tbuckley/cabot-search huggingface dataset:
The Efficacy and Safety of Miglitol Therapy Compared With Glibenclamide in Patients With NIDDM Inadequately Controlled by Diet Alone
Authors: P Segal, PU Feig, G Schernthaner, KP Ratzmann, J Rybka, D Petzinna, C Berlin
Journal: Diabetes Care (1997)

OBJECTIVE To compare the therapeutic effects of the α-glucosidase inhibitor miglitol (BAY m 1099), the sulfonylurea glibenclamide, and placebo on parameters of metabolic control and safety in patients with NIDDM that is inadequately controlled by diet alone. RESEARCH DESIGN AND METHODS After a 4-week placebo run-in period, 201 patients in 18 centers in 4 countries were randomized in a double-blind manner to miglitol (50 mg t.i.d., followed by 100 mg t.i.d.), glibenclamide (3.5 mg q.d/b.i.d.), or placebo for 24 weeks. Efficacy criteria were changes from baseline of HbA1c, fasting and postprandial blood glucose and insulin levels, body weight, and serum triglycerides. RESULTS Efficacy was assessed in 119 patients who completed the full protocol, and the results were similar to those obtained in 186 patients who fulfilled the validity criteria for analysis. Compared with placebo, mean baseline-adjusted HbA1c decreased by 0.75% (P = 0.0021) and 1.01% (P = 0.0001) in the miglitol and glibenclamide treatment groups, respectively. Blood glucose decreased slightly in the fasting state and considerably in the postprandial state in both treatment groups but not in the placebo group. Fasting insulin levels increased slightly (NS) in all treatment groups; however, postprandial insulin levels decreased with miglitol, while increasing markedly with glibenclamide (P = 0.0001 between all treatment groups). Gastrointestinal side effects (flatulence and diarrhea) occurred mostly in the miglitol-treated patients, while some glibenclamide-treated patients had symptoms suggestive of hypoglycemia. CONCLUSIONS Miglitol monotherapy is effective and safe in NIDDM patients. Compared with glibenclamide, it reduced HbA1c less effectively and caused more gastrointestinal side effects. On the other hand, glibenclamide, unlike miglitol, tended to cause hypoglycemia, hyperinsulinemia, and weight gain, which are not desirable in patients with NIDDM.
Atrial Ectopy as a Predictor of Incident Atrial Fibrillation
Authors: Thomas A. Dewland, Eric Vittinghoff, Mala C. Mandyam, Susan R. Heckbert, David S. Siscovick, Phyllis K. Stein, Bruce M. Psaty, Nona Sotoodehnia, John S. Gottdiener, Gregory M. Marcus
Journal: Annals of Internal Medicine (2013)

Background: Atrial fibrillation (AF) prediction models have unclear clinical utility given the absence of AF prevention therapies and the immutability of many risk factors. Premature atrial contractions (PACs) play a critical role in AF pathogenesis and may be modifiable. Objective: To investigate whether PAC count improves model performance for AF risk. Design: Prospective cohort study. Setting: 4 U.S. communities. Patients: A random subset of 1260 adults without prevalent AF enrolled in the Cardiovascular Health Study between 1989 and 1990. Measurements: The PAC count was quantified by 24-hour electrocardiography. Participants were followed for the diagnosis of incident AF or death. The Framingham AF risk algorithm was used as the comparator prediction model. Results: In adjusted analyses, doubling the hourly PAC count was associated with a significant increase in AF risk (hazard ratio, 1.17 [95% CI, 1.13 to 1.22]; P < 0.001) and overall mortality (hazard ratio, 1.06 [CI, 1.03 to 1.09]; P < 0.001). Compared with the Framingham model, PAC count alone resulted in similar AF risk discrimination at 5 and 10 years of follow-up and superior risk discrimination at 15 years. The addition of PAC count to the Framingham model resulted in significant 10-year AF risk discrimination improvement (c-statistic, 0.65 vs. 0.72; P < 0.001), net reclassification improvement (23.2% [CI, 12.8% to 33.6%]; P < 0.001), and integrated discrimination improvement (5.6% [CI, 4.2% to 7.0%]; P < 0.001). The specificity for predicting AF at 15 years exceeded 90% for PAC counts more than 32 beats/h. Limitation: This study does not establish a causal link between PACs and AF. Conclusion: The addition of PAC count to a validated AF risk algorithm provides superior AF risk discrimination and significantly improves risk reclassification. Further study is needed to determine whether PAC modification can prospectively reduce AF risk. Primary Funding Source: American Heart Association, Joseph Drown Foundation, and National Institutes of Health.
Richard Scheller and Thomas Südhof receive the 2013 Albert Lasker Basic Medical Research Award
Authors: Jillian H. Hurst
Journal: Journal of Clinical Investigation (2013)

