tbuckley/cabot-search huggingface dataset:
Estimation of occlusion pressure during assisted ventilation in patients with intrinsic PEEP.
Authors: G Conti, G Cinnella, E Barboni, F Lemaire, A Harf, L Brochard
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

We conducted a study to assess the validity of the occlusion pressure (P0.1) measured during activation of the trigger mechanism (P0.1(aw)trig) in patients showing variable levels of PEEPi during pressure-support ventilation. We first compared P0.1(aw)trig and P0.1 measured with the conventional method (i.e., the airway pressure drop after the first 100 ms of an occluded inspiration) in 16 patients with chronic obstructive pulmonary disease (COPD). We observed good agreement and a highly significant correlation (r = 0.99; bias = 0.3 +/- 0.5 cm H20) between the two methods. In a second part of the study, we compared, in 17 patients, P0.1(aw)trig with (P0.1(es)), measured as the depression generated on the esophageal pressure tracing in the first 100 ms of the inspiratory negative swing, and with P0.1 measured on the P(es) tracing simultaneously with P(aw)trig (P0.1(es-synchro)). Our results showed a good correlation and good agreement between P(aw)trig and P0.1(es) (r = 0.92; bias = 0.3 +/- 0.5 cm H20); P(aw)trig and P0.1(es-synchro) (r = 0.97; bias = 0.1 +/- 0.2 cm H20); and P0.1(es) and P0.1(es-synchro) (r = 0.95, bias = 0.2 +/- 0.4 cm H20), respectively. This study suggests that reliable measurements of inspiratory drive can be obtained easily, on a breath-by-breath basis, from airway pressure tracings during pressure-support ventilation in patients with variable levels of PEEPi.
Evolutionary Scenarios of Notch Proteins
Authors: A. Theodosiou, S. Arhondakis, M. Baumann, S. Kossida
Journal: Molecular Biology and Evolution (2009)

Notch is a highly conserved family of transmembrane receptors and transcription factors that are key players in several developmental processes. In this study, we identified novel Notch sequences from various species covering from worm to human and conducted a comprehensive phylogenetic analysis in order to confirm and extend the evolutionary history of Notch. Our findings confirm an independent duplication event in Caenorhabditis elegans resulting in two Notch genes and show that the vertebrate Notch genes resulted from two duplication events, both of which occurred before the divergence of teleosts and tetrapoda. Furthermore, we demonstrate that the vertebrate Notch2 group is phylogenetically closer to Notch3 and that Notch2 appeared at the first round of vertebrate duplication events. Moreover, there is evidence that the two Notch1 genes in fish, appeared by a recent duplication of Notch1 in teleost after the divergence of teleost and tetrapoda. Whether this is from ancient whole genome duplication (WGD) or gene duplication remains to be elucidated. The fourth group of Notch (Notch4) was found only in mammals. We suggest two possible scenarios for the origin of the Notch4 subfamily: 1) Notch4 appeared at the time of the two WGDs in the early chordate but has been maintained only in the mammalian lineage and was lost in the other lineages, 2) a recent independent duplication event took place in the mammalian lineage. The increase of the sequencing data from Xenopus tropicalis, Gallus gallus genome projects and of other avian and reptile genomes will shed more light on this event. Nevertheless, the great divergence of Notch4, from the other three Notch genes, suggests a rapid divergence raising questions about the functional implication of this event. In addition, comparison of the organization of Notch syntenic genes among species supports the coordinated rearrangements during evolution for Nοtch, PBX, and BRD families that may lead to possible functional relationships.
The Fontan Procedure
Authors: Yves d’Udekem, Ajay J. Iyengar, Andrew D. Cochrane, Leeanne E. Grigg, James M. Ramsay, Gavin R. Wheaton, Dan J. Penny, Christian P. Brizard
Journal: Circulation (2007)

