tbuckley/cabot-search huggingface dataset:
Vascular Intervention: A Clinical Approach
Authors: Sameer Mehta
Journal: Circulation (2001)

The surge in the diagnosis and treatment of endovascular disease can be attributed to the proliferation of stents.Stents are metallic scaffolds that reduce abrupt vessel closure and provide superior long-term results.They have revolutionized the management of vascular disease, fueled the growth of endovascular procedures, led to the creation of "vascular physicians," and provided a platform for tremendous research and development.An extension of this remarkable phenomenon is the publication of numerous textbooks that extol the benefits of vascular interventions.The quality of these texts varies from ordinary to excellent.Vascular Interventions by Perler and Becker is a commendable text.It differentiates itself from other books on the subject by providing a comprehensive, multidisciplinary approach to the management of vascular disorders.This textbook boasts a commanding list of contributing editors from premier institutions in the United States.Importantly, some of these authors have pioneered various techniques in the specialty.Unfortunately, there are no foreign contributors.These individuals could have enriched the work by providing a unique perspective; in particular, to the issue of resource utilization.
CLINICAL-PATHOLOGICAL CONFERENCE
Authors: Roy W. Scott, Howard B. Sprague, Johnson Mcguire, Chester S. Keefer, Alan R. Moritz
Journal: Annals of Internal Medicine (1953)

Article1 April 1953CLINICAL-PATHOLOGICAL CONFERENCEROY W. SCOTT, M.D., F.A.C.P., HOWARD B. SPRAGUE, M.D., F.A.C.P., JOHNSON MCGUIRE, M.D., F.A.C.P., CHESTER S. KEEFER, M.D., F.A.C.P., ALAN R. MORITZ, M.D.ROY W. SCOTT, M.D., F.A.C.P.Search for more papers by this author, HOWARD B. SPRAGUE, M.D., F.A.C.P.Search for more papers by this author, JOHNSON MCGUIRE, M.D., F.A.C.P.Search for more papers by this author, CHESTER S. KEEFER, M.D., F.A.C.P.Search for more papers by this author, ALAN R. MORITZ, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-38-4-878 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptCLINICAL PROTOCOLThe patient, a white unmarried female, first came under observation in January 1946 at age 27 years complaining of hoarseness and increasing breathlessness with effort over the preceding year. The family history was irrelevant. The past history was non-contributory as the patient had always enjoyed good health and was quite active in competitive athletics during school days with no cardio-respiratory limitations.On physical examination the patient presented a normal appearance. She was well developed and well nourished and was neither dyspneic nor cyanotic. The neck veins were not distended. Examination of the eyes revealed no abnormalities. To elicit... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Presented at the 33rd Annual Session of the American College of Physicians, Cleveland, April 22, 1952.Received for publication July 5, 1952. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byUnrecognized Emboli to the Lungs with Subsequent Cor Pulmonale 1 April 1953Volume 38, Issue 4Page: 878-885KeywordsDyspneaSportsVeins Issue Published: 1 April 1953 PDF downloadLoading ...
Abstract 1741: Predicting Coronary Stenosis by Computer-Enhanced, Resting Electrocardiogram: Effect of Gender, Age, and Revascularization on Sensitivity and Specificity
Authors: Eberhard Grube, Andreas Bootsveld, Seyrani Yuecel, Lutz Buellesfeld, Joseph T Shen, Michael Imhoff
Journal: Circulation (2007)

Background: Resting electrocardiogram (ECG) shows limited sensitivity and specificity for the detection of coronary artery disease (CAD). We wanted to evaluate a new computer-enhanced resting ECG d...
FCER2 T2206C variant associated with chronic symptoms and exacerbations in steroid-treated asthmatic children
Authors: E. S. Koster, A.-H. Maitland-van der Zee, R. Tavendale, S. Mukhopadhyay, S. J. H. Vijverberg, J. A. M. Raaijmakers, C. N. A. Palmer
Journal: Allergy (2011)

