tbuckley/cabot-search huggingface dataset:
ANCA associated vasculitis – Evaluation of diagnosis, treatment and outcome in a group of 68 patients
Authors: Ionela Belaconi, Claudia Toma, Simona Stancu, Stefan Dumitrache-Rujinski, Cornelia Tudose, Alina Croitoru, Liliana Grigoriu, Diana Leonte, Elena Magheran, Miron Bogdan
Journal: European Respiratory Journal (2014)

Background: Granulomatosis with polyangiitis (GPA), eosinophilic granulomatosis with polyangiitis (EGPA) and microscopic polyangiitis(MPA) are antineutrophil cytoplasmic antibodies (ANCA) – associated vasculitides with significant morbidity and mortality.

Objective: We evaluated the evolution of 68 patients diagnosed with vasculitis between 1997 and 2013, treated with conventional treatment (prednisolone and pulse cyclophosphamide initially, and after remission with prednisolone and azathioprine).

Results: We evaluated 68 patients (36 females), median age of 54 years (range 17-84), with a median duration of follow up of 39.5 months (range 1-144 months), 26 with GPA, 40 with MPA and 2 with EGPA. Seven patients out of 13 performed had alveolar haemorrhage at broncho-alveolar lavage. Seventeen patients had relapses (25%), 1 developed subglottic stenosis, 1 retro-orbital pseudo tumor and 2 patients developed opportunistic infectious of the lung cavities and needed lung resection. Due to immunosuppressive therapy 2 patients developed lung tuberculosis (one multi-drug-resistant) and 1 pulmonary nocardiosis. Patients with GPA had renal failure at diagnosis in a procent of 46,2% and MPA 90%. Twenty seven patients needed definitive hemodialysis for renal failure. Fifteen patients died: 10 with alveolar haemorrhage, 3 with sepsis, 1 with stroke and one cancer. MPA diagnosis, older age and renal failure were predictors of death.

Conclusions: Significant differences exist between GPA and MPA at the initial presentation that can predict the evolution of the disease. The management of patients with ANCA-associated vasculitides is difficult and marked by the adverse effects of the therapy.
Macrophages and Resistance to Tumors. IV. Influence of Age on Susceptibility of Mice to Anti-inflammatory and Antimacrophage Effects of Tumor Cell Products23
Authors: Margaret Nelson, D. S. Nelson
Journal: JNCI Journal of the National Cancer Institute (1980)

Supernatants from cultures of mouse tumors inhibited delayed-type hypersensitivity (DTH) reactions to sheep red blood cells (SRBC) in immunized (C57BL/6J X A/J)F1 and CBA/J mice. In mice older than 17 weeks, two activities were detectable. Material having an apparent molecular weight of less than 10,000 (by membrane filtration) inhibited only the early phase of the reactions: material having a higher molecular weight inhibited only the later phase. In younger mice, DTH reactions were not inhibited. Susceptibility of resistance could not be conferred on young or old mice by reciprocal transfer of spleen cells or sera. Only older SW or A/J mice treated with tumor supernatants displayed reduced inflammation following intradermal injection of concanavalin A (Con A) and depressed cellular responses to Con A injected ip. Supernatant fractions containing material of lower molecular weight inhibited migration and phagocytosis of opsoniazid SRBC in vitro by peritoneal macrophages from both young and old (C57BL/6J X A/J)F1 and CBA/J mice.
Euthanasia and physician-assisted suicide: a comparative survey of physicians, terminally ill cancer patients, and the general population.
Authors: M E Suarez-Almazor, M Belzile, E Bruera
Journal: Journal of Clinical Oncology (1997)

PURPOSE AND METHODS There is an ongoing debate about the legalization of euthanasia. The attitudes and beliefs of the general public and physicians appear to differ; the views of patients have not been adequately explored. During 1995, we conducted a simultaneous survey in the province of Alberta, Canada, of a random sample of 1,240 individuals from the general population, 179 physicians, and 62 consecutive patients with terminal cancer. The same instrument was administered to the public and physicians through telephone interview, and to patients in a face-to-face interview. Statements related to the legalization of euthanasia and physician-assisted suicide were scored using 1-to-7 Likert agreement scales. RESULTS A slight majority of members of the public and terminally ill patients (50% to 60%) agreed with the legalization of euthanasia and assisted suicide, while most physicians (60% to 80%) opposed it. In multivariate analysis, independent associations with support of active end of life measures included the following: group surveyed, strength of religious beliefs, religion (highest support by individuals with no religion), education (lower education associated with higher support), and the perception of burden on families, and physical and emotional suffering by cancer patients. CONCLUSION In all groups, a marked polarization of attitudes was observed, with most individuals either strongly agreeing or strongly disagreeing with the statements in the survey. Although a slight majority of the public supported euthanasia, one third opposed it. Most physicians opposed these interventions and appeared not to be willing to perform these procedures if legalized. Our findings suggest that legalization at this time could be highly divisive and controversial from a societal perspective.
High dose grass pollen tablets used for hyposensitization in hay fever patients
Authors: H. Mosbech, S. Dreborg, F. Madsen, H. Ohlsson, P. Stahl Skov, E. Taudorf, B. Weeke
Journal: Allergy (1987)

