tbuckley/cabot-search huggingface dataset:
Instability of Symptoms in Recurrent Major Depression: A Prospective Study
Authors: Maria A. Oquendo, Andres Barrera, Steven P. Ellis, Shuhua Li, Ainsley K. Burke, Michael Grunebaum, Jean Endicott, J. John Mann
Journal: American Journal of Psychiatry (2004)

Recurrent episodes of major depressive disorder are reported to have similar or stable characteristics across episodes. However, symptoms appear to be moderately stable only in consecutive depressive episodes or if episode severity is considered. The authors prospectively studied major depressive episodes occurring within 2 years to determine whether symptoms in the second episode could be predicted on the basis of symptoms in the first.Inpatients (N=78) with major depressive disorder were rated with the Hamilton Depression Rating Scale during two separate episodes. Patients had a baseline assessment at index hospitalization and follow-up visits at 3, 12, and 24 months after discharge. Information regarding the presence of a major depressive episode, its duration, and its severity was documented. Baseline and follow-up data were analyzed by using Pearson correlations with and without adjustments for severity of depression.Subtype of depression appeared not to be stable. The most robust, although still weak, correlations across episodes were for anxiety and suicidal behavior. Only modest correlations were identified for a few depressive symptoms.The lack of robust consistency of symptoms or depressive subtype across episodes is striking given the requirement of five of nine predetermined symptoms for depression, increasing the chances of finding an association. These findings suggest that there is a superfamily of mood disorders with pleomorphic manifestations across major depressive episodes within individual patients with unipolar depression.
A 1-year multicenter randomized double-blind comparison of repaglinide and glyburide for the treatment of type 2 diabetes. Dutch and German Repaglinide Study Group.
Authors: B H Wolffenbuttel, R Landgraf
Journal: Diabetes Care (1999)

OBJECTIVE: Repaglinide is a newly developed oral blood glucose-lowering agent that exerts its effect by stimulating insulin secretion. This multicenter study was designed to compare the efficacy and safety of this drug with glyburide in a 1-year randomized double-blind study of outpatients with type 2 diabetes. RESEARCH DESIGN AND METHODS: A total of 424 subjects (154 women, 270 men) participated and had the following characteristics: age, 61 +/- 9 years; duration of diabetes. 8 years (range 0.5-35); BMI, 28.3 +/- 3.5 kg/m2; HbA1c, 7.1 +/- 1.4%; and fasting plasma glucose, 10.8 +/- 3.1 mmol/l. The majority of the subjects (91%) were previously treated with sulfonylurea, alone or in combination with metformin. The patients were randomized to a 2:1 ratio of repaglinide (0.5-4 mg t.i.d.) or glyburide (1.75-10.5 mg daily) treatment. The study protocol included a screening visit to assess patient eligibility; a titration period of 6-8 weeks, during which the dosages of repaglinide and glyburide were optimized; and a subsequent 12-month treatment period on fixed, optimal dosages. RESULTS: The trial was completed by 320 subjects, 211 (74%) in the repaglinide and 109 (78%) in the glyburide group. HbA1c initially decreased in both groups and then increased during the second half-year of the maintenance period to a similar extent in the repaglinide and glyburide subjects (0.58 and 0.45% vs. at screening, respectively). In the small group of subjects who previously controlled their condition with diet only (n = 37), a sustained improvement of metabolic control could be observed with both drugs, which was slightly better with glyburide than with repaglinide (theta HbA1c -2.4 vs. -1.0%; P &amp;lt; 0.05). The same trends were seen with fasting plasma glucose. There were no changes in serum lipids. Over the course of the study, 15% of the repaglinide-treated and 13% of glyburide-treated subjects withdrew due to adverse events, mostly hyperglycemia. No differences in adverse events between both drugs were reported. There were no differences in incidences of hypoglycemia. CONCLUSIONS: Repaglinide is a safe and efficacious oral blood glucose-lowering agent, with a potency similar to that of glyburide. Its rapid onset of action and hepatic clearance allows meal-related administration, including in subjects with impaired kidney function.
The Role of Adjuvant Radiation Therapy for Stage I Endometrial Cancer: Does Meta-Analysis Reveal the Answer?
Authors: P. J. Eifel
Journal: JNCI Journal of the National Cancer Institute (2012)

