tbuckley/cabot-search huggingface dataset:
Diagnostic Applications of Indicator-Dilution Technics In Congenital Heart Disease
Authors: Earl H. Wood
Journal: Circulation Research (1962)

In summarizing the diagnostic value of the indicator-dilution technics in the study and investigation of congenital heart disease, perhaps a simple listing of the advantages and disadvantages of the technics will suffice. The advantages are as follows: 1. The technics have a high degree of safety. In the more than 3000 cardiac patients in whom they have been utilized there have been no deaths and little or no morbidity. 2. The sensitivity of the technics for the detection and localization of right-to-left and left-to-right shunts is much superior to that of the conventional blood-gas methods. 3. Quantitative determinations of systemic and pulmonary blood flow and intrathoracic shunts by indicator-dilution methods can be made simultaneously over periods of less than 1 minute; when indicator dyes are used, these technics do not require manometrie analyses, accessory respiratory exchange studies, or active cooperation of the patient; and they are independent of foreign (anesthetic) gases in the blood. 4. The technics are versatile and can be extremely useful either for the detection and diagnosis of minimal, relatively simple defects or for the elucidation of the extremely complex types of congenital malformations. 5. The information obtained is of both a qualitative and a quantitative nature; that is, the nature and location of defects can be determined and, in addition, the magnitude and direction of flow through the defects in question as well as the levels of systemic and pulmonary blood flows can be estimated. The disadvantages of the technics are as follows: 1. Rather complicated and sensitive recording equipment is essential. 2. Considerable technical skill is required of the persons carrying out the procedure in the placement of the necessary needles and catheters and in the proper selection of the multiple possible injection and sampling sites reached by these instruments in order to obtain the information needed to establish the diagnosis in question. 3. Correct interpretation of the diagnostic significance of the dilution curves obtained requires careful study and considerable experience by the person responsible for this phase of the investigation. In other words, these technics entail relatively little discomfort and little danger for the patient, but require good equipment and, more important, considerable time, effort and skill on the part of the investigator and his assistants in order to obtain highly successful results.
G.M.C. proposals and vocational training
Authors: J. A. Dunbar
Journal: BMJ (1969)

requirement is hammered through our quali- fication will be the longest in the world ?These moves of compulsory service are not in accord with the freedom of this country.The Royal Commission has thrown our present qualifications into unbelievable ridicule, and the G.M.C. has not only accepted this ridicule but is bending over backwards to follow its suggestions at the expense of the freedom and choice of
Endothelial PAS Domain Protein 1 Gene Promotes Angiogenesis Through the Transactivation of Both Vascular Endothelial Growth Factor and Its Receptor, Flt-1
Authors: Norihiko Takeda, Koji Maemura, Yasushi Imai, Tomohiro Harada, Daiji Kawanami, Takefumi Nojiri, Ichiro Manabe, Ryozo Nagai
Journal: Circulation Research (2004)

Endothelial PAS domain protein 1 (EPAS1) is a basic-helix-loop-helix/PAS domain transcription factor that is expressed preferentially in vascular endothelial cells. EPAS1 shares high homology with hypoxia-inducible factor-1alpha (HIF-1alpha) and is reported to transactivate vascular endothelial growth factor (VEGF), fetal liver kinase-1 (Flk-1), and Tie2 promoters. In this study, we analyzed the role of EPAS1 in the process of angiogenesis. Using microarray technology, we looked for target genes regulated by EPAS1 in vascular endothelial cells. A total of 130 genes were upregulated by EPAS1, including fms-like tyrosine kinase-1 (Flt-1). Reporter analysis using human Flt-1 promoter and gel mobility shift assays showed that the heterodimer of EPAS1 and aryl hydrocarbon receptor nuclear translocator binds directly to HIF-1-binding site upstream of Flt-1 promoter and transactivates it. Small interfering RNA targeted to EPAS1 but not HIF-1alpha attenuated desferrioxamine-induced Flt-1 mRNA expression, thus EPAS1 is thought to play an essential role in hypoxic induction of Flt-1 gene. Furthermore, using mouse wound healing models, we demonstrated that adenovirus-mediated delivery of EPAS1 gene significantly induced the expression of VEGF, Flt-1, Flk-1, and Tie2 mRNA at the wound site and promoted mature angiogenesis. The proportion of the number of mural cells in newly formed vessels was significantly higher in EPAS1-treated wound area than VEGF-treated area. In conclusion, EPAS1 promotes Flt-1 gene expression and induces mRNA expression of VEGF, Flk-1, and Tie2, leading to enhancement of mature angiogenesis in vivo. Thus, EPAS1 may contribute to the construction of mature vessels by modulating the coordinated expressions of VEGF, Flt-1, Flk-1, and Tie2.
Transient Ischemic Attacks in a Community
Authors: Gary D. Friedman
Journal: JAMA (1969)

