tbuckley/cabot-search huggingface dataset:
Biphasic patterns of memory deficits following moderate-dose partial-brain irradiation: neuropsychologic outcome and proposed mechanisms.
Authors: C Armstrong, J Ruffer, B Corn, K DeVries, J Mollman
Journal: Journal of Clinical Oncology (1995)

PURPOSE To identify the longitudinal neurobehavioral characteristics of the early-delayed and late-delayed effects of partial-brain radiotherapy for patients with supratentorial brain tumors with favorable histology. This study improves on previous attempts to identify radiation effects, because of the inclusion of baseline measures and the use of subjects as their own controls. PATIENTS AND METHODS Ten neuropsychologic domains were measured in 12 patients at baseline (post-surgery and immediately before initiation of radiotherapy), and followed trimonthly for 1 year. Four to six patients were examined at 2 and 3 years postbaseline. RESULTS Patients were impaired at baseline compared with controls only in visual memory and sentence recall, but demonstrated significant improvement in visual memory by 2 years postbaseline. Speed of processing information also showed a slope of improvement over 2 years. Retrieval from verbal long-term memory was impaired at 1.5 months postcompletion of radiotherapy, but recovered to baseline levels by 1 year. At 2 years postbaseline, long-term memory retrieval demonstrated a decline, but remained unchanged at 3 years. CONCLUSION Long-term memory appears to be sensitive to the effects of radiotherapy. We confirmed our previous findings of a decrement with rebound during the early-delayed period, and propose that these findings are consistent with demyelination/remyelination. Decrement was observed again at 2 years postbaseline, which suggests that memory retrieval may be the earliest marker of late-delayed effects. These neurocognitive patterns are consistent with leukoencephalopathy. Confirmation of these observations will be possible if neuropsychologic testing with the same sensitivity can be incorporated into national collaborative trials.
Improving management of diabetes in residential and nursing homes
Authors: D. Hicks, S. Atkin, E. Masson, D. Hepburn, C. Walton, M. Hall
Journal: BMJ (1998)

Editor—Tattersall and Page highlighted the problem of providing diabetes care for patients in residential and nursing homes.1 In Hull we have attempted to tackle the growing problem of unstructured diabetes care in these establishments with the development of our “home clinic service.” 2 This service started in 1991 to provide structured diabetes care in the community by secondary care staff. 

We had identified a small but increasing number of patients who attended the hospital based clinic but gained little from the consultation. A high proportion of this group lived in nursing or residential homes. They commonly required hospital transport, which prolonged the hospital visit, and usually had a relative or a professional carer providing day to day diabetes care and support. However, the carers rarely accompanied the patient on the hospital visit. Accurate information was often unavailable to assist the consultation, and the only reliable method of relaying changes made during the consultation back to the carer was by letter. 

Referrals to our home clinic service are currently made only by consultant diabetologists, although some general practitioners have recently shown interest in purchasing this service for housebound patients with diabetes. The protocol encompasses all annual review procedures, which are carried out by a diabetes specialist nurse who visits the patients’ residence. Screening includes a foot examination, for which training was provided by the diabetes centre podiatrist. The nurse also arranges eye screening through a domiciliary visit by an optometrist or attendance at the ophthalmology department. Control of glycaemia is assessed and problems are discussed with the carer. The home visit improves communication and means that any changes to treatment can be made immediately and treatment goals can be discussed.
Creatine supplementation attenuates systemic and pulmonary effects of acute lung injury induced by pulmonary ischemia-reperfusion in rats
Authors: Francine Almeida, Rogerio Pazetti, Fernanda Degobbi Tenório Quirino Santos Lopes, Sonia Fatima Soto, Milton Arruda Martins, Marisa Dolhnikoff, Rodolfo Paula Vieira
Journal: European Respiratory Journal (2012)

