tbuckley/cabot-search huggingface dataset:
Mental Health Act
Authors: James Finlayson, Daniel Vincent Riordan
Journal: BMJ (2007)

stent thrombosisAntiplatelets alone won't do the job Gershlick and Richardson say that premature discontinuation of clopidogrel is the greatest risk factor for thrombosis of drug eluting stents. 1 In Iakovou's series thrombosis occurred in five of 17 patients (29%) who prematurely discontinued dual antiplatelet therapy. 2 One of them discontinued only clopidogrel, and the others stopped both antiplatelets (aspirin and clopidogrel or ticlopidine).We do not know whether continuation of aspirin alone would have been adequate to prevent thrombosis associated with drug eluting stents.In only a minority of patients (five out of 29; 17%) did discontinuation of antiplatelets seem to have a role in the occurrence of stent thrombosis.The tragedy of drug eluting stents is not the risk of late stent thrombosis but the fact that these devices have only a limited effect on patients' wellbeing.In several randomised trials they did not lead to a lower mortality and did not affect the incidence of acute myocardial infarction. 3Recently presented meta-analyses and data from registries show that they might increase the occurrence of acute infarctions and even late mortality. 4 5
The Glasgow-Blatchford Bleeding Score identified patients with upper GI bleeding who could be managed as outpatients
Authors: Kris V. Kowdley
Journal: Annals of Internal Medicine (2009)

Source Citation Stanley AJ, Ashley D, Dalton HR, et al. Outpatient management of patients with low-risk upper-gastrointestinal haemorrhage: multicentre validation and prospective evaluation. Lancet. 2009;373:42-7. 19091393
Inhibition of vasculogenesis, but not angiogenesis, prevents the recurrence of glioblastoma after irradiation in mice
Authors: Mitomu Kioi, Hannes Vogel, Geoffrey Schultz, Robert M. Hoffman, Griffith R. Harsh, J. Martin Brown
Journal: Journal of Clinical Investigation (2010)

Despite the high doses of radiation delivered in the treatment of patients with glioblastoma multiforme (GBM), the tumors invariably recur within the irradiation field, resulting in a low cure rate. Understanding the mechanism of such recurrence is therefore important. Here we have shown in an intracranial GBM xenograft model that irradiation induces recruitment of bone marrow-derived cells (BMDCs) into the tumors, restoring the radiation-damaged vasculature by vasculogenesis and thereby allowing the growth of surviving tumor cells. BMDC influx was initiated by induction of HIF-1 in the irradiated tumors, and blocking this influx prevented tumor recurrence. Previous studies have indicated that BMDCs are recruited to tumors in part through the interaction between the HIF-1-dependent stromal cell-derived factor-1 (SDF-1) and its receptor, CXCR4. Pharmacologic inhibition of HIF-1 or of the SDF-1/CXCR4 interaction prevented the influx of BMDCs, primarily CD11b+ myelomonocytes, and the postirradiation development of functional tumor vasculature, resulting in abrogation of tumor regrowth. Similar results were found using neutralizing antibodies against CXCR4. Our data therefore suggest a novel approach for the treatment of GBM: in addition to radiotherapy, the vasculogenesis pathway needs to be blocked, and this can be accomplished using the clinically approved drug AMD3100, a small molecule inhibitor of SDF-1/CXCR4 interactions.
Relation of the Internal Medicine Residency and the Medical School Curriculum
Authors: Daniel D. Federman
Journal: Annals of Internal Medicine (1992)

Students should have contact with faculty members in internal medicine throughout their medical education. Faculty internists should play a role in admission of students, in the basic science courses of the first year of medical school, and in the introductory course to clinical medicine and pathophysiology of the second year of medical school. The core medical clerkship is not an academic advertisement and should not be designed specifically to attract students to internal medicine. The core clerkship is designed for all students, regardless of their intended specialty and should include inpatient and outpatient care in a context and at a pace that allow time for reflection, reading, and problem solving. The advanced medicine experience should give students at least a glimpse of the mastery of the discipline of internal medicine. For students entering internal medicine, the fourth year of medical school and first year of residency could be combined to improve the content and quality of both.
Hyperlipoproteinemia— A Difference of Opinion
Authors: Stanley Schor
Journal: JAMA (1968)