annual death rate from uterine cancer is much less than that from ovarian cancer and only modestly higher than that from cervical cancer, suggesting that high-risk endometrial cancer is actually a relatively rare disease (4). In Northern Europe, where most of the randomized trials were conducted, racial and other demographic characteristics differ from those in the United States, and highrisk endometrial cancer may be even less common. For example, in the Netherlands, home of the PORTEC trials, the annual death rate from endometrial cancer is about 3 per 100 000 women, compared with an annual rate of 5 per 100 000 women in the United States (4,5). We know from these data and from numerous clinical-pathologic analyses that uterine cancer has a heterogeneous presentation and that most of the recurrence (and death) risk, particularly for patients with stage I disease, resides in a relatively small subset of patients whose tumors exhibit multiple risk factors. Ideally, clinical trials would focus on these higher-risk patients for whom the margin for improvement is substantial. However, the desire to assure rapid accrual often leads investigators to broaden inclusion criteria. In fact, this has been one of the primary weaknesses of the endometrial cancer trials. Studies have tended to include large numbers of patients with low-grade or minimally invasive cancers—patients whose baseline risk of recurrence may be less than 5% to 10%. For these patients, even relatively minor side effects from radiation therapy (or lymphadenectomy or chemotherapy) will outweigh the most optimistic level of benefit from that treatment. If the proportion of patients with low-grade or minimally invasive cancers in a trial is large, treatment-related morbidity experienced by patients with low-risk tumors can easily obscure real benefits experienced by the smaller number of patients who have a greater margin for improvement. This phenomenon was well described by Kent and Haywood in their discussion of the potential pitfalls of summary statistics (6). The phenomenon is also clearly illustrated in the results of the GOG-99 trial (7). In that trial, subset analysis of a high-intermediate-risk subgroup suggested a fairly large potential benefit that was completely obscured when the entire group of patients, which on average was a relatively low-risk group, was
Respiratory muscles trainings as physical rehabilitation in patients with chronic obstructive pulmonary disease and myocardial infarction
Authors: Grigory Aruryunov, Anna Rylova, Elena Kolesnikova, Natalia Rylova
Journal: European Respiratory Journal (2012)

Background: Patients with MI and concomitant COPD often can9t take part in physical trainings as a part of cardiac rehabilitation. Purpose: To study the effect of respiratory muscles trainings (RMT) in patients with acute MI and COPD. Methods: 87 patients were randomized to either an exercise training group (EG) or to a control group (CG). Patients were on their 5-7 day of MI. The EG participated in a RMT with gradual increase of inspire and expire resistance. RMT were held with the use of Threshold IMT and PEP devices. RMT were started at the hospital on the 5-7th day after MI and were continued for 1 year at home by patients themselves. Results: In 1 year the distance of 6 minute walk test increased significantly in EG (285±8,7 m vs 275,3±9,28 m, p
Pancreatic hormones and amino acid levels following liver transplantation
Authors: Antonio Francavilla, Lorenzo Polimeno, David H. Van Thiel, Saturo Todo, Igal Kam, Stephen Lynch, Thomas E. Starzl
Journal: Hepatology (1987)

Glucose intolerance, hyperinsulinemia, peripheral insulin resistance and hyperglucagonemia are common in patients with advanced liver disease. These abnormalities in the plasma levels of the pancreatic hormones, insulin and glucagon have been thought to be responsible, at least in part, for the abnormal plasma ratio of branched-chain amino acids to aromatic amino acids. To evaluate this issue, plasma levels of glucose, insulin, glucagon, C-peptide and the branched-chain and aromatic amino acids were measured before and serially after orthotopic liver transplantation in 9 humans and 5 dogs. The abnormal plasma amino acid levels rapidly improved and achieved normal levels following orthotopic liver transplantation. Insulin levels also became normal following orthotopic liver transplantation, despite enhanced insulin secretion documented by an even further increased level of C-peptide. In contrast, the baseline abnormal plasma glucagon levels which are commonly seen in cirrhotics became even more abnormal following orthotopic liver transplantation. Despite this progressive increase in the abnormally elevated plasma glucagon levels, plasma amino acid levels, both branched-chain and aromatic, became normal. These data demonstrate that before and after orthotopic liver transplantation, there is: (i) no relationship between the changes in plasma levels of glucagon and changes observed in the plasma level of amino acids; and (ii) plasma insulin and amino acid levels change in the same direction. In addition, these changes in plasma insulin and amino acid levels following orthotopic liver transplantation occur despite enhanced secretion of insulin evidenced by the progressive increase in plasma levels of C-peptide.
Observations on Excision of the Rectum for Malignant Disease, Describing a Method of Operation
Authors: F. T. Heuston
Journal: BMJ (1895)

