tbuckley/cabot-search huggingface dataset:
A Variegated Squirrel Bornavirus Associated with Fatal Human Encephalitis
Authors: Bernd Hoffmann, Dennis Tappe, Dirk Höper, Christiane Herden, Annemarie Boldt, Christian Mawrin, Olaf Niederstraßer, Tobias Müller, Maria Jenckel, Elisabeth van der Grinten, Christian Lutter, Björn Abendroth, Jens P. Teifke, Daniel Cadar, Jonas Schmidt-Chanasit, Rainer G. Ulrich, Martin Beer
Journal: New England Journal of Medicine (2015)

Between 2011 and 2013, three breeders of variegated squirrels (Sciurus variegatoides) had encephalitis with similar clinical signs and died 2 to 4 months after onset of the clinical symptoms. With the use of a metagenomic approach that incorporated next-generation sequencing and real-time reverse-transcriptase quantitative polymerase chain reaction (RT-qPCR), the presence of a previously unknown bornavirus was detected in a contact squirrel and in brain samples from the three patients. Phylogenetic analyses showed that this virus, tentatively named variegated squirrel 1 bornavirus (VSBV-1), forms a lineage separate from that of the known bornavirus species. (Funded by the Federal Ministry of Food and Agriculture [Germany] and others.).
Noninvasive diagnostic assessment of peripheral vascular disease.
Authors: Barnes Rw
Journal: Circulation (1991)

Noninvasive techniques have assumed an increasingly important role in the management of patients with vascular disease. Both ultrasonic and plethysmographic instruments allow objective evaluation of vascular disorders by the measurement of segmental limb blood pressures, analysis of blood velocity disturbances, recording of digit or limb pulse waveforms, or imaging of vascular disease, with or without Doppler flow analysis or color-flow mapping. These techniques have been applied for screening asymptomatic individuals, diagnosis of symptomatic patients, monitoring of interventional or surgical procedures, and follow-up of the natural history or the efficacy of medical, interventional, or surgical therapy of vascular disease. This article reviews the clinical application of these modalities to patients with peripheral arterial disease and briefly discusses cost-effectiveness and potential abuses of noninvasive technology.
Dengue virus infections among travelers returning from Haiti - Georgia and Nebraska, October 2010.
Authors: T. Anderson, J. Collinson, T. Vap, R. M. Williams, T. J. Safranek, D. P. Leschinsky, A. K. Bredthauer, J. Gabel, B. F. Buss, M. J. Sotir, E. S. Jentes, J. L. Muñoz-Jordan, E. A. Hunsperger, F. Argüello, P. Pillai, T. M. Sharp
Journal: MMWR Morbidity and Mortality Weekly Report (2011)
Injury Prevention
Authors: Frederick P. Rivara, David C. Grossman, Peter Cummings
Journal: New England Journal of Medicine (1997)

Injuries are the most common cause of death among people 1 to 34 years of age, a leading cause of disability and years of life lost, and a major contributor to health care costs. There have been dramatic reductions in injury-associated mortality since the turn of the century, largely because of a decrease in the proportion of workers involved in dangerous occupations as well as improvements in the safety of buildings, motor vehicles, roads, and everyday products.The involvement of the health care community in injury prevention was small until recently, when injuries came to be viewed as a public . . .
Autoimmunity in Lung Disease
Authors: M CAPLIN, L H CAPEL, W F WHEELER
Journal: BMJ (1965)

