tbuckley/cabot-search huggingface dataset:
Determining Surgical Indications for Acute Type B Dissection Based on Enlargement of Aortic Diameter During the Chronic Phase
Authors: Masaaki Kato, Hong-zhi Bai, Kenji Sato, Seiichi Kawamoto, Mitsunori Kaneko, Takashi Ueda, Daisuke Kishi, Kenji Ohnishi
Journal: Circulation (1995)

Background In patients with Stanford type B dissection who have been treated successfully with medical hypotensive therapy during the acute phase, a large number have incurred the risk of surgery during their chronic phases because of enlargement of the dissected aorta. The purpose of this study was to determine the indications for surgical treatment of acute type B dissection by studying chronic-phase enlargements of aortic dissections in patients treated successfully with medical hypotensive therapy during the acute phase. Methods and Results In 41 patients with type B dissection who had been treated medically during the acute phase, univariate and multivariate factor analyses were made to determine the predominant predictors for chronic-phase enlargement (≥60 mm) of the dissected aorta. Computed tomography was performed every 4 to 14 months to observe whether there was enlargement of the maximum aortic diameter. The predominant predictors for aortic enlargement in the chronic phase were the existence of a maximum aortic diameter of ≥40 mm during the acute phase ( P &lt;.001) and a patent primary entry site in the thoracic aorta ( P =.001). The values of actuarial freedom from aortic enlargement for the patients with a large aortic diameter (≥40 mm) during the acute phase and a patent primary entry site in the thorax at 1, 3, and 5 years were 70%, 29%, and 22%, respectively. No aortic enlargement was observed in the other patients throughout the entire follow-up period. Conclusions These data suggest that patients with acute type B dissection who have a large aortic diameter (≥40 mm) and a patent primary entry site in the thorax should be treated surgically during the acute phase on the condition that the surgical risk in this phase is limited.
Intravenous amiodarone in atrial fibrillation complicating myocardial infarction.
Authors: R L Blandford, J Crampton, H Kudlac
Journal: BMJ (1982)

Logynon was introduced into Britain in May 1980 after initial pilot studies.' 2 The preparation contains three different combinations of ethinyloestradiol and levonorgestrel: 30 and 50 Hg respectively for six days; 40 and 75 jLg for five days; and 30 and 125 itg for 10 days.Lachnit-Fixon3 cited 8028 treatment cycles with no pregnancies on 22 July
Effects of treatments for symptoms of painful diabetic neuropathy: systematic review
Authors: Man-chun Wong, Joanne W Y Chung, Thomas K S Wong
Journal: BMJ (2007)

<b>Objective</b> To evaluate the effects of treatments for the symptoms of painful diabetic neuropathy. <b>Design</b> Systematic review. <b>Data sources</b> Articles (English and full text) on double blind randomised trials found by searching with the key words anticonvulsant, antidepressant, non-steroidal anti-inflammatory drugs, tramadol, opioid, ion channel blocker, diabetic neuropathy, diabetic peripheral neuropathy, peripheral neuropathy, and neuropathy. The search included Medline, Embase, EMB reviews-AP Journal club, and the Cochrane central register of controlled trials. <b>Study selection</b> Randomised controlled trials comparing topically applied and orally administered drugs with a placebo in adults with painful diabetic neuropathy. <b>Data extraction</b> Data were extracted to examine quality of methods, characteristics of studies and patients, efficacy, and side effects. The primary outcome was dichotomous information for 50% or moderate reduction of pain. Secondary outcomes were 30% reduction of pain and withdrawals related to adverse events. <b>Results</b> Odds ratios were calculated for achievement of 30%, 50%, or moderate pain relief and for withdrawals related to adverse effects. Twenty five reports were included and seven were excluded. The 25 included reports compared anticonvulsants (n=1270), antidepressants (94), opioids (329), ion channel blockers (173), <i>N</i>-methyl-D-aspartate antagonist (14), duloxetine (805), capsaicin (277), and isosorbide dinitrate spray (22) with placebo. The odds ratios in terms of 50% pain relief were 5.33 (95% confidence interval 1.77 to 16.02) for traditional anticonvulsants, 3.25 (2.27 to 4.66) for newer generation anticonvulsants, and 22.24 (5.83 to 84.75) for tricylic antidepressants. The odds ratios in terms of withdrawals related to adverse events were 1.51 (0.33 to 6.96) for traditional anticonvulsants, 2.98 (1.75 to 5.07) for newer generation anticonvulsants, and 2.32 (0.59 to 9.69) for tricylic antidepressants. Insufficient dichotomous data were available to calculate the odds ratios for ion channel blockers. <b>Conclusion</b> Anticonvulsants and antidepressants are still the most commonly used options to manage diabetic neuropathy. Oral tricyclic antidepressants and traditional anticonvulsants are better for short term pain relief than newer generation anticonvulsants. Evidence of the long term effects of oral antidepressants and anticonvulsants is still lacking. Further studies are needed on opioids, <i>N</i>-methyl-D-aspartate antagonists, and ion channel blockers.
Hydroxyl radical generation by rheumatoid blood and knee joint synovial fluid.
Authors: H Kaur, S E Edmonds, D R Blake, B Halliwell
Journal: Annals of the Rheumatic Diseases (1996)

