tbuckley/cabot-search huggingface dataset:
Ga-67 Scintigraphy of Ischiorectal Fossa Horseshoe Abscess
Authors: D G K VARMA, J W HOLMES
Journal: Clinical Nuclear Medicine (1989)

Horsehoe abscess is a descriptive term indicating a suppurative process originating in the deep posterior rectal space and extending into the infralevator ischiorectal spaces. The source of infection is usually cryptoglandular near the posterior midline, and the pus may extend in a horseshoe manner to involve both ischiorectal spaces. The authors illustrate the Ga–67 imaging findings in a surgically proven horseshoe abscess along with CT correlation.
Admission International Normalized Ratio Levels, Early Treatment Strategies, and Major Bleeding Risk Among Non–ST-Segment–Elevation Myocardial Infarction Patients on Home Warfarin Therapy
Authors: Sumeet Subherwal, Eric D. Peterson, Anita Y. Chen, Matthew T. Roe, Jeffrey B. Washam, Brian F. Gage, Richard G. Bach, Deepak L. Bhatt, Stephen D. Wiviott, Renato D. Lopes, Karen P. Alexander, Tracy Y. Wang
Journal: Circulation (2012)

Non-ST-segment-elevation myocardial infarction patients on home warfarin pose treatment concerns because of their potential increased risk of bleeding. Expert opinion from the American College of Cardiology/American Heart Association guidelines suggest holding anticoagulants and initiating antiplatelet therapy among therapeutically anticoagulated non-ST-segment-elevation myocardial infarction patients. Yet, little is known about contemporary treatment patterns and bleeding risks in this population.We stratified 5787 non-ST-segment-elevation myocardial infarction patients on home warfarin therapy using data from the National Cardiovascular Data Registry Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With the Guidelines by admission international normalized ratio (INR) levels: subtherapeutic (INR <2), therapeutic (INR, 2-3), and supratherapeutic (INR >3). Multivariable logistic generalized estimating equations models were constructed to examine the associations between admission INR level, early antithrombotic treatment and invasive therapy, and risk of in-hospital major bleeding. Among these patients, 46%, 35%, and 19% had subtherapeutic, therapeutic, and supratherapeutic admission INR levels, respectively. Risk of major bleeding was higher among patients with therapeutic (15%; adjusted odds ratio, 1.25; 95% confidence interval [CI], 1.03-1.50) and supratherapeutic (22%; odds ratio, 1.60; 95% CI, 1.30-1.97) anticoagulation compared with the subtherapeutic group (12%). Among patients with admission INR ≥2, 45% were treated with early (within 24 hours) heparin, 35% with early clopidogrel, 14% with early glycoprotein IIb/IIIa inhibitor, and 36% with early invasive strategy. Early antithrombotic treatment was associated with increased bleeding risk (odds ratio, 1.40 [95% CI, 1.14-1.72] for heparin; 1.50 [95% CI, 1.22-1.84] for clopidogrel; and 1.82 [95% CI, 1.43-2.32] for glycoprotein IIb/IIIa inhibitor); however, an early invasive strategy was not (odds ratio, 1.09; 95% CI, 0.86-1.37). No significant interactions were observed between INR level and use of each early treatment in its association with bleeding.National patterns of early antithrombotic treatment for non-ST-segment-elevation myocardial infarction patients on home warfarin diverge from expert opinion provided by current practice guidelines. Early antithrombotic treatment was associated with increased bleeding risk regardless of admission INR level.
Routine Electrocardiograms on Admission
Authors: Donald A. Opila
Journal: Annals of Internal Medicine (1986)

