tbuckley/cabot-search huggingface dataset:
Validation of a Diabetes-Specific Quality-of-Life Scale for Patients With Type 1 Diabetes
Authors: Uwe Bott, Ingrid Mühlhauser, Hubert Overmann, Michael Berger
Journal: Diabetes Care (1998)

OBJECTIVE To validate a diabetes-specific quality-of-life scale and to assess its psychometric properties in a large sample of patients with type 1 diabetes. RESEARCH DESIGN AND METHODS To assess the quality of diabetes care in a population-based study, a representative sample of 684 patients with type 1 diabetes was examined. A total of 657 patients (42% female; mean age 36 years; mean diabetes duration 18 years) completed the diabetes-specific quality-of-life scale (DSQOLS), which comprised 64 items on individual treatment goals (10 items), satisfaction with treatment success (10 items), and diabetes- related distress (44 items). Statistical examinations covered factor analysis, internal consistency of subscales, and construct and discriminant validity. RESULTS Factor analysis of the 44 items on diabetes-specific burdens revealed six reliable components (Cronbach's α): social relations (0.88), physical complaints (0.84), worries about future (0.84), leisure time flexibility (0.85), diet restrictions (0.71), and daily hassles (0.70). All six subscales were significantly correlated with a validated well-being scale (r = -0.35 to -0.53, P &amp;lt; 0.001) and treatment satisfaction (r = 0.28 to 0.43, P &amp;lt; 0.001). Physical complaints (r = 0.24) and worries about future (r = 0.17) showed the highest correlations with HbA1c (P &amp;lt; 0.001). A flexible insulin therapy, a liberalized diet, the absence of late complications, and a higher social status were significantly associated with more favorable scores in different domains. CONCLUSIONS The DSQOLS is a reliable and valid measure of diabetes-specific quality of life. The scale is able to distinguish between patients with different treatment and dietary regimens and to detect social inequities. Use of the DSQOLS for assessment of individual treatment goals as defined by the patients may be helpful to identify motivational deficits and to tailor individual treatment strategies.
Mediastinal paraganglioma presenting as an intracardiac mass with SVC obstruction.
Authors: M N Sheppard
Journal: Thorax (1994)

Measurement of distal airspace sizeAirspace size in human lungs obviously depends on the degree to which the lung is inflated and on tissue shrinkage in prep- aration for histological examination.Dr D Lamb et al (October 1993;48:1012-7) minimise the latter by embedding tissue in methacrylate but appear to ignore the for- mer.They inflated the resected lungs used in their study with 10% buffered formalin at a transpulmonary pressure of 25 cm H2O for a minimum of 24 hours.What technique did they use and how well were the lungs in- flated?Satisfactory inflation via the bronchus of surgically resected lobes has been found unsatisfactory in two Vancouver hospitals.In one, expansion had to be achieved by inflation with fixative through the pleura using a large bore needle.'In another,2 using a technique similar to that of Lamb et al, the mean ratio of predicted lobar volume to fixed lobar volume was 3 50.More to the point, the standard deviation of this ratio was 2 03 indicating huge potential errors.How did Lamb et al correct for these when measuring airspace size (AWUV)?
Electronic Consent Channels: Preserving Patient Privacy Without Handcuffing Researchers
Authors: Robert H. Shelton
Journal: Science Translational Medicine (2011)

Advances in health information technology and electronic medical records have the tremendous potential to accelerate translational and clinical research. However, privacy concerns threaten to be a rate-limiting factor. By recognizing and responding to patient privacy concerns, policy-makers, researchers, and information technology leaders have the opportunity to transform trial recruitment and make it safer to electronically locate and convey sensitive health information.
Stratum corneum lipids in disorders of cornification: increased cholesterol sulfate content of stratum corneum in recessive x-linked ichthyosis.
Authors: M L Williams, P M Elias
Journal: Journal of Clinical Investigation (1981)

