tbuckley/cabot-search huggingface dataset:
Aneurysm of the membranous ventricular septum in transposition of the great arteries.
Authors: B A Vidne, S Subramanian, H R Wagner
Journal: Circulation (1976)

In patients with transposition of the great arteries (TGA), both the D- and L- forms, an aneurysm of the membranous ventricular septum (AMS) produces subpulmonic stenosis due to the higher right ventricular pressure which forces the aneurysm to protrude into the left ventricular, i.e., subpulmonic, outflow tract. The clinical signs and symptoms, hemodynamic findings as well as surgical results were analyzed in eight patients with TGA and AMS. The presence of an AMS should be suspected from hemodynamic data consisting of a combination of elevated left ventricular pressure, gradient across the left ventricular outflow tract and presence of a small ventricular septal defect with or without pulmonary artery hypertension. The AMS can be demonstrated by a right ventricular injection in the lateral view. The anomaly needs to be corrected at the time of the Mustard procedure. If uncorrected it may lead to postoperative death or progressive obstruction. In the presence of an aneurysm even small ventricular septal defects should be closed by a patch and the aneurysm should be excised.
Survival from rare cancer in adults: a population-based study
Authors: Gemma Gatta, Laura Ciccolallo, Ian Kunkler, Riccardo Capocaccia, Franco Berrino, Michel P Coleman, Roberta De Angelis, Jean Faivre, Jean Michel Lutz, Carmen Martinez, Torgil Möller, Risto Sankila
Journal: The Lancet Oncology (2005)
Role of lipase in the regulation of postprandial gastric acid secretion and emptying of fat in humans: a study with orlistat, a highly specific lipase inhibitor
Authors: J Borovicka
Journal: Gut (2000)

<h3>BACKGROUND AND AIMS</h3> To investigate the importance of lipase on gastric functions, we studied the effects of orlistat, a potent and specific inhibitor of lipase, on postprandial gastric acidity and gastric emptying of fat. <h3>METHODS</h3> Fourteen healthy volunteers participated in a double blind, placebo controlled, randomised study. In a two way cross over study with two test periods of five days, separated by at least 14 days, orlistat 120 mg three times daily or placebo was given with standardised daily meals. In previous experiments we found that this dose almost completely inhibited postprandial duodenal lipase activity. Subjects underwent 28 hour intragastric pH-metry on day 4, and a gastric emptying study with a mixed meal (800 kcal) labelled with <sup>999m</sup>Tc sulphur colloid (solids) and <sup>111In</sup>thiocyanate (fat) on day 5. Gastric pH data were analysed for three postprandial hours and the interdigestive periods. <h3>RESULTS</h3> Orlistat inhibited almost completely (by 75%) lipase activity and accelerated gastric emptying of both the solid (by 52%) and fat (by 44%) phases of the mixed meal (p&lt;0.03). Orlistat increased postprandial gastric acidity (from a median pH of 3.3 to 2.7; p&lt;0.01). Postprandial cholecystokinin release was lower with orlistat (p&lt;0.03). <h3>CONCLUSION</h3> Lipase has an important role in the regulation of postprandial gastric acid secretion and fat emptying in humans. These effects might be explained by lipolysis induced release of cholecystokinin.
Comparative assessment of safety and efficacy of inhaled corticosteroids: report of a committee of the Canadian Thoracic Society
Authors: LP Boulet, DW Cockcroft, J Toogood, Y Lacasse, J Baskerville, FE Hargreave
Journal: European Respiratory Journal (1998)

Asthma is an inflammatory disease characterized by reversible airflow limitation and hyperresponsiveness [1].Inhaled corticosteroids (ICS) are considered the mainstay of asthma treatment [2,3].Their role in the treatment of asthma has been reviewed recently [4][5][6].Since the introduction of beclomethasone more than 25 yrs ago, new topical corticosteroids such as triamcinolone, flunisolide, budesonide and fluticasone have been introduced.Also, the patent on beclomethasone has expired in many countries, making the introduction of generic preparations possible.New modes of delivery of drugs have been developed, including different types of powder devices and spacers.New propellants, such as hydrofluoroalkanes (HFA), should shortly replace chlorofluorocarbons (CFC), eliminated for environmental reasons [7].Clinical efficacy may be assumed from pharmacological equivalence, but for therapeutic equivalence and systemic effects, it should, ideally, be demonstrated [8,9].Government agencies, industry and clinicians are, therefore, faced with the task of evaluating the comparative safety and efficacy of generic preparations, and different corticosteroids, delivery systems and aerosol formulations.As a result, the Canadian Thoracic Society, with the support of Health Canada, asked its Asthma Committee to perform this task.Two symposia were held, the first in Seattle in May 1995 (which included international experts) and the other in Toronto in December 1995.Another objective of the Committee was to suggest a model that could be tested through a National Study and, if data were insufficient to do this, determine what other studies should be conducted.This document summarizes these discussions and adds data from recent publications.
P49 Incidental pulmonary nodules; are we doing too many follow up scans? Service review and value of PET-CT imaging
Authors: Z Zaitout, A Zia, R Senasi, S Matthews
Journal: Thorax (2013)

