tbuckley/cabot-search huggingface dataset:
The hyperviscosity syndrome
Authors: Malcolm R. MacKenzie, H. Hugh Fudenberg, Robert A. O'Reilly
Journal: Journal of Clinical Investigation (1970)

The hyperviscosity syndrome is an uncommon complication in IgG myeloma. Its occurrence has been ascribed to the presence in the serum of high molecular weight polymers of the IgG proteins. Three patients with IgG myeloma and the clinical hyperviscosity syndrome were investigated, none of whom had IgG polymers in the serum by analytical ultracentrifugation. Relative serum viscosity in these patients ranged from 10 to 17.4 (normal 1.4-1.8). The total serum proteins ranged from 14 to 19 g/100 ml of which 10 to 17 g/100 ml was IgG globulin. Physicochemical studies of two of the isolated myeloma proteins indicated that they were of normal molecular weight (near 158,000 and 162,000). Protein Ca had a normal molecular radius (52.2 A) and configuration, (intrinsic viscosity of 5.5 cc/g, frictional ratio 1.48), but was present in very high concentration in the serum. Protein Pur had an increased molecular radius (58.2 A) and was asymmetrical (intrinsic viscosity 10.2 cc/g, frictional ratio 1.63). These results indicate that the concentration and molecular configuration of the myeloma protein are important determinants of the presence or absence of the hyperviscosity syndrome.
Prevalence of Sleep-disordered Breathing in Women
Authors: EDWARD O. BIXLER, ALEXANDROS N. VGONTZAS, HUNG-MO LIN, THOMAS TEN HAVE, JENNIFER REIN, ANTONIO VELA-BUENO, ANTHONY KALES
Journal: American Journal of Respiratory and Critical Care Medicine (2001)

The prevalence of sleep-disordered breathing has not been well studied in women, especially in terms of the effects of age, body mass index (BMI), and menopause. We evaluated this question using a two-phase random sample from the general population. In Phase I, 12,219 women and 4,364 men ranging in age from 20 to 100 yr were interviewed; and in Phase II, 1,000 women and 741 men of the Phase I subjects were selected for one night of sleep laboratory evaluation. The results of our study indicated that, for clinically defined sleep apnea (apnea/hypopnea index ⩾ 10 and daytime symptoms), men had a prevalence of 3.9% and women 1.2%, resulting in an overall ratio of sleep apnea for men to women of 3.3:1 (p = 0.0006). The prevalence of sleep apnea was quite low in premenopausal women (0.6%) as well as postmenopausal women with hormone replacement therapy (HRT) (0.5%). Further, in these women the presence of sleep apnea appeared to be associated exclusively with obesity (BMI ⩾ 32.3 kg/m2). Postmenopausal women without HRT had a prevalence of sleep apnea that was significantly higher than the prevalence in premenopausal women with HRT (2.7 versus 0.6%, p = 0.02) and was more similar to the prevalence in men (3.9%), although it remained significantly less when controlling for age and BMI (p = 0.001). These data combined indicate that menopause is a significant risk factor for sleep apnea in women and that hormone replacement appears to be associated with reduced risk.
Ten-year outcome of tardive dyskinesia
Authors: G Gardos, D E Casey, J O Cole, A Perenyi, E Kocsis, M Arato, J A Samson, C Conley
Journal: American Journal of Psychiatry (1994)

The purpose of this study was to assess the long-term outcome of patients with tardive dyskinesia.A group of 122 neuroleptic-treated Hungarian outpatients were assessed for tardive dyskinesia on the Abnormal Involuntary Movement Scale and the Tardive Dyskinesia Rating Scale by the same rater over a 10-year period.Sixty-three of the patients received both 5- and 10-year follow-up assessments and are the subjects of this report. The overall prevalence of tardive dyskinesia in this group changed little over time; it was 30.2% at baseline, 36.5% at 5 years, and 31.7% at 10 years. However, there were changes in the tardive dyskinesia status of individual patients; 11 patients had remissions, and 12 who did not have tardive dyskinesia at the baseline assessment had developed it by the 10-year assessment. These two subgroups did not differ significantly on demographic and drug history variables. Outcome of tardive dyskinesia was not significantly related to neuroleptic treatment or to age.The data of this 10-year follow-up study provide evidence for the long-term stability of tardive dyskinesia and for the feasibility of maintenance neuroleptic therapy for chronic psychotic patients who have tardive dyskinesia.
Prescriptions: The Dissemination of Medical Authority
Authors: Gayle L. Ormiston, Raphael Sassower
Journal: Annals of Internal Medicine (1991)

