tbuckley/cabot-search huggingface dataset:
Internet-based Home Monitoring of Pulmonary Function after Lung Transplantation
Authors: BIRGIT MORLION, CHRISTIANE KNOOP, MANUEL PAIVA, MARC ESTENNE
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Home monitoring of spirometry has been advocated in lung transplant recipients for the early detection of acute infection and rejection of the allograft. We have developed a user-friendly, Internet-based telemonitoring system providing direct transmission of home spirometry to the hospital. In this prospective study, we assessed patient adherence with the monitoring, agreement between home and hospital spirometry, intrasubject coefficient of variation (CV) for FEV1 and FEF25–75, and sensitivity of these variables for the detection of acute complications. Twenty-two bilateral-lung and heart–lung transplant recipients were followed for a median of 473 d (range, 60–822), during which 13,833 measurements were obtained. Patient compliance was 55% for two measurements a day and 84% for one measurement a day. Agreement between home and hospital spirometry was within 4% for FEV1 and 6% for FEF25–75. Mean CV was 3.2% for FEV1 and 7.5% for FEF25–75. Using transbronchial lung biopsy and/or bronchoalveolar lavage as gold standards, the sensitivity of home spirometry was 63%, and 23% of true positives were detected by changes in FEF25–75 alone. We conclude that home monitoring of pulmonary function in lung transplant recipients via the Internet is feasible and provides very reproducible data; yet it has only a mild sensitivity for the detection of acute allograft dysfunction.
Vaccination with <i>Leishmania</i> Hemoglobin Receptor–Encoding DNA Protects Against Visceral Leishmaniasis
Authors: Rajan Guha, Deepika Gupta, Ruchir Rastogi, Rajagopal Vikram, Ganga Krishnamurthy, Sanjiva Bimal, Syamal Roy, Amitabha Mukhopadhyay
Journal: Science Translational Medicine (2013)

Hemoglobin receptor is a vaccine candidate against visceral leishmaniasis .
Acquired haemophilia in urticarial vasculitis revealed by injudicious heparin
Authors: N. Patel
Journal: Journal of the Royal Society of Medicine (2006)

A swollen tender calf may be due to haematoma: be careful with anticoagulation. CASE HISTORYA 66-year-old woman had a 4½ year history of urticarial vasculitis confirmed by skin biopsy. 1 She was on long-term prednisolone 10mg/day; she had recently received a short course of colchicine.She presented to casualty with acute swelling of the left calf, which was tender, warm and firm but not, at this stage, discoloured.A deep venous thrombosis was suspected.No investigations were done at this stage (d-dimers were not available in the hospital).She was treated with low molecular weight heparin and was asked to return the next day for Doppler studies.However, her general condition proceeded to worsen.Swellings occurred in her other leg and in both upper limbs.She began to feel light-headed and she fainted.On return to casualty, it was observed that all of the limbs now showed both swelling and frank bruising which was widespread and appeared to be of deep origin.Figure 1 shows her condition a day after admission.She denied bleeding from the skin or gastrointestinal tract.Her pulse was 120min 71 and regular; the blood pressure was 118/66 mmHg lying, 92/44 standing.Routine blood tests showed Hb, 5.0 g/dL; white blood count 11610 9 /L; MCV, 86 fl; platelets, 200610 9 /L; ESR, 65 mm; the urea and electrolytes and liver tests were all normal.At this point, the diagnosis was not clear.A simple DVT it was not.Although there was a spontaneous bruising problem, the platelet count was normal, and in any case this was not the kind of superficial skin bruising seen in thrombocytopenia.Tests of coagulation were performed.The prothrombin and thrombin times were normal but the
Magnesium Intake and Risk of Type 2 Diabetes
Authors: Jia-Yi Dong, Pengcheng Xun, Ka He, Li-Qiang Qin
Journal: Diabetes Care (2011)

