tbuckley/cabot-search huggingface dataset:
PWE-364 High fibre diet, low fibre diet or habitual diet for the prevention of radiation-induced toxicity in pelvic cancer: a multi-centre randomised controlled trial
Authors: LJ Wedlake, C Shaw, A Lalji, K Mohammed, S Essapen, K Whelan, J Andreyev
Journal: Gut (2015)

<h3>Introduction</h3> An estimated 17,000 patients a year in the UK receive radiotherapy (RT) for pelvic cancers. Acute damage to normal gastrointestinal mucosa (toxicity) is characterised by an inflammatory response that may respond to altered dietary fibre intake through a range of mechanisms. The aim was to undertake a 3-arm, randomised controlled trail comparing high fibre, low fibre, and habitual fibre diet for the prevention of radiation induced toxicity in the short (6 weeks) and long term (1 year) in patients receiving radical (≥45 Grey) RT for lower gastrointestinal or gynaecological malignancies. <h3>Method</h3> Patients were randomised to high fibre (target ≥18 g/d non-starch polysaccharide, NSP), low fibre (≤10 g/d NSP) or habitual fibre (control) groups. The primary end-point was the inter-group difference in change in Inflammatory Bowel Disease Questionnaire – Bowel Subset (IBDQ-B) score: start of RT to nadir (worst) score. Patients completed two 7-day food diaries, daily Bristol Stool Form Scale and a sub-group provided stool samples for faecal short-chain fatty acid (SCFA) analysis. <h3>Results</h3> A total of 166 patients were randomised (High: 56, Low: 55, Control: 55); median (range) age: 62.5 (26 – 91) years; males:females 42%:58%; median RT dose: 50.4 Grey; 72% concomitant chemotherapy. NSP intake was significantly different between groups at start and end-RT (p &lt; 0.001 all comparisons). Mean IBDQ-B scores reduced in all groups (worsening symptoms) between start and end-RT, however, the reduction was significantly smaller in the high fibre group (-3.1 ± 13.0) compared with control (-10.8, ± 13.6) (p = 0.007). No significant differences were observed in SCFA concentrations. One year IBDQ-B scores were available for n = 121 (withdrawn: 7; deceased: 9; lost to follow-up: 29) and improved in all groups compared to start-RT. Again the difference between high fibre (+1.6 ± 11.9) and control groups (-6.9, ± 12.5) was significant (p = 0.010). <h3>Conclusion</h3> The results show a benefit for increased fibre intake during pelvic RT. However, the findings are equivocal as the fall in IBDQ-B scores at end-RT and at one year were not significantly different between high fibre and low fibre groups. High and low fibre intake may provide benefit via different mechanisms although the possible therapeutic effect of dietary intervention alone cannot be ruled out. A high fibre diet was shown to reduce radiation-induced toxicity in patients undergoing pelvic RT. <h3>Disclosure of interest</h3> None Declared.
Quality to the fore in health policy---at last
Authors: R. Thomson
Journal: BMJ (1998)

News p 97 

In its own words, the consultation document on quality in the English NHS sets out a formidable agenda for change. Nevertheless, it constitutes a major advance, putting quality improvement at the heart of the service.1 The proposals describe a national approach that encompasses the National Institute of Clinical Excellence (NICE); the Commission for Health Improvement (CHIMP); national frameworks in key disease areas; the previously described performance management framework, with indicators relevant to NHS priorities; and a national patient survey. Locally, implementation and monitoring will be delivered through clinical governance, supported by national and local systems for lifelong learning, and reviewed systems of professional self regulation. Do all these elements add up to a coherent approach?

