tbuckley/cabot-search huggingface dataset:
Association of Health Literacy With Self-Management Behavior in Patients With Diabetes
Authors: Sarang Kim, Frances Love, D. Alex Quistberg, Judy A. Shea
Journal: Diabetes Care (2004)

Limited health literacy, common in patients with diabetes, has been associated with worse diabetes outcomes (1–4). While patients with limited health literacy have worse diabetes knowledge (2–5), knowledge does not necessarily predict outcomes (6–8). Because diabetes requires extensive self-care, differences in self-management behaviors may be a key contributor to the disparity in outcomes. In fact, low health literacy has been associated with poor self-care in other chronic illnesses (9,10). However, no study has examined the relationship between health literacy and self-management behaviors in patients with diabetes. In addition, studies have not assessed whether diabetes education, which is widely recommended, is effective in improving self-management behaviors in patients with limited health literacy. The objectives of our study were to examine the association of health literacy with self-management behaviors in patients with diabetes and to determine whether diabetes education improves self-management behaviors in patients with limited compared with adequate health literacy. Understanding the relationship between health literacy and self-management behaviors should enhance efforts to improve diabetes outcomes.

We conducted a prospective observational study of patients enrolled in diabetes education classes at the Hospital of the University of Pennsylvania. The classes consist of an individual meeting with a diabetes educator and three weekly 3-h group classes and are recognized by the American Diabetes Association (11). All patients ≥18 years of age present for a regularly scheduled diabetes class were recruited. …
Comparative Genetics and Evolution of Annexin A13 as the Founder Gene of Vertebrate Annexins
Authors: Juan-Manuel Iglesias, Reginald O. Morgan, Nancy A. Jenkins, Neal G. Copeland, Debra J. Gilbert, Maria-Pilar Fernandez
Journal: Molecular Biology and Evolution (2002)

Annexin A13 (ANXA13) is believed to be the original founder gene of the 12-member vertebrate annexin A family, and it has acquired an intestine-specific expression associated with a highly differentiated intracellular transport function. Molecular characterization of this subfamily in a range of vertebrate species was undertaken to assess coding region conservation, gene organization, chromosomal linkage, and phylogenetic relationships relevant to its progenitor role in the structure-function evolution of the annexin gene superfamily. Protein diagnostic features peculiar to this subfamily include an alternate isoform containing a KGD motif, an elevated basic amino acid content with polyhistidine expansion in the 5′-translated region, and the conservation of 15% core tetrad residues specific to annexin A13 members. The 12 coding exons comprising the 58-kb human ANXA13 gene were deduced from BAC clone sequencing, whereas internal repetitive elements and neighboring genes in chromosome 8q24.12 were identified by contig analysis of the draft sequence from the human genome project. A unique exon splicing pattern in the annexin A13 gene was corroborated by coanalysis of mouse, rat, zebrafish, and pufferfish genomic DNA and determined to be the most distinct of all vertebrate annexins. The putative promoter region was identified by phylogenetic footprinting of potential binding sites for intestine-specific transcription factors. Mouse annexin A13 cDNA was used to map the gene to an orthologous linkage group in mouse chromosome 15 (between Sdc2 and Myc by backcross analysis), and the zebrafish cDNA permitted its localization to linkage group 24. Comparative analysis of annexin A13 from nine species traced this gene's speciation history and assessed coding region variation, whereas phylogenetic analysis showed it to be the deepest-branching vertebrate annexin, and computational analysis estimated the gene age and divergence rate. The unique, conserved aspects of annexin A13 primary structure, gene organization, and genetic maps identify it as the probable common ancestor of all vertebrate annexins, beginning with the sequential duplication to annexins A7 and A11 approximately 700 MYA, before the emergence of chordates.
Early monotherapy with pegylated interferon alpha-2b for acute hepatitis C infection: The HEP-NET acute-HCV-II study
Authors: Johannes Wiegand, Peter Buggisch, Wulf Boecher, Stefan Zeuzem, Cornelia M. Gelbmann, Thomas Berg, Wolfgang Kauffmann, Birgit Kallinowski, Markus Cornberg, Elmar Jaeckel, Heiner Wedemeyer, Michael P. Manns
Journal: Hepatology (2006)

