tbuckley/cabot-search huggingface dataset:
Regional differences in specific gas volume in the healthy lung
Authors: Caterina Salito, Livia Barazzetti, Jason C. Woods, Andrea Aliverti
Journal: European Respiratory Journal (2012)

Specific gas volume (SVg) converts CT lung density into the physiological meaningful index of volume of gas per gram of tissue (Salito, C. et al. Radiology 2009; 253:380-389). The aim of this study was to establish a baseline of SVg values for healthy lungs, to study regional differences of SVg in the different lung segments and to evaluate the influence of the reconstruction kernel on SVg parameters.

CT scans of 10 healthy volunteers were performed during breath holding at total lung capacity (TLC) and residual volume (RV). CT images were reconstructed using Siemens b30f and b50f convolution kernels. For each broncho-pulmonary segment, one cylindrical region of interest within the parenchyma was selected.

Mean SVg was significantly higher with b50f both at TLC and RV (12.1 vs 7.5 ml/g, p<0.001) while median SVg was not affected by the reconstruction filter (7.8 vs ∼2.9 ml/g for TLC and RV, respectively). ΔSVg =SVg,TLC - SVg,RV was independent of broncho-pulmonary segment.

Variability of ΔSVg/ΔV values between different broncho-pulmonary segments within the same subject and between different subjects within the same broncho-pulmonary segment was very low. Higher values of SVg were found in more anterior locations with little to no cranio-caudal or lateral dependence.

In conclusion, in healthy subjects SVg and ΔSVg are highly homogeneous within the lung. Conversely, in emphysema the expected larger heterogeneity can potentially be used as a measure of inhomogeneous lung emptying and a biomarker for surgical planning and post-treatment evaluation.

This work was supported by a NIH grant R01- HL090806.
The BMJ interview: Sir Liam Donaldson: The health services and the dream
Authors: William G Pickering
Journal: BMJ (2006)

EDITOR—The audience for the BMJ interview of Sir Liam Donaldson on doctors' careers, patient safety, the GMC, and whether we should have an independent NHS should perhaps have moderated their expectations.1 The main participant was an esteemed spokesperson for a huge state bureaucracy—the personal advancement of whose employees depends on compliance towards their masters, while …
Personality Factors and Breast Cancer Development: a Prospective Longitudinal Study
Authors: E. M. A. Bleiker, H. M. van der Ploeg, J. H. C. L. Hendriks, H. J. Ader
Journal: JNCI Journal of the National Cancer Institute (1996)

