tbuckley/cabot-search huggingface dataset:
Abstract 15162: Assessment of Appropriate Use Criteria for Stress Echocardiography in the Emergency Room Evaluation of Chest Pain
Authors: Deborah C Akinniyi, Heather A Young, Jannet F Lewis, Brian G Choi
Journal: Circulation (2012)

Introduction:  Rational use of imaging is needed in all healthcare settings, including the emergency room (ER). The aim of this study was to assess the application of the American College of Cardiology/American Society of Echocardiography appropriate use criteria for stress echocardiography (SE) in the ER evaluation of chest pain.   Hypothesis:  We assessed the hypothesis that the ER generates a significant number of inappropriate SE studies and that inappropriate SE referred from the ER would have significant gender, risk factor, and age differences compared to appropriate SE.   Methods:  In this retrospective analysis, SE referred from the ER at a single-center university hospital from January 2006 to June 2011 were reviewed. The patient records were analyzed to determine SE indication and classification as appropriate, uncertain, or inappropriate. We compared patient characteristics for appropriate and inappropriate studies using t-tests and chi-square analysis.   Results:  Of 141 SE studies, 71 (50%) were classified as appropriate, 69 (49%) were inappropriate, and 1 (1%) was uncertain. Females were more likely than males to be referred for inappropriate studies (odds ratio, 16.7; 95% confidence interval, 5.0-55.6; p   Conclusions:  In this analysis, nearly half of SE studies ordered in the ER for evaluation of chest pain were inappropriate. Owing to their lower pre-test probability of disease, younger patients and women were most likely to receive an inappropriate SE. More attention should be given to pre-test probability, in particular age and gender, when determining which patients should be referred for stress echocardiography from the ER.
Balloon Dilatation of Porcine Pulmonary Arteries Decreases Endothelium-Dependent Relaxations and Increases Vasoconstriction to Aggregating Platelets
Authors: Susan J. Razzuk, Thomas M. Zellers
Journal: Circulation (1995)

Background Balloon dilatation of muscular coronary arteries disrupts endothelium and smooth muscle and allows platelet aggregation and adherence and cell proliferation, which can lead to restenosis. Balloon dilatation of the more distensible pulmonary artery is commonly performed, but the extent of damage to endothelium and its effect on the release of endothelium-derived nitric oxide (EDNO) and prostacyclin has not been studied. Methods and Results We dilated distal pulmonary arteries of intact ex vivo porcine lungs (n=20; balloon-dilated [BD] group) using similar-sized adjacent vessels as controls with (E+ group) and without (E− group) endothelium. Isolated rings were studied in vitro. Aggregating platelets caused constrictions of quiescent rings from the BD (27.4±8% of constriction to 80 mmol/L KCl) and E− groups (24±5%), which were inhibited by pyrilamine, a histamine blocker (11±4%; P &lt;.05), and an intact endothelium (8±5%; P &lt;.05). Constrictions to histamine and KCl were similar in the BD and E− groups. In rings with increased tone, platelets caused endothelium-dependent relaxations in the E+ group (70±6% relaxation), which were significantly ( P &lt;.05) inhibited in the BD group (20±7%), by l -nitro-arginine (EDNO blocker, 17±7%) and in the E− group (21±9%). Balloon dilatation markedly reduced endothelium-dependent relaxations to 5-hydroxytryptamine, thrombin, acetylcholine, and the calcium ionophore A23187, but relaxations to sodium nitroprusside were unaffected. Conclusions Despite the distensibility of the pulmonary artery, balloon dilatation significantly damages the pulmonary endothelium, decreases EDNO production, impairs vasodilation, and favors platelet-induced vasoconstriction.
Fasting Plus Prandial Insulin Supplements Improve Insulin Secretory Ability in NIDDM Subjects
Authors: Ryuzo Kawamori, Kazuo Bando, Yoshimitsu Yamasaki, Minoru Kubota, Takao Watarai, Norimichi Iwama, Motoaki Shichiri, Takenobu Kamada
Journal: Diabetes Care (1989)