OBJECTIVE Emerging epidemiological evidence suggests that higher magnesium intake may reduce diabetes incidence. We aimed to examine the association between magnesium intake and risk of type 2 diabetes by conducting a meta-analysis of prospective cohort studies. RESEARCH DESIGN AND METHODS We conducted a PubMed database search through January 2011 to identify prospective cohort studies of magnesium intake and risk of type 2 diabetes. Reference lists of retrieved articles were also reviewed. A random-effects model was used to compute the summary risk estimates. RESULTS Meta-analysis of 13 prospective cohort studies involving 536,318 participants and 24,516 cases detected a significant inverse association between magnesium intake and risk of type 2 diabetes (relative risk [RR] 0.78 [95% CI 0.73–0.84]). This association was not substantially modified by geographic region, follow-up length, sex, or family history of type 2 diabetes. A significant inverse association was observed in overweight (BMI ≥25 kg/m2) but not in normal-weight individuals (BMI &amp;lt;25 kg/m2), although test for interaction was not statistically significant (Pinteraction = 0.13). In the dose-response analysis, the summary RR of type 2 diabetes for every 100 mg/day increment in magnesium intake was 0.86 (95% CI 0.82–0.89). Sensitivity analyses restricted to studies with adjustment for cereal fiber intake yielded similar results. Little evidence of publication bias was observed. CONCLUSIONS This meta-analysis provides further evidence supporting that magnesium intake is significantly inversely associated with risk of type 2 diabetes in a dose-response manner.
The north-south health divide
Authors: M. Whitehead, T. Doran
Journal: BMJ (2011)

The NHS must do more than pick up the pieces

The north-south divide is one of England’s most powerful and enduring myths: one country geographically, politically, and culturally separated into beautiful south and grim north. On one side rolling fields, dazzling sunshine, conspicuous wealth, conservatism, and flat beer; on the other coal, cloud, desolation, socialism, and froth.

In the linked observational study (doi:10.1136/bmj.d508), Hacking and colleagues show that not only is the divide in premature mortality real, but that it has persisted and continued to widen over four decades and under five governments.1 Since 1965, the toll of excess deaths has surpassed 1.5 million—the north is being decimated at the rate of a major city every decade⇓.



Many explanations have been offered for this northern catastrophe. Hacking and colleagues discuss the contributions of genetics, lifestyle, and migration and find them modest. Explanations related to the differing social composition of the population in the north compared with the south also fall short, because southerners enjoy better health across the entire social spectrum.2 Any damage inflicted by climate and geology is likely to be indirect: the cotton industry developed where the weather was …
Investigations of an automatic screening device (MESAM) for obstructive sleep apnoea
Authors: R Stoohs, C Guilleminault
Journal: European Respiratory Journal (1990)

A digital recording device developed to monitor heart rate (HR) and breathing sounds (snoring), and used to screen subjects for obstructive sleep apnoea syndrome (OSAS), was investigated. This device is called the MESAM and is currently commercially available in some western European countries. The computer-based automatic scoring systems provided with the equipment and a hand-scoring technique developed at Stanford and requiring 10-15 min to perform, were used. Polysomnography and MESAM recordings were performed simultaneously on two groups of 25 sleep disorder patients (each with respiratory disturbance index greater than or less than 10). Patients were randomly monitored and records were analysed by two teams blind to the initial clinical impression, to the events which occurred during the recordings, and to each other's findings. Specificity and sensitivity were calculated for each of the MESAM scoring techniques considered, with polysomnography being selected as the recording standard, With "automatic HR scoring" specificity was 12%, sensitivity 92%; with "automatic breathing sounds (snoring)" scoring, specificity was 8% and sensitivity 96%; with "hand-scoring" specificity was 72% and sensitivity 92%. If the three scoring techniques were combined, all patients with a respiratory disturbance index (RD) greater than 10 were recognized as having OSAS.
The paediatric wrist revisited: redefining MR findings in healthy children
Authors: Lil-Sofie Ording Müller, D Avenarius, B Damasio, O P Eldevik, C Malattia, K Lambot-Juhan, L Tanturri, C M Owens, K Rosendahl
Journal: Annals of the Rheumatic Diseases (2010)

