tbuckley/cabot-search huggingface dataset:
Association of Coronary CT Angiography or Stress Testing With Subsequent Utilization and Spending Among Medicare Beneficiaries
Authors: Jacqueline Baras Shreibati, Laurence C. Baker, Mark A. Hlatky
Journal: JAMA (2011)

Coronary computed tomography angiography (CCTA) is a new noninvasive diagnostic test for coronary artery disease (CAD), but its association with subsequent clinical management has not been established.To compare utilization and spending associated with functional (stress testing) and anatomical (CCTA) noninvasive cardiac testing in a Medicare population.Retrospective, observational cohort study using claims data from a 20% random sample of 2005-2008 Medicare fee-for-service beneficiaries 66 years or older with no claims for CAD in the preceding year, who received nonemergent, noninvasive testing for CAD (n = 282,830).Cardiac catheterization, coronary revascularization, acute myocardial infarction, all-cause mortality, and total and CAD-related Medicare spending over 180 days of follow-up.Compared with stress myocardial perfusion scintigraphy (MPS), CCTA was associated with an increased likelihood of subsequent cardiac catheterization (22.9% vs 12.1%; adjusted odds ratio [AOR], 2.19 [95% CI, 2.08 to 2.32]; P < .001), percutaneous coronary intervention (7.8% vs 3.4%; AOR, 2.49 [2.28 to 2.72]; P < .001), and coronary artery bypass graft surgery (3.7% vs 1.3%; AOR, 3.00 [2.63 to 3.41]; P < .001). CCTA was also associated with higher total health care spending ($4200 [$3193 to $5267]; P < .001), which was almost entirely attributable to payments for any claims for CAD ($4007 [$3256 to $4835]; P < .001). Compared with MPS, there was lower associated spending with stress echocardiography (-$4981 [-$4991 to -$4969]; P < .001) and exercise electrocardiography (-$7449 [-$7452 to -$7444]; P < .001). At 180 days, CCTA was associated with a similar likelihood of all-cause mortality (1.05% vs 1.28%; AOR, 1.11 [0.88 to 1.38]; P = .32) and a slightly lower likelihood of hospitalization for acute myocardial infarction (0.19% vs 0.43%; AOR, 0.60 [0.37 to 0.98]; P = .04).Medicare beneficiaries who underwent CCTA in a nonacute setting were more likely to undergo subsequent invasive cardiac procedures and have higher CAD-related spending than patients who underwent stress testing.
The Anatomy of Hope—How People Prevail in the Face of Illness
Authors: Kate Scannell
Journal: Annals of Internal Medicine (2004)

Medical Writings: Book Notes20 July 2004The Anatomy of Hope—How People Prevail in the Face of IllnessKate Scannell, MDKate Scannell, MDFrom The Permanente Medical Group, Oakland, California.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-2-200407200-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Groopman J. 248 pages. New York: Random House; 2004. $24.95. ISBN 0375506381. Order at www.randomhouse.com.Fields of medicine: All.Format: Hardcover book.Audience: All physicians, medical students, and patients.Purpose: To remind us of the exquisitely particular ways that hope emerges between a doctor and a patient who faces a serious illness. To journey deeply into the art of clinical decision making with an articulate and seasoned guide.Content: Through finely rendered prose, the physician–author recounts the stories of 5 of his patients with cancer, each of whom illuminates “another dimension of the anatomy of hope.” The sixth chapter concerns ... Author, Article, and Disclosure InformationAffiliations: From The Permanente Medical Group, Oakland, California. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 20 July 2004Volume 141, Issue 2Page: 164KeywordsCancer treatmentDecision makingFallsForecastingFrailtyLower back painSoftware tools ePublished: 20 July 2004 Issue Published: 20 July 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Handing over the prescription pad
Authors: N. Hawkes
Journal: BMJ (2009)

