tbuckley/cabot-search huggingface dataset:
Sex Differences in the Effectiveness of Early Coronary Computed Tomographic Angiography Compared With Standard Emergency Department Evaluation for Acute Chest Pain
Authors: Quynh A. Truong, Douglas Hayden, Pamela K. Woodard, Ruth Kirby, Eric T. Chou, John T. Nagurney, Stephen D. Wiviott, Jerome L. Fleg, David A. Schoenfeld, James E. Udelson, Udo Hoffmann
Journal: Circulation (2013)

Background— We evaluate sex-based differences in the effectiveness of early cardiac computed tomographic angiography (CCTA) and standard emergency department (ED) evaluation in patients with acute chest pain. Methods and Results— In the Rule-Out Myocardial Infarction With Computer-Assisted Tomography (ROMICAT)-II multicenter, controlled trial, we randomized 1000 patients (47% women) 40 to 74 years of age with symptoms suggestive of acute coronary syndrome to an early CCTA or standard ED evaluation. In this prespecified analysis, women in the CCTA arm had a greater reduction in length of stay, lower hospital admission rates, and lesser increased cumulative radiation dose than men in a comparison of ED strategies ( P for interaction ≤0.02). Although women had lower acute coronary syndrome rates than men (3% versus 12%; P &lt;0.0001), sex differences in length of stay persisted after adjustment for baseline differences, including acute coronary syndrome rate ( P for interaction &lt;0.03). Length of stay was similar between sexes with normal CCTA findings ( P =0.11). There was no missed acute coronary syndrome for either sex. No difference was observed in major adverse cardiac events between sexes and ED strategies ( P for interaction =0.39). Women had more normal CCTA examinations than men (58% versus 37%; P &lt;0.0001), less obstructive coronary disease by CCTA (5% versus 17%; P =0.0001), but similar normalcy rates for functional testing ( P =0.65). Men in the CCTA arm had the highest rate of invasive coronary angiography (18%), whereas women had comparable low 5% rates regardless of ED strategy. Conclusions— This trial provides data supporting an early CCTA strategy as an attractive option in women presenting to the ED with symptoms suggestive of acute coronary syndrome. The findings may be explained by lower CAD prevalence and severity in women than men. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01084239.
Effects of Pulmonary Rehabilitation on Physiologic and Psychosocial Outcomes in Patients with Chronic Obstructive Pulmonary Disease
Authors: Andrew L. Ries
Journal: Annals of Internal Medicine (1995)

To compare the effects of comprehensive pulmonary rehabilitation with those of education alone on physiologic and psychosocial outcomes in patients with chronic obstructive pulmonary disease.Randomized clinical trial.University medical center.119 outpatients with chronic obstructive pulmonary disease that was stable while patients received a standard medical regimen.Patients were randomly assigned to either an 8-week comprehensive pulmonary rehabilitation program or to an 8-week education program. Pulmonary rehabilitation consisted of twelve 4-hour sessions that included education, physical and respiratory care instruction, psychosocial support, and supervised exercise training. Monthly reinforcement sessions were held for 1 year. The education group attended four 2-hour sessions that included video-tapes, lectures, and discussions but not individual instruction or exercise training.Pulmonary function, maximum exercise tolerance and endurance, gas exchange, symptoms of perceived breathlessness and muscle fatigue with exercise, shortness of breath, self-efficacy for walking, depression, general quality of well-being, and hospitalizations associated with pulmonary diseases. Patients were followed for 6 years.Compared with education alone, comprehensive pulmonary rehabilitation produced a significantly greater increase in maximal exercise tolerance (+1.5 metabolic equivalents [METS] compared with +0.6 METS [P < 0.001]; maximal oxygen uptake, +0.11 L/min compared with +0.03 L/min [P = 0.06]), exercise endurance (+10.5 minutes compared with +1.3 minutes [P < 0.001]), symptoms of perceived breathlessness (score of -1.5 compared with +0.2 [P < 0.001]) and muscle fatigue (score of -1.4 compared with -0.2 [P < 0.01]), shortness of breath (score of -7.0 compared with +0.6 [P < 0.01]), and self-efficacy for walking (score of +1.4 compared with +0.1 [P < 0.05]). There were slight but nonsignificant differences in survival (67% compared with 56% [P = 0.32]) and duration of hospital stay (-2.4 days/patient per year compared with +1.3 days/patient per year [P = 0.20]). Measures of lung function, depression, and general quality of life did not differ between groups. Differences tended to diminish after 1 year of follow-up.Comprehensive pulmonary rehabilitation significantly improved exercise performance and symptoms for patients with moderate to severe chronic obstructive pulmonary disease. Benefits were partially maintained for at least 1 year and tended to diminish after that time.
May Stricture of the Urethra be Hereditary?
Authors: M. Allen
Journal: BMJ (1876)

