tbuckley/cabot-search huggingface dataset:
Expiratory flow limitation in compressed air divers and oxygen divers
Authors: K Tetzlaff, L Friege, M Reuter, J Haber, T Mutzbauer, B Neubauer
Journal: European Respiratory Journal (1998)

Divers are exposed to dense gases under hyperbaric and hyperoxic conditions and, therefore, may be at risk of developing respiratory disease. Long-term effects on respiratory function have been found in commercial divers who perform deep dives. This study was conducted to detect possible lung function changes in scuba divers who dive in shallow water using compressed air or oxygen as a breathing gas. A cross-sectional sample of 180 healthy male divers (152 air divers and 28 oxygen divers) and 34 healthy male controls underwent a diving medical examination including body plethysmography, diffusion capacity measurement and a cold-air isocapnic hyperventilation test (CAIH). Air divers and oxygen divers had a lower mid-expiratory flow at 25% of vital capacity (MEF25) than controls (p&lt;0.01 and p&lt;0.05, respectively). Oxygen divers also had a decreased mid-expiratory flow at 50% of vital capacity (MEF50) (p&lt;0.05). Divers' groups and controls did not differ with respect to age, smoking or medical history. The prevalence of airway hyperresponsiveness to CAIH was 1.4% (n=3 divers). MEF25 and MEF50 were inversely related to years of diving (p&lt;0.01 and p&lt;0.001, respectively). The pattern of lung function changes obtained in scuba divers is consistent with small airways dysfunction and the association between diving exposure and lung function changes may indicate long-term effects on respiratory function.
Jaundice increases the rate of complications and one-year mortality in patients with hypoxic hepatitis
Authors: Bernhard Jäger, Andreas Drolz, Barbara Michl, Peter Schellongowski, Andja Bojic, Miriam Nikfardjam, Christian Zauner, Gottfried Heinz, Michael Trauner, Valentin Fuhrmann
Journal: Hepatology (2012)

Hypoxic hepatitis (HH) is the most frequent cause of acute liver injury in critically ill patients. No clinical data exist about new onset of jaundice in patients with HH. This study aimed to evaluate the incidence and clinical effect of jaundice in critically ill patients with HH. Two hundred and six consecutive patients with HH were screened for the development of jaundice during the course of HH. Individuals with preexisting jaundice or liver cirrhosis at the time of admission (n = 31) were excluded from analysis. Jaundice was diagnosed in patients with plasma total bilirubin levels >3 mg/dL. One-year-survival, infections, and cardiopulmonary, gastrointestinal (GI), renal, and hepatic complications were prospectively documented. New onset of jaundice occurred in 63 of 175 patients with HH (36%). In patients who survived the acute event of HH, median duration of jaundice was 6 days (interquartile range, 3-8). Patients who developed jaundice (group 1) needed vasopressor treatment (P < 0.05), renal replacement therapy (P < 0.05), and mechanical ventilation (P < 0.05) more often and had a higher maximal administered dose of norepinephrine (P < 0.05), compared to patients without jaundice (group 2). One-year survival rate was significantly lower in group 1, compared to group 2 (8% versus 25%, respectively; P < 0.05). Occurrence of jaundice was associated with an increased frequency of complications during follow-up (54% in group 1 versus 35% in group 2; P < 0.05). In particular, infections as well as renal and GI complications occurred more frequently in group 1 during follow-up.Jaundice is a common finding during the course of HH. It leads to an increased rate of complications and worse outcome in patients with HH.
Fertility- and Menopause-Related Information Needs of Younger Women With a Diagnosis of Early Breast Cancer
Authors: B. Thewes, B. Meiser, A. Taylor, K.A. Phillips, S. Pendlebury, A. Capp, D. Dalley, D. Goldstein, R. Baber, M.L. Friedlander
Journal: Journal of Clinical Oncology (2005)

