tbuckley/cabot-search huggingface dataset:
Incentives to quit smoking in primary care
Authors: Raphaël Bize, Jacques Cornuz
Journal: BMJ (2008)

Spirometry with pictorial feedback on lung age, not just raw data, improves quit rates

In the accompanying randomised controlled trial, Parkes and colleagues assess the effect of telling patients over 35 years of age their estimated spirometric lung age as an incentive to quit smoking.1 Support for conducting the trial comes from a recent Polish observational study on the potential association between smoking cessation and participants’ spirometry results, as communicated using Fletcher and Peto’s diagram (a pictorial representation of how smoking ages the lungs).2 The Polish study showed higher smoking cessation rates at one year in smokers with airway obstruction than in those with normal spirometric parameters. However, the study had no control group without spirometry testing or without feedback on such testing. The authors called for a large randomised controlled trial comparing the effect of providing spirometry results versus no spirometry results on smoking cessation.

In Parkes and colleagues’ trial, participants in the intervention group received comprehensive information about their spirometry results including individualised interpretation, …
Time to Positivity of a Rapid Bedside Assay for Cardiac-Specific Troponin T Predicts Prognosis in Acute Coronary Syndromes: A Thrombolysis in Myocardial Infarction (TIMI) 11A Substudy
Authors: Elliott M. Antman, David B. Sacks, Nader Rifai, Carolyn H. McCabe, Christopher P. Cannon, Eugene Braunwald
Journal: Journal of the American College of Cardiology (1998)
Serum Amyloid A Is a Biomarker of Acute Exacerbations of Chronic Obstructive Pulmonary Disease
Authors: Steven Bozinovski, Anastasia Hutchinson, Michelle Thompson, Lochlan MacGregor, James Black, Eleni Giannakis, Anne-Sophie Karlsson, Roger Silvestrini, David Smallwood, Ross Vlahos, Louis B. Irving, Gary P. Anderson
Journal: American Journal of Respiratory and Critical Care Medicine (2007)

Rationale: Much of the total disease burden and cost of chronic obstructive pulmonary disease (COPD) is associated with acute exacerbations of COPD (AECOPD). Serum amyloid A (SAA) is a novel candidate exacerbation biomarker identified by proteomic screening. Objectives: To assess SAA as a biomarker of AECOPD.Methods: Biomarkers were assessed (1) cross-sectionally (stable vs. AECOPD; 62 individuals) and (2) longitudinally with repeated measures (baseline vs. AECOPD vs. convalescence; 78 episodes in 37 individuals). Event severity was graded (I, ambulatory; II, hospitalized; III, respiratory failure) based on consensus guidelines.Measurements and Main Results: Presumptively newly acquired pathogens were associated with onset of symptomatic AECOPD. In the cross-sectional study, both SAA and C-reactive protein (CRP) were elevated at AECOPD onset compared with stable disease (SAA median, 7.7 vs. 57.6 mg/L; P < 0.01; CRP median, 4.6 vs. 12.5 mg/L; P < 0.01). Receiver operator characteristics analysis was used to generate area-under-curve values for event severity. SAA discriminated level II/III events (SAA, 0.88; 95% confidence interval, 0.80–0.94 vs. CRP, 0.80; 95% confidence interval, 0.70–0.87; P = 0.05). Combining SAA or CRP with major symptoms (Anthonisen criteria, dyspnea) did not further improve the prediction model for severe episodes. IL-6 and procalcitonin were not informative.Conclusions: SAA is a novel blood biomarker of AECOPD that is more sensitive than CRP alone or in combination with dyspnea. SAA may offer new insights into the pathogenesis of AECOPD.
The Healing Power of Listening in the ICU
Authors: Craig M. Lilly, Barbara J. Daly
Journal: New England Journal of Medicine (2007)

