tbuckley/cabot-search huggingface dataset:
Atrial Amyloidosis
Authors: Christoph Röcken, Brigitte Peters, Gina Juenemann, Wolfgang Saeger, Helmut U. Klein, Christof Huth, Albert Roessner, Andreas Goette
Journal: Circulation (2002)

Structural changes, like atrial fibrosis, may increase the likelihood of atrial fibrillation (AF) occurring in response to triggering events. The influence of isolated atrial amyloidosis (IAA) is largely unknown.Right atrial appendages (1 or 2 entire cross sections) were obtained from 245 patients undergoing open-heart surgery. Atrial amyloid was identified by Congo red staining and classified by immunohistochemistry. Amyloid was found in 40 (16.3%) of 245 patients, and all deposits were immunoreactive for atrial natriuretic peptide (ANP). Thirty-eight (15.5%) patients suffered from persistent AF. The presence of amyloid correlated with age and P-wave duration and was related to sex, valve diseases, and the presence of AF (P<0.01). The association between atrial amyloid, AF, and P-wave duration was independent of age and sex. According to multiple logistic regression analysis, amyloid was the only age- and sex-independent predictor for the presence of AF. Atrial fibrosis was not a predictor for AF, and the amount of amyloid correlated inversely with the degree of interstitial fibrosis (P=0.001; r=-0.55).Our study provides evidence that IAA affects atrial conduction and increases the risk of AF. The occurrence of IAA depends on age leading to the formation of an amyloid nidus. The progression and consequences of IAA are then influenced by pathological conditions, such as valve diseases, that increase synthesis and secretion of ANP. The inverse correlation between IAA and atrial fibrosis suggests that these patients may not benefit from treatment with ACE inhibitors to reduce the amount of atrial fibrosis.
Abstract P3-06-33: Effect of trastuzumab-based therapy on serum activin A levels in metastatic breast cancer.
Authors: LM Zubritsky, SM Ali, K Leitzel, W Koestler, E-M Fuchs, L Costa, R Knight, A Laadem, ML Sherman, A Lipton
Journal: Cancer Research (2012)

Abstract Background: Only half of HER2-positive metastatic breast cancer patients will respond to first-line trastuzumab-containing therapy, but of these, most will progress within a year. Trastuzumab resistance remains a continuing clinical problem, and better biomarkers and therapies are needed. Activin A is a TGF-beta superfamily member that regulates cell proliferation, apoptosis, differentiation, and immune response. We have previously reported that higher pretreatment serum activin A level predicted reduced progression-free survival (PFS) and overall survival (OS) to first-line trastuzumab, independent of age, line of therapy, CA 15–3, and hormone receptor status (ASCO Ab ID 607, 2012). Methods: Serum activin A was measured using ELISA (R&amp;D Systems, Minneapolis, MN) in 60 metastatic breast cancer patients before and 1 month after starting first-line trastuzumab-containing therapy. PFS and OS were analyzed using the Kaplan-Meier method and Cox modeling with both continuous and dichotomous (median) serum activin A analyses. Results: Pretreatment serum activin A levels had a median of 629 pg/mL and an inter-quartile range of 406 to 1791 pg/mL. There was no significant change in activin A levels between pretreatment and one month after starting trastuzumab therapy. Median activin A level at one month was 655 pg/mL, with an inter-quartile range of 405 to 1517 pg/mL. 83% of patients who had low pretreatment activin A levels (below median) had low activin levels at one month, and 83% who had high activin levels (above median) at baseline had high activin A levels at one month. Patients who had high activin A levels at baseline and one month had the worst outcome for both PFS (HR 3.9; median 134 days vs.776 days; p &amp;lt; 0.0001) and OS (HR 6.7; p &amp;lt; 0.0001) when compared to patients with low activin A levels which remained low at one month. Conclusions: Higher pretreatment and 1 month post-treatment serum activin A predicted for reduced PFS and overall survival in metastatic breast cancer patients treated with first-line trastuzumab-containing therapy. Trastuzumab-based therapy did not have a significant effect on activin A levels at one month. Patients with persistently high activin A levels had significantly worsened outcomes compared to those with low activin A levels. Serum activin A deserves further study to select patients most likely to respond to activin A-targeted therapy. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-06-33.
How can we treat multiple chronic conditions?
Authors: D. Kamerow
Journal: BMJ (2012)

