tbuckley/cabot-search huggingface dataset:
The use of ultrasound in pre-operative assessment of the axilla in breast cancer.
Authors: BV Hogan, HG Shenoy, MB Peter, FE Langlands, BJ Dall, KM Horgan
Journal: Cancer Research (2009)

Abstract Abstract #1019 Introduction&amp;#x2028; Sentinel lymph node biopsy is now standard practice in axillary staging in breast cancer. It is associated with less morbidity than an axillary node clearance. A drawback of sentinel node biopsy is the need for a second surgical procedure if the sentinel node shows metastases. Clinical examination of the axilla has been the standard pre-operative assessment but this has been shown to be unreliable. More recently ultrasound has been used to identify axillary metastases pre-operatively. The aim of our study is to assess the role of pre-operative ultrasound and fine needle aspirate cytology in refining the selection of patients for whom sentinel node biopsy is appropriate.&amp;#x2028; Methods&amp;#x2028; Three hundred patients with primary operable invasive breast cancer had axillary ultrasound preoperatively. If the ultrasound was normal the patient was offered a sentinel node procedure. If it identified equivocal nodes a fine needle cytology was performed. If the cytology was benign a sentinel node biopsy was performed. If the cytology was malignant then an axillary node clearance was performed. In cases where pathological nodes were identified on imaging, cytology was performed to confirm malignancy. An axillary node clearance was then performed.&amp;#x2028; Results.&amp;#x2028; Eighty three percent of our patients (n=249) had a normal axillary ultrasound pre-operatively. Of these 74.5% had a benign sentinel node biopsy. Sixty two percent of patients with equivocal nodes on pre-operative imaging had metastases on final histology (n=19). Of these 63% (n=12) were correctly identified pre-operatively with fine needle aspirate cytology of the equivocal node and had an axillary node clearance performed form the outset. Ultrasound identified pathological nodes in 7% of our patients (n=20). Malignancy was confirmed on cytology and an axillary node clearance was performed.&amp;#x2028; Using ultrasound and fine needle aspirate cytology to assess the axilla pre-operatively sentinel node biopsy was performed in 265 patients (88%). Of these, 74.8% had a benign final histology. Thirty two patients had a pre-operative diagnosis of nodal metastases and had an axillary node clearance. All 32 had lymph node metastases on final histology. Factors that predicted for a malignant sentinel node were lymphovascular invasion (p&amp;lt;0.001), tumour grade (p&amp;lt;0.008) and size of tumour (p&amp;lt;0.001).&amp;#x2028; Conclusion&amp;#x2028; Eighty eight percent of our patients had a sentinel lymph node biopsy to stage the axilla. Pre-operative ultrasound combined with cytology correctly determined the status of the node in 78% of cases. Our rate of second axillary operations was reduced by 32%. Importantly all patients diagnosed with node metastases pre-operatively and advised to have an axillary node clearance did have metastases on final histology. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1019.
Interactions between neutrophils and cytokines in blood and alveolar spaces during ARDS.
Authors: S Chollet-Martin, B Jourdain, C Gibert, C Elbim, J Chastre, M A Gougerot-Pocidalo
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

Although the pathogenesis of the acute respiratory distress syndrome (ARDS) is complex and poorly understood, several observations point to an important role of interactions between polymorphonuclear neutrophils (PMN) and cytokines in this process. We therefore studied certain parameters involved in PMN transendothelial migration (adhesion molecule expression and cytoskeletal organization) in patients with ARDS (n = 14) in comparison with other ventilated patients (n = 15). We found that in the basal state, both whole-blood PMN and alveolar PMN obtained by bronchoalveolar lavage (BAL) were activated, as shown by decreased L-selectin CD62L and increased beta 2 integrin CD11b expression, as well as decreased F-actin content. The degree of PMN activation increased with the degree of lung injury and with the levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and interleukin-8 (IL-8). Moreover, the capacity of ex vivo stimulation of alveolar PMN by a bacterial peptide was low in ARDS and could partly account for the high susceptibility of these patients to lung infection. Therefore, ARDS-associated lung injury could be caused, at least in part, by inappropriate adhesion and transendothelial migration of proinflammatory cytokine-primed PMN.
Improved Biomass Stove Intervention in Rural Mexico
Authors: Isabelle Romieu, Horacio Riojas-Rodríguez, Adriana Teresa Marrón-Mares, Astrid Schilmann, Rogelio Perez-Padilla, Omar Masera
Journal: American Journal of Respiratory and Critical Care Medicine (2009)

