tbuckley/cabot-search huggingface dataset:
Frequent Asymptomatic Pulmonary Embolism in Patients With Deep Venous Thrombosis
Authors: Kenneth M. Moser
Journal: JAMA (1994)

To determine the frequency of pulmonary embolism in patients admitted for treatment of deep venous thrombosis.An open, multicenter, dose-ranging study to assess the safety and pharmacokinetic characteristics of tissue-type plasminogen activator in deep venous thrombosis and pulmonary embolism. Perfusion and ventilation lung scans, chest roentgenograms, and venograms (in deep venous thrombosis) or pulmonary angiograms (in pulmonary embolism) were obtained before and 24 hours after inception of therapy. Heparin therapy was then administered.Five tertiary-care hospitals.All patients with suspected deep venous thrombosis or pulmonary embolism seen from August 1987 through November 1988 entered the study if they met inclusion criteria and if the diagnosis was confirmed by venogram (deep venous thrombosis) or pulmonary angiogram (pulmonary embolism).All patients received tissue-type plasminogen activator followed by intravenous heparin therapy.The primary measure was the frequency of pulmonary embolism in patients with deep venous thrombosis who had no symptoms of pulmonary embolism. This was not the original purpose of the study but emerged as an important finding as the data were analyzed.Nearly 40% of patients with deep venous thrombosis who had no symptoms of pulmonary embolism had evidence of pulmonary embolism based on ventilation-perfusion scan and chest roentgenogram findings.Because all of those considered to have embolism had so-called high-probability scan results, the frequency of embolism reported likely represents the minimum incidence of pulmonary embolism in patients with deep venous thrombosis who have no embolic symptoms. These data emphasize that venous thromboembolism is one disorder.
The Relation of Physical Activity to Risk for Symptomatic Gallstone Disease in Men
Authors: Michael F. Leitzmann
Journal: Annals of Internal Medicine (1998)

Background: Gallstone disease is a major source of morbidity in the United States. Gallstones are twice as common in women as in men, but severe biliary events leading to surgery occur with equal frequency in the two sexes. Objective: To determine whether physical activity decreases risk for symptomatic gallstone disease in men. Design: Prospective cohort study. Setting: U.S. male health professionals. Patients: 45 813 men 40 to 75 years of age were followed from 1986 to 1994. Measurements: Questionnaires mailed in 1986, 1988, 1990, 1992, and 1994 asked about physical activity, incidence of gallstone disease, age, body weight, dietary and alcohol intake, smoking habits, use of medications, and occurrence of diagnosed medical conditions other than gallstone disease. Results: 828 men reported having newly symptomatic gallstones (diagnosed by ultrasonography or radiography) or undergoing cholecystectomy for recent symptoms. After adjustment for multiple confounders, increased physical activity was inversely related to risk for symptomatic gallstone disease. When extreme quintiles were compared, men younger than 65 years of age had a stronger inverse association (multivariate relative risk, 0.58 [95% CI, 0.44 to 0.78]) with risk than did men 65 years of age or older (relative risk, 0.75 [CI, 0.52 to 1.09]). In contrast, sedentary behavior was positively related to risk for symptomatic gallstone disease. Men who watched television more than 40 hours per week had a higher risk for symptomatic gallstones than men who watched less than 6 hours per week (relative risk for older men, 3.32 [CI, 1.51 to 7.27]; relative risk for younger men, 1.58 [CI, 0.38 to 6.48]). Conclusions: Physical activity may play an important role in the prevention of symptomatic gallstone disease in men even beyond its benefit for control of body weight. The results of this study indicate that 34% of cases of symptomatic gallstone disease in men could be prevented by increasing exercise to 30 minutes of endurance-type training five times per week.
Abstract A44: Inhibition of EGFR phosphorylation in a panel of human breast cancer cells correlates with synergistic interactions between gefitinib and 5'-DFUR, the bioactive metabolite of Xeloda®
Authors: Maria Ait Tihyaty, Zakaria Rachid, Bertrand Jean-Claude, Catalin Mihalcioiu
Journal: Clinical Cancer Research (2010)

