tbuckley/cabot-search huggingface dataset:
Effect of coping styles on the psychological impact of discussing life expectancy for men with advanced cancer
Authors: L. D. Cripe, S. Rawl, P. Monahan, Y. Tong, K. Schmidt, K. Rand
Journal: Journal of Clinical Oncology (2009)

9615 Background: Discussions of life expectancy between men and oncologists are limited, in part, because of the potential adverse effect on psychological outcomes. However, appraisal of the cancer threat may enhance coping and improve psychological outcomes for some men with advanced cancer. Methods: We recruited 81 men with advanced cancer to complete surveys including coping (Mini-MAC), post-traumatic growth (PTGI), psychological outcomes (Hospital Anxiety and Depression Scale). Men and oncologists rated extent of discussions about life expectancy. Moderation was assessed with regression interactions and follow-up within group Pearson correlations. Results: Men reported a full (33%), brief (41%), or no (26%) discussion of life expectancy. Concordance was low. Only 23 (28%) agreed with oncologists about the extent of discussion. Among the 34 oncologists who reported having a full discussion, 16 (47%) of their patients reported having a brief discussion and 8 (24%) reported no discussion. Men who reported having a full discussion had significantly lower depression scores (mean = 2.8) than those who reported a brief or no discussion (mean = 4.6; p=.018). As expected, the extent of discussion moderated some of the relationships between coping style and outcomes. Helpless-hopeless coping was associated with greater depression only among patients who reported a full or brief discussion of life expectancy (n=61, r=.56, p&lt;.0001). Interestingly, greater fatalism was associated with greater PTGI spiritual change among men who reported no or brief discussions (n = 54, r = .39, p = .004) and greater PTGI personal strength (n = 20, r = .63, p = .003) and PTGI appreciation of life (n = 20, r = .62, p = .003) among men who reported no discussion compared to men with full and brief or full discussion, respectively. Conclusions: Most men and oncologists reported discussions of life expectancy but there was little agreement on extent. Full discussions were not associated with depression; however this effect was moderated by coping styles. No significant financial relationships to disclose.
Lactate Metabolism in Anxiety Neurosis
Authors: Ferris N. Pitts, James N. McClure
Journal: New England Journal of Medicine (1967)

FOUR investigations conducted in 4 countries during the past twenty-five years have shown excessive lactate production on standard exercise in patients with anxiety neurosis.1 2 3 4 The characteristic anxiety symptoms were often evoked by the exercise and appeared to be concomitant with the extremely rapid rise of blood lactic acid. In general, the patients were unable to perform as much work per unit of time or to maintain as great a workload as normal matched controls.4 5 6 The rise in blood lactate per unit of work output per unit of time in the anxiety neurotics approximates that of patients with arteriosclerotic heart disease . . .
BYPASS DUODENO-YEYUNAL ENDOSCÓPICO (ENDOBARRIER®) EN PACIENTES CON OBESIDAD LEVE Y DIABETES COMPLEJA. RESULTADOS PRELIMINARES
Authors: E Espinet Coll, A García Ruiz De Gordejuela, J Pujol Gebelli, M Galvao Neto, JA Gómez Valero, C Vila Lolo, A Juan-Creix Comamala
Journal: Endoscopy (2015)

El bypass duodeno-yeyunal endoscópico (Endobarrier®) es un dispositivo intraluminal diseñado para remedar el efecto metabólico del bypass gástrico quirúrgico. Estudios preliminares demuestran resultados metabólicos prometedores en pacientes diabéticos tipo 2 con obesidad mórbida.
Association Between Hypertonic Saline and Hospital Length of Stay in Acute Viral Bronchiolitis
Authors: Corinne G. Brooks, Wade N. Harrison, Shawn L. Ralston
Journal: JAMA Pediatrics (2016)

