tbuckley/cabot-search huggingface dataset:
Pancreatic duct abnormalities in gall stone disease: an endoscopic retrograde cholangiopancreatographic study.
Authors: S P Misra, P Gulati, V Choudhary, B S Anand
Journal: Gut (1990)

This study was carried out to assess pancreatic duct abnormalities in gall stone disease. Endoscopic retrograde cholangiopancreatograms of 50 patients with gall stone disease were analysed and the results compared with those obtained in 33 patients investigated for cholestatic jaundice who were found to have a normal biliary tree (control group). Abnormal pancreatograms were obtained in 24 (48%) patients with gall stone disease and in only two (6%) in the control group; the differences were statistically significant (chi 2 = 14.3; p less than 0.001). The patients in the control group showed mild abnormalities as did those in the gall stone group. The frequency of various abnormalities were: mild 16 (32%), moderate five (10%), and severe three (6%). Pancreatic duct abnormalities were more severe and occurred more frequently in patients with gall stones who had stones in the biliary tree than in patients with a normal biliary tree (postcholecystectomy patients, 55% v 25%) but the difference between the two groups just failed to be significant (chi 2 = 3.34). In conclusion, nearly half of all patients with gall stone disease have pancreatic duct abnormalities and in 16% these were severe enough to be labelled as chronic pancreatitis.
Earliest Symptoms of Coronary Heart Disease and their Recognition
Authors: D. Short, M. Stowers
Journal: BMJ (1972)

We have reviewed the histories of 320 patients in whom a diagnosis of coronary heart disease was ultimately established and traced the symptoms back to their first appearance. In 51% the first symptom was effort angina. Difficulties in recognition arose when the symptom was localized to an unusual site, when its occurrence was dependent on a combination of exercise with cold or a recent meal, or when it was induced by excitement rather than by effort. In a quarter of the cases the onset of angina was abrupt, and in these there was usually evidence of acute infarction. In 43% of cases the first symptom was an attack of pain or discomfort in the torso occurring without any discernable precipitating factor. Again, diagnosis was difficult when the pain was in an atypical site and also when it was of brief duration associated with skeletal or abdominal disease which could cause pain at the same site, or if the patient was able to undertake strenuous exertion. In four patients cardiac pain was first experienced during a paroxysm of tachycardia. In 6% of cases the onset was marked by a symptom other than pain—most frequently dyspnoea, tiredness, faintness, or syncope. Clinical examination was of no direct value in diagnosis. Its importance lay in disclosing factors which had to be taken into account in interpreting the electrocardiogram. The electrocardiogram was invaluable, though by no means infallible. In over half of the patients the first tracing showed major abnormalities of coronary type, and nearly a quarter more showed minor S-T/T depression consistent with coronary disease. Ten per cent. showed miscellaneous abnormalities, such as left ventricular hypertrophy or bundle-branch block, and 15% no definite abnormality. There is as yet no completely reliable objective method of diagnosing early coronary heart disease, so that the recognition of symptoms remains of paramount importance.
Peer Review: Prospects and Problems
Authors: DONALD G. LANGSLEY
Journal: American Journal of Psychiatry (1973)

Peer review is now mandated for the treatment of all patients covered by the Medicare and Medicaid programs. Utilization of services—especially inpatient services—will be controlled as norms of treatment by age and diagnosis are developed. Psychiatrists, working through district branches, are encouraged to develop guidelines for peer review in line with a recent APA position statement. In doing so they must be concerned about protecting the confidences of the patient and about threats of litigation.
The allergen bronchoprovocation model: an important tool for the investigation of new asthma anti‐inflammatory therapies
Authors: L.‐P. Boulet, G. Gauvreau, M.‐E. Boulay, P. O’Byrne, D. W. Cockcroft
Journal: Allergy (2007)

Allergen bronchoprovocation tests have been used for more than two decades in the investigation of respiratory allergic diseases such as asthma and rhinitis. These bronchial challenges are now well standardized and can offer key information on the therapeutic potential of new agents and on their anti‐inflammatory effects on the airways. Both standard and low‐dose allergen provocations are safe when performed by experienced investigators and do not lead to persistent worsening of asthma or change in airway function. The evaluation of new therapeutic agents by these methods can also provide important information on the mechanisms of development and persistence of airway diseases.
A CASE OF VALULAR DISEASE OF THE HEART, SHOWING UNUSUAL POWERS OF PHYSICAL ENDURANCE
Authors: R. D. Rudolf
Journal: BMJ (1919)

