tbuckley/cabot-search huggingface dataset:
Menopausal status influences ambulatory blood pressure levels and blood pressure changes during mental stress.
Authors: J F Owens, C M Stoney, K A Matthews
Journal: Circulation (1993)

BACKGROUND Frequent and large cardiovascular and neuroendocrine responses to psychological stress are thought to enhance an individual's risk for cardiovascular diseases. Preliminary data suggest that levels of reproductive hormones affect the magnitude of stress responses, perhaps contributing to the protective effect of ovarian hormones on premenopausal women's rates of coronary heart disease. METHODS AND RESULTS Healthy middle-aged men and premenopausal and postmenopausal women performed a series of standardized mental and physical challenges while blood pressure, heart rate, plasma catecholamines, lipids, and lipoproteins were measured. Subjects then wore an ambulatory blood pressure monitor during two consecutive workdays. Results showed that postmenopausal women had larger mean +/- SEM stress-induced increases in systolic blood pressure (24.7 +/- 2.2 mm Hg) and diastolic blood pressure (14.3 +/- 1.0 mm Hg) compared with either premenopausal women (16.9 +/- 1.3 and 10.2 +/- 0.9 mm Hg) or men (17.7 +/- 1.5 and 10.9 +/- 1.1 mm Hg, respectively). Postmenopausal women and men had higher mean +/- SEM ambulatory diastolic blood pressure levels (75.5 +/- 3.2 and 76.4 +/- 1.8 mm Hg) than did premenopausal women (69.9 +/- 2.2 mm Hg). Large blood pressure responses during public speaking were associated with high cholesterol levels and low educational attainment. CONCLUSIONS Menopause is associated with enhanced stress-induced cardiovascular responses and elevated ambulatory blood pressure during the workday. These effects may contribute to the risk of cardiovascular morbidity and mortality after the menopause.
Coming Together to Achieve Quality Cardiovascular Care
Authors: Pamela S. Douglas, Robert H. Eckel, Darryl T. Gray, Jerod M. Loeb, Barry M. Straube
Journal: Circulation (2006)

greement on the processes of health care that are necessary to achieve healthcare quality goals is the foundation of performance measurement.In addition, standardization of performance measures themselves is essential to avoid confusion and undue burden among those whose performance is being measured.Recent work on cardiovascular performance measures establishes a new standard for how those agreements can be achieved and maintained among multiple stakeholders.The collaboration among the American College of Cardiology (ACC), the American Heart Association (AHA), the Centers for Medicare and Medicaid Services (CMS), the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), and the Agency for Healthcare Research and Quality (AHRQ) serves as a useful model for how to reduce the burden of measure development, endorsement for public reporting, and implementation for quality improvement and accountability.
Serum methylprednisolone levels following intra-articular injection of methylprednisolone acetate.
Authors: R D Armstrong, J English, T Gibson, J Chakraborty, V Marks
Journal: Annals of the Rheumatic Diseases (1981)

Twenty-one patients with rheumatoid arthritis received injections of either 40 mg or 80 mg of methylprednisolone acetate into one or both knee joints. Serum methylprednisolone and cortisol levels were measured at intervals up to 1 week following injection. Peak serum levels of methylprednisolone were reached at between 2 and 12 hours following injection, and increasing the injected dose resulted in correspondingly higher serum levels. Injection of 80 mg of methylprednisolone as 40 mg into each knee produced consistently higher peak serum levels than when given as a single intra-articular injection. Serum cortisol levels were substantially suppressed for up to 1 week, and this effect was seen at all dose levels.
A profibrotic polymorphism (of TGFbeta1) in systemic sclerosis
Authors: J P Pandey
Journal: Annals of the Rheumatic Diseases (2002)

TGFβ1 and several other polymorphic determinants are risk factors for SSc

In this issue, Crilly et al demonstrate polymorphisms of transforming growth factor β1 (TGFβ1) in subjects with systemic sclerosis (SSc) which might have functional significance.1 Much remains unknown about the pathogenesis of SSc, the generalised form of scleroderma, which comprises prominent autoimmune, vascular/microvascular, and ultimately fibrotic features. This combination substantially reduces both quality of life and life expectancy, depending on the site and a highly variable rate of involvement. Underlying the unregulated deposition of extracellular matrix (ECM) in skin, lung, heart, gut, and kidney, there is a fibroproliferative intimal vascular lesion which extends into the microcirculation, seems to be progressive, and remains poorly understood, despite attempts to isolate abnormalities of platelets, and of endothelial, immune, and vascular wall smooth muscle cells, among others (for example, pericytes and myofibroblasts).

