tbuckley/cabot-search huggingface dataset:
Information Sharing Preferences of Older Patients and Their Families
Authors: Bradley H. Crotty, Jan Walker, Meghan Dierks, Lewis Lipsitz, Jacqueline O’Brien, Shira Fischer, Warner V. Slack, Charles Safran
Journal: JAMA Internal Medicine (2015)

Elderly patients often share control of their personal health information and decision making with family and friends when needed. Patient portals can help with information sharing, but concerns about privacy and autonomy of elderly patients remain. Health systems that implement patient portals would benefit from guidance about how best to implement access to portals for caregivers of elderly patients.To identify how patients older than 75 years (hereinafter, elders) and family caregivers of such patients approach sharing of health information, with the hope of applying the results to collaborative patient portals.A qualitative study was conducted from October 20, 2013, to February 16, 2014, inviting participants older than 75 years (n = 30) and participants who assist a family member older than 75 years (n = 23) to 1 of 10 discussion groups. Participants were drawn from the Information Sharing Across Generations (InfoSAGE) Living Laboratory, an ongoing study of information needs of elders and families based within an academically affiliated network of senior housing in metropolitan Boston, Massachusetts. Groups were separated into elders and caregivers to allow for more detailed discussion. A professional moderator led groups using a discussion guide. Group discussions were audiotaped, transcribed, and analyzed inductively using immersion/crystallization methods for central themes.Central themes regarding sharing of health information between elderly patients and family caregivers.Seven lessons emerged from 2 main themes. First, sharing information has consequences: (1) elders and caregivers have different perspectives on what is seen as the "burden" of information, (2) access to medical information by families can have unintended consequences, and (3) elders do not want to feel "spied on" by family. Second, control of information sharing is dynamic: (4) elders wish to retain control of decision making as long as possible, (5) transfer of control occurs gradually depending on elders' health and functional status, (6) control of information sharing and decision making should be fluid to maximize elders' autonomy, and (7) no "one-size-fits-all" approach can satisfy individuals' different preferences.Information sharing and control are complex issues even under the most well-meaning circumstances. While elders may delegate control and share information with family, they want to retain granular control of their information. When using patient portals, simple proxy access may not adequately address the needs and concerns of aging patients.
NON-FATAL REACTION TO IMIPRAMINE-MAO INHIBITOR COMBINATION
Authors: FRANCIS J. KANE, DONALD FREEMAN
Journal: American Journal of Psychiatry (1963)

A non-fatal reaction to Tofrānil-Monase mixture is reported in the smallest dosages hitherto reported. Cautious use of subtherapeutic dosages of these agents is suggested where other potent non-psycho-pharmacologic drugs are used in hope of prevention of serious reactions to drug combinations.
Acute severe asthma: pathophysiology and pathobiology of gas exchange abnormalities
Authors: R Rodriguez-Roisin
Journal: European Respiratory Journal (1997)

Acute severe asthma, or "status asthmaticus", is a devastating clinical condition ultimately resulting in life-threatening hypoxaemia. The pivotal intrapulmonary mechanism of this condition is profound ventilation/perfusion (V'A/Q') mismatch, characterized by a predominant bimodal blood flow pattern reflecting a marked deterioration (increase) of the dispersion of pulmonary blood flow. This V'A/Q' profile is consistent with the presence of numerous alveolar units with low V'A/Q' ratios, in which ventilation is markedly reduced, although never abolished, but perfusion is maintained. Further V'A/Q' worsening whilst breathing 100% O2 suggests the presence of an underlying vigorous hypoxic vascular response. Of equal importance, gas exchange disturbances are poorly related to the severity of reduced maximal airflow rates. Inhaled platelet-activating factor (PAF), both in normal individuals and asthmatic patients, results in moderate-to-severe disturbance of V'A/Q' status, a finding that is probably related to altered microvascular permeability within the airway wall. Salbutamol, but not ipratropium bromide, prevented all PAF-induced systemic and lung function abnormalities, possibly because venoconstriction in the bronchial circulation was antagonized. Taken together, these findings support the hypothesis that platelet-activating factor may play a critical role in the pathobiology of severe acute exacerbations of asthma.
Collectins and Ficolins: Humoral Lectins of the Innate Immune Defense
Authors: Uffe Holmskov, Steffen Thiel, Jens C. Jensenius
Journal: Annual Review of Immunology (2003)

