tbuckley/cabot-search huggingface dataset:
PQ Segment Depression in Acute Q Wave Inferior Wall Myocardial Infarction
Authors: Yo Nagahama, Tetsuro Sugiura, Kazuya Takehana, Noritaka Tarumi, Toshiji Iwasaka, Mitsuo Inada
Journal: Circulation (1995)

Background PQ segment deviation is almost as characteristic as the classic ST segment deviation and is detected in most patients with pericarditis. However, as infarction-associated pericarditis remains over the infarct zone, PQ segment depression is observed much less often in patients with acute myocardial infarction. Methods and Results We designed this study to examine the clinical significance of PQ segment depression in acute Q wave inferior myocardial infarction. We examined 171 consecutive patients with acute Q wave inferior myocardial infarction by means of auscultation, ECG, and two-dimensional echocardiography. The diagnosis of pericarditis was made on the basis of pericardial rub detected by more than two observers during the first 3 days after admission. At least 0.5 mm of PQ segment depression from the TP segment lasting more than 24 hours in both limb and precordial leads was considered diagnostic of PQ segment depression. Conclusions PQ segment depression was present in 14 patients and absent in 157 patients. Eleven patients with and 55 patients without PQ segment depression had advanced asynergy (akinesis or dyskinesis) in the posterior segments, whereas 9 patients with and 20 patients without PQ segment depression had pericardial rub. When multivariate analysis was performed to determine the important variables related to the occurrence of PQ segment depression, pericardial rub was selected with advanced asynergy of the posterior segment as significant factors related to PQ segment depression. Major complications (ventricular fibrillation, sustained ventricular tachycardia, cardiogenic shock, need for pacing) were present in 63 patients; 9 with (64%) and 54 without (34%) PQ segment depression. PQ segment depression was one of the clinical signs of more extensive damage extending to the posterior segments and increased incidence of major complications.
Disseminated Gonococcal Infection and Tenosynovitis from an Asymptomatically Infected Intrauterine Contraceptive Device
Authors: Michael J. Colin, Gerald Weissmann
Journal: New England Journal of Medicine (1976)

Disseminated gonococcal infection has been increasingly recognized as a cause of acute septic arthritis and tenosynovitis.1 2 3 4 However, despite recent improvements in culture technics, which have allowed more frequent isolation of Neisseria gonorrhoeae, suspected cases remain undiagnosed. In the following case an intrauterine contraceptive device, previously unrecognized as a source of asymptomatic infection, produced disseminated gonococcal infection.Case ReportIn a 36-year-old nurse fever (temperature of 39.8°C) and chills developed, followed by severe pain, swelling and redness in the left hand, with restricted extension of her third, fourth, and fifth fingers. After the onset of a skin rash, accompanied by . . .
Studies to Compare Treatment Regimens: The Randomized Clinical Trial and Alternative Strategies
Authors: Susan S. Ellenberg
Journal: JAMA (1981)

The randomized clinical trial (RCT) has become generally accepted as the most valid study mechanism for assessment of therapeutic regimens. Because random allocation of treatment guards against any systematic association of treatment assignment with prognosis, differences in outcome that are observed among treatment groups in an RCT will tend to result from treatment effects and not from inherent differences among the groups. Studies in which treatment allocation is by design associated with patient characteristics—eg, where treatment is selected individually for each patient, or according to the clinic to which the patient comes, or according to the time period in which the patient is treated—are vulnerable to selection bias. This bias is incurred whenever patients with differing prognoses have differing probabilities of receiving the treatments to be compared. In an article in this issue (p 2455), Horwitz and Feinstein explore the potential usefulness of another approach to the evaluation of therapeutic
New once a day, fixed dose antimalarial is now available for adults and children
Authors: Anne Griffin
Journal: BMJ (2007)

