tbuckley/cabot-search huggingface dataset:
Incidence and treatment of 'no-reflow' after percutaneous coronary intervention.
Authors: R N Piana, G Y Paik, M Moscucci, D J Cohen, C M Gibson, A D Kugelmass, J P Carrozza, R E Kuntz, D S Baim
Journal: Circulation (1994)

Profound reduction in antegrade epicardial coronary flow with concomitant ischemia is seen occasionally during percutaneous coronary intervention despite the absence of evident vessel dissection, obstruction, or distal vessel embolic cutoff. In a prior small series of cases, this "no-reflow" phenomenon appeared to be promptly reversed by the intra-coronary administration of verapamil.To further understand the prevalence of this syndrome and its responsiveness to the proposed therapy, we reviewed 1919 percutaneous interventions performed between January 1991 and April 1993. During the study period, 39 patients (2.0%) met our criteria for no reflow, 37 of whom were treated with intracoronary nitroglycerin followed by intracoronary verapamil and 2 of whom received intracoronary nitroglycerin alone. An additional 16 patients (0.8%) were given verapamil as part of the management of a flow-limiting dissection or distal embolus (mechanical obstruction). Intracoronary verapamil (50 to 900 micrograms, total dose) improved TIMI flow grade in 89% of no-reflow patients and markedly reduced the number of cineframes between contrast injection and opacification of a selected distal landmark (from 91 +/- 56 to 38 +/- 21 frames, P < .001). By contrast, only 19% of patients with epicardial mechanical obstruction showed improvement in TIMI flow grade after verapamil, with minimal reduction in frames to opacification (from 107 +/- 42 to 101 +/- 69, P = .73).The no-reflow phenomenon--reduction in distal flow without apparent dissection or distal embolization--occurs in 2% of coronary interventions. It generally responds promptly to intracoronary verapamil administration, suggesting that distal microvascular spasm may be its etiology.
Prime minister promises a more personal NHS
Authors: Zosia Kmietowicz
Journal: BMJ (2007)

Prime Minister Gordon Brown pledged to make the NHS more personal this week, promising quicker test results and better access to GPs, “because we know that being unwell is not just a nine to five problem.”

In his first speech to the Labour party conference as prime minister, Mr Brown promised an expansion of the screening services for breast and bowel cancer, quicker access to cancer treatment for more people, and £15bn (€21bn; $30bn) for research over the next 10 years. His long term plans include a regular health check for every adult in Britain.

“Our great achievement of the 1940s was a service universal to all. In 2007 we need a service that is accessible to all and personal to all,” said Mr Brown in an impassioned speech, during which he expressed his gratitude to the NHS for saving the sight in one of his eyes.

He added, “I want an NHS [that is] personal to you because you are seen by a consultant in a matter of days, not months; personal to you because there is …
Relationship of Leukemia Risk to Radiation Dose Following Cancer of the Uterine Corpus
Authors: R. E. Curtis, J. D. Boice, M. Stovall, L. Bernstein, E. Holowaty, S. Karjalainen, F. Langmark, P. C. Nasca, A. G. Schwartz, M. J. Schymura, H. H. Storm, P. Toogood, P. Weyer, W. C. Moloney
Journal: JNCI Journal of the National Cancer Institute (1994)

