tbuckley/cabot-search huggingface dataset:
Survival in cancer patients hospitalized for psoriasis: a population-based cohort study in Sweden
Authors: X. Shu, J. Ji, J. Sundquist, K. Sundquist, K. Hemminki
Journal: British Journal of Dermatology (2011)

Background Increased cancer risk after psoriasis has been observed in previous studies, whereas little is known about the prognosis in cancer patients with previously diagnosed psoriasis. Objectives We aimed at examining the cancer-specific and overall mortality among psoriatic cancer patients compared with the reference population. Methods The population-based Swedish registers were used to identify psoriatic cancer patients and cancer patients without psoriasis. We estimated hazard ratios (HRs) showing the probability of death in the two groups. Results In total, 1746 psoriatic cancer patients and 1 011 757 other cancer patients were identified from 1964 to 2006, showing a significant survival disparity [overall HR 1·27, 95% confidence interval (CI) 1·20–1·35 and cancer-specific HR 1·26, 95% CI 1·18–1·35]. An overall mortality excess after psoriasis was observed for nine cancer sites and a cancer-specific mortality excess for seven cancer sites. Stratified analyses showed that the prognosis was worse for psoriatic cancer patients diagnosed below age 65 years and for those who had been treated for alcohol-related diseases. Those with more than one hospitalization for psoriasis were more likely to be associated with an increased risk of cancer-specific mortality. Conclusions A previous diagnosis of psoriasis worsens the prognosis of many cancers. A worse prognosis was more pronounced in psoriatic cancer patients diagnosed at an earlier age, previously hospitalized for alcohol-related diseases, or with severe symptoms. Our study provides clinicians and patients with information about mortality risk and prognostic factors for psoriatic cancer patients. The mechanisms underlying this disparity warrant further studies.
Self-Help, Mutual Aid and Chronic Patients' Clubs in Croatia, Yugoslavia: Discussion Paper
Authors: Z Kulčar
Journal: Journal of the Royal Society of Medicine (1991)

This paper describes the clubs for patients with hypertension which have operated effectively in parts of Croatia and Slovenia (Yugoslavia) for more than 15 years, with many thousands of patients enrolling voluntarily. Based on the principle of self-help, yet involving the regular participation of members of a patient's own primary health team, they increase compliance with long-term treatment regimens and improve the quality of life. Such programmes are capable of reducing the amount of time devoted by a medical practitioner while increasing the effectiveness of treatments. If they are to succeed, it is essential to ensure regular club meetings, social activities and encouragement to each individual member to find a role and to continue attending for as long as possible. A new life style and consequent benefits to health are obtained only through long membership.
Drug treatment in general practice in Japan is evidence based
Authors: K. Tsuruoka, Y. Tsuruoka, M. Yoshimura, K. Imai, S. Sekiguchi, J. Mise, Y. Asai, N. Nago, M. Igarashi
Journal: BMJ (1996)

helpful in opening up the debate on evidence based decision making, they have to be handled with care.They should be the vehicle for achieving better value for money in health care.
Concussion
Authors: Allan H. Ropper, Kenneth C. Gorson
Journal: New England Journal of Medicine (2007)

A 64-year-old woman slipped on an icy walk, falling forward and striking her forehead. She had a brief convulsion immediately after the fall, was unresponsive for less than 1 minute, and awakened with a severe generalized headache and nausea but no vomiting. In addition to being perplexed about the circumstances of the fall, she could not recall the previous few hours. She was awake and oriented and had no abnormalities on neurologic examination. Tenderness and a scalp contusion were apparent at the site of the impact, and there were abrasions on her right cheek. What is the expected course, and how should her case be managed?
Pulmonary manifestation of lassa fever and the impact on mortality
Authors: Peter Okokhere, Johnson Ugheoke, Cyril Erameh
Journal: European Respiratory Journal (2012)