Background: Colorectal cancers (CRC) with high level of microsatellite instability (MSI-H) are characterized by lower metastasis propensity and better prognosis than their stable microsatellite (MSS) counterpart. It was hypothesized that the difference in cancer progression might be related to distinct gelatinase-tissue inhibitors of metalloproteinase (TIMPs) balance in MSI-H and MSS sporadic CRC. Patients and Methods: Levels of gelatinase-A (MMP-2) and -B (MMP-9), TIMP-1 and -2 and membrane-type matrix metalloproteinase-1 (MT1-MMP) were compared in tumors and normal mucosa from patients with MSI-H and MSS CRC. Results: Active levels of MMP-2 and -9, normalized to normal mucosa, were lower in MSI-H than MSS CRC. There was a trend for higher levels of TIMP-1 and TIMP-2 within MSI-H tumors compared with MSS tumors (p=0.08 and p=0.15, respectively), while TIMP-2 amounts were significantly higher in adjacent normal tissue (p&lt;0.001) in patients with MSI-H vs. MSS cancers. There was also a trend for lower MT1-MMP activity in MSI-H than in MSS CRC. Conclusion: Our data suggest that the distinct invasive and metastatic behaviors of MSI-H and MSS CRC may be related to different patterns of gelatinase secretion and regulation.
IMPACT OF ACUTE KIDNEY INJURY ON OUTCOMES IN PATIENTS UNDERGOING BALLOON AORTIC VALVULOPLASTY
Authors: Nilusha Gukathasan, Annapoorna Kini, Roxana Mehran, Georgios Vlachojannis, Mauricio Cohen, Jennifer Yu, Ziad Sergie, Usman Baber, Samantha Sartori, Robert Pyo, Kleanthis Theodoropoulos, Eliot Elias, Socrates Kakoulides, Evan Jacobs, David Knopf, Jason Kovacic, Raj Vadde, Brian O'Neill, Samin Sharma, George Dangas
Journal: Journal of the American College of Cardiology (2013)
Alcohol consumption, serum low density lipoprotein cholesterol concentration, and risk of ischaemic heart disease: six year follow up in the Copenhagen male study
Authors: H. O. Hein, P. Suadicani, F. Gyntelberg
Journal: BMJ (1996)

<h3>Abstract</h3> <b>Objectives</b>: To investigate the interplay between use of alcohol, concentration of low density lipoprotein cholesterol, and risk of ischaemic heart disease. <b>Design</b>: Prospective study with controlling for several relevant confounders, including concentrations of other lipid fractions. <b>Setting</b>: Copenhagen male study, Denmark. <b>Subjects</b>: 2826 men aged 53-74 years without overt ischaemic heart disease. <b>Main outcome measure</b>: Incidence of ischaemic heart disease during a six year follow up period. <b>Results</b>: 172 men (6.1%) had a first ischaemic heart disease event. There was an overall inverse association between alcohol intake and risk of ischaemic heart disease. The association was highly dependent on concentration of low density lipoprotein cholesterol. In men with a high concentration (&gt;/=5.25 mmol/l) cumulative incidence rates of ischaemic heart disease were 16.4% for abstainers, 8.7% for those who drank 1-21 beverages a week, and 4.4% for those who drank 22 or more beverages a week. With abstainers as reference and after adjustment for confounders, corresponding relative risks (95% confidence interval) were 0.4 (0.2 to 1.0; P&lt;0.05) and 0.2 (0.1 to 0.8; P&lt;0.01). In men with a concentration &lt;3.63 mmol/l use of alcohol was not associated with risk. The attributable risk (95% confidence interval) of ischaemic heart disease among men with concentrations &gt;/=3.63 mmol/l who abstained from drinking alcohol was 43% (10% to 64%). <b>Conclusions</b>: In middle aged and elderly men the inverse association between alcohol consumption and risk of ischaemic heart disease is highly dependent on the concentration of low density lipoprotein cholesterol. These results support the suggestion that use of alcohol may in part explain the French paradox. <h3>Key messages</h3> Key messages The low risk of ischaemic heart disease in men with a low concentration of serum low density lipoprotein cholesterol was not modified by use of alcohol The risk of ischaemic heart disease in men with a high concentration of serum low density lipoprotein cholesterol was strongly modified by use of alcohol: those who did not drink alcohol had five times the risk of ischaemic heart disease compared with those who consumed three alcoholic beverages or more a day The results support the hypothesis that the apparent discrepancy between a low risk of ischaemic heart disease and a high intake of fat, a phenomenon known as the French paradox, may partly be explained by consumption of alcohol In studies of the use of alcohol and risk of ischaemic heart disease, serum low density lipoprotein cholesterol should be regarded as a potentially strong effect modifier not as a potential confounder
A world not his own
Authors: T. Dalrymple
Journal: BMJ (2008)

At the beginning of Georges Simenon’s 1960 detective story Maigret et les Vieillards (published in English as Maigret in Society ) Commissaire Maigret has dinner with his friends, Dr and Mrs Pardon. Dr Pardon mentions that the Lancet , “the famous and very austere English medical journal,” had mentioned Maigret. (Would anyone use the word “austere” to describe the journal now, I wonder?)

