tbuckley/cabot-search huggingface dataset:
Transesophageal Echocardiography: Useful Tool or Expensive Toy?
Authors: Warren J. Manning
Journal: Annals of Internal Medicine (1998)

Letters1 November 1998Transesophageal Echocardiography: Useful Tool or Expensive Toy?Warren J. Manning, MD and Pamela S. Douglas, MDWarren J. Manning, MDBeth Israel Deaconess Medical Center; Boston, MA 02215Search for more papers by this author and Pamela S. Douglas, MDBeth Israel Deaconess Medical Center; Boston, MA 02215Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-9-199811010-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Dr. Kearon that in the younger patient with atrial fibrillation who lacks clinical risk factors, TEE is unlikely to improve on risk stratification. Our comments on the potential role of TEE were restricted to a population at high clinical risk. The SPAF-III study specifically looked at this population (women >75 years of age or persons with hypertension, thromboembolism, left ventricular dysfunction, or congestive heart failure). In this population, dense spontaneous echocardiographic contrast and complex atherosclerotic plaque in the thoracic aorta were independent predictors of clinical thromboembolism [1]. Patients at high clinical risk for thromboembolism who ...References1. Transesophageal echocardiographic correlates of thromboembolism in high-risk patients with nonvalvular atrial fibrillation. The Stroke Prevention in Atrial Fibrillation Investigators Committee on Echocardiography. Ann Intern Med. 1998; 128:639-47. Google Scholar2. Stollberger C, Chnupa P, Kronik G, Brainin M, Finsterer J, Schneider B, et al. Transesophageal echocardiography to assess embolic risk in patients with atrial fibrillation. Ann Intern Med. 1998; 128:630-8. Google Scholar Author, Article, and Disclosure InformationAffiliations: Beth Israel Deaconess Medical Center; Boston, MA 02215 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 November 1998Volume 129, Issue 9Page: 749KeywordsAspirinAtrial fibrillationClinical trialsEchocardiographyHeart failureHypertensionLongitudinal studiesMedical risk factorsStrokeThromboembolism Issue Published: 1 November 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
ON THE EXCRETION OF GLYCURONIC ACID IN PNEUMOCOCCUS INFECTIONS, WITH SPECIAL REFERENCE TO LOBAR PNEUMONIA
Authors: Florentin Medigreceanu
Journal: The Journal of Experimental Medicine (1913)

1. It has been found that the amount of glycuronic acid excreted in the urine, estimated by Tollens's furfurol distillation method, is increased during the febrile period of almost all cases of lobar pneumonia in man. Patients weighing from fifty-five to seventy kilograms excrete during the febrile period 0.8 to 1.3 grams of glycuronic acid in twenty-four hours, while the output of a normal individual of the same weight, age, and under similar conditions would not exceed 0.4 to 0.6 of a gram. 2. This increased output is not dependent on outside factors; it is attributable to pathological changes of the organism itself during the disease. 3. Similar observations have been made in postpneumonic empyema and bronchopneumonia. 4. Fasting rabbits, with general pneumococcus infection, have also shown a marked increase in the output of glycuronic acid during the pathological process. Whether the conjugated substances with the glycuronic acid in the cases studied have the same origin and are qualitatively the same as under normal conditions, or whether we are dealing with different compounds, has not yet been determined.
Knowledge for better health
Authors: Kamran Abbasi
Journal: BMJ (2004)

