tbuckley/cabot-search huggingface dataset:
1077-73 Enhancing quality of heart failure care in managed medicare and medicaid in North Carolina: Results of the North Carolina achieving cardiac excellence (NC ACE) project
Authors: David C Goff, Mark W Massing, Alain G Bertoni, Jennifer Davis, Walter T Ambrosius, Jill McArdle, Vanessa Duren-Winfield, Carla A Sueta, Janet B Croft
Journal: Journal of the American College of Cardiology (2004)
MINIMIZING EARLY POSTOPERATIVE PNEUMONIA
Authors: RAYMOND C. COBURN
Journal: JAMA (1933)

The literature of recent years is replete with articles dealing with the early pneumonic complications following anesthesia and operation. The frequency and gravity of these conditions have everywhere been recognized. But as their etiology was obscure, the suggested means for prophylaxis were many, but unavailing.  A great impetus, however, was given to research in this field with the postulation of the theory that these complications are caused primarily by an altered physiology, depressed respiration. This decreased pulmonary ventilation prevents the tracheobronchial secretions from being removed by nature's processes, and, remaining in situ, these secretions block the air passages, thus often imprisoning pathogenic bacteria. The air in the areas of the lungs supplied by the bronchioles or in the bronchi closed by these plugs of mucus is soon absorbed. Thus atelectasis is caused, its extent depending on the size and number of the air passages so occluded. The imprisoned bacteria, being
Symposium on Cancer of the Head and Neck: Total Treatment and Reconstructive Rehabilitation
Authors: Clifford C. Snyder
Journal: JAMA (1970)

This compilation of 54 contributions brings the reader medical and surgical information on neoplastic disease involving the head and neck region. The Educational Foundation of the American Society of Plastic and Reconstructive Surgeons is responsible for this text, which will be a valuable contribution to the practitioner and academician alike. The editor gathered the material into ten parts, subdivided into 40 chapters. The initial five chapters are directed toward general considerations in head and neck surgery, and take up epidemiology, medical evaluation, anesthesia, preoperative, and postoperative care and pathology. The succeeding nine chapters are devoted to ways of destroying the disease and reconstructing the surgical defect. The radical neck operation is afforded detailed attention, including indications and technique. Surgical reconstruction of the operative defect is considered an immediate therapy, and the authors illustrate specific steps with photographs and drawings. Fourteen authors present current concepts involving neoplastic disease of particular anatomical
A National Prediction Model for PM<sub>2.5</sub>Component Exposures and Measurement Error–Corrected Health Effect Inference
Authors: Silas Bergen, Lianne Sheppard, Paul D. Sampson, Sun-Young Kim, Mark Richards, Sverre Vedal, Joel D. Kaufman, Adam A. Szpiro
Journal: Environmental Health Perspectives (2013)

Studies estimating health effects of long-term air pollution exposure often use a two-stage approach: building exposure models to assign individual-level exposures, which are then used in regression analyses. This requires accurate exposure modeling and careful treatment of exposure measurement error.To illustrate the importance of accounting for exposure model characteristics in two-stage air pollution studies, we considered a case study based on data from the Multi-Ethnic Study of Atherosclerosis (MESA).We built national spatial exposure models that used partial least squares and universal kriging to estimate annual average concentrations of four PM2.5 components: elemental carbon (EC), organic carbon (OC), silicon (Si), and sulfur (S). We predicted PM2.5 component exposures for the MESA cohort and estimated cross-sectional associations with carotid intima-media thickness (CIMT), adjusting for subject-specific covariates. We corrected for measurement error using recently developed methods that account for the spatial structure of predicted exposures.Our models performed well, with cross-validated R2 values ranging from 0.62 to 0.95. Naïve analyses that did not account for measurement error indicated statistically significant associations between CIMT and exposure to OC, Si, and S. EC and OC exhibited little spatial correlation, and the corrected inference was unchanged from the naïve analysis. The Si and S exposure surfaces displayed notable spatial correlation, resulting in corrected confidence intervals (CIs) that were 50% wider than the naïve CIs, but that were still statistically significant.The impact of correcting for measurement error on health effect inference is concordant with the degree of spatial correlation in the exposure surfaces. Exposure model characteristics must be considered when performing two-stage air pollution epidemiologic analyses because naïve health effect inference may be inappropriate.
Abstract 4786: MiR-17-92 expression in differentiated T cells - Implications for cancer immunotherapy
Authors: Gary Kohanbash, Kotaro Sasaki, Aki Hoji, Mitsugu Fujita, Hideho Okada
Journal: Cancer Research (2010)

