tbuckley/cabot-search huggingface dataset:
Is the National Health Service at the Edge of Chaos?
Authors: Marios C Papadopoulos, Michalis Hadjitheodossiou, Costas Chrysostomou, Carl Hardwidge, B Anthony Bell
Journal: Journal of the Royal Society of Medicine (2001)

We used chaos and complexity theory to analyse waiting-list data (1998-2001) pertaining to over 20 000 National Health Service (NHS) patients from general surgical, orthopaedic and neurosurgical units across England. Plots of frequency versus quarter-to-quarter change in waiting times revealed a power relation which seems independent of surgical specialty and hospital location. One interpretation of these findings is that, for the period in question, the NHS was a system at the edge of chaos. This hypothesis might explain why waiting times have resisted attempts at shortening.
Partial Deletion of Chromosome #2 in Myelocytic Leukemias of Irradiated C3H/He and RFM Mice2
Authors: Isamu Hayata, Takaaki Ishihara, Kunitake Hirashima, Toshihiko Sado, Junji Yamagiwa
Journal: JNCI Journal of the National Cancer Institute (1979)

Journal Article Partial Deletion of Chromosome #2 in Myelocytic Leukemias of Irradiated C3H/He and RFM Mice Get access Isamu Hayata, Isamu Hayata 3National Institute of Radiological Sciences, 4-9-1 Anagawa, Chiba, Japan 260. Search for other works by this author on: Oxford Academic PubMed Google Scholar Takaaki Ishihara, Takaaki Ishihara 3National Institute of Radiological Sciences, 4-9-1 Anagawa, Chiba, Japan 260. Search for other works by this author on: Oxford Academic PubMed Google Scholar Kunitake Hirashima, Kunitake Hirashima 3National Institute of Radiological Sciences, 4-9-1 Anagawa, Chiba, Japan 260. Search for other works by this author on: Oxford Academic PubMed Google Scholar Toshihiko Sado, Toshihiko Sado 3National Institute of Radiological Sciences, 4-9-1 Anagawa, Chiba, Japan 260. Search for other works by this author on: Oxford Academic PubMed Google Scholar Junji Yamagiwa Junji Yamagiwa 3National Institute of Radiological Sciences, 4-9-1 Anagawa, Chiba, Japan 260. Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 63, Issue 3, September 1979, Pages 843–848, https://doi.org/10.1093/jnci/63.3.843 Published: 01 September 1979 Article history Received: 01 December 1978 Accepted: 27 March 1979 Published: 01 September 1979
Oesophageal entrapment of wireless capsule endoscopy in valvular patients
Authors: E Redondo-Cerezo
Journal: Gut (2005)

The degree and significance of postoperative mental changes caused by surgery and anesthesia are still debatable. However, after open heart surgery and after extensive surgery on elderly patients, long-lasting mental changes do occur. The susceptibility of older people to such cerebral damage may be due to preoperative marginal circulation in parts of the brain, and a small reserve of functioning neurones compared to younger patients.
Silent microaspiration in idiopathic pulmonary fibrosis: The role of videolaryngoscopy
Authors: Emanuela Rossi, Ariel Floriani, Claudia Rinaldo, Nazarena Nannini, Giuseppe Marulli, Monica Loy, Federico Rea, Fiorella Calabrese, Elisabetta Balestro
Journal: European Respiratory Journal (2012)

A strong association between gastroesophageal reflux (GER) and idiopathic pulmonary fibrosis (IPF) has been reported. A significant proportion of patients may have signs of microaspiration and still remain asymptomatic. Videolaringoscopy can be a useful tool to detect silent microaspiration, which to date has never been investigated in IPF. The aim of the study was to assess signs of micro-aspiration by videolaryngoscopy in patients with IPF and to relate them with clinical findings.  We recruited 20 IPF patients (mean age 52 + 7 yrs). We investigated the presence/absence of GER symptoms and performed videolaryngoscopy to evaluate abnormal laryngeal findings considered indirect signs of micro-aspiration. Three out of twenty patients (15%) had classic GER symptoms, while 17 (85%) did not report any kind of GER symptoms. Among asymptomatic patients, 5 (29%) had indirect signs of microaspiration at videolaryngoscopy while the remaining twelve had no such signs. Of interest, IPF patients with laryngeal abnormalities at videolaryngoscopy showed a lower FVC% at the diagnosis compared to patients without such abnormalities [46%(45-82) vs 75%(72-87) p=0,03]. Conversely, no differences in age, smoking history and BMI were found between the two groups of patients. In conclusion our study suggests that videolaryngoscopy may be a useful diagnostic tool to detect silent microaspiration in patients with IPF even in the absence of GER symptoms. These findings may have important therapeutic implications.
Effect of &lt;italic&gt;Corynebacterium parvum&lt;/italic&gt; and Chronic &lt;italic&gt;Toxoplasma&lt;/italic&gt; Infection on Metastatic Brain Tumors in Mice&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: F K Conley
Journal: JNCI Journal of the National Cancer Institute (1979)

