tbuckley/cabot-search huggingface dataset:
Dissociative disorders in psychiatric inpatients
Authors: G N Saxe, B A van der Kolk, R Berkowitz, G Chinman, K Hall, G Lieberg, J Schwartz
Journal: American Journal of Psychiatry (1993)

This study attempted to determine 1) the prevalence of dissociative disorders in psychiatric inpatients, 2) the degree of reported childhood trauma in patients with dissociative disorders, and 3) the degree to which dissociative experiences are recognized in psychiatric patients.A total of 110 patients consecutively admitted to a state psychiatric hospital were given the Dissociative Experiences Scale. Patients who scored above 25 were matched for age and gender with a group of patients who scored below 5 on the scale. All patients in the two groups were then interviewed in a blind manner, and the Dissociative Disorders Interview Schedule, the Traumatic Antecedent Questionnaire, and the posttraumatic stress disorder (PTSD) module of the Structured Clinical Interview for DSM-III-R, Nonpatient Version, were administered. Chart reviews were also conducted on all patients.Fifteen percent of the psychiatric patients scored above 25 on the Dissociative Experiences Scale; 100% of these patients met DSM-III criteria for a dissociative disorder. These patients had significantly higher rates of major depression, PTSD, substance abuse, and borderline personality than did the comparison patients, and they also reported significantly higher rates of childhood trauma. Chart review data revealed that dissociative symptoms were largely unrecognized.A high proportion of psychiatric inpatients have significant dissociative pathology, and these symptoms are underrecognized by clinicians. The proper diagnosis of these patients has important implications for their clinical course.
Management of asthma in general practice Question patients about occupation and hobbies
Authors: J D M Douglas
Journal: BMJ (1994)

there are few published data to support these claims.In a prospective randomised trial in 140 patients that compared laparoscopic and open appendicectomy Tate et al found no significant differences between the groups in pain score, analgesic requirement, hospital stay, or time to return to work.2The only significant finding was that the operating time was nearly twice as long in the laparoscopic group.In addition, conversion to an open operation was necessary in a fifth of the patients undergoing laparoscopy.Further prospective randomised trials are needed to establish the place of laparoscopic surgery.Without such data the current enthusiasm for laparoscopic surgery may be unfounded.
Abstract 15194: Achievement of TIMI-3-Flow Results in Significant Decrease in Hospital Mortality of Primary PCI for STEMI and PCI for NSTE-ACS - Findings of the Euro Heart Survey PCI-Registry
Authors: Anselm K Gitt, Timm Bauer, Matthias Hochadel, Uwe Zeymer, Ralf Zahn, Christian Hamm
Journal: Circulation (2013)

Background: Acute reperfusion is common in ACS within Europe. High success rates of reperfusion have resulted in improvement of hospital outcome. Little is known about the impact of non-reperfusion...
A phase II randomized study comparing pegfilgrastim (PEG) versus filgrastim (FIL) after high-dose chemotherapy (HDC) and autologous peripheral blood stem cell support (PBSC)
Authors: L. Castagna, S. Bramanti, A. Levis, M. Michieli, A. Anastasia, R. Mazza, B. Sarina, E. Todisco, L. Giordano, A. Santoro
Journal: Journal of Clinical Oncology (2009)