Abstract As type-1 T cells have been shown to mediate effective anti-tumor immune response, we sought to identify microRNA (miRs) differentially regulated between type-1 and type-2 T cells, and determine how the expression of such miRs are regulated. We performed miR microarray analyses on in vitro differentiated murine T helper type-1 (Th1) and T helper type-2 (Th2) cells to identify differentially expressed miRs. We used RT-PCR to confirm the differential expression levels. WST-1, ELISA, and flow cytometry were used to evaluate the survival, function and phenotype of cells, respectively. Lastly, we employed mice transgenic for the identified miRs to determine the biological impact of the miR expression in T cells. Our miR microarray analyses revealed that the miR-17-92 cluster is one of the most significantly over-expressed miR in murine Th1 cells compared with Th2 cells. RT-PCR confirmed that the miR-17-92 cluster expression was consistently higher in Th1 cells than Th2 cells. Disruption of the IL-4 signaling through either IL-4 neutralizing antibody or knockout of signal transducer and activator of transcription (STAT)6 reversed the miR-17-92 cluster suppression in Th2 cells. Furthermore, T cells from tumor bearing mice and glioma patients had decreased levels of miR-17-92 compared with cells from non-tumor bearing counterparts. CD4+ T cells derived from miR-17-92 transgenic mice demonstrated superior type-1 phenotype with increased IFN-γ production and very late antigen (VLA)-4 expression when compared with counterparts derived from wild type mice. Finally Jurkat T cells ectopically expressing increased levels of miR-17-92 cluster members demonstrated increased IL-2 production and resistance to activation-induced cell death (AICD). Collectively, our data suggest that the type-2-skewing tumor microenvironment can induce the down-regulation of miR-17-92 expression in T cells, thereby diminishing the persistence of tumor-specific T cells and tumor destruction. Genetic engineering of T cells to express miR-17-92 may prove to be a promising approach for cancer immunotherapy. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4786.
Adrenal Cortical Failure During Steroid Therapy for Mammary Carcinoma
Authors: M. C. Crawford, F. J. Forster
Journal: BMJ (1962)

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~MEIA JORA Ihave been present in the patient's circulation.Further studies on other members of her family indicated that the patient's mother, one of her sisters, and probably her son exhibited a similar trait confirming thalassaemia of a mild degree (Fig. 2).
Ultrasound plus mammography may detect more early cancers
Authors: S. Gottlieb
Journal: BMJ (2002)

Ultrasound exams can significantly increase the chance of detecting breast cancer early in women with dense breast tissue, finds new research.

Women should be told how dense their breasts are, which only a mammogram can determine, and those with the densest tissue should also have an ultrasound examination, it concludes (Radiology 2002;225:165-75).

Breast density is affected by age, motherhood, and hormone replacement therapy, but size and texture are not reliable predictors of breast density.

Researchers compared how well mammography, physical breast exam, and ultrasound detected cancers in 11 130 …
High-altitude pulmonary hypertension: a pathophysiological entity to different diseases
Authors: M. Maggiorini, F. Léon-Velarde
Journal: European Respiratory Journal (2003)

Pulmonary hypertension is a hallmark of high-altitude pulmonary oedema (HAPE) and of congestive right heart failure in subacute mountain sickness (SMS) and chronic mountain sickness (CMS) in the Himalayas and in the end-stage of CMS (Monge's disease) in the Andes. There are studies to suggest that transmission of excessively elevated pulmonary artery pressure and/or flow to the pulmonary capillaries leading to alveolar haemorrhage is the pathophysiological mechanism of HAPE. In the Himalayas, HAPE was successfully prevented by extending the acclimatisation period from a few days to 5 weeks, however, this did not prevent the occurrence of congestive right heart failure after several weeks of stay at 6,000 m. This leads to the concept that rapid remodelling of the small precapillary arteries prevents HAPE but not the development of right heart failure in SMS and CMS. Unresponsiveness of pulmonary hypertension to oxygen at high altitude and its complete resolution only after weeks of stay at low altitude suggest that structural rather than functional changes are its pathophysiological mechanism. Since pulmonary hypertension at high altitude is the driving force leading to high-altitude pulmonary oedema and “high-altitude right heart failure” in newcomers and residents of high altitude, the authors propose to adjust current terminology accordingly.
Prevention of Atrial Fibrillation by Bucindolol Is Dependent on the Beta 1 389 Arg/Gly Adrenergic Receptor Polymorphism
Authors: Ryan G. Aleong, William H. Sauer, Gordon Davis, Guinevere A. Murphy, J. David Port, Inder S. Anand, Mona Fiuzat, Christopher M. O'Connor, William T. Abraham, Stephen B. Liggett, Michael R. Bristow
Journal: JACC Heart Failure (2013)