Previous, placebo-controlled clinical trials with oral hyposensitization in grass pollinosis have been disappointing. Since the results possibly could be explained by too low doses of ingested allergens, the present study was initiated to evaluate the effect of high doses of allergens. Forty-two adults with symptoms in the grass pollen season and with grass pollen sensitivity demonstrated by skin prick test and conjunctival provocation test were included. Enterosoluble tablets were administered daily for 1 year. Twenty-two patients, who completed the study, received placebo and 17 mixed grass pollen allergens from rye grass, timothy grass, cultivated rye and velvet grass. Evaluated either by self-assessment or by symptom and medicine score before and after treatment, the group receiving pollens did not improve clinically compared the controls. During the study, conjunctival sensitivity decreased equally in the two groups, and changes in specific IgE, allergen-induced histamine release from blood cells and skin prick test were insignificant and with no difference between groups. Five patients, who received pollen allergens, had episodes of urticaria or angioedema, and a further three patients on the same treatment had slight gastrointestinal side effects. In conclusion, enterosoluble grass pollen allergens in contrast to birch pollens did not have any therapeutic effect, even in doses more than 4,000 times higher than those used for subcutaneous hypersensitization. The reason may be degradation of allergens before the immune system is reached.
“Low-Risk” Prediction Rule for Pediatric Oncology Patients Presenting With Fever and Neutropenia
Authors: Robert J. Klaassen, T. Robin Goodman, Ba Pham, John J. Doyle
Journal: Journal of Clinical Oncology (2000)

To prospectively derive and validate a clinical prediction rule to allow a more tailored approach to the management of pediatric oncology outpatients presenting with fever and neutropenia.The clinical prediction rule was derived over a 1-year period and then validated over the following 8 months in a new set of fever and neutropenia episodes. Patients were excluded if they presented with comorbidity or an abnormal chest x-ray (CXR).Significant bacterial infection (SBI; defined as any blood or urine culture positive for bacteria, interstitial or lobar consolidation on CXR, or unexpected death from infection) was documented in 43 of the 227 episodes. Multivariate analysis found four significant factors: bone marrow disease, general appearance unwell on initial examination, monocyte count less than 0.1 x 10(9)/L, and peak oral or oral equivalent temperature greater than 39 degrees C. Only the monocyte count contributed to determining a low-risk group, excluding SBI with 84% sensitivity (95% confidence interval [CI], 61% to 100%), 42% specificity (95% CI, 38% to 46%), and a negative predictive value of 92% (95% CI, 76% to 100%). If the monocyte count was >/= 0.1 x 10(9)/L at the time of presentation (low risk), the incidences of SBI and bacteremia were 8% and 5%, respectively, versus 25% and 17% in the high-risk group. When validated in a new population of 136 episodes of fever and neutropenia, the incidences of SBI and bacteremia in the low-risk group were 12% and 5%, respectively, and 25% and 19% in the high-risk group.Pediatric oncology outpatients with fever and neutropenia who present with an initial monocyte count of >/= 0.1 x 10(9)/L and do not have comorbidity or an abnormal CXR at the time of presentation are at lower risk for SBI and can be considered for less aggressive initial therapy.
Histopathology of Lung Cancer in New Mexico, 1970–72 and 1980–812
Authors: Cooley Butler, Jonathan M. Samet, Charles G. Humble, E. Steven Sweeney
Journal: JNCI Journal of the National Cancer Institute (1987)

