tbuckley/cabot-search huggingface dataset:
Selection of Patients for Coronary Angiography and Coronary Revascularization Early after Myocardial Infarction: Is There Evidence for a Gender Bias?
Authors: Harlan M. Krumholz, Pamela S. Douglas, Michael S. Lauer, Richard C. Pasternak
Journal: Annals of Internal Medicine (1992)

Objective: To determine whether a gender bias exists in the selection of patients for diagnostic and therapeutic cardiovascular procedures early after myocardial infarction. Design: A retrospective cohort study. Setting: A community-based tertiary care teaching hospital. Patients: A total of 2473 consecutive patients with a principal discharge diagnosis of acute myocardial infarction and a peak creatine kinase MB fraction of at least 4%. Measurements: Comparison of men and women regarding the frequency with which they underwent various cardiac procedures. Results: Women had coronary angiography during hospitalization for myocardial infarction much less frequently than men (odds ratio, 0.55; 95% Cl, 0.46 to 0.65), but the age-adjusted rates were similar in women and men (odds ratio, 0.91; Cl, 0.75 to 1.12). An abnormal ejection fraction (<50%) was equally frequent in women and men who underwent left ventriculography (odds ratio, 0.85; Cl, 0.56 to 1.30). Among patients who had coronary angiography, women had a significantly lower rate of severe coronary artery disease, defined as either a left main stenosis of more than 50%, three-vessel disease, or two-vessel disease with a proximal left anterior descending stenosis of more than 70% (odds ratio, 0.67; Cl, 0.48 to 0.93). When adjustments were made for age, women had percutaneous transluminal coronary angioplasty as often as men (odds ratio, 1.16; Cl, 0.83 to 1.62) but had coronary artery bypass graft surgery significantly less frequently (odds ratio, 0.58; Cl, 0.37 to 0.91). When adjustments were made for age and the severity of coronary artery disease, the difference in rates was of borderline significance (odds ratio, 0.65; Cl, 0.41 to 1.01). Conclusions: No evidence of a difference in the rate of coronary angiography early after myocardial infarction between women and men was found after age adjustment. Among patients who have cardiac catheterization early after myocardial infarction, women and men are equally likely to have angioplasty, but women are less likely than men to have coronary artery bypass surgery.
Lower Limb Venous Pressure in Diabetic Neuropathy
Authors: Tejpal S Purewal, David E Goss, Peter J Watkins, Michael E Edmonds
Journal: Diabetes Care (1995)

OBJECTIVE Distended turgid veins have been noted in the feet of patients with diabetic neuropathy. This study assessed the supine venous pressure and its correlation with diabetic neuropathy and arteriovenous (AV) shunting in the feet of type I and type II diabetic subjects. RESEARCH DESIGN AND METHODS Seventeen patients with chronic Charcot joints, 11 patients with a history of neuropathic foot ulceration, 14 diabetic control subjects, and 11 normal control subjects were studied. Neuropathy was assessed by vibration and thermal thresholds and standard cardiovascular autonomie neuropathy tests. Supine venous pressure was measured by insertion of a 21-gauge needle connected to a strain gauge manometer into the veins on the dorsum of the foot. Venous Po2 was used as a measure of AV shunting. RESULTS Venous pressure was raised in the group with chronic Charcot joints (18.9 ± 4.2mmHg, P &amp;lt; 0.001 vs. the diabetic control group [11.3 ± 2.6mmHg]), the normal control group (12.3 ± 2.3 mmHg, mean ± SD), and the diabetic group with a history of neuropathic foot ulceration (16.0 ± 3.7 mmHg, P = 0.008 vs. diabetic control subjects and P = 0.04 vs. normal control subjects), with a maximum of 28 mmHg. Venous pressure was correlated with heart rate variation to deep breathing, r = −0.61 (P = 0.001), vibration threshold, r = 0.56 (P = 0.001), Valsalva ratio, r = −0.64 (P = 0.001), warm threshold, r = 0.69 (P = 0.001), and venous Po2, r = 0.43 (P = 0.02). There was no correlation with skin temperature, duration of diabetes, age, HbAlc, random blood glucose, ankle/brachial Doppler index, height, or serum creatinine. CONCLUSIONS Venous pressure is much higher in the neuropathic diabetic limb and is correlated with the severity of neuropathy and with AV shunting.
The cytokinesis-block micronucleus technique and its application to genotoxicity studies in human populations.
Authors: M Fenech
Journal: Environmental Health Perspectives (1993)

