tbuckley/cabot-search huggingface dataset:
Outcome Impact of Coronary Revascularization Strategy Reclassification With Fractional Flow Reserve at Time of Diagnostic Angiography
Authors: Eric Van Belle, Gilles Rioufol, Christophe Pouillot, Thomas Cuisset, Karim Bougrini, Emmanuel Teiger, Stéphane Champagne, Loic Belle, Didier Barreau, Michel Hanssen, Cyril Besnard, Raphael Dauphin, Jean Dallongeville, Yassine El Hahi, Georgios Sideris, Christophe Bretelle, Nicolas Lhoest, Pierre Barnay, Laurent Leborgne, Patrick Dupouy
Journal: Circulation (2013)

Background— There is no large report of the impact of fractional flow reserve (FFR) on the reclassification of the coronary revascularization strategy on individual patients referred for diagnostic angiography. Methods and Results— The Registre Français de la FFR (R3F) investigated 1075 consecutive patients undergoing diagnostic angiography including an FFR investigation at 20 French centers. Investigators were asked to define prospectively their revascularization strategy a priori based on angiography before performing the FFR. The final revascularization strategy, reclassification of the strategy by FFR, and 1-year clinical follow-up were prospectively recorded. The strategy a priori based on angiography was medical therapy in 55% and revascularization in 45% (percutaneous coronary intervention, 38%; coronary artery bypass surgery, 7%). Patients were treated according to FFR in 1028/1075 (95.7%). The applied strategy after FFR was medical therapy in 58% and revascularization in 42% (percutaneous coronary intervention, 32%; coronary artery bypass surgery, 10%). The final strategy applied differed from the strategy a priori in 43% of cases: in 33% of a priori medical patients, in 56% of patients undergoing a priori percutaneous coronary intervention, and in 51% of patients undergoing a priori coronary artery bypass surgery. In reclassified patients treated based on FFR and in disagreement with the angiography-based a priori decision (n=464), the 1-year outcome (major cardiac event, 11.2%) was as good as in patients in whom final applied strategy concurred with the angiography-based a priori decision (n=611; major cardiac event, 11.9%; log-rank, P =0.78). At 1 year, &gt;93% patients were asymptomatic without difference between reclassified and nonreclassified patients (Generalized Linear Mixed Model, P =0.75). Reclassification safety was preserved in high-risk patients. Conclusion— This study shows that performing FFR during diagnostic angiography is associated with reclassification of the revascularization decision in about half of the patients. It further demonstrates that it is safe to pursue a revascularization strategy divergent from that suggested by angiography but guided by FFR.
In vivo tumor targeting and radionuclide imaging with self-assembled nanoparticles: Mechanisms, key factors, and their implications
Authors: Yong Woo Cho, Soo Ah Park, Tae Hee Han, Dai Hyun Son, Ji Sun Park, Seung Jun Oh, Dae Hyuk Moon, Kyung-Ja Cho, Cheol-Hee Ahn, Youngro Byun, In-San Kim, Ick Chan Kwon, Sang Yoon Kim
Journal: Biomaterials (2006)
Dicer, Drosha, and Outcomes in Patients with Ovarian Cancer
Authors: William M. Merritt, Yvonne G. Lin, Liz Y. Han, Aparna A. Kamat, Whitney A. Spannuth, Rosemarie Schmandt, Diana Urbauer, Len A. Pennacchio, Jan-Fang Cheng, Alpa M. Nick, Michael T. Deavers, Alexandra Mourad-Zeidan, Hua Wang, Peter Mueller, Marc E. Lenburg, Joe W. Gray, Samuel Mok, Michael J. Birrer, Gabriel Lopez-Berestein, Robert L. Coleman, Menashe Bar-Eli, Anil K. Sood
Journal: New England Journal of Medicine (2008)

