tbuckley/cabot-search huggingface dataset:
Children eroticized by incest
Authors: Alayne Yates
Journal: American Journal of Psychiatry (1982)

The assumption that children involved in incest are passive, unwilling victims is an oversimplification of a complex situation. Young children may find such relationships gratifying and, when exposed over time to intense genital and extragenital stimulation, they often become highly erotic. This hypermature responsiveness may be viewed as learned behavior; the behavior is self-reinforcing and may be difficult to modify. The author describes three children to illustrate their arousal, inability to differentiate sensual from affectionate touch, early gender discrimination, and stereotyped role modeling. Foster homes are neither trained nor supported in caring for these children, so serial placements are common.
Psychiatric disorders in the first-degree relatives of probands with bulimia nervosa
Authors: J A Kassett, E S Gershon, M E Maxwell, J J Guroff, D M Kazuba, A L Smith, H A Brandt, D C Jimerson
Journal: American Journal of Psychiatry (1989)

Data from a family study of psychiatric disorders showed higher rates of major affective disorders, eating disorders, and alcoholism in first-degree relatives of 40 bulimic probands than in first-degree relatives of 24 control subjects. More importantly, the data showed higher rates of major affective disorders in relatives of bulimic probands who themselves had no history of major affective disorders than in relatives of control subjects. This significant finding indicates a familial relationship between bulimia nervosa and major affective disorders, which suggests the possibility of a common diathesis.
Abstract 8687: C-peptide Levels Predict Cardiovascular And Diabetes Related Mortality In Non-diabetic Adults
Authors: Nileshkumar Patel, Tracey H Taveira, Gaurav Choudhary, Wen Chih Wu
Journal: Circulation (2011)

Objective: Insulin resistance (IR), characterized by high endogenous insulin levels with or without clinical diabetes mellitus (DM), is an established pathophysiological precursor to the development of cardiovascular disease (CVD). Since IR can be intervened upon and endogenous insulin production is best measured by c-peptide levels, we sought to evaluate whether c-peptide levels can predict future CVD and DM related mortality before the onset of DM. Methods: US adults 40-74 years of age without clinical DM were identified based on a negative history, glucose tolerance test, fasting glucose or glycated hemoglobin levels from the III National Health and Nutrition Examination Survey (1988-1994) and followed through 12/31/2006. Vital status was obtained via linkage with the National Death Index and ICD-10 for causes of death. Participants were stratified by their degree of IR as measured by quartiles of fasting c-peptide levels and weighted analysis conducted to compare their cumulative risk of CVD and/or DM related mortality using lowest c-peptide quartile as the referent. Cox proportional hazard ratios (HR) adjusted for potential confounding. Analyses were repeated in subgroups of low CVD risk. Results: We identified 5,124 subjects, representative of 61,594,485 US adults without DM, mean age 54.9 ± 10.5, 48.4% male, 81.8% of Caucasian race. Quartiles of c-peptide levels were significantly associated with both CVD and DM death separately, and combined (table). Subgroup analyses suggested that c-peptide levels further stratified combined CVD/DM death risk in patients with traditionally low CVD/DM risk (ldl &lt;130mg/dl, normal glucose, BMI &lt;25kg/m2, BP&lt;140/90 mmHg). Conclusion: C-peptide levels predict CVD and DM related death in non-diabetic adults beyond traditional CVD/DM risk factors and may be a useful biomarker to identify otherwise unrecognized high risk subjects with significant IR for early intervention.
Abstract 13867: Molecular Mechanisms of Ezetimibe-Induced Attenuation of Postprandial Hypertriglyceridemia
Authors: Daisaku Masuda, Jose C Sandoval, Hajime Nakaoka, Ryota Kawase, Miyako Yuasa-Kawase, Kazuhiro Nakatani, Miwako Inagaki, Kazumi Tsubakio-Yamamoto, Tohru Ohama, Makoto Nishida, Masato Ishigami, Issei Komuro, Shizuya Yamashita
Journal: Circulation (2010)

Background: Postprandial hypertriglyceridemia (PHTG) is caused by the accumulation of chylomicron and chylomicron remnants and has been shown to be associated with metabolic syndrome and the develo...
Abstract 10590: Serum Inhibitory Factor 1 Concentration Positively Correlates with HDL-Cholesterol Level and is a New Independent Determinant of Cardiovascular Heart Disease Risk
Authors: Annelise Genoux, Jean-Bernard Ruidavets, Muriel Laffargue, Guillaume Combes, Didier Carrie, Michel Galinier, Jean Ferrieres, Bertrand Perret, Laurent Martinez
Journal: Circulation (2011)