OBJECTIVE: To demonstrate directly that highly reactive hydroxyl radicals (OH.) can be generated in patients with rheumatoid arthritis and contribute to joint damage, and to examine the ability of blood to cause OH. generation. METHODS: The sensitive and specific technique of hydroxylation of aromatic compounds (salicylate and phenylalanine) was used to measure OH.. Synovial fluid and blood from patients with active rheumatoid arthritis were aspirated and immediately added to tubes containing salicylate and phenylalanine as detectors of OH., or to tubes containing saline as a control. Levels of specific products of attack of OH. upon salicylate (2,3- and 2,5-dihydroxybenzoates) and phenylalanine (ortho- and meta-tyrosines) were measured by high performance liquid chromatography. RESULTS: Synovial fluid samples aspirated into saline never contained ortho- or meta-tyrosines or 2,3-dihydroxybenzoate. Of 53 patients examined, synovial fluid and blood from 36 caused formation of ortho- and meta-tyrosines when aspirated into solutions containing phenylalanine. Repeated sampling from three "positive" patients showed consistent evidence of these hydroxylation products. Similarly, of 22 patients examined, synovial fluid and blood from 18 caused formation of 2,3- and 2,5-dihydroxybenzoates when aspirated into salicylate solutions. Further evidence for the role of OH. was provided by inhibition of the hydroxylation by the specific OH. scavengers mannitol and sodium formate. CONCLUSIONS: Aspirated knee joint fluids and blood from rheumatoid arthritis patients can generate OH., consistent with current views on the importance of this radical as a cytotoxic agent in rheumatoid disease. The ability of body fluids to cause OH. formation is not correlated with simple laboratory indices of disease activity, but is reproducible on sequential sampling from the same patients. The mechanism and significance of the phenomenon in rheumatoid arthritis pathology remain to be established.
Severe nonendemic pemphigus foliaceus presenting in the postpartum period
Authors: Hossein C Nousari, Arash Kimyai-Asadi, Nooshin Ketabchi, Luis A Diaz, Grant J Anhalt
Journal: Journal of the American Academy of Dermatology (1999)

