tbuckley/cabot-search huggingface dataset:
Projected Valve Area at Normal Flow Rate Improves the Assessment of Stenosis Severity in Patients With Low-Flow, Low-Gradient Aortic Stenosis
Authors: Claudia Blais, Ian G. Burwash, Gerald Mundigler, Jean G. Dumesnil, Nicole Loho, Florian Rader, Helmut Baumgartner, Rob S. Beanlands, Boris Chayer, Lyes Kadem, Damien Garcia, Louis-Gilles Durand, Philippe Pibarot
Journal: Circulation (2006)

We sought to investigate the use of a new parameter, the projected effective orifice area (EOAproj) at normal transvalvular flow rate (250 mL/s), to better differentiate between truly severe (TS) and pseudo-severe (PS) aortic stenosis (AS) during dobutamine stress echocardiography (DSE). Changes in various parameters of stenosis severity have been used to differentiate between TS and PS AS during DSE. However, the magnitude of these changes lacks standardization because they are dependent on the variable magnitude of the transvalvular flow change occurring during DSE.The use of EOAproj to differentiate TS from PS AS was investigated in an in vitro model and in 23 patients with low-flow AS (indexed EOA <0.6 cm2/m2, left ventricular ejection fraction < or =40%) undergoing DSE and subsequent aortic valve replacement. For an individual valve, EOA was plotted against transvalvular flow (Q) at each dobutamine stage, and valve compliance (VC) was derived as the slope of the regression line fitted to the EOA versus Q plot; EOAproj was calculated as EOAproj=EOArest+VCx(250-Q(rest)), where EOArest and Q(rest) are the EOA and Q at rest. Classification between TS and PS was based on either response to flow increase (in vitro) or visual inspection at surgery (in vivo). EOAproj was the most accurate parameter in differentiating between TS and PS both in vitro and in vivo. In vivo, 15 of 23 patients (65%) had TS and 8 of 23 (35%) had PS. The percentage of correct classification was 83% for EOAproj and 91% for indexed EOAproj compared with percentages of 61% to 74% for the other echocardiographic parameters usually used for this purpose.EOAproj provides a standardized evaluation of AS severity with DSE and improves the diagnostic accuracy for distinguishing TS and PS AS in patients with low-flow, low-gradient AS.
Cystic fibrosis, Duchenne muscular dystrophy and preimplantation genetic disorders
Authors: J Liu
Journal: Human Reproduction Update (1996)

Cystic fibrosis (CF) is the most common genetic disease among Caucasians. Duchenne muscular dystrophy (DMD) is one of the most common X-linked genetic disorders. The CF and DMD genes were discovered a few years ago, which provided the possibility for prenatal diagnosis and preimplantation diagnosis of CF and DMD by using specific DNA analysis. In this article, CF, DMD, the process of the identification of the genes of CF and DMD and preimplantation genetic diagnosis are briefly described.
Disseminated tumor cells and the risk of locoregional recurrence in nonmetastatic breast cancer
Authors: F.-C. Bidard, Y.M. Kirova, A. Vincent-Salomon, S. Alran, Y. de Rycke, B. Sigal-Zafrani, X. Sastre-Garau, L. Mignot, A. Fourquet, J.-Y. Pierga
Journal: Annals of Oncology (2009)
Severe deep white matter lesions and outcome in elderly patients with major depressive disorder: follow up study
Authors: J. O'Brien, D. Ames, E. Chiu, I. Schweitzer, P. Desmond, B. Tress
Journal: BMJ (1998)

<h3>Abstract</h3> <b>Objective</b> To determine the difference in outcome among elderly people with major depression who do and do not have severe white matter lesions on magnetic resonance imaging. <b>Design</b> Follow up study. <b>Setting</b> Two psychiatric and two general hospitals in Melbourne, Australia. <b>Subjects</b> 60 depressed subjects aged over 55 referred to hospital psychiatric services with major depressive disorder meeting American Psychiatric Association (DSM-IIIR) criteria. <b>Main outcome measure</b> Proportion with good outcome as determined by full recovery from initial illness and no evidence of depressive relapse or cognitive decline during follow up among those with and without lesions. <b>Results</b> Mean (SD) follow up was 31.9 (9.9) months. Survival analysis showed a significant effect of severe lesions on time to poor outcome (P=0.04), with median survival 136 days in those with severe lesions compared with 315 days in those without. <b>Conclusion</b> Severe white matter change on magnetic resonance imaging is associated with poor outcome in elderly depressed subjects. <h3>Key messages</h3> Severe deep white matter lesions on magnetic resonance imaging are common in elderly patients with depression Patients with these lesions are at greater risk of poor long term outcome (chronicity and relapse) than those without lesions The neuropathogical and neurochemical correlates of these white matter changes need investigation
Joint hypermobility leading to osteoarthrosis and chondrocalcinosis.
Authors: H A Bird, C R Tribe, P A Bacon
Journal: Annals of the Rheumatic Diseases (1978)

