tbuckley/cabot-search huggingface dataset:
Treatment for Cerebral Toxoplasmosis Protects against <i>Pneumocystis carinii</i> Pneumonia in Patients with AIDS
Authors: Alison Heald, Markus Flepp, Jean-Philippe Chave, Raffaele Malinverni, Sigmund Rüttimann, Victor Gabriel, Catherine Renold, Aviva Sugar, Bernard Hirschel
Journal: Annals of Internal Medicine (1991)

Objective: To determine whether long-term maintenance treatment for toxoplasmosis protects against Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome (AIDS). Design: Cohort study. Setting: Switzerland. Patients: A total of 453 patients with human immunodeficiency virus (HIV) entered the Swiss HIV Cohort Study. Ninety-nine patients with cerebral toxoplasmosis but no previous or simultaneous P. carinii pneumonia were compared with 240 patients with AIDS and other severe opportunistic infections (Centers for Disease Control [CDC] stage IVC1 infection other than toxoplasmosis and P. carinii pneumonia) as well as with 114 patients receiving inhaled pentamidine in a study of primary pneumocystis prophylaxis in patients infected with HIV. Measurements: Life-table analysis for P. carinii-free survival. Main Results: Six of 99 (6%) patients with toxoplasmosis, 50 of 240 (21%) patients with other severe opportunistic infections, and 8 of 114 (6%) patients receiving inhaled pentamidine developed P. carinii pneumonia. Life-table analysis showed that the incidence of pneumonia was substantially lower in patients with toxoplasmosis compared with that in patients with other severe opportunistic infections and was similar to the incidence in patients receiving pentamidine as prophylaxis. Analysis of the medication records from patients with toxoplasmosis showed that pyrimethamine and sulfonamides were administered 50% of the time; pyrimethamine and clindamycin, 25% of the time; and pyrimethamine alone, 9.9% of the time but that only one of the six patients with toxoplasmosis who developed P. carinii pneumonia received pyrimethamine and sulfonamides in the month before diagnosis. Conclusion: Patients with cerebral toxoplasmosis have a low risk for subsequently developing P. carinii pneumonia. This decreased risk is probably the result of chronic suppressive treatment with pyrimethamine and sulfonamides.
Estimating the Population Prevalence of Diagnosed and Undiagnosed Diabetes
Authors: Aaron Leong, Kaberi Dasgupta, Jean-Louis Chiasson, Elham Rahme
Journal: Diabetes Care (2013)

Health administrative data are frequently used for diabetes surveillance, but validation studies are limited, and undiagnosed diabetes has not been considered in previous studies. We compared the test properties of an administrative definition with self-reported diabetes and estimated prevalence of undiagnosed diabetes by measuring glucose levels in mailed-in capillary blood samples.A stratified random sample of 6,247 individuals (Quebec province) was surveyed by telephone and asked to mail in fasting blood samples on filter paper to a central laboratory. An administrative definition was applied (two physician claims or one hospitalization for diabetes within a 2-year period) and compared with self-reported diabetes alone and with self-reported diabetes or elevated blood glucose level (≥7 mmol/L). Population-level prevalence was estimated with the use of the administrative definition corrected for its sensitivity and specificity.Compared with self-reported diabetes, sensitivity and specificity were 84.3% (95% CI 79.3-88.5%) and 97.9% (97.4-98.4%), respectively. Compared with diabetes by self-report and/or glucose testing, sensitivity was lower at 58.2% (52.2-64.6%), whereas specificity was similar at 98.7% (98.0-99.3%). Adjusted for sampling weights, population-level prevalence of physician-diagnosed diabetes was 7.2% (6.3-8.0%). Prevalence of total diabetes (physician-diagnosed and undiagnosed) was 13.4% (11.7-15.0%), indicating that ∼40% of diabetes cases are undiagnosed.A substantial proportion of diabetes cases are missed by surveillance methods that use health administrative databases. This finding is concerning because individuals with undiagnosed diabetes are likely to have a delay in treatment and, thus, a higher risk for diabetes-related complications.
Serious eye injuries due to war games
Authors: S J Morgan
Journal: BMJ (1989)