Letters and Corrections1 March 1986Routine Electrocardiograms on AdmissionDONALD A. OPILA, M.D.DONALD A. OPILA, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-104-3-444 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In the recent article on admission electrocardiograms by Moorman and coworkers (1), it is difficult for the reader to come to the same conclusion as the authors. From the data presented, in fact, one can conclude that the electrocardiogram was not useful, but that careful history taking and physical examination are more important.I have the following questions about the patient data presented in Table 2. Was the patient who had aortic stenosis totally asymptomatic by history, and was there a heart murmur? It is unusual for left ventricular hypertrophy on electrocardiography to be the only tip-off...Reference1. MOORMANHLATKYEDDYWAGNER JMDG. The yield of the routine admission electrocardiogram: a study in a general medical service. Ann Intern Med. 1985;103:590-5. LinkGoogle Scholar1. CHOU T. Electrocardiography in Clinical Practice. New York: Grune & Stratton; 1979:172. Google Scholar2. SECKER-WALKER R. On purple emperors, pulmonary embolism, and venous thrombosis [Editorial]. Ann Intern Med. 1983;98:1006-8. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: State University of New York at Buffalo Buffalo, NY 14203 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 March 1986Volume 104, Issue 3Page: 444-445KeywordsElectrocardiographyHeart murmursLeft ventricular hypertrophyStenosis Issue Published: 1 March 1986 PDF DownloadLoading ...
Computed Tomographic Measures of Pulmonary Vascular Morphology in Smokers and Their Clinical Implications
Authors: Raúl San José Estépar, Gregory L. Kinney, Jennifer L. Black-Shinn, Russell P. Bowler, Gordon L. Kindlmann, James C. Ross, Ron Kikinis, MeiLan K. Han, Carolyn E. Come, Alejandro A. Diaz, Michael H. Cho, Craig P. Hersh, Joyce D. Schroeder, John J. Reilly, David A. Lynch, James D. Crapo, J. Michael Wells, Mark T. Dransfield, John E. Hokanson, George R. Washko
Journal: American Journal of Respiratory and Critical Care Medicine (2013)

Angiographic investigation suggests that pulmonary vascular remodeling in smokers is characterized by distal pruning of the blood vessels.Using volumetric computed tomography scans of the chest we sought to quantitatively evaluate this process and assess its clinical associations.Pulmonary vessels were automatically identified, segmented, and measured. Total blood vessel volume (TBV) and the aggregate vessel volume for vessels less than 5 mm(2) (BV5) were calculated for all lobes. The lobe-specific BV5 measures were normalized to the TBV of that lobe and the nonvascular tissue volume (BV5/T(issue)V) to calculate lobe-specific BV5/TBV and BV5/T(issue)V ratios. Densitometric measures of emphysema were obtained using a Hounsfield unit threshold of -950 (%LAA-950). Measures of chronic obstructive pulmonary disease severity included single breath measures of diffusing capacity of carbon monoxide, oxygen saturation, the 6-minute-walk distance, St George's Respiratory Questionnaire total score (SGRQ), and the body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index.The %LAA-950 was inversely related to all calculated vascular ratios. In multivariate models including age, sex, and %LAA-950, lobe-specific measurements of BV5/TBV were directly related to resting oxygen saturation and inversely associated with both the SGRQ and BODE scores. In similar multivariate adjustment lobe-specific BV5/T(issue)V ratios were inversely related to resting oxygen saturation, diffusing capacity of carbon monoxide, 6-minute-walk distance, and directly related to the SGRQ and BODE.Smoking-related chronic obstructive pulmonary disease is characterized by distal pruning of the small blood vessels (<5 mm(2)) and loss of tissue in excess of the vasculature. The magnitude of these changes predicts the clinical severity of disease.
Increased natriuretic efficiency of furosemide in rats with carbon tetrachloride-induced cirrhosis
Authors: Thomas E.N. Jonassen, Anne-Mette Sørensen, Jørgen S Petersen, Frederik Andreasen, Sten Christensen
Journal: Hepatology (2000)

The authors examined the natriuretic efficiency of furosemide in rats with cirrhosis induced by carbon tetrachloride (CCl(4)). Rats were treated for 17 weeks with intraperitoneal injections of CCl(4) in groundnut oil twice a week throughout the study. Control rats were treated with vehicle (groundnut oil). Studies in metabolic cages showed that sodium retention was present from week 14. Renal clearance experiments were performed in chronically, instrumented conscious rats at the end of week 14 and at the termination of the study (end week 16) when ascites and hyponatremia were present. After 14 weeks, cirrhotic rats had sodium retention along with increased renal plasma flow, normal GFR, normal renal lithium handling, and a significantly increased diuretic (+41% vs. control) and natriuretic (+56% vs. control) response to a test dose furosemide (7.5 mg/kg b.w., intravenously). The natriuretic efficiency of furosemide, i.e., the natriuresis expressed relative to the furosemide excretion rate (triangle upU(Na)V/U(FUR)V) was increased by 51% versus control. After 17 weeks, ascites and hyponatremia had developed, and significant decreases in renal plasma flow (-33%), GFR (-30%), and fractional lithium excretion (-44%) were observed. At this stage urinary recovery of furosemide was significantly decreased and the diuretic (-27% vs. Control) and natriuretic (-38% vs. control) responses to furosemide were significantly impaired. However, the increased natriuretic efficiency of furosemide was still present (+34% vs. control). Together these results suggest that increased sodium reabsorption in the thick ascending limb of Henle's loop is involved in the renal sodium retention in cirrhosis in rats that eventually results in decompensation with the formation of ascites.
The Glucose-Transporter Protein and Glucopenic Brain Injury
Authors: Robert A. Fishman
Journal: New England Journal of Medicine (1991)