<h3></h3> Incidental lung nodules are problematic. Their detection generates 2 years of CT scan follow-up, causing patient anxiety, immense cost and a high radiation burden. Few of these nodules are malignant. The 2005 Fleischner society guidelines are complex with no reference to the value of PET- CT imaging. The Sheffield Teaching Hospital Trust follows a modified Fleischner protocol where the majority of patients have 3 follow-up scans over 2 years. This study aimed to: Determine the final diagnosis of each nodule and the number of follow-up CT scans performed. Asses the value of PET-CT nodule imaging. Determine whether an experienced chest radiologist could predict which nodules were malignant/ benign by CT characteristics alone. Pulmonary nodules under review were extracted from the Trust lung cancer database. The final diagnoses were determined after 2 + years of follow up. An experienced chest radiologist reviewed all the nodules, recording their impression of whether the nodules were benign/ malignant. 162 nodules in 140 patients were analysed. Six patients were excluded as no follow up data. 148\156 nodules were benign (95%), 7 malignant and one presumed malignant (had inadequate follow-up). The 140 patients had 427 scans follow-up CT scans (mean 2.7, mode 3). 47 patients had fewer scans than required by protocol due to eg nodule resolution (9), recommendation to stop follow-up on CT report (13) and diagnosis of other disease (11). 20/22 patients had 4 + follow-up scans due to shortened time interval between scans. 35 patients had PET CT scan. 28/29 nodules with low FDG uptake were morphologically benign and stable at 2 years. 1 “cold” nodule with malignant morphology was resected (adenocarcinoma). The analysis of lung nodules by experienced chest radiologist found NPV 97.6%, PPV 15%, specificity 81% and sensitivity 62.5%. <h3>Comment</h3> The vast majority of lung nodules followed-up were benign. Better use of CT nodule morphology and review by an experienced chest radiologist is advised. We recommend that patients with a “cold”, morphologically benign, nodule on PET-CT scan should have a single 12 month CT scan to confirm stability. <h3>References</h3> H MacMahon, <i>et al. Radiology</i> 2005;237:395–400.
Two kinds of representational functionalism: Defusing the combinatorial explosion
Authors: Joel Pust
Journal: Behavioral and Brain Sciences (1995)

Abstract Alvin Goldman (1993) presents three arguments against the psychological plausibility of representational functionalism (RF) as a theory of how subjects self-ascribe mental predicates. Goldman appears to construe RF as an account of attitude type self-ascription. His “combinatorial explosion” argument, however, proves devastating only to an implausible construal of RF as an account of attitude content self-ascription.
A comparison of the effects of vasodilator stimuli on peripheral resistance vessels in normal subjects and in patients with congestive heart failure
Authors: Robert Zelis, Dean T. Mason, Eugene Braunwald
Journal: Journal of Clinical Investigation (1968)

