tbuckley/cabot-search huggingface dataset:
Nonemergency PCI without onsite cardiac surgery was noninferior to PCI with onsite services for MACE
Authors: Siddharth A. Wayangankar, Herbert D. Aronow
Journal: Annals of Internal Medicine (2013)

ACP Journal Club16 July 2013Nonemergency PCI without onsite cardiac surgery was noninferior to PCI with onsite services for MACESiddharth A. Wayangankar, MD, MPH, Herbert D. Aronow, MD, MPHSiddharth A. Wayangankar, MD, MPHUniversity of Oklahoma, Oklahoma City, Oklahoma, USA (S.A.W.)Search for more papers by this author, Herbert D. Aronow, MD, MPHSt. Joseph Mercy Hospital, Ann Arbor, Michigan, USA (H.D.A.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-2-201307160-02006 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationJacobs AK, Normand SL, Massaro JM, et al; MASS COMM Investigators. Nonemergency PCI at hospitals with or without on-site cardiac surgery. N Engl J Med. 2013;368:1498-508. https://pubmed.ncbi.nlm.nih.gov/23477625Clinical Impact RatingsHospitalists: Cardiology: References1 Aversano T, Lemmon CC, Liu L; Atlantic CPORT Investigators. Outcomes of PCI at hospitals with or without on-site cardiac surgery. N Engl J Med. 2012;366:1792-802. [PMID: 22443460] Google Scholar2 Levine GN, Bates ER, Blankenship JC, et al; American College of Cardiology Foundation; American Heart Association Task Force on Practice Guidelines; Society for Cardiovascular Angiography and Interventions. 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. J Am Coll Cardiol. 2011;58:e44-122. [PMID: 22070834] Google Scholar Author, Article, and Disclosure InformationAuthors: Siddharth A. Wayangankar, MD, MPH; Herbert D. Aronow, MD, MPHAffiliations: University of Oklahoma, Oklahoma City, Oklahoma, USA (S.A.W.)St. Joseph Mercy Hospital, Ann Arbor, Michigan, USA (H.D.A.) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 16 July 2013Volume 159, Issue 2 Page: JC6 Keywords Angioplasty Cardiac surgery Catheterization Coronary arteries Ejection fraction Heart rate Hospitalists Lesions Myocardial infarction Myocardium Percutaneous coronary intervention Revascularization Safety Stable coronary artery disease Statistical data Stenosis Stent implantation Stroke Surgery Veins ePublished: 8 March 2020 Issue Published: 16 July 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Providing High-Value, Cost-Conscious Care
Authors: Steven E. Weinberger
Journal: Annals of Internal Medicine (2011)

Letters20 December 2011Providing High-Value, Cost-Conscious CareSteven E. Weinberger, MDSteven E. Weinberger, MDFrom American College of Physicians, Philadelphia, PA 19106.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-12-201112200-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:I appreciate the many thoughtful comments in response to my proposal that cost-consciousness be elevated to the level of a seventh general competency for physicians.Dr. Pollak appropriately notes, as mentioned in the article, that cost-consciousness currently resides within the general competency of systems-based practice. However, as mentioned by Dr. Graham, Dr. Potyk, and Ms. Raimi, this wording in the training program requirements is very general and does not include sufficient specificity to achieve the intended goal (1). As I argued in my article, the inclusion of cost-consciousness under systems-based practice does not give it sufficient visibility or ...References1. Accreditation Council for Graduate Medical Education. Common Program Requirements: General Competencies. Accessed at www.acgme.org/outcome/comp/GeneralCompetenciesStandards21307.pdf on 24 October 2011. Google Scholar2. ABIM Foundation. American Board of Internal Medicine. Medical professionalism in the new millennium: a physician charter. Ann Intern Med. 2002;136:243-6. [PMID: 11827500] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From American College of Physicians, Philadelphia, PA 19106.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-1081. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMedical Professionalism in the New Millennium: A Physician CharterProviding High-Value, Cost-Conscious Care: A Critical Seventh General Competency for Physicians Steven E. Weinberger Providing High-Value, Cost-Conscious Care Brian Pollak Providing High-Value, Cost-Conscious Care Jeremy D. Graham , Darryl K. Potyk , and Elise D. Raimi Providing High-Value, Cost-Conscious Care Christine K. Cassel Providing High-Value, Cost-Conscious Care Carlos O. Weiss , Maia Holden , and Matthew McNabney Providing High-Value, Cost-Conscious Care Ira S. Nash Providing High-Value, Cost-Conscious Care Christopher L. Knight Providing High-Value, Cost-Conscious Care Erik A. Wallace Metrics Cited byHigh-Value, Cost-Conscious Care Attitudes in the Graduate Medical Education Learning Environment: Various Stakeholder Attitudes That Residents Misjudge 20 December 2011Volume 155, Issue 12Page: 860KeywordsDisclosureHealth careHealth care providersHealth care qualityHealth information technologyMedical educationMedical servicesPatientsPhysiciansSpecificity ePublished: 20 December 2011 Issue Published: 20 December 2011 Copyright & PermissionsCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Continuous recording of direct arterial pressure in unrestricted patients. Its role in the diagnosis and management of high blood pressure.
Authors: W A Littler, A J Honour, D J Pugsley, P Sleight
Journal: Circulation (1975)

