tbuckley/cabot-search huggingface dataset:
Dynamics of Left Ventricular Apex Rotation During Angioplasty
Authors: Merril L. Knudtson, P. Diane Galbraith, Kathy L. Hildebrand, John V. Tyberg, Rafael Beyar
Journal: Circulation (1997)

Apex rotation has been shown to provide a reliable index of the dynamics of left ventricular (LV) twist. In this study, we aimed to characterize twist at baseline and during acute ischemia in 20 patients undergoing percutaneous transluminal coronary angioplasty to the left anterior descending (LAD) artery and to test whether an old myocardial infarction or collateral flow affected twist dynamics.Among patients with no previous infarction, five had no collaterals (group A) and six had angiographically visible collaterals (group B). Previous anterior infarction was present in nine patients (group C). Data were acquired with the LAD angioplasty wire passed beyond the apex using a view aligned with the LV long axis. Frame-by-frame dynamics of apex rotation were measured from the angular movement of the portion of the wire that traversed the apex. Aortic pressure recordings allowed precise temporal definition of the cardiac cycle. Dynamics of apex rotation were measured at fixed intervals until 60 seconds of occlusion and up to 60 seconds of reperfusion. In group A, counterclockwise apex rotation (twist) during ejection of -22.0+/-1.7 degrees (mean+/-SEE) was followed by rapid clockwise rotation (untwist) during isovolumic relaxation. During 60 seconds of ischemia, maximum apex rotation decreased to -8.2+/-2.0 degrees (P<.001 versus baseline). In group B, baseline apex rotation was similar (-26.2+/-6.9 degrees) to that in group A, but ischemia had less effect, with apex rotation values of -17.7+/-3.4 degrees (P<.05 versus group A values). Group C was characterized by reduced baseline apex rotation values (-9.7+/-3.1 degrees, P<.05 versus group A values), with little change observed during ischemia (-8.1+/-2.6 degrees).Apex rotation, an index of ventricular twist, is sensitive to acute ischemia in patients without previous myocardial infarction. Visible collaterals to the ischemic region attenuate the acute ischemic response at 60 seconds. Previous myocardial infarction causes abnormalities in the baseline twist pattern with no further deterioration at 60 seconds of ischemia.
Genetic immunization of outbred mice with thyrotropin receptor cDNA provides a model of Graves’ disease
Authors: Sabine Costagliola, Marie-Christine Many, Jean-François Denef, Joachim Pohlenz, Samuel Refetoff, Gilbert Vassart
Journal: Journal of Clinical Investigation (2000)

We performed genetic immunization of outbred NMRI mice, using a cDNA encoding the human thyrotropin receptor (TSHr). All mice produced antibodies capable of recognizing the recombinant receptor expressed at the surface of stably transfected Chinese hamster ovary (CHO) cells, and sera from most of the immunized mice blocked TSH-dependent stimulation of cAMP accumulation in cells expressing the TSHr. Five out of 29 female mice showed sign of hyperthyroidism including elevated total T4 and suppressed TSH levels. The serum of these mice contained thyroid-stimulating activity, as measured in a classic assay using CHO cells expressing recombinant TSHr. In contrast, only 1 male out of 30 had moderately elevated serum total T4 with undetectable TSH values. The hyperthyroid animals had goiters with extensive lymphocytic infiltration, characteristic of a Th2 immune response. In addition, these animals displayed ocular signs reminiscent of Graves' ophthalmopathy, including edema, deposit of amorphous material, and cellular infiltration of their extraocular muscles. Our results demonstrate that genetic immunization of outbred NMRI mice with the human TSHr provides the most convincing murine model of Graves' disease available to date.
Increased left ventricular diastolic chamber stiffness immediately after coronary artery bypass surgery
Authors: Patrice A. McKenney, Carl S. Apstein, Lisa A. Mendes, Gilbert P. Connelly, Gabriel S. Aldea, Richard J. Shemin, Ravin Davidoff
Journal: Journal of the American College of Cardiology (1994)