Insulin-induced hypoglycemic coma is rapidly and dramatically reversed by the intravenous administration of glucose. This old observation attests to the efficient transfer of this lipid-insoluble sugar across the plasma membranes of the brain endothelial cells that constitute the blood–brain barrier. Moreover, glucose readily moves across the cellular membranes of neurons and glia to sustain their metabolism. The mechanism of the rapid transfer of glucose from blood into cerebrospinal fluid1 and the brain2 has the features of carrier-facilitated diffusion, whereby the combination of glucose with a membrane carrier or transporter facilitates its transfer across the intervening membranes and its entry into . . .
The clinical application of monoclonal antibodies in chronic lymphocytic leukemia
Authors: Samantha M. Jaglowski, Lapo Alinari, Rosa Lapalombella, Natarajan Muthusamy, John C. Byrd
Journal: Blood (2010)

Chronic lymphocytic leukemia (CLL) represents the most prevalent adult leukemia. Treatment with chemotherapy over the past 3 decades has been palliative. The introduction of therapeutic antibodies has increased the number of treatment options for this disease. Despite this increase, our true understanding of the mechanism of action of antibody therapy in CLL remains limited. Rituximab, a CD20 antibody, is currently widely used in combination-based strategies for both previously untreated symptomatic CLL and as salvage therapy. Recent data suggest that the addition of rituximab to fludarabine with or without cyclophosphamide prolongs survival in younger patients with CLL. Other improved CD20 antibodies with promising clinical activity, including ofatumumab and GA-101, are coming forward. Alemtuzumab, a CD52 antibody, likewise has demonstrated benefit in both symptomatic, previously untreated CLL and in patients with relapsed disease but has less selectivity. Development of other therapeutic antibodies targeting alternative B-cell-specific antigens in CLL has been less successful, although many promising candidate antibodies and/or small modular immune pharmaceuticals (SMIPs) are coming forward. In addition, recent efforts to combine currently applied therapeutic antibodies with other biologic and targeted therapies with efficacy in CLL offers the potential to move toward alternative non-chemotherapy-based treatment approaches.
Lipid and lipoprotein triglyceride and cholesterol interrelationships: Effects of sex, hormone use, and hyperlipidemia
Authors: P.W. Wahl, C.E. Walden, R.H. Knopp, G.R. Warnick, J.J. Hoover, W.R. Hazzard, J.J. Albers
Journal: Metabolism (1984)
Type II collagen-induced arthritis in mice. I. Major histocompatibility complex (I region) linkage and antibody correlates.
Authors: P H Wooley, H S Luthra, J M Stuart, C S David
Journal: The Journal of Experimental Medicine (1981)

A model of arthritis was established by the injection of type II collagen into mice. Only mice bearing the H-2q haplotype were susceptible to the disease. Susceptibility was further mapped by the use of recombinant strains on the Iq locus. Type II collagen arthritis was observed in the (resistant X susceptible) F1 cross. Mice strains were designated high, intermediate, or low responders with respect to the anti-type II antibody levels measured by radioimmunoassay. Arthritis-susceptible strains were all classified as high antibody responders. The clinical and histological appearance of type II collagen arthritis in the mouse indicates that it may be a good animal model for the investigation of various immunogenetic traits in rheumatoid arthritis.
English NHS could be 54bn in red by 2021 if budget or output doesn't increase
Authors: N. Hawkes
Journal: BMJ (2012)

The current squeeze on NHS spending in England is no short term measure but is likely to be sustained for many years, the Nuffield Trust has warned in a new report. 

Without unprecedented gains in productivity or an economic turnaround leading to greater spending, the total costs incurred in running the health service in England are likely to exceed the cash available by a cumulative total of as much as £54bn (€66bn; $86bn) by 2021-2, says the report.1

This worst case scenario assumes that the current efforts to achieve efficiency gains of 4% a year to 2014-5 (the “Nicholson challenge”) fail, that funding remains flat in real terms, and that demand continues to grow at the historical rate of 4% a year throughout the period. If any of these assumptions is changed for the better, the gap narrows.

