tbuckley/cabot-search huggingface dataset:
Abstract 12667: Red or White Thrombus in Patients with ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: Does it Matter?
Authors: Alexandre S Quadros, Eduardo Cambruzzi, Renato David, Juliana Sebben, Anibal Abelin, Dulce Welter, Rogerio Sarmento-Leite, Renato D Lopes, Carlos A Gottschall
Journal: Circulation (2011)

Background: Aspiration thrombectomy is generally used in primary percutaneous coronary interventions (pPCI), and this method allows assessment of the retrieved thrombus. The color of the thrombus, ...
Personal paper: Ethics and evidence based medicine
Authors: I. Kerridge, M. Lowe, D. Henry
Journal: BMJ (1998)

Evidence based medicine is founded upon an ideal—that decisions about the care of individual patients should involve the “conscientious, explicit and judicious use of current best evidence.”1 Several publications are dedicated to evidence based medicine, and, at an international level, the Cochrane Collaboration has been formed to gather, analyse, and disseminate evidence derived from published research.2 Several practical approaches to evidence based medicine in clinical decision making have also been described. 3 4

Evidence based medicine, it is claimed, leads to improvements in clinicians' knowledge, reading habits, and computer literacy; provides a framework for teaching; enables junior team members to contribute to decisions; and allows better communication with patients and more effective use of resources.5 From an ethical perspective, the strongest arguments in support of evidence based medicine are that it allows the best evaluated methods of health care (and useless or harmful methods) to be identified and enables patients and doctors to make better informed decisions. 5 6

However, the presence of reliable evidence does not ensure that better decisions will be made. Claims that evidence based medicine offers an improved method of decision making are difficult to evaluate because current practice is so poorly defined. Medical decision making draws upon a broad spectrum of knowledge—including scientific evidence, personal experience, personal biases and values, economic and political considerations, and philosophical principles (such as concern for justice). It is not always clear how practitioners integrate these factors into a final decision, but it seems unlikely that medicine can ever be entirely free of value judgments.

#### Summary points

Evidence based medicine is based on a strong ethical and clinical ideal—that it allows the best evaluated methods of health care to be identified and enables patients and doctors to make better informed decisions

Evidence based medicine is unable to resolve competing …
A Historical Approach to Understanding Drug Abuse Among Nurses
Authors: DAVID G. LEVINE, PHYLLIS A. PRESTON, SALLY G. LIPSCOMB
Journal: American Journal of Psychiatry (1974)

Investigation of the histories of 12 nurses who abused drugs disclosed an early and extensive involvement in medical treatment. A "medical dependence" became evident, manifested by somatic orientation, chronic medical difficulties, dependence on alcohol, and, finally, dependence on other drugs. Irrational attitudes toward addicting substances underlie this kind of progression. The authors believe that this developmental theme is significant in the genesis of addiction among nurses and that it should be dealt with during rehabilitation.
DNA Measurement on Cell Nucleus of Normal Liver, Adenoma, and Hepatoma in Mice: Histologic Features
Authors: N. Inui, S. Takayama, N. Kuwabara
Journal: JNCI Journal of the National Cancer Institute (1971)

A microspectrophotometric estimation was made on the DNA content of cell nuclei of liver tumors of mice. Cells from normal liver showed modal peaks of DNA in basic diploid and tetraploid ranges, with limited variation around these modes. In 19 of 20 liver adenomas, the modal DNA value in cell nuclei from each was in the basic diploid range, with a rather wider deviation around the mode than in normal liver. In the remaining adenoma, it was in the triploid region. In contrast, the modal DNA value in carcinoma cells ranged from diploid to hyperhexaploid, with greater deviation from cell to cell. In tumors classified histologically as intermediate between adenoma and carcinoma, two groups could be recognized by DNA estimations. Of 16 tumors, 11 had diploid DNA values, 1 hyperdiploid, 2 hypertriploid, and 2 tetraploid. The tumors which could not be classified histologically as benign or malignant could be subdivided into two groups (benign or malignant) by the DNA estimation of cell nuclei.
Appropriate and inappropriate influences on outpatient discharge decision making in dermatology: a prospective qualitative study
Authors: N.A. Harun, A.Y. Finlay, M.S. Salek, V. Piguet
Journal: British Journal of Dermatology (2015)

