tbuckley/cabot-search huggingface dataset:
Cost effectiveness of strategies to combat chronic obstructive pulmonary disease and asthma in sub-Saharan Africa and South East Asia: mathematical modelling study
Authors: A. E. Stanciole, M. Ortegon, D. Chisholm, J. A. Lauer
Journal: BMJ (2012)

To determine the population level costs, effects, and cost effectiveness of selected, individual based interventions to combat chronic obstructive pulmonary disease (COPD) and asthma in the context of low and middle income countries.Sectoral cost effectiveness analysis using a lifetime population model.Two World Health Organization sub-regions of the world: countries in sub-Saharan Africa with very high adult and high child mortality (AfrE); and countries in South East Asia with high adult and high child mortality (SearD).Disease rates and profiles were taken from the WHO Global Burden of Disease study; estimates of intervention effects and resource needs were drawn from clinical trials, observational studies, and treatment guidelines. Unit costs were taken from a WHO price database.Cost per disability adjusted life year (DALY) averted, expressed in international dollars ($Int) for the year 2005.In both regions low dose inhaled corticosteroids for mild persistent asthma was considered the most cost effective intervention, with average cost per DALY averted about $Int2500. The next best value strategies were influenza vaccine for COPD in Sear-D (incremental cost $Int4950 per DALY averted) and low dose inhaled corticosteroids plus long acting β agonists for moderate persistent asthma in Afr-E (incremental cost $Int9112 per DALY averted).COPD is irreversible and progressive, and current treatment options produce relatively little gains relative to the cost. The treatment options available for asthma, however, generally decrease chronic respiratory disease burden at a relatively low cost.
Causes and Treatment of Recurrent Dysphagia after Self-Expanding Metal Stent Placement for Palliation of Esophageal Carcinoma
Authors: M. Homs, E. Steyerberg, E. Kuipers, A. van der Gaast, J. Haringsma, M. van Blankenstein, P. Siersema
Journal: Endoscopy (2004)

Background and Study Aims: Recurrent dysphagia frequently complicates the palliative treatment of esophageal cancer with self-expanding metal stents. Strategies for repeat interventions and subsequent outcomes have not been adequately reported to date. Patients and Methods: A total of 216 patients underwent placement of a self-expanding metal stent (Ultraflex, n = 75; Flamingo Wallstent, n = 71; Z-stent, n = 70) for malignant dysphagia, and were followed up prospectively. The causes of stent-related recurrent dysphagia, the intervals after first stent placement, and the procedures used for repeat intervention and their outcomes were evaluated. Results: Seventy-four episodes of stent-related recurrent dysphagia occurred in 63 patients (29 %), mainly due to tumor overgrowth (n = 30; median 129 days), stent migration (n = 26; median 92 days) and food bolus obstruction (n = 16; median 80 days). Stent migration occurred more frequently (P = 0.05), whereas tumor overgrowth occurred less frequently (P = 0.05) with Ultraflex stents in comparison with Flamingo Wallstents and Z-stents. Tumor overgrowth was treated in 25 patients mainly by a second stent (n = 19) and was effective in 23 of the 25 patients (92 %). Five patients received no further treatment. Stent migration was treated by placing a second stent (n = 14), repositioning the migrated stent (n = 7), other treatments (n = 3), or no further treatment (n = 2), and treatment was effective in 20 of 24 (83 %) patients. Food bolus obstruction was treated by endoscopic stent clearance in all patients. Repeat intervention for stent-related recurrent dysphagia improved the dysphagia score from a median of 3 to 1 (P < 0.001). The median survival period after repeat treatment was 68 days. Conclusions: Recurrent dysphagia occurs in almost one-third of patients after stent placement. Repeat interventions for stent-related recurrent dysphagia are effective in over 90 % of patients. New innovations in stent design are needed to reduce the risk of stent-related recurrent dysphagia.
Value of axillary ultrasound and cytology in assessing nodal status preoperatively.
Authors: MS Absar, N Barr, M Wilson, U Beetles, F Knox, J Morris, NJ Bundred
Journal: Cancer Research (2009)

