tbuckley/cabot-search huggingface dataset:
Clustering of teenage suicides after television news stories about suicides: a reconsideration
Authors: R C Kessler, G Downey, J R Milavsky, H Stipp
Journal: American Journal of Psychiatry (1988)

A recent study reported a significant increase in teenage suicides after television newscasts about suicide in the period 1973-1979 and suggested that the increase might have resulted from an imitative effect of television. In the present study, the authors found no significant association between newscasts and subsequent teenage suicides over the period 1973-1984. Although teenage suicides increased after newscasts in 1973-1980, the authors identify reasons why this increase is not consistent with an imitative effect of television. Furthermore, during 1981-1984 teenage suicides decreased after newscasts about suicide; the reversal differs significantly from the association before 1981.
Abstract 19352: Features of Plaque Disruption by Coronary CT Angiography Are Associated with Lipid Core Plaque by Intra-coronary Near-infrared Spectroscopy
Authors: Ivan D Hanson, Ryan D Madder, A N Bilolikar, Mark Pica, Simon R Dixon, James A Goldstein
Journal: Circulation (2010)

Background: Features of plaque rupture and thrombus formation by invasive imaging correlate with lipid-rich necrotic core at pathological examination. Using intra-coronary near-infrared spectroscop...
Patients' action during their cardiac event: qualitative study exploring differences and modifiable factors Commentary: Grounded theory and the constant comparative method
Authors: A. Ruston, J. Clayton, M. Calnan, J. Green
Journal: BMJ (1998)

<h3>Abstract</h3> <b>Objectives:</b> To explore the circumstances and factors that explain variations in response to a cardiac event and to identify potentially modifiable factors. <b>Design:</b> Qualitative analysis of semistructured, face to face interviews with patients admitted to two district hospitals for a cardiac event and with other people present at the time of the event. Patients were divided into three groups according to the length of delay between onset of symptoms and calling for medical help. <b>Subjects:</b> 43 patients and 21 other people present at the time of the cardiac event. Patients were divided into three groups according to the length of time between onset of symptoms and seeking medical help: non-delayers (&lt;4 h; n=21), delayers (4-12 h; n=12), and extended delayers (&gt;12 h; n=10). <b>Main outcome measures:</b> Decision making process, strategies for dealing with symptoms, and perception of risk and of heart attacks before the event according to delay in seeking help. <b>Results:</b> The illness and help seeking behaviour of informants had several components, including warning, interpretation, preliminary action, re-evaluation, and final action stages. The length of each stage was variable and depended on the extent to which informants mobilised and integrated resources into a strategy to bring their symptoms under control. There were obvious differences in informants9 knowledge of the symptoms that they associated with a heart attack before the event. Non-delayers described a wider range of symptoms before their heart attack and twice as many (13) considered themselves to be potentially at risk of a heart attack compared with the other two groups. For most informants the heart attack differed considerably from their concept of a heart attack. <b>Conclusion:</b> The most critical factor influencing the time between onset of symptoms and calling for professional medical help is that patients and others recognise their symptoms as cardiac in origin. This study suggests that various points of intervention in the decision making process could assist symptom recognition and therefore faster access to effective treatment. <h3>Key messages</h3> Research using methods that can explain variations in response to cardiac events has been neglected Informants in this study thought of heart attacks as sudden dramatic events in which people collapse and probably die, rather than as the evolving event that they experienced Those who sought medical help within 4 hours were more likely to see themselves as potentially at risk, knew a wider range of symptoms of a heart attack, and were much less likely to use drugs to treat their symptoms compared with those who waited longer Intervention at various points in the decision making process could help recognition of symptoms and speed access to effective treatment
Backdoor euthanasia
Authors: J. Paul, M. Bliss
Journal: BMJ (1999)

Editor—Recent articles in the general1 and medical press2 on “backdoor euthanasia” illustrate the confusion that surrounds the subject. This is especially true for decisions to withdraw or withhold food and fluids from ill patients. Focusing on the issue of the intention behind such actions may help to achieve some clarity.

