tbuckley/cabot-search huggingface dataset:
Prevention of type 2 diabetes in British Bangladeshis: qualitative study of community, religious, and professional perspectives
Authors: C. Grace, R. Begum, S. Subhani, P. Kopelman, T. Greenhalgh
Journal: BMJ (2008)

<b>Objective</b> To understand lay beliefs and attitudes, religious teachings, and professional perceptions in relation to diabetes prevention in the Bangladeshi community. <b>Design</b> Qualitative study (focus groups and semistructured interviews). <b>Setting</b> Tower Hamlets, a socioeconomically deprived London borough, United Kingdom. <b>Participants</b> Bangladeshi people without diabetes (phase 1), religious leaders and Islamic scholars (phase 2), and health professionals (phase 3). <b>Methods</b> 17 focus groups were run using purposive sampling in three sequential phases. Thematic analysis was used iteratively to achieve progressive focusing and to develop theory. To explore tensions in preliminary data fictional vignettes were created, which were discussed by participants in subsequent phases. The PEN-3 multilevel theoretical framework was used to inform data analysis and synthesis. <b>Results</b> Most lay participants accepted the concept of diabetes prevention and were more knowledgeable than expected. Practical and structural barriers to a healthy lifestyle were commonly reported. There was a strong desire to comply with cultural norms, particularly those relating to modesty. Religious leaders provided considerable support from Islamic teachings for messages about diabetes prevention. Some clinicians incorrectly perceived Bangladeshis to be poorly informed and fatalistic, although they also expressed concerns about their own limited cultural understanding. <b>Conclusion</b> Contrary to the views of health professionals and earlier research, poor knowledge was not the main barrier to healthy lifestyle choices. The norms and expectations of Islam offer many opportunities for supporting diabetes prevention. Interventions designed for the white population, however, need adaptation before they will be meaningful to many Bangladeshis. Religion may have an important part to play in supporting health promotion in this community. The potential for collaborative working between health educators and religious leaders should be explored further and the low cultural understanding of health professionals addressed.
Evaluation of sleep related breathing disorders and obstructive sleep apnea in patients with interstitial lung disease
Authors: Pervin Hanci, Aylin Alpaydin, Oya Itil, Can Sevinc, Ibrahim Oztura, Baris Baklan
Journal: European Respiratory Journal (2013)

Patients with ILD are at risk for sleep disorders due to respiratory abnormalities and adverse effects of treatment.We aimed to determine the relationship between quality of sleep,sleep disordered breathing and incidence of obstructive sleep apnea in these patients.  Fifty two patients with ILD were enrolled in study. Pittsburgh Sleep Quality Index(PSQI) and Epworth Sleepiness Score(ESS) were applied. All patients underwent spirometry and COdiffusion test. Polysomnography was performed to 27 patients who had an ESS >=10.Subjective parameters of sleepiness and sleep quality compered with PSG mesurements.  Patients were classified according to daytime sleepiness. Demographic characteristics, body mass index, immunosuppressive medication, spirometry and diffusion measurements, the sub-components of PSQI and global score didn’t differ between groups.Subjective sleep quality was poor in 44% of patients. PSQI global score and sub-components weren’t correlated with AHI, stage 1 latency, sleep efficiency and nocturnal desaturation. We found increased stage 1 sleep and decreased stage 2-3 and REM sleep.Nocturnal hypoxemia was determined related with severity of restriction, arousals and sleep efficiency.Nineteen(70%) of subjects were diagnosed with OSAS. AHI was negatively correlated with percentage of FEV1-FVC and sleep efficiency and was evident during REM sleep and supine position.  Although patients with ILD don’t have daytime hypoxemia; nocturnal hypoxemia estimated by severity of restriction can contribute to apnea- hypopnea episodes. Therefore ILD patients must be evaluated for daytime sleepiness, sleep quality and inspected for sleep-related breathing disorders.
Proliferating cell nuclear antigen in oesophageal diseases; correlation with transforming growth factor alpha expression.
Authors: J Jankowski, R McMenemin, C Yu, D Hopwood, K G Wormsley
Journal: Gut (1992)

