tbuckley/cabot-search huggingface dataset:
Critical Role of Endogenous Thrombospondin-1 in Preventing Expansion of Healing Myocardial Infarcts
Authors: Nikolaos G. Frangogiannis, Guofeng Ren, Oliver Dewald, Pawel Zymek, Sandra Haudek, Anna Koerting, Kim Winkelmann, Lloyd H. Michael, Jack Lawler, Mark L. Entman
Journal: Circulation (2005)

Matricellular proteins are extracellular matrix proteins that do not contribute directly to tissue integrity but are capable of modulating cell function. We hypothesized that the matricellular protein thrombospondin (TSP)-1, a potent inhibitor of angiogenesis and activator of transforming growth factor (TGF-beta), is induced in healing myocardial infarcts and plays a role in suppressing the postinfarction inflammatory response, inhibiting local angiogenesis, and limiting expansion of granulation tissue into the noninfarcted area.We used a canine and a murine model of reperfused infarction. TSP-1 mRNA was induced in canine infarcts after 1 hour of ischemia and 3 to 7 days of reperfusion. TSP-1 protein showed a strikingly selective localization in the extracellular matrix, microvascular endothelium, and a subset of mononuclear cells of the infarct border zone after 5 to 28 days of reperfusion. Isolated canine venous endothelial cells showed low-level constitutive expression of TSP-1 mRNA, which was markedly induced by TGF-beta, and basic fibroblast growth factor. Murine infarcts also had marked TSP-1 deposition in the border zone. Infarcted TSP-1-/- mice exhibited sustained upregulation of the chemokines monocyte chemoattractant protein-1, macrophage inflammatory protein-1alpha, and interferon-gamma-inducible protein-10/CXCL10 and the cytokines interleukin-1beta, interleukin-6, and TGF-beta, suggesting an enhanced and prolonged postinfarction inflammatory response. In addition, TSP-1-/- mice had markedly increased macrophage and myofibroblast density in infarcts and in remodeling noninfarcted myocardial areas neighboring the myocardial scar, suggesting expansion of granulation tissue formation into the noninfarcted territory. TSP-1-/- animals had more extensive postinfarction remodeling than wild-type mice, although infarct size was similar in both groups.The infarct border zone may be capable of modulating the healing process through its unique extracellular matrix content. The selective endogenous expression of TSP-1 in the infarct border zone may serve as a "barrier," limiting expansion of granulation tissue and protecting the noninfarcted myocardium from fibrotic remodeling.
Physicians declining patient enrollment in a critical care trial: a case study in thromboprophylaxis
Authors: D. Cook, Y. Arabi, N. D. Ferguson, D. Heels-Ansdell, A. Freitag, E. McDonald, F. Clarke, S. Keenan, G. Pagliarello, W. Plaxton, M. Herridge, T. Karachi, S. Vallance, J. Cade, T. Crozier, S. Alves da Silva, R. Costa Filho, N. Brandao, I. Watpool, T. McArdle, G. Hollinger, Y. Mandourah, M. Al-Hazmi, N. Zytaruk, N. K. J. Adhikari
Journal: Intensive Care Medicine (2013)
Long-term Safety and Systemic Effects of Budesonide and Formoterol Administered via One Pressurized Metered-Dose Inhaler (pMDI) in Children With Asthma
Authors: J LEFLEIN, W BERGER, T URYNIAK, P VERVAET, L ODOWD, C OBRIEN
Journal: Journal of Allergy and Clinical Immunology (2008)
Resurrectionists and Spunkers
Authors: Charles H. Bradford
Journal: New England Journal of Medicine (1976)

RESEARCHERS at the Countway Library have recently been studying a medical enigma that is perhaps of minor importance, though of major interest. It sounds like one of those mathematical paradoxes for which there is no solution. In the good, old days, two centuries or more ago, the law required that before qualifying as a doctor every candidate must demonstrate thorough knowledge of anatomy, but the law also prohibited the practical study of anatomy through dissection. Obviously, such a situation could only be met by supra-legal or infra-legal technics. It is these technics that have interested us.The commonest method of . . .
ARTERIAL STIFFNESS IS ASSOCIATED WITH THE DEGREE OF PULMONARY IMPAIRMENT IN SARCOIDOSIS PATIENTS
Authors: Elias Gialafos, Gerasimos Siasos, Dimitris Tousoulis, Evangelos Oikonomou, Marina Zaromitidou, Athanasios Verveniotis, Thodoris Paraskevopoulos, Konstantinos Maniatis, Christos Kostopoulos, Aggeliki Rapti, Georgios Marinos, Athanasios G. Papavassiliou
Journal: Journal of the American College of Cardiology (2011)
Screening for Tuberculosis-Reply
Authors: Jeffrey R. Starke
Journal: JAMA (1995)

