tbuckley/cabot-search huggingface dataset:
To dilate or to operate? That is the question.
Authors: G Vantrappen, J Janssens
Journal: Gut (1983)

To dilate or to operate?That is the question In this issue Fellows et al report their experience with pneumatic dilatation in the treatment of achalasia of the cardia.Their conclusion that pneumatic dilatation is safe and effective and should be the initial treatment for all patients with achalasia may seem provocative to some surgeons, and warrants comment.Present treatment of achalasia and related motor disorders of the oesophagus is at best palliative.Most symptoms and complications of achalasia are because of retention of food and fluid in the oesophagus as a result of defective relaxation of an often hypertensive lower oesophageal sphincter, together perhaps with loss of propulsive peristaltic contractions.Palliative treatment aims therefore at improving oesophageal emptying by decreasing the resistance at the cardia sufficiently to allow easy aboral flow, but insufficiently to favour gastro-oesophageal reflux.Several methods are available to diminish the resistance at the cardia: drugs, forceful dilatation, and cardiomyotomy with, or without an antireflux procedure. DRUGSVarious drugs such as anticholinergics, gliceryltrinitrate, a-adrenergic blocking agents, and calcium entry blockers have been tried, but only the latter seem to have a role.Nifedipine has been shown to reduce the lower oesophageal sphincter pressure significantly for more than one hour.1 2 When administered sublingually in a dose of 10-20 mg before each meal, it produced good or excellent results in 72.4% of patients with mild or moderate achalasia.1If these results can be confirmed, it may be tempting to try this treatment in selected cases, because it is not likely to induce a significant degree of gastro-oesophageal reflux.On the other hand, most people do not like the idea that they will have to open their lower oesophageal sphincter artificially whenever they want to have a meal, or a drink.Diltiazem, another calcium entry blocker, seems to be promising for the treatment of diffuse oesophageal spasm.3 SURGICAL PROCEDURESEffective and lasting decrease of the resistance at the cardia can be achieved by either surgery or forceful dilatation.Three types of surgical procedures are advocated.Cardiomyotomy was the procedure of choice for many years.The length of the incision on the gastric side varies from a few millimetres to several centimetres.Ellis4 has repeatedly insisted that an incision extending more than a few millimetres on the gastric side leads to reflux oesophagitis, but this is a controversial point.
Human Herpesvirus 8 Seropositivity and Risk of Kaposi's Sarcoma and Other Acquired Immunodeficiency Syndrome-Related Diseases
Authors: G. Rezza, M. Andreoni, M. Dorrucci, P. Pezzotti, P. Monini, R. Zerboni, B. Salassa, V. Colangeli, L. Sarmati, E. Nicastri, M. Barbanera, R. Pristera, F. Aiuti, L. Ortona, B. Ensoli
Journal: JNCI Journal of the National Cancer Institute (1999)

The incidence of Kaposi's sarcoma (KS) is increased severalfold in individuals infected with human immunodeficiency virus-1 (HIV). Human herpesvirus 8 (HHV8) has also been implicated in KS. We investigated several factors that may determine the onset of KS, particularly HHV8 infection in individuals after becoming seropositive for HIV.We studied 366 individuals belonging to different HIV-exposure categories (i.e., homosexual activity, intravenous drug use, and heterosexual contact) for whom a negative HIV serologic test and then a positive HIV serologic test were available within a 2-year period. HHV8 antibody testing was performed by use of an immunofluorescence assay on the first serum sample available after the first positive HIV test. Actuarial rates of progression of KS and of other acquired immunodeficiency syndrome (AIDS)-defining diseases were estimated by use of time-to-event statistical methods. All statistical tests were two-sided.Twenty-one of the 366 study participants developed AIDS-related KS, and 83 developed AIDS without KS. One hundred forty (38.3%) participants had detectable anti-HHV8 antibodies. The actuarial progression rate to KS among persons co-infected with HIV/HHV8 was nearly 30% by 10 years after HIV seroconversion. Increasing HHV8 antibody titers increased the risk of developing KS (for seronegative versus highest titer [1:125 serum dilution], adjusted relative hazard [RH] = 51.82; 95% confidence interval [CI] = 6.08-441.33) but not of other AIDS-defining diseases (adjusted RH = 1.14; 95% CI = 0.72-1.80). HHV8-seropositive homosexual men compared with HHV8-seropositive participants from other HIV-exposure categories showed an increased risk of KS that approached statistical significance (adjusted RH = 6.93; 95% CI = 0.88-54.84).Approximately one third of individuals co-infected with HIV/HHV8 developed KS within 10 years after HIV seroconversion. Progression to KS increased with time after HIV seroconversion. Higher antibody titers to HHV8 appear to be related to faster progression to KS but not to other AIDS-defining diseases.
Rheumatoid arthritis with extensive lung lesions.
Authors: C Fellbaum, W Domej, H Popper
Journal: Thorax (1989)