Purpose The use of chemotherapy and endocrine therapies in the treatment of premenopausal women carries with it reproductive and gynecologic implications that young women may find distressing and discordant with plans for childbearing. This multicenter study aimed to investigate fertility- and menopause-related information needs among young women with a diagnosis of early-stage breast cancer. Patients and Methods Two hundred twenty-eight women with a diagnosis of early-stage breast cancer who were aged 40 years or younger at diagnosis and who were 6 to 60 months after diagnosis were entered onto the trial. Participants completed a mailed self-report questionnaire that included a purposely designed fertility- and menopause-related information needs survey and standardized measures of distress, anxiety, quality of life, menopausal symptoms, and information-seeking style. Results Seventy-one percent of participants discussed fertility-related issues with a health professional as part of their breast cancer treatment, and 86% discussed menopause-related issues. Consultation with a fertility or menopause specialist was the most preferred method of obtaining this information. Receiving fertility-related information was rated as being significantly more important than receiving menopause-related information at time of diagnosis (P &lt; .001) and at treatment decision making (P = .058). Receiving menopause-related information was rated as being significantly more important than receiving fertility-related information during adjuvant treatment (P &lt; .05), at completion of adjuvant treatment (P &lt; .001), and during follow-up (P &lt; .001). Common questions, sources of information, and correlates of perceived importance were identified. Conclusion The results of this study suggest that younger women have unmet needs for fertility- and menopause-related information and provide preliminary empirical data to guide the development of better fertility- and menopause-related patient education materials for younger women with a diagnosis of early breast cancer.
Two-Year Outcomes after Transcatheter or Surgical Aortic-Valve Replacement
Authors: Susheel K. Kodali, Mathew R. Williams, Craig R. Smith, Lars G. Svensson, John G. Webb, Raj R. Makkar, Gregory P. Fontana, Todd M. Dewey, Vinod H. Thourani, Augusto D. Pichard, Michael Fischbein, Wilson Y. Szeto, Scott Lim, Kevin L. Greason, Paul S. Teirstein, S. Chris Malaisrie, Pamela S. Douglas, Rebecca T. Hahn, Brian Whisenant, Alan Zajarias, Duolao Wang, Jodi J. Akin, William N. Anderson, Martin B. Leon
Journal: New England Journal of Medicine (2012)

The Placement of Aortic Transcatheter Valves (PARTNER) trial showed that among high-risk patients with aortic stenosis, the 1-year survival rates are similar with transcatheter aortic-valve replacement (TAVR) and surgical replacement. However, longer-term follow-up is necessary to determine whether TAVR has prolonged benefits.At 25 centers, we randomly assigned 699 high-risk patients with severe aortic stenosis to undergo either surgical aortic-valve replacement or TAVR. All patients were followed for at least 2 years, with assessment of clinical outcomes and echocardiographic evaluation.The rates of death from any cause were similar in the TAVR and surgery groups (hazard ratio with TAVR, 0.90; 95% confidence interval [CI], 0.71 to 1.15; P=0.41) and at 2 years (Kaplan-Meier analysis) were 33.9% in the TAVR group and 35.0% in the surgery group (P=0.78). The frequency of all strokes during follow-up did not differ significantly between the two groups (hazard ratio, 1.22; 95% CI, 0.67 to 2.23; P=0.52). At 30 days, strokes were more frequent with TAVR than with surgical replacement (4.6% vs. 2.4%, P=0.12); subsequently, there were 8 additional strokes in the TAVR group and 12 in the surgery group. Improvement in valve areas was similar with TAVR and surgical replacement and was maintained for 2 years. Paravalvular regurgitation was more frequent after TAVR (P<0.001), and even mild paravalvular regurgitation was associated with increased late mortality (P<0.001).A 2-year follow-up of patients in the PARTNER trial supports TAVR as an alternative to surgery in high-risk patients. The two treatments were similar with respect to mortality, reduction in symptoms, and improved valve hemodynamics, but paravalvular regurgitation was more frequent after TAVR and was associated with increased late mortality. (Funded by Edwards Lifesciences; ClinicalTrials.gov number, NCT00530894.).
Myelomatosis with Extensive Pulmonary Involvement
Authors: Z. Freeman
Journal: Thorax (1961)

This patient had a plasma cell myeloma, infiltrating the lung in a lobar manner, without obvious osseous involvement, and simultaneously showing Bence-Jones protein in the urine and an abnormal globulin content of the blood.The extensive pulmonary involvement is unusual. CASE REPORTA woman, aged 75 years, was admitted to the Eastern Suburbs Hospital for investigation of loss of weight and strength, occurring over the previous 12 months, which followed an attack of "pneumonia" a year before.She had no cough or sputum, no bone pain or history of fractures, and apart from generalized weakness and anorexia had no complaints.She was a frail patient with some purpuric spots on the forearms.She was pale but had no lymph node enlargement or abdominal masses.There was no sputum for examination, and at no time during her six weeks' stay in hospital was there any fever.Radiography of the lungs (Figs. 1 and 2) showed a left-sided opacity which was confined to the upper lobe and sharply demarcated by the interlobar fissure.This was described as consolidation, ?inflammatory in origin, and a right basal shadow was also noted.Radiographs of the skull, spine, and long bones revealed no abnormality, apart from well-marked degenerative spondylosis in the lumbar region.The Mantoux test (1 in 1,000) was negative.Haemoglobin was 9.2 g./100 ml., white cell count on July 29,
Progestogens for endometriosis: forward to the past
Authors: P. Vercellini
Journal: Human Reproduction Update (2003)