We have reviewed 21 adults referred to rheumatology clinic and considered to have generalised joint hypermobility by the criteria of Carter and Wilkinson (1964), modified by Beighton et al. (1973). They fell into two categories. 5 patients had a raised plasma viscosity (PV) and in each case a definite pathology was found to account for this, superimposed on hypermobile joints. The remaining 16 had a normal PV and this group was thought to represent the late natural history of hypermobility. 5 of these (aged 32 to 54 years) had no evidence of osteoarthrosis but the remaining 11 (aged 34 to 80 years) had widespread radiological osteoarthrosis. Synovial histology was obtained at arthroscopy in 6 of these patients and 4 (aged 60 to 75) had chondrocalcinosis. This previously undescribed finding may be the end result of hypermobile joints. Hypermobile patients with joint deformity (lax connective tissue), widespread synovial thickening (traumatic), and hot joint effusions (chondrocalcinosis) may mimic rheumatoid arthritis. They must be distinguished from patients who develop rheumatoid arthritis in hypermobile joints.
PTU-032 Two Week Rule Referrals For Upper Gi Cancer: Right Patients, Wrong Test?
Authors: J Raker, G Sadler
Journal: Gut (2014)

<h3>Introduction</h3> Patients with alarm symptoms for upper gastrointestinal (GI) cancer or those over 55 years with persistent, recent onset dyspepsia are referred for a specialist opinion under the two week rule (TWR) referral pathway. Referrals are vetted by two consultants, and in the majority of cases patients are sent directly for upper GI endoscopy (OGD). The incidence of gastric cancer in patients undergoing TWR endoscopy is around 4%.<sup>1</sup> Alarm symptoms have very variable specificity and sensitivity for upper GI cancer.<sup>2</sup> This study aimed to analyse outcomes for both patients triaged direct to OGD and direct to clinic. <h3>Methods</h3> A prospective analysis of patients referred to a single centre in South London (St George’s Hospital) under the TWR pathway for upper gastrointestinal cancer was performed. Patients referred during two random four week periods in 2012 were identified. The referral form, endoscopy records, clinic letters, radiology reports and histology results were reviewed. <h3>Results</h3> Data were analysed for 114 patients. Mean age was 63 years, with 23% of referrals aged under 55 years. 96 (84%) patients went direct to OGD, of which 3 (3%) had upper GI cancer and 4(4%) had significant non-malignant pathology. In the 27 (28%) patients under 55, no significant pathology was identified at OGD. Dyspepsia, dysphagia and weight loss were the commonest indications for the referrals. 47 (49%) patients had further imaging after endoscopy of which 18 (38%) had significant pathology leading to a change in management. 18 (16%) were seen directly in clinic following referral of which 11 (61%) went on to have further imaging. Of these patients, 45% had malignancy and 35% had significant abnormalities leading to a change in management. <h3>Conclusion</h3> The yield of pathology at OGD undertaken as a first line investigation in patients referred via the TWR pathway is low, regardless of the referral criteria. However, imaging modalities appear to have a reasonably high yield of pathology in this group of patients. This suggests that General Practitioners are identifying the correct group of patients for referral, but that perhaps OGD is not the most appropriate first line test. Clinical review, as a first point of contact of patients referred via the TWR pathway, is likely to facilitate a more guided investigation process, while reducing the number of endoscopies being undertaken, and has potential cost-saving implications. <h3>References</h3> <i>Gut</i> 2005;54(1):40–5 <i>Gastroenterology</i> 2006;131(2):390–401 <h3>Disclosure of Interest</h3> None Declared.
Cardiomegaly and heart failure in a patient with prolactin-secreting pituitary tumour.
Authors: G Curtarelli, C Ferrari
Journal: Thorax (1979)

