tbuckley/cabot-search huggingface dataset:
Effectiveness of Nurses as Providers of Birth Labor Support in North American Hospitals&lt;SUBTITLE&gt;A Randomized Controlled Trial&lt;/SUBTITLE&gt;
Authors: Ellen D. Hodnett
Journal: JAMA (2002)

ContextNorth American cesarean delivery rates have risen dramatically since the 1960s, without concomitant improvements in perinatal or maternal health. A Cochrane Review concluded that continuous caregiver support during labor has many benefits, including reduced likelihood of cesarean delivery.ObjectiveTo evaluate the effectiveness of nurses as providers of labor support in North American hospitals.DesignRandomized controlled trial with prognostic stratification by center and parity. Women were enrolled during a 2-year period (May 1999 to May 2001) and followed up until 6 to 8 postpartum weeks.SettingThirteen US and Canadian hospitals with annual cesarean delivery rates of at least 15%.ParticipantsA total of 6915 women who had a live singleton fetus or twins, were 34 weeks' gestation or more, and were in established labor at randomization.InterventionPatients were randomly assigned to receive usual care (n = 3461) or continuous labor support by a specially trained nurse (n = 3454) during labor.Main Outcome MeasuresThe primary outcome measure was cesarean delivery rate. Other outcomes included intrapartum events and indicators of maternal and neonatal morbidity, both immediately after birth and in the first 6 to 8 postpartum weeks.ResultsData were received for all 6915 women and their infants (n = 6949). The rates of cesarean delivery were almost identical in the 2 groups (12.5% in the continuous labor support group and 12.6% in the usual care group; P = .44). There were no significant differences in other maternal or neonatal events during labor, delivery, or the hospital stay. There were no significant differences in women's perceived control during childbirth or in depression, measured at 6 to 8 postpartum weeks. All comparisons of women's likes and dislikes, and their future preference for amount of nursing support, favored the continuous labor support group.ConclusionsIn hospitals characterized by high rates of routine intrapartum interventions, continuous labor support by nurses does not affect the likelihood of cesarean delivery or other medical or psychosocial outcomes of labor and birth.
Bionic Baroreceptor Corrects Postural Hypotension in Rats With Impaired Baroreceptor
Authors: Kazuya Hosokawa, Tomomi Ide, Tomoyuki Tobushi, Kazuo Sakamoto, Ken Onitsuka, Takafumi Sakamoto, Takeo Fujino, Keita Saku, Kenji Sunagawa
Journal: Circulation (2012)

Background— Impairment of the arterial baroreflex causes orthostatic hypotension. Arterial baroreceptor sensitivity degrades with age. Thus, an impaired baroreceptor plays a pivotal role in orthostatic hypotension in most elderly patients. There is no effective treatment for orthostatic hypotension. The aims of this investigation were to develop a bionic baroreceptor (BBR) and to verify whether it corrects postural hypotension. Methods and Results— The BBR consists of a pressure sensor, a regulator, and a neurostimulator. In 35 Sprague-Dawley rats, we vascularly and neurally isolated the baroreceptor regions and attached electrodes to the aortic depressor nerve for stimulation. To mimic impaired baroreceptors, we maintained intracarotid sinus pressure at 60 mm Hg during activation of the BBR. Native baroreflex was reproduced by matching intracarotid sinus pressure to the instantaneous pulsatile aortic pressure. The encoding rule for translating intracarotid sinus pressure into stimulation of the aortic depressor nerve was identified by a white noise technique and applied to the regulator. The open-loop arterial pressure response to intracarotid sinus pressure (n=7) and upright tilt–induced changes in arterial pressure (n=7) were compared between native baroreceptor and BBR conditions. The intracarotid sinus pressure–arterial pressure relationships were comparable. Compared with the absence of baroreflex, the BBR corrected tilt-induced hypotension as effectively as under native baroreceptor conditions (native, −39±5 mm Hg; BBR, −41±5 mm Hg; absence, −63±5 mm Hg; P &lt;0.05). Conclusions— The BBR restores the pressure buffering function. Although this research demonstrated feasibility of the BBR, further research is needed to verify its long-term effect and safety in larger animal models and humans.
Distribution of technetium-99m-labelled QVAR<sup>TM</sup>delivered using an Autohaler<sup>TM</sup>device in children
Authors: S.G. Devadason, T. Huang, S. Walker, R. Troedson, P.N. Le Souëf
Journal: European Respiratory Journal (2003)