We performed a MEDLINE and EMBASE search to identify all studies published in the last decade in the English language literature on the use of progestogens for the treatment of endometriosis. Our aim was to clarify the biological rationale for treatment and define the drugs that can be used with their doses, routes of administration, efficacy and tolerability. Progestogens may prevent implantation and growth of regurgitated endometrium inhibiting expression of matrix metalloproteinases and angiogenesis, and they have several anti‐inflammatory in‐vitro and in‐vivo effects that may reduce the inflammatory state generated by the metabolic activity of the ectopic endometrium, and the consequent immune response. Oral contraceptives increase the abnormally low apoptotic activity of the endometrium of women with endometriosis. Moreover, anovulation, decidualization, amenorrhoea and the establishment of a steady estrogen–progestogen milieu contribute to disease quiescence. Progestogens are effective in the control of pain symptoms in approximately three out of four women with endometriosis. Their effect does not seem to be inferior to that of other drugs used for the disease. Different compounds can be administered by the oral, intramuscular, subcutaneous, intravaginal or intrauterine route, each with specific advantages or disadvantages. Medical treatment plays a role in the therapeutic strategy when administered over a prolonged period of time. Given their good tolerability, minor metabolic effects and low cost, progestogens must therefore be considered drugs of choice and are currently the only safe and economic alternative to surgery. However, their contraceptive effectiveness limits their use to women who do not wish to have children in the short term.
Myocardial Blood Flow in Pacing-Induced Angina
Authors: C. RICHARD CONTI, BERTRAM PITT, WALTER D. GUNDEL, GOTTLIEB C. FRIESINGER, RICHARD S. ROSS
Journal: Circulation (1970)

Current methods of measuring myocardial blood flow using 133 xenon have failed to separate normals from patients with ischemic heart disease at rest. In the present study such a separation was attempted by utilizing pacing-induced tachycardia (PIT) to stress the myocardium. 133 Xenon was injected into the left coronary artery to measure blood flow in 27 patients at rest and during pacing-induced tachycardia. Oxygen content was simultaneously measured in the aorta and coronary sinus of 13 of these patients. Pacing rates of 150 beats/min or greater were obtained in 21 patients. In 10 patients (group I), who developed ischemia, manifested either by typical angina or ischemic electrocardiographic changes during PIT, myocardial blood flow increased 32 ml/min/100 g of tissue ( P &lt; 0.001). In 17 patients (group II), who did not develop ischemia, myocardial blood flow increased 12 ml/min/100 g of tissue ( P &lt; 0.02). The increase in group I patients was significantly greater than in group II ( P &lt; 0.02). Myocardial oxygen consumption increased 4.63 ml/min/100 g of tissue ( P &lt; 0.01) in ischemic responders (group I) and 2.62 ml/min/100 g of tissue in nonischemic responders (group II). It is concluded that patients with an ischemic response to pacing-induced tachycardia had a greater increase in myocardial blood flow and myocardial oxygen consumption than patients who did not develop an ischemic response. This unexpected finding is best explained by an increased myocardial blood flow in the nonischemic areas of the myocardium which may result from a vasodilator response to ischemia.
EVOLUTION OF ANTIGEN BINDING RECEPTORS
Authors: Gary W. Litman, Michele K. Anderson, Jonathan P. Rast
Journal: Annual Review of Immunology (1999)