dence and post mortem examination.Let it not be said that this capacity in the judge for taking the place of his own witness was a gain to the public.I hold it to be entirely the contrary.He acquired the capacity by a special education, which of itself guarantees that he shall not possess the knowledge of law required for the due discharge of his function, and this ignorance of law he has no power of supple- menting by calling, in ordinary cases at least, a legal adviser, and hence gross and irremediable mistakes and omissions frequently occur.The position of a medical coroner must often, I should suppose, be as uncomforlable as it is undignified.Having obtained it by an expensive election and, perhaps, a servile canvass, he finds the remuneration too small for a sole source of income, and has, therefore, to make its duties fit in with the toils and anxieties of private practice ; and he is also restrained in the inquiries lie may think it necessary to make by objec- tions, on the score of expense, made by an irresponsible authority to
RUBBER FROM RUBBER GLOVES NOT A PROTECTIVE AGAINST MUSTARD GAS
Authors: C. I. Reed
Journal: JAMA (1942)

<h3>To the Editor:—</h3> It has come to my attention that many physicians are instructing gas defense workers to the effect that surgical rubber gloves are to be used as protection against mustard gas. This should be corrected, as it may lead to unpleasant consequences. This particular grade of rubber is not only an inadequate protection but even accentuates mustard gas burns as well as permanently contaminating the rubber itself. Mustard gas is soluble in the rubber, and a droplet that would produce only a small blister on bare skin may spread through an entire glove, in time, and burn the whole surface. Of course, if no other protection is available, a rubber glove can afford protection for a short time; but the limitations should be recognized. Mustard gas will not burn the skin rapidly, and even wiping with a cloth is often ample protection; or rubbing the skin with damp
Abstract 2602: The cardiotoxicity and myocyte damage caused by small molecule anticancer tyrosine kinase inhibitors is correlated with lack of target specificity
Authors: Brian B. Hasinoff, Daywin Patel
Journal: Cancer Research (2010)

Abstract The use of the new anticancer tyrosine kinase inhibitors (TKI) has revolutionized the treatment of certain cancers. However, the use of some of these results in cardiotoxicity. Large scale profiling data recently made available for the binding of 7 of the 9 FDA-approved tyrosine kinase inhibitors to a panel of 317 kinases has allowed us to correlate kinase inhibitor binding selectivity scores with TKI-induced damage to neonatal rat cardiac myocytes. The 7 TKIs that were the subject of this study were: imatinib (Gleevec), sunitinib (Sutent), dasatinib (Sprycel), sorafenib (Nexavar), lapatinib (Tykerb), gefitinib (Iressa), and erlotinib (Tarceva). The tyrosine kinase selectivity scores, but not the serine-threonine kinase scores, were highly correlated with the myocyte damaging effects of the TKIs. Additionally, we showed that damage to myocytes gave a good rank order correlation with clinical cardiotoxicity. Finally, strength of TKI binding to colony stimulating factor 1 receptor (CSF1R) was highly correlated with myocyte damage, thus possibly implicating this kinase in contributing to TKI-induced cardiotoxicity. Support: CIHR and a Canada Research Chair in Drug Development to BBH. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2602.
Coronary Artery Fistula After Cardiac Transplantation
Authors: Deepak Acharya, Silvio Litovsky, Silvio E. Papapietro, Salpy V. Pamboukian, Jose A. Tallaj
Journal: Circulation (2012)

