tbuckley/cabot-search huggingface dataset:
Improving Patient Handovers From Hospital to Primary Care
Authors: Gijs Hesselink, Lisette Schoonhoven, Paul Barach, Anouk Spijker, Petra Gademan, Cor Kalkman, Janine Liefers, Myrra Vernooij-Dassen, Hub Wollersheim
Journal: Annals of Internal Medicine (2012)

Evidence shows that suboptimum handovers at hospital discharge lead to increased rehospitalizations and decreased quality of health care.To systematically review interventions that aim to improve patient discharge from hospital to primary care.PubMed, CINAHL, PsycInfo, the Cochrane Library, and EMBASE were searched for studies published between January 1990 and March 2011.Randomized, controlled trials of interventions that aimed to improve handovers between hospital and primary care providers at hospital discharge.Two reviewers independently abstracted data on study objectives, setting and design, intervention characteristics, and outcomes. Studies were categorized according to methodological quality, sample size, intervention characteristics, outcome, statistical significance, and direction of effects.Of the 36 included studies, 25 (69.4%) had statistically significant effects in favor of the intervention group and 34 (94.4%) described multicomponent interventions. Effective interventions included medication reconciliation; electronic tools to facilitate quick, clear, and structured summary generation; discharge planning; shared involvement in follow-up by hospital and community care providers; use of electronic discharge notifications; and Web-based access to discharge information for general practitioners. Statistically significant effects were mostly found in reducing hospital use (for example, rehospitalizations), improvement of continuity of care (for example, accurate discharge information), and improvement of patient status after discharge (for example, satisfaction).Heterogeneity of the interventions and study characteristics made meta-analysis impossible. Most studies had diffuse aims and poor descriptions of the specific intervention components.Many interventions have positive effects on patient care. However, given the complexity of interventions and outcome measures, the literature does not permit firm conclusions about which interventions have these effects.The European Union, the Framework Programme of the European Commission.
Genetic Alterations of the <i>ATBF1</i> Gene in Gastric Cancer
Authors: Yong Gu Cho, Jae Hwi Song, Chang Jae Kim, Youn Soo Lee, Su Young Kim, Suk Woo Nam, Jung Young Lee, Won Sang Park
Journal: Clinical Cancer Research (2007)

Abstract Purpose: α-Fetoprotein (AFP)–producing gastric cancers are aggressive tumors with venous and lymphatic invasion and hepatic metastasis. The goal of the present study was to investigate whether somatic changes of the AFP-negative regulator AT motif binding factor-1 (ATBF1) gene are involved in the development or progression of gastric cancers and the production of AFP in gastric cancer cells. Experimental Design: We searched for genetic alterations of the ATBF1 gene by single-strand conformational polymorphism and sequencing methods as well as allelic loss analysis with the microsatellite markers D16S3066 and D16S3139. Immunochemistry for AFP expression in gastric cancer cells was also done. Results: In 81 sporadic gastric cancers, four mutations were detected in seven cases: one was a missense mutation and three were deletions; loss of heterozygosity at the ATBF1 locus was detected in 52.9% of informative samples. Five of the eight cancers with AFP expression showed ATBF1 genetic alterations. Conclusions: These results suggest that genetic alteration of the ATBF1 gene may contribute to the aggressive nature of gastric cancers and the production of AFP in gastric cancer cells.
Intercostal Muscle Blood Flow Limitation during Exercise in Chronic Obstructive Pulmonary Disease
Authors: Ioannis Vogiatzis, Dimitris Athanasopoulos, Helmut Habazettl, Andrea Aliverti, Zafiris Louvaris, Evgenia Cherouveim, Harrieth Wagner, Charis Roussos, Peter David Wagner, Spyros Zakynthinos
Journal: American Journal of Respiratory and Critical Care Medicine (2010)

