tbuckley/cabot-search huggingface dataset:
Assessment of Endogenous and Therapeutic Arteriogenesis by Contrast Ultrasound Molecular Imaging of Integrin Expression
Authors: Howard Leong-Poi, Jonathan Christiansen, Peter Heppner, Christopher W. Lewis, Alexander L. Klibanov, Sanjiv Kaul, Jonathan R. Lindner
Journal: Circulation (2005)

We hypothesized that molecular imaging with contrast-enhanced ultrasound (CEU) and microbubbles targeted to endothelial integrins could be used to noninvasively assess early angiogenic responses to ischemia and growth factor therapy.Hindlimb ischemia was produced in 48 rats by ligation of an iliac artery. Half of the animals received intramuscular sustained-release fibroblast growth factor-2 (FGF-2). Immediately after ligation and at subsequent intervals from 4 to 28 days, blood flow and oxygen tension in the proximal adductor muscles were measured by CEU perfusion imaging and phosphor quenching, respectively. Targeted CEU imaging of alpha(v)- and alpha5beta1-integrin expression was performed with microbubbles bearing the disintegrin echistatin. Iliac artery ligation produced a 65% to 70% reduction in blood flow and oxygen tension. In untreated ischemic muscle, muscle flow and oxygen tension partially recovered by days 14 to 28. In these animals, signal from integrin-targeted microbubbles was intense and peaked before flow increase (days 4 to 7). In comparison to untreated animals, FGF-2-treated muscle had a greater rate and extent of blood flow recovery and greater signal intensity from integrin-targeted microbubbles, which peaked before maximal recovery of flow. On immunohistology, arteriolar but not capillary density increased in the ischemic limb after ligation, the rate and degree of which were greater in FGF-2-treated rats. Immunofluorescence demonstrated intense staining for alpha(v) in arterioles, the temporal course of which correlated with targeted imaging.Targeted CEU can be used to assess endogenous and therapeutic arteriogenesis before recovery of tissue perfusion. These results suggest that molecular imaging of integrin expression may be useful for evaluating proangiogenic therapies.
Bile duct stone extraction under endoscopic ultrasound guidance without fluoroscopy or contrast injection
Authors: E. Artifon, A. Kumar, S. Marques, S. Ishioka, P. Sakai, M. Bhutani
Journal: Endoscopy (2008)

A 57-year-old woman with an allergy to iodinated contrast presented with intermittent right upper quadrant pain. Laboratory test results were as follows: total bilirubin 4 mg/dL, alkaline phosphatase 164 mg/dL, and normal amylase, aspartate transaminase, and alanine transaminase levels. A solitary 1-cm calculus was identified in the distal common bile duct on magnetic resonance imaging ([Fig. 1]); linear-array endosonography confirmed the presence of a 0.9-cm calculus ([Fig. 2]). Using a needle-knife, a 0.035-inch guide wire, and a 12-mm extraction balloon (all Boston Scientific, Natick, Massachusetts, USA), the bile duct was cannulated, the papilotomy extended, and the stone extracted, all under endoscopic ultrasound (EUS) guidance ([Fig. 3], [4]). Standard cannulation under EUS guidance was unsuccessful, probably due to the presence of stone in the distal common bile duct/ampulla. There were no complications resulting from the endocopic intervention. The patient underwent an uneventful laparoscopic cholecystectomy and no residual stones were noted at intraoperative cholangiography.
A Physician's Perspective on a Right to Health Care
Authors: Mark Siegler
Journal: JAMA (1980)

POLITICAL scientists and philosophers have described elegantly the origin and evolution of rights language that has occurred in Western society during the past 200 years.<sup>1,2</sup>These analyses suggest that there are legal and moral rights, positive and negative rights, and absolute and conditional rights, and, furthermore, that there exists a subtle relationship between rights and obligations. Rights language is established as part of our political rhetoric when attempts are made to extend a variety of services to those whom one wishes to benefit. In medicine, we have witnessed an explosion in the use and misuse of the language of rights. Claims of rights in medicine abound and include a right to obtain treatment and a right to refuse treatment, a right to health care, a right to complete truth, a right to confidentiality, a right to die, a right to live, and even occasionally, an assertion of a right
Treatment with 311-nm ultraviolet B accelerates and improves the clearance of psoriatic lesions in patients treated with etanercept
Authors: P. Wolf, A. Hofer, F.J. Legat, A. Bretterklieber, W. Weger, W. Salmhofer, H. Kerl
Journal: British Journal of Dermatology (2008)

