tbuckley/cabot-search huggingface dataset:
Sickle cell trait associated with a RR of death of 37 times in national collegiate athletic association football athletes: a database with 2 million athlete-years as the denominator
Authors: Kimberly G Harmon, Jonathan A Drezner, David Klossner, Irfan M Asif
Journal: British Journal of Sports Medicine (2012)

Background This study examines sickle cell trait (SCT) as a cause of sudden death in National Collegiate Athletic Association (NCAA) athletes and explores the cost-effectiveness of different screening models. Methods The authors reviewed the cause of all cases of sudden death in NCAA student-athletes from January 2004 through December 2008. The authors also explored the cost-effectiveness of screening for this condition in selected populations assuming that identifying athletes with SCT would prevent death. Results There were 273 deaths and a total of 1 969 663 athlete-participant-years. Five (2%) deaths were associated with SCT. In football athletes, there were 72 (26%) deaths. Of these, 52 (72%) were due to trauma unrelated to sports activity and 20 (28%) were due to medical causes; nine deaths were cardiac (45%), five were associated with SCT (25%). Thirteen of the 20 deaths due to medical causes occurred during exertion; cardiac (6, 46%) SCT associated (5, 39%), and heat stroke unrelated to SCT (2, 15%). All deaths associated with SCT occurred in black Division I football athletes. The risk of exertional death in Division I football players with SCT was 1:827 which was 37 times higher than in athletes without SCT. The cost per case identified varied widely depending on the population screened and the price of the screening test. Conclusions Exertional death in athletes with SCT occurs at a higher rate than previously appreciated. More research is needed to (1) understand the pathophysiology of death in SCT-positive athletes and (2) determine whether screening high-risk populations reduces mortality.
Does CRP predicts severity of hospitalized patients with diffuse interstitial lung disease
Authors: Ezgi Demirdogen Cetinoglu, Asli Gorek Dilektasli, Esra Uzaslan, Funda Coskun, Dane Ediger, Guven Ozkaya
Journal: European Respiratory Journal (2014)

Backround:  Interstitial lung diseases (ILD) are a heterogenic group of diseases requires several hospital admission due to infective or noninfective exacerbation during its progress.   Objective:  We aimed to evaluate correlations between C-reactive protein (CRP) levels and clinical parameters of patients during hospitalization of acute exacerbation of diffuse interstitial lung diseases to predict in hospital risks of diseases.   Method: A retrospective analyzes of 184 patients who hospitalized for diffuse ILD in Pulmonary Department between 2010-2013 was conducted.   Results:  The mean age of the patients was 62 and 51% were female . The 66% of patients had other comorbid conditions. Eleven patients also had collagen vascular diseases. In 48 patients, cultures for sputum, stool, urine or blood were positive and 43% of the whole case series had antibiotic treatment. Mean duration of hospitalization for the patients was 11 days. In 143 patients serum CRP levels were obtained and divided to two group as CRP    Conclusion:  Therefore we come to the conclusion that in ILD patients with high CRP and procalcitonin levels an infective processes should be suspected and longer duration of hospitalization should is awaited.
Usefulness of transbronchial biopsy in immunosuppressed patients with pulmonary infiltrates.
Authors: S Puksa, M A Hutcheon, R H Hyland
Journal: Thorax (1983)

In a retrospective study of thirty-one immunosuppressed patients with new pulmonary infiltrates transbronchial biopsy provided a specific diagnosis in 11 of the 31 (36%) patients. In a further five patients, whose biopsy showed non-specific interstitial pneumonitis, a specific diagnosis was established by other means. Overall a specific diagnosis was obtained in 52% of patients. Twelve patients were left with a diagnosis of non-specific interstitial pneumonitis. In three out of 31 (10%) patients insufficient tissue was obtained. The seven patients who had metastatic carcinoma of the lung did poorly. The nine with other specific diagnoses did better in that five of them were alive after more than 11 months of follow-up. Patients with non-specific pneumonitis did well; eight out of 12 (67%) were alive after an average follow-up of 13.4 months. In 27 of the 31 (87%) patients the procedure was felt to have influenced therapeutic decisions. This was true whether the biopsy yielded a specific or a non-specific diagnosis. In our series making a specific diagnosis did not improve the patients' survival. Those with non-specific pneumonitis who were treated empirically did well, as did patients with specific diagnoses other than metastatic carcinoma of the lung.
Alpha-1-antitrypsin aerosolised augmentation abrogates neutrophil elastase-induced expression of cathepsin B and matrix metalloprotease 2 in vivo and in vitro
Authors: P Geraghty, M P Rogan, C M Greene, M L Brantly, S J O'Neill, C C Taggart, N G McElvaney
Journal: Thorax (2008)

