tbuckley/cabot-search huggingface dataset:
Comparison of Shunt Types in the Norwood Procedure for Single-Ventricle Lesions
Authors: Richard G. Ohye, Lynn A. Sleeper, Lynn Mahony, Jane W. Newburger, Gail D. Pearson, Minmin Lu, Caren S. Goldberg, Sarah Tabbutt, Peter C. Frommelt, Nancy S. Ghanayem, Peter C. Laussen, John F. Rhodes, Alan B. Lewis, Seema Mital, Chitra Ravishankar, Ismee A. Williams, Carolyn Dunbar-Masterson, Andrew M. Atz, Steven Colan, L. LuAnn Minich, Christian Pizarro, Kirk R. Kanter, James Jaggers, Jeffrey P. Jacobs, Catherine Dent Krawczeski, Nancy Pike, Brian W. McCrindle, Lisa Virzi, J. William Gaynor
Journal: New England Journal of Medicine (2010)

The Norwood procedure with a modified Blalock-Taussig (MBT) shunt, the first palliative stage for single-ventricle lesions with systemic outflow obstruction, is associated with high mortality. The right ventricle-pulmonary artery (RVPA) shunt may improve coronary flow but requires a ventriculotomy. We compared the two shunts in infants with hypoplastic heart syndrome or related anomalies.Infants undergoing the Norwood procedure were randomly assigned to the MBT shunt (275 infants) or the RVPA shunt (274 infants) at 15 North American centers. The primary outcome was death or cardiac transplantation 12 months after randomization. Secondary outcomes included unintended cardiovascular interventions and right ventricular size and function at 14 months and transplantation-free survival until the last subject reached 14 months of age.Transplantation-free survival 12 months after randomization was higher with the RVPA shunt than with the MBT shunt (74% vs. 64%, P=0.01). However, the RVPA shunt group had more unintended interventions (P=0.003) and complications (P=0.002). Right ventricular size and function at the age of 14 months and the rate of nonfatal serious adverse events at the age of 12 months were similar in the two groups. Data collected over a mean (+/-SD) follow-up period of 32+/-11 months showed a nonsignificant difference in transplantation-free survival between the two groups (P=0.06). On nonproportional-hazards analysis, the size of the treatment effect differed before and after 12 months (P=0.02).In children undergoing the Norwood procedure, transplantation-free survival at 12 months was better with the RVPA shunt than with the MBT shunt. After 12 months, available data showed no significant difference in transplantation-free survival between the two groups. (ClinicalTrials.gov number, NCT00115934.)
Efficacy of <scp>I</scp>g<scp>E</scp>‐targeted <i>vs</i> empiric six‐food elimination diets for adult eosinophilic oesophagitis
Authors: J. Rodríguez‐Sánchez, E. Gómez Torrijos, B. López Viedma, E. de la Santa Belda, F. Martín Dávila, C. García Rodríguez, F. Feo Brito, J. Olmedo Camacho, P. Reales Figueroa, J. Molina‐Infante
Journal: Allergy (2014)

Abstract Background Skin testing‐guided elimination diet has proved unsuccessful for adult eosinophilic oesophagitis ( E o E ), whereas empiric six‐food elimination diet ( SFED ) achieves an efficacy of 70%. Objective To compare the efficacy of food‐specific serum I g E ‐targeted elimination diet ( sIgE ‐ ED ) and SFED . Methods Prospective study in adult patients with E o E . Food‐specific serum I g E , skin prick test ( SPT ) and atopy patch test ( APT ) to foods included in SFED were performed. Those with ≥1 positive IgE test, defined by ≥0.1 kU/l, followed a 6‐week sIgE ‐ ED , whereas non‐IgE‐sensitized patients underwent a 6‐week SFED. Responders to diet (&lt;15 eos/HPF) underwent individual reintroduction of foods followed by histological assessment. Results Forty‐three EoE patients were included (26 sIgE ‐ ED and 17 SFED ). Regarding sIgE ‐ ED , the mean number of eliminated foods per patient was significantly lower than in SFED (3.81 vs 6; P &lt; 0.001), being wheat (85%), nuts (73%) and cow's milk (61%) the most commonly foods withdrawn. No difference in histological response was observed between sIgE ‐ ED and SFED (73% vs 53%, P = 0.17). Causative foods identified by food challenge were cow's milk (64%), wheat (28%), egg (21%) and legumes (7%), with a single food trigger in 71% of patients. sIgE exhibited the higher accuracy to predict offending foods in IgE‐sensitized patients (sensitivity 87.5%, specificity 68% ( κ = 0.43)), with k values of 1 for cow's milk. APT results were all negative. Conclusions Histological remission was accomplished in 73% of patients undergoing sIgE ‐ED, which was nonsignificantly superior to SFED . sIgE effectively identified cow's milk as a food trigger in IgE‐sensitized patients.
Nd:YAG laser with sapphire tip combined with balloon angioplasty in peripheral arterial occlusions. Long-term results.
Authors: E Pilger, J Lammer, H Bertuch, G Stark, M Decrinis, K P Pfeiffer, G J Krejs
Journal: Circulation (1991)

