tbuckley/cabot-search huggingface dataset:
99mTechnetium-labelled neutrophil scanning in pneumonia
Authors: P Ruparelia, K Szczepura, C Summers, A M Peters, E R Chilvers
Journal: Thorax (2008)

A 70-year-old man with severe smoking-related chronic obstructive pulmonary disease (COPD) was recruited to a research study to examine the trafficking of 99m-technetium (99mTc)-labelled neutrophils. These studies were undertaken in patients with stable moderate to severe COPD and designed to establish novel methodology (using autologous 99mTc-labelled neutrophils and single photon emission computed tomography (SPECT)) to quantify neutrophil trafficking and accumulation within the lungs of patients with COPD. At the time of scanning he was clinically stable with a C-reactive …
Histocompatibility antigens in black patients with essential hypertension.
Authors: R Patel, J Johnson
Journal: Circulation (1981)

Essential hypertension is a common disorder with potentially life-threatening sequelae. Hypertension among black persons may have characteristics different from hypertension among white persons. It has been estimated that up to 60% of population variance in blood pressure may be attributable to genetic differences. We studied the distribution of HLA antigens in 100 black hypertensives and 100 normotensive controls. Hypertension was not significantly associated with any of the 25 HLA antigens identified. We conclude that HLA-A and HLA-B locus antigens are not associated with essential hypertension in the black patient.
A rare cause of abdominal pain, diarrhoea and GI bleeding
Authors: Faidon-Marios Laskaratos, Mark Hamilton, Marco Novelli, Neil Shepherd, Gareth Jones, Christopher Lawrence, Miriam Mitchison, Charles D Murray
Journal: Gut (2014)

A 62-year-old woman presented with abdominal pain and diarrhoea. She had a history of primary biliary cirrhosis and renal transplantation secondary to reflux nephropathy. Cross-sectional imaging and a colonoscopy demonstrated terminal ileal inflammation and ulceration, but histological biopsies were inconclusive and cytomegalovirus staining was negative. The patient subsequently developed spontaneous small bowel perforation due to deep ulceration, necessitating an emergency right hemicolectomy. Her postoperative period was complicated by several episodes of rectal bleeding. After a prolonged admission at her local hospital, the patient was referred to our unit for further management.

On arrival, the patient's immunosuppression consisted of tacrolimus and low-dose prednisolone. Mycophenolate mofetil …
Legibility and authorship of clinical notes
Authors: A R Panigrahi, C Cunningham
Journal: Journal of the Royal Society of Medicine (2003)

Dr Rodriguez-Vera and colleagues (November 2002 JRSM1) report that 18 (15%) of 117 clinical histories in a representative sample of case notes from a Spanish general hospital were illegible. Legibility was worse in records from surgical departments.

Another important issue is the manner in which the authors of clinical note entries identify themselves. The lack of a legible name, position and pager number identifying note entries has major implications in large and complex hospital systems where the case notes are an important means of communication between teams from different specialties. At the John Radcliffe Hospital between February and August 2002 we audited how well authors of note entries for patients on the colorectal surgical firm identified themselves, by looking for a legible name, rank and pager number. A total of 540 note entries in 20 patients made in 2002 were compared with 480 note entries made between 1995 and 1999 for the same group of patients. In the earlier series a legible name, rank and pager number were included in respectively 31%, 29% and 49% of note entries, and this increased to 56%, 49% and 72% in 2002. Although the new figures represent an improvement, they point to persistent deficiencies in the way authors of note entries identify themselves. We therefore support the conclusion of Rodriguez-Vera et al. that clinical notes should become computer based.
Cytochrome P450 and Glutathione Transferase Expression in Squamous Cell Cancer
Authors: Shadan Ali, Basil F. El-Rayes, Lance K. Heilbrun, Fazlul H. Sarkar, John F. Ensley, Omar Kucuk, Philip A. Philip
Journal: Clinical Cancer Research (2004)

