tbuckley/cabot-search huggingface dataset:
Breathing 30 per cent oxygen attenuates bronchial responsiveness to methacholine in asthmatic patients
Authors: H Inoue, C Inoue, M Okayama, K Sekizawa, W Hida, T Takishima
Journal: European Respiratory Journal (1989)

The effect of breathing 30% oxygen on bronchial responsiveness to inhaled methacholine was studied in 30 asthmatic patients using a direct graphical recording method. An aerosol of methacholine solution was inhaled during tidal breathing by measuring respiratory resistance (Rrs) continuously, and dose-response curves were obtained on two separate days during air and 30% oxygen inhalation. Oxygen inhalations for 20 min caused no change in baseline Rrs. The threshold dose of methacholine, the dose which increased Rrs from the baseline value while breathing 30% oxygen, increased significantly compared with that while breathing air (p less than 0.01). No significant difference was found between the mean values of the slopes of the dose-response curves of the two groups. End-expiratory oxygen concentration (FETO2) during air breathing decreased significantly from 13.7% to 12.0% at the point where methacholine dosage reached threshold. This study suggests that hyperoxia attenuates the bronchial responsiveness to methacholine in asthmatic patients.
Benefit of Pulmonary Vein Isolation Guided by Loss of Pace Capture on the Ablation Line
Authors: Daniel Steven, Arian Sultan, Vivek Reddy, Jakob Luker, Manuel Altenburg, Boris Hoffmann, Thomas Rostock, Helge Servatius, William G. Stevenson, Stephan Willems, Gregory F. Michaud
Journal: Journal of the American College of Cardiology (2013)
Assessing the impact of body mass index on FEV1% and quality of life in asthma patients
Authors: Sarus Jain, Amin Golmohamed
Journal: European Respiratory Journal (2013)

Background :Direct correlation of Body Mass Index (BMI) and its effect on FEV1% has not previously been investigated in asthma patients.Patients with a lower FEV1% tend to experience more severe asthma exacerbations due to greater narrowing of airflow passages and this can reduce the quality of life of the patient, however high BMI may be a contributing factor to this.   Aim :To assess whether having a higher BMI impacts on FEV1% and to assess the quality of life of the patient using the Asthma Control Questionnaire(ACQ).   Methods :A retrospective audit was conducted from a random sample of 547 patients from a specialist asthma clinic in a UK district general hospital. Relevant data was extracted from routine asthma review case notes.   Results :The sample comprised 63.8%(348) females vs. 36.2%(199) males with a mean age of 52.8 years.The average BMI was 31.3kg/m 2 .Obese Class III patients had a significant 10.9% (p   Conclusions :The results clearly identified that the greater the BMI, the lower the FEV1% and the higher the ACQ score, thus prompting that obesity can have a massive impact on patient asthma exacerbation severity.Therefore, these results suggest that asthma patients should receive lifestyle advice by the clinician during routine asthma review in order to reduce BMI which will ultimately lead to a more improved quality of life for the patient.
Abstract 3265: A Comparison of Echocardiographic and Electrocardiographic Characteristics of Patients with Apical Hypertrophic Cardiomyopathy
Authors: Josepha Binder, Brandon R Grossardt, Christine Attenhofer Jost, Kyle W Klarich, Michael J Ackerman, A. J Tajik, Steve R Ommen
Journal: Circulation (2007)

