tbuckley/cabot-search huggingface dataset:
Racial Differences in the Use of Revascularization Procedures After Coronary Angiography
Authors: John Z. Ayanian
Journal: JAMA (1993)

To assess whether rates of coronary revascularization procedures differ between blacks and whites after coronary angiography is performed and to assess the relationship of these rates to hospital characteristics.A retrospective cohort study using 1987 and 1988 data on hospital claims and characteristics from the Health Care Financing Administration.One thousand four hundred twenty-nine acute care hospitals that provide coronary angiography in the United States.A national sample of 27,485 Medicare Part A enrollees, aged 65 to 74 years, who underwent inpatient angiography for coronary heart disease in 1987.The adjusted odds of revascularization with either coronary angioplasty or bypass graft surgery within 90 days of angiography for whites relative to blacks, controlling for age, sex, region, Medicaid eligibility, principal diagnosis, comorbid diagnoses, and hospital characteristics of ownership, teaching status, urban/suburban or rural location, and availability of revascularization procedures.White men and women were significantly more likely than black men and women, respectively, to receive a revascularization procedure after coronary angiography (57% and 50% vs 40% and 34%, both P < .001). The adjusted odds of receiving a revascularization procedure after coronary angiography were 78% higher for whites than blacks (95% confidence interval for odds ratio, 1.56 to 2.03). Statistically significant racial differences in the adjusted odds of receiving a revascularization procedure were present in all types of hospitals except rural hospitals, and these differences did not vary significantly by any of the four hospital characteristics (all P > .20 for interaction terms).Among Medicare enrollees, whites are more likely than blacks to receive revascularization procedures after coronary angiography. Racial differences of similar magnitude occur in all types of hospitals. These differences may reflect overuse in whites or underuse in blacks, but they are unlikely to reflect access to cardiologists or hospitals that perform revascularization procedures. Potential explanations include unmeasured clinical or socioeconomic factors, differing patient preferences, and racial bias at the hospitals performing angiography.
Special Problems in Treating Tuberculosis
Authors: James R. Johnson
Journal: Annals of Internal Medicine (1994)

Letters1 March 1994Special Problems in Treating TuberculosisJames R. Johnson, MDJames R. Johnson, MDUniversity of Minnesota Medical School; Minneapolis, MD 55455Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-5-199403010-00027 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In the study by Strang and colleagues [1], cited by Barnes and Barrows in their excellent review [2], it is true that the lower frequency of death due to tuberculous pericarditis among patients treated with prednisolone did not differ significantly from that in the control group (2 of 53 patients [4%] compared with 7 of 61 patients [11%]). However, in a subsequent larger study by Strang and associates [3], a lower pericarditis death rate was noted among patients who received prednisolone (2 of 76 patients [3%] compared with 10 of 74 patients [14%]) (P < 0.05). Taken ...References1. Strang JI, Gibson DG, Nunn AJ, Kakaza HH, Girling DJ, Fox W. Controlled trial of prednisolone as adjuvant in treatment of tuberculous consitictive pericarditis in Transkei. Lancet. 1987; 2:1418-22. Google Scholar2. Barnes PF, Barrows SA. Tuberculosis in the 1990s. Ann Intern Med. 1993; 119:400-10. Google Scholar3. Strang JI, Gibson DG, Mitchison DA, Girling DJ, Kakaza HH, Allen BW, et al. Controlled clinical trial of complete open surgical drainage and of prednisolone in treatment of tuberculous pericardial effusion in Transkei. Lancet. 1988; 2:759-64. Google Scholar Author, Article, and Disclosure InformationAuthors: James R. Johnson, MDAffiliations: University of Minnesota Medical School; Minneapolis, MD 55455 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 March 1994Volume 120, Issue 5 Page: 440-441 Keywords Corticosteroid therapy Death rates Randomized trials Signs and symptoms Tuberculosis ePublished: 15 August 2000 Issue Published: 1 March 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Standard for Breast Conservation Therapy in the Management of Invasive Breast Carcinoma
Authors: M. Morrow, E. A. Strom, L. W. Bassett, D. D. Dershaw, B. Fowble, A. Giuliano, J. R. Harris, F. O'Malley, S. J. Schnitt, S. E. Singletary, D. P. Winchester
Journal: CA A Cancer Journal for Clinicians (2002)