Neural communication underlies all brain activity. It governs our thoughts, feelings, sensations, and actions. But knowing the importance of neural communication does not answer a central question of neuroscience: how do individual neurons communicate? We know that communication between two neurons occurs at specialized cell junctions called synapses, at which two communicating neurons are separated by the synaptic cleft. The presynaptic neuron releases chemicals, known as neurotransmitters, into the synaptic cleft in which neurotransmitters bind to receptors on the surface of the postsynaptic neuron. Neurotransmitter release occurs in response to an action potential within the sending neuron that induces depolarization of the nerve terminal and causes an influx of calcium. Calcium influx triggers the release of neurotransmitters through a specialized form of exocytosis in which neurotransmitter-filled vesicles fuse with the plasma membrane of the presynaptic nerve terminal in a region known as the active zone, spilling neurotransmitter into the synaptic cleft.

By the 1950s, it was clear that brain function depended on chemical neurotransmission; however, the molecular activities that governed neurotransmitter release were virtually unknown until the early 1990s. This year, the Lasker Foundation honors Richard Scheller (Genentech) and Thomas Sudhof (Stanford University School of Medicine) for their “discoveries concerning the molecular machinery and regulatory mechanisms that underlie the rapid release of neurotransmitters.” Over the course of two decades, Scheller and Sudhof identified and characterized a set of proteins that mediate the fusion of neurotransmitter-filled synaptic vesicles with the plasma membranes of presynaptic nerve terminals. These proteins participate in the formation and regulation of a membrane-bridging complex, known as the soluble NSF attachment protein (SNAP) receptor (SNARE) complex. It is now known that this mechanism is used to mediate various forms of exocytosis throughout the body.
We believe in freedom of the will so that we can learn
Authors: Clark Glymour
Journal: Behavioral and Brain Sciences (2004)

The central theoretical issue of Wegner's book is: Why do we have the illusion of conscious will? I suggest that learning requires belief in the autonomy of action. You should believe in freedom of the will because if you have it you're right, and if you don't have it you couldn't have done otherwise anyway. —Sam Buss (Lecture at University of California, San Diego, 2000)
Classification of axial SpA based on positive imaging (radiographs and/or MRI of the sacroiliac joints) by local rheumatologists or radiologists versus central trained readers in the DESIR cohort
Authors: Rosaline van den Berg, Grégory Lenczner, Fabrice Thévenin, Pascal Claudepierre, Antoine Feydy, Monique Reijnierse, Alain Saraux, Alain Rahmouni, Maxime Dougados, Désirée van der Heijde
Journal: Annals of the Rheumatic Diseases (2014)

Investigating changes in patient classification (ASAS (Assessment of SpondyloArthritis international Society) axSpA criteria) based on evaluation of images of the sacro-iliac joints (MRI-SI and X-SI) by local and central readers.The DESIR cohort included patients with inflammatory back pain (IBP; ≥3 months, but <3 years), suggestive of axSpA. Local radiologists/rheumatologists (local-reading) and two central readers (central-reading) evaluated baseline images. Agreement regarding positive MRI (pos-MRI) between central readers and between local-reading and central-reading was calculated (κs). Number of patients classified differently (ASAS criteria) by using local-reading instead of central-reading was calculated.Inter-reader agreement between the two central readers and between local-reading and central-reading was substantial (κ=0.73 and κ=0.70, respectively). In 89/663 MRI-SIs (13.4%) local-reading and central-reading disagreed; 38/223 patients (17.0%) with pos-MRI (local-reading) were negative by central-reading; 51/440 patients (11.6%) with neg-MRI (local-reading) were positive by central-reading.In 163/582 patients eligible for applying ASAS criteria (28.0%), local-reading and central-reading disagreed on positive imaging (MRI-SI and/or X-SI; κ=0.68). In 46/582 patients (7.9%) a different evaluation resulted in a different classification; 18/582 patients (3.1%) classified no-SpA (central-reading) were axSpA by local-reading; 28/582 patients (4.8%) classified axSpA (central-reading) were no-SpA by local-reading. Among axSpA patients (central-reading), 16/419 patients (3.8%) fulfilling imaging-arm by central-reading fulfilled clinical-arm by local-reading; 29/419 patients (6.9%) fulfilling clinical-arm by central-reading fulfilled also imaging-arm by local-reading.In patients with recent onset IBP, trained readers and local rheumatologists/radiologists agree well on recognising a pos-MRI. While disagreeing in 28% of the patients on positive imaging (MRI-SI and/or X-SI), classification of only 7.9% of the patients changed based on a different evaluation of images, showing the ASAS axSpA criteria's robustness.
Facet Joint Arthropathy Demonstrated on FDG-PET
Authors: Mohamed Houseni, Wichana Chamroonrat, Hongming Zhuang, Abass Alavi
Journal: Clinical Nuclear Medicine (2006)

