tbuckley/cabot-search huggingface dataset:
Positional Related Shifting Inferior Wall Deficits on Myocardial Perfusion Imaging Caused by Fluid in the Gastric Fundus
Authors: SHAMIM MOMTAZ FERDOUSI BEGUM, FRED MISHKIN
Journal: Clinical Nuclear Medicine (1999)

In 48 consecutive SPECT stress myocardial perfusion studies, we prospectively evaluated the cine projection of raw acquisition data for predicting an inferior wall deficit related to gastric lucency. Comparison with reconstructed SPECT images indicated a sensitivity rate of 77% and specificity rate of 91%. In seven patients, a defect on the supine study resolved on the prone view, indicating absorption artifact. Two patients had activity within the gastric lumen. With the patient in the supine position, activity was in the gastric fundus overlying the inferior wall, moving to the antrum, unmasking the inferior wall when the patient was prone. Absorption caused by fluid in the gastric fundus may be responsible for inferior wall deficits. Two cases illustrate this.
Heterogeneity in the breakpoints of chromosome 19 among acute leukemia patients with the t(11;19)(q23;p13) translocation
Authors: Kinuko Mitani, Yuko Sato, Yukio Kobayashi, Yoshikazu Shibasaki, Masato Kasuga, Toshiya Inaba, Yasuhide Hayashi, Yasusada Miura, Kohei Miyazono, Hisamaru Hirai, Akio Urabe, Fumimaro Takaku
Journal: American Journal of Hematology (1989)

Abstract Gene probes for insulin receptor (INSR) and c‐ ets ‐1 were hybridized to metaphase cells from three leukemic patients with the t(11;19)(q23;p13) translocation. Patients 1 and 2 were diagnosed as acute lymphocytic leukemia (ALL) (L2), and patient 3, as acute myelogenous leukemia (AML) (M4). The c‐ ets ‐1 gene was demonstrated to have translocated from chromosome 11 to the short arm of the rearranged chromosome 19 (19p+) in all three patients. On the other hand, the INSR gene translocated from chromosome 19 to the rearranged chromosome 11 (11q‐) in the AML case, but remained on the rearranged chromosome 19 in the two ALL cases. Thus, the breakpoints of chromosome 19 are different among the patients studied, proximal to the INSR gene locus in the AML case and distal in the two ALL cases. Consequently, the c‐ ets ‐1 gene and the INSR gene remain separated in the AML case, whereas they become close to each other in the two ALL cases. Rearrangement of these two genes was studied in the two ALL patients, with no positive data being obtained. The results suggest that there may be heterogeneity in the breakpoints of chromosome 19 among the t(11;19)‐associated acute leukemias.
Role of vascular endothelial insulin sensitisation in vascular repair in systemic insulin resistance
Authors: Anshuman Sengupta, Nadira Yuldasheva, Matthew Gage, Hema Viswambharan, Amir Aziz, Noman Ali, Stacey Galloway, Ben Mercer, Mark Kearney, Richard Cubbon
Journal: The Lancet (2014)
Guidelines from the British Hypertension Society: Authors' reply
Authors: Bryan Williams
Journal: BMJ (2004)

EDITOR—The optimal lipid targets are a total cholesterol concentration of < 4.0 mmol/l or a reduction of 25% from baseline. The percentage reduction approach is needed for patients starting statin treatment for secondary prevention or because of their high cardiovascular risk but whose total cholesterol value is already close to the target. For example, for such patients starting statin treatment with a total cholesterol of 4.1 mmol/l, lowering cholesterol to 3.9 mmol/l is clearly not sufficient and a 25% reduction is required.

Many people in the United Kingdom are indeed unaware that they have a raised blood pressure and are therefore at increased risk. Most will develop more serious hypertension over time. How will that be detected without a programme of monitoring? It may not be cost effective for Green to do it, but somebody should. The “real world of general practice” cannot meet the challenges of modern health care, so changes in service delivery are needed.