In 167 patients with complete occlusion (greater than 3 cm) of the femoropopliteal artery, percutaneous transluminal laser angioplasty (PTLA) was performed after an unsuccessful attempt at crossing with a guide wire and was immediately followed by balloon dilatation. An Nd-YAG laser and an optical fiber delivery system with a sapphire tip serving as a contact probe were used for PTLA. In 132 of 167 (79%) patients, the occluded segment was successfully reopened. Clinical symptoms improved in 126 of 167 (75%) patients. PTLA was unsuccessful in 35 patients, and in 15 of these, injury of the vessel wall occurred. In one patient, surgical drainage of a large hematoma became necessary. All patients in whom recanalization had been achieved were randomized to receive long-term treatment with either phenprocumarol or acetylsalicylic acid (ASA) plus dipyridamole to prevent rethrombosis. At 36 months of follow-up, the cumulative patency rate (CPR) was 63%. A complete reobstruction in 32 patients (24%) and a partial reobstruction in 15 patients (11%) were found angiographically. The CPR after 36 months was significantly lower (p less than 0.05) in patients younger than 60 years of age (54%) than in patients older than 60 (68%); it was also significantly lower (p less than 0.05) in patients with reduced peripheral runoff (55%) due to obstructed arteries of the lower leg than in patients with unaffected runoff (73%). The CPR was 65% in recanalized segments shorter than 7 cm and was 62% in recanalized segments longer than 7 cm.(ABSTRACT TRUNCATED AT 250 WORDS)
Chemical characterization and reactivity of iron chelator-treated amphibole asbestos.
Authors: J Gold, H Amandusson, A Krozer, B Kasemo, T Ericsson, G Zanetti, B Fubini
Journal: Environmental Health Perspectives (1997)

Iron in amphibole asbestos is implicated in the pathogenicity of inhaled fibers. Evidence includes the observation that iron chelators can suppress fiber-induced tissue damage. This is believed to occur via the diminished production of fiber-associated reactive oxygen species. The purpose of this study was to explore possible mechanisms for the reduction of fiber toxicity by iron chelator treatments. We studied changes in the amount and the oxidation states of bulk and surface iron in crocidolite and amosite asbestos that were treated with iron-chelating desferrioxamine, ferrozine, sodium ascorbate, and phosphate buffer solutions. The results have been compared with the ability of the fibers to produce free radicals and decompose hydrogen peroxide in a cell-free system in vitro. We found that chelators can affect the amount of iron at the surface of the asbestos fibers and its valence, and that they can modify the chemical reactivity of these surfaces. However, we found no obvious or direct correlations between fiber reactivity and the amount of iron removed, the amount of iron at the fiber surface, or the oxidation state of surface iron. Our results suggest that surface Fe3+ ions may play a role in fiber-related carboxylate radical formation, and that desferrioxamine and phosphate groups detected at treated fiber surfaces may play a role in diminishing and enhancing, respectively, fiber redox activity. It is proposed that iron mobility in the silicate structure may play a larger role in the chemical reactivity of asbestos than previously assumed.
Phospholipase D activation in hepatocyte growth factor-stimulated rat hepatocytes mediates the expressions of c-jun and c-fos: Involvement of protein tyrosine kinase, protein kinase C, and Ca2+
Authors: T Adachi
Journal: Hepatology (1996)

