tbuckley/cabot-search huggingface dataset:
Adverse events and factors associated with toxicity in patients with early rheumatoid arthritis treated with methotrexate tight control therapy: the CAMERA study
Authors: S M M Verstappen, M F Bakker, A H M Heurkens, M J van der Veen, A A Kruize, M A W Geurts, J W J Bijlsma, J W G Jacobs
Journal: Annals of the Rheumatic Diseases (2009)

Objective To evaluate toxicity profiles in patients with rheumatoid arthritis (RA) treated either according to an intensive or a conventional treatment strategy approach with methotrexate (MTX) and to study factors associated with MTX-related toxicity. Methods Data were used from the Computer-Assisted Management in Early Rheumatoid Arthritis (CAMERA) study, in which clinical efficacy of an intensive treatment strategy with MTX was more beneficial than a conventional treatment strategy approach. In this study, data on adverse events (AEs) were compared between the two strategy groups. Logistic regression analyses were used to identify possible associations between factors assessed at baseline and withdrawal due to MTX-related AEs or liver toxicity at follow-up. Results Although significantly more patients in the intensive strategy group experienced MTX-related AEs than in the conventional strategy group, all recorded AEs were relatively mild. A higher body mass index (BMI) was significantly associated with withdrawal due to MTX-related AEs in the multiple regression analyses (odds ratio=1.207, 95% confidence interval 1.02 to 1.44, p=0.033). There was a trend towards an association between diminished creatinine clearance and MTX withdrawal. For liver toxicity, increased serum liver enzymes at baseline were associated with liver toxicity during follow-up. Conclusion Although the occurrence of AEs in the intensive strategy group was higher than in the conventional strategy group, the previously observed clinical efficacy of an intensive treatment strategy seems to outweigh the observed toxicity profiles. When starting MTX, attention should be given to patients with a high BMI and those with increased levels of liver enzymes and decreased renal function.
Post-Abortion Group Therapy
Authors: GEORGE M. BURNELL, WILLIAM A. DWORSKY, ROBERT L. HARRINGTON
Journal: American Journal of Psychiatry (1972)

Two hundred fifty women who had had a therapeutic abortion attended a group therapy program after discharge from the hospital. Each group was led by a psychiatrist-gynecologist team and consisted of three to five women. The authors concluded that the program was beneficial, helping patients to cope with guilt feelings and to clear areas of misinformation about sexual function and contraception. This program also provided an opportunity to combine educational, therapeutic, and preventive aspects of gynecological and psychiatric practice.
Treatment of tuberculosis and optimal dosing schedules
Authors: K. C. Chang, C. C. Leung, J. Grosset, W. W. Yew
Journal: Thorax (2010)

Intermittent tuberculosis treatment regimens have been developed to facilitate treatment supervision. Their efficacy has been substantiated by clinical trials and tuberculosis control programmes, notwithstanding the lack of head-to-head comparison between daily and intermittent regimens. Recently, there has been opposing evidence from observational studies, pharmacokinetic-pharmacodynamic studies and animal models that intermittent treatment increases the risk of relapse, treatment failure or acquired rifamycin resistance, especially among HIV-infected patients. Systematic reviews have been conflicting. PubMed, Ovid MEDLINE and EMBASE were systematically searched for publications in English to evaluate the evidence about dosing schedules and treatment efficacy. Levels of evidence and grades of recommendation were assigned largely according to clinical evidence with reference to the Scottish Intercollegiate Guidelines Network guideline development handbook. A total of 32 articles were included after excluding 331 ineligible articles, 42 non-analytical studies, 22 narrative reviews or expert opinions and 44 articles embedded in systematic reviews. These included 9 systematic reviews, 8 controlled studies, 9 pharmacokinetic-pharmacodynamic studies, 5 mouse studies and 1 article about guinea pig experiments. Findings suggest high levels of evidence for using daily dosing schedules, especially during the initial phase in the presence of cavitation, isoniazid resistance and advanced HIV co-infection, to reduce the risk of treatment failure, recurrence and acquired drug resistance including acquired rifamycin resistance. This review justifies the use of daily schedules in standard tuberculosis treatment regimens (particularly in the initial phase), corroborates prevailing understanding of pharmacokinetics-pharmacodynamics and mycobacterial persisters, and supports exploration of rifapentine-containing regimens in higher dosages and frequency.
Lung function in infants with cystic fibrosis.
Authors: C S Beardsmore, E Bar-Yishay, C Maayan, Y Yahav, D Katznelson, S Godfrey
Journal: Thorax (1988)

