tbuckley/cabot-search huggingface dataset:
Obstructive sleep apnea and metabolic syndrome in thin patients; characteristics and comparation with patients with overweight and obesity
Authors: Raquel Dacal Quintas, Manuel Tumbeiro Novoa, Maria Teresa Alves Pérez, Adela Acuña Fernánez, Mari Luz Santalla Martínez, Pedro Marcos Velázquez
Journal: European Respiratory Journal (2012)

Objective :we wanted to know the prevalence of obstructive sleep apnea(OSA)and metabolic syndrome(MS)in thin patients and their characteristics.We also wanted to know if there were differences with overweight and obese.   Methods: we studied the patients that were referred to our sleep laboratory, from January to December2009.OSAS was diagnosed when apnea hipopnea index (AHI)was>5.MS was diagnosed according to the International Diabetes Federation criteria.The patients were distributed in 3groups according to BMI: normal or thin(BMI   Results  : We studied 475patients:7,6%thin, 36%overweight and 56,4%obese.In the thin9s group,most were women,snorers,non-smokers and don9t drink alcohol.We diagnosed of OSA 428(90,1%): in thin77,7%, in overweight84,79% and in obese91,4%.Thin patients with OSA were mostly mild OSA, in overweight mostly moderate and in obese severe.There were differences between OSA9s diagnose and categorized BMI.We diagnosed of MS 288(64,4%): in the thin9s group33,3%,in overweight43,94% and in obese80,93%.We found more probability of MS(p   Conclusions   OSA9s prevalence in thin patients is minor  OSA and MS9prevalence in thin patients is minor than in obese  Thin patients were most women, younger and without toxic habits  OSA and MS were not related in thin patients.
Safety of patients participating in drug trials
Authors: E. Armstrong, S. Dollow
Journal: BMJ (1998)

Editor—Several advertisements have recently been placed in the national and local press by a private agency, requesting volunteers with manic depression to join a drug trial. This drug trial requires participants to stop all current drug treatment, albeit under psychiatric supervision. They are then randomised to one of three groups, receiving treatment with lithium, lamotrigine (at one of three doses), or placebo for one year.

This poses three ethical problems. Firstly, advertising publicly for volunteers with serious mental illness is a dubious practice. Secondly, there is evidence that stopping lithium, as required by the trial, results in both relapse and a more severe pattern of illness.1,2 Thirdly, most participants in the trial will not be treated with an established mood stabilising drug. This would be unacceptable in trials for drugs to treat participants with life threatening infections or cancer. It is no more acceptable for severe mental illness.

The use of placebo in trials of drugs for mental illness should be debated, and so should the issue of informed consent, rather than taken for granted as it is at present. Moreover, I would like to see Glaxo Wellcome accept responsibility for all episodes of mental illness that might have been prevented if its trial of lamotrigine (£60 ($96) a month and two years left on its patent) was being run more sensitively.
Abstract 3483: Management of Hyperphosphatemia Is an Important Novel Therapeutic Target in Chronic Heart Failure
Authors: Hiroshi Asanuma, Masanori Asakura, Jiyoong Kim, Hiroyuki Takahama, Hideyuki Sasaki, Shoji Sanada, Takahiro Ohara, Kyondoku Min, Shin Ito, Masashi Fujita, Yoshihiro Asano, Seiji Takashima, Tetsuo Minamino, Kazuo Komamura, Masafumi Kitakaze
Journal: Circulation (2008)
L-arginine suppresses lipopolysaccharide-induced expression of RANTES in glomeruli.
Authors: U Haberstroh, K Stilo, J Pocock, G Wolf, U Helmchen, U Wenzel, G Zahner, R A Stahl, F Thaiss
Journal: Journal of the American Society of Nephrology (1998)