Abstract Abstract #1007 Preoperative identification of axillary node involvement in early breast cancer allows correct surgical procedures to be performed and avoids second axillary operations. We compared preoperative axillary assessment using ultrasound ± cytology with the eventual histopathological results to identify the accuracy of preoperative axillary node assessment.&amp;#x2028; Methods: Preoperative axillary ultrasound was used to identify the presence of suspicious or malignant nodes which were then confirmed with cytological assessment to allow management decisions regarding axillary clearance (or sentinel node biopsy (SNB) if nodes appeared negative).&amp;#x2028; Results: Overall 79/365 (21%) early breast cancer patients had suspicious or malignant nodes on ultrasound, of which 78 were confirmed on cytology, thus avoiding an unnecessary SNB operation in these patients. Ultrasound and cytology accurately identified patients with ER negative (P=≤0.001), high grade (P=≤0.001) and large size tumours ≤20mm (P=≤0.001), with involved nodes. Only 11% ER negative compared to 46% ER positive tumours were incorrectly classified (P=0.002). In contrast ER positive, low grade, small tumours were most likely to have a false negative axillary assessment. Specificity of cytological assessment of nodes was 99% and sensitivity 54%.&amp;#x2028; Conclusions: Axillary ultrasound combined with cytological assessment of suspicious nodes accurately identifies majority of women who require axillary clearance.&amp;#x2028; &amp;#x2028; Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1007.
Canada faces nurse shortage
Authors: D. Spurgeon
Journal: BMJ (2000)

Canada is in the grip of a serious shortage of registered nurses that by all accounts will grow worse in years to come. The most comprehensive national study, published by the Canadian Nurses Association, predicts a shortage in Canada (except Quebec) of between 59000 and 113000 by 2011.

Quebec, which has a nurses association separate from the Canadian Nurses Association, predicts its own shortage of 11000 nurses between 2001 and 2015. The Canadian Nurses Association's study was based on figures up to 1997, and its predictions are now considered conservative.

The latest (1998) figures—released by the Canadian Institute for Health Information (a national, not for profit organisation), the Canadian Nurses Association, and Statistics …
Dermatomyositis and malignancy in Tunisia: A multicenter national retrospective study of 20 cases
Authors: Amel Mebazâa, Hamouda Boussen, Rafıâa Nouira, Lilia Rokbani, Amel Ben Osman-Dhahri, Noureddine Bouaouina, Chedia Laouani-Kechrid, Bessem Louzir, Abdelmajid Zahaf, Mohamed Ridha Kamoun
Journal: Journal of the American Academy of Dermatology (2003)
You've Come a Long Way, Baby
Authors: Pauline Furth
Journal: JAMA (1983)

The exam question asked, "How much is<i>your</i>calcium requirement?" My answer was crossed out because I had written 1,200 mg instead of the expected 800 mg. In class the following day, the professor directed the same query to me, obviously allowing the opportunity for a correction. Happily, albeit naively, I repeated my answer, adding that pregnant women had a greater calcium need. Soon thereafter I received a summons to the Dean's office. Just how pregnant was I? If all went as per expectation, I explained, I should deliver several weeks after graduation. "Well, that's just the point.... I know you're married and all that... but don't you see that it would be very embarrassing for the school and your classmates to have you go up on the stage in THAT CONDITION. And, it would be even more embarrassing for patients to see you THAT WAY. We'd like to have
Adrenomedullin signaling is necessary for murine lymphatic vascular development
Authors: Kimberly L. Fritz-Six, William P. Dunworth, Manyu Li, Kathleen M. Caron
Journal: Journal of Clinical Investigation (2007)

The lymphatic vascular system mediates fluid homeostasis, immune defense, and tumor metastasis. Only a handful of genes are known to affect the development of the lymphatic vasculature, and even fewer represent therapeutic targets for lymphatic diseases. Adrenomedullin (AM) is a multifunctional peptide vasodilator that transduces its effects through the calcitonin receptor-like receptor (calcrl) when the receptor is associated with a receptor activity-modifying protein (RAMP2). Here we report on the involvement of these genes in lymphangiogenesis. AM-, calcrl-, or RAMP2-null mice died mid-gestation after development of interstitial lymphedema. This conserved phenotype provided in vivo evidence that these components were required for AM signaling during embryogenesis. A conditional knockout line with loss of calcrl in endothelial cells confirmed an essential role for AM signaling in vascular development. Loss of AM signaling resulted in abnormal jugular lymphatic vessels due to reduction in lymphatic endothelial cell proliferation. Furthermore, AM caused enhanced activation of ERK signaling in human lymphatic versus blood endothelial cells, likely due to induction of CALCRL gene expression by the lymphatic transcriptional regulator Prox1. Collectively, our studies identify a class of genes involved in lymphangiogenesis that represent a pharmacologically tractable system for the treatment of lymphedema or inhibition of tumor metastasis.
B cells from patients with chronic GVHD are activated and primed for survival via BAFF-mediated pathways
Authors: Jessica L. Allen, Matthew S. Fore, Jenna Wooten, Philip A. Roehrs, Nazmim S. Bhuiya, Todd Hoffert, Andrew Sharf, Allison M. Deal, Paul Armistead, James Coghill, Don A. Gabriel, Robert Irons, Amber Essenmacher, Thomas C. Shea, Kristy Richards, Corey Cutler, Jerome Ritz, Jonathan Serody, Albert S. Baldwin, Stefanie Sarantopoulos
Journal: Blood (2012)
Contraction uncoupling with butanedione monoxime versus low calcium or high potassium solutions on flow and contractile function of isolated hearts after prolonged hypothermic perfusion.
Authors: D F Stowe, M Boban, B M Graf, J P Kampine, Z J Bosnjak
Journal: Circulation (1994)