Activity of the microsomal enzyme, steroid sulfatase, is absent in keratinocytes, fibroblasts, and leukocytes of patients with recessive x-linked ichthyosis. This study was undertaken to determine if cholesterol sulfate, a substrate of this enzyme, accumulates in the pathological scale of these patients. Scales from 8 patients with recessive x-linked ichthyosis, 10 patients with other forms of ichthyosis, and normal human outer stratum corneum were extracted with chloroform/water (1:2:0.8 by vol) and lipids were fractionated by quantitative, sequential thin-layer chromatography. Cholesterol sulfate was identified by cochromatography in several solvent systems, by its staining characteristics, by biochemical analysis, and by mass spectrometry. The mean cholesterol sulfate content of recessive x-linked ichthyotic scale was 12.5 +/- 0.8% of the total lipid, a fivefold increase over normal (P less than 0.0025), whereas the cholesterol sulfate content of other ichthyotic scale was normal. This increase in cholesterol sulfate content was accompanied by a decrease in total neutral lipids (P less than 0.0025) and free sterols (P less than 0.025) but no change in sterol esters or total sterols. These results demonstrate that deficiency of steroid sulfatase in recessive x-linked ichthyosis results in excessive accumulation of a substrate, cholesterol sulfate, in the pathologic scale, which may underly the pathogenesis of the scaling in this disorder. Measurement of cholesterol sulfate content in scale provides an alternative method to enzymatic assay for the diagnosis of this form of ichthyosis.
Increased Brain GABA Concentrations Following Acute Administration of a Selective Serotonin Reuptake Inhibitor
Authors: Zubin Bhagwagar, Marzena Wylezinska, Matthew Taylor, Peter Jezzard, Paul M. Matthews, Philip J. Cowen
Journal: American Journal of Psychiatry (2004)

OBJECTIVE: The authors used magnetic resonance spectroscopy (MRS) to assess the effect of acute administration of the selective serotonin reuptake inhibitor (SSRI) citalopram on cortical levels of γ-aminobutyric acid (GABA). METHOD: Ten healthy volunteers received either intravenous citalopram (10 mg) or saline in a randomized, double-blind, crossover design. The occipital GABA/creatine ratio was measured with a proton MR spectral editing technique. RESULTS: In comparison with saline, citalopram produced a mean increase of 35% in relative brain GABA concentration in the occipital cortex. CONCLUSIONS: These findings extend previous work showing that SSRI treatment increases cortical GABA in depressed patients and suggest that this results from an action of SSRIs on GABA neurons rather than as a secondary consequence of mood improvement.
Narrative Review: Drug-Eluting Stents for the Management of Restenosis: A Critical Appraisal of the Evidence
Authors: Roderick Tung, Sanjay Kaul, George A. Diamond, Prediman K. Shah
Journal: Annals of Internal Medicine (2006)

Interventional cardiologists have quickly replaced bare metal stents with intravascular drug-eluting stents for treating and preventing restenosis, largely on the basis of empirical evidence that shows profound reduction in angiographic and clinical restenosis. A critical reassessment of the published evidence, however, suggests that the putative superiority of intravascular drug-eluting stents is founded on questionable premises, including 1) overestimation of restenosis benefit, 2) underestimation of the risk for stent thrombosis, 3) overreliance on "soft" rather than "hard" outcomes (need for repeated revascularization vs. death or myocardial infarction), and 4) the attendant overestimation of cost-effectiveness. Because the long-term incremental risks, benefits, and costs of drug-eluting stents have not yet been optimally evaluated in a broad spectrum of patient and lesion cohorts, the rational role of these devices in clinical management warrants reappraisal.
Extracellular Matrix Scaffold for Cardiac Repair
Authors: Keith A. Robinson, Jinshen Li, Megumi Mathison, Alka Redkar, Jianhua Cui, Nicolas A.F. Chronos, Robert G. Matheny, Stephen F. Badylak
Journal: Circulation (2005)

Background— Heart failure remains a significant problem. Tissue-engineered cardiac patches offer potential to treat severe heart failure. We studied an extracellular matrix scaffold for repairing the infarcted left ventricle. Methods and Results— Pigs (n=42) underwent left ventricular (LV) infarction. At 6 to 8 weeks, either 4-layer multilaminate urinary bladder-derived extracellular matrix or expanded polytetrafluoroethlyene (ePTFE) was implanted as full-thickness LV wall patch replacement. At 1-week, 1-month, or 3-month intervals, pigs were terminated. After macroscopic examination, samples of tissue were prepared for histology, immunocytochemistry, and analysis of cell proportions by flow cytometry. One-week and 1-month patches were intact with thrombus and inflammation; at 1 month, there was also tissue with spindle-shaped cells in proteoglycan-rich and collagenous matrix. More α-smooth muscle actin-positive cells were present in urinary bladder matrix (UBM) than in ePTFE (22.2±3.3% versus 8.4±2.7%; P =0.04). At 3 months, UBM was bioresorbed, and a collagen-rich vascularized tissue with numerous myofibroblasts was present. Isolated regions of α-sarcomeric actin-positive, intensely α-smooth muscle actin-immunopositive, and striated cells were observed. ePTFE at 3 months had foreign-body response with necrosis and calcification. Flow cytometry showed similarities of cells from UBM to normal myocardium, whereas ePTFE had limited cardiomyocyte markers. Conclusions— Appearance of a fibrocellular tissue that included contractile cells accompanied biodegradation of UBM when implanted as an LV-free wall infarction patch. UBM appears superior to synthetic material for cardiac patching and trends toward myocardial replacement at 3 months.
Increased rate of gluconeogenesis in type II diabetes mellitus. A 13C nuclear magnetic resonance study.
Authors: I Magnusson, D L Rothman, L D Katz, R G Shulman, G I Shulman
Journal: Journal of Clinical Investigation (1992)

