tbuckley/cabot-search huggingface dataset:
Outcome of Patients with Cystic Fibrosis Awaiting Lung Transplantation
Authors: CARMINE DARIO VIZZA, ROGER D. YUSEN, JOHN P. LYNCH, FRANCESCO FEDELE, G. ALEXANDER PATTERSON, ELBERT P. TRULOCK
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Cystic fibrosis is a common indication for lung transplantation. Under the current organ allocation system, donor lungs are distributed to patients based solely on their accrued waiting time, and the death rate on the waiting list has been high. Physiologic parameters have been used to guide the referral, but risk factors for death while awaiting transplantation have not been well defined. This study aimed to identify factors at the time of evaluation that were associated with death on the waiting list. A consecutive cohort of 146 patients with cystic fibrosis who were listed for lung transplantation was retrospectively reviewed. Characteristics of patients who died awaiting transplantation were compared with those of patients who survived until transplantation or the end of the study. Thirty-seven patients died while waiting, 76 underwent transplantation, and 33 were alive and still waiting. Actuarial survival rates for the entire cohort were 81% at 1 yr, 67% at 2 yr, and 59% at 3 yr. Although a multivariate Cox proportional hazards model ( χ2 = 29.6; p < 0.001) identified shorter six-minute walk distance (50 m increments; RR, 0.69; 95% CI, 0.57 to 0.84), higher systolic pulmonary artery pressure (5 mm Hg increments; RR, 1.41; 95% CI, 1.11 to 1.80), and diabetes mellitus (RR, 1.57; 95% CI, 1.06 to 2.32) as significant risk factors for death on the waiting list, these factors and other features overlapped considerably between the group of patients who died waiting and the group who lived until transplantation or the end of the study. The transplant evaluation selects a rather homogeneous cohort of patients for the waiting list. Unless outcome on the waiting list can be reliably predicted, establishing criteria to allocate donor lungs according to medical urgency may not be feasible.
Inappropriate erythropoietin secretion in polycythemia vera
Authors: G. Chikkappa, H. Burlingtont, A. D. Chanana, P. Chandra, E. P. Cronkite, U. Reincke, E. Zanjani
Journal: American Journal of Hematology (1977)

Abstract A patient with classical polycythemia vera (PV) was found to have an inappropriately elevated serum erythropoietin (Ep) level. Investigations did not reveal any lesion or blood abnormality known to be associated with excessive Ep production and erythrocytosis. Sudden withdrawal of blood to reduce the Hb and Hct from 18.5 gm% and 56% to 13.6 gm% and 41.5%, respectively, resulted in an increment of serum Ep to abnormal level. With iron treatment there was a brisk return of Hb and Hct to prebleeding levels which was associated with reduction in the serum Ep. The inverse relationship between the EP and Hb or Hct is inconsistent with the presence of excessive Ep‐producing lesion. These results suggested that the threshold for Ep secretion from normal Ep‐secreting tissue to Hb and Hct levels is set at an abnormal level. This patient's marrow cells when cultured in vitro in the absence of Ep, unlike other PV patients' (except one) marrow cells, did not grow erythroid colonies. In the presence of Ep, however, the colonies comparable to those formed from normal marrow cultures were obtained. These results suggested that his marrow erythropoietic cells were neither Ep independent nor Ep‐hyperresponsive, as has been suggested by some investigators for erythropoiesis in PV. This patient presents phenomena that hitherto have not been reported.
A mathematical model for the quantification of mitral regurgitation. Experimental validation in the canine model using contrast echocardiography.
Authors: J M Dent, A R Jayaweera, W P Glasheen, S P Nolan, W D Spotnitz, F S Villanueva, S Kaul
Journal: Circulation (1992)

