tbuckley/cabot-search huggingface dataset:
SUPPLEMENT 2275
Authors: H E W ROBERTSON
Journal: BMJ (1948)

It is common in Christchurch, New Zealand, to find mothers of young babies in a poor state of health and suffering from fatigue out of all proportion to the work they do.In almost every case there are also intense irritability, undue coldness, and dryness of the hair, usually with a tendency to abnormal loss of hair.Treatment with thyroid extract gives dramatic relief.Myxoedema, gain in weight, cracked voice, and loss of eyebrows are not found, but other symptoms of mild hypo- thyroidism (Warfield, 1930; Werner, 1942) are found in varying degrees.The usual descriptions apply to cases of hypothyroidism of menopausal age rather than the third decade.Young nulliparae have symptoms which appear to be identical with those found after pregnancy (Roberton, 1946).On questioning 219 unselected patients with 483 pregnancies it was found that many had mild symptoms.In 114 cases the therapeutic test with thyroid extract confirmed the diagnosis.For all pregnancies recorded the incidence was as follows: No symptoms of hypothyroidism, 225 (53%); doubtful symptoms, 54 (11%); mild symptoms, 127 (26%); severe symptoms, 47 (10%).Where the last pregnancy only is considered there were 13% with severe symptoms and 33% with mild symptoms.Case Histories Case 1.-A patient aged 22 had slight enlargement of the thyroid.She felt well after the first pregnancy.She was good-natured, always smiling, and justly proud of a fresh complexion and long silky fair hair.A year after the birth of the second baby she came " for a tonic," complaining of having been tired and nervy for the last 9 months.Her complexion was dull and muddy.Her hair was coarse, her clothing, which was unduly thick for warm weather, was untidy, and she had no smile.She confessed to being so irritable with her husband that it was a wonder he put up with her.After 6 weeks' treatment with thyroid extract, 1 gr.' (65 mg.) daily for 2 weeks and then + gr.daily for 4 weeks, she regained her nor- mal health and appearance.After this she stopped treatment and relapsed.During the 6 months of relapse she had not the energy to come for further prescriptions, and by the end of that time she was not on speaking terms with her husband.She then took thyroid regularly for 5 months, after which she was able to leave it off with- out further relapse.Case 2.-This case was found on routine questioning after the second pregnancy.The patient, aged 36, said that she had felt well after the first pregnancy.When the second baby was 3 months old she began to feel tired and attributed this to the amount of work she had to do.She did not complain of the cold, but her husband reminded her that it was the first time that she had used a hot-water bottle all through the summer.She said that her hair was dry and lifeless, and had a tendency to come out.Normally placid, she complained of " nerves," and her husband, who had previously looked on her as the best-natured woman he had ever met, complained of her temper.She returned to normal on I gr. of thyroid sicc.daily.
Abstract 17621: VisiTag as a New Promising Index of Optimal Lesion Formation During Atrial Fibrillation Ablation with Adequate Contact Force
Authors: Masaomi Kimura, Shingo Sasaki, Hiriuchi Daisuke, Kenichi Sasaki, Taihei Itoh, Yuji Ishida, Takahiko Kinjo, Ken Okumura
Journal: Circulation (2014)

Backgrounds: Contact force (CF) information is effective in accomplishing circumferential pulmonary vein (PV) isolation (CPVI). However, residual conduction gap still remains despite ablation with optimal CF in some patients. Objective: Using a VisiTag module, we examined the influence of catheter position stability during CPVI to the residual conduction gap. Methods: The consecutive 131 patients with atrial fibrillation (AF) (85 men; mean age, 63 years; paroxysmal AF, 101) undergoing CPVI using a Thermcool Smarttouch catheter were enrolled. CPVI was performed with target CF at 10-20 g and power at 25-30W without monitoring PV potentials. PV potentials were recorded with a lasso catheter before and after CPVI. In the initial 62, CPVI was performed only with CF information (CF group). In the other 69, it was performed using a VisiTag module installed on CARTO3 Version 3, in which force time index (FTI) was predetermined while setting filter thresholds at 5 seconds for the minimum time, 1 mm for the maximum...
Abstract P231: Asian American Disparities in Risk of Coronary Artery Disease
Authors: Ashim Hajra, Yan Li, Stanton Siu, Natalia Udaltsova, Mary Anne Armstrong, Gary D. Friedman, Arthur L. Klatsky
Journal: Circulation (2013)

