tbuckley/cabot-search huggingface dataset:
Screening for Hepatitis B Virus Infection in Adolescents and Adults: A Systematic Review to Update the U.S. Preventive Services Task Force Recommendation
Authors: Roger Chou, Tracy Dana, Christina Bougatsos, Ian Blazina, Jessi Khangura, Bernadette Zakher
Journal: Annals of Internal Medicine (2014)

Background: In 2004, the U.S. Preventive Services Task Force (USPSTF) recommended against screening for hepatitis B virus (HBV) infection. Purpose: To update the 2004 USPSTF review on screening for HBV infection in adolescents and adults. Data Sources: MEDLINE (through January 2014), the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and PsycINFO. Study Selection: Randomized trials of screening and treatment and observational studies of screening or the association between intermediate and clinical outcomes after antiviral therapy. Data Extraction: One investigator abstracted data, and a second investigator checked them; 2 investigators independently assessed study quality. Data Synthesis: No study directly evaluated the effects of screening for HBV infection versus no screening on clinical outcomes. Vaccination against HBV infection was associated with decreased risk in high-risk populations. On the basis of 11 primarily fair-quality trials, antiviral therapy may be more effective than placebo for reducing the risk for clinical outcomes associated with HBV infection. However, differences were not statistically significant. On the basis of 22 primarily fair-quality trials, antiviral therapy was more effective than placebo for various intermediate outcomes, with limited evidence that first-line antiviral agents are superior to lamivudine. Antiviral therapy was associated with a higher risk for withdrawal due to adverse events than placebo, but risk for serious adverse events did not differ. Limitation: Only English-language articles were included, clinical outcome data for antiviral therapies were limited, and several studies were done in countries where the prevalence and natural history of HBV infection differ from those of the United States. Conclusion: Antiviral treatment for chronic HBV infection is associated with improved intermediate outcomes, but more research is needed to understand the effects of screening and subsequent interventions on clinical outcomes and to identify optimal screening strategies. Primary Funding Source: Agency for Healthcare Research and Quality.
A feasibility study: Home-telemonitoring for rural lung cancer patients
Authors: Georgia Narsavage, Yea-Jyh Chen, Trisha Petitte, Charles Coole, Tara Forth
Journal: European Respiratory Journal (2013)

Home-telemonitoring benefits for patients with lung cancer are unknown. We used a Honeywell system ( GenesisDM© ) to study WVU hospital patients with Time-1 data collected after consent in-hospital. T2 data began in-home monitoring for a feasibility group. At 14 days, research RNs collected T3 data at home & retrieved monitors/surveys. Demographic/disease profiles, vital signs, weight, oxygen saturation, & symptom data were studied. Telemonitors captured changes.  T1 symptoms included pain, fatigue, coughing, & limited activities. Fatigue/limited activity persisted & pain/coughing decreased; poor appetite & nausea/ vomiting increased by T3. Activity limited patients also had >2 symptoms after discharge & lower functional status/Quality of Life (PFSS-11:M=3.36 at discharge vs. 2.73 at 14-days; WHO-5:M=2.08 at discharge vs. 1.8 at 14-days; p>.05). Landline phones easily transmitted data; others had monitors with built-in modems (T-Mobile©). Pt/family telemonitor satisfaction was high. Usual care was not satisfactory; comparison group retention was a problem. Other challenges related to patients’ families & rural environments; the feasibility study will support a more efficient larger study. Telemonitors can be used to provide real-time data to educate rural patients to develop self-management skills in living with lung cancer.
A prognostic index to predict long‐term mortality in patients with mild to moderate chronic heart failure stabilised on angiotensin converting enzyme inhibitors
Authors: Mark T. Kearney, James Nolan, Amanda J. Lee, Paul W. Brooksby, Robin Prescott, Ajay M. Shah, Azfar G. Zaman, Dwain L. Eckberg, H. Stephen Lindsay, Philip D. Batin, Richard Andrews, Keith A.A. Fox
Journal: European Journal of Heart Failure (2003)
Medalists With Extreme Duration of Type 1 Diabetes Exhibit Only Mild Diastolic Dysfunction and Myocardial Fibrosis
Authors: Andrew Fagan, Omar Asghar, Keith Pearce, Martin Stout, Simon G. Ray, Matthias Schmitt, Rayaz A. Malik
Journal: Diabetes Care (2014)

Medalists are a unique subset of patients with more than 50 years of type 1 diabetes. One would expect these patients to have significant microvascular and macrovascular complications. However, the Joslin observational study showed that of their medalists, a substantial proportion remained free of proliferative diabetic retinopathy (42.6%), nephropathy (86.9%), and neuropathy (39.4%) (1). Whether this protection extends to the heart is unknown.