To examine how insulin secretory ability is modified by strict glycemic control in non-insulin-dependent diabetes mellitus (NIDDM) subjects, basal and/or prandial insulin was supplemented for 4 wk in 24 diabetic subjects who were secondary failures to sulfonylurea treatment. One intermediate-acting insulin injection a day (n = 7) failed to suppress the rise in plasma C-peptide after meals and did not improve plasma C-peptide responses during a posttreatment oral glucose challenge. Continuous subcutaneous insulin infusion with a premeal bolus (n = 8) suppressed both fasting and meal-related rises in C-peptide and improved C-peptide response during the posttreatment oral glucose challenge. Daily insulin requirements during the 4 wk of treatment were reduced significantly by 52%. A short-acting insulin injection before each meal (n = 9) without basal supplementation suppressed the prandial rise in C-peptide and was associated with a significant reduction in daily insulin requirements during 4 wk of treatment by 28%. Diabetic subjects whose fasting and prandial hyperglycemia were &amp;lt;140 and &amp;lt;200 mg/dl, respectively, showed a significantly higher C-peptide response during oral glucose challenge after treatment than those whose insulin treatment only normalized (&amp;lt;200 mg/dl) prandial but not basal hyperglycemia (&amp;gt;140 mg/dl). These results suggest that a short-term period of meal-related insulin treatment (which normalized prandial glycemia) increases residual β-cell function in NIDDM subjects who failed long-term sulfonylurea administration. A basal insulin supplement alone was not effective. The effectiveness of a prandial insulin supplement may have been further improved by a combined basal and meal-related treatment program
Transplantation (Handbuch der aligemeinen Pathologie
Authors: Corazon S. Sian
Journal: JAMA (1978)

As with so many multiauthored volumes, this book suffers, in part, from a lack of cohesiveness. Each chapter in general is well written but without apparent regard for what has come before or what is to follow. This is especially true in the first several chapters concerned with the basic aspect of the major histocompatibility system in man and animals. There are repetitive descriptions of transplantation immunogenetics, antigenetic expression of genes, and methods of mixed lymphocyte cultures. The editors, however, have provided an extremely comprehensive and detailed index, so that almost every specific point of any general heading can be found with ease. As stated in the preface, some of the articles included in the book are several years old and contain information that is now of questionable use. The basics of immunogenetics can be found in several recent review articles and less expensive books, and those sections might have
Effects of glibenclamide on ventricular arrhythmias and cardiac function in ischaemia and reperfusion in isolated rat heart
Authors: A. Bril, M.-P. Laville, B. Gout
Journal: Cardiovascular Research (1992)

The aim was to investigate the effects of glibenclamide, a specific blocker of the ATP sensitive potassium channel, on the incidence of ventricular arrhythmias and the functional changes occurring during myocardial ischaemia and reperfusion.Hearts (n = 10 per group) were obtained from male Wistar rats, weight 250-300 g. The study was performed in isolated Langendorff perfused rat hearts subjected to ligation of the left coronary artery and reperfusion. Because of the occurrence of arrhythmias, cardiac function was not evaluated during reperfusion. Glibenclamide (1 or 10 microM) was added to the perfusion solution before the coronary artery occlusion, during ischaemia or after reperfusion. In some experiments the incidence of various durations of ischaemia (5, 10, 15, and 30 min) was evaluated.During the preischaemic period, glibenclamide induced a marked reduction in coronary flow, with a slight decrease in heart rate and left ventricular pressure. The ischaemia induced decrease in left ventricular pressure was markedly attenuated when glibenclamide was given before ischaemia. Thus the isovolumetric left ventricular pressure measured after 15 min ischaemia, which represents 59(SEM 6)% of the preischaemic value in the control group, was increased to 82(9) and 94(8)% in presence of glibenclamide (1 and 10 microM, p < 0.05 respectively). The effect was less pronounced when glibenclamide was added to the perfusion fluid during the ischaemic period. None of the hearts showed ventricular fibrillation during the ischaemic period. Glibenclamide (1 and 10 microM) did not reduce the incidence of reperfusion induced ventricular fibrillation. However, a defibrillatory action was observed since glibenclamide reduced the duration of ventricular fibrillation during reperfusion.Glibenclamide may increase the probability of spontaneous termination of ventricular fibrillation and facilitate the restoration of the myocardial function during regional ischaemia.
TONIC NECK REFLEXES IN TUBERCULOUS MENINGITIS IN CHILDREN
Authors: I. S. WECHSLER
Journal: JAMA (1925)

