tbuckley/cabot-search huggingface dataset:
P198 Establishing the palliative and supportive care needs of patients with Idiopathic Pulmonary Fibrosis and Non Specific Interstitial Pneumonia: Abstract P198 Table 1.
Authors: J Wall, V Crosby, A Hussain, A Wilcock, G Saini, R Braybrooke, G Jenkins
Journal: Thorax (2013)

<h3>Background</h3> Idiopathic Pulmonary Fibrosis (IPF) and Non Specific Interstitial Pneumonia (NSIP) are Idiopathic Interstitial Lung Diseases (ILD) without a known cure. IPF is progressive and fatal. Management of Idiopathic ILD must address patients’ palliative and supportive care needs. The Sheffield Profile for Assessment and Referral to Care (SPARC©) questionnaire is a health needs assessment tool covering common biological, psychological and social needs. Local use of SPARC led to service refinements for thoracic cancer patients. We now explore SPARC in patients with Idiopathic ILD to identify patients’ perceptions of disease burden. <h3>Methods</h3> Patients within 18 months of an Idiopathic ILD diagnosis, identified through specialist clinics, were invited to complete a SPARC questionnaire as part of an ongoing multicentre clinical study. Patients were excluded if concerns existed regarding ability to consent. SPARC questionnaires included 45 questions: four (concerning personal, communication and information issues) required “yes/ no” responses. 41 questions related to symptoms and issues which were rated by patients as to the degree of distress they’d caused in the preceding month. Ratings were 0 “not at all”, 1 “a little bit”, 2 “quite a bit” and 3 “very much”. Responses were analysed using descriptive statistics. To highlight the most troubling issues, the percentage of patients reporting either “very much” or “quite a bit” of distress was identified for each question. <h3>Results</h3> 97 patients with Idiopathic ILD (77 male) with median age 69 (range 47- 86) were included. 79 (81%) had IPF, 18 (19%) NSIP. 38 (39%) had severe lung function defects (TLCO &lt;40%). Table 1 shows the 20 most common issues reported to cause “quite a lot” or “very much” distress. <h3>Conclusions and implications</h3> Symptoms causing highest levels of distress in the Idiopathic ILD group reflect the commonly observed 9fibrotic triad9 of dyspnoea, fatigue and cough. Surprisingly concerns with dry mouth, sleep and effect on sexual life were also in the ‘top 10’ of distressing issues: further investigation into these is suggested. Utilisation of SPARC can highlight troublesome issues experienced by patients with Idiopathic Interstitial Lung Diseases. Addressing these concerns, which may have been otherwise unrecognised, can guide best supportive care.
Obesity as an Adverse Prognostic Factor for Patients Receiving Adjuvant Chemotherapy for Breast Cancer
Authors: Jorge Bastarrachea
Journal: Annals of Internal Medicine (1994)

Objective: To determine whether obesity is an independent prognostic factor among women receiving adjuvant chemotherapy for lymph node–positive breast cancer and to determine how obesity relates to other commonly used prognostic indicators. Design: Retrospective review of the clinical characteristics and clinical course of 735 patients with stages II and III primary breast cancer who were treated using three consecutive postoperative adjuvant chemotherapy protocols. Univariate and multivariate analyses were used to determine the prognostic implications of obesity defined by weight and height tables and body mass index. In addition, we analyzed the relation between obesity and other known prognostic indicators for patients with primary breast cancer. Setting: A comprehensive cancer center. Patients: 735 patients with lymph node–positive primary breast cancer who were treated using three consecutive fluorouracil-doxorubicin-cyclophosphamide-containing adjuvant chemotherapy protocols and for whom complete data on weight, height, standard prognostic factors, and outcome were available. Main Outcome Measurements: Disease-free and overall survival for the entire group and obese and nonobese subgroups. Results: 24 percent of patients were more than 20% overweight. With a median follow-up of 10.7 years, the estimated 10-year, disease-free rate for patients not more than 20% overweight was 54% (95% CI, 50% to 58%) compared with 40% (CI, 33% to 47%) for remaining patients classified as obese. Although obese patients tended to have somewhat less favorable prognoses based on standard prognostic criteria, a proportional-hazards regression model adjusting for other factors indicated that risk for disease recurrence among obese patients was 1.33 times that of the nonobese population (CI, 1.05 to 1.68). Conclusions: Obesity is an indicator of poor prognosis for patients with primary breast cancer even after the administration of adjuvant chemotherapy. The effect of dietary interventions to reduce body weight on the outcome of breast cancer therapy must be investigated.
Behavioral Counseling Interventions to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults: U.S. Preventive Services Task Force Recommendation Statement
Authors: Virginia A. Moyer
Journal: Annals of Internal Medicine (2012)

