tbuckley/cabot-search huggingface dataset:
Individualised physiotherapy as an adjunct to guideline-based advice for low back disorders in primary care: a randomised controlled trial
Authors: Jon J Ford, Andrew J Hahne, Luke D Surkitt, Alexander Y P Chan, Matthew C Richards, Sarah L Slater, Rana S Hinman, Tania Pizzari, Megan Davidson, Nicholas F Taylor
Journal: British Journal of Sports Medicine (2015)

Many patients with low-back disorders persisting beyond 6 weeks do not recover. This study investigates whether individualised physiotherapy plus guideline-based advice results in superior outcomes to advice alone in participants with low-back disorders.This prospective parallel group multicentre randomised controlled trial was set in 16 primary care physiotherapy practices in Melbourne, Australia. Random assignment resulted in 156 participants receiving 10 sessions of physiotherapy that was individualised based on pathoanatomical, psychosocial and neurophysiological barriers to recovery combined with guideline-based advice, and 144 participants receiving 2 sessions of physiotherapist-delivered advice alone. Primary outcomes were activity limitation (Oswestry Disability Index) and numerical rating scales for back and leg pain at 5, 10, 26 and 52 weeks postbaseline. Analyses were by intention-to-treat using linear mixed models.Between-group differences showed significant effects favouring individualised physiotherapy for back and leg pain at 10 weeks (back: 1.3, 95% CI 0.8 to 1.8; leg: 1.1, 95% CI 0.5 to 1.7) and 26 weeks (back: 0.9, 95% CI 0.4 to 1.4; leg: 1.0, 95% CI 0.4 to 1.6). Oswestry favoured individualised physiotherapy at 10 weeks (4.7; 95% CI 2.0 to 7.5), 26 weeks (5.4; 95% CI 2.6 to 8.2) and 52 weeks (4.3; 95% CI 1.4 to 7.1). Responder analysis at 52 weeks showed participants receiving individualised physiotherapy were more likely to improve by a clinically important amount of 50% from baseline for Oswestry (relative risk (RR=1.3) 1.5; 95% CI 1.2 to 1.8) and back pain (RR 1.3; 95% CI 1.2 to 1.8) than participants receiving advice alone.10 sessions of individualised physiotherapy was more effective than 2 sessions of advice alone in participants with low-back disorders of ≥6 weeks and ≤6 months duration. Between-group changes were sustained at 12 months for activity limitation and 6 months for back and leg pain and were likely to be clinically significant.ACTRN12609000834257.
Electron Microscopic Study of Fused Cells, With Special Reference to Chromosome Pulverization&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: M. Sanbe, T. Aya, T. Ikeuchi, A. A. Sandberg
Journal: JNCI Journal of the National Cancer Institute (1970)

Fused cells, induced by Sendai virus in cultured cells of the Chinese hamster, were observed with the electron microscope to characterize their pulverized chromosomes. Consisting of interphasic and mitotic cells, these cells were examined without hypotonic treatment for chromosome analysis. Most of them had no morphological changes in the interphase nuclei, and in rare instances, fused cells contained metaphasic chromosomes and pulverization-like nuclei. These abnormal nuclei were dense masses, consisting of irregular chromatin clumps of various sizes often surrounded by a fragmented nuclear envelope. Occasionally, spindle tubules also were found in association with these abnormal nuclei. Most of these nuclei seemed to be in the prophase or early metaphase stage. Hypotonic treatment may bring out and/or induce chromosome pulverization in the fused cells containing mitotic nuclei and interphasic ones and, thus, may account for the higher incidence of chromosome pulverization observed following such treatment. In addition, the relation of mitosis to chromosome pulverization is briefly discussed.
Correlation of karyotype and immunophenotype in childhood acute lymphoblastic leukemia.
Authors: C H Pui, D L Williams, P K Roberson, S C Raimondi, F G Behm, S H Lewis, G K Rivera, D K Kalwinsky, M Abromowitch, W M Crist
Journal: Journal of Clinical Oncology (1988)