7038 Background: The aim of this study was to demonstrate the non-inferiority of one fixed dose of PEG compared to daily FIL, in patients (pts) receiving HDC and PBSC. Methods: Criteria for elegibility were: HDC for haematological or solid tumors; at least 3 x10^6/kg CD34+ reinfused; age &gt;18 years; normal cardiac, renal, liver and pulmonary function; signed written informed consent. Pts were randomized to receive on day+1 subcutaneously(sc) PEG (6mg) or 5 mcg/kg/d sc of FIL until ANC &gt;1.0 x 10^9/L. Primary end points were: absolute neutrophil count (ANC) &lt; 0.5 x 10^9/L and the number (no.) of days to achieve an ANC &gt; 0.5 x 10^9/L from day +1. Secondary end points were: no. of days to achieve an ANC &gt; 1.0 x 10^9/L; no. of days with fever &gt; 38 °C; duration of antibiotic therapy; and no. of documented infections. Results: 80 pts were enrolled (40 pts for group). The duration of ANC &lt; 0.5 x 10^9/L, the time to reach an ANC &gt; 0.5 x 10^9/L and the time to reach an ANC &gt; 1.0 x 10^9/L were superimposable in the two groups (mean days 6, 11, 12 respectively ). No. significant differences between FIL versus PEG group were observed in incidence of fever (24 vs 22), no. of documented infections (12 vs 10), no. of days with fever (1.7 vs 0.97 days), duration of antibiotic therapy (5.7 vs 3.5 days). No. differences in terms of extra-hematological toxicities and time to discharge between the two groups (16 vs 14). Time to reach a platelets count &gt; 20 x 10^9/L was significantly shorter in PEG group compared to FIL group (15 vs 11 days, p value 0.05). Conclusions: This study shows that PEG was not inferior to FIL in terms of hematological reconstitution. Additionally PEG significantly shortened duration of thrombocytopenia &lt;20 x 10^9/L. Consequently, PEG could be safely used after PBSC infusion. No significant financial relationships to disclose.
TRAIL-mediated induction of apoptosis as a targeted therapy for prostate cancer
Authors: W. O. Arafat, D. J. Buchsbaum
Journal: Journal of Clinical Oncology (2005)

3186 Purpose: TRAIL (tumor necrosis factor-related apoptosis-inducing ligand) induces a death signal following binding to death receptors (DR4, DR5). TRA-8 anti-human DR-5 mAb induces cell killing in most TRAIL sensitive cancer cell lines. Overexpression of antiapoptotic genes protects prostate cancer cell lines from TRAIL-induced apoptosis. The mechanism is thought to be by protection of mitochondria from releasing different apoptotic molecules including bax. We hypothesized that targeting the mitochondria by radiotherapy might overcome the downstream block of the TRAIL pathway and sensitize prostate cancer cell lines to the cytotoxic effect of TRA-8 or TRAIL. Methods and Materials: Human prostate cancer cell lines LnCap, PC-3 and DU145 were treated with TRA-8, radiation assay, or a combination of each. Cell survival was determined using the MTS assay. Crystal violet staining for cell proliferation and a colony forming assay were used to determine radiosensitization. An adenovirus encoding soluble TRAIL (Ad/TRAIL) was also investigated for radiosensitization. Real-time PCR was performed to look for the effect of radiation on mRNA in prostate cancer cell lines. Taxotere was used in combination with TRA-8 or Ad/TRAIL with and without radiation. A mouse model of prostate cancer was used to evaluate the effect of TRA-8 or Ad/TRAIL and radiation treatment. Results: There was increased cell killing after treatment with TRA-8 or Ad/TRAIL and radiation, TRA-8 or Ad/TRAIL and Taxotere, than either single agent alone. This was due to induction of apoptosis in cells treated with combination treatments only. Increased expression of bax was associated with the radiation enhancing effect of TRA-8 or Ad/TRAIL. RT-PCR showed an increased copy number of bax and a decreased copy number of bcl-2 in cells treated with TRA-8 and radiation. Nude mice bearing prostate cancer xenografts treated with a combination TRA-8 and radiation showed inhibition of tumor growth compared to animals treated with TRA-8 or radiation alone. Conclusion: Combined treatment with radiation and TRA-8 or Ad/TRAIL produced a synergistic effect in refractory prostrate cancer cell lines and xenografts. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Sankyo
Abstract 14295: Ongoing Muscle Wasting Despite Stable Weight in Cachectic Heart Failure Patients
Authors: Heidi M Christensen, Caroline Kistorp, Morten Schou, Niels Keller, Bo Zerahn, Jens Faber
Journal: Circulation (2012)

