tbuckley/cabot-search huggingface dataset:
Accuracy of 16-Row Multidetector Computed Tomography for the Assessment of Coronary Artery Stenosis
Authors: Mario J. Garcia, Jonathan Lessick, Martin H. K. Hoffmann, for the CATSCAN Study Investigators
Journal: JAMA (2006)

Multidetector computed tomography (MDCT) has been proposed as a noninvasive method to evaluate coronary anatomy.To determine the diagnostic accuracy of 16-row MDCT for the detection of obstructive coronary disease based exclusively on quantitative analysis and performed in a multicenter study.Eleven participating sites prospectively enrolled 238 patients who were clinically referred for nonemergency coronary angiography from June 2004 through March 2005. Following a low-dose MDCT scan to evaluate coronary artery calcium, 187 patients with an Agatston score of less than 600 underwent contrast-enhanced MDCT. Conventional angiography was performed 1 to 14 days after MDCT. Conventional angiographic and MDCT studies were analyzed by independent core laboratories.Segment-based and patient-based sensitivities and specificities for the detection of luminal stenosis of more than 50% (of luminal diameter) and more than 70% (of luminal diameter) based on quantitative coronary angiography.Of 1629 nonstented segments larger than 2 mm in diameter, there were 89 (5.5%) in 59 (32%) of 187 patients with stenosis of more than 50% by conventional angiography. Of the 1629 segments, 71% were evaluable on MDCT. After censoring all nonevaluable segments as positive, the sensitivity for detecting more than 50% luminal stenoses was 89%; specificity, 65%; positive predictive value, 13%; and negative predictive value, 99%. In a patient-based analysis, the sensitivity for detecting patients with at least 1 positive segment was 98%; specificity, 54%; positive predictive value, 50%; and negative predictive value, 99%. After censoring all nonevaluable segments as positive, the sensitivity for detecting more than 70% luminal stenoses was 94%; specificity, 67%; positive predictive value, 6%; and negative predictive value, 99%. In a patient-based analysis, the sensitivity for detecting patients with at least 1 positive segment was 94%; specificity, 51%; positive predictive value, 28%; and negative predictive value, 98%.The results of this study indicate that MDCT coronary angiography performed with 16-row scanners is limited by a high number of nonevaluable cases and a high false-positive rate. Thus, its routine implementation in clinical practice is not justified. Nevertheless, given its high sensitivity and negative predictive value, 16-row MDCT may be useful in excluding coronary disease in selected patients in whom a false-positive or inconclusive stress test result is suspected.
Points: Totally implantable vascular access for long term chemotherapy
Authors: M F McMullin
Journal: BMJ (1986)

ever, urine osmolality depends-not only on secretion of antidiuretic hormone but also on the kidney's ability to respond.If the kidney's concentratmg ability haa been lost the urine will.bedilute irrespective of the level ofantidiuretic hormone, so the finding ofa dilute urne in this situation does not by itself permit any conclusion to be drawn about antidiuretic hormone secretion.Furthermore, if the kidney is insensitive.toantidiuretic hormone urine osmoLality conveys .noinformation on the setting of the osmostat, which can be assessed only by direct assay of antidiuretic hormoneas a function of serum osmolality Totally implantable vascular access for long.term chemotherapy Dr M F-McMULUN (Royal Victoria Hospital,eat BTl2 6BA) writes: Following the comments of MrA E Youngandcolleagues (7 tecember,-p 1608) I would like to draw attention to another advantage of.thePort-a-Cath.In this unit two patients have used the Hickdman -catheter as a means of attempted suicide, Both patients, young men, had Hickman catheters inserted for intensive chemotherapy, and both attempted suicide by-removing large quantities of blood through the catheter.Despite the problems of assessment, psychiarc disorders are.common among patients with cancer, 2 and cancercan increase the risk of suicide.3In both these patiepis the Hickman catheter,,which.the patients mpulated daily tb selves, was an easy means of access tao the circulatin.Perhaps the insertion of.a Port-a-Cath would have ayoided this complication.
Early Psychosomatic Pathology
Authors: Renata Gaddini
Journal: Psychotherapy and Psychosomatics (1979)

