tbuckley/cabot-search huggingface dataset:
Antireflux Surgery in Children
Authors: Robert A. Garrett
Journal: JAMA (1966)

A rationale for, and the results of, antireflux surgery in 58 children are reported. Suitability of the patient with primary reflux for this type of surgical correction is emphasized. Conversely, it is pointed out that the child with neurogenic reflux is usually unsuitable for this type of management. Allusion is made to a probable relationship between juvenile reflux and chronic pyelonephritis in young women. Primary importance is placed on differentiation of the obstructed from the unobstructed causation of reflux. Relief of the obstructing lesion is of primary importance in the former, whereas preliminary intensive medical management in the latter is emphasized. Discontinuation of reflux was noted in somewhat over half of the primary type with adequate medical management. Results of antireflux surgery were considered excellent in 41, no change in 12, and poor in 4.
A Tracking and Feedback Registry to Reduce Racial Disparities in Breast Cancer Care
Authors: Nina A. Bickell, Kruti Shastri, Kezhen Fei, Soji Oluwole, Henry Godfrey, Karen Hiotis, Anitha Srinivasan, Amber A. Guth
Journal: JNCI Journal of the National Cancer Institute (2008)

Black and Hispanic women with early-stage breast cancer are more likely than white women to experience fragmented care and less likely to see medical oncologists to get effective adjuvant treatment. We implemented a tracking and feedback registry to close the referral loop between surgeons and oncologists.We compared completed oncology consultations and use of adjuvant treatment among a group of 639 women with newly diagnosed stage I or II breast cancer who had undergone surgery at one of six New York City hospitals from 1999 to 2000 with the same outcomes for a different group of 300 women with breast cancer whose surgeries occurred in 2004-2006, after the implementation of the tracking registry. Underuse of adjuvant treatment was defined as no radiotherapy after breast-conserving surgery, no chemotherapy for estrogen receptor (ER)-negative tumors, or no hormonal therapy for ER-positive tumors 1 cm or larger. We used hierarchical modeling to adjust for clustering within hospital and surgeon practice. Odds ratios were converted to adjusted relative risks (aRRs). All statistical tests were two-sided.Implementation of the tracking and feedback registry was accompanied by a statistically significant increase in oncology consultations (83% before vs 97% after the intervention; difference = 14%; 95% confidence interval [CI] = 11% to 18%; P < .001) and decrease in underuse of adjuvant treatment (23% before vs 14% after the intervention; difference = -9%, 95% CI = -12% to -6%; P < .001). Underuse declined from 34% to 14% among black women, from 23% to 13% among Hispanic women, and from 17% to 14% among white women (chi-square of change in underuse from before to after among the three racial groups; P = .001). In multivariable models adjusting for clustering by hospital and surgeon, the intervention was associated with increased rates of oncology consultation (aRR = 1.6, 95% CI = 1.3 to 1.8), and reduced underuse of adjuvant treatment (aRR = 0.75, 95% CI = 0.6 to 0.9). Compared with the preintervention findings, minority race was no longer a risk factor for low rates of oncology consultation (aRR = 1.0, 95% CI = 0.7 to 1.3) or for underuse of adjuvant therapy (aRR = 1.0, 95% CI = 0.8 to 1.3).A tracking and feedback registry that enhances completed oncology consultations between surgeons and oncologists also appears to reduce rates of adjuvant treatment underuse and to eliminate the racial disparity in treatment.
Continuous vs Episodic Prophylactic Treatment With Amiodarone for the Prevention of Atrial Fibrillation
Authors: Sheba Ahmed, Michiel Rienstra, Harry J. G. M. Crijns, Thera P. Links, Ans C. P. Wiesfeld, Hans L. Hillege, Hans A. Bosker, Dirk J. A. Lok, Dirk J. Van Veldhuisen, Isabelle C. Van Gelder, for the CONVERT Investigators
Journal: JAMA (2008)

