tbuckley/cabot-search huggingface dataset:
Association of Depressed Mood and Mortality in Older Adults With and Without Cognitive Impairment in a Prospective Naturalistic Study
Authors: Helen Lavretsky, Ling Zheng, Michael W. Weiner, Dan Mungas, Bruce Reed, Joel H. Kramer, William Jagust, Helena Chui, Wendy J. Mack
Journal: American Journal of Psychiatry (2010)

Objective The authors examined predictors of mortality in individuals age 50 or older with or without cognitive impairment in a 12-year prospective naturalistic study of subcortical ischemic vascular disease focusing on symptoms of depressed mood, apathy, anhedonia, or anergia. Method A total of 498 participants were recruited from the community and from memory clinics into a multicenter longitudinal study of subcortical ischemic vascular disease. For baseline cognitive status, 36% of participants were assessed as cognitively intact, 31% as cognitively impaired, and 33% as demented. All participants underwent a research protocol MRI, and 41% were classified as having subcortical lacunes. Depressed mood, anhedonia, anergia, and apathy were assessed at baseline using a structured behavioral assessment. Cox regression models were used to investigate the associations between neuropsychiatric symptoms and mortality, controlling for age, gender, race, education level, cognitive status, presence of vascular lacunes, and vascular risk factors. Results Of 498 participants, 175 (35%) died over the follow-up period, with a median survival time of 5.6 years. In the multivariate analyses, cognitive impairment, age, male gender, depressed mood, and the presence of lacunes predicted higher mortality. Participants with both lacunes and depressed mood had the shortest survival among all cognitive groups. The mortality hazard ratio for participants with depressed mood was 2.2 (95% CI=1.5–3.2) after adjustment for cognitive status, age, gender, education level, race, lacunes, and all vascular conditions. Conclusions These findings suggest the importance of detecting depressed mood in individuals with cerebrovascular disease and of developing more aggressive treatment and preventive interventions for this vulnerable population.
A CHEMICAL STUDY OF THE SPECIFIC ELEMENTS OF TUBERCULIN
Authors: J. Howard Mueller
Journal: The Journal of Experimental Medicine (1926)

A non-protein gum has been isolated from broth filtrates of human tubercle bacilli grown on a simple medium. It fixes complement and precipitates in high dilution in the presence of homologous immune serum, but fails to give a skin test in tuberculous animals. The preparation and some of the chemical properties of the substance are described.
Risk of Cardiac Death After Adjuvant Radiotherapy for Breast Cancer
Authors: S. H. Giordano, Y.-F. Kuo, J. L. Freeman, T. A. Buchholz, G. N. Hortobagyi, J. S. Goodwin
Journal: JNCI Journal of the National Cancer Institute (2005)

Background: Women with breast cancer who are treated with adjuvant radiation have a decreased risk of local recurrence but an increased risk of mortality from ischemic heart disease. Patients with left-sided breast tumors receive a higher dose of radiation to the heart than patients with right-sided tumors. Because radiation techniques have improved over time, we investigated whether the risk of death from ischemic heart disease after adjuvant breast radiotherapy decreased over time. Methods: We used the 12-registry 1973–2000 dataset from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program. Women (n = 27 283) treated with adjuvant radiation for breast cancer diagnosed in 1973–1989 were included in the study. Ischemic heart disease mortality was calculated at 15 years and compared for women diagnosed during 1973–1979, 1980–1984, and 1985–1989. Cox proportional hazards models were used to calculate the hazard of death from ischemic heart disease for women diagnosed 1973–1988 and censored at 12 years. All statistical tests were two-sided. Results: There were no differences in age, race/ethnicity, disease stage, or follow-up time between the 13 998 women with left-sided and 13 285 with right-sided cancer. For women diagnosed in 1973–1979, there was a statistically significant difference in 15-year mortality from ischemic heart disease between patients with left-sided (13.1%, 95% confidence interval [CI] = 11.6 to 14.6) and those with right-sided (10.2%, 95% CI = 8.9 to 11.5) breast cancer ( P = .02); no such difference was found for women diagnosed in 1980–1984 (9.4%, [95% CI = 8.1 to 10.6] versus 8.7% [95% CI = 7.4 to 10.0], respectively, P = .64) or 1985–1989 (5.8% [95% CI = 4.8 to 6.8] versus 5.2% [95% CI = 4.4 to 5.9], respectively, P = .98). In the Cox model, the hazard ratio [HR] for ischemic heart disease mortality for women with left-sided versus women with right-sided disease was 1.50 (95% CI = 1.19 to 1.87) in 1979. With each succeeding year after 1979, the hazard of death from ischemic heart disease for women with left-sided versus those with right-sided disease declined by 6% (HR = 0.94, 95% CI = 0.91 to 0.98). Conclusions: Risk of death from ischemic heart disease associated with radiation for breast cancer has substantially decreased over time.
Suicidal Ideation and Attempts in Adult Survivors of Childhood Cancer
Authors: Christopher J. Recklitis, Rebecca A. Lockwood, Monica A. Rothwell, Lisa R. Diller
Journal: Journal of Clinical Oncology (2006)

