tbuckley/cabot-search huggingface dataset:
Clinical Value of Acute Rest Technetium-99m Tetrofosmin Tomographic Myocardial Perfusion Imaging in Patients With Acute Chest Pain and Nondiagnostic Electrocardiograms
Authors: Gary V Heller, Stephen A Stowers, Robert C Hendel, Steven D Herman, Edouard Daher, Alan W Ahlberg, Jack M Baron, Carlos F Mendes de Leon, John A Rizzo, Frans J.Th Wackers
Journal: Journal of the American College of Cardiology (1998)

Objectives. We sought to evaluate the clinical use and cost-analysis of acute rest technetium-99m (Tc-99m) tetrofosmin single-photon emission computed tomographic (SPECT) myocardial perfusion imaging in patients with chest pain and a normal electrocardiogram (ECG). Background. Current approaches used in emergency departments (EDs) for treating patients presenting with chest pain and a nondiagnostic ECG result in poor resource utilization. Methods. Three hundred fifty-seven patients presenting to six centers with symptoms suggestive of myocardial ischemia and a nondiagnostic ECG underwent Tc-99m tetrofosmin SPECT during or within 6 h of symptoms. Follow-up evaluation was performed during the hospital period and 30 days after discharge. All entry ECGs, SPECT images and cardiac events were reviewed in blinded manner and were not available to the admitting physicians. Results. By consensus interpretation, 204 images (57%) were normal, and 153 were abnormal (43%). Of 20 patients (6%) with an acute myocardial infarction (MI) during the hospital period, 18 had abnormal images (sensitivity 90%), whereas only 2 had normal images (negative predictive value 99%). Multiple logistic regression analysis demonstrated abnormal SPECT imaging to be the best predictor of MI and significantly better than clinical data. Using a normal SPECT image as a criterion not to admit patients would result in a 57% reduction in hospital admissions, with a mean cost savings per patient of $4,258. Conclusions. Abnormal rest Tc-99m tetrofosmin SPECT imaging accurately predicts acute MI in patients with symptoms and a nondiagnostic ECG, whereas a normal study is associated with a very low cardiac event rate. The use of acute rest SPECT imaging in the ED can substantially and safely reduce the number of unnecessary hospital admissions.
Toxocara Larval Papillitis
Authors: D. H. Garrow
Journal: BMJ (1973)

Effect of Oxprenolol on Heart Rate SIR,-Dr.U. Thadani and others (20 January, p. 138) found that the resting heart rate was higher after intravenous than after oral administration of oxprenolol.We recently gave oxprenolol intravenously (0.1 and 0-2 mg/kg body weight) and orally (40 and 80 mg) to six normal volunteers under double-blind conditions in an investi- gation to determine whether it influenced central nervous activity at these doses.No significant changes were found in critical flicker frequency, hand-eye co-ordination, or serial subtraction, nor did the resting heart rate after intravenous oxprenolol differ from that after a placebo.After oral oxprenolol, however, there was a significant, doserelated reduction in resting heart rate (P < 0-05), most marked at four hours.A possible explanation of these observations could be the formation of a metabolite after oral administration which has a potent /-receptor blocking action without the intrinsic activity possessed by the parent compound.-Weare, etc.,
Alfred Nowell Hamilton Peach
Authors: M. Parkes
Journal: BMJ (2012)

Studied the effects of malnutrition and vitamin deficiency in prisoners of war 



Alfred Nowell Hamilton Peach⇑ was born in Bristol in 1914. He was educated at Clifton College and studied medicine in the city, qualifying in 1937. At the outbreak of the war he joined the Royal Air Force Volunteer Reserve and was posted to Malaya in 1940. During the Japanese invasion of Northern Malaya in December 1941 Peach took huge risks to evacuate patients into trenches under heavy bombardment and then remained at the hospital until it was almost too late. For such selflessness he was mentioned in Despatches. In Nowell’s words his retreat was done in style, at the wheel of an “old thirty horsepower Ford V8, secondhand from the Chinese garage in Singapore, which went like a train … I escaped down the length of Malaya … stopped at Kuala Lumpur … [for] a shower and lunch and then carried on down to Singapore and got there later in the evening … .” He was swiftly drafted to Sumatra but had barely unpacked before more Japanese soldiers were parachuting on to the island.