INTRODUCTION: The number of Asian Americans (Asians) has increased substantially in recent decades, yet prospective data about their risk for coronary artery disease (CAD) remain sparse. We hypothesized significant disparities of CAD risk among Asians. METHODS: A multi-ethnic population of 126,088 adults in Northern California supplied baseline data from 1978-1985. Self-classified ethnicity yielded 13,448 (10.6%) Asians including 5,951 Chinese (CH), 1,676 Japanese (JA), 4,236 Filipinos (FI), 689 South Asians (SA) (mostly Asian Indians), and 896 Other Asians (OA). Persons with incident CAD hospitalizations through 2008 numbered 7,658, including 700 Asians. Analyses used Cox proportional hazards models which included age, sex, ethnicity, smoking, alcohol, body mass index, education, marital status, and a composite of possible baseline CAD history/symptoms/risk factors. Models with various referents enabled comparison of all Asian groups to each other as well as to whites, blacks, or Hispanics. These models yielded hazard ratios (HR) and 95% confidence intervals (CI). RESULTS: With whites as referent the adjusted HR (CI) for all Asians was 1.0 (0.9-1.0). In a separate model the HRs were: CH = 0.8 (0.7-0.9, p&lt;0.001), JA = 0.9 (0.7-1.1), FI = 1.2 (1.0-1.3, p=0.02); SA = 2.4 (1.9-3.2, p&lt;0.001), and OA = 0.8 (0.5-1.1). Addition of blood pressure, total cholesterol, blood glucose, or leukocyte count to the models had minimal effect on the magnitude of these HRs. SAs were at substantially higher risk than whites, blacks, Hispanics, and each other Asian group with HRs ranging from 2.2 to 3.3 (all p values &lt; 0.001). FI were at a higher risk than all groups except for SA, with HRs ranging from 1.3-1.7 (all p values &lt;0.04). The table gives HRs for Asian groups vs. CH. CONCLUSION: Disparities in CAD risk among Asian American ethnic groups are marked, indicating the need to study disease outcomes separately for the groups. The high risks of SAs and FIs mandate further investigation into causes and targeted public health measures.
Academic medicine
Authors: C. Murdoch
Journal: BMJ (2002)

Editor—Stewart in his editorial on academic medicine displayed a total lack of recognition that academic medicine includes general practice and other disciplines not included in “teaching hospitals.”1 The largest group of consultants in the NHS work in general practice, not anaesthesia, and maybe Stewart wondered how many general practice trainees were contemplating an academic career.

As someone who started an academic career in 1976 and is about to re-enter the fray, let me offer a different reason why academic medicine is so unpopular. Academic medicine is still dominated by the aristocratic hospital minorities such as internal medicine and surgery, which play such a small part in the modern practice of medicine. Perhaps it is because they have so much time to spare that they can spend their time administering. To become a professor of medicine or surgery now you have to be young, impossibly specialised to the point of non-functionality in any clinical reality zone, and skilled either in the treatment of rats and cats or in plagiarising other people's research through meta-analysis. You then progress to deanship and the task of creating academics in your own image.

The hospital is now an obsolete concept, and most of the departments on which academic medicine is based are as outdated as orders of the garter, the bath, or the chamber(pot). What we need is for academic medicine to provide generic training in the education of students and postgraduates for the cream of those who have shown themselves worthy by surviving in the real world for a few years. The creation of a such a community of scholars is an urgent task and needs to be well funded. If I were in the British government I would not leave the task in the hands of universities because they would be the last people to know what I am talking about.
Re: Sabine D. Brookman-May, Matthias May, Ingmar Wolff, et al. Evaluation of the Prognostic Significance of Perirenal Fat Invasion and Tumor Size in Patients with pT1–pT3a Localized Renal Cell Carcinoma in a Comprehensive Multicenter Study of the CORONA Project. Can We Improve Prognostic Discrimination for Patients with Stage pT3a tumors? Eur Urol 2015;67:943–51
Authors: Marco Borghesi, Gaetano La Manna, Riccardo Schiavina
Journal: European Urology (2015)
P0215 : Metformin reduces hyperammonemia in portacaval shunted rats inhibiting glutaminase activity
Authors: A. Gil-Gómez, I. Ranchal, A.I. Gómez-Sotelo, J. Ampuero, M. García-Valdecasas, Á. Rojas, R. Gallego-Durán, J.A. Del Campo, M. Romero-Gómez
Journal: Journal of Hepatology (2015)
Comparative effectiveness of management strategies for renal artery stenosis
Authors: Ethan Balk, Gowri Raman, Mei Chung, Stanley Ip, Athina Tatsioni, Alvaro Alonso, Bruce Kupelnick, Priscilla Chew, Deirdre DeVine, Scott Gilbert, Joseph Lau
Journal: Annals of Internal Medicine (2006)