▪ Abstract This review addresses issues related to the evolution of the complex multigene families of antigen binding receptors that function in adaptive immunity. Advances in molecular genetic technology now permit the study of immunoglobulin (Ig) and T cell receptor (TCR) genes in many species that are not commonly studied yet represent critical branch points in vertebrate phylogeny. Both Ig and TCR genes have been defined in most of the major lineages of jawed vertebrates, including the cartilaginous fishes, which represent the most phylogenetically divergent jawed vertebrate group relative to the mammals. Ig genes in cartilaginous fish are encoded by multiple individual loci that each contain rearranging segmental elements and constant regions. In some loci, segmental elements are joined in the germline, i.e. they do not undergo genetic rearrangement. Other major differences in Ig gene organization and the mechanisms of somatic diversification have occurred throughout vertebrate evolution. However, relating these changes to adaptive immune function in lower vertebrates is challenging. TCR genes exhibit greater sequence diversity in individual segmental elements than is found in Ig genes but have undergone fewer changes in gene organization, isotype diversity, and mechanisms of diversification. As of yet, homologous forms of antigen binding receptors have not been identified in jawless vertebrates; however, acquisition of large amounts of structural data for the antigen binding receptors that are found in a variety of jawed vertebrates has defined shared characteristics that provide unique insight into the distant origins of the rearranging gene systems and their relationships to both adaptive and innate recognition processes.
Antibiotic prescribing for adults with acute cough/lower respiratory tract infection: congruence with guidelines
Authors: J. Wood, C.C. Butler, K. Hood, M.J. Kelly, T. Verheij, P. Little, A. Torres, F. Blasi, T. Schaberg, H. Goossens, J. Nuttall, S. Coenen
Journal: European Respiratory Journal (2011)

European guidelines for treating acute cough/lower respiratory tract infection (LRTI) aim to reduce nonevidence-based variation in prescribing, and better target and increase the use of first-line antibiotics. However, their application in primary care is unknown. We explored congruence of both antibiotic prescribing and antibiotic choice with European Respiratory Society (ERS)/European Society of Clinical Microbiology and Infectious Diseases (ESCMID) guidelines for managing LRTI. The present study was an analysis of prospective observational data from patients presenting to primary care with acute cough/LRTI. Clinicians recorded symptoms on presentation, and their examination and management. Patients were followed up with self-complete diaries. 1,776 (52.7%) patients were prescribed antibiotics. Given patients’ clinical presentation, clinicians could have justified an antibiotic prescription for 1,915 (71.2%) patients according to the ERS/ESCMID guidelines. 761 (42.8%) of those who were prescribed antibiotics received a first-choice antibiotic ( i.e. tetracycline or amoxicillin). Ciprofloxacin was prescribed for 37 (2.1%) and cephalosporins for 117 (6.6%). A lack of specificity in definitions in the ERS/ESCMID guidelines could have enabled clinicians to justify a higher rate of antibiotic prescription. More studies are needed to produce specific clinical definitions and indications for treatment. First-choice antibiotics were prescribed to the minority of patients who received an antibiotic prescription.
Severity and correlates of liver disease in hepatitis C virus-infected injection drug users
Authors: Rudra Rai, Lucy E. Wilson, Jacquie Astemborski, Frank Anania, Michael Torbenson, Charles Spoler, David Vlahov, Steffanie A. Strathdee, John Boitnott, Kenrad E. Nelson, David L. Thomas
Journal: Hepatology (2002)

Between May 1996 and June 1998, 210 members of a cohort of 1,667 hepatitis C virus (HCV)-infected injection drug users (IDUs) were selected for liver biopsy procedure after stratification based on 2 consecutive serum alanine transaminase (ALT) levels. Liver histology, which could be fully evaluated for 207 subjects, was classified by using the modified Ishak scores. At the time of biopsy, the median age of subjects was 41.3 years and the median estimated duration of HCV infection was 20.7 years; 94% were African American; 78% men; 31% were human immunodeficiency virus (HIV) seropositive; and 76% had HCV genotype 1a or 1b. Total modified histologic activity index (MHAI) scores ranged from 0 to 9, and 26.6% had a total MHAI score of 5 or greater. Persons with a total MHAI score of 5 or greater were more likely to be HIV infected ( P = .04). Higher fibrosis, indicated by Ishak modified fibrosis scores of 3 to 6, was present in 10.1% of subjects and was found more often in those older than 46 years of age (the highest quartile) ( P &lt; .01). Both fibrosis scores of 3 or greater and total scores of 5 or greater were associated with elevated ALT, aspartate transaminase (AST), and γ-glutamyl transpeptidase (GGT) levels ( P &lt; .01). When serial values were considered, the results of liver enzyme testing could reduce the probability of an IDU having a fibrosis score of 3 or greater from 10% to 3%. In conclusion, these data indicate that severe liver disease is uncommon in this urban, HCV-infected IDU cohort, especially in younger persons and those with repeatedly normal liver enzymes.
Overexpression of Mitochondrial Transcription Factor A Ameliorates Mitochondrial Deficiencies and Cardiac Failure After Myocardial Infarction
Authors: Masaki Ikeuchi, Hidenori Matsusaka, Dongchon Kang, Shouji Matsushima, Tomomi Ide, Toru Kubota, Toshiyuki Fujiwara, Naotaka Hamasaki, Akira Takeshita, Kenji Sunagawa, Hiroyuki Tsutsui
Journal: Circulation (2005)

