tbuckley/cabot-search huggingface dataset:
Sleep as a Potential Fundamental Contributor to Disparities in Cardiovascular Health
Authors: Chandra L. Jackson, Susan Redline, Karen M. Emmons
Journal: Annual Review of Public Health (2015)

Optimal sleep is integral to health but is commonly not obtained. Despite its wide-ranging public health impact, sleep health is considered only rarely by policy makers, employers, schools, and others whose policies and structures can adversely affect sleep. An inadequate duration of sleep and poor-quality sleep are prevalent in minority and low-income populations, and may be fundamental to racial and socioeconomic status inequities that contribute to a range of health conditions, including cardiovascular disease (CVD). This review examines the relationship between sleep and disparities in CVD. We describe the public health importance of sleep and the role of sleep duration, as well as the two most common disorders (sleep apnea and insomnia) as risk factors for a number of chronic diseases. We use a multilevel model focused on population health and health disparities, which is based on the notion that individual behaviors, such as sleep, are influenced by complex and dynamic interrelations among individuals and their physical and social environments. We also describe modifiable factors that contribute to insufficient sleep and circadian misalignment, propose potential interventions in various sectors (e.g., neighborhoods, schools, workplaces) that can address social structures that contribute to disparities, and recommend areas for future research. Integrating sleep into public health research will identify novel approaches for closing gaps in health disparities.
Helicobacter pylori stimulates pepsinogen secretion from isolated human peptic cells
Authors: S Lorente
Journal: Gut (2002)

Background: Different acid and peptic related gastroduodenal diseases are associated with both increased gastric secretion and <i>Helicobacter pylori</i> infection. Patients with <i>H pylori</i> associated gastritis or duodenal ulcer have increased serum pepsinogen levels which decrease after eradication. The mechanisms of <i>H pylori</i> induced gastric mucosal damage are not completely understood. Aim: To determine the effects of <i>H pylori</i> on pepsinogen secretion from isolated human peptic cells. Methods: Dispersed human peptic cells were prepared from endoscopically obtained biopsy specimens after collagenase digestion, mechanical disruption, and density gradient centrifugation. <i>H pylori</i> was obtained from gastric biopsies (antrum and body), and cultured in non-selective and selective media. Isolates of <i>H pylori</i> were used at different concentrations (1–20×10<sup>6</sup> colony forming units (cfu)). Results: <i>H pylori</i> (10<sup>6</sup>–2×10<sup>7</sup> cfu) increased basal pepsinogen secretion in a concentration dependent manner. This stimulus was not observed with <i>Escherichia coli</i>. The increased secretion was in addition to that observed with 0.1 mM histamine and 0.1 mM dibutyryl-cyclic adenosine monophosphate. However, <i>H pylori</i> did not affect either carbamylcholine (0.1–10 μM) or cholecystokinin (1 μM) stimulated pepsinogen secretion. Addition of the nitric oxide synthase inhibitor N<sup>w</sup>-monomethyl-l-arginine (1 mM) inhibited <i>H pylori</i> induced cGMP generation and pepsinogen secretion, which were also reduced in the absence of extracellular calcium. <i>H pylori</i> induced pepsinogen secretion was not affected by the absence/presence of the <i>cagA</i> gene. Conclusions: <i>H pylori</i> increases pepsinogen secretion from human peptic cells through a calcium and nitric oxide mediated intracellular pathway. This effect is independent of the <i>H pylori</i> virulent <i>cagA</i> gene, and may be a mechanism of <i>H pylori</i> induced gastric mucosal damage.
B lymphocytes undergo TLR2-dependent apoptosis upon<i>Shigella</i>infection
Authors: Katharina Nothelfer, Ellen T. Arena, Laurie Pinaud, Michel Neunlist, Brian Mozeleski, Ilia Belotserkovsky, Claude Parsot, Premkumar Dinadayala, Anke Burger-Kentischer, Rubhana Raqib, Philippe J. Sansonetti, Armelle Phalipon
Journal: The Journal of Experimental Medicine (2014)