To correlate leukemic cell karyotype with immunophenotype, we studied 364 children with acute lymphoblastic leukemia (ALL). A prognostically favorable cytogenetic feature, hyperdiploidy greater than 50 chromosomes, was found in 33% of cases classified as common ALL antigen positive (CALLA+) early pre-B (common) ALL, in contrast to 18% of pre-B cases (P = .012), 5% of T cell cases (P less than .001), and none of the B cell cases (P less than .001) or cases of CALLA negative (CALLA-) early pre-B ALL (P = .002). The frequency of translocations, an adverse cytogenetic feature, was significantly lower in CALLA+ early pre-B ALL cases (35%) than in B cell (100%; P less than .0001), pre-B (59%; P less than .001), or CALLA- early pre-B (62%; P = .016) cases. Thus, patterns of chromosomal change differ widely among the major immunophenotypic groups of ALL and may account for reported differences in responsiveness to treatment.
Most provider trust finance directors expect performance to be worse than last year’s
Authors: Matthew Limb
Journal: BMJ (2015)

NHS trusts’ finances continue to deteriorate at an “alarming rate,” but clinical commissioning groups (CCGs) are performing “relatively well,” a survey has found.

The poll of 196 finance directors in England1 was carried out by the Healthcare Financial Management Association, its first since the new Conservative government took office in May 2015. Some 117 of the finance directors were based in provider trusts (47% of provider trusts), and 79 were in CCGs (37% of CCGs).

While 78% of provider trust finance directors expect their trust to be in …
Nutritional status and physical impairment in patients with chronic respiratory disease
Authors: Marie Carmen Valenza, Adelina Martín-Salvador, Irene Torres-Sánchez, German Sáez-Roca, Alfredo Molina-Ocaña, Francisca Elías-Bezares
Journal: European Respiratory Journal (2014)

Introduction:  In patients with chronic obstructive pulmonary disease (COPD) malnutrition is common. Levels of muscular mass have been associated with reduced levels of force, activity, functionality and increase of the morbidity and mortality risk.  Objective:  The aim of this study was to assess the relation between nutritional status and force in hospitalized due to COPD exacerbation patients.  Methods:  Nutritional status was assessed with Mini Nutritional Assessment (MNA). Previous studies have shown that MNA and anthropometric and biochemical indicators in blood have a high correlation . Also MNA has been validated in patients with COPD. Upper and lower limbs strength was measured by hand held dynamometry and exercise capacity with 2 Minute Step in Place (2MSP).  Results:  A sample of 80 hospitalized COPD patients were included in this study. The results of the correlation between nutritional status and muscle force are shown in table 1.  Conclusion:  Nutritional status in hospitalized COPD is related to muscle force and endurance. Without doubt nutritional interventions has to be taken into account.
Breast conservation versus mastectomy: distress sequelae as a function of choice.
Authors: S M Levy, R B Herberman, J K Lee, M E Lippman, T d'Angelo
Journal: Journal of Clinical Oncology (1989)

Between 1981 and 1984, 93 stage I and II breast cancer patients were entered onto a trial at the National Cancer Institute (NCI) randomizing patients to excisional biopsy plus radiation v mastectomy. Between 1984 and 1987, 98 stage I and II breast cancer patients were entered onto a behavioral study in Pittsburgh, approximately 70% of whom elected to have breast conservation surgery. Patients at both sites were assessed three to five days postsurgery, and again at 3-month's follow-up, using a well-validated mood measure, the Profile of Mood States (POMS). There were no demographic or disease differences between the two samples. In the Pittsburgh sample, using a repeated measures multivariate analysis of covariance (MANCOVA) analysis, after adjusting for menopausal status and radiotherapy and chemotherapy toxicity, the conservation group was psychologically worse off (F = 2.7, P less than .03). For example, they were significantly more distressed over time (F = 5.5, P less than .02), and more depressed in general (F = 9.2, P less than .005). Using Karnofsky ratings, the two groups were identical in terms of disability at 3-month's follow-up. In contrast, for the NCI patients participating in the randomized trial, after adjusting for chemotherapy and radiotherapy treatments, reported overall distress decreased over time (F = 17.4, P less than .0001) for all patients, irrespective of treatment group, and the between-groups MANCOVA was not significant. Thus, when comparing the two samples, when "choice" played a major role, the conservation patients were psychologically worse off--at least at 3-month's follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)
The peculiarities of basic metabolism in cystic fibrosis patients
Authors: Alexander Orlov, Alexander Pashkevich, Ludmila Jelenina
Journal: European Respiratory Journal (2011)

