tbuckley/cabot-search huggingface dataset:
Sex inequalities in ischaemic heart disease in general practice: cross sectional survey
Authors: J. Hippisley-Cox
Journal: BMJ (2001)

<h3>Abstract</h3> <b>Objective:</b> To study differences in treatment for men and women with ischaemic heart disease by using standards defined in England9s national service framework for coronary artery disease. <b>Design:</b> Cross sectional survey using routinely collected data. <b>Setting:</b> 18 practices in 18 primary care groups in Trent Region. <b>Subjects:</b> 5891 men and women aged over 35 years with a diagnosis of ischaemic heart disease or prescription for nitrates recorded on computer. <b>Main outcome measure:</b> Difference in the proportion of men and women with ischaemic heart disease and taking lipid lowering treatment. <b>Results:</b> Women were less likely than men to have a recording of body mass index (79% (2197/2783) <i>v</i> 82% (2552/3102), P=0.002), smoking (86% (2386) <i>v</i> 89% (2779), P&lt;0.0001), and blood pressure (95% (2643) <i>v</i> 96% (2986), P=0.04). Women were also less likely to have a recording of fasting cholesterol concentration (35% (968) <i>v</i> 50% (1550), P&lt;0.0001) but were more likely to be obese (25% (558/2197) <i>v</i> 20% (514/2552), P&lt;0.0001) and have their most recently recorded blood pressure value over the recommended 140/85 mm Hg (60% (1598/2643) <i>v</i> 52% (1553/2986), P&lt;0.0001). Although a higher proportion of women had a raised serum cholesterol concentration (77% (749/968) <i>v</i> 67% (1043/1550), P&lt;0.0001), men were more likely to take aspirin (76% (2358) <i>v</i> 71% (1979), P&lt;0.0001), have a recorded diagnosis of hyperlipidaemia (13% (418) <i>v</i> 10% (274), P&lt;0.0001), and be prescribed lipid lowering drugs (31% (973) <i>v</i> 21% (596), P&lt;0.0001). These differences remained despite adjustments for the practice where the patient is registered, age, smoking status, obesity, diabetes, and hypertension. <b>Conclusion:</b> The results suggest a systematic bias towards men compared with women in terms of secondary prevention of ischaemic heart disease. <h3>What is already known on this topic</h3> England9s national service framework for coronary artery disease requires general practitioners to identify and treat patients at high risk of ischaemic heart disease Substantial evidence of sex inequality for this disease exists for access to secondary care less but less is known about equity for its management in general practice <h3>What this study adds</h3> Among patients with ischaemic heart disease, men were more likely than women to have cardiovascular risk factors and serum cholesterol concentration recorded on computer A higher proportion of women, however, had raised cholesterol concentrations recorded on computer, but more men were treated with lipid lowering drugs The results suggest a systematic bias towards men compared with women in terms of secondary prevention of ischaemic heart disease.
Cigarette smoke induced Muc5AC is regulated by CARM1 in an ex-vivo airway model
Authors: Jie Jia, Oliver Eickelberg, Ali Önder Yildirim
Journal: European Respiratory Journal (2013)

Chronic obstructive pulmonary disease (COPD) is a progressive lung disease caused mostly by cigarette smoke and characterized by chronic inflammation, emphysema, airway remodeling and mucus hypersecretion. Coactivator-associated arginine methyltransferase 1 (CARM1), member of protein arginine methyltransferases (PRMTs), plays a role as co-activator, participate in multiple mechanisms of gene regulation, e.g. NF-kB pathway and CBP transcriptional activity. In this study we hypothesize that CARM1 regulates mucus production in cigarette smoke stimulated mouse airway epithelial cells.  Our aim was to investigate the role of CARM1 on the Muc5AC expression in cigarette smoke exposed wild-type (wt) and CARM1 heterozygous (CARM1+/-) mouse distal airway.  We observed that mouse distal airway epithelial cells, which were microdissected from mouse lung, were viable during 4 days in ex-vivo cultivation. Stimulation of isolated airway for 6h and 24h with 5%, 10%, and 20% of cigarette smoke extract (CSE) induces dose- and time-dependent Muc5AC mRNA expression and increases goblet cell metaplasia. Interestingly, CARM1+/- mouse isolated airways showed a significantly enhanced Muc5AC over-expression compared to CSE treated wt mouse.  Together these results demonstrate for the first time that CARM1 contributed smoke-induced Muc5AC over-expression in distal airway epithelial cell and support the notion that CARM1 may be a potential target to treat mucus hypersecretion in chronic lung diseases.
Influence of geriatric consultation with Comprehensive Geriatric Assessment (CGA) on therapeutic decision in elderly cancer patients
Authors: P. Chaibi, N. Magne, S. Breton, A. Chebib, J. Duron, M. Tagzirt, L. Hannoun, F. Piette, D. Khayat, J. Spano
Journal: Journal of Clinical Oncology (2009)