Objectives. The aim of this study was to assess the incidence and severity of left ventricular diastolic dysfunction immediately after coronary artery bypass surgery by utilizing simultaneous transesophageal echocardiographic and hemodynamic monitoring. Background. Left ventricular diastolic dysfunction has been documented after coronary bypass surgery, but its measurement has been technically difficult to acquire and limited by dependence on loading conditions. Methods. End-diastolic pressure-area curves were constructed before and immediately after coronary bypass surgery in 20 patients. Transesophageal echocardiographic images at the mid-papillary level of the left ventricle and hemodynamic data were recorded. Volume status was manipulated to alter loading conditions, and muitiple measurements were taken at each loading condition. Results. Diastolic function worsened in all patients, as manifested by a postoperative leftward shift of the end-diastolic pressure-area curve. At a comparable preload, mean end-diastolic area ± SEM decreased by 15% from 17.6 ± 0.8 to 14.9 ± 0.8 cm2postoperatively (p = 0.0001). Conclusions. Left ventricular diastolic chamber stiffness frequently increases immediately after coronary artery bypass surgery. Simultaneous hemodynamic and transesophageal echocardiographic monitoring, through the construction of end-diastolic pressure-area curves, is a useful method to evaluate diastolic function and guide management after cardiac surgery.
Association between vascular endothelial growth factor gene polymorphisms and survival in hepatocellular carcinoma patients†
Authors: Sun‐Young Kong, Joong‐Won Park, Jung An Lee, Jung Eun Park, Kyung Woo Park, Eun Kyung Hong, Chang‐Min Kim
Journal: Hepatology (2007)

Vascular endothelial growth factor (VEGF) plays an important role in angiogenesis and progression of tumor, including hepatocellular carcinoma (HCC), and elevated VEGF levels in serum and tissues have been known to be related with poor prognosis in patients with HCC. However, the effect of such polymorphisms of the VEGF gene on HCC prognosis has not been elucidated. In the present study, we investigated the association between VEGF gene polymorphisms and HCC patient prognosis. The study involved 416 HCC patients treated at the National Cancer Center Korea from November 2000 to December 2005. The median patient age was 57 years, and 328 patients (78.8%) were men. A total of 19 polymorphisms were analyzed, and the hazard ratios (HRs) for genotypes and haplotypes were determined in terms of risk for overall survival using Cox proportional hazard regression analysis. Of the 19 alleles, 7 showed no heterozygous allele. PHASE analysis identified a total of 36 haplotypes. The −2578 to −1498 region of the VEGF gene showed a strong linkage disequilibrium (correlation coefficient, r2 = 0.91; Lewontin's D′, D′ = 0.982). The adjusted HRs were 0.67 [95% confidence interval (CI), 0.46 to 0.99] for −634CC genotype carriers and 0.57 (95% CI, 0.36 to 0.92) for homozygous haplotype 1 (Ht1: CCGAGCCC at −2578/−1203/−1190/−1179/−1154/−634/−7/+936) carriers compared with noncarriers. Conclusion: These findings suggest that VEGF polymorphisms may be significant prognostic indicators for HCC patients. (HEPATOLOGY 2007.)
Pertussis cases rise 10-fold among older children and adults in England and Wales
Authors: Z. Kmietowicz
Journal: BMJ (2012)

Pertussis is affecting nearly 10 times the number of older children and adults this year than when the disease last peaked in England and Wales in 2008, figures show.

The Health Protection Agency has written to GPs in areas where the incidence is highest, advising them to look out for symptoms in children aged over 15 as well as adults and to treat them with antibiotics to stop the infection spreading to babies and vulnerable adults.

The agency is keeping the Department of Health for England up to date with the situation and is discussing what, if any, measures need to …
Remarks on the Tincture of the Muriate of Iron
Authors: C. Bell
Journal: BMJ (1887)