A 68-year-old man with ischemic cardiomyopathy underwent heart transplantation in 2007.A routine endomyocardial biopsy done 4 weeks after transplantation reported 2 arterial branches (Figure 1).Physical examination did not reveal a murmur.Echocardiogram did not show a pericardial effusion.Coronary arteriogram 4 months later showed a left anterior descending artery-to-right ventricle fistula (Figure 2 and Movie I in the online-only Data Supplement).Right-sided pressures were normal and there was no significant step-up in oxygen saturations from the right atrium to the right ventricle or pulmonary artery.Four years later, the fistula has enlarged in size (Figure 3 and Movie II in the online-only Data Supplement), but the patient has normal rightsided pressures and cardiac output, and remains asymptomatic.Cardiac transplantation is an effective therapy for end-stage heart failure.Rejection is a common problem after transplant, and most patients undergo repeated endomyocardial biopsies to detect rejection.Complications from endomyocardial biopsies are infrequent, but include coronary artery-to-right ventricula fistulas 1 and tricuspid regurgitation.We hypothesize that the fistula developed during the biopsy that showed 2 arterial branches.Coronary artery fistulas are more common in the transplant population compared with the general population (5%-8% vs 0.2%). 2 Most fistulas are asymp-tomatic and are discovered accidentally during the course of surveillance angiograms.If they are large, they may cause angina, dyspnea, and right-sided heart failure.In these cases, treatment can be surgical 3 or percutaneous with a covered stent. 4Most patients with fistulas, however, continue to do well without specific therapy and can be managed conservatively.
The impairment of health-related quality of life in patients with intermittent atrial fibrillation: implications for the assessment of investigational therapy
Authors: Paul Dorian, Werner Jung, David Newman, Miney Paquette, Kathryn Wood, Gregory M Ayers, John Camm, Masood Akhtar, Berndt Luderitz
Journal: Journal of the American College of Cardiology (2000)
A Clinical Observation in Support of the Theory of the Contagiousness of Pulmonary Consumption
Authors: F. Ogston
Journal: BMJ (1884)

FROM all that could be learned of the family-history of Mr.and Mrs G., no suspicion of an hereditary tendency to oonsumptiona could be traced; on the contrary, both his and her forefathrs-had been noted as being healthy and long-lived, and they, 'thie'sees at the ages of fifty-seven and fifty-five respectively, are, quite ,haile and strong.Their family consisted of six sons aDd' two' daughters, be- tween the ages of thirty-one and twelve; -and they.hadbeen.strong and healthy childr'n, with no apparent tendeney to disease.About threeyears ago, the third son 5George) caught cold, as it w,as said, and came from his home in Glasgow, Where he wa;s ing with his wife, to be nursed in his father's house in Aber'deen.He was examined by a medical man in town, who stated tat he was suf--
Snow shoveller's infarction.
Authors: R Heppell, S K Hawley, K S Channer
Journal: BMJ (1991)

patients are to be tested then surgeons must also be tested.We presume therefore that the Royal College of Surgeons will also support the compulsory testing of the surgeon in order to "secure the safety" of the patient.If surgeons will not accept this they will request HIV serology on their patients in vain, for many microbiologists will refuse to perform the test.
Bremen doctors sign up to reduce drug use in ADHD patients
Authors: N. Stafford
Journal: BMJ (2011)

Doctors in the German state of Bremen have signed an agreement with the regional branch of the AOK, Germany’s largest public health insurer, to start a pilot project to improve the diagnosis and treatment of attention deficit hyperactivity disorder (ADHD).

Jorg Hermann, chairman of the Bremen Association of Statutory Health Insurance Physicians, which coordinates payments from Germany’s public health insurance system to doctors, told the BMJ that a major goal of the programme is to reduce unnecessary prescriptions of methylphenidate (Ritalin and other formulations), to treat the disorder.

“Paediatricians and GPs have been prescribing a lot of these drugs to kids,” said Dr Hermann. “It hasn’t been necessary to be a specialist or even a …
Orlistat Augments Postprandial Increases in Glucagon-Like Peptide-1 in Obese Type 2 Diabetic Patients
Authors: Michael Horowitz, Christine Feinle-Bisset, Karen Jones, Michael Nauck
Journal: Diabetes Care (2004)

Damci et al. (1) suggest that the lipase inhibitor, orlistat, stimulates the postprandial secretion of glucagon-like peptide-1 (GLP-1) after meals containing fat and speculate that this may lead to reductions in both postprandial glycemia and energy intake. The authors observed (in a cohort of 29 type 2 diabetic patients) that after ingestion of a 600 kcal breakfast (comprising 38% fat, 50% carbohydrate, and 12% protein), the increases from baseline in plasma GLP-1 and serum C-peptide were slightly greater and that of serum glucose slightly less, as measured in a single blood sample taken 60 min after commencement of the …
PERFORMING TRANSFEMORAL AORTIC VALVE REPLACEMENT UNDER LOCAL ANESTHESIA AND CONSCIOUS SEDATION VERSUS GENERAL ANESTHESIA AND TRACHEAL INTUBATION IN HIGH-RISK PATIENTS WITH SEVERE AORTIC STENOSIS
Authors: Danny Dvir, Itsik Ben-Dor, Israel Barbash, Rebecca Torguson, Salem Badr, Gabriel Sardi, Ana Laynez Carnicero, Lowell Satler, Augusto Pichard, Ron Waksman
Journal: Journal of the American College of Cardiology (2012)
A comparison of alcoholic pancreatitis in rat and man
Authors: H. Sarles, G. Lebreuil, F. Tasso, C. Figarella, F. Clemente, M. A. Devaux, B. Fagonde, H. Payan
Journal: Gut (1971)

