tbuckley/cabot-search huggingface dataset:
Cost-effectiveness of Routine Coronary Angiography After Acute Myocardial Infarction
Authors: Karen M. Kuntz, Joel Tsevat, Lee Goldman, Milton C. Weinstein
Journal: Circulation (1996)

Background Coronary angiography is indicated for many patients after acute myocardial infarction (AMI). There are a number of subgroups of AMI patients, however, for whom the indication for coronary angiography is not well established. Methods and Results We developed a decision-analytic model for AMI in representative patient subgroups based on relevant clinical characteristics. The model estimates quality-adjusted life expectancy and direct lifetime costs for two strategies: coronary angiography and treatment guided by its results versus initial medical therapy without angiography. Decision tree chance node probabilities were estimated with the use of pooled data from randomized clinical trials and other relevant literature, costs were estimated with the use of the Medicare Part A database, and quality of life adjustments were derived from a survey of 1051 patients who had had a recent AMI. In our analysis, incremental cost-effectiveness ratios for coronary angiography and treatment guided by its result, compared with initial medical therapy without angiography, ranged between $17 000 and &gt;$1 million per quality-adjusted year of life gained. Patient subgroups with severe postinfarction angina or a strongly positive exercise tolerance test (ETT) typically had cost-effectiveness ratios of &lt;$50 000 per quality-adjusted year of life gained. In addition, most patient subgroups with a prior AMI had cost-effectiveness ratios of &lt;$50 000 per quality-adjusted year of life gained, even with a negative ETT result. Conclusions In many patient subgroups after AMI, the cost-effectiveness of routine coronary angiography and treatment guided by its results compares favorably with other treatment strategies for coronary heart disease.
Is there a contradiction between the network and latent variable perspectives?
Authors: Stephen M. Humphry, Joshua A. McGrane
Journal: Behavioral and Brain Sciences (2010)

First, we question whether Cramer et al.'s proposed network model can provide a viable scientific foundation for investigating comorbidity without invoking latent variables in some form. Second, the authors' claim that the network perspective is radically different from a latent variable perspective rests upon an undemonstrated premise. Without being demonstrated, we think the premise is potentially misleading.
Regulation of cardiac output after administration of isoproterenol and ouabain: interactions of systolic impedance and contractility
Authors: A. J. LIEDTKE, J. F. BUONCRISTIANI, E. S. KIRK, E. H. SONNENBLICK, C. W. URSCHEL
Journal: Cardiovascular Research (1972)

Average systolic impedance during ejection and myocardial contractility were evaluated as determinants of cardiac output in two studies. In group I, 10 dogs received separate infusions of isoproterenol and ouabain systemically, both before and after adjustments in afterload. In group II, five dogs received intracoronary infusions of calcium and/or isoproterenol. Data from both studies, as discussed, support the conclusion that independently or in combination both average systolic impedance and myocardial contractility act significantly to alter cardiac output.
Results of Percutaneous Transluminal Coronary Angioplasty in Unstable Angina and Non–Q-Wave Myocardial Infarction
Authors: David O. Williams, Eugene Braunwald, Bruce Thompson, Barry L. Sharaf, Chris E. Buller, Genell L. Knatterud
Journal: Circulation (1996)

Background This report describes the results of percutaneous transluminal coronary angioplasty (PTCA) in the Thrombolysis in Myocardial Ischemia (TIMI) IIIB Investigation. Methods and Results PTCA was performed before hospital discharge in 444 of 1473 patients with either unstable angina pectoris or non–Q-wave myocardial infarction (NQWMI) enrolled in TIMI IIIB. Angiographic success was observed in 96.1% of patients. For the entire cohort, the cumulative incidences of death and infarction at 1 year were 2.0% and 8.2%, respectively. The periprocedural incidence of myocardial infarction was 2.7%; emergency coronary bypass surgery, 1.4%; and death, 0.5%. By 1 year of follow-up, 122 patients (28.0%, Kaplan-Meier) had an additional revascularization procedure, 75 (61.5%) had PTCA only, 30 (24.6%) had coronary bypass surgery only, and 17 (13.9%) had both procedures. The results of PTCA were not improved by routine pretreatment with intravenous tissue plasminogen activator (TPA). Periprocedural myocardial infarction was more common among patients receiving TPA than placebo (odds ratio [OR], 2.19; P =.03) and among those with unstable angina than those with NQWMI (OR, 15.5; P =.007). No difference in outcome was observed when patients were analyzed according to age (OR, 1.06; P =.092) or sex (OR, 1.54; P =.51). Variables predictive of poor outcome were PTCA within the first 24 hours of enrollment, PTCA site being the left anterior descending coronary artery, and unsuccessful angiography. Conclusions In TIMI IIIB, PTCA was performed for patients with unstable angina and NQWMI with a very high rate of angiographic success and a low incidence of complications. By 1 year, repeat revascularization was performed in 28.0% of patients. Routine pretreatment with thrombolysis did not enhance outcome.
A Common Variant of the PAX2 Gene Is Associated with Reduced Newborn Kidney Size
Authors: Jacklyn Quinlan, Mathieu Lemire, Thomas Hudson, Huiqi Qu, Alice Benjamin, Anne Roy, Elena Pascuet, Meigan Goodyer, Chandhana Raju, Zhao Zhang, Fiona Houghton, Paul Goodyer
Journal: Journal of the American Society of Nephrology (2007)