In a paper read before the American Neurological Association,<sup>1</sup>I discussed the clinical application of the Magnus and de Kleijn tonic neck reflexes in various types of diseases of the nervous system and recorded also a number of cases of tuberculous meningitis. There I suggested that the reflex may possibly have limited clinical value and discussed its pathologic, anatomic and physiologic significance. The literature on the subject was fully referred to. Since then I have had occasion to observe an additional number of cases of tuberculous meningitis. While the total number is still too small to warrant definite conclusions, it seems that the reflex can be elicited sufficiently often to justify looking for it in every case of tuberculous meningitis. As is well known, the Magnus and de Kleijn tonic neck reflex is a physiologic sign elicited in decerebrate animal preparations. In such animals, if the head is turned
Immunohistochemical localization of laminin, type IV and type V collagen in basal cell carcinoma
Authors: D. CAUWENBERGE, G.E. PIERARD, J.M. FOIDART, C.H.M. LAPIERE
Journal: British Journal of Dermatology (1983)

Laminin, type IV and type V collagen were localized in twenty-five basal cell carcinomas (BCCs) by immunofluorescence. All basal cell carcinomas were separated from the connective tissue by a continuous basement membrane (BM) which always contained the three antigenic determinants. Nodular and cystic BCCs, but not pagetoid BCCs, contain linear and globular deposits of these BM components. The linear deposits probably represent BM debris that remains undigested and the globular deposits correspond to residual cytoplasmic fragments occurring during apoptosis. These results suggest that BM components are synthesized by epithelial cells and are secreted to polymerize at the dermo-epidermal junction.
Comprehensive Textbook of Psychiatry/V.
Authors: Harold I. Kaplan, Benjamin J. Sadock, Robert Cancro
Journal: Annals of Internal Medicine (1991)

Neural science neurology contributions of the psychological sciences contributions of the sociocultural sciences quantitative and experimental methods in psychiatry theories of personality and psychopathology - psychoanalysis theories of personality and psychopathology - other psycho-dynamic schools theories of personality and psychopathology - approaches derived from psychology and philosophy diagnosis and psychiatry - examination of the psychiatric patient - clinical manifestations of psychiatric disorders classification of mental disorders organic mental syndromes and disorders psychoactive substance use disorders schizophrenia delusional (paranoid) disorders psychotic disorders not elsewhere classified mood (affective) disorders anxiety disorders (anxiety and phobic neuroses) somatoform disorders (hysterical neuroses, dissociative type) normal human sexuality and sexual disorders factitious disorders adjustment disorder and impulse control disorder psychological factors affecting physical condition (psychosomatic disorders psychiatry and other specialties personality disorders conditions not attributable to a mental disorder emergency psychiatry psychotherapies biological therapies child psychiatry psychiatric examination of the infant, child and adolescent mental retardation pervasive developmental disorders specific developmental disorders of childhood disruptive behaviour disorders anxiety disorders eating disorders tic disorders elimination disorders other disorders of infancy, childhood and adolescence child psychiatry - psychiatric treatment child psychiatry - special areas of interest adulthood geriatric psychiatry community psychiatry graduate psychiatric education forensic psychiatry psychiatry - past and future.
Ethics Consultants' Recommendations for Life-Prolonging Treatment of Patients in a Persistent Vegetative State
Authors: Ellen Fox
Journal: JAMA (1993)

<h3>Objective.</h3> —Surprisingly little is known about the content of ethics consultants' recommendations. We chose to study this issue using hypothetical persistent vegetative state (PVS) cases. We addressed four questions: What recommendations do ethics consultants give regarding life-prolonging treatment (LPT) in PVS cases? To what degree is there consensus? What factors influence recommendations? Do recommendations conform to established guidelines? <h3>Design.</h3> —Questionnaire survey. Our questionnaire asked subjects what they would recommend for seven hypothetical vignettes involving a PVS patient that varied with respect to advance directives and family wishes. We also questioned subjects about demographic characteristics, ethics consultation experience, and personal preference for LPT in PVS. <h3>Subjects.</h3> —Attendees at an annual meeting of the Society for Bioethics Consultation (n=154). <h3>Results.</h3> —The response rate was 77%. Eighty-one percent of respondents were ethics committee members and 62% were ethics consultants. There was general agreement among respondents for only one of seven vignettes: in the case of a PVS patient whose advance directive and family agree that LPT be stopped, 93% recommended stopping all LPT. Responses to other vignettes varied considerably. Although patient wishes were an important factor influencing recommendations, none of the respondents adhered invariably to the patient's advance directive. Recommendations were also influenced by family wishes, resource allocation considerations, legal constraints, and personal preference for LPT in PVS. Guidelines we examined were generally too equivocal to be useful for evaluating ethics consultants' recommendations. <h3>Conclusions.</h3> —The finding of wide variability in ethics consultants' recommendations suggests a need to clarify standards for ethics consultation. (<i>JAMA</i>. 1993;270:2578-2582)
Factors Influencing the Absorption, Serum Insulin Concentration, and Blood Glucose Responses After Injections of Regular Insulin and Various Insulin Mixtures
Authors: J A Galloway, C T Spradlin, R L Nelson, S M Wentworth, J A Davidson, J L Swarner
Journal: Diabetes Care (1981)

