tbuckley/cabot-search huggingface dataset:
Transplantation-Free Survival and Interventions at 3 Years in the Single Ventricle Reconstruction Trial
Authors: Jane W. Newburger, Lynn A. Sleeper, Peter C. Frommelt, Gail D. Pearson, William T. Mahle, Shan Chen, Carolyn Dunbar-Masterson, Seema Mital, Ismee A. Williams, Nancy S. Ghanayem, Caren S. Goldberg, Jeffrey P. Jacobs, Catherine D. Krawczeski, Alan B. Lewis, Sara K. Pasquali, Christian Pizarro, Peter J. Gruber, Andrew M. Atz, Svetlana Khaikin, J. William Gaynor, Richard G. Ohye
Journal: Circulation (2014)

Background— In the Single Ventricle Reconstruction (SVR) trial, 1-year transplantation-free survival was better for the Norwood procedure with right ventricle–to–pulmonary artery shunt (RVPAS) compared with a modified Blalock-Taussig shunt (MBTS). At 3 years, we compared transplantation-free survival, echocardiographic right ventricular ejection fraction, and unplanned interventions in the treatment groups. Methods and Results— Vital status and medical history were ascertained from annual medical records, death indexes, and phone interviews. The cohort included 549 patients randomized and treated in the SVR trial. Transplantation-free survival for the RVPAS versus MBTS groups did not differ at 3 years (67% versus 61%; P =0.15) or with all available follow-up of 4.8±1.1 years (log-rank P =0.14). Pre-Fontan right ventricular ejection fraction was lower in the RVPAS group than in the MBTS group (41.7 ± 5.1% versus 44.7 ± 6.0%; P =0.007), and right ventricular ejection fraction deteriorated in RVPAS ( P =0.004) but not MBTS ( P =0.40) subjects (pre-Fontan minus 14-month mean, −3.25±8.24% versus 0.99±8.80%; P =0.009). The RVPAS versus MBTS treatment effect had nonproportional hazards ( P =0.004); the hazard ratio favored the RVPAS before 5 months (hazard ratio=0.63; 95% confidence interval, 0.45–0.88) but the MBTS beyond 1 year (hazard ratio=2.22; 95% confidence interval, 1.07–4.62). By 3 years, RVPAS subjects had a higher incidence of catheter interventions ( P &lt;0.001) with an increasing HR over time ( P =0.005): &lt;5 months, 1.14 (95% confidence interval, 0.81–1.60); from 5 months to 1 year, 1.94 (95% confidence interval, 1.02–3.69); and &gt;1 year, 2.48 (95% confidence interval, 1.28–4.80). Conclusions— By 3 years, the Norwood procedure with RVPAS compared with MBTS was no longer associated with superior transplantation-free survival. Moreover, RVPAS subjects had slightly worse right ventricular ejection fraction and underwent more catheter interventions with increasing hazard ratio over time. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00115934.
Heparin Improves Gas Exchange during Experimental Acute Lung Injury in Newborn Piglets
Authors: KABIR ABUBAKAR, BARBARA SCHMIDT, SHELLEY MONKMAN, COLIN WEBBER, DEREK deSA, ROBIN ROBERTS
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

Although intrapulmonary fibrin deposition is a pathognomonic feature of acute lung injury, it remains uncertain whether thrombin inhibitors affect clinically important outcomes. We hypothesized that both heparin and antithrombin (AT) concentrate improve gas exchange during experimental respiratory distress syndrome. We also tested whether combination therapy is more beneficial than monotherapy. Forty-eight newborn piglets were randomized within 12 litters to one of four groups in a factorial design: (1) AT; (2) heparin; (3) AT plus heparin; (4) untreated control animals. After lung lavage and 4 h of barovolutrauma, mechanical ventilation was continued for 24 h during which ventilator pressures and inspired oxygen were adjusted to maintain normal blood gases. The arterial/ alveolar oxygen tension ratio (a/A ratio) and the ventilator efficiency index (VEI) at 18 and 24 h were compared by repeated measures analysis of variance (ANOVA). In contrast to our hypothesis, only heparin improved gas exchange, and we found little evidence of an interaction with AT. The a/A ratio was 0.48 ± 0.27 (mean ± SD) in the presence of heparin versus 0.33 ± 0.26 in its absence; p = 0.01. Corresponding VEI was 0.30 ± 0.12 versus 0.25 ± 0.14; p = 0.04. Hyaline membrane formation was also decreased in heparin-treated animals (p = 0.02).
US medical home model delivers savings and improves care, says health insurer
Authors: M. McCarthy
Journal: BMJ (2014)

CareFirst, a not-for-profit health insurance company that provides coverage to nearly 3.4 million people in Maryland, Virginia, and Washington, DC, says that its patient centered medical home program has substantially slowed the growth of its costs and improved the quality of care.