Purpose: Cachexia is a complex metabolic syndrome associated with underlying illness and characterized by reduced muscle mass and in some studies also reduced fat mass. Cachexia is defined by unint...
Intensification of radiation therapy by temozolomide and fractionated stereotactic boost in newly diagnosed glioblastoma multiforme: A long-term analysis of a phase II study.
Authors: G. R. D'Agostino, G. Chiloiro, S. Manfrida, S. Chiesa, G. Apicella, B. Diletto, A. Fiorentino, A. Mangiola, C. Anile, M. Balducci
Journal: Journal of Clinical Oncology (2010)

e12515 Background: The aim of this phase II study was to assess toxicity, local control and survival of 3D- conformal radiation therapy (3D-CRT) intensified by concomitant temozolomide (TMZ) and fractionated stereotactic conformal radiation therapy (FSCRT) boost in patients with newly diagnosis of glioblastoma multiforme (GBM). Methods: Patients (≥ 18 yrs old) with histological proven GBM and clinical target volume (CTV: including tumor bed ± residual tumor + margin of 5 mm) £ 8 cm were included. A total radiation dose (6940 cGy) was administered combining two different techniques: conformal 3D-RT and FSCRT boost; radiation dose of 3D-CRT (5,040 cGy if FSCRT boost was concomitant plus sequential, 5,940 cGy if only sequential) and FSCRT (1900 cGy if concomitant plus sequential boost or 1,000 cGy if only sequential boost) was tailored according to the CTV1 diameter (less or more 6 cm, respectively). Temozolomide (75 mg/m2) was administered during the first two or four weeks of radiotherapy based on FSCRT modality. All patients received adjuvant temozolomide (150-200 mg/m2 per) for 6 cycles after the end of RT. Results: From November 2003 to October 2008 37 patients were enrolled; 21 (57%) were male and 16 (43%) female. Median age was 56 years (range 25-72 yrs). No major toxicity was recorded, but a RTOG G1-G2 acute neurological toxicity in 3 patients (8%). Late neurologic toxicity included two cases (4.8%) of histologically-proven radio-necrosis (at 14 and 24 months). At a median follow-up of 63 months (range 16-75), ten patients were alive; median progression free survival (PFS) and overall survival (OS) were 10 months and 22 months respectively. The actuarial 2-year PFS and OS were 25% and 51%, respectively. Conclusions: Intensification by temozolomide and FSCRT is well tolerated and seems to increase survival and local control; these promising results warrant the start-up of a prospective randomized trial. No significant financial relationships to disclose.
Association of Proton Pump Inhibitors With Risk of Dementia
Authors: Willy Gomm, Klaus von Holt, Friederike Thomé, Karl Broich, Wolfgang Maier, Anne Fink, Gabriele Doblhammer, Britta Haenisch
Journal: JAMA Neurology (2016)

<h3>Importance</h3> Medications that influence the risk of dementia in the elderly can be relevant for dementia prevention. Proton pump inhibitors (PPIs) are widely used for the treatment of gastrointestinal diseases but have also been shown to be potentially involved in cognitive decline. <h3>Objective</h3> To examine the association between the use of PPIs and the risk of incident dementia in the elderly. <h3>Design, Setting, and Participants</h3> We conducted a prospective cohort study using observational data from 2004 to 2011, derived from the largest German statutory health insurer, Allgemeine Ortskrankenkassen (AOK). Data on inpatient and outpatient diagnoses (coded by the German modification of the<i>International Statistical Classification of Diseases and Related Health Problems, Tenth Revision</i>) and drug prescriptions (categorized according to the Anatomical Therapeutic Chemical Classification System) were available on a quarterly basis. Data analysis was performed from August to November 2015. <h3>Exposures</h3> Prescription of omeprazole, pantoprazole, lansoprazole, esomeprazole, or rabeprazole. <h3>Main Outcomes and Measures</h3> The main outcome was a diagnosis of incident dementia coded by the German modification of the<i>International Statistical Classification of Diseases and Related Health Problems, Tenth Revision</i>. The association between PPI use and dementia was analyzed using time-dependent Cox regression. The model was adjusted for potential confounding factors, including age, sex, comorbidities, and polypharmacy. <h3>Results</h3> A total of 73 679 participants 75 years of age or older and free of dementia at baseline were analyzed. The patients receiving regular PPI medication (n = 2950; mean [SD] age, 83.8 [5.4] years; 77.9% female) had a significantly increased risk of incident dementia compared with the patients not receiving PPI medication (n = 70 729; mean [SD] age, 83.0 [5.6] years; 73.6% female) (hazard ratio, 1.44 [95% CI, 1.36-1.52];<i>P</i> &lt; .001). <h3>Conclusions and Relevance</h3> The avoidance of PPI medication may prevent the development of dementia. This finding is supported by recent pharmacoepidemiological analyses on primary data and is in line with mouse models in which the use of PPIs increased the levels of β-amyloid in the brains of mice. Randomized, prospective clinical trials are needed to examine this connection in more detail.
The impact on patient management of whole-body FDG-PET scanning in patients with liver metastases from colorectal carcinoma
Authors: T. W. Bauer, S. A. Curley, H. A. Macapinlac, M. A. Rodriguez-Bigas, C. Eng, E. H. Lin, J. N. Vauthey, L. M. Ellis, J. M. Skibber, B. W. Feig
Journal: Journal of Clinical Oncology (2004)