Nonspecifically induced resistance to growth of metastatic tumor in the central nervous system (CNS) was studied in mice either chronically infected with Toxoplasma gondll or pretreated lv with Corynebacterium parvum. Groups ot control, C. parvum-treated, and Toxoplasma-infected C3H/BI female mice received direct left intracardlac injections of 1x105 KHT sarcoma cells; in some mice tumor injections were tollowed 24 hours later by 3,000 rads cardiac irradiation. Mice were observed until death and then autopsied, and tumor incidence was recorded. All brains were examined microscopically. Cardiac irradiation eliminated cardiac tumor in all experimental groups, did not affect tumor incidence at any anatomic site in C. parvum-treated or Toxoplasma-infected mice, and protected control mice from developing lung tumor. The incidence of metastatic brain tumor in Toxoplasma-infected mice was markedly decreased when compared with nonirradiated or irradiated controls; however, C. parvum-treated mice had an incidence of brain tumors equal to that of control mice despite evidence that C. parvum provided systemic protection against development of heart and lung tumors. Peritoneal macrophages from both treated and infected mice were cytostatic to KHT cells in vitro, whereas those from control mice were not. A marked inflammatory response was observed in the brains of the few Toxoplasma-infected mice that developed metastatic brain tumor; no inflammation was seen in the brains of either control or C. parvum-treated mice. These results suggested that the differing action of C. parvum and Toxoplasma in resistance to metastatic brain tumor is related to the ability of the immunomodulatlng agent to stimulate an inflammatory response in the CNS.
Low molecular weight heparin: a critical analysis of clinical trials.
Authors: D Green, J Hirsh, J Heit, M Prins, B Davidson, A W Lensing
Journal: Pharmacological Reviews (1994)

LMWHs are an important new class of antithrombotic agents. They differ from UFH in having relatively more anti-Xa activity, greater bioavailability at low doses, longer half-life, and more predictable anticoagulant response when administered in fixed doses. These properties allow LMWHs to be administered QD or at most BID and without laboratory monitoring. The incidence of heparin-induced thrombocytopenia also appears to be lower with an LMWH than with heparin. Given their favorable pharmacological profile, it was of interest to critically appraise clinical trials of thromboprophylaxis and treatment with these new agents. In orthopedic trials, it was noted that LMWH provided safe and effective thromboprophylaxis for patients undergoing major orthopedic surgery of the lower limb. In those having hip arthroplasty, LMWH was as effective as low-intensity warfarin therapy, but its use was associated with more wound hematomas. In those having total knee arthroplasty, LMWH was more effective than warfarin and did not increase bleeding. However, the prevalence of DVTs complicating this procedure as well as acute hip fracture remains unacceptably high, and additional studies of LMWH in combination with other prophylactic methods, such as external pneumatic compression, are needed. Only one adequately designed trial found less bleeding resulted from LMWH prophylaxis administered at an equivalent antithrombotic dose to UFH. In general medical patients, LMWH appeared to be as effective as UFH and had the advantages of less frequent injections and fewer injection site hematomas. In general surgical patients, there was a lower risk of thromboembolism but a trend toward an increase in bleeding events. Subjects with strokes and spinal cord injuries benefited from fewer thrombotic events, and the latter had fewer bleeding complications. Other potential indications for LMWH, such as cardiopulmonary bypass, hemodialysis, and preservation of graft patency, are presently under study. Perhaps the most impressive benefits of LMWH will be realized when it is used for the treatment of venous thromboembolism. The meta-analysis presented in this review showed a trend toward greater efficacy with LMWH and fewer major bleeding events in comparison with adjusted-dose intravenous UFH. Also, during the months following the thrombotic event, there was significantly less mortality in patients receiving LMWH. A further advantage was the subcutaneous route of administration and lack of requirement for laboratory monitoring. Additional treatment trials are presently in progress and may establish LMWH as the treatment of choice for patients with thromboembolic disorders.
Measurement of serum levels of eosinophil cationic protein in the diagnosis of acute gastrointestinal anisakiasis
Authors: J. Domínguez-Ortega, J.C. Martínez-Alonso, A. Alonso-Llamazares, C. Argüelles-Grande, M. Chamorro, T. Robledo, R. Palacio, C. Martínez-Cócera
Journal: Clinical Microbiology and Infection (2003)
Abstract MP18: DNA Methylation Variants, B Vitamins Intake, and Long-Term Weight Change: Gene-Diet Interactions in Two Us Cohorts
Authors: Tao Huang, Yan Zheng, Qi Qibin, Min Xu, Sylvia H. Ley, Yanping Li, Jae H. Kang, Janey Wiggs, Louis R. Pasquale, Andrew T. Chan, Eric B. Rimm, David J. Hunter, JoAnn E. Manson, Walter C. Willett, Frank B. Hu, Lu Qi
Journal: Circulation (2015)