Amiodarone effectively suppresses atrial fibrillation but causes many adverse events.To compare major events in patients randomized to receive episodic amiodarone treatment with those who received continuous amiodarone treatment while still aiming to prevent atrial fibrillation.A randomized trial of 209 ambulatory patients with recurrent symptomatic persistent atrial fibrillation, conducted from December 2002 through March 2007 at 7 Dutch medical centers.Patients were randomly assigned to receive either episodic or continuous amiodarone treatment after electrical cardioversion following amiodarone loading. Episodic amiodarone treatment was discontinued after a month of sinus rhythm and reinitiated if atrial fibrillation relapsed (1 month peri-electrical cardioversion). In the continuous treatment group amiodarone was maintained throughout.The primary end point was a composite of amiodarone and underlying heart disease-related major events. The secondary end points were all-cause mortality and cardiovascular hospitalizations.After a median follow-up of 2.1 years (range, 0.4-2.5 years), 51 (48%) of those receiving episodic treatment vs 64 (62%) receiving continuous treatment had sinus rhythm (P = .05). There were 85 atrial fibrillation recurrences (80%) among the episodic treatment group vs 56 (54%) in the continuous treatment group (P < .001). No significant difference existed in the incidence of the primary composite end point between each group (37 [35%] episodic vs 34 [33%] continuous; incidence rate difference, 0.2; 95% confidence interval [CI], -10.2 to 10.6). However, there were nonstatistically significant differences in the incidence of amiodarone-related major events (20 [19%] episodic vs 25 [24%] continuous; incidence rate difference, -2.0; 95% CI, -8.7 to 4.6) and underlying heart disease-related major events (17 [16%] episodic vs 9 [9%] continuous; incidence rate difference, 3.6; 95% CI, -1.6 to 8.7). All-cause mortality and cardiovascular hospitalizations were higher among those receiving episodic treatment (56 [53%] vs 35 [34%], P = .02).In this study population, there was no difference in the composite of amiodarone and cardiac major adverse events between groups. However, patients receiving episodic treatment had a significantly increased rate of atrial fibrillation recurrence and a significantly higher rate of all-cause mortality and cardiovascular hospitalizations.clinicaltrials.gov Identifier: NCT00392431.
Effects of maximal breath holding on maximal expiratory flows
Authors: P Mialon, L Barthelemy, P Sebert
Journal: European Respiratory Journal (1989)

Effects of breath holdings (BH) on bronchomotor tone, maintained until their breaking points, have been studied using maximal expiratory flow volume curves (MEFVC). BHs have been performed either at high lung volume (total lung capacity, EIBH) or at low lung volume (residual volume +250 ml, EEBH), an inspiratory manoeuvre immediately preceding the MEFVC. The results show that: (1) EIBH induces a significant increase of expiratory flow at 25% of FVC; (2) EEBH induces a significant and constant decrease of expiratory flows at 50% and 25% of FVC. The same modifications were recorded after inhalation of 400 micrograms of Fenoterol or 80 micrograms of Ipratropium bromide. The observed results are suggestive of mechanical effects of BH on expiratory flows. After EIBH airway hysteresis dominates over lung hysteresis, with opposite effects after EEBH.
Thymic Deletion and Regulatory T Cells Prevent Antimyeloperoxidase GN
Authors: Diana S.Y. Tan, Poh Y. Gan, Kim M. O’Sullivan, Maree V. Hammett, Shaun A. Summers, Joshua D. Ooi, Brita A. Lundgren, Richard L. Boyd, Hamish S. Scott, A. Richard Kitching, Ann P. Chidgey, Stephen R. Holdsworth
Journal: Journal of the American Society of Nephrology (2013)

Loss of tolerance to neutrophil myeloperoxidase (MPO) underlies the development of ANCA-associated vasculitis and GN, but the mechanisms underlying this loss of tolerance are poorly understood. Here, we assessed the role of the thymus in deletion of autoreactive anti-MPO T cells and the importance of peripheral regulatory T cells in maintaining tolerance to MPO and protecting from GN. Thymic expression of MPO mRNA predominantly localized to medullary thymic epithelial cells. To assess the role of MPO in forming the T cell repertoire and the role of the autoimmune regulator Aire in thymic MPO expression, we compared the effects of immunizing Mpo(-/-) mice, Aire(-/-) mice, and control littermates with MPO. Immunized Mpo(-/-) and Aire(-/-) mice developed significantly more proinflammatory cytokine-producing anti-MPO T cells and higher ANCA titers than control mice. When we triggered GN with a subnephritogenic dose of anti-glomerular basement membrane antibody, Aire(-/-) mice had more severe renal disease than Aire(+/+) mice, consistent with a role for Aire-dependent central deletion in establishing tolerance to MPO. Furthermore, depleting peripheral regulatory T cells in wild-type mice also led to more anti-MPO T cells, higher ANCA titers, and more severe GN after immunization with MPO. Taken together, these results suggest that Aire-dependent central deletion and regulatory T cell-mediated peripheral tolerance both play major roles in establishing and maintaining tolerance to MPO, thereby protecting against the development of anti-MPO GN.
ANCA Associated with Behçet's Disease
Authors: N P Burrows, H M Zhao, P G Norris, C M Lockwood
Journal: Journal of the Royal Society of Medicine (1996)