Background: Apical hypertrophic cardiomyopathy (apical HCM) is a less common subtype of HCM characterized by a focal thickening in the left ventricular apex. “Classic” ECG features have been described, however, apical HCM can persist for many years without detection. We investigated the relationship between ECG findings and echocardiographic morphometry in a large referral series of patients with apical HCM. Methods: We enumerated all patients diagnosed with apical HCM prior to Sept. 30, 2006 using the Mayo Clinic HCM database. We compared echocardiographic measures separately for patients with positive status for two ECG indices of left ventricular hypertrophy (LVH); the Sokolow-Lyon index and the Romhilt-Estes (RE) point-score. We also compared echocardiographic measurements in patients with and without negative T-waves in the precordial leads. Results: Apical HCM was detected in 177 patients (111 men and 68 women). Only 51% had positive Sokolow criteria and 51% had positive RE criteria. The agreement between Sokolow and RE status was high (agreement = 75.0%; kappa = 0.50; 95% CI = 0.38 – 0.62). In particular, Sokolow positive patients had increased LV ejection fraction (P = 0.02), and decreased LV end-systolic diameter (P = 0.03) compared with Sokolow negative patients. The prevalence of right atrial enlargement (47 vs. 28%; P = 0.02) and intracavity obstruction (22 vs. 8%; P = 0.01) were more common in Sokolow positive patients. Positive RE criteria was associated with a greater thickness of the basal septal and basal posterior walls (P = 0.001 and 0.02, respectively), and with a higher frequency of intracavity obstruction (21 vs. 9%; P = 0.04). Most patients (89%) exhibited at least one negative T-wave in the precordial leads; however, only 10% of patients had a negative T-wave of greater than 1.0 mV. We found that patients with an inverted T-wave larger than 0.4 mV (median) had a significantly increased LV ejection fraction (P = 0.03) compared with patients who had smaller or no negative T-waves. Conclusions: Among patients with apical HCM, nearly half do not have ECG evidence of LVH based on classic criteria and most do not have marked T-wave inversions. However, the majority did have at least a mild expression of negative T-waves.
Radiographic evaluation of modern oral implants with emphasis on crestal bone level and relevance to peri‐implant health
Authors: Hugo De Bruyn, Stefan Vandeweghe, Christian Ruyffelaert, Jan Cosyn, Lars Sennerby
Journal: Periodontology 2000 (2013)

Implant stability and maintenance of stable crestal bone level are prerequisites for the successful long-term function of oral implants, and continuous crestal bone loss constitutes a threat to the longevity of implant-supported prosthetic constructions. The prevalence/incidence and reasons for crestal bone loss are under debate. Some authors regard infection (i.e. peri-implantitis) as the cause for virtually all bone loss, while others see crestal bone loss as an unavoidable phenomenon following surgery and implant loading. Irrespective of the cause of continuous crestal bone loss, correct usage and scientifically sound interpretation of radiographs are of utmost importance for evaluation of oral implants. The periapical radiographic technique is currently the preferred method for evaluating implant health based on bone loss, and digital radiographs allow easy standardization of the image contrast. It is suggested that baseline radiographs should be taken at the time the transmucosal part pierces the mucosal tissues and annually thereafter. The number of unreadable radiographs should be presented in scientific publications to give insights into the quality of the radiographic examination. It is suggested that not only mean values, but also the range of bone levels, should be presented to describe the proportion of implants that show continuous crestal bone loss. In the absence of other clinical symptoms, bleeding on probing around implants seems to be a weak indicator of ongoing or future loss of crestal bone. According to recent longitudinal studies on modern implant surfaces peri-implantitis defined as 'infection with suppuration associated with clinically significant progressing crestal bone loss' occurs with a prevalence of less than 5 % in implants with 10 years in function.
Increased right ventricular cardiomyocyte stiffness in patients with pulmonary arterial hypertension
Authors: Silvia Rain, M. Louis Handoko, Nico Westerhof, Cris dos Remedios, Marc Humbert, Peter Dorfmuller, Christophe Guignabert, Anton Vonk-Noordegraaf, Jolanda van der Velden, Frances S. de Man
Journal: European Respiratory Journal (2012)

Introduction  This study aims to determine whether changes in right ventricular (RV) cardiomyocyte contractile apparatus are involved in RV failure secondary to pulmonary arterial hypertension (PAH).  Methods  - Maximal force and passive stiffness were determined in membrane-permeablized RV cardiomyocytes isolated from RV tissue obtained after heart-lung transplantation of PAH-patients and non-failing donors. Maximal force was measured at maximal Ca2+-activation, while cardiomyocyte passive stiffness in relaxing solution (low Ca2+ concentration).  - The role of β-Adrenergic receptor signaling on cardiomyocyte passive stiffness was mimicked by determining passive stiffness after PKA incubation.  Results  - No significant differences were found in cardiomyocyte maximal force in PAH patients and donors.  - Passive stiffness was significantly increased at all sarcomere lengths in PAH patients compared to donors.  - PKA incubation partially restored RV cardiomyocytes passive tension in PAH patients to donor values.  Conclusions  Our study demonstrates increased RV cardiomyocytes passive stiffness in PAH patients, partially restored by PKA incubation. This finding suggests that reduced β-adrenergic receptor signaling plays an important role in the development of RV diastolic stiffness in PAH patients.
An accurate and inexpensive color‐based assay for detecting severe anemia in a limited‐resource setting
Authors: Patrick T. McGann, Erika A. Tyburski, Vysolela de Oliveira, Brigida Santos, Russell E. Ware, Wilbur A. Lam
Journal: American Journal of Hematology (2015)

