tbuckley/cabot-search huggingface dataset:
Vitamin D Supplements and the Risk of Falls
Authors: Mark J. Bolland, Andrew Grey, Ian R. Reid
Journal: JAMA Internal Medicine (2015)

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Is therapy adherence to inhaled corticosteroids related to hospitalization, pneumonia or mortality in COPD?
Authors: Kirsten Koehorst-ter Huurne, Kris Movig, Paul VanderValk, Job Van der Palen, Marjolein Brusse-Keizer
Journal: European Respiratory Journal (2014)

Objective: To study the relationship between therapy adherence to inhaled corticosteroids and morbidity and mortality in COPD.  Methods: Therapy adherence of 627 patients was recorded from pharmacy records over 3 years. It was expressed as percentage and deemed good at 75–125%, suboptimal 50-75%, and poor  125%. The relationship between adherence and morbidity and mortality was analyzed by Cox Regression. Inhaled steroids include fluticasone, budesonide, beclometasone, ciclesonide, all as a single component or combined with a sympathomimetic. If a patient used >1inhaled steroid, therapy adherence percentages were combined to an average adherence.  Results: Suboptimal adherence to inhaled steroids is related to hospital admission. Compared to optimal use there is a 1.4 increased risk for hospital admission (table 1).  Combining therapy adherence to an average adherence when patients use >1 inhaled steroid may distort our results. However, analyzing therapy adherence of patients using only one inhaled steroid (n= 508) gave similar results. The Hazard ratio for hospital admission with suboptimal adherence is 1.44 (95%CI: 1.03-2.03).  Conclusion: Only suboptimal adherence to inhaled corticosteroids is associated with an increased risk of hospital admission.
Drug-drug interactions in cardiothoracic intensive care unit of a pulmonary teaching hospital
Authors: Shadi Baniasadi, Marjan Bastani, Behrooz Farzanegan
Journal: European Respiratory Journal (2014)

Introduction: Little is known about clinically significant drug-drug interactions (DDIs) in a respiratory hospital. DDIs are more likely to occur in critically ill patients due to complex pharmacotherapy regimens and organ dysfunctions.  Aims: The purpose of this study was to identify the prescription patterns and drug combinations involved in DDIs occurring in cardiothoracic intensive care unit (ICU) of a pulmonary tertiary care hospital.  Methods: A prospective observational study was conducted for six months. DDIs for admitted patients in cardiothoracic ICU were identified with the Lexi-Interact program and assessed by a clinical pharmacologist. The interactions classified in five categories according to severity (contraindicated, severe, moderate, mild and unknown). The mechanisms, scientific evidences, and clinical consequences of DDIs were evaluated.  Results: The study included 195 patients. Tracheal stenosis was most often specified as main diagnosis (13.85%) followed by lung cancer (8.72%).The rate of DDIs was 721.54 DDIs/100 patient days. 17.77% of DDIs were considered as contraindicated and severe. Formally contraindicated drug combinations were the combination of combivent/atrovent (11.11%), and ciprofloxacin/ granisetrone (11.11%). The two most common drug combinations involved in sever DDIs (in transplant patients) were Itraconazole/ tacrolimus (1.79%); and fentanyl/cyclosporine (1.79%) that could manage by monitoring and dose adjustment.  Conclusions: Severity and drug combinations related to DDIs in the cardiothoracic ICU differ from other ICU settings. Knowledge of the epidemiology of drug interactions may help clinical practitioners to reduce the risk of adverse drug events.
Variations on the musical brain
Authors: Jason D Warren
Journal: Journal of the Royal Society of Medicine (1999)

If intelligent extraterrestrials ever intercept Voyager, the first message they decode will be Glenn Gould playing Bachl. Music, an ancient and peculiarly human pastime, is valued by all cultures. For highly visual primates, we are surprisingly susceptible to these abstract acoustic stimuli with no obvious survival value2. Neurologists have long been fascinated by musical curiosities they occasionally meet in their clinical practice. With the advent of techniques such as functional magnetic resonance imaging (fMRI), positron emission tomography (PET) and transcranial magnetic brain stimulation (TMS) it has become possible to study the perception and production of music in detail. A brief set of variations may serve to outline the theme.
A randomised comparison between six months of bolus fluorouracil (5-FU)/leucovorin (LV) and twelve weeks of protracted venous infusion (PVI) 5-FU as adjuvant treatment in colorectal cancer: An update with 5 years' follow-up
Authors: N. Starling, I. Chau, A. R. Norman, D. Tait, T. Iveson, M. Hill, T. Hickish, F. Lofts, D. Jodrell, D. Cunningham
Journal: Journal of Clinical Oncology (2004)