It has been estimated that approximately 25% of all breast cancers in women can be explained by currently recognized somatic (i.e., hereditary and physiologic) risk factors. It has also been hypothesized that psychological factors may play a role in the development of breast cancer. We investigated the extent to which personality factors, in addition to somatic risk factors, may be associated with the development of primary breast cancer. We employed a prospective, longitudinal study design. From 1989 through 1990, a personality questionnaire was sent to all female residents of the Dutch city of Nijmegen who were 43 years of age or older. This questionnaire was sent as part of an invitation to participate in a population-based breast cancer screening program. Women who developed breast cancer among those who returned completed questionnaires were compared with women without such a diagnosis in regard to somatic risk factors and personality traits, including anxiety, anger, depression, rationality, anti-emotionality (i.e., an absence of emotional behavior or a lack of trust in one's own feelings), understanding, optimism, social support, and the expression and control of emotions. Conditional logistic regression analysis was used to identify variables that could best explain group membership (i.e., belonging to the case [breast cancer] or the control [without disease] group). Personality questionnaires were sent to 28 940 women, and 9705 (34%) were returned in such a way that they could be used for statistical analyses. Among the 9705 women who returned useable questionnaires, 131 were diagnosed with breast cancer during the period from 1989 through 1994. Seven hundred seventy-one age-matched control subjects (up to six per case patient) were selected for the analyses. Three variables were found to be statistically significantly associated with an increased risk of breast cancer: 1) having a first-degree family member with breast cancer (versus not having an affected first-degree relative, odds ratio [OR] = 4.05; 95% confidence interval [CI] = 1.76−9.31); 2) nulliparity (i.e., having no children) (versus having had a child before the age of 30 years, OR = 2.67; 95% CI = 1.26−5.68); and 3) a relatively high score on the personality scale of anti-emotionality (versus a low score, OR = 1.19; 95% CI = 1.05–1.35). With the exception of a weak association between a high score on the anti-emotionality scale and the development of breast cancer, no support was found for the hypothesis that personality traits can differentiate between groups of women with and without breast cancer. We recommend that this study be continued and that other studies be encouraged to explore possible relationships between personality factors and the risk of breast cancer.
PREDICTORS OF NO-REFLOW PHENOMENON DURING PRIMARY PCI IN STEMI PATIENTS
Authors: Myungjun M. Seong, Kee Sik Kim, Byong-kyu Kim, ja-young Son, Seung-pyo Hong, Young Soo Lee, Jin Bae Lee, Jae Kean Ryu, Ji Young Choi, Sung-Gug Chang
Journal: Journal of the American College of Cardiology (2011)
Spirometry in 3- to 6-Year-Old Children with Cystic Fibrosis
Authors: Paulo J. C. Marostica, Andrea D. Weist, Howard Eigen, Connie Angelicchio, Kathy Christoph, Julie Savage, Debra Grant, Robert S. Tepper
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Spirometry is routinely used to assess pulmonary function of older children and adults with cystic fibrosis (CF); however, few data exist concerning the preschool age group. We have reported normative spirometric data for 3- to 6-year-old children. The current study was designed to assess a similarly aged group of clinically stable patients with CF. Thirty-three of 38 children with CF were able to perform 2 or 3 technically acceptable maneuvers. These patients had significantly decreased FVC, FEV(1), FEV(1)/FVC, and FEF(25-75) when expressed as z scores (number of SD from predicted): -0.75 +/- 1.63, -1.23 +/- 1.97, -0.87 +/- 1.33, and -0.74 +/- 1.63, respectively. There were significant positive correlations of the Brasfield radiological score with FVC and FEV(1) z scores (r(2) = 0.26, p < 0.01 and r(2) = 0.24, p < 0.01). In addition, homozygous patients for the DeltaF508 mutation had lower z scores for FVC (-1.21 versus 0.47, p < 0.01) and FEV(1) (-1.38 versus 0.21, p < 0.05) than heterozygous patients. Of the 14 patients who had full flow-volume spirometric measurements during infancy, 10 had FEF(25-75) z scores greater than -2 at both evaluations. Our findings suggest that spirometry can successfully be used to assess lung function in preschool children with CF and has the potential for longitudinal assessment from infancy through adulthood.
Patterns of failure following surgical resection of renal cell carcinoma: implications for adjuvant local and systemic therapy.
Authors: R A Rabinovitch, M J Zelefsky, J J Gaynor, Z Fuks
Journal: Journal of Clinical Oncology (1994)

PURPOSE This report is a patterns-of-failure analysis of resected renal cell carcinoma (RCC) performed to determine the relative incidences of local failure (LF) and distant failure, to identify the pathologic features predicting for each using a multivariate analysis, and to assess the relative impact of each form of failure on overall survival (OS). In this way, the potential value of and selection of patients for adjuvant local and/or systemic therapy can be better evaluated. MATERIALS AND METHODS The records of 172 patients with unilateral, nonmetastatic RCC who were treated with definitive surgery between 1978 and 1988, and who had a minimum follow-up duration of 1 year, were identified through the Memorial Sloan-Kettering tumor registry. Distribution by stage included T1, 10 patients; T2, 102; T3a, 32; T3b, 27; and T4, one. The incidences of positive lymph nodes (LNs) and positive margins were 5.8% and 6.4%, respectively. RESULTS LF developed in only six patients, yielding a 7-year actuarial incidence of 5%. In this subset, four patients developed distant metastases (DM), three occurring concurrently with or before LF. DM developed in 30 patients, yielding a 7-year actuarial incidence of 26%. Among the variables that had an impact on the development of DM according to univariate log-rank tests, only positive LNs (P = .026) and renal vein extension (P = .001) remained as significant independent prognosticators. The overall 7-year actuarial survival rate was 80%. Eleven patients died of RCC during follow-up, nine of whom (82%) died of metastatic disease. CONCLUSION LF is rare following surgical management of RCC, and shows no clear causal relationship with the development of DM. Patients die of DM, and not LF. These data do not support the role of adjuvant radiation therapy in this disease. Patients with LN involvement or renal vein extension have a significantly increased risk for developing DM, and are therefore appropriate candidates for trials investigating systemic therapy.
Improving pay and working conditions is better than merely rewarding healthcare teams
Authors: K G M M Alberti
Journal: BMJ (1998)