The new onset of pemphigus in the postpartum period is exceedingly rare with only 1 case previously reported in the literature. We describe a 31-year-old woman who developed extensive denudation of her skin shortly after delivering her second child. Histologic examination, immunofluorescence testing, and immunoprecipitation with desmoglein 1 confirmed the diagnosis of pemphigus foliaceus. The patient responded to treatment with prednisone, cyclophosphamide, and plasmapheresis. The effect of the postpartum period on the onset and exacerbation of immune-mediated bullous diseases is discussed. (J Am Acad Dermatol 1999;40:845-6.)
ROBOTICALLY-ASSISTED 3-VESSEL PCI WITH CORPATH™ 200 SYSTEM RESULTS IN REDUCED OPERATOR RADIATION EXPOSURE BUT EQUIVALENT PROCEDURE AND X-RAY TIME, CONTRAST VOLUME AND HISTOLOGY OUTCOME WHEN COMPARED TO CONVENTIONAL MANUAL INTERVENTION IN SWINE
Authors: Greg L. Kaluza, Michail M. Pankratov, Gerard B. Conditt, Jennifer C. McGregor, Diane Ordanes, Armando Tellez, Frank D. Kolodgie, Renu Virmani, Juan F. Granada
Journal: Journal of the American College of Cardiology (2011)
Human monoclonal anti-basement membrane zone antibodies derived from virally transformed lymphocytes of a patient with bullous pemphigoid recognize epitopes associated with hemidesmosomes
Authors: H. SHIMIZU, T. HASHIMOTO, T. NISHIKAWA, R. A. J. EADY
Journal: British Journal of Dermatology (1991)

The purpose of this study was to determine the ultrastructural localization of the epitopes recognized by two human monoclonal antibodies designated 5E and 10D, that were derived from virally transformed lymphocytes from a patient with bullous pemphigoid (BP). Previous immunoblotting showed that 5E but not 10D reacted with a 230‐kDa protein in extracts of normal human skin. In the present study, indirect immunofluorescence showed that both 5E and 10D bound to the epidermal side of 1 m NaCl‐separated normal human skin. Immunoperoxidase electron microscopy showed that 5E and 10D formed discontinuous focal deposits along the basal region of the epidermal basal cells in normal human skin in a similar localization to that seen with whole BP sera. Post‐embedding immunogold electron microscopy demonstrated binding of both monoclonal antibodies to the intracellular components of hemidesmosomes. As far as we are aware, 5E and 10D are the first monoclonal antibodies to be described that recognize epitopes of BP antigen associated with hemidesmosomes and should serve as useful probes for future studies.
Effectiveness of out-of-hours biochemistry investigations.
Authors: R M Young, R B Payne
Journal: BMJ (1981)

A survey was carried out of doctors who used their out-of-hours biochemistry service to find out why requests for investigations were made, how often the results altered patient management, and whether they could define areas where investigations were unproductive. Of 107 questionnaires distributed, 147 (88%) were completed. In 86% the requests were for diagnosis or immediate patient management and in 35% the results actually altered management. Senior clinical staff were more efficient than their juniors in instigating biochemical investigations that proved to be effective. In no instance where the clinical staff predicted that it was unlikely that the results would alter management was management altered. It is suggested that joint reviews of case notes by junior and senior clinical staff would prove to be the most appropriate way to increase the effectiveness and efficiency of clinical investigation.
P73 A TRANSFORMING GROWTH FACTOR KINASE I INHIBITOR, LY2157299, MODULATES STEMNESS-RELATED BIOMARKERS IN HCC
Authors: B. Rani, F. Di Turi, L. Lupo, Y. Cao, A. Malfettone, I. Fabregat, E. Villa, G. Giannelli
Journal: Journal of Hepatology (2014)
Bilateral fetal uropathy: what is the outlook?
Authors: R. J. Arthur, H. C. Irving, D. F. Thomas, J. K. Watters
Journal: BMJ (1989)