Current research, although limited, suggests that the desire for food and drink lessens in terminally ill patients and that artificial hydration neither prolongs survival nor alleviates symptoms.3,4 Furthermore, drips and nasogastric feeding tubes can cause unnecessary distress to patients and their relatives. In such cases the withholding of these treatments is entirely appropriate as the intention is to save the patient from a treatment that has no medical benefit.

But what about those who are not in the terminal stages of an illness—for example, patients who have had a recent stroke or with acute infection? In most instances death is not imminent. However, not providing food and fluids would certainly lead to death. In this case the intention behind the omission is to let the patient die. It fulfils the definition of an act of euthanasia and as such is morally unjustifiable.

This leaves one further question: when is a patient's condition terminal? That is, when is a patient at a stage where recovery is highly improbable and provision of artificial nutrition and hydration is of no benefit? This is not always easy to answer. Clinical signs and biochemical tests act as a good indicator, as does experience in dealing with such cases. But when there is doubt, as there often is, it seems common sense to err on the side of caution and provide all reasonable means to aid recovery, including the basic human needs for food and drink.
Abstract 9635: A Novel in vitro Model of Danon Disease Confirms the Critical Role of LAMP2 in Regulating Autophagy
Authors: Stacey Clegg, Qiuming Gong, Zhengfeng Zhou, Eric Adler
Journal: Circulation (2011)

Introduction: Danon disease is an X-linked cardiomyopathy caused by mutations in the lysosomal associated membrane protein 2 (LAMP2). LAMP2 plays a critical role in autophagy, but the mechanisms in which mutations lead to myocyte dysfunction are poorly understood. We identified a novel frame shift mutation that introduces a premature termination codon (PTC) in the LAMP2 gene in a patient with Danon disease. Degradation of PTC-containing mRNA transcripts by nonsense mediated decay (NMD) has been shown in a variety of heart diseases. We hypothesized that 1) the mechanism of LAMP2 dysfunction in this patient is NMD mediated, and 2) induced Pluripotent Stem (iPS) cell-derived myocytes generated from these fibroblasts would show evidence of impaired autophagy. Methods: Dermal fibroblast lines were established from a patient with Danon disease and used for RNA and protein assays. Fibroblasts were subsequently used to create iPS cell-derived cardiomyocytes using previously described techniques. Immunohistochemistry and protein gel electrophoresis of the autophagosome associated protein, LC3-II, were used to assay for autophagic function. Ultrastructural studies were performed using electron microscopy. Results: Patient fibroblasts were shown to completely lack the LAMP2 protein. Treatment with the protein synthesis inhibitor cyclohexamide stabilized LAMP2 mRNA levels, suggesting this LAMP2 mutation is targeted by NMD. Compared to wild type cells, Danon disease iPS-derived cells demonstrated reduced basal levels of the autophagosome-associated protein LC3-II, suggestive of impaired autophagy. Electron microscopy of iPS cells showed excessive intracytoplasmic vacuoles consistent with the disease phenotype. Conclusions: We have successfully created the first in vitro human model of Danon disease. Using this system, we identified NMD as a novel mechanism responsible for LAMP2 dysfunction in a patient with Danon disease. Furthermore, we confirmed the critical role of LAMP2 in the regulation of autophagy. This study highlights the utility of this in vitro system for elucidating the pathophysiology of inherited cardiovascular disease.
Abstract 1629: Genetic Polymorphism A1675G On Angiotensin Receptor Type 2, Is Implicated In The Expression Of Acute Phase Proteins And The Development Of Coronary Atherosclerosis In Hypertensive Patients
Authors: Dimitris Tousoulis, Nikolas Koumallos, Charalambos Antoniades, Despina Kardara, Alexis S Antonopoulos, D Mentzikof, Carmen Vasiliadou, Charalambos Vlachopoulos, Emmanouil Vavuranakis, Christodoulos Stefanadis
Journal: Circulation (2007)

