tbuckley/cabot-search huggingface dataset:
Uncertainties Regarding Pelvic Radiotherapy for Prostate Cancer
Authors: Ronald D. Ennis
Journal: Journal of Clinical Oncology (2004)

endothelial dysfunction may contribute to X syndrome. 3 However, little is known about the association between cavernosal vasculopathy and X syndrome.This is important, as ED may present as a symptom of a serious underlying disease of X syndrome.Here we report two recipients of HDC who developed some of the core signs of X syndrome (impaired glucose tolerance test according WHO criteria, persistent hypertension, and hyperlipidemia) 3,4 and ED at 72 and 80 months post-transplant, respectively.Table 1 provides patients' information, including endocrine profile and penile Doppler studies at the time of diagnosis of the X syndrome.Endocrine assays, testicular ultrasonography scan, and color Doppler studies of cavernosal vessels were conducted according to previous published protocols. 2 Both patients had fasting lipid profile, endocrine tests at 0900 hours, which was followed by glucose tolerance test.Routine biochemical tests were undertaken in the chemical pathology lab at University College London Hospital (London, UK).Patient 1 had normal weight (body-mass index 21 kg/m 2 and hip/waist ratio 0.7), and patient 2 was overweight (body-mass index Ͼ 33 kg/m 2 and hip/waist ratio Ͼ 1) and also had persistent functional hyperplolactinemia with grade 2 gynecomastia.However, he had normal magnetic resonance imaging scan of the pituitary gland and normal thyroid function.Our data suggests a possible common link between endothelial dysfunction, ED, and metabolic syndrome.Even though aging may be an additional contributing factor implicated for the development of hypogonadism, atherosclerosis, and changes in penile blood vessels, 5 these findings highlight the fact that endothelial dysfunction manifested as generalized vasculopathy may be an important pathologic link between the metabolic syndrome and the cavernosal arterial insufficiency.To the best of our knowledge, this is the first report showing the association between ED with cavernosal vascu-lar insufficiency and X syndrome.As X syndrome may remain asymptomatic, and ED an under-reporting complication, physicians should become aware of this association, highlighting the need for careful medical assessment including primary and secondary prevention strategies.
Biomaterials: Where We Have Been and Where We Are Going
Authors: Buddy D. Ratner, Stephanie J. Bryant
Journal: Annual Review of Biomedical Engineering (2004)

Since its inception just over a half century ago, the field of biomaterials has seen a consistent growth with a steady introduction of new ideas and productive branches. This review describes where we have been, the state of the art today, and where we might be in 10 or 20 years. Herein, we highlight some of the latest advancements in biomaterials that aim to control biological responses and ultimately heal. This new generation of biomaterials includes surface modification of materials to overcome nonspecific protein adsorption in vivo, precision immobilization of signaling groups on surfaces, development of synthetic materials with controlled properties for drug and cell carriers, biologically inspired materials that mimic natural processes, and design of sophisticated three-dimensional (3-D) architectures to produce well-defined patterns for diagnostics, e.g., biological microelectromechanical systems (bioMEMs), and tissue engineering.
THE USE OF PROTRYPTYLINE (MK-240) AS AN ANTIDEPRESSANT A PRELIMINARY REPORT
Authors: WILFRED DORFMAN
Journal: American Journal of Psychiatry (1963)

1. Protryptyline (MK-240) is an effective antidepressant. 2. Its major usefulness appears to be for patients with retardation and apathy without agitation. Patients with marked agitation did poorly; in some patients agitation emerged as the depression was lifted. 3. The drug showed some promise in depressed psychoneurotic patients with obsessive compulsive defenses. 4. In some patients the preference for medications given prior to protryptyline seemed to be related to psychological considerations rather than to the physiological effects of the drug.
Using Patient-Reported Outcomes in Clinical Practice: A Promising Approach?
Authors: Claire F. Snyder
Journal: Journal of Clinical Oncology (2014)

