nils-herrmann/clean_scirepeval huggingface dataset:
Outcomes of Lung Transplantation in Patients with Scleroderma

Patients with pulmonary insufficiency due to scleroderma have long been considered suboptimal candidates for lung transplantation. This has been supported by small single-center experiences that did not reflect the entire U.S. experience. We sought to evaluate the outcome of patients with scleroderma who underwent lung transplantation. We conducted a retrospective review of 47 patients with scleroderma who underwent lung transplantation at 23 U.S. centers between 1987 and 2004 and were reported to the United Network for Organ Sharing. Women constituted 57% of the patients. The mean age was 46 years. Twenty-seven patients received single lung transplants (57%), and the remaining received double lung transplants. The mean cold ischemia time was 4.1 hours. There were 7 early deaths (≤30 days) and 17 late deaths (> 30 days). The causes of early death were primary graft failure and a cardiac event in two patients each and bacterial infection and stroke in one patient each. Late mortality was due to infection in seven patients, respiratory failure in three, malignancy in two, and multisystem organ failure, rejection, pulmonary hypertension, and a cardiac event in one patient each. The causes of early and late death were not recorded for two patients. One patient received a second transplant owing to graft failure of the first. Twenty-three patients (49%) were alive at a mean follow-up of 24 months. The Kaplan-Meier 1- and 3-year survival rates were 67.6% and 45.9% respectively, which are not significantly different from those of 10,070 patients given transplants for other lung conditions during the same period (75.5% and 58.8% respectively, P = 0.25). Donor gender, recipient’s age, and type of transplant did not affect survival. In carefully selected patients with scleroderma who have end-stage lung disease, lung transplantation is a valid life-saving therapeutic option. Available data suggest acceptable short-term morbidity and mortality and a long-term survival similar to that of patients given transplants for other lung conditions.
Evidence for opioid modulation and generation of prostaglandins in sulphur dioxide (SO)2-induced bronchoconstriction.

Inhalation of sulphur dioxide (SO2) provokes bronchoconstriction in asthmatic subjects. Cholinergic mechanisms contribute, but other mechanisms remain undefined. The effect of morphine, an opioid agonist, on the cholinergic component of SO2-induced bronchoconstriction was investigated, and the effect of indomethacin, a cyclooxygenase inhibitor, on SO2-induced bronchoconstriction and tachyphylaxis was studied.



In the first study 16 asthmatic subjects inhaled either ipratropium bromide or placebo 60 minutes before an SO2 challenge on days 1 and 2. On day 3 an SO2 challenge was performed immediately after intravenous morphine. In the second study 15 asthmatic subjects took either placebo or indomethacin for three days before each study day when two SO2 challenges were performed 30 minutes apart. The response was measured as the cumulative dose causing a 35% fall in specific airways conductance (sGaw; PDsGaw35).



Ipratropium bromide significantly inhibited SO2 responsiveness, reducing PDsGaw35 by 0.89 (95% CI 0.46 to 1.31) doubling doses. This effect persisted after correction for bronchodilatation induced by ipratropium bromide. The effect of ipratropium bromide and morphine on SO2 responsiveness also correlated (r2 = 0.71). In the second study SO2 tachyphylaxis developed with PDsGaw35 on repeated testing, being reduced by 0.62 (95% CI 0.17 to 1.07) doubling doses. Indomethacin attenuated baseline SO2 responsiveness, increasing PDsGaw35 by 0.5 (95% CI 0.06 to 0.93) doubling doses.



These results suggest that opioids modulate the cholinergic component of SO2 responsiveness and that cyclooxygenase products contribute to the immediate response to SO2.
Timing of levothyroxine administration affects serum thyrotropin concentration.

Patients treated with levothyroxine typically ingest it in a fasting state to prevent food impairing its absorption. The serum thyrotropin concentration is the therapeutic index of levothyroxine action.



The study objective was to determine the effect of the timing of levothyroxine administration in relationship to food on serum thyrotropin levels.



Participants were randomized to one of six sequences, each consisting of three 8-wk regimens in a three-period crossover design. These regimens were in a fasting state, at bedtime, and with breakfast. The concentrations of TSH, free T(4), and total T(3) during each of the three timing regimens were documented. The primary outcome was the difference between serum TSH concentrations under fasting conditions compared with concentrations during the other 8-wk regimens.



