tbuckley/cabot-search huggingface dataset:
Cognitive Outcomes in Elderly High-Risk Patients After Off-Pump Versus Conventional Coronary Artery Bypass Grafting
Authors: Birte Ostergaard Jensen, Pia Hughes, Lars S. Rasmussen, Preben U. Pedersen, Daniel A. Steinbrüchel
Journal: Circulation (2006)

Background— It has been suggested that the risk of cerebral dysfunction is less with off-pump coronary artery bypass grafting (OPCAB) than with conventional coronary artery bypass grafting (CCAB). However, evidence for this statement is preliminary, and additional insight is needed. Methods and Results— The study was a substudy of the randomized Best Bypass Surgery trial that compared OPCAB with CCAB treatment with respect to intraoperative and postoperative mortality and morbidity in patients with a moderate to high level of predicted preoperative risk. The outcome was cognitive function. A total of 120 elderly patients (mean age 76 years, SD 4.5 years) underwent psychometric testing before surgery and at a mean of 103 (SD 15) days postoperatively with a neuropsychological test battery that included 7 parameters from 4 tests. Cognitive dysfunction was defined as the occurrence of at least 2 of the 7 possible deficits. Secondary analysis was performed on the basis of the definition of a 20% decline in cognitive scores compared with baseline, and with z score analysis. Cognitive dysfunction was identified in 4 of the 54 patients (7.4%, 95% confidence interval [CI] 2.1% to 17.9%) in the OPCAB group and 5 of the 51 patients (9.8%, 95% CI 3.3% to 21.4%) in the CCAB group. We found no difference in incidence of cognitive dysfunction between the groups regardless of the definition applied. Conclusions— In elderly high-risk patients, no significant difference was found in the incidence of cognitive dysfunction 3 months after either OPCAB or CCAB.
Lean body mass in twins
Authors: Gilbert B. Forbes, Eva Prochaska Sauer, Lowell R. Weitkamp
Journal: Metabolism (1995)

A study of 49 pairs of monozygous (MZ) twins and 38 pairs of same-sexed dizygous (DZ) twins showed that lean body mass (LBM), as determined by potassium 40 counting, is under genetic influence. Intrapair variances for LBM are much smaller than those for body fat, which suggests that LBM has a higher degree of heritability. There is a correlation between the magnitude of intrapair LBM differences and intrapair weight differences for both sets of twins, showing that environment is also an important influence. The effect of weight variation on LBM variation is greater for thin people than for those with appreciable burdens of body fat, an observation previously made on individuals who undergo a nutrition-induced weight change.
P3 Efficacy Of A Physiotherapy, Speech And Language Therapy Intervention (psalti) On Health Related Quality Of Life (hrqol) For Patients With Refractory Chronic Cough: A Randomised Control Trial
Authors: S. Chamberlain, S. Birring, L. Clarke, A. Douiri, S. Parker, S. Fowler, J. Hull, K. Chung, A. Pandyan, R. Garrod
Journal: Thorax (2014)