We studied Dicer and Drosha, components of the RNA-interference machinery, in ovarian cancer.We measured messenger RNA (mRNA) levels of Dicer and Drosha in specimens of invasive epithelial ovarian cancer from 111 patients, using a quantitative reverse-transcriptase-polymerase-chain-reaction assay, and compared the results with clinical outcomes. Validation was performed with the use of published microarray data from cohorts of patients with ovarian, breast, and lung cancer. Mutational analyses of genomic DNA from the Dicer and Drosha genes were performed in a subgroup of ovarian-cancer specimens. Dicer-dependent functional assays were performed by means of in vitro transfection with small interfering RNA (siRNA) and short hairpin RNA (shRNA).Levels of Dicer and Drosha mRNA correlated with the levels of expression of the corresponding protein and were decreased in 60% and 51% of ovarian-cancer specimens, respectively. Low Dicer expression was significantly associated with advanced tumor stage (P=0.007), and low Drosha expression with suboptimal surgical cytoreduction (P=0.02). Cancer specimens with both high Dicer expression and high Drosha expression were associated with increased median survival (>11 years, vs. 2.66 years for other subgroups; P<0.001). We found three independent predictors of reduced disease-specific survival in multivariate analyses: low Dicer expression (hazard ratio, 2.10; P=0.02), high-grade histologic features (hazard ratio, 2.46; P=0.03), and poor response to chemotherapy (hazard ratio, 3.95; P<0.001). Poor clinical outcomes among patients with low Dicer expression were validated in additional cohorts of patients. Rare missense mutations were found in the Dicer and Drosha genes, but their presence or absence did not correlate with the level of expression. Functional assays indicated that gene silencing with shRNA, but not siRNA, may be impaired in cells with low Dicer expression.Our findings indicate that levels of Dicer and Drosha mRNA in ovarian-cancer cells have associations with outcomes in patients with ovarian cancer.
The third Colloquium on clinical problems related to sport
Authors: D. Crean
Journal: British Journal of Sports Medicine (1980)

As running and jogging became more popular, so the number of associated injuries increases placing extra burdens on the doctor.Possible causes, diagnosis and therapy are discussed: plantar fasciitis, bunions, hammer toe, interdigital neuroma, stress fractures, corns, nerve entrapment in the foot; anterior and posterior tibial tendonitis, tibial periostitis, tibial stress fracture and acute and chronic compartment syndromes in the leg; chondromalacia, patellar compression syndrome, patellar tendinitis, iliotibial band friction syndrome, fat pad inflammation, popliteus tendinitis, pes bursitis, medial and lateral gastrocnemius tendinitis/bursitis, medial retinacular inflammation, internal derangements, chronic instabilities, and arthritis in the knee joint; hamstring strains; hip pain; back pain.The runner should be taught to listen to his body and the doctor to be prepared to give time.Prevention is better than cure but the doctor should be careful to check that there is no lower extremity misalignment.(contributed by R. A.
Acute Dilatation of the Stomach: Gastrotomy: Recovery
Authors: G. G. Farquhar
Journal: BMJ (1911)

THz BRiTinS 675 after opening the abdomen is to examine the stomach, the pylorus, and the duodenum thoroughly.Without this precaution it would be easy to overlook either a cardiac pouch or pyloric obstruction.The exact nature of the operation to be performed must depend upon the condi- tions found upon exploration.The same operation is not suitable for all cases.A good deal depends upon the presence or absence of ulceration, of pyloric obstruction, and of adhesions.When there is no pyloric obstruction, and especially if the pyloric pouch be small, a single pos- terior gastro-enterostomy is all that is necessary, the cardiac pouch, which is generally large, being easily joined to the jejunum.With an open pylorus there is no fear of stasis in the pyloric pouch.The condition then
The appointment quest
Authors: K. Patel
Journal: BMJ (2009)

My fiancee has a mole. A small mole, on her left leg. Better get this checked out, she thought. So, she went to her GP, who thought it warranted a specialist opinion. So far, so good.

The next contact she had with the NHS was a letter from the Choose and Book service. This was not asking her where and when she would like to be seen, as you might expect it would. Instead, the letter admonished her for not having attended her outpatient appointment, …
Covert manifestations of child abuse.
Authors: A Grace, M Kalinkiewicz, A B Drake-Lee
Journal: BMJ (1984)