Abstract Purpose: The cytochrome P-450 (CYP) and glutathione S-transferase (GST) enzyme systems modulate the carcinogenic effects of tobacco. Therefore, the expression of these enzymes may be in part responsible for the observed interindividual and inter-racial differences in the risk of development of squamous cell carcinoma of the head and neck (SCCHN). The first aim of this study was to evaluate the feasibility of measuring the expression of the CYP and GST in target tissue from the head and neck. The second aim was to compare the expression of CYPs 1A1, 2E1, and 3A4 in squamous epithelium from African-American and Caucasian pediatric patients. The third aim was to compare the expression of CYPs 1A1, 2E1, 3A4, and GST-π on the p16 expression in patients with SCCHN. Experimental Design: The expression of CYP 1A1, 2E1, 3A4, GST-π, and p16 was quantified by immunoblotting. Expression of CYPs 1A1, 2E1, and 3A4 was quantified in tissue from 160 pediatric patients undergoing tonsillectomy. Expression of CYPs 1A1, 2E1, 3A4, GST-π, and p16 was determined in 46 resected SCCHN patients. Results: Large interindividual variability in the expression of these enzymes was observed in the pediatric and adult populations. No significant difference was observed in CYP 1A1, 2E1, and 3A4 expression of Caucasian and African-American patients. There was no correlation between p16 and enzyme expression in patients with SCCHN. Conclusion: Evaluation of CYP expression in the target tissue of interest is feasible. The clinical significance of CYPs and GST-π alterations in the risk of developing SCCHN will need to be investigated in larger trials.
Personality Disorders in DSM-5
Authors: Andrew E. Skodol
Journal: Annual Review of Clinical Psychology (2012)

A substantive revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) last occurred in 1994; therefore, the mental health field should anticipate significant changes to the classification of mental disorders in the fifth edition. Since DSM-5 Work Groups have recently proposed revisions for the major diagnostic classes of mental disorders, an article on the current status of the personality disorders (PDs) is timely. This article reviews scientific principles that have influenced the development of proposed changes for the assessment and diagnosis of personality psychopathology in DSM-5, presents the proposed model as of the summer of 2011, summarizes rationales for the changes, and discusses critiques of the model. Scientific principles were articulated for DSM-5 more than a decade ago; their application to the process has not been straightforward, however. Work Group members have labored to improve the DSM-5 approach to personality and PDs to make the classification more valid and more clinically useful. The current model continues to be a work in progress.
New technique helps to assess vegetative state
Authors: Z. Kmietowicz
Journal: BMJ (2000)

Doctors and relatives of patients with brain injury can now determine more accurately whether they have any awareness thanks to a technique developed by staff at the Royal Hospital for Neuro-Disability in London.

The sensory modality assessment and rehabilitation technique (SMART), which took 10 years to develop, is the brainchild of occupational therapists in the brain injury unit at the hospital. Dissatisfied with the lack of a standardised tool for assessing patients with brain injuries, they set about making their own.

In 1996 a study showed that after assessment …
Previously irradiated areas spared from skin toxicity induced by cetuximab in six patients: implications for the administration of EGFR inhibitors in previously irradiated patients
Authors: P. Bossi, C. Liberatoscioli, C. Bergamini, L.D. Locati, S. Fava, G. Rinaldi, E. Orlandi, P. Olmi, E. Tagliabue, S. Ménard, L. Licitra
Journal: Annals of Oncology (2006)
Routine screening for cystic fibrosis-related diabetes
Authors: Daniel Peckham
Journal: Journal of the Royal Society of Medicine (2009)

Cystic fibrosis-related diabetes (CFRD) is an important and well-established complication of cystic fibrosis (CF) affecting up to 35% of patients by the third decade of life.1,2 Prevalence increases with age and is associated with pancreatic insufficiency, female gender, liver disease and the DF508 mutation.3–7

CFRD has a negative impact on lung function, weight and survival and is associated with late complications such as retinopathy, nephropathy, microalbuminuria and neuropathy.6,8–15 Decline in respiratory function and nutritional health has been shown to develop several years prior to presentation, although most of this data has been collated from unscreened populations.3,11,13,16–18 The pre-diabetic state may contribute directly to clinical decline as a consequence of abnormal glucose metabolism or alternatively, the decline in nutrition and lung function may result from increased inflammation and nutritional requirements in patients with poorer health.14

A delay in the diagnosis of CFRD is commonly due to an absence of symptoms. Early identification through screening is therefore essential as prompt intervention with insulin can impact on weight, lung function and overall prognosis.17–20 It has also been suggested that insulin therapy may be beneficial in patients with CF and impaired glucose tolerance.21,22

In this short review, three key areas will be addressed. These include defining CFRD in the context of type 1 and 2 diabetes, determining the most effective screening tools and addressing the impact of screening on outcome.
PROGNOSTIC FACTORS IN THE INVOLUTIONAL PSYCHOSES
Authors: SIDNEY DROBNES
Journal: American Journal of Psychiatry (1943)

