tbuckley/cabot-search huggingface dataset:
Hormone Replacement Therapy After a Diagnosis of Breast Cancer in Relation to Recurrence and Mortality
Authors: E S O'Meara, M A Rossing, J R Daling, J G Elmore, W E Barlow, N S Weiss
Journal: JNCI Journal of the National Cancer Institute (2001)

Hormone replacement therapy (HRT) is typically avoided for women with a history of breast cancer because of concerns that estrogen will stimulate recurrence. In this study, we sought to evaluate the impact of HRT on recurrence and mortality after a diagnosis of breast cancer.Data were assembled from 2755 women aged 35-74 years who were diagnosed with incident invasive breast cancer while they were enrolled in a large health maintenance organization from 1977 through 1994. Pharmacy data identified 174 users of HRT after diagnosis. Each HRT user was matched to four randomly selected nonusers of HRT with similar age, disease stage, and year of diagnosis. Women in the analysis were recurrence free at HRT initiation or the equivalent time since diagnosis. Rates of recurrence and death through 1996 were calculated. Adjusted relative risks were estimated by use of the Cox regression model. All statistical tests were two-sided.The rate of breast cancer recurrence was 17 per 1000 person-years in women who used HRT after diagnosis and 30 per 1000 person-years in nonusers (adjusted relative risk for users compared with nonusers = 0.50; 95% confidence interval [CI] = 0.30 to 0.85). Breast cancer mortality rates were five per 1000 person-years in HRT users and 15 per 1000 person-years in nonusers (adjusted relative risk = 0.34; 95% CI = 0.13 to 0.91). Total mortality rates were 16 per 1000 person-years in HRT users and 30 per 1000 person-years in nonusers (adjusted relative risk = 0.48; 95% CI = 0.29 to 0.78). The relatively low rates of recurrence and death were observed in women who used any type of HRT (oral only = 41% of HRT users; vaginal only = 43%; both oral and vaginal = 16%). No trend toward lower relative risks was observed with increased dose.We observed lower risks of recurrence and mortality in women who used HRT after breast cancer diagnosis than in women who did not. Although residual confounding may exist, the results suggest that HRT after breast cancer has no adverse impact on recurrence and mortality.
Impact of chronic intermittent spinal cord stimulation (SCS) on airway pressure generation (P) for cough production in spinal cord injury (SCI)
Authors: Krzysztof Kowalski, Dana Hromyak, Anthony DiMarco
Journal: European Respiratory Journal (2014)

Background:  SCS has been shown to restore an effective cough mechanism in SCI subjects.Following spinal cord injury however, the expiratory muscles may have developed significant atrophy with consequent reductions in their force generating capacity.   Objective:  To assess expiratory muscle strength following SCI and evaluate the impact of chronic intermittent SCS on P and cough production.   Methods:  In 10 SCI subjects, single disc electrodes were implanted at the T9, T11 and L1 spinal levels and connected to an implanted radiofrequency receiver. Post-implantation, each subject was instructed to apply stimulation as needed for secretion management.   Results:  P during spontaneous efforts was 28±5cmH2O. Initial T9, T11, L1 SCS alone resulted in P of 50±8, 52±8 and 48±9cmH2O, respectively. Initial combined stimulation with a 2 lead system resulted in P of 72±9cmH2O. A reconditioning program (40V, 50Hz 0.2ms, 0.6s on) 2-3 times per day for 10min, 7 days/week over a 14-21 week period resulted in substantial increases in P to 80±16, 80±14 and 68±13cmH2O, respectively. With a 2 lead system, P was 112±18cmH2O. P was maintained at the 1, 2 and mean 4.6 year follow-up points.   Conclusion:  SCS has the potential to reverse expiratory muscle atrophy and improve expiratory muscle strength. SCS may provide a useful method to restore an effective cough mechanism in patients with SCI.   Support: NIH:  NIH-NINDS (R01NS049516 and RC1NS068576), NCRR (M01RR0080 and UL1RR024989).   Disclosure:  Dr. DiMarco is a Founder of and has a significant financial interest in Synapse BioMedical, Inc, a manufacturer of diaphragm pacing systems.
Treatment of Cheyne-Stokes respiration with nasal oxygen and carbon dioxide
Authors: S Andreas, K Weidel, G Hagenah, S Heindl
Journal: European Respiratory Journal (1998)

