tbuckley/cabot-search huggingface dataset:
Mechanical properties of the velopharynx in obese patients with obstructive sleep apnea.
Authors: C F Ryan, L L Love
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

Epidemiologic data indicate that the relationship between obesity and obstructive sleep apnea (OSA) is largely explained by variation in neck size. Fat deposits in the neck may predispose to upper airway (UA) occlusion during sleep by altering the mechanical properties of the UA, particularly at the level of the velopharynx (VP). To determine whether effective compliance (CEFF) of the VP is related to obesity in the neck, we have performed anthropometrics, polysomnography, and dynamic UA videoendoscopy in 18 patients with OSA and eight nonapneic control subjects. Following topical anesthesia (cocaine 4%) to one nasal passage, subjects were examined with a thin fiberscope (outer diameter [OD] 3.8 mm) while awake, supine, breathing exclusively through the nose, during a maximal vital capacity (VC) maneuver against an unoccluded airway. UA cross-sectional area (CSA), anteroposterior (AP) and lateral (L) diameters were measured from stored images. CEFF was expressed as the ratio of CSAVP in expiration (E) to inspiration (I) during the maximal VC maneuver (expiratory CSAMAX/inspiratory CSAMIN), and airway shape as AP/L diameter. The OSA patients were divided into two groups based on median neck circumference (NC). CEFF of the VP was greater in OSA patients compared with control subjects (CEFF 2.0 +/- 0.8 versus 1.1 +/- 0.5; p < 0.001). CEFF was greater in the large NC group compared with both the small NC group (p < 0.05) and control subjects (p < 0.01), but the difference between the small NC group and control subjects was not significant. CEFF was related to NC (r = 0.63; p = 0.001; n = 26), body mass index (r = 0.54; p < 0.01, n = 26), and apnea-hypopnea index (r = 0.43; p < 0.05; n = 23). The change in CSAVP during the maximal VC maneuver was mainly due to inspiratory narrowing. Obese patients with large necks have a more collapsible velopharynx during wakefulness, which may predispose to upper airway obstruction during sleep.
Immunological effects of chlorinated dibenzo-p-dioxins.
Authors: N I Kerkvliet
Journal: Environmental Health Perspectives (1995)

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) and structurally similar halogenated aromatic hydrocarbons cause a broad range of immunologic effects in experimental animals including decreased host resistance to infectious disease and suppressed humoral and cell-mediated immune responses. In the mouse, TCDD immunotoxicity has been shown to be an aryl hydrocarbon (Ah) receptor-dependent process. However, despite considerable research, the biochemical and molecular alterations that occur subsequent to Ah receptor activation that lead to altered immune reactivity remain to be elucidated. In addition to immune suppression, TCDD promotes inflammatory responses. This effect may result from an upregulation of the production of inflammatory cytokines such as interleukin-1 and tumor necrosis factor. Nonhuman primates exposed to TCDD show suppressed antibody responses and changes in lymphocyte subsets in the peripheral blood. The immunotoxic effects of TCDD in humans are poorly characterized, and few studies have examined the immune status of individuals with known, documented exposure to TCDD. It is important for laboratory research to focus on defining TCDD-sensitive immunologic biomarkers in animal models that can also be used in human subjects. Understanding the mechanisms that underlie species differences in TCDD immunotoxicity is also of critical importance for extrapolation of effects seen in laboratory animals to man.
Effect of glucocorticoids on collagen accumulation in pulmonary vascular remodeling in the rat.
Authors: G J Poiani, C A Tozzi, S Thakker-Varia, J K Choe, D J Riley
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