1. During the period January 1930 to January 1940, 68 cases of involutional psychoses were admitted to the Norwich State Hospital, representing 0.8% of the total admissions. 17 died within 6 months, leaving 51 cases for the present study. 2. Twenty-three (45%) had left the hospital as recovered or improved at the expiration of this period. Twenty-eight (55%) were unimproved or worse. 3. The prognostic significance of sex, marital status, time of onset and elapsed period before hospitalization, positive family history, relationship to menopause, effect of treatment, and prepsychotic personality was investigated. 4. Depressive features, such as agitation, sadness, self-accusatory and self-depreciative ideas, somatic delusions, suicidal threats and attempts, predominated in 78% of those that got well. 5. Schizophrenic symptoms, such as auditory and visual hallucinations, ideas of persecution, systematized delusions and catatonic behavior, were associated with an unfavorable outcome. 6. An analysis of the development and eventual outcome of the case material suggests the conclusion that involutional psychosis might more properly be diagnosed either manic-depressive psychosis or schizophrenia which has occurred late in life.
Effects of theophylline and ipratropium bromide on exercise performance in patients with stable chronic obstructive pulmonary disease
Authors: M. Tsukino, K. Nishimura, A. Ikeda, T. Hajiro, H. Koyama, T. Izumi
Journal: Thorax (1998)

<h3>BACKGROUND</h3> The effects of theophylline or anticholinergic agents on exercise capacity in patients with chronic obstructive pulmonary disease (COPD) remain controversial. The aim of the present study was to compare the effect of an oral theophylline with an inhaled anticholinergic agent and to examine the effects of combined therapy on exercise performance using progressive cycle ergometry. <h3>METHODS</h3> Twenty one men with stable COPD and a mean (SD) forced expiratory volume in one second (FEV<sub>1</sub>) of 1.00 (0.40) l were studied. Theophylline (600 or 800 mg daily), ipratropium bromide (160 μg), a combination of both drugs, and placebo were given in a randomised, double blind, four period crossover design study. Spirometric data, pulse rate, and blood pressure were assessed before and at 90 and 120 minutes after inhalation. Symptom limited progressive cycle ergometer exercise tests (20 watts/min) were performed 90 minutes after each inhalation, and dyspnoea was measured during exercise using the Borg scale. <h3>RESULTS</h3> The mean (SD) serum theophylline concentration was 18.3 (6.3) μg/ml, and seven patients had side effects during treatment with theophylline. Theophylline and ipratropium bromide produced greater increases in FEV<sub>1</sub>, maximal oxygen consumption, maximal minute ventilation, and several dyspnoea ratios than placebo. There were no differences between theophylline and ipratropium bromide except in maximal heart rate. A combination of both drugs produced greater improvements in pulmonary function and exercise capacity than either drug alone. <h3>CONCLUSIONS</h3> Both high dose theophylline and high dose ipratropium bromide improved exercise capacity in patients with stable COPD. Although data based on short term effects cannot be directly applied to long term therapy, theophylline added to an inhaled anticholinergic agent may have beneficial effects on exercise capacity in patients with COPD.
Drug survival on TNF inhibitors in patients with rheumatoid arthritis comparison of adalimumab, etanercept and infliximab
Authors: M Neovius, E V Arkema, H Olsson, J K Eriksson, L E Kristensen, J F Simard, J Askling
Journal: Annals of the Rheumatic Diseases (2013)

