tbuckley/cabot-search huggingface dataset:
Electrocardiographic diagnosis of postinfarction regional pericarditis. Ancillary observations regarding the effect of reperfusion on the rapidity and amplitude of T wave inversion after acute myocardial infarction.
Authors: P B Oliva, S C Hammill, W D Edwards
Journal: Circulation (1993)

BACKGROUND The ECG recognition of diffuse pericarditis following acute myocardial infarction has been based on changes of the ST segment and, to a lesser extent, alterations of the PQ segment. No ECG criteria exist for the diagnosis of postinfarction regional pericarditis. Recently, it was observed that the T wave evolution follows an atypical pattern before fatal free wall rupture and that this pattern is due to the associated pericarditis. Therefore, this study was conducted on 200 patients with acute myocardial infarction to further elucidate the sensitivity and specificity of the atypical T wave changes in patients with regional postinfarction pericarditis without rupture and to assess the affect of lytic treatment on the rapidity and amplitude of postinfarction T wave evolution. METHODS AND RESULTS An analysis of the clinical courses and serial ECGs of 200 consecutive patients with acute myocardial infarction was performed. Among 43 patients with postinfarction pericarditis, the pattern of T wave evolution consistently differed from the customary postinfarction pattern of T wave evolution. This unusual evolutionary course was expressed as either persistently positive T waves 48 or more hours after infarction (67%) or premature, gradual reversal of inverted T waves to positive deflections (33%). The sensitivity and specificity of these T wave alterations were 100% and 77%, respectively. The only other processes identified that caused this type of postinfarction T wave evolution were cardiopulmonary resuscitation, reinfarction, and very small infarcts. Both reperfusion, as judged by the creatine kinase-MB curve, and patency, as assessed by the angiogram, were correlated with the rapidity and depth of T wave inversion. Ninety percent of patients with reperfusion attained a maximum T wave negativity of 3 mm or more within 48 hours after the onset of chest pain in the lead that initially displayed the greatest ST segment elevation. Seventy-six percent of patients without reperfusion attained a maximum negativity of 2 mm or less within 72 hours. Thus, like the ST segment, accelerated evolution and deepening of the T wave may be noninvasive markers of reperfusion. CONCLUSIONS First, premature reconcordancy of the ST segment and T wave after acute myocardial infarction is a sensitive, reasonably specific, and easily recognizable ECG manifestation of postinfarction regional pericarditis. Second, reperfusion is associated with accelerated evolution and deepening of the T waves following acute myocardial infarction.
Cessation interventions in routine health care
Authors: Tim Coleman
Journal: BMJ (2004)

Smoking cessation interventions are widely underused in primary and secondary care despite being effective and easy to deliver (see earlier articles in this series). Smoking causes much greater harm than, say, hypertension (which is generally identified and managed entirely in primary care by health professionals working to agreed routine, systematic, and structured protocols), yet few primary healthcare teams manage smoking as methodically as they approach hypertension.

Maximising the delivery of cessation interventions to smokers wanting to quit can probably achieve more in terms of years of life saved and provide better value for money (see later article in this series) than almost any other simple medical intervention.



Example of record sheet for noting information on smoking status and intervention. The sheet can be inserted into paper records; computer templates enable a similar electronic record to be kept 



The first step towards developing a systematic approach for the management of smoking is to treat smoking as a “vital sign.” To do this, health professionals must regularly inquire about patients' smoking status and have a methodical approach towards documenting and updating this in medical records. This information needs to be recorded in a prominent place so that it can be seen whenever medical records are accessed during consultations. In paper records, a summary card can be used, and, in electronic records, smoking status data should be lodged with other important summary information on a patient's health. Recording information where it is easily noticed prompts health professionals to raise the topic of smoking more frequently with patients.