turbance of higher cerebral function, which together suggest extensive ischaemia in the distri- bution of the carotid artery.This pattern was present in case 2 reported by Koudstaal et al; their case 1 may have lacked the hemianopia.Patho- logical evidence suggests that occlusion of the internal carotid or middle cerebral artery, or both, is usually necessary to cause such extensive ischaemia.The case fatality rate at 30 days for patients with this syndrome was 37% (27 of 73) compared with only 10% for all types of cerebral infarction combined.The direct neurological sequelae of the stroke, transtentorial herniation, caused seven deaths.Thus from the calculation used by Koudstaal et al the risk of two consecutive patients dying in this way would be one in 109.A further 16 (59%) deaths, however, occurred from complications of immobility, such as pneumonia, pulmonary embolism, and sepsis.When the sur- vivors were assessed one year after their stroke fewer than 10% were capable of independent existence.These data suggest that a group of patients who are at high risk of death or serious disability can be identified rapidly using simple clinical criteria; this will be necessary if thrombolytic treatment is to be given to patients so early that their computed tomograms will show no evidence of infarction.The data also show that when larger numbers of patients are studied, preferably in randomised controlled trials, functional assessment of the survivors will be as important an outcome measure as simple survival.
Effects of Continuous Positive Airway Pressure on Cardiovascular Outcomes in Heart Failure Patients With and Without Cheyne-Stokes Respiration
Authors: Don D. Sin, Alexander G. Logan, Fabia S. Fitzgerald, Peter P. Liu, T. Douglas Bradley
Journal: Circulation (2000)

Background —Continuous positive airway pressure (CPAP) improves cardiac function in patients with congestive heart failure (CHF) who also have Cheyne-Stokes respiration and central sleep apnea (CSR-CSA). However, the effects of CPAP in CHF patients without CSR-CSA have not been tested, and the long-term effects of this treatment on clinical cardiovascular outcomes are unknown. Methods and Results —We conducted a randomized, controlled trial in which 66 patients with CHF (29 with and 37 without CSR-CSA) were randomized to either a group that received CPAP nightly or to a control group. Change in left ventricular ejection fraction (LVEF) from baseline to 3 months and the combined mortality-cardiac transplantation rate over the median 2.2-year follow-up period were compared between the CPAP-treated and control groups. For the entire group of patients, CPAP had no significant effect on LVEF, but it was associated with a 60% relative risk reduction (95% confidence interval, 2% to 64%) in mortality–cardiac transplantation rate in patients who complied with CPAP therapy. Stratified analysis of patients with and without CSR-CSA revealed that those with CSR-CSA experienced both a significant improvement in LVEF at 3 months and a relative risk reduction of 81% (95% confidence interval, 26% to 95%) in the mortality–cardiac transplantation rate of those who used CPAP. CPAP had no significant effect on either of these outcomes in patients without CSR-CSA. Conclusions —CPAP improves cardiac function in CHF patients with CSR-CSA but not in those without it. Although not definitive, our findings also suggest that CPAP can reduce the combined mortality–cardiac transplantation rate in those CHF patients with CSR-CSA who comply with therapy.
Are delusions biologically adaptive? Salvaging the doxastic shear pin
Authors: Aaron L. Mishara, Phil Corlett
Journal: Behavioral and Brain Sciences (2009)

Abstract In their target article, McKay &amp; Dennett (M&amp;D) conclude that only “positive illusions” are adaptive misbeliefs. Relying on overly strict conceptual schisms (deficit vs. motivational, functional vs. organic, perception vs. belief), they prematurely discount delusions as biologically adaptive. In contrast to their view that “motivation” plays a psychological but not a biological function in a two-factor model of the forming and maintenance of delusions, we propose a single impairment in prediction-error–driven (i.e., motivational) learning in three stages in which delusions play a biologically adaptive role.
Increased regional myocardial stiffness of the left ventricle during pacing-induced angina in man.
Authors: P D Bourdillon, B H Lorell, I Mirsky, W J Paulus, J Wynne, W Grossman
Journal: Circulation (1983)