Administration of corticosteroids may attenuate the development of pulmonary hypertension by inhibiting the cell proliferation and protein synthesis that occur in early pulmonary vascular remodeling. However, in vitro studies show that corticosteroids stimulate collagen synthesis in vascular smooth muscle cells, and corticosteroid administration may be deleterious in stimulating collagen deposition. To test whether corticosteroid treatment promotes vascular collagen production in vivo, we administered triamcinolone diacetate to rats exposed to 10% O2 for 3 days and measured pro alpha 1(I) collagen mRNA and the hydroxyproline/protein ratio in the main pulmonary artery. Triamcinolone treatment (12 mg/kg intraperitoneally, once daily for 3 days) reduced mean right ventricular pressure (11 +/- 1 versus 14 +/- 1 mm Hg) and protein content of pulmonary arteries (1.8 +/- 0.1 versus 2.7 +/- 0.1 mg/vessel) (both p < 0.05). However, corticosteroid treatment produced a dose-related increase in pro alpha 1(I) mRNA levels and increased the ratio of hydroxyproline/protein (47 +/- 2 versus 38 +/- 3 micrograms/mg; p < 0.05). Thus, corticosteroid administration ameliorated the increase in pulmonary hypertension in early hypoxia, but increased the proportion of collagen in the vessel wall. Corticosteroid treatment in pulmonary vascular remodeling may be deleterious in increasing the concentration of collagen in the vessel wall.
A Different Medicine Is Possible
Authors: Giovanni A. Fava
Journal: Psychotherapy and Psychosomatics (2005)

More and more voices from academic medicine are questioning the relationship between the pharmaceutical industry and the physicians [5] . We wished such reactions had occurred in the nineties, when the phenomenon of confl ict of interest was more controllable, and when our journal actually did react [6, 7] . The question is now whether the growing number of episodes concerned with confl ict of interest is the unavoidable drawback of a system which functions in an independent and satisfactory way, or whether they are the expression of a clinical medicine devoid of its psychosocial dimension and therefore extremely liable to corporate infl uences. Is the image of a dehumanized, technological medicine, loaded with confl ict of interest and with marketing strategies, the only model we have to offer? Or is there a different model which physicians may refer to?
Ascorbic Acid Economy in Surgical Patients as Indicated by Blood Ascorbic Acid Levels
Authors: John H. Crandon, Bernard Landau, Stanley Mikal, James Balmanno, Mildred Jefferson, Norman Mahoney
Journal: New England Journal of Medicine (1958)

TODAY, ascorbic acid is well recognized as having an important role in the preoperative and postoperative nutrition of surgical patients. Nevertheless, information on the requirements and total physiologic action of this vitamin is scanty. The result frequently has been either shotgun therapy or none at all.This study has centered around the requirements of ascorbic acid, the effects of deficiency and the significance of blood acid levels in adult surgical patients exclusive of those suffering burns or severe trauma. The classic work of Bartlett, Jones and Ryan,1 in 1942, suggested that in the adult, plasma ascorbic acid levels below 0.2 . . .
Aerobic fitness of Anglo-Saxon and Indian students.
Authors: C P Hardy, R G Eston
Journal: British Journal of Sports Medicine (1985)

The purpose of this study was to compare the aerobic fitness of two groups of male college students: 32 Anglo-Saxon males (age range 16-18 years) with 27 Indian males, born in England, (age range 16-23 years), none of whom was highly active in any particular sport. Maximal oxygen uptake was estimated by submaximal test on a cycle ergometer and percent body fat was assessed by skinfold calipers. The Anglo-Saxon group had higher absolute and relative maximal oxygen consumption values and higher body weight. There was no difference in percent fat between the two groups. Strength data were also provided for descriptive purposes.
Phase I Trial of a Pathotropic Retroviral Vector Expressing a Cytocidal Cyclin G1 Construct (Rexin-G) in Patients With Advanced Pancreatic Cancer
Authors: Evanthia Galanis, Stephanie K Carlson, Nathan R Foster, Val Lowe, Fernando Quevedo, Robert R McWilliams, Axel Grothey, Aminah Jatoi, Steven R Alberts, Joseph Rubin
Journal: Molecular Therapy (2008)
Functional and Structural Studies of Small Bowel in Ankylostomiasis
Authors: B. N. Tandon, B. C. Das, A. K. Saraya, M. G. Deo
Journal: BMJ (1966)