It has been hypothesized that, because of the high work of breathing sustained by patients with chronic obstructive pulmonary disease (COPD) during exercise, blood flow may increase in favor of the respiratory muscles, thereby compromising locomotor muscle blood flow.To test this hypothesis by investigating whether, at the same work of breathing, intercostal muscle blood flow during exercise is as high as during resting isocapnic hyperpnea when respiratory and locomotor muscles do not compete for the available blood flow.Intercostal and vastus lateralis muscle perfusion was measured simultaneously in 10 patients with COPD (FEV₁ = 50.5 ± 5.5% predicted) by near-infrared spectroscopy using indocyanine green dye.Measurements were made at several exercise intensities up to peak work rate (WRpeak) and subsequently during resting hyperpnea at minute ventilation levels up to those at WRpeak. During resting hyperpnea, intercostal muscle blood flow increased with the power of breathing to 11.4 ± 1.6 ml/min per 100 g at the same ventilation recorded at WRpeak. Conversely, during graded exercise, intercostal muscle blood flow remained unchanged from rest up to 50% WRpeak (6.8 ± 1.3 ml/min per 100 g) and then fell to 4.5 ± 0.8 ml/min per 100 g at WRpeak (P = 0.003). Cardiac output plateaued above 50% WRpeak (8.4 ± 0.1 l/min), whereas vastus lateralis muscle blood flow increased progressively, reaching 39.8 ± 7.1 ml/min per 100 g at WRpeak.During intense exercise in COPD, restriction of intercostal muscle perfusion but preservation of quadriceps muscle blood flow along with attainment of a plateau in cardiac output represents the inability of the circulatory system to satisfy the energy demands of locomotor and respiratory muscles.
Adjuvant tamoxifen and exemestane in early breast cancer (TEAM): a randomised phase 3 trial
Authors: Cornelis JH van de Velde, Daniel Rea, Caroline Seynaeve, Hein Putter, Annette Hasenburg, Jean-Michel Vannetzel, Robert Paridaens, Christos Markopoulos, Yasuo Hozumi, Elysee TM Hille, Dirk G Kieback, Lina Asmar, Jan Smeets, Johan WR Nortier, Peyman Hadji, John MS Bartlett, Stephen E Jones
Journal: The Lancet (2011)
Asthma education and quality of life in the community: a randomised controlled study to evaluate the impact on white European and Indian subcontinent ethnic groups from socioeconomically deprived areas in Birmingham, UK
Authors: H Moudgil
Journal: Thorax (2000)

<h3>BACKGROUND</h3> Whether asthma morbidity in minority groups can be reduced by preventative health care measures delivered in the relevant ethnic dialects requires further evaluation. This study reports clinical outcomes and quality of life from a community based project investigating white European (W/E) and Indian subcontinent (ISC) ethnic groups with asthma living in deprived inner city areas of Birmingham, UK. <h3>METHODS</h3> Six hundred and eighty nine asthmatic subjects (345 W/E, 344 ISC) of mean (SD) age 34.5 (15) years (range 11–59) and mean forced expiratory volume in one second (FEV<sub>1</sub>) of 80% predicted were interviewed in English, Punjabi, Hindi, or Urdu. Subjects randomised to the active limb of a prospective, open, randomised, controlled, parallel group, 12 month follow up study underwent individually based asthma education and optimisation of drug therapy with four monthly follow up (active intervention). Control groups were seen only at the beginning and end of the study. Urgent or emergency interactions with primary and secondary health care (clinical outcomes) and both cross sectional and longitudinal data from an Asthma Quality of Life Questionnaire (AQLQ) were analysed. <h3>RESULTS</h3> Clinical outcomes were available for 593 subjects. Fewer of the active intervention group consulted their GP (41.8% versus 57.8%, odds ratio (OR) 0.52 (95% CI 0.37 to 0.74)) or were prescribed antibiotics (34.9% versus 51.2%, OR 0.51 (95% CI 0.36 to 0.72)), but by ethnicity statistically significant changes occurred only in the W/E group with fewer also attending A&amp;E departments and requiring urgent home visits. Active intervention reduced the number of hospital admissions (10 versus 30), GP consultations (341 versus 476), prescriptions of rescue oral steroids (92 versus 177), and antibiotics (220 versus 340), but again significant improvements by ethnicity only occurred in the active W/E group. AQLQ scores were negatively skewed to the higher values; regression analysis showed that lower values were associated with ISC ethnicity. Longitudinal changes (for 522 subjects) in the mean AQLQ scores were small but statistically significant for both ethnic groups, with scores improving in the active and worsening in the control groups. <h3>CONCLUSIONS</h3> Active intervention only improved clinical outcomes in the W/E group. AQLQ scores, although lower in the ISC group, were improved by active intervention in both ethnic groups.
INCOMPETENCY TO STAND TRIAL : PROCEDURES, RESULTS, AND PROBLEMS
Authors: JOHN H. HESS, HERBERT E. THOMAS
Journal: American Journal of Psychiatry (1963)

