tbuckley/cabot-search huggingface dataset:
Changes in demographics and asthma characteristics of the hospitalized asthma exacerbations in Barcelona in the 2000 decade
Authors: Jose Valdivia, Stijn Verhulst, Virginia Pajares, Ignasi Bolibar, Anna Mola, Jesus Bellido, Vicente Plaza
Journal: European Respiratory Journal (2013)

The increased use of inhaled corticosteroids (ICS) caused a great reduction in the morbimortality rates in the last years. And probably, have changed the actual patients profile requiring hospitalization. We hypothesized an increase in the migrant population and psychiatric disorders rate in the current hospitalized asthma patients.  O  bjectives: To determine the demographic, comorbidity and asthma characteristics of the hospitalized patients suffered asthma exacerbation (AE) in the 2000 decade.  Methods: Retrospective cross-sectional study which included 609 hospitalized patients with AE in a Spanish tertiary hospital during 2,000-09. Demographic and clinical data were taken of the medical records of 198 (33%) spanish randomized patients and all migrants.  Results: 59 (29%) patients of the sample had a psychiatric illness and 33 (13%) were migrants from low-income countries. A significant (p  Conclusions: An increasing proportion of migrants with AE require admission to hospital. They have a clinical profile different from the traditional. Specific strategies should be designed to manage this population and particularly addressed to promote their ICS use.
Future career plans of a cohort of senior doctors working in the National Health Service
Authors: Kathryn Taylor, Trevor Lambert, Michael Goldacre
Journal: Journal of the Royal Society of Medicine (2008)

Summary Objective To report on the future career plans of senior doctors working in the NHS. Design Postal questionnaires. Setting All doctors who qualified in 1977 from all UK medical schools. Main outcome measures Future plans and whether participants had any unmet needs for advice on how to put their future plans into effect. Results 25% definitely intended to continue with their current employment on the same basis until they retired; 75% hoped for change. A reduction in working hours was the most commonly desired change; but a substantial percentage also wanted changes in job content. 50% of respondents intended definitely (17%) or probably (33%) to work in the NHS to their normal retirement age; and 37% definitely (20%) or probably (17%) intended to retire early. 48% had made plans, in addition to the standard pension, to facilitate early retirement. The main factors given for considering early retirement were family reasons and wanting more time for leisure, a desire to maintain good health, excessive pressure of work, and disillusionment with NHS changes. A reduction in workload would be the greatest inducement to stay. 31% of respondents reported that they had unmet needs for advice about their future plans. Of these, about half were needs for advice about planning for retirement. Conclusions Many senior NHS doctors would like to reduce their working hours. Less than a quarter definitely intend to work in the NHS to normal retirement age. Even for senior doctors, advice on career development is needed.
Mycosis fungoides: management with topical nitrogen mustard.
Authors: R T Hoppe, E A Abel, D G Deneau, N M Price
Journal: Journal of Clinical Oncology (1987)

The technique of treatment, response rate, freedom from relapse, survival, and complications of therapy in 123 patients treated with topical nitrogen mustard (HN2) for cutaneous mycosis fungoides (MF) at Stanford University Medical Center are reviewed. Patients were treated with HN2 in an aqueous or ointment base with equal efficacy. Response rates depended on the extent of skin involvement. In limited plaque (T1) disease, complete and overall response rates were 51% and 88%, respectively, while in generalized plaque (T2) disease they were 26% and 69%. No patients with tumorous involvement (T3) achieved complete skin clearance and all 13 of these patients developed progression of disease. Only two of nine patients with erythrodema (T4) achieved a complete response (CR), and both later relapsed. After achieving a CR, 40% of patients with T1 disease and 60% with T2 disease later relapsed; however, subsequent therapies, including repeat courses of topical HN2, often were successful in achieving later skin clearance. Overall, 42% of T1 patients and 31% of T2 patients were without evidence of MF at last follow-up. When death occurred, it was usually unrelated to MF in the T1 group. However, half of the deaths of patients with T2 disease were attributable to MF. Among the 22 patients with T3 or T4 disease, 80% of deaths were attributable to MF. The most common complication observed was a cutaneous hypersensitivity reaction, which occurred much more commonly with the aqueous than the ointment preparation. Fourteen patients (11%) developed subsequent cutaneous malignancies.
Is outpatient initiation of non invasive ventilatory support not inferior to inpatient initiation in ALS patients
Authors: Enrica Bertella, Sonia Gilè, Domenico Fiorenza, Mara Paneroni, Luca Bianchi, Paolo Banfi, Silvia Grilli, Michele Vitacca
Journal: European Respiratory Journal (2014)

In ALS patients we evaluated if outpatient initiation (OP) to NIV is effective as inpatient initiation (IP) in terms of: adherence to NIV (≥ 150 hours/months), respiratory function changes, symptoms and patient's satisfaction.

