tbuckley/cabot-search huggingface dataset:
Worldwide patterns of bronchodilator responsiveness: results from the Burden of Obstructive Lung Disease study
Authors: Wan C Tan, William M Vollmer, Bernd Lamprecht, David M Mannino, Anamika Jithoo, Ewa Nizankowska-Mogilnicka, Filip Mejza, Thorarinn Gislason, Peter G J Burney, A Sonia Buist
Journal: Thorax (2012)

<h3>Rationale</h3> Criteria for a clinically significant bronchodilator response (BDR) are mainly based on studies in patients with obstructive lung diseases. Little is known about the BDR in healthy general populations, and even less about the worldwide patterns. <h3>Methods</h3> 10 360 adults aged 40 years and older from 14 countries in North America, Europe, Africa and Asia participated in the Burden of Obstructive Lung Disease study. Spirometry was used before and after an inhaled bronchodilator to determine the distribution of the BDR in population-based samples of healthy non-smokers and individuals with airflow obstruction. <h3>Results</h3> In 3922 healthy never smokers, the weighted pooled estimate of the 95th percentiles (95% CI) for bronchodilator response were 284 ml (263 to 305) absolute change in forced expiratory volume in 1 s from baseline (ΔFEV<sub>1</sub>); 12.0% (11.2% to 12.8%) change relative to initial value (%ΔFEV<sub>1i</sub>); and 10.0% (9.5% to 10.5%) change relative to predicted value (%ΔFEV<sub>1p</sub>). The corresponding mean changes in forced vital capacity (FVC) were 322 ml (271 to 373) absolute change from baseline (ΔFVC); 10.5% (8.9% to 12.0%) change relative to initial value (ΔFVC<sub>i</sub>); and 9.2% (7.9% to 10.5%) change relative to predicted value (ΔFVC<sub>p</sub>). The proportion who exceeded the above threshold values in the subgroup with spirometrically defined Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 2 and higher (FEV<sub>1</sub>/FVC &lt;0.7 and FEV<sub>1</sub>% predicted &lt;80%) were 11.1%, 30.8% and 12.9% respectively for the FEV<sub>1</sub>-based thresholds and 22.6%, 28.6% and 22.1% respectively for the FVC-based thresholds. <h3>Conclusions</h3> The results provide reference values for bronchodilator responses worldwide that confirm guideline estimates for a clinically significant level of BDR in bronchodilator testing.
Cognitive Function Is Not Associated With Recurrent Foot Ulcers in Patients With Diabetes and Neuropathy
Authors: Christof Kloos, Franziska Hagen, Claudia Lindloh, Anke Braun, Karena Leppert, Nicolle Müller, Gunter Wolf, Ulrich A. Müller
Journal: Diabetes Care (2009)

OBJECTIVE To study whether there is an association between cognitive impairment and the relapse rate of foot ulcers in diabetic patients and those with previous foot ulcers. RESEARCH DESIGN AND METHODS This single-center prospective study assessed the association of cognitive function and risk for ulcer relapse in 59 patients with diabetes (mean age 65.1 years, diabetes duration 16.5 years, and A1C 7.4%), peripheral neuropathy, and a history of foot ulceration. Premorbid and current cognitive functions were measured (multiple-choice vocabulary test [Lehrl], number-symbol test, mosaic test [HAWIE-R], and trail-making tests A and B [Reitan]). Prevalence of depression was evaluated retrospectively (diagnoses in patient files or use of antidepressive medication). Patients were re-examined after 1 year. RESULTS Three patients (5%) died during follow-up (one of sepsis and two of heart problems). The remaining 56 patients (48%) developed 27 new foot ulcerations (78% superficial ulcerations [Wagner stage 1]). Characteristics of patients with and without ulcer relapse were not different. In a binary logistic regression analysis, cognitive function is not predictive of foot reulceration. CONCLUSIONS Cognitive function is not an important determinant of foot reulceration.
Accuracy of liquid based versus conventional cytology: overall results of new technologies for cervical cancer screening: randomised controlled trial
Authors: Guglielmo Ronco, Jack Cuzick, Paola Pierotti, Maria Paola Cariaggi, Paolo Dalla Palma, Carlo Naldoni, Bruno Ghiringhello, Paolo Giorgi-Rossi, Daria Minucci, Franca Parisio, Ada Pojer, Maria Luisa Schiboni, Catia Sintoni, Manuel Zorzi, Nereo Segnan, Massimo Confortini
Journal: BMJ (2007)