This study assessed the impact of bucindolol, a beta-blocker/sympatholytic agent, on the development of atrial fibrillation (AF) in advanced chronic heart failure with reduced left ventricular ejection fraction (HFREF) patients enrolled in the BEST (Beta-Blocker Evaluation of Survival Trial). β-blockers have modest efficacy for AF prevention in HFREF patients. Bucindolol's effects on HF and ventricular arrhythmic endpoints are genetically modulated by β1- and α2c-adrenergic receptor (AR) polymorphisms that can be used to subdivide HFREF populations into those with bucindolol effectiveness levels that are enhanced, unchanged, or lost. BEST enrolled 2,708 New York Heart Association (NYHA) class III to IV HFREF patients. A substudy in which 1,040 patients' DNA was genotyped for the β1-AR position 389 Arg/Gly and the α2c322–325 wild type (Wt)/deletion (Del) polymorphisms, and new-onset AF was assessed from adverse event case report forms or electrocardiograms at baseline and at 3 and 12 months. In the entire cohort, bucindolol reduced the rate of new-onset AF compared to placebo by 41% (hazard ratio [HR]: 0.59 [95% confidence interval (CI): 0.44 to 0.79], p = 0.0004). In the 493 β1389 arginine homozygotes (Arg/Arg) in the DNA substudy, bucindolol reduced new-onset AF by 74% (HR: 0.26 [95% CI: 0.12 to 0.57]), with no effect in β1389 Gly carriers (HR: 1.01 [95% CI: 0.56 to 1.84], interaction test = 0.008). When β1389 Gly carriers were subdivided by α2c Wt homozygotes (n = 413, HR: 0.94 [95% CI: 0.48 to 1.82], p = 0.84) or Del variant carriers (n = 134, HR: 1.33 [95% CI: 0.32 to 5.64], p = 0.70), there was a positive interaction test (p = 0.016) when analyzed with β1389 Arg homozygotes. Bucindolol prevented new-onset AF; β1 and α2c polymorphisms predicted therapeutic response; and the 47% of patients who were β1389 Arg homozygotes had an enhanced effect size of 74%. (Beta-Blocker Evaluation in Survival Trial [BEST]; NCT00000560)
A quantitative evaluation of refractoriness within a reentrant circuit during ventricular tachycardia. Relation to termination.
Authors: C D Gottlieb, M E Rosenthal, N J Stamato, L H Frame, M D Lesh, J M Miller, M E Josephson
Journal: Circulation (1990)

Programmed ventricular stimuli introduced during sustained monomorphic ventricular tachycardia frequently reset the tachycardia, resulting in a less than fully compensatory pause. A resetting response curve is generated when the set of return cycles is evaluated as the function of the coupling intervals of the extrastimuli delivered during the ventricular tachycardia. If the stimulated wave front encounters tissue within the tachycardia circuit that is not fully recovered, interval-dependent conduction changes should occur producing an increasing resetting response pattern. We quantified the magnitude of this interval-dependent conduction slowing in 17 morphologically distinct ventricular tachycardias. The slope of the increasing limb of the resetting response curve was determined by linear regression analysis and ranged from -0.30 to -1.14 (mean +/- SD, 0.70 +/- 0.25). Seven of the 17 ventricular tachycardias (41%) terminated during introduction of ventricular extrastimuli. The slope of the resetting response pattern in those ventricular tachycardias that terminated were significantly steeper than in those that did not terminate (-0.85 +/- 0.15 versus -0.61 +/- 0.21, respectively, p = 0.025). Six of the seven ventricular tachycardias terminated with programmed ventricular stimuli had a slope steeper than -0.75, whereas only one of 10 ventricular tachycardias that did not terminate exceeded this value. In conclusion, the slope of the increasing portion of the resetting response curve correlates with ability to terminate uniform sustained ventricular tachycardia by timed extrastimuli. This slope is the quantification of the magnitude of interval-dependent conduction slowing. Additionally, tissue within the reentrant circuit displaying greater degrees of interval-dependent conduction slowing may also have relatively longer effective refractory periods.
Aberrant Carotid Artery Injured at Myringotomy
Authors: Oscar Sugar
Journal: JAMA (1983)