This study was designed to correlate mucosal proliferation in Barrett's oesophagus with expression of a growth promoting peptide, transforming growth factor alpha (TGF alpha). Oesophageal mucosa was studied from 50 patients with oesophageal disease who had been treated by oesophagectomy. Histological analysis showed a range of oesophageal pathology - 18 patients had gastric type Barrett's mucosa, 18 had intestinal type Barrett's mucosa, and 14 had oesophageal adenocarcinomas. Sections were stained immunohistochemically for proliferating cell nuclear antigen (PCNA) (an index of cellular proliferation) and TGF alpha. PCNA immunostaining was seen mainly in the basal cells of the neck/foveolar epithelial compartment of the glands in Barrett's oesophagus. However, in mucosa with high grade dysplasia, the proliferative compartment extended upwards into the superficial layers of the glands. At least 2000 cells were counted in each patient to determine the proportion with PCNA immunoreactivity (PCNA labelling index). The labelling index was highest in adenocarcinoma (25%) and in Barrett's intestinal type mucosa with high grade dysplasia (26%) compared with intestinal type mucosa with no significant dysplasia (20%) and Barrett's gastric type mucosa (12%). There was a significant positive correlation between PCNA labelling indices and TGF alpha expression in Barrett's mucosa (p less than 0.01). In glands showing high grade dysplasia, TGF alpha immunoreactivity was seen in the same regions of the glands as PCNA immunoreactivity, indicating the possibility of involvement of TGF alpha in (pre) neoplastic proliferation in Barrett's oesophagus.
The crossover lung segment: congenital malformation associated with a variant of scimitar syndrome.
Authors: B S Clements, J O Warner
Journal: Thorax (1987)

Three cases of a congenitally misplaced segment of lung are described. In one case the abnormal segment was identified at thoracotomy; it extended from an origin in the right upper lobe across the midline into the left hemithorax. The remaining two patients, with identical radiographic features, were identified in a review of 24 cases of bronchovascular malformation. In all three patients the crossover segment was associated with a variant of the scimitar syndrome: right lung hypoplasia with dextrocardia, aberrant systemic arterial supply to the right lower lobe, and anomalous venous drainage of the whole of the right lung, and in two patients with eventration of the right diaphragm.
Recruitment of an inotropic reserve in moderately ischemic myocardium at the expense of metabolic recovery. A model of short-term hibernation.
Authors: R Schulz, B D Guth, K Pieper, C Martin, G Heusch
Journal: Circulation Research (1992)

The regional, functional as well as metabolic consequences of inotropic stimulation on myocardium subjected to prolonged moderate ischemia were investigated. In 35 enflurane-anesthetized swine the left anterior descending coronary artery was cannulated and perfused at constant flow. The vein paralleling the left anterior descending coronary artery was cannulated for measurement of lactate and oxygen content. Transmural biopsies from the anterior myocardium were taken for the measurement of ATP, creatine phosphate, and glycogen. After control measurements, flow was adjusted to reduce regional contractile function (expressed as a work index, determined by sonomicrometry) by approximately 50%. After either 5, 25, 40, or 85 minutes of moderate ischemia, dobutamine was infused for 5 minutes into the ischemic region. In a separate group of five swine also subjected to 85 minutes of ischemia followed by infusion of dobutamine and 2 hours of reperfusion, triphenyltetrazolium chloride staining and light microscopy were used to identify infarcted tissue. Moderate ischemia (regional myocardial blood flow, 0.21 +/- 0.07 ml.min-1.g-1, determined by radiolabeled microspheres) was associated with a reduction of creatine phosphate after 5 minutes (from 9.35 +/- 2.54 to 6.43 +/- 1.06 mumol/g wet wt, p less than 0.05) and a further reduction after 25 minutes (3.18 +/- 0.69 mumol/g wet wt, p less than 0.05). Thereafter, creatine phosphate recovered despite continued ischemia (after 40 minutes, 4.95 +/- 1.37 mumol/g wet wt; after 85 minutes, 5.78 +/- 2.27 mumol/g wet wt). Lactate consumption during control conditions was reversed to production after 5 minutes of ischemia, which moderated during more prolonged ischemia. Without changing regional myocardial blood flow, infusion of dobutamine increased the work index significantly at any time point but also caused worsening of metabolic markers of ischemia. Nevertheless, even after 85 minutes of ischemia followed by the infusion of dobutamine and 2 hours of reperfusion, there was no evidence of necrosis. This experimental model provides a means of characterizing the mechanisms of short-term hibernation.
Life in slow motion: quantifying physical activity in COPD
Authors: M. Morgan
Journal: Thorax (2008)

We probably all acknowledge that regular spontaneous physical activity plays a large role in maintaining health and physical fitness. In health, the promotion of regular physical activity has been a feature of active living since at least the time of Ancient Greece. In more modern times we have continued this tradition by encouraging our children to play sport and sustaining recreational physical activity through to old age.