A man of 74 who had had seropositive rheumatoid arthritis for 10 years presented with dyspnoea and reticular striation in both lung fields. At necropsy two years later there was pulmonary fibrosis with multiple rheumatoid nodules and non-specific granulomas.
Reducing damage through Nrf-2
Authors: Jean-Luc Balligand
Journal: Cardiovascular Research (2013)

This editorial refers to ‘Defective Nrf2-dependent redox signalling contributes to microvascular dysfunction in type 2 diabetes’ by G. V. Velmurugan et al ., pp. 143–150 , this issue and ‘Nrf2 deficiency prevents reductive stress-induced hypertrophic cardiomyopathy’ by S. Kannan et al ., pp. 63–73, this issue. 

Conventional wisdom has it that excessive oxidant stress usually causes tissue damage, with adverse cardiovascular remodelling. As a consequence, efforts have been amply developed to identify mechanisms and strategies to increase anti-oxidant defences. The transcription factor nuclear factor NF-E2-related factor 2 (Nrf2) has come into focus as a main regulator of the expression of anti-oxidant enzymes able to restore redox balance in the context of increased oxidant stress. However, as in many biological processes, dosage matters and too much of an apparently good thing can result in a catastrophe, as highlighted in the observations of two papers in this issue of Cardiovascular Research .

The first paper by Velmurugan et al . started from the observation that reactive oxygen species (ROS) play an important role in the generation of myogenic tone in the microvasculature, i.e. in response to an acute increase in intraluminal pressure, vessels produce a burst of ROS that increases vessel contraction, as demonstrated in their study. This phenomenon is amplified in diabetes (type I and II), which is also associated with excessive production of various oxidant radicals; the latter may result from the dysregulation of the anti-oxidant defence mechanisms normally orchestrated by Nrf-2, which is reduced in diabetes.1 Therefore, the authors examined the hypothesis that excessive ROS contribute to microvascular dysfunction in a mouse type II diabetes model (db/db …
The role of microRNAs in endometriosis and associated reproductive conditions
Authors: E. Maria C. Ohlsson Teague, Cristin G. Print, M. Louise Hull
Journal: Human Reproduction Update (2009)

microRNAs (miRNAs) are short, single-stranded RNAs that regulate gene expression at the post-transcriptional level. Recent research has shown that miRNAs and their target mRNAs are differentially expressed in endometriosis and other disorders of the female reproductive system. Since miRNAs control a broad spectrum of normal and pathological cellular functions, they may play pivotal roles in the pathogenesis of these disorders. A systematic review was undertaken of the published literature on; (i) the expression and functions of miRNAs in mammalian female reproductive tissues with a focus on endometriosis and the malignancies and fertility disorders related to this disease; and (ii) the potential roles played by validated mRNA targets of endometriosis-associated miRNAs. The current understanding of the biology of miRNAs is overviewed and the potential diagnostic and therapeutic potential of miRNAs in endometriosis is highlighted. The differential expression of miRNAs in endometriosis, and the putative molecular pathways constituted by their targets, suggests that miRNAs may play an important role in endometriotic lesion development. Models for miRNA regulatory functions in endometriosis are presented, including those associated with hypoxia, inflammation, tissue repair, TGFβ-regulated pathways, cell growth, cell proliferation, apoptosis, extracellular matrix remodelling and angiogenesis. In addition, specific miRNAs which may be associated with malignant progression and subfertility in endometriosis are discussed. miRNAs appear to be potent regulators of gene expression in endometriosis and its associated reproductive disorders, raising the prospect of using miRNAs as biomarkers and therapeutic tools in endometriosis.
Multiple roles of nitric oxide in the airways
Authors: F L M Ricciardolo
Journal: Thorax (2003)

