tbuckley/cabot-search huggingface dataset:
Sex Differences in Reperfusion in Young Patients With ST-Segment–Elevation Myocardial Infarction
Authors: Gail D’Onofrio, Basmah Safdar, Judith H. Lichtman, Kelly M. Strait, Rachel P. Dreyer, Mary Geda, John A. Spertus, Harlan M. Krumholz
Journal: Circulation (2015)

Sex disparities in reperfusion therapy for patients with acute ST-segment-elevation myocardial infarction have been documented. However, little is known about whether these patterns exist in the comparison of young women with men.We examined sex differences in rates, types of reperfusion therapy, and proportion of patients exceeding American Heart Association reperfusion time guidelines for ST-segment-elevation myocardial infarction in a prospective observational cohort study (2008-2012) of 1465 patients 18 to 55 years of age, as part of the US Variations in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) study at 103 hospitals enrolling in a 2:1 ratio of women to men. Of the 1238 patients eligible for reperfusion, women were more likely to be untreated than men (9% versus 4%, P=0.002). There was no difference in reperfusion strategy for the 695 women and 458 men treated. Women were more likely to exceed in-hospital and transfer time guidelines for percutaneous coronary intervention than men (41% versus 29%; odds ratio, 1.65; 95% confidence interval, 1.27-2.16), more so when transferred (67% versus 44%; odds ratio, 2.63; 95% confidence interval, 1.17-4.07); and more likely to exceed door-to-needle times (67% versus 37%; odds ratio, 2.62; 95% confidence interval, 1.23-2.18). After adjustment for sociodemographic, clinical, and organizational factors, sex remained an important factor in exceeding reperfusion guidelines (odds ratio, 1.72; 95% confidence interval, 1.28-2.33).Young women with ST-segment-elevation myocardial infarction are less likely to receive reperfusion therapy and more likely to have reperfusion delays than similarly aged men. Sex disparities are more pronounced among patients transferred to percutaneous coronary intervention institutions or who received fibrinolytic therapy.
Impact of Adjuvant Radiotherapy on Survival of Patients With Node-Positive Prostate Cancer
Authors: Firas Abdollah, R. Jeffrey Karnes, Nazareno Suardi, Cesare Cozzarini, Giorgio Gandaglia, Nicola Fossati, Damiano Vizziello, Maxine Sun, Pierre I. Karakiewicz, Mani Menon, Francesco Montorsi, Alberto Briganti
Journal: Journal of Clinical Oncology (2014)

The role of adjuvant radiotherapy (aRT) in treating patients with pN1 prostate cancer is controversial. We tested the hypothesis that the impact of aRT on cancer-specific mortality (CSM) in these individuals is related to tumor characteristics.We evaluated 1,107 patients with pN1 prostate cancer treated with radical prostatectomy and anatomically extended pelvic lymph node dissection between 1988 and 2010 at two tertiary care centers. All patients received adjuvant hormonal therapy with or without aRT. Regression tree analysis stratified patients into risk groups on the basis of their tumor characteristics and the corresponding CSM rate. Cox regression analysis tested the relationship between aRT and CSM rate, as well as overall mortality (OM) rate in each risk group separately.Overall, 35% of patients received aRT. At multivariable analysis, aRT was associated with more favorable CSM rate (hazard ratio [HR], 0.37; P < .001). However, when patients were stratified into risk groups, only two groups of men benefited from aRT: (1) patients with positive lymph node (PLN) count ≤ 2, Gleason score 7 to 10, pT3b/pT4 stage, or positive surgical margins (HR, 0.30; P = .002); and (2) patients with PLN count of 3 to 4 (HR, 0.21; P = .02), regardless of other tumor characteristics. These results were confirmed when OM was examined as an end point.The beneficial impact of aRT on survival in patients with pN1 prostate cancer is highly influenced by tumor characteristics. Men with low-volume nodal disease (≤ two PLNs) in the presence of intermediate- to high-grade, non-specimen-confined disease and those with intermediate-volume nodal disease (three to four PLNs) represent the ideal candidates for aRT after surgery.
Nontuberculous mycobacteria in bronchiectasis: prevalence and patient characteristics
Authors: S. J. Fowler, J. French, N. J. Screaton, J. Foweraker, A. Condliffe, C. S. Haworth, A. R. Exley, D. Bilton
Journal: European Respiratory Journal (2006)