We have compared casual indirect measurements of arterial pressure obtained 1) by the general practitioner (GP) and 2) in the outpatient clinic (OPC) with 24 hour continuous recording of direct arterial pressure in two selected group of unrestricted patients. 1) Eight asymptomatic, untreated patients with suspected hypertension. 2) Eight asymptomatic, treated patients whose indirect pressure readings seemed inappropriately high when considered against a general absence of target organ damage. Both groups showed that usually there was good agreement between arterial pressure recorded indirectly by GP and OPC while continuous recording showed wide variability of systolic and diastolic pressures over 24 hours and a significant fall during sleep. The first groups with suspected hypertension showed that the indirect measurements were not significantly different from the 24 hour direct recording. The second group of patients on treatment for hypertension showed a discrepancy, the direct readings being significantly lower than the indirect. This difference (approixmately 30 mm Hg mean arterial pressure) would explain the lack of target organ damage and may have been due to the effect of exercise augmenting the hypotensive action of drugs or due to a well developed defense reflex which biased the indirect readings.
SUGAR IN THE DIET
Authors: R. A. Guy
Journal: JAMA (1942)

<h3>To the Editor:—</h3> Now it can be told! Today, when we are confronted by the inestimable nutritional boon of sugar restriction, cannot those who have the health of the nation in keeping, those who have pointed out that some forty million people in this country are not properly nourished, make it plain to the public as a whole that a large role in this deficit of minerals and vitamins is due to the excessive consumption of sugar— refined sugar which supplies energy without any other nutritive assets? The public should be brought to understand that sugar as such is no necessity, that the energy can better be derived from foods that carry other essential nutrients. Even the youngest artificially fed infants today are usually provided with extra carbohydrate in the form of corn syrup. All those concerned with nutrition have long felt that the excessive consumption of sugar in this
Treatment of Acute Falciparum Malaria With Sulfalene and Trimethoprim
Authors: Daniel C. Martin
Journal: JAMA (1968)

The combination of a long-acting sulfonamide, sulfalene, and a dihydrofolic acid reductase inhibitor, trimethoprim, proved to be effective as a radical cure against a normal, as well as a chloroquine-quinine-pyrimethamine-resistant<i>Plasmodium falciparum</i>in nonimmune volunteers. The malaria caused by normal<i>P falciparum</i>was cured (eight of eight cases) by sulfalene (0.25 gm) plus trimethoprim (0.125 gm) administered as a single dose. Sulfalene (0.75 gm) plus trimethoprim (0.5 gm) combined cured ten of 11 patients with malaria caused by chloroquine-pyrimethamine-quinine-resistant<i>P falciparum</i>. Attempts to induce resistance to the combination have been unsuccessful thus far. The speed of action in clearance of parasites and lysis of fever compares favorably with that of chloroquine at its best. The combination is easily tolerated as a single dose.
Thyroid hormone improves the mechanical performance of the post-infarcted diabetic myocardium: A response associated with up-regulation of Akt/mTOR and AMPK activation
Authors: Iordanis Mourouzis, Irini Giagourta, Georgios Galanopoulos, Polixeni Mantzouratou, Erietta Kostakou, Alexandros D. Kokkinos, Nikolaos Tentolouris, Constantinos Pantos
Journal: Metabolism (2013)
TRANSPERITONEAL LIGATION OF THE RENAL VESSELSAS A PRELIMINARY TO A LUMBAR NEPHRECTOMY IN TUBERCULOSIS OR MALIGNANT GROWTHS OF THE KIDNEY.
Authors: GEORGE WALKER
Journal: JAMA (1905)