Substrates that are specific for certain UDP-glucuronosyltransferase (UGT) isoforms are usually used as specific inhibitors to identify UGT isoforms responsible for the glucuronidation of drugs. 1-Naphthol and 4-nitrophenol are probe substrates for human UGT1A6. In the present study, we found that UGT1A1-catalyzed estradiol 3-<i>O</i>-glucuronide formation and UGT1A4-catalyzed imipramine <i>N</i>-glucuronide formation in human liver microsomes were prominently decreased in the presence of 1-naphthol, but those by recombinant human UGT1A1 and UGT1A4, respectively, were not. Interestingly, when recombinant UGT1A6 was added in the reaction mixture, these activities by recombinant UGT1A1 and UGT1A4 were diminished in the presence of 1-naphthol. To interpret this phenomenon, the inhibitory effects of 1-naphthol <i>O</i>-glucuronide and UDP, products of the glucuronidation of 1-naphthol, were investigated. We found that UDP strongly inhibited the UGT1A1 (<i>K</i><sub>i</sub> = 7 μM) and UGT1A4 (<i>K</i><sub>i</sub> = 47 μM) activities in a competitive manner for the 5′-diphosphoglucuronic acid binding. These results suggest that UDP produced by UGT1A6-catalyzed 1-naphthol glucuronidation, but not 1-naphthol <i>O</i>-glucuronide and 1-naphthol per se, is the actual inhibition substance. Next, we examined the inhibitory effects of 15 compounds that are substrates of UGTs on estradiol 3-<i>O</i>-glucuronide formation in human liver microsomes compared with those by recombinant UGT1A1. Among them, 4 compounds (1-naphthol, 2-naphthol, 4-nitrophenol, and 4-methylumbelliferone) with high turnover rates (<i>V</i><sub>max</sub>/<i>K</i><sub>m</sub> value &gt;200 μl/min/mg) showed more potent inhibition of the activity in human liver microsomes compared with that by the recombinant UGT1A1. Thus, we should pay attention to the inhibitory effects of UDP on UGT, which may cause erroneous evaluations in inhibition studies using human liver microsomes.
Mechanistic insights into Bardet-Biedl syndrome, a model ciliopathy
Authors: Norann A. Zaghloul, Nicholas Katsanis
Journal: Journal of Clinical Investigation (2009)

Bardet-Biedl syndrome (BBS) is a multisystemic disorder typified by developmental and progressive degenerative defects. A combination of genetic, in vitro, and in vivo studies have highlighted ciliary dysfunction as a primary cause of BBS pathology, which has in turn contributed to the improved understanding of the functions of the primary cilium in humans and other vertebrates. Here we discuss the evidence linking the clinical BBS phenotype to ciliary defects, highlight how the genetic and cellular characteristics of BBS overlap with and inform other ciliary disorders, and explore the possible mechanistic underpinnings of ciliary dysfunction.
Hypercoagulability in Working Men and Women with High Levels of Panic-Like Anxiety
Authors: Roland von Känel, Brigitte M. Kudielka, Renate Schulze, Marie-Louise Gander, Joachim E. Fischer
Journal: Psychotherapy and Psychosomatics (2004)

&lt;i&gt;Background:&lt;/i&gt; There is growing evidence that cardiovascular diseases are relatively more prevalent in subjects who feel anxious. An increased clotting diathesis might subject anxious individuals to an elevated arterial thrombotic risk. We investigated whether panic-like anxiety would relate to a hypercoagulable state. &lt;i&gt;Methods:&lt;/i&gt; Study participants with a complete data set were 691 employees (mean age ± SD 40 ± 11 years, 83% men) recruited from two German companies. Subjects were asked to self-rate the onset of sudden feelings of panic in the previous week on a 4-point Likert scale: 0 = not at all (n = 416), 1 = not very often (n = 179), 2 = quite often (n = 55), and 3 = very often indeed (n = 41). Levels of fibrinogen, of the antifibrinolytic enzyme type 1 plasminogen activator inhibitor (PAI-1), and of the hypercoagulability marker fibrin D-dimer were measured in plasma. &lt;i&gt;Results:&lt;/i&gt; While the level of D-dimer was significantly different across the 4 scores of panic feelings (F&lt;sub&gt;3, 687&lt;/sub&gt; = 6.49, p &lt; 0.001), the levels of fibrinogen and PAI-1 were not. After having controlled for a range of confounders of hemostatic function, the 96 subjects reporting panic feelings either ‘quite often’ or ‘very often indeed’ had higher D-dimer levels (mean ± SEM 165 ± 12.0 vs. 145 ± 4.3 ng/ml, F&lt;sub&gt;20, 670&lt;/sub&gt; = 4.78, p = 0.030) and lower fibrinogen levels (259 ± 6.9 vs. 274 ± 2.5 mg/dl, F&lt;sub&gt;20, 670&lt;/sub&gt; = 4.71, p = 0.030) than the 595 subjects reporting panic feelings either ‘not at all’ or ‘not very often’. &lt;i&gt;Conclusions:&lt;/i&gt; The findings suggest increased fibrin turnover with sudden feelings of panic. Prospective studies need to show whether such a procoagulant mechanism may contribute to the increased coronary risk with panic-like anxiety.
Abstract 1237: Role of Src in resistance to anoikis in detachedpancreatic cancer cells
Authors: Evan Gomes, Sarah F. Connelly, Justin M. Summy
Journal: Cancer Research (2011)