The medical home program provides participating primary care physicians and nurse practitioners with financial incentives, data, and other services to help them give more coordinated care to high cost, chronically ill patients.

The medical home model emphasizes a team based approach that focuses on prevention and …
Interactions among lead, cadmium, and arsenic in relation to porphyrin excretion patterns.
Authors: B A Fowler, K R Mahaffey
Journal: Environmental Health Perspectives (1978)

This paper reviews the effects of lead (Pb), cadmium (Cd), and arsenic (As) on the mitrochondrion with emphasis on alteration of mitochondrial heme biosynthetic pathway. The information was used to examine results of a Pb x Cd x As interaction study which employed urinary porphyrin excretion patterns as one assessment criterion. Data from the study showed that dietary Pb produced increased urinary excretion of aminolevulinic acid (ALA) and coproporphyrin. Dietary exposure to organic or inorganic As caused increased excretion of uroporphyrin and to a lesser extent coproporphyrin, while dietary Cd caused no significant changes in urinary levels of any of the porphyrins measured. The combination of Pb plus As produced an additive effect on coproporphyrin excretion but not that of either ALA or uroporphyrin. These data are discussed in relation to utilization of urinary porphyrins for assessing toxicity and elemental interactions.
The Cholescintigraphic Pattern of Small Bowel Obstruction
Authors: MICHAEL TOBIN, M G VELCHIK, J POWE, C HIBBARD, A ALAVI
Journal: Clinical Nuclear Medicine (1987)

An elderly patient presenting with acute abdominal pain, nausea, and vomiting underwent a hepatoviliary scan. This demonstrated normal filling of the gallbladder but dilatation of the small bowel, which was found to correspond radiographically to partial small bowel obstruction.
Exploration of Health Disparities
Authors: Ichiro Kawachi, Marie S. O?Neill
Journal: Environmental Health Perspectives (2005)

Health disparities have received growing attention in recent years from both the research community (Adler and Ostrove 1999) and the policy community [U.S. Department of Health and Human Services (DHHS) 2000]. Under the leadership of Dr. Kenneth Olden, the National Institute of Environmental Health Sciences (NIEHS) has played a key role in giving prominence to this issue. Some notable milestones in the field of health disparities within the United States include the launch of Healthy People 2010 in January 2000, which signaled the commitment of DHHS to the national goal of eliminating health disparities (DHHS 2000); the creation of the National Center on Minority Health and Health Disparities by Congress in November 2000; and the establishment in 2003 of the Trans-HHS Cancer Health Disparities Progress Review Group, which published its call to action, Making Cancer Health Disparities History, in March 2004 (DHHS 2004). Yet health disparities are not a new problem. They have been documented almost since the beginning of vital records registration in the United States and elsewhere (Krieger and Fee 1996). The leading causes of premature mortality and morbidity have changed over time, as exemplified by the decline in mortality from infectious diseases during the first half of the 20th century, followed by the subsequent rise in chronic diseases such as ischemic heart disease (which initially showed an excess among higher socioeconomic groups). Nonetheless, throughout history, the poor, the less educated, and people of color have always had shorter lifespans compared with the more affluent and advantaged members of society (Link and Phelan 1995). The reason for the resurgent interest in health disparities—as well as the attendant sense of urgency about solving the problem—is that they have persisted E s s a y o n Health Disparities
Beef was not "perfectly safe"
Authors: J. Warden
Journal: BMJ (1998)

Sir Donald Acheson, who was chief medical officer for England at the start of the epidemic of bovine spongiform encephalopathy (BSE) 10 years ago, has admitted that government assurances that British beef was safe to eat should have been qualified.

“In retrospect, statements should have acknowledged an element of uncertainty due to incomplete knowledge,” Sir Donald states in his written evidence …
Relative Glucose Metabolic Rate Higher in White Matter in Patients With Schizophrenia
Authors: Monte S. Buchsbaum, Bradley R. Buchsbaum, Erin A. Hazlett, M. Mehmet Haznedar, Randall Newmark, Cheuk Y. Tang, Patrick R. Hof
Journal: American Journal of Psychiatry (2007)