pletion only (attention-control), and no PRO completion (control). They found that the intervention improved discussion of symptoms but did not change treatment. Further, although the intervention demonstrated benefits in health-related quality of life (HRQOL) compared with the control group, there were no statistically significant differences in mean change scores between the intervention and attention-control group. This study by Wolfe et al 1 adds to this body of knowledge by investigating the use of PROs to aid treatment of pediatric patients with advanced cancer. The 104 patients and their parents enrolled in this trial completed a computerized battery of PRO questionnaires, at most once a week, and were monitored for 3 months, with the option of re-enrolling after each 3-month period. The PRO measures included a symptom assessment, an HRQOL questionnaire, and an overall sickness question. The results of these PRO assessments for the intervention group (n 51) were provided to both the oncologist and the families, with e-mail alerts to clinical team members for scores that exceeded predetermined thresholds. There was no feedback of the data in the control group. The investigators hypothesized that the intervention would lead to decreased symptom distress and improved HRQOL. They also assessed participant and provider satisfaction with the intervention. In the primary analysis, although changes were in the expected directions, there were no statistically significant differences between study arms on average symptom, HRQOL, or sickness scores over 20 weeks. Post hoc subgroup analyses found larger and statistically significant improvements on the HRQOL emotional domain scores and the sickness question for patients who survived longer than 20 weeks, particularly those who were at least 8 years old. There was also a suggestion that emotional function improved among children 8 years and older, regardless of length of survival, although this was not statistically significant. Likewise, children who both survived longer than 20 weeks and were at least 8-years old also demonstrated changes of marginal statistical significance on the total and physical HRQOL domains. In terms of satisfaction with the intervention, 28% of children and 54% of parents reported the intervention helped them talk to the doctor quite a bit or very much, and 75% of parents said the intervention often or almost always helped them understand how their child feels. Among the clinicians, 50% strongly agreed or agreed that the PRO reports were useful when speaking to patients, with 61%
INCREASED PLASMA CONCENTRATIONS OF ENDOTHELIN-1 AND BIG ENDOTHELIN-1 IN ACUTE MYOCARDIAL INFARCTION
Authors: Takashi Miyauchi, Masashi Yanagisawa, Takuji Tomizawa, Yasuro Sugishita, Nobuhiro Suzuki, Masahiko Fujino, Ryuichi Ajisaka, Katsutoshi Goto, Tomoh Masaki
Journal: The Lancet (1989)
Abstract 16338: Efficacy and Safety of Dabigatran versus Acenocoumarol in “Real World” Patients With Atrial Fibrillation
Authors: Jennie Korenstra, Petra Wijtvliet, Christiane Geluk, Louis Bartels, Jan Posma, Isabelle van Gelder, Robert Tieleman
Journal: Circulation (2014)

Purpose: Randomized trials showed non-inferior or superior results of the non-vitamin K oral anticoagulants (NOACs) compared with warfarin. The aim of this study was to assess the efficacy and safety of dabigatran versus acenocoumarol in patients with atrial fibrillation (AF) in daily clinical practice. Methods: In this retrospective study we evaluated all patients who started anticoagulation because of AF in our outpatient clinic from 2010 till 2012. In later years we preferably prescribed dabigatran. Data were collected from the electronical patient chart. Primary outcomes were stroke or systemic embolism and major bleeding, based on the definitions used in the RE-LY study. Results: In total 467 patients with dabigatran and 491 patients with acenocoumarol were enrolled. Mean follow-up duration was 1.3±0.6yr versus 2.3±0.9yr, respectively. On average, the dabigatran patients were a bit younger (69.5yr vs. 73.3yr) and more often male (55.5% vs. 48.3%) as compared with the acenocoumarol patients. The mean ...
SDF1 induction by acidosis from principal cells regulates intercalated cell subtype distribution
Authors: George J. Schwartz, XiaoBo Gao, Shuichi Tsuruoka, Jeffrey M. Purkerson, Hu Peng, Vivette D’Agati, Nicolas Picard, Dominique Eladari, Qais Al-Awqati
Journal: Journal of Clinical Investigation (2015)