To compare drug survival on adalimumab, etanercept and infliximab in patients with rheumatoid arthritis (RA).Patients with RA (n=9139; 76% women; mean age 56 years) starting their first tumour necrosis factor (TNF) inhibitor between 2003 and 2011 were identified in the Swedish Biologics Register (ARTIS). Data were collected through 31 December 2011. Drug survival over up to 5 years of follow-up was compared overall and by period of treatment start (2003-2005/2006-2009; n=3168/4184) with adjustment for age, sex, education, period, health assessment questionnaire (HAQ), disease duration, concomitant disease modifying antirheumatic drug (DMARD) treatment and general frailty (using hospitalisation history as proxy).During 20 198 person-years (mean/median 2.2/1.7 years) of follow-up, 3782 patients discontinued their first biological (19/100 person-years; 51% due to inefficacy, 36% due to adverse events). Compared with etanercept, infliximab (adjusted HR 1.63, 95% CI 1.51 to 1.77) and adalimumab initiators had higher discontinuation rates (1.26, 95% CI 1.16 to 1.37), and infliximab had a higher discontinuation rate than adalimumab (1.28, 95% CI 1.18 to 1.40). These findings were consistent across periods, but were modified by time for adalimumab versus etanercept (p<0.001; between-drug difference highest the 1st year in both periods). The discontinuation rate was higher for starters in 2006-2009 than 2003-2005 (adjusted HR 1.12, 95% CI 1.04 to 1.20). The composition of 1-year discontinuations also changed from 2003-2005 vs 2006-2009: adverse events decreased from 45% to 35%, while inefficacy increased from 43% to 53% (p<0.001).Discontinuation rates were higher for infliximab compared with adalimumab and etanercept initiators, and for adalimumab versus etanercept during the 1st year. Discontinuation rates increased with calendar period, as did the percentage discontinuations due to inefficacy.
Discordance for ankylosing spondylitis in monozygotic twins.
Authors: C J Eastmond, J C Woodrow
Journal: Annals of the Rheumatic Diseases (1977)

Three monozygotic twin pairs, each over the age of 45 years, with ankylosing spondylitis are described. In two pairs there is discordance for this disease and in the third pair there is a marked difference in the severity of this disease. These findings provide evidence that environmental factors are necessary not only for the initial development of ankylosing spondylitis, but possibly also for determining its future severity.
Initial Experience with the New Electronic Endoscope
Authors: W. Matek, G. Lux, J.F. Riemann, L. Demling
Journal: Endoscopy (1984)

With the introduction of an electronic sensor attached to the tip of a flexible endoscope, which functions in the manner of a television camera, new dimensions have been opened up for endoscopy. First reports on the clinical application of this new method have been presented at congresses held recently. We, too, were given the opportunity of trying out the prototype of an electronic colonoscope in four patients. This is a brief report of our findings.
Association of the 2011 ACGME Resident Duty Hour Reforms With Mortality and Readmissions Among Hospitalized Medicare Patients
Authors: Mitesh S. Patel, Kevin G. Volpp, Dylan S. Small, Alexander S. Hill, Orit Even-Shoshan, Lisa Rosenbaum, Richard N. Ross, Lisa Bellini, Jingsan Zhu, Jeffrey H. Silber
Journal: JAMA (2014)

Patient outcomes associated with the 2011 Accreditation Council for Graduate Medical Education (ACGME) duty hour reforms have not been evaluated at a national level.To evaluate the association of the 2011 ACGME duty hour reforms with mortality and readmissions.Observational study of Medicare patient admissions (6,384,273 admissions from 2,790,356 patients) to short-term, acute care, nonfederal hospitals (n = 3104) with principal medical diagnoses of acute myocardial infarction, stroke, gastrointestinal bleeding, or congestive heart failure or a Diagnosis Related Group classification of general, orthopedic, or vascular surgery. Of the hospitals, 96 (3.1%) were very major teaching, 138 (4.4%) major teaching, 442 (14.2%) minor teaching, 443 (14.3%) very minor teaching, and 1985 (64.0%) nonteaching.Resident-to-bed ratio as a continuous measure of hospital teaching intensity.Change in 30-day all-location mortality and 30-day all-cause readmission, comparing patients in more intensive relative to less intensive teaching hospitals before (July 1, 2009-June 30, 2011) and after (July 1, 2011-June 30, 2012) duty hour reforms, adjusting for patient comorbidities, time trends, and hospital site.In the 2 years before duty hour reforms, there were 4,325,854 admissions with 288,422 deaths and 602,380 readmissions. In the first year after the reforms, accounting for teaching hospital intensity, there were 2,058,419 admissions with 133,547 deaths and 272,938 readmissions. There were no significant postreform differences in mortality accounting for teaching hospital intensity for combined medical conditions (odds ratio [OR], 1.00; 95% CI, 0.96-1.03), combined surgical categories (OR, 0.99; 95% CI, 0.94-1.04), or any of the individual medical conditions or surgical categories. There were no significant postreform differences in readmissions for combined medical conditions (OR, 1.00; 95% CI, 0.97-1.02) or combined surgical categories (OR, 1.00; 95% CI, 0.98-1.03). For the medical condition of stroke, there were higher odds of readmissions in the postreform period (OR, 1.06; 95% CI, 1.001-1.13). However, this finding was not supported by sensitivity analyses and there were no significant postreform differences for readmissions for any other individual medical condition or surgical category.Among Medicare beneficiaries, there were no significant differences in the change in 30-day mortality rates or 30-day all-cause readmission rates for those hospitalized in more intensive relative to less intensive teaching hospitals in the year after implementation of the 2011 ACGME duty hour reforms compared with those hospitalized in the 2 years before implementation.
Phase I study of Doxil and vinorelbine in metastatic breast cancer
Authors: H.J. Burstein, M.J. Ramirez, W.P. Petros, K.D. Clarke, M.A. Warmuth, P.K. Marcom, U.A. Matulonis, L.M. Parker, L.N. Harris, E.P. Winer
Journal: Annals of Oncology (1999)
Identification of a polyI:C-inducible membrane protein that participates in dendritic cell–mediated natural killer cell activation
Authors: Takashi Ebihara, Masahiro Azuma, Hiroyuki Oshiumi, Jun Kasamatsu, Kazuya Iwabuchi, Kenji Matsumoto, Hirohisa Saito, Tadatsugu Taniguchi, Misako Matsumoto, Tsukasa Seya
Journal: The Journal of Experimental Medicine (2010)