Abstract Pancreatic adenocarcinoma is an aggressive malignancy currently ranked as the fourth leading cause of cancer related death in the United States, with over 95% of patients succumbing to the disease within 5 years of diagnosis. The vast majority of pancreatic cancer deaths are due to metastatic dissemination of the primary tumor. The non-receptor protein tyrosine kinase, c-Src (Src) has emerged in recent years as a potential target for pancreatic cancer treatment. In vitro studies have demonstrated the importance of Src for pancreatic tumor cell adhesion, migration, invasiveness, and resistance to apoptotic death. Mouse models of pancreatic cancer have indicated an important role for Src in formation of metastases. In addition, SHP-2, a non-receptor protein tyrosine phosphatase that regulates Src family kinase activity, has been recently shown to be a key mediator of various signaling pathways and evidence has established clinical relevance for SHP-2 in human diseases. Our goal is to determine the importance of Src for discrete steps in the progression to pancreatic cancer metastasis and resistance to detachment-induced cell death and the role of SHP-2 in modulating Src activity and downstream biology during this process. We have demonstrated a rapid and robust activation of Src in L3.6 human pancreatic cancer cells that have become detached from the extracellular environment, a crucial step in the development of metastases. Also, we have observed co-immunoprecipitation between Src and SHP-2 in detached cells, suggesting a potential role for SHP-2 in regulating Src activity in detached pancreatic cancer cells. In addition, our results reveal a Src-dependent activation of the Akt cell survival cascade and the stress kinase, Jun N-terminal kinase (JNK) in detached cells. Furthermore, this study confirmed that inhibition of both Src and SHP-2 in combination sensitizes L3.6 pancreatic cancer cells to anoikis in detached cells. We hypothesize that Src activity in detached pancreatic cancer cells promotes metastasis through suppression of anoikis. We will confirm these in vitro studies by testing the effects of inhibition of Src alone or in combination with SHP-2 inhibition on metastatic tumor formation using a nude mouse experimental metastasis model. The potential use for the Src and SHP-2 signaling axes as therapeutic targets for many cancers remains largely untapped. Our studies suggest that the anti-tumor and anti-metastatic effects of Src inhibition may be improved through simultaneous inhibition of SHP-2. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1237. doi:10.1158/1538-7445.AM2011-1237
Estrogenicity of resin-based composites and sealants used in dentistry.
Authors: N Olea, R Pulgar, P Pérez, F Olea-Serrano, A Rivas, A Novillo-Fertrell, V Pedraza, A M Soto, C Sonnenschein
Journal: Environmental Health Perspectives (1996)

We tested some resin-based composites used in dentistry for their estrogenic activity. A sealant based on bisphenol-A diglycidylether methacrylate (bis-GMA) increased cell yields, progesterone receptor expression, and pS2 secretion in human estrogen-target, serum-sensitive MCF7 breast cancer cells. Estrogenicity was due to bisphenol-A and bisphenol-A dimethacrylate, monomers found in the base paste of the dental sealant and identified by mass spectrometry. Samples of saliva from 18 subjects treated with 50 mg of a bis-GMA-based sealant applied on their molars were collected 1 hr before and after treatment. Bisphenol-A (range 90-931 micrograms) was identified only in saliva collected during a 1-hr period after treatment. The use of bis-GMA-based resins in dentistry, and particularly the use of sealants in children, appears to contribute to human exposure to xenoestrogens.
Induction of the Mitochondrial NDUFA4L2 Protein by HIF-1α Decreases Oxygen Consumption by Inhibiting Complex I Activity
Authors: Daniel Tello, Eduardo Balsa, Bárbara Acosta-Iborra, Esther Fuertes-Yebra, Ainara Elorza, Ángel Ordóñez, María Corral-Escariz, Inés Soro, Elia López-Bernardo, Ester Perales-Clemente, Antonio Martínez-Ruiz, José Antonio Enríquez, Julián Aragonés, Susana Cadenas, Manuel O. Landázuri
Journal: Cell Metabolism (2011)
GW25-e4467 Efects of Tongxinluo on vascular stenosis and TGF-β1 after balloon injury of rabbit iliac artery
Authors: Zhou Bin, Lin Liang-Ying, Liu Yong, Hao Bao-Shun, Yu Shu-Jie, Liu Ding-Hui, Wang Min, Wu Lin, Song Zhi-Ming, Chen Lin, Qian Xiao-Xian
Journal: Journal of the American College of Cardiology (2014)
Quantitative Evaluation of Posternbolized Splenic Tissue Using Technetium-99m Sulfur Colloid
Authors: THOMAS W. ERTZNER, MARTIN P. SANDLER, MADAN V. KULKARNI, J A PATTON, MURRAY M. MAZER
Journal: Clinical Nuclear Medicine (1987)