Background: Lassa fever is associated with multi-systemic clinical disease in severe cases, with consequent increase in mortality. The respiratory system has been shown, both clinically and pathologically, to be involved. However, there is little information on the impact of this on mortality. This study aims to determine the impact of pulmonary involvement on mortality.  Materials and methods: The medical records of 65 RT-PCR confirmed cases of Lassa fever patients with respiratory symptoms (cough and/ or breathlessness) admitted to the medical wards of our hospital between January 2009 and February 2011 were reviewed. There were 34 males and 31 females. Of the 65 patients, 10 had both physical and chest x-ray features of pulmonary involvement. Case fatality rates (CFR) were compared between the sub-groups of patients with, and those without pulmonary involvement. Significance level was set at P value   Results: The pulmonary features were pneumonia (5); pneumonia with pleural effusion (3); ARDS (2). Among the 10 patients with pulmonary involvement, 7 died, giving a CFR of 70%, while with the group without pulmonary involvement 21 died out of 55, with a CFR of 38.2%.(p= 0.086; Odds ratio 0.26; 0.04-1.34(2-tailed Fisher exact)). Over all CFR was 44.6% (29/65).  Conclusion: Lassa fever with respiratory features is associated with high CFR, especially when the lungs and pleura are involved.  Key words: Lassa fever, pulmonary involvement, mortality.
Physical activity for smoking cessation in pregnancy: randomised controlled trial
Authors: M. Ussher, S. Lewis, P. Aveyard, I. Manyonda, R. West, B. Lewis, B. Marcus, M. Riaz, A. Taylor, A. Daley, T. Coleman
Journal: BMJ (2015)

<b>Objective</b> To determine the effectiveness of a physical activity intervention for smoking cessation during pregnancy. <b>Design</b> Parallel group, randomised controlled, multicentre trial. <b>Setting</b> 13 hospitals in England, April 2009 to January 2014. <b>Participants</b> 789 pregnant smokers, aged 16-50 years and at 10-24 weeks' gestation, who smoked at least one cigarette daily and were prepared to quit smoking one week after enrollment were randomised (1:1); 785 were included in the intention to treat analyses, with 392 assigned to the physical activity group. <b>Interventions</b> Interventions began one week before a target quit date. Participants were randomised to six weekly sessions of behavioural support for smoking cessation (control) or to this support plus 14 sessions combining supervised treadmill exercise and physical activity consultations. <b>Main outcome measures</b> The primary outcome was continuous smoking abstinence from the target quit date until end of pregnancy, validated by exhaled carbon monoxide or salivary cotinine levels. To assess adherence, levels of moderate-vigorous intensity physical activity were self reported and in a 11.5% (n=90) random subsample of participants, physical activity was objectively measured by an accelerometer. <b>Results</b> No significant difference was found in rates of smoking abstinence at end of pregnancy between the physical activity and control groups (8% <i>v</i> 6%; odds ratio 1.21, 95% confidence interval 0.70 to 2.10). For the physical activity group compared with the control group, there was a 40% (95% confidence interval 13% to 73%), 34% (6% to 69%), and 46% (12% to 91%) greater increase in self reported minutes carrying out physical activity per week from baseline to one week, four weeks, and six weeks post-quit day, respectively. According to the accelerometer data there was no significant difference in physical activity levels between the groups. Participants attended a median of four treatment sessions in the intervention group and three in the control group. Adverse events and birth outcomes were similar between the two groups, except for significantly more caesarean births in the control group than in the physical activity group (29% <i>v</i> 21%, P=0.023). <b>Conclusion</b> Adding a physical activity intervention to behavioural smoking cessation support for pregnant women did not increase cessation rates at end of pregnancy. During pregnancy, physical activity is not recommended for smoking cessation but remains indicated for general health benefits. <b>Trial registration</b> Current Controlled Trials ISRCTN48600346.
Mammography guidelines
Authors: J. Osuch
Journal: CA A Cancer Journal for Clinicians (1994)

