tbuckley/cabot-search huggingface dataset:
Sirolimus-Eluting versus Uncoated Stents in Acute Myocardial Infarction
Authors: Christian Spaulding, Patrick Henry, Emmanuel Teiger, Kevin Beatt, Ezio Bramucci, Didier Carrié, Michel S. Slama, Bela Merkely, Andrejs Erglis, Massimo Margheri, Olivier Varenne, Ana Cebrian, Hans Peter Stoll, David B. Snead, Christoph Bode
Journal: New England Journal of Medicine (2006)

Sirolimus-eluting stents reduce rates of restenosis and reintervention, as compared with uncoated stents. Data are limited regarding the safety and efficacy of such stents in primary percutaneous coronary intervention (PCI) for acute myocardial infarction with ST-segment elevation.We performed a single-blind, multicenter, prospectively randomized trial to compare sirolimus-eluting stents with uncoated stents in primary PCI for acute myocardial infarction with ST-segment elevation. The trial included 712 patients at 48 medical centers. The primary end point was target-vessel failure at 1 year after the procedure, defined as target-vessel-related death, recurrent myocardial infarction, or target-vessel revascularization. A follow-up angiographic substudy was performed at 8 months among 174 patients from selected centers.The rate of the primary end point was significantly lower in the sirolimus-stent group than in the uncoated-stent group (7.3% vs. 14.3%, P=0.004). This reduction was driven by a decrease in the rate of target-vessel revascularization (5.6% and 13.4%, respectively; P<0.001). There was no significant difference between the two groups in the rate of death (2.3% and 2.2%, respectively; P=1.00), reinfarction (1.1% and 1.4%, respectively; P=1.00), or stent thrombosis (3.4% and 3.6%, respectively; P=1.00). The degree of neointimal proliferation, as assessed by the mean (+/-SD) in-stent late luminal loss, was significantly lower in the sirolimus-stent group (0.14+/-0.49 mm, vs. 0.83+/-0.52 mm in the uncoated stent group; P<0.001).Among selected patients with acute myocardial infarction, the use of sirolimus-eluting stents significantly reduced the rate of target-vessel revascularization at 1 year. (ClinicalTrials.gov number, NCT00232830 [ClinicalTrials.gov].).
Inhibition by acetylcholine of the norepinephrine release evoked by potassium in canine saphenous veins.
Authors: P M Vanhoutee, T J Verbeuren
Journal: Circulation Research (1976)

In the dog's saphenous vein acetylcholine inhibits the norepinephrine release caused by nerve stimulation, but not that caused by tyramine. Experiments were performed to determine whether acetylcholine affects the release of norepinephrine evoked by high K+ concentrations. We recorded changes in isometric tension of dog saphenous vein strips. Acetylcholine (5 X 10(-9) to 10(-6) g/ml) caused dose-dependent relaxations during contractions caused by K+ = 40 mEq/liter. These relaxations were not depressed by tetrodotoxin (10(-7) g/ml), which abolished the response to nerve stimulation, but were inhibited by atropine (10(-7) g/ml). Strips of saphenous veins were incubated with [3H]norepinephrine and mounted for superfusion (3 ml/min) and isometric tension recording; the total radioactivity and the amount of intact [3H]norepinephrine present in the superfusate were determined. K+ at 50 mEq/liter increased tension, total radioactivity of the superfusate, and the [3H]norepinephrine afflux; acetylocholine (10(-7) g/ml) depressed the contractions and diminished the efflux of [3H]norepinephrine. Increasing the K+ concentration from 50 to 70 mEq/liter augmented both tension and the evoked release of [3H]norepinephrine. Acetylcholine did not significantly alter the release of [3H]norepinephrine evoked by K+ = 120mEq/liter. These experiments show that acetylcholine inhibits the norepinephrine release evoked by potassium ions, as it does during nerve stimulation. The inhibition of adrenergic neurotransmission is not due to interference with action potential electrogenesis, but probably is caused by hyperpolarization of the adrenergic nerve endings.
Low-molecular-weight heparin for 7 days was more effective than compression stockings for preventing DVT in knee arthroscopy
Authors: Marcel Levi
Journal: Annals of Internal Medicine (2008)