Introduction The Conceptual Displacement of Health-Care Protocols Democratizing Medicine by Joseph Agassi Contemporary Bioethics and the Demise of Modern Medicine by Robert M. Veatch Humanizing Health-Care Practice Through a More Humane Technology of Concepts by James W. Dickoff and Patricia James Eliminating Hierarchies: Realigning Individual Values and Social Norms Increasing Health Consumerism: Can It Be Done? by Marilyn L. Stember The New Reproductive Technologies: Ethical, Social, and Public Policy Concerns by Michael A. Grodin Overcoming Scientific Pretenses: The Duplicity of Psychoanalysis Psychoanalysis as Religion: Psychoanalytic Theory as Ideology, Psychoanalytic Practice as Cure of Souls by Thomas Szasz Seduction in Tongues: Reconstructing the Field of Metaphor in the Treatment of Schizophrenia by Nathaniel Laor Selected Bibliography Index
Our most unforgettable error: Always take a proper drug history
Authors: P B Sabapathy, A K Sharma
Journal: BMJ (1999)

It was a busy on call for our surgical unit when a 50 year old veterinary surgeon presented at the accident and emergency department with severe abdominal pain and distension of 10 hours' duration He had not passed wind or motions since the beginning of the episode His vomit was green. He had also been having loose motions—about two or three episodes a day—in the preceding six days.

On examination, …
Validity of the MMPI with native Americans
Authors: David Pollack, James H. Shore
Journal: American Journal of Psychiatry (1980)

A study was conducted to determine the validity of the MMPI for 142 American Indian patients from Pacific Northwest tribes. All the MMPI profiles were similar and had significant elevations in the Sc, Pd, and Pa scales. There was no significant difference between diagnostic groups on many clinical scales. Nonpsychotic, depressed Indian patients could not be distinguished from schizophrenic patients on any clinical scale, and there were no significant differences between antisocial-alcoholic patients and those with situational reactions. There were minimal differences between the Northwest Coast, Plateau, and Plains cultural groups. The authors believe that the similarity of all subgroup profiles demonstrates a significant cultural influence on the results of the MMPI in this population of American Indians.
Doing it my way: Sensation, perception – and feeling red
Authors: Nicholas Humphrey
Journal: Behavioral and Brain Sciences (2001)

The theory presented here is a near neighbour of Humphrey's theory of sensations as actions. O'Regan &amp; Noë have opened up remarkable new possibilities. But they have missed a trick by not making more of the distinction between sensation and perception; and some of their particular proposals for how we use our eyes to represent visual properties are not only implausible but would, if true, isolate vision from other sensory modalities and do little to explain the phenomenology of conscious experience in general.
Effectiveness of smoking cessation advice following admission to hospital
Authors: Nicola Hunt, Laura Watkins, Oliver McConnell, Sam Westall, Catriona Holden, James Young-Jamieson, Marta Babores, Sriram Chandramouli
Journal: European Respiratory Journal (2012)

Intro   Hospitalization offers patients a good opportunity to quit smoking especially when they are admitted with a respiratory illness. The Department of Health (DoH) recommends that all inpatient smokers should be offered support by a smoking cessation officer(SCO) 1 .   Aims   • Evaluate if smoking cessation advice is offered to patients admitted with a respiratory illness  • Identify a relationship between abstinence and types of smoking cessation aids used   Methods   Prospective follow up of 100 patients in respiratory clinic following hospital admission with a respiratory condition between December 2010 and October 2011. Baseline demographics and data on smoking habits and cessation advice were collected. Chi squared test was used to assess statistical significance.   Results   Median (range) age of patients was 62 years (22 – 97). 52 were male.  Of 100 patients 85 were offered cessation advice. 51 (60%) were seen by SCO.  At follow up (1 to 3 months post discharge) 36 patients were abstinent. Age, gender or degree of tobacco consumption pre-admission did not influence likelihood of cessation.  SCO review was associated with abstinence (p=0.02). The most effective methods of cessation were willpower (P=0.001) and use of nicotine replacement therapy (NRT, p=0.006).   Conclusions   The majority of patients admitted with an acute respiratory illness were offered cessation advice as recommended by DoH. SCO counselling and NRT are powerful tools and affect success rates. Surprisingly, most quitters in our study did not use additional aids and used hospitalization alone as an impetus to give up smoking.   References   1.Department of Health (1999) Smoking kills: a White Paper on tobacco.(The Stationery Office, London).
Piebaldism associated with congenital dyserythropoietic anemia type II (HEMPAS)
Authors: Seyfettin Köklü, Derun Ertuğrul, Ahmet Mesut Onat, Sema Karakuş, İbrahim C. Haznedaroğlu, Yahya Büyükaşık, Nilgün Sayınalp, Osman Özcebe, Semra V. Dündar
Journal: American Journal of Hematology (2002)

