tbuckley/cabot-search huggingface dataset:
Abstract 12707: Chads2 and Chads2vasc Scores Predict the Risk for Left Atrial Thrombus in Patients With Atrial Fibrillation
Authors: Fengpeng Jia, Minghuan Fu, Zhiyu Ling, Suxin Luo, Jun Gu, Quan He, Lei Han, Zhenguo Liu
Journal: Circulation (2014)

Background: The study was to evaluate the value of CHADS2 and CHADS2VASC scores on predicting left atrial (LA) thrombus in the patients with atrial fibrillation (AF). Methods and Results: All the non-valvular AF patients undergoing AF ablation from June 2010 to June 2012 were included and divided into two groups: patients without anticoagulation and with Coumadin anticoagulation for at least 4 weeks. The relationship between CHADS2 and CHADS2VASC scores and LA thrombus as identified on transesophageal echocardiography (TEE) was analyzed prior to ablation. A total of 397 patients underwent pre-ablation TEE: 212 patients without anticoagulation, and 185 with anticoagulation. There were no differences in the CHADS2 and CHADS2VASC scores in the two groups. LA thrombus was present in 15.6% and 5.9% for the patients without anticoagulation and for those with anticoagulation, respectively (p = 0.002). There was a strong association between CHADS2 and LA thrombus, and between CHADS2VASC and LA thrombus in the two groups. No thrombus was identified in patients with CHADS2VASC score of 0 in both groups. However, thrombus was detected in 3.5% of patients with CHADS2 score of 0 in the group without anticoagulation, while no thrombus was present in the ones with anticoagulation. CHADS2VASC score of ≥1 (r=2.03, p = 0.04) was the only factor independently associated with LA thrombus in patients without anticoagulation, while both CHADS2VASC score of ≥2 (r=2.61, p=0.02) and CHADS2 score of ≥2 (r=2.73, p=0.01) were independently associated with LA thrombus. Further analyses showed that CHADS2VASC score was a better predictor for LA thrombus than CHADS2 score in patients without anticoagulation. However, there was no difference between the two scoring systems in predicting LA thrombus in patients with anticoagulation. Conclusions: LA thrombus was associated with CHADS2VASC and CHADS2 scores in non-valvular AF patients without anticoagulation. CHADS2VASC score was a better predictor than CHADS2 score for LA thrombus in patients without anticoagulation. The data suggested that it might be unnecessary to undergo a TEE evaluation for LA thrombus in low risk patients identified by CHADS2VASC score regardless anticoagulation therapy prior to cardioversion or ablation.
Doctors who changed a patient's life: Today's dogma may be tomorrow's joke
Authors: J. H Turney
Journal: BMJ (1998)

She was a tall, distinguished looking, elderly woman who, despite having severe nephrotic syndrome, still carried herself erect. My inquiry about her medical history elicited a startling response.

Fifty years previously she had been an attractive, athletic young woman, engaged to be married, when she developed severe peripheral oedema. Her wealthy parents spared no expense in obtaining the best medical opinions available. All the distinguished doctors agreed that she had nephritis, that she should have strict bed rest in a darkened room, and that the prognosis was grave, telling her …
Abstract 11556: Association of Sleep Disordered Breathing and ECG R-Wave to Radial Artery Pulse Delay: The MESA Study
Authors: Younghoon Kwon, David R Jacobs, Pamela L Lutsey, Peter Hannan, Julio A Chirinos, Lyndia Brumback, Dennis Dean, Susan Redline, Daniel Duprez
Journal: Circulation (2014)