Source Citation Camporese G, Bernardi E, Prandoni P, et al. Low-molecular-weight heparin versus compression stockings for thromboprophylaxis after knee arthroscopy: a randomized trial. Ann Intern Med. 2008;149:73-82. 18626046
Markedly increased circulating pyridoxal-5'-phosphate levels in hypophosphatasia. Alkaline phosphatase acts in vitamin B6 metabolism.
Authors: M P Whyte, J D Mahuren, L A Vrabel, S P Coburn
Journal: Journal of Clinical Investigation (1985)

Markedly increased circulating concentrations of pyridoxal-5'-phosphate (PLP) were found in each of 14 patients representing all clinical forms of hypophosphatasia, an inborn error characterized by deficient activity of the tissue nonspecific (bone/liver/kidney) isoenzyme of alkaline phosphatase (AP). The mean PLP concentration in plasma was 1174 nM (range, 214-3839 nM) in the patients and 57 +/- 26 nM (mean +/- SD) in 38 control subjects. In four affected children, urinary excretion of the PLP degradation product, 4-pyridoxic acid, was unremarkable during consumption of normal quantities of dietary vitamin B6. Our findings identify increased circulating PLP concentration as a marker for hypophosphatasia and provide further evidence that tissue nonspecific AP acts in vitamin B6 metabolism. Tissue nonspecific AP appears to function as an ectoenzyme to regulate extracellular but not intracellular levels of PLP substrate. Performing assays of circulating PLP concentration alone to assess vitamin B6 nutrition may be misleading in disorders associated with altered AP activity.
Logic, physics, physiology, and topology of color
Authors: H. M. Hubey
Journal: Behavioral and Brain Sciences (1997)

This commentary starts with a simplified Cartesian vector space of the tristimulus theory of color. This vector space is then further simplified so that bitstrings are used to represent the vector space. The Commission Internationale de l'Eclairage (CIE) diagram is shown to follow directly and simply from this vector space. The Berlin &amp; Kay results are shown to agree quite well with the vector space and the two-dimensional version of it, especially if the dimensions are normalized to take into account the sensitivity of the eye to the different wavelengths comprising color. There is asymmetry with respect to the colors and a similar asymmetry in vocalic phonemes; these effects can be explained in terms of physiology. The (in)famous problem of the color channels is given a unified treatment at various levels. An eight-valued color algebra is created, with addition and multiplication corresponding to additive and subtractive blending of colors. Finally, it is shown that the discrete Hamming metric for colors has a natural toroidal topology.
More Liberal Use of a Plasma Expander
Authors: Benjamin F. Rush, Robert A. Stewart
Journal: New England Journal of Medicine (1969)

More liberal use of a plasma expander in the treatment of operative and traumatic blood loss, with transfusions given only when the hematocrit was less than 30 per cent, reduced the amount of blood distributed by our blood bank. Blood consumed per patient admission dropped 35 per cent, and blood used by the surgical service decreased 320 ml per patient operated on; relative use of single unit transfusions decreased 47 per cent and relative use of plasma fell 50 per cent. Calculated amount of blood saved in the past year was 3863 units, and transfusion reactions avoided were 81. A plasma expander can be employed in properly limited amounts in patients suffering acute blood loss without detriment to the patient's clinical state and with a diminished need for whole blood.
Effects of increased cholinergic activity on naming in aphasia
Authors: Yutaka Tanaka, Masao Miyazaki, Martin L Albert
Journal: The Lancet (1997)

Cholinergic activity may be preferentially lateralised to the left temporal lobe 1 Amaducci L Sorbu S Albanese A et al. Choline acetyltransferase (ChAT) activity differes in right and left human temporal cortex. Neurology. 1981; 31: 7899-7905 Crossref Google Scholar and anomia and verbal memory deficits may result from damage to it. Also, neurological syndromes other than aphasia, such as Alzheimer's disease, (in which anomia and verbal memory deficit can occur) and which are associated with temporal lobe disease, are correlated with reduced cholinergic activity. Cholinergic blockade impairs naming in healthy individuals. 2 Aarsland D Larsen P Reinvang I et al. Effects of cholinergic blockade on language in healthy young women: implications for the cholinergic hypothesis in dementia of the Alzheimer type. Brain. 1994; 117: 1377-1384 Crossref PubMed Scopus (52) Google Scholar Our hypothesis is that damage to the left temporal lobe, causing fluent aphasia with anomia, produces a relative deficit in cholinergic activity, and, therefore, that treatment with cholinergic agents will improve naming ability in fluent aphasia due to temporal lobe lesions.
MALIGNANT DISEASE OF NOSE AND THROAT
Authors: JONATHAN WRIGHT
Journal: JAMA (1899)