Maigret is surprised, of course, until Dr Pardon explains that it was of his profession as a whole that the journal—or Dr Richard Fox, to be precise—had written, not of him personally. Dr Pardon then translates the passage to which he refers: “A competent psychiatrist, who relies upon his scientific knowledge and on his experience …
Algorithm based improvement of clinical quality.
Authors: S C Schoenbaum, L K Gottlieb
Journal: BMJ (1990)

Ambulatory medical practice has traditionally taken place behind closed office doors.In recent years there has been a shift of important clinical decision making from the hospital setting to the physician's office, and ambulatory practices have been organised into managed entities (for example, health maintenance organisations and large group practices).Concomitantly, there has been an increasing interest in managing the practice that occurs behind the closed office door without violating the confidentiality of the physician-patient relationship.Problems relating to widespread variation in practices and practice styles have begun to surface, and the issue is not whether, but how best, to manage the variation.One approach, which is increasingly discussed, is to develop guidelines for practice.Though developing and disseminating guidelines undoubtedly will be increasingly important in managing clinical practices, guidelines are just the initial component of a cyclical process for improving clinical performance.In this article we illustrate some of the clinical management issues that managers face; provide a general framework for dealing with those problems, which includes developing and implementing practice guidelines; give a specific example of a clinical quality improvement project in our own organisation; and make some general points about the opportunities and difficulties of this approach.
Serious Sequelae of Intrauterine Contraceptive Devices
Authors: Gordon F. Schwartz
Journal: JAMA (1970)

Although the intrauterine contraceptive device (IUD) has been widely accepted as a safe, convenient means of preventing conception, the use of these devices in their various forms has been attended by complications related both to the type of device and to its insertion. Although most of these complications have been minor, reports of uterine perforations secondary to the use of IUD have been noted. The Surgical Service of the Columbia-Presbyterian Medical Center has encountered three patients with peritonitis or intestinal obstruction or both resulting from displaced IUDs. These seriously ill patients form the basis of this report and experiences with them lead to the conclusion that the discovery of an intraperitoneal IUD, despite the absence of symptoms, is sufficient reason for its elective removal.
Association of Retinal Sensitivity to Integrity of Photoreceptor Inner/Outer Segment Junction in Patients with Diabetic Macular Edema
Authors: Jithin Yohannan, Millena Bittencourt, Yasir Jamal Sepah, Elham Hatef, Raafay Sophie, Ahmadreza Moradi, Hongting Liu, Mohamed Ibrahim, Diana V. Do, Elizabeth Coulantuoni, Quan Dong Nguyen
Journal: Ophthalmology (2013)
Epidermal Growth Factor Receptor and Epidermal Growth Factor Receptor Therapies in Renal Cell Carcinoma: Do We Need a Better Mouse Trap?
Authors: Janet E. Dancey
Journal: Journal of Clinical Oncology (2004)

For many patients with metastatic renal cell carcinoma (RCC), successful therapy remains elusive. Despite earlier diagnosis and extensive efforts to develop more effective therapies, the outcome remains poor, with less than 10% of patients with metastases surviving 5 years. 1 Complete resection of metastases can result in long-term survival in some individuals, while removal of the primary tumor in patients with disseminated disease has also been shown to improve survival in selected patients receiving systemic immunotherapy. 2 While cytokine-based immunotherapies with interleukin-2 or interferon-alfa are the mainstays of treatment, response rates are 15% to 20%, and long-term survival rates are 6% to 8%. Thus, the systemic treatment of this disease remains unsatisfactory, and the need for more effective therapies is urgent. The rationale for testing epidermal growth factor receptor (EGFR) inhibitors in patients with advanced RCC is compelling. Multiple studies have documented that the overexpression of EGFR and its ligands epidermal growth factor (EGF) and transforming growth factor-alpha (TGF) in RCC occurs frequently. 3-6 Autocrine and paracrine signaling loops are associated with the development and progression of RCC metastases. 7,8 Most significantly for drug development decisions, EGFR signaling blockade decreases the proliferation of RCC cells in vitro and in vivo. 9,10 Current knowledge regarding the frequency of EGFR expression in human RCC and its successful manipulation in nonclinical human RCC models provides a sound basis for the clinical testing of EGFR inhibitors in RCC patients. However, results from clinical trials evaluating these agents to date have been unimpressive.
Radiation protection in digestive endoscopy: European Society of Digestive Endoscopy (ESGE) Guideline
Authors: J.-M. Dumonceau, F. Garcia-Fernandez, F. Verdun, E. Carinou, L. Donadille, J. Damilakis, I. Mouzas, K. Paraskeva, N. Ruiz-Lopez, L. Struelens, V. Tsapaki, F. Vanhavere, V. Valatas, M. Sans-Merce
Journal: Endoscopy (2012)

