tbuckley/cabot-search huggingface dataset:
Improving management of breathlessness in lung cancer.
Authors: James John MacDonald, Jennifer S. Temel, Elene Viscosi, Jeanne Griffin Vaughn, Lara Traeger, Theresa Margaret McDonnell, William F. Pirl, Joseph A. Greer
Journal: Journal of Clinical Oncology (2014)

220 Background: Dyspnea is a common and debilitating symptom of advanced lung cancer that interferes with quality of life (QOL). Though few evidence-based treatments for dyspnea exist, there is support for non-pharmacological interventions that include elements of cognitive-behavioral therapy (CBT). The purpose of this study was to pilot a brief nurse-delivered CBT intervention for dyspnea in patients with lung cancer, assessing feasibility and effect. Methods: For this single-group, nonrandomized pilot trial, 20 patients receiving outpatient chemotherapy for advanced lung cancer (ECOG Performance Status 0-2) and reporting dyspnea participated in a two-session CBT intervention. We enrolled a convenience sample of patients referred by their medical oncologists based on self-reported dyspnea. Two nurse practitioners taught the participants breathing and relaxation techniques within the infusion clinic and encouraged home practice. Patients completed measures of dyspnea (Modified Medical Research Council Dyspnea Scale [MMRCDS]), QOL (Functional Assessment of Cancer Therapy-Lung [FACT-L] and Trial Outcome Index [TOI]), and depression symptoms (Hospital Anxiety and Depression Scale depression subscale [HADS-D]) at baseline and within 6 weeks after enrollment. We used dependent-samples t-tests to analyze treatment effect on dyspnea and QOL and sign test to analyze depressions symptoms. Results: Of the 20 patients (50% Female; Mean Age=64.80 years) enrolled in the study, 85% (17) completed post-assessment. We observed significant improvement in MMRCDS (p=.001), FACT –L (p=.029), and FACT-TOI (p=.008) scores from baseline to post-assessment. The proportion of patients reporting depression symptoms (e.g. HADS-D &gt;7) decreased from 50% (n=10/20) to 12 % (n=2/17) (p=.016). Conclusions: In this sample of patients with advanced lung cancer and dyspnea, we observed a high completion rate for the 2-session CBT intervention. Patients also showed improvements in dyspnea, QOL, and mood. Follow-up randomized controlled trials are needed to examine the efficacy of brief CBT interventions for dyspnea. Clinical trial information: NCT01937637.
Psychiatric complications of family reunion after four decades of separation
Authors: W S Tseng, T A Cheng, Y S Chen, P L Hwang, J Hsu
Journal: American Journal of Psychiatry (1993)

After four decades of separation due to civil war, many people who had migrated to Taiwan from mainland China had the unexpected opportunity to briefly visit their families in mainland China. A study was conducted to examine psychiatric complications associated with these family reunions following long involuntary separation.Eighty subjects who made the journey were given semistructured interviews investigating their psychological experiences relating to the family reunion. The variables investigated were sociodemographic characteristics, the subject's previsit emotional condition, factors related to the family reunion experience, and stress encountered during the visit.The survey indicated that more than one-fifth of the subjects (22.5%) developed psychiatric complications, mainly depression, immediately after the visit. Determinants found to contribute significantly to the occurrence of emotional disorders were previous ways of expressing homesickness, family members seen during the reunion, family misfortunes that the subjects discovered, family conflict encountered at the reunion, and tactics for coping with such stressors.The study results suggest that family reunions after long-term separation can be trauma-repairing experiences for some but for others can lead to trauma reexperiencing and psychiatric complications requiring mental health intervention.
Developmental issues in the psychiatric hospitalization of children
Authors: I N Berlin
Journal: American Journal of Psychiatry (1978)

Rather than becoming repositories for the community's seriously disturbed children, children's psychiatric hospitals need to develop milieu programs that involve trained child care staff and developmentally oriented child mental health professionals. Treatment programs should address the developmental needs and abilities of the various age groups and the particular developmental deficits reflected in their psychopathologies and should include a variety of treatment elements.
Reversible Alteration in the Expression of the Gap Junctional Protein Connexin 32 During Tumor Promotion in Rat Liver and Its Role during Cell Proliferation
Authors: M J Neveu, J R Hully, D L Paul, H C Pitot
Journal: Cancer Communications (1990)