The left ventricular diastolic pressure-volume relationship shifts upward during angina, but why this happens is not known. To assess regional myocardial stiffness, we studied 12 patients who had coronary artery disease using simultaneous left ventricular micromanometer pressure recording and M-mode echocardiography before and during angina induced by pacing tachycardia. All patients had two- or three-vessel coronary artery disease that involved the posterior left ventricular wall circulation and had positive pacing stress tests, i.e., development of angina and a postpacing rise in left ventricular end-diastolic pressure (15 +/- 3 to 31 +/- 6 mm Hg, p less than 0.001). A marked upward shift in the relationship between the diastolic left ventricular pressure and the posterior wall thickness (h) occurred after pacing tachycardia, but the change in left ventricular posterior wall end-diastolic thickness was minimal (8.9 +/- 2.1 to 9.2 +/- 2.1 mm, NS). After pacing, the peak rate of left ventricular posterior wall thinning decreased (82 +/- 37 to 48 +/- 27 mm/sec, p less than 0.005) and the time constant of relaxation derived from the best exponential fit to the isovolumic left ventricular pressure decay increased (49 +/- 5 to 58 +/- 7 msec, p less than 0.001). Diastolic active left ventricular pressure decay, extrapolated from the exponential fit, was subtracted from the measured left ventricular pressure (which is equal in magnitude but opposite in sign to the radial stress at the endocardium) to calculate residual left ventricular pressure (PR) and hence residual stress (sigma R = -PR). A radial stiffness modulus (ER) was determined by the slope of the PR vs log h plots before and after pacing. Over the same range of residual radial stress (sigma R), ER was always higher during pacing-induced angina, indicating increased residual myocardial stiffness. Increased myocardial stiffness in addition to a decreased rate of wall thinning and slow active pressure decay contribute to the upward shift in left ventricular pressure-wall thickness and pressure-volume relationships during pacing-induced angina.
Microcomputer system in an accident unit.
Authors: D M Clarkson, R H Gray, D H Jones, P H Smith, I W Jones
Journal: BMJ (1982)

A microcomputer-based records system has been developed for use in the accident unit of a district general hospital. Patient details are entered directly at the reception desk and the computer generates a casualty card that is updated after the patient has been seen by the doctor, who determines the diagnosis to be recorded and specifies the injury coding. Information is stored on floppy discs, each holding the details of 3400 patients. The computer is used to produce a daily log-book of attendances, including revisits. The stored data may be examined and analysed for both administrative and medical purposes. The work load can be rapidly analysed according to various options that include the nature, type, and site of injuries. The system was introduced in December 1980. Location within the unit allows control over its operation, and many of the limitations of a manual system have been overcome.
Sputum E-cadherin and asthma severity
Authors: Kuniko Masuyama, Yuko Morishima, Yukio Ishii, Akihiro Nomura, Tohru Sakamoto, Toru Kimura, Mie Mochizuki, Yoshiyuki Uchida, Kiyohisa Sekizawa
Journal: Journal of Allergy and Clinical Immunology (2003)
Cigarette smoke inhibition of ion transport in canine tracheal epithelium.
Authors: M J Welsh
Journal: Journal of Clinical Investigation (1983)

Inhalation of cigarette smoke is known to impair pulmonary mucociliary clearance. Active ion transport by airway epithelium plays an important role in maintaining effective mucociliary clearance by regulating the volume and composition of the airway secretions. To determine the effect of cigarette smoke on airway epithelial ion transport, the electrical properties and transepithelial Na and Cl fluxes were measured in canine tracheal epithelium. In vivo, the inhalation of the smoke from one cigarette acutely and reversibly decreased the electrical potential difference across the tracheal epithelium. In vitro, exposure of the mucosal surface of the epithelium to cigarette smoke decreased the short circuit current and transepithelial resistance. The decrease in short circuit current was due to an inhibition of the rate of Cl secretion with minimal effect on the rate of Na absorption. The effect of cigarette smoke was reversible, was not observed upon exposure of the submucosal surface to smoke, and was most pronounced when secretion was stimulated. The particulate phase of smoke was largely responsible for the inhibitory effect, since filtering the smoke minimized the effect. The effect of cigarette smoke was not prevented by addition of antioxidants to the bathing solutions, suggesting that the inhibition of Cl secretion cannot be entirely attributed to an oxidant mechanism. These results indicate that cigarette smoke acutely inhibits active ion transport by tracheal epithelium, both in vivo and in vitro. This effect may explain, in part, both the abnormal mucociliary clearance and the airway disease observed in cigarette smokers.
"Settling the UGDP Controversy"?
Authors: Robert F. Bradley
Journal: JAMA (1975)