Sixty cases of transient cerebral ischemic attack (TIA) were noted during five years of observation of a large retirement community. The incidence of new cases was 1.1/1,000/yr and was 1.8 times greater in men than in women. Electrocardiographic abnormalities were associated with increased risk of TIA development; hypertension and cardiomegaly on chest roentgenograms were not. Most patients were not hospitalized for TIA. Forty-four patients with TIA and without previous cerebrovascular disease were followed up for an average of 27.4 months. Subsequent thromboses developed in eight (18%), confirming the prognosis of TIA reported from hospitals and neurologic clinics. The incidence of subsequent thrombosis was greatest during the first year after the initial TIA. Preliminary studies indicated that women, older patients, and those with attacks of less than one hour's duration were at increased risk of subsequent thrombosis.
AT514, a cyclic depsipeptide from Serratia marcescens, induces apoptosis of B-chronic lymphocytic leukemia cells: interference with the Akt/NF-κB survival pathway
Authors: E Escobar-Díaz, E M López-Martín, M Hernández del Cerro, A Puig-Kroger, V Soto-Cerrato, B Montaner, E Giralt, J A García-Marco, R Pérez-Tomás, A Garcia-Pardo
Journal: Leukemia (2005)
SUICIDE ATTEMPTS IN HYPO-OESTROGENIC PHASES OF THE MENSTRUAL CYCLE
Authors: Vincent Fourestié, BrunoDe Lignières, Françoise Roudot-Thoraval, Ivana Fulli-Lemaire, Kahlil Nahoul, Didier Cremniter, Sabine Fournier, Jean-Louis Lejonc
Journal: The Lancet (1986)
Glass Houses and the Glory of the Climb
Authors: Christopher M. Callahan
Journal: Annals of Internal Medicine (2001)

Editorials16 October 2001Glass Houses and the Glory of the ClimbChristopher M. Callahan, MDChristopher M. Callahan, MDDr. Callahan: Indiana University Center for Aging Research; Regenstrief Institute for Health Care; Indianapolis, IN 46202Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-8_Part_1-200110160-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Every day you may make progress. Every step may be fruitful. Yet there will stretch out before you an ever-lengthening, ever-ascending, ever-improving path. You know you will never get to the end of the journey. But this, so far from discouraging, only adds to the joy and glory of the climb.–Winston ChurchillThe Institute of Medicine's Committee on Quality in Health Care in America recently concluded that “Health care today harms too frequently and routinely fails to deliver its potential benefits” (1). The potential for harm and failure is perhaps greatest among vulnerable older Americans because they are more likely ...References1. Committee on Quality of Health Care in America. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Pr; 2001. Google Scholar2. Wenger NS, Shekelle PG, MacLean C. Assessing care of vulnerable elders: ACOVE Project overview. The ACOVE investigators. Ann Intern Med. 2001;135:642-6. LinkGoogle Scholar3. McDonald CJ, Overhage JM, Tierney WM, Dexter PR, Martin DK, Suico JG, et al . The Regenstrief Medical Record System: a quarter century experience. Int J Med Inf. 1999;54:225-53. [PMID: 10405881] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Dr. Callahan: Indiana University Center for Aging Research; Regenstrief Institute for Health Care; Indianapolis, IN 46202Grant Support: Dr. Callahan is supported by grant K07AG00868 from the National Institute on Aging.Corresponding Author: Christopher M. Callahan, MD, Indiana University Center for Aging Research, 1050 Wishard Boulevard, RG6, Indianapolis, IN 46202; e-mail, [email protected]org. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySelf-reported medication use in community-residing older adults: A pilot study 16 October 2001Volume 135, Issue 8_Part_1Page: 613-615KeywordsElderlyHealth careHealth care qualityHealth care quality assessmentHealth information technologyPeer reviewPrimary care physiciansQuality improvementQuality indicatorsResearch quality assessment ePublished: 16 October 2001 Issue Published: 16 October 2001 Copyright & PermissionsCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Pitfalls in Clinical Recognition and a Novel Operative Approach for Hypertrophic Cardiomyopathy With Severe Outflow Obstruction Due to Anomalous Papillary Muscle
Authors: Barry J. Maron, Rick A. Nishimura, Gordon K. Danielson
Journal: Circulation (1998)