<h3>To the Editor:—</h3> Reading the lead article "Response of Hyperlipoproteinemia to Cholestyramine Resin" by Fallon and Woods (<b>204</b>:1161, 1968) combined with participation on various drug committees compels me to take microphone in hand and dictate a response. This manuscript is an excellent example for elementary biostatistics courses to show beginning students how one can take a set of data which shows practically no drug effect and leave the unsuspecting reader with the implication that the drug was effective. In any study aimed at determining the efficacy of a drug on people with hyperlipoproteinemia the target population (the group of people about which conclusions are to be drawn) should be all<i>people</i>with hyperlipoproteinemia. A random sample is then selected and statistical tests may be used to draw inferences about all hyperlipoproteinemia cases on the basis of those observed in the sample. Thus, if one wishes to know whether there
Gleanings From AMA Specialty Journals
Authors: Hugh H. Hussey
Journal: JAMA (1974)

Almost every issue of the Association's ten specialty journals contains articles of general interest to physicians and often to the public. The January issue of<i>Archives of Dermatology</i>proved to be no exception. Coskey and Mehregan<sup>1</sup>described the development of painful, tender, bluish-red nodules on one foot (each) of three girls aged 6, 10, and 7 years, respectively. The history was identical in the three patients. All had been wearing shoe-boots (boots with a waterproof outer covering and insulated inner lining) during cold weather. In two instances, the children had been playing in the snow when the inner linings of their boots became wet, and the third child had fallen into a pond. The wetness of the boots' inner lining could not evaporate because of the waterproof cover. Within about 24 hours, the tender nodules appeared and persisted for one to two weeks. Microscopical examination of biopsy specimens and
Longitudinal study of obesity in the National Survey of Health and Development.
Authors: O Stark, E Atkins, O H Wolff, J W Douglas
Journal: BMJ (1981)

In a nationally representative cohort of 5362 children born in one week in March 1946 weights and heights were recorded at 6, 7, 11, 14, 20, and 26 years. Overweight was defined as a weight that exceeded the standard weight for height, age, and sex by more than 20% (relative weight greater than 120%). The prevalence of overweight was 1.7% and 2.9% in boys and girls respectively at 6 years; 2.0% and 3.8% at 7 years; 6.4% and 9.6% at 11 years; 6.5% and 9.6% at 14 years; 5.4% and 6.5% at 20 years; and 12.3% and 11.2% at 26 years. The risk of being overweight in adulthood was related to the degree of overweight in childhood and was about four in 10 for overweight 7-year-olds. Analysis of the data in the reverse direction showed that 7% and 13% respectively of 26-year-old overweight men and women had been overweight at the age of 7. These results suggest that there is no optimal age during childhood for the prediction of overweight in adult life and that excessive weight gain may begin at any time. Overweight children are more likely to remain overweight than their contemporaries of normal weight are to become overweight.
Induction of bronchial hypersensitivity: evidence for a role for prostaglandins.
Authors: E H Walters, R W Parrish, C Bevan, A P Smith
Journal: Thorax (1981)

Bronchial hyper-responsiveness is a particular feature of asthma, but also occurs in normal subjects after a viral upper respiratory tract infection or ozone inhalation. Such stimuli would be expected to result in the release of chemical mediators of inflammation. In this study, the effects of one of these, prostaglandin F2 alpha (PGF2 alpha), on the response of normal subjects to inhaled histamine has been investigated. Nine normal volunteers took 10 inhalations of increasing concentrations of PGF2 alpha at 15-minute intervals from a Wright9s nebuliser under standard conditions until a change in sGaw could be detected. The next lowest serial dilution of PGF2 alpha was subsequently inhaled by each subject every 15 min for 90 min to ensure the absence of a cumulative effect. Inhalation dose-response curves to histamine diphosphate were constructed on two separate occasions using the same standardised technique. Doses were administered every 15 min and sGaw determined five minutes after each. On one occasion each dose of histamine was immediately preceded by the non-active test dose of PGF2 alpha and on the second by saline as placebo. The study was performed double-blind and in random order. After pretreatment with PGF2 alpha the histamine dose-response curve was significantly shifted to the left in a parallel fashion (p less than 0.001). There was a significant decrease in the doses of histamine required to cause a 20% fall in sGaw (p less than 0.0015) but no significant change in the slopes of the dose-response regression lines, indicating that bronchial muscle sensitivity rather than reactivity had been predominantly affected.
Abstract 2466: Tobacco carcinogen-enhanced lung tumorigenesis in Gprc5a knockout mice recapitulates human lung cancer development
Authors: Junya Fujimoto, Humam N. Kadara, Qingguo Tao, Taoyan Men, Carolyn van Pelt, Dafna Lotan, Reuben Lotan
Journal: Cancer Research (2010)

