tbuckley/cabot-search huggingface dataset:
Gene profiling to predict recurrence in lung cancer
Authors: S Mandal
Journal: Thorax (2006)

▴ Potti A, Mukherjee S, Petersen R, et al. A genomic strategy to refine prognosis in early-stage non-small-cell lung cancer. N Engl J Med2006;355:570–80 [OpenUrl][1][CrossRef][2][PubMed][3] Patients with stage I non-small cell lung cancer are traditionally treated with surgical resection alone. However, 30–35% will relapse and these patients may therefore have benefited from adjuvant chemotherapy. The current clinicopathological classification system is an imprecise prognostic indicator, and the authors have evaluated the use of … [1]: {openurl}?query=rft.jtitle%253DNew%2BEngland%2BJournal%2Bof%2BMedicine%26rft.stitle%253DNEJM%26rft.issn%253D0028-4793%26rft.aulast%253DPotti%26rft.auinit1%253DA.%26rft.volume%253D355%26rft.issue%253D6%26rft.spage%253D570%26rft.epage%253D580%26rft.atitle%253DA%2BGenomic%2BStrategy%2Bto%2BRefine%2BPrognosis%2Bin%2BEarly-Stage%2BNon-Small-Cell%2BLung%2BCancer%26rft_id%253Dinfo%253Adoi%252F10.1056%252FNEJMoa060467%26rft_id%253Dinfo%253Apmid%252F16899777%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1056/NEJMoa060467&link_type=DOI [3]: /lookup/external-ref?access_num=16899777&link_type=MED&atom=%2Fthoraxjnl%2F61%2F11%2F944.atom
Application of the who fracture risk assessment tool (FRAX) to predict need for dexa scanning and treatment in patients with inflammatory bowel disease at risk of osteoporosis
Authors: J. R. Goodhand, N. Kamperidis, H. Nguyen, M. Wahed, D. S. Rampton
Journal: Gut (2011)

<h3>Introduction</h3> Although patients with inflammatory bowel disease (IBD) are at increased risk of osteoporosis, low bone mineral density (BMD) confers only a modest increase in the risk of fracture. The FRAX score is a web-based clinical scale designed by the WHO to measure in individual patients the 10-year risk of fracture: it divides the level of risk into high, intermediate and low and can be calculated with or without BMD score. Using guidelines from the National Osteoporosis Guidelines Group (NOGG), the tool then recommends the need for treatment, DEXA scanning or lifestyle advice/reassurance. In order to prevent unnecessary DEXA scanning and anti-osteoporotic therapy, we aimed to assess the accuracy of pre-BMD FRAX scores in identifying at risk patients with IBD who need BMD measurement (intermediate risk) and/or preventive therapy (high risk with or without DEXA scan). <h3>Methods</h3> We retrospectively calculated FRAX scores in 81 patients with Crohn9s disease and 35 with ulcerative colitis in whom DEXA scans had been requested during the years 2005–2009 because they were considered by their clinicians to be at risk of osteoporosis. Scores were assessed before and after inclusion of BMD results obtained from the DEXA scans. <h3>Results</h3> On DEXA scans, 47% (38/81) and 12% (10/81) patients with Crohn9s disease were osteopaenic and osteoporotic, respectively; equivalent figures for patients with UC were 34% (12/35) and 14% (5/35). The clinical FRAX score alone, when compared to the FRAX score including the BMD result, had a sensitivity of 100% (95% CI: 70%&gt;100%), specificity of 40% (95% CI: 31%&gt;50%), positive predictive value of 16% (95% CI: 9%&gt;27%) and negative predictive value of 100% (95% CI: 90%&gt;100%) in identifying those patients needing BMD measurement (intermediate risk) or preventive therapy (high risk). On the basis of their BMD alone and as part of our routine practice, eleven patients were started on treatment for osteoporosis with a bisphosphonate following their DEXA scan. In this small group of patients, there was no significant difference between our existing practice and that suggested by NOGG (post BMD inclusion) in the 97 patients at low or intermediate risk for fracture. However, according to the NOGG guidance, 10% (9/97) patients were being treated unnecessarily. Moreover, in the high risk group, while treatment was recommended by NOGG in 11/19 (58%) patients, only 1 patient was being treated with a bisphosphonate (p&lt;0.01). <h3>Conclusion</h3> In patients with IBD who are perceived by their clinicians as being at increased risk of osteoporosis and/or osteopaenia, the clinical criteria of the FRAX score can be used to predict more accurately than DEXA scan alone the risk of osteoporotic fracture.
Mediastinal yolk sac tumour mimicking pericardial effusion.
Authors: H Chamsi-Pasha, A Bernstein
Journal: Thorax (1988)

