tbuckley/cabot-search huggingface dataset:
P136 Do structured exercise classes for inpatients with COPD increase community pulmonary rehabilitation (PR) referral and completion rates?
Authors: TC Avent, RC Colclough, RG Edgar, C Owen, KH Swindells, S Gompertz
Journal: Thorax (2015)

<h3>Introduction</h3> NICE recommends community PR as an essential component of chronic obstructive pulmonary disease (COPD) management,<sup>1</sup> although nationally mean uptake is only 15%.<sup>2</sup> PR has been proven to improve quality of life and to be cost effective.<sup>1</sup> Our team routinely assess and refer COPD inpatients to PR, however, many decline referral. We piloted an inpatient exercise class with the objective of increasing referrals to PR and explored the reasons patients declined referral. <h3>Methods</h3> Patients admitted with an acute exacerbation of COPD (June–November 2014) were given the opportunity to attend a Physiotherapy-led exercise class twice weekly. Baseline referral and completion rates to PR were calculated over two separate months during 2013–2014 and comparisons made with rates for the class attendees. <h3>Results</h3> Baseline referral rate to PR was calculated at 25%. 50 patients were offered in-patient exercise during the study; 30 agreed (60%). PR referral rate for patients who attended the in-patient class was 57% compared with 40% of those who did not. Baseline PR completion rate was 15%. In those exposed to in-patient exercise, completion rose to 18%. In the group declining inpatient exercise only 13% completed PR. The reasons for declining subsequent referral to PR are outlined in Figure 1. <h3>Discussion</h3> Whilst not achieving statistical significance the referral rate to PR was higher amongst patients exposed to an inpatient exercise class, suggesting an effect on the initial uptake to PR may be improved with this intervention. Completion rates of PR were similar but sample size was insufficient to reliably detect this and it is acknowledged this was a small preliminary study. As an improvement in referral rate to PR was observed the feasibility of providing a routine exercise class warrants further investigation in a larger cohort. Further investigation is also required into why many patients decline PR referral and find it difficult to express reasons why. <h3>References</h3> 1 NICE. CG101 Chronic Obstructive Pulmonary Disease-(Update), 2010 2 Stone RA, <i>et al</i>. COPD: Who cares matters<i>. National COPD audit programme: Clinical audit of COPD exacerbations admitted acute units in England and Wales 2014. National clinical audit report</i>. London: RCP, 2015
The social context of schizophrenia
Authors: J K Wing
Journal: American Journal of Psychiatry (1978)

During the past 25 years psychiatry has increased its understanding of the social context of schizophrenia in four major areas. Reasonable reliability can now be achieved in describing and recognizing many of the acute and chronic syndromes, so that comparability can be achieved between different research teams. Much is now known about the proximate social causes of symptoms and disabilities. The relationship between social and pharmacological treatments is now better understood. A more rational approach to the planning and prescription of services and to the counseling of patients and relatives can be made. Each of these lines of advance promises to lead to further progress in the future.
Abstract 8681: The Cardioprotective Role of Renin-Angiotensin System Antagonism in the Prevention of Doxorubicin and Trastuzumab Mediated Cardiac Dysfunction
Authors: Navdeep Bhullar, Marian Kotrec, Matthew Zeglinski, Mehrdad Golian, Megan daSilva, Matthew Lytwyn, Sheena Bohonis, Tielan Fang, Sacha Oomah, Roman Nepomuceno, Xiaozhou Du, Erin Karlstedt, Anita Sharma, Philip Garber, Pawan Singal, Davinder Jassal
Journal: Circulation (2011)

