tbuckley/cabot-search huggingface dataset:
Center-Specific Graft and Patient Survival Rates
Authors: Hung-Mo Lin, H. Myron Kauffman, Maureen A. McBride, Darcy B. Davies, John D. Rosendale, Carol M. Smith, Erick B. Edwards, O. Patrick Daily, James Kirklin, Charles F. Shield, Lawrence G. Hunsicker
Journal: JAMA (1998)

Multiple comprehensive, risk-adjusted studies evaluating short-term surgical mortality have been reported previously. This report analyzes short-term and long-term outcomes, both nationally and at each individual transplant program, for all solid organ transplantations performed in the United States.To report graft and patient survival rates for all solid organ transplantations, both nationally and at each specific transplant program in the United States, and to compare the expected survival rate with the actual survival rate of each individual program.Multivariate regression analysis of donor and recipient factors affecting graft and patient survival of all kidney, liver, pancreas, heart, lung, and heart-lung transplants reported to the United Network for Organ Sharing from 742 separate transplant programs.A cohort of 97587 solid organ transplantations performed on 92966 recipients in the United States from January 1988 through April 1994.Short-term and conditional 3-year national and individual transplant program graft and patient survival rates overall and from 2 separate eras (era 1, January 1988-April 1992; era 2, May 1992-April 1994); comparison of actual center-specific performance with risk-adjusted expected performance and identification of centers with better-than-expected or worse-than-expected survival rates.One-year graft follow-up exceeded 98% and conditional 3-year follow-up exceeded 91% for all organs. Graft and patient survival improved significantly in era 2 compared with era 1 for all cadaver organs except heart, which remained the same. One-year cadaveric graft survival ranged from 81.5% for heart to 61.9% for heart-lung and 3-year conditional graft survival ranged from 91.3% for pancreas to 74.7% for lung. The percentage of programs whose actual 1-year graft survival was not different from or was better than their risk-adjusted expected survival ranged from 98.3% for heart-lung to 75.7% for liver. Most kidney, liver, and heart programs whose actual survival was significantly less than expected performed small numbers (less than the national average) of transplantations per year.Graft and patient survival for solid organ transplantations showed improvement over time. Conditional 3-year graft and patient survival rates were approximately 90% for all organs except for lung and heart-lung. The conditional 3-year survival rates were better than 1-year survival rates, indicating the major risk after transplantation occurs in the first year. The majority of transplant programs achieved actual survival rates not significantly different from their expected survival rates. Center effects were most significant within the first year after transplantation and had much less influence on long-term survival outcomes.
Efficacy and safety of antidepressants for children and adolescents
Authors: Jon N Jureidini, Christopher J Doecke, Peter R Mansfield, Michelle M Haby, David B Menkes, Anne L Tonkin
Journal: BMJ (2004)

How safe and effective are antidepressants in children and adolescents?The authors of this review have found disturbing shortcomings in the methods and reporting of trials of newer antidepressants in this patient group Antidepressants introduced since 1990, especially selective serotonin reuptake inhibitors and venlafaxine, have been used increasingly as first line treatment for depression in children. 1 2 The safety of prescribing antidepressants to children (including adolescents) has been the subject of increasing concern in the community and the medical profession, leading to recommendations against their use from government and industry (box 1).In this paper, we review the published literature on the efficacy and safety of newer antidepressants in children. MethodsHaving criticised the way in which Keller et al interpreted the results of their study, 3 4 we sought to check the quality of methods and reporting of other published trials of newer antidepressants in children (box 2).Of seven published randomised controlled trials of newer antidepressants for depressed children published in refereed journals, six used a placebo control. 3 5-9 We analysed each study's methods and the extent to which authors' conclusions were supported by data.The seventh study, which compared a newer antidepressant with a tricyclic antidepressant without finding significant difference, 10 was not included in the analysis but appears in the table on bmj.com. Funding of trialsPharmaceutical companies paid for the trials and otherwise remunerated the authors of at least three of the four larger studies (table ). Box 1: Warnings about antidepressants in childrenJune 2003-Letter from GlaxoSmithKline to all medical practitioners in the United Kingdom actively discouraging the use of paroxetine in patients less than 18 years of age, on the basis of recently disclosed trial results showing unacceptable risk of serious adverse effects, including hostility and suicidality.www.researchprotection.org/risks/PaxilRisks0603.html
Impact of Awareness of Terminal Illness and Use of Palliative Care or Intensive Care Unit on the Survival of Terminally Ill Patients With Cancer: Prospective Cohort Study
Authors: Young Ho Yun, Myung Kyung Lee, Seon Young Kim, Woo Jin Lee, Kyung Hae Jung, Young Rok Do, Samyong Kim, Dae Seog Heo, Jong Soo Choi, Sang Yoon Park, Hyun Sik Jeong, Jung Hun Kang, Si-Young Kim, Jungsil Ro, Jung Lim Lee, Sook Ryun Park, Sohee Park
Journal: Journal of Clinical Oncology (2011)