Obeyesekere and colleagues report that systemic hypertension often occurs in mitral valve disease and relate it to renal embolisation (p.441).Leader at p. 432.Subdural Haematoma: Dr. Patricia Russell reviews 25 cases in children under 2 years of age Less than half had a history of trauma (p.446).Idiopathic Hypercalciuria: Professor C. E. Dent and Dr. Lyal Watson describe a patient in whom the primary defect was probably
Increased circulating sclerostin levels in end-stage renal disease predict biopsy-verified vascular medial calcification and coronary artery calcification
Authors: Abdul Rashid Qureshi, Hannes Olauson, Anna Witasp, Mathias Haarhaus, Vincent Brandenburg, Annika Wernerson, Bengt Lindholm, Magnus Söderberg, Lars Wennberg, Louise Nordfors, Jonaz Ripsweden, Peter Barany, Peter Stenvinkel
Journal: Kidney International (2015)
An ethical dilemma: Should egg donors be paid?
Authors: I. Craft
Journal: BMJ (1997)

I favour egg donation without financial reward, but the demand for eggs far outstrips the supply from women who donate for altruistic reasons. The end results are an inordinate delay, often of 1-2 years, for treatment for women who are destined to be barren, and the proliferation of private organisations that put donors and recipients in contact for financial reward.



Egg retrieval is an inconvenient procedure.

HANK MORGAN/SCIENCE PHOTO LIBRARY



My preference is probably unrealistic in today's world, where money determines health care. Our prime concern is to provide an efficient clinical service. The principle of payment for donation is enshrined in the Human Fertilisation and Embryology Act 1990 since sperm donors are allowed £15 ($24) per donation. They can earn hundreds of pounds over several months for acts of transient pleasure. Concerns that egg donors were receiving £750 per treatment cycle led to the Human Fertilisation and Embryology Authority hosting a conference on payment to donors in June 1995. Delegates pointed out that egg donation required greater involvement and invasive treatment than did sperm donation and …
The Challenge of Correcting Volume Overload in Hospitalized Patients With Decompensated Heart Failure⁎⁎Editorials published in the Journal of the American College of Cardiology reflect the views of the authors and do not necessarily represent the views of JACC or the American College of Cardiology.
Authors: Uri Elkayam, Parta Hatamizadeh, Munir Janmohamed
Journal: Journal of the American College of Cardiology (2007)
Abstract 285: Acute Myocardial Infarction Following Free-Fall Trauma in a 21-Year-Old Male Patient
Authors: Jin Yu, Hexiang Cheng, Wenyi Guo, Chengxiang Li, Ronghua Luan, Haichang Wang
Journal: Circulation (2011)

A 21-year-old man who was sleeping was fallen from the higher deck of a double-deck bed. 10 minutes after free fall, he experienced chest pain and then took a nonsteroidal antiinflammatory medication, however, which did not relieve the pain. The pain continued to increase, and prompting him to seek medical attention. 6 hours after the trauma, he was admitted to the emergency room of our hospital. Although the accident just caused mild subcutaneous hemorrhage, he felt severe chest pain, headache and left hand pain. He has 4 year's history of cigarette smoking, no history of diabetes mellitus, hypertension, hyperlipidemia coronary artery disease. On admission, physical examination showed blood pressure of 120/80 mm Hg and regular pulse at 100 beat per minute. X ray revealed no bone fracture around the chest. Cardiac examination showed regular heart rhythm without murmurs and pericardial rubs. Electrocardiogram (ECG) performed on admission demonstrated Q wave and 1mm ST segment elevation in leads V1 to V5. Laboratory test results are as follows: serum creatine phosphokinase MB 89.8 U/L, Troponin I 120 ng/ml. Due to the persistent injury pattern on the ECG, the patient underwent emergency cardiac catheterization following the administration of aspirin, Clopidogrel and Atorvastatin etc. CAG showed an acute thrombus induced 99% occlusion in Left Anterior Descending artery and no serious atherosclerotic disease was seen in the remaining coronary arteries. Then, the thrombus has been taken out with a Thrombus Aspiration Catheter. Afterwards, CAG showed the occlusion has been relieved and considering his age, we didn’t implant any artificial stent in the left anterior descending artery. After procedure, the patient felt good and discharged
A Multicenter, Randomized, Controlled Clinical Trial of Transfusion Requirements in Critical Care
Authors: Paul C. Hébert, George Wells, Morris A. Blajchman, John Marshall, Claudio Martin, Giuseppe Pagliarello, Martin Tweeddale, Irwin Schweitzer, Elizabeth Yetisir
Journal: New England Journal of Medicine (1999)