Non-specific Haemorrhagic Proctocolitis-Riis et al. MEDICALJOURThe main reason for discrepancy between the two methods of evaluation thus seems to be a difference of threshold. SummarySixty-five episodes of complete clinical remission in 46 patients with a verified diagnosis of non-specific haemorrhagic proctocolitis were studied with respect to macroscopic and microscopical signs of mucosal inflammation.The microscopical evaluation was based on the cytological method described in a previous paper.Macroscopic assessment was made by sigmoidoscopy with the use of conventional criteria.In 31 episodes sigmoidoscopy revealed macroscopically abnormal mucosas; in 24 of these the cytological preparations also showed inflammatory changes, while the cytological pictures were normal in seven.In the remaining 34 episodes no mucosal changes were found at sigmoidoscopy; in 16 of these distinct inflammation was seen microscopically, while normal cytology was demonstrated in 18.In about two-thirds of the episodes of patients with remissions shorter than six months the cytological method showed inflammatory changes, whereas the corresponding proportion in remissions of more than six months' duration was only slightly over two-fifths.The ability of microscopical techniques-like the cytological method used in the present investigation-to demonstrate unequivocal signs of inflammation in proctocolitis patients who are in full clinical remission, and who may even show a normal sigmoidoscopical picture, can be utilized diagnostically when such patients are first seen in a symptom-free or symptom-poor phase.The fact also points to the latent chronicity of non- specific haemorrhagic proctocolitis and calls for circumspection with regard to the prognosis of the disease.
Bilateral Cerebral Mediofrontal Hypoactivity in Tc-99m HMPAO SPECT Imaging
Authors: R. DENAYS, M. TONDEUR, P. NOEL, H. R. HAM
Journal: Clinical Nuclear Medicine (1994)

Fifteen patients who had bilateral mediofrontal hypoactivity and 30 control subjects without this SPECT anomaly underwent Tc-99m HMPAO brain SPECT imaging. Bilateral mediofrontal hypoactivity was found in various neurologic disorders, including subcortical arteriosclerotic encephalopathy, lacunar state, chronic alcoholism, progressive nonvascular dementia, carbon monoxide poisoning, and diabetes mellitus. This SPECT abnormality was, however, specifically associated with three clinical signs: motor disabilities predominating in the lower limbs, urinary incontinence, and akinetic mutism.
Medicine and the Holocaust
Authors: Barron H. Lerner
Journal: Annals of Internal Medicine (1995)

Letters15 December 1995Medicine and the HolocaustBarron H. Lerner, MD and David J. Rothman, PhDBarron H. Lerner, MDColumbia University New York, NY 10032Search for more papers by this author and David J. Rothman, PhDColumbia University New York, NY 10032Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-123-12-199512150-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Our query about whether an ethic of “do no harm” can be reconciled with physician-assisted suicide was intended to frame, not resolve, the issue. Dr. Schnaper's readiness to put patient suffering into the Equation is certainly legitimate. But this concern must be weighed against the potential for abuse. The German experience clarifies why physicians must never administer a lethal injection, however quick and painless, as capital punishment. It also suggests why physicians should be wary of recent legislative attempts to sanction their direct assistance in bringing about their patients' death.Nazi eugenics, as Dr. Gelles notes, did borrow ...References1. Jones JH. Bad Blood. The Tuskegee Syphilis Experiment. New York: Free Press; 1993. Google Scholar2. Gamble VN. A legacy of distrust: African Americans and medical research. Am J Prev Med. 1993; 9(6 Suppl):35-8. Google Scholar Author, Article, and Disclosure InformationAuthors: Barron H. Lerner, MD; David J. Rothman, PhDAffiliations: Columbia University New York, NY 10032 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 December 1995Volume 123, Issue 12Page: 964-965KeywordsHomicideJewish peopleMedical educationSuicide ePublished: 15 August 2000 Issue Published: 15 December 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Immune-Complex Nephritis (ICN) with Hepatitis-Associated Antigen (HAA) in Chronic Hepatitis.
Authors: D. T. Lowenthal
Journal: Annals of Internal Medicine (1973)

