tbuckley/cabot-search huggingface dataset:
Avoiding premature coronary deaths in Asians in Britain
Authors: S. Gupta, A. de Belder, L. O Hughes
Journal: BMJ (1995)

Spend now on prevention or pay later for treatment

Over 1.5 million people have settled in Britain from the Indian subcontinent (India, Pakistan, and Bangladesh) and east Africa.1 Epidemiological studies have shown that, irrespective of regional, cultural, and religious differences, immigrant south Asians all share a significantly higher mortality from coronary heart disease than the indigenous white population.2 3 4 This increased risk also applies to second generation Asian immigrants who have adverse risk factor profiles for coronary heart disease.5 First recognised in Singapore,6 this increase is a worldwide phenomenon.7 8

In 1977 a 40% excess incidence of myocardial infarction was found among Asians admitted to hospitals in Leicester,9 and more recently a group from Northwick Park Hospital found that Gujarati Asian men had four times the risk of a first myocardial infarction compared with north European men.10 This study also reported that the Asian men were significantly younger at the time of their first infarct, had more extensive atheroma, and had lower mean cholesterol concentrations than white men.

Whether the prevalence and incidence of coronary heart disease in Asians living in the Indian subcontinent differ from those in Asians abroad is uncertain. One small study showed no significant differences in risk profiles or extent of coronary disease between Asian men settled in Britain …
Cathepsin S expression is up-regulated following balloon angioplasty in the hypercholesterolemic rabbit
Authors: Cynthia L Burns-Kurtis, Alan R Olzinski, Saul Needle, Josephine H Fox, Elizabeth A Capper, Fiona M Kelly, Michael S McQueney, Anne M Romanic
Journal: Cardiovascular Research (2004)

Neointimal development following balloon angioplasty involves many factors including smooth muscle cell (SMC) migration and proliferation and extracellular matrix (ECM) remodeling. Further, in hypercholesterolemic (HC) conditions, there is an influx of macrophage foam cells (FCs) into the restenotic lesion, which also involves degradation of the basement membrane and surrounding ECM. The ECM remodeling that occurs during restenosis has been shown to be mediated by various proteases. Here we have investigated the role of cathepsin S (CatS), a cysteine protease, in this process.We have demonstrated by Taqman quantitative PCR, Western blot, and immunohistochemistry that CatS is up-regulated in restenotic lesions of HC rabbits following balloon injury of the iliofemoral artery. CatS mRNA expression was elevated 28-fold in balloon-injured vessels relative to uninjured contralateral vessels in HC rabbits 8 weeks post-angioplasty (p<0.05). CatS protein expression was detected within 1 day post-injury, persisted throughout the entire time course evaluated (60 days post-injury), and was co-localized with SMCs, macrophages, and FCs. In contrast, cystatin C (CysC), the endogenous inhibitor of cathepsins, was only minimally up-regulated following injury. CysC mRNA expression was elevated 3.5-fold in balloon-injured vessels relative to uninjured contralateral vessels in HC rabbits 8 weeks post-angioplasty (p<0.005), and up-regulation of protein expression was not detected until days 28 and 60 post-injury. Additional biochemical studies using recombinant rabbit CatS revealed that rabbit CatS digests laminin, fibronectin, and type I collagen. Further, CatS expression was evaluated in SMCs that were induced to migrate through a matrix-coated Boyden chamber upon platelet-derived growth factor (PDGF) stimulation. The addition of a selective CatS inhibitor reduced SMC migration dose-dependently with an 80% reduction in migration at 30 nM (p<0.005). Additionally, we have shown that CatS protein expression by human macrophages was increased upon stimulation with oxidized low density lipoprotein (ox-LDL), implying augmentation of CatS production during foam cell formation.Taken together, our results indicate an enhanced expression of CatS during neointima formation and it is associated with invading SMCs, macrophages, and FCs, highlighting the importance of CatS in the pathogenesis of restenosis.
Effects of carbon monoxide on myocardial ischemia.
Authors: E N Allred, E R Bleecker, B R Chaitman, T E Dahms, S O Gottlieb, J D Hackney, M Pagano, R H Selvester, S M Walden, J Warren
Journal: Environmental Health Perspectives (1991)