ECM depositions by immune/inflammatory reactions have in common the expression of profibrogenic cytokines, including platelet derived growth factor (PDGF), connective tissue growth factor (CTGF), vascular endothelial growth factor (VEGF), and perhaps the master profibrogenic cytokine, TGFβ, a ligand-receptor system with many family members, which is highly conserved among vertebrates. Biologically, each of three ligands is expressed in inactive form and …
A 5-item calculator predicted risk for postoperative respiratory failure
Authors: Francis Whalen
Journal: Annals of Internal Medicine (2012)

ACP Journal Club15 May 2012A 5-item calculator predicted risk for postoperative respiratory failureFrancis Whalen, MDFrancis Whalen, MDMayo Clinic, Rochester, Minnesota, USA (F.W.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-10-201205150-02013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationGupta H, Gupta PK, Fang X, et al. Development and validation of a risk calculator predicting postoperative respiratory failure. Chest. 2011;140:1207-15. https://pubmed.ncbi.nlm.nih.gov/21757571Clinical Impact RatingsHospitalists: Pulmonology: References1 Arozullah AM, Khuri SF, Henderson WG, Daley J; Participants in the National Veterans Affairs Surgical Quality Improvement Program. Development and validation of a multifactorial risk index for predicting postoperative pneumonia after major noncardiac surgery. Ann Intern Med. 2001;135:847-57. [PMID: 11712875] Google Scholar2 Khuri SF, Henderson WG, DePalma RG, et al; Participants in the VA National Surgical Quality Improvement Program. Determinants of long-term survival after major surgery and the adverse effect of postoperative complications. Ann Surg. 2005;242:326-41. [PMID: 16135919] Google Scholar3 Fernández-Pérez ER, Sprung J, Afessa B, et al. Intraoperative ventilator settings and acute lung injury after elective surgery: a nested case control study. Thorax. 2009;64:121-7. [PMID: 18988659] Google Scholar Author, Article, and Disclosure InformationAffiliations: Mayo Clinic, Rochester, Minnesota, USA (F.W.)This article was published at Annals.org on 1 May 2012. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByDay of Surgery Admission in Total Joint Arthroplasty: Why Are Surgeries Cancelled? An Analysis of 3195 Planned Procedures and 114 Cancellations 15 May 2012Volume 156, Issue 10Page: JC5-13KeywordsMyocardial infarctionPulmonary medicineQuality improvementRespiratory failureSepsisSurgeonsSurgeryThoraxVentilators ePublished: 15 May 2012 Issue Published: 15 May 2012 CopyrightCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Biliary excretion of radioactivity after intravenous administration of 3H-1,25-dihydroxyvitamin D3 in man.
Authors: J E Ledger, G J Watson, C C Ainley, J E Compston
Journal: Gut (1985)

Biliary radioactivity excretion was studied in 10 patients with postcholecystectomy T-tube drainage after intravenous administration of 3H-1,25-dihydroxyvitamin D3. The mean +/- SD radioactivity excreted in T-tube bile expressed as a percentage of the administered dose was 18.9 +/- 10.7% per 24 hours. After correction for incomplete bile collection the value obtained was 28.8 +/- 12.8%. The mean chloroform solubility of the biliary radioactivity increased from 17.0 +/- 8.4% to 69.4 +/- 15.1% after incubation with beta-glucuronidase. High performance liquid chromatography of chloroform extracts of bile revealed that most of the eluted radioactivity was more polar than 1,25(OH)2D3. The percentage radioactivity eluting as 3H-1,25(OH)2D3 increased from approximately 2.4 +/- 1.9 to 16.2 +/- 8.0 after incubation with beta-glucuronidase. We conclude that significant amounts of intravenously administered 3H-1,25(OH)2D3 are excreted in bile, mostly as more polar metabolites. The increase in free 3H-1,25(OH)2D3 after incubation with beta-glucuronidase indicates that glucuronides of 1,25(OH)2D3 are present in bile.
Socioeconomic deprivation and notification rates for tuberculosis in London during 1982-91
Authors: P. Mangtani, D. J Jolley, J. M Watson, L. C Rodrigues
Journal: BMJ (1995)

