tbuckley/cabot-search huggingface dataset:
Differences in the manegement of latent tuberculosis infection in patients treated with anti-TNF-α in Turkey
Authors: Serpil Ocal, Nalan Demir, Sebnem Ataman, Ahmet Ugur Demir, Nurben Suldur, Akin Kaya, Oya Kayacan
Journal: European Respiratory Journal (2012)

AIM:  Latent tuberculosis infection (LTBI) is commonly detected with the tuberculin skin test (TST) before anti-TNF-α. BCG vaccination modifies TST reaction. We use different approaches to evaluate LTBI. We aimed to evaluate different approaches to LTBI and results in our clinic.   METHOD:  This report retrospectively evaluated data of patients treated with anti-TNF-α, including symptoms, size of TST reaction, used anti-TNF agent, treatment details and development of active tuberculosis disease.   RESULTS:  The study identified 99 consecutive patients referred for the evaluation of LTBI before starting anti-TNF therapy (54 men; mean age±SD: 44±12). The diagnosis of ankylosing spondylitis was established in 56 patients, rheumatoid arthritis in 36 and other systemic inflammatory diseases in 7. Fifty four patients received infliximab, 36 adalimumab, 41 etanercept. The median follow up was 25 months (range 9-41). Of the 56 patients who underwent LTBI treatment, 29 took isoniazid for 6 months and 20 for 9 months, 7 did not complete a 6-month course of LTBI treatment. Two took isoniazid for 12 months and one for 24 months. Three patients who had a history of treatment of tuberculosis had received anti-TNF-α agonist. Active tuberculosis developed in one of the two patients who had TST >15 mm and refused LTBI treatment after 3 month of anti-TNF-α treatment.   CONCLUSION:  Different LTBI approaches according to threshold size of TST reaction was observed even in the same center in our country. We need a multicenter study to determine the best TST thresold value to develop national guidelines.
Central Obesity and Survival in Subjects With Coronary Artery Disease
Authors: Thais Coutinho, Kashish Goel, Daniel Corrêa de Sá, Charlotte Kragelund, Alka M. Kanaya, Marianne Zeller, Jong-Seon Park, Lars Kober, Christian Torp-Pedersen, Yves Cottin, Luc Lorgis, Sang-Hee Lee, Young-Jo Kim, Randal Thomas, Véronique L. Roger, Virend K. Somers, Francisco Lopez-Jimenez
Journal: Journal of the American College of Cardiology (2011)
Supporting "second victims" is a system-wide responsibility
Authors: K. Stewart, R. Lawton, R. Harrison
Journal: BMJ (2015)

The “second victim” phenomenon—the inability of clinicians to cope with their emotions after a medical error or adverse event—can be devastating for the clinician affected.1 It also has implications for patient safety and safety culture, so responsibility for dealing with it goes beyond individual clinicians.

Second victim experiences are worse if clinicians have negative experiences of investigations or feel that they were dealt with in …
Kfc determination after ischemia-reperfusion in lungs treated with sildenafil and tadalafil
Authors: Raúl Guerra, Carlos Bravo, Nadezdha Aguilar, Diana Aguilar, Patricio Santillán
Journal: European Respiratory Journal (2012)