Early life vicissitudes and care, which are physical and concrete variables in their occurrence, but which are stored in the infant's mind in terms of relationships and emotional interplay, are basic for development in terms of body as well as of psychic orientation. Just as in psychic growth the interplay continues in the child's investment in the outside world (object), in the physical growth distorted early relationships, possibly deviated by the infant's physiological immaturities, interfere with the child's total health, and may lead to early psychosomatic pathology.
The effects of dietary iron on initiation and promotion in chemical hepatocarcinogenesis
Authors: Per Stål, Rolf Hultcrantz, Lennart Möller, Lennart C. Eriksson
Journal: Hepatology (1995)

The aim of this study was to evaluate the effects of dietary iron on hepatocarcinogenesis in an animal model mimicking noncirrhotic genetic hemochromatosis. Iron overload may lead to liver cirrhosis and an increased risk of developing primary hepatocellular carcinoma. It is unknown if iron is of pathogenic importance for the carcinogenic process, or whether the increased cancer risk results solely from the cirrhotic process. We investigated the initiating, promoting, and mitogenic properties of carbonyl iron in the Solt-Farber model of chemical hepatocarcinogenesis. A diet supplemented with 2.5% to 3.0% carbonyl iron was either added to, or replaced, the initiating and promoting events in the model. None of the animals developed hepatic fibrosis. Hepatic iron was increased 6- to 13-fold in iron-treated animals, and predominantly located in periportal hepatocytes. Iron as an initiator did not increase the number of glutathione-S-transferase-Yp–positive foci. Iron reduced the number of foci when added to low-dose diethylnitrosamine plus partial hepatectomy, which may be explained by a delayed hepatic regeneration in iron-loaded liver. As a promoter, iron did not selectively induce proliferation of initiated cells. Added to a complete promotive regimen, iron decreased the volume density of preneoplastic nodules, possibly because of a mitostimulatory effect of iron on normal hepatocytes surrounding the nodules. Iron increased the hepatocyte labeling index and counteracted the mitoinhibitory effect of 2-acetylaminofluorene on regenerating liver. We conclude that in this animal model, dietary carbonyl iron, mimicking the iron loading pattern of genetic hemochromatosis (1) does not possess genotoxic properties detectable as increased preneoplastic foci formation; (2) does not promote the growth of initiated cells; (3) has mitogenic properties in vivo, but not strong enough to replace partial hepatectomy in promotion; and (4) leads to a decreased number of foci or volume density of nodules when added to a complete initiating or promoting regimen. (HEPATOLOGY 1995;21:521–528.)
New editor takes charge at New England Journal of Medicine
Authors: J. H. Tanne
Journal: BMJ (1999)

Dr Marcia Angell, formerly executive editor of the New England Journal of Medicine , has taken over as editor in chief until a new editor is found by a search committee, which may take up to a year.

The editorships of two major journals in the United States are now vacant, at the New England Journal of Medicine and JAMA (the journal of the American Medical Association). They may be competing for the same pool of candidates.

Dr Jerome Kassirer, who was editor for eight years, …
Depressive Symptoms and CD4 Lymphocyte Decline Among HIV-Infected Men
Authors: Jeffrey H. Burack
Journal: JAMA (1993)