Multidisciplinary guidelines for management of invasive breast carcinoma from the American College of Radiology, the American College of Surgeons, the College of American Pathology, and the Society of Surgical Oncology have been updated to reflect the continuing advances in the diagnosis and treatment of invasive breast cancer. The guidelines provide a framework for clinical decision-making for patients with invasive breast carcinoma based on review of relevant literature and include information on patient selection and evaluation, technical aspects of surgical treatment, techniques of irradiation, and follow-up care.
Genetic Identification by a Drug-Induced Flush
Authors: Samuel Vaisrub
Journal: JAMA (1979)

Thirty years ago when the Japanese otolaryngologist Takahara suspected a genetic enzyme deficiency in a child whose blood from a bleeding mouth wound turned black on contact with hydrogen peroxide, he unwittingly sired pharmacogenetics, the science of interactions between genetic makeup and drugs. Many other genetic traits that are recognizable by idiosyncratic responses to drugs have come to light since Takahara's accidental observation in his acatalasic patient. Notable among these is the discovery of glucose-6-phosphate dehydrogenase deficiency among patients in whom hemolytic anemia is induced by primaquine phosphate, nitrofurantoin, phenacetin, probenecid, and other drugs. Pharmacogenetics has two main applications. It alerts physicians to the danger of administering certain drugs to patients with genetically determined specific drug sensitivities. Equally important, it helps unveil unsuspected genetic traits, thus serving both as a diagnostic probe and as a key to a genetic marker. A recent addition to pharmacologically identifiable genetic traits is the
Endocrine-Disrupting Chemicals and Climate Change: A Worst-Case Combination for Arctic Marine Mammals and Seabirds?
Authors: Bjørn Munro Jenssen
Journal: Environmental Health Perspectives (2005)

The effects of global change on biodiversity and ecosystem functioning encompass multiple complex dynamic processes. Climate change and exposure to endocrine-disrupting chemicals (EDCs) are currently regarded as two of the most serious anthropogenic threats to biodiversity and ecosystems. We should, therefore, be especially concerned about the possible effects of EDCs on the ability of Arctic marine mammals and seabirds to adapt to environmental alterations caused by climate change. Relationships between various organochlorine compounds, necessary such as polychlorinated biphenyls, dichlorophenyldichloroethylene, hexachlorobenzene, and oxychlordane, and hormones in Arctic mammals and seabirds imply that these chemicals pose a threat to endocrine systems of these animals. The most pronounced relationships have been reported with the thyroid hormone system, but effects are also seen in sex steroid hormones and cortisol. Even though behavioral and morphological effects of persistent organic pollutants are consistent with endocrine disruption, no direct evidence exists for such relationships. Because different endocrine systems are important for enabling animals to respond adequately to environmental stress, EDCs may interfere with adaptations to increased stress situations. Such interacting effects are likely related to adaptive responses regulated by the thyroid, sex steroid, and glucocorticosteroid systems.
Fibrinogen and lipid concentrations as risk factors for transient ischaemic attacks and minor ischaemic strokes.
Authors: N Qizilbash, L Jones, C Warlow, J Mann
Journal: BMJ (1991)

OBJECTIVES--To determine whether fibrinogen and lipid concentrations are risk factors for ischaemic stroke. DESIGN--Case-control study with a population based comparison within the overall study. SETTING--Oxfordshire community stroke project and a neurology clinic. SUBJECTS--105 patients who had a transient ischaemic attack or minor ischaemic stroke and 352 randomly chosen controls matched for age and sex from the same general practitioners as the incident cases. 52 controls were ineligible or refused interview. 104 cases and 241 controls gave blood samples for analysis. MAIN OUTCOME MEASURES--Response to structured questionnaire, height, weight, blood pressure, and serum concentrations of fibrinogen and lipids. RESULTS--Adjusted for other variables, odds ratios of ischaemic stroke were 1.78 (95% confidence interval 0.91 to 3.48; p = 0.09) [corrected] for fibrinogen concentrations greater than 3.6 g/l; 1.73 (0.90 to 3.29; p = 0.09) [corrected] for total cholesterol concentrations greater than 6.0 mmol/l; 1.34 (0.69 to 2.61; p greater than 0.4) for low density lipoprotein cholesterol concentrations greater than 3.5 mmol/l; and 0.32 (0.15 to 0.69; p = 0.002) for high density lipoprotein cholesterol concentration greater than 1.2 mmol/l. Similar results emerged comparing only community derived cases with transient ischaemic attacks and controls. The effects of fibrinogen, total cholesterol, and high density lipoprotein cholesterol were significant in a test of trend after adjusting for all other variables in the study (chi 2 = 4.14, p less than 0.05; chi 2 = 4.31, p less than 0.05, and chi 2 = 12.15, p greater than 0.001, respectively). History of ischaemic heart disease and hypertension were the only other variables that showed significance, though both lost significance after adjustment (2.06, p = 0.08 and 1.53, p = 0.2, respectively). CONCLUSIONS--Fibrinogen and lipids are important risk factors for ischaemic stroke. The pattern of changes mirrors that found in ischaemic heart disease.
Human cytomegalovirus increases modified low density lipoprotein uptake and scavenger receptor mRNA expression in vascular smooth muscle cells.
Authors: Y F Zhou, E Guetta, Z X Yu, T Finkel, S E Epstein
Journal: Journal of Clinical Investigation (1996)