CALLING it the "UGDP controversy" is an understatement. Unquestionably, the study itself triggered lively debate, but it was the prepublication extracting of supportive statements from the American Diabetes Association,<sup>1</sup>the American Medical Association,<sup>2</sup>the Food and Drug Administration (FDA),<sup>3</sup>and the press (<i>New York Times</i>, May 21, 1970;<i>Wall Street Journal</i>, May 21, 1970;<i>Washington Post</i>, May 22, 1970) that broadened the issue far beyond the implications of the University Group Diabetes Program (UGDP) itself. History now repeats itself, in that furor has again been created by reckless extrapolation of a small and temporary cardiovascular mortality trend observed in the UGDP to the entire diabetic population of the United States,<sup>4</sup>and by unilateral publicizing (AMA news release, Jan 27, 1975) of the controversy. The observations and comments that follow relate not only to the espoused biostatistical validity<sup>5</sup>of the original UGDP report,<sup>6</sup>but also
Statins and hepatic steatosis: Perspectives from the Dallas Heart Study
Authors: Jeffrey D. Browning
Journal: Hepatology (2006)

Non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease are independently associated. Due to the efficacy of 3-hydroxy 3-methylglutaryl-coenzyme A reductase inhibitors (statins) in the prevention of cardiovascular disease, increasing interest has been shown in establishing the safety of these drugs in NAFLD. In this study, the relationship between statin use, hepatic triglyceride content (HTGC), and serum alanine aminotransferase (ALT) levels was examined in 2,264 Dallas Heart Study participants who were using no lipid-lowering agent (n = 2,124) or using only a statin for lipid management (n = 140). Statin use was not associated with a greater frequency of hepatic steatosis (38% vs. 34%) or elevated serum ALT (15% vs. 13%) by a pair-matched analysis. Statin use was also not associated with a greater prevalence of elevated serum ALT among subjects with hepatic steatosis (n = 638). This finding persisted when controlling for possible sample bias as a result of current prescribing practices for statins. Among subjects with serum lipid abnormalities who were not using a statin, hepatic steatosis was present in 60% of those with mixed hyperlipidemia and 83% of those with both mixed hyperlipidemia and an elevated serum ALT. In conclusion, statin use was not associated with a higher frequency of hepatic steatosis or serum ALT abnormalities, even among those with hepatic steatosis. Individuals meeting criteria for statin therapy are likely to have coexistent hepatic steatosis. (HEPATOLOGY 2006;44:466–471.)
Multiple Considerations in Studying the CVA
Authors: Michael Scott
Journal: JAMA (1964)

<h3>To the Editor:—</h3> The study by Eisenberg et al on "Cerebrovascular Accidents" (<i>JAMA</i><b>189</b>:883 [Sept 21] 1964) is timely and informative. However, I question whether their diagnosis of embolism, hemorrhage, and "thrombosis" is exact, unless they obtained supportive information which was not published. I would like to know the percentage of patients with embolism who had had auricular fibrillation; the percentage of those with the diagnosis of hemorrhage who had proven bloody spinal fluid; and, finally, in what percentage of all the classifications was the diagnosis proven by cerebro-angiography, operation, or autopsy. The term "cerebral thrombosis" is used too loosely, since this diagnosis can only be made by gross and microscopic examination of the vessels. Perhaps a better designation would be "cerebrovascular occlusive disease of undetermined etiology" or "cerebrovascular insufficiency of undetermined etiology." The above comments do not detract from the general excellence of the survey and the information
Cellular association of antiproteases in lavages from ventilated preterm human neonates.
Authors: M Griese, M Schredl, K Hochstrasser, W Gebhard
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