To cite this article: Koster ES, Maitland-van der Zee A-H, Tavendale R, Mukhopadhyay S, Vijverberg SJH, Raaijmakers JAM, Palmer CNA. FCER2 T2206C variant associated with chronic symptoms and exacerbations in steroid-treated asthmatic children. Allergy 2011; 66: 1546–1552. Abstract Background: The T2206C FCER2 variant was found previously to be associated with IgE levels, exacerbation rates and decreased FCER2 expression in children on inhaled corticosteroids (ICS) participating in a clinical trial. This finding has not been replicated. We sought to replicate the association between the FCER2 gene and exacerbations in children with asthma. In addition, we tested the hypothesis that the T2206C variant may be associated with other markers of steroid resistance such as asthma symptom scores and asthma medication use. Methods: The influence of the T2206C variant on asthma exacerbations (emergency department visits or hospitalization), symptoms scores and medication use was explored using data from two populations of asthmatic children using ICS: Pharmacogenetics of Asthma medication in Children: Medication with ANti-inflammatory effects study (n = 386) and BREATHE study (n = 939). Results: The T2206C variant was associated with increased risk of asthma-related hospital visits in both cohorts (OR: 1.91, 95%CI: 1.08–3.40), and meta-analysis with previously published results was highly significant (OR: 2.38, 95%CI: 1.47–3.85, P = 0.0004). The FCER2 variant was also associated with increased risk of uncontrolled asthma measured by Asthma Control Questionnaire (OR: 2.64, 95%CI: 1.00–6.98) and was associated with increased daily steroid dose (OR: 2.46, 95%CI: 1.38–4.39). Conclusion: The association between the FCER2 T2206C variant and asthma-related hospitalizations in steroid-treated asthma appears robust and may also be associated with other indicators of lack of ICS efficacy such as asthma symptoms and a requirement for higher daily doses of ICS. Our results suggest that the FCER2 T2206C variant might be a useful pharmacogenetic predictor of steroid refractory patients.
Lead Exposure and Cataract Risk in Men
Authors: Brian J Song
Journal: JAMA (2005)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Computed Tomographic Imaging of Anomalous Coronary Arteries
Authors: Thomas C. Gerber, Ronald S. Kuzo, Robert E. Safford
Journal: Circulation (2002)

To the Editor:Ropers et al 1 present a series of images demonstrating that the proximal course of anomalous left main and left anterior descending coronary arteries originating from the right sinus of Valsalva can be visualized by electron beam computed tomography.We are writing to communicate that more widely available, retrospectively gated multislice computed tomography (MSCT) of the heart 2 can be used to similar effect.For example, we recently examined a 34-year-old hypertensive smoker who was referred for evaluation of atypical chest pain and equivocal results on exercise technetium Tc-99 m sestamibi scanning.Coronary angiography showed a single coronary artery, without significant stenosis, originating from the right coronary cusp.The proximal course of the left anterior descending and circumflex coronary arteries relative to the great vessels could not be established with certainty.MSCT scanning was performed (VolumeZoom, Siemens Medical Systems), enhanced by 140 mL of nonionic contrast material injected at 2.5 mL/s.The patient's heart rate was 57 bpm after oral administration of 100 mg of metoprolol 90 minutes before the scan.The image data were reconstructed to 1.25-mm slice thickness and gated retrospectively to a 250-ms time window, beginning 400 ms before the subsequent R-wave.The tomographic images and volume rendering unequivocally showed the anomalous left anterior descending coronary artery to course in front of the pulmonary artery and the anomalous circumflex coronary artery, behind the aorta.Therefore, referral for coronary artery bypass surgery was not needed.Instead, the patient received counseling on coronary risk factor modification and was begun on a trial of proton-pump inhibition.
Abstract 13037: Age-Specific Stroke Trends from 1980 to 2000: The Minnesota Stroke Survey
Authors: Kristian B Filion, Arthur Sillah, Russell V Luepker, Kamakshi Lakshminarayan
Journal: Circulation (2011)

Introduction: With an increasing prevalence of obesity and diabetes, two known risk factors for stroke, there is a need to re-evaluate age-specific stroke trends. We hypothesized increasing stroke ...
A father remembered: Syringomyelia can be treated
Authors: H. Williams
Journal: BMJ (1998)

