tbuckley/cabot-search huggingface dataset:
P28 A Successful Ambulatory Pathway For Elective CT Guided Lung Biopsy Which Reduces Bed Days is Co-Dependant on Adequate Discharge Planning Including a Pathway For Managing Patients with Small Pneumothoraces: Abstract P28 Table 1
Authors: M Tufail, T Hussain, E Hadley
Journal: Thorax (2012)

<h3>Introduction and Objectives</h3> CT guided lung biopsy is a cost effective and reliable method to diagnose lung malignancy. The procedure has a low morbidity and mortality although pneumothorax complicates up to 61% of all lung biopsies.<sup>1</sup> Patients were previously admitted for this procedure but the lack of beds and the resources prompted the conversion to an out-patient service.<sup>2</sup> The aim of this study was to look at how a new policy for day-case CT guided biopsy of the lung affected bed-days, in particular those patients with a post biopsy pneumothorax. <h3>Methods</h3> We collected data on CT guided lung biopsies, its complications and bed days per biopsy during 2008 when procedure was performed as inpatient and compared it with the findings when procedure was performed as day case between 2009 and 2011. <h3>Results</h3> During 2008 we performed 35 CT guided lung biopsies as inpatients. Total bed days per biopsy were 2.31(81/35). With the introduction of a day case procedure in 2009 total bed days per biopsy were remarkably reduced to 0.12 (9/73). Post biopsy pneumothorax rate was 18.8% (13/73) over 3 years, but only one patient required treatment with a chest drain 7.7% (1/13). However 9/13 patients were admitted for observation irrespective of the symptoms and size of the pneumothorax. <h3>Conclusion</h3> We present evidence that the implementation of a successful day-case CT biopsy pathway has dramatically reduced bed days per successful biopsy. We have demonstrated that a further pathway for the ambulatory management of post-biopsy complications would further reduce this figure by a factor of 10 from 0.12 to 0.014 days (1/73)[see table). We recommend discharging suitably selected patients with small asymptomatic pneumothorax with an appropriate information leaflet. A CXR to confirm resolution of the pneumothorax could be done when the patient returns to clinic for their biopsy results. <h3>References</h3> MacDuff A, Arnold A, Harvey J; BTS Pleural Disease Guideline Group. Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Thorax. 2010; 65. CT-guided cutting needle biopsy of lung lesions–safety and efficacy of an out-patient service. Charig MJ, Phillips AJ. Clin Radiol. 2000 Dec; 55(12):964–9.
OP0295 Low Back Pain in Primary Care - Preliminary Pilot Results of Group Exercise/Education Intervention Using the Startback Screening Tool to Subgroup Patients
Authors: S. Murphy, C. Blake, C. Power, B. M. Fullen
Journal: Annals of the Rheumatic Diseases (2013)

Background Back pain is a major public health problem. To improve patient outcomes, sub-grouping patients into more homogenous groups for targeted treatment has been advocated (Foster 2011). The STarTBack screening tool (Hill 2008) subgroups patients based on risk of persisting symptoms (low, medium, high risk). Objectives To determine if patients subgrouped as 'High Risk' (STarTBack tool) and managed accordingly using targeted treatment in a physiotherapy group setting, achieve better outcomes with regard to pain and disability compared to a retrospective matched control group who received a standard 10 week exercise/education intervention regardless of STarTBack risk category. Methods Patients referred from primary care centres were stratified into: (i) one off exercise/education session (Low Risk). (ii) 10 week exercise/education intervention (Medium Risk) or (iii) 10 week Cognitive Behavioural Therapy/exercise intervention (High Risk) groups, the 'High Risk' intervention being the new Intervention. Disability was measured using the Roland Morris Disability Questionnaire (RMDQ) (0-24) and pain using the Visual Analogue Scale [VAS 0-10]. Follow up occurred at 3 months. Ethical approval was obtained. All data were entered into PASW 18. Differences between targeted and standard treatment outcomes were analysed and effect sizes analysed using Cohen d calculations. Results In total 39 matched patients were assigned to the 'High Risk' new intervention and retrospective standard control. There was no statistically significant difference between the groups at baseline with regard to disability and pain. (p>0.05). At 3 month follow up, a large effect size was found in the 'High Risk' stratified group (cohen's d 1.14) compared with control group where a moderate effect size (Cohen d 0.51) was found. Moderate effect sizes for changes in VAS were found in both intervention (Cohen's d 0.58) and control data (Cohen's d 0.56). Neither variable reached statistical significance(p>0.05) Conclusions Preliminary pilot results demonstrate that a stratified approach for 'High Risk' patients has a greater effect than standard exercise/education intervention. Longer-term follow up with a larger patient cohort may demonstrate even greater benefits. References Foster, N, Hill J, Hay E. (a) Sub-grouping patients with low back pain in primary care : Are we getting any better at it? Manual Therapy 2011; 16:3-8. Hill Jonathan, Dunn K, Lewis M, Mullis R, Main C, Foster N, Hay E. A primary care Back Pain Screening Tool: Identifying patient subgroups for initial treatment. Arthritis and Rheumatism. 2008; 59: 5: 632 -641. Acknowledgements Funded by an unrestricted educational grant from Pfizer Healthcare Ireland Disclosure of Interest None Declared
U.S. Groups To Help Control Latin American Smoking Epidemic
Authors: J. Neild
Journal: JNCI Journal of the National Cancer Institute (1989)