Early treatment of acute hepatitis C with interferon alpha-2b for 24 weeks prevents chronic infection in almost all patients. Because pegylated interferons have replaced conventional interferon in the therapy of chronic hepatitis C, the aim of this study was to analyze the efficacy of an early treatment of acute hepatitis C with peginterferon alfa- 2b. Between February 2001 and February 2004, 89 individuals with acute HCV infection were recruited at 53 different centers in Germany. Patients received 1.5 μg/kg peginterferon alfa-2b for 24 weeks; treatment was initiated after a median of 76 days after infection (range 14-150). End-of-treatment response and sustained virological response were defined as undetectable HCV RNA at the end of therapy and after 24 weeks of follow-up, respectively. In the total study population, virological response was 82% at the end of treatment and 71% at the end of follow-up. Of 89 individuals, 65 (73%) were adherent to therapy, receiving 80% of the interferon dosage within 80% of the scheduled treatment duration. End-of-treatment and sustained virological response rates in this subpopulation were 94% and 89%, respectively. A maximum alanine aminotransferase level of more than 500 U/L prior to therapy was the only factor associated with successful treatment. In conclusion , in acute HCV infection, early treatment with peginterferon α2b leads to high virological response rates in individuals who are adherent to treatment. The high number of dropouts underlines the importance of thorough patient selection and close monitoring during therapy. Thus, future studies should identify factors predicting spontaneous viral clearance to avoid unnecessary therapy. (Hepatology 2006;43:250–256.)
When Did Artificial Heart Implants Begin?
Authors: C. William Hall
Journal: JAMA (1988)

<h3>To the Editor.</h3> —In the article entitled "Artificial Heart Implants Began Five Years Ago," Ms Cowart<sup>1</sup>forgot to mention that the first total artificial heart was implanted in 1969 at Baylor College of Medicine. The first implantable blood pump, a left ventricular assist device (then called a "left ventricular bypass pump"), also was implanted at Baylor College of Medicine six years previously (1963). The latter device has been on display at the Smithsonian Institution since being donated in 1964. This places the use of artificial pumping devices in humans at least four years ahead of the first human heart transplant. It also makes the total artificial heart implant 19 years old rather than five years old, as described in the article.
Acute Type B Aortic Dissection: Does Aortic Arch Involvement Affect Management and Outcomes?
Authors: Thomas T. Tsai, Eric M. Isselbacher, Santi Trimarchi, Eduardo Bossone, Linda Pape, James L. Januzzi, Arturo Evangelista, Jae K. Oh, Alfredo Llovet, Joshua Beckman, Jeanna V. Cooper, Dean E. Smith, James B. Froehlich, Rossella Fattori, Kim A Eagle, Christoph A. Nienaber
Journal: Circulation (2007)

Stanford Type B acute aortic dissection (TB-AAD) spares the ascending aorta and is optimally managed with medical therapy in the absence of complications. However, the treatment of TB-AAD with aortic arch involvement (AAI) remains an unresolved issue.We examined 498 patients with TB-AAD enrolled in the International Registry of Acute Aortic Dissection (IRAD) between 1996 and 2003. Kaplan-Meier mortality curves were constructed and multivariate regression models were performed to identify independent predictors of AAI and to evaluate whether AAI was an independent predictor of follow-up mortality. We found that 371 (74.5%) patients with TB-AAD did not have AAI versus 127 (25.5%) with AAI. Independent predictors of AAI were a history of previous aortic surgery (OR 3.4; 95% CI, 1.6 to 7.6; P=0.002), absence of back pain (OR 1.6; 95% CI, 1.1 to 2.5; P=0.05), and any pulse deficit (1.9; 95% CI, 1.1 to 3.3, P=0.03). Mortality for patients without AAI was 9.4%+/-4.3% and 21.0%+/-6.9% at 1 and 3 years versus 9.2%+/-7.7% and 19.9%+/-11.1% with AAI, respectively (mean follow-up overall, 2.3 years, log rank P=0.82). AAI was not an independent predictor of long-term mortality.Patients with TB-AAD and aortic arch involvement do not differ with regards to mortality at 3 years. Whether or not AAI involvement impacts other measures of morbidity such as freedom from operation or endovascular intervention deserves further study.
Requisite Role of Cardiac Myocytes in Coronary α <sub>1</sub> -Adrenergic Constriction
Authors: Christiane P. Tiefenbacher, David V. DeFily, William M. Chilian
Journal: Circulation (1998)