To quantitate hepatic glycogenolysis, liver glycogen concentration was measured with 13C nuclear magnetic resonance spectroscopy in seven type II diabetic and five control subjects during 23 h of fasting. Net hepatic glycogenolysis was calculated by multiplying the rate of glycogen breakdown by the liver volume, determined from magnetic resonance images. Gluconeogenesis was calculated by subtracting the rate of hepatic glycogenolysis from the whole body glucose production rate, measured using [6-3H]glucose. Liver glycogen concentration 4 h after a meal was lower in the diabetics than in the controls; 131 +/- 20 versus 282 +/- 60 mmol/liter liver (P < 0.05). Net hepatic glycogenolysis was decreased in the diabetics, 1.3 +/- 0.2 as compared to 2.8 +/- 0.7 mumol/(kg body wt x min) in the controls (P < 0.05). Whole body glucose production was increased in the diabetics as compared to the controls, 11.1 +/- 0.6 versus 8.9 +/- 0.5 mumol/(kg body wt x min) (P < 0.05). Gluconeogenesis was consequently increased in the diabetics, 9.8 +/- 0.7 as compared to 6.1 +/- 0.5 mumol/(kg body wt x min) in the controls (P < 0.01), and accounted for 88 +/- 2% of total glucose production as compared with 70 +/- 6% in the controls (P < 0.05). In conclusion: increased gluconeogenesis is responsible for the increased whole body glucose production in type II diabetes mellitus after an overnight fast.
Activation specificity of arsonate-reactive T cell clones. Structural requirements for hapten recognition and comparison with monoclonal antibodies.
Authors: A Rao, S J Faas, H Cantor
Journal: The Journal of Experimental Medicine (1984)

We describe clones of hapten-specific inducer T cells from (BALB/c X A/J)F1 mice that respond to the p-azobenzenearsonate hapten conjugated to carrier proteins or directly conjugated to antigen-presenting cells. Some of the clones are also activated by haptens structurally related to arsonate. All activating analogues are recognized by each clone in association with the same major histocompatibility complex (MHC) protein as is arsonate. Weakly activating and nonactivating analogues are immunogenic in D2.GD amd (BALB/c X A/J)F1 mice, since they can effectively activate primed lymph node cells or long-term hapten-reactive cell lines. Hence the specificities of these clones may reflect their intrinsic recognition of arsonate and its analogues, rather than more efficient presentation of certain analogues than of others by antigen-presenting cells, or differential recognition of associated MHC epitopes by the clones. We compare the activation specificities of the clones with the binding specificities of monoclonal antibodies to arsonate, and discuss structural features of the analogues that may be important for activation and binding. Our results suggest that a site (or subsite) on arsonate-reactive T cell clones may interact directly with hapten, and may be experimentally separable from the site (or subsite) for MHC determinants.
THE NEED OF EDUCATION IN QUESTIONS OF SEX
Authors: T. W. Pym
Journal: BMJ (1931)