Background: Arterial stiffness is a well-recognized predictor of cardiovascular disease (CVD). ECG R-wave to Radial artery pulse delay (RRD) is a novel hemodynamic index in which arterial stiffness is an important component (shorter delay = Higher arterial stiffness) and is obtainable from a single tonometric measurement at the radial artery with simultaneous ECG. Sleep disordered breathing (SDB) has emerged as a risk factor for CVD. The aim of the study was to determine the association of SDB with RRD. Methods: Multi-Ethnic Study of Atherosclerosis participants in 2010-2012 without overt CVD who underwent a sleep study, radial artery tonometry and cardiac MRI were eligible for this cross-sectional analysis (N = 1173, Mean [SD] age: 67.8 ± 8.8, Women: 55.4%). Independent associations between SDB indices including apnea hypopnea index (AHI) and oxygen (O2) desaturation index (ODI: events with more than 4% O2 desaturation), and RRD (transit time in msec) were examined. Model was constructed to adjust for isovolumetric contraction time, another component of RRD, by including measures of contractility and preload (left ventricular ejection fraction (LVEF) and left ventricular end diastolic volume (LVEDV) respectively). Results: Median [IQR] of AHI and ODI were 7.9/hr [2.9- 18.0] and 7.5/hr [3.0- 17.5] respectively. Adjusting for transit path length, demographic factors, BMI and CVD risk factors, both AHI and ODI were inversely associated with RRD (β= -50.3 msec per SD, p = 0.09 and β= -0.60.2 msec per SD, p = 0.04 respectively). In gender stratified analyses given presence of significant interaction, measures of SDB were predictive of RRD only in men. No significant associations were found with key nocturnal hypoxemia indices including mean O2 saturation (SpO2), percent time with SpO2less than 90 % and minimum SpO2. Men, older age, Asian race, high blood pressure, LVEF and LVEDV were also inversely associated with RRD. Conclusion: SDB was associated with shorter RRD implying higher arterial stiffness in men only. These findings suggest the importance of apnea related dynamic change in SpO2 (intermittent hypoxia and reoxygenation) in its potential link to arterial stiffness and also highlights effect modification by gender in the association between the two.
A Genomics-Based Classification of Human Lung Tumors
Authors: Danila Seidel, Thomas Zander, Lukas C. Heukamp, Martin Peifer, Marc Bos, Lynnette Fernandez-Cuesta, Frauke Leenders, Xin Lu, Sascha Ansen, Masyar Gardizi, Chau Nguyen, Johannes Berg, Prudence Russell, Zoe Wainer, Hans-Ulrich Schildhaus, Toni-Maree Rogers, Benjamin Solomon, William Pao, Scott L. Carter, Gad Getz, D. Neil Hayes, Matthew D. Wilkerson, Erik Thunnissen, William D. Travis, Sven Perner, Gavin Wright, Elisabeth Brambilla, Reinhard Buettner, Juergen Wolf, Roman Thomas, Franziska Gabler, Ines Wilkening, Christian Mueller, Ilona Dahmen, Roopika Menon, Katharina Koenig, Kerstin Albus, Sabine Merkelbach-Bruse, Jana Fassunke, Katja Schmitz, Helen Kuenstlinger, Michaela Kleine, Elke Binot, Silvia Querings, Janine Altmueller, Ingelore Boessmann, Peter Nuemberg, Peter Schneider, Magdalena Bogus, Alex Soltermann, Holger Moch, Odd Terje Brustugun, Steinar Solberg, Marius Lund-Iversen, Aslaug Helland, Thomas Muley, Hans Hoffmann, Philipp A. Schnabel, Yuan Chen, Harry Groen, Wim Timens, Hannie Sietsma, Joachim H. Clement, Walter Weder, Joerg Saenger, Erich Stoelben, Corinna Ludwig, Walburga Engel-Riedel, Egbert Smit, Danille A. M. Heideman, Peter J. F. Snijders, Lucia Nogova, Martin L. Sos, Christian Mattonet, Karin Toepelt, Matthias Scheffler, Eray Goekkurt, Rainer Kappes, Stefan Krueger, Kato Kambartel, Dirk Behringer, Wolfgang Schulte, Wolfgang Galetke, Winfried Randerath, Matthias Heldwein, Andreas Schlesinger, Monika Serke, Khosro Hekmat, Konrad F. Frank, Roland Schnell, Marcel Reiser, Ali-Nuri Huenerlituerkoglu, Stephan Schmitz, Lisa Meffert, Yon-Dschun Ko, Markus Litt-Lampe, Ulrich Gerigk, Rainer Fricke, Benjamin Besse, Christian Brambilla, Sylvie Lantuejoul, Philippe Lorimier, Denis Moro-Sibilot, Federico Cappuzzo, Claudia Ligorio, Stefania Damiani, John K. Field, Russell Hyde, Pierre Validire, Philippe Girard, Lucia A. Muscarella, Vito M. Fazio, Michael Hallek, Jean-Charles Soria, Viktor Achter, Ulrich Lang
Journal: Science Translational Medicine (2013)

