tbuckley/cabot-search huggingface dataset:
The Asia-Pacific Colorectal Screening score: a validated tool that stratifies risk for colorectal advanced neoplasia in asymptomatic Asian subjects
Authors: K.-G. Yeoh, K.-Y. Ho, H.-M. Chiu, F. Zhu, J. Y. L. Ching, D.-C. Wu, T. Matsuda, J.-S. Byeon, S.-K. Lee, K.-L. Goh, J. Sollano, R. Rerknimitr, R. Leong, K. Tsoi, J.-T. Lin, J. J. Y. Sung
Journal: Gut (2011)

<h3>Objective</h3> To develop and validate a clinical risk score predictive of risk for colorectal advanced neoplasia for Asia. <h3>Methods</h3> A prospective, cross-sectional and multicentre study was carried out in tertiary hospitals in 11 Asian cities. The subjects comprise 2752 asymptomatic patients undergoing screening colonoscopy. From a development set of 860 asymptomatic subjects undergoing screening colonoscopy, multiple logistic regression was applied to identify significant risk factors for advanced colorectal neoplasia defined as invasive carcinoma or advanced adenoma. The ORs for significant risk factors were utilised to develop a risk score ranging from 0 to 7 (Asia-Pacific Colorectal Screening (APCS) score). Three tiers of risk were arbitrarily defined: 0–1 'average risk' (AR); 2–3 'moderate risk' (MR); and 4–7 'high risk' (HR). Subjects undergoing screening colonoscopy between July 2006 and December 2007 were prospectively enrolled to form an independent validation group. Each subject had a personal APCS score calculated by summing the points attributed from the presence of risk factors in the individuals. The performance of the APCS score in predicting risk of advanced neoplasia was evaluated. <h3>Results</h3> There were 860 subjects in the derivation set and 1892 subjects in the validation set, with a baseline prevalence of advanced neoplasia of 4.5% and 3%, respectively. Applying the APCS stratification in the validation set, 559 subjects (29.5%) were in the AR tier, 966 subjects (51.1%) in the MR tier and 367 (19.4%) subjects in the HR tier. The prevalence of advanced neoplasia in the AR, MR and HR groups was 1.3, 3.2 and 5.2%, respectively. The subjects in the MR and HR tiers had 2.6-fold (95% CI 1.1 to 6.0) and 4.3-fold (95% CI 1.8 to 10.3) increased prevalence of advanced neoplasia, respectively, than those in the AR tier. <h3>Conclusions</h3> The APCS score based on age, gender, family history and smoking is useful in selecting asymptomatic Asian subjects for priority of colorectal screening.
Exercise during pregnancy improves maternal glucose screen at 24–28 weeks: a randomised controlled trial
Authors: Ruben Barakat, Yaiza Cordero, Javier Coteron, Maria Luaces, Rocio Montejo
Journal: British Journal of Sports Medicine (2011)

Objective The influence of an exercise programme performed by healthy pregnant women on maternal glucose tolerance was studied. Study design A physical activity (PA, land/aquatic activities) programme during the entire pregnancy (three sessions per week) was conducted by a qualified instructor. 83 healthy pregnant women were randomly assigned to either an exercise group (EG, n=40) or a control (CG, n=43) group. 50 g maternal glucose screen (MGS), maternal weight gain and several pregnancy outcomes were recorded. Results Significant differences were found between study groups on the 50 g MGS. Values corresponding to the EG (103.8±20.4 mg/dl) were better than those of the CG (126.9±29.5 mg/dl), p=0.000. In addition, no differences in maternal weight gain and no cases of gestational diabetes in EG versus 3 in CG (7%) (p&gt;0.05) were found. Conclusion A moderate PA programme performed during pregnancy improves levels of maternal glucose tolerance.
Combining carboplatin and etoposide in docetaxel-pretreated patients with castration-resistant prostate cancer: a prospective study evaluating also neuroendocrine features
Authors: Y. Loriot, C. Massard, M. Gross-Goupil, M. Di Palma, B. Escudier, A. Bossi, K. Fizazi
Journal: Annals of Oncology (2009)
Hypoxic Radiosensitization: Adored and Ignored
Authors: Jens Overgaard
Journal: Journal of Clinical Oncology (2007)