In conjunction with a population-based case-control study of lung cancer in New Mexico, the histopathology of cases diagnosed during 1980 and 1981 and during 1970–72 was reviewed. Adequate histologic or cytologic material was obtained for 725 cases, with 308 during 1970–72 and 417 during 1980–81. The light microscopic histologie type was classified on the basis of review by 2 pathologists. No significant differences were found in the histologic-type distributions in Hispanics and non-Hispanic whites. In males, the distributions of histologic types were similar in the two time periods, but in non-Hispanic white women the proportion of adenocarcinoma declined during 1980–81 as the proportion of small cell carcinoma increased. The panel classification was compared with that recorded by the New Mexico Tumor Registry. Overall agreement was 52.1% for 1970–72 and increased to 65.2% for 1980–81. The discrepancies between the two classifications were largest for the categories of large cell undifferentiated carcinoma and “other malignancy.”.
Modafinil Effects during Acute Continuous Positive Airway Pressure Withdrawal
Authors: Shaun C. Williams, Nathaniel S. Marshall, Marina Kennerson, Naomi L. Rogers, Peter Y. Liu, Ronald R. Grunstein
Journal: American Journal of Respiratory and Critical Care Medicine (2010)

Continuous positive airway pressure (CPAP) use is associated with reduced motor vehicle accidents in patients with obstructive sleep apnea (OSA). However, interruption of CPAP therapy is common and is associated with a decline in daytime function.We hypothesized that the wakefulness promoter, modafinil, would ameliorate this decline.Patients were admitted to the laboratory for three consecutive nights. CPAP was used for the first night, followed by a baseline day, and was then withdrawn for the two subsequent nights (nasal airflow monitored). On each of the mornings after the two CPAP withdrawal nights, patients received 200 mg modafinil or placebo (n = 21) in a randomized, double-blind, crossover design. Treatment periods were separated by a 5-week washout. Driving simulator performance, neurocognitive performance, and subjective alertness were measured by the AusEd driving simulator, psychomotor vigilance task, and Karolinska Sleepiness Scale, respectively.During CPAP withdrawal, severe sleep-disordered breathing was evident and administration of modafinil improved simulated driving performance (steering variability, P < 0.0001; mean reaction time, P <or= 0.0002; lapses, P <or= 0.01 on a concurrent task), psychomotor vigilance task (mean 1/reaction time and lapses, both P <or= 0.0002), and subjective sleepiness (P <or= 0.01).Modafinil prevented the decline in simulated driving performance, neurocognitive performance, and subjective sleepiness in patients with OSA with acutely interrupted CPAP therapy. Clinical trial registered with the Australian New Zealand Clinical Trials Registry at www.anzctr.org.au (ACTRN12606000027516).
Barrett's Esophagus and Its Progression to Adenocarcinoma
Authors: Carlo C. Maley, Anil K. Rustgi
Journal: Journal of the National Comprehensive Cancer Network (2006)

Barrett's esophagus (BE) is the only known precursor for esophageal adenocarcinoma (EA). Therefore, the presence of BE identifies a high-risk group of patients who may be followed-up for early detection of EA and treated to reduce the risk for its progression. The initiating event for BE is unknown, although it is associated with chronic gastric reflux. Many of the genetic lesions involved in BE neoplastic progression are known, including loss of CDKN2A (p16) and TP53 (p53) and the development of tetraploidy and aneuploidy. Intensive endoscopic surveillance has been shown to improve survival although it can be difficult to implement in practice. Several exposures may be altered to reduce the risk for progression, including weight, diet, and the use of nonsteroidal anti-inflammatory drugs. However, most of these results should be confirmed in additional cohorts before they are used to change clinical practice.
The Non-Specific Enhancement of Allergy.
Authors: H. Bergstrand, I. Andersson, I. Nyström, R. Pauwels, H. Bazin
Journal: Allergy (1983)