3523 Background: We performed a multicentre randomised trial to compare the efficacy and toxicity of 12 weeks of PVI 5-FU against the standard bolus monthly regimen of 5-FU/LV given for 6 months as adjuvant treatment in colorectal cancer. Methods: Patients with curatively resected stage II and III colorectal cancer were randomly assigned to 5-FU/LV (5-FU 425mg/m2 iv and LV 20mg/m2 iv bolus days 1–5 every 28 days for 6 months) or to PVI 5-FU (300mg/m2/day for 12 weeks). Results: Between 1993 and 2003, 801 eligible patients were randomised to 5-FU/LV (n=404) or PVI 5-FU (n=397). 59% of patients had stage III disease and 40% of patients had rectal cancer. With a median follow-up of 5.3 years, 231 relapses and 220 deaths have been observed. Five-year relapse free survival (RFS) was 66.7% (95% confidence interval [CI]: 61.6–71.3%) and 73.3% (95% CI: 68.4–77.6%) with bolus 5-FU/LV and PVI 5-FU respectively (Hazard ratio[HR]: 0.8; 95% CI: 0.62–1.04; p=0.10). Five-year overall survival (OS) was 71.5% (95% CI: 66.4–75.9%) and 75.7% (95% CI: 70.8–79.9%) with bolus 5-FU/LV and PVI 5-FU respectively (HR: 0.79; 95% CI: 0.61–1.03; p=0.083). For the rectal cancer patients (n=323), five-year RFS was 57.7% (95% CI: 48.4–65.9%) and 73.9% (95% CI: 65.3–80.6%) with bolus 5-FU/LV and PVI 5-FU respectively (p=0.035). Five-year OS was 65.3% (95% CI: 55.7–73.3%) and 78.7% (95% CI: 70.1–85.1%) with bolus 5-FU/LV and PVI 5-FU respectively (p=0.071). Significantly less diarrhoea, stomatitis, nausea & vomiting, alopecia, lethargy, neutropenia (all with p<0.0001) were seen with PVI 5-FU. Conclusions: PVI 5-FU was associated with a trend towards better relapse-free and overall survival compared to bolus 5-FU/LV, but with significantly less toxicity. Based on our results, the probability of twelve weeks of PVI 5-FU being inferior to 6 months of bolus 5-FU/LV is extremely low (p<0.005), and therefore shorter duration of adjuvant treatment should be further explored. No significant financial relationships to disclose.
Abstract 209: Time Intervals and Rearrest After Out-of-Hospital Cardiac Arrest
Authors: Allison C Koller, David D Salcido, Clifton W Callaway, James J Menegazzi
Journal: Circulation (2012)