Although numerous biochemical markers can identify putative preneoplastic altered hepatic foci (AHF) in rat liver, no consistent pattern of expression during hepatocarcinogenesis has emerged. Using quantitative stereologic analyses we demonstrated that decreased expression of the major hepatocyte gap junction protein, connexin 32 (Cx32), in rat AHF is a consistent observation in several protocols of multistage hepatocarcinogenesis. This change was observed after initiation by either ethylnitrosourea (ENU) or diethylnitrosamine (DEN), followed by promotion with phenobarbital (PB), dioxin, chlorendic acid, C.I. Solvent Yellow, or tamoxifen. AHF generated by Wy-14,643, ciprofibrate, and a choline/methionine-deficient dietary regimen also showed decreased Cx32 expression. The decrease of Cx32 in AHF was rapidly reversible after withdrawal of PB, and this change preceded a reduction in placental isozyme of glutathione-S-transferase (GST) expression in the same AHF. Within 20 days of withdrawal, fewer than 4% of GST-positive AHF were Cx32 deficient, while the volume of total AHF decreased 30%. Chronic PB treatment also resulted in a reversible decrease in Cx32 specifically in mid- and centro-lobular hepatocytes. Continuous thymidine labeling demonstrated that Cx32 could be uncoupled from the cell cycle, suggesting that some liver promoters may act directly to alter the expression of Cx32. These observations suggest that a decrease in Cx32 content was a relatively common epigenetic change in AHF induced during hepatocarcinogenesis by a number of initiating and promoting agents but that this change was not sufficient for carcinogenesis. This change, however, may be necessary for the mechanism(s) of tumor promotion, since Cx32-positive AHF did not proliferate as readily as Cx32-deficient AHF.
ECT and ethical psychiatry
Authors: C Salzman
Journal: American Journal of Psychiatry (1977)

The author discusses the right to receive ECT and describes voluntary and involuntary patients for whom the treatment seemed both ethical and humane. The right to refuse ECT must be respected in competent patients. However, problems arise when patients' decision-making ability is compromised by their illness. Informed consent questions include how much and what type of information patients should receive and how much those with disordered cognitive functioning can be expected to understand. The author believes that ECT should be fully voluntary whenever possible and that a court-appointed guardian should make such treatment decisions for incompetent patients.
Control of breast cancer through mass screening
Authors: P. Strax
Journal: JAMA (1976)

MASS screening for detection of earlier breast cancer by palpation and mammography is the only method that has produced a notable reduction in mortality from this disease. A onethird reduction in death rate has been achieved in a seven-year follow-up in the mass-screening program conducted by the Health Insurance Plan of Greater New York under contract with the National Cancer Institute. This has led to the creation of the Guttman Breast Diagnostic Institute in New York City, whose major objective has been to develop practical methods for mass screening. In this program, a higher proportion of localized breast cancer with no nodal involvement than is the case in general medical practice has been found. These findings point up the potential of mass screening not only in increasing survival from the disease, but in increasing salvage. <h3>BACKGROUND</h3> Mass-screening programs for breast cancer detection were conducted in the 1940s and 1950s by
Case 23-1967
Authors: Gordon S. Myers, Benjamin Castleman
Journal: New England Journal of Medicine (1967)

Presentation of Case First admission. An eighty-six-year-old man was admitted to the hospital because of edema of the legs.He had been well until three years previously, when edema of the legs and an ulcer over the lower portion of the right leg developed. He was treated at another hospital for thrombophlebitis, and a diuretic agent was prescribed. Two years later the swelling of the legs increased, and nocturnal dyspnea occurred. Five months before entry he was admitted to another hospital for a week; meralluride was administered. He experienced increasing swelling of the legs and abdomen, with progressive difficulty . . .
Combined monoamine oxidase inhibitor-tricyclic antidepressant treatment: a pilot study
Authors: K White, T Pistole, J L Boyd
Journal: American Journal of Psychiatry (1980)