Acute ethanol intoxication was studied in 38 Wistar rats, 18 on a balanced diet and 20 on a high fat diet, fed by gavage on 47% ethanol in a dosage of from 3 to 12 g/kg body weight daily for periods ranging from three to 16 days. No macroscopic changes in pancreas or liver were found in any of these animals. Histological changes (venous congestion of the pancreas, the liver, and the kidneys) were found in rats given 4 g or more per kilogram. The only difference between the findings in rats given a balanced diet and those given a high fat diet was the development of fatty livers in the latter group. Chronic ethanol intoxication was studied in 45 Wistar rats, on a balanced diet, which were given 20% ethanol freely for 20 to 30 months. More than half the animals developed pancreatic lesions very similar to those of human chronic pancreatitis. The pathological changes, in foci surrounded by normal pancreatic tissue, were a reduction in acini, duct multiplication (probably by neogenesis), protein plugs, sometimes calcified in the ducts and sclerosis. Samples of pancreatic juice from four animals exposed to ethanol contained significantly higher protein concentrations than samples taken from two control animals. Protein precipitates appeared spontaneously in the pancreatic juice of the animals exposed to ethanol, but not in that of the controls. These findings are very similar to those in alcoholic pancreatitis in man, which has thus been reproduced for the first time in experimental animals. Beta-cell adenomata of the islets of Langerhans were observed in four of the rats exposed to ethanol.
Impact of hematopoietic cyclooxygenase-1 deficiency on obesity-linked adipose tissue inflammation and metabolic disorders in mice
Authors: Viswanathan Saraswathi, Christopher J. Ramnanan, Anson W. Wilks, Cyrus V. Desouza, Amy A. Eller, Ganesan Murali, Ramesh Ramalingam, Ginger L. Milne, Katie C. Coate, Dale S. Edgerton
Journal: Metabolism (2013)
Medical Biology-Reply
Authors: Bert L. Vallee
Journal: JAMA (1963)

We are delighted that Dr. Baker was so stimulated by our paper on medical biology and are happy to have his semantic analysis of some of the pertinent comments. It is always a pleasure to find someone who is in such substantial agreement with one's views. In passing it might be pointed out that unifying concepts [italics are ours] may arise from any number of intellectual approaches: analytic, synthetic, their combination—or perhaps free association. Whether or not any idea or concept unifies can, of course, only be tested operationally.  Letter Reminders  Contributions to Letters to the Journal are reviewed according to the same standards as other contributions. Manuscripts should be typewritten, double-spaced, and should not exceed 250 words in length. The correspondent should indicate clearly whether the letter is to be considered for publication. Unsigned letters cannot be published.
Effectiveness of Diabetic Therapeutic Footwear in Preventing Reulceration
Authors: Ernst Chantelau
Journal: Diabetes Care (2004)

The report by Maciejewski et al. (1) concerning the three quoted articles from our institution (2–4) is flawed. Our 1990 article is one of the first ever to attempt to assess custom-made “diabetic” footwear in a scientific manner. It was an observational study (not a trial), which could serve for generating hypotheses concerning technical features of diabetic footwear, the selection of patients for footwear studies, etc., rather than for settling the issue of the effectiveness of whatever kind of diabetic footwear.