Critical care services are highly valued because they can often restore function in patients with acute life-threatening illnesses. In this context, advances in medical science have led to increased expectations for favorable outcomes of episodes of critical illness, even when the patient has severe coexisting chronic disease. The growing demand for critical care has led both to increased numbers of patients who survived with desirable functional outcomes and to increased numbers of patients who die in the intensive care unit (ICU). Today, many deaths in the ICU occur after a decision has been made to discontinue or forgo advanced supportive . . .
Etiology of Ibrutinib Therapy Discontinuation and Outcomes in Patients With Chronic Lymphocytic Leukemia
Authors: Kami J. Maddocks, Amy S. Ruppert, Gerard Lozanski, Nyla A. Heerema, Weiqiang Zhao, Lynne Abruzzo, Arletta Lozanski, Melanie Davis, Amber Gordon, Lisa L. Smith, Rose Mantel, Jeffrey A. Jones, Joseph M. Flynn, Samantha M. Jaglowski, Leslie A. Andritsos, Farrukh Awan, Kristie A. Blum, Michael R. Grever, Amy J. Johnson, John C. Byrd, Jennifer A. Woyach
Journal: JAMA Oncology (2015)

<h3>Importance</h3> The Bruton tyrosine kinase (BTK) inhibitor ibrutinib is effective in patients with chronic lymphocytic leukemia (CLL). Reasons for discontinuing therapy with this drug and outcomes following discontinuation have not been evaluated outside of clinical trials with relatively short follow-up. <h3>Objective</h3> To determine features associated with discontinuation of ibrutinib therapy and outcomes. <h3>Design, Setting, and Participants</h3> A total of 308 patients participating in 4 sequential trials of ibrutinib at The Ohio State University Comprehensive Cancer Center were included. These clinical trials accrued patients included in this analysis from May 2010 until April 2014, and data were locked in June 2014. <h3>Main Outcomes and Measures</h3> Patients were evaluated for time to therapy discontinuation, reasons for discontinuation, and survival following discontinuation. For patients who discontinued therapy because of disease progression, targeted deep sequencing was performed in samples at baseline and time of relapse. <h3>Results</h3> With a median follow-up of 20 months, 232 patients remained on therapy, 31 had discontinued because of disease progression, and 45 had discontinued for other reasons. Disease progression includes Richter’s transformation (RT) or progressive CLL. Richter’s transformation appeared to occur early and CLL progressions later (cumulative incidence at 12 months, 4.5% [95% CI, 2.0%-7.0%] and 0.3% [95% CI, 0%-1.0%], respectively). Median survival following RT was 3.5 months (95% CI, 0.3-6.0 months) and 17.6 months (95% CI, 4.7 months–“not reached”) following CLL progression. Sequencing on peripheral blood from 8 patients with RT revealed 2 with mutations in<i>BTK</i>, and a lymph node sample showed no mutations in<i>BTK</i>or<i>PLCG2</i>. Deep sequencing on 11 patients with CLL progression revealed<i>BTK</i>or<i>PLCG2</i>mutations in all. These mutations were not identified before treatment in any patient. <h3>Conclusions and Relevance</h3> This single-institution experience with ibrutinib confirms it to be an effective therapy and identifies, for the first time, baseline factors associated with ibrutinib therapy discontinuation. Outcomes data show poor prognosis after discontinuation, especially for those patients with RT. Finally, sequencing data confirm initial reports associating mutations in<i>BTK</i>and<i>PLCG2</i>with progression and clearly show that CLL progressions are associated with these mutations, while RT is likely not. <h3>Trial Registrations</h3> clinicaltrials.gov Identifiers:NCT01105247,NCT01217749,NCT01589302, andNCT01578707
The role of the cellular antioxidant defense in oxidant carcinogenesis.
Authors: P Cerutti, R Ghosh, Y Oya, P Amstad
Journal: Environmental Health Perspectives (1994)