In Reply.  —Dr Bayuk has correctly pointed out several of the current problems and debates concerning TB control among immigrants to the United States. Currently, 32% of all US TB cases occur among non—US-born persons. 1 The rate of TB disease among non—US-born children is 13 times the rate among US-born children. Most children immigrating through established channels get neither a tuberculin skin test nor a chest radiograph since children rarely have contagious TB. However, some of the children with undetected TB infection will develop contagious TB after arrival in the United States, often within 5 years of arrival and at higher than expected rates. 2   While most countries (all but the United States and the Netherlands) have relied on BCG vaccination to try to prevent TB, the United States has emphasized detection of asymptomatic infection and treatment with chemotherapy. Both approaches have severe limitations. The BCG vaccines have limited
Clinical Diabetes Mellitus: A Problem Oriented Approach
Authors: David L. Horwitz
Journal: JAMA (1986)

Therapy in diabetes is rapidly advancing, and the practitioner is often left behind in his efforts to keep up with the latest advances. Thus, a new, comprehensive textbook of diabetology is always welcome, especially when it contains the wealth of information found in Davidson's book. The volume is particularly strong in several areas. Most noteworthy are the numerous tables and exhibits, which make up large portions of many chapters. These serve as useful guides to the management of important therapeutic problems in diabetes and can easily serve as checklists for patient management. As such, students (medical, nursing, and dietetic) and residents will find them most helpful and efficient. Another valuable aspect of this book is its recognition that diabetes rarely occurs as an isolated finding. A major section covers concomitant problems such as hypertension, anesthesia, and family planning, while another welldone section considers the socioeconomic problems of diabetes. Most clinicians
Aberrant TNF secretion by whole blood in healthy subjects with a history of reactive arthritis: time course in adherent and non-adherent cultures
Authors: K Anttonen
Journal: Annals of the Rheumatic Diseases (2005)

<b>Background:</b> The pathogenesis of reactive arthritis (ReA) apparently involves aberrations in innate immune functions such as monocyte tumour necrosis factor (TNF) generation. <b>Objective:</b> To investigate TNF production in healthy subjects with previous yersinia triggered reactive arthritis. <b>Methods:</b> The study comprised HLA-B27 positive subjects with previous reactive arthritis (B27+ReA+), and B27+ReA− and B27−ReA− subjects (n = 15 each). Whole blood TNF production was induced by lipopolysaccharide (LPS), which binds to CD14/TLR4 on the monocyte surface, or by a combination of phorbol 12-myristate 13-acetate (PMA) and Ca<sup>2+</sup> ionophore A23187, which activates monocytes independently of cell surface receptors. To further evaluate the possible role of adhesion mediated signalling on TNF production, blood samples were incubated in adherent or non-adherent conditions. TNF levels in culture supernatants were measured using an automated immunoassay analyser. The <i>CD14</i>(−159)C/T genotype was determined by a cycle minisequencing method. <b>Results:</b> B27+ReA+ supernatants had higher TNF levels than B27+ReA− supernatants in PMA/A23187 wells in two hour (p = 0.004) and four hour cultures (p = 0.001). Rapid initial TNF release took place in adherent but not in non-adherent conditions. This adhesion associated difference was greater in the B27+ReA+ group than in the B27+ReA− or B27−ReA− group in response to PMA/A23187 (p values &lt;0.001), and greater in the B27+ReA+ group than in the B27−ReA− group in response to LPS (p = 0.021). <i>CD14</i>(−159)T was associated allele dose dependently with an increase in the LPS induced TNF secretion allele (p = 0.030). <b>Conclusions:</b> Subjects who have recovered from yersinia arthritis show enhanced TNF production, which may be regulated at the level of monocyte adhesion.
Three-Phase Bone Scintigraphy Asymmetric Patterns in the Upper Extremities of Asymptomatic Normals and Reflex Sympathetic Dystrophy Patients
Authors: J P O??DONOGHUE, J E POWE, A G MATTAR, G A HURWITZ, N R LAURIN
Journal: Clinical Nuclear Medicine (1993)

