tbuckley/cabot-search huggingface dataset:
AIDS-related Kaposi's sarcoma: prospective validation of the AIDS Clinical Trials Group staging classification. AIDS Clinical Trials Group Oncology Committee.
Authors: S E Krown, M A Testa, J Huang
Journal: Journal of Clinical Oncology (1997)

PURPOSE To prospectively validate the AIDS Clinical Trials Group (ACTG) staging classification for AIDS-associated Kaposi's sarcoma (KS). PATIENTS AND METHODS Two hundred ninety-four consecutive patients enrolled in eight ACTG therapeutic trials for AIDS-associated KS were staged prospectively according to tumor extent (T), severity of immunosuppression (I), and other systemic human immunodeficiency virus type 1 (HIV-1)-associated illness (S) and were observed for survival. Patients were classified as good risk (subscript 0) or poor risk (subscript 1) for each variable according to published ACTG criteria. Univariate and multivariate analyses were used to evaluate the associations between TIS variables and survival; additional analyses were conducted to improve the predictive value of the staging system. RESULTS Survival was significantly shorter for patients in the poor-risk category for each of the TIS variables. Respective median survivals for patients in the good- and poor-risk categories were 27 and 15 months for T (P &lt; .001); 40 and 13 months for I (P &lt; .001) when I0 included CD4 counts &gt; or = 200/microL and 22 and 16 months for S (P = .04). Multivariate analysis indicated that severity of immunosuppression gave the most predictive information but also showed that T provided significant additional predictive information in patients whose immune function was least impaired. Refined Cox models using a CD4 count of 150/microL rather than 200/microL to distinguish I0 and I1 yielded a simplified model with better fit to the observed data. CONCLUSION The ACTG TIS classification predicts survival in patients with AIDS-associated KS; CD4 count and tumor stage provide the most predictive information. However, a lower CD4 count than the one originally proposed provides better discrimination between prognostic groups.
Abstract 60: Prehospital induced hypothermia after out-of-hospital cardiac arrest: Emergency Medical Services State of the Practice in the US in 2007
Authors: Brian Suffoletto, James Menegazzi, David Salcido
Journal: Circulation (2007)

Objective-Post-resuscitation care of comatose survivors of cardiac arrest using induced hypothermia (IH) is recommended by the American Heart Association (AHA) and the International Liaison Committee on Resuscitation (ILCOR). However, the current rate of its use by Emergency Medical Services (EMS) in the US is not known. We sought to determine the prevalence of EMS agencies that initiate IH in the prehospital setting, and to identify perceived barriers to initiating IH. Methods- We conducted a prospective, anonymous, IRB-approved survey using a convenience sample of physician members of the National Association of EMS Physicians. We conducted the survey during the national conference, from January 11–13, 2007. Results- One-hundred forty-five of the 244 (59%) physician members in attendance completed the survey, representing 109 EMS Medical Directors and 36 non-Medical Director EMS Physicians from 92 regions of 34 US states. A total of 9/145 (6.2%) physicians stated that the EMS agency they are affiliated ...
Characterization of the genotype and integration patterns of hepatitis B virus in early‐ and late‐onset hepatocellular carcinoma
Authors: Hongli Yan, Yuan Yang, Ling Zhang, Guannan Tang, YuZhao Wang, Geng Xue, Weiping Zhou, Shuhan Sun
Journal: Hepatology (2015)

