tbuckley/cabot-search huggingface dataset:
Cardiovascular risk in rheumatoid arthritis and diabetes: how does it compare and when does it start?
Authors: Michael T Nurmohamed, George Kitas
Journal: Annals of the Rheumatic Diseases (2011)

There is a substantial amount of evidence for an increased cardiovascular risk in rheumatoid arthritis (RA), 1.5–2-fold in comparison with the general population,1 2 but large-scale studies are still lacking. The majority of the evidence originates from several decades ago, a different era of natural history and management of RA, and thus there is still an unmet need for contemporary large epidemiological studies addressing the magnitude of the cardiovascular risk in RA. These studies should also address if and to what extent the cardiovascular risk in RA is comparable to that of diabetes, an established paradigm for a doubled cardiovascular risk,3 as recent studies have pointed towards this direction.4 5 If confirmed, then this may underpin the need for cardiovascular risk prevention and management in patients with RA, and a possible approach towards achieving this in everyday practice.

In a prospective Dutch study, the magnitude of the enhanced cardiovascular risk in RA was investigated by comparing prevalent cardiovascular disease (CVD) with that of diabetes.5 The study comprised 353 RA patients (diagnosed between 1989 and 2001, aged between 50 and 75 years; the CARdiovascular research in RhEumatoid arthritis (CARRE) study), and participants of a population-based cohort study on CVD and its risk factors (Hoorn study). Prevalent CVD was observed in 13% patients with RA, 5% in individuals without diabetes and 12% in individuals with type 2 diabetes (n=194), respectively. The OR for CVD, adjusted for age and sex, were 3.1 in RA patients and 2.3 in individuals with type 2 diabetes in comparison with individuals without diabetes. Adjustment for (other) cardiovascular risk factors only slightly attenuated the OR, indicating that RA itself is an independent CVD risk factor. The prospective part of the investigation showed cardiovascular events …
Molecular characterisation of soft tissue tumours: a gene expression study
Authors: Torsten O Nielsen, Rob B West, Sabine C Linn, Orly Alter, Margaret A Knowling, John X O'Connell, Shirley Zhu, Mike Fero, Gavin Sherlock, Jonathan R Pollack, Patrick O Brown, David Botstein, Matt van de Rijn
Journal: The Lancet (2002)
On the History and Future Study of Personality and Its Disorders
Authors: Theodore Millon
Journal: Annual Review of Clinical Psychology (2012)

The study of personality differences can be traced back to the early speculations of ancient societies, such as India, China, Babylonia, Greece, and Rome. Though a few clinicians, notably Hippocrates, stressed the importance of careful and systematic observation, hoping thereby to shift the focus of attention to natural rather than animistic events, it was not until centuries later that semiscientific approaches began to take hold, e.g., phrenology. In the past century, descriptive psychiatrists of note began to pose "typologies," e.g., Kraepelin and Schneider, and several insightful psychoanalysts, e.g., Freud, Abraham, and Reich, articulated the developmental roots of "character" variations. Official classification systems, e.g., the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases, have become the guiding arbiter of late-twentieth-century proposals. No less significant currently is the work of empirically oriented inductivists, e.g., Livesley and Widiger, and theoretically oriented deductivists, e.g., Kernberg and Millon.
AAP Presidential Address The AAP and the transformation of medicine
Authors: Ralph Snyderman
Journal: Journal of Clinical Investigation (2004)

As much as I enjoy blazing new trails, my approach to this Presidential Address has followed the requisites faithfully taken by my illustrious predecessors. I have read the Constitution of the Association of American Physicians (AAP) developed in 1886, I have reviewed the history of the organization, and I have studied most of the Presidential Addresses delivered over the last decade.
Connective Tissue Disease–associated Pulmonary Arterial Hypertension in the Modern Treatment Era
Authors: Robin Condliffe, David G. Kiely, Andrew J. Peacock, Paul A. Corris, J. Simon R. Gibbs, Florenc Vrapi, Clare Das, Charlie A. Elliot, Martin Johnson, Julia DeSoyza, Chantal Torpy, Kim Goldsmith, Denise Hodgkins, Rodney J. Hughes, Joanna Pepke-Zaba, J. Gerry Coghlan
Journal: American Journal of Respiratory and Critical Care Medicine (2008)