To assess the morbidity and mortality associated with a prenatal diagnosis of bilateral fetal uropathy.Retrospective study.Departments of radiology, paediatric surgery, obstetrics, and pathology in two teaching hospitals that serve as referral centres for the Yorkshire region.126 Cases of fetal uropathy were referred either prenatally or postnatally from hospitals in Yorkshire between August 1982 and December 1987. The disease was bilateral in 54 cases and unilateral in 72 cases. In 14 cases bilateral fetal uropathy was associated with coexistent disease.All cases were managed individually by an obstetrician after discussion with the radiologists and paediatric surgeons. Babies who survived were treated prophylactically with antibiotics after delivery and were operated on if appropriate.Assessment of prognosis for long term renal function for each baby referred between August 1982 and December 1987: follow up ranged from six months to five years.Of the 54 fetuses with bilateral fetal uropathy, 13 were terminated as the prenatal findings of ultrasonography were considered to be incompatible with long term survival. Ten of the liveborn babies died, five of renal or pulmonary insufficiency, or both, and five of associated congenital anomalies. Thirty one infants survived to follow up; four of these had serious coexistent disease and two had impaired renal function. Thus the overall mortality was 43% and the morbidity rate 19%. The renal anomaly was associated with other serious disease in 14 cases (26%) compared with two (3%) of the 72 cases of unilateral fetal uropathy. All but two of the 27 infants with isolated bilateral urinary tract disease had excellent prospects for survival.Although bilateral fetal uropathy is associated with a high morbidity rate and mortality, careful prenatal assessment can help to identify fetuses with a poor prognosis. The outlook for a fetus with isolated renal disease if treated promptly after delivery is excellent and compares favourably with that reported after prenatal surgical intervention.
Cytokines and NASH: A pilot study of the effects of lifestyle modification and vitamin E
Authors: Marcelo Kugelmas, Daniell B. Hill, Beverly Vivian, Luis Marsano, Craig J. McClain
Journal: Hepatology (2003)

There are few data evaluating plasma and/or peripheral blood monocyte cytokine concentrations/production or attempts to manipulate proinflammatory cytokines in nonalcoholic steatohepatitis (NASH). A pilot project in a general clinical research center evaluated the effects of a step 1 American Heart Association diet plus aerobic exercise with or without 800 IU of vitamin E daily on cytokine profiles and liver enzyme levels in 16 patients with biopsy–proven NASH. Biochemical assessment of liver function, lipid profiles, and body mass index significantly improved during the first 6 weeks of therapy and remained stable during the following 6 weeks. Plasma hyaluronic acid (HA) concentrations decreased in parallel with weight loss. Plasma tumor necrosis factor (TNF) concentrations were significantly elevated in patients with NASH and similar to patients with stable alcoholic cirrhosis but not as elevated as in patients with acute alcoholic steatohepatitis (AH). Although plasma TNF, interleukin 8 (IL–8), and IL–6 concentrations were all significantly elevated compared with control values, only plasma IL–6 levels significantly decreased with therapy. Peripheral blood monocyte TNF, IL–8, and IL–6 production was significantly elevated in patients with NASH but did not significantly decrease. Independent effects of vitamin E were not observed in this small sample. In conclusion, patients with NASH have dysregulated cytokine metabolism similar to, but less pronounced than abnormalities documented in AH. Cytokine values generally did not decrease significantly with weight loss with or without vitamin E over the duration of the study. Lifestyle modifications (low–fat diet and exercise) were associated with improvement in liver enzymes, cholesterol, and plasma HA levels in patients with NASH, whereas the level of vitamin E supplementation used in this short–term pilot study provided no apparent added benefit.
Ambulatory Care in Teaching Hospitals
Authors: JOSEPH C. SHIPP
Journal: Annals of Internal Medicine (1977)

Editorial Notes1 February 1977Ambulatory Care in Teaching HospitalsJOSEPH C. SHIPP, M.D.JOSEPH C. SHIPP, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-86-2-237 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTeaching hospitals provide good care for the hospitalized patient but are less effective in caring for the ambulatory patient. This dichotomy exists because hospitals were established primarily to care for the hospitalized patient. Clinics and emergency services were established piecemeal to refer patients to the hospital and to support the clinical, educational, and research efforts of the faculty. Teaching hospitals have given little thought to the problem of providing accessible, individualized, continuing, and comprehensive care. The ambulatory patient is often "cared for" in multiple clinics at unnecessary cost to both the patient and the providers.In recent years several factors...References1. : Hospital Statistics, 1975 Google Scholar2. HUDSONNOURSE JE: Perspectives in primary care education. J Med Educ 50(12, suppl): 1-253, 1975 Google Scholar3. BERADUCCIDELBANCORABKIN ATM: The teaching hospitals and primary care: closing down the clinics. N Engl J Med 292:615-620, 1975 CrossrefMedlineGoogle Scholar4. GROSSMANSTOECKLEDINEEN JJJ: New organizations out of old ones: teaching group practices out of private practice and outpatient departments. Milbank Mem Fund Q 53(1): 65-73, 1975 CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Department of Internal Medicine University of Nebraska Medical Center Omaha, Nebraska Department of Health Services Association of American Medical Colleges Washington, D.C. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byExperience with community academic practice: Strategies for the ambulatory education of residentsClosing the clinics: Would it close the teaching hospital?Impact of attending level supervision of the emergency department experienceHealth care costs of medical patients at an urban care centerPrimary health care in an academic medical center. 1 February 1977Volume 86, Issue 2Page: 237-237KeywordsHospitalsPatients Issue Published: 1 February 1977 PDF downloadLoading ...
Insulin resistance and depression
Authors: Daniel J Smith
Journal: BMJ (2005)