<h3>Abstract</h3> Postoperative choice of the most effective DBS contact in patients with essential tremor (ET) so far relies on lengthy clinical testing. It has been shown that the postoperative effectiveness of DBS contacts depends on the distance to the dentatorubrothalamic tract (DRTT). Here, we investigated whether the most effective DBS contact could be determined from the stimulation overlap with the individual DRTT. Seven ET patients with bilateral thalamic deep brain stimulation were included retrospectively. Tremor control was assessed contact-wise during test stimulation with 2mA. The individual DRTTs were identified from diffusion tensor imaging. Contacts were ranked by their overlap of the test stimulation with the respective DRTT in relation to their clinical effectiveness. A linear mixed-effects model was calculated to determine the influence of the DRTT-overlap on tremor control. In 92.9 % of the cases, the contact with the best clinical effect was the contact with the highest or second-highest DRTT-overlap. On the group level, the DRTT-overlap explained 26.7% of the variance of the clinical outcome (p&lt;0.001). To conclude, data suggest that the overlap with the DRTT based on individual tractography may serve as a marker to determine the most effective DBS contact in ET patients and reduce burdensome clinical testing in the future.
Alexander Maitland Rennie
Authors: J. McLauchlan
Journal: BMJ (2008)

Alexander Maitland Rennie was born in 1911 and grew up on the family farm at Wester Fintray in Aberdeenshire. He attended the local school at Fintray and then the grammar school in Aberdeen. He was the dux of the grammar school in 1928. After qualifying MB ChB from Aberdeen University in 1933, he was a house surgeon at the old infirmary at Woolmanhill. He then worked for Naughton Dunn in Birmingham, as well as working at Great Ormond Street Hospital in London.

At the …
Atrial Flutter with Irregular Ventricular Response as a Contraindication to Digitalis
Authors: SEYMOUR B. LONDON, ROSE E. LONDON
Journal: Circulation (1961)

Digitalis may have an additive effect on impaired atrioventricular conduction, so that atrial flutter with variable ventricular response may progress to complete heart block with ventricular asystole. Two cases are presented of atrial flutter with. variable ventricular response in whom ventricular standstill occurred during digitalis therapy. External electric stimulation of the heart can maintain the circulation in digitalis-induced ventricular standstill.
Diagnosis and management of fetal cardiac tumors: a multicenter experience and review of published reports
Authors: Deidre G. Holley, Gerard R. Martin, Joel I. Brenner, Derek A. Fyfe, James C. Huhta, Charles S. Kleinman, Samuel B. Ritter, Norman H. Silverman
Journal: Journal of the American College of Cardiology (1995)

We sought to determine the prevalence and natural history of cardiac tumors in patients referred for fetal echocardiography.Cardiac tumors are rare; the prevalence, reported from autopsy studies of patients of all ages, varies from 0.0017% to 0.28%. Despite many case reports, the prevalence and natural history of fetal cardiac tumors are unclear.Fourteen thousand fetal echocardiograms recorded over an 8-year period in seven centers were available for retrospective review. Medical records and echocardiograms were studied to determine the reason for referral, family history of tuberous sclerosis, prenatal and postnatal course and tumor description and type.Cardiac tumors were present in 19 pregnancies (0.14%). Gestational age at diagnosis ranged from 21 to 38 weeks. The most common indication for referral was a mass on an obstetric ultrasound study. The tumors were singular in 10 patients and multiple in 9. Tumor size ranged from 0.4 x 0.4 to 3.5 x 4 cm, and the majority of tumors were not hemodynamically significant. There were 17 patients with rhabdomyomas, 1 with a fibroma and 1 with an atrial hemangioma. Tuberous sclerosis complex was diagnosed in 10 patients. Partial or complete tumor regression was seen in eight patients; tumors were unchanged in five; and three required operation.Fetal cardiac tumors, a rare condition, are often benign. The majority of tumors are rhabdomyomas, but not all fetuses with rhabdomyoma have tuberous sclerosis.
1006-56 Virtual histology of intravascular ultrasound images: Feasibility and clinical correlations in humans
Authors: Gary S Mintz, Eugenia Nikolsky, William Wijns, Yoshio Kobayashi, Raimund Erbel, Roxana Mehran, Ramona Pop, Antonio Colombo, Patrick W Serruys, Stephane G Carlier, Alexandre Abizaid, D.Geoffrey Vince, Jeffrey W Moses, Gregg W Stone, Martin B Leon
Journal: Journal of the American College of Cardiology (2004)
ON ALLERGY TO COTTONSEED OIL
Authors: H. S. BERNTON
Journal: JAMA (1949)