Severe anemia is an important cause of morbidity and mortality among children in resource‐poor settings, but laboratory diagnostics are often limited in these locations. To address this need, we developed a simple, inexpensive, and color‐based point‐of‐care (POC) assay to detect severe anemia. The purpose of this study was to evaluate the accuracy of this novel POC assay to detect moderate and severe anemia in a limited‐resource setting. The study was a cross‐sectional study conducted on children with sickle cell anemia in Luanda, Angola. The hemoglobin concentrations obtained by the POC assay were compared to reference values measured by a calibrated automated hematology analyzer. A total of 86 samples were analyzed (mean hemoglobin concentration 6.6 g/dL). There was a strong correlation between the hemoglobin concentrations obtained by the POC assay and reference values obtained from an automated hematology analyzer (r=0.88, P &lt;0.0001). The POC assay demonstrated excellent reproducibility (r=0.93, P&lt; 0.0001) and the reagents appeared to be durable in a tropical setting (r=0.93, P&lt; 0.0001). For the detection of severe anemia that may require blood transfusion (hemoglobin &lt;5 g/dL), the POC assay had sensitivity of 88.9% and specificity of 98.7%. These data demonstrate that an inexpensive (&lt;$0.25 USD) POC assay accurately estimates low hemoglobin concentrations and has the potential to become a transformational diagnostic tool for severe anemia in limited‐resource settings. Am. J. Hematol. 90:1122–1127, 2015. © 2015 Wiley Periodicals, Inc.
Ethnic differences in aortic aneurysm and peripheral vascular disease
Authors: P. Wilmshurst
Journal: BMJ (1996)

The third child, a 2 year old who had had recur- rent chest symptoms for several months, was referred for surgery for a possible bronchogenic or duplication cyst diagnosed on computed tomogra- phy.Surgery was cancelled when a preoperative Mantoux test (1 U) yielded a positive result.None of the patients had a history of contact with some- one with tuberculosis.All were given standard antituberculous treatment and progressed well.
Abstract MP70: Habitual Sleep Variability, Mediated by Energy Intake, is Associated with Abdominal Obesity in Adolescents
Authors: Fan He, Edward O Bixler, Jiangang Liao, Arthur Berg, Yuka Imamura Kawasawa, Julio Fernandez-Mendoza, Alexandros N Vgontzas, Duanping Liao
Journal: Circulation (2015)

Introduction: Although self-reported sleep duration has been associated with obesity, study of the association between objectively-measured habitual sleep pattern and the more metabolically relevant abdominal obesity, and the mediation factors for such an association, is limited. Hypothesis: We assessed the hypothesis that objectively-measured variability, mediated by excessive energy intake, is associated with abdominal obesity in adolescents. Methods: We used data from 421 adolescents in the Penn State Child Cohort follow-up examination. Actigraphy was used for 7 consecutive nights to calculate each participant’s mean sleep duration as habitual sleep duration (HSD) and the standard deviation of the mean as habitual sleep variability (HSV). Abdominal obesity was assessed by dual-energy x-ray absorptiometry as Android/Gynoid Fat Ratio and visceral fat area . Youth/Adolescents Food Frequency Questionnaire was used to obtain daily caloric, fat, carbohydrate, and protein intakes one year prior to the study. The R-based Mediation Effect Models were used to assess the association between sleep pattern and abdominal obesity, and quantitatively estimate the mediation effects of caloric intake and of other factors not analyzed in this report. Results: As shown in the table, after controlling for major confounders and BMI percentile, HSV was significantly and consistently associated with both abdominal obesity measures. The Mediation analysis consistently indicated a significant mediation effect of caloric intake, especially carbohydrate intake. For example, 20% of the association between HSV and visceral fat could be attributed to carbohydrate intake, while 80% by other factors not analyzed. HSD was not associated with abdominal obesity. Conclusions: Higher HSV, not HSD, is associated with abdominal obesity, which can be partially explained by increased caloric intake, especially from carbohydrate, in adolescents. More studies are needed to identify other mediation factors in the association.
Students Sitting Finals: Ready to be House Officers?
Authors: Daniel M Sado, Philip Seager, Vassilis Vassiliou, Nimesh N Patel, David S Sanders, Iman A F Azmy
Journal: Journal of the Royal Society of Medicine (2001)

