tbuckley/cabot-search huggingface dataset:
The general public's knowledge and perceptions about rheumatic diseases
Authors: E. M V. D. Wardt
Journal: Annals of the Rheumatic Diseases (2000)

<h3>OBJECTIVE</h3> In the Netherlands, the mass media pay little attention to rheumatic diseases. For this reason, it might be assumed that in general people know very little about rheumatic diseases and thus have an unrealistic image of them. The purpose of this study was to gain insight into the general public9s knowledge and perceptions regarding rheumatic diseases in the Netherlands. <h3>METHODS</h3> A questionnaire was sent by mail to a random sample of 1800 Dutch homes; the response was 658. Questions mainly focused on knowledge, attitudes, behavioural intentions and use of the mass media with regard to rheumatic diseases. <h3>RESULTS</h3> The respondents gave the right answer to a mean of 8.2 statements out of 17 true/false statements regarding factual knowledge of rheumatic diseases. Respondents particularly underestimated the prevalence of rheumatic diseases and were unaware of several rheumatic disorders. Most respondents had rarely used the mass media to gain information about rheumatic diseases, but they did show a moderate interest in acquiring information. Knowledge correlated positively with the respondents9 level of education, acquaintance with rheumatic patients, and use of the mass media. Knowledge correlated negatively with the idea that rheumatic patients are themselves able to influence the course of their disease. In general, respondents judged rheumatic diseases to be rather serious but did not feel very frightened or vulnerable of becoming a rheumatic patient. Fear of rheumatic diseases correlated positively with interest in information about rheumatic diseases, intentions of visiting a doctor if experiencing rheumatic complaints and helping rheumatic patients in daily life. <h3>CONCLUSIONS</h3> This study found that the public in general do not know very much about rheumatic diseases, but they do have a moderate desire for more information about them. Furthermore, they do not feel frightened of being confronted with a rheumatic disorder. More information about rheumatic diseases in the media might lead to better knowledge and perception of rheumatic diseases among the general public.
Population Pharmacokinetic-Pharmacodynamic Model for Neutropenia with Patient Subgroup Identification: Comparison across Anticancer Drugs
Authors: Charlotte Kloft, Johan Wallin, Anja Henningsson, Etienne Chatelut, Mats O. Karlsson
Journal: Clinical Cancer Research (2006)

Abstract Purpose: Cancer chemotherapy, although based on body surface area, often causes unpredictable myelosuppression, especially severe neutropenia. The aim of this study was to evaluate qualitatively and quantitatively the influence of patient-specific characteristics on the neutrophil concentration-time course, to identify patient subgroups, and to compare covariates on system-related pharmacodynamic variable between drugs. Experimental Design: Drug and neutrophil concentration, demographic, and clinical chemistry data of several trials with docetaxel (637 patients), paclitaxel (45 patients), etoposide (71 patients), or topotecan (191 patients) were included in the covariate analysis of a physiology-based pharmacokinetic-pharmacodynamic neutropenia model. Comparisons of covariate relations across drugs were made. Results: A population model incorporating four to five relevant patient factors for each drug to explain variability in the degree and duration of neutropenia has been developed. Sex, previous anticancer therapy, performance status, height, binding partners, or liver enzymes influenced system-related variables and α1-acid glycoprotein, albumin, bilirubin, concomitant cytotoxic agents, or administration route changed drug-specific variables. Overall, female and pretreated patients had a lower baseline neutrophil concentration. Across-drug comparison revealed that several covariates (e.g., age) had minor (clinically irrelevant) influences but consistently shifted the pharmacodynamic variable in the same direction. Conclusions: These mechanistic models, including patient characteristics that influence drug-specific parameters, form the rationale basis for more tailored dosing of individual patients or subgroups to minimize the risk of infection and thus might contribute to a more successful therapy. In addition, nonsignificant or clinically irrelevant relations on system-related parameters suggest that these covariates could be negligible in clinical trails and daily use.
Best Threshold for Diagnosis of Stenosis or Thrombosis within Six Months of Access Flow Measurement in Arteriovenous Fistulae
Authors: Marcello Tonelli, Gian S. Jhangri, David J. Hirsch, Joanne Marryatt, Paula Mossop, Colleen Wile, Kailash K. Jindal
Journal: Journal of the American Society of Nephrology (2003)