The question of specific sensitiveness to edible cottonseed oil in contradistinction to cottonseed is worthy of recognition and more critical study than it has received. Discussions of cottonseed sensitiveness in textbooks on allergy generally imply that cutaneous sensitiveness to allergenic extracts of cottonseed or cottonseed meal signifies clinical sensitiveness to foods containing salad oil or vegetable shortening made from cottonseed oil. A pronounced difference of opinion concerning this concept is displayed in the testimony of six allergists who appeared as expert witnesses at a public hearing<sup>1</sup>in relation to label declaration of vegetable oils in salad dressings. Opportunity to study allergy to cottonseed oil is rare.<sup>1</sup>Hence, worthy of record are results of a concurrent comparison of two cottonseed-sensitive allergic subjects, one of whom disclaimed and the other proclaimed a demonstrable sensitiveness to edible cottonseed oil. <h3>REPORT OF CASES</h3><h3>Case 1.—</h3> A male asthmatic patient (S.), age 34,
RDX Induces Aberrant Expression of MicroRNAs in Mouse Brain and Liver
Authors: Baohong Zhang, Xiaoping Pan
Journal: Environmental Health Perspectives (2008)

BackgroundAlthough microRNAs (miRNAs) have been found to play an important role in many biological and metabolic processes, their functions in animal response to environmental toxicant exposure are largely unknown.ObjectivesWe used hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX), a common environmental contaminant, as a toxicant stressor to investigate toxicant-induced changes in miRNA expression in B6C3F1 mice and the potential mechanism of RDX-induced toxic action.MethodsB6C3F1 mice were fed diets with or without 5 mg/kg RDX for 28 days. After the feeding trials, we isolated RNAs from both brain and liver tissues and analyzed the expression profiles of 567 known mouse miRNAs using microarray and quantitative real-time polymerase chain reaction technologies.ResultsRDX exposure induced significant changes in miRNA expression profiles. A total of 113 miRNAs, belonging to 75 families, showed significantly altered expression patterns after RDX exposure. Of the 113 miRNAs, 10 were significantly up-regulated and 3 were significantly down-regulated (p < 0.01) in both mouse brain and liver. Many miRNAs had tissue-specific responses to RDX exposure. Specifically, expression of seven miRNAs was up-regulated in the brain but down-regulated in the liver or up-regulated in the liver but down-regulated in the brain (p < 0.01). Many aberrantly expressed miRNAs were related to various cancers, toxicant-metabolizing enzymes, and neurotoxicity. We found a significant up-regulation of oncogenic miRNAs and a significant down-regulation of tumor-suppressing miRNAs, which included let-7, miR-17-92, miR-10b, miR-15, miR-16, miR-26, and miR-181.ConclusionsEnvironmental toxicant exposure alters the expression of a suite of miRNAs.
Efficacy of a Hip Protector to Prevent Hip Fracture in Nursing Home Residents
Authors: Douglas P. Kiel, Jay Magaziner, Sheryl Zimmerman, Linda Ball, Bruce A. Barton, Kathleen M. Brown, Judith P. Stone, Dawn Dewkett, Stanley J. Birge
Journal: JAMA (2007)