The development of the cytokinesis-block (CB) technique has made the human lymphocyte micronucleus assay (MN) a reliable and precise method for assessing chromosome damage. Recent studies in our laboratory have confirmed that this method is a sensitive indicator of in vivo radiation exposure in patients undergoing fractionated partial-body radiotherapy and rodents exposed to uniform whole-body irradiation, thus supporting the application of the cytokinesis-block micronucleus (CBMN) assay for biological dosimetry. To further define the use of this assay in biomonitoring, we have also undertaken extensive studies to determine the spontaneous level of MN in normal human populations and its relationship to various lifestyle factors. During the past year, we have also developed a new variation to the CBMN assay that enables the conversion of excision-repairable lesions to MN within one cell-cycle using cytosine arabinoside. With this method the slope of the in vitro dose-response curves was increased by a factor of 1.8 for X-rays, 10.3 for ultraviolet (254 nm) radiation, and approximately 40-fold for methylnitrosourea. Consequently, the CBMN assay can now be used not only to measure whole chromosome loss or chromosome breaks but also excision repair events. The versatility and simplicity of the CBMN assay together with new developments in automation should enable its successful application in monitoring exposed populations as well as identifying mutagen-sensitive individuals within a population.
1012-130 Long-term effect of statin on exercise tolerance, cardiac function and clinical outcome in patients with ischemic chronic heart failure
Authors: Takahisa Yamada, Tsuyoshi Shimonagata, Naoyuki Misaki, Mitsutoshi Asai, Nobuhiko Makino, Hidetaka Kioka, Shunsuke Tamaki, Masatake Fukunami
Journal: Journal of the American College of Cardiology (2004)
Reply to L.W. Cuttino et al
Authors: Carolyn J. Presley, Pamela R. Soulos, Jeph Herrin, Kenneth B. Roberts, James B. Yu, Cary P. Gross
Journal: Journal of Clinical Oncology (2013)

meeting of the American Society for Radiation Oncology and demonstrated that for all forms of APBI (including BB), toxicity was less than or equal to that observed with WBI (n ϭ 1,500). 5 Malin of the University of California, Los Angeles, wrote an editorial accompanying the Yale study entitled, "When Hope Hinders Science and Patient-Centered Care." 11 The progression of BB during the last 20 years from institutional phase I/II studies, to multiinstitution phase II trials, to the creation of patient selection guidelines from several major organizations, and finally to the implementation of prospective randomized trials that have enrolled more than 10,000 women to date is the very definition of rigorous scientific evaluation.Malin recognizes "the important role CER can have in providing data on therapies for which outcomes from randomized clinical trials are lacking," 11(p4283) but fails entirely to acknowledge the existence of randomized data on BB.Prospective data should not be ignored in favor of retrospective analyses that are based on billing claims data.Just as with the publication of the MD Anderson BB analysis, the media is reporting on the Yale study with fervor.On October 22, 2012, Reuters published a story entitled, "New breast cancer therapy tied to more complications," 12 which has been picked up by most of the lay press.In this article, the senior author of the Yale study, Gross, is cited as saying that "there is no solid research showing brachytherapy is a safe and effective alternative to whole-breast radiation."This statement ignores the results of multiple large, prospective studies.Unfortunately, this media sensationalism is creating a false equivalence between patient-derived prospective data and retrospective analyses that are based on billing claims.The efficacy of APBI and BB in comparison with WBI is best answered by randomized phase III clinical trials.Ioannidis of Stanford University recently observed, "…observational evidence about commonly and easily measured exposures and outcomes resembles an opinion poll or self-fulfilling prophecy: researchers can selectively mold… data into studies that produce the desired result." 13(p576) This type of analysis should simply never trump the results of carefully conducted randomized trials.Moreover, these data may serve as distractions and fruitless scientific detours that steal precious time and resources from the next generation of rigorously designed and conducted clinical trials.Thus far, there is absolutely no evidence to suggest increased toxicity or local failure after APBI in the thousands of women who have been treated prospectively in modern phase III trials.
Information in the Health Sciences: Working to the Future
Authors: William K. Beatty
Journal: JAMA (1972)