There is increasing evidence demonstrating that circuits involving the frontal lobe, striatum, temporal lobe, and cerebellum are abnormal in individuals with schizophrenia, which suggests that metabolic activity in the white matter connecting these areas should be investigated.The authors obtained [(18)F]fluorodeoxyglucose (FDG) positron emission tomography (PET) and matching T1-weighted magnetic resonance imaging (MRI) on 170 subjects. Participants were 103 normal volunteers and 67 unmedicated patients with schizophrenia (N=61) or schizoaffective disorder (N=6). The images were coregistered and warped to standard space for significance probability mapping.Compared with normal volunteers, patients showed higher relative metabolic rates in the frontal white matter, corpus callosum, superior longitudinal fasciculus, and white matter core of the temporal lobe. Elevated activity in white matter was most pronounced in the center of large white matter tracts, especially the frontal parts of the brain and the internal capsule. The white matter elevation did not appear to be entirely related to changes in gray matter/white matter brain proportions, whole brain metabolic rate bias, or excess head motion in patients, but this cannot be ruled out without absolute glucose determinations. Patients also showed significantly lower relative glucose metabolism in the frontal and temporal lobes, caudate nucleus, cingulate gyrus, and mediodorsal nucleus of the thalamus relative to normal volunteers, which is consistent with earlier studies.In comparisons of unmedicated schizophrenia patients with normal volunteers, relative metabolic increases are apparent in white matter in patients with schizophrenia as well as decreases in gray matter. Inefficiency in brain circuitry, defects in white matter leading to enhanced energy need, white matter damage, and alterations in axon packing density are among the possible explanations for these schizophrenia-related findings of relatively increased metabolism in white matter.
Oat Products: Lowering of Lipids, Education of Public-Reply
Authors: Cynthia M. Ripsin
Journal: JAMA (1992)

In Reply.  —We appreciate Dr Brumback's comments; they offer a valuable historical perspective to the issues surrounding dietary fiber in our culture. We are in full agreement that public education in this area needs to begin anew and would like to add that research also must continue to elucidate mechanisms of action and to shed more light on individual and subgroup responsiveness. We hope that our meta-analysis will be helpful in planning the direction of future research in the area of dietary fiber and human health.
Infantile systemic hyalinosis: a case report and mutation analysis in a Chinese infant
Authors: Y-C. Huang, Y-Y. Xiao, Y-H. Zheng, W. Jang, Y-L. Yang, X-J. Zhu
Journal: British Journal of Dermatology (2007)

Journal Article Infantile systemic hyalinosis: a case report and mutation analysis in a Chinese infant Get access Y‐C. Huang, Y‐C. Huang Departments of Dermatology and Pediatrics, Peking University First Hospital, Beijing 100034, China Search for other works by this author on: Oxford Academic Google Scholar Y‐Y. Xiao, Y‐Y. Xiao Departments of Dermatology and Pediatrics, Peking University First Hospital, Beijing 100034, China Search for other works by this author on: Oxford Academic Google Scholar Y‐H. Zheng, Y‐H. Zheng Departments of Dermatology and Pediatrics, Peking University First Hospital, Beijing 100034, China Search for other works by this author on: Oxford Academic Google Scholar W. Jang, W. Jang Departments of Dermatology and Pediatrics, Peking University First Hospital, Beijing 100034, China Search for other works by this author on: Oxford Academic Google Scholar Y‐L. Yang, Y‐L. Yang Departments of Dermatology and Pediatrics, Peking University First Hospital, Beijing 100034, China Search for other works by this author on: Oxford Academic Google Scholar X‐J. Zhu X‐J. Zhu Departments of Dermatology and Pediatrics, Peking University First Hospital, Beijing 100034, China Correspondence: Xue‐Jun Zhu. E‐mail: zhuxj@public.bta.net.cn Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 156, Issue 3, 1 March 2007, Pages 602–604, https://doi.org/10.1111/j.1365-2133.2006.07701.x Published: 01 March 2007
Poisoning From Ingestion Of Asthma "Powders"
Authors: Marvin Koff
Journal: JAMA (1966)

<h3>To the Editor:—</h3> In the past several months, seven young male patients, all hospitalized in a psychiatric facility, have ingested varying quantities of Asthmador, a proprietary drug sold in powder form to be ignited and the vapor inhaled for the relief of asthma. (On the label of the product there is a clear warning against oral use.) According to a written communication from R. S. Stewart of the manufacturing company, Asthmador contains two solanaceous herbs,<i>Atropa belladonna</i>and<i>Datura stramonium</i>, whose active principles are atropine and scopolamine. The drug was taken orally by the seven patients for the stated purpose of "getting high" or "getting a kick." Five patients took the drug together on the hospital grounds. The other two patients took the drug on separate occasions while away from the hospital. They stated they took from 1 1/2 to 4 teaspoons, the dose varying according to the individual. One
Oxpentifylline treatment of venous ulcers of the leg.
Authors: M P Colgan, J A Dormandy, P W Jones, I G Schraibman, D G Shanik, R A Young
Journal: BMJ (1990)