I commend the CA journal and Drs.Mettlin and Smart for publishing an article explaining the American Cancer Society breast cancer screening guidelines. 1 However, I'd like to clarify several points in the article, specifically about NCI guidelines for breast cancer screening and the outcome of the UICC Meeting on Screening Premenopausal Women in Developed Countries that was held in Geneva in September/October 1993. 2 There were several conclusions reached at the UICC Geneva meeting.The report from the meeting concluded, "The available data can support a range of guidelines, including recommendations to begin screening at age 40 or at age 50."In the published report in the proceedings, there was not a data-based preference for one social policy over another.What this means was that there was an affirmation of the ACS guidelines, as well as an affirmation of guidelines and social policies that support beginning screening at age 50.Indeed, with respect to ACS guidelines, the conclusion of this workshop was an important acknowledgment of both the current uncertainty on this issue and the presence of compelling inferential evidence for the age group 40 to 49.In addition, the NCI no longer has guidelines or recommendations for screening for any age group, having replaced them with statements of scientific fact.While the statement acknowledges that mortality reductions have been observed for women aged 50 to 59, specifically it neither encourages nor discourages mammography or clinical breast examination for women in any age group.
Comparison of Video Laryngoscopy versus Direct Laryngoscopy during Urgent Endotracheal Intubation; Trial of the Route of Early Nutritional Support in Critically Ill Adults; and Transfusion of Plasma, Platelets, and Red Blood Cells in a 1:1:1 versus a 1:1:2 Ratio and Mortality in Patients with Severe Trauma
Authors: Parth Rali, Hammad Arshad, Tejpreet Lamba
Journal: American Journal of Respiratory and Critical Care Medicine (2015)
Decision analysis for avoiding postchemotherapy surgery in patients with disseminated nonseminomatous germ cell tumors.
Authors: D J Debono, D K Heilman, L H Einhorn, J P Donohue
Journal: Journal of Clinical Oncology (1997)

PURPOSE This retrospective study was undertaken to assess the outcome of patients with disseminated nonseminomatous germ cell tumor (NSGCT) managed under a postchemotherapy strategy developed at Indiana University. PATIENTS AND METHODS This is a retrospective analysis of 295 consecutive patients with disseminated NSGCT treated with primary chemotherapy at Indiana University from 1987 to 1994. The patients were placed into five groups based on response to primary chemotherapy and the presence or absence of teratoma in the primary tumor. The 295 patients were divided as follows: group A (complete remission [CR]) n = 78; group B (unresectable), n = 50; group C (serologic CR, teratoma-positive primary tumor, resectable partial remission [PR]), n = 90; group D [serologic CR, teratoma-negative primary tumor, &lt; 90% radiographic PR], n = 50; and group E (serologic CR, teratoma-negative primary tumor, &gt; or = 90% radiographic PR), n = 27. Groups A, B, and E patients were routinely observed after chemotherapy, whereas groups C and D patients were routinely taken to postchemotherapy surgery. RESULTS The percent of patients who continuously had no evidence of disease (NED) were as follows: group A, 92%; group B, 40%; group C, 87%; group D, 86%; and group E, 74%. In assessing group A patients, the bulk of retroperitoneal disease at presentation had no influence on ultimate outcome. CONCLUSION Patients with NSGCT who achieve a serologic and radiographic CR with primary chemotherapy (group A) can be safely observed without surgical intervention, regardless of initial tumor bulk. Patients with a teratoma-negative primary tumor who achieve a serologic CR and a &gt; or = 90% radiographic remission and are followed-up without surgical resection (group E) are at an increased risk of relapsed NSGCT. Decisions about postchemotherapy resection in this group remain complicated and controversial. Options include observation with serial radiologic evaluation or surgical resection of persistent mass or masses.
Pharmacokinetics and metabolism of epidoxorubicin and doxorubicin in humans.
Authors: K Mross, P Maessen, W J van der Vijgh, H Gall, E Boven, H M Pinedo
Journal: Journal of Clinical Oncology (1988)