The objective of this investigation was to characterize the mechanism of peripheral vasoconstriction observed in heart failure and to determine whether it can be attributed to the augmented sympathetic nervous activity, characteristic of this state. The response of the resistance bed in the forearm after release of inflow occlusion (reactive hyperemia), to hand exercise, and to local heating and the response of the calf resistance vessels to arterial occlusion and intra-arterial sodium nitrite and phentolamine were studied in 23 patients with congestive heart failure and 21 normal subjects. In the normal subjects, reactive hyperemia blood flow after varying periods of arterial occlusion greatly exceeded the values observed in patients with heart failure. Local anesthetic blockade and intra-arterial phentolamine did not significantly alter the reactive hyperemia response in heart failure patients, militating against the possibility that increased sympathetic vasoconstrictor activity is responsible for the reduction of this response. Following compensation, the reactive hyperemia response returned toward normal. The striking elevations of the forearm blood flow observed after hand exercise and heating of the forearm in normal subjects were also markedly attenuated in patients with heart failure. Following intra-arterial phentolamine and/or sodium nitrite, peak calf blood flow was still significantly reduced in heart failure. These observations indicate that (1) heart failure is characterized by a striking reduction in the response to a variety of endogenous and exogenous vasodilator stimuli; (2) circulating catecholamines and sympathetic vasoconstrictor activity are not solely responsible for the elevation of peripheral vascular resistance and the reduced response to vasodilator stimuli in heart failure; and (3) heart failure may increase systemic vascular resistance directly by altering the mechanical properties and reducing the dilating ability of the resistance vessels.
Recurrent 'sterile' verrucous cyst abscesses and epidermodysplasia verruciformis-like eruption associated with idiopathic CD4 lymphopenia
Authors: E. Tobin, A. Rohwedder, S.M. Holland, B. Philips, J.A. Carlson
Journal: British Journal of Dermatology (2003)

Journal Article Recurrent 'sterile' verrucous cyst abscesses and epidermodysplasia verruciformis‐like eruption associated with idiopathic CD4 lymphopenia Get access E. Tobin, E. Tobin Upstate Infectious Disease, 567 New Scotland Ave., Albany, NY 12208, U.S.A Search for other works by this author on: Oxford Academic Google Scholar A. Rohwedder, A. Rohwedder Department of Microbiology and Virology, Ruhr‐University Bochum, 44801 Bochum, Germany Search for other works by this author on: Oxford Academic Google Scholar S.M. Holland, S.M. Holland Immunopathogenesis Unit, Clinical Pathophysiology Section, Laboratory of Host Defenses, NIAID, NIH, Building 10, Room 11N103, 10 Center Dr. MSC 1886, Bethesda, MD 20892‐1886, U.S.A Search for other works by this author on: Oxford Academic Google Scholar B. Philips, B. Philips Divisions of Dermatology and Dermatopathology, Albany Medical College MC‐81, Albany, NY 12208, U.S.A Search for other works by this author on: Oxford Academic Google Scholar J.A. Carlson J.A. Carlson Divisions of Dermatology and Dermatopathology, Albany Medical College MC‐81, Albany, NY 12208, U.S.A J.Andrew Carlson. E‐mail: carlsoa@mail.amc.edu Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 149, Issue 3, 1 September 2003, Pages 627–633, https://doi.org/10.1046/j.1365-2133.2003.05543.x Published: 01 September 2003 Article history Accepted: 04 April 2003 Published: 01 September 2003
Lung Parenchyma Remodeling in a Murine Model of Chronic Allergic Inflammation
Authors: Debora G. Xisto, Luciana L. Farias, Halina C. Ferreira, Miguel R. Picanço, Daniel Amitrano, Jose R. Lapa e Silva, Elnara M. Negri, Thais Mauad, Denise Carnielli, Luiz Fernando F. Silva, Vera L. Capelozzi, Debora S. Faffe, Walter A. Zin, Patricia R. M. Rocco
Journal: American Journal of Respiratory and Critical Care Medicine (2005)

This study tested the hypotheses that chronic allergic inflammation induces not only bronchial but also lung parenchyma remodeling, and that these histologic changes are associated with concurrent changes in respiratory mechanics. For this purpose, airway and lung parenchyma remodeling were evaluated by quantitative analysis of collagen and elastin, immunohistochemistry (smooth-muscle actin expression, eosinophil, and dendritic cell densities), and electron microscopy. In vivo (airway resistance, viscoelastic pressure, and static elastance) and in vitro (tissue elastance, resistance, and hysteresivity) respiratory mechanics were also analyzed. BALB/c mice were sensitized with ovalbumin and exposed to repeated ovalbumin challenges. A marked eosinophilic infiltration was seen in lung parenchyma and in large and distal airways. Neutrophils, lymphocytes, and dendritic cells also infiltrated the lungs. There was subepithelial fibrosis, myocyte hypertrophy and hyperplasia, elastic fiber fragmentation, and increased numbers of myofibroblasts in airways and lung parenchyma. Collagen fiber content was increased in the alveolar walls. The volume proportion of smooth muscle–specific actin was augmented in distal airways and alveolar duct walls. Airway resistance, viscoelastic pressure, static elastance, and tissue elastance and resistance were significantly increased. In conclusion, prolonged allergen exposure induced remodeling not only of the airway wall but also of the lung parenchyma, leading to in vivo and in vitro mechanical changes.
Insulin, Insulin Resistance, and Platelet Signaling in Diabetes
Authors: Voahanginirina Randriamboavonjy, Ingrid Fleming
Journal: Diabetes Care (2009)