ABSTRACT. Canadian clinical practice guidelines recommend performing angiography when access blood flow (Qa) is &lt;500 ml/min in native vessel arteriovenous fistulae (AVF), but data on the value of Qa that best predicts stenosis are sparse. Because correction of stenosis in AVF improves patency rates, this issue seems worthy of investigation. Receiver-operating characteristic curves were constructed to examine the relationship between different threshold values of Qa and stenosis in 340 patients with AVF. Stenosis was defined by the composite outcome of access failure or angiographic stenosis occurring within 6 mo of the first Qa measurement. The Qa value was then classified as true negative, true positive, false negative, or false positive for stenosis. An additional analysis was performed in which Qa was corrected for systolic BP before assigning it to one of the four diagnostic categories. The area under the curve for the composite definition of stenosis was 0.86. Graphically, Qa thresholds of &lt;500 and &lt;600 ml/min had similar efficacy for detecting stenosis or access failure within 6 mo, and both seemed superior to &lt;400 ml/min. However, the frequency of the composite definition of stenosis among AVF with Qa between 500 and 600 ml/min was only 6 (25%) of 24, as compared with 58 (76%) of 76 when Qa was &lt;500 ml/min. This suggests that most lesions that would be found using a threshold of &lt;600 ml/min occurred in AVF with Qa &lt;500 ml/min and that the small gain in sensitivity associated with the &lt;600-ml/min threshold would be outweighed by the reduced specificity compared with &lt;500 ml/min. Correcting Qa for BP did not improve diagnostic performance or change these results, which were consistent in several sensitivity analyses. Qa measurements seemed to predict stenosis or incipient access failure equally well in groups defined by diabetic status, gender, and AVF location. In conclusion, it was found that Qa &lt;500 ml/min seems to be the most appropriate threshold for performing angiography in patients with native vessel AVF. It is recommended that clinicians arrange angiography when Qa is &lt;500 ml/min in AVF.
Malignant peritoneal mesothelioma treated by continuous hyperthermic peritoneal perfusion chemotherapy
Authors: E. de Bree, M. Christodoulakis, D. Tsiftsis
Journal: Annals of Oncology (2000)

Malignant mesothelioma of the peritoneum is a rare tumour for which the therapeutic approach has not yet been standardized. The efficacy of the current regimes is limited. Effective locoregional therapy is crucial, since this tumour is most often confined to the peritoneal cavity at the time of the initial diagnosis and remains there for much of its clinical course. If and when haematogenous metastases occur, they rarely contribute to the death of the patient, which is often caused by the overgrowth of the primary tumour and its local complications. A case of diffuse malignant peritoneal mesothelioma treated by cytoreductive surgery and continuous hyperthermic peritoneal perfusion with cisplatin is reported. The patient received systemic combination chemotherapy postoperatively. She is in good condition and free of disease 28 months after her treatment. Continuous hyperthermic peritoneal perfusion chemotherapy has recently been used in patients with secondary peritoneal carcinomatosis from digestive and gynecological malignancies with promising results. It is also possible that the same treatment alone or in combination with systemic chemotherapy may be effective in the treatment of primary peritoneal malignancies, as in the case of diffuse peritoneal mesothelioma.
A clinical and echocardiographic study of patients with the hypermobility syndrome.
Authors: R Grahame, J C Edwards, D Pitcher, A Gabell, W Harvey
Journal: Annals of the Rheumatic Diseases (1981)

Three age- and symptom-matched groups of patients with a hypermobility score of 5-9, 3-4, and 0-2 (controls), respectively, were examined for clinical and echocardiographic evidence of mitral valve prolapse and other stigmata of a collagen disorder. Mitral valve prolapse, a reduced upper segment/lower segment mitral ratio, reduced skin thickness, spinal anomalies, and a history of fracture were found to be significantly commoner among the hypermobile patients than the controls. The data suggest that the so-called hypermobility syndrome, far from being a benign locomotor disorder of healthy persons, may be a forme fruste of a hereditary disorder of connective tissue.
PSYCHOLOGICAL SERVICES FOR CHRONIC MENTAL PATIENTS IN STATE AND VA HOSPITALS
Authors: ABRAHAM M. ZEICHNER, JULES D. HOLZBERG, EDGAR C. YERBURY
Journal: American Journal of Psychiatry (1955)