Exposure to biomass smoke has been related to adverse health effects. In Mexico, one household in four still cooks with biomass fuel, but there has been no evaluation of the health impact of reducing indoor air pollution.To evaluate the health impact of the introduction of an improved biomass stove (Patsari; Interdisciplinary Group for Appropriate Rural Technology [GIRA], Patzcuaro, Mexico) in Mexican women.A randomized controlled trial was conducted in the Central Mexican state of Michoacán. Households were randomized to receive the Patsari stove or keep their traditional open fire. A total of 552 women were followed with monthly visits over 10 months to assess stove use, inquire about respiratory and other symptoms, and obtain lung function measurements. Statistical analysis was conducted using longitudinal models.Adherence to the intervention was low (50%). Women who reported using the Patsari stove most of the time compared with those using the open fire had significantly lower risk of respiratory symptoms (relative risk [RR], 0.77; 95% confidence interval [CI], 0.62-0.95 for cough and RR, 0.29; 95% CI, 0.11-0.77 for wheezing) adjusted for confounders. Similar results were found for other respiratory symptoms as well as for eye discomfort, headache, and back pain. Actual use of the Patsari stove was associated with a lower FEV(1) decline (31 ml) compared with the open fire use (62 ml) over 1 year of follow-up (P = 0.012) for women 20 years of age and older, adjusting for confounders.The use of the Patsari stove was significantly associated with a reduction of symptoms and of lung function decline comparable to smoking cessation.
Pyrexia and lymphadenopathy in a south Asian woman
Authors: T. T. Chung, N. Chowdhury, K. Piper, T. A Chowdhury
Journal: Journal of the Royal Society of Medicine (2004)

before, the findings were consistent with Crohn's colitis with relative preservation of mucosal architecture, but unexpectedly there was evidence of cytomegalovirus infection in the form of multiple large cells with eccentric nuclei surrounded by a clear halo and viral inclusion bodies in the cytoplasm (Figure 1).Rectal biopsies a year later revealed Crohn's colitis but no cytomegalovirus infection. COMMENTCytomegalovirus infection can complicate both ulcerative colitis and Crohn's disease.The virus belongs to the herpes virus family and 40-100% 1 of the adult population have been infected.Most infections are subclinical and lead to lifelong latency.However, in immunocompromised individuals such as transplant recipients and AIDS patients, the virus can cause severe disease.A connection has been suspected between cytomegalovirus inclusion disease and ulcerative colitis since 1961. 2 The prevalence of cytomegalovirus complicated colitis in patients with inflammatory bowel disease has been estimated at 0.53-4%, [3][4] but in patients presenting with severe steroid refractive Crohn's disease it is thought to be much higher at 11-36%. 5 Clinical pointers to viral complications include persistent severe hypokalaemia, high spiking pyrexia, lymphadenopathy and bone marrow suppression 3 but such features are seen also in patients with uncomplicated severe steroid-resistant Crohn's colitis.6] Serological tests and virus isolation from blood or faeces do not prove colonic infection.With earlier diagnosis the present patient might have been spared surgery.When cytomegalovirus infection is found to be complicating Crohn's colitis, steroid treatment should be reduced, other immunomodulatory treatments stopped, and ganciclovir 10-15 mg/kg daily in divided doses given for 2-3 weeks. 3,6Such treatment has reduced emergency colectomy rates from 80% to 33% and case fatality from 33% to 5% in patients with severe steroidrefractory inflammatory bowel disease complicated by cytomegalovirus infection.However, about one-fifth of patients so treated need colectomy within three months because the underlying bowel disease has become reactivated or the viral infection has persisted. 6
Diagnosis of Drug-Induced Hepatic Damage
Authors: Fenton Schaffner
Journal: JAMA (1965)