The national institute will appraise evidence and develop and disseminate guidance and audit methods. It will coordinate or take over current activities such as guideline development and effectiveness bulletins. This is desperately needed because the plethora of guidelines—of variable quality and developed by multiple bodies—has created confusion in the service.2 But how will it deliver this huge agenda, apparently without additional resources? The original role of the Agency for Health Care Policy and Research in the United States was similar, but even with huge resources …
The dexamethasone suppression test and depressive symptoms in early and late withdrawal from alcohol
Authors: S D Ravi, W Dorus, Y N Park, M C Collins, R W Reid, G F Borge
Journal: American Journal of Psychiatry (1984)

Results of the dexamethasone suppression test (DST) in 30 alcoholic patients tested on day 5 and again on day 25 after their last drink are presented. Nineteen patients (63%) failed to suppress cortisol on day 5; three (11%) failed to suppress cortisol on day 25. Depressive symptoms, measured by the Beck Depression Inventory, were significantly correlated with DST results; the lifetime diagnosis of depressive illness was not. The authors conclude that the DST is not useful in detecting primary affective disorders during the early phase of withdrawal from alcohol.
A Prospective Study of New Infections with Herpes Simplex Virus Type 1 and Type 2
Authors: Andria G.M. Langenberg, Lawrence Corey, Rhoda L. Ashley, Wai Ping Leong, Stephen E. Straus
Journal: New England Journal of Medicine (1999)

Herpes simplex virus (HSV) infections are endemic, but the clinical characteristics of newly acquired HSV type 1 (HSV-1) and HSV type 2 (HSV-2) infections in adults have not been rigorously defined. We monitored 2393 sexually active HSV-2-seronegative persons for clinical and serologic evidence of new HSV infection. Of the participants, 1508 were seropositive for HSV-1 and 885 were seronegative. Charts were reviewed in a blinded manner for classification of those with genitourinary or oropharyngeal symptoms. Charts were also reviewed for all 174 persons with HSV seroconversion.The rates of new HSV-1 and HSV-2 infections were 1.6 and 5.1 cases per 100 person-years, respectively. Of the 155 new HSV-2 infections, 57 (37 percent) were symptomatic, 47 of which (82 percent) were correctly diagnosed at presentation. Among the 74 patients given a clinical diagnosis of genital HSV-2 during the study, 60 were given a correct diagnosis and 14 were given an incorrect diagnosis of genital herpes, for a ratio of true positive results to false positive results of 4:1. Among the 98 persons with asymptomatic HSV-2 seroconversion, 15 percent had genital lesions at some time during follow-up. Women were more likely than men to acquire HSV-2 (P<0.01) and to have symptomatic infection. Previous HSV-1 infection did not reduce the rate of HSV-2 infection, but it did increase the likelihood of asymptomatic seroconversion, as compared with symptomatic seroconversion, by a factor of 2.6 (P<0.001). Of the 19 new HSV-1 infections, 12 were symptomatic. The rates of symptomatic genital HSV-1 infection and oropharyngeal HSV-1 infection were the same (0.5 case per 100 person-years).Nearly 40 percent of newly acquired HSV-2 infections and nearly two thirds of new HSV-1 infections are symptomatic. Among sexually active adults, new genital HSV-1 infections are as common as new oropharyngeal HSV-1 infections.
Acute manic episodes in pregnancy [clinical conference]
Authors: M Finnerty, Z Levin, L J Miller
Journal: American Journal of Psychiatry (1996)

A 33-year-old pregnant woman at 26 weeks gestation, who had a history of bipolar mood disorder, type I, was admitted to the hospital for hypomania and poorly controlled diabetes mellitus. The patient had had her first episode of affective illness at age 28, after the birth of her second child. After an initial postpartum depression, she had cycled into a manic state. She had subsequently been hospitalized seven times for acute mania. A combination of valproate and chlorpromazine had proven effective in managing most of her manic episodes, while her two most severe episodes had been successfully managed with bilateral ECT.
Abstract P088: The Cholesterol-Lowering Effect of Phytosterols across Different Dose Ranges: A Meta-analysis of Randomized Controlled Trials
Authors: Rouyanne T Ras, Elke A Trautwein
Journal: Circulation (2013)