Nitric oxide is endogenously released in the airways by nitric oxide synthase. Functionally, two isoforms of this enzyme exist: constitutive and inducible. The former seems to protect airways from excessive bronchoconstriction while the latter has a modulatory role in inflammatory disorders of the airways such as asthma. This review explores the physiological and pathophysiological role of endogenous nitric oxide in the airways, and the clinical aspects of monitoring nitric oxide in exhaled air of patients with respiratory disease.
Graft Ischemic Time and Outcome of Lung Transplantation
Authors: Gabriel Thabut, Hervé Mal, Jacques Cerrina, Philippe Dartevelle, Claire Dromer, Jean-François Velly, Marc Stern, Philippe Loirat, Guy Lesèche, Michelle Bertocchi, Jean-François Mornex, Alain Haloun, Philippe Despins, Christophe Pison, Dominique Blin, Martine Reynaud-Gaubert
Journal: American Journal of Respiratory and Critical Care Medicine (2005)

The effect of graft ischemic time on early graft function and long-term survival of patients who underwent lung transplantation remains controversial. Consequently, graft ischemic time has not been incorporated in the decision-making process at the time of graft acceptance.To investigate the relationship between graft ischemic time and (1) early graft function and (2) long-term survival after lung transplantation.The data from 752 patients who underwent single lung transplantation (n = 258), bilateral lung transplantation (n = 247), and heart-lung transplantation (n = 247) in seven French transplantation centers during a 12-year period were reviewed. Independent data quality control was done to ensure the quality of the collected variables. Mean graft ischemic time was 245.8 +/- 96.4 minutes (range 50-660). After adjustment on 11 potential confounders, graft ischemic time was associated with the recipient Pa(O2)/FI(O2) ratio recorded within the first 6 hours and with long-term survival in patients undergoing single or double lung transplantation but not in patients undergoing heart-lung transplantation. The relationship between graft ischemic time and survival appears to be of cubic form with a cutoff value of 330 minutes. These results were unaffected by the preservation fluid employed.The results of this large cohort of patients suggest a close relationship between graft ischemic time and both early gas exchange and long-term survival after single and double lung transplantation. Such relationship was not found in patients undergoing heart-lung transplantation. The expected graft ischemic time should be incorporated in the decision-making process at the time of graft acceptance.
Occupational risks of glutaraldehyde.
Authors: P. S. Burge
Journal: BMJ (1989)

adjusted as the child grows and quickly adapted for adult use.Restraint systems for babies and toddlers differ according to age and, in contrast, represent a considerable financial outlay for a short period of use.Legislation for this age group should be restricted to the use of appropriate restraints, where already fitted, and the requirement that all car hire companies provide a comprehensive range of restraint systems for all ages.Owners of private cars should be encouraged but not compelled to fit toddler seats for children aged under 4 and carrycots for infants under 9 months.Leasing schemes are ideal.The initiative of the Kwit Fit Company in establishing over 300 child safety centres must be applauded: since their introduction in February 1988 over 100000 child restraint seats have been supplied and fitted at a cost (refundable on return of the seat) which is less than the purchase price of a new seat.This combination of legislation for older children and financial incentives to provide restraints for toddlers and infants should be welcomed.The impact of these develop-ments should be monitored carefully, as was done in 1983.Once the predictions of the bioengineers are translated into falling casualty statistics for children, public and political support for comprehensive legislation on seat belts will be overwhelming.
YOUTH ACCESS TO TOBACCO: Policies and Politics
Authors: Jean L. Forster, Mark Wolfson
Journal: Annual Review of Public Health (1998)