Neutrophil elastase (NE) activity is increased in lung diseases such as alpha(1)-antitrypsin (A1AT) deficiency and pneumonia. It has recently been shown to induce expression of cathepsin B and matrix metalloprotease 2 (MMP-2) in vitro and in a mouse model. It is postulated that increased cathepsin B and MMP-2 in acute and chronic lung diseases result from high levels of extracellular NE and that expression of these proteases could be inhibited by A1AT augmentation therapy.Cathepsin and MMP activities were assessed in bronchoalveolar lavage (BAL) fluid from patients with A1AT deficiency, pneumonia and control subjects. Macrophages were exposed to BAL fluid rich in free NE from patients with pneumonia following pretreatment with A1AT. MMP-2, cathepsin B, secretory leucoprotease inhibitor (SLPI) and lactoferrin levels were determined in BAL fluid from A1AT-deficient patients before and after aerosolisation of A1AT.BAL fluid from both patients with pneumonia and those with A1AT deficiency containing free NE had increased cathepsin B and MMP-2 activities compared with BAL fluid from healthy volunteers. The addition of A1AT to BAL fluid from patients with pneumonia greatly reduced NE-induced cathepsin B and MMP-2 expression in macrophages in vitro. A1AT augmentation therapy to A1AT-deficient individuals also reduced cathepsin B and MMP-2 activity in BAL fluid in vivo. Furthermore, A1AT-deficient patients had higher levels of SLPI and lactoferrin after A1AT augmentation therapy.These findings suggest a novel role for A1AT inhibition of NE-induced upregulation of MMP and cathepsin expression both in vitro and in vivo.
Staphylococcus aureus Endocarditis
Authors: Vance G. Fowler, Jose M. Miro, Bruno Hoen, Christopher H. Cabell, Elias Abrutyn, Ethan Rubinstein, G. Ralph Corey, Denis Spelman, Suzanne F. Bradley, Bruno Barsic, Paul A. Pappas, Kevin J. Anstrom, Dannah Wray, Claudio Q. Fortes, Ignasi Anguera, Eugene Athan, Philip Jones, Jan T. M. van der Meer, Tom S. J. Elliott, Donald P. Levine, Arnold S. Bayer, for the ICE Investigators
Journal: JAMA (2005)

OR DECADES, INFECTIVE ENDOCARditis (IE) caused by Staphylococcus aureus has been viewed primarily as a community-acquired disease, especially associated with injection drug use. [1]][10][11] S aureus IE is relatively infrequent at any individual institution, and observations of its characteristics were based primarily upon relatively small samples, 1,3,6,9,[12][13][14] single-center experiences, 5,6,8,9,[13][14][15][16] or retrospectively identified patients. 2,7,8,15,16tient characteristics, treatment practices, and outcomes in these single-center studiesoftendifferedconsiderably.Moreover, because no large, prospectively col-
Maintenance Cognitive-Behavioral Therapy and Manualized Psychoeducation in the Treatment of Recurrent Depression: A Multicenter Prospective Randomized Controlled Trial
Authors: Ulrich Stangier, Christine Hilling, Thomas Heidenreich, Anne Katrin Risch, Arnd Barocka, Ralf Schlösser, Kai Kronfeld, Christian Ruckes, Hartmut Berger, Joachim Röschke, Florian Weck, Stephan Volk, Martin Hambrecht, Richard Serfling, Ralf Erkwoh, Aglaja Stirn, Thomas Sobanski, Martin Hautzinger
Journal: American Journal of Psychiatry (2013)

