tbuckley/cabot-search huggingface dataset:
Short-Term Aerobic Exercise Reduces Arterial Stiffness in Older Adults With Type 2 Diabetes, Hypertension, and Hypercholesterolemia
Authors: Kenneth M. Madden, Chris Lockhart, Darcye Cuff, Tiffany F. Potter, Graydon S. Meneilly
Journal: Diabetes Care (2009)

OBJECTIVE The relationship between increased arterial stiffness and cardiovascular mortality is well established in type 2 diabetes. We examined whether aerobic exercise could reduce arterial stiffness in older adults with type 2 diabetes complicated by comorbid hypertension and hyperlipidemia. RESEARCH DESIGN AND METHODS A total of 36 older adults (mean age 71.4 ± 0.7 years) with diet-controlled or oral hypoglycemic–controlled type 2 diabetes, hypertension, and hypercholesterolemia were recruited. Subjects were randomly assigned to one of two groups: an aerobic group (3 months vigorous aerobic exercise) and a nonaerobic group (no aerobic exercise). Exercise sessions were supervised by a certified exercise trainer three times per week, and a combination of cycle ergometers and treadmills was used. Arterial stiffness was measured using the Complior device. RESULTS When the two groups were compared, aerobic training resulted in a decrease in measures of both radial (−20.7 ± 6.3 vs. +8.5 ± 6.6%, P = 0.005) and femoral (−13.9 ± 6.7 vs. +4.4 ± 3.3%, P = 0.015) pulse-wave velocity despite the fact that aerobic fitness as assessed by Vo2max did not demonstrate an improvement with training (P = 0.026). CONCLUSIONS Our findings indicate that a relatively short aerobic exercise intervention in older adults can reduce multifactorial arterial stiffness (type 2 diabetes, aging, hypertension, and hypercholesterolemia).
Factors associated with serum alanine transaminase activity in healthy subjects: Consequences for the definition of normal values, for selection of blood donors, and for patients with chronic hepatitis C
Authors: Annie Piton, Thierry Poynard, Françoise Imbert-Bismut, Lina Khalil, Jacques Delattre, Elisabeth Pelissier, Nicole Sansonetti, Pierre Opolon
Journal: Hepatology (1998)

In clinical research, the definition of the upper limit of normal (ULN) alanine transaminase (ALT) is never detailed. However, such a definition can vary and may have practical consequences. Our aim was to assess factors associated with serum ALT activity in apparently healthy subjects and then to apply seven different definitions of ULN in three different populations so as to assess the prevalence of subjects with normal ALT among blood donors and among hepatitis C patients before (normal ALT hepatitis C patients) and after treatment (interferon [IFN] responders). ALT measurements were performed in the same laboratory using the same technique; 1,033 donors were prospectively investigated, 186 patients with hepatitis C never treated and 40 patients treated with 3 MU three times per week of IFN-alpha for at least 6 months. The seven definitions (D) of ULN were: D1: 95th percentile of ALT; D2: 95th percentile after separating males and females; D3: males and females separately, ULN=10 (mean of log10 ALT + 1.96 SD); D4: ULN=45 IU/L given by the manufacturer; D5: mean + 1 SD after exclusion of the 5% extreme values; D6: 95th percentile after separating subjects with body mass index (BMI) under or equal to the median (23); and D7: 95th percentile after separating subjects according to BMI and sex. BMI and male sex were independently associated (P < .0001; logistic regression) with ALT, without an association with alcohol. The range of ULN varied from 26 IU/L in females (D5) to 66 IU/L in males with BMI >23 (D7). Depending on the definition, the prevalence of blood donors with normal ALT varied from 82% to 96%, i.e., a range of 14%; that of hepatitis C patients with normal ALT varied from 16% to 27%, i.e., a range of 11%; the prevalence of IFN responders varied from 25% to 42%, i.e., a range of 17%. Definitions of normal ALT values should be adjusted for sex and BMI to reduce artificial heterogeneity in blood donor selection and in hepatitis C clinical studies.
Improved Glycemic Control in Poorly Controlled Patients with Type 1 Diabetes Using Real-Time Continuous Glucose Monitoring
Authors: Dorothee Deiss, Jan Bolinder, Jean-Pierre Riveline, Tadej Battelino, Emanuele Bosi, Nadia Tubiana-Rufi, David Kerr, Moshe Phillip
Journal: Diabetes Care (2006)