Among the many untoward reactions produced by drugs, those involving the liver have received much attention, usually because the clinical manifestations are dramatic. In the screening of new drugs, careful observations are made of various but often inadequate parameters of hepatic function. Thus, despite extensive testing, drugs become generally available before hepatic side effects are recognized. This then brings to the practicing physician the problem of deciding whether or not an abnormality involving the liver has been caused by a drug his patient was taking. The purpose of this paper is to explore an approach to this problem based on coordinated use of clinical, laboratory, and morphologic data. <h3>Clinical Manifestations</h3> The most obvious clinical manifestation of an untoward drug reaction involving the liver is jaundice. This is considered an alarm signal leading to discontinuation of drug therapy. However, involvement of the liver without jaundice is probably more common but is
pH-Dependent Interdomain Tethers of CD1b Regulate Its Antigen Capture
Authors: Miguel Relloso, Tan-Yun Cheng, Jin S. Im, Emilio Parisini, Carme Roura-Mir, Charles DeBono, Dirk M. Zajonc, Leonel F. Murga, Mary Jo Ondrechen, Ian A. Wilson, Steven A. Porcelli, D. Branch Moody
Journal: Immunity (2008)
[227] CONTRAST ENHANCED ULTRASOUND WITH SONOVUE. A NEW TOOL TO DETECT PERITONEAL-PLEURAL COMMUNICATIONS IN CIRRHOTIC PLEURASCITES
Authors: F.G. Foschi, M. Pompili, G.F. Stefanini, G. Marano, C. Corbelli, R. Righini, V. Alvisi, L. Bolondi, G. Gasbarrini, M. Bernardi, F. Piscaglia
Journal: Journal of Hepatology (2007)
Anti-Monocyte Chemoattractant Protein-1 Gene Therapy Attenuates Left Ventricular Remodeling and Failure After Experimental Myocardial Infarction
Authors: Shunji Hayashidani, Hiroyuki Tsutsui, Tetsuya Shiomi, Masaki Ikeuchi, Hidenori Matsusaka, Nobuhiro Suematsu, Jing Wen, Kensuke Egashira, Akira Takeshita
Journal: Circulation (2003)

Background— Increased expression of monocyte chemoattractant protein-1 (MCP-1) has recently been described in clinical and experimental failing heart. However, its pathophysiological significance in heart failure remains obscure. We thus determined whether MCP-1 is increased in post-myocardial infarction (MI) hearts and its blockade can attenuate the development of left ventricular (LV) remodeling and failure. Methods and Results— Anterior MI was produced in mice by ligating the left coronary artery. After 4 weeks, MI mice exerted LV dilatation and contractile dysfunction in association with myocyte hypertrophy and interstitial fibrosis of noninfarcted LV. MCP-1 mRNA levels were increased by 40-fold in noninfarcted LV 1 day after ligation, which persisted until 28 days. To block the MCP-1 signals, an N-terminal deletion mutant of the human MCP-1 gene was transfected into the limb skeletal muscle 3 days before and 14 days after ligation. This method improved the survival rate of mice with MI at 4 weeks (61% versus 87%, P &lt;0.05) as well as attenuated LV cavity dilatation and contractile dysfunction, interstitial fibrosis, recruitment of macrophages, and myocardial gene expression of tumor necrosis factor-α and transforming growth factor-β compared with the nontreated MI mice despite the comparable infarct size calculated as percent LV circumference. Conclusions— The activation of MCP-1 expression contributes to the LV remodeling and failure after MI. An anti-MCP-1 gene therapy can be a useful novel strategy for preventing post-MI heart failure.
Are right ventricular wall motion abnormalities reliable for the diagnosis of arrhythmogenic right ventricular cardiomyopathy? A cardiac magnetic resonance imaging study in healthy subjects using a new segmental model
Authors: Burkhard Sievers, Ulrich Franken, Marvin Addo, Asli Bakan, Simon Kirchberg, Hans-Joachim Trappe
Journal: Journal of the American College of Cardiology (2003)
Glycoproteins: Structure, Metabolism and Biology
Authors: Robert G. Spiro
Journal: New England Journal of Medicine (1963)

PROTEINS containing carbohydrate are widely distributed in animal tissues and include such diverse compounds as serum proteins, mucins, blood-group substances, pituitary hormones and connective-tissue elements. Interest in glycoproteins has been stimulated by their physiologic importance, as well as by their involvement in a variety of pathologic states.In recent years the amount of attention paid to these compounds has increased markedly. Many have now been isolated in satisfactorily pure form, and a substantial amount of information regarding their chemical structure has been obtained. Moreover, some aspects of the metabolism of these complicated molecules are now beginning to be understood.It . . .
Abnormal Peripheral Vascular Dynamics in Systemic Amyloidosis
Authors: ROBERT ZELIS
Journal: Annals of Internal Medicine (1969)