Background: A high level of HDL-cholesterol (HDL-C) is the only one established negative risk factor for coronary artery disease (CAD). The HDL protective effect is mainly attributed to their major...
Abstract 1898: A Prognostic Risk Index Predicts Long-Term Mortality in Patients with Peripheral Arterial Disease
Authors: Harm H Feringa, Virginie H van Waning, Inge de Liefde, Jeroen J Bax, Eric Boersma, Olaf Schouten, Peter G Noordzij, Martin Dunkelgrun, Stefanos Karagiannis, Radosav Vidakovic, Don Poldermans
Journal: Circulation (2006)

Background: Prognostic information in patients with peripheral arterial disease (PAD) may provide the basis for optimal treatment strategies. In this study, a prognostic risk index for 10-year mort...
Resistance to antidepressant medications and short-term clinical response to ECT
Authors: J Prudic, R F Haskett, B Mulsant, K M Malone, H M Pettinati, S Stephens, R Greenberg, S L Rifas, H A Sackeim
Journal: American Journal of Psychiatry (1996)

Traditionally, it has been widely assumed that the likelihood of response to ECT is independent of the adequacy of previous treatment with antidepressant medications. However, recent research has raised the possibility that medication-resistant patients with depression have a poorer clinical ECT outcome than patients who have not failed previous adequate medication trials.Medication resistance of 100 patients with primary, unipolar, nonpsychotic major depression was evaluated during the index episode with the Antidepressant Treatment History Form. Patients were recruited and treated with ECT at three sites; standardized ECT and clinical assessment procedures were used. Clinical outcome was assessed immediately and 1 week after completion of the ECT course.Patients who previously had failed one or more adequate antidepressant medication trials were less likely to respond to subsequent ECT than patients not known to be medication resistant. This finding held within each study site, whether clinical response was assessed categorically or in terms of the magnitude of symptomatic improvement and after the authors accounted for other potential predictors of clinical outcome. Resistance to heterocyclic antidepressants predicted poorer outcome after ECT, while resistance to selective serotonin reuptake inhibitors and monoamine oxidase inhibitors did not show significant predictive relations.While a substantial percentage of medication-resistant patients respond to ECT, clinical outcome in this group is inferior to that of patients without established medication resistance. The predictive power of medication resistance is generalizable across diverse clinical settings, particularly for heterocyclic antidepressants, which perhaps suggests an overlap in the mechanisms of actions of ECT and this medication class.
Abstract 3064: Prognostic Significance of Left Atrial Appendage “Sludge” in Patients with Atrial Fibrillation: A New Transesophageal Echocardiographic Thromboembolic Risk Factor
Authors: Boris S Lowe, Brandon Varr, Kevin Shrestha, Christine Whitman, Allan L Klein
Journal: Circulation (2007)

Background: Among the clinical and echocardiographic indices used to stratify thromboem-bolic risk to patients with atrial fibrillation (AF), left atrial appendage (LAA) thrombus stands as the only...
Abstract 2006: A 31-Year-Old Woman with Fever, Rash, Facial Swelling, and Fulminant Heart Failure
Authors: Jessica L Mega, Jason R Becker, Marc S Sabatine
Journal: Circulation (2006)

A 31-year-old woman with a history of multiple sclerosis was started on modafinil (Provigil). When periorbital edema and a rash were noted, the medication was stopped and steroids were initiated. S...
Rethinking Consultants: Where medical science and human behaviour meet
Authors: J. Rees
Journal: BMJ (1995)

Although we may be wrong about the details, we should try to imagine what the future holds for hospital consultants. The days of the independent consultant in the same post for 30 years are over, and there will be a change from "the" consultant to a few tiers of senior staff. Patients will increasingly demand to see specialists, so more specialists will be needed. As patients and their advocates become better informed the traditional rationing of clinical care to patients in Britain, such as restricting access to specialists, cannot continue. There is a current trend for evidence based health care, but the idea that each element of medical practice can be dictated by systematic evidence based research will prove to be naïve--such research informs practice rather than dictates it. Science will continue to act as the guide to medical practice but specialists will not be turned into a set of logical operators running programs designed by health planners.
Infectious Diseases and Medical Microbiology.
Authors: Abraham I. Braude, Charles E. Davis, Joshua Fierer
Journal: Annals of Internal Medicine (1986)