Intensive self-management with frequent self-monitoring of blood glucose (SMBG) is important in type 1 diabetes to achieve good metabolic control (1–3). Nevertheless, many patients still experience episodes of unrecognized hypo- and hyperglycemia (4). Novel technologies for continuous glucose monitoring (CGM) that provide information about glucose excursions are now available. Previous studies reported the benefits of retrospective evaluation of CGM data (5–11), but few assessed effects on glycemic control (5,12–14), and only one showed improvements compared with SMBG (14). We evaluated the effect of a new real-time glucose monitor on glycemic control in patients with poorly controlled type 1 diabetes. The device, Guardian RT (Medtronic MiniMed, Northridge, CA), allows users to see glucose readings and set hypo- and hyperglycemic alarms and provides trend information on changing glucose values.

The study included 81 children (median age 14.4 years [range 8.0–18.9]) and 81 adults (age 39.1 years [19.0–59.5]) with stable type 1 diabetes. All had adhered to intensified insulin treatment (continuous subcutaneous insulin infusion, n = 78; multiple daily injection, n = 84) but had HbA1c (A1C) levels ≥8.1%. Informed consent was obtained from patients regularly attending the eight participating centers.

Subjects were randomly assigned 1:1:1 for 3 months to Guardian RT continuously (arm 1) or biweekly for 3-day periods every 2 weeks (arm 2) or to continue conventional SMBG (control). Treatment adjustments made by physicians and patients were based on SMBG profiles in control subjects and on real-time glucose profiles in arms 1 and 2. Patients were instructed to perform confirmatory SMBG measurements before therapeutical interventions or corrective action if hypo- or hyperglycemic alarms or symptoms occurred. …
Statins for Stroke Prevention
Authors: Pierre Amarenco, Andrew M. Tonkin
Journal: Circulation (2004)

The occurrence of stroke increases with age, particularly affecting the older elderly, a population also at higher risk for coronary heart disease (CHD). Epidemiological and observational studies have not shown a clear association between cholesterol levels and all causes of stroke. Nonetheless, large, long-term statin trials in patients with established CHD or at high risk for CHD have shown that statins decrease stroke incidence in these populations. Combined data from 9 trials including 70,070 patients indicated relative and absolute risk reductions for stroke of 21% and 0.9%, respectively, with statins. The number of strokes prevented per 1000 patients treated for 5 years in patients with CHD is 9 for statins, compared with 17.3 for antiplatelet agents. Statins have not yet been shown to reduce stroke risk in the typical general population without known CHD, nor have they been shown to prevent recurrent stroke in patients with prior stroke. Potential reasons for the effects of statins on stroke and the non-cholesterol-lowering mechanisms that may be involved are discussed. Treatment strategies based on global cardiovascular risk may be most effective. Additional studies in patients representative of the typical stroke population are needed.
Vitamin D Supplementation and the Risk of Colds in Patients with Asthma
Authors: Loren C. Denlinger, Tonya S. King, Juan Carlos Cardet, Timothy Craig, Fernando Holguin, Daniel J. Jackson, Monica Kraft, Stephen P. Peters, Kristie Ross, Kaharu Sumino, Homer A. Boushey, Nizar N. Jarjour, Michael E. Wechsler, Sally E. Wenzel, Mario Castro, Pedro C. Avila
Journal: American Journal of Respiratory and Critical Care Medicine (2015)

Rationale: Restoration of vitamin D sufficiency may reduce asthma exacerbations, events that are often associated with respiratory tract infections and cold symptoms.Objectives: To determine whether vitamin D supplementation reduces cold symptom occurrence and severity in adults with mild to moderate asthma and vitamin D insufficiency.Methods: Colds were assessed in the AsthmaNet VIDA (Vitamin D Add-on Therapy Enhances Corticosteroid Responsiveness) trial, in which 408 adult patients were randomized to receive placebo or cholecalciferol (100,000 IU load plus 4,000 IU/d) for 28 weeks as add-on therapy. The primary outcome was cold symptom severity, which was assessed using daily scores on the 21-item Wisconsin Upper Respiratory Symptom Survey.Measurements and Main Results: A total of 203 participants experienced at least one cold. Despite achieving 25-hydroxyvitamin D levels of 41.9 ng/ml (95% confidence interval [CI], 40.1–43.7 ng/ml) by 12 weeks, vitamin D supplementation had no effect on the primary outcome: the average peak WURSS-21 scores (62.0 [95% CI, 55.1–68.9; placebo] and 58.7 [95% CI, 52.4–65.0; vitamin D]; P = 0.39). The rate of colds did not differ between groups (rate ratio [RR], 1.2; 95% CI, 0.9–1.5); however, among African Americans, those receiving vitamin D versus placebo had an increased rate of colds (RR, 1.7; 95% CI, 1.1–2.7; P = 0.02). This was also observed in a responder analysis of all subjects achieving vitamin D sufficiency, regardless of treatment assignment (RR, 1.4; 95% CI, 1.1–1.7; P = 0.009).Conclusions: Our findings in patients with mild to moderate asthma undergoing an inhaled corticosteroid dose reduction do not support the use of vitamin D supplementation for the purpose of reducing cold severity or frequency.
Inhaled corticosteroids in COPD: awaiting controlled trials.
Authors: J A Wedzicha
Journal: Thorax (1993)