Radiotherapy has been linked infrequently to secondary leukemia despite extensive exposure of the active bone marrow to ionizing radiation. Few studies include substantial numbers of elderly patients. Purpose: We evaluated women with cancer of the uterine corpus, the majority of whom were treated at older ages, to gain additional information on cancer risk following partial-body radiotherapy and to examine differences in risk between external-beam therapy and brachytherapy. A cohort of 110 000 women with invasive cancer of the uterine corpus who survived at least 1 year following their initial cancer was assembled from nine population-based cancer registries. Cancer diagnoses occurred from 1935 through 1985, and most patients were diagnosed during the 1960s and 1970s. Radiation doses were computed to 17 sections of the active bone marrow for 218 women who developed leukemia and for 775 matched control subjects. Radiotherapy did not increase the risk of chronic lymphocytic leukemia (CLL) (relative risk [RR] = 0.90; 95% confidence interval [CI] = 0.4–1.9). However, for all leukemias except CLL, a significant risk was identified (RR = 1.92; 95% CI = 1.3–2.9). Overall, the pattern of risk in relation to dose was erratic and was most consistent with a constant increased risk across the entire dose range. The risk following continuous exposures from brachytherapy at comparatively low doses and low dose rates (RR = 1.80; 95% CI = 1.1–2.8; mean dose = 1.72 Gy) was similar to that after fractionated exposures at much higher doses and higher dose rates from external-beam treatment (RR = 2.29; 95% CI = 1.4–3.7; mean dose = 9.88 Gy), indicating a large difference in the estimated risk per unit dose. Risk did not vary by age at first exposure; increased risks were apparent for irradiated patients aged 65 years or older (RR = 1.77; 95% CI = 0.9–3.5). The leukemia risk associated with partial-body radiotherapy for uterine corpus cancer was small; about 14 excess leukemia cases were due to radiation per 10 000 women followed for 10 years. Women aged 65 years or older had a radiation risk comparable with that found in younger women. The relationship of leukemia risk to radiation dose was found to be complex due to the competing processes of cell killing, transformation, and repair. At very high doses delivered at high rates, destruction of cells likely dominates, and the risk per unit dose is low. In the low dose range, where dose was protracted and delivered at relatively low dose rates, the leukemia risk appears lower than that projected from risk estimates derived from the instantaneous whole-body exposures of atomic bomb survivors. [J Natl Cancer Inst 86: 1315–1324, 1994]
A Comparative 1-123 IMP SPECT Study in Binswanger??s Disease and Alzheimer??s Disease
Authors: KEITA KAWABATA, HISAO TACHIBANA, MINORU SUGITA, MINORU FUKUCHI
Journal: Clinical Nuclear Medicine (1993)

The regional cerebral blood flow in 31 patients was semiquantitatively measured with SPECT using N-isopropyl iodo-amphetamine (I-123 IMP). Of the 31 patients, 9 had Binswanger's disease (BD) (mean age: 64.2 years), 10 had Alzheimer's disease (AD) (mean age: 66.8 years), and 12 were neurologically normal (mean age: 67.8 years). Tracer activity was determined in 7 pairs of cerebellar, cortical, and subcortical regions and was expressed as two ratios: the activity in each region of interest (ROI) compared to the mean count in the cerebellar region (ROI/CER ratio) and compared to the mean count in the occipital cortex (ROI/OCC ratio). Patients with BD showed a reduction of the ROI/CER ratio in the temporal cortex, thalamus, and basal ganglia compared to normal subjects. However, the ROI/CER ratio for the occipital region was higher than that of normal controls, suggesting that cerebellar blood flow was reduced in patients with BD. AD patients showed a decreased ROI/CER ratio in the frontal, temporal, and parietal cortices. Both BD and AD patients showed decreased ROI/OCC ratios in all the cortical and subcortical regions compared to the neurologically normal patients. In BD patients, the most marked reduction of both ratios was found in the thalamus, while for AD patients the most prominent reduction was seen in the parietal cortex. Our results indicate that these two types of dementia show characteristic regional cerebral blood flow patterns, which may be associated with their clinical features.
Phenotypic expression of the HFE gene mutation (C282Y) among the hospitalised population Reply
Authors: S J MOODIE
Journal: Gut (2001)