Purpose This study examined the prevalence of suicidal ideation and past suicide attempt in adult survivors of childhood cancer and investigated the relationship of suicidal symptoms to cancer treatment and current health. The hypothesis that poor physical health would be significantly associated with suicidality after adjusting for mental health variables was specifically tested. Methods Two hundred twenty-six adult survivors of childhood cancer (mean age, 28 years) seen in a survivor clinic completed the Short Form-36 and the Beck Depression Inventory (BDI), as well as suicide items from the Symptom Checklist-90 Revised, and Beck Scale for Suicide Ideation. Participants reporting current suicide ideation or any past suicide attempt were classified as suicidal. Results Twenty-nine participants (12.83%) reported suicidality, although only 11 of these were significantly depressed by BDI criteria. Univariate analyses found suicidality unrelated to age or sex but positively associated with younger age at diagnosis, longer time since diagnosis, cranial radiation treatment, leukemia diagnosis, depression, hopelessness, pain, and physical appearance concern. A hierarchical logistic regression showed that current physical functioning, including pain, was significantly associated with suicidality even after adjusting for treatment and depression variables. Conclusion Suicidal symptoms, which are reported by a significant minority of adult survivors of childhood cancer, are related to cancer treatments and post-treatment mental and physical health. Association of suicidal symptoms with physical health problems is important because these represent treatable conditions for which survivors may seek follow-up care. The relationship of physical well-being to suicidality underscores the need for a multidisciplinary approach to survivor care.
Heparin for adhesion prevention: Comparison of three different dosages with Seprafilm in a murine model
Authors: Metin Kement, Zafer Censur, Mustafa Oncel, Mehmet E. Buyukokuroglu, Fazli C. Gezen
Journal: International Journal of Surgery (2010)

This study aimed to assess the safety and effectiveness of different dosages of heparin for adhesion prevention by comparing with Seprafilm, in a murine model.Seventy five Balb/c mice were randomized into five groups. Group C were reserved as controls, and 62.5 IU, 125 IU, 250 IU of heparin, and Seprafilm were intraperitoneally applied in studied groups. The severity and locations of adhesions were assessed after the sacrification on day 14. The cause of death was investigated to evaluate the side effects of the drugs.The death of 2 subjects due to peritonitis (1 in Group C, 1 in Group H62.5) left 14 subjects in Group C and Group H62.5 (P ≥ 0.05), and no hemorrhage related death was observed. The use of the products significantly reduced the severity score of adhesion and the number of animals, had adhesions in different locations of the abdominal cavity, when the results were compared with the control group (P < 0.05 for all comparisons). Higher dosages of heparin seemed to be more effective. The results in group S, groups H250 and H125 were quite similar.Relatively high doses (125 IU and 250 IU) of intra-abdominal heparin may be comparable in safety and effectiveness to Seprafilm in adhesion prevention in mice.
A Mini-Symposium on Acupuncture
Authors: Edmund Y. M. Chein
Journal: JAMA (1974)