A questionnaire was submitted to all state and VA hospitals caring for chronically mentally ill patients. Responses were received from 67% and 77% respectively. The survey indicates that VA hospitals are making much greater use of psychological services with chronic patients. Approximately one-fourth of state hospitals do not provide any such service. While the VA hospitals utilize psychological services to a greater extent, both state and VA hospitals make limited use of full-time psychologists. Where part-time personnel is utilized, they spend, for the most part, less than 50% of their time with chronic patients. A considerable portion of the psychological services for chronic patients is performed by trainees rather than by fully trained staff at the Ph. D. level. The survey indicates that one of the great needs is for psychotherapy and that psychologists in the VA hospitals are being used more extensively in providing both individual and group psychotherapy for chronic patients. The survey uncovered in both state and VA hospitals a substantial discrepancy between the current ratio of psychologists to patients, and that recommended by both the Veterans Administration and The American Psychiatric Association. While the Veterans Administration recommends one psychologist for every 300 chronic patients and The American Psychiatric Association one for every 500, the survey indicates that veterans hospitals have one full-time psychologist for every 720 patients and state hospitals one for every 4,907. The paper describes the various psychological services being performed by psychologists working with chronic patients.
Effect of inadvertent intradermal administration of high dose percutaneous BCG vaccine
Authors: M M Miles, R J Shaw
Journal: BMJ (1996)

In the United Kingdom it is recommended that all children receive BCG vaccination to prevent development of tuberculosis.1 2 The standard route of administration is intradermal. In neonates a 10 times more potent percutaneous preparation is used, a small volume being injected to a depth of 2 mm with a modified Heaf gun. The two preparations have similar packaging and labelling and so may easily be confused.3 We report the outcome of inadvertent intradermal administration of the stronger percutaneous product and define the relation between the development of skin lesions and the dose of vaccine.

Thirty two school children aged 11-14 received 0.1 …
Circulating soluble E-selectin in early rheumatoid arthritis: a prospective five year study
Authors: A Kuuliala
Journal: Annals of the Rheumatic Diseases (2002)

Soluble E-selectin (sE-selectin) is a marker of activation of vascular endothelium.To examine serum levels of sE-selectin in a cohort of 85 patients with early rheumatoid arthritis (RA) followed up for five years.sE-selectin levels were assessed annually using an enzyme linked immunosorbent assay (ELISA) and related to simultaneously obtained clinical and laboratory measures. Joint inflammation was evaluated by active joint count, functional status by Health Assessment Questionnaire (HAQ), and radiographic findings in hands and feet by the Larsen method. Laboratory tests included serum C reactive protein (CRP) level, erythrocyte sedimentation rate, blood haemoglobin level, white blood cell count (WBC), and platelet count. Area under the curve (AUC) was calculated for each variable, and Jonckheere's test for ordered alternatives was applied to assess significance of association between sE-selectin AUC tertiles and other variables. Baseline sE-selectin tertiles were related to change in Larsen score and HAQ score at five years. Odds ratios (OR) with 95% confidence interval (CI) were calculated using univariate and multivariate logistic regression.sE-selectin levels were associated with CRP level (p=0.012), WBC (p=0.037), active joint count (p=0.019), progression of joint destruction (p=0.038), and HAQ score at five years (p=0.021), but not with extra-articular symptoms or comorbidity. Baseline sE-selectin levels in the third tertile predicted the HAQ score at five years (OR 4.18, 95% CI 1.15 to 15.22). sE-selectin levels of patients did not differ significantly from those of healthy control subjects.The degree of activation of vascular endothelium is associated with activity and outcome of early RA.
Microbleeds, Mortality, and Stroke in Alzheimer Disease
Authors: Marije R. Benedictus, Niels D. Prins, Jeroen D. C. Goos, Philip Scheltens, Frederik Barkhof, Wiesje M. van der Flier
Journal: JAMA Neurology (2015)