Normal fasting subjects received regular insulin and mixtures of regular with NPH or lente to assess the effects of the combinations on serum insulin concentrations (SIC) and blood glucose responses (BGR). In addition, the influence of concentration, depth, and method and site of administration was investigated. In studies of mixtures of regular with NPH and with lente, it was observed that the regular: lente ratio needed to achieve peak SIC was higher than with the regular: NPH combination. Increased SIC, including either the peak and/or the time interval required to achieve the peak, were related to the depth and site (deltoid and abdominal greater than anterior thigh or buttocks). Assuming linear kinetics of absorption, significant quantities of insulin fail to reach the serum. Marked intra- and intersubject variations in SIC and BGR to regular, NPH, and lente insulins were observed.
New government will put politics before policy, but money ahead of both, health expert says
Authors: A. Ferriman
Journal: BMJ (2010)

<b>Aim:</b> to reveal the role of biomarkers in the progression of OILD. <b>Methods:</b> 13 pneumoconiosis (PC), 26 exogenous allergic alveolitis (EAA) and 20 exogenous toxic alveolitis (ETA) patients (mean age 54,8±0,7 yrs, 59,4±2,5 yrs. and 57,1±2,1 yrs. correspondingly) were investigated. Exposition factors in PC were silica (0,7), welding aerosols (0,3) 59,4±2,5, ETA were metals (0,15), irritants (0,15), drugs (0,4), dyes (0,3); in EAA – animals and birds (0,25), dyes (0,4), antibiotics (0,35). The blood levels of CC16, Alveomucin (Alv) and KL6 were detected by ELISA methods. <b>Results:</b> Clinical, CT signs, lung function parameters proved the activity of the disease in EAA-, ETA-patients. The progression/remission of alveolites was observed in 15/12 cases of ETA, in 14/6 cases of EAA correspondingly. The level of Alv, KL6 and CC16 were significant higher in active EAA (p&lt;0,001, &lt;0,002, &lt;0,02) and ETA (p&lt;0,001, &lt;0,005, &lt;0,005) vs PC. In remission significant decrease of Alv level was noted only in EAA (19,22±5,4 ng/ml) vs in ETA remission (39,03±5,01 ng/ml, p&lt;0,02) and in PC (40,89±3,49 ng/ml, p&lt;0,005). CC16 levels decreased in remission of alveolites and were not differs from PC. <b>Conclusion:</b> Alv, KL6 and CC16 may be useful in evaluation of the activity of alveolitis and in differential diagnosis with PC. In alveolitis remission, Alv is more preferable as the marker of fibrosis in PC and ETA. CC16 as injury marker is in value only for the disease activity, but not in PC diagnostics.
Association of Rectal and Urethral Colonization With Urinary Tract Infection in Patients With Indwelling Catheters
Authors: Richard Daifuku
Journal: JAMA (1984)

To assess the role of antecedent rectal and urethral colonization in the pathogenesis of catheter-associated urinary tract infections, we prospectively studied 64 patients, obtaining urine, rectal, and urethral cultures on study entry, two days later, and every four days thereafter. Of 55 patients who remained catheterized for at least three days, urethral colonization with the same microorganism present in bladder urine was observed in the sampling period preceding the onset of bacteriuria in 12 of 18 infections in women and five of 17 in men. Rectal colonization with the infecting strain preceded bacteriuria in 14 of 18 infections in women and five of 17 in men. The identity of the urinary, urethral, and rectal isolates was confirmed by speciation, serotyping, antibiograms, and biotyping. We conclude that rectal and periurethral colonization often precedes catheter-associated bacteriuria, especially in women, and that effective preventive measures aimed at transurethral infection should be developed.
HIV-associated eosinophilic folliculitis: case report and review of the literature
Authors: T. BASARAB, R. RUSSELL JONES
Journal: British Journal of Dermatology (1996)