To determine whether a restrictive strategy of red-cell transfusion and a liberal strategy produced equivalent results in critically ill patients, we compared the rates of death from all causes at 30 days and the severity of organ dysfunction.
Book: Psychosocial Issues in Palliative Care
Authors: Ignasi Agell
Journal: BMJ (2003)

The title of Lloyd-Williams' book makes for an interesting reflection. Palliative care was born with the hospice movement as a response to a medical service that seemed unable or unwilling to care adequately for dying people and their families, so the concept of psychosocial issues should be embedded in it. However, increasing subspecialisation and advances in medical technology mean that those original values are at risk of disappearing. It is therefore encouraging to see that such a dynamic specialty is able to observe itself critically and tries to avoid further departure from the definition the World Health Organization gave of palliative care in 1990: “Control of pain, of other symptoms and of psychological, social and spiritual problems.”




Figure 1



Mari Lloyd-Williams (ed)

Oxford University Press, £24.95, pp 208 ISBN 0 19 851540 5

Rating: ★★★★




Advocates of the biomedical model could claim psychosocial issues to be out of place in an evidence based culture, but all of the contributors make excellent reviews of the literature that prove otherwise. The chapters are full of sharp references and are empty of wasteful philosophical interpretations or of personal opinions. This reinforces greatly the need for psychosocial issues to be taken more seriously in the development of services, as the actual provision seems to fall very short of what would be acceptable, let alone ideal. After the fore-word and the preface the book defines its title, and this first chapter sets out very well the scope of the following chapters. The book covers many different aspects, from communication skills to service provision, anxiety and depression, spiritual care, non-malignant disease, bereavement care, and carers and staff, and the final chapter looks at the future of psychosocial care. However, I missed a chapter looking at ethical issues in palliative care, from research to patient autonomy and euthanasia (even when the last topic falls outside the philosophy of palliative care).

The book concludes by highlighting the need for good quality research in psychological, social, and spiritual areas of palliative care as a priority for the future.

This is an excellent book, to be celebrated not only because of the area it covers but also for the high quality of its contents.
Abstract 18981: Diagnostic Utility and Safety of Contrast Enhanced Gated Multislices Cardiac Computed Tomography (CT) for Evaluation of Patient s with Left Ventricular Assist Device (LVAD)
Authors: Su Min Chang, Mahwash Kassi, Tareq M Abu Sharifeh, HaoJie Wang, Barbara A Elias, Arvind Bhimaraj, Jerry Estep
Journal: Circulation (2012)