Background:  The first epigenome-wide association study of body-mass index (BMI) identified DNA methylation at a HIF3A locus associated with BMI. However, the DNA methylation-associated genetic variants themselves were not associated with BMI. We aimed to test the hypothesis that DNA methylation variants might be associated with BMI according to intake of B vitamins, established metabolic cofactors of methylation.   Methods:  We analyzed the interaction between DNA methylation-associated HIF3A variants (rs3826795 and rs8102595) and intake of B vitamins in relation to BMI and its 10-year change in 8109 women from the Nurses’ Health Study (NHS) and 6761 men from the Health Professionals Follow-up Study (HPFS). Intake of B vitamins was assessed by validated semi-quantitative food frequency questionnaires. Results for the two cohorts were pooled by means of inverse-variance-weighted, fixed-effects meta-analyses.   Results:  In meta-analyses of the NHS and HPFS, DNA methylation variants were not associated with adiposity measures. However, we found significant interactions between the DNA methylation-associated HIF3A SNP rs3826795 and habitual intake of B vitamins in relation to 10-year changes in BMI. The association between rs3826795 and BMI changes consistently increased across the tertiles of total vitamin B2 and vitamin B12 intake in the NHS and HPFS. In combined analyses of cohorts, the differences in the continuous BMI changes per increment of minor allele (A allele) were -0•10 (SE 0•06), -0•01 (SE 0•06), and 0•12 (SE 0•07) kg/m2 within subgroups defined by increasing tertiles of total vitamin B2 intake (all P for interaction    Conclusions:  In the combined data from these two cohorts, a DNA methylation variant in HIF3A was associated with BMI changes through interactions with intakes of vitamin B2, vitamin B12, and folate. These findings, which should be replicated, suggest a potential causal relation between DNA methylation and adiposity.
Comparison of Static and Dynamic Repairs for Ligamentous Instability of the Knee
Authors: Richard Rawlins
Journal: Journal of the Royal Society of Medicine (1983)

Twenty-three patients who have had a Macintosh type of fasciodesis for anterolateral rotary instability of the knee have been studied. Overall 73% were improved by this procedure; of those whose only instability was when turning on the run, 90% improved. These results have been compared with a series of 51 patients who had a pes anserinus transfer for anteromedial instability (D'Arcy 1978). It is suggested that both static and dynamic reconstructions have a place in the management of knee instability resulting from anterior cruciate injury.
Pulmonary pathological findings in autopsies of sickle cell disease in Brazil
Authors: Germán Rasse, Guilherme Hencklain, Sandra Menosi, Vera Demarchi, Rogerio Souza, Thais Mauad
Journal: European Respiratory Journal (2013)

Sickle cell disease (SCD) is characterized by hemolysis, vasculopathy and prothrombotic tendency. Pulmonary arterial hypertension (PAH) affects up to 10% of patients and is associated with higher mortality. We describe lung pathological findings of SCD patients in a large autopsy setting of 60 years, in Sao Paulo, Brazil.  Methods: One-hundred and one cases with autopsy diagnosis of SCD were identified in the period 1950-2011. We excluded cases without material, other lung pathology (cancer, HIV), of children   Results: Mean age was 31 (10-64) years, gender ratio 1:1. Nineteen cases had SS disease, 8 had SC disease and 4 had Sβ0 thal. Recent thrombosis, constrictive arteriopathic changes and focal or diffuse capillary hemangiomatosis-like lesions were common findings. A single case presented a small plexiform lesion (SS female with severe iron overload, hepatitis C and cirrhosis).  Conclusion: Pulmonary vascular changes are frequent in deceased SCD patients, comprising both acute and chronic vasculopathies. Noteworthy is the rarity of plexiform lesions in this setting, as compared to those seen in idiopathic PAH.
Poor treatment outcomes of XDR-TB patients in resource-limited settings
Authors: Giovanni Sotgiu, Elize Pietersen, Rosella Centis, Malika Davids, Andrea Piana, Devan Vaghela, Kai Kliiman, Lia D'Ambrosio, Grant Theron, Giovanni Battista Migliori, Keertan Dheda
Journal: European Respiratory Journal (2012)

Background: According to the last report of the World Health Organization 69, countries have diagnosed at least one case of extensively drug-resistant tuberculosis (XDR-TB). Treatment success rates for XDR-TB have been highly variable. To gain further insight into this issue we compared outcomes in a low (LI) versus middle/high income (MHI) countries.