Behçcet's disease is a multisystem disorder affecting primarily mucocutaneous and ocular sites although the gastrointestinal, cardiovascular, central nervous and respiratory systems may also be involved. Hulusi Behçet, a Turkish dermatologist, first described Behçet's disease in 1937 and suggested a possible infectious aetiology 1 . The pathogenesis of this condition still remains unclear although it is likely that infection acts as a trigger in genetically susceptible individuals. We report a patient with unusual cutaneous manifestations of Behçet's disease and antineutrophil cytoplasmic antibodies (ANCA) directed against the cytotoxic protein, bactericidal/permeability-increasing protein (BPI). This is the first report of Behçet's disease associated with this autoantibody.
Acute febrile neutrophilic dermatosis (Sweet's syndrome) in Behclet's disease
Authors: M. MIZOGUCHI, K. CHIKAKANE, K. GOH, Y. ASAHINA, K. MASUDA
Journal: British Journal of Dermatology (1987)

Journal Article Acute febrile neutrophilic dermatosis (Sweet's syndrome) in Behçlet's disease Get access M. MIZOGUCHI, M. MIZOGUCHI Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan Professor M.Mizoguchi, Department of Dermatology, University of Teikyo School of Medicine, 11‐1, Kaga 2, Itabashi‐ku, Tokyo 173, Japan. Search for other works by this author on: Oxford Academic Google Scholar K. CHIKAKANE, K. CHIKAKANE Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan Search for other works by this author on: Oxford Academic Google Scholar K. GOH, K. GOH Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan Search for other works by this author on: Oxford Academic Google Scholar Y. ASAHINA, Y. ASAHINA Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan Search for other works by this author on: Oxford Academic Google Scholar K. MASUDA K. MASUDA Department of Ophthalmology, Faculty of Medicine, University of Tokyo, Tokyo, Japan Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 116, Issue 5, 1 May 1987, Pages 727–734, https://doi.org/10.1111/j.1365-2133.1987.tb05908.x Published: 01 May 1987
A CASE OF LUPOID SYCOSIS OR ULERYTHEMA SYCOSIFORME BEGINNING IN INFANCY.
Authors: L. J. A. LOEWENTHAL
Journal: British Journal of Dermatology (1957)

Journal Article A CASE OF LUPOID SYCOSIS OR ULERYTHEMA SYCOSIFORME BEGINNING IN INFANCY. Get access L. J. A. LOEWENTHAL, M.D., M.R.C.P., D.T.M. & H. L. J. A. LOEWENTHAL, M.D., M.R.C.P., D.T.M. & H. Dermatologist, General Hospital; Hon. Fellow, South African Institute for Medical Research, Johannesburg Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 69, Issue 12, 1 December 1957, Pages 443–449, https://doi.org/10.1111/j.1365-2133.1957.tb13218.x Published: 01 December 1957
Procainamide Assay: A Spitting Image
Authors: Rudolph H. de Jong
Journal: JAMA (1977)

Tracing the rise and fall of drug molecules in the human body is beginning to pay off. Consider cardiology, where pharmacokinetic studies have already provided the clinician with practical guidelines for optimal dosing with lidocaine; now we learn that tissue levels of procainamide hydrochloride, another antiarrhythmic agent, can be assayed quite simply in saliva. In fact, salivary levels mirror procainamide's pharmacologic actions more accurately than do its plasma levels. University of California (San Francisco) investigators gave 500 mg of procainamide hydrochloride intravenously to selected subjects. From the drug's subsequent concentration profiles in plasma, urine, and saliva, they then constructed a mathematical model corresponding to a two-compartment kinetic system— with a separate third compartment accounting for procainamide movement into and out of saliva (<i>Clin Pharmacol Ther</i>20:278-289, 1976). Concurrently, procainamide's therapeutic effect was gauged from alterations of the QT interval. Over the years, we have come to accept that a drug's
Graft Vascular Disease: Immune Response Meets the Vessel Wall
Authors: Richard N. Mitchell
Journal: Annual Review of Pathology Mechanisms of Disease (2008)

