tbuckley/cabot-search huggingface dataset:
Obstructive Sleep Apnea Among Obese Patients With Type 2 Diabetes
Authors: Gary D. Foster, Mark H. Sanders, Richard Millman, Gary Zammit, Kelley E. Borradaile, Anne B. Newman, Thomas A. Wadden, David Kelley, Rena R. Wing, F. Xavier Pi Sunyer, Valerie Darcey, Samuel T. Kuna
Journal: Diabetes Care (2009)

OBJECTIVE To assess the risk factors for the presence and severity of obstructive sleep apnea (OSA) among obese patients with type 2 diabetes. RESEARCH DESIGN AND METHODS Unattended polysomnography was performed in 306 participants. RESULTS Over 86% of participants had OSA with an apnea-hypopnea index (AHI) ≥5 events/h. The mean AHI was 20.5 ± 16.8 events/h. A total of 30.5% of the participants had moderate OSA (15 ≤ AHI &amp;lt;30), and 22.6% had severe OSA (AHI ≥30). Waist circumference (odds ratio 1.1; 95% CI 1.0–1.1; P = 0.03) was significantly related to the presence of OSA. Severe OSA was most likely in individuals with a higher BMI (odds ratio 1.1; 95% CI 1.0–1.2; P = 0.03). CONCLUSIONS Physicians should be particularly cognizant of the likelihood of OSA in obese patients with type 2 diabetes, especially among individuals with higher waist circumference and BMI.
Variations in ribosomal DNA and mitochondrial DNA among chromosomal species of subterranean mole rats
Authors: H. Suzuki, S. Wakana, H. Yonekawa, K. Moriwaki, S. Sakurai, E. Nevo
Journal: Molecular Biology and Evolution (1996)

Restriction site variations in nuclear ribosomal DNA (rDNA) spacers and mitochondrial DNA (mtDNA) were examined in several populations of mole rats with variable numbers of chromosomes, which represented the two superspecies Spalax leucodon (2n = 38, 54, or 62) and Spalax ehrenbergi (2n = 52, 54, 58, or 60). Sequence divergence of rDNA spacers between the members of the superspecies was approximately 8%, while the variation within each superspecies was 4% on average. The intrasuperspecies differentiation of rDNA spacers was generally associated with changes in the diploid number of chromosomes. However, substantial divergence (approximately 1.5%) was also detected among populations with the same diploid number of chromosomes. The sequence divergence of mtDNA among haplotypes of S. ehrenbergi was 10% or higher and among haplotypes of S. leucodon it was approximately 12%. By contrast, the range of sequence divergence between superspecies was 7.4%-12%. The large divergence of mtDNAs within each superspecies of mole rats may be explained by the preservation of ancient mtDNA polymorphisms.
Long-term follow-up (12 to 35 weeks) after dynamic cardiomyoplasty
Authors: Caroline M.H.B. Lucas, Frederik H. Van der Veen, Emile C. Cheriex, Roberto Lorusso, Michael Havenith, Olaf C.K.M. Penn, Hein J.J. Wellens
Journal: Journal of the American College of Cardiology (1993)
Down-regulation of intra-hepatic T-cell signaling associated with GB virus C in a HCV/HIV co-infected group with reduced liver disease
Authors: Mark D. Berzsenyi, David J. Woollard, Catriona A. McLean, Scott Preiss, Victoria M. Perreau, Michael R. Beard, D. Scott Bowden, Benjamin C. Cowie, Shuo Li, Anne M. Mijch, Stuart K. Roberts
Journal: Journal of Hepatology (2011)
Unraveling human natural killer cell deficiency
Authors: Jordan S. Orange
Journal: Journal of Clinical Investigation (2012)

NK cells are a component of the innate immune system identified in animals as serving an essential role in antiviral immunity. Establishing their role in human health has been challenging, with the most direct insight coming from the study of NK cell-deficient individuals. However, NK cell deficiencies are rare, and more research is needed. In this issue of the JCI, two independent groups of researchers have simultaneously identified the genetic cause of a human NK cell deficiency as mutation in the MCM4 gene, encoding minichromosome maintenance complex component 4. These reports suggest a critical role for the minichromosome maintenance helicase complex in NK cells and NK cell-mediated host defense.
Radiotherapy Patterns of Care Study in Lung Carcinoma
Authors: B. Movsas, J. Moughan, R. Komaki, H. Choy, R. Byhardt, C. Langer, M. Goldberg, M. Graham, D. Ettinger, D. Johnstone, R. Abrams, R. Munden, G. Starkschall, J. Owen
Journal: Journal of Clinical Oncology (2003)

