tbuckley/cabot-search huggingface dataset:
Surface Electrocardiographic Characteristics of Right and Left Atrial Flutter
Authors: Andres Bochoeyer, Yanfei Yang, Jie Cheng, Randall J. Lee, Edmund C. Keung, Nassir F. Marrouche, Andrea Natale, Melvin M. Scheinman
Journal: Circulation (2003)

There is little information about the surface expression of non-cavotricuspid isthmus (CTI)-dependent right atrial (RA) or left atrial (LA) flutter circuits.We retrospectively evaluated 32 episodes (in 26 patients) of atypical RA and 22 episodes (in 21 patients) of LA flutter. The surface ECG of 13 patients with lower-loop reentry was similar to that of their pattern during counterclockwise (CCW) CTI atrial flutter (AFL), except for decreased amplitude of the terminal forces in the inferior leads. In 11 of 24 episodes characterized by high or multiple breaks over the crista, the ECG showed changes that depended on the initial activation sequence of the LA. In 7 of 8 episodes of upper-loop reentry, the ECG pattern completely mimicked that for clockwise (CW) CTI AFL. All 11 patients with an LA septal circuit showed a typical ECG pattern characterized by prominent forces in lead V1 with flat deflections in the other surface leads. Eleven patients with other LA circuits had a more variable pattern but showed decreased voltage in the inferior leads compared with that of a group with CCW-CTI AFL (1.6+/-1 vs 2.68+/-0.7 mV, respectively; P<0.05).The RA surface-ECG patterns different from those of CCW or CW-CTI could still be CTI dependent. In contrast, a typical CW-CTI surface pattern was always seen in patients with upper-loop reentry, which was non-CTI dependent. LA AFL circuits had either flat or low-amplitude forces in the inferior leads.
Disparities in Access to Deep Brain Stimulation Surgery for Parkinson Disease
Authors: Andrew K. Chan, Robert A. McGovern, Lauren T. Brown, John P. Sheehy, Brad E. Zacharia, Charles B. Mikell, Samuel S. Bruce, Blair Ford, Guy M. McKhann
Journal: JAMA Neurology (2014)

African American individuals experience barriers to accessing many types of health care in the United States, resulting in substantial health care disparities. To improve health care in this patient population, it is important to recognize and study the potential factors limiting access to care.To examine deep brain stimulation (DBS) use in Parkinson disease (PD) to determine which factors, among a variety of demographic, clinical, and socioeconomic variables, drive DBS use in the United States.We queried the Nationwide Inpatient Sample in combination with neurologist and neurological surgeon countywide density data from the Area Resource File. We used International Classification of Diseases, Ninth Revision codes to identify discharges of patients at multicenter, all-payer, nonfederal hospitals in the United States diagnosed with PD (code 332.0) who were admitted for implantation of intracranial neurostimulator lead(s) (code 02.39), DBS.We analyzed factors predicting DBS use in PD using a hierarchical logistic regression analysis including patient and hospital characteristics. Patient characteristics included age, sex, comorbidity score, race, income quartile of zip code, and insurance type. Hospital characteristics included teaching status, size, regional location, urban vs rural setting, experience with DBS discharges, year, and countywide density of neurologists and neurological surgeons.Query of the Nationwide Inpatient Sample yielded 2,408,302 PD discharges from 2002 to 2009; 18,312 of these discharges were for DBS. Notably, 4.7% of all PD discharges were African American, while only 0.1% of DBS for PD discharges were African American. A number of factors in the hierarchical multivariate analysis predicted DBS use including younger age, male sex, increasing income quartile of patient zip code, large hospitals, teaching hospitals, urban setting, hospitals with higher number of annual discharges for PD, and increased countywide density of neurologists (P < .05). Predictors of nonuse included African American race (P < .001), Medicaid use (P < .001), and increasing comorbidity score (P < .001). Countywide density of neurological surgeons and Hispanic ethnicity were not significant predictors.AND RELEVANCE: Despite the fact that African American patients are more often discharged from hospitals with characteristics predicting DBS use (ie, urban teaching hospitals in areas with a higher than average density of neurologists), these patients received disproportionately fewer DBS procedures compared with their non-African American counterparts. Increased reliance on Medicaid in the African American population may predispose to the DBS use disparity. Various other factors may be responsible, including disparities in access to care, cultural biases or beliefs, and/or socioeconomic status.
Treatment of recurrent hepatitis C in liver transplants: efficacy of a six versus a twelve month course of interferon alfa 2b with ribavirin
Authors: Bruna Lavezzo, Alessandro Franchello, Antonella Smedile, Ezio David, Anna Barbui, Maria Torrani, Antonio Ottobrelli, Fausto Zamboni, Maurizio Fadda, Adriana Bobbio, Mauro Salizzoni, Mario Rizzetto
Journal: Journal of Hepatology (2002)
Abstract 5641: Sunitinib inhibits AXL phosphorylation in tumor cells.
Authors: Johannes C. Van der Mijn, Kristy J. Gotink, Richard R. de Haas, Henk Dekker, Connie R. Jimenez, Henk J. Broxterman, Henk M.w. Verheul
Journal: Cancer Research (2013)