The purpose of this study was to determine whether low doses of carbon monoxide (CO) exacerbate myocardial ischemia during a progressive exercise test. The effect of CO exposure was evaluated using the objective measure of time to development of electrocardiographic changes indicative of ischemia and the subjective measure of time to onset of angina. Sixty-three male subjects (41-75 years) with well-documented coronary artery disease, who had exertional angina pectoris and ischemic ST-segment changes in their electrocardiograms, were studied. Results from three randomized, double-blind test visits (room air, low and high CO) were compared. The effect of CO exposure was determined from the percent difference in the end points obtained on exercise tests performed before and after a 1-hr exposure to room air or CO. The exposures resulted in postexercise carboxyhemoglobin (COHb) levels of 0.6% +/- 0.3%, 2.0% +/- 0.1%, and 3.9% +/- 0.1%. The results obtained on the 2%-COHb day and 3.9%-COHb day were compared to those on the room air day. There were 5.1% (p = 0.01) and 12.1% (p less than or equal to 0.0001) decreases in the time to development of ischemic ST-segment changes after exposures producing 2.0 and 3.9% COHb, respectively, compared to the control day. In addition, there were 4.2% (p = 0.027) and 7.1% (p = 0.002) decreases in time to the onset of angina after exposures producing 2.0 and 3.9% COHb, respectively, compared to the control day. A significant dose-response relationship was found for the individual differences in the time to ST end point and angina for the pre- versus postexposure exercise tests at the three carboxyhemoglobin levels. These findings demonstrate that low doses of CO produce significant effects on cardiac function during exercise in subjects with coronary artery disease.
Management of bronchial carcinoma by segmental resection
Authors: B. T. Le Roux
Journal: Thorax (1972)

Of 4,000 patients with bronchial carcinoma, a small peripheral tumour in 17 was managed by segmental resection because the lesion palpated at thoracotomy was thought to be tuberculous, because the segment in which the tumour lay was separated from adjacent lung by an anatomically complete fissure, or to avoid unnecessary limitation of an already diminished respiratory reserve. One patient died as a direct result of operation; eight died from metastases or recurrence of tumour one to seven years after operation; three died from non-metastatic causes; and five are alive five to eight years after operation. From this small selected group of patients the results of management of bronchial carcinoma by segmental resection seem no worse than after more extensive resections for small tumours.
Preadmission Screening of Medicare Patients
Authors: George D. Lavers
Journal: JAMA (1988)

To the Editor.—  In the June 17 issue, there is an article on preadmission screening 1 and an editorial by Dr Dans 1 on the same subject. It is interesting that the main finding of this study was the failure to detect major adverse outcomes. Furthermore, the authors seem pleased that only 0.37% of requests for admission were denied.  It would be nice to see some figures as to the advantages of this expensive and cumbersome screening program. In short, does it do any good? The group from Connecticut implies that as long as no one suffers from the program it is probably all right. There is no mention of the tremendous cost to the Connecticut Peer Review Organization, to physicians, and to the hospital, and this cost is not only financial but a burden of wasted time with telephone calls and paperwork.
Investigations of AIDS Patients With No Previously Identified Risk Factors
Authors: Kenneth G. Castro
Journal: JAMA (1988)

Through Sept 30, 1987, two thousand fifty-nine patients with acquired immunodeficiency syndrome (AIDS) and no recognized risk factors were reported to the Centers for Disease Control. Risk history was incomplete or unobtainable for 921 (45%) of them. Risk factors were ultimately identified for 825 (72%) of the remaining 1138. Another 32 persons (3%) did not meet the case definition for AIDS. Risk factors could not be identified for the remaining 281 patients (25%), despite additional information. Of these, 178 (63%) were interviewed with standard questionnaires; 38% reported sexually transmitted diseases and 34% of the men reported sexual contact with prostitutes. There was no evidence for new transmission modes. Although the proportion of AIDS patients with undetermined risk factors has increased significantly during the past year, the adjusted proportion shows no significant change over time. Thus, follow-up of AIDS patients with no apparent risk factors suggests that modes of transmission for human immunodeficiency virus have remained stable.
Molecular characterization of hemoglobin C in Thailand
Authors: Kanokwan Sanchaisuriya, Goonnapa Fucharoen, Nattaya Sae‐ung, Nirut Siriratmanawong, Sutja Surapot, Supan Fucharoen
Journal: American Journal of Hematology (2001)