Insulin resistance and the metabolic syndrome are associated with a prothrombotic state that contributes to the pathogenesis and progression of the vascular complications of type 2 diabetes. Development of the disease is also linked to the loss of the direct antiplatelet effect of insulin and platelets obtained from patients with diabetes who are hyperreactive (i.e., demonstrate increased adhesiveness and exaggerated aggregation and thrombus generation). Conditions linked to insulin resistance and development of type 2 diabetes are generally associated with redox stress within the vasculature that, in turn, affects platelet function. There are numerous platelet signaling events that are sensitive to changes in the vascular balance of nitric oxide (NO) and oxygen-derived free radical generation; however, recent studies have highlighted the link among platelet hyperreactivity and oxidative modifications in Ca2+-ATPase activity and Ca2+ homeostasis, altered surface expression of glycoprotein receptors and adhesive proteins on the platelet surface, and increased binding of fibrinogen (rev. in (1).

### Effects of insulin on platelet function

A direct antiplatelet effect of insulin has been demonstrated by many groups; although we and others have observed an insulin-induced attenuation of the thrombin-induced Ca2+ response and platelet aggregation as well as the release of ADP (2,3), reports from groups assessing the same responses are inconsistent. Part of the controversy may be attributed to the fact that responses to insulin are highly heterogeneous; indeed, clear populations of “responders” and “nonresponders” have been identified in several studies (3,4) and can be related to numerous factors including physical condition (5).

Studies in which an effect of insulin has been documented and that were aimed at addressing the molecular mechanisms that underlie the antiaggregatory effects of insulin have not yet managed to completely clarify the events involved. Thus, although insulin has been reported to stimulate the AMP-activated protein kinase …
German Adjuvant Intergroup Node-Positive Study: A Phase III Trial to Compare Oral Ibandronate Versus Observation in Patients With High-Risk Early Breast Cancer
Authors: Gunter von Minckwitz, Volker Möbus, Andreas Schneeweiss, Jens Huober, Christoph Thomssen, Michael Untch, Christian Jackisch, Ingo J. Diel, Dirk Elling, Bettina Conrad, Rolf Kreienberg, Volkmar Müller, Hans-Joachim Lück, Ingo Bauerfeind, Michael Clemens, Marcus Schmidt, Stefanie Noeding, Helmut Forstbauer, Jana Barinoff, Antje Belau, Valentina Nekljudova, Nadia Harbeck, Sibylle Loibl
Journal: Journal of Clinical Oncology (2013)

Purpose Bisphosphonates prevent skeletal-related events in patients with metastatic breast cancer. Their effect in early breast cancer is controversial. Ibandronate is an orally and intravenously available amino-bisphosphonate with a favorable toxicity profile. It therefore qualifies as potential agent for adjuvant use. Patients and Methods The GAIN (German Adjuvant Intergroup Node-Positive) study was an open-label, randomized, controlled phase III trial with a 2 × 2 factorial design. Patients with node-positive early breast cancer were randomly assigned 1:1 to two different dose-dense chemotherapy regimens and 2:1 to ibandronate 50 mg per day orally for 2 years or observation. In all, 2,640 patients and 728 events were estimated to be required to demonstrate an increase in disease-free survival (DFS) by ibandronate from 75% to 79.5% by using a two-sided α = .05 and 1-β of 80%. We report here the efficacy analysis for ibandronate, which was released by the independent data monitoring committee because the futility boundary was not crossed after 50% of the required DFS events were observed. Results Between June 2004 and August 2008, 2,015 patients were randomly assigned to ibandronate and 1,008 to observation. Patients randomly assigned to ibandronate showed no superior DFS or overall survival (OS) compared with patients randomly assigned to observation (DFS: hazard ratio, 0.945; 95% CI, 0.768 to 1.161; P = .589; OS: HR, 1.040; 95% CI, 0.763 to 1.419; P = .803). DFS was numerically longer if ibandronate was used in patients younger than 40 years or older than 60 years compared with patients age 40 to 59 years (test for interaction P = .093). Conclusion Adjuvant treatment with oral ibandronate did not improve outcome of patients with high-risk early breast cancer who received dose-dense chemotherapy.
British guidelines on the management of asthma: what's new for 2011?
Authors: S. Turner, J. Paton, B. Higgins, G. Douglas
Journal: Thorax (2011)

