tbuckley/cabot-search huggingface dataset:
Physician groups each identify five of their own inappropriate practices
Authors: M. E. Tucker
Journal: BMJ (2013)

Physicians from 17 specialty medical organizations have each produced lists of five common practices that are of questionable value, as part of a project to promote dialog with patients about appropriate use of tests, procedures, and medications.

The Choosing Wisely initiative (www.choosingwisely.org) was set up by the American Board of Internal Medicine Foundation, and 17 new lists were launched last week. 

Each specialty society’s list is made up of common practices that are not supported by evidence, are not necessary, or may cause harm. The “five things physicians and patients should question” are written in simple language, including explanations for why the practice is not advised.

Antibiotic use is a major target, with advice against its routine use for acute sinusitis (from the …
Is Sex a Factor in Determining Operative Risk for Aortocoronary Bypass Graft Surgery?
Authors: Lynda L. Mickleborough, Yasushi Takagi, Hiroshi Maruyama, Zhao Sun, Shanas Mohamed
Journal: Circulation (1995)

This study examines trends and sex differences in characteristics of patients referred for bypass graft surgery to identify factors associated with operative morbidity and mortality.Data were collected prospectively on consecutive patients (1132 men and 355 women). Over time, the proportion of patients > 65 years old, with diabetes, or requiring urgent surgery, increased. Predictors of mortality were age > 75 years, urgent surgery, and poor left ventricular (LV) grade. Women were older (62 +/- 9 versus 59 +/- 9 years, P < .001) and had more varicose veins (18% versus 7%, P < .001), diabetes (27% versus 18%, P < .001), hypertension (48% versus 41%, P < .05), peripheral vascular disease (16% versus 12%, P < .05), and more severe angina (P < .001). There were no sex differences in prior myocardial infarction (59% versus 62%) or need for urgent surgery (17% versus 18%). Women had a higher ejection fraction (51% +/- 12% versus 47% +/- 14%, P < .001) and fewer diseased vessels (2.4 +/- 0.7 versus 2.6 +/- 0.6, P < .001) and received fewer grafts (2.9 +/- 0.9 versus 3.3 +/- 0.8, P < .001). Women had smaller body size but were no more likely to have small target vessels (< 1.5 mm). There was no sex difference in operative mortality (1.4% versus 1.1%), perioperative myocardial infarction (4.8% versus 3.5%), need for intra-aortic balloon pump (10% versus 8%), stroke (1.7% versus 1.4%), reexploration for bleeding (1.7% versus 1.7%), or leg infection (2.0% versus 1.4%). Women had fewer sternal wound infections (0.6% versus 2.2%, P < .05).Predictors of mortality include advanced age, decreased LV function, and need for urgent surgery. With time, despite increasing age, associated diabetes, and increased urgent surgery, operative mortality has decreased. Women were older and had more diabetes and hypertension but less extensive disease and better LV function. Bypass graft surgery was associated with equally low mortality in women and men (1.4% versus 1.1%). Concern over increased operative mortality in women should not bias referral patterns for angiography and coronary bypass graft surgery.
Ischemic preconditioning: a plea for rationally targeted clinical trials
Authors: R Kloner
Journal: Cardiovascular Research (2002)

Time for primary review 20 days. 

The concept of myocardial ischemic ‘preconditioning’ (PC) has been with us since 1986 [1]. A tremendous body of research over the last 15 years has documented this phenomenon in virtually every species tested, with both an early and late phase of PC-induced cardioprotection, manifest ∼5–30 min and 12–24 h after the PC trigger, having been identified. A host of additional studies have yielded insight into the cellular mediators and complex second messenger pathways that purportedly contribute to the protection achieved with brief antecedent PC ischemia, with the currently favored paradigm involving initial stimulation of one or more G protein-coupled receptors; subsequent activation of multiple ‘in parallel’ or ‘in series’ kinases (i.e. including, among others, the e-isoform of protein kinase C and one or more isoforms of p38 mitogen activated protein kinase); followed by phosphorylation and activation of a membrane-bound end-effector, possibly the sarcolemmal and/or mitochondrial KATP channel. These mechanistic studies have, as an ancillary benefit, provided a rational framework for the identification of pharmacologic agents that, when given in lieu of brief ischemia, may effectively mimic the benefits of conventional ischemic PC.