Abstract Background Sunitinib is a multi-targeted tyrosine kinase inhibitor (TKI), that is used for treatment of patients with advanced renal cell cancer (RCC) Drug resistance to sunitinib is a major clinical problem. We recently reported that continuous exposure to sunitinib causes acquired resistance of tumor cells. The receptor tyrosine kinase Axl has been implicated in acquired resistance to multiple TKIs, including erlotinib and lapatinib. In addition, sunitinib was previously reported to be a potential inhibitor of Axl catalytic activity. We therefore investigated the potential role of Axl in sunitinib resistance. Methods 786-O cells resistant to sunitinib were obtained by continuous exposure to the drug as previously published (Gotink et al. Clin Cancer Res 2011). AXL expression was studied in 786-O cell lines and EC-RF24 endothelial cells by RT-PCR and Western blot. Sunitinib and AXL inhibitor R428 sensitivity of cells transfected with siRNAs against AXL or scrambled siRNAs was determined by MTT cell viability assays. For kinase activity experiments recombinant AXL and tyrosine peptide arrays (PamGene, ‘s Hertogenbosch, the Netherlands) were used. Phospho-AXL and total AXL in cell lysates were measured by ELISA. Results Axl phosphorylation in vitro in both 786-O and EC-RF24 cells was dose-dependently inhibited by sunitinib, with a 50% inhibitory concentration of 5 μM. Activity of recombinant Axl kinase was measured on tyrosine containing peptide arrays in presence of 0, 1 or 4 μM sunitinib or 2 μM R428. Sunitinib induced dose-dependent inhibition of Axl activity, where 2 μM R428 blocked all peptide phosphorylations. In addition, 786-O sunitinib resistant cells (786-O SUN) showed a 4-fold overexpression of Axl protein compared to 786-O parental cells. However, gene silencing of AXL in 786-O SUN cells by RNA interference did not sensitize the cells to sunitinib. Sunitinib resistant cells were shown to be cross-resistant to the Axl inhibitor R428 with respective IC50 values of 0.9 μM (±0.1 μM) and 1.8 μM (±0.1 μM). Conclusion Phosphorylation of Axl is inhibited by sunitinib in both 786-O RCC and EC-RF24 endothelial cells. Despite its overexpression in sunitinib resistant cells, gene silencing of AXL did not sensitize 786-O resistant cells to sunitinib, indicating that sunitinib resistance is not mediated by AXL. Citation Format: Johannes C. Van der Mijn, Kristy J. Gotink, Richard R. de Haas, Henk Dekker, Connie R. Jimenez, Henk J. Broxterman, Henk M.w. Verheul. Sunitinib inhibits AXL phosphorylation in tumor cells. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 5641. doi:10.1158/1538-7445.AM2013-5641
Increased urinary dipeptidyl peptidase IV activity in extrahepatic biliary atresia
Authors: György Rákoczi, László Takács, Péter Jakabfi, Ildikó Kunos, Lászió Selmeci, Tibor Gyuris, Miklós Péterfy, Tibor Verebély, Ferenc Perner
Journal: The Lancet (1995)
Prevention of Neonatal Hepatitis B Infection by High-Dose Hepatitis B Immune Globulin
Authors: Harvey Dosik, Ramesh Jhaveri
Journal: New England Journal of Medicine (1978)

NEONATAL infection with hepatitis B is potentially a severe disease1 , 2 and may later cause a large number of adults to be chronically infected with hepatitis B surface antigen HBsAg.3 Retrospective studies indicate that severe or fatal infection in the neonate is due to transmission early in the neonatal period.1 , 2 Two families have been described in which fatal hepatitis B infection developed in successive children.2 , 4 Both mothers were chronic carriers of HBsAg. In a third family fatal neonatal hepatitis B infection developed in four of six children of a chronic carrier.5 We report here a family in which such a fatal . . .
Idealized human mating strategies versus social complexity
Authors: Timothy Perper, Martha Cornog
Journal: Behavioral and Brain Sciences (2000)