The aim of the current study was to investigate the prevalence and clinical associations of nontuberculous mycobacteria (NTM) in a well-characterised cohort of patients with adult-onset bronchiectasis. The sputum of all patients attending a tertiary referral bronchiectasis clinic between April 2002 and August 2003 was examined for mycobacteria as part of an extensive diagnostic work-up. NTM-positive patients subsequently had further sputa examined. A modified bronchiectasis scoring system was applied to all high-resolution computed tomography (HRCT) scans from NTM-positive patients, and a matched cohort without NTM. Out of 98 patients attending the clinic, 10 had NTM in their sputum on first culture; of those, eight provided multiple positive cultures. Three patients were treated for NTM infection. A higher proportion of NTM-positive than -negative patients were subsequently diagnosed with cystic fibrosis (two out of nine versus two out of 75). On HRCT scoring, more patients in the NTM-positive group had peripheral mucus plugging than in the NTM-negative group. In the current prospective study of a large cohort of patients with bronchiectasis, 10% cultured positive for nontuberculous mycobacteria in a random clinic sputum sample. Few clinical parameters were helpful in discriminating between groups, except for a higher prevalence of previously undiagnosed cystic fibrosis and of peripheral mucus plugging on high-resolution computed tomography in the nontuberculous mycobacteria group.
Gap junctional remodeling in relation to stabilization of atrial fibrillation in the goat
Authors: H van der Velden
Journal: Cardiovascular Research (2000)

It has been postulated that high atrial rate induced changes at the level of the gap junctions ('gap junctional remodeling', i.e. changes in distribution, intercellular orientation and expression of gap junction proteins), could be part of the vicious circle of electrophysiologic and structural changes leading to sustained atrial fibrillation (AF). To obtain experimental evidence in favour of such a postulate the timing of this remodeling process was studied in relation to the development of sustained AF in a goat model.Thin sections from the left (LAA) and right atrial appendage (RAA) from goats in sinus rhythm (SR) or AF, induced through programmed endocardial burst pacing for time periods between 0 and 16 weeks, were immunolabeled with antibodies against connexin(Cx)40 and Cx43 and analysed by immunofluorescence and confocal laser scanning microscopy. During SR the distribution pattern for Cx43 was completely homogeneous (LAA and RAA) and for Cx40 mostly homogeneous (LAA: all five goats, RAA: three out of five goats). The distribution pattern for Cx43 remained stable during AF, while the Cx40 distribution pattern became increasingly heterogeneous, both in the LAA and RAA, with increasing duration of pacing. This increase in heterogeneity in Cx40 distribution correlated (Spearman rank order) with an increase in stability of AF and the occurrence of structural changes (myolysis) in atrial myocytes. The Cx40/Cx43 immunofluorescence signal ratio in both the LAA and RAA appeared to be significantly lower in AF (1-16 weeks) as compared to SR (0 weeks); going from 0 to 16 weeks average ratios decreased 54.5% (n=5; P=0.026) in the LAA and 35.8 (n=5; P=0.034) in the RAA. Western blot analyses revealed similar decreases in the total Cx40/Cx43 protein ratio, on average 50.0% (n=5; P=0.008) and 47.8% (n=5; P=0.02) in the LAA and RAA, respectively. No changes were measured in the levels of Cx40 or Cx43 mRNA, as was assessed through RT-PCR.The time course of changes in the distribution and content of Cx40 gap junctions as observed during endocardial burst pacing of the goat atrium suggests that Cx40 gap junctional remodeling might be involved in the pathogenesis of sustained atrial fibrillation.
The use of Fundus Photographs and Fluorescein Angiograms in the Identification and Treatment of Choroidal Neovascularization in the Macular Photocoagulation Study
Authors: Judith A. Chamberlin, Neil M. Bressler, Susan B. Bressler, Michael J. Elman, Robert P. Murphy, Timothy P. Flood, Barbara S. Hawkins, Maureen G. Maguire, Stuart L. Fine
Journal: Ophthalmology (1989)
Seasonal Variation in Mood in African American College Students in the Washington, D.C., Metropolitan Area
Authors: Charles O Agumadu, Samina M Yousufi, Irum S Malik, Minh-Chau T Nguyen, Michael A Jackson, Kambiz Soleymani, Courtney M Thrower, Michelle J Peterman, Gene W Walters, Mariana J Niemtzoff, John J Bartko, Teodor T Postolache
Journal: American Journal of Psychiatry (2004)

