tbuckley/cabot-search huggingface dataset:
Information recall by patients
Authors: K. M. Chow
Journal: Journal of the Royal Society of Medicine (2003)

In his review article (May 2003 JRSM1) Dr Kessels indicates that patients recall as little as half of what they are told by their physicians. With reference to low-literacy patients, he contends that neither spoken nor written information is efficient to improve memory performance. That said, interactive communication skills deserve emphasis as a means to better convey the verbal information. Simply asking patients to restate what they have been told is associated with better information retention.2 Clearly, overlooking the information-verifying strategy could have been one of the main reasons for losing the take-home message. Suffice here to quote the example of a study (involving diabetic patients with low functional health literacy) in which glycaemic control was significantly better for patients whose primary care physicians assessed recall or comprehension. Physician assessment as such is best illustrated by the conversation3 below:


Physician: 'So... let's make sure. What medications are we going to change?'

Patient: 'I think we're going to stop this one (is it metformin?)... and I'm going to take glipizide twice a day... I think that's the green one...'
Lack of effect of peritubular protein on passive NaCl transport in the rabbit proximal tubule.
Authors: C A Berry
Journal: Journal of Clinical Investigation (1983)

The effect of peritubular protein removal on passive NaCl transport was examined in the isolated rabbit proximal convoluted tubule (PCT). Three modes of passive NaCl transport were tested: (a) paracellular backflux of NaCl, (b) convective flow of NaCl through junctional complexes, and (c) anion gradient-dependent NaCl transport. The effect of peritubular protein removal on the paracellular permeability to NaCl was examined using transepithelial specific resistance. Eight PCT were perfused with ultrafiltrate (UF) and bathed in either serum or UF. Transepithelial specific resistance averaged 14.5 +/- 1.9 in the presence and 13.7 +/- 1.7 omega cm2 in the absence of peritubular protein. The effect of peritubular protein removal on the convective flow of a NaCl solution across functional complexes was examined in the absence of active transport by using colloid osmotic pressure (COP) gradients. 12 PCT were perfused with simple salt solutions in Donnan equilibrium with and without protein at 20 degrees C. A COP gradient of 60.1 and -60.1 mmHg drove only 0.06 and -0.23 nl/min, respectively. These values are approximately 10% of the value predicted for an effect of peritubular protein on NaCl solution flow (1.98 nl/min) and are approximately equal to the value predicted for pure water equilibration for the small osmotic pressure difference between solutions in Donnan equilibrium (0.17-0.18 nl/min). The effect of peritubular protein removal on the passive absorption of NaCl driven by anion concentration gradients was examined in seven PCT perfused with a high chloride solution simulating late proximal tubular fluid and bathed in either serum or UF at 20 degrees C. Volume absorption averaged 0.34 +/- 0.20 in the presence and 0.39 +/- 0.20 nl/mm min in the absence of peritubular protein. In conclusion, peritubular protein removal did not significantly affect any of the three distinct modes of passive NaCl transport tested. The lack of effect of peritubular protein removal on passive paracellular NaCl transport suggests that protein modulates an active transcellular NaCl transport process.
Effects of CPAP on oxidative stress and nitrate efficiency in sleep apnoea: a randomised trial
Authors: A Alonso-Fernandez, F Garcia-Rio, M A Arias, A Hernanz, M de la Pena, J Pierola, A Barcelo, E Lopez-Collazo, A Agusti
Journal: Thorax (2008)

<h3>Background:</h3> Previous studies have presented contradictory data concerning obstructive sleep apnoea syndrome (OSAS), lipid oxidation and nitric oxide (NO) bioavailability. This study was undertaken to (1) compare the concentration of 8-isoprostane and total nitrate and nitrite (NOx) in plasma of middle-aged men with OSAS and no other known co-morbidity and healthy controls of the same age, gender and body mass index; and (2) test the hypothesis that nasal continuous positive airway pressure (CPAP) therapy attenuates oxidative stress and nitrate deficiency. <h3>Methods:</h3> A prospective, randomised, placebo controlled, double-blind, crossover study was performed in 31 consecutive middle-aged men with newly diagnosed OSAS and 15 healthy control subjects. Patients with OSAS were randomised to receive sham CPAP or effective CPAP for 12 weeks. Blood pressure, urinary catecholamine levels and plasma 8-isoprostane and NOx concentrations were obtained before and after both treatment modalities. <h3>Results:</h3> Patients with OSAS had significantly higher 8-isoprostane levels (median (IQR) 42.5 (29.2–78.2) vs 20.0 (12.5–52.5) pg/ml, p = 0.041, Mann-Whitney test) and lower NOx levels (264 (165–650) vs 590 (251–1465) μmol/l, p = 0.022) than healthy subjects. Body mass index, blood pressure and urinary catecholamines were unchanged by CPAP therapy, but 8-isoprostane concentrations decreased (38.5 (24.2–58.7) pg/ml at baseline vs 22.5 (16.2–35.3) pg/ml on CPAP, p = 0.0001) and NOx levels increased (280 (177–707) vs 1373 (981–1517) μmol/l, p = 0.0001) after CPAP. <h3>Conclusions:</h3> OSAS is associated with an increase in oxidative stress and a decrease in NOx that is normalised by CPAP therapy.
Maternal Age and Prevalence of Gestational Diabetes Mellitus
Authors: Terence T. Lao, Lai-Fong Ho, Ben C.P. Chan, Wing-Cheong Leung
Journal: Diabetes Care (2006)

