tbuckley/cabot-search huggingface dataset:
Regression After Whole-Brain Radiation Therapy for Brain Metastases Correlates With Survival and Improved Neurocognitive Function
Authors: Jing Li, Soren M. Bentzen, Markus Renschler, Minesh P. Mehta
Journal: Journal of Clinical Oncology (2007)

Purpose Brain metastasis (BM) is a major cause of suffering and health costs in cancer patients. Whole-brain radiation therapy (WBRT) offers tumor shrinking and palliation in many cases, but it has been speculated that these benefits may be outweighed by adverse effects on neurocognitive function (NCF). Patients and Methods Two hundred eight BM patients from the WBRT arm of phase III trial PCI-P120-9801 evaluating motexafin gadolinium were analyzed. NCF, assessed by tests of memory, executive function, and fine motor coordination, was correlated to magnetic resonance imaging–measured BM volume. NCF and survival were compared in 135 patients assessable at 2 months with tumor shrinkage below (poor responders) and above (good responders) the population median (45%). Mean NCF scores and BM volume at 4 and 15 months were compared. Results Good responders experienced a significantly improved survival (unidirectional P = .03). For all tests, the median time to NCF deterioration was longer in good compared with poor responders, with statistical significance seen for Trailmaking B (executive function), and two Pegboard tests (fine motor). In long-term survivors, tumor shrinkage significantly correlated with preservation of executive function and fine motor coordination (r = 0.68 to 0.88). During the early follow-up period, the population mean NCF scores were dominated by patients with progressive disease. A small subset of 15-month survivors had stable or improving scores, and greater mean BM reduction. Conclusion WBRT-induced tumor shrinkage correlates with better survival and NCF preservation. NCF is stable or improved in long-term survivors. Tumor progression adversely affects NCF more than WBRT does, thus making enhancement of radiation response a worthwhile aim in this patient population.
Ancillary Help for General Practitioners
Authors: E. M. Wallis
Journal: BMJ (1966)

BRinsH 1483 unless one limits the operation to cases really in need of it, the patient may be made worse or at best no better.Turning to psychiatric indications, which occurred in 93 out of 100 terminations at Cambridge, one cannot help asking what good-if any-came of these operations.Personally I would agree with Dr. Myre Sim's conclusion that at present there are no psychiatric indications.As Hemphill' has written, " Depression, mania and schizo- phrenia are the only important forms of psychosis in pregnancy, which is com- paratively rare anyway. . . .Termination, although often requested, can rarely be justified on psychiatric grounds."Perhaps Professor Rhodes (7 May, p. 1168) gets nearer the mark when he wonders " if we may not be in danger of losing sight of the fact that there are other solutions than termination of pregnancy in the psychiatrically ill pregnant woman."So much rubbish has been talked and written about abortion that it is exceedingly difficult to differentiate fact from fantasy.But it is high time that there was an end to the completely mistaken idea that only the rich are in a position to obtain medical justice.Medically and psychiatrically thera- peutic abortion is seldom indicated because it is very seldom indeed that it does any medical good.In the very few cases where it does so, the patient will have no difficulty whatsoever in obtaining assistance under the National Health Service free of charge.-Iam, etc.,
The Future of the Public Mental Hospital
Authors: LUCY D. OZARIN, ALAN I. LEVENSON
Journal: American Journal of Psychiatry (1969)

What will be the future of public mental hospitals as community mental health center programs expand? The authors suggest that their emerging role lies in joining the community's network of human services by adapting present organizational structures to permit flexibility and change. Mental hospital staffs can provide leadership and support to local, regional, and state mental health programs if they incorporate current scientific, technological, and social changes in their operations.
Lessons from disclosure of audit
Authors: R P Symonds
Journal: BMJ (2001)

We are supposed to audit all aspects of practice. Problems arise when you find something unpleasant. This is what happened in Leicestershire this spring. Our pathologists carried out a retrospective audit of the cervical smear history of 403 patients who developed invasive cervical cancer between January 1993 and September 2000. Of these women, 324 (80%) had had a cervical smear before diagnosis and their test results were re-examined. In 84 cases a false negative report had been issued; in 38 cases the cytological abnormality had been undergraded.

> Relatives, especially, tended to blame the messenger 

Twenty of the 122 patients had died; diagnostic delay was an important factor in 14 deaths. The same diagnostic delay led to 64 patients having more radical treatment than necessary. Despite what seem to be shocking results, there is no evidence that the Leicestershire laboratory is failing. Indeed, quality assurance tests have shown that the laboratory is at least as good as comparable departments.

