tbuckley/cabot-search huggingface dataset:
Late repair of simultaneous bilateral distal biceps brachii tendon avulsion with fascia lata graft.
Authors: A Bayat, L Neumann, W A Wallace
Journal: British Journal of Sports Medicine (1999)

A 50 year old rock climber sustained a bilateral rupture of the distal biceps brachii tendons. He retained some flexion power in both arms but minimal supination, being weaker on the non-dominant right side. As the patient presented late, with retraction and shortening of the biceps muscle bellies, reconstruction was carried out using fascia lata grafts on both sides. Because of residual weakness on the left (dominant) side, three further surgical procedures had to be carried out to correct for elongation of the graft. A functionally satisfactory outcome, comparable with that on the right side, was eventually obtained. In summary, bilateral fascia lata grafts to bridge the gap between the retracted biceps bellies and the radial tuberosities were successful in restoring function and flexion power to the elbow. Despite being the stronger side, the dominant arm did not respond as well to the initial surgery. This may be due to overuse of this arm after the operation.
Body Iron Stores and Glucose Intolerance in Premenopausal Women
Authors: M. Ángeles Martínez-García, Manuel Luque-Ramírez, José L. San-Millán, Héctor F. Escobar-Morreale
Journal: Diabetes Care (2009)

OBJECTIVE Increased serum ferritin levels and iron stores may be involved in the development of abnormal glucose tolerance in women presenting with obesity and/or polycystic ovary syndrome (PCOS). We aimed to study the determinants of serum ferritin levels in premenopausal women among indexes of insulin resistance, adiposity, hyperandrogenism, and genotypes pertaining to inflammation, oxidative stress, and iron metabolism. RESEARCH DESIGN AND METHODS A total of 257 premenopausal women, classified depending on the presence or absence of PCOS, obesity, and/or abnormal glucose tolerance, underwent a complete metabolic evaluation, serum ferritin, haptoglobin, and C-reactive protein (CRP) measurements, and genotyping for proinflammatory and prooxidant variants and mutations in the HFE gene. RESULTS Serum ferritin concentrations were increased in women presenting with PCOS and/or abnormal glucose tolerance, independent of obesity. A stepwise multivariate linear regression analysis (R2 = 0.18, P &amp;lt; 0.0001) retained menstrual dysfunction (β = 0.14, P = 0.035), free testosterone (β = 0.14, P = 0.052), insulin sensitivity index (β = −0.12, P = 0.012), the His63Asp variant in HFE (β = 0.16, P = 0.008), and abnormal glucose tolerance (β = 0.15, P = 0.015) as significant predictors of the logarithm of ferritin levels, whereas CRP, haptoglobin, waist-to-hip ratio, or variants in the TNFα, TNFRSF1B, IL6, IL6ST, IL6Rα, PON1, and HFE Cys282Tyr mutation exerted no influence. CONCLUSIONS Androgen excess (partly because of hyperandrogenemia and partly because of menstrual dysfunction), insulin resistance, abnormal glucose tolerance, and the HFE His63Asp variant correlate with ferritin levels in premenopausal women.
Lack of activation of renal functional reserve predicts the risk of significant renal involvement in systemic sclerosis
Authors: R. Livi, S. Guiducci, F. Perfetto, G. Ciuti, E. Grifoni, L. Conforti, F. Galluccio, A. Moggi Pignone, M. Matucci Cerinic
Journal: Annals of the Rheumatic Diseases (2011)

