tbuckley/cabot-search huggingface dataset:
Impact of regurgitation on health-related quality of life in gastro-oesophageal reflux disease before and after short-term potent acid suppression therapy
Authors: Peter J Kahrilas, Andreas Jonsson, Hans Denison, Börje Wernersson, Nesta Hughes, Colin W Howden
Journal: Gut (2013)

<h3>Objective</h3> Limited data exist on the impact of regurgitation on health-related quality of life (HRQOL) in gastro-oesophageal reflux disease (GORD). We assessed the relationship between regurgitation frequency and HRQOL before and after acid suppression therapy in GORD. <h3>Method</h3> We used data from two randomised trials of AZD0865 25–75 mg/day versus esomeprazole 20 or 40 mg/day in non-erosive reflux disease (NERD) (n=1415) or reflux oesophagitis (RO) (n=1460). The Reflux Disease Questionnaire was used to select patients with frequent and intense heartburn for inclusion and to assess treatment response. The Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire was used to assess HRQOL. <h3>Results</h3> At baseline, 93% of patients in both the NERD and RO groups experienced regurgitation. Mean QOLRAD scores were similar for NERD and RO at baseline and at week 4 and disclosed decremental HRQOL with increasing frequency of regurgitation; a clinically relevant difference of &gt;0.5 in mean QOLRAD scores was seen with regurgitation ≥4 days/week versus &lt;4 days/week. The prevalence of frequent, persistent regurgitation (≥4 days/week) at week 4 among heartburn responders (≤1 day/week of mild heartburn) was 28% in NERD and 23% in RO. QOLRAD scores were higher among heartburn responders. There was a similar pattern of impact related to regurgitation frequency in heartburn responders compared with the group as a whole. <h3>Conclusions</h3> Frequent regurgitation was associated with a clinically relevant, incremental decline in HRQOL beyond that associated with heartburn before and after potent acid suppression in both NERD and RO. <h3>Clinical trial numbers</h3> NCT00206284 and NCT00206245.
Prevention of Ultraviolet Radiation–Induced Immunosuppression by (−)-Epigallocatechin-3-Gallate in Mice Is Mediated through Interleukin 12–Dependent DNA Repair
Authors: Syed M. Meeran, Sudheer K. Mantena, Santosh K. Katiyar
Journal: Clinical Cancer Research (2006)

Abstract Purpose: Solar UV radiation–induced immunosuppression is considered to be a risk factor for melanoma and nonmelanoma skin cancers. We previously have shown that topical application of (−)-epigallocatechin-3-gallate (EGCG) prevents UV-induced immunosuppression in mice. We studied whether prevention of UV-induced immunosuppression by EGCG is mediated through interleukin 12 (IL-12)–dependent DNA repair. Experimental Design: IL-12 knockout (KO) mice on C3H/HeN background and DNA repair–deficient cells from xeroderma pigmentosum complementation group A (XPA) patients were used in this study. The effect of EGCG was determined on UV-induced suppression of contact hypersensitivity and UV-induced DNA damage in the form of cyclobutane pyrimidine dimers (CPD) in mice and XPA-deficient cells using immunohistochemistry and dot-blot analysis. Results: Topical treatment with EGCG prevented UV-induced suppression of the contact hypersensitivity in wild-type (WT) mice but did not prevent it in IL-12 KO mice. Injection of anti-IL-12 monoclonal antibody to WT mice blocked the preventive effect of EGCG on UV-induced immunosuppression. EGCG reduced or repaired UV-induced DNA damage in skin faster in WT mice as shown by reduced number of CPDs+ cells and reduced the migration of CPD+ antigen-presenting cells from the skin to draining lymph nodes. In contrast, this effect of EGCG was not seen in IL-12 KO mice. Further, EGCG was able to repair UV-induced CPDs in XPA-proficient cells obtained from healthy person but did not repair in XPA-deficient cells, indicating that nucleotide excision repair mechanism is involved in DNA repair. Conclusions: These data identify a new mechanism by which EGCG prevents UV-induced immunosuppression, and this may contribute to the chemopreventive activity of EGCG in prevention of photocarcinogenesis.
Neuromuscular Diseases: A Practical Approach to Diagnosis and Management
Authors: G. D. Perkin
Journal: Annals of the Rheumatic Diseases (1982)