Introduction: Phytosterols (plant sterols and stanols) are proven to lower LDL-cholesterol (LDL-C). Recent evidence suggests a larger maximal lowering effect for plant stanols vs. plant sterols based on their respective continuous dose-response relationships. The objective of the present analysis was to investigate the combined and separate LDL-C-lowering effects of plant sterols and stanols at intakes up to on average 3 g/d when classified into different dose ranges. Studies with doses exceeding 4 g/d were not included as these are scarce. Hypothesis: Comparable efficacy between plant sterols and stanols. Methods: Studies were searched in several databases and selected based on predefined selection criteria. Studies were classified into different dose ranges for investigating the dose-response relationship; this approach was chosen as it was judged being more robust in controlling for any over- or underestimation of the estimated effects at certain doses which is a potential limiting factor in continuous...
CHAPTER 3: Mineral Metabolism
Authors: Kailash Jindal, Christopher T. Chan, Clement Deziel, David Hirsch, Steven D. Soroka, Marcello Tonelli, Bruce F. Culleton
Journal: Journal of the American Society of Nephrology (2006)

### Recommendations



1.  Serum phosphate levels should be monitored and maintained within the normal range. (Grade C) 

2.  To optimize control of serum phosphate, use restriction of dietary phosphate (Grade D), adjust the dialysis prescription (Grade D), and use oral phosphate binders. (Grade C
Abstract 18589: Virus-Derived Serpin Prolongs Survival and Reduces Vasculitis in Lethal Viral Sepsis in Unrelated Infections
Authors: Hao Chen, Donghang Zheng, Mee Y Bartee, Jennifer A Davids, Alexandra R Lucas
Journal: Circulation (2012)

Lethal viral infections produce a cytokine storm with disseminated vascular leak, clotting, bleeding, organ failure and high mortality, but treatment remains limited. With this cytokine storm there is a massive influx of inflammatory macrophage and T lymphocytes into the arterial wall and affected organs. Serine proteases in clot-forming and clot-dissolving cascades are regulated by inhibitors termed serpins. Serpins such as anti-thrombin III have been used to reduce DIC and improve outcomes but with limited success. Myxomavirus secretes a potent anti-inflammatory serpin, Serp-1, that inhibits thrombotic factor Xa (fXa) and thrombolytic tissue and urokinase-type plasminogen activators (tPA, uPA). Serp-1 treatment was tested in mouse models of lethal gammaHerpesvirus68 and Ebola virus infections. Serp-1 significantly increased survival in both infections, whereas mammalian neuroserpin, that targets only tPA and uPA, did not. Fator Xa levels were reduced in aortic tissues after Serp-1 treatment. Serp-1 reduced virus load, hemorrhage, inflammation, and organ damage. NSP treatment allowed for a marked suppression of normal spleen cell responses during infections on flow cytometry analysis, while Serp-1 did not. RT-PCR array analysis of aortic sections from infected mice demonstrated significantly altered thrombotic and thrombolytic pathway proteases and serpins as well as addressin gene expression changes with Serp-1 treatment but not with NSP treatment. Treatments with other myxomaviral anti-inflammatory proteins, Serp-2 targeting apoptosis, and M-T7 a chemokine modulator showed trends toward reduced inflammation in the MHV68 infected mice. Conclusions: Myxomaviral Serp-1 modulates thrombotic and thrombolytic proteases, markedly improving survival in unrelated lethal viral infections, whereas a mammalian serpin targeting only thrombolysis was ineffective. Treatment targeting both thrombotic and the thrombolytic cascades may improve outcomes in severe viral septic states with vascular inflammation and DIC.
Managing acute hypercapnic respiratory failure in adults: where do we need to get to?
Authors: A Craig Davidson
Journal: Thorax (2016)

The concept of augmenting spontaneous breathing effort by a close fitting face mask has evolved from initial case reports, nearly two decades ago, to become part of mainstream acute clinical care. Indeed, it has become the preferred option to invasive ventilation in many cases of acute hypercapnic respiratory failure (AHRF). In the UK, service development has been driven largely by respiratory physicians and this has resulted in an unintended, and unhelpful, dichotomy of responsibility for patient care. NIV guidelines that have been published have, by being concerned with the practicalities of delivery of a new service, failed to promote appropriate integration between those providing the acute NIV service and intensivists, the gate keepers to the intensive care unit (ICU) and who manage the invasively ventilated patient. The joint British Thoracic Society (BTS) and Intensive Care Society guideline for ‘the ventilatory management of acute hypercapnic respiratory failure in adults’, a supplement to this edition of Thorax , instead aims to promote shared clinical responsibility and reviews the evidence base for both invasive and NIV in the variety of conditions that may present as AHRF.