3 observations de lesions du tympan et de l'oreille, avec en plus dans un cas lesions de la bouche et du palais et dans un autre perforation mastoidienne, brulure d'une main et introduction d'epingles, toutes lesions provoquees par des meres desequilibrees
Mast cell–derived proteases control allergic inflammation through cleavage of IgE
Authors: Ingrid Rauter, Maria-Theresa Krauth, Kerstin Westritschnig, Friedrich Horak, Sabine Flicker, Anna Gieras, Andreas Repa, Nadja Balic, Susanne Spitzauer, Johannes Huss-Marp, Knut Brockow, Ulf Darsow, Heidrun Behrendt, Johannes Ring, Franz Kricek, Peter Valent, Rudolf Valenta
Journal: Journal of Allergy and Clinical Immunology (2007)
OBSERVATIONS IN DIPHTHERIA.
Authors: H. D. JEROWITZ
Journal: JAMA (1898)

It is not the purpose of this paper to lecture upon diphtheria and its treatment before this assembly of eminent physicians nor to enter into any detailed bacteriologic study which would perhaps be only an incomplete reiteration of principles thoroughly known, discovered and taught by some of the other members present; but merely to base my remarks upon conclusions drawn from an impartial observation covering an experience of seven years, which, as has been my good fortune, has been much larger than one would naturally expect for that short space of time. As to conclusions, it must be remembered that experiences vary with different observers; depending 1, upon the virulence of the epidemic, and 2, upon the mode of treatment. A third item may also be mentioned, as it plays an important rôle in deductions made in this article, and that is the susceptibility and resisting powers of certain classes
On Epithelial Cells Conveying Cholera
Authors: J. Bullar
Journal: BMJ (1866)

THE invaluable researches of Snow and Dr. W. Budd, showing that the contagion of cholera is conveyed in the secretions from the intestines, give a new in- terest to the microscopical examination of these se- cretions, for in them must the morbid poison be found.
Clinical relevance of airway remodelling in airway diseases
Authors: A. L. James, S. Wenzel
Journal: European Respiratory Journal (2007)

Asthma and chronic obstructive pulmonary disease (COPD) are characterised by airflow obstruction, airway remodelling (measurable structural change) and inflammation. The present review will examine the relationship between airway remodelling in these two conditions with respect to symptoms, abnormal lung function, airway hyperresponsiveness and decline in lung function. The potential for remodelling to be a protective response will also be discussed. Asthma is associated with variable symptoms and changes in lung function and also fixed abnormalities of lung function and an increased rate of decline in lung function with age. There is a relative preservation of the relaxed airway lumen dimensions, prominent thickening of the smooth muscle layer and reduced airway distensibility. The severity of asthma is related to the degree of airway remodelling, which is most marked in cases of fatal asthma. In COPD, symptoms are persistent and predictable but also progressive and are related to fixed abnormalities of lung function. Remodelling is associated with narrowing of the airway lumen and an increased thickness of the airway wall, although not usually to the extent seen in asthma. COPD is most often due to smoking where there is also remodelling of the parenchyma that may contribute to symptoms.
Adult Acquired Toxoplasmosis.
Authors: Thomas C. Jones
Journal: Annals of Internal Medicine (1967)

s1 May 1967Adult Acquired Toxoplasmosis.Thomas C. Jones, M.D., B. H. Kean, M.D., F.A.C.P., Anne C. Kimball, Ph.D.Thomas C. Jones, M.D.Search for more papers by this author, B. H. Kean, M.D., F.A.C.P.Search for more papers by this author, Anne C. Kimball, Ph.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-66-5-1046_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptFifty-two adult patients were seen at The New York Hospital with a Sabin-Feldman dye test titer of 1:256 or greater in at least one serum specimen. Thirty-eight met serologic criteria considered highly suggestive of recently acquired toxoplasmosis, that is, a single serum specimen with a dye test of 1:256 or greater and a complement fixation test of 1:8, and/or a changing titer. Isolation of Toxoplasma gondii was attempted on 16 lymph node biopsies and was successful in 10. Eleven of the 14 remaining patients had illnesses with lymphadenopathy compatible with toxoplasmosis.The clinical picture was cervical or axillary lymph node... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New York, New York PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByInfectious diseases. Annual review of significant publications. 1 May 1967Volume 66, Issue 5Page: 1046-1046KeywordsBiopsyComplement fixation testLymph nodesToxoplasma gondiiToxoplasmosis Issue Published: 1 May 1967 PDF DownloadLoading ...
THE INTERRELATION OF LESIONS OF BONE MARROW, LIVER AND SPLEEN
Authors: WILLIAM J. MAYO
Journal: JAMA (1926)