Editor,—Distante and colleagues ((2000) Gut 47:575–9; [OpenUrl][1]) found that C282Y homozygotes detected by testing all patients acutely admitted to hospital for non-liver associated problems had a considerably lower transferrin saturation during the acute illness (median 27%) compared with at follow up (median 71%). Indeed their strategy of performing C282Y genotyping on all acute patients with a raised transferrin saturation (>50%) would have detected only 1/14 (8%) C282Y homozygotes. This is in contrast with our study of HFE (C282Y) gene mutation and phenotypic expression in outpatients referred to a liver clinic.1 … Dr S Distante. Sonia.distante{at}ioks.uio.no [1]: {openurl}?query=rft.jtitle%253DGut%26rft.volume%253D32%26rft.spage%253D133%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx
Don't be complacent about cot death
Authors: D P Davies, E Webb, P Davis
Journal: BMJ (1993)

different outcomes of our trial and Grethe St0a-Birketvedt's trial3 could be explained by a difference in weight loss before randomisation.The weight of all the patients in our trial, however, remained stable within a few kilograms during the month before the trial, and most patients were at their maximum weight.We did not show our data on the number of previous attempts at slimming.There was no difference, however, in the mean number of such attempts between the cimetidine and placebo groups.We agree that the different numbers of previous attempts in the cimetidine and the placebo groups in St0a-Birketvedt's trial cannot explain the remarkable weight loss reported.
Unusual Vertebral and Pelvic Visualization During 99mTc-Sn-DTPA Renal Dynamic Study in a Leukemic Patient
Authors: KYOICHI UENO, KINJI HARIKI, YOICHI KAWAMURA
Journal: Clinical Nuclear Medicine (1979)

Unusual bone and/or bone marrow images were visualized during a 99mTc-Sn-DTPA renal dynamic study in a patient with acute leukemia. The possible mechanism of this phenomenon is discussed.
Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit
Authors: K. Andrews, L. Murphy, R. Munday, C. Littlewood
Journal: BMJ (1996)

To identify the number of patients who were misdiagnosed as being in the vegetative state and their characteristics.Retrospective study of the clinical records of the medical, occupational therapy, and clinical psychology departments.20 bed unit specialising in the rehabilitation of patients with profound brain damage, including the vegetative state.40 patients admitted between 1992 and 1995 with a referral diagnosis of vegetative state.Patients who showed an ability to communicate consistently using eye pointing or a touch sensitive single switch buzzer.Of the 40 patients referred as being in the vegetative state, 17 (43%) were considered as having been misdiagnosed; seven of these had been presumed to be vegetative for longer than one year, including three for over four years. Most of the misdiagnosed patients were blind or severely visually impaired. All patients remained severely physically disabled, but nearly all were able to communicate their preference in quality of life issues-some to a high level.The vegetative state needs considerable skill to diagnose, requiring assessment over a period of time; diagnosis cannot be made, even by the most experienced clinician, from a bedside assessment. Accurate diagnosis is possible but requires the skills of a multidisciplinary team experienced in the management of people with complex disabilities. Recognition of awareness is essential if an optimal quality of life is to be achieved and to avoid inappropriate approaches to the courts for a declaration for withdrawal of tube feeding.
Ischemia induces translocation of the insulin-responsive glucose transporter GLUT4 to the plasma membrane of cardiac myocytes.
Authors: D Sun, N Nguyen, T R DeGrado, M Schwaiger, F C Brosius
Journal: Circulation (1994)