Background: Re-arrest (RA) occurs when a patient loses pulses following return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA), but the exact causes of RA are not fully understood. Time-to-treatment intervals may affect patient outcome and could be a plausible contributor to RA. Objectives: To compare emergency medical services (EMS) time intervals between cases with and without RA. We hypothesized that RA cases will have significantly longer time intervals than no-RA cases. Methods: The Institutional Review Board of the University of Pittsburgh approved this study. Cases of EMS-treated, non-traumatic OHCA from 2006 to 2011 with at least one instance of prehospital ROSC were retrospectively gathered from the Pittsburgh site of the Resuscitation Outcomes Consortium. Prehospital event times were derived from computer assisted dispatch records. We calculated time intervals to the nearest minute, including 911 call to EMS arrival, arrival to first EMS CPR, EMS CPR to ROSC, and 911 call to arrival at the emergency department (ED). RA status was determined from electronic defibrillator downloads and patient care reports. We used logistic regression to examine the association between RA and each time interval while controlling for patient demographic and clinical variables with alpha = 0.05. Results: Two-hundred and thirty-five cases were analyzed, and 79 (34%) cases had an instance of RA. Mean time intervals and patient demographics are in Table 1. The RA group had a significantly higher proportion of males and shocked cases than the non-RA group. Odds ratios for the outcome of RA by time interval are as follows: 911 to arrival: 1.09 (CI: .98 - 1.21, p = 0.10); arrival to CPR: 1.02 (CI: 0.89 - 1.19, p = 0.74); CPR to ROSC: 0.99 (CI: 0.96 - 1.02, p = 0.86); 911 to ED: 0.99 (CI: 0.96 - 1.01, p = 0.35). Conclusion: EMS time intervals for OHCA were not predictive of RA.
Is there any relationship between the duration to diagnosis of COPD and severity of the disease
Authors: Esra Yazar, Fusun Sahin, Engin Aynaci, Pinar Yildiz, Akif Ozgul, Veysel Yilmaz
Journal: European Respiratory Journal (2012)

The aim of this study was to investigate whether there is a relation between the duration from begining of symptoms until diagnosis of chronic obstructive pulmonary disease (COPD) and severity of COPD. METHOD: One hundred and fifty patients with stable COPD (140 males, 10 females) were included in the study. All the patients had a history of smoking at least 10 pack/years. None of the patient had reversibility.

RESULTS: The mean of age, FEV1 and smoking history was 61±9 years, 45±16% and 48±21 pack/year, respectively. According to the GOLD criteria the patients had 40,7% moderate, 42% severe and 17,3% very severe COPD. Fifty five (59,8%) patients before, 19 (20,7%) patients during and 18 (19,5%) patients after diagnosis of COPD stopped smoking. The median duration of symptoms was 7,2±6,5 years. The median duration from the beginning of symptoms to diagnosis of COPD was 3,6±4 years. The median duration with the diagnosis of COPD was 4±6,5 years. The severity of the disease has a positive correlation with the duration of symptoms (r=0,23, p<0,01) and the duration to diagnosis of COPD (r=0,191, p<0,05). FEV1 has a negative correlation with duration of symptoms (r=-0,26, p<0,01), the duration to diagnosis (r=-16, p<0,05) and duration of COPD (r=-0,19, p<0,05).

CONCLUSION: The longer duration of symptoms and the duration to diagnosis of COPD the more severe of COPD will develop. It is important to be aware of the symptoms of COPD for early diagnosis.
The existence of internal visual memory representations
Authors: Jennifer D. Ryan, Neal J. Cohen
Journal: Behavioral and Brain Sciences (2001)

Although O'Regan &amp; Noë (O&amp;N) claim that the world may serve as the viewers' external visual memory, findings from the field of memory research have demonstrated the existence of internal visual representations. These representations are stored in the viewer's brain, contain information regarding visual objects and their relations, guide subsequent exploration of the visual world and promote change detection.
Women's mental health in Tunisia.
Authors: Saïda Douki, Fathy Nacef
Journal: World Psychiatry (2002)

Tunisia is the only country in the Arab world where the principle of equality between genders has been consecrated in legal texts. In 1956, the Code of Personal Status introduced the equality of rights, through a set of provisions such as the abolition of polygamy, the institution of legal divorce and recognition of both spouses' right to seek divorce, and the setting of a minimum age for marriage to young women. From that time on, these rights have become irreversible and have continued to adapt to social transformations which have occurred in Tunisia. However, women keep on being more exposed than men to many specific risk factors which greatly contribute to threaten their mental health, throughout their life (1).
The effect of a helicobacter pylori lysate on the tolerant state of human monocyte derived dendritic cells
Authors: Yolanda van Wijck, Alwin van der Ham, Leonie Hussaarts, Maria Yazdanbakhsh, Pieter Hiemstra, Anne Müller, Hermelijn Smits, Christian Taube
Journal: European Respiratory Journal (2014)