Background: In breast cancer patients, the administration of chemotherapeutic based agents, in particular Doxorubicin (Dox), is associated with an increased risk of cardiotoxicity. The introduction of novel monoclonal antibodies in breast cancer therapy, specifically Trastuzumab (Trz), further compounds this issue of drug induced cardiac dysfunction. Little is known about the use of renin-angiotensin system (RAS) antagonists in the prevention of Dox and Trz mediated cardiac dysfunction. Objective: To evaluate the cardioprotective effects of RAS antagonism in the prevention of Dox and Trz mediated cardiomyopathy in a chronic murine model. Methods: A total of 120 C57Bl/6 mice were randomized to three arms: (A) Trz; (B) Dox; or (C) Dox+Trz. The mice in each arm were further randomized to receive prophylactic treatment daily in their drinking water with either placebo, direct renin inhibitor (DRI), angiotensin converting enzyme inhibitor (ACEI), or angiotensin receptor blocker (ARB). Serial murine echocardiography was performed weekly for 13 weeks, after which the hearts were removed for histopathologic analyses. Results: In arm A (Trz), there was no evidence of cardiotoxicity at week 13. In arms B (Dox) and C (Dox+Trz), prophylactic treatment with either RAS antagonist was partially cardioprotective. In arm C (Dox+Trz), mice prophylactic treated with either placebo, DRI, ACEI or ARB demonstrated a decrease in fractional shortening from 51±2% at baseline to 26±2%, 40±2%, 32±2% and 34±2% (p&lt;0.05), at week 13, respectively. Survival analyses of each arm corroborated the echocardiographic findings (Figure 1). There was a decrease in histologic evidence of cardiac damage due to Dox+Trz pretreated with either RAS antagonist. Conclusion: Prophylactic administration of RAS antagonists is partially cardioprotective in a chronic murine model of chemotherapy induced cardiac dysfunction. Figure 1:
Case 19-2004
Authors: Mary S. Huang, Robert P. Hasserjian
Journal: New England Journal of Medicine (2004)

A boy was seen by his physician because of a one-week history of profound fatigue. He had mild fever, muscle aches, and chest pain but no gastrointestinal or respiratory symptoms. He was taking no medications and had no known allergies. A complete blood count revealed marked eosinophilia but no other abnormalities.
PTH-164 The incidence of artificial feeding tube complications in non surgical upper gi cancer patients: Abstract PTH-164 Table 1
Authors: S Chowdhury, M Roy, S Freemantle
Journal: Gut (2015)

<h3>Introduction</h3> Nutritional problems in upper gastrointestinal (UGI) cancer are common and artificial nutrition support (ANS) is sometimes needed to meet requirements. Whilst ANS could have a positive impact on nutritional status, this may not always improve quality of life (QoL) due to problems with tube placement and function potentially causing psychological distress.<sup>1</sup>We aim to investigate the incidence of tube related complications in this patient group. <h3>Method</h3> All UGI cancer patients treated by the oncology team who received ANS in 2014 were included. We looked at the number of episodes of feeding rather than number of patients as some switched between feeding routes. Patients receiving ANS in the immediate post operative period who remained under the care of the surgical team only were excluded. Data was analysed descriptively. <h3>Results</h3> There were 86 feeding episodes of amongst 67 patients. 76% of these episodes were in oesophageal cancer patients. 43%, 17% and 11% were in patients receiving high dose radiotherapy, palliative chemotherapy and best supportive care respectively. 26%, 22% and 17% of the feeding episodes used nasojejunal tube (NJT), jejunostomy tube or radiologically inserted gastrostomy respectively. Common reasons for ANS were dysphagia (37%), eating problems relating to UGI surgery (14%) and side effects of high dose radiotherapy (13%). The most common complications were tube displacement (21%), infected stoma site (12%) and blocked tube (10%). 60% of these episodes had feeding tubes <i>in situ</i>for &gt;30 days and 60% also continued ANS at home. Median time on ANS was 40 days (Range: 1–365+ days). 38% of patients were admitted to hospital due to a feeding tube complication. Reasons for admission were hydration and treatment of a stoma infection. <h3>Conclusion</h3> Tube related complications are particularly common amongst NJT and jejunostomy tubes. Further guidance on tube care and dietetic support to patients and their carers needs to be in place to reduce the frequency of these complications and reduce admissions resulting from this. Consideration may be needed as to whether other feeding tubes may be more appropriate in some patients which carry less complications. Further research on the clinical outcomes of ANS in UGI cancers and the effect of ANS on QoL would help to better support clinical practice. <h3>Disclosure of interest</h3> None Declared. <h3>Reference</h3> Bozetti F. Quality of life and enteral nutrition. Curr Opin Clin Nutr Metab Care. 2008;11(5):661–5
Nodular and Diffuse Types of Lymphocyte Predominance Hodgkin's Disease
Authors: Donald P. Regula, Richard T. Hoppe, Lawrence M. Weiss
Journal: New England Journal of Medicine (1988)