The minimum information to record is whether the patient smokes and the date on which this was ascertained. It is also useful to record the average number of cigarettes smoked each day, not least because those who smoke more heavily are more likely to benefit from …
The MAPK ERK1 is a negative regulator of the adult steady-state splenic erythropoiesis
Authors: Soizic Guihard, Denis Clay, Laurence Cocault, Nathalie Saulnier, Paule Opolon, Michèle Souyri, Gilles Pagès, Jacques Pouysségur, Françoise Porteu, Murielle Gaudry
Journal: Blood (2010)
Monoclonal Antibodies: Progress is Slow but Sure
Authors: Carl M. Pinsky
Journal: New England Journal of Medicine (1986)

The article by Carrasquillo and colleagues in this issue1 is one step along the path taking the production of monoclonal antibodies from a laboratory tour de force to a usable diagnostic or therapeutic clinical tool. Despite the small number of patients in their study, these investigators have generated important new data concerning the behavior of a Radio-labeled monoclonal antibody, [111In]T101, in patients with cutaneous T-cell lymphoma, a rather rare disease. In addition to showing which metastases are most likely to be detected (lymph-node and thick erythrodermatous skin lesions) or missed (liver and spleen deposits and skin plaques) in imaging . . .
The Medical Directive
Authors: Linda L. Emanuel, Ezekiel J. Emanuel
Journal: JAMA (1989)

Living wills have been strongly endorsed in principle. Unfortunately, existing living wills are rarely used in clinical practice because they are vague and difficult to apply. To remedy this, we propose a new advance care document: the Medical Directive. The Medical Directive delineates four paradigmatic scenarios, defined by prognosis and disability of incompetent patients. In each scenario, patients are to indicate their preferences regarding specific life-sustaining interventions. The Medical Directive also provides for the designation of a proxy to make decisions in circumstances where the patient's preferences are uncertain. Finally, there is a section for a statement of wishes regarding organ donation. The Medical Directive provides an opportunity for significant improvement in the documentation of patients' preferences regarding life-sustaining care in states of incompetence. As an expression of a patient's wishes, the Medical Directive should be honored by courts and should facilitate physician-patient discussions of critical and terminal care options.Living wills have been endorsed in principle but little used in practice because physicians and patients find them vague and difficult to apply. The authors propose a new advance care document, the Medical Directive, that physicians can recommend to promote the inclusion of patient preferences in medical decisions at the end of life. A Medical Directive is divided into five parts: an introduction, a section of five paradigmatic scenarios of illness in which preferences for treatment are given, a section for the designation of a proxy decision maker, a section for organ donation, and a personal statement of the patient's goals and values. Possible objections to the Medical Directive are answered by the authors, who recommend routine availability and discussion of the Directive.
Effects of hexamethylene diisocyanate exposure on human airway epithelial cells: in vitro cellular and molecular studies.
Authors: Adam V Wisnewski, Qing Liu, Jing-Jing Miller, Nadine Magoski, Carrie A Redlich
Journal: Environmental Health Perspectives (2002)

In this study we developed an in vitro exposure model to investigate the effects of hexamethylene diisocyanate (HDI) on human airway epithelial cells at the cellular and molecular level. We used immunofluorescence analysis (IFA) to visualize the binding and uptake of HDI by airway epithelial cell lines (A549 and NCI-NCI-H292) and microarray technology to identify HDI sensitive genes. By IFA, we observed that subcytotoxic concentrations of HDI form microscopic micelles that appear to be taken up by cells over a 3-hr period postexposure. Microarray analysis (4.6K genes) of parallel cultures identified four genes (thioredoxin reductase, dihydrodiol dehydrogenase, TG interacting factor, and stanniocalcin) whose mRNA levels were up-regulated after HDI exposure. Northern analysis was used to confirm that HDI increased message levels of these four genes and to further explore the dose dependence and kinetics of the response. The finding that HDI exposure increases thioredoxin reductase expression supports previous studies suggesting that HDI alters thiol-redox homeostasis, an important sensor of cellular stress. Another of the HDI-increased genes, a dihydrodiol dehydrogenase, encodes a protein previously shown to be specifically susceptible to HDI conjugation, and known to detoxify other hydrocarbons. Together, the data describe a novel approach for investigating the effects of HDI binding and uptake by human airway epithelial cells and begin to identify genes that may be involved in the acute response to exposure.
409 The DC-signR tandem-repeat polymorphism in hepatitis C virus infection
Authors: J. Nattermann, G. Ahlenstiel, G. Feldmann, H.D. Nischalke, T. Muller, T. Berg, J. Rockstroh, R. Woitas, T. Sauerbruch, U. Spengler
Journal: Journal of Hepatology (2004)
Abstract 4604: Some of oral squamous cell carcinomas might originate from minor salivary glands, and these tumors shows aggressive biological behavior and poor prognosis
Authors: Hitoshi Kawamata, Sayaka Izumi, Yutaka Doi, Yutaka Imai
Journal: Cancer Research (2012)