Since observations from the beginning of the last century, it has become well established that solid tumors may contain oxygen-deficient hypoxic areas and that cells in such areas may cause tumors to become radioresistant. Identifying hypoxic cells in human tumors has improved by the help of new imaging and physiologic techniques, and a substantial amount of data indicates the presence of hypoxia in many types of human tumors, although with a considerable heterogeneity among individual tumors. Controlled clinical trials during the last 40 years have indicated that this source of radiation resistance can be eliminated or modified by normobaric or hyperbaric oxygen or by the use of nitroimidazoles as hypoxic radiation sensitizers. More recently, attention has been given to hypoxic cytotoxins, a group of drugs that selectively or preferably destroys cells in a hypoxic environment. An updated systematic review identified 10,108 patients in 86 randomized trials designed to modify tumor hypoxia in patients treated with curative attempted primary radiation therapy alone. Overall modification of tumor hypoxia significantly improved the effect of radiotherapy, with an odds ratio of 0.77 (95% CI, 0.71 to 0.86) for the outcome of locoregional control and with an associated significant overall survival benefit (odds ratio = 0.87; 95% CI, 0.80 to 0.95). No significant influence was found on the incidence of distant metastases or on the risk of radiation-related complications. Ample data exist to support a high level of evidence for the benefit of hypoxic modification. However, hypoxic modification still has no impact on general clinical practice.
Psoriasis: an audit of patients' views on the disease and its treatment
Authors: P.M. McHENRY, V.R. DOHERTY
Journal: British Journal of Dermatology (1992)

Summary This audit aimed to establish the effect of out-patient clinic attendance on patients' attitudes to their psoriasis, its severity and its treatment. A secondary aim was to determine if there was any correlation between the patients subjective concept of disease severity and objective medical assessment. The audit was carried out by means of paired questionnaries completed by patients at their first visit to the out-patient clinic and at a review visit 3 months later. On each of these occasions an objective assessment of psoriasis severity score was made by the dermatologist. We were able to confirm previous reports of major psychosocial effects of psoriasis on the life-style of many patients. At their first visit 67%(30/45) of patients stated that their life-style was affected by psoriasis, while at review 3 months later this figure was 40%(18/45). Overall 76%(34/45) of patients felt their psoriasis had improved following attendance at the clinic, while 11%(5/45) of patients felt it had deteriorated over the 3-month period. However, all patients stated they found attendance at the out-patient clinic to be of benefit. There was a significant correlation between the psoriasis severity score by the patient and by the dermatologist(P<0.001).
5-Fluorouracil Pharmacokinetics Predicts Disease-free Survival in Patients Administered Adjuvant Chemotherapy for Colorectal Cancer
Authors: Antonello Di Paolo, Monica Lencioni, Federica Amatori, Samantha Di Donato, Guido Bocci, Cinzia Orlandini, Marianna Lastella, Francesca Federici, Mauro Iannopollo, Alfredo Falcone, Sergio Ricci, Mario Del Tacca, Romano Danesi
Journal: Clinical Cancer Research (2008)

