tbuckley/cabot-search huggingface dataset:
Diminutive Coronary Artery Syndrome
Authors: Laurence A. Grossman, Crawford W. Adams
Journal: JAMA (1964)

Angina pectoris or myocardial infarction in a child, youth, or young adult often results from anomalies of the coronary arteries, particularly when hypertension and metabolic disease are not present. Two men, 18 and 25 years old, respectively, who had myocardial infarctions, were investigated with cardiac catheterization and selective retrograde angiocardiography. In both cases a small hypoplastic right coronary artery was demonstrated. A revascularization procedure was done on one patient.
Radiofrequency ablation of idiopathic monomorphic ventricular tachycardia: Usefulness of unipolar recordings
Authors: Rafael Peinado, Angel Arenal, Jesús Almendral, Jose L. Merino, Jesús Martinez-Alday, Julián P. Villacastin, Luis Tercedor, Olga Medina, Agustin Pastor, Jose A. Sobrino
Journal: Journal of the American College of Cardiology (1996)
Patients' and Cardiologists' Perceptions of the Benefits of Percutaneous Coronary Intervention for Stable Coronary Disease
Authors: Michael B. Rothberg
Journal: Annals of Internal Medicine (2010)

It is unclear whether patients understand that percutaneous coronary intervention (PCI) reduces only chronic stable angina and not myocardial infarction (MI) or associated mortality.To compare cardiologists' and patients' beliefs about PCI.Survey.Academic center.153 patients who consented to elective coronary catheterization and possible PCI, 10 interventional cardiologists, and 17 referring cardiologists.Patients' and cardiologists' beliefs about benefits of PCI. All cardiologists reported beliefs about PCI for patients in hypothetical scenarios. Interventional cardiologists also reported beliefs for study patients who underwent PCI.Of 153 patients, 68% had any angina, 42% had activity-limiting angina, 77% had a positive stress test result, and 29% had had previous MI. The 53 patients who underwent PCI were more likely than those who did not to have a positive stress test result, but angina was similar in both groups. Almost three quarters of patients thought that without PCI, they would probably have MI within 5 years, and 88% believed that PCI would reduce risk for MI. Patients were more likely than physicians to believe that PCI would prevent MI (prevalence ratio, 4.25 [95% CI, 2.31 to 7.79]) or fatal MI (prevalence ratio, 4.83 [CI, 2.23 to 10.46]). Patients were less likely than their physicians to report pre-PCI angina (prevalence ratio, 0.79 [CI, 0.67 to 0.92]). For the scenarios, 63% of cardiologists believed that the benefits of PCI were limited to symptom relief. Of cardiologists who identified no benefit of PCI in 2 scenarios, 43% indicated that they would still proceed with PCI in these cases.The study was small and conducted at 1 center, and information about precatheterization counseling was limited.Cardiologists' beliefs about PCI reflect trial results, but patients' beliefs do not. Discussions with patients before PCI should better explain anticipated benefits.None.
The Contribution of Geriatric Health Services Research to Successful Aging
Authors: Robert L. Kane
Journal: Annals of Internal Medicine (2003)

Successful aging seems to refer to a broad set of circumstances that include but transcend healthy aging. The contribution of medical care to successful aging may lie in better management of chronic diseases. Health services research can contribute to successful aging by informing the delivery of medical care in this area. It can provide useful insights into what kinds of new approaches have proven successful and how to implement and sustain these changes. However, many of these lessons from health services research have been ignored in practice to date.
Prolapse of the Upper into the Lower Part of the Rectum without External Protrusion
Authors: H. Cripps
Journal: BMJ (1887)

throat.In the early stage, the pent-up fluids cause serious distension, but these become gradually absorbed,; and thep, unless the normal communication between the ear and the pharynx is re-established, the atmospheric pressure on the outer surface of the membrana tympani presses it inwards, and forces it against the fenestra ovalis.In this way, the organ undergoes permanenat injury, and the drum, together with the contents of the tympanum, are damaged by structural changes.The membrane then appears to be deeply indented and concave, the margin looks thickened, the centre thin and trans- parent, and sometimes the short process of the malleus is visible through it.Deafness and tinnitus are also intimately associated with diseases of
Proinflammatory functions of vascular endothelial growth factor in alloimmunity
Authors: Marlies E.J. Reinders, Masayuki Sho, Atsushi Izawa, Ping Wang, Debabrata Mukhopadhyay, Kerith E. Koss, Christopher S. Geehan, Andrew D. Luster, Mohamed H. Sayegh, David M. Briscoe
Journal: Journal of Clinical Investigation (2003)