Abstract We describe hematologic and DNA characterization of 12 hemoglobin C heterozygotes and three compound heterozygotes for hemoglobin C and hemoglobin E found in Thailand. Amplification and DNA analysis of genomic DNA by the polymerase chain reaction procedure permitted the identification of the β C mutation at codon 6 of β‐globin gene (β 6; GAG–AAG). β‐Globin gene haplotype analysis demonstrated that all β C globin genes detected in these Thai individuals were associated with the haplotype (+ − − − − − +), indicating a non‐African origin of this abnormal hemoglobin in Thailand. On routine hemoglobin typing, hemoglobin C is usually mistakenly identified as hemoglobin E because of theirs similar mobilities on cellulose acetate electrophoresis. The simple DNA assay for hemoglobin C based on an allele‐specific polymerase chain reaction for accurate diagnosis of hemoglobin C was therefore developed. Am. J. Hematol. 67:189–193, 2001. © 2001 Wiley‐Liss, Inc.
[311] URSODEOXYCHOLIC ACID, BUT NOT NORURSODEOXYCHOLIC ACID REVERSES TAUROLITHOCHOLIC ACID-INDUCED CHOLESTASIS IN RAT LIVER
Authors: S. Maitz, G.U. Denk, R. Wimmer, P. Invernizzi, A.F. Hofmann, U. Beuers
Journal: Journal of Hepatology (2007)
SITES OF FORMATION OF IMMUNE GLOBULINS AND OF A COMPONENT OF C'3
Authors: G. M. Hochwald, G. J. Thorbecke, R. Asofsky
Journal: The Journal of Experimental Medicine (1961)

The development of a new method for the determination of the sites of serum protein formation has been described. The method involves the incorporation of C14-labeled amino acids by tissues cultured in vitro, and subsequent autoradiography of immunoelectrophoretic patterns prepared from a mixture of culture fluids and carrier serum with an antiserum against the carrier serum. This technique has been used to demonstrate formation of γ-globulin, of ß2-macroglobulin, and of a component of C'3 by mouse spleen tissue, and of various other serum proteins by liver tissue. The specificity and sensitivity of this method have been discussed, and some of its advantages and pitfalls were mentioned. In addition, a rabbit antimouse serum was prepared, and the immunoelectrophoretic patterns obtained with mouse serum were compared with those described in the literature.
Compliance with Zidovudine Therapy
Authors: Lee B. Reichman
Journal: Annals of Internal Medicine (1990)

Letters and Corrections15 August 1990Compliance with Zidovudine TherapyLee B. Reichman, MD, MPHLee B. Reichman, MD, MPHSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-113-4-332_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors:Recent articles (1, 2) and Food and Drug Administration (FDA) recommendations suggesting that zidovudine be used for treatment of human immunodeficiency virus (HIV)-infected persons with no or early symptoms fail to consider patient compliance. How do we get expensive multidose daily "preventive" medication into so many less symptomatic patients for an indefinite period? Such an activity has never before been tried on such a scale and, when done in far fewer subjects, has usually failed. Researchers and the FDA appear to assume that, despite being asymptomatic, most HIV-infected patients will take their zidovudine as prescribed without specific...References1. Fischl M, Richman D, and Hansen N. The safety and efficacy of zidovudine (AZT) in the treatment of subjects with mildly symptomatic human immunodeficiency virus type 1 (HIV) infection. Ann Intern Med. 1990;112:727-37. LinkGoogle Scholar2. Ruedy J, Schechter M, and Montaner J. Zidovudine for early human immunodeficiency virus (HIV) infection: who, when, and how? [Editorial]. Ann Intern Med. 1990;112:721-4. LinkGoogle Scholar3. Reichman L. Compliance in developed nations. Tubercle. 1987;685:25-9. CrossrefGoogle Scholar4. Eraker S, Kirscht J, and Becker M. Understanding and improving patient compliance. Ann Intern Med. 1984;100:258-68. LinkGoogle Scholar5. McDonald R, Memon A, and Reichman L. Successful supervised ambulatory management of tuberculosis treatment failures. Ann Intern Med. 1982;96:297-302. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Lee B. Reichman, MD, MPHAffiliations: University of Medicine and Dentistry of New Jersey New Jersey Medical School University Hospital Newark, NJ 07103-2406 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byA prospective study of predictors of adherence to combination antiretroviral medicationSecret Pills: HIV-Positive Patients' Experiences Taking Antiretroviral Therapy in North Carolina 15 August 1990Volume 113, Issue 4Page: 332-333KeywordsFood and Drug AdministrationHIV ePublished: 1 December 2008 Issue Published: 15 August 1990 PDF downloadLoading ...
Phytoestrogen signaling and symbiotic gene activation are disrupted by endocrine-disrupting chemicals.
Authors: Jennifer E Fox, Marta Starcevic, Phillip E Jones, Matthew E Burow, John A McLachlan
Journal: Environmental Health Perspectives (2004)