Endotoxemia leads to the infiltration of inflammatory cells in glomeruli and the tubulointerstitium of the kidney. The ultimate mechanisms for this infiltration, however, are not entirely clear. In this study, the glomerular formation of the chemokine RANTES (regulated upon activation normal T cell expressed and secreted) was examined in an in vivo model of endotoxemia to evaluate the role the local release of chemokines might play in the regulation of this inflammatory cell infiltrate. Since the beneficial effects of nitric oxide (NO) on immune-mediated tissue injury have been reported, we also examined possible interactions between the chemokine RANTES and the L-arginine/NO pathway. To induce endotoxemia, rats were injected intraperitoneally with lipopolysaccharide (LPS). Glomeruli were isolated over a 24-h time period, and RANTES was assessed by Northern blotting, a chemotactic assay, and a specific enzyme-linked immunosorbent assay. The chemokine release was associated with increased glomerular infiltration of monocytes/macrophages. LPS also stimulated the mRNA expression of inducible NO synthase and increased the release of nitrite into the supernatants of isolated glomeruli. Supplementation of L-arginine intake increased the release of glomerular nitrite and reduced glomerular RANTES expression after the injection of LPS. Inhibition of the L-arginine/NO pathway by the unspecific NO synthase inhibitor N(G)-nitro-L-arginine methylester significantly increased glomerular RANTES mRNA expression and the number of infiltrating glomerular macrophages. These data demonstrate that L-arginine suppresses glomerular RANTES formation and suggest that the chemokine-mediated recruitment of glomerular macrophages in LPS-induced endotoxemia can be modulated by the L-arginine/NO pathway.
Does Hospital-at-Home Make Economic Sense? Early Discharge Versus Standard Care for Orthopaedic Patients
Authors: Martin Hensher, Naomi Fulop, Sonja Hood, Sarah Ujah
Journal: Journal of the Royal Society of Medicine (1996)

Hospital-at-home has been promoted as a potentially effective means of replacing costly inpatient care with cheaper domiciliary care. We studied three hospital-at-home schemes in West London providing intensive home care for early discharge orthopaedic patients, comparing their costs with those of standard inpatient care. Although costs per day of hospital-at-home care were lower than those of inpatient care, the schemes appeared to increase the total duration of orthopaedic episodes, so that the costs of standard care, per episode, were lower than those of hospital-at-home. While hospital-at-home may offer considerable future potential, substitution of home care for inpatient care will not necessarily save resources.
Pioglitazone Use and Risk of Bladder Cancer and Other Common Cancers in Persons With Diabetes
Authors: James D. Lewis, Laurel A. Habel, Charles P. Quesenberry, Brian L. Strom, Tiffany Peng, Monique M. Hedderson, Samantha F. Ehrlich, Ronac Mamtani, Warren Bilker, David J. Vaughn, Lisa Nessel, Stephen K. Van Den Eeden, Assiamira Ferrara
Journal: JAMA (2015)

<h3>Importance</h3> Studies suggest pioglitazone use may increase risk of cancers. <h3>Objective</h3> To examine whether pioglitazone use for diabetes is associated with risk of bladder and 10 additional cancers. <h3>Design, Setting, and Participants</h3> Cohort and nested case-control analyses among persons with diabetes. A bladder cancer cohort followed 193 099 persons aged 40 years or older in 1997-2002 until December 2012; 464 case patients and 464 matched controls were surveyed about additional confounders. A cohort analysis of 10 additional cancers included 236 507 persons aged 40 years or older in 1997-2005 and followed until June 2012. Cohorts were from Kaiser Permanente Northern California. <h3>Exposures</h3> Ever use, duration, cumulative dose, and time since initiation of pioglitazone as time dependent. <h3>Main Outcomes and Measures</h3> Incident cancer, including bladder, prostate, female breast, lung/bronchus, endometrial, colon, non-Hodgkin lymphoma, pancreas, kidney/renal pelvis, rectum, and melanoma. <h3>Results</h3> Among 193 099 persons in the bladder cancer cohort, 34 181 (18%) received pioglitazone (median duration, 2.8 years; range, 0.2-13.2 years) and 1261 had incident bladder cancer. Crude incidences of bladder cancer in pioglitazone users and nonusers were 89.8 and 75.9 per 100 000 person-years, respectively. Ever use of pioglitazone was not associated with bladder cancer risk (adjusted hazard ratio [HR], 1.06; 95% CI, 0.89-1.26). Results were similar in case-control analyses (pioglitazone use: 19.6% among case patients and 17.5% among controls; adjusted odds ratio, 1.18; 95% CI, 0.78-1.80). In adjusted analyses, there was no association with 8 of the 10 additional cancers; ever use of pioglitazone was associated with increased risk of prostate cancer (HR, 1.13; 95% CI, 1.02-1.26) and pancreatic cancer (HR, 1.41; 95% CI, 1.16-1.71). Crude incidences of prostate and pancreatic cancer in pioglitazone users vs nonusers were 453.3 vs 449.3 and 81.1 vs 48.4 per 100 000 person-years, respectively. No clear patterns of risk for any cancer were observed for time since initiation, duration, or dose. <h3>Conclusions and Relevance</h3> Pioglitazone use was not associated with a statistically significant increased risk of bladder cancer, although an increased risk, as previously observed, could not be excluded. The increased prostate and pancreatic cancer risks associated with ever use of pioglitazone merit further investigation to assess whether they are causal or are due to chance, residual confounding, or reverse causality.
Evidence that children can assess their asthma medication devices
Authors: Katerina Papataxiarchou, Nikolaos Grekas, Katerina Athanassiou, Athanasios Kaditis, Polytimi Panaghiotopoulou-Gartagani
Journal: European Respiratory Journal (2011)