Some patients with plaque-type psoriasis respond slowly to treatment with etanercept. In such cases combining etanercept with conventional treatments might be helpful.To investigate whether treatment with 311-nm ultraviolet (UV) B can improve the therapeutic response in patients treated with etanercept.Four women and one man (mean age 57 years, range 48-66) with moderate to severe plaque-type psoriasis who had received standard treatment with etanercept 50 mg twice weekly for 6 weeks without Psoriasis Area and Severity Index (PASI) reduction of 75% or greater (of initial mean PASI of 16.0, range 15.4-20.4) were enrolled in the study. Starting at 6 weeks, 311-nm UVB treatment was given to a randomly selected body half (left or right, excluding the head) for another 6 weeks, while all patients continued receiving etanercept. The patients were monitored by half-body PASI at weekly intervals.During the 6-week irradiation regimen, 311-nm UVB significantly bolstered the therapeutic response in the patients on etanercept treatment. After 6 weeks of 311-nm UVB, the patients had a mean PASI on their UV-irradiated body halves of 1.6 (range 0.6-3.3) vs. 4.7 (range 1.4-8.6) on nonirradiated body halves (P = 0.0192, paired two-tailed t-test), compared with 10.7 (range 6-16.4) and 10.5 (range 5.2-16.4) at start of 311-nm UVB treatment. The overall mean PASI reduction from baseline (i.e. at etanercept start) was 89% vs. 68%, respectively (P = 0.0009 and P = 0.0088).Treatment with 311-nm UVB significantly accelerates and improves the clearance of psoriatic lesions in patients responding slowly to etanercept monotherapy.
Evaluation of Oncology Drugs at the European Medicines Agency and US Food and Drug Administration: When Differences Have an Impact on Clinical Practice
Authors: Francesco Trotta, Hubert G.M. Leufkens, Jan H.M. Schellens, Richard Laing, Giovanni Tafuri
Journal: Journal of Clinical Oncology (2011)

The aims of this study were to compare the approaches of the European Medicines Agency (EMA) and the US Food and Drug Administration (FDA) in the evaluation and approval of new anticancer indications and to identify possible clinical implications associated with these differences.Information on the European Union therapeutic indications for the cohort of anticancer drugs was extracted from the European Public Assessment Reports and from the FDA review reports.Overall, 42 anticancer drugs were approved by EMA between 1995 and 2008, corresponding to a total of 100 indications. In 47 of 100 indications, a difference was found. For 19 of these 47 indications, the difference was that one agency approved an indication, whereas the other agency did not. For the remaining 28 indications, the same indication was approved by both of the agencies and differences were evaluated through an algorithm; in 10 cases, discrepancies in therapeutic indications between EMA and FDA were considered clinically relevant. We found an overall trend that the agency that was second to give a positive approval was usually more restrictive in terms of wording of the indication compared with the agency that provided approval first. Regarding the use and robustness of available clinical data for evaluation, no clear associations could be found.Clinically relevant differences in the outcome of the EMA and FDA approval process of oncology products were found. Neither of the agencies seems to have a prevailing restrictive behavior over the other. Further efforts on harmonizing decision making between regulatory systems are needed.
Syndrome of Analgesic Abuse.
Authors: M. Henry Gault
Journal: Annals of Internal Medicine (1968)

s1 May 1968Syndrome of Analgesic Abuse.M. Henry Gault, M.D., F.A.C.P., John B. Dossetor, M.D., F.A.C.P., Dennis Engles, M.D., Christopher T. Rudwal, M.D.M. Henry Gault, M.D., F.A.C.P.Search for more papers by this author, John B. Dossetor, M.D., F.A.C.P.Search for more papers by this author, Dennis Engles, M.D.Search for more papers by this author, Christopher T. Rudwal, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-68-5-1142_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe symptom complex of psychiatric disorder, headache, peptic ulcer, anemia, and nephropathy may be considered a syndrome of analgesic abuse.Of 22 patients developing serious impairment of renal function associated with the daily ingestion of analgesics, 17 had taken 5 or more tablets of a phenacetin-salicylate-caffeine-codeine preparation daily for 5 or more years. The typical patient was female (15), had suffered with headaches for many years (19), had received psychiatric investigation or treatment (18), and had had episodes of dyspepsia or upper gastrointestinal bleeding leading to gastrectomy before the diagnosis of renal disease (12). Peptic ulcer had been present in... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Montreal, Quebec, PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1968Volume 68, Issue 5Page: 1142-1142KeywordsAnalgesicsAnemiaGastrectomyHeadachesHemorrhageIngestionPeptic ulcersRenal diseases ePublished: 1 December 2008 Issue Published: 1 May 1968 PDF downloadLoading ...
Secretory and accessory cell functions of the alveolar macrophage.
Authors: K Miller, B N Hudspith, C Meredith
Journal: Environmental Health Perspectives (1992)