Mr Goodfellow and Dr Claydon suggested that the competence of medical students in practical procedures could be improved by introduction of skills laboratories and logbooks. I fully agree about skills laboratories and there is sufficient evidence to support them1,2. However, I disagree with the use of logbooks. As acknowledged in the paper, most logbooks simply testify that a procedure was performed and do not certify competence, although this deficiency could be overcome by asking the doctor to grade competence as good, average or below average. I would also suggest that logbooks cause additional stress to many students and become a major preoccupation. Even if doctors' evaluations were conscientiously done, the logbooks might offer a temptation to student fraud3,4. After training in a skills laboratory, students should be assessed on models with an objective structured clinical examination (OSCE) before practising on real patients.
Profile of physical activity in daily life in apparently healthy smokers and its correlate factors
Authors: Karina Furlanetto, Leandro Cruz Mantoani, Demétria Kovelis, Juliana Zabatiero, Mahara Proença, Jully Anne Felici, Fábio Pitta
Journal: European Respiratory Journal (2011)

Objectives: To evaluate the characteristics of physical activity in daily life (PADL) in Brazilian smokers; and to study the factors which correlate with PADL in this population.

Methods: Eighty-three smokers with normal lung function (GS; 34 male, 48±11 years, BMI 26±5 kg.m-2) and 29 nonsmokers (GNS; 10 male, 45±11 years, BMI 27±5 kg.m-2) were included. Subjects were submitted to assessment of lung function, smoking habits, functional exercise capacity, health related quality of life (HRQL), anxiety and depression, as well as PADL using a step counter. The groups were divided in active or inactive subgroups according to the number of steps/day (  10000 steps/day).

Results: Average steps/day was 8645±4204 in GS and 9480±3550 in GNS (p>0.05). In GS, there was significant difference between active and inactive subgroups in steps/day, distance walked and%pred of the 6-minute walk test (6MWT) (13209±2939 steps/day; 569±70 m; 84±8%pred versus 5985±2529 steps/day; 514±53 m; 78±8%pred, respectively; p=0.02 for all). Active smokers showed no difference in comparison to active nonsmokers concerning steps/day, lung function and HRQL (p>0.05 for all), despite a significant difference in the 6MWT (p<0.05). PADL level in GS correlated modestly with the 6MWT both in meters and%pred (r=0.34 and 0.31; p<0.002 for both). A linear regression model showed that 6MWT explained 10% of GS steps/day variation (adjusted R2=0.104).

Conclusions: In general, smokers walk as much as nonsmokers in daily life, especially when comparing the physically active subjects from both groups. Active smokers showed PADL, lung function and HRQL similar to active nonsmokers, although with reduced exercise capacity.
Geographic variation in the incidence of treated end-stage renal disease.
Authors: B Foxman, L H Moulton, R A Wolfe, K E Guire, F K Port, V M Hawthorne
Journal: Journal of the American Society of Nephrology (1991)

To facilitate identification of geographic clusters of areas with high or low incidence of treated end-stage renal disease, the 1983 to 1988 incidence by county was studied among whites and nonwhites less than 60 yr of age in the United States. End-stage renal disease incidence counts for 1983 to 1988 were obtained from the United States Renal Data System data base and linked to the 1985 county population obtained from U.S. Census data. Maps were smoothed by the method adopted by the National Cancer Institute that smooths only according to variability of the local rates, ignoring geographic information on clustering of events. In addition to identifying specific counties with exceptionally high or low incidence, geographic patterns were observed with many similarities across whites and nonwhites: notably high rates of disease in areas of the Southwest, the Southeast and in counties with Native American reservations and low rates in the West and Northwest. On the basis of these findings, several hypotheses are presented to explain the observed variation in treated end-stage renal disease incidence rates.
Inositol treatment of obsessive-compulsive disorder
Authors: M Fux, J Levine, A Aviv, R H Belmaker
Journal: American Journal of Psychiatry (1996)

