tbuckley/cabot-search huggingface dataset:
Low-Density Lipoprotein Triglycerides Associated With Low-Grade Systemic Inflammation, Adhesion Molecules, and Angiographic Coronary Artery Disease
Authors: Winfried März, Hubert Scharnagl, Karl Winkler, Andreas Tiran, Markus Nauck, Bernhard O. Boehm, Bernhard R. Winkelmann
Journal: Circulation (2004)

Markers of systemic inflammation and LDL cholesterol (LDL-C) have been considered independent risk factors of coronary artery disease (CAD). We examined whether alterations of LDL metabolism not reflected by LDL-C were associated with low-grade inflammation, vascular injury, and CAD.We studied 739 subjects with stable angiographic CAD and 570 matched control subjects in which CAD had been ruled out by angiography. The association of LDL triglycerides (LDL-TGs) (odds ratio [OR], 1.30; 95% CI, 1.19 to 1.43; P<0.001) with CAD was stronger than that of LDL-C (OR, 1.10; 95% CI, 1.00 to 1.21; P=0.047). The predictive value of LDL-TG for CAD was independent of LDL-C. "Sensitive" C-reactive protein (CRP), serum amyloid A, fibrinogen, interleukin 6, intercellular adhesion molecule-1 (ICAM-1), and vascular adhesion molecule-1 (VCAM-1) increased in parallel to LDL-TG. CRP, ICAM-1, and VCAM-1 were inversely related to LDL-C. To examine whether LDL-TGs were associated with the distribution of LDL subfractions, we studied 114 individuals with impaired fasting glucose, impaired glucose tolerance, or type 2 diabetes mellitus. In subjects with high LDL-TG, LDLs were depleted of cholesteryl esters (CEs), and VLDLs, IDLs, and dense LDLs were significantly elevated.Alterations of LDL metabolism characterized by high LDL-TG are related to CAD, systemic low-grade inflammation, and vascular damage. High LDL-TGs are indicative of CE-depleted LDL, elevated IDL, and dense LDL. LDL-TG may better reflect the atherogenic potential of LDL than LDL-C.
Causes of Impotence
Authors: Alan J. Cooper
Journal: JAMA (1983)

<h3>To the Editor.—</h3> I was greatly interested in the article entitled "Impotence in Medical Clinical Outpatients," which draws attention to the<i>possibility</i>of an organic cause in a higher proportion of impotent males than is generally believed. Usually, it is asserted that up to 90% of cases are psychogenic (but see reference 1). I use the word<i>possibility</i>deliberately, since the development of a sexual dysfunction in close temporal relationship to a medical illness, although suggestive, does not invariably imply a causal relationship (post hoc, ergo propter hoc). Such would be strengthened if (1) the frequency and turgescence of penile erections during rapid eye movement sleep were found to be significantly diminished<sup>2</sup>and (2) the presumptive cause was treated with the appropriate medical remedy (eg, stopping use of a drug) and potency restored. Neither of these strategies was adopted by Slag et al, although there is a suggestion that
NEW MOVIE MONSTERS
Authors: Lester S. King
Journal: JAMA (1972)

Movies fall into many different categories: historical extravaganzas, mysteries, adaptations of literary classics, slapstick comedy, drawing room (or bedroom) farces, Westerns, the pornies, science fiction, horror stories, gangster films, and many others. For a great many movie goers the horror stories make a particularly strong appeal. There is a vast chasm between the science fiction and the horror films. Even though some of the props may be comparable, with the same kind of complicated apparatus, the same kind of scientist, whether austere or jovial, mad or sane, the physiological effects on the spectator are different. Science fiction movies produce impulses which tend to ripple across the cerebral cortex, skipping lightly from one Brodmann area to another, occasionally burrowing down as deep as the second or third cell layer, and even sending an occasional hit-and-run impulse into the thalamus. But the horror movies set up reverberations through the gut, tie knots
Brain Amyloid and Alzheimer Disease
Authors: Harry V. Vinters
Journal: Annals of Internal Medicine (1988)