In this report we present a case of primary yolk sac tumour of the anterior mediastinum in which two dimensional echocar- diography showed an extracardiac mass simulating a large pericardial effusion.Mediastinal yolk sac tumour is a rare germ cell neoplasm affecting mainly young men.'The most common presenting symptoms are dyspnoea, cough, and chest pain.2The prognosis is usually poor, though in this case complete resolution of the tumour has been achieved. Case report
Exhaled Nitric Oxide, Sensitization, and Exposure to Allergens in Patients with Asthma Who Are Not Taking Inhaled Steroids
Authors: ANGELA SIMPSON, ADNAN CUSTOVIC, SPIROS PIPIS, ANIL ADISESH, BRIAN FARAGHER, ASHLEY WOODCOCK
Journal: American Journal of Respiratory and Critical Care Medicine (1999)

The level of exhaled nitric oxide (eNO) is elevated in patients with asthma and eNO may be involved in airway inflammation. Exposure to allergen in sensitized individuals may contribute to airway inflammation. Our aim was to investigate the relationship between eNO, sensitization, and exposure to indoor allergen in nonsmoking adults with asthma who are not taking inhaled steroids. In subjects with a positive methacholine challenge (PD20 < 4 mg) we measured eNO (LR 2000 chemiluminesence analyzer); serum total and specific IgE; skin test to mite, cat, and dog; and allergen levels in domestic dust (Der p 1, Fel d 1, and Can f 1). Subjects were classified as exposed or not exposed to allergen according to previously proposed significant levels (> 2 micrograms/g Der p 1, > 8 micrograms/g Fel d 1, and > 10 micrograms/g Can f 1). Of the 43 subjects (> 95% atopic) complete data were available for 38, of whom 26 were both sensitized and exposed to one or more allergen and 12 were sensitized but not exposed to any allergens. eNO was significantly higher in those subjects who were both sensitized and exposed to indoor allergen than in those who were sensitized but not exposed (GM and 95% CI: 17. 69 [14.1- 22.15] versus 9.09 [6.5-12.7], p = 0.001). Levels of eNO are significantly higher in patients with asthma who are both sensitized and exposed to relevant allergen than in those who were sensitized but not exposed. eNO may be a marker of the airway inflammation induced by domestic exposure to allergen in sensitized patients with asthma.
Effects of internet-based training on antibiotic prescribing rates for acute respiratory-tract infections: a multinational, cluster, randomised, factorial, controlled trial
Authors: Paul Little, Beth Stuart, Nick Francis, Elaine Douglas, Sarah Tonkin-Crine, Sibyl Anthierens, Jochen WL Cals, Hasse Melbye, Miriam Santer, Michael Moore, Samuel Coenen, Chris Butler, Kerenza Hood, Mark Kelly, Maciek Godycki-Cwirko, Artur Mierzecki, Antoni Torres, Carl Llor, Melanie Davies, Mark Mullee, Gilly O'Reilly, Alike van der Velden, Adam WA Geraghty, Herman Goossens, Theo Verheij, Lucy Yardley
Journal: The Lancet (2013)
New bioelectrical impedance formula for patients with respiratory insufficiency: comparison to dual-energy X-ray absorptiometry
Authors: UG Kyle, C Pichard, T Rochat, DO Slosman, JW Fitting, D Thiebaud
Journal: European Respiratory Journal (1998)

Malnutrition in patients with severe respiratory insufficiency can lead to severe complications, justifying the use of objective nutritional assessment techniques, such as bioelectrical impedance analysis (BIA), which is an easy, noninvasive method of measuring body composition. The purpose of this study was to develop, and validate against dual-energy X-ray absorptiometry (DXA), a BIA formula to predict fat-free mass (FFM) specific for patients with chronic severe respiratory insufficiency. Seventy-five ambulatory patients (15 females and 60 males) with severe chronic respiratory insufficiency (obstructive and restrictive) aged 63.6+/-19.2 yrs (mean+/-SD), in a stable pulmonary and cardiac condition for &gt; or = 2 months, were measured simultaneously with BIA and DXA. Patients younger than 45 yrs of age and with a body mass index &gt; or = 32 kg x m(-2) were excluded. The best-fitting multiple regression equation to predict FFM = -6.06 +/- (height x 0.283) +/- (weight x 0.207) - (resistance x 0.024) +/- (sex (males=1, females=0) x 4.036), gave a correlation coefficient of r=0.952, slope+/-SEM 0.902+/-0.034, standard error of the estimate 1.670, and p&lt;0.0001. The mean difference for FFM was 0.2+/-2.3 kg (mean+/-SD) and percentage fat mass was -0.7+/-3.8%. These results suggest that the bioelectrical impedance analysis formula specific to patients with severe respiratory insufficiency give a better correlation and smaller mean differences than 12 different bioelectrical impedance analysis formulae described in the medical literature. A prediction equation, validated against dual-energy X-ray absorptiometry and based on subjects with similar clinical characteristics, is more applicable to the patients with respiratory insufficiency than a formula developed for healthy subjects.
Reliance on constraints means detection of information
Authors: David M. Jacobs, Sverker Runeson, Isabell E.K. Andersson
Journal: Behavioral and Brain Sciences (2001)