To the Editor.—  The controversial correspondence about double-blind studies of acupuncture began with Adler (222:833, 1972) who advocated wellcontrolled double-blind studies to determine efficacy of acupuncture. Mark (223:922, 1973) responded by stating that double-blind studies of acupuncture were not feasible because correct placement of acupuncture needles requires cooperation of the patient (subject) in reporting paresthesias, sensation of soreness, or mild discomfort, and hence, renders useless efforts to deceive the patient with placebo needles deliberately inserted elsewhere.  Chein and Shapiro (224:1533, 1973) agreed that this may be a problem with manually stimulated needles but not with needles inserted with concomitant electric stimulation. Since signs of correct needle placement could be obtained at correct and various placebo points on the meridian, double-blind studies were feasible.  Mark (225:1532, 1973) replied that the two steps in the application of acupuncture included:  first , the needles must be correctly placed [inserted], then they can be stimulated,
Negative Regulation of the Osteoblast Function in Multiple Myeloma through the Repressor Gene E4BP4 Activated by Malignant Plasma Cells
Authors: Franco Silvestris, Paola Cafforio, Monica De Matteo, Nicola Calvani, Maria A. Frassanito, Franco Dammacco
Journal: Clinical Cancer Research (2008)

Abstract Purpose: To explore the pathogenetic mechanisms that suppress the osteoblast function in multiple myeloma because osteogenesis results in defective new bone formation and repair. Experimental Design: Microarray gene analysis revealed the overexpression of E4BP4, a transcriptional repressor gene, in normal osteoblasts cocultured with myeloma cells that were releasing the parathyroid hormone-related protein (PTHrP). Thus, the effect of E4BP4 was assessed in PTHrP-stimulated osteoblasts by measuring the RNA levels of both Runx2 and Osterix as major osteoblast transcriptional activators. Because E4BP4 is a negative regulator of the cyclooxygenase-2 (COX-2) pathway that drives the expression of both Runx2 and Osterix, these factors were investigated after prostaglandin E2 treatment to overcome the COX-2 defect as well as in E4BP4-silenced osteoblasts. Finally, E4BP4, PTHrP, Osterix, and osteocalcin levels were measured in vivo in patients with bone disease together with the E4BP4 protein in bone biopsies. Results: E4BP4 was specifically induced by PTHrP and inhibited both Runx2 and Osterix, whereas E4BP4-silenced osteoblasts expressed functional levels of both factors. The prostaglandin E2 treatment of E4BP4-up-regulated osteoblasts promptly restored Runx2 and Osterix activities, suggesting that integrity of COX-2 pathway is essential for their transcription. Down-regulation of Osterix by E4BP4 was confirmed in vivo by its inverse levels in osteoblasts from myeloma patients with increased serum PTHrP, whose bone biopsies expressed the E4BP4 protein. Conclusions: Our data support the role of E4BP4 as osteoblast transcriptional repressor in inhibiting both Runx2 and Osterix in myeloma bone disease and correlate its effect with the increased PTHrP activity.
Increased cyclooxygenase-2 (COX-2) expression is associated with chemotherapy resistance and outcome in ovarian cancer patients
Authors: G. Ferrandina, L. Lauriola, G.F. Zannoni, A. Fagotti, F. Fanfani, F. Legge, N. Maggiano, M. Gessi, S. Mancuso, F.O. Ranelletti, G. Scambia
Journal: Annals of Oncology (2002)
Why general practitioners do not implement evidence: qualitative study
Authors: A C Freeman, K Sweeney
Journal: BMJ (2001)

<h3>Abstract</h3> <b>Objectives:</b> To explore the reasons why general practitioners do not always implement best evidence. <b>Design:</b> Qualitative study using Balint-style groups. <b>Setting:</b> Primary care. <b>Participants:</b> 19 general practitioners. <b>Main outcome measures:</b> Identifiable themes that indicate barriers to implementation. <b>Results:</b> Six main themes were identified that affected the implementation process: the personal and professional experiences of the general practitioners; the patient-doctor relationship; a perceived tension between primary and secondary care; general practitioners9 feelings about their patients and the evidence; and logistical problems. Doctors are aware that their choice of words with patients can affect patients9 decisions and whether evidence is implemented. <b>Conclusions:</b> General practitioner participants seem to act as a conduit within the consultation and regard clinical evidence as a square peg to fit in the round hole of the patient9s life. The process of implementation is complex, fluid, and adaptive. <h3>What is already known on this topic</h3> General practitioners do not always act on evidence in clinical practice General practitioners are reluctant to jeopardise their relationship with the patient and sometimes feel that patients are unwilling to take drugs <h3>What this study adds</h3> Implementation of evidence by general practitioners is a complex and fluid process Decisions are influenced by the doctor9s personal and professional experience as well as by their knowledge of and relationship with the patient Doctors9 choice of words can influence patients9 decisions about treatment
Oral iloprost as a treatment for Raynaud's syndrome: a double blind multicentre placebo controlled study.
Authors: J J Belch, H A Capell, E D Cooke, J D Kirby, C S Lau, R Madhok, E Murphy, M Steinberg
Journal: Annals of the Rheumatic Diseases (1995)