itCdoes not follow that in other cases in which the secretion isivery moderate and localised, and not very virulent after thorough examination, cleansing of the focus of infection, and removal of the exciting cause it should be necessary to pro- vide elaborate drainage for a secretion which the peritoneum itself can dispose of easily.Another conclusion follows upon these considerations, if they be correct, namely that in those cases in which we open the abdomen for septic peritonitis, and regard drainage as indispensable, we may in many cases remove the tube at a much earlier date than has hitherto been the custom.The tube will have done all that is required of it in many cases in the first twenty-four hours, and though there may still be a certain amount of effused fluid to be got rid of, what does not leak away through the chink left by the removal of the drain, may often be left safely to be disposed of by the peri- toneum.But only often, not always.It is for the surgeon of large experience in abdominal work to determine for each case which line he will adopt; but I would suggest again that where he can dispense with the drain tube he will find it a great gain.
Junctional adhesion molecule-C regulates vascular endothelial permeability by modulating VE-cadherin–mediated cell–cell contacts
Authors: Valeria V. Orlova, Matina Economopoulou, Florea Lupu, Sentot Santoso, Triantafyllos Chavakis
Journal: The Journal of Experimental Medicine (2006)

We recently reported that junctional adhesion molecule (JAM)-C plays a role in leukocyte transendothelial migration. Here, the role of JAM-C in vascular permeability was investigated in vitro and in vivo. As opposed to macrovascular endothelial cells that constitutively expressed JAM-C in cell–cell contacts, in quiescent microvascular endothelial cells, JAM-C localized mainly intracellularly, and was recruited to junctions upon short-term stimulation with vascular endothelial growth factor (VEGF) or histamine. Strikingly, disruption of JAM-C function decreased basal permeability and prevented the VEGF- and histamine-induced increases in human dermal microvascular endothelial cell permeability in vitro and skin permeability in mice. Permeability increases are essential in angiogenesis, and JAM-C blockade reduced hyperpermeability and neovascularization in hypoxia-induced retinal angiogenesis in mice. The underlying mechanisms of the JAM-C–mediated increase in endothelial permeability were studied. JAM-C was essential for the regulation of endothelial actomyosin, as revealed by decreased F-actin, reduced myosin light chain phosphorylation, and actin stress fiber formation due to JAM-C knockdown. Moreover, the loss of JAM-C expression resulted in stabilization of VE-cadherin–mediated interendothelial adhesion in a manner dependent on the small GTPase Rap1. Together, through modulation of endothelial contractility and VE-cadherin–mediated adhesion, JAM-C helps to regulate vascular permeability and pathologic angiogenesis.
Syntax is more diverse, and evolutionary linguistics is already here
Authors: William Croft
Journal: Behavioral and Brain Sciences (2009)

Abstract Evans &amp; Levinson (E&amp;L) perform a major service for cognitive science. The assumption of Chomskyan generative linguistics – that there are absolute unrestricted universals of grammatical structure – is empirically untenable. However, E&amp;L are too reluctant to abandon word classes and grammatical relations in syntax. Also, a cognitive scientist can already draw on a substantial linguistics literature on variationist, evolutionary models of language.
A comparative study to evaluate the effects of salmetrol/fluticasone and formoterol/budesonide combinations on lung functions and sleep quality in asthma
Authors: Mahesh Gupta, Dhruva Chaudhry, Pooja Jindal
Journal: European Respiratory Journal (2011)