9505 Background: Elderly patients represent an heterogeneous population in which anticancer therapeutic decision is often difficult and may be helped by CGA. We report 2 years activity of the geriatric assessment consultation of our institution, and its impact on therapeutic decision Methods: Since January 2007, we propose a geriatric consultation for elderly cancer patients for whom therapeutic decision appears complex to oncologists. This consultation included a CGA, with focuses on items like comorbidity, dependance, cognitive impairment, depression and malnutrition using international well known scales. Results: 161 patients (57 men, 104 women) (median age 82,4 years, extremes 73 -97) were seen at the geriatric consultation. Most of the patients (134/161) were in fist line treatment for colorectal (54), other digestive (28), breast (30) and pulmonary (14) cancers. Cancer was metastatic in 86 patients (53 %). Geriatric assessment found: severe comorbidity (grade 3 or 4 in CIRS-G scale) in 75 patients, dependance for at least one activity of daily living (ADL) in 52 patients, cognitive impairment in 42 patients, including 13 patients with already diagnosed Alzheimer disease, malnutrition in 104 patients (65 %), depression in 39 patients. According to prior oncologist decision, there have been no change in therapeutic decision in 29 patients only. Geriatric interventional treatment was delivered to 122 patients (76 %). Anticancer treatment was changed in 79 patients (49 %), including delayed therapy in 5 patients, less intensive therapy in 29 patients and more intensive therapy in 45 patients. Patients for whom final decision was delayed or less intensive therapy had significantly more frequent severe comorbidity (23/34, p &lt; 0.01) and dependance for at least one ADL (19/34, p &lt; 0.01). Patients for whom final decision was more intensive therapy had significantly more frequent metastatic disease (33/45, p &lt; 0.01) Conclusions: Geriatric evaluation did influence therapeutic decision in 82 % of the patients. Follow up data will be presented to evaluate quality of final therapeutic decision, especially data concerning dose intensity and toxicity for patients with a more intensive therapy final decision. No significant financial relationships to disclose.
Bronchoalveolar lavage procollagen-III-peptide in recent onset hypersensitivity pneumonitis: correlation with extracellular matrix components
Authors: H Teschler, AB Thompson, WR Pohl, N Konietzko, SI Rennard, U Costabel
Journal: European Respiratory Journal (1993)

Hypersensitivity pneumonitis (HP) is characterized by the accumulation of inflammatory cells in the lung parenchyma, and may progress to fibrosis. The content of the fibroblast derived collagen metabolite procollagen-III-peptide (PCP-III) in bronchoalveolar lavage (BAL) fluid of HP patients has been found to be increased. Previous studies have shown elevation of the fibroblast adhesion molecules, vitronectin and fibronectin in the BAL fluid of recent onset HP. In view of these observations, it was hypothesized that increases in PCP-III would be associated with increases in vitronectin and fibronectin in the BAL fluid of subjects with untreated recent onset HP. BAL was performed in 14 patients with HP and nine normal controls. The aminoterminal domain of PCP-III was measured by radioimmunoassay, and vitronectin and fibronectin by enzyme-linked immunosorbent assay. Detectable amounts of BAL PCP-III were seen in all HP patients but not in the normal controls (mean +/- SEM 5.1 +/- 1.2 versus < 0.2 ng.ml-1; i.e. below the limit of detection of the PCP-III assay). The BAL fluid concentration of PCP-III correlated well with the amount of vitronectin (r = 0.638) and fibronectin (r = 0.710). Except for PCP-III and mast cells, no significant correlations were found between PCP-III, vitronectin, fibronectin and the cellular parameters. The findings suggest that an increased turnover of collagens and proteoglycans is present in the lower respiratory tract of patients with recent onset HP, possibly reflecting remodelling of the extracellular matrix.
Depressive symptoms and family history in seasonal and nonseasonal mood disorders
Authors: J M Allen, R W Lam, R A Remick, A D Sadovnick
Journal: American Journal of Psychiatry (1993)