To evaluate if defective activation of renal functional reserve (RFR) in systemic sclerosis (SSc) without clinical signs of renal involvement predicts the risk of developing clinically relevant renal damage.Twenty-eight normotensive SSc patients with normal renal function and no urinary abnormalities were submitted to an intravenous amino acid load to activate RFR. Nineteen patients (six with diffuse cutaneous SSc (dcSSc)) had an RFR activation defect, while nine (two with dcSSc) showed normal RFR. All patients were followed up for 5 years, with periodic evaluation of renal function, urinary protein excretion and systemic blood pressure (BP).At admission, patients with normal RFR had lower BP than those with abnormal RFR; no age, disease duration or creatinine clearance (CCr) differences were found. Five years later, patients with abnormal RFR showed, with respect to basal values, a significantly higher CCr reduction than patients with normal RFR (mean percent decrease 15.4 ± 9.5 vs 2.6 ± 3.8, p<0.001). Among patients with abnormal RFR, 13 (68.4%) showed a CCr reduction of ≥ 2 ml/min/year, with a final CCr of ≤ 70 ml/min in eight cases; two patients developed microalbuminuria and 10 grade 1 or 2 systemic hypertension. Significant CCr reduction rates were found in eight patients with high BP and in five patients who remained normotensive. No patient with normal RFR had proteinuria or high BP during follow-up.Lack of RFR activation is an early sign of renal involvement in SSc, and is a harbinger of an increased risk of developing renal insufficiency and systemic hypertension.
Biomarkers to assess graft quality during conventional and machine preservation in liver transplantation
Authors: Cornelia J. Verhoeven, Waqar R.R. Farid, Jeroen de Jonge, Herold J. Metselaar, Geert Kazemier, Luc J.W. van der Laan
Journal: Journal of Hepatology (2014)

A global rising organ shortage necessitates the use of extended criteria donors (ECD) for liver transplantation (LT). However, poor preservation and extensive ischemic injury of ECD grafts have been recognized as important factors associated with primary non-function, early allograft dysfunction, and biliary complications after LT. In order to prevent for these ischemia-related complications, machine perfusion (MP) has gained interest as a technique to optimize preservation of grafts and to provide the opportunity to assess graft quality by screening for extensive ischemic injury. For this purpose, however, objective surrogate biomarkers are required which can be easily determined at time of graft preservation and the various techniques of MP. This review provides an overview and evaluation of biomarkers that have been investigated for the assessment of graft quality and viability testing during different types of MP. Moreover, studies regarding conventional graft preservation by static cold storage (SCS) were screened to identify biomarkers that correlated with either allograft dysfunction or biliary complications after LT and which could potentially be applied as predictive markers during MP. The pros and cons of the different biomaterials that are available for biomarker research during graft preservation are discussed, accompanied with suggestions for future research. Though many studies are currently still in the experimental setting or of low evidence level due to small cohort sizes, the biomarkers presented in this review provide a useful handle to monitor recovery of ECD grafts during clinical MP in the near future.
Smoking status, clinical presentation and outcomes in obstructive sleep apnoea
Authors: A. Boldova, S. Carrizo, E. Minchole, V. Moya, E. Forcen, J.M. Marin
Journal: European Respiratory Journal (2014)

Rationale . The effect of tobacco on obstructive sleep apnoea (OSA) is well-documented but its effect on the OSA severity and cardiovascular (CVS) outcomes has not been established

Methods. In the frame of the Zaragoza Sleep cohort we retrospectively evaluate the clinical presentation, OSA severity and CVS outcomes of subjects. Participants were recoded as “have never been smokers” (non-smokers) or “active or past smokers” (smokers). Baseline demographic, anthropometric, and comorbidities were recorded on study inclusion. Apnoea-hypopnoea index (#episodes of apnoeas/hypopnoeas per hour of sleep –AHI-) was calculated from in-hospital or at home validated sleep studies. During follow-up, CVS events (myocardial infarction, Heart failure, stroke) were annually recorded.

Results. Among 3771 patients who were not treated with CPAP, 43% were smokers. Age and body-mass index (BMI) were similar in smokers and non-smokers. Nevertheless, mean AHI (35.8 vs 29.9, p  30) than non-smokers (OR = 2.7; P=0.001). There was 632 CVS events during follow-up: 12.3% in non-OSA (AHI<10) and 18.1% in OSA patients (p<0.001). In Cox regression analysis, smoking status independently predict CVS events in addition of age, systolic blood pressure, BMI, Charlson Index and AHI.