It would be eliminated totally if …
Abstract 73: Preclinical evaluation of chemoradiation with cetuximab HPV-positive head and neck cancer suggests significant radiosensitization.
Authors: Molly A. Smith, Grace C. Blitzer, Alexandra D. Torres, Eric A. Armstrong, Paul F. Lambert, Paul M. Harari, Randall J. Kimple
Journal: Cancer Research (2013)

Abstract PURPOSE: Whether cetuximab, a monoclonal antibody to the epidermal growth factor receptor, should be combined with radiation in patients with human papillomavirus (HPV) positive locally advanced head and neck cancer (HNC) is not known. Currently available data are inadequate to address this important therapeutic question. We sought to examine the ability of cetuximab to act as a radiosensitizer and to examine the mechanism of action of this combination in a model system of HPV+ HNC. METHODS: Four cell lines (UD-SCC2, UM-SCC47, UPCI-SCC90, 93-VU-147T) validated for HPV expression were used for all assays. Subcutaneous flank xenografts were performed in Hsd:athymic Nude-Foxn1nu female mice treated with intraperitoneal cetuximab (0.2mg/mouse) or flank radiation (2 Gy/fraction) delivered twice weekly for 2 weeks. Time to tumor quadrupling from baseline was assessed by Kaplan-Meier method. Flow cytometry was used to assess apoptosis by Annexin V staining and cell cycle distribution by propidium iodide staining. RESULTS: While there was minimal in vitro radiosensitization after treatment with cetuximab (similar to that seen in HPV-negative HNC), cetuximab + radiation resulted in a significant increase in time to tumor quadrupling compared to cetuximab alone (p=0.001) or radiation alone (p&amp;lt;0.0001) in HPV+ HNC xenografts. Increased apoptosis was seen in cetuximab and radiation treated cells. Analysis of cell cycle distribution 24 hours after drug treatment showed that cetuximab induced a modest G1 cell cycle arrest when given prior to radiation, but that 24 hours after combined therapy, a significant G2 arrest was present. CONCLUSIONS: Using HPV+ HNC cell lines, radiation and cetuximab appear to be beneficial compared to either treatment alone. This combination, currently undergoing study in randomized clinical trial is being further evaluated in a direct from patient tumorgraft model of HPV+ HNC to further understand predictors of response. Citation Format: Molly A. Smith, Grace C. Blitzer, Alexandra D. Torres, Eric A. Armstrong, Paul F. Lambert, Paul M. Harari, Randall J. Kimple. Preclinical evaluation of chemoradiation with cetuximab HPV-positive head and neck cancer suggests significant radiosensitization. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 73. doi:10.1158/1538-7445.AM2013-73
TCT-827 Heparins Crossover In Percutaneous Coronary Interventions: Is It A Real Issue With Increasing Rate Of Transradial Procedures?
Authors: Alessandro Sciahbasi, Stefano Rigattieri, Simone Calcagno, Massimo Mancone, Gianluca Pendenza, Maria Cera, aurora I. Danza, Cristian Di Russo, Pasqualina Bruno, Silvio Fedele, Francesco R. Pugliese, Gennaro Sardella
Journal: Journal of the American College of Cardiology (2014)
Short-Term Use of Intravenous Electrode in Heart Block
Authors: Roman W. DeSanctis
Journal: JAMA (1963)

Our experience with 16 patients indicates that use of an indwelling electrode, introduced preferably through the right external jugular vein into the cavity of the right ventricle, is a safe and effective method for treatment of patients with heart block and Adams-Stokes disease when other medical measures have been ineffective. In addition endocardial stimulation may be used to pace patients with heart block through anesthesia and operation. When congestive failure complicates heart block, it is usually significantly improved by the more rapid rate that can be achieved through electrical pacing.
Laparoscopic caecal wedge resection with intraoperative endoscopic assistance
Authors: Luisa Giavarini, Luigi Boni, Camillo Claudio Cortellezzi, Sergio Segato, Elisa Cassinotti, Stefano Rausei, Gianlorenzo Dionigi, Francesca Rovera, Alessandro Marzorati, Sebastiano Spampatti, Daniele Sambucci, Renzo Dionigi
Journal: International Journal of Surgery (2013)
Ever been had?
Authors: T. Greenhalgh
Journal: BMJ (1996)

It was a warm spring evening, and we were on a rare mid-week trip to the theatre. Just as we finished parking the car, a man knocked on the window.

He was acutely embarrassed, he said. Never had to ask anyone this before. His car, over there, had been clamped, and he had left his credit cards at home. He only needed £6.50 to make up the fine. “Daft, isn't it? I just got out to get some flowers for my wife's birthday. Five minutes later it would have been legal to park on that line anyway.”

