tbuckley/cabot-search huggingface dataset:
Medical thoracoscopy management of spontaneous pneumothorax in a pulmonology department: 17 year overview
Authors: Telma Sequeira, Luciana Bento, José Pedro Boléo-Tomé, Rui Costa, Fernando Rodrigues
Journal: European Respiratory Journal (2014)

Introduction :Management of spontaneous pneumothorax has been debated over decades. Discussion remains over the best time and form of intervention to prevent recurrences.   Objectives : Characterization of a pulmonology department experience in managing spontaneous pneumothoraxes through medical thoracoscopy over the last 17 years.   Methods :Cohort comprising 76 patients with primary or secondary spontaneous pneumothorax submitted to medical thoracoscopy between 1996-2013. Data were collected from revision of case files. Microsoft Excel®2010 was used for statistical analysis.   Results : 88% of patients were male, with an average age of 34 years (minimum 17; maximum 73);78% had a history of smoking. Patients were classified as: primary spontaneous pneumothorax (PSP) 59%; secondary spontaneous pneumothorax (SSP) 38%; iatrogenic 3%. Concerning PSP, 49% of patients were classified as Vanderschueren stage III. Pleurodesis was performed in 40 (89%), with talc poudrage used in 90% of cases and mechanic abrasion on 10%. Electric or thermal (Argon) coagulation was used in 12 (71%) and 5 (29%) cases, respectively. Bullae resection was performed with Endo Gia® in 6 patients. Three patients recurred (7%) within 12 months.  SSP revealed equal distribution (31%) in Vanderschueren stage III and IV. Pleurodesis was done in 26 (90%) patients, mostly by talc poudrage (85%). Bullae resection was done in 52% of cases. Success rate was 85%, and 3 patients needed referral to a thoracic surgeon.   Conclusion : Optimal management strategy for spontaneous pneumothorax remains undefined. In this series, medical thoracoscopy was shown to be effective, with high success rate, thus avoiding referral to surgery.
The International Foundation for Dermatology: an exemplar of the increasingly diverse activities of the International League of Dermatological Societies
Authors: R. Hay, R. Marks
Journal: British Journal of Dermatology (2004)

The International Foundation of Dermatology (IFD) was established by the International League of Dermatology Societies to promote the care of skin disease in the developing world. Starting from an initial base of the Regional Dermatology Training Centre in Tanzania it has successfully trained a cadre of clinical officers and dermatology residents from different African countries. It has now broadened this approach to an assessment of the effectiveness of focused training in Mali. The IFD is also completing a global assessment of dermatological needs in developing countries with a view to establishing guidelines and programmes for the control of common skin diseases. An ongoing strategy has been to work with other agencies to help ease the burden of other endemic tropical diseases that affect the skin; preventing the development of elephantiasis in filarial lymphoedema has been one such project implemented through a programme of skin hygiene.
Evaluation of specific value of endoscopic biopsies and brush cytology for malignancies of the oesophagus and stomach.
Authors: L Witzel, F Halter, P A Gretillat, U Scheurer, M Keller
Journal: Gut (1976)

The value of multiple biopsies and brush cytology at oesophago-gastroscopy was assessed in relation to macroscopy and localization on 100 verified tumours in a prospective study. The cumulative accuracy achieved was 96%. This was significantly better (P less than 0-01) than that of biopsy (83%) and of cytology (85%). While the reliability of both procedures was not significantly different in malignancies of the oesophagus, the gastric body, and the antrum, cytoloty was significantly more accurate in cancers of the cardia (90% and 55% respectively, P less than 0-05). Cytology was also more reliable in stenosing tumours (92%/72%,P less than 0-05). In polypoid malignancies a positive but not significant trend was found in favour of multiple biopsies (94%/64%). One of the two early cancers was only diagnosed by cytology. The results confirm the high diagnostic accuracy of multiple endoscopic biopsies combined with brush cytology and demonstrate the value of cytology in stenosing tumours, especially in those of the cardia.
Identification of residues in the V domain of CD80 (B7-1) implicated in functional interactions with CD28 and CTLA4.
Authors: C A Fargeas, A Truneh, M Reddy, M Hurle, R Sweet, R P Sékaly
Journal: The Journal of Experimental Medicine (1995)