Introduction:  The value of obtaining children9s reports about their health from questionnaires is important in clinical paediatrics and child health research. FSI-10 questionnaire for asthma devices9 assessment has been developed and implemented for adult patients. The reliable Greek version has also been used in adults for both clinical practice and research.   Objectives:  The aim of this pilot study was to examine the suitability of Greek FSI-10 in asthmatic children in order to measure their satisfaction and the usability of inhalers in daily practice.   Methods:  This 8-week pilot study was designed and conducted as an open label, single-centre, non interventional, notified to regulatory authorities. Patients have consented in study participation by their legally authorised persons. 33 (15 female) asthmatic school children aged between 6 and 16 years were on the same device use at least two months before study enrollment. Four different breath activated dry powder inhalers (Aeroliser®, Elpenhaler®, Diskus®, Turbuhaler®) were used by study subjects. Questionnaire9s items were child-reported and completed by the two pediatricians who interviewed in details the selected patients at the end of the study. All necessary clarifications and explanations were also given by the phycisians during interview.   Results:  Evidence that school children can reliably assess their inhalers by using the Greek FSI-10 was concluded. The questionnaire was easily understood. Reliability was very good as shown by Cronbach test (Cronbach9s alpha = 0.925).   Conclusions:  Greek FSI-10 may be used in pediatric school aged population. Minor modifications may improve its measuring properties and reliability. Further work on this topic is needed.
Detection of Health-Related Warning Signals Through Daily Telemonitoring of Cancer Patients on Multidrug Chemotherapy at Home (European Project Incasa)
Authors: A. Arbaud, P. Innominato, A. Mohammad-Djafari, A. Ulusakarya, R. Bossevot-Desmaris, V. Plessis, M. Mocquery, D. Bouchoucha, J. Beau, M. Bouchahda, A. Karaboue, J. Morère, J. Fursse, M. Caprino, F. Levi
Journal: Annals of Oncology (2014)
The Evolution of Palliative Care
Authors: Cicely Saunders
Journal: Journal of the Royal Society of Medicine (2001)

The development by the second half of the twentieth century of new technologies and effective specific treatments for disease still left much suffering unaddressed. As Professor Patrick Wall wrote in 1986, ‘Symptoms were placed on one side and therapy directed at [them] was denigrated’1. In the same vein, when Aneurin Bevan introduced the National Health Service Bill to Parliament, he stated that he would ‘rather be kept alive in the efficient if cold altruism of a large hospital than expire in a gush of sympathy in a small one’2.

But what if no cure was possible and the end of life was inevitable? Referring particularly to the hospice movement, Wall added that ‘The old methods of care and caring had to be rediscovered and the best of modern medicine had to be turned to the task of new study and therapy specifically directed at pain’. Care, matched with an increasingly sound evidence base, was by then underpinned by the concept of ‘total pain’—defined in 1964 as including not only physical symptoms but also mental distress and social or spiritual problems3. This approach met ready audiences among nursing and medical students during lectures or in articles, as well as social workers and more gradually among senior members of the medical profession.
The research on early detection of lung cancer with exhaled volatile organic compounds
Authors: Yanjie Hu, Kejing Ying
Journal: European Respiratory Journal (2014)

