tbuckley/cabot-search huggingface dataset:
Are the Most Distressing Concerns of Patients With Inoperable Lung Cancer Adequately Assessed? A Mixed-Methods Analysis
Authors: Carol Tishelman, Malin Lövgren, Eva Broberger, Katarina Hamberg, Mirjam A.G. Sprangers
Journal: Journal of Clinical Oncology (2010)

Purpose Standardized questionnaires for patient-reported outcomes are generally composed of specified predetermined items, although other areas may also cause patients distress. We therefore studied reports of what was most distressing for 343 patients with inoperable lung cancer (LC) at six time points during the first year postdiagnosis and how these concerns were assessed by three quality-of-life and symptom questionnaires. Patients and Methods Qualitative analysis of patients' responses to the question “What do you find most distressing at present?” generated 20 categories, with 17 under the dimensions of “bodily distress,” “life situation with LC,” and “iatrogenic distress.” Descriptive and inferential statistical analyses were conducted. Results The majority of statements reported as most distressing related to somatic and psychosocial problems, with 26% of patients reporting an overarching form of distress instead of specific problems at some time point. Twenty-seven percent reported some facet of their contact with the health care system as causing them most distress. While 55% to 59% of concerns reported as most distressing were clearly assessed by the European Organisation for Research and Treatment for Cancer Quality of Life Questionnaire Core-30 and Lung Cancer Module instruments, the Memorial Symptom Assessment Scale, and the modified Distress Screening Tool, iatrogenic distress is not specifically targeted by any of the three instruments examined. Conclusion Using this approach, several distressing issues were found to be commonly reported by this patient group but were not assessed by standardized questionnaires. This highlights the need to carefully consider choice of instrument in relation to study objectives and characteristics of the sample investigated and to consider complementary means of assessment in clinical practice.
Utility of the Wood's light: five cases from a pigmented lesion clinic
Authors: L.-R. Paraskevas, A.C. Halpern, A.A. Marghoob
Journal: British Journal of Dermatology (2005)

Summary We demonstrate the utility of the Wood's light in a practice that specializes in the evaluation of pigmented lesions. The Wood's light assisted the physician in locating the site of a completely regressed primary cutaneous melanoma, determining the clinical borders of a lentigo maligna melanoma, differentiating between agminated naevi and a naevus spilus and detecting the recurrence of pigmentation after the excision of a dysplastic naevus, and also proved useful in monitoring a large segmental speckled atypical lentiginous naevus for change. Despite the availability of many 'high‐tech' imaging and diagnostic devices designed to evaluate skin lesions, the relatively simple Wood's lamp continues to be of great value. We encourage physicians not to abandon the use of the Wood's light in their clinical practice.
Angiogenesis Gene Therapy
Authors: Todd K. Rosengart, Leonard Y. Lee, Shailen R. Patel, Timothy A. Sanborn, Manish Parikh, Geoffrey W. Bergman, Rory Hachamovitch, Massimiliano Szulc, Paul D. Kligfield, Peter M. Okin, Rebecca T. Hahn, Richard B. Devereux, Martin R. Post, Neil R. Hackett, Taliba Foster, Tina M. Grasso, Martin L. Lesser, O. Wayne Isom, Ronald G. Crystal
Journal: Circulation (1999)

Therapeutic angiogenesis, a new experimental strategy for the treatment of vascular insufficiency, uses the administration of mediators known to induce vascular development in embryogenesis to induce neovascularization of ischemic adult tissues. This report summarizes a phase I clinical experience with a gene-therapy strategy that used an E1(-)E3(-) adenovirus (Ad) gene-transfer vector expressing human vascular endothelial growth factor (VEGF) 121 cDNA (Ad(GV)VEGF121.10) to induce therapeutic angiogenesis in the myocardium of individuals with clinically significant coronary artery disease.Ad(GV)VEGF121.10 was administered to 21 individuals by direct myocardial injection into an area of reversible ischemia either as an adjunct to conventional coronary artery bypass grafting (group A, n=15) or as sole therapy via a minithoracotomy (group B, n=6). There was no evidence of systemic or cardiac-related adverse events related to vector administration. In both groups, coronary angiography and stress sestamibi scan assessment of wall motion 30 days after therapy suggested improvement in the area of vector administration. All patients reported improvement in angina class after therapy. In group B, in which gene transfer was the only therapy, treadmill exercise assessment suggested improvement in most individuals.The data are consistent with the concept that direct myocardial administration of Ad(GV)VEGF121.10 to individuals with clinically significant coronary artery disease appears to be well tolerated, and initiation of phase II evaluation of this therapy is warranted.
Pregnancy Outcomes for Kidney Transplant Recipients With Transplantation as a Child
Authors: Melanie L. Wyld, Philip A. Clayton, Sean E. Kennedy, Stephen I. Alexander, Steven J. Chadban
Journal: JAMA Pediatrics (2015)