Pharmacokinetics of doxorubicin (DOX), epidoxorubicin (EPI), and their metabolites in plasma have been performed in eight patients receiving 40 to 56 mg/m2 of both anthracyclines as a bolus injection in two sequential cycles. Terminal half-life and volume of distribution appeared to be smaller in case of EPI, whereas plasma clearance and cumulative urinary excretion was larger in comparison to DOX. The major metabolite of DOX was doxorubicinol (Aol) followed by 7-deoxy-doxorubicinol (7d-Aolon). Metabolism to glucuronides was found in case of EPI only. The area under the curves (AUC) of the metabolites of EPI decreased in the order of the glucoronides E-glu greater than Eol-glu, 7d-Aolon greater than epirubicinol (Eol). The AUC of Eol was half of the value in its counterpart Aol. In the case of EPI, the AUC of 7d-Aolon was twice the level of that of the corresponding metabolite of DOX. The terminal half-lives of the cytostatic metabolites Aol and Eol were similar, but longer than the corresponding values of their parent drugs. Half-lives of the glucuronides (E-glu, Eol-glu) were similar to the half-life of their parent drug. 7d-Aolon had a somewhat shorter half-life in comparison to both DOX and EPI. Approximately 6.2% of EPI and 5.9% of DOX were excreted by the kidney during the initial 48 hours. Aol was found in the urine of patients treated with DOX, whereas Eol, E-glu, and Eol-glu were detected in urine of patients treated with EPI. The cumulative urinary excretion appeared to be 10.5% for EPI and its metabolites, and 6.9% for DOX and its metabolite. The plasma concentration v time curves of (7d)-aglycones showed a second peak between two and 12 hours after injection, suggesting an enterohepatic circulation for metabolites lacking the daunosamine sugar moiety. The plasma concentrations of the glucuronides were maximal at 1.2 hours for E-glu and 1.9 hours for Eol-glu. All other compounds reached their maximum plasma concentration during the first minutes after the administration of DOX and EPI. Deviating plasma kinetics were observed in one patient, probably due to prior drug administration.
The effect of body mass on COPD in non-smoking women
Authors: Tamara Schikowski, Martin Adam, Andrea Vierkötter, Barbara Hoffmann, Ursula Krämer, Thierry Rochat, Christian Schindler, Elisabeth Zemp, Nino Künzli, Nicole Probst-Hensch
Journal: European Respiratory Journal (2012)

Rationale: Smoking is the strongest COPD risk factor, however it has been recognised that a substantial proportion of COPD cases arises in non-smokers. Many studies suggest that obesity is more prevalent in patients with COPD, but it has not been elucidated whether this is also true for never-smokers. Aim of the current study was to assess the effect of change in BMI on incidence and persistence of COPD in never smoking women.  Methods: The current study used pooled data from the population based SAPALDIA and SALIA cohorts. Weight status was defined based on BMI at baseline and change in BMI. Pre-bronchodilator ratio of forced expiratory volume in one second over forced vital capacity (FEV1/FVC) was measured in both studies at baseline and follow-up. COPD was defined according to the GOLD criteria or having FEV1/FVC  Mixed regression models with random intercept for study area were used to assess the association between BMI change and COPD prevalence and incidence in non smoking women after adjustment for selected confounders.  Results: Lung function data and information on potential confounders were available in 9662 women. The majority of women were never smokers (62.5%). The average BMI between baseline and follow-up ranged between 15.48-53.89 kg/m2. The incidence of COPD according to the GOLD criteria stage 1 was 3.2% and the incidence in the combined stage 2 and higher was 2.52%. The odds of developing COPD stage 2 increased by a factor of 1.3 per unit increment in BMI. Menopausal status did not influence this association.  Conclusion: The results of our analysis suggest that a change in BMI influences the development of COPD in non-smoking women.
Simultaneous bilateral quadriceps tendon rupture while playing basketball
Authors: M Shah, N Jooma
Journal: British Journal of Sports Medicine (2002)

Simultaneous bilateral quadriceps tendon rupture is an uncommon injury in healthy people and only a few cases have been reported in athletes. This is the first report of a patient with simultaneous bilateral quadriceps tendon rupture incurred while playing basketball. The injury was surgically repaired and the patient had a good functional outcome.
Mycobacterial heat shock protein 16 kDa, marker of dormant stage of mycobacteria, in precipitated circulating immune complexes in sarcoidosis
Authors: Anna Dubaniewicz, Adam Holownia, Mahavir Singh
Journal: European Respiratory Journal (2011)

