tbuckley/cabot-search huggingface dataset:
Influence of excessive weight loss after gastroplasty for morbid obesity on respiratory muscle performance
Authors: P. Weiner, J. Waizman, M. Weiner, M. Rabner, R. Magadle, D. Zamir
Journal: Thorax (1998)

Morbidly obese subjects are known to have impaired respiratory function and inefficient respiratory muscles. A study was undertaken to investigate the influence of excessive weight loss on pulmonary and respiratory muscle function in morbidly obese individuals who underwent gastroplasty to induce weight loss.Twenty one obese individuals with mean (SE) body mass index (BMI) 41.5 (4.5) kg/m2 without overt obstructive airways disease (FEV1/FVC ratio > 80%) were studied before and six months after vertical banded gastroplasty. Only patients who had lost at least 20% of baseline BMI were included in the study. Standard pulmonary function tests and respiratory muscle strength and endurance were measured.Before operation the predominant abnormalities in respiratory function were significant reductions in lung volumes and respiratory muscle endurance and, to a lesser degree, reductions in respiratory muscle strength. All parameters increased towards normal values after weight loss with significant increases in functional residual capacity (FRC) from 84.0 (2.2) to 91.3 (2.5)% of predicted normal values (mean difference 7.3, 95% confidence interval of difference (CI) 4.2 to 10.5), total lung capacity (TLC) from 85.6 (3.0) to 93.5 (3.7)% of predicted normal values (mean difference 7.9, 95% CI 4.5 to 11.5), residual volume (RV) from 86.7 (3.1) to 96.4 (3.0) of predicted normal values (mean difference 9.7, 95% CI 5.2 to 14.1), expiratory reserve volume (ERV) from 76.6 (3.0) to 89.0 (3.4)% of predicted normal values (mean difference 12.4, 95%, CI 6.3 to 18.9), respiratory muscle strength: PImax from 92 (4.4) to 113 (4.6) cm H2O (mean difference 21, 95% CI 12.2 to 31.6), PEmax from 144 (5.6) to 166 (4.3) cm H2O (mean difference 22, 95% CI 12.9 to 32.0), and endurance: PmPeak/PImax from 56 (1.4) to 69 (2.0)% (mean difference 13, 95% CI 9.7 to 16.9). The strongest correlation was between weight loss and the improvement in respiratory muscle endurance.Lung volumes and respiratory muscle performance are decreased in obese individuals. Weight loss following gastroplasty is associated with improvement in lung volumes and respiratory muscle function.
Seasonal Exacerbation of Esophageal Eosinophilia in Children with Eosinophilic Esophagitis and Allergic Rhinitis
Authors: Juhee Lee, Gita S. Ram, Michele Shuker, Megan T. Ott, Terri F. Brown-Whitehorn, Chris A. Liacouras, Jonathan M. Spergel
Journal: Journal of Allergy and Clinical Immunology (2015)
Effects of Interdisciplinary Team Care Interventions on General Medical Wards
Authors: Samuel Pannick, Rachel Davis, Hutan Ashrafian, Ben E. Byrne, Iain Beveridge, Thanos Athanasiou, Robert M. Wachter, Nick Sevdalis
Journal: JAMA Internal Medicine (2015)