Picturesquely speaking, the blood may be regarded as an organ in which, in a liquid medium called the plasma, various cellular elements, all necessary to life, are brought into intimate contact with every part of the living body. All vertebrates have red blood, with the exception of the amphioxus, which has white blood. This cordate animal is possibly the connecting link between the invertebrates and the vertebrates. All invertebrates that have a circulating medium have white blood, although a few have blood cells showing a trace of hemoglobin. The first blood in the human embryo is white, and there is evidence of a primitive mechanism for circulating white blood that has become a part of the vascular system. Fairly accurate knowledge of the structure of the cellular elements of the blood has been gained through the microscope, but the constituents of the plasma lie in the colloid and molecular fields
Drinking water--doubts about quality.
Authors: A. Walker
Journal: BMJ (1992)

glealth and the Environment Drinking water -doubts about quality// AlisonTalker Does anyone trust tap water any more?Sales of bottled mineral water increased from three million to 128 million litres between 1976 and 1986, and a survey of over 250 people in London and the midlands in 1988 showed that over a quarter never drank water directly from the tap.'The water industry, feeling the consequences of privatisation, stringent European Community directives, and growing pressure from environmental groups, is finding it hard to convince the public that tap water is still safe, let alone palatable.Scares like the accidental contamination of water at Camelford with aluminium have not helped either.But are the public's fears justified?Is drinking water any less safe than it was 50 years ago?Water sources Some impurities in tap water are inevitable.These derive both from the different sources of water and from the treatment process.Domestic water is extracted from groundwater, reservoirs, or rivers depending on local geography.2Groundwater is pumped up from aquifers or water permeable rocks.These are mostly found in the chalk regions of the south of England and the sandstones of the east midlands.They provide nearly a third of the water in England and Wales.Natural filtering takes place through the rock, but contamination is still possible.Supplies from aquifers near waste disposal sites, for example, may be contaminated if drainage water from the sites percolates through them.A survey carried out by the Department of the Environment in 1987 of 100 landfill sites in Britain showed that a disturbingly high percentage (62%) took no measures to prevent groundwater ingress.3Groundwater in agricultural areas is also at increased risk of contami- nation as nitrate based fertilisers and pesticides can don leach into the supply.Reservoirs are mainly found in upland areas of Scotland, Wales, northern England, and the south west, where the local geography makes damming of valleys practicable.The water tends to be soft and peaty and is relatively uncontaminated, being situated away from industrial areas.Rivers such as the Thames, Ouse, and Severn provide water for the dense urban populations of the towns and cities located nearby.River water is often
Natural resolution of inflammation
Authors: Marcelo O. Freire, Thomas E. Van Dyke
Journal: Periodontology 2000 (2013)

Inflammation is a protective response essential for maintaining human health and for fighting disease. As an active innate immune reaction to challenge, inflammation gives rise to clinical cardinal signs: rubor, calor, dolor, tumor and functio laesa. Termination of acute inflammation was previously recognized as a passive process; a natural decay of pro-inflammatory signals. We now understand that the natural resolution of inflammation involves well-integrated, active, biochemical programs that return tissues to homeostasis. This review focuses on recent advances in the understanding of the role of endogenous lipid mediators that modulate cellular fate and inflammation. Biosynthesis of eicosanoids and other lipids in exudates coincides with changes in the types of inflammatory cells. Resolution of inflammation is initiated by an active class switch in lipid mediators, such as classic prostaglandins and leukotrienes, to the production of proresolution mediators. Endogenous pro-resolving lipid mediators, including arachidonic acid-derived lipoxins, aspirin-triggered lipoxins, ω3-eicosapentaenoic acid-derived resolvins of the E-series, docosahexaenoic acid-derived resolvins of the D-series, protectins and maresins, are biosynthesized during the resolution phase of acute inflammation. Depending on the type of injury and the type of tissue, the initial cells that respond are polymorphonuclear leukocytes, monocytes/macrophages, epithelial cells or endothelial cells. The selective interaction of specific lipid mediators with G protein-coupled receptors expressed on innate immune cells (e.g. G protein-coupled receptor 32, lipoxin A4 receptor/formyl peptide receptor2, chemokine-like receptor 1, leukotriene B4 receptor type 1 and cabannoid receptor 2) induces cessation of leukocyte infiltration; vascular permeability/edema returns to normal with polymorphonuclear neutrophil death (mostly via apoptosis), the nonphlogistic infiltration of monocyte/macrophages and the removal (by macrophages) of apoptotic polymorphonuclear neutrophils, foreign agents (bacteria) and necrotic debris from the site. While an acute inflammatory response that is resolved in a timely manner prevents tissue injury, inadequate resolution and failure to return tissue to homeostasis results in neutrophil-mediated destruction and chronic inflammation. A better understanding of the complex mechanisms of lipid agonist mediators, cell targets and actions allows us to exploit and develop novel therapeutic strategies to treat human inflammatory diseases, including periodontal diseases.
Quality Medical Care
Authors: Grant E. Steffen
Journal: JAMA (1988)