Past studies of the efficacy of hip protectors to prevent hip fracture in nursing home residents have had conflicting results, possibly due to potential biases from clustered randomization designs and modest adherence to intervention.To determine whether an energy-absorbing and energy-dispersing hip protector would reduce the risk of hip fracture when worn by nursing home residents.Multicenter, randomized controlled clinical trial in which 37 nursing homes were randomly assigned to having residents wear a 1-sided hip protector on the left or right hip. Participants were 1042 nursing home residents (mean [SD] aged 85 [7] years; 79% women) who consented and adhered to the hip protector use during a 2-week run-in period and were enrolled. Participating facilities were in greater Boston, Massachusetts, St Louis, Missouri, and Baltimore, Maryland from October 2002 to October 2004. Mean duration of participation for nursing home residents was 7.8 months. None were withdrawn because of adverse effects.Undergarments with a 1-sided hip protector made of a 0.32-cm outer layer of polyethylene (2.7 kg/m3) backed by a hard high-density polyethylene shield (0.95 cm) that was backed by 0.9 kg/m3 of 1.27-kg ethylene vinyl acetate foam. Each facility was visited 3 times per week to assess adherence and provide staff support.Adjudicated hip fracture occurrences on padded vs unpadded hips.After a 20-month follow-up (676 person-years of observation), the study was terminated due to a lack of efficacy. The incidence rate of hip fracture on protected vs unprotected hips did not differ (3.1%; 95% confidence interval [CI], 1.8%-4.4% vs 2.5%; 95% CI, 1.3%-3.7%; P = .70). For the 334 nursing home residents with greater than 80% adherence to hip protector use, the incidence rate of hip fracture on protected vs unprotected hips did not differ (5.3%; 95% CI, 2.6%-8.8% vs 3.5%; 95% CI, 1.3%-5.7%; P = .42). Overall adherence was 73.8%.In this clinical trial of an energy-absorbing/shunting hip protector conducted in US nursing homes, we were unable to detect a protective effect on the risk of hip fracture, despite good adherence to protocol. These results add to the increasing body of evidence that hip protectors, as currently designed, are not effective for preventing hip fracture among nursing home residents.clinicaltrials.gov Identifier: NCT00058864.
Mechanisms of atrial structural changes caused by stretch occurring before and during early atrial fibrillation
Authors: A. M. De Jong, A. H. Maass, S. U. Oberdorf-Maass, D. J. Van Veldhuisen, W. H. Van Gilst, I. C. Van Gelder
Journal: Cardiovascular Research (2010)

Structural remodelling occurring before, due to the underlying heart disease, and during atrial fibrillation (AF) sets the stage for permanent AF. Current therapy in AF aims to maintain sinus rhythm in symptomatic patients, but outcome is unfortunately poor. Stretch of the atria is a main contributor to atrial remodelling. In this review, we describe different aspects of structural remodelling as seen in animal models and in patients with AF, including atrial enlargement, cellular hypertrophy, dedifferentiation, fibrosis, apoptosis, and loss of contractile elements. In the second part, we describe downstream signals of mechanical stretch and their contribution to AF and structural remodelling. Ultimately, knowledge of mechanisms underlying structural remodelling may help to identify new pharmacological targets for AF prevention.
THE RELATIVE EFFECTS OF PROTEIN, CHOLINE, AND METHIONINE IN THE TREATMENT OF EXPERIMENTAL DIETARY CIRRHOSIS IN THE RAT
Authors: Irvin C. Plough, Arthur J. Patek, Margaret Bevans
Journal: The Journal of Experimental Medicine (1952)

Cirrhosis of the liver was produced in rats by feeding a diet low in protein (4 per cent casein) and deficient in lipotropic factors. The degree of liver cirrhosis was determined from specimens obtained at biopsy. Comparable groups of animals then were treated with diets containing 4 per cent casein and 30 per cent casein. The 4 per cent casein diets were supplemented with choline and methionine; the 30 per cent casein diets were fed with and without added choline. On supplementing the low protein diet with choline and methionine the animals remained feeble, their growth remained stunted, and their livers showed signs of progressive cirrhosis. In contrast, animals fed the higher protein diet (with or without added choline) grew normally, and their livers showed signs indicating arrest and regression of the disease process. These studies suggest that the feeding of high protein (30 per cent casein) diets to rats with nutritional cirrhosis produces reparative effects greater than those attributable to the supplements choline and methionine.
Assuring Quality Cancer Care In an Evolving Health Care Delivery System
Authors: D. P. Winchester
Journal: CA A Cancer Journal for Clinicians (1989)

Although quality assurance programs may be viewed with skepticism by some clinicians, there is an unquestionable need to protect quality care in the present hostile Historical PerspectiveAttempts to assure quality care date back to the early part of this century.In 1988, Jurkiewicz' published aâ€• knowledgeable, historical review of the JCAHO and the
Policy Options for Public Long-term Care Insurance
Authors: Edward C. Norton, Joseph P. Newhouse
Journal: JAMA (1994)

CONTROVERSY surrounds the place of long-term care insurance as part of national health system reform and the nature of such insurance if it is to be part of the reform. Some groups, most notably those representing older adults, believe that the current financing system, which relies heavily on the Medicaid program, must be altered. Others would not modify present arrangements, at least in the short run. Under current law, individuals are eligible for nursing home benefits through Medicaid if they have few assets other than housing equity. The following proposals would markedly change these arrangements: The Pepper Commission1 recommends a universal insurance system for those sufficiently disabled, but limits benefits to an initial period of 3 months. After 3 months, nursing home residents would pay for everything, unless they are poor enough to qualify for coverage similar to the current Medicaid program. Analysts at the Brookings Institution<sup>2</sup>advocate expanding the
Doctors postpone decision on industrial action
Authors: A. Ferriman
Journal: BMJ (2003)

Doctors at the annual representative meeting of the BMA this week decided not to endorse earlier calls for a ballot on industrial action from the annual consultants' conference in the light of an imminent meeting with the new health secretary, Dr John Reid. Consultant leaders were due to meet Dr Reid on 4 July.