Cheyne-Stokes respiration (CSR) is common in patients with congestive heart failure (CHF) and is associated with significant nocturnal O2 desaturation, arousals and sympathetic activation. Nocturnal O2 reduces CSR by only about 50%. More complete suppression of CSR may be achieved by adding CO2 to O2. This study therefore aimed to evaluate the effects of nocturnal O2 plus CO2 on CSR, sleep and sympathetic activation. Nine patients with CHF (age 59+/-5 yrs; left ventricular ejection fraction 17.8+/-1.2% (mean+/-SEM) were studied in a cross-over, single-blind, placebo-controlled trial. After an accommodation night the patients were randomly assigned to one night each of O2 plus CO2 as well as air applied by nasal prongs. Nocturnal O2 plus CO2 reduced the duration of CSR as percentage of total sleep time (48.0+/-10 versus 7.4+/-2.0%; p=0.008) and increased arterial oxygen saturation (Sa,O2) as well as mean transcutaneous carbon dioxide tension (Ptc,CO2) (5.2+/-0.3 kPa (39+/-2 mmHg) versus 5.7+/-0.3 kPa (43+/-2 mmHg) p=0.011). Sleep did not improve and arousals were not reduced. Plasma noradrenaline was higher on the treatment night (486+/-116 versus 669+/-163 ng x L(-1); p=0.035). In conclusion, nocturnal O2 plus CO2 improves Cheyne-Stokes respiration in patients with congestive heart failure but has adverse effects on the sequel of Cheyne-Stokes respiration, namely sympathetic activation.
Scopolamine-Morphine Anaesthesia in Labour
Authors: J. R. Freeland, B. A. H. Solomons
Journal: BMJ (1911)

Jx MAL I07 to be the case, were obtained without the slightest thought of any etiological.significance.Since obtaining cobra venom, I have had only a short time in which to confirm this work, but so far as I have gone I am in agreement with him.I will not give my results in detail at present, as I hope they will, when completed, form part of a future communication on the diagnoins in vitro of pregnancy by complement-fixation and haemolytic tests.Mach of this work is already
Fruit and Vegetable Intake in Relation to Risk of Ischemic Stroke
Authors: K J Joshipura, A Ascherio, J E Manson, M J Stampfer, E B Rimm, F E Speizer, C H Hennekens, D Spiegelman, W C Willett
Journal: JAMA (1999)

ContextFew studies have evaluated the relationship between fruit and vegetable intake and cardiovascular disease.ObjectiveTo examine the associations between fruit and vegetable intake and ischemic stroke.Design, Setting, and SubjectsProspective cohort studies, including 75,596 women aged 34 to 59 years in the Nurses' Health Study with 14 years of follow-up (1980-1994), and 38,683 men aged 40 to 75 years in the Health Professionals' Follow-up Study with 8 years of follow-up (1986-1994). All individuals were free of cardiovascular disease, cancer, and diabetes at baseline.Main Outcome MeasureIncidence of ischemic stroke by quintile of fruit and vegetable intake.ResultsA total of 366 women and 204 men had an ischemic stroke. After controlling for standard cardiovascular risk factors, persons in the highest quintile of fruit and vegetable intake (median of 5.1 servings per day among men and 5.8 servings per day among women) had a relative risk (RR) of 0.69 (95% confidence interval [CI], 0.52-0.92) compared with those in the lowest quintile. An increment of 1 serving per day of fruits or vegetables was associated with a 6% lower risk of ischemic stroke (RR, 0.94; 95% CI, 0.90-0.99; P=.01, test for trend). Cruciferous vegetables (RR, 0.68 for an increment of 1 serving per day; 95% CI, 0.49-0.94), green leafy vegetables (RR, 0.79; 95% CI, 0.62-0.99), citrus fruit including juice (RR, 0.81; 95% CI, 0.68-0.96), and citrus fruit juice (RR, 0.75; 95% CI, 0.61-0.93) contributed most to the apparent protective effect of total fruits and vegetables. Legumes or potatoes were not associated with lower ischemic stroke risk. The multivariate pooled RR for total stroke was 0.96 (95% CI, 0.93-1.00) for each increment of 2 servings per day.ConclusionsThese data support a protective relationship between consumption of fruit and vegetables—particularly cruciferous and green leafy vegetables and citrus fruit and juice—and ischemic stroke risk.
Current status of and future strategies for multimodality treatment of unresectable stage III nonsmall cell lung cancer
Authors: Rudolf M. Huber, Martin Reck, Michael Thomas
Journal: European Respiratory Journal (2013)

