tbuckley/cabot-search huggingface dataset:
Randomised controlled trial of midwife led debriefing to reduce maternal depression after operative childbirth
Authors: R. Small
Journal: BMJ (2000)

<h3>Abstract</h3> <b>Objective:</b> To assess the effectiveness of a midwife led debriefing session during the postpartum hospital stay in reducing the prevalence of maternal depression at six months postpartum among women giving birth by caesarean section, forceps, or vacuum extraction. <b>Design:</b> Randomised controlled trial. <b>Setting:</b> Large maternity teaching hospital in Melbourne, Australia. <b>Participants:</b> 1041 women who had given birth by caesarean section (n= 624) or with the use of forceps (n= 353) or vacuum extraction (n= 64). <b>Main outcome measures:</b> Maternal depression (score ≥13 on the Edinburgh postnatal depression scale) and overall health status (comparison of mean scores on SF-36 subscales) measured by postal questionnaire at six months postpartum. <b>Results:</b> 917 (88%) of the women recruited responded to the outcome questionnaire. More women allocated to debriefing scored as depressed six months after birth than women allocated to usual postpartum care (81 (17%) <i>v</i> 65 (14%)), although this difference was not significant (odds ratio=1.24, 95% confidence interval 0.87 to 1.77). They were also more likely to report that depression had been a problem for them since the birth, but the difference was not significant (123 (28%) <i>v</i> 94 (22%); odds ratio=1.37, 1.00 to 1.86). Women allocated to debriefing had poorer health status on seven of the eight SF-36 subscales, although the difference was significant only for role functioning (emotional): mean scores 73.32 <i>v</i> 78.98, <i>t</i>= −2.31, 95% confidence interval −10.48 to −0.84). <b>Conclusions:</b> Midwife led debriefing after operative birth is ineffective in reducing maternal morbidity at six months postpartum. The possibility that debriefing contributed to emotional health problems for some women cannot be excluded.
Reproductive, maternal, newborn, and child health in Pakistan: challenges and opportunities
Authors: Zulfiqar A Bhutta, Assad Hafeez, Arjumand Rizvi, Nabeela Ali, Amanullah Khan, Faatehuddin Ahmad, Shereen Bhutta, Tabish Hazir, Anita Zaidi, Sadequa N Jafarey
Journal: The Lancet (2013)
S63 Telehealth in acute community acquired pneumonia: proof of concept and provisional evaluation of impact on hospital length of stay
Authors: S. Selvaraj, E. Davies, C. Humphries, K. S. Srinivasan, H. Moudgil
Journal: Thorax (2011)

<h3>Background/Aims</h3> Although remote patient monitoring systems are rapidly emerging, much has concentrated on managing chronic rather than acute conditions. British Thoracic Society (BTS) guidelines on acute community acquired pneumonia (CAP) suggest not all patients with CURB65 scores 0 to 2 need hospital inpatient treatment and, with the alternative of a supervised environment, we report post hoc analysis of what was initially a proof of concept model adopting a Telehealth enabled system as a potentially effective option designed to reduce hospital length of stay (LOS). <h3>Methods</h3> Over 1 year to May 2011, 138 patients (60 male, 78 female) with mean (SD, range) age 65.5 (18.7, 19–95) years were admitted with CAP were identified. Selection for Telehealth was guided by initial CURB65 scores, patient competence/compliance with technology, social considerations and geographical factors as the provision was only within the area supported by Telford &amp; Wrekin (T&amp;W) PCT; patients were declined while on intravenous antibiotics. Remote monitoring (blood pressure, heart rate, respiratory rate, oxygen saturation, temperature) was via a Broomwell Health system (wrist watch concept) with twice daily planned data downloads managed and triaged through a HUB system filtering recordings to community based nurses. Data on LOS were skewed and non-parametric analysis of median (IQ) values undertaken to compare outcomes by area. <h3>Results</h3> Abstract S63 table 1 shows raw data by age, sex, and LOS (days). 85% had CURB65 scores 0 to 2 and 17 (12.3%) died (8 had higher CURB65 scores). 33/138 (24%) were managed using Telehealth (majority CURB65 0–1) representing 35.5% from the T&amp;W area. Comparing groups as a whole showed significantly (p&lt;0.05) lower (median, IQ) LOS (days) for T&amp;W (4, 2–8) vs the rest (6, 4–9). Differences in initial CURB65 scores, age and sex distribution between groups were not statistically significant when considering those patients with CURB65 0–2 where again LOS was reduced for T&amp;W (n=75) at 4 (2–7) vs the rest (n=42) at 6 (3.8–9.3). None on Telehealth died but one had an unrelated admission. <h3>Conclusion</h3> We have shown the proof of concept in adopting this technology in managing acute CAP and although we provide additional evidence to demonstrate reduction in length of stay, more controlled studies with economic models and an assessment of the return on investment are required. Most of the observed benefit seems to stem from more actively managing and discharging patients with lower CURB65 scores but who nevertheless presented as acute hospital admissions and subsequently benefited from the same provisions offered by Telehealth.
Plasmin inhibitor interactions. The effectiveness of alpha2-plasmin inhibitor in the presence of alpha2-macroglobulin.
Authors: P C Harpel
Journal: The Journal of Experimental Medicine (1977)