Maternal age is an established risk factor for gestational diabetes mellitus (GDM), but there is no consensus on the age above which there is significantly increased risk of GDM. In the literature, the lowest cutoff is ≥25 years, as recommended by the American Diabetes Association (1), but there are little data to support this recommendation. To determine the age threshold for increased risk of GDM, we have reviewed the prevalence of GDM, diagnosed by the World Health Organization criteria (2), in the singleton pregnancies managed in our department from 1998 to 2001. Data on maternal …
A prospective randomised controlled study of the use of ranitidine in patients with gastric cancer
Authors: J N Primrose, G V Miller, S R Preston, J Gokhale, N S Ambrose, U M Ward, J G Mills, R S B Ehsanullah, B Darekar
Journal: Gut (1998)

Does the use of the histamine H2 receptor antagonist ranitidine improve the outcome of patients with gastric cancer?A total of 222 patients with gastric cancer who had received radical or palliative resection or who were deemed inoperable at presentation.Hospitals within Yorkshire, the participating clinicians being members of the Yorkshire GI Tumour Group.A multicentre prospective randomised double blind trial comparing ranitidine 150 mg twice daily with placebo twice daily was undertaken. The principal outcome measures were survival and survival excluding those who died within 30 days of operation.The median survival (95% confidence intervals) was 331 (232 to 393) days for patients in the ranitidine group compared with 187 (143 to 269) for those in the placebo group. The difference in survival was not statistically significant (p = 0.225). When patients who died within 30 days of operation were excluded (21 in the placebo group, 15 in the ranitidine group), the difference in survival remained not significant (p = 0.358). No subgroup could be identified who significantly benefited from treatment, but for patients with stage VIa cancer the median survival was 134 days with placebo compared with 313 days with ranitidine (p = 0.073).This study does not show significant benefit from the use of ranitidine for gastric cancer but further larger studies may be indicated.
Birth Weight and Risk for Childhood Leukemia in Denmark, Sweden, Norway, and Iceland
Authors: L. L. Hjalgrim, K. Rostgaard, H. Hjalgrim, T. Westergaard, H. Thomassen, E. Forestier, G. Gustafsson, J. Kristinsson, M. Melbye, K. Schmiegelow
Journal: JNCI Journal of the National Cancer Institute (2004)

Background: Compelling evidence suggests that childhood leukemia often originates in utero . Birth weight is one of the few pregnancy-related risk factors that has been associated with leukemia risk, but the association has remained poorly characterized. We conducted a population-based case–control study in Denmark, Sweden, Norway, and Iceland to investigate the association between birth weight (and other birth characteristics) and the risk of childhood leukemia. Methods: Overall, 1905 children (aged 0–14 years) with acute lymphoblastic leukemia (ALL) and 299 children with acute myeloid leukemia (AML) diagnosed between January 1, 1984, and December 31, 1999, were identified in the Nordic Society of Paediatric Haematology and Oncology acute leukemia database. Each case patient was matched to five population control subjects (n = 10745) on nationality, age, and sex. All live-born siblings of case patients (n = 3812) and control subjects (n = 17 937) were also identified in population registers. Information on birth weight and gestational age at birth was ascertained from the national Medical Birth Registers. The association between various birth characteristics and leukemia risk was assessed by conditional logistic regression. All statistical tests were two-sided. Results: Risk of ALL overall was statistically significantly associated with birth weight (odds ratio [OR] = 1.26 per 1-kg increase in birth weight, 95% confidence interval [CI] = 1.13 to 1.41). The association was similar for B- and T-lineage ALL and across all diagnostic ages (0–14 years). However, children with ALL did not weigh more at birth than their siblings. Statistically significantly reduced risks of B-precursor ALL were observed with increasing position in the birth order (OR = 0.90 per position increase, 95% CI = 0.84 to 0.96) and increasing gestational age (OR = 0.87 per 2-week increase in gestational age, 95% CI = 0.81 to 0.94). Risk of AML did not vary monotonically with birth weight, and low birth weight (<1500 g [i.e., 3.3 pounds]) was associated with the highest risk. Conclusion: Our results are compatible with the hypothesis that a high birth weight is associated with an increased risk of ALL.
Emergence of Constitutively Active Estrogen Receptor-α Mutations in Pretreated Advanced Estrogen Receptor–Positive Breast Cancer
Authors: Rinath Jeselsohn, Roman Yelensky, Gilles Buchwalter, Garrett Frampton, Funda Meric-Bernstam, Ana Maria Gonzalez-Angulo, Jaime Ferrer-Lozano, Jose A. Perez-Fidalgo, Massimo Cristofanilli, Henry Gómez, Carlos L. Arteaga, Jennifer Giltnane, Justin M. Balko, Maureen T. Cronin, Mirna Jarosz, James Sun, Matthew Hawryluk, Doron Lipson, Geoff Otto, Jeffrey S. Ross, Addie Dvir, Lior Soussan-Gutman, Ido Wolf, Tamar Rubinek, Lauren Gilmore, Stuart Schnitt, Steven E. Come, Lajos Pusztai, Philip Stephens, Myles Brown, Vincent A. Miller
Journal: Clinical Cancer Research (2014)

