tbuckley/cabot-search huggingface dataset:
A study of antibiogram assay, risk factors and etiology of ventilator associated pneumonia (VAP) in a tertiary care hospital of Pakistan
Authors: Tayyaba Ijaz, Sana Aslam, Sarwat Raja, Bilal Ahmad, Aftab Anjum, Saadia Ijaz
Journal: European Respiratory Journal (2013)

Background:  Ventilator associated pneumonia (VAP) is a kind of nosocomial infection among the patients upon mechanical ventilation; resulting in high mortality rate among individuals admitted in Intensive Care Units (ICU).   Objective:  The objective of this study was to determine the etiology, trends of antibiotic resistance and other risk factors contributing towards the severity of VAP in an ICU of a tertiary care hospital in Pakistan.   Methods:  For the purpose, a total of 250 suspected cases of VAP were selected during 2010-2012 after following Clinical Pulmonary Infectious Score Chart. The samples of tracheal aspirates processed for evidence of microbes. Antibiogram assay was conducted using variety of commercially available antibiotics. Other parameters/risk factors contributed towards high mortality/deterioration were also observed.   Results:  A total of 167(66.8%) VAP patients admitted in ICU were identified. in the study. The isolates were Staphylococci, Streptococci, Acinetobacter, Pseudomonas, Klebsiella, Escherichia, fungi etc.Most of the isolates found resistant (>40%) to Augmentin, Gentamycin, Cefazolin, Ceftriaxone, Ceftazidime, Doxycycline, Tetracycline, Clindamycin and Ciprofloxacin. Maximum antimicrobial activity was observed for Meropenem, Tobramycin, Amikacin, Fucidin, Linezolid, Vancomycin andTazocin.Tygecycline being superior to others. High mortality (69.5%) was observed in VAP cases. Major factors contributed towards mortality were the length of ventilation, age, treatment failure, organ deterioration and underlying illness.   Conclusions:T his study indicate poor infection control and emergence of resistant microbes.
Correlation of CSF 5-HIAA concentration with sociality and the timing of emigration in free-ranging primates
Authors: P T Mehlman, J D Higley, I Faucher, A A Lilly, D M Taub, J Vickers, S J Suomi, M Linnoila
Journal: American Journal of Psychiatry (1995)

The purpose of this study was to examine the relationship between behavior and serotonin in nonhuman primates.During a routine capture and medical examination, 26 adolescent male rhesus macaques (Macaca mulatta) were selected as subjects from a free-ranging population of 4,500 rhesus monkeys inhabiting a 475-acre sea island. Blood samples (N = 23) and CSF samples (N = 22) were obtained, and each subject was fitted with a radio transmitter collar for rapid location. The subjects were released into their social groups, and quantitative behavioral observations were made over a 3-month period.CSF 5-hydroxyindoleacetic acid (5-HIAA) concentration was positively correlated with three measures of sociality: 1) total time spent grooming others, 2) total time spent in close proximity to other group members, and 3) mean number of neighbors within a 5-m radius. In addition, CSF 5-HIAA concentration was positively correlated with age at emigration from the natal group (in months).In adolescent male rhesus macaques living in naturalistic settings, CSF 5-HIAA concentration is positively correlated with affiliative sociality. Rhesus males with low CSF 5-HIAA concentrations exhibit less social competence and emigrate from their social groups at a younger age than do males with higher concentrations of CSF 5-HIAA.
An empirical study of diagnostic criteria for delirium
Authors: B Liptzin, S E Levkoff, P D Cleary, D M Pilgrim, C H Reilly, M Albert, T T Wetle
Journal: American Journal of Psychiatry (1991)

The objective of this study was to determine empirically how many patients are identified as delirious or nondelirious according to DMS-III, DMS-III-R, and ICD-10 criteria.Daily, a trained research assistant using a structured instrument to detect the presence of symptoms of delirium evaluated 325 elderly patients who were admitted to a general hospital for acute medical problems. Each patient's symptoms were then compared with these diagnostic criteria sets to determine if the patient met criteria for delirium.DSM-III criteria were the most inclusive: they identified 125 patients as delirious. DSM-III-R identified a somewhat different group of 106 patients as delirious. ICD-10 criteria identified only 30 patients as delirious.The development of new criteria for delirium (e.g., DSM-IV) will have to balance the need to define a pure group of patients for research purposes with the need to include cases of clinical interest. Changes in criteria should be based on data such as those presented in this paper.
Platelet Reactivity in Patients and Recurrent Events Post-Stenting
Authors: Paul A. Gurbel, Kevin P. Bliden, Kirk Guyer, Peter W. Cho, Kazi A. Zaman, Rolf P. Kreutz, Ashwani K. Bassi, Udaya S. Tantry
Journal: Journal of the American College of Cardiology (2005)
Abstract 14947: JAK/STAT-Signaling in Giant Cell Arteritis
Authors: Björn Hartmann, Shalini V Mohan, Jörg J Goronzy, Cornelia M Weyand
Journal: Circulation (2013)