Ischemia reperfusion phenomenon (IR) is the major factor implicated in primary graft failure, condition that occurs around the 20% of the lung transplants. Some drugs in theory can diminish the IR injury. Sildenafil and tadalafil are drugs that inhibit the 5-Phosphodiesterase, enzyme that inhibits cGMP, leading to vasoconstriction, edema and finally organ failure. The inhibition of 5-phosphodiesterase results in dilatation of pulmonary vasculature and lower hydrostatic pressure, likely decreasing edema formation. The objective of this study was to determinate the edema formation in lungs treated with Sildenafil and tadalafil in animal (ex vivo) model of ischemia-reperfusion. Lung blocks were harvested (Wistar rats) and distributed in the following groups (G): G I: immediately reperfusion. G II: 8 hours preservation, and reperfusion. G III and G IV: Sildenafil (0.7 mg/kg) or tadalafil (0.15 mg/kg) donor pretreatment respectively, 8 hours preservation, and reperfusion. Pulmonary arterial pressure (PAP), pulmonary venous pressure (PVP), lung difference weight (W), pulmonary capillary pressure (PCP) and the capillary filtration coefficient (Kfc) were measured. Results: (mean ± SE). PAP (mmHg): G I: 20.31±1.23, G II: 25.53 ±3.31, G III: 20.78±0.90, G IV: 18.94±1.87. Kfc (ml/min/cmH2O/100gr): G I: 0.18±0.047 G II: 0.99±0.89 G III: 0.34±0.12 G IV: 1.81±0.90*. p=<0.05. Conclusion: Donor pretreatment with sildenafil decrease PAP and edema formation compared with lungs without pretreatment (not statistical significant). The use of tadalafil decrease the PAP (not statistical significant) but increase the lung edema formation (statistical significant) compared with control lungs.
Suppression of in vitro megakaryopoiesis by maternal sera containing anti-HPA-1a antibodies
Authors: Zhi-Jian Liu, James B. Bussel, Madhavi Lakkaraja, Francisca Ferrer-Marin, Cedric Ghevaert, Henry A. Feldman, Janice G. McFarland, Chaitanya Chavda, Martha Sola-Visner
Journal: Blood (2015)
Fasting Levels of High-Sensitivity Growth Hormone Predict Cardiovascular Morbidity and Mortality
Authors: Erik Hallengren, Peter Almgren, Gunnar Engström, Bo Hedblad, Margaretha Persson, Jennifer Suhr, Andreas Bergmann, Olle Melander
Journal: Journal of the American College of Cardiology (2014)

Both pathological excess and deficiency of growth hormone (GH) are associated with cardiovascular mortality.
Abstract 14001: Adeno-Associated Virus Serotype 9 Efficiently Targets Ischemic Skeletal Muscle Following Systemic Delivery in a Mouse Model of Peripheral Arterial Disease
Authors: Arabindra B Katwal, Konkal-Matt R Prasad, John M Sanders, Elisa A Ferrante, R. J Lye, Brian H Annex, Brent A French
Journal: Circulation (2011)

Introduction: Adeno-associated viral (AAV) vectors can be targeted to skeletal muscle following intravenous (IV) delivery. While this approach has potential for treating peripheral arterial disease...
Severe complicated pneumococcal pneumonia in young adults
Authors: Sebastien Ellis, Matthew Harris, Suzanne Shuttleworth, Chris Taylor, Aye Aye Lwin
Journal: European Respiratory Journal (2011)

Background:  Pneumococcal pneumonia causes parapneumonic effusion (PPE) in 40%-57%. Severity can be influenced by both host characteristics e.g. co-morbidity, age and vaccination status and, bacterial factors.   Aims and objectives:  To study the relationship between host characteristics (age, co-morbidity and previous vaccination) and disease severity in adults admitted with pneumococcal pneumonia.   Methods:  A cohort of 21 inpatients with pneumococcal pneumonia between December 2010 to January 2011 were retrospectively studied using electronic patient records, medical notes and the PACS system. Uncomplicated PPE (UPPE) was defined as pleural fluid pH >7.2, complicated PPE (CPPE) as pH    Results:  21 patients were admitted with pneumococcal pneumonia, 8 male and 13 female, median age 48 years (range 18-76). 9 (43%) had no associated co-morbidity, of which 7 were   All patients who developed pleural effusion or empyema, 8/21 (38%), had an admission CRP >100 (range 101->500) and albumin   7/21 (33%) patients were admitted to the intensive care unit (ICU). 4/7 had no associated co-morbidities, median age was 33 (range 29-48) and all 4 patients were not vaccinated.   Conclusion:  Our study highlights that along with high risk groups, young unvaccinated adults with no co-morbidity are also at risk of developing severe pneumococcal pneumonia with complicating pleural effusion or empyema.
Lesbian, Gay, Bisexual, and Transgender Health Disparities: Executive Summary of a Policy Position Paper From the American College of Physicians
Authors: Hilary Daniel, Renee Butkus
Journal: Annals of Internal Medicine (2015)

In this position paper, the American College of Physicians examines the health disparities experienced by the lesbian, gay, bisexual, and transgender (LGBT) community and makes a series of recommendations to achieve equity for LGBT individuals in the health care system. These recommendations include enhancing physician understanding of how to provide culturally and clinically competent care for LGBT individuals, addressing environmental and social factors that can affect their mental and physical well-being, and supporting further research into understanding their unique health needs.
Abstract 2128: Predictive Value of Short-term Deceleration Capacity
Authors: Georg Schmidt, Axel Bauer, Petra Barthel, Alexander Müller
Journal: Circulation (2008)