ous edition. The book is divided into three sections. The first covers general principles of microbiology, bacteriology, virology, mycology, parasitology, and antimicrobial chemotherapy. The second section discusses specific microbial agents, with a brief review of general response to infection. The third section reviews the clinical infectious disease syndromes by organ system. A subsection on infections acquired from animals and factitious illness is provided. As with any textbook of this type, where the same subject matter is covered in two or possibly three sections, there is a tendency toward repetition. However, for the most part this has been avoided, since the initial section covers the characteristics of the organisms, eg, morphology, antigenic composition, physiology, immunity, and laboratory diagnosis, while the third section focuses much
Results of a randomized trial comparing idarubicin and cytosine arabinoside with daunorubicin and cytosine arabinoside in adult patients with newly diagnosed acute myelogenous leukemia
Authors: E Berman, G Heller, J Santorsa, S McKenzie, T Gee, S Kempin, S Gulati, M Andreeff, J Kolitz, J Gabrilove
Journal: Blood (1991)
Abstract 1908: Noninvasive Coronary Angiography Using 256-slice Multislice Computed Tomography
Authors: Sadako Motoyama, Hirofumi Anno, Masayoshi Sarai, Takahisa Sato, Kaori Inoue, Yoshihiro Sanda, Yukio Ozaki, Hitoshi Hishida, Kazuhiro Katada, Teruhito Mochizuki, Naoki Sugihara
Journal: Circulation (2006)
Abstract 3898: Implementation of a Novel Pathway for Management of Acute Decompensated Heart Failure Improves Guidelines Adherence Along With Decreases in Mortality and Readmissions: A Four Years ACAP-HF Analysis
Authors: Emad F Aziz, Marrick Kukin, Fahad Javed, Sandeep Pulimi, Balaji Pratap, Amjad Nader, Eyal Herzog
Journal: Circulation (2009)

Background: Clinical guidelines for the management of acute decompensated heart Failure (ADHF) have consistently shown a major gap between the national guidelines and their application in the actual management of patients with ADHF. In 2004 a new program “Advanced Cardiac Admission Program” ACAP was developed and implemented at our Institution. The program consists of tools and strategies for implementing guidelines.  Methods: 747 patients admitted with ADHF were risk stratified on admission and managed according to our implemented pathway. Implementation feasibility and clinical response were reviewed at 48 months, and compared to published national statistics for hospital performances.  Results: Over the past 4 years, B blocker utilization rate at discharge improved from 35% to 76%; p  Conclusion: Implementation of a novel pathway for management of acute decompensated heart failure improves guidelines adherence and significantly decreases mortality and readmission rates at four years follow up.
Abstract 19450: Manual Thrombus Aspiration is not Associated with Reduction in Infarct Size Assessed by Delayed Enhancement MDCT
Authors: Doo Sun Sim, Yun-Hyeon Kim, Daun Lee, Hyun Ju Seon, Myung Ho Jeong, Jeong Gwan Cho, Jong Chun Park, Youngkeun Ahn
Journal: Circulation (2012)

Objective: We sought to assess whether manual thrombus aspiration could reduce infarct size in patients with acute ST-elevation myocardial infarction (MI) undergoing primary percutaneous coronary intervention (PCI). Background: The efficacy of manual thrombus aspiration during primary PCI for acute MI remains controversial. Methods: Between April 2009 and Mar 2011, 86 consecutive patients presenting with first acute STEMI (Killip≤II) within 12 hours after the symptom onset were randomized to manual thrombus aspiration (group I, N=44) or conventional PCI without thrombus aspiration (group II, N=42). The use of glycoprotein IIb/IIIa inhibitor (GPI) was left to the discretion of the operator. All patients received aspirin 300 mg and clopidogrel 600 mg before PCI and underwent delayed enhancement (DE) multi-detector computed tomography (MDCT) immediately after PCI without injection of an additional contrast media for assessment of infarct size, determined as the total volume of myocardium showing DE. DE MDCT was repeated at 2 months after PCI. The primary endpoint was infarct size reduction at 2 months. Results: Baseline clinical characteristics and angiographic findings were similar between the 2 groups. There were no differences between group I and II in symptom-to-door time, door-to-balloon time, PCI-to-MDCT time, Pre-PCI TIMI 0/1, post-PCI TIMI 3, or the use of GPI. Markers of myocardial reperfusion showed better outcome in group I but without statistical difference: ST-resolution rate &gt;70% (74% vs. 65%), myocardial blush grade 3 (88% vs. 68%), and corrected TIMI frame count &lt;28 (31% vs. 24%). Initial infarct size determined by DE MDCT and left ventricular ejection fraction (LVEF) by 2-dimensional echocardiography were similar between group I and II (17±18 mL vs. 22±23 mL and 58±11% vs. 55±10%, respectively). At 2 months, there was no difference in infarct size and left ventricular ejection fraction between the groups: 14±10 mL vs. 17±12 mL and 62±12% vs. 60±2%, respectively. No adverse cardiac events occurred in either group during the 2-month clinical follow-up. Conclusion: Manual thrombus aspiration was not associated with reduction in infarct size in patients with acute ST-elevation MI undergoing primary percutaneous coronary intervention.
Abstract 3778: Combining First-pass Perfusion and Cine Wall Motion Assessment by Cardiac Magnetic Resonance During High-Dose Dobutamine Stress Provides Strong Association with Long-Term Patient Prognosis from Coronary Artery Disease
Authors: Raymond Y Kwong, Matthew A Kaminski, Maung M Khin, Kenneth Brown, Sui Tsang, H. Glenn Reynolds, E. Kent Yucel
Journal: Circulation (2006)