BACKGROUND Because the clearance of contrast from the left atrium (LA) relative to the left ventricle (LV) depends on the degree of mitral regurgitation (MR), we hypothesized that a mathematical model can be developed that would provide a quantitative estimation of MR from the washout of contrast from these chambers. METHODS AND RESULTS After mathematically developing the model, we performed experiments in two groups of dogs with the use of contrast echocardiography. Group 1 consisted of nine dogs in which different degrees of MR were produced by creating ischemic LV dysfunction. Contrast was injected into the LV, and MR was graded visually on a scale of from 0 to 4+. Videointensity plots generated from the LA and LV were provided to the model. There was excellent correlation between visual assessment of MR and model-derived regurgitant fraction in the 33 stages: y = 0.16x + 0.002 (r = 0.97, p less than 0.001, SEE = 0.06). To obtain a more quantitative validation, we placed electromagnetic flow probes on the aorta and just cephalad to the mitral annulus in six dogs (group 2) during cardiopulmonary bypass. Different degrees of MR were produced by chordal traction and/or myocardial ischemia. Regurgitant fraction was calculated at each stage from the flow probe and videointensity data. There was excellent correlation between flow probe and model-derived regurgitant fraction (y = 0.90x + 0.03; r = 0.96, p less than 0.001, SEE = 0.06), and close interobserver and intraobserver correlations were noted using flow probe and contrast echocardiographic data. CONCLUSIONS A mathematical model that uses the clearance of contrast from the LA relative to the LV can be used to accurately measure the severity of MR. These findings may have important practical implications for the quantification of MR.
Effects of Smoking on Digital Blood-Flow Velocity
Authors: Chaman L. Sarin
Journal: JAMA (1974)

The ultrasonic Doppler flow meter was used to measure digital blood velocity in two groups of ten male volunteers. In the experimental group, digital blood-flow velocity was measured before and after smoking one cigarette. In the control group, two digital blood-flow velocity measurements were made at the same intervals. Blood-flow velocity remained unchanged in the control group. In the experimental group the Doppler shift was reduced by 40±9% during systole, 48±10% during diastole, and the mean Doppler shift was reduced by 42±6% Since the Doppler shift is proportional to blood-flow velocity, it is concluded that smoking a single cigarette reduces mean blood-flow velocity by 42±6% (<i>JAMA</i>229:1327-1328, 1974)
EVALUATION OF ADRENAL RESECTION AND SYMPATHECTOMY IN NINETY-NINE PERSONS WITH HYPERTENSION
Authors: William A. Jeffers
Journal: JAMA (1953)

This study was begun in March, 1950, after a subtotal adrenalectomy was completed in a patient in whom severe hypertension had recurred one year after a thoracolumbar sympathectomy was performed. As our series of patients increased, we reported encouraging results 1 after employing various types of sympathectomy and various degrees of adrenal resection. This analysis includes 99 such patients followed for from 1 to 37 months after operation. It is our present feeling that sympathectomy combined with adrenalectomy is more effective than either sympathectomy or adrenalectomy alone. We feel, however, that further observations are required to prove or disprove this impression.  INDICATIONS AND CONTRAINDICATIONS  We have required that all three of the following indications be present before operation is attempted. 1. Average diastolic blood pressures should be 120 mm. Hg or more. 2. There should be failure to respond to intensive medical therapy. 3. There should be evidence of progressive
What is this thing called agitation?
Authors: R. McShane
Journal: BMJ (2011)

In the context of broader discussions of clinical dynamometry, earlier reviews have raised concerns about the potential effects of variations in subject factors and test procedures on measurements. None, however, have dealt exclusively with these effects. We therefore reviewed more than 200 articles to evaluate in detail the effects of variations in subject factors and test procedures on measurements. Factors relating to subjects that affected measurements were age, gender, weight, athletic background, disability, and limb dominance. Test conditions that led to variations in measurements were range of movement in which values were obtained, type of contraction or movement (concentric, eccentric, isokinetic, isometric, isotonic), pretest procedures (warm-up and gravity-correction procedures, starting position, stabilization, axes alignment, lever arm length, preload, damp/ramp settings), test conditions (speed, test sequence, rest intervals, feedback), and type of data analysis (the data selected and how they are manipulated). In the majority of the publications, the authors failed to provide sufficient detail for accurate replication of test procedures or for comparison with other studies. We advocate that the factors identified in this review be included whenever measurements obtained with a dynamometer are reported. Effective development of normative data, formation of ratios, comparison of measurements across studies, and relating measurements with other performance criteria (eg, measurements of functional performance) all require descriptions of variables relating to subjects and testing. Similarly, meaningful use of these measurements in clinical practice requires consideration and documentation of these variables.
Abstract 15455: Radial Versus Femoral Access for Percutaneous Coronary Intervention in Patients with Chronic Total Occlusion
Authors: Giuseppe Ferrante, Yves Louvard, Kentaro Hayashida, Hakim Benamer, Thomas Hovasse, Thierry Unterseeh, Philippe Garot, Thierry Lefevre
Journal: Circulation (2012)