Abstract Purpose: To evaluate 5-fluorouracil (5-FU) and 5-fluoro-5,6-dihydrouracil (5-FDHU) pharmacokinetics and disease-free survival (DFS) in colorectal cancer patients given 5-FU–based adjuvant chemotherapy within a nonrandomized, retrospective, pharmacokinetic study. Experimental Design: One hundred fifteen patients including 72 men (median age, 63 years; range, 36-79 years) and 43 women (median age, 60 years; range, 36-73 years) received 6 cycles of l-leucovorin 100 mg/m2/day and 5-FU 370 mg/m2/day i.v. boluses (5 days every 4 weeks). Individual plasma concentrations of 5-FU and 5-FDHU were determined on day 1 of the first cycle with a validated high performance liquid chromatography method, and the main pharmacokinetic variables were determined. Follow-up of all patients was extended up to 5 years after the end of adjuvant chemotherapy, and DFS was recorded. Univariate and multivariate analyses were conducted to evaluate any correlation among 5-FU pharmacokinetics, clinical and pathologic variables, and DFS. Results: The area under the time/concentration curve (AUC) of 5-FU was significantly lower in 58 subjects who recurred (7.5 ± 2.9 h × mg/L) with respect to other patients (9.3 ± 4.1 h × mg/L). Furthermore, AUC values lower than 8.4 h × mg/L together with lymph node involvement and the interruption of treatment or reduction of doses were identified as risk factors at univariate analysis. The completion of 6 cycles of adjuvant treatment without dosage modifications was the only independent risk factor at multivariate analysis, despite a trend toward significance for 5-FU AUC values (cutoff value, 8.4 h×mg/L) was observed (P = 0.06). Conclusions: Pharmacokinetics of 5-FU should be regarded as an important factor for predicting disease recurrence in colorectal cancers.
P15 * COMPARATIVE OUTCOMES OF BEVACIZUMAB AND PCV CHEMOTHERAPY IN PATIENTS WITH RECURRENT AND PROGRESSIVE GLIOBLASTOMA: A RETROSPECTIVE STUDY
Authors: S. Dixit, A. Mohan, None Aziz, S. Achawal, G. O'Rielley, C. Rajaraman, L. Baker, L. Gill, M. Hingorani
Journal: Neuro-Oncology (2014)

INTRODUCTION: Bevacizumab (Bev)is used in patients with recurrent high grade glioma in many countries; however, its efficacy has not been compared with a combination of procarbazine, lomustine and vincristine (PCV), a commonly used chemotherapy regimen in the UK. We present comparative outcomes in patients treated with Bev and PCV. METHOD: During January 2011 and March 2013, 40 patients receiving PCV and 35 patients receiving bev for recurrent and progressive glioblastoma (GBM)and anaplastic glioma (AA) were analysed for progression free survival (PFS,overall survival,and duration of neurological improvement. PFS is calculated from date of first cycle to the last cycles before radiological or neurological deterioration. RESULTS: PCV group had significantly younger patients with a median age 51 years compared to 56 in Bev group. Bev was used as I and II or III salvage line 49 and 51%, respectively. PCV was used I and II or III salvage line in 67 and 23% of patients, respectively. 6-month PFS was 38% (95%, CI 22-55%) with Bev and 22% (95%, CI 10-35%) with PCV (not significant). Similarly, superior but not significant increase in median PFS (4.7 vs. 3.3 months) and median overall survival (8.8 vs.5.4 months) were observed in Bev and PCV group, respectively. The number of patients experiencing neurological improvement was higher (57% vs.10%) and mean number of weeks of neurologically improvement compared to the mean number of weeks chemotherapy exposure were significantly longer in Bev group Bev:12/20weeks, PCV:2/1 weeks. CONCLUSION: Although statistically not significant, patients receiving Bev had better 6-month PFS and over survival . Also patients in Bev group experienced longer duration of neurological improvement.
Respiratory and Skeletal Muscles in Hypogonadal Men with Chronic Obstructive Pulmonary Disease
Authors: Franco Laghi, W. Edwin Langbein, Andreea Antonescu-Turcu, Amal Jubran, Christine Bammert, Martin J. Tobin
Journal: American Journal of Respiratory and Critical Care Medicine (2005)