We argue four points. First, perception always relies on environmental constraints, not only in special cases. Second, constraints are taken advantage of by detecting information granted by the constraints rather than by internalizing them. Third, apparent motion phenomena reveal reliance on constraints that are irrelevant in everyday perception. Fourth, constraints are selected through individual learning as well as evolution. The “perceptual-concept-of-velocity” phenomenon is featured as a relevant case. [Hecht; Kubovy &amp; Epstein; Shepard]
Nicola Jane Gilbertson
Authors: M. T. T. Gilbertson
Journal: BMJ (2014)

Nicola Jane Gilbertson (“Nicki”) spent her early years travelling round England and Ghana with her family; her father was a Royal Air Force medical officer. She went to five schools in her first six years. This did not seem to have held her back academically because she gained entry into Liverpool University Medical School and qualified in 1981. She was immediately attracted to paediatrics and trained in Newcastle and London. She gained her MRCP in 1985. After her senior registrar post at Charing Cross Hospital she was invited to take up the post of acting consultant, the post from which she was appointed at Royal Cornwall Hospital. She had numerous publications to her name, including …
Case Number 29: Hitting three with one strike: rapid improvement of psoriatic arthritis, psoriatic erythroderma, and secondary renal amyloidosis by treatment with infliximab (Remicade)
Authors: C Fiehn
Journal: Annals of the Rheumatic Diseases (2004)

A 64 year old woman presented with a 30 year history of psoriasis vulgaris and polyarticular psoriatic arthritis as well as a newly diagnosed renal insufficiency. At the physical examination she showed severe psoriatic erythroderma (fig 1A) and signs of destructive polyarthritis of the joints of the fingers and feet. Radiology disclosed almost complete ankylosis of both wrists, and high grade erosive …
Hormonal, renal, and autonomic nerve factors involved in the excretion of sodium and water during dynamic salt and water loading in hypoxaemic chronic obstructive pulmonary disease.
Authors: A G Stewart, J C Waterhouse, C G Billings, P H Baylis, P Howard
Journal: Thorax (1995)

Some patients with hypoxaemic chronic obstructive pulmonary disease (COPD) develop sodium and water retention and a subclinical autonomic neuropathy. The possibility that these might be associated has been investigated.The ability of 24 patients with COPD to excrete a 6 ml/kg 2.7% intravenous saline or 15 ml/kg oral water load was studied and changes in plasma electrolyte levels, osmolality, plasma aldosterone and vasopressin levels, urinary volume and sodium content, glomerular filtration rate, renal blood flow, and cardiovascular autonomic nerve function were measured. Patients were divided into groups of eight: those in group A (controls) had mild COPD with a Pa02 of > 9 kPa and no oedema, patients in group B were more hypoxaemic but had never been oedematous, whilst those in group C were hypoxaemic and mildly oedematous at the time of the study.Patients in groups B and C excreted less sodium and water during saline loading and a lesser proportion of the water load. Patients in group C had a reduction in renal blood flow and glomerular filtration rate and all had a subclinical autonomic neuropathy, which was also found in three patients in group B. Their plasma aldosterone level was raised but did suppress appropriately on saline loading. Vasopressin levels were abnormally raised for the osmolality in patients in group C and in those with autonomic dysfunction throughout the water load and at 240 minutes after the salt load. Sodium and urine excretion was highly correlated with autonomic dysfunction, aldosterone levels at time zero, and renal blood flow. The 11 patients with autonomic dysfunction were more likely to be oedematous, more hypoxaemic, excreted much less urine and sodium, had lower glomerular filtration rate and renal blood flow, and higher aldosterone and vasopressin levels than the remaining patients.In patients with COPD the inability to excrete sodium and water is multifactorial. This is the first study to show that autonomic dysfunction is at least associated and might play an important part in the impaired sodium and water homeostasis seen in patients with severe COPD.
Family History of Type 2 Diabetes Is Associated With Decreased Insulin Sensitivity and an Impaired Balance Between Insulin Sensitivity and Insulin Secretion in White Youth
Authors: Silva A. Arslanian, Fida Bacha, Rola Saad, Neslihan Gungor
Journal: Diabetes Care (2005)