IMPORTANCE Pregnancy outcomes for women who received a kidney transplant in childhood are uncertain.OBJECTIVES To report pregnancy outcomes for women with kidney transplantation in childhood (aged <18 years; child-tx mothers) and to compare them with those for women who received a kidney transplant in adulthood (aged Ն18 years; adult-tx mothers). DESIGN, SETTING, AND PARTICIPANTS Observational cohort study in Australia and NewZealand of all women with a functioning kidney transplant included in the Australia and New Zealand Dialysis and Transplant Registry for whom at least 1 pregnancy was reported between January 1, 1963, and December 31, 2012. MAIN OUTCOMES AND MEASURESPregnancy outcomes including live birth rates, gestational age, and proportion of babies who are small for gestational age.RESULTS A total of 101 pregnancies in 66 child-tx mothers and 626 pregnancies in 401 adult-tx mothers were reported.At the time of pregnancy, child-tx mothers had a mean age of 25 (95% CI, 24-26) years with a functioning transplant for 10 (95% CI, 9-11) years, while adult-tx mothers had a mean age of 31 (95% CI, 31-31) years with a functioning transplant for 6 (95% CI, 5-6) years (both P < .001).Live births occurred in 76% of pregnancies in child-tx mothers and 77% of pregnancies in adult-tx mothers.The mean gestational ages were similar between child-tx and adult-tx mothers (35 [95% CI, 33-37] vs 36 [95% CI, 35-36] weeks, respectively; P = .68).The incidence of prematurity (<37 weeks' gestation) was also similar (child-tx mothers, 45%; adult-tx mothers, 53%).A similar proportion of preterm babies born to child-tx and adult-tx mothers were small for gestational age (22% vs 10%, respectively; odds ratio [OR] = 2.53 [95% CI, 1.13-5.69]).Term babies born to child-tx and adult-tx mothers were frequently small for gestational age (57% vs 38%, respectively; OR = 2.16 [95% CI, 1.23-3.81]),both significantly more frequently than babies born at term in the general population (child-tx mothers, OR = 11.93 [95% CI, 5.56-25.61];adult-tx mothers, OR = 5.52 [95% CI, 2.56-11.89]).CONCLUSIONS AND RELEVANCE Pregnancy outcomes for child-tx mothers are similar to those for adult-tx mothers, with no difference in the rate of live births, gestational age, or small for gestational age.Regardless of when women received their kidney transplant, their pregnancies are likely to result in a live, albeit preterm, birth.This work should provide comfort to child-tx mothers and their physicians that their early onset of kidney failure and longer period of transplantation and immunosuppression do not adversely affect their pregnancy outcomes compared with adult-tx mothers.
Angina Pectoris and Carbon Monoxide
Authors: JAMES THEODORE
Journal: Annals of Internal Medicine (1973)

Comments and Corrections1 March 1973Angina Pectoris and Carbon MonoxideJAMES THEODORE, M.D.JAMES THEODORE, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-78-3-455 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: There are several serious questions that should be raised concerning the lead article in the November 1972 issue (pp. 669-676), "Effect of Freeway Travel on Angina Pectoris" by W. S. Aronow and associates, which was enthusiastically endorsed by an editorial in the same issue (pp. 808-810). The criticisms fall into three major categories: [1] validity of carboxyhemoglobin levels measured, [2] design of the study, and [3] conclusions drawn from the results.1. The levels of carboxyhemoglobin reported by the authors in their subjects after 90 minutes of breathing "freeway air" would appear to be suspect. In fact,...Reference1. PETERSONSTEWART JR: Absorption and elimination of carbon monoxide by inactive young men. Arch Environ Health 21:165-171, 1970 CrossrefMedlineGoogle Scholar1. LYNNTABOROTT DEW: Present and future commuter exposures to carbon monoxide. Presented at the 60th Annual Meeting, Air Pollution Control Association, Cleveland, Ohio, 1967; quoted by JAFFE LS: Sources, characteristics, and fate of atmospheric carbon monoxide. Ann NY Acad Sci 174:76-88, 1970 Google Scholar2. PETERSONSTEWART JR: Absorption and elimination of carbon monoxide by inactive young men. Arch Environ Health 21:165-171, 1970 CrossrefMedlineGoogle Scholar3. GOLDSMITH J: Carbon monoxide and coronary heart disease: compelling evidence in angina pectoris (editorial). Ann Intern Med 77:808-810, 1972 LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Division of Respiratory Medicine Department of Medicine Stanford University Medical Center Stanford, California PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byNew method for simultaneous measurement of viscosity, density and surface tension of metallic melts at high temperaturesEffects of Passive Smoking 1 March 1973Volume 78, Issue 3Page: 455-457KeywordsAnginaBreathingCarbon monoxideCarboxyhemoglobinFalls ePublished: 1 December 2008 Issue Published: 1 March 1973 PDF downloadLoading ...
Human DIIIA Erythrocytes: RhD protein is associated with multiple dispersed amino acid variations
Authors: Cheng-Han Huang, Ying Chen, Marion Reid
Journal: American Journal of Hematology (1997)