For the first time, a lung Patterns of Care Study was conducted to determine the national patterns of radiation (RT) practice in patients treated for nonmetastatic lung cancer in 1998 to 1999.A national survey of randomly selected RT institutions in the United States was conducted using two-stage cluster sampling, stratified by practice type. Patients with nonmetastatic lung cancer (Karnofsky performance score [KPS] > or = 60), who received RT as definitive or adjuvant therapy, were randomly selected. To determine national estimates, sample size was weighted by the relative number of institutions per strata and the number of patient records reviewed per the number of patients eligible. Accordingly, 42,335 patient records from 58 institutions were reviewed by trained research associates. The unweighted sample size (or number of patients) was 541.The histologies were small-cell lung cancer (SCLC) in 14.5% of patients versus non-small-cell lung cancer (NSCLC) in 85.5% of patients. The median age was 67 years (range, 29 to 92 years); 61% of patients were male, and 38% were current smokers. Bone scans and brain imaging were not obtained in 34% and 52% of clinical stage (CS) III NSCLC patients, respectively. Regarding treatment strategies, for SCLC and CS III NSCLC, chemotherapy plus RT was used significantly more than RT alone (P <.05); in CS I NSCLC, RT alone was the primary treatment (P <.05). Overall, 58% of patients received systemic therapy. On multivariate analysis, factors correlating with increased use of chemotherapy included younger age, histology (SCLC > NSCLC), increasing CS, increasing KPS, and lack of comorbidities. Only 3% of all patients were treated on prospective clinical trials.This study establishes the general patterns of care for lung carcinoma in RT facilities within the United States. As supported by clinical trials, patients with limited-stage SCLC and CS III NSCLC received chemotherapy plus RT more than they received RT alone. Further improvements in staging, smoking cessation, and increased accrual to clinical trials must be encouraged.
Capillary limitation of oxygen distribution in the isolated rete mirabile of the eel (Anguilla anguilla).
Authors: E A Rasio, C A Goresky
Journal: Circulation Research (1979)

The presence of a significant barrier at the level of the capillary to the diffusion of oxygen into tissue would have major significance in biology.The rete mirabile of the eel, an organ made up of alternately disposed arterial and venous capillaries, was used to study this question.The two capillary beds were perfused with albumin-containing Krebs-Ringer bicarbonate buffer in an uncoupled countercurrent fashion with equal flows, and the preparation was shielded from atmospheric oxygen with a polyvinylidene chloride fibs.A constant arterial infusion containing labeled albumin, inulin, and water, and an increased oxygen content, and a venous infusion containing a greatly reduced oxygen content were begun, and from the steady state response to these, capillary permeability-surface products were calculated.Approximately half the labeled water and one-third of the arterial minus venous oxygen increment emerged in the arterial outflow, whereas in the flow-limited case none would be expected.We calculated permeability values for the labeled tracers (albumin, inulin, and water), assuming a surface area of 1 cm'/mg, and found these not to be significantly different from those previously reported (Circ Res 41: 791-798, 1977).The permeability value for oxygen at 25°C was 11.8 ± 1.9 (SD) x 10~5 cm/sec.The data indicate that the limiting effect of the capillary wall on oxygen transfer is of a magnitude that must be taken into account in describing the factors affecting the distribution of oxygen to tissues.
Psychological and Behavioral Correlates of Baseline BMI in the Diabetes Prevention Program (DPP)
Authors: Linda M. Delahanty, James B. Meigs, Doug Hayden, Donald A. Williamson, David M. Nathan
Journal: Diabetes Care (2002)