Background: Giant cell arteritis (GCA) is a granulomatous vasculitis that preferentially targets the aorta and its major branches. CD4 T cells and macrophages are key pathogenic drivers and cause l...
Pain, Opioids, and Addiction
Authors: Jessica Gregg
Journal: Annals of Internal Medicine (2015)

Letters6 October 2015Pain, Opioids, and AddictionJessica Gregg, MD, PhDJessica Gregg, MD, PhDFrom Hooper Detoxification and Stabilization Center, Portland, Oregon.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5142-2 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:I appreciate Dr. Galishoff's comments and for the most part agree. Like other chronic diseases, addiction is not just a problem of biology. A person's environment and his or her behavior also play critical roles in the initiation and perpetuation of the disease of addiction (1). However, for better or worse, as physicians we are primarily trained to diagnose and intervene in biological problems. That is where we excel and where we focus most of our attention. We have a much poorer track record when it comes to intervening in the stickier and more complicated problems of changing ...References1. National Institute on Drug Abuse.. Drugs, Brain, and Behavior: The Science of Addiction. National Institutes of Health publication no. 14-5605. Bethesda, MD: National Institutes of Health; 2007 [updated July 2014]. Google Scholar2. Horowitz MM, Byrd JC, Gruchow HW. Attitudes of faculty members, residents, students, and community physicians toward health promotion. J Med Educ. 1987;62:931-4. [PMID: 3681923] MedlineGoogle Scholar3. Whitlock EP, Orleans CT, Pender N, Allan J. Evaluating primary care behavioral counseling interventions: an evidence-based approach. Am J Prev Med. 2002;22:267-84. [PMID: 11988383] CrossrefMedlineGoogle Scholar4. Carroll KM, Onken LS. Behavioral therapies for drug abuse. Am J Psychiatry. 2005;162:1452-60. [PMID: 16055766] CrossrefMedlineGoogle Scholar5. Strang J, Babor T, Caulkins J, Fischer B, Foxcroft D, Humphreys K. Drug policy and the public good: evidence for effective interventions. Lancet. 2012;379:71-83. [PMID: 22225672] doi:10.1016/S0140-6736(11)61674-7 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Jessica Gregg, MD, PhDAffiliations: From Hooper Detoxification and Stabilization Center, Portland, Oregon.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-1396. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoA Startling Injustice: Pain, Opioids, and Addiction Jessica Gregg Pain, Opioids, and Addiction Mitchel L. Galishoff Pain, Opioids, and Addiction Mitchel L. Galishoff Metrics 6 October 2015Volume 163, Issue 7Page: 565-566KeywordsBehaviorDisclosureHistory of medicineOpioid addictionOpioids ePublished: 6 October 2015 Issue Published: 6 October 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Positive Remodeling of the Coronary Arteries Detected by Magnetic Resonance Imaging in an Asymptomatic Population
Authors: Cuilian Miao, Shaoguang Chen, Robson Macedo, Shenghan Lai, Kiang Liu, Debiao Li, Bruce A. Wasserman, Jens Vogel-Clausen, João A.C. Lima, David A. Bluemke
Journal: Journal of the American College of Cardiology (2009)
Determinants of Health-Related Quality of Life after Deep Venous Thrombosis: Two-Year Results from a Canadian Multicenter Prospective Cohort Study (The VETO Study).
Authors: Susan R. Kahn, Tatiana Vydykhan, Donna L. Lamping, Thierry Ducruet, Louise Arsenault, Marie Jose Miron, Andre Roussin, Sylvie Desmarais, Francine Joyal, Jeannine Kassis, Susan Solymoss, Jeffrey S. Ginsberg, Louis Desjardins, Mira Johri, Ian Shrier
Journal: Blood (2005)
Abstract 1187: Effects of Ezetimibe and/or Simvastatin on LDL Receptor Protein and on LDL Receptor and HMG-CoA Reductase Gene Expression in Mononuclear Blood Cells: A Randomized Trial in Healthy Men
Authors: Ioanna Gouni-Berthold, Heiner K Berthold, Yon Ko, Helena Gylling, Jogchum Plat, Wilhelm Krone
Journal: Circulation (2006)
Abstract 3542: Coronary Atherosclerosis Burden and the Number of Marathons Predict the Presence of Myocardial Late Enhancement in Asymptomatic Healthy Master Marathon Runners
Authors: Stefan Mohlenkamp, Frank Breukmann, Nils Lehmann, Kai Nassenstein, Kirsten Leineweber, Axel Schmermund, Susanne Moebus, Martina Brocker-Preuss, Gerd Kerkhoff, Klaus Mann, Thomas Budde, Gerd Heusch, Karl-Heinz Jockel, Jorg Barkhausen, Raimund Erbel
Journal: Circulation (2007)
Abstract 2405: Acute Increase In Left Ventricular Filling Pressure Leads To Hyperventilation In Heart Failure Patients With Central But Not Obstructive Sleep Apnea Or Without Sleep Disordered Breathing
Authors: Olaf Oldenburg, Cornelia Piper, Thomas Bitter, Christian Prinz, Christoph Langer, Marcus Wiemer, Dieter Horstkotte
Journal: Circulation (2008)