Background Visualization of the entire LVAD and surrounding cardiovascular structure is paramount for comprehensive assessment of LVAD-patients. Transthoracic echocardiogram is often limited by the artifacts and acoustic window. We studied the diagnostic utility and safety of Cardiac CT for evaluation of patients with LVAD. Method Between 2010-2012, 16 consecutive LVADs-Pts ( 14 Heart-Mate II) underwent 64 slices cardiac CT. The primary clinical indications were : 6 suspected cannula malposition ( frequent LVAD alarm, low output , recurrent VT, and hemolysis ), 5 source of emboli/infection, 3 effusion/hematoma, and 2 LV function/aortic valve assessment . Abnormal finding were defined as presence of inflow cannula (IC) malposition , significant outflow cannula (OC) kinking , mass/clot in the LVAD or heart/aorta or large effusion/hematoma . CT was considered diagnostic if the finding answered the clinical indications as determined by the LVAD/transplant cardiologist. CT-related complication was defined as worsened heart failure (HF) , anaphylaxis or contrast induced nephropathy (CIN : creatinine increase over 25 % at 7 days post CT ) . Beta-blocker was given prior to CT in 12 pts. Median contrast volume was 120 ml. Result The mean age was 55 +-14 yrs , 50 % male and history of ischemic cardiomyopathy in 10 pts. Abnormal findings were present in 11 cases including 6 IC malposition , 1 IC malposition plus significant OC kinking , 1 clot in the aortic root and 3 large effusion/hematoma . In 11 pts (70 %) , the CT findings were considered diagnostic for the primary clinical indication . And in 9 pts (55%) , therapeutic changes were made according to the CT findings . Four were medical ( LVAD speed or anticoagulation changes ) and 5 were surgical ( 1 transplant, 3 LVAD exchange and 1 surgical evacuation of mediastinal hematoma with RV collapse) . There were no cases of worsened HF , anaphylaxis after CT. The mean GFR pre CT was 1 +-0.4 mg/dl . Eight pts was in stage 2 or 3 chronic kidney disease. CIN developed in only 1 pt with creatinine increased from 0.8 to 1.1 mg/dl. Conclusion For evaluation of pts with LVAD, cardiac CT appeared to be safe, had good diagnostic utility and often lead to therapeutic changes . However, the impact on outcomes remains to be determined.
Abstract 8717: A Significant Reduction in Air Kerma with A Simple Radiation Quality Initiative
Authors: William Prabhu, Enkhtuyaa L Mueller, Harold Dauerman, Prospero B Gogo
Journal: Circulation (2011)

Background: Minimizing exposure to ionizing radiation in the cardiac catheterization laboratory reduces the risk of both deterministic and stochastic injury to patients as well as lab personnel. We hypothesize that a Radiation Quality Improvement (RQI) program of education and feedback could modify operator behavior to decrease radiation use. Methods: We performed a single center prospective registry from March 2010 to March 2011 incorporating all consecutive coronary diagnostic and interventional procedures. Both air kerma (AK) and fluoroscopic time (FT) values were documented. RQI consisted of mandatory physician training of all staff and operators with 2 follow up educational sessions. Intervention included a mandatory warning system for excessive FT (&gt;25min) during procedures as well as regular e-mail tips on c-arm settings associated with lower radiation use. Feedback tools were developed to provide quarterly individual operator FT and AK. We compared the use of radiation in the 4 month period before and the 6 month period after RQI. Results: A total of 1,838 patients were enrolled across 9 PCI operators. Pre-RQI (N=704) and Post-RQI (N=1,134) procedures were similar in terms of indication, clinical characteristics, level of urgency and operator representation. FT per case was similar pre and post RQI: 9.98±0.70 min vs. 10.48±0.53 min; p=0.26. There was a significant decrease in the average AK per case (1652±116 mGy vs. 1515±78 mGy, p=0.047). There was heterogeneity in the response to our intervention amongst the operators (p=0.001 for the interaction) but no heterogeneity in response based on diagnostic versus interventional cases. Conclusions: Radiation quality improvement is feasible and an intervention consisting of physician/staff education and rapid individualized feedback significantly reduces the use of radiation in the cardiac catheterization laboratory. This simple intervention has potential to improve patient and lab personnel safety.
Abstract 359: Disordered Chemokine Expression in Diabetes Following Experimental Myocardial Infarction: Potential Role in Impaired Progenitor Cell Recruitment
Authors: Jean-Francois Desjardins, Kim A Connelly, Kerri Thai, Cory A Johnson, Thomas G Parker, Richard E Gilbert
Journal: Circulation (2008)