Interstitial lung abnormalities (ILA) can be incidentally detected in patients undergoing low-dose CT screening for lung cancer. In this retrospective study, we explore the downstream impact of ILA detection on interstitial lung disease (ILD) diagnosis and treatment. Using a targeted approach in a lung cancer screening programme, the rate of de novo ILD diagnosis was 1.5%. The extent of abnormality on CT and severity of lung function impairment, but not symptoms were the most important factors in differentiating ILA from ILD. Disease modifying therapies were commenced in 39% of ILD cases, the majority being antifibrotic therapy for idiopathic pulmonary fibrosis.
Trends in Medical Knowledge as Assessed by the Certifying Examination in Internal Medicine
Authors: John J. Norcini
Journal: JAMA (1989)

The past decade has seen less competition for medical school positions accompanied by the declining interest of medical students in internal medicine. At the same time, the number of first postgraduate—year positions in internal medicine residencies has increased, as has the number of first-year residents who take those positions. The purpose of this study was to examine trends in the medical knowledge of internal medicine residents during the past 6 years. Comparison of performance on the items common to pairs of the certifying examinations of the American Board of Internal Medicine from 1983 to 1988 revealed that the scores of candidates in the reference group have declined, but not dramatically. This trend has occurred among candidates from the top residency programs as well as all other residency programs, and it is present in candidates of all levels of overall clinical competence. Continuing declines in this area could ultimately affect patient care. (<i>JAMA</i>. 1989;262:2402-2404)
P96The aortic root phenotype in bicuspid aortic valve disease: evidence of shared Smad2 activation in aortic regions of distinct embryologic origin
Authors: S Prapa, KP Mccarthy, D Krexi, MA Gatzoulis, SY Ho
Journal: Cardiovascular Research (2014)

Background: Transforming growth factor-b (TGFb) signalling plays a central role in vascular remodelling and aneurysm formation. A hypothesis of lineage-specific capacity in TGFb responsiveness has recently emerged which may explain the different aortopathy patterns in bicuspid aortic valve (BAV) disease. We aimed to assess the degree of histological abnormalities and TGFb activation in the BAV mesoderm-derived aortic root and ectoderm-derived ascending aorta.
Metabolism of Differently Labeled Cholesterol in Normal and Hypercholesteremic Rabbit
Authors: Walter M. Bartz, Inouye Kojima, Mary Connor
Journal: Circulation Research (1962)

C-4- and C-26-labeled cholesterols were fed via stomach tube to normal and several groups of hypercholesteremic rabbits. The serum, liver, and aortic cholesterol levels were measured, as were the liver and intestinal content and stool nonsaponifiable and saponifiable lipid fractions. The appearance of the isotopic cholesterol in these fractions and in the exhaled CO 2 was measured. The recovery rates of the cholesterol -26-C 14 was 20.0 to 38.3 per cent, and of the cholesterol -4-C 14 , 79.0 to 109.2 per cent. The cholesterol-fed animals showed distinctly higher radioactivity in the blood and in the aorta. The C-26, but not the C-4, activity was detected in the exhaled CO 2 . No activity was detected in the urine. Both tags were detected in the saponifiable fractions of the liver and intestinal contents. Arachidonic acid supplements to four rabbits resulted in increased excretion of activity in the saponifiable portion of the intestinal contents.