We have attempted to address the requirements necessary for alveolar macrophage accessory cell function. We have also examined the in vitro and in vivo factors that must be taken into account when interpreting results from experimental studies. Differences in phenotypic expression by rat alveolar pleural and peritoneal macrophages are noted, as well as the differing expression of major histocompatibility complex (MHC) class II molecules. Furthermore, alveolar macrophages, harvested from rat lung, do not express the interleukin (IL)-1 cytokines, and lipopolysaccharide (LPS) treatment of quiescent cells (after 24-hr in vitro culture) induces low levels of expression of IL-1 alpha and IL-1 beta. Short-term inhalation of refractory ceramic fibers, however, results in markedly increased IL-1 beta expression after stimulation with LPS. We suggest that, in vivo, IL-1 beta may be involved in the initial recruitment and activation of inflammatory cells rather than in induction of immune responses. We also postulate, based on recent published evidence, that alveolar macrophages activate the dendritic cells within the respiratory epithelium. Thus alveolar macrophages would release cytokines critical for the activation of dendritic cells during the afferent limb of the immune response, and they would respond to products of sensitized T-cells such as interferon-gamma and IL-4 to interact with T-helper cells in an antigen-specific MHC-restricted manner during the efferent limb of the response.
Hemodynamic Effect of Increased Heart Rate in Patients with Prosthetic Mitral Valves.
Authors: Onkar S. Narula
Journal: Annals of Internal Medicine (1969)

s1 May 1969Hemodynamic Effect of Increased Heart Rate in Patients with Prosthetic Mitral Valves.Onkar S. Narula, M.D., Joseph W. Linhart, M.D., Frank J. Hildner, M.D., S. Serge Barold, M.D., Roger P. Javier, M.D., Philip Samet, M.D., F.A.C.P.Onkar S. Narula, M.D.Search for more papers by this author, Joseph W. Linhart, M.D.Search for more papers by this author, Frank J. Hildner, M.D.Search for more papers by this author, S. Serge Barold, M.D.Search for more papers by this author, Roger P. Javier, M.D.Search for more papers by this author, Philip Samet, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-70-5-1079_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTen patients were studied after mitral valve replacement (six with Beall, two with Starr-Edwards, and two with Kay-Shiley valves). Gradients across the valve were measured by direct left atrial and left ventricular pressures. During atrial pacing in seven patients in normal sinus rhythm (increasing the heart rate from 70 to 134 beats/min), a progressive increase in mitral gradient (7.4 to 11.5 mm Hg,P= 0.001) and left arterial pressure from 10 to 13 mm Hg was noted. Stroke volume and left ventricular end-diastolic pressure decreased from 57 to 36 cc (P= 0.001) and 6.5 to 4.5 mm Hg,... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Onkar S. Narula, M.D.; Joseph W. Linhart, M.D.; Frank J. Hildner, M.D.; S. Serge Barold, M.D.; Roger P. Javier, M.D.; Philip Samet, M.D., F.A.C.P.Affiliations: Miami Beach, Florida PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1969Volume 70, Issue 5Page: 1079-1080KeywordsBlood pressureHeart rateHemodynamicsMitral valve replacementStroke ePublished: 1 December 2008 Issue Published: 1 May 1969 PDF downloadLoading ...
Functional relationships between cricopharyngeal sphincter and oesophageal body in response to graded intraluminal distension.
Authors: N A Andreollo, D G Thompson, G P Kendall, R J Earlam
Journal: Gut (1988)