Tc-99m sulfur colloid scans were used to quantitate the percent of residual splenic tissue after partial splenic embolization (PSE) performed for the treatment of hypersplenlsm in 17 renal transplant patients. A liverspleen phantom was designed which simulated the human liver and spleen configuration to evaluate the technique. This phantom contained a solution of tc-99m sulfur colloid, which allowed precise quantities of the spleen phantom volume to be displaced using lucite pseudo-emboli. After each lucite embolus, computer images of the spleen phantom were collected and analyzed in the same manner used for the transplant patients. Correlation of the actual volume displaced or embolized with the computer estimated values was 0.996 (P < 0.001). This technique was superior to both CT and MRI, which were more difficult to perform and less precise in measuring a decrease in postlnfarction functioning splenic tissue.
Facilitating effect of cold shock on recovery from anoxia-induced contractile depression in isolated rat heart and heart muscle.
Authors: T Okada
Journal: Circulation Research (1988)

The effect of rapid cooling on the recovery process from anoxia-induced hypodynamic state was studied in isolated rat ventricular muscle and ventricle. Following 10-15 minutes' perfusion of N2-saturated Krebs solution, the muscle was reoxygenated. When the muscle was rapidly cooled for 10-30 seconds during the early phase of reoxygenation, the rate of recovery from contracture significantly increased (p less than 0.01). Rapid cooling was also effective on the recovery from contracture induced by superfusion of Krebs solution with lowered sodium chloride concentration, but it did not affect the recovery from rigor induced by CN-. In the recovery from sustained anoxia (60 minutes), cooling facilitated reattainment of tension development and reduction in contracture tension. Similarly, in whole heart, 2-3 episodes of rapid cooling for about 60 seconds significantly accelerated the recovery of pressure development after 30 minutes of anoxia. At 60 minutes after reoxygenation, pressure development in hearts that were reoxygenated without rapid cooling was 29.8 +/- 26.9% (mean +/- SD) of pressure developed before anoxia. This value increased to 93.8 +/- 27.5% following recurrent rapid cooling (p less than 0.001). At the same time, rapid cooling prevented any significant elevation in resting tension (development of oxygen paradox). These results indicate that excess intracellular calcium ions were removed by rapid cooling. This relief of the myocardium from calcium overload is believed to improve mitochondrial function and result in facilitated recovery of contractile activity.
Tuberculin Skin Test Conversion
Authors: Raj Narain
Journal: JAMA (1970)

To the Editor.—  Dr. Edwards in her reply to a question (212:1219, 1970) has stated that isoniazid chemoprophylaxis is recommended for anyone of any age whose tuberculin reaction  from negative to positive and that appearance of a positive reaction signals the occurrence of tuberculous infection. Thus a 62-year-old physician whose reaction converted seven months after a negative tuberculin test was advised chemoprophylaxis for one year.  We have shown1,2that a tuberculin test itself converts a negative tuberculin reaction to a positive one in a substantial number of persons in the absence of tuberculous infection. Such conversions as a result of the previous tuberculin test increased in frequency with age and could be more frequent in areas with high prevalence of nonspecific sensitivity. The physician given the advice came from New York, an area from which 15% to 19% of the life-time Navy recruits gave 4-mm or larger reactions
Effect of bile on vitamin B12 absorption.
Authors: N H Teo, J M Scott, G Neale, D G Weir
Journal: BMJ (1980)

The standard double-isotope Schilling test was used to study vitamin B12 absorption in seven patients with obstructive jaundice and 10 with T-tube bile duct drainage after cholecystectomy and bile duct exploration. In three and five of these patients respectively absorption was impaired. In the second group six patients were restudied after removal of the T tube, and in each case absorption was improved. Similar results were obtained after bile duct ligation in rats. Bile exclusion produced a 50-60% reduction in renal and hepatic uptake of vitamin B12 from the intestinal lumen. The malabsorption was corrected by replacing bile. These studies suggest that bile plays a part in the normal absorption of vitamin B12.
Promoting successful ageing through integrated care
Authors: D. V. Jeste
Journal: BMJ (2011)