To investigate whether high levels of depressive symptomatology at baseline predict more rapid decline of CD4 lymphocyte counts and progression of clinical disease in persons infected with the human immunodeficiency virus (HIV).Prospective cohort study with semiannual data collection waves and up to 66 months of follow-up.Population-based probability sample of single men in areas of San Francisco with high case rates of the acquired immunodeficiency syndrome (AIDS).All 330 homosexual or bisexual men who by January 1985 had serological evidence of HIV infection but had not had an AIDS diagnosis. Analysis of CD4 lymphocyte change was performed for 277 subjects (83.9%) who had three or more CD4 lymphocyte counts recorded during the study period January 1985 through July 1990.Depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression scale (CES-D). All subjects were classified according to two indicators of depression: (1) as overall depressed using a cut point of 16 or higher on the complete CES-D, and (2) as affectively depressed using a cut point of more than 1 SD above the mean on a subscale of the CES-D measuring affective depression. Laboratory and symptom measures, antiretroviral use, demographics, and behavioral measures were also used. The primary outcome measure was the rate of change of the CD4 lymphocyte count. Secondary outcomes were AIDS-free survival and mortality.At baseline 65 subjects (19.7%) were classified as depressed on the overall scale and 53 (16.1%) were classified as depressed on the affective scale. The unadjusted mean rate of CD4 change was 38% greater for overall depressed subjects than for the overall nondepressed (-0.0812 vs -0.0588 x 10(9)/L [-81.2 vs -58.8/microL per year; P = .07) and 34% greater for affectively depressed subjects than for the affectively nondepressed (-0.0804 vs -0.0598 x 10(9)/L per year; P = .06). In hierarchical multivariate analysis controlling for antiretroviral use, symptoms, and other predictors, baseline overall depression was associated with an excess decline in CD4 count of -0.0285 x 10(9)/L per year (95% confidence interval, -0.0496 to -0.0073), and baseline affective depression was associated with an excess decline in CD4 count of -0.0236 x 10(9)/L per year (95% confidence interval, -0.0464 to -0.0008). Neither overall depression nor affective depression was significantly associated with earlier AIDS diagnosis or earlier mortality.Overall depression and affective depression predicted a more rapid decline in CD4 lymphocyte counts; this association was not attributable to baseline physiological differences. While the mechanism of the association remains unknown and cannot be addressed directly by this study, the data suggest that it can be explained neither as simply a reflection of perceived somatic symptoms nor as the result of differences in recreational drug and alcohol use. Further study is necessary to determine whether treating depression can alter the course of HIV infection.
The intricate interplay among body weight, stress, and the immune response to friend or foe
Authors: Lawrence Steinman, Paul Conlon, Rich Maki, Alan Foster
Journal: Journal of Clinical Investigation (2003)

We all know that when we suffer from fever we feel sleepy and do not feel like eating.Our mothers and grandmothers provided sound wisdom during our bouts of illness with fever.They recommended rest and tried to make us eat, advocating folk remedies like chicken soup or various teas.The physiologic roles of mediators of fever such as IL-1, TNF-α, IL-6, and prostaglandins account for some of the physiological changes in the sleep/wake cycle and in appetite (1, 2).Prostaglandins are involved in the induction of sleep, while TNF-α triggers loss of appetite and pyrexia.However, we are now learning that the interconnections between molecules that modulate brain function and those that mediate the immune response are more intertwined than we had previously imagined.
Pathophysiological Changes in Calf Muscle Predict Mobility Loss at 2-Year Follow-Up in Men and Women With Peripheral Arterial Disease
Authors: Mary McGrae McDermott, Luigi Ferrucci, Jack Guralnik, Lu Tian, Kiang Liu, Frederick Hoff, Yihua Liao, Michael H. Criqui
Journal: Circulation (2009)

Associations of pathophysiological calf muscle characteristics with functional decline in people with lower extremity peripheral arterial disease are unknown.
Abstract 3297: Endothelial cells function as a niche to cancer stem-like cells by providing notch ligands in glioblastoma
Authors: Thant S. Zhu, Mark A. Costello, Shawn Hervey-Jumper, Francesco DiMeco, Angelo L. Vescovi, Jason A. Heth, Karin M. Muraszko, Xing Fan
Journal: Cancer Research (2011)

Abstract Recent data show that endothelial cells function as a stem cell niche to promote CD133-positive cancer stem-like cells (CSLCs) self-renewal in glioblastoma (GBM). However, the molecular mechanism by which endothelial cells function as a stem cell niche is largely unknown. We had demonstrated recently that activation of NOTCH signaling is required for GBM CSLC propagation both in vitro and in vivo. To investigate if the acquisition of NOTCH activation in GBM CSLCs results from adjacent endothelial cells, we first examined the expression of NOTCH ligands JAG/DLL in primary GBM frozen samples. We found that JAG1, JAG2 and DLL4 are expressed mostly in endothelial cells adjacent to NESTIN- and NOTCH receptor-positive cancer cells. Some tumor cells also express JAG1, JAG2, and DLL1, but not DLL4, adjacent to NESTIN- and NOTCH-receptor positive cells in primary GBMs. Furthermore, we found that forced differentiated GBM cells from GBM neurospheres express a higher level of NOTCH ligands and a lower level of stem cell marker CD133, have reduced NOTCH activity, and are less tumorigenic in mice compared to GBM neurospheres. In addition, when we co-cultured GBM neurospheres with human brain microvascular endothelial cells (hBMECs) which express NOTCH ligands JAG/DLL, we found that hBMECs promote GBM neurosphere growth, increase the CD133-positive CSLC population and clonogenicity in vitro, whereas knocking down JAG1 or DLL4 in hBMECs abrogates hBMEC-induced GBM growth both in vitro and in vivo. Finally, we found that knockdown of JAG1 or DLL4 in hBMECs decreases growth of GBM intracranial xenograft in mice through reducing the CD133-positive population. In summary, we have demonstrated that NOTCH activation in GBM CSLCs is driven by juxtacrine signaling between tumor cells and surrounding endothelial cells, suggesting that targeting both CSLCs and their niche may provide an effective strategy to deplete GBM CSLCs. 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 3297. doi:10.1158/1538-7445.AM2011-3297
Enhancement of secretagogue-induced phosphoinositide turnover and amylase secretion by bile acids in isolated rat pancreatic acini.
Authors: Y Takeyama, H Nakanishi, H Ohyanagi, Y Saitoh, K Kaibuchi, Y Takai
Journal: Journal of Clinical Investigation (1986)

