tbuckley/cabot-search huggingface dataset:
Coronary Artery Imaging in Grown Up Congenital Heart Disease
Authors: Andrew M. Taylor, Sara A. Thorne, Michael B. Rubens, Permi Jhooti, Jennifer Keegan, Peter D. Gatehouse, Frank Wiesmann, Frank Grothues, Jane Somerville, Dudley J. Pennell
Journal: Circulation (2000)

Background —There is a high incidence of anomalous coronary arteries in subjects with congenital heart disease. These abnormalities can be responsible for myocardial ischemia and sudden death or be damaged during surgical intervention. It can be difficult to define the proximal course of anomalous coronary arteries with the use of conventional x-ray coronary angiography. Magnetic resonance coronary angiography (MRCA) has been shown to be useful in the assessment of the 3-dimensional relationship between the coronary arteries and the great vessels in subjects with normal cardiac morphology but has not been used in patients with congenital heart disease. Methods and Results —Twenty-five adults with various congenital heart abnormalities were studied. X-ray coronary angiography and respiratory-gated MRCA were performed in all subjects. Coronary artery origin and proximal course were assessed for each imaging modality by separate, blinded investigators. Images were then compared, and a consensus diagnosis was reached. With the consensus readings for both magnetic resonance and x-ray coronary angiography, it was possible to identify the origin and course of the proximal coronary arteries in all 25 subjects: 16 with coronary anomalies and 9 with normal coronary arteries. Respiratory-gated MRCA had an accuracy of 92%, a sensitivity of 88%, and a specificity of 100% for the detection of abnormal coronary arteries. The MRCA results were more likely to agree with the consensus for definition of the proximal course of the coronary arteries ( P &lt;0.02). Conclusions —For the assessment of anomalous coronary artery anatomy in patients with congenital heart disease, the use of the combination of MRCA with x-ray coronary angiography improves the definition of the proximal coronary artery course. MRCA provides correct spatial relationships, whereas x-ray angiography provides a view of the entire coronary length and its peripheral run-off. Furthermore, respiratory-gated MRCA can be performed without breath holding and with only limited subject cooperation.
887 HCV-SPECIFIC T CELL RESPONSE IN PATIENTS WITH CHRONIC HIV/HCV CO-INFECTION IS NOT DEPENDENT OF HCV GENOTYPE
Authors: N. Rallón, V. Soriano, J. García-Samaniego, M. Lopez, M. Romero, P. Labarga, J. González-Lahoz, C. Restrepo, S. Lozano, A. Peris, J.M. Benito
Journal: Journal of Hepatology (2009)
Association Between a Literature-Based Genetic Risk Score and Cardiovascular Events in Women
Authors: Nina P. Paynter
Journal: JAMA (2010)

<h3>Context</h3>While multiple genetic markers associated with cardiovascular disease have been identified by genome-wide association studies, their aggregate effect on risk beyond traditional factors is uncertain, particularly among women.<h3>Objective</h3>To test the predictive ability of a literature-based genetic risk score for cardiovascular disease.<h3>Design, Setting, and Participants</h3>Prospective cohort of 19 313 initially healthy white women in the Women's Genome Health Study followed up over a median of 12.3 years (interquartile range, 11.6-12.8 years). Genetic risk scores were constructed from the National Human Genome Research Institute's catalog of genome-wide association study results published between 2005 and June 2009.<h3>Main Outcome Measure</h3>Incident myocardial infarction, stroke, arterial revascularization, and cardiovascular death.<h3>Results</h3>A total of 101 single nucleotide polymorphisms reported to be associated with cardiovascular disease or at least 1 intermediate cardiovascular disease phenotype at a published P value of less than 10<sup>−7</sup> were identified and risk alleles were added to create a genetic risk score. During follow-up, 777 cardiovascular disease events occurred (199 myocardial infarctions, 203 strokes, 63 cardiovascular deaths, 312 revascularizations). After adjustment for age, the genetic risk score had a hazard ratio (HR) for cardiovascular disease of 1.02 per risk allele (95% confidence interval [CI], 1.00-1.03/risk allele; P = .006). This corresponds to an absolute cardiovascular disease risk of 3% over 10 years in the lowest tertile of genetic risk (73-99 risk alleles) and 3.7% in the highest tertile (106-125 risk alleles). However, after adjustment for traditional factors, the genetic risk score did not improve discrimination or reclassification (change in c index from Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults [ATP III] risk score, 0; net reclassification improvement, 0.5%; [P = .24]). The genetic risk score was not associated with cardiovascular disease risk (ATP III–adjusted HR/allele, 1.00; 95% CI, 0.99-1.01). In contrast, self-reported family history remained significantly associated with cardiovascular disease in multivariable models.<h3>Conclusion</h3>After adjustment for traditional cardiovascular risk factors, a genetic risk score comprising 101 single nucleotide polymorphisms was not significantly associated with the incidence of total cardiovascular disease.
How to diagnose axial spondyloarthropathy early
Authors: N Barkham
Journal: Annals of the Rheumatic Diseases (2004)