The nephron cortical collecting duct (CCD) is composed of principal cells, which mediate Na, K, and water transport, and intercalated cells (ICs), which are specialized for acid-base transport. There are two canonical IC forms: acid-secreting α-ICs and HCO3-secreting β-ICs. Chronic acidosis increases α-ICs at the expense of β-ICs, thereby increasing net acid secretion by the CCD. We found by growth factor quantitative PCR array that acidosis increases expression of mRNA encoding SDF1 (or CXCL12) in kidney cortex and isolated CCDs from mouse and rabbit kidney cortex. Exogenous SDF1 or pH 6.8 media increased H+ secretion and decreased HCO3 secretion in isolated perfused rabbit CCDs. Acid-dependent changes in H+ and HCO3 secretion were largely blunted by AMD3100, which selectively blocks the SDF1 receptor CXCR4. In mice, diet-induced chronic acidosis increased α-ICs and decreased β-ICs. Additionally, IC-specific Cxcr4 deletion prevented IC subtype alterations and magnified metabolic acidosis. SDF1 was transcriptionally regulated and a target of the hypoxia-sensing transcription factor HIF1α. IC-specific deletion of Hif1a produced no effect on mice fed an acid diet, as α-ICs increased and β-ICs decreased similarly to that observed in WT littermates. However, Hif1a deletion in all CCD cells prevented acidosis-induced IC subtype distribution, resulting in more severe acidosis. Cultured principal cells exhibited an HIF1α-dependent increase of Sdf1 transcription in response to media acidification. Thus, our results indicate that principal cells respond to acid by producing SDF1, which then acts on adjacent ICs.
International European Respiratory Society/American Thoracic Society guidelines on severe asthma
Authors: Jean Bousquet, Nikolai Khaltaev, Alvaro Cruz, Arzu Yorgancioglu, Alexander Chuchalin
Journal: European Respiratory Journal (2014)

To the Editor: 

In their recent paper on severe asthma, Chung et al. [1] proposed excellent guidelines concerning this difficult topic. We commend them for having used the Grading of Recommendations Assessment, Development and Evaluation approach to study the evidence for the management of the disease. This method has been recognised to be of great importance for guideline development.

The authors have reviewed recent statements on severe asthma [2, 3] and agree upon most …
Angiotensin II
Authors: D H Sigmon, J M Newman, W H Beierwaltes
Journal: Journal of the American Society of Nephrology (1994)

In anesthetized rats, renal perfusion is largely regulated by a balance between the vasodilator influence of endothelium-derived nitric oxide (EDNO) and angiotensin II (AII)-mediated vasoconstriction. However, in conscious rats, which are characterized by lower PRA, the influence of AII is largely dissipated. To determine whether chronically increasing PRA enhances the interaction between AII and EDNO in regulating renal perfusion, radioactive microspheres were used to assess RBF in conscious sodium-depleted rats. PRA of control rats on a standard diet was 2.3 +/- 0.3 ng of AI/mL per hour compared with 16.8 +/- 1.5 ng of AI/mL per hour (P < 0.001) for rats on a sodium-restricted diet. In 12 rats on a standard diet, the inhibition of EDNO synthesis with L-Nw-nitroarginine methyl ester (L-NAME) increased blood pressure (BP) from 111 +/- 2 to 135 +/- 3 (P < 0.001) and decreased RBF by 47% (from 8.0 +/- 0.6 to 4.3 +/- 0.3 mL/min per gram kidney wt; P < 0.001). Renal vascular resistance (RVR) increased by 132% (from 14.9 +/- 1.2 to 34.7 +/- 3.3 resistance units (RU); P < 0.001). Pretreatment with Losartan, an AII receptor antagonist, did not modify the changes in BP, RBF, and RVR induced by L-NAME.(ABSTRACT TRUNCATED AT 250 WORDS)
Systemic Metabolic Abnormalities in Adult-onset Acid Maltase Deficiency
Authors: Juan M. Pascual, Charles R. Roe
Journal: JAMA Neurology (2013)

<h3>Importance</h3>The physiological relevance of acid maltase (acid α-glucosidase, an enzyme that degrades lysosomal glycogen) is well recognized in liver and muscle. In late (adult)–onset acid maltase deficiency (glycogen storage disease type II [GSD II]), glycogen accumulates inside muscular lysosomes in the context of reduced enzymatic activity present not only in muscle, but also throughout the organism. Yet, disease manifestations are commonly attributed to lysosomal disruption and autophagic vesicle buildup inside the myofiber due to a lack of obvious hepatic or broader metabolic dysfunction. However, current therapies primarily focused on reducing glycogen deposition by dietary or enzyme replacement have not been consistently beneficial, providing the motivation for a better understanding of disease mechanisms.<h3>Objective</h3>To provide a systematic overview of metabolism and methylation capacity using widely available analytical methods by evaluating secondary compromise of (1) the citric acid cycle, (2) methylation capacity, and (3) nutrient sensor interaction in as many as 33 patients with GSD II (ie, not all patients were available for all assessments) treated with only a low-carbohydrate/high-protein, calorie-balanced diet.<h3>Design, Setting, and Patients</h3>Case series including clinical and analytical characterization in an academic setting involving 33 enzymatically proved adults with GSD II treated only with a low-carbohydrate/high-protein, calorie-balanced diet.<h3>Main Outcome and Measure</h3>Biochemical analysis of blood and urine samples.<h3>Results</h3>Patients exhibited evidence for disturbed energy metabolism contributing to a chronic catabolic state and those who were studied further also displayed diminished plasma methylation capacity and elevated levels of insulin-like growth factor type 1 and its carrier protein insulin-like growth factor binding protein 3 (IGFBP-3).<h3>Conclusions and Relevance</h3>The simplest unifying interpretation of these abnormalities is nutrient sensor disturbance with secondary energy failure leading to a chronic catabolic state. Data also provide the framework for the investigation of potentially beneficial interventions, including methylation supplementation, as adjuncts specifically targeted to ameliorate the systemic metabolic abnormalities of this disorder.
Protective Influence of Cardiac Denervation Against Arrhythmias of Myocardial Infarction
Authors: S. F. Schaal, A. G. Wallace, W. C. Sealy
Journal: Cardiovascular Research (1969)