During a multicentre study on juvenile idiopathic arthritis, wide variations were observed in bone shape, signal intensity and volume of joint fluid as shown by MRI which in part appeared to be unrelated to disease activity. A study was undertaken to examine these features in a cohort of healthy children.88 children of mean age 9.8 years (range 5-15) underwent MRI imaging (T1-weighted Spin Echo and Spectral Selection Attenuated Inversion Recovery (SPAIR)) of the left wrist. The number of bony depressions, distribution and amount of joint fluid and the presence of bone marrow changes were assessed.Bony depressions were present in all children, increasing with age from a mean of 4.0 in children aged 4-6 years to 9.2 in those aged 12-15 years (p<0.001)). 45 of 84 children (53.6%) had a high signal on SPAIR with a corresponding low signal on T1 in at least one bone. No associations were seen between bone marrow change (present or not) and sex (p=0.827) or sports club membership (p=0.616). All children had visible joint fluid in at least one of the joints assessed. No associations were seen between the presence of joint fluid and age group, except for the radius/scaphoid and capitate-scaphoid joints and a recess lateral to the hamate.It is important to be aware of the high prevalence of bony depressions, signal changes suggestive of bone marrow oedema and the volume of joint fluid seen in normal children. Such findings must be interpreted with care in children with suspected disease such as juvenile arthritis.
3q26 Amplification and Polysomy of Chromosome 3 in Squamous Cell Lesions of the Lung: A Fluorescence <i>In situ</i> Hybridization Study
Authors: Giuseppe Pelosi, Barbara Del Curto, Maurizio Trubia, Andrew G. Nicholson, Michela Manzotti, Giulia Veronesi, Lorenzo Spaggiari, Patrick Maisonneuve, Felice Pasini, Alberto Terzi, Antonio Iannucci, Giuseppe Viale
Journal: Clinical Cancer Research (2007)

Abstract Purpose: An overlapping area of gain at 3q26 has been reported in lung squamous cell carcinoma (SCC), but whether this also occurs in preneoplastic/preinvasive squamous cell proliferations and early-stage invasive carcinomas of the lung is still unknown. Experimental Design: We evaluated the prevalence and the clinicopathologic implications of 3q26 amplification and polysomy of chromosome 3 in 31 preneoplastic/preinvasive squamous cell lesions of the bronchial mucosa and in 139 early-stage invasive pulmonary SCC, both of limited growth within the bronchial wall [early hilar SCC (EHSCC)] and involving the pulmonary parenchyma [parenchyma-infiltrating SCC (PISCC)]. Moreover, mRNA expression of two candidate genes (h-TERC and SKI-like), both mapping to the minimal common amplification region, was also studied by quantitative real-time reverse transcription-PCR. Results: 3q26 amplification and polysomy of chromosome 3 were confined to malignant samples, with 37% of invasive SCC, and 27% of severe dysplasias/in situ carcinomas showing these chromosomal abnormalities. Amplification (with minimal common amplification region at 3q26.2), polysomy 3, concurrent amplification and polysomy 3, or other changes (monosomy) were found in 25 SCC and 1 dysplasia, 24 and 2, 2 and 0, and 1 and 0, respectively. Amplification was significantly associated with EHSCC, polysomy 3 with PISCC. 3q26 amplification correlated with increased tumor diameter and a history of smoking, whereas polysomy 3 correlated with tumor diameter, pT class, and p53, p21, and fascin immunoreactivity. No relationship of either 3q26 gain or polysomy was found with patients' survival. Overexpression of h-TERC or SKI-like mRNA was found in 3q26-amplified or polysomic SCC, with higher levels of h-TERC in the former and of SKI-like in the latter. Conclusions: 3q26 amplification and chromosome 3 polysomy may be related to the development of invasive SCC, with differential distribution in tumor subsets, despite substantial histologic uniformity. Both h-TERC and SKI-like may be involved in tumor progression.
Prognostic accuracy of day versus night ambulatory blood pressure: a cohort study
Authors: José Boggia, Yan Li, Lutgarde Thijs, Tine W Hansen, Masahiro Kikuya, Kristina Björklund-Bodegård, Tom Richart, Takayoshi Ohkubo, Tatiana Kuznetsova, Christian Torp-Pedersen, Lars Lind, Hans Ibsen, Yutaka Imai, Jiguang Wang, Edgardo Sandoya, Eoin O'Brien, Jan A Staessen
Journal: The Lancet (2007)
The Syndrome of Short P-R Interval Normal QRS Complex and Paroxysmal Rapid Heart Action
Authors: BERNARD LOWN, WILLIAM F. GANONG, SAMUEL A. LEVINE
Journal: Circulation (1952)