To determine whether patients undergoing the lateral tunnel and extracardiac conduit modifications of the Fontan procedure have better outcomes than patients undergoing a classical atriopulmonary connection.Between 1980 and 2000, 305 consecutive patients underwent a Fontan procedure at our institution. There were 10 hospital deaths (mortality: 3%) with no death after 1990. Independent risk factors for mortality were preoperative elevated pulmonary artery pressures (P=0.002) and common atrioventricular valve (P=0.04). Fontan was taken down during hospital stay in 7 patients. A mean of 12+/-6 years of follow-up was obtained in the 257 nonforeign Fontan survivors. Completeness of concurrent follow-up was 96%. Twenty-year survival was 84% (95% CI: 79 to 89%). Recent techniques improved late survival. The 15-year survival after atriopulmonary connection was 81% (95% CI: 73% to 87%) versus 94% (95% CI: 79% to 98%) for lateral tunnel (P=0.004). Nine pts required heart transplantation (8 atriopulmonary connection, 1 lateral tunnel). Undergoing a Fontan modification independently predicted decreased occurrence of arrhythmia, and 15-year freedom from SVT was 61% (95% CI: 51% to 70%) for atriopulmonary connection versus 87% (95% CI: 76% to 93%) for lateral tunnel (P=0.02). Freedom from Fontan failure (death, take-down, transplantation, or NYHA class III-IV) was 70% (95% CI: 58% to 79%) at 20 years. After extra-cardiac conduits, no death, SVT, or failure was observed.The Fontan procedure remains a palliation, but outcomes of patients have improved. Better patient selection minimizes hospital mortality. Patients with lateral tunnel and extracardiac conduit modifications experience less arrhythmia and are likely to have failure of their Fontan circulation postponed.
GPs prescribe self help books for mental health problems
Authors: R. Dobson
Journal: BMJ (2003)

Patients are being prescribed “do it yourself” health books from the local public library in what's believed to be the first project of its kind in the United Kingdom.

Patients with mild to moderate forms of a range of mental health problems, including depression, anxiety, stress, social phobia, and eating disorders, are being offered the option of a prescription for a …
What You Should Know About Estrogens
Authors: Richard L. Landau
Journal: JAMA (1979)

WHILE maturing, America seems to have lost its sense of humor. A younger, more vigorous, democratic nation preserved its perspective with the help of great humorists such as Mark Twain, Will Rogers, Oliver Wendell Holmes, William D. Howells, Josh Billings, and George Ade. Today we are amused at the contrived one-liners of our comics, but with few exceptions their only mission is to generate a guffaw. Ralph Nader would probably have been laughed out of town by Mark Twain, who said in his autobiography:  It seems a pity that the world should throw away so many good things merely because they are unwholesome. I doubt if God has given us any refreshment which, taken in moderation, is unwholesome, except microbes. Yet there are people who strictly deprive themselves of each and every eatable, drinkable, and smokable which has in any way acquired a shady reputation. They pay this price for
Osteosarcoma Pulmonary Metastasis Mimicking Abnormal Skeletal Uptake in Bone Scan
Authors: Mohammed Mebarki, Abdelkader Medjahedi, Abdelghani Menemani, Siham Betterki, Sabah Terki, Necib Berber
Journal: Clinical Nuclear Medicine (2013)

We present a case of a 15-year-old boy with osteoblastic osteosarcoma of the left distal femur. The patient was referred to bone scan for initial staging. On planar bone scan, there is increased uptake of 99mTc-MDP (99mTc-methylene diphosphonate) in the left distal femur. There are also multiple sites of abnormal tracer uptake projecting to the thoracic cage, initially assumed to be localized in the ribs. SPECT/CT correctly identified them as pulmonary metastases. This case illustrates the potential advantages and utility of SPECT/CT imaging of skeletal bone scan in order to decide on the optimal treatment.
Obstructive Hydronephrosis
Authors: Daniel H. Present, Jack G. Rabinowitz, Peter A. Banks, Henry D. Janowitz
Journal: New England Journal of Medicine (1969)

Ten patients with obstructive hydronephrosis were discovered among a group of approximately 150 patients with granulomatous (Crohn's) disease of the bowel (nine with regional enteritis and one with colitis). Symptoms of urinary-tract disease were notably absent as was laboratory evidence of urinary-tract infection. Hip and thigh pain, usually right sided, was the important clinical clue. Extrinsic compression of the ureter appeared to be caused by retroperitoneal extension of the severe intestinal inflammatory process. Seven of the nine patients treated by surgical bypass operations had prompt resolution of the hydronephrosis, but suffered a high rate of postoperative complications and clinical recurrence of the intestinal disease.
Deregulated BCL6 expression recapitulates the pathogenesis of human diffuse large B cell lymphomas in mice
Authors: Giorgio Cattoretti, Laura Pasqualucci, Gianna Ballon, Wayne Tam, Subhadra V. Nandula, Qiong Shen, Tongwei Mo, Vundavalli V. Murty, Riccardo Dalla-Favera
Journal: Cancer Cell (2005)
Androgen-Producing Hilus Cell Tumor of the Ovary
Authors: Jeffrey B. Russell
Journal: JAMA (1987)