Hypercapnic respiratory failure is less common than hypoxic respiratory failure but is still a frequent cause of emergency hospital admission. It complicates around 20% of acute exacerbations of COPD (AECOPD), signalling advanced disease, a high risk of future hospital admission and limited long-term prognosis. Its presence increases the mortality of an exacerbation from 8% to as much as 30%, depending on the degree of respiratory acidosis.1 Morbid obesity is now the second most common cause of AHRF …
Induction of Tumors in ACI Rats Given a Diet Containing Ptaquiloside, a Bracken Carcinogen&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: I Hirono, H Ogino, M Fujimoto, K Yamada, Y Yoshida, M Ikagawa, M Okumura
Journal: JNCI Journal of the National Cancer Institute (1987)

Journal Article Induction of Tumors in ACI Rats Given a Diet Containing Ptaquiloside, a Bracken Carcinogen Get access Iwao Hirono, Iwao Hirono Search for other works by this author on: Oxford Academic PubMed Google Scholar Hiroshi Ogino, Hiroshi Ogino Search for other works by this author on: Oxford Academic PubMed Google Scholar Masao Fujimoto, Masao Fujimoto Search for other works by this author on: Oxford Academic PubMed Google Scholar Kiyoyuki Yamada, Kiyoyuki Yamada Search for other works by this author on: Oxford Academic PubMed Google Scholar Yoshifumi Yoshida, Yoshifumi Yoshida Search for other works by this author on: Oxford Academic PubMed Google Scholar Megumi Ikagawa, Megumi Ikagawa Search for other works by this author on: Oxford Academic PubMed Google Scholar Manabu Okumura Manabu Okumura Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 79, Issue 5, November 1987, Pages 1143–1149, https://doi.org/10.1093/jnci/79.5.1143 Published: 01 November 1987 Article history Received: 09 February 1987 Accepted: 12 June 1987 Published: 01 November 1987
Use of intraoperative breast cancer sentinel lymph node (SLN) assay to predict of ≥4 positive (+) lymph nodes (LN)
Authors: A. B. Chagpar, P. Blumencranz, P. W. Whitworth, K. B. Deck, A. Rosenberg, R. M. Simmons, D. S. Reintgen, P. Beitsch, S. Saha, T. B. Julian
Journal: Journal of Clinical Oncology (2009)