We therefore comprehensively investigated cardiac structure and function in 14 medalists and 9 control subjects. They underwent rest and stress (vasodilator) perfusion MRI to exclude significant coronary artery disease and echocardiography to quantify cardiac structure and left ventricular systolic function, including strain, strain rate, torsion, and diastolic dimensions. Pulsed-wave Doppler sequences of the mitral valve assessing passive early (E) and active atrial (A) …
Natural Recovery and Treatment-Seeking in Pathological Gambling: Results of Two U.S. National Surveys
Authors: Wendy S. Slutske
Journal: American Journal of Psychiatry (2006)

OBJECTIVE: Pathological gambling is described in DSM-IV as a chronic and persisting disorder, but recent community-based longitudinal studies that have highlighted the transitory nature of gambling-related problems have called into question whether this is an accurate characterization. This emerging evidence of high rates of recovery coupled with low rates of treatment-seeking for pathological gambling suggests that natural recovery might be common. The purpose of the present study was to document the rates of recovery, treatment-seeking, and natural recovery among individuals with DSM-IV pathological gambling disorder in two large and representative U.S. national surveys. METHOD: Prevalences of recovery, treatment-seeking, and natural recovery were estimated among individuals from the Gambling Impact and Behavior Study (N=2,417) and the National Epidemiologic Survey on Alcohol and Related Conditions (N=43,093) who reported a lifetime history of DSM-IV pathological gambling disorder (N=21 and N=185, respectively). RESULTS: Among individuals with a lifetime history of DSM-IV pathological gambling, 36%–39% did not experience any gambling-related problems in the past year, even though only 7%–12% had ever sought either formal treatment or attended meetings of Gamblers Anonymous. About one-third of the individuals with pathological gambling disorder in these two nationally representative U.S. samples were characterized by natural recovery. CONCLUSIONS: Pathological gambling may not always follow a chronic and persisting course. A substantial portion of individuals with a history of pathological gambling eventually recover, most without formal treatment. The results of large epidemiological surveys of pathological gambling may eventually overturn the established wisdom about pathological gambling disorder.
Nuclear Factor-κB–Related Serum Factors as Longitudinal Biomarkers of Response and Survival in Advanced Oropharyngeal Carcinoma
Authors: Clint Allen, Sonia Duffy, Theodoros Teknos, Mozaffarul Islam, Zhong Chen, Paul S. Albert, Gregory Wolf, Carter Van Waes
Journal: Clinical Cancer Research (2007)

Abstract Purpose: Cytokines and growth factors modulated by transcription factor nuclear factor-κB and secreted by tumor and stromal cells are detectable in serum of patients with advanced cancers, including head and neck squamous cell carcinomas (SCC). Longitudinal changes in these serum factors could be early biomarkers of treatment response and survival. Experimental Design: Interleukin (IL)-6, IL-8, growth-related oncogene-1 (GRO-1), vascular endothelial growth factor (VEGF), and hepatocyte growth factor (HGF) concentrations were determined by Luminex multiplex assay using serum obtained at baseline and every 3 months in a prospective study of 30 patients with locally advanced (stage III/IV) oropharyngeal SCC receiving chemoradiation therapy. The relationship between baseline and direction of change in individual and multiple cytokines with cause-specific and disease-free survival was determined by Cox proportional hazards models and Kaplan-Meier survival analysis. Statistical analyses included adjustment for smoking status and response to chemoradiation. Results: Three-year cause-specific and disease-free survival was 74.4% and 68.9%. Nonsmoking history (P = 0.05) and higher baseline VEGF (P = 0.003) correlated with increased survival. Longitudinal increases in levels of individual factors predicted decreased cause-specific survival when adjusted for smoking history [IL-6: relative risk (RR), 3.8; 95% confidence interval (95% CI), 2.0-7.4; P = 0.004; IL-8: RR, 1.6; 95% CI, 1.2-2.2; P = 0.05; VEGF: RR, 3.0; 95% CI, 1.6-5.6; P = 0.01; HGF: RR, 2.9; 95% CI, 1.9-4.4; P = 0.02; and GRO-1: RR, 1.2; 95% CI, 1.1-1.3; P = 0.02]. For a given individual, large increases in the upper quartile for any three or more factors predicted poorer cause-specific survival compared with patients with two or fewer large increases in factor levels (P = 0.004). Conclusions: Pretreatment VEGF levels and longitudinal change in IL-6, IL-8, VEGF, HGF, and GRO-1 may be useful as biomarkers for response and survival in patients with locally advanced oropharyngeal and head and neck SCC treated with chemoradiation.
Long-term cardiac memory in canine heart is associated with the evolution of a transmural repolarization gradient
Authors: R CORONEL, T OPTHOF, A PLOTNIKOV, F WILMSSCHOPMAN, I SHLAPAKOVA, P DANILOJR, E SOSUNOV, E ANYUKHOVSKY, M JANSE, M ROSEN
Journal: Cardiovascular Research (2007)