It is well known to all of us that statistics, those figures which<i>do</i>occasionally lie, have shown that malignant disease is apparently increasing among mankind. I have seen no statistics to prove whether this is altogether an absolute increase or whether it is to some extent a relative one. It must be remembered that the average duration of life has been prolonged into that period which is most liable to malignant disease. Emphasis has of late been given to the old observation that cancer is the disease of the rich and luxurious, of the beef eater, of the high liver and the slothful. There has been considerable evidence advanced to show that some forms of malignant diseases are due to the presence of a micro-organism coming in contact with the soil made suitable for its growth by the general predisposing cause of age, or by coming in contact with
Prognosis for South Asian and white patients with heart failure in the United Kingdom: Authors' reply
Authors: I. Squire
Journal: BMJ (2003)

Editor—Population estimates from the 1991 census—the only data available to us—could introduce error in calculating age standardised rates and ratios, particularly for subpopulations with differing age structures. Using 2001 census data, we found that admission rates in the South Asian population were more than twofold higher for both men and women.

The reason for the higher standardised admission rates for heart disease for the city is debatable.1 Our system captures all hospital admissions for the population of Leicestershire, irrespective of the location of the admission. Missing out of county data could not have been a source of error.

We are confident of the validity of assignment of ethnic group as hospital codes were validated for all cases in the survival cohort. Age was a significant predictor of mortality, and due care was taken to obtain the best fitting model. We recognise that severity of heart failure at admission and details of clinical management will affect survival, but routine data do not capture this information.

We agree that the relation between deprivation and heart failure survival is puzzling. We are confident that categorising the index is valid. In keeping with published data, modelling all cause survival with the index gave an estimated hazard ratio of 0.93 (95% confidence interval 0.88 to 0.98) and a 7% improvement in survival between quintiles 2-4 and 1 (least deprived) and a 14% improvement between quintiles 5 and 1.

That coronary heart disease is less prevalent in the most deprived groups seems unlikely. Indeed 23% of those from the least deprived and 25% from the most deprived cohorts had such a previous hospital diagnosis.

The impact of social disadvantage measures on survival in heart failure has been little investigated. MacIntyre et al showed a 6-10% increase in hazard ratio in the most deprived areas.2 A life course approach to determining patients' social status could have given us different results.3,4 However, our results are important in showing the complexity of the relation between social disadvantage and how it is measured.
Commentary: Itching for a diagnosis
Authors: William R Phillips
Journal: BMJ (2004)

This real patient illustrates real challenges of general practice: incomplete information, evolution of illness, clinical uncertainty, and providing good care in an imperfect system.1

Mrs Prior caught the attention of her general practitioner during her husband's scheduled consultation. Caring for the “secondary patient” is part of general practice, occurring in up to 18% of encounters.2 This initial evaluation was necessarily brief, yet dealt with three problems: itch, rash, and cystitis.

Blood tests are sometimes used as a temporising tactic, but in this case they identified cholestatic liver disease before jaundice became evident. By the time Mrs Prior returned for a consultation of her own, she was frankly jaundiced and her liver tests results were very high.3

Painless jaundice made some respondents on bmj.com predict cancer. Itching made many put primary biliary cirrhosis at the top of their list. Macro-cytic anaemia suggested chronic disease, including alcohol misuse. The rapid rise in bilirubin and liver enzyme concentrations suggested a more acute process.4 Mrs Prior deserved the early ultrasound examination she had to pay for privately.

The patient and her family were most worried about ovarian cancer. The ultrasonogram showed no evidence of that malignancy but could not rule out cancer obstructing the common bile duct or infiltrating the liver. The consulting gastroenterologist recommended routine referral with a possible delay of 21 weeks. Respondents wanted to fast track this patient to consultation, diagnostic tests, and treatment. Few felt it was appropriate or necessary to call this a cancer case just to get the patient prompt care.

After the ultrasonogram we knew that Mrs Prior had gall stones and obstruction.5 Even if she had another coexistent disease, she needed urgent relief of the obstruction. Chronic progressive liver disease and even metastatic cancer are not emergencies; obstruction of the common bile duct is.