<h3>Importance</h3> Improving the quality of health care for general medical patients is a priority, but the organization of general medical ward care receives less scrutiny than the management of specific diseases. Optimizing teams' performance improves patient outcomes in other settings, and interdisciplinary practice is a major target for improvement efforts. However, the effect of interdisciplinary team interventions on general medical ward care has not been systematically reviewed. <h3>Objectives</h3> To describe the range of objective patient outcomes used in studies of general medical ward interdisciplinary team care, and to evaluate the performance of interdisciplinary interventions against them. <h3>Evidence Review</h3> We searched EMBASE, MEDLINE, and PsycINFO from January 1, 1998, through December 31, 2013, for interdisciplinary team care interventions in adult general medical wards using an objective patient outcome measure. Reference lists of included articles were also searched. The last search was conducted on January 29, 2014, and the narrative and statistical analysis was conducted through December 1, 2014. Study quality was assessed using the Cochrane Effective Practice and Organization of Care group's tool. <h3>Findings</h3> Thirty of 6934 articles met the selection criteria. The studies included 66 548 patients, with a mean age of 63 years. Nineteen of 30 (63%) studies reported length of stay, readmission, or mortality rate as their primary outcome, or did not specify the primacy of their outcomes. The most commonly reported objective patient outcomes were length of stay (23 of 30 [77%]), complications of care (10 of 30 [33%]), in-hospital mortality rate (8 of 30 [27%]), and 30-day readmission rate (8 of 30 [27%]). Of 23 interventions, 16 (70%) had no effect on length of stay, 12 of 15 (80%) did not reduce readmissions, and 14 of 15 (93%) did not affect mortality. Five of 10 (50%) interventions reduced complications of care. In an exploratory quantitative analysis, the interventions did not consistently reduce the relative risk of early readmission or early mortality, or the weighted mean difference in length of stay. All studies had a medium or high risk of bias. <h3>Conclusions and Relevance</h3> Current evidence suggests that interdisciplinary team care interventions on general medical wards have little effect on traditional measures of health care quality. Complications of care or preventable adverse events may merit inclusion as quality indicators for general medical wards. Future study should clarify how best to implement interdisciplinary team care interventions and establish quality metrics that are credible to both health care professionals and patients in this setting.
Are patient characteristics associated with the accuracy of hysterosalpingography in diagnosing tubal pathology? An individual patient data meta-analysis
Authors: K.A. Broeze, B.C. Opmeer, N. Van Geloven, S.F.P.J. Coppus, J.A. Collins, J.E. Den Hartog, P.J.Q. Van der Linden, P. Marianowski, E.H.Y. Ng, J.W. Van der Steeg, P. Steures, A. Strandell, F. Van der Veen, B.W.J. Mol
Journal: Human Reproduction Update (2010)

Conventional meta-analysis has estimated the sensitivity and specificity of hysterosalpingography (HSG) to be 65% and 83%. The impact of patient characteristics on the accuracy of HSG is unknown. The aim of this study was to assess by individual patient data meta-analysis whether the accuracy of HSG is associated with different patient characteristics. We approached authors of primary studies reporting on the accuracy of HSG using findings at laparoscopy as the reference. We assessed whether patient characteristics such as female age, duration of subfertility and a clinical history without risk factors for tubal pathology were associated with the accuracy of HSG, using a random intercept logistic regression model. We acquired data of seven primary studies containing data of 4521 women. Pooled sensitivity and specificity of HSG were 53% and 87% for any tubal pathology and 46% and 95% for bilateral tubal pathology. In women without risk factors, the sensitivity of HSG was 38% for any tubal pathology, compared with 61% in women with risk factors (P = 0.005). For bilateral tubal pathology, these rates were 13% versus 47% (P = 0.01). For bilateral tubal pathology, the sensitivity of HSG decreased with age [factor 0.93 per year (P = 0.05)]. The specificity of HSG was very stable across all subgroups. The accuracy of HSG in detecting tubal pathology was similar in all subgroups, except for women without risk factors in whom sensitivity was lower, possibly due to false-positive results at laparoscopy. HSG is a useful tubal patency screening test for all infertile couples.
Traumatic Grief as a Disorder Distinct From Bereavement-Related Depression and Anxiety: A Replication Study With Bereaved Mental Health Care Patients
Authors: Paul A. Boelen, Jan van den Bout, Jos de Keijser
Journal: American Journal of Psychiatry (2003)

Earlier studies have shown that symptoms of traumatic grief are distinct from those of bereavement-related depression and anxiety. This study was an attempt to replicate that finding.Data were derived from 103 patients. Traumatic grief was measured with the Inventory of Traumatic Grief. Depression and anxiety were measured with the Symptom Checklist. The distinctiveness of the three symptom clusters was determined with principal axis factoring.Symptoms of traumatic grief, depression, and anxiety clustered together in three distinct factors.These results confirm the previous finding of a distinction between symptoms of traumatic grief and symptoms of bereavement-related depression and anxiety.
Case-control study of self reported genitourinary infections and risk of gastroschisis: findings from the national birth defects prevention study, 1997-2003
Authors: Marcia L Feldkamp, Jennita Reefhuis, James Kucik, Sergey Krikov, Andy Wilson, Cynthia A Moore, John C Carey, Lorenzo D Botto
Journal: BMJ (2008)