QVAR TM , an extrafine hydrofluoroalkane/beclomethasone dipropionate formulation, has been shown to double lung deposition in adults. The aim of the present study was to assess the total body deposition and distribution oftechnetium-99m-labelled ( 99m Tc) QVAR TM in children after inhalation via an Autohaler TM . Sixteen male asthmatic children (5–14 yrs) inhaled labelled drug (&lt;4 MBq 99m Tc; 100 µg beclomethasone dipropionate) via an Autohaler within 30 min after salbutamol (200 µg) administration. Simultaneous anterior and posterior planar scintigraphic scans(120 s acquisition time) were collected after inhalation of labelled drug. Mean±sd lung deposition of labelled drug (attenuation-corrected; percentage of ex-actuator dose) was 36.9±9.2, 46.5±11.6 and 54.1±10.7% in children aged 5–7, 8–10 and 11–14 yrs, respectively. Combined oropharyngeal and gastrointestinal deposition was 59.7±8.2, 48.9±12.3 and 40.3±11.8%. Lung deposition positively correlated with the forced expiratory volume in one second (FEV 1 ) and forced vital capacity (FVC). Gastrointestinal dose negatively correlated with the FEV 1 , FVC, height and age. In older children (11–14 yrs), lung deposition was almost identical to that reported inadults using QVAR TM . In children aged 5–10 yrs, lung deposition using QVAR TM was greater than the levels measured using other commercial aerosol delivery systems. Oropharygeal and gastrointestinal deposition was inversely related toage.
THE AGGLUTINATION OF BACTERIA IN VIVO
Authors: Carroll G. Bull
Journal: The Journal of Experimental Medicine (1915)

1. Small quantities of antiserum bring about instantaneous agglutination of pneumococci in the circulation of the rabbit; the reaction is specific and occurs in every case in which sufficient serum is given to influence the course of the septicemia or to prolong the life of the animal. 2. The agglutinating titer of antipneurnococcus serum can be made considerably higher by adding only a small quantity of culture to the tests, thus making the test a finer differential. 3. Typhoid bacilli agglutinate spontaneously in the circulation of the normal rabbit; the reaction is positive in vivo even in cases in which undiluted serum gives a negative result in vitro; heating the bacilli to 80 degrees C. for thirty minutes renders them more agglutinable in vivo. 4. Dysentery bacilli of the Shiga type do not agglutinate in the blood stream of the normal rabbit, but a small quantity of antiserum injected into the circulation causes immediate agglutination; while all strains of the Flexner group undergo spontaneous agglutination. 5. Non-virulent influenza bacilli agglutinate spontaneously in the circulation of the normal rabbit; virulent strains remain in the blood unclumped. 6. In all instances so far investigated of both passive and natural immunity, agglutination of the bacteria within the blood of the infected animal was followed by a rapid removal of the bacteria from the circulation, and by phagocytosis and destruction of the agglutinated bacteria in the capillary systems of the viscera; while those bacteria which are not agglutinated remain in the circulation and produce a progressive septicemia. 7. Hence the agglutinins seem to play the decisive part in at least certain instances of bacterial infections.
247 REDUCED COX-RELATED PRODUCTION OF VASOCONSTRICTORS AND NOT NO-MEDIATED VASODILATION IS A COMMON MECHANISM OF VASCULAR HYPOREACTIVITY IN DIFFERENT MODELS OF PORTAL HYPERTENSION IN RATS
Authors: W. Verlinden, I. Brosius, E. Van Marck, A. Herman, P. Pelckmans, P. Michielsen, S. Francque
Journal: Journal of Hepatology (2008)
A Role for Immune Complexes in Enhanced Respiratory Syncytial Virus Disease
Authors: Fernando P. Polack, Michael N. Teng, Peter L.Collins, Gregory A. Prince, Marcus Exner, Heinz Regele, Dario D. Lirman, Richard Rabold, Scott J. Hoffman, Christopher L. Karp, Steven R. Kleeberger, Marsha Wills-Karp, Ruth A. Karron
Journal: The Journal of Experimental Medicine (2002)