Background —α-Adrenergic activation in vivo causes constriction of coronary arterioles, but, paradoxically, in vitro these microvessels do not contract to this stimulus. We hypothesized that cardiac myocytes have a requisite role in α 1 -adrenergic coronary arteriolar constriction through the release of myocyte-derived contractile factor(s). Methods and Results —Administration of the α 1 -adrenergic agonist phenylephrine did not constrict isolated coronary arterioles, but constriction was observed to supernatant obtained from phenylephrine-treated cardiac myocytes. Constriction to the supernatant was blocked by administration of an endothelin-A antagonist to the microvessel preparation or an α-adrenergic antagonist to the myocytes and was augmented after administration of an adenosine antagonist. Administration of phenylephrine to the myocytes increased endothelin-1 levels in the supernatant, but only to subthreshold concentrations. Conclusions —Cardiac myocytes have a requisite role in constriction of coronary resistance vessels to α 1 -adrenergic stimuli, which may be mediated by endothelin-1 and other unidentified myocyte-derived vasoconstrictors.
Relative effects of pregnancy, estradiol, and progesterone on plasma insulin and pancreatic islet insulin secretion
Authors: N. V. Costrini, R. K. Kalkhoff
Journal: Journal of Clinical Investigation (1971)

Influences of estrogen and progesterone on the development of hyperinsulinemia and augmented pancreatic islet insulin secretion during pregnancy were assessed in this study. Groups of female rats were injected subcutaneously for 21 days with varying daily dosages of estradiol benzoate or progesterone in oil. On day 21, pancreatic islets were isolated by a collagenase method. Total insulin secretion was measured after 90-min incubations of 10 islets in buffered medium containing glucose. Higher physiologic dosages of estradiol or progesterone, singly or in combination, significantly increased islet secretion above values of untreated control rats and were comparable to augmented islet responses of term, 3-wk pregnant rats. Diameter and protein content of islets obtained from steroid-treated and pregnant rats exceeded control measurements in these instances. However, 2-hr preincubations of control islets with 1 or 10 mug/ml of either steroid did not influence subsequent glucose-stimulated insulin output. In related studies, plasma insulin responses during 30 min intravenous glucose tolerance tests were significantly above control responses in term-pregnant rats and animals receiving comparable dosages of steroids for 3 wk. Unlike pregnancy or progesterone treatment, estradiol administration alone or with progesterone significantly lowered postchallenge plasma glucose concentrations. These results indicate that estradiol and progesterone contribute to enhanced islet insulin secretion and plasma insulin responses to glucose administration during pregnancy. This change is not acutely produced but can be related to hypertrophy of islets following chronic hormonal administration. Although the data do not distinguish between direct and indirect beta-cytotrophic effects of these sex steroids, metabolic actions of estradiol and progesterone may differ, since estrogen treatment lowers plasma glucose curves following the induction of hyperinsulinemia.
Acute and chronic effects of cigarette smoking on exhaled nitric oxide.
Authors: S A Kharitonov, R A Robbins, D Yates, V Keatings, P J Barnes
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Cigarette smoking is associated with an increased risk of respiratory tract infections, chronic airway disease, and cardiovascular diseases, all of which may be modulated by endogenous nitric oxide (NO). We have investigated whether cigarette smoking reduces the production of endogenous NO. We compared exhalations of 41 current cigarette smokers with normal lung function and 73 age-matched non-smoking controls. Peak exhaled NO levels were measured by a modified chemiluminescence analyzer. The effects of inhaling a single cigarette in smokers were also measured. In control subjects we also measured the effects of inhalation of NO itself and carbon monoxide, both constituents of tobacco smoke. Peak exhaled NO concentrations were significantly reduced in smokers (42 +/- 3.9 compared with 88 +/- 2.7 parts per billion in nonsmokers, p < 0.01), with a significant relation between the exhaled NO and cigarette consumption (r = 0.77, p < 0.001). Smoking a single cigarette also significantly (p < 0.02), but transiently, reduced exhaled NO. Inhalation of carbon monoxide and NO had no effect on exhaled NO in normal subjects. Cigarette smoking decreased exhaled NO, suggesting that it may inhibit the enzyme NO synthase. Since endogenous NO is important in defending the respiratory tract against infection, in counteracting bronchoconstriction and vasoconstriction, and in inhibiting platelet aggregation, this effect may contribute to the increased risks of chronic respiratory and cardiovascular disease in cigarette smokers.
Factors associated with self-reported risk-taking behaviour on ski slopes
Authors: G Ruedl, E Pocecco, R Sommersacher, H Gatterer, M Kopp, W Nachbauer, M Burtscher
Journal: British Journal of Sports Medicine (2010)