EditorialsInhaled corticosteroids in COPD: awaiting controlled trials Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality.Recent stud- ies have suggested that mortality from COPD may be still increasing worldwide, especially in the older age groups.'Cigarette smoking is the most important aetiological fac- tor, although genetic predisposition, and occupational and environmental exposures are also implicated.2Epidemiological studies have shown an excessive decline in forced expiratory volume in one second (FEVI)in smokers compared with non-smokers23 and approximately 15% of smokers develop symptomatic disease.4The loss of lung function in COPD is greater with increasing age and is related to the initial level of FEV, and bronchial hyperresponsiveness.56If patients with COPD stop smoking, however, the decline in FEV, is much less rapid than if smoking had continued.27Smoking cessation is the only currently recognised long term intervention that affects the natural history of COPD7 although the success of smoking cessation pro- grammes is limited.Previous studies examining predictors of mortality in COPD have consistently shown that the most important determinants of survival are the age of the patient and degree of airways obstruction.8Patients with advanced COPD who develop chronic hypoxaemia have improved survival when treated with long term oxy- gen therapy,9 10 although even then the eventual prognosis is related to the severity of the underlying airways obstruction."This emphasises the importance of pre- venting deterioration of lung function in patients with COPD, and the role of long term inhaled corticosteroids in this situation has recently aroused much interest.
Vagal release of vasoactive intestinal peptide can promote vagotonic tachycardia in the isolated innervated rat heart
Authors: A. Shvilkin, P. Danilo, P. Chevalier, F. Chang, I. S Cohen, M. R Rosen
Journal: Cardiovascular Research (1994)

The aim was to determine the extent to which endogenous release of vasoactive intestinal polypeptide (VIP) might be implicated in the modulation of sinoatrial rate in the presence and absence of muscarinic blockade or beta blockade.Langendorff perfused rat hearts were studied with the right vagus intact. The hearts were maintained in sinus rhythm and subjected to right vagal stimuli of 5, 10, 20, and 30 Hz.Administration of exogenous VIP, 10(-8) M, increased sinus rate by 20% (p < 0.05). This increase in heart rate was reduced significantly to 8% by the VIP antagonist [D-p-Cl-Phe6, Leu17]VIP, 10(-7) M, which alone had no effect on sinus rate. Vagal stimulation reduced sinus rate from a control of 254(SEM 2) to 164(17) beats.min-1 (p < 0.05) at 20 Hz. VIP, 10(-8) M, increased these rates to 284(6) and 220(21) beats.min-1 (p < 0.05). In another eight vagally stimulated hearts, frequencies of 5-20 Hz reduced sinus rate. At 30 Hz heart rate increased in five, and the resultant rate was significantly faster in these [154(10) beats.min-1] than in the remainder [98(12) beats.min-1, p < 0.05]. Vagal stimulation also increased sinus rate (p < 0.05) in four of seven additional hearts perfused with atropine, 2 x 10(-6) M. This increase was completely abolished by [D-p-Cl-Phe6, Leu17]VIP. That the effect was not beta adrenergic was demonstrated in eight experiments using atropine plus propranolol, 1 x 10(-7) M. A vagally induced increment in rate still occurred (p < 0.05) and was abolished by [D-p-CL-Phe6, Leu17]VIP. The ability to ascribe a rate change to VIP release was maximal in the presence of propranolol and atropine, intermediate in the presence of atropine alone, and minimal in the absence of muscarinic or beta blockade.Vagally released VIP is capable of limiting the decrement in sinus rate that occurs at high frequencies of vagal stimulation, and in some circumstances can actually increment sinus rate. Its role as an endogenous modulator of vagal effects on heart rate and as a possible cause of vagal and postvagal tachycardias should be further explored.
Regulation of B Lymphocytes by Dendritic Cells
Authors: Edward A. Clark
Journal: The Journal of Experimental Medicine (1997)