Book reviews 323and of immunofluorescence and immunoperoxidase tech-mechanisms found in skeletal muscle.There are then separ- niques.Comparable analyses incorporating these newer ate parts devoted to diseases of the anterior horn cell, the methods will undoubtedly follow.peripheral nerve, muscle itself, and the neuromuscular Stemming directly from the present volume and in-junction.corporated in the papers to which I refer above is the appli-The book is presumably intended for those specialists cation to synovial diagnosis of the approach that is coming dealing with neuromuscular disease, and therefore must to be called 'probability diagnosis', an advance in histostand comparison with Walton's Disorders of Voluntary pathology that reflects the anxiety of many contemporary Muscle, the fourth edition of which has recently appeared.It investigators to apply all that is best in statistics and com-has one advantage in this respect, in that it is not a multiputer technology to the interpretation of the often difficult author text.This advantage is sustained, however, only if problems posed by synovial biopsies.The results are a the authors are able to cover the wide area of the subject
Respiratory mechanics and morphometric changes during pneumoperitoneum in normal rats
Authors: LF Moreira, CF Gobbi, M Feijoo, PR Rocco, WA Zin
Journal: European Respiratory Journal (1997)

Pneumoperitoneum may give rise to several respiratory changes; nevertheless, no comprehensive analysis of respiratory mechanics has been performed under this condition. Respiratory mechanics and thoracoabdominal morphometry were evaluated in six sedated, anaesthetized, paralysed, and mechanically-ventilated rats before (control) and during pneumoperitoneum. After airway occlusion at end-inspiration, respiratory system, pulmonary, and chest wall resistive pressures (deltaP1,rs, deltaP1,L and deltaP1,cw, respectively) and viscoelastic/inhomogeneous pressures (deltaP2,rs, deltaP2,L and deltaP2,cw, respectively) were determined. Total pressure changes (deltaPtot) were calculated as the sum of deltaP1 and deltaP2, yielding the values of deltaPtot,rs, deltaPtot,L and deltaPtot,cw, respectively. Respiratory system, lung, and chest wall static (Est,rs, Est,L and Est,cw, respectively), and dynamic elastances (Edyn,rs, Edyn,L and Edyn,cw, respectively), and the corresponding changes in elastance (deltaE) (calculated as Edyn-Est) were also obtained. Chest wall configuration both at functional residual capacity (FRC) and end-inspiration (FRC + tidal volume (VT)) was also evaluated in another four rats. Pneumoperitoneum significantly increased deltaPtot,rs, deltaPtot,cw, deltaP2,rs, deltaP2,cw, deltaErs, deltaEcw, Est,rs, Est,L and Est,cw. Lateral and anteroposterior diameters increased significantly, with the exception of lateral diameters at the level of crista iliaca. Cephalocaudal diameter and FRC decreased. In conclusion, pneumoperitoneum augments elastances and increases the pressure dissipated against viscoelasticity/inhomogeneity of the respiratory system and chest wall. These changes are related to a cephalad displacement of the diaphragm plus changes in thoracoabdominal configuration.
The state of basic surgical training in the UK: ophthalmology as a case example
Authors: M P Watson, M G Boulton, A Gibson, P I Murray, M J Moseley, A R Fielder
Journal: Journal of the Royal Society of Medicine (2004)

Concern is being expressed about the state of basic surgical training in the context of growing demands to improve service provision in the National Health Service. Taking ophthalmology as a case example, we sent questionnaires to all 466 senior house officers (SHOs) in recognized surgical training posts in England, Wales, Scotland and Northern Ireland. The main outcome measures were intraocular surgery performed in the previous two weeks and since starting as an SHO in ophthalmology; access to protected teaching time or cases on theatre lists; and supervision during surgery. Phakoemulsification, the most common type of cataract surgery, was used as a generic indicator of intraocular procedures. 314 (67%) of the SHOs responded. Of those working in the hospital in the previous two weeks, 50% had performed at least one component part of a phakoemulsification (phako) operation and 44% had performed at least one full phako operation. The average number of full phako operations done per week was 0.741. 77% reported some protected surgical teaching time over the two weeks and those with protected teaching time reported more full phako operations per week. Of those who had performed at least one surgical procedure in the previous two weeks, 79% had been supervised by a consultant. Of those who had completed two or more years’ training as an SHO, only 42% met the Royal College of Ophthalmologists minimum requirement of 50 complete intraocular operations performed under supervision. Women were less likely than men, and SHOs in district general hospitals were less likely than those in teaching hospitals, to have achieved this target. As many as half the SHOs in ophthalmology are not receiving an adequate basic surgical training. If this continues it may prove difficult to train sufficient new surgeons to an acceptable standard to meet the increasing demands of an ageing population. This is not an issue for ophthalmology alone but for all surgical specialties.
Flexible neural circuitry in word processing
Authors: Michael I. Posner, Gregory J. DiGirolamo
Journal: Behavioral and Brain Sciences (1999)