Background: Deceleration Capacity (DC) derived from 24-hour Holter recordings is a strong predictor of mortality in patients after acute myocardial infarction (MI). This prospective cohort study investigates the predictive power of DC derived from short-term recordings. Methods: 938 survivors of acute MI (age ≤80 years, sinus rhythm) were included. Within one week after index infarction, 30-min high resolution ECGs (1600Hz, supine position and resting conditions) as well as 24h-Holter recordings were performed. Short-term DC (DCs) and long-term DC (DCl) were calculated according to the previously published technology. Primary endpoint was death from any cause at two years. Multivariate Cox-regression analyses were adjusted for LVEF ≤30% and clinical covariates. Results: During the 2-year follow-up, 36 patients (3.8%) died. Both, DCs and DCl were strong predictors of death with areas under the receiver-operator characteristics curves of 76.3% and 77.8%, respectively (p&lt;0.0001). DCs was significantly correlated with DCl (r=0.7, p&lt;0.0001). After adjustment for LVEF, presence of diabetes mellitus, advanced age and history of a previous MI, DCs (≤2.5ms) remained a highly significant predictor of death (Table ). Conclusion: DC derived from high-resolution short-term ECGs is a strong and significant predictor of death in post-infarction patients. Multivariate Cox regression analysis for Prediction of 2y-Mortality
Discordance between CT measures of COPD and spirometry: Assessment of mechanistic differences
Authors: Sandeep Bodduluri, Surya Bhatt, MeiLan Han, John Newell, Jessica Sieren, Mark Dransfield, Eric Hoffman, Joseph Reinhardt
Journal: European Respiratory Journal (2014)

Background 

Many COPD patients have marked discordance between FEV1 and extent of emphysema on volumetric CT. The etiology for this is not well understood.

Methods 

Subjects with GOLD stage I-IV from a large multicenter study (COPDGene) were arranged by percentiles of %pred FEV1 and emphysema on CT. Three categories were created using differences in percentiles: cat1 with predominant airflow obstruction and minimal emphysema, cat2 with matched FEV1 and emphysema, and cat3 with predominant emphysema and relatively minimal airflow obstruction. Image registration methods of Jacobian determinants, anisotropy and strain tensors were used to assess mechanistic differences between the groups. Regression models were created with above categories as outcome variable, adjusting for age, gender, emphysema (%LAA<-950HU at end inspiration), gas trapping (%LAA<-856HU at end expiration), and thickness of segmental airways (model 1), and after adding Jacobian mean (model 2).

Results: 

FEV1 %pred for cat 1, 2, and 3 was 37.9+8.7, 88.7+12.2, and 49.2+26.1 respectively, and emphysema 1.4+1.2, 18.9+9.8, and 20.1+18.1, respectively. With cat 2 as control, model 2 predicted cat 1 and 3 better than model 1 (adjusted R2 0.63 vs. 0.45;p<0.001). In each category, model 2 predicted FEV1 better than model 1 (cat1: R2 0.49 vs. 0.44;p=0.01; cat2: R2 0.79 vs. 0.74;p=0.01; cat3:R2 0.91 vs. 0.90;p=0.01).

Conclusions 

Lung elasticity might not be predicted by static measures of emphysema. Compared to density measures on CT, Jacobian measures of lung mechanics significantly improve prediction of airflow obstruction.
Women take top four jobs in health and social care in Wales
Authors: Roger Dobson
Journal: BMJ (2001)

Ann Lloyd has been appointed the new NHS director in Wales. Her appointment means that women now occupy all four top positions in health and social care in the principality.

Ms Lloyd, aged 53, a former chief executive of Frenchay Healthcare NHS Trust in Bristol, is part of a team that includes Jane Hutt (the Assembly health secretary), Dr Ruth Hall (chief medical officer), and Helen Thomas (head of social care).