Early‐onset hepatocellular carcinoma (HCC) accounts for 15%‐20% of total HCC cases in Asia, and the incidence is increasing. The low frequency of cirrhosis and poor prognosis of early‐onset HCC suggests that its mechanisms may differ from late‐onset HCC. Although hepatitis B virus (HBV) infection is epidemiologically associated with HCC, the role of HBV in early‐onset HCC remains poorly understood. Here, we report a comparative study of HBV subgenotypes and integration in early‐ (≤30) and late‐onset (≥70) HBV‐associated HCC using a novel high‐throughput viral integration detection method. We report that HBV B2 is predominantly present in early‐onset HCC. HBV integration is a common phenomenon, both in early‐ and late‐onset HCC, which favors integrating into human repeat regions. Moreover, we found a breakpoint in 8q24 located between c‐Myc and plasmocytoma variant translocation 1 ( PVT1 ), which was detected in 12.4% (14 of 113) of early‐onset HCCs, but only 1.4% (2 of 145) in late‐onset HCCs. HBV integrating this site results in c‐MYC, PVT1, and microRNA‐1204 overexpression in tumors, thereby potentially contributing to the development of early‐onset HCC. Conclusion : HBV genotype and integration patterns may be distinct in early‐onset HCC. Our results may shed light on HCC risk factors in young HBV carriers. Further studies are needed to elucidate at which time in tumor development this integration event occurs and whether it plays an important, causative role in HCC development or progression. (H epatology 2015;61:1821‐1831)
Physical Findings and the Risk for Obstructive Sleep Apnea
Authors: JOSEPH B. SCHELLENBERG, GREG MAISLIN, RICHARD J. SCHWAB
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

In this study, we hypothesized that anatomic abnormalities of the oropharynx, particularly narrowing of the airway by the lateral pharyngeal walls, tonsils, and tongue, would be associated with an increased likelihood for obstructive apnea among patients presenting to a sleep disorders center. To test this hypothesis, we used data from a cohort of 420 patients presenting to the Penn Center for Sleep Disorders. Associations between individual variables in the clinical evaluation model and sleep apnea as defined by a re-spiratory disturbance index greater than or equal to 15 events per hour were characterized by odds ratios (ORs) with 95% confidence intervals (CIs). Multivariable logistic regression was used to simultaneously estimate ORs for multiple variables and to control for other relevant patient characteristics. Results showed that narrowing of the airway by the lateral pharyngeal walls (OR = 2.5; 95% CI, 1.6–3.9) had the highest association with obstructive sleep apnea (OSA) followed by tonsillar enlargement (OR = 2.0; 95% CI, 1.0–3.8), enlargement of the uvula (OR = 1.9; 95% CI, 1.2–2.9), and tongue enlargement (OR = 1.8; 95% CI, 1.0–3.1). Low-lying palate, retrognathia, and overjet were not found to be significantly associated with OSA. Controlling for BMI and neck circumference, only lateral narrowing and enlargement of the tonsils maintained their significant (OR = 2.0 and 2.6, respectively). A subgroup analysis examining differences between male and female subjects showed that no oropharyngeal risk factor achieved significance in women while lateral narrowing was the sole independent risk factor in men. These findings suggest that enlargement of the oropharyngeal soft tissue structures, particularly the lateral pharyngeal walls, is associated with an increased likelihood of OSA among patients presenting to sleep disorders centers.
A memorable patient: It pays to be specific
Authors: J. Troughton
Journal: BMJ (1998)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following It pays to be specific Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Using condoms to prevent transmission of HIV
Authors: J. Kelly
Journal: BMJ (1996)

British urologists provide a cost effective service EDrrOR,-The juxtaposition of Linda Beecham's article on NHS doctors' pay' and Charles-Gene McDaniel's article on American doctors' income2 leads to comparisons of the earning capacity of different doctors.It would be fair, however, also to compare the work that each of the two groups does, and I have considered urol- ogy on the two sides ofthe Atlantic.For a current maximum annual salary in Britain of £52 440 and an average American salary of £100 000, the two groups of urologists do quite different aver- age amounts of work.The ratio ofpopulation to consultants in urology in the United States is roughly 200 million to 9000,
Potassium channels in pulmonary arterial hypertension
Authors: Olivier Boucherat, Sophie Chabot, Fabrice Antigny, Frédéric Perros, Steeve Provencher, Sébastien Bonnet
Journal: European Respiratory Journal (2015)