Congenital nephron number ranges widely in the human population. Suboptimal nephron number may be associated with increased risk for essential hypertension and susceptibility to renal injury, but the factors that set nephron number during kidney development are unknown. In renal-coloboma syndrome, renal hypoplasia and reduced nephron number are due to heterozygous mutations of the PAX2 gene. This study tested for an association between a common haplotype of the PAX2 gene and subtle renal hypoplasia in normal newborns. A PAX2 haplotype was identified to occur in 18.5% of the newborn cohort, which was significantly associated with a 10% reduction in newborn kidney volume adjusted for body surface area. This haplotype was also associated with reduced allele-specific PAX2 mRNA level in a human renal cell carcinoma cell line. Subtle renal hypoplasia in normal newborns may be partially due to a common variant of the PAX2 gene that reduces mRNA expression during kidney development.
Metabolism and toxicity of hydrochlorofluorocarbons: current knowledge and needs for the future.
Authors: M W Anders
Journal: Environmental Health Perspectives (1991)

Hydrochlorofluorocarbons (HCFCs) are being developed as replacements for chlorofluorocarbons (CFCs) that deplete stratospheric ozone. The depletion of stratospheric ozone may increase the intensity of ultraviolet radiation at the earth's surface, which may be associated with global, adverse human health effects. The greater tropospheric lability of HCFCs, which is due to the presence of C-H bonds, reduces HCFC migration to the stratosphere; HCFCs should, therefore, cause less depletion of stratospheric ozone than CFCs. HCFCs under development include HCFC-22 (chlorodifluoromethane), HCFC-123 (2,2-dichloro-1,1,1-trifluoroethane), HCFC-132b (1,2-dichloro-1,1-difluoroethane), HCFC-134a (1,1,1,2-tetrafluoroethane), HCFC-141b (1,1-dichloro-1-fluoroethane, and HCFC-142b (1-chloro-1,1-difluoroethane). With the exception of HCFC-22, which is already in use, the metabolism and toxicity of HCFCs have not been studied in detail. By analogy to chlorinated ethanes, predictions can be made about the possible metabolism of HCFCs, but there are insufficient data available to predict rates of metabolism. Although most HCFCs appear to show low acute toxicity, some HCFCs are mutagenic in the Ames test. Hence, future research on HCFCs should include studies on the in vivo and in vitro metabolism of HCFCs as well as on their toxicity in in vivo and in vitro systems.
Primary Prevention of Sudden Cardiac Death in Idiopathic Dilated Cardiomyopathy
Authors: Dietmar Bänsch, Matthias Antz, Sigrid Boczor, Marius Volkmer, Jürgen Tebbenjohanns, Karlheinz Seidl, Michael Block, Frank Gietzen, Jürgen Berger, Karl Heinz Kuck
Journal: Circulation (2002)