Evidence suggests a possible role for human cytomegalovirus (HCMV) in the development of arteriosclerosis. One of the earliest events in plaque formation is the accumulation of lipid-laden foam cells, derived from macrophages and smooth muscle cells (SMCs). The lipid accumulation that occurs depends upon the uptake of oxidized LDL (Ox-LDL), a process in which the scavenger receptor (SR) has been postulated to play an important role. We therefore examined the effects of HCMV on this process. We demonstrate that HCMV infection of human SMCs increases modified LDL uptake and stimulates class A SR gene (SR-A) mRNA expression. In addition, infection of rat SMCs with HCMV, which causes immediate early gene expression (IE72/IE84), but no early or late HCMV gene products and no cytopathic effects, also increases SMC uptake of Ox-LDL and acetylated LDL, with either effect blocked by an excess of either cold Ox-LDL or acetylated-LDL, and by fucoidin, an SR competitor. Cotransfection of an IE72, but not an IE84, expression plasmid and a plasmid containing a Class A SR promoter/reporter gene construct enhances SR promoter activity. Since increased Ox-LDL uptake is believed to play an important role in arteriosclerosis, these results provide a link between HCMV infection and arteriosclerotic plaque formation.
Adenoma without Dysplasia: What Does It Mean?
Authors: J. Orlowska, W. Zych
Journal: Endoscopy (2002)

We read with great interest and surprise the article by Kiesslich et al. [1] on the results of chromoendoscopy with indigo carmine in improving the detection of adenomatous and nonadenomatous lesions in the colon. The authors describe a method of detecting very small lesions using vital staining with indigo carmine dye, which reveals multiple mucosal lesions that are not identified on routine video endoscopy. They used the classification by Kudo et al. [2] for pit patterns seen after staining with the above method, and validated its usefulness for differentiating between hyperplastic and adenomatous lesions.
70 year old man with scrotal swelling, abdominal aortic aneurysm, and renal lesions: case outcome
Authors: Saroj Kumar Das, Devdatta Sarwate, J K Mordani, K J Ng, Mark Nel
Journal: BMJ (2006)

Last week (15 April, BMJ 2006;332: 899), we presented the case of Mr Mahon, who presented with scrotal swelling. He had had ultrasonography that showed an abdominal aortic aneurysm and renal lesions. Computed tomography showed a renal tumour and an abdominal aortic aneurysm. As there was no tumour extension into the left renal vein or evidence of obstruction to the gonadal vein, the varicocele was probably coincidental. The cost effectiveness of routine ultrasonography in …
Acid-base Balance in Acute Gastrointestinal Bleeding
Authors: T. C. Northfield, B. J. Kirby, A. E. Tattersfield
Journal: BMJ (1971)