The pattern of mutations in human lung cancer differs by tumor subtype and is a useful addition to histology for selecting targeted therapy and improving patient survival.
Time to switch from whole cell to acellular pertussis vaccines
Authors: Adam Finn, Frank Bell
Journal: BMJ (2000)

EDITOR—In a letter to all doctors last December the chief medical and nursing officers and pharmacist announced that triple vaccines against diphtheria, tetanus, and pertussis containing acellular pertussis would, for the first time, but only temporarily, enter routine use for infants in the United Kingdom.1 Difficulties in obtaining supplies of triple vaccine containing whole cell pertussis during 1999 seem to …
DIET OF THE BLUFF DWELLERS OF THE OZARK MOUNTAINS AND ITS SKELETAL EFFECTS
Authors: Elmer G. Wakefield, Samuel C. Dellinger
Journal: Annals of Internal Medicine (1936)

Article1 April 1936DIET OF THE BLUFF DWELLERS OF THE OZARK MOUNTAINS AND ITS SKELETAL EFFECTSE. G. WAKEFIELD, M.D., SAMUEL C. DELLINGERE. G. WAKEFIELD, M.D.Search for more papers by this author, SAMUEL C. DELLINGERSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-9-10-1412 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIn another study we presented data on the diseases of bone which were prevalent among an ancient primitive race of people who inhabited the shelters of the bluffs in the Ozark Mountains of Arkansas and Missouri. The period of their occupation, from whence they came, or where they went are questions which cannot be answered. The absence of smooth stone or iron gadgets among their burial effects is mute evidence that they lived in ancient times and that they were very primitive people. Whether they lived twenty, thirty, or more centuries ago is irrelevant in this study.In making a...Bibliography1. MOODIE RL: Roentgenologic studies of Egyptian and Peruvian mummies. (Anthropology, memoirs.) Field Museum of Natural History, Chicago. Vol. III, 1931, 66 pp. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Rochester, MinnesotaFayetteville, Arkansas*Research Series No. 411. Received for publication Jan. 6, 1936.From the Division of Medicine, The Mayo Clinic, and the Department of Zoölogy, University of Arkansas. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMiddle Holocene menus: dietary reconstruction from coprolites at the Connley Caves, Oregon, USAEdible Insects and Their Uses in North America; Past, Present and FutureDiscovery of colon contents in a skeletonized burial: Soil sampling for dietary remainsDietary and Parasitological Analysis of Coprolites Recovered from Mummy 5, Ventana Cave, ArizonaPaleoethnobotany in American ArchaeologyThe steroids of 2000-year-old human coprolitesSurvival properties of organic residues through the human digestive tractBiological and Cultural Evidence from Prehistoric Human CoprolitesBibliography of american archaeological plant remainsThe digestive qualifications of man 1 April 1936Volume 9, Issue 10Page: 1412-1418KeywordsBoneDietRacial and ethnic issues ePublished: 1 December 2008 Issue Published: 1 April 1936 PDF downloadLoading ...
Neonatal Systemic AAV Induces Tolerance to CNS Gene Therapy in MPS I Dogs and Nonhuman Primates
Authors: Christian Hinderer, Peter Bell, Jean-Pierre Louboutin, Yanqing Zhu, Hongwei Yu, Gloria Lin, Ruth Choa, Brittney L Gurda, Jessica Bagel, Patricia O'Donnell, Tracey Sikora, Therese Ruane, Ping Wang, Alice F Tarantal, Margret L Casal, Mark E Haskins, James M Wilson
Journal: Molecular Therapy (2015)