Microbleeds are more prevalent in patients with Alzheimer disease (AD) compared with the general elderly population. In addition, microbleeds have been found to predict mortality in AD.To investigate whether microbleeds in AD increase the risk for mortality, stroke (including intracerebral hemorrhage), and cardiovascular events.The MISTRAL (do MIcrobleeds predict STRoke in ALzheimer's disease) Study is a longitudinal cohort study within the memory clinic-based Amsterdam Dementia Cohort. We selected all patients with AD with a baseline visit between January 2, 2002, and December 16, 2009, and microbleeds (n = 111) and matched those (1:2) for age, sex, and magnetic resonance imaging scanner to 222 patients with AD without microbleeds. After a minimal follow-up of 3 years, information on all-cause mortality, stroke-related mortality, and cardiovascular mortality was obtained between November 1, 2012, and May 1, 2014. In addition, we obtained information on the occurrence of incident stroke or transient ischemic attack, cardiovascular events, and nursing home admittance.Stroke-related mortality, incident stroke, and intracerebral hemorrhage.Patients had a mean (SD) age of 71.2 (7.8) years and 127 (42%) were female. Compared with having no microbleeds, microbleeds in lobar locations were associated with an increased risk for stroke-related mortality (hazard ratio [HR], 33.9; 95% CI, 2.5-461.7), whereas nonlobar microbleeds were associated with an increased risk for cardiovascular mortality (HR, 12.0; 95% CI, 3.2-44.7). In addition, lobar microbleeds were associated with an increased risk for incident stroke (HR, 3.8; 95% CI, 1.5-10.1) and nonlobar microbleeds with an increased risk for cardiovascular events (HR, 6.2; 95% CI, 1.5-25.0). Even higher risks for incident stroke and cardiovascular events were found in patients using antithrombotic medication. All 5 patients with an intracerebral hemorrhage had lobar microbleeds at baseline; 4 of them used antithrombotics.In patients with AD, the presence of nonlobar microbleeds was associated with an increased risk for cardiovascular events and cardiovascular mortality. Patients with lobar microbleeds had an increased risk for stroke and stroke-related mortality, indicating that these patients should be treated with the utmost care.
Is Axillary Lymph Node Dissection Indicated for Early-Stage Breast Cancer? A Decision Analysis
Authors: Giovanni Parmigiani, Donald A. Berry, Eric P. Winer, Claudia Tebaldi, J. Dirk Iglehart, Leonard R. Prosnitz
Journal: Journal of Clinical Oncology (1999)

PURPOSE: Axillary lymph node dissection (ALND) has been a standard procedure in the management of breast cancer. In a patient with a clinically negative axilla, ALND is performed primarily for staging purposes, to guide adjuvant treatment. Recently, the routine use of ALND has been questioned because the results of the procedure may not change the choice of adjuvant systemic therapy and/or the survival benefit of a change in adjuvant therapy would be small. We constructed a decision model to quantify the benefits of ALND for patients eligible for breast-conserving therapy. METHODS: Patients were grouped by age, tumor size, and estrogen receptor (ER) status. The model uses the Oxford overviews and three combined Cancer and Leukemia Group B studies. We assumed that patients who did not undergo ALND received axillary radiation therapy and that the two procedures are equally effective. All chemotherapy combinations were assumed to be equally efficacious. RESULTS: The largest benefits from ALND are seen in ER-positive women with small primary tumors who might not be candidates for adjuvant chemotherapy if their lymph nodes test negative. Virtually no benefit results in ER-negative women, almost all of whom would receive adjuvant chemotherapy. When adjusted for quality of life (QOL), ALND may have an overall negative impact. In general, the benefits of ALND increase with the expected severity of adjuvant therapy on QOL. CONCLUSION: Our model quantifies the benefits of ALND and assists decision making by patients and physicians. The results suggest that the routine use of ALND in breast cancer patients should be reassessed and may not be necessary in many patients.
Risk factors for injury in rugby union football in New Zealand: a cohort study
Authors: David J Chalmers, Ari Samaranayaka, Pauline Gulliver, Bronwen McNoe
Journal: British Journal of Sports Medicine (2011)