Pulmonary arterial hypertension (PAH) is a devastating cardiopulmonary disorder with various origins. All forms of PAH share a common pulmonary arteriopathy characterised by vasoconstriction, remodelling of the pre-capillary pulmonary vessel wall, and in situ thrombosis. Although the pathogenesis of PAH is recognised as a complex and multifactorial process, there is growing evidence that potassium channels dysfunction in pulmonary artery smooth muscle cells is a hallmark of PAH. Besides regulating many physiological functions, reduced potassium channels expression and/or activity have significant effects on PAH establishment and progression. This review describes the molecular mechanisms and physiological consequences of potassium channel modulation. Special emphasis is placed on KCNA5 (Kv1.5) and KCNK3 (TASK1), which are considered to play a central role in determining pulmonary vascular tone and may represent attractive therapeutic targets in the treatment of PAH.
Abstract 21080: Future Development of Fibroatheromas Can be Predicted by NIRS: Insights From the DM/HC Pig Model.
Authors: Dhavalkumar Patel, Raul Llano, Robert Fenning, Daivesh Patel, Damir Hamamdzic, Khalid Bannan, Robert L Wilensky
Journal: Circulation (2010)

Introduction: Fibroatheromas are the pathologic cause of acute coronary syndromes and ischemic sudden death. Near Infrared Spectroscopy (NIRS) detects lipid concentration in the arterial wall and I...
Increased respiratory symptoms in COPD patients living in the vicinity of livestock farms
Authors: Floor Borlée, C. Joris Yzermans, Christel E. van Dijk, Dick Heederik, Lidwien A.M. Smit
Journal: European Respiratory Journal (2015)

Several studies have investigated the effect of livestock farm emissions on the respiratory health of local residents, but results are inconsistent. This study aims to explore associations between the presence of livestock farms and respiratory health in an area of high-density livestock farming in the Netherlands. We focused especially on associations between farm exposures and respiratory symptoms within subgroups of potentially susceptible patients with a pre-existing lung disease.In total, 14 875 adults (response rate 53.4%) completed a questionnaire concerning respiratory health, smoking habits and personal characteristics. Different indicators of livestock farm exposures relative to the home address were computed using a geographic information system.Prevalence of chronic obstructive pulmonary disease (COPD) and asthma was lower among residents living within 100 m of a farm (OR 0.47, 95% CI 0.24-0.91 and OR 0.65, 95% CI 0.45-0.93, respectively). However, >11 farms in 1000 m compared to fewer than four farms in 1000 m (fourth quartile versus first quartile) was associated with wheezing among COPD patients (OR 1.71, 95% CI 1.01-2.89). Using general practitioners' electronic medical records, we demonstrated that selection bias did not affect the observed associations.Our data suggest a protective effect of livestock farm emissions on the respiratory health of residents. Nonetheless, COPD patients living near livestock farms reported more respiratory symptoms, suggesting an increased risk of exacerbations.
Physiotherapy after lung resection surgery: Comparison between video-assisted thoracic surgery (VATS) and open thoracotomy
Authors: Raquel Sebio, Maria Isabel Yañez, Esther Gimenez, Yolanda Sanesteban, Beatriz Lopez
Journal: European Respiratory Journal (2014)

BACKGROUND: Video-assisted thoracic surgery (VATS) has started to replace open thoracotomy (TH) for major lung resection over the past years. As the new approach is less invasive, a review of the chest physiotherapy given in the immediate postoperative period should be evaluated. OBJECTIVES: to compare the number of physiotherapy sessions, Length Of Stay (LOS) and Postoperative Pulmonary Complications (PPCs) between VATS and open thoracotomy. MATERIAL AND METHODS: Restrospective observational study. We collected data from all patients submitted to lung resection between April 2009 to October 2010. We recorded the number of physiotherapy sessions, LOS, respiratory function values and PPCs. We excluded pneumonectomies, bullectomies, sternotomies and cervical thoracotomies. RESULTS: 208 patients were enrolled in the study. There were 138 VATS and 70 TH. Median age was 63.09±11.61 for VATS and 57.96±13.17 for TH patients. Baseline comparison analysis shown a statistically significant difference between groups for age and Body Mass Index (BMI) (p 0.05). CONCLUSIONS: VATS patients needed fewer physiotherapy sessions after surgery despite no difference in the PPCs or LOS.
The effect of early use of continuous positive airway pressure (CPAP) therapy to treat acute atelectasis after cardiac surgery: Randomized study
Authors: Fouad Al Mutairi, Stephen Fallows, Elizabeth Mason-Whitehead, Waleed Abukhudair, Baharul Islam
Journal: European Respiratory Journal (2011)

Rationale: Cardiac surgery incisional pain can decrease inspiratory effort, alter normal respiratory mechanics, and increase the potential for post-operative pulmonary complications such as acute atelectasis.