The potential host immune response to a nonself protein poses a fundamental challenge for gene therapies targeting recessive diseases. We demonstrate in both dogs and nonhuman primates that liver-directed gene transfer using an adeno-associated virus (AAV) vector in neonates induces a persistent state of immunological tolerance to the transgene product, substantially improving the efficacy of subsequent vector administration targeting the central nervous system (CNS). We applied this approach to a canine model of mucopolysaccharidosis type I (MPS I), a progressive neuropathic lysosomal storage disease caused by deficient activity of the enzyme α-l-iduronidase (IDUA). MPS I dogs treated systemically in the first week of life with a vector expressing canine IDUA did not develop antibodies against the enzyme and exhibited robust expression in the CNS upon intrathecal AAV delivery at 1 month of age, resulting in complete correction of brain storage lesions. Newborn rhesus monkeys treated systemically with AAV vector expressing human IDUA developed tolerance to the transgene, resulting in high cerebrospinal fluid (CSF) IDUA expression and no antibody induction after subsequent CNS gene therapy. These findings suggest that inducing tolerance to the transgene product during a critical period in immunological development can improve the efficacy and safety of gene therapy. The potential host immune response to a nonself protein poses a fundamental challenge for gene therapies targeting recessive diseases. We demonstrate in both dogs and nonhuman primates that liver-directed gene transfer using an adeno-associated virus (AAV) vector in neonates induces a persistent state of immunological tolerance to the transgene product, substantially improving the efficacy of subsequent vector administration targeting the central nervous system (CNS). We applied this approach to a canine model of mucopolysaccharidosis type I (MPS I), a progressive neuropathic lysosomal storage disease caused by deficient activity of the enzyme α-l-iduronidase (IDUA). MPS I dogs treated systemically in the first week of life with a vector expressing canine IDUA did not develop antibodies against the enzyme and exhibited robust expression in the CNS upon intrathecal AAV delivery at 1 month of age, resulting in complete correction of brain storage lesions. Newborn rhesus monkeys treated systemically with AAV vector expressing human IDUA developed tolerance to the transgene, resulting in high cerebrospinal fluid (CSF) IDUA expression and no antibody induction after subsequent CNS gene therapy. These findings suggest that inducing tolerance to the transgene product during a critical period in immunological development can improve the efficacy and safety of gene therapy.
Daha Önceki Başarısız Orta Üretra Bant Ameliyatından Sonra Nüks Eden Ürodinamik Stres İdrar Kaçırmanın Tedavisinde Tansiyonsuz Vajinal Bant
Authors: Angelos Liapis, Panagiotis Bakas, Georgios Creatsas
Journal: European Urology (2009)
Commentary: Best practice in primary care
Authors: Pippa Oakeshott, Phillip Hay
Journal: BMJ (2006)

the recent attempts to validate self collection methods for cervical cancer screening to eliminate the need for smears. 15 16Some studies have shown that beliefs about pain during the procedure can influence screening behaviours for some women. 1 3 Respect for patients' preferences and ensuring physical comfort are core dimensions of patient centred care, one of the six domains of quality advocated by the Institute of Medicine. 17Our findings suggest that examination without stirrups represents a more patient centred way to perform speculum examinations.
Circulating Epstein-Barr viral DNA load at mid-course of chemoradiotherapy/ radiotherapy predicts therapy outcome in advanced-stage nasopharyngeal carcinoma
Authors: S. Leung, K Chan, Edwin Hui, Frankie Mo, Katherine Chow, Brigette Ma, Benny Zee, Ym Lo, Anthony Chan
Journal: Clinical Cancer Research (2008)