Antibody-mediated immunity to Shigella, the causative agent of bacillary dysentery, requires several episodes of infection to get primed and is short-lasting, suggesting that the B cell response is functionally impaired. We show that upon ex vivo infection of human colonic tissue, invasive S. flexneri interacts with and occasionally invades B lymphocytes. The induction of a type three secretion apparatus (T3SA)–dependent B cell death is observed in the human CL-01 B cell line in vitro, as well as in mouse B lymphocytes in vivo. In addition to cell death occurring in Shigella-invaded CL-01 B lymphocytes, we provide evidence that the T3SA needle tip protein IpaD can induce cell death in noninvaded cells. IpaD binds to and induces B cell apoptosis via TLR2, a signaling receptor thus far considered to result in activation of B lymphocytes. The presence of bacterial co-signals is required to sensitize B cells to apoptosis and to up-regulate tlr2, thus enhancing IpaD binding. Apoptotic B lymphocytes in contact with Shigella-IpaD are detected in rectal biopsies of infected individuals. This study therefore adds direct B lymphocyte targeting to the diversity of mechanisms used by Shigella to dampen the host immune response.
36 PDX-1/HES-1 INTERACTIONS DETERMINE CHOLANGIOCYTE PROLIFERATIVE RESPONSE TO INJURY: THE SIGNIFICANCE FOR SCLEROSING CHOLANGITIS
Authors: M. Marzioni, S. Saccomanno, L. Agostinelli, C. Rychlicki, I. Pierantonelli, M. Trauner, P. Fickert, T. Müller, K. Shanmukhappa, G. Alpini, L. Trozzi, S. De Minicis, C. Candelaresi, G. Svegliati Baroni, A. Benedetti
Journal: Journal of Hepatology (2012)
“Play-or-Pay” Insurance Reforms for Employers — Confusion and Inequity
Authors: Bradley Herring, Mark V. Pauly
Journal: New England Journal of Medicine (2009)

One prominent feature of the current health care reform bills is a “play-or-pay” rule for employers: workers must receive part of their compensation in the form of employer-sponsored health insurance, or the company's payroll will be subjected to a tax penalty. Although the latter possibility is framed as a penalty on employers, it would almost surely be passed along as a levy on workers' wages.1 And although the “play” option is usually described as involving employer “contributions” toward insurance, this money, too, actually comes out of what would otherwise have been workers' wages.2,3 Rather than fostering transparency, the play-or-pay . . .
Noninvasive measurement of mean alveolar carbon dioxide tension and Bohr's dead space during tidal breathing
Authors: N.G. Koulouris, P. Latsi, J. Dimitroulis, B. Jordanoglou, M. Gaga, J. Jordanoglou
Journal: European Respiratory Journal (2001)

The lack of methodology for measuring the alveolar carbon dioxide tension (PA,CO2) has forced investigators to make several assumptions, such as that PA,CO2 is equal to end-tidal (PET,CO2) and arterial CO2 tension (Pa,CO2). The present study measured the mean PA,CO2 and Bohr's dead space ratio (Bohr's dead space/tidal volume (VD,Bohr/VT)) during tidal breathing. The method used is a new, simple and noninvasive technique, based on the analysis of the expired CO2 volume per breath (VCO2) versus the exhaled VT. This curve was analysed in 21 normal, healthy subjects and 35 chronic obstructive pulmonary disease (COPD) patients breathing tidally through a mouthpiece apparatus in the sitting position. It is shown that: 1) PA,CO2 is similar to Pa,CO2 in normal subjects, whilst it is significantly lower than Pa,CO2 in COPD patients; 2) PA,CO2 is significantly higher than PET,CO2 in all subjects, especially in COPD patients; 3) VD,Bohr/VT is increased in COPD patients as compared to normal subjects; and 4) VD,Bohr/VT is lower than the "physiological" dead space ratio (VD,phys/VT) in COPD patients. It is concluded that the expired carbon dioxide versus tidal volume curve is a useful tool for research and clinical work, because it permits the noninvasive and accurate measurement of Bohr's dead space and mean alveolar carbon dioxide tension accurately during spontaneous breathing.
Inhibition of Food Intake in Obese Subjects by Peptide YY<sub>3–36</sub>
Authors: Rachel L. Batterham, Mark A. Cohen, Sandra M. Ellis, Carel W. Le Roux, Dominic J. Withers, Gary S. Frost, Mohammad A. Ghatei, Stephen R. Bloom
Journal: New England Journal of Medicine (2003)