Unexplained cardiomegaly with cardiac failure was observed in a 42-year-old woman in whom a pituitary tumour had been treated by radiotherapy five years previously. She had been amenorrhoeic for 10 years. Thyroid and adrenal function was normal. Despite treatment with digitalis and diuretic, her cardiac disease progressed until she died suddenly at the age of 45. Hyperprolactinaemia was evident some weeks before death, her serum concentration of 68 ng/ml being well above both the reported normal range (2--20 ng/ml) and the concentrations in eight female controls being treated for severe cardiac failure (5--25 ng/ml). Although the association of these two disorders might merely represent coincidence, heart disease with similar features is common in acromegaly and does not correlate with plasma growth hormone concentration. Since prolactin is known to exert metabolic growth hormone-like effects in animals and in man, the possibility should be considered that prolactin hypersecretion might induce or maintain cardiac disease in some patients with pituitary tumours. A preliminary survey of 35 subjects with hyperprolactinaemia has shown five with raised blood pressure and four, two of whom were normotensive, with cardiomegaly on chest radiography.
Does brain tumor histology influence cognitive function?
Authors: Anne E. Kayl, Christina A. Meyers
Journal: Neuro-Oncology (2003)

This retrospective study investigated the relationship between tumor histology and postsurgical cognitive function in patients diagnosed with malignant brain tumors.The neuropsychological functioning of 24 adult patients diagnosed with glioblastoma multiforme (GBM) was compared with the neuropsychological functioning of 24 adult patients diagnosed with anaplastic astrocytoma (AA).The groups were matched with respect to patient age, gender, and education, as well as tumor location and tumor volume.The mean raw test scores of the AA patient group were superior to the mean scores of the GBM patient group on nearly all measures administered.However, significant performance differences were not detected for any of 5 neuropsychological domain scores (Intellectual, Language, Memory, Executive, and Motor Function).Analysis of covariance (ANCOVA) revealed that tumor histology was not a significant predictor of domain score after controlling for tumor volume.Multiple regression and correlation analyses supported the results of the ANCOVA by offering further evidence of weak relationships between tumor type, tumor volume, and neuropsychological test scores.We conclude that tumor histology is not clearly predictive of cognitive performance in adults with AA and GBM.
The origin and antigen-dependent distribution of IgA-containing cells in the intestine.
Authors: A J Husband, J L Gowans
Journal: The Journal of Experimental Medicine (1978)

The aims of this paper were to establish the origin of cells producing IgA antibody to cholera toxoid in the lamina propria of the small intestine and to define the role of antigen in their distribution. The use of Thirty-Vella loops made it possible to restrict antigenic challenge to a defined segment of the intestine in rats which had been primed i.p. with toxoid in Freund's complete adjuvant. The anti-toxin-containing cells (ACC) which appeared in the draining thoracic duct lymph after challenge of a loop were almost all of IgA specificity and their numbers were proportional to the length of intestine exposed to antigen. The abolition of this cellular response which occurred when Peyer's patches (PP) were removed from a loop before challenge and the failure of mesenteric lymphadenectomy significantly to affect the response indicated that ACC originated exclusively from PP. Cell transfer studies showed that although nonrecirculating large lymphocytes gave rise to ACC in the lamina propria, some of the recirculating small lymphocytes also developed subsequently into ACC. Counts of ACC in the lamina propria of challenged loops were consistently greater than in nonchallenged loops although some ACC were always present in the latter. However, a time-course study on the appearance of ACC in the lamina propria of cannulated rats given a single dose of thoracic duct lymphocytes from immunized donors demonstrated that ACC continued to accumulate and persist in challenged loops but only appeared transiently in nonchallenged loops. These transients did not migrate from the lamina propria back into the lymph and they presumably died in situ. The increase in the number of ACC in loops which had been challenged with antigen was probably due both to cell division in the lamina propria and to the development of new ACC from recirculating lymphocytes which had been recruited into the loop. Thus, the cells which give rise to intestinal ACC can migrate into the lamina propria independently of antigen, but antigen has a profound effect on the location, magnitude, and persistence of the response.
Detection of obstructive sleep apnoea by an electronic nose
Authors: Timm Greulich, Akira Hattesohl, Antje Grabisch, Janine Koepke, Severin Schmid, Sarah Noeske, Christoph Nell, Marion Wencker, Rudolf A. Jörres, Claus Franz Vogelmeier, Ulrich Köhler, Andreas Rembert Koczulla
Journal: European Respiratory Journal (2012)