A37    Purpose : To test the hypothesis that prognostication for treatment outcome is feasible by biomarker response at mid-course of radiotherapy, with respect to the model of circulating load of Epstein-Barr viral (EBV) DNA in nasopharyngeal carcinoma (NPC).   Method:  108 patients with Stage IIB-IV NPC were prospectively studied. Plasma EBV DNA load was measured by quantitative PCR before commencement of therapy (pre-DNA), at completion of 4 weeks of CRT/RT (wk4-DNA) and within 3 months of completion of therapy (post-DNA). The endpoints are post-DNA load, a recognised powerful prognostic marker of survival, and clinical outcome at 2 years of follow-up.   Results:  94% of patients had detectable EBV DNA before therapy (median load = 874 copies/ml). At the end of week 4 of therapy, EBV DNA became undetectable in 58 (54%) patients. Detectable wk4-DNA correlates with detectable residual post-DNA (P=0.028, Chi-Square test) and significantly worse clinical outcome at 2 years of follow-up, in terms of progression-free survival (HR 2.86, P=0.0062) and distant failure (HR 3.6; P=0.0176). Patients with undetectable wk4-DNA and low pre-DNA load constitutes a very good risk group, representing 42% of patients, with an actuarial 2-year recurrence risk of 9%.   Conclusion:  This is the first model example of biomarker response during mid-course of radiotherapy being capable of predicting clinical outcome at early follow-up. It allows identification of a good risk group among patients with advanced stage disease, and has potential application in modifying treatment decisions for the latter phase of therapy, within the context of individualized therapy.
Gastric Tuberculosis With Report of Two Cases
Authors: Olin J. Cameron
Journal: Annals of Internal Medicine (1929)

Article1 June 1929Gastric Tuberculosis With Report of Two CasesOLIN J. CAMERON, M.D.OLIN J. CAMERON, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-2-12-1265 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTuberculosis of the stomach is seldom encountered and practically never diagnosed clinically. Two instances of it are on record at the University of Michigan Hospital. In a series of 2900 consecutive autopsies, one case was encountered. In the routine pathological examination of surgical specimens, another case has recently been found.Broders of the Mayo Clinic made an exhaustive review and analysis of the literature on the subject in 1917. He reported the single case occurring in their series of 2501 gastric operations. His analysis included 305 published cases, in addition to his own. He divided the cases into four groups...References(1) BRODERS AC: Tuberculosis of the Stomach. Surgery, Gynecology and Obstetrics, 1917, 25: 490-504. Google Scholar(2) RAZZABONI G: Gastretomia subtotale per tuberculosi gastrica a forma pseudoneoplastica. Il Policlinico, sez. chir., May 15, 1919, 26: 153. Google Scholar(3) GEUKEN HC: A case of Tuberculosis of the Stomach and its Surroundings. Archives of Radiology and Electrotherapy. 1920, 24: 354. CrossrefGoogle Scholar(4) SUERMONDT WF: Een Geval van Tuberculose de Maag. Nederlandsh Tijschrift voor Geneeskunde, 1925, 69: 2335-2341. Google Scholar(5) HURST AF: Chronic Tuberculous Ulcer of the Stomach. Guy's Hospital Report. 1925, 75: 428-431. Google Scholar(6) LUNDGREN A: Dilatation oesophagienne provenant d'un rétrécissement tuberculeux du cardia. Acta Chir. Scandinav. 1926, 61: 172-180. Google Scholar(7) FALTIN R: Gleichzeitiges Vorkommen von Tuberculose und Carcinom im Magen. Acta Chir. Scandinav. 1927, 61: 331-338. Google Scholar(8) COLLINSONSTEWART HMJ: Chronic Peptic Ulcer of the Stomach with Acute Miliary Tuberculosis of the Gastric Mucosa. British Journal of Surgery. 1928, 15: 626-634. CrossrefGoogle Scholar(9) WILLERDING HJ: Tuberculosis of the Stomach. Arch. f. klin. Chir. 1924, 128: 109-177. Google Scholar(10) DUERCK H: Cited by Broders, loc. cit. Google Scholar(11) ZAGARI : Cited by Broders, loc. cit. Google Scholar(12) STRAUSSWUERTZ : Cited by Broders, loc. cit. Google Scholar(13) CARRIERE : Cited by Broders, loc. cit. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Ann Arbor, Michigan*From the Department of Pathology, University of Michigan. Service of Dr. Warthin. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byTuberculosis of the StomachGastric mucosal changes of tuberculosisÜber einen Fall von lymphogen entstandenem tuberkulösem Magengeschwür 1 June 1929Volume 2, Issue 12Page: 1265-1276KeywordsAutopsyStomach ePublished: 1 December 2008 Issue Published: 1 June 1929 PDF downloadLoading ...
Putting the genetics genie back into its bottle
Authors: Alastair Kent
Journal: BMJ (2001)