I might refer to, several oth'er caaes, of -the disease which were sue- REMARKS ~~~~~~~e sf1lAe4e but If shall satify-myself with ref6rring to theB last which caime under, my :treatment.It occ'urred in a, WOman agd 20, who lived in anill-aired"locality. 'Shewas ~delivered with forceps oinT HE TINCTURE OF THE MURIATE OF Novemb~~~er21st,-and. slemed to -be dloing'-well until the 25th of the moth, when sbe had, a rigor, followed by pain in hsadmen, rapi IRON.pulae, and high temperature, scanty and fdetid, lochia, In a few houirs By C.BELL, M.D., F.RC.P.E~.'the pulse rose to 180 -and the tenmpera.tureto, 103.50F .She was put Lecturer ~~~I.underthe'sahoylatei of soda, and had the 'vagina washed -out WI'th on Midwfery an the tiseasesof Womn and Cildren Edinbugh tepd -milk anid water, -but with, little benefit, as o.Nvember 26th, Schoolof Medicine, etc.~~she was suffering seee n in the left iliac reion, tympamiites, 'and HA&MdiN purchased the last edition of' Dr." GArrod's wo-V caijd teteprtr wsl2a.&s~~~~~~ntials ~~~~~~~~~I w-asnow ruet~ddto seehier, and I ordered her to have 30 drops the ~Zstakof 3f6ateria X3idica gn'd Therapeutics, und-er the-oi the-tiudture of_~the muit fio veytohus n to have impressi6n that it contained all the most important medicines.now'-tEe vagina rwashed'eut w'ith a solutiont of -Condy's fluid, in proportion
HIV and Tuberculosis Infection in San Francisco's Homeless Adults
Authors: Andrew R. Zolopa
Journal: JAMA (1994)

<h3>Objective.</h3> —To determine the prevalence and risk factors for human immunodeficiency virus (HIV) and tuberculosis (TB) infection and investigate the relationship between these two infections in homeless adults. <h3>Design.</h3> —Cross-sectional study. <h3>Setting.</h3> —Inner-city shelters and free meal programs. <h3>Participants.</h3> —A representative sample of 1226 adults (≥18 years) were enrolled from community sites. <h3>Main Outcome Measures.</h3> —Serum HIV-1 antibody status and tuberculin skin test reactivity. <h3>Results.</h3> —Human immunodeficiency virus seroprevalence was 8.5% (95% confidence interval [CI], 7.0% to 10.1%) and the prevalence of TB infection was 32% (95% CI, 30% to 37%). Nineteen percent of the HIV-seropositive subjects had positive tuberculin skin tests. Independent risk factors for HIV infection included younger age, black race, male homosexual contact, injection drug use, use of injection drugs in shooting galleries, and selling sex. Tuberculosis infection was associated with the duration of homelessness and living in crowded shelters or single-room-occupancy hotels. Injection drug use, a risk factor for HIV, was also a risk factor for TB, with a particularly strong association in women. No evidence of an association between TB and HIV infection was found, even after accounting for anergy. <h3>Conclusions.</h3> —The homeless population in the United States should be considered a group at high risk for HIV infection and TB. Given the constellation of risk factors present, the high prevalence of infection, and lack of access to medical services, we anticipate that these communicable diseases in this population will represent a growing public health problem. (<i>JAMA</i>. 1994;272:455-461)
Eosinophilia in Malignant Pleural Effusion
Authors: JOHN G. MEHARG
Journal: Annals of Internal Medicine (1980)

Letters and Corrections1 May 1980Eosinophilia in Malignant Pleural EffusionJOHN G. MEHARG JR, M.D., SCOTT A. CHERRY, M.D.JOHN G. MEHARG JR, M.D.Search for more papers by this author, SCOTT A. CHERRY, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-92-5-715 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We were interested to read the exchange of letters (1) in your journal after publication of the review of malignant pleural effusion by Leff and colleagues (2) with regard to the presence or absence of eosinophilia in pleural effusion due to metastatic malignancy. The crux of the matter would seem to be the definition of eosinophilia, which Leff and associates state is "an eosinophil count exceeding 10% of the total leukocyte differential." Using that criterion, they report that they have encountered no cases with metastatic malignancy as the cause of the effusion in which pleural fluid eosinophilia...References1. DERESINSKI S. Eosinophils, pleural effusions, and malignancy. Ann Intern Med. 1978;89:424-5. Letter. LinkGoogle Scholar2. LEFFHOPEWELLCOSTELLO APJ. Pleural effusion from malignancy. Ann Intern Med. 1978;88:532-7. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Reading Hospital and Medical Center West Reading, PA 19603 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1980Volume 92, Issue 5Page: 715-715KeywordsEosinophiliaEosinophilsPleural effusion Issue Published: 1 May 1980 PDF downloadLoading ...
Health checks in general practice: another example of inverse care?
Authors: D Waller, M Agass, D Mant, A Coulter, A Fuller, L Jones
Journal: BMJ (1990)

