tbuckley/cabot-search huggingface dataset:
Reduction of jaw opening in giant cell arteritis
Authors: E Liozon
Journal: Annals of the Rheumatic Diseases (2003)

In the September issue of the journal, Nir-Paz et al described six patients who developed reduction in jaw opening in association with giant cell arteritis.1 These authors found that patients with such a complaint seem to have a more severe disease with a higher prevalence of eye involvement.

Although the precise pathological mechanism underlying reduction in jaw opening is unknown, this symptom probably results, like jaw claudication, from partial failure in blood supply to masseter muscles. However, the value of jaw claudication as a harbinger of visual loss has been debated.2–7 We sought to determine, in a large series of patients with temporal (giant cell) arteritis, the prevalence and clinical associations of reduction in jaw opening.

Between January 1977 and August 2002, 222 consecutive patients were diagnosed as having temporal arteritis in the Department of Internal Medicine. Clinical, laboratory, and pathological data were recorded prospectively before treatment at the time of diagnosis in 217 patients (178 biopsy proven), using a specifically designed, comprehensive questionnaire. …
External Validation of the Canadian CT Head Rule and the New Orleans Criteria for CT Scanning in Patients With Minor Head Injury
Authors: Marion Smits
Journal: JAMA (2005)

Two decision rules for indications of computed tomography (CT) in patients with minor head injury, the Canadian CT Head Rule (CCHR) and the New Orleans Criteria (NOC), suggest that CT scanning may be restricted to patients with certain risk factors, which would lead to important reductions in the use of CT scans.To validate and compare these 2 published decision rules in Dutch patients with head injuries.A prospective multicenter study conducted between February 11, 2002, and August 31, 2004, in 4 university hospitals in the Netherlands of 3181 consecutive adult patients with minor head injury who presented with a Glasgow Coma Scale (GCS) score of 13 to 14 or with a GCS score of 15 and at least 1 risk factor.Primary outcome was any neurocranial traumatic finding on CT scan. Secondary outcomes were neurosurgical intervention and clinically important CT findings. Sensitivity and specificity were estimated for each outcome for the CCHR and the NOC, using both rules as originally derived and also as adapted to apply to an expanded patient population.Of 3181 patients with a GCS score of 13 to 15, neurosurgical intervention was performed in 17 patients (0.5%); neurocranial traumatic CT findings were present in 312 patients (9.8%). Sensitivity for neurosurgical intervention was 100% for both the CCHR and the NOC. The NOC had a higher sensitivity for neurocranial traumatic findings and for clinically important findings (97.7%-99.4%) than did the CCHR (83.4%-87.2%). Specificities were very low for the NOC (3.0%-5.6%) and higher for the CCHR (37.2%-39.7%). The estimated potential reduction in CT scans for patients with minor head injury would be 3.0% for the adapted NOC and 37.3% for the adapted CCHR.For patients with minor head injury and a GCS score of 13 to 15, the CCHR has a lower sensitivity than the NOC for neurocranial traumatic or clinically important CT findings, but would identify all cases requiring neurosurgical intervention, and has greater potential for reducing the use of CT scans.
Diabetic Ketoacidosis Charges Relative to Medical Charges of Adult Patients With Type I Diabetes
Authors: Kimberly A Javor, James G Kotsanos, Robert C McDonald, Alain D Baron, Joseph G Kesterson, William M Tierney
Journal: Diabetes Care (1997)

OBJECTIVE To determine the medical charges for treating diabetic ketoacidosis (DKA) episodes relative to direct medical care charges of adult patients with type I diabetes. RESEARCH DESIGN AND METHODS Using data from an electronic medical record system, we identified adult patients with type I diabetes who had received inpatient or outpatient care on at least two occasions between 1 January 1993 and 30 June 1994. Resources and charges for hospitalizations, emergency room visits, outpatient visits, and pharmaceuticals were recorded during this period. One additional year of information was collected to assess the resources and charges associated with multiple DKA episodes. RESULTS A total of 200 patients were identified, of whom 72 (36.0%) experienced a total of 161 DKA episodes. The direct medical care charges associated with DKA episodes represented 28.1% of the direct medical care charges for the cohort of patients with type I diabetes. The average charge per DKA episode was $6,444. The estimated annual medical care charge for each patient was $7,855 ($13,096 per patient experiencing a DKA episode versus $4,907 per patient not experiencing an episode). Multiple DKA episodes were experienced by 24 (12.0%) of the study patients and accounted for 55.6% of the direct medical care charges for these patients. CONCLUSIONS DKA episodes represented more than $1 of every $4 spent on direct medical care for adult patients with type I diabetes and $1 of every $2 in those patients experiencing multiple episodes. Interventions that are capable of even a modest reduction in the number of DKA episodes could produce substantial cost savings in a health care system and could be particularly cost-effective in adult patients with recurrent DKA.
M<scp>OLECULAR</scp> A<scp>PPROACHES TO</scp> S<scp>PINAL</scp> C<scp>ORD</scp> R<scp>EPAIR</scp>
Authors: Samuel David, Steve Lacroix
Journal: Annual Review of Neuroscience (2003)