The gut hormone fragment peptide YY3-36 (PYY) reduces appetite and food intake when infused into subjects of normal weight. In common with the adipocyte hormone leptin, PYY reduces food intake by modulating appetite circuits in the hypothalamus. However, in obesity there is a marked resistance to the action of leptin, which greatly limits its therapeutic effectiveness. We investigated whether obese subjects were also resistant to the anorectic effects of PYY.
Hospital trusts are failing to monitor common infections
Authors: A. O'Dowd
Journal: BMJ (2014)

NHS acute care trusts in England are failing to monitor and assess the effects of several hospital acquired infections that pose a threat to patients, a new report has concluded.

Many trusts are ignorant of the full scale of hospital infections, says the report, published on 15 September by the Medical Technology Group, a coalition of patients’ groups, research charities, and medical device manufacturers.

The report includes findings from responses to a request made under freedom of information legislation to 160 acute care trusts, 76 of which replied, a 48% response rate.1 It warns that trusts have shown that there is worrying complacency over healthcare acquired …
Performance on the National Board of Medical Examiners Part I Examination by Men and Women of Different Race and Ethnicity
Authors: B Dawson, C K Iwamoto, L P Ross, R J Nungester, D B Swanson, R L Volle
Journal: JAMA (1994)

<h3>Objective.</h3> —To investigate the performance of men and women from various racial and ethnic backgrounds on the National Board of Medical Examiners Part I examination, controlling for any differences in measures of educational background and academic performance before entering medical school. <h3>Design.</h3> —A retrospective analysis of existing records from the National Board of Medical Examiners and the Association of American Medical Colleges. <h3>Setting.</h3> —National Board of Medical Examiners. <h3>Participants.</h3> —All students taking the June administration of Part I for the first time in 1986, 1987, or 1988 and who were 2 years from graduation from an accredited medical school. <h3>Methods.</h3> —Multiple regression methods were used to estimate Part I examination group differences in performance that would be expected if all students entered medical school with similar Medical College Admission Test scores, undergraduate grade point averages, and other prematriculation measures. <h3>Main Outcome Measure.</h3> —Performance on the Part I examination. <h3>Results.</h3> —There were substantial differences in performance, with white students scoring highest, followed by Asian/Pacific Islanders, Hispanics, and blacks; within all racial and ethnic categories, women scored lower than men. Controlling for dissimilarities in academic background greatly reduced Part I differences among most racial and ethnic groups, except Asian/Pacific Islander men; unexplained differences remained between men and women. Results were consistent for the 3 years examined. <h3>Conclusions.</h3> —The results of this study do not imply that physician performance varies among racial and ethnic groups or between men and women; no written examination can measure all the abilities that may be desirable to assess. Validity research investigating reasons for the reported gender and racial and ethnic differences in performance on the National Board examinations should be continued. (<i>JAMA</i>. 1994;272:674-679)
HEMATOLOGICAL FINDINGS IN THE GOLDEN HAMSTER (CRICETUS AURATUS)
Authors: Mabel O. Stewart, Lloyd Florio, Edward R. Mugrage
Journal: The Journal of Experimental Medicine (1944)

