tbuckley/cabot-search huggingface dataset:
Asymptomatic adults should not be screened for carotid artery stenosis, US panel concludes
Authors: M. McCarthy
Journal: BMJ (2014)

Asymptomatic adults should not be screened for carotid artery stenosis, the US Preventive Services Task Force (USPSTF) has recommended.1

The new recommendations applied to adults without a history of transient ischemic attack, stroke, or other neurologic signs and symptoms and reaffirmed similar recommendations made by the task force in 2007. USPSTF makes recommendations on the effectiveness of preventive care services for patients without related conditions and services. It bases its recommendations on the evidence for benefits and harms but does not consider costs.

The review was funded by the US Agency for Healthcare Research and Quality. The …
Antiviral Activity of Nrf2 in a Murine Model of Respiratory Syncytial Virus Disease
Authors: Hye-Youn Cho, Farhad Imani, Laura Miller-DeGraff, Dianne Walters, Guillermina A. Melendi, Masayuki Yamamoto, Fernando P. Polack, Steven R. Kleeberger
Journal: American Journal of Respiratory and Critical Care Medicine (2008)

Rationale: Respiratory syncytial virus (RSV) is the most frequent cause of significant lower respiratory illness in infants and young children, but its pathogenesis is not fully understood. The transcription factor Nrf2 protects lungs from oxidative injury and inflammation via antioxidant response element (ARE)-mediated gene induction.Objectives: The current study was designed to determine the role of Nrf2-mediated cytoprotective mechanisms in murine airway RSV disease.Methods: Nrf2-deficient (Nrf2−/−) and wild-type (Nrf2+/+) mice were intranasally instilled with RSV or vehicle. In a separate study, Nrf2+/+ and Nrf2−/− mice were treated orally with sulforaphane (an Nrf2-ARE inducer) or phosphate-buffered saline before RSV infection.Measurements and Main Results: RSV-induced bronchopulmonary inflammation, epithelial injury, and mucus cell metaplasia as well as nasal epithelial injury were significantly greater in Nrf2−/− mice than in Nrf2+/+ mice. Compared with Nrf2+/+ mice, significantly attenuated viral clearance and IFN-γ, body weight loss, heightened protein/lipid oxidation, and AP-1/NF-κB activity along with suppressed antioxidant induction was found in Nrf2−/− mice in response to RSV. Sulforaphane pretreatment significantly limited lung RSV replication and virus-induced inflammation in Nrf2+/+ but not in Nrf2−/− mice.Conclusions: The results of this study support an association of oxidant stress with RSV pathogenesis and a key role for the Nrf2-ARE pathway in host defense against RSV.
Detection of a Venous Collateral Pathway by Mammography
Authors: Gordon K. McLean, Adele K. Friedman
Journal: JAMA (1978)

THE SYNDROME of superior vena caval syndrome (SVCS) may be associated with a variety of patterns of collateral circulation. We report the case of a patient with SVCS who had a unique route of collateral circulation consisting of a superficial breast vein discovered in the course of routine mammography. This finding provided a clue to the cause of a mediastinal pseudotumor in the chest roentgenogram that resulted from dilation of the left superior intercostal and accessory hemiazygous veins. <h3>Report of a Case</h3> In 1970 a 35-year-old woman entered the emergency room of the Hospital of the University of Pennsylvania with chief complaint of swelling in the left axilla for two days. A chest x-ray showed a mediastinal mass, and the patient was admitted for further study. Additional history included tightness in the throat and anterior superior chest wall for approximately one year, mild shortness of breath on exertion, and intermittent
Air Pollution Exposures and Circulating Biomarkers of Effect in a Susceptible Population: Clues to Potential Causal Component mixtures and mechanisms
Authors: Ralph J. Delfino, Norbert Staimer, Thomas Tjoa, Daniel L. Gillen, Andrea Polidori, Mohammad Arhami, Micheal T. Kleinman, Nosratola D. Vaziri, John Longhurst, Constantinos Sioutas
Journal: Environmental Health Perspectives (2009)