Introduction: Renin-angiotensin system affects cardiovascular disease pathogenesis through a balance of angiotensin II effects on proatherogenic constitutive type 1 and antiatherogenic inducible type 2 (AT2R) receptors. The impact of A1675G polymorphism on the development of hypertension and advanced atherosclerosis is controversial. We examined the impact of A1675G polymorphism on AT2R, on the risk for arterial hypertension and coronary atherosclerosis, and its effect on the expression of proatherogenic inflammatory molecules. Methods. The study population consisted of 310 males: 145 with arterial hypertension and 165 controls, matched for age and risk factors for atherosclerosis. Among hypertensive subjects, 37 had angiographically documented coronary atherosclerosis and 108 had no evidence of atherosclerosis. The presence of A1675G polymorphism on AT2R gene (located in chromosome X) was determined by PCR. Serum levels of C-reactive protein and fibrinogen was measured in all the participants. Results. The frequency of the A allele was similar between patients with arterial hypertension (64/145, 44.1%) and non-hypertensive subjects (73/165, 44.2%, p=NS), while the risk for arterial hypertension was OR[95%CI]:1.004[0.641–1.574], p=0.985 for the G vs A carriers. However, the risk for coronary atherosclerosis within the group of hypertensive subjects was significantly elevated in the carriers of the A allele (OR[95%CI]:2.128[1.003–4.513], p=0.04 vs carriers of the G allele). Importantly, the presence of the A allele was also associated with significantly higher levels of CRP (4.8±0.8mg/dl) compared to the carriers of the G allele (3.0±0.3mg/dl, p&lt;0.05). Similarly, fibrinogen levels were higher in A-allele carriers (median(25 th –75th percentile) 395(340 – 455) mg/ml) compared to G-allele carriers (369(320 – 406) mg/ml, p&lt;0.05). Conclusions: Although genetic polymorphism A1675G on AT2R is not associated with the development of arterial hypertension, it affects the risk for coronary artery disease among hypertensive patients. The presence of the A allele also leads to higher levels of CRP and fibrinogen, implying that this polymorphism may induce atherogenesis by modulating acute phase response in hypertensive individuals.
Economic issues in lung cancer: a review.
Authors: P J Goodwin, F A Shepherd
Journal: Journal of Clinical Oncology (1998)

PURPOSE Lung cancer is a major source of morbidity, mortality, and health care costs in the developed and developing world. It is estimated that lung cancer is responsible for 20% of all cancer care costs. Concerns exist that this expenditure is associated with questionable benefits. DESIGN The economic literature that relates to smoking was reviewed, followed by a summary of the economics of the diagnosis, treatment, and palliation of lung cancer. Methodologic considerations are also discussed in this section. RESULTS Published studies suggest that the increased lifetime health care costs from smoking-related illnesses in smokers are partially or fully offset by the higher medical costs that result from increased longevity in nonsmokers. However, lost productivity costs, which result from morbidity and early mortality among smokers, result in an overall net cost of smoking to society. Discounting rates of 3% to 5% do not substantively alter these results. The per-patient cost to treat lung cancer is substantial. The major cost center is hospitalization; palliative or terminal treatment is associated with significant costs. Savings can be obtained through the judicious use of diagnostic and staging procedures. Furthermore, combined modality treatment approaches and the palliative use of combination chemotherapy appear to be associated with acceptable cost-effectiveness compared with commonly used therapies for other diseases. CONCLUSION Although the increased medical care costs of treating smoking-related diseases are somewhat offset by the higher medical care costs due to increased longevity in nonsmokers, the lost productivity that results from smoking results in a net cost to society. Standard approaches to the management of lung cancer are associated with cost-effectiveness similar to that of other commonly used medical interventions.
Longitudinal Left Ventricular Function for Prediction of Survival in Systemic Light-Chain Amyloidosis
Authors: Sebastian J. Buss, Mostafa Emami, Derliz Mereles, Grigorios Korosoglou, Arnt V. Kristen, Andreas Voss, Dieter Schellberg, Christian Zugck, Christian Galuschky, Evangelos Giannitsis, Ute Hegenbart, Anthony D. Ho, Hugo A. Katus, Stefan O. Schonland, Stefan E. Hardt
Journal: Journal of the American College of Cardiology (2012)
Proceedings of the First Jack Pepys Occupational Asthma Symposium
Authors: Moira Chan-Yeung, Jean-Luc Malo, Susan M Tarlo, Leonard Bernstein, Denyse Gautrin, Christina Mapp, A Newman-Taylor, Mark C Swanson, Guy Perrault, Lesage Jaques, Paul D Blanc, Olivier Vandenplas, Andre Cartier, Margaret R Becklake
Journal: American Journal of Respiratory and Critical Care Medicine (2003)
Psychology and the Day's Work. A Study in the Application of Psychology to Daily Life.
Authors: Edgar James Swift
Journal: JAMA (1918)

