarily limited by cardiovascular system. Functional capacity in walking and strength-agility  was preserved (6MWT- 490 ±155 m, 89±25 % predicted). PFT was diminished as expected, (FVC %predicted-55±13, FEV 1  % predicted - 46±14, DLCO % predicted- 53±18). Resting Doppler-echocardiography showed normal left ventricle systolic function with mildly elevated sPAP (39±11 mmHg).   Conclusions:  Long-term post-pneumonctomy patients had reduced PFT, mildly elevated sPAP and moderate exercise intolerance which was primarily limited by cardiovascular system. Although these attenuations, functional capacity in walking and strength-agility  was well preserved. It seem that most patients can maintain near normal life in activities of daily living, but the late cardiovascular impairments of pneumonectomy should be taken to account for clinical decisions.
First Clinical Trials Employing Sleeping Beauty Gene Transfer System and Artificial Antigen Presenting Cells To Generate and Infuse T Cells Expressing CD19-Specific Chimeric Antigen Receptor
Authors: Partow Kebriaei, Helen Huls, Harjeet Singh, Simon Olivares, Matthew Figliola, Pappanaicken R. Kumar, Bipulendu Jena, Marie Andree Forget, Sonny Ang, Rineka N. Jackson, Tingting Liu, Doyle Bosque, Ian K. McNiece, Gabriela Rondon, Perry Hackett, Chitra M. Hosing, Elizabeth J. Shpall, Richard E. Champlin, Laurence J N. Cooper
Journal: Blood (2013)