Lung function was measured in 28 infants with cystic fibrosis and repeated in 17 of the infants during the first year of life. Thoracic gas volume (TGV) and specific airway conductance (sGaw) were measured plethysmographically and maximum forced expiratory flow at functional residual capacity (VmaxFRC) was derived from the partial expiratory flow-volume curve. At the time of the initial evaluation respiratory function was correlated with the clinical condition of the infants but not with age. There was a good correlation between sGaw and VmaxFRC when both were expressed as percentages of the predicted normal values. On the basis of the normal range for sGaw the infants were divided into two groups. Group A (n = 9), who had normal sGaw, were younger and had a lower clinical score and normal VmaxFRC and TGV values. Group B (n = 19), who had low sGaw, had increased TGV and decreased VmaxFRC. There was no correlation with age for any measure of lung function for the population as a whole. Repeat testing was undertaken at intervals in 17 representative infants. In most of these infants the relation between sGaw and VmaxFRC was maintained; there was no evidence that VmaxFRC was affected before sGaw. There was no functional evidence that the earliest changes in cystic fibrosis occur in small airways, as reflected by changes in VmaxFRC in infancy.
Validation of the New Zealand Physical Activity Questionnaire (NZPAQ-LF) and the International Physical Activity Questionnaire (IPAQ-LF) with accelerometry
Authors: R M Boon, M J Hamlin, G D Steel, J J Ross
Journal: British Journal of Sports Medicine (2008)

Background Validation of instruments used to measure physical activity patterns is essential when attempting to assess the effectiveness of physical activity interventions. Objectives To assess the validity of two self-report physical activity questionnaires on a representative sample of New Zealand adults. Methods 70 adults aged 18–65 years from around Christchurch, New Zealand were required to wear an ActiGraph GT1M accelerometer during all waking hours for 7 consecutive days. Immediately following the 7 day accelerometer period participants were required to complete the long forms of both the New Zealand Physical Activity Questionnaire (NZPAQ-LF) and the International Physical Activity Questionnaire (IPAQ-LF). Results Both the NZPAQ-LF and the IPAQ-LF questionnaires showed small to moderate correlations with ActiGraph data for time spent in moderate-intensity physical activity (r=0.19–0.30) and total physical activity (sum of moderate and vigorous-intensity physical activity, r=0.30–0.32). In comparison with the ActiGraph data, both self-report questionnaires tended to overestimate activity levels by approximately 165%. Total physical activity levels gathered from both questionnaires were strongly correlated with each other (r=0.79) and showed good levels of agreement in the Bland–Altman plots. Conclusions The long forms of the NZPAQ and IPAQ were found to have acceptable validity when detecting participants' ability to meet activity guidelines based on exercise duration, but a significant amount of overestimation was evident. This presents a need for both instruments to be further developed and tested in order to increase validity.
Diagnostic implications of telomerase activity in pleural effusions
Authors: G. Dikmen, E. Dikmen, M. Kara, E. Şahin, P. Doğan, N. Özdemir
Journal: European Respiratory Journal (2003)

The aim of the present study was to investigate the diagnostic efficacy of telomerase activity for discrimination of malignant and benign pleural effusions. Pleural effusions were collected from 109 consecutive patients in whom the diagnosis was confirmed with cytological and/or histological examinations. Cytological samples were classified as malignant (n=63) and benign (n=46). Telomerase activity was determined with the polymerase chain reaction-based telomeric repeat amplification protocol assay. Telomerase activity was detected in 52 (82.5%) and nine (19.6%) samples from the malignant and benign groups, respectively, which was a significant difference. The sensitivity rate of cytological examination when combined with telomerase activity (92.1%) was significantly greater than that of cytological examination alone (53.9%). The sensitivity and specificity of telomerase activity were 82.5 and 80.4%, respectively. Diagnostic accuracy of telomerase activity was 81.6%. Telomerase activity is a highly sensitive diagnostic biomarker for malignancy and may be used as an adjunct to cytological findings in determining malignant pleural effusions.
Determinants of Real-World Functional Performance in Schizophrenia Subjects: Correlations With Cognition, Functional Capacity, and Symptoms
Authors: Christopher R Bowie, Abraham Reichenberg, Thomas L Patterson, Robert K Heaton, Philip D Harvey
Journal: American Journal of Psychiatry (2006)