Clinicopathologic features of Alzheimer disease, the commonest cause of presenile or senile dementia, are presented. Several of the microscopic brain lesions found in patients with this dementia share the staining properties of amyloid and at least two of these lesions (senile plaque cores and amyloid angiopathy) are biochemically identical. Theories pertinent to the origins of brain amyloid and its role in the pathogenesis of Alzheimer disease are discussed in relation to theories of the cause of this dementia. Possible treatments for Alzheimer disease developed from our knowledge of brain amyloid processing and biochemistry are considered.
Quantitative Coronary Angiographic and Intravascular Ultrasound Assessment of a New Nonarticulated Stent: Report From the Advanced Cardiovascular Systems MultiLink Stent Pilot Study
Authors: Joseph P. Carrozza, James B. Hermiller, Thomas J. Linnemeier, Jeffrey J. Popma, Paul G. Yock, Gary S. Roubin, Larry S. Dean, Richard E. Kuntz, Linda Robertson, Kalon K.L. Ho, Donald E. Cutlip, Donald S. Baim
Journal: Journal of the American College of Cardiology (1998)
The Premonitory Symptoms of Insanity
Authors: H. Sutherland
Journal: BMJ (1886)

When, therefore, you feel compelled to resort to the more sweeping measure of total ablation of the penis, I think the consideration of the patient's condition in the future, should he recover from the operation, should be laid fully before him, should be carefully ex- plained to him beforehand, and, shouldl he determine to submit to the removal of the testes, as well as of the penis, I should not often hesitate to make the operation complete.So long as any portion of the penis is left, this qluestion will never, of course, arise; but, when that organ is completely and entirely removed, it becomes a vory essential part of tho consideration to be placed before the patient.Pray, gentlemen, remembering what I said to you in my last lec- ture on the unwisdom of claiming priority in any surgical proceeding, bear in mind that I claim no precedence as to this; I derived it fromn a German source, and, whilst I find that my own countrymen are nearly as tenaciouis of their claims to priority and inventiveness as is possible, I fear our foreign colleagues are just a little more so.As concerns the next operation to which I desire to draw your atten- tion, I might, I think with safety, be a little more venturesome in this respect, without running any very serious risk; for, without any attempt on my part to claim originality or priority in the metliod of performing perineal section or external urethrotoiliy, as you will see it performed in Leeds, niy colleagues first, and the profession generally afterwards, have done me the honour to call the operation mine, and to assign it a high rank among surgical proceedings.Certainly in our hands it has proved a very successtul one, and, I think I may say without fear of contradliction, has enabled us to find the correct and safe way into the bladder in many cases in which, by any other, it would have been impossiole to do so.I do niot clsim for it anything in the way of originality ; it has been entirely a matter of observation, and is, after all, only an imlprovement on former methodls of operating in certain points, at which, wheni I have either been myself, or have seen others, met by unusual difficulty, I have set myself to think how those difficulties might best be overcome.It happened to me, in my early days, to see so many mishaps in attempting to reach the bladder from the perinaurm without any actual guide, that I resolved, if possible, to find or to invent some better method than the old operation.But perhaps I had better describe that to you first, thel the earliest modifications of it that I saw, and, lastly, iny own operation, as the result of my observations.Given a case of stricture which, by reason of long, continued neg- lect has at last become practically impervious, or, so nearly so that, though a fine catgut or whalebone bougie may sometimes, and at others may not, be capable of being passed through it, the patient's
The Idaho Medical Practice Act.
Authors: M. W. Wood
Journal: JAMA (1898)

Boise Barracks, Idaho, Feb. 8, 1898. <h3>To the Editor:</h3> —The item in theJournalfor January 29, announcing that the supreme court of this State had declared the medical law unconstitutional because it had passed the senate irregularly, is calculated to create a wrong impression among those who should know the facts. The bill was passed regularly, but the journal of the senate, which should have stated "the bill was then read a third time in full by sections and passed," simply stated, "the bill was then read a third time and passed." The constitution of the State was complied with but the journal was incomplete. On this technicality the bill was pronounced unconstitutional. Verily, on what a slight thread hangs the fate of medical legislation, even after as long and stubbornly fought contest as that by which our "dead" law was procured! Very truly yours, Chairman Committee on Legislation
Is HFE involved in increased hepcidin expression and hypoferremia in inflammation and anemia of chronic disease?
Authors: Elizabeth A. Milward, Deborah Trinder, Chantelle E.J. Wilcox, Robert S. Britton, Grant A. Ramm, John K. Olynyk, Hartmut Jaeschke, Kevin Mullen, Darius Moradpour
Journal: Hepatology (2005)