Journal Article U.S. Groups To Help Control Latin American Smoking Epidemic Get access Julie Neild Julie Neild Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 81, Issue 20, 18 October 1989, Pages 1531–1533, https://doi.org/10.1093/jnci/81.20.1531 Published: 18 October 1989
Prevention of Type 2 Diabetes Mellitus by Changes in Lifestyle among Subjects with Impaired Glucose Tolerance
Authors: Jaakko Tuomilehto, Jaana Lindström, Johan G. Eriksson, Timo T. Valle, Helena Hämäläinen, Pirjo Ilanne-Parikka, Sirkka Keinänen-Kiukaanniemi, Mauri Laakso, Anne Louheranta, Merja Rastas, Virpi Salminen, Sirkka Aunola, Zygimantas Cepaitis, Vladislav Moltchanov, Martti Hakumäki, Marjo Mannelin, Vesa Martikkala, Jouko Sundvall, Matti Uusitupa
Journal: New England Journal of Medicine (2001)

Type 2 diabetes mellitus is increasingly common, primarily because of increases in the prevalence of a sedentary lifestyle and obesity. Whether type 2 diabetes can be prevented by interventions that affect the lifestyles of subjects at high risk for the disease is not known.
Quality of life evaluation and decision-making after mastectomy for breast reconstruction of breast cancer patients.
Authors: M Kalder, T Eibisch, P Hadji, U Wagner, U Albert
Journal: Cancer Research (2009)

Abstract Abstract #4098 Background:&amp;#x2028; What is the level of information and the information needs of Breast Cancer patients after mastectomy regarding secondary breast reconstruction. Evaluation of the impact of a mastectomy regarding Quality of Life, satisfaction with the surgical result and personal job situation as well as the influence of a partnership according to the Quality of Life parameters.&amp;#x2028; Material and Methods:&amp;#x2028; From January 2000 until May 2003 a number of 282 women suffering from Breast Cancer underwent a mastectomy for various indications. During the routinely Breast Cancer follow-up Quality of Life was assessed using the EORTC QLQ-C30 questionnaire and the breast cancer specific module BR23 in patients at least one year after the mastectomy. 149 (52.8%) patients were excluded for the following reasons: Local recurrence (5%), pT4 stage cancer (3.5%), performed secondary breast reconstruction (22%) and an age of over 75 years (22.3%). 3.5% of the remaining 133 (47.2%) patients died, 3.5% moved with unknown address and 7.1% refused the questionnaire. All together 86 (30.5%) questionnaires could be evaluated.&amp;#x2028; Results:&amp;#x2028; 93% of the patients were aware of the possibility to have a breast reconstruction.&amp;#x2028; Patients satisfied with the results of the surgical procedure comprised a higher level of content with their body image and reported higher overall Quality of Life compare to less satisfied patients.&amp;#x2028; Patients with a good body image had significantly less problems showing themselves nude to their partner (p &amp;lt; .0001) and accepted physical touch by them in the breast region significantly more frequently (p &amp;lt; .004) compared to those with a poor body image.&amp;#x2028; 16% of the patients underwent secondary breast reconstruction between the last follow-up and the start of the questionnaire. 8% of the patients made the decision for breast reconstruction after filling in the questionnaire due to more information.&amp;#x2028; Discussion:&amp;#x2028; Although the majority of patients were well informed about the modalities of breast reconstruction, an additional 8% of the patients made a decision for breast reconstruction. In conclusion, due to our observation, additional information to patients about the possibility of secondary breast reconstruction even after one or more years, can lead to an unexpected high number of secondary breast reconstruction. We believe that this further information should be integrated into routine clinical practice. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4098.
Commentary: Medical and Ethical Issues in Genetic Screening: An Academic View
Authors: Neil A. Holtzman
Journal: Environmental Health Perspectives (1996)