Meeting Abstracts1 May 1973Immune-Complex Nephritis (ICN) with Hepatitis-Associated Antigen (HAA) in Chronic Hepatitis.D. T. Lowenthal, M.D., M. Kneiser, M.D., William A. Briggs, M.D., E. Jenis, M.D.D. T. Lowenthal, M.D.Search for more papers by this author, M. Kneiser, M.D.Search for more papers by this author, William A. Briggs, M.D.Search for more papers by this author, E. Jenis, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-78-5-817_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThree patients with chronic hepatitis with either HAA or anti-HAA antibody and glomerulonephritis were studied to determine the relationship between these two disease processes. All had elevated levels of serum glutamic-pyruvic transaminase, serum glutamic-oxalactic transaminase, and alkaline phosphatase and various degrees of azotemia, creatinemia, and proteinuria. Onset of liver disease preceded the renal disease in two and in a third patient was associated with the development of a distinct glomerular disease, in addition to underlying congenital obstructive uropathy. Renal biopsies showed three distinct histologic types of glomerulonephritis: membranous, membranoproliferative, and focal. Further, electron microscopy showed clusters of viral-like particles in... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Washington, D.C. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByArthritis in acute hepatitis and chronic active hepatitis 1 May 1973Volume 78, Issue 5Page: 817-817KeywordsAminotransferasesBiopsyChronic hepatitisElectron microscopyGlomerulonephritisLiver diseasesNephritisPhosphatasesProteinuriaRenal diseases Issue Published: 1 May 1973 PDF DownloadLoading ...
TGF-β prevents T follicular helper cell accumulation and B cell autoreactivity
Authors: Mark J. McCarron, Julien C. Marie
Journal: Journal of Clinical Investigation (2014)

T follicular helper (Tfh) cells contribute to the establishment of humoral immunity by controlling the delivery of helper signals to activated B cells; however, Tfh development must be restrained, as aberrant accumulation of these cells is associated with positive selection of self-reactive germinal center B cells and autoimmunity in both humans and mice. Here, we show that TGF-β signaling in T cells prevented Tfh cell accumulation, self-reactive B cell activation, and autoantibody production. Using mice with either T cell–specific loss or constitutive activation of TGF-β signaling, we demonstrated that TGF-β signaling is required for the thymic maturation of CD44+CD122+Ly49+CD8+ regulatory T cells (Tregs), which induce Tfh apoptosis and thus regulate this cell population. Moreover, peripheral Tfh cells escaping TGF-β control were resistant to apoptosis, exhibited high levels of the antiapoptotic protein BCL2, and remained refractory to regulation by CD8+ Tregs. The unrestrained accumulation of Tfh cells in the absence of TGF-β was dependent on T cell receptor engagement and required B cells. Together, these data indicate that TGF-β signaling restrains Tfh cell accumulation and B cell–associated autoimmunity and thereby controls self-tolerance.
FOOD-BASED ORAL REHYDRATION SALT SOLUTION FOR ACUTE CHILDHOOD DIARRHOEA
Authors: Philippe Lepage, Deo-Gratias Hitimana, Christiaan Vand Goethem, Mélanie Ntahorutaba, François Nsengumuremyi, R.H. Behrens, A.M. Tomkins
Journal: The Lancet (1989)
Effectiveness of Vaginal Papanicolaou Smear Screening After Total Hysterectomy for Benign Disease
Authors: Michael D. Fetters
Journal: JAMA (1996)

<h3>Objective.</h3> —Using literature review, we assessed (1) Papanicolaou smear screening recommendations after hysterectomy for benign disease, (2) total hysterectomy for benign disease as a risk for vaginal dysplasia or carcinoma, and (3) effectiveness of screening for vaginal carcinoma after total hysterectomy for benign disease. <h3>Data Sources.</h3> —We considered (1) organizations' recommendations about screening, (2) references from major textbooks of gynecology, and (3) MEDLINE searches of English-language studies published from 1966 through 1995 using the search strategy (hysterectomy and vaginal smears) or (vaginal smears and vaginal neoplasms). <h3>Study Selection.</h3> —Published or verbal confirmations of screening recommendations were eligible. Criteria for assessing risk of vaginal dysplasia or carcinoma included original research, documented reports of hysterectomy as an exposure, and evidence of preinvasive vaginal disease or vaginal carcinoma outcomes. We sought data assessing burden of suffering, screening efficacy, and effectiveness of early detection. <h3>Data Extraction.</h3> —Descriptive and analytic data from each study were abstracted. <h3>Data Synthesis.</h3> —Screening recommendations were categorized by the organizations' positions: two opposed screening, two supported screening, and six lacked specific guidelines. Data on the risk between total hysterectomy for benign disease and subsequent vaginal carcinoma were organized by study design (three case control, two cohort, and 13 case series) and described. Data on screening effectiveness were organized to address the criteria advocated by the US Preventive Services Task Force. <h3>Conclusions.</h3> —There are conflicting guidelines on screening after hysterectomy and conflicting data on the risk of vaginal carcinoma after total hysterectomy for benign disease, though the best-designed research suggests no association. There is insufficient evidence to recommend routine vaginal smear screening in women after total hysterectomy for benign disease. (<i>JAMA</i>. 1996;275:940-947)
Antenatal care for twin and triplet pregnancies: summary of NICE guidance
Authors: C. Visintin, M. A. Mugglestone, D. James, M. D. Kilby
Journal: BMJ (2011)