Purpose We conducted this study to evaluate the validity of the perception that awareness of their terminal prognosis and use of palliative care or nonuse of an intensive care unit (ICU) causes patients to die sooner than they would otherwise. Patients and Methods In this prospective cohort study at 11 university hospitals and the National Cancer Center in Korea, we administered questionnaires to 619 consecutive patients immediately after they were determined by physicians to be terminally ill. We followed patients during 6 months after enrollment and assessed how their survival was affected by the disclosure of terminal illness and administration of palliative care or nonuse of the ICU. Results In a follow-up of 481 patients and 163.8 person-years, we identified 466 deceased patients. Nineteen percent of the patients died within 1 month, while 41.3% lived for 3 months, and 17.7% lived for 6 months. Once the cancer was judged terminal, the median survival time was 69 days. On multivariate analysis, neither patient awareness of terminal status at baseline (adjusted hazard ratio [aHR], 1.20; 95% CI, 0.96 to 1.51), use of a palliative care facility (aHR, 0.96; 95% CI, 0.76 to 1.21), nor general prostration (aHR, 1.23; 95% CI, 0.96 to 1.57) was associated with reduced survival. Use of the ICU (aHR, 1.47; 95% CI, 1.06 to 2.05) and poor Eastern Cooperative Oncology Group performance status (aHR, 1.37; 95% CI, 1.10 to 1.71) were significantly associated with poor survival. Conclusion Patients' being aware that they are dying and entering a palliative care facility or ICU does not seem to influence patients' survival.
A Tympanitic Abdomen
Authors: Richard Krysztopik
Journal: Journal of the Royal Society of Medicine (2001)

In the March JRSM, Mr Richard Krysztopik presented a diagnostic dilemma. Here he records the outcome. The names of those who offered the correct diagnosis, and the prizewinner drawn from a hat, will be announced in the next issue

The patient, a man aged 61 with type 2 diabetes, had been referred with hesitancy of micturition, poor stream, haematuria and dysuria. Pneumaturia was not reported. On examination his abdomen was distended and tympanitic; the prostate was mildly enlarged and smooth. The urine contained 1% glucose and Gram-negative bacteria were seen on microscopy. Antibiotics were prescribed.

Abdominal radiography revealed a massive gas-filled structure, seemingly arising from the pelvis, and a diagnosis of caecal volvulus was suggested. Colonoscopically, the distal colon appeared normal. On barium enema, contrast flowed freely as far as the ascending colon but none reached the caecum (Figure 1).



Figure 1

Abdominal radiograph



Caecostomy was undertaken through a right gridiron incision. On entry into the peritoneal cavity a large smooth viscus was encountered, into which a balloon catheter was inserted and secured with a purse-string suture. Gas was released and the viscus deflated; subsequently pus and then urine drained from it. When contrast solution was instilled down the tube, radiographs disclosed an irregular cavity in the pelvis anterior to the rectum. Intravenous urography showed bilateral pelvicalyceal dilatation, with a high-capacity bladder filling easily and corresponding topographically to the gas-filled structure seen on the original radiographs. On cystoscopy the bladder was oedematous and there was moderate enlargement of the median and lateral lobes of the prostate.