Outpatient discharge decision making in dermatology is poorly understood.To identify the influences on clinicians' thought processes when making discharge decisions in dermatology outpatient clinics.Forty clinicians from 11 National Health Service Trusts in England were interviewed. The interviews were audiorecorded, transcribed, coded and thematically analysed.The mean age of the clinicians was 48.8 years (range 33.0-67.0), 17 (43%) were men and 19 (48%) had > 20 years of clinical experience. One hundred and forty-eight influences were reported, with five main themes: (i) disease-based influences included type of diagnosis (100% of clinicians), guidelines (100%) and treatment needed (100%); (ii) clinician-based influences included the clinician's level of experience (100%), seniority (37%), emotional attitude (95%), 'gut feeling' (25%), personal attitude towards discharge (45%) and level of perception (100%); (iii) patient-based influences included patients' ability to cope with their disease (100%), wishes (70%), quality of life (32%), command of English (40%) and cultural background (25%); (iv) practice-based influences included good primary care (100%), secondary support structure (100%) and clinic capacity pressure (67%); (v) policy-based influences included pressure from hospital managers (57%) and an active discharge policy (7%). Fourteen (9%) influences were potentially inappropriate.This study has identified multiple factors influencing outpatient discharge decision making. This provides the basis for developing evidence-based training to improve discharge decision appropriateness.
Do COPD severity parameters predict mood disorders
Authors: Giuseppina Cuttitta, Palma Audino, Pietro Alfano, Salvatore Bucchieri, Mario Raphael Melis, Fabio Cibella
Journal: European Respiratory Journal (2013)

We evaluated the mood states disorders in COPD patients and their relationship with COPD severity parameters. We studied 60 consecutive stable COPD outpatients (39 M; aged 53-91) and 30 subjects without respiratory disease (control group) (14 M; aged 50-86). All subjects performed a spirometry and a six minutes walking test (6’WT). Dyspnea perception was evaluated by modified Medical Research Council questionnaire (mMRC). Depressive and anxious symptoms were investigated by Beck Depression Inventory-II and Stay Y, respectively. The COPD patients were classified on the basis of guidelines: 30 in group A, 8 in B, 13 in C, and 9 in D. The prevalence of depressive symptoms in COPD patients and in controls was 28% and 23%, respectively (NS). No significant difference was found between groups for depression severity.  Among COPD patients, depressive symptoms distribution was: 5 in categorie A, 4 in B, 2 in C and 6 in D (p=.034).  A higher prevalence of depressive symptoms and higher severity levels were found in B+D when compared to A+C subjects (p  6’WT and mMRC were inversely related only in COPD patients (p  mMRC and depression were directly correlated (p  Anxiety prevalence was not different between groups. Anxiety was not associated with mMRC, GOLD stages, exacerbation in the last year.  We conclude that, among individual parameters of COPD severity, only mMRC score is a good, strong and direct predictor of depression in COPD patients. Depressive symptoms should be investigated in COPD when mMRC score is high.
The population attributable fraction of COPD due to smoking in Australian adults: Results from BOLD
Authors: Brett Toelle, Rosario Ampon, Michael Abramson, Deborah Burton, Alan James, Graeme Maguire, Richard Wood-Baker, David Johns, Guy Marks
Journal: European Respiratory Journal (2014)