This multicenter study compared the relapse and recurrence outcomes of two active treatments, maintenance cognitive-behavioral therapy (CBT) and manualized psychoeducation, both in addition to treatment as usual, in patients in remission from depression. This was a multicenter prospective randomized observer-blinded study with two parallel groups. The authors assessed 180 patients with three or more previous major depressive episodes who met remission criteria over a 2-month baseline period and who were randomly assigned to 16 sessions of either maintenance CBT or manualized psychoeducation over 8 months and then followed up for 12 months. The main outcome measure was time to first relapse or recurrence of a major depression, based on DSM-IV criteria, as assessed by blinded observers with the Longitudinal Interval Follow-Up Evaluation. Cox regression analysis showed that time to relapse or recurrence of major depression did not differ significantly between treatment conditions, but a significant interaction was observed between treatment condition and number of previous episodes (<5 or ≥5). Within the subsample of patients with five or more previous episodes, maintenance CBT was significantly superior to manualized psychoeducation, whereas for patients with fewer than five previous episodes, no significant treatment differences were observed in time to relapse or recurrence. The results indicate that maintenance CBT has significant effects on the prevention of relapse or recurrence only in patients with a high risk of depression recurrence. For patients with a moderate risk of recurrence, nonspecific effects and structured patient education may be equally effective.
Prevalence and prognosis of unclassifiable interstitial lung disease
Authors: Christopher J. Ryerson, Thomas H. Urbania, Luca Richeldi, Joshua J. Mooney, Joyce S. Lee, Kirk D. Jones, Brett M. Elicker, Laura L. Koth, Talmadge E. King, Paul J. Wolters, Harold R. Collard
Journal: European Respiratory Journal (2012)

The aim of this study was to determine the prevalence, characteristics and outcomes of patients with unclassifiable interstitial lung disease (ILD) and to develop a simple method of predicting disease behaviour. Unclassifiable ILD patients were identified from an ongoing longitudinal cohort. Unclassifiable ILD was diagnosed after a multidisciplinary review did not secure a specific ILD diagnosis. Clinical characteristics and outcomes were compared with idiopathic pulmonary fibrosis (IPF) and non-IPF ILDs. Independent predictors of mortality were determined using Cox proportional-hazards analysis to identify subgroups with distinct disease behaviour. Unclassifiable ILD was diagnosed in 10% of the ILD cohort (132 out of 1370 patients). The most common reason for being unclassifiable was missing histopathological assessment due to a high risk of surgical lung biopsy. Demographic and physiological features of unclassifiable ILD were intermediate between IPF and non-IPF disease controls. Unclassifiable ILD had longer survival rates when compared to IPF on adjusted analysis (hazard ratio 0.62, p = 0.04) and similar survival compared to non-IPF ILDs (hazard ratio 1.54, p = 0.12). Independent predictors of survival in unclassifiable ILD included diffusion capacity of the lung for carbon monoxide (p = 0.001) and a radiological fibrosis score (p = 0.02). Unclassifiable ILD represents approximately 10% of ILD cases and has a heterogeneous clinical course, which can be predicted using clinical and radiological variables.
Home recording of PEF in young asthmatics: does it contribute to management?
Authors: K Uwyyed, C Springer, A Avital, E Bar-Yishay, S Godfrey
Journal: European Respiratory Journal (1996)

The value of home monitoring of peak expiratory flow (PEF) as part of an action plan for asthma management in children and young adults is uncertain. We sought to determine whether home recording of PEF benefited asthma management and whether any contribution was affected by the severity of the asthma. Twenty-eight children and young adults with asthma of different severity (mean age 14 yrs; 95% confidence interval (95% CI) 12-16 yrs) recorded their symptoms, drug consumption and PEF twice daily for a mean of 82 days over a 12 week period, and attended the laboratory every 2 weeks for measurement of lung function. The number of individual patients with significant correlations for laboratory lung function tests compared with ambulatory PEF and diary scores averaged over the preceeding 2 weeks was low in all severity groups. When measured in the laboratory, PEF meter readings correlated poorly with PEF measured by spirometry. The proportion of patients with significant correlations for PEF, symptoms and rescue bronchodilator use on a day-to-day basis was 70-80% in the group of severe asthmatics and significantly less in the mild asthmatics. In a subgroup of 14 patients who were sick on a mean of 19 days, the mean difference in PEF between well and sick days was 14% of predicted. Diurnal PEF variation correlated poorly with other parameters in all groups. It is concluded that PEF monitoring adds little to daily recording of symptoms and bronchodilator use in the management of young patients with severe asthma, and it is too insensitive to register meaningful clinical changes in those with milder asthma.
Identification of Biomarkers Modulated by the Rexinoid LGD1069 (Bexarotene) in Human Breast Cells Using Oligonucleotide Arrays
Authors: Hee-Tae Kim, Gu Kong, David DeNardo, Yuxin Li, Ivan Uray, Sunita Pal, Syed Mohsin, Susan G. Hilsenbeck, Reid Bissonnette, William W. Lamph, Karen Johnson, Powel H. Brown
Journal: Cancer Research (2006)