Cells within the DC lineage of white blood cells are the sentinels of the immune system, the most potent of APCs; at various ports of entry, they specialize in capturing antigens and stimulating T cell–associated immunity (([1][1])–([3][2])). DCs regulate the activation of T cells not only by
Gaps in Service Utilization by Mexican Americans With Mental Health Problems
Authors: William A. Vega, Bohdan Kolody, Sergio Aguilar-Gaxiola, Ralph Catalano
Journal: American Journal of Psychiatry (1999)

OBJECTIVE: The purpose of this study was to ascertain the degree of underutilization of services for mental health problems among urban and rural Mexican American adults. METHOD: A probability sample (N=3,012) was used to represent the Mexican American population of Fresno County, California, and face-to-face interviews were conducted with the use of the Composite International Diagnostic Interview. Bivariate and multivariate analyses were used to analyze the data on diagnosis and service utilization. RESULTS: Among the respondents with DSM-III-R-defined disorders, only about one-fourth had used a single service or a combination of services in the past 12 months, and Mexican immigrants had a utilization rate which was only two-fifths of that of Mexican Americans born in the United States. Overall use of mental health care providers by persons with diagnosed mental disorders was 8.8%, use of providers in the general medical sector was 18.4%, use of other professionals was 12.7%, and use of informal providers was only 3.1%. According to logistic regression analyses, factors associated with utilization of mental health services included female sex, higher educational attainment, unemployment, and comorbidity. CONCLUSIONS: Immigrants are unlikely to use mental health services, even when they have a recent disorder, but may use general practitioners, which raises questions about the appropriateness, accessibility, and cost-effectiveness of mental health care for this population. Several competing hypotheses about the reasons for low utilization of services need to be examined in future research.
Clinical synovitis in a particular joint is associated with progression of erosions and joint space narrowing in that same joint, but not in patients initially treated with infliximab
Authors: N B Klarenbeek, M Güler-Yüksel, D M F M van der Heijde, H M J Hulsmans, P J S M Kerstens, T H E Molenaar, P B J de Sonnaville, T W J Huizinga, B A C Dijkmans, C F Allaart
Journal: Annals of the Rheumatic Diseases (2010)

Objectives To assess the relationship between joint tenderness, swelling and joint damage progression in individual joints and to evaluate the influence of treatment on these relationships. Methods First-year data of the Behandel Strategieën (BeSt) study were used, in which patients recently diagnosed as having rheumatoid arthritis (RA) were randomly assigned into four different treatment strategies. Baseline and 1-year x-rays of the hands and feet were assessed using the Sharp–van der Heijde score (SHS). With generalised estimating equations, 3-monthly assessments of tender and swollen joints of year 1 were related to erosion progression, joint space narrowing (JSN) progression and total SHS progression at the individual joint level (definition &gt;0.5 SHS units) in year 1, corrected for potential confounders and within-patient correlation for multiple joints per patient. Results During year 1, 59% of all 13 959 joints analysed were ever tender and 45% ever swollen, 2.1% showed erosion progression, 1.9% JSN progression and 3.6% SHS progression. Swelling and tenderness were both independently associated with erosion and JSN progression with comparable OR, although with higher OR in the hands than in the feet. Local swelling and tenderness were not associated with local damage progression in patients initially treated with infliximab. Conclusion Clinical signs of synovitis are associated with erosion and JSN progression in individual joints after 1 year in RA. A disconnect between synovitis and joint damage progression was observed at joint level in patients who were treated with methotrexate and infliximab as initial treatment, confirming the disconnect between synovitis and the development of joint damage in tumour necrosis factor blockers seen at patient level.
DEVELOPMENT OF CHICKEN LYMPHOID SYSTEM
Authors: Yong Sung Choi, Robert A. Good
Journal: The Journal of Experimental Medicine (1972)