Perhaps most importantly, a substantial amount of evidence favors the concept that ischemic preconditioning (both early and delayed) can occur in human hearts. However, the translation of ischemic preconditioning from the experimental laboratory to clinical utility has been disappointing and slow. Our goals in this manuscript are to: (i) review the clinical models and scenarios in which conventional ischemic PC and/or pharmacologic PC-mimetic agents have shown promise in eliciting cardioprotection; (ii) summarize, for each of these multiple scenarios, the potential benefits that might be achieved in the implementation of PC as a therapeutic strategy; (iii) outline, for each of the relevant clinical settings, a proposed design for the multicenter trials … 

* Corresponding author. Tel.: +1-213-977-4050; fax: +1-213-977-4107 rkloner{at}goodsam.org
Retinal Detachment After Cataract Removal
Authors: Seymour H. Perlstein
Journal: JAMA (1983)

To the Editor.—  I read in the QUESTIONS AND ANSWERS section (1983; 249:1649) the recommendations for treatment of an 84-year-old woman with a cataract in one eye and poor vision in the other eye after repair of an aphakic retinal detachment. Dr Hartstein advised that use of an extended-wear contact lens be considered.  I strongly disagree with the advisability of contact lenses in one-eyed or effectively one-eyed patients. Ocular injuries do occur, and when they happen to the patient's one good eye, the results are catastrophic. 1 These patients need as much protection for their good eye as possible, and contact lenses do not provide it. Cataract glasses are unquestionably a challenge to adapt to, but they do provide the necessary safety shield for the eye. Even if a daily or an extended-wear contact lens is fitted and the patient also wears safety glasses, the risk of subsequent corneal infection
Saturated fat is not the major issue
Authors: A. Malhotra
Journal: BMJ (2013)

f6340) by Aseem Malhotra stated that a recent "real world" study of 150 000 patients who were taking statins showed "unacceptable" side effects-including myalgia, gastrointestinal upset, sleep and memory disturbance, and erectile dysfunction-in 20% of participants.The author withdraws this statement.Although it was based on statements in the referenced observational study by Zhang and colleagues that "the rate of reported statin-related events to statins was nearly 18%," 1 the article did not reflect necessary caveats and did not take sufficient account of the uncontrolled nature of the study.
The Effect of Calcium Supplementation on Bone Density during Lactation and after Weaning
Authors: Heidi J. Kalkwarf, Bonny L. Specker, Donna C. Bianchi, Julie Ranz, Mona Ho
Journal: New England Journal of Medicine (1997)

Women may lose bone during lactation because of calcium lost in breast milk. We studied whether calcium supplementation prevents bone loss during lactation or augments bone gain after weaning.
Primary Hypertension: A Disease
Authors: George A. Perera
Journal: JAMA (1970)

<h3>To the Editor.—</h3> Primary (essential) hypertension has been interpreted by some as a specific entity and by others as a quantitative deviation from the norm. As most students of this disorder are aware, single "resting" or casual diastolic blood pressure readings may give erroneous impressions concerning the presence or absence of hypertension. However, tabulating the lowest of five casually recorded diastolic values in a series of 1,000 ambulatory subjects aged 45 to 50 years has disclosed two distinct groups with practically no overlap (79 mm Hg ± SD 6.2 and 98 ± 5.4), suggesting that a fraction of the population has a distinct abnormality.<sup>1</sup> Utilizing this approach in a large sample of ambulatory adults under 30 years of age, I have observed the onset of persistent hypertension in five instances. Five successive readings of the blood pressure were made in the sitting position and the first as well as
Prothrombin gene 20210 G-A mutation in Turkish patients with thrombosis
Authors: Aytemiz Gürgey, Gönül Hiçsönmez, Hülya Parlak, Günay Balta, Alpay Çeliker
Journal: American Journal of Hematology (1998)

To the Editor: Recent studies have demonstrated that common mutations in the genes encoding coagulation factor V (FV Leiden) and prothrombin
Ideal Cardiovascular Health
Authors: Vanessa Xanthakis, Danielle M. Enserro, Joanne M. Murabito, Joseph F. Polak, Kai C Wollert, James L. Januzzi, Thomas J. Wang, Geoffrey Tofler, Ramachandran S. Vasan
Journal: Circulation (2014)