Vascular endothelial growth factor (VEGF), an established angiogenesis factor, is expressed in allografts undergoing rejection, but its function in the rejection process has not been defined. Here, we initially determined that VEGF is functional in the trafficking of human T cells into skin allografts in vivo in the humanized SCID mouse. In vitro, we found that VEGF enhanced endothelial cell expression of the chemokines monocyte chemoattractant protein 1 and IL-8, and in combination with IFN-γ synergistically induced endothelial cell production of the potent T cell chemoattractant IFN-inducible protein-10 (IP-10). Treatment of BALB/c (H-2d) recipients of fully MHC-mismatched C57BL/6 (H-2b) donor hearts with anti-VEGF markedly inhibited T cell infiltration of allografts and acute rejection. Anti-VEGF failed to inhibit T cell activation responses in vivo, but inhibited intragraft expression of several endothelial cell adhesion molecules and chemokines, including IP-10. In addition, whereas VEGF expression was increased, neovascularization was not associated with acute rejection, and treatment of allograft recipients with the angiogenesis inhibitor endostatin failed to inhibit leukocyte infiltration of the grafts. Thus, VEGF appears to be functional in acute allograft rejection via its effects on leukocyte trafficking. Together, these observations provide mechanistic insight into the proinflammatory function of VEGF in immunity.
Endoscopic correction of primary vesicoureteric reflux: results in 94 ureters.
Authors: B O'Donnell, P Puri
Journal: BMJ (1986)

Sixty one patients with primary vesicoureteric reflux were treated by endoscopic injection of Mentor Polytef paste. Seventy six of the 94 treated ureters showed complete disappearance of vesicoureteric reflux after one injection. Eight refluxing ureters required a second injection, one required a third, and one a fourth. Six ureters showed improvement in the grade of reflux after the first injection. Two ureters did not show any change in the grade of reflux after endoscopic injection. The amount of paste injected to correct reflux in the 94 ureters varied from 0.1 to 1.0 ml (mean 0.33 ml). Patients were followed up for three to 25 months (mean 13.4 months). Follow up micturating cystograms in the 94 ureters showed absence of reflux in 83. Eleven ureters showed recurrence of reflux. Recurrence of reflux was attributed to early technical difficulties and to insufficient amounts of polytef paste used in some cases. Follow up urograms did not show evidence of ureteric obstruction in the treated ureters. Endoscopic injection of polytef paste is a safe, simple, and effective procedure for primary vesicoureteric reflux and averts the need for open operation.
Subgroup Variation in Diagnostic Test Evaluation
Authors: Ronald R. Scobbo
Journal: Annals of Internal Medicine (2003)

Letters15 April 2003Subgroup Variation in Diagnostic Test EvaluationRonald R. Scobbo, MDRonald R. Scobbo, MDWest Virginia University; Morgantown, WV 26505-9190 (Scobbo)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-8-200304150-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Mulherin and Miller (1) stated that correct diagnosis is nearly as important as correct treatment. The context for this statement was the clinical trial. I appreciate this context yet remain concerned about the ranking implied in Mulherin and Miller's conclusion. Is correct treatment more important than correct diagnosis? Fundamentally, how does one correctly treat an incorrect diagnosis?The Annals Information for Authors (2) describes Academia and Clinic papers as descriptions and evaluations of innovations in concepts and procedures in medical education and training and in clinical practice. A concern is that Mulherin and Miller's nuanced statement suggesting ...References1. Mulherin SA, Miller WC. Spectrum bias or spectrum effect? Subgroup variation in diagnostic test evaluation. Ann Intern Med. 2002;137:598-602. [PMID: 12353947] LinkGoogle Scholar2. Appendix: Information for authors. Ann Intern Med. 2002; 136:I-16. Google Scholar Author, Article, and Disclosure InformationAuthors: Ronald R. Scobbo, MDAffiliations: West Virginia University; Morgantown, WV 26505-9190 (Scobbo) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSpectrum Bias or Spectrum Effect? Subgroup Variation in Diagnostic Test Evaluation Stephanie A. Mulherin and William C. Miller Subgroup Variation in Diagnostic Test Evaluation Stephanie A. Mulherin and William C. Miller Subgroup Variation in Diagnostic Test Evaluation Arthur T. Evans Metrics Cited byComparison of Alternative Diagnostic Approaches for Managing Appendicitis in Children: The Effect of Disease Prevalence and Spectrum 15 April 2003Volume 138, Issue 8Page: 686KeywordsClinical trialsMedical education ePublished: 15 April 2003 Issue Published: 15 April 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Response to Letter Regarding Article, “Bridging Evidence-Based Practice and Practice-Based Evidence in Periprocedural Anticoagulation”
Authors: Pilar Gallego, Stavros Apostolakis, Gregory Y.H. Lip
Journal: Circulation (2013)