A short A-V conduction time, whether present with normal or with abnormal QRS complex, is associated with an increased incidence of paroxysmal rapid heart action. There are a considerable number of patients who have a short P-R interval, normal QRS complex and bouts of tachycardia. They are usually females, in middle life, devoid of organic heart disease and exhibit a snapping apical first heart sound. They do not demonstrate any of the features of anomalous A-V conduction. Evidence is presented suggesting the operation of endocrine and autonomic nervous system factors in the genesis both of the short P-R interval and the tachycardia.
Plasma Phospholipid <i>Trans</i> Fatty Acids, Fatal Ischemic Heart Disease, and Sudden Cardiac Death in Older Adults
Authors: Rozenn N. Lemaitre, Irena B. King, Dariush Mozaffarian, Nona Sotoodehnia, Thomas D. Rea, Lewis H. Kuller, Russel P. Tracy, David S. Siscovick
Journal: Circulation (2006)

Background— Intake of trans fatty acids is associated with increased risk of coronary heart disease. Whether different classes of trans fatty acids show similar associations is unclear. We previously reported an association of sudden cardiac death with red cell membrane trans -18:2 but not trans -18:1 fatty acids. To extend these findings, we investigated the associations of plasma phospholipid trans fatty acids with fatal ischemic heart disease (IHD) and sudden cardiac death. Methods and Results— We conducted a case-control study nested in the Cardiovascular Health Study. We identified 214 cases of fatal IHD (fatal myocardial infarction and coronary heart disease death) between 1992 and 1998. We randomly selected 214 controls, matched to cases on demographics, prevalent cardiovascular disease, and timing of blood draw. Plasma phospholipid fatty acids were assessed in blood samples collected earlier. Higher levels of plasma phospholipid trans -18:2 fatty acids were associated with higher risk of fatal IHD (odds ratio [OR] for interquintile range 1.68, 95% confidence interval [CI] 1.21 to 2.33) after adjustment for risk factors and trans -18:1 levels. Trans -18:1 levels above the 20th percentile were associated with lower risk (OR 0.34, 95% CI 0.18 to 0.63). In analyses limited to cases of sudden cardiac death (n=95), higher levels of trans -18:2 fatty acids were associated with higher risk (OR 2.34, 95% CI 1.27 to 4.31) and higher trans -18:1 with lower risk (OR 0.18, 95% CI 0.06 to 0.54). Conclusions— Higher levels of trans -18:2 and lower levels of trans -18:1 fatty acids are associated with higher risks of fatal IHD and sudden cardiac death. If confirmed, these findings suggest that current efforts at decreasing trans fatty acid intake in foods should take into consideration the trans -18:2 content.
Comparison of Standard Cardiopulmonary Resuscitation Versus the Combination of Active Compression-Decompression Cardiopulmonary Resuscitation and an Inspiratory Impedance Threshold Device for Out-of-Hospital Cardiac Arrest
Authors: Benno B. Wolcke, Dietmar K. Mauer, Mark F. Schoefmann, Heinke Teichmann, Terry A. Provo, Karl H. Lindner, Wolfgang F. Dick, Dorothee Aeppli, Keith G. Lurie
Journal: Circulation (2003)