OBJECTIVE--To determine the effect of oxpentifylline on the healing of venous ulcers of the leg. DESIGN--Double blind, randomised, prospective, placebo controlled, parallel group study. SETTING--Four outpatient clinics treating leg ulcers in England and the Republic of Ireland. PATIENTS--80 Consecutive patients with clinical evidence of venous ulceration of the leg in whom appreciable arterial disease was excluded by the ratio of ankle to brachial systolic pressure being greater than 0.8. INTERVENTIONS--All patients received either oxpentifylline 400 mg three times a day by mouth or a matching placebo for six months (or until their reference ulcer healed if this occurred sooner) in addition to a locally standardised method of compression bandaging. MAIN OUTCOME MEASURES--The primary end point was complete healing of the reference ulcer within six months. The secondary end point was the change in the area of the ulcer over the six month observation period. RESULTS--Complete healing of the reference ulcer occurred in 23 of the 38 patients treated with oxpentifylline and in 12 of the 42 patients treated with a placebo. Life table analysis showed that the proportion of ulcers healed at six months was 64% in the group treated with oxpentifylline compared with 34% in the group treated with a placebo (log rank test chi 2 = 4.78, p = 0.03), which was significant (odds ratio = 1.81, 95% confidence interval 1.20 to 2.71). CONCLUSION--Oxpentifylline used in conjunction with compression bandaging improves the healing of venous ulcers of the leg.
141 Human upper airway epithelial cell and fibroblast IL-8 production and its modulation by steroids
Authors: T. Ohtoshi, X. Zhou, J. Gauldie, B. Andersson, M. Vanzieleghem, E. Liehl, M. Ceska, J. Dolovich, M. Jordana, J. Denburg
Journal: Journal of Allergy and Clinical Immunology (1991)
Cardiac Arrest on the Myelographic Tilt Table
Authors: David R. Cooper
Journal: JAMA (1964)

PASSIVE ASSUMPTION of the upright posture or prolonged quiet standing may cause decreased cardiac output of variable duration.<sup>1-5</sup>This in turn may lead to inadequate perfusion and cerebral or myocardial ischemia or infarction, with or without thrombosis.<sup>3, 5-7</sup>Prolonged cerebral ischemia, convulsions, and even death might follow if an individual were held in the upright position after a loss of consciousness so produced.<sup>5, 6,8</sup>The risks of causing such complications using the techniques of tilt table electroencephalogram (EEG) and electrocardiogram (ECG) are so well substantiated that the method is used for investigative purposes or special cases only. Little stress has been placed upon the liability of causing such a major complication by tilting the immobile patient on the x-ray table during routine myelography. It is the purpose of this paper to report a case of successfully treated cardiac arrest in a patient who was passively moved into
Saddam Hussein's medical examination should not have been broadcast: Doctors are not released from duty of care because of whom their patient is
Authors: L. Farrell
Journal: BMJ (2004)

<h3>ABSTRACT</h3> Interstitial collateral branching of axons is a critical component in the development of functional neural circuits. Axon collateral branches are established through a series of cellular processes initiated by the development of a specialized, focal F-actin network in axons. The formation, maintenance and remodelling of this F-actin patch is critical for the initiation of axonal protrusions that are subsequently consolidated to form a collateral branch. However, the mechanisms regulating F-actin patch dynamics are poorly understood. Fmn2 is a formin family member implicated in multiple neurodevelopmental disorders. We find that Fmn2 regulates the initiation of axon collateral protrusions. Fmn2 localises to the protrusion-initiating axonal F-actin patches and regulates the lifetime and size of these F-actin networks. The F-actin nucleation activity of Fmn2 is necessary for F-actin patch stability but not for initiating patch formation. We show that Fmn2 insulates the F-actin patches from disassembly by the actin-depolymerizing factor, ADF, and promotes long-lived, larger patches that are competent to initiate axonal protrusions. The regulation of axonal branching can contribute to the neurodevelopmental pathologies associated with Fmn2 and the dynamic antagonism between Fmn2 and ADF may represent a general mechanism of formin-dependent protection of Arp2/3-initiated F-actin networks from disassembly.
Left Ventricular Dilatation and Diastolic Compliance Changes during Chronic Volume Overloading
Authors: WILLIAM H. MCCULLAGH, JAMES W. COVELL, JOHN ROSS
Journal: Circulation (1972)