<h3>Importance</h3> Two previous meta-analyses of nebulized hypertonic saline (HS) on hospital length of stay (LOS) in acute viral bronchiolitis have suggested benefit. Neither study fully addressed the issue of excessive heterogeneity in the cohort of studies, indicating that it may be inappropriate to combine such dissimilar studies to estimate a common treatment effect. <h3>Objective</h3> To reanalyze the existing data set for sources of heterogeneity to delineate the population most likely to benefit from HS. <h3>Data Sources</h3> We used the previously analyzed cohort of randomized trials from 2 published meta-analyses comparing HS with normal saline (or, in 1 case, with standard of care) in infants hospitalized for bronchiolitis. We also repeated the search strategy used by the most recent Cochrane Review in the Medline database through September 2015. <h3>Study Selection</h3> Eighteen randomized clinical trials of HS in infants with bronchiolitis reporting LOS as an outcome measure were included. <h3>Data Extraction and Synthesis</h3> The guidelines used for abstracting data included LOS, study year, setting, sample size, type of control, admission/discharge criteria, adjunct medications, treatment frequency, mean day of illness at study enrollment, mean severity of illness scores, and mean age. <h3>Main Outcomes and Measures</h3> Weighted mean difference in LOS and study heterogeneity as measured by the<i>I</i><sup>2</sup>statistic. <h3>Results</h3> There were 18 studies included of 2063 infants (63% male), with a mean age of 4.2 months. The mean LOS was 3.6 days. Two main sources of heterogeneity were identified. First, the effect of HS on LOS was entirely sensitive to the removal of one study population, noted to have a widely divergent definition of the primary outcome. Second, there was a baseline imbalance in mean day of illness at presentation between treatment groups. Controlling for either of these factors resolved the heterogeneity (<i>I</i><sup>2</sup> = reduced from 78% to 45% and 0%, respectively) and produced summary estimates in support of the null hypothesis (that HS does not affect LOS). There was a weighted mean difference in LOS of −0.21 days (95% CI, −0.43 to +0.02) for the sensitivity analysis and +0.02 days (95% CI, −0.14 to +0.17) for studies without unbalanced treatment groups on presentation. <h3>Conclusions and Relevance</h3> Prior analyses were driven by an outlier population and unbalanced treatment groups in positive trials. Once heterogeneity was accounted for, the data did not support the use of HS to decrease LOS in infants hospitalized with bronchiolitis.
Residential greenness is differentially associated with childhood allergic rhinitis and aeroallergen sensitization in seven birth cohorts
Authors: E. Fuertes, I. Markevych, G. Bowatte, O. Gruzieva, U. Gehring, A. Becker, D. Berdel, A. von Berg, A. Bergström, M. Brauer, B. Brunekreef, I. Brüske, C. Carlsten, M. Chan‐Yeung, S. C. Dharmage, B. Hoffmann, C. Klümper, G. H. Koppelman, A. Kozyrskyj, M. Korek, I. Kull, C. Lodge, A. Lowe, E. MacIntyre, G. Pershagen, M. Standl, D. Sugiri, A. Wijga, J. Heinrich
Journal: Allergy (2016)

The prevalence of allergic rhinitis is high, but the role of environmental factors remains unclear. We examined cohort-specific and combined associations of residential greenness with allergic rhinitis and aeroallergen sensitization based on individual data from Swedish (BAMSE), Australian (MACS), Dutch (PIAMA), Canadian (CAPPS and SAGE), and German (GINIplus and LISAplus) birth cohorts (n = 13 016).Allergic rhinitis (doctor diagnosis/symptoms) and aeroallergen sensitization were assessed in children aged 6-8 years in six cohorts and 10-12 years in five cohorts. Residential greenness was defined as the mean Normalized Difference Vegetation Index (NDVI) in a 500-m buffer around the home address at the time of health assessment. Cohort-specific associations per 0.2 unit increase in NDVI were assessed using logistic regression models and combined in a random-effects meta-analysis.Greenness in a 500-m buffer was positively associated with allergic rhinitis at 6-8 years in BAMSE (odds ratio = 1.42, 95% confidence interval [1.13, 1.79]) and GINI/LISA South (1.69 [1.19, 2.41]) but inversely associated in GINI/LISA North (0.61 [0.36, 1.01]) and PIAMA (0.67 [0.47, 0.95]). Effect estimates in CAPPS and SAGE were also conflicting but not significant (0.63 [0.32, 1.24] and 1.31 [0.81, 2.12], respectively). All meta-analyses were nonsignificant. Results were similar for aeroallergen sensitization at 6-8 years and both outcomes at 10-12 years. Stratification by NO2 concentrations, population density, an urban vs rural marker, and moving did not reveal consistent trends within subgroups.Although residential greenness appears to be associated with childhood allergic rhinitis and aeroallergen sensitization, the effect direction varies by location.
Response Assessment in Neuro-Oncology working group and European Association for Neuro-Oncology recommendations for the clinical use of PET imaging in gliomas
Authors: Nathalie L. Albert, Michael Weller, Bogdana Suchorska, Norbert Galldiks, Riccardo Soffietti, Michelle M. Kim, Christian la Fougère, Whitney Pope, Ian Law, Javier Arbizu, Marc C. Chamberlain, Michael Vogelbaum, Ben M. Ellingson, Joerg C. Tonn
Journal: Neuro-Oncology (2016)