OBJECTIVE: Impairments in adaptive life skills are a major source of disability in patients with schizophrenia. The relationship between adaptive life skills in real-world settings and performance on neuropsychological tests may be complicated by other factors that interfere with deployment of skills. Assessment of the ability to perform life skills under optimal conditions (i.e., assessment of functional capacity) has been proposed as a means to clarify these relationships. METHOD: The authors examined cross-sectional data from a study of the course of neuropsychological and adaptive life skills of older (age 50–85) schizophrenia patients (N=78). Functional capacity was examined with a performance-based measure (UCSD Performance-Based Skills Assessment), and case managers rated real-world adaptive functions (i.e., interpersonal skills, work skills, and community activities). Neuropsychological performance was assessed with a comprehensive battery, while symptoms were assessed with patient self-report and clinical ratings. RESULTS: Confirmatory path analyses were used to evaluate the effects of neuropsychological performance, functional capacity, and symptoms on the various domains of real-world functioning. Neuropsychological performance predicted functional capacity, which predicted all three domains of real-world functioning. Depression predicted interpersonal and work skills, while negative symptoms affected interpersonal skills independently of other predictors. CONCLUSIONS: Real-world adaptive life skills are predicted by neuropsychological performance, symptoms, and functional capacity. Neuropsychological performance contributes little to the prediction of real-world performance after accounting for functional capacity. In some domains, negative and depressive symptoms influenced real-world performance while not relating to functional capacity or neuropsychological performance.
White Blood Cell Count Is Associated With Macro- and Microvascular Complications in Chinese Patients With Type 2 Diabetes
Authors: Peter C. Tong, Ka-Fai Lee, Wing-Yee So, Margaret H. Ng, Wing-Bun Chan, Matthew K. Lo, Norman N. Chan, Juliana C. Chan
Journal: Diabetes Care (2004)

OBJECTIVES—There are close associations among raised white blood cell (WBC) count, coronary heart disease, and metabolic syndrome in the general population. The association between WBC count and vascular complications of diabetes has not been explored. We carried out a cross-sectional cohort study to determine the association between WBC count and the presence of macro- and microvascular complications in type 2 diabetes. RESEARCH DESIGN AND METHODS—In this study, 3,776 patients with type 2 diabetes and normal WBC count (3.5–12.5 × 109/l) underwent a comprehensive assessment of complications and cardiovascular risk factors based on the European DiabCare protocol. Demographic and anthropometric parameters were recorded. Metabolic profiles, including complete blood picture and urinary albumin excretion, were measured. RESULTS—Patients with higher WBC counts (categorized into quintiles) had adverse metabolic profiles as evidenced by higher blood pressure, BMI, HbA1c, fasting plasma glucose, LDL cholesterol, triglycerides, and urinary albumin excretion, but lower HDL cholesterol (all P &amp;lt;0.001 for trend). The prevalence of macro- and microvascular complications increased in a dosage-related manner with WBC count. After adjustments for smoking and other known cardiovascular risk factors, a 1-unit (1 × 109/l) increment of WBC count was associated with a 15.8% (95% CI 9.3–22.6; P &amp;lt; 0.001) and 12.3% increase (5.8–19.1; P &amp;lt; 0.001) in the prevalence of macro- and microvascular complications, respectively. CONCLUSIONS—Elevated WBC count, even within the normal range, is associated with both macro- and microvascular complications in type 2 diabetes. Chronic inflammation, as indicated by a higher WBC count, may play a linkage role in the development of macro- and microvascular complications in diabetes.
Cardiac remodeling after myocardial infarction is impaired in IGF-1 deficient mice
Authors: M Palmen
Journal: Cardiovascular Research (2001)