Objective To identify risk factors for injury in amateur club rugby. Design Prospective cohort design; with follow-up over the 2004 season. Setting Amateur club rugby in New Zealand. Participants Seven hundred and four male rugby players, aged 13 years and over. Assessment of risk factors The study investigated the independent effect on injury incidence of age, ethnicity, rugby experience, height, weight, body mass index, physical activity, cigarette smoking, previous injury, playing while injured, grade, position, training, time of season, warm-up, foul play, weather conditions, ground conditions and protective equipment. Generalised Poisson regression was used to estimate the effect of each factor after adjusting for all other factors. Main outcome measures Game injury, defined as ‘any event that resulted in an injury requiring medical attention or causing a player to miss at least one scheduled game or team practice’. Results A total of 704 players, representing 6263 player-games, contributed information on injury and exposure. Evidence was obtained of the effect on injury incidence of increasing age, Pacific Island versus Maori ethnicity (injury rate ratio (IRR)=1.48, 1.03–2.13), ≥40 h strenuous physical activity per week (IRR=1.54, 1.11–2.15), playing while injured (IRR=1.46, 1.20–1.79), very hard ground condition (IRR=1.50, 1.13–2.00), foul-play (IRR=1.87, 1.54–2.27) and use of headgear (IRR=1.23, 1.00–1.50). Conclusions Opportunities for injury prevention might include promoting injury-prevention measures more vigorously among players of Pacific Island ethnicity, ensuring injured players are fully rehabilitated before returning to play, reducing the effects of ground hardness through ground preparation and stricter enforcement of the laws relating to foul play.
Chromosome Pulverization in Virus-Induced Heterokaryons of Mammalian Cells From Different Species&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: T Ikeuchi, A A Sandberg
Journal: JNCI Journal of the National Cancer Institute (1970)

The phenomena of cell fusion and chromosome pulverization after inoculation with UV-inactivated Sendai virus were studied in mixed suspensions of cell lines from different mammalian species. Two cell combinations were used: the Chinese hamster cell line (Don) and RPMI 8226 (Simpson) cell line of human hematopoietic origin, and the Don and LLC-MK2 (MK) cell lines, the latter derived from monkey kidney cells. Each of the 3 cell lines had a high cell-fusion capacity when infected with the virus in homologous cultures. The heterokaryons of Don and Simpson cells were formed at lower frequency than homokaryons in either Don or Simpson cells, and heterokaryon formation between Don and MK cells was rare. The findings indicated that the cells used maintained some specificity of the cell surfaces. Chromosome pulverization was found in heterokaryons and was similar to that observed in homokaryons. The results confirmed further our presently held concept that cell fusion is a prerequisite for induction of pulverization, and also suggest that the possible role played by the mitotic nucleus with its cytoplasm in pulverization applies to the heterologous as well as to the homologous nuclei.
Rational Clinical Experiment: Assessing Prior Probability and Its Impact on the Success of Phase II Clinical Trials
Authors: Daniel M. Halperin, J. Jack Lee, Cecile Gonzales Dagohoy, James C. Yao
Journal: Journal of Clinical Oncology (2015)

Despite a robust clinical trial enterprise and encouraging phase II results, the vast minority of oncologic drugs in development receive regulatory approval. In addition, clinicians occasionally make therapeutic decisions based on phase II data. Therefore, clinicians, investigators, and regulatory agencies require improved understanding of the implications of positive phase II studies. We hypothesized that prior probability of eventual drug approval was significantly different across GI cancers, with substantial ramifications for the predictive value of phase II studies.We conducted a systematic search of phase II studies conducted between 1999 and 2004 and compared studies against US Food and Drug Administration and National Cancer Institute databases of approved indications for drugs tested in those studies.In all, 317 phase II trials were identified and followed for a median of 12.5 years. Following completion of phase III studies, eventual new drug application approval rates varied from 0% (zero of 45) in pancreatic adenocarcinoma to 34.8% (24 of 69) for colon adenocarcinoma. The proportion of drugs eventually approved was correlated with the disease under study (P < .001). The median type I error for all published trials was 0.05, and the median type II error was 0.1, with minimal variation. By using the observed median type I error for each disease, phase II studies have positive predictive values ranging from less than 1% to 90%, depending on primary site of the cancer.Phase II trials in different GI malignancies have distinct prior probabilities of drug approval, yielding quantitatively and qualitatively different predictive values with similar statistical designs. Incorporation of prior probability into trial design may allow for more effective design and interpretation of phase II studies.