<b>Objective</b> To compare the accuracy of conventional cytology with liquid based cytology for primary screening of cervical cancer. <b>Design</b> Randomised controlled trial. <b>Setting</b> Nine screening programmes in Italy. <b>Participants</b> Women aged 25-60 attending for a new screening round: 22 466 were assigned to the conventional arm and 22 708 were assigned to the experimental arm. <b>Interventions</b> Conventional cytology compared with liquid based cytology and testing for human papillomavirus. <b>Main outcome measure</b> Relative sensitivity for cervical intraepithelial neoplasia of grade 2 or more at blindly reviewed histology, with atypical cells of undetermined significance or more severe cytology considered a positive result. <b>Results</b> In an intention to screen analysis liquid based cytology showed no significant increase in sensitivity for cervical intraepithelial neoplasia of grade 2 or more (relative sensitivity 1.17, 95% confidence interval 0.87 to 1.56) whereas the positive predictive value was reduced (relative positive predictive value <i>v</i> conventional cytology 0.58, 0.44 to 0.77). Liquid based cytology detected more lesions of grade 1 or more (relative sensitivity 1.68, 1.40 to 2.02), with a larger increase among women aged 25-34 (P for heterogeneity 0.0006), but did not detect more lesions of grade 3 or more (relative sensitivity 0.84, 0.56 to 1.25). Results were similar when only low grade intraepithelial lesions or more severe cytology were considered a positive result. No evidence was found of heterogeneity between centres or of improvement with increasing time from start of the study. The relative frequency of women with at least one unsatisfactory result was lower with liquid based cytology (0.62, 0.56 to 0.69). <b>Conclusion</b> Liquid based cytology showed no statistically significant difference in sensitivity to conventional cytology for detection of cervical intraepithelial neoplasia of grade 2 or more. More positive results were found, however, leading to a lower positive predictive value. A large reduction in unsatisfactory smears was evident. <b>Trial registration</b> Current Controlled Trials ISRCTN81678807.
Prognostic Value of Bronchiectasis in Patients with Moderate-to-Severe Chronic Obstructive Pulmonary Disease
Authors: Miguel-Angel Martínez-García, David de la Rosa Carrillo, Juan-Jose Soler-Cataluña, Yolanda Donat-Sanz, Pablo Catalán Serra, Marco Agramunt Lerma, Javier Ballestín, Irene Valero Sánchez, Maria Jose Selma Ferrer, Anna Roma Dalfo, Montserrat Bertomeu Valdecillos
Journal: American Journal of Respiratory and Critical Care Medicine (2013)

