tbuckley/cabot-search huggingface dataset:
Outpatient pulmonary rehabilitation following acute exacerbations of COPD
Authors: J. M. Seymour, L. Moore, C. J. Jolley, K. Ward, J. Creasey, J. S. Steier, B. Yung, W. D. C. Man, N. Hart, M. I. Polkey, J. Moxham
Journal: Thorax (2010)

BACKGROUND Exacerbations of chronic obstructive pulmonary disease (COPD) are characterised by increased dyspnoea, reduced quality of life and muscle weakness. Re-exacerbation and hospital admission are common. Pulmonary rehabilitation (PR) administered after hospital admission for an exacerbation can improve quality of life and exercise capacity. OBJECTIVE To determine whether outpatient post-exacerbation PR (PEPR) could reduce subsequent hospital admission episodes. METHODS Patients admitted to hospital for an exacerbation of COPD were randomised to receive either usual follow-up care (UC) or PEPR after discharge. Hospital admission and emergency department attendances for COPD exacerbations were recorded over a 3-month period and analysed on an intention-to-treat basis. Secondary outcomes included exercise capacity and quadriceps strength. RESULTS 60 patients underwent concealed randomisation at the time of their hospital discharge (UC: n=30, mean (SD) age 65 (10) years, forced expiratory volume in 1 s (FEV(1)) 52 (22)% predicted; PEPR: n=30, 67(10) years, 52 (20)% predicted). The proportion of patients re-admitted to hospital with an exacerbation was 33% in the UC group compared with 7% in those receiving PEPR (OR 0.15, 95% CI 0.03 to 0.72, p=0.02). The proportion of patients that experienced an exacerbation resulting in an unplanned hospital attendance (either admission or review and discharge from the emergency department) was 57% in the UC group and 27% in those receiving PEPR (OR 0.28, 95% CI 0.10 to 0.82, p=0.02). CONCLUSIONS Post-exacerbation rehabilitation in COPD can reduce re-exacerbation events that require admission or hospital attendance over a 3-month period. Clinical Trials Registration Number NCT00557115.
Phylogeographic Congruence Between mtDNA and rDNA ITS Markers in Brown Trout
Authors: P. Presa, B. G. Pardo, Paulino Martínez, L. Bernatchez
Journal: Molecular Biology and Evolution (2002)

Variation in the internal transcribed spacer (ITS) of rDNA was examined throughout the range of the brown trout (Salmo trutta) to analyze the usefulness of this molecular marker for phylogeographic analysis. The results were compared with those previously obtained with mtDNA, a region exhaustively analyzed along the brown trout distribution. ITS2 was essentially conserved at all populations sampled, no informative characters being detected across the main lineages described in this species. Conversely, ITS1 showed a greater homogenization than other genetic markers at a microgeographic scale, with variation partitioning into several major phylogenetic groups. Phylogeographic patterns were partially congruent between both ITS1 and mtDNA. The main discrepancies were the detection of intra-individual variation and putative recombinant ITS1 sequences in hybridization areas between genetically different, yet historically overlapping, assemblages. Also, the existence of an ancient ITS1 sequence in the Mediterranean-southeastern area (rMEDA), not revealed by mtDNA analysis, was evidenced after rDNA ITS1 analysis.
New Technology for Noninvasive Evaluation of Coronary Artery Disease
Authors: Marcelo F. Di Carli, Rory Hachamovitch
Journal: Circulation (2007)