satisfactory way, but an attempt has been made to divide homes into three groups-namely, " bad " homes, " fair " homes, and " good " homes.This was done after con- sideration of (a) total income, (b) locality, and (c) general hygienic conditions.In a series of 494 homes in which there was Ino tuberculous person living, 110 were classified as " bad," 154 as " fair," and 230 as " good."The incidence of tuberculous infection in each of these groups was practically the same, the figures being 30.9, 37.6, and 35 per cent.respectively.In 228 homes where there was a person suffering from tuiberculosis, the corresponding figures were 86.4,76.8, and 68.6 per cent.These figures would seem to show that where there is no known tuberculosis in the home, the incidence of tuberculouis infection is much the same, whether the horne conditions are "bad," " fair," or " good," while in the case of the tuberculous household there is a considerably lower per- centage of tuberculous infection, in the " good " home than in the " fair " home, and much more is this the case when comparing the " good " with the " bad home.CONCLUSIONS 1.The Mlantoux test is more delicate than the Pirquet test.The Pirquet test is equivalent to 0.1 c.cm. *of 1 in 10,000 tuberculin given intracutaneously.2. The incidence of tuberculous infection in children increases gradually from infancy to puberty.3. The incidence of tuberculous infection up to the age of 15 years is 43.1 per cent. -23.0 per cent.are infected between 0 and 5 years, 39.0 per cent.are infected between 5 and l0 years, 58.3 per cent.are inifected between 10 and 15 years.4. The incidence of tuberculous infection is slightly higher in girls than in boys.5. The incidence of tuberculous infection in children between 0 and 15 is doubled when there is contact with open tuberculosis.6.The incidence of tuberculous infection from birth to 5 years is five times greater when there is contact witlh open tuberculosis than when there is no contact with the disease.7. The incidence of tuberculous infection in children of tuberculous fathers with positive sputum is slightly higher than in children whose mothers have positive sputum.8. Our figures suggest that the incidence of tuberculous infection in contact children in bad " homes is higher than in contact children in "good " homes.
Diverse modes of genomic alteration in hepatocellular carcinoma
Authors: Suchit Jhunjhunwala, Zhaoshi Jiang, Eric W Stawiski, Florian Gnad, Jinfeng Liu, Oleg Mayba, Pan Du, Jingyu Diao, Stephanie Johnson, Kwong-Fai Wong, Zhibo Gao, Yingrui Li, Thomas D Wu, Sharookh B Kapadia, Zora Modrusan, Dorothy M French, John M Luk, Somasekar Seshagiri, Zemin Zhang
Journal: Genome biology (2014)

Abstract Background Hepatocellular carcinoma (HCC) is a heterogeneous disease with high mortality rate. Recent genomic studies have identified TP53 , AXIN1 , and CTNNB1 as the most frequently mutated genes. Lower frequency mutations have been reported in ARID1A , ARID2 and JAK1 . In addition, hepatitis B virus (HBV) integrations into the human genome have been associated with HCC. Results Here, we deep-sequence 42 HCC patients with a combination of whole genome, exome and transcriptome sequencing to identify the mutational landscape of HCC using a reasonably large discovery cohort. We find frequent mutations in TP53 , CTNNB1 and AXIN1 , and rare but likely functional mutations in BAP1 and IDH1 . Besides frequent hepatitis B virus integrations at TERT , we identify translocations at the boundaries of TERT . A novel deletion is identified in CTNNB1 in a region that is heavily mutated in multiple cancers. We also find multiple high-allelic frequency mutations in the extracellular matrix protein LAMA2. Lower expression levels of LAMA2 correlate with a proliferative signature, and predict poor survival and higher chance of cancer recurrence in HCC patients, suggesting an important role of the extracellular matrix and cell adhesion in tumor progression of a subgroup of HCC patients. Conclusions The heterogeneous disease of HCC features diverse modes of genomic alteration. In addition to common point mutations, structural variations and methylation changes, there are several virus-associated changes, including gene disruption or activation, formation of chimeric viral-human transcripts, and DNA copy number changes. Such a multitude of genomic events likely contributes to the heterogeneous nature of HCC.
Long-term modification of cortical synapses improves sensory perception
Authors: Robert C Froemke, Ioana Carcea, Alison J Barker, Kexin Yuan, Bryan A Seybold, Ana Raquel O Martins, Natalya Zaika, Hannah Bernstein, Megan Wachs, Philip A Levis, Daniel B Polley, Michael M Merzenich, Christoph E Schreiner
Journal: Nature Neuroscience (2012)
Care of the multisport athlete: lessons from Goldilocks
Authors: David Scott Marr
Journal: British Journal of Sports Medicine (2011)

Once upon a time, a young triathlete named Goldilocks visited three sports medicine doctors. She was experiencing Achilles tendon pain and was concerned about her ability to train and compete. The first doctor told her she was training too much and simply needed complete rest; the second doctor told her she could bike and swim but could not run; the third doctor told her she could continue to train but prescribed a course of physical therapy. Goldilocks was confused and did not know what treatment was just right.