The authors attempted to estimate the occurrence, frequency, and pattern (winter versus summer) of seasonal affective disorder in African American college students. They hypothesized that winter seasonal affective disorder would be more prevalent than summer seasonal affective disorder.Undergraduate and graduate college students who identified themselves as African Americans living in the Washington, D.C., metropolitan area were invited to participate in the study. The Seasonal Pattern Assessment Questionnaire was used to calculate a global seasonality score and to estimate the frequency of seasonal affective disorder and subsyndromal seasonal affective disorder. The frequency of the summer versus winter pattern of seasonality of seasonal affective disorder was compared by using multinomial probability distribution tests. The effects of gender and the awareness of seasonal affective disorder were evaluated with a two-way analysis of variance.Of 646 students who were invited to participate, 597 returned the questionnaires, and 537 (83.1%) fully completed them. Winter seasonal affective disorder was significantly more prevalent than summer seasonal affective disorder. The mean global seasonality score was 8.3 (SD=5.3). The majority of the subjects (80%) were not aware of the existence of seasonal affective disorder.The authors found that the frequency, magnitude, and pattern of seasonality of mood in African American students were similar to those previously reported in the general population at similar latitude, but that awareness of the existence of seasonal affective disorder, a condition with safe and effective treatment options, was lower.
Complement in acute and chronic arthritides: assessment of C3c, C9, and protectin (CD59) in synovial membrane.
Authors: Y.T Konttinen, A Ceponis, S Meri, A Vuorikoski, P Kortekangas, T Sorsa, A Sukura, S Santavirta
Journal: Annals of the Rheumatic Diseases (1996)

To investigate the role of complement cascade induced damage and protection against it in acute arthritides compared to rheumatoid arthritis and other chronic joint derangements. C3c, C9, and protectin (CD59) were examined by avidin-biotin-peroxidase complex staining. Marked deposits of C3c and C9 were found in synovial vasculature and intercellular matrix of the lining in rheumatoid arthritis and in acute arthritides (including bacterial, reactive, and osteoarthritis flare up). Furthermore, protectin was not visible in synovial lining cells and was relatively weakly expressed in stromal and endothelial cells in rheumatoid arthritis; also in acute arthritides protectin expression was weak. In contrast, C3c and C9 deposits were not found in chronic conditions associated with degenerative diseases (osteoarthritis and osteochondritis dissecans) or mechanical causes (patellar luxation and a ruptured meniscus), in which also the protectin expression was prominent in synovial lining, endothelial and some stromal cells. Activation of the complement in rheumatoid arthritis and in acute arthritides seems to be associated with a decreased protection of synovial cells against cellular effects and lysis mediated by membrane attack complex.
Surgical Management of Heart Failure: An Overview
Authors: David Zeltsman, Michael A. Acker
Journal: Annual Review of Medicine (2002)

▪ Abstract Cardiac transplantation remains the gold standard of surgical therapies for advanced and end-stage heart failure. However, this very limited option trades one disease for another and can benefit only a small minority of patients. Heart failure is currently considered secondary to a structural increase in ventricular chamber volume or remodeling. Surgical therapies formerly contraindicated for the failing heart, as well as new therapies, can successfully affect ventricular remodeling and improve cardiac function. Surgical revascularization for patients with ejection fractions &lt;20% is becoming common. Mitral valve repair is being explored, with surprisingly low operative mortality and encouraging intermediate results. Direct surgical approaches to restoring normal geometry and size to failing hearts, such as left ventricular reduction (Batista procedure), endoventricular patch plasty (Dor procedure), cardiomyoplasty, and prosthetic external constraints are under clinical investigation. Developments in mechanical assist therapy and a new generation of implantable intracorporeal assist devices are also discussed.
Candida myocarditis causing complete atrioventricular block
Authors: J. E. Van Kirk
Journal: JAMA (1974)