This article is intended to acquaint those whose principal concerns are the health and safety of workers with genetic screening and some of the medical and ethical issues it raises.Population- based genetic screening increasingly is being considered for predicting future disease in the person being screened.A major problem in screening for alleles that contribute to the development of common, multifactorial disorders is low sensitivity and positive predictive value.In many instances, no demonstrably effective prophylaxis or treatment is available to help those with positive test results.This creates ethical problems of assuring that testing is in the person's best interest and raises in turn issues of autonomy, discrimination, and privacy.Instead of screening for genetic predispositions to harm from workplace exposures, other means of improving the health of workers may bring greater benefits to a higher proportion of workers.The current state of genetic tests for chronic beryllium disease are considered.None are suitable for screening.
Abstract 2970: Whole genome sequencing analysis of multiple liver cancer nodules for determination of causal events for multi-occurrence
Authors: Mayuko Furuta, Akihiro Fujimoto, Masaki Ueno, Shinya Hayami, Yoshi-iku Kawakami, Kunihito Gotoh, Tatsuhiko Tsunoda, Satoru Miyano, Hideki Ohdan, Kazuaki Chayama, Hiroki Yamaue, Hidewaki Nakagawa
Journal: Cancer Research (2015)

Abstract Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide. Despite the recent progress in diagnostic accuracy and therapeutic efficacy, its five-year survival rate is still low. Characteristically, HCC shows a high rate of intrahepatic metastasis (IM) or multi-centric (MC) occurrence within the liver, and discrimination of IM/MC is difficult and important for therapeutic decision. Previously we reported that there were no common somatic mutations between whole genomes of MC tumors, indicating that MC tumors independently developed in their genetic aspect (Nat Genet, 44: 760-764, 2012). Here we performed whole genome sequencing (WGS) analysis on 43 multiple liver cancer nodules derived from 20 patients, which were clinically defined as IM or MC occurrence. We first analyzed common and unique somatic mutations in each individual and divided the cases into IM or MC by using the information of common somatic mutations between the multiple nodules. Interestingly, the clinical and pathological diagnoses of MC/IM in five of 20 cases were not concordant with the judgments from WGS, indicating the usefulness of WGS for a precise IM/MC judgment. Analysis of common somatic alterations in IM tumors enabled to extract early and late event in hepatocarcinogenesis among a large number of somatic events in each cases, while MC pairs shared only a few numbers of common alterations, including false positives. Importantly, one somatic mutation in non-coding region was exceptionally detected commonly among MC tumor pairs from three cases. Sanger sequencing confirmed that this mutation was also commonly detected in 10.9% (35/321) of liver cancer samples somatically. These results indicate the significance of this function-unknown and recurrent mutation in liver cancer development. To illuminate common driver events in MC tumors, we analyzed all detectable genetic alterations, including copy number alterations and rearrangements, on multi-time point or MC tumors derived from same individuals and extracted significant genetic alterations from them, which can help the understanding of driver genetic alterations in liver cancers. Citation Format: Mayuko Furuta, Akihiro Fujimoto, Masaki Ueno, Shinya Hayami, Yoshi-iku Kawakami, Kunihito Gotoh, Tatsuhiko Tsunoda, Satoru Miyano, Hideki Ohdan, Kazuaki Chayama, Hiroki Yamaue, Hidewaki Nakagawa. Whole genome sequencing analysis of multiple liver cancer nodules for determination of causal events for multi-occurrence. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 2970. doi:10.1158/1538-7445.AM2015-2970
Foreign doctors strike over new French law
Authors: A. Dorozynski
Journal: BMJ (1995)

Doctors who practise in France with a foreign diploma held two one day strikes recently in protest against their status of “assistant practitioner,” imposed by recent legislation. They claim that the new law also restricts their work to poorly paid and precarious jobs in public hospitals.

These so called “foreign” doctors are also protesting against a recent ruling that requires them to take aptitude tests similar to those required of full time hospital doctors. Only those doctors who have practised for at least three years will be admitted for testing, and even if they pass the test they …
DIAGNOSTIC VALUE OF LEFT VENTRICULAR FUNCTION OF POST-STRESS AND AT REST IN THE DETECTION OF MULTI-VESSEL CORONARY ARTERY DISEASE AS ASSESSED BY LOW-DOSE PROTOCOL USING CADMIUM-ZINC-TELLURIDE CAMERA
Authors: Satoshi Hida, Taishiro Chikamori, Hirokazu Tanaka, Yuko Igarashi, Chie Shiba, Tetsushi Saito, Kimihiko Hirose, Yuka Otaki, Akira Yamashina
Journal: Journal of the American College of Cardiology (2015)
EFFECTS OF DABIGATRAN VERSUS WARFARIN IN RELATION TO LEFT VENTRICULAR HYPERTROPHY IN ATRIAL FIBRILLATION
Authors: Paolo Verdecchia, Giuseppe Di Pasquale, Gianpaolo Reboldi, Fabio Angeli, Giovanni Mazzotta, Martina Brueckmann, Eva Kleine, Lars Wallentin, Michael Ezekowitz, Salim Yusuf, Stuart Connolly
Journal: Journal of the American College of Cardiology (2016)
A memorable patient: Long ago, at another hospital
Authors: M. Choksey
Journal: BMJ (2002)