Object: The study of a basic metabolism dependence on the disease state and infection process in cystic fibrosis patients in Saint-Petersburg.   Materials and methods:  23 patients with mixed forms of cystic fibrosis confirmed by the genetic examination were recorded in this clinical research study.  The examination of basic metabolism in the children with cystic fibrosis was performed by the apparatus “Fit mate PRO, Cosmed, Italy”. The basic metabolism rate is calculated as a percentage of target values and depends on respired O2 volume in ml/min, sex, age and height and body weight. The examinations were performed within 15 minutes at a comfortable ambient temperature (18-20°C) in the lying position, in an emotionally resting condition 12-16 hours later of the last meal without considering of daily stresses.   Results:  The basic metabolism in the all examined cystic fibrosis patients exceeds the respective age norm by 30-90%. The statistic evaluation by the Mann-Whitney test the basic metabolism appeared to be significantly higher in the patient group with the chronic pseudomonas infection (p=0.0167).  In 8 patients an oxygen intake volume during the maximal physical stress was determined. In all these patients it was considerably reduced.   Conclusion:  The direct dependence of the basic metabolism on the state severity of cystic fibrosis (with the increase of severity) and the clear dependence on the infection process (the basic metabolism increase with the addition of pseudomonas infection) were revealed. The very low training of cystic fibrosis patients in Saint-Petersburg (on the base of oxygen intake rates) should be noted.
Biomarker expression during oral carcinogenesis using an in vivo imaging approach.
Authors: Petra Wilder-Smith, Ani Sarkassian, Joseph Morcos, Daniel Jun, Marie Hammer-Wilson, Diana Messadi, Tatiana Krasieva
Journal: Clinical Cancer Research (2006)

A33   Background and Objective: Oral carcinogenesis is a multistep process in which genetic events cause disruption of the normal regulatory pathways controlling basic cellular function, Multiple genetic events lead to oral cancer, and various cellular genes are overexpressed in oral squamous cell carcinoma. Goal of these studies was to image and quantify expression of specific biomarkers known to play a role in the vascular and extracellular matrix (ECM) changes. Study Design/Materials and Methods: In the hamster cheek model (30 hamsters) throughout carcinogenesis, in vivo multi-wavelength multi-photon (MPM) and second harmonic generated (SHG) fluorescence techniques were used to image surface and subsurface fluorescence prior to and after the injection of biomarkers: Vascular Endothelial Growth Factor (VEGF); urinase type Plasminogen Activator (uPA) and Inhibitor (PAI-1); Matrix Metalloproteinases 1,2,9 (MMPs). At 0,4,6,8,10,12 weeks, one animal was sacrificed., Histopathological sections were prepared and pathology evaluated on a scale of 0-6. Results: Carcinogenesis-related structural and vascular changes were clearly visible. Biomarker expression was clearly identified, localized and quantified at all timepoints throughout carcinogenesis, providing important new information on the carcinogenesis process. Conclusion: Time- and spatially-resolved determination of (1) specific biomarker expression, (2) vascular and ECM changes throughout oral carcinogenesis provide valuable information on mechanisms of dysplastic and malignant change. Supported by: CRFA 30003, NIH (LAMMP) P41 RR01192, AFOSR FA 9550-04-1-0101, CA TRDRP 445174-18079.
Pharmacological Inhibition of β3 Integrin Reduces the Inflammatory Toxicities Caused by Oncolytic Adenovirus without Compromising Anticancer Activity
Authors: Ashley Browne, Laura A. Tookman, Carin K. Ingemarsdotter, Russell D. Bouwman, Katrina Pirlo, Yaohe Wang, Iain A. McNeish, Michelle Lockley
Journal: Cancer Research (2015)

Abstract Adenoviruses have been clinically tested as anticancer therapies but their utility has been severely limited by rapid, systemic cytokine release and consequent inflammatory toxicity. Here, we describe a new approach to tackling these dangerous side effects. Using human ovarian cancer cell lines as well as malignant epithelial cells harvested from the ascites of women with ovarian cancer, we show that tumor cells do not produce cytokines in the first 24 hours following in vitro infection with the oncolytic adenovirus dl922-947. In contrast, dl922-947 does induce inflammatory cytokines at early time points following intraperitoneal delivery in mice with human ovarian cancer intraperitoneal xenografts. In these animals, cytokines originate predominantly in murine tissues, especially in macrophage-rich organs such as the spleen. We use a nonreplicating adenovirus to confirm that early cytokine production is independent of adenoviral replication. Using β3 integrin knockout mice injected intraperitoneally with dl922-947 and β3 null murine peritoneal macrophages, we confirm a role for macrophage cell surface β3 integrin in this dl922-947–induced inflammation. We present new evidence that co-administration of a cyclic RGD-mimetic–specific inhibitor of β3 integrin significantly attenuates the cytokine release and inflammatory hepatic toxicity induced by dl922-947 in an intraperitoneal murine model of ovarian cancer. Importantly, we find no evidence that β3 inhibition compromises viral infectivity and oncolysis in vitro or anticancer efficacy in vivo. By enabling safe, systemic delivery of replicating adenoviruses, this novel approach could have a major impact on the future development of these effective anticancer agents. Cancer Res; 75(14); 2811–21. ©2015 AACR.
Six minute walk test in obese children and adolescents
Authors: Mariana Simoes Ferreira, Roberto Teixeira Mendes, Maria Angela G. de O Ribeiro, Jose Dirceu Ribeiro
Journal: European Respiratory Journal (2011)