Three-phase Tc-99m MDP scans of 61 patients with asymptomatic upper extremities randomly mixed with 17 studies of patients previously diagnosed with reflex sympathetic dystrophy were blindly interpreted by three observers. Asymmetry in any of the phases was recorded and a final diagnostic impression made. Thirteen of 17 reflux sympathetic dystrophy studies were rated abnormal by at least two observers. Mild to striking asymmetry was occasionally seen in all three phases in asymptomatic upper extremities. Twenty of 61 asymptomatic patients (33%) were rated abnormal by at least one observer, and 5 of 61 studies (8%) were rated abnormal by all observers. Asymmetries in normal patients occurred more commonly in the earlier phases, while asymmetry in the delayed images was mild in all but one. Tightening the criteria to exclude mild asymmetry in delayed images resulted in unacceptably low sensitivity for reflex sympathetic dystrophy (29%). Interob-server variability was most prominent in the flow and immediate images. In the diagnosis of reflex sympathetic dystrophy a greater reliance should be placed on the delayed images, which in themselves have an overall sensitivity of 94%. It is important, however, to recognize that occasional mild and rare moderate asymmetries in even the delayed images of normal individuals result in an overall lower specificity of 77%.
GENDER DIFFERENCES IN CORONARY ARTERY DISEASE: AN ANALYSIS FROM A 1500 PATIENTS CORONARY MULTIDETECTOR COMPUTED TOMOGRAPHY REGISTRY
Authors: Ricardo G. Baeza, Victor Neira, Cea G. Constanza, Javier Revello Pedemonte, Samuel Zvaighaft, Monica Acevedo, Alvaro Huete, Angelica Dominguez, Luigi Gabrielli
Journal: Journal of the American College of Cardiology (2014)
Negligible synergistic effect of β2-glycoprotein I on the reactivity of antioxidized low-density lipoprotein antibody to oxidized low-density lipoprotein
Authors: Juzo Matsuda, Moritaka Gotoh, Kazuo Kawasugi, Kengo Gohchi, Miyo Tsukamoto, Noriko Saitoh
Journal: American Journal of Hematology (1996)

We conducted this study to investigate whether antioxidized low-density lipoprotein (a-oxLDL) is an antibody to cryptic and/or neo-antigen on beta2-glycoprotein I (GPI), which is introduced by binding to anionic phospholipid, similar to that of GPI-dependent anticardiolipin antibody (aCL) employing a-oxLDL ELISA. We found that no significant optical density differences existed among systemic lupus erythematosus patients, including cases with aCL and/or lupus anticoagulant positivity, before and after the addition of GPI. Our results suggest that a-oxLDL is not an antibody to denatured GPI, but rather to oxLDL.
Molecular mechanisms of in vivo metal chelation: implications for clinical treatment of metal intoxications.
Authors: Ole Andersen, Jan Aaseth
Journal: Environmental Health Perspectives (2002)

Successful in vivo chelation treatment of metal intoxication requires that a significant fraction of the administered chelator in fact chelate the toxic metal. This depends on metal, chelator, and organism-related factors (e.g., ionic diameter, ring size and deformability, hardness/softness of electron donors and acceptors, route of administration, bioavailability, metabolism, organ and intra/extracellular compartmentalization, and excretion). In vivo chelation is not necessarily an equilibrium reaction, determined by the standard stability constant, because rate effects and ligand exchange reactions considerably influence complex formation. Hydrophilic chelators most effectively promote renal metal excretion, but they complex intracellular metal deposits inefficiently. Lipophilic chelators can decrease intracellular stores but may redistribute toxic metals to, for example, the brain. In chronic metal-induced disease, where life-long chelation may be necessary, possible toxicity or side effects of the administered chelator may be limiting. The metal selectivity of chelators is important because of the risk of depletion of the patient's stores of essential metals. Dimercaptosuccinic acid and dimercaptopropionic sulfonate have gained more general acceptance among clinicians, undoubtedly improving the management of many human metal intoxications, including lead, arsenic, and mercury compounds. Still, development of new safer chelators suited for long-term oral administration for chelation of metal deposits (mainly iron), is an important research challenge for the future.
OC-023 Factors Influencing Mortality Following Gastrostomy Insertion
Authors: RE Andrews, M Kurien, JS Leeds, J Grant, ME McAlindon, DS Sanders
Journal: Gut (2014)