Development of Ig-synthesizing cells in the bursa of chick embryo was studied by immunohistochemical staining method as well as by in vitro incorporation of leucine-(3)H into Ig. Ig-synthesizing cells are first detected in the bursa of a 14 day old chick embryo and increase with the maturation of the embryo. Acrylamide gel analysis of leucine-(3)H-labeled Ig shows that synthesis of nonsecretory IgM-H(0) precedes that of secretory IgM-H, reflecting an ontogenetic sequence of development of lymphoid cells synthesizing IgM. Since IgM-H(0) is not secreted, we further studied biochemical differences between two heavy chains. The difference is attributable to lack of galactose attachment to H(0) chains. It is proposed that during differentiation of lymphoid cells synthesizing and secreting Ig, attachment of galactose may play an obligatory role in the development of cellular capacity for Ig secretion.
Handedness and deformities, radiographic changes, and function of the hand in rheumatoid arthritis.
Authors: G M Mody, O L Meyers, S G Reinach
Journal: Annals of the Rheumatic Diseases (1989)

The correlation of handedness with deformities, radiographic changes, and function of the hand was studied in a large group of patients with rheumatoid arthritis and a dominant right hand. There was no significant difference in the proportion of patients who had swan neck deformity, boutonnière deformity, uncorrectable ulnar deviation, and flexor tenosynovitis in the dominant and non-dominant hands. There were significantly greater radiological changes in the dominant hand, however, and the middle and index fingers were most severely affected. The severe involvement of these fingers may be related to their greater use in daily activities. There was also more severe functional impairment in the dominant hand.
Squamous cell carcinoma and precursor lesions: diagnosis and screening in a technical era
Authors: Catherine F. Poh, Calum E. MacAulay, Denise M. Laronde, P. Michele Williams, Lewei Zhang, Miriam P. Rosin
Journal: Periodontology 2000 (2011)

Oral cancer is a substantial, though often unrecognized issue globally, with close to 300,000 new cases reported annually (18).The disease presents a management conundrum.It occurs at a site that is easily accessible for examination, yet, regrettably, is often diagnosed at an advanced stage when functional impairment due to treatment and mortality rates are high.Late stage identification is associated with high mortality with 5-year survival rates ranging from 30-60%, depending on the global locale (64;76).It is also associated with high rates of second oral malignancies, with up to a third of such patients suffering a recurrence of the tumor or the development of a second primary despite intensive follow-up (11;36;56).These figures have shown little improvement over the past few decades.Despite these statistics, there is hope for change in the not-too-distant future.This hope is fueled by recent strides being made in our understanding of cancer and in the emergence of promising technologies that could aid clinicians in detection, risk assessment and management of this disease.Several alternative detection and diagnostic aids for examining the oral cavity are commercially available or in development.The current challenge is to recognize that these devices are still evolving, yet in many cases they already are moving into the clinical arena.There is a need for the clinician to better understand these new innovations: the biology underlying their function, their strengths and weaknesses, and the scenarios under which they may demonstrate clinical utility.The intent of this paper is to highlight parameters to be considered when utilizing such technology and to indicate where we are in the development and validation of such approaches and in their incorporation into clinical practice.The paper will explore more recent concepts with respect to tissue change that underlies evident disease, briefly summarize difficulties with the current clinicopathological approaches for detection and diagnostic management of disease and then present an overview of current and developing diagnostic and screening methods.There have been several recent reviews of some of these devices (16;32;33;40;41).Our intent is not to duplicate this activity but rather to supplement it by building a framework for technology assessment that integrates data summarized in these papers.
Minimizing the toxicity of aminoglycosides in cystic fibrosis
Authors: Alan R Smyth
Journal: Journal of the Royal Society of Medicine (2010)

By the late teenage years over half of cystic fibrosis (CF) patients in the UK will have chronic pulmonary infection with Pseudomonas aeruginosa. Regular treatment of this infection with intravenous antibiotics, at three monthly intervals, has been associated with increased survival in historical cohort studies. However, this increased survival may be achieved at the cost of cumulative sideeffects of the antibiotics used and the more frequent occurrence of severe adverse-effects, such as acute renal failure. This article discusses how antibiotic treatment may harm patients, how such harm may be detected at an early stage and how it may be prevented.
The pulmonary endothelial glycocalyx regulates neutrophil adhesion and lung injury during experimental sepsis
Authors: Eric P Schmidt, Yimu Yang, William J Janssen, Aneta Gandjeva, Mario J Perez, Lea Barthel, Rachel L Zemans, Joel C Bowman, Dan E Koyanagi, Zulma X Yunt, Lynelle P Smith, Sara S Cheng, Katherine H Overdier, Kathy R Thompson, Mark W Geraci, Ivor S Douglas, David B Pearse, Rubin M Tuder
Journal: Nature Medicine (2012)