Rationale: Pulmonary arterial hypertension in association with connective tissue disease (CTD-PAH) has historically had a poor prognosis, with a 1-year survival rate among patients with systemic sclerosis–associated pulmonary arterial hypertension (SSc-PAH) of 45%. However, more therapies have become available.Objectives: To investigate the survival and characteristics of all patients diagnosed with CTD-PAH in the U.K. pulmonary hypertension service.Methods: National registry of all incident cases of CTD-PAH diagnosed consecutively between January 2001 and June 2006.Measurements and Main Results: Patients with CTD-PAH (429; 73% SSc-PAH) were diagnosed by a catheter-based approach. One- and 3-year survival rates were 78 and 47% for patients with isolated SSc-PAH. Survival was worse for those with respiratory disease–associated SSc-PAH (3-yr survival, 28%; P = 0.005) whereas survival among patients with exercise-induced SSc-PAH was superior (3-yr survival, 86%; P = < 0.001). Age, sex, mixed venous oxygen saturation, and World Health Organization functional class were independent predictors of survival in isolated SSc-PAH. Nineteen percent of patients with exercise-induced SSc-PAH and 39% of patients with isolated SSc-PAH who were in functional classes I and II had evidence of disease progression. The prevalence of diagnosed SSc-PAH is 2.93 per 1 million. The 3-year survival rate of 75% for those with pulmonary arterial hypertension associated with systemic lupus erythematosus (SLE-PAH) was significantly better than that for patients with SSc-PAH (P = 0.01).Conclusions: Survival of patients with SSc-PAH in the modern treatment era is better than in historical series. A significant proportion of patients with mild functional impairment or exercise-induced SSc-PAH have evidence of disease progression. Survival of patients with respiratory disease–associated pulmonary hypertension is inferior. SLE-PAH has a better prognosis than SSc-PAH.
Partial Hospitalization Within an Urban Slum
Authors: PEDRO RUIZ, GEORGE SAIGER
Journal: American Journal of Psychiatry (1972)

Data on 343 patients admitted to the Partial Hospitalization Service of the Lincoln Community Mental Health Center, New York City, over a two-year period indicate that the presence of this service cut admissions to the state hospital by two-thirds. The pressures that exist in an urban slum area in which no inpatient psychiatric facility is available undoubtedly played a role in producing these results. The authors hope this program will serve as a model alternative to inpatient services for similar slum areas throughout the nation.
A variant of the gene encoding leukotriene A4 hydrolase confers ethnicity-specific risk of myocardial infarction
Authors: Anna Helgadottir, Andrei Manolescu, Agnar Helgason, Gudmar Thorleifsson, Unnur Thorsteinsdottir, Daniel F Gudbjartsson, Solveig Gretarsdottir, Kristinn P Magnusson, Gudmundur Gudmundsson, Andrew Hicks, Thorlakur Jonsson, Struan F A Grant, Jesus Sainz, Stephen J O'Brien, Sigurlaug Sveinbjornsdottir, Einar M Valdimarsson, Stefan E Matthiasson, Allan I Levey, Jerome L Abramson, Murdach P Reilly, Viola Vaccarino, Megan L Wolfe, Vilmundur Gudnason, Arshed A Quyyumi, Eric J Topol, Daniel J Rader, Gudmundur Thorgeirsson, Jeffrey R Gulcher, Hakon Hakonarson, Augustine Kong, Kari Stefansson
Journal: Nature Genetics (2005)
Low grade inflammation and coronary heart disease: prospective study and updated meta-analyses
Authors: J. Danesh
Journal: BMJ (2000)

<h3>Abstract</h3> <b>Objective:</b> To assess associations between baseline values of four different circulating markers of inflammation and future risk of coronary heart disease, potential triggers of systemic inflammation (such as persistent infection), and other markers of inflammation. <b>Design:</b> Nested case-control comparisons in a prospective, population based cohort. <b>Setting:</b> General practices in 18 towns in Britain. <b>Participants:</b> 506 men who died from coronary heart disease or had a non-fatal myocardial infarction and 1025 men who remained free of such disease until 1996 selected from 5661 men aged 40–59 years who provided blood samples in 1978-1980. <b>Main outcome measures:</b> Plasma concentrations of C reactive protein, serum amyloid A protein, and serum albumin and leucocyte count. Information on fatal and non-fatal coronary heart disease was obtained from medical records and death certificates. <b>Results:</b> Compared with men in the bottom third of baseline measurements of C reactive protein, men in the top third had an odds ratio for coronary heart disease of 2.13 (95% confidence interval 1.38 to 3.28) after age, town, smoking, vascular risk factors, and indicators of socioeconomic status were adjusted for. Similar adjusted odds ratios were 1.65 (1.07 to 2.55) for serum amyloid A protein; 1.12 (0.71 to 1.77) for leucocyte count; and 0.67 (0.43 to 1.04) for albumin. No strong associations were observed of these factors with <i>Helicobacter pylori</i> seropositivity, <i>Chlamydia pneumoniae</i> IgG titres, or plasma total homocysteine concentrations. Baseline values of the acute phase reactants were significantly associated with one another (P&lt;0.0001), although the association between low serum albumin concentration and leucocyte count was weaker (P=0.08). <b>Conclusion:</b> In the context of results from other relevant studies these findings suggest that some inflammatory processes, unrelated to the chronic infections studied here, are likely to be involved in coronary heart disease.
Congenital lung abnormality in a 1‐yr old
Authors: R. Ajitsaria, W.I. Awad, A. Jaffe, M.N. Sheppard, P. Goldstraw, D. Hansell, A. Bush
Journal: European Respiratory Journal (2004)