Hepatocyte growth factor (HGF) activated phospholipase D (PLD) in primary-cultured rat hepatocytes, as assessed by the formation of phosphatidylbutanol (PBut), a specific and stable product of PLD activity in the presence of 0.3% butanol. PLD hydrolyzes phosphatidylcholine to choline and phosphatidic acid (PA), which is further metabolized to diacylglycerol (DG) by PA phosphohydrolase (PAP). In HGF-stimulated hepatocytes, butanol prevented the formation of PA and DG. A PAP inhibitor, propranolol, inhibited DG production with a reciprocal increase of PA, implying that PLD played a role in the formation of not only PA but DG. Inhibitors for protein kinase C (PKC), Ro31-8425, H-7, and calphostin C, reduced HGF-induced PLD activation. A protein tyrosine kinase (PTK) inhibitor, genistein but not its inactive analogue daidzein, inhibited PLD activation by HGF. Moreover, depletion of extracellular Ca2+ by omission of Ca2+ or by chelating residual Ca2+ with ethyleneglycol-bis(beta-aminoethyl ether)-N,N,N',N'-tetraacetic acid (EGTA) abolished HGF-induced PLD activation. HGF, phorbol myristate acetate (PMA) and a DG analog, oleylacetylglycerol (OAG), activated the expression of c-jun and c-fos messenger RNAs (mRNAs). Ro31-8425, calphostin C, and genistein, which prevented HGF-induced PLD activation, inhibited induction of these immediate early genes. Butanol and propranolol at concentrations which effectively inhibited the formation of DG, suppressed HGF-induced expression of c-jun and c-fos mRNAs. However, HGF-induced mitogen-activated protein kinase (MAPK) activation was not affected by both butanol and propranolol. These results suggest that PTK, PKC, and Ca2+ regulate HGF-induced PLD activation, and that DG produced by PLD pathway may play a role in the induction of immediate early genes, which is activated in MAPK-independent manner, in rat hepatocytes.
Light protection of the skin after photodynamic therapy reduces inflammation: an unblinded randomized controlled study
Authors: B. Petersen, S.R. Wiegell, H.C. Wulf
Journal: British Journal of Dermatology (2014)

Photodynamic therapy (PDT) is followed by significant inflammation. Protoporphyrin (Pp)IX is still formed in the skin after PDT and patients are sensitive to daylight 24-48 h after treatment. Exposure to daylight after PDT may therefore increase inflammation.To investigate whether protection with inorganic sunscreen, foundation or light-blocking plaster after PDT can reduce inflammation caused by daylight-activated PpIX.On the right arm of 15 subjects with sun-damaged skin, four identical squares (3 × 3 cm) were given conventional PDT treatment. Immediately after red-light illumination the squares were either left unprotected or protected by inorganic sunscreen [sun protection factor (SPF) 50], foundation (SPF50) or light-blocking plaster. The skin was then illuminated with artificial daylight for 2 h and afterwards covered for 24 h. Fluorescence and erythema (inflammation) were measured with a fluorescence camera and a reflectance meter.PpIX was significantly reduced after artificial daylight illumination (P < 0·0004), except on the square protected with light-blocking silver plaster, where it had increased (P = 0·09). The increased erythema 24 h after treatment was reduced by 19% with the sunscreen (P = 0·29), by 27% with the foundation (P = 0·10) and by 44% with the silver plaster (P = 0·002).Artificial daylight exposure after conventional PDT increases skin erythema. Light-blocking plaster gives more effective protection against post-PDT daylight exposure than inorganic sunscreen and foundation. In practice such full protection can be achieved by use of sun-blocking clothes or daylight avoidance for 24 h.
Statins are the new aspirin, Oxford researchers say
Authors: Z. Kmietowicz
Journal: BMJ (2001)

Results of the world's largest trial into the effects of cholesterol lowering therapy show that routine use of cholesterol lowering drugs in patients at high risk of vascular disease reduces the incidence of heart attacks and strokes by a third, even in people whose cholesterol concentration is normal.

Professor Rory Collins, lead investigator of the Heart Protection Study (HPS) and codirector of Oxford University's Clinical Trial Service Unit, declared statins to be the new aspirin, when he presented the findings at the American Heart Association's Scientific Sessions 2001 this week.