The prostate was resected transurethrally and histological examination of the material showed benign prostatic hypertrophy with foci of chronic infection, and chronic cystitis with prominent lymphoid follicles in the lamina propria. On culture the urine grew Escherichia coli. The abdominal tube was removed and the patient recovered without incident.
Time-Dependent Changes in Atherosclerotic Plaque Composition in Patients Undergoing Carotid Surgery
Authors: Guus W. van Lammeren, Hester M. den Ruijter, Joyce E. P. Vrijenhoek, Sander W. van der Laan, Evelyn Velema, Jean-Paul P. M. de Vries, Dominique P. V. de Kleijn, Aryan Vink, Gert Jan de Borst, Frans L. Moll, Michiel L. Bots, Gerard Pasterkamp
Journal: Circulation (2014)

Time-dependent trends in the incidence of cardiovascular disease have been reported in high-income countries. Because atherosclerosis underlies the majority of cardiovascular diseases, we investigated temporal changes in the composition of atherosclerotic plaques removed from patients undergoing carotid endarterectomy.The Athero-Express study is an ongoing, longitudinal, vascular biobank study that includes the collection of atherosclerotic plaques of patients undergoing primary carotid endarterectomy in the province of Utrecht from 2002 to 2011. Histopathologic features of plaques of 1583 patients were analyzed in intervals of 2 years. The analysis included quantification of collagen, calcifications, lipid cores, plaque thrombosis, macrophages, smooth muscle cells, and microvessels. Large atheroma, plaque thrombosis, macrophages, and calcifications were less frequently observed over time, with adjusted odds ratios of 0.72 (95% confidence interval, 0.650-0.789), 0.62 (95% confidence interval, 0.569-0.679), 0.87 (95% confidence interval, 0.800-0.940), and 0.75 (95% confidence interval, 0.692-0.816) per 2-year increase in time, respectively. These changes in plaque characteristics were consistently observed in patient subgroups presenting with stroke, transient ischemic attack, ocular symptoms, and asymptomatic patients. Concomitantly, risk factor management and secondary prevention strategies among vascular patients scheduled for carotid endarterectomy significantly improved over the past decade.In conclusion, over the past decade, atherosclerotic plaques harvested during carotid endarterectomy show a time-dependent change in plaque composition characterized by a decrease in features currently believed to be causal for plaque instability. This appears to go hand in hand with improvements in risk factor management.
Intracoronary Low-Dose β-Irradiation Inhibits Neointima Formation After Coronary Artery Balloon Injury in the Swine Restenosis Model
Authors: Ron Waksman, Keith A. Robinson, Ian R. Crocker, Chris Wang, Michael B. Gravanis, Gustavo D. Cipolla, Richard A. Hillstead, Spencer B. King
Journal: Circulation (1995)

Background Neointima formation contributing to recurrent stenosis remains a major limitation of percutaneous transluminal angioplasty. Endovascular low-dose γ-irradiation has been shown to reduce intimal thickening (hyperplasia) after balloon overstretch injury in pig coronary arteries, a model of restenosis. The objective of this study was to determine whether the use of a β-emitting radioisotope for this application would have similar effects and to examine the dose-response relations with this approach. Methods and Results Normal domestic pigs underwent balloon overstretch injury in the left anterior descending and left circumflex and coronary arteries. A flexible catheter was introduced by random assignment into one of these arteries and was afterloaded with a 2.5-cm ribbon of encapsulated 90 Strontium/ 90 Yttrium sources ( 90 Sr/Y, a pure β-emitter). It was left in place for a period of time sufficient to deliver one of four doses: 7, 14, 28, or 56 Gy, to a depth of 2 mm. Animals were killed 14 days after balloon injury, the coronary vasculature was pressure-perfusion fixed, and histomorphometric analysis of arterial cross sections was performed. All arteries treated with radiation demonstrated significantly decreased neointima formation compared with control arteries. The ratio of intimal area to medial fracture length was inversely correlated with increasing radiation dose: control (no radiation), 0.47; 7 Gy, 0.34; 14 Gy, 0.20; 28 Gy, 0.08; and 56 Gy, 0.02 ( r =−.78, P &lt;.000001). Scanning electron microscopy demonstrated a confluent layer of endothelium-like cells both in control and in 14 Gy–irradiated arteries. There was neither evidence of significant necrosis nor excess fibrosis in the media, adventitia, or perivascular space of the coronary arteries or adjacent myocardium in the irradiated groups. Furthermore, the exposure to the staff and the total body exposure to the pig with the β source was a small fraction of the dose previously measured and calculated with 192 Ir, a γ-emitting radioisotope. Conclusions Administration of endovascular β-radiation to the site of coronary arterial overstretch balloon injury in pigs with 90 Sr/Y is technically feasible and safe. Radiation doses between 7 and 56 Gy showed evidence of inhibition of neointima formation. A dose-response relation was demonstrated, but no further inhibitory effect was seen beyond 28 Gy. These data suggest that intracoronary β-irradiation is practical and feasible and may aid in preventing clinical restenosis.
Female soccer referees selected for the FIFA Women’s World Cup 2007: survey of injuries and musculoskeletal problems
Authors: M Bizzini, A Junge, R Bahr, J Dvorak
Journal: British Journal of Sports Medicine (2008)