<h3>Introduction</h3> Refractory chronic cough has a significant negative impact on HRQoL. There are currently limited effective antitussive therapies. Few studies have explored the effectiveness of nonpharmacological interventions for refractory chronic cough. This study investigated the efficacy of PSALTI on HRQoL for people with refractory chronic cough in a multi-centred RCT. <h3>Methods</h3> Participants were recruited across five NHS hospitals trusts. 76 participants were randomised to PSALTI or placebo (equal attention) intervention. PSALTI consisted of education, laryngeal hygiene and hydration advice, cough control techniques and psycho-educational counselling. Placebo consisted of general education on exercise, diet, stress and relaxation. Both groups attended 4 weekly sessions of 1:1 therapy. HRQoL was measured at baseline, four weeks (end of treatment) and 3 month follow up by Leicester cough questionnaire (LCQ). Cough reflex sensitivity was assessed at baseline and four weeks by capsaicin cough challenge (C2, C5, concentration that caused first urge to cough (Cu)) and was analysed by geometric means (GM). Outcomes between groups were analysed using ANCOVA. <h3>Results</h3> The PSALTI (n = 35) and Placebo groups (n = 41) were well matched (p &gt; 0.05) for age [mean (SD)] 58(15) vs. 56(11) years; gender 71% vs 63% females; cough duration [median (IQR)] 60(30 to 126) vs 48(24 to 126) months and baseline LCQ [mean (SD)] 10.4(3.6) vs 11.9(3.5). At four weeks HRQoL improved in both groups, mean LCQ increase in PSALTI was 3.4 (95% CI 2.26 to 4.55) vs placebo 1.7 (95% CI 0.78 to 2.54); difference in LCQ change between groups was 1.5 (95% CI 0.27 to 7.31, p = 0.02) points more on average in the PSALTI group. This effect is greater than the MCID for LCQ and was sustained at 3 months (mean difference change between groups after 4 weeks to 3 months was -0.28 (95% CI -1.83 to 1.38). There was a significant increase in Cu in the PSALTI group compared to placebo (GM(SD) change 2 µm (5.07) vs 0.612 µm (3.26), p = 0.02). There was no significant difference in cough reflex sensitivity between the groups (C2, p = 0.46; C5, p = 0.74). <h3>Conclusions</h3> PSALTI significantly improved HRQoL compared with equal attention placebo intervention and this improvement was sustained at three months. PSALTI also significantly increased Cu compared to placebo.
Diffuse Thoracoabdominal Radioactivity Seen in Bone Imaging
Authors: WEI-JEN SHIH, JOHN J. COUPAL, PEGGY A. DOMSTAD, FRANK H. DeLAND
Journal: Clinical Nuclear Medicine (1986)

Diffusely increased radioactivity in the thoracoabdominal region (lower thorax and/or upper abdomen) occasionally has been observed when performing Tc-99m phosphonate bone studies. To assess the significance of activity in this finding, 1100 bone scintigrams were reviewed and the clinical data and other diagnostic imaging procedures were evaluated in these cases. With the exclusion of Tc-99m sulfur colloid liver-spleen scans 18 patients were found to have mild but diffuse increased radioactivity in the thoracoabdominal region either on the right or left. Clinical findings in these cases with abnormal uptakes were pleural effusions (six cases), hepatic colonic metastases (six cases), splenic metastases from bronchogenic carcinoma (one case), abdominal and peritoneal colonic metastases (one case), a massive metastatic squamous cell carcinoma (from lung) in the right lower chest (one case), and defective radiopharmaceuticals (three cases). Since the defective radiopharmaceuticals contained 5% of hydrolyzed reduced Tc-99m colloid by thin-layer chromatography, each of three patients received approximately 740 mu Ci of Tc-99m sulfur colloid. Factors to be considered in the interpretation of diffuse thoraco-abdominal activity from a bone agent should include splenic or hepatic metastases, a Tc-99m sulfur colloid splenic or hepatic metastases, a Tc-99m sulfur colloid study within the previous 24 hours, pleural effusion, faulty radiopharmaceuticals, and abdominal and peritoneal colonic metastases.
Increased Plasma Rifabutin Levels with Concomitant Fluconazole Therapy in HIV-Infected Patients
Authors: Carol Braun Trapnell
Journal: Annals of Internal Medicine (1996)

Objective: To determine the effect of fluconazole on rifabutin pharmacokinetics. Design: An open-label, crossover, phase 1 trial. Setting: Outpatient clinical research center at a university medical center in Washington, D.C. Patients: 12 persons with human immunodeficiency virus (HIV) infection whose CD4 lymphocyte counts were between 200 and 500 cells/mm3 and who were receiving maintenance therapy with zidovudine. Intervention: Fluconazole, 200 mg/d for 2 weeks; then a combination of fluconazole, 200 mg/d, and rifabutin, 300 mg/d, for 2 weeks; and then rifabutin, 300 mg/d, for the final 2 weeks of the study. Measurements: Blood and urine samples were obtained at regular intervals for 24 hours at the end of each 2-week dosing period to ascertain concentrations of fluconazole and rifabutin and the 25-desacetyl metabolite of rifabutin, LM565. Results: Fluconazole significantly increased the plasma concentrations of both rifabutin and LM565. Mean increases in the area under the plasma concentration curve compared with the time curve over a 24-hour dosing interval were 82% (5442 ± 2404 ng · h/mL compared with 3025 ± 1117 ng · h/mL; P ≤ 0.05) for rifabutin and 216% (959 ± 529 ng · h/mL compared with 244 ± 141 ng · h/mL; P ≤ 0.05) for LM565. Conclusions: Fluconazole significantly increases the systemic exposure of both rifabutin and LM565. This pharmacokinetic interaction offers a mechanism that may explain the changes reported in both the efficacy and toxicity of rifabutin with concomitant fluconazole therapy.
Stem cells in normal growth and disease.
Authors: T M Dexter
Journal: BMJ (1987)