This guideline provides recommendations for the use of PET imaging in gliomas. The review examines established clinical benefit in glioma patients of PET using glucose (18F-FDG) and amino acid tracers (11C-MET, 18F-FET, and 18F-FDOPA). An increasing number of studies have been published on PET imaging in the setting of diagnosis, biopsy, and resection as well radiotherapy planning, treatment monitoring, and response assessment. Recommendations are based on evidence generated from studies which validated PET findings by histology or clinical course. This guideline emphasizes the clinical value of PET imaging with superiority of amino acid PET over glucose PET and provides a framework for the use of PET to assist in the management of patients with gliomas.
Role of the ACE2/Angiotensin 1–7 Axis of the Renin–Angiotensin System in Heart Failure
Authors: Vaibhav B. Patel, Jiu-Chang Zhong, Maria B. Grant, Gavin Y. Oudit
Journal: Circulation Research (2016)

Heart failure (HF) remains the most common cause of death and disability, and a major economic burden, in industrialized nations. Physiological, pharmacological, and clinical studies have demonstrated that activation of the renin–angiotensin system is a key mediator of HF progression. Angiotensin-converting enzyme 2 (ACE2), a homolog of ACE, is a monocarboxypeptidase that converts angiotensin II into angiotensin 1–7 (Ang 1–7) which, by virtue of its actions on the Mas receptor, opposes the molecular and cellular effects of angiotensin II. ACE2 is widely expressed in cardiomyocytes, cardiofibroblasts, and coronary endothelial cells. Recent preclinical translational studies confirmed a critical counter-regulatory role of ACE2/Ang 1–7 axis on the activated renin–angiotensin system that results in HF with preserved ejection fraction. Although loss of ACE2 enhances susceptibility to HF, increasing ACE2 level prevents and reverses the HF phenotype. ACE2 and Ang 1–7 have emerged as a key protective pathway against HF with reduced and preserved ejection fraction. Recombinant human ACE2 has been tested in phase I and II clinical trials without adverse effects while lowering and increasing plasma angiotensin II and Ang 1–7 levels, respectively. This review discusses the transcriptional and post-transcriptional regulation of ACE2 and the role of the ACE2/Ang 1–7 axis in cardiac physiology and in the pathophysiology of HF. The pharmacological and therapeutic potential of enhancing ACE2/Ang 1–7 action as a novel therapy for HF is highlighted.
A memorable patient: Students forever
Authors: Sadananda B Naik
Journal: BMJ (2006)

An elderly woman was admitted under my care after an extensive myocardial infarction. After I had explained her prognosis to the waiting relatives, they asked me to speak to another family member, a retired professor of medicine. When I telephoned him, I was surprised to discover that he was my professor from 20 years ago when I was at medical college. He cautioned me about the risk of conduction block as well as heart failure.

On the third day after the patient's admission, he called me to suggest referring the patient to him for further management. This pricked my ego as a senior physician, and I declined—the patient was recovering well, and I said I was able to handle any emergencies. Barely two hours later, she collapsed as she sat up in bed. I found that she had intermittent heart block and had collapsed because of a Stokes-Adams attack. I advised transfer to a specialist cardiac centre for emergency pacemaker implantation. Once again the relatives contacted my old professor; oddly, he asked me not to transfer the patient, as the risk was unacceptable. I did not argue, the patient made a smooth recovery, and her family applauded me for my bold decision to treat her.

We tend to become more confident with age and experience. We may even feel more knowledgeable than our teachers and deride their unfamiliarity with state of the art tools and modern treatments. But incidents like this teach us that, in their eyes, we remain students forever.
Platinum-Amine Compounds: Importance of the Labile and Inert Ligands for Their Pharmacological Activities Toward L1210 Leukemia Cells<xref ref-type="fn" rid="FN2">2</xref>
Authors: J P Macquet, J L Butour
Journal: JNCI Journal of the National Cancer Institute (1983)