ERP studies have shown modulation of activation in left frontal and posterior cortical language areas, as well as recruitment of right hemisphere homologues, based on task demands. Furthermore, blood-flow studies have demonstrated changes in the neural circuitry of word processing based on experience. The neural areas and time course of language processing are plastic depending on task demands and experience.
Effects of Evolocumab on Vitamin E and Steroid Hormone Levels
Authors: Dirk J. Blom, C. Stephen Djedjos, Maria Laura Monsalvo, Ian Bridges, Scott M. Wasserman, Rob Scott, Eli Roth
Journal: Circulation Research (2015)

Vitamin E transport and steroidogenesis are closely associated with low-density lipoproteins (LDLs) metabolism, and evolocumab can lower LDL cholesterol (LDL-C) to low levels.To determine the effects of evolocumab on vitamin E and steroid hormone levels.After titration of background lipid-lowering therapy per cardiovascular risk, 901 patients with an LDL-C ≥2.0 mmol/L were randomized to 52 weeks of monthly, subcutaneous evolocumab, or placebo. Vitamin E, cortisol, adrenocorticotropic hormone, and gonadal hormones were analyzed at baseline and week 52. In a substudy (n=100), vitamin E levels were also measured in serum, LDL, high-density lipoprotein, and red blood cell membranes at baseline and week 52. Absolute vitamin E decreased in evolocumab-treated patients from baseline to week 52 by 16% but increased by 19% when normalized for cholesterol. In the substudy, vitamin E level changes from baseline to week 52 mirrored the changes in the lipid fraction, and red blood cell membrane vitamin E levels did not change. Cortisol in evolocumab-treated patients increased slightly from baseline to week 52, but adrenocorticotropic hormone and the cortisol:adrenocorticotropic hormone ratio did not change. No patient had a cortisol:adrenocorticotropic hormone ratio <3.0 (nmol/pmol). Among evolocumab-treated patients, gonadal hormones did not change from baseline to week 52. Vitamin E and steroid changes were consistent across subgroups by minimum postbaseline LDL-C <0.4 and <0.6 mmol/L.As expected, vitamin E levels changed similarly to lipids among patients treated for 52 weeks with evolocumab. No adverse effects were observed in steroid or gonadal hormones, even at very low LDL-C levels.URL: http://www.clinicaltrials.gov. Unique identifier: NCT01516879.
INTERNAL DERANGEMENT OF THE KNEE-JOINT
Authors: N. Smith
Journal: BMJ (1902)

Pneumonia is often diagnosed and treated empirically, but the accuracy of clinical assessment alone is largely unknown. We therefore set out to determine the diagnostic accuracy of clinical judgment based on signs and symptoms to detect radiographic pneumonia in patients presenting with acute cough in primary care. In 2810 patients consulting with acute cough in 12 European countries, general practitioners (GPs) recorded whether they considered pneumonia present (“yes” or “no”) immediately after the history and physical examination. Chest radiography was performed within one week by local radiologists blind to other patient characteristics. 140 patients had radiographic pneumonia (5%), of whom 41 (29%) had been diagnosed as such by the GP. GPs diagnosed pneumonia in 31 (1%) patients on clinical grounds who turned out not to have radiographic pneumonia (n=2670). In patients diagnosed with pneumonia by GPs on clinical grounds alone, 57% were subsequently diagnosed with radiographic pneumonia (positive predictive value, PPV). Negative predictive value (NPV), sensitivity and specificity of GPs9 clinical judgment were 96%, 29% and 99% respectively. Patients with radiographic pneumonia, but who had not been diagnosed empirically by GPs, presented with less severe symptoms compared to patients with a clinical diagnosis of pneumonia (p&lt;0.05). The predictive values of GPs9 clinical judgment, particularly the high NPV9s, are helpful in routine care. Nonetheless, the majority of diagnoses of radiographic pneumonias was not suspected on clinical grounds. There is a need to further support the detection of clinically relevant pneumonia in primary care.
Requiem for a Heavyweight
Authors: Amy K. Saenger, Allan S. Jaffe
Journal: Circulation (2008)

