tbuckley/cabot-search huggingface dataset:
A case of cough, lymphocytic bronchoalveolitis and coeliac disease with improvement following a gluten free diet
Authors: C E Brightling
Journal: Thorax (2002)

The aim of the study was to evaluate the possible changes in CD4<sup>+</sup> and CD8<sup>+</sup> T-cell cytokine production patterns in Hashimoto9s thyroiditis (HT) with elevated calcitonin (CT). Fourteen consecutive patients with verified HT were included in the present study. Patients were divided into two groups. Group I: 7 HT patients with elevated CT levels (&gt;10 pg/ml); Group II: 7 HT patients with CT levels &lt;10 pg/ml). All patients underwent intracellular cytokine detection in CD4<sup>+</sup> and CD8<sup>+</sup> T-cells of peripheral blood mononuclear cells (PBMC) by flow cytometry. Patients with elevated CT levels (group I) had significantly higher percentages of CD8<sup>+</sup> cells producing IFN-γ compared to healthy donors. A detailed analysis of cytokine production patterns revealed that this was accompanied by an increased frequency of single IFN-γ positive cells, i.e., cells not expressing most of the other cytokines tested. Similarly, patients in group I also showed higher percentages of CD8<sup>+</sup> TNF-α positive cells than healthy donors. In this case, cells co-expressing TNF-α and IFN-γ were found at significantly higher frequencies. No increase in Th1 type cytokines, such as IFN-γ or TNF-α, was detectable in CD4<sup>+</sup> T-cells. In contrast, CD4<sup>+</sup> T-cells from group I patients showed significantly higher percentages of cells producing Th2 cytokines, such as IL-4 or IL-13. The lack of increased Th1 cytokine production accompanied by an increased Th2 cytokine production seems to be a special feature of HT patients with elevated CT levels that may reflect a pathogenetic mechanism for tumor initiation.
PrLZ Is Expressed in Normal Prostate Development and in Human Prostate Cancer Progression
Authors: Ruoxiang Wang, Jianchun Xu, Nicola Mabjeesh, Guodong Zhu, Jianguang Zhou, Mahul Amin, Dalin He, Fray F. Marshall, Haiyen E. Zhau, Leland W.K. Chung
Journal: Clinical Cancer Research (2007)

Abstract Purpose: We previously reported the isolation and characterization of PrLZ, a novel prostate-specific and androgen-responsive gene of the tumor protein D52 family at chromosome 8q21.1. PrLZ is the only known gene in this locus with prostate specificity. Expression level of PrLZ was elevated specifically in cancer cells, suggesting its association with malignancy. Experimental Design: To define its biological function in the morphogenesis, development, and functional maturation of the prostate gland and to gain further insight into its role in prostate cancer, we examined PrLZ expression in prostate specimens during early embryonic development and in adult tissue. Results: PrLZ first appears in the nuclei of the prostate epithelia at 16 weeks of gestation before its distribution in the cytoplasm at later ages. Its expression peaks at 24 years of age, declines at 31 years of age, and maintains a minimal level in later age. On prostate cancer development, PrLZ expression is reactivated, and its expression increases from primary localized tumor to bone metastasis. Overexpression of PrLZ in prostate cancer cells accelerates their growth in vitro and tumor formation in vivo. Conclusion: This work identifies PrLZ as a marker for prostate cancer progression and metastasis, and its pattern of expression is suggestive of a proto-oncogene.
Clinical Results of Long-Term Follow-Up of a Large, Active Surveillance Cohort With Localized Prostate Cancer
Authors: Laurence Klotz, Liying Zhang, Adam Lam, Robert Nam, Alexandre Mamedov, Andrew Loblaw
Journal: Journal of Clinical Oncology (2009)