The general practitioner faced two communication challenges. Firstly, what to tell the patient? Respondents agreed they would tell her she has a liver problem that may be serious and she needs more tests. The second challenge was for the general practitioner to be the patient's advocate and negotiate prompt assessment in secondary care.

Mrs Prior's general practitioner worked the patient into his schedule, identified her problems, ordered key diagnostic tests, followed her course, recognised the urgent need for intervention, and helped the patient and her family understand the process. What more can you hope for? Only that the consultant system meets this patient's needs.
Noninvasive Diagnosis of Ischemia-Induced Wall Motion Abnormalities With the Use of High-Dose Dobutamine Stress MRI
Authors: Eike Nagel, Hans B. Lehmkuhl, Wolfgang Bocksch, Christoph Klein, Uta Vogel, Eckart Frantz, Axel Ellmer, Stefan Dreysse, Eckart Fleck
Journal: Circulation (1999)

Background —The analysis of wall motion abnormalities with dobutamine stress echocardiography (DSE) is an established method for the detection of myocardial ischemia. With ultrafast magnetic resonance tomography, identical stress protocols as used for echocardiography can be applied. Methods and Results —In 208 consecutive patients (147 men, 61 women) with suspected coronary artery disease, DSE with harmonic imaging and dobutamine stress magnetic resonance (DSMR) (1.5 T) were performed before cardiac catheterization. DSMR images were acquired during short breath-holds in 3 short-axis views and a 4- and a 2-chamber view (gradient echo technique). Patients were examined at rest and during a standard dobutamine-atropine scheme until submaximal heart rate was reached. Regional wall motion was assessed in a 16-segment model. Significant coronary heart disease was defined as ≥50% diameter stenosis. Eighteen patients could not be examined by DSMR (claustrophobia 11 and adipositas 6) and 18 patients by DSE (poor image quality). Four patients did not reach target heart rate. In 107 patients, coronary artery disease was found. With DSMR, sensitivity was increased from 74.3% to 86.2% and specificity from 69.8% to 85.7% (both P &lt;0.05) compared with DSE. Analysis for women yielded similar results. Conclusions —High-dose dobutamine magnetic resonance tomography can be performed with a standard dobutamine/atropine stress protocol. Detection of wall motion abnormalities by DSMR yields a significantly higher diagnostic accuracy in comparison to DSE.
BRCA1 Mutations in Women With Ovarian Cancer-Reply
Authors: Baruch Modan
Journal: JAMA (1997)

In Reply.  —Our preliminary data related to the frequency of the 185delAG germline mutation in the BRCA1 gene in a subset of 79 of 585 Israeli women with ovarian cancer. Our study included 16 patients (20.3%) with borderline histopathology, none of whom carried the mutation. In subsequent extended analysis, 2 (5.6%) of 36 additional borderline cases were found to be mutation carriers (unpublished data). The latter finding is in line with the findings of 2.9% of mutation carriers having a positive family history among women with low malignant potential ovarian cancer (ie, presumably borderline) reported by Dr Shushan et al. 1 Similarly, Rubin and coworkers 2 reported that of 53 patients with ovarian cancer who might have been carriers of a variety of BRCA1 mutations, 3 were of a low malignant potential type.  These data indeed support the notion that the genetics of borderline ovarian tumors differ from that of the invasive
Understanding and Responding to Adverse Events
Authors: Charles Vincent
Journal: New England Journal of Medicine (2003)

This article describes a method of investigating and learning from adverse events. Careful investigation and systems analysis can identify the factors that set the stage for a medical error. The author argues that the process of understanding adverse events leads to improvements in care and reductions in errors and that insensitive and inadequate handling of an incident can result in additional harm to patients and families. He outlines practical strategies to minimize the trauma resulting from adverse events.
1132 HIGH CONCORDANCE BETWEEN SVR12 AND SVR24 IN PATIENTS RECEIVING TELAPREVIR PLUS PEGINTERFERON AND RIBAVIRIN IN THREE PHASE III CLINICAL TRIALS: ADVANCE, ILLUMINATE AND REALIZE
Authors: D. Luo, S. Zeuzem, I.M. Jacobson, K. Sherman, N. Adda, C.I. Wright, G. Picchio, J. Witek
Journal: Journal of Hepatology (2012)
Abstract 1384: Estrogen receptor beta inhibits migration and invasion of breast cancer cells by regulating E-cadherin levels
Authors: Christoforos Thomas, Gayani Rajapaksa, Fotis Nikolos, Jan-Ake Gustafsson
Journal: Cancer Research (2011)