Thirty newly hospitalized patients with RDC major or minor depressive disorder were randomly assigned to open treatment according to fixed dosage steps with 1) amitriptyline alone, up to a maximum dose of 300 mg/day; 2) tranylcypromine alone, up to a maximum dose of 40 mg/day; or 3) the combination of amitriptyline, up to 150 mg/day, and tranylcypromine, up to 20 mg/day. For 28 patients this protocol continued for 4 weeks or until discharge. As measured by the Hamilton and Zung depression scales, patients in all three treatment groups improved equally. The combination treatment produced a nonsignificantly higher frequency of minor side effects, none of which required discontinuation of treatment. The results indicate the feasibility and safety of further controlled clinical research with combined treatment, although caution is advised.
Efficiency of Single-View Mammography: Rate of Interval Cancer Cases
Authors: B Lundgren
Journal: JNCI Journal of the National Cancer Institute (1979)

A nonselected population of women screened by single-view mammography was followed up to 2 years after screening, and breast carcinoma cases diagnosed were registered; 28,350 women were followed for 1 year. At screening, 132 invasive carcinoma cases were detected, and during the first year after screening, 10 cases were detected. According to an efficiency index, which takes into consideration both detections at screening and interval cases, the 1-year efficiency was 93%. The efficiency of single-view mammography for breast cancer screening was found to be satisfactory.
Gastrointestinal illnesses in tourists: whose responsibility?
Authors: R Cartwright
Journal: Eurosurveillance (2004)

Improvements in public health and the control of communicable diseases throughout Europe have been achieved due to the multidisciplinary approach and not only as a result of efforts of public health physicians. The conclusions of the Spanish team that studied the outbreak of gastroenteritis in tourists visiting the Dominican Republic provides a good example of the need for both cross discipline and international cooperation. Tourism is one of the top three global economic forces, with an increasing number of tourists each year. It is estimated that there are over 70 million package holidays sold in Europe annually with destinations worldwide. The tourists are exposed to a wide range of conditions and pathogenic organisms.
Enterohaemorrhagic Escherichia coli O104:H4: are we prepared now?
Authors: A W Friedrich
Journal: Eurosurveillance (2011)

Preview this article: Enterohaemorrhagic Escherichia coli O104:H4: are we prepared now?, Page 1 of 1 < Previous page | Next page > /docserver/preview/fulltext/eurosurveillance/16/31/art19938-en-1.gif
Introduction
Authors: R.A. Pierloot
Journal: Psychotherapy and Psychosomatics (1970)

Psychosomatic research is concerned with the problems of ascertaining, defining and explaining the interaction of phenomena belonging to the psychic and somatic systems of reference. Most of the contributions can be grouped in three main areas: research based on clinical data, the experimental approach of connections between physiological and psychological data and the elaboration of conceptual tools permitting to deal with the relationship between psychic and somatic phenomena. A restricted survey of the principal contributions and new perspectives in each of these areas is offered. We are far from a unifying und integrating theory of psychosomatic interaction, but the field of psychosomatic research remains an exciting challenge, because it embraces the problems of life and human nature itself.
Anticipation in schizophrenia: new light on a controversial problem [published erratum appears in Am J Psychiatry 1997 Apr;154(4):590]
Authors: P Gorwood, M Leboyer, B Falissard, M Jay, F Rouillon, J Feingold
Journal: American Journal of Psychiatry (1996)

Anticipation, recently found in several neuropsychiatric disorders, is an inheritance pattern within a pedigree in which disease severity increases or age at onset decreases in successive generations. Demonstration of genetic anticipation in schizophrenia could be of heuristic value, since unstable trinucleotide repeat DNA is known to be the biological basis of anticipation. However, to overcome one of the major ascertainment biases that might mimic anticipation--namely, the fact that patients in different generations are not interviewed at the same age, resulting in a greater chance of finding a later age at onset in the older generation--a new method of investigating anticipation was used.The study subjects were 97 systematically ascertained schizophrenic patients belonging to 24 families with at least two generations affected who were identified during a 1-year prevalence study in a limited geographical area of Reunion Island (Indian Ocean). A method of calculating expected age at onset according to age at interview was used in the analyses.In the younger generation of patients, the observed age at onset (21.80 years) was earlier than the expected age at onset (24.95 years), demonstrating anticipation, even when five additional biases that can mimic this genetic effect--the proband effect, the presence of an affected father or mother, the bilineality of the illness, the fertility effect, and the cohort effect--were taken into account.Evidence for anticipation was demonstrated in this group of schizophrenic patients. This may help the search for pathological genes implicated in the genesis of schizophrenia.
The Use of Viral Culture and p24 Antigen Testing to Diagnose Human Immunodeficiency Virus Infection in Neonates
Authors: Marianne Burgard, Marie-Jeanne Mayaux, Stéphane Blanche, Agnès Ferroni, Marie-Luce Guihard-Moscato, Marie-Christine Allemon, Nicole Ciraru-Vigneron, Ghislaine Firtion, Corinne Floch, François Guillot, Eric Lachassine, Michèle Vial, Claude Griscelli, Christine Rouzioux
Journal: New England Journal of Medicine (1992)