Abstract Purpose: We undertook this study to determine the prevalence of estrogen receptor (ER) α (ESR1) mutations throughout the natural history of hormone-dependent breast cancer and to delineate the functional roles of the most commonly detected alterations. Experimental Design: We studied a total of 249 tumor specimens from 208 patients. The specimens include 134 ER-positive (ER+/HER2−) and, as controls, 115 ER-negative (ER−) tumors. The ER+ samples consist of 58 primary breast cancers and 76 metastatic samples. All tumors were sequenced to high unique coverage using next-generation sequencing targeting the coding sequence of the estrogen receptor and an additional 182 cancer-related genes. Results: Recurring somatic mutations in codons 537 and 538 within the ligand-binding domain of ER were detected in ER+ metastatic disease. Overall, the frequency of these mutations was 12% [9/76; 95% confidence interval (CI), 6%–21%] in metastatic tumors and in a subgroup of patients who received an average of 7 lines of treatment the frequency was 20% (5/25; 95% CI, 7%–41%). These mutations were not detected in primary or treatment-naïve ER+ cancer or in any stage of ER− disease. Functional studies in cell line models demonstrate that these mutations render estrogen receptor constitutive activity and confer partial resistance to currently available endocrine treatments. Conclusions: In this study, we show evidence for the temporal selection of functional ESR1 mutations as potential drivers of endocrine resistance during the progression of ER+ breast cancer. Clin Cancer Res; 20(7); 1757–67. ©2014 AACR.
To drink or not to drink? Explaining “contradictory findings” in fluid replacement and exercise performance: evidence from a more valid model for real-life competition
Authors: Toby Mündel
Journal: British Journal of Sports Medicine (2009)

Research into exercise and hydration is not new. Twenty-five years ago, White and Ford1 reported on the voluntary dehydration (hypohydration) during a competitive cycling road race; subjects' mean body mass losses were greater than 3%, and there were low rates of fluid ingestion despite fluid being freely available. It is notable that there was no relationship between fluid intake and finishing position. The BJSM published one of the first consensus statements on fluid replacement2 during and after exercise.