Inflammation influences iron balance in the whole organism. A common clinical manifestation of these changes is anemia of chronic disease (ACD; also called anemia of inflammation). Inflammation reduces duodenal iron absorption and increases macrophage iron retention, resulting in low serum iron concentrations (hyposideremia). Despite the protection hyposideremia provides against proliferating microorganisms, this "iron withholding" reduces the iron available to maturing red blood cells and eventually contributes to the development of anemia. Hepcidin antimicrobial peptide (Hamp) is a hepatic defensin-like peptide hormone that inhibits duodenal iron absorption and macrophage iron release. Hamp is part of the type II acute phase response and is thought to have a crucial regulatory role in sequestering iron in the context of ACD. Mice with deficiencies in the hemochromatosis gene product, Hfe, mounted a general inflammatory response after injection of lipopolysaccharide but lacked appropriate Hamp expression and did not develop hyposideremia. These data suggest a previously unidentified role for Hfe in innate immunity and ACD.
What do implantable cardioverter/defibrillators teach us about the mechanisms of sudden cardiac death?
Authors: G Grönefeld
Journal: Cardiovascular Research (2001)

Almost two decades of experience with the ICD have resulted in a better understanding of the nature of life-threatening ventricular tachyarrhythmias. The most pertinent achievements in this respect stem from clinical follow-up observations in patients with important clinical entities such as dilated cardiomyopathy or the Brugada syndrome. For instance, patients with dilated cardiomyopathy presenting with syncope and a negative electrophysiological study have been shown to have a high incidence of appropriate usage of their ICD. On the other hand, relative little has been gained from the extensive electrogram storage capabilities of third and fourth generation ICDs. Basically, careful evaluation of these electrograms has confirmed previous anecdotal data obtained from analysis of Holter recordings of patients who died suddenly while wearing the ECG recorder. In most instances, VT/VF episodes are triggered by relatively late-coupled premature beats whereas short—long–short sequences have been observed only in few patients. One future research avenue concerns the more detailed analysis of changes in cardiac autonomic tone preceding the occurrence of sustained ventricular tachyarrhythmias which can be assessed from the electrogram storage of the ICD.
Atypical Pathogen Infection in Adults with Acute Exacerbation of Bronchial Asthma
Authors: David Lieberman, Devora Lieberman, Shmuel Printz, Miriam Ben-Yaakov, Zilia Lazarovich, Bella Ohana, Maureen G. Friedman, Bella Dvoskin, Maija Leinonen, Ida Boldur
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

In a serologically based prospective study, acute infections with four atypical pathogens were determined in 100 adults hospitalized for acute exacerbation of bronchial asthma, and compared with the corresponding rate in a matched control group. Paired sera were tested using immunofluorescence or enzyme immunoassay methods to establish the serologic diagnosis. In 18 patients (18%), there was evidence of acute infection with Mycoplasma pneumoniae, compared with 3% in the control group (p = 0.0006). In 10 of these patients there was evidence of infection with at least one additional pathogen, a respiratory virus in 7. There was no significant difference between the study groups in the rates of acute infection by Chlamydia pneumoniae (8% in the hospitalized patients versus 6% in the control subjects), Legionella spp. (5 versus 3%, respectively), or Coxiella burnettii (no patients in either group). We conclude that of these four atypical pathogens, only infection with M. pneumoniae is associated with hospitalization for acute exacerbation of bronchial asthma. In most of these M. pneumoniae patients there is evidence of infection with a respiratory virus as well. The pathophysiologic and therapeutic significance of these findings should be tested in further studies specifically designed to address these questions.
Spectral energy of the first heart sound in acute myocardial ischemia. A correlation with electrocardiographic, hemodynamic, and wall motion abnormalities.
Authors: W B Clarke, S M Austin, P M Shah, P M Griffin, J T Dove, J McCullough, B F Schreiner
Journal: Circulation (1978)