Complete heart block developed unexpectedly in a 54-year-old patient with acute myelomonocytic leukemia and was successfully treated with temporary transvenous pacing. Subsequent autopsy showed several microabscesses of<i>Candida albicans</i>in the His bundle, without evidence of leukemic infiltration or hemorrhage into the conduction system. While the general incidence and importance of<i>Candida</i>myocarditis in leukemic patients is unknown, fungal myocarditis with abscess formation should be considered as a cause of cardiac rhythm disturbances in these and other immunosuppressed patients.
ECM remodelling in IBD: innocent bystander or partner in crime? The emerging role of extracellular molecular events in sustaining intestinal inflammation
Authors: Elee Shimshoni, Doron Yablecovitch, Liran Baram, Iris Dotan, Irit Sagi
Journal: Gut (2014)

IBD, which primarily includes UC and Crohn's disease (CD), is a progressive, chronic and relapsing condition. This debilitating disease is steadily becoming a worldwide medical concern, with increasing prevalence and incidence in both industrialised and developing countries.1 While the exact aetiology of the disease remains unknown, genetic predisposition and various environmental and immunological causes have been identified as contributing factors.2 Generally, IBD is characterised by a dysregulated excessive immune response and tissue damage in the GI tract.3 ,4 This aberrant and sustained immune response is thought to be mainly facilitated by defects in the function of the intestinal epithelial barrier and in the regulation of mucosal immunity.5 Yet, tissue damage associated with IBD is commonly considered solely a downstream effect and not a contributing factor. This view has led to a concentrated focus on the development of IBD treatments that target inflammatory pathways, but all, thus far, have exhibited limited efficacy. In contrast, none of the IBD drugs released to date were designed to specifically target the tissue-destructive processes associated with the disease.

When it comes to basic and clinical research of IBD-associated tissue destruction, most groups have directed their efforts to investigating cellular responses during inflammation, neglecting altogether the main component undergoing physical rupture, namely, the extracellular matrix (ECM). In a similar manner, while the regulatory role of the ECM in the progression of invasive diseases, such as cancer, is becoming acknowledged, its function in IBD is often overlooked despite the common notion that tissue destruction is imperative to disease progression.

In this article, we highlight ECM remodelling as an integral part of directional pathological signalling in IBD rather than, as is often considered, a passive bystander. We argue that the ECM, in the context of IBD, is not only a static scaffold holding …
Digital image analysis for diagnosis of cutaneous melanoma. Development of a highly effective computer algorithm based on analysis of 837 melanocytic lesions
Authors: A. Blum, H. Luedtke, U. Ellwanger, R. Schwabe, G. Rassner, C. Garbe
Journal: British Journal of Dermatology (2004)

Background Digital image analysis has been introduced into the diagnosis of skin lesions based on dermoscopic pictures. Objectives To develop a computer algorithm for the diagnosis of melanocytic lesions and to compare its diagnostic accuracy with the results of established dermoscopic classification rules. Methods In the Department of Dermatology, University of Tuebingen, Germany, 837 melanocytic skin lesions were prospectively imaged by a dermoscopy video system in consecutive patients. Of these lesions, 269 were excised and examined by histopathology: 84 were classified as cutaneous melanomas and 185 as benign melanocytic naevi. The remaining 568 lesions were diagnosed by dermoscopy as benign. Digital image analysis was performed in all 837 benign and malignant melanocytic lesions using 64 different analytical parameters. Results For lesions imaged completely (diameter ≤ 12 mm), three analytical parameters were found to distinguish clearly between benign and malignant lesions, while in incompletely imaged lesions six parameters enabled differentiation. Based on the respective parameters and logistic regression analysis, a diagnostic computer algorithm for melanocytic lesions was developed. Its diagnostic accuracy was 82% for completely imaged and 84% for partially imaged lesions. All 837 melanocytic lesions were classified by established dermoscopic algorithms and the diagnostic accuracy was found to be in the same range (ABCD rule 78%, Menzies' score 83%, seven-point checklist 88%, and seven features for melanoma 81%). Conclusions A diagnostic algorithm for digital image analysis of melanocytic lesions can achieve the same range of diagnostic accuracy as the application of dermoscopic classification rules by experts. The present diagnostic algorithm, however, still requires a medical expert who is qualified to recognize cutaneous lesions as being of melanocytic origin.
Web Apollo: a web-based genomic annotation editing platform
Authors: Eduardo Lee, Gregg A Helt, Justin T Reese, Monica C Munoz-Torres, Chris P Childers, Robert M Buels, Lincoln Stein, Ian H Holmes, Christine G Elsik, Suzanna E Lewis
Journal: Genome biology (2013)