This article expresses the current view of the European Society of Gastrointestinal Endoscopy (ESGE) about radiation protection for endoscopic procedures, in particular endoscopic retrograde cholangiopancreatography (ERCP). Particular cases, including pregnant women and pediatric patients, are also discussed. This Guideline was developed by a group of endoscopists and medical physicists to ensure that all aspects of radiation protection are adequately dealt with. A two-page executive summary of evidence statements and recommendations is provided. The target readership for this Guideline mostly includes endoscopists, anesthesiologists, and endoscopy assistants who may be exposed to X-rays during endoscopic procedures.
Obstructed tilting disc mitral valve prosthesis associated with placenta praevia.
Authors: H G Kingston, B T Le Roux, T G Armstrong, F Margolis
Journal: Thorax (1977)

The occurrence of a bleeding placenta praevia in a young woman, with a viable fetus and an acutely obstructed Lillehei-Kaster valve, provided serious difficulties in priorities and decision making. This has prompted an analysis of the problems which others may encounter.
Multidisciplinary care team for cancer patients and its implementation in several Middle Eastern countries
Authors: M. Silbermann, B. Pitsillides, N. Al-Alfi, S. Omran, K. Al-Jabri, K. Elshamy, I. Ghrayeb, J. Livneh, M. Daher, H. Charalambous, A. Jafferri, R. Fink, M. El-Shamy
Journal: Annals of Oncology (2013)
Common (Single) Ventricle with Normally Related Great Vessels
Authors: JOSÉ MARÍN-GARCÍA, RAJENDRA TANDON, JAMES H. MOLLER, JESSE E. EDWARDS
Journal: Circulation (1974)

A rare form of common ventricle with normally related great vessels and normal tricuspid and mitral valves should be considered in the differential diagnosis of cardiac anomalies presenting with cyanosis. Fourteen cases of this type of common ventricle were studied; in seven the diagnosis was made at necropsy and in seven it was based on angiographic evidence. That the common ventricle was morphologically a left ventricle was determined in the seven necropsy cases, and angiocardiographic examination confirmed the finding in the others. Continuity of the aortic valve and the mitral valve was observed in all the necropsy cases and in five of the clinical cases. Cyanosis had been observed clinically in 13 of the 14 cases, and pulmonary stenosis was present in four necropsy and three clinical cases. Electrocardiograms showed left axis deviation in nine of the 13 cases studied. Vectorcardiographic findings, though variable and available in only seven cases, tended to show a narrow horizontal plane QRS vector loop in patients with restricted pulmonary blood flow and a wide loop in those with increased pulmonary flow. The clinical, laboratory, and pathologic findings are reported and the differential diagnosis and the profile of the condition are considered.
955-56 Contrast Echocardiographic Assessment of Myocardial Pertusion Following Acute Coronary Artery Occlusion and Repertusion Using Intravenous Injection of Aerosome™ MRX 115 in Monkeys
Authors: Jinping Xu, George A. Pantely, Shuping Ge, Susan Grauer, Takahiro Shiota, Zheng Gong, Xiaodong Zhou, David J. Sahn
Journal: Journal of the American College of Cardiology (1995)
Fulminating Infection with Herpes-Simplex Virus in Premature and Newborn Infants
Authors: James G. White
Journal: New England Journal of Medicine (1963)

HERPES-simplex virus was first isolated from a "fever blister" in 1919 by Lowenstein.1 This virus has been shown in more recent years to be the etiologic agent in acute infectious gingivostomatitis.2 3 4 5 In that these two entities are most commonly thought of when herpes simplex is mentioned, one tends to think of the virus more as a nuisance than as one causing fatal illness, although it is an occasional cause of encephalitis.6 Hass,7 however, in 1935, and, more recently, others8 9 10 11 12 13 14 15 16 17 reported cases of disseminated infection in premature and newborn infants. These investigators recorded a total of 19 cases with virus isolations . . .
BORIC-ACID POISONING.REPORT OF A FATAL CASE, WITH AUTOPSY.
Authors: CHARLES L. BEST
Journal: JAMA (1904)