A proposed algorithmic approach may be useful in the early detection of AS

Physicians’ perceptions of the spondyloarthropathies are changing. Ankylosing spondylitis (AS), the prototype of this group, has traditionally been considered a rare disease with few therapeutic options. In addition, diagnosis is difficult, sometimes delayed for decades, mainly owing to the lack of sensitivity of the traditional imaging method, radiography, to detect the hallmark of AS, sacroiliitis. Also, the widespread perception of these diseases as “innocuous” or having a good outcome has hampered the development of protocols for defining early disease and identifying those patients who would benefit from early treatment.

It is now clear that these assumptions are incorrect. Ankylosing spondylitis is more common than previously estimated, with some studies suggesting a prevalence as high as 1%.1 Importantly it affects people at a time when they are economically active (most commonly in the third decade), and the disease has a major impact on a person’s ability to work. Recent evidence from a survey from our group shows that a high proportion of patients with AS still in work have major problems suggesting imminent job loss.2 In addition, the assumption of a good clinical outcome has recently been challenged, with 70% of patients progressing to fusion of the spine by 10–15 years.3,4 Mortality is also increased by 1.5–4 times that of the general population,5and a …
Managing Liability Risk in the Office Laboratory
Authors: Patrick Murray
Journal: JAMA (1987)

<h3>To the Editor.—</h3> As Belsey et al<sup>1</sup>comment, new responsibilities and new risks are created for practitioners who develop and use an office laboratory. In addition to the pitfalls related to negligence in performing and interpreting laboratory tests, which they ably discuss, another pitfall is related to conflict of interest. A physician who maintains an office laboratory or who establishes and shares a laboratory with other physicians may prefer that laboratory to any other (for such reasons as convenience for patients, faster test turnaround time, and financial considerations). He may also delay or omit referral of patient specimens for studies more sophisticated than those the preferred laboratory can perform, which would increase the physician's liability. (This is analogous to liability for failure to refer patients to specialists.)<sup>2</sup>At the very least, the perception may be created that the physician's financial interest in the laboratory represents a conflict of
Authors' reply to Symonds
Authors: B. Metcalf, W. Henley, T. Wilkin
Journal: BMJ (2012)

Symonds misses (or denies) the value of systematic review and meta-analysis.1 It is not appropriate to cherry pick individual studies that seem to work best because this introduces the risk of selection error. Rather, trials should be grouped and compared according to type, setting, design, etc, as they were in our …
Influence of skin prick test criteria on estimation of prevalence and incidence of allergic sensitization in children
Authors: R. Meinert, T. Frischer, W. Karmaus, J. Kuehr
Journal: Allergy (1994)