As a partial D antigen of the Rh blood group system, the D category IIIa phenotype occurs mainly in Blacks, but its molecular basis has not been defined. Here we describe studies of the D category DIIIa and VS+ red blood cells (RBC) from two unrelated probands by Southern blot, cDNA PCR, and nucleotide sequencing. Rh haplotyping by Sph I restriction fragment length polymorphisms indicated that the two probands carried Dce/dCe and Dce/DcE genotypes, respectively. Sequence analysis of Rh cDNAs showed that their erythroid cells expressed both D and CE transcripts. Nevertheless, the D transcripts were found to contain four nucleotide changes scattered in three exons: nt455 A-to-C (exon 3), nt602 C-to-G (exon 4), nt 654 C-to-G (exon 5), and nt667 T-to-G (exon 5). These variations resulted in the following amino acid substitutions characteristic of RhCE polypeptides: 152 Asn-to-Thr, 201 Thr-to-Arg, 218 Ile-to-Met, and 223 Phe-to-Val. The 152Thr and 223Val residues were predicted to reside in proximity to the third and fourth extracellular loops, respectively. Together, these results establish a correlation of the four amino acid changes in the RhD protein with the expression of DIIIa as a partial D antigen on the RBC membrane. Since the varied nucleotides identified in DIIIa all pre-exist in CE, they are likely to have originated from CE by templated micro-conversion event(s). The identification of a specific nt736 C-to-G transversion in CE in the two probands suggests that 245Val may involve the expression of VS antigen. Am. J. Hematol. 55:139–145, 1997. © 1997 Wiley-Liss, Inc.
Human Papillomaviruses in Head and Neck Carcinomas
Authors: Stina Syrjänen
Journal: New England Journal of Medicine (2007)

Each year, almost 650,000 patients worldwide receive the diagnosis of head and neck cancer and some 350,000 die from this disease.1 Nearly 90% of these cancers are squamous-cell carcinomas. The two main causative factors in approximately 80% of oral, oropharyngeal, and laryngeal carcinomas are smoking and alcohol use. Consumption of vegetables and fruit may modulate the carcinogenic effects of tobacco and alcohol, whereas low body-mass index increases the risk of oral cancer.2 The idea that human papillomavirus (HPV) plays a role in these cancers has been under investigation for at least 20 years. It is widely accepted that HPV causes . . .
ON THE TREATMENT OF TYPHOID FEVER.
Authors: S. K. JACKSON
Journal: JAMA (1884)

Read in Section on Practical Medicine and Materia Medica, American Medical Association, May, 1884. My apology for occupying the valuable time of this Section must be found in my conviction of the importance of the subject I propose to discuss. I know it is thought trite and hackneyed, but the discussion of it cannot be considered as finished until there be a better agreement among us as to the treatment of this disease, or until the mortality from it is diminished much below its present rate. It is claimed to have been reduced from the 18 to 20 per cent. of a half century ago to 10 or 12 per cent.; but these lowest figures are still too high, and it is to be hoped that the profession will not be satisfied until there is a much greater reduction. My object is not to boast of any great success in
Delayed Onset of Hemolytic Anemia in a Child
Authors: B. LYNN MILLER, HOWARD A. PEARSON, MYRON W. WHEAT, ALVYN W. WHITE, GEROLD L. SCHIEBLER
Journal: Circulation (1969)