Gangestad &amp; Simpson present an idealized model of human mate strategies based on rational economics and genetics that elides most social constraints on human sexuality. They do not deal with observable complexities of courtship nor with ambiguities in short- and long-term mating. The model successfully explicates a narrow set of premises, but cannot yet explain complex sexual behavior.
Statistical limitations in relation to sample size.
Authors: C E Land
Journal: Environmental Health Perspectives (1981)

The statistical difficulties of estimating cancer risks from low doses of a carcinogen are illustrated by examples from radiation carcinogenesis. Although more is known about dose-response relationships for ionizing radiation than for any other environmental carcinogen, estimates of cancer risk from low radiation doses have been extremely controversial; disagreements by factors of 100 or more are not uncommon. Direct estimation, based on data from populations exposed to low doses, is usually impracticable because of sample size requirements. Curve-fitting analyses, by which higher dose data determine lower dose risk estimates, require simple dose-response models if the estimates are to be statistically stable. The current level of knowledge about biological mechanisms of carcinogenesis dose not usually permit the confident assumption of a simple model, however; thus frequently the choice is between unstable risk estimates obtained using general models and statistically stable estimates whose stability depends on arbitrary model assumptions.
Low-Dose Aspirin to Prevent Pregnancy-Induced Hypertensive Disease-Reply
Authors: Thomas F. Imperiale
Journal: JAMA (1991)

In Reply.  —We appreciate the comments by Drs Clemenson and Bisonni regarding the potential cost savings of low-dose aspirin with respect to cesarean section. We agree with their concerns about the need to ascertain the indications for cesarean section and to study the effect of low-dose aspirin in greater numbers of subjects.  The points made by Drs Rosa and Miwa are well stated. We concur with the need to examine the effect of low-dose aspirin in well-characterized patient subgroups. A more accurate and quantitative way of estimating risk is needed and should consider the variables that they mention. Unfortunately, because of the summary-level data contained in published studies, meta-analysis often cannot examine the effect of individual variables on outcome. This limitation may result in the failure to identify subgroups of patients that may respond differently to treatment than the overall results indicate.  A careful reading of our article by Drs
Regional function and perfusion at the lateral border of ischemic myocardium.
Authors: D C Homans, R Asinger, K J Elsperger, D Erlien, E Sublett, F Mikell, R J Bache
Journal: Circulation (1985)

To determine whether function is depressed in areas of myocardium adjacent to an area of myocardial ischemia, 16 open-chest dogs were studied with both two-dimensional echocardiography and ultrasonic microcrystals. Regional myocardial blood flow was measured with radioactive microspheres during control periods and after coronary arterial ligation. Segments of myocardium adjacent to the area of ischemia were found to have no significant change in transmural blood flow (1.02 +/- 0.38 ml/g/min control vs 0.95 +/- 0.3 ml/g/min after ligation) or subendocardial flow (1.18 +/- 0.41 ml/g/min control vs. 1.19 +/- 0.37 ml/g/min after ligation). Regional function assessed echocardiographically as percent change in segment area was significantly depressed in these normally perfused adjacent areas (69.5 +/- 18.8% control vs 52.5 +/- 19.8% after ligation; p less than .01). There was a significant relationship between proximity to border of infarction and degree of adjacent dysfunction (r = .50, p less than .01 for echocardiography; r = .70, p less than .01 for ultrasonic microcrystals). It is concluded that systolic performance is depressed in nonischemic myocardium directly adjacent to the lateral border of an area of acute myocardial ischemia.
IS ACUTE CHOREA AN INFECTIOUS DISEASE?
Authors: ALFRED GORDON
Journal: JAMA (1910)