▪ Abstract Axon growth inhibitors associated with myelin and the glial scar contribute to the failure of axon regeneration in the injured adult mammalian central nervous system (CNS). A number of these inhibitors, their receptors, and signaling pathways have been identified. These inhibitors can now be neutralized by a variety of approaches that point to the possibility of developing new therapeutic strategies to stimulate regeneration after spinal cord injury.
Factors Affecting Longevity of Homograft Valves Used in Right Ventricular Outflow Tract Reconstruction for Congenital Heart Disease
Authors: J. S. Tweddell, A. N. Pelech, P. C. Frommelt, K. A. Mussatto, J. D. Wyman, R. T. Fedderly, S. Berger, M. A. Frommelt, D. A. Lewis, D. Z. Friedberg, J. P. Thomas, R. Sachdeva, S. B. Litwin
Journal: Circulation (2000)

Few studies have explored the long-term function of cryopreserved homograft valves used for reconstruction of the right ventricular tract (RVOT) in patients with congenital heart disease.Among 205 patients receiving cryopreserved homografts for reconstruction of the RVOT between November 1985 and April 1999, the outcome of 220 homografts in 183 operative survivors was analyzed. There were 150 pulmonary and 70 aortic homografts used. Median age at implantation was 4.4 years (mean 6.9+/-7.6 years, range 3 days to 48 years). End points included (1) patient survival, (2) homograft failure (valve explant or late death), and (3) homograft dysfunction (homograft insufficiency or homograft stenosis). Survival was 88% at 10 years. Freedom from homograft failure was 74+/-4% at 5 years and 54+/-7% at 10 years. Univariable analysis identified younger age, longer donor warm ischemic time, valve Z: value <2, and previous procedure as risk factors for homograft failure and dysfunction. Aortic homograft type and extracardiac operative technique predicted homograft failure but not dysfunction. For patients </=1 year of age, valve type did not predict failure or dysfunction. Multivariable analysis identified younger age and longer donor warm ischemic time as risk factors for homograft failure and dysfunction, whereas, Z: value <2 and aortic valve type predicted homograft valve failure.Homograft valves used for RVOT reconstruction provide effective intermediate palliation with excellent late survival. Factors that adversely affect graft longevity include younger age, longer donor warm ischemic time, smaller homograft size, use of aortic homograft in the older patient, and extracardiac operative technique.
Electron microsocpy of plasmic fragments of human fibrinogen as related to trinodular structure of the intact molecule.
Authors: W E Fowler, L J Fretto, H P Erickson, P A McKee
Journal: Journal of Clinical Investigation (1980)

We have examined rotary shadowed, purified plasmic fragments of human fibrinogen with the electron microscope and have determined the relation of these fragments to the intact fibrinogen molecule. Both intact fibrinogen and its earliest cleavage product, fragment X, are trinodular. The next largest product, fragment Y, consists of two linked nodules. The two terminal products, fragments D and E, are single nodules. From measurements of simultaneously shadowed specimens of these different species, we conclude that the outer nodules of the trinodular fibrinogen molecule are the fragment D-containing regions and the central nodule is the fragment E-containing region.
A prospective large-scale study of methods for the detection of latent Mycobacterium tuberculosis infection in refugee children
Authors: M. Lucas, P. Nicol, E. McKinnon, R. Whidborne, A. Lucas, A. Thambiran, D. Burgner, J. Waring, M. French
Journal: Thorax (2010)