Objective: To obtain more insight in the role of IGF-1 in cardiac remodeling and function after experimental myocardial infarction. We hypothesized that cardiac remodeling is altered in IGF-1 deficient mice, which may affect cardiac function. Methods: A myocardial infarction was induced by surgical coronary artery ligation in heterozygous IGF-1 deficient mice. One week after surgery, left ventricular function was analyzed, and parameters of cardiac remodeling were measured. Results: No significant difference in cardiac function was found between infarcted wildtype and knock-out animals, despite a marked reduction in capillarization and blunting of the hypertrophic response of the interventricular septum in the IGF-1 deficient group. Furthermore, decreased DNA synthesis and increased apoptosis rates were observed in the IGF-1 knock-out mice. Conclusion: IGF-1 deficient mice show preservation of cardiac function 1 week after MI, despite an altered cardiac remodeling process.
Interventions to Enhance Physical and Psychological Functioning Among Younger Women Who Are Ending Nonhormonal Adjuvant Treatment for Early-Stage Breast Cancer
Authors: Michael F. Scheier, Vicki S. Helgeson, Richard Schulz, Suzanne Colvin, Sarah Berga, Michael W. Bridges, Judy Knapp, Kristina Gerszten, William Scott Pappert
Journal: Journal of Clinical Oncology (2005)

To conduct a clinical trial to determine if an educational intervention and a nutritional intervention could enhance physical and psychological functioning among younger women completing treatment for early-stage breast cancer.Younger women (50 years of age or younger, N = 252), within 2 months of having completed active nonhormonal adjuvant therapy, diagnosed with stage 0, I, or II breast cancer with 10 or fewer positive lymph nodes were randomly assigned to a three-arm clinical trial. Women in the control arm of the trial received standard medical care. Women in the two active arms received either an educational intervention, designed to provide information about their illness and enhance adjustment, or a nutritional intervention, designed to promote a more healthy diet. Primary end points included mental functioning, physical functioning, and depressive symptoms. Women were assessed before random assignment, 4 months later (immediately post-intervention), and 13 months later (9 months post-intervention).Participants assigned to the two active treatment arms had significantly less depressive symptomatology and better physical functioning by 13-month follow-up (differences between the two active arms were nonsignificant). These effects were primarily accounted for by changes in intrusive thoughts, concerns regarding cancer recurrence and mortality, self-concept perceptions, and self-efficacy expectations. CONCLUSION Tailored psychosocial interventions can be effectively designed to enhance adjustment among younger women who are completing nonhormonal adjuvant therapy.
The Wisdom of Hindsight
Authors: Melvin Cohn
Journal: Annual Review of Immunology (1994)

This essay is a highly personalized account of some of the important conceptual contributions to immunology. I have asked myself, “What were the ideas that caught my attention and how and by whom were they presented?” I have learned that most of what immunologists have called concepts deal with too small a slice of the subject. They are essentially inductive extrapolations from one experiment to a possible next step. Historically, these extrapolations extended over too narrow a chasm to account for the information available at the time. The result was that an extrapolation from one misleading observation could dominate and distort, for a significant time, the course of the field. It is also why there has been an inverse relationship between the clarity of a theory and its ease of acceptance by immunologists. Looking to the past, I have used two areas to illustrate the role of conceptualization: the self-nonself discrimination and the origin of the humoral repertoire. To illustrate all of this I have chosen as a cast &amp; characters the founding fathers of immunologays we know it today. I hope that by taking this look into the rear view mirror our efforts will be guided in more productive ways. The take-home lesson is that we need to widen our horizon constantly to make more general concepts that then render the manipulation of the immune system more useful.
Autonomic and behavioural thermoregulation in tennis
Authors: S M Morante, J R Brotherhood
Journal: British Journal of Sports Medicine (2007)