A series of Pt-amine compounds was assayed for their ability to inhibit the growth of cultured L1210 leukemia cells [median inhibitory dose (lD50)], their toxicity in mice [highest nonlethal dose in healthy mice (LD0)], their antitumor activity against leukemia L1210 cells grafted intraperitoneally into mice [mean survival of treated leukemic mice:mean survival of untreated leukemic mice (T/C)], and the ability to hydrolyze their labile ligands in vitro [hydrolysis half-time (t1/2)]. All Pt compounds exhibiting antitumor activity had a pair of labile ligands in the cis geometry with different charges, and the leaving groups had a wide range of hydrolysis rates. Among the compounds that showed antitumor activity, ID50 depended more on the inert ligands than on the labile ligands and was correlated with T/C. A relationship between LD0 and t1/2 was verified in the series of cis-Pt(II) compounds with the exception of the oxalate derivatives. Pt(II) and Pt(IV) compounds exhibited similar ID50, LD0, and T/C.
Gene expressions for thymidylate synthase (TS), orotate phosphoribosyltransferase (OPRT), and thymidine phosphorylase (TP), not dihydropyrimidine dehydrogenase (DPD), influence outcome of patients (pts) treated with S-1 for gastric cancer (GC)
Authors: W. Ichikawa, T. Takahashi, K. Suto, R. Hirayama
Journal: Journal of Clinical Oncology (2004)

4050 Background: We have reported that patients with low TS, low DPD, high OPRT or low TP tumor showed a high response rate and a long survival time than patients when treated with UFT/LV for colorectal cancer (Clin Cancer Res, 2003, Br J Cancer, 2003). We investigated the association between gene expressions of 5-FU metabolism-relating enzymes (TS, DPD, OPRT, TP) and clinical efficacy in pts of GC treated with S-1. Methods: The study population consisted of all 41 pts with metastatic GC who received the chemotherapy for metastatic disease after resection of primary tumors at Saitama Medical School. S-1 (40 mg/m2) was administrated orally twice a day for consecutive 28 days every 6 weeks. Gene expressions in primary gastric tumors were analyzed by a real-time RT-PCR method. Results: There was no difference in DPD gene expression between responding and non-responding tumors. Responded tumors had lower TS, higher OPRT, or lower TP gene expressions than non-responded tumors. The median values of each gene were defined for cutoff values separating high and low gene expression. Pts with low TS, high OPRT, or low TP survived longer than those with high TS, low OPRT, or high TP (median survival months; 5.5/9.6 for high/low TS, p<0.001, 9.9/5.8 for high/low OPRT, p<0.01, 7.6/9.9 for high/low TP, p<0.01). However, median survival times were 8.0 and 8.2 months for pts with low and high DPD tumors, respectively, without a statistical significance. Response rates were 90% (9/10) for tumors with low TS and high OPRT and low TP, and 19% (6/31) for tumors with high TS or low OPRT or high TP (p<0.001). Median survival time was 15.3 months for pts with tumors with low TS and high OPRT and low TP, statistically longer than 6.2 months for those with other combination of gene expressions (p<0.0001). Conclusions: These results showed that the favorable gene expression for responding to S-1 was low TS, high OPRT, and low TP, regardless of DPD gene expression status. No significant financial relationships to disclose.
Spinal Anesthesia for Pelvic Delivery
Authors: Phillip S. Marcus, John W. Tunnell, Lawrence H. Wilkinson
Journal: New England Journal of Medicine (1947)

THE relief of pain during childbirth has been since time immemorial a subject of discussion and controversy. At first the differences of opinion were based on biblical interpretations. Snow's use of chloroform, however, for the delivery of Queen Victoria of England in 1853 sounded the death knell for the opponents of obstetric anesthesia. The recent work of Lull and Hingson1 has again focused attention on this subject, which is now a lay as well as a professional topic of discussion.This series of 595 cases delivered under spinal anesthesia out of 1000 consecutive cases is presented without any claim to . . .
NTCT-10INCREASED RISK FOR HEMOLYTIC ANEMIA IN GLIOBLASTOMA PATIENTS TREATED WITH DAPSONE
Authors: Peter Oppelt, Lalitha Nayak, Jill Barnholtz-Sloan, Lisa Rogers
Journal: Neuro-Oncology (2015)