<h3>Objective:</h3> To investigate if molecular defects in insulin pathway might contribute metabolic dysfunctions observable in patients affected by myotonic dystrophy type 1 (DM1) and type 2 (DM2). <h3>Background:</h3> DM1 and DM2 are autosomal dominant multisystemic disorders characterized by metabolic dysfunctions such as insulin resistance and a fourfold higher risk of developing Diabetes Mellitus type 2. They are caused by expanded CTG or CCTG nucleotide sequences which lead to aberrant alternative splicing of different genes. Splicing alteration of insulin receptor (<i>INSR</i>) gene is considered one of the causes of these metabolic manifestations. However, post receptor signalling abnormalities could also contribute to the insulin resistance observed in these patients. <h3>Design/Methods:</h3> <i>Biceps brachii</i> (BB) and <i>tibialis anterior</i> (TA) biopsies were taken from a total of 6 DM1 (4 BB, 4 TA), 3 DM2 (3 BB) and 7 healthy subjects (4 BB, 3 TA). <i>INSR</i> splicing alteration was analysed by RT-PCR. The expression of several proteins involved in insulin pathway (IRS-1, AKT, p70, MAPK and GSK3β), was analysed by western blot. <h3>Results:</h3> Contrary to CTR, DM muscle biopsies express more fetal than adult <i>INSR</i> isoform. However, in DM1 the <i>INSR</i> splicing alterations were more evident in TA than in BB. WB results showed that both BB and TA DM muscles exhibit alterations of basal phosphorylation levels of the proteins analysed, suggesting that these changes might be accompanied by a lack of further insulin stimulation. In DM1 patients these alterations were more manifest in TA than in BB. <h3>Conclusions:</h3> Our <i>in vivo</i> results confirm that distal muscles in DM1 and proximal muscles in DM2 are suitable for biomarker discovery. However, in DM1 patients alterations in <i>INSR</i> splicing and insulin signalling are already evident in BB suggesting that proximal muscle should be used for bimolecular studies when distal muscle are severely affected or at end-stage pathology. <b>Study Supported by:</b> FMM-Fondazione Malattie Miotoniche - Italy <b>Disclosure:</b> Dr. Meola has nothing to disclose. Dr. Renna has nothing to disclose. Dr. Bosè has nothing to disclose. Dr. Fossati has nothing to disclose. Dr. Brigonzi has nothing to disclose. Dr. Cavalli has nothing to disclose. Dr. Cardani has nothing to disclose.
Firearms and Fatalities
Authors: Arch G. Mainous
Journal: JAMA (1996)

<h3>To the Editor.</h3> —The work of Dr Hargarten and colleagues<sup>1</sup>points to the significance of firearm availability as a critical public health concern. The availability of firearms and the corresponding implications for homicide and suicide become of even greater consequence when noting the prevalence of firearms in the general population, the manner in which guns are stored, and attitudes toward guns, particularly by youth. In a statewide survey with 1301 adult (aged &gt;18 years) respondents we conducted in 1993 in Kentucky, 63% of homes contained firearms.<sup>2</sup>As high as this prevalence is, more concerning is the 75% household prevalence of firearms we found in surveys in 1993 and 1994 of 1014 students in an urban, a suburban, and a rural high school in Kentucky.<sup>2</sup>These numbers can be compared with the 65% household firearm prevalence among suicide cases and 41% among control subjects reported in the study
Acute Eczema of the Face following Neuralgia
Authors: J. Cavafy
Journal: BMJ (1880)

CHARLES F., aged 38, pastry-cook, applied as an out-patient on February 13th, i88o, stating that for five days he had suffered from severe pain in the left side of the head and face.The pain extended over the orbit, cheek, and lower jaw, and also to some extent over and behind the ear.On the scalp and down the neck numerous tender
GENETICS OF SOMATIC MAMMALIAN CELLS
Authors: Theodore T. Puck, Steven J. Cieciura, Arthur Robinson
Journal: The Journal of Experimental Medicine (1958)

A methodology designed to eliminate mitotic inhibitor action and involving use of pretested fetal calf serum and careful pH and temperature control has been described by which cells from normal human and animal tissue can be maintained in active growth for long periods in vitro without development of aneuploidy. By means of this procedure, it is possible reliably to establish cell cultures from minute skin biopsies which can be taken from any individual. Clones of mammalian cells with chromosomal markers have been isolated by this means from x-irradiated non-irradiated cell cultures. Application of these techniques to chromosome delineation in large numbers of human subjects; determination of chromosomal sex in patients; spontaneuos and induced genetic changes in somatic mammalian cells in vivo and in vitro; comparison of metabolic differences between normal and cancerous cells and other problems have been indicated.
Macrophage Functions in Atherosclerosis
Authors: Iris Zeller, Sanjay Srivastava
Journal: Circulation Research (2014)

The goal of "Recent Developments" is to provide a concise but comprehensive overview of new advances in cardiovascular research, which we hope will keep our readers abreast of recent scientific discoveries and facilitate discussion, interpretation, and integration of the findings.This will enable readers who are not experts in a particular field to grasp the significance and effect of work performed in other fields.It is our hope and expectation that these "Recent Development" articles will help readers to gain a broader awareness and a deeper understanding of the status of research across the vast landscape of cardiovascular research-The Editors.
Differences in outcomes of patients with congestive heart failure prescribed celecoxib, rofecoxib, or non-steroidal anti-inflammatory drugs: population based study
Authors: Marie Hudson, Hugues Richard, Louise Pilote
Journal: BMJ (2005)