Although the health benefits of maintaining spontaneous physical activity in otherwise healthy people are evident, it is only in more recent times that we have realised its importance in people with chronic disease. In people with chronic obstructive pulmonary disease (COPD), the reduction of physical activity is both a consequence and a symptom. Advancing airway obstruction leads to breathlessness that impedes activities of daily living and may naturally be compounded by the physical deconditioning induced by inactivity. We now understand that reduced physical activity is associated with a poorer prognosis in those with COPD, as well as a higher risk of hospital admission.1–3 In addition, therapies such as pulmonary rehabilitation are beneficial because they improve health status indirectly through the medium of physical exercise training and the increase in functional exercise capacity. Apart from slowing down the rate of decline of airway function, the main aims of treatment in COPD are to increase the quality of life and to improve symptoms of breathlessness during activity. To have a sustained beneficial effect, any therapy will have to bequeath a change in lifestyle which results in increased spontaneous physical activity. The simple provision of improvements in airway function or physical exercise capacity is insufficient to ensure sustained benefit unless the new capacity continues to be used. The recording of spontaneous daily physical activity therefore adds a different dimension to patient assessment that …
Changes in plasma levels of tissue‐plasminogen activator/inhibitor complex and active plasminogen activator inhibitor in patients with disseminated intravascular coagulation
Authors: Hidesaku Asakura, Hiroshi Jokaji, Masanori Saito, Chika Uotani, Ichiro Kumabashiri, Eriko Morishita, Masahide Yamazaki, Tamotsu Matsuda
Journal: American Journal of Hematology (1991)

Abstract Plasma levels of tissue‐plasminogen activator · plasminogen activator inhibitor (t‐PA · PAI) complex and active PAI were assayed in 58 cases of disseminated intravas‐cular coagulation (DIC). A significant elevation of both parameters was observed in most cases of DIC, especially in patients with non‐Hodgkin lymphoma, sepsis, or some patients with acute leukemia, but no such elevation was observed in patients with acute promyelocytic leukemia (APL). The levels of both parameters were higher in cases of DIC with multiple organ failure (MOF) than in those without MOF. Since no elevation of t‐PA · PAI complex was observed in most cases of APL, t‐PA did not seem to play an important role in the activation of fibrinolytic system in APL. Active PAI, which reflects the inhibitory regulation in fibrinolytic system, was considered to play a role in the progression of MOF. Plasma levels of active PAI were low in the cases of APL, which had no complication of MOF.
Diacetylspermine Is a Novel Prediagnostic Serum Biomarker for Non–Small-Cell Lung Cancer and Has Additive Performance With Pro-Surfactant Protein B
Authors: William R. Wikoff, Samir Hanash, Brian DeFelice, Suzanne Miyamoto, Matt Barnett, Yang Zhao, Gary Goodman, Ziding Feng, David Gandara, Oliver Fiehn, Ayumu Taguchi
Journal: Journal of Clinical Oncology (2015)