C ardiac computed tomography (CT) and positron emis- sion tomography (PET) are emerging as powerful noninvasive imaging tools for the evaluation of atherosclerosis in patients with known or suspected coronary artery disease (CAD).Unlike invasive coronary angiography, CT coronary angiography (CTA) not only assesses disease within the coronary lumen but can also provide direct qualitative and quantitative information about nonobstructive atherosclerotic plaque burden within the vessel wall.Thus, it is possible that CTA-based patient evaluation may provide more clinically relevant information on which to base risk assessments compared with conventional "lumenography."On the other hand, PET is rapidly growing as a powerful and efficient alternative to conventional single-photon emission CT (SPECT) imaging to evaluate regional myocardial perfusion and metabolism in patients with CAD.In addition, PET scanners are now being converted to hybrid PET/CT devices, which, in the setting of CAD, offer the potential for a comprehensive noninvasive cardiac evaluation of anatomy and function.This review will discuss current and potential future applications of cardiovascular CT, PET, and hybrid PET/CT, with a particular focus on ischemic heart disease.
Platelets Activated by Collagen Through Immunoreceptor Tyrosine-Based Activation Motif Play Pivotal Role in Initiation and Generation of Neointimal Hyperplasia After Vascular Injury
Authors: Hakuoh Konishi, Youichi Katoh, Norihide Takaya, Yuji Kashiwakura, Seigo Itoh, Chisei Ra, Hiroyuki Daida
Journal: Circulation (2002)

Platelet adhesion on components of the extracellular matrix and platelet activation by those components are crucial for the arrest of posttraumatic bleeding, but they can also harm tissue by occluding diseased vessels. Recent studies have shown that the activation of platelets by collagen is mediated through the same pathway used by immune receptors, with an immunoreceptor tyrosine-based activation motif on the Fc receptor gamma chain (FcRgamma) playing a pivotal role.We examined the role of collagen-stimulated platelets in the development of injury-induced neointimal formation by using mice deficient in FcRgamma. The left femoral arteries of 8- to 12-week-old FcRgamma-deficient mice (n=16) and C57BL/6 (wild-type) mice (n=16) were injured by a straight spring wire (0.35-mm diameter). Segments of the injured and uninjured femoral arteries were excised at 7 days and 28 days after the vascular injury. Arterial segments were examined by immunohistochemistry and electron microscopy. Two hours after injury, electron microscopy showed marked decreases in platelet adhesion and neutrophil attachment to the vascular wall surface in FcRgamma-knockout mice compared with wild-type mice. At 7 days after injury, staining with anti-neutrophil antibody showed fewer neutrophils in FcRgamma-knockout mice than in wild-type mice. Computer-aided morphometry performed to measure the neointimal area, intima/media ratio, and stenotic area at 28 days after injury showed a significantly smaller ratio and area in FcRgamma-knockout mice than in wild-type mice (for neointimal area, 16 635 +/- 1406 versus 31 483 +/- 2309 microm2, respectively; for intima/media ratio, 1.25 +/- 0.40 versus 2.68 +/- 0.04, respectively; and for stenotic area, 26.8 +/- 2.1% versus 49.3 +/- 4.1%, respectively).These results demonstrate that FcRgamma may play important roles in the initiation and generation of neointimal hyperplasia after balloon injury through the activation of platelets by collagen.
Samuel Harold Swann Love
Authors: G. Black
Journal: BMJ (2011)

One of the first anaesthetists to specialise solely in the management of children, Samuel Harold Swann Love (“Harold”) was a highly skilled clinician and dedicated teacher. For over 40 years he gave devoted and loyal service to the Royal Belfast Hospital for Sick Children and played an important part in the development of anaesthetic and intensive care services in the hospital and, indeed, nationally.

Harold …
Field evaluation of alternative HIV testing strategy with a rapid immunobinding assay and an agglutination assay
Authors: S.W. Mitchell, D.S. Hanson, S. Mboup, J. Mingle, D. Sambe, K. Milenge, P. Tukei, J. Nyamongo, O-K. Mubarak, J-L. Sankale, T.C. Quinn
Journal: The Lancet (1991)
Phase III Trial Assessing Bevacizumab in Stages II and III Carcinoma of the Colon: Results of NSABP Protocol C-08
Authors: Carmen J. Allegra, Greg Yothers, Michael J. O'Connell, Saima Sharif, Nicholas J. Petrelli, Linda H. Colangelo, James N. Atkins, Thomas E. Seay, Louis Fehrenbacher, Richard M. Goldberg, Seamus O'Reilly, Luis Chu, Catherine A. Azar, Samia Lopa, Norman Wolmark
Journal: Journal of Clinical Oncology (2010)