<h3>Abstract</h3> <b>Objectives</b>: To investigate the association between four sociodemographic measures (unemployment, overcrowding, low social class, and the proportion of migrants from areas of high prevalence of tuberculosis) and average level and rate of change of notification rates for tuberculosis. <b>Design</b>: Ecological analysis of both the average and the rate of change of standardised annual notification rates for tuberculosis from 1982-91 and sociodemographic measures from the 1981 and 1991 censuses. <b>Setting</b>: 32 London boroughs. <b>Subjects and data</b>: Sociodemographic measures from the 1981 and 1991 censuses and tuberculosis notification rates for 1982-91. <b>Main outcome measures</b>: A measure of the association between average levels and rate of change in tuberculosis notification rates and four sociodemographic measures in 1981 and between the rate of change in tuberculosis notification rates between 1981 and 1991 and changes in sociodemographic measures between 1981 and 1991. <b>Results</b>: The average level of notifications was correlated with overcrowding and the proportion of migrants but not with unemployment or social class. No significant association was found between the rate of change in notification rates and sociodemographic measures in 1981. An association was found between increases in unemployment and the rate of change in notification rates, but the effect was small. Changes in the levels of unemployment explained 23% of the variation between boroughs in the rate of change in their notification rates. <b>Conclusion</b>: The average tuberculosis notification rates were related to overcrowding and the proportion of migrants in 1981. Only increases in unemployment from 1981 to 1991, however, were significantly associated with the rate of change in notifications over the same period. <h3>Key messages</h3> Key messages Sociodemographic variables such as poverty, overcrowding, and migration (from parts of the world with relatively high rates of tuberculosis) are known to be associated with higher rates of tuberculosis The recent rates of change in notification rates in London boroughs in the past decade do not seem to be associated with the absolute levels of overcrowding, unemployment, social class distribution, or proportion of migrants as measured in the 1981 census An association, however, was found between changes in unemployment levels between 1981 and 1991 and the rates of change in tuberculosis notification rates in the same period, but the effect was small Further research is necessary to determine the reasons for the association found and to investigate the other factors contributing to the changing rates of tuberculosis in the developed world
NHS spinal units
Authors: J. Cowley
Journal: BMJ (2010)

My experience of an NHS spinal unit mirrors closely that described by Sonksen and Hillier.1 I have a complete cord transection at mid-thoracic level and was treated conservatively, which meant 14 weeks in bed, being log rolled etc, and several complications from such recumbency.

The rehabilitation staff, especially the physiotherapists, were vastly …
Effects of the 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors, atorvastatin and simvastatin, on the expression of endothelin-1 and endothelial nitric oxide synthase in vascular endothelial cells.
Authors: O Hernández-Perera, D Pérez-Sala, J Navarro-Antolín, R Sánchez-Pascuala, G Hernández, C Díaz, S Lamas
Journal: Journal of Clinical Investigation (1998)

Endothelial dysfunction associated with atherosclerosis has been attributed to alterations in the L-arginine-nitric oxide (NO)-cGMP pathway or to an excess of endothelin-1 (ET-1). The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) have been shown to ameliorate endothelial function. However, the physiological basis of this observation is largely unknown. We investigated the effects of Atorvastatin and Simvastatin on the pre-proET-1 mRNA expression and ET-1 synthesis and on the endothelial NO synthase (eNOS) transcript and protein levels in bovine aortic endothelial cells. These agents inhibited pre-proET-1 mRNA expression in a concentration- and time-dependent fashion (60-70% maximum inhibition) and reduced immunoreactive ET-1 levels (25-50%). This inhibitory effect was maintained in the presence of oxidized LDL (1-50 microg/ml). No significant modification of pre-proET-1 mRNA half-life was observed. In addition, mevalonate, but not cholesterol, reversed the statin-mediated decrease of pre-proET-1 mRNA levels. eNOS mRNA expression was reduced by oxidized LDL in a dose-dependent fashion (up to 57% inhibition), whereas native LDL had no effect. Statins were able to prevent the inhibitory action exerted by oxidized LDL on eNOS mRNA and protein levels. Hence, these drugs might influence vascular tone by modulating the expression of endothelial vasoactive factors.
Abstract 134: DHA induces apoptosis via lipid rafts modulation and downregulation of EGFR and Akt inactivation
Authors: Yong-Nyun Kim, Eun Jeong Lee, Byung-Kiu Park
Journal: Cancer Research (2010)