Background — Patients with idiopathic dilated cardiomyopathy (DCM) and impaired left ventricular ejection fraction have an increased risk of dying suddenly. Methods and Results — Patients with recent onset of DCM (≤9 months) and an ejection fraction ≤30% were randomly assigned to the implantation of an implantable cardioverter-defibrillator (ICD) or control. The primary end point of the trial was all-cause mortality at 1 year of follow-up. The trial was terminated after the inclusion of 104 patients because the all-cause mortality rate at 1 year did not reach the expected 30% in the control group. In August 2000, the vital status of all patients was updated by contacting patients, relatives, or local registration offices. One hundred four patients were enrolled in the trial: Fifty were assigned to ICD therapy and 54 to the control group. Mean follow-up was 22.8±4.3 months, on the basis of investigators’ follow-up. After 1 year, 6 patients were dead (4 in the ICD group and 2 in the control group). No sudden death occurred during the first and second years of follow-up. In August 2000, after a mean follow-up of 5.5±2.2 years, 30 deaths had occurred (13 in the ICD group and 17 in the control group). Cumulative survival was not significantly different between the two groups (93% and 80% in the control group versus 92% and 86% in the ICD group after 2 and 4 years, respectively). Conclusions — This trial did not provide evidence in favor of prophylactic ICD implantation in patients with DCM of recent onset and impaired left ventricular ejection fraction.
Changes in right heart haemodynamics and echocardiographic function in an advanced phenotype of pulmonary hypertension and right heart dysfunction associated with pulmonary fibrosis
Authors: Rajeev Saggar, Dinesh Khanna, Anjali Vaidya, Ariss Derhovanessian, Paul Maranian, Erin Duffy, John A Belperio, Sam S Weigt, Shiv Dua, Shelley S Shapiro, Jonathan G Goldin, Fereidoun Abtin, Joseph P Lynch, David J Ross, Paul R Forfia, Rajan Saggar
Journal: Thorax (2014)

<h3>Background</h3> Pulmonary hypertension (PH)-targeted therapy in the setting of pulmonary fibrosis (PF) is controversial; the main clinical concern is worsening of systemic hypoxaemia. We sought to determine the effects of gentle initiation and chronic administration of parenteral treprostinil on right heart function in patients with PF associated with an advanced PH phenotype. <h3>Methods</h3> Open-label, prospective analysis of patients with PF-PH referred for lung transplantation (LT). Advanced PH was defined as mean pulmonary artery pressure (mPAP) ≥35 mm Hg. We compared haemodynamics, Doppler echocardiography (DE), oxygenation, dyspnoea and quality of life indices, and 6 min walk distance (6MWD) before and 12 weeks after parenteral treprostinil. <h3>Results</h3> 15 patients were recruited in the study. After therapy, there were significant improvements in right heart haemodynamics (right atrial pressure (9.5 ± 3.4 vs 6.0 ± 3.7); mPAP (47 ± 8 vs 38.9 ± 13.4); CI (2.3 ± 0.5 vs 2.7 ± 0.6); pulmonary vascular resistance (698 ± 278 vs 496 ± 229); transpulmonary gradient (34.7 ± 8.7 vs 28.5 ± 10.3); mvO<sub>2</sub> (65 ± 7.2 vs 70.9 ± 7.4); and stroke volume index (29.2 ± 6.7 vs 33 ± 7.3)) and DE parameters reflecting right heart function (right ventricular (RV) end diastolic area (36.4 ± 5.2 vs 30.9 ± 8.2 cm<sup>2</sup>), left ventricular eccentricity index (1.7 ± 0.6 vs 1.3 ± 0.5), tricuspid annular planar systolic excursion (1.6 ± 0.5 vs 1.9 ± 0.2 cm)). These changes occurred without significant alteration in systemic oxygenation, heart rate, or mean systemic arterial pressure. In addition, improvements were seen in 6MWD (171 ± 93 vs 230 ± 114), 36-Item Short Form Health Survey Mental Component Summary aggregate (38 ± 11 vs 44.2 ± 10.7), University of California, San Diego Shortness of Breath Questionnaire (87 ± 17.1 vs 73.1 ± 21), and brain natriuretic peptide (558 ± 859 vs 228 ± 340). <h3>Conclusions</h3> PH-targeted therapy may improve right heart haemodynamics and echocardiographic function without affecting systemic oxygen saturation in an advanced PH phenotype associated with RV dysfunction in the setting of PF.
Gynecologic Urology and Urodynamics: Theory and Practice
Authors: Linda M. Dairiki Shortliffe
Journal: JAMA (1986)

The goal of this text, as stated in the preface, is to promote a more active role for the obstetrician-gynecologist in the evaluation of the lower urinary  (p ix).  The book is divided into four sections, focusing on the normal urinary tract, evaluation of the lower urinary tract, the pathology and treatment of lower urinary tract abnormalities, and the surgical treatment of genuine stress incontinence. It is authored by neurologists, urologists, psychiatrists, and gynecologists. Although topics such as the urinary tract in pregnancy, interstitial cystitis, urinary fistulas, and the use of the neodymium-YAG laser in the female genitourinary tract are introduced, the book deals primarily with the evaluation and treatment of urinary incontinence in women.  As with many multiauthored books, the quality of the chapters varies. In addition, the organization of the chapters is sometimes confusing and cumbersome and portions of chapters are repetitious. For instance, a chapter on
Abstract 5279: Over-expression of EGFRviii induces an angiogenic switch in infiltrative human glioblastomas
Authors: Gro V. Røsland, Krishna Talasila, Rolf Bjerkvig, Hrvoje Miletic
Journal: Cancer Research (2012)