The CD80 (B7-1) molecule is a 45-60-kD member of the immunoglobulin superfamily that is expressed on a variety of cell types of haematopoietic origin. CD80 can provide a critical costimulatory signal to T cells by interacting with the T cell surface molecule CD28. CD80 also binds to the CD28-related molecule CTLA4, which is expressed on activated T cells, Recently, additional ligands of CD28 and CTLA4 have been described in mice and humans. One of them, CD86 (B-70 or B7-2) was characterized at the molecular level. Although similar in predicted structure to CD80, it is distantly related in amino acid sequence. In this study, human CD80 mutants were generated and tested for their ability to maintain the interaction with CD28 leading to adhesion and enhanced IL-2 production. Two hydrophobic residues in the V-like domain of CD80 were identified as critical for binding to CD28 and are also important for the interaction with CTLA4. These residues are adjacent to the epitope of the BB1 antibody, which inhibits CD28-CD80 interactions. One of these residues, Y87, is conserved in all CD80 and CD86 cloned from various species. These results being to unravel the structural requirements for binding to CD28 and CTLA4.
US patients of Hispanic and African ancestry develop lupus nephritis early in the disease course: data from LUMINA, a multiethnic US cohort (LUMINA LXXIV)
Authors: P. I. Burgos, G. McGwin, G. J. Pons-Estel, J. D. Reveille, G. S. Alarcon, L. M. Vila
Journal: Annals of the Rheumatic Diseases (2010)

Lupus nephritis (LN) is a major cause of morbidity and mortality in systemic lupus erythematosus (SLE).1 As previously described, LN occurs more frequently in Hispanic and African-American people in the multiethnic US LUMINA (Lupus in Minorities: Nature vs Nurture) cohort.2 With more patients (one-third) and years of observation (2949.3 patient-years from enrolment or baseline), we have now examined whether LN occurs earlier in the disease course in these patients relative to Caucasians. Four hundred and forty-nine patients (American College of Rheumatology (ACR) criteria, age ≥16 years, disease duration ≤5 years, predominantly women) were studied. Time-to-LN (ACR criterion (persistent proteinuria >0.5 g/day or ≥3 if quantitation not performed or cellular casts)) from baseline (incident cases) was examined by multivariable Cox proportional hazards regression adjusting for pertinent …
Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC
Authors: Augusto Caraceni, Geoffrey Hanks, Stein Kaasa, Michael I Bennett, Cinzia Brunelli, Nathan Cherny, Ola Dale, Franco De Conno, Marie Fallon, Magdi Hanna, Dagny Faksvåg Haugen, Gitte Juhl, Samuel King, Pål Klepstad, Eivor A Laugsand, Marco Maltoni, Sebastiano Mercadante, Maria Nabal, Alessandra Pigni, Lukas Radbruch, Colette Reid, Per Sjogren, Patrick C Stone, Davide Tassinari, Giovambattista Zeppetella
Journal: The Lancet Oncology (2012)
Socioeconomic inequalities in survival and provision of neonatal care: population based study of very preterm infants
Authors: L. K Smith, E. S Draper, B. N Manktelow, D. J Field
Journal: BMJ (2009)

<h3>Summary</h3> Checkpoints cascades coordinate cell cycle progression with essential chromosomal processes. During meiotic G2/prophase, recombination and chromosome synapsis are monitored by what are considered distinct checkpoints [1–3]. In budding yeast, the AAA+ ATPase Pch2 is thought to specifically promote cell cycle delay in response to synapsis defects [4–6]. However, unperturbed <i>pch2Δ</i> cells are delayed in meiotic G2/prophase [6], suggesting paradoxical roles for Pch2 in cell cycle progression. Here, we provide insight into the checkpoint roles of Pch2 and its connection to Hop1, a HORMA domain-containing client protein. Contrary to current understanding, we find that the Pch2-Hop1 module is crucial for checkpoint function in response to both recombination and synapsis defects, thus revealing a shared meiotic checkpoint cascade. Meiotic checkpoint responses are transduced by DNA break-dependent phosphorylation of Hop1 [7, 8]. Based on our data and on the effect of Pch2 on HORMA topology [9–11], we propose that Pch2 promotes checkpoint proficiency by catalyzing the availability of signaling-competent Hop1. Conversely, we demonstrate that Pch2 can act as a checkpoint silencer, also in the face of persistent DNA repair defects. We establish a framework in which Pch2 and Hop1 form a homeostatic module that governs general meiotic checkpoint function. We show that this module can - depending on the cellular context - fuel or extinguish meiotic checkpoint function, which explains the contradictory roles of Pch2 in cell cycle control. Within the meiotic checkpoint, the Pch2-Hop1 module thus operates analogous to the Pch2/TRIP13-Mad2 module in the spindle assembly checkpoint that monitors chromosome segregation [12–16].
Impact of Insulin Resistance on HCV Treatment Response and Impact of HCV Treatment on Insulin Sensitivity Using Direct Measurements of Insulin Action
Authors: Danielle Brandman, Peter Bacchetti, Claudia E. Ayala, Jacquelyn J. Maher, Mandana Khalili
Journal: Diabetes Care (2012)