The opinion appears to exist that boric acid, even in large amounts, is entirely innocuous to the human body when applied externally to wounds, suppurating cavities, etc. That this is erroneous and that the surgeon must be on his guard against its too free usage, as it is not impossible for a fatal issue to ensue, is shown by the literature, in which five cases of severe intoxication and four deaths are reported in addition to the case at hand. These cases all resulted from the prolonged irrigation with saturated solutions of boric acid or the packing of large cavities with the dry powder. Welch<sup>1</sup>reports his experience in the treatment of lencorrhea, in which he packed the upper third of the vagina with boric acid, allowing it to remain until liquefied, usually two to three days. This was repeated every seventh day. In three cases intoxication resulted, and are
Guillain-Barré Syndrome Following Influenza Vaccination
Authors: Penina Haber
Journal: JAMA (2004)

An unexplained increase in the risk of Guillain-Barre syndrome (GBS) occurred among recipients of the swine influenza vaccine in 1976-1977. Guillain-Barre syndrome remains the most frequent neurological condition reported after influenza vaccination to the Vaccine Adverse Events Reporting System (VAERS) since its inception in 1990.To evaluate trends of reports to VAERS of GBS following influenza vaccination in adults.VAERS is the US national spontaneous reporting system for adverse events following vaccination. Reports of GBS in persons 18 years or older following influenza vaccination were evaluated for each influenza season from July 1, 1990, through June 30, 2003. The number of people vaccinated was estimated from the National Health Interview Survey and US census data. Beginning in 1994, active follow-up was conducted to verify GBS diagnosis and obtain other clinical details.Reporting rates of GBS following influenza vaccination over time.From July 1990 through June 2003, VAERS received 501 reports of GBS following influenza vaccination in adults. The median onset interval (13 days) was longer than that of non-GBS reports of adverse events after influenza vaccine (1 day) (P<.001). The annual reporting rate decreased 4-fold from a high of 0.17 per 100,000 vaccinees in 1993-1994 to 0.04 in 2002-2003 (P<.001). A GBS diagnosis was confirmed in 82% of reports. Preceding illness within 4 weeks of vaccination was identified in 24% of reported cases.From 1990 to 2003, VAERS reporting rates of GBS after influenza vaccination decreased. The long onset interval and low prevalence of other preexisting illnesses are consistent with a possible causal association between GBS and influenza vaccine. These findings require additional research, which can lead to a fuller understanding of the causes of GBS and its possible relationship with influenza vaccine.
One-Hour Value for Urinary Amylase in 96 Patients with Pancreatitis
Authors: Earl E. Gambill
Journal: JAMA (1963)

In 96 patients with unquestionable pancreatitis the hourly excretion of amylase in the urine was determined on the basis of a 2-hour collection of urine. The values obtained were compared with the values for serum amylase and, in some instances, for serum lipase. The value for serum amylase exceeded the upper limit of normal in only 36% of tests, while the value for urinary amylase exceeded this limit in 74% when both were determined on the same day. When these two tests and the serum-lipase test (all three performed on the same day) gave increased values, the mean values exceeded the upper limit of normal 80% for serum lipase, 120% for serum amylase, and 710% for urinary amylase. Early, when the disease process clinically seemed more acute, the values for serum and urinary amylase were higher than normal in 53% and 78% of tests respectively, as compared with 15% and 54% later, when the acute process had largely subsided. Our observations, therefore, confirm those of earlier investigators that the urinary-amylase test is a much more sensitive reflector of the presence of pancreatitis and of its clinical course than is the serum-amylase or serum-lipase test.
Altered distribution and function of natural killer cells in murine and human Niemann-Pick disease type C1
Authors: Anneliese O. Speak, Danielle te Vruchte, Lianne C. Davis, Anthony J. Morgan, David A. Smith, Nicole M. Yanjanin, Louise Simmons, Ralf Hartung, Heiko Runz, Eugen Mengel, Michael Beck, Jackie Imrie, Elizabeth Jacklin, James E. Wraith, Christian Hendriksz, Robin Lachmann, Celine Cognet, Rohini Sidhu, Hideji Fujiwara, Daniel S. Ory, Antony Galione, Forbes D. Porter, Eric Vivier, Frances M. Platt
Journal: Blood (2013)