EDITOR —I read with admiration, interest, amusement, and some sadness the editorial on rewarding healthcare teams by Bloor and Maynard.1 My admiration is for Maynard's persistence. He has for many years advocated the replacement of doctors by other healthcare professionals and the abolition of distinction awards. He manages to mount a range of interesting alternative methods to justify this. The only thing that he forgot to introduce in this …
Transcoronary Transplantation of Functionally Competent BMCs Is Associated With a Decrease in Natriuretic Peptide Serum Levels and Improved Survival of Patients With Chronic Postinfarction Heart Failure
Authors: Birgit Assmus, Ulrich Fischer-Rasokat, Jörg Honold, Florian H. Seeger, Stephan Fichtlscherer, Torsten Tonn, Erhard Seifried, Volker Schächinger, Stefanie Dimmeler, Andreas M. Zeiher
Journal: Circulation Research (2007)

Although intracoronary administration of bone marrow-derived mononuclear progenitor cells (BMCs) may be associated with improved cardiac function in patients with chronic postinfarction heart failure, the impact on prognosis and clinical outcome of these patients is unknown. To identify potential predictors for a favorable clinical outcome, we assessed natriuretic peptide serum levels as objective markers of heart failure and the occurrence of cardiac death in relation to functional capacity of the infused cells in a consecutive series of 121 patients with chronic ischemic heart disease treated with intracoronary infusion of BMCs. Our analyses show that both N-terminal pro-brain natriuretic peptide (NT-proBNP) and N-terminal pro-atrial natriuretic peptide (NT-proANP) serum levels were significantly reduced in patients with established postinfarction heart failure 3 months after transcoronary progenitor cell administration. NT-proBNP serum levels greater than or equal to median (735 pg/mL) at baseline and a high number of infused progenitor cells with colony-forming capacity were the only independent predictors of a favorable response 3 months after intracoronary administration of BMCs. During extended clinical follow-up (577+/-442 days), a total of 14 deaths occurred in the overall patient population. Kaplan-Meier curves for both all cause and cardiac mortality showed that patients receiving a higher number of colony-forming cells were significantly less likely to die than those patients receiving low numbers of colony-forming cells (P=0.01). Most importantly, infusion of a high number of cells with colony-forming capacity was associated with a complete abrogation of increased mortality in patients with elevated NT-proBNP serum levels (> or =735 pg/mL; median) at baseline (P<0.001). Taken together, our results show that patients with objective evidence of postinfarction heart failure demonstrate a significant reduction of both NT-proBNP and NT-proANP serum levels within 3 months following intracoronary infusion of BMCs. Importantly, infusion of progenitor cells with a high functional capacity is associated with a significantly lower mortality during further follow-up.
OCCULT CERVICAL CARCINOMA REVEALED BY LARGE LOOP DIATHERMY
Authors: David Fenton, Steven Beck, David Slater, Juliet Peel, G.A.J. McIndoe, J.R. Smith, J.A. Tidy, A. Yahya, W.P. Mason, M.C. Anderson, P.F. Byrne, L.J.Sant Cassia
Journal: The Lancet (1989)
A Test of Pancreatic Function in Man Based on the Analysis of Duodenal Contents after Administration of Secretin and Pancreozymin
Authors: P. Burton, D. G. Evans, A. A. Harper, H. T. Howat, S. Oleesky, J. E. Scott, H. Varley
Journal: Gut (1960)

Pancreozymin in man as in animals appears to act as a specific enzyme stimulant. The preparations of pancreozymin used in these experiments also contain cholecystokinin, which causes the gall bladder to contract, and a smooth muscle stimulant, possibly substance P. The duodenal contents obtained in response to a standard dose of secretin and pancreozymin have been collected quantitatively in man and the volume and amount of bicarbonate, amylase, trypsin, and lipase measured in order to study pancreatic function. The results of 105 tests undertaken on a normal group, in pancreatic and biliary disease, and in non-pancreatic steatorrhoea have been analysed. In localized pancreatic lesions and after recovery from acute pancreatitis, normal function is often retained. Mild functional impairment may be demonstrated only by a poor enzyme output in the post-pancreozymin fractions, while at a later stage bicarbonate output is affected and finally the volume of the duodenal contents is reduced. The secretin-pancreozymin test is most valuable, therefore, in the more chronic and advanced forms of pancreatic disease in which it gives a good assessment of residual pancreatic function. In diagnosis care must be taken in interpreting a functional test in terms of anatomical pathology. The test has proved useful not only in diagnosis but also as a guide to treatment and an index of prognosis.
Percutaneous renal denervation in patients with treatment-resistant hypertension: final 3-year report of the Symplicity HTN-1 study
Authors: Henry Krum, Markus P Schlaich, Paul A Sobotka, Michael Böhm, Felix Mahfoud, Krishna Rocha-Singh, Richard Katholi, Murray D Esler
Journal: The Lancet (2013)
Double-Blind, Randomized Placebo Controlled Trial of Fulvestrant Compared With Exemestane After Prior Nonsteroidal Aromatase Inhibitor Therapy in Postmenopausal Women With Hormone Receptor–Positive, Advanced Breast Cancer: Results From EFECT
Authors: Stephen Chia, William Gradishar, Louis Mauriac, Jose Bines, Frederic Amant, Miriam Federico, Luis Fein, Gilles Romieu, Aman Buzdar, John F.R. Robertson, Adam Brufsky, Kurt Possinger, Pamela Rennie, Francisco Sapunar, Elizabeth Lowe, Martine Piccart
Journal: Journal of Clinical Oncology (2008)