The nodular form of lymphocyte predominance Hodgkin's disease has been shown to be immunophenotypically distinct from the histologically diffuse form and from other types of Hodgkin's disease. We undertook a clinicopathological study of 73 cases to determine whether any clinical differences between the nodular and diffuse subtypes could be discerned. Patients with the diffuse form (n = 41) tended to have a course similar to that of other types of Hodgkin's disease; there were few relapses and only two deaths due to Hodgkin's disease. In contrast, patients with the nodular form (n = 32) had significantly more relapses, which were independent of stage or treatment and equally distributed up to 10 years after initial therapy. Despite the frequent relapses, patients with the nodular form had an indolent course, and there was only one death due to Hodgkin's disease. There were seven fatal second cancers and two non-neoplastic treatment-related deaths, equally distributed between the nodular and diffuse groups. We conclude that nodular lymphocyte predominance Hodgkin's disease may have important clinical as well as immunophenotypic differences from other forms of Hodgkin's disease, and that patients with this condition should be followed carefully because of the possibility of late relapse. (N Engl J Med 1988; 318:214–9.)
Helpline for patients to report adverse reactions is piloted
Authors: Susan Mayor
Journal: BMJ (2003)

The NHS in England has introduced a pilot scheme in which people can telephone a helpline to report suspected adverse reactions to a drug.

In the scheme members of the public are being invited to telephone one call centre in the NHS Direct system—Beckenham, which covers southeast London—to report their experiences of possible adverse drug reactions. The scheme will be publicised in local media.

Announcing the pilot scheme, health minister David Lammy said: “Rather than having to go to a GP, patients can quickly access advice and report reactions that can help to improve our knowledge of the safe use of medicines.”

The pilot scheme will be evaluated as part of a regular monthly evaluation of NHS Direct. If considered successful it will then be introduced in all 22 NHS Direct call centres in England.
P91 Post-infective obliterative bronchiolitis acquired beyond the first 3 years of life
Authors: S Sonmez-Ajtai, S Moss
Journal: Thorax (2015)

<h3>Introduction</h3> Obliterative bronchiolitis (OB) is a rare form of chronic obstructive lung disease that follows a severe insult to the lower respiratory tract, resulting in fibrosis of the small airways. In the non-transplant paediatric population, adenovirus infection is the most common cause. The initial infective insult occurs in the early years and the diagnosis requires a history of acute severe bronchiolitis/viral pneumonia in previously healthy children in the first 3 years of life. Though there has been a case report of post-infectious OB in an adult female,<sup>1</sup> to our knowledge, there are no published cases in children acquired after 3 years of age. <h3>Aim</h3> We describe two previously healthy older boys with normal immunological investigations who developed post-infectious OB. <h3>Cases</h3> The first patient had severe adenovirus pneumonia aged 7, requiring ventilation, oxygen and bronchodilator therapy. In view of atopic background (nut allergy and paternal asthma) inhaled corticosteroids were initiated at discharge. A year later he presented with productive cough, debilitating shortness of breath on exertion, moderately reduced PEFR but no wheeze. He did not respond to Amoxicillin or step-up asthma treatments. CXR and exercise test were normal and pulmonary function tests (PFT) did not show evidence of reversibility. A mixed growth of typical respiratory pathogens were isolated in sputum and treated with prolonged oral antibiotic course. High resolution chest CT (HRCT) showed air trapping in the right upper lobe consistent with OB. The second patient developed severe mixed mycoplasma and adenovirus pneumonia aged 3.5, followed by persistent left lower lobe collapse and wet cough requiring intravenous antibiotics and physiotherapy. His left lower lobe re-expanded, but his HRCT revealed air trapping consistent with OB. He continued to have intermittent chest infections with various typical respiratory pathogens isolated in sputum requiring oral and intravenous antibiotics. His PFTs are stable with moderately reduced FEV1/FVC. Both patients are maintained on regular chest physiotherapy and intermittent antibiotics. <h3>Conclusion</h3> Post-infectious OB can develop in healthy children older than 3 years. <h3>Reference</h3> 1 Marinopoulos GC, Huddle KR, Wainwright H. Obliterative bronchiolitis: virus induced? <i>Chest</i> 1991;<b>99</b>(1):243–5
Case 23-1993
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, Joel B. Karlinsky, Eugene J. Mark
Journal: New England Journal of Medicine (1993)