My father dedicated his working life to the study of syringomyelia. Early in his career the condition could be diagnosed using a variety of radiological techniques, but this has been made easier by the introduction of magnetic resonance imaging. Initially, there was no satisfactory treatment but, during the course of his work, our understanding of the disease increased greatly, Surgery can now be offered to many patients, which can halt an otherwise inexorable process of pain, paralysis, and paraesthesia. In some cases neurological improvements can occur following operation. For people with this condition the loss of my father, who died …
Abstract 17460: Initial Clinical Experience with the Medtronic LinQ Loop Recorder: Concerns about Data Deluge
Authors: Geordan S Kushner BA, Martha Ferrara CNP, Obiananma Nwokike BS, Aysha Arshad MD, Dan Musat MD, Mark Preminger MD, Tina Sichrovsky MD, Jonathan S Steinberg MD, Suneet Mittal MD
Journal: Circulation (2014)

Introduction: Long-term ECG monitoring is often necessary in patients (pts) with unexplained syncope and suspected or known atrial fibrillation (AF). The recently released Medtronic LinQ loop recorder (ILR) accrues ECG data daily; “alert” conditions are wirelessly transmitted to providers. To date, the frequency and characteristics of these alerts are unknown. Hypothesis: We hypothesized that alerts would occur infrequently, thus allowing for remote management of large numbers of pts. Methods: Consecutive pts implanted with the LinQ were assessed. All alerts were collected and analyzed. Alerts ideally reflect a change within the past 24 hours of monitoring. However, some alerts (once triggered) perpetuate daily until cleared by a patient initiating a manual transmission. Results: Our first 100 LinQ pts (mean age 67.5 years; 51% male) implanted within the first 3 months of market release were assessed. The indications for monitoring included suspected AF (cryptogenic stroke, n=10; history of atrial flutter, n=1), known AF (n=61), and unexplained syncope (n=25). During follow-up, an alert occurred in 63 pts; a similar frequency of alerts occurred in AF and syncope pts (Figure). Once present, 29 (46%) alerts perpetuated daily and required manual transmission to clear. Conclusion: We report the initial clinical experience with the LinQ ILR. We found that alerts occurred frequently, irrespective of indication for monitoring. Once present, alerts were frequently perpetuated due to a major design limitation. A more robust system is needed to triage the data being accrued to prevent unnecessary data deluge.
The role of sleep clinical record and nocturnal pulse oximetry in predicting childhood obstructive sleep apnea
Authors: Nicoletta Pietropaoli, Maria Chiara Supino, Jole Rabasco, Ottavio Vitelli, Chiara Romano, Manuela Cecili, Maria Pia Villa
Journal: European Respiratory Journal (2014)

Introduction 

Polysomnography (PSG) is the gold standard for the diagnosis of Obstructive Sleep Apnea (OSA). However, it is expensive and not available everywhere. For these reasons, alternatives to full PSG for the evaluation of suspected OSAS are often sought. The aim of our study is to develop a simple tool to screen OSA, thus reducing the use of PSG.

Methods 

Children with suspected OSA referred to our Pediatric Sleep Centre from September 2012 to September 2013 were included. Each patient underwent Sleep Clinical Record (SCR), full PSG, and nocturnal pulse oximetry. A diagnosis of OSA was made in children with an Apnea/Hypopnea Index (AHI) ≥1 ev/h. A SCR score ≥ 6.5 and a McGill Oximetry Score (MOS) ≥ 2 were considered positive.

Results 

We enrolled 285 children, mean age 6.2 ± 3.1, 187 (65.6%) male. 52 children (18.2%) showed MOS ≥ 2 with a sensitivity of 20.5% and specificity of 97.2%. 227 children (79.6%) had SCR score ≥ 6.5 with a sensitivity of 81.1% and specificity of 30.5%.

48 children (16.8%) showed positive SCR and MOS; all of them received a diagnosis of OSA at the PSG, reaching a specificity of 100%. Sensitivity was 52%; positive and negative predictive value were respectively 100% and 18.5%.