We thank Llau et al for their comments on our editorial. 1The challenge in periprocedural management of anticoagulated patients focuses on the need to balance the risk of thromboembolism (in case of anticoagulation interruption) with the risk of bleeding during the procedure (in case of anticoagulation continuation).Some procedures have demonstrated improved outcomes when oral anticoagulation was not discontinued (eg, minor dental, dermatologic procedures, or cataract surgery), and the meta-analysis performed by Siegal et al 2 showed an increased risk of bleeding with similar thrombotic risk among patients who underwent periprocedural bridging therapy.Similar results were shown by Feng et al. 3 Understandably, novel oral anticoagulants have increased the fear of bleeding during surgery because of the absence of a specific antidote for these drugs.However, theoretical advantages such as rapid onset of action and a short half-life (similar to low-molecular-weight heparins) allow no need of bridging. 4f renal function is impaired, drug clearance for some novel oral anticoagulants (eg, dabigatran) will be slowed.Our algorithm has the advantage of taking into account the bleeding risk of surgery, arguing for control of the hemostasis in the morning before surgery.Although lacking of standardized monitoring, a normal prothrombin time/activate partial thromboplastin time ratio usually exclude an anticoagulation effect resulting from rivaroxaban or dabigatran, respectively.Patients at high thrombotic risk (such as prostatic valves carriers) or with impaired renal function (creatinine clearance ≤30mL/min) should continue taking vitamin K antagonists, but our algorithm could be nuanced for those patients at moderate thrombotic risk who may benefit from bridging after novel oral anticoagulant discontinuation.The limited evidence on bridging therapy makes it difficult to openly advocate a single way of practice, and even international guidelines usually provide recommendations with a low grade of evidence.If evidence is limited on the old vitamin K antagonists, even more gaps remain about novel oral anticoagulants, and some controversy in the perioperative period endures.We refer to the expected results of the clinical trials (A Double Blind Randomized Control Trial of Post-Operative Low Molecular Weight Heparin Bridging Therapy Versus Placebo Bridging Therapy for Patients Who Are at High Risk for Arterial Thromboembolism [PERIOP-2], Effectiveness of Bridging Anticoagulation for Surgery [BRIDGE],and Bridge or Continue Coumadin for Device Surgery Randomized Controlled Trial [BRUISECONTROL]) mentioned in our editorial that may help to clarify the periprocedural bridging controversy.Until then, the debate will continue. 5,6
Recent results from the study of West Bohemian uranium miners exposed to radon and its progeny.
Authors: L Tomásek, S C Darby
Journal: Environmental Health Perspectives (1995)

A brief description is given of the study of West Bohemian uranium miners, and recent and ongoing efforts to improve the quality of the data are summarized. Three recent analyses of the data from the cohort have led to rather different estimates of the excess relative risk of mortality from lung cancer per working-level month. The reasons for these different estimates are described, and it is concluded that estimates of lung cancer risk are strongly influenced by the quality of the exposure estimates, especially by the omission of some exposures accumulated during employment at other uranium mines, following the closure of most of the shafts at the original two mines. The most recent analysis has shown that, in common with other cohorts of radon-exposed miners, the excess relative risk of lung cancer per working-level month is modified by age and time since exposure. An inverse effect of exposure rate was also demonstrated, but it affected only men at very high concentrations and appears to be related to the time pattern of exposure. In addition, the risk was found to differ between the two main mines, possibly due to the influence of arsenic in the dust of the mines.
Diffuse Metabolic Activation of Reticuloendothelium on F-18 FDG PET Imaging in a Case of Visceral Leishmania
Authors: Andrea Lupi, Giuseppe Todeschini, Pierluigi Zanco
Journal: Clinical Nuclear Medicine (2005)