This study aims to assess the effect of the early use of CPAP via mask therapy to treat acute atelectasis.

Methods: 72 participants who fit the inclusive criteria were included. The control group used Incentive Spirometry (IS) 15 times/hour and the trial group used CPAP for half hour every 2 hours both for 3days. Vital capacity (VC), RR, HR and SpO2 were measured after operation as baseline-test, after 12 hours, 24hours, 48 hours and posts the therapy. Failure was defined as a need for an advance therapy.

Result: 66 male and 6 female (mean ages; 57±5.3 years) were participated. 26/36 participants from CPAP group had succeed (72%) and 19/36 from IS group had succeed (53%). VC was increased significantly in CPAP group (baseline mean for IS group 1.31L and CPAP group 1.43L, post- therapy mean 1.59L and 1.88L respectively, p=0.02) (figure 1). SpO2 was decreased significantly in IS group (baseline 98.25%, 97.19%, post-therapy 96.53%, 96.83 respectively, p=0.003) and no significant different in RR and HR.

![Figure][1] 

Figure 1





Conclusion: Early used of CPAP via mask therapy had better outcomes to treat post surgical atelectasis especially with smoker and elderly patients.

 [1]: pending:yes
NIH Panel Examines Conflicts
Authors: Brian Vastag
Journal: JAMA (2004)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Cytotoxic T lymphocyte antigen-4 and immune checkpoint blockade
Authors: Elizabeth Buchbinder, F. Stephen Hodi
Journal: Journal of Clinical Investigation (2015)

The relationship between cancer and the immune system is complex and provides unique therapeutic opportunities. Cytotoxic T lymphocyte antigen-4 (CTLA-4) is a regulatory molecule that suppresses T cell effector function following initial activation by costimulatory signals. Fully human monoclonal antibodies targeting CTLA-4 have been shown to increase T cell function and antitumor responses in patients with advanced metastatic melanoma. Responses observed with such immune checkpoint therapy can follow a different pattern from that seen with cytotoxic chemotherapy or targeted therapy and may continue after therapy is discontinued. In addition, the toxicities that are associated with anti-CTLA-4 therapy may differ from those of conventional therapies and consist of inflammatory events in parts of the body that do not contain cancerous cells. Early recognition of these inflammatory events and intervention is important, and the identification of predictive biomarkers continues to be an unfulfilled need in the field of immunotherapy. Combinatorial approaches with targeted therapies, radiation therapy, chemotherapy, or other immune checkpoint agonists/antagonists have the potential to increase the efficacy of CTLA-4 blockade.
Immunohistochemical (IHC) assessment of transforming growth factor alpha (TGF-α) in conjunction with epidermal growth factor receptor (EGFR) as potential determinants of response to EGFR-targeted therapy in patients with advanced colorectal cancer (C
Authors: Matthew W. Beer, Christopher Ung, Janice Spohn, Karen Pry, Sarah S. Bacus
Journal: Clinical Cancer Research (2006)