Conclusion 

The combined use of SCR and nocturnal pulse oximetry with MOS may represent a valid alternative to full PSG.
Adverse Events Associated with Testosterone Administration
Authors: Cornelia Weikert, Tobias Pischon, Steffen Weikert
Journal: New England Journal of Medicine (2010)

To the Editor: In their study involving elderly men with impaired mobility, Basaria et al. (July 8 issue)1 found that men who received testosterone treatment, as compared with those who received placebo, had a higher rate of cardiovascular adverse events. Apart from the reasons discussed by the authors, this observation may also be a consequence of a higher degree of physical activity among the men receiving testosterone supplementation. In line with this hypothesis, limited physical vigor has been associated with total testosterone levels below 13 nmol per liter, a threshold crossed by the intervention.2 The beneficial effects of long-term physical activity notwithstanding, a body of evidence suggests that short-term physical exertion can precipitate myocardial infarction, sudden death, stroke, and acute left ventricular dysfunction.3,4 The authors found that the men in the intervention group had improved muscle performance and physical function after 6 months, but unfortunately the authors do not report about possible changes in the level of physical activity over the course of the study period. This information would be valuable, since the reported data do not preclude the possibility that the risk of adverse events associated with testosterone supplementation in elderly men can be reduced by the avoidance of sudden and inadequate physical exertion.
Abstract 14897: Gender Differences and Flow Category Effects on Left Ventricular Remodelling in Patients With Severe Aortic Stenosis and Preserved Left Ventricular Ejection Fraction
Authors: Weiqin Lin, Ivandito Kuntjoro, Edgar Tay, William Kong, Tiong Cheng Yeo, Kian Keong Poh
Journal: Circulation (2014)

Introduction: Gender differences in the pattern of adaptive left ventricular (LV) hypertrophy to pressure overload from aortic stenosis (AS) has previously been identified. Differential effects in low versus normal-flow AS have not been investigated. We aim to examine effect of gender on LV remodeling in patients with low flow (LF) compared with normal flow (NF) AS. Methods: We studied 486 patients over a 12-year period with severe AS (valve area &lt;1cm2) and preserved left ventricular ejection fraction (LVEF ≥50%). They were divided into LF (stroke volume index &lt;35 ml/m2) and NF. Parameters were compared between genders. Results: There were 287 (59%) females, 93 (32%) were LF. In both genders, LV was smaller with lower mass index and higher relative wall thickness in the LF group. In the NF group, although aortic valve area index (AVAI) was larger in the females, mean gradient, peak velocity, degree of LV hypertrophy and LVEF were similar between the genders. LV volumes and LA dimensions were significantly smaller and larger in females respectively. Conversely in the LF group, all parameters indicate consistently more severe AS in males (Table). LVEF was lower and LV mass indexed to body surface area was higher in males (Table). The gender differences of end diastolic LV volume and LA dimension were similar between the categories. Valvuloarterial impedance was elevated and systemic compliance was reduced in the LF group in both genders compared to the NF group (Table). Conclusions: In patients with severe AS and preserved LVEF, LV appears smaller with lower mass and higher remodeling in LF compared to NF. Greater gender disparity in LV remodeling is documented in LF. Further studies on the prognostic significance are warranted.
Sleep disturbances in survivors of the Nazi Holocaust
Authors: J Rosen, C F Reynolds, A L Yeager, P R Houck, L F Hurwitz
Journal: American Journal of Psychiatry (1991)