Active compression-decompression (ACD) CPR combined with an inspiratory impedance threshold device (ITD) improves vital organ blood flow during cardiac arrest. This study compared survival rates with ACD+ITD CPR versus standard manual CPR (S-CPR).A prospective, controlled trial was performed in Mainz, Germany, in which a 2-tiered emergency response included early defibrillation. Patients with out-of-hospital arrest of presumed cardiac pathogenesis were sequentially randomized to ACD+ITD CPR or S-CPR by the advanced life support team after intubation. Rescuers learned which method of CPR to use at the start of each work shift. The primary end point was 1-hour survival after a witnessed arrest. With ACD+ITD CPR (n=103), return of spontaneous circulation and 1- and 24-hour survival rates were 55%, 51%, and 37% versus 37%, 32%, and 22% with S-CPR (n=107) (P=0.016, 0.006, and 0.033, respectively). One- and 24-hour survival rates in witnessed arrests were 55% and 41% with ACD+ITD CPR versus 33% and 23% in control subjects (P=0.011 and 0.019), respectively. One- and 24-hour survival rates in patients with a witnessed arrest in ventricular fibrillation were 68% and 58% after ACD+ITD CPR versus 27% and 23% after S-CPR (P=0.002 and 0.009), respectively. Patients randomized > or =10 minutes after the call for help to the ACD+ITD CPR had a 3 times higher 1-hour survival rate than control subjects (P=0.002). Hospital discharge rates were 18% after ACD+ITD CPR versus 13% in control subjects (P=0.41). In witnessed arrests, overall neurological function trended higher with ACD+ITD CPR versus control subjects (P=0.07).Compared with S-CPR, ACD+ITD CPR significantly improved short-term survival rates for patients with out-of-hospital cardiac arrest. Additional studies are needed to evaluate potential long-term benefits of ACD+ITD CPR.
Therapeutic drug monitoring of A77 1726, the active metabolite of leflunomide: serum concentrations predict response to treatment in patients with rheumatoid arthritis
Authors: E N van Roon
Journal: Annals of the Rheumatic Diseases (2004)

<b>Background:</b> Leflunomide is the prodrug of the disease modifying antirheumatic metabolite A77 1726. More than 50% of patients withdraw from leflunomide treatment within one year, mainly because of adverse drug reactions. Therapeutic drug monitoring of A77 1726 may be useful in predicting the efficacy of leflunomide treatment. <b>Objective:</b> To study the relation between A77 1726 steady state serum concentrations and disease activity using the 28 joint (DAS28) response. <b>Methods:</b> Outpatients with rheumatoid arthritis on a stable leflunomide dose for &gt;4 months were included. DAS28 score and adverse drug reactions were recorded. Blood samples were taken for determination of A77 1726 concentrations. The primary end point was the relation of serum A77 1726 concentrations with DAS28 response category <b>Results:</b> Serum A77 1726 concentrations were determined in 52 patients. A receiver operating characteristic (ROC) curve showed an area under the curve (AUC) of 0.73 (95% confidence interval, 0.54 to 0.93) (p&lt;0.05). The sensitivity exceeded 99% at concentrations below 16 mg/l. DAS28 values at the point of sampling showed no relation with A77 1726 concentrations (AUC of the ROC curve = 0.50 (0.33 to 0.67) (NS)). <b>Conclusions:</b> A77 1726 steady state serum concentrations show a relation with DAS28 response. Determination of serum A77 1726 concentrations in patients with insufficient response to treatment may help when decisions have to be made about continuation of treatment or dose adjustment.
A patient with fatigue and subfebrile temperature
Authors: G.J.m Herder, E.f Smit, P.j Borgstein, P.e Postmus
Journal: European Respiratory Journal (2000)