Abstract Retinoids have been found to be promising chemopreventive agents that play an important role in regulating cell growth, differentiation, and apoptosis. The action of retinoids is mediated by retinoid receptors (retinoic acid receptors and retinoid X receptors), which are nuclear transcription factors that, when bound to retinoids, regulate gene expression. LGD1069 is a highly selective RXR agonist that has reduced toxicity compared with retinoids. Our previous studies have shown that RXR-selective ligands (or “rexinoids”), including LGD1069, can inhibit the growth of normal and malignant breast cells and can suppress the development of breast cancer in transgenic mice. For the current study, we attempted to identify biomarkers of the chemopreventive effect of the RXR-selective retinoid LGD1069. In these experiments, we used Affymetrix microarrays to identify target genes that were modulated by LGD1069 in normal human breast cells. Affymetrix and dChip analysis identified more than 100 genes that were up-regulated or down-regulated by LGD1069 treatment. We then tested 16 of these genes in validation experiments using quantitative reverse transcription-PCR and Western blotting of independently prepared samples, and found that 15 of 16 genes were modulated in a similar manner in these validation experiments as in the microarray experiments. Genes found to be regulated include known retinoid-regulated genes, growth regulatory genes, transcription factors, and differentiation markers. We then showed that the expression of several of these rexinoid-regulated biomarkers is modulated in vivo in mammary glands from mice treated with LGD1069. These critical growth-regulating proteins will be promising targets of future agents for the prevention and treatment of breast cancer. (Cancer Res 2006; 66(24): 12009-18)
Skeletal muscle microvascular blood flow and oxygen transport in patients with severe sepsis.
Authors: R Neviere, D Mathieu, J L Chagnon, N Lebleu, J P Millien, F Wattel
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

To compare skeletal muscle microvascular blood flow at rest and during reactive hyperemia in septic patients, a prospective, controlled trial was conducted on 16 patients with severe sepsis and a control group of 10 patients free of infection in the intensive care unit of a university hospital. Systemic hemodynamics, whole-body oxygen transport, and skeletal muscle microvascular blood flow at rest and during reactive hyperemia were measured. Reactive hyperemia was produced by arrest of leg blood flow with a pneumatic cuff; on completion of the 3 min ischemic phase the occluding cuff was rapidly deflated to 0. Hemodynamic and oxygen-derived variables were determined invasively. Skeletal muscle microvascular blood flow data were obtained using a laser Doppler flowmetry technique and values expressed in millivolts. Whole-body oxygen delivery in septic patients was increased compared with control subjects. Resting skeletal muscle blood flow was decreased in septic patients compared with control subjects (233 +/- 52 versus 394 +/- 93 mV; p < 0.05). Peak flow during reactive hyperemia was also decreased in septic patients compared with control subjects (380 +/- 13 versus 2,033 +/- 853 mV; p < 0.05). Cyclic variation in blood flow (vasomotion) was observed in control subjects but not in septic patients. Skeletal muscle microvascular perfusion is altered in patients with severe sepsis despite normal or elevated whole-body oxygen delivery. These microvascular abnormalities may further compromise tissue nutrient flow and may contribute to the development of organ failure in septic patients.
Detection of cholangiocarcinoma in primary sclerosing cholangitis by positron emission tomography
Authors: Susanne Keiding, Søren B. Hansen, Henrik H Rasmussen, Antony Gee, Aksel Kruse, Klaus Roelsgaard, Ulrik Tage-Jensen, Jens Frederik Dahlerup
Journal: Hepatology (1998)