We report human immunodeficiency virus (HIV)-associated eosinophilic folliculitis in a previously well 40-year-old Portuguese lady. This condition, although similar to Ofuji's disease, has distinguishing features which allow the two to be differentiated. To the best of our knowledge, this is the first reported case of HIV-associated eosinophilic folliculitis in a female and in a patient in whom the HIV was heterosexually transmitted. Our patient is also unusual in being, we believe, only the second reported in whom this eruption was the presenting feature of HIV infection.
Counseling in Marital and Sexual Problems: A Physician's Handbook
Authors: Marjorie C. Meehan
Journal: JAMA (1965)

"Bull" Williams, obstetrics professor of a generation ago, used to say, "One-third of the women I see are pregnant and don't want to be, one-third aren't pregnant and want to be, and the other third don't know what they want." This judgment we may consider too pessimistic but, certainly, a high percentage of patients who consult doctors seek help for marital and sexual problems. The old family doctor, with his wide experience, may give such help wisely. Young physicians, and those with more specialized training, are often ill equipped to counsel in this area. They may depend on personal prejudices or try to refer the patient to a psychiatrist or marriage counselor. But often such referrals are impossible or undesirable. To help these physicians the present book offers practical recommendations. Obstetricians, psychiatrists, psychologists, sociologists, social workers, and a lawyer have contributed clearly written articles on a variety of related topics.
TCT-409 Impact Of Rotational Atherectomy For Heavily Calcificated Unprotected Left Main Disease
Authors: Hiroto Yabushita, Takayuki Warisawa, Hiroyoshi Kawamoto, Yusuke Watanabe, Satoru Mitomo, Takahiro Matsumoto, Yusuke Fujino, Kensuke Takagi, Keiko Fukino, Hisaaki Ishiguro, Satoko Tahara, Naoyuki Kurita, Koji Hozawa, Shotaro Nakamura, Sunao Nakamura
Journal: Journal of the American College of Cardiology (2013)
Quantitative Approach for Incorporating Methylmercury Risks and Omega-3 Fatty Acid Benefits in Developing Species-Specific Fish Consumption Advice
Authors: Gary L. Ginsberg, Brian F. Toal
Journal: Environmental Health Perspectives (2008)

Despite general agreement about the toxicity of methylmercury (MeHg), fish consumption advice remains controversial. Concerns have been raised that negative messages will steer people away from fish and omega-3 fatty acid (FA) benefits. One approach is to provide advice for individual species that highlights beneficial fish while cautioning against riskier fish.Our goal in this study was to develop a method to quantitatively analyze the net risk/benefit of individual fish species based on their MeHg and omega-3 FA content.We identified dose-response relationships for MeHg and omega-3 FA effects on coronary heart disease (CHD) and neurodevelopment. We used the MeHg and omega-3 FA content of 16 commonly consumed species to calculate the net risk/benefit for each species.Estimated omega-3 FA benefits outweigh MeHg risks for some species (e.g., farmed salmon, herring, trout); however, the opposite was true for others (swordfish, shark). Other species were associated with a small net benefit (e.g., flounder, canned light tuna) or a small net risk (e.g., canned white tuna, halibut). These results were used to place fish into one of four meal frequency categories, with the advice tentative because of limitations in the underlying dose-response information. Separate advice appears warranted for the neurodevelopmental risk group versus the cardiovascular risk group because we found a greater net benefit from fish consumption for the cardiovascular risk group.This research illustrates a framework for risk/benefit analysis that can be used to develop categories of consumption advice ranging from "do not eat" to "unlimited," with the caveat that unlimited may need to be tempered for certain fish (e.g., farm-raised salmon) because of other contaminants and end points (e.g., cancer risk). Uncertainties exist in the underlying dose-response relationships, pointing in particular to the need for more research on the adverse effects of MeHg on cardiovascular end points.