Acute myocardial ischemia is accompanied by an increase in glucose uptake and metabolism, which appears to be important in protecting myocardial cells from irreversible ischemic injury. Because insulin augments myocardial glucose uptake by inducing the translocation of glucose transporters from an intracellular compartment to the plasma membrane, we hypothesized that acute ischemia would trigger a similar translocation.We used a subcellular fractionation method to separate intracellular membrane and plasma membranes from control, ischemic, and hypoxic Langendorff-isolated perfused rat hearts and determined the expression of the major myocardial glucose transporter, GLUT4, in these separated membrane fractions. We found that translocation of GLUT4 molecules occurred in ischemic, hypoxic, and insulin-treated hearts and in hearts that underwent ischemia plus insulin treatment. The percentages of GLUT4 molecules present on the plasma membrane in the different conditions were as follows: control, 18.0 +/- 2.8%; ischemia, 41.3 +/- 9.4%; hypoxia, 31.1 +/- 2.9%; insulin, 61.1 +/- 2.6%; and ischemia plus insulin, 66.8 +/- 5.7%. Among the statistically significant differences in these values were the difference between control and ischemia and the difference between ischemia alone and insulin plus ischemia.Ischemia causes substantial translocation of GLUT4 molecules to the plasma membrane of cardiac myocytes. A combination of insulin plus ischemia stimulates an even greater degree of GLUT4 translocation. GLUT4 translocation is likely to mediate at least part of the increased glucose uptake of ischemic myocardium and may be a mechanism for the cardioprotective effect of insulin during acute myocardial ischemia.
Gender matters: Estrogen receptor alpha (ERα) and histone deacetylase (HDAC) 1 and 2 control the gender-specific transcriptional regulation of human uridine diphosphate glucuronosyltransferases genes (UGT1A)
Authors: Sandra Kalthoff, Anja Winkler, Nicole Freiberg, Michael P. Manns, Christian P. Strassburg
Journal: Journal of Hepatology (2013)
Evolution of microsatellites in Arabis petraea and Arabis lyrata, outcrossing relatives of Arabidopsis thaliana
Authors: R. van Treuren, H. Kuittinen, K. Karkkainen, E. Baena-Gonzalez, O. Savolainen
Journal: Molecular Biology and Evolution (1997)

We examined microsatellite variation in two diploid, outcrossing relatives of Arabidopsis thaliana, Arabis petraea and Arabis lyrata. The primer sequences were derived from A. thaliana. About 50% (14 loci) of the A. thaliana primers could successfully amplify microsatellites in the related species. Analysis of microsatellite structure in the related species showed that there had been large changes in the microsatellites: there were large differences in repeat numbers and many of the A. thaliana simple repeats were shorter in the related species. For the loci we compared, the related species had a much lower level of variability at the microsatellites than Japanese wild populations of A. thaliana. This is presumably related to the different microsatellite structures, because allozyme data showed that the outcrossing relatives were highly polymorphic compared to other outcrossing herbaceous species. Use of microsatellites in assessing variability or phylogenetic relationships between different species requires caution, because changes in microsatellite structure may alter evolutionary rates.
Out of sight but not out of mind: Isomorphism and absent qualia
Authors: Robert Van Gulick
Journal: Behavioral and Brain Sciences (1999)

The isomorphism constraint places plausible limits on the use of third-person evidence to explain color experience but poses no difficulty for functionalists; they themselves argue for just such limits. Palmer's absent qualia claim is supported by neither the Color Machine nor Color Room examples. The nature of color experience depends on relations external to the color space, as well as internal to it.
Nasal cancer in the shoe industry.
Authors: E D Acheson, R H Cowdell, B Jolles
Journal: BMJ (1970)

Nasal Cancer in the Shoe Industry SIR,-In our article on "Nasal Cancer in the Northamptonshire Boot and Shoe Industry" (14 February, p. 385) we were unable to give estimates of incidence within the industry because we lacked comprehensive information on the numbers of men employed in the different departments.We have since received from the British Foot- wear Manufacturers' Federation national figures relating to 1949-61 inclusive giving the numbers of operatives in each sex employed in the various departments.The figures include the numbers of men and women employed in clicking, closing, pressing, lasting, finishing, and shoe room departments.In making the calculations in the Table the figures for 1949-61 have been averaged and the proportions applied to the Northamptonshire industry.If the cases of Adenocarcinoma Other Carcinomas All Carcinomas
Registration, Evaluation, and Authorization of Chemicals (REACH) Is but the First Step–How Far Will It Take Us? Six Further Steps to Improve the European Chemicals Legislation
Authors: Christina Rudén, Sven Ove Hansson
Journal: Environmental Health Perspectives (2009)

