tbuckley/cabot-search huggingface dataset:
Total effective compliance, cardiac output and fluid volumes in essential hypertension.
Authors: G M London, M E Safar, A C Simon, J M Alexandre, J A Levenson, Y A Weiss
Journal: Circulation (1978)

Total effective compliance, hemodynamic parameters, extracellular fluid volume, cardiopulmonary (CPBV) and total blood (TBV) volumes were determined in 32 men, including 14 normotensive controls and 18 sustained essential hypertensive patients. The effective compliance was calculated from the changes in central venous pressure recorded simultaneously with the changes in blood volume obtained after a rapid Dextran infusion. In normotensive controls, compliance was 2.08 +/- 0.09 ml/mm Hg/kg and was positively correlated with plasma (r = 0.79) and extracellular fluid (r = 0.84) volumes. In hypertensives, compliance was significantly reduced (1.49 +/- 0.06 ml/mm Hg/kg; P is less than 0.001) and was correlated negatively with the CPBV/TBV ratio (r = -0.75) and positively with the plasma volume/interstitial fluid volume ratio (r = 0.84). These results suggest that in normotensives, there is a regulatory mechanism between volume and compliance and that this contributes to maintaining filling pressure and cardiac output within normal ranges. In hypertensives, the reduced compliance could participate in the maintenance of normal values of cardiac output and extracellular fluid volume by influencing the partition of intravascular and extracellular fluid volumes.
Measurement of Arterial Activity on Routine FDG PET/CT Images Improves Prediction of Risk of Future CV Events
Authors: Amparo L. Figueroa, Amr Abdelbaky, Quynh A. Truong, Erin Corsini, Megan H. MacNabb, Zachary R. Lavender, Meredith A. Lawler, Steven K. Grinspoon, Thomas J. Brady, Khurram Nasir, Udo Hoffmann, Ahmed Tawakol
Journal: JACC. Cardiovascular imaging (2013)
Association Between Hospital-Level Obstetric Quality Indicators and Maternal and Neonatal Morbidity
Authors: Elizabeth A. Howell, Jennifer Zeitlin, Paul L. Hebert, Amy Balbierz, Natalia Egorova
Journal: JAMA (2014)

In an effort to improve the quality of care, several obstetric-specific quality measures are now monitored and publicly reported. The extent to which these measures are associated with maternal and neonatal morbidity is not known.To examine whether 2 Joint Commission obstetric quality indicators are associated with maternal and neonatal morbidity.Population-based observational study using linked New York City discharge and birth certificate data sets from 2010. All delivery hospitalizations were identified and 2 perinatal quality measures were calculated (elective, nonmedically indicated deliveries at 37 or more weeks of gestation and before 39 weeks of gestation; cesarean delivery performed in low-risk mothers). Published algorithms were used to identify severe maternal morbidity (delivery associated with a life-threatening complication or performance of a lifesaving procedure) and morbidity in term newborns without anomalies (births associated with complications such as birth trauma, hypoxia, and prolonged length of stay). Mixed-effects logistic regression models were used to examine the association between maternal morbidity, neonatal morbidity, and hospital-level quality measures while risk-adjusting for patient sociodemographic and clinical characteristics.Individual- and hospital-level maternal and neonatal morbidity.Severe maternal morbidity occurred among 2372 of 115,742 deliveries (2.4%), and neonatal morbidity occurred among 8057 of 103,416 term newborns without anomalies (7.8%). Rates for elective deliveries performed before 39 weeks of gestation ranged from 15.5 to 41.9 per 100 deliveries among 41 hospitals. There were 11.7 to 39.3 cesarean deliveries per 100 deliveries performed in low-risk mothers. Maternal morbidity ranged from 0.9 to 5.7 mothers with complications per 100 deliveries and neonatal morbidity from 3.1 to 21.3 neonates with complications per 100 births. The maternal quality indicators elective delivery before 39 weeks of gestation and cesarean delivery performed in low-risk mothers were not associated with severe maternal complications (risk ratio [RR], 1.00 [95% CI, 0.98-1.02] and RR, 0.99 [95% CI, 0.96-1.01], respectively) or neonatal morbidity (RR, 0.99 [95% CI, 0.97-1.01] and RR, 1.01 [95% CI, 0.99-1.03], respectively).Rates for the quality indicators elective delivery before 39 weeks of gestation and cesarean delivery performed in low-risk mothers varied widely in New York City hospitals, as did rates of maternal and neonatal complications. However, there were no correlations between the quality indicator rates and maternal and neonatal morbidity. Current quality indicators may not be sufficiently comprehensive for guiding quality improvement in obstetric care.
Asthma among Puerto Rican Hispanics: a multi-ethnic comparison study of risk factors.
Authors: W S Beckett, K Belanger, J F Gent, T R Holford, B P Leaderer
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