alpha2-Plasmin inhibitor and alpha2-macroglobulin were allowed to compete for the protease plasmin. The binding of the enzyme to these inhibitors was assessed by two different but comparable methods. The interactions were completed in 10 s of incubation, and transfer of plasmin from one inhibitor to the other did not occur. Almost as much plasmin was bound to alpha2-plasmin inhibitor in mixtures containing a large molar excess of alpha2-macroglobulin relative to plasmin or alpha2-plasmin inhibitor, as was bound in mixtures not containing alpha2-macroblobulin. These studies demonstrate directly the effectiveness of alpha2-plasmin inhibitor in binding and inhibiting plasmin in the presence of alpha2-macroglobulin, and suggest that the alpha2-plasmin inhibitor may be the major circulating plasmin inhibitor.
Treatment Delay in Endometrial Cancer
Authors: Joseph Menczer
Journal: Journal of Clinical Oncology (2014)

TO THE EDITOR: I read with great interest the population-based study entitled “Impact of Wait Times on Survival for Women With Uterine Cancer” by Elit et al in the January 1 issue of Journal of Clinical Oncology. The authors concluded that longer wait times from diagnosis to surgery have a negative impact on survival. However, in this study, almost 23% of the patients had histological types of endometrial cancer (clear-cell carcinoma, serous carcinoma, adenosquamous carcinoma, and sarcoma) that are known to behave differently than endometrial endometrioid carcinoma and also known to have a unfavorable prognosis. In contrast, our study, cited by the authors, that found that a delay had no impact on prognosis, included only patients with endometrial endometrioid carcinoma. Our findings are also supported by several other studies. Indeed we reported a prolonged survival in a small series of untreated patients with endometrial endometrioid cancer and patients with a prolonged treatment delay. This seems to indicate that the natural progression course, even in untreated patients, may be slow in endometrial endometrioid carcinoma with favorable prognostic factors. Joseph Menczer Edith Wolfson Medical Center, Holon; Tel Aviv University, Tel Aviv, Israel
Prenatal Alcohol Exposure Affects Galactosyltransferase Activity and Glycoconjugates in the Golgi Apparatus of Fetal Rat Hepatocytes
Authors: J Renau-Piqueras, R Guasch, I Azorín, J Seguí, C Guerri
Journal: Hepatology (1997)

Prenatal exposure to alcohol affects the morphological, structural, and functional features of the Golgi apparatus (GA), thus altering the glycosylation process in fetal hepatocytes. To elucidate the cellular mechanisms underlying these alterations, we have studied the effect of alcohol exposure in utero on the activity of liver galactosyltransferase, an enzyme involved in the glycosylation process, and on the hepatic glycoprotein sugar composition. For this, livers from 21-day-old fetuses obtained from control and ethanol-fed rats were used. Galactosyltransferase (GT) activity was determined in isolated GA cis and trans fractions. Colloidal gold-labeled lectin cytochemistry was used to analyze sugar residues in hepatocytes at the subcellular level. Finally, the integrity of the GA after alcohol treatment was assessed by electron microscopy and by evaluating the distribution of the Golgi beta-COP, a protein involved in vesicular trafficking. Prenatal alcohol exposure induces a significant increase in both liver weight and total protein content in the trans Golgi. Moreover, this treatment decreases the activity of galactosyltransferase, increases alpha-L-Fuc residues, and reduces the number of alpha-Man, GlcNAc(beta1,4,GlcNAc)1,2, GalNAc alpha1,3GalNAc, alpha-GalNAc, and a-Gal residues. Alcohol exposure also causes the Golgi cisternae to disappear in about 30% of the hepatocytes, and reduces 75% the number of anti-Golgi beta-COP protein binding sites. Our results suggest that the decrease in galactosyltransferase activity, the alterations in the oligosaccharide chain composition, and the reduction in the amount of Golgi beta-COP protein could be involved in the alterations in the glycosylation process, as well as in the accumulation of hepatic proteins observed after prenatal alcohol exposure. These alterations could contribute, therefore, to the alcohol-induced injury in the developing liver.
Clostridium difficile infection (CDI): Are junior doctors aware of risk factors and markers of severity?
Authors: Clara Addison, Toni Jordan
Journal: European Respiratory Journal (2012)