In a prospective cohort study on atopy in childhood, three skin prick tests (SPT) were performed in 1135 primary schoolchildren over a 2–year period. We studied the development of average sizes of allergen wheals in reactive children and of average sizes of histamine wheals in all children, and we investigated the influence of choice of SPT criterion on the prevalence and incidence of sensitization. A year‐to‐year increase of average allergen wheal sizes as well as of average histamine wheal sizes was observed. These increases seemed to be related to the natural growth of the children. Furthermore, an observer bias effect of the person who did the pricking on average wheal sizes was found. There were considerable differences in estimations of prevalences and incidences depending on the definition of SPT criterion. Estimations using a criterion based solely on the allergen wheal size were affected by variation of allergen wheal sizes caused by growth and observer effects. The ratio criterion was not influenced by observer effects, nor did it seem to be affected by aging effects. In conclusion, our data suggest that the ratio criterion, which relates the size of the allergen wheal to the size of the histamine wheal, is the most appropriate SPT criterion because it is not affected by growth of allergen wheals in childhood and it appears to compensate for possible observer bias.
LINING FOR MEDICAL BAG
Authors: Lee W. Paul
Journal: JAMA (1928)

Several years ago, in purchasing a medical bag of the usual size and design, I was furnished with a canvas lining for it. This lining was held in place by snaps, so that it could be removed for laundering. The use of a lining is good, as it is clean and lights up the bag, making it more easy to pick out the articles wanted. Snaps on the lining were found impracticable, as the first time the bag was laundered mutilation rendered them useless. An improvement is a white muslin lining, as this is whiter than canvas. In place of snaps, eight buttonholes are made in the lining to conform with an equal number of patent buttons placed inside the grip. By patent button is meant the commonly called "bachelor button." These buttons are placed about an inch from each corner. It is desirable to have a sufficient number of these linings
Abstract 5110: Divergent gene expression profiles in HPV-positive and HPV-negative head and neck squamous cell carcinomas
Authors: Swati Tomar, Sangeeta Kowli, Diego Altomare, Natalie Sutkowski, Marion Boyd Gillespie, Saundra H. Glover, Kim E. Creek, Lucia A. Pirisi-Creek
Journal: Cancer Research (2012)

Abstract Up to 60% of oropharyngeal cancers and 25% of head and neck squamous cell carcinomas (HNSCC) are due to high-risk Human Papillomavirus (HPV), primarily HPV16. Differences in risk factors, age of presentation and clinical behavior of these tumors indicate that HPV+ and HPV- tumors develop with different molecular mechanisms and are biologically distinct. To further investigate the molecular characteristics of these tumors, we compared the gene expression profiles of three HPV- and four HPV+ HNSCC specimens, obtained from the Medical University of South Carolina ENT/Head and Neck Surgery clinic. All HPV+ tumors were positive for HPV16 and expressed E7, as documented by real-time RT/PCR using tumor-derived RNA. Gene expression profiles were determined on Agilent 4x44K human oligonucleotide microarrays. Identification of differentially expressed genes (&amp;gt;2-fold change, p&amp;lt;0.05) and pathway analysis were performed using GeneSifter Software (Geospiza). Overall, 125 genes were up-regulated and 223 were down-regulated in HPV+ in comparison with HPV- tumors. Gene Ontology analysis of the dataset revealed that pathways related to cell cycle control, mitotic checkpoint, regulation of cell proliferation, programmed cell death and DNA metabolism were heavily affected in HPV+ tumors, while pathways affected in HPV- tumors included regulation of cell motility and migration, angiogenesis and integrin-mediated signaling. We confirmed by Real-Time RT/PCR the differential expression of a panel of genes of interest on these samples and several additional HNSCC specimens, and then we extended our follow-up analysis to specimens from over 30 new cases of HNSCC. Among the genes we targeted for follow-up is the MET oncogene, which encodes the hepatocyte growth factor/scatter factor receptor. MET is overexpressed about 5-fold in HPV- tumors, in comparison with HPV+ tumors actively expressing E7. The MET product, which controls growth, invasion and metastasis in cancer cells, has been recently proposed as a new therapeutic target for HNSCC. Supported by grant #P20MD001770 from the NIH/NIMHD. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5110. doi:1538-7445.AM2012-5110
Relevance of Antigenicity of Candida Albicans Growth Phases to Diagnosis of Systemic Candidiasis
Authors: E. G. V. Evans, M. D. Richardson, F. C. Odds, K. T. Holland
Journal: BMJ (1973)