Mechanisms involving oxidative stress and inflammation have been proposed to explain associations of ambient air pollution with cardiovascular morbidity and mortality. Experimental evidence suggests that organic components and ultrafine particles (UFP) are important.We conducted a panel study of 60 elderly subjects with coronary artery disease living in retirement communities within the Los Angeles, California, air basin. Weekly biomarkers of inflammation included plasma interleukin-6, tumor necrosis factor-alpha soluble receptor II (sTNF-RII), soluble platelet selectin (sP-selectin), and C-reactive protein (CRP). Biomarkers of erythrocyte antioxidant activity included glutathione peroxidase-1 and superoxide dismutase. Exposures included outdoor home daily particle mass [particulate matter < 0.25, 0.25-2.5, and 2.5-10 microm in aerodynamic diameter (PM(0.25), PM(0.25-2.5), PM(2.5-10))], and hourly elemental and black carbon (EC-BC), estimated primary and secondary organic carbon (OC(pri), SOC), particle number (PN), carbon monoxide (CO), and nitrogen oxides-nitrogen dioxide (NO(x)-NO(2)). We analyzed the relation of biomarkers to exposures with mixed effects models adjusted for potential confounders.Primary combustion markers (EC-BC, OC(pri), CO, NO(x)-NO(2)), but not SOC, were positively associated with inflammatory biomarkers and inversely associated with erythrocyte anti-oxidant enzymes (n = 578). PN and PM(0.25) were more strongly associated with biomarkers than PM(0.25-2.5). Associations for all exposures were stronger during cooler periods when only OC(pri), PN, and NO(x) were higher. We found weaker associations with statin (sTNF-RII, CRP) and clopidogrel use (sP-selectin).Traffic-related air pollutants are associated with increased systemic inflammation, increased platelet activation, and decreased erythrocyte antioxidant enzyme activity, which may be partly behind air pollutant-related increases in systemic inflammation. Differences in association by particle size, OC fraction, and seasonal period suggest components carried by UFP are important.
Pertussis Disease, Vaccine, and Controversy
Authors: Vincent A. Fulginiti
Journal: JAMA (1984)

Whooping cough affected as many as 265,000 persons and killed 9,000 to 12,000 at its peak in the United States in the 1930s.<sup>1</sup>Today, five to 20 persons die each year and the disease has been reduced to 1,000 to 2,000 cases per year. Pertussis vaccine was widely introduced in the 1950s and 1960s, and we have achieved a 90%+ rate of immunization among school-children.<sup>2</sup>It is not a perfect vaccine; some persons are only partially protected and some not at all. Furthermore, it has a high frequency of transient, nondamaging side effects, a lesser frequency of potentially serious adverse effects, and a remote risk of permanent neurological sequelae or death.<sup>3</sup> Given this brief summary, one might expect cautious rejoicing. We can rejoice in that, once again, preventive measures seem to have triumphed in diminishing disease; indeed, the reduction in pertussis is striking and impressive. We are
TERMINATION OF CHLORPROMAZINE WITH SCHIZOPHRENIC PATIENTS
Authors: W. W. GOOD, MAC STERLING, WAYNE H. HOLTZMAN
Journal: American Journal of Psychiatry (1958)

The primary purpose of this study was to determine the effect upon behavior of withdrawing chlorpromazine treatment after it had been established as the preferred treatment routine. Four groups of patients, each containing 28 chronic schizophrenics matched for length of treatment on clinical dosage of chlorpromazine, were studied intensively for 6 months. During the first 3 months, groups PP and PT were given placebo tablets while groups TP and TT were continued on chlorpromazine. Groups PP and TP were given placebo during the second 3-month period, while the other two groups received chlorpromazine. Behavior ratings by nursing personnel were gathered on each of the 112 patients every 3 weeks, using the MSRPP. Independent ratings were made by the ward psychiatrist every 3 months. Measures of mental functioning were also obtained at the beginning, middle, and end of the experiment by a psychologist using the Army Beta, the Bender-Gestalt, and the Draw-A-Person tests.
MANAGEMENT OF PREGNANCY, COMPLICATED BY ABDOMINAL TUMORS.
Authors: RUFUS B. HALL
Journal: JAMA (1899)

The subject of abdominal and pelvic tumors, associated with pregnancy, including as it must malignant growths, being so large a subject, I will confine myself entirely to the discussion of the management of ovarian and uterine tumors complicating pregnancy. One of the gravest problems ever presented to a physician is the satisfactory settlement of this question. We not only have the interests of the mother to conserve, but the interests of one that is wholly unable to protect itself. On the satisfactory settlement of this question much depends, not only to the patient and her friends, but to the good name of the physician in charge and, indirectly, to that of the whole profession. While these cases are not common, they occur frequently enough to make this subject one of exceeding interest to every man engaged in the special work of this Section. I think I voice the sentiments of
Female gender as a risk factor for torsades de pointes associated with cardiovascular drugs
Authors: R. R. Makkar
Journal: JAMA (1993)