OBJECTIVE—To determine psychological and behavioral correlates of baseline BMI in the Diabetes Prevention Program (DPP). RESEARCH DESIGN AND METHODS—Of 1,079 DPP lifestyle intervention participants, 274 completed validated questionnaires at baseline assessing weight loss history, stage of change, self-efficacy, dietary restraint, emotional eating, binge eating, perceived stress, depression, and anxiety. RESULTS—The mean age of subjects was 52.5 years, 65% were women, and their mean BMI was 33.9 kg/m2. Higher BMI correlated with more frequent weight cycling (r = 0.50, P &amp;lt; 0.0001) and efforts at weight loss (r = 0.34, P &amp;lt; 0.0001); younger age when first overweight (r = −0.42, P &amp;lt; 0.0001); lower exercise efficacy (r = −0.15, P = 0.015); lower weight loss efficacy (r = −0.21, P &amp;lt; 0.001); a less advanced stage of change for weight loss (r = −0.12, P = 0.04); more perceived stress (r = 0.14, P = 0.02); emotional eating (r = 0.19, P = 0.001); poor dietary restraint (r = −0.14, P = 0.02); binge eating frequency (r = 0.18, P = 0.004) and severity (r = 0.30, P &amp;lt; 0.0001); feeling deprived, angry, or upset while dieting (r = 0.27, P ≤ 0.0001); and food cravings while dieting (r = 0.31, P &amp;lt; 0.0001). Correlations did not differ as a function of sex; however, correlations of BMI with anxiety and low-fat diet and weight loss self-efficacy differed as a function of ethnicity. In multivariate models, binge eating severity, poor dietary restraint, and food craving were independent correlates of baseline BMI. CONCLUSIONS—Many psychological and behavioral factors are associated with higher BMI in this ethnically diverse group of men and women. Whether strategies that help patients increase levels of dietary restraint and reduce binge eating and food craving lead to long-term weight loss maintenance needs longitudinal study.
Gaps in Public Knowledge of Peripheral Arterial Disease
Authors: Alan T. Hirsch, Timothy P. Murphy, Marge B. Lovell, Gwen Twillman, Diane Treat-Jacobson, Eileen M. Harwood, Emile R. Mohler, Mark A. Creager, Robert W. Hobson, Rose Marie Robertson, W. James Howard, Paul Schroeder, Michael H. Criqui
Journal: Circulation (2007)

Lower-extremity peripheral arterial disease (PAD) is associated with decreased functional status, diminished quality of life, amputation, myocardial infarction, stroke, and death. Nevertheless, public knowledge of PAD as a morbid and mortal disease has not been previously assessed.We performed a cross-sectional, population-based telephone survey of a nationally representative sample of 2501 adults > or = 50 years of age, with oversampling of blacks and Hispanics. The survey instrument measured the demographic, risk factor, and cardiovascular disease characteristics of the study population; prevalent leg symptoms; PAD awareness relative to atherosclerosis risk factors and other cardiovascular and noncardiovascular diseases; perceived causes of PAD; and perceived systemic and limb consequences of PAD. Respondents were 67.2+/-12.6 years of age with a high prevalence of risk factors but only a modest burden of known coronary or cerebrovascular disease. Twenty-six percent of respondents expressed familiarity with PAD, a rate significantly lower than that for any other cardiovascular disease or atherosclerosis risk factor. Within the "PAD-aware" cohort, knowledge was poor. Half of these individuals were not aware that diabetes and smoking increase the risk for PAD; 1 in 4 knew that PAD is associated with increased risk of heart attack and stroke; and only 14% were aware that PAD could lead to amputation. All knowledge domains were lower in individuals with lower income and education levels.The public is poorly informed about PAD, with major knowledge gaps regarding the definition of PAD, risk factors that lead to PAD, and associated limb symptoms and amputation risk. The public is not aware that PAD imposes a high short-term risk of heart attack, stroke, and death. For the national cardiovascular disease burden to be reduced, public PAD knowledge could be improved by national PAD public education programs designed to reduce critical knowledge gaps.
Mechanisms of injury--a pictorial record.
Authors: J A Fairclough, R Evans, G A Farquhar
Journal: British Journal of Sports Medicine (1986)

The illustrations of both these incidents show, with extraordinary detail, the mechanism of injury involved in the production of these lesions. It is often difficult, when dealing with the end product of trauma of any description, to appreciate its mechanism of occurrence and gain an accurate estimate of the amount of force which has produced the damage. The two photographic sequences highlight the problem of attempting to prevent sporting injuries, as in both cases the incidents illustrated (Fig. 1 and Fig. 4) would not necessarily be interpreted as ones which precede major sporting injuries. In the case of the knee injury, the forcible anterior translocation of the tibia, as pictured, demonstrates well the mechanism of the tear produced in the anterior cruciate. In the case showing the injury to the spine, the position of the back prior to impact is exactly in keeping with the flexion/rotation forces which cause such spinal damage. The camera has recorded with impassionate accuracy the fact that major injuries, far from always having a preventable cause, are inherent in all high-velocity body-contact sports.
Pulmonary ventilation and gas exchange in bronchiectasis
Authors: J. N. Pande, B. P. Jain, R. G. Gupta, J. S. Guleria
Journal: Thorax (1971)