Collectins and ficolins, present in plasma and on mucosal surfaces, are humoral molecules of the innate immune systems, which recognize pathogen-associated molecular patterns. The human collectins, mannan-binding lectin (MBL) and surfactant protein A and D (SP-A and SP-D), are oligomeric proteins composed of carbohydrate-recognition domains (CRDs) attached to collagenous regions and are thus structurally similar to the ficolins, L-ficolin, M-ficolin, and H-ficolin. However, they make use of different CRD structures: C-type lectin domains for the collectins and fibrinogen-like domains for the ficolins. Upon recognition of the infectious agent, MBL and the ficolins initiate the lectin pathway of complement activation through attached serine proteases (MASPs), whereas SP-A and SP-D rely on other effector mechanisms: direct opsonization, neutralization, and agglutination. This limits the infection and concurrently orchestrates the subsequent adaptive immune response. Deficiencies of the proteins may predispose to infections or other complications, e.g., reperfusion injuries or autoimmune diseases. Structure, function, clinical implications, and phylogeny are reviewed.
Overcoming Chronic Myeloid Leukemia Stem Cell Resistance to Imatinib by Also Targeting JAK2
Authors: C. R. Cogle
Journal: JNCI Journal of the National Cancer Institute (2013)

Chronic myeloid leukemia (CML) originates in the hematopoietic stem cell because of a reciprocal translocation of chromosomes 9 and 22.This translocation juxtaposes the ABL1 proto-oncogene with BCR, which translates into a constitutively active BCR-ABL kinase that drives expansion of leukemic progeny.Treatment of CML with ABL kinase inhibitors such as imatinib is very effective and brings about complete cytogenetic response in more than 80% of newly diagnosed patients.CML is a celebrated model disease because of its stem cell origin, straightforward oncogene, targeted therapy, easy monitoring, and high odds of remission.
Molecular Mechanism for Age-Related Memory Loss: The Histone-Binding Protein RbAp48
Authors: Elias Pavlopoulos, Sidonie Jones, Stylianos Kosmidis, Maggie Close, Carla Kim, Olga Kovalerchik, Scott A. Small, Eric R. Kandel
Journal: Science Translational Medicine (2013)

To distinguish age-related memory loss more explicitly from Alzheimer's disease (AD), we have explored its molecular underpinning in the dentate gyrus (DG), a subregion of the hippocampal formation thought to be targeted by aging. We carried out a gene expression study in human postmortem tissue harvested from both DG and entorhinal cortex (EC), a neighboring subregion unaffected by aging and known to be the site of onset of AD. Using expression in the EC for normalization, we identified 17 genes that manifested reliable age-related changes in the DG. The most significant change was an age-related decline in RbAp48, a histone-binding protein that modifies histone acetylation. To test whether the RbAp48 decline could be responsible for age-related memory loss, we turned to mice and found that, consistent with humans, RbAp48 was less abundant in the DG of old than in young mice. We next generated a transgenic mouse that expressed a dominant-negative inhibitor of RbAp48 in the adult forebrain. Inhibition of RbAp48 in young mice caused hippocampus-dependent memory deficits similar to those associated with aging, as measured by novel object recognition and Morris water maze tests. Functional magnetic resonance imaging studies showed that within the hippocampal formation, dysfunction was selectively observed in the DG, and this corresponded to a regionally selective decrease in histone acetylation. Up-regulation of RbAp48 in the DG of aged wild-type mice ameliorated age-related hippocampus-based memory loss and age-related abnormalities in histone acetylation. Together, these findings show that the DG is a hippocampal subregion targeted by aging, and identify molecular mechanisms of cognitive aging that could serve as valid targets for therapeutic intervention.
Severe Osteoporosis in Men
Authors: Nicky Kelepouris
Journal: Annals of Internal Medicine (1995)