530 Background: Predicting which patients will have ≥4 +LN and may need radiation therapy affects immediate breast reconstruction. We hypothesized that model s to predict the likelihood of ≥4+LN may be improved by incorporation of quantitative real time RT-PCR analysis of SLN. Methods: 728 patients were enrolled in 2 prospective studies of the GeneSearch BLN Assay (Veridex LLC) for SLN metastases. 205 (28.2%) were found to have +SLN by hematoxylin-eosin staining. Of these, 115 pts (15.8%) had tumors ≤5 cm in size with &gt;4 total LN removed, forming the cohort of interest for this study. Quantitative cycle times (CT) for mammaglobin (MG) and CK19 were correlated with finding ≥4+LN on final pathology. Results: Median tumor size was 2.0 cm (range; 0.2–5.0 cm). Median number of SLN removed was 3 (range; 1–11). 18 patients (15.7%) had ≥4 +LN on final pathology. Median CT for MG was 29.1 (interquartile range (IQR): 24.7–39.0) in patients with &lt;4 +LN vs. 21.4 (IQR: 18.5–26.8) in those with ≥4 +LN, p&lt;0.001. Median CT for CK19 was 23.7 (IQR: 20.9–28.2) in patients with &lt;4 +LN vs. 19.6 (IQR: 17.8–20.7) in those with ≥4 +LN, p&lt;0.001. Tumor size ≥2cm, proportion of SLN+ &gt;50%, MG CT &lt;25.8 and CK19 &lt;20.8 were correlated with ≥4 +LN on final pathology. On multivariate analysis, tumor size, MG CT and CK19 CT were significant (see table). A simplified CPR was created with 1 point given if tumor size was ≥2cm, 1 point if MG CT &lt;25.8 and 2 points if CK19 CT&lt;20.8. Of the 24 patients (20.9%) with 0 points, only 1 (4.2%) had ≥4 +LN; of the 12 patients (10.4%) with 3 points, 8 (66.7%) had ≥4 +LN on final pathology, p&lt;0.001. Area under the receiver-operator curve was 86.2% (95% CI: 76.1%-96.2%). Conclusions: Intraoperative quantitative RT-PCR of SLN improves prediction of ≥4 +LN; further validation of this model will have clinical utility regarding the use of immediate, delayed, or delayed-immediate reconstruction approaches. [Table: see text] [Table: see text]
Inhibition of Lymphocyte Proliferation With Hepatocellular Carcinoma: Lack Serum Alpha-Fetoprotein Levels
Authors: E.C. Ren
 5, S.H. Chan
Journal: JNCI Journal of the National Cancer Institute (1981)

Sera from 23 hepatocellular carcinoma (HCC) patients were studied for their effects on lymphocyte proliferation during polyclonal mitogen stimulation and one-way mixed lymphocyte culture (MLC). The effect of 25% HCC serum on tritiated thymidine uptake of cultures varied from slight augmentation to 95% inhibition; however, no relationship was found between the potency of inhibition and serum alpha-fetoprotein (AFP) concentration. Purified AFP from the ascitic fluid of an HCC patient had no effect on MLC or cultures containing pokeweed mitogen; but at a concentration of 200 micro g/ml, AFP inhibited up to 30% of the proliferative responses in cultures containing phytohemagglutinin or concanavalin A. Results strongly suggest that the AFP in HCC sera is not inhibitory in itself.
Abstract 12761: The High Prevalence of Early Repolarization in Genotyped Long QT Syndrome
Authors: Kanae Hasegawa, Hiroshi Watanabe, Seiko Ohno, Hideki Itoh, Takeru Makiyama, Takashi Ashihara, Hideki Hayashi, Minoru Horie
Journal: Circulation (2013)

Background:  Early repolarization (ER) has recently been shown to be related to the increased risk of lethal arrhythmias and sudden death in patients with idiopathic ventricular fibrillation as well as in the general population. Furthermore, there is increasing evidence that ER increases the arrhythmia risk in other types of heart diseases including short QT syndrome and coronary artery disease. The present study aimed to investigate the association between ER and arrhythmia events in genotyped long QT syndrome (LQTS) patients.   Methods and Results:  We studied the association of electrocardiographic findings with cardiac events (syncope, torsades de pointes, ventricular tachycardia, or ventricular fibrillation) in 247 probands from unrelated families (age, 20±17 years; female, n=153, 62%) who were identified to carry a mutation in either KCNQ1 (n=111), KCNH2 (n=117), or SCN5A (n=19). There were 154 patients (62%) who had the events. QT and corrected QT intervals were 466±57 ms and 490±52 ms, respectively. ER was defined as an elevation of the J point noted as either as QRS slurring or notching ≥ 0.1 mV in more than two leads in the inferior and/or lateral leads and was present in 66 patients (27%). The frequency of ER was higher in KCNH2 mutation carriers (33%) than those with other genotypes (KCNQ1, 22%; SCN5A, 16%). In univariate models, age, female gender, genotype (increased risk in KCNH2 and SCN5A than KCNQ1), heart rate, PR interval, QT interval, and ER were significantly associated with cardiac events. Multivariate model analyses revealed that the presence of ER was a significant risk (odds ratio [OR], 3.19; 95% confidence interval [CI], 1.56-6.55; P=0.02) along with four other factors: (1) female gender (OR, 2.05; 95% CI, 1.10-3.81; P=0.02), (2) KCNH2 mutation (OR, 2.35; 95% CI, 1.24-4.44; P=0.009), (3) prolonged PR interval (OR, 1.14/10 ms; 95% CI, 1.01-1.28/10 ms; P=0.03), and (4) prolonged QT interval (OR, 1.07/10 ms; 95% CI, 1.01-1.14/10 ms; P=0.04).   Conclusions:  Genotyped symptomatic LQTS patients showed a higher prevalence of ER. The presence of ER may be a useful risk predisposing to arrhythmias in genotyped LQTS.
Modification in Growth of Transplantable Rat Tumors Exposed to Friend Virus
Authors: Kobayashi, Hiroshi, Sendo, Fujiro, Shirai, Toshikazu, Kaji, Hiroshi, Kodama, Takao, Saito, Hiroshi
Journal: JNCI Journal of the National Cancer Institute (1969)