Background In recent years, discussions have arisen about the potential influence of wearing a ski helmet on an increasing level of risk taking and higher speeds on ski slopes. Objective To evaluate factors associated with selfreported risk-taking behaviour in recreational skiers and snowboarders. Methods Speeds of skiers and snowboarders were measured with a radar speed gun and sex, age, nationality, height, weight and helmet use, used type of gear, self-estimated skill level and self-estimated fitness level were recorded. In addition, participants were asked if they considered themselves as cautious or risk-taking skier or snowboarder. Results In total, 453 skiers (39.6 (14.8) years) and 74 snowboarders (26.4 (9.6) years) have been interviewed. A stepwise forward logistic regression model revealed five independent factors for a risk-taking behaviour on slopes. Adjusted OR and their 95% CI showed that risk takers were &lt;40 years (OR 2.4, 95% CI 1.51 to 3.80), had a higher skill level (OR 2.1, 95% CI 1.25 to 3.50), were more likely males (OR 2.0, 95% CI 1.22 to 3.26), had a lower body mass index (22.8 vs 24.2) and skied with higher speeds (on average 53 vs 45 km/h) compared to cautious skiers. Conclusion Risk-taking behaviour on ski slopes is associated with younger age, higher skiing ability, male sex, lower body mass index and on average higher speeds. Helmet use is not associated with riskier behaviour on slopes. In addition, helmet use has to be recommended because helmet use reduces the risk of head injuries among skiers and snowboarders.
Chemokines in joint disease: the key to inflammation?
Authors: J J Haringman
Journal: Annals of the Rheumatic Diseases (2004)

Targeting chemokines and/or chemokine receptors appears to be an intriguing new approach to treating chronic inflammatory disorders like rheumatoid arthritis, inflammatory bowel diseases, multiple sclerosis, and transplant rejections. The involvement of chemokines and chemokine receptors in inflammatory joint diseases, the in vitro and in vivo characteristics of the chemokine family in inflammatory joint disease, and initial clinical data on chemokine blockade in patients with rheumatoid arthritis suggest that targeting the chemokine and chemokine receptor family might provide a new, promising antirheumatic strategy.
IMMUNOLOGICAL MATURATION
Authors: Joseph M. Davie, William E. Paul
Journal: The Journal of Experimental Medicine (1973)

Immunological maturation, the gradual increase in affinity for antigen of serum antibody with time after immunization, has been postulated to result from a competition among precursors of antibody-forming cells for available antigen (1, 2).Thus, as the antigen concentration in the cellular environment falls, only those cells with antigen-binding receptors of sufficiently high avidity to capture antigen will continue to be stimulated, proliferate, and mature into antibody-secreting cells.Furthermore, this thesis requires that the binding characteristics of the receptor on the precursor cell are identical, or very similar, to those of the antibody produced by the descendents.Results from our previous studies have supported this view (3, 4).In them, we have shown that immune maturation results from the relative persistence of high-affinity antibody-producing cells later after immunization while the number of cells secreting lower affinity antibody falls rapidly after the early days of the immune response.This conclusion was based on an analysis of individual anti-2,4-dinitrophenyl (DNP) antibody-secreting cells in guinea pigs immunized with 50 ttg of dinitrophenyl guinea pig albumin (DNP-GPA).By dividing the antibody-secreting cell population at each time point into avidity groups (see below), it was possible to follow independently the changes in frequency of cells producing antibody of different affinities.It was found that among the population of antibody-secreting cells which appeared in draining lymph nodes shortly after immunization were relatively large numbers of cells secreting high-affinity as well as cells secreting intermediate-and low-at~nity antibody.The exponential increase in the number of antibody-secreting cells which occurred during the first few days of the response was an increase in frequency of cells in each avidity group.After 12 days, however, the relative frequencies of antibody-secreting cells in the various avidity groups changed markedly.The number of cells in the lower avidity groups began to fall in frequency while the number of cells in the higher avidity groups was preserved.By day 30, only high-avidity producers remained.
Predictors of patient relevant outcome after total hip replacement for osteoarthritis: a prospective study
Authors: A-K Nilsdotter
Journal: Annals of the Rheumatic Diseases (2003)