<h3>Abstract</h3> <b>Objectives</b> To compare the risk of death and recurrent congestive heart failure in elderly patients prescribed celecoxib, rofecoxib, or non-steroidal anti-inflammatory drugs (NSAIDs) and to determine whether there are class differences between celecoxib and rofecoxib. <b>Design</b> Population based retrospective cohort study. <b>Setting</b> Databases of hospital discharge summaries and prescription drug claims in Quebec. <b>Participants</b> 2256 patients aged 66 or more prescribed celecoxib, rofecoxib, or an NSAID after an index admission for congestive heart failure between April 2000 and March 2002. <b>Main outcome measures</b> Time to all cause death and recurrent congestive heart failure, combined and separately. <b>Results</b> The risk of death and recurrent congestive heart failure combined was higher in patients prescribed NSAIDs or rofexocib than in those prescribed celecoxib (hazard ratio 1.26, 95% confidence interval 1.00 to 1.57 and 1.27, 1.09 to 1.49, respectively). The findings were similar when the outcomes were assessed separately. In pairwise analysis, the risks of death and recurrent congestive heart failure, combined and separate, were similar between patients prescribed NSAIDs and rofecoxib. <b>Conclusions</b> Celecoxib seems safer than rofecoxib and NSAIDs in elderly patients with congestive heart failure. Differences were found among cyclo-oxygenase-2 inhibitors.
Dyspnoea in patients with acute heart failure: an analysis of its clinical course, determinants, and relationship to 60‐day outcomes in the PROTECT pilot study
Authors: Marco Metra, John G. Cleland, Beth Davison Weatherley, Howard C. Dittrich, Michael M. Givertz, Barry M. Massie, Christopher M. O'Connor, Piotr Ponikowski, John R. Teerlink, Adriaan A. Voors, Gad Cotter
Journal: European Journal of Heart Failure (2010)
Accuracy and self correction of information received from an internet breast cancer list: content analysis
Authors: Adol Esquivel, Funda Meric-Bernstam, Elmer V Bernstam
Journal: BMJ (2006)

<h3>Abstract</h3> <b>Objectives</b> To determine the prevalence of false or misleading statements in messages posted by internet cancer support groups and whether these statements were identified as false or misleading and corrected by other participants in subsequent postings. <b>Design</b> Analysis of content of postings. <b>Setting</b> Internet cancer support group Breast Cancer Mailing List. <b>Main outcome measures</b> Number of false or misleading statements posted from 1 January to 23 April 2005 and whether these were identified and corrected by participants in subsequent postings. <b>Results</b> 10 of 4600 postings (0.22%) were found to be false or misleading. Of these, seven were identified as false or misleading by other participants and corrected within an average of four hours and 33 minutes (maximum, nine hours and nine minutes). <b>Conclusions</b> Most posted information on breast cancer was accurate. Most false or misleading statements were rapidly corrected by participants in subsequent postings.
Current Practice in Orthopaedic Surgery 1963
Authors: Leonard F. Peltier
Journal: JAMA (1964)

The first thing which comes to mind on picking up a book of this sort is whether there is a need for such a publication. Does it really augment the current periodical literature in its field? In this present case, the answer is definitely, yes. Dr. Adams has assembled a group of ten papers, all of which are more satisfying than the usual journal article. The discussion by Allan of spina bifida cystica is especially interesting and timely. The publishers have produced an attractive small book, a good traveling companion, fitting easily into bag or briefcase. This volume deserves a wide distribution among orthopedic surgeons.
P1-02-05: Invasive Lobular Carcinoma – A Luminal Breast Cancer Histotype Enriched for Epithelial-to-Mesenchymal Transition Features.
Authors: O Metzger, SK Singhal, S Michiels, M Ignatiadis, F Bertucci, C Galant, D Larsimont, R Salgado, I Veys, D Fumagalli, KS Saini, M Piccart, C Sotiriou
Journal: Cancer Research (2011)