Conclusions . Smoking habits seems to be associated with the severity of OSA and CVS outcomes. These results underline the importance of smoking cessation in the treatment of patients with OSA.

Supported by ISCIII grant PI12/02175, SADAR/2013 and SEPAR/2013.
Effects of sodium metabisulphite on guinea pig contractile airway smooth muscle responses in vitro.
Authors: J Sun, T Sakamoto, K F Chung
Journal: Thorax (1995)

Sodium metabisulphite (MBS) is known to induce bronchoconstriction in asthmatic patients. The effects of MBS on guinea pig airway smooth muscle and on neurally mediated contraction in vitro have been examined.Tracheal and bronchial airway segments were placed in oxygenated buffer solution and electrical field stimulation was performed in the presence of indomethacin (10(-5) M) and propranolol (10(-6) M) for the measurement of isometric tension. Atropine (10(-6) M) was added to bronchial tissues.Concentrations of MBS up to 10(-3) M had no direct effect on airway smooth muscle contraction and did not alter either tracheal smooth muscle contraction induced by electrical field stimulation at all frequencies or acetylcholine-induced tracheal smooth muscle contraction. There was a similar response in the absence of epithelium, except for potentiation of the response induced by electrical field stimulation at 0.5 Hz (24 (10)% increase). However, MBS (10(-5), 10(-6) and 10(-7) M) augmented neurally-mediated non-adrenergic non-cholinergic contractile responses in the bronchi (13.3 (3.2)%, 23.8 (9.6)%, and 6.4 (1.6)%, respectively). MBS had no effect on the contractile response induced by substance P, but at higher concentrations (10(-3) M and 10(-4) M) it caused a time-dependent attenuation of responses induced by either electrical field stimulation or exogenously applied acetylcholine or substance P.MBS had no direct contractile responses but enhanced bronchoconstriction induced by activation of non-cholinergic neural pathways in the bronchus, probably through increased release of neuropeptides. At high concentrations MBS inhibited contractile responses initiated by receptor or neural stimulation.
In-Hospital and Long-term Mortality in Male Veterans Following Noncardiac Surgery
Authors: Warren S. Browner
Journal: JAMA (1992)

<h3>Objectives.</h3> —To determine the causes of and risk factors for mortality following noncardiac surgery. <h3>Design.</h3> —Prospective cohort study. <h3>Setting.</h3> —A university-affiliated Veterans Affairs medical center. <h3>Patients.</h3> —Consecutive series of 474 men between the ages of 38 and 89 years (mean age, 68 years) who were undergoing major noncardiac surgery involving general anesthesia. All subjects had known coronary artery disease or were at high risk for coronary artery disease. <h3>Measurements and Results.</h3> —During the initial hospitalization, 26 patients (5%) died, most commonly from sepsis (n=6) or cardiac diseases (n=6). Deaths occurred from postoperative days 2 to 69; half occurred more than 3 weeks after surgery. Multivariable analysis disclosed that a history of hypertension (odds ratio [OR]=3.8; 95% confidence interval [Cl], 1.1 to 13), a severely limited activity level (OR=9.7; 95% Cl, 2.5 to 37), and a creatinine clearance of less than 0.83 mL/s (OR=6.8; 95% Cl, 2.8 to 16) were all independently associated with an increased risk of postoperative mortality. The mortality rate in patients with two or more of these risk factors was 20%, nearly eight times higher (95% Cl, 3.6 to 16) than those with one or no risk factors. An additional 82 patients died within the next 2 years; cancer, renal dysfunction, congestive heart failure, and obstructive pulmonary disease were independently associated with long-term mortality. <h3>Conclusions.</h3> —Even in patients at high risk of cardiac complications following surgery, noncardiac causes of death are more common. Patients with a history of hypertension, severely limited activity, and reduced renal function appear to be at especially high risk of in-hospital mortality after noncardiac surgery. (<i>JAMA</i>. 1992;268:228-232)
Vascular Dysfunction in Women With a History of Preeclampsia and Intrauterine Growth Restriction
Authors: Yoav Yinon, John C.P. Kingdom, Ayodele Odutayo, Rahim Moineddin, Sascha Drewlo, Vesta Lai, David Z.I. Cherney, Michelle A. Hladunewich
Journal: Circulation (2010)