She was a vicar's wife in her 50s who had developed a sudden agonising headache. Her general practitioner diagnosed a subarachnoid haemorrhage, which was confirmed by computed tomography. Angiography revealed a right posterior communicating artery aneurysm. She remained well, and because of the risk of re-bleeding we decided to operate as soon as possible. My usual consultant anaesthetist was away on holiday, and a relatively junior (but experienced) registrar standing in. (The level of cover provided when seniors were away had long been a source of contention.)

From the outset conditions were difficult: she was tachycardic; the skull, bone edges, and extradural space bled profusely; the brain bulged. I complained that conditions …
Abstract 467: Bcl2A1 - an IFN-gamma dependent master switch for the function of CD11b+Gr-1high myeloid derived suppressor cells.
Authors: Lydia Haile, Jose Medina Echeverz, Fei Zhao, Jean-Yves Métais, Cynthia Dunbar, Firouzeh Korangy, Tim Greten
Journal: Cancer Research (2013)

Abstract Myeloid derived suppressor cells (MDSC) play a crucial role in suppression of immune responses in cancer and inflammation. Here, we describe differential IFN-γ/STAT1 dependent regulation of the suppressor function of CD11b+Gr-1high granulocytic and CD11b+Gr-1dull/int monocytic MDSC subsets. IFN-γ induced STAT1 phosphorylation in both MDSC subsets, which led to NOS2 expression in CD11b+Gr-1dull/int. monocytic MDSC and enhanced suppression of T cell proliferation. In sharp contrast, the suppressor function of CD11b+Gr-1high granulocytic MDSC was enhanced in the absence of IFN-γ using IFN-γR-/- MDSC or IFN-γ-/- effector cells, which led to upregulation of Bcl2a1 and improved survival of the granulocytic subpopulation during MDSC-T cell interaction. Likewise Bcl2a1 overexpression in CD11b+Gr-1high granulocytic MDSC supported their suppressor activity. Thus, depending on the local IFN-γ concentration, STAT1 regulates the function of MDSC subsets antithetically so that these two cell subpopulations can substitute each other and suppress antigen-specific T cell immunity. Citation Format: Lydia Haile, Jose Medina Echeverz, Fei Zhao, Jean-Yves Métais, Cynthia Dunbar, Firouzeh Korangy, Tim Greten. Bcl2A1 - an IFN-gamma dependent master switch for the function of CD11b+Gr-1high myeloid derived suppressor cells. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 467. doi:10.1158/1538-7445.AM2013-467
O67 COMORBID CONDITIONS ASSOCIATED WITH DECISION-MAKING REGARDING TREATING OR NOT TREATING CHRONIC HEPATITIS C IN A LARGE U.S. HEALTH MAINTENANCE ORGANIZATION
Authors: L.M. Nyberg, K.M. Chiang, Z. Li, A.H. Nyberg, Z.M. Younossi, T.C. Cheetham
Journal: Journal of Hepatology (2014)
ASSOCIATION OF MATRIX METALLOPROTEINASE 2 (MMP2) BASELINE PLASMA LEVEL WITH RESPONSE AND SURVIVAL AND CHANGE OVERTIME IN PATIENTS TREATED WITH BEVACIZUMAB FOR RECURRENT HIGH GRADE GLIOMA
Authors: O.-L. Chinot, F. Boudouresque, M. Barrie, M. Matta, C. Boucard, A. Loundou, D. Figarella-Branger, L. Ouafik, E. Tabouret
Journal: Neuro-Oncology (2014)