Ms Lloyd said that her main priority was the implementation of the new NHS plan in Wales, under which the five health authorities will be abolished by April 2003 and which will also see the National Assembly taking direct control of its health responsibilities.
Treatment costs and use of community mental health services for schizophrenia by age cohorts
Authors: B J Cuffel, D V Jeste, M Halpain, C Pratt, H Tarke, T L Patterson
Journal: American Journal of Psychiatry (1996)

Research on schizophrenia has tended to ignore patterns and costs of mental health service use in late life. The present study examined the types of mental health services used and their costs for several age-defined cohorts in a large community mental health system.The data covered all users of the mental health system included in the San Diego county billing information system in fiscal years 1986 and 1990. Community mental health service use and codes were modeled as a function of patient demographic characteristics, diagnosis, and age. The patients were grouped into the following age categories: 18-29, 30-44, 45-54, 55-64, 65-74, and > or = 75 years of age.The total costs for schizophrenia were higher than those for other psychiatric disorders, and they were also age dependent. In both fiscal years, the costs of schizophrenia were higher for the youngest and oldest cohorts than for the patients in the 30-65-year range.The economic burden of late-life schizophrenia to the public mental health system is at least as high as that of schizophrenia in younger adults.
Right heart catheterization in elderly patients with suspected pre-capillary pulmonary hypertension
Authors: Tatiana Lamon, Grégoire Prévot, Laurent Têtu, Alain Didier
Journal: European Respiratory Journal (2013)

Introduction: despite more comorbidities and risk factors for heart failure with preserved left ventricular ejection fraction, elderly are often addressed in Pulmonary Hypertension (PH) center for suspicion of pre-capillary PH.  Aims and method: the aims of the study were to compare results of right heart catheterization (RHC) in a large sample of elderly (age > 65 yrs) patients and in a group of younger patients, and to observe aetiologies of confirmed pre-capillary PH in both groups. All files of patients referred for suspicion of pre-capillary PH after non invasive assessment in Toulouse university PH center from 2009 to 2011 were retrospectively analysed.  Results: data of 108 elderly patients and 92 younger were reviewed. PH was confirmed in 83% and 73% respectively. PH was considered post-capillary in 29.4% of cases in elderly versus 18.5% in younger (p>0.05). Aetiologies of pre-capillary PH were different according to age : 33% of group 1, 2.5% group 19, 35% group 3, 28% group 4 and 2.5% group 5 in elderly vs 55%, 2%, 21%, 17% and 5% in younger (p  Conclusion: pre-capillary PH diagnosis is challenging in elderly patients; when confirmed by RHC, PAH (excepted scleroderma associated PAH) is less frequent than in younger subjects, reinforcing the interest of a meticulous screening toward an aetiology in this population.
Canada’s prescription opioid epidemic grows despite tamperproof pills
Authors: Owen Dyer
Journal: BMJ (2015)

“Weak” doctors who cannot say no to their patients are driving Canada’s prescription opioid epidemic, the Canadian Medical Association’s annual general council heard this week, as new research showed that the mortality risk from chronic high doses may have been badly underestimated.

OxyContin (oxycodone), the drug most closely associated with the rapid spread of opioid prescribing across North America, has been replaced with a tamperproof formula called OxyNEO. But in Canada, where provincial drug formularies have mostly refused to cover the new drug, oxycodone prescriptions have fallen only to be replaced by other, often more powerful opioids, such as fentanyl and hydromorphone.

Opioid prescribing continues to rise overall, as do related deaths. Fatal overdoses in Ontario, Canada’s largest province by population, are almost as common as in the United States …
Systematic revisions to inherent notions may shape improvements in cognitive infrastructure
Authors: Rose Meleady, Richard J. Crisp
Journal: Behavioral and Brain Sciences (2014)

The proposed inherence heuristic centers on perceivers' failure to systematically consider external, historical factors when explaining observed patterns. We stress that this does not preclude the potential of subsequently encountered information to challenge intuitions. Drawing on models of diversity-defined social cognition, we discuss how an updating mechanism may reciprocally shape the cognitive infrastructure that underlies reliance on heuristic systems.
Association of intelligence with severity of posttraumatic stress disorder symptoms in Vietnam Combat veterans
Authors: R J McNally, L M Shin
Journal: American Journal of Psychiatry (1995)