B53   Introduction: Clinical trials of the EGFR-directed monoclonal antibodies cetuximab and panitumumab have widely employed demonstration of EGFR expression by IHC as an entry or screening criteria. Recent reports have called into question the predictive value of this testing prompting the search for markers truly predictive of response. We postulate that the presence of TGF-α, a major autocrine ligand to EGFR implicated in CRC, may act as a surrogate marker for EGFR expression, which may be both transient and extremely heterogeneous, and be associated with response to therapy in supposed EGFR-undetectable tumors.Materials and Methods: Automated IHC assessment of formalin-fixed, paraffin-embedded tissues from 91 consecutive patients was performed for EGFR and TGF-α. Quantitative assessment of TGF-α was performed using digital imaging software to generate an average optical density (OD) for the tumor component of each specimen.Results: A total of 91 patients (117 total specimens) were evaluated for both EGFR and TGF-α. All 117 specimens demonstrated positive staining for TGF-α. Quantitative assessment of intratumoral TGF-α expression by image analysis showed no significant differences between 66 EGFR positive (0.25 median TGF-α OD, SD = 0.13) and 25 EGFR negative (0.26 median TGF-α OD, SD = 0.11) patients. Comparable levels of TGF-α were also seen in specimens from 85 primary tumors (0.25 median OD, SD = 0.15) and 32 various distant metastases (0.315 median OD, SD = 0.12). No statistically significant differences in TGF-α expression were observed between different EGFR staining intensities (0, 1+, 2+, 3+). In a subgroup of 14 patients with multiple tumor specimens available, no significant difference in TGF-α expression patterns were seen within individual patients.Conclusions: The ubiquitous expression of TGF-α by CRC observed across multiple anatomic sites suggests that the presence of the ligand, with or without coordinate EGFR expression, is likely a hallmark of CRC tumorogenesis rather than an indicator of EGFR-dependent growth and is therefore unlikely to differentiate either responsive or resistant tumors when considered in the context of the relatively low clinical response rates observed with cetuximab and panitumumab treatment. Examination of erbB receptor family co-expression, including HER-2 as the preferred EGFR dimerization partner, in combination with downstream markers of EGFR signaling activity should be considered.
European Committee on Antimicrobial Susceptibility Testing (EUCAST) Technical Notes on antimicrobial susceptibility testing
Authors: G. Kahlmeter, D.F.J. Brown, F.W. Goldstein, A.P. MacGowan, J.W. Mouton, I. Odenholt, A. Rodloff, C-J. Soussy, M. Steinbakk, F. Soriano, O. Stetsiouk
Journal: Clinical Microbiology and Infection (2006)
Neurogenetic determinism and the new euphenics
Authors: N. Craddock, I. R Jones, L. Kent, J. H G Williams, S. Rose
Journal: BMJ (1999)

Editor—Various implications of advances in understanding of the genetic contribution to susceptibility to neuropsychiatric disorders must be debated. Rose’s article on this subject, however, contains important errors of fact, severely misrepresents current research, and is neither reasoned nor balanced.1

He accuses researchers of simplistically assuming that behaviours are genetically determined. In fact, most researchers in the field, ourselves included, are fully aware of the complexity of pathogenesis and accept a model in which both genetic and non-genetic factors influence susceptibility to disease.2–4 Rose makes the unfounded and disingenuous presumption that researchers seek to identify genes “with a view to ... aborting fetuses which show the potential for ... undesirable characteristics or generating drugs which will alleviate the condition, turn gays into straights, or radicals into conservatives.” This emotive statement both misrepresents and trivialises the aim of most research, which is to better define the pathophysiology of major psychiatric disorders such as schizophrenia and bipolar disorder. Rose gives the impression that this desirable end is a fortuitous byproduct of research. In fact, it is the primary motivation.

Rose also attacks psychiatrists for creating illnesses where none exist. He offers attention deficit hyperactivity disorder as an example that he claims “was almost unknown in the United Kingdom a decade ago” and berates psychiatrists for prescribing the stimulant methylphenidate as a treatment. Attention deficit hyperactivity disorder may be a new name, but it describes a syndrome that has undergone almost a century of study and is certainly not merely a label for naughty and disruptive children.5 Rose is wrong to claim that it is not a valid diagnosis, and to maintain that people with this condition should not have the opportunity to benefit from potentially effective treatment seems both unsympathetic and arrogant.

Most researchers in psychiatric genetics reject the notion of neurogenetic determinism. Their modest goal is to contribute to improved understanding and treatment of the major psychiatric illnesses that cause so much suffering to so many. Rose should stop propounding his familiar but outdated antipsychiatry, antigenetic message and adopt a more constructive and informed position. We need to work together to ensure that the opportunities provided by molecular genetics are used to the benefit of our patients.