Hypogonadism, found in about one-third of patients with chronic obstructive pulmonary disease (COPD), has potential for decreasing muscle mass and muscle performance. Compared with eugonadal patients, we hypothesized that hypogonadal patients with COPD have decreased respiratory and skeletal muscle performance. Nineteen hypogonadal and 20 eugonadal men with COPD (FEV(1) 1.14 +/- 0.08 and 1.17 +/- 0.11 L [standard error], respectively) were studied. Diaphragmatic contractility, assessed as transdiaphragmatic twitch pressure generated by phrenic nerve stimulation, was similar in hypogonadal and eugonadal patients: 20.6 +/- 2.2 and 19.8 +/- 2.5 cm H(2)O, respectively. During progressive inspiratory threshold loading, hypogonadal and eugonadal patients had similar respiratory muscle endurance times (302 +/- 29 and 313 +/- 48 seconds, respectively) and airway pressure sustained during the last minute of loading (38.2 +/- 3.0 and 40.5 +/- 4.7 cm H(2)O, respectively) (similar to predicted values in healthy subjects). Hypogonadal and eugonadal patients had equivalent limb muscle strength and endurance. During cycle exercise to exhaustion, exercise performance, gas exchange, and respiratory muscle recruitment (estimated by esophageal and gastric pressure swings during tidal breathing) were similar in both groups. In conclusion, hypogonadism does not decrease respiratory or limb muscle performance and exercise capacity in men with moderate-to-severe COPD who, for the most part, are not underweight.
Vascular permeability factor/endothelial growth factor (VPF/VEGF): accumulation and expression in human synovial fluids and rheumatoid synovial tissue.
Authors: R A Fava, N J Olsen, G Spencer-Green, K T Yeo, T K Yeo, B Berse, R W Jackman, D R Senger, H F Dvorak, L F Brown
Journal: The Journal of Experimental Medicine (1994)

Vascular permeability factor (VPF, also known as vascular endothelial growth factor or VEGF), is a potent microvascular permeability enhancing cytokine and a selective mitogen for endothelial cells. It has been implicated in tumor angiogenesis and ascites fluid accumulation. Since development of the destructive synovial pannus in rheumatoid arthritis (RA) is associated with changes in vascular permeability (synovial fluid accumulation), synovial cell hyperplasia, and angiogenesis, we examined synovial fluids (SFs) and joint tissue for the expression and local accumulation of VPF/VEGF. VPF/VEGF was detected in all of 21 synovial fluids examined and when measured by an immunofluorimetric assay, ranged from 6.9 to 180.5 pM. These levels are biologically significant, since &amp;lt; 1 pM VPF/VEGF can elicit responses from its target cells, endothelial cells. Levels of VPF/VEGF were highest in rheumatoid arthritis fluids (n = 10), with a mean value (+/- SEM) of 59.1 +/- 18.0 pM, vs. 21.4 +/- 2.3 pM for 11 SFs from patients with other forms of arthritis (p = 0.042). In situ hybridization studies that were performed on joint tissues from patients with active RA revealed that synovial lining macrophages strongly expressed VPF/VEGF mRNA, and that microvascular endothelial cells of nearby blood vessels strongly expressed mRNA for the VPF/VEGF receptors, flt-1 and KDR. Immunohistochemistry performed on inflamed rheumatoid synovial tissue revealed that the VPF/VEGF peptide was localized to macrophages within inflamed synovium, as well as to microvascular endothelium, its putative target in the tissue. Together, these findings indicate that VPF/VEGF may have an important role in the pathogenesis of RA.
Patterns of Statin Initiation, Intensification, and Maximization Among Patients Hospitalized With an Acute Myocardial Infarction
Authors: Suzanne V. Arnold, Mikhail Kosiborod, Fengming Tang, Zhenxiang Zhao, Thomas M. Maddox, Patrick L. McCollam, Julie Birt, John A. Spertus
Journal: Circulation (2014)

Intensive statins are superior to moderate statins in reducing morbidity and mortality after an acute myocardial infarction. Although studies have documented rates of statin prescription as a quality performance measure, variations in hospitals' rates of initiating, intensifying, and maximizing statin therapy after acute myocardial infarction are unknown.
An Explanation for the Increase in Heart Disease Mortality Rates in Diabetic Pima Indians
Authors: Meda E. Pavkov, Maurice L. Sievers, William C. Knowler, Peter H. Bennett, Robert G. Nelson
Journal: Diabetes Care (2004)