The subdivisions of the lung volume, pulmonary mechanics, and resting steady state pulmonary transfer factor were measured in 31 patients with bronchographically proven bronchiectasis. In seven patients the process of gas exchange was further investigated by fractionating the total alveolar-arterial oxygen tension gradient into diffusion, distribution, and true shunt components. A restrictive type of ventilatory defect with varying degrees of airway obstruction was observed in a majority of the patients; the airway obstruction was partially reversed by a bronchodilator. Dynamic compliance was usually decreased and the pulmonary resistance increased. Pulmonary transfer factor was decreased in proportion to the number of segments involved. Vital capacity, maximum breathing capacity, and dynamic compliance bore a less significant correlation with the extent of disease. The degree of airway obstruction, as judged by pulmonary resistance, was independent of the extent of disease. All the patients were hypoxaemic and some had hypercapnia as well. The alveolar-arterial oxygen tension gradient was widened primarily because of distributional abnormalities and, to some extent, by the presence of true right-to-left shunts. The latter amounted to 13·6% of the total cardiac output. Surgical resection of the affected lobe or segments resulted in a further deterioration of all the parameters of pulmonary function tested.
Stratification of High-risk Prostate Cancer into Prognostic Categories: A European Multi-institutional Study
Authors: Steven Joniau, Alberto Briganti, Paolo Gontero, Giorgio Gandaglia, Lorenzo Tosco, Steffen Fieuws, Bertrand Tombal, Giansilvio Marchioro, Jochen Walz, Burkhard Kneitz, Pia Bader, Detlef Frohneberg, Alessandro Tizzani, Markus Graefen, Paul van Cangh, R Jeffrey Karnes, Francesco Montorsi, Hein Van Poppel, Martin Spahn
Journal: European Urology (2014)
Soluble apoE/Aβ complex: mechanism and therapeutic target for APOE4-induced AD risk
Authors: Leon M Tai, Shipra Mehra, Varsha Shete, Steve Estus, G William Rebeck, Guojun Bu, Mary Jo LaDu
Journal: Molecular Neurodegeneration (2014)

The APOE4 allele of apolipoprotein E (apoE) is the greatest genetic risk factor for Alzheimer's disease (AD) compared to APOE2 and APOE3. Amyloid-β (Aβ), particularly in a soluble oligomeric form (oAβ), is considered a proximal cause of neurodegeneration in AD. Emerging data indicate that levels of soluble oAβ are increased with APOE4, providing a potential mechanism of APOE4-induced AD risk. However, the pathway(s) by which apoE4 may increase oAβ levels are unclear and the subject of continued inquiry. In this editorial review, we present the hypothesis that apoE isoform-specific interactions with Aβ, namely apoE/Aβ complex, modulate Aβ levels. Specifically, we propose that compared to apoE3, apoE4-containing lipoproteins are less lipidated, leading to less stable apoE4/Aβ complexes, resulting in reduced apoE4/Aβ levels and increased accumulation, particularly of oAβ. Evidence that support or counter this argument, as well as the therapeutic significance of this pathway to neurodegeneration, are discussed.
Serious Transport Accidents in Adults With Attention-Deficit/Hyperactivity Disorder and the Effect of Medication
Authors: Zheng Chang, Paul Lichtenstein, Brian M. D’Onofrio, Arvid Sjölander, Henrik Larsson
Journal: JAMA Psychiatry (2014)

Studies have shown that attention-deficit/hyperactivity disorder (ADHD) is associated with transport accidents, but the magnitude of the association remains unclear. Most important, it is also unclear whether ADHD medication reduces this risk.To estimate the association between ADHD and the risk of serious transport accidents and to explore the extent to which ADHD medication influences this risk among patients with ADHD.In total, 17,408 patients with a diagnosis of ADHD were observed from January 1, 2006, through December 31, 2009, for serious transport accidents documented in Swedish national registers. The association between ADHD and accidents was estimated with Cox proportional hazards regression. To study the effect of ADHD medication, we used stratified Cox regression to compare the risk of accidents during the medication period with the risk during the nonmedication period within the same patients.Serious transport accident, identified as an emergency hospital visit or death due to transport accident.Compared with individuals without ADHD, male patients with ADHD (adjusted hazard ratio, 1.47; 95% CI, 1.32-1.63) and female patients with ADHD (1.45; 1.24-1.71) had an increased risk of serious transport accidents. In male patients with ADHD, medication was associated with a 58% risk reduction (hazard ratio, 0.42; 95% CI, 0.23-0.75), but there was no statistically significant association in female patients. Estimates of the population-attributable fractions suggested that 41% to 49% of the accidents in male patients with ADHD could have been avoided if they had been receiving treatment during the entire follow-up.Attention-deficit/hyperactivity disorder is associated with an increased risk of serious transport accidents, and this risk seems to be possibly reduced by ADHD medication, at least among male patients. This should lead to increased awareness among clinicians and patients of the association between serious transport accidents and ADHD medication.
Hyperventilation-Induced Hypotension During Cardiopulmonary Resuscitation
Authors: Tom P. Aufderheide, Gardar Sigurdsson, Ronald G. Pirrallo, Demetris Yannopoulos, Scott McKnite, Chris von Briesen, Christopher W. Sparks, Craig J. Conrad, Terry A. Provo, Keith G. Lurie
Journal: Circulation (2004)