Lower back pain is a common medical problem. Facet joint arthropathy is one of the many causes of lower back pain and diagnosing it as the source of pain is a medical challenge. In this report, the potential of fluorodeoxyglucose (FDG) positron emission tomography (PET) in the diagnosis of facet joint arthropathy was demonstrated.
Abstract 3931: Progesterone and estrogen affect the expression and secretion of heparin binding epidermal growth factor like growth factor (HB-EGF) in RL95-2 cells, an endometrial cancer cell line
Authors: Phane Gesare Otenyo, Ebonee Williams, Daniel Macaulay, Laura Carson, E. Gloria C. Regisford
Journal: Cancer Research (2012)

Abstract Endometrial cancer is one of the most common gynecological cancers. Heparin Binding Growth Factor-like Growth Factor exerts acute effects on cancer cells; in that it induces and promotes proliferation and hence the pathogenesis and progression of endometrial cancer. Steroid hormones directly or indirectly affect the expression of HB-EGF and may thus play a role in the malignant transformation of endometrial cells. The aim of this project is therefore to evaluate the effects of progesterone (P4) and estrogen (E2) treatments on the expression and secretion of HB-EGF in endometrial cancer cells. We hypothesized that P4 will reduce HB-EGF expression and secretion while E2 will increase its expression and secretion. To test our hypothesis, an endometrial cell line, RL95-2, was treated for four days asfollows: (1) 10−8M E2, (2)10−6M P4, (3) 10−8M E2 + 10−6M P4 (4) 10−8M E2 in two days followed by 10−6M P4 and (5) Control. Immunocytochemistry (ICC), ELISA and western blot analysis were performed to evaluate the secretion and expression of HB-EGF in RL95-2 cells. Western blot analysis and ICC showed a consistently enhanced expression of HB-EGF in cells treated with E2 and in cells treated with E2 followed by P4 relative to the control groups. Alternatively, cells treated with P4 showed a down-regulation of HB-EGF expression relative to the control group. ELISA analysis showed high secretion of HB-EGF in cells treated with E2 and cells treated with E2 followed by P4 relative to the control groups. The secretion of HB-EGF was lower in cells treated with P4 alone compared to the control. In sum, there is an acute effect of E2 and P4 on the expression and secretion of HB-EGF and thus consequently may affect endometrial cancer cell proliferation. 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 3931. doi:1538-7445.AM2012-3931
Website of the week: After the disaster
Authors: A. Moscrop
Journal: BMJ (2001)

In the wake of Tuesday's tragedy the psychological impact of events on children became an important issue on the web. In his article above, Ron Davis refers to the website of the Children's Hospital of Pittsburgh (www.chp.edu/). This is by far the most comprehensive and considered of the many sites purporting to help young people come to terms with the disaster. It offers pages for parents and teachers, as well as empathic and age-appropriate advice for teenagers and children themselves.

Meanwhile, Yahoo has constructed a “Featured category: children and traumatic events” (http://dir.yahoo.com/Society_and_Culture/Cultures_and_Groups/Children/Children_and_Traumatic_Events/). Some of the sites listed, such as “Tips for recognizing traumatic stress in children,” hint at the threat of excess psychiatric diagnoses as much as actual psychological trauma in the aftermath of events.

As part of its “America responds” initiative, PBS KIDS has created a “resources for parents” page (www.pbs.org/americaresponds/parents.html). A worrying link is to a Teletubbies site that contains instructions on flag making. The aim is to ensure that “America's youngest children can feel a sense of pride and patriotism by making an American flag and having a parade to express their feelings.”