The contribution of regional electrophysiologic heterogeneity to the T-wave changes of long-term cardiac memory (CM) is not known. We mapped activation and repolarization in dogs after induction of CM and in sham animals.CM was induced by three weeks of AV-sequential pacing at the anterior free wall of the left ventricle (LV), midway between apex and base in 5 dogs. In 4 sham controls a pacemaker was implanted but ventricular pacing was not performed. At 3 weeks, unipolar electrograms were recorded (98 epicardial, 120 intramural and endocardial electrodes) during atrial stimulation (cycle length 450 ms). Activation times (AT) and repolarization times (RT) were measured and activation recovery intervals (ARIs) calculated. CM was associated with 1) deeper T waves on ECG, with no change in QT interval; 2) longer activation time at the site of stimulation in CM (29.7+/-1.0, X+/-SEM) than sham (23.9+/-1.3 ms p<0.01); 3) an LV transmural gradient in repolarization time such that repolarization at the epicardium terminated 12.4+/-2.4 ms later than at the endocardium p<0.01), in contrast to no gradient in shams (2.7+/-4.2 ms); in memory dogs, the repolarization time gradient was greatest at sites around the pacing electrode varying from 13.1+/-2.3 ms to 25.5+/-3.8 ms; 4) more negative left ventricular potentials at the peak of the body surface T wave (-4.9+/-0.8 vs -2.2+/-0.4 mV; p<0.05) but no altered right ventricular epicardial T-wave potentials. ARIs did not differ between groups. Right ventricular activation was delayed but was not associated with altered repolarization because of compensatory shortening of the right ventricular ARIs.CM-induced T-wave changes are caused by evolution of transmural repolarization gradients manifested during atrial stimulation that are maximal near the site of ventricular pacing.
The Copolymer of Poly(2‐dimethylaminoethyl methacrylate) and Methacrylated Chondroitin Sulfate with Low Cytotoxicity for Gene Delivery
Authors: Yu‐Lun Lo, Yao‐Sheng Wang, Li‐Fang Wang
Journal: Advanced Healthcare Materials (2013)

Abstract Poly(2‐dimethylaminoethyl methacrylate) (PDMAEMA) is one of the most potent synthetic nonviral gene‐delivery vectors because of its high transfection efficiency. However, the cytotoxicity of PDMAEMA is a major concern for its clinical applications. An anionic crosslinker is synthesized based on a natural polysaccharide, chondroitin sulfate (CS), by introducing methacrylate groups (CSMA). By systematically adjusting the substitution degree of methacrylation on CS and the weight percent of CSMA and PDMAEMA, sol‐type copolymers are obtained as a gene‐delivery vector. The combination of CS and PDMAEMA is expected not only to reduce the cytotoxicity of PDMAEMA, but also to facilitate better transfection efficiency than PDMAEMA because of the recognition of CS by CD44 receptors on cell surfaces. Two CSMA‐modified PDMAEMA copolymers with different CSMA constituents are selected and their polyplexes prepared with plasmid DNA. The cytotoxicity and gene transfection efficiency of the polyplexes are tested and compared with those of PDMAEMA/pDNA. The copolymers of CSMA and PDMAEMA show significantly improved cell viability as compared with PDMAEMA. Their formed polyplexes with pDNA also show lower cytotoxicity than does PDMAEMA/pDNA. The transfection efficiency remarkably increases as the CSMA‐modified PDMAEMA/pDNA polyplex is prepared at a weight ratio of 2.4. The internalization mechanism of CSMA‐modified PDMAEMA/pDNA in HEK 293T cells is mainly based on caveolae‐mediated endocytosis. However, both caveolae‐mediated and CD44‐mediated endocytosis mechanisms are involved in U87 cells.
In-vitro fertilization and embryo transfer in women aged 40 years and over
Authors: S. Marcus
Journal: Human Reproduction Update (1996)