Breath test might be used as a new mode, non-invasive, and convenient diagnostic method, which can make the assessment of disease through detecting the range of the VOCs exhaled or consumed by the patients, and reflecting the metabolism of the corresponding tissue cell. Considering the location, lung cancer is closely related to VOCs, therefore, to find out the lung cancer-associated specific VOCs might be provided us a new idea and target for early diagnosis of lung cancer.  The study confirmed that there are stable conclusion and good repeatability to analyze special VOCs from exhaled breath by SPME-GCMS. We analyzed exhaled breath VOCs of 243 samples by SPME-GCMS system, including 88 samples of lung cancer, 70 samples of lung benign disease, 85 samples of health person, and further researched the sensitivity and specificity of the diagnostic models based on different combinations of special VOCs by applying statistical approaches, such as cluster analysis or stepwise discriminant analysis. In the end, we selected age, as well as 4 to 6 VOCs, as the diagnostic models for lung cancer, including 2,6-dimethylnaphthalene, palmitic aldehyde, nonadecyl alcohol, etc, basically with high sensitivity and specificity more than 85% . Take one model for example, which is consisted of palmitic aldehyde, nonadecyl alcohol, 2,6-dimethylnaphthalene, age, and so on, its specificity is 94.9%, and 78.7% of early stage lung cancer patients were correctly identificated, however, 31.9% of them were misclassificated to advanced stage. The study found that several special VOCs expression are associated with pathological classification, lesion locations, surgery and smoking situation.
The D<sub>2</sub> Dopamine Receptor Gene as a Determinant of Reward Deficiency Syndrome
Authors: K Blum, P J Sheridan, R C Wood, E R Braverman, T J H Chen, J G Cull phd, D E Comings
Journal: Journal of the Royal Society of Medicine (1996)

The dopaminergic system, and in particular the dopamine D 2 receptor, has been profoundly implicated in reward mechanisms in the brain. Dysfunction of the D 2 dopamine receptors leads to aberrant substance seeking behaviour (alcohol, drug, tobacco, and food) and other related behaviours (pathological gambling, Tourette's syndrome, and attention deficit hyperactivity disorder). We propose that variants of the D 2 dopamine receptor gene are important common genetic determinants of the ‘reward deficiency syndrome’.
The Risk of Coronary Heart Disease Associated With Glycosylated Hemoglobin of 6.5% or Greater Is Pronounced in the Haptoglobin 2-2 Genotype
Authors: Leah E. Cahill, Majken K. Jensen, Stephanie E. Chiuve, Hadar Shalom, Jennifer K. Pai, Alan J. Flint, Kenneth J. Mukamal, Kathryn M. Rexrode, Andrew P. Levy, Eric B. Rimm
Journal: Journal of the American College of Cardiology (2015)
Pharmacologic bronchodilation response to salbutamol in COPD patients
Authors: Fariba Mansouri, Mohamad Hossin Boskabady
Journal: European Respiratory Journal (2014)

BACKGROUND: Airway hyperresponsiveness (AHR) is the most characteristic feature of asthma, which is reported in COPD patients and smokers. Increased airway responsiveness to s-agonists is also demonstrated in asthmatics as well as smokers. However, there is no report regarding AHR to s-agonist drugs in COPD patients. Therefore, in this study pharmacologic bronchodilation response to salbutamol in COPD patients was examined.  MATERIALS AND METHODS: The threshold concentrations of inhaled salbutamol required for a 20% change in forced expiratory flow in 1 sec (FEV1) as PC20, or a 35% change in specific airway conductance (sGaw) as PC35 was measured in 14 COPD patients and 14 normal subjects. RESULTS: Airway responsiveness to salbutamol in COPD patients (PC20 = 14.14 ± 1.62 and PC35 = 9.70 ± 1.48 mg/l) was significantly lower than normal subjects (PC20 = 224.57 ± 16.62 and PC35 = 81.87 ± 8.16 mg/l, P   CONCLUSION: These results showed increased airway responsiveness of most COPD patients to salbutamol which was highly correlated to airway caliber.  Key words: Airway caliber, airway responsiveness, COPD, salbutamol, smoker.
Abstract P180: The Risk of Infectious and Septic Complications from Trauma are Age-Associated: An Analysis of the National Trauma Database
Authors: Christian D McClung, Joseph Dubose, Amin A Abdi, M. J Yen, Sean O Henderson
Journal: Circulation (2008)

INTRODUCTION: Understanding the immune response to injury may allow us to better characterize tolerance to injury and shock. OBJECTIVE: To evaluate the relationship between age and infectious morbi...
Large-Cell Neuroendocrine Carcinoma: Controversies in Diagnosis and Treatment
Authors: Bonnie S. Glisson, Cesar A. Moran
Journal: Journal of the National Comprehensive Cancer Network (2011)

