tbuckley/cabot-search huggingface dataset:
Asthma drug ratios and exacerbations: claims data from universal health coverage systems
Authors: Laurent Laforest, Idlir Licaj, Gilles Devouassoux, Gérard Chatte, Jennifer Martin, Eric Van Ganse
Journal: European Respiratory Journal (2014)

In claims data, controller-to-total asthma drug ratios may reflect adequacy of disease management. We verified whether asthma patients with high ratios (≥ 50%) experienced fewer asthma-related outcomes. Two ratios were studied: that of the inhaled corticosteroids to total asthma drug (ICS/R03) and that of the inhaled corticosteroids plus leukotriene antagonist receptors-to-total asthma drug (ICS+LTRA/R03). Patients aged 13-40 years, with ≥ 3 respiratory drugs dispensed prescriptions in 2005 were selected from the French national claims data. After excluding null ratios, two groups were defined according to ratio values in 2007: low-ratio group (0% < ratio < 50%) and high-ratio group (ratio ≥ 50%). For both ratios, asthma-related outcomes and medical-resource utilisation were compared between groups. Of 2162 patients (mean age 27 years and 52% female), patients with non-null ratios were 81% and 85% for ICS/R03 and ICS+LTRA/R03 ratios, respectively. Patients with high ratios were less likely to receive oral corticosteroids than those in the low-ratio group (relative risk 0.79, 95% CI 0.72-0.88, and 0.80, 95% CI 0.72-0.88, for ICS/R03 and ICS+LTRA/R03, respectively). High ratio groups also presented fewer asthma-related hospitalisations. Significant negative correlations were also observed for both ratios, when studied quantitatively, according to patients' dispensed level of oral corticosteroids in 2007. In claims data, both ICS/R03 and ICS+LTRA/R03 ≥ 50% were related to fewer asthma-related outcomes. Ratios should be explored to identify asthma patients at risk of exacerbations. Low ratios can be considered as risk factors of exacerbation whatever the underlying cause.
Comparison of oral feeding of peptide and amino acid meals to normal human subjects
Authors: D. B. A. Silk, Y. C. Chung, K. L. Berger, K. Conley, M. Beigler, M. H. Sleisenger, G. A. Spiller, Y. S. Kim
Journal: Gut (1979)

Intestinal perfusion studies performed in man have suggested that amino acid nitrogen may be absorbed more rapidly from peptides than free amino acids. The aim of the present study was to compare the effects of the oral administration of peptides and free amino acids. Two isonitrogenous liquid test meals, one containing 50 g of a partial enzymic hydrolysate of fish protein in which approximately 80% of the nitrogen content was present as small peptides (peptide meal), and the other a mixture of free amino acids (amino acid meal) the composition and molar pattern of which simulated that of the peptide meal, were administered on separate occasions to six normal subjects intubated with a triple lumen tube. Both meals contained the reference marker polyethylene glycol. Fractional absorption of amino acid residues one and two hours after ingestion of the two meals was similar at three intestinal locations situated 120, 160, and 200 cm from the mouth of each subject, and at two hours 73·8% and 72·0% of the amino acid residues had been absorbed respectively by the time the contents of the peptide and amino acid meals reached the middle sampling port of the tube. The total sum of individual amino acid increments in plasma was significantly greater 30 minutes (p &lt; 0·025) and one hour (p &lt; 0·05) after ingestion of the peptide than amino acid meals. By three hours the total area under the two plasma curves was similar. Normal human subjects thus appeared to be capable of assimilating orally administered mixtures of peptides and free amino acids with equal efficiency. Secretion of fluid into the lumen of the upper small intestine, assessed by reference to dilution of the polyethylene glycol, was less after ingestion of the peptide meal. In clinical situations characterised by fluid and electrolyte malabsorption consideration might be given to using small peptides rather than free amino acids as the nitrogen source in nutritional diets.
Scientists receive Nobel prize for unravelling secrets of smell
Authors: Geoff Watts
Journal: BMJ (2004)

As winners of the 2004 Nobel prize in physiology or medicine, Richard Axel and Linda Buck have a double claim to knowing more than most about the sweet smell of success. Cited by the Nobel Foundation “for their discoveries of odorant receptors and the organisation of the olfactory system,” the two researchers have done much to explain the workings of this least understood sense.