To test the hypothesis that female prevalence is greater than expected among reported cases of torsades de pointes associated with cardiovascular drugs that prolong cardiac repolarization.A MEDLINE search of the English-language literature for the period of 1980 through 1992, using the terms torsade de pointes, polymorphic ventricular tachycardia, atypical ventricular tachycardia, proarrhythmia, and drug-induced ventricular tachycardia, supplemented by pertinent references (dating back to 1964) from the reviewed articles and by personal communications with researchers involved in this field.Ninety-three articles were identified describing at least one case of polymorphic ventricular tachycardia (with gender specified) associated with quinidine, procainamide hydrochloride, disopyramide, amiodarone, sotalol hydrochloride, bepridil hydrochloride, or prenylamine. A total of 332 patients were included in the analysis following application of prospectively defined criteria (eg, corrected QT [QTc] interval of 0.45 second or greater while receiving drug).Clinical and electrocardiographic descriptors were extracted for analysis. Expected female prevalence for torsades de pointes associated with quinidine, procainamide, disopyramide, and aminodarone was conservatively estimated from gender-specific data reported for antiarrhythmic drug prescriptions in 1986, as derived from the National Disease and Therapeutic Index, a large pharmaceutical database; expected female prevalence for torsades de pointes associated with sotalol, bepridil, and prenylamine was assumed to be 50% or less since these agents are prescribed for male-predominant cardiovascular conditions.Women made up 70% (95% confidence interval, 64% to 75%) of the 332 reported cases of cardiovascular-drug-related torsades de pointes, and a female prevalence exceeding 50% was observed in 20 (83%) of 24 studies having at least four included cases. When analyzed according to various descriptors, women still constituted the majority (range, 51% to 94% of torsades de pointes cases), irrespective of the presence or absence of underlying coronary artery or rheumatic heart disease, left ventricular dysfunction, type of underlying arrhythmia, hypokalemia, hypomagnesemia, bradycardia, concomitant digoxin treatment, or level of QTc at baseline or while receiving drug. When cases of torsades de pointes were analyzed by individual drug, observed female prevalence was always greater than expected, representing a statistically significant difference (P < .05) for all agents except procainamide.These findings strongly suggest that women are more prone than men to develop torsades de pointes during administration of cardiovascular drugs that prolong cardiac repolarization. The pathophysiological basis for, and therapeutic implications of, this gender disparity should be further investigated.
Regulation of monoclonal immunoglobulin G synthesis by antiidiotypic antibody in a patient with hypogammaglobulinemia.
Authors: F Mudawwar, Z Awdeh, K Ault, R S Geha
Journal: Journal of Clinical Investigation (1980)

The regulation of in vitro antibody synthesis by antiidiotypic antibodies was studied in a child with hypogammaglobulinemia and a serum immunoglobulin (Ig)G1 kappa M component. A rabbit antiserum was raised against the purified M component and was rendered idiotype specific by extensive absorption with Cohn fraction II and with IgG derived from the patient's parents. Hemagglutination-inhibition studies demonstrated that less than 1 in 300,000 molecules of pooled human IgG carried M component-related idiotypic determinants. 12% of the patient's B cells, but none of her T cells, expressed idiotypic determinants on their surface. Spontaneous de novo synthesis of the M component by the patient's peripheral blood lymphocytes was demonstrated in vitro and was shown to proceed independently of the polyclonal activator pokeweed mitogen. Antiidiotypic rabbit IgG, but not its F(ab')2, fragments, profoundly inhibited the synthesis of M component by the patient's peripheral blood lymphocytes. We concluded that antiidiotypic antibodies may play a role in the regulation of antibody synthesis in man.
Inhibition of cartilage breakdown by hydrocortisone in a tissue culture model of rheumatoid arthritis.
Authors: J J Steinberg, S B Kincaid, C B Sledge
Journal: Annals of the Rheumatic Diseases (1983)