Patients were randomized into 2 groups (OP vs IP). Diurnal adaptation, advice to use nocturnal NIV until adaptation (≥ 6 hours/night for 3 nights) were conducted in a respiratory ward with H 24 care (IP) or as outpatient with at least 4 hours of care during scheduled visits (OP). Educational sessions were as much as needed to accept NIV and learn ventilator management. Arterial blood gas analysis (ABG), pulmonary function tests (PFT), sleep study and symptoms assessment (dyspnea, sleep quality) with visual analogue scale (VAS) were performed. At discharge, VAS for patient satisfaction (PS-VAS), difficulty to NIV initiation (DI-VAS) and ventilator management (DM-VAS) were performed. After 3 months basal exams and symptoms assessment were repeated.

50 patients (25 for group) (19 female) aged 65±9.4 years participated to the study being similar in terms of ALS score, age, BMI, PFT and ABG. The number of patients non adherent to NIV was not different in IP (5) vs OP (6) group.

After 3 months, the number of hours of nocturnal ventilation in adherent patients was higher in OP (7.8±1.06) than in IP (7.0±0.5) (p<0.05); IP reported higher DM-VAS than OP (3.2±2.6 vs 1.5±1.9, respectively, p= 0.05). Satisfaction, symptoms, PFT, sleep data and ABG variation were similar into the 2 groups.

In ALS, OP initiation of NIV is not inferior to IP initiation. OP adherent patients used nocturnal NIV longer and presented less difficulties in NIV management.
Hunt promises more transparency and fewer targets in “more human” NHS
Authors: Gareth Iacobucci
Journal: BMJ (2015)

England’s health secretary, Jeremy Hunt, has promised more transparency and fewer targets as part of his vision for a seven day “more human” NHS.

In a speech at the King’s Fund, which he described as his most important to date, the health secretary said that the NHS was facing a “Reformation moment.”1 As he outlined his bold plan, which he says will transform the service over the next 25 years, Hunt said that he wanted the NHS to become “the world’s largest learning organisation supporting the world’s most powerful patients.”

But he set himself on a collision course with the BMA by threatening to impose changes to doctors’ contracts that would remove consultants’ ability to opt out of weekend working, unless the association agreed a deal with the government within six weeks.2

Hunt said that the move to seven day working across the NHS was central to his plans to reduce the number of …
BiPAP in advanced IPF: Hope for palliation?
Authors: Arvind Kate, H.S. Sandeep, Parag Chaudhari, Chandrashekhar Tulasigeri, Prashant Chhajed
Journal: European Respiratory Journal (2012)

Introduction: IPF poses challenges in patient management due to limited treatment options particularly in countries without option of lung transplantation. BiPAP was offered to patients admitted with acute exacerbation of IPF/ worsening of disease as a final non invasive supportive measure. We report 7 such patients of advanced IPF who were administered home BiPAP.  Aim: To assess role of BiPAP on quality of life in patients with end stage ILD on optimal medical management visiting ILD clinic in NaviMumbai, India.  Methods: 7 patients with advanced IPF on home O2 therapy & optimal medical management were included. Pharmacotherapy included pirfenidone (1 did not tolerate), NAC, PPI and prednisolone. BiPAP was administered as final non invasive supportive therapy under supervision in hospital setting. Upon discharge BiPAP continued on trial basis for 2-4 weeks. On subjective benefit in dyspnoea, sleep quality and feeling of well being patients opted to continue use of BiPAP on regular basis. Objective assessment like PFT, DLCO, 6MWT were not done or patients were too sick to perform test.  Results: Mean duration of BiPAP therapy was 8.5 months (range 1-18 months). 7 patients reported improvement in quality of sleep and decrease in severity of breathlessness. 4 patients reported decrease in cough. 1patient died. All patients had subjective symptomatic improvement.  Conclusion: In these limited number of patients, definite subjective improvement in symptoms and well being was reported by the patients. These information provide stimulus for prospective assessment of role of home BiPAP in home setting targeting symptom benefit & impact on quality of life.
A pilot study on an idiographic assessment of quality of life in patients enrolled in phase I clinical trials.
Authors: June YiJuan Hou, Gurpreet Kaur, Merieme Klobocista, Jenna R. Zechmeister, Dennis Yi-Shin Kuo, Bruce D. Rapkin, Gary L. Goldberg, Nicole Suzanne Nevadunsky
Journal: Journal of Clinical Oncology (2014)