Values for hemoglobin, erythrocytes, volume of packed cells, leucocytes, and their distribution, and red blood cell diameter are presented as determined on a group of 114 hamsters of both sexes and of various ages.
Clinical Evaluation of a Computer-controlled Pressure Support Mode
Authors: MICHEL DOJAT, ALAIN HARF, DOMINIQUE TOUCHARD, FRANÇOIS LEMAIRE, LAURENT BROCHARD
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

We have designed a computerized system providing closed-loop control of the level of pressure support ventilation (PSV). The system sets itself at the lowest level of PSV that maintains respiratory rate (RR), tidal volume (Vt), and end-tidal CO2 pressure (Pet CO2 ) within predetermined ranges defining acceptable ventilation (i.e., 12 < RR < 28 cycles/min, Vt > 300 ml [ > 250 if weight < 55 kg], and Pet CO2 < 55 mm Hg [ < 65 mm Hg if chronic CO2 retention]). Ten patients received computer-controlled (automatic) PSV and physician-controlled (standard) PSV, in random order, during 24 h for each mode. An estimation of occlusion pressure (P0.1) was recorded continuously. The average time spent with acceptable ventilation as previously defined was 66 ± 24% of the total ventilation time with standard PSV versus 93 ± 8% with automatic PSV (p < 0.05), whereas the level of PSV was similar during the two periods (17 ± 4 cm H2O versus 19 ± 6 cm H2O). The time spent with an estimated P0.1 above 4 cm H2O was 34 ± 35% of the standard PSV time versus only 11 ± 17% of the automatic PSV time (p < 0.01). Automatic PSV increased the time spent within desired ventilation parameter ranges and apparently reduced periods of excessive workload.
Narrative Review: The Systemic Capillary Leak Syndrome
Authors: Kirk M Druey, Philip R Greipp
Journal: Annals of Internal Medicine (2010)

The systemic capillary leak syndrome (SCLS) is a rare disease of reversible plasma extravasation and vascular collapse accompanied by hemoconcentration and hypoalbuminemia. Its cause is unknown, although it is believed to be a manifestation of transient endothelial dysfunction due to endothelial contraction, apoptosis, injury, or a combination of these. Fewer than 150 cases of SCLS have been reported, but the condition is probably underrecognized because of its nonspecific symptoms and signs and high mortality rate. Patients experience shock and massive edema, often after a nonspecific prodrome of weakness, fatigue, and myalgias, and are at risk for ischemia-induced organ failure, rhabdomyolysis and muscle compartment syndromes, and venous thromboembolism. Shock and edema reverse almost as quickly as they begin, at which time patients are at risk for death from flash pulmonary edema during rapid fluid remobilization. Diagnosis is made clinically and by exclusion of other diseases that cause similar symptoms and signs, most notably sepsis, anaphylaxis, and angioedema. Acute episodes are treated with vasopressor therapy and judicious fluid replacement, possibly with colloid solutions for their osmotic effects, to prevent the sequelae of underperfusion. Between episodes, patients may be treated with theophylline and terbutaline, which clinical experience suggests may reduce the severity and frequency of acute episodes. Prognosis is uncertain, but patients who survive an initial severe SCLS episode are estimated to have a 10-year survival rate greater than 70%. Much remains to be learned about SCLS, and clinicians should consider the diagnosis in patients with unexplained edema, increased hematocrit, and hypotension.
Long–Term Maintenance of the Adult Pattern of Liver–Specific Expression for P–450B, P–450E, Albumin and α–Fetoprotein Genes in Intrasplenically Transplanted Hepatocytes
Authors: Paloma Maganto, Peter G. Traber, Christopher Rusnell, William O. Dobbins, David Keren, Jorge J. Gumucio
Journal: Hepatology (1990)