BACKGROUND: Impaired collateral vessel formation is thought to contribute to the excessive morbidity in diabetic subjects with ischaemic heart disease where following myocardial infarction (MI) patients with diabetes are twice more likely to develop heart failure than non-diabetic subjects. Since the trafficking of bone marrow derived endothelial progenitor cells is thought to contribute to new vessel formation in ischemia, we postulated that altered chemokine expression may contribute to the impaired angiogenic response in diabetes. METHODS: Six week old F344 rats were randomized to vehicle or streptozotocin (35mg/kg i.p.) in order to induce diabetes. Once diabetes was confirmed (plasma glucose &gt;15 mM), a total of 40 animals then underwent sham procedure or LAD ligation (MI) at age 10 weeks, and sacrificed at day 0 (sham) and days 1, 2, 4 and 7 post-MI (4 per group). Infarct size was determined by echocardiography 24 hours after ligation. RT q PCR was used to assess mRNA expression levels of SDF-1 and its receptor CXCR4 at each time point, from tissue obtained from the peri-MI zone. RESULTS: There was no difference in mortality or infarct size between the groups. In control rats an increase in SDF-1 gene expression was apparent at Day 2 post-MI, persisting through Day 7 (p&lt;0.05). In contrast, diabetic rats showed high basal expression (6-fold vs. control, p&lt;0.01) that fell abruptly after MI and remained persistently low throughout the 7-day time course. Diabetes was also associated with increased basal gene expression of CXCR4 (2-fold vs. control, p&lt;0.05). Post-MI, CXCR4 gene expression increased in control rats at each time point, with fold differences up to maximally 3 times at Day 2 (p&lt;0.05 vs. Day 0). In diabetic rats, the level of expression remained high at Day 1, significantly decreased at Day 2 (3-fold vs. non-diabetic, p&lt;0.01) and was comparable to that of non-diabetic rats at days 4 and 7. CONCLUSIONS: Diabetes was associated with paradoxical alterations in gene expression of both SDF-1 and its receptor CXCR4 with high baseline expression and diminution following an ischemic insult. These findings suggest that disordered chemokine expression may reduce the diabetic heart’s ability to recruit endothelial progenitor cells to sites of ischemic injury.
Abstract 2081: The Effect Of Left Atrial Volume On Prognostic Value Of Dobutamine-atropine Stress Echocardiography In Patients With Suspected Or Known Coronary Artery Disease.
Authors: Jeane Tsutsui, Paulo M Dourado, Sandra N Falcão, Antonio C Chagas, Protásio L daLuz, Wilson Mathias-Jr
Journal: Circulation (2007)

Although dobutamine-atropine stress echocardiography (DSE) is an established technique for detecting coronary artery disease (CAD), new echocardiographic parameters have been recently described to influence the prognostic value of this test. Objective: To determine the influence of left atrial anatomical evaluation on the prognostic value of DSE in patients with known or suspected CAD. Methods: From January 2000 to October 2004 we studied 981 pts (61±12 years, 536 men) who underwent DSE with early-atropine injection protocol. Primary end-point was major cardiovascular events, defined as non-fatal myocardial infarction (MI) and cardiac death (CD). Secondary end-point was major cardiovascular events plus revascularization (surgical and percutaneous). Left atrial diameter was determined by two-dimensional echocardiography in longitudinal paraesternal view and left atrial volume in apical 4-chamber view, at rest. Abnormal DSE was defined as fixed or inducible wall motion abnormalities. Pts were followed for a mean of 18 months (6 to 47 months). Results: DSE was abnormal in 330(34%) pts. Mean left atrial diameter was 3.9±0.6 cm (2.2±0.4 cm/m2) while mean left atrial volume was 54.4±18.9 ml (30.7±11.2 ml/m2). Major cardiovascular events occurred in 39(4%) pts (29 CD and 10 non-fatal MI). A total of 120(12%) pts achieved secondary end-point. By univariate analysis the predictors of CD or non-fatal MI were left atrial diameter (p=0.0013), left atrial volume (p&lt;0.001), male sex (p=0.007), diabetes mellitus (p=0.013), previous MI (p=0.013), left ventricular ejection fraction (p&lt;0.001), and abnormal DSE (p&lt;0.001). By multivariate analysis, the independent predictors of CD and MI were left atrial volume (RR=1.02; 95%CI =1.01–1.03; p&lt;0.001) and abnormal DSE (RR=6.38; 95%CI =3.1–13.2; p&lt;0.001). When considering secondary end-point, independent predictors of combined events were left atrial volume (RR=1.01; 95%CI =1.01–1.02; p&lt;0.001), male sex (RR=1.7; 95%CI =1.1–2.5; p=0.017), and abnormal DSE (RR=4.4; 95%CI =2.9 – 6.6; p&lt;0.001). Conclusion: Resting left atrial volume is an independent predictor of major cardiovascular events and combined events and can be used as an incremental tool for prognostic evaluation of patients who underwent DSE.
Website of the week: Pros and cons of suntans
Authors: D. Carnall
Journal: BMJ (1999)