Introduction:  Asthma is a prevalent chronic inflammatory disorder associated with dyspnoea,deterioration of lung functions and a negative impact on the quality of sleep. Combination treatment with a glucocorticoid and a bronchodilator is the mainstay of treatment.   Aims and objectives:  To evaluate the effects of two commonly used combinations salmeterol/fluticasone and formoterol/budesonide on lung functions, dyspnoea and the quality of sleep in patients with moderately severe persistent asthma.   Methods:  Sixty patients of moderate severe asthma were allocated to two different treatment groups i.e. salmeterol/fluticasone and formoterol/budesonide in a prospective, open, randomized and comparative study over a period of 6 weeks. The lung functions and Borgs dyspnoea scoring were done at the baseline and at the end of 3 and 6 weeks. Quality of sleep was assessed at the same time intervals by Pittsburgh Sleep Quality Index (PSQI) for quality of sleep and day time sleepiness by Epworth Sleep Scale (ESS).   Results:  Salmeterol/fluticasone and formoterol/budesonide, caused a comparable and significant improvement in the lung functions (FEV1, FVC, FEV1/FVC and PEFR). The two treatments had a highly significant and comparable improvement in dyspnoea. Quality of sleep as assessed by PSQI and ESS also improved significantly with both the combinations.However the salmeterol/fluticasone was relatively superior in improving quality of sleep.   Conclusions:  Both the combinations were equivalent in improving lung functions & dyspnoea but salmeterol/fluticasone combination was superior with respect to sleep quality.
Leucocyte migration studies in Crohn's disease using Crohn's colon homogenate and mitochondrial and microsomal fractions
Authors: E. R. Richens, M. J. Williams, K. R. Gough, R. J. Ancill
Journal: Gut (1974)

Leucocytes from 38 patients with Crohn9s disease were tested for evidence of migration inhibition in the presence of preparations of colon from a patient with this disease. The occurrence of migration inhibition showed a positive correlation with clinically active disease and a negative correlation with immunosuppressive treatment. It was not seen with leucocytes from 12 healthy subjects.
From Cradle to Grave: Palliative Medicine Education in the UK
Authors: Richard Hillier, Bee Wee
Journal: Journal of the Royal Society of Medicine (2001)

Since the death rate in the UK population is approximately 100%, it seems reasonable that approximately 100% of healthcare professionals should have a sane attitude towards death and dying and some knowledge and skills in dealing with patients who experience the inevitable challenges, physical, psychological, emotional and spiritual. The depths of knowledge and skill required will depend on the kind of health professional. Those who deal with death and dying only infrequently will require only a basic knowledge of palliative care: others, such as those training to be specialists in palliative care or in palliative medicine, will undergo a lengthy educational programme, in the UK four years.

Whichever category healthcare workers fall into, there is always likely to be a training element of one form or another. Administrative and clerical staff in every health setting should learn how to cope with distressed relatives and families; healthcare staff in hospitals and the community need to understand basic symptom control and have good communication skills. Senior nurses and doctors in palliative care may need to gain higher degrees, undergo accredited training and be able to participate in continuing professional development at all levels.

However, more important than any of this is conveying the ethos, at the start of training, that palliative care is important. Not just because it improves quality of life and relieves suffering for patients and families, but because many of the skills in palliative care are useful in every other health setting—e.g. empathy, listening, communication, identification of problems and goals, developing priorities fast, and perhaps most important, working with and developing interprofessional teams so that patients get the right care at the right time from the right person. This is why palliative care education needs to start in the cradle and why it needs to continue to the grave.
Distinct populations of dendritic cells are present in the subepithelial dome and T cell regions of the murine Peyer's patch.
Authors: B L Kelsall, W Strober
Journal: The Journal of Experimental Medicine (1996)