Update of the 2003 and 2002 U.S. Preventive Services Task Force (USPSTF) recommendation statements on behavioral counseling to promote a healthful diet and physical activity in adults without preexisting cardiovascular disease (CVD) or its risk factors.The USPSTF reviewed new evidence on whether counseling interventions relevant to primary care for physical activity or a healthful diet modify self-reported behaviors; intermediate physiologic outcomes (for example, reduced lipid levels, blood pressure, weight, and body mass index and increased glucose tolerance); and cardiovascular morbidity and mortality in adults without known CVD, hypertension, hyperlipidemia, or diabetes.General adult population without a known diagnosis of hypertension, diabetes, hyperlipidemia, or CVD.Although the correlation among healthful diet, physical activity, and the incidence of CVD is strong, existing evidence indicates that the health benefit of initiating behavioral counseling in the primary care setting to promote a healthful diet and physical activity is small. Clinicians may choose to selectively counsel patients rather than incorporate counseling into the care of all adults in the general population. Issues to consider include other risk factors for CVD, a patient's readiness for change, social support and community resources that support behavioral change, and other health care and preventive service priorities. Harms may include the lost opportunity to provide other services that have a greater health effect. This is a grade C recommendation.
Histidine for Treatment of Uraemic Anaemia
Authors: C. Giordano, N. G. De Santo, S. Rinaldi, D. Acone, R. Esposito, B. Gallo
Journal: BMJ (1973)

A group of 28 uraemic patients on dialysis treatment were given daily supplements of histidine by mouth. Plasma amino-acid concentration, plasma iron, serum transferrin, packed cell volume, and reticulocyte count were all measured before and after two months of histidine supplementation. The treatment raised the plasma histidine concentration and at the same time there was a rise in transferrin and iron levels and packed cell volume. Reticulocyte counts fell after two months of histidine supplementation.
USEFULNESS OF SOLUBLE FMS-LIKE TYROSINE KINASE 1 AS A BIOMARKER OF ACUTE AND CHRONIC PHASE OF CORONARY ARTERY DISEASE
Authors: Shiro Uemura, Kenji Onoue, Ken-ichi Ishigami, Satoshi Somekawa, Tsuneari Soeda, Satoshi Okayama, Hiroyuki Kawata, Manabu Horii, Yoshihiko Saito
Journal: Journal of the American College of Cardiology (2010)
Birth Order Effect on the Prevalence of Childhood Allergy: Comparisons among Different Allergic Diseases
Authors: T. Kusunoki, K. Mukaida, T. Morimoto, M. Sakuma, N. Mito, T. Yasumi, R. Nishikomori, T. Fujii, T. Heike
Journal: Journal of Allergy and Clinical Immunology (2011)
A prospective randomized study of the clinical efficacy and safety of transvenous cardioversion for termination of ventricular tachycardia.
Authors: J M Ciccone, S Saksena, Y Shah, D Pantopoulos
Journal: Circulation (1985)