The American Academy of Pediatrics (www.aap.org) offers links to a handful of sites for health professionals. Most useful is “Psychosocial issues for children and families in disasters: a guide for the primary care physician” (www.mentalhealth.org/publications/allpubs/SMA95-3022/SMA3022.htm). Written before the events of 11 September, not all of this document is relevant to present circumstances. However, it valuably considers the effects of events on adults as well as children and maintains a sense of perspective—“children and families are having a normal reaction to an abnormal situation,” we are reminded.
PULMONARY VEIN ISOLATION FOR PERSISTENT ATRIAL FIBRILLATION IN PATIENTS WITH SEVERE HEART FAILURE
Authors: Michael R. MacDonald, John McMurray, Tracey Steedman, Morag Shaw, Henry Dargie, Nathaniel Hawkins, Martin Denvir, Sai Bhagra, John Payne, Derek Connelly, Mark Petrie
Journal: Journal of the American College of Cardiology (2010)
Tuberculosis Patient Care of the Future
Authors: Winthrop N. Davey
Journal: JAMA (1971)

<h3>To the Editor.—</h3> I am surprised that you feel well enough informed and knowledgeable of the problems of tuberculosis control in the United States to take the editorial stand (<b>215</b>:148, 1971) entitled "Care of Tuberculosis Patients: Reprise." I am particularly disturbed because this stand appears to be based upon a "number of letters," obviously from persons opposed to a change in the status quo of methods of tuberculosis control. Tuberculosis control activities in this country are badly in need of reevaluation and reform. The efforts of the Public Health Service and the National Tuberculosis and Respiratory Disease Association in this reform are to be commended. Patients with tuberculosis should not be treated as second-class citizens, and, as such, they should receive the best of medical care. If inpatient care is indicated, it should be given in general hospitals. The defense which you outline for the maintenance of specialized, second-class
Characterization of Acute and Chronic Myocardial Infarcts by Multidetector Computed Tomography
Authors: Bernhard L. Gerber, Bénédicte Belge, Gabin J. Legros, Pascal Lim, Alain Poncelet, Agnès Pasquet, Giovanna Gisellu, Emmanuel Coche, Jean-Louis J. Vanoverschelde
Journal: Circulation (2006)

We evaluated whether contrast-enhanced multidetector computed tomography (CE-MDCT) might characterize myocardial infarct (MI) with patterns similar to those obtained by contrast-enhanced magnetic resonance (CE-MR) and studied the underlying mechanisms.In vivo infarct characterization by CE-MDCT was shown to be feasible between 4 and 20 minutes after contrast injection in 7 pigs with MI. Subsequently, in 16 patients with acute MI and 21 patients with chronic MI, contrast patterns by CE-MDCT were related to CE-MR. Eighteen patients had hypoenhanced regions on early CE-MDCT images at the time of coronary imaging, and 34 patients had hyperenhanced regions on images acquired 10 minutes later. On a segmental basis, there was moderately good concordance of early hypoenhanced regions (92%, kappa=0.54, P<0.001) and late hyperenhanced regions (82%, kappa=0.61, P<0.001) between CE-MDCT and CE-MR. Absolute sizes of early hypoenhanced (6+/-16 versus 7+/-16 g, P=0.25) and late hyperenhanced (36+/-34 versus 31+/-40 g, P=0.14) regions were similar on CE-MDCT and CE-MR and were highly correlated (r=0.93, P<0.001 and r=0.89, P<0.001 respectively). In 8 retrogradely perfused infarcted rabbit hearts, contrast kinetics of iomeprol were similar to gadodiamide, ie, slow wash in (8.7+/-6.7 versus 1.2+/-0.3 minutes, P<0.001) in infarct core and slow washout (20+/-12 versus 2.5+/-0.5 minutes, P<0.001) in both infarct core and rim compared with the remote region.Because iodated contrast agents have similar kinetics in infarcted and noninfarcted myocardium as gadolinium DPTA, CE-MDCT can characterize acute and chronic MI with contrast patterns similar to CE-MR. CE-MDCT may thus provide important information on infarct size and viability at the time of noninvasive coronary imaging.
TECHNETIUM-99M LABELING AND BIODISTRIBUTION OF NEW BONE SEEKING MONOPHOSPHATES
Authors: F. Hosain, R. P. Spencer, H. M. Couthon, G. L. Sturtz
Journal: Clinical Nuclear Medicine (1996)

Dept. Nuclear Medicine, University of Connecticut Health Center, Farmington, CT, USA, and Laboratoire de Chemi Hetero-Organique, Faculte de Science et Techniques, Brest, France.
Medical Research and the News Media
Authors: Edward W. Campion
Journal: New England Journal of Medicine (2004)