Abstract Estrogen receptor beta (ERβ) mediates the effects of estrogens in a variety of human tissues including the mammary gland and regulates biological processes involved in initiation, progression and metastasis of breast cancer such as cell proliferation and migration. Although induction in cell-cell adhesion has been shown to be involved in the ERβ-mediated inhibition of cell migration, the molecular mechanism has not been fully elucidated. Here we show that induction in the expression of ERβ alters the morphology of the metastatic MDA-MB-231breast cancer cells by inducing cell-cell contact and inhibits migration and invasion. This correlates with an ERβ-mediated induction in the expression of the epithelial marker E-cadherin and downregulation of mesenchymal markers vimentin and N-cadherin. We found that the ERβ-mediated increase in the expression of E-cadherin involves an induction in the levels of miR-200 and a concomitant downregulation of its target component and transcriptional repressor of E-cadherin, ZEB1. These data suggest that ERβ through inhibiting migration and invasion in breast cancer cells may have a role in the clinical intervention of metastatic breast cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1384. doi:10.1158/1538-7445.AM2011-1384
An Estimate of the Global Burden of Anthropogenic Ozone and Fine Particulate Matter on Premature Human Mortality Using Atmospheric Modeling
Authors: Susan C. Anenberg, Larry W. Horowitz, Daniel Q. Tong, J. Jason West
Journal: Environmental Health Perspectives (2010)

Ground-level concentrations of ozone (O3) and fine particulate matter [< or = 2.5 microm in aerodynamic diameter (PM2.5)] have increased since preindustrial times in urban and rural regions and are associated with cardiovascular and respiratory mortality.We estimated the global burden of mortality due to O3 and PM2.5 from anthropogenic emissions using global atmospheric chemical transport model simulations of preindustrial and present-day (2000) concentrations to derive exposure estimates.Attributable mortalities were estimated using health impact functions based on long-term relative risk estimates for O3 and PM2.5 from the epidemiology literature. Using simulated concentrations rather than previous methods based on measurements allows the inclusion of rural areas where measurements are often unavailable and avoids making assumptions for background air pollution.Anthropogenic O3 was associated with an estimated 0.7 +/- 0.3 million respiratory mortalities (6.3 +/- 3.0 million years of life lost) annually. Anthropogenic PM2.5 was associated with 3.5 +/- 0.9 million cardiopulmonary and 220,000 +/- 80,000 lung cancer mortalities (30 +/- 7.6 million years of life lost) annually. Mortality estimates were reduced approximately 30% when we assumed low-concentration thresholds of 33.3 ppb for O3 and 5.8 microg/m3 for PM2.5. These estimates were sensitive to concentration thresholds and concentration-mortality relationships, often by > 50%.Anthropogenic O3 and PM2.5 contribute substantially to global premature mortality. PM2.5 mortality estimates are about 50% higher than previous measurement-based estimates based on common assumptions, mainly because of methodologic differences. Specifically, we included rural populations, suggesting higher estimates; however, the coarse resolution of the global atmospheric model may underestimate urban PM(2.5) exposures.
Care of Cambodian Refugees
Authors: Patricia F. Walker
Journal: JAMA (1980)

<h3>To the Editor.—</h3> The article by Keith Dahlberg, MD (243:1062, 1980), on "Medical Care of Cambodian Refugees" was both interesting and timely. Having recently returned from volunteer work on the Thai-Cambodian border, I thought I might add one insight that our team, sponsored by the American Refugee Committee, gained. Dahlberg states that, with anemias "among the refugees, it is reasonable to try iron therapy and transfusions (and perhaps folic acid) at first." Our policy, also, was to provide our patients with daily multivitamins, B complex, and iron, and it was not until my return to the United States that I realized such an empirical approach may not always be advisable. In a 1977 article dealing with the relationship of nutritional status to infection, Murray and Murray' discussed their observations of the Sahel famine of 1973 and the Ogaden famine of 1975. They noted that within two to four weeks of