Abstract Glioblastoma multiforme (GBM) is the most common and most aggressive primary brain tumor where local cancer cell invasion into the normal brain represents a major obstacle preventing successful therapeutic interventions. A well known mediator of invasion, proliferation and survival, is the epidermal growth factor receptor (EGFR). Amplification and subsequent over-expression of EGFR protein is the most common genetic alteration in primary GBM, with a frequency of about 40%. Of the GBMs that have an amplification of EGFR, 63-75% also show genetic rearrangements of the gene, resulting in tumors that express both the wild type, as well as mutated forms of EGFR. The most common mutation in EGFR, is the EGFRviii, were the ligand binding part of the protein is missing (del exon 2-7). This mutation leads to a constitutive activation of the protein. In patients with amplified EGFR, 50-60% also express the EGFRviii. In this work we determined a functional role of EGFRviii within invasive human GBM cells in vivo. We cultured human GBM cells, lacking EGFR amplification and EGFRviii expression, in serum-free neuro-basal (NB) medium. By orthotopic transplantation into the brains of immunodeficient rats, tumors developed that showed a highly infiltrative non-angiogenic phenotype. By over-expressing EGFRviii in these tumors, we demonstrate a robust switch towards angiogenesis as shown by dynamic-contrast enhanced MRI and by histologic verification of angiogenic vessels. Molecular analysis confirmed an up-regulation of HIF1A as well as a panel of angiogenic factors. Our results demonstrate a distinct role of EGFRviii as a vital driver of angiogenic tumor growth within human GBMs in vivo. Thus, the presented observations should have important implications for therapeutic strategies targeting EGFRviii in patients. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5279. doi:1538-7445.AM2012-5279
Studies on the Epidemiology of Adverse Drug Reactions
Authors: Leighton E. Cluff, George F. Thornton, Larry G. Seidl
Journal: JAMA (1964)

OVER 13,000 drugs are listed in the<i>Physicians' Desk Reference</i>.<sup>1</sup>Although some vary in compounding, preparation, or brand name, the number of different drugs is staggering. No drug is completely harmless, even when used correctly, and all may produce adverse reactions. With rare exceptions, however, the exact incidence of adverse reactions to any of the drugs is not known. Based on sporadic reports of such reactions, and drawing from experience and observations, the physician empirically evaluates risks and hopes to avoid serious adverse drug reactions in his patients. Nevertheless, drugs do occasionally produce severe illness and death. Most often, adverse drug reactions are not severe, but the predictability of seriousness usually is not possible, and when reactions occur they are unexpected. The circumstances and factors predisposing patients to reactions, for the most part, are undefined. Previous observations suggest that certain individuals or certain diseases may be associated with increased
Is Aspirin Use Associated With Lower Rates of Cataracts in Diabetic Individuals?
Authors: Barbara E K Klein, Ronald Klein, Scot E Moss
Journal: Diabetes Care (1987)

The relationship between a history of aspirin use and cataracts in diabetic individuals is examined in this report from a population-based study of 1370 individuals who developed diabetes after 30 yr of age. After pupil dilation lenses were examined for the presence and severity of nuclear sclerotic and posterior subcapsular cataracts and for surgical aphakia. A history of aspirin usage was obtained. Seven hundred eighty-four individuals had used aspirin in the month before the exam. There was no relationship between such usage and cataracts. For 338 people who reported using aspirin daily for at least 3 mo while having diabetes, there was also no association. These data suggest that aspirin usage as measured here has little effect on the prevalence of cataract in older-onset diabetic patients.
Osteomyelitis: The Past Decade
Authors: F. A. Waldvogel, H. Vasey
Journal: New England Journal of Medicine (1980)

THE high success rate observed with antibiotic therapy in most bacterial diseases contrasts with the substantial failure rate in the treatment of bone infections. This discrepancy can be partly accounted for by a variety of specific problems pertaining to the diagnosis and treatment of this type of infection, discussed in the Journal 10 years ago.1 Since then, continued interest in osteomyelitis has provided new insight into its pathogenesis, diagnosis, and therapy; it is our aim to put this new information into perspective. Other, more conventional aspects of osteomyelitis, made familiar by previous studies, will be dealt with more briefly, and . . .
Second opinions for patients with cancer
Authors: K. Sikora
Journal: BMJ (1995)