Abstract Web Apollo is the first instantaneous, collaborative genomic annotation editor available on the web. One of the natural consequences following from current advances in sequencing technology is that there are more and more researchers sequencing new genomes. These researchers require tools to describe the functional features of their newly sequenced genomes. With Web Apollo researchers can use any of the common browsers (for example, Chrome or Firefox) to jointly analyze and precisely describe the features of a genome in real time, whether they are in the same room or working from opposite sides of the world.
Personalised medicine in the UK: challenges of implementation and impact on healthcare system
Authors: Anna Pokorska-Bocci, Mark Kroese, Gurdeep S Sagoo, Alison Hall, Hilary Burton
Journal: Genome Medicine (2014)

*Personalised medicine initiatives in the UK In light of the increasing momentum towards personalised medicine and healthcare, driven by genomic science and a spectrum of technological and information tools [1], we discuss the challenges and impact of personalised approaches within the UK National Health Service (NHS). Various initiatives in the UK have attempted a shift from population-centred to individual-centred approaches and there have been some successful attempts to make healthcare systems more participatory and prevention-oriented. In the UK, personalised approaches have featured on policy agendas for some time. In 2009, the House of Lords report on Genomic Medicine noted that using genomics to enable stratified use of medicines holds ‘the greatest potential for the healthcare sector’ but also presents ‘one of the biggest translational challenges’ [2]. Stratified medicine initiatives, co-financed by industry and government, have encouraged the pharmaceutical industry to embrace personalised treatments and devices. In 2011, the Technology Strategy Board published a strategic vision for making the UK the world leader in development and adoption of stratified medicine. In 2012, the potential emergence of stratified medicine across the entire healthcare system fuelled by genomic information was a central theme of the governmental Human Genomics Strategy Group report [3]. Challenges for implementing personalised medicine in the UK Despite the high-level political endorsement, personalised medicine remains elusive and several challenges remain. These include establishing a robust evidence base, changing practice within existing health services, and facilitating an increasingly participatory approach. Some of these challenges were analysed in the PHG Foundation response to the Genomic Medicine report and its report on next-generation sequencing [4,5]. The Academy of Medical Sciences noted a further set of economic drivers for adopting personalised approaches [6]. Establishing the evidence base A personalised approach necessitates tests and interventions that target increasingly finely divided subgroups requiring a valid evidence base incorporating genomic data. Genomics may contribute to personalised medicine by allowing refined knowledge of a diagnostic group or a subgroup characterised by its response to a treatment . Demonstrating the clinical utility and cost-effectiveness of expensive complex technologies in genetic diseases, and that the replacement test is superior to existing interventions in efficacy, cost-effectiveness or discriminatory power, are necessary steps for implementation. Many molecular tests have failed to satisfy these requirements [7].
Tuberculosis infection in children who are contacts of immigrant tuberculosis patients
Authors: S. Verver, J. H. van Loenhout-Rooyackers, R. Bwire, J. A. C. M. Annee-van Bavel, H. J. M. de Lange, P. J. H. J. van Gerven, M. W. Borgdorff
Journal: European Respiratory Journal (2005)

The present study aimed to determine what proportion of children who are in close contact with immigrant tuberculosis (TB) patients are infected with Mycobacterium tuberculosis . For 1.5 yrs, 14 municipal health services in the Netherlands collected data from all non-Dutch TB patients and their contacts. Close contacts aged &lt;16 yrs received a tuberculin skin test (TST). A positive TST was defined as an induration of ≥10 mm among nonvaccinated children, and ≥16 mm among bacille Calmette–Guérin-vaccinated children. In total, 244 patients had 359 close contacts aged &lt;16 yrs. Nine out of the 359 (2.5%) had TB. A TST test was given to 298 out of the 359 (83%). Of the 115 contacts of 44 extrapulmonary TB patients, three (3%) had a positive TST. Of the 186 contacts of 58 positive pulmonary TB patients, 30 (16%) had a positive TST. Contacts of sputum smear-positive patients significantly more often had a positive TST (25%), compared with the contacts of sputum smear-negative patients (7%). Children born abroad significantly more often had a positive TST (20%) than children born in the Netherlands (5%). In conclusion, the prevalence of active tuberculosis and latent tuberculosis infection among children who are close contacts of immigrant tuberculosis patients is high and warrants an expansion of contact investigation.