To assess the association between genitourinary infections in the month before conception to the end of the first trimesterand gastroschisis.Case-control study with self reported infections from a computer assisted telephone interview.National birth defects prevention study, a multisite, population based study including 10 surveillance systems for birth defects in the United States.Mothers of 505 offspring with gastroschisis and 4924 healthy liveborn infants as controls.Adjusted odds ratios for gastroschisis with 95% confidence intervals.About 16% (n=81) of case mothers and 9% (n=425) of control mothers reported a genitourinary infection in the relevant time period; 4% (n=21) and 2% (n=98) reported a sexually transmitted infection and 13% (n=67) and 7% (n=338) reported a urinary tract infection, respectively. Case mothers aged <25 years reported higher rates of urinary tract infection alone and in combination with a sexually transmitted infection compared with control mothers. In women who reported both types of infection, there was a greater risk of gastroschisis in offspring (adjusted odds ratio 4.0, 95% confidence interval 1.4 to 11.6).There is a significant association between self reported urinary tract infection plus sexually transmitted infection just before conception and in early pregnancy and gastroschisis.
Echocardiographic prediction ofleft ventricular dysfunction aftermitral valve repair for mitral regurgitation as anindicator to decide the optimal timing of repair
Authors: Takayoshi Matsumura, Eiji Ohtaki, Kaoru Tanaka, Kazuhiko Misu, Tetsuya Tobaru, Ryuta Asano, Masatoshi Nagayama, Koichi Kitahara, Jun Umemura, Tetsuya Sumiyoshi, Hitoshi Kasegawa, Saichi Hosoda
Journal: Journal of the American College of Cardiology (2003)
Deep Brain Stimulation of Anteromedial Globus Pallidus Interna for Severe Tourette's Syndrome
Authors: Elisabeth Cannon, Peter Silburn, Terrence Coyne, Karen O'Maley, John D. Crawford, Perminder S. Sachdev
Journal: American Journal of Psychiatry (2012)

Severe Tourette's syndrome that cannot be managed with medication is now being experimentally treated with deep brain stimulation. Ten of 11 patients in a series reported 48% reduction in motor tics and 56% reduction in phonic tics. Effects were sustained for at least 3 months, and only two patients still required pharmacotherapy. One patient discontinued the treatment because of intolerability, two patients had anxiety, and one had an electronic malfunction. The stimulating electrodes were targeted to the anteromedial globus pallidus interna. Tourette's syndrome is thought to result from a defect in the cortical-basal ganglia-thalamic-cortical neuronal circuit. Stimulation in the thalamus, pallidum, ventral caudate, and anterior internal capsule has been investigated by other centers.
Comparisons of Patients With Comorbid Psychiatric and Substance Use Disorders: Implications for Treatment and Service Delivery
Authors: Barbara E. Havassy, Jennifer Alvidrez, Karilyn K. Owen
Journal: American Journal of Psychiatry (2004)

OBJECTIVE: Individuals with co-occurring psychiatric and substance use disorders are treated in mental health and substance abuse treatment systems, yet research on comorbid disorders rarely includes comparisons across systems. Knowledge about patients who share the label "comorbid" but are found in different treatment sectors should illuminate service issues and inform policy development. Differences across systems should provide support for separate treatments; similarities should indicate the value of the integration of services. The hypothesis that there are meaningful clinical differences between patients with comorbid mental health disorders and patients in drug treatment was tested. METHOD: As part of a larger longitudinal study, 106 patients with comorbid illness from mental health (N=106) and drug treatment (N=120) settings were compared regarding diagnosis, drug use, and problem severity. Data were obtained by using the Diagnostic Interview Schedule for DSM-IV and the Addiction Severity Index. RESULTS: Few differences between groups emerged. There were no diagnostic differences except that schizophrenia spectrum disorders were more common among mental health (43%) than drug treatment (31%) patients. Although more drug abuse than mental health subjects reported drug use in the 30 days before treatment entry, the average number of days of drug use in this period was not different. CONCLUSIONS: These findings document the high prevalence of severe mental illness in drug treatment clients and of serious drug problems in mental health patients. Only minimal differences emerged between the groups and none that indicated need for specialized treatments in separate systems of care.
ANTIGENICITY OF THE M PROTEINS OF GROUP A HEMOLYTIC STREPTOCOCCI
Authors: Eugene N. Fox, M. K. Wittner, Albert Dorfman
Journal: The Journal of Experimental Medicine (1966)