An article in this week's BMJ (p 114) argues that the risks of exposure to sunlight are small in absolute terms and are possibly balanced by its beneficial effects, a conclusion that “lay epidemiologists” (that's ordinary people) have reached already. People enjoy exposure to sunlight, like getting a tan, and, …
Abstract 15691: Modelling the Potential of "Heart Age/Vascular Age" Awareness on Cardiovascular Disease Event Rates in the United States
Authors: Peter Murray, Mariska Dotsch, Jane Upritchard, Rachel Newson, Mark R Cobain
Journal: Circulation (2011)

Background: “Heart Age” or “Vascular Age” is an alternative expression of age-appropriate cardiovascular risk based on the output of Framingham Risk Scores and shown to promote more accurate risk p...
Abstract 1818: Wnt5a Increases the Histone Demethylase Jmjd2b and Induces Epigenetic Remodelling in Adult Progenitor Cells
Authors: Masamichi Koyanagi, Masayoshi Iwasaki, Jes-Niels Boeckel, Andreas M Zeiher, Stefanie Dimmeler
Journal: Circulation (2008)

Wnt signalling controls the balance between stem cell proliferation and differentiation and patterning throughout development. Non-canonical Wnts, such as Wnt5a or Wnt11, enhance cardiac gene expression of endothelial progenitor cells (EPC), mesenchymal stem cells (MSC) and bone marrow mononuclear cells suggesting that non-canonical Wnts regulate cardiac commitment. However, the underlying mechanism is unclear. Using microarray analysis of Wnt5a-induced gene expression in EPC, we discovered that Wnt5a (1.0 μM, 24hours) significantly increased a variety of enzymes, which play key roles in epigenetic remodelling by modifying histone acetylation and methylation. Specifically, JMJD2B (205%), REST (311%), HDAC5 and HDAC7A (716 and 381%), YY1 (304%), and PCGF2 (352%), were significantly increased by Wnt5a. Wnt5a induced up-regulation of JMJD2B in EPC and MSC was further confirmed by real-time RT-PCR. The member of the JmjC-domain containing family, JMJD2B was recently shown to demethylate trimethylated histone H3 at lysine 9 (H3K9me3), thereby removing repressive histone modifications. Therefore, we hypothesized that increased JMJD2B might epigenetically modify gene expression, open chromatin structures at silenced promoters and modulate the differentiation of adult progenitor cells. Indeed, Wnt5a treatment reduced the repressive chromatin mark H3K9me3 as shown by Western blot and immunohistochemistry whereas global active chromatine marks (acetyl-H3 and trimethyl- H3K4) remained unchanged indicating that Wnt5a shifts the balance towards active gene expression. Furthermore, chromatin immunoprecipitation revealed that Wnt5a treatment increased the binding of JMJD2B at the promoter of the cardiac gene ANF. In line with removal of repressive chromatin marks, Wnt5a significantly increased differentiation of progenitor cells to cardiomyocytes. These data demonstrate that non-canonical Wnt5a induces epigenetic remodelling by removing repressive chromatin marks and may, thereby, sensitize adult progenitor cells for acquiring a cardiac cell fate. Further studies will investigate the specific contribution of the novel epigenetic modulator JMJD2B for adult stem cell functions.