Lung antiprotease activity is routinely assayed in the supernatant of bronchoalveolar lavage fluid (BALF). In this study the cellular fraction of lavages was also analyzed. Functionally active acid-resistant inhibitors with molecular masses characteristic of the mucus proteinase inhibitor (MPI, 14 kDa) and elastase-specific inhibitor (ESI, 7 kDa) were demonstrated by gel chromatography. Immunocytochemical studies of cells obtained at various postnatal time points from lavages of 10 premature infants with chronic lung disease showed that the inhibitors were confined to neutrophils and macrophages. At each time point, about 70% and 21% of these cells, respectively, stained positively. The polyclonal antibodies usually used to detect MPI did not distinguish between MPI and ESI. Because of this cross reactivity, it was not possible to differentiate between MPI and ESI. Analysis with reverse transcriptase-polymerase chain reaction (RT-PCR) of cells from lavages and of nucleated cells isolated from the peripheral blood showed the production of ESI only, but not of MPI. Nevertheless, MPI can associate with neutrophils and macrophages, as was shown in binding studies with the recombinant protein. These data suggest that when assaying bronchoalveolar lavages (BALs) for these antiproteases in the supernatant only, the total pool of inhibitors may be underestimated.
Use of nasal peak flow to assess nasal patency
Authors: S. B. Phagoo, R. A. Watson, N. B. Pride
Journal: Allergy (1997)

Nasal patency is usually assessed in the laboratory by measuring nasal airflow conductance ( Gnaw ); peak inspiratory and/or expiratory flow measurements via the nose (PIFna, PEFna) have been proposed as simple alternatives suitable for home monitoring of rhinitis. We have compared the scale of changes in PIFna and PEFna (measured with a pneumotachograph) with changes in Gnaw (measured by the forced‐oscillation technique) when nasal patency was increased by a topical α‐adrenergic agonist, xylometazoline (five control subjects, seven with seasonal rhinitis, studied when asymptomatic) or decreased by topical histamine (eight control subjects). In further experiments, we altered intrapulmonary airway calibre by having subjects inhale histamine or salbutamol aerosols and examined effects on the configuration of nasal flow‐volume curves (six subjects with rhinitis and mild asthma). After topical xylometazoline, there was a mean 283% increase in Gnaw 80% increase in PEFna, and 63% increase in PIFna. After topical histamine, there was a mean 72% decrease in Gnaw, 38% decrease in PEFna, and 39% decrease in PIFna. Inducing intrapulmonary airway obstruction sometimes obscured changes in nasal patency by removing the effects of added nasal resistance on expiration and preventing development of flow limitation in the nose on inspiration. Thus, after topical drug treatment to the nose, changes in Gnaw were considerably larger than in PEFna or PIFna, which were proportionately similar. Because PIFna is usually restricted by nasal flow limitation, it is probably superior to PEFna for assessing nasal patency. When effort is submaximal, intrapulmonary dynamic resistance is increased, or nasal dynamic resistance is low, PEFna and PIFna can give a misleading impression of nasal patency. These errors can be avoided by comparisons with mouth PEF and/or PIF, suggesting that nasal and mouth peak flow should both be measured during home monitoring.
Severe anaphylaxis due to passive sensitisation by donor blood.
Authors: R C Routledge, D M De Kretser, L D Wadsworth
Journal: BMJ (1976)

therapy.After a dose of viprynium with conventional purgation on the preceding day she was given whole-gut perfusion with piperazine added to the lavage solution in a dose of 0-25 g/l.Many dead threadworms were recovered.The patient remained symptom free for six months and no threadworms have since been identified in her stools. DiscussionWhole-gut perfusion is a safe, simple, and comfortable procedure in patients who are neither obstructed nor constipated.After 30 to 45 minutes of perfusion regular, comfortable bowel action is estab- lished.The stools soon become rice-water in type, indicating that nearly all faecal material has been evacuated.The treatment saves nursing time.It deserves wider use whenever thorough cleansing of the bowel is required or slowly absorbed poisons need to be rapidly evacuated.
CAROTID 2D STRAIN IS A NEW ECHOCARDIOGRAPHIC MEASURE OF ARTERIAL STIFFNESS IN BOTH CONTROLS AND HYPERTENSIVES
Authors: Kye Hun Kim, Donghan Kim, Ki Hong Lee, Hyun Ju Yoon, Young Joon Hong, Hyung Wook Park, Ju Han Kim, Young Keun Ahn, Myung Ho Jeong, Jeong-Gwan Cho, Jong Chun Park, Jung Chaee Kang
Journal: Journal of the American College of Cardiology (2012)