It is widely acknowledged that smoking is an important risk factor for the development of COPD. However, there are other environmental exposures that have also been associated with COPD.   Aim : To estimate the population attributable fraction (PAF) of COPD due to a history of smoking in Australian adults aged 40 years and over.   Methods : We used data from the BOLD-Australia study. Persons aged 40 years and over were randomly selected from the electoral roll, either directly or via a two stage sampling procedure, or from household census in 6 centres based in 4 Australian States. Spirometry was performed before and after administration of salbutamol 200 μg, according to a standardised protocol with careful attention to quality control. Subjects with post-bronchodilator FEV 1 /FVC ratio  1     Results : A total of 3498 adults provided good quality spirometry for these analyses. The sample prevalence of GOLD stage 1 or higher was 15.6% and GOLD stage 2 or higher was 7.2%. The population prevalence of ever smoking was 53.6% (95%CI 52.3-54.9) in those > 40 years and 48.8% in those aged > 70 years.   Conclusions : In Australia, more than half of post-bronchodilator airflow obstruction is attributable to factors other than a history of smoking. While discouraging smoking remains a high priority, reducing the burden of COPD will require attention to other causes as well.
H-2-Dependent Regulation of the High Level of Expression of Ecotropic Murine Leukemia Virus
Authors: Alfonso Colombatti, Anna Dux, Anton Berns, Peter Démant, Jo Hilgers
Journal: JNCI Journal of the National Cancer Institute (1979)

Adult B10.Y mice, which are congenic with C57BL/10ScSn ((B10) mice for the H-2 region, expressed a high titer of infectious ecotropic virus in the spleen. F1 hybrids between B10.Y and B10 mice were negative or had very low levels of virus expression. In (B10.Y x B10)F2 segregant mice, the high virus phenotype segregated with the H-2pa haplotype of B10.Y, whereas the virus-negative phenotype was associated with the H-2b haplotype of B10. Molecular hybridization experiments with a selected ecotropic AKR murine leukemia virus cyclic DNA probe indicated that both partner strains possessed ecotropic virus sequences and that the number of sequences present was the same in B10.Y mice as in B10 mice. This finding excluded the possibility that the H-2-related effect might be due to the presence of additional viral structural genes within or close to the H-2 region of B10.Y mice. The level of expression of this endogenous ecotropic virus was therefore affected by regulatory genes of the H-2 region.
Chronic treatment of β-blocker inhibited mucus hypersecretion and MUC5AC expression exposed to cigarette smoking through β-arrestin2–ERK1/2 pathway
Authors: Bei He, Yujiao Zhou, Yang Guo, Ming Xu, Youyi Zhang
Journal: European Respiratory Journal (2014)

BACKGROUND  Progression of COPD is associated with the small airway obstruction by accumulation of inflammatory mucous exudates, while MUC5AC is the predominant component of mucous exudates.   AIMS  To explore the effects of chronic propranolol administration on airway mucins hypersecretion and the potential mechanisms of the protection of β-blocker against airway MUC5AC hyperproduction.   METHODS  Rat model exposed to cigarette smoke and NCI-H292 cell line were used to study the effects of propranolol on mucus production, MUC5AC expression and contribution of β 2- AR signaling. The isolated tracheal segments were studied  in vitro  to assess the contractile function of the smooth muscle.   RESULTS  1. In cigarette smoke-exposed rats9 model, chronic administration of propranolol (25mg kg -1 d -1 ) significantly attenuated the airway goblet cell metaplasia, mucus hypersecretion and MUC5AC expression. 2. Pretreatment NCI-H292 cells with propranolol (10 -5 M), ICI118551(10 -5 M) or β 2 AR–targeted siRNA (100 nM) reduced MUC5AC mRNA and protein levels by cigarette smoke extract stimulation. The mechanism might be β 2 -AR mediated MUC5AC expression induced by smoking through β-arrestin2–ERK1/2 pathway. 3. Chronic administration of propranolol increased the relaxant effect mediated by the β 2 -AR and decreased the contractile response to acetylcholine.   CONCLUSION  β 2 -AR-β-arrestin2–ERK1/2 signaling is required for cigarette smoke-induced MUC5AC expression. Chronic treatment of β-blocker improved airway mucus hypersecretion resulting from smokingwithout increased the contractile response. Those data may contribute to the optimization of β 2 -AR target therapy in COPD.
Perivascular M2 Macrophages Stimulate Tumor Relapse after Chemotherapy
Authors: Russell Hughes, Bin-Zhi Qian, Charlotte Rowan, Munitta Muthana, Ioanna Keklikoglou, Oakley C. Olson, Simon Tazzyman, Sarah Danson, Christina Addison, Mark Clemons, Ana Maria Gonzalez-Angulo, Johanna A. Joyce, Michele De Palma, Jeffrey W. Pollard, Claire E. Lewis
Journal: Cancer Research (2015)