Fever of unknown origin may represent a substantial diagnostic challenge. Metabolic total body imaging may be of help in detecting inflammatory foci when clinical evaluation cannot identify the source of prominent local symptoms. In particular, F-18 FDG PET may offer superior sensibility in detecting the considerable local increase of metabolism of activated granulocytes and macrophages in focal inflammation. On the other hand, systemic pathology with diffuse macrophage activation may determine peculiar PET patterns, contributing to draw the clinician's attention to diffuse rather than focal illness. A case of PET/CT total body imaging in visceral Mediterranean leishmaniasis, showing a diffuse increase of reticuloendothelial metabolic activity, is presented here.
Living articular cartilage is not smooth. The structure of mammalian and avian joint surfaces demonstrated in vivo by immersion incident light microscopy.
Authors: D L Garner, D C McGillivray
Journal: Annals of the Rheumatic Diseases (1971)

William Hunter (1742-3) looked at the surface of articular cartilage 'with a glass'.He found the surface 'smooth,+ polished, and covered with a membrane'.Hunter's views were contained in a brief, classical paper in which he established the undisputed existence of the circulus vasculosus of the diarthrodial joint.On two of three counts it appears that he was mistaken, since the evidence contained in the present paper, and briefly reported on a previous occasion (Gardner and McGillivray, 1970), demonstrates that living articular cartilage is not smooth.Further, it has been accepted since the middle of the 19th century that the articulating surfaces are not covered by an extension of the synovial membrane, a view which prevailed as recently as 1838 (Bichat, 1801;Brodie, 1813;Henle, 1838) until proof of the absence of synovia from the cartilage surface was given by Leidy (1849); (Gardner and McGillivray, 1971).Joint surfaces were surveyed with a Zeiss operating microscope or with a Leitz Ortholux microscope fitted with X 6'5 and X 11 incident light objectives (Fig. 1).A perspex cone could be added to these objectives to permit FIG. 1 Leltz Ortholux microscope arrangedfor Incident light microscopy.Illumination is provided by an Internal, coaxial source or externally, by an oblique light source.
Exposure to Soy-Based Formula in Infancy and Endocrinological and Reproductive Outcomes in Young Adulthood
Authors: Brian L. Strom, Rita Schinnar, Ekhard E. Ziegler, Kurt T. Barnhart, Mary D. Sammel, George A. Macones, Virginia A. Stallings, Jean M. Drulis, Steven E. Nelson, Sandra A. Hanson
Journal: JAMA (2001)

egory of phytoestrogens, are naturally occurring plant compounds.Phytoestrogens have been shown to bind to estrogen receptors in the adult [1][2][3] and to act either as estrogens 4 or as antiestrogens. 5,62][13][14][15] Evidence in some animal species of a contraceptive or sexual development effect from dietary phytoestrogens [16][17][18][19][20][21][22][23][24][25][26] has led some to suggest that dietary habits should be investigated in women with differences in menstrual cycle length. 27Lowered sperm counts have also been suggested as possibly associated with phytoestrogens, but more recent work has not confirmed this pattern. 28nfants fed soy formula receive relatively high doses (per unit of body Context A large body of evidence documents the role of phytoestrogens in influencing hormone-dependent states.Infants fed soy formula receive high levels of phytoestrogens, in the form of soy isoflavones, during a stage of development at which permanent effects are theoretically possible.However, a paucity of data exists on the long-term effects of infant soy formulas.Objective To examine the association between infant exposure to soy formula and health in young adulthood, with an emphasis on reproductive health. Design, Setting, and ParticipantsRetrospective cohort study conducted from March to August 1999 among adults aged 20 to 34 years who, as infants, participated during 1965-1978 in controlled feeding studies conducted at the University of Iowa, Iowa City (248 were fed soy formula and 563 were fed cow milk formula during infancy).Main Outcome Measures Self-reported pubertal maturation, menstrual and reproductive history, height and usual weight, and current health, compared based on type of formula exposure during infancy. ResultsNo statistically significant differences were observed between groups in either women or men for more than 30 outcomes.However, women who had been fed soy formula reported slightly longer duration of menstrual bleeding (adjusted mean difference, 0.37 days; 95% confidence interval [CI], 0.06-0.68),with no difference in severity of menstrual flow.They also reported greater discomfort with menstruation (unadjusted relative risk for extreme discomfort vs no or mild pain, 1.77; 95% CI, 1.04-3.00).Conclusions Exposure to soy formula does not appear to lead to different general health or reproductive outcomes than exposure to cow milk formula.Although the few positive findings should be explored in future studies, our findings are reassuring about the safety of infant soy formula.
Clinical and Endocrine Side-effects of Methylprednisolone Acetate as used in Hay-fever
Authors: M. A. Ganderton
Journal: BMJ (1970)