Objective: To evaluate men with severe osteoporosis for pathogenetic factors and to review the reported features of primary osteoporosis in men. Design: Case series and clinical review. Patients: 47 men consecutively referred to a metabolic bone center because of atraumatic (or minimally traumatic) fractures (91%) or radiographic osteopenia (9%). Measurements: Clinical assessment, radiographs, chemical analyses of serum and urine, hormone assays, skeletal densitometry, and histomorphometry of iliac crest biopsy specimens. Results: 27 of the 47 men (57%) had vertebral fractures, and 16 (34%) had appendicular fractures. Causal factors identified in 30 men (64%) included glucocorticosteroid treatment (8 men); hypogonadism (7 men); excessive alcohol consumption (7 men); and anticonvulsant use, osteomalacia, severe hyperthyroidism, or bone marrow neoplasia (8 men). Seventeen men (36%) had no medical conditions or known risk factors associated with bone disease. Spinal mineral density was well below the mean value for healthy young men in 94% of the patients with primary osteoporosis tested. Examination of biopsy specimens from 13 of 17 men with primary osteoporosis showed reduced trabecular bone volumes, normal bone formation rates, and slightly increased resorption surfaces. Fasting hypercalciuria was seen in some men (41%). In the primary osteoporosis group, eight men were followed serially (range of follow-up, 6 months to 9 years) while they were receiving a nonpharmacologic regimen (diet and activity); the mean axial bone mineral density of these men increased slightly. Conclusions: A thorough evaluation for identifiable causes of severe osteoporosis in men is warranted because definable pathogenetic factors are seen in many cases. A few men with severe osteoporosis have primary or idiopathic osteoporosis. Primary osteoporosis in men is probably caused by many factors because heterogeneous clinical, laboratory, and histologic features were seen in our series and in those of others. Further studies of primary osteoporosis are needed to define the course of the disease, to identify pathogenetic mechanisms, and to develop therapeutic interventions.
Hyperthyroidism with low thyroid hormone
Authors: M K Harkness, R D Hardern, J H Barth
Journal: Journal of the Royal Society of Medicine (2003)

Dr Obuobie and Dr Jones (April 2003 JRSM1) attribute the hyperthyroidism with low serum thyroid hormone concentrations in their patient to suppression of the thyroid hormone concentrations by an infective illness which lasted only one week. It is more likely that this patient had painless thyroiditis. In the days before thyroid hormone concentrations could be measured, the clinical diagnosis of thyrotoxicosis was confirmed by a high uptake of radioactive iodine. Occasionally, the hyperthyroidism was found to be associated with a low uptake. The hyperthyroid phase was due to liberation of thyroid hormones into the blood from the damaged gland. Patients with painless thyroiditis usually became well after a month or so when the thyroid hormones and TSH returned to normal. When the diagnosis of painless thyroiditis was missed, patients ran the risk of receiving antithyroid drugs for as long as one or two years.
Inhibition of Mammalian Target of Rapamycin by Rapamycin Causes the Regression of Carcinogen-Induced Skin Tumor Lesions
Authors: Panomwat Amornphimoltham, Kantima Leelahavanichkul, Alfredo Molinolo, Vyomesh Patel, J. Silvio Gutkind
Journal: Clinical Cancer Research (2008)

The activation of Akt/mammalian target of rapamycin (mTOR) pathway represents a frequent event in squamous cell carcinoma (SCC) progression, thus raising the possibility of using specific mTOR inhibitors for the treatment of SCC patients. In this regard, blockade of mTOR with rapamycin prevents the growth of human head and neck SCC cells when xenotransplanted into immunodeficient mice. However, therapeutic responses in xenograft tumors are not always predictive of clinical anticancer activity.As genetically defined and chemically induced animal cancer models often reflect better the complexity of the clinical setting, we used here a two-step chemical carcinogenesis model to explore the effectiveness of rapamycin for the treatment of skin SCC.Rapamycin exerted a remarkable anticancer activity in this chemically induced cancer model, decreasing the tumor burden of mice harboring early and advanced tumor lesions, and even recurrent skin SCCs. Immunohistochemical studies on tumor biopsies and clustering analysis revealed that rapamycin causes the rapid decrease in the phosphorylation status of mTOR targets followed by the apoptotic death of cancer cells and the reduction in the growth and metabolic activity of the surviving ones, concomitant with a decrease in the population of cancer cells expressing mutant p53. This approach enabled investigating the relationship among molecular changes caused by mTOR inhibition, thus helping identify relevant biomarkers for monitoring the effectiveness of mTOR inhibition in the clinical setting.Together, these findings provide a strong rationale for the early evaluation of mTOR inhibitors as a molecular targeted approach to treat SCC.
Efficacy, safety, and immunogenicity of the human papillomavirus 16/18 AS04-adjuvanted vaccine in women older than 25 years: 4-year interim follow-up of the phase 3, double-blind, randomised controlled VIVIANE study
Authors: S Rachel Skinner, Anne Szarewski, Barbara Romanowski, Suzanne M Garland, Eduardo Lazcano-Ponce, Jorge Salmerón, M Rowena Del Rosario-Raymundo, René H M Verheijen, Swee Chong Quek, Daniel P da Silva, Henry Kitchener, Kah Leng Fong, Céline Bouchard, Deborah M Money, Arunachalam Ilancheran, Margaret E Cruickshank, Myron J Levin, Archana Chatterjee, Jack T Stapleton, Mark Martens, Wim Quint, Marie-Pierre David, Dorothée Meric, Karin Hardt, Dominique Descamps, Brecht Geeraerts, Frank Struyf, Gary Dubin
Journal: The Lancet (2014)
Nonsurgical Treatment of Gallstone Disease
Authors: Alan F. Hofmann
Journal: Annual Review of Medicine (1990)