Creatine supplementation (CS) presents prophylactic and therapeutic effects for some muscular, cardiovascular and neurological disorders. In case of temporary ischemia, CS improves the capacity to generate ATP reducing cell damage. Ischemia and reperfusion (IR) injury is partially attributed to decreased intracellular ATP turnover, but also to increased oxidative stress and reduced IGF-1. Thus, this study evaluated the effects of 5 days of CS prior 90 minutes ischemia of left pulmonary artery followed by 120 minutes of reperfusion in 40 male Wistar rats divided in 4 groups: Sham-operated, Creatine+Sham, Ischemia/Reperfusion, Creatine+Ischemia/Reperfusion. Lung mechanics, exhaled nitric oxide, cellularity in systemic circulation and in bronchoalveolar lavage (BAL), neutrophils and edema in lung tissue, total proteins in BAL, the levels of IL-1beta, IL-4, IL-6, IL-17, KC, MCP-1 and TNF-alpha in serum and in bronchoalveolar lavage were evaluated by ELISA, as well as the expression of IGF-1, iNOS and caspase-3 in lung tissue. Compared with IR group, CS supplementation (CS+IR group) resulted in a reduction of exhaled nitric oxide (p<0.05), tissue damping (GTIS) and tissue elastance (HTIS) (p<0.05), total cells and neutrophils number in systemic circulation, in BAL and also in lung tissue (p<0.01), BAL levels of total proteins (p<0.05) and edema index in lung tissue (p<0.05), and systemic and pulmonary IL-1beta levels (p<0.05). In addition, CS resulted in increased expression of IGF-1 in lung tissue. CS presents protective effects for the development of pulmonary and systemic manifestations of acute lung injury caused by pulmonary IR.
Effects of needs-based patient education on self-efficacy and health outcomes in people with rheumatoid arthritis: a multicentre, single blind, randomised controlled trial
Authors: M Ndosi, D Johnson, T Young, B Hardware, J Hill, C Hale, J Maxwell, E Roussou, A Adebajo
Journal: Annals of the Rheumatic Diseases (2015)

Objectives The Educational Needs Assessment Tool (ENAT) is a self-completed questionnaire, which allows patients with arthritis to prioritise their educational needs. The aim of this study was to evaluate the effects of needs-based patient education on self-efficacy, health outcomes and patient knowledge in people with rheumatoid arthritis (RA). Methods Patients with RA were enrolled into this multicentre, single-blind, parallel-group, pragmatic randomised controlled trial. Patients were randomised to either the intervention group (IG) where patients completed ENAT, responses of which were used by the clinical nurse specialist to guide patient education; or control group (CG) in which they received patient education without the use of ENAT. Patients were seen at weeks 0, 16 and 32. The primary outcome was self-efficacy (Arthritis Self Efficacy Scale (ASES)-Pain and ASES-Other symptoms). Secondary outcomes were health status (short form of Arthritis Impact Measurement Scale 2, AIMS2-SF) and patient knowledge questionnaire-RA. We investigated between-group differences using analysis of covariance, adjusting for baseline variables. Results A total of 132 patients were recruited (IG=70 and CG=62). Their mean (SD) age was 54 (12.3) years, 56 (13.3) years and disease duration 5.2 (4.9) years, 6.7 (8.9) years for IG and CG, respectively. There were significant between-group differences, in favour of IG at week 32 in the primary outcomes, ASES-Pain, mean difference (95% CI) −4.36 (1.17 to 7.55), t=−2.72, p=0.008 and ASES-Other symptoms, mean difference (95% CI) −5.84 (2.07 to 9.62), t=−3.07, p=0.003. In secondary outcomes, the between-group differences favoured IG in AIMS2-SF Symptoms and AIMS2-SF Affect. There were no between-group differences in other secondary outcomes. Conclusions The results suggest that needs-based education helps improve patients’ self-efficacy and some aspects of health status. Trial registration number ISRCTN51523281.
The relative contribution of bronchoalveolar macrophages and neutrophils to lucigenin- and luminol-amplified chemiluminescence
Authors: C Ward, CA Kelly, SC Stenton, M Duddridge, DJ Hendrick, EH Walters
Journal: European Respiratory Journal (1990)