The prevalence of bronchiectasis is high in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) and it has been associated with exacerbations and bacterial colonization. These have demonstrated some degree of prognostic value in patients with COPD but no information about the relationship between bronchiectasis and mortality in patients with COPD is currently available.To assess the prognostic value of bronchiectasis in patients with moderate-to-severe COPD.Multicenter prospective observational study in consecutive patients with moderate-to-severe COPD. Bronchiectasis was diagnosed by high-resolution computed tomography scan. A complete standardized protocol was used in all patients covering general, anthrophometric, functional, clinical, and microbiologic data. After follow-up, the vital status was recorded in all patients. Multivariate Cox analysis was used to determine the independent adjusted prognostic value of bronchiectasis.Ninety-nine patients in Global Initiative for Chronic Obstructive Lung Disease (GOLD) II, 85 in GOLD III, and 17 in GOLD IV stages were included. Bronchiectasis was present in 115 (57.2%) patients. During the follow-up (median, 48 mo [interquartile range, 35-53]) there were 51 deaths (43 deaths in the bronchiectasic group). Bronchiectasis was associated with an increased risk of fully adjusted mortality (hazard ratio, 2.54; 95% confidence interval, 1.16-5.56; P = 0.02).Bronchiectasis was associated with an independent increased risk of all-cause mortality in patients with moderate-to-severe COPD.
Modulation of glomerular endothelin and endothelin receptor gene expression in aminonucleoside-induced nephrosis.
Authors: T Nakamura, I Ebihara, M Fukui, S Osada, Y Tomino, T Masaki, K Goto, Y Furuichi, H Koide
Journal: Journal of the American Society of Nephrology (1995)

This study assessed glomerular endothelin (ET)-1, ET-3, and ET-receptor A and B mRNA levels in puromycin aminonucleoside (PAN)-induced nephrosis. During the nephrotic stage, 8 days after PAN injection, ET-1 and ETB receptor mRNA were elevated by 2.8 +/- 0.8-fold (P < 0.01) and 2.4 +/- 0.9-fold (P < 0.01), respectively, as compared with controls. These mRNA levels decreased to control levels by Day 20, when the nephrosis was in remission. In contrast, glomerular ETA receptor mRNA levels did not change in PAN nephrosis or control rats during the experimental period. ET-3 mRNA was not detected in the glomeruli of PAN nephrosis or control rats. Additionally, plasma ET concentration and glomerular ET production were measured in PAN nephrosis and control rats by radio-immunoassay. Eight days after PAN injection, ET-1 levels in plasma and glomeruli were not significantly altered in rats with PAN-induced nephrosis (glomeruli, 104.68 +/- 16.46 pg/mg of protein versus 98.24 +/- 13.68 pg/mg of protein; plasma, 2.68 +/- 1.10 versus 2.52 +/- 0.98 pg/mL). The administration of methylprednisolone to PAN rats resulted in the rapid disappearance of proteinuria and partially attenuated the increased ET-1 and ETB receptor gene expression in the glomeruli. These data indicate that glomerular ET-1 and ETB receptor expression in PAN nephrosis in increased at the mRNA level and that methylprednisolone treatment results in an attenuated increase.
Absence of a gastrin inhibitory factor in the IgG fraction of serum from patients with pernicious anaemia.
Authors: J T Smith, A Garner, S E Hampson, R E Pounder
Journal: Gut (1990)

Patients with Addisonian pernicious anaemia are alleged to generate antibodies directed against the gastrin receptor. We purified IgG from 15 patients with pernicious anaemia and 15 healthy controls in an effort to show attenuation of gastrin specific binding in vitro and inhibition of gastrin stimulated acid secretion in vivo. Binding of the IgG fraction was determined in a radioreceptor assay utilising the rat pancreatic carcinoma cell line AR42J which expresses high affinity gastrin binding sites (Kd = 5 x 10(-10)). In comparison with control serum, there was no significant displacement (p = 0.10) of human gastrin-17 binding by pernicious anemia samples at either 0.3 mg protein/ml (control (mean (SEM)) 1489 (131) cpm; patients 1858 (174) cpm) or 3 mg protein/ml (control 1930 (110); patients 2195 (107) cpm). The effect of intravenous and intragastric IgG on acid secretion in the anaesthetised rat was determined over a 60 minute period after stimulation with 1 microgram/kg human gastrin-17. A bolus injection of IgG (60-200 mg/kg) had no significant effect (p = 0.50) on gastrin stimulated acid output (29.21 (1.28) mumol H+/h) compared with control (27.48 (4.70) mumol H+/h). Similarly, instillation of 800 mg/kg IgG directly into the stomach for 90 minutes also failed to influence gastrin stimulated acid output (29.69 (3.22) mumol H+/h). Thus, we have been unable to confirm previous reports of an IgG from patients with pernicious anaemia capable of blocking gastrin receptor binding or gastrin stimulated acid secretion.
Surgery for Aneurysms of the Aortic Root
Authors: Kenton J. Zehr, Thomas A. Orszulak, Charles J. Mullany, Alireza Matloobi, Richard C. Daly, Joseph A. Dearani, Thoralf M. Sundt, Francisco J. Puga, Gordon K. Danielson, Hartzell V. Schaff
Journal: Circulation (2004)