A 75th anniversary can be a time for self-congratulation, serene looking backwards, or provocative thoughts about the future. The Cleveland Medical Library Association arranged their anniversary meeting (held Dec 3 through 4,1969) primarily with the third possibility in mind. The published proceedings consist of 16 papers ranging in length from 3 to 23 pages. The speakers represented the fields of medical practice, medical education (both clinical and basic sciences), librarianship (both practicing and teaching), computers, editing, and publishing. The book opens, after the usual introductions, with a brief narration of the Association's history by one of its prime moving forces, Dr. Robert Stecher, who, unhappily, did not live to see the publication of this volume. Franz Ingelfinger set the pattern for the meeting by stating, "The business of the day... is the improvement of medical communication." This theme in all its stages (production, transmission, use, and analysis) runs through most
On Rare Diseases and Exceptional Symptoms
Authors: J. Hutchinson
Journal: BMJ (1888)

A FOOTMAN looking on at a cricket match received the ball as he says "deliberately" on the tip of his chin.He was almost knocked down by the blow, hut did not actually fall.lie felt somnewhat stunned, and immediately afterwards recognised that he was d(leaf in the left ear.When he got home his fellow-ser- vants."lalughedat him because his face was all on one side."After this he had complete facial paralysis and almost complete deafness, but both gradually improved.When I saw him four months later the facial paralysis was not perceptible unless his muscles were thrown into action.I1e could use most of them fairly well, but could not frown on the left side of hlis forehead at all (occipito-frontalis), nor could he whlistle, as the left half of his mouth remained flabby.Ile could( close the left eye well: he could hear a watch two inchles from the ear.There was nothing amiss with the membrana tympani, and he hlad never had bleeding either from nose or ear.It seemed certain that in this case there must have been afracture of the petrous bone caused by the condyle being vio- lently driven against it.In no other way could the simultaneous paralysis of the auditor', and facial nerves be accounted for.
Retinal Images in Oblique Astigmatism.
Authors: G. C. Savage
Journal: JAMA (1895)

Nashville, Tenn., March, 1895. <h3>To the Editor:</h3> —In your issue of February 23, on page 280, I found the following report of some remarks made in the Chicago Ophthalmological Society, by Dr. F. C. Hotz: "Dr. Hotz then spoke about the theory of the symmetric action of the oblique muscles in oblique astigmatism, so persistently advocated by Dr. Savage. He showed that Dr. Savage has given no proof of the existence of such action of the muscles. Dr. Hotz has never been able to find such action in any case of oblique astigmatism and denied that the supposed action would benefit binocular vision. He further<i>proved by demonstrations that oblique astigmatism does not cause obliquity of the retinal images and showed that the laws of physiologic optics do not sustain such doctrine</i>. [Italics mine.] The theory is based on false premises and wholly untenable." In commenting on the above, allow
CLOSTRIDIUM DIFFICILE ENTERITIS COMPLICATING UNDIAGNOSED COELIAC DISEASE, A NEW CLINICAL PROBLEM?
Authors: J A Gray, F Mullan, P B Allen
Journal: Gut (2013)

<h3>Introduction</h3> Clostridium difficile (CD) represents the leading cause of health care associated infective diarrhea in the UK. Normally manifesting as infectious colitis, small bowel involvement known as CD enteritis is a very rare condition. We present the first documented case in the literature of CD enteritis complicating previously undiagnosed coeliac disease. A 63 year old male with no significant past medical history presented with a 3 month history of abdominal pain, bloating, weight loss, intermittent diarrhoea and night sweats. He was prescribed no regular medications, however had a course of antibiotics 6 weeks previous for a confirmed UTI. Blood results revealed WCC 49 (4–11), PLTs 597 (150–400), CRP 86 (0–5) and albumin 22 (35–50). A CT scan of abdomen showed a short segment of small bowel thickening with adjacent lymphadenopathy. The differential diagnosis included Crohns disease, small bowel lymphoma and carcinoid tumour. Due to worsening pain he underwent diagnostic laparotomy, with small bowel resection revealing severe mucosal ulceration and pseudomembranous lining. Histology identified gram-positive rods in the areas of marked ulceration with proximal subtotal villous atrophy and marked intra-epithelial lymphocytosis. Stool samples confirmed presence of CD toxin. Coeliac serology revealed anti-TTG levels of 29.4 (0–15). Duodenal biopsies confirmed coeliac disease. The patient improved with a 14 day course of oral metronidazole and commencement of a gluten free diet. <h3>Conclusion</h3> This case highlights the importance of considering extra-colonic manifestations of CD especially in those with risk factors including increasing age, comorbidities, IBD and recent antibiotic use.
Angiotensin II in Treatment of Hypotensive States
Authors: A. C. Nassif, T. R. Nolan, A. C. Corcoran
Journal: JAMA (1963)