IN 1942 Berger<sup>1</sup>reported the first clinical case of a hilar cell tumor of the ovary in a 50-year-old woman with signs of virilization. Since then approximately 50 cases have been reported in the literature.<sup>2,3</sup>This is a case of a hilar cell tumor in a postmenopausal woman detected by ultrasound and duplex Doppler scanning. The<i>hilar cell tumor</i>is a neoplastic growth of mature hilar cells with a closely packed uniform appearance. The tumors are often brown, small (&lt;6 cm), unilateral, and benign. The hallmark feature of the hilus cell tumor is virilization in a perimenopausal or postmenopausal woman. This virilization is usually insidious in onset, having been present in some cases for more than ten years. There has also been an unusually high frequency of endometrial hyperplasia found in these patients.<sup>2,3</sup> The possibility of using pulsed Doppler flow signals for the early detection of physiologically
Prevention of progression of coronary atherosclerosis by treatment of hyperlipidaemia: a seven year prospective angiographic study.
Authors: E A Nikkila, P Viikinkoski, M Valle, M H Frick
Journal: BMJ (1984)

The progression of coronary atherosclerosis was assessed by repeat angiography in 28 patients and 20 controls with hyperlipidaemia (serum cholesterol concentration greater than 7.2 mmol/l (278 mg/100 ml) or serum triglyceride concentration greater than 2.0 mmol/l (177 mg/100 ml), or both) and symptomatic coronary artery disease of two or three vessels. Twenty eight patients (26 men and two women) were treated with diet and drugs (clofibrate or nicotinic acid, or both) to lower lipid concentrations. Twenty men taking part in a simultaneous study served as non-randomised controls. They received medical treatment for coronary artery disease but no treatment to reduce lipid concentrations. The initial levels of coronary risk factors and the angiographic state were comparable in the two groups. In the 28 patients total cholesterol, total triglyceride, and low density lipoprotein cholesterol concentrations were reduced by an average 18%, 38%, and 19% respectively by treatment for hyperlipidaemia and high density lipoprotein cholesterol concentration was increased on average by 10%. The treatment maintained these concentrations during a follow up of seven years. By all criteria coronary lesions progressed significantly less in the patients than the controls: the angiographic state remained completely unchanged in nine (32%) of the patients compared with only one (8%) of the surviving controls; of the arterial segments at risk, 46 (16.5%) progressed in the patients compared with 50 (38.2%) in the controls (p less than 0.001); and the coronary obstruction increased less in patients than in controls (p less than 0.05). Cardiac survival was 89% in seven years in the patients compared with 65% in five years in the controls (p less than 0.01). The anginal symptoms diminished or remained stable in 16 of the 24 patients who survived until the end of the study. The progression of coronary atheromatosis was significantly greater in those patients who during the seven years of treatment had an average total cholesterol concentration, VLDL plus LDL cholesterol concentration, or ratio of LDL to HDL cholesterol concentration above the respective median value than in those with the corresponding values below median. On the other hand, the patients with HDL cholesterol concentrations above the median during treatment showed less progression than those with lower HDL cholesterol concentrations. The increase in coronary obstruction was inversely related to the average HDL cholesterol concentration during treatment. The progression was not, however, related to LDL cholesterol concentration during treatment.(ABSTRACT TRUNCATED AT 400 WORDS)
Abstract 911: Tyrosine kinase inhibitor Gefitinib selectivley induces apoptosis in Zap70+ chronic lymphocytic leukemia cells and inhibits B cell receptor signaling.
Authors: Rebecca Dielschneider, Wenyan Xiao, Ju Yoon Yoon, Edward Noh, James B. Johnston, Spencer B. Gibson
Journal: Cancer Research (2013)