This study evaluated long-term results of aortic root replacement and valve-preserving aortic root reconstruction for patients with aneurysms involving the aortic root.Two-hundred three patients aged 53+/-16 years (mean+/-SD; 153 male, 50 female) underwent elective or urgent aortic root surgery from 1971 to 2000 for an aortic root aneurysm: 149 patients underwent a composite valve conduit reconstruction, and 54 patients underwent valve-preserving aortic root reconstruction. Fifty patients had Marfan syndrome. In-hospital and 30-day mortality was 4.0% (8/203) overall: for a composite valve conduit procedure, the corresponding value was 4.0% (6/149) and for valve-preserving procedure, 3.7% (2/54) (P=NS). Morbidity included 3 strokes (1%), 10 perioperative myocardial infarctions (5%), and 8 reoperations for bleeding (4%). Actuarial survival at 5, 10, 15, and 20 years was 93% (95% confidence interval [CI] = 88% to 97%), 79% (95% CI = 71% to 87%), 67% (95% CI = 57% to 79%), and 52% (95% CI = 36% to 69%), respectively. Freedom from reoperation was 72% (95% CI = 54% to 86%) at 20 years. Complications with anticoagulation occurred in 29 patients; with valve thrombosis, in 2; and with hemorrhage, in 27 (4 life threatening and 23 minor). Freedom from thromboembolism was 91% (95% CI = 77% to 98%) at 20 years. Freedom from endocarditis was 99% (95% CI = 92% to 100%) at 20 years. Multivariate analysis revealed preoperative mitral valve regurgitation (+3 to 4) and older age to be significant predictors of late death (P< or =0.005), and Marfan syndrome, initial valve-preserving aortic root reconstruction, and need for a concomitant procedure at initial operation to be significant predictors of the need for reoperation (P< or =0.01).Aortic root replacement for aortic root aneurysms can be done with low morbidity and mortality. Composite valve conduit reconstruction resulted in a durable result. There were few serious complications related to the need for long-term anticoagulation or a prosthetic valve. Reoperation was most commonly required because of failure of the aortic valve when a valve-preserving aortic root reconstruction was performed or for other cardiac or aortic disease elsewhere.
Dual Kidneys from Marginal Adult Donors as a Source For Cadaveric Renal Transplantation in the United States
Authors: Suphamai Bunnapradist, H. Albin Gritsch, Alice Peng, Stanley C. Jordan, Yong W. Cho
Journal: Journal of the American Society of Nephrology (2003)

The current organ shortage has led to the utilization of double kidney transplants from marginal adult donors, but outcomes data are limited. The United Network for Organ Sharing registry database was used to compare the outcomes of 403 dual adult kidney transplantations (DKT) and 11,033 single kidney transplantations (SKT) from 1997 to 2000. Graft and patient survival and the effect of multiple risk factors were evaluated. It was found that DKT patients were older, less sensitized, and received grafts from older, more mismatched donors with longer cold ischemia times. There was also a greater percentage of donors with a history of diabetes or hypertension and African-American recipients and donors in the DKT group. Graft survival was inferior in the DKT group, with a 7% lower graft survival rate at 1 yr. There was a higher incidence of primary nonfunction in the DKT group, although the incidence of delayed graft function, early rejection treatment, and graft thrombosis did not differ. Multivariate analysis was used to identify African-American recipient ethnicity and retransplant as risk factors for graft loss. Graft survival was comparable in DKT and SKT with donors over 55 yr of age. DKT resulted in inferior graft outcomes compared with SKT. When compared with SKT with donors over 55 yr of age, DKT resulted in similar graft outcomes. These otherwise discarded kidneys should be cautiously considered as a source of marginal donors.
Pancreatic stellate cells respond to inflammatory cytokines: potential role in chronic pancreatitis
Authors: P Mews
Journal: Gut (2002)