Abstract Tumor relapse after chemotherapy-induced regression is a major clinical problem, because it often involves inoperable metastatic disease. Tumor-associated macrophages (TAM) are known to limit the cytotoxic effects of chemotherapy in preclinical models of cancer. Here, we report that an alternatively activated (M2) subpopulation of TAMs (MRC1+TIE2HiCXCR4Hi) accumulate around blood vessels in tumors after chemotherapy, where they promote tumor revascularization and relapse, in part, via VEGF-A release. A similar perivascular, M2-related TAM subset was present in human breast carcinomas and bone metastases after chemotherapy. Although a small proportion of M2 TAMs were also present in hypoxic tumor areas, when we genetically ablated their ability to respond to hypoxia via hypoxia-inducible factors 1 and 2, tumor relapse was unaffected. TAMs were the predominant cells expressing immunoreactive CXCR4 in chemotherapy-treated mouse tumors, with the highest levels expressed by MRC1+ TAMs clustering around the tumor vasculature. Furthermore, the primary CXCR4 ligand, CXCL12, was upregulated in these perivascular sites after chemotherapy, where it was selectively chemotactic for MRC1+ TAMs. Interestingly, HMOX-1, a marker of oxidative stress, was also upregulated in perivascular areas after chemotherapy. This enzyme generates carbon monoxide from the breakdown of heme, a gas known to upregulate CXCL12. Finally, pharmacologic blockade of CXCR4 selectively reduced M2-related TAMs after chemotherapy, especially those in direct contact with blood vessels, thereby reducing tumor revascularization and regrowth. Our studies rationalize a strategy to leverage chemotherapeutic efficacy by selectively targeting this perivascular, relapse-promoting M2-related TAM cell population. Cancer Res; 75(17); 3479–91. ©2015 AACR.
Do general practitioners use effective communication for discussing patients' adherence with asthma medications?
Authors: Juliet Foster, Lorraine Smith, Tim Usherwood, Susan Sawyer, Helen Reddel
Journal: European Respiratory Journal (2012)

Introduction : Use of empathic communication techniques such as Motivational Interviewing (MI) can improve patients9 motivation to adhere to medication.  Aim : To investigate general practitioners9 (GPs) attitudes to and use of MI.  Methods : Fifty-three Sydney-based GPs (mean age 51, mean yrs. practicing 22, 55% male) entering a study to improve asthma control completed baseline questionnaires about attitudes to MI principles, usefulness, frequency of use and confidence in using MI techniques with asthma patients. Chi-square was used to test categorical differences.  Results : 72% of GPs felt confident in motivating patients to adhere and 94% of GPs agreed it is their role to do so. When discussing adherence, only 53% of GPs commonly (often/always) asked patients to nominate their most important asthma problem. 23% rarely (never/hardly ever) asked for patients9 interest in information; patients were more commonly (sometimes/often/always) asked about this by male than female GPs (90% vs. 63% p=0.01). Only 55% of GPs agreed they should respect a patient9s choice to use medication differently than prescribed. 72% thought confronting patients with negative consequences was useful to improve adherence and more younger GPs rated this as useful (moderately-extremely) than older GPs (79% vs. 64% p=0.02). GPs in disadvantaged districts rated stressing the importance of medication for disease control more useful (very-extremely) than other GPs (96% vs. 67% p=0.04).  Conclusion : GPs report confidence in motivating patients to take asthma medications, but sub-optimally use effective communication skills. GP education on MI may promote patients9 adherence in primary care.
The influence of the UK national lung cancer campaign on fast-track referrals to secondary care
Authors: Laura Coxon, Phoebe Hodges, Iyad Ismail, David Parr, Asad Ali
Journal: European Respiratory Journal (2013)

Introduction:

The UK Department of Health(DoH) implemented a campaign to raise awareness of early symptoms of lung cancer.We conducted an audit in our hospital to see the influence of this campaign.