<h3>Introduction</h3> High mortality rates have previously been reported following gastrostomy insertion, particularly among certain patient groups (e.g., dementia). With the increasing use of prophylactic gastrostomy for head and neck cancer (HNC), our group aimed to examine survival in this cohort compared to other referral indications and assess risk factors. <h3>Methods</h3> Gastrostomy insertions were examined from two hospitals in Sheffield between 2004–2013. Data was prospectively collected from all referred patients including demographic data, biochemical parameters, referral indications and gastrostomy type. Statistical analysis was performed with Chi-squared or Fishers exact tests. <h3>Results</h3> 1733 patients were included (1004 male, mean age=65). 30 day and 1 year mortality was 9.66% and 44.98% respectively. Indications for gastrostomy included; HNC (n = 591), neurological disease (n = 429), dysphagic stroke (n = 393), dementia (n = 9) and other (n = 311). The lowest mortality was seen in patients with HNC (30 day mortality = 5.2%, 1 year mortality = 32.6%). In comparison, 30 day mortality in all other groups was significantly higher (8.47% in neurological diseases, 15.86% in dysphagic stroke, 33.3% in dementia and 11.25% in ‘other’ indication, p &lt; 0.01). Mortality was also significantly higher at one year (p &lt; 0.01). There was no significant difference in mortality when comparing radiologically inserted and percutaneous endoscopic gastrostomies. Higher mortality rates were seen in patients aged 60 years or above at 30 days (OR 2.439 (1.666 – 3.731) p &lt; 0.0001) and also at 1 year (OR 3.140 (0.268 – 0.600) p &lt; 0.0001). Albumin less than 30 g/L was also associated with significantly higher 30 day (OR 4.486 (3.067 – 6.561) p &lt; 0.0001) and 1 year mortality outcomes (OR 2.319 (1.830 to 2.939) p &lt; 0.0001). In accordance with recent published data, our findings would support an elevated CRP (&gt;5 mg/L) being a factor associated with 30 day mortality (OR 8.930 (1.199 to 66.51) p = 0.006). <h3>Conclusion</h3> Referral indication for gastrostomy significantly impacts 30 day and 1 year mortality outcomes, with lowest rates demonstrated in patients with HNC. Identification of factors associated with mortality as seen in this study could help improve patient selection and be of relevance in the decision making process for gastrostomy. <h3>Disclosure of Interest</h3> None Declared.
Percutaneous Coronary Interventions without On-Site Cardiac Surgical Backup
Authors: David M. Shahian, Gregg S. Meyer, Robert W. Yeh, Michael A. Fifer, David F. Torchiana
Journal: New England Journal of Medicine (2012)

PCIs for acute coronary disease are increasingly being performed at centers without on-site surgical backup. This review summarizes the safety and the efficacy of this practice, along with the policy implications, including those for patients undergoing elective procedures.
Acute myocardial infarction, non‐bacterial thrombotic endocarditis, and disseminated intravascular coagulation in a severe hemophiliac
Authors: David Green, Howard Snapper, Graziella Abu‐Jawdeh, Janardan Reddy
Journal: American Journal of Hematology (1990)

Abstract Thrombosis in hemophilia is very rare and is usually associated with the administration of prothrombin complex concentrates. We describe a severe hemophiliac with P. carinii pneumonia who had clinical and laboratory evidence of acute myocardial infarction and disseminated intravascular coagulation, and at autopsy, nonbacterial thrombotic endocarditis as well. We suggest that prothrombin complex concentrates should be used cautiously in the setting of acute infection, and perhaps be given with appropriate doses of anticoagulants such as heparin.
Elastolytic activity of alveolar macrophages in chronic bronchitis: comparison of current and former smokers.
Authors: S O'Neill, J S Prichard
Journal: Thorax (1983)