Abstract Chronic lymphocytic leukemia (CLL), the most common adult leukemia in the western world, is characterized by an accumulation of B cells in the peripheral blood, lymph nodes, and bone marrow leading to immunosuppression. Patients can be stratified into two distinct groups based upon the expression of a T-cell receptor kinase, ZAP70. CLL patients with ≥20% cells staining for the ZAP70 have more aggressive disease and survive shorter times compared with patients with lower ZAP70 expression. Thus, tyrosine kinase inhibitors could be attractive therapeutic agents targeting ZAP70 over expressing CLL cells. In this study, we investigated tyrosine kinase inhibitor gefitinib that has been shown to inhibit tyrosine kinase Syk (a ZAP70 family member) and is not a myelo- or immuno-suppressive drug as other chemotherapeutic agents are in treating CLL. We found using MTT viability assay that the tyrosine kinase inhibitor gefitinib is effective in primary CLL cells with a significant preference for Zap70+ CLL; gefitinib had a median IC50 of 4.5 μM in Zap70+ patient cells and &amp;gt;15.0 μM in Zap70- patient cells. Flow cytometry analysis showed a decrease of viable Zap70+ CLL cells 24 hours post gefitinib treatment. Although gefitinib decreased the viability of the Zap70+ Jurkat T leukemia cell line, it failed to affect T cells from CLL patients. Western blot analysis showed gefitinib inhibited tyrosine phosphorylation of ZAP70 and Syk in CLL cells. In addition, both basal and B cell receptor-stimulated tyrosine phosphorylation was reduced after gefinitib treatment. Compared with other known inhibitors dasatinib and ibrutinib, gefitinib has the same downstream inhibition of Erk and Akt phosphorylation in Zap70+ cells. The significance of Zap70 expression was further determined by treating the Raji B lymphoma cell line transduced with vector control or vector encoding Zap70; indeed Zap70 expression sensitized the B cell line Raji to gefitinib treatment whereas other tyrosine kinase inhibitors were less effective. Therefore, gefitinib inhibits the Zap70 signaling pathway in CLL cells and holds potential as a targeted therapy for aggressive CLL. Citation Format: Rebecca Dielschneider, Wenyan Xiao, Ju Yoon Yoon, Edward Noh, James B. Johnston, Spencer B. Gibson. Tyrosine kinase inhibitor Gefitinib selectivley induces apoptosis in Zap70+ chronic lymphocytic leukemia cells and inhibits B cell receptor signaling. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 911. doi:10.1158/1538-7445.AM2013-911
Availability of Comparative Efficacy Data at the Time of Drug Approval in the United States
Authors: Nikolas H. Goldberg
Journal: JAMA (2011)

<h3>Context</h3>Comparative effectiveness is taking on an increasingly important role in US health care, yet little is known about the availability of comparative efficacy data for drugs at the time of their approval in the United States.<h3>Objective</h3>To quantify the availability of comparative efficacy data for new molecular entities (NMEs) approved in the United States.<h3>Data Sources</h3>Approval packages publicly available through the online database of drug products approved by the US Food and Drug Administration (FDA).<h3>Study Selection</h3>Identification of efficacy studies that supported approval of each NME approved by FDA between 2000 and 2010.<h3>Data Extraction</h3>We determined whether eligible studies were head-to-head active controlled trials and whether the results of such studies were available in the approval packages. We recorded the approved indication, whether the NME was an orphan product, whether the NME had undergone priority review, and whether the control group was a specific active comparator or standard care.<h3>Results</h3>Of 197 NMEs identified that met eligibility criteria, 100 (51% [95% confidence interval {CI}, 44%-58%]) met criteria for having comparative efficacy data available at the time of market authorization. After excluding NMEs designated as orphan products (n = 37) and those approved for indications for which no alternative treatments existed (n = 17), this proportion increased to 70% (95% CI, 62%-77%). The proportions of NMEs with available comparative efficacy data varied widely by therapeutic area, from 33% (95% CI, 9%-67%) for hormones and contraceptives to 89% (95% CI, 56%-99%) for diabetes medications.<h3>Conclusion</h3>Publicly available FDA approval packages contain comparative efficacy data for about half of NMEs recently approved in the United States and for more than two-thirds of NMEs for which alternative treatment options exist. We did not investigate the extent to which available comparative efficacy information is useful for clinical guidance.
Chronic Obstructive Pulmonary Disease, Asthma, and Risk of Type 2 Diabetes in Women
Authors: Jamal S. Rana, Murray A. Mittleman, Javed Sheikh, Frank B. Hu, JoAnn E. Manson, Graham A. Colditz, Frank E. Speizer, R. Graham Barr, Carlos A. Camargo
Journal: Diabetes Care (2004)