is the result of stabilizing the casein, for it is a well known fact that casein in curding carries down mechan¬ ically most of the milk fat present,7 yielding a greasy, fully curd which is very difficult for tlie digestive juices to work on.It is evident, then, that, there is something to hesaid on both sides of Ihe nmch-inooled question as to whether fal or casein is responsible for certain forms of indigestion, for apparently both have to do with the formation of the "fat stools."So-called "fat indiges¬ tion" therefore may be, and in many cuses probably is.caused by insufficient colloidal protection of the casein.and may in such cases he met hv adding protective col¬ loids rather than by reducing the percentage ol' fal to an undesirable minimum.Indeed, eases of "fat indiges¬ tion" occur in which the quantity of I'm in the cow's milk fed has been reduced lo 2 per cent.The most conflicting opinions have been expressedregarding Ihe desirable percentages of protein ¡nul fut in cow's milk us modified for infants.Thus Jacobi8 states (hut a high percentage of protein does not improve a milk's digestibility (therein disagreeing with Dr. Walls, of the Northwestern University), and he therefore at¬ tributes the digestibility of asses' milk to its low fat coulent.lint, on the average, mother's milk contains more fat than the less digestible cow's milk; and even if cow's milk he so mollified that it contains the same percentages of "proteid" and fat as mother's milk, it is si ill not so readily digested.Jacobi suggests that a difference in the fat itself is a factor of importance, and this is undoubtedly so, for S. Lévites has shown8 that flic most lluid fais ¡ne most readily digested.The main source of these conflicting opinions, however, lies in ihe rather unhappy term "total proteids," which as u^od.includes substances with such different properties as casein, lactalbumin, gluten, and broth extractives; ¡md thus conceals ihe protective action that the reversible colloids exert on Ihe coagulable casein.Colloidal protection may he accomplished by the use of animal proteins (gelatin, albumin), vegetable proteins (gluten) or carbohydrates (gum arabic, tragacanth, Irish moss), so thai there is wide choice in clinical practice.The de.xt rini/ed gruels now used combine the protective colloids ululen and dextrin.Under the or¬ dinary conditions of digestion, casein is coagulated only in neutral or acid solution; it is quite evident, therefore, that alkalis such as lime water and bicarbonate of soda.may by their antacid action, partially or entirely inhibit the coagulation of casein.Quite dureront, however, is the case of sodium cil rate which acts as a protective col¬ loid, as he fore stated."CONCUSIÓN Increasing the colloidal protection of the casein in cow's milk by the audit ion of suitable protective colloids lends m improve the digestibility and absorption of both the casein and the fat, and lo prevent the formation of indigestible curds and their consequences.
A Comparison of Two Stereotactic Body Radiation Fractionation Schedules for Medically Inoperable Stage I Non-small Cell Lung Cancer: The Cleveland Clinic Experience
Authors: Kevin L. Stephans, Toufik Djemil, Chandana A. Reddy, Stephen M. Gajdos, Matthew Kolar, David Mason, Sudish Murthy, Thomas W. Rice, Peter Mazzone, Michael Machuzak, Tarek Mekhail, Gregory M.M. Videtic
Journal: Journal of Thoracic Oncology (2009)
Randomized Prospective Double-Blind Trial in Healing Chronic Diabetic Foot Ulcers: CT-102 activated platelet supernatant, topical versus placebo
Authors: David L Steed, J Blake Goslen, G Allen Holloway, James M Malone, T J Bunt, Marshall W Webster
Journal: Diabetes Care (1992)

OBJECTIVE To assess the efficacy of topically applied CT-102 APST for treating diabetic neurotrophic foot ulcers. RESEARCH DESIGN AND METHODS Thirteen patients entered a randomized, double-blind trial of topically applied CT-102 APST vs. placebo (normal saline) gauze dressings for the treatment of nonhealing diabetic neurotrophic foot ulcers. CT-102 APST (Curative Technologies, Setauket, NY) was prepared from homologous platelets and contained multiple growth factors including PDGF, PDAF, EGF, PF-4, TGF-β, aFGF, and bFGF. Inclusion criteria for subjects included diabetes, ulcer of &amp;gt; 8 wk duration, peri-wound transcutaneous oxygen tension &amp;gt; 30 mmHg, platelet count &amp;gt; 100,000/mm3, and no wound infection. Wounds were excised before entry and were &amp;gt; 700 mm3 but &amp;lt; 50,000 mm3 in volume, &amp;lt; 100 cm2 in area, and involved subcutaneous tissue. RESULTS In the CT-102 group, 5 of 7 ulcers were healed (100% epithelialized) by 15 wk, but only 1 of 6 ulcers was healed by 20 wk with placebo (P &amp;lt; 0.05). Average percent reduction in ulcer area at 20 wk was 94% for CT-102 vs. 73% for placebo. Daily reduction in ulcer volume was 73.8 ± 42.4 mm3/day (mean ± SE) for CT-102 vs. 21.8 ± 8.1 mm3/day for placebo (P &amp;lt; 0.05). Daily reduction in ulcer area was 6.2 ± 1.8 mm2/day for CT-102 vs. 1.8 ± 0.4 mm2/day for placebo (P &amp;lt; 0.05). CONCLUSIONS CT-102 significantly accelerated wound closure in diabetic leg ulcers when administered as part of a comprehensive program for the healing of chronic ulcers.
Ticagrelor Versus Clopidogrel in Acute Coronary Syndromes in Relation to Renal Function
Authors: Stefan James, Andrzej Budaj, Philip Aylward, Kristen K. Buck, Christopher P. Cannon, Jan H. Cornel, Robert A. Harrington, Jay Horrow, Hugo Katus, Matyas Keltai, Basil S. Lewis, Keyur Parikh, Robert F. Storey, Karolina Szummer, Daniel Wojdyla, Lars Wallentin
Journal: Circulation (2010)