For a study of childhood asthma we interviewed 9,276 mothers during 1993-1994, ascertaining whether they had asthmatic children younger than 18 yr of age and asking about genetic and environmental risk factors for asthma. Independent risk factors for asthma in 7,776 children were: Hispanic and African American ethnicity, maternal history of asthma, lower socioeconomic status (SES) of the mother, and the presence of a cigarette smoker in the household. Hispanic ethnicity was also a strong risk factor for asthma in the mother. The prevalence of asthma among children of Hispanic (mainly Puerto Rican) mothers with one or more children older than 9 mo of age was 18.4%, for blacks it was 1 1.3%, and for non-Hispanic whites it was 7.4%. The marked increased risk for asthma in children of Hispanic mothers was not explained by SES or maternal age. In addition, increased risk for asthma in these children was not associated with higher reporting of environmental tobacco smoke (ETS) exposure. In this study of asthma in primarily Puerto Rican Hispanics, the risk of physician-diagnosed asthma as reported by mothers was significantly associated with Hispanic ethnicity, and it was not confounded by SES or active smoking in the home.
Hyponatremia and Ion-Selective Electrodes
Authors: Susan A. Fuhrman, John H. Eckfeldt
Journal: Annals of Internal Medicine (1985)

Letters and Corrections1 June 1985Hyponatremia and Ion-Selective ElectrodesSUSAN A. FUHRMAN, M.D., JOHN H. ECKFELDT, M.D., Ph.D.SUSAN A. FUHRMAN, M.D.Search for more papers by this author, JOHN H. ECKFELDT, M.D., Ph.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-102-6-872_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We read with interest Anderson and coworker's study (1) of hyponatremia in hospitalized patients. The high frequency of the so-called syndrome of inappropriate secretion of antidiuretic hormone (SIADH) as a cause of hyponatremia was intriguing and well documented. However, we wish to point out a common clinical misconception regarding sodium measurement by ion-selective electrodes.Anderson and coworkers state that spurious hyponatremia due to hyperlipidemia or hyperproteinemia was excluded because they used a Beckman analyzer (Beckman Instruments, Fullerton, California) that uses ion-selective electrodes for sodium determinations. Methods of using ion-selective electrodes are classified as either direct, when serum,...References1. ANDERSONCHUNGKLUGESCHRIER RHRR. Hyponatremia: a prospective analysis of its epidemiology and the pathogenic role of vasopressin. Ann Intern Med. 1985;102:164-8. LinkGoogle Scholar2. MILLER W. Sodium and potassium. In: KAPLAN L, PESCE A, eds. Clinical Chemistry: Theory, Analysis and Correlation. St. Louis: C.V. Mosby Co.; 1984:1075-8. Google Scholar3. LEVY G. Determination of sodium with ion-selective electrodes. Clin Chem. 1983;31:1434-8. Google Scholar4. MASSSIGGAARD-ANDERSONWEISBERGZIJLSTRA AOHW. Ion-selective electrodes for sodium and potassium: a new problem of what is measured and what should be reported. Clin Chem. 1983;31:482-5. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1985Volume 102, Issue 6Page: 872-872KeywordsAntidiuretic hormoneHyperlipidemiaHyponatremiaSodiumSyndrome of inappropriate antidiuretic hormone secretion Issue Published: 1 June 1985 PDF DownloadLoading ...
Vermont Health Care Reform Aims for More Coverage, Less Expense, and Better Care
Authors: Jennifer Fisher Wilson
Journal: Annals of Internal Medicine (2008)