Despite the fact that the Peyer's patch (PP) is the primary site for antigen uptake in the intestine, the cellular basis of antigen handling after transport into the PP is poorly understood. We performed immunohistology of murine PPs using the dendritic cell (DC)-reactive monoclonal antibodies N418, NLDC-145, M342, and 2A1, as well as antibodies to other T cell, B cell, and macrophage markers. N418+, 2A1+, NLDC-145-, M342- cells form a dense layer of cells in the subepithelial dome (SED), just beneath the follicle epithelium, and are scattered throughout the follicle, sparing the germinal center. In contrast, N418+, 2A1+, NLDC-145+, and M342+ DCs are present in the interfollicular T cell regions (IFR). CD3+ and CD4+, but no CD8+ T cells were present in the SED and the follicle, including the germinal center, while CD3+, CD4+, and CD8+ T cells were present in the IFR. B cells and macrophages were poorly represented in the SED as no B220+ cells, only few Mac-1lo cells, and no F4/80+ cells were present at this site. In contrast, Mac-1hi cells were found in the IFR and lamina propria of intestinal villi, while F4/80+ cells were found only in the latter. In further phenotypic studies, we analyzed surface molecules of PP and spleen DCs by flow cytometry and found that these cells had similar fluorescence profiles when stained with N418, NLDC-145, and 33D1 DC-reactive antibodies, and antibodies to the costimulatory molecules B7-1 (1G10) and B7-2 (GL1). In contrast, PP DCs expressed 5-10-fold higher levels of major histocompatibility complex class II antigens (IEk) than spleen DCs. Finally, in functional studies, we demonstrated that both PP and spleen DCs process soluble protein antigens during overnight culture and induce similar levels of proliferation in CD3+ T cells, and CD4+/Mel 14hi T cells from T cell receptor transgenic mice. The in vivo relevance of such presentation was shown by the fact that PP DCs isolated from Balb/c mice after being fed ovalbumin stimulated proliferation in ovalbumin T cell receptor T cells. Taken together, our data suggest that DCs in the SED of the PP are uniquely positioned for the processing of antigens passed into the PP from the overlying M cell, and that PP DCs are effective at processing and presenting oral antigens to naive T cells.
Effect of Rosiglitazone on the Risk of Myocardial Infarction and Death from Cardiovascular Causes
Authors: Steven E. Nissen, Kathy Wolski
Journal: New England Journal of Medicine (2007)

Rosiglitazone is widely used to treat patients with type 2 diabetes mellitus, but its effect on cardiovascular morbidity and mortality has not been determined.We conducted searches of the published literature, the Web site of the Food and Drug Administration, and a clinical-trials registry maintained by the drug manufacturer (GlaxoSmithKline). Criteria for inclusion in our meta-analysis included a study duration of more than 24 weeks, the use of a randomized control group not receiving rosiglitazone, and the availability of outcome data for myocardial infarction and death from cardiovascular causes. Of 116 potentially relevant studies, 42 trials met the inclusion criteria. We tabulated all occurrences of myocardial infarction and death from cardiovascular causes.Data were combined by means of a fixed-effects model. In the 42 trials, the mean age of the subjects was approximately 56 years, and the mean baseline glycated hemoglobin level was approximately 8.2%. In the rosiglitazone group, as compared with the control group, the odds ratio for myocardial infarction was 1.43 (95% confidence interval [CI], 1.03 to 1.98; P=0.03), and the odds ratio for death from cardiovascular causes was 1.64 (95% CI, 0.98 to 2.74; P=0.06).Rosiglitazone was associated with a significant increase in the risk of myocardial infarction and with an increase in the risk of death from cardiovascular causes that had borderline significance. Our study was limited by a lack of access to original source data, which would have enabled time-to-event analysis. Despite these limitations, patients and providers should consider the potential for serious adverse cardiovascular effects of treatment with rosiglitazone for type 2 diabetes.
Smoking and Depression: An Examination of Mechanisms of Comorbidity
Authors: Lisa C. Dierker, Shelli Avenevoli, Marilyn Stolar, K.R. Merikangas
Journal: American Journal of Psychiatry (2002)

OBJECTIVE: Although the association between depression and smoking has been consistently established, little evidence regarding the mechanisms that influence this association is currently available. The present study evaluates alternate familial mechanisms of comorbidity between depression and smoking. METHOD: Probands from a case-control family study were selected from outpatient specialty clinics or through a random-digit dialing procedure. A total of 133 probands and 273 directly interviewed, first-degree relatives of the probands were included in the present analyses. RESULTS: The pattern of cross-aggregation of heavy smoking and depression differed according to the subtype of depressive disorder. There was evidence of a shared etiology between dysthymia and heavy smoking, whereas major and double depression did not demonstrate a shared vulnerability with heavy smoking. CONCLUSIONS: This report contributes to the present sparse evidence regarding the mechanisms involved in the etiology of smoking and depressive disorders and highlights the need for greater attention to this issue through genetic epidemiological study methods.