Diabetic nephropathy (DN) became the leading cause of death in diabetic Pima Indians in the 1970s, but was superseded by ischemic heart disease (IHD) in the 1980s. This study tests the hypothesis that the rise in the IHD death rate between 1965 and 1998 is attributable to access to renal replacement therapy (RRT).Underlying causes of death were determined among 2,095 diabetic Pima Indians > or = 35 years old during four 8.5-year time intervals. To assess the effect of access to RRT on IHD death rates, trends were reexamined after subjects receiving RRT were classified as if they had died of DN.During a median follow-up of 11.1 years (range 0.01-34), 818 subjects died. The age- and sex-adjusted DN death rate decreased over the 34-year study (P = 0.05), whereas the IHD death rate increased from 3.3 deaths/1,000 person-years (95% CI 1.4-5.2) to 6.3 deaths/1,000 person-years (95% CI 4.5-8.0; P = 0.03). After 151 subjects on RRT were reclassified as if they had died of DN, the death rate for DN increased from 4.8 deaths/1,000 person-years (95% CI 2.6-7) to 11.3 deaths/1,000 person-years (95% CI 9-13.6; P = 0.0007), whereas the increase in the IHD death rate disappeared (P = 0.57).The incidence rate of renal failure attributable to diabetes has increased rapidly over the past 34 years in Pima Indians. IHD has emerged as the leading cause of death due largely to the availability of RRT and to changes in the pattern of death among those with DN.
Predicting outcome of children with diffuse intrinsic pontine gliomas using multiparametric imaging
Authors: S. J. Hipp, E. Steffen-Smith, D. Hammoud, J. H. Shih, R. Bent, K. E. Warren
Journal: Neuro-Oncology (2011)

Noninvasive evaluation using MRI is the primary means to routinely assess children with diffuse intrinsic pontine gliomas (DIPGs). However, no standard MR sequence has correlated with outcome in these patients. In this study, patients with DIPGs were assessed to determine the combined prognostic value via dynamic susceptibility contrast (DSC) MRI, single-voxel spectroscopy (SVS), multivoxel MR spectroscopy (MRS), and T1-weighted post-gadolinium imaging. Eligible patients had clinical and radiographic findings consistent with a DIPG. Imaging studies were acquired on a 1.5T MRI at various time points during each patient's course. Data were evaluated using a Cox proportional hazard model, a time-dependent covariant Cox model, a Wald test, and a Kaplan-Meier analysis. Ninety-eight studies were performed on 34 patients of median age 5.5 years. Median survival from diagnosis was 468 days. At baseline imaging only, increased ratio of choline to n-acetylaspartate (Cho:NAA) on SVS and increased perfusion on DSC-MRI each predicted shorter survival (relative risk [RR] = 1.48, P = .015 and RR = 4.91, P = .0012, respectively). When analyzing all subsequent time points, increased maximum Cho:NAA on MRS (RR = 1.45, P = .042), increased Cho:NAA on SVS (RR = 1.69, P = .003), increased perfusion (RR = 4.68, P = .0016), and the presence of enhancement (RR = 5.69, P = .022) each predicted shorter survival. Kaplan-Meier analysis showed shorter survival associated with increased perfusion at baseline (P = .0004). Increased perfusion at any time point predicts a significantly shorter survival in children with DIPG. In addition, enhancement, increased Cho:NAA on SVS, and increased maximum Cho:NAA on chemical shift imaging are predictive of shorter survival over time. Routine baseline and subsequent imaging for children with DIPG should, at minimum, incorporate DSC-MRI and SVS.
Repeated measurements and multiple comparisons in cardiovascular research
Authors: J. Ludbrook
Journal: Cardiovascular Research (1994)