<h3>Objective</h3> To describe outcomes for women with a Fontan circulation attending preconception counselling (PCC). Exploring (1) impact of counselling on decision to become pregnant; (2) pregnancy rates in those opting for pregnancy and (3) short-term and long-term outcome of those who succeeded in becoming pregnant. <h3>Methods</h3> Retrospective review of women aged 16–45 years with a Fontan circulation from 1994 to 2014. <h3>Results</h3> 58 women were offered PCC, 3 declined and 55 received PCC. Following PCC, 15 opted against conception, 16 decided to delay pregnancy, 19 attempted pregnancy and 5 were lost to follow-up. Of the 19 women, 14 succeeded, becoming pregnant a total of 43 times (median 1, range 1–9). Of these, 6 miscarried all pregnancies. 8 carried 14 pregnancies to viability. Baseline hypoxaemia and cardiac disease in pregnancy (CARPREG) score was similar in those opting for and against pregnancy, but CARPREG score was better in those delaying conception. Women exclusively miscarrying or unable to conceive were more likely to have baseline hypoxaemia and greater CARPREG score. Cardiac complications included arrhythmia requiring treatment (n=4) and one thromboembolism. Obstetric complications were greater in women with a Fontan circulation, 10 preterm births (&lt;37 weeks) and 8 small for gestational age babies (&lt;10th centile). There was one neonatal death. At follow-up, there was no deterioration in clinical status as determined by echo. <h3>Conclusions</h3> Most women accept PCC and decided to pursue pregnancy; in some cases, this was despite being advised of a poor prognosis. Pregnancy outcome was related to baseline hypoxia and CARPREG scores.
BEHAVIORAL PATTERNS IN EARLY MEETINGS OF THERAPEUTIC GROUPS
Authors: JEROME D. FRANK, EDUARD ASCHER, JOSEPH B. MARGOLIN, HELEN NASH, ANTHONY R. STONE, EDITH J. VARON
Journal: American Journal of Psychiatry (1952)

Successful treatment of patients in groups requires consideration of the needs of the individual patients as well as the group as a whole. Understanding of these needs may be aided by the identification and study of behavior patterns shown by patients in early group meetings. These patterns often reflect the patients' habitual ways of dealing with important personal issues, and may strongly influence the group's functioning. As such, they seem to be more closely related to the therapeutic process than are clinical diagnoses in terms of symptoms. This paper outlines a method for identifying such patterns and describes two of them. That of the "help-rejecting complainer" consists essentially of constantly demanding help while denying its usefulness, and seems to express both the patient's feeling that he needs help, and his distrust of all potential help-givers. The " doctor's assistant" stresses his own competence, gives advice, and refuses to admit weakness as ways of claiming superiority. This pattern seems to represent these patients' way of dealing with their conflicting attitudes toward authority. The therapeutic problems posed by these patterns for both the patients and the group in early meetings are discussed.
Intraaortic Balloon Pumping
Authors: Adrian Kantrowitz
Journal: JAMA (1968)

<h3>To the Editor:—</h3> With reference to our article, "Initial Clinical Experience With Intraaortic Balloon Pumping in Cardiogenic Shock," which appeared inThe Journal(<b>203</b>:113, 1968), at the time our addendum regarding three additional patients was submitted, a complete follow-up on the sixth patient was not available. The patient subsequently died seven days after the procedure, from pulmonary complications. His hemodynamic status remained stable until his sudden death from pulmonary and renal complications.
Development of Quality Measures for the Care of Patients With Gastroesophageal Reflux Disease
Authors: Rena Yadlapati, Andrew J. Gawron, Karl Bilimoria, Rajesh N. Keswani, Kerry B. Dunbar, Peter J. Kahrilas, Philip Katz, Joel Richter, Felice Schnoll-Sussman, Nathaniel Soper, Marcelo F. Vela, John E. Pandolfino
Journal: Clinical Gastroenterology and Hepatology (2014)
Accelerated gene transfer through a polysorbitol-based transporter mechanism
Authors: Mohammad Ariful Islam, Cheol-Heui Yun, Yun-Jaie Choi, Ji-Young Shin, Rohidas Arote, Hu-Lin Jiang, Sang-Kee Kang, Jae-Woon Nah, In-Kyu Park, Myung-Haing Cho, Chong-Su Cho
Journal: Biomaterials (2011)
PREDICTORS OF ASPIRIN VERSUS ORAL ANTICOAGULANT PRESCRIPTION IN ATRIAL FIBRILLATION PATIENTS AT-RISK FOR STROKE: INSIGHTS FROM THE NCDR® PINNACLE REGISTRY
Authors: Jonathan Hsu, Thomas Maddox, Kevin Kennedy, David Katz, Lucas Marzec, Anil Gehi, Mintu Turakhia, Gregory Marcus
Journal: Journal of the American College of Cardiology (2014)
Hepatic Reactions to Tetracycline
Authors: Harry F. Dowling, Mark H. Lepper
Journal: JAMA (1964)