Highly purified M proteins were used for determining cutaneous hypersensitivity and type-specific circulating antibodies in normal adults and infants. 80% of 91 adults and 8% of 59 infants exhibited a transient delayed cutaneous reaction to at least two of types 12, 14, and 24 M proteins. Antibodies assayed by passive hemagglutination were observed in 90% of the adults and 13% of the infants. Vaccines of 10 microg of alum-precipitated M protein or 20 microg of the soluble antigen were administered to adults not exhibiting delayed hypersensitivity. Within 2 wk hemagglutination liters increased significantly in 31 of 33 subjects. Preimmunization antibody levels indicated that these responses were probably anamnestic reactions from previous exposures to homologous serotypes of group A streptococci. Sera exhibiting large increments in antibody titers resulting from M protein inoculations also had type-specific bactericidal properties. "Attenuated" M proteins, produced by partial degradation with trypsin induced only minimal cutaneous reactions in hypersensitive adults, but still retained most of the antigenic specificity when assayed in vitro and in vivo. The utility of M protein vaccines for human use is discussed in reference to the low incidence of cutaneous hypersensitivity in infants, the potentials of polyvalent attenuated M protein vaccines and the apparent absence of immune cross-reactivity between pure M proteins and human heart and kidney tissues.
Characterization of human anti-glomerular basement membrane antibodies eluted from glomerulonephritic kidneys
Authors: J. J. McPhaul, Frank J. Dixon
Journal: Journal of Clinical Investigation (1970)

Eluates from glomerulonephritic kidneys of nine patients with anti-glomerular basement membrane (anti-GBM)-mediated nephritis were studied to define their antigenic specificity and content of kidney-fixing antibodies. Five of these patients had Goodpasture's syndrome with pulmonary and renal involvement clinically; four patients did not. All had in vivo fixation of IgG in the characteristic linear pattern by direct immunofluorescence, and eluted IgG fixed to normal human kidney sections. Eluates from kidneys of patients with Goodpasture's syndrome fixed more frequently to homologous nonglomerular renal and extrarenal antigenic sites and to heterologous GBM than did non-Goodpasture eluates over a hundredfold range of antibody concentrations; both could be blocked by prior absorption with soluble GBM antigens. By radial immunodiffusion and precipitation tests the content of IgG in the eluates was measured to range from 2 to 20% of the total protein eluted. By paired label isotopic fixation studies with some of the eluates the per cent of IgG that was kidney fixing ranged from 0.6 to 23.4%. Although the in vivo fixation studies with radiolabeled eluates failed to indicate significant fixation to monkey lung, the observations define quantitative as well as qualitative differences between anti-GBM antibody populations mediating the Good-pasture syndrome compared to those causing glomerulonephritis without lung involvement.
Nonresponse to Treatment for Depression Following Myocardial Infarction: Association With Subsequent Cardiac Events
Authors: Peter de Jonge, Adriaan Honig, Joost P. van Melle, Aart H. Schene, Astrid M.G. Kuyper, Dorien Tulner, Annique Schins, Johan Ormel
Journal: American Journal of Psychiatry (2007)

Depression following myocardial infarction is associated with an increased risk of cardiac events, but attempts to alter cardiovascular prognosis by providing antidepressive treatment have not been successful. This may be because of the limited effects of antidepressive treatment on depression itself. The authors assessed whether nonresponse to treatment of post-myocardial infarction depression is associated with new cardiac events.The authors made a subgroup analysis of a multicenter randomized, clinical trial on the effects of antidepressant treatment for post-myocardial infarction depression. Patients were enrolled in double-blind, placebo-controlled treatment with mirtazapine (30 mg/day) and, in the case of insufficient treatment response after 8 weeks, open treatment with citalopram. Patients were classified as responders to antidepressants (at least 50% reduction in Hamilton Depression Rating scale [HAM-D] score or HAM-D score <9 at 24 weeks) (N=43) or as nonresponders (N=27) and compared to untreated control subjects (N=98) on cardiac events (cardiac mortality or cardiac-related hospital admission) after 24 weeks post-random assignment and within 18 months after index infarction.The event rate was 25.6% among nonresponders, 11.2% among untreated control subjects, and 7.4% among responders. In relation to untreated comparison subjects, nonresponders had a hazard ratio of 2.66 for new cardiovascular events, which remained after the authors controlled for potential confounders (hazard ratio=2.92).This study provides further preliminary evidence that nonresponse to treatment of post-myocardial infarction depression may be associated with cardiac events. Efforts should be dedicated to developing more effective treatments for depressed patients with myocardial infarction.
Clinical arrhythmia and sudden death in repaired tetralogy of Fallot: a multi-centre study
Authors: M.A. Gatzoulis, S. Balaji, C. Poile, S.A. Webber, J.S. Hokanson, S.C. Siu, T. Shinohara, J.H. Moller, M. Nakazawa, P.C. Gillette, G.D. Webb, A.N. Redington
Journal: Journal of the American College of Cardiology (1998)
The home environment and asthma symptoms in childhood: two population based case-control studies 13 years apart
Authors: B. K. Butland, D. P. Strachan, H. R. Anderson
Journal: Thorax (1997)