The pathohysiology of Cheyne-Stokes-respiration (CSR) in congestive heart failure (CHF) is not fully understood. Increase in pulmonary capillary wedge pressure (PCWP) may lead to stimulation of pulmonary J-receptors and consecutive hyperventilation. The present study investigates the influence of an acute increase in PCWP in CHF pts without sleep disordered breathing (SDB) compared to pts with central (CSR) and obstructive sleep apnea (OSA). Simultaneous left and right heart catheterizations were performed in 29 CHF pts (NYHA ≥ II, LVEF ≤ 40%). PCWP and arterial pCO 2 were measured under standardized settings at baseline and after left ventricular angio- and/or aortography resulting in an acute increase in intravascular volumes. Type and severity of SDB were determined by cardiorespiratory polygraphy the night before or thereafter. NT-proBNP concentration was measured and central CO 2 - receptor sensitivity determined by testing hypercapnic-hyperoxic-ventilatory response (HCVR) according to Read. CSR was diagnosed in 15 pts (apnea-hypopnoea-index [AHI] 32 ± 19/h; 59 ± 11 years; LVEF 32 ± 6%), OSA in 9 pts (AHI 27 ± 29/h; 64 ± 13 years; LVEF 33 ± 5%); 5 pts had no SDB (AHI 1 ± 2/h; 48 ± 13 years; LVEF 32 ± 7%). HCVR and NT-proBNP concentrations were significantly higher in CSR (5.6 ± 6.5l/min/mmHg and 5237 ± 6268pg/ml) compared to OSA (2.2 ± 0.6l/min/mmHg and 1127 ± 874pg/ml) or pts without SDB (1.6 ± 0.6l/min/mmHg and 197 ± 146pg/ml; p &lt; 0.05). PCWP were elevated at baseline and increased significantly after angiography in all groups (CSR: 20.3 ± 6.6 mmHg to 22.9 ± 7.9 mmHg; OSA 22.8 ± 10 to 25.4 ± 11 mmHg; noSDB: 14.2 ± 10 to 17.4 ± 9mmHg; all p &lt; 0.05). Arterial pCO 2 at baseline tended to be lower in pts with CSR. Only in CSR, not in OSA or pts without SDB increase in PCWP was accompanied by a further decrease in pCO 2 (CSR: 36.1 ± 5mmHg to 33.3 ± 5mmHg, p = 0.05; OSA: 38.7 ± 4mmHg to 40.1 ± 6mmHg, p = ns; noSDB: 39.6 ± 6mmHg to 39.7 ± 6mmHg, p = ns). In CHF pts with CSR but not in those without SDB or OSA, acute increase in PCWP stimulates ventilation, together with other factors like an increased central CO 2 - receptor sensitivity this may lead to hyperventilation and a consecutive decrease in pCO 2 below the apnea threshold. Moreover, the present data may explain why CSR in some pts reflects CHF severity.
Abstract 11251: Skinny but Unhealthy: Metabolic Syndrome in Lean T2DM Patients Leads to a Doubling of Cardiovascular Complications
Authors: Michel P Hermans, Sylvie A Ahn, Michel F Rousseau
Journal: Circulation (2013)