We have investigated the potential of metabolomics to discover blood-based biomarkers relevant to lung cancer screening and early detection. An untargeted metabolomics approach was applied to identify biomarker candidates using prediagnostic sera from the Beta-Carotene and Retinol Efficacy Trial (CARET) study.A liquid chromatography/mass spectrometry hydrophilic interaction method designed to profile a wide range of metabolites was applied to prediagnostic serum samples from CARET participants (current or former heavy smokers), consisting of 100 patients who subsequently developed non-small-cell lung cancer (NSCLC) and 199 matched controls. A separate aliquot was used to quantify levels of pro-surfactant protein B (pro-SFTPB), a previously established protein biomarker for NSCLC. On the basis of the results from the discovery set, blinded validation of a metabolite, identified as N(1),N(12)-diacetylspermine (DAS), and pro-SFTPB was performed using an independent set of CARET prediagnostic sera from 108 patients with NSCLC and 216 matched controls.Serum DAS was elevated by 1.9-fold, demonstrating significant specificity and sensitivity in the discovery set for samples collected up to 6 months before diagnosis of NSCLC. In addition, DAS significantly complemented performance of pro-SFTPB in both the discovery and validations sets, with a combined area under the curve in the validation set of 0.808 (P < .001 v pro-SFTPB).DAS is a novel serum metabolite with significant performance in prediagnostic NSCLC and has additive performance with pro-SFTPB.
Repeated Intermittent Low-Dose Therapy with Zoledronic Acid Induces an Early, Sustained, and Long-Lasting Decrease of Peripheral Vascular Endothelial Growth Factor Levels in Cancer Patients
Authors: Daniele Santini, Bruno Vincenzi, Sara Galluzzo, Fabrizio Battistoni, Laura Rocci, Olga Venditti, Gaia Schiavon, Silvia Angeletti, Federica Uzzalli, Michele Caraglia, Giordano Dicuonzo, Giuseppe Tonini
Journal: Clinical Cancer Research (2007)

Abstract Purpose: On the basis of stimulating data on animals reporting that weekly regimens of zoledronic acid (ZA) were effective in reducing skeletal tumor burden, we designed a study on humans to investigate the potential antiangiogenic role of a weekly low-dose therapy with ZA in patients with malignancies. Experimental Design: Twenty-six consecutive patients with advanced solid cancer and bone metastases received 1 mg of ZA every week for four times (days 1, 7, 14, and 21) followed by 4 mg of ZA with a standard 28-day schedule repeated thrice (days 28, 56, and 84). Patients were prospectively evaluated for circulating levels of vascular endothelial growth factor (VEGF) just before the beginning of drug infusion (0) and again at 7, 14, 21, 28, 56, and 84 days after the first ZA infusion. Results: The median VEGF basal value showed an early statistically significant (P = 0.038) decrease 7 days after the first 1-mg infusion of ZA. This effect on VEGF-circulating levels persisted also after the following 1-mg infusions at 14 (P = 0.002), 21 (P = 0.001), and 28 days (P = 0.008). Interestingly, the decrease of VEGF-circulating levels persisted also at each programmed time point during the second phase of the study (ZA 4 mg every 4 weeks). No significant differences were recorded in platelet levels, WBC count, or hemoglobin concentration before and after each ZA infusion. Conclusions: In the present study, we report that a repeated low-dose therapy with ZA is able to induce an early significant and long-lasting decrease of VEGF levels in cancer patients.
Involvement of Estrogen Receptor β in Ovarian Carcinogenesis
Authors: Aurélie Bardin, Pascale Hoffmann, Nathalie Boulle, Dionyssios Katsaros, Françoise Vignon, Pascal Pujol, Gwendal Lazennec
Journal: Cancer Research (2004)

Abstract Knockout and expression studies suggest that estrogen receptor β (ERβ) plays a prominent role in ovarian function and pathology. Moreover, ovarian cancers are characterized by high morbidity and low responsiveness to anti-estrogens. Here we demonstrate, using quantitative PCR to measure ERα and ERβ levels in 58 ovarian cancer patients, that ERβ expression decreased in cysts and ovarian carcinomas as compared with normal ovaries and that this decrease is attributable only to a selective loss in ERβ expression during cancer progression. To address the question of a possible involvement of ERβ in ovarian cancers, we restored ERα and ERβ expression in two human ovarian cancer cell lines PEO14 (ERα-negative) and BG1 (ERα-positive) using adenoviral delivery. ERα, but not ERβ, could induce progesterone receptor and fibulin-1C. Moreover, ERα and ERβ had opposite actions on cyclin D1 gene regulation, because ERβ down-regulated cyclin D1 gene expression, whereas ERα increased cyclin D1 levels. Interestingly, ERβ expression strongly inhibited PEO14 and BG1 cell proliferation and cell motility in a ligand-independent manner, whereas ERα had no marked effect. Induction of apoptosis by ERβ also contributed to the decreased proliferation of ovarian cancer cells, as shown by Annexin V staining. This study shows that ERβ is an important regulator of proliferation and motility of ovarian cancer and provides the first evidence for a proapoptotic role of ERβ. The loss of ERβ expression may thus be an important event leading to the development of ovarian cancer.
Role of membrane sphingomyelin and ceramide in platform formation for Fas-mediated apoptosis
Authors: Michihiko Miyaji, Zhe-Xiong Jin, Shohei Yamaoka, Ryuichi Amakawa, Shirou Fukuhara, Satoshi B. Sato, Toshihide Kobayashi, Naochika Domae, Tsuneyo Mimori, Eda T. Bloom, Toshiro Okazaki, Hisanori Umehara
Journal: The Journal of Experimental Medicine (2005)