OBJECTIVE—Family history of type 2 diabetes is a major risk factor for type 2 diabetes in youth, which is increasing. This investigation aimed to evaluate the impact of family history of type 2 diabetes on insulin secretion relative to insulin sensitivity in healthy children. β-Cell compensation for insulin sensitivity was calculated as the product of insulin sensitivity × first-phase insulin secretion, termed glucose disposition index (GDI). RESEARCH DESIGN AND METHODS—A total of 28 healthy white children (12 boys and 16 girls; 12.1 ± 0.5 years of age) with a positive family history of type 2 diabetes and 26 healthy white children (13 boys and 13 girls; 11.5 ± 0.4 years of age) with a negative family history of type 2 diabetes underwent a 3-h 40 mU · m−2 · min−1 hyperinsulinemic-euglycemic clamp to assess insulin sensitivity and clearance and a 2-h hyperglycemic clamp to assess insulin secretion. Body composition and visceral adiposity were evaluated with dual-energy X-ray absorptiometry and computed tomography at the L4-L5 intervertebral space. RESULTS—Insulin sensitivity was lower in children with a family history of type 2 diabetes versus children without a family history (8.8 ± 0.9 vs. 12.2 ± 1.1 μmol · kg−1 · min−1 per pmol/l, P = 0.02). Similarly, insulin clearance was lower. First- and second-phase insulin levels were not different between groups with and without a positive family history. The GDI was lower in youth with versus youth without a positive family history (4.1 ± 0.3 vs. 5.2 ± 0.5 mmol · kg−1 · min−1, P = 0.039). IGF binding protein-1 (IGFBP-1) was 60% lower in youth with versus youth without the positive family history. CONCLUSIONS—These results demonstrate that family history of type 2 diabetes in white children is associated with decreased insulin sensitivity and clearance, decreased IGFBP-1, and an impaired relationship between insulin action and β-cell compensation. Detection of these alterations in hormonal and metabolic parameters in children with a positive family history suggests that at least some of the determinants of GDI are genetic/heritable.
Effect of electrotonic potentials on pacemaker activity of canine Purkinje fibers in relation to parasystole.
Authors: J Jalife, G K Moe
Journal: Circulation Research (1976)

Isolated false tendons excised form dog hearts were mounted in a three-chamber tissue bath. Isotonic sucrose solution was perfused in the central chamber to provide a region of depressed conductivity between the fiber segments in chambers 1 and 3, which were perfused with Tyrode's solution. The electrotonic influence of spontaneous or driven responses evoked in chamber 3 during the first half of the spontaneous cycle of a chamber 1 peacemaker delayed the next spontaneous discharge. This effect changed to acceleration when the chamber 3 segment fired during the second half of the spontaneous cycle. We found that subthreshold depolarizing current pulses 50-300 msec applied across the sucrose gap caused similar degrees of delay or acceleration. Furthermore, hyperpolarizing currents caused the reverse pattern. The results indicate that the discharge pattern of a parasystolic focus may be altered by the electrotonic influence of activity in the surrounding tissue. The significance of these findings is considered in relation to the mechanism of production of parasystolic rhythms.
A cloudy pleural effusion
Authors: Puneet Malhotra, John P Watson, Paul K Plant, Richard Bishop
Journal: Thorax (2011)

A 55-year-old previously fit and well woman was admitted with a 4-week history of dry cough and 1-week history of progressive breathlessness. She had never smoked, was on no regular medications and there was no history of heart disease, malignancy, rheumatological disease or tuberculosis.

Physical examination revealed signs of a moderate right-sided pleural effusion but was otherwise unremarkable. Full blood count, clotting, and renal and liver function tests were normal. C reactive protein was <5 mg/l. Chest x-ray revealed a moderate right sided pleural effusion.

She underwent bedside diagnostic aspiration of 50 ml of pleural fluid …
When in doubt should we cut it out? The role of surgery in non-small cell lung cancer
Authors: J-E C Holty
Journal: Thorax (2006)

Will we ever really know whether surgery is effective in patients with resectable NSCLC?