Oxidant carcinogens interact with multiple cellular targets including membranes, proteins, and nucleic acids. They cause structural damage to DNA and have the potential to mutate cancer-related genes. At the same time, oxidants activate signal transduction pathways and alter the expression of growth- and differentiation-related genes. Indeed, the carcinogenic action of oxidants results from the superposition of these genetic and epigenetic effects. All cells possess elaborate antioxidant defense systems that consist of interacting low and high molecular weight components. Among them, superoxide dismutases (SOD), glutathione peroxidases (GPx), and catalase (CAT) play a central role. Our studies with mouse epidermal cells demonstrate that the balance between several antioxidant enzymes rather than the activity of a single component determines the degree of protection. Unexpectedly, increased levels of Cu,Zn-SOD alone in stable transfectants resulted in sensitization to oxidative chromosomal aberrations and DNA strand breaks. However, a concomitant increase in CAT or GPx in double transfectants corrected or overcorrected the hypersensitivity of the SOD clones depending on the ratios of activities CAT/SOD or GPx/SOD. The cellular antioxidant capacity also affected oxidant induction of the growth-related immediate early protooncogene c-fos. Increases in CAT or SOD reduced the accumulation of c-fos message, albeit for different reasons. The cellular antioxidant defense also affects the action of UVB light (290-320 nm) that represents the most potent carcinogenic wavelength range of the solar spectrum. UVB light is known to exert its action in part through oxidative mechanisms. Increases in CAT and GPx protected mouse epidermal cells from UVB-induced DNA breakage.(ABSTRACT TRUNCATED AT 250 WORDS)
Adverse Reactions (AR) during milk Oral Immunotherapy (mOIT) and its Relationship with specific IgE (sIgE) in 105 Milk-allergic Patients
Authors: S. Sanchez-Garcia, C. Escudero, P. Rodriguez del Rio, C. Garcia-Fernandez, C. Ortega-Casanueva, A. Lopez-Torrijos, M.D. Ibañez
Journal: Journal of Allergy and Clinical Immunology (2011)
Dr. Jared Kirtland and His Warbler
Authors: G. Edmund Gifford
Journal: New England Journal of Medicine (1972)

EVERY bird watcher in the United States worth his salt knows about Kirtland's warbler or "jack-pine warbler," even though few have seen it. It is a rare bird (less than 1000), which nests only in the northern part of the lower peninsula of Michigan and nowhere else. The nesting area, 160 km long and 96.5 km wide, is restricted to tracts densely covered with small jack-pine, Pinus bankstana, 1.5 to 5.5 meters high, with ground cover of blueberry, bearberry, and sweet fern.1 2 3 4 Kirtland's warbler first became known to science when Spencer Fullerton Baird (1823–1887), "the best informed man of . . .
Immunhistochemistry by Means of Widely Agreed-Upon Markers (Cytokeratins 5/6 and 7, p63, Thyroid Transcription Factor-1, and Vimentin) on Small Biopsies of Non-small Cell Lung Cancer Effectively Parallels the Corresponding Profiling and Eventual Diagnoses on Surgical Specimens
Authors: Giuseppe Pelosi, Giulio Rossi, Fabrizio Bianchi, Patrick Maisonneuve, Domenico Galetta, Angelica Sonzogni, Giulia Veronesi, Lorenzo Spaggiari, Mauro Papotti, Mattia Barbareschi, Paolo Graziano, Andrea Decensi, Alberto Cavazza, Giuseppe Viale
Journal: Journal of Thoracic Oncology (2011)
Acute rejection of non-functional allograft in kidney transplant recipients with hepatitis C treated with peginterferon alpha-2a: Reply
Authors: Maria Rendina, Antonio Francavilla, Antonio Schena, Francesco Paolo Schena
Journal: Journal of Hepatology (2008)