Abstract Lung carcinogenesis occurs through a multi-step process, which involves the activation or over-expression of oncogenes and the inactivation or silencing of tumor-suppressor genes. Mouse models for human lung cancer have proven to be valuable tools for understanding the basic tumor biology as well as for the development and validation of new approaches to cancer prevention and therapy. Previously, we found that mice with a knockout (KO) of G-protein coupled receptor 5A (Gprc5a) develop lung tumors after a long latent period (12 to 24 months). To determine whether a tobacco carcinogen will enhance tumorigenesis in this model, we administered 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) i.p. to 2-months old Gprc5a-KO mice and sacrificed groups (n=5) of mice at 6, 9, 12, and 18 months later. Compared to control Gprc5a-KO mice, NNK-treated mice developed lung tumors at least 6 months earlier, exhibited 2- to 4-fold increased tumor incidence and multiplicity, and showed a dramatic increase in lesion size. A signature of differentially expressed genes derived by transcriptome analysis of epithelial cell lines from normal lungs of Gprc5a-KO mice and from NNK-induced adenocarcinoma was highly similar to differential expression patterns observed between normal and tumorigenic human lung cells. The signature also separated both mouse and human adenocarcinomas from normal lung tissues based on publicly available microarray datasets. A key feature of the signature, up-regulation of UBE2C, MCM2, and FEN-1, was validated in mouse normal lung and adenocarcinoma tissues and cells by immunohistochemistry and western blotting, respectively. Our findings support the following conclusions: 1) lung tumorigenesis in the Gprc5a-KO mouse model is augmented by NNK, 2) gene expression changes induced by tobacco carcinogen(s) are conserved between mouse and human lung epithelial cells, 3) the Gprc5a-KO mouse model recapitulates human lung adenocarcinoma. Thus, the Gprc5a-KO mouse model could be useful for cancer chemoprevention studies. Supported by the Samueal Waxman Cancer Research Foundation and the NCI Cancer Center Core Grant P30-CA16672. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2466.
Genetic linkage of type VII collagen (COL7A1) to dominant dystrophic epidermolysis bullosa in families with abnormal anchoring fibrils.
Authors: M Ryynänen, J Ryynänen, S Sollberg, R V Iozzo, R G Knowlton, J Uitto
Journal: Journal of Clinical Investigation (1992)

Epidermolysis bullosa (EB) in a group of genodermatoses characterized by the fragility of skin. Previous studies on the dystrophic (scarring) forms of EB have suggested abnormalities in anchoring fibrils, morphologically recognizable attachment structures that provide stability to the association of the cutaneous basement membrane to the underlying dermis. Since type VII collagen is the major component of the anchoring fibrils, we examined the genetic linkage of dominant dystrophic EB (EBDD) and the type VII collagen gene (COL7A1) locus, which we have recently mapped to chromosome 3p, in three large kindreds with abnormal anchoring fibrils. Strong genetic linkage of EBDD and COL7A1 loci was demonstrated with the maximum logarithm of odds (LOD) score of 8.77 at theta = 0. This linkage was further confirmed with two additional markers in this region of the short arm of chromosome 3, and these analyses allowed further refinement of the map locus of COL7A1. Since there were no recombinants between the COL7A1 and EBDD loci, our findings suggest that type VII collagen is the candidate gene that may harbor the mutations responsible for the EB phenotype in these three families.
The effect of coronary angioplasty on coronary flow reserve.
Authors: R F Wilson, M R Johnson, M L Marcus, P E Aylward, D J Skorton, S Collins, C W White
Journal: Circulation (1988)