Acid-base balance has been studied in 21 patients with acute upper gastrointestinal bleeding. A low plasma bicarbonate concentration was found in nine patients, accompanied in each case by a base deficit of more than 3 mEq/litre, indicating a metabolic acidosis. Three patients had a low blood pH. Hyperlactataemia appeared to be a major cause of the acidosis. This was not accompanied by a raised blood pyruvate concentration. The hyperlactataemia could not be accounted for on the basis of hyperventilation, intravenous infusion of dextrose, or arterial hypoxaemia. Before blood transfusion it was most pronounced in patients who were clinically shocked, suggesting that it may have resulted from poor tissue perfusion and anaerobic glycolysis. Blood transfusion resulted in a rise in lactate concentration in seven patients who were not clinically shocked, and failed to reverse a severe uncompensated acidosis in a patient who was clinically shocked. These effects of blood transfusion are probably due to the fact that red blood cells in stored bank blood, with added acid-citrate-dextrose solution, metabolize the dextrose anaerobically to lactic acid. Monitoring of acid-base balance is recommended in patients with acute gastrointestinal bleeding who are clinically shocked. A metabolic acidosis can then be corrected with intravenous sodium bicarbonate.
Low Cardiorespiratory Fitness and Physical Inactivity as Predictors of Mortality in Men with Type 2 Diabetes
Authors: Ming Wei, Larry W. Gibbons, James B. Kampert, Milton Z. Nichaman, Steven N. Blair
Journal: Annals of Internal Medicine (2000)

Background: Although physical activity is recommended as a basic treatment for patients with diabetes, its long-term association with mortality in these patients is unknown. Objective: To evaluate the association of low cardiorespiratory fitness and physical inactivity with mortality in men with type 2 diabetes. Design: Prospective cohort study. Setting: Preventive medicine clinic. Patients: 1263 men (50 ± 10 years of age) with type 2 diabetes who received a thorough medical examination between 1970 and 1993 and were followed for mortality up to 31 December 1994. Measurements: Cardiorespiratory fitness measured by a maximal exercise test, self-reported physical inactivity at baseline, and subsequent death determined by using the National Death Index. Results: During an average follow-up of 12 years, 180 patients died. After adjustment for age, baseline cardiovascular disease, fasting plasma glucose level, high cholesterol level, overweight, current smoking, high blood pressure, and parental history of cardiovascular disease, men in the low-fitness group had an adjusted risk for all-cause mortality of 2.1 (95% CI, 1.5 to 2.9) compared with fit men. Men who reported being physically inactive had an adjusted risk for mortality that was 1.7-fold (CI, 1.2-fold to 2.3-fold) higher than that in men who reported being physically active. Conclusions: Low cardiorespiratory fitness and physical inactivity are independent predictors of all-cause mortality in men with type 2 diabetes. Physicians should encourage patients with type 2 diabetes to participate in regular physical activity and improve cardiorespiratory fitness.
Bilateral clicking ribs.
Authors: W Parry, I Breckenridge, Y F Khalil
Journal: Thorax (1989)

Congenital abnormalities of the ribs, including slipping or clicking rib, are well recognised but rarely give rise to symptoms. Slipping rib has previously been described as a unilateral condition. We report an unusual case of symptomatic bilateral slipping ribs treated successfully by surgery.
Microtubule-associated protein 1 light chain 3 is a fibronectin mRNA-binding protein linked to mRNA translation in lamb vascular smooth muscle cells.
Authors: B Zhou, N Boudreau, C Coulber, J Hammarback, M Rabinovitch
Journal: Journal of Clinical Investigation (1997)

Intimal cushions form in the fetal ductus arteriosus by fibronectin-dependent smooth muscle cell migration which is associated with greater efficiency of fibronectin mRNA translation. We investigated whether the AU-rich element (ARE), UUAUUUAU, in the 3'-untranslated region (3'UTR) of fibronectin mRNA is involved in this mechanism by transfecting smooth muscle cells with plasmids containing the chloramphenicol acetyltransferase coding region with its 3'UTR replaced by fibronectin 3'UTR bearing intact or mutated ARE. More efficient translation of fusion mRNA with intact versus mutated ARE was observed. This effect was amplified in ductus (10.9-fold) compared with nonmigratory, lower fibronectin-producing aorta cells (6.5-fold). Ductus cells transfected with wild-type but not ARE-mutated plasmid reverted to the stellate phenotype of aorta cells associated with reduced fibronectin production. This suggested that plasmid ARE sequesters RNA-binding factors, thereby reducing endogenous fibronectin mRNA translation. We next purified a 15-kD fibronectin ARE-dependent RNA-binding protein and identified it as microtubule-associated protein 1 light chain 3 (LC3). LC3 is present in greater amounts in ductus compared with aorta cells, and overexpression of LC3 in aortic cells by transfection enhances fibronectin mRNA translation to levels observed in ductus cells.
Thumbing Noses at Prognoses
Authors: Samuel Vaisrub
Journal: JAMA (1974)