We have described the breakdown of a vital social system necessitating collaboration between two highly respected professions. The confused statute regarding incompetency to stand trial and its distorted application by both physician and lawyer tends to subvert the social and legal principle inherent in the concept of competency and in so doing to sacrifice the professional identity of both lawyer and physician as well as their appropriate functions as assigned by society and which their client has the right to expect. In this process, the legal position becomes untenable. The court cannot use the psychiatrist effectively because it cannot understand him and because it does not demand that which could be understood. Therefore, in lieu of using his competence, it must accept his pronouncements and tacitly his usurpation of its role. The valued and traditional legal insistence on the right to determine fact is passively given over to the acceptance of opinion as fact. The result is that from start to finish the physician occupies a foremost yet counterfeit role in incompetency proceedings. The abhorence of the psychiatric discipline for actions based on value judgments involving the moral and ethical behavior of the patient is well known. Yet, in dealing with his legal brethren, the psychiatrist seems willing not only to evaluate his client's psychological status but to judge his behavior, evaluate its social significance in an ethical sense, and to decide the fitting consequence of such behavior. In short, often the physician usurps the function of the law and in so doing relinquishes his therapeutic opportunity. The process all too often ends at the hospital where we have seen the therapeutic confusion, the contradictory practice of parole, and the dismal treatment results. The individual truly has been victimized by a process designed to protect his rights and it may be stated that a social system that victimizes its individuals will soon find itself the victim.
Flavonoid–Metal Ion Complexes: A Novel Class of Therapeutic Agents
Authors: Stalin Selvaraj, Sridharan Krishnaswamy, Venkappayya Devashya, Swaminathan Sethuraman, Uma Maheswari Krishnan
Journal: Medicinal Research Reviews (2013)

Abstract Flavonoids are among the most investigated phytochemicals due to their pharmacological and therapeutic activities. Their ability to chelate with metal ions has resulted in the emergence of a new category of molecules with a broader spectrum of pharmacological activities. However, the biological significance of these flavonoid–metal ion complexes is yet to be completely explored. Moreover, no concerted efforts have been made to elucidate their molecular targets and mechanisms of action. This review attempts to provide a snapshot of the various biological activities reported for flavonoid–metal ion complexes and their potential as therapeutic agents. Understanding the mechanism of action and the influence of structure will provide a strong basis to design novel flavonoid–metal ion complexes of therapeutic significance.
Statins and the Risk of Hepatocellular Carcinoma in Patients With Hepatitis C Virus Infection
Authors: Yu-Tse Tsan, Chang-Hsing Lee, Wen-Chao Ho, Meng-Hung Lin, Jung-Der Wang, Pau-Chung Chen
Journal: Journal of Clinical Oncology (2013)

Statins may have protective effects against cancer, but no studies have focused on their effects in patients with chronic hepatitis C virus (HCV) infection. The purpose of this study was to investigate the association between use of statins and risk of hepatocellular carcinoma (HCC) in HCV-infected patients.Ours was a population-based cohort study of 260,864 HCV-infected patients enrolled in the Taiwan National Health Insurance Research Database since January 1, 1999, and observed through December 31, 2010. Cox proportional hazards regression with time-dependent covariates for drug exposures was employed to evaluate the association between statin use and HCC risk.There were 27,883 cases of HCC in the HCV cohort during a follow-up period of 2,792,016.6 person-years. Among the 35,023 patients using statins (defined as ≥ 28 cumulative defined daily doses [cDDDs]), 1,378 had HCC. Among the 225,841 patients not using statins (< 28 cDDDs), 26,505 were diagnosed with HCC. A dose-response relationship between statin use and HCC risk was observed. The adjusted hazard ratios were 0.66 (95% CI, 0.59 to 0.74), 0.47 (95% CI, 0.40 to 0.56), and 0.33 (95% CI, 0.25 to 0.42) for patients with 28 to 89, 90 to 180, and > 180 cDDDs per year, respectively, relative to nonusers. The reduction in risk also demonstrated a progressive duration-response relationship in patients with ≥ 28 cDDDs per year when compared with nonusers.Among patients with HCV infection, statin use was associated with reduced risk of HCC. Further research is needed to elucidate the mechanism responsible for this effect.
A Prescription for Improving Drug Formulary Decision Making
Authors: Gordon D. Schiff, William L. Galanter, Jay Duhig, Michael J. Koronkowski, Amy E. Lodolce, Pam Pontikes, John Busker, Daniel Touchette, Surrey Walton, Bruce L. Lambert
Journal: PLoS Medicine (2012)

Gordon Schiff and colleagues present a new tool and checklist to help formularies make decisions about drug inclusion and to guide rational drug use.
Childhood Jessner's lymphocytic infiltrate of the skin
Authors: C.R. HIGGINS, R.A. PWAKEEL, R. CERIO
Journal: British Journal of Dermatology (1994)