To assess attendance at and the characteristics of patients attending health checks for cardiovascular disease offered in a general practice over a period of five years (1984-9).Medical record audit and postal questionnaire survey.One general practice in Oxfordshire with a socially diverse population.1101 Men and 1110 women aged 35-64 registered with the practice.Age, sex, marital state, social class, smoking habits, alcohol consumption, and diet.Of the 2211 men and women in the target age group (35-64) in 1989, 1458 (65.9%) had been offered screening and 963 (43.6%) had attended for a health check. Attenders were more likely to be women, aged greater than or equal to 45, married, non-smokers, and of higher social class than patients who did not respond to the invitation. The relative likelihood of non-attendance was 1.24 for smokers, 1.20 for the overweight, 1.16 for heavy drinkers, and 1.28 for those with a less healthy diet, even after adjustment for age, sex, marital state, and social class.After five years of offering health checks, opportunistically (to men) and in the context of cervical smear tests (to women), less than half of the eligible patients had attended. The likelihood of acceptance of an invitation to attend was inversely related to the patient's cardiovascular risk for all factors measured except age. A coherent strategy to reduce cardiovascular disease depends on more careful targeting of scarce health service resources and more emphasis on public health measures (such as dietary regulation and tobacco taxation). Doctors should be careful not to absolve the government of its public health obligations by substituting unproved preventive interventions aimed at the individual patient.
Insulin decreases myocardial adiponectin receptor 1 expression via PI3K/Akt and FoxO1 pathway
Authors: Xiao-Bing Cui, Cheng Wang, Li Li, Dong Fan, Yun Zhou, Dan Wu, Qing-Hua Cui, Feng-Ying Fu, Li-Ling Wu
Journal: Cardiovascular Research (2011)

Adiponectin is considered an important adipokine protecting against diabetes, atherosclerosis, and cardiovascular disease. Because adiponectin receptors (AdipoRs) are critical components in the adiponectin signalling cascade, we investigated the effect of insulin on the expression of myocardial AdipoRs and explored the possible molecular mechanism. The hyperinsulinaemia rat model was induced by infusion of insulin (1 U/day) for 28 days: serum and myocardial adiponectin levels were increased, and skeletal muscle and myocardial AdipoR1 expression and AMP-activated protein kinase (AMPK) phosphorylation were decreased. In primary cultured neonatal rat ventricular myocytes (NRVMs), insulin decreased AdipoR1 but not AdipoR2 expression and AMPK phosphorylation; high glucose had no affect on AdipoRs expression. Akt and extracellular signal-regulated kinase 1/2 (ERK1/2) phosphorylation was increased in insulin-treated hearts and in NRVMs. P13K inhibitor LY294002 and Akt1/2 kinase inhibitor but not the ERK1/2 kinase (MEK) inhibitors PD98059 and U0126 blocked the insulin-induced reduction in AdipoR1 expression and AMPK phosphorylation. Insulin induced forkhead/winged helix box gene group O-1 (FoxO1) phosphorylation and translocation from the nucleus to the cytosol, and this was blocked by LY294002. FoxO1 small interfering RNA reduced AdipoR1 expression and AMPK phosphorylation. In electrophoretic mobility shift assay and chromatin immunoprecipitation, FoxO1 bound to the putative site from −167 to −157 bp of the AdipoR1 promoter both in vitro and in living cells; insulin suppressed this binding, which was blocked by LY294002. Insulin inhibits myocardial AdipoR1 expression via PI3K/Akt and FoxO1 pathways, and FoxO1 mediates AdipoR1 transcription by binding to its promoter directly.
Cancer Mortality and Incidence of Mesothelioma in a Cohort of Wives of Asbestos Workers in Casale Monferrato, Italy
Authors: Daniela Ferrante, Marinella Bertolotti, Annalisa Todesco, Dario Mirabelli, Benedetto Terracini, Corrado Magnani
Journal: Environmental Health Perspectives (2007)