Cyclo-oxygenase-2 (COX 2) inhibitors should be used only as the last choice after other types of non-steroidal anti-inflammatory drugs (NSAIDs) to relieve chronic pain in people with heart disease or at high risk of it, the American Heart Association has recommended.Its statement, published online in Circulation on 26 February (http://circ.ahajournals.orgdoi:10.1161/circulationaha.106.181424), was designed to end any remaining confusion about the cardiovascular risk of these agents.The association has recommended a stepped approach to treatment.The first step should be non-pharmacological approaches, such as physical therapy and weight loss, for patients with known cardiovascular disease or with risk factors for ischaemic heart disease.Drug treatment should start with agents with the lowest reported risk of cardiovascular events, before other agents are prescribed, and at each step account should be taken of the risk-benefit balance.First line drug choices include paracetamol (acetaminophen), aspirin, tramadol, and short term use of other narcotic analgesics.If these fail to achieve adequate pain control, the next option is non-acetylated salicylates, such as naproxen.The association recommended NSAIDs that aren't COX 2 inhibitors if pain is still inadequately controlled, then NSAIDs with some COX 2 activity as the next step, and lastly COX 2 selective NSAIDs.The committee considered the risk of all three of these classes to be sufficiently high to require that patients taking them should be monitored regularly for sustained hypertension (or worsening of prior blood pressure control), oedema, worsening renal function, or gastrointestinal bleeding.See pp 436, 450. Save COX 2 inhibitors till last for cardiac patientsUK NEWS HFEA allows women to donate eggs for research, p445 World NEWS repeal law that puts "FdA on the payroll of the industry", p447 bmj.comUK government defeated on community treatment forms
Oral Direct Factor Xa Inhibitors Versus Low-Molecular-Weight Heparin to Prevent Venous Thromboembolism in Patients Undergoing Total Hip or Knee Replacement
Authors: Ignacio Neumann, Gabriel Rada, Juan Carlos Claro, Alonso Carrasco-Labra, Kristian Thorlund, Elie A. Akl, Shannon M. Bates, Gordon H. Guyatt
Journal: Annals of Internal Medicine (2012)

Background: Thromboembolic disease is the most frequent medical complication of arthroplasty. Purpose: To evaluate the benefits and harms of oral direct factor Xa inhibitors versus low-molecular-weight heparin (LMWH) in patients undergoing total hip or knee replacement. Data Sources: MEDLINE (1966 to December 2011), EMBASE (1980 to December 2011), and the Cochrane Central Register of Controlled Trials (up to December 2011), without language restrictions. References of reviews and abstracts of conferences were hand-searched. Study Selection: Randomized trials in patients undergoing hip or knee replacement that evaluated factor Xa inhibitors versus LMWH. Data Extraction: Two reviewers independently evaluated eligibility, abstracted the data, and assessed risk for bias. Data Synthesis: In 22 trials, high-quality evidence indicated that the absolute effect of factor Xa inhibitors and LMWH does not differ in terms of all-cause mortality (risk difference, 0 fewer deaths per 1000 patients [95% CI, 2 fewer to 1 more death]) or nonfatal pulmonary embolism (risk difference, 0 fewer events per 1000 patients [CI, 1 fewer to 2 more events]). Factor Xa inhibitors can prevent 4 instances of symptomatic deep venous thrombosis per 1000 treated patients (CI, 3 to 6 fewer events; high-quality evidence) but may increase major bleeding by 2 more events per 1000 patients (CI, 0 to 4 more events; moderate-quality evidence). High, but not lower, doses of oral factor Xa inhibitors increased bleeding compared with LMWH. Limitations: Most trials did not report outcome data for a substantial proportion of the patients. In 9 trials, the follow-up period was 14 days or less. Conclusion: Compared with LMWH, lower doses of oral factor Xa inhibitors can achieve a small absolute risk reduction in symptomatic deep venous thrombosis without increasing bleeding. Primary Funding Source: None.
Experimentally Increasing Titin Compliance in a Novel Mouse Model Attenuates the Frank-Starling Mechanism But Has a Beneficial Effect on Diastole
Authors: Mei Methawasin, Kirk R. Hutchinson, Eun-Jeong Lee, John E. Smith, Chandra Saripalli, Carlos G. Hidalgo, Coen A.C. Ottenheijm, Henk Granzier
Journal: Circulation (2014)