The clinical efficacy and safety of transvenous cardioversion for termination of sustained ventricular tachycardia (VT) were examined by a prospective randomized study design in 22 patients (19 men, three women; mean age 64 +/- 9 years) with organic heart disease and sustained VT. Patients were randomly assigned to undergo an incremental low-energy protocol from 0.03 to 2.2 J (group A, 11 patients) or an incremental high-energy protocol from 0.5 to 10.0 J (group B, 11 patients). Transvenous cardioversion was performed during electrophysiologic studies in the control (drug-free) state and during serial antiarrhythmic drug testing in all patients. Both groups were comparable for demographic, disease and functional status, and electrophysiologic parameters. A total of 77 episodes of VT (group A, 45; group B, 32) were analyzed. The overall efficacy of transvenous cardioversion for termination of VT was 62% (group A 56% vs group B 72%; p less than .01). Antiarrhythmic drug therapy did not significantly enhance efficacy of transvenous cardioversion (control 59% vs drug 65%; p greater than .2). Stepwise discriminant analysis correlated successful transvenous cardioversion with longer VT cycle length (p less than .0005), higher energy (p less than .025), lower energy waveform tilt (p less than .025), shorter time to initial cardioversion attempt (p less than .025), and shorter QRS duration in sinus rhythm (p less than .05). Acceleration of VT was frequent (8% incidence per delivered shock). Thirty-one percent of all incremental shock protocols were terminated because of this complication. After cardioversion, transient arrhythmias were common (bradyarrhythmias 23%, supraventricular tachyarrhythmias 12%). Displacement of electrode catheters after transvenous cardioversion was uncommon (3%).(ABSTRACT TRUNCATED AT 250 WORDS)
Changes in Glutamate Receptors on Synaptic Membranes Associated with Hepatic Encephalopathy or Hyperammonemia in the Rabbit
Authors: Peter Ferenci, Chris S. Pappas, Peter J. Munson, Anthony E. Jones
Journal: Hepatology (1984)

The status of the excitatory glutamatergic neurotransmitter system in hepatic encephalopathy has been studied. Synaptic membranes (SM) were prepared from the brains of normal rabbits, hyperammonemic normal rabbits, and rabbits with fulminant hepatic failure. Data on the specific binding of glutamate to SM indicated that fulminant hepatic failure was associated with a decrease in the number of glutamate receptors on SM from cerebral cortex, cerebellum, and particularly the hippocampus, without any associated change in the affinity of these receptors. In contrast, hyperammonemia was associated with an increase in the affinity and no decrease in the number of glutamate receptors on SM from the hippocampus. These findings indicate that the effects of hyperammonemia and fulminant hepatic failure on cerebral glutamate receptors are fundamentally different. The decreased number of glutamate receptors in hepatic encephalopathy might reflect a decreased sensitivity of glutamatergic neurons to glutamate-mediated neural excitation, a phenomenon that could contribute to the neural inhibition of hepatic encephalopathy.
Treatment of the Terminally III-Reply
Authors: John A. Beall
Journal: JAMA (1983)

<h3>In Reply.—</h3> Mr Fish, as an attorney, has responded in typical legalistic fashion to a situation that would be almost impossible to legislate. It is apparent that Mr Fish has missed the thrust of my essay. It specifically refers to the terminally ill<i>cancer</i>patient! It is regrettable that the tempering of overaggressive therapy cannot be exercised by members of the medical profession without adversarial legalistic elements. There will always be a difference of opinion in the decisions over whether to offer conservative<i>v</i>aggressive treatment. From the personal communications that I have received in response to my essay, I can report that many physicians and others have expressed themselves in commending an<i>appeal</i>for more conservatism and for more consideration of the practice of the art of medicine. The terminally ill and devastated patient with cancer deserves merciful supportive therapy and not a prolongation of his wretched state by
Diagnostic accuracy of digital chest radiography for pulmonary tuberculosis in a UK urban population
Authors: I. Abubakar, A. Story, M. Lipman, G. Bothamley, R. van Hest, N. Andrews, J. M. Watson, A. Hayward
Journal: European Respiratory Journal (2010)

lymphoid follicles [7].Furthermore, the significantly higher pulmonary Treg cell numbers in air-and CS-exposed CCR7 -/- mice correlated with a stronger abundance of lymphoid follicles, compared with WT animals (fig.1b and [7]).In contrast, baseline and chronic CS-induced Treg cell accumulation were severely compromised in lymph nodes of CCR7 -/- mice compared to WT controls (fig.1c).Our study provides evidence that CS exposure induces increased Treg cell numbers, first in the lung and secondly in the lymph node compartment.Whereas CCR7 is crucial for the homing of Treg cells to the lymph nodes, it is ultimately not required for the chronic CS-induced accumulation of these cells in the lung.However, we can not differentiate whether the observed CS-induced Treg increase results from the recruitment of natural Treg cells as opposed to the local induction of Treg cells from precursors.The methylation status of the FOXP3 promoter is generally considered to discriminate between natural and induced Treg cells.Further translational research is needed to elucidate the functional role of lymphoid follicles and Treg cells in the pathogenesis of COPD, for instance by determining the contribution of natural committed Treg cells versus induced Treg cells in pulmonary lymphoid follicles and lymph nodes.
Combined influence of ventricular loading and relaxation on the transmitral flow velocity profile in dogs measured by Doppler echocardiography.
Authors: C Y Choong, V M Abascal, J D Thomas, J L Guerrero, S McGlew, A E Weyman
Journal: Circulation (1988)