Abstract Congenital dyserythropoietic anemias (CDAs) are a group of relatively rare inherited anemias. They are characterized by ineffective erythropoiesis and classified as three major groups and a number of variants. CDA type II, also known as hereditary erythroblastic multinuclearity with a positive acidified serum test (HEMPAS), is the most frequent one. A number of associations with CDA II have been reported, although each described only one or a few patients. Here we presented a piebald woman with vaginal atresia who was tested for anemia and diagnosed as CDA type II. Piebaldism and anemia association were previously described in the mouse. Our case was the first that shows the features of both piebaldism and CDA in the same patient. This association may suggest a stem cell defect to cause both hematopoietic and cutaneous manifestations. Am. J. Hematol. 69:210–213, 2002. © 2002 Wiley‐Liss, Inc.
Abstract 1120: Chest Pain and Dyspnea in a Pregnant Woman with a Prosthetic Valve
Authors: Jameel Ahmed, George Philippides, Michael Klein
Journal: Circulation (2008)

A 31 year old pregnant female at nine weeks gestation presented with a complaint of recurrent chest pain and dyspnea. The patient had undergone aortic valve replacement with a bileaflet mechanical valve at 25 years of age. Most recently, she had been anti-coagulated with low-molecular weight heparin. The patient had missed two doses of enoxaparin over the prior week. Physical examination was notable for muffled, but audible mechanical valve sounds with an early peaking, systolic murmur over the right sternal border. Transthoracic echocardiogram revealed an elevated mean trans-aortic gradient of 38 mm Hg. Of note, echocardiogram at an outside hospital six days earlier had revealed normal gradients. Trans-esophageal echocardiography was performed, which revealed a poorly mobile posterior leaflet without large thrombus, and confirmed elevated gradients. Fluoroscopy of the aortic prosthesis also revealed a fixed posterior leaflet. A presumptive diagnosis of prosthetic valve obstruction (PVO) due to prosthetic valve thrombosis (PVT) was made. After discussion with the patient, intravenous tissue plasminogen activator was administered. Fluoroscopy the following day revealed both aortic valve leaflets to be fully mobile and transthoracic echocardiogram demonstrated normal trans-aortic gradients. Patient was anti-coagulated with enoxaparin until twelve weeks gestation and with coumadin for the duration of her pregnancy. At 37 weeks, a healthy, baby boy was delivered. PVO can be caused by thrombus, pannus formation or endocarditis. PVT is the most common etiology, with an annual rate of 0.5 to 8%. An increase in clotting factors during pregnancy results in a physiologic hypercoagulable state and higher rates of thromboembolic complications. Management options of PVT include surgery or intravenous thrombolytic therapy. Trans-esophageal echocardiography can be used to help guide management. This case illustrates the difficulties in the diagnosis and management of a relatively uncommon condition (prosthetic valve thrombosis) in a common patient (pregnant female). In conjunction with the clinical history and physical examination, various imaging modalities were utilized to arrive at a likely diagnosis and formulate a management plan.
Quality of life and asthma control: A UK population survey
Authors: Emily Humphreys, Jane Upton, Samantha Walker, David Price
Journal: European Respiratory Journal (2014)

Introduction : Asthma is a long term condition resulting in 65,000 emergency hospital admissions/year in the UK. Interventions to improve asthma outcomes are required but up-to-date outcomes data is lacking.   Aims and objectives : To describe asthma specific quality of life, asthma control and exacerbation rates in the UK.   Methods : Adults (18-75y) in England, Scotland and Wales with a diagnosis of asthma and a current prescription for asthma medication were invited to participate in this cross-sectional telephone survey. Measures included the Marks Asthma Quality of Life Questionnaire (AQLQ-M), 0-60; high scores=poorer control; Asthma Control Test (ACT), well controlled asthma ≥20; and the Royal College of Physicians 3 Questions (RCP3Q), well controlled asthma =0; and exacerbation rates.   Results:  Of the 658 participants (response rate 49%), 427 (65%) were female. Median (IQR) age was 50 (41-63y). Median AQLQ-M score was 9.1 (IQR 2-12). 17% reported ≥1 asthma exacerbation over the last year. Asthma control was poor for 38% (ACT) - 52% (RCP3Q) participants. Of those prescribed inhaled bronchodilators alone, 33% (ACT) - 45% (RCP3Q) did not have well controlled asthma. In the past week 50% of all participants reported having asthma symptoms, 16% said asthma had interfered with their daily activities and 15% had difficulty sleeping due to asthma. 27% felt dependent on asthma medication, 26% reported a general lack of energy, 19% were restricted in doing exercise and 18% had been troubled by episodes of shortness of breath.   Conclusions : Asthma outcomes remain sub-optimal in this UK population. Interventions to reduce morbidity and mortality should focus on preventing asthma attacks and improving asthma control.
Influence of ventilatory inefficiency in to limit exercise capacity in COPD patients
Authors: Iván Caviedes, Rodrigo Soto
Journal: European Respiratory Journal (2012)