BACKGROUND: Metabolic syndrome (MetS) and type 2 diabetes (T2DM) are two major comorbidities of obesity. Yet, a minority of obese without MetS is considered metabolically healthy, and therefore at ...
Abstract 2608: Alterations In Biomechnical Properties of Ascending Aorta in Marfan Syndrome by Real-time 2-D Ultrasound Speckle Tracking Imaging
Authors: Jin Wu, Mingxing Xie, Minjuan Zheng, Xinyi Ge, Kathy Kendall, John Lynn Jefferies, Jeffrey Towbin, Ricardo Pignatelli, Nancy Ayres, Shuping Ge
Journal: Circulation (2008)

Background : Thoracic aortic aneurysm and dissection (TAAD) is the leading cause of death in patients with Marfan syndrome (MFS) and other aortic disease (AD). The natural history of AD aries significantly. The size of the aorta alone does not always predict the risks of complications, such as catastrophic TAAD. Objectives : We sought to develop an ultrasound technique to quantitatively measure deformation of the ascending aorta (Ao) using a real-time 2-D ultrasound speckle tracking imaging (USTI) technique to investigate: alterations in biomechanical properties of AAo in MFS, and early and sensitive markers for TAAD for MFS. Methods: A total of 40 patients (MFS: n=18, age=11.4 ± 6.2 years, versus Control: n = 22, age=10.2 ± 4.3, p = 0.46) were prospectively enrolled. Real-time 2-D echocardiography was performed. The dimension of the AAo root (at the level of aortic annulus, sinus of Valsalva (SOV), sino-tubular junction and ascending aorta) was tracked and measured continuously in the cardiac cycle to derive the maximal and minimal systolic and diastolic dimensions using USTI (Philips Medical Systems). These measurements were used to yield dimensions, strain (deformation), strain rate (rate of deformation), distensibility, stiffness index and elastic modulus. Results: The results were summarized in Table 1 . Compared with controls, the MFS group had significantly enlarged dimension of the AAo root (P&lt;0.0001). In addition, the biomechanical properties were significantly altered, suggestive of reduced deformation, distensibility, elasticity and increased stiffness of the AAo root. Conclusions: This study demonstrated the feasibility of quantitative measurement of the biomechanical properties of the AAo in MFS using USTI. We have also shown significant deterioration of the biomechanical properties in MFS. Table 1. Biomechanical properties of AAO in MFS
Symptom differences in major depression, dysthymia, panic disorder, and generalized anxiety disorder
Authors: D A Clark, A T Beck, J S Beck
Journal: American Journal of Psychiatry (1994)

The authors compared symptom features of specific subtypes of depressive and anxiety disorders.Psychiatric outpatients with moderate levels of psychopathology and DSM-III diagnoses of major depression, dysthymia, panic disorder, or generalized anxiety disorder were given five standard measures of symptoms of anxiety and depressive disorders. Most of the outpatients were white, and most were middle-class.Principal components analysis revealed 12 orthogonal symptom components. Discriminant function analysis indicated that anxiety was distinguished by specific autonomic arousal symptoms, threat-related cognitions, and subjective anxiety and tension. Discriminant function analysis also indicated that depression was distinguished by anhedonia, cognitions of personal loss and failure, and dysphoric mood.As nosological categories, major depression and panic disorder were better differentiated by specific symptom markers than dysthymia and generalized anxiety disorder.
A framework to assess evolutionary responses to anthropogenic light and sound
Authors: John P. Swaddle, Clinton D. Francis, Jesse R. Barber, Caren B. Cooper, Christopher C.M. Kyba, Davide M. Dominoni, Graeme Shannon, Erik Aschehoug, Sarah E. Goodwin, Akito Y. Kawahara, David Luther, Kamiel Spoelstra, Margaret Voss, Travis Longcore
Journal: Trends in Ecology & Evolution (2015)
Adrenal suppression in paediatric asthmatic patients
Authors: Christopher Edwards, James Paton, Guftar Shaikh
Journal: European Respiratory Journal (2013)