Introduction

There are approximately 20 000 cases of CDI in England per annum.1 Lower Respiratory Tract Infections are the main indication for antibiotic prescription in hospitals.2 In order to reduce CDI, it is essential that doctors are able to identify patients at risk of CDI to facilitate appropriate antibiotic prescribing. 2 Trust's clinical guidance on CDI informs on markers of severity but not risk factors. We sought to determine the level of knowledge of both among doctors based on a Respiratory ward including clinical guidelines as a conduit of knowledge.

Methods and Results

Using a questionnaire 19 doctors and 5 fourth and fifth year medical students were asked to identify risk factors and markers of severity for CDI. 1st year doctors identified 36% of risk factors, 28% of severity markers; senior house officers 38% and 24%; registrars 47% and 21%; medical students 41% and 21%.

Conclusions

Knowledge of risk factors and severity markers for CDI amongst doctors and medical students on the Respiratory ward is poor. Clinical guidance is not a reliable conduit of knowledge. To raise awareness, information should be relayed more directly e.g. at induction.

References

1.http://www.dh.gov.uk/prod\_consum\_dh/groups/dh\_digitalassets/documents/digitalasset/dh\_132045.pdf

2. Chalmers, J et al. Proposed changes to the management of lower respiratory tract infections in response to the Clostidium difficile epidemic. J Antimicrob Chemother. 2010. 65: 608-18.
A Novel Human Cancer Vaccine Elicits Cellular Responses to the Tumor-Associated Antigen, Human Chorionic Gonadotropin β
Authors: Li-Zhen He, Venky Ramakrishna, John E. Connolly, Xi-Tao Wang, Patricia A. Smith, Charles L. Jones, Maria Valkova-Valchanova, Alahari Arunakumari, John F. Treml, Joel Goldstein, Paul K. Wallace, Tibor Keler, Michael J. Endres
Journal: Clinical Cancer Research (2004)

Abstract Purpose: The oncofetal antigen, human chorionic gonadotropin β subunit (hCGβ), is expressed by a number of carcinomas and is a prognostic indicator in renal, colorectal, bladder, and pancreatic cancers. We describe the development of a novel antibody-based dendritic cell (DC)-targeted cancer vaccine capable of eliciting cellular immune responses directed against hCGβ. Experimental Design: The tumor-associated antigen hCGβ was coupled genetically to a human anti-DC antibody (B11). The resulting fusion protein (B11-hCGβ) was evaluated for its ability to promote tumor antigen-specific cellular immune responses in a human in vitro model. Monocyte-derived human DCs from normal donors were exposed to purified B11-hCGβ, activated with CD40 ligand, mixed with autologous lymphocytes, and tested for their ability to promote hCGβ-specific proliferative and cytotoxic T-lymphocyte responses. Results: B11-hCGβ was found to be a soluble, well-defined, and readily purified product that specifically recognized the human mannose receptor via the B11 antibody portion of the fusion protein. B11-hCGβ functionally promoted the uptake and processing of tumor antigen by DCs, which led to the generation of tumor-specific HLA class I and class II-restricted T-cell responses, including CTLs capable of killing human cancer cell lines expressing hCGβ. Conclusions: Although other hCG vaccines have been shown to be capable of eliciting antibody responses to hCGβ, this is the first time that cellular immune responses to hCGβ have been induced by a vaccine in a human system. This DC-targeted hCGβ vaccine holds promise for the management of a number of cancers and merits additional clinical development.
Patient choice promotes adherence in preventive treatment for latent tuberculosis
Authors: T. W. Rennie, G. H. Bothamley, D. Engova, I. P. Bates
Journal: European Respiratory Journal (2007)