Despite being a preventable disease, the public health impact of lung cancer is daunting. Lung cancer accounts for more than an estimated one million deaths each year.1 Unfortunately, most persons with non-small-cell lung cancer (NSCLC) have unresectable disease at presentation with an overall 5 year survival rate of approximately 15%.2,3 In contrast, 99% of patients with prostate cancer, 88% of those with breast cancer and 63% of patients with colon cancer are alive at 5 years.3 For early stage NSCLC the preferred treatment is surgical resection, with an estimated 75 000 procedures performed in the US and 3000 in the UK each year.4 This preference is supported by favourable 5 year survival rates for patients with potentially resectable tumours (stage IA 67%, stage IB, 57%, stage IIA 55%, stage IIB 39%).5 However, up to 30% of patients with stage I and 65% of patients with stage II cancers will experience recurrence within 5 years of resection.6 Furthermore, although recent survival rates for resected stage I and II disease have increased compared with historical controls,7 this has been attributed in part to more careful surgical lymph node analysis (stage migration)8,9,10 and the detection of earlier disease (lead time bias).11

Surgical resection of lung cancer with intent to cure was introduced in the early 1930s by Graham and Singer.12 Surgery was quickly accepted as the preferred treatment modality for early stage NSCLC, based in large part on the results from observational and retrospective studies.13,14 However, relying on these type of studies can be misleading because the apparent benefit of surgical resection may be due to patient characteristics, supportive measures and care, or other …
Low dose famotidine and cimetidine in single postprandial doses: a placebo controlled comparative study of overnight pH.
Authors: T G Reilly, S G Mann, M Z Panos, R P Walt
Journal: Gut (1995)

To investigate the relative abilities of low doses of famotidine and cimetidine to raise intragastric pH after a single postprandial evening dose, 16 healthy volunteers were recruited to a four period crossover trial of famotidine 10 mg, cimetidine 100 mg and 200 mg compared with placebo. Intragastric pH was monitored between 1800 and 0730 with a nasogastric pH electrode. Median gastric pH rose from 1.35 (interquartile range 1.1-1.65) with placebo to 1.95 (1.6-5.35, p &lt; 0.001 Friedman rank) after dosing with famotidine 10 mg, to 1.46 (1.3-2.0, 0.05 &lt; p &lt; 0.1) after cimetidine 200 mg, and remained 1.35 (1.1-1.6, p &gt; 0.2) after cimetidine 100 mg. Intragastric pH was above 3 for 34% (p &lt; 0.005) of the time after dosing with famotidine, compared with 13.6% (p &gt; 0.2) after cimetidine 200 mg, 9.5% (p &gt; 0.2) after cimetidine 100 mg, and 4.7% after placebo. The rise of intragastric pH after famotidine 10 mg is significantly greater than that after either 200 mg or 100 mg cimetidine when the drugs are used postprandially.
Weight Management Through Lifestyle Modification for the Prevention and Management of Type 2 Diabetes: Rationale and Strategies
Authors: Samuel Klein, Nancy F. Sheard, Xavier Pi-Sunyer, Anne Daly, Judith Wylie-Rosett, Karmeen Kulkarni, Nathaniel G. Clark
Journal: Diabetes Care (2004)

The prevalence of diabetes in the U.S. continues to rise by epidemic proportions. This increase parallels the rising rates of obesity and overweight observed over the past decade (1,2). Indeed, as BMI increases, the risk of developing type 2 diabetes increases in a “dose-dependent” manner (3,4). The prevalence of type 2 diabetes is 3–7 times higher in obese than in normal-weight adults, and those with a BMI >35 kg/m2 are 20 times more likely to develop diabetes than those with a BMI between 18.5 and 24.9 kg/m2 (5,6). In addition, weight gain during adulthood is also directly correlated with an increased risk of type 2 diabetes (3,7–9).

Obesity also complicates the management of type 2 diabetes by increasing insulin resistance and blood glucose concentrations (10). It is an independent risk factor for dyslipidemia, hypertension, and cardiovascular disease (6,11–14) and, thus, increases the risk of cardiovascular complications and cardiovascular mortality in patients with type 2 diabetes (15).

The purpose of this statement is to review the important role of weight management in the prevention and management of type 2 diabetes and to describe strategies for achieving and maintaining a healthy body weight through lifestyle modification. The use of weight loss medications and bariatric surgery in the management of obesity will not be discussed in this document. Pharmacotherapy can be a useful adjunct to lifestyle modification in the long-term management of obesity in selected patients (16). Weight loss medications may be considered for those with a BMI ≥30 or those with a BMI ≥27 plus obesity-related comorbid conditions. Weight loss surgery may be a therapeutic alternative for patients with a BMI ≥40 or a BMI ≥35 plus comorbid conditions (16). Comprehensive review articles that …