Introduction Femoral access (FEM) is usually employed in percutaneous coronary intervention (PCI) for chronic total occlusions (CTO) because this is considered to provide better catheter support, a...
DETECTION OF MYOCARDIAL AMYLOID INVOLVEMENT USING 2-DIMENTIONAL SPECKLE TRACKING ECHOCARDIOGRAPHY: UTILIZATION OF INNER AND OUTER MYOCARDIAL STRAIN AND STRAIN RATE
Authors: Kenya Kusunose, Hirotsugu Yamada, Susumu Nishio, Noriko Tomita, Keisuke Endo, Toshiyuki Niki, Koji Yamaguchi, Kunihiko Koshiba, Yoshio Taketani, Takashi Iwase, Takeshi Soeki, Tetsuzo Wakatsuki, Masashi Akaike, Masataka Sata
Journal: Journal of the American College of Cardiology (2010)
34 000 die in Chinese quake—but authorities say major disease outbreak avoided
Authors: Jane Parry
Journal: BMJ (2008)

Patients who have confounded doctors with signs and symptoms that elude diagnosis are to be offered the expertise of hundreds of doctors in a unique programme from the US National Institutes of Health."Physicians deal with about 6600 conditions and 6000 of them are quite rare.Even common diseases have many subtypes," the institutes' director Elias A Zerhouni said during a telephone news conference with reporters earlier this week.He said it was not surprising that many can go undiagnosed for years.The programme aims to combine the revolution in tools and information at the molecular level with the expertise of the 1600 doctors at the NIH Clinical Center "to assist patients around the country and their doctors."It will add to the knowledge base by creating a phenotype atlas of disease."We are doing this now because of the advances that have been made over the last five years at the fundamental level.We have many more biologic markers, the significance of which is not always understood." Dr Zerhouni said that for the first time his organisation was going to apply these sophisticated laboratory tests to human diseases on a large scale.Under the current system of research at the NIH Clinical Center, patients with challenging conditions "are triaged to a specific institute or protocol programme, and are assessed by one team," said John I Gallin, director of the centre.Participants in the new programme "will be assessed by a large spectrum of teams."Candidate patients must be referred by a healthcare provider and will have to submit exhaustive medical records that will be reviewed by a multidisciplinary team of 25 senior doctors.Those who are accepted into the programme will travel to the centre for an evaluation, which is likely to take at least a week.Details are available at http://rarediseases.info.nih.gov/
Acute rejection before cytomegalovirus infection enhances von Willebrand factor and soluble VCAM-1 in blood
Authors: Adriana M. Kas-Deelen, Martin C. Harmsen, Eltjo F. De Maar, Wia W. Oost-Kort, Jan W. Cohen Tervaert, Jan Van Der Meer, Willem J. Van Son, T. Hauw The
Journal: Kidney International (2000)
SOME RELATIONSHIPS BETWEEN EXCITEMENT, DEPRESSION AND ANXIETY
Authors: D. EWEN CAMERON
Journal: American Journal of Psychiatry (1945)