To humans, smell has long been less than essential. But for many animals, high and low, it is central to their interpretation of the world. Yet until …
Fasting Triglycerides, High-Density Lipoprotein, and Risk of Myocardial Infarction
Authors: J. Michael Gaziano, Charles H. Hennekens, Christopher J. O’Donnell, Jan L. Breslow, Julie E. Buring
Journal: Circulation (1997)

Background Recent data suggest that triglyceride-rich lipoproteins may play a role in atherogenesis. However, whether triglycerides, as a marker for these lipoproteins, represent an independent risk factor for coronary heart disease remains unclear, despite extensive research. Several methodological issues have limited the interpretability of the existing data. Methods and Results We examined the interrelationships of fasting triglycerides, other lipid parameters, and nonlipid risk factors with risk of myocardial infarction among 340 cases and an equal number of age-, sex-, and community-matched control subjects. Cases were men or women of &lt;76 years of age with no prior history of coronary disease who were discharged from one of six Boston area hospitals with the diagnosis of a confirmed myocardial infarction. In crude analyses, we observed a significant association of elevated fasting triglycerides with risk of myocardial infarction (relative risk [RR] in the highest compared with the lowest quartile=6.8; 95% confidence interval [CI]=3.8 to 12.1; P for trend &lt;.001). Results were not materially altered after control for nonlipid coronary risk factors. As expected, the relationship was attenuated after adjustment for HDL but remained statistically significant (RR in the highest quartile=2.7; 95% confidence interval [CI]=1.4 to 5.5; P for trend=.016). Furthermore, the ratio of triglycerides to HDL was a strong predictor of myocardial infarction (RR in the highest compared with the lowest quartile=16.0; 95% CI=7.7 to 33.1; P for trend &lt;.001). Conclusions Our data indicate that fasting triglycerides, as a marker for triglyceride-rich lipoproteins, may provide valuable information about the atherogenic potential of the lipoprotein profile, particularly when considered in context of HDL levels.
Abstract 2410: Development of a genetically-optimized whole tumor cell vaccine for ovarian cancer using HSV-derived glycoprotein D
Authors: Andrea R. Hagemann, Rachel Leskowitz, Gary H. Cohen, George Coukos, Daniel J. Powell
Journal: Cancer Research (2010)

Abstract Background: Dendritic cell (DC) vaccines offer a promising addition to standard treatment for ovarian cancer with surgery and chemotherapy. We have previously shown that treatment of whole tumor cells with replication-deficient herpes simplex virus (HSV) results in a potent, specific T-Cell response to ovarian tumors. We sought to improve vaccine efficiency by isolating and comparing two specific components of HSV-treated SK-OV-3-pulsed DCs: glycoprotein D (gD) and IL12p70. Methods: SK-OV-3 cells were treated with HSV1716 or transfected with HSV-1-derived gD engineered to express a similar amount of surface of gD. We further engineered these cells to express IL12p70 by lentiviral transduction. Theses cells were UVB-irradiated and pulsed with DCs. ELISA was used to measure the kinetics of the IL12p70 burst of each tumor-pulsed DC, as well as to compare the naïve, autologous lymphocyte priming responses of each cell line. Results: IL12p70 was increased 3-fold with gD-SKOV3 compared to HSV-SKOV3, while following the same kinetic curve (646 ± 45.2 pg/mL v. 234 ± 24.2 pg/mL; p &amp;lt;0.01). gD-SKOV3 also resulted in a 2-fold higher priming response. Both the IL12p70 burst and priming response were blocked by treatment of SKOV3-gD cells with an antibody to gD. With the addition of IL12 to these cells, SKOV3-gD, but not SKOV3-HSV cells, resulted in significantly higher and more prolonged IL12 burst than that of SKOV3-IL12 cells alone. Conclusions: Our in vitro results suggest a synergistic effect of IL12p70 and gD that is not seen with infection by intact HSV-1. We have isolated two key components from HSV, cytokine stimulation and gD-mediated blockade of immunosuppression, that in combination result in a more potent, specific immune response to ovarian cancer tumor cells. We can now utilize these key components to engineer a more efficient whole tumor cell vaccine for EOC. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2410.
Medical faculty members at different professorial levels
Authors: Student
Journal: BMJ (2005)