Journal Article Repeated measurements and multiple comparisons in cardiovascular research Get access John Ludbrook John Ludbrook Cardiovascular Research Laboratory, University of Melbourne Department of Surgery, Royal Melbourne Hospital, Parkville, Victoria 3050, Australia: Professor J Ludbrook. Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 28, Issue 3, March 1994, Pages 303–311, https://doi.org/10.1093/cvr/28.3.303 Published: 01 March 1994 Article history Received: 15 July 1993 Accepted: 22 October 1993 Published: 01 March 1994
Both L3T4+ and Lyt-2+ helper T cells initiate cytotoxic T lymphocyte responses against allogenic major histocompatibility antigens but not against trinitrophenyl-modified self.
Authors: T Mizuochi, H Golding, A S Rosenberg, L H Glimcher, T R Malek, A Singer
Journal: The Journal of Experimental Medicine (1985)

This study characterizes the T helper (Th) cells that initiate primary cytotoxic T lymphocyte (CTL) responses against allogeneic and trinitrophenyl (TNP)-modified self class I major histocompatibility (MHC) determinants. We show that two distinct Th cell subsets participate in allospecific CTL responses: (a) an L3T4+,Lyt-2- class II-restricted Th cell population, and (b) an L3T4-,Lyt-2+ class I-restricted Th cell population. Both of these T cell subpopulations were shown to function in allospecific CTL responses as helper cells by their ability to show synergy with allospecific CTL precursors. Thus, primary class I allospecific CTL responses represent an immune response involving not only L3T4+ Th cells, but Lyt-2+ Th cells as well. One of the necessary functions performed by both L3T4+ and Lyt-2+ Th cell populations in allospecific CTL responses was found to be the secretion of interleukin 2. Finally, despite the many similarities between anti-allo- and anti-TNP-CTL responses, anti-TNP-CTL responses were found to be mediated by only L3T4+ Th cells, not by Lyt-2+ Th cells. Consequently, Lyt-2+ Th cells appear to be a helper cell population that is primarily involved in MHC-specific immune responses.
Diuretic-Induced Hyponatremia
Authors: MARSHAL P. FICHMAN
Journal: Annals of Internal Medicine (1971)

Severe hyponatremia (serum Na, 91 to 120 mEq/liter) secondary to the use of diuretics was observed in 25 nonedematous patients with clinically normal hydration and creatinine clearances; it was distinguishable from other hyponatremic syndromes by the presence of hypokalemia and alkalosis, the return of serum Na to normal and unimpaired excretion of a water load of 20 ml/kg body weight 3 to 10 days after withdrawing diuretics, and the recurrence of hyponatremia within 2 to 12 days of readministering the drugs. Bioassay of plasma samples in ethanol-anesthetized rats showed elevated (1 to 15 µunits/ml) antidiuretic hormone (ADH) activity in 10 of 10 patients with diuretic-induced hyponatremia, 20 of 23 patients with inappropriate-ADH syndrome, but in none of 10 patients with hypopituitarism. Simultaneous isotope dilution studies in 10 diuretic-induced hyponatremic patients showed a marked decrease in measured exchangeable potassium in relation to a 75%-predicted mean but only a borderline decrease in mean exchangeable sodium. Increasing potassium intake improved hyponatremia. Hyponatremia apparently results from potassium depletion, which exaggerates the volume receptor release of vasopressin that is the response to minimal diuretic-induced sodium loss.
Subspecialties and Physician Maldistribution
Authors: J. Lee Dockery
Journal: JAMA (1993)

<h3>To the Editor.</h3> —The article by Martini<sup>1</sup>in<i>JAMA</i>contains useful information but conveys an unbalanced perspective concerning the relationship between "specialties" and "specialists." The article concludes by stating that the increase in the number of subspecialties has been responsible for the improper geographical distribution of physicians and has generated an improper mix of specialties, and the number of approved specialties and subspecialties is the result of "proceeding without successful planning or coordination." Since 1985 there have been 60 applications for subspecialty recognition by the 24 boards of the American Board of Medical Specialties (ABMS). Only 34 applications have been approved. Standards for review and approval of subspecialties are published and accepted by the medical profession with participation from all of the member boards and the six associate members of the ABMS: the American Medical Association, the Association of American Medical Colleges, the Council of Medical Specialty Societies, the