He landed in Java, where at the end of February 1942 he arrived in Bandung at the No 1 Allied General Hospital, an Australian field hospital in a converted …
Abstract P1-01-26: Clinical Implications of pN0 mol+ in Breast Cancer Patients
Authors: C Falo, MAR Varela, A Moreno, E Villalba, JM Serra, E Benito, A Fernandez, I Morilla, A Guma, AP. Escobedo
Journal: Cancer Research (2010)

Abstract Introduction: Axillary lymph node involvement is the most significant prognostic factor in breast cancer patients. The real-time PCR (RT-PCR) appeared to be a sensitive method to diagnose the lymph node axillary stage, but the clinical relevance of pN0 (mol+) has not yet been established. We present the clinical characteristics of the subgroup of patients diagnosed as pN0 (mol+) and their clinical outcome after a mean follow-up of 72 months. Material &amp; Methods: Between June 2000 and November 2006, 674 patients with T1-T3 primary invasive breast cancer and low probability of axillary lymph node involvement, were included in a prospective study of the molecular analyses of the sentinel lymph node (SLN) biopsy. Each SLN was bi-dissected; one half was snap frozen for subsequent molecular analysis, on the other half, routine pathological analyses was performed, including immunoassaying for cam 5.2 antibody. The molecular analyses was performed by RT-PCR using the gene marker KRT 19. Adjuvant treatment and clinical outcome has been recorded after a mean follow-up of 72 months. Results: 135 cases were staged as pN0 (mol+). Most of them corresponded to infiltrating ductal carcinoma (95%), 2.2% lobular, 1.5% colloid and 1.5% medullar. Nuclear grade: I in 5% of cases, II in 35% and III in 34% of them. By tumour stage, 1.5% were pT1a; 24% pT1b: 58% pT1c; 15% pT2 and 1.5% pT3. According to molecular subtypes, 73% of cases were luminal, 18.5% triple negative ones and 8.5% HER2 positive. All the patients except 5 ones received adjuvant systemic treatment: 41.5% hormonal therapy for at least 5 years; 32% chemotherapy followed by hormonotherapy and 18.5% chemotherapy, of those two patients received trastuzumab for 1 year. At the time of the analysis, there have been 4 local recurrences, 3 metastasic recurrences and 2 contra lateral ones. For survival analyses, 2 cases were excluded for presenting a previous breast cancer history, and one patient died after the last CMF from a septic shock. Of the 132 resting patients, 122 are free of relapse at the time of this analysis, the 3 patients with distant metastasis are on treatment for metastatic disease, 2 patients were death by other neoplastic diseases and 5 cases were death by other medical causes (4 cardiac and 1 respiratory failure). Survival rate for N0 mol+ was 94%, no specific breast cancer death have occurred at the present survival analyses. Conclusions: Tumours diagnosed as pN0 (mol+) presented clinical and molecular characteristics of worse prognosis than pN0 (mol-) and this is translated in a higher proportion of patients staged N0 (mol+) treated with chemotherapy than pN0 (mol-). Survival in this subgroup of patients is high in relation to the adjuvant treatment delivered. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-01-26.
Effects of Aerobic and Resistance Training on Hemoglobin A<sub>1c</sub>Levels in Patients With Type 2 Diabetes
Authors: Timothy S. Church, Steven N. Blair, Shannon Cocreham, Neil Johannsen, William Johnson, Kimberly Kramer, Catherine R. Mikus, Valerie Myers, Melissa Nauta, Ruben Q. Rodarte, Lauren Sparks, Angela Thompson, Conrad P. Earnest
Journal: JAMA (2010)