Severe intravascular hemolysis is described as a complication of implantation of an aortic Starr-Edwards ball-valve prosthesis and insertion of a Teflon patch in the ascending aorta in a 9-year-old boy with severe aortic valvar stenosis. This progressive hemolysis of delayed onset was the sole indicator of extreme degeneration of the silicone rubber ball of the prosthetic aortic valve, a potentially lethal condition requiring surgical intervention. The phonocardiographic signs of aortic ball variance were not present, and there was no overt valvar incompetence. A lesser but noteworthy aspect in this case was the occurrence of an "aplastic crisis" superimposed on the severe hemolysis. This transient bone marrow, red cell aplasia, which was unrelated to drugs, precipitated an acutely severe anemia which accounted for the presenting symptoms of the patient and required transfusion.
Improving golf performance with a warm up conditioning programme
Authors: A J Fradkin, C A Sherman, C F Finch
Journal: British Journal of Sports Medicine (2004)

Objectives: To determine whether a golf specific warm up programme (both immediately prior to play and after performing it five times a week for 5 weeks) improved performance in 10 male golfers compared with 10 controls matched for age, sex, and handicap. Methods: Twenty male golfers were matched for age (±2 years) and handicap (±1 stroke). Club head speed was assessed by two dimensional video analysis in a laboratory setting. In week 1, all golfers performed 10 strokes. In weeks 2 and 7, the controls underwent the same procedure as in week 1. The exercise group performed the golf specific warm up followed by their 10 strokes. Between weeks 2 and 7, the exercise group performed the specially designed warm up five times a week for 5 weeks. Results: The mean club head speeds of the exercise group improved at each testing week. Between weeks 1 and 2, golfers in the exercise group improved their club head speed on average by 3–6 m/s (12.8%), and between weeks 1 and 7, they increased their club head speeds by 7–10 m/s (24.0%). With the exception of one golfer whose club head speed varied by 1.7 m/s, the mean club head speeds of the golfers in the control group hardly varied over the testing period (range: 0.3–0.8 m/s). A significant difference (p = 0.029) was found between the mean club head speeds of the exercise and control groups over the duration of the study, and a significant interaction over time (p&lt;0.001) was also found. Conclusions: This study has shown that golfers’ performances will be significantly improved by undertaking a golf specific warm up programme compared with not performing the warm up.
Characterization of the ultraviolet B and X-ray response of primary cultured epidermal cells from patients with disseminated superficial actinic porokeratosis
Authors: M. D'Errico, M. Teson, A. Calcagnile, R. Corona, B. Didona, R. Meschini, G. Zambruno, E. Dogliotti
Journal: British Journal of Dermatology (2004)

Disseminated superficial actinic porokeratosis (DSAP) is the most common porokeratosis and is characterized by multiple keratotic lesions which tend to occur at sun-exposed sites. A mild hypersensitivity to X-rays has been reported for DSAP-derived fibroblasts and frequent over-expression of p53 has been found in lesional epidermis.In order to clarify whether genome maintenance mechanisms might be compromised in this disease the following approaches were undertaken: (i) primary cultured keratinocytes and fibroblasts from DSAP patients were characterized for ultraviolet (UV) B and X-ray response; (ii) 15 lesions were studied for p53 mutations, and (iii) the differentiation status of DSAP-derived keratinocytes was evaluated.Primary cultures of keratinocytes and fibroblasts were established from lesional and nonlesional skin biopsies of two subjects with DSAP. p53 mutations were analysed by DNA sequencing of the conserved region of the TP53 gene. Differentiation was evaluated both in stratified epithelial sheets from confluent keratinocyte cultures and in organotypic skin cultures.The cytotoxic and apoptotic response to UVB or X-irradiation was similar in DSAP-derived keratinocytes and fibroblasts when compared with normal cells. Two of 15 lesions examined presented p53 mutations located at nondipyrimidine sites. A strikingly decreased expression of filaggrin was observed both in reconstructed epidermis and in reconstructed skin.The UVB and X-ray response of DSAP-derived keratinocytes and fibroblasts indicates that the actinic character of this skin pathology is not due to radiation hypersensitivity. In agreement with this finding, mutations in the p53 gene, which are often associated with UV-related skin carcinogenesis, were rarely detected in DSAP lesions and were not UV-specific. Reconstructed epidermis and reconstructed skin models successfully reproduced the main features of this genodermatosis, showing that DSAP-derived keratinocytes bear an inherent defect in the terminal differentiation programme.
Airway and Lung Tissue Mechanics in Asthma
Authors: DAVID W. KACZKA, EDWARD P. INGENITO, ELLIOT ISRAEL, KENNETH R. LUTCHEN
Journal: American Journal of Respiratory and Critical Care Medicine (1999)