Purpose We assessed the outcome of a watchful-waiting protocol with selective delayed intervention by using clinical prostate-specific antigen (PSA), or histologic progression as treatment indications for clinically localized prostate cancer. Patients and Methods This was a prospective, single-arm, cohort study. Patients were managed with an initial expectant approach. Definitive intervention was offered to those patients with a PSA doubling time of less than 3 years, Gleason score progression (to 4 + 3 or greater), or unequivocal clinical progression. Survival analysis and Cox proportional hazard model were applied to the data. Results A total of 450 patients have been observed with active surveillance. Median follow-up was 6.8 years (range, 1 to 13 years). Overall survival was 78.6%. The 10-year prostate cancer actuarial survival was 97.2%. Overall, 30% of patients have been reclassified as higher risk and have been offered definitive therapy. Of 117 patients treated radically, the PSA failure rate was 50%, which was 13% of the total cohort. PSA doubling time of 3 years or less was associated with an 8.5-times higher risk of biochemical failure after definitive treatment compared with a doubling time of more than 3 years (P &lt; .0001). The hazard ratio for nonprostate cancer to prostate cancer mortality was 18.6 at 10 years. Conclusion We observed a low rate of prostate cancer mortality. Among the patients who were reclassified as higher risk and who were treated, PSA failure was relatively common. Other-cause mortality accounted for almost all of the deaths. Additional studies are warranted to improve the identification of patients who harbor more aggressive disease despite favorable clinical parameters at diagnosis.
Perinatal Transmission of HIV-1
Authors: Lowell Wood
Journal: JAMA (1996)

<h3>To the Editor.</h3> —The article by Dickover et al<sup>1</sup>reporting differential risks of vertical transmission of HIV-1 infection perinatally<sup>1</sup>begs questions in 3 distinct areas. The first concern is the antiviral therapeutic base for some of the conclusions. The dose-independent 1-hour serum half-life of zidovudine, following a peak concentration attained 0.5 to 1.5 hours after oral dosing, indicates that zidovudine should be given at least as frequently as the 4 times per day schedule recommended by the manufacturer and the Food and Drug Administration<sup>2</sup>in order to maintain serum trough levels adequate to suppress proviral DNA transcription by even zidovudine-sensitive strains of HIV-1. Were the mothers-to-be in the study adequately dosed in these respects, ie, was the specified 500-mg total daily dose divided adequately and properly spaced in time? What objective verification was made, eg, by serum analysis, of patient compliance with the prescribed dosing, particularly during the last few
Respiratory Symptoms, Sensitization, and Exposure–Response Relationships in Spray Painters Exposed to Isocyanates
Authors: Anjoeka Pronk, Liesbeth Preller, Monika Raulf-Heimsoth, Irene C. L. Jonkers, Jan-Willem Lammers, Inge M. Wouters, Gert Doekes, Adam V. Wisnewski, Dick Heederik
Journal: American Journal of Respiratory and Critical Care Medicine (2007)

Rationale: Associations between oligomeric isocyanate exposure, sensitization, and respiratory disease have received little attention, despite the extensive use of isocyanate oligomers.Objectives: To investigate exposure–response relationships of respiratory symptoms and sensitization in a large population occupationally exposed to isocyanate oligomers during spray painting.Methods: The prevalence of respiratory symptoms and sensitization was assessed in 581 workers in the spray-painting industry. Personal exposure was estimated by combining personal task-based inhalatory exposure measurements and time activity information. Specific IgE and IgG to hexamethylene diisocyanate (HDI) were assessed in serum by ImmunoCAP assay and enzyme immunoassays using vapor and liquid phase HDI–human serum albumin (HDI–HSA) and HSA conjugates prepared with oligomeric HDI.Measurements and Main Results: Respiratory symptoms were more prevalent in exposed workers than among comparison office workers. Log–linear exposure–response associations were found for asthmalike symptoms, chronic obstructive pulmonary disease–like symptoms, and work-related chest tightness (prevalence ratios for an interquartile range increase in exposure of 1.2, 1.3 and 2.0, respectively; P ⩽ 0.05). The prevalence of specific IgE sensitization was low (up to 4.2% in spray painters). Nevertheless, IgE to N100 (oligomeric HDI)–HSA was associated with exposure and work-related chest tightness. The prevalence of specific IgG was higher (2–50.4%) and strongly associated with exposure.Conclusions: The results provide evidence of exposure–response relationships for both work-related and non–work-related respiratory symptoms and specific sensitization in a population exposed to oligomers of HDI. Specific IgE was found in only a minority of symptomatic individuals. Specific IgG seems to be merely an indicator of exposure.
PTU-177 Reduction in length of stay for patients undergoing major upper gastrointestinal resections with implementation of enhanced recovery packages
Authors: E Gemmill, J Tang, D Humes, P Daliya, N Welch, S Parsons, J Catton
Journal: Gut (2012)