The transfusion centres are computerised and automated for screening hundreds of blood samples each day.The huge workload with blood donors assures the lowest possible costs of reagents for antenatal screening, and, so long as the close links with virology reference laboratories ensure that all reactive samples are referred for confirmation those labora- tories will continue to test for markers of infectivity and advise the maternity units directly.We need a standardised, nationwide universal screening programme for hepatitis B carriage.The blood transfusion service is likely to be the most cost effective provider.
Phenotype and Course of Hutchinson–Gilford Progeria Syndrome
Authors: Melissa A. Merideth, Leslie B. Gordon, Sarah Clauss, Vandana Sachdev, Ann C.M. Smith, Monique B. Perry, Carmen C. Brewer, Christopher Zalewski, H. Jeffrey Kim, Beth Solomon, Brian P. Brooks, Lynn H. Gerber, Maria L. Turner, Demetrio L. Domingo, Thomas C. Hart, Jennifer Graf, James C. Reynolds, Andrea Gropman, Jack A. Yanovski, Marie Gerhard-Herman, Francis S. Collins, Elizabeth G. Nabel, Richard O. Cannon, William A. Gahl, Wendy J. Introne
Journal: New England Journal of Medicine (2008)

Hutchinson–Gilford progeria syndrome is a rare, sporadic, autosomal dominant syndrome that involves premature aging, generally leading to death at approximately 13 years of age due to myocardial infarction or stroke. The genetic basis of most cases of this syndrome is a change from glycine GGC to glycine GGT in codon 608 of the lamin A (LMNA) gene, which activates a cryptic splice donor site to produce abnormal lamin A; this disrupts the nuclear membrane and alters transcription.
Association of Advanced Leukemic Stage and Skin Cancer Tumor Stage With Poor Skin Cancer Outcomes in Patients With Chronic Lymphocytic Leukemia
Authors: Nicole F. Velez, Pritesh S. Karia, Alexander R. Vartanov, Matthew S. Davids, Jennifer R. Brown, Chrysalyne D. Schmults
Journal: JAMA Dermatology (2014)

Although it has been well established that patients with chronic lymphocytic leukemia (CLL) have an increased risk of developing skin cancer, few studies have investigated the effect of CLL stage on the risk of poor skin cancer outcomes. The present study of CLL staging assesses outcomes of melanoma, squamous cell carcinoma, and Merkel cell carcinoma in this high-risk population.To determine if progression of CLL measured by advanced Rai stage (III or IV) is associated with worse skin cancer outcomes.Twenty-year retrospective study at 2 academic centers in Boston, Massachusetts, of adults with CLL and either melanoma, squamous cell carcinoma, or Merkel cell carcinoma.Hazard ratios (HRs) for the development of poor skin cancer outcomes (local recurrence, nodal metastasis, distant metastasis, or death from skin cancer).In total, 133 patients with 377 primary skin cancers and a median follow-up of 41 months were included. Squamous cell carcinoma predominated (92.0%). The risk of death from skin cancer was equivalent to the risk of death from CLL (13.5%). On multivariate analysis, advanced Rai stage (III or IV) at the time of the first skin cancer diagnosis (HR, 4.5; 95% CI, 2.3-8.9) and a high skin cancer tumor (T) stage (HR, 4.9; 95% CI, 2.2-10.8) were associated with poor skin cancer outcomes. Those with both a low skin cancer T stage and a low Rai stage (n = 265) had a low risk (5.3%; 95% CI, 3.2%-8.7%) of poor skin cancer outcomes. Those with a low T stage and a high Rai stage (n = 89) had a significantly higher risk of poor skin cancer outcomes (16.9%; 95% CI, 10.9%-26.0%). The 23 patients with a high T stage had high risks of poor outcomes regardless of CLL status (27.3% if a low Rai stage and 50.0% if a high Rai stage, with wide 95% CIs).In patients with CLL and non-basal cell carcinoma skin cancer, mortality is as high from skin cancer as from CLL. The Rai stage and skin cancer T stage should be considered when risk-stratifying patients with skin cancer. Regular communication between dermatologists and oncologists will help facilitate the identification of patients with CLL who are at high risk of having poor skin cancer outcomes.