Background— Women with a history of placental disease are at increased risk for the future development of vascular disease. It is unknown whether preexisting endothelial dysfunction underlies both the predisposition to placental disease and the later development of vascular disease. The aim of this study was to assess vascular function in postpartum women and to determine whether differences emerged depending on the presentation of placental disease. Methods and Results— Women with a history of early-onset preeclampsia (n=15), late-onset preeclampsia (n=9), intrauterine growth restriction without preeclampsia (n=9), and prior normal pregnancy (n=16) were studied 6 to 24 months postpartum. Flow-mediated vasodilatation and flow-independent (glyceryl trinitrate–induced) vasodilatation were studied through the use of high-resolution vascular ultrasound examination of the brachial artery. Arterial stiffness was assessed by pulse-wave analysis (augmentation index). Laboratory assessment included circulating angiogenic factors (vascular endothelial growth factor, soluble fms-like tyrosine kinase 1, placental growth factor, and soluble endoglin). Flow-mediated vasodilatation was significantly reduced in women with previous early-onset preeclampsia and intrauterine growth restriction compared with women with previous late-onset preeclampsia and control subjects (3.2±2.7% and 2.1±1.2% versus 7.9±3.8% and 9.1±3.5%, respectively; P &lt;0.0001). Flow-independent vasodilatation was similar among all groups. Similarly, the radial augmentation index was significantly increased among women with previous early-onset preeclampsia and intrauterine growth restriction, but not among late preeclamptic women and control subjects ( P =0.0105). Circulating angiogenic factors were similar in all groups. Conclusion— Only women with a history of early-onset preeclampsia or intrauterine growth restriction without preeclampsia exhibit impaired vascular function, which might explain their predisposition to placental disease and their higher risk of future vascular disease.
Glycemic Exposure and Blood Pressure Influencing Progression and Remission of Diabetic Retinopathy
Authors: Yiyuan Liu, Minghui Wang, Andrew D. Morris, Alex S.F. Doney, Graham P. Leese, Ewan R. Pearson, Colin N.A. Palmer
Journal: Diabetes Care (2013)

OBJECTIVE This study sought to investigate the progression and regression of diabetic retinopathy (DR) and the effects of population risk factors on the rates of transition across retinopathy stages. RESEARCH DESIGN AND METHODS The study cohort consisted of 44,871 observed DR events between the calendar years 1990 and 2011 for 4,758 diabetic patients who were diagnosed at 35 years of age or older. The first retinal observation was recorded within a year from diagnosis, and the result was recorded as free of retinopathy. A multistate Markov model was applied for analyzing the development of DR and its relation to the patterns of changes in risk factors. RESULTS We observed a consistent risk effect of HbA1c on the progression (no retinopathy to mild background DR [BDR] hazard ratio per SD of HbA1c [HR] 1.42 [95% CI 1.32–1.52], mild BDR to observable BDR HR 1.32 [95% CI 1.08–1.60], and observable BDR to severe nonproliferative/proliferative DR HR 2.23 [95% CI 1.16–4.29]). Similarly, systolic blood pressure (SBP) and diastolic blood pressure increased the risk for the transition from the asymptomatic phase to mild BDR (HR 1.20 [95% CI 1.11–1.30]) and the mild BDR to observable BDR (HR 1.87 [95% CI 1.46–2.40]), respectively. Regression from mild BDR to no DR was associated with lower SBP (HR 0.79 [95% CI 0.64–0.97]) and lower HbA1c (HR 0.76 [95% CI 0.64–0.89]). CONCLUSIONS Progression and regression of DR were strongly associated with blood pressure and glycemic exposure.
Contributions of Dust Exposure and Cigarette Smoking to Emphysema Severity in Coal Miners in the United States
Authors: Eileen D Kuempel, Matthew W Wheeler, Randall J Smith, Val Vallyathan, Francis H Y Green
Journal: American Journal of Respiratory and Critical Care Medicine (2009)