SOMETIMES an uncommon reaction to a drug will be discovered and reported by a number of observers, and then for a time it will be forgotten and thus go undetected. Later it will be rediscovered and publicized again. This is essentially what has happened in the case of the tetracyclines. Reports of fatty changes in the liver and, ocsionally, jaundice<sup>1-7</sup>appeared soon after chlortetracycline and oxytetracycline began to be used extensively. Studies on mice, rats, rabbits, and dogs showed that chlortetracycline and, to a lesser extent, oxytetracycline and tetracycline produced fatty metamorphosis and cellular necrobiosis in the liver.<sup>8-10</sup>Physicians were advised to use no more than 2 gm per day of chlortetracycline or oxytetracycline intravenously or by mouth (or comparable doses for children), and after this no cases were reported. During the next few years tetracycline was developed, and it rapidly became the most frequently used antibiotic in
Lipoprotein(a) and apolipoprotein changes after cardiac transplantation
Authors: John A. Farmer, Christie M. Ballantyne, O.Howard Frazier, Branislav Radovancevic, Charlotte Payton-Ross, Wolfgang Patsch, Joel D. Morrisett, Antonio M. Gotto, James B. Young
Journal: Journal of the American College of Cardiology (1991)
Women of Science: Righting the Record
Authors: Bernadine Z. Paulshock
Journal: JAMA (1991)

The book, undoubtedly as much a la bor of love as of resentment by its 11 women authors, cannot possibly redress the wrong of which it accuses academe: women's roles in universities have been restricted and their work has been ignored or purloined. The editors believe that in the main, women scientists of the past were unfairly treated but "Rather than cry over spilled milk, they made cottage cheese of it," a curiously feminine metaphor coined by the essayist and novelist, Joan Didion. The disciplines examined include archeology before 1960, geology, astronomy (this chapter is cleverly titled "Straying From Their Orbits"), mathematics, engineering, physics, biology, medicine, chemistry, and crystallography. Among the surprises in the chapter on chemistry by Jane Miller is this revelation: Moses' sister Miriam was an alchemist. To that purpose she devised laboratory equipment, including the double boiler, which is still called a bain marie in French kitchens. The chapter on medicine is written by Dr Patricia Fames, one of the two editors. Dr Fames was director of hematology at Rhode Island Hospital and associate professor of medical science at Brown University. She reminds us that women were healers before medical
Revalidation in Australia and New Zealand: approach of Royal Australasian College of Physicians
Authors: D. Newble, N. Paget, B. McLaren
Journal: BMJ (1999)

Maintaining standards of practice and ensuring that doctors remain up to date with medical developments are assuming increasing importance in Western healthcare systems. The language used to express this, however, differs. In the United Kingdom the process is now referred to as revalidation and continuing professional development, whereas in Australia and New Zealand the terms maintenance of professional standards, recertification, and continuing medical education remain in more common use.1

Within Australasia, only the Royal Australian College of Obstetricians and Gynaecologists has a true recertification procedure in that there is a three year time limit applied to the award of the fellowship diploma (FRACOG). Other colleges give certificates for participation in maintenance of standards programmes that are not tied directly to the fellowship diploma, which is awarded at the completion of advanced training. Most programmes, including that of the Royal Australian College of Obstetricians and Gynaecologists, are based on collecting points for continuing medical education and quality assurance activities. Most do not have practice related components The programmes are all voluntary, except for that of the Royal Australian College of Obstetricians and Gynaecologists. The incentives to take part vary. For example, failure to participate in the Royal Australian College of General Practitioners' programme leads to a lower level of government rebate on consulting fees. Increasingly, hospitals are requiring specialists to participate in order to be accredited to practice. This article reflects on the first five years of the Royal Australasian College of Physicians' maintenance of professional standards programme, which has several innovative components and is currently undergoing internal and external evaluation.

The maintenance of professional standards programme was introduced in 1994.2 The college's council intended the programme to focus primarily on the maintenance and improvement of clinical standards and not on identifying underperforming doctors. It wished to ensure that …