BACKGROUND Normal ionic perfusate containing butanedione monoxime (BDM), a reversible myofilament inhibitor, could be better than either a high potassium (KCl) or a low calcium (CaCl2) perfusate for long-term cardiac preservation. This hypothesis was tested in 70 isolated guinea pig hearts. METHODS AND RESULTS Three groups--time control (8 hours, 37 degrees C), cold control (22 hours, 3.8 degrees C), and cold+BDM (22 hours)--were perfused with typical Krebs-Ringer solution (2.5 mmol/L CaCl2 and 4.5 mmol/L KCl). Two other groups were cold perfused for 22 hours either with 2.5 mmol/L CaCl2 + 20 mmol/L KCl (high) or with 0.5 mmol/L CaCl2 (low) + 4.5 mmol/L KCl. These changes were maintained from 20 minutes before cold perfusion until 30 minutes after rewarming to 37 degrees C. Coronary vasodilator reserve was tested before cold perfusion and 2 hours after warm reperfusion with adenosine (Ade), acetylcholine (Ach, endothelium dependent), and nitroprusside (NP, endothelium independent). Each treatment decreased left ventricular pressure (LVP) by more than 80% before cold perfusion. During warm reperfusion, LVP was lower in cold control (-72 +/- 5%), high KCl (-76 +/- 4%), and low CaCl2 (-80 +/- 4%) groups than in BDM (-38 +/- 3%) or time control (-18 +/- 4%) groups; coronary flow (CF) was lower in high KCl (-67 +/- 4%) and low CaCl2 (-54 +/- 7%) groups than in cold control (-37 +/- 6%), BDM (-30 +/- 5%), or time control (+2 +/- 3%) groups; and percent oxygen extraction (controls, 62 +/- 4%) was higher in the high KCl group (83 +/- 6%) than in cold control (72 +/- 3%), BDM (73 +/- 3%), low CaCl2 (72 +/- 5%), or time control (63 +/- 3%) groups. CF responses to Ade, Ach, and NP (+103 +/- 7%, +24 +/- 5%, and +34 +/- 5% before cold) were attenuated (+76 +/- 6%, +18 +/- 5%, and +23 +/- 4%) in the time control group (5 hours later), were reduced but present in the BDM group (+10 +/- 5%, -5 +/- 5%, and -5 +/- 5%), and were absent in both low CaCl2 and high KCl groups after 2 hours of reperfusion. CONCLUSIONS Normal ionic BDM solution better preserves cardiac function and basal CF after prolonged cold perfusion than do cold control, high KCl, and low CaCl2 solutions. Vasodilatory capacity is markedly diminished after perfusion with either the high KCl or the low CaCl2 solution.
The thromboxane A2 mimetic U46619 worsens canine myocardial hypoperfusion during exercise in the presence of a coronary artery stenosis
Authors: R. J Bache, X.-Z. Dai
Journal: Cardiovascular Research (1992)

Objective: The aim was to test the hypothesis that thromboxane A2 can cause vasoconstriction of coronary resistance vessels during exercise in hypoperfused regions of myocardium distal to an arterial stenosis. Methods: Eight adult mongrel dogs were studied. Chronically instrumented animals with a left circumflex coronary artery Doppler flow meter, hydraulic occluder, and indwelling catheter underwent treadmill exercise at heart rates of 190-200 beats·min−1. Myocardial blood flow was measured with microspheres during unimpeded arterial inflow and in the presence of a coronary stenosis which decreased distal pressure to 42-45 mm Hg. Measurements were repeated during infusion of the thromboxane A2 analogue, U46619. Results: When the occluder was partially inflated to produce a stenosis, blood flow in the region perfused by the stenotic artery was 58(SEM 6)% of flow in the normally perfused region (p<0.01). U46619 (0.01 μg·kg−1·min−1) caused a further 21(7)% decrease in blood flow in the region perfused by the stenotic artery (p<0.05). The vasoconstriction produced by U46619 was uniform across the left ventricular wall from epicardium to endocardium. U46619 did not significantly decrease myocardial blood flow in the absence of a coronary stenosis. Conclusions: Even during hypoperfusion produced by a flow limiting arterial stenosis, the coronary resistance vessels remain responsive to the vasoconstrictor effect of thromboxane A2. Liberation of thromboxane A2 during platelet activation at the site of a proximal coronary stenosis may worsen myocardial hypoperfusion by causing vasoconstriction of the distal resistance vessels.
Involvement of PA28γ in the propagation of hepatitis C virus†
Authors: Kohji Moriishi, Ikuo Shoji, Yoshio Mori, Ryosuke Suzuki, Tetsuro Suzuki, Chikako Kataoka, Yoshiharu Matsuura
Journal: Hepatology (2010)