Background —Ventricular septal myotomy/myectomy (Morrow procedure) is the standard surgical option for severely symptomatic patients with hypertrophic cardiomyopathy (HCM) and marked basal obstruction to left ventricular outflow due to mitral valve systolic anterior motion. In some patients, however, congenital malformations of the mitral apparatus may be responsible for outflow obstruction; the failure to recognize this morphology before operation could have adverse consequences. Methods and Results —We recently evaluated 2 patients with obstructive HCM operated on at Mayo Medical Center in 1997 who demonstrated direct anomalous papillary muscle insertion into the anterior mitral leaflet, producing muscular midcavity obstruction. This anomaly is potentially identifiable with echocardiography by exaggerated anterior displacement of hypertrophied papillary muscles within the left ventricular cavity and the direct continuity between papillary muscle and anterior leaflet associated with a rigid motion pattern of the mitral apparatus. Echocardiographic diagnosis, however, was confused in both patients by the association of systolic anterior motion of the mitral valve, probably produced by freely mobile margins of the mitral leaflet unencumbered by papillary muscle insertion, and in 1 patient probably representing a second and more basal level of obstruction. Because outflow tract morphology was judged unsuitable for conventional myotomy/myectomy, a novel surgical strategy was designed to remove the outflow gradient in which an extensive myectomy trough (wider at its apical than basal extent) was created within the ventricular septum to papillary muscle level; also, in 1 patient, attachment of anterolateral papillary muscle with the lateral free wall was partially severed to increase mobility of the mitral apparatus. After surgery, both patients reported substantial relief of symptoms and improved exercise tolerance and also showed reduced or abolished basal outflow obstruction. Conclusions —In HCM, outflow obstruction due to anomalous papillary muscle insertion directly into anterior mitral leaflet is challenging to identify but should always be contemplated before operative intervention. This important (but often unsuspected) congenital malformation may require alternative surgical strategies to standard myotomy/myectomy, similar to those described here.
Abstract 260: Relationship Between the Blood Hemoglobin Level at Hospital Arrival and Post--Cardiac Arrest Neurological Outcome
Authors: Kei Hayashida, Masaru Suzuki, Akiko Shiroshita-Takeshita, Yosuke Honma, Hiroshi Kamura, Tsuyoshi Hatada, Msafumi Otuka, Masayuki Fujioka, Taku Oomura, Akira Murai, Tomohiko Orita, Satoru Beppu, Hideki Arimoto, Kei Nishiyama, Noritoshi Ito, Shingo Hori
Journal: Circulation (2012)

OBJECTIVE: Recent studies have revealed that regional brain oxygen saturation (rSO2) is an excellent predictor for a neurological outcome in OHCA. It also has been suggested that brain tissue oxygenation is crucial for a post cardiac arrest syndrome (PCAS). Hemoglobin (Hb) is an indispensable for oxygen delivery to peripheral tissue. Therefore, it is considered that Hb plays an important role in PCAS. In the present study, we aim to elucidate the relationship between blood Hb level and the neurological outcome in PCAS. METHODS: The database of the J-POP registry (multicenter observational study) has prospectively enrolled 764 OHCA patients. Of these, 193 PCAS patients admitted to the wards after ROSC were included in this study. Blood Hb level (median 12.0g/dL, [IQR 10.4-13.8]) and rSO2 (35%, [15-55]) were obtained during resuscitation within 3 min after hospital arrival. The neurological outcome was evaluated by CPC at 30 days, and CPC1 and 2 were defined as favorable neurologic outcome. RESULTS: Among 193 PCAS patients, 27 showed favorable outcome (14%). There was no significant correlation between rSO2 and Hb level (P=0.43). Univariate analyses revealed that the favorable outcome group was characterized as younger, male, witnessed CA, initial shockable rhythm, higher Hb level, rSO2&gt;35%, and shorter transport interval from the scene to the hospital. Coronary angiography (CAG) and therapeutic hypothermia were also associated with the favorable outcome. The multivariate analysis showed that rSO2&gt;35% (OR 35.0 [7.5-163.4]), Hb (1.48 [1.08-2.01]), CAG (45.8 [7.7-271.1]) were independent predictors for the favorable outcome. CONCLUSIONS: A higher blood Hb level was associated with a favorable short-term neurological outcome in patients with PCAS regardless of rSO2.
Drug-Induced Systemic Lupus Erythematosus
Authors: Joseph H. Greenberg
Journal: JAMA (1972)