A recent somewhat exhaustive study of tuberculosis of the kidney, the results of which have been published elsewhere, necessitated the examination of a large number of pathologic specimens, not only of renal tuberculosis but also of malignant tumors, in the Johns Hopkins Pathological Laboratory. From a careful analysis of over 400 cases of renal tuberculosis which I have collected from the literature and from personal observations on a number of instances of tuberculosis and malignant growth, I have been led to conclude that in the course of a lumbar nephrectomy for either of these two conditions, the operator is liable to squeeze tuberculous or malignant material into the general circulation and thereby cause an infection or metastasis. This conclusion is based on the following facts: <h3>First.</h3> —Microscopic examination of numerous specimens of renal tuberculosis showed that the lymphatic vessels and the capillaries not infrequently end very near the tuberculous area.
Cost Containment in Oregon: As Simple as A×B?-Reply
Authors: David M. Eddy
Journal: JAMA (1992)

<h3>In Reply.</h3> —First, I have to admit that I do not completely understand everything Dr Goris is saying. I think that Goris' discussion of "isomorphism" and "<i>a</i>(risk) times<i>b</i>(benefit) is necessarily equal to<i>b</i>(risk) times<i>a</i>(benefit)" is based on his belief that Oregon was calculating benefit-risk ratios. (Read "<i>a</i>[benefit]" as "the benefit of treatment<i>a</i>," and so forth. Then "treatment<i>a</i>" will be equivalent to "treatment<i>b</i>" if<i>a</i>[benefit]×<i>a</i>[risk]=<i>b</i>[benefit]×<i>b</i>[risk].) Goris wants to be certain that if formulas like this are to be used, benefits and risks must be measured on numerical scales that have the properties required in order to make the formulas correct. It also appears that Goris believes I was endorsing Oregon's original formula, or endorsing Oregon's final method, or offering a correct method of my own. Based on these assumptions, I can offer the following
P266 Respiratory, sleepiness and metabolic measures and obstetric outcomes in obese expectant mothers
Authors: J James, A K Datta
Journal: Thorax (2012)

<h3></h3> Increasing obesity in the UK population includes expectant mothers.<sup>1</sup> Data from local antenatal clinics(3391 deliveries and 3826 women booked in 2011) show that the number of women with a BMI&gt; 30 (O) and BMI&gt;50 (SO) are rising particularly in the last 5 years (Fig. 1). We wished to determine the respiratory consequences and maternal outcome for these women. We examined obese women with a BMI &gt;50 Kg/m<sup>2</sup> (<b>SO</b>) who gave birth in 2011 and matched them against non-obese (BMI &lt;30) women (<b>N</b>) who delivered on the same day. The percentage of <b>SO</b> v <b>N</b> women respectively who gave a history of asthma, diabetes and depression, was 67% v 17%, 50% v 0% and 50% v 17% respectively. Mean Oxygen saturation in (<b>O and SO)</b> women, supine at rest and awake was 98% and in <b>N</b> 99%. This difference was statistically significant (p = 0.016, unpaired t test, 26 df). Snoring was seen in 67% (<b>O</b> &amp;<b> SO</b>) v 40% <b>N</b> (p = 0.07, χ<sup>2</sup>). No difference was seen in the mean Epworth sleepiness scores (<b>ESS;</b><b>0</b> 6.2 v <b>N</b> 6.6) suggesting <b>ESS</b> is insensitive in these patients. Mean (range) heart rate at rest awake was 84.7 (72–106) bpm in <b>SO</b> and <b>O,</b> v 81.5 (70–99) in <b>N</b> (p= 0.66, unpaired t test) Mean (range) weight gain during pregnancy in <b>N</b> was 10 (1–16)Kg v 6.3 (–5 – 20) Kg in <b>SO</b> and <b>O</b> (p=0.17, unpaired t test). 100% <b>N</b> but only 67% <b>SO</b> women delivered babies with an acceptable birth weight defined as 2.7–4.0Kg. 37.5% of <b>O</b> and <b>SO</b> women had miscarriages v 8.3% <b>N</b> (p=0.066, χ<sup>2</sup>). We conclude that obesity, particularly in <b>SO</b>, is associated with an increasing burden on the respiratory and psychological health of expectant mothers, on the outcome of their pregnancies and hospital services. <h3>Reference</h3> Heslehurst N, Ells LJ, Simpson H, Batterham A, Wilkinson J, Summerbell CD (2007)Trends in Maternal Obesity incidence rates, demographic predictors, and health inequalities in 36,821 women over a 15-year period. BJOG 114:187–94. We acknowledge support of Consultant obstetricians, anaesthetists and Midwifery staff.
Extrahepatic obstructive cholestasis reverses the bile salt secretory polarity of rat hepatocytes.
Authors: G Fricker, L Landmann, P J Meier
Journal: Journal of Clinical Investigation (1989)

