tbuckley/cabot-search huggingface dataset:
Predictive Value of 16-Slice Multidetector Spiral Computed Tomography to Detect Significant Obstructive Coronary Artery Disease in Patients at High Risk for Coronary Artery Disease
Authors: Udo Hoffmann, Fabian Moselewski, Ricardo C. Cury, Maros Ferencik, Ik-kyung Jang, Larry J. Diaz, Suhny Abbara, Thomas J. Brady, Stephan Achenbach
Journal: Circulation (2004)

In this study, we investigated the diagnostic value and limitations of multidetector computed tomography (MDCT)-based noninvasive detection of significant obstructive coronary artery disease (CAD) in a consecutive high-risk patient population with inclusion of all coronary segments.In a prospective, blinded, standard cross-sectional technology assessment, a cohort of 33 consecutive patients with a positive stress test result underwent 16-slice MDCT and selective coronary angiography for the detection of significant obstructive CAD. We assessed the diagnostic accuracy of MDCT in a segment-based and a patient-based model and determined the impact of stenosis location and the presence of calcification on diagnostic accuracy in both models. Analysis of all 530 coronary segments demonstrated moderate sensitivity (63%) and excellent specificity (96%) with a moderate positive predictive value of 64% and an excellent negative predictive value (NPV) of 96% for the detection of significant coronary stenoses. Assessment restricted to either proximal coronary segments or segments with excellent image quality (83% of all segments) led to an increase in sensitivity (70% and 82%, respectively), and high specificities were maintained (94% and 93%, respectively). In a patient-based model, the NPV of MDCT for significant CAD was limited to 75%. Coronary calcification was the major cause of false-positive findings (94%).For all coronary segments included, 16-slice MDCT has moderate diagnostic value for the detection of significant obstructive coronary artery stenosis in a population with a high prevalence of CAD. The moderate NPV of patient-based detection of CAD suggests a limited impact on clinical decision-making in high-risk populations.
Retrospective analysis of evidence base for tests used in diagnosis and monitoring of disease in respiratory medicine
Authors: Z Borrill
Journal: BMJ (2003)

<h3>Abstract</h3> <b>Objectives</b> To determine how many common clinical tests used in a respiratory medicine outpatient clinic are based on high quality evidence. <b>Design</b> Retrospective review of case notes. Record of first three tests for each patient. Diagnostic tests, tests used to assess existing condition, explicit trials of therapy were included. Literature search for supporting evidence and grading of best evidence for each test. <b>Setting</b> Inner city university teaching hospital in the United Kingdom. <b>Participants</b> All new outpatients referred to a single respiratory medicine team over a period of three months. <b>Main outcome measures</b> Proportion of tests supported by level 1a-1c evidence (scale developed by Centre for Evidence Based Medicine). <b>Results</b> Only half the tests that were used to make or exclude a diagnosis and a fifth of the tests used to assess a known condition were supported by level 1a-1c evidence. There was no evidence to support trials of therapy. <b>Conclusions</b> A large proportion of clinical tests in respiratory medicine are not supported by level 1a-1c evidence. None of the therapeutic trials that were used were supported by evidence.
Effects of debulking before intracoronary beta-radiation therapy for diffuse in-stent restenosis
Authors: Seong-Wook Park, Myeong-Ki Hong, None Dae Hyuk Moon, None Seung Jun Oh, None Cheol Whan Lee, Jae-Joong Kim, Seung-Jung Park
Journal: Journal of the American College of Cardiology (2002)
On the Distinction Between Social Roles and Social Types, with Special Reference to the Hippie
Authors: THEODORE R. SARBIN
Journal: American Journal of Psychiatry (1969)

Social, or folk, typing can be used to identify individuals who occupy relatively undifferentiated social positions and thus cannot be adequately distinguished from other members of a collectivity by means of role characteristics. The author discusses the hippie as a folk type resembling that of the early gnostics and offers some speculations, based upon observations of the fate of similar historical groups, about the ultimate destiny of the hippie type.
Pressures in Cat Mesenteric Arterioles and Capillaries during Changes in Systemic Arterial Blood Pressure
Authors: ROBERT W. GORE
Journal: Circulation Research (1974)