Background— Reduced renal function is associated with a poorer prognosis and increased bleeding risk in patients with acute coronary syndromes and may therefore alter the risk-benefit ratio with antiplatelet therapies. In the Platelet Inhibition and Patient Outcomes (PLATO) trial, ticagrelor compared with clopidogrel reduced the primary composite end point of cardiovascular death, myocardial infarction, and stroke at 12 months but with similar major bleeding rates. Methods and Results— Central laboratory serum creatinine levels were available in 15 202 (81.9%) acute coronary syndrome patients at baseline, and creatinine clearance, estimated by the Cockcroft Gault equation, was calculated. In patients with chronic kidney disease (creatinine clearance &lt;60 mL/min; n=3237), ticagrelor versus clopidogrel significantly reduced the primary end point to 17.3% from 22.0% (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.65 to 0.90) with an absolute risk reduction greater than that of patients with normal renal function (n=11 965): 7.9% versus 8.9% (HR, 0.90; 95% CI, 0.79 to 1.02). In patients with chronic kidney disease, ticagrelor reduced total mortality (10.0% versus 14.0%; HR, 0.72; 95% CI, 0.58 to 0.89). Major bleeding rates, fatal bleedings, and non–coronary bypass–related major bleedings were not significantly different between the 2 randomized groups (15.1% versus 14.3%; HR, 1.07; 95% CI, 0.88 to 1.30; 0.34% versus 0.77%; HR, 0.48; 95% CI, 0.15 to 1.54; and 8.5% versus 7.3%; HR, 1.28; 95% CI, 0.97 to 1.68). The interactions between creatinine clearance and randomized treatment on any of the outcome variables were nonsignificant. Conclusions— In acute coronary syndrome patients with chronic kidney disease, ticagrelor compared with clopidogrel significantly reduces ischemic end points and mortality without a significant increase in major bleeding but with numerically more non–procedure-related bleeding. Clinical Trial Registration— URL:http://www.clinicatrials.gov. Unique identifier: NCT00391872.
Memoirs of a Physician
Authors: Boleslav Lichterman
Journal: BMJ (2007)

“I am but an average practitioner. I am about to describe my sensations on my first acquaintance with medicine, what I expected of it, and how it actually affected me. I will endeavour to set down all , hiding nothing, and I will strive to write with absolute frankness.” These words, written by the 33 year old Russian physician Vikenty Veresaev, introduced his book Zapiski vracha ( Memoirs of a Physician ).

Vikenty Vikentievich Smidovich (Veresaev was his pen name) was born in 1867 in Tula, a provincial city 200 km south of Moscow, into a doctor's family. On qualifying Veresaev worked as a resident doctor in St Petersburg and joined a Marxist literary circle. In 1901 he was fired from his hospital job by order of …
Human Papillomavirus-11 DNA in a Patient with Chronic Laryngotracheobronchial Papillomatosis and Metastatic Squamous-Cell Carcinoma of the Lung
Authors: Janet C. Byrne, Ming-Sound Tsao, Richard S. Fraser, Peter M. Howley
Journal: New England Journal of Medicine (1987)

Medical Intelligence from The New England Journal of Medicine — Human Papillomavirus-11 DNA in a Patient with Chronic Laryngotracheobronchial Papillomatosis and Metastatic Squamous-Cell Carcinoma of the Lung
Polymyalgic presentation of enterovirus infection: a cause of diagnostic confusion.
Authors: R J Stevens, R A Hughes
Journal: Annals of the Rheumatic Diseases (1996)

<h3>Abstract</h3> Energy dissipation through interscapular brown adipose tissue (iBAT) thermogenesis is an important contributor to adaptive energy expenditure. However, it remains unresolved how acute and chronic changes in energy availability are detected by the brain to adjust iBAT activity and maintain energy homeostasis. Here we provide evidence that AGRP inhibitory tone to iBAT represents an energy-sparing circuit that integrates environmental food cues and internal signals of energy availability. We establish a role for the nutrient-sensing mTORC1 signaling pathway within AGRP neurons in the detection of environmental food cues and internal signals of energy availability, and in the bi-directional control of iBAT thermogenesis during nutrient deficiency and excess. Collectively, our findings provide insights into how mTORC1 signaling within AGRP neurons surveys energy availability to engage iBAT thermogenesis, and identify AGRP neurons as a neuronal substrate for the coordination of energy intake and adaptive expenditure under varying physiological and environmental contexts.