Stage III nonsmall cell lung cancer (NSCLC) encompasses a heterogeneous group of patients, some of whom may be candidates for potentially curative surgery, although for the majority surgery is not an option. Recommended therapy for patients with unresectable stage III disease is concurrent treatment with chemotherapy and thoracic radiotherapy, although even with this dual modality therapy survival remains disappointing. Novel classes of agents including targeted therapies have been shown to improve survival in advanced stage NSCLC, raising the possibility that these agents may have benefits in multimodal therapy when combined with chemoradiotherapy. Here we consider the rationale for combining new agents with chemoradiotherapy and the evidence from clinical studies assessing multimodal strategies for the management of patients with unresectable stage III NSCLC.
The association between lichen sclerosus et atrophicus and autoimmune disease in males—an addendum
Authors: R.H. Meyrick Thomas, C.M. Ridley, M.M. Black
Journal: British Journal of Dermatology (1984)

Journal Article The association between lichen sclerosus et atrophicus and autoimmune disease in males—an addendum Get access R.H. Meyrick Thomas, R.H. Meyrick Thomas Departments of Dermatology St Bartholomew's, Whittington and St Thomas'Hospitals, London, U. K. Search for other works by this author on: Oxford Academic Google Scholar C.M. Ridley, C.M. Ridley Departments of Dermatology St Bartholomew's, Whittington and St Thomas'Hospitals, London, U. K. Search for other works by this author on: Oxford Academic Google Scholar M.M. Black M.M. Black Departments of Dermatology St Bartholomew's, Whittington and St Thomas'Hospitals, London, U. K. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 111, Issue 3, 1 September 1984, Page 371, https://doi.org/10.1111/j.1365-2133.1984.tb04737.x Published: 01 September 1984
A Phase I/II Study of Infusional Vinblastine with the P-Glycoprotein Antagonist Valspodar (PSC 833) in Renal Cell Carcinoma
Authors: Susan E. Bates, Susan Bakke, Min Kang, Robert W. Robey, Suoping Zhai, Paul Thambi, Clara C. Chen, Sheela Patil, Tom Smith, Seth M. Steinberg, Maria Merino, Barry Goldspiel, Beverly Meadows, Wilfred D. Stein, Peter Choyke, Frank Balis, William D. Figg, Tito Fojo
Journal: Clinical Cancer Research (2004)