Graft vascular disease (GVD) is the single most important long-term limitation to solid-organ transplantation. It is a concentric vascular intimal hyperplastic lesion composed of smooth muscle-like cells and associated matrix. GVD diffusely involves allograft vessels, eventually compromising perfusion and resulting in graft ischemia and failure. Animal models and an increasing sophistication in analyzing human GVD have provided important new insights into GVD pathogenesis. Innate and specific immune responses both participate in the initial vascular injury; GVD develops as a consequence of downstream chemokine- and cytokine-effector pathways. Other significant developments in the field include recognition of the central pathogenic role played by interferon-gamma as well as the contribution of host cell precursors to the intimal lesions. Because GVD shares many features with more common vascular pathologies, insights gleaned from our understanding of allograft vasculopathy may well impact our treatment for "traditional" atherosclerosis or restenosis lesions.
CD4 Cell Lymphopenia and Atherosclerosis in Renal Transplant Recipients
Authors: Didier Ducloux, Bruno Challier, Philippe Saas, Pierre Tiberghien, Jean-Marc Chalopin
Journal: Journal of the American Society of Nephrology (2003)

Several animal studies suggest that T cell-mediated immunodeficiency may play a role in the progression of atherosclerosis. This study examined the association between lymphocyte subsets and atherosclerotic events in renal transplant recipients. A total of 302 consecutive renal transplant recipients were enrolled in this prospective study. Peripheral blood lymphocyte subsets were quantified and analyzed with respect to other known cardiovascular risk factors. The patients were followed for a mean duration of 23.5 +/- 4.5 mo. Mean CD4, CD8, and CD19 cell levels were 511 +/- 290/mm(3), 553 +/- 596/mm(3), and 66 +/- 62/mm(3), respectively. CD4 levels were positively related to transplant duration (r = 0.32; P = 0.02) and inversely related to age (r = 0.35; P = 0.01). Twenty-five atherosclerotic events (AE) occurred in 25 patients (8.3%). CD4 levels were lower in patients who experienced CVE (288 +/- 170/mm(3) versus 531 +/- 290/mm(3); P < 0.0001). Cox regression analysis showed that patients in the three upper quartiles of CD4 cell count had a decreased risk of CVE compared with those in the lowest quartile. There was a linear increase in risk of CVE with decreasing CD4 cell count (P < 0.0001). A CD4 cell count in the highest quartile (>663/mm(3)) divided the risk of CVE by 10 as compared with the lowest quartile. In conclusion, CD4 lymphocytopenia is an independent risk factor for the development of cardiovascular complications in renal transplant recipients, suggesting that impaired immune response promotes accelerated atherogenesis in this population.
Peripheral blood neutrophils are hyperresponsive to IL-8 and Gro-α in cryptogenic fibrosing alveolitis
Authors: P.C. Glynn, E.M. Henney, I.P. Hall
Journal: European Respiratory Journal (2001)

Cryptogenic fibrosing alveolitis (CFA) is characterized by increased pulmonary recruitment of peripheral blood neutrophils (PBNs) by interleukin (IL)-8 and other chemotactic mediators. This study investigated whether, in CFA, the PBN motility response is primed by IL-8 and growth-related oncogene (Gro)-α, as demonstrated in other neutrophilic inflammatory diseases, and whether the motility response of PBNs to IL-8 and Gro-α can be abrogated using a selective antagonist for the neutrophil receptor for IL-8 and Gro-α, CXCR2. The percentage of PBNs to undergo shape change (%SC), spontaneously and in response to IL-8 and Gro-α, was measured in patients with CFA (n=10) and controls (n=10), and the effect of the CXCR2 antagonist SB272844 studied. Plasma levels of IL-8, and Gro-α were measured using an enzyme-linked immunosorbent assay (ELISA). The %SC of unstimulated PBNs and the potency of Gro-α and IL-8 to produce neutrophil polarization was greater in CFA than in controls; dose which produces 50% of maximal effect (EC 50 ) of IL-8 was 3.6±0.7 nM for CFA versus 6.3±1.0 nM for controls; p&lt;0.05. SB272844 inhibited Gro-α induced but not IL-8 induced neutrophil shape change (equilibrium constant (K D ) 123±18 nM). Plasma concentrations of Gro-α were increased in patients with CFA. PBNs are spontaneously activated and undergo a greater motility response to IL-8 and Gro-α in CFA. Interleukin-8 and growth-related oncogene-α, circulating in substimulatory amounts in cryptogenic fibrosing alveolitis, may prime the peripheral blood neutrophils motility response, thus increasing their capacity for migration to the lung. Selective CXCR2 antagonists may be useful to block the Gro-α-induced priming response whilst preserving neutrophil functions mediated by CXCR1, the alternative neutrophil receptor for interleukin-8.
International approaches to the prescription of long-term oxygen therapy
Authors: P.J. Wijkstra, G.H. Guyatt, N. Ambrosino, B.R. Celli, R. Guell, J.F. Muir, C. Prefaut, E.S. Mendes, I. Ferreira, P. Austin, B. Weaver, R.S. Goldstein
Journal: European Respiratory Journal (2001)