Medical faculty members at different professorial levelsStudent How can we recognise certain distinguishing features of professors at different levels?In academic medicine, the process of professorial promotion has previously proceeded in a predictable pattern.Senior faculty members have now become alarmed by the thought that a competency based approach might be applied to the world of academic medicine. 1 2The competencies and "metacompetencies" of senior faculty are complex and reflect such higher order thought processes that they cannot be meaningfully assessed by the demeaning use of superficial checklists.Given that a reductionist system of assessment may nevertheless be attempted, it might be useful to depict the general characteristics and competencies of medical faculty at different professorial ranks.While this snapshot relies on generalities and stereotypes, it at least allows an observer who is unfamiliar with the system to recognise certain distinguishing features of faculty at different levels.
Tetraplegia caused by gymnastics.
Authors: R F Evans
Journal: BMJ (1979)

constituents in the two groups was in exact proportion to the machine-smoked yields of the two types of product.This means that any long-term benefits from switching to a low-tar cigarette are better than the hitherto published short-term switching studies would suggestprovided that any dose-response relationship between "disease" and "tar" intake regresses toward zero, and cigarette consumption does not increase.
Resuscitation outside the Hospital — What's Lacking?
Authors: W. Douglas Weaver
Journal: New England Journal of Medicine (1991)

DESPITE the widespread implementation of emergency-resuscitation programs since the 1960s, only modest gains in the rate of successful resuscitation after cardiopulmonary arrest have been realized. Have we failed? Was the concept of resuscitation outside the hospital poorly conceived? Are treatments ineffective? To place these questions in their proper context, it is important to remember that before emergency medical care was available, cardiac arrest was almost always fatal, and that given the circumstances necessary for resuscitation to be successful, it is remarkable that anyone survives.The rationale for cardiac resuscitation outside the hospital is based on the fact that in most . . .
John Nettleton Warren
Authors: Robert Warren
Journal: BMJ (2005)

Former general practitioner Littlehampton and Arundel, Sussex (b Windermere 1905; q London 1930; DPM), d 4 March 2004.

After house jobs at the London Hospital, Whitechapel, he went into general practice in Sussex. He was a medical officer in the Home Guard during the second world war, course doctor at Fontwell and Goodwood racecourses, and he ran busy private and NHS practices. He was a keen gardener and enjoyed golf, shooting, racing, and the theatre until late in life. Predeceased by his wife, Mary, he leaves four sons and eight grandchildren.
Parenchymal, bronchiolar, and bronchial measurements in centrilobular emphysema: Relation to weight of right ventricle
Authors: J. Bignon, J. Andre-Bougaran, G. Brouet
Journal: Thorax (1970)

Measurements of lung parenchyma, membranous bronchioles, and bronchial mucous gland hyperplasia were made on lungs from eight cases of pure centrilobular emphysema (CLE) and on five normal lungs. The lungs were fixed in formalin and inflated under partial vacuum at a standard transpulmonary pressure of +30 cm. H<sub>2</sub>O. The results obtained from the upper halves and the lower halves of the lungs were compared. The circulatory effects of the disease were measured by weighing the heart ventricles, by studying the small pulmonary arteries in microscopical sections, and by post-mortem arteriography. Whereas the parenchymal and internal surface areas destroyed by the emphysematous spaces were relatively moderate and localized, right ventricular hypertrophy was noted in most of the cases. In these cases bronchiolar stenoses were found scattered throughout the whole lung and there was a reduction in the number of these bronchioles, mainly in the upper halves of the lungs. In CLE ventilatory disturbances were caused not only by the centriacinar dilated spaces delaying gas diffusion, but also by scattered bronchiolar stenoses situated at the termination of the conducting air passages. The stenoses seemed the more important cause. It was shown statistically that chronic arterial pulmonary hypertension and right ventricular hypertrophy were mainly the result of functional disturbances, especially hypoxia and abnormalities of VA/Q produced by the two structural changes situated at the end of the small airways.
261 Exclusion of subcapsular tumors prevents peritoneal seeding in hepatocellular carcinoma (HCC) patients treated with radiofrequency
Authors: F. Pons, M. Squarcia, R. Vilana, M. Sala, L. Bianchi, M.C. Ayuso, M. Varela, J.M. Llovet, C. Bru, J. Bruix
Journal: Journal of Hepatology (2004)
Differential Effects of Targeted Disruption of Thiopurine Methyltransferase on Mercaptopurine and Thioguanine Pharmacodynamics
Authors: Christine Hartford, Erick Vasquez, Matthias Schwab, Mathew J. Edick, Jerold E. Rehg, Gerard Grosveld, Ching-Hon Pui, William E. Evans, Mary V. Relling
Journal: Cancer Research (2007)