Abstract Oral cancer massively invades the adjacent tissues and frequently metastasizes to the regional lymph nodes. Most of the oral cancer is histopathologically squamous cell carcinoma, and approximately 10 % of the oral floor cancer is salivary gland cancer, such as mucoepidermoid carcinoma and adenoid cystic carcinoma. According to the clinical behavior and histopathological features of the oral squamous cell carcinoma (OSCC), we hypothesize that OSCC might originate from either oral squamous epithelium or minor salivary glands. In this study, we attempted to clarify the possibility, in which some of the OSCC originated from minor salivary glands by microarray and clustering analysis. Furthermore, by using the eleven molecular markers which were identified by the microarray and clustering analysis, we determined the origin of OSCC, and compared their biological aggressiveness in the patients. The mRNA expression profile of the samples obtained from 6 patients with OSCC was analyzed by the AB1700 Chemiluminescent Microarray Analyzer on the Human Genome Survey Array containing 29,098 genes. Clustering analysis was performed by GeneSping GX 7.3. Clustering analysis by the expression level of the 917 genes, which were differentially expressed at least 3-folds in normal oral squamous epithelium and normal salivary glands, revealed that 6 samples can be divided into 2 groups. The expression profile of one group (4 cases) was similar to that of normal oral squamous epithelium, and that of another group (2 cases) was similar to that of normal salivary glands. Furthermore, we identified 11 genes from the 917 genes which can easily determine the origin of the OSCC. Subsequently, we examined the expression levels of 9 marker genes in 73 OSCC (45 men, 28 women) by RT-PCR and determined the origin of the OSCC. Twelve cases from 73 OSCCs (16%) were considered to originate from minor salivary glands, and these tumors showed highly metastatic potentials and poor prognosis. In conclusion, OSCC originates from either oral squamous epithelium or minor salivary glands. OSCCs originating from minor salivary glands showed aggressive biological behavior. Determination of the origin of the OSCC is helpful to make a treatment plan for the patients with OSCC. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4604. doi:1538-7445.AM2012-4604
Wills and wishes in organ donation
Authors: P. L. Tapley, P. J. McQuillan
Journal: BMJ (2012)

Families have difficulty accepting organ donation.1 Despite the patient’s wishes being pre-eminent, the family’s reluctance to agree carries an effective veto. Carers of dying patients and the transplantation service tread carefully, proceeding only with agreement and consensus, not in the face of opposition and resentment. An opt-out system, whereby organs are harvested …
MBD2 is a critical component of a methyl cytosine-binding protein complex isolated from primary erythroid cells
Authors: Evan P. Kransdorf, Shou Zhen Wang, Sheng Zu Zhu, Timothy B. Langston, Jeremy W. Rupon, Gordon D. Ginder
Journal: Blood (2006)

The chicken embryonic beta-type globin gene, rho, is a member of a small group of vertebrate genes whose developmentally regulated expression is mediated by DNA methylation. Previously, we have shown that a methyl cytosine-binding complex binds to the methylated rho-globin gene in vitro. We have now chromatographically purified and characterized this complex from adult chicken primary erythroid cells. Four components of the MeCP1 transcriptional repression complex were identified: MBD2, RBAP48, HDAC2, and MTA1. These 4 proteins, as well as the zinc-finger protein p66 and the chromatin remodeling factor Mi2, were found to coelute by gel-filtration analysis and pull-down assays. We conclude that these 6 proteins are components of the MeCPC. In adult erythrocytes, significant enrichment for MBD2 is seen at the inactive rho-globin gene by chromatin immunoprecipitation assay, whereas no enrichment is observed at the active beta(A)-globin gene, demonstrating MBD2 binds to the methylated and transcriptionally silent rho-globin gene in vivo. Knock-down of MBD2 resulted in up-regulation of a methylated rho-gene construct in mouse erythroleukemic (MEL)-rho cells. These results represent the first purification of a MeCP1-like complex from a primary cell source and provide support for a role for MBD2 in developmental gene regulation.
Challenging Man-Made Disease: The Memoirs of Harriet L. Hardy
Authors: J. F. McCahan
Journal: JAMA (1985)