To elucidate the consequences of extrahepatic cholestasis on the structure and function of hepatocytes, we studied the effects of bile duct ligation on the turnover, surface distribution, and functional activity of the canalicular 100-kD bile salt transport protein (cBSTP). Basolateral (blLPM) and canalicular (cLPM) liver plasma membrane vesicles were purified to the same degree from normal and cholestatic rat livers and the membrane bound cBSTP identified and quantitated using polyclonal anti-cBSTP antibodies. Cholestasis of 50 h resulted in an increased release of cBSTP into bile, thereby decreasing its in vivo half-life from 65 to 25 h. Furthermore, a significant portion of cBSTP accumulated at the basolateral surface and in intracellular vesicles of cholestatic hepatocytes. This redistribution of cBSTP was functionally paralleled by decreased and increased electrogenic taurocholate anion transport in cLPM and blLPM vesicles, respectively. These results demonstrate that biliary obstruction causes a reversal of the bile salt secretory polarity of rat hepatocytes. The resulting increase in basolateral (sinusoidal) bile salt efflux might protect hepatocytes from too high an accumulation of toxic bile salts within the cell interior.
Multiple and Overlapping Combinatorial Codes Orchestrate Hormonal Responsiveness and Dictate Cell-Specific Expression of the Genes Encoding Luteinizing Hormone
Authors: Joan S. Jorgensen, Christine C. Quirk, John H. Nilson
Journal: Endocrine Reviews (2004)

Normal reproductive function in mammals requires precise control of LH synthesis and secretion by gonadotropes of the anterior pituitary. Synthesis of LH requires expression of two genes [alpha-glycoprotein subunit (alphaGSU) and LHbeta] located on different chromosomes. Hormones from the hypothalamus and gonads modulate transcription of both genes as well as secretion of the biologically active LH heterodimer. In males and females, the transcriptional tone of the genes encoding alphaGSU and LHbeta reflects dynamic integration of a positive signal provided by GnRH from hypothalamic neurons and negative signals emanating from gonadal steroids. Although alphaGSU and LHbeta genes respond transcriptionally in the same manner to changes in hormonal input, different combinations of regulatory elements orchestrate their response. These hormone-responsive regulatory elements are also integral members of much larger combinatorial codes responsible for targeting expression of alphaGSU and LHbeta genes to gonadotropes. In this review, we will profile the genomic landscape of the promoter-regulatory region of both genes, depicting elements and factors that contribute to gonadotrope-specific expression and hormonal regulation. Within this context, we will highlight the different combinatorial codes that control transcriptional responses, particularly those that mediate the opposing effects of GnRH and one of the sex steroids, androgens. We will use this framework to suggest that GnRH and androgens attain the same transcriptional endpoint through combinatorial codes unique to alphaGSU and LHbeta. This parallelism permits the dynamic and coordinate regulation of two genes that encode a single hormone.
Errors in Measuring Drug Concentrations
Authors: William McCormick, Joseph A. Ingelfinger, Gordon Isakson, Peter Goldman
Journal: New England Journal of Medicine (1978)

MUCH of the research and practice of clinical pharmacology depends on the measurement of drug concentrations in the serum.1 The error of these measurements can be monitored by assaying samples containing known amounts of drug.2 However, errors made in the measurement of quality-control specimens may underestimate the error made on clinical samples.3 Quality-control specimens often do not resemble clinical specimens either in appearance or in the route of access to the laboratory.4 Laboratory personnel may exert unusual care in assaying samples recognized as quality-control specimens, and measurements made on specially submitted specimens circumvent errors arising in the handling and reporting . . .
BCG Vaccine Treatment of Hodgkin Disease
Authors: Vincent T. DeVita
Journal: JAMA (1974)