A clinical observational study revealed that rescuers consistently hyperventilated patients during out-of-hospital cardiopulmonary resuscitation (CPR). The objective of this study was to quantify the degree of excessive ventilation in humans and determine if comparable excessive ventilation rates during CPR in animals significantly decrease coronary perfusion pressure and survival.In humans, ventilation rate and duration during CPR was electronically recorded by professional rescuers. In 13 consecutive adults (average age, 63+/-5.8 years) receiving CPR (7 men), average ventilation rate was 30+/-3.2 per minute (range, 15 to 49). Average duration per breath was 1.0+/-0.07 per second. No patient survived. Hemodynamics were studied in 9 pigs in cardiac arrest ventilated in random order with 12, 20, or 30 breaths per minute. Survival rates were then studied in 3 groups of 7 pigs in cardiac arrest that were ventilated at 12 breaths per minute (100% O2), 30 breaths per minute (100% O2), or 30 breaths per minute (5% CO2/95% O2). In animals treated with 12, 20, and 30 breaths per minute, the mean intrathoracic pressure (mm Hg/min) and coronary perfusion pressure (mm Hg) were 7.1+/-0.7, 11.6+/-0.7, 17.5+/-1.0 (P<0.0001), and 23.4+/-1.0, 19.5+/-1.8, and 16.9+/-1.8 (P=0.03), respectively. Survival rates were 6/7, 1/7, and 1/7 with 12, 30, and 30+ CO2 breaths per minute, respectively (P=0.006).Professional rescuers were observed to excessively ventilate patients during out-of-hospital CPR. Subsequent animal studies demonstrated that similar excessive ventilation rates resulted in significantly increased intrathoracic pressure and markedly decreased coronary perfusion pressures and survival rates.
Mycobacterium xenopi infection in an immunosuppressed patient with Crohn's disease
Authors: C J Majoor
Journal: Thorax (2004)

A 48 year old patient with active Crohn's disease presented with bilateral nodules over his lungs resembling malignant metastasis. Bronchoscopic and pathological examination of the airways and sputum did not show any malignancy. After 6 weeks Mycobacterium xenopi was cultured from his bronchial washings while all other cultures remained negative. Treatment was started with rifampicin, ethambutol, and clarithromycin and, after 9 months of treatment, there was an almost complete resolution of his chest radiograph.
Modelling pathogenic mechanisms of upper airway dysfunction in the molecular age
Authors: A. R. Schwartz, S. P. Patil, H. Schneider, P. L. Smith
Journal: European Respiratory Journal (2008)

bstructive sleep apnoea (OSA) is a complex disorder consisting of periods of upper airway obstruction during sleep [1], which are terminated by arousals and oxyhaemoglobin desaturations.Most adults with this disorder present in mid-life with an up to ,20-yr progressive history of loud snoring often of increasing intensity, punctuated by witnessed apnoeas and resuscitative snorts.As sleep apnoea develops, patients may begin to complain of sleep disruption and frank daytime hypersomnolence.The reasons for the development and progression of this disorder, however, are not well understood.A combination of inherited and acquired factors may contribute to the pathogenesis of OSA [2, 3].A heritable predisposition to this disorder is suggested by the elevated prevalence of sleep apnoea in males compared with females and in African-American and East Asian compared with Western populations [4-9], as well as by studies demonstrating alterations in pharyngeal anatomy between those with and without sleep apnoea [10][11][12].Conversely, weight gain and age can contribute substantially to sleep apnoea prevalence, suggesting that sleep apnoea susceptibility may also be acquired [13, 14].The precise mechanisms for the development of upper airway dysfunction during sleep, however, are not known.