We have read very carefully the Letter to the Editor by Dr. Sperl and collegues and the answers to the questions they raised are provided below:1.In our series, of the 19 haemodialysed patients, who had previously been transplanted, 14 had retained the graft in situ. Five patients, before treatment, had already been submitted to graftectomy on account of symptoms such as, for example, acute rejection which occurred after a mean time of 3–7 months after graft failure. As far as concerns immunosuppressive treatment, the policy in our centre is to stop Calcineurin inhibitors and to taper steroids within 3 months of graft failure. Our patients received anti-viral treatment only after a mean period of 12–36 months after graft failure.2.In the series described by Dr. Sperl, interferon treatment was started very early after graft loss (i.e., 4 and 8 months) and no information is provided regarding either immunosuppressive treatment or the immunological background of the two patients. We chose to start treatment after a period of clinical and immunological stabilisation (>12 months after restarting dialysis) on the basis of previous experience showing that most cases of rejection occurred before this time interval. With regard to the rate of side-effects, this may be due to the fact that a high dose of interferon was used by the authors, while ribavirin was avoided in most cases. Conversely, and as reported in our paper, we carefully assessed the type and dosage of pegylated interferon (i.e., peginterferon alpha-2a, 135 μg/weekly) due to the presence of chronic renal failure and individually tailored the dosage of ribavirin to avoid even more severe anaemia which was controlled by administration of erythropoietin. This strategy resulted in a strong anti-viral effect and avoided, in most instances, major side-effects and, probably, also rejection. To better define the use of graftectomy, further studies, on a larger series, are necessary focusing on comparisons between the rejection rates in patients receiving interferon and those not receiving interferon. On the basis of our experience and available data, anti-viral treatment should, in our opinion, be delayed until 12 months after graft loss. We wish to thank Dr. Sperl who gave us the opportunity to emphasize these points which complete our results and would, no doubt, contribute to improving the pharmacological approach with pegylated interferon and ribavirin in this particular category of patients.
Effect of low dose nebulised morphine on exercise endurance in patients with chronic lung disease.
Authors: I H Young, E Daviskas, V A Keena
Journal: Thorax (1989)

Low dose nebulised morphine may relieve dyspnoea through a direct effect on lung afferent nerves. To study this further 11 adult patients with advanced chronic lung disease (FEV1 range 0.4-1.41), whose exercise endurance was limited by dyspnoea, were entered into a double blind, randomised, crossover study in which low dose morphine or a placebo was inhaled. The effects were assessed by an endurance exercise test at 80% of maximum work load. One hour after a control endurance test patients inhaled 5 ml of morphine 1 mg/ml or isotonic saline for 12 minutes from a jet nebuliser. An endurance exercise test was repeated 15 minutes later and change in endurance time recorded. The two endurance tests were repeated on a separate day, before and after inhalation of the alternative solution. In all tests 100% oxygen was inhaled from a demand valve. The mean (SD) increase in endurance time was significantly greater after the subjects had inhaled morphine (64.6 (115) s, 35%) than after placebo (8.9 (55) s, 0.8%; p less than 0.01). The mean dose of morphine nebulised was 1.7 (0.66) mg, giving a mean inhaled dose of about 0.6 mg, on the assumption of 30% retention of the nebulised dose by each patient. No side effects were reported. Possibly small amounts of morphine delivered to the lungs act directly on lung afferent nerves to reduce dyspnoea.
A rabbit model to tissue engineer the bladder
Authors: J.E. Nuininga, H.van Moerkerk, A. Hanssen, C.A. Hulsbergen, J. Oosterwijk-Wakka, E. Oosterwijk, R.P.E. de Gier, J.A. Schalken, T.H.van Kuppevelt, W.F.J. Feitz
Journal: Biomaterials (2003)
TCT-248 Immediate Stenting in Comparison with Surgical Revascularization Strategy in Patients with Non-ST Elevation Acute Coronary Syndrome and Multivessel Coronary Artery Disease - The MILESTONE Registry.
Authors: Piotr P. Buszman, Andrzej Bochenek, Marek Gierlotka, Mariusz Gasior, R. Stefan Kiesz, Krzysztof P. Milewski, Wojciech Wojakowski, Marian Zembala, Lech Polonski, Buszman E. Pawel
Journal: Journal of the American College of Cardiology (2013)
Rifaximin Improves Systemic Hemodynamics and Renal Function in Patients With Alcohol-Related Cirrhosis and Ascites
Authors: Georgios N. Kalambokis, Athanasia Mouzaki, Maria Rodi, Konstantinos Pappas, Andreas Fotopoulos, Xanthi Xourgia, Epameinondas V. Tsianos
Journal: Clinical Gastroenterology and Hepatology (2012)
Analysis of NUP98/NSD1 translocations in adult AML and MDS patients
Authors: F Thol, B Kölking, I H I Hollink, F Damm, M M van den Heuvel-Eibrink, C Michel Zwaan, G Bug, O Ottmann, K Wagner, M Morgan, W K Hofmann, G Göhring, B Schlegelberger, J Krauter, A Ganser, M Heuser
Journal: Leukemia (2012)
Charities and rock stars join forces to tackle world poverty
Authors: Lynn Eaton
Journal: BMJ (2005)