To the Editor.—  I feel obliged to respond to the MEDICAL NEWS article about the use of BCG vaccine in Hodgkin disease (227:131, 1974). I consider Dr. McIlvanie's comment, We have been killing people with chemotherapy for so many years to be somewhat irresponsible if correctly quoted. Not only has survival improved markedly in drug-treated patients, 1,2 but many patients remain disease-free after ending all therapy for periods now approaching ten years, a phenomenon not observed before aggressive chemotherapy. These data are derived from many hundreds of patients in multiple institutions. It is difficult to understand, therefore, how a physician could draw this negative conclusion based on two patients, both of whom received what most experienced physicians would consider an inappropriate sequence, and therefore inadequate, trial of chemotherapy. In addition, both these patients are apparently not entirely free of disease; their short follow-up period would certainly warrant more cautious optimism.  Since
Analogical apes and paleological monkeys revisited
Authors: Roger K. R. Thompson, Timothy M. Flemming
Journal: Behavioral and Brain Sciences (2008)

Abstract We argue that formal analogical reasoning is not a uniquely human trait but is found in chimpanzees, if not in monkeys. We also contest the claim that the relational matching-to-sample task is not exemplary of analogical behavior, and we provide evidence that symbolic-like treatment of relational information can be found in nonhuman species, a point in contention with the relational reinterpretation hypothesis.
Echocardiographic quantification of left ventricular asynchrony predicts an acute hemodynamic benefit of cardiac resynchronization therapy
Authors: Ole A. Breithardt, Christoph Stellbrink, Andrew P. Kramer, Anil M. Sinha, Andreas Franke, Rodney Salo, Bernhard Schiffgens, Etienne Huvelle, Angelo Auricchio
Journal: Journal of the American College of Cardiology (2002)
Pulmonary Embolectomy
Authors: H. C. Stansel, M. Hume, William W. L. Glenn
Journal: New England Journal of Medicine (1967)

TRENDELENBURG,1 in 1908, first proposed the possibility of embolectomy for patients with massive pulmonary embolism. He attempted his operation upon 3 patients but was unsuccessful in each.The first successful pulmonary embolectomy was performed in 1924 by Kirschner.2 Although sporadic reports of successful embolectomies came from Europe, it was not until 1958 that the first embolectomy with a surviving patient was reported from America. This report, by Steenburg et al.,3 describes the classic pulmonary embolectomy performed without the use of cardiopulmonary bypass.The availability of reliable extracorporeal circulation led to the reports by Sharp,4 and Cooley et al.5 and subsequently . . .
Hepatic Bile Formation
Authors: Norman B. Javitt
Journal: New England Journal of Medicine (1976)

Except that hepatic excretory function is frequently disturbed during the course of many illnesses, attempts by investigators to understand the physiologic mechanisms governing bile formation might better be delayed until more fundamental knowledge has accumulated in the basic disciplines that must be applied to the problem. These disciplines include the structure of water,1 water transport across biologic membranes,2 solute transport across biologic membranes3 and the structure of membranes.4 In these reports studies of transport across a variety of tissues are described, but in none does one find a study of transport function of the liver. Investigators usually try to limit . . .
Dual natriuretic peptide response to volume load in the fetal circulation
Authors: T. Walther, H. Stepan, R. Faber
Journal: Cardiovascular Research (2001)

Objective: To measure atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) in control fetuses and fetuses with Rhesus isoimmunisation before and after intravascular transfusion. The current study was designed to investigate the response of ANP and BNP to cardiac short-term and long-term volume load in the human fetus. Methods: Fetal blood samples were collected from 18 human fetuses (nine controls, nine anemic fetuses with Rhesus isoimmunisation before and after intravascular transfusion). Fetal ANP and BNP concentrations were measured and compared to maternal plasma levels. Results: Both ANP and BNP were significantly higher in fetal blood compared to the mothers. Fetuses with Rhesus isoimmunisation, characterized by long-term cardiac overload, showed significantly elevated ANP but not BNP concentration compared to the fetal controls (ANP: 80.8±16.6 vs. 31.6±7.7 pg/ml, P<0.05). However, short-term volume load due to intravascular transfusion leads to a significant increase in the fetal BNP- but not ANP-plasma level (BNP: 112.9±14.1 vs. 64.8±6.6 pg/ml, P<0.05). Conclusion: ANP and BNP respond differently to cardiac short- and long-term volume load in the fetal circulation. Therefore, the data suggest that in the fetus, similar to adults, ANP and BNP constitute a dual natriuretic peptide system responsive to changes in cardiac filling pressure.