Abstract The introduction of Xeloda® (capecitabine) in the clinical management of breast cancer has significantly improved survival in patients with mammary carcinoma. It is administered orally and first is metabolized in the liver by carboxylesterases to generate 5'-deoxy- 5-flurocytidine ribose (5'-DFCR), which is subsequently converted to 5'-deoxy-5-fluorouridine ribose (5'-DFUR) by cytidine deaminase. While the latter conversion takes place in tumour and normal tissues, the conversion of 5'-DFUR to the cytotoxic compound 5-FU, occurs principally in the tumour. This reaction is catalyzed by thymidine phosphorylase (TP), which is overexpressed in cancer cells. It has been observed that tumours expressing high levels of TP are the most responsive to capecitabine treatment. Therefore, it was hypothesized that conditions leading to an increase of TP expression could potentiate the action of capecitabine. Our recent studies in a panel of human breast cancer cell lines showed an increase in TP levels upon exposure to gefitinib, an inhibitor of the epidermal growth factor receptor (EGFR). Here, we report on the factors influencing the potency of gefitinib in combination with 5'-DFUR, the bioactive metabolite of capecitabine. The results showed that: 1) 5'-DFUR activity linearly correlated with TP basal level (R2= 0.808), 2) importantly, the strength of the synergistic interaction between gefitinib and 5'-DFUR, as measured by the combination index at IC50 concentrations (CI50) increased with TP fold changes after gefitinib treatment (R2=0.6449), 3) inversely, it decreased with increasing thymidylate synthase (TS) fold changes after gefitinib treatment (R2=0.6229), 4) moreover, the strength of the synergy correlated with an increase in the proportion of cells arrested in the S and G2M phases of cell cycle (R2=0.6355), 5) changes in TP levels correlated with the magnitude of inhibition of EGFR phosphorylation by gefitinib (R2=0.63) but not with its IC50 values for growth inhibition in the cell panel (R2=0.03611), 6) likewise, DNA damage induced by 5'-DFUR alone or in combination with gefitinib did not correlate with IC50 values for growth inhibition. The results in toto suggest that the observed synergistic interactions between gefitinib and 5'-DFUR may be imputed to molecular events associated with inhibition EGFR phosphorylation and modulation of TP/TS expression in the cells. Citation Information: Clin Cancer Res 2010;16(14 Suppl):A44.
Mechanism of ventricular vulnerability to single premature stimuli in open-chest dogs.
Authors: P S Chen, P D Wolf, E G Dixon, N D Danieley, D W Frazier, W M Smith, R E Ideker
Journal: Circulation Research (1988)

To determine the mechanism of ventricular vulnerability to electrical stimulation, we simultaneously recorded from 120 transmural electrodes in a 35 X 20 X 5-mm portion of right ventricular infundibulum in seven dogs. Baseline pacing (S1) was performed from outside the mapped region followed by single premature stimulation (S2) of increasing strength at the center of the mapped region. In five of six episodes of ventricular fibrillation and 26 of 30 episodes of repetitive responses, complete reentrant pathways were observed. Earliest activation following S2 was not at the site of S2 stimulation but was at a point between the S1 and S2 sites of stimulation. Activation spread away from the early site toward the opposite side of the mapped region around the sides of an arc of block near the S2 site to form a "figure-of-eight." The activation fronts coalesced to activate the region around the S2 site last and, if the difference in times between activation at the early site and near the S2 site was large, reentered the tissue toward the S1 site. Ventricular refractory periods were determined in four dogs following S1 pacing; the regions with the greatest nonuniformity in the dispersion of refractoriness were not the regions of unidirectional block after S2 stimulation. Thus, 1) ventricular fibrillation and repetitive responses induced electrically with S1 and S2 stimuli at different ventricular sites arise by figure-of-eight reentry, 2) this reentry is caused by the ability of S2 stimulation both to prolong refractoriness near the S2 site and to initiate a propagated response in the region between the S1 and S2 sites, and 3) a nonuniform dispersion of refractoriness is not crucial for the electrical induction of reentry leading to ventricular fibrillation or repetitive responses when S1 and S2 stimuli are given at different locations on the right ventricular outflow tract.
Insulin's direct effects on the liver dominate the control of hepatic glucose production
Authors: D. S. Edgerton
Journal: Journal of Clinical Investigation (2006)