To the Editor.—  Dr Reilly and associates have written about fortuitous injury of an aberrant carotid artery at myringotomy. The statements are made that  carotid artery ligation alone would have allowed retrograde flow into the pseudoaneurysm through the intact anterior communicating artery. An intracranial approach to the artery above the aneurysm might have damaged several cranial nerves permanently. The first statement indicates that a worldwide experience with internal carotid artery occlusion for aneurysm (in the years before clips and microscopes made direct approach more palatable) was misguided. In point of fact, internal carotid ligation in the neck allows contralateral flow only as far as the ophthalmic artery (if that far!) and certainly would not permit flow to the petrous portion of the carotid, since there is no place for the blood to make an exit (small branches of the internal carotid in its canal do not permit such retrograde
Brain tumour boy can be given radiotherapy against mother's wishes, court says
Authors: C. Dyer
Journal: BMJ (2012)

This case report describes the treatment of a 73-year-old woman with long-standing, severe rheumatoid arthritis, using custom-made foot orthoses and shoe modifications. The patient was referred for physical therapy 4 weeks after triple arthrodesis of her right foot. Her primary complaint was periodic unsteadiness during gait, which necessitated the use of a cane at all times. Other problems included a lower-extremity length discrepancy and right foot pain. Physical therapy included fabrication of bilateral semirigid foot orthoses, shoe modifications, gait training, and instruction in strengthening exercises. After treatment, the patient reported feeling steady during walking without a cane, and she was able to resume community activities without right foot pain. Computerized movement analysis of gait revealed that the use of orthoses and modified footwear reduced weight bearing and movement-pattern abnormalities, as compared with barefoot walking. The findings in this case show that physical therapy including foot orthoses, shoe modifications, gait training, and strengthening exercises can be instrumental in the postsurgical rehabilitation of a patient with severe rheumatoid arthritis.
US guideline may drop cholesterol limits but keep link between dietary saturated fats and trans fats and heart disease
Authors: M. McCarthy
Journal: BMJ (2015)

A draft version of a document due out later this year may no longer warn consumers to limit their consumption of dietary cholesterol. The 2015 version of the Dietary Guidelines for Americans , which are revised every five years, have urged US consumers to limit cholesterol in their diet since the 1980s.

The decision to drop the cholesterol limits, reported first by the Washington Post , was discussed at a 15 December meeting of the Dietary Guidelines Advisory Committee. The expert panel evaluates the current scientific evidence …
Impaired Left Ventricular Diastolic Function and Vascular Postischemic Vasodilation Associated with Microalbuminuria in IDDM Patients
Authors: Maria D Guglielmi, Sante D Pierdomenico, Luigi Salvatore, Ferdinando Romano, Evandro Tascione, Mario Pupillo, Ettore Porreca, Tiziana Imbastaro, Franco Cuccurullo, Andrea Mezzetti
Journal: Diabetes Care (1995)