The …
Dominant-Negative Notch3 Receptor Inhibits Mitogen-Activated Protein Kinase Pathway and the Growth of Human Lung Cancers
Authors: Nobuhiro Haruki, Keiko S. Kawaguchi, Shannon Eichenberger, Pierre P. Massion, Sandra Olson, Adriana Gonzalez, David P. Carbone, Thao P. Dang
Journal: Cancer Research (2005)

Abstract Notch3 is a member of an evolutionarily conserved family of cell surface receptors important in cell-fate determination in both vertebrates and invertebrates. Significant data support the role of Notch pathway in cancer development, although the conflicting role of Notch signaling pathways in tumorigenesis suggests that its action is highly context-dependent. Furthermore, although Notch receptors signal primarily through the regulation of hairy enhancer of split (HES) and HES-related (HRT) genes, they are known to crosstalk with other signaling pathways, including the epidermal growth factor (EGF) and the mitogen-activated protein kinase pathways. Whereas much is known about the role of Notch1 in human cancer, the role of Notch3 in epithelial tumors, such as lung carcinomas, has not been well established. In this study, we show that Notch3 is expressed in 80 of 207 (39%) resected human lung tumors and that its expression is positively correlated with EGF receptor expression. Inhibition of the Notch3 pathway using a dominant-negative receptor dramatically reduces growth in soft agar and increases growth factor dependence. We also find that Notch inhibition increases sensitivity to EGF receptor tyrosine kinase inhibition and decrease in phosphorylation of the mitogen-activated protein kinase. These observations support a role for Notch3 signaling in lung cancer, and one potential mechanism of maintaining the neoplastic phenotype is through the modulation of the EGF pathway.
Cervicovestibular rehabilitation in sport-related concussion: a randomised controlled trial
Authors: Kathryn J Schneider, Willem H Meeuwisse, Alberto Nettel-Aguirre, Karen Barlow, Lara Boyd, Jian Kang, Carolyn A Emery
Journal: British Journal of Sports Medicine (2014)

Background/aim Concussion is a common injury in sport. Most individuals recover in 7–10 days but some have persistent symptoms. The objective of this study was to determine if a combination of vestibular rehabilitation and cervical spine physiotherapy decreased the time until medical clearance in individuals with prolonged postconcussion symptoms. Methods This study was a randomised controlled trial. Consecutive patients with persistent symptoms of dizziness, neck pain and/or headaches following a sport-related concussion (12–30 years, 18 male and 13 female) were randomised to the control or intervention group. Both groups received weekly sessions with a physiotherapist for 8 weeks or until the time of medical clearance. Both groups received postural education, range of motion exercises and cognitive and physical rest until asymptomatic followed by a protocol of graded exertion. The intervention group also received cervical spine and vestibular rehabilitation. The primary outcome of interest was medical clearance to return to sport, which was evaluated by a study sport medicine physician who was blinded to the treatment group. Results In the treatment group, 73% (11/15) of the participants were medically cleared within 8 weeks of initiation of treatment, compared with 7% (1/14) in the control group. Using an intention to treat analysis, individuals in the treatment group were 3.91 (95% CI 1.34 to 11.34) times more likely to be medically cleared by 8 weeks. Conclusions A combination of cervical and vestibular physiotherapy decreased time to medical clearance to return to sport in youth and young adults with persistent symptoms of dizziness, neck pain and/or headaches following a sport-related concussion. Trial registration number NCT01860755.
Assessing and Changing Organizational Social Contexts for Effective Mental Health Services
Authors: Charles Glisson, Nathaniel J. Williams
Journal: Annual Review of Public Health (2015)

Culture and climate are critical dimensions of a mental health service organization's social context that affect the quality and outcomes of the services it provides and the implementation of innovations such as evidence-based treatments (EBTs). We describe a measure of culture and climate labeled Organizational Social Context (OSC), which has been associated with innovation, service quality, and outcomes in national samples and randomized controlled trials (RCTs) of mental health and social service organizations. The article also describes an empirically supported organizational intervention model labeled Availability, Responsiveness, and Continuity (ARC), which has improved organizational social context, innovation, and effectiveness in five RCTs. Finally, the article outlines a research agenda for developing more efficient and scalable organizational strategies to improve mental health services by identifying the mechanisms that link organizational interventions and social context to individual-level service provider intentions and behaviors associated with innovation and effectiveness.
Viral specificity of H-2-restricted T killer cells directed against syngeneic tumors induced by Gross, Friend, or Rauscher leukemia virus.
Authors: F Plata, F Lilly
Journal: The Journal of Experimental Medicine (1979)