Few studies have examined the physiology, training and more recently injury profile of the soccer referee, and these have involved almost exclusively male referees.To analyse the frequency and characteristics of injuries and musculoskeletal problems in female referees selected for the FIFA Women's World Cup 2007.Retrospective and prospective descriptive epidemiological study.During the preparation camps a few months before the FIFA Women's World Cup 2007, all 81 preselected female referees completed a questionnaire on injuries and musculoskeletal problems. During the final 32 matches of the tournament in China, all injuries, musculoskeletal problems and related treatment of the 36 officiating referees were documented.Almost 50% of the referees reported having incurred at least one injury during their career that had led to time loss from the game. In the previous 12 months, 13 (16%) referees reported having sustained an injury and 64 (79%) reported musculoskeletal problems related to refereeing. During the World Cup and 14 (39%) referees incurred an injury and 17 (33%) were treated for musculoskeletal problems. The commonest location of injuries and problems were hamstrings, quadriceps, calf and ankle. The prospectively collected data found an incidence of 34.7 match injuries per 1000 match hours (95% CI 4.2 to 65.1).Top-level female referees are exposed to an even greater risk of injury and/or musculoskeletal problems related to officiating than are male referees. Considering the growth of women's soccer, injury prevention programmes should be specifically developed for female referees.
Abl Silencing Inhibits CAS-Mediated Process and Constriction in Resistance Arteries
Authors: Yana Anfinogenova, Ruping Wang, Qing-fen Li, Amy M. Spinelli, Dale D. Tang
Journal: Circulation Research (2007)

The tyrosine phosphorylated protein Crk-associated substrate (CAS) has previously been shown to participate in the cellular processes regulating dynamic changes in the actin architecture and arterial constriction. In the present study, treatment of rat mesenteric arteries with phenylephrine (PE) led to the increase in CAS tyrosine phosphorylation and the association of CAS with the adapter protein CrkII. CAS phosphorylation was catalyzed by Abl in an in vitro study. To determine the role of Abl tyrosine kinase in arterial vessels, plasmids encoding Abl short hairpin RNA (shRNA) were transduced into mesenteric arteries by chemical loading plus liposomes. Abl silencing diminished increases in CAS phosphorylation on PE stimulation. Previous studies have shown that assembly of the multiprotein compound containing CrkII, neuronal Wiskott–Aldrich Syndrome Protein (N-WASP) and the Arp2/3 (Actin Related Protein) complex triggers actin polymerization in smooth muscle as well as in nonmuscle cells. In this study, Abl silencing attenuated the assembly of the multiprotein compound in resistance arteries on contractile stimulation. Furthermore, the increase in F/G-actin ratios (an index of actin assembly) and constriction on contractile stimulation were reduced in Abl-deficient arterial segments compared with control arteries. However, myosin regulatory light chain phosphorylation (MRLCP) elicited by contractile activation was not inhibited in Abl-deficient arteries. These results suggest that Abl may play a pivotal role in mediating CAS phosphorylation, the assembly of the multiprotein complex, actin assembly, and constriction in resistance arteries. Abl does not participate in the regulation of myosin activation in arterial vessels during contractile stimulation.
<sup>18</sup> F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Enables the Detection of Recurrent Same-Site Deep Vein Thrombosis by Illuminating Recently Formed, Neutrophil-Rich Thrombus
Authors: Tetsuya Hara, Jessica Truelove, Ahmed Tawakol, Gregory R. Wojtkiewicz, William J. Hucker, Megan H. MacNabb, Anna-Liisa Brownell, Kimmo Jokivarsi, Chase W. Kessinger, Michael R. Jaff, Peter K. Henke, Ralph Weissleder, Farouc A. Jaffer
Journal: Circulation (2014)