The decline of fertility with age and its possible causes are discussed; in particular the effect of ageing of oocytes and the uterus, and the effect of the ageing processes on the results of in-vitro fertilization (IVF) and embryo transfer in women aged <40 years. The role of prestimulation testing in older women is considered together with the importance of screening and counselling these patients about the likelihood of achieving a live birth. The potential problems that they may face should they become pregnant are reviewed, together with the role of oocyte donation as an alternative treatment for patients with reduced ovarian reserve. Possible ways of improving the chances of achieving a live birth in older women using their own oocytes are reviewed, including the use of more effective stimulation protocols, assisted embryo hatching and co-culture and high order embryo transfer. The outcome of pregnancies in older women and some of the ethical problems relating to their treatment are also discussed.
HYPERTROPHIC CARDIOMYOPATHY WITH AORTOPATHY: A NOVEL ASSOCIATION
Authors: Rayan Yousefzai, Anushree Agarwal, Michael Anigbogu, Kambiz Shetabi, Chi Cho, Michelle Bush, Khawaja Afzal Ammar, Timothy E. Paterick, Bijoy K. Khandheria, A. Jamil Tajik
Journal: Journal of the American College of Cardiology (2014)
New Testing Strategy to Detect Early HIV-1 Infection for Use in Incidence Estimates and for Clinical and Prevention Purposes
Authors: Robert S. Janssen
Journal: JAMA (1998)

Differentiating individuals with early human immunodeficiency virus 1 (HIV-1) infection from those infected for longer periods is difficult but important for estimating HIV incidence and for purposes of clinical care and prevention.To develop and validate a serologic testing algorithm in which HIV-1-positive persons with reactive test results on a sensitive HIV-1 enzyme immunoassay (EIA) but nonreactive results on a less sensitive (LS) EIA are identified as having early infection.Diagnostic test and testing strategy development, validation, and application. Specimens were tested with both a sensitive HIV-1 EIA (3A11 assay) and a less sensitive modification of the same EIA (3A11-LS assay).For assay development: 104 persons seroconverting to HIV-1 comprising 38 plasma donors, 18 patients of a sexually transmitted disease clinic in Trinidad, and 48 participants in the San Francisco Men's Health Study (SFMHS); 268 men without the acquired immunodeficiency syndrome (AIDS) in the SFMHS who had been infected for at least 2.5 years; and 207 persons with clinical AIDS; for testing strategy validation: 488 men in the SFMHS from 1985 through 1990 and 1275449 repeat blood donors at 3 American Red Cross blood centers from 1993 through 1995; and for HIV-1 incidence estimates: 2717910 first-time blood donors. We retrospectively identified persons eligible for a study of early infection.Ability to identify early HIV infection.Estimated mean time from being 3A11 reactive/3A11-LS nonreactive to being 3A11 reactive/3A11-LS reactive was 129 days (95% confidence interval [CI], 109-149 days) [corrected]. Our testing strategy accurately diagnosed 95% of persons with early infection; however, 0.4% (1/268) of men with established infection and 2% (5/207) of persons with late-stage AIDS were misdiagnosed as having early HIV-1 infection. Average yearly incidence estimates in SFMHS subjects were 1.5% per year vs observed average incidence of 1.4 per 100 person-years. Incidence in repeat blood donors using the sensitive/less sensitive assay testing strategy was 2.95 per 100000 per year (95% CI, 1.14-6.53/100000) vs observed incidence of 2.60 per 100000 person-years (95% CI, 1.49-4.21/100000). Overall incidence in first-time blood donors was 7.18 per 100000 per year (95% CI, 4.51-11.20/100000) and did not change statistically significantly between 1993 and 1996. Use of the sensitive/less sensitive testing strategy alone would have identified all 17 persons with antibodies to HIV-1 eligible for a study of early HIV-1 infection and would have increased enrollment.The sensitive/less sensitive testing strategy provides accurate diagnosis of early HIV-1 infection, provides accurate estimates of HIV-1 incidence, can facilitate clinical studies of early HIV-1 infection, and provides information on HIV-1 infection duration for care planning.
Comments on “Presidential Address: Advocacy as Leadership”
Authors: CATHRYN CLARY, ANTONY LOEBEL, ILISE LOMBARDO, LARRY ALPHS, BRENDON BINNEMAN, DOUGLAS VANDERBURG, LEWIS WARRINGTON, BRUCE PARSONS, ILAN FOGEL, BARRY HERMAN, HOLLY ROBERTS, HILDA TEMPLETON, DIANA HUGHES, PHILLIP CHAPPELL, DOUGLAS FELTNER, KATHY TOBIAS, ERIC WATSKY, TANYA RAMEY, FRED RAPPARD
Journal: American Journal of Psychiatry (2007)
Biliary lipid output during three meals and an overnight fast. I. Relationship to bile acid pool size and cholesterol saturation of bile in gallstone and control subjects.
Authors: T C Northfield, A F Hofmann
Journal: Gut (1975)