Cytolytic T lymphocytes (CTL) were generated against murine tumors induced by Gross, Friend, or Rauscher leukemia virus (LV) in syngeneic mixed leukocyte-tumor cell cultures. Analogous to the patterns of specificity observed with antibodies to LV-induced cell surface antigens, CTL could be classified into two major groups of specificity. Tumor cells induced by Friend, Moloney, or Rauscher virus and positive for the FMR antigen were killed by syngeneic CTL immune to any one of these three LV; the same CTL, however, were incapable of killing syngeneic tumor cells induced by Gross LV. The converse was true for Gross LV-specific CTL: these CTL were specific for syngeneic tumor cells expressing the Gross virus-associated cell-surface antigen (GCSA), and not the FMR antigen. The H-2 specificities of the two groups of LV-immune CTL were also compared, because in both cases, CTL were restricted in their killing activity to H-2-identical tumor target cells. When CTL from single strains of mice were generated against syngeneic FMR- or GCSA-positive tumor cells, differences were observed with respect both to the requirement for the expression of compatible H-2K or H-2D specificities, and to the intensity of the CTL response in congenic mice of the H-2b, H-2d, and H-2k haplotypes.
P52 Is a pulmonary rehabilitation (PR) programme effective in reducing severe symptoms of anxiety and depression in patients with COPD?
Authors: S. Harrison, N. Greening, J. Williams, S. Singh
Journal: Thorax (2010)

<h3>Introduction</h3> Patients with COPD have a high prevalence of anxiety and depression which has been associated with poorer health outcomes. PR has been found to be successful in reducing anxiety and depression. Previous studies have not differentiated between mild, moderate and severe symptoms of anxiety and depression and therefore the efficacy of PR are unproven in treating those across a spectrum of anxious and depressed symptoms. Our study aimed to explore the effectiveness of a PR programme in reducing mild, moderate and severe symptoms of anxiety and depression in patients with COPD. <h3>Methods</h3> Patients with a clinical and spirometric (GOLD stage ≥2) diagnosis of COPD were identified from the PR database in Leicester, UK. Patients were categorised into three groups based on their Hospital Anxiety and Depression Scale (HADS) scores pre PR (‘none’ 0–7, ‘probable’ 8–10 and ‘presence’ 11–14). These patients undertook an outpatient PR programme between 2000 and January 2009 at a single centre. Changes in HADS scores were retrospectively compared. The two subscales were analysed separately. <h3>Results</h3> 518 patients were identified (mean (SD) age 69.2 (8.80) years FEV<sub>1</sub> 39.9% (15.10) predicted 310 male). Patients with a ‘probable’ and a ‘presence’ of anxiety and depression had a reduction in HADS scores pre- to post- PR (p&lt;0.001). Patients who had ‘none’ did not have a reduction (p&gt;0.05) (Abstract P52 Figure 1). An ANOVA with post hoc analysis showed a difference in the amount of change pre to post PR between the three groups. Patients with a ‘presence’ had the greatest reductions in their scores (p&lt;0.05). <h3>Conclusions</h3> PR is effective in reducing moderate and severe symptoms of anxiety and depression in patients with COPD. However, PR is not effective in reducing severe symptoms to a level which represents no presence of anxiety and depression.
Time course of daily activity at COPD exacerbation
Authors: Ayedh AlAhmari, Anant Patel, Beverly Kowlessar, Alex Mackay, Richa Singh, James Allinson, Jadwiga Wedzicha, Gavin Donaldson
Journal: European Respiratory Journal (2013)

COPD patients may have reduced daily physical activity (DPA), which worsens during acute exacerbations. Early pulmonary rehabilitation (EPR) post-exacerbation may not be feasible in more symptomatic patients. We investigated DPA alongside symptoms and airflow limitation during COPD exacerbations.

Patients recorded any increase in respiratory symptoms, peak expiratory flow (PEF) every morning, hours spent outdoors and the number of steps walked daily using a pedometer (Yamax SW-200) on daily diary cards. Exacerbations were defined by our usual symptomatic criteria (Seemungal et al, AJRCCM 1998).