On the basis of our findings we consider that the manic excitements, the depressions and the anxiety states are related in terms of the degree of facilitation and inhibition which is present. In all three the total tensional level is raised but in the excitements facilitation is maximal and inhibition is greatly reduced, though still present. In the depressions inhibition is present with facilitation greatly reduced. In the anxiety states there is an increase in both facilitation and inhibition, the two, as it were, competing against each other and being responsible for the characteristic picture of curbed overactivity. On this basis it is possible to recognize a range of reactions—predominant facilitation (manic excitements), facilitated anxiety states, inhibitory anxiety states and predominantly inhibitory states (depressions). The advantages inherent in this series of concepts which we have set up are first that they offer an explanation of the difficulty which initiated the investigations, namely that of differentiating between depressions and anxiety states. For it is clear that save where inhibition is outstandingly dominant and where facilitation is minimal some anxiety symptoms may be anticipated in the depressive reaction and similarly some depressive features are to be seen in all anxiety states, save where inhibition plays an entirely secondary rôle to facilitation. Second they tend to break up the old pathological pictures of manic depressive and anxiety conditions and to restate them in terms of reactions which occur in everyday life so that it is possible to see these conditions essentially as constituting intensifications of activities normally present in the individual. Third they afford some insight into the fact that the total reaction of the organism is most intense as demonstrated, for example, by the biochemical findings in the anxiety states where facilitation and inhibition are in sharp conflict as contrasted with the depressions and excitements where one or other has acquired dominance. Fifth these concepts offer new vistas on possible therapies. In stating this it is necessary to bear in mind that a therapy to be successful does not necessarily have to deal with the primary cause but needs only to be capable of interrupting in a constructive manner an undesirable train of events (Cameron, 1944, a, b). Therapies of excitement, depression and anxiety, based upon the modification of inhibition and facilitation, have already acquired some measure of success. It would seem that continued inquiry into the development of more effective means of controlling these states would be fruitful.
Abstract P2-06-09: Mucin4 Is Associated with the Loss of Estrogen-Receptor-α in Breast Cancer
Authors: AC Chen, I Migliaccio, M Gilcrease, CK Osborne, R. Schiff
Journal: Cancer Research (2010)

Abstract Data suggests that breast carcinomas that overexpress the HER2 oncoprotein are more resistant to endocrine treatments such as tamoxifen (Tam) or estrogen deprivation (ED) via aromatase inhibitors. To investigate possible mechanisms of endocrine resistance in vivo, we performed a gene microarray analysis on estrogen receptor-(ER)+, HER2-overexpressing xenograft tumors that are de novo resistant to tamoxifen treatment and acquire resistance to ED therapy. A large number of genes were upregulated, including several members of the mucin family of genes. This corroborated our finding from histological staining of the resistant tumors that indicated striking increases of mucin vacuoles when compared to sensitive tumors. These vacuoles were located mostly intracellularly and stained positive for mucins with mucicarmine. We were particularly interested in one particular mucin, mucin4 (MUC4) because previous studies have suggested its role in stabilizing and enhancing HER2 signaling. Quantitative realtime PCR confirmed the microarray results and showed that there was an approximately 156-fold increase in MUC4 transcript between the ED-sensitive and ED-resistant tumors, with a 65-fold increase between the early Tam and late Tam-resistant tumors. Immunohistochemistry confirmed that this upregulation in these two treatment groups was present also at the protein level. Furthermore, western blot analysis of these tumors demonstrated that resistant tumors have downregulation of ER protein and its downstream effectors with corresponding increase in total HER2 protein levels. These tumors have seemingly shifted away from the ER pathway to signaling via the growth factor signaling pathway. Preliminary experiments where MUC4 protein was stably overexpressed in ER+, HER2-overexpressing cells model these results in vitro with a downregulation of ER protein and downstream effectors, showing that ER expression and activity are affected. Furthermore, immunohistochemical analysis of 73 primary human invasive breast carcinomas suggests that MUC4 is associated with estrogen-receptor negative tumors (P=0.05). This clinical data validates the preclinical studies for investigating a possible mechanism for the loss of ER, and suggest MUC4 as an inviting biomarker for endocrine treatment and a potential therapeutic target for endocrine resistant breast cancer. Crosstabulation of MUC4 and ER Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-06-09.
The Risks of Drowning: Males in Maryland Rivers
Authors: Susan Pardee Baker, G. H. Li
Journal: JAMA (1991)