Background: Assessment of myocardial perfusion and regional function during dobutamine cardiac MRI (CMR) can characterize the cascade of demand ischemia. We tested the hypothesis that ischemia by p...
Abstract 5763: GP IIb/IIIa Inhibitors During Primary Percutaneous Coronary Intervention for STEMI: A Meta-Analysis of Randomized Controlled Trials
Authors: Umesh U Tamhane, Pascal Meier, Stanley Chetcuti, P. Michael Grossman, Hitinder S Gurm
Journal: Circulation (2009)

Background: Earlier meta analyses demonstrated a survival benefit with adjunctive GP IIb/IIIa inhibitors (GPI) during primary percutaneous interventions (pPCI) for STEMI. Recent pPCI trials evaluating the role of GPI have demonstrated conflicting results. We performed a comprehensive meta-analysis to evaluate the role of adjuvant GPI therapy in patients undergoing pPCI. Methods: Our meta-analysis included 15 randomized trials (n= 11407 patients) comparing adjunctive GPI therapy with heparin or bivalirudin in patients undergoing pPCI for STEMI. Summary odds ratios for safety and efficacy endpoints at 30 days were calculated using random-effects models. Results: There was no significant difference in the incidence of 30-day mortality (Odds ratio [OR] 0.90, 95% CI 0.65–1.23, p = 0.49), reinfarction (OR 0.84, 95% CI 0.61–1.15, p = 0.27) or stroke (OR 0.68, 95% CI 0.35–1.30, p = 0.25). GPI therapy was associated with a significant reduction in rates of target vessel revascularization (OR 0.67, 95% CI 0.53 – 0.85, p = 0.001) and stent thrombosis (OR 0.51, 95% CI 0.32 – 0.83, p = 0.006). The risk of major bleeding (OR 1.72, 95% CI 1.39 –2.14, p&lt; 0.001) and thrombocytopenia (OR 2.2, 95% CI 1.63–2.98, p&lt; 0.001) was significantly increased in the GPI regimen.GPI therapy would prevent approximately 9 ST at the cost of 10 major bleeding episodes for every 1000 STEMI patients. Conclusion: Adjuvant GPI therapy is not associated with improved survival compared to control therapy in STEMI patients undergoing pPCI. It significantly reduced ST and TVR at the cost of increase in major bleeding and thrombocytopenia.
Abstract 17437: Ultra Fast Brightfield and Fluorescence Imaging of Micron Size Objects for Research in Microbubble-Ultrasound Mediated Therapeutics
Authors: Xucai Chen, Jianjun Wang, Flordeliza Villanueva
Journal: Circulation (2011)