Background : We recently demonstrated an influence of Ventilatory efficiency (VE/VCO2) over exercise capacity in COPD (Resp Care 2012 in press). Purpose: to demonstrate increase of ventilatory inefficiency depending on the severity of COPD, and its influence into reduce exercise capacity.

Methods : 58 Gold I - III patients, mean age 61, mean FEV1: 98, 68.5 and 44.3%, mean DCO: 68, 59.5 and 45%. A cardiopulmonary stress test measuring Power (Wmax), Oxygen consumption (VO2max), VE/VCO2, expiratory flow limitation (EFL) and dynamic end expiratory volume (DEELV) was performed. In patients with hyperinflation correlations and multiple regressions between BMI, EFL, DEELV and VE/VCO2 over Wmax and VO2max were calculated.

Results: patients ended the test due to dyspnea with increased VE/VCO2 (mean 34). Depending on the severity of COPD, VE/VCO2 was higher. 36 patients presented hyperinflation (mean DEELV 0.5 L), with a reduction in Wmax and in VO2max(mean: 63 and 76%). Significative correlation was demonstrated between VE/VCO2 over VO2max and Wmax (r: -0.5 and -0.5). In multiple regression the relation between VE/VCO2 and Wmax and VO2max was significative (p< 0.05 and <0.05), but not to BMI, EFL and DEELV. 

Conclusions: in COPD patients ventilatory inefficiency increases depending on the severity and is related with a reduction in the exercise capacity. Ventilatory inefficiency is an independent factor in to reduce exercise capacity in COPD.
Sexual abuse in childhood and deliberate self-harm
Authors: S E Romans, J L Martin, J C Anderson, G P Herbison, P E Mullen
Journal: American Journal of Psychiatry (1995)

The authors investigated the association between sexual abuse in childhood and subsequent incidents of deliberate self-harm in women.A random community sample of women (N = 252) that reported having been sexually abused as children was interviewed and compared to a similarly sized group (N = 225) that did not report abuse. The subgroup of women sexually abused as children who reported subsequent incidents of deliberate self-harm was then contrasted with abused women who did not report self-harm.There was a clear statistical association between sexual abuse in childhood and self-harm that was most marked in those subjected to more intrusive and more frequent abuse. Self-harm was also associated with major interpersonal problems in the subject's family of origin and with becoming involved in further abusive relationships as an adult.Sexual abuse in childhood is associated with later incidents of deliberate self-harm and may well be an etiologic factor in its development.
Evaluating aerosol administration of a candidate TB vaccine MVA85A
Authors: Zita-Rose Manjaly Thomas, Iman Satti, Stephanie Harris, Joel Meyer, Sharon Sheehan, Henry Bettinson, Helen McShane
Journal: European Respiratory Journal (2014)