Some organochlorine pesticides and other synthetic chemicals mimic hormones in representatives of each vertebrate class, including mammals, reptiles, amphibians, birds, and fish. These compounds are called endocrine-disrupting chemicals (EDCs). Similarly, hormonelike signaling has also been observed when vertebrates are exposed to plant chemicals called phytoestrogens. Previous research has shown the mechanism of action for EDCs and phytoestrogens is as unintended ligands for the estrogen receptor (ER). Although pesticides have been synthesized to deter insects and weeds, plants produce phytoestrogens to deter herbivores, as attractant cues for insects, and as recruitment signals for symbiotic soil bacteria. Our data present the first evidence that some of the same organochlorine pesticides and EDCs known to disrupt endocrine signaling through ERs in exposed wildlife and humans also disrupt the phytoestrogen signaling that leguminous plants use to recruit Sinorhizobium meliloti soil bacteria for symbiotic nitrogen fixation. Here we report that a variety of EDCs and pesticides commonly found in agricultural soils interfere with the symbiotic signaling necessary for nitrogen fixation, suggesting that the principles underlying endocrine disruption may have more widespread biological and ecological importance than had once been thought.
Altered Folate Metabolism in Early HIV Infection
Authors: Richard S. Beach, Emilio Mantero-Atienza, Carl Eisdorfer, Marianna K. Fordyce-Baum
Journal: JAMA (1988)

<h3>To the Editor.</h3> —We are currently conducting a longitudinal study of various biologic, psychological, and social factors in the progression of human immunodeficiency virus (HIV) infection in 100 male homosexuals between the ages of 20 and 45 years. These men have HIV infection confirmed by the Western blot technique; the only symptoms are lymphadenopathy (Centers for Disease Control stage 3). Initial determinations have shown significantly elevated plasma and erythrocyte folate levels as determined by microbiological assay.<sup>1</sup>Fifty-eight percent of HIV-infected individuals had plasma folate values above the normal range, the first 24 subjects having a mean plasma folate level of 22.0 ± 1.40 nmol/L (9.71 ± 0.62 ng/mL). Three hundred health professionals used as controls had serum folate levels varying between 4.53 and 22.66 nmol/L (2 and 10 ng/mL) (<i>P</i>&lt;.005). Seventy-five percent of the participants had erythrocyte folate levels above normal, with a mean in the HIV-infected subjects
Action on clinical audit: progress report 2
Authors: A. Berger
Journal: BMJ (1998)

In the first progress report on “Action on clinical audit” I described how West Middlesex University Hospital NHS Trust is looking at the role of stakeholder ownership in clinical audit.1 This second report follows the progress of the Essex Rivers Healthcare Trust and its use of open space technology for redesigning services for children with diabetes.

#### Summary points

Essex Rivers Healthcare Trust is a combined acute and community trust with a district general hospital in the city of Colchester and community hospitals in Clacton, Harwich, and Halstead. The trust has set up its own clinical effectiveness programme, and became interested in the action on clinical audit project partly as an offshoot of this. The feeling from some clinicians within the trust is that audit is struggling, and while many audit projects are conducted with worthwhile aims in mind, the end product is all too often “a report that ends up in a drawer.”