In 10 normal awake dogs coronary occlusion produced frequent premature beats in all dogs and ventricular tachycardia in nine of the 10. After total cardiac denervation coronary occlusion failed to produce arrhythmias in eight of 10 dogs.
Lung damage induced by intermittent ozone exposure and exercise in rats
Authors: Manuel Oyarzún, Nelson Dussaubat, María Angélica Miller, Martín López, Tatiana Reyes
Journal: European Respiratory Journal (2013)

Tropospheric ozone (O3) exceeds Chilean standard (0.06 ppm/8 h) in the city of Santiago. This exposure is intermittent and coincides with the time at which citizens get out for exercising. Lung damage induced by O3 increases with exercise. However, intermittent exposure to O3 induces tolerance to lung injury. We studied lung damage in controlled intermittent O3 exposure under standardized exercise. For this purpose, 4 series of male Sprague-Dawley rats (211 ± 11 g of body weight) were used: (1) exposed to 0.5 ppm O3 (4 hours a day for 2 days) at rest (n=13), (2) exposed to 0.5 ppm O3 during exercise (n=12), (3) breathing filtered air (FA) at rest (n=13), and (4) breathing FA during exercise (n=13). Exercise was done in a vertical rotary wheel for 15 min alternated with 15 min of rest during 4 hours a day for 2 days. Rats were euthanized. We determined the wet weight / dry weight ratio (WW/DW) in left lung, and measured in the right lung total cell counting, total proteins and γ-glutamyltranspeptidase (GGT) activity in the broncho-alveolar lavage fluid (BALF). We found that WW/DW, cell count and proteins increased in BALF from resting rats exposed to O3 as compared with resting rats breathing FA (p<0.05, ANOVA). In series breathing FA, GGT activity in BALF (1.04 ± 0.11 mIU/100 g of body weight)increased in rats under exercise (57% over baseline; p<0.05). Moreover, exercise was associated with greater GGT activity (234% over baseline), proteins and cell count in BALF (p< 0.05) in rats breathing O3. Conclusion: physical exercise by itself increases GGT activity. Exercise enhances lung damage induced by intermittent and acute O3 exposure in rats. We proposed that this lung damage is mediated by oxidative stress.
Ethics, Pandemics, and the Duty to Treat
Authors: Heidi Malm, Thomas May, Leslie P. Francis, Saad B. Omer, Daniel A. Salmon, Robert Hood
Journal: The American Journal of Bioethics (2008)

Numerous grounds have been offered for the view that healthcare workers have a duty to treat, including expressed consent, implied consent, special training, reciprocity (also called the social contract view), and professional oaths and codes. Quite often, however, these grounds are simply asserted without being adequately defended or without the defenses being critically evaluated. This essay aims to help remedy that problem by providing a critical examination of the strengths and weaknesses of each of these five grounds for asserting that healthcare workers have a duty to treat, especially as that duty would arise in the context of an infectious disease pandemic. Ultimately, it argues that none of the defenses is currently sufficient to ground the kind of duty that would be needed in a pandemic. It concludes by sketching some practical recommendations in that regard.
Automated Ankle-Brachial Pressure Index Measurement by Clinical Staff for Peripheral Arterial Disease Diagnosis in Nondiabetic and Diabetic Patients
Authors: Cécile Clairotte, Sylvie Retout, Louis Potier, Ronan Roussel, Brigitte Escoubet
Journal: Diabetes Care (2009)