Earlier studies reported that inositol, a simple polyol second messenger precursor, was effective in controlled trials for patients with depression and panic. In this study its effectiveness in obsessive-compulsive disorder was investigated.Thirteen patients with obsessive-compulsive disorder completed a double-blind, controlled crossover trial of 18 g/day of inositol or placebo for 6 weeks each.The subjects had significantly lower scores on the Yale-Brown Obsessive Compulsive Scale when taking inositol than when taking placebo.The authors conclude that inositol is effective in depression, panic, and obsessive-compulsive disorder, a spectrum of disorders responsive to selective serotonin reuptake inhibitors.
Healthcare-associated pneumonia among hospitalized patients. Is it really different from community acquired pneumonia?
Authors: Gil Myeong Seong, Jaechun Lee, Jong Hoo Lee, Miok Kim
Journal: European Respiratory Journal (2012)

Background . Current practice guideline suggested that all patients with health-care associated pneumonia (HCAP) should receive similar combination empirical therapy like hospital acquired pneumonia. This study aimed to determine the differences in etiology and clinical outcomes between HCAP and community acquired pneumonia (CAP) patients.

Methods. We conducted a retrospective study of patients with HCAP and CAP who were hospitalized between January 2010 and December 2011. We investigated the 30-days mortality and occurrence of potentially drug-resistant (PDR) pathogens.

Results. A total of 483 patients (208 HCAP patients, 275 CAP patients) were evaluated. HCAP patients were older than patients with CAP (mean 72.3 yr [SD 13.7] vs. 63.4 yr [SD 17.8]; p < 0.0001) and more frequently infected PDR pathogens (18.8% vs. 4.9%; p < 0.0001). Patients with HCAP had higher initial severity compared to CAP patients (Pneumonia Severity Index score, mean 122.8 [SD 35.1] vs. mean 85.8 [SD 41.6]; p < 0.0001) and mortality rate was increased in HCAP patients on univariate analysis. (16.3% vs. 5.1%; p < 0.0001). Multivariate logistic regression analysis after adjusting for sex, age, and inital severity, revealed that HCAP, use of antipseudomonal combination antibiotics, and occurrence of PDR pathogens are no more independent risk factors for 30-day mortality.

Conclusions. HCAP is common cause of hospital admission and is associated with a high mortality. This increased mortality was primarily related to age and initial severity rather than HCAP and presence of PDR pathogens. It may suggest that HCAP patients could be treated in the same way as patients with severe CAP.
Antiviral resistance of influenza A (H3N2) strains isolated in northern Greece between 2004 and 2007
Authors: A Melidou, V Kyriazopoulou, E Diza, S Alexiou, Y Pierroutsakos
Journal: Eurosurveillance (2009)

The prevention and control of influenza with vaccines and antiviral drugs is of great importance. M2 inhibitors, amantadine and rimantadine have been extensively used in some countries. The next generation of antiviral drugs, neuraminidase (NA) inhibitors oseltamivir and zanamivir, are being stockpiled for a potential influenza pandemic. The emergence of resistant strains is thus an important issue. The purpose of this study was to examine the sensitivity to M2 and NA inhibitors of Greek influenza A(H3N2) strains isolated during three influenza seasons between 2004 and 2008 and to determine the phylogenetic clades of those strains. M2 and NA sequences of 34 patient isolates were checked for known resistance mutations. In addition, haemagglutinin (HA) sequences were used to determine the phylogenetic relationship between resistant and sensitive strains. All influenza A(H3N2) strains isolated during the season 2004-5 were found susceptible to adamantanes, bearing the S31N mutation, compared to 88% of the strains isolated in 2005-6 and 75% of the strains isolated in 2006-7. Molecular analysis of the HA gene showed a correlation of the mutants with specific phylogenetic clades. No known mutations in the NA or HA gene that have been implicated in resistance to NA inhibitors were found in the A(H3N2) strains isolated in the three influenza seasons. Despite the fact that amantadine is the only drug approved for prophylaxis in Greece, it has not been extensively used. So it seems that resistant strains circulating in the area after 2005 followed the global trend of replacement of susceptible strains by resistant ones. Oseltamivir and zanamivir are currently approved only for therapeutic use in Greece and has not been extensively used either.