The worldwide observed change in the commensal flora is thought to affect tolerance to allergens and other harmless antigens. Epidemiological studies suggest that infection with  H. pylori  protects against developing asthma. Symptoms of allergic airway inflammation were reduced in mice infected with  H. pylori  and this effect has been linked to the modulation of dendritic cell (DC) function, induction of regulatory T cells (Treg) and production of IL-10 (Arnold, I.C. et al. JCI 2011 and Oertli, M. et al. JCI 2012). As live infection with  H. pylori  is potentially harmful, we tested a lysate of  H. pylori  on human monocyte-derived (mo-)DC. In this  in vitro  culture system DCs exposed to  H. pylori  lysate in presence or absence of LPS for 48 h fully matured, but strongly increased release of the anti-inflammatory cytokine IL-10. Subsequently, DC exposed to the lysate were cultured with naive T cells. Th1 cell skewing by DCs stimulated with the lysate was reduced. In contrast, T cells differentiated by the lysate-exposed DCs of a subgroup of donors secreted more IL-10 compared to T cells from control LPS-primed DCs, suggesting the induction of Tregs. These Tregs were able to suppress proliferation of alloreactive memory T cells  in vitro . Our results suggest that  H. pylori  lysate has strong IL-10 inducing capacities also in human mo-DCs, which can induce IL-10 secreting T cells with a suppressive function. Therefore we provide evidence that lysate from  H. pylori,  comparable to live bacteria ,  induces a tolerant state of the immune system. As this approach is not associated with the drawback of live infection the potential usage as a therapeutic approach needs to be further determined.
Pneumonia in Acute Respiratory Distress Syndrome
Authors: G. UMBERTO MEDURI, RAJU C. REDDY, TIMMYE STANLEY, FATEN EL-ZEKY
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

We evaluated the diagnostic yield of bilateral bronchoalveolar lavage (BAL) in patients with acute respiratory distress syndrome (ARDS) with suspected ventilator-associated pneumonia (VAP) and compared BAL results from contralateral sites. Ninety-four ARDS patients with suspected VAP underwent 172 bronchoscopies (344 BALs). BAL was processed for quantitative cultures, total cell count and subjected to microscopic analysis for cell differential, presence of intracellular organisms (ICO), and Gram stain. The diagnostic threshold for VAP was a growth of ⩾ 104 cfu/ml in BAL culture. Most episodes (68%) had bilateral insignificant bacterial growth. Forty (43%) patients had one or more episodes of VAP. Thirty-three of the 55 (60%) positive bronchoscopies had significant growth in only one side, 18 were right BAL, and 15 were left BAL. Episodes with bilateral significant growth were more likely to be polymicrobial, to have a bacterial growth ⩾ 105 cfu/ml in the BAL, and to possess a higher percentage of neutrophils and ICO. Among 65 microorganisms recovered in significant concentration, Pseudomonas aeruginosa occurred in 43% and S. aureus in 15%. Overall, Gram stain had a sensitivity of 54% and a specificity of 87%; and Giemsa stain ( > 2% ICO) had a sensitivity of 46% and a specificity of 93%. Antibiotic treatment was modified by the results of BAL cultures in 50 (91%) episodes of pneumonia. In patients with ARDS and suspected VAP, bilateral BAL quantitative bacterial cultures had significant growth on one side only in 19% and in both sides in 13%.
The relationship between syndrome and personality disorder in DSM-III: experience with 2,462 patients
Authors: Harold W. Koenigsberg, Richard D. Kaplan, Margaret M. Gilmore, Arnold M. Cooper
Journal: American Journal of Psychiatry (1985)

The authors studied the relationship between DSM-III axis I and axis II diagnoses in 2,462 medical center patients. Personality disorders were most commonly associated with substance use disorders and with the anxiety and somatoform disorders traditionally classified as neuroses. There was a particularly strong connection between antisocial personality disorder and substance abuse. The psychotic and major affective illnesses were significantly less often associated with personality disorders. The results of this study suggest a need for refining the criteria for several DSM-III categories. Overall, the separate personality disorder axis in the DSM-III system provides information not contained with the syndromal classification alone.
Role of Cytoskeletal Tension in the Induction of Cardiomyogenic Differentiation in Micropatterned Human Mesenchymal Stem Cell
Authors: Ajay Tijore, Pingqiang Cai, Mui Hoon Nai, Li Zhuyun, Wang Yu, Chor Yong Tay, Chwee Teck Lim, Xiaodong Chen, Lay Poh Tan
Journal: Advanced Healthcare Materials (2015)