Background: Ultrasound (US)-assisted therapies such as US-induced microbubble (MB) destruction have potential to enhance thrombolysis and drug or gene delivery for cardiovascular disease. Visualization of US-MB-cell interactions, which occur in nano-second time scale due to the physics of US, should yield insights into therapeutically relevant MB dynamics, and improve design of US-MB-mediated therapies. We present a high speed brightfield and fluorescence imaging system that allows unique in vitro and in vivo microscopic observations of MB acoustic behavior. Methods: Our integrated system includes a custom multi-frame camera and software control (Cordin Co), customized modular microscope and laser system, US generator, and combined US and optical imaging chamber for in vitro and in vivo MB observations. The camera system, based on a rotating mirror design, contains 64 digital CCD cameras (1392 x 1040 pixels) and acquires 128 image frames. A strobe light triggered from the timing board is used for the brightfield light source. A fast pulse capable Cyan-488 optically pumped semiconductor laser system is used for fluorescence imaging. A custom fiber optics alignment system delivers laser light through the microscope. Results: The system images at up to 25 million frames per second (Mfps). Fig 1A shows selected frames of fluorescent beads (1, 2, 4 um), proving the concept of ultra-fast fluorescent imaging, and demonstrating the potential for in vivo intravital microscopy of vibrating fluorescent MB in the microcirculation. Fig 1B shows selected brightfield frames of US-induced MB vibration, fluid jets, and invagination of thrombus (block arrow). Conclusion: We have developed a high speed camera system for fluorescence and brightfield imaging at 25 Mfps. This system should enable unique visualization of interactions between US, MB, and cells in vitro and in vivo, and ultimately help to optimize novel US-MB mediated therapies for cardiac disease.
Fish Oil and Post-Operative Atrial Fibrillation
Authors: Dariush Mozaffarian, Jason H.Y. Wu, Marcia C. de Oliveira Otto, Chirag M. Sandesara, Robert G. Metcalf, Roberto Latini, Peter Libby, Federico Lombardi, Patrick T. O'Gara, Richard L. Page, Maria G. Silletta, Luigi Tavazzi, Roberto Marchioli
Journal: Journal of the American College of Cardiology (2013)
OC-035 Elastography for the diagnosis of severity of fibrosis in chronic liver disease: a diagnostic test accuracy meta-analysis
Authors: E Tsochatzis, K Gurusamy, S Ntaoula, M Garcovich, B Davidson, A Burroughs
Journal: Gut (2010)

<h3>Introduction</h3> Transient elastography is a non-invasive method developed as an alternative to liver biopsy to assess fibrosis severity. In this meta-analysis, we assessed the performance of elastography in diagnosing fibrosis using liver biopsy as the reference standard. <h3>Methods</h3> Electronic search of MEDLINE, EMBASE, Science citation index and Cochrane Library; and hand-search of major conference abstracts and article references were performed by two authors independently. Included studies used biopsy as reference standard, reported on data necessary to calculate the true-positive, false-positive, true-negative, and false-negative diagnostic results of elastography for a fibrosis stage and had a 3-month maximum interval between tests. METAVIR F2 and cirrhosis were analysed. Study quality was assessed using the QUADAS tool. Data were combined using the hierarchical summary receiver operator characteristics, and bivariate normal random-effects analysis of sensitivity and specificity methods, using the METANDI module. <h3>Results</h3> We identified 40 eligible studies (32 full papers). No article was assessed as adequate for all the questions in QUADAS. Only nine studies had both an acceptable reference and index test quality. Overall, the summary sensitivity and specificity was 0.79 (95% CI 0.74 to 0.82) and 0.78 (95% CI 0.72 to 0.83) for F2 and 0.83 (95% CI 0.79 to 0.86) and 0.89 (95% CI 0.87 to 0.91) for cirrhosis. With an elastography result at or over the threshold value as determined in each study, for F2 or cirrhosis (“positive” result), the corresponding post-test probability for presence of these stages (if pre-test probability was 50%) was 78%, and 88%, respectively, while values falling below those thresholds (“negative” result), the post-test probability was 21% and 16%, respectively. No optimal stiffness cut-offs for specific fibrosis stages were validated in independent cohorts. There was a wide range and overlap of cut-offs within and between different fibrosis stages. <h3>Conclusion</h3> Elastography is a good screening test for cirrhosis, with an 88% disease probability following a “positive” measurement, and a slightly worse tool in F=2. However, a “negative” measurement is less accurate, with disease being present in 15–20% of cases depending on fibrosis stage. Validation of liver stiffness cut-offs is required before elastography can be considered as sufficiently accurate for non-invasive diagnosis of fibrosis stages.
Abstract 13690: Clinical Benefits of Lowering Severely High Triglycerides on Cardiovascular Events, Pancreatitis, and Diabetes
Authors: Jennifer B Christian, Bhakti Arondekar, Erin K Buysman, Susan L Johnson, John D Seeger, Terry A Jacobson
Journal: Circulation (2011)

Background: The impact on clinical outcomes when severely elevated triglycerides (TG) are lowered to below 500 mg/dL is not known. We aimed to quantify the effect of reducing severely elevated TG l...