Insulin inhibits glucose production through both direct and indirect effects on the liver; however, considerable controversy exists regarding the relative importance of these effects. The first aim of this study was to determine which of these processes dominates the acute control of hepatic glucose production (HGP). Somatostatin and portal vein infusions of insulin and glucagon were used to clamp the pancreatic hormones at basal levels in the nondiabetic dog. After a basal sampling period, insulin infusion was switched from the portal vein to a peripheral vein. As a result, the arterial insulin level doubled and the hepatic sinusoidal insulin level was reduced by half. While the arterial plasma FFA level and net hepatic FFA uptake fell by 40–50%, net hepatic glucose output increased more than 2-fold and remained elevated compared with that in the control group. The second aim of this study was to determine the effect of a 4-fold rise in head insulin on HGP during peripheral hyperinsulinemia and hepatic insulin deficiency. Sensitivity of the liver was not enhanced by increased insulin delivery to the head. Thus, this study demonstrates that the direct effects of insulin dominate the acute regulation of HGP in the normal dog.
CD8+ but not CD4+ T cells require cognate interactions with target tissues to mediate GVHD across only minor H antigens, whereas both CD4+ and CD8+ T cells require direct leukemic contact to mediate GVL
Authors: Catherine Matte-Martone, Jinli Liu, Dhanpat Jain, Jennifer McNiff, Warren D. Shlomchik
Journal: Blood (2008)
Community mothers' programme: randomised controlled trial of non-professional intervention in parenting.
Authors: Z Johnson, F Howell, B Molloy
Journal: BMJ (1993)

OBJECTIVE--To see whether non-professional volunteer community mothers could deliver a child development programme to disadvantaged first time mothers for children aged up to 1 year. DESIGN--Randomised controlled trial. SETTING--A regional health authority in Dublin. SUBJECTS--262 first time mothers who were delivered during six months in 1989 and who lived in a deprived area of Dublin; 30 experienced mothers from the same community recruited as community mothers. INTERVENTIONS--All the first time mothers received standard support from the public health nurse. In addition, those in the intervention group received the services of a community mother, who was scheduled to visit monthly during the first year of the child9s life. RESULTS--232 (89%) first time mothers completed the study--127 in the intervention group, 105 controls. At the end of the study children in the intervention group were more likely to have received all of their primary immunisations, to be read to, and to be read to daily, played more cognitive games; and were exposed to more nursery rhymes. They were less likely to begin cows9 milk before 26 weeks and to receive an inappropriate energy intake and inappropriate amounts of animal protein, non-animal protein, wholefoods, vegetables, fruit, and milk. Mothers in the intervention group also had a better diet than controls. At the end of the study they were less likely to be tired, feel miserable, and want to stay indoors; had more positive feelings; and were less likely to display negative feelings. CONCLUSION--Non-professionals can deliver a health promotion programme on child development effectively. Whether they can do so as effectively as professionals requires further study.
No redress for failed sterilisations
Authors: C. Dyer
Journal: BMJ (1999)

The House of Lords, the United Kingdom's highest court, ruled last week that parents who produce a healthy child after a failed sterilisation or vasectomy have no right to claim compensation for the child's upbringing.

The decision, in a Scottish case, amazed English lawyers because it overturned an English Court of Appeal judgment in 1985 that led to scores of awards …
Evaluation of eplerenone in the subgroup of EPHESUS patients with baseline left ventricular ejection fraction ≤30%
Authors: Bertram Pitt, Mihai Gheorghiade, Faiez Zannad, Jeffrey L. Anderson, Dirk J. van Veldhuisen, Alexander Parkhomenko, Ramon Corbalan, Eric Q. Klug, Robin Mukherjee, Henry Solomon
Journal: European Journal of Heart Failure (2006)
Prostaglandin D2 synthase/GPR44: a signaling axis in PNS myelination
Authors: Amelia Trimarco, Maria Grazia Forese, Valentina Alfieri, Alessandra Lucente, Paola Brambilla, Giorgia Dina, Damiana Pieragostino, Paolo Sacchetta, Yoshihiro Urade, Brigitte Boizet-Bonhoure, Filippo Martinelli Boneschi, Angelo Quattrini, Carla Taveggia
Journal: Nature Neuroscience (2014)
Mechanical Pressure and Stretch Release Endothelin-1 From Human Atherosclerotic Coronary Arteries In Vivo
Authors: David Hasdai, David R. Holmes, Kirk N. Garratt, William D. Edwards, Amir Lerman
Journal: Circulation (1997)