To determine the effects of coronary angioplasty on coronary flow reserve (CFR), we studied 32 patients before and immediately after single-vessel coronary angioplasty and 31 patients evaluated late after angioplasty (7.5 +/- 1.2 months, mean +/- SEM). The geometry (percent area stenosis and minimal cross-sectional area) of each lesion was determined by quantitative coronary angiography (Brown/Dodge method) and the integrated optical density was measured by videodensitometry. CFR was measured with a No. 3F coronary Doppler catheter placed immediately proximal to the lesion and a maximally vasodilating dose of intracoronary papaverine. The translesional pressure gradient was obtained in all lesions before and immediately after angioplasty and in 18 of 31 vessels late after angioplasty. CFR immediately after angioplasty returned to normal levels (greater than 3.5 peak/resting velocity ratio) in 14 of 31 patients and was improved, although not normalized, in the remaining 17 patients. CFR immediately after dilation was not significantly correlated with any of the angiographic variables of arterial stenosis nor the resting pressure gradient. Moreover, the pressure gradient and absolute distal coronary pressure at peak hyperemia were not significantly different in vessels with normal and those with abnormal flow reserve immediately after dilation, suggesting that the residual stenosis did not significantly limit hyperemia. Late after angioplasty, however, a significant relationship emerged between CFR and all four indexes of residual arterial stenosis (percent area stenosis r = .70, p less than .01; minimum arterial cross-sectional area r = .70, p less than .01; integrated optical density r = .60, p less than .01; and translesional pressure gradient r = .77, p less than .01). Furthermore, in the absence of restenosis, CFR eventually normalized in all patients. These findings demonstrate that in one-half of patients there is a transient reduction in coronary flow reserve immediately after angioplasty. In the absence of restenosis, coronary flow reserve later normalizes. Consequently, measurements of coronary flow reserve immediately after angioplasty may not reflect the eventual success of the procedure in removing physiologic obstruction to coronary blood flow.
Australian medical journal says no to drug industry advertising
Authors: M. Sweet
Journal: BMJ (2011)

A medical journal’s decision to stop accepting pharmaceutical advertisements has prompted calls for journal publishers to break their links with the drug industry.

An editorial in the latest Emergency Medicine Australasia (doi:10.1111/j.1742-6723.2010.01393) says that the journal’s move is a response to growing evidence about the detrimental effects of the drug industry in medicine, including claims that the industry distorts research findings and engages in dubious and unethical publishing practices.

George Jelinek, a former editor of the journal, and Anthony Brown, editor in chief, wrote, “Marketing of drugs by the pharmaceutical industry, whose prime aim is to bias readers towards prescribing a particular product, is fundamentally at odds with the mission of medical journals.”

The editorial says that …
LEFT VENTRICULAR DILATION DECREASES THE CONVECTIVE COMPONENT OF THE EARLY DIASTOLIC INTRAVENTRICULAR PRESSURE
Authors: Takahiro Ohara, Cassie L. Niebel, Kelley C. Stewart, Rahul Kumar, John J. Charonko, Min Pu, Pavlos P. Vlachos, William C. Little
Journal: Journal of the American College of Cardiology (2011)
Electrocardiographic Recognition of the Epicardial Origin of Ventricular Tachycardias
Authors: Antonio Berruezo, Lluis Mont, Santiago Nava, Enrique Chueca, Eduardo Bartholomay, Josep Brugada
Journal: Circulation (2004)

Some ventricular tachycardias (VTs) originating from the epicardium are not suitable for endocardial radiofrequency ablation and require an epicardial approach. The aim of this study was to define the ECG characteristics that may identify an epicardial origin of VTs.We analyzed the 12-lead ECG recordings during epicardial and endocardial left ventricular pacing in 9 patients to verify the hypothesis that the epicardial origin of the ventricular activation widens the initial part of the QRS complex. Then, we analyzed the ECG pattern in 14 VTs successfully ablated from the epicardium after a failed endocardial approach (group A), in 27 VTs successfully ablated from the endocardium (group B), and in 28 additional VTs that could not be ablated from the endocardium (group C). Four distinct intervals of ventricular activation were defined and measured: (1) the pseudodelta wave, (2) the intrinsicoid deflection time in V2, (3) the shortest RS complex, and (4) the QRS complex. VTs from groups A and C showed a significantly longer pseudodelta wave, intrinsicoid deflection time, and RS complex duration compared with VTs of group B. There was no difference between groups A and C. A pseudodelta wave of > or =34 ms has a sensitivity of 83% and a specificity of 95%, an intrinsicoid deflection time of > or =85 ms has a sensitivity of 87% and a specificity of 90%, and an RS complex duration of > or =121 ms has a sensitivity of 76% and a specificity of 85% in identifying an epicardial origin of the VTs.ECG suggests VTs originating from the epicardium and those with an unsuccessful radiofrequency ablation from the endocardium.
Evolving concepts of chemical sensitivity.
Authors: R C MacPhail
Journal: Environmental Health Perspectives (1997)