Using a duodenal perfusion technique, the biliary output of bile acids, phospholipid, and cholesterol was measured hourly during three meals and an overnight fast in seven Caucasians with radiolucent gallstones in a functioning gallbladder, and in seven health controls without gallstones, closely matched for age, sex, and weight. Before the perfusion, bile acid kinetics were defined by an isotope dilution procedure, and the biliary lipid composition of fasting gallbladder bile was determined. Total daily biliary lipid output was similar in gallstone and control subjects, and was unrelated to cholesterol saturation of fasting gallbladder bile and to bile acid pool size. There was an inverse relationship between the size and recycling frequency of the bile acid pool, so that secretion rate and hepatic return of bile acids remained constant, despite a wide range of pool sizes. The finding of a normal bile acid synthesis rate in subjects with a small pool size therefore indicated normal feedback regulation of bile acid synthesis. Hourly measurements of biliary lipid output showed a linear relationship between bile acid and cholesterol output, with a similar regression line for gallstone and control subjects, but a non-linear relationship between bile acid and phospholipid output. Consequently, samples from all subjects were consistently supersaturated with cholesterol at low bile acid outputs, especially during overnight fasting, but not at high bile acid outputs. These findings indicate that hepatic secretion of bile supersaturated with cholesterol is physiological in man at low bile acid outputs, that bile acid pool size is probably determined in part by its recycling frequency, and that cholesterol cholelithiasis in some Caucasians may be due to an underlying extrahepatic abnormality.
Tumour markers in the clinical management of patients with small cell lung cancer
Authors: M Hansen, HH Hansen
Journal: European Respiratory Journal (1989)

Neoplastic cells produce and release several substances. Some of these substances are produced specifically by certain tumour types, making it possible to use these substances as tumour markers. The latter implies that they can be used in the histopathological classification and, provided the substances can be measured in blood or urine, also in the clinical management of patients, e.g. in screening, diagnosis, staging, prognostication, therapy monitoring, including evaluation of tumour response and early relapse. Well-known examples of clinically useful tumour markers are amines in carcinoids and pheocro­ mocytomas, and the M-component in myeloma. In recent years, human chorionic gonadotrophin (HCG) and alpha foetoprotein have contributed significantly to the diagnosis and treatment of germ cell tumours, including testicular cancer. For patients with lung cancer in general, carcinoem­ bryonic antigen (CEA) was one of the first markers described. The concentration of this marker has been found to be related to the prognosis and tumour burden in groups of patients with small cell lung cancer (SCLC), but CEA has no significant predictive value for the individual patient. Among the various histological cell types, SCLC has been known to produce a series of tumour makers compatible with the neuro-endocrine histological origin of SCLC from the amine precursor uptake and decarboxylation (APUD)-system. Already in 1928 a patient with small cell lung cancer was described with the ectopic Cushing syndrome a few years before Cush­ ing described the syndrome related to his name in non­ malignant cases [1]. Subsequently, it was recognized that endocrine syndromes, such as the ectopic Cushing syndrome and the Schwartz-Barrter syndrome (SIADH) in lung cancer were particularly related to SCLC [2, 3]. During the 1970's considerable progress was made in the cytostatic treatment of SCLC with a subsequent interest in identification of tumour markers in order to improve the clinical management of patients with SCLC. Initially, the hormonal peptides were investigated, and ACTH, ADH and calcitonin were classified as being special hormonal markers for SCLC. However, measure­ ment of these markers was not found to contribute significantly to the clinical management of patients with SCLC [3).