Current Clinical Issues20 May 2008Vermont Health Care Reform Aims for More Coverage, Less Expense, and Better CareJennifer Fisher WilsonJennifer Fisher WilsonSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-10-200805200-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail For 2 decades, political leaders in Vermont attempted to pass comprehensive health care reform before Governor Jim Douglas (R) finally signed legislation presented by the Democratic-controlled legislature on 25 May 2006. The Health Care Affordability Act (Act 191) integrated the aim of universal access to health insurance with other initiatives centered on comprehensive coordinated care (especially for people with chronic diseases) and payment reform. “I think that it is the most innovative and important reform that any state has ever passed,” said Kenneth E. Thorpe, PhD, professor of health policy and management at Emory University.Thorpe, who worked as a ...References1. Douglas J. Comprehensive health care reform in Vermont: a conversation with Governor Jim Douglas. Interview by James Maxwell. Health Aff (Millwood). 2007;26:w697-702. [PMID: 17940086] MedlineGoogle Scholar2. Wagner EH. Chronic disease management: what will it take to improve care for chronic illness? [Editorial]. Eff Clin Pract. 1998;1:2-4. [PMID: 10345255] MedlineGoogle Scholar3. Fisher ES, Staiger DO, Bynum JP, Gottlieb DJ. Creating accountable care organizations: the extended hospital medical staff. Health Aff (Millwood). 2007;26:w44-57. [PMID: 17148490] MedlineGoogle Scholar4. Institute of Medicine. Performance Measurements: Accelerating Improvement. Pathways to Quality Health Care Series. Washington: National Academies Pr; 2006. Google Scholar Author, Article, and Disclosure InformationAuthors: Jennifer Fisher WilsonDisclosures: None disclosed.E-mail:jenwilson@acponline.org. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoWho Owns Vermont's Hospitals? Megan E. Castonguay Metrics Cited bySuccessful Integration of Pediatrics Into State Health Care Reform EffortsAccountable care organizationsWho Owns Vermont's Hospitals?Megan E. Castonguay 20 May 2008Volume 148, Issue 10Page: 797-800KeywordsAccountable care organizationsCancer preventionElectronic medical recordsHealth careHealth economicsHealth information technologyHealth insuranceLong-term careMotivationTaxes ePublished: 20 May 2008 Issue Published: 20 May 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
S100 Novel T helper cell responses against Pseudomonas aeruginosa in healthy individuals and patients with cystic fibrosis
Authors: HK Bayes, M Brodlie, C Ward, PA Corris, G MacGregor, S Bicknell, T Evans
Journal: Thorax (2013)

<h3>Introduction and Objectives</h3> <i>Pseudomonas aeruginosa</i> (PA) colonisation is a hallmark of cystic fibrosis (CF) resulting in damaging neutrophilic inflammation. Patients with CF produce anti-pseudomonal antibodies but the role of CD4<sup>+ </sup> T cell responses to PA remains unclear. Novel T helper cell subsets, Th17 and Th22 cells, have important roles in host defense but may also enhance tissue damage. We aimed to define the antigen-specific memory T helper cell responses to <i>Pseudomonas aeruginosa </i>in healthy humans and patients with cystic fibrosis. <h3>Methods</h3> CD14<sup>+</sup> monocytes and memory CD4<sup>+</sup> CD45RO<sup>+</sup> T cells were isolated from peripheral blood of CF patients with PA colonisation (n = 8) and healthy controls (n = 10). Monocyte-derived dendritic cells (DCs) were stimulated with live Pseudomonas strain PA103 and PA isolates derived from CF patients. Autologous T cells were co-cultured with activated DCs. The resultant T helper response was determined by measuring proliferation, immunoassay of cytokine output, and immunostaining of intracellular cytokines. Lavage samples from explanted CF lungs were assayed for IL-22 secretion. <h3>Results</h3> Healthy individuals andpatients with cystic fibrosis had robust antigen-specific memory CD4<sup>+</sup> T cell responses to <i>Pseudomonas aeruginosa </i>that not only contained a Th1 and Th17 component but also Th22 cells. In contrast to previous descriptions of human Th22 cells, these Pseudomonal-specific Th22 cells lacked the skin homing markers CCR4 or CCR10, although they did express the chemokine receptor CCR6 that would direct migration to damaged epithelial surfaces. Furthermore, IL-22 production was evident in the lungs of CF patients colonised with PA. Healthy individuals and patients with cystic fibrosis had similar levels of Th22 and Th1 cells, but the patient group had significantly fewer Th17 cells in peripheral blood. <h3>Conclusions</h3> MemoryTh22 cells specific to <i>Pseudomonas aeruginosa </i>are induced in both healthy individuals and patients with CF, with IL-22 secretion being demonstrated in the CF lung. These Th22 cells do not express tissue specificity for gut or skin sites and we thus hypothesise may have a role in respiratory defense. Along with Th17 cells, they may play an important role in the pathogenesis of pulmonary infection with this microbe in patients with cystic fibrosis.
Early Diagnosis and Treatment of Atrioventricular Block in the Fetus Exposed to Maternal Anti-SSA/Ro-SSB/La Antibodies
Authors: A.J.J.T. Rein, D. Mevorach, Z. Perles, S. Gavri, M. Nadjari, A. Nir, U. Elchalal
Journal: Circulation (2009)