Background— The American Heart Association Cardiovascular Health score (CVH score) is inversely associated with cardiovascular disease (CVD) incidence, but the mechanisms underlying this association warrant exploration. Methods and Results— We related the CVH score to circulating biomarkers and prevalent subclinical CVD (defined as ≥1 of the following: increased carotid intima-media thickness or stenosis, left ventricular hypertrophy [by ECG or echocardiography], left ventricular systolic dysfunction, microalbuminuria, and a reduced ankle-brachial index) in 2680 Framingham Study participants (mean age, 58 years; 55% women). After adjustment for age and sex, an ideal CVH score (nonsmoking status, ideal body mass index, regular physical activity, healthy diet, and an optimal profile of serum cholesterol, blood pressure, and glucose; 1 point for each) was associated with higher circulating concentrations of natriuretic peptides (N-terminal pro-atrial natriuretic peptide and B-type natriuretic peptide) and lower blood concentrations of plasminogen activator inhibitor-1, aldosterone, C-reactive protein, D-dimer, fibrinogen, homocysteine, and growth differentiation factor-15 levels ( P &lt;0.001 for all), as well as lower odds of subclinical disease (odds ratio, 0.74 per 1-unit increase in CVH score; 95% confidence interval, 0.68–0.80). The incidence of CVD (267 events over 16 years) was inversely associated with the CVH score in age- and sex-adjusted models (hazard ratio, 0.77 per 1-unit increase in CVH score; 95% confidence interval, 0.70–0.86), which was slightly attenuated upon adjustment for biomarkers and subclinical disease (hazard ratio, 0.87; 95% confidence interval, 0.78–0.97). Conclusion— In our prospective community-based study, the inverse association between an ideal cardiovascular health score and CVD incidence was partly attributable to its favorable impact on CVD biomarker levels and subclinical disease.
Commentary: Consent to publication--no absolutes
Authors: F. Oberklaid
Journal: BMJ (2008)

Two years ago four paediatricians and an ethicist submitted to the <i>BMJ</i> a case study as an ethical debate which the <i>BMJ</i> decided not to publish because the authors had not obtained the consent of the patient’s parents for publication. The authors submitted it elsewhere, and the article was published last year.
Video Capsule Endoscopy and Histology for Small-Bowel Mucosa Evaluation: A Comparison Performed by Blinded Observers
Authors: Federico Biagi, Emanuele Rondonotti, Jonia Campanella, Federica Villa, Paola Ilaria Bianchi, Catherine Klersy, Roberto De Franchis, Gino Roberto Corazza
Journal: Clinical Gastroenterology and Hepatology (2006)
Periodic Hematopoiesis in Human Cyclic Neutropenia
Authors: D. Guerry, D. C. Dale, M. Omine, S. Perry, S. M. Wolff
Journal: Journal of Clinical Investigation (1973)

Human cyclic neutropenia is characterized by severe depression of blood neutrophil levels approximately every 21 days. To investigate the mechanism of cyclic neutropenia four patients were studied with daily complete blood counts, serial bone marrow examinations, marrow reserve testing, serum muramidase determinations, DF22P granulocytokinetic studies, and, in one patient, in vivo [3H]TdR labeling. Periodogram analysis of the serial blood counts in the latter patient and visual inspection of multiple cycles in the others revealed periodic fluctuations in the levels of blood neutrophils, monocytes, lymphocytes, reticulocytes, and platelets. Rhythmic changes in the morphologic and radioisotopic studies as well as the marrow reserve tests and muramidase measurements were consonant with a mechanism of periodic failure of marrow production rather than peripheral destruction. Human cyclic neutropenia is analogous to cyclic neutropenia in the grey collie dog and may be viewed as the consequence of cyclic hematopoiesis.
Clinical Course in Hemophilia
Authors: Armand J. Quick
Journal: JAMA (1969)

<h3>To the Editor:—</h3> Can the clinical course in hemophilia, such as in the case reported by Shanbrom and Thelin (<b>208</b>:1853, 1969), be explained solely by the low concentration of factor VIII? Remarkably, the boy at age 11 survived a ruptured appendix without surgery, yet six years later he had a retinal hemorrhage, which is exceedingly uncommon in hemophilia. Was this due to lack of factor VIII or was it drug-induced in view of the fact that he was on a regimen of antihypertensive therapy? Likewise, the repeated gastrointestinal bleeding and the spontaneous intracerebral hemorrhage which this patient had may not necessarily be attributable solely to lack of factor VIII. From my observations of hemophiliacs, some for more than a period of 30 years, I have found that ( 1 ) the bleeding time is normal in uncomplicated factor VIII deficiency; (2) mucous membrane bleeding, particularly epistaxis and gastrointestinal hemorrhage, is uncommon;
Haemoglobin C in a Spanish family.
Authors: A. Casado, A. Pellicer, L. Vicente
Journal: BMJ (1969)

have the opportunity of attending a theore- tical and practical course on this subject as part of their undergraduate course.This co-operation has been extremely fruitful, but the development of such projects is costly, and if they are to succeed funds need to be provided as a matter of urgency.Both the N.H.S
Excess HLA antigens after transfusion of sickle cell patient with AIDS
Authors: Oswaldo Castro, Lamya Alarif, Carl Saxinger, Winston Frederick
Journal: American Journal of Hematology (1987)