BACKGROUND: Antibiotic prophylaxis against Pneumocystis jirovecii pneumonia (PCP) is recommended for glioblastoma (GBM) patients receiving radiation and temozolomide. Trimethoprim-sulfamethoxazole (TMP-SMX), dapsone, atovaquone, and inhaled pentamadine are accepted antibiotics. Oxidant hemolysis is a known complication of dapsone, typically associated with G6PD deficiency. We report hemolytic anemia in 7/12 GBM patients treated with dapsone. We compare the rate of anemia with TMP-SMX and pentamadine-treated patients. METHODS: Retrospective review of charts of GBM patients treated with radiation and temozolomide 2009 -14 at our institution. RESULTS: Of 52 patients, 23 received TMP-SMX, 17 pentamadine, and 12 dapsone. Seven (58%) of the dapsone treated patients experienced > 2.0 g/dl drop in hemoglobin from baseline. In each patient, G6PD screening was normal. Macrocytosis was present in 4/7 dapsone-treated patients with anemia. Lactate dehydrogenase levels were elevated (range 312-414 U/L) in 3 / 4 in whom it was available. Peripheral smears of 5 demonstrated degmacytes (‘bite cells’). CONCLUSION: Anemia was more common in patients treated with dapsone than with TMP-SMX or pentamadine. The frequency of anemia is higher than anticipated, especially with normal G6PD levels. Evidence of hemolysis is supported by characteristic bite cells, increased LDH levels, with compensatory reticulocytosis suggested by macrocytosis. Close monitoring for anemia in GBM patients treated with dapsone for PCP prophylaxis is required, even with normal pretreatment G6PD levels.
The Respiratory Muscles
Authors: Charis Roussos, Peter T. Macklem
Journal: New England Journal of Medicine (1982)

THE respiratory system consists essentially of two parts: a gas-exchanging organ — the lungs—and a pump that ventilates the lungs. The pump consists of the chest wall, the respiratory muscles that displace it, the centers in the nervous system that control the muscles, and the nerves connecting the centers to the muscles. Both parts of the system are vital. In general, failure of the gas-exchanging function due to lung disease results in hypoxemia with normocapnia or hypocapnia, whereas failure of the pump (which also causes hypoxemia) leads to hypoventilation and hypercapnia, which is the hallmark of ventilatory failure (Fig. 1). . . .
Transvenous Left Atrial Pacing for the Control of Recurrent Ventricular Fibrillation
Authors: Arthur J. Moss, Robert J. Rivers, Lawrence S. C. Griffith, Jeffrey A. Carmel, Ernest B. Millard
Journal: New England Journal of Medicine (1968)

A 67-year-old man with acute anterolateral myocardial infarction had recurrent ventricular fibrillation that required insertion of temporary pacemaker. When a permanent pacemaker was inserted stable pacing was not obtained until the catheter tip stimulated the left atrium. Four months after discharge from the hospital the patient was doing well, and left atrial pacing has continued.
Benefits for Type 2 Diabetes of Interrupting Prolonged Sitting With Brief Bouts of Light Walking or Simple Resistance Activities
Authors: Paddy C. Dempsey, Robyn N. Larsen, Parneet Sethi, Julian W. Sacre, Nora E. Straznicky, Neale D. Cohen, Ester Cerin, Gavin W. Lambert, Neville Owen, Bronwyn A. Kingwell, David W. Dunstan
Journal: Diabetes Care (2016)

OBJECTIVE To determine whether interrupting prolonged sitting with brief bouts of light-intensity walking (LW) or simple resistance activities (SRA) improves postprandial cardiometabolic risk markers in adults with type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS In a randomized crossover trial, 24 inactive overweight/obese adults with T2D (14 men 62 ± 6 years old) underwent the following 8-h conditions on three separate days (with 6–14 days washout): uninterrupted sitting (control) (SIT), sitting plus 3-min bouts of LW (3.2 km · h−1) every 30 min, and sitting plus 3-min bouts of SRA (half-squats, calf raises, gluteal contractions, and knee raises) every 30 min. Standardized meals were consumed during each condition. Incremental areas under the curve (iAUCs) for glucose, insulin, C-peptide, and triglycerides were compared between conditions. RESULTS Compared with SIT, both activity-break conditions significantly attenuated iAUCs for glucose (SIT mean 24.2 mmol · h · L−1 [95% CI 20.4–28.0] vs. LW 14.8 [11.0–18.6] and SRA 14.7 [10.9–18.5]), insulin (SIT 3,293 pmol · h · L−1 [2,887–3,700] vs. LW 2,104 [1,696–2,511] and SRA 2,066 [1,660–2,473]), and C-peptide (SIT 15,641 pmol · h · L−1 [14,353–16,929] vs. LW 11,504 [10,209–12,799] and SRA 11,012 [9,723–12,301]) (all P &amp;lt; 0.001). The iAUC for triglycerides was significantly attenuated for SRA (P &amp;lt; 0.001) but not for LW (SIT 4.8 mmol · h · L−1 [3.6–6.0] vs. LW 4.0 [2.8–5.1] and SRA 2.9 [1.7–4.1]). CONCLUSIONS Interrupting prolonged sitting with brief bouts of LW or SRA attenuates acute postprandial glucose, insulin, C-peptide, and triglyceride responses in adults with T2D. With poor adherence to structured exercise, this approach is potentially beneficial and practical.