Case historyAn asymptomatic 8-week-old male infant was referred for assessment.A prenatal ultrasound had been suggestive of a congenital cystic adenomatoid malformation (CCAM).Following delivery, he had a plain chest radiograph (fig. 1) and went on to have a computed tomography (CT) scan of the thorax (fig.2), which showed an extrapulmonary mass close to the vertebral column.He proceeded to have magnetic resonance imaging of the thorax to look for intraspinal extension.The appearances were not anticipated, in that the lesion appeared to be intrapulmonary with no extension into the mediastinum, spinal canal or chest wall.The diaphragm was reported as being intact and separating the lesion from the abdominal cavity.There were no abnormal vessels reported.These features were in keeping with an intrapulmonary cystic lesion and the infant was referred for a surgical opinion.As the infant remained well, surgery was deferred until the child was 1-yr old.A routine pre-operative CT scan (fig.3) was performed on the day before the planned surgery followed by a barium swallow (fig.4).A surgical procedure for what
CPR with Chest Compression Alone or with Rescue Breathing
Authors: Thomas D. Rea, Carol Fahrenbruch, Linda Culley, Rachael T. Donohoe, Cindy Hambly, Jennifer Innes, Megan Bloomingdale, Cleo Subido, Steven Romines, Mickey S. Eisenberg
Journal: New England Journal of Medicine (2010)

The role of rescue breathing in cardiopulmonary resuscitation (CPR) performed by a layperson is uncertain. We hypothesized that the dispatcher instructions to bystanders to provide chest compression alone would result in improved survival as compared with instructions to provide chest compression plus rescue breathing.We conducted a multicenter, randomized trial of dispatcher instructions to bystanders for performing CPR. The patients were persons 18 years of age or older with out-of-hospital cardiac arrest for whom dispatchers initiated CPR instruction to bystanders. Patients were randomly assigned to receive chest compression alone or chest compression plus rescue breathing. The primary outcome was survival to hospital discharge. Secondary outcomes included a favorable neurologic outcome at discharge.Of the 1941 patients who met the inclusion criteria, 981 were randomly assigned to receive chest compression alone and 960 to receive chest compression plus rescue breathing. We observed no significant difference between the two groups in the proportion of patients who survived to hospital discharge (12.5% with chest compression alone and 11.0% with chest compression plus rescue breathing, P=0.31) or in the proportion who survived with a favorable neurologic outcome in the two sites that assessed this secondary outcome (14.4% and 11.5%, respectively; P=0.13). Prespecified subgroup analyses showed a trend toward a higher proportion of patients surviving to hospital discharge with chest compression alone as compared with chest compression plus rescue breathing for patients with a cardiac cause of arrest (15.5% vs. 12.3%, P=0.09) and for those with shockable rhythms (31.9% vs. 25.7%, P=0.09).Dispatcher instruction consisting of chest compression alone did not increase the survival rate overall, although there was a trend toward better outcomes in key clinical subgroups. The results support a strategy for CPR performed by laypersons that emphasizes chest compression and minimizes the role of rescue breathing. (Funded in part by the Laerdal Foundation for Acute Medicine and the Medic One Foundation; ClinicalTrials.gov number, NCT00219687.)
Practical ways of alleviating auditory hallucinations.
Authors: H E Nelson, S Thrasher, T R Barnes
Journal: BMJ (1991)

In selected patients auditory hallucinations have been found to respond to several non-pharmacological inter- ventions,' among the simplest of which are the use of an ear plug,2 the use of a personal cassette recorder,' and various vocalisation tasks.4We evaluated the acceptability and efficacy of these interventions in patients with chronic schizophrenia.
A Molecular Timeline for the Origin of Photosynthetic Eukaryotes
Authors: Hwan Su Yoon, Jeremiah D. Hackett, Claudia Ciniglia, Gabriele Pinto, Debashish Bhattacharya
Journal: Molecular Biology and Evolution (2004)