Abstract A woman with sickle cell‐hemoglobin C disease developed the acquired immunodeficiency syndrome (AIDS), possibly as the result of blood transfusions administered 4 years earlier. Three months after subsequent transfusions, she had excess HLA‐A and DR antigens (triplets) on her circulating lymphocytes. Three of her first‐degree relatives were HLA‐typed, and none had excess antigens. Family studies also indicated that the patient had at least one HLA‐A antigen that was probably not inherited. These findings suggest the possibility that transient hemopoietic engraftment can occur in transfused sickle cell patients with AIDS.
Treatment of Thrombotic Thrombocytopenic Purpura with Plasma
Authors: John J. Byrnes, Mohan Khurana
Journal: New England Journal of Medicine (1977)

Thrombotic thrombocytopenic purpura, the acute form of which is usually fatal, is characterized clinically by thrombocytopenia, microangiopathic hemolytic anemia, fluctuating neurologic signs and renal dysfunction, and pathologically by diffuse thrombotic occlusions in the microcirculation, in which platelets are consumed.1 2 3 4Since the pathogenesis of this disease is not understood, treatment has been empirical or with an assumed rationale. Among the various modes of therapy tried, four are especially advocated: splenectomy and use of antiplatelet agents, of high doses of glucocorticoids, and of exchange transfusions. The value of splenectomy remains undefined.5 Proponents of antiplatelet treatment argue that whether or not platelet adhesion . . .
The Mental Health Risks of Adolescent Cannabis Use
Authors: Wayne Hall
Journal: PLoS Medicine (2006)

Since the early 1970s, when cannabis first began to be widely used [1], the proportion of young people who have used cannabis has steeply increased and the age of first use has declined [2, 3]. Most cannabis users now start in the mid-to-late teens [1], an important period of psychosocial transition when misadventures can have large adverse effects on a young person's life chances.
Compatibility of Sickling with Malaria
Authors: G. A. Deliyannis, N. Tavlarakis
Journal: BMJ (1955)

Sickling phenomenon can be regarded as a particular characteristic of any race which shows it in the absence of admixture with another race in which it exists.Its higher incidence around the Mediterranean could be accounted for by the suggestion that some races of the Mediterranean basin, with a few exceptions in other parts of the world, appear to be more prone to develop a mutation affecting their blood-forming tissue.At the same time some unknown geophysical and other factors, one of which may possibly be malaria, favour the high frequency of this mutation in these areas of the globe.
Chinese medicines for slimming still cause health problems
Authors: K. Metcalfe
Journal: BMJ (2002)

EDITOR—Local events caused great public health concern recently. After the referral of a 44 year woman with new onset hypertension, palpitation, anxiety, and a body mass index of 19 kg/m2 it became apparent that an alarming number of the local population had been attending a particular Chinese herbalist for weight loss remedies. Most had been taking multiple preparations—as many as nine—and described “spectacular” results. Several reported considerable cardiovascular symptoms but were …
Cardiac-Specific LIM Protein FHL2 Modifies the Hypertrophic Response to β-Adrenergic Stimulation
Authors: Yanfeng Kong, John M. Shelton, Beverly Rothermel, Xiangqing Li, James A. Richardson, Rhonda Bassel-Duby, R. Sanders Williams
Journal: Circulation (2001)

Background —A deficiency of muscle LIM protein results in dilated cardiomyopathy, but the function of other LIM proteins in the heart has not been assessed previously. We have characterized the expression and function of FHL2, a heart-specific member of the LIM domain gene family. Methods and Results —Expression of FHL2 mRNA and protein was examined by Northern blot, in situ hybridization, and Western blot analyses of fetal and adult mice. FHL2 transcripts are present at embryonic day (E) 7.5 within the cardiac crescent in a pattern that resembles that of Nkx2.5 mRNA. During later stages of cardiac development and in adult animals, FHL2 expression is localized to the myocardium and absent from endocardium, cardiac cushion, outflow tract, or coronary vasculature. The gene encoding FHL2 was disrupted by homologous recombination, and knockout mice devoid of FHL2 were found to undergo normal cardiovascular development. In the absence of FHL2, however, cardiac hypertrophy resulting from chronic infusion of isoproterenol is exaggerated (59% versus 20% increase in heart weight/body weight in FHL null versus wild-type mice; P &lt;0.01). Conclusions —FHL2 is an early marker of cardiogenic cells and a cardiac-specific LIM protein in the adult. FHL2 is not required for normal cardiac development but modifies the hypertrophic response to β-adrenergic stimulation.
Pulmonary hemorrhage in a hemophiliac simulating a lung neoplasm
Authors: Michael E. O'Dwyer, Thomas G. DeLoughery
Journal: American Journal of Hematology (2000)