The ALLHAT study is just one …
Abstract 5098: Identification of copy number alterations associated with the progression and clinical outcomes of oral cavity squamous cell carcinoma
Authors: Huei-Tzu Chien, Shiang-Fu Huang, Sou-De Cheng, I-How Chen, Chun-Ta Liao, Hung-Ming Wang, Ling-Ling Hsieh
Journal: Cancer Research (2012)

Abstract The molecular mechanisms contributing to the progression of oral cavity squamous cell carcinoma (OSCC) remain poorly understood. The primary treatment for advanced-stage OSCC is radical surgery with post-operative chemoradiation. However, the prognoses are usually discouraging. If we can better understand the characteristics of OSCCs, this may ultimately help clinicians to provide OSCC patients with more appropriate treatment. The advent of genome-wide profiling methods has opened up new possibility to catalogue chromosomal abnormal regions at high resolution. In the present study, 72 advanced-stage OSCCs were analyzed using two microarray platforms (26 cases with Affymetrix SNP 500K and 46 cases with Affymetrix SNP 6.0). Genomic copy number was determined by calculating the intensity ratio between the OSCC and a set of 270 normal DNAs from HapMap project. Segmented copy numbers for each tumor were inferred with the hidden markov model (HMM) using the Partek GS software. To identify regions for copy-number alterations (CNAs), GISTIC (genomic identification of significant targets in cancer) was applied to determine the significance. With this approach, 46 (14 gain and 32 loss) and 208 (48 gain and 160 loss) significant regions (FDR q-value &amp;lt; 0.25) were identified from SNP 500K and SNP 6.0 platform, respectively. Among them, 15 focal CNAs (8 gains (3q26.1, 7p11.2, 11q13.3, 13q22.1, 15q11.2, 17p13.3, 18p11.23-18p11.31, and 20p11.22) and 7 losses (1q21.1, 6p21.33, 7q31.3, 12q14.1, 2 focal regions in 14q11.2, 15q11.2)) are identical in these 2 platforms. Amplification of 11q13.3 containing a known oncogene CCND1 was confirmed by fluorescence in situ hybridization (FISH) with Vysis CCND1/CEP11 FISH probe kit. The clinicopathologic significances of these 15 CNAs were examined. Gain of 3q26.1 and 18p11.23-18p11.31, and loss of 15q11.2 were correlated significantly with lymph node metastasis. Furthermore, loss of two focal regions in 14q11.2 was significantly associated with disease-free and overall survival. In conclusion, CNAs associated with the progression and clinical outcomes of Taiwanese OSCC were identified by genomic approach using high-density SNP array. These results provide useful clues for future characterization of important oncogenes or tumor suppressor genes associated with the behaviors of the disease. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5098. doi:1538-7445.AM2012-5098
PTU-134 Durham Pathway For Care Of Patients With Advance Stage Liver Disease (asld)
Authors: S Saksena, L Hammal, M Hewett, C Lancaster
Journal: Gut (2014)

<h3>Introduction</h3> Care of patients with ASLD is poorly organised. This service improvement project aimed to develop a consistent pathway of care for ASLD patients. <h3>Methods</h3> Methods and results were iterative and included: 1. Track patient journey and Carer Experience: 2. Capture Activity Data from Clinical Coding: 3. Process mapping patient journey and Identify gaps in service provision 4. Design “Durham pathway” Figure for improving care of patients with ASLD with in reach liver service in community and developed range of both quantitative and qualitative metrics “Durham metrics” to monitor the effectiveness of the new pathway on patient outcomes and experience. 5. Engage relevant stakeholders and shared pathway 6. A 6 month Pilot of 20 ASLD patients with Community matron led inreach service. 7. Engage commissioners to fund ASLD pathway. <h3>Results</h3> Pre-pilot patient and carer experience was poor with multiple unplanned admissions, preferred place of death was not discussed, majority of deaths in hospital, care was not coordinated, and quality of life of patient and carer was poor. All post-pilot metrics reported significant improvements. Improved efficiency evidenced by reduction in unplanned hospital admissions, increase use of alternative community services, with use of shared care plans. 83% of these achieved their preferred place of care and death in contrast to nil pre pilot. <h3>Conclusion</h3> This pathway worked for ASLD and needs wider evaluation and consideration of similar approaches to other groups. <h3>Disclosure of Interest</h3> None Declared.
Metabolic Effects of Dietary Fructose in Diabetic Subjects
Authors: John P Bantle, Joyce E Swanson, William Thomas, Dawn C Laine
Journal: Diabetes Care (1992)