3569 Background: The accuracy and utility of FDG-PET (PET) scanning in patients with colorectal carcinoma metastatic to the liver was evaluated. Methods: Whole-body PET scans performed on 100 consecutive patients with liver metastases from colorectal carcinoma between July 2001 and January 2003 were reviewed and correlated with spiral triple-phase computed tomography (CT), serum carcinoembryonic antigen (CEA) level, and final histopathologic diagnosis. Results: The indication for PET was a rise in CEA in 19% of patients, surveillance or restaging in 37%, to exclude additional disease prior to metastasectomy in 33%, or to evaluate “indeterminate” findings on CT in 11%. The sensitivity, specificity, and accuracy of CT were 81%, 100%, and 84%, respectively. The sensitivity, specificity, and accuracy of PET were 84%, 89%, and 85%, respectively. The PET false-positive (FP) rate was 2%: liver & wound (1), mediastinum (1). Sixteen false-negative (FN) sites were observed in 13% of PET scans: liver (5), lung (5), porta hepatis lymph node (2), abdomen/pelvis (4). Two patients underwent unnecessary laparotomy based on FN PET results, whereas CT correctly suggested extrahepatic disease in these two. There was no difference in CEA level between the PET true-positive (TP) and FN groups. In the six cases where CT was “indeterminate,” PET correctly diagnosed patients. PET directly altered patient management in 23% of cases and this was independent of PET indication. PET detected liver metastasis not seen on CT in 8%, confirmed liver metastasis read as “indeterminate” on CT in 2%, detected extrahepatic metastasis not seen on CT in 6%, detected metabolic response in metastasis which led to a change in management in 4%, and excluded disease read as “indeterminate” on CT in 2%. When PET was combined with CT, the overall sensitivity, specificity, and accuracy of diagnosis were 96%*, 88%*, and 95%*, respectively (*p<0.05 vs CT alone). Conclusions: PET, when used selectively in patients with liver metastases from colorectal carcinoma, marginally improved the accuracy of diagnosis but directly altered management in 23% of patients. No significant financial relationships to disclose.
Comparison of CISH and FISH for detection of <i>EGFR </i>copy number in lung adenocarcinoma and correlation with <i>EGFR</i> and <i>KRAS </i>mutation status and EGFR immunoreactivity
Authors: M. Varella-Garcia, M. Ladanyi, M. G. Kris, A. Li, D. A. Chitale, N. Rekhtman, G. J. Riely, V. A. Miller, F. R. Hirsch, M. F. Zakowski
Journal: Journal of Clinical Oncology (2008)