Hepatocytes isolated from livers of Fischer 344 rats and transplanted into the spleens of rats from the same strain survived for at least 15 mo in the absence of immunosuppressive drugs. Hepatocytes attached themselves only in the red pulp of the spleen, most commonly in clumps without a discernible structure. Throughout the 15–mo period, intrasplenically transplanted hepatocytes expressed cytochrome P–450b, P–450e and albumin messenger RNAs, whereas alphafetoprotein messenger RNA was not expressed. In addition, the relative expression of albumin and P–450 genes was similar to that in liver. For example, albumin messenger RNA was expressed to higher levels than P–450b or e messenger RNAs. Northern blots hybridized with oligonucleotides specific for P–450b or P–450e showed that, as in liver, both P–450b and P–450e genes were induced in response to phenobarbital. Quantitative slot–blot hybridizations performed at 15 days and 1, 6, and 15 mo after hepatocyte transplantation revealed that cytochrome P–450b and P–450e messenger RNAs were induced about 20– to 30–fold by a single dose of phenobarbital. This level of induction was also similar to that observed in liver. Hence, intrasplenically transplanted hepatocytes represent a unique system in which hepatocytes, cultured in an extrahepatic in vivo environment, maintain for at least 15 mo a pattern of expression for these four liver genes similar to that in the adult liver. Moreover, these studies suggest that neither the organization of liver into acini nor a specific zonal sinusoidal microenvironment is necessary for adult hepatocytes to respond to phenobarbital with induction of P–450b and P–450e genes.(HEPATOLOGY 1990; 11:585:593.)
Utility of echocardiography in assessment of pulmonary hypertension secondary to COPD
Authors: M.A. Higham, D. Dawson, J. Joshi, P. Nihoyannopoulos, N.W. Morrell
Journal: European Respiratory Journal (2001)

Studies have confirmed the close correlation of echocardiographically estimated pulmonary arterial pressure with invasive measurements in patients with chronic obstructive pulmonary disease (COPD), but there are few data on utility of echocardiographic measurement in assessing pulmonary arterial hypertension (PH) in COPD and correlation with pulmonary function tests. Presence or absence of tricuspid regurgitation (TR) was determined by Doppler echocardiography in 73 consecutive COPD patients attending a hospital outpatient clinic. Transtricuspid pressure gradient (TTPG) was calculated. PH was defined as TTPG ≥30 mmHg. Patients also underwent spirometry, forced expiratory volume in one second (FEV 1 ), single breath gas transfer (carbon monoxide transfer coefficient; ( K CO ) and carbon monoxide diffusing capacity of the lung; D L , CO ) and arterial blood gas measurement. Measurable TR was observed in 56/73 patients (77%). There were no differences between the group in which TR was observed compared to that in which it was absent, with regard to age, smoking history nor pulmonary function variables. PH was seen in 31/56 cases (55%), with good reproducibility. There were statistically significant correlations of TTPG with FEV 1 (r=−0.26, p=0.05), K CO (r=−0.31, p=0.04) and D L , CO (r=−0.42, p=0.006) expressed as % pred. Stepwise regression analysis showed that age and K CO combined provide a multivariate model for prediction of TTPG. It is concluded the presence and degree of pulmonary arterial hypertension is readily and reliably determined by echocardiography in the majority of chronic obstructive pulmonary disease patients. Pulmonary arterial hypertension is common in severe chronic obstructive pulmonary disease and transtricuspid pressure gradient correlates with spirometry and indices of gas transfer, similar to previous invasive studies. In view of the adverse effects of pulmonary arterial hypertension on morbidity and mortality routine echocardiography in patients with severe chronic obstructive pulmonary disease may be warranted.
Cardiovascular changes during acute episodic repetitive hypoxic and hypercapnic breathing in rats
Authors: M Bakehe, JL Miramand, B Chambille, C Gaultier, P Escourrou
Journal: European Respiratory Journal (1995)