Abstract Lipid rafts are plasma membrane micro-domains that are known to be a depot of various signaling molecules, including EGF receptor. Intact lipid rafts are critical for Akt activation, which is important for cell survival. Therefore, lipid rafts have been involved in regulations of cellular functions such as cell survival and adhesion. (n-3) PUFAs, such as and eicosapentaenoic acid (EPA), are known to influence lipid rafts and have anti-cancer effects. In this study, we hypothesized that DHA induces apoptosis via alteration of lipid rafts-associated survival signaling and we investigated PUFA's anti-cancer effects and a possible mechanism involved in this process using human breast cancer cell line, MDA-MB-231. We found that DHA inhibited the growth of MDA-MB-231 cells up to 50-60% in the presence of DHA in a dose- and time-dependent manner, which was due to apoptosis. Interestingly, DHA treatment down-regulated multiple proteins that are associated with lipid rafts, including EGFR, AKT, Src in their protein levels, and thus inactivated those proteins. DHA stimulated rafts internalization from cell surface to the cytoplasm. DHA attenuated EGF-induced EGFR activation, probably due to EGFR down-regulation. Akt was inactivated with DHA treatment and the over-expression of active-Akt or wt-Akt was able to attenuate cell death by DHA. Cholesterol, a major component of rafts, reversed DHA-induced effects, including lipid raft internalization, Akt inactivation, and apoptosis. All these data indicate that DHA's anti-cancer effect is mediated by rafts internalization and subsequently Akt inactivation. Our study suggests that DHA is a putative modulator of lipid rafts and thus could be developed as an anticancer drug by targeting lipid rafts. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 134.
Accuracy of recording of deaths from asthma in the UK: the false negative rate.
Authors: H. F. Guite, P. G. Burney
Journal: Thorax (1996)

BACKGROUND: A study was carried out to determine the extent to which asthma deaths are wrongly attributed to another cause on UK death certificates. METHODS: Deaths from all causes occurring anywhere in the UK were identified amongst 2382 subjects aged 16-64 years within three years of discharge following hospital treatment for asthma (ICD9 493) in hospitals in the South East Thames region. The deaths were reviewed by an expert panel to assess the proportion of asthma deaths identified by the panel which were attributed to another cause of death on the death certificate (false negatives). RESULTS: Eighty five deaths from all causes were identified in a mean follow up period of two years and three months. In 61 cases (72%) there was sufficient information for the expert panel to be confident about the cause of death. The panel identified 22 deaths from asthma, four of which were certified as non-asthma deaths (two as deaths from chronic obstructive pulmonary disease (COPD) and two as deaths from cardiovascular disease). The proportion of false negative death certificates was four of 22 (18%, 95% confidence interval (CI) 5 to 40). CONCLUSIONS: There is evidence that asthma deaths in the UK are wrongly certified as deaths from both chronic obstructive pulmonary disease and diseases of the cardiovascular system.
Puffability People: a new way to promote health.
Authors: A G Dunn, P Dunn
Journal: BMJ (1983)

I have left out a number of other matters rarely considered by clinicians when they start either to design or to participate in a clinical trial and about which the arch exponents of the discipline are somewhat coy. These include: whether entry by accrual into a trial, particularly a multicentre one, is truly random; whether we should continue to use the formal 5()() level of statistical significance and what that level actually means for decision making; and the need to consider the matter of start? up variation. I hope, however, that I have given enough of an alternative point of view to shift what I fear might have become a central dogma?the concept of overriding need to prosecute controlled clinical trials as the only way of ensuring reliable knowledge.
Detection of Coronary Microembolization by Doppler Ultrasound in Patients With Stable Angina Pectoris Undergoing Elective Percutaneous Coronary Interventions
Authors: Philipp Bahrmann, Gerald S. Werner, Gerd Heusch, Markus Ferrari, Tudor C. Poerner, Andreas Voss, Hans R. Figulla
Journal: Circulation (2007)