The aim of the present study was to compare the effect of patient choice on completion rates and adverse drug reactions for patients treated for latent tuberculosis infection (LTBI) using 3-month rifampicin and isoniazid treatment (3RH) or 6-month isoniazid treatment (6H). Data for all patients treated using 3RH or 6H for LTBI between 1998 and 2004 were analysed. In total, 675 patients attended for chemoprophylaxis. Of these, 314 received 3RH and 277 received 6H. From April 1, 2000, patients were offered a choice of regimen; 53.5% completed the regimen successfully, a further 10.3% potentially completed it successfully and 36.2% failed to complete treatment. Logistic regression analysis suggested that successful completion was more likely in patients who were younger (an association that was lost after removing all patients aged &lt;16 yrs), were offered a choice of regimen and attended all clinic visits before commencing treatment. Treatment was discontinued due to adverse reactions in 16 (5.1%) patients who were prescribed 3RH and 16 (5.8%) who were prescribed 6H. Treatment failure was most likely during the first 4 weeks of treatment for both regimens. At 13 weeks of treatment, more patients taking 6H had stopped compared with those completing the 3RH regimen. Drug costs were greater using 6H compared with 3RH. In conclusion, offering a choice of regimen improves completion. Most patients chose the 3-month rifampicin and isoniazid treatment over the 6-month isoniazid treatment. Adverse drug reaction rates between the two regimens were similar.
RNAi-Mediated Targeting of Noncoding and Coding Sequences in DNA Repair Gene Messages Efficiently Radiosensitizes Human Tumor Cells
Authors: Zhiming Zheng, Wooi Loon Ng, Xiangming Zhang, Jeffrey J. Olson, Chunhai Hao, Walter J. Curran, Ya Wang
Journal: Cancer Research (2012)

Human tumor cell death during radiotherapy is caused mainly by ionizing radiation (IR)-induced DNA double-strand breaks (DSB), which are repaired by either homologous recombination repair (HRR) or nonhomologous end-joining (NHEJ). Although siRNA-mediated knockdown of DNA DSB repair genes can sensitize tumor cells to IR, this approach is limited by inefficiencies of gene silencing. In this study, we show that combining an artificial miRNA (amiR) engineered to target 3'-untranslated regions of XRCC2 (an HRR factor) or XRCC4 (an NHEJ factor) along with an siRNA to target the gene coding region can improve silencing efficiencies to achieve more robust radiosensitization than a single approach alone. Mechanistically, the combinatorial knockdown decreased targeted gene expression through both a reduction in mRNA stability and a blockade to mRNA translation. Together, our findings establish a general method of gene silencing that is more efficient and particularly suited for suppressing genes that are difficult to downregulate by amiR- or siRNA-based methods alone.
GENETIC INFLUENCE ON THE DEVELOPMENT OF RENAL HYPERTENSION IN PARABIOTIC RATS
Authors: J. Iwai, K. D. Knudsen, L. K. Dahl, M. Heine, G. Leitl
Journal: The Journal of Experimental Medicine (1969)

The effects of several renal manipulations including uninephrectomy, unilateral renal artery constriction, and a combination of these two (Goldblatt procedure) were studied in two strains of rats with opposite constitutional predispositions to experimental hypertension. The protective value of intact renal tissue to protect against hypertension was shown to be genetically determined. The Goldblatt procedure carried out on only one member of a parabiotic pair induced hypertension in this operated rat but significant hypertension developed in the intact partner only when the operated animal belonged to the strain predisposed to hypertension. It was speculated that there were qualitative differences in the pressor signals of the two strains of rats. In the strain genetically predisposed to hypertension there are at least two pressor principles: (a) one which is common to both strains, not transmittable via the parabiosis junction and presumably related to the renin-angiotensin system; and (b) a second which is specific for the hypertension-prone strain and can be transmitted through the parabiosis junction. This transmittable agent is probably identical with the factor that produces salt hypertension and is associated with the salt-excreting mechanism.
A western blot assay for detecting mutant nucleophosmin (NPM1) proteins in acute myeloid leukaemia
Authors: M P Martelli, N Manes, A Liso, V Pettirossi, B Verducci Galletti, B Bigerna, A Pucciarini, M F De Marco, M T Pallotta, N Bolli, M Sborgia, F di Raimondo, F Fabbiano, G Meloni, G Specchia, M F Martelli, B Falini
Journal: Leukemia (2008)
Diminished Impulsivity in Older Patients With Borderline Personality Disorder
Authors: Janine Stevenson, Russell Meares, Anne Comerford
Journal: American Journal of Psychiatry (2002)