An interpretive model of the myogenic autoregulatory response of cat mesenteric arterioles has appeared in the literature; it describes arteriolar dimensional changes during changes in mean systemic arterial blood pressure in terms of tension-radius diagrams (Laplace relationship). The original model assumes that arteriolar pressure is a simple, linear function of systemic blood pressure and that arteriolar pressure is always 40% of systemic blood pressure. The purpose of the present study was to test the validity of these assumptions. Using the isolated, autoperfused mesentery of 14 cats, direct, simultaneous measurements of diameter and pressure were made in microvessels during changes in systemic blood pressure. Diameters and micropressures were recorded with a video filar micrometer system and a servonull transducer, respectively. Control microvascular pressure, dimensional distributions, and stress distributions were established when systemic blood pressure was set at 100 ± 10 ( SD ) mm Hg. Three regions of the arteriolar vasculature were defined and identified for study in terms of these control states. Pressures in the arteriolar regions were a linear function of systemic blood pressure, thus confirming the validity of the previous assumption. Capillary pressures tended not to follow this pattern; pressure in five of eight capillaries sampled was relatively independent of changes in systemic blood pressure between 100 and 40 mm Hg. The apparent constancy of capillary pressure during changes in systemic blood pressure was examined in terms of the modular arrangement of mesenteric microvessels and resistance changes, and the question of physiological regulation of capillary pressure was considered. Data are presented to suggest that a constant capillary pressure in mesentery during changes in systemic blood pressure is primarily the consequence of the vascular geometry peculiar to this tissue.
Tissue Sources and Blood Flow Limitations of Osmotic Water Transport Across the Peritoneum
Authors: HAILU DEMISSACHEW, JOANNE LOFTHOUSE, MICHAEL F. FLESSNER
Journal: Journal of the American Society of Nephrology (1999)

Despite the daily use of hypertonic solutions to remove fluid from patients throughout the world who are undergoing peritoneal dialysis, the tissue sources of this water flow are unknown. To study this phenomenon in specific tissues, small plastic chambers were affixed to parietal and visceral surfaces of the peritoneum and were filled with either an isotonic or hypertonic solution. The volume changes over 60 to 90 min were determined and divided by the chamber area to yield the volume flux. The hypertonic solution produced a positive flux into the chamber of 0.6 to 1.1 microl/min per cm2 in all tissues tested. In contrast, the isotonic solution resulted in a net loss or an insignificant change in the chamber volume. Additional experiments tested the influence of blood flow on the hypertonic water flux during periods of control, reduced (50 to 80%), or postmortem (no) blood flow, as determined by laser Doppler flowmetry. With the exception of the liver, small but insignificant changes in the flux into the chamber were observed during the period of reduced flow; all water fluxes were markedly depressed during the postmortem period. It is concluded that both parietal and visceral tissues are sources of osmotically induced water flow into the cavity. Except for the liver, marked blood flow reductions have small but insignificant effects on osmotic water transport.
Enhanced Cellular Immune Response in Women With PTSD Related to Childhood Abuse
Authors: Margaret Altemus, Marylene Cloitre, Firdaus S Dhabhar
Journal: American Journal of Psychiatry (2003)

Disturbed regulation of both the hypothalamic-pituitary-adrenal (HPA) axis and the sympathoadrenomedullary system in posttraumatic stress disorder (PTSD) suggests that immune function, which is modulated by these systems, also may be dysregulated in individuals with PTSD.Delayed-type hypersensitivity skin test responses were measured in 16 women with PTSD due to childhood sexual or physical abuse and 15 women who did not have a history of abuse, other trauma, or psychiatric disorders. HPA axis activity was assessed by examination of circadian salivary cortisol levels and a single time point measurement of plasma cortisol.Delayed-type hypersensitivity was enhanced in women with PTSD. Cortisol measures did not differ between PTSD and healthy comparison subjects.These results suggest that cell-mediated inflammatory reactions are greater in individuals with PTSD.
Lysozyme turnover in man
Authors: Niels Ebbe Hansen, Hans Karle, Vagn Andersen, Klaus Ølgaard
Journal: Journal of Clinical Investigation (1972)