Background: It is now generally accepted that chronic pancreatic injury and fibrosis may result from repeated episodes of acute pancreatic necroinflammation (the necrosis-fibrosis sequence). Recent studies suggest that pancreatic stellate cells (PSCs), when activated, may play an important role in the development of pancreatic fibrosis. Factors that may influence PSC activation during pancreatic necroinflammation include cytokines known to be important in the pathogenesis of acute pancreatitis, such as tumour necrosis factor α (TNF-α), and the interleukins 1, 6, and 10 (IL-1, IL-6, and IL-10). Aim: To determine the effects of these cytokines on PSC activation, as assessed by cell proliferation, α smooth muscle actin (α-SMA) expression, and collagen synthesis. Methods: Cultured rat PSCs were incubated with cytokines for 24 hours. Cell proliferation was assessed by measuring <sup>3</sup>H thymidine incorporation into cellular DNA, α-SMA expression by western blotting, and collagen synthesis by incorporation of <sup>14</sup>C proline into collagenase sensitive protein. mRNA levels for procollagen α<sub>1</sub>(1) in PSCs were determined by northern and dot blotting methods. Results: Expression of α-SMA by PSCs was increased on exposure to each of the cytokines used in the study. Stellate cell proliferation was stimulated by TNF-α but inhibited by IL-6, while IL-1 and IL-10 had no effect on PSC proliferation. Collagen synthesis by PSCs was stimulated by TNF-α and IL-10, inhibited in response to IL-6, and unaltered by IL-1. Changes in collagen protein synthesis in response to TNF-α, IL-10, and IL-6 were not regulated at the mRNA level in the cells. Conclusion: This study has demonstrated that PSCs have the capacity to respond to cytokines known to be upregulated during acute pancreatitis. Persistent activation of PSCs by cytokines during acute pancreatitis may be a factor involved in the progression from acute pancreatitis to chronic pancreatic injury and fibrosis.
The development of an observational tool to code knockouts in Mixed Martial Arts (MMA)
Authors: Michael Hutchison, Michael Cusimano, David Lawrence, Tanveer Singh
Journal: British Journal of Sports Medicine (2013)

Objective To develop an observational tool to reliably code the situational characteristics and mechanism of contact for fights ending in knockout (KO) or technical KO (TKO). Design Digital video images and fight card information were collected retrospectively for UFC events during 2006–2009. Subjects Two coders independently viewed and completed to the Mixed Martial Arts (MMA) ‘Knockout’ Tool for 60 events (30=KO's 30=TKO's) chosen randomly from the pool of identified events during 2006–2009. Outcome Measures The MMA ‘Knockout’ Tool was developed by consensus and consists of 17 factors, including the Situational Context (eg, Round, octagon location, technical position), Pre-KO/TKO Strike Profile (eg, striking implement, strike location), Assessment of Fighters (eg, visual obstruction, clinical signs of concussion), and KO strike profile (eg, striking implement, strike location, head motion, additional head impacts). Intercoder agreements for each factor of interest were calculated using weighted κ coefficient. Results Coders achieved substantial agreement for the majority of the factors with κ coefficients ranging from 0.46 to 1.00. An overall reliability value was calculated based on all factors of the MMA ‘Knockout’ Tool, with an average κ coefficient of 0.81. Conclusion The MMA ‘Knockout’ Tool is reliable for coding the situational characteristics and mechanism of contact(s) for fights ending in a TKO or KO. Acknowledgements The Canadian Institutes of Health Research (CIHR) Strategic Team in Applied Injury Research funded this research Competing interests None.
Neurological Complications of So-called "Influenza": A Winter Study in South-east Wales
Authors: C. E. C. Wells
Journal: BMJ (1971)