Background Endothelin-1 (ET-1) is an endothelium-derived vasoactive peptide with mitogenic properties. In vitro, vascular release of ET-1 is increased in response to mechanical stress. The goal of the present study was to examine whether ET-1 is released from human atherosclerotic coronary arteries in vivo in response to mechanical pressure and stretch and to characterize immunoreactivity for ET-1 and its precursor, big ET-1, within the atheromatous plaque. Methods and Results Circulating ET-1 levels were measured in 20 patients before and after coronary angioplasty for stable angina at three sampling sites: the femoral artery and the coronary artery segments proximal and distal to the lesion dilated. In addition, atheromatous tissue obtained from 20 patients undergoing directional coronary atherectomy for stable angina were analyzed for immunoreactivity for ET-1 and big ET-1. In patients undergoing angioplasty, ET-1 levels in the distal coronary artery increased after balloon dilatation (8.4±0.9 to 16.4±2 pg/mL, P &lt;.05); proximal coronary artery and systemic ET-1 levels were unchanged. The degree of mechanical stress applied (product of duration and pressure of balloon inflation) correlated with the change in distal coronary artery ET-1 levels ( r =.71, P &lt;.01). Immunoreactivity for big ET-1 and ET-1 was ubiquitous in the extracellular space and the intracellular compartment (macrophages, myointimal cells, myofibroblasts, and endothelial cells) of human coronary atheromatous tissue. Conclusions Big ET-1 and ET-1 immunoreactivity is ubiquitous within the intracellular and extracellular compartments of coronary atherosclerotic tissue. ET-1 is released from these sites in response to mechanical stress. These findings support a role for endothelins in the evolution and progression of coronary atherosclerosis in humans.
Ethanol, Thyroid Hormones and Acute Liver Injury: Is There a Relationship?
Authors: Andrew Szilagyi, Sam Lerman, Robert H. Resnick
Journal: Hepatology (1983)

Alcoholic liver disease continues to be an important cause of morbidity and mortality, and the hypermetabolic hypothesis continues to be an attractive area for research. However, the current state of knowledge does not allow unequivocal acceptance or rejection of the role of thyroid hormone and antithyroid medication in alcoholic hepatitis. Clinical trials will help to establish or disprove the veracity of this hypothesis. What has been established is that chronic ethanol ingestion enhances EMR (19-22) which probably reflects the degree of hepatocellular necrosis, at least when relatively mild (25). The influence of thyroid hormone or a hyperthyroid-like state on EMR would be established if it could be shown that different antithyroid medications inhibit the enhanced EMR in chronic alcoholics. This effect has been shown in rats (125), but not in man. It is not apparent that events in the rat model can be readily applied to man. Furthermore, proof that antithyroid medications can inhibit enhanced EMR in chronic ethanol-consuming patients may allow this feature to be used to select patients who may best benefit from such treatment. A controlled randomized clinical trial using different anti-thyroid medications in alcoholic hepatitis may shed light on this important question. At the very least, demonstration of inhibition of enhanced EMR by antithyroid medications may provide the rationale for research concerning the role of thyroid hormone (or a similar hypermetabolic factor) in alcohol-mediated hepatocellular injury.
Survival and cardiac event rates in the first year after emergency coronary angioplasty for acute myocardial infarction
Authors: Richard S. Stack, Robert M. Califf, Tomoaki Hinohara, Harry R. Phillips, David B. Pryor, Charles A. Simonton, Eric B. Carlson, Kenneth G. Morris, Victor S. Behar, Yihong Kong, Robert H. Peter, Mark A. Hlatky, Christopher M. O'Connor, Daniel B. Mark
Journal: Journal of the American College of Cardiology (1988)
Use of influenza vaccine in The Netherlands.
Authors: I A Meynaar, J W van't Wout, J P Vandenbroucke, R van Furth
Journal: BMJ (1991)

Influenza vaccination is safe and effective in reducing mortality and morbidity due to influenza, but com- pliance with the guidelines for use of the vaccine seems to be low in both the United Kingdom and The Netherlands.The aims of this study were to establish the degree to which patients who should be immunised according to official Dutch guidelines are actually immunised and to understand why some patients receive the vaccine and others do not.'
Diversities of Sex
Authors: C. N. Armstrong
Journal: BMJ (1955)