Accurate detection of recurrent same-site deep vein thrombosis (DVT) is a challenging clinical problem. Because DVT formation and resolution are associated with a preponderance of inflammatory cells, we investigated whether noninvasive (18)F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) imaging could identify inflamed, recently formed thrombi and thereby improve the diagnosis of recurrent DVT.We established a stasis-induced DVT model in murine jugular veins and also a novel model of recurrent stasis DVT in mice. C57BL/6 mice (n=35) underwent ligation of the jugular vein to induce stasis DVT. FDG-PET/computed tomography (CT) was performed at DVT time points of day 2, 4, 7, 14, or 2+16 (same-site recurrent DVT at day 2 overlying a primary DVT at day 16). Antibody-based neutrophil depletion was performed in a subset of mice before DVT formation and FDG-PET/CT. In a clinical study, 38 patients with lower extremity DVT or controls undergoing FDG-PET were analyzed. Stasis DVT demonstrated that the highest FDG signal occurred at day 2, followed by a time-dependent decrease (P<0.05). Histological analyses demonstrated that thrombus neutrophils (P<0.01), but not macrophages, correlated with thrombus PET signal intensity. Neutrophil depletion decreased FDG signals in day 2 DVT in comparison with controls (P=0.03). Recurrent DVT demonstrated significantly higher FDG uptake than organized day 14 DVT (P=0.03). The FDG DVT signal in patients also exhibited a time-dependent decrease (P<0.01).Noninvasive FDG-PET/CT identifies neutrophil-dependent thrombus inflammation in murine DVT, and demonstrates a time-dependent signal decrease in both murine and clinical DVT. FDG-PET/CT may offer a molecular imaging strategy to accurately diagnose recurrent DVT.
The Effectiveness of Group Psychotherapy in a Correctional Institution
Authors: CHARLES C. JEW, T. L. CLANON, ARTHUR L. MATTOCKS
Journal: American Journal of Psychiatry (1972)

The effect of group psychotherapy on 257 inmates suffering primarily from personality and character disorders in a correctional institution is described. Findings based on parole outcome indicated that patients who had treatment did significantly better than controls at one-year follow-up, but the positive effects had disappeared after four years. This suggests the need for crisis intervention with parolees who successfully complete their first year on parole and the development of a program providing continuity of professional service between the institution and the community to sustain the gains made within the institution.
Vitamin D and liver fibrosis: let's start soon before it's too late
Authors: Valerio Nobili, Shimon Reif
Journal: Gut (2014)

Vitamin D is a prohormone that requires sequential enzymatic modification of 25 and 1a-hydroxylation in the liver and kidney respectively, leading to production of calcitriol (1,25(OH)2D3), the active form of vitamin D.1 Several studies have supported the notion that vitamin D, in addition to its classical action of maintaining systemic calcium homoeostasis and bone mineralisation, has non-classical extraskeletal actions including a potential capacity to inhibit fibrosis in various tissues. Murine lung fibroblasts treated with 1,25(OH)2D3, inhibited transforming growth factor (TGF)-β1-induced fibroblast proliferation, α-smooth-muscle actin expression, and diminished the upregulation of fibronectin and collagen expression. Furthermore, 1,25(OH)2D3 is able to inhibit the TGF-β1-dependent transdifferentiation of lung epithelial cells into myofibroblasts.2 Recent studies in mesenchymal multipotent cells showed that treatment with vitamin D led to an antiproliferative effect by inducing cell cycle arrest.3 Moreover, vitamin D reduced the collagen expression and other key profibrotic factors and increased the expression of antifibrotic factors, such as BMP7 and matrix metalloproteinase 8, in those cells.4 A mouse obstructed kidney model treated with paricalcitol (19-nor-1,25 hydroxyvitamin D2), a synthetic analogue of vitamin D, significantly …
Political barriers are hampering efforts to develop vCJD screening tools, MPs are told
Authors: A. O'Dowd
Journal: BMJ (2014)

The work of the biomedical industry to develop tools to screen for variant Creutzfeldt-Jakob disease (vCJD) is being hampered by political and scientific barriers, MPs have been told.

Science experts and representatives from biomedical companies appearing before the House of Commons Science and Technology Committee on 5 March said that various approaches to detecting vCJD had been and were being tried but that obstacles were slowing this work.

The degenerative brain disease, sometimes called the human form of bovine spongiform encephalopathy (BSE), emerged after widespread exposure to BSE prions in the late 1980s and early 1990s through contaminated meat products in the food chain.

Witnesses were quizzed for the committee’s inquiry into blood, tissue, and organ screening. The …