Background: Six minute walk test (6MWT) is an accessible tool to evaluate the submaximal physical capacity. There are few studies that evaluate the 6MWT in obese children and adolescents.

Aim: To compare the performance of obese and healthy children and adolescents in the 6MWT analyzing the walked distance (WD), the work (W) and the physiological cost.

Method: Comparative, analytical and cross sectional study including, eighty four subjects (28 obese and 56 eutrophic) with age between 5.7 and 16.8 years. Obesity was defined according to CDC standards (IMC≥p95). Subjects with respiratory diseases were excluded. The 6MWT followed the ATS guidelines.

Results: The obese subjects walked a significantly shorter distance than the eutrophic subjects in the 6MWT (p=0.00). The W (W=body weight X WD) in the obese group was significantly higher than the healthy group (p=0.00). There were not differences between the groups in the PC (PC=ΔHeart Rate/Median Velocity). Mann-Whitney test was used to compare the groups.

Conclusion: The worse performance in the obese group must be associated to a limitation in the physiological mechanisms involved in the exercise and the excessive charge that difficult the performance. It is necessary more studies in order to define the limiting mechanisms in the physical performance in obese children and adolescents during the walking.
Thoracoscopic video-assisted partial resection of rib for pain control in patient with atypical pulmonary and bone Langerhans histiocytosis
Authors: Tsvetan Minchev, Emanuil Manolov, Vladislav Marinchev, Anton Angelov, Galina Kirova, Ivan Stoimenov
Journal: European Respiratory Journal (2012)

Introduction  : Langerhans histiocytosis (LH) is a rare disease that occurs in 1-2:2 millions of people, which affects mainly children and adults between twenty and forty years old. Bones affection is an rarely occurs.

Clinical case : A 19 year old female with severe pain and discomfort of left subskapular area. After CT procedure, it was found that there are bilaterally a great number of small diffusely scattered nodular lesions in the lung parenchyma and formations, destructed cortex on the 5-th rib with the suspected for histiocytosis X.

![Figure][1] 



Treatment: A video-assisted thoracoscopic (VATS) partial resection of the fifth rib has been made, under three port. Lung biopsy has been made over several suspected lesions. The postoperative period has been uneventful. The pain and the discomfort were reduced.

![Figure][1] 



Conclusion : VATS resection of the rib could be a good modern approach to eradicate or interference of pain in the rib LH. VATS remains the ultimate cross-cutting unique therapeutic approach for the treatment of the bone Langerhans-cellular histiocytosis and change the quality of life in these patients.

 [1]: pending:yes
Impact of continuous, non-invasive blood pressure (BP) measurement on sleep quality during polysomnography (PSG)
Authors: Thomas Wibmer, Benedikt Schildge, Christoph Fischer, Stephanie Brunner, Cornelia Kropf, Kathrin M. Stoiber, Stefan Ruediger, Ioanna Blanta, Wolfgang Rottbauer, Christian Schumann
Journal: European Respiratory Journal (2012)

Introduction:

Obstructive sleep apnea (OSA) is generally considered an etiologic factor in the development of hypertension (HT). Recent findings, demonstrating that renal sympethetic denervation could also reduce OSA severity, provoke new questions on the interaction of HT and OSA. Portapres continuous non-invasive blood pressure measurement during PSG might be a powerful tool for future research to better understand these mechanisms. However, the effect of overnight Portapres BP monitoring itself on sleep is unclear.

Aims:

To analyze the impact of Portapres BP measurement on sleep quality during PSG.

Methods:

40 individual patients with either treated or newly diagnosed untreated sleep apnoea syndrome were recruited. They underwent one overnight PSG randomly with or without simultaneous Portapres BP measurement.