Methods:

Details of patients referred to the fast track lung cancer clinic between 1st of January to 31st of April and 1st of May to 31st of August 2012 for the pre and post campaign periods, respectively, were collected retrospectively and compared.

Results:

There was 16% increase in General Practitioner referrals and higher proportion of stage 1a diagnosis and less Stage IV. Despite higher referrals actual lung cancer diagnosis was less, so was abnormal chest xrays.

View this table:

Pre and Post campaign, referrals, diagnosis and staging of Lung cancer





Discussion:

Our data suggest that the DoH campaign was effective in increasing awareness of lung cancer, reflected in an increase in referrals to secondary care. Although less patients turned out to have lung cancer but were diagnosed at an earlier stage with potentially positive influence on survival. Although the scope of this audit was of short duration and limited to the practice of a single hospital.

Conclusion:

Raising the awareness of lung cancer symptoms does appear to increase referrals to Secondary Care and earlier stage diagnosis. Further assessment of the effectiveness and health economics of such programmes is required.
Phylogenetic analysis supports horizontal transfer of P transposable elements.
Authors: J B Clark, W P Maddison, M G Kidwell
Journal: Molecular Biology and Evolution (1994)

Nucleotide sequence comparisons were used to investigate the evolution of P transposable elements and the possibility that horizontal transfer has played a role in their occurrence in natural populations of Drosophila and other Diptera. The phylogeny of P elements was examined using published sequences from eight dipteran taxa and a new, partial sequence from Scaptomyza elmoi. The results from a number of different analyses are highly consistent and reveal a P-element phylogeny that contradicts the phylogeny of the species. At least three instances of horizontal transfer are necessary to explain this incongruence, but other explanations cannot be ruled out at this time.
Adjuvant radiotherapy and regional lymph node field control in melanoma patients after lymphadenectomy: Results of an intergroup randomized trial (ANZMTG 01.02/TROG 02.01)
Authors: M. A. Henderson, B. Burmeister, J. F. Thompson, J. Di Iulio, R. Fisher, A. Hong, R. Scolyer, K. Shannon, H. Hoesktra, J. Ainslie
Journal: Journal of Clinical Oncology (2009)

LBA9084 The full, final text of this abstract will be available in Part II of the 2009 ASCO Annual Meeting Proceedings, distributed onsite at the Meeting on May 30, 2009, and as a supplement to the June 20, 2009, issue of the Journal of Clinical Oncology. No significant financial relationships to disclose.
A randomized comparison of high-dose infusion methotrexate versus standard-dose weekly therapy in head and neck squamous cancer.
Authors: S G Taylor, W P McGuire, W W Hauck, J L Showel, T E Lad
Journal: Journal of Clinical Oncology (1984)

Forty-seven patients with recurrent or metastatic head and neck squamous cancer were entered into a prospectively controlled study comparing high-dose infusion methotrexate with leucovorin against standard-dose methotrexate without leucovorin. Patients were stratified for prior treatment and hematogenous metastases prior to randomization. Patients received either methotrexate (1,500 mg/m2) infused over 24 hours with leucovorin or 40 mg/m2 intramuscularly. Each treatment was given weekly for the first six weeks and followed a dose escalation schedule to toxicity. After six weeks patients received the high-dose regimen every two weeks and the low-dose schedule continued weekly. One patient was ineligible and four had inadequate follow-up to assess response (less than two weeks). Forty-two patients were evaluable for survival and 37 for response. Six of 19 patients (32%) treated with high-dose infusion responded (one complete response) and four of 18 patients (22%) receiving standard dosage responded (P = .52). Treatment with high-dose methotrexate resulted in an improved duration of disease control over standard dosage with the respective median times to progression of 11 weeks and five weeks (P = .04). These differences were most marked in good performance status patients (P = .007) and those without hematogenous dissemination (P = .02). Toxicity, however, was also significantly worse in the high-dose treatment group (P = .01) and survival was identical between treatments (4.2 months). The authors conclude that any treatment advantage to high-dose methotrexate may be attributable to its greater toxicity rather than to a selective therapeutic effect and this regimen does not result in improved patient survival. Good performance status patients may benefit from more aggressive therapy.