▪ Abstract The late 1980s marked the beginning of a sea change in research and intervention on tobacco use by young people, when the first studies were published demonstrating the ease with which adolescents could purchase cigarettes. Since then concern with the commercial availability of tobacco products to youth has grown, becoming deeply entrenched in both research and policy efforts. This paper reviews the history of restrictions on youth access to tobacco, the evidence that commercial sources of tobacco are available and important to adolescents, and the rationale for various components of policies to restrict access. We also review the recent expansion of policies addressing youth access to tobacco at all levels of government, the tobacco industry response to this expansion, and issues that have arisen as this expansion has developed.
Patient Preferences for Deactivation of Implantable Cardioverter-Defibrillators
Authors: James M. Beattie, Terry N. Flynn, Alexander M. Clark
Journal: JAMA Internal Medicine (2013)

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Treatment of rheumatic diseases: a companion to Kelley's textbook of rheumatology: Eds M H Wiseman, M E Weinblatt, J S Louie. (Pp 563; $129.) London: Saunders, 2001. ISBN 0-7216-8464-5.
Authors: H Schulze-Koops
Journal: Annals of the Rheumatic Diseases (2002)

Behçet's disease and thrombophiliaSurely the authors of the comprehensive review of Behçet's disease and thrombophilia 1 meant to cite the year 1937, not 1973, for Behçet's eponymic description of the disease.However, contrary to their statement, Behçet was not the first to describe the disorder that now bears his name.He was preceded by Shigeta in Japan (1924), Amantiades in Greece (1931), and Whitewell in Great Britain (1934), probably also by Kurosawa, Lipschutz, and arguably even earlier by Hippocrates, among extant descriptions.Behçet deserves to have the disease named after him, however, because he was the first modern author to group the various ophthalmic, dermatological, and orogenital lesions together as a syndrome.
The Culture of Biomedicine.
Authors: D. Heyward Brock, Ann Harward
Journal: Annals of Internal Medicine (1984)

Science and humanities / Michael S. Gregory -- The goals of medicine and society / David C. Thomasma -- The phenomenon of medicine / Richard M. Zaner -- Scientific views of human nature / James E. Trosko -- The sociobiology of human sexuality / Michael Ruse -- Bioethics and the human prospect / Van Rensselaer Potter -- Patients in particular / W.J. Coggins and Peter Graham -- Health, art, and drama / Dennis Carlson -- How Annandale went out / Peter Graham -- Pathos and pathology / Edmund L. Erde -- Humpty Dumpty, a literary challenge to the concept of personality integration / Kathryn Allen Rabuzzi.
Diaphragmatic dysfunction and dyspnoea in amyotrophic lateral sclerosis
Authors: T Similowski, V Attali, G Bensimon, F Salachas, S Mehiri, I Arnulf, L Lacomblez, M Zelter, V Meininger, J-PH Derenne
Journal: European Respiratory Journal (2000)

Amyotrophic lateral sclerosis (ALS) is a progressive disorder of unknown origin. Respiratory involvement is the principal cause of death, and dyspnoea is a major source of discomfort. In this study, diaphragm function is described and its relationship with dyspnoea examined in 48 ALS patients (32 male, age 26-80 yrs). The detailed neurological and respiratory evaluation (clinical examination, pulmonary function tests, static pressures, mouth twitch pressures (Pm,t), electromyographic responses to phrenic nerve stimulation and cortical magnetic stimulation were analysed after stratification according to dyspnoea. Dyspnoeic (group I) and nondyspnoeic (group II) patients were similar, bulbar signs being more frequent in group I. Vital capacity was lower in group I (mean+/-SD 67.9+/-22.7 versus 87.9+/-15.6% of the predicted value, p=0.0028), as were maximal static inspiratory pressure (41+/-24 versus 60+/-27% pred, p=0.0242) maximal static inspiratory pressure (18+/-11 versus 32+/-14% pred, p=0.0042), and Pm,t (3.71+/-2.5 versus 7.26+/-3.45 cmH2O, p=0.0011). Abdominal (Abd) paradox and respiratory pulse were frequent in group I (15 of 25 and 14 of 25) but absent or rare in group II (0 of 23 and four of 23) (p&lt;0.05). The electromyographic responses to phrenic and cortical stimulation were generally abnormal in group I but subnormal in group II. Multivariate analysis selected only signs of diaphragm dysfunction (namely, Abd paradox and abnormal electromyographic responses) as significant predictors of dyspnoea. It is concluded that dyspnoea in amyotrophic lateral sclerosis patients should prompt diaphragm function tests.
Recreational and Occupational Physical Activities and Risk of Breast Cancer
Authors: Marilie D. Gammon, Esther M. John, Julie A. Britton
Journal: JNCI Journal of the National Cancer Institute (1998)