Since 1999 the British Guidelines on the Management of Asthma have been produced jointly by the British Thoracic Society (BTS) and Scottish Intercollegiate Guideline Network (SIGN) using a rigorous evidence-based methodology.Sections within the guideline have been revised regularly, with the Pharmacological Management section being updated nearly every year.We believe this has resulted in a 'living guideline' that is responsive to new research and is current for clinicians.For 2011, two new sections have been added on Monitoring and Control and Asthma in Adolescents.
Abstract 829: Reduction in Macrophage Lipid Burden by Transgenic Expression of Human Macrophage Cholesteryl Ester Hydrolase Significantly Attenuates Inflammation in LDLR / mice
Authors: Bin Zhao, Jingmei Song, Shobha Ghosh
Journal: Circulation (2007)

Under hypercholesterolemic conditions, accumulation of intracellular cholesteryl esters (CE) in macrophages leads to the formation of foam cells that secrete high levels of pro-inflammatory mediato...
Beat-to-beat changes in atrioventricular nodal excitability and its modulation by concealed conduction during functional 2:1 block in man.
Authors: R T Steinman, M H Lehmann
Journal: Circulation (1987)

An atrial pacing model of functional 2:1 block was used in 10 patients to investigate for the first time the electrophysiologic properties of the human atrioventricular node during intermittent conduction. By varying the terminal portion of the 2:1 atrial train and using the extrastimulus technique, we characterized atrioventricular nodal (AVN) conduction and refractoriness after five different methods of AVN activation: a conducted beat (method I), a conducted beat with omission of the prior blocked beat (method II), a blocked beat (method III), a blocked beat "converted" to one that conducts by omission of the prior conducted beat (method IV), and finally, 1:1 conduction at twice the cycle length of the 2:1 train (control method V). Observed AVN conduction times obeyed the following relationship: method I greater than method II greater than method V, indicating a cumulative effect of concealed penetration by the blocked beats. During 2:1 block, the AVN effective refractory period (ERP) alternated with a mean beat-to-beat difference of at least 100 msec, due mostly to marked ERP abbreviation during AVN activation by method III (vs both 2:1 train cycle length and activation by method V). Concealed penetration by the blocked beat prolonged AVN ERP for the propagated beat (vs that with methods II and V), but to a lesser extent than conduction time was increased. Moreover, the AVN recovery curve with method I was displaced upward and to the right compared with that with methods II to V.(ABSTRACT TRUNCATED AT 250 WORDS)
Decline in Treatment of Pediatric Depression After FDA Advisory on Risk of Suicidality With SSRIs
Authors: Anne M Libby, David A Brent, Elaine H Morrato, Heather D Orton, Richard Allen, Robert J Valuck
Journal: American Journal of Psychiatry (2007)

Objective: In October 2003, the U.S. Food and Drug Administration (FDA) issued a public health advisory about the risk of suicidality in pediatric patients taking selective serotonin reuptake inhibitors (SSRIs) for depression. This study used data from a large national pediatric cohort to examine patterns of diagnosis of depression, prescription of antidepressants, prescription of pharmacological alternatives to antidepressants, and use of psychosocial care before and after the FDA advisory was issued. Method: A large pediatric cohort with newly diagnosed episodes of depression was created from a national integrated claims database of managed care plans from October 1998 to September 2005 (N=65,349). Time-series models were used to compare diagnosing and prescribing trends during the 2 years after the FDA advisory and the expected trends based on data from the 5-year period preceding the advisory. Results: From 1999 to 2004, pediatric diagnoses of depression increased from 3 to 5 per 1,000. After the FDA advisory was issued, the national rate decreased to 1999 levels, a significant deviation from the historical trend. Pediatricians and nonpediatrician primary care physicians accounted for the largest reductions in new diagnoses. Among patients with depression, the proportion receiving no antidepressant increased to three times the rate predicted by the preadvisory trend, and SSRI prescription fills were 58% lower than predicted by the trend. There was no evidence of a significant increase in use of treatment alternatives (psychotherapy, atypical antipsychotics, and anxiolytics). Conclusions: The FDA advisory was associated with significant reductions in aggregate rates of diagnosis and treatment of pediatric depression.