OBJECTIVE To assess the metabolic effects of chronic dietary fructose consumption in diabetic subjects. RESEARCH DESIGN AND METHODS Six type I and 12 type II diabetic subjects consumed, in random order, two isocaloric study diets for 28 days. In one diet, 20% of energy was derived from fructose. In the other diet, &amp;lt;3% of energy came from fructose, and carbohydrate energy was derived primarily from starch. Both study diets were composed of common foods. All meals were prepared in a metabolic kitchen where all foods were weighed during meal preparation. RESULTS Mean plasma glucose, urine glucose, and serum glycosylated albumin values were lower during the fructose diet than during the starch diet, but the differences achieved only marginal statistical significance. The day-28 value for mean plasma glucose was 12.5% lower (P = 0.03) during the fructose diet than during the starch diet. At days 14, 21, and 28, fasting serum cholesterol and LDL cholesterol were both significantly higher during the fructose diet than during the starch diet. The day-28 values for serum cholesterol and LDL cholesterol during the fructose diet were 6.9% (P = 0.008) and 10.9% (P = 0.002) higher, respectively, than the corresponding values during the starch diet. No differences were observed between the study diets in fasting serum HDL cholesterol, fasting serum triglycerides, peak postprandial serum triglycerides, or fasting serum lactate. Peak postprandial serum lactate was significantly higher during the fructose diet. Type I and type II diabetic subjects responded to the diets in a consistent way, but type I subjects experienced significantly more hypoglycemia during the fructose diet than during the starch diet. CONCLUSIONS A high-fructose diet may result in reduced glycemia in diabetic subjects but at the expense of increased fasting serum total and LDL cholesterol.
Pancreas Transplant Alone
Authors: Rainer W.G. Gruessner, Angelika C. Gruessner
Journal: Diabetes Care (2013)

The goal of this review is to highlight the significant improvements, over the past four decades, in outcomes after a pancreas transplant alone (PTA) in patients with brittle diabetes and recurrent episodes of hypoglycemia and/or hypoglycemic unawareness. A successful PTA—in contrast to intensive insulin regimens and insulin pumps—restores normoglycemia without the risk of hypoglycemia and prevents, halts, or reverses the development or progression of secondary diabetes complications. In this International Pancreas Transplant Registry (IPTR) analysis, we reviewed the records of 1,929 PTA recipients from December 1966 to December 2011. We computed graft survival rates according to the Kaplan-Meier method and used uni- and multivariate analyses. In the most recent era (January 2007–December 2011), patient survival rates were &amp;gt;95% at 1 year posttransplant and &amp;gt;90% at 5 years. Graft survival rates with tacrolimus-based maintenance therapy were 86% at 1 year and 69% at 3 years and with sirolimus, 94 and 84%. Graft survival rates have significantly improved owing to marked decreases in technical and immunologic graft failure rates (P &amp;lt; 0.05). As a result, the need for a subsequent kidney transplant has significantly decreased, over time, to only 6% at 5 years. With patient survival rates of almost 100% and graft survival rates of up to 94% at 1 year, a PTA is now a highly successful long-term option. It should be considered in nonuremic patients with brittle diabetes in order to achieve normoglycemia, to avoid hypoglycemia, and to prevent the development or progression of secondary diabetes complications.
Correlation of Smoking History and Other Patient Characteristics With Major Complications of Pelvic Radiation Therapy for Cervical Cancer
Authors: Patricia J. Eifel, Anuja Jhingran, Diane C. Bodurka, Charles Levenback, Howard Thames
Journal: Journal of Clinical Oncology (2002)

The purpose of this study was to identify patient-related factors that influence the risk of serious late complications of pelvic radiation therapy.The records of 3,489 patients treated with radiation therapy for International Federation of Gynecology and Obstetrics stage I or II carcinoma of the cervix were reviewed for information about patient characteristics, treatment details, and outcomes. Any complication occurring or persisting more than 3 months after treatment that required hospitalization, transfusion, or an operation or caused severe symptoms or the patient's death was considered a major late complication. Complication rates were calculated actuarially. The median duration of follow-up was 85 months, and 99% of patients were followed for at least 3 years or until they died.Heavy smoking was the strongest independent predictor of overall complications (multivariate hazard ratio, 2.30; 95% confidence interval [CI], 1.84 to 2.87). The most striking influence of smoking was on the incidence of small bowel complications (hazard ratio for smokers of one or more packs per day, 3.25; 95% CI, 2.21 to 4.78). Hispanics had a significantly lower rate of small bowel complications than whites, and blacks had higher rates of bladder and rectal complications than whites. Thin women had an increased risk of gastrointestinal complications, and obese women were more likely to have serious bladder complications.Complications of pelvic radiation therapy are strongly correlated with smoking, race, and other patient characteristics. These factors should be considered before the results of clinical studies are generalized to different cultural and racial groups.
Pili prove pertinent to enterococcal endocarditis
Authors: J. M. Budzik, O. Schneewind
Journal: Journal of Clinical Investigation (2006)