250 Background: Patient centered quality of life (QOL) is pivotal in treatment decision making for poor prognoses and recurrent solid tumors. Data regarding the best methods of QOL assessment for patients receiving chemotherapy for high risk cancers and enrolled in Phase I trials are sparse. We therefore piloted a QOL assessment that incorporated a validated metric as well as a novel “idiographic” questionnaire. Methods: Twenty-five women with high risk gynecologic malignancies (defined as &lt; 30% five year survival) and 10 patients enrolled in Phase I clinical trials were recruited after IRB approval was obtained. Patients’ answers to the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire 30 (QLQ-30) and “idiographic” QOL assessment were recorded and decoded. Raw scores of the QLQ-30 were standardized using linear transformation. Statistical analysis was performed using Mann-Whitney U and Chi-square testing with SPSS software. Results: Idiographic assessment resulted in 100 goal statements in 17 domains from patients in Phase I trials as compared to 260 goals in 20 domains from patients with high risk gynecologic malignancies. There were no differences in goal attainment or satisfaction with attainment between groups. There was a trend toward increased number of autonomy directed goals in the high risk group versus Phase I participants (23% vs. 11%, p=0.07) Median scores on functional (71 high risk vs. 84 Phase I) and global health status (58 high risk vs. 67 Phase I) scales were not different between the two groups. However, higher symptom burden was reported by the high risk group as compared to the median Phase I score (51 vs. 27, p&lt;0.01) Conclusions: There is a complex relationship between treatment decision-making and QOL for patients diagnosed with poor prognoses cancers. Further research is needed to better define QOL indicators and the impact of treatment on patient centered QOL.
Cerium oxide nanoparticles reduce steatosis, portal hypertension and display anti-inflammatory properties in rats with liver fibrosis
Authors: Denise Oró, Tetyana Yudina, Guillermo Fernández-Varo, Eudald Casals, Vedrana Reichenbach, Gregori Casals, Bernardino González de la Presa, Silvia Sandalinas, Silvia Carvajal, Victor Puntes, Wladimiro Jiménez
Journal: Journal of Hepatology (2015)
Five-year dynamics of general and specific quality of life in asthmatics with cold airway hyperresponsiveness (CAH)
Authors: Natalia L. Perelman, Victor P. Kolosov
Journal: European Respiratory Journal (2014)

Background:  CAH significantly worsens the course of asthma and the quality of life (QL) of patients in the cold climate. It is unknown to what extent it affects the QL long-term dynamics.   Aim:  To estimate QL in asthmatics with CAH during a five-year period depending on changes in the emotional status and asthma control.   Methods : 30 patients with mild-to-moderate asthma were interviewed with interval of 5 years by general (SF-36) and specific (AQLQ) questionnaires. The asthma control was identified by ACT, the anxiety and depression by HADS. The interviewing was done during the winter. All the respondents got the controller therapy. 1st group included the patients with CAH and 2nd group - without it.   Results . In the 1st group the level of anxiety decreased (from 9.3±1.4 to 6.8±0.7 points, p   Conclusion:  The presence of CAH influences the level of specific QL negatively, which is revealed through the absence of its dynamics. The decrease of anxiety leads to the reduction of the negative influence of emotions on the self-esteem of the general QL.
Alterations in leucocyte subsets and histomorphology in normal-appearing perilesional skin and early and chronic hidradenitis suppurativa lesions
Authors: H.H. van der Zee, L. de Ruiter, J. Boer, D.G. van den Broecke, J.C. den Hollander, J.D. Laman, E.P. Prens
Journal: British Journal of Dermatology (2011)