In the October issue of BJSM , Marino and colleagues3 challenge the common belief that (full) fluid replacement is necessary to maintain/improve high-intensity exercise performance in moderate and warm conditions. Their data show neuromuscular adjustments according to hydration status allowing the attainment of similar …
Daytime Predictors of Sleep Hypoventilation in Duchenne Muscular Dystrophy
Authors: CRAIG A. HUKINS, DAVID R. HILLMAN
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Sleep hypoventilation is an inevitable consequence of Duchenne muscular dystrophy (DMD), usually preceding daytime respiratory failure. Appropriate scheduling of polysomnography and the introduction of noninvasive ventilation (NIV) during sleep are not defined. Our aim was to determine the parameters of daytime lung function associated with sleep hypoventilation in patients with DMD. As our method we chose a prospective comparison of wakeful respiratory function (spirometry, lung volumes, maximal mouth pressures, arterial blood gases) with outcomes of polysomnography. All measurements were made with subjects breathing air. Nineteen subjects were studied. The FEV1 was correlated with PaCO2 (r = − 0.70, p < 0.001) and base excess (r = − 0.68, p < 0.01). All of these parameters were significantly related to sleep oxygenation (proportion of total sleep time spent at an SaO2 ⩽ 90% [TST < 90%]). An FEV1 < 40% was a sensitive (91%) but not specific (50%) indicator of sleep hypoventilation (TST < 90% of ⩾ 2%); a PaCO2 of ⩾ 45 mm Hg was an equally sensitive (91%) but more specific (75%) indicator while a base excess of ⩾ 4 mmol/L was highly specific (100%) but less sensitive (55%). After introduction of NIV during sleep (n = 8), there was a significant reduction in wakeful PaCO2 (54 ± 7.4 to 49.1 ± 4 mm Hg, p < 0.02) over 0.9 ± 0.4 yr despite a further decline in FEV1 (0.84 ± 0.46 to 0.64 ± 0.39 L, p < 0.05). We conclude that in patients with DMD, (1) arterial blood gases should be performed once the FEV1 falls below 40% of the predicted value; (2) polysomnography should be considered when the PaCO2 is ⩾ 45 mm Hg, particularly if the base excess is ⩾ 4 mmol/L; (3) the decrease in wakeful PaCO2 after NIV administered during sleep implicates sleep hypoventilation in the pathogenesis of respiratory failure; and (4) impaired ventilatory drive is a possible mechanism for respiratory failure, as the NIV-associated decrease in wakeful PaCO2 occurs despite a further decline in ventilatory capacity, suggesting continuing deterioration in respiratory muscle function. Hukins CA, Hillman DR. Daytime predictors of sleep hypoventilation in Duchenne muscular dystrophy.
Breathing pattern and respiratory mechanics in patients with amyotrophic lateral sclerosis
Authors: M Vitacca, E Clini, D Facchetti, M Pagani, M Poloni, R Porta, N Ambrosino
Journal: European Respiratory Journal (1997)

The aim of this study was to evaluate the time course of breathing pattern and respiratory mechanics in patients with amyotrophic lateral sclerosis (ALS). A study was conducted on 25 out of 38 eligible ALS patients. Neurological status, arterial blood gases (ABGs), spirometry, breathing pattern (minute ventilation (V'E), tidal volume (VT), respiratory frequency (fR), duty cycle (duration of inspiration/duration of total breathing cycle (tI/ttot)), respiratory drive (P0.1)), respiratory mechanics (oesophageal pressure (Ppl), dynamic compliance (CL,dyn), pressure time product (PTP) and index (PTI), work of breathing (WOB)), and respiratory muscle (RM) strength as assessed by maximal oesophageal pressure (Ppl,max) were evaluated at presentation (to) in all patients and after 6 months (t6) in 11 patients. At to, the mean values of the degree of neurological impairment were 60+/-20 and 103+/-30 as assessed by the Norris scale and Medical Research Council (MRC) score, respectively. From the time of the first neurological symptom, survival time ranged 7-50 months. Diurnal ABGs were normal. A mild restrictive pattern was observed, a forced vital capacity (FVC) <70% of predicted being present in 45% of patients, only FVC % pred (r=0.59; p<0.05), forced expiratory volume in one second (FEV1) % pred (r=0.53; p<0.05) and survival (r=0.64; p<0.05) showing a significant correlation with the Norris scale. A Ppl,max <30 cmH2O was associated with a significantly greater mortality, Ppl,max being correlated with survival (r=0.79, p<0.05). At t6, fR, fR/VT, P0.1/Ppl,max, were significantly increased in comparison to to, while FVC % pred, vital capacity (VC) % pred, FEV1 % pred, VT and Ppl,max were significantly reduced. These results suggest a progressive deterioration in breathing pattern and in respiratory muscle strength with progression of disease.
Implications of Birth Cohort Patterns in Interpreting Trends in Breast Cancer Rates
Authors: R. E. Tarone, K. C. Chu
Journal: JNCI Journal of the National Cancer Institute (1992)