Insulin resistance, as measured by surrogate markers, is associated with lower response to hepatitis C virus (HCV) therapy and may improve with HCV eradication. We prospectively evaluated the impact of directly measured insulin resistance and abnormal glucose metabolism on achieving sustained virologic response (SVR) with HCV therapy and assessed whether SVR results in improved insulin sensitivity and fasting glucose.A total of 50 noncirrhotic, nondiabetic, HCV-infected patients (27 untreated, 23 treated with pegylated interferon/ribavirin, nonrandomized) underwent clinical and histologic evaluation and 75-g oral glucose tolerance test. Insulin sensitivity was assessed directly with insulin suppression test by measuring steady-state plasma glucose (SSPG) concentration during a 240-min infusion of octreotide, glucose, and insulin. Of the subjects, 43 had at least one follow-up evaluation.Patient characteristics were median age 48, 57% male, and 52% white. SVR was achieved in 61% (14 of 23) of treated subjects. SVR was independently associated with HCV genotypes 2 and 3 (odds ratio 8.8 [95% CI 1.2-61.7]) but was not strongly associated with insulin sensitivity. When controlling for elapsed time between measurements, being on interferon, and BMI, SSPG decreased by 36 mg/dL (-88 to 16) in those with SVR and decreased by 28 mg/dL (-93 to 38) in those without SVR, compared with the untreated group. BMI (coefficient 9.1 per 5 units; 95% CI 5.3-12.9) and interferon use (coefficient 56; 95% CI 6.8-105) were associated with SSPG.Insulin resistance does not appear to be strongly associated with SVR. HCV therapy may improve insulin resistance regardless of virologic response; however, BMI and interferon use were clearly associated with insulin resistance.
Clinical examination of athletes with groin pain: an intraobserver and interobserver reliability study
Authors: P Hölmich, L R Hölmich, A M Bjerg
Journal: British Journal of Sports Medicine (2004)

Groin pain is a diagnostic and therapeutic challenge to sports medicine. The literature provides no consensus on definitions of or diagnostic criteria for groin pain in athletes. To compare the results of research and treatments, the methods used to diagnose and evaluate the degree of groin pain must be clearly defined and reproducible.To describe clinical examination techniques for groin pain in athletes and evaluate the intraobserver and interobserver reliability of these.Eighteen athletes, nine with sports related groin pain and nine without groin pain, were examined by two doctors and two physiotherapists. The examiners were trained in the examination techniques before the study. The examiners were blinded to the symptoms and identity of the subjects. The subjects were examined twice by each examiner in random order. The examinations included evaluation of adductor muscle related pain and strength, iliopsoas muscle related pain, strength, and flexibility, abdominal muscle related pain, and strength and pain at the symphysis joint. Kappa statistics and percentage of agreement were used to evaluate the data.Overall, the kappa values and percentage of agreement were in accordance and showed good reliability of the examinations. The kappa values for the intraobserver agreement were above 0.60 in 11 of 14 tests, and those for the interobserver agreement of the pain tests were above 0.60 in eight of 10 tests. The only test without acceptable interobserver reliability was the strength test for iliopsoas muscle.All but one of the tests investigated were reproducible and subject only to limited intraobserver and interobserver variation.
Cytokeratin expression in pilonidal sinus
Authors: I. Kurokawa, S. Nishijima, K. Suzuki, K. Kusumoto, H. Sensaki, N. Shikata, A. Tsubura
Journal: British Journal of Dermatology (2002)

Pilonidal sinus (PS) is considered to belong in the category of follicular occlusion diseases (acne triad).The aim of our study was to elucidate the pathogenesis of PS by evaluating its cytokeratin (CK) expression.CK expression in nine cases of PS was studied immunohistochemically using six antikeratin antibodies.Infundibular-like epithelium contained CK1, 10 and 14 similar to normal infundibulum, but it did not contain CK17. In non-infundibular-like epithelium, CK14, 16 and 17 were detected similar to that in normal outer root sheath. CK expression in PS was similar to that in hidradenitis suppurativa, suggesting that sinus epithelium may be fragile, hyperproliferative and undifferentiated.PS can be classified in the same entity as follicular occlusion diseases based on CK expression.
Acidosis: The Prime Determinant of Depressed Sensorium in Diabetic Ketoacidosis
Authors: Ebenezer A. Nyenwe, Laleh N. Razavi, Abbas E. Kitabchi, Amna N. Khan, Jim Y. Wan
Journal: Diabetes Care (2010)