The aim of this study was to test, in terms of impulsivity, the hypothesis that borderline personality disorder "burns out" with age.Linear regression analyses, with age as a predictor variable, were conducted on subsection scores of the Revised Diagnostic Interview for Borderlines (DIB-R) for 123 individuals with a diagnosis of borderline personality disorder who were accepted into an outpatient-based psychotherapy program. The subsection scores of the DIB-R allow quantification of the core features of the disorder: affective disturbance, relationship disturbance, cognitive disturbance, and impulsive behavior.Older patients with borderline personality disorder showed less impulsivity than younger patients, but there was no difference in terms of affect disturbance, identity disturbance, and interpersonal problems.The view that borderline personality disorder burns out with age is supported in terms of impulsivity.
HOTAIR, a cell cycle–associated long noncoding RNA and a strong predictor of survival, is preferentially expressed in classical and mesenchymal glioma
Authors: Jun-Xia Zhang, Lei Han, Zhao-Shi Bao, Ying-Yi Wang, Lu-Yue Chen, Wei Yan, Shi-Zhu Yu, Pei-Yu Pu, Ning Liu, Yong-Ping You, Tao Jiang, Chun-Sheng Kang
Journal: Neuro-Oncology (2013)

Long noncoding RNA Hox transcript antisense intergenic RNA (HOTAIR) has been characterized as a negative prognostic factor in breast and colon cancer patients. The clinical significance and function of HOTAIR in glioma remains unclear.We analyzed the clinical significance of HOTAIR in 3 different glioma cohorts with gene expression data, including correlation with tumor grade, prognosis, and molecular subtype. The function of HOTAIR in glioma was explored by performing gene set enrichment analysis and in vitro and in vivo experiments.HOTAIR expression was closely associated with glioma grade and poor prognosis. Multivariate Cox regression analysis revealed that HOTAIR was an independent prognostic factor in glioblastoma multiforme patients. HOTAIR expression correlated with glioma molecular subtype, including those of The Cancer Genome Atlas. HOTAIR was preferentially expressed in the classical and mesenchymal subtypes compared with the neural and proneural subtypes. A gene set enrichment analysis designed to show gene set differences between patients with high and low HOTAIR expression indicated that HOTAIR expression was associated with gene sets involved in cell cycle progression. HOTAIR reduction induced colony formation suppression, cell cycle G0/G1 arrest, and orthotopic tumor growth inhibition.Our data establish that HOTAIR is an important long noncoding RNA that primarily serves as a prognostic factor for glioma patient survival, as well as a biomarker for identifying glioma molecular subtypes, a critical regulator of cell cycle progression.
Frequency and Heritability of <i>WT1</i> Mutations in Nonsyndromic Wilms' Tumor Patients: A UK Children’s Cancer Study Group Study
Authors: Suzanne E. Little, Sandra P. Hanks, Linda King-Underwood, Chris Jones, Elizabeth A. Rapley, Nazneen Rahman, Kathy Pritchard-Jones
Journal: Journal of Clinical Oncology (2004)

Purpose Constitutional WT1 mutations in patients with Wilms' tumor (WT) have specifically been associated with genitourinary abnormalities, such as cryptorchidism and hypospadias. We sought to ascertain the frequency and heritability of constitutional WT1 mutations in nonsyndromic WT patients. Patients and Methods Constitutional DNA from 282 patients treated at seven United Kingdom Children's Cancer Study Group centers was screened for WT1 mutations using heteroduplex analysis. Bidirectional sequencing was used to confirm the mutation and to analyze the corresponding parental DNA samples. Results Five different constitutional WT1 mutations were identified in six children. Mutations in four patients were confirmed to be de novo, and all five mutations are predicted to produce truncated protein. The WT1 mutation group had a young median age at diagnosis of 13.8 months, compared with 34.9 months in the group in whom no WT1 mutations were found; four were female and two were male; and all tumors were of favorable histology. The three tumors with known histologic subtype were stromal-predominant. Contrary to expectation, four of six mutations occurred in children with unilateral tumors without any associated genitourinary abnormality. Conclusion Constitutional WT1 mutations occur with a low frequency (2.1%; 95% CI, 0.8% to 4.6%) in nonsyndromic WT patients. Most mutations occurred in children with unilateral WT without associated genitourinary abnormalities, creating difficulties in identifying individuals with germline mutations on phenotype alone. Two factors that may indicate that an individual is carrying a germline WT1 mutation are an early age of onset and stromal-predominant histology of the WT.