Journal Article Modification in Growth of Transplantable Rat Tumors Exposed to Friend Virus Get access Hiroshi Kobayashi, Hiroshi Kobayashi Laboratory of Pathology, Cancer Institute, Hokkaido University School of Medicine, Sapporo, Japan Search for other works by this author on: Oxford Academic PubMed Google Scholar Fujiro Sendo, Fujiro Sendo Laboratory of Pathology, Cancer Institute, Hokkaido University School of Medicine, Sapporo, Japan Search for other works by this author on: Oxford Academic PubMed Google Scholar Toshikazu Shirai, Toshikazu Shirai Laboratory of Pathology, Cancer Institute, Hokkaido University School of Medicine, Sapporo, Japan Search for other works by this author on: Oxford Academic PubMed Google Scholar Hiroshi Kaji, Hiroshi Kaji Laboratory of Pathology, Cancer Institute, Hokkaido University School of Medicine, Sapporo, Japan Search for other works by this author on: Oxford Academic PubMed Google Scholar Takao Kodama, Takao Kodama Laboratory of Pathology, Cancer Institute, Hokkaido University School of Medicine, Sapporo, Japan Search for other works by this author on: Oxford Academic PubMed Google Scholar Hiroshi Saito Hiroshi Saito Laboratory of Pathology, Cancer Institute, Hokkaido University School of Medicine, Sapporo, Japan Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 42, Issue 3, March 1969, Pages 413–419, https://doi.org/10.1093/jnci/42.3.413 Published: 01 March 1969 Article history Received: 18 September 1968 Accepted: 06 November 1968 Published: 01 March 1969
Lobular Capillary Hemangioma (“Pyogenic Granuloma”) of the Trachea
Authors: Satish Kalanjeri, Anupam Kumar, Sanjay Mukhopadhyay, Atul C. Mehta
Journal: American Journal of Respiratory and Critical Care Medicine (2016)

Lobular Capillary Hemangioma (“Pyogenic Granuloma”) of the Trachea Satish Kalanjeri, Anupam Kumar, Sanjay Mukhopadhyay, and Atul C. Mehta Interventional Pulmonology, Section of Pulmonary, Critical Care, and Sleep Medicine, Louisiana State University Health, Shreveport, Louisiana; and Department of Pulmonary, Allergy, and Critical Care Medicine, and Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
Low urinary dopamine and prediction of phenothiazine-induced Parkinsonism: a preliminary report
Authors: T J Crowley, C O Rutledge, M M Hoehn, M A Stallings, S Sundell
Journal: American Journal of Psychiatry (1976)

Psychiatric patients who excreted larger amounts of urinary free dopamine before treatment were significantly more likely than patients excreting smaller amounts to develop parkinsonian side effects during moderate-dose trifluoperazine therapy. If this finding is replicated, urinary free dopamine determinations could prove valuable in indicating which patients should receive those antipsychotic drugs least likely to produce extrapyramidal side effects.