A fetus exposed to maternal anti-SSA/Ro or anti-SSB/La antibodies (or both) may develop complete atrioventricular block (AVB), which results in high prenatal and postnatal morbidity and mortality. Until recently, only high-grade AVB could be diagnosed in utero. The tissue velocity-based fetal kinetocardiogram (FKCG) enables accurate measurement of AV conduction time and diagnosis of low-grade AVB. In the present multicenter observational study, we used FKCG to detect first-degree AVB in fetuses at risk.FKCG was performed in 70 fetuses of 56 mothers who were positive for anti-SSA/Ro and/or anti-SSB/La. Fetuses were monitored with weekly FKCG from 13 to 24 weeks' gestation, followed by monthly assessments until delivery in unaffected fetuses and weekly assessments in affected fetuses. AV conduction in 70 at-risk and 109 normal fetuses was compared. FKCG was obtained readily in all fetuses; 6 showed first-degree AVB (AV conduction time >2 z scores above normal mean) at 21 to 34 gestational weeks. Immediate maternal treatment with dexamethasone resulted in normalization of AV conduction in all affected fetuses within 3 to 14 days. AV conduction time in the remaining 64 untreated fetuses remained normal throughout gestation. The ECG PR interval immediately after birth was normal in all affected newborns. No child developed AVB or cardiomyopathy in the subsequent 1- to 6-year (median 4-year) follow-up.The present findings suggest that an FKCG can detect first-degree AVB in the fetus exposed to maternal anti-SSA/Ro or anti-SSB/La antibodies (or both). Dexamethasone given on detection was associated with normalized AV conduction in fetuses with first-degree AVB. No fetus in the present study developed complete prenatal or postnatal AVB.
Choreoathetosis and Diphenylhydantoin Intoxication
Authors: Edwin Shuttleworth
Journal: JAMA (1974)

Three patients who had excessive diphenylhydantoin blood levels (29μg, 30μg, and 43μg per milliliter) developed choreoathetosis. The involuntary movements rapidly disappeared with a reduction of the diphenylhydantoin dose. One of the three patients did not have any of the common neurologic signs of diphenylhydantoin toxicity. The mechanism for the production of this phenomenon with excessive diphenylhydantoin is unknown, but it appears that the reaction is most likely to occur in epileptic patients with decreased intellect or persistent neurologic signs. (<i>JAMA</i>230:1170-1171, 1974)
<i>In</i><i>vivo</i>Desensitization of a Phobic Shop Steward
Authors: T. Kraft
Journal: Psychotherapy and Psychosomatics (1975)

Techniques used in behaviour therapy effectively counteract the symptoms presented by the patient. The question arises as to the precise nature of such intervention, and whether this form of treatment is in fact a superficial one which deals only with symptom removal, or whether this is really a much more fundamental form of therapy, in which the patient alters as a whole. The case reported here is of interest in that, during a course of in vivo desensitization, in which the therapist accompanied the patient on journeys through London, it was shown that, as the symptoms were alleviated, there were concomitant changes in his whole personality structure. He no longer needed to be a militant shop steward and developed an amicable relationship with his employers, and yet he was still able to negotiate a pay rise for the men. This suggests that the treatment had an effect on his hostility level, so that he could deal effectively with his superiors without the need to fight them. This has important theoretical and ethical implications.
Superiority of B locus matching over other HLA matching in renal graft survival.
Authors: P J Dewar, R Wilkinson, R W Elliott, M K Ward, D N Kerr, D H Kenward, G Proud, R M Taylor
Journal: BMJ (1982)