The most important step is to improve society’s attitudes towards older people

Longevity increased in most countries during the first half of the 20th century mainly as a result of reduced infant mortality from infections and other preventable causes. However, since the 1950s the average lifespan has again increased, mainly because older people with chronic illnesses such as cancer, heart disease, and stroke are living longer. Data showing that the proportion of older people with depression and other mental illnesses will grow disproportionately faster than the overall older population are less well known. One reason for this is a higher risk of these mental illnesses in people born in the post-second world war baby boom than in those born before the war.1 The changing demographics have been described as a “silver tsunami,” pointing to the high healthcare costs of the ageing population. A more constructive socioscientific approach would be to develop means of keeping older adults healthy.

The linked randomised controlled trial by Von Korff and colleagues (doi:10.1136/bmj.d6612) assessed an important model for promoting healthy ageing in people with multiple chronic illnesses.2 The authors sought to improve hyperglycaemia, …
Satellite nodules are a prognostic factor of hepatocellular carcinoma recurrence after liver transplantation
Authors: A. Plessier, L. Codes, Y. Consigny, D. Sommacale, F. Dondero, F. Degos, P.Y. Brillet, V. Vilgrain, C. Degott, F. Durand, V. Paradis, J. Belghiti
Journal: Journal of Hepatology (2003)
Fruits of Molecular Studies Include Gene Linking Diet and Cancer, Novel Markers for Malignancy
Authors: Joan Stephenson
Journal: JAMA (1995)

NEW FINDINGS about cancer's molecular underpinnings are revealing how genetic and environmental factors interact to cause at least one type of cancer and are pointing the way to the detection of other malignancies. As researchers decipher at the molecular level the events that lead to cancer, they're beginning to weave together once independent threads of research. The picture emerging from these efforts is revealing how relationships such as the link between high-fat diets and certain cancers make sense in light of an individual's genetic background, and why some family members with a particular cancer gene develop a malignancy while others do not. One malignancy in which such threads are coming together is colon cancer. Scientists have known that mutations of the human adenomatous polyposis coli gene (APC) are responsible for sporadic and familial colorectal cancers, including familial adenomatous polyposis (FAP). In this autosomal dominant inherited disease, family members who inherit
GRISEOFULVIN AND FAVUS. A Report on Work in Progress.
Authors: JOHN H. S. PETTIT
Journal: British Journal of Dermatology (1960)

Journal Article GRISEOFULVIN AND FAVUS. A Report on Work in Progress. Get access JOHN H. S. PETTIT, M.D., M.R.C.P. JOHN H. S. PETTIT, M.D., M.R.C.P. Department of Dermatology, University of Shiraz, Iran Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 72, Issue 5, 1 May 1960, Pages 179–184, https://doi.org/10.1111/j.1365-2133.1960.tb13871.x Published: 01 May 1960
Sculpting organ innervation
Authors: Barbara L. Hempstead
Journal: Journal of Clinical Investigation (2004)

Neurotrophic growth factors, including nerve growth factor (NGF) and glial-derived neurotrophic factor (GDNF), have well-established roles in promoting the innervation of target tissues, yet little is known about how the temporal and organ-specific expression of these factors is regulated. A new study reveals that NGF is a direct target of the well-characterized peptide factor endothelin-1 (ET-1), and that ET-1–induced NGF expression is required for sympathetic innervation of the developing heart. These results, and recent studies implicating GDNF and ET-3 in the patterning of the enteric nervous system, suggest that specific pairing of endothelins and neurotrophic factors may be used in distinct target organs to coordinate neuronal migration, differentiation, and survival.
Identity cards may exclude vulnerable groups from health care, says BMA
Authors: Debashis Singh
Journal: BMJ (2004)

Junior hospital doctors throughout Europe were supposed to start a new, shorter, 58 hour week from this month.Aimed at improving their working livesand their patients' safety-the European directive aims to reduce the limit further to just 48 hours by 2009.But despite the new rules, many doctors will continue to work long hours.United Kingdom: A recent survey of 100 NHS chief executives by the NHS Confederation, which represents NHS management, showed that 16% did not expect their trusts to have complied with the European Working Time Directive by 1 August.Junior doctors could take their employers to employment tribunals, and hospitals will be liable to fines of up to £5000 ($9200; €7600) from the Health and Safety Executive each time they break the directive.The BMA said that it will support UK doctors who take legal action against employers that do not limit their working hours to those set out in the directive.The NHS has been struggling to meet the requirements of the new directive, but it is not alone in failing to do so fully.Austria: Compliance with