Respiratory syncytial virus (RSV) is the leading cause of bronchiolitis and viral pneumonia in infants and young children. Administration of a formalin inactivated vaccine against RSV to children in the 1960s resulted in increased morbidity and mortality in vaccine recipients who subsequently contracted RSV. This incident precluded development of subunit RSV vaccines for infants for over 30 years, because the mechanism of illness was never clarified. An RSV vaccine for infants is still not available. Here, we demonstrate that enhanced RSV disease is mediated by immune complexes and abrogated in complement component C3 and B cell–deficient mice but not in controls. Further, we show correlation with the enhanced disease observed in children by providing evidence of complement activation in postmortem lung sections from children with enhanced RSV disease.
In vivo evaluation of chemical biopersistence of nonfibrous inorganic particles.
Authors: J D Brain, J Godleski, W Kreyling
Journal: Environmental Health Perspectives (1994)

The lung's response to deposited particles may depend upon the physical-chemical properties of the particles, the amount initially deposited, and the persistence of the particles. Clearance involves mucociliary transport as well as the action of phagocytic cells in nonciliated regions of the lung. Depending on the animal species studied, particle type, and particle load, inorganic materials are ingested by macrophages on alveolar surfaces with half-times of 0.6 to 7 hr. Particle-laden macrophages may migrate to airways, but we believe that an important mechanism of clearance is the dissolution of particles within alveolar macrophages and the subsequent translocation of dissolved materials to the blood. Particle dissolution in situ has long been recognized but was often thought to be carried out extracellularly in the alveolar lining layer, airway mucus, or interstitial fluid. However, many particles such as cobalt oxide or iron oxide which dissolve very little in simulated lung fluid, are solubilized more rapidly within alveolar macrophages. Clearance of particles from the lungs can be followed by a number of techniques, both invasive and noninvasive. The approaches vary in expense and resolution, and can be directed toward quantifying mechanical removal of particles versus their intracellular dissolution. Noninvasive methods permit repeated measurements of particle retention in the lungs of the same animal or human and thus allow replications and serial measurements. Greater precision with respect to the sites of retention and redistribution is achieved with quantitative morphometric methods that utilize fixation followed by physically dividing the respiratory tract into individual pieces.(ABSTRACT TRUNCATED AT 250 WORDS)
Small-Diameter Artificial Arteries Engineered In Vitro
Authors: Brett C. Isenberg, Chrysanthi Williams, Robert T. Tranquillo
Journal: Circulation Research (2006)

Although the need for a functional arterial replacement is clear, the lower blood flow velocities of small-diameter arteries like the coronary artery have led to the failure of synthetic materials that are successful for large-diameter grafts. Although autologous vessels remain the standard for small diameter grafts, many patients do not have a vessel suitable for use because of vascular disease, amputation, or previous harvest. As a result, tissue engineering has emerged as a promising approach to address the shortcomings of current therapies. Investigators have explored the use of arterial tissue cells or differentiated stem cells combined with various types of natural and synthetic scaffolds to make tubular constructs and subject them to chemical and/or mechanical stimulation in an attempt to develop a functional small-diameter arterial replacement graft with varying degrees of success. Here, we review the progress in all these major facets of the field.
UEFA Champions League study: a prospective study of injuries in professional football during the 2001-2002 season
Authors: M Walden
Journal: British Journal of Sports Medicine (2005)

<b>Background:</b> No previous study on adult football involving several different countries has investigated the incidence and pattern of injuries at the highest club competitive level. <b>Objective:</b> To investigate the risk exposure, risk of injury, and injury pattern of footballers involved in UEFA Champions League and international matches during a full football season. <b>Method:</b> Eleven top clubs (266 players) in five European countries were followed prospectively throughout the season of 2001–2002. Time-lost injuries and individual exposure times were recorded during all club and national team training sessions and matches. <b>Results:</b> A total of 658 injuries were recorded. The mean (SD) injury incidence was 9.4 (3.2) injuries per 1000 hours (30.5 (11.0) injuries per 1000 match hours and 5.8 (2.1) injuries per 1000 training hours). The risk of match injury was significantly higher in the English and Dutch teams than in the teams from France, Italy, and Spain (41.8 (3.3) <i>v</i> 24.0 (7.9) injuries per 1000 hours; p = 0.008). Major injuries (absence &gt;4 weeks) constituted 15% of all injuries, and the risk of major injury was also significantly higher among the English and Dutch teams (p = 0.04). National team players had a higher match exposure, with a tendency towards a lower training injury incidence than the rest of the players (p = 0.051). Thigh strain was the most common injury (16%), with posterior strains being significantly more common than anterior ones (67 <i>v</i> 36; p&lt;0.0001). <b>Conclusions:</b> The risk of injury in European professional football is high. The most common injury is the thigh strain typically involving the hamstrings. The results suggest that regional differences may influence injury epidemiology and traumatology, but the factors involved are unclear. National team players have a higher match exposure, but no higher risk of injury than other top level players.
The Fourth Psychiatric Revolution
Authors: LOUIS LINN
Journal: American Journal of Psychiatry (1968)