Presentation of CaseA 30-year-old man was admitted to a hospital because of a chronic cough and increasing exertional dyspnea.The patient had been well until 18 months earlier, when a monarticular arthritis developed in the right second finger after he had camped in the woods in southeastern Massachusetts. Antibiotic treatment for Lyme disease was administered empirically, with symptomatic improvement. Fourteen months before admission the patient's reserve unit was activated for service in Operation Desert Shield. Seventeen days later he arrived at Fort Devens, Massachusetts, and five days after his arrival he experienced nausea, vomiting, sweats, and fever, without respiratory . . .
Effects of MK-870 in Normal Subjects and Hypertensive Patients
Authors: Ervin A. Gombos, Edward D. Freis, Abdol Moghadam
Journal: New England Journal of Medicine (1966)

MK-870 (n-amidino-3,5 diamino-6-chloropyrazine carboxamide), is an orally effective agent that has in limited clinical use proved effective as a diuretic.1 Jones, Russo and Zacchei2 reported that this is an active potassium-sparing natriuretic agent in rats and dogs. Baer et al.3 found that small doses enhanced the natriuresis and depressed the kaliuresis produced by thiazide diuretics in dogs. The diuretic properties of the drug in "normal" subjects and its value in the treatment of hypertension alone or in conjunction with other agents has not previously been reported.Diuretic EffectsWe are here concerned with the effects of MK-870 on sodium, potassium, . . .
Abstract 318: Identification of Novel Cardiac Fibroblast Enriched Genes
Authors: Jessica M Swonger, Michelle D Tallquist
Journal: Circulation Research (2014)

The leading cause of death in the United States is heart disease. While current therapies have reduced mortality, patients surviving the initial stages of cardiac injury are left with long-term disruption of heart function including fibrosis. Pathological fibrosis in the heart is caused by excess proliferation and deposition of extracellular matrix primarily by cardiac fibroblasts (CFs). One factor required for cardiac fibroblast formation is the basic helix-loop-helix transcription factor, TCF21 (epicardin/Pod1/capsulin). Previous studies from our lab have shown that Tcf21 null embryos lack CFs. Our current work focuses on identifying genes downstream of TCF21. Deep-sequencing identified over one hundred differentially expressed genes when comparing embryonic hearts from Tcf21 nulls to wild types. We have verified a subset of these differentially expressed genes by qPCR and have demonstrated that these genes are also expressed in cultured primary cardiac fibroblasts. Future work will focus on determining the function of these genes during fibroblast activation and determine which of these genes are directly regulated by TCF21. The elucidation of cardiac fibroblast specific genes and their function will provide much needed information for identification of therapeutic targets aimed at cardiac fibroblast activation.
HL-A W27 — A Clue to the Diagnosis and Pathogenesis of Reiter's Syndrome
Authors: Robert Morris, Allan L. Metzger, Rodney Bluestone, Paul I. Terasaki
Journal: New England Journal of Medicine (1974)

RECENTLY, an extraordinary correlation between the second-segregant series histocompatibility antigen (HL-A), W27, and a well characterized rheumatic disease, ankylosing spondylitis was reported.1 , 2 Indeed, 90 per cent of patients with the disease are W27 positive. Because ankylosing spondylitis has a strong heredofamilial distribution,3 and since the second-segregant series of HL-A antigens in certain animals is linked to immune-response genes,4 this highly important association suggests that the pathogenesis of the disease might be directly related to some aberrant, genetically controlled, cellular immune response.Reiter's syndrome is a puzzling disease with several features in common with ankylosing spondylitis — i.e., male predominance, young . . .
Thyrotoxicosis Occurring in Two Patients on Prolonged High Doses of Steroids
Authors: David M. Brown, James T. Lowman
Journal: New England Journal of Medicine (1964)

The suppressive effect of adrenocortical steroids on thyroid function is well documented in laboratory animals1 2 3 4 and in human beings.5 6 7 8 9 The relation of adrenocortical steroids and the thyroid gland has been comprehensively reviewed by Ingbar and Freinkel.9 The evidence presented suggests that short-term ACTH and cortisone administration suppress the hypophyseal secretion of thyroid-stimulating hormone (TSH). There are few experimental data utilizing long-term administration of these substances. The histologic data of Halmi and Barker10 present evidence of activation of rat thyroid glands as well as probable increased pituitary production of TSH.The following case reports of hyperthyroidism in patients on long-term, high-steroid . . .
Case 7-2005
Authors: Robert G. Dluhy, Michael M. Maher, Chin-Lee Wu
Journal: New England Journal of Medicine (2005)