Synthetic angiotensin II (SA II) is an effective pressor agent in hypotensive states. In this experience the theoretically expected advantages over available agents have been demonstrated. SA II was administered to 14 patients with hypotensive states of varied origin and was effective to some degree in all, including those who were relatively unresponsive to other pressor agents. Responsiveness to SA II tended to diminish with deterioration of clinical status of patients who did not survive and to increase as patients capable of recovery improved. Perhaps characteristically, responses were poor or briefly sustained in four patients with portal cirrhosis. The agent seemed most helpful in two of three patients with apparent bacteremic shock.
Is agmatine a novel neurotransmitter in brain?
Authors: Donald J Reis, Soundararajan Regunathan
Journal: Trends in Pharmacological Sciences (2000)

Recent evidence suggests that agmatine, which is an intermediate in polyamine biosynthesis, might be an important neurotransmitter in mammals. Agmatine is synthesized in the brain, stored in synaptic vesicles in regionally selective neurons, accumulated by uptake, released by depolarization, and inactivated by agmatinase. Agmatine binds to α2-adrenoceptors and imidazoline binding sites, and blocks NMDA receptor channels and other ligand-gated cationic channels. Furthermore, agmatine inhibits nitric oxide synthase, and induces the release of some peptide hormones. As a result of its ability to inhibit both hyperalgesia and tolerance to, and withdrawal from, morphine, and its neuroprotective activity, agmatine has potential as a treatment of chronic pain, addictive states and brain injury.
FATAL FUNGUS INFECTIONS COMPLICATING ANTIBIOTIC THERAPY
Authors: Curtland Brown
Journal: JAMA (1953)

For many years Candida albicans has been known to cause local infection in the mouth, skin, nails, and vagina. In the past such lesions have shown little tendency to spread and have rarely been fatal.1Recently, however, there has been a noticeable increase in the frequency with which fungi, particularly C. albicans, have produced generalized and fatal infections. The importance of this change has not been universally accepted,2although many clinical and laboratory reports have appeared warning of the increased virulence of C. albicans during antibiotic therapy.3We wish to emphasize this warning by reporting three additional cases of fatal fungus infection.  REPORT OF CASES  Case 1.  —A 47-year-old dentist was first admitted to the Albany Hospital on Sept. 30, 1950. For about a year, the patient had suffered from abscessed teeth. Three weeks before admission, he had contracted a respiratory infection characterized by fever, cough, brownish
Changes in Blood Protein Glycosylation During a Diabetes Summer Camp
Authors: Alva L Strickland, Kay F McFarland, Martha H Murtiashaw, Suzanne R Thorpe, John W Baynes
Journal: Diabetes Care (1984)

To evaluate changes in glycemic control during a 2-wk diabetes summer camp program, fasting plasma glucose (FPG), glycosylated hemoglobin (GHb), and glycosylated serum protein (GSP) levels were measured in a group of 36 children at the beginning and end of camp. Average FPG and GHb were unchanged during the 2-wk period, but the average decrease in GSP (7%) was significant (P &amp;lt; 0.005). The results of this study indicate that a measurable improvement in diabetic control occurred in some children during the 2-wk summer camp program.
Effects of thrombosis on vascular tone in rat mesenteric arteries with endothelium in vivo.
Authors: H Araki, K Nishi, M Jougasaki
Journal: Circulation Research (1990)