37 COPD patients (28 male) had a mean (±SD) age of 70 (±7) years and FEV1 52 (±15)% predicted. 79 exacerbations were captured and data from repeat exacerbations were averaged. Pre, versus post-exacerbation data were analysed with paired t-tests. Mean daily steps in the first week post-exacerbation week was 480 (±1407) steps/day lower than over a week, starting two weeks earlier (p=0.045) and took one week to recover (fig.1A). Similarly, mean symptom count rose by 1.9 (±1.3) p<0.001 (fig.1B), but took longer to recover and PEF fell by 6.7 (±13.3) L/min (p=0.005) fig.1C. There was no significant difference in time outdoors (p=0.13) fig.1D.

DPA measured by pedometry fell during COPD exacerbations, likely due to increased symptoms and airflow limitation – although no change in outdoors activity. One week post-exacerbation may be the optimal day for starting EPR.

![Figure][1]  [1]: pending:yes
Exudative Ascites in the Course of Acute Type B Hepatitis
Authors: Carmen Viola, Lydia Vineta, Jaime Bosch, Juan Rodés
Journal: Hepatology (1983)

Two patients who presented with an exudative ascites in the course of typical acute type B hepatitis are reported. In one of them, ascites was associated with an exudative pleural effusion. In both patients, the clinical course of the hepatitis was uneventful, and ascites and pleural effusion disappeared spontaneously. Portal hypertension and common causes of exudative ascites were excluded. It is suggested that the development of exudative ascites in these patients represent a hitherto unrecognized manifestation of the hepatitis itself.
Response of Congenitally Athymic (Nude) Mice to Infection With Mycobacterium boyis (Strain BCG)
Authors: Neal A. Sher, Sotiros D. Chaparas, Lynn E. Greenberg, E. Bruce Merchant, James H. Vickers
Journal: JNCI Journal of the National Cancer Institute (1975)

Mice homozygous for the mutation "nude" (nu/nu) are athymic and lack thymus-dependent lymphocytes. Heterozygote (nu/+) controls, which are phenotypically and immunologically normal, and (nu/nu) mice were infected with 1.0 times 10-6 colony-forming units of Phipps strain BCG. In the spleens of nu/+ mice, there was a progressive increase in number of BCG up to the second week, followed by a gradual decline. However, in the nu/nu mice, BCG growth was gradual and continuous until termination of the experiment at 5 weeks. In the lung, significant differences were not noted until after the second week, at which time the nude mice showed a rapid increase (of more than 2 log10) in the number of BCG. However, the number of BCG was not significantly greater in the livers of either group. Changes in the normal histology of the lung included a massive influx of monocytes during the first 2 weeks which peaked at day 21. In the lungs of the nu/+ mice by day 28, there was considerable granuloma formation consisting of monocytes and small lymphocytes. However, in the lungs of nu/nu animals, the granulomas were made up primarily of monocytes with a lack of small lymphocytes. Acid-fast stains confirmed the presence of large numbers of organisms in the macrophages of nu/nu mice, with gradual destruction of these phagocytic cells.
Taste and Smell in Disease
Authors: Franklin H. Epstein, Susan S. Schiffman
Journal: New England Journal of Medicine (1983)

A RECENT report to the National Advisory Neurological and Communicative Disorders and Stroke Council (1979) estimated that approximately 2 million American adults have disorders of taste and smell. For 1975 and 1976 combined, a chemosensory problem was the major presenting symptom in approximately 435,000 visits to a physician's office.1 In spite of the prevalence of chemosensory dysfunctions, medical textbooks provide little information on how to evaluate or treat them. Chronic disorders of taste and smell have been largely neglected because they are seldom fatal and, unlike deficiencies in sight or hearing, are not considered serious handicaps. In addition, they are . . .
Acute lymphoblastic leukemia–hand mirror cell variant: A detailed cytological and ultrastructural study with an analysis of the immunologic surface markers
Authors: Sanford A. Stass, Elliot Perlin, Elaine S. Jaffe, David R. Simon, W. J. Creegan, J. J. Robinson, M. L. Holloway, Harold R. Schumacher
Journal: American Journal of Hematology (1978)