The etiology of altered sensorium in diabetic ketoacidosis (DKA) remains unclear. Therefore, we sought to determine the origin of depressed consciousness in DKA.We analyzed retrospectively clinical and biochemical data of DKA patients admitted in a community teaching hospital.We recorded 216 cases, 21% of which occurred in subjects with type 2 diabetes. Mean serum osmolality and pH were 304 +/- 31.6 mOsm/kg and 7.14 +/- 0.15, respectively. Acidosis emerged as the prime determinant of altered sensorium, but hyperosmolarity played a synergistic role in patients with severe acidosis to precipitate depressed sensorium (odds ratio 2.87). Combination of severe acidosis and hyperosmolarity predicted altered consciousness with 61% sensitivity and 87% specificity. Mortality occurred in 0.9% of the cases.Acidosis was independently associated with altered sensorium, but hyperosmolarity and serum "ketone" levels were not. Combination of hyperosmolarity and acidosis predicted altered sensorium with good sensitivity and specificity.
Wilms’ Tumor 1 Gene Mutations Independently Predict Poor Outcome in Adults With Cytogenetically Normal Acute Myeloid Leukemia: A Cancer and Leukemia Group B Study
Authors: Peter Paschka, Guido Marcucci, Amy S. Ruppert, Susan P. Whitman, Krzysztof Mrózek, Kati Maharry, Christian Langer, Claudia D. Baldus, Weiqiang Zhao, Bayard L. Powell, Maria R. Baer, Andrew J. Carroll, Michael A. Caligiuri, Jonathan E. Kolitz, Richard A. Larson, Clara D. Bloomfield
Journal: Journal of Clinical Oncology (2008)

Purpose To analyze the prognostic impact of Wilms’ tumor 1 (WT1) gene mutations in cytogenetically normal acute myeloid leukemia (CN-AML). Patients and Methods We studied 196 adults younger than 60 years with newly diagnosed primary CN-AML, who were treated similarly on Cancer and Leukemia Group B (CALGB) protocols 9621 and 19808, for WT1 mutations in exons 7 and 9. The patients also were assessed for the presence of FLT3 internal tandem duplications (FLT3-ITD), FLT3 tyrosine kinase domain mutations (FLT3-TKD), MLL partial tandem duplications (MLL-PTD), NPM1 and CEBPA mutations, and for the expression levels of ERG and BAALC. Results Twenty-one patients (10.7%) harbored WT1 mutations. Complete remission rates were not significantly different between patients with WT1 mutations and those with unmutated WT1 (P = .36; 76% v 84%). Patients with WT1 mutations had worse disease-free survival (DFS; P &lt; .001; 3-year rates, 13% v 50%) and overall survival (OS; P &lt; .001; 3-year rates, 10% v 56%) than patients with unmutated WT1. In multivariable analyses, WT1 mutations independently predicted worse DFS (P = .009; hazard ratio [HR] = 2.7) when controlling for CEBPA mutational status, ERG expression level, and FLT3-ITD/NPM1 molecular-risk group (ie, FLT3-ITD negative /NPM1 mutated as low risk v FLT3-ITD positive and/or NPM1 wild-type as high risk). WT1 mutations also independently predicted worse OS (P &lt; .001; HR = 3.2) when controlling for CEBPA mutational status, FLT3-ITD/NPM1 molecular-risk group, and white blood cell count. Conclusion We report the first evidence that WT1 mutations independently predict extremely poor outcome in intensively treated, younger patients with CN-AML. Future trials should include testing for WT1 mutations as part of molecularly based risk assessment and risk-adapted treatment stratification of patients with CN-AML.
Accuracy of measurements of HbF with OSM3 in neonates and infants
Authors: A Denjean, F Bridey, JP Praud, JF Magny, M Dehan, C Gaultier
Journal: European Respiratory Journal (1992)