BACKGROUND: Prevalence surveys of asthma and/or wheezing among all children aged between 7 1/2 and 8 1/2 attending state and private schools in the London Borough of Croydon were conducted in February 1978 and February 1991. Two population based case-control studies drawn from the survey responders were used to investigate the association between childhood wheeze and characteristics of the home environment and to assess whether changes in these characteristics between 1978 and 1991 may have contributed to an increase in the population prevalence of wheeze among school children. METHODS: Information on exposure to potential indoor environmental risk factors was obtained from parents by home interview and compared between cases-that is, children with frequent (&gt; or = 5) or in-frequent (1-4) attacks of asthma or wheezing in the past 12 months- and controls, with adjustment for study. Changes in exposure over time were assessed by comparing control groups. RESULTS: Between 1978 and 1991 the population prevalence odds of wheeze increased by 20% (OR 1.20; 95% CI 1.04 to 1.39). Change in parental smoking, gas cooking, pet ownership, and central heating did not appear to explain the rise. Use of non-feather pillows was positively associated with childhood wheeze even after adjusting for other risk factors and after re-coding from non-feather to feather cases thought to have changed pillow in response to symptoms (OR 1.54; 95% CI 1.13 to 2.10). The proportion of control children reportedly using non-feather pillows was 44% in 1978 and 67% in 1991. CONCLUSIONS: Increased use of non-feather pillows was the only domestic indoor exposure studied which appeared to explain a modest rise in prevalence of wheeze from 1978 to 1991. Our analysis attempts to address behavioural change in response to the child9s symptoms but an artifact arising from lifelong avoidance of feather bedding in atopic families cannot be entirely discounted.
Persistent Stunning Induces Myocardial Hibernation and Protection
Authors: Song-Jung Kim, Athanasios Peppas, Suk-Keun Hong, Guiping Yang, Yanhong Huang, Gissela Diaz, Junichi Sadoshima, Dorothy E. Vatner, Stephen F. Vatner
Journal: Circulation Research (2003)

To test the hypothesis that persistent myocardial stunning can lead to hibernating myocardium, 13 pigs were chronically instrumented, and persistent stunning was induced regionally by 6 repetitive episodes of 90-minute coronary stenosis (CS) (30% reduction in baseline coronary blood flow [CBF]) followed by full reperfusion every 12 hours. During the 1st CS, CBF fell from 43+/-2 to 31+/-2 mL/min, and anterior wall thickening (AWT) fell by 54+/-8%, but posterior WT did not change. AWT never recovered fully and remained depressed by 31+/-7% before the 6th CS, reflecting persistent myocardial stunning, but baseline CBF was not changed. Surprisingly, during the 6th CS, AWT did not fall further despite a similar reduction in CBF during CS, as occurred with the 1st episode. Regional Mo2 fell similarly during the 1st and 6th CS. During the 1st CS, plasma glucose uptake increased, whereas free fatty acid (FFA) uptake was reduced. Before the 6th CS, glucose uptake remained elevated, whereas FFA uptake remained reduced. Histology revealed enhanced glycogen deposition, which could be explained by decreased glycogen synthase kinase (GSK)-3beta protein levels and activity. These results indicate that persistent stunning, even in the absence of chronic ischemia, can recapitulate the phenotype of myocardial hibernation. This results in a shift in the flow/function relationship where a 30% decrease in CBF is no longer accompanied by a fall in myocardial function, which could be explained, in part, by a shift in substrate utilization. These hemodynamic/metabolic adjustments could facilitate survival of hibernating myocardium.