Abstract Acute lymphoblastic leukemia was observed in a 22‐year‐old white female patient and was manifested by normal platelet counts, 50–60% hand mirror cells (HMC) in the bone marrow, and prolonged survival without treatment. The characteristic neoplastic cell had a nucleus within the “mirror” portion and a cytoplasmic uropod forming the “handle” portion. The presence of acid phosphatase and B‐glucuronidase activity suggested that the cell was a T cell lymphoblast. However, extensive immunologic surface marker studies indicated the cells were non‐T, non‐B. Terminal transferase activity further supported the lymphoid nature of the cell. The hand mirror cells were considered a real phenomenon since they were demonstrated on phase contrast microscopy, scanning electron microscopy, and transmission electron microscopy. The cells did not grow in tissue culture and cytogenetics revealed a normal female karyotype. From the above observations, the HMC is a lymphoblast with morphological, cytochemical, and immunological features which may differentiate it from the usual cell in acute lymphoblastic leukemia. Therefore, cases involving increased numbers of hand mirror cells in the bone marrow and acute lymphoblastic leukemia require further investigation to elucidate the full importance of this cell. This study represents the first attempt to investigate this cell in detail.
Stress-Induced Hyperglycemia After Hip Fracture and the Increased Risk of Acute Myocardial Infarction in Nondiabetic Patients
Authors: Yan Chen, Xincun Yang, Kang Meng, Zechun Zeng, Baotong Ma, Xingpeng Liu, Baoqing Qi, Shuangshuang Cui, Peihong Cao, Yan Yang
Journal: Diabetes Care (2013)

OBJECTIVE To investigate the risk of acute myocardial infarction (AMI) following stress hyperglycemia after hip fracture. RESEARCH DESIGN AND METHODS From February 2007 to February 2012, we carried out a prospective observational analysis of 1,257 consecutive patients with no history of diabetes who suffered hip fractures. Fasting blood glucose (FBG) and glycosylated hemoglobin tests as well as electrocardiography, ultrasonic cardiography, and chest X-ray examinations were performed after admission. All selected hip fracture patients were divided into stress hyperglycemia and non-hyperglycemia groups according to their FBG, and the incidence of AMI was monitored. RESULTS Among the patients enrolled, the frequency of stress hyperglycemia was 47.89% (602/1,257) and that of AMI was 9.31% (117/1,257), and the occurrence of AMI in the stress hyperglycemia group was higher than in the non-hyperglycemia group (12.46 vs. 6.41%, P &amp;lt; 0.05). In the stress hyperglycemia patients, FBG reached maximum levels at 2–3 days after hip fractures and then decreased gradually. The AMI incidence (62.67% [47/75]) of the stress hyperglycemia group was highest in the initial 3 days after hip fracture, significantly coinciding with the FBG peak time (P &amp;lt; 0.05). In all patients with AMI, non–ST-segment elevation myocardial infarction occurred more often than ST-segment elevation myocardial infarction (62.39% [73/117] vs. 37.61% [44/117]). CONCLUSIONS Stress-induced hyperglycemia after hip fracture increased the risk of AMI.
Cell surface antigens of murine leukemias induced by radiation leukemia virus. Recognition of individually distinct cell surface antigens by cytotoxic T cells on leukemias expressing crossreactive transplantation antigens.
Authors: H Morishita, H Shiku, K Horibe, Y Obata, E Stockert, H F Oettgen, L J Old, K Yamada
Journal: The Journal of Experimental Medicine (1986)

The specificity of transplantation immunity and T cell cytotoxicity against leukemias induced by RadLV was examined. Subcutaneous inoculation of two RadLV leukemias induced in BALB/c mice, BALBRVB and BALBRVD, resulted in initial tumor growth in CB6F1 mice, followed by complete tumor regression. Mice that had rejected leukemias BALBRVB or BALBRVD were subsequently challenged with various tumors of BALB/c origin. The growth of all five RadLV leukemias tested, and of one radiation-induced leukemia, was significantly inhibited. Another radiation-induced leukemia, a methylcholanthrene-induced sarcoma, and a leukemia induced by the Moloney leukemia virus, were not inhibited. The results indicate that RadLV leukemias share cell surface antigens that induce transplantation immunity in vivo. Cytotoxic lymphocytes were generated by coculturing spleen cells from mice that had rejected leukemia BALBRVB or BALBRVD with the corresponding leukemia cells. Direct tests and inhibition tests showed that such cytotoxic cells recognized individually specific antigens on leukemias BALBRVB and BALBRVD, distinct from the shared antigens detected in transplantation experiments. The effector cells in cytotoxicity assays were Thy-1+, Lyt-1+,-, Lyt-2+, and Lyt-3+ T cells.