Rich countries should increase aid and make it work better for poor people, cancel world debt, and change the rules of world trade so that they favour the interests of the poor. That was the new year's message to Britain's prime minister, Tony Blair, from a coalition of more than 100 UK charities, trades unions, and campaigners, including rock and pop stars.

Their Make …
P151 Can The Decaf Score Be Used To Guide Prognosis After An Acute Admission For Copd Exacerbation?
Authors: B. Rabbani, P. Brammer
Journal: Thorax (2014)

<h3>Introduction</h3> Each year chronic obstructive pulmonary disease (COPD) causes approximately 23,000 deaths in England. Patients are admitted daily with exacerbation of COPD which can often be life-threatening. Steer <i>et al</i> have shown the use of DECAF score to predict inpatient mortality in COPD exacerbation. The DECAF score stratifies patients into low, intermediate and high risk dependant on their admission score. <h3>Aim</h3> The aim of our study was to further evaluate the accuracy of DECAF score as a prognostic tool for patients admitted with exacerbation of COPD. <h3>Method</h3> A retrospective review of notes of patients admitted with COPD exacerbations between December 2012 and January 2013 was undertaken. The data collected was used to determine the DECAF score which was compared to inpatient mortality, 30 days post-discharge mortality, usage of NIV and readmission within 3 months. <h3>Results</h3> 159 patient notes were reviewed. 62.3% were classified as low risk according to DECAF score, with a 4.0% inpatient mortality. 22% were intermediate risk with 2.6% inpatient deaths. 15.7% of the patients were high risk, out of which 40% died as an inpatient. In addition, high DECAF score showed increased risk of 30 days post discharge mortality with 33.3% deaths in high risk patients (Table 1). The DECAF score did not predict the use of NIV. There was however a trend towards increasing use of NIV with higher DECAF score. 90 day readmission data showed similar patterns between risk groups based on DECAF score. <h3>Conclusion</h3> Our study showed that high DECAF score is a strong predictor of inpatient and 30 day mortality in patients admitted with COPD exacerbation. A high DECAF score did not predict the need for NIV and it did not appear useful in predicting readmission over a 3 months period. The use of DECAF score in clinical settings would help guide physicians to risk stratify patients, to plan management and to determine whether patients are cared for in high dependency unit, respiratory or a general ward. It may be useful in guiding levels of support for patients by community teams on discharge to prevent adverse events.
Mid Staffordshire lawyers say they withheld report from coroner to protect trust
Authors: C. Dyer
Journal: BMJ (2011)

Two former senior members of the legal team at Mid Staffordshire NHS Foundation Trust have defended their failure to disclose to the local coroner a damning consultant’s report on the death of a patient who, it later emerged, had died from an undiagnosed ruptured spleen.