A patient with suspected isoniazid-induced lupus erythematosus had positive reaction for antinuclear antibody, lupus erythematosus cell, gamma and nongamma direct antiglobulin tests. Severe pericarditis with life-threatening pericardial tamponade required emergency pericardiocentesis. Recurrence of the pericardial effusion with tamponade necessitated use of corticosteroids. We suggest use of steroids early in drug-induced lupus erythematosus, if associated with severe pericarditis with any question of pericardial tamponade (even in the face of underlying tuberculosis).
Authors' perceptions of electronic publishing: two cross sectional surveys
Authors: Sara Schroter, Helen Barratt, Jane Smith
Journal: BMJ (2004)

To evaluate how acceptable authors find the BMJ's current practice of publishing short versions of research articles in the paper journal and a longer version on the web and to determine authors' attitudes towards publishing only abstracts in the paper journal and publishing unedited versions on bmj.com once papers have been accepted for publication.
Nearly half of adults in England don't understand health information material, study indicates
Authors: S. Mayor
Journal: BMJ (2012)

Nearly half of adults in England are unable to understand standard health information material—such as instructions on how to calculate the dosage of paracetamol for a child—well enough to act on it, indicate results from a study reported this week.

Researchers extrapolated results for levels of literacy and numeracy collected in interviews with more than 6000 people aged 16-65 years to assess understanding of 64 items of information on health and safety. The data came from a nationally representative sample taking part in the Skills for Life survey,1 conducted by the Department for Business, Innovation and Skills, and were applied …
121 HIGH LIVER EXPRESSION OF SPINK-1 IS ASSOCIATED WITH PROGENITOR CELL AND HEPATOCYTE PROLIFERATION AND DETERMINES MELD SCORE IMPROVEMENT IN DECOMPENSATED ALCOHOLIC LIVER DISEASE
Authors: N. Lanthier, L. Rubbia-Brandt, N. Lin-Marq, Y. Chalandon, L. Spahr
Journal: Journal of Hepatology (2013)
Many Patients With Interleukin 28B Genotypes Associated With Response to Therapy Are Ineligible for Treatment Because of Comorbidities
Authors: Fasiha Kanwal, Donna L. White, Shahriar Tavakoli–Tabasi, Li Jiao, Derek Lin, David J. Ramsey, Andrew Spiegelman, Jill Kuzniarek, Hashem B. El–Serag
Journal: Clinical Gastroenterology and Hepatology (2013)
Novel adoptive T-cell immunotherapy using a WT1-specific TCR vector encoding silencers for endogenous TCRs shows marked antileukemia reactivity and safety
Authors: Toshiki Ochi, Hiroshi Fujiwara, Sachiko Okamoto, Jun An, Kozo Nagai, Toshiaki Shirakata, Junichi Mineno, Kiyotaka Kuzushima, Hiroshi Shiku, Masaki Yasukawa
Journal: Blood (2011)
THE PERCENTAGE INDEX VERSUS THE BACILLARY INDEX IN THE ESTIMATION OF THE OPSONINS.
Authors: CHARLES E. SIMON
Journal: JAMA (1907)

In a previous communication<sup>1</sup>I have drawn attention to certain fallacies which attach to Wright's method of estimating the opsonic content of the blood, and have shown that more accurate results can be obtained by estimating the percentage of phagocyting leucocytes. By comparing the figure thus obtained with the figure corresponding to a specimen of pooled normal blood serum, terming the latter value 1, an index is obtained which is directly comparable to Wright's index. For routine work this method will be found more convenient than Wright's method of counting the organisms pro leucocyte and comparing the resulting figure with the corresponding one obtained with normal blood. If for any reason, however, Wright's method is to be used, I should recommend that the percentage index be calculated at the same time; it will be found a useful check on the former and readily shows up errors that may have been
Inspiratory Flow Dynamics During Phrenic Nerve Stimulation in Awake Normals During Nasal Breathing
Authors: FRÉDÉRIC SÉRIÈS, ALEXANDRE DEMOULE, ISABELLE MARC, CATHIE SANFAÇON, JEAN PHILIPPE DERENNE, THOMAS SIMILOWSKI
Journal: American Journal of Respiratory and Critical Care Medicine (1999)