Current insight into the histopathological course of events during disease progression in hidradenitis suppurativa (HS) is fragmentary.To identify histological alterations and leucocyte subsets in normal-appearing perilesional skin, and early and chronic HS lesions.In this observational study we examined eight perilesional skin samples, and six early and 10 chronic prototypic HS lesions, as well as skin samples from four healthy donors using in situ immunostaining.Perilesional skin showed mild psoriasiform hyperplasia and follicular plugging as well as a low-grade influx of tryptase-positive mast cells, CD3+ T cells, CD138+ plasma cells and factor XIIIa+ dendritic cells. In early HS lesions, neutrophilic abscess formation and influx of mainly macrophages, monocytes and dendritic cells predominated. In chronic disease, the infiltrate expanded with markedly increased frequencies of CD20+ and CD79a+ B cells and CD138+ plasma cells. As in early lesions, free keratin fibres were detected in the dermis and within giant cells. Single detached keratinocytes and strands of follicular epithelium were observed in the dermis, the latter frequently expressing Ki67, indicative of active proliferation.Psoriasiform hyperplasia, follicular plugging and low-grade leucocytic infiltration are already present in normal-appearing perilesional skin. Keratin fibres in the dermis are associated with clinical disease. Early lesions are characterized by neutrophilic abscess formation and influx of mainly histiocytes, and chronic lesions mainly by expansion of B cells and plasma cells in 'pseudo' follicles. Proliferating strands of follicular epithelium may initiate fistula formation. Mast cells are increased in all stages of HS including perilesional skin.
Safety and efficacy of erlotinib in patients with squamous cell lung cancer
Authors: Marko Jakopovic, Branka Cucevic, Sanja Plestina, Silvana Smojver-Jezek, Suzana Kukulj, Nabil Chalfe, Marta Korsic, Zarko Vrbica, Gzim Redzepi, Miroslav Samarzija
Journal: European Respiratory Journal (2014)

Background:Erlotinib is epidermal growth factor receptor (EGFR) tyrosine-kinase inhibitor which showed efficacy and tolerability in patients with advanced non-small cell lung cancer(NSCLC)  Aim:To determine safety and efficacy of erlotinib in patients with advanced(stage IIIB and IV)squamous NSCLC  Methods:patients with advanced squamous NSCLC who had failed prior chemotherapy were treated with oral erlotinib 150 mg daily until disease progression or unaccaptable toxicity.Data was analyzed retrospectively.  Results:a total of 122 patients(107 men and 15 women, mean age 62±8 years)with advanced squamous NSCLC were enrolled in the study from 2006 to 2012 in 14 centers in throughout Croatia.Most of the patients were in performance status ECOG 1 & 2.Majority of patients were treated with erlotinib in 3rd line setting.After cycle 2,10% of patients had partial response (PR),and 45% of patients had stable diseases.In total, 55% of patients had disease control after cycle 2.Progression free survival (PFS) was 3.7 months in overall population. Statistically significant differences in PFS were recorded according to response to treatment;patients with PR after two cycles had PFS of 6.2 months comparing with patients with progressive disease of 2.0 months(p  Conclusions:erlotinib as single agent showed efficacy and tolerability in treatment of patients with squamous cell NSCLC. The best predictive factor of response to treatment was response to erlotinib after 2 months of treatment.
Neural Correlates of the Propensity for Retaliatory Behavior in Youths With Disruptive Behavior Disorders
Authors: Stuart F. White, Michelle VanTieghem, Sarah J. Brislin, Isaiah Sypher, Stephen Sinclair, Daniel S. Pine, Soonjo Hwang, R. James R. Blair
Journal: American Journal of Psychiatry (2015)