Lysozyme turnover studies with (125)I-labeled human lysozyme were carried out on 22 patients, viz. nine control patients, seven nephrological patients with varying degrees of renal insufficiency, including three bilaterally nephrectomized patients, and six hematological patients with disturbed turnover of the neutrophilic granulocytes. It was found that plasma lysozyme has a rapid turnover with a fractional catabolic rate of 76%/hr of the plasma content. Lysozyme catabolism varied with the endogenous creatinine clearance; in addition however, extrarenal sites of catabolism were demonstrated since lysozyme could be broken down in the anephric patients, although only at a rate amounting to about 15% of the rate found in persons with intact kidneys. In the uremic patients the increased plasma lysozyme concentration was due to decreased rates of catabolism; in the hematological patients the increased plasma lysozyme level was due to increased rates of synthesis which supports the hypothesis that plasma lysozyme mainly stems from disintegrating neutrophilic granulocytes. Furthermore, it was shown that in the nonhematological patients examined, the rate of synthesis varied with the endogenous creatinine clearance.
Comment on Palmas et al. Results of the Northern Manhattan Diabetes Community Outreach Project: A Randomized Trial Studying a Community Health Worker Intervention to Improve Diabetes Care in Hispanic Adults. Diabetes Care 2014;37:963–969
Authors: Viviktha Ramesh, Partha Haldar
Journal: Diabetes Care (2015)

Palmas et al. (1) described the results of the Northern Manhattan Diabetes Community Outreach Project (NOCHOP), which was a randomized trial to study a community health worker intervention for patients with poorly controlled diabetes among underserved urban Hispanics in New York. The intervention was comprised of individual and group contact and phone calls over a period of 1 year and evaluated primarily the change in glycosylated hemoglobin and secondarily the change in systolic and diastolic blood pressures …
Diabetic Peripheral Neuropathy: Should a Chaperone Accompany Our Therapeutic Approach?
Authors: Kevin L. Farmer, Chengyuan Li, Rick T. Dobrowsky
Journal: Pharmacological Reviews (2012)

Diabetic peripheral neuropathy (DPN) is a common complication of diabetes that is associated with axonal atrophy, demyelination, blunted regenerative potential, and loss of peripheral nerve fibers. The development and progression of DPN is due in large part to hyperglycemia but is also affected by insulin deficiency and dyslipidemia. Although numerous biochemical mechanisms contribute to DPN, increased oxidative/nitrosative stress and mitochondrial dysfunction seem intimately associated with nerve dysfunction and diminished regenerative capacity. Despite advances in understanding the etiology of DPN, few approved therapies exist for the pharmacological management of painful or insensate DPN. Therefore, identifying novel therapeutic strategies remains paramount. Because DPN does not develop with either temporal or biochemical uniformity, its therapeutic management may benefit from a multifaceted approach that inhibits pathogenic mechanisms, manages inflammation, and increases cytoprotective responses. Finally, exercise has long been recognized as a part of the therapeutic management of diabetes, and exercise can delay and/or prevent the development of painful DPN. This review presents an overview of existing therapies that target both causal and symptomatic features of DPN and discusses the role of up-regulating cytoprotective pathways via modulating molecular chaperones. Overall, it may be unrealistic to expect that a single pharmacologic entity will suffice to ameliorate the multiple symptoms of human DPN. Thus, combinatorial therapies that target causal mechanisms and enhance endogenous reparative capacity may enhance nerve function and improve regeneration in DPN if they converge to decrease oxidative stress, improve mitochondrial bioenergetics, and increase response to trophic factors.
Functional Interaction of the Retinoblastoma and Ini1/Snf5 Tumor Suppressors in Cell Growth and Pituitary Tumorigenesis
Authors: Cynthia J. Guidi, Rajini Mudhasani, Kathleen Hoover, Andrew Koff, Irwin Leav, Anthony N. Imbalzano, Stephen N. Jones
Journal: Cancer Research (2006)