The study was conducted in an academic medical center.



Study participants were receiving levothyroxine for treatment of hypothyroidism or thyroid cancer.



Sixty-five patients completed the study. The mean thyrotropin concentration was 1.06 +/- 1.23 mIU/liter when levothyroxine was administered in the fasting state. When levothyroxine was taken with breakfast, the serum thyrotropin concentration was significantly higher (2.93 +/- 3.29 mIU/liter). When levothyroxine was taken at bedtime, the serum TSH concentration was also significantly higher (2.19 +/- 2.66 mIU/liter).



Nonfasting regimens of levothyroxine administration are associated with higher and more variable serum TSH concentrations. If a specific serum TSH goal is desired, thereby avoiding iatrogenic subclinical thyroid disease, then fasting ingestion of levothyroxine ensures that TSH concentrations remain within the narrowest target range.
An open trial on short-term Omeprazole therapy for gastric and duodenal ulcers

Omeprazole, a proton pump inhibitor, is a potent and long-acting gastric acid reducing agent. To assess its short-term efficacy and safety, 27 gastric ulcers (GU) and 40 duodenal ulcers (DU) in 64 patients were treated with 20 mg. Omeprazole was given once daily. At 2 weeks, the healing rate for gastric ulcers was 66% (18/27) and for duodenal ulcers, 78% (31/40). At 4 weeks, the healing rate was 85% and 95% for GU and DU, respectively. Pain relief was achieved after 2 weeks in 62% with GU and 61% in DU. There were no significant side effects noted during the treatment course. Omeprazole is effective and safe in the treatment of gastric and duodenal ulcers.
Patient characteristics, practice activities, and one-month outcomes for chronic, recurrent low-back pain treated by chiropractors and family medicine physicians: a practice-based feasibility study.

Chronic low-back pain is a significant public health problem for which few therapies are supported by predictable outcomes. In this report, practice activities and 1-month outcomes data are presented for 93 chiropractic patients and 45 medical patients with chronic, recurrent low-back pain.



A prospective, observational, community-based feasibility study involving chiropractors and family medicine physicians.



Forty private chiropractic clinics, the outpatient clinic of the Department of Family Medicine at Oregon Health Sciences University, and 5 other Portland area family medicine clinics.



The main outcome measures were pain severity, functional disability, sensory and affective pain quality at 1 month, and patient satisfaction assessed at 7 to 10 days and at 1 month.



Although differences were noted in age, sex, education, and employment, the patients were closely matched at baseline with respect to frequency, severity, and type of low-back pain and the psychosocial dimensions of general health. The treatment of choice for chiropractors was spinal manipulation and physical therapy modalities; for medical physicians antiinflammatory agents were most frequently used. Chiropractic patients averaged 4 visits, and medical patients averaged 1 visit. On average, chiropractic patients showed improvement across all outcomes: 31% change in pain severity, 29% in functional disability, 36% in sensory pain quality, and 57% in affective pain quality. Medical patients showed minimal improvement in pain severity (6%) and functional disability (1%) and showed deterioration in the sensory (29%) and affective (26%) dimensions of pain quality. Satisfaction scores were higher for chiropractic patients. Outcomes for medical patients were heavily dependent on psychosocial status at baseline.



Patients with chronic low-back pain treated by chiropractors show greater improvement and satisfaction at 1 month than patients treated by family physicians. Nonclinical factors may play an important role in patient progress. Findings from the Health Resources and Services Administration-funded project will include a report on the influence of practice activities, including more frequent visits by chiropractic patients, on the clinical course of low-back pain and patient outcomes.
Isolated aortic valve replacement in octogenarians before and after the introduction of trans-catheter aortic valve implantation.

Trans-catheter aortic valve implantation (TAVI) became available at Auckland City Hospital in 2011 for patients with severe aortic stenosis in whom surgical aortic valve replacement (AVR) was deemed at high risk. We assessed whether introduction of TAVI affected the characteristics and outcomes of octogenarians undergoing AVR.