Background:  High dose inhaled steroids can lead to adrenal suppression. It is not clear how the use of other steroids (nasal, topical or oral) in addition to inhaled steroids, affect adrenal suppression.  Aims  The aim of this study was to review past synacthen tests and try to determine steroid risk factors for those with suppressed cortisol.  Methods  A review of synacthen tests done over a 3 year period on patients with asthma was carried out. Data extracted and determined included age; BMI sd; calculated surface area, beclometasone equivalent steroid dose, oral steroid intake, other steroids (nasal, topical), and result of synacthen test.  Results  19 synacthen tests were available for analysis. The average age was 11.3 years (range 4.6-16.2). 10 were boys. 6 patients were on doses of inhaled corticosteroids not recommended in the British National Formulary for Children (BNFc), and 3 of these had adrenal suppression. Of the remaining 13 patients only 2 had adrenal suppression. Only 2 patients were documented as taking nasal steroids and 1 as taking topical steroids. The odds ratio of adrenal suppression when a patient had 5 or more courses of oral prednisolone in the last year and is on an dose of inhaled steroids not recommended in the BNFc compared to those who had fewer courses of oral steroids or on recommended doses of inhaled steroids was 5.6. There was no association with inhaled steroid dose adjusted for surface area and adrenal suppression.  Conclusions  Using a dose of inhaled steroids not recommended in the BNFc and having 5 or more courses of steroids together increases a patients’ risk of adrenal suppression.This association is not seen when the inhaled steroid dose is adjusted for beclometasone equivalence per surface area.
Lung Cancer Mortality in World War I Veterans With Mustard-Gas Injury: 1919–1965 2
Authors: James E. Norman
Journal: JNCI Journal of the National Cancer Institute (1975)

A study of the mortality experience of three samples of World War I veterans totaling 7,151 U.S. white males was extended from 1956 through 1965 to learn whether a single exposure to mustard gas with respiratory injury was associated with increased risk of lung cancer in later life. Rosters of men born between 1889 and 1893 [2,718 exposed to mustard gas, 1,855 hospitalized with pneumonia in 1918, and 2,578 with wounds of the extremities (controls)] were traced via the Veterans Administration's death records. The 4,136 deaths reported were 95% of that expected. The conclusions of the original study were not altered by the additional 10 years of follow-up. Observed deaths from lung cancer numbered 69, or 2.5%, for the mustard-gas group as compared to 33, or 1.8%, for the pneumonia group and 50, or 1.9%, for the controls. The risk of death from lung cancer among men gassed relative to that for the controls was estimated as 1.3, with 95% confidence limits of 0.9–1.9. These figures tailed to make a strong case for a carcinogenic effect, apparently because a sufficent dose of mustard gas was not received.
The health of Gypsies
Authors: G A C Binnie, E. Ginter
Journal: BMJ (1998)

Editor—The editorial by McKee1 on Gypsies, or Romas, was an interesting factual account of their origins as well as of the disadvantages and oppression they face as a minority group in continental Europe. Yet it is remarkable in that there is no mention of the disadvantages and oppression endured by the same minority community in the United Kingdom—from the Romas of folklore in the south of England to the tinkers of Scotland and to the New Age wanderers who seem to seek the romantic image without the responsibilities. Now they travel in trucks towing large caravans; when parked they are usually seen in lay-bys or on waste ground with lots of dogs, children, and rubbish. 

In these unofficial caravan sites they live in the squalor and type of conditions prevailing in this country a couple of centuries ago—no clean or adequate water supply, no sewage disposal system, no rubbish collection, and certainly totally inadequate education, immunisation, and medical attention. The reaction is often to “get rid of them,” preferably by moving them on to some rundown housing estate in the next town but one. Local authorities have a duty to provide proper sites for travelling people, although this is too often frustrated by the “not in my back yard” (“nimby”) attitude and an inability of local authorities to attempt to work with the Gypsy culture by cooperating with their lifestyle. 

It is easy to be disapproving about the unwelcome refugees in and around Dover. As far as our own travellers are concerned, it is a sad reflection on our society, and perhaps on the BMJ, that we behave as if nothing needs to be done in this country although it seems to be agreed that much needs to be done across the channel.
Abstract 11557: Perioperative Risk of Hemodynamically Significant Aortic Stenosis
Authors: Teruko Tashiro, Jodi M Blustin, Sorin V Pislaru, Vuyisile T Nkomo, Christopher G Scott, Patricia A Pellikka
Journal: Circulation (2012)

Introduction: Hemodynamically significant aortic stenosis (hsAS) is associated with increased risk for non-cardiac surgery. The impact of hsAS and left ventricular (LV) function on risk of major no...