Dr Hardy recounts the fascinating story of the trials and tribulations she has experienced during the more than four decades that she has labored in the fields of preventive and occupational medicine. Her efforts have been richly rewarded through recognition by her peers as an outstanding leader in occupational medical teaching and practice. In her autobiography, Dr Hardy tells of her early educational experiences as an English literature major at Wellesley College, her medical school studies at Cornell, and finally the residency at Philadelphia General Hospital. After completing her formal training, she entered private practice and served as health physician for a girls' boarding school and subsequently transferred to Radcliffe in a similar capacity. These experiences stimulated her interest in clinical preventive medicine as a career. It was through a position in the Division of Occupational Hygiene in the Massachusetts Department of Labor that she was exposed to the challenges
As good as it gets? Chronic care management in nine leading US physician organisations
Authors: T. G Rundall
Journal: BMJ (2002)

Innovations in care management processes have improved the care of patients with chronic illnesses, but many patients still do not receive these benefits. The authors have studied the barriers and facilitators to implementing these improvements in leading US physician practices About 125 million of the 276 million people living in the United States have some type of chronic illness (table 1).1 Four chronic conditions affect nearly half of Americans with a chronic disease: asthma, depression, and diabetes each affect about 15 million,2–4 while five million have congestive heart failure.5 In 1999 these four chronic diseases were directly responsible for 140 000 deaths in the United States6 and generated at least $173bn (£108bn, €170bn) in medical and other costs. 5 7–9 Over the past decade the effectiveness of care for patients with these and other major chronic illnesses has been improved by innovations in care management processes such as the use of guidelines, disease management techniques, case management, and patient education to improve self management of chronic disease.10 However, many patients are not benefiting from these advances. Recent studies indicate that fewer than half of US patients with asthma, depression, and diabetes receive appropriate treatment.11–13 Organisational characteristics of physician practices associated with effective chronic disease care include the use of patient care teams, supportive information systems, and a high volume of patients.14 Hence, we expect that in the United States moderate and large sized, well organised, multispecialty practices are likely to offer chronic disease care that is as good as it gets and provide other physician organisations with benchmarks against which performance can be measured. #### Summary points
Discharge Dilemmas as System Failures
Authors: John Banja, Jennifer Eig, Mark V. Williams
Journal: The American Journal of Bioethics (2007)

Click to increase image sizeClick to decrease image size Acknowledgement This paper was supported by Grant 1 U18 HS015882-01, “Hospital Patient Safe D(ischarge): A Discharge Bundle for Patients” from the Agency on Healthcare Research and Quality.
Significant improvement in specific bronchial challenge test after 6 months of immunotherapy with a standardized depigmented and polymerized Dermatophagoides pteronyssinus extract (Depigoid®)
Authors: Angel Ferrer, Javier García-Sellés, Pilar García-Ortega, Joan Bartra, Pere Gaig, María José Gómez, Enrique Fernández-Caldas, Miguel Casanovas
Journal: Journal of Allergy and Clinical Immunology (2002)
Ian Douglas Hutchinson Todd
Authors: J. Malcolm, S. Todd, P. Todd
Journal: BMJ (2012)

Ian Douglas Hutchinson Todd was born in Braemar. His father was in the civil service, which prompted many moves around the country, with Ian attending nine different schools before studying medicine at Aberdeen, where he qualified in 1950. House doctor posts were in and around London, and he met his future wife, Jo, a nurse in charge of the surgical theatres at Chase Farm Hospital, in 1951. He did his National Service in the Royal Army Medical Corps in Malaya in 1952-53. 