Summary We report a case of Jessner's lymphocytic infiltrate of the skin in an 11-year-old boy. This benign lymphocytic infiltrate was originally described in 1953, and classically occurs in middle-aged men. Its occurrence in children appears to be very rare, and there are only two other case reports in the literature.
Water deprivation stimulates transforming growth factor-beta 2 accumulation in the juxtaglomerular apparatus of mouse kidney.
Authors: S Horikoshi, B K McCune, P E Ray, J B Kopp, M B Sporn, P E Klotman
Journal: Journal of Clinical Investigation (1991)

Transforming growth factor-beta (TGF-beta) modulates the growth and differentiation of many cells and often functions in an autocrine or paracrine fashion. The myoepithelial cells of the renal juxtaglomerular apparatus (JGA) synthesize and secrete renin. Under conditions which chronically stimulate renin production, the JGA undergoes hypertrophy and hyperplasia. The molecular factors responsible for these changes in the JGA have not been identified. In the present study, plasma renin activity was stimulated in the mouse by water deprivation. Using immunoperoxidase staining with specific antibodies against TGF-beta 1, beta 2, and beta 3, we found increased TGF-beta 2 accumulation in the JGA and interlobular arteries. Immunostaining with renin antiserum demonstrated colocalization of TGF-beta 2 and renin. TGF-beta 1 and beta 3 expression was not different between control and water-deprived mice. Our results suggest that in the setting of water deprivation, TGF-beta 2 is localized in a manner which would allow it to act either as a growth factor for or as a phenotypic modulator of the JGA and renal arterioles.
Endpiece: Insult to cabbages
Authors: P. J. Carey
Journal: BMJ (1999)

Among the current cliches I especially deplore is the one which refers to hospital patients kept alive by machines as “cabbages.” This is both inaccurate and insulting to vegetables. For a cabbage is a sturdy, self-reliant being, and compared with an average specimen of twentieth-century manhood it has, when well grown, a positively athletic air.
It Takes Two to Tango: Dual Inhibition of PI3K and MAPK in Rhabdomyosarcoma
Authors: Arman Jahangiri, William A. Weiss
Journal: Clinical Cancer Research (2013)

The PI3K/AKT/mTOR and RAS/RAF/MAPK pathways play essential roles in rhabdomyosarcoma. Singular targeting of each pathway is ineffective due to extensive cross-talk and compensatory feedback between these two pathways. Dual blockade with inhibitors of PI3K and MAPK in combination synergistically inhibits growth of rhabdomyosarcoma both in vitro and in vivo.
Whole-Brain Radiotherapy in the Management of Brain Metastasis
Authors: Deepak Khuntia, Paul Brown, Jing Li, Minesh P. Mehta
Journal: Journal of Clinical Oncology (2006)

Brain metastases are an important cause of morbidity and mortality, afflicting nearly 170,000 Americans annually. The prognosis for these patients is poor, with median survival times measured in months. In this review article, we present the standard treatment approach of whole-brain radiotherapy and discuss new directions, including the role of chemical modifiers and the management and prevention of neurocognitive deficits.
Evidence for the presence of an inactive precursor of human hepatocyte growth factor in plasma and sera of patients with liver diseases
Authors: Naokatu Arakaki, Shuichi Kawakami, Osamu Nakamura, Tomokazu Ohnishi, Hiroomi Miyazaki, Takehisa Ishii, Hirohito Tsubouchi, Yasushi Daikuhara
Journal: Hepatology (1995)

Human hepatocyte growth factor (hHGF), which is now known to be the same protein as the scatter factor and the tumor cytotoxic factor, is a heterodimeric protein with one heavy chain and one light chain linked together by a disulfide bond, and is thought to be involved in liver regeneration. Using an enzyme-linked immunosorbent assay (ELISA) and Western blot analysis, we found that a significant amount of single chain precursor of hHGF (pro-hHGF) was present in plasma of patients with fulminant hepatic failure (FHF) and that normal human serum contained a protease or proteases that convert pro-HGF to a heterodimeric (mature) form of hHGF. We also showed that the processing protease activity for hHGF was suppressed by such serine protease inhibitors as leupeptin, antipain, and aprotinin, and that sera of patients with liver diseases such as fulminant hepatic failure, acute hepatitis, chronic hepatitis, and cirrhosis contained not only pro-hHGF but also the protease. This is the first report showing the presence of pro-hHGF in human blood, and our observations suggest that hHGF is synthesized and secreted from the hHGF-producing cells as an inactive pro-hHGF after hepatic injuries, and the pro-hHGF is then converted to an active heterodimeric form of hHGF in the blood. It is also suggested that plasma of patients with liver diseases contains an active protease or proteases that convert pro-hHGF to a mature form of hHGF.
Heart-Healthy Exercise
Authors: Lauren Healey Mellett, Gisele Bousquet
Journal: Circulation (2013)