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Gene Therapy for Severe Combined Immunodeficiency Disease
Authors: Rupert Handgretinger, Ewa Koscielniak, Dietrich Niethammer
Journal: New England Journal of Medicine (2002)

To the Editor: Correction of X-linked severe combined immunodeficiency by infusion of autologous CD34+ stem cells transduced with retrovirus containing common g chain, reported by Hacein-Bey-Abina et al. (April 18 issue), 1 is a milestone in medicine.We used a different therapy with a similarly good outcome.X-linked severe combined immunodeficiency was diagnosed in two patients after the initiation of mechanical ventilation for pulmonary failure caused by infections.Immediately after the diagnosis had been made, haploidentical CD34+ peripheral progenitor cells mobilized with granulocyte colony-stimulating factor were isolated to a purity of more than 99 percent. 2 These cells were infused with no preparative regimen and no prophylaxis against graft-versus-host disease.Both patients showed signs of T-cell reconstitution beginning three weeks after the CD34+ infusion and were weaned from the ventilator.They are in excellent health, without graft-versus-host disease, 34 and 68 months after transplantation.Patient 1 does not need replacement immune globulin.Patient 2 received a "booster" infusion of CD34+ stem cells from the original donor one year later to improve B-cell function and now receives immune globulin every three months.Our experience indicates that purified haploidentical CD34+ progenitor cells reconstitute the T-cell compartment and can correct the B-cell defect.Given the possibility of long-term risks 3,4 and the availability of effective alternatives, we think that broader application of gene therapy for the treatment of patients with severe combined immunodeficiency or strategies for the correction of persistent B-cell deficiency after successful allogeneic transplantation 5 are premature and warrant longer follow-up.
RSV hospitalization in Down syndrome in the Canadian Registry of Synagis (CARESS) following prophylaxis (2006-2011)
Authors: Ian Mitchell, Bosco Paes, Abby Li, Krista Lanctot
Journal: European Respiratory Journal (2012)

Background: The Canadian Registry of Synagis (CARESS) tracks palivizumab use and RSV hospitalizations iincluding 299 full term Down syndrome (DS) infants without congenital heart disease.  Objective: To determine respiratory illness (RIH) and RSV hospitalization (RSVH) rates in healthy DS)infants who received palivizumab compared to: 1) infants with underlying medical disorders (MD) and 2) infants who meet standard indications for RSV prophylaxis (SD).  Design/Methods: A prospective, observational, registry of infants who received 1 dose of palivizumab during the 2006-2011 RSV seasons. Data collected monthly.  Results: 10,061 infants were enrolled (DS: 299, 3.0%; infants with MD: 1247, 12.4%; and SD: 8515, 84.6%). Participants were significantly different (p  Conclusions: Rates of hospitalization for respiratory illnesses and RSV-related hospitalization did not differ among the groups following prophylaxis. Palivizumab may be efficacious in reducing RSVH in DS compared to reported historical untreated controls in a similar Danish cohort of DS patients (untreated; 7.6%; versus treated; 1.6% - 77% reduction).
Significance of Radiological Calcification of Joint Cartilage
Authors: H. L. F. Currey, J. J. Key, R. M. Mason, K. V. Swettenham
Journal: Annals of the Rheumatic Diseases (1966)