We report an elderly, male smoker with moderate hemophilia B who presented with hemoptysis. Chest imaging revealed a well-circumscribed, pulmonary, mass lesion. Repeated bronchoscopy failed to make a diagnosis, and the patient ultimately underwent open thoracotomy with resection of the mass. Pathologic examination revealed hemorrhagic changes in association with bullous lung disease. This is the first report of symptomatic pulmonary hemorrhage in a patient with hemophilia B. Hemorrhage into a pre-existing bulla can simulate a primary lung neoplasm. Am. J. Hematol. 64:299–302, 2000. © 2000 Wiley-Liss, Inc.
Expression of lymphoid‐associated antigens in mast cell disease: New observations
Authors: Maria Sironi, Maurizio Spinelli
Journal: American Journal of Hematology (2003)

To the Editor: Studying cutaneous mastocytosis, we observed an unusual phenotype expression of lymphoid-associated antigens (Table I).With the exclusion of the reported reactivity of neoplastic mast cells for Bcl-2 [1], CD22 and CD2 [2], to the best of our knowledge, no other lymphoidassociated markers have been shown to be positive in mast cells.CD2 may be regarded as a mastocytosis-specific mast cell marker [3], even if not all neoplastic mast cells appeared to react with the antibody.The Bcl-2 positivity could be justified by the very long survival of mast cells, but the described reactivity [1] is not in agreement with that observed by other authors [3].We verify the strong reactivity of mast cells to a pan-T antigen, CD45RO, clones UCHL1 and A6 (Fig. 1), without any positivity for CD3 and CD5, and the aberrant reactivity for CD10 (CALLA) and Cyclin D1.CD10 is expressed by a wide variety of non-neoplastic hematopoietic, epithelial, and mesenchymal stromal cells and tumors [4], and thus it is not surprising to find reactivity in mast cells.Cyclin D1 (Bcl-1) belongs the family of Bcl proteins, which regulate the cellular survival: this finding is coherent with the proven Bcl-2 and Bcl-x positivity [1].Hence, it is important to know these immunohistochemical findings in mast cell diseases, to exclude incorrect diagnoses of lymphoproliferative diseases.
Abstract 2148: Inhibitory effects of liensinine and nuciferine on breast cancer-associated bone loss
Authors: Eun-Ji Kang, Won-Yoon Chung, Kwang-Kyun Park
Journal: Cancer Research (2014)

Abstract Breast cancer is the most common cause of cancer death in women and has a propensity to metastasize to bone. Once tumor cells become lodged in the skeleton, they interact with bone microenvironment establishing the “vicious cycle” that accelerates both tumor growth and bone destruction. Therefore, the vicious cycle between metastatic cancer cells and bone cells can be a possible target for cancer therapy. Nelumbo nucifera (Lotus) has been used for various medicinal purposes in some parts of the world for treatment of several disorders including skin disease, cough, inflammation, fever. Liensinine and nuciferine are active components in Lotus but it is still unknown whether they can effectively inhibit breast cancer associated bone destruction. In this study, we found that liensinine and nuciferine inhibited the receptor activator of nuclear factor kappa-B ligand (RANKL)-induced osteoclast formation in mouse bone marrow macrophage cells at non-cytotoxic concentrations. In addition, liensinine and nuciferine inhibited cell proliferation and induced apoptosis in MDA-MB-231 human breast cancer cells. Liensinine also displayed an inhibitory effect on the migration and invasion ability of MDA-MB-231 cells compared with nuciferine. Furthermore, liensinine and nuciferine may modulate cell cycle distribution and expression of apoptosis-related proteins in MDA-MB-231 cells and inhibit breast cancer-induced bone resorption in vivo. Therefore, liensinine and nuciferine can possess the potential to prevent breast cancer-mediated osteolysis. Citation Format: Eun-Ji Kang, Won-Yoon Chung, Kwang-Kyun Park. Inhibitory effects of liensinine and nuciferine on breast cancer-associated bone loss. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2148. doi:10.1158/1538-7445.AM2014-2148