Results:

20 PSG recordings with additional Portapres monitoring and 20 gender and treatment matched control PSGs were investigated for comparisons. In the Portapres and the control group mean age was 58 and 56 years, 55 and 60 % were males, 75 and 60 % had predominantly OSA, 50 and 50 % had CPAP treatment, mean apnea-hypopnea-index was 14.1 and 21.0, mean arousal index 21.4 and 24.7, mean total sleep time 5.2 and 5.4 hours, mean sleep efficiency 75.2 and 73.9 %, mean sleep onset latency 20 and 21 minutes, mean REM-sleep 16 and 15 % and mean slow-wave sleep was 8.8 and 11.5 %, respectively.

Conclusions:

The results of this pre-study suggest that Portapres BP measurement during overnight PSG does not have a clinically relevant impact on sleep quality and might therefore be a good diagnostic tool for future research on HT and BP changes in sleep apnea.
Handwashing Promotion and Childhood Diarrhea in Pakistan
Authors: Syed Abdul Mujeeb
Journal: JAMA (2004)

The major cause of diarrhea in poor settlements in Pakistan is strongly believed to be the contamination of drinking water and water treatment food hygiene and handwashing are the standard intervention practices. I believe that there is no equipoise in this regard and because of this no need to have a “placebo” control with standard habits and practices as was done in the study on handwashing and childhood diarrhea by Dr Luby and colleagues. In their study field workers neither encouraged nor discouraged handwashing in the control group allowing habits and practices that were promoting diarrhea in the community to continue. I believe that it would have been more ethical to have a control group that received handwashing promotional messages and 2 intervention groups that received handwashing promotional messages and either plain or antibacterial soap.  (excerpt)
Abstract 1587: Conditional Overexpression of the Oncogene c-Myc Produces Hypertrophic Cardiomyopathy and Results in Mitochondrial Dysfunction at Complex I
Authors: Hyoung-Gon Lee, Brian D Hoit, Anna Liner, Sandra Richardson, Qun Chen, Edward J Lesnefsky, Mark A Smith
Journal: Circulation (2008)

c-Myc is transiently expressed early during cardiac pressure overload, but its pathological role is unclear. To address the contribution of c-myc in the genesis of cardiomyopathy, we established a tetracycline-inducible, cardiomyocyte-specific, c-myc-overexpressing bitrans-genic mouse. Doxycyline treatment (DOX) for 2 weeks (Myc-ON, n=5) increased cardiac mass two-fold with myocyte disarray, and increased fiber width and fibrosis compared to control mice (Myc-OFF, n=8); LV fractional shortening (15MHz, Sequoia, Siemens) was less (0.28±0.03(SEM) vs.0.53±0.04) and myocardial performance index was greater (0.91±0.15 vs. 0.36±0.03, both p&lt;0.05) indicating ventricular dysfunction in Myc-ON vs. Myc-OFF. Death resulted from irreversible heart failure. The cell cycle markers PCNA, Ki-67 and cyclin D1 were strongly induced and BrdU incorporation confirmed cell cycle progression to S-phase. To determine if mitochondrial dysfunction contributed to the cardiomyopathy of c-Myc-overexpression, oxidative phosphorylation (OXPHOS) was studied with glutamate/malate (complex I), succinate (complex II) and TMPD-ascorbate (complex IV) as substrates. OXPHOS decreased with glutamate/malate (213±40 vs.329±25 nAO/min/mg, p&lt;0.05) after two weeks of Myc-ON (n=4) vs. control (n=4), but was unaltered with other substrates, localizing a defect to complex I of the electron transport chain. The complex I defect was confirmed by a decrease in NADH:decylubiquinone oxidoreductase activity (561±49 vs.752±38 mU/mg). PGC-1a (a major regulatory mechanism of mitochondrial proliferation) was increased in Myc-ON, and ultrastructural analysis revealed a 2.5-fold increase in mitochondrial number, possibly in response to the OXPHOS defect. Taken together, these findings suggest: cardiac restricted temporally-defined Myc overexpression turns on cell cycle machinery in cardiomyocytes and produces decompensated hypertrophic cardiomyopathy; and activation of c-Myc leads to an OXPHOS defect at complex I. Since complex I defects impair energy production and increase the production of reactive oxygen species, we speculate that mitochondrial dysfunction contributes to the cardiomyopathy that develops when adult cardiomyocytes overexpress c-Myc.