Experimentally upregulating compliant titins has been suggested as a therapeutic for lowering pathological diastolic stiffness levels. However, how increasing titin compliance impacts global cardiac function requires in-depth study. We investigate the effect of upregulating compliant titins in a novel mouse model with a genetically altered titin splicing factor; integrative approaches were used from intact cardiomyocyte mechanics to pressure-volume analysis and Doppler echocardiography.Compliant titins were upregulated through deletion of the RNA Recognition Motif of the splicing factor RBM20 (Rbm20(ΔRRM)mice). A genome-wide exon expression analysis and a candidate approach revealed that the phenotype is likely to be dominated by greatly increased lengths of titin's spring elements. At both cardiomyocyte and left ventricular chamber levels, diastolic stiffness was reduced in heterozygous (+/-) Rbm20(ΔRRM)mice with a further reduction in homozygous (-/-) mice at only the intact myocyte level. Fibrosis was present in only -/- Rbm20(ΔRRM) hearts. The Frank-Starling Mechanism was reduced in a graded fashion in Rbm20(ΔRRM) mice, at both the cardiomyocyte and left ventricular chamber levels. Exercise tests revealed an increase in exercise capacity in +/- mice.Titin is not only important in diastolic but also in systolic cardiac function. Upregulating compliant titins reduces diastolic chamber stiffness owing to the increased compliance of myocytes, but it depresses end-systolic elastance; under conditions of exercise, the beneficial effects on diastolic function dominate. Therapeutic manipulation of the RBM20-based splicing system might be able to minimize effects on fibrosis and systolic function while improving the diastolic function in patients with heart failure.
Violence and Health Care Professionals
Authors: H Mutch
Journal: BMJ (1994)

Ed Til Wykes Chapman and Hall, £14.99, pp 265 ISBN 0-412-46170-6

Being threatened recently by a patient concentrated my mind on the risks run by people working with the public. Reports of violence towards doctors and their staff regularly feature in the weekly medical papers. Most of us have heard stories of attacks on colleagues, and many general practitioners now fear for their safety on night visits. Several surveys published in the past few years suggest that violence and aggression are a common problem …
The Exception that Reinforces the Rule: Crosspriming by Cytosolic Peptides that Escape Degradation
Authors: Avital Lev, Kazuyo Takeda, Damien Zanker, Jason C. Maynard, Peniel Dimberu, Elizabeth Waffarn, James Gibbs, Nir Netzer, Michael F. Princiotta, Len Neckers, Didier Picard, Christopher V. Nicchitta, Weisan Chen, Yoram Reiter, Jack R. Bennink, Jonathan W. Yewdell
Journal: Immunity (2008)
Effectiveness of a once weekly double dose of etanercept in patients with juvenile idiopathic arthritis: a clinical study
Authors: F. H M Prince, M. Twilt, N. C J A Jansen-Wijngaarden, L. W A van Suijlekom-Smit
Journal: Annals of the Rheumatic Diseases (2007)

Etanercept is effective in juvenile idiopathic arthritis (JIA).1–3 Currently it is administered subcutaneously at a dose of 0.4 mg/kg (maximum of 25 mg) twice a week. Clinical trials in adults show that administration of a double dose once a week is effective enough to induce and retain remission.4,5 A pharmacokinetic model developed by Yim et al 6 indicates that the same dosing regimen could be used in children. Wallace7 mentions the once weekly double dose in patients with JIA, but this is not supported by clinical trials. Therefore we evaluated the efficacy of etanercept administered subcutaneously once a week at a dose of …
Behavioral Factors and Urinary Tract Infection
Authors: Kiku Adatto
Journal: JAMA (1979)

Voiding and sexual habits of 84 female university students with a history of recurrent urinary infection were compared with those of a control group. There was one highly significant difference between the two groups: 61% of the patients but only 11% of the controls gave a history of regular voluntary deferral of micturition for periods of one hour to longer than six hours. Sexual practices among patients and controls were remarkably similar. A behavioral regimen stressing regular, complete bladder emptying was shown to be effective in preventing reinfection in the patient group. Voluntary urinary retention may play a pathogenic role in women with recurrent urinary tract infection, and its correction may play an important part in the management of urinary tract infection. (<i>JAMA</i>241:2525-2526, 1979)
Abstract 883: Cell-based selection of RNA-aptamers to specifically target glioblastoma cancer stem cells
Authors: Cristina Quintavalle, Lucia Ricci-Vitiani, Carla Lucia Esposito, Simona Di Martino, Laura Cerchia, Ruggero De Maria, Vittorio de Franciscis, Gerolama Condorelli
Journal: Cancer Research (2012)