Isolated AVR performed in patients ≥80 years of age during 2008-2012 were divided into two groups, pre- and post-TAVI introduction, for analyses.



Isolated AVR was undertaken in 35 and 33 octogenarians pre- and post-TAVI introduction. The post-TAVI group were older (84.2 vs 82.3 years, P=0.003), had lower ejection fraction (P=0.026), more had inpatient surgery (76% vs 29%, P<0.001), with higher EuroSCORE II (5.4 vs 3.9%, P=0.033). Operative mortality was 0.0% in both groups. One-year survival was similar (97.6% vs 94.3%, P=0.613), but composite morbidity was lower in the post-TAVI group (9.1% vs 31.4%, P=0.035). Chronic respiratory disease (P=0.043) independently predicted mortality during follow-up, while number of coronary vessel>50% stenosis (P=0.050), creatinine clearance (P=0.016) and being in the pre-TAVI era group (P=0.022) predicted composite morbidity.



Since TAVI was introduced, mean age and risk scores significantly increased in octogenarians undergoing AVR, while mortality rates remained similar and composite morbidity decreased.
Endogenous Opioid Activity Is Associated with Obsessive-Compulsive Symptomology in Individuals with a Family History of Alcoholism

Endogenous opioid activity has been associated with the regulation of mood and inhibition of the hypothalamic-pituitary-adrenal (HPA) axis. We assessed differences in psychological symptomology and naloxone sensitivity in non-alcoholic males and females with a family history of alcoholism (FHP) and without a family history of alcoholism (FHN). This was followed by assessment of the association between naloxone sensitivity and psychological symptomology. Psychological symptomology was measured using the Revised Symptom Checklist (SCL-90-R) during enrollment. Adrenocorticotropin was measured following intravenous administration of naloxone/placebo. FHP males reported more obsessive-compulsive symptomology as well as increased sensitivity to naloxone relative to other groups. A positive association was observed between degree of obsessive-compulsive symptomology and naloxone sensitivity, and the association was strongest among FHP males. These findings suggest that the increased risk of alcoholism in FHP subjects (especially males) may be associated with altered opioid activity, which is expressed through an elevated level of obsessive compulsive symptomology.
Ethnic differences in ST height in the multiethnic study of atherosclerosis.

ST elevation in precordial leads has been associated with genetic syndromes of arrhythmias and sudden death. ST height data in different ethnic groups are limited.



ST height was determined in 4612 African-American, Chinese, Hispanic, and non-Hispanic white men and women aged 45-84 years in the Multiethnic Study of Atherosclerosis (MESA). For leads I, II, and V(1) to V(6,) ST height, measured at the J point and 60 ms after the J point, adjusted for covariates were compared between non-Hispanic white and other ethnic groups using analysis of covariance (ANCOVA).



Among men, ST height was significantly different across all ethnic groups at both time points for all leads (P < 0.01), except at the J point for limb lead II (P = 0.2). Among women, differences were also significant at the J point and 60 ms past the J point (P < 0.01). ST height was lowest for non-Hispanic whites in all leads and at both time points. At the J point, Chinese had the highest ST height for leads V(1) and V(2), whereas African Americans had the greatest ST height for leads I and V(3) to V(6). At 60 ms past the J point, Chinese men had the greatest ST height for lead I and V(1) to V(6;) and Chinese women had greatest ST height for leads V(1) to V(3).



There were significant differences in ST height among ethnic groups in all ECG leads. The physiological mechanisms and clinical significance of these differences and the possible association with arrhythmias require further study.
Static platelet adhesion, flow cytometry and serum TXB2 levels for monitoring platelet inhibiting treatment with ASA and clopidogrel in coronary artery disease: a randomised cross-over study