Youths with disruptive behavior disorders (DBD) (conduct disorder and oppositional defiant disorder) have an elevated risk for maladaptive reactive aggression. Theory suggests that this is due to an elevated sensitivity of basic threat circuitry implicated in retaliation (amygdala/periaqueductal gray) in youths with DBD and low levels of callous-unemotional traits and dysfunctional regulatory activity in the ventromedial prefrontal cortex in youths with DBD irrespective of callous-unemotional traits.A total of 56 youths 10-18 years of age (23 of them female) participated in the study: 30 youths with DBD, divided by median split into groups with high and low levels of callous-unemotional traits, and 26 healthy youths. All participants completed an ultimatum game task during functional MRI.Relative to the other groups, youths with DBD and low levels of callous-unemotional traits showed greater increases in activation of basic threat circuitry when punishing others and dysfunctional down-regulation of the ventromedial prefrontal cortex during retaliation. Relative to healthy youths, all youths with DBD showed reduced amygdala-ventromedial prefrontal cortex connectivity during high provocation. Ventromedial prefrontal cortex responsiveness and ventromedial prefrontal cortex-amygdala connectivity were related to patients' retaliatory propensity (behavioral responses during the task) and parent-reported reactive aggression.These data suggest differences in the underlying neurobiology of maladaptive reactive aggression in youths with DBD who have relatively low levels of callous-unemotional traits. Youths with DBD and low callous-unemotional traits alone showed significantly greater threat responses during retaliation relative to comparison subjects. These data also suggest that ventromedial prefrontal cortex-amygdala connectivity is critical for regulating retaliation/reactive aggression and, when dysfunctional, contributes to reactive aggression, independent of level of callous-unemotional traits.
BRCA1 and BRCA2: from molecular genetics to clinical medicine.
Authors: M A Blackwood, B L Weber
Journal: Journal of Clinical Oncology (1998)

Inherited susceptibility to breast cancer has been an area of intense investigation for the past 10 years. Early work focused on identifying modes of transmission, which culminated in the identification of chromosome 17q12-21 as the first human genomic region that harbored an autosomal dominant susceptibility gene for breast cancer (BRCA1) in 1990. BRCA1 was subsequently identified and was followed shortly by the identification of BRCA2. Research in the past 3 years has elucidated much about the mutation spectrum and mutation frequency of these genes in specific populations and is beginning to identify potential functions. Whereas progress in this area has been rapid and much is now known about inherited susceptibility to breast cancer, much more needs to be done to make these discoveries useful in the diagnosis, treatment, and ultimately, the prevention of breast cancer.
Trilateral Retinoblastoma: A Meta-Analysis of Hereditary Retinoblastoma Associated With Primary Ectopic Intracranial Retinoblastoma
Authors: Tero Kivelä
Journal: Journal of Clinical Oncology (1999)

PURPOSE: To obtain refined knowledge regarding trilateral retinoblastoma (TRb), which is a syndrome that consists of hereditary retinoblastoma associated with an intracranial neuroblastic tumor. MATERIALS AND METHODS: Using a systematic literature review, we contacted authors to obtain missing information. Data from 106 children were used in a meta-analysis including frequency distributions and Kaplan-Meier survival curves. RESULTS: TRb showed no sex predilection. Median age at diagnosis of retinoblastoma was 5 months (range, 0 to 29 months); age at diagnosis was younger among 47 children (47%) with familial retinoblastoma compared with age at diagnosis among 52 children (53%) with sporadic retinoblastoma (2 v 6.5 months, P &lt; .0001). TRb usually affected the second or third generation with retinoblastoma. Median time from retinoblastoma to TRb was 21 months (range, 6 months before to 141 months after); time to TRb was longer for 78 (77%) pineal tumors compared with 23 (23%) suprasellar tumors (32 v 6.5 months, P &lt; .0001). The size (27 v 32 mm, P = .57) and prognosis (survival of 9 v 8 months, P = .91) of pineal and suprasellar tumors were similar. TRb was detected earlier (1 v 22 months, P = .0007) and the child survived longer if neuroimaging was routinely performed (16 v 8 months, P = .001), but age at death was similar (36 v 37 months, P = .98). Cumulative 5-year survival (which was likely to indicate cure) was 27% (v 0%) if screening was undertaken. All children whose TRb exceeded 15 mm in size died. CONCLUSION: The family history, age at diagnosis, and laterality of retinoblastoma in children with TRb resembled that of ordinary hereditary retinoblastoma. Suprasellar TRb were diagnosed earlier, and may arise earlier, than pineal TRb. Screening by neuroimaging could improve the cure rate if cases of TRb were detected when tumors were 15 mm or smaller in size.