CD40 is a cell-surface member of the TNF (tumor necrosis factor) receptor superfamily. Upon activation, CD40 can license dendritic cells to promote antitumor T cell activation and re-educate macrophages to destroy tumor stroma. Numerous agonist CD40 ...Read More
Constitutive expression of high affinity interleukin 2 receptors on human CD16-natural killer cells in vivo.
Authors: A Nagler, L L Lanier, J H Phillips
Journal: The Journal of Experimental Medicine (1990)

The majority of human NK cells express low affinity IgG Fc receptors (CD16+), whereas a minor subset of NK cells lack Fc receptor expression (CD16-). In contrast to CD16+ NK cells that express only p75 IL-2 receptors, CD16- NK cells constitutively co-express both p75 and p55 IL-2 receptors in vivo and preferentially respond to low concentrations of IL-2 with increased cytolytic activation and proliferation. Scatchard analysis demonstrated the presence of approximately 1,200 high affinity (approximately 25 pM kD) and approximately 9,600 intermediate affinity (approximately 2 nM kD) IL-2 receptors on CD16- NK cells. CD16+ NK cells expressed only a single intermediate affinity IL-2 receptor of approximately 1.9 nM kD (approximately 9,000 sites per cell). The IL-2 binding data thus substantiated the phenotypic and functional studies and definitively show that the differential responsiveness of CD16- and CD16+ NK cells to IL-2 is manifested through different affinity IL-2 receptors.
Effect of nicotine, silver acetate, and ordinary chewing gum in combination with group counselling on smoking cessation.
Authors: E J Jensen, E Schmidt, B Pedersen, R Dahl
Journal: Thorax (1990)

Four hundred and ninety six smokers participated in a randomised comparison of the effect of silver acetate, nicotine, and ordinary chewing gum on smoking cessation. All were motivated to stop smoking abruptly and all had smoked at least 10 cigarettes a day for at least five years. Side effects and taste acceptability were related to outcome after six months. The participants attended nine meetings over a year, at which lectures, support, and advice about stopping smoking were given. Tobacco abstinence was confirmed by measurement of carbon monoxide in expired air. The chewing gums were used for 12 weeks. After 12 weeks there was a trend towards more abstainers in the nicotine group (59%) than in the silver acetate (50%) and ordinary (45%) chewing gum groups that was not quite significant (p = 0.07). At 26 and 52 weeks the number of cigarette abstainers was similar in the three treatment groups. Subjects in the nicotine chewing gum group had a longer mean time before relapse than those in the silver acetate and ordinary chewing gum groups. Mean success rates for all subjects combined at 12, 26, and 52 weeks were 52.8%, 39.7%, and 23.3%. The side effects of nicotine and silver acetate chewing gum were generally mild and transient, and unimportant except for mouth irritation from silver acetate, which had a negative effect on outcome, and the low taste acceptability of nicotine, which had a strong negative influence on the success rate. The results suggest a short term effect on nicotine chewing gum on smoking cessation, but the abstinence rates after one year were generally disappointing.
Treatment of mantle-cell lymphoma with Rituximab (chimeric monoclonal anti-CD20 antibody): Analysis of factors associated with response
Authors: J.M. Foran, D. Cunningham, B. Coiffier, P. Solal-Celigny, F. Reyes, M. Ghielmini, P.W.M. Johnson, C. Gisselbrecht, M. Bradburn, J. Matthews, T.A. Lister
Journal: Annals of Oncology (2000)
Body composition and health-related quality of life in patients with obstructive airways disease
Authors: R Shoup, G Dalsky, S Warner, M Davies, M Connors, M Khan, F Khan, R ZuWallack
Journal: European Respiratory Journal (1997)