In the past 30 years the incidence of twin and triplet pregnancies has increased, mainly because of increasing use of assisted reproduction techniques, such as in vitro fertilisation. Multiple births currently account for 3% of live births in England and Wales.1 Twin and triplet pregnancies are associated with higher maternal and fetal mortality and morbidity than singleton pregnancies. Women with twin and triplet pregnancies therefore need more frequent contact with healthcare professionals and specialised care from a multidisciplinary team. This article summarises the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) on antenatal care for women with twin and triplet pregnancies.2 NICE recommendations are based on systematic reviews of best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on the Guideline Development Group's experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets. ### Determining gestational age and chorionicity
Cardiac Dysfunction in the Trastuzumab Clinical Trials Experience
Authors: Andrew Seidman, Clifford Hudis, Mary Kathryn Pierri, Steven Shak, Virginia Paton, Mark Ashby, Maureen Murphy, Stanford J. Stewart, Deborah Keefe
Journal: Journal of Clinical Oncology (2002)

PURPOSE: This study sought to estimate cardiac dysfunction (CD) risk for patients receiving trastuzumab; to characterize observed CD by severity, treatment, and clinical outcome; to assess effects of baseline clinical risk factors on CD; and to assess effects of cumulative doses of anthracyclines and trastuzumab on CD. PATIENTS AND METHODS: A retrospective review of records for patients enrolled onto any of seven phase II and III trastuzumab clinical trials was performed. Predefined criteria were used for the diagnosis, and the New York Heart Association functional classification system was used to document CD severity. Product-limit estimates were used to summarize the cumulative anthracycline and trastuzumab doses at the time of CD onset. RESULTS: Patients treated with trastuzumab were found to be at an increased risk for CD. The incidence was greatest in patients receiving concomitant trastuzumab and anthracycline plus cyclophosphamide (27%). The risk was substantially lower in patients receiving paclitaxel and trastuzumab (13%) or trastuzumab alone (3% to 7%); however, most of these patients had received prior anthracycline therapy. CD was noted in 8% of patients receiving anthracycline plus cyclophosphamide and 1% receiving paclitaxel alone. Most trastuzumab-treated patients developing CD were symptomatic (75%), and most improved with standard treatment for congestive heart failure (79%). CONCLUSION: Trastuzumab is associated with an increased risk of CD, which is greatest in patients receiving concurrent anthracyclines. In most patients with metastatic breast cancer, the risk of CD can be justified given the improvement in overall survival previously reported with trastuzumab.
Value of washings and brushings at fibreoptic bronchoscopy in the diagnosis of lung cancer.
Authors: V H Mak, I D Johnston, M R Hetzel, C Grubb
Journal: Thorax (1990)

A retrospective study was performed to evaluate the diagnostic yield for lung cancer from histological biopsy specimens and from washings and brushings for cytological examination taken at fibreoptic bronchoscopy. The records of 680 bronchoscopies were analysed. Of 300 patients eventually diagnosed as having a malignant lesion, 188 had had biopsy, washing, and brushing. Of these, 125 had endoscopically visible tumour (group A) and 63 had no abnormal findings or abnormal findings that were not diagnostic of malignancy (group B). In group A biopsy specimens gave a positive result in 76% of cases, washings in 49.6%, and brushings in 52%; biopsy material gave the only positive result in 22.4% of cases, washings in 2.2%, and brushings in 4.8%. In group B biopsy specimens were positive in 36.5%, washings in 38.1%, and brushings in 28.6%; biopsy gave the only positive result in 11.1% of cases, washing in 9.5%, and brushing in 3.2%. Washing had a higher diagnostic yield than brushing in group B. Biopsy and cytological examination of either washings or brushings were found to give over 95% of all positive results in group A, but in group B the combination of biopsy and washing was more often successful (94.3%) than biopsy and brushing (82.8%). It is concluded that for the maximum diagnostic yield in the diagnosis of lung cancer biopsy should be combined with cytology using both washings and brushings.