The antigenicity of the two growth phases of Candida albicans has been compared by using crossed immunoelectrophoresis and double-diffusion techniques. Qualitative and quantitative differences in antigenic composition between the phases have been revealed and moreover a specific mycelial antigenic component demonstrated.It is postulated that the use of specific mycelial antigens for routine diagnostic precipitin testing in patients with suspected systemic candidiasis would give more reliable results than at present obtained with yeast cell antigens.
Reviews and Notes: Textbook of Physical Diagnosis: History and Examination; and Physical Diagnosis: Bedside Evaluation of Diagnosis and Function
Authors: Valerie W. Fornasieri
Journal: Annals of Internal Medicine (1995)

Literature of Medicine15 June 1995Reviews and Notes: Textbook of Physical Diagnosis: History and Examination; and Physical Diagnosis: Bedside Evaluation of Diagnosis and FunctionValerie W. FornasieriValerie W. FornasieriUniversity of Pennsylvania School of Medicine, Philadelphia, PA 19104.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-122-12-199506150-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Textbook of Physical Diagnosis: History and Examination2nd edition. M Schwartz. 644 pages. Philadelphia: WB Saunders; 1994. $49.95. ISBN 0-7216-553-00. Order phone 800-545-2522.Physical Diagnosis: Bedside Evaluation of Diagnosis and FunctionJL Willms, H Schneiderman, and PS Algranati. 804 pages. Baltimore: Williams & Wilkins; 1994. $48.00. ISBN 0-683-091-107. Order phone 800-638-0672.Many fine physicians have learned the art of physical diagnosis without benefit of a textbook. Moreover, writing a text on the physical examination is somewhat akin to writing a guide to fly-fishing: Much may be lost in the translation of action to the written word. This being the case, ... Author, Article, and Disclosure InformationAffiliations: University of Pennsylvania School of Medicine, Philadelphia, PA 19104. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 June 1995Volume 122, Issue 12Page: 965KeywordsHealth careHematologic testsInfectious diseasesMedical educationNeurology ePublished: 15 August 2000 Issue Published: 15 June 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Congenital Aortic Stenosis in Pregnancy, Corrected by Extracorporeal Circulation
Authors: Robert Leyse
Journal: JAMA (1961)

Severe heart disease associated with an unusual combination of circumstances necessitated surgical correction of congenital aortic stenosis in a 4-months pregnant, 23-year-old housewife. Extracorporeal circulation was utilized to support the mother and fetus during the 20minute period of arrested circulation to the heart. Following this successful surgery and an uneventful postoperative convalescence, pregnancy, and labor, a full-term viable infant was delivered. The child had multiple congenital anomalies and succumbed at the age of 4 months. Fourteen months later, a normal male infant was delivered from the same mother. Despite any proof of cause and effect in this situation, it appears wisest to assume, until proved otherwise, that the congenital anomalies in the first infant appeared as a direct result of the perfusion.
New Information on Lead in Dirt and Dust as Related to the Childhood Lead Problem
Authors: Gary Ter Haar, Regine Aronow
Journal: Environmental Health Perspectives (1974)