Early diagnosis of human immunodeficiency virus (HIV) infection in infants born to infected mothers is important for the infants' medical care, but the presence of maternal antibodies makes serologic tests uninformative.
SP0197 Uncommon Comorbidities in Rheumatic Diseases
Authors: Z. Szekanecz
Journal: Annals of the Rheumatic Diseases (2015)

It has been well established that comorbidities including cardiovascular disease, osteoporosis or malignancies have high impact on the outcome of rheumatic conditions. In addition to this rather common complications, more uncommon comorbidities, such as anemia and other hematological disorders, as well as amyloidosis may also occur. There have been much less data on the epidemiology, assessment and management of these conditions. In this review we will discuss that –hematological conditions including anemia should be screened in rheumatic patients –the possible role of anti-inflammatory and DMARD therapy in the development of anemia should be considered –amyloidosis may be a life-threatening complication, therefore, early diagnosis is necessary –the management of anemia and amyloidosis is not always easy, however, DMARD treatment of the underlying disease may also be effective to prevent or control these conditions. <h3>Disclosure of Interest</h3> None declared
Myelodysplastic syndrome (MDS) patients at a VA medical center: Comorbidity and survival.
Authors: K. Kim, T. Kalwar, M. Barry, S. Srinivas, V. T. Chang, K. Toomey, M. L. Gonzalez, L. Duque, M. McPherson, B. Kasimis
Journal: Journal of Clinical Oncology (2010)

6611 Background: To determine whether co morbidity indices predict survival in myelodysplastic syndrome (MDS) patients. Methods: In an IRB approved protocol, we reviewed the records of patients (pts) diagnosed with MDS at a VA Medical Center from June 1998 to December 2009. Records were reviewed for demographic, clinical and pathological data, ECOG PS, Erythropoietin use and response, transfusion dependency, International Prognostic Scoring System (IPSS), total number of treatments and survival. Cox survival regression analysis was performed. Comorbidity was assessed with three co morbidity indices, the Charlson Comorbidity Index (CMI), the Kaplan-Feinstein Index (KFI) and the Cumulative Illness Rating Scale (CIRS). Results: There were 81 analyzable pts with a median (M) age of 74.5 (47-94). The M hemoglobin was 9.5 g/dl (4.3-16.9), M WBC 5.05 K/cmm (1.2-100), M platelets 158.5 K/cmm (10-1346), M albumin 3.9 g/dL (0-5), M ferritin 378 ng/mL (0-7750), M LDH 188 IU/L (0-2426). The M CMI was 2 (0-8), M KFI 2 (0-3), M CIRS 15 4 (0-10), M CIRS 16 7 (0-19), M CIRS 17 1.7 (0-3), and M survival was 925 days (14-3871). Of the 63 pts (77.8%) who received treatment, 34 (42.5%) received an erythroid stimulating agent, 9 (11.25%) lenalidomide, and 8 (10.1%) azacytidine. There were 28 (34.2%) who were transfusion dependent with the M number of transfusions was 4 (0-100). In the univariate survival analysis, hemoglobin, wbc, platelets, ferritin, LDH, albumin, and transfusion dependency were significant predictors of survival. Of the co morbidity indices, only Charlson CMI and CIRS 19 were significant; age, race, KFI, CIRS 15, 16, 17, and 18 were not significant. In the multivariate analysis, hemoglobin (p < 0.0040), LDH (p < 0.0016), transfusion dependency (p < 0.0028) and CIRS 19 (p < 0.0303) were independent predictors of survival. Conclusions: Severe comorbidity, as reflected in the CIRS19, may be an independent predictor of survival. Further analysis of a larger sample will be needed. This was supported by the New Jersey Commission for Cancer Research 09-1133-CCR-EO. No significant financial relationships to disclose.
G-CSF Dosing to Prevent Recurrent Clozapine-Induced Agranulocytosis
Authors: G. Mark Freeman, Beth A. Martin, Rona J. Hu
Journal: American Journal of Psychiatry (2016)