Abstract Purpose: P-glycoprotein (Pgp) inhibitors have been under clinical evaluation for drug resistance reversal for over a decade. Valspodar (PSC 833) inhibits Pgp-mediated efflux but delays drug clearance, requiring reduction of anticancer drug dosage. We designed an infusional schedule for valspodar and vinblastine to mimic infusional vinblastine alone. The study was designed to determine the maximally tolerated dose of vinblastine, while attempting to understand the pharmacokinetic interactions between vinblastine and valspodar and to determine the response rate in patients with metastatic renal cell cancer. Patients and Methods: Thirty-nine patients received continuous infusion valspodar and vinblastine. Vinblastine was administered for 3 days to compensate for the expected delay in clearance and the required dose reduction. Valspodar was administered initially at a dose of 10 mg/kg/d; the dose of vinblastine varied. Results: The maximum-tolerated dose of vinblastine was 1.3 mg/m2/d. As suggested previously, serum valspodar concentrations exceeded those needed for Pgp inhibition. Consequently, the dose of valspodar was reduced to 5 mg/kg, allowing a vinblastine dose of 2.1 mg/m2/d to be administered. Pharmacodynamic studies demonstrated continued inhibition of Pgp at lower valspodar doses by functional assay in Pgp-expressing CD56+ cells and by 99mTc-sestamibi imaging. A 15-fold range in cytochrome P450 activity was observed, as measured by midazolam clearance. No major responses were observed. Conclusions: These results suggest that the pharmacokinetic impact of cytochrome P450 inhibition by valspodar can be reduced although not eliminated, while preserving Pgp inhibition, thus separating the pharmacokinetic and pharmacodynamic activities of valspodar.
Radiation-induced Cancer Risk from Annual Computed Tomography for Patients with Cystic Fibrosis
Authors: Amy Berrington de González, Kwang Pyo Kim, Jonathan M. Samet
Journal: American Journal of Respiratory and Critical Care Medicine (2007)

Rationale: Computed tomography (CT) is being considered as a tool for routine monitoring of lung damage in people with cystic fibrosis. Concern has been raised, however, about the associated risk of radiation-induced cancer.Objectives: To estimate the risk of radiation-induced cancer from lung CT for patients with cystic fibrosis, assuming annual monitoring starting at age 2 years.Methods: Radiation risk models (derived primarily from the study of Japanese atomic bomb survivors) were used to estimate the excess risk of radiation-induced cancer for the organs that receive measurable doses from lung CT. Two scenarios were considered: median survival to age 36 years (approximate current median survival) and median survival to age 50 years (projected median survival by 2030).Measurements and Main Results: The estimated risk of radiation-induced cancer from annual lung CT was 0.02% for males and 0.07% for females assuming median survival to age 36 years. The estimated risks increased to 0.08% for males and 0.46% for females assuming median survival increases to age 50 years. The risks are higher for females because of the risk of radiation-induced breast cancer (50% of total risk) and higher risk of thyroid cancer.Conclusions: The cumulative risk of radiation-induced cancer from repeated lung CT scans for patients with cystic fibrosis is relatively small (less than 0.5%). However, routine monitoring should not be recommended until there is a demonstrated benefit that will outweigh these risks.
LUNOKID: can numerical American Thoracic Society/European Respiratory Society quality criteria replace visual inspection of spirometry?
Authors: Christine Müller-Brandes, Ursula Krämer, Monika Gappa, Gabriele Seitner-Sorge, Anke Hüls, Andrea von Berg, Barbara Hoffmann, Antje Schuster, Sabina Illi, Matthias Wisbauer, Dietrich Berdel
Journal: European Respiratory Journal (2013)