Abstract The Ini1 subunit of the SWI/SNF chromatin remodeling complex suppresses formation of malignant rhabdoid tumors in humans and mice. Transduction of Ini1 into Ini1-deficient tumor-derived cell lines has indicated that Ini1 arrests cell growth, controls chromosomal ploidy, and suppresses tumorigenesis by regulating components of the retinoblastoma (Rb) signaling pathway. Furthermore, conditional inactivation of Ini1 in mouse fibroblasts alters the expression of various Rb-E2F-regulated genes, indicating that endogenous Ini1 levels may control Rb signaling in cells. We have reported previously that loss of one allele of Ini1 in mouse fibroblasts results only in a 15% to 20% reduction in total Ini1 mRNA levels due to transcriptional compensation by the remaining Ini1 allele. Here, we examine the effects of Ini1 haploinsufficiency on cell growth and immortalization in mouse embryonic fibroblasts. In addition, we examine pituitary tumorigenesis in Rb-Ini1 compound heterozygous mice. Our results reveal that heterozygosity for Ini1 up-regulates cell growth and immortalization and that exogenous Ini1 down-regulates the growth of primary cells in a Rb-dependent manner. Furthermore, loss of Ini1 is redundant with loss of Rb function in the formation of pituitary tumors in Rb heterozygous mice and leads to the formation of large, atypical Rb+/− tumor cells lacking adrenocorticotropic hormone expression. These results confirm in vivo the relationship between Rb and Ini1 in tumor suppression and indicate that Ini1 plays a role in maintaining the morphologic and functional differentiation of corticotrophic cells. (Cancer Res 2006; 66(16): 8076-82)
Cost-Effectiveness of a Collaborative Care Program for Primary Care Patients With Persistent Depression
Authors: Gregory E. Simon, Wayne J. Katon, Michael VonKorff, Jürgen Unützer, Elizabeth H.B. Lin, Edward A. Walker, Terry Bush, Carolyn Rutter, Evette Ludman
Journal: American Journal of Psychiatry (2001)

The authors evaluated the incremental cost-effectiveness of stepped collaborative care for patients with persistent depressive symptoms after usual primary care management.Primary care patients initiating antidepressant treatment completed a standardized telephone assessment 6-8 weeks after the initial prescription. Those with persistent major depression or significant subthreshold depressive symptoms were randomly assigned to continued usual care or collaborative care. The collaborative care included systematic patient education, an initial visit with a consulting psychiatrist, 2-4 months of shared care by the psychiatrist and primary care physician, and monitoring of follow-up visits and adherence to medication regimen. Clinical outcomes were assessed through blinded telephone assessments at 1, 3, and 6 months. Health services utilization and costs were assessed through health plan claims and accounting data.Patients receiving collaborative care experienced a mean of 16.7 additional depression-free days over 6 months. The mean incremental cost of depression treatment in this program was $357. The additional cost was attributable to greater expenditures for antidepressant prescriptions and outpatient visits. No offsetting decrease in use of other health services was observed. The incremental cost-effectiveness was $21.44 per depression-free day.A stepped collaborative care program for depressed primary care patients led to substantial increases in treatment effectiveness and moderate increases in costs. These findings are consistent with those of other randomized trials. Improving outcomes of depression treatment in primary care requires investment of additional resources, but the return on this investment is comparable to that of many other widely accepted medical interventions.
Vitamin D Status: Ready for Guiding Prostate Cancer Diagnosis and Treatment?
Authors: William B. Grant
Journal: Clinical Cancer Research (2014)

Abstract Vitamin D deficiency is associated with increased risk of prostate cancer for those with elevated prostate-specific antigen (PSA) level or abnormal digital rectal examination. Vitamin D deficiency is also associated with aggressive prostate cancer. Vitamin D level could be added as an additional factor to consider before ordering a biopsy. Clin Cancer Res; 20(9); 2241–3. ©2014 AACR.
Increasing incidence of pulmonary embolism
Authors: J Mathew
Journal: Thorax (2008)

The introduction of investigations like spiral CT scanning and D-dimer assay have altered the outcome of patients with pulmonary embolism in recent years. This study aimed to determine whether there had been a significant improvement in the diagnosis of pulmonary embolism and, consequently, a reduction in mortality with the advent of spiral CT.

The study population consisted …
Atrial Overdrive Pacing for the Obstructive Sleep Apnea–Hypopnea Syndrome
Authors: Emmanuel N. Simantirakis, Sophia E. Schiza, Stavros I. Chrysostomakis, Gregory I. Chlouverakis, Nikolaos C. Klapsinos, Nikolaos M. Siafakas, Panos E. Vardas
Journal: New England Journal of Medicine (2005)