The purpose of this study was to determine whether intelligence predicts variance in posttraumatic stress disorder (PTSD) symptoms beyond that predicted by extent of combat exposure.The subjects were 105 male Vietnam combat veterans. They completed the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder, the Combat Exposure Scale, and the Shipley Institute for Living Scale, a measure of general intelligence. Number of years of education was recorded for each subject.Multiple regression analyses revealed that estimated full-scale IQ significantly predicted variance in PTSD symptoms beyond that predicted by extent of combat exposure. The lower a subject's intelligence, the more severe were his PTSD symptoms.Cognitive variables may affect the ability to cope with trauma, thereby affecting whether a person develops chronic PTSD.
Drugs and the Autonomic Nervous System
Authors: Sheila Doggrell
Journal: BMJ (1941)

The nervous systems can initially be divided up into the central and peripheral nervous systems. The central nervous system is the brain and spinal cord and drugs that modify the central nervous system are considered as a subject in systematic pharmacology (therapeutics) section. Everything neural, other that the central nervous system, can be considered peripheral nervous systems. The peripheral nervous systems can be divided into the autonomic(involuntary) nervous system, which is the system that performs without your conscious help, and the somatic or voluntary nervous system, which you can consciously control(Figure 7.1). In addition the autonomic nervous system is divided into the sympathetic and parasympathetic nervous systems...
Health and Social Justice: Which Inequalities Matter (Most)? Response to Open Peer Commentaries on “The Social Determinants of Health: Why Should We Care?”
Authors: Adina Preda, Kristin Voigt
Journal: The American Journal of Bioethics (2015)

We thank the open peer commentators for their thoughtful responses to our article, “The Social Determinants of Health: Why Should We Care?” (Preda and Voigt 2015). Since space constraints prevent u...
Intermittent Claudication
Authors: Christopher White
Journal: New England Journal of Medicine (2007)

A 58-year-old, previously healthy mail carrier reports cramping pain in his right calf when he walks. The discomfort has progressively worsened over the past 6 months and is interfering with his ability to perform his job; he can now walk no farther than half a block without rest. He has a normal right femoral pulse and a diminished right popliteal pulse; right ankle and foot pulses are absent. How should this patient be evaluated and treated? Should he undergo revascularization?
Dobutamine Echocardiography Is Effective in the Noninvasive Detection of Prognostically Important Coronary-artery Disease in Patients With End-stage Renal-disease
Authors: J. Albanese, J. Nally, T. Marwick, Am. Dhondt, W. Wijins, C. Vanlpersele
Journal: Journal of the American Society of Nephrology (1994)
Expressionn of ERCC1 and its influence on efficacy of induction chemotherapy in non-small cell lung cancer (NSCLC)
Authors: C. Zhou, C. Su, C. Su, S. Zhou, Q. Xu, X. Chen, X. Chen
Journal: Journal of Clinical Oncology (2007)

18102 Background: Chemotherapy efficacy is related to pharmacogenomic differences among NSCLC patients. It is thought that up-regulated ERCC1 may be responsible for platinum resistance in NSCLC.This study was to investigate expression of ERCC1 in Chinese NSCLC patients and determine its influence on efficacy of induction chemotherapy. Methods: We retrospectively compared expression of ERCC1 between NSCLC patients receiving and not receiving induction chemotherapy. Expression of ERCC1 was detected with immunohistochemistry and defined as positive if more than 10% of tumor cells expressed ERCC1 in their nuclei. Results: Consecutive 73 NSCLC patients resected from December 1997 to Feb.1998 in our hospital were randomly selected for the study. Among them, 33 patients were given 1 to 2 cycles of cisplatin-based induction chemotherapy (mainly MVP as regimen) and their characteristics were not different from those receiving no chemotherapy. Expression of ERCC1 was higher in those younger than 60 years old than older than 60 years, in those with adenocarcinoma than in those with squamous carcinoma and in those receiving induction chemotherapy than those not receiving chemotherapy. Response (and progression) rates of induction chemotherapy were 59% (6%) and 31% (19%) in those without and with ERCC1 expression, respectively. Median survival, 3 year survival, and 5 year survival were 54 months, 53% and 35% in the patients with negative ERCC1 and 36 months, 50% and 25% in those with positive ERCC1, respectively. Difference in response rate of induction chemotherapy tended to be significant between those with and with expression of ERCC1( P&lt;0.1). Conclusions: ERCC1 is expressed in Chinese NSCLC patients. Its expression might be induced by chemotherapy. ERCC1 in NSCLC might be useful to select patients for induction chemotherapy, which needs further study. No significant financial relationships to disclose.