It has been shown that chronic repetitive ambient hypoxia, simulating pulmonary gas disturbances observed in apnoea, leads to systemic hypertension in rats. However, the relative roles of hypoxia (HO), hypercapnia (HC), gas stress and vigilance on the cardiovascular changes have not yet been demonstrated. The aim of this study was to investigate the acute haemodynamic changes observed during the repetitive inhalation of various gas mixtures in rats for HO alone and HO+HC, and to analyse the effects of vigilance and of the stress of gas administration. We studied 6 unanaesthetized Wistar rats chronically instrumented with an aortic catheter. Nitrogen, nitrogen+CO2 mixtures and compressed air were randomly administered in a Plexiglass chamber for 10 s and then flushed by compressed air for 20 s. Two cycles were repeated every min for 10 to 12 min. The inhaled gas fractions (FI,O2,FI,CO2) were monitored by O2 and CO2 analysers. Blood pressure (BP) was measured by a P23XL transducer. The blood gases were analysed by a 1306 IL meter. In control experiments, with compressed air alone, there were no significant acute changes in heart rate (HR) and BP. During HO there were no changes in HR or BP at FI,O2 values from 0.05-0.14, whilst at FI,O2 values from 0-0.05 systolic blood pressure (SBP) rose significantly (+25.3 +/- 25.7 (SD) mmHg) and HR decreased (-93.8 +/- 124.1 bpm). During HOHC, SBP rose (+35.1 +/- 26.4 mmHg) and HR decreased (-139.3 +/- 75.7 bpm), significantly more than in HO alone. SBP was linearly correlated with Pa,O2 during HO (r = 0.53) and also during HOHC (r = 0.44) and was not directly related to Pa,CO2 which has, nevertheless, an additive effect to HO. SBP rose with each challenge significantly more when the rats were awake than when asleep (behavioural sleep). We conclude that in this acute repetitive inhalation model, the rise in SBP is not related to gas stress or to Pa,CO2 but to a decrease in Pa,O2 and is enhanced by wakefulness.
Relative exposure to inhaled steroids (ratio "ICS-to-total asthma therapy"): Concordant data from electronic medical records, claims data and patient-reported outcomes
Authors: Laurent Laforest, Idlir Licaj, Gilles Devouassoux, Genevieve Chamba, Laurent Letrilliart, Gerard Chatte, Eric Van Ganse
Journal: European Respiratory Journal (2012)

Background: In claims data, computation of “ICS-to-total-asthma-therapy” ratios (R) has shown interest to identify asthmatics more at risk of exacerbations, as a result of insufficient exposure to ICS for their level of disease severity. Ratios have seldom been computed from other data sources. The relationship between asthma outcomes and ratios was studied, from different sources: electronic medical records (EMRs) (Cegedim-Strategic-Data), claims data, and patient-reported outcomes (PROs) obtained from a pharmacy-based survey.

Methods: In all settings, the primary comparison was between non users (R=0%), inadequate ICS users (0<R<50%) and adequate ICS users (R≥50%), as to asthma-related hospitalizations, use of oral steroids (OCS) or antibiotics (ATB), and Asthma Control Test (Pharmacy-based study).

Results: In claims data (n=2,142, mean age=27 yrs, 53% females), inadequate users had higher rates of hospitalizations (p=0.0007), oral steroids or antibiotics use than other groups (p<0.0001 for both). OCS and ATB use were more common (p<0.0001 for both) among inadequate users in EMRs (n=4,587, mean age=28 yrs, 54% females). In the pharmacy-based survey (n=919, mean age=37 yrs, 55% females), inadequate users were more likely to be poorly controlled, hospitalized for asthma and to receive OCS or ATB (p<0.0001 for all).

Conclusions: Despite differences in study designs and patients baseline characteristics, conclusions were highly concordant between the 3 data sources, with evidence of poorer control in inadequate users. Advantages and limitations of each data source for the interpretation of ratios will be discussed.