Abstract Background: Invasive lobular carcinoma (ILC) represent the second most common breast cancer (BC) histotype, but little information is available about its molecular features. We sought to perform a comprehensive molecular classification of ILC and to investigate the molecular features that can differentiate ILC from invasive ductal carcinoma (IDC). Methods: A consecutive series of 174 ILC tumors from three different centers with mininum 5-year follow-up was selected. Gene expression data were generated using Affymetrix U133 Plus 2.0 arrays. Data were analyzed by using frozen robust multiarray analysis (Matthew et al. 2009). ILC tumors were classified into BC molecular subtypes using the PAM50 classifier. Invasive Disease Free Survival (IDFS) was defined as the interval between the date of surgery and the date of any invasive recurrence or death. Multivariate analyses for 10-y IDFS containing classical clinico-pathologic characteristics were performed for different gene signatures, which were scaled so that 2.5 and 97.5% percentiles equal −1 and 1. A cohort of 90 IDC tumor samples, normalised with the same method, was used to compare expression data between ILC and IDC. Results: ILCs were mainly characterized as luminal A (LA: 76%, n=133) and luminal B (LB:; 20%, n=34) followed by a minority of HER2−positive (2%, n=3), basal (1%, n=2) and normal-like (1%, n=2) based on Perou's classification. LB had inferior 10-y IDFS than LA in univariate cox regression analysis (HR = 1.99, 95% CI, 1.08−3.67, p=0.026). The EMT gene module was significantly higher expressed in ILC as compared to IDC (p &amp;lt; 0.001). Adjusted hazard ratios (HR) for different gene modules investigated are detailed in the table below. Conclusions: ILC is mainly composed of luminal tumors and a minority of HER2−positive tumors. Similarly to IDC, proliferation remains a statistically significant prognostic factor for ILC. ILC tumors were enriched with an EMT phenotype, which is not observed among IDC luminals. Of interest IGF signaling, which is known to be associated with poor prognosis in ER-positive BC, added prognostic value in this population which may open new therapeutics avenues for ILC. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-02-05.
Clinical Relevance of Magnetic Resonance Imaging in Cervical Spine Clearance
Authors: Shelby Resnick, Kenji Inaba, Efstathios Karamanos, Martin Pham, Saskya Byerly, Peep Talving, Sravanthi Reddy, Megan Linnebur, Demetrios Demetriades
Journal: JAMA Surgery (2014)

IMPORTANCE A missed cervical spine (CS) injury can have devastating consequences.When CS injuries cannot be ruled out clinically using the National Emergency X-Radiography Utilization Study low-risk criteria because of either a neurologic deficit or pain, the optimal imaging modality for CS clearance remains controversial.OBJECTIVE To investigate the accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) for CS clearance. DESIGN, SETTING, AND PARTICIPANTSA prospective observational study was conducted from January 1, 2010, through May 31, 2011, at a level I trauma center.Participants included 830 adults who were awake, alert, and able to be examined who experienced blunt trauma with resultant midline CS tenderness and/or neurologic deficits and were undergoing CT of the CS.Initial examinations, all CS imaging results, interventions, and final CS diagnoses were documented.The criterion standard for the sensitivity and specificity calculations was final diagnosis of CS injury at the time of discharge.MAIN OUTCOMES AND MEASURES Clinically significant CS injuries, defined as injuries requiring surgical stabilization or halo placement. RESULTSOverall, 164 CS injuries (19.8%) were diagnosed, and 23 of these (2.8%) were clinically significant.All clinically significant injuries were detected by CT.Fifteen of 681 patients (2.2%) with a normal CT scan had a newly identified finding on MRI; however, none of the injuries required surgical intervention or halo placement.There was no change in management on the basis of MRI findings.The sensitivity and specificity of CT for detecting CS injury was 90.9% and 100%, respectively.For clinically significant CS injuries, the sensitivity was 100% and specificity was 100%.CONCLUSIONS AND RELEVANCE Computed tomography is effective in the detection of clinically significant CS injuries in adults deemed eligible for evaluation who had a neurologic deficit or CS pain.Magnetic resonance imaging does not provide any additional clinically relevant information.
Risks from Microbes on the Rise: Reasons Why and Ways To Prevent Future Epidemics
Authors: Jennifer Fisher Wilson
Journal: Annals of Internal Medicine (2004)