“This is …
Gonococcal Osteomyelitis
Authors: Nelson M. Gantz
Journal: JAMA (1976)

GONOCOCCAL arthritis, which usually responds readily to appropriate antimicrobial therapy, is a potentially destructive process. Before the introduction of antimicrobial agents, 23% to 85% of patients who recovered from gonococcal arthritis had residual joint damage.<sup>1</sup>Although osteomyelitis has been described as a complication of infective arthritis caused by bacteria other than the gonococcus, it has been infrequently associated with gonococcal arthritis. We report the case of a young woman who had gonococcal arthritis with contiguous osteomyelitis. <h3>Report of a Case</h3> A 31-year-old woman was admitted to Boston City Hospital with pain and swelling of the second right metacarpophalangeal joint. She was well until six weeks prior to admission, when she noted pain in the left hand and shoulder and in both wrists. Four weeks prior to admission, she came to the emergency room because of pain and swelling of the second, third, and fourth left metacarpophalangeal and proximal interphalangeal joints.
The Semantic Differential as a Measure of the Patients’ Image of their Therapist
Authors: A.E. Meyer, Hilka Otte
Journal: Psychotherapy and Psychosomatics (1970)

Coercive tube feeding under phenothiazines as a standard therapy of anorexia nervosa is shortly described. From psychoanalytic theory it was hypothesized that the patients would form a transference image to their principal therapist (male) of either an orally overpowering mother or a raping father. For a quantitative evaluation of these possibilities Osgood-Hofstätter's semantic differential was given to 33 patients during follow-up. Due to incompleteness of our method the results are not clearcut but they seem to favor the hypothesis of a transference of a raping male.
Effects of Beta Adrenergic Blockade on the Circulation, with Particular Reference to Observations in Patients with Hypertrophic Subaortic Stenosis
Authors: DONALD C. HARRISON, EUGENE BRAUNWALD, GERALD GLICK, DEAN T. MASON, CHARLES A. CHIDSEY, JOHN ROSS
Journal: Circulation (1964)

The circulatory effects of blocking the beta adrenergic receptors with Nethalide were studied in 10 patients with hypertrophic subaortic stenosis and in five postoperative subjects undergoing right heart catheterization. In the resting state, the heart rate and the rate of pressure development in the right ventricle diminished slightly, but cardiac index was not altered by the administration of Nethalide. These observations suggest that tonic sympathetic activity is not of major importance in basal subjects in the supine position. Nethalide attenuated the increase in heart rate and right ventricular dp/dt associated with exercise, and abolished the response of these two variables to the administration of isoproterenol. In the patients with hypertrophic subaortic stenosis Nethalide had little effect on the severity of the obstruction at rest, but reduced the intensification of the obstruction produced by exercise or isoproterenol. The possible clinical benefits of blocking the beta adrenergic receptors in these patients were discussed.
The COPD CO-factor
Authors: G. P. Anderson
Journal: European Respiratory Journal (2007)

In the current issue of the European Respiratory Journal , Bathoorn et al. 1 present findings that may open up new avenues of treatment for chronic obstructive pulmonary disease (COPD) and provide fundamental insights into the pathogenesis of the condition. Bathoorn et al. 1 present a pilot study on the effect of inhaled carbon monoxide (CO) on inflammation and methacholine responsiveness in COPD.

In their study, 22 ex-smokers with stable COPD (forced expiratory volume in one second (FEV1) >1.2 L, FEV1/forced vital capacity <70% predicted) were administered 100–125 ppm CO, a low concentration, for 2 h a day over 4 days in a randomised, cross-over protocol 1. Maximal blood carboxyhaemoglobin peaked at 4.5%, well within safe levels. Eosinophil counts, but not other cells, followed a downward trend in induced sputum, while methacholine responsiveness was slightly and significantly improved. The study was designed and performed with careful attention to ethics and patient safety. However, it is noteworthy that two of the patients experienced exacerbations of COPD during the CO treatment arm.

The effects of CO were weak, but tangible, and not uniformly statistically significant. Yet, in several ways this pilot study is intriguing. Why? Because the paper points to the potential therapeutic utility of inhaled CO, a known respiratory system poison that is abundant in tobacco smoke, the cause of most COPD. In addition to this, endogenously generated CO has been discovered by other authors in exhaled breath and blood in COPD 2, 3, and recent fundamental basic research has revealed that endogenous CO is an important physiological regulatory factor in systems as diverse as smooth muscle and the immune system. Like nitric oxide (NO), CO is emerging as a major, and …
Lowering cholesterol, 1988. Rationale, mechanisms, and means.
Authors: R J Havel
Journal: Journal of Clinical Investigation (1988)