The relationship between differential cell counts and latex-stimulated luminol and lucigenin-amplified chemiluminescence (CL) was investigated by mixing alveolar macrophages (AM) obtained at bronchoalveolar lavage (BAL) with allogeneic peripheral blood neutrophils (PMN) in varying proportions. In 5 non-asthmatic subjects, the mean luminol-amplified CL increased linearly from 2.1 (0.9 SEM) x 10(5) counts per second (cps) with less than 2% PMN, greater than 96% AM to 47.3 (11.1 SEM) x 10(5) cps with greater than 94% PMN, 0% AM (r = 0.996, p less than 0.001). The regression had a y-intercept indistinguishable from 0 cps, suggesting that luminol-amplified CL exclusively reflected PMN activity. Using the same technique, the mean lucigenin-amplified CL showed a fall from 35 (2.3 SEM) x 10(5) cps with a cell population of greater than 96% AM, less than 2% PMN to 20 (2.3 SEM) x 10(5) cps with 0% AM, greater than 94% PMN. Both PMN and AM appeared to contribute to lucigenin-amplified CL, with AM contributing approximately 1.7 times as much activity per cell as PMN. Lucigenin-amplified CL appeared to be an appropriate technique for measuring AM activity when the proportion of PMN in mixed cell populations was small. A linear relationship was found between percent PMN count and luminol-amplified CL measured in a mixed BAL cell population from asthmatic subjects (p less than 0.01) and non-asthmatic controls (p less than 0.01). The slope of this regression line was significantly greater for subjects with asthma than for control subjects (p less than 0.01), suggesting a uniform increase in PMN activity in cells obtained from asthmatic airways.
Patient-specific dose rate for continuous infusion high-dose cytarabine in relapsed acute myelogenous leukemia.
Authors: V Heinemann, E Estey, M J Keating, W Plunkett
Journal: Journal of Clinical Oncology (1989)

We hypothesized that the steady-state concentration of intracellular cytarabine 5'-triphosphate (ara-CTPss) in leukemia cells is proportional to the dose rate of cytarabine (ara-C) during continuous infusion. To evaluate this possibility, patients with acute myelogenous leukemia in relapse were treated with two sequential schedules of serially increasing ara-C dose rates over a total of 36 hours. Schedule I consisted of serial infusions of 250, 500, and 750 mg/m2 each over 12 hours. Subsequently, patients entered on schedule II received 500, 1,000, and 1,500 mg/m2 serially, each over 12 hours. Steady-state levels of ara-CTP were achieved within four hours after beginning ara-C infusion and, in separate studies of a single ara-C dose rate, were shown to be maintained beyond 36 hours. Four patients treated with schedule I and two patients treated with schedule II showed a linear dose rate-dependent increase-of ara-CTPss at all three dose rates. The cells of one patient on schedule I and two patients on schedule II had a dose rate-dependent ara-CTPss increase only over the first two dose levels, while no increase or lower ara-CTPss was observed at the third dose rate. The ara-CTPss of one patient on schedule II did not change. These results suggest that there is a proportionality between the continuous infusion dose rate of ara-C and the ara-CTPss in circulating leukemia cells within the dose range of 250 to 1,000 mg/m2 over 12 hours. This opens the possibility that pharmacologic determinations may be used to redirect the ara-C dose rate to achieve a desired ara-CTPss level in leukemia blasts during therapy.
18S rRNA data indicate that Aschelminthes are polyphyletic in origin and consist of at least three distinct clades.
Authors: B Winnepenninckx, T Backeljau, L Y Mackey, J M Brooks, R De Wachter, S Kumar, J R Garey
Journal: Molecular Biology and Evolution (1995)

The Aschelminthes is a collection of at least eight animal phyla, historically grouped together because the absence of a true body cavity was perceived as a pseudocoelom. Analyses of 18S rRNA sequences from six Aschelminth phyla (including four previously unpublished sequences) support polyphyly for the Aschelminthes. At least three distinct groups of Aschelminthes were detected: the Priapulida among the protostomes, the Rotifera-Acanthocephala as a sister group to the protostomes, and the Nematoda as a basal group to the triploblastic Eumetazoa.
The resistance rates of Acinetobacter baumannii at endotracheal aspirate cultures
Authors: Sibel Doruk, Deniz Celik, Gulgun Yenisehirli, Handan InonuKoseoglu, Nermin Bulut, Ozgur Gunal, Serhat Celikel
Journal: European Respiratory Journal (2012)

Aim: We aimed to determine the rate of Acinetobacter baumannii resistance in intensive care unit (ICU).

Method: We analyzed 34 cases' (30 entubated and 4 nonentubated) files who had positive cultures for Acinetobacter baumannii at endotracheal aspirate.