This systematic review of 83 studies compares benefits and harms of percutaneous transluminal renal angioplasty with stent placement versus medical therapy alone in adults with atherosclerotic rena...
Two views mean twice the dose of radiation
Authors: R. Blomfield
Journal: BMJ (1995)

while the lymph nodes are not affected.This is the key to the eventual reduction in mortality.The rate of positive nodes in incidence screens in Edinburgh, where the films were read by nonradiologist doctors,5 was 10% higher than that in the Ostergotland component of the two county study.Differences in radiological sensitivity are probably major influences on all these issues.The current figures relating to size and nodal spread (unpublished) for the south east Scotland screening programme reflect an improved sensitivity.The mortality in the study group after 10 years in the Edinburgh trial was between 14% and 21% lower than that in controls, depending on the precise definition of the end point.3To achieve a reduction equivalent to or greater than this by the year 2000 in Britain is ambitious but will be best served by maximising compliance6 as well as radiological sensitivity.Mechanisms to promote these need urgent support.
1-Year Outcomes After Transfemoral Transcatheter or Surgical Aortic Valve Replacement
Authors: Corrado Tamburino, Marco Barbanti, Paola D’Errigo, Marco Ranucci, Francesco Onorati, Remo Daniel Covello, Francesco Santini, Stefano Rosato, Gennaro Santoro, Danilo Fusco, Claudio Grossi, Fulvia Seccareccia
Journal: Journal of the American College of Cardiology (2015)
Abstract B78: Warfarin blocks Gas6-mediated Axl activation required for pancreatic tumor plasticity and metastasis
Authors: Amanda Kirane, Kathleen W. Ludwig, Gry Haaland, Tone Sandal, Renata Ranaweera, Jason E. Toombs, Laura A. Sullivan, Miao Wang, Noah Sorrelle, Sean P. Dineen, Michael T. Dellinger, James B. Lorens, Rolf A. Brekken
Journal: Cancer Research (2015)

Abstract Warfarin, a vitamin K antagonist anti-coagulant in clinical use for over 50 years, is reported to exert anti-cancer effects. We hypothesized that the molecular mechanism underlying the observed anti-tumor effects of warfarin is unrelated to generalized anti-coagulation, but rather due to inhibition of the Axl receptor tyrosine kinase. Activation of Axl by its ligand Gas6, a vitamin K-dependent protein, is inhibited at doses of warfarin that do not affect coagulation. Here we document that inhibiting Gas6-mediated Axl activation with low dose warfarin blocks pancreatic cancer progression and spread. Warfarin and other Axl-targeting agents inhibit tumor progression and block spontaneous metastasis in multiple murine models of pancreatic cancer. Warfarin inhibited Axl-dependent tumor cell migration, invasiveness and proliferation while increasing apoptosis and sensitivity to chemotherapy. We demonstrate that Axl signaling is necessary for pancreatic tumor cell epithelial plasticity which is potently reversed by warfarin or selective Axl inhibition in vitro and in vivo. We anticipate Axl is a critical driver of pancreatic cancer progression and its inhibition with low dose warfarin or Axl-selective targeting agents may significantly improve outcome in patients. Citation Format: Amanda Kirane, Kathleen W. Ludwig, Gry Haaland, Tone Sandal, Renata Ranaweera, Jason E. Toombs, Laura A. Sullivan, Miao Wang, Noah Sorrelle, Sean P. Dineen, Michael T. Dellinger, James B. Lorens, Rolf A. Brekken. Warfarin blocks Gas6-mediated Axl activation required for pancreatic tumor plasticity and metastasis. [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Innovations in Research and Treatment; May 18-21, 2014; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2015;75(13 Suppl):Abstract nr B78.
Emergency contraception
Authors: Anna Glasier
Journal: BMJ (2006)