We have reported previously that the proteasome activator PA28γ participates not only in degradation of hepatitis C virus (HCV) core protein in the nucleus but also in the pathogenesis in transgenic mice expressing HCV core protein. However, the biological significance of PA28γ in the propagation of HCV has not been clarified. PA28γ is an activator of proteasome responsible for ubiquitin-independent degradation of substrates in the nucleus. In the present study, knockdown of PA28γ in cells preinfection or postinfection with the JFH-1 strain of HCV impaired viral particle production but exhibited no effect on viral RNA replication. The particle production of HCV in PA28γ knockdown cells was restored by the expression of an small interfering RNA (siRNA)-resistant PA28γ. Although viral proteins were detected in the cytoplasm of cells infected with HCV, suppression of PA28γ expression induced accumulation of HCV core protein in the nucleus. HCV core protein was also degraded in the cytoplasm after ubiquitination by an E3 ubiquitin ligase, E6AP. Knockdown of PA28γ enhanced ubiquitination of core protein and impaired virus production, whereas that of E6AP reduced ubiquitination of core protein and enhanced virus production. Furthermore, virus production in the PA28γ knockdown cells was restored through knockdown of E6AP or expression of the siRNA-resistant wild-type but not mutant PA28γ incapable of activating proteasome activity. Conclusion: Our results suggest that PA28γ participates not only in the pathogenesis but also in the propagation of HCV by regulating the degradation of the core protein in both a ubiquitin-dependent and ubiquitin-independent manner. (HEPATOLOGY 2010;)
The fetal origins hypothesis—10 years on
Authors: Johan G Eriksson
Journal: BMJ (2005)

Events before birth remain important, but we need to consider later modifiers too 

E pidemiological studies have largely contributed to our understanding of the natural history of coronary heart disease. Although clinical manifestations of the disease usually become evident in adult life, early signs are recognisable in childhood. The discovery that individuals who develop coronary heart disease grow differently during early life has led to the recognition of new developmental models for the disease. In 1995 David Barker wrote: “The fetal origins hypothesis states that fetal undernutrition in middle to late gestation, which leads to disproportionate fetal growth, programmes later coronary heart disease.”1 Now, 10 years later, the importance of events before birth for lifetime health has been confirmed in many populations.2–4 In humans, birth size serves as a marker of the intrauterine environment. Considering that birth size is just one snapshot of the trajectory of fetal growth it is fascinating that long term …
Who should receive treatment for sleep apnoea?
Authors: L. S. Bennett, J. R. Stradling
Journal: Thorax (1997)

In the spinal pithed rat, DuP 753, 2-n-butyl-4-chloro-5-hydroxy-methyl-1-[(29-(1H-tetrazol-5-yl)biphe nyl-4-yl) methyl] imidazole potassium salt, inhibited competitively the pressor response to angiotensin II (AII), whereas saralasin showed a noncompetitive pattern of interaction. It did not alter the pressor responses to vasopressin and norepinephrine as well as the heart rate response to isoproterenol. In the anesthetized rat, DuP 753 did not affect the vasodepressor response to bradykinin. Given p.o. or i.v., DuP 753 did not lower blood pressure in conscious normotensive rats, but it inhibited the pressor response to AII but not to vasopressin. It lowered blood pressure in furosemide-treated normotensive rats. Unlike saralasin, DuP 753 did not cause a transient increase in blood pressure even at 100 mg/kg i.v. DuP 753 at 3.5 micrograms i.c.v. inhibited the pressor response to i.c.v. AII, whereas DuP 753 at 10 mg/kg p.o. did not, suggesting that a single p.o. administration of DuP 753 does not affect brain AII receptors which are accessible by i.c.v. injection. Our study indicates that DuP 753 is a p.o. active, nonpeptide, selective, competitive AII receptor antagonist.
Hematological evaluation of patients with various combinations of α‐thalassemia
Authors: C. Altay, A. Gurgey, E. Tuncbilek
Journal: American Journal of Hematology (1980)