Acute neurological disorder followed an upper respiratory infection in 19 patients in south-east Wales during the winter of 1969-70. Spinal and radicular syndromes predominated and included seven cases of transverse myelopathy. Serological tests suggested that the preceding infection was due to influenza A virus in eight cases, to other viruses in six, and were negative in five.
Cholecystectomy: from open surgery to single-incision laparoscopic and transluminal endoscopic surgery
Authors: D. Gouma
Journal: Endoscopy (2010)

Cholecystectomy is generally accepted as the treatment of choice for symptomatic gallstone disease and is one of the most frequently performed surgical procedures in the world. The first successful procedure was performed in 1882 by Langenbuch and more than a century later Philip Mouret (1987) performed the first laparoscopic cholecystectomy [1]. During the past two decades minimally invasive surgery progressed well and laparoscopic cholecystectomy is currently the gold standard for removal of the gallbladder. Numerous studies, as well as a Cochrane Systematic Review, have reported a shorter hospital stay, shorter period of recovery, reduction of postoperative pain, and better cosmetic results compared with open surgery [2].
Diabetes and Obesity-Related Risks for Pelvic Reconstructive Surgery in a Cohort of Swedish Twins
Authors: Mats Forsman, Anastasia Iliadou, Patrik Magnusson, Christian Falconer, Daniel Altman
Journal: Diabetes Care (2008)

OBJECTIVE—To determine the diabetes- and obesity-related risks for surgically managed stress urinary incontinence and pelvic organ prolapse. RESEARCH DESIGN AND METHODS—This twin cohort study used the Swedish Twin Register to identify 8,443 female twin pairs born from 1926 through 1958. The association between diabetes and pelvic floor surgery was estimated while taking into account the correlated (twin) structure of the data. RESULTS—For type 1 and type 2 diabetes, no significant associations were observed for stress urinary incontinence (odds ratio [OR] 1.0 [95% CI 0.1–9.2] and 2.0 [1.0–4.0], respectively). There were no cases of prolapse surgery in type 1 diabetic subjects, and for type 2 diabetes the risk estimate was nonsignificant (1.6 [1.0–2.7]). BMI &amp;gt;25 kg/m2, age ≥60 years, and childbirth were the strongest risk factors for having incontinence surgery. CONCLUSIONS—Our data suggest that diabetes is not associated with stress urinary incontinence or pelvic organ prolapse surgery.
Controversies in lupus: nervous system involvement.
Authors: G.A. Bruyn
Journal: Annals of the Rheumatic Diseases (1995)

What have we learned about CNS lupus in recent years? An enormous amount of knowledge on pathophysiology of antiphospholipid antibodies, in particular, has been gathered. Although hard evidence of a direct pathogenetic role of these antibodies in cerebral lupus is still lacking, it is generally felt that the multiple microinfarctions found in the brains of lupus patients are related to their presence. Better understanding of the pathogenesis of cerebral lupus will come from the study of experimental models, as it has been possible to develop an antiphospholipid antibody syndrome in mice. Because no specific laboratory test for CNS lupus is yet available, diagnosing the condition remains a challenge to every clinician. Techniques including neuropsychometric testing, quantitative EEG, and SPECT scans have taught us more about cognitive dysfunction and psychosis in patients with SLE. These categories remain the most difficult to define. The concept of hypercoagulability in SLE patients has diverted the direction of therapy from immunosuppression towards anticoagulation. It is of utmost importance that randomised trials are commenced in order to determine the optimal mode of anticoagulation for various groups of lupus patients. It will be necessary to conduct such trials under strict inclusion criteria, based on well defined patient categories. Such an enterprise will require international co-operation of investigators.