Small amounts (0.1-0.5 mM) of deoxycholate enhanced amylase secretion, which had been induced by submaximal doses of carbachol or cholecystokinin octapeptide, without affecting the maximal levels of these reactions from isolated rat pancreatic acini. Deoxycholate alone did not induce these reactions. The other bile acids such as cholate, chenodeoxycholate, ursodeoxycholate, and taurocholate were also active. Under the similar conditions, deoxycholate enhanced the secretagogue-induced diacylglycerol formation that was derived mainly from the phospholipase C-mediated hydrolysis of phosphatidylinositol and phosphatidylinositol-4-monophosphate. Deoxycholate did not enhance the secretagogue-induced hydrolysis of phosphatidylinositol-4,5-bisphosphate or Ca2+ mobilization. Deoxycholate did not affect amylase secretion, which was induced by the simultaneous addition of protein kinase C-activating 12-O-tetradecanoylphorbol-13-acetate and Ca2+ ionophore ionomycin. Since diacylglycerol and Ca2+ may be responsible for the secretagogue-induced amylase secretion, our results indicate that small amounts of bile acids increase the sensitivity to the secretagogue of diacylglycerol formation and subsequent activation of protein kinase C, and thereby enhance amylase secretion from pancreatic acini.
ALCOHOL OR NO ALCOHOL IN THE TREATMENT OF TYPHOID FEVER.
Authors: J. B. GARBER
Journal: JAMA (1896)

There is no disease in the entire catalogue of human ailments that is of more concern to both the physician and the patient than that of typhoid fever. It attacks the young, the old, the rich, the poor, the high, the low, the monarch and the slave, and while the disease has a special fondness for certain ages and conditions yet none are exempt even after having once had an attack. It is found on the mountain top and in the valley, and an epidemic may begin on the mountain top and spend its force in the valley as was the case in the noted "Plymouth epidemic." It is both epidemic and endemic, and no physician who engages in the general practice of medicine will continue long ere he comes face to face with this dreaded destroyer of family ties and human comfort. The diagnosis and symptoms of the disease
ACID-BASE EQUIVALENCE OF THE BLOOD IN DISEASES ASSOCIATED WITH HYPERGLOBULINEMIA; WITH SPECIAL REFERENCE TO LYMPHOGRANULOMA INGUINALE AND MULTIPLE MYELOMA
Authors: Alexander B. Gutman, Ethel Benedict Gutman, Ruth Jillson, Russell D. Williams
Journal: Journal of Clinical Investigation (1936)

Attention was called recently (1) to the occurrence of hyperproteinemia in patients with lymphogranuloma inguinale.Thirty-five cases have now been examined, in 26 of whom the protein content of the serum exceeded 8.0 per cent (Table
The<i>ATG16L1–T300A</i>allele impairs clearance of pathosymbionts in the inflamed ileal mucosa of Crohn's disease patients
Authors: Mehdi Sadaghian Sadabad, Anouk Regeling, Marcus C de Goffau, Tjasso Blokzijl, Rinse K Weersma, John Penders, Klaas Nico Faber, Hermie J M Harmsen, Gerard Dijkstra
Journal: Gut (2014)