Engagement of the Fas receptor (CD95) initiates multiple signaling pathways that lead to apoptosis, such as the formation of death-inducing signaling complex (DISC), activation of caspase cascades, and the generation of the lipid messenger, ceramide. Sphingomyelin (SM) is a major component of lipid rafts, which are specialized structures that enhance the efficiency of membrane receptor signaling and are a main source of ceramide. However, the functions of SM in Fas-mediated apoptosis have yet to be clearly defined, as the responsible genes have not been identified. After cloning a gene responsible for SM synthesis, SMS1, we established SM synthase-defective WR19L cells transfected with the human Fas gene (WR/Fas-SM(-)), and cells that have been functionally restored by transfection with SMS1 (WR/Fas-SMS1). We show that expression of membrane SM enhances Fas-mediated apoptosis through increasing DISC formation, activation of caspases, efficient translocation of Fas into lipid rafts, and subsequent Fas clustering. Furthermore, WR/Fas-SMS1 cells, but not WR/Fas-SM(-) cells, showed a considerable increase in ceramide generation within lipid rafts upon Fas stimulation. These data suggest that a membrane SM is important for Fas clustering through aggregation of lipid rafts, leading to Fas-mediated apoptosis.
Reentry Into Clinical Practice
Authors: Saralyn Mark, Jhumka Gupta
Journal: JAMA (2002)

Women and men who reenter clinical practice after a period of clinical inactivity often face personal, professional, and institutional obstacles. Although many associations and academic medical institutions realize the critical importance of retaining and promoting highly qualified individuals, it is equally important for health care professionals to have the opportunity to return to a successful professional career following extended clinical inactivity. Here we provide a review of factors that may contribute to clinical inactivity, discuss challenges associated with the reentry process, describe current reentry efforts, and propose recommendations for future directions.
Series on education: Teaching rheumatology in primary care
Authors: G. A C Hosie
Journal: Annals of the Rheumatic Diseases (2000)

General practitioners (GPs) are, by name and by training, generalists.They have an extraordinarily wide knowledge base, and, in the course of a morning surgery may deal with all ages from the new born to the elderly, with minor self limiting disease to terminal care, with almost insoluble social problems to major illicit drug dependency, and with clinical problems in every specialty from gynaecology to psychiatry.It would, therefore, be impossible for all GPs to have specialist abilities in all subjects, though many primary care physicians do have in-depth knowledge of certain diseases.Although GPs cannot be expert in all areas, they should have basic competencies in all the major diseases that they deal with each day.A problem with the musculoskeletal system is the third commonest reason for a patient seeking a consultation in general practice, and these problems account for 15% of all consultations in primary care. 1 If such patients could be adequately diagnosed and treated by the primary care team and with the resources within the community, this would reduce some of the pressure on secondary care and leave rheumatologists free to deal with inflammatory and connective tissue disease. Need for rheumatology education in primary careIn 1995 Lanyon et al, in collaboration with the Primary Care Rheumatology (PCR) Society, 2 evaluated rheumatology education and skills during vocational training using questionnaires sent to all GP trainees in the United Kingdom and their trainers.The survey concluded that rheumatology education needed to be improved, especially the component provided by GP trainers and local postgraduate centres.To date, however, little has changed.There have been two main blocks to this process: + Rheumatology is not considered a core subject by the Joint Committee of PostGraduate Training for General Practice + There is no standard core curriculum as suggested by Lanyon et al. 2 EVorts are underway to deal with these problems.