Eight patients were treated with two 80-mg. doses of methylprednisolone acetate (Depo-Medrone), given at an interval of two weeks. Pituitary-adrenal function was assessed before, during, and after treatment. Plasma cortisol levels were depressed maximally 72 hours after each injection of methylprednisolone acetate, and then gradually returned to normal. The adrenocortical response to administered corticotrophin was similarly affected; in seven patients normal values were again recorded three weeks after the second injection of methylprednisolone acetate. One patient whose adrenal function had returned to normal still showed some degree of pituitary suppression eight weeks after his second injection. Several side-effects were noted, and clinically the patients fared less well than a larger series studied during the previous year.
Symptom Resolution or Relief after Cholecystectomy Correlates Strongly with Positive Combined Endoscopic Ultrasound and Stimulated Biliary Drainage
Authors: J. E. Dill
Journal: Endoscopy (1997)

Background and study aims: Combined endoscopic ultrasound and stimulated biliary drainage (EUS/SBD) has been shown to have better sensitivity than transabdominal ultrasonography (TUS) in the diagnosis of subtle gallbladder disease. The aim of the present study was to obtain long-term postoperative outcome data on a group of patients diagnosed by EUS/SBD.
Atherothrombosis and ischaemic stroke
Authors: P M Rothwell
Journal: BMJ (2007)

<h3>ABSTRACT</h3> Extracellular matrix (ECM) remodeling by proteases results in the release of protein fragments that promote tumor progression and metastasis. The protease cathepsin D (cath-D), a marker of poor prognosis in triple-negative breast cancer (TNBC), is aberrantly secreted in the tumor microenvironment. Using degradomic analyses by TAILS, we discovered that the matricellular protein SPARC is a substrate of extracellular cath-D. <i>In vitro</i>, cath-D induced limited proteolysis of SPARC C-terminal extracellular Ca<sup>2+</sup> binding domain at acidic pH, leading to the production of SPARC fragments (34-, 27-, 16-, 9-, and 6-kDa). Similarly, cath-D secreted by TNBC cells cleaved fibroblast- and cancer cell-derived SPARC at the tumor pericellular acidic pH. SPARC cleavage also occurred in TNBC tumors. Among these fragments, only the 9-kDa SPARC fragment inhibited TNBC cell adhesion and spreading on fibronectin, and stimulated their migration, endothelial transmigration, and invasion. Our study establishes a novel crosstalk between proteases and matricellular proteins in the tumor microenvironment through limited proteolysis of SPARC, revealing a novel targetable 9-kDa bioactive SPARC fragment for new TNBC treatments.
Effect of chloroquine on insulin and glucose homoeostasis in normal subjects and patients with non-insulin-dependent diabetes mellitus.
Authors: G D Smith, T A Amos, R Mahler, T J Peters
Journal: BMJ (1987)

Plasma glucose, insulin, and C peptide concentrations were determined after an oral glucose load in normal subjects and in a group of patients with non-insulin-dependent diabetes mellitus before and during a short course of treatment with chloroquine. In the control group there was a small but significant reduction in fasting blood glucose concentration but overall glucose tolerance and hormone concentrations were unaffected. In contrast, the patients with non-insulin-dependent diabetes mellitus showed a significant improvement in their glucose tolerance, which paralleled the severity of their diabetes. This response seems to reflect decreased degradation of insulin rather than increased pancreatic output. These observations suggest that treatment with chloroquine or suitable analogues may be a new approach to the management of diabetes.