The magnitude and time course of alterations in left ventricular size, end-diastolic pressure (LVEDP), and stiffness consequent to chronic volume overloading were examined in conscious dogs. A large infrarenal aortocaval shunt was produced surgically, left ventricular dimensions were measured by cineradiography using radiopaque beads implanted subendocardially, and LVEDP was measured via an indwelling catheter. In nine experimental and seven control animals, LVEDP was related to the left ventricular end-diastolic diameter (LVEDD) over a range of LVEDP produced by transfusion and bleeding. In control studies LVEDP averaged 6.7 ± 1.42 ( sem ) mm Hg, LVEDD determined at 15 mm Hg LVEDP averaged 4.8 ± 1.13 cm, and the mean slope of linear stiffness curves was 45.9 ± 2.3 mm Hg/cm. Time-dependent changes in all of these parameters were observed following creation of the shunt: A progressive increase of LVEDP reached a maximum by 2 to 3 weeks, and when early postshunt studies (mean 5.2 days) were compared with late postshunt studies (mean 6.8 weeks) LVEDP had increased from 9.7 ± 1.2 to 18.9 ± 1.1 mm Hg ( P &lt; 0.01). There was a progressive, more gradual, increase in left ventricular size, LVEDD being 4.81 ± 2.4 cm in early postshunt and 5.34 ± 2.8 cm in late postshunt studies ( P &lt; 0.01). Left ventricular diastolic stiffness showed an increase from 50.2 ± 5.6 to 96.6 ± 10.7 mm Hg/cm between early and late postshunt studies, respectively ( P &lt; 0.01), and functional compliance was reduced. In six animals the shunts were closed; at approximately 1 week there was a substantial drop in LVEDP (9.5 ± 1.9 mm Hg), and although LVEDD were unchanged stiffness decreased to 58.6 ± 12.2 mm Hg/cm ( P &lt; 0.01). Observations up to 4 months after shunt closure suggested further progressive return toward normal of these parameters. It is concluded that chronic volume overloading in the normal dog causes a time-dependent shift to the right of the diastolic left ventricular pressure-dimension relation accompanied by a progressive reduction of diastolic compliance, and that these changes are at least in part reversible following correction of the shunt.
The Effect of Metformin and Intensive Lifestyle Intervention on the Metabolic Syndrome: The Diabetes Prevention Program Randomized Trial
Authors: Trevor J. Orchard, Marinella Temprosa, Ronald Goldberg, Steven Haffner, Robert Ratner, Santica Marcovina, Sarah Fowler
Journal: Annals of Internal Medicine (2005)

Background: The metabolic syndrome is a high-risk state for diabetes and cardiovascular disease. Little is known about its prevalence and prevention in those with impaired glucose tolerance. Objective: To determine the prevalence of the metabolic syndrome at baseline in the Diabetes Prevention Program and the effect of intensive lifestyle intervention and metformin therapy on the syndrome's incidence and resolution. Design: Randomized, controlled clinical trial. Setting: Research and community-based centers. Participants: Participants had impaired glucose tolerance (World Health Organization criteria plus fasting plasma glucose level ≥5.3 mmol/L [≥95 mg/dL]) and were followed for a mean of 3.2 years after random assignment to intensive lifestyle intervention, metformin therapy, or placebo. Interventions: Metformin, 850 mg twice daily, or intensive lifestyle intervention designed to achieve and maintain a 7% weight loss and 150 minutes of exercise per week. Measurements: The metabolic syndrome was defined as having 3 or more characteristics (waist circumference; blood pressure; and levels of high-density lipoprotein cholesterol, triglycerides, and fasting plasma glucose) that met criteria from the National Cholesterol Education Program Adult Treatment Panel III. Results: Fifty-three percent of participants (n = 1711) had the metabolic syndrome at baseline; incidence did not vary substantially by age. However, low levels of high-density lipoprotein cholesterol predominated in younger participants (age 25 to 44 years), and high blood pressure predominated in older participants (age 60 to 82 years). In life-table analyses (log-rank test), incidence of the metabolic syndrome was reduced by 41% in the lifestyle group (P < 0.001) and by 17% in the metformin group (P = 0.03) compared with placebo. Three-year cumulative incidences were 51%, 45%, and 34% in the placebo, metformin, and lifestyle groups, respectively. There was no significant heterogeneity by ethnic group. Limitations: The study involved a volunteer group with impaired glucose tolerance, which limits generalizability. Conclusions: The metabolic syndrome affected approximately half of the participants in the Diabetes Prevention Program at baseline. Both lifestyle intervention and metformin therapy reduced the development of the syndrome in the remaining participants.