The appearance of photosynthetic eukaryotes (algae and plants) dramatically altered the Earth's ecosystem, making possible all vertebrate life on land, including humans. Dating algal origin is, however, frustrated by a meager fossil record. We generated a plastid multi-gene phylogeny with Bayesian inference and then used maximum likelihood molecular clock methods to estimate algal divergence times. The plastid tree was used as a surrogate for algal host evolution because of recent phylogenetic evidence supporting the vertical ancestry of the plastid in the red, green, and glaucophyte algae. Nodes in the plastid tree were constrained with six reliable fossil dates and a maximum age of 3,500 MYA based on the earliest known eubacterial fossil. Our analyses support an ancient (late Paleoproterozoic) origin of photosynthetic eukaryotes with the primary endosymbiosis that gave rise to the first alga having occurred after the split of the Plantae (i.e., red, green, and glaucophyte algae plus land plants) from the opisthokonts sometime before 1,558 MYA. The split of the red and green algae is calculated to have occurred about 1,500 MYA, and the putative single red algal secondary endosymbiosis that gave rise to the plastid in the cryptophyte, haptophyte, and stramenopile algae (chromists) occurred about 1,300 MYA. These dates, which are consistent with fossil evidence for putative marine algae (i.e., acritarchs) from the early Mesoproterozoic (1,500 MYA) and with a major eukaryotic diversification in the very late Mesoproterozoic and Neoproterozoic, provide a molecular timeline for understanding algal evolution.
Amateur boxing in the last 59 years. Impact of rules changes on the type of verdicts recorded and implications on boxers’ health
Authors: Massimiliano Bianco, Mike Loosemore, Gianlorenzo Daniele, Vincenzo Palmieri, Marcello Faina, Paolo Zeppilli
Journal: British Journal of Sports Medicine (2013)

Several changes have occurred in Olympic boxing (OB) in the last few decades, influencing the results in official competitions. The aim of this study was to assess how the evolution of rules changed the rate of the results that can influence boxers' health.From a web-research, the results of OB tournaments from 1952 to 2011 were reviewed (29,357 bouts). For each event, rate of knockout (KO), referee-stop contest (RSC), RSC-Head (RSCH), RSC-Injury (RSCI), RSC-Outclassed (RSCO), abandon, disqualification and points decisions were recorded. In our analysis we investigated the changes that occurred after the introduction of the standing-count rule (1964), mandatory head guard (1984), computerised scoring system (1992), RSCO (2000-2009) and modification of bout formula 3×3 min rounds (3×3, until 1997, 5×2 min rounds (5×2) until 1999, 4×2 min rounds (4×2) until 2008, 3×3 from 2009).The most important results were: (1) an RSCI rate increase (0.72-2.42%, p<0.03) after the standing-count rule; (2) a lower RSCI (0.60%, p<0.001) and higher RSCH (1.31-4.92%, p<0.001) and RSC (9.71-13.05%, p<0.03) rate with mandatory head guard; (3) a KO rate reduction (6.44-2.09%, p<0.001) with the computerised scoring system; (4) an RSC (13.15-5.91%, p<0.05) and RSCH (4.23-1.41%, p<0.001) rate reduction comparing 5×2-4×2 bouts.In the last six decades, along with rule changes in OB, a clear reduction of health challenging results was observed. In the near future, older rules will be adopted (no head guard and a manual scoring system). Continued medical surveillance is important to ensure that new rule changes do not result in poor medical outcomes for the boxers.
The utilization by rabbit aorta of carbohydrates, fatty acids, ketone bodies, and amino acids as substrates for energy production.
Authors: K V Chace, R Odessey
Journal: Circulation Research (1981)