There is an urgent need for a better TB vaccine than BCG.  Heterologous prime-boost vaccination regimens using virally-vectored vaccines induce strong cellular immune responses and are a leading strategy for TB vaccine development. Boosting BCG with MVA85A, a recombinant viral vector expressing antigen 85A, can enhance BCG induced protection in animal models. MVA85A in humans is safe and immunogenic when administered systemically.  Animal data suggests delivering a vaccine to the respiratory mucosa may be the most protective route. We recently completed the first trial where a virally-vectored vaccine, MVA85A, was delivered to humans by aerosol; and was found to be safe and highly immunogenic.  A limitation of virally-vectored vaccines is anti-vector immunity, which limits use and re-use.  Non-human primate data with aerosolised MVA85A suggests that aerosol vaccination induces less systemic anti-vector immunity than systemic routes. We have demonstrated this is also true in humans in our first aerosol trial, where humoral anti-vector immunity to MVA was induced by volunteers vaccinated by the systemic route but not the aerosol route.  An on-going trial now addresses the question, if alternating routes of vaccination can abrogate anti-vector immunity, by immunising twice with MVA85A by heterologous routes one month apart.  This would be an important development for the development of aerosolised TB vaccines but also for new vectored vaccines for RSV, universal influenza and a range of bacterial respiratory pathogens.
Abstract 631: Nonpeptide Factor XIa (FXIa) Inhibitor. In vitro Kinetic Evaluation and in vivo Studies of BMS-262084 on Arterial Thrombosis and Hemostasis in Rabbits
Authors: Pancras C Wong, William A Schumacher, Carol A Watson, Earl J Crain, Martin L Ogletree, Alan R Rendina
Journal: Circulation (2006)
Acute exacerbations of asthma in Barcelona, the recent experience
Authors: Iñigo Ojanguren, Ferran Morell, Teresa Genover, María Jesus Cruz, Xavier Muñoz
Journal: European Respiratory Journal (2013)

Introduction: Asthma is a chronic respiratory disease which involves investment of lots of human and economic resources. In spite of the development of new treatments asthma exacerbations (AE) are increasing.  Objective: to analyze the clinical features of the asthmatic exacerbations attended in the emergency care unit (ECU) in Barcelona during 2005 and 2011.  Patients and Methods: all the asthmatic exacerbations attended in the Vall d9Hebron University Hospital since January until December of 2005 and 2011 were identified in patients between 16 and 70 years old. The diagnosis of asthma was accepted if clinical features agreed with those established by the Global Initiative for Asthma (GINA).  Results: 219 and 220 AE were identified respectively in 2005 and 2011. In 2005 149/219(68%) corresponded to female and in 2011 149/220 (68%). In 2005 62/219 (30%) were current smokers while in 2011 61/220 (28%). In 2005 in 104/219 (47%) a nasal catarrh of slow beginning was registered; in 2011 in 107/220 (49%). In 2005 40% of the patients were being treated with inhaled corticosteroids as basal treatment, while in 2011 the 50%. In 2005 the 44% of patients were receiving short acting beta agonist in the moment of discharge while in 2011 the 81%. In 2005 the AE were mild in 65/219 (41%), moderate in 68/219 (44%) and severe in 72/220 (33%). In 2011 120/220 (55%) of AE were mild, 72/220 (33%) were moderate and 24/219 (15%) were severe.  Conclusions: the majority of AE corresponded to female and most of the AE were appearing in context of nasal catarrh of slow beginning. In recent years we observe a great increase of use of inhaled corticosteroids and short acting beta agonist. Asthma is still an infra treated disease.
Tiotropium attenuates pulmonary inflammation in a novel mouse smoke RSV re-infection model
Authors: Hannes Bucher, Benjamin Strobel, Birgit Jung, Klaus Erb, Matthias Düchs
Journal: European Respiratory Journal (2014)

Background:  Acute exacerbation of COPD (AECOPD) leads to a worsening of respiratory symptoms which are related to an increased risk of mortality in patients. An important trigger of AECOPD are viral infections of the respiratory tract with Respiratory Syncytial Virus (RSV).   Aim:  Compare the effect of dexamethasone, roflumilast and tiotropium in a novel mouse smoke RSV re-infection model.   Method:  BALB/c mice were exposed to cigarette smoke for ten days. They were infected with RSV on the first day of experiment and one day prior to readout. For preventive treatment studies, they received dexamethasone, roflumilast and tiotropium bromide for a total of ten days. Cells in BAL fluid, cytokine levels in lung homogenate, lung function, viral replication and histological changes were investigated.   Results:  Smoke exposure, RSV infection and re-infection resulted in pulmonary neutrophil and CD8+ lymphocyte accumulation. Pro-inflammatory cytokines were elevated in lung homogenate compared to the smoke only group. Surprisingly, Th2 components IL-4, IL-5 were detectable. Steroid treatment increased loss of bodyweight and enhanced viral replication. Roflumilast significantly decreased IL-6 levels but showed no significant effects on other cytokine levels and cellular influx. Treatment with tiotropium reduced neutrophil accumulation and levels of IL-10, TNF-α, IL-6 and IFN-γ in the airways.   Conclusion:  Our novel smoke RSV re-infection model depicts clinically relevant aspects of AECOPD, including CD8+ lymphocytes and Th2 components. Treatment with dexamethasone increases loss of bodyweight and enhances viral replication. Tiotropium attenuates inflammation and does not increase viral load in the airways.