Most investigations of trends in cancer rates are based on a cross-sectional approach, i.e., an examination of trends in rates by year of diagnosis or death. When there are longitudinal effects (i.e., trends in rates with successive birth cohorts), interpretation of cross-sectional trends can be misleading. Based on cross-sectional comparisons, U.S. breast cancer mortality rates have been reported to be decreasing over the last 20 years in younger women but to be increasing during the same period in older women.To examine the impact of longitudinal effects on the divergence of cross-sectional trends in breast cancer mortality with age, we examined breast cancer mortality rates from 1969 to 1988 by birth cohort for White women in the United States.By using a novel, nonparametric, permutational method to analyze 2-year, age-specific mortality rates for women aged 30-89 years, we identified trends in rates with successive birth cohorts.The divergence in trends with age is shown to be consistent with an increase in breast cancer risk with successive birth cohorts from 1900 to 1916 and with a decrease in breast cancer risk with successive birth cohorts beginning around 1926.Longitudinal effects have a significant impact on cross-sectional trends in breast cancer mortality.Continuation of the birth cohort trend in younger women, which could correspond to changes in reproductive patterns accompanying the "baby boom," would result in decreasing cross-sectional trends in women 60-69 years of age over the next decade and in women 70-79 years of age in the subsequent decade. Longitudinal effects must be taken into consideration when monitoring and evaluating the effects of early detection, treatment, and intervention programs using national rates.
Evidence for an effect of insulin on the peripheral utilization of ketone bodies in dogs
Authors: E. O. Balasse, R. J. Havel
Journal: Journal of Clinical Investigation (1971)

The rates of transport and oxidation of acetoacetate have been measured in seven anesthetized, pancreatectomized, ketotic dogs using a constant infusion of acetoacetate-3-(14)C. Control experiments were performed in 14 normal dogs. In addition to the acetoacetate-(14)C, the latter were infused at a constant rate with varying amounts of unlabeled acetoacetate so as to obtain a range of ketone transport (26-65 mumoles/min.kg) comparable with that observed in the diabetic dogs (21-41 mumoles/min.kg). The specific activities of acetoacetate and beta-hydroxybutyrate in blood became equal during the infusion of labeled acetoacetate, indicating that the net transport of acetoacetate represents that of total ketones. In each group, the concentration of ketones was an exponential function of the rate of transport, but for any value below 30 mumoles/min.kg, ketone concentration in the diabetic dogs was about 3 times that in normal dogs, indicating an impairment of mechanisms for utilizing ketones in insulin deficient animals. Maximal capacity to utilize ketones in diabetic dogs was slightly more than half that of normal ones. A similar fraction (32-63%) of the infused (14)C appeared in respiratory CO(2) in the two groups and was independent of the rate of transport. In seven of the normal dogs, administration of insulin and glucose increased removal of the infused ketones and increased the fraction of (14)C appearing in respiratory CO(2). These results demonstrate that utilization of ketones in extrahepatic tissues is influenced by insulin; impaired utilization contributes to diabetic ketosis and is probably essential to the production of severe ketoacidosis.
Incidence of virological failure and major regimen change of initial combination antiretroviral therapy in the Latin America and the Caribbean: an observational cohort study
Authors: Carina Cesar, Cathy A Jenkins, Bryan E Shepherd, Denis Padgett, Fernando Mejía, Sayonara Rocha Ribeiro, Claudia P Cortes, Jean W Pape, Juan Sierra Madero, Valeria Fink, Omar Sued, Catherine McGowan, Pedro Cahn
Journal: The Lancet HIV (2015)
Use of a modified angioplasty balloon catheter in the dilatation of tight biliary strictures.
Authors: K J Rao, H Blake, A Theodossi
Journal: Gut (1990)

Nineteen biliary strictures were dilated using a modified angioplasty balloon catheter to allow insertion of a 10F prosthesis. In each instance biliary strictures were successfully dilated which had previously been too tight to widen with standard endoscopic biliary dilating catheters. Eleven patients had malignant hilar strictures, four malignant distal common bile duct strictures, and four benign strictures. There were no complications as a result of the procedure and satisfactory biliary drainage was established in all patients. We conclude that tight biliary strictures can be successfully dilated using a modified angioplasty balloon catheter.
Addition of zoledronic acid to neoadjuvant chemotherapy does not enhance tumor response in patients with HER2-negative stage II/III breast cancer: the NEOZOTAC trial (BOOG 2010-01)
Authors: A. Charehbili, S. van de Ven, V.T.H.B.M. Smit, E. Meershoek-Klein Kranenbarg, N.A.T. Hamdy, H. Putter, J.B. Heijns, L.J.C. van Warmerdam, L. Kessels, M. Dercksen, M.J. Pepels, E. Maartense, H.W.M. van Laarhoven, B. Vriens, M.N. Wasser, A.E. van Leeuwen-Stok, G.J. Liefers, C.J.H. van de Velde, J.W.R. Nortier, J.R. Kroep
Journal: Annals of Oncology (2014)
Congenital agminated segmental naevi
Authors: M. BRUNNER, E. VARDARMAN, M. MEGAHED, T. RUZICKA
Journal: British Journal of Dermatology (1995)

We report a 39-year-old woman with agminated segmental naevi on the right side of her face. The lesions were present at birth, and she had no other congenital abnormalities.