Enterococcus faecalis is an important agent of endocarditis and urinary tract infections, which occur frequently in hospitals. Antimicrobial therapy is complicated by the emergence of drug-resistant strains, which contribute significantly to mortality associated with E. faecalis infection. In this issue of the JCI, Nallapareddy and colleagues report that E. faecalis produces pili on its surface and that these proteinaceous fibers are used for bacterial adherence to host tissues and for the establishment of biofilms and endocarditis (see the related article beginning on page 2799). This information may enable new vaccine strategies for the prevention of E. faecalis infections.
The Medical Outcomes Study
Authors: Steven A. Smith
Journal: JAMA (1996)

<h3>To the Editor.</h3> —The often quoted interpretation from Dr Greenfield and colleagues<sup>1-3</sup>that endocrinologists are high-cost providers is open to criticism. Because outcomes were not controlled for specific practices of the endocrinologist or their system of care, it would be more appropriate to confine the interpretation of cost only to systems of care and not to physician type. Interpretation of the cost data in the MOS<sup>1,2</sup>was stratified for patient mix for a severity index (physical function index) reported by physicians (not disease specific). Using physician-reported severity of illness is influenced by the interpretation of the physician. Specialists in cognitive fields often underrate the complexity and severity of illnesses for patients seen. A more objective measure of severity of illness in the outpatient setting is needed. Also, the data of Greenfield et al support the observation that patients with diabetes generate greater costs whether they are seen by
Comparison of Blood Pressures in the Arms and Legs
Authors: Emil F. Pascarelli, Charles A. Bertrand, Marie Lopez
Journal: New England Journal of Medicine (1964)

SURPRISINGLY enough, a variety of answers can be elicited from the simple question, Are blood pressures in the arms and legs the same? Such a difference of opinion is also manifested by varying reports in the literature utilizing different technics of blood-pressure measurement. Some studies employed the cuff method alone,1 2 3 4 5 6 7 whereas others used aneroid8 or other types of manometers9 10 11 and still others attempted to compare different methods.12 In many of these publications the number of subjects studied has been small. For these reasons the validity of some of the conclusions must be questioned. The majority opinion, based on various technics, . . .
Dangerous Dusts and Furtive Fumes
Authors: Jan Lieben
Journal: JAMA (1961)

<h3>To the Editor:—</h3> I have read the editorial, "Dangerous Dusts and Furtive Fumes—'New' and Resurrected," which appeared inThe Journal,<b>174</b>:1321 (Nov. 5) 1960, dealing with a respiratory disease of mushroom workers described by Bringhurst, Byrne, and Gershen-Cohen, with great interest. In it the authors are correctly quoted that the disease has shown a mysterious predilection for migrant Puerto Rican laborers. After the appearance of this article, the Division of Occupational Health of the Pennsylvania Department of Health conducted an extensive investigation of the mushroom plants, which employ approximately 20,000 workers in this state. It became evident that the only reason for the "predilection for Puerto Rican laborers" was the fact that the plants from which Bringhurst and co-workers obtained their cases employed only Puerto Rican laborers for the particular operations, namely, the changing and cultivation of mushroom beds. During our investigation, we found that several other laborers who
Matrix metalloproteinase-3 and coronary remodelling: Implications for unstable coronary disease
Authors: A WHITE, S DUFFY, A WALTON, J NG, G RICE, S MUKHERJEE, J SHAW, G JENNINGS, A DART, B KINGWELL
Journal: Cardiovascular Research (2007)

Matrix metalloproteinases (MMPs) are plausible candidates for prediction of unstable coronary syndromes. We hypothesised that the MMP-3 polymorphism (- 1171, 5A/6A) would relate to coronary plaque characteristics and unstable clinical presentation.Forty patients with de novo presentation of coronary artery disease (CAD) were classified into unstable coronary syndrome (n=19) or stable angina pectoris (n=21). On coronary intravascular ultrasound, patients with unstable disease had a greater plaque burden, more positive (outward) coronary remodelling, and all but one were MMP-3 6A allele carriers (p=0.027 compared with stable). The relationship between the 6A allele and unstable presentation was substantiated in a validation cohort of 161 CAD patients (58 stable and 103 unstable) and in the total population of 201 CAD patients (79 stable and 122 unstable, p=0.007), and was independent of conventional risk factors. Furthermore, 6A allele carriers had a higher plasma MMP-3 concentration (15.8+/-12.5 versus 11.7+/-7.2 ng/mL, p=0.01), maximum coronary stenosis on angiography (89+/-15% versus 80+/-23%, p=0.02), plaque area (12.0+/-5.2 versus 7.5+/-3.6 mm(2), p=0.03), percentage plaque burden (82+/-7 versus 71+/-13%, p=0.003), and remodelling ratio (1.03+/-0.23 versus 0.83+/-0.12, p=0.003).The MMP-3 6A allele promotes positive coronary remodelling, greater plaque burden, and increased susceptibility to unstable coronary syndromes in humans.
Strategies Toward Improved Control During Insulin Lispro Therapy in IDDM: Importance of basal insulin
Authors: Pertti Ebeling, Per-Anders Jansson, Ule Smith, Carlo Lalli, Geremia B Bolli, Veikko A Koivisto
Journal: Diabetes Care (1997)