Objective: To compare XDR-TB-related treatment outcomes (i.e. culture conversion and mortality) in MHI vs. LI countries

Methods: A comparative retrospective evaluation of a European (Estonia and Italy) vs. South-African datasets, which included only culture-confirmed XDR-TB cases, was performed. Covariates, potentially associated to negative or positive treatment outcomes, were partially explored.

Results: A total of 235 XDR-TB patients were enrolled [61 from Europe (70.5%, males) and 174 (51.2% males) from South Africa]. Their mean (standard deviation) age was 47.0 (12.2) and 35.2 (11.2) years, respectively (P<0.001). HIV co-infection was significantly more frequent in the South-African cohort (82/174, 47.1%, vs. 2/58, 3.5%; P<0.001). A higher proportion of deaths was recorded among South-African XDR-TB cases (61/174, 35.1%, vs. 14/61, 23.0%; P:0.08). By contrast, the proportion of culture converters during anti-TB treatment was significantly higher in the European group (28/57, 49.1%, vs. 33/174, 19.0%; P<0.001). HIV co-infection was significantly associated with death, but not culture conversion, in the combined cohort (aOR: 2.37; P:0.008).

Conclusion: Unfavorable outcomes, although common in both settings, are more frequent in a resource-poor setting. These data can inform prevention and treatment strategies for XDR-TB in different settings.
Randomized comparison of four tools measuring overall quality of life in patients with advanced cancer.
Authors: J A Sloan, C L Loprinzi, S A Kuross, A W Miser, J R O'Fallon, M R Mahoney, I M Heid, M E Bretscher, N L Vaught
Journal: Journal of Clinical Oncology (1998)

PURPOSE We report on a clinical trial developed to compare four different instruments that provide overall quality-of-life (QOL) scores, ranging from a simple, one-item instrument to more detailed instruments. Two issues addressed were (1) Will QOL tools suffer from missing data when used in a community-based cooperative group setting?, and (2) Are there additional data generated by a more detailed multiitem instrument over that provided by a single-item global QOL question? MATERIALS AND METHODS A four-arm randomized trial was designed to compare four instruments that provide overall QOL scores in patients with advanced colorectal cancer. Patients and physicians completed the single-item Spitzer Uniscale (UNISCALE) at baseline and monthly. Patients were randomly assigned to complete, in addition, either the 22-item Functional Living Index-Cancer (FLIC), the five-item Spitzer QOL index (QLI), a picture-face scale (PICT), or nothing else. RESULTS A total of 128 patients were randomized. Greater than 90% complete QOL data were obtained. There was strong correlation, concordance, and criterion-related validity among all four patient-completed tools. The UNISCALE had a greater decrease over time than did the FLIC (P=.005), which suggests a greater sensitivity; the UNISCALE was similar to the QLI and the PICT in this regard. Physicians provided lower UNISCALE scores than patients. Results supported the hypothesis that QOL is prognostic for survival. CONCLUSION Patients can effectively complete QOL tools in a cooperative group setting with proper education of health care providers and patients. A simple single-item tool (UNISCALE) appears to be appropriate to obtain a measure of overall QOL.
Abstract P345: Prediction of Cardiovascular Disease Events and Death using Multiple Biomarkers in African Americans: the Jackson Heart Study
Authors: Solomon K Musani, Ramachandran Vasan, Aurelian Bidulescu, Jung Lee, Gregory Wilson, Tandaw Samdarshi, Michael Steffes, Michael J Pencina, Vanessa Xanthakis, Herman A Taylor, Ervin R Fox
Journal: Circulation (2014)