While there is broad agreement about who should receive long-term oxygen therapy (LTOT), there is little information available on how clinicians should decide on the oxygen prescription itself, at rest, during sleep and during exercise. The authors describe the results of an international survey that was undertaken to compare how respirologists prescribed oxygen. A questionnaire was sent to 100 respirologists in each of seven countries. The questionnaire identified whether resting flow rates were derived in a standard manner or by individualized patient testing. Test targets were ascertained for rest, exercise and sleep, as was the percentage of time that each test target had to reach for the test to be accepted. The majority of respondents individualized the oxygen prescription at rest (81%). Resting arterial oxygen saturation (Sa,O2) was most commonly targeted at 90-91%. The approach to night prescription varied (p<0.001). Respirologists in Canada and the USA increased the resting Sa,O2 by 1-2 L x min(-1) during sleep, while those in Spain used the resting (awake) flow for the night prescription (62%). Respirologists in the Netherlands, France, and Italy individualized the night prescription more frequently. Although oxygen during exercise was individualized in most countries (74%), significant differences remained among countries (p<0.001). The majority of respirologists (62%) aimed to achieve an Sa,O2 of 90-91% during exercise, while 70% of all respirologists tried to achieve the desired Sa,O2 for 90% of the test. There were substantial differences among countries as to how the oxygen prescription was written. This survey highlights the need for multicentre studies that improve the effectiveness of long-term oxygen therapy utilization.
Transcriptional and Posttranscriptional Regulation of Endothelial Nitric Oxide Synthase Expression by Hydrogen Peroxide
Authors: Grant R. Drummond, Hua Cai, Michael E. Davis, Santhini Ramasamy, David G. Harrison
Journal: Circulation Research (2000)

Abstract —Diverse stimuli, including shear stress, cyclic strain, oxidized LDL, hyperglycemia, and cell growth, modulate endothelial nitric oxide synthase (eNOS) expression. Although seemingly unrelated, these may all alter cellular redox state, suggesting that reactive oxygen intermediates might modulate eNOS expression. The present study was designed to test this hypothesis. Exposure of bovine aortic endothelial cells for 24 hours to paraquat, a superoxide (O 2 −· )–generating compound, did not affect eNOS mRNA levels. However, cotreatment with paraquat and either Cu 2+ /Zn 2+ superoxide dismutase or the superoxide dismutase mimetic tetrakis(4-benzoic acid)porphyrin chloride increased eNOS mRNA by 2.3- and 2.2-fold, respectively, implicating a role for H 2 O 2 . Direct addition of 100 and 150 μmol/L H 2 O 2 caused increases in bovine aortic endothelial cell eNOS mRNA that were dependent on concentration (ie, 3.1- and 5.2-fold increases) and time, and elevated eNOS protein expression and enzyme activity, accordingly. Nuclear run-on and 5,6-dichloro-1-β- d -ribofuranosylbenzimidazole–chase studies showed that H 2 O 2 caused a 3.0-fold increase in eNOS gene transcription and a 2.8-fold increase in eNOS mRNA half-life. Induction of eNOS by H 2 O 2 was not affected by the hydroxyl radical scavenger DMSO, mannitol, or N-tert-butyl -α-phenylnitrone, but it was inhibited by the antioxidants N -acetylcysteine, ebselen, and exogenously added catalase. Unlike H 2 O 2 , the 4.0-fold induction of eNOS by shear stress (15 dyne/cm 2 for 6 hours) was not inhibited by N -acetylcysteine or exogenous catalase. In conclusion, H 2 O 2 increases eNOS expression through transcriptional and post-transcriptional mechanisms. Although H 2 O 2 does not mediate shear-dependent eNOS regulation, it is likely to be involved in regulation of eNOS expression in response to other physiological and/or pathophysiological stimuli.