PVG tats given injections of 1 μg ovalbumin (OA) together with 10 mg Silica gel failed lo provide serosal mast cells or lung tissue with the capacity to release histamine on in vitro challenge with the antigen. However, if such animals were injected i.p. with 100 mg of alum (without any further antigen addition) 3–9 weeks after the primary antigen injection, their mast cells and lung tissue showed a clear‐cut capacity to respond in vitro , when examined 1 week after the alum injection. Injection of only 15 mg alum did not induce such a response capacity. The lading of the reactivity induced by an alum injection could be prevented by a repeated injection of the adjuvant alone. Pretreatment of the rats with cyclophosphamide (33 mg/kg) 2 days before the primary antigen injection did not affect the response capacity induced by a booster injection 3 weeks later. S.c. injection of alum also precipitated response capacity in animals primed by i.p. injection of antigen and Silica gel. The anaphylactic response capacity induced by injection(s) of alum was generally accompanied by increased levels of OA‐IgE and especially OA‐IgG 2a antibody; however, a clear‐cut correlation between either serosal mast cell or lung tissue response capacity and serum OA‐IgE or IgG 2a antibody titer could not be demonstrated. These data show that in primed animals, which do not express allergic response capacity, such a capacity can be induced by injecting adjuvant alone, even several weeks after the primary antigen injection.
Efficacy of a 6-month versus 9-month Intermittent Treatment Regimen in HIV-infected Patients with Tuberculosis
Authors: Soumya Swaminathan, Gopalan Narendran, Perumal Venkatesan, Sheik Iliayas, Rameshkumar Santhanakrishnan, Pradeep Aravindan Menon, Chandrasekharan Padmapriyadarsini, Ranjani Ramachandran, Ponnuraja Chinnaiyan, Mohanarani Suhadev, Raja Sakthivel, Paranji R. Narayanan
Journal: American Journal of Respiratory and Critical Care Medicine (2009)

The outcome of fully intermittent thrice-weekly antituberculosis treatment of various durations in HIV-associated tuberculosis is unclear.To compare the efficacy of an intermittent 6-month regimen (Reg6M: 2EHRZ(3)/4HR(3) [ethambutol, 1,200 mg; isoniazid, 600 mg; rifampicin, 450 or 600 mg depending on body weight <60 or > or =60 kg; and pyrazinamide, 1,500 mg for 2 mo; followed by 4 mo of isoniazid and rifampicin at the same doses]) versus a 9-month regimen (Reg9M: 2EHRZ(3)/7HR(3)) in HIV/tuberculosis (TB).HIV-infected patients with newly diagnosed pulmonary or extrapulmonary TB were randomly assigned to Reg6M (n = 167) or Reg9M (n = 160) and monitored by determination of clinical, immunological, and bacteriological parameters for 36 months. Primary outcomes included favorable responses at the end of treatment and recurrences during follow-up, whereas the secondary outcome was death. Intent-to-treat and on-treatment analyses were performed. All patients were antiretroviral treatment-naive during treatment.Of the patients, 70% had culture-positive pulmonary TB; the median viral load was 155,000 copies/ml and the CD4(+) cell count was 160 cells/mm(3). Favorable response to antituberculosis treatment was similar by intent to treat (Reg6M, 83% and Reg9M, 76%; P = not significant). Bacteriological recurrences occurred significantly more often in Reg6M than in Reg9M (15 vs. 7%; P < 0.05) although overall recurrences were not significantly different (Reg6M, 19% vs. Reg9M, 13%). By 36 months, 36% of patients undergoing Reg6M and 35% undergoing Reg9M had died, with no significant difference between regimens. All 19 patients who failed treatment developed acquired rifamycin resistance (ARR), the main risk factor being baseline isoniazid resistance.Among antiretroviral treatment-naive HIV-infected patients with TB, a 9-month regimen resulted in a similar outcome at the end of treatment but a significantly lower bacteriological recurrence rate compared with a 6-month thrice-weekly regimen. ARR was high with these intermittent regimens and neither mortality nor ARR was altered by lengthening TB treatment. Clinical Trials Registry Information: ID# NCT00376012 registered at www.clinicaltrials.gov.
Reproducible Chromosome Changes of Polycyclic Hydrocarbon-Induced Rat Leukemia: Incidence and Chromosome Banding Pattern 2
Authors: Taketoshi Sugiyama, Hiroshi Uenaka, Norifumi Ueda, Shirou Fukuhara, Sakan Maeda
Journal: JNCI Journal of the National Cancer Institute (1978)

Statistical analysis of 361 cases of primary leukemia induced in outbred Long-Evans and Sprague-Dawley rats by 7,12-dimethylbenz[a]anthracene (DMBA) and 7,8,12-trimethylbenz[a]anthracene (TMBA) showed that the incidence of trisomy of chromosome No. 2 was significantly lower with TMBA (17.8%) than with DMBA (29.3%). This tendency was reproducible in both sexes. Another characteristic chromosome abnormality, long No. 2, was found in 10 cases (2.8%). Quinacrine fluorescence analysis revealed that cells with No. 2 trisomy or either of two types of long No. 2 had total and partial No. 2 trisomy, respectively. Other chromosome members of cells with long No. 2, as well as the chromosomes of cells with typical No. 2 trisomy and "normal diploid" leukemia cells, revealed no band abnormality. The phenotype of No. 2 trisomy, severe anemia of the hosts reported in DMBA-induced leukemias, was also noted in leukemias with TMBA-induced No. 2 trisomy but not in leukemias with long No. 2.
Lower levels of depression, fatigue and symptoms are associated with higher levels of physical activity in lung cancer
Authors: Linda Denehy, Christine McDonald, Louis Irving, Catherine Granger
Journal: European Respiratory Journal (2014)