Purpose The third-generation nonsteroidal aromatase inhibitors (AIs) are increasingly used as adjuvant and first-line advanced therapy for postmenopausal, hormone receptor–positive (HR+) breast cancer. Because many patients subsequently experience progression or relapse, it is important to identify agents with efficacy after AI failure. Materials and Methods Evaluation of Faslodex versus Exemestane Clinical Trial (EFECT) is a randomized, double-blind, placebo controlled, multicenter phase III trial of fulvestrant versus exemestane in postmenopausal women with HR+ advanced breast cancer (ABC) progressing or recurring after nonsteroidal AI. The primary end point was time to progression (TTP). A fulvestrant loading-dose (LD) regimen was used: 500 mg intramuscularly on day 0, 250 mg on days 14, 28, and 250 mg every 28 days thereafter. Exemestane 25 mg orally was administered once daily. Results A total of 693 women were randomly assigned to fulvestrant (n = 351) or exemestane (n = 342). Approximately 60% of patients had received at least two prior endocrine therapies. Median TTP was 3.7 months in both groups (hazard ratio = 0.963; 95% CI, 0.819 to 1.133; P = .6531). The overall response rate (7.4% v 6.7%; P = .736) and clinical benefit rate (32.2% v 31.5%; P = .853) were similar between fulvestrant and exemestane respectively. Median duration of clinical benefit was 9.3 and 8.3 months, respectively. Both treatments were well tolerated, with no significant differences in the incidence of adverse events or quality of life. Pharmacokinetic data confirm that steady-state was reached within 1 month with the LD schedule of fulvestrant. Conclusion Fulvestrant LD and exemestane are equally active and well-tolerated in a meaningful proportion of postmenopausal women with ABC who have experienced progression or recurrence during treatment with a nonsteroidal AI.
Anti–Interleukin-9 Antibody Treatment Inhibits Airway Inflammation and Hyperreactivity in Mouse Asthma Model
Authors: Gang Cheng, Masafumi Arima, Kyoko Honda, Hirokuni Hirata, Fukiko Eda, Nozomi Yoshida, Fumiya Fukushima, Yoshiki Ishii, Takeshi Fukuda
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Numerous in vitro and in vivo studies in both animals and patients with asthma have shown that interleukin (IL)-9 is an important inflammatory mediator in asthma. To examine the effects of IL-9 antagonism on airway inflammation, ovalbumin-sensitized BALB/c mice were intravenously given anti-IL-9 antibody or an isotype-matched control antibody 30 minutes before challenge with aerosolized ovalbumin. Airway response to methacholine was measured, and samples of bronchoalveolar lavage fluid (BALF) were obtained 24 hours after the last antigen challenge. Lung tissue was harvested and examined histopathologically. After ovalbumin challenge, there were significant increases in airway hyperreactivity, the numbers of inflammatory cells in lung, and IL-4, IL-5, and IL-13 production in BALF. Treatment with anti-IL-9 antibody significantly prevented airway hyperreactivity in response to methacholine inhalation. Blockade of IL-9 reduced the numbers of eosinophils (0.3 +/- 0.1 x 10(5) and 23.6 +/- 0.5 x 10(5)/ml, anti-IL-9 antibody/control immunoglobulin G) and lymphocytes (0.2 +/- 0.2 x 10(5) and 0.8 +/- 0.1 x 10(5)/ml) in BALF. Anti-IL-9 antibody treatment also reduced the concentrations of IL-4 (from 70.6 +/- 4.6 to 30.8 +/- 5.2 pg/ml), IL-5 (from 106.4 +/- 12 to 54.4 +/- 6.6 pg/ml), and IL-13 (from 44.2 +/- 7.6 to 30.1 +/- 5.5 pg/ml) in BALF. Macrophage-derived cytokine expression in the airways was also decreased by IL-9 blockade. Taken together, our findings emphasize the importance of IL-9 in the pathogenesis of asthma and suggest that blockade of IL-9 may be a new therapeutic strategy for bronchial asthma.
TDP-43 Pathology, Cognitive Decline, and Dementia in Old Age
Authors: Robert S. Wilson, Lei Yu, John Q. Trojanowski, Er-Yun Chen, Patricia A. Boyle, David A. Bennett, Julie A. Schneider
Journal: JAMA Neurology (2013)