<h3>Introduction</h3> The high mortality and morbidity associated with resection for gastro-oesophageal malignancy has resulted in a conservative approach to the post-operative management of this patient group. In August 2009 an Enhanced Recovery After Surgery (ERAS) pathway tailored for patients undergoing resection for gastro-oesophageal malignancy was introduced. We aimed to assess the impact of this change in practice on standard clinical outcomes. <h3>Methods</h3> We performed a retrospective review of two cohorts of patients undergoing resection for gastro-oesophageal malignancy before (08/08–07/09) and after (08/09–07/10) the implementation of the ERAS pathway. Data were collected on demographics, interventions, length of stay, morbidity and in hospital mortality. <h3>Results</h3> There were 53 and 55 gastro-oesophageal resections undertaken in each year for malignant disease. The median length of stay for both gastric and oesophageal resection decreased from 15 to 11 days (p&lt;0.001) following the implementation of the ERAS pathway. There was no increase in morbidity (gastric resection 23.1% vs 5.3% and oesophageal resection 25.9% vs 16.7%) or mortality (gastric resection no deaths and oesophageal resection 1.8% vs 3.6%) associated with the changes. There was a significant decrease in the number of oral contrast studies used following oesophageal resection with a reduction from 21 (77.8%) in 2008–2009 to 6 (16.7%) in 2009–2010 (χ<sup>2</sup>, p&lt;0.0001). <h3>Conclusion</h3> The introduction of an enhanced recovery programme following gastro-oesophageal surgery resulted in a significant decrease in length of median patient stay in hospital without a significant increase in associated morbidity and mortality. <h3>Competing interests</h3> None declared.
Early Identification of Patients at Risk for Difficult Intubation in the Intensive Care Unit
Authors: Audrey De Jong, Nicolas Molinari, Nicolas Terzi, Nicolas Mongardon, Jean-Michel Arnal, Christophe Guitton, Bernard Allaouchiche, Catherine Paugam-Burtz, Jean-Michel Constantin, Jean-Yves Lefrant, Marc Leone, Laurent Papazian, Karim Asehnoune, Nicolas Maziers, Elie Azoulay, Gael Pradel, Boris Jung, Samir Jaber
Journal: American Journal of Respiratory and Critical Care Medicine (2013)

Difficult intubation in the intensive care unit (ICU) is a challenging issue.To develop and validate a simplified score for identifying patients with difficult intubation in the ICU and to report related complications.Data collected in a prospective multicenter study from 1,000 consecutive intubations from 42 ICUs were used to develop a simplified score of difficult intubation, which was then validated externally in 400 consecutive intubation procedures from 18 other ICUs and internally by bootstrap on 1,000 iterations.In multivariate analysis, the main predictors of difficult intubation (incidence = 11.3%) were related to patient (Mallampati score III or IV, obstructive sleep apnea syndrome, reduced mobility of cervical spine, limited mouth opening); pathology (severe hypoxia, coma); and operator (nonanesthesiologist). From the β parameter, a seven-item simplified score (MACOCHA score) was built, with an area under the curve (AUC) of 0.89 (95% confidence interval [CI], 0.85-0.94). In the validation cohort (prevalence of difficult intubation = 8%), the AUC was 0.86 (95% CI, 0.76-0.96), with a sensitivity of 73%, a specificity of 89%, a negative predictive value of 98%, and a positive predictive value of 36%. After internal validation by bootstrap, the AUC was 0.89 (95% CI, 0.86-0.93). Severe life-threatening events (severe hypoxia, collapse, cardiac arrest, or death) occurred in 38% of the 1,000 cases. Patients with difficult intubation (n = 113) had significantly higher severe life-threatening complications than those who had a nondifficult intubation (51% vs. 36%; P < 0.0001).Difficult intubation in the ICU is strongly associated with severe life-threatening complications. A simple score including seven clinical items discriminates difficult and nondifficult intubation in the ICU. Clinical trial registered with www.clinicaltrials.gov (NCT 01532063).
Ranolazine Improves Cardiac Diastolic Dysfunction Through Modulation of Myofilament Calcium Sensitivity
Authors: Joshua D. Lovelock, Michelle M. Monasky, Euy-Myoung Jeong, Harvey A. Lardin, Hong Liu, Bindiya G. Patel, Domenico M. Taglieri, Lianzhi Gu, Praveen Kumar, Narayan Pokhrel, Dewan Zeng, Luiz Belardinelli, Dan Sorescu, R. John Solaro, Samuel C. Dudley
Journal: Circulation Research (2012)