Exercise guidelines for individuals with diabetes include both aerobic and resistance training although few studies have directly examined this exercise combination.To examine the benefits of aerobic training alone, resistance training alone, and a combination of both on hemoglobin A(1c) (HbA(1c)) in individuals with type 2 diabetes.A randomized controlled trial in which 262 sedentary men and women in Louisiana with type 2 diabetes and HbA(1c) levels of 6.5% or higher were enrolled in the 9-month exercise program between April 2007 and August 2009.Forty-one participants were assigned to the nonexercise control group, 73 to resistance training 3 days a week, 72 to aerobic exercise in which they expended 12 kcal/kg per week; and 76 to combined aerobic and resistance training in which they expended 10 kcal/kg per week and engaged in resistance training twice a week. Main Outcome Change in HbA(1c) level. Secondary outcomes included measures of anthropometry and fitness.The study included 63.0% women and 47.3% nonwhite participants who were a mean (SD) age of 55.8 years (8.7 years) with a baseline HbA(1c) level of 7.7% (1.0%). Compared with the control group, the absolute mean change in HbA(1c) in the combination training exercise group was -0.34% (95% confidence interval [CI], -0.64% to -0.03%; P = .03). The mean changes in HbA(1c) were not statistically significant in either the resistance training (-0.16%; 95% CI, -0.46% to 0.15%; P = .32) or the aerobic (-0.24%; 95% CI, -0.55% to 0.07%; P = .14) groups compared with the control group. Only the combination exercise group improved maximum oxygen consumption (mean, 1.0 mL/kg per min; 95% CI, 0.5-1.5, P < .05) compared with the control group. All exercise groups reduced waist circumference from -1.9 to -2.8 cm compared with the control group. The resistance training group lost a mean of -1.4 kg fat mass (95% CI, -2.0 to -0.7 kg; P < .05) and combination training group lost a mean of -1.7 (-2.3 to -1.1 kg; P < .05) compared with the control group.Among patients with type 2 diabetes mellitus, a combination of aerobic and resistance training compared with the nonexercise control group improved HbA(1c) levels. This was not achieved by aerobic or resistance training alone.clinicaltrials.gov Identifier: NCT00458133.
Predictors of Quality-of-Life Benefit After Percutaneous Coronary Intervention
Authors: John A. Spertus, Adam C. Salisbury, Philip G. Jones, Darcy Green Conaway, Randall C. Thompson
Journal: Circulation (2004)

Background— Improving patients’ quality of life is a primary indication for percutaneous coronary intervention (PCI), yet little is known about patient characteristics associated with greater quality-of-life improvement from the procedure. This study was conducted to identify patient characteristics associated with quality-of-life benefit after PCI. Methods and Results— A consecutive series of 1518 patients undergoing PCI in nonacute myocardial infarction settings were prospectively enrolled into an observational study documenting their postprocedural health status. We examined univariate and multivariable associations between baseline patient characteristics and quality of life 1 year after the procedure using the disease-specific Seattle Angina Questionnaire (SAQ) to quantify the impact of patients’ coronary disease on their quality of life. Baseline angina frequency and physical function were the strongest predictors of quality-of-life improvement 1 year after PCI. In comparing patients without angina to those experiencing monthly, weekly, and daily angina, the quality-of-life improvements (mean±SEM) were 21.4±2.1, 30.7±2.2, and 34.6±2.6 points greater ( P &lt;0.001). Patients with mild, moderate, and severe physical limitation improved 13.8±1.9, 20.0±2.1, and 13.5±3.5 points more than those with minimal baseline physical limitation ( P &lt;0.001). These findings were maintained in multivariable models correcting for baseline differences in demographic, clinical, disease-severity, and health-status variables. Conclusions— Preprocedural angina frequency is the most important prognostic indicator of quality-of-life improvement after PCI. Although substantial quality-of-life benefits are attained in most patients with preprocedural angina, more careful consideration of the potential benefits and risks of the procedure are needed in asymptomatic patients.
Adult onset idiopathic hypogonadotrophic hypogonadism may be overdiagnosed
Authors: R. Quinton, G. S Conway, H. S Jacobs, P.-M. G Bouloux, M. P J Vanderpump
Journal: BMJ (1998)

EDITOR —Tweed and Roland made an important point in their Lesson of the Week on diagnosing adult onset idiopathic hypogonadotrophic hypogonadism.1 We have found that although biochemical testing and cranial imaging are performed routinely to exclude other hypothalamopituitary disorders, serum iron studies are often neglected.

The prevalence of idiopathic or isolated hypogonadotrophic hypogonadism has been estimated at …
The LeFE algorithm: embracing the complexity of gene expression in the interpretation of microarray data
Authors: Gabriel S Eichler, Mark Reimers, David Kane, John N Weinstein
Journal: Genome biology (2007)

Abstract Interpretation of microarray data remains a challenge, and most methods fail to consider the complex, nonlinear regulation of gene expression. To address that limitation, we introduce Learner of Functional Enrichment (LeFE), a statistical/machine learning algorithm based on Random Forest, and demonstrate it on several diverse datasets: smoker/never smoker, breast cancer classification, and cancer drug sensitivity. We also compare it with previously published algorithms, including Gene Set Enrichment Analysis. LeFE regularly identifies statistically significant functional themes consistent with known biology.
Tuition fee changes may scupper government plans to widen access to medical school
Authors: O. Mashta
Journal: BMJ (2010)

Government proposals could “deter students from poorer backgrounds from entering medicine”

Medical students in England face leaving university with debts of up to £70 000 (€84 000; $109 000), the British Medical Association has estimated after the government announced proposals to transfer much of the cost of courses from the state to students.