Sleep disturbances are commonly reported by victims of extraordinary stress and can persist for decades. This study was designed to test the hypothesis that survivors of the Nazi Holocaust would have significantly more and different sleep problems than depressed and healthy comparison subjects and that the severity of the survivors' problems would be correlated with length of time spent in a concentration camp. Forty-two survivors, 37 depressed patients, and 54 healthy subjects of about the same age, all living in the community, described their sleep patterns over the preceding month on the Pittsburgh Sleep Quality Index, a self-rating instrument that inquires about quality, latency, duration, efficiency, and disturbances of sleep, use of sleep medication, and daytime dysfunction.The survivors had significantly greater sleep impairment than the healthy comparison subjects, as measured by all subscales of the index, but had less impairment than the depressed patients except on the sleep disturbances and daytime dysfunction subscales. However, for specific items within these subscales, survivors had significantly more frequent awakenings due to bad dreams and had less loss of enthusiasm than the depressed subjects. Sleep disturbances and frequency of nightmares were significantly and positively correlated with the duration of the survivors' internment in concentration camps.These findings suggest that for some Holocaust survivors, impaired sleep and frequent nightmares are considerable problems even 45 years after liberation.
Abstract 19958: Evaluation of Tricuspid Regurgitation (TR) Severity Prior to and after Device Extraction in Patients with Cardiac Device Infection
Authors: Thomas Butler, Akhlaq Khan, Abhishek Sengupta, Jonathan Sherman, Russell Denman, Darryl Burstow, John F Sedgwick
Journal: Circulation (2014)

Aim: This study sought to evaluate the impact of device extraction on the severity of TR in patients with cardiac device related infection (CDI) and infective endocarditis (CDRIE). Methods: The medical and echocardiographic records of 142 patients who had undergone device extraction for suspected infection from 2007 - 2013 were reviewed. Data on clinical complications, echocardiographic documentation of TR severity prior to and after device removal and potential risk factors for change in TR severity was obtained. A paired t test was used to evaluate whether the TR mean grade changed significantly. Patient Demographics: A total of 56 patients out of the 142 patients had TTE and/or TOE imaging. Of these patients, 22 patients had ICD’s, 27 patients had PPM’s and 7 patients had BiV Devices. The mean age was 62 years (47 males). Clinical complications included decompensated heart failure (12.5%), septic shock (8.9%), septic arthritis (8.9%), splenic abscess (1.78%), septic pulmonary embolism (5.35%), leukocytoclastic vasculitis (1.78%). Results: The mean duration of device in situ prior to extraction was 64 months (5.33yrs). The mean grade of TR prior to device extraction was grade 1.35/4 (SD=0.901, C.I. 1.16 to 1.72). The mean grade of TR post extraction was 1.54/4 (SD= 0.96 with C.I. 1.26 to 1.89). The mean difference in mean TR grade was 0.13 (C.I. 0.37 to -0.106) p &gt;0.05. One patient had a worsening of TR by at least 2 grades post extraction. This was due to valve perforation from infection rather than extraction related trauma. This was the only patient that required surgery for clinically significant TR. Risk factors for worsening TR post extraction included the length of time leads were in situ and age of the patient. Time of Device in situ prior to extraction did not correlate significantly with severity of TR post procedure rho 0.12 (p value = 0.45). Furthermore, age at the time of the procedure did not correlate with tricuspid regurgitation severity post extraction rho 0.21 (p value = 0.18). Conclusions: Worsening of TR post extraction is uncommon and is more likely due to valve destruction from infection rather than trauma to the valve during extraction. Furthermore, a number of complications occur peri-procedurally that impacts on patient outcomes.
How to treat haemorrhoids
Authors: G. Brisinda
Journal: BMJ (2000)

Haemorrhoids and their symptoms are one of the most common afflictions in the Western world.1–4 They can occur at any age and can affect both women and men. Because the presence of haemorrhoidal tissue is normal—it acts as a compressible lining which allows the anus to close completely—disease should be thought of as haemorrhoidal tissue that causes significant symptoms. 1 2 Unfortunately, haemorrhoids tend to get worse over time, and disease should be treated as soon as it occurs.

Haemorrhoids cushion sinusoids, and bleeding occurs from presinusoidal arterioles.2 The main cushions lie at the left lateral, right anterolateral, and right posterolateral portions of the anal canal. Secondary cushions may be present. Proposed aetiological factors include constipation, prolonged straining, derangement of the internal anal sphincter, and pregnancy. Haemorrhoids may be caused by more than one factor. Despite being examined in several studies, the pathogenesis remains unclear. 1 2 Haemorrhoids can be either internal or external, and patients may have both types.1–4 External haemorrhoids occur below the dentate line and are generally painful. When …