22105 Background: EGFR copy number has been shown to correlate with the presence of EGFR mutations and response to tyrosine kinase inhibitors (TKIs) in patients with lung adenocarcinoma. Fluorescent in situ hybridization (FISH) for EGFR has been more widely used than chromogenic in situ hybridization (CISH) but the latter offers some advantages in terms of equipment, ease of implementation and preservation of results. We compared CISH and FISH for EGFR in a series of lung adenocarcinomas and correlated the findings with EGFR and KRAS mutation status and EGFR expression by immunohistochemistry (IHC). Methods: A tissue microarray was constructed containing triplicate cores of 28 EGFR mutated lung adenocarcinomas and 31 EGFR non-mutated cases, the latter including 8 KRAS mutated cases. For both ISH methods, nuclear counts of 5 or more signals were scored as positive. The criteria for FISH include polysomy or high copy number. EGFR IHC was scored from 0–3 with 0 and 1 counted as negative and 2 and 3 as positive. Results: Overall correlation of CISH and FISH was excellent. 20 of 59 (33%) cases were amplified by CISH and 23 of 59 (37%) were amplified by FISH, with 18 (30%) positive and 34 (57%) negative by both methods (p<0.0001). Discordant cases included 5 negative by CISH and positive by FISH and 2 positive by CISH and negative by FISH. Of 20 EGFR CISH positive cases, 15 (75%) were mutated (p=0.003) and of the 23 FISH positive cases, 16 (70%) were mutated (p=0.007). One case called positive by FISH, negative by CISH showed a KRAS mutation. No other KRAS mutant case was scored as EGFR-amplified by either method. EGFR was positive by IHC in 28 cases, of which 15 were positive by CISH (p=0.003) and 16 by FISH (p=0.007). There was no correlation with IHC and mutations status. Conclusions: EGFR CISH and FISH show excellent concordance in scoring EGFR amplification, which shows a highly significant association with EGFR mutation. No significant financial relationships to disclose.
Tumors in the Duck (Family Anatidae): A Review&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: R. H. Rigdon
Journal: JNCI Journal of the National Cancer Institute (1972)

Tumors resulting from chemical carcinogens, aflatoxin, and viruses, tumors occurring spontaneously, and a group of unpublished neoplasms are reported in ducks. Spontaneously occurring tumors are infrequent in the duck and very infrequent in the white Pekin duck for unknown reasons. The first tumor observed in a duck was in 1889. Tumors in ducks are similar histologically to those in mammals. Rous sarcoma virus, aflatoxin, and some chemical carcinogens readily induce neoplasms in the white Pekin duck. In the inbreeding of the white Pekin duck for 100 years, a genetic pattern may have been established in which spontaneous tumors are not likely to develop. This hypothesis is in contrast to that suggested for the increase in frequency of tumors in young chicks genetically bred for rapid growth and for specific strains of mice in which there is a high frequency of tumors.
Abstract 17124: Sex Differences in the Incidence of Peripheral Artery Disease (PAD) in the Chronic Renal Insufficiency Cohort (CRIC)
Authors: Grace J Wang, Pamela A Shaw, Raymond R Townsend, Amanda H Anderson, Dawei Xie, Lisa C Nessel, Emile R Mohler, Stephen M Sozio, Bernard G Jaar, Jing Chen, Jackson Wright, Jonathan J Taliercio, Akinlolu Ojo, Ana C Ricardo, Eva Lustigiva, Ronald M Fairman, Harold I Feldman, Bonnie Ky
Journal: Circulation (2015)