We have compared the macrophage elastolytic activity of a group of current and former smokers with irreversible airflow obstruction. Elastolytic activity was determined in an initial bronchoalveolar lavage cell population and in alveolar macrophages cultured for three days, to investigate whether enhanced macrophage elastolytic activity alone is a determining factor in the susceptibility of some smokers to obstructive lung disease. Twenty current smokers and 12 former smokers who had abstained from smoking for at least three years were studied. All patients had spirometric evidence of irreversible air flow obstruction. Current smokers had a cell yield (mean +/- SD) of 138.7 +/- 36.4 X 10(6) cells (alveolar macrophages 94.2% +/- 2.1%) compared with 31.4 +/- 14.1 X 10(6) cells (macrophages 86.5% +/- 4.7%) in former smokers. Elastolytic activity in the initial lavage cell population from current and former smokers, measured with the synthetic elastase substrate succinyl-L-alanyl-L alanyl-L-alanine-p-nitroanilide, and expressed as the equivalent of 1 microgram of porcine pancreatic elastase, was respectively 0.113 +/- 0.003 and 0.096 +/- 0.004 microgram pancreatic elastase/mg cell protein. After three days in culture macrophage elastolytic activity in the current and former smokers9 cells was respectively 0.107 +/- 0.006 and 0.011 +/- 0.001 microgram pancreatic elastase/mg cell protein (p less than 0.05). The elastase activity of the cultured alveolar macrophages from five current smokers had the inhibitor profile of a metalloproteinase. Our results indicate that enhanced macrophage elastolytic activity alone is not a determining factor in the susceptibility of some smokers to develop obstructive lung disease.
Topical rapamycin combined with pulsed dye laser in the treatment of capillary vascular malformations in Sturge-Weber syndrome: Phase II, randomized, double-blind, intraindividual placebo-controlled clinical trial
Authors: Laura Marqués, Jorge M. Núñez-Córdoba, Leyre Aguado, Maider Pretel, Pablo Boixeda, Eduardo Nagore, Eulalia Baselga, Pedro Redondo
Journal: Journal of the American Academy of Dermatology (2014)
Maternal Brain Death During Pregnancy
Authors: Jerome S. Litvinoff
Journal: JAMA (1989)

To the Editor.—  Field and colleagues 1 are to be congratulated for their clear exposition of the neurophysiological derangements seen in brain death. I agree with their statement that brain death results in loss of medullary vagal activity while the spinal sympathetic nuclei survive. I do take issue, however, with their statement that after brain death cardiac activity is determined by the sympathetic system alone. The spinal sympathetic nuclei are driven by the sympathetic cells in the hypothalamus, and these hypothalamic nuclei are just as vulnerable as the medullary vagal nuclei in brain death. Thus, both sympathetic and vagal (parasympathetic) systems become severely deranged and eventually nonfunctional. These derangements tend to balance each other out. It is not surprising, therefore, that tachycardia was noted in less than half of the brain dead patients. It does not seem necessary to invoke additional influences such as hypothermia or myocardial ischemia to account
DISTINCT PROGNOSTIC IMPLICATIONS OF ATRIAL ANATOMICAL REMODELING AFTER RADIOFREQUENCY ABLATION BETWEEN PAROXYSMAL AND PERSISTENT ATRIAL FIBRILLATION: 3D IMAGING STUDY USING MULTIDETECTOR COMPUTED TOMOGRAPHY
Authors: Jeonggeun Moon, Hye-Jeong Lee, Young Jin Kim, Jaemin Shim, Hui-Nam Pak, Boyoung Joung
Journal: Journal of the American College of Cardiology (2013)
Growth abnormalities in the population exposed in utero and early postnatally to polychlorinated biphenyls and dibenzofurans.
Authors: Y L Guo, G H Lambert, C C Hsu
Journal: Environmental Health Perspectives (1995)

This article reviews the findings in children exposed to various levels of polychlorinated biphenyls (PCBs) and related compounds in utero and early postnatally. Yu-Cheng ("oil-disease") mothers were Taiwanese women exposed to PCBs and their heat-degradation products from the ingestion of contaminated rice oil in 1979. Children of these mothers were born growth retarded, with dysmorphic physical findings, and delayed cognitive development compared with unexposed children. In this article, findings in Yu-Cheng children born between 1978 and 1985 are summarized and compared with two other well-documented cohorts of children prenatally exposed to different levels of PCBs. Results of the investigation in Yu-Cheng children will provide important information about the toxicities, health effects, and mechanisms of PCB/PCDF exposure and demonstrate that the developing human is more sensitive than the adult to the toxic effects of these chemicals.
Sleep walking to another Stanley Royd?
Authors: Brian Keeble
Journal: BMJ (2006)

I n August 1984 an outbreak of salmonella food poisoning at Stanley Royd Hospital, a large psychogeriatric hospital in Wakefield, Yorkshire, claimed the lives of 19 patients. Just over six months later, in April 1985, an outbreak of legionnaires' disease at Stafford District General Hospital caused the deaths of 28 people.

Public inquiries into these outbreaks were established by the then Department of Health and Social Security, and their findings were published in 1986. The inquiries, in highlighting concerns about the decline in available medical expertise in environmental health and in the investigation and control of infectious diseases, called for a review of the responsibilities and authority of medical officers of environmental health—the local public health doctors who at the time were responsible for investigating outbreaks of communicable diseases in the community.

> Primary care trusts may even have to recreate the post of local consultants in communicable disease control 

The then secretary of state, Norman Fowler, asked the …