First heart sound (S1) energy spectra in isovolumic systole, hemodynamics, and angiographic left ventricular wall motion (LVWM) at rest and with atrial pacing were compared in 27 patients who underwent diagnostic cardiac catheterization and angiography because of chest pain. Eighteen patients were found to have coronary artery disease (CAD) and nine patients, normal coronary arteries. Eleven of the 18 CAD patients (61%) had a mean reduction in the spectral energy of S1 of 6.5 +/- 1.4 (SEM) dB below control (-52%), during interruption of ischemic stress of rapid atrial pacing, compared to only one of nine patients without CAD (P less than 0.05). Only five CAD patients (28%) had an abnormal rise (greater than or equal to 5 mm) in left ventricular end-diastolic pressure (LVEDP) either during or upon interruption of pacing, and six (33%) had ischemic ST-segment depression greater than or equal to mv in the ECG. Similarly two patients free of CAD (22%) had an abnormal increase in LVEDP, and none had ECG evidence of ischemia. Seventeen CAD patients (94%) had segmental LVWM abnormalities at rest or with interruption of pacing, while three patients with normal coronary arteries (33%) had abnormal angiographic LVWM (P less than 0.01). Thus, reduction is S1 spectral energy is a common accompaniment of myocardial ischemia. In the present study, it was more frequently observed than abnormalities in either the ECG or LVEDP, but was not was consistently seen as segmental left ventricular wall motion abnormalities.
Abstract 14569: Descriptive Analysis of the Evolution of Fetal Hemodynamics from 6 - 30 Weeks
Authors: Lisa Howley, Priya Sekar, Yuka Yamamoto, Venu Jain, Jean Trines, Winnie Savard, Lisa K Hornberger
Journal: Circulation (2010)

Background: The complex hemodynamic changes that occur in the early developing human fetus remain ill-defined. We prospectively studied Doppler indices of fetal heart function in 124 consecutively ...
An Unusual Orbital Localization of Wegener Granulomatosis Detected by 18F-FDG PET/CT
Authors: Francesco Bertagna, Giorgio Treglia, Pierluigi Rossini, Raffaele Giubbini
Journal: Clinical Nuclear Medicine (2013)

We report a case of a 61-year-old male patient affected by Wegener granulomatosis and left exophthalmos who underwent F-FDG PET/CT during follow-up for rectal cancer. The study was negative for secondary lesions but revealed high uptake at the left orbital mass consistent with Wegener granulomatosis.
The Role of Exercise Testing in Screening for Coronary Artery Disease
Authors: Harold C. Sox
Journal: Annals of Internal Medicine (1989)

Purpose: To predict the effects of using exercise testing to screen healthy persons for coronary artery disease. Data Identification: The publications of the Coronary Artery Surgery Study were the principal sources of data for the cost-effectiveness analysis; we also used data from the Veterans Administration Cooperative Study of stable angina and the publications of the European Coronary Surgery Study Group. Study Selection: We used studies that provided the data that our decision model required—life expectancy and probabilities of outcomes in persons who have or do not have coronary artery disease. Data Extraction: We did not use a structured method for abstracting data. We tested the susceptibility of our conclusions to poor quality of data by substituting a wide range of values for a variable in the decision model, and by calculating life expectancy and costs if screening was used routinely or not used. Results of Data Synthesis: We assumed that persons with an abnormal exercise test would have arteriography and that persons with severe coronary artery disease would have by-pass surgery. When there were no suitable published data for the model, we made assumptions that favored screening. The model predicts that screening would increase the life expectancy of 60-year-old men at average risk by at most 12 days. Sixty-year-old men with no risk factors for coronary artery disease would derive less benefit, as would women and younger men. Conclusions: The effect of exercise testing is too small to justify doing this procedure routinely in healthy persons. If coronary bypass surgery is found to prolong life in asymptomatic persons as much as it does in angina pectoris, screening older men with risk factors for coronary artery disease may prove to be worthwhile.
Optimal dosage of ribavirin
Authors: Alessandra Mangia, Angelo Andriulli
Journal: Hepatology (2010)