We knew this was …
Abnormal Response of the Pulmonary Artery of the Rabbit after High Frequency Sympathetic Nerve Stimulation
Authors: JOHN A. BEVAN, OVE A. NEDERGAARD
Journal: Circulation Research (1968)

When the sympathetic nerve supply (right recurrent cardiac nerve) to a ring of the pulmonary artery of the rabbit is stimulated repetitively in vitro at frequencies of 10/second or more, the following changes occur which are not seen after stimulation at lower frequencies. (1) The minimum number of pulses in a train needed to cause a just-detectable contractile response is reduced from a mean of 7 to unity; the higher the frequency of repetitive stimulation the fewer the number of repetitive pulses needed to effect this change. (2) The basal tone of the blood vessel exhibits fairly rapid, small, spontaneous fluctuations. (3) The resting or basal tone of the vessel slowly increases for 1/2 to 2 hours. It is speculated that changes 1 and 2 may be the result of an irreversible change in transmitter storage or release mechanisms.
Assessment of Patients' Competence to Consent to Treatment
Authors: Paul S Appelbaum
Journal: New England Journal of Medicine (2007)

A 75-year-old woman has type 2 diabetes mellitus, peripheral vascular disease, and a gangrenous ulcer of her left foot. A below-the-knee amputation is recommended, but she declines, saying that she has lived long enough and wants to die with her body intact. Her internist is concerned about her increasing confusion over the past year and notes that she appears to be depressed. How should her physician determine whether her decision is competent?
Geode development and multiple fractures in rheumatoid arthritis.
Authors: P J Lowthian, A Calin
Journal: Annals of the Rheumatic Diseases (1985)

The radiological development from normal bone of geodes and subsequent fractures in phalanges of two adjacent fingers is described in a patient with classical rheumatoid arthritis. Presentation was as a septic, discharging focus, but infection was excluded; the pathology is described.
Immune responses to administration of a vaccine against Haemophilus influenzae Type B in splenectomized and non-splenectomized patients
Authors: S. Li Volti, A. Sciotto, M. Fisichella, A. Sciacca, S.E. Munda, A. Mangiagli, G. Li Volti, L. Lupo
Journal: Journal of Infection (1999)
938-54 Echocardlographic Assessment of Myocardial Viability After Reperfusion: Contractile or Microvascular Reserve, which is Better?
Authors: Jiri Sklenar, Gustavo Camarano, Suad Ismail, Norman C. Goodman, Danny Skyba, Sanjiv Kaul
Journal: Journal of the American College of Cardiology (1995)
Improvement in Colonoscopy Performance with Adjunctive Magnetic Endoscope Imaging: A Randomized Controlled Trial
Authors: H. Cheung, C. Chung, S. Kwok, W. Tsang, M. Li
Journal: Endoscopy (2006)

Background and Study Aim: Although magnetic endoscope imaging (MEI) has been reported to improve the performance of colonoscopy, so far only a few randomized controlled studies have been published supporting its adjunctive role. This randomized study was designed to evaluate the role of MEI on the overall performance of colonoscopy. Patients and Methods: Patients admitted for elective colonoscopy were recruited. They were randomly allocated into two groups, either with an MEI view (study group) or without (control group). Examinations were performed by one of the two designated, trained endoscopists. The primary end point was intubation time. Other outcome measures included completion rate, pain score graded by patients, and ease of procedure as reflected by the number of attempts at straightening the scope, the number of times of hand pressure was applied abdominally, and the need to change the patient's position. Endoscopists were also asked to score the ease of procedure. Finally, in the MEI group, endoscopists were asked to comment on whether MEI helped to locate colonic lesions during endoscopy.
WHAT BECOMES OF PATIENTS AFTER VAGINAL PUNCTURE AND INCISION?
Authors: FERNAND HENROTIN
Journal: JAMA (1899)

A paper, bearing the above title, was announced to be read before this Section by Dr. Joseph Price of Philadelphia. I am sure we all regret the inability of Dr. Price to be present. These remarks are intended as a practical reply to his question, rather than as an exhaustive article on vaginal vs. suprapubic incision. Many years ago I became convinced that, excepting in very rare and unusual cases, puncture of the abdominal cavity for inflammatory conditions was unsurgical. I accordingly began to make use of exploratory incisions, which permitted the proper inspection of the parts affected, avoided the dangers of the blind puncture and allowed drainage, the latter becoming a safeguard or a means of treatment. I have learned to recognize the value of a vaginal incision over a vaginal puncture, when the abdomen was opened by this route. About five years ago, after having had considerable experience,