Diagnosis of obstructive sleep apnoea syndrome (OSAS) is technically demanding, cost-intensive and time-consuming. The measurement of volatile organic compounds by an electronic nose is an innovative method that determines distinct molecular patterns of exhaled breath in different patient groups. We addressed the following questions: What is the diagnostic accuracy of an electronic nose in the detection of OSAS and the ability to detect effects of standard therapy in patients with OSAS? Are these results related to changes in distinct markers of airway inflammation and extracellular remodelling? We included 40 OSAS patients and 20 healthy controls. Exhaled breath of all participants was analysed using the Cyranose 320 electronic nose. Pharyngeal washings were performed to sample the upper airway compartment. For statistical analysis linear discriminant analysis was employed. We identified a linear discriminant function separating OSAS from control (p&lt;0.0001). The corresponding area under the receiver-operating curve was 0.85 (95% CI 0.75–0.96; sensitivity 0.93 and specificity 0.7). In pharyngeal washing fluids of OSAS patients, we observed higher levels of α 1 -antitrypsin and markers of extracellular remodelling compared to controls. The electronic nose can distinguish between OSAS patients and controls with high accuracy.
Cutaneous Blood Flow in Type 2 Diabetic Individuals After an Acute Bout of Maximal Exercise
Authors: Sheri R. Colberg, Henri K. Parson, D. Robb Holton, Tanja Nunnold, Aaron I. Vinik
Journal: Diabetes Care (2003)

OBJECTIVE—We previously demonstrated a positive association between chronic aerobic exercise and dorsal foot skin blood flow during local heating in type 2 diabetic individuals. Thus, we hypothesized that a prior acute bout of maximal exercise would also have positive effects on postexercise blood flow. RESEARCH DESIGN AND METHODS—Subjects consisted of 32 individuals with type 2 diabetes and 26 nondiabetic control subjects further subdivided based on their physical activity status: diabetic exerciser (DE), diabetic sedentary (DS), control exerciser (CE), or control sedentary. Dorsal foot cutaneous blood flow was measured noninvasively by continuous laser-Doppler assessment at baseline and during local heating to 44°C before and after a maximal bout of cycle exercise. Interstitial nitric oxide (NO) levels were measured concurrently in the foot dorsum. RESULTS—Increases in blood flow and its responsiveness to local heating to 44°C were significantly lower in both diabetic groups compared with CE before maximal exercise, but perfusion responsiveness remained lower in DS subjects only after exercise (P &amp;lt; 0.05). Baseline skin blood flow was not different among groups preexercise, but it was significantly increased postexercise in DE subjects only. Interstitial NO levels were not significantly different at either time. At baseline, groups differed only in HbA1c, fasting serum glucose, HDL cholesterol, and insulin resistance (homeostasis model assessment method). CONCLUSIONS—All diabetic individuals exhibit a blunted responsiveness of cutaneous blood flow with local heating to 44°C before maximal exercise compared with active nondiabetic individuals, but after an exercise bout, it remains significantly blunted only in diabetic individuals who are sedentary. These findings occur independently of changes in interstitial NO levels.
Returning to the golden age of boxing
Authors: Paul McCrory, Éanna Falvey, Michael Turner
Journal: British Journal of Sports Medicine (2012)

Whether we agree or disagree with boxing as a sport, it remains a popular participation sport worldwide. The safety of participants, both in the short- and long-term creates strong opinions on both sides of the debate and calls to ban the sport continue. Published systematic reviews have thoroughly reviewed the scientific evidence for the health effects of boxing participation and found no strong evidence for an association between amateur boxing and chronic traumatic brain injury1 whereas a small but significant proportion of professional boxers appear to suffer from this problem.2 The cause for these changes are complex.

Amateur boxing is a different sport from professional boxing for a number of reasons, including in the motivation to participate, different rules and equipment, but, most importantly, there is greater injury exposure in professional boxers (longer bouts, greater boxing experience, increased sparring, smaller and lighter gloves, greater scoring reward for punches that visibly hurt an opponent, longer careers often after an amateur career). A knockout is a rare event in amateur boxing for example, world amateur championships 2001 – 6 knockouts in a total of 366 bouts. Highlighting these differences are studies showing that a single punch from a professional heavyweight boxing champion can deliver an impact force of up to 6320 N (0.63 ton).3 For comparison, an equivalent blow would be delivered by a padded wooden mallet with a mass of 6 kg (13 lbs) if swung …
A Study of Mitral Valve Action Recorded by Reflected Ultrasound and Its Application in the Diagnosis of Mitral Stenosis
Authors: ADIB ZAKY, WILLIAM K. NASSER, HARVEY FEIGENBAUM
Journal: Circulation (1968)