OBJECTIVE Peripheral arterial disease (PAD) is a prognostic marker in cardiovascular disease. The use of Doppler-measured ankle-brachial pressure index (Dop-ABI) for PAD diagnosis is limited because of time, required training, and costs. We assessed automated oscillometric measurement of the ankle-brachial pressure index (Osc-ABI) by nurses and clinical staff. RESEARCH DESIGN AND METHODS Clinical staff obtained Osc-ABI with an automated oscillometric device in 146 patients (83 with diabetes) at the time of Dop-ABI measurement and ultrasound evaluation. RESULTS Measurements were obtained in most legs (Dop-ABI 98%; Osc-ABI 95.5%). Dop- and Osc-ABI were significantly related in diabetic and nondiabetic patients with good agreement over a wide range of values. When Dop-ABI ≤0.90 was used as the gold standard for PAD, receiver operating characteristic curve analysis showed that PAD was accurately diagnosed with Osc-ABI in diabetic patients. When ultrasound was used to define PAD, Dop-ABI had better diagnostic performance than Osc-ABI in the whole population and in diabetic patients (P = 0.026). Both methods gave similar results in nondiabetic patients. The cutoff values for the highest sensitivity and specificity for PAD screening were between 1.0 and 1.1. Estimation of cost with the French medical care system fees showed a potential reduction by three of the screening procedures. CONCLUSIONS PAD screening could be improved by using Osc-ABI measured by clinical staff with the benefit of greater cost-effectiveness but at the risk of lower diagnostic performance in diabetic patients.
Snoring is not a specific symptom of obstructive sleep apnea in children
Authors: Li Chang, Ling Cao
Journal: European Respiratory Journal (2013)

Objective   To determine if snoring is a specific symptom of obstructive sleep apnea (OSA) in children.    Methods   141 Chinese patients were included in this retrospective study. Each child had a sleep questionnaire and nocturnal polysomnography (PSG). Snoring was recorded using a microphone during PSG. An apnea-hypopnea index (AHI) >5 was defined as OSA. A sleep physician interpreted the nocturnal PSG and snoring data. The occurrence ratio of sleep problems were compared between the OSA and non-OSA groups by the chi-square test. The Pearson correlation test was used to determine the correlation of snoring items and occurences of sleep problems with AHI.    Results   Among the 141 patients aged 21 months to 12.8 years, 78 (55%) had OSA as determined by PSG. No significant difference was found between the OSA and non-OSA groups in terms of the occurrence ratio of snoring based on the data from the questionnaire( 87.2% vs85.7%, P>0.05). The occurrence of observable apnea during sleep, mouth breathing, and restlessness was significantly different between the OSA and non-OSA groups (20.5% vs.4.8%, 85.9% vs. 71.4%, and 69.2% vs. 52.4%, respectively, P 0.05, correlation coefficients=0.109,0.143 and 0.163 respectively). However, the occurrence of observable apnea during sleep, mouth breathing, and restlessness were correlated with AHI (P    Conclusion   Snoring is not a specific symptom of OSA in children. Observable apnea during sleep, mouth breathing, and restlessness were more important in the diagnosis of OSA in children.
Ice hockey injuries: a 4-year prospective study of a Swedish élite ice hockey team.
Authors: M Pettersson, R Lorentzon
Journal: British Journal of Sports Medicine (1993)

In this prospective study, we have investigated the incidence of injuries of different severity, types of injury, and mechanisms of injury during ice hockey practice and games. One Swedish élite hockey team was closely observed during four seasons (1986-1990). There were 376 injuries, of which 148 resulted in absence from practice or games. The incidence of injury (injuries associated with later absence) during practice was 2.6 per 1000 player-practice hours and 74.1 per 1000 player-game hours. Nuisance injuries (without any later absence) and minor injuries (absence < 1 week) constituted the vast majority (95.2%) and only 4.8% (18 cases) were classified as moderate or major injuries (absence > 1 week). Of the injuries 85% were caused by trauma and 15% by overuse. Injuries were most often localized to the lower limb (37.8%) and head/face (31.4%). The commonest injuries were contusions, lacerations/wounds, strains and sprains. Most injuries resulted from stick or player contact (predominantly checking). The results are in close agreement with those of a previous investigation of another Swedish élite hockey team covering the years 1982-1985. It should be possible to reduce the number of injuries by stricter enforcement of the hockey rules, especially against stick violations, and a more widespread use of visors.