A 59-year-old woman was incidentally found to have an adrenal cortical nodule on abdominal computed tomography for evaluation of a colovesical fistula. Two years earlier, she had been found to have mild hypertension, which proved difficult to control with antihypertensive medication. She was slightly obese. How should she be evaluated?
A novel genomic inversion in Wiskott-Aldrich–associated autoinflammation
Authors: Immacolata Brigida, Samantha Scaramuzza, Dejan Lazarevic, Davide Cittaro, Francesca Ferrua, Lorena Leonardelli, Maria Alessio, Ornella Forma, Chiara Lanzani, Gianluca Viarengo, Fabio Ciceri, Momcilo Jankovic, Fernando Pesce, Alessandro Aiuti, Maria Pia Cicalese
Journal: Journal of Allergy and Clinical Immunology (2016)
Micafungin Compared with Voriconazole for Empirical Antifungal Therapy in Patients with Neutropenia and Persistent Fever
Authors: Tatsuo Oyake, Shugo Kowata, Kazunori Murai, Shigeki Ito, Tomoaki Akagi, Kohmei Kubo, Kenichi Sawada, Yoji Ishida
Journal: Annals of Oncology (2014)
Paramyloidosis with Diabetes Mellitus and Gastrointestinal Hemorrhage
Authors: Dean S. Pocock, Janet Dickens
Journal: New England Journal of Medicine (1953)

PARAMYLOIDOSIS (or primary amyloidosis)1 is a rare condition, only about 70 cases having been reported in the literature. Paramyloid deposition is widespread in the body, and as a result its clinical manifestations are protean. The case reported below is interesting in that it further illustrates this point, and presents prominent involvement of the gastrointestinal tract and pancreas, with resulting gastrointestinal bleeding and diabetes mellitus.A review of the literature on amyloidosis and paramyloidosis discloses that classification of the several types is unsettled. Indeed, there is evidence that there may be only a minor, though fundamental, difference between these two conditions. . . .
Impact of Response to Induction Chemotherapy in Patients with Germ Cell Tumors (Gct) Receiving Salvage High-Dose Chemotherapy (Hdct): a Study of the Ebmt Solid Tumors Working Party (Stwp)
Authors: A. Necchi, R. Miceli, L.A. Berger, K. Schumacher, J.H. Bourhis, D. Laszlo, E. Nicolas-Virelizier, F. Arpaci, S. Secondino, P. Dreger, W. Kruger, M. Ringhoffer, A. Unal, A. Nagler, A. Campos, A. Wahlin, I. Donnini, M. Badoglio, P. Pedrazzoli, F. Lanza
Journal: Annals of Oncology (2014)
Gastrointestinal perforation and fistula formation in colorectal cancer patients during regorafenib treatment
Authors: Ayako Doi, Kohei Shitara, Shota Fukuoka, Yasutoshi Kuboki, Hideaki Bando, Wataru Okamoto, Takashi Kojima, Toshihiko Doi, Atsushi Ohtsu, Takayuki Yoshino
Journal: Annals of Oncology (2015)
Immunochemical Characterization of Circulating Parathyroid Hormone–Related Protein in Patients with Humoral Hypercalcemia of Cancer
Authors: William J. Burtis, Thomas G. Brady, John J. Orloff, Julie B. Ersbak, Raymond P. Warrell, Beatriz R. Olson, Terence L. Wu, MaryAnn E. Mitnick, Arthur E. Broadus, Andrew F. Stewart
Journal: New England Journal of Medicine (1990)

Tumors from patients with humoral hypercalcemia of cancer produce a parathyroid Hormone-Related protein (PTHRP). We have developed two region-specific immunoassays capable of measuring PTHRP in plasma: an immunoradiometric assay directed toward PTHRP amino acid sequence 1 to 74 and a radioimmunoassay directed toward PTHRP amino acid sequence 109 to 138.
Lung Cancer Risk With Cigar and Pipe Use
Authors: Jay H. Lubin, Bonnie S. Richter, William J. Blot
Journal: JNCI Journal of the National Cancer Institute (1984)

Journal Article Lung Cancer Risk With Cigar and Pipe Use Get access Jay H. Lubin, Jay H. Lubin Search for other works by this author on: Oxford Academic PubMed Google Scholar Bonnie S. Richter, Bonnie S. Richter Search for other works by this author on: Oxford Academic PubMed Google Scholar William J. Blot William J. Blot Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 73, Issue 2, August 1984, Pages 377–381, https://doi.org/10.1093/jnci/73.2.377 Published: 01 August 1984 Article history Received: 25 November 1983 Accepted: 16 March 1984 Published: 01 August 1984