Our second article is from 1994 …
Regulation of Osteoblast Differentiation Mediated by Bone Morphogenetic Proteins, Hedgehogs, and Cbfa1
Authors: Akira Yamaguchi, Toshihisa Komori, Tatsuo Suda
Journal: Endocrine Reviews (2000)

Osteoblasts arise from common progenitors with chondrocytes, muscle and adipocytes, and various hormones and local factors regulate their differentiation. We review here regulation of osteoblast differentiation mediated by the local factors such as bone morphogenetic proteins (BMPs) and hedgehogs and the transcription factor, core-binding factor alpha-1 (Cbfa1). BMPs are the most potent regulators of osteoblast differentiation among the local factors. Sonic and Indian hedgehogs are involved in osteoblast differentiation by interacting with BMPs. Cbfa1, a member of the runt domain gene family, plays a major role in the processes of a determination of osteoblast cell lineage and maturation of osteoblasts. Cbfa1 is an essential transcription factor for osteoblast differentiation and bone formation, because Cbfa1-deficient mice completely lacked bone formation due to maturation arrest ofosteoblasts. Although the regulatory mechanism of Cbfa1 expression has not been fully clarified, BMPs are an important local factor that up-regulates Cbfa1 expression. Thus, the intimate interaction between local factors such as BMPs and hedgehogs and the transcription factor, Cbfa1, is important to osteoblast differentiation and bone formation.
Assessment of Patients with Chest Pain
Authors: James R. Johnson
Journal: Annals of Internal Medicine (2004)

Letters17 August 2004Assessment of Patients with Chest PainJames R. Johnson, MDJames R. Johnson, MDFrom Veterans Affairs Medical Center and University of Minnesota, Minneapolis, MN 55417.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-4-200408170-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:A system factor that contributed to the missed diagnosis of acute MI in Goldman and Kirtane's case presentation and that deserves further attention was the use of half-standard voltage electrocardiography (1). This caused the approximately 0.5-mm anterolateral ST-segment depressions to appear as nonsignificant, since the criterion for significance is at least 1 mm. When later interpreted in the context of the half-standard voltage, these findings were correctly appreciated as significant. Since the magnitude of ST-segment displacement in millimeters (compared with threshold criteria based on standard voltage) is such an important component of the electrocardiographic assessment for acute ...Reference1. Goldman L, Kirtane AJ. Triage of patients with acute chest pain and possible cardiac ischemia: the elusive search for diagnostic perfection. Ann Intern Med. 2003;139:987-95. [PMID: 14678918] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: James R. Johnson, MDAffiliations: From Veterans Affairs Medical Center and University of Minnesota, Minneapolis, MN 55417. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTriage of Patients with Acute Chest Pain and Possible Cardiac Ischemia: The Elusive Search for Diagnostic Perfection Lee Goldman and Ajay J. Kirtane Assessment of Patients with Chest Pain Lee Goldman and Ajay J. Kirtane Assessment of Patients with Chest Pain Brendan M. Reilly and Arthur T. Evans Assessment of Patients with Chest Pain Stephen Workman Metrics 17 August 2004Volume 141, Issue 4Page: 325-326KeywordsElectrocardiographyIschemia ePublished: 17 August 2004 Issue Published: 17 August 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Identification of autoantibodies to RNA polymerase II. Occurrence in systemic sclerosis and association with autoantibodies to RNA polymerases I and III.
Authors: M Hirakata, Y Okano, U Pati, A Suwa, T A Medsger, J A Hardin, J Craft
Journal: Journal of Clinical Investigation (1993)

In this study, autoantibodies to RNA polymerase II from sera of patients with systemic sclerosis have been identified and characterized. These antibodies immunoprecipitated polypeptides of 220 kD (IIA) and 145 kD (IIC), the two largest subunits of RNA polymerase II, and bound both subunits in immunoblots. These polypeptides were immunoprecipitated by the anti-RNA polymerase II monoclonal antibody 8WG16, which recognizes the carboxyl-terminal domain of the 220-kD subunit, and their identity to the proteins bound by human sera was confirmed in immunodepletion studies. Sera with anti-RNA polymerase II antibodies also immunoprecipitated proteins that were consistent with components of RNA polymerases I and III. In vitro transcription experiments showed that the human antibodies were an effective inhibitor of RNA polymerase II activity. In indirect immunofluorescence studies, anti-RNA polymerase II autoantibodies stained the nucleoplasm, as expected from the known location of RNA polymerase II, and colocalized with the anti-RNA polymerase II monoclonal antibody. The human sera also stained the nucleolus, the location of RNA polymerase I. From a clinical perspective, these antibodies were found in 13 of 278 patients with systemic sclerosis, including 10 with diffuse and three with limited cutaneous disease, but were not detected in sera from patients with other connective tissue diseases and from normal controls. We conclude that anti-RNA polymerase II antibodies are specific to patients with systemic sclerosis, and that they are apparently associated with antibodies to RNA polymerases I and III. These autoantibodies may be useful diagnostically and as a probe for further studies of the biological function of RNA polymerases.