Essex Rivers Healthcare Trust



The Essex Rivers' local action team—Charles Bodmer (consultant physician and specialist in diabetes), Anne Ferris (senior nurse …
Pelvic and perineal complications of Crohn's disease: assessment using magnetic resonance imaging.
Authors: P J Haggett, N R Moore, J D Shearman, S P Travis, D P Jewell, N J Mortensen
Journal: Gut (1995)

This study evaluated the role of magnetic resonance imaging (MRI) in the demonstration of the pelvic and perianal complications of Crohn's disease. Twenty five patients with active Crohn's disease were studied (12 male; mean age 41.1 years). MRI examinations were performed using a 1.5 Tesla system, within 14 days after clinical assessment. T1 and T2 weighted fast spin echo sequences in two or three orthogonal planes were performed, with fat suppression in some cases. The MRI results were correlated with surgical and clinical findings. In 16 patients, cutaneous, deep perineal or enterovesical fistulas or abscesses were diagnosed at MRI which showed close correlation with findings at examination under anaesthetic. In eight patients no fistulas or abscesses were seen at MRI nor was there any evidence of complications on clinical examination and flexible sigmoidoscopy. There was one false negative examination in a patient who had a colovesical fistula. In conclusion, MRI can accurately show the pelvic and perineal complications of Crohn's disease and may render examination under anaesthetic unnecessary.
S82 Fungal sensitisation in children with severe therapy resistant asthma
Authors: S. Castanhinha, A. Gupta, M. Maglione, S. Koo, C. Bossley, L. Fleming, A. Bush, S. Saglani
Journal: Thorax (2011)

<h3>Introduction</h3> Severe asthma with fungal sensitisation (SAFS) in adults is associated with reduced lung function and increased morbidity [<i>EurRespir J</i> 2006;<b>27</b>:615–26, <i>Am J RespirCare Med</i> 2009; <b>179</b>:11–18]. We hypothesised that fungal sensitisation in children with severe, therapy-resistant asthma (STRA) is associated with increased symptoms, medication use and airway inflammation, and reduced lung function. <h3>Methods</h3> STRA was defined as before [<i>Lancet</i> 2010;<b>376</b>:814–25]. All children had been through a detailed assessment to optimise adherence and other aspects of basic management, as far as possible. We retrospectively evaluated 166 patients (median age at referral 11.7 years [4;17]; 61% males). SAFS (n=76) was defined as specific IgE (spIgE) or skin prick test (SPT) positivity to any of <i>Aspergillus fumigatus, Alternaria alternata</i> or <i>Cladosporium herbarum</i>. Non-sensitised patients (n=90) had negative spIgE and SPT to all fungal allergens tested. Age of onset, atopy, symptoms (asthma control test), medication usage, lung function and airway inflammation were assessed. <h3>Results</h3> More boys had SAFS (57/76 (75%) vs 43/90 (48%), p&lt;0.001). Children with SAFS had earlier onset of asthma (median 0.5 years [0;12.5] vs 1.5 [0;12.5], p=0.006), higher total serum IgE (637 IU/ml [12;6737] vs 177 [1;10 881], p=0.002) and higher sum of inhalant allergen SPT and spIgE [<i>Allergy</i> 2007;<b>62</b>:1379;86] (16 mm [0;38] vs 9 mm [0;36], p&lt;0.001, and 78 IU/ml [0;400] vs 19 IU/ml [0;243], p=0.02, respectively). Children with SAFS had a lower FEV<sub>1</sub> (1.4 L [0.5;3.8], vs 1.9 [0.7;4.3], p=0.008) and lower FVC (2.3 L [0.6;4] vs 2.6 [0.8;5.5], p=0.045). Bronchodilator reversibility was more frequent in SAFS (n=59/73 (81%) vs 42/81 (52%), p&lt;0.001). Maintenance oral steroids were more frequently prescribed in SAFS (n=18/76(24%) vs 8/88 (9%), p=0.02). Symptoms and airway inflammation (assessed in sputum, bronchoalveolar lavage and endobronchial biopsy) were similar in children with and without fungal sensitisation. <h3>Conclusions</h3> Children with STRA and fungal sensitisation had lower lung function, earlier asthma onset, more atopy and more bronchodilator responsiveness. There is a need for a randomised controlled trial of antifungal therapy in paediatric SAFS.