Introduction: Chronic kidney disease (CKD) results in an increased risk of peripheral artery disease (PAD). However, the epidemiology of PAD in CKD, and particularly how the incidence differs according to sex remains incompletely defined. We sought to define how the epidemiology of peripheral arterial disease (PAD) in chronic kidney disease (CKD) differs according to sex and age. Methods: The Chronic Renal Insufficiency Cohort (CRIC) is a multi-center, prospective cohort study of CKD participants. Fine and Gray methods were used to determine the cumulative incidence of PAD, defined by an ankle brachial index (ABI) &lt; 0.90 or a confirmed PAD event, with death as a competing event. Adjusted subdistribution hazard ratios from the Fine and Gray model determined the risk of PAD according to sex. A priori, we hypothesized that the relationship between sex and cumulative incidence of PAD differed according to age. Results: The mean age of the 3,174 participants in this study was 56.6 years and consisted of 55% males. Over a median follow-up of 5.9 years, 17.8% developed PAD and 11.1% died. Females had a 1.72-fold greater adjusted PAD risk compared to men (95% CI 1.44-2.06, p&lt;0.001). These sex-related differences in PAD risk also differed by age (p&lt;0.001, Figure). Women, compared to men, were at a markedly increased risk for PAD at younger ages; however, at ages greater than 70 years, the risk was similar across both sexes. Older men had a substantially greater PAD risk compared to younger men. In women, PAD risk did not vary with age. Conclusions: Females with CKD have a higher PAD risk compared to males at younger ages. There is an important need to improve our understanding of the biological and clinical basis for these differences.
A phase I study of gemcitabine, capecitabine, and vandetanib in patients with advanced solid tumors with an expanded cohort in biliary and pancreatic malignancies.
Authors: S. Nallapareddy, S. G. Eckhardt, C. L. O'Bryant, S. Eppers, S. Diab, M. A. Kane, C. D. Weekes, J. L. Spratlin, W. A. Messersmith, S. Leong
Journal: Journal of Clinical Oncology (2010)

2535 Background: Vandetanib (V) is a multitargeted tyrosine kinase that inhibits three key pathways involved in tumor growth: VEGF, EGF, and RET. Both VEGF and EGF pathways are overexpressed in biliary and pancreatic cancers. Objectives of this phase I study were to evaluate the safety profile of V in combination with standard doses of gemcitabine (G) and capecitabine (C) and to determine the maximum tolerated dose (MTD). In the expanded cohort, additional patients (pts) with biliary or pancreatic malignancies were enrolled to further evaluate the safety of the combination and to assess the antitumor activity in this subset of pts. Methods: Escalating doses of V (200 mg and 300 mg) were administered orally for 28 days in combination with G 1000 mg/m2 IV on days 1, 8, 15 with C 1660 mg/m2/d orally in divided doses on days 1–21 for a 28-day cycle (cy). Dose-limiting toxicity (DLT) was defined as ≥ grade 3 (gr) nonhematologic toxicity or ≥ gr 4 hematologic toxicity persisting for ≥ 5 days. Responses were assessed by RECIST criteria and plasma concentrations of VEGF and soluble VEGFR2 were evaluated as potential biomarkers in the expanded cohort. Results: Twenty-three pts were enrolled: 9 in the dose escalation cohort and 14 in the dose expansion cohort (5 biliary and 9 pancreatic cancer). The median age was 60 (range, 35-75; M/F, 15/8). All but one pt was evaluable for toxicity and received a total of 155+ cy (mean 6.7). One DLT (gr 4 neutropenia) occurred in the 200mg V cohort. The only adverse events ≥ gr 2 occurring in ≥ 10% of the cy were neutropenia (23.8%) and thrombocytopenia (17.4%). For antitumor activity, 3 pts exhibited a confirmed PR and 15 maintained stable disease for ≥ 4 cy. Five pts remain on study. Ten of 20 pts had a ≥75% drop in either CEA or CA19-9. Pharmacodynamic analyses are ongoing. Conclusions: V at 300mg in combination with G and C was generally well tolerated and demonstrated clinical activity in metastatic biliary and pancreatic cancer. Based on these results further evaluation is warranted in these diseases. No significant financial relationships to disclose.
The BMJ’s Christmas appeal 2015: the refugees of Calais and Dunkirk are in dire need of medical aid
Authors: Bryony Corbyn, Morven Telling
Journal: BMJ (2015)

Two UK doctors saw the physical squalor and mental suffering in the camps at first hand. The charity Doctors of the World is well versed in bringing care to the most vulnerable people in developing and developed countries, including refugees in France, which is why we’ve chosen it for  The BMJ ’s Christmas appeal this year. Please give generously