The authors' goal was to compare the symptoms and family history of seasonal affective disorder with those of nonseasonal mood disorders.From a subspecialty mood disorders clinic, 34 patients with major depression, seasonal pattern (seasonal affective disorder), diagnosed with DSM-III-R criteria, were matched in age, sex, and diagnostic subtype (recurrent unipolar, bipolar I, or bipolar II) to 34 patients with nonseasonal mood disorders. Data on symptoms during the most recent depressive episode were obtained by chart review and compared by using chi-square tests. Family history data for first-degree relatives of patients with seasonal and nonseasonal mood disorders were gathered by using the family history method, and diagnoses were based on Family History Research Diagnostic Criteria.Patients with seasonal affective disorder reported significantly more hypersomnia, hyperphagia, and weight gain and reported less suicidal ideation and morning worsening of mood than the patients with nonseasonal mood disorders. No differences were found in family histories of mood disorders, other psychiatric disorders, and any psychiatric disorder between the groups with seasonal versus nonseasonal mood disorders. Alcoholism was found more frequently in the relatives of the patients with seasonal affective disorder.Differences in symptoms between seasonal and nonseasonal mood disorders provide some support for seasonal affective disorder as a diagnostic subtype of mood disorders. However, the genetic loading for mood disorders (of unspecified seasonality), as determined by the family history method, is similar for seasonal and nonseasonal mood disorders.
OP01 Alcohol and liver disease detection study ALDDeS: early results and implications
Authors: N Sheron, M Moore, P Roderick, W O'Brian, G Leydon, C Bowerman
Journal: Gut (2010)

Introduction  Liver deaths have increased 5–8 fold in 30 years and the majority are alcohol related. Cirrhosis develops silently and presents late; around 25% of subjects die before they have a chance to stop drinking. Blood tests in routine use do not stage fibrosis and diagnosis often requires a liver biopsy—impractical for the 2 million UK residents drinking at levels that may result in cirrhosis. Newer blood tests detect cirrhosis and progressive fibrosis at an earlier stage and, combined with alcohol screening, could greatly improve detection and management of these patients, reducing morbidity and mortality.  Aim  Assess feasibility of screening a primary care population for hazardous drinking using the AUDIT questionnaire, practicality of screening heavy alcohol users for liver disease using a non-invasive test and resource implications of assessment and follow-up.  Method  We offered postal screening to 10 000 adults age 25–55 randomly selected from general practice lists using the AUDIT questionnaire. An offer of liver fibrosis tests was made to those screening positive. Those with marked elevation of fibrosis markers are referred on for liver health checks markers. Participants were followed up after 1 year.  Results  10 000 AUDITs were dispatched from 9 primary care sites. Response rate was 3677 (37%) Of these responders 907 were hazardous/harmful drinkers (18.5%), of whom 207 (4.2%) were dependent drinkers. Audit positive subjects were invited to attend a research clinic of whom 290 (32%) attended and were screened using our traffic light algorithm (HA, P3NP, PTS, albumin, INR) of whom 28 (9.6%) were red (cirrhosis/severe fibrosis) and 121 (41%) amber (50% likelihood of progressive fibrosis in a secondary care population).  Conclusion  Postal screening for hazardous drinking followed by non-invasive liver assessment is feasible in the primary care setting. Ten percent of hazardous drinkers had good evidence of significant liver disease and a half had equivocal serum fibrosis markers, with these results fed back to subjects to encourage behaviour change. Further details and follow-up results will be available.
Risk factors for poor asthma control in asthmatic children
Authors: Fotios Kirvassilis, Katerina Chrysaidou, Elpis Hatziagorou, Nikos Karantaglis, John Tsanakas
Journal: European Respiratory Journal (2014)