We examined the partitioning of total lung resistance (Rl) into airway resistance (Raw) and tissue resistance (Rti) in patients with mild to moderate asthma (baseline FEV1, 54 to 91% of predicted) before and after albuterol inhalation. An optimal ventilator waveform was used to measure Rl and lung elastance (El) in 21 asthmatics from approximately 0.1 to 8 Hz during tidal excursions. Analysis of the Rl and El provided separate estimates of airway and lung tissue properties. Eleven subjects, classified as Type A asthmatics, displayed slightly elevated Rl but normal El. Their data were well described with a model consisting of homogeneous airways leading to viscoelastic tissues before and after albuterol. The other 10 subjects, classified as Type B asthmatics, demonstrated highly elevated Rl and an El that became highly elevated at frequencies above 2 Hz. These subjects required the inclusion of an airway wall compliance in the model prealbuterol but not postalbuterol. This suggests that the Type B subjects were experiencing pronounced constriction in the periphery of the lung, resulting in shunting of flow into the airway walls. Spirometric data were consistent with higher constriction in Type B subjects. Both groups demonstrated significant (p < 0.05) decreases in Raw and tissue damping after albuterol, but tissue elastance decreased only in the Type B group. The percent contributions of Raw and Rti to Rl were similar in both groups and did not change after albuterol. We conclude that in asthma, Raw comprises the majority ( > 70%) of Rl at breathing frequencies. The relative contributions of Raw and Rti to Rl appear to be independent of the degree of smooth muscle constriction.
Frank William Sheffield
Authors: Maurice Philpott
Journal: BMJ (2006)

Former virologist and vaccine investigator London (b 1923; q Liverpool 1946), d 13 October 2005. After a fleeting flirtation with orthopaedics Frank Sheffield became increasingly attracted to laboratory work, particularly in the field of virology. Following national service in the Royal Army Medical Corps he took up a registrar post in Sheffield. Then he migrated to London to work in the Wellcome Laboratories with the late John Beale (obituary BMJ 2006;332: 181) and so became increasingly involved with vaccines. After a period of tutoring at University College he joined the Medical Research Council to investigate vaccine batches that had caused concern. This took up most of his life and he finished his working days at Porton Down involved with the production of vaccines for the armed forces. He leaves a wife, Mu, and two children.​children.




Figure 1
Liver X receptor α and farnesoid X receptor are major transcriptional regulators of OATP1B1
Authors: Henriette E. Meyer zu Schwabedissen, Kerstin Böttcher, Amarjit Chaudhry, Heyo K. Kroemer, Erin G. Schuetz, Richard B. Kim
Journal: Hepatology (2010)

Organic anion transporting polypeptide 1B1 (OATP1B1) is a liver-enriched transporter involved in the hepatocellular uptake of many endogenous molecules and several structurally divergent drugs in clinical use. Although OATP1B1 coding region polymorphisms are known to make an impact on substrate drug disposition in humans, little is known regarding the mechanisms underlying the transcriptional regulation of this transporter. In this study, we note that messenger RNA (mRNA) expression of OATP1B1 in a large human liver bank exhibited marked interindividual variability that was not associated with coding region polymorphisms. Accordingly, we hypothesized that such variability in expression is reflective of nuclear receptor-mediated transcriptional regulation of this transporter. We tested prototypical ligands for the nuclear receptors pregnane X receptor (PXR), constitutive androstane receptor (CAR), liver X receptor (LXR) α, and farnesoid X receptor (FXR) in a human hepatoma-derived cell line and noted induction of OATP1B1 mRNA when the cells were treated with LXRα or FXR ligands. To confirm a direct role for LXRα and FXR to OATP1B1 expression, we performed detailed promoter analysis and cell-based reporter gene assays resulting in the identification of two functional FXR response elements and one LXRα response element. The direct interaction between nuclear receptors with the identified response elements was assessed using chromatin immunoprecipitation assays. Using isolated primary human hepatocytes, we show that LXRα or FXR agonists, but not PXR or CAR agonists, are capable of OATP1B1 induction. Conclusion: We note that OATP1B1 transcriptional regulation is under dual nuclear receptor control through the oxysterol sensing LXRα and the bile acid sensor FXR. Accordingly, the interplay between OATP1B1 and nuclear receptors may play an important and heretofore unrecognized role during cholestasis, drug-induced liver injury, and OATP1B1 induction–related drug interactions. (Hepatology 2010)