Genetics is rarely out of the headlines. Almost every day there is a new story either promising the earth or threatening the end of civilisation as we know it. When the “first draft” of the human genome was announced last June, Bill Clinton claimed that, for our children, “cancer would be the name for a cluster of stars in the sky.” More recently it has been alleged that letting insurance companies have access to the results of predictive DNA tests for Huntington's …
Estimating Mortality Associated With Antipsychotics and Other Psychotropics—Reply
Authors: Donovan T. Maust, Lon S. Schneider, Helen C. Kales
Journal: JAMA Psychiatry (2015)

In Reply Dr Lozano suggests that in our article,1 we failed to take into account the variation in depression prevalence between the various medication user groups and matched nonusers and that our findings were therefore biased.
Abstract 284: Extracorporeal CPR with Therapeutic Hypothermia Plus Percutaneous Coronary Intervention for Patients with Out-of-Hospital Shockable Cardiac Arrest Due to Acute Coronary Syndrome
Authors: Ken Nagao, Tetsuya Sakamoto, Naoto Morimura, Yasufumi Asai, Hiroyuki Yokota, Satoshi Nara, Mamoru Hase, Yoshio Tahara, Takahiro Atsumi
Journal: Circulation (2014)

BACKGROUND: There is insufficient evidence for a treatment bundle including extracorporeal cardiopulmonary resuscitation (ECPR) and therapeutic hypothermia plus percutaneous coronary intervention (PCI) for out-of-hospital cardiac arrest (OHCA) due to acute coronary syndrome (ACS). METHODS: From the SAVE-J, a prospective, multicenter, comparative study of ECPR, ACS patients who arrived at the hospital in cardiac arrest after OHCA due to ventricular fibrillation (VF) were included. We investigated whether ECPR and therapeutic hypothermia plus PCI for ACS had neurological benefit. The primary endpoint was favorable 30-day neurological outcome after OHCA. RESULTS: Of the 454 patients meeting the criteria of the SAVE-J, 280 (61.7%) were ACS, including 165 in the ECPR group and 115 in the non-ECPR group. Based on intention-to-treat analysis, frequency of favorable 30-day neurological outcome was 10.3% (17/165) in the ECPR group and 1.7% (2/115) in the non-ECPR group (p&lt;0.001). By per protocol analysis, frequency of favorable 30-day neurological outcome was 11.3% (17/151) in the ECPR group and 2.2% (2/89) in the non-ECPR group (p&lt;0.001). In the ECPR group (n=165), treatment included therapeutic hypothermia in 91.5% and emergency PCI in 90.3%. After adjustment for confounders, in 131 ACS patients treated with ECPR and therapeutic hypothermia plus PCI, longer collapse-to-hospital-arrival interval (adjusted OR, 0·93, 95% CI, 0.87-0.99) and female (adjusted OR, 0·14, 95% CI, 0.02-0.97) resulted in worse neurological outcome, and lower age and longer duration of cooling showed a tendency toward neurological benefits. CONCLUSION: In ACS patients who arrived at the hospital in cardiac arrest after OHCA due to ventricular fibrillation (VF), a treatment bundle including ECPR, therapeutic hypothermia plus PCI was associated with improved neurological outcome.
Improving Global Vascular Risk Prediction With Behavioral and Anthropometric Factors
Authors: Ralph L. Sacco, Minesh Khatri, Tatjana Rundek, Qiang Xu, Hannah Gardener, Bernadette Boden-Albala, Marco R. Di Tullio, Shunichi Homma, Mitchell S.V. Elkind, Myunghee C. Paik
Journal: Journal of the American College of Cardiology (2009)