Primary sclerosing cholangitis (PSC) predisposes to cholangiocarcinoma (CC), which usually is widespread in the liver at the time of the diagnosis and which has a median survival of approximately 6 months. Positron emission tomography (PET) is a noninvasive scanning method that allows the assessment of metabolism in vivo by means of positron-emitting radiolabeled tracers. [ 18 F]Fluoro-2-deoxy- d -glucose (FDG) is a glucose analogue that accumulates in various malignant tumors because of their high glucose metabolic rates. The purpose of the study was to develop a PET method to detect small CC tumors in patients with PSC. PET scanning of the liver was performed after intravenous injection of 200 MBq FDG in 9 patients with PSC, 6 patients with PSC + CC, and 5 controls. The scanning was performed at successive time intervals for a total of 90 minutes with simultaneous successive arterial blood sampling for radioactivity concentration determination. In each of the PSC + CC patients, 2 to 7 “hot spots” were seen, with volumes of 1.0 to 45 mL (median, 4.4 mL). There were no hot spots in the two other patient groups. The localization of hot spots was confirmed by single-blind evaluation. Data were analyzed by the Gjedde-Patlak plot, yielding values of the net metabolic clearance of FDG, K [mL min −1 100 mL −1 tissue]. In the CC hot spots, maximum K values were 1.59 to 4.17 (median, 2.34; n = 6); in the reference liver tissues of these patients, K values were 0.40 to 0.69 (median, 0.49); in PSC patients, they were 0.23 to 0.53 (median, 0.36); and in controls, they were 0.20 to 0.34 (median, 0.31). The difference between K in CC hot spots and the other groups was statistically significant ( P &lt; .001). We conclude that FDG-PET seems to be able to detect small CC tumors and may be useful in the therapeutic management of PSC.
Toward a Clinical Model of Suicidal Behavior in Psychiatric Patients
Authors: J J Mann, C Waternaux, G L Haas, K M Malone
Journal: American Journal of Psychiatry (1999)

Risk factors for suicide attempts have rarely been studied comprehensively in more than one psychiatric disorder, preventing estimation of the relative importance and the generalizability of different putative risk factors across psychiatric diagnoses. The authors conducted a study of suicide attempts in patients with mood disorders, psychoses, and other diagnoses. Their goal was to determine the generalizability and relative importance of risk factors for suicidal acts across diagnostic boundaries and to develop a hypothetical, explanatory, and predictive model of suicidal behavior that can subsequently be tested in a prospective study.Following admission to a university psychiatric hospital, 347 consecutive patients who were 14-72 years old (51% were male and 68% were Caucasian) were recruited for study. Structured clinical interviews generated axis I and axis II diagnoses. Lifetime suicidal acts, traits of aggression and impulsivity, objective and subjective severity of acute psychopathology, developmental and family history, and past substance abuse or alcoholism were assessed.Objective severity of current depression or psychosis did not distinguish the 184 patients who had attempted suicide from those who had never attempted suicide. However, higher scores on subjective depression, higher scores on suicidal ideation, and fewer reasons for living were reported by suicide attempters. Rates of lifetime aggression and impulsivity were also greater in attempters. Comorbid borderline personality disorder, smoking, past substance use disorder or alcoholism, family history of suicidal acts, head injury, and childhood abuse history were more frequent in suicide attempters.The authors propose a stress-diathesis model in which the risk for suicidal acts is determined not merely by a psychiatric illness (the stressor) but also by a diathesis. This diathesis may be reflected in tendencies to experience more suicidal ideation and to be more impulsive and, therefore, more likely to act on suicidal feelings. Prospective studies are proposed to test this model.
Developmental Programming of Energy Balance and Its Hypothalamic Regulation
Authors: Floor Remmers, Henriette A. Delemarre-van de Waal
Journal: Endocrine Reviews (2010)

Developmental programming is an important physiological process that allows different phenotypes to originate from a single genotype. Through plasticity in early life, the developing organism can adopt a phenotype (within the limits of its genetic background) that is best suited to its expected environment. In humans, together with the relative irreversibility of the phenomenon, the low predictive value of the fetal environment for later conditions in affluent countries makes it a potential contributor to the obesity epidemic of recent decades. Here, we review the current evidence for developmental programming of energy balance. For a proper understanding of the subject, knowledge about energy balance is indispensable. Therefore, we first present an overview of the major hypothalamic routes through which energy balance is regulated and their ontogeny. With this background, we then turn to the available evidence for programming of energy balance by the early nutritional environment, in both man and rodent models. A wealth of studies suggest that energy balance can indeed be permanently affected by the early-life environment. However, the direction of the effects of programming appears to vary considerably, both between and within different animal models. Because of these inconsistencies, a comprehensive picture is still elusive. More standardization between studies seems essential to reach veritable conclusions about the role of developmental programming in adult energy balance and obesity.
Psychophysical studies of expressions of pain
Authors: Temre N. Davies, Donald D. Hoffman
Journal: Behavioral and Brain Sciences (2002)

What differentiates expressions of pain from other facial expressions? Which facial features convey the most information in an expression of pain? To answer such questions we can explore the expertise of human observers using psychophysical experiments. Techniques such as change detection and visual search can advance our understanding of facial expressions of pain and of evolved mechanisms for detecting these expressions.