Physical activity has been hypothesized to reduce breast cancer risk, but an inverse association has not been consistently reported. In this review, we critically evaluate for coherence, validity, and bias the epidemiologic studies on recreational or occupational physical activity, discuss the biologic plausibility of the association, and identify areas for future research. Results from seven of nine studies suggest that higher levels of occupational physical activity may be associated with a reduction in risk, at least among a subgroup of women. Eleven of 16 investigations on recreational exercise reported a 12%-60% decrease in risk among premenopausal and postmenopausal women, although a dose-response trend was not evident in most of the studies. The reduction in risk associated with exercise was more likely to be observed in case-control studies than in cohort studies. Most investigations incompletely assessed physical activity, which contributed to conflicting findings on the optimal time period, duration, frequency, or intensity of activity to minimize risk. Physical activity may exert its effects through changes in menstrual characteristics, reduced body size, or alterations in immune function. In summary, most epidemiologic studies of physical activity reported a reduction in the risk of breast cancer among physically active women. Future research studies should focus on using a cohort design to rule out recall bias as a possible explanation for the decrease in risk associated with exercise, on improving assessment of lifetime physical activity from all sources to clarify whether there is a dose-response relation or an optimal time period, duration, frequency, or intensity of activity, and on elucidating the underlying mechanisms for the inverse association.
Porcine heart valves produce a protein that induces cell-mediated connective tissue degradation: II. Biochemical properties of the partially purified protein.
Authors: R S Decker, A M Henney, J T Dingle
Journal: Circulation Research (1986)

A cardiac catabolic factor (CCF) has been partially purified from serum-free medium conditioned by minced porcine heart valves. CCF was prepared by a series of chromatographic techniques and compared directly with porcine synovial catabolin purified by the same protocol. CCF displayed a somewhat higher molecular weight (Mr 21,000) and isoelectric point (pI 5.2) than did synovial catabolin (Mr 18,000 and pI 4.8), but the two factors clearly resemble one another closely. CCF stimulated the release of glycosaminoglycans from cultured cartilage and mitral valve and provoked porcine valves to degrade their own collagen extracellular matrix. The release of hydroxyproline was inhibited by corticosteroids, whereas proteoglycan breakdown was not. Partially pure preparations of CCF and synovial catabolin stimulated murine thymocyte proliferation; moreover, that activity was almost totally abolished by an antibody raised against pure porcine interleukin-1. These observations suggest that CCF may represent a catabolic factor that belongs to the interleukin-1 family and that it could potentially regulate the composition of valvular connective tissue.
Cardiovascular Disturbances in Chronic Severe Anemia
Authors: L. M. SANGHVI, R. SHARMA, S. N. MISRA
Journal: Circulation (1957)

Cardiovascular disturbances in 60 patients with chronic severe anemia have been studied. Although in a majority the classical hyperkinetic syndrome of anemia was seen, 40 per cent of the patients showed a different pattern that was characterized by absence of tachycardia, comparatively diminished velocity of the blood flow, and a normal or diminished cardiac output even in the presence of congestive failure. Other differences in the manifestations have been evaluated. No cause could be discovered for this difference and for the high incidence of congestive failure seen in this series.