Poor asthma control among asthmatic children has been reported worldwide. Many risk factors were identified. The aim of this study was the identification of risk factors that may be associated with poor asthma control among a population of children attended by an asthma clinic. Patients and methods: Parents of 365 asthmatic children > 2 years old (mean age 7.8 yrs) followed-up by a tertiary asthma clinic, interviewed by a doctor and answered questionnaire about asthma symptoms, activities llimitation, resque madication and exacerbations at the previous 2 months. Mechanical ventilation at the neonatal period, respiratory tract infections at the first year of life, atopies, number of emergency visits and hospitalizations due to asthma, parental asthma history, parental smoking, socioeconomic status, residency conditions, area of living, compliance to treatment as reported by the parents and the training of the parents to use inhaler devices evaluated by the doctor, were recorded. Results: 93/365 (25,48%) of the children achieved control of asthma, 176/365 (48,22%) had partly controlled and 96/365 (26,3%) uncontrolled asthma. Asthma control level significantly correlated with the parental smoking (p=0,02), the training of parents to use inhaler devices (p=0) and parent9s perception that the use of the inhaler device was easy (p=0,008). No statistically significant correlation (p>0,05) demonstrated between the level of asthma control and all other factors. Conclusion: In this population of asthmatic children, parental smoking, poor training of the inhaler technique and poor parental perception considering the convenience of the use of the inhaler device, are risk factors found to be correlated with poor asthma control.
Metabolic Inhibitors and Viral Lymphomagenesis in Thymic Grafts 2
Authors: Esther F. Hays
Journal: JNCI Journal of the National Cancer Institute (1974)

The effect of actinomycin D, puromycin, cytarabine, 3-(4-benzylpiperazineiminomethyl)rifampicin SV(AF/ABP), streptovaricin complex, and streptonigrin on Iymphomagenesisin thymic grafts infected with a murine leukemia virus was studied. Grafts with viral infection induced at the time of grafting, with 24-hour established infection, and with 3-week established infection were tested. Thymic lymphomagenesis was inhibited byactinomycin D, AF/ABP, streptovaricin complex, and streptonigrin if present at the time of initial viral infection. Only actinomycin D inhibited lymphoma development after 24 hours of virus infection and no inhibition with 3-week established infection was demonstrated. These inhibitor compoundsdid not impair thymic graft functions as measured by ability to develop lymphoma in virus-infected hosts, ability to restore immune responsiveness in thymectomized irradiated mice, and regenerative capacity.
Evolutionary rate of immunoglobulin alpha noncoding region is greater in hominoids than in Old World monkeys.
Authors: S Kawamura, H Tanabe, Y Watanabe, K Kurosaki, N Saitou, S Ueda
Journal: Molecular Biology and Evolution (1991)

Recent studies on the molecular evolution of primates show that the evolutionary rate among hominoids is considerably slower than that among nonhominoid primates. However, this observation at the nucleotide-sequence level is restricted to the beta-globin family region. In this study, we sequenced orthologous immunoglobulin alpha (C alpha) genes of chimpanzee, gorilla, orangutan, and crab-eating macaque (an Old World monkey) and compared them with that of the human by using noncoding regions for analysis. Since significant differences in rates among hominoids were not found by using the relative rate test, we evaluated the ratio (R) of the evolutionary distance between Old World monkey and human to the distance between orangutan and human. The R value (1.12) for the C alpha gene was much smaller than the expected value (1.38-2.33), showing that the nucleotide substitution rate (= mutation rate per year under selective neutrality) of the C alpha gene is greater in the human lineage than in the Old World monkey lineage. We also did a similar analysis for the gamma 1-, gamma 2-, psi eta-, and delta-globin genes and found a considerable heterogeneity (1.12-2.37) among the R values, including that for the C alpha gene. This indicates that the hominoid slowdown of the evolutionary rate is not a universal phenomenon in primate evolution.
Increased Immunogenicity and Cause of Graft Loss of Old Donor Kidneys
Authors: JOHAN W. DE FIJTER, MARKO J. K. MALLAT, ILIAS I. N. DOXIADIS, JAN RINGERS, FRITS R. ROSENDAAL, FRANS H. J. CLAAS, LEENDERT C. PAUL
Journal: Journal of the American Society of Nephrology (2001)