The gold standard for assessing quality of forced expiratory manoeuvres is visual inspection by an expert. American Thoracic Society/European Respiratory Society numerical quality criteria (NQC) include back-extrapolated volume (BEV), repeatability and forced expiratory time (FET). Equipment currently available provides feedback tempting the investigator to use NQC as pass–fail criterion. To investigate whether using NQC instead of visual acceptability is a valid option, we analysed data from a multicentre national reference study in Germany of children aged 4–18 years. Spirometry was performed under field conditions. Receiver operating characteristic analysis was used to assess performance of BEV, repeatability, FET and a combination thereof in relation to visual acceptability. We included data from 3133 healthy Caucasians in the analyses; 72% delivered at least two visually acceptable manoeuvres. Of these, 59% would have been rejected based on combined NQC, mainly because the FET criterion was not feasible. Specificity of the NQC was generally low (BEV 10%, repeatability 30% and FET 50%). Receiver operating characteristic analysis showed that a combination of the three measures could reach at best a sensitivity of 90% and specificity of 56%. We conclude that visual control is mandatory and NQC may help obtain the best possible results, but a fixed cut-off for FET should be abandoned.
Thyroid Cancer After Diagnostic Doses of Iodine-131: A Retrospective Cohort Study
Authors: L.-E. Holm, K. E. Wiklund, G. E. Lundell, N.A k. Bergman, G. Bjelkengren, E. S. Cederquist, U.-B. C. Ericsson, L.-G. Larsson, M. E. Lidberg, R. S. Lindberg, H. V. Wicklund, J. D. Boice
Journal: JNCI Journal of the National Cancer Institute (1988)

The incidence of thyroid cancer was evaluated in 35,074 patients examined for suspected thyroid disorders between 1951 and 1969 with an average of 1.92 megabecquerel [(MBq) 52 microCi] of 131I. The radiation dose to the thyroid gland was, on the average, approximately 0.5 Gy. The mean age at the time of examination was 44 years; 5% were under age 20. Patients were followed for an average of 20 years. Record linkage with the Swedish Cancer Register identified 50 thyroid cancers occurring 5 years or more after the initial 131I examination, in contrast to 39.4 expected based on general population rates [standardized incidence ratio (SIR) = 1.27, 95% confidence interval = 0.94-1.67]. Risk was highest among males (SIR = 2.70, n = 10), patients followed 5-9 years (SIR = 2.22, n = 23), and patients receiving more than 74 microCi or 2.74 MBq of 131I (SIR = 2.04, n = 17). However, these observations were confounded by the fact that patients examined for a suspected thyroid tumor received the highest 131I exposures and were at highest overall risk (SIR = 2.77, n = 34). Patients given 131I for reasons other than a suspected tumor were not at increased risk (SIR = 0.62, n = 16). Patients anticipated to be at highest risk, i.e., women (SIR = 1.12, n = 40) and those observed for 10 years or more (SIR = 0.93, n = 27), showed no evidence of a dose response. Overall, these data provide little proof that 131I is carcinogenic in humans and support the notion that the carcinogenic potential of internal 131I beta particles might be as low as four times less than external x rays or gamma rays.
A Mosaic Activating Mutation in<i>AKT1</i>Associated with the Proteus Syndrome
Authors: Marjorie J. Lindhurst, Julie C. Sapp, Jamie K. Teer, Jennifer J. Johnston, Erin M. Finn, Kathryn Peters, Joyce Turner, Jennifer L. Cannons, David Bick, Laurel Blakemore, Catherine Blumhorst, Knut Brockmann, Peter Calder, Natasha Cherman, Matthew A. Deardorff, David B. Everman, Gretchen Golas, Robert M. Greenstein, B. Maya Kato, Kim M. Keppler-Noreuil, Sergei A. Kuznetsov, Richard T. Miyamoto, Kurt Newman, David Ng, Kevin O'Brien, Steven Rothenberg, Douglas J. Schwartzentruber, Virender Singhal, Roberto Tirabosco, Joseph Upton, Shlomo Wientroub, Elaine H. Zackai, Kimberly Hoag, Tracey Whitewood-Neal, Pamela G. Robey, Pamela L. Schwartzberg, Thomas N. Darling, Laura L. Tosi, James C. Mullikin, Leslie G. Biesecker
Journal: New England Journal of Medicine (2011)

The Proteus syndrome is characterized by the overgrowth of skin, connective tissue, brain, and other tissues. It has been hypothesized that the syndrome is caused by somatic mosaicism for a mutation that is lethal in the nonmosaic state.
Community-acquired pneumonia through Enterobacteriaceae and Pseudomonas aeruginosa: diagnosis, incidence and predictors
Authors: H. von Baum, T. Welte, R. Marre, N. Suttorp, S. Ewig
Journal: European Respiratory Journal (2009)