Proceedings in Cases Relating to Hospital Medical and Dental Staff (HM(61)112). Originally circulated to health authorities in 1961 by the Ministry of Health, this document remains unchanged since that time. The fact that the health service has moved apace, as has society, seems to have gone unnoticed. The document establishes, though by no means clearly, a series of steps starting from preliminary investigation for the establishment of a prima facie case and progressing through to a formal inquiry. These inquiries are formal and legalistic, requiring a high standard of proof, with many rights enshrined for the consultant under investigation, including the ability to comment on the proceedings, to make a plea of mitigation, and to appeal to the Secretary of State. In practice this results in years of delay and excessive cost to the various health authorities. There are currently approximately 40 NHS consultants suspended on full pay pending such inquiries, and this could add up to a cost of ?4 000 000 to the health service. There is certainly a case to be made for reviewing this disciplinary procedure which benefits neither the doctor nor the service. Until we have a clearer system which has the support of consultants and health authorities, difficult and often painful cases will continue to arise in which problems of competence may be confused with difficult relationships and interpersonal problems. Teaching districts and university based medical schools have different disciplinary procedures. The teaching districts' consultant contracts are district based and disciplinary procedures receive the attention of the district medical officer rather than being directed to the region, while teaching hospitals may direct problems through the university disciplinary procedure. Cases concerning professional conduct and competence in general practice will be directed to the family practitioner committee.
CELLULAR DIFFERENTIATION OF THE IMMUNE SYSTEM OF MICE
Authors: G. M. Shearer, G. Cudkowicz, R. L. Priore
Journal: The Journal of Experimental Medicine (1969)

Spleen cell suspensions of primed donor mice containing precursors of immunocytes have been transplanted into X-irradiated recipient mice 122-138 days after immunization. Following secondary stimulation with antigen (sheep erythrocytes), these precursors, called antigen-sensitive units (ASU), gave rise to progeny cells secreting specific antibody in the spleens of recipients. Single cells releasing IgM hemolysins (direct plaque-forming cells or PFC), IgG hemolysins (indirect PFC), and hemagglutinins (cluster-forming cells or CFC) were enumerated. By transplanting graded and limiting numbers of primed spleen cells, inocula were found which contained one or a few ASU reaching the recipient spleens. We estimated, thereby, the frequency of ASU detectable by our procedures in donor cell suspensions. The values obtained from direct and in-indirect plaque assays, and from cluster assays were 1 in approximately 8.0 x 10(5), 1 in approximately 4.4 x 10(5), and 1 in approximately 5.9 x 10(5) nucleated spleen cells, respectively. The number of splenic ASU for direct PFC was not greater than that of unimmunized mice; however, immunization greatly increased the number of splenic ASU for indirect PFC and for CFC. By applying to each recipient spleen direct and indirect plaque tests and cluster tests, we found that positivity for each type of immunocyte was independent from that of the other two types. These results confirm the unipotent nature of splenic ASU in general, and document the commitment of ASU primed with SRBC to generate progeny cells secreting antibody of a single molecular (IgM or IgG) or functional (lysin or agglutinin) class. We concluded that splenic ASU are composed of relatively differentiated cells of the immune system of mice. With respect to specificity and class differentiation, ASU appear to be as specialized as antibody-producing cells themselves. Our results did not support the view that ASU-derived clonal populations shift from IgM to IgG antibody production.
The circulation in patients with chronic bronchitis and emphysema at rest and during exercise, with special reference to the influence of changes in blood viscosity and blood volume on the pulmonary circulation.
Authors: N Segel, J M Bishop
Journal: Journal of Clinical Investigation (1966)