The National Surgical Adjuvant Breast and Bowel Project C-08 trial was designed to investigate the safety and efficacy of adding bevacizumab to modified FOLFOX6 (mFOLFOX6; ie, infusional/bolus fluorouracil, leucovorin, and oxaliplatin) for the adjuvant treatment of patients with stages II to III colon cancer.Patients received mFOLFOX6 every 2 weeks for 26 weeks alone or modified as FOLFOX6 + bevacizumab (5 mg/kg every 2 weeks for 52 weeks [ie, experimental group]). The primary end point was disease-free survival (DFS).Among 2,672 analyzed patients, demographic factors were well balanced by treatment. With a median follow-up of 35.6 months, the addition of bevacizumab to mFOLFOX6 did not result in an overall significant increase in DFS (hazard ratio [HR], 0.89; 95% CI, 0.76 to 1.04; P = .15). The point estimates for 3-year DFS for the overall population were 77.4% and 75.5% for the experimental and control arms, respectively. For patients with stages II and III diseases, these same estimates were 87.4% and 84.7%, respectively, for stage II and 74.2% and 72.4%, respectively, for stage III. Exploratory analyses found that the effect of bevacizumab on DFS was different before and after a 15-month landmark (time-by-treatment interaction P value < .0001). Bevacizumab had a strong effect before the landmark (HR, 0.61; 95% CI, 0.48 to 0.78; P < .001) but no significant effect after (HR, 1.22; 95% CI, 0.98 to 1.52; P = .076).Bevacizumab for 1 year with mFOLFOX6 does not significantly prolong DFS in stages II and III colon cancer. However, a significant but transient effect during bevacizumab exposure was observed in the experimental arm. We postulate that this observation reflects a biologic effect during bevacizumab exposure. Given the lack of improvement in DFS, the use of bevacizumab cannot be recommended for use in the adjuvant treatment of patients with colon cancer.
Stories about "doomsday killer bugs": the aftermath
Authors: S G Jones, J Howard
Journal: BMJ (1996)

and direct ophthalmoscopy alone are similar, but they have not fully understood the data presented or their relevance.As any screening programme must recall patients in whom findings are ungradable any attempt to measure sensitivity or specificity that ignores this will give a false picture of effectiveness.When patients with multiple pathology or ungradable findings are included in the analysis sensitivities for the detection of sight threatening eye disease are much higher for photography.Of the 45 patients found to have sight threatening eye disease on slit lamp bio- microscopy, direct ophthalmoscopy detected 30 and photography 40.We set out to compare two accepted methods of screening.We agree that slit lamp biomicroscopy by opticians may ultimately prove to be effective.Contrary to the suggestion by Hickey-Dwyer and Ellerby, we did not investigate this model.Furthermore, it should not be implemented until a detailed analysis of sensitivity and specificity is available.Optometrists have not been shown to be cost effective,' high false positive rates have been reported,2 and rates of non-attendance may be high.Peymane Adab points out correctly that findings were ungradable in 34 (11%) patients in the photography group (12 were unobtainable).This reflects a first pass effect in the identification of patients with appreciable media opacity and should fall with rescreening.Fifty three per cent of the patients in the group had cataract sufficient to interfere with screening.The rate of ungradable findings for the direct ophthalmoscopy group was lower, but this was due to a false impression of ability to grade.Comparison of the two groups showed that photography detected 10 cases missed by ophthalmoscopy (six without appreciable cataract) but that direct ophthalmoscopy detected only one case missed by photography.Ryder et al added photography to direct ophthalmoscopy to increase sensitivity.'Our data suggest that it is the photographic element alone that is important and that combined modalities may not be necessary.Finally, as R H B Grey and J C Dean Hart point out, both methods are unable to detect macular oedema in the absence of macular exudate.In our group four such cases occurred.Interestingly, recalling patients with vision worse than 6/9 in an attempt to detect macular oedema did not prove helpful.We are presently conducting a similar study incorporating a stereo-macular pair of photographs.
Oxygen uptake is slower than heart rate on-kinetics in recent myocardial infarction patients
Authors: Marlus Karsten, Laura Neves, Thomas Beltrame, Audrey Borghi-Silva, Piergiuseppe Agostoni, Aparecida Catai
Journal: European Respiratory Journal (2012)