Crohn's disease (CD) is caused by a complex interplay among genetic, microbial and environmental factors. ATG16L1 is an important genetic factor involved in innate immunity, including autophagy and phagocytosis of microbial components from the gut. We investigated the effect of inflammation on the composition of microbiota in the ileal mucosa of CD patients in relation to the ATG16L1 risk status.Biopsies (n=35) were obtained from inflamed and non-inflamed regions of the terminal ileum of 11 CD patients homozygous for the ATG16L1 risk allele (ATG16L1-T300A) and 9 CD patients homozygous for the ATG16L1 protective allele (ATG16L1-T300). Biopsy DNA was extracted and the bacterial composition analysed by pyrosequencing. Intracellular survival rates of adherent-invasive Escherichia coli (AIEC) were analysed by determining colony forming units after exposure to monocytes isolated from healthy volunteers homozygous for the ATG16L1 risk or protective allele.Inflamed ileal tissue from patients homozygous for the ATG16L1 risk allele contained increased numbers of Fusobacteriaceae, whereas inflamed ileal tissue of patients homozygous for the ATG16L1 protective allele showed decreased numbers of Bacteroidaceae and Enterobacteriaceae and increased Lachnospiraceae. The ATG16L1 allele did not affect the bacterial composition in the non-inflamed ileal tissue. Monocytes homozygous for the ATG16L1 risk allele showed impaired killing of AIEC under inflammatory conditions compared with those homozygous for the ATG16L1 protective allele.CD patients homozygous for the ATG16L1-T300A risk allele show impaired clearance of pathosymbionts in ileal inflammation indicating that ATG16L1 is essential for effective elimination of pathosymbionts upon inflammation.
Doctors told how to manage hypertension in sub-Saharan Africa
Authors: S. Mayor
Journal: BMJ (2003)

Guidelines published this week on the management of hypertension and cardiovascular risk factors in sub-Saharan Africa aim to deal with the growing epidemic of cardiovascular disease in the area with the limited resources available.

Hypertension was placed second only to AIDS in the health challenges facing countries in Africa at a meeting of the African Union in 2001. This resulted in the Durban Decision being adopted by African heads of state …
Cosmetic surgeon is struck off for putting commercial interests ahead of his patients
Authors: C. Dyer
Journal: BMJ (2014)

A cosmetic surgeon who provided liposuction at private clinics has been struck off for “subordinating his proper responsibilities as a doctor to the pursuit of a commercial enterprise.”

Krishnamurthi Nulliah failed to adequately examine patients, take a proper history, or obtain informed consent, a panel of the Medical Practitioners Tribunal Service found. He also took a deposit on the first consultation and committed vulnerable patients to surgery without a “cooling off” period. Nulliah, who was neither represented nor present at the Manchester hearing, defended himself in emails sent a few days earlier; but the panel, chaired by the barrister …
Tight Glycemic Control Reduces Heart Inflammation and Remodeling During Acute Myocardial Infarction in Hyperglycemic Patients
Authors: Raffaele Marfella, Clara Di Filippo, Michele Portoghese, Franca Ferraraccio, Maria Rosaria Rizzo, Mario Siniscalchi, Emilio Musacchio, Michele D'Amico, Francesco Rossi, Giuseppe Paolisso
Journal: Journal of the American College of Cardiology (2009)
Abstract BS1-1: Essential Role for Wnt Signaling in Metastatic Colonization
Authors: J Huelsken
Journal: Cancer Research (2012)

Abstract Metastatic growth in distant organs is the major cause of cancer mortality. Formation of metastasis is a multi-step process with several rate-limiting steps: while dissemination of tumour cells appears to be an early and frequent event, successful initiation of metastatic growth, a process termed metastatic colonization, is rather inefficient and accomplished only by a minority of cancer cells that reach distant sites. We now identify two key mechanisms essential for the initiation of metastasis: first, a small population of cancer stem cells that are critical for metastatic colonization, i.e. the initial expansion of cancer cells at the secondary site. Second, we find stromal niche signals to be crucial for this process. This niche is required to promote Wnt signaling in infiltrating cancer stem cells and thereby this pathway plays an essential role in metastatic colonization. We suggest that interfering with this stromal support may represent a novel treatment strategy against metastatic disease. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr BS1-1.