The role of atrial overdrive pacing (AOP) in sleep apnea remains uncertain. We prospectively evaluated the effect of AOP after 24 hours and after one month in patients with the obstructive sleep apnea-hypopnea syndrome and compared it with the use of nasal continuous positive airway pressure (n-CPAP).We studied 16 patients with a moderate or severe case of the obstructive sleep apnea-hypopnea syndrome (baseline mean apnea-hypopnea index, 49) and normal left ventricular systolic function in whom a dual-chamber pacemaker had been implanted. After 48 hours, the patients were randomly assigned to AOP (pacing at 15 bpm above the spontaneous mean nocturnal heart rate) or backup atrial pacing (pacing at a heart rate below 40 bpm); the latter group began n-CPAP therapy one day later. After one month, the two groups switched therapies and were followed for an additional month. Polysomnographic studies were performed at baseline, on the first night after randomization, at crossover, and at the end of the study.During AOP, no significant changes were observed in any of the respiratory variables measured. The change in the apnea-hypopnea index at one month with AOP was +0.2 (95 percent confidence interval, -2.7 to +2.3; P=0.87). In contrast, all variables improved significantly after one month of n-CPAP (change in the apnea-hypopnea index, -46.3; 95 percent confidence interval, -56.2 to -36.5; P<0.001).Nasal continuous positive airway pressure therapy is highly effective for the treatment of the obstructive sleep apnea-hypopnea syndrome, whereas AOP has no significant effect.
Bulk De Novo Mitogenome Assembly from Pooled Total DNA Elucidates the Phylogeny of Weevils (Coleoptera: Curculionoidea)
Authors: Conrad P.D.T. Gillett, Alex Crampton-Platt, Martijn J.T.N. Timmermans, Bjarte H. Jordal, Brent C. Emerson, Alfried P. Vogler
Journal: Molecular Biology and Evolution (2014)

Complete mitochondrial genomes have been shown to be reliable markers for phylogeny reconstruction among diverse animal groups. However, the relative difficulty and high cost associated with obtaining de novo full mitogenomes have frequently led to conspicuously low taxon sampling in ensuing studies. Here, we report the successful use of an economical and accessible method for assembling complete or near-complete mitogenomes through shot-gun next-generation sequencing of a single library made from pooled total DNA extracts of numerous target species. To avoid the use of separate indexed libraries for each specimen, and an associated increase in cost, we incorporate standard polymerase chain reaction-based "bait" sequences to identify the assembled mitogenomes. The method was applied to study the higher level phylogenetic relationships in the weevils (Coleoptera: Curculionoidea), producing 92 newly assembled mitogenomes obtained in a single Illumina MiSeq run. The analysis supported a separate origin of wood-boring behavior by the subfamilies Scolytinae, Platypodinae, and Cossoninae. This finding contradicts morphological hypotheses proposing a close relationship between the first two of these but is congruent with previous molecular studies, reinforcing the utility of mitogenomes in phylogeny reconstruction. Our methodology provides a technically simple procedure for generating densely sampled trees from whole mitogenomes and is widely applicable to groups of animals for which bait sequences are the only required prior genome knowledge.
Magnetic resonance and computed tomographic imaging in the evaluation of acute neuropsychiatric disease in systemic lupus erythematosus.
Authors: W L Sibbitt, R R Sibbitt, R H Griffey, C Eckel, A D Bankhurst
Journal: Annals of the Rheumatic Diseases (1989)

Magnetic resonance (MR) imaging and computed tomography (CT) are useful for the evaluation of central nervous system (CNS) lupus. This report describes the use of cranial MR and CT in 21 patients with systemic lupus erythematosus (SLE) with acute neuropsychiatric symptoms manifested by headache, seizures, focal neurological deficits, psychosis, or organic brain syndrome. Computed tomography was found to be insensitive and detected only diffuse atrophy (two cases), cerebral infarct (one case), and intracerebral haemorrhage (one case) in the 21 patients. Cranial MR images obtained with a General Electric 1.5 tesla Signa unit detected labile and fixed areas of increased proton intensity interpreted as focal oedema (eight cases), infarct (10 cases), haemorrhage (one), atrophy (seven), and acute sinusitis (two). Focal oedema was characterised by labile, high intensity lesions in the gray or white matter of the cerebellum, cerebrum, or brain stem, which completely resolved after aggressive corticosteroid treatment. Most high intensity reversible or fixed lesions evident on MR were not apparent on cranial CT images. In several patients sequential MR images were valuable in monitoring the efforts of treatment. Although histological confirmation of the high intensity brain lesions apparent on MR is desirable, prior necropsy studies suggest that pathological confirmation may be difficult owing to the paucity of recognisable brain lesions in patients with CNS lupus. It is concluded that for the evaluation of acute neuropsychiatric SLE MR is useful and provides more information than cranial CT.