Results: The mean age of patients was 65.5, 73.5% (n:25) was male. The most common comorbidities were COPD and CVD. In 27 paient, blood culture was taken concurrent with endotracheal aspirate culture and 22.2% (n:6) was positive with same agent. 52.9% (n:18) of patients were dead. The rate of Acinetobacter baumannii resistance and MICs presented in Table 1 and 2.

View this table:

Table 1. The rates of Acinetobacter baumannii resistance to broad spectrum antibiotics





View this table:

Table 2. The MICs of Acinetobacter baumannii resistance to broad spectrum antibiotics.





Conclusion: Higher resistance rates for broad spectrum antibiotics in Acinetobacter baumannii infections explains higher mortality rates in these patients. Higher resistance rates for carbapenems seems to limit of these antibiotics usage for ICU patients in time.
Infection of Hamster Spleen and Thymus with Herpes Simplex Virus &lt;italic&gt;In Vitro&lt;/italic&gt; and &lt;italic&gt;In Vivo&lt;/italic&gt;
Authors: Nubia Muñoz, Alan Rabson, Victor Bedoya, Sandra Tyrrell
Journal: JNCI Journal of the National Cancer Institute (1969)

In generalized herpes simplex virus infection in man and experimental animals, involvement of the thymus has not been described and involvement of the spleen is rare. In organ cultures of hamster tissues, however, both spleen and thymus are susceptible to infection, with growth of virus, production of necrotizing lesions, and development of intranuclear inclusion bodies. Similar lesions can be produced in vivo when virus is inoculated directly into thymus or spleen, suggesting the possibility of some type of “blood-thymus barrier” for virus. Although members of the herpesvirus family have been suggested as possible etiologic agents in malignant lymphomas, we found no evidence of proliferation of lymphoreticular cells, thymocytes or thymic epithelium in the lesions produced by herpes simplex virus.
Late preterm and low birth weight - possible impact on respiratory system at age of 12 month
Authors: Eka Kandelaki, Maia Kherkheulidze, Nani Kavlashvili, Ivane Chkhaidze
Journal: European Respiratory Journal (2014)

This study was carried out to evaluate short-term respiratory morbidity in late preterm infants compared with full term LBW (low birth weight) and full term infants at age of 12 month at a single center in Georgia.

Medical records of infants assessed in Child Developmental Center of Iashvili central Hospital, Tbilisi, from 2010 to 2013 were reviewed. The cases were divided into three groups by their gestational age (GA) and birth weight. 438 late preterm births (GA - 34 to 36 weeks), 758 term births (GA, 37to 41weeks) and 355 (LBW, full term). We compared late preterm births and term births considered to perinatal characteristics and respiratory morbidities.

From 438 late preterm births 187 – 42, 7 % had respiratory tract disease. From 758 term births 90 -15 % had respiratory tract disease at the age of 12 month. Compared with term births, late preterms represented significantly more respiratory diseases and conditions such as upper respiratory tract infections(P< 0.01) transient tachypnea of newborn (P<0.05) and pneumonia (P<0.01), wheezing (P<0.001) Full term LBW infants at age of 12 month represented the higher incidence of upper respiratory tract infections then full term infants (P< 0.01) and late preterm infants (P< 0.05). Congenital infection was most significant factor affecting respiratory tract later in infancy in this two groups. Late preterm infants are more likely to develop respiratory system illnesses than term infants. LBW full term infants are more prone to respiratory diseases than peers born with gestational age appropriate weight.LBW and late preterm infant's morbidity with respiratory system diseases was associated with congenital infections.
Cardiovascular comorbidities prevails in the early stages of COPD irrespective of predominant airway or emphysema phenotype
Authors: Gianna Camiciottoli, Francesca Bigazzi, Valentina Luzzi, Elena Torricelli, Matteo Vannini, Alessio Garcea, Lorenzo Corsi, Matteo Paoletti, Lucia Cestelli, Massimo Pistolesi
Journal: European Respiratory Journal (2013)