In this commentary we analyze how much data will in fact be generated within REACH.We conclude that the data requirements for many end points still have not been determined but depend on prioritization criteria and waiving practices that will be decided in the years to come. We propose six important steps toward an improved REACH: a) Clarify prioritization and waiving criteria. Implement decisions to ensure that sufficient data are obtained to make first hazard assessments of as many substances and end points as possible. b) Increase data requirements. Introduce data requirements similar to those currently required for substances produced or imported in quantities of >or= 10 metric tons/year for substances produced or imported in quantities of >or= 1 metric tons/year. c) Develop the tests and approaches needed to satisfy the information requirements taking into account resource limitations and the aim to reduce animal testing. d) Promote substitution of high risk chemicals. Create an effective process for identifying substances of very high concern and for making the appropriate risk management decisions for these substances. e) Address the control of substances incorporated in articles. And f) acknowledge uncertainties. Systematically report lack of data and include this as a basis for risk management.
Clinical significance of high frequency QRS potentials in myocardial infarction: analysis based on power spectrum of lead III
Authors: K. K TALWAR, G. S. RAO, U. NAYAR, M. L. BHATIA
Journal: Cardiovascular Research (1989)

Power spectrum analysis of ECG lead III QRS potentials using the Fast Fourier Transform technique was performed in 10 normal subjects and nine patients with inferior wall myocardial infarction (IWMI). A relative lowering in both low and high frequency QRS potentials was observed in the infarct group, in agreement with previous studies on power spectrum of lead II. However, contrary to earlier conclusions, the lowering was independent of a general attenuation in QRS voltages. Discriminant analysis of the frequency components showed that the high frequency components (190-310 Hz) were able to discriminate better between the two groups than the low frequency components (10-120 Hz).
Chronic Musculoskeletal Pain
Authors: P. Dieppe
Journal: BMJ (2013)

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Copyrighted Material, used by arrangement with John Wiley & Sons Limited. For personal use only, must not be reproduced or shared with third parties. Anyone wishing to reproduce this content in whole or in part, in print or in electronic format, should contact digitalrightsuk@wiley.com Browse the ABC series at www.wiley.com

### Overview

Musculoskeletal pain is ubiquitous – everyone gets it. There are three main causes: 

1.  everyday activities that put unusual or repetitive strains on the system;

2.  acute traumatic events;

3.  musculoskeletal diseases.

Everyone is familiar with the aches and pains that generally follow unaccustomed activity and most of us will have had at least one episode of acute post-traumatic pain affecting our muscles, bones or joints. These problems are generally short lasting and not very bothersome. However, huge numbers of us, particularly older adults, also experience chronic, intrusive musculoskeletal pain. …

 [1]: /embed/graphic-1.gif
Comparison of Nephrotoxicity of Tobramycin and Gentamicin
Authors: George M. Matuschak
Journal: JAMA (1981)

<h3>To the Editor.—</h3> The prospective study of the clinical nephrotoxicity of tobramycin sulfate and gentamicin sulfate reported by Gerald D. Kumin, MD (1980;244:1808), brings further attention to the magnitude of the problem of aminoglycoside-related renal failure and presents data indicative of a substantially higher incidence of gentamicin-associated renal dysfunction in comparison with that of tobramycin in groups receiving standard clinical daily doses of these drugs. However, despite the admission of the difficulty in designing controlled clinical studies in seriously ill patients, 62 patients were treated with 2 to 5 mg/kg/day of gentamicin sulfate or tobramycin sulfate for a variety of serious infections. No serum aminoglycoside levels are reported, and no data are presented to allow conclusions regarding possible differences in efficacy of therapy between groups. Yet there is another issue. Riff and Jackson<sup>1</sup>demonstrated that the dosage of gentamicin based on the weight of the patient produced wide variations
Reactions to Live-Measles-Virus Vaccine in Children Previously Inoculated with Killed-Virus Vaccine
Authors: T. F. McNair Scott, Donn E. Bonanno
Journal: New England Journal of Medicine (1967)

ONE of the recommended technics of vaccination against measles is to give a course of killed-measles-virus vaccine followed, after an interval of months, by a booster of live attenuated measles virus either accompanied or unaccompanied by gamma globulin.1 This technic is advocated as preventing the untoward reactions that may accompany the administration of the live virus even when gamma globulin is given coincidentally.In a certain number of these children, a local and, sometimes, general reaction may follow the final inoculation of the live-virus vaccine and may be severe enough to bring the child to the physician. This may occur . . .