Background: The heart rate (HR) and oxygen uptake (VO2) on-kinetics analysis provides information about the individual response to aerobic exercise, which may be reduced after recent myocardial infarction (MI), mainly due to impairment in the oxygen transport system. Design: to determine whether the HR and VO2 onset dynamics were affected by recent MI, we evaluated the VO2 and HR on-kinetics in three groups of subjects with preserved ventricular (VF) and pulmonary function (PF). Methods: Eight men (49±8 years) with a recent MI (RMI), eleven men (52±7 years) with a late MI (LMI) and ten apparently healthy men (48±9 years) (CG) underwent to PF assessment, ramp cardiopulmonary exercise test (CPX) and two constant workload exercise tests (CWETs) on treadmill at moderate and high workloads, corresponding to 75% and 125% of the gas exchange threshold identified at CPX. VO2 was registered breath-by-breath and analyzed after smoothed by moving averages of 8 respiratory cycles. HR was recorded by digital telemetry system. A monoexponencial fit was applied to analyze VO2 and HR on-transient response to the first 360 seconds of the CWETs. Intragroup and intergroup comparisons were realized (p
Effects of the Live Attenuated Measles-Mumps-Rubella Booster Vaccination on Disease Activity in Patients With Juvenile Idiopathic Arthritis
Authors: Marloes W. Heijstek, Sylvia Kamphuis, Wineke Armbrust, Joost Swart, Simone Gorter, Lara D. de Vries, Gaby P. Smits, Pieter G. van Gageldonk, Guy A. M. Berbers, Nico M. Wulffraat
Journal: JAMA (2013)

The immunogenicity and the effects of live attenuated measles-mumps-rubella (MMR) vaccination on disease activity in patients with juvenile idiopathic arthritis (JIA) are matters of concern, especially in patients treated with immunocompromising therapies.To assess whether MMR booster vaccination affects disease activity and to describe MMR booster immunogenicity in patients with JIA.Randomized, multicenter, open-label clinical equivalence trial including 137 patients with JIA aged 4 to 9 years who were recruited from 5 academic hospitals in The Netherlands between May 2008 and July 2011.Patients were randomly assigned to receive MMR booster vaccination (n=68) or no vaccination (control group; n=69). Among patients taking biologics, these treatments were discontinued at 5 times their half-lives prior to vaccination.Disease activity as measured by the Juvenile Arthritis Disease Activity Score (JADAS-27), ranging from 0 (no activity) to 57 (high activity). Disease activity in the year following randomization was compared between revaccinated patients and controls using a linear mixed model. A difference in JADAS-27 of 2.0 was the equivalence margin. Primary immunogenicity outcomes were seroprotection rates and MMR-specific antibody concentrations at 3 and 12 months.Of 137 randomized patients, 131 were analyzed in the modified intention-to-treat analysis, including 60 using methotrexate and 15 using biologics. Disease activity during complete follow-up did not differ between 63 revaccinated patients (JADAS-27, 2.8; 95% CI, 2.1-3.5) and 68 controls (JADAS-27, 2.4; 95% CI, 1.7-3.1), with a difference of 0.4 (95% CI, -0.5 to 1.2), within the equivalence margin of 2.0. At 12 months, seroprotection rates were higher in revaccinated patients vs controls (measles, 100% vs 92% [95% CI, 84%-99%]; mumps, 97% [95% CI, 95%-100%] vs 81% [95% CI, 72%-93%]; and rubella, 100% vs 94% [95% CI, 86%-100%], respectively), as were antibody concentrations against measles (1.63 vs 0.78 IU/mL; P = .03), mumps (168 vs 104 RU/mL; P = .03), and rubella (69 vs 45 IU/mL; P = .01). Methotrexate and biologics did not affect humoral responses, but low patient numbers precluded definite conclusions.Among children with JIA who had undergone primary immunization, MMR booster vaccination compared with no booster did not result in worse JIA disease activity and was immunogenic. Larger studies are needed to assess MMR effects in patients using biologic agents.clinicaltrials.gov Identifier: NCT00731965.
Postsynaptic Elevation of Calcium Induces Persistent Depression of Developing Neuromuscular Synapses
Authors: Sydney Cash, Yang Dan, Mu-ming Poo, Robert Zucker
Journal: Neuron (1996)