This study evaluated the effects of body weight and lean mass abnormalities on health-related quality of life (HRQL) in obstructive airways disease. Body weight, lean mass (using dual-energy X-ray absorptiometry), and HRQL (using the St George's Respiratory Questionnaire (SGRQ)) were measured in 50 patients. Low lean mass was defined as a lean mass index (lean mass/height2) below the fifth percentile of a control population. Dyspnoea was measured by the baseline dyspnoea index. The mean (SD) age was 69+/-9 yrs; the forced expiratory volume in one second (FEV1) was 39+/-19% of predicted. Patients had 2.4+/-4.1 kg less lean mass than predicted. Increased dyspnoea was the most influential predictor of poor HRQL. Compared to normal-weight patients, those who were underweight had significantly greater impairment in activity, impact, and total SGRQ scores, while those who were overweight had greater impairment in impact and total SGRQ scores. Low lean mass was associated with greater impairment in symptoms, activity and impact subscores and the total SGRQ score. When dyspnoea was added to the model as a covariate, neither weight nor lean mass remained significantly related to HRQL. Thus, although body weight and lean mass abnormalities influence health-related quality of life, their effects appear to be mediated through increased levels of dyspnoea.
Extracorporeal Circulation: A Device for the Quantitative Study of Thrombus Formation in Flowing Blood
Authors: H. G. DOWNIE, E. A. MURPHY, H. C. ROWSELL, J. F. MUSTARD
Journal: Circulation Research (1963)

A standardized extracorporeal shunt system has been described. It allows examination of the sequence of events in thrombus formation and it provides a means of quantitating it in flowing blood. It further allows assessment to be made of the usefulness of classical in vitro clotting tests in thrombogenesis. The platelet adhesive index and clotting time in silicone showed the best correlation with the amount of thrombus formed. Pig serum presumably rich in serum thrombotic accelerator (STA) has been shown to enhance thrombus formation from flowing blood. Within the limits of these experiments, the rate of blood flow has been found to be of little importance.
NAEVUS SEBACEUS (JADASSOHN) WITH SQUAMOUS CELL EPITHELIOMA
Authors: THOMAS PARKIN
Journal: British Journal of Dermatology (1950)

Journal Article NAEVUS SEBACEUS (JADASSOHN) WITH SQUAMOUS CELL EPITHELIOMA Get access THOMAS PARKIN, M.B., Ch. B. Edin., M.R.C.P.E. THOMAS PARKIN, M.B., Ch. B. Edin., M.R.C.P.E. Registrar, Rupert Hallam Department of Dermatology, United Sheffield Hospitals Royal Infirmary, Shaffield Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology and Syphilis, Volume 62, Issue 4, 1 April 1950, Pages 167–170, https://doi.org/10.1111/j.1365-2133.1950.tb10982.x Published: 01 April 1950
Cystic fibrosis presenting with corneal perforation and crystalline lens extrusion
Authors: Danielle S Hall, Saurabh Goyal
Journal: Journal of the Royal Society of Medicine (2010)

We describe a 5-month-old female Caucasian infant who presented with corneal perforation and crystalline lens extrusion secondary to Pseudomonas aeruginosa endophthalmitis and was later diagnosed with cystic fibrosis (CF). To our knowledge, this is the first report of CF presenting with P. aeruginosa endophthalmitis.
Career Advice for Oncology Trainees
Authors: Mark Rosenthal
Journal: Journal of Clinical Oncology (2006)

entitled "Shaping Your Career to Maximize Personal Satisfaction in the Practice of Oncology."As a mentor to many medical oncology trainees, I am frequently asked to provide career advice.Can I add two aphorisms?First, there is no rush, and secondly, life gets more complicated.In Australia at least, most trainees complete their training in their late 20s or early 30s.I always recommend that they experience medical oncology beyond their limited training experience in academic institutions before making their career choice.I suggest a period of spending time in a laboratory, undertaking locum work in a busy private practice, and finally, spending time working in regional centers, interstate or overseas.Even if they formally commence their career in their late 30s, they still have 25 to 30 years of practice ahead of them-a sobering thought.Shanafelt et al allude to the fact that many "young oncologists. ..hope that things will get better." 1 Invariably life becomes more complex rather than less complex: marriage, partnerships, children, mortgages, illnesses, and aging parents.Many of our trainees have relatively uncluttered lives and do not appreciate the inevitable extracurricular tensions that will befall them.As a mentor, I carefully consider my advice to trainees.