The accuracy of the Radiometer OSM3 oxymeter for measurement of fetal haemoglobin (HbF) in infants was investigated, and compared to one of the standard reference methods using alkali electrophoresis of haemoglobin. Blood samples of 37 infants with different gestational (27-41 weeks) and postnatal (1-198 days) ages were analysed. The two methods gave very close results but a significant mean difference (range -4.5-16.5%). However, agreement between the two methods was judged clinically acceptable (95% limits of agreement -7.5-15.5%). A rapid determination of HbF percentage, using OSM3, is an important determinant for correct assessment of oxygen saturation in newborn infants in intensive care units.
Cross Talk Between Endothelial and Smooth Muscle Cells in Pulmonary Hypertension
Authors: Saadia Eddahibi, Christophe Guignabert, Anne-Marie Barlier-Mur, Laurence Dewachter, Elie Fadel, Philippe Dartevelle, Marc Humbert, Gerald Simonneau, Naïma Hanoun, Françoise Saurini, Michel Hamon, Serge Adnot
Journal: Circulation (2006)

Background— The mechanism of pulmonary artery smooth muscle cell (PA-SMC) hyperplasia in idiopathic pulmonary artery hypertension (iPH) may involve both an inherent characteristic of PA-SMCs and abnormal control by external stimuli. We investigated the role of pulmonary microvascular endothelial cells (P-ECs) in controlling PA-SMC growth. Methods and Results— Serum-free medium of quiescent P-ECs elicited marked PA-SMC proliferation, and this effect was greater with P-ECs from patients with iPH than from control subjects and greater with PA-SMCs from these patients than from control subjects. Fluoxetine, which inhibits serotonin-induced mitogenesis by blocking the serotonin transporter, and p-chlorophenylalanine, which inhibits serotonin synthesis by blocking tryptophan hydroxylase (TPH), caused a similar 60% reduction in the growth-promoting effect of P-EC media, whereas endothelin receptor blockers had no effect. Assays of TPH activity in P-EC medium based on p-chlorophenylalanine–sensitive 5-hydroxytryptophan accumulation or serotonin determination indicated serotonin synthesis by P-ECs and an increase in this TPH-dependent process in iPH. Expression of the tph1 gene encoding the peripheral form of the TPH enzyme was increased in lungs and P-ECs from patients with iPH. Lung TPH1 immunostaining was confined to the pulmonary vessel intima. Conclusions— P-ECs produce paracrine factors governing PA-SMC growth. Serotonin, the main P-EC–derived growth factor, is overproduced in iPH and contributes to PA-SMC hyperplasia.
Mind, Brain, and Personality Disorders
Authors: Glen O. Gabbard
Journal: American Journal of Psychiatry (2005)

OBJECTIVE: The use of the terms "mind" and "brain" in psychiatry is often associated with a set of polarities. Concepts such as environment, psychosocial, and psychotherapy are linked with "mind," while genes, biology, and medication are often associated with "brain." The author examines these dichotomies as they apply to personality disorders. METHOD: Research on antisocial and borderline personality disorders that is relevant to these dichotomies is evaluated. The implications of the findings for the understanding of pathogenesis and treatment are reconsidered. RESULTS: In the clinical setting, it is problematic to lump together terms such as "genes," "brain," and "biological" as though they are separate and distinct from terms such as "environment," "mind," and "psychosocial." These dichotomies are problematic, because genes and environment are inextricably intertwined in the pathogenesis of personality disorders, psychosocial experiences may result in permanent changes in the brain, and psychotherapy may have its effect by altering brain structure and function. The "theory of mind" is a useful construct for bridging "mind" and "brain" in the treatment of personality disorders. CONCLUSIONS: Severe personality disorders are best understood and treated without "either-or" dichotomies of brain and mind. Each domain has a different language, however, and the language of the mind is necessary to help the patient develop a theory of mind.
Intra-abdominal Abscess
Authors: Joseph T. Ferrucci
Journal: JAMA (1981)

THE LETHAL nature of intraabdominal abscesses is evident from published rates of mortality that range from 30% in treated patients to 80% to 100% in patients with undrained abscesses. 1-3 However, recent advances in diagnostic radiology have substantially altered the investigative approach and therapeutic alternatives for such patients. The new noninvasive cross-sectional imaging modalities of ultrasonography and body computed tomography (CT) have both been extremely effective diagnostic modalities for abscess detection, while radionuclide abscessimaging agents have also been introduced that demonstrate considerable accuracy in detection of septic foci, both within the abdominal cavity and in extra-abdominal locations. Finally, invasive interventional radiological techniques for percutaneous diagnostic needle-aspiration of fluid collections under ultrasonographic or CT guidance have been widely employed and can be followed by percutaneous catheter drainage for definitive non-surgical therapy. This article outlines some of the emerging trends in the diagnosis and treatment of intraabdominal abscess by radiological means.  CROSS-SECTIONAL