The relation of the Doppler transmitral flow velocity profile to left ventricular loading conditions and diastolic properties remains poorly described. We studied seven adult mongrel dogs with an open-chest right heart bypass model in which left atrial pressure, representing preload, was varied by controlling blood flow into the pulmonary artery and left ventricular systolic pressure, representing afterload, was controlled independently by pumping blood into or from the femoral arteries. Heart rate was kept constant by crushing the sinus node and pacing the right atrium. Mitral inflow velocity profiles were measured by pulsed-wave Doppler echocardiography at multiple left atrial and left ventricular systolic pressures. In individual dogs, the peak E-wave velocity increased linearly with increasing left atrial V-wave pressure at constant left ventricular systolic pressure and decreased with increasing left ventricular systolic pressure at constant left atrial pressure. Stepwise multiple linear regression analysis of data pooled from all experimental stages in all dogs identified left atrial V-wave pressure, the time constant of relaxation (TL), and left ventricular systolic pressure, in order of decreasing significance, as predictors of the peak E-wave velocity (n = 82, multiple r = 0.87, p less than 0.0001). Multivariate analysis with the same three factors in individual dogs yielded higher r values (mean r = 0.89; range, 0.85-0.97), suggesting the presence of important interdog differences that were not accounted for by these three factors alone. When the values of codeterminant hemodynamic factors were kept within narrower limits, correlations between peak E-wave velocity and left atrial V-wave pressure (n = 35, multiple r = 0.83, p less than 0.0001), TL (n = 76, multiple r = -0.54, p less than 0.0001) and left ventricular systolic pressure (n = 20, multiple r = -0.59, p less than 0.005) improved substantially. In the pooled data, the relation of the peak E-wave velocity to left atrial V-wave pressure was shifted downward by an increase in TL (reduced relaxation rate), and the relation of the peak E-wave velocity to TL was shifted upward by an increase in left atrial V-wave pressure. Multivariate analysis also selected left atrial V-wave pressure and TL as the two most significant correlates of the velocity-time integral and deceleration rate of the E wave.(ABSTRACT TRUNCATED AT 400 WORDS)
Hitting the Preacher Below the Belt?
Authors: James Basil Hall
Journal: JAMA (1976)

To the Editor.—  Our minister occasionally organizes and directs world travel tours. He often insists that  make one of the trips with them.   have told him that such trips simply were not for me for  knew that  would find myself spending much of my time advising and treating some of the group (their average age is around 70).  He approached me again last week and assured me that their medical needs would be no problem, and attempting to add the clincher said, they have spiritual problems all the time and it never interferes with my enjoyment—why we have group prayer meetings and, individually,  pray for them often. See, your situation would be no different from mine.  Thus backed into a corner,  came up with the only rejoinder that  could think of at the time. Preacher,  argued, I believe that there is one
Treatments for heavy menstrual bleeding
Authors: A. Lethaby
Journal: BMJ (2003)

Guidelines improve prescribing practice but may not affect hysterectomy rates 

Heavy menstrual bleeding is a common cause of iron deficiency anaemia and may affect a woman's quality of life. Thirty per cent of women consider their menstruation to be excessive.w1 In more than half of women with menorrhagia no obvious cause for the bleeding is found, and in at least half of those who undergo hysterectomies in the United Kingdom heavy menstrual bleeding is the main presenting problem.w2 Concern has been expressed that unnecessary surgery is being performed, and treatment of this common condition is not appropriate and evidence based.1