Bovine nasal cartilage discs cocultured with human rheumatoid synovial membrane or synovial-membrane-conditioned media release proteoglycan largely as a result of cartilage breakdown. We assessed the effects of hydrocortisone on proteoglycan distribution between cartilage and culture medium, and on cartilage breakdown expressed as the release of either proteoglycan or 35S-products from prelabelled discs. The presence of synovial membrane inhibited the capacity for net proteoglycan synthesis, preventing its accumulation in cartilage; this was little affected by hydrocortisone. The major response to pharmacological concentrations of hydrocortisone was suppression of both spontaneous and synovial-membrane-induced cartilage breakdown. The autolysis of synovial protein that normally occurred during culture was similarly prevented by comparable doses of corticosteroid. Changes in chromatographic distribution of the 35S-labelled degradation products released from cartilage conformed with a corticosteroid-induced inhibition of endogenous lysosomal or related proteinase activity. Additionally, inhibition of the early events in synovial membrane that are responsible for chondrocyte-mediated breakdown of cartilage may contribute significantly to the overall corticosteroid effect.
TCTAP A-016 The Impact of First- Versus Second-generation Drug-eluting Stent on 1-year Outcomes in Patients with ST-segment Elevation Myocardial Infarction Undergoing Primary Coronary Intervention
Authors: Pyung Chun Oh, Woong Chol Kang, Jong Goo Seo, Soon Yong Suh, Kyounghoon Lee, Seung Hwan Han, Taehoon Ahn, Eak Kyun Shin
Journal: Journal of the American College of Cardiology (2014)
Smokers May Pay, but Not Their Own Way
Authors: Paul Cotton
Journal: JAMA (1994)

PREMATURE DEATH is not usually considered to be cost-effective. Yet the assumption that early death cuts future medical and Social Security expenditures is essential to the tobacco industry's assertion that cigarette sales taxes and excise taxes more than cover the cost to government of diseases caused by smoking. "If it weren't for that particular argument, there would be no way any calculation could show that smokers pay their own way," says Jeffrey E. Harris, MD, PhD, an internist and economics professor at the Massachusetts Institute of Technology, Cambridge. Harris told the US House Ways and Means Committee that even with the proposed 75-cent-per-pack tax increase being proposed to finance health system reform, nonsmokers will still be paying for more than half of smoking-related health care costs. Harris estimated in his congressional testimony that "cigarette smoking accounts for 8% of all health care spending in the United States," with a range
Clinical value of exercise tests in childhood asthma.
Authors: R S Jones
Journal: Thorax (1970)

Exercise Tests in Assessing Children with Lung or Heart Disease S. GODFREY The commonest symptom of children with lung or heart disease is shortness of breath on exertion or inability to exercise.Conventional tests at rest never really evaluate this complaint.Almost all children of 5 and over can be persuaded to perform graded work on a cycle ergometer.Simply
PHYSICAL CULTURE A NECESSITY.Introductory Lecture delivered at Rush Medical College, Chicago, Sept. 29, 1891.
Authors: JOHN B. HAMILTON
Journal: JAMA (1891)

I venture to predict that if aristol proves to be possessed of actual curative properties in catar- rhal diseases the results will come from its power to stimulate secretion as well as from its disin¬ fectant properties.That it is a useful agent can¬ not be denied, but conclusive judgment cannot be passed until it has been given a longer trial.
Origin of Cardiovascular Risk in Overweight Preschool Children
Authors: Blegina Shashaj, Giorgio Bedogni, Maria P. Graziani, Alberto E. Tozzi, Maria L. DiCorpo, Donatella Morano, Ludovica Tacconi, Patrizio Veronelli, Benedetta Contoli, Melania Manco
Journal: JAMA Pediatrics (2014)