Background: The usefulness of biomarkers from different biologic pathways for predicting cardiovascular disease (CVD) events among African Americans is not well understood. Methods: We evaluated prospectively 3,102 Jackson Heart Study participants (mean age 54 years; 64% women) with data on a panel of 9 biomarkers representing inflammation (high sensitivity C - reactive protein), adiposity (adiponectin, leptin), neurohormonal activation (B-type natriuretic peptide [BNP], aldosterone, and cortisol); insulin resistance (HOMA-IR); and endothelial function (endothelin and homocysteine). We used Cox proportional hazard regression to relate the biomarker panel to the incidence of CVD (stroke, coronary heart disease, angina, heart failure and intermittent claudication) adjusting for standard CVD risk factors. Results: On follow-up (median 8.2 years), 224 participants (141 women) experienced a first CVD event, and 238 (140 women) died. Circulating concentrations of aldosterone, BNP and HOMA-IR were associated with CVD (multivariable-adjusted hazard ratios [HR] and 95% confidence interval [CI] per standard deviation (SD) increase in log-biomarker) were, respectively 1.15, (95% CI 1.01-1.30, p=0.016), 1.97, (95% CI 1.22-2.41, p&lt;0.0001), and 1.30, (95% CI 1.10-1.52, p=0.0064). Blood cortisol and homocysteine were associated with death (HR per SD increment log-biomarker, respectively, 1.17, (95% CI 1.01-1.35, p=0.042), and 1.24, (95% CI 1.10-1.40, pvalue=0.0005). Biomarkers improved risk reclassification by 0.135; 0.120 of which was gained in classification of participants that experienced CVD events and 0.015 from participants that did not. Also, biomarkers marginally increased the model c-statistic beyond traditional risk factors. Conclusions: In our community-based sample of African Americans, circulating aldosterone, BNP and HOMA-IR predicted CVD risk, whereas serum cortisol and homocysteine predicted death. However, the incremental yield of biomarkers over traditional risk factors for risk prediction was minimal.
Specific challenge tests: The relationship between response, clinical variables and lung function
Authors: Chung Hu, Maria-Jesus Cruz, Iñigo Ojanguren, Ferran Morell, Xavier Muñoz
Journal: European Respiratory Journal (2014)

Introduction:  The specific inhalation challenge (SIC) is considered the gold standard for the diagnosis of occupational asthma (OA). However, it is not well standardized, and the intensity of exposure is regulated empirically. The aim of this study was to identify clinical variables and/or pulmonary function variables able to predict the magnitude of the response to SIC.   Material and methods:  All patients who underwent SIC between 2005 and 2013 were studied. Anthropometric characteristics, atopic status, type of causal agent, latency times, pulmonary function tests and SIC results were analysed.   Results:  203 patients (51% men, mean age 42.6 ± 11.3 years) were assessed, of whom 88 (43%) had positive SIC. Among patients with positive SIC those with a lower PC20 at baseline presented a greater decline in FEV1 during testing (r = -0376, p = 0.002). In the overall population, the mean (SD) % falls in FEV1 were 23.3 (13.60) and 16.30 (10.13) for patients exposed to high-molecular weight and low molecular weight agents respectively; the differences were significant (p = 0.002). No relationship was observed between the other variables analysed and the fall in FEV1 during SIC.   Conclusions:  The size of the response to SIC is influenced by a positive methacholine baseline test and by the causal agent. These data should be taken into account in the stages prior to the performance of SIC.
Physiological signals distinguish between reading emotional and non-emotional sections in a novel
Authors: Anne-Marie Brouwer, Maarten Hogervorst, Boris Reuderink, Ysbrand van der Werf, Jan van Erp
Journal: Brain-Computer Interfaces (2015)

We are interested in monitoring an individual's emotions during the reading of a novel. While physiological responses to experimentally induced emotions are often small and inconsistent, being engaged in a novel may elicit relatively strong responses. We analyzed EEG, ECG, skin conductance and respiration of 57 readers reading a complete, yet to be published novel written by a popular contemporary writer (Arnon Grunberg) and compared physiology during the reading of pre-defined sections that were either emotionally intense or not. Heart rate was lower while reading emotional sections. We also found effects of emotional intensity on breathing variability and alpha asymmetry. Most of the examined physiological variables were strongly affected by time on task. We could estimate whether the physiological data of an individual reader were collected during the reading of an emotional or non-emotional section with an accuracy of up to 72% using individualized models and after correcting data for individually modeled time-related effects. Our results imply that using our methodology, it is possible to examine fluctuating reader's emotion during the reading of a novel after reading, but not (yet) in real time.
Breathless
Authors: John J. Ross, Anand Vaidya, Michael C. Gavin, Danielle Morse, Ann H. Partridge
Journal: New England Journal of Medicine (2011)

A 50-year-old woman presented with fatigue and shortness of breath. One week before presentation, she experienced the gradual onset of dyspnea after moderate exertion, profound malaise, and a non-productive cough. In the 48 hours before admission, her shortness of breath worsened, such that she was dyspneic while at rest. She reported palpitations, nausea, and bilious emesis . . .