Abstract. Donor age was identified recently as a major factor that determines long-term outcome after transplantation, but the mechanism that is responsible for increased graft loss of old donor kidneys is unknown. The influence of donor age on graft survival was assessed retrospectively in 514 consecutive first cadaveric transplants that were treated with cyclosporine maintenance immunosuppression. Donor age ≥50 yr (relative risk [RR] = 1.7; 95% confidence interval [CI], 1.2 to 2.6), acute rejection (RR = 2.0; 95% CI, 1.3 to 3.0), and type of rejection (RR = 3.3; 95% CI, 2.0 to 5.3) had a significant impact on graft survival. However, when subsets of patients who entered subsequent intervals after transplantation were analyzed, donor age was not an independent predictive factor of graft loss. Donor age (RR = 1.53; 95% CI, 1.19 to 1.98), human leukocyte antigen-DR mismatch (RR = 2.28; 95% CI, 1.78 to 2.92), and recipient age (RR = 1.34; 95% CI, 1.05 to 1.72) were associated significantly with acute rejection episodes. Delayed graft function alone was not associated independently with the occurrence of early acute rejection (RR = 1.24; 95% CI, 0.96 to 1.61). The timing of the rejection episodes of old donor kidneys was not different, and the excess rejection prevalence was attributable entirely to interstitial (grade I) types of rejection. Interstitial rejection episodes in kidneys from old donors had a significant ( P &lt; 0.05) negative impact on graft survival. Beyond the first year, poor renal function and proteinuria were significant risk factors for graft loss, regardless of rejection. Our data fit best the hypothesis that increased graft loss of older donor kidneys results from an increased incidence of acute interstitial rejection episodes in the early posttransplantation months. It is proposed that kidneys from older donors are more immunogenic than kidneys from young donors and that acute rejection episodes result in functional deterioration. Contrary to interstitial rejection in kidneys from younger donors, kidneys from old donors seem to have an impaired ability to restore tissue.
Clinical characteristics and treatment outcomes of tuberculosis in the elderly
Authors: Yong Soo Kwon, Su Young Chi, Yu Il Kim, Sung Chul Lim, Yoo Duk Choi
Journal: European Respiratory Journal (2012)

Background

The purpose of this study was to describe the differences clinical characteristics and treatment outcomes between elderly TB patients and young TB patients.

Methods

The medical records of 271 young(aged 20 to 64 at diagnosis) and 199 elderly(aged 65 and older) TB patients, who were newly diagnosed with and treated for TB from May 2008 to August 2010, were analyzed retrospectively.

Results

Respiratory symptoms such as cough, sputum, and dyspnea and comorbid medical conditions such as cardiovascular disease, diabetes mellitus and chronic obstructive pulmonary disease were more frequent in elderly TB patients. In chest CT scan of pulmonary TB patients, findings of active TB such as nodules (  30 mm in diameter), and cavities were less frequently found in elderly TB patients except consolidations. However in microbiological diagnosis, positive TB culture rates were higher in elderly TB patients. Of those with known results of drug sensitive test, resistance to any drugs were more frequently found in younger TB patients. In adverse drug reactions, the incidences were not different between two groups except severe GI troubles which were more frequently developed in elderly TB patients. There were no significant differences in the rates of treatment success (97% vs. 93.7%, p=0.161), failure (0% vs. 0.7%, p=0.619), and deaths due to TB (0.5% vs. 1.1%, p=0.844) between two groups.

Conclusions

Elderly TB patients presented more frequent respiratory symptoms and showed less frequent active TB findings on chest CT scan. Treatment success rates of elderly TB patients were not inferior to those of younger TB patients without development of more frequent adverse drug reactions.
Diabetes and Obesity—Time Bombs to Be Defused
Authors: George A. Bray
Journal: Diabetes Care (2015)

Seventeen years ago I wrote a commentary entitled “Obesity: A Time Bomb to Be Defused” (1). At that time the prevalence of obesity (defined as a BMI >30 kg/m2) was 20% in men and 24.9% in women. In the intervening 17 years, it has risen to 33.5% in men and 36.1% in women—clearly in the wrong direction (2). After reading the article by Esparza-Romero et al. (3), I would expand the title of this earlier commentary to say that both obesity and diabetes are time bombs to be defused and that nothing much has happened in the past 17 years to prevent these bombs from exploding.

That obesity is a major public health problem has been recognized for more than 40 years (4). Obesity continues to increase particularly rapidly in those who are more overweight (5). Obesity is an important contributor to the rising tide of diabetes (6). Although genetic factors provide a key background for these events and may account for up to 20% of the variance in BMI, it is clear that environmental factors play a major role (7,8). In the 17 years that have passed since I wrote my earlier commentary, both problems have only become more severe and threaten the future economic base of health care in many nations (9).

Like obesity, diabetes has become more prevalent in the past 50 years (10). A relationship between diabetes and obesity was recognized by Joslin nearly 100 years ago (10). In this issue …