One difficulty with the available research is that the focus has been on trying accurately to measure blood loss as a response to treatment. There are problems with this approach. Firstly, there is a large discrepancy between women's perception of their menstrual loss and accurate measurement of the blood flow. For example, only about half of women complaining of heavy menstrual bleeding have a menstrual loss greater than 80 ml per cycle, which is the cut-off for a clinical diagnosis of heavy menstrual bleeding.2 Secondly, the current gold standard for measuring menstrual blood loss is a modification of the alkaline haematin technique,3 but this …
Rapid Medical Relief — Project Medishare and the Haitian Earthquake
Authors: Enrique Ginzburg, William W. O'Neill, Pascal J. Goldschmidt-Clermont, Eduardo de Marchena, Daniel Pust, Barth A. Green
Journal: New England Journal of Medicine (2010)

On the evening of January 12, 2010, a few hours after the Haitian earthquake, the leaders of Project Medishare in Miami began contacting Haitian associates, faculty and staff of the Miller School of Medicine at the University of Miami, and owners of small private jets in southern Florida. Project Medishare is a nonprofit nongovernmental organization created in 1995. Given our geographic proximity to Haiti and our 15-year relationship with Haitian physicians through Project Medishare, we were able to offer emergency medical relief and provide medical staff within 20 hours after the earthquake. A five-person team of medical relief workers arrived . . .
Location of mutations within the PKD2 gene influences clinical outcome
Authors: Nick Hateboer, Barbera Veldhuisen, Dorien Peters, Martijn H. Breuning, José L. San-Millán, Nadja Bogdanova, Eliecer Coto, Marjan A.V. Dijk, Ali R. Afzal, Steve Jeffery, Anand K. Saggar-Malik, Roser Torra, Dimitar Dimitrakov, Isabel Martinez, Saturnino Sanz de Castro, Michael Krawczak, David Ravine
Journal: Kidney International (2000)
Virtues of Freedom
Authors: Edward R. Annis
Journal: JAMA (1963)

FIVE PHYSICIANS signed the Declaration of Independence. That historic document outlined the virtues of freedom and established a background of principle for our Constitution—a constitution of laws wherein free men have the right to work and to achieve, to plan and to accomplish—with horizons limited only by a recognition of the rights of others, ana Dy dedication to tne fundamental principles of truth, justice, and honor.  In a society of free men understanding is necessary. To play our role in society effectively we in medicine must give a continuing explanation of our aims and objectives, our policies, and our actions on the many issues which affect our patients, the American people.  As a student in school I was taught that always in times of crisis, and frequently at other times, it is wise for every human being to retreat into himself, to pause in his regular activities and to ask
Termination from Medi-Cal — Does It Affect Health?
Authors: Nicole Lurie, Nancy B. Ward, Martin F. Shapiro, Robert H. Brook
Journal: New England Journal of Medicine (1984)

To control rising health-care costs, California enacted legislation in 1982 that eliminated its Medicaid program (Medi-Cal) for its 270,000 medically indigent adults.1 Medically indigent adults are Medi-Cal recipients aged 21 to 65 who received state Medi-Cal benefits because they were poor and medically needy but were not eligible for federal assistance programs such as those for the aged, blind, or disabled or for families with dependent children. Although states are not required to provide health benefits to medically needy or medically indigent residents, 30 states provide some form of benefits as optional features of their Medicaid programs.2 In California, responsibility . . .
Maternal and Child Health Practices: Problems, Resources, and Methods of Delivery
Authors: Audrey F. Manley
Journal: JAMA (1984)

The purpose of this book is to present a complete and comprehensive assessment of modern maternal and child health practices. Topics covered are the scope of maternal and child health, including a historical perspective from about 1890; the organization of and legislative base for federal programs, trends, and demography; the services provided for maternal care, perinatal care, the young child, the adolescent, and handicapped children in the United States; and maternal and child health practices in developing countries.  The book is appropriate as a textbook for courses in maternal and child health at the undergraduate level for students majoring in medical care administration or at the graduate level for physicians, nurses, social workers, nutritionists, public health professionals, and other health professionals interested in maternal and child health or other types of administration. Tables for reporting data are liberally used throughout the book. The material is presented in a logical, well-organized