BACKGROUND: Predictive marker of bevacizumab activity is an unmet medical need. We evaluated predictive value of selected circulating prebiomarkers involved in neoangiogenesis and invasion on patient outcome in recurrent high grade glioma (HGG) treated with bevacizumab. METHODS: A set of eleven prebiomakers of interest (VEGF, VEGF-R2, bFGF, SDF1, PlGF, uPA, PAI1, MMP2, MMP7, MMP9, and adrenomedulline) were analyzed in plasma, using ELISA, at baseline and 2 weeks apart from bevacizumab initiation in a prospective cohort of 26 patients (Cohort1). Correlations were validated in a separate retrospective cohort (Cohort2;n = 50) and tested in cohort patients treated with cytotoxic agents without bevacizumab (Cohort3;n = 34). Dosages were correlated to objective response (OR), Progression-free survival (PFS), and overall survival (OS). In cohort 1, multiple time points were performed up to progression. Additionally MMP2 and MMP9 plasma levels were analyzed in patients with newly diagnosed GB, after surgery. Finally, MMP2 and 9 RNA were assessed in tumor tissue of a separated group of paired newly diagnosed and recurrent GB (n = 29). RESULTS: In cohort1, high MMP2 baseline level was associated to a probability of OR of 83.3% versus 15.4% in case of low MMP2 level (p = 0.001). In multivariate analysis, baseline level of MMP2 correlated with PFS (hazard-ratio(HR), 3.92; 95% confidence-interval(CI):1.46-10.52; p = 0.007) and OS (HR, 4.62; 95%CI 1.58-13.53; p = 0.005), as decrease of VEGF (p = 0.038 for PFS and p = 0.013 for OS) and MMP9 (p = 0.016 for PFS and p= 0.025 for OS). In cohort2, MMP2, but not MMP9, confirmed its predictive significance. In cohort3, no association was found between MMP2, MMP9 and outcome. In cohort 1, significant changes in MMP2 and MMP9 plasma levels were observed during treatment. MMP2 increased after Bev initiation (p = 0.002), and decreased at progression (p = 0.002) while MMP9 initially decreased (p = 0.007) then increased at progression (p = 0.031). No significant difference was observed both for plasma level and tissue RNA expression between newly diagnosed and recurrent GB. CONCLUSIONS: In patients with recurrent HGG treated with bevacizumab, but not with cytotoxic agent, high MMP2 plasma levels are associated with prolonged tumor control and survival, while changes over time may reflect tumor control. Comparison of MMP2/MMP9 levels between initial diagnosis and recurrence may suggest that bevacizumab could be similarly effective in this two setting. MMP2 should be tested in randomized clinical trials that evaluate bevacizumab efficacy, and its biological role reassessed. SECONDARY CATEGORY: Clinical Neuro-Oncology.
Treatment Results of 54 American Patients with Burkitt's Lymphoma Are Similar to the African Experience
Authors: John L. Ziegler
Journal: New England Journal of Medicine (1977)

Burkitt's lymphoma in Africa may be curable by chemotherapy alone; in nonendemic regions results are reportedly less favorable. Fifty-four Americans with Burkitt's lymphoma were treated with two sequential combined treatment regimens that incorporated therapeutic approaches from clinical trials in Africa. Four patients died during induction therapy, and 48 of the remaining 50 achieved complete remissions. Twenty-two relapsed at a median of three months from the start of therapy. The overall two-year actuarial survival was 54 per cent: younger patients (<12 years old) and patients with minimal tumor burden (stages A, B and AR) had significantly better survivals than older patients (P<0.02) and patients with advanced abdominal tumors (stages C and D) (P<0.01). No differences in survival were detected between patients treated at the National Institutes of Health and those treated in their regional institutions on either protocol. Complete response rates, relapse frequency and survival in American patients are similar to results in Africa. (N Engl J Med 297:75–80, 1977)
Central European Countries Find Communism Was No Bloc To Cancer
Authors: K. Smigel
Journal: JNCI Journal of the National Cancer Institute (1992)

Journal Article Central European Countries Find Communism Was No Bloc To Cancer Get access Kara Smigel Kara Smigel Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 84, Issue 8, 15 April 1992, Pages 566–569, https://doi.org/10.1093/jnci/84.8.566 Published: 15 April 1992
Management of Urinary Tract Infections in Adults
Authors: Jane F. Desforges, Walter E. Stamm, Thomas M. Hooton
Journal: New England Journal of Medicine (1993)

Urinary tract infections account for more than 7 million visits to physicians' offices and necessitate or complicate well over 1 million hospital admissions in the United States annually1,2. It is helpful to categorize adult patients with urinary infection into five groups: young women with acute uncomplicated cystitis, young women with recurrent cystitis, young women with acute uncomplicated pyelonephritis, all adults with complicated urinary infection, and all adults with asymptomatic bacteriuria. This review will highlight recent advances in the treatment of patients in each of these categories, emphasizing cost-effective strategies that may be particularly important in the coming era . . .