OBJECTIVE--To compare the efficacy, tolerance and safety of 50-150 micrograms orally administered iloprost given twice a day versus placebo in patients with Raynaud9s syndrome. METHODS--The study was multicentre (n = 3), double blind and placebo controlled. Sixty three patients who had eight or more vasospastic attacks per week were enrolled. After a one week run-in period, all patients received either iloprost or placebo treatment to a maximum tolerated dose of 150 micrograms twice a day for 10 days. Diary cards assessed the duration and severity of the vasospastic attacks. Side effects were monitored by direct questioning. A global assessment of treatment efficacy was made by the patient at the end of treatment and two weeks later. RESULTS--Patient opinion tended to favour iloprost at the end of the 10 day treatment phase (p = 0.09) and this was significant at day 24 (the follow up visit) (p = 0.011). Although the duration and severity of attacks tended to decrease in the iloprost treated group, these results tended not to reach statistical significance (for severity p = 0.06 at end of treatment, p = 0.09 on day 24). CONCLUSION--Iloprost administered intravenously has been shown to be of benefit in the treatment of the Raynaud9s syndrome associated with systemic sclerosis, but this route of administration is inconvenient. This study evaluated the use of iloprost administered orally to patients with Raynaud9s syndrome. Patient documented improvement was significantly improved by iloprost. Diary card analysis showed a trend in favour of iloprost, but these results did not reach statistical significance.
Unique role of the complement receptor CR1 in the degradation of C3b associated with immune complexes.
Authors: M E Medof, K Iida, C Mold, V Nussenzweig
Journal: The Journal of Experimental Medicine (1982)

The main finding of this paper is that CR1, the membrane receptor for C3b and C4b, together with C3b/C4b-inactivator (I), degrades C3b bound to immune complexes (C3b*). Two fragments are generated: C3c, which is released from the immune complexes, and C3d*. The C3c fragment released from the cell intermediate EAC1423b prepared with 125I-C3 was analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and radioautography. It has a 135,000 mol wt and contains disulfide bonded labeled polypeptide chains of 75,000 and 31,000 mol wt, which presumably represent the beta and a fragment of the alpha-chain of C3b*. Silver staining of the SDS-PAGE gels revealed other C3-derived bands with 39-42,000 mol wt. Human erythrocytes + I also cleave C3b* into C3c and C3d*. The activity of the erythrocytes is CR1 mediated because it can be totally inhibited by monoclonal antibodies to CR1. In contrast with these results, I together with the serum protein beta 1H (H) transform EAC1423b into hemolytically inactive EAC1423bi and cleave the alpha' chain of C3b* into fragments of 70,000 and 40,000 mol wt. Small amounts of C3c are also released at relatively high concentrations of H. On a molar basis, the efficiency of CR1 in the generation of C3c and C3d is 10(4)-10(5) greater than H. An additional observation was that C3c could be released by treating EAC1423bi with CR1 + I and that this reaction was also inhibited by monoclonal antibodies to CR1. Therefore, it is likely that CR1 has binding affinity for iC3b and that the degradation of C3b* proceeds as follows: C3b (formula, see text) C3c + C3d*. Taken together, our findings argue that the processing of C3b* in vivo occurs in solid phase, that is, on the surface of cells bearing CR1.
Extracellular Matrix Regulates Enhanced Eotaxin Expression in Asthmatic Airway Smooth Muscle Cells
Authors: Vivien Chan, Janette K. Burgess, Jonathan C. Ratoff, Brian J. O'Connor, Anne Greenough, Tak H. Lee, Stuart J. Hirst
Journal: American Journal of Respiratory and Critical Care Medicine (2006)