Not so long ago, medical research reports were published in medical journals, to be read and evaluated primarily by physicians. If patients ever learned anything about research studies, it was from their physicians. But patterns of communication have changed. Today, the news media and the Internet are major sources of health information for the public. This shift in the flow of information has definite benefits, but it brings with it some tricky tensions for patients, physicians, researchers, and even the editors of medical journals.Physicians may feel that they are working at cross-purposes with the health-news media, especially when news . . .
SNP Genotyping: Technologies and Biomedical Applications
Authors: Sobin Kim, Ashish Misra
Journal: Annual Review of Biomedical Engineering (2007)

Single nucleotide polymorphisms (SNPs) are the most frequently occurring genetic variation in the human genome, with the total number of SNPs reported in public SNP databases currently exceeding 9 million. SNPs are important markers in many studies that link sequence variations to phenotypic changes; such studies are expected to advance the understanding of human physiology and elucidate the molecular bases of diseases. For this reason, over the past several years a great deal of effort has been devoted to developing accurate, rapid, and cost-effective technologies for SNP analysis, yielding a large number of distinct approaches. This article presents a review of SNP genotyping techniques and examines their principles of genotype determination in terms of allele differentiation strategies and detection methods. Further, several current biomedical applications of SNP genotyping are discussed.
Leucocyte function in Crohn's disease. Studies on mobilisation using a quantitative skin window technique and on the function of circulating polymorphonuclear leucocytes in vitro.
Authors: J H Wandall, V Binder
Journal: Gut (1982)

<b>Background:</b> Cardiac procedure guidelines often include psychosocial criteria for selecting patients that potentially introduce social value judgements into clinical decisions and decisions about the rationing of care. The aim of this study was to investigate the terms and justifications for and the meanings of psychosocial patient characteristics used in cardiac procedure guidelines. <b>Methods:</b> We selected English-language guidelines published since 1990 and chapters in textbooks published since 1989. These guidelines amalgamated multiple sources of evidence and expertise and made recommendations regarding patient selection for specific procedures. A multidisciplinary team of physicians and social scientists extracted passages regarding psychosocial criteria and developed categories and conceptual relationships to describe and interpret their content. <b>Results:</b> Sixty-five papers met the criteria for inclusion in the study. Forty-five (69%) mentioned psychosocial criteria as procedure indications or contraindications. The latter fell into several categories, including behavioural and psychological issues, relationships with significant others, financial resources, social roles and environmental circumstances. <b>Interpretation:</b> Psychosocial characteristics are portrayed as having 2 roles in patient selection: as risk factors intrinsic to the candidate or as indicators of need for special intervention. Guidelines typically simply list psychosocial contraindications without clarifying their specific nature or providing any justification for their use. Psychosocial considerations can help in the evaluation of patients for cardiac procedures, but they become ethically controversial when used to restrict access. The use of psychosocial indications and contraindications could be improved by more precise descriptions of the psychosocial problem at issue, explanations regarding why the criterion matters and justification of the characteristic using a biological rationale or research evidence.
“Positive” Tc-99m Red Blood Cell Scintigraphy in a Patient With Hepatic Lymphoma
Authors: Nir Hod, Mehrzad Cohen Pour, Yoav Juven, Tifha Horne
Journal: Clinical Nuclear Medicine (2004)

Tc-99m red blood cell (RBC) scintigraphy is a very specific method for the diagnosis of hepatic hemangioma and false-positive cases have been rarely reported. The authors present an interesting case in which markedly increased blood pool was seen on Tc-99m RBC scintigraphy in a patient with an hepatic mass. However, the “positive” RBC scan did not explain the entire abnormality seen on the colloid liver scan. Therefore, an additional mass was suspected and further investigation revealed hepatic lymphoma.
UK defines action to tackle health in developing countries
Authors: T. Richards
Journal: BMJ (2000)

The UK government's Department for International Development has launched a new policy document outlining its strategy to tackle health problems in developing countries. The paper is one of a set that collectively aims to define what needs to be done to achieve the ambitious international development targets agreed by the United Nations and recently endorsed by the G8 countries in Okinawa, Japan.

The first of eight targets is to halve the proportion of people living in extreme poverty, by 2015. In an acknowledgement that tackling this target requires international action in many areas, the department has published separate strategy papers on the environment, education, good government, and economic policies in addition to the current paper on health.

The link …