Mitochondrial DNA (mtDNA) copy number is decreased not only in mtDNA-mutation diseases but also in a wide variety of acquired degenerative and ischemic diseases. Mitochondrial transcription factor A (TFAM) is essential for mtDNA transcription and replication. Myocardial mtDNA copy number and TFAM expression both decreased in cardiac failure. However, the functional significance of TFAM has not been established in this disease state.We have now addressed this question by creating transgenic (Tg) mice that overexpress human TFAM gene and examined whether TFAM could protect the heart from mtDNA deficiencies and attenuate left ventricular (LV) remodeling and failure after myocardial infarction (MI) created by ligating the left coronary artery. TFAM overexpression could ameliorate the decrease in mtDNA copy number and mitochondrial complex enzyme activities in post-MI hearts. Survival rate during 4 weeks of MI was significantly higher in Tg-MI than in wild-type (WT) littermates (WT-MI), although infarct size was comparable. LV cavity dilatation and dysfunction were significantly attenuated in Tg-MI. LV end-diastolic pressure was increased in WT-MI, and it was also reduced in Tg-MI. Improvement of LV function in Tg-MI was accompanied by a decrease in myocyte hypertrophy, apoptosis, and interstitial fibrosis as well as oxidative stress in the noninfarcted LV.Overexpression of TFAM inhibited LV remodeling after MI. TFAM may provide a novel therapeutic strategy of cardiac failure.
Atrial natriuretic peptide promotes cardiomyocyte survival by cGMP-dependent nuclear accumulation of zyxin and Akt
Authors: Takahiro Kato, John Muraski, Yan Chen, Yasuyuki Tsujita, Jason Wall, Christopher C. Glembotski, Erik Schaefer, Mary Beckerle, Mark A. Sussman
Journal: Journal of Clinical Investigation (2005)

This study delineates a mechanism for antiapoptotic signaling initiated by atrial natriuretic peptide (ANP) stimulation leading to elevation of cGMP levels and subsequent nuclear accumulation of Akt kinase associated with zyxin, a cytoskeletal LIM-domain protein. Nuclear targeting of zyxin induces resistance to cell death coincident with nuclear accumulation of activated Akt. Nuclear translocation of zyxin triggered by cGMP also promotes nuclear Akt accumulation. Additional supportive evidence for nuclear accumulation of zyxin-enhancing cardiomyocyte survival includes the following: (a) promotion of zyxin nuclear localization by cardioprotective stimuli; (b) zyxin association with phospho-Akt473 induced by cardioprotective stimuli; and (c) recruitment of zyxin to the nucleus by activated nuclear-targeted Akt as well as recruitment of Akt by nuclear-targeted zyxin. Nuclear accumulation of zyxin requires both Akt activation and nuclear localization. Potentiation of cell survival is sensitive to stimulation intensity with high-level induction by ANP or cGMP signaling leading to apoptotic cell death rather than enhancing resistance to apoptotic stimuli. Myocardial nuclear accumulation of zyxin and Akt responds similarly in vivo following treatment of mice with ANP or cGMP. Thus, zyxin and activated Akt participate in a cGMP-dependent signaling cascade leading from ANP receptors to nuclear accumulation of both molecules. Nuclear accumulation of zyxin and activated Akt may represent a fundamental mechanism that facilitates nuclear-signal transduction and potentiates cell survival.
Worry and Generalized Anxiety Disorder: A Review and Theoretical Synthesis of Evidence on Nature, Etiology, Mechanisms, and Treatment
Authors: Michelle G. Newman, Sandra J. Llera, Thane M. Erickson, Amy Przeworski, Louis G. Castonguay
Journal: Annual Review of Clinical Psychology (2013)

Generalized anxiety disorder (GAD) is associated with substantial personal and societal cost yet is the least successfully treated of the anxiety disorders. In this review, research on clinical features, boundary issues, and naturalistic course, as well as risk factors and maintaining mechanisms (cognitive, biological, neural, interpersonal, and developmental), are presented. A synthesis of these data points to a central role of emotional hyperreactivity, sensitivity to contrasting emotions, and dysfunctional attempts to cope with strong emotional shifts via worry. Consistent with the Contrast Avoidance model, evidence shows that worry evokes and sustains negative affect, thereby precluding sharp increases in negative emotion. We also review current treatment paradigms and suggest how the Contrast Avoidance model may help to target key fears and avoidance tendencies that serve to maintain pathology in GAD.