COPD is a heterogeneous disorder with extrapulmonary manifestations. Multivariate models based on sputum features and whole lung function allow patients to be classified in a graph whose coordinates CT1and CT2 reflect COPD phenotype and severity as assessed by CT (Camiciottoli,G et al. ERJ in press). Phenotypic characteristics range progressively from airway predominant (AP)(CT1-) to emphysema predominant (EP)(CT1+). Severity of COPD increases progressively from CT2- to CT2+. In 242 COPD patients we assessed prevalence of Hypertension(H), Coronary Artery Disease(CAD), Peripheral Arterial Disease(PAD), Heart failure(HF), Diabetes(D),Osteoporosis(O), and Psychological Disorders(PD).We compared prevalence among subsets partitioned according to COPD phenotype and severity  Cardiovascular comorbidities are very common in COPD, with the highest prevalence in milder disease (CT2-) irrespective of the phenotype,suggesting that COPD severity progression is allowed to patients without concomitant cardiovascular comorbidity. These data support recent findings of excess mortality in GOLD B with respect to GOLD C patients and underline the need to suspect,diagnose and treat cardiovascular comorbidities in early stages of COPD.
Creatinine clearance as a predictor of ultrafilterable platinum disposition in cancer patients treated with cisplatin: relationship between peak ultrafilterable platinum plasma levels and nephrotoxicity.
Authors: P A Reece, I Stafford, J Russell, M Khan, P G Gill
Journal: Journal of Clinical Oncology (1987)

Ultrafilterable platinum (UP) disposition was studied in 22 cancer patients receiving their first course of cisplatin (50 to 140 mg/m2) by two-hour infusion. UP plasma and urinary platinum levels were quantitated using a high-performance liquid chromatographic (HPLC) assay, which was selective for cisplatin and active platinum metabolites. Creatinine clearance was determined in all patients at the time of the pharmacokinetic studies and ranged from 58 to 214 mL/min. Creatinine clearance was a poor predictor of UP disposition in patients, probably as a consequence of the complex renal clearance mechanism for UP in the human kidney, which involves both tubular secretion and reabsorption. However, the peak plasma level of UP was closely related to the area under curve (AUC) of UP (r2 = .831), P less than .0001) and was significantly correlated with the decline in creatinine clearance observed after four courses of cisplatin therapy to 12 of the patients (r2 = .727, P less than .005). Cisplatin dose and the AUC of UP were less satisfactory predictors of the change in creatinine clearance with four courses of therapy (r2 = .488, P less than .025 and r2 = .623, P less than .005). The large interpatient variability in all the parameters of cisplatin disposition measured in this study suggested that there may be a role for individualization of cisplatin dosage based on a peak level obtained in the first course of therapy. Longer term infusion of cisplatin could also be justified.
The outcome of broncho-dilation among subjects with airway obstruction in the general population
Authors: Sami Sawalha, Linnea Hedman, Eva Rönmark, Bo Lundbäck, Anne Lindberg
Journal: European Respiratory Journal (2014)

Background: Airway obstruction in COPD is defined as FEV 1 /(F)VCl0.70 after broncho-dilator. There are hardly any population-based data evaluating the clinical impact of the pre- and post bronchodilator quotation.  Aim: To compare subjects with pre- but not post respectively pre- and post bronchodilator quotation FEV 1 /(F)VCl0.70 in the population.  Methods: In 2002-04 all previously examined subjects from four adult OLIN (Obstructive Lung disease in Northern Sweden) cohorts were invited to re-examination including spirometry and structured interview. All subjects with FEV 1 /best of FVC and VCl0.70 were identified (n=993). Clinical characteristics were based on interview data.  Results: After bronchodilator 736 subjects had FEV 1 /(F)VCl0.70 and 257 had a quotation g0.70. Those with quotation l0.70 were older than those with quotation g0.70 (64.4 vs. 63.3, p=0.012). There were no significant differences in sex, prevalence ever smokers, allergic rhinitis, physician diagnosis of asthma before the age of 40 or exacerbations during the last 12 months between the groups. Prevalence of heart disease and cardiovascular disease was also similar. Reversibility, FEV 1 +12%&≥200ml, was significantly more common among those with quotation g0.70 (22.6 vs. 8.8%, pl0.001), while productive cough and chronic bronchitis was more common among those with quotation l0.70 (45.9 vs. 33.9% and 41.4 vs. 30.4%, p= 0.002 and 0.001).  Conclusion: Subjects with pre- but not post-bronchodilator quotation l0.70 have similar characteristics as those with post-bronchodilator quotation l0.70, but they may include more asthmatics. Further, the fairly common bronchitis symptoms among them may be markers of risk to develop COPD.