Abstract Stem cells are a group of cells, which have two important fundamental properties: self-renewal and multipotency. Stem cells have been identified also in many human cancers on the basis of being both morphologically and functionally distinct from other cells within the heterogeneous tumor mass. According to “cancer stem cell hypothesis,” the cancer stem cells (CSC) would remain unaffected by conventional therapies, and capable of repopulating the tumor and giving rise to cancer recurrence. The possibility to identify highly selective biomarkers on CSC would greatly improve cancer diagnosis and treatment. Recently, nucleic acid-based aptamers have proven useful as reagents for identifying cell surface proteins and for cell typing. Further, their high specificity and low toxicity render them a valid alternative to antibodies for in vivo cell recognition. We have developed the SELEX technology on intact glioblastoma cancer stem cells to generate aptamers as biologically active high affinity ligands for CSC-specific cell surface proteins. The approach has been applied by utilizing glioblastoma differentiated tumor cells as a negative selection, and cancer stem cells obtained from two different patients, as positive selection. Upon 16 cycles of SELEX, we generated a set of 2′-fluoro-pyrimidines containing RNA aptamers that, based on sequence analysis, have been grouped into 5 main families. Best aptamers have been then selected by binding experiments for their ability to distinguish glioblastoma CSC from differentiated tumor cells. We thus determined the binding affinity of each molecule to the cell surface specific targets. Functional experiments will be as well presented to further insight the biological role of the most promising aptamer molecules in the acquisition and maintenance of stem cells properties of glioma cancer cells. Results demonstrate the possibility to generate RNA-based aptamers as potential innovative tools for the selective targeting of cancer stem cells. A proteomic approach will define the specific membrane targets of the selected aptamers 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 883. doi:1538-7445.AM2012-883
Poor checks for bedside blood transfusion put patients at risk
Authors: Robert Short
Journal: BMJ (2006)

Patients having blood transfusion at the bedside continue to be put at risk of getting the wrong blood or of delayed management of adverse reactions, through misidentification and lack of observation.

These were the conclusions from an audit of 8054 transfusion episodes from 217 UK hospitals, carried out by the Royal College of Physicians and the National Blood Service.

This 2005 audit was designed to assess good practice in identifying patients before bedside blood transfusions and to check on progress in reducing risk to patients since the first audit …
Effect of Orlistat on Weight and Body Composition in Obese Adolescents
Authors: Jean-Pierre Chanoine, Sarah Hampl, Craig Jensen, Mark Boldrin, Jonathan Hauptman
Journal: JAMA (2005)

ContextThe prevalence of overweight and obesity in children and adolescents is increasing rapidly. In this population, behavioral therapy alone has had limited success in providing meaningful, sustained weight reduction, and pharmacological treatment has not been extensively studied.ObjectiveTo determine the efficacy and safety of orlistat in weight management of adolescents.Design, Setting, and PatientsMulticenter, 54-week (August 2000-October 2002), randomized, double-blind study of 539 obese adolescents (aged 12-16 years; body mass index [BMI] ≥2 units above the 95th percentile) at 32 centers in the United States and Canada.InterventionsA 120-mg dose of orlistat (n = 357) or placebo (n = 182) 3 times daily for 1 year, plus a mildly hypocaloric diet (30% fat calories), exercise, and behavioral therapy.Main Outcome MeasuresChange in BMI; secondary measures included changes in waist and hip circumference, weight loss, lipid measurements, and glucose and insulin responses to oral glucose challenge.ResultsThere was a decrease in BMI in both treatment groups up to week 12, thereafter stabilizing with orlistat but increasing beyond baseline with placebo. At the end of the study, BMI had decreased by 0.55 with orlistat but increased by 0.31 with placebo (P = .001). Compared with 15.7% of the placebo group, 26.5% of participants taking orlistat had a 5% or higher decrease in BMI (P = .005); 4.5% and 13.3%, respectively, had a 10% or higher decrease in BMI (P = .002). At study end, weight had increased 0.53 kg with orlistat and 3.14 kg with placebo (P&lt;.001). Dual-energy x-ray absorptiometry showed that this difference was explained by changes in fat mass. Waist circumference decreased in the orlistat group but increased in the placebo group (–1.33 cm vs +0.12 cm; P&lt;.05). Generally mild to moderate gastrointestinal tract adverse events occurred in 9% to 50% of the orlistat group and in 1% to 13% of the placebo group.ConclusionsIn combination with diet, exercise, and behavioral modification, orlistat statistically significantly improved weight management in obese adolescents compared with placebo. The use of orlistat for 1 year in this adolescent population did not raise major safety issues although gastrointestinal adverse events were more common in the orlistat group.
Typhoid Fever Treatment.
Authors: F. Grover
Journal: JAMA (1896)