To date, the relationship among adiposity, insulin resistance, and cardiovascular risk factors at the onset of overweight or obesity has been unexplored.To assess whether insulin resistance and metabolic abnormalities are detectable at the onset of obesity and to unravel the interplay among adiposity, insulin resistance, and other such abnormalities.The Origin of Cardiovascular Risk in Overweight Preschool Children cohort study aimed to evaluate at the onset of obesity in preschool children the prevalence of metabolic abnormalities, including hypertension, dyslipidemia, impaired carbohydrate metabolism, and nonalcoholic fatty liver disease. Between July 1, 2011, and July 30, 2012, in the Rome municipality, 13 family pediatricians enrolled healthy children (age range, 2.0-5.8 years) in the study during their routine practice of growth monitoring. Clinical medical records of 5729 children were reviewed; 597 children manifested new-onset overweight or obesity as their body mass index changed from normal weight to overweight or obesity in the previous 12 months according to the International Obesity Task Force classification. Of them, 219 were studied.Patients with new-onset overweight or obesity underwent clinical laboratory testing, including oral glucose tolerance test, and ultrasonographic investigations of fatty liver and intimal medial thickness of the common carotid arteries, subcutaneous adipose tissue, and visceral adipose tissue. The homeostatic assessment model algorithm-insulin resistance was calculated.Among the entire population (n = 5729), overweight increased from 7.0% at 2.0 years to 16.9% at 5.8 years, with corresponding figures of 1.1% to 2.9% for obesity. In total, 597 overweight or obese children (10.4%) were identified, and 219 of them (36.7%) were studied. Among the latter, 86 patients (39.3%) had at least 1 metabolic abnormality. Hypertension was diagnosed in 29 patients (13.2%), dyslipidemia in 55 patients (25.1%), impaired fasting glucose level in 7 patients (3.2%), and glucose intolerance in 6 patients (2.7%). Nonalcoholic fatty liver disease was diagnosed in 68 patients (31.1%).Cardiometabolic risk factors, including fatty liver, are detectable in preschoolers at the onset of overweight or obesity, despite short-term exposure to excess weight and reduced insulin sensitivity. Our findings suggest the need to screen for cardiometabolic abnormalities at an earlier age than is now recommended.
Dietary reduction of serum cholesterol concentration: time to think again.
Authors: L E Ramsay, W W Yeo, P R Jackson
Journal: BMJ (1991)

OBJECTIVE--To evaluate the long term efficacy of diets in lowering serum cholesterol concentration. DESIGN--Descriptive overview of 16 published controlled trials of six months9 duration or longer. SETTING--Trials had been conducted in hospital clinics (6), industry (3), mental hospitals or institutions (3), and in general populations (4). PATIENTS--Trials had been conducted in high risk subjects (5), in unselected healthy subjects (6), or for secondary prevention in patients with coronary heart disease (5). Women were included in only four trials. INTERVENTIONS--Diets equivalent to the step 1 diet were employed in eight trials, with individual intervention by dietitians (3) or occupational physicians (2) or with population advice (3). Intensive diets which were more rigorous than the step 2 diet were employed in eight trials. MAIN OUTCOME MEASURES--Net change in serum total cholesterol concentration in subjects receiving treatment with diet compared with values in control subjects after six months to 10 years. RESULTS--In five trials with the step 1 diet as individual intervention the net reduction in serum cholesterol concentration ranged from 0% to 4.0% over six months to six years. In trials with population education reductions in cholesterol concentrations were 0.6-2.0% over five to 10 years. When population and individual dietary advice were combined changes in cholesterol concentration ranged from a fall of 2.1% to a rise of 1.0% over four to 10 years. Diets more intensive than the step 2 diet reduced serum cholesterol concentration by 13% over five years in selected high risk men in the population; by 6.5-15.1% over two to five years in hospital outpatients; and by 12.8-15.5% over one to four and a half years in patients in institutions. CONCLUSIONS--The response to a step 1 diet is too small to have any value in the clinical management of adults with serum cholesterol concentrations above 6.5 mmol/l. Current guidelines recommend screening of serum cholesterol concentration in healthy subjects, followed by treatment with a step 1 diet. The guidelines should be reviewed to provide a more realistic estimate of the effect of a step 1 diet and of the likely need for lipid lowering drugs.
A gene expression database for the molecular pharmacology of cancer
Authors: Uwe Scherf, Douglas T. Ross, Mark Waltham, Lawrence H. Smith, Jae K. Lee, Lorraine Tanabe, Kurt W. Kohn, William C. Reinhold, Timothy G. Myers, Darren T. Andrews, Dominic A. Scudiero, Michael B. Eisen, Edward A. Sausville, Yves Pommier, David Botstein, Patrick O. Brown, John N. Weinstein
Journal: Nature Genetics (2000)
Proliferative aspects of airway smooth muscle
Authors: Stuart J Hirst, James G Martin, John V Bonacci, Vivien Chan, Elizabeth D Fixman, Qutayba A Hamid, Berenice Herszberg, Jean-Pierre Lavoie, Clare G McVicker, Lyn M Moir, Trang T.-B Nguyen, Qi Peng, David Ramos-Barbón, Alastair G Stewart
Journal: Journal of Allergy and Clinical Immunology (2004)