MiICAL JoHuWaL 1173 huge figure of approximately 650 per annum.In addition to local graduates, some 585 doctors from Great Britain and Ireland and from foreign countries have emigrated to Australia between 1948 and 1952.There can be little doubt, therefore, that Australia is rapidly becoming over-doctored.TABLE IV.-British Dominions: Increase in Number of Medical Students Graduating in Selected Years Compared with In- crease of Population (data obtained from the " Year Book of the Universities of the Commonwealth") Approximate Approximate Population % No. of
Cost Containment and Quality Care
Authors: Robert Carlen
Journal: JAMA (1988)

<h3>To the Editor.</h3> —In his review of<i>Common Diagnostic Tests: Use and Interpretation</i>, Dr Boisaubin<sup>1</sup>says, "Creating new standards for excellent, cost-effective medical care may be the greatest challenge to the practice of American medicine in the next decade. The greatest undeclared benefit of this (seminal) work lies in its potential to increase cost-effectiveness in all physician testing behavior. This manual should... find its way into the labcoat pocket of every thinking physician." The first question every thinking physician should ask is whether he can lawfully consider costs in reaching his professional decisions. I have never set foot in a law school but I learned the answer from a suit I brought against the local health commissioner and also, in effect, from a private ruling by the commissioner of the agency that licenses physicians. There is nothing whatever in New York law that permits a physician to consider costs;
IMPACT OF BODY MASS INDEX ON MAJOR BLEEDING AFTER PCI: 2-YEAR RESULTS FROM THE MULTICENTER PROSPECTIVE PARIS REGISTRY
Authors: Kleanthis Theodoropoulos, Annapoorna Kini, Bernhard Witzenbichler, Giora Weisz, James Hermiller, Fayaz Shawl, Thomas Stuckey, Alaide Chieffo, Peter Berger, David Cohen, Ron Waksman, Melissa Aquino, samantha sartori, Usman Baber, George Dangas, Roxana Mehran
Journal: Journal of the American College of Cardiology (2014)
The Wilmer Information System
Authors: Kevin M. Miller, H. Jay Wisnicki, James P. Buchman, Marcia J. Riley, Michael X. Repka, Hugh R. Taylor, David L. Guyton
Journal: Ophthalmology (1988)

The Wilmer Information System is a computerized medical information system used for the storage and retrieval of data pertaining to patient demographics, diagnosis, and therapy. The heart of the system is an expandable, hierarchical code based on International Classification of Diseases, 9th Revision (ICD-9) diagnosis codes and Physicians' Current Procedural Terminology procedure codes. Customized coding sheets containing highly specific diagnosis and procedure codes have been designed for each subspecialty area in ophthalmology. Interactive database management software facilitates data entry and retrieval. The system can be used to search for patients who meet very specific critera, or to produce cumulative visit reports and summary statistics.
When Does CHD Start?
Authors: Zenonas Danilevicius
Journal: JAMA (1974)

Studies that link coronary heart disease (CHD) to the status of health during childhood concentrate on three main areas: (1) elevated levels of cholesterol and triglicerides, even in infancy, (2) genetic inclination to CHD in children of CHD victims, and (3) histological differences in the structure of the coronary vessel wall in children of families with higher or lower incidence of CHD.  In this issue ofThe Journal(p 1531) Chase et al report elevated lipid levels in 29% of 179 offspring of 71 victims of early heart attacks. Similar findings in the Busselton study in western Australia led Godfrey et al 1 to say that mass screening of school children's cholesterol levels might be a more effective method of planning prophylaxis of atherosclerosis than the examinations of middle-aged men whose disease is likely to be far advanced and possibly irreversible.  Chase et al agree with this recommendation and suggest
Evaluation of the treatment of port-wine stains with the 595-nm long pulsed dye laser: A large prospective study in adult Japanese patients
Authors: Akihiko Asahina, Takahiro Watanabe, Akiko Kishi, Naoko Hattori, Akira Shirai, Shinji Kagami, Rei Watanabe, Andre Le Pavoux, Takeo Maekawa, Kunihiko Tamaki, Kuniaki Ohara
Journal: Journal of the American Academy of Dermatology (2006)
Association of Heart Rate and Outcomes in a Broad Spectrum of Patients With Chronic Heart Failure
Authors: Davide Castagno, Hicham Skali, Madoka Takeuchi, Karl Swedberg, Salim Yusuf, Christopher B. Granger, Eric L. Michelson, Marc A. Pfeffer, John J.V. McMurray, Scott D. Solomon
Journal: Journal of the American College of Cardiology (2012)