Rationale: Previously, we demonstrated that a deoxycorticosterone acetate (DOCA)-salt hypertensive mouse model produces cardiac oxidative stress and diastolic dysfunction with preserved systolic function. Oxidative stress has been shown to increase late inward sodium current (I Na ), reducing the net cytosolic Ca 2+ efflux. Objective: Oxidative stress in the DOCA-salt model may increase late I Na , resulting in diastolic dysfunction amenable to treatment with ranolazine. Methods and Results: Echocardiography detected evidence of diastolic dysfunction in hypertensive mice that improved after treatment with ranolazine (E/E′:sham, 31.9±2.8, sham+ranolazine, 30.2±1.9, DOCA-salt, 41.8±2.6, and DOCA-salt+ranolazine, 31.9±2.6; P =0.018). The end-diastolic pressure-volume relationship slope was elevated in DOCA-salt mice, improving to sham levels with treatment (sham, 0.16±0.01 versus sham+ranolazine, 0.18±0.01 versus DOCA-salt, 0.23±0.2 versus DOCA-salt+ranolazine, 0.17±0.0 1 mm Hg/L; P &lt;0.005). DOCA-salt myocytes demonstrated impaired relaxation, τ, improving with ranolazine (DOCA-salt, 0.18±0.02, DOCA-salt+ranolazine, 0.13±0.01, sham, 0.11±0.01, sham+ranolazine, 0.09±0.02 seconds; P =0.0004). Neither late I Na nor the Ca 2+ transients were different from sham myocytes. Detergent extracted fiber bundles from DOCA-salt hearts demonstrated increased myofilament response to Ca 2+ with glutathionylation of myosin binding protein C. Treatment with ranolazine ameliorated the Ca 2+ response and cross-bridge kinetics. Conclusions: Diastolic dysfunction could be reversed by ranolazine, probably resulting from a direct effect on myofilaments, indicating that cardiac oxidative stress may mediate diastolic dysfunction through altering the contractile apparatus.
Increased Mortality Associated With Digoxin in Contemporary Patients With Atrial Fibrillation
Authors: Mintu P. Turakhia, Pasquale Santangeli, Wolfgang C. Winkelmayer, Xiangyan Xu, Aditya J. Ullal, Claire T. Than, Susan Schmitt, Tyson H. Holmes, Susan M. Frayne, Ciaran S. Phibbs, Felix Yang, Donald D. Hoang, P. Michael Ho, Paul A. Heidenreich
Journal: Journal of the American College of Cardiology (2014)
Sahaja yoga in the management of moderate to severe asthma: a randomised controlled trial
Authors: R Manocha
Journal: Thorax (2002)

Background: Sahaja Yoga is a traditional system of meditation based on yogic principles which may be used for therapeutic purposes. A study was undertaken to assess the effectiveness of this therapy as an adjunctive tool in the management of asthma in adult patients who remained symptomatic on moderate to high doses of inhaled steroids. Methods: A parallel group, double blind, randomised controlled trial was conducted. Subjects were randomly allocated to Sahaja yoga and control intervention groups. Both the yoga and the control interventions required the subjects to attend a 2 hour session once a week for 4 months. Asthma related quality of life (AQLQ, range 0–4), Profile of Mood States (POMS), level of airway hyperresponsiveness to methacholine (AHR), and a diary card based combined asthma score (CAS, range 0–12) reflecting symptoms, bronchodilator usage, and peak expiratory flow rates were measured at the end of the treatment period and again 2 months later. Results: Twenty one of 30 subjects randomised to the yoga intervention and 26 of 29 subjects randomised to the control group were available for assessment at the end of treatment. The improvement in AHR at the end of treatment was 1.5 doubling doses (95% confidence interval (CI) 0.0 to 2.9, p=0.047) greater in the yoga intervention group than in the control group. Differences in AQLQ score (0.41, 95% CI –0.04 to 0.86) and CAS (0.9, 95% CI –0.9 to 2.7) were not significant (p&gt;0.05). The AQLQ mood subscale did improve more in the yoga group than in the control group (difference 0.63, 95% CI 0.06 to 1.20), as did the summary POMS score (difference 18.4, 95% CI 0.2 to 36.5, p=0.05). There were no significant differences between the two groups at the 2 month follow up assessment. Conclusions: This randomised controlled trial has shown that the practice of Sahaja yoga does have limited beneficial effects on some objective and subjective measures of the impact of asthma. Further work is required to understand the mechanism underlying the observed effects and to establish whether elements of this intervention may be clinically valuable in patients with severe asthma.
Plasma thrombopoietin compared with immunoglobulin heavy-chain mutation status as a predictor of survival in chronic lymphocytic leukemia
Authors: Charles Koller, B. Nebiyou Bekele, Xian Zhou, Charles Park, Zeev Estrov, Susan O'Brien, Michael Keating, Iman Jilani, Francis J. Giles, Hagop M. Kantarjian, Maher Albitar
Journal: Blood (2006)
Vasodilator and constrictor actions of platelet-activating factor in the isolated microperfused afferent arteriole of the rabbit kidney. Role of endothelium-derived relaxing factor/nitric oxide and cyclooxygenase products.
Authors: L A Juncos, Y L Ren, S Arima, S Ito
Journal: Journal of Clinical Investigation (1993)