Cognitive decline is a leading cause of disability and death in old age but its neurobiological bases are not well understood.
A Comparison of Black and White Women With Binge Eating Disorder
Authors: Kathleen M. Pike, Faith-Anne Dohm, Ruth H. Striegel-Moore, Denise E. Wilfley, Christopher G. Fairburn
Journal: American Journal of Psychiatry (2001)

OBJECTIVE: Binge eating disorder was introduced in DSM-IV as a psychiatric disorder needing further study. This community-based study describes the relationship between race and clinical functioning in black and white women with and without binge eating disorder. METHOD: A group of 150 women with binge eating disorder (52 black, 98 white) and a race-matched group of 150 healthy comparison subjects were recruited from the community. Eating and psychiatric symptoms were assessed through interviews and self-report. RESULTS: Black and white women with binge eating disorder differed significantly on numerous eating disorder features, including binge frequency, restraint, history of other eating disorders, treatment-seeking behavior, and concerns with eating, weight, and shape. Black and white healthy comparison subjects differed significantly in obesity rates. CONCLUSIONS: For both black and white women, binge eating disorder was associated with significant impairment in clinical functioning. Yet, racial differences in clinical presentation underscore the importance of considering race in psychopathology research.
Robotic Versus Laparoscopic Partial Nephrectomy for Complex Tumors: Comparison of Perioperative Outcomes
Authors: Jean-Alexandre Long, Rachid Yakoubi, Byron Lee, Julien Guillotreau, Riccardo Autorino, Humberto Laydner, Remi Eyraud, Robert J. Stein, Jihad H. Kaouk, Georges-Pascal Haber
Journal: European Urology (2012)
The assessment of mitral stenosis and prosthetic mitral valve obstruction, using the posterior aortic wall echocardiogram.
Authors: B L Strunk, E J London, J Fitzgerald, R L Popp, W H Barry
Journal: Circulation (1977)

The echocardiographic motion of the aortic root reflects, in part, left atrial filling and emptying. Patients with mitral valve obstruction were studied to determine whether clinically important alterations in patterns of left atrial emptying would alter motion of the posterior aortic wall. Patients with mitral stenosis had a characteristic pattern of slowing of left atrial emptying in early diastole, with loss of the conduit phase in mid-diastole. The atrial emptying index, defined as the fraction of passive posterior aortic wall motion occurring in the first third of diastole, was significantly related to the mitral valve area index (r = 0.86), and thus provides a noninvasive quantitation of the degree of mitral stenosis. Determination of the atrial emptying index also proved useful in the evaluation of patients with prosthetic mitral valve obstruction and in documenting improvement in left atrial emptying after mitral valve surgery.
Perioperative Practice: Time to Throttle Back
Authors: Vineet Chopra
Journal: Annals of Internal Medicine (2010)

The United States spends more on health care than other nations, yet our health outcomes remain inferior to those of many countries. Change is therefore necessary. One approach to health care reform is to identify and eliminate practices associated with high cost and limited benefit. Recent research has shown that many perioperative practices meet this definition. An opportunity thus exists for rational reduction of perioperative expenditure. Perioperative tests and treatments improve outcomes only when targeted at specific patient subsets. For example, routine perioperative stress testing provides no incremental diagnostic yield in patients at low risk for cardiac events, and indiscriminate perioperative therapy with beta-blockers can increase mortality in otherwise stable patients. Thus, many "accepted" perioperative practices conflict with the evidence and can be safely discontinued while preserving outcomes and reducing costs. Implementation of the American College of Cardiology/American Heart Association perioperative guidelines ensures cost-effective management and promises the greatest benefit for our patients. Our society demands better care at lower cost; in perioperative medicine, it is time for us to throttle back.