Abstract Six patients and their parents from five different families with Hb H have been evaluated clinically and hematologically. Previous studies using restriction endo‐nuclease mapping technique indicated that α‐thalassemia determinants in these cases are heterogeneous. Only one of the five cases have the usual genotype for Hb H, which is characterized by an α‐DNA‐specific fragment of 20 kb long by Eco RI digestion. Three cases from two different families have Hb H disease with α‐specific DNA fragments of 22.5 kb/2.6 kb long; and the other two have α‐specific DNA fragments of 20 kb/2.6 kb long, in Eco RI digestion of the cellular DNA. The hematological examination of the parents suggests that the α‐thalassemia condition associated with the Eco RI fragment of α‐specific cellular DNA of approximately 22.5 kb long produces an α‐thal‐2‐like clinical condition, while the other α‐thalassemia determinant associated with a fragment 2.6 kb long results in an α‐thal‐1‐like clinical condition. The clinical and hematological findings of the cases with 22.5 kb/2.6 kb fragment patterns were more severe than the case with the 20 kb/2.6 kb combination. This study suggests that variation in the clinical and hematological findings among patients with Hb H disease may well reflect a heterogeneity of the genotypic combination.
Lichen myxoedematosus in a patient with AIDS
Authors: G. TARANTINI, R. ZERBONI, S. MURATORI, M. CERNUSCHI, C. CARRER, E. ALESSI
Journal: British Journal of Dermatology (1996)

We report a patient with acquired immunodeficiency syndrome (AIDS) who developed a widespread papular eruption due to deposition of mucin in the dermis. Paraproteinaemia was demonstrated. Lichen myxoedematosus type 2 was diagnosed. This is the third case of this rare disorder reported in a human immunodeficiency virus (HIV)-seropositive subject.
Total Therapy 2 in Treatment of Multiple Myeloma: Questions About Gene Expression Profiling and Treatment-Related Mortality
Authors: Jayesh Mehta
Journal: Journal of Clinical Oncology (2010)

TO THEEDITOR:Inareportpresentingthereiterativeoutcomeof patients with multiple myeloma who were treated as part of the Total Therapy 2 study performed at the University of Arkansas for Medical Sciences (Total Therapy II: Study for Multiple Myeloma Evaluating Anti-Angiogenesis With Thalidomide and Post-Transplant Consolidation Chemotherapy), 1 the authors suggest that stability of patient characteristics during the accrual period underpins the robustness of the results and the prognostic factors found. This is only partly accurate; completeness of analysis and data presentation are at least as important in determining validity. Unfortunately, incompleteness in these areas undermines the report as it stands. One major weakness is that the influence of specific cytogenetic abnormalities has not been shown individually, and all abnormalities have been grouped together (present/absent). The prognostic implications of various karyotype abnormalities differ. For example, t(4;14), del(17p), and 1q21 abnormalities are adverse, whereas hyperdiploidy and t(11;14) are favorable. It is not logicalforallofthesekaryotypeabnormalitiestobegroupedtogether. Itispossiblethattheonlyreasonthatgeneexpressionprofiling(GEP), whichapparentlyidentifiesasmallsubgroupofpatientswithhigh-risk
METABOLISM AND REFLEX IRRITABILITY IN ANESTHESIA
Authors: ARTHUR E. GUEDEL
Journal: JAMA (1924)

The accompanying chart was compiled by Dr. Will Shimer of Indianapolis, two years ago, and conforms in general with charts of the same purpose compiled by others. It shows the metabolic rate in the average normal person from birth to the age of 80 years, estimated in calories per hour per square meter of body surface. This paper is based on clinical observation during the last three years, with the average metabolic rate in surgical patients as the foundation for consideration. We have observed from the standpoint of anesthesia that a curve of reflex irritability follows a course parallel to that of metabolism. Cell oxygen demand, of course, is the same curve as that of metabolism. Proper anesthesia, with any method, means the obtundation of body reflexes to the point at which they do not interfere with the progress of the operation. Anesthesia should be as light as possible and
HCV replication and respone to treatment in chronic hepatitis
Authors: S. Magrin, A. Craxi, C. Fabiano, C. Ficrentino, P. Almasio, V. Di Marco, O. Lo Iacono, R. Bruno, G.B. Pinzello, U. Palazzo, L. Marino, G. Provenzano, M. Vitale, A. Maggio, L. Pagliaro
Journal: Journal of Hepatology (1991)