The government has said that universities could charge students between £6000 and £9000 a year from 2012. Those that charge more than £6000 will have to show that they are making more effort to encourage applications from the poorest students. Fees are currently £3290 a year. A new £150m national scholarship fund has been set up to encourage bright potential students from lower income families.

George Osborne, the chancellor of the exchequer, announced in the comprehensive spending review in October that the higher education teaching budget is to be cut by 40%, from £7.1bn to £4.2bn, over the next four years, though science, technology, engineering, and maths based subjects will …
Wintrobe’s Atlas of Clinical Hematology
Authors: William H. Wehrmacher, Harry L. Messmore
Journal: JAMA (2007)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Prediction of Long-Term Outcomes by Signal-Averaged Electrocardiography in Patients With Unsustained Ventricular Tachycardia, Coronary Artery Disease, and Left Ventricular Dysfunction
Authors: J. Anthony Gomes, Michael E. Cain, Alfred E. Buxton, Mark E. Josephson, Kerry L. Lee, Gail E. Hafley
Journal: Circulation (2001)

An abnormal signal-averaged ECG (SAECG) is a noninvasive marker of the substrate of sustained ventricular tachycardia after myocardial infarction. We assessed its prognostic ability in patients with asymptomatic unsustained ventricular tachycardia, coronary artery disease, and left ventricular dysfunction. A blinded core laboratory analyzed SAECG tracings from 1925 patients in a multicenter trial. Cox proportional hazards modeling was used to examine individual and joint relations between SAECG variables and arrhythmic death or cardiac arrest (primary end point), cardiac death, and total mortality. We also assessed the prognostic utility of SAECG at different levels of ejection fraction (EF). A filtered QRS duration >114 ms (abnormal SAECG) independently predicted the primary end point and cardiac death, independent of clinical variables, cardioverter-defibrillator implantation, and antiarrhythmic drug therapy. With an abnormal SAECG, the 5-year rates of the primary end point (28% versus 17%, P=0.0001), cardiac death (37% versus 25%, P=0.0001), and total mortality (43% versus 35%, P=0.0001) were significantly higher. The combination of EF <30% and abnormal SAECG identified a particularly high-risk subset that constituted 21% of the total population. Thirty-six percent and 44% of patients with this combination succumbed to arrhythmic and cardiac death, respectively. SAECG is a powerful predictor of poor outcomes in this population. The noninvasive combination of an abnormal SAECG and reduced EF may have utility in selecting high-risk patients for intervention.
SLC5A8 Triggers Tumor Cell Apoptosis through Pyruvate-Dependent Inhibition of Histone Deacetylases
Authors: Muthusamy Thangaraju, Elangovan Gopal, Pamela M. Martin, Sudha Ananth, Sylvia B. Smith, Puttur D. Prasad, Esta Sterneck, Vadivel Ganapathy
Journal: Cancer Research (2006)