OBJECTIVE—Inflammation plays a key role in chronic obstructive pulmonary disease (COPD) and asthma. Increasing evidence points toward a role of inflammation in the pathogenesis of type 2 diabetes. We wanted to determine the relation of COPD and asthma with the development of type 2 diabetes. RESEARCH DESIGN AND METHODS—The Nurses’ Health Study is a prospective cohort study. From 1988–1996, 103,614 female nurses were asked biennially about a physician diagnosis of emphysema, chronic bronchitis, asthma, and diabetes. RESULTS—During 8 years of follow-up, we documented a total of 2,959 new cases of type 2 diabetes. The risk of type 2 diabetes was significantly higher for patients with COPD than those without (multivariate relative risk 1.8, 95% CI 1.1–2.8). By contrast, the risk of type 2 diabetes among asthmatic patients was not increased (1.0, 0.8–1.2). The asthma results remained nonsignificant even when we evaluated diabetes risk by duration of asthma exposure. CONCLUSIONS—Our findings suggest that COPD may be a risk factor for developing type 2 diabetes. Differences in the inflammation and cytokine profile between COPD and asthma might explain why COPD, but not asthma, is associated with increased risk of type 2 diabetes.
Been to Africa
Authors: C. Holcombe
Journal: BMJ (1991)

the large bowel and found that they did not give rise to malignancies.'At Baragwanath Hospital, colonoscopy studies (over 100 a year) confirm absence of polyps; the colons even of elderly black patients have the same appearance and elasticity as those of young white patients.8Conceivably, any population subsisting on a diet high in foods containing fibre could be similarly protected.In the early 1.800s rural Scots ate oat porridge three times a day, seven days a week, with a thick vegetable soup at night.9In England, rural farm workers consumed a huge amount of bread, several times our present consumption,'0 but virtually all were active physically.Perhaps their gastrointestinal tracts resembled those of rural Africans in their lesser proneness to disease.Present dietary guidelines, however vehemently urged, will never cause the gastrointestinal tract to revert to its pattern in former times.
Medicine and Religion
Authors: George P. Fletcher
Journal: JAMA (1968)

<h3>To the Editor:—</h3> I am indebted to Dr. Butler for pointing out that the evidence against Dr. Hermann Sander was equivocal. Sander retracted his confession at trial (though he never explained why he might wish to inject air into the veins of a dead patient); and Dr. Ford testified that it was very unlikely that air injected into the veins could have reached the deceased's heart. It is true that a jury concerned only about the evidence might have reasonable doubts whether Sander's injection was the cause of death. That the jury might have acquitted Sander on the basis of the evidence is not to say that it<i>did</i>in fact do so. The evidence against Sander was at least as strong as that against others convicted of serious offenses. To offset Ford's testimony, the prosecution could point to the contradictory testimony of two medical witnesses and to Sander's own
Transdermal Medication Exchange: The Case of the Light-headed Lover
Authors: James R. Roberts
Journal: JAMA (1993)

<h3>To the Editor.</h3> —Patients occasionally are administered drugs without their knowledge, and clandestine exposure can present diagnostic problems when symptoms prompt a physician visit. We present an unusual case of inadvertent drug exposure that is a variation on the theme of "somebody slipped something into my drink." A 54-year-old woman presented to the hospital complaining of fainting and a headache. She denied trauma and was taking no prescription or over-the-counter medications. She described the rapid onset of extreme orthostatic dizziness and a constant throbbing headache shortly after getting out of bed that morning. No one else in the house was ill, and there was no known exposure to infectious diseases or toxic fumes. She had been in excellent health until this episode and could offer no explanation for her symptoms. On examination she was afebrile, but demonstrated marked orthostatic hypotension. A severe constant throbbing headache persisted. Routine tests, including an