Chemical sensitivity appears to be an elusive phenomenon. Studies on individual differences in susceptibility may provide glimpses into the range of sensitivity in a population, which can be used for further study. Preliminary evidence in laboratory animals suggests the range of sensitivity to manufactured chemicals may span orders of magnitude. Determining the reasons that underlie individual differences in sensitivity is a more difficult enterprise. Conditioning of adverse physiological effects of airborne chemicals may play a vital role in the etiology of chemical sensitivity, and it provides a rigorous laboratory model by which to investigate some aspects of this elusive phenomenon.
Endoscopic ultrasound-guided fine needle aspiration in cystic pancreatic lesions: is it still controversial?
Authors: Y. Ustundag, O. Tarcin
Journal: Endoscopy (2011)

We read with great interest the article by K. de Jong et al. entitled “Endoscopic ultrasound-guided fine-needle aspiration of pancreatic cystic lesions provides inadequate material for cytology and laboratory analysis: initial results from a prospective study” [1]. The authors performed endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) in 128 patients with pancreatic cystic lesions of varying sizes. The authors reported a very low technical success rate for FNA in their consecutive patients because adequate cellular material and sufficient fluid for biochemical analysis were obtained in only 44 out of 128 patients (34 %) and 68 out of 128 (53 %) respectively. They reported no significant difference between the sizes of the cysts in cases with or without a classifying diagnosis, or between cases from which sufficient fluid for biochemical analysis was or was not obtained. Nevertheless, they indicated that EUS-FNA was a safe technique that could be performed with a very low complication rate (2.4 %).
Demonstration of a pH gradient across the mucus layer on the surface of human gastric mucosa in vitro.
Authors: H M Bahari, I N Ross, L A Turnberg
Journal: Gut (1982)

In previous studies we have demonstrated a hydrogen ion concentration gradient across the mucus on rat and rabbit fundic mucosa, in vivo and in vitro respectively, observations which support the possibility of a 'mucus-bicarbonate' protective barrier. In the present studies we have demonstrated a similar gradient across the mucus on human gastric mucosa in vitro. The minimum mean hydrogen ion concentration at the mucus-epithelium interface was 1 . 1 X 10(-4) mM (pH 6 . 96, n = 10) when the luminal concentration was 5 . 6 mM (pH 2 . 25). Aspirin (10 mM) and N-acetyl cysteine (306 mM) (5%) increased the minimum intra-mucus hydrogen ion concentration and the gradient was overwhelmed by a luminal hydrogen ion concentration of 40 mM (pH 1 . 4). These results suggest that a hydrogen ion concentration gradient exists across the mucus on human gastric mucosa and that potential damaging agents may act by compromising one or other of th components of this 'mucus-alkaline', presumed 'mucus-bicarbonate', barrier.
The Intestinal Cell Surface: Some Properties of Normal, Undifferentiated, and Malignant Cells
Authors: KURT J. ISSELBACHER
Journal: Annals of Internal Medicine (1974)

The isolation of the microvillus and basolateral portions of the intestinal cell has made possible a better understanding of the structure and function of these surface components. The microvillus membranes contain both hydrolytic (for example, disaccharidases, dipeptidases) and synthetic enzymes (such as glycosyltransferases) and possess the carrier proteins involved in sugar and amino acid transport. Membrane vesicles have been used to show the presence of such carriers in the membrane. Most of the adenylate cyclase activity appears to be in the basolateral rather than microvillus membranes. In contrast with villus cells, the undifferentiated, mitotically active crypt cells are not active in transport and have glycoproteins on their cell surface that are incomplete. Furthermore, the surface membranes of crypt cells also have a high activity of the enzyme galactosyltransferase and are agglutinated by the plant lectin, concanavalin A. These surface properties of crypt cells are strikingly similar to fetal and malignant cells.