T he development of rapid, automated, and accurate labo- ratory testing for creatine kinase MB (CK-MB) revolutionized the treatment of patients with acute cardiac events in the 1970s and 1980s. 1 To clinicians, CK-MB values augmented a thorough history, physical, and ECG findings, and elevations rapidly became the gold standard for identifying cardiac injury. 1 CK-MB allowed earlier diagnosis of acute myocardial infarction (AMI), and detection of reinfarction, and measurements could be used to provide a facile clinical estimate of infarct size.Elevations of CK-MB were never intended to be synonymous with myocardial infarction, only indicative of cardiac injury. 1 However, because of the relative insensitivity of measurements, increased concentrations occurred predominantly with larger insults such those associated with acute ischemic heart disease.For that reason, AMI was rarely diagnosed, assuming appropriate timing of the samples, in the absence of a CK-MB elevation. 2,3K-MB assays initially relied on the measurement of enzyme activity, but over time, improved accuracy and ease of use were established by the use of mass assays.Mass assays allowed earlier detection of abnormal values and improved both clinical sensitivity and specificity.However, mass assays unmasked an increased frequency of CK-MB elevations due primarily to skeletal muscle injury because of their increased sensitivity. 4 -6 Clinical use of the percent relative index was then initiated.This approach improved the specificity of elevations for cardiac muscle injury but was insensitive when concurrent cardiac injury and skeletal muscle injury were present because elevations from skeletal muscle often are of a large magnitude. 7-10A large number of analytical confounds such as macrokinases and interfering substances also were substantial problems with these assays. 10,11Attempts to standardize assays 12 have been partially successful, but differences still exist between manufacturers and even between the same testing antibodies used on different analytical platforms (ie, small versus large automated instruments).A frequency of up to 20% "falsepositive" levels, thought to be due to skeletal muscle injury, was reported in patients with renal failure. 13,14This was only one of many conditions such as noncardiac surgery, chest trauma, asthma, pulmonary embolism, chronic and acute muscle disease, head trauma, hyperventilation, and hypothy-roidism in which CK-MB was elevated in the absence of cardiac injury. 11In some ways, analytical tribulations and the lack of cardiac specificity provided clinicians with more flexibility in their decision-making processes.Enough analytical and physiological reasons not related to cardiac injury were available that elevations of CK-MB in any given patient could be considered false positives if the physician did not believe the assay results fit the clinical presentation.It was clear that cardiac biomarkers with better specificity and sensitivity were needed.
Influence of intestinal transit time on azo-reduction of salicylazosulphapyridine (Salazopyrin).
Authors: P A van Hees, J H Tuinte, J M van Rossum, J H van Tongeren
Journal: Gut (1979)

During a normal and an accelerated intestinal transit, in seven healthy volunteers, the recoveries of salicylazosulphapyridine (SASP) and its split products sulphapyridine (SP) and 5-aminosalicylic acid (5-ASA) were determined in urine and faeces. The azo-reduction of SASP and consequently the recovery of 5-ASA in the faeces was found to be substantially decreased during an accelerated intestinal transit. In addition, in 18 patients with inflammatory disease of the colon during maintenance therapy of SASP it could be demonstrated that the serum SP levels were related to the diarrhoeal state and did not correlate with disease activity. As recent studies have reported that 5-ASA is possibly the active therapeutic moiety of SASP, the ineffectiveness of SASP therapy in patients with active colitis may be ascribed to the reduced azo reduction of SASP as the result of profuse diarrhoea.
Incomplete Stent Apposition and Very Late Stent Thrombosis After Drug-Eluting Stent Implantation
Authors: Stéphane Cook, Peter Wenaweser, Mario Togni, Michael Billinger, Cyrill Morger, Christian Seiler, Rolf Vogel, Otto Hess, Bernhard Meier, Stephan Windecker
Journal: Circulation (2007)