The forearm blood flow response to restoration of the circulation after arterial occlusion (reactive hyperemia blood flow (RHBF)) and to vigorous forearm exercise (exercise hyperemia blood flow (EXBF)) was measured with a strain gauge Plethysmograph in 9 patients with systemic amyloidosis and 20 normal subjects. The patients with systemic amyloidosis were clearly separated functionally into two groups. Four patients had striking reductions in RHBF as well as EXBF; all four had symptoms of peripheral vascular insufficiency, and the three of these patients who had a muscle biopsy showed severe infiltration of amyloid into the walls of arterioles. The remaining five patients without ischemic symptom had normal blood vessels on biopsy and did not differ significantly from the normal subjects. It is suggested that the exertional muscle discomfort experienced by some patients with systemic amyloidosis is at least in part the result of diseased arterioles, leading to a diminished arteriolar dilator capacity and compromised blood supply during exertion.
A Phytoestrogen-Rich Diet Increases Energy Expenditure and Decreases Adiposity in Mice
Authors: Christopher R. Cederroth, Manlio Vinciguerra, Françoise Kühne, Rime Madani, Daniel R. Doerge, Theo J. Visser, Michelangelo Foti, Françoise Rohner-Jeanrenaud, Jean-Dominique Vassalli, Serge Nef
Journal: Environmental Health Perspectives (2007)

Obesity is an increasingly prevalent health problem, and natural effective therapeutic approaches are required to prevent its occurrence. Phytoestrogens are plant-derived compounds with estrogenic activities; they can bind to both estrogen receptors alpha and beta and mimic the action of estrogens on target organs.The purpose of this study was to examine the influence of soy-derived phytoestrogens on energy balance and metabolism.Male outbred mice (CD-1) were allowed ad libitum access to either a high soy-containing diet or a soy-free diet from conception to adulthood. We measured circulating serum isoflavone levels using reverse-phase solid-phase extraction for subsequent liquid chromatography electrospray tandem mass spectrometry analysis. Adult animals were analyzed for body composition by dual-energy X-ray absorptiometry, locomotor activity by running-wheel experiments, respiratory exchange rate by indirect calorimetry, and food intake using metabolic cages. Quantitative reverse transcriptase-polymerase chain reaction was performed to determine the expression of hypothalamic neuropeptide genes.We found that adult mice fed a soy-rich diet had reduced body weight, adiposity, and resistance to cold. This lean phenotype was associated with an increase in lipid oxidation due to a preferential use of lipids as fuel source and an increase in locomotor activity. The modulation of energy balance was associated with a central effect of phytoestrogens on the expression of hypothalamic neuropeptides, including agouti-related protein.The data suggest that dietary soy could have beneficial effects on obesity, but they also emphasize the importance of monitoring the phytoestrogen content of diets as a parameter of variability in animal experiments.
Evolutionary Time and Human Memory
Authors: Roger N. Rosenberg
Journal: JAMA (2002)

ContextCerebrospinal fluid tau protein and β-amyloid 42 (Aβ42) protein are altered even in very mild Alzheimer disease (AD). So far, few data exist for subjects with mild cognitive impairment (MCI).ObjectiveTo investigate the potential of cerebrospinal fluid tau and Aβ42 for predicting progression from MCI to AD in a longitudinal study of 28 patients with MCI who received follow-up for 18 months.DesignAn 18-month prospective study.SettingClinical follow-up study of community-residing subjects with MCI.Main Outcome MeasuresCerebrospinal fluid tau and Aβ42 concentrations were measured using enzyme-linked immunosorbent assay at baseline. The potential ofboth biomarkers was evaluated to predict the progression to dementia, the end point of this study, using multiple logistic regression analysis.ResultsOf 28 subjects with MCI, 12 progressed to dementia (2 to frontotemporal dementia; 10 to AD). Six subjects had progressive MCI, and 10 subjects showed stable MCI. Cerebrospinal fluid tau levels were significantly elevated in patients who progressed to probable AD (P = .002) and subjects with progressive MCI (P = .003) compared with subjects who had stable MCI. Cerebrospinal fluid Aβ42 levels were significantly lower in patients who progressed to probable AD (P = .007) and those with progressive MCI (P = .04) than in subjects with stable MCI. Logistic regression analysis identified elevated tau protein level as a predictor of cognitive deterioration (P = .02), whereas a delayed verbal recall score at baseline was significantly associated with the development of probable AD (P = .03).ConclusionOur results indicate that altered tau and Aβ42 concentrations may be detectable in subjects who are clinically diagnosed as having MCI but demonstrate the pathological changes of AD.
Determinants of lung volume in spontaneously breathing preterm infants.
Authors: C F Poets, G A Rau, K Neuber, M Gappa, J Seidenberg
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