It is widely held that increased blood viscosity due to polycythemia is an important factor contributing to pulmonary hypertension in patients with chronic bronchitis (1-5). An increase in the viscosity factor in -Poiseuille's equation will increase the pressure drop across a vascular bed proportionately, provided volume flow and the dimensions of the vessels remain constant. Roos (6) showed, in the isolated lung of a dog, that increasing packed cell volume is associated with an increase in the pressure drop across the pulmonary vascular bed, blood flow being maintained constant. However, the effects of alterations in blood viscosity upon pulmonary intravascular pressures in man have not been established. Baldwin, Cournand, and Richards (7) noted that the association of polycythemia with chronic bronchitis is rare. It has been shown that red cell volume is often slightly increased in patients with chronic bronchitis who have arterial desaturation (8, 9), but judging by the hematocrit or hemoglobin values in other reports of large numbers of patients (10-12), substantial polycythemia is an uncommon complication. The present investigation is concerned with a highly selected group of patients with chronic bronchitis complicated by marked secondary polycythemia. They were drawn from a large population of patients with chronic bronchitis who were seen in an area where
Liver Function: A Symposium on Approaches to the Quantitative Description of Liver Function
Authors: Khalil G. Wakim
Journal: JAMA (1961)

This book is a report of an excellent symposium on liver function and structure. It is unique in that the various chapters recount original work done by the authors. The discussions which follow the original contributions embody the salient features of the presentations in a critical and analytical manner. The book correlates hepatic functions with morphologic, physiologic, biochemical, pathologic, and clinical aspects of the liver in health and in disease. The various contributors assess critically the functions of the liver in both the isolated and the intact state, and appraise these functions in terms of alterations in chemical composition or rates of flow of blood, bile, and lymph, and their dynamics. An appealing feature of the book is the description of minute morphologic, biochemical, histochemical, and electromicroscopic details of the constituents of the liver cell, and of the architecture and function of the connective tissue elements of the liver and
18F-FDG PET in the Evaluation of Acuity of Deep Vein Thrombosis
Authors: Matthew T. Rondina, Uyen T. Lam, Robert C. Pendleton, Larry W. Kraiss, Nathan Wanner, Guy A. Zimmerman, John M. Hoffman, Christopher Hanrahan, Kenneth Boucher, Paul E. Christian, Regan I. Butterfield, Kathryn A. Morton
Journal: Clinical Nuclear Medicine (2012)

F-FDG PET has been used for vascular disease, but its role in deep vein thrombosis (DVT) remains prospectively unexplored.Whole-body F-FDG PET/CT scans were performed in patients 1 to 10 weeks after onset of symptomatic DVT (n = 12) and in control subjects without DVT (n = 24). The metabolic activity (SUVmax) of thrombosed and contralateral nonthrombosed vein segments was determined. The sensitivity and specificity of F-FDG PET/CT for the diagnosis of DVT were determined by receiver operating characteristic curve analyses. In 2 patients with DVT, changes in the metabolic activity of thrombosed vein segments in serial F-FDG PET scans.The metabolic activity in thrombosed veins [SUVmax, 2.41 (0.75)] was visually appreciable and significantly higher than in nonthrombosed veins in either the contralateral extremity of patients with DVT [SUVmax, 1.09 (0.25), P = 0.007] or control subjects [1.21 (0.22), P < 0.001]. The area under the receiver operating characteristic curve for SUVmax was 0.9773 (P < 0.001), indicating excellent accuracy. An SUVmax threshold of greater than 1.645 was 87.5% sensitive and 100% specific for DVT. Metabolic activity in thrombosed veins correlated significantly with time from DVT symptom onset (decrease in SUVmax of 0.02/d, P < 0.05). Best-fit-line analyses suggested that approximately 84 to 91 days after acute DVT, the maximum metabolic activity of thrombosed veins would return to normal levels.F-FDG PET/CT is accurate for detecting acute symptomatic, proximal DVT. Metabolic activity in thrombosed veins decreases with time, suggesting that F-FDG PET may be helpful in assessing the age of the clot.
Stable and Functional Lymphoid Reconstitution in Artemis-deficient Mice Following Lentiviral Artemis Gene Transfer Into Hematopoietic Stem Cells
Authors: Fatine Benjelloun, Alexandrine Garrigue, Corinne Demerens-de Chappedelaine, Pauline Soulas-Sprauel, Michele Malassis-Séris, Daniel Stockholm, Julia Hauer, Johanna Blondeau, Julie Rivière, Annick Lim, Marc Le Lorc'h, Serge Romana, Nicole Brousse, Frederique Pâques, Anne Galy, Pierre Charneau, Alain Fischer, Jean-Pierre de Villartay, Marina Cavazzana-Calvo
Journal: Molecular Therapy (2008)