They passed a motion regretting the impasses in delivering a new consultant contract to deliver a modern, …
Metabolic Effects of New Oral Hypoglycemic Agent CS-045 in NIDDM Subjects
Authors: Stephan L Suter, John J Nolan, Penny Wallace, Barry Gumbiner, Jerrold M Olefsky
Journal: Diabetes Care (1992)

To study the metabolic effects of a new oral antidiabetic agent, CS-045, in subjects with non-insulin-dependent diabetes mellitus (NIDDM).Eleven NIDDM subjects (mean age 59 yr and body mass index 32.3) were treated with 400 mg/day CS-045 for 6-12 wk. Patients were hospitalized before and at the end of the drug-treatment period for metabolic studies, including oral glucose tolerance test (OGTT), meal tolerance test (MTT), euglycemic glucose-clamp studies, and lipid analyses.Eight subjects showed a marked clinical response to the drug, whereas 3 were nonresponders. The data were analyzed both for the total group and for the responders. Fasting plasma glucose (FPG) fell from 12.5 +/- 0.7 to 10.7 +/- 1.0 mM in the total group but fell more dramatically from 12.7 +/- 0.5 to 8.3 +/- 0.6 mM in the responder group. The area under the OGTT glucose curve improved by 17% in the total group and by 29% in the responders. The area under the MTT glucose curve improved by 38 and 52%, respectively. MTT levels of insulin, free fatty acids, and glucagon were significantly lower after treatment. Glucose disposal rates during glucose-clamp studies were increased in all subjects after CS-045 treatment. Mean increases were 63% at 120 mU.m-2.min-1 and 41% at 300 mU.m-2.min-1. Basal hepatic glucose production fell by 17% in the total group and by 28% in the responders.CS-045 improves insulin resistance, reduces insulinemia, lowers hepatic glucose production, and improves both fasting and postprandial glycemia in NIDDM subjects. CS-045 may represent a new therapeutic option for NIDDM.
Abstract 14235: Plasma PCSK9 Levels and Clinical Outcomes in the Treating to New Targets Trial: A Nested Case-Control Study
Authors: Benoit J Arsenault, Roeland Huijgen, S. Matthijs Boekholdt, Weihang Bao, Fatiha Tabet, Francine Petrides, Kerry-Anne Rye, David A DeMicco, Philip J Barter, John J Kastelein, Gilles Lambert
Journal: Circulation (2011)

Background - Statins activate low-density lipoprotein (LDL) receptor gene expression, thus lowering plasma LDL levels. But statins also activate the expression of proprotein convertase subtilisin k...
Study of the Relationship Between the Neurotransmitter Store and Adrenergic Nerve Block Induced by Reserpine and Guanethidine
Authors: THOMAS E. GAFFNEY, CHARLES A. CHIDSEY, EUGENE BRAUNWALD
Journal: Circulation Research (1963)

The heart rate response to cardioaccelerator nerve stimulation and the corresponding levels of myocardial norepinephrine content were determined and correlated in dogs at various time intervals following the intravenous injection of either 3 mg/kg reserpine, or 10 mg/kg guanethidine. Guanethidine produced complete blockade of the cardiac accelerator response before producing measurable myocardial depletion of norepinephrine. In contrast, reserpine reduced the positive chronotropic response to cardioaccelerator nerve stimulation only after myocardial norepinephrine levels have been reduced to approximately 0.3 µg/g. An infusion of norepinephrine did not restore the heart rate response to cardioaccelerator nerve stimulation in either the reserpine or guanethidine treated dogs. These data suggest that the interference with adrenergic transmission produced by guanethidine is independent of changes in the level of stored adrenergic transmitter. The reserpine-induced blockade of adrenergic transmission may ultimately be dependent upon the mission may ultimately be dependent upon the depletion of adrenergic transmitter, but almost complete depletion of stored adrenergic transmitter must occur before reserpine-induced adrenergic blockade occurs.