Work references for Ian from the 1950s already identified him as a good doctor, inspiring confidence in his patients …
Suppurative Pericarditis Complicating Osteomyelitis Treated with Streptomycin
Authors: T. E. J. Davies, C. Campbell
Journal: BMJ (1950)

±4-8 Curare .. 38 2 5.3% ± 3-7 (Local) .. (128) (27) (21 *09%8) (+3 7)The figures for local analgesia are included for rough comparison, but they are not strictly comparable with the others.
CpG‐Loaded Multifunctional Cationic Nanohydrogel Particles as Self‐Adjuvanting Glycopeptide Antitumor Vaccines
Authors: Sebastian Hartmann, Lutz Nuhn, Björn Palitzsch, Markus Glaffig, Natascha Stergiou, Bastian Gerlitzki, Edgar Schmitt, Horst Kunz, Rudolf Zentel
Journal: Advanced Healthcare Materials (2014)

Self-adjuvanting antitumor vaccines by multifunctional cationic nanohydrogels loaded with CpG. A conjugate consisting of tumor-associated MUC1-glycopeptide B-cell epitope and tetanus toxin T-cell epitope P2 is linked to cationic nanogels. Oligonucleotide CpG complexation enhances toll-like receptor (TLR) stimulated T-cell proliferation and rapid immune activation. This co-delivery promotes induction of specific MUC1-antibodies binding to human breast tumor cells without external adjuvant.
Plasma Levels of Norepinephrine
Authors: IRWIN J. KOPIN
Journal: Annals of Internal Medicine (1978)

Plasma norepinephrine derives from sympathetic nerves, but the proportion reaching the circulation before being metabolized varies with the type of nerve ending-effector junctions in the tissue. Plasma levels of norepinephrine also will fluctuate because of rapid metabolism rates and environmental, emotional, and endogenous stimuli provoking a sympathetic response. The responses of plasma catecholamines in spontaneously hypertensive rats and in normotensive rats of the same strain were compared after exposure to a variety of stressors. Drugs that inhibit monoamine oxidase, catechol-O-methyl transferase, or neuronal uptake were administered to show the effects of metabolic enzymes and neuronal uptake on the amounts of catecholamines reaching the circulation. Sympathetic nervous activity and the ability of the sympathetic nervous system to respond to a uniform stimulus are studied in hypertensive and normotensive subjects. A survey of the plasma levels of norepinephrine in a variety of neurologic disorders is given.
Contrast echocardiography in acute myocardial ischemia. III. An in vivo comparison of the extent of abnormal wall motion with the area at risk for necrosis
Authors: Sanjiv Kaul, Natesa G. Pandian, Linda D. Gillam, John B. Newell, Robert D. Okada, Arthur E. Weyman
Journal: Journal of the American College of Cardiology (1986)
Influence of neutralizing antibodies to adalimumab and infliximab on the treatment of psoriasis
Authors: T. Bito, R. Nishikawa, M. Hatakeyama, A. Kikusawa, H. Kanki, H. Nagai, Y. Sarayama, T. Ikeda, H. Yoshizaki, H. Seto, A. Adachi, T. Horikawa, M. Oka, C. Nishigori
Journal: British Journal of Dermatology (2013)

Background Current treatment with biologics has produced dramatic therapeutic effects in patients with psoriasis, although these agents occasionally decrease in efficacy. One of the main factors responsible for this attenuation is attributed to the development of antidrug antibodies (ADAs). Objectives To analyse the relationship between serum drug concentrations, the presence of ADAs and treatment efficacy of adalimumab and infliximab, and to determine the optimal use of these biologics. Methods This was a 1-year prospective study in the dermatology departments of Kobe University Hospital and collaborating hospitals. All patients starting a regimen of adalimumab and infliximab for psoriasis were included. We measured the serum concentration of the drugs and titres of antibodies to adalimumab and infliximab, as well as the Psoriasis Area and Severity Index scores at weeks 0, 4, 12, 24 and 48 during the first year of treatment. Results We observed a 50% positive rate of ADAs to adalimumab, and a 41% positive rate of ADAs to infliximab. The titres of ADAs showed a wide range from low to high titres. In the high-titre groups, the patients exhibited a decreased clinical response, and demonstrated a negative correlation between titre and clinical response. However, an equivalent therapeutic effect was observed between the low-titre group and the group with no antibodies detected for adalimumab. For infliximab, the patients with ADAs showed decreased clinical response. An apparent negative correlation between antibody production and reduced clinical response was observed. Conclusions Two biologics, adalimumab and infliximab, showed different therapeutic behaviour. The measurement of ADAs and drug concentrations has important implications for treatment with biologics.