It has been known for many years that the eating of leaded paint is the prime cause of lead poisoning and elevated blood leads of children living in deteriorated housing. Recently, there has been speculation that children may eat dirt and dust contaminated with lead exhausted from cars and that this amount of ingested lead is sufficient to contribute significantly to the childhood lead problem. This paper reports on a twopart study conducted to evaluate the validity of the dirt-and-dust hypotheses. The first part of the study was made to determine the source of lead in dirt to which children are normally exposed. Dirt samples were taken in old urban areas around 18 painted frame houses and 18 houses of brick construction. Samples also were taken around seven old frame farmhouses remote from traffic. Based on the fact that lead concentrations in the dirt were similar in city and rural yards at corresponding distances from the houses, it is clear that nearly all of the lead in dirt around these houses is due to paint from the houses. Lead antiknock additives are therefore not a significant contributor to the lead content of dirt around houses where children usually play. The second part of the study used a naturally occurring radioactive tracer (210)Pb to determine the relative amounts of dust and other lead-containing materials (e.g., paint) eaten by young children. This tracer is present in very low concentrations in paint and in significantly higher concentrations in fallout dust. Stable lead and (210)Pb were analyzed in fecal material from eight children suspected of having elevated body burdens of lead and ten children living in good housing where lead poisoning is not a problem. The normal children averaged 4 mug Pb/g dry feces, with a range of 2 to 7. Of the eight children suspected of having elevated lead body burdens, two had fecal lead values within the normal range. However, the remaining six were 4 to 400 times as high. Despite these differences in fecal lead between the two groups, the groups were essentially identified in the (210)Pb content of their feces. The "elevated" children averaged 0.040 pCi of (210)Pb dry feces, while the normal group averaged 0.044 pCi/g. The results provide sound evidence that these children suspected of elevated lead body burden were not ingesting dust or air-suspended particulate.
Disease Management — Promises and Pitfalls
Authors: T Bodenheimer
Journal: New England Journal of Medicine (1999)

“Disease management” is the latest catch phrase in the ever-evolving American health care spectacle. What does it mean? Who is promoting it and why? What does it portend for the future of health care? Disease management has two forms — a contracted “carve-out” model and a primary care–based model — and I argue here that the carve-out model may have negative consequences for American health care.What is Disease Management?One hundred million Americans live with chronic illnesses.1 Yet physicians are not adequately caring for this population. According to Dr. Edward Wagner, a leading scholar on the subject, “Surveys and . . .
346 COMPRISED FUNCTION OF NATURAL KILLER CELLS IN ACUTE AND CHRONIC VIRAL HEPATITIS
Authors: S. Lunemann, D.F.G. Malone, V. Schlaphoff, M.P. Manns, J.K. Sandberg, M. Cornberg, H.-G. Ljunggren, N.K. Bj örkstr öm, H. Wedemeyer
Journal: Journal of Hepatology (2013)
Predicting mental illness in soldiers
Authors: Ferhal Utku, Ken Checinski
Journal: BMJ (2006)

How doctors' anonymity in family courts is under threat Gornall is way out of dateEditor-Gornall is embarrassingly out of date in his detailed analysis of the B case (which was dealt with by the family courts nearly three years ago), and its relevance to proposed changes in the law to make the English family court system more transparent. 1 Since then, notwithstanding the ever increasingly exaggerated claims from some quarters that opening the family courts would harm children and deter court experts, the courts themselves are acknowledging the need for English family courts to do their business in the more transparent way that courts in Canada, Australia, and of course Scotland have done without apparent difficulty for years.Several High Court judgments have recorded judicial support for more openness to increase public confidence, and Gornall fails to mention that the president and many of his senior judges are in favour of change in this direction.In a landmark case which was decided on 3 November, Munby J agreed that an ongoing case where parents dispute expert evidence that they injured their child should be open to the media.The local authority concerned issued a "position statement" to the press and the reporting in the Times, Guardian, and the Mail on Sunday set out both sides' cases, as did the broadcasting media.A BBC "Real Story" programme on the case allowed a senior official from the local authority ample time to put their case.No vilification of any experts involved was reported.It is likely that more judges will follow Munby J's example and more public interest cases will be opened to the media pending any change in the law.Will the skies fall in?I doubt it, but your readers can judge for themselves.Hopefully they will understand that in complex childcare cases where expert evidence may be tenuous and the stakes for children are very high, public debate can stimulate awareness of the problems faced by all professionals involved in child protection.It's difficult getting the balance right, but doing it in secret doesn't help.