Abstract The recessive deficiency in thiopurine methyltransferase (TPMT), caused by germ-line polymorphisms in TPMT, can cause severe toxicity after mercaptopurine. However, the significance of heterozygosity and the effect of the polymorphism on thioguanine or in the absence of thiopurines is not known. To address these issues, we created a murine knockout of Tpmt. Pharmacokinetic and pharmacodynamic studies of mercaptopurine and thioguanine were done in Tpmt−/−, Tpmt+/−, and Tpmt+/+ mice and variables were compared among genotypes. Methylated thiopurine and thioguanine nucleotide metabolites differed among genotypes after treatment with mercaptopurine (P &amp;lt; 0.0001 and P = 0.044, respectively) and thioguanine (P = 0.011 and P = 0.002, respectively). Differences in toxicity among genotypes were more pronounced following treatment with 10 daily doses of mercaptopurine at 100 mg/kg/d (0%, 68%, and 100% 50-day survival; P = 0.0003) than with thioguanine at 5 mg/kg/d (0%, 33%, and 50% 15-day survival; P = 0.07) in the Tpmt−/−, Tpmt+/−, and Tpmt+/+ genotypes, respectively. Myelosuppression and weight loss exhibited a haploinsufficient phenotype after mercaptopurine, whereas haploinsufficiency was less prominent with thioguanine. In the absence of drug challenge, there was no apparent phenotype. The murine model recapitulates many clinical features of the human polymorphism; indicates that mercaptopurine is more affected by the TPMT polymorphism than thioguanine; and provides a preclinical system for establishing safer regimens of genetically influenced antileukemic drug therapy. [Cancer Res 2007;67(10):4965–72]
Effect of salcatonin given intranasally on bone mass and fracture rates in established osteoporosis: a dose-response study.
Authors: K. Overgaard, M. A. Hansen, S. B. Jensen, C. Christiansen
Journal: BMJ (1992)

To study the dose related response of salmon calcitonin (salcatonin) given intranasally on bone mass and bone turnover and the effect of salcatonin on rates of fracture in elderly women with moderate osteoporosis.Double blind, placebo controlled, randomised group comparison.Outpatient clinic for research into osteoporosis.208 healthy women aged 68-72 years who had a bone mineral content of the distal forearm on average 30% below the mean value for healthy premenopausal women.The 208 women were allocated randomly in blocks of four to two years of treatment with either salcatonin 50 IU, 100 IU, or 200 IU given intranasally or placebo. All groups received a calcium supplement of 500 mg. 32 of the women left the study before its end and 164 women complied with the study criteria throughout.Bone mineral content of the distal forearm and lumbar spine and rates of vertebral and peripheral fractures after two years of treatment.The average changes in bone mineral content of the spine showed positive outcomes of 1% (95% confidence interval -0.1% to 1.5%) in the group treated with calcium (placebo) and 3% (1.8% to 4.2%) in the group treated with salcatonin 200 IU. There was a significant dose related response to salcatonin, manifested by an increase of 1.0%/100 IU (0.2% to 1.7%, p = 0.008). The rate of patients with new fractures was reduced significantly in the women treated with salcatonin to about one third of that in the non-salcatonin treated women (relative risk 0.23 (0.07 to 0.77)).The results suggest that, compared with calcium alone, salcatonin given intranasally reduces the rates of fracture by two thirds in elderly women with moderate osteoporosis. Furthermore, it increases spinal bone mass in a dose dependent manner.
Psychiatric and social aspects of brittle asthma.
Authors: G M Garden, J G Ayres
Journal: Thorax (1993)