What response is needed?The global scale and molecular epidemiology of extensively drug resistant tuberculosis require urgent assessment, and laboratory capacity needs to be greatly increased within a network of sentinel sites.Control practices must be rigorously and effectively implemented.Increasing cure rates for tuberculosis through directly observed treatment short course (DOTS) is crucial.Detection rates for cases of tuberculosis need to be improved, highlighting the need for a new diagnostic test.Technologies that can determine the presence of drug resistance at the point of care are needed, as are new drug treatments.The DOTS-Plus strategy 10 for treatment of multidrug resistant tuberculosis needs to be further developed for areas where the disease is established.Nosocomial transmission of tuberculosis is probably commonplace in the developing world, and simple, effective strategies to reduce such transmission need to be urgently implemented.More fundamentally, the emergence of extensively drug resistant tuberculosis is a reminder that tuberculosis needs massive broader commitment: the incompletely funded Global Plan to Stop TB 11 demands political will and financial action.
Abstract 18192: Aortic Stenosis: The Effect of Spectral Broadening in the Left Ventricular Outflow Tract on Stroke Volume and Calculated Aortic Valve Area
Authors: Jeremy J Thaden, Michael Y Tsang, Saki Ito, Sorin V Pislaru, Vuyisile T Nkomo, Rakesh M Suri, Thomas A Foley, Eric E Williamson, Jae K Oh
Journal: Circulation (2014)

Introduction: Accurate stroke volume (SV) calculation is critical for calculating aortic valve area by echocardiography. 2D-Doppler estimation of SV (SV 2D ) assumes uniform blood flow velocities through the left ventricular outflow tract (LVOT). Non-uniform flow through the LVOT, appreciated as spectral broadening of the LVOT Doppler signal, could result in inaccurate SV calculation. Hypothesis: Increased spectral broadening in the LVOT will result in overestimation of SV by the SV 2D method compared to 3D volumetric assessment of SV (SV 3D ). Methods: Fifty-one consecutive patients with aortic stenosis underwent comprehensive 2D-TTE and assessment of SV 3D . Patients with ≥ moderate mitral or aortic regurgitation were excluded. An LVOT pulse-wave Doppler signal with &gt; 0.4 m/s difference between outer and inner edge of velocity spectral display (at time of peak velocity) was considered non-uniform flow (i.e., spectral broadening). Results: Spectral broadening was present in 33% of the cohort. These patients were commonly female with smaller ventricles and higher ejection fraction. Spectral broadening was associated with a significant overestimation of SV on Doppler-based measurements (101±20 ml vs 78±15 mL, SV 2D vs SV 3D , respectively; r=0.83, p&lt;0.0001); such differences were not seen in patients with uniform flow velocities (82±15 vs 79±14 mL, r=0.83, p=0.03). Patient characteristics by spectral broadening are shown in table 1. Conclusion: In aortic stenosis patients with non-uniform flow, Doppler-based methods overestimated SV by 29.5% on average (maximum 64%) when compared to 3D methods. This results in a proportional increase in calculated valve area despite a similar mean gradient between groups. Substituting SV 3D resulted in similar SV, valve area, and mean gradient between uniform and non-uniform groups. When spectral broadening &gt;0.40 cm/s is present, 3D volumetric assessment of SV should be considered for accurate estimation of aortic valve area.
Ischaemic stroke and combined oral contraceptives: results of an international, multicentre, case-control study
Authors: N. R. Poulter, C. L. Chang, Tmm Farley, O. Meirik, Michael Gideon Marmot, Myriam Debert-Ribeiro, Ernesto Medina, Jorge Artigas, He Shen, Yu Hui Zhong, De Wei Zhang, Wei Jin Zhao, Oscar Rojas, Martin Vessey, Lothar Heinemann, Stuart Donnan, Suzanne Ho, Gyorgy Bartfai, J. Kisjanto, Rainford Wilks, Reuben Agwanda, Rossario Ruiz, Mateja Kozuh-Novak, Nikorn Dusitsin, Pramuan Virutamasen, Kammant Phanthumcinda, Suporn Koetsawang, Manee Piya-Anant, Jasenka Demirovic, Karen Belkic, W. S. Mwandila, C. M. Mutale, Jonathon Matenga, Adrian Wilson, D. Petitti, J. Perlman, J. Keleghan, S. Lawley, S. Smith, M. Shipley, J. Olsen, M. Thorogood
Journal: The Lancet (1996)
Small rise in vitamin C intake could greatly reduce heart disease
Authors: Jacqui Wise
Journal: BMJ (2001)

Just a small increase in vitamin C intake could produce a substantial reduction in cardiovascular mortality, the authors of a prospective study have concluded.

Professor Kay-Tee Khaw and colleagues from Cambridge University measured plasma ascorbic acid concentrations in 19 496 men and women aged 45–79 years and followed them up for four years ( Lancet 2001;357:657-63).