The diagnosis and treatment of large cell neuroendocrine carcinoma are controversial, difficult, and clearly still evolving. Diagnosing this particular entity can be hampered by the limitations and restrictions imposed by its own definition in the current WHO classification. These complexities in the semantics of diagnostic criteria can puzzle not only the pathologist but also the treating physician, and lead to difficulties in choosing treatment for individual patients. Because of its low incidence (2%-3% of non-small cell carcinomas) and the difficulties in diagnosis, data regarding treatment outcomes are based on series in which the diagnosis is frequently made retrospectively in reclassification, the numbers of patients are small, and the determinants of therapy choice (e.g., treatment with or without adjuvant chemotherapy postresection) cannot be known. Thus, the evidence on which to base recommendations for stage-based treatment paradigms is flawed in many respects. This article discusses these difficult issues for pathologists and oncologists, offers a perspective regarding approaches in treatment, and suggests ways in which prospective data on this uncommon cancer can be gathered to inform treatment guidelines and improve patient outcomes.
Effect of Pharmacotherapy on Rate of Decline of Lung Function in Chronic Obstructive Pulmonary Disease
Authors: Bartolomé R. Celli, Nicola E. Thomas, Julie A. Anderson, Gary T. Ferguson, Christine R. Jenkins, Paul W. Jones, Jørgen Vestbo, Katharine Knobil, Julie C. Yates, Peter M. A. Calverley
Journal: American Journal of Respiratory and Critical Care Medicine (2008)

Chronic obstructive pulmonary disease (COPD) is characterized by an accelerated decline in lung function. No drug has been shown conclusively to reduce this decline.In a post hoc analysis of the Toward a Revolution in COPD Health (TORCH) study, we investigated the effects of combined salmeterol 50 microg plus fluticasone propionate 500 microg, either component alone or placebo, on the rate of post-bronchodilator FEV(1) decline in patients with moderate or severe COPD.A randomized, double-blind, placebo-controlled study was conducted from September 2000 to November 2005 in 42 countries. Of 6,112 patients from the efficacy population, 5,343 were included in this analysis.Spirometry was measured every 24 weeks for 3 years. There were 26,539 on-treatment observations. The adjusted rate of decline in FEV(1) was 55 ml/year for placebo, 42 ml/year for salmeterol, 42 ml/year for fluticasone propionate, and 39 ml/year for salmeterol plus fluticasone propionate. Salmeterol plus fluticasone propionate reduced the rate of FEV(1) decline by 16 ml/year compared with placebo (95% confidence interval [CI], 7-25; P < 0.001). The difference was smaller for fluticasone propionate and salmeterol compared with placebo (13 ml/year; 95% CI, 5-22; P = 0.003). Rates of decline were similar among the active treatment arms. FEV(1) declined faster in current smokers and patients with a lower body mass index, and varied between world regions. Patients who exacerbated more frequently had a faster FEV(1) decline.Pharmacotherapy with salmeterol plus fluticasone propionate, or the components, reduces the rate of decline of FEV(1) in patients with moderate-to-severe COPD, thus slowing disease progression. Clinical trial (GSK Study Code SCO30003) registered with www.clinicaltrials.gov (NCT00268216).
Marked Granulocytosis in C57BL/6 Mice Bearing a Transplanted BMT-11 Fibrosarcoma&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: M Ishikawa, M Hosokawa, N Oh-hara, Y Niho, H Kobayashi
Journal: JNCI Journal of the National Cancer Institute (1987)

When a 3-methylcholanthrene (CAS: 56-49-5)-induced fibrosarcoma, BMT-11, and its eight clones were transplanted sc into syngeneic C57BL/6 mice, leukemoid reaction characterized by a progressive increase in peripheral white blood cells (WBCs) and by splenomegaly was observed as the tumors grew. The WBC count reached about forty-fold of the normal level, and more than 90% of WBCs were found to be polymorphonuclear leukocytes. The increase in WBCs was correlated with tumor size, and its count decreased to normal level within 7 days after surgical excision of subcutaneous tumors. Moreover, a high level of colony-stimulating activity was detected in the supernatant of BMT-11 culture. These results suggest that the colony-stimulating factor produced by BMT-11 cells caused granulocytosis in mice. This is the first report of the marked degree of granulocytosis induced by a transplanted tumor in C57BL/6 strain mice.