It has been suggested that platelet-activating factor (PAF) plays a prominent role in the control of glomerular hemodynamics in various physiological and pathological conditions. We examined the direct effect of PAF on rabbit glomerular afferent arterioles (Af-Arts) microperfused in vitro and tested whether endothelium-derived relaxing factor/nitric oxide (EDNO) and cyclooxygenase products are involved in its actions. In nanomolar concentrations PAF caused dose-dependent constriction of Af-Arts, with the maximum constriction being 34 +/- 10% at 4 x 10(-8) M (n = 9, P < 0.001). The constriction was blunted by cyclooxygenase inhibition (11 +/- 6%, n = 7, P < 0.05) but augmented by EDNO inhibition (76 +/- 14%, n = 8, P < 0.005). To study a possible vasodilator effect of PAF, Af-Arts were preconstricted with norepinephrine and increasing concentrations of PAF added to the lumen. At picomolar concentrations (lower than those that caused constriction), PAF produced dose-dependent vasodilation that was unaffected by cyclooxygenase inhibition but was abolished by EDNO synthesis inhibition. Both PAF-induced constriction and dilation of Af-Arts were blocked by a PAF receptor antagonist. This study demonstrates that PAF has a receptor-mediated biphasic effect on rabbit Af-Arts, dilating them at low concentrations while constricting them at higher concentrations. Our results suggest that PAF's vasodilator action may be due to production of EDNO, while its constrictor action is mediated at least in part through cyclooxygenase products.
Results of myocardial revascularization: a 12-year experience.
Authors: D M Cosgrove, F D Loop, W C Sheldon
Journal: Circulation (1982)

All 740 patients who underwent isolated myocardial revascularization procedures from 1967 to 1970 at our institution were compared with the first 1000 patients who underwent similar elective operations each from 1971 to 1979. Data from these 9 years were processed through a computerized cardiovascular information registry. In the 1971-1979 period, the patients were older (median age 57 years, compared with 50 years in the 1967-1970 period), more had multivessel disease (90% vs 44%) and more had ventricular asynergy (54% vs 41%). The number of grafts per patient increased from 1.5 to 2.7, and yet morbidity declined in every category except neurologic deficit. The operative mortality rate was 1.1% from 1967 to 1979 and 1.0% from 1971 to 1979. Graft patency was determined in 475 patients from 1967 to 1970, in 533 patients from 1971, in 519 from 1972, in 540 from 1973 and in 408 from 1974. Patency rates after a mean catheterization interval of 21 months were 77%, 77%, 84%, 87% and 87%, respectively. Five- and 10-year follow-ups were completed for the 1967-1970 series and a 5-year follow-up was completed for 1971, 1972, 1973 and 1974 cohorts. The 5- and 10-year actuarial survival rates for the 1967-1970 series were 89.4% and 77.3%, respectively. The 5-year survival rates for the 1971-1974 series were 91.9%, 93.4%, 92.1% and 91.7%. Abnormal ventricular function and incomplete revascularization adversely influenced the mortality rate (p less than 0.05) in all years. The percentage of asymptomatic patients at 5 years was 66%, 65%, 69%, 67% and 74% for the five patient cohorts. Lower risk and a higher 5-year survival rate are attributable to greater technical experience, changing technology and improved management rather than to selection of lower-risk cases. These 5- and 10-year survival rates compare favorably with the reported results of medical therapy.