<h3>To the Editor.—</h3> The work of Howland and collegues,<sup>1</sup>as reported from<i>MMWR</i>, provides useful data, not only on alcohol use in connection with aquatic activity but also on the site of activity. The high exposure to the ocean (54% of activity) is of particular interest because ocean drowning is relatively uncommon. Maryland's popular ocean beaches were the site of only one of 117 drownings in an early study that also identified the important role of alcohol.<sup>2</sup>The majority of the Maryland drownings occurred in rivers and creeks, where supervision is often absent, footing uncertain, and currents treacherous. Gender differences in drowning rates vary dramatically with age (Figure). The male-female ratio is approximately 9:1 for ages 15 to 29,1.4:1 for infants less than 1 year of age, and 4.3:1 for all ages combined. In the teens, there is a sharp increase in the male drowning rate that is
Performance indices or patient care
Authors: J Brodribb
Journal: BMJ (1994)

As a consultant general surgeon who has recently completed three years as medical director of a large acute hospital group I would like to offer some advice to aspiring surgeons working in the NHS in the mid-1990s. The NHS Management Executive is creating a climate where consultants are under increasing pressure to fulfil performance targets rather than concentrate on good patient care.

* Ensure that the minimum number of new patients are referred to you.

This will enable you to see each patient within three months in your outpatient clinic, giving …
Characterization of beta 1- and beta 2-adrenoceptor subtypes in the rat atrioventricular node by quantitative autoradiography.
Authors: K Saito, M Kurihara, R Cruciani, W Z Potter, J M Saavedra
Journal: Circulation Research (1988)

We characterized beta-adrenoceptor subtypes in the atrioventricular node of the rat heart by quantitative autoradiography. Consecutive 16-microns-thick sections from single rat hearts containing the atrioventricular node were incubated with increasing concentrations of [125I]iodocyanopindolol. After exposure to [3H]Ultrofilm, optical densities corresponding to the atrioventricular node were determined by computerized densitometry after comparison with [125I]standards. The computer program LIGAND was used for analysis of receptor subtypes. Delineation of beta-adrenoceptor subtypes was achieved by incubating consecutive tissue sections with 50 pM [125I]iodocyanopindolol in the presence of increasing concentrations of the beta 1-selective antagonist atenolol or the beta 2-selective antagonist ICI 118,551. The atrioventricular node contains a higher concentration of beta-adrenoceptors than the adjacent interventricular septum. We estimated that the proportions of beta 1- and beta 2-adrenoceptors in the atrioventricular node were about 56% and 44% of the total binding capacity respectively.
Bitemporal Visual Field Defects in Presumed Multiple Sclerosis
Authors: Joel G. Sacks
Journal: JAMA (1975)

Three patients with presumed multiple sclerosis had bitemporal hemianopia mimicking that caused by parasellar tumors; the visual loss was probably due to a plaque within the chiasm. The diagnosis of multiple sclerosis was made on the basis of a history of relapse and remission, signs and symptoms indicating involvement of different levels of the central nervous system, and normal neuroradiological studies. Extensive neuroradiological studies may be delayed or omitted in patients with established multiple sclerosis and nonprogressive bitemporal visual field defects if central visual acuity is not greatly reduced.
Diltiazem and Propranolol in Mild to Moderate Essential Hypertension as Monotherapy or with Hydrochlorothiazide
Authors: Massie B, MacCarthy Ep, Ramanathan Kb, Weiss Rj, Anderson M, Eidelson Ba, Labreche Dg, Tubau Jf, Ulep D, Bartels D
Journal: Annals of Internal Medicine (1987)

We compared the safety and efficacy of diltiazem and propranolol, and examined demographic factors influencing responses to these agents. One hundred ninety-six patients with supine diastolic blood pressures of 95 to 114 mm Hg were treated with propranolol (80 to 240 mg twice a day) or a sustained-release preparation of diltiazem (60 to 180 mg twice a day) in a double-blind, randomized, parallel group protocol for 6 months. Hydrochlorothiazide was added for patients not achieving the treatment goal. Both agents produced nearly identical and highly significant (p < 0.001) reductions in supine blood pressure. There were no significant differences at the end of the optional combination therapy phase, although additional reduction with hydrochlorothiazide was slightly greater in the propranolol group. Blood pressure responses in relation to age, gender, race, and smoking history showed that diltiazem produced greater changes in older subjects and women, whereas propranolol was less effective in blacks. However, these differences were not critical.