Intracoronary Doppler guidewires can be used for real-time detection and quantification of microembolism during percutaneous coronary interventions (PCIs). We investigated whether the frequency of Doppler-detected microembolism is related to the incidence of myonecrosis during elective PCI.The study population included 52 consecutive patients (aged 64+/-10 years; 36 men, 16 women) with coronary artery disease who underwent elective PCI of a single-vessel stenosis. Using intracoronary Doppler ultrasound, we compared the frequency of microembolism during PCI in 22 patients with periprocedural non-ST-segment elevation myocardial infarctions (pNSTEMI) and 30 patients without pNSTEMI. The 2 groups were comparable with regard to their clinical and procedural characteristics. In the group with pNSTEMI, the total number of coronary microemboli after PCI (27+/-10 versus 16+/-8, P<0.001) was higher than in the group without pNSTEMI. Although high-sensitivity C-reactive protein plasma levels were similar before PCI (2.9+/-2.2 versus 3.4+/-1.7 mg/L, P=NS), they were higher in the group with pNSTEMI after PCI (12.6+/-10.4 versus 6.1+/-5.1 mg/L, P<0.05). Microembolic count independently correlated to postprocedural cardiac troponin I elevation (r=0.565, P<0.001), coronary flow velocity reserve (r=-0.506, P<0.001), and baseline average peak velocity (r=0.499, P<0.001).Patients with pNSTEMI had a significantly higher frequency of coronary microembolization during PCI, and their systemic inflammatory response and microvascular impairment after PCI were more pronounced. Intracoronary Doppler ultrasound provides evidence that pNSTEMI in patients undergoing elective PCI is caused by microembolization during the procedure.
FACTORS ASSOCIATED WITH USE OF NEWER ANTIPLATELET AGENTS IN PATIENTS UNDERGOING DRUG ELUTING STENT PLACEMENT: ANALYSIS FROM THE PINNACLE® REGISTRY
Authors: Salman Jamaluddin Bandeali, Philip Jones, Salim Virani, Ravi Hira, Paul Chan, James Wilson, Neal Kleiman, Nasser Lakkis, Mahboob Alam
Journal: Journal of the American College of Cardiology (2015)
Many foundation trusts face tough financial future, warns Monitor
Authors: A. Cole
Journal: BMJ (2012)

A growing number of England’s 144 foundation trusts are likely to face financial problems over the next three years, says a review by independent regulating body Monitor.1

Foundation trusts are forecasting a decline in income and greater financial risk as they attempt to meet growing demand while simultaneously making substantial cuts in costs, says the review of their annual plans.

Stephen Hay, Monitor’s chief operating officer, predicted many trusts would be financially weaker by 2015. “We expect an increasing number of trusts could be placed in significant breach for financial …
In vitro Ca-P precipitation on biodegradable thermoplastic composite of poly(ε-caprolactone-co-dl-lactide) and bioactive glass (S53P4)
Authors: T. Jaakkola, J. Rich, T. Tirri, T. Närhi, M. Jokinen, J. Seppälä, A. Yli-Urpo
Journal: Biomaterials (2003)
Preventing Medication Errors
Authors: Prentiss Taylor
Journal: JAMA (2007)

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Scottish NHS should not be exempt from budget cuts, independent review advises
Authors: B. Christie
Journal: BMJ (2010)

The NHS in Scotland should not be given special protection against cutbacks in public expenditure, an independent budget review set up by the Scottish government has concluded.

The review, which was asked to identify options for savings, also says that free, universal services such as eye tests and personal and nursing care, and plans to abolish prescription charges, “may no longer be affordable.”

It proposes that up to 60 000 jobs be cut from the total public sector workforce in Scotland by 2014-15 and that public sector pay be frozen for two years, in line with plans for …