The movements of two ultrasound echo signals, believed to arise from the anterior mitral leaflet and from the mitral ring, were studied in 30 normal subjects and in 100 heart-catheterization patients. Fifty patients had proven mitral stenosis. The echo from the anterior mitral leaflet is shown to have a complex pattern of movement. This pattern is analyzed into the opening and closing movements of the leaflet, and the underlying movement transmitted from the mitral ring. In the normal condition, the characteristic feature of leaflet motion is a sharp closing movement that follows the initial opening in diastole. This sharp closing movement is not seen in the presence of mitral stenosis. It is believed that the demonstration of a sustained wide-open poisition of the leaflet in diastole has the same diagnostic significance as the finding of a persistent positive-pressure gradient across the valve. The value of this method in diagnosing the severity of the stenosis is discussed.
Second ESMO consensus conference on lung cancer: pathology and molecular biomarkers for non-small-cell lung cancer
Authors: K.M. Kerr, L. Bubendorf, M.J. Edelman, A. Marchetti, T. Mok, S. Novello, K. O'Byrne, R. Stahel, S. Peters, E. Felip, Rolf Stahel, Enriqueta Felip, Solange Peters, Keith Kerr, Benjamin Besse, Johan Vansteenkiste, Wilfried Eberhardt, Martin Edelman, Tony Mok, Ken O'Byrne, Silvia Novello, Lukas Bubendorf, Antonio Marchetti, Paul Baas, Martin Reck, Konstantinos Syrigos, Luis Paz-Ares, Egbert F. Smit, Peter Meldgaard, Alex Adjei, Marianne Nicolson, Lucio Crinò, Paul Van Schil, Suresh Senan, Corinne Faivre-Finn, Gaetano Rocco, Giulia Veronesi, Jean-Yves Douillard, Eric Lim, Christophe Dooms, Walter Weder, Dirk De Ruysscher, Cecile Le Pechoux, Paul De Leyn, Virginie Westeel
Journal: Annals of Oncology (2014)
Genomic Profiling of Cancer: What Next?
Authors: Paul Workman, Patrick G. Johnston
Journal: Journal of Clinical Oncology (2005)

During the last decade, the development of a number of high-throughput genomic technologies has begun to have significant implications for both clinical and basic research in cancer. The ability to obtain gene expression profiles or genetic fingerprints at a genome-wide level has begun to have an impact on the diagnosis and prognostic classification of tumors, as well as on the prediction of response of individual patients to specific chemotherapeutic regimes. In addition, the identification of novel tumor targets that can be exploited therapeutically has also become a reality. Advances in genomic technologies such as gene expression microarrays, high-throughput sequencing, and molecular and functional imaging approaches such as magnetic resonance spectroscopy and imaging and positron emission tomography have facilitated the integration of genomic and functional data to allow better understanding of the molecular biology of a given disease and to facilitate clinical decision making. These powerful technologies are being used to study many biologic and clinical processes and have provided important insights in areas such as cancer pathogenesis, cancer diagnosis, pharmacogenetics and prediction of clinical outcome, as well as the development of novel targeted therapeutics. This potential is exemplified by the studies presented in this issue of the Journal of Clinical Oncology, which examine genomic expression signatures and specific patterns of loss of heterozygosity (LOH) and polymorphisms in growth factor receptors as important clues to the pathogenesis of disease or as potential genomic signatures for prognosis or prediction of outcome to therapy. They highlight the potential to exploit our understanding of tumor biology at the genetic and molecular level to improve cancer treatment and illustrate the biggest challenge of modern biology and medicine: to understand the ‘‘software and hardware’’ of the cancer cell and the cancer patient in comparison with the nondiseased state. For the clinician, the appropriate diagnosis and classification of cancer is of key importance for the selection of the most appropriate treatment or for defining patient prognosis. During the last 50 years, we have depended on the anatomic and morphologic classification of tumors and have treated patients accordingly. However, the application of modern genomic technology is revealing a new genetic taxonomy that has begun to facilitate the reclassification of cancers based on a molecular signature. Many tumors that until now appeared indistinguishable at the morphologic level are molecularly very distinct, and such molecular distinction may be helpful when applied to pa