Aims  1) To compare the association between physical activity (PA) and health-related quality of life (HRQoL), mood and symptoms in surgically and non-surgically treated individuals with non-small cell lung cancer (NSCLC). 2) Measure change in PA, HRQoL, mood and symptoms over time.  Methods  50 participants with stage I-III NSCLC (32male), mean±SD age 68±9years, FEV 1  74±21% predicted were assessed at diagnosis, 10weeks and six months. 24% were undergoing chemotherapy/radiotherapy at time of 10week assessment. Measures included Physical Activity Scale for the Elderly (PASE) and questionnaires (HRQoL, mood, symptoms).  Results:  There was a significant change from baseline to six months for the whole cohort (n=50) in PA (p=0.01) and symptoms (p=0.001) but not in HRQoL. For non-surgical individuals there was deterioration in PA, function, global HRQoL, fatigue and symptoms over 10weeks from baseline (pl0.05). At 10weeks 17% met PA guidelines and level of PA was moderately correlated with depression (r=-0.53), anxiety (r=-0.55), function (r=0.66), global HRQoL (r=0.65) and fatigue (r=-0.50); but correlations with distress (r=-0.35), symptoms (r=-0.40) and dyspnoea (r=-0.29) were fair. In comparison, individuals undergoing surgery did not experience deterioration in HRQOL or fatigue. At 10weeks 25% met PA guidelines. Correlations between level of PA with depression (r=-0.45), distress (r=-0.25) and global HRQoL (r=0.28) were fair.  Conclusion:  Lower levels of PA are associated with worse depression, fatigue, symptoms and HRQoL in individuals with NSCLC undergoing chemotherapy/radiotherapy. A weaker relationship is found in surgically treated individuals.
A REVIEW OF CASES OF VETERANS OF WORLD WAR II DISCHARGED WITH NEUROPSYCHIATRIC DIAGNOSES
Authors: CHARLES B. HUBER
Journal: American Journal of Psychiatry (1943)

1. The precipitating factor in 99 per cent of these cases cannot be said to be due to any excessive stress or strain as found in actual combat. 2. No one outstanding or abnormal factor is found in family or personal histories. 3. It is believed that in some cases, perhaps in the psychoneurotic group primarily, the sudden change of environment together with an inadequate personality to begin with, may have contributed as a precipitating factor in the patient's mental breakdown. 4. Venereal disease in this study did not play an important role. 5. It is my opinion that a great number of cases found in this study could have been rejected prior to induction had proper notation been made as to educational advantages. Those found to have less than an eighth grade education could have been segregated by draft boards, proper psychometric examinations could have been given and social service histories obtained.
Decrease of physical capacity during acute induction at high altitude is associated with more pronounced increased pulmonary arterial pressure
Authors: Akpay Sarybaev, Abdirashit Maripov, Almaz Akunov, Ulan Shermatov, Dhurati Majumdar, Shashi B. Singh
Journal: European Respiratory Journal (2012)

The aim is to assess the relation between physical performance (max VO2) and systolic pulmonary arterial pressure (sPAP) at high altitude (HA).  Subjects and methods. Twenty one subjects aged from 18 to 30 years were examined. After being examined at the low altitude (Bishkek, 700 m above sea level) all subject were transported at 3200 m.  At the HA patients were repeatedly examined in the 7th, 14th and 21st days of the sojourning, as well as on the 3rd day after coming down to Bishkek.  Results. The subjects were divided into two groups: the 1st group - normoresponders (n=14), subjects, whose sPAP was up to 35 mmHg in the first days at HA and the 2nd group - hyperresponders (n=7), subjects with sPAP 35 mmHg or higher. Results are shown.  At Bishkek the 1st group had the higher max VO2 value, but after the ascent at HA the max VO2 significantly decreased at that group (from 45,8 to 38,8 ml/min/kg, p  Obtained data can denote the presence of the interrelation between sPAP response to HA hypoxia and decrease of the physical capacity at HA. This supposition should be tested on a larger sample of volunteers.