OBJECTIVE Microalbuminuria is considered an important predictor of cardiovascular events in diabetic patients. In this study, a possible association of microalbuminuria with significant changes in left ventricular (LV) morphology and function and generalized vascular dysfunction was analyzed in insulin-dependent diabetes mellitus (IDDM) patients without hypertension, coronary artery disease, or autonomie dysfunction. RESEARCH DESIGN AND METHODS Thirty-four young long-term IDDM patients, 16 with and 18 without microalbuminuria, and 20 control subjects were studied. LV systolic function and wall thickness were evaluated by M-mode echocardiography. LV diastolic function was studied using a combined echo-Doppler and phonocardiographic technique. The hyperemic response to forearm ischemia was measured by strain-gauge plethysmography. All patients underwent 24-h ambulatory blood pressure monitoring. RESULTS LV mass index and wall thickness:radius ratio were significantly higher in microalbuminuric patients. LV relaxation was significantly impaired in both diabetic groups compared with control subjects; moreover, this impairment was significantly greater in microalbuminuric than in normoalbuminuric patients. In microalbuminuric patients, forearm postischemic vasodilation was also significantly lower and mean awake diastolic blood pressure (dBP) was significantly higher than in the other two groups. CONCLUSIONS Our data suggest that microalbuminuria is associated with significant changes in LV morphology, a more severe impairment of cardiac diastolic function, altered vascular dilatory capacity, and higher daytime dBP. Therefore, microalbuminuric patients should be considered to have a higher risk of cardiovascular complications and be kept under closer surveillance.
Bile acid concentrations in the gastric juice of patients with erosive oesophagitis.
Authors: B J Collins, G Crothers, R J McFarland, A H Love
Journal: Gut (1985)

Intragastric total bile acid concentrations were measured before and after a corn oil test meal in 16 patients with erosive oesophagitis and symptoms of gastro-oesophageal reflux. Sixteen age and sex matched control subjects were also studied. No significant difference was detected between fasting or postprandial gastric bile acid concentrations in patients and in control subjects although a wide range of bile acid concentrations was detected among individuals in both groups. Gastric juice pH was less than 3.5 in seven patients when intragastric bile acid concentrations were greater than 200 mumol/l. These results do not support a role for abnormal duodenogastric reflux in the pathogenesis of erosive oesophagitis. The detection of acid reflux in such patients during intra-oesophageal pH monitoring, however, does not exclude the presence of bile acids which may contribute to the cytotoxic potential of gastric juice.
Clinical Trials in Hairy Cell Leukemia
Authors: BRUCE D. CHESON
Journal: Annals of Internal Medicine (1987)

During the past 5 years, clinical trials in hairy cell leukemia have shown dramatic activity for alpha-interferon and 2′-deoxycoformycin (pentostatin). Responses can be induced in more than 80% of patients using either agent, although a greater number of complete pathologic remissions may be achieved with deoxycoformycin. Despite interesting preliminary data, the optimal dose, schedule, treatment duration, and impact of therapy on survival are unknown. Clinical trials comparing efficacy and toxicity of alpha-interferon and deoxycoformycin, the extent of cross-resistance, and relationship of activity to previous splenectomy are in progress. Additional studies are testing combinations of these agents. Although interferon is commercially available for treating hairy cell leukemia, considering such therapy routine is counterproductive. Long-term clinical trials of interferon and deoxycoformycin are essential to advance our biologic knowledge of this rare disease, and to ensure optimal therapy for a potentially curable malignancy.
Effects of combined deferiprone and desferrioxamine iron chelating therapy in β‐thalassemia major end‐stage heart failure
Authors: Maurizio Porcu, Novella Landis, Stefano Salis, Marco Corda, Pierpaolo Orrù, Emanuela Serra, Barbara Usai, Gildo Matta, Renzo Galanello
Journal: European Journal of Heart Failure (2006)
885 ALTERNATIVE SPLICING IN RESULTING IN A MITOCHONDRIAL DEFECT AND PROGRESSIVE HEPATIC STEATOSIS IN MICE
Authors: N.G. Abd Al Ahad, H.-J. Kao, C.-F. Yang, C.-C. Huang, W.-D. Lin, F.-J. Tsai, T.-H. Chen, W.-Y. Tarn, J.-Y. Wu, Y.-T. Chen
Journal: Journal of Hepatology (2011)
Radionuclide Brain Perfusion Studies in Suspected Brain Death
Authors: C C KUNI, D M ROGGE
Journal: Clinical Nuclear Medicine (1986)

The radionuclide brain perfusion study (RPS) has been suggested as a method of confirming suspected brain death. The hospital records and RPSs of 34 patients referred were reviewed because brain death was suspected. In every case but one the RPS showed absent or drastically reduced cerebral blood flow. No patient survived more than five days, and 25 survived less than 24 hours. These findings are consistent with the results of previous reports of a total of 248 patients; only one of 248 survived and was discharged from the hospital after having had a positive RPS. The RPS is highly accurate in confirming brain death.