Many studies have shown that emotional factors play a part in asthma, but few have compared patients with differing severities of asthma. It was our impression that patients with "brittle" asthma (BA; more than 40% diurnal variation in peak flow on 15 or more days a month over a period of at least six months, and persistent symptoms despite multiple drug treatment) had greater psychosocial morbidity than asthmatic patients with less variable asthma.Twenty patients with BA and a control group of less severe asthmatic subjects matched for age, sex, and duration of illness were asked to complete the General Health Questionnaire (GHQ), a screening test for psychiatric disorders, the Eysenck Personality Inventory which measures extraversion and neuroticism, and to participate in a life events interview and a structured clinical interview (SCID) to diagnose psychiatric disorder.The mean (SD) age was 45.6 (12.3) years for the BA group, and 45.7 (13.1) years for the control group. All patients were receiving inhaled steroids and regular beta 2 agonists; nine patients with BA but no control patients were taking oral steroids, and 12 of the patients with BA but no controls were receiving beta 2 agonists by subcutaneous infusion or injection. Eight of the patients with BA scored more than 11 on the GHQ compared with five of the control group (NS). Significantly more subjects with BA (12/20) than controls (5/20) had intercurrent or past psychiatric disorder, and 7/20 subjects with BA had a lifetime history of anxiety disorder compared with 3/20 controls. Life events analysis showed no overall difference in the total number, but the patients with BA had significantly more life events related to asthma. There was no difference in personality profiles between the two groups.The results suggest that patients with "brittle" asthma have greater psychiatric morbidity than those with less severe asthma, but that their personality profiles and overall life event experiences are similar.
Cross-sectional echocardiographic diagnosis of coronary artery aneurysms in patients with the mucocutaneous lymph node syndrome.
Authors: J Yoshikawa, K Yanagihara, T Owaki, H Kato, Y Takagi, F Okumachi, T Fukaya, Y Tomita, K Baba
Journal: Circulation (1979)

Real-time cross-sectional echocardiographic studies revealed the presence of coronary artery aneurysms in five patients with mucocutaneous lymph node syndrome. These lesions appeared as circular echo-free spaces with clearly-defined borders in sites corresponding to angiographically proven aneurysms. In 15 normal subjects who were studied only by noninvasive methods, and in 17 who had normal coronary arteriograms (including eight with the mucocutaneous lymph node syndrome), we found no similar echo findings. The aneurysms were in both right and left coronary arteries in three patients, and were confined to the left side in two. The mucocutaneous lymph node syndrome is an increasingly common condition in Japan which may be fatal due to myocardial infarction occurring in a setting of coronary aneurysm with thrombosis. Therefore, the ability to demonstrate coronary aneurysms noninvasively is of prognostic and potentially therapeutic value in this inadequately understood syndrome.
Prediction of Severe Hypoglycemia
Authors: Daniel J. Cox, Linda Gonder-Frederick, Lee Ritterband, William Clarke, Boris P. Kovatchev
Journal: Diabetes Care (2007)

Prevention of severe hypoglycemia (SH) is premised partially on the ability to accurately anticipate its occurrence. This study prospectively tests methods for predicting SH using blood glucose meter readings.One hundred adults with type 1 diabetes were followed for 6 months, and 79 insulin-using adults with type 2 diabetes were followed for 4 months. During this time, subjects' routine self-monitored blood glucose (SMBG) readings were stored on and retrieved from memory meters, and participants were queried biweekly about occurrence of SH. Respective demographics for the two groups were age 40.7 and 50.2 years, duration of diabetes 20.0 and 12.2 years, A1C 7.6 and 8.8%, and male sex 43 and 39%, respectively.Relative risk for SH, quantified by the ratio of an individual's low blood glucose index (LBGI) based on the previous 150 SMBG readings to the LBGI based on recent SMBG readings, increased significantly in the 24 h before SH episodes in individuals with type 1 and type 2 diabetes (t = 10.3, P < 0.0001, and t = 4.2, P < 0.001, respectively). A sliding algorithm detected 58% of imminent (within 24 h) SH episodes in the type 1 diabetic group and 60% of those in the type 2 diabetic group when three SMBG readings were available in the 24 h before an episode. Detection increased to 63 and 75%, respectively, if five SMBG readings were available in the 24 h before an episode.SH often follows a specific blood glucose fluctuation pattern that is identifiable from SMBG. Thus, partial prediction of imminent SH is possible, providing a potential tool to trigger self-regulatory prevention of significant hypoglycemia.
Art: The embodiment of art
Authors: J. Beadle
Journal: BMJ (2000)

here were bodies everywhere at the Tate Modern on May's bank holiday weekend, not only hanging on the gallery walls but streaming through the entrance in vast numbers.The doors were closed to visitors for a while, perhaps the first time that crowd control has been needed in a public art space.The Tate gallery's 20th century collection, housed in a disused power station on the banks of the Thames, has been divided into four broad themes-"Landscape, Still Life, History, and Nude/Action/Body."Entering the gallery through the vast and physically imposing turbine hall, our own bodies seem incredibly small.Other humans seem tiny as we rise above them on the escalators to "Nude/Action/Body" on level five, a cultural hall of mirrors reflecting how artists have looked at the human figure.Just outside the entrance is Rodin's The Kiss, the art world's most famous embrace