A pproximately 600 000 people die of heart disease in the United States every year, and it is the leading cause of death for both men and women. 1 Coronary artery disease occurs when cholesterol-filled plaque builds up in the coronary arteries that supply blood to the heart muscle.Over time, this plaque buildup can cause significant narrowing of the arteries (called atherosclerosis), which may lead to chest pain (angina) or heart attack.Regular exercise is one of the best treatments to prevent coronary artery disease and to decrease your risk of future events if you already have heart disease.
PMO-020 Audit to assess the acceptability and usefulness of an audiovisual aid in the preparation of patients for outpatient endoscopy: Abstract PMO-020 Table 1
Authors: I Williams, S Edwards, R Boulton
Journal: Gut (2012)

<h3>Introduction</h3> Written information is traditionally used to educate patients about endoscopy, but it is difficult to fully convey endoscopy via a leaflet. We assessed whether a video following a “patient” through the endoscopy journey was a useful tool to assist patient9s understanding of endoscopy as a supplement to the information that we have been using in our Unit. <h3>Methods</h3> A DVD showing the endoscopy process was sent to all individuals booked for an outpatient upper GI endoscopy over 2 months. On arrival at endoscopy unit they were asked to complete a questionnaire. <h3>Results</h3> Abstract PMO-020 table 1 demonstrating responses to questions 4–6. Of 158 questionnaires, 149 replies were suitable for analysis. 81% gave the DVD top score for clarity and ease of understanding. The majority of responders found the DVD useful in preparing them for what will happen on the day of endoscopy with 81% of responders scoring the DVD one of the top two ratings for this category. All of the responders felt the DVD was a good idea and all but one individual recommended that we should continue to include it in the information packs. <h3>Conclusion</h3> Overall, the response to the endoscopy DVD was very positive. Some of the issues related to not watching the DVD will likely be solved once it is in use in an endoscopy pre-admission clinic. On the basis of this extremely positive result, we plan to utilise the endoscopy information DVD more widely and extend it to other endoscopic procedures. <h3>Competing interests</h3> None declared.
Efficacy of Gene Therapy for X-Linked Severe Combined Immunodeficiency
Authors: Salima Hacein-Bey-Abina, Julia Hauer, Annick Lim, Capucine Picard, Gary P. Wang, Charles C. Berry, Chantal Martinache, Frédéric Rieux-Laucat, Sylvain Latour, Bernd H. Belohradsky, Lily Leiva, Ricardo Sorensen, Marianne Debré, Jean Laurent Casanova, Stephane Blanche, Anne Durandy, Frederic D. Bushman, Alain Fischer, Marina Cavazzana-Calvo
Journal: New England Journal of Medicine (2010)

The outcomes of gene therapy to correct congenital immunodeficiencies are unknown. We reviewed long-term outcomes after gene therapy in nine patients with X-linked severe combined immunodeficiency (SCID-X1), which is characterized by the absence of the cytokine receptor common gamma chain.The nine patients, who lacked an HLA-identical donor, underwent ex vivo retrovirus-mediated transfer of gamma chain to autologous CD34+ bone marrow cells between 1999 and 2002. We assessed clinical events and immune function on long-term follow-up.Eight patients were alive after a median follow-up period of 9 years (range, 8 to 11). Gene therapy was initially successful at correcting immune dysfunction in eight of the nine patients. However, acute leukemia developed in four patients, and one died. Transduced T cells were detected for up to 10.7 years after gene therapy. Seven patients, including the three survivors of leukemia, had sustained immune reconstitution; three patients required immunoglobulin-replacement therapy. Sustained thymopoiesis was established by the persistent presence of naive T cells, even after chemotherapy in three patients. The T-cell-receptor repertoire was diverse in all patients. Transduced B cells were not detected. Correction of the immunodeficiency improved the patients' health.After nearly 10 years of follow-up, gene therapy was shown to have corrected the immunodeficiency associated with SCID-X1. Gene therapy may be an option for patients who do not have an HLA-identical donor for hematopoietic stem-cell transplantation and for whom the risks are deemed acceptable. This treatment is associated with a risk of acute leukemia. (Funded by INSERM and others.)