<h2>Abstract</h2> Synaptic activity is known to modulate neuronal connectivity in the nervous system. At developing Xenopus neuromuscular synapses in culture, repetitive postsynaptic application of ACh near the synapse leads to immediate and persistent synaptic depression, which was shown to be caused by reduction of presyaptic evoked transmitter release. However, little depression was found when ACh was applied to the muscle 20 μm or further from the synapse. Fluorescence imaging of cytosolic Ca<sup>2+</sup> ([Ca<sup>2+</sup>]<sub>i</sub>) showed that each ACh pulse induced a transient elevation of myocyte [Ca<sup>2+</sup>]<sub>i</sub> that spread approximately 20 μm. Local photoactivated release of Ca<sup>2+</sup> from the caged Ca<sup>2+</sup> chelators nitr-5 or nitrophen in the postsynaptic cell was sufficient to induce persistent synaptic depression. These results support a model in which localized Ca<sup>2+</sup> influx into the postsynaptic myocyte initiates transsynaptic retrograde modulation of presynaptic secretion mechanisms.
Haemorrhagic gastritis in a neurologically impaired boy
Authors: R Berni Canani, A G Fratellanza, E Del Giudice
Journal: Gut (2007)

A 7-year-old boy, affected by spastic quadriplegia secondary to perinatal respiratory distress, presented with a 15-day history of severe abdominal pain. Paracetamol and omeprazole brought no relief. On physical examination, the boy was in …
Reinforcing the mucus: a new therapeutic approach for ulcerative colitis?
Authors: P R Gibson
Journal: Gut (2005)

Variability in detection of MAP by PCR (0-100% in Crohn's disease and ulcerative colitis tissues) 8 and serological testing 37 (6) No evidence of mycobacterial cell wall by histochemical staining (7) No worsening of Crohn's disease with immunosuppressive agents or HIV infection (8) No documented cell mediated immune responses to MAP in patients with Crohn's disease 20 (9) No therapeutic response to traditional antimycobacterial antibiotics 23 MAP, Mycobacterium avium subspecies paratuberculosis; PCR, polymerase chain reaction; FISH, fluorescent in situ hybridisation; HIV, human immunodeficiency virus.
Differential Contribution of Three Mitogen-Activated Protein Kinases to PDGF-BB-Induced Mesangial Cell Proliferation and Gene Expression
Authors: Hitomi Kawano, Shokei Kim, Kensuke Ohta, Takafumi Nakao, Hitoshi Miyazaki, Tatsuya Nakatani, Hiroshi Iwao
Journal: Journal of the American Society of Nephrology (2003)