Graft survival after 348 consecutive first cadaver-donor renal transplants was significantly improved by HLA matching when recipients who had received pretransplant blood transfusions were matched with their kidney donor for two HLA-B locus antigens. No other type of HLA matching significantly improved graft survival in transfused recipients nor did any type of HLA matching in non-transfused recipients. Matching for one HLA-DR antigen had no benefit in transfused recipients. Only two patients received kidneys matched for both DR antigens and only two of those in whom DR matching had been performed had not been transfused. These results indicate that pretransplant blood transfusion and selection of graft recipients predominantly on the basis of HLA-B matching has significantly reduced the renal graft rejection rate in Newcastle upon Tyne over two years. Thus, HLA-B antigen matching should be adopted as the main criterion for kidney sharing between transplant centres.
Advising Patients Who Seek Alternative Medicine
Authors: David Eisenberg
Journal: Annals of Internal Medicine (1998)

Letters15 February 1998Advising Patients Who Seek Alternative MedicineDavid Eisenberg, MDDavid Eisenberg, MDBeth Israel Deaconess Medical Center; Boston, MA 02215Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-4-199802150-00049 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Three of the four letters received display a level of professional indignation that borders on contempt. These letters' hostile tone underscores the challenge of generating constructive professional guidelines for alternative medical therapies. The good news is that this debate has finally begun in earnest.Dr. Bagley suggests that physicians inquire about alternative medical therapies; make note of them; and, when appropriate, advise patients about potential adverse effects. He disagrees with my suggestion that physicians consider referral to alternative practitioners or investigate alternative therapies. I accept this suggestion because it would constitute a considerable advance over the current status ...References1. Sackett D, Haynes RB, Guyatt GH, Tugwell P. Clinical Epidemiology: A Basic Science for Clinical Medicine. Boston: Little, Brown; 1991:191. Google Scholar Author, Article, and Disclosure InformationAffiliations: Beth Israel Deaconess Medical Center; Boston, MA 02215 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 February 1998Volume 128, Issue 4Page: 329-330KeywordsDecision makingDistillationPostural controlProspective studiesRandomized trialsRelative riskResearch quality assessmentSafetySpineToxicity Issue Published: 15 February 1998 CopyrightCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Diesel Particulate Matter Induces Receptor for Advanced Glycation End-Products (RAGE) Expression in Pulmonary Epithelial Cells, and RAGE Signaling Influences NF-κB–Mediated Inflammation
Authors: Paul R. Reynolds, Karisa M. Wasley, Camille H. Allison
Journal: Environmental Health Perspectives (2010)

BackgroundReceptors for advanced glycation end-products (RAGE) are cell-surface receptors expressed by alveolar type I (ATI) epithelial cells and are implicated in mechanisms of alveolar development and sustained pulmonary inflammation.ObjectivesIn the present study, we tested the hypothesis that diesel particulate matter (DPM) up-regulates RAGE in rat ATI-like R3/1 cells and human primary small airway epithelial cells (SAECs), leading to an inflammatory response.Methods and ResultsUsing real-time reverse transcriptase polymerase chain reaction and immunoblotting, we found that RAGE mRNA and protein are up-regulated in cells exposed to DPM for 2 hr. Use of a luciferase reporter containing nuclear factor-κB (NF-κB) response elements revealed decreased NF-κB activation in cells transfected with small interfering RNA (siRNA) for RAGE (siRAGE) before DPM exposure compared with cells transfected with scrambled control siRNA (siControl). In addition, immunostaining revealed diminished nuclear translocation of NF-κB in DPM-exposed cells transfected with siRAGE compared with cells transfected with siControl before DPM stimulation. Enzyme-linked immunosorbent assay demonstrated that in R3/1 cells DPM induced secretion of monocyte chemoattractant protein-1 (MCP-1) and interleukin-8 (IL-8), two cytokines induced by NF-κB and associated with leukocyte chemotaxis during an inflammatory response. Incorporating siRAGE was sufficient to significantly decrease DPM-induced MCP-1 and IL-8 secretion compared with cells transfected with siControl.ConclusionsThese data offer novel insights into potential mechanisms whereby RAGE influences pulmonary inflammation exacerbated by DPM exposure. Further research may demonstrate that molecules involved in RAGE signaling are potential targets in lessening the degree of particulate matter-induced exacerbations of inflammatory lung disease.