Fraser, Mich., Feb. 4, 1896. <h3>To the Editor:</h3> —Many of the conflicting reports of Woodbridge's treatment of typhoid fever would give results similar to those obtained by Dr. Woodbridge if they would use capsules instead of tablets. Take a bottle of tablets that has been carried in your rig some time, use your tablets all out; what have you left in your bottle? About one-eighth of your tablets in powder form. I have used in fifteen cases the Woodbridge treatment and have not lost a case that I have seen in the first ten days of the sickness. The following is the record of a unique case: Mr. A. H.,age 43 years. Seen Nov. 23,1895, 3 p.m.; temperature 103.5; this continued within less than ½ degree day and night until December 2, when he lost about three to four quarts of blood from bowel. Temperature 97 to 99 for two
Are pigmented lesion clinics worthwhile?
Authors: R.B. MALLETT, M.E. FALLOWFIELD, M.G. COOK, W.N. LANDELLS, C.A. HOLDEN, R.A. MARSDEN
Journal: British Journal of Dermatology (1993)

Journal Article Are pigmented lesion clinics worthwhile? Get access R.B. MALLETT, R.B. MALLETT St Helier NHS Trust, Carshalton, Surrey, U.K. Dr R.B.Mallett, Department of Dermatology, Peterborough District Hospital, Thorpe Road, Peterborough. Search for other works by this author on: Oxford Academic Google Scholar M.E. FALLOWFIELD, M.E. FALLOWFIELD St George's Hospital, London, U.K. Search for other works by this author on: Oxford Academic Google Scholar M.G. COOK, M.G. COOK St George's Hospital, London, U.K. Search for other works by this author on: Oxford Academic Google Scholar W.N. LANDELLS, W.N. LANDELLS St Helier NHS Trust, Carshalton, Surrey, U.K. Search for other works by this author on: Oxford Academic Google Scholar C.A. HOLDEN, C.A. HOLDEN St Helier NHS Trust, Carshalton, Surrey, U.K. Search for other works by this author on: Oxford Academic Google Scholar R.A. MARSDEN R.A. MARSDEN St George's Hospital, London, U.K. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 129, Issue 6, 1 December 1993, Pages 689–693, https://doi.org/10.1111/j.1365-2133.1993.tb03332.x Published: 01 December 1993 Article history Accepted: 04 May 1993 Published: 01 December 1993
Gwent criticised again over appointment
Authors: R. Dobson
Journal: BMJ (1997)

Gwent Health Authority, which was strongly criticised over the procedures surrounding the appointment of a director only days after she received a redundancy cheque from an NHS trust in the same area, is at the centre of another appointment controversy.

This time the awarding of a £1000 a day management consultant deal to a member of the authority four days after …
To My Wife
Authors: Clayton J. Baker
Journal: Annals of Internal Medicine (2008)

Ad LibitumNovember 18, 2008To My WifeClayton J. Baker, MDClayton J. Baker, MDFrom Pittsford, NY 14534-4727.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-10-200811180-00010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Once you've found her, coweringin the hall linen closet,and carried her downthe back staircase, draped overyour arm like the handlesof your leather handbag,and set her feet down onthe worn basement steps,you whisper, God bless,sweetheart, go catch a mouse.And closing the doorbehind your benediction,hear the baby still screamdecrescendos of MAA-mee!Each MAA-mee! makes meslightly shift my positionmore facedown, more sunkin the living room sofa.As you trudge up the stairsI would think you must wonderhow you could have marrieda sloth like yours trulyand still fill your householdwith such troubled sleepers. Author, Article, and Disclosure InformationAffiliations: From Pittsford, NY 14534-4727.Current Author Address: Clayton J. Baker, MD, Pittsford, NY 14534-4727. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics November 18, 2008Volume 149, Issue 10Page: 760 ePublished: 18 November 2008 Issue Published: November 18, 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Relationship between Hemoglobin Level and Blood Pressure Variability in Patients with Newly Diagnosed Untreated Essential Hypertension
Authors: Osman Turak, Uğur Canpolat, Ahmet İşleyen, Mehmet Mendi, Fatih Öksüz, Fırat Özcan, Kumral Çağlı, Derya Tok, Zehra Gölbaşı, Sinan Aydoğdu
Journal: Journal of the American College of Cardiology (2013)