We examined the effects of thrombosis on vascular tone in vivo, using small mesenteric arteries of rats (about 300 microns i.d.) and a video recording system attached to a microscope. To induce thrombosis we damaged the vessel wall over a short segment by compression and exposed the media to the bloodstream. A thrombus mainly consisting of platelets gradually enlarged at the damaged site and caused 50-100% narrowing of the lumen. The diameter at the site downstream from the thrombus did not change as long as the blood flow was not interrupted. Instead, vasoconstrictor response to serotonin (3.0 and 30 micrograms/ml) or norepinephrine (0.1, 0.3, and 1.0 microgram/ml) given topically was significantly inhibited at the site downstream from the thrombus compared with that at the upstream site (p less than 0.01). Nonthrombotic mechanical narrowing of the vascular lumen did not affect vascular constriction by these agents. After damage to the endothelium by intra-arterial infusion of a detergent (0.3% CHAPS), the inhibition of the constrictor response by the thrombus was no longer observed. Once the thrombus occluded the vascular lumen and the blood flow was interrupted, the diameter at the downstream site declined markedly, from 291 +/- 22 to 77 +/- 21 microns (mean +/- SEM, n = 7, p less than 0.01) even without endothelial damage. Mechanical nonthrombotic occlusion of the vascular lumen induced only a small diameter reduction to 241 +/- 16 microns. We conclude that a partially occlusive thrombus may release a material that inhibits vascular constriction by serotonin or norepinephrine through an endothelium-dependent mechanism and that an occlusive thrombus induces constriction of the downstream vascular bed even with endothelium.
Quality of life in patients receiving home parenteral nutrition
Authors: P B Jeppesen, E Langholz, P B Mortensen
Journal: Gut (1999)

Quality of life is an important determinant of the effectiveness of health technologies, but it has rarely been assessed in patients receiving home parenteral nutrition (HPN).The non-disease specific sickness impact profile (SIP) and the disease specific inflammatory bowel disease questionnaire (IBDQ) were used on a cohort of 49 patients receiving HPN, and the results compared with those for 36 non-HPN patients with either anatomical (<200 cm) or functional (faecal energy excretion >2.0 MJ/day (approximately 488 kcal/day)) short bowel.In the HPN patients the SIP scores were worse (higher) overall (17 (13)% v 8 (9)%) and with regard to physical (13 (15)% v 5 (8)%) and psychosocial (14 (12)% v 9 (11)%) dimensions and independent categories (20 (12)% v 9 (8)%) compared with the non-HPN patients (means (SD); all p<0.001). The IBDQ scores were worse (lower) in the HPN patients overall (5.0 (4.3-5.7) v 5.6 (4.8-6.2)) and with regard to systemic symptoms (3.8 (2.8-5.4) v 5.2 (3.9-5.9)) and emotional (5.3 (4.4-6.2) v 5.8 (5.4-6.4)) and social (4.3 (3.4-5. 5) v 4.8 (4.5-5.8)) function (median (25-75%); all p<0.05), but only tended to be worse with regard to bowel symptoms (5.2 (4.8-6.1) v 5.7 (4.9-6.4), p = 0.08). HPN also reduced quality of life in patients with a stoma, whereas a stoma did not reduce quality of life among the non-HPN patients. Female HPN patients and HPN patients older than 45 scored worse.Quality of life is reduced in patients on HPN compared with those with anatomical or functional short bowel not receiving HPN, and compares with that reported for patients with chronic renal failure treated by dialysis.
Basement Membrane Regulation of Sertoli Cells*
Authors: MARTIN DYM
Journal: Endocrine Reviews (1994)

MOST vertebrate cells are in contact with an extracellular matrix (ECM) composed of both protein and carbohydrate in the form of glycoproteins and proteoglycans (1). The glycoproteins are defined by the attachment of relatively small carbohydrate moieties and include the major structural proteins laminin, fibronectin, collagen, and elastin. The proteoglycans, on the other hand, are characterized by a covalent linkage between a core protein and one or more glycosaminoglycans, which are large, negatively charged polymers of repeating disaccharide units such as heparan and chondroitin sulfate. In addition, many ECMs contain the glycosaminoglycan, hyaluronan, which does not appear to be covalently linked to protein. The various components of the ECM interact with each other in a complex fashion to form a meshwork-like structure. Some cell types, such as muscle cells and chondrocytes, are completely surrounded by ECM while others, such as simple epithelial cells and endothelial cells, are exposed to the ECM only on one surface. Because of its widespread distribution and strategic location, the ECM was originally believed to be an inert scaffolding for the support of cells and tissues. However, more recently, it has become increasingly clear that the ECM plays a fundamental role in the process of morphogenesis and differentiation and is essential in the development and maintenance of the differentiated state (2). During embryonic development an ECM is present from the two-cell stage.