Objectives: This report describes physiological and behavioural mechanisms behind the control of body temperature and thermal comfort during competitive singles tennis. Methods: Thermoregulatory responses and workload were observed during “best of three sets” tennis matches among 25 players. In total, 94 matches were played in ambient temperatures ranging from 14.5 to 38.4°C. The thermal environment was assessed by dry bulb, wet bulb and natural wet bulb temperatures, globe temperature and wind speed. Core body and skin temperatures were recorded each minute throughout the match, and body mass and fluid intake were measured before the match, after 30 minutes of play and at the completion of the match to determine sweat rate. Subjective ratings of thermal strain included thermal comfort, sweatiness and perceived exertion. Workload observations included match, game and point durations, and the proportion of match time spent in play (effective playing time). Results: Change in rectal temperature was positively correlated with point duration (p&lt;0.001) and effective playing time (p&lt;0.05). Sweat rate showed positive associations with air (p&lt;0.0001), rectal (p&lt;0.03) and skin (p&lt;0.0001) temperature. Thermal comfort was reduced with increasing rectal (p&lt;0.03) and skin (p&lt;0.0001) temperature. Point duration and effective playing time were reduced when conditions were rated increasingly difficult (p&lt;0.002 and p&lt;0.0002, respectively). Conclusion: Autonomic (increase in sweat rate) and behavioural (reduction in workload) thermoregulation are responsible for the control of body temperature and thermal comfort during tennis.
Prostate-Specific Antigen Changes As Surrogate for Overall Survival in Men With Metastatic Castration-Resistant Prostate Cancer Treated With Second-Line Chemotherapy
Authors: Susan Halabi, Andrew J. Armstrong, Oliver Sartor, Johann de Bono, Ellen Kaplan, Chen-Yen Lin, Nicole C. Solomon, Eric J. Small
Journal: Journal of Clinical Oncology (2013)

Prostate-specific antigen (PSA) kinetics, and more specifically a ≥ 30% decline in PSA within 3 months after initiation of first-line chemotherapy with docetaxel, are associated with improvement in overall survival (OS) in men with metastatic castration-resistant prostate cancer (mCRPC). The objective of this analysis was to evaluate post-treatment PSA kinetics as surrogates for OS in patients receiving second-line chemotherapy.Data from a phase III trial of patients with mCRPC randomly assigned to cabazitaxel plus prednisone (C + P) or mitoxantrone plus prednisone were used. PSA decline (≥ 30% and ≥ 50%), velocity, and rise within the first 3 months of treatment were evaluated as surrogates for OS. The Prentice criteria, proportion of treatment explained (PTE), and meta-analytic approaches were used as measures of surrogacy.The observed hazard ratio (HR) for death for patients treated with C + P was 0.66 (95% CI, 0.55 to 0.79; P < .001). Furthermore, a ≥ 30% decline in PSA was a statistically significant predictor of OS (HR for death, 0.52; 95% CI, 0.43 to 0.64; P < .001). Adjusting for treatment effect, the HR for a ≥ 30% PSA decline was 0.50 (95% CI, 0.40 to 0.62; P < .001), but treatment remained statistically significant, thus failing the third Prentice criterion. The PTE for a ≥ 30% decline in PSA was 0.34 (95% CI, 0.11 to 0.56), indicating a lack of surrogacy for OS. The values of R(2) were < 1, suggesting that PSA decline was not surrogate for OS.Surrogacy for any PSA-based end point could not be demonstrated in this analysis. Thus, the benefits of cabazitaxel in mediating a survival benefit are not fully captured by early PSA changes.
EFFECTIVE UTILIZATION OF ELECTRIC CONVULSIVE TREATMENT
Authors: PETER F. REGAN
Journal: American Journal of Psychiatry (1957)

This study is concerned with the effectiveness of ECT as an adjunct to the psychotherapeutic treatment of 200 patients. It is found that effectiveness depends both on diagnostic entity and psychopathologic state. Thus, affective disorders responded best to ECT; paranoid reactions and psychoneurotic reactions with depression responded well; and schizophrenic reactions poorly. Influencing these results, however, was the fact that depression associated with agitation, anxiety, fear, or sexual content yielded better results, and depression associated with hostility, guilt, or body concern yielded poor results, in each diagnostic category. In the absence of depression, fear and sexual content yielded good results, and hostility, anxiety, and fixation yielded poor results. Optimal efficiency was obtained only when ECT was indicated by both diagnosis and psychopathologic state. It seems essential that information about differential effectiveness be determined for each of the physical treatments available in psychiatry. Only thus will it be possible to achieve maximum effectiveness and complementary utilization of these treatments.