Case reportA 76-yr-old nonsmoking female was referred for evaluation of complaints of subfebrile temperature and fatigue for 4 weeks.A few days before the visit she developed pain in the back of the left hemithorax and a tickling cough when breathing deeply.Two months earlier she had experienced a period of nonproductive cough, which resolved after medical treatment.There were no other pulmonary symptoms.Past medical history revealed venous thrombosis with pulmonary embolism after a curettage, rheumatoid arthritis and pneumonia.On physical examination she appeared healthy with a pulse of 80 beats .min -1 , blood pressure of 170/90 mmHg and a normal temperature.Apart from dullness over the basal part of the left hemithorax with normal breath sounds, physical examination was normal.Except for an erythrocyte sedimentation rate of 79 mm, laboratory tests were within normal limits.
A piece of my mind. The only outlet
Authors: J. P. Cegielski
Journal: JAMA (1990)

The presentation was the culmination of 2 years' work. "Diarrheal disease remains the major threat to the life and health of children in the world, especially in developing countries such as this one . . ." There was no outlet for the overhead projector: the European-type plug with two round pins did not fit the African-type outlets with three square holes. We decided an x-ray viewing box would be adequate to illuminate my carefully prepared transparencies. ". . . Parasitic intestinal infections cause a large proportion of these cases of diarrhea . . ." Only one electrical outlet worked and it was located in the ward itself, where the light box was already plugged in. My audience was small—only the staff physicians and nurses of ward 17, the pédiatrie diarrhea ward. ". . . Since the advent of this era of HIV infection, the distribution and manifestations of infectious diseases are changing. Certain pathogens are associated with the immunodeficiency state caused by HIV and increasing evidence of the importance of cell-mediated immunity in host defense against others . . ."
Production of 20-HETE and Its Role in Autoregulation of Cerebral Blood Flow
Authors: Debebe Gebremedhin, Andrew R. Lange, Timothy F. Lowry, M. Reza Taheri, Eric K. Birks, Antal G. Hudetz, Jayashree Narayanan, John R. Falck, Hirotsugu Okamoto, Richard J. Roman, Kasem Nithipatikom, William B. Campbell, David R. Harder
Journal: Circulation Research (2000)

In the brain, pressure-induced myogenic constriction of cerebral arteriolar muscle contributes to autoregulation of cerebral blood flow (CBF). This study examined the role of 20-HETE in autoregulation of CBF in anesthetized rats. The expression of P-450 4A protein and mRNA was localized in isolated cerebral arteriolar muscle of rat by immunocytochemistry and in situ hybridization. The results of reverse transcriptase-polymerase chain reaction studies revealed that rat cerebral microvessels express cytochrome P-450 4A1, 4A2, 4A3, and 4A8 isoforms, some of which catalyze the formation of 20-HETE from arachidonic acid. Cerebral arterial microsomes incubated with [(14)C]arachidonic acid produced 20-HETE. An elevation in transmural pressure from 20 to 140 mm Hg increased 20-HETE concentration by 6-fold in cerebral arteries as measured by gas chromatography/mass spectrometry. In vivo, inhibition of vascular 20-HETE formation with N-methylsulfonyl-12, 12-dibromododec-11-enamide (DDMS), or its vasoconstrictor actions using 15-HETE or 20-hydroxyeicosa-6(Z),15(Z)-dienoic acid (20-HEDE), attenuated autoregulation of CBF to elevations of arterial pressure. In vitro application of DDMS, 15-HETE, or 20-HEDE eliminated pressure-induced constriction of rat middle cerebral arteries, and 20-HEDE and 15-HETE blocked the vasoconstriction action of 20-HETE. Taken together, these data suggest an important role for 20-HETE in the autoregulation of CBF.