Despite the use of anti-platelet agents such as acetylsalicylic acid (ASA) and clopidogrel in coronary heart disease, some patients continue to suffer from atherothrombosis. This has stimulated development of platelet function assays to monitor treatment effects. However, it is still not recommended to change treatment based on results from platelet function assays. This study aimed to evaluate the capacity of a static platelet adhesion assay to detect platelet inhibiting effects of ASA and clopidogrel. The adhesion assay measures several aspects of platelet adhesion simultaneously, which increases the probability of finding conditions sensitive for anti-platelet treatment. With a randomised cross-over design we evaluated the anti-platelet effects of ASA combined with clopidogrel as well as monotherapy with either drug alone in 29 patients with a recent acute coronary syndrome. Also, 29 matched healthy controls were included to evaluate intra-individual variability over time. Platelet function was measured by flow cytometry, serum thromboxane B2 (TXB2)-levels and by static platelet adhesion to different protein surfaces. The results were subjected to Principal Component Analysis followed by ANOVA, t-tests and linear regression analysis. The majority of platelet adhesion measures were reproducible in controls over time denoting that the assay can monitor platelet activity. Adenosine 5'-diphosphate (ADP)-induced platelet adhesion decreased significantly upon treatment with clopidogrel compared to ASA. Flow cytometric measurements showed the same pattern (r2 = 0.49). In opposite, TXB2-levels decreased with ASA compared to clopidogrel. Serum TXB2 and ADP-induced platelet activation could both be regarded as direct measures of the pharmacodynamic effects of ASA and clopidogrel respectively. Indirect pharmacodynamic measures such as adhesion to albumin induced by various soluble activators as well as SFLLRN-induced activation measured by flow cytometry were lower for clopidogrel compared to ASA. Furthermore, adhesion to collagen was lower for ASA and clopidogrel combined compared with either drug alone. The indirect pharmacodynamic measures of the effects of ASA and clopidogrel might be used together with ADP-induced activation and serum TXB2 for evaluation of anti-platelet treatment. This should be further evaluated in future clinical studies where screening opportunities with the adhesion assay will be optimised towards increased sensitivity to anti-platelet treatment.
Characterization of spinal subarachnoid bleeding associated to graded traumatic spinal cord injury in the rat

Observational study in rats subjected to traumatic spinal cord injury (To describe the features of spinal subarachnoid bleeding (SSB) occurring after graded SCI. SSB after SCI has been reported previously, but has not been studied systematically despite the fact that cerebral subarachnoid bleeding often produces severe neurological damage.Mexico.Anesthetized rats were subjected to mild or severe spinal cord contusion at T9. Occurrence, size, progression and location of SSB were characterized morphologically and scored from T7–T12 at 1 h and 1, 3 and 7 days post injury. Besides, contusions were videotaped to visualize bleeding at the moment of impact.SSB started immediately after contusion (severe or mild) and decreased gradually over time. For all vertebral segments, at all time points examined by histology, 48% of areas scored after severe contusion showed bleeding: 25% minor, 17% moderate and 6% major. After mild contusion, only 15% showed bleeding: 13 minor and 2% moderate. Maximum bleeding occurred early after injury in dorsal area of the epicenter in 100% of severe contusions (6% minor, 38 moderate and 56% major), and in 69% of mild contusions (63 minor and 6% moderate).Conclusion:Here, we detail SSB patterns occurring after graded SCI. Further studies are warranted to elucidate the possible role extramedullary events, such as SSB, in the pathophysiology of SCI that might encourage the development of new strategies for its management.
Field-To-Frame Transcoding with Spatial and Temporal Downsampling

We present an algorithm for transcoding high-rate compressed bitstreams containing eld-coded interlaced video to lower-rate compressed bitstreams containing frame-coded progressive video. We focus on MPEG-2 to H.263 transcoding, however these results can be extended to other lowerrate video compression standards including MPEG-4 simple pro le and MPEG-1. A conventional approach to the transcoding problem involves decoding the input bitstream, spatially and temporally downsampling the decoded frames, and re-encoding the result. The proposed transcoder achieves improved performance by exploiting the details of the MPEG2 and H.263 compression standards when performing interlaced to progressive (or eld to frame) conversion with spatial downsampling and frame-rate reduction. The transcoder reduces the MPEG-2 decoding requirements by temporally downsampling the data at the bitstream level and reduces the H.263 encoding requirements by largely bypassing H.263 motion estimation by reusing the motion vectors and coding modes given in the input bitstream. In software implementations, the proposed approach achieved a 5x speedup over the conventional approach with only a 0.3 and 0.5 dB loss in PSNR for the Carousel and Bus sequences.
Treatment of Non-transplant patients with multiple myeloma: routine treatment by office-based haematologists in Germany--data from the prospective Tumour Registry Lymphatic Neoplasms (TLN).