The aim of the present study was to determine the relevance of the presence of Enterobacteriaceae (EB) and Pseudomonas aeruginosa (PA) in patients with community-acquired pneumonia (CAP) and how the true incidence of these pathogens can be assessed. Based on prospective data from 5,130 patients with CAP included in the German Competence Network for Community-Acquired Pneumonia (CAPNETZ), the incidence, clinical characteristics, outcome and predictors of patients with CAP due to EB and PA were studied applying strict case definitions. The incidence of EB was 67 (1.3%) out of 5,130, including 27 patients with bacteraemia. PA was found in 22 (0.4%) out of 5,130 patients. These microorganisms were judged to be indeterminate pathogens in an additional 172 and 27 isolates, respectively. Patients with indeterminate pathogens differed considerably from those with definite isolates in terms of clinical presentation, comorbidity, pneumonia severity and outcome. Independent risk factors for EB included cardiac and cerebrovascular disease, and for PA chronic respiratory disease and enteral tube feeding. The 30-day mortality was significantly higher in patients with definite pathogens. In the present large population, the incidence of CAP due to EB/ PA was low. The risk of the presence of these pathogens can be assessed using several predictors, which may identify those patients in need of an extended diagnostic work-up and initial antimicrobial treatment.
Morphological assessment of sucrose preservation for porcine heart valves.
Authors: P J Drury, E G Olsen, D N Ross
Journal: Thorax (1982)

Porcine aortic valves stored in various concentrations of sucrose (50-80%) for up to 52 weeks were examined both histologically and by electron microscopy. The valves were compared with porcine aortic valves stored in a nutrient and antibiotic medium for 12 weeks. Overall preservation was better in those porcine valves stored in sucrose solution than in nutrient and antibiotic medium, the best preservation being in 50% sucrose. Despite wide separation of collagen at that concentration seen on electron microscopy (not noted histologically), tissue preservation was good after storage in sucrose solutions at concentrations up to 80%, at which clumping of collagen and distortion of fibroblasts occurred. It is suggested that sucrose solution is acceptable for the long-term preservation of biological valves.
Obstructive sleep apnoea and metabolic impairment in severe obesity
Authors: M. Gasa, N. Salord, A. M. Fortuna, M. Mayos, N. Vilarrasa, J. Dorca, J. M. Montserrat, M. R. Bonsignore, C. Monasterio
Journal: European Respiratory Journal (2011)

Obstructive sleep apnoea (OSA) seems to worsen metabolism. This effect has not been evaluated in morbid obesity (MO). We hypothesised that the metabolic profile is more impaired in MO patients with OSA than in those without, and investigated whether any specific metabolic dysfunction is related to OSA in MO. A prospective multicentre cross-sectional study was conducted in consecutive subjects before bariatric surgery. OSA was defined as apnoea/hypopnoea index (AHI) ≥15 by overnight polysomnography. Anthropometrical, blood pressure (BP) and fasting blood measurements were obtained the morning after. Metabolic syndrome (MetS) was defined according to National Cholesterol Education Program Adult Treatment Panel III modified criteria. 159 patients were studied: 72% were female and 72% had OSA. MetS prevalence was 70% in OSA <i>versus</i> 36% in non-OSA (p&lt;0.001). As AHI severity increased, metabolic parameters progressively worsened, even in those without type 2 diabetes (DM2). AHI was independently associated with systolic and diastolic BP, triglycerides and the percentage of glycosylated haemoglobin (HbA1c) in the total sample, and with systolic BP, high-density lipoprotein cholesterol and HbA1c in those samples without DM2. OSA increased the adjusted odds ratio of having MetS by 2.8 (95% CI 1.3–6.2; p=0.009). In MO, OSA is associated with major metabolic impairment caused by higher BP and poorer lipid and glucose control, independent of central obesity or DM2.