The Goldilocks Principle states that something must fall within certain margins, as opposed to reaching extremes. In the care of multisport athletes, we often apply this principle to define the appropriate balance of training volume, intensity and recovery to avoid and treat injury. This principle may work for a girl in the forest looking for a warm meal and a proper sized bed to sleep in, but anyone who has ever watched the video footage of triathlete Julie Moss stumbling, staggering and eventually crawling across the finish line in Kona at the 1982 World Championship understands that ‘extreme’ is what many multisport endurance triathletes do. The remarkable force of mental and physical will that defines many of these athletes is also the Achilles heel that exposes them to injury. Overuse injury risk has been reported to be higher during the competitive race season as opposed to preseason training,1 likely because of the strong competitive drive of these athletes. After hours and hours of training, these athletes are focused on accomplishing their competitive goals first and dealing with injury later.

It is not always the competition, however, that forces an athlete to the sideline, but sometimes their …
IFN alpha 2b and ribavirin in naive patients with HCV type 1 chronic hepatitis: results after 6 months of therapy
Authors: G. Benetti, G. Ramella, A. Tagger, M.L. Ribero, L. Tortora, M. Borzio, S. Fargion, G. Croce, P. Del Poggio, G. Bellati, L. Roffi
Journal: Journal of Hepatology (2001)
STUDIES ON THE PATHOGENESIS OF FEVER WITH INFLUENZAL VIRUSES
Authors: Elisha Atkins, Wei Cheng Huang
Journal: The Journal of Experimental Medicine (1958)

A substance with pyrogenic properties appears in the blood streams of rabbits made febrile by the intravenous inoculation of the PR8 strain of influenza A and Newcastle disease viruses (NDV). By means of a technique involving passive transfer of sera from animals given virus to recipient rabbits, the titer of circulating pyrogen was found to be closely correlated with the course of fever produced by virus. Certain properties of the pyrogen are described which differentiate it from the originally injected virus and suggest that the induced pyrogen is of endogenous origin. These properties resemble those of endogenous pyrogens occurring in other forms of experimental fever. The source of virus-induced pyrogen is unknown. In vitro incubation of virus with various constituents of the circulation did not result in the appearance of endogenous pyrogen. Granulocytopenia induced by HN(2) failed to influence either fever or the production of endogenous pyrogen in rabbits injected with NDV. Similarly, the intraperitoneal inoculation of NDV into prepared exudates did not modify the febrile response. These findings do not lend support to the possibility that the polymorphonuclear leukocyte is a significant source of endogenous pyrogen in virus-induced fever. It is concluded that the liberation of an endogenous pyrogen from some as yet undefined source is an essential step in the pathogenesis of fever caused by the influenza group of viruses.
Utility of Casual Postprandial Glucose Levels in Type 2 Diabetes Management
Authors: Imad M. El-Kebbi, David C. Ziemer, Curtiss B. Cook, Daniel L. Gallina, Catherine S. Barnes, Lawrence S. Phillips
Journal: Diabetes Care (2004)

OBJECTIVE—Because readily available glycemic indicators are needed to guide clinical decision-making for intensification of diabetes therapy, our goals were to define the relationship between casual postprandial plasma glucose (cPPG) levels and HbA1c in patients with type 2 diabetes and to determine the predictive characteristics of a convenient glucose cutoff. RESEARCH DESIGN AND METHODS—We examined the relationship between cPPG levels (1–4 h post meal) and HbA1c levels in 1,827 unique patients who had both determinations during a single office visit. RESULTS—The population studied was predominantly African American and middle-aged, with average cPPG of 201 mg/dl and HbA1c of 8.4%. The prevalence of HbA1c ≥7.0% was 67% and HbA1c &amp;gt;6.5% was 77%. Overall, cPPG and HbA1c were linearly correlated (r = 0.63, P &amp;lt; 0.001). The correlation between cPPG and HbA1c was strongest in patients treated with diet alone (n = 348, r = 0.75, P &amp;lt; 0.001) and weaker but still highly significant for patients treated with oral agents (n = 610, r = 0.64, P &amp;lt; 0.001) or insulin (n = 869, r = 0.56, P &amp;lt; 0.001). A cutoff cPPG &amp;gt;150 mg/dl predicted an HbA1c level ≥7.0% in the whole group, with a sensitivity of 78%, a specificity of 62%, and an 80% positive predictive value. The same cPPG cutoff of 150 mg/dl predicted an HbA1c level &amp;gt;6.5%, with a sensitivity of 74%, a specificity of 66%, and an 88% positive predictive value. CONCLUSIONS—When rapid-turnaround HbA1c determinations are not available, a single cPPG level &amp;gt;150 mg/dl may be used during a clinic visit to identify most inadequately controlled patients and allow timely intensification of therapy.