Abstract Tumor cells up-regulate glycolysis but convert pyruvate into lactate instead of oxidizing it. Here, we show that pyruvate, but not lactate, is an inhibitor of histone deacetylases (HDAC) and an inducer of apoptosis in tumor cells and that SLC5A8, a Na+/monocarboxylate cotransporter, is obligatory for this process. We found that SLC5A8 is expressed in nontransformed breast epithelial cell lines but silenced by DNA methylation in tumor cell lines. The down-regulation of the gene is also evident in primary breast tumors. When MCF7 breast tumor cells are transfected with SLC5A8 cDNA, the cells undergo pyruvate-dependent apoptosis. Butyrate and propionate also induce apoptosis in SLC5A8-expressing cells, whereas lactate does not. The differential ability of these monocarboxylates to cause apoptosis in SLC5A8-expressing MCF7 cells correlates with their ability to inhibit HDACs. Apoptosis induced by SLC5A8/pyruvate in MCF7 cells is associated with up-regulation of p53, Bax, tumor necrosis factor–related apoptosis-inducing ligand (TRAIL), TRAIL receptor (TRAILR) 1, and TRAILR2 and down-regulation of Bcl2 and survivin. Lactate dehydrogenase isozymes are differentially expressed in nontransformed cells and tumor cells such that the latter convert pyruvate into lactate. Silencing of SLC5A8 coupled with conversion of pyruvate into lactate in tumor cells correlates with increased HDAC activity in these cells compared with nontransformed cells. Our studies thus identify pyruvate as a HDAC inhibitor and indicate that the Na+-coupled pyruvate transport underlies the tumor-suppressive role of SLC5A8. We propose that tumor cells silence SLC5A8 and convert pyruvate into lactate as complementary mechanisms to avoid pyruvate-induced cell death. (Cancer Res 2006; 66(24): 11560-4)
Number of "oldest old" has doubled in the past 25 years
Authors: J. Wise
Journal: BMJ (2010)

The number of people aged 85 years or more in the United Kingdom has doubled since 1983 to 1.3 million in 2008. Data from the Office for National Statistics show that these “oldest old” now make up 2.2% of the total population, up from 1.1% 25 years ago.

The 42nd edition of Regional Trends shows that there were 410 000 people aged 90 and over in 2008, of whom more than 10 000 were centenarians.

Over the past 25 years the number of people aged 65 and over in the UK has increased by 18%, from 8.4 million in 1983 to 9.9 million in 2008. In the same period the population aged 16-64 years increased by 11% whereas the population under 16 years decreased by 5%.

The south west of England and Wales have the …
Coronary atherosclerotic wall thickening and vascular reactivity in humans. Elevated high-density lipoprotein levels ameliorate abnormal vasoconstriction in early atherosclerosis.
Authors: A M Zeiher, V Schächlinger, S H Hohnloser, B Saurbier, H Just
Journal: Circulation (1994)

Abnormal vascular reactivity represents a fundamental disturbance in vascular biology with the development of atherosclerosis. Because endothelial vasodilator function plays a pivotal role in controlling vasomotor tone, we hypothesized that atherosclerotic wall thickening might directly interfere with deficient endothelium-mediated dilation and thereby contribute to the abnormal reactivity of atherosclerotic arteries in vivo.In 26 patients without focal stenoses in the left anterior descending coronary artery, acetylcholine (0.036 to 3.6 micrograms/mL) was infused into the artery to evaluate endothelium-mediated vasodilation. Segmental vasomotor responses to acetylcholine were correlated with the local extent of atherosclerotic wall thickening quantitated by intracoronary ultrasound examination. Seventeen of the patients also underwent cold pressor testing to assess the vasoreactivity to sympathetic activation. The response of coronary artery segments to acetylcholine varied from 35% dilation to 52% constriction and demonstrated a segmental pattern, with dilation and constriction observed in different segments of the same artery. The vasomotor response to acetylcholine was closely correlated with the extent of local atherosclerotic wall thickening (r = -.82, P < .0001). Over the entire range of atherosclerotic wall thickening, segments from patients with elevated high-density lipoprotein (HDL) cholesterol serum levels (> 75th percentile) demonstrated a significantly blunted constrictor response to acetylcholine (P < .01 at the maximal acetylcholine concentration) compared with segments from patients with HDL cholesterol < 75th percentile. The degree of constriction or dilation in response to the acetylcholine infusion correlated with the response to cold pressor testing (r = .75, P < .0001). Again, the cold pressor test-induced constrictor response was significantly (P < .05) blunted in segments from patients with elevated HDL cholesterol serum levels compared with those from patients with HDL cholesterol < 75th percentile despite equal degrees of atherosclerotic wall thickening.Coronary vasomotor responses to the endothelium-dependent dilator acetylcholine and to sympathetic stimulation by cold pressor test correlate with local atherosclerotic wall thickening. Thus, the degree of abnormal local vascular reactivity is closely related to the extent of atherosclerotic "plaque load" in human epicardial arteries in vivo. Elevated HDL cholesterol serum levels ameliorate abnormal vasoconstriction at any given extent of atherosclerotic wall thickening, suggesting that HDL cholesterol exerts a beneficial effect on abnormal vascular reactivity, a fundamental functional disturbance associated with coronary atherosclerosis.