<h3>Background</h3> Diagnosis of latent tuberculosis infection (LTBI) is a cornerstone of the health assessment of resettled high incidence populations, particularly in children. Two blood-based interferon γ release assays (IGRAs), T-SPOT.<i>TB</i> and QFT-Gold in-tube (QFT-GIT), have greater sensitivity and specificity than the tuberculin skin test (TST), but their performance as screening tools for LTBI in children, especially refugee children, remains unclear. <h3>Methods</h3> 524 African and ethnic Burmese children, including 107 under 3 years of age, were prospectively enrolled in a comparison of the T-SPOT.<i>TB</i> and QFT-GIT. The TST was also performed in 342 of the children. <h3>Results</h3> The T-SPOT.<i>TB</i> and QFT-GIT had similar rates of positivity (8% and 10%, respectively) and showed good concordance when both tests gave definitive results (κ=0.78; p&lt;0.0001). However, the IGRAs had significant failure rates: 15% of QFT-GIT gave indeterminate results due to failed mitogen response and 14% of T-SPOT.<i>TB</i> results were inconclusive, largely because of insufficient mononuclear leucocyte yields. Failure of the QFT-GIT mitogen response was associated with African ethnicity and co-morbid infections, particularly with helminths. The TST results showed poor concordance (∼50%) with both IGRAs. <h3>Conclusions</h3> It is reasonable to screen using either IGRA with follow-up by the alternative if the test fails. In general, the QFT-GIT is the preferred option for non-African populations but the T-SPOT.<i>TB</i> is recommended when there are epidemiological and/or clinical high risk factors for TB infection. However, both IGRAs have methodological and performance characteristics that limit their usefulness in refugee children, highlighting the need for continued development of screening strategies.
The Autonomic Nervous System and Heart Failure
Authors: Viorel G. Florea, Jay N. Cohn
Journal: Circulation Research (2014)

The pathophysiology of heart failure (HF) is characterized by hemodynamic abnormalities that result in neurohormonal activation and autonomic imbalance with increase in sympathetic activity and withdrawal of vagal activity. Alterations in receptor activation from this autonomic imbalance may have profound effects on cardiac function and structure. Inhibition of the sympathetic drive to the heart through β-receptor blockade has become a standard component of therapy for HF with a dilated left ventricle because of its effectiveness in inhibiting the ventricular structural remodeling process and in prolonging life. Several devices for selective modulation of sympathetic and vagal activity have recently been developed in an attempt to alter the natural history of HF. The optimal counteraction of the excessive sympathetic activity is still unclear. A profound decrease in adrenergic support with excessive blockade of the sympathetic nervous system may result in adverse outcomes in clinical HF. In this review, we analyze the data supporting a contributory role of the autonomic functional alterations on the course of HF, the techniques used to assess autonomic nervous system activity, the evidence for clinical effectiveness of pharmacological and device interventions, and the potential future role of autonomic nervous system modifiers in the management of this syndrome.
The effect of exemestane on serum lipid profile in postmenopausal women with metastatic breast cancer: a companion study to EORTC Trial 10951, ‘Randomized phase II study in first line hormonal treatment for metastatic breast cancer with exemestane or tamoxifen in postmenopausal patients’
Authors: G. Atalay, L. Dirix, L. Biganzoli, L. Beex, M. Nooij, D. Cameron, C. Lohrisch, T. Cufer, J.P. Lobelle, M.R. Mattiaci, M. Piccart, R. Paridaens
Journal: Annals of Oncology (2004)
Local government funding issues are forcing public health leaders to be "crafty" with resources
Authors: A. O'Dowd
Journal: BMJ (2015)

Efforts to improve public health through encouraging physical exercise and looking at diet are being affected by cuts to local government funding, public health leaders have told MPs.

At an evidence session on 10 February for the parliamentary Health Committee’s inquiry into the effects of physical activity and diet on health, witnesses said that directors of public health had to be “crafty” with their resources.

MPs asked witnesses representing directors of public health whether their budgets were sufficient for what they wanted to achieve and whether their finances were constrained.

Dagmar Zeuner, director of public health for the London Borough of Richmond upon Thames, giving evidence, said, “We have been very crafty with rather humble money. The …
Regression of Experimental Medulloblastoma following Transfer of HER2-Specific T Cells
Authors: Nabil Ahmed, Maheshika Ratnayake, Barbara Savoldo, Laszlo Perlaky, Gianpietro Dotti, Winfried S. Wels, Meenakshi B. Bhattacharjee, Richard J. Gilbertson, H. David Shine, Heidi L. Weiss, Cliona M. Rooney, Helen E. Heslop, Stephen Gottschalk
Journal: Cancer Research (2007)