We read with interest the article by Diago et al.,1 who attempted to identify factors predictive of sustained virological response (SVR) in patients with hepatitis C virus genotype 2 or 3 who were treated for only 16 weeks with peginterferon alfa-2a and flat doses of ribavirin. After a 5-year-long debate about the value of abbreviated antiviral therapy for naive patients infected with hepatitis C virus genotype 2 or 3, a general agreement seems to have been reached. An abbreviated regimen may be an option in patients with rapid virological response (RVR), lower body weight, and an absence of advanced fibrosis. This proposal, which was originally based on our data,2 has found successive support in the trial by Dalgard et al.3 and recently in repetitive analyses of results generated by the ACCELERATE study.4 What remains to be further stressed is the optimal dosage of ribavirin to be administered when short-term therapy is being contemplated. In two studies, a flat dose of 800 mg daily was administered, and the highest difference in SVR rates between patients treated for a short duration and patients treated for the standard duration was reported.3, 5 On the contrary, when higher doses were given (1000-1200 mg daily), this difference was not significant or was barely significant.1, 2 In Diago et al.'s reanalysis,1 only patients with RVR were considered, and the authors found body weight to be inversely related to either the SVR or the relapse rate. Indeed, among patients with low body weights (<65 kg) who were assigned to 16 or 24 weeks of treatment, SVR rates were 89% and 93%, respectively, and the respective relapse rates were 7% and 3%. The resulting differences were not significant, and this implies that when the ribavirin dosage (mg/kg of body weight) is given at a higher dosage than that conventionally suggested, short-term therapy is as effective as therapy of the standard duration. As a matter of fact, in the subset of patients with high body weights (>65 kg), the administration of 800 mg of ribavirin would not be enough to protect them from lower SVR rates and higher relapse rates. We have recently stressed the relevance of administering adequate doses of ribavirin (>15.2 mg/kg of body weight) when a short treatment duration is being considered for genotype 2 and 3–infected patients without advanced fibrosis/cirrhosis who achieve RVR,6 and the data presented by Diago et al. reinforce our original findings. Consequently, determining the ribavirin dosage by body weight is the first step in further consideration of predictors of SVR. This point has not been addressed in the reanalysis of the ACCELERATE study presented by Diago et al.,1 who have evaluated only the impact of ribavirin exposure on SVR rates. Alessandra Mangia M.D.*, Angelo Andriulli M.D. , * Liver Unit, Ospedale Casa Sollievo della Sofferenza San Giovanni Rotondo, Italy, Gastroenterology, Ospedale Casa Sollievo della Sofferenza San Giovanni Rotondo, Italy.
Sensitivity and Specificity of the History and Physical Examination for Coronary Artery Disease
Authors: Linda K. Shaw
Journal: Annals of Internal Medicine (1994)

Letters15 February 1994Sensitivity and Specificity of the History and Physical Examination for Coronary Artery DiseaseLinda K. Shaw, AB and David B. Pryor, MDLinda K. Shaw, ABDuke University Medical Center; Durham, ND 27710Search for more papers by this author and David B. Pryor, MDDuke University Medical Center; Durham, ND 27710Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-4-199402150-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate the thoughtful comments of Dr. Evans regarding the potential for evaluation bias. Indeed, the predicted probabilities of significant, severe, and left main disease for patients who had cardiac catheterization were 0.68, 0.28, and 0.06, respectively, compared with 0.47, 0.18, and 0.04, respectively, in patients not referred for cardiac catheterization. As expected, patients unlikely to have these outcomes were not referred as often for diagnostic cardiac catheterization.Dr. Evans requested that we recalculate the sensitivity and specificity using the Bayesian approach to correct for the verification bias [1, 2]. Figure 1 shows the receiver operating curves for ...References1. Begg CB. Biases in the assessment of diagnostic tests. Stat Med. 1987; 6:411-23. Google Scholar2. Greenes RA, Begg CB. Assessment of diagnostic technologies: methodology for unbiased estimation from samples of selectively verified patients. Invest Radiol. 1985; 20:751-6. Google Scholar3. Pryor DB, Shaw L, McCants CB, Lee KL, Mark DB, Harrell FE Jr, et al. Value of the history and physical in identifying patients at increased risk for coronary artery disease. Ann Intern Med. 1993; 118:81-90. Google Scholar4. Pryor DB, Lee KL. Methods for the analysis and assessment of clinical databases: the clinician's perspective. Stat Med. 1991; 10:617-28. Google Scholar5. Gray D, Hampton JR, Shaw LK, Bernstein SJ, Pryor DB. Successful international application of a predictive model of coronary disease (Abstract). Circulation. 1992; 86:I-41. Google Scholar Author, Article, and Disclosure InformationAuthors: Linda K. Shaw, AB; David B. Pryor, MDAffiliations: Duke University Medical Center; Durham, ND 27710 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byProbability and the Principles of Diagnostic Certainty in Medical Imaging 15 February 1994Volume 120, Issue 4Page: 344-345KeywordsBayesian methodCatheterizationHeart diseasesOutpatientsPopulation statisticsPrimary careSpecificityStable coronary artery disease ePublished: 15 August 2000 Issue Published: 15 February 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...