The author defines community psychiatry as the theory and practice of psychiatry as it applies to the principle of districting—the saturation of a given area with preventive and therapeutic medical services for all the families in the area. He feels that psychoanalysis has played a key role in the birth of the community psychiatry era and has a continuing major role in bringing this era to its finest fruition.
QUANTITATIVE INVESTIGATIONS OF IDIOTYPIC ANTIBODIES
Authors: Susan B. Spring, Kenneth W. Schroeder, Alfred Nisonoff
Journal: The Journal of Experimental Medicine (1971)

The effect of challenge by antigen on persistence of clones of antibody-producing cells and on the induction of new clones was investigated through quantitative measurements of idiotypic specificities. In each of nine rabbits idiotypic specificities present in the earliest bleedings were completely replaced after a few months; subsequent changes occurred much more slowly. On a quantitative basis the population of molecules used as immunogen always reacted most effectively with the homologous anti-idiotypic antiserum. Little effect of increased antigen dose on the rate of change of idiotype was observed. Even large amounts of antigen administered every 2 wk caused only gradual changes in idiotypic specificities. This was attributed either to more effective capture of antigen by memory cells, as compared to precursor cells, or to the induction of tolerance in those clones that were not expressed. In two of three rabbits on a monthly injection schedule, the idiotypic specificities identified underwent very slow changes over a period as long as 17 months. Changes occurred more rapidly when antigen was administered every 2 wk. In each of four rabbits investigated, all idiotypic specificities identified before a 5 month rest period were still present afterwards, indicating the survival of essentially all clones of antibody-producing cells during that interval. Quantitative inhibition data indicated that some new clones of cells were initiated.
NO contributes to EDHF-like responses in rat small arteries: a role for NO stores
Authors: S Chauhan
Journal: Cardiovascular Research (2002)

Objectives: Responses to EDHF are usually characterised in the presence of nitric oxide synthase (NOS) and cyclooxygenase (COX) inhibitors. The contribution of NO to endothelium-dependent relaxation in the presence of NOS inhibitors was assessed using NO scavengers with the objective of testing (i) whether any residual NO produces endothelium-dependent relaxation in a manner similar to EDHF and (ii) to identify the source of the residual NO. Methods: Small rat hepatic and mesenteric arteries were mounted in a tension myograph for either isometric or membrane potential measurements. Results: Relaxation to ACh was unaffected by pre-treatment with NG-nitro-l-arginine methyl ester (l-NAME, 300 μM), and indomethacin (Indo, 5 μM) in the absence or presence of 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ, 1 μM), nitro-l-arginine (300 μM) or l-nitro-mono-methyl-arginine (l-NMMA, 300 μM). Addition of OxyHb (20 μM) or carboxy-PTIO (300 μM) produced a significant suppression of ACh-induced relaxations (≈40%). In l-NAME+Indo treated arteries ACh-induced hyperpolarisation (Δ16.3±2.1 mV, n=8) was significantly suppressed with the addition of OxyHb (Δ10.2±1.6 mV, n=12). ACh-induced relaxation, in the presence of l-NAME+Indo+OxyHb, was abolished by raised extracellular K+, or the combination of charybdotoxin (CTX, 100 nM)+apamin (100 nM). In contrast whilst l-NAME+indo+barium+ouabain suppressed ACh-induced relaxation, the presence of OxyHb had no additional effect. Ultraviolet light induced a relaxation in arteries treated with l-NMMA+Indo (37.0±5.2%, n=9) which was sensitive to OxyHb (15.2±10.9%, n=4), and barium+ouabain (6.39±2.7%, n=4), but not CTX+apamin (37.8±2.4%, n=4). Conclusions: These findings suggest that NO contributes significantly to the "EDHF-like" response seen in rat small arteries and that the source of this NO may be preformed vascular stores.
Sodium handling in patients with well compensated cirrhosis is dependent on the severity of liver disease and portal pressure
Authors: R Jalan
Journal: Gut (2000)