An increase in plasma ascorbic acid concentration was strongly and independently associated with a reduction in mortality from all causes, cardiovascular disease, and ischaemic heart disease. Vitamin C was also associated with a decreased risk of death related to cancer in men.

The results showed a clear dose-response relation. …
Cost-Effectiveness of Cervical-Cancer Screening in Developing Countries
Authors: Eric J Suba, William J Frable, Stephen S Raab
Journal: New England Journal of Medicine (2006)

The study by the Alliance for Cervical Cancer Prevention Cost Working Group reported by Goldie et al. is biased against cytologic screening. Costs for cytologic tests are overestimated. Costs for human papillomavirus (HPV) tests are underestimated. Single-visit cytologic screening is not considered. The Alliance was awarded a $50-million gift from the Bill and Melinda Gates Foundation on the assumption that noncytologic screening tests constitute the most likely solution to the problem of cervical cancer in developing countries. This assumption constitutes a potential source of bias against cytology that should be disclosed. Similarly the partnership between the Program for Appropriate Technology in Health a study cosponsor and Digene which markets HPV tests should be disclosed.  (excerpt)
Noninvasive pacemaker stress echocardiography for diagnosis of coronary artery disease
Authors: Eugenio Picano, Annalisa Alaimo, Vlad Chubuchny, Edyta Plonska, Vittorio Baldo, Umberto Baldini, Marina Pauletti, Roberto Perticucci, Lucas Fonseca, Hector Ricardo Villarraga, Carlo Emanuelli, Gennaro Miracapillo, Enrico Hoffmann, Maurizio De Nes
Journal: Journal of the American College of Cardiology (2002)
The novel inhibitor of heterotrimer G-protein signaling, BIM-46174, enhances the anticancer activity of cisplatin in human NSCLC lung tumor xenografts
Authors: Gregoire Prevost, Marie-Odile Lonchampt, Susan Holbeck, S. Attoub, Daniel W. Zaharevitz, Michael C. Alley, John J. Wright, Marie-Christine Brezak, Helene Couloumb, Ann Savola, Marion Huchet, Sophie Chaumeron, Q.-D. Nguyen, P. Forgez, Eric Ferrandis, Pierre Roubert, Christian Gespach, Philip G. Kasprzyk
Journal: Cancer Research (2005)

Proc Amer Assoc Cancer Res, Volume 46, 2005

670 

Lung cancer is a very aggressive disease with a poor prognosis where cisplatin-based regimens are the standard care. Heterotrimeric guanine-binding protein-coupled receptors are involved in lung cancer since multiple GPCR agonists fuel tumor growth, invasion, and metastasis. Thus, the therapeutic impact based on single antagonists acting on a given GPCR is very limited since invasive tumor growth is driven by multiple GPCRs. Here, the novel imidazo-pyrazine derivative BIM-46174 is characterized as an inhibitor of several agonist-activated G-protein signaling pathways linked to cAMP generation, calcium translocation, as well as lung cancer cell invasion. An NCI COMPARE analysis of BIM-46174 showed no similar pattern of antiproliferative activity with standard agents supporting the identification of a novel mechanism of tumor growth inhibition. Furthermore, BIM-46174 combined with cisplatin strongly delays the growth of human NSCLC xenografts in athymic mice. These data obtained with BIM-46174 establish heterotrimeric G-protein signaling as a new therapeutic target in lung cancer, especially in combination with cisplatin. This result was previously reported in SCLC.
Reporting of errors should be free of recrimination
Authors: D R Upton, D H Cousins
Journal: BMJ (1995)

Avoiding drug errorsRead the label EDITOR,-The diversity of drug packaging that R E Ferner criticises has existed for many years.'What Ferner now identifies is a move towards standardisation through pharmaceutical manufacturers' adoption of the NHS ampoule labelling specification.The work leading to this has been described by Nunn.2The NHS specification seeks to establish a standard for labels, with the information presented in a consistent format and printed in the most legible way.The problem with diversity is that practitioners use features such as colour, shape, etc as a substitute for correct reading and inspection of the label.Use of such substitutes is both fallible and dangerous.The company whose products are illustrated in Femer's letter manufactures nearly 100 different ampoules.To differentiate between that number of products by use of colour, shape, etc is obviously impossible.Femer's hypothetical practitioner with modest presbyopia would obviously find it easier to read the labels illustrated than the text of the letter criticising the labels.The only way to be sure of the contents of an ampoule (or any other product) is to read the label.