Patients with mutations in the Artemis gene display a complete absence of T- and B lymphocytes, together with increased cellular radiosensitivity; this leads to a radiosensitive severe combined immunodeficiency (RS-SCID). Allogenic hematopoietic stem-cell (HSC) transplantation is only partially successful in the absence of an human leukocyte antigen-genoidentical donor, and this has prompted a search for alternative therapeutic approaches such as gene therapy. In this study, a self-inactivated lentiviral vector expressing Artemis was used to complement the Artemis knockout mouse (Art(-/-)). Transplantation of Artemis-transduced HSCs into irradiated Art(-/-) mice restored a stable (over a 15-month period of follow-up) and functional T- and cell repertoire that was comparable to that of control mice. The success of secondary transplantations demonstrated that the HSCs had been transduced. One of thirteen mice developed a thymoma 6 months after gene therapy. Although thymic cells were seen to be carrying two lentiviral integration sites, there was no evidence of lentivirus-driven oncogene activation. The Art(-/-) mice were found to be prone to develop T-cell lymphomas, either spontaneously or after irradiation. These data indicate that the observed lymphoproliferation was probably the consequence of the chromosomal instability associated with the Artemis-deficient background. As a whole, our work provides a basis for supporting the gene therapy approach in Artemis-deficient SCID.
PERITONEAL REACTION TO LIQUID PETROLATUM
Authors: Jack C. Norris
Journal: JAMA (1934)

For many years surgeons have hoped for a method of procedure, or a remedy, that would prevent the occurrence of adhesions in the peritoneal cavity. In the past some of the substances that have been used are petrolatum, iodine and petrolatum, and liquid petrolatum. This paper does not deal with the efficiency of those remedies, but it presents a report of interesting changes of an inflammatory nature that have occurred in the peritoneal cavities of two patients. In August 1934 Mrs. G. W., aged 53, was undergoing an abdominal operation at Grady Hospital. The surgeon (T. C. D.) observed a quantity of peculiar chylus-like fluid in the peritoneal cavity. Likewise there was considerable fatty necrosis of the omentum. On several areas of the jejunum there were small, elevated, irregular in size, grayish white granular nodules, which tended to spread. When these nodulations were removed, they left a bleeding serosal surface.
Single-passage extraction and permeability estimation of sodium in normal dogs lungs.
Authors: T Yipintsoi
Journal: Circulation Research (1976)

Bolus injections of 24NaCl, 131I-albumin, and indocyanine green dye were made into the right atria of anesthetized, ventilated dogs. Blood was sampled from the femoral artery, and from the dilution curves, instantaneous extractions, E2(t), and area averaged extractions, E3(t), were calculated for sodium at various plasma flows (Fp). Flow reduction was produced by transient inferior vena cava obstruction. E2(t) and E3(t) within any dilution curve generally started off with a high value, then decreased with time. The E3 that occurred at the peak of the albumin-dilution curve were about 0.11 for plasma flow of 0.75 liter/min and tended to decrease as flow increased. Parallel study of the sodium extravascular space at equilibrium gave values of 0.3-0.4 g of plasma sodium per g of tissue, suggesting that this volume is not infinitely small. Since the E was low it is unlikely that the high initial E(t) and the decreasing E(t) were due to early back flux. Calculation of capillary permeability surface area product [PS = Fp loge (1 - E)] showed an increasing PS with plasma flows. The injection of 9-mum microspheres at low and high total blood flow gave evidence supporting a decrease of capillary surface area (S) with decreasing total blood flow. Regional pulmonary blood flow also showed marked heterogeneity. Because of the low average extraction of sodium in the lung, insensitivity of the method in normal lungs cannot be excluded.