Abstract Medulloblastoma is a common malignant brain tumor of childhood. Human epidermal growth factor receptor 2 (HER2) is expressed by 40% of medulloblastomas and is a risk factor for poor outcome with current aggressive multimodal therapy. In contrast to breast cancer, HER2 is expressed only at low levels in medulloblastomas, rendering monoclonal antibodies ineffective. We determined if T cells grafted with a HER2-specific chimeric antigen receptor (CAR; HER2-specific T cells) recognized and killed HER2-positive medulloblastomas. Ex vivo, stimulation of HER2-specific T cells with HER2-positive medulloblastomas resulted in T-cell proliferation and secretion of IFN-γ and interleukin 2 (IL-2) in a HER2-dependent manner. HER2-specific T cells killed autologous HER2-positive primary medulloblastoma cells and medulloblastoma cell lines in cytotoxicity assays, whereas HER2-negative tumor cells were not killed. No functional difference was observed between HER2-specific T cells generated from medulloblastoma patients and healthy donors. In vivo, the adoptive transfer of HER2-specific T cells resulted in sustained regression of established medulloblastomas in an orthotopic, xenogenic severe combined immunodeficiency model. In contrast, delivery of nontransduced T cells did not change the tumor growth pattern. Adoptive transfer of HER2-specific T cells may represent a promising immunotherapeutic approach for medulloblastoma. [Cancer Res 2007;67(12):5957–64]
Selective Atrial Vagal Denervation Guided by Evoked Vagal Reflex to Treat Patients With Paroxysmal Atrial Fibrillation
Authors: Mauricio Scanavacca, Cristiano F. Pisani, Denise Hachul, Sissy Lara, Carina Hardy, Francisco Darrieux, Ivani Trombetta, Carlos Eduardo Negrão, Eduardo Sosa
Journal: Circulation (2006)

Background— The aim of this study was to evaluate whether selective radiofrequency (RF) catheter ablation of the atrial sites in which high-frequency stimulation induces vagal reflexes prevents paroxysmal atrial fibrillation (AF). Methods and Results— Ten patients with episodes suggestive of vagal-induced paroxysmal AF and no heart disease were selected for percutaneous epicardial and endocardial mapping of the atria to search for sites in which high-frequency transcatheter stimulation (20 Hz,) induced vagal reflexes. A vagal response defined as AV block of &gt;2 seconds was elicited in 7 of 10 patients (70%) with an average of 5±2.4 (range, 2 to 9) sites per patient, and RF pulses (21.0±12.0 per patient) were applied at those sites to eliminate all evoked vagal reflexes. The 3 patients in whom evoked vagal reflexes were not obtained underwent circumferential pulmonary vein ablation with an average of 58.0±13.9 RF pulses per patient ( P =0.022). Autonomic evaluation was performed before and 48 hours and 3 months after the procedure and was consistent with vagal withdrawal in all patients. Two of the 7 patients who underwent denervation remained asymptomatic without the use of antiarrhythmic medication at a mean follow-up of 8.3±2.8 months (range, 5 to 15 months); 4 had frequent recurrences and were referred for circumferential pulmonary vein ablation; and 1 had few AF episodes without antiarrhythmic medication. The 3 patients without evoked vagal reflexes who underwent circumferential pulmonary vein ablation remained asymptomatic without antiarrhythmic medication. One patient had acute delayed gastric emptying after atrial vagal denervation. Conclusions— RF catheter ablation of selected atrial sites in which high-frequency stimulation induced vagal reflexes may prevent AF recurrences in selected patients with apparently vagal-induced paroxysmal AF.
Cloning of rodent megsin revealed its up-regulation in mesangioproliferative nephritis
Authors: Masaomi Nangaku, Toshio Miyata, Daisuke Suzuki, Tomoya Umezono, Tsutomu Hashimoto, Takehiko Wada, Mikio Yagi, Nobuo Nagano, Reiko Inagi, Kiyoshi Kurokawa
Journal: Kidney International (2001)
Integration of Molecular Profiling into the Lung Cancer Clinic
Authors: William Pao, Mark G. Kris, A. John Iafrate, Marc Ladanyi, Pasi A. Jänne, Ignacio I. Wistuba, Ryn Miake-Lye, Roy S. Herbst, David P. Carbone, Bruce E. Johnson, Thomas J. Lynch
Journal: Clinical Cancer Research (2009)