TO THE EDITOR: Prescribing guidelines for clozapine have recently changed (1).Clozapine may now be continued if the risk of psychiatric illness outweighs the risk of recurrent severe neutropenia; however, literature to guide treatment is sparse.Here, we report the 5.4-year course of a 19-year-old Caucasian male with schizoaffective disorder who developed agranulocytosis on three consecutive clozapine trials, but who thereafter achieved long-term stabilization of psychiatric symptoms and absolute neutrophil count (ANC) through concurrent use of clozapine and granulocyte colony-stimulating factor (G-CSF) with clear dosing parameters.Clozapine was first initiated for the patient's disabling psychotic symptoms despite multiple antipsychotic trials.Nine months later, agranulocytosis occurred (ANC nadir, 70 cells/mL; normal range51,500-6,700 cells/mL).Per prescribing guidelines, clozapine was discontinued.As supported by prior reports (2, 3), a time-limited course of G-CSF normalized ANC, and the patient briefly stabilized on a combination of lithium, risperidone, asenapine, ziprasidone, and olanzapine, but he did not regain significant functioning.Over the next 2.5 years, he required multiple hospitalizations for refractory delusions, hallucinations, and assaultiveness.ECT was ineffective.Accumulating evidence supported clozapine rechallenge with concurrent G-CSF dosing (2, 3).Clozapine was reinitiated with twice-weekly 300 mg G-CSF (5.6 mg/kg/week) (2, 3).After 16 days, G-CSF was discontinued, and ANC remained within normal range.However, 30 days following G-CSF discontinuation, severe agranulocytosis recurred (nadir of ANC was undetectable).Consistent with the literature (4), this duration of exposure was significantly shorter than the patient's initial 297-day course.Clozapine was discontinued, and he was briefly admitted to internal medicine for neutropenic fever but stabilized on G-CSF and empiric antibiotics.No infection was identified.Given the severity of psychiatric symptoms, the risks and benefits of a third clozapine trial were discussed with the patient and family.Clozapine was restarted with concurrent twice-weekly injections of 300 mg G-CSF (2, 3).Psychiatric symptoms improved significantly; however, agranulocytosis recurred on day 68 despite concurrent G-CSF dosing (nadir of ANC, 300 cells/mL).Clozapine was discontinued, and 480 mg G-CSF subcutaneous was given daily to raise ANC to the upper levels of normal range.Nonmedication-related causes
High Ambient Temperatures and Risk of Motor Vehicle Crashes in Catalonia, Spain (2000–2011): A Time-Series Analysis
Authors: Xavier Basagaña, Juan Pablo Escalera-Antezana, Payam Dadvand, Òscar Llatje, Jose Barrera-Gómez, Jordi Cunillera, Mercedes Medina-Ramón, Katherine Pérez
Journal: Environmental Health Perspectives (2015)

Experimental studies have shown a decrease in driving performance at high temperatures. The epidemiological evidence for the relationship between heat and motor vehicle crashes is not consistent.We estimated the impact of high ambient temperatures on the daily number of motor vehicle crashes and, in particular, on crashes involving driver performance factors (namely distractions, driver error, fatigue, or sleepiness).We performed a time-series analysis linking daily counts of motor vehicle crashes and daily temperature or occurrence of heat waves while controlling for temporal trends. All motor vehicle crashes with victims that occurred during the warm period of the years 2000-2011 in Catalonia (Spain) were included. Temperature data were obtained from 66 weather stations covering the region. Poisson regression models adjusted for precipitation, day of the week, month, year, and holiday periods were fitted to quantify the associations.The study included 118,489 motor vehicle crashes (an average of 64.1 per day). The estimated risk of crashes significantly increased by 2.9% [95% confidence interval (CI): 0.7%, 5.1%] during heat wave days, and this association was stronger (7.7%, 95% CI: 1.2%, 14.6%) when restricted to crashes with driver performance-associated factors. The estimated risk of crashes with driver performance factors significantly increased by 1.1% (95% CI: 0.1%, 2.1%) for each 1 °C increase in maximum temperature.Motor vehicle crashes involving driver performance-associated factors were increased in association with heat waves and increasing temperature. These findings are relevant for designing preventive plans in a context of global warming.