The ability of rabbit aorta to oxidize various substrates was studied to determine which of these compounds may be energy substrates for vascular smooth muscle (VSM). Glucose, ketone bodies, medium-chain length fatty acids, branched-chain amino acids, and glutamine all are oxidized at comparable rates on a molar basis. Some other amino acids, long chain fatty acids, pyruvate and glycerol also are oxidized, but at lower rates. The oxidation of 6 amino acids could not be detected. VSM was found to release ketone bodies when incubated in leucine beta-hydroxybutyrate or octanoate. This suggests that the acetoacetyl CoA and/or acetoacetate derived from these substrates is not completely oxidized. The oxidation rate of several substrates when measured individually is inhibited by 50-80% by the presence of a combination of other substrates in the medium. Under these conditions, glucose is a minor substrate for oxidative metabolism accounting for only 5% of O2 consumption. The oxidation rate of all the exogenous substrates together is calculated to account for less than half of the oxygen consumption; this finding indicates that an endogenous substrate must also be utilized.
Is aspirin effective in women undergoing in vitro fertilization (IVF)? Results from an individual patient data meta-analysis (IPD MA)
Authors: E. Groeneveld, K.A. Broeze, M.J. Lambers, M. Haapsamo, K. Dirckx, B.C. Schoot, B. Salle, C.I. Duvan, R. Schats, B.W. Mol, P.G.A. Hompes
Journal: Human Reproduction Update (2011)

BACKGROUNDAspirin is believed to improve the outcome of IVF, but previous conventional meta-analyses on the subject are conflicting. Therefore, we performed a meta-analysis with individual patient data (IPD MA) of randomized clinical trials (RCTs) on the subject.
Diabetic Nephropathy: Pathogenesis and Treatment
Authors: S Adler, C Nast, A Artishevsky
Journal: Annual Review of Medicine (1993)

CD40 is a cell-surface member of the TNF (tumor necrosis factor) receptor superfamily. Upon activation, CD40 can license dendritic cells to promote antitumor T cell activation and re-educate macrophages to destroy tumor stroma. Numerous agonist CD40 ...Read More
Evidence-based detection of pulmonary arterial hypertension in systemic sclerosis: the DETECT study
Authors: J Gerry Coghlan, Christopher P Denton, Ekkehard Grünig, Diana Bonderman, Oliver Distler, Dinesh Khanna, Ulf Müller-Ladner, Janet E Pope, Madelon C Vonk, Martin Doelberg, Harbajan Chadha-Boreham, Harald Heinzl, Daniel M Rosenberg, Vallerie V McLaughlin, James R Seibold
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Objective</h3> Earlier detection of pulmonary arterial hypertension (PAH), a leading cause of death in systemic sclerosis (SSc), facilitates earlier treatment. The objective of this study was to develop the first evidence-based detection algorithm for PAH in SSc. <h3>Methods</h3> In this cross-sectional, international study conducted in 62 experienced centres from North America, Europe and Asia, adults with SSc at increased risk of PAH (SSc for &gt;3 years and predicted pulmonary diffusing capacity for carbon monoxide &lt;60%) underwent a broad panel of non-invasive assessments followed by diagnostic right heart catheterisation (RHC). Univariable and multivariable analyses selected the best discriminatory variables for identifying PAH. After assessment for clinical plausibility and feasibility, these were incorporated into a two-step, internally validated detection algorithm. Nomograms for clinical practice use were developed. <h3>Results</h3> Of 466 SSc patients at increased risk of PAH, 87 (19%) had RHC-confirmed PAH. PAH was mild (64% in WHO functional class I/II). Six simple assessments in Step 1 of the algorithm determined referral to echocardiography. In Step 2, the Step 1 prediction score and two echocardiographic variables determined referral to RHC. The DETECT algorithm recommended RHC in 62% of patients (referral rate) and missed 4% of PAH patients (false negatives). By comparison, applying European Society of Cardiology/European Respiratory Society guidelines to these patients, 29% of diagnoses were missed while requiring an RHC referral rate of 40%. <h3>Conclusions</h3> The novel, evidence-based DETECT algorithm for PAH detection in SSc is a sensitive, non-invasive tool which minimises missed diagnoses, identifies milder disease and addresses resource usage.
E-Cigarettes: A Rapidly Growing Internet Phenomenon
Authors: Cyrus K. Yamin, Asaf Bitton, David W. Bates
Journal: Annals of Internal Medicine (2010)

Electronic cigarettes (e-cigarettes) aerosolize nicotine and produce a vapor that emulates that of cigarettes but purportedly has fewer traditional toxins than secondhand smoke. Although e-cigarettes are widely sold online and by retailers, new research suggests that they may contain unexpected toxins and may provide unreliable nicotine delivery. Many countries have already banned or strictly regulated e-cigarettes. Currently in the United States, e-cigarettes are exempt from regulation as drug-delivery devices. Meanwhile, the presence of e-cigarettes on the Internet, including in Web searches, virtual user communities, and online stores where people sell e-cigarettes on commission, is increasing rapidly. Physicians should be aware of the popularity, questionable efficacy claims, and safety concerns of e-cigarettes so that they may counsel patients against use and advocate for research to inform an evidence-based regulatory approach.