This study examined the role of mitogen-activated protein (MAP) kinase in PDGF-BB-induced proliferation and gene expression of human mesangial cells (MC). PDGF-BB stimulation of MC increased mRNA for transforming growth factor-beta1 (TGF-beta1), monocyte chemoattractant protein-1 (MCP-1), and plasminogen activator inhibitor-1 (PAI-1) and increased the cell numbers. To inhibit activation of extracellular signal-regulated kinase (ERK), c-Jun amino-terminal kinase (JNK), and p38, MC were infected with recombinant adenovirus containing dominant-negative mutants of ERK, JNK, and p38 (Ad-DN-ERK, Ad-DN-JNK, Ad-DN-p38, respectively), respectively. Infection of MC with Ad-DN-ERK or Ad-DN-JNK inhibited PDGF-BB-induced increase in [(3)H]thymidine incorporation and cell numbers, whereas Ad-DN-p38 did not. Ad-DN-ERK inhibited MCP-1 and PAI-1 mRNA expression in MC, but not TGF-beta1. Ad-DN-JNK and Ad-DN-p38 inhibited TGF-beta1 and MCP-1 mRNA expression, but not PAI-1. The inhibition of activator protein-1 (AP-1) in MC, by adenovirus containing dominant-negative mutant of c-Jun (Ad-DN-c-Jun), inhibited PDGF-BB-induced cell proliferation and TGF-beta1, MCP-1, and PAI-1 expressions. Furthermore, Ad-DN-JNK or Ad-DN-p38, but not Ad-DN-ERK, attenuated PDGF-BB-induced AP-1 activation in MC, indicating the involvement of JNK and p38 in AP-1 activation. Our results indicated that ERK and JNK, but not p38, participated in PDGF-BB-induced MC proliferation. PDGF-BB-induced expression of TGF-beta1 was mediated by JNK and p38, MCP-1 expression was through ERK, JNK, and p38, whereas PAI-1 expression was due to only ERK. AP-1 activation, which was partially due to JNK and p38 activations, was involved in MC proliferation and these three gene expressions. Thus, three MAP kinases seem to contribute to progression of glomerular disease via different molecular mechanisms.
Advanced Oxidation Protein Products Accelerate Renal Fibrosis in a Remnant Kidney Model
Authors: Hong Yan Li, Fan Fan Hou, Xun Zhang, Ping Yan Chen, Shang Xi Liu, Jian Xun Feng, Zhi Qiang Liu, Yue Xin Shan, Guo Bao Wang, Zhan Mei Zhou, Jian Wei Tian, Di Xie
Journal: Journal of the American Society of Nephrology (2007)

Accumulation of plasma advanced oxidation protein products (AOPP) has been found in patients with chronic kidney disease. However, the biologic consequences of AOPP consumption on progression of renal disease still are unclear. For testing of the hypothesis that AOPP accelerate progression of chronic kidney disease, Sprague-Dawley rats were subjected to five-sixths nephrectomy (5/6 Nx) or to sham operation. Rats in each group were randomly assigned in three subgroups (n = 30 in each group) and treated with repeated intravenous injections of AOPP-modified rat serum albumin (RSA), unmodified RSA, or vehicle for indicated period. Compared with RSA- or vehicle-treated 5/6 Nx rats, AOPP RSA-treated 5/6 Nx rats displayed greater proteinuria, higher serum creatinine, and lower creatinine clearance. AOPP challenge resulted in more renal hypertrophy, higher macrophage influx, and greater renal fibrosis in the remnant kidney. Chronic administration of AOPP in sham-operated rats increased urinary protein excretion and renal macrophage infiltration, but histologic renal fibrosis was not observed during the study period. AOPP treatment enhanced AOPP level in renal tissue. This was associated with marked increase of thiobarbituric acid reactive substances, decrease of glutathione peroxidase activity, and upregulated expression of monocyte chemoattractant protein-1 and TGF-beta1 in renal cortex. These data indicate that AOPP might be a new and potentially important mediator of renal fibrosis in the remnant kidney. Chronic accumulation of AOPP promotes renal fibrosis probably via a redox-sensitive inflammatory pathway.