The accident and emergency consultant Ivan Phair concluded in his report that 20 year old John Moore-Robinson’s death might have been avoided and could have been caused by a junior doctor’s negligence in failing to carry out a proper examination. Mr Moore-Robinson, who had been injured in a mountain bike accident, was seen at Stafford Hospital in April 2006 but was sent home and died a day later in another hospital. …
Effects of Dietary Protein on Renal Disease
Authors: Nirav Shah
Journal: Annals of Internal Medicine (1997)

Letters15 February 1997Effects of Dietary Protein on Renal DiseaseNirav Shah, AB, Ralph I. Horwitz, MD, and John Concato, MD, MS, MPHNirav Shah, ABYale University School of Medicine, West Haven Veterans Affairs Medical Center, New Haven, CT 06520-8025Search for more papers by this author, Ralph I. Horwitz, MDYale University School of Medicine, West Haven Veterans Affairs Medical Center, New Haven, CT 06520-8025Search for more papers by this author, and John Concato, MD, MS, MPHYale University School of Medicine, West Haven Veterans Affairs Medical Center, New Haven, CT 06520-8025Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-4-199702150-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The recent meta-analysis of low-protein diets in diabetic and nondiabetic renal disease by Pedrini and colleagues [1] contains examples of three limitations of meta-analysis in clinical medicine. First, the criteria used for study selection were inconsistent. For nondiabetic nephropathy, the meta-analysis included only randomized trials that had end points of end-stage renal disease or death. The meta-analysis of diabetic nephropathy, however, included two observational studies, and only one of three randomized trials used intention-to-treat analysis. In addition, the studies of diabetic nephropathy used surrogate outcomes of glomerular filtration rate, urinary albumin excretion rate, and creatinine clearance. Thus, ...REFERENCE1. Pedrini MT, Levey AS, Lau J, Chalmers TC, Wang PH. The effect of dietary protein restriction on the progression of diabetic and nondiabetic renal diseases: a meta-analysis. Ann Intern Med. 1996; 124:627-32. Google Scholar Author, Article, and Disclosure InformationAuthors: Nirav Shah, AB; Ralph I. Horwitz, MD; John Concato, MD, MS, MPHAffiliations: Yale University School of Medicine, West Haven Veterans Affairs Medical Center, New Haven, CT 06520-8025 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDiabetic NephropathyDiabetic NephropathyDiabetic NephropathyEffect of dietary protein restriction on prognosis in patients with diabetic nephropathy 15 February 1997Volume 126, Issue 4 Page: 331 Keywords Creatinine Diet Excretion Intent to treat analysis Observational studies Proteins Randomized trials Renal diseases Renal failure Serum proteins ePublished: 15 August 2000 Issue Published: 15 February 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Neural correlates of attention in primate visual cortex
Authors: Stefan Treue
Journal: Trends in Neurosciences (2001)

The processing of visual information combines bottom-up sensory aspects with top-down influences, most notably attentional processes. Attentional influences have now been demonstrated throughout visual cortex, and their influence on the processing of visual information is profound. Neuronal responses to attended locations or stimulus features are enhanced, whereas those from unattended locations or features are suppressed. This influence of attention increases as one ascends the hierarchy of visual areas in primate cortex, ultimately resulting in a neural representation of the visual world that is dominated by the behavioral relevance of the information, rather than designed to provide an accurate and complete description of it. This realization has led to a rethinking of the role of areas that have previously been considered to be 'purely sensory'.
Hyperkalemia Due to Nafamostat Mesylate
Authors: Hirochika Kitagawa, Hangil Chang, Toshiro Fujita
Journal: New England Journal of Medicine (1995)

To the Editor: Nafamostat mesylate (6-amidino-2-naphthyl p-guanidinobenzoate, dimethanesulfonate; molecular weight, 540) is a synthetic serine protease inhibitor that is widely used to treat acute ...