To test the contribution of portal pressure gradient (PPG) and neurohumoral factors to sodium handling in cirrhotic patients without ascites, by comparing preascitic cirrhotic patients with patients with transjugular intrahepatic portosystemic stent shunt (TIPSS) and previous ascites.Ten patients with TIPSS and 10 preascitic cirrhotic patients.Changes in glomerular filtration, renal plasma flow, urinary sodium excretion (U(Na)V), and neurohumoral factors were measured before and for two hours after infusion of one litre of 0. 9% saline over one hour.Glomerular filtration rate and renal plasma flow were significantly higher in patients with TIPSS compared with preascitic cirrhotic patients. Following saline infusion both parameters increased significantly; this increase was significantly greater in patients with TIPSS. U(Na)V increased significantly in both groups following saline infusion. The increase in U(Na)V was significantly greater in the TIPSS group. Plasma renin activity and angiotensin II decreased significantly in both groups. Basal U(Na)V was independently correlated with angiotensin II concentration and PPG and the change in U(Na)V correlated with the PPG.Results suggest that patients with advanced liver disease and low portal pressure handle sodium as well as patients with compensated liver disease and high portal pressure. These results are consistent with the notion that in addition to peripheral vasodilatation and severity of liver disease, the severity of portal hypertension contributes to the abnormalities of sodium retention in cirrhosis.
Government may leave some patients out of 18 week target
Authors: Adrian O'Dowd
Journal: BMJ (2007)

The government may adjust its 18 week target for treatment by the NHS in England so that it does not apply to all patients, a health minister said last week.

The target of guaranteeing patients treatment within 18 weeks of being referred by their GP, first announced in 2004, is due to be met throughout England by December 2008.

The health minister Ben Bradshaw, however, has now said in a radio interview that a “clarification” of the target was needed, to mean 90% of patients.

Some patients may be “clinically justified” in waiting longer than 18 weeks for …
Interpretation of the Coronary Artery Calcium Score in Combination With Conventional Cardiovascular Risk Factors
Authors: Mark J. Pletcher, Christopher T. Sibley, Michael Pignone, Eric Vittinghoff, Philip Greenland
Journal: Circulation (2013)

Background— The coronary artery calcium (CAC) score predicts coronary heart disease (CHD) events, but methods for interpreting the score in combination with conventional CHD risk factors have not been established. Methods and Results— We analyzed CAC scores and CHD risk factor measurements from 6757 black, Chinese, Hispanic, and white men and women aged 45 to 84 years in the Multi-Ethnic Study of Atherosclerosis (MESA). CAC was associated with age, sex, race/ethnicity, and all conventional CHD risk factors. Multivariable models using these factors predicted the presence of CAC (C statistic=0.789) and degree of elevation (16% of variation explained) and can be used to update a “pretest” CHD risk estimate, such as the 10-year Framingham Risk Score, that is based on an individual’s conventional risk factors. In scenarios in which a high CAC score is expected, a moderately elevated CAC score of 50 is reassuring (eg, reducing risk from 10% to 6% in a healthy older white man), but when a low/zero CAC score is expected, even with identical pretest CHD risk, the same CAC score of 50 may be alarmingly high (eg, increasing risk from 10% to 20% in a middle-aged black woman with multiple risk factors). Both the magnitude and direction of the shift in risk varied markedly with pretest CHD risk and with the pattern of risk factors. Conclusions— Knowledge of what CAC score to expect for an individual patient, based on their conventional risk factors, may help clinicians decide when to order a CAC test and how to interpret the results.
High‐intensity vs. sham inspiratory muscle training in patients with chronic heart failure: a prospective randomized trial
Authors: Ester Marco, Alba L. Ramírez‐Sarmiento, Ana Coloma, Monique Sartor, Josep Comin‐Colet, Joan Vila, Cristina Enjuanes, Jordi Bruguera, Ferran Escalada, Joaquim Gea, Mauricio Orozco‐Levi
Journal: European Journal of Heart Failure (2013)