Individuals from five thoracic oncology centers in the United States recently met to discuss how to integrate molecular profiling into the care of all patients with carcinoma of the lung. Lung cancer is an area of medical oncology in which clinicians are beginning to use specific tumor-associated molecular aberrations to assign and/or prioritize targeted therapies for patients. At this early stage, multiple hurdles remain before molecular profiling becomes a routine part of thoracic oncology practice. Concrete collaborative next steps were discussed that could help lead to standardized methods across institutions. In particular, to develop specific targeted therapies for patients whose tumors harbor rare mutations, it will be important for multiple institutions to work together to identify appropriate candidates, design the appropriate trials, and execute the trials with adequate numbers to achieve the necessary end points. Implementation will facilitate realization of the promise of molecularly tailored therapy, which could lead to more effective treatments with fewer side effects.
Nuclear p21-Activated Kinase 1 in Breast Cancer Packs Off Tamoxifen Sensitivity
Authors: Suresh K. Rayala, Poonam R. Molli, Rakesh Kumar
Journal: Cancer Research (2006)

Abstract There is significant clinical interest in the factors that influence the development of tamoxifen resistance in estrogen receptor-α (ER-α)–positive breast cancers. Recent studies suggest that in ER-positive breast tumor cells, elevated protein levels, and in particular, nuclear localization of p21-activated kinase 1 (PAK1), is associated with the progressive limitation of tamoxifen sensitivity. These phenotypic effects of PAK1 in model systems are mechanistically linked with the ability of PAK1 to phosphorylate ER-α on serine 305 and subsequent secondary activation of serine 118. These findings prompt further investigation of how nuclear signaling by PAK1 may affect estrogen's action and whether tamoxifen resistance might be prevented or reversed by PAK1 inhibition. (Cancer Res 2006; 66(12): 5985-8)
56 THE PROPHYLACTIVE EFFECT OF MILD HYPOTHERMIA TO PREVENT BRAIN EDEMA IN PATIENTS WITH ACUTE LIVER FAILURE: RESULTS OF A MULTICENTER RANDOMIZED, CONTROLLED TRIAL
Authors: F.S. Larsen, N. Murphy, W. Bernal, P.N. Bjerring, J. Hauerberg, J. Wendon
Journal: Journal of Hepatology (2011)
A Rare Truncating BRCA2 Variant and Genetic Susceptibility to Upper Aerodigestive Tract Cancer
Authors: Manon Delahaye-Sourdeix, Devasena Anantharaman, Maria N. Timofeeva, Valérie Gaborieau, Amélie Chabrier, Maxime P. Vallée, Pagona Lagiou, Ivana Holcátová, Lorenzo Richiardi, Kristina Kjaerheim, Antonio Agudo, Xavier Castellsagué, Tatiana V. Macfarlane, Luigi Barzan, Cristina Canova, Nalin S. Thakker, David I. Conway, Ariana Znaor, Claire M. Healy, Wolfgang Ahrens, David Zaridze, Neonilia Szeszenia-Dabrowska, Jolanta Lissowska, Eleonora Fabianova, Ioan Nicolae Mates, Vladimir Bencko, Lenka Foretova, Vladimir Janout, Maria Paula Curado, Sergio Koifman, Ana Menezes, Victor Wünsch-Filho, José Eluf-Neto, Paolo Boffetta, Leticia Fernández Garrote, Jerry Polesel, Marcin Lener, Ewa Jaworowska, Jan Lubiński, Stefania Boccia, Thangarajan Rajkumar, Tanuja A. Samant, Manoj B. Mahimkar, Keitaro Matsuo, Silvia Franceschi, Graham Byrnes, Paul Brennan, James D. McKay
Journal: JNCI Journal of the National Cancer Institute (2015)

Deleterious BRCA2 genetic variants markedly increase risk of developing breast cancer. A rare truncating BRCA2 genetic variant, rs11571833 (K3326X), has been associated with a 2.5-fold risk of lung squamous cell carcinoma but only a modest 26% increase in breast cancer risk. We analyzed the association between BRCA2 SNP rs11571833 and upper aerodigestive tract (UADT) cancer risk with multivariable unconditional logistic regression adjusted by sex and combinations of study and country for 5942 UADT squamous cell carcinoma case patients and 8086 control patients from nine different studies. All statistical tests were two-sided. rs11571833 was associated with UADT cancers (odds ratio = 2.53, 95% confidence interval = 1.89 to 3.38, P = 3x10-10) and was present in European, Latin American, and Indian populations but extremely rare in Japanese populations. The association appeared more apparent in smokers (current or former) compared with never smokers (Phet = .026). A robust association between a truncating BRCA2 variant and UADT cancer risk suggests that treatment strategies orientated towards BRCA2 mutations may warrant further investigation in UADT tumors.