In an all-out attack on the despoilers of the American language, the 1970 Pulitzer Prize winner for literature Jeanne Stafford makes the following statement:<sup>1</sup> The prognosis for the ailing language is not good... I fear that it will be assailed by countless cerebral accidents and massive strokes and gross insults to the brain and finally will no longer be able to sit up in bed and take nourishment by mouth. Clearly, cerebral accidents, asthenia, and malnutrition are medical problems—indeed they call for the creation of a new specialty. Can doctors help the ailing language? It may be comforting to know they have done so already in one instance. The familiar "Winston tastes good like a cigarette should" with its follow-up "What do you want, good grammar or good taste?"—a combination, that Miss Stafford finds singularly distasteful, even sadistic [<i>sic!</i>], because it equates taste as flavor with taste as discernment—have
Quantitatively Assessed Spontaneous Echo Contrast Density Predicts Left Atrial Thrombus Formation in Patients with Rheumatismal Mitral Stenosis: An Integrated Backscatter Analysis Study
Authors: Osman Turak, Fırat Özcan, Ahmet İşleyen, Mehmet A Mendi, Fatih Öksüz, Uğur Canpolat, Fatma N Başar, Kumral Çağlı, Zehra Gölbaşı, Sinan Aydoğdu
Journal: Journal of the American College of Cardiology (2013)
Clinical medical officers in a child health service.
Authors: P M Lambert
Journal: BMJ (1979)

SIR,-Perhaps I am unwise to enter the debate on clinical medical officers and their future contribution to child health services (27 January, p 242).Specialists in community medicine (child health) like myself may be too close to the scene of action to be objective.Also we are probably thought to have vested interests in the status quo.Approaching retirement encourages an independence which others may find difficult.Sometimes one even hopes that what has been learnt by hard experience may have some continuing influ- ence after one's departure.
Overexpression of nucleolin in chronic lymphocytic leukemia cells induces stabilization of bcl2 mRNA
Authors: Yoko Otake, Sridharan Soundararajan, Tapas K. Sengupta, Ebenezer A. Kio, James C. Smith, Mauricio Pineda-Roman, Robert K. Stuart, Eleanor K. Spicer, Daniel J. Fernandes
Journal: Blood (2006)
MR-02 * A GENOME-WIDE miRNA SCREEN REVEALED MIR-603 AS A MGMT-REGULATING miRNA IN GLIOBLASTOMAS
Authors: D. Kushwaha, V. Ramakrishnan, K. Ng, T. Steed, T. Nguyen, D. Futalan, J. Akers, J. Tao, D. Chowdhury, B. Carter, C. Chen
Journal: Neuro-Oncology (2014)

MGMT expression is a critical determinant for therapeutic resistance to DNA alkylating agents. We previously demonstrated that MGMT expression is post-transcriptionally regulated by miR-181d and other miRNAs. Here, we performed a genome-wide screen to identify MGMT regulating miRNAs. Candidate miRNAs were further tested for inverse correlation with MGMT expression in clinical specimens. We identified 15 candidate miRNAs. Comparison of these candidates to those predicted computational algorithms, including DIANA micro, Targetscan, miRanda, and microcosm showed poor agreement (3-22%), suggesting the need for empiric validation of in silico predictions. Transfection of miR-603, the top scoring candidate, suppressed MGMT mRNA/protein expression in vitro and in vivo; this effect was reversed by transfection with antimiR-603. miR-603 affinity-precipitated with MGMT mRNA and suppressed luciferase activity in an MGMT-3'UTR-luciferase assay, suggesting direct interaction between miR-603 and MGMT 3'UTR. miR-603 transfection enhanced the temozolomide (TMZ) sensitivity of MGMT-expressing glioblastoma cell lines. Importantly, miR-603 mediated MGMT suppression and TMZ resistance were reversed by expression of an MGMT cDNA. miR-603 cooperates with miR-181d to bind to the 3'UTR of MGMT to suppress MGMT expression. In a collection of 74 clinical glioblastoma specimens, both miR-603 and miR-181d levels inversely correlated with MGMT expression. However, a combined index of the two miRNAs better reflected MGMT expression than each individually. These results suggest that MGMT is co-regulated by independent miRNAs. Our results further suggest that these miRNA may regulate MGMT by direct binding of MGMT 3'UTR or through modulation of proteins that regulate MGMT stability/degradation. Characterization of these miRNAs should contribute toward strategies for enhancing the efficacy of DNA alkylating agents.