The loss of upper airway (UA) dilators preactivation before inspiratory muscle contraction is an important determinant of the pathophysiology of obstructive sleep apnea. We hypothetized that phrenic nerve stimulation could provide a practical way to explore the effects of the dissociation between UA dilators and inspiratory muscles, and possibly to determine UA critical closing pressure during wakefulness. The pattern of inspiratory airflow was therefore studied in normal awake subjects during diaphragm twitches induced by either electrical phrenic stimulation (ES) or cervical magnetic stimulation (CMS) (n = 9) and with and without a nasal stent during ES (n = 7). End-expiratory stimulations applied during exclusive nasal breathing induced 200 to 300 ms twitch inspiratory flow. The average maximal twitch flow of flow-limited twitches was higher during CMS than ES (1.18 ± 0.29 L ·
Race to Report: Are Vascular Endothelial Growth Factor Genetic Polymorphisms Associated With Outcome in Advanced Breast Cancer Patients Treated With Paclitaxel Plus Bevacizumab?
Authors: Tan Min-Han, Tan Chuen Seng, Lim Wei Yen
Journal: Journal of Clinical Oncology (2009)

TO THE EDITOR: In the October 1, 2008, issue of Journal of Clinical Oncology, Schneider et al reported a positive association between the VEGF-2578 AA genotype and overall survival in patients with metastatic breast cancer receiving paclitaxel and bevacizumab. In addition, an association between the VEGF-1154 A allele and superior median overall survival was also reported in patients in the same arm, with each active allele having an additive effect. The authors are to be commended for their novel exploratory analysis of a difficult pharmacogenomic question, in the context of a large prospective randomized trial. Nevertheless, we would like to raise epidemiologic and statistical concerns with regard to the way in which the study was conducted. First, a more conservative formal test of interaction would have been preferred to study the association of the reported vascular endothelial growth factor polymorphisms with the relevant outcomes. This would have been a single test to demonstrate that there was an association with the relevant outcome (overall survival) in the experimental arm but no such association in the control arm. The authors presented data for the experimental arm only, reporting that there was no statistically significant result in the control arm. Second, with the selection of paraffin-embedded tumor blocks for genotyping, the benefits of randomization in eliminating bias are diminished, even if the numbers in each arm are equal. Hence, particularly in this exploratory analysis, controlling for any additional clinically relevant confounders after the univariate analysis would be important. In particular, we note that both polymorphisms predicting for better outcomes were more common in the white population in comparison with the African American population. As reported by the authors, the VEGF 2578 A allele and the VEGF-1154 A allele have respective frequencies of 49% and 33% in the white population, and 24% and 10% in the African American population. The disparity of breast cancer survival between whites and African Americans is well known, and is multifactorial in nature. Ethnic variation and admixture are major concerns in any association study, and thus, a breakdown of the patient genotypes by ethnicity would be useful in assessing the validity of this study. We hope that clarifications of these concerns will strengthen the conclusions of the study.
Haemosiderin-laden macrophages in the bronchoalveolar lavage fluid of patients with diffuse alveolar damage
Authors: F. Maldonado, J. G. Parambil, E. S. Yi, P. A. Decker, J. H. Ryu
Journal: European Respiratory Journal (2009)

Quantification of haemosiderin-laden macrophages in bronchoalveolar lavage fluid (BALF) has been used to diagnose diffuse alveolar haemorrhage (DAH) but has not been assessed in patients with diffuse alveolar damage (DAD). The present study analysed BALF obtained from 21 patients with DAD diagnosed by surgical lung biopsy. The median age of 21 patients with DAD was 68 yrs (range 18-79 yrs); 14 (67%) were male and 12 (57%) were immunocompromised. The median proportion of haemosiderin-laden macrophages in BALF was 5% (range 0-90%), but was >or=20% in seven (33%) patients, fulfilling the commonly used BALF criterion for DAH. There was a trend toward a positive correlation between the percentage of haemosiderin-laden macrophages in BALF and parenchymal haemorrhage assessed semiquantitatively by histopathological analysis. Patients with >or=20% haemosiderin-laden macrophages in BALF showed a significantly increased mortality rate (p = 0.047) compared to those with <20%. In patients with an acute onset of diffuse lung infiltrates and respiratory distress, >or=20% haemosiderin-laden macrophages in BALF can occur with DAD, and is not necessarily diagnostic of DAH. The finding of >or=20% haemosiderin-laden macrophages in BALF is associated with a worse prognosis in patients with DAD.
P858 EPICARDIAL FAT THICKNESS IN PATIENTS WITH NON ALCOHOLIC FATTY LIVER DISEASE (NAFLD) IS ASSOCIATED WITH MARKERS OF CARDIOVASCULAR DAMAGE AND SEVERITY OF STEATOSIS
Authors: G. Pisano, R. Lombardi, C. Bertelli, M. Porzio, L. Valenti, A. Baragetti, L. Grigore, A. Catapano, S. Fargion, A.L. Fracanzani
Journal: Journal of Hepatology (2014)