To study the effects of apneic pauses, sighs, and breathing patterns on functional residual capacity (FRC), we measured FRC repeatedly in 48 healthy preterm infants (weight at study 2,042 +/- 316 g [mean +/- SD], postconceptional age 36.6 +/- 2.0 wk), during unsedated sleep using a modified heliox/nitrogen washout technique. Breathing movements and pulse oximeter saturation (SpO2) were recorded throughout and recordings analyzed for the presence of regular and nonregular breathing pattern, apneic pauses, sighs, and desaturations (SpO2 < 90%) during the last 2 min prior to each FRC measurement. FRC was lower during nonregular than during regular breathing pattern (23.3 +/- 7.2 ml/kg versus 26.9 +/- 7.8 ml/kg, p < 0.02); however, this apparent effect of breathing pattern disappeared after controlling the data for apneic pauses. Apneic pauses resulted in a significant decrease in FRC: mean FRC was 20.0 +/- 6.8 ml/kg if measured within 2 min of an apneic pause, 26.0 +/- 6.9 ml/kg if measured after a sigh (p < 0.001), and 24.0 +/- 7.7 ml/kg if there had been neither a sigh nor an apneic pause (p < 0.05). The interval between the apneic pause and the FRC measurement had no effect on FRC. There was an inverse correlation between FRC and the speed with which SpO2 fell during desaturation (r = -O.5, p < 0.03). Apneic pauses resulted in a persistent reduction in FRC in these preterm infants. Sighs appeared to restore FRC. The significant relationship between FRC and the speed of desaturation found in this study underscores the importance of endogenous or exogenous strategies that help to increase FRC, such as sighs or the application of continuous positive airway pressure, for the stability of oxygenation in preterm infants who have difficulty maintaining their oxygenation.
Pragmatic Trial of Health Care Technologies to Improve Adherence to Pediatric Asthma Treatment
Authors: Bruce G. Bender, Peter J. Cvietusa, Glenn K. Goodrich, Ryan Lowe, Heather A. Nuanes, Cynthia Rand, Susan Shetterly, Cathy Tacinas, William M. Vollmer, Nicole Wagner, Frederick S. Wamboldt, Stanley Xu, David J. Magid
Journal: JAMA Pediatrics (2015)

Most patients with asthma take fewer than half of prescribed doses of controller medication. Interventions to improve adherence have typically been costly, impractical, and at best only minimally successful. To test a speech recognition (SR) intervention to improve adherence to pediatric asthma controller medication. The Breathe Well study was a 24-month pragmatic randomized clinical trial. The study was conducted within Kaiser Permanente Colorado, a large, group-model health maintenance organization. A total of 1187 children aged 3 to 12 years with a persistent asthma diagnosis and prescription for an inhaled corticosteroid were randomized to the computerized SR intervention or usual care condition and followed up for 24 months between October 2009 and February 2013. Speech recognition telephone calls to parents in the intervention condition were triggered when an inhaled corticosteroid refill was due or overdue. Calls were automatically tailored with medical and demographic information from the electronic health record and from parent answers to questions in the call regarding recent refills or a desire to receive help refilling, learn more about asthma control, or speak with an asthma nurse or pharmacy staff member. Adherence to pediatric asthma controller medication, measured as the medication possession ratio over 24 months. In the intention-to-treat analysis, inhaled corticosteroid adherence was 25.4% higher in the intervention group than in the usual care group (24-month mean [SE] adherence, 44.5% [1.2%] vs 35.5% [1.1%], respectively; P < .001). Asthma-related urgent care events did not differ between the 2 groups. The intervention effect was consistent in subgroups stratified by age, sex, race/ethnicity, body mass index, and disease-related characteristics. The intervention's significant impact on adherence demonstrates strong potential for low-cost SR adherence programs integrated with an electronic health record. The absence of change in urgent care visits may be attributable to the already low number of asthma urgent care visits within Kaiser Permanente Colorado. Application of electronic health record-leveraged SR interventions may reduce health care utilization when applied in a population with less-controlled asthma. clinicaltrials.gov Identifier: NCT00958932.