In myeloid dendritic cells (mDCs), TLR3 is expressed in the endosomal membrane and interacts with the adaptor toll/interleukin 1 receptor homology domain-containing adaptor molecule 1 (TICAM-1; TRIF). TICAM-1 signals culminate in interferon (IFN) regulatory factor (IRF) 3 activation. Co-culture of mDC pretreated with the TLR3 ligand polyI:C and natural killer (NK) cells resulted in NK cell activation. This activation was triggered by cell-to-cell contact but not cytokines. Using expression profiling and gain/loss-of-function analyses of mDC genes, we tried to identify a TICAM-1-inducing membrane protein that participates in mDC-mediated NK activation. Of the nine candidates screened, one contained a tetraspanin-like sequence and satisfied the screening criteria. The protein, referred to as IRF-3-dependent NK-activating molecule (INAM), functioned in both the mDC and NK cell to facilitate NK activation. In the mDC, TICAM-1, IFN promoter stimulator 1, and IRF-3, but not IRF-7, were required for mDC-mediated NK activation. INAM was minimally expressed on NK cells, was up-regulated in response to polyI:C, and contributed to mDC-NK reciprocal activation via its cytoplasmic tail, which was crucial for the activation signal in NK cells. Adoptive transfer of INAM-expressing mDCs into mice implanted with NK-sensitive tumors caused NK-mediated tumor regression. We identify a new pathway for mDC-NK contact-mediated NK activation that is governed by a TLR signal-derived membrane molecule.
Significance of myoglobin as an oxygen store and oxygen transporter in the intermittently perfused human heart: a model study
Authors: Volker Endeward, Gerolf Gros, Klaus D. Jürgens
Journal: Cardiovascular Research (2010)

The mechanisms by which the left ventricular wall escapes anoxia during the systolic phase of low blood perfusion are investigated, especially the role of myoglobin (Mb), which can (i) store oxygen and (ii) facilitate intracellular oxygen transport. The quantitative role of these two Mb functions is studied in the maximally working human heart.Because discrimination between Mb functions has not been achieved experimentally, we use a Krogh cylinder model here. At a heart rate of 200 beats/min and a 1:1 ratio of diastole/systole, the systole lasts for 150 ms. The basic model assumption is that, with mobile Mb, the oxygen stored in the end-diastolic left ventricle wall exactly meets the demand during the 150 ms of systolic cessation of blood flow. The coronary blood flow necessary to achieve this agrees with literature data. By considering Mb immobile or setting its concentration to zero, respectively, we find that, depending on Mb concentration, Mb-facilitated O(2) transport maintains O(2) supply to the left ventricle wall during 22-34 of the 150 ms, while Mb storage function accounts for a further 12-17 ms. When Mb is completely absent, anoxia begins to develop after 116-99 ms.While Mb plays no significant role during diastole, it supplies O(2) to the left ventricular wall for < or = 50 ms of the 150 ms systole, whereas capillary haemoglobin is responsible for approximately 80 ms. Slight increases in haemoglobin concentration, blood flow, or capillary density can compensate the absence of Mb, a finding which agrees well with the observations using Mb knockout mice.