This article offers a definition of quality medical care. Quality itself is defined not as consisting of the properties of an object but rather as the capacity of these properties to achieve goals. Accordingly, quality medical care is the capacity of the elements of that care to achieve legitimate medical and nonmedical goals. This definition is compared with other current definitions. I offer answers to the questions of how to choose goals, who chooses goals, and what are legitimate goals. Implications of this definition are discussed, particularly with reference to chart review. Because patient values shape goals and because these values are not always assessed and recorded, it is recommended that a formal assessment of patient values become part of the patient's record.The definition of quality medical care as the capacity of the elements of that care to achieve legitimate medical and nonmedical goals is compared with other current definitions. The difficulty of choosing goals is reflected in the contrast between the technical and the interpersonal aspects of care; doctor and patient should work together to achieve "legitimate" goals which integrate scientific knowledge and personal beliefs. Because this definition will affect chart review, a formal assessment of patient values must become part of the patient's record.
THE DISINFECTION OF DRINKING WATER: With a Description of a New Substance for the Preparation of Stable Tablets for the Sterilization of Polluted Water
Authors: H. D. Dakin, E. K. Dunham
Journal: BMJ (1917)

MAY 26, r9r7 fluid, and so arrests osmosis anid diffusion in the case of the parietal peritoneal vessels.This arrest of osmosis occurs at a certain stage in each animal, depending entirely upon tlle rate of output of lymph.The protein tlius originates in the lymph which is being rapidly produced by the viscera, and for this reason the fluid becomes of the same composition as the original ascites.Wlhen salt solution is introduced into the peritoneum of tlle normnal animal protein appears in it for the same reason-namely, that there is normally a very slow output of lym-ph into the peritoneuLm, whiclh is being as rapidly absorbed, so that this structure is kept slightly moist, and there is no accumulation of fluid in it.It is this normal lymilph production which accouLnts for the appearance of protein in the peritoneal saline solution.In support of this hypothesis may be mentioned tthe fact, noted by Gray and myself, that sometimes in the nor-Mal hutch-fed rabbit, and commonly when it is pregnant and the muscles are flabby and the abdomen is full, ascitic fluid is present.We showed that there were no pressure changes in the circu- lation of these ascitic animals.The ascitic fluid of these rabbits appears to be nor-mal tissue fluid, the rate of pro- duction of wlhieh is probably normal, but absorption by tlle
Treatment of typhoid.
Authors: K V Thiruvengadam, N Subramanian, A V Sharma, S Krishnaswamy, S Nalini
Journal: BMJ (1973)

were demonstrated in normal subjects.'Sir Thomas Lewis showed in 19272 that intra- cutaneous morphine elicited a triple re- sponse similar to that induced by histamine.Histamine release by opium alkaloids has been demonstrated in isolated cat skin and muscle preparations.3Elevated plasma levels of histamine have been measured in intact dogs following the administration of morphine and pethidine.4A significant de- crease in the lung capacity of intact dogs has been observed following the administra- tion of morphine and pethidine-an effect most likely to be due to bronchoconstriction.5 The mechanism of opiate-induced bronchoconstriction may include central vagal stimulation, histamine release leading to enhanced bronchomotor tone and pul- monary vascular congestion, and histamine- induced reflex enhancement of vagal tone.5In view of this evidence and the availability of alternative sedatives, we feel that the use of opium alkaloids in asthma is unjustified and should be avoided.-Weare, etc.