OBJECTIVE To examine whether overall glycemic control can be improved with insulin lispro by adjustment of the basal insulin regimen without an increased risk of hypoglycemia. RESEARCH DESIGN AND METHODS A 5-month open study was performed in 66 IDDM patients after they had been transferred from human regular insulin to insulin lispro as a premeal therapy. The premeal and basal insulin regimens were adjusted according to self-monitoring of blood glucose during the visits at 2-week to 1-month intervals. Diurnal glucose profile, hypoglycemic events, HbA1c, and patient satisfaction were evaluated. RESULTS The mean daily glucose level decreased from 9.2 ± 0.2 to 8.4 ± 0.2 mmol/l (P = 0.001) and HbA1c decreased from 8.8 ± 0.1 to 8.0 ± 0.1% (P &amp;lt; 0.001) (mean ± SD). The number of daily NPH injections increased from 1.4 ± 0.1 at baseline to 3.1 ± 0.1 at the end of the study. Total daily insulin dose increased by 3 U (7%) because of an 8-U (43%) rise in basal insulin, whereas premeal insulin dose decreased by 5 U (20%). The number of hypoglycemic episodes did not change during the study. Of the patients, 86% considered insulin lispro equal or better than human regular insulin. CONCLUSIONS Although the study was open, the date suggest that the appropriate combination of insulin lispro and basal insulin can improve postmeal hyperglycemia, HbA1c, and treatment satisfaction without increasing the risk of hypoglycemia.
Histamine H<sub>4</sub> receptor antagonist ameliorates chronic allergic contact dermatitis induced by repeated challenge
Authors: M. Seike, K. Furuya, M. Omura, K. Hamada‐Watanabe, A. Matsushita, H. Ohtsu
Journal: Allergy (2009)

To cite this article: Seike M, Furuya K, Omura M, Hamada‐Watanabe K, Matsushita A, Ohtsu H. Histamine H 4 receptor antagonist ameliorates chronic allergic contact dermatitis induced by repeated challenge. Allergy 2010; 65 : 319–326. Abstract Background: The present study observed effects of the histamine H 4 receptor on chronic allergic contact dermatitis induced by repeated challenge in mice. Methods: Acute contact dermatitis was induced by single epicutaneous challenge of 2,4,6‐trinitro‐1‐chlorobenzene (TNCB) to the ear. Chronic allergic contact dermatitis was developed by repeated epicutaneous challenge using TNCB on the dorsal back skin. H 4 receptor antagonist JNJ7777120 was administered to wild‐type mice, while H 4 receptor agonist 4‐methylhistamine was administered to histidine decarboxylase (HDC) (−/−) mice that synthesized no histamine. Results: HDC (−/−) mice did not differ phenotypically from HDC (+/+) mice, and H 4 receptor antagonist/agonist did not have clinical effects in terms of acute contact dermatitis reactions. H 4 receptor antagonist ameliorated skin eczematous lesions induced by repeated TNCB challenge in HDC (+/+) mice. On the contrary, H 4 receptor agonist exacerbated skin lesions exclusively in HDC (−/−) mice. Application of H 4 receptor agonist induced migration of mast cells and eosinophils in skin lesions, and H 4 receptor antagonist suppressed these changes. H 4 receptor was immunohistochemically detected on mast cells in eczematous lesions. Levels of interleukin (IL)‐4, ‐5, and ‐6 in lesions were decreased, whereas levels of interferon‐γ and IL‐12 were increased by H 4 receptor antagonistic activity. Serum Immunoglobulin E levels rapidly increased with repeated challenge, but decreased with H 4 receptor antagonist. Conclusion: Because chronic allergic contact dermatitis is developed by H 4 receptor stimulation, H 4 receptor antagonists might represent new candidate drugs for treating chronic allergic contact dermatitis.