Various treatment options exist for patients with multiple myeloma (MM). Clinical registries provide insight into routine treatment and identify changes in treatment over time.



The Tumour Registry Lymphatic Neoplasms (TLN) prospectively collects data on the treatment of patients with lymphoid B cell neoplasms as administered by office-based haematologists in Germany. Data on patient and tumour characteristics, comorbidities, systemic treatments and outcome parameters are recorded.



371 non-transplant patients with MM were recruited between 2009 and 2011. At the start of first-line (second-line) treatment, the median age was 73 (75) years; 67% (74%) of the patients had stage III MM (classification of Durie and Salmon) and 19% (28%) had renal insufficiency. In the first line, 40% of the patients received bortezomib+melphalan+prednisone (VMP), 25% received bortezomib±dexamethasone (V±D) and 8% were treated with melphalan+prednisone+thalidomide (MPT). While use of bortezomib-based regimens increased from 67% (2009) to 85% (2011), use of melphalan-based regimens decreased from 68% to 48%. The overall objective response rate of treatment was 82%. In the second line, 34% of the patients received V±D and 16% lenalidomide+dexamethasone (LD).



Bortezomib-based regimens dominate the first- and second-line treatment of MM. Future analyses will investigate outcome data, e.g. effectiveness of bortezomib retherapy compared to other second-line treatments.
Organization and outcomes of inpatient AIDS care.

To compare differences in AIDS patients' 30-day mortality and satisfaction with care in dedicated AIDS units, scattered-bed units in hospitals with and without dedicated AIDS units, and in magnet hospitals known to provide good nursing care.



Data were obtained on 1,205 consecutively admitted patients in 40 units in 20 hospitals and on 820 of their nurses.



Mortality was lower and satisfaction was higher for AIDS patients in dedicated AIDS units and in nursing magnet hospitals. Primary nursing, end-of-life care counseling, and discharge planning were also more common. Higher nurse to patient ratios and AIDS physician specialty services were strongly associated with lower mortality. Patient satisfaction was strongly associated with organizational control of care by bedside nurses. Homosexuals were more likely to be admitted to dedicated AIDS units, which largely explains the under-representation of minorities and women.



Dedicated AIDS units and magnet hospitals offer important benefits to AIDS patients, including lower odds on dying within 30 days of admission, higher patient satisfaction, and care meeting professional standards. Better nurse staffing, AIDS physician specialty services, and more organizational control by bedside nurses improve patient outcomes.
Adaptation and applicability of a diuretic algorithm for patients with heart failure.

Congestive states can be identified and managed through algorithms such as the Diuretic Treatment Algorithm (DTA) to adjust the diuretic over the telephone, focused on the clinical evaluation. However, the DTA is currently available only in English.



To adapt the DTA and test its applicability for Brazil in outpatients with heart failure.



The stages of translation, synthesis, back-translation, review by an expert committee, and pre-test (clinical applicability by means of a random clinical trial) were followed. The Brazilian version of the DTA was called algoritmo de ajuste de diurético (AAD; as per its acronym in Portuguese, standing for diuretic adjustment algorithm). Patients were randomized to the intervention group (IG) - diuretic adjustment according to the AAD - or control group (CG) - conventional adjustment. The clinical congestion score (CCS) and weight values were obtained for both groups.



A total of 12 changes were made to the DTA. Thirty-four patients were included. For those with congestion, the increase in the diuretic as guided by the AAD solved their condition, reducing the CCS by two points for 50% of the sample -2 (-3.5; -1.0), while the median for the CG was 0 (-1.25; -1.0), (p < 0.001). The median for weight variation was greater in IG -1.4 (-1.7; -0.5) compared to the CG 0.1 (1.2; -0.6), p = 0.001.



The AAD proved applicable in clinical practice after adaption and appears to result in better congestion management in patients with heart failure. The clinical effectiveness of the tool should be tested in a larger patient sample aiming at validating the instrument for Brazil.