M. tuberculosis  antigens, e.g., heat shock proteins (Mtb-hsp), genetic factor and autoimmunity have been explored as potential causes of sarcoidosis (SA). Mtb-hsp inducing both cellular and humoral immune response may provide a link between infection and autoimmunity. We have recently demonstrated the presence of Mtb-hsp70, Mtb-hsp65 and Mtb-hsp16 in sarcoid tissue. Higher occurrence of serum Mtb-hsp70 than Mtb-hsp65 and Mtb-hsp16 in SA patients could be caused by sequestration of Mtb-hsp65 and Mtb-hsp16 in circulating immune complexes (CIs). To test this hypothesis, we have evaluated and quantified Mtb-hsp70, Mtb-hsp65 and Mtb-hsp16 in precipitated CIs from blood of 20 patients with SA, 19 patients with active tuberculosis (TB) and 21 healthy volunteers using PEG precipitation and Western Blot. The results showed significantly increased CIs levels in SA vs TB and Control, whereas there was no difference between TB and healthy individuals. The Mtb-hsp16, Mtb-hsp65 and Mtb-hsp70 concentrations in precipitated CIs were significantly higher in SA than in TB and Control, but there was no difference between TB and Control. In all tested groups, the Mtb-hsp16 concentration was significantly increased than Mtb-hsp70 and Mtb-hsp65. In summary, our results show increased presence of Mtb-hsp16, Mtb-hsp65 and Mtb-hsp70 in precipitated CIs in sarcoidosis comparing to corresponding levels in TB and healthy individuals. It seems that Mtb-hsp16 may be more important than Mtb-hsp70 and Mtb-hsp65 in circulating immune complexes formation and possibly the protein may be implicated (auto)immune response in SA related to stationary-phase of  M. tuberculosis .
Diagnosing pediatric leukemia: Clinical application of microarray data
Authors: Ruth Lyons, Helena Kempski, John Anderson, Mike Hubank
Journal: Clinical Cancer Research (2006)

A1  Pediatric leukemias are commonly characterized by the presence of fusion genes that give rise to different subtypes of leukemia and play an important role in prognosis. Prognistically important subgroups include AML1-ETO, PML-RARA, CBFB-MYH11, MLL rearrangement (in both AML and ALL), BCR-ABL and TEL-AML1. These subtypes have unique gene expression signatures which have been used to develop diagnostic classifiers. The robustness of classifiers and their potential clinical application requires careful investigation.We have analyzed four published gene expression classifiers for diagnostic utility using three pediatric leukemia datasets (Ross et al. (2003 and 2004) and van Delft et al. 2005), totaling 392 patients. We applied a robust classification approach, using 4 different algorithms, to a training set of 268 patients and created gene lists for the leukemia subtypes listed above. Clinically important in determining the diagnosis of patients as either AML or ALL we have determined a subset of 11 genes capable of distinguishing these two classes with an accuracy of 99% in a test set of 204 samples. Application of a robust classifier of 18 genes to a test set of 128 ALL patients decreased the rate of misdiagnosis of TEL-AML1 to 1.56%, compared to 7.03% using the Ross et al. classifier and 6.25% using van Delft et al. gene list. In the AML test set (76 patients) AML1-ETO was misdiagnosed by 2.63% using van Delft et al. gene list, 1.32% by Ross et al. classifier and no patients were misdiagnosed using the genes selected by our robust classification method (52 genes*).This robust gene list selection method improves accuracy and can be applied to any microarray dataset. Assigning a probability to subtype selection allows us to attach a significance value to the certainty of correct diagnosis and so the clinician can decide whether further molecular biology tests are required.* (only 40 were used in the van Delft et al. gene list as this was the maximum number of genes available in the supplementary data)
Transient acantholytic dermatosis in oncology patients.
Authors: A L Guana, P R Cohen
Journal: Journal of Clinical Oncology (1994)

PURPOSE To evaluate the characteristics of patients with cancer who have a previous history, concurrent episode, or subsequent appearance of transient acantholytic dermatosis (TAD). METHODS We report four oncology patients who developed TAD and review the 22 reports that have previously been published of individuals in whom TAD appeared either before, concomitant with, or after the diagnosis of their malignancy. RESULTS TAD was associated more frequently in patients with hematologic malignancies, especially acute and chronic myelogenous leukemia. It also appeared in patients with solid tumors, primarily those of the genitourinary organs. In almost all the cases, the onset of TAD was either concurrent or followed the discovery of malignancy. The TAD resolved completely, with or without treatment, in at least 20 patients in a median of 3 weeks. CONCLUSION TAD is a benign and temporary condition that may occur in patients with an internal malignancy. When the diagnosis of TAD is being considered, a lesional skin biopsy readily establishes histologic confirmation in a febrile patient with cancer who develops a new rash. TAD has been observed most frequently in oncology patients who have either myelogenous leukemia or carcinoma of the genitourinary organs. The appearance of TAD coincided with either the detection or the recurrence of malignancy in three individuals (12%). In the other 23 oncology patients, TAD was most likely secondary to either antineoplastic agents, excessive perspiration, fever, occlusive immobility, and/or ionizing or UV radiation.