Rationale: Altered airway smooth muscle (ASM) function and enrichment of the extracellular matrix (ECM) with fibronectin and collagen are key features of asthma. Previously, we have reported these ECM proteins enhance ASM synthetic function.Objective: We compared ASM cultured from endobronchial biopsies from subjects with and without asthma to assess if asthmatic cells were hypersecretory and determined whether the underlying mechanism involved autocrine ECM production.Methods and Measurements: Cells from subjects with and without asthma were cultured on plastic or in plates precoated with ECM proteins. Cytokine production was evaluated by enzyme-linked immunosorbent assay and by reverse transcriptase–polymerase chain reaction. Function-blocking integrin antibodies were used to identify integrin involvement.Results: Baseline eotaxin and its production after stimulation with interleukin (IL)-13, IL-1β, or tumor necrosis factor-α was increased (2.5- to 6.0-fold) in ASM cells cultured from subjects with asthma compared with healthy subjects. When seeded on ECM from asthmatic ASM, IL-13–dependent eotaxin release from healthy or asthmatic ASM was enhanced compared with culture on healthy ECM. The ECM substrates fibronectin and type I collagen each enhanced IL-13–dependent eotaxin release, and Western immunoblot indicated that fibronectin expression was higher in asthmatic ASM cells. Integrin-blocking antibodies revealed that α5β1 was required for more than 50% of the enhanced IL-13–dependent eotaxin release by ASM cells from subjects with asthma, whereas α2β1 or αvβ3 neutralization lacked effect.Conclusion: The data indicate that ASM cells cultured from subjects with asthma are hypersecretory compared with cells from healthy donors and that autocrine fibronectin secretion acting via α5β1 in part underlies this effect.
Airway humidity during oxygen therapy: Impact of humidification and applicator design
Authors: Markus Wenzel, Dominic Dellweg, Ekkehard Höhn, Olaf Bourgund, Peter Haidl
Journal: European Respiratory Journal (2011)

Background: Stationary oxygen therapy is usually combined with a humidification device in order to prevent mucosal dryness. The impact of the applicator design on airway humidity however has not been investigated to date.

Rationale: To investigate the impact of oxygen applicator design on airway humidity.

Method: First we developed a sampling and analysis system with a heated sampling probe to measure humidity of air samples under standard conditions during the inspiratory cycle.

We measured 12 individuals with an intranasal (standard nasal cannula) and prenasal (Oxynasor) applicator at different flow rates with and without humidification devices. The Oxynasor device is characterized by a cyclone effect of the emitting gas which reduces the oxygen velocity at the outlet.

Results: Intranasal humidity dropped significantly from 40.3±8.7% to 29.0±6.8% at a flow rate of three litres when oxygen was given intranasally without humidification (p<0.01). We observed no significant change in airway humidity when oxygen was given prenasally with and without humidification.

Conclusion: We propose two mechanisms to be responsible for this phenomenon: First prenasal application with low outlet velocity of dry oxygen allows for absorption of humidity from the surrounding air prior to nasal entry and second intranasal application with a high exit velocity from the applicator system might dry out the nasal mucosa by means of convection. Prenasal oxygen application with the Oxynasor device might obviate the need for humidification and therefore might simplify application and reduce therapy cost.
Peri-operative myocardial tissue injury and the release of inflammatory mediators in coronary artery bypass graft patients
Authors: E Fransen
Journal: Cardiovascular Research (2000)

Objective: This study was conducted to evaluate to what extent the ischemia-reperfusion injury resulting from the cardiopulmonary bypass (CPB) and aortic cross-clamping procedures during coronary artery bypass grafting (CABG) contributes to the systemic inflammatory response generally found in these patients. Methods: Serum levels of enzymes (CK and CK-MB) and non-enzymatic proteins (FABP and myoglobin) as markers of myocardial tissue injury, bactericidal permeability increasing protein (BPI) as an indicator of neutrophil activation, interleukin-6 (IL-6) as inducer of the acute phase response and lipopolysaccharide binding protein (LBP) as parameter of the acute phase response were measured in 15 low-risk CABG patients with cardiopulmonary bypass (CPB), and 17 low-risk CABG patients without CPB. Results: Already 0.5 h after reperfusion significantly increased plasma levels of all markers of myocardial tissue injury were noted in patients having surgery with CPB, but not in non-CPB patients. No significant differences were found between both groups for BPI and IL-6 levels in the early reperfusion period. BPI and IL-6 levels were higher in the non-CPB group on the first post-operative day (P<0.05). However, no correlations were found for any marker of peri-operative tissue damage with either early neutrophil activation, or acute phase reactants. Conclusions: Perioperative myocardial injury resulting from CPB and aortic cross-clamping in low-risk CABG patients does not contribute to the release of inflammatory mediators in these patients.