Previous studies have shown associations between dust exposure or lung burden and emphysema in coal miners, although the separate contributions of various predictors have not been clearly demonstrated.To quantitatively evaluate the relationship between cumulative exposure to respirable coal mine dust, cigarette smoking, and other factors on emphysema severity.The study group included 722 autopsied coal miners and nonminers in the United States. Data on work history, smoking, race, and age at death were obtained from medical records and questionnaire completed by next-of-kin. Emphysema was classified and graded using a standardized schema. Job-specific mean concentrations of respirable coal mine dust were matched with work histories to estimate cumulative exposure. Relationships between various metrics of dust exposure (including cumulative exposure and lung dust burden) and emphysema severity were investigated in weighted least squares regression models.Emphysema severity was significantly elevated in coal miners compared with nonminers among ever- and never-smokers (P < 0.0001). Cumulative exposure to respirable coal mine dust or coal dust retained in the lungs were significant predictors of emphysema severity (P < 0.0001) after accounting for cigarette smoking, age at death, and race. The contributions of coal mine dust exposure and cigarette smoking were similar in predicting emphysema severity averaged over this cohort.Coal dust exposure, cigarette smoking, age, and race are significant and additive predictors of emphysema severity in this study.
Fibril specific, conformation dependent antibodies recognize a generic epitope common to amyloid fibrils and fibrillar oligomers that is absent in prefibrillar oligomers
Authors: Rakez Kayed, Elizabeth Head, Floyd Sarsoza, Tommy Saing, Carl W Cotman, Mihaela Necula, Lawrence Margol, Jessica Wu, Leonid Breydo, Jennifer L Thompson, Suhail Rasool, Tatyana Gurlo, Peter Butler, Charles G Glabe
Journal: Molecular Neurodegeneration (2007)

Amyloid-related degenerative diseases are associated with the accumulation of misfolded proteins as amyloid fibrils in tissue. In Alzheimer disease (AD), amyloid accumulates in several distinct types of insoluble plaque deposits, intracellular Abeta and as soluble oligomers and the relationships between these deposits and their pathological significance remains unclear. Conformation dependent antibodies have been reported that specifically recognize distinct assembly states of amyloids, including prefibrillar oligomers and fibrils.We immunized rabbits with a morphologically homogeneous population of Abeta42 fibrils. The resulting immune serum (OC) specifically recognizes fibrils, but not random coil monomer or prefibrillar oligomers, indicating fibrils display a distinct conformation dependent epitope that is absent in prefibrillar oligomers. The fibril epitope is also displayed by fibrils of other types of amyloids, indicating that the epitope is a generic feature of the polypeptide backbone. The fibril specific antibody also recognizes 100,000 x G soluble fibrillar oligomers ranging in size from dimer to greater than 250 kDa on western blots. The fibrillar oligomers recognized by OC are immunologically distinct from prefibrillar oligomers recognized by A11, even though their sizes overlap broadly, indicating that size is not a reliable indicator of oligomer conformation. The immune response to prefibrillar oligomers and fibrils is not sequence specific and antisera of the same specificity are produced in response to immunization with islet amyloid polypeptide prefibrillar oligomer mimics and fibrils. The fibril specific antibodies stain all types of amyloid deposits in human AD brain. Diffuse amyloid deposits stain intensely with anti-fibril antibody although they are thioflavin S negative, suggesting that they are indeed fibrillar in conformation. OC also stains islet amyloid deposits in transgenic mouse models of type II diabetes, demonstrating its generic specificity for amyloid fibrils.Since the fibril specific antibodies are conformation dependent, sequence-independent, and recognize epitopes that are distinct from those present in prefibrillar oligomers, they may have broad utility for detecting and characterizing the accumulation of amyloid fibrils and fibrillar type oligomers in degenerative diseases.
Relapse in Alcohol Use Disorder
Authors: Mark L. Willenbring
Journal: JAMA Psychiatry (2013)

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