Current Clinical Issues16 March 2004Risks from Microbes on the Rise: Reasons Why and Ways To Prevent Future EpidemicsJennifer Fisher WilsonJennifer Fisher WilsonSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-6-200403160-00040 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Although scientists have long known that animals could transmit infections to humans, they are increasingly concerned about animal-borne diseases. All of the recent high-profile infectious diseases in humans have been acquired from animals: mice carrying hantavirus, cows with bovine spongiform encephalopathy (BSE), chickens with avian influenza, birds and mosquitoes carrying West Nile virus, civet cats infected with severe acute respiratory syndrome (SARS)–associated coronavirus. Raised awareness of these animal-to-human diseases transmitted, called zoonotic diseases, has helped contain their spread, but factors such as changes in land use and global travel mean that these infections are an increasing threat to humans worldwide. ... Author, Article, and Disclosure InformationAffiliations: Disclosures: None disclosed.E-mail:[email protected]org. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 16 March 2004Volume 140, Issue 6Page: 497-500KeywordsBovine spongiform encephalopathyFeversFoodInfectious disease surveillanceInfectious diseasesPathogensPrevention, policy, and public healthSARS coronavirusScientistsZoonoses ePublished: 16 March 2004 Issue Published: 16 March 2004 CopyrightCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Prevention of Stroke in Older Persons With Isolated Systolic Hypertension
Authors: Geza Simon
Journal: JAMA (1991)

<h3>To the Editor.</h3> — Treatment of all persons with isolated systemic hypertension in the Veterans Affairs medical system is not practical. I hope that the recent report<sup>1</sup>on stroke prevention by antihypertensive drug therapy in older persons with isolated systemic hypertension contains hidden information that may help practitioners establish selection criteria for treating isolated systemic hypertension. Because of the relatively low incidence of strokes in persons with isolated systemic hypertension (one to two per year per 100 persons),<sup>1</sup>the public health impact of treating isolated systemic hypertension is expected to be modest. The incidence of total strokes was reduced by 36%, with a 5-year absolute benefit of 30 events per 1000 participants. Stroke reduction was more pronounced (48%) in patients who were receiving antihypertensive therapy at initial contact than in previously untreated patients (27%). The wash-out period in previously treated patients was 2 to 8 weeks. This interval
Differences in primary cellular factors influencing the metabolism and distribution of 3,5,3′-L-triiodothyronine and L-thyroxine
Authors: Jack H. Oppenheimer, Harold L. Schwartz, Harvey C. Shapiro, Gerald Bernstein, Martin I. Surks
Journal: Journal of Clinical Investigation (1970)

Administration of phenobarbital, which acts exclusively on cellular sites, results in an augmentation of the liver/plasma concentration ratio of L-thyroxine (T4) in rats but no change in the liver/plasma concentration ratio of L-triiodothyronine (T3). Whereas phenobarbital stimulates the fecal clearance rate both of T3 and T4, it increases the deiodinative clearance rate of T4 only. These findings suggest basic differences in the cellular metabolism of T3 and T4. Further evidence pointing to cellular differences was obtained from a comparison of the distribution and metabolism of these hormones with appropriate corrections for the effect of differential plasma binding. The percentage of total exchangeable cellular T4 within the liver (28.5) is significantly greater than the corresponding percentage of exchangeable cellular T3 within this organ (12.3). Extrahepatic tissues bind T3 twice as firmly as T4. The cellular metabolic clearance rate (= free hormone clearance rate) of T3 exceeds that of T4 by a factor 1.8 in the rat. The corresponding ratio in man, 2.4, was determined by noncompartmental analysis of turnover studies in four individuals after the simultaneous injection of T4-(125)I and T3-(131)I. The greater cellular metabolic clearance rate of T3 both in rat and man may be related to the higher specific hormonal potency of this iodothyronine.
Suicide and homicide by people with mental illness
Authors: J. Geddes
Journal: BMJ (1999)

Papers pp 1235, 1240 

The national confidential inquiry into suicide and homicide by people with mental illness began in 1992 in response to concern about mental health services in the United Kingdom. The usefulness of the initial reports was limited by the disappointing case ascertainment rate.1–3 Two papers in this issue (pp 1235, 1240) 4 5 report the methods and results of Safer Services , the 1999 inquiry report.6 Case finding has now been much improved and the new report provides a valuable descriptive cross section of the characteristics of suicides and homicides in relation to the mental health services.

About 1000 people who commit suicide each year (a quarter of all UK suicides) and about 40 of those who commit homicide (about 8% of all UK homicides) have had some contact with the mental health services in the year before death. In patients committing suicide comorbidity, including substance misuse, and previous self harm are common. In people convicted of homicide, personality …