Stent thrombosis may occur late after drug-eluting stent (DES) implantation, and its cause remains unknown. The present study investigated differences of the stented segment between patients with and without very late stent thrombosis with the use of intravascular ultrasound.Since January 2004, patients presenting with very late stent thrombosis (> 1 year) after DES implantation underwent intravascular ultrasound. Findings in patients with very late stent thrombosis were compared with intravascular ultrasound routinely obtained 8 months after DES implantation in 144 control patients, who did not experience stent thrombosis for > or = 2 years. Very late stent thrombosis was encountered in 13 patients at a mean of 630+/-166 days after DES implantation. Compared with DES controls, patients with very late stent thrombosis had longer lesions (23.9+/-16.0 versus 13.3+/-7.9 mm; P<0.001) and stents (34.6+/-22.4 versus 18.6+/-9.5 mm; P<0.001), more stents per lesion (1.6+/-0.9 versus 1.1+/-0.4; P<0.001), and stent overlap (39% versus 8%; P<0.001). Vessel cross-sectional area was similar for the reference segment (cross-sectional area of the external elastic membrane: 18.9+/-6.9 versus 20.4+/-7.2 mm2; P=0.46) but significantly larger for the in-stent segment (28.6+/-11.9 versus 20.1+/-6.7 mm2; P=0.03) in very late stent thrombosis patients compared with DES controls. Incomplete stent apposition was more frequent (77% versus 12%; P<0.001) and maximal incomplete stent apposition area was larger (8.3+/-7.5 versus 4.0+/-3.8 mm2; P=0.03) in patients with very late stent thrombosis compared with controls.Incomplete stent apposition is highly prevalent in patients with very late stent thrombosis after DES implantation, suggesting a role in the pathogenesis of this adverse event.
Metabolic Syndrome and Onset of Depressive Symptoms in the Elderly
Authors: Tasnime N. Akbaraly, Marie-Laure Ancelin, Isabelle Jaussent, Craig Ritchie, Pascale Barberger-Gateau, Carole Dufouil, Mika Kivimaki, Claudine Berr, Karen Ritchie
Journal: Diabetes Care (2011)

Given the increasing prevalence of both metabolic syndrome (MetS) and depressive symptoms during old age, we aimed to examine prospectively the association between MetS and the onset of depressive symptoms according to different age-groups in a large, general elderly population.This was a prospective cohort study of 4,446 men and women aged 65-91 years who were free of depression or depressive symptoms at baseline (the Three-City Study, France). MetS was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. New onset of depressive symptoms (the Center for Epidemiologic Studies Depression Scale score ≥16 and use of antidepressant treatment) was assessed at 2- and 4-year follow-ups.After adjusting for a large range of potential confounders, we observed MetS to be associated with 1.73-fold (95% CI 1.02-2.95) odds for new-onset depressive symptoms in the youngest age-group (65-70 years at baseline), independently of cardiovascular diseases. No such association was seen in older age-groups.Our findings suggest that the link between MetS and depressive symptoms evidenced until now in middle-aged people can be extended to older adults but not to the oldest ones. Additional research is needed to examine if a better management of MetS prevents depressive symptoms in people aged 65-70 years.
Trends in A1C Concentrations Among U.S. Adults With Diagnosed Diabetes From 1999 to 2004
Authors: Earl S. Ford, Chaoyang Li, Randie R. Little, Ali H. Mokdad
Journal: Diabetes Care (2007)

A1C is formed when glucose reacts nonenzymatically with amino acids on hemoglobin. Its concentration represents an integrated measure of glucose concentration during hemoglobin's lifespan, which is about 2–3 months (1). Because A1C concentration predicts the risk for microvascular and macrovascular complications (2,3), it is used in the clinical setting to assess longer-term glycemic control among people with diabetes. Generally, A1C concentrations <7% are regarded as acceptable glycemic control (4).

Approximately 44% of U.S. adults with diagnosed diabetes had a concentration of A1C <7% during 1988–1994 compared with ∼36–37.0% during 1999–2000 (5,6). More recently, data from the National Committee for Quality Assurance showed steady increases in the percentage of patients receiving annual testing for A1C and decreases in the percentage of patients with poor glycemic control from 2000 to 2006 (7). Our objective was to examine trends in glycemic control among U.S. adults with diagnosed diabetes from 1999 to 2004.

The National Health and Nutrition Examination Survey (NHANES) 1999–2004 included nationally representative samples of the noninstitutionalized, civilian U.S. population, selected using a multistage, stratified sampling design (8). Participants were asked the following: “Other than during pregnancy, have you ever been told by a doctor or health professional that you have diabetes or sugar …