BackgroundFamily members of asbestos workers are at increased risk of malignant mesothelioma (MM). Although the hazard is established, the magnitude of the risk is uncertain, and it is unclear whether risk is also increased for other cancers. Few cohort studies have been reported.ObjectiveThe "Eternit" factory of Casale Monferrato (Italy), active from 1907 to 1986, was among the most important Italian plants producing asbestos-cement (AC) goods. In this article we present updated results on mortality and MM incidence in the wives of workers at the factory.MethodsWe studied a cohort of 1,780 women, each married to an AC worker during his employment at the factory but not personally occupationally exposed to asbestos. Cohort membership was defined starting from the marital status of each worker, which was ascertained in 1988 from the Registrar's Office in the town where workers lived. At the end of follow-up (April 2003), 67% of women were alive, 32.3% dead, and 0.7% lost to follow-up. Duration of exposure was computed from the husband's period of employment. Latency was the interval from first exposure to the end of follow-up.ResultsThe standardized mortality ratio (SMR) for pleural cancer [21 observed vs. 1.2 expected; SMR = 18.00; 95% confidence interval (CI), 11.14–27.52] was significantly increased. Mortality for lung cancer was not increased (12 observed vs. 10.3 expected; SMR = 1.17; 95% CI, 0.60–2.04). Eleven incident cases of pleural MM were observed (standardized incidence ratio = 25.19; 95% CI, 12.57–45.07).ConclusionsHousehold exposure, as experienced by these AC workers' wives, increases risk for pleural MM but not for lung cancer.
IOM Report Advises Shift in Focus for Next Phase of US AIDS Relief Program
Authors: Anita Slomski
Journal: JAMA (2013)

When President George W. Bush announced the President's Emergency Plan for AIDS Relief (PEPFAR) in 2003, the $15 billion 5-year program was an ambulance racing to the global AIDS firestorm. With no consensus that it was even possible to administer large-scale AIDS services in sub-Saharan African countries, the goal then was to provide antiretroviral treatment to 2 million people with HIV and to prevent 7 million new HIV infections.
Health system report ranks UK first, US last
Authors: M. McCarthy
Journal: BMJ (2014)

The United Kingdom was ranked highest overall, Switzerland second, and the United States last in a new report that compared the health systems of 11 developed nations.1 The US, the report noted, spent more than $8500 (£5000; €6270) per capita on health in a year, while the UK spent less than half that, at $3400 per person.

The study was the fifth in a series produced by the Commonwealth Fund. It draws on international surveys that the New York City based foundation has conducted with patients and doctors, as well as data on health spending and outcomes from the Organisation for Economic Cooperation and Development and the World Health Organization.

The report ranked the 11 countries in this order: 

The report ranked the nations according to five measures of health system performance: quality of care, access to care, efficiency, equity, and healthy lives, which were based on indicators such as infant mortality or mortality amenable to healthcare. The US came last or nearly last in four of …
The dermoscopic classification of atypical melanocytic naevi (Clark naevi) is useful to discriminate benign from malignant melanocytic lesions
Authors: A. Blum, H.P. Soyer, C. Garbe, H. Kerl, G. Rassner, R. Hofmann-Wellenhof
Journal: British Journal of Dermatology (2003)

The dermoscopic classification is a useful tool for handling patients with atypical naevi (Clark naevi).To investigate if the dermoscopic classification of atypical naevi is of any value to discriminate benign from malignant melanocytic lesions.Consecutive patients (n = 205) were included with 254 suspicious melanocytic lesions, confirmed by histopathology at the Pigmented Lesions Clinic of the Department of Dermatology, University Medical Center, University of Tuebingen, Germany. In this retrospective study, dermoscopic images of benign and malignant melanocytic lesions were classified according to the dermoscopic classification of atypical naevi (reticular, globular, homogeneous or combinations of two of these) and pigmentation (uniform, central hyper- or hypopigmentation, eccentric peripheral hyper- or hypopigmentation, or multifocal hyper- or hypopigmentation). The three-structure type (reticular, globular and homogeneous) was additionally defined.Reticular, homogeneous and reticular-homogeneous types were significantly more frequent in naevi than in melanomas, whereas the three-structure type was significantly more frequent in melanomas (P < 0.001). A sensitivity of 86.7%, specificity of 87.7% and diagnostic accuracy of 87.4% was obtained. Uniformly pigmented and centrally hyperpigmented types were significantly more frequent in naevi than in melanomas, whereas eccentric peripheral hyperpigmented and multifocal hyper- or hypopigmented types were significantly more frequent in melanomas (P < 0.001).The dermoscopic classification of atypical naevi (Clark naevi) is useful to discriminate benign from malignant melanocytic lesions. The three-structure type and eccentric peripheral hyperpigmentation were significantly more frequently found in malignant than in benign melanocytic lesions. The knowledge of these two dermoscopic types should be helpful for the management of patients presenting with multiple melanocytic lesions.