<b>Objectives:</b> To investigate prospectively long term patient relevant outcomes after unilateral total hip replacement (THR) for osteoarthritis (OA). To identify non-responders to this intervention and patient related predictors of unsatisfactory outcome. <b>Methods:</b> A case-control study comparing health related quality of life of 219 patients (mean age 71) after THR with that of a matched reference group of 117 subjects without hip complaints recruited from the community. Patients and reference group answered SF-36 and WOMAC questionnaires preoperatively, at 3, 6, 12 months, and at 3.6 years (range 26–65 months) postoperatively. Supplementary questions were asked at the final follow up. <b>Results:</b> 198/211 (94%) of the patients and 83/109 (76%) of the reference group participated at the final follow up. At follow up, the only difference between the two groups in the SF-36 was physical function, where patients scored worse. Patients also reported worse WOMAC function. 31% of the patients had improved by &lt;10/100 WOMAC score points for pain and/or function at final follow up, compared with preoperatively. More pain preoperatively and higher age and postoperative low back pain predicted a worse outcome in WOMAC function. <b>Conclusion:</b> 3.6 years after THR for OA, health related quality of life was similar for patients and reference group except for function, where patients had worse function. Higher age and more pain preoperatively predicted a poor outcome. Patients with hip OA with musculoskeletal comorbidities, such as low back pain and OA of the non-operated hip, have less long term functional improvement after THR.
Health-related quality of life measurement in women with polycystic ovary syndrome: a systematic review
Authors: G.L. Jones, J.M. Hall, A.H. Balen, W.L. Ledger
Journal: Human Reproduction Update (2007)

The symptoms typically associated with polycystic ovary syndrome (PCOS) such as acne, hirsutism, irregular menses, amenorrhoea, obesity and subfertility are a major source of psychological morbidity and can negatively affect quality of life (QoL). We systematically searched the literature to identify the impact of symptoms and treatments for PCOS on health-related QoL (HRQoL) and to report on the types and psychometric properties of the instruments used. Papers were retrieved by systematically searching four electronic databases and hand searching relevant reference lists and bibliographies. Nineteen papers used a standardized questionnaire to measure health status; of these 12 (63.2%) used generic tools and 8 (42%) used the disease-specific PCOS questionnaire. Although a meta-analysis was not possible, it appears that weight concerns have a particular negative impact upon HRQoL, although the role of body mass index in affecting HRQoL scores is inconclusive from the available evidence. Acne is the area least reported upon in terms of its impact upon HRQoL. With the exception of three studies, most of the research has focused upon adult women with PCOS. Despite the benefits of HRQoL measures in research, few are being used to evaluate the outcomes of treatment for PCOS upon the subjective health status of women with the condition.
Chemoprevention of Prostate Cancer
Authors: Eric A. Klein
Journal: Annual Review of Medicine (2006)

Prostate cancer is an attractive target for chemoprevention because of its ubiquity, treatment-related morbidity, long latency between premalignant lesions and clinically evident cancer, and defined molecular pathogenesis. The Prostate Cancer Prevention Trial has provided the first firm evidence that this cancer can be prevented by a relatively nontoxic oral agent. Additional agents, many of which are antioxidants with antiandrogenic effects, are being tested (or soon will be) in large clinical trials. The current body of evidence is insufficient to make a routine recommendation of any dietary or nutritional supplement for the prevention of prostate cancer.