This past year, 1987, has seen publication of some important studies of the ability of cholesterol-lowering therapies to pre- vent complications of coronary heart disease (CHD)1 and to modify atherosclerotic lesions.It has also seen the release of the first ofa new class ofpotent cholesterol-lowering drugs that inhibit beta-hydroxy-beta-methylglutaryl CoA reductase.Phy- sicians are evincing new interest in treating patients with hy- percholesterolemia and there is rapidly increasing public ac- ceptance of the importance of measuring plasma cholesterol levels and acting upon the results.Clinical investigators who have been studying and treating patients with hyperlipidemia may have felt neglected in the past, but now they are showered with the attention of colleagues and patients.This attention is merited by the new information on the effectiveness of choles- terol-lowering therapies and increasing evidence that such treatment can influence health status.The recent issuance of guidelines for cholesterol lowering by the National Cholesterol Education Program provides help for practitioners and repre- sents a consensus among the majority of clinical lipidologists, but many issues regarding -indications for specific interven- tions need to be clarified.Moreover, new insights into the relationship between the plasma lipoproteins and atherogene- sis could modify currently recommended approaches.Here I will briefly review the intervention trials that pro- vide the basis for current recommendations and point out areas of continuing uncertainty and controversy about the ap- plication of the results ofthese trials to the prevention of CHD and the treatment ofestablished disease.I will discuss the metabolic basis for cholesterol lowering and the mechanisms by which diet and drugs reduce cholesterol levels.Finally, I will give a perspective on intervention strategies and techniques. Cholesterol-lowering intervention trialsThere have now been at least 10 trials in which diet or drugs have been used to modify the course of established CHD and
Effect of congestive heart failure on rate of atrial natriuretic factor release in response to stretch and isoprenaline
Authors: G Agnoletti, A Cornacchiari, A F Panzali, S Ghielmi, F D. Giuli, R Ferrari
Journal: Cardiovascular Research (1990)

The aim was to investigate the pattern of release of atrial natriuretic factor induced by mechanical and adrenergic stimulation from atria of rats with or without congestive heart failure.Monocrotaline, a pyrrolizidine alkaloid, was given to rats to cause severe pulmonary hypertension, leading to a marked degree of right ventricular hypertrophy and failure. Measurements of noradrenaline and atrial natriuretic factor were performed in each cardiac chamber and in plasma. Right and left atria of control rats and rats with congestive heart failure were isolated and subjected to mechanical or adrenergic stimulation to study the in vitro release of atrial natriuretic factor.Studies were performed on plasma, ventricles, and isolated right and left atria of 276 male Wistar rats, 80-100 g weight, with or without congestive heart failure.In monocrotaline rats right and left ventricular concentrations of noradrenaline were significantly reduced. In the same rats concentrations of atrial natriuretic factor fell to 15.2% in the right atria and to 65.5% in the left atria. Whole heart content of atrial natriuretic factor was diminished, while plasma concentrations were increased sevenfold. Isolated hypertrophied right atria of failing hearts did not release atrial natriuretic factor in response to stretch or to isoprenaline (10(-9)M) and they were insensitive to the inotropic action of isoprenaline. On the other hand, non-hypertrophied left atria from the same animals released increased amounts of atrial natriuretic factor under basal conditions and after both stimuli, despite reduced tissue stores of the peptide.Heart failure may deplete cardiac stores of noradrenaline and atrial natriuretic factor, especially in hypertrophied chambers, and can result in a decrease in the release of atrial natriuretic factor from atrial tissue in response to mechanical and adrenergic stimulation.
Focal Uptake of Tc-99m MDP in a Gossypiboma
Authors: Bejoy G. Thomas, Eugene D. Silverman
Journal: Clinical Nuclear Medicine (2008)

A 51-year-old Korean woman with a history of breast cancer underwent screening bone scintigraphy, which revealed minimal soft tissue uptake of Tc-99m methylene diphosphonate (MDP) in the right lower quadrant. CT and plain films confirmed that the uptake was due to a retained surgical sponge or gossypiboma. The incidence of gossypibomas has been reported at high as 1 in 1000 to 15,000 intra-abdominal operations. The natural progression of an aseptic gossypiboma is a foreign body reaction and granuloma formation. This inflammatory granulomatous reaction is the most likely cause of the extraosseous accumulation of Tc-99m MDP. This entity should be added to the already extensive list of etiologies of extraosseous MDP accumulation.