The role of biophysical induction methods such as cell micropatterning in stem cell differentiation has been well documented previously. However, the underlying mechanistic linkage of the engineered cell shape to directed lineage commitment remains poorly understood. Here, it is reported that micropatterning plays an important role in regulating the optimal cytoskeletal tension development in human mesenchymal stem cell (hMSC) via cell mechanotransduction pathways to induce cardiomyogenic differentiation. Cells are grown on fibronectin strip patterns to control cell polarization and morphology. These patterned cells eventually show directed commitment toward the myocardial lineage. The cell's mechanical properties (cell stiffness and cell traction forces) are observed to be very different for cells that have committed to the myocardial lineage when compared with that of control. These committed cells have mechanical properties that are significantly lower indicating a correlation between the micropatterning‐induced differentiation and actomyosin‐generated cytoskeletal tension within patterned cells. To study this correlation, patterned cells are treated with RhoA pathway inhibitor. Severely down‐regulated cardiomyogenic marker expression is observed in those treated patterned cells, thus emphasizing the direct dependence of hMSCs differentiation fate on the cytoskeletal tension.
End of life care still requires improvement at nearly half of hospitals, report finds
Authors: Ingrid Torjesen
Journal: BMJ (2015)

Almost half of hospitals provide unacceptable care services at the end of life, a summary of data collected from inspections and published in a report by the Department of Health has found.1 

In July 2013 an independent review of the Liverpool care pathway by the rabbi and peer Julia Neuberger recommended that use of the pathway, which had been introduced in the 1990s, should be phased out in England because, although it delivered good care when used well, in many cases it was regarded as a tick box exercise.2 3 

A year later a coalition of 21 organisations known as …
Abstract 18263: Incident Heart Failure and All-Cause Mortality in Older Current Smokers and Former Smokers with 15 or More Years of Abstinence: Findings From a Prospective Population Study
Authors: Amiya A Ahmed, Gregg Fonarow, Gerasimos Filippatos, Yan Zhang, Inmaculada Aban, Maria Anastasiou-Nana, Wilbert Aronow, Patricia Sawyer, Richard Allman, Ali Ahmed
Journal: Circulation (2011)

Background: The 2004 Surgeon General's Report on “The Health Consequences of Smoking” suggests that after 15 years of abstinence, the cardiovascular (CV) risk of smoking becomes similar to that of never-smokers. At the AHA2010, we presented data that indicated that while that is true for most older former smokers, this benefit may not extend to older former heavy (≥32 pack-years) smokers. While the CV risk of former heavy smokers may take much longer than 15 years to become like that of never smokers, it is believed that the risk may be reduced compared to current smokers. In the current analysis, we compared the CV risk of older adults who quit smoking &gt;15 years ago relative to older current smokers. Methods: Of the 5795 community-dwelling older adults, age ≥65 years, in the public-use copy of the Cardiovascular Health Study data obtained from the NHLBI, 5604 had detailed data on current and past smoking. Of these, 5338 were free of prevalent HF at baseline. Of these, 629 were current smokers and 1298 were former smokers who quit &gt;15 years ago, who were categorized as former heavy (≥32 pack-years; n=312) and former light (&lt;32 pack-years; n=986) smokers. Results: Patients had a mean (±SD) age of 73 (±5) years; 45% were women; and 14% were African American. Former heavy smokers were older and more likely to be white men ( Table ). Unadjusted, age-sex-race-adjusted and multivariable-adjusted risk of centrally-adjudicated incident HF and all-cause mortality associated with former light and heavy smoking relative to current smokers during over 13 years of follow-up are displayed in the Table. Conclusions: Among community-dwelling older adults, compared with current smokers, former smokers who quit smoking &gt;15 years ago had substantial and significant independent reduction in all-cause mortality regardless of amount and duration of smoking prior to cessation. However, the association with reduced risk of incident HF was only significant for older former light (&lt;32 PY) smokers.