Sporadic reports of radiological calcification of knee menisci have appeared in the literature for many years, but it was not until recently that Zitnian and Sitaj (1958, 1960, 1963) established the associa- tion of joint cartilage calcification and arthropathy.These authors described the familial occurrence of acute and chronic arthritis in patients with calcification of cartilage in multiple joints.A similar radiological appearance was then observed by McCarty, Kohn, and Faires (1962) in patients with attacks of acute arthritis attributed to the presence of crystalline calcium pyrophosphate within affected joints.It now appears that there is at least considerable overlap between the "chondrocalcinosis" of Zitnian and Sitaj, and the "pseudo-gout" of McCarty, Kohn, and Faires.A similar pattern of joint calci- fication may be present in patients with functioning Total on July 8, 2023 by guest.
Abstract 19033: p53-Mediated Decrease in ROS Signal Reduces Mitophagy via Inactivation of Bnip3 to Aggravate Cardiac Damage After Ischemic Injury
Authors: Atsushi Hoshino, Satoaki Matoba, Eri Iwai-Kanai, Masaki Kimata, Hideo Nakamura, Mikihiko Nakaoka, Yoshifumi Okawa, Maki Katamura, Hiroaki Matsubara
Journal: Circulation (2010)
A memorable patient: Psychiatric problem dismissed
Authors: H. Davis
Journal: BMJ (1998)

I was a medical student in my first clinical rotation, assigned to a medical firm under a consultant renowned for his diagnostic skills and general medical approach in an ever specialising world of internal medicine. I first saw the patient in the senior house officer's (SHO) new patient clinic, and with my fellow students watched on impressed, as the highly motivated and extremely capable SHO took a painstakingly detailed history from a intelligent woman in general good health, who spoke animatedly about herself and her symptoms. She described recurrent episodes of apparent hypoglycaemia, which came on without warning, leaving her with an array of symptoms including tremor, confusion, tachycardia, and general malaise. The diagnostic possibilities were too much for us first time …
Cognitive learning function in OSA children
Authors: Silke Weber, Silvana Hilario, Έrico Moreira da Silva, Victor Barbosa dos Santos, Cristiane Mendes-Chiloff
Journal: European Respiratory Journal (2011)

Introduction:  Obstructive Sleep Apnea (OSA) in children is associated with learning problems, as attention and memory.   Aim:  To assess learning, memory and attention function in OSA children.   Methods:  OSA children (IAH>4 or IA>1), both genders, aged 6 to 12 years, were submitted to psychological learning test (symbol, digits and code – WISC III Wechsler Intelligence Scale for Children). Test result were pondered for age, 10 points were considered normal,    Results:  30 children, 9 girls, median age 8.5 years, were enrolled. Median IAH was 11.9 (4 to 65) and mean IDO 12.8 (3.4 to 71). 14 (46%) children, 10 boys, were considered suspicious, 9 (30%), 8 boys, were considered as having learning disturbance (LD). 67% werde diagnosed LD in 2 or more subareas, showing global learning dysfunction as discrimination, velocity and attention. There was no correlation of learning disturbance to IAH or IDO (OSA severity), but it was correlated to male gender and to older age, 50% of children aged 9 to 12 years were diagnosed LD.   Conclusion:  Learning disturbances are frequent in OSA children, independent of OSA severity. Exposing time to OSA seems to be an important factor. OSA children should undergo neurocognitive evaluation.