tbuckley/cabot-search huggingface dataset:
Coronary Artery Bypass Graft Surgery vs Percutaneous Interventions in Coronary Revascularization
Authors: Saswata Deb, Harindra C. Wijeysundera, Dennis T. Ko, Hideki Tsubota, Samantha Hill, Stephen E. Fremes
Journal: JAMA (2013)

Ischemic heart disease is the leading cause of death globally. Coronary artery bypass graft (CABG) surgery and percutaneous coronary intervention (PCI) are the revascularization options for ischemic heart disease. However, the choice of the most appropriate revascularization modality is controversial in some patient subgroups.To summarize the current evidence comparing the effectiveness of CABG surgery and PCI in patients with unprotected left main disease (ULMD, in which there is >50% left main coronary stenosis without protective bypass grafts), multivessel coronary artery disease (CAD), diabetes, or left ventricular dysfunction (LVD).A search of OvidSP MEDLINE, EMBASE, and Cochrane databases between January 2007 and June 2013, limited to randomized clinical trials (RCTs) and meta-analysis of trials and/or observational studies comparing CABG surgery with PCI was performed. Bibliographies of relevant studies were also searched. Mortality and major adverse cardiac and cerebrovascular events (MACCE, defined as all-cause mortality, myocardial infarction, stroke, and repeat revascularization) were reported wherever possible.Thirteen RCTs and 5 meta-analyses were included. CABG surgery should be recommended in patients with ULMD, multivessel CAD, or LVD, if the severity of coronary disease is deemed to be complex (SYNTAX >22) due to lower cardiac events associated with CABG surgery. In cases in which coronary disease is less complex (SYNTAX ≤22) and/or the patient is a higher surgical risk, PCI should be considered. For patients with diabetes and multivessel CAD, CABG surgery should be recommended as standard therapy irrespective of the severity of coronary anatomy, given improved long-term survival and lower cardiac events (5-year MACCE, 18.7% for CABG surgery vs 26.6% for PCI; P = .005). Overall, the incidence of repeat revascularization is higher after PCI, whereas stroke is higher after CABG surgery. Current literature emphasizes the importance of a heart-team approach that should consider coronary anatomy, patient characteristics, and local expertise in revascularization options. Literature pertaining to revascularization options in LVD is scarce predominantly due to LVD being an exclusion factor in most studies.Both CABG surgery and PCI are reasonable options for patients with advanced CAD. Patients with diabetes generally have better outcomes with CABG surgery than PCI. In cases of ULMD, multivessel CAD, or LVD, CABG surgery should be favored in patients with complex coronary lesions and anatomy and PCI in less complicated coronary disease or deemed a high surgical risk. A heart-team approach should evaluate coronary disease complexity, patient comorbidities, patient preferences, and local expertise.
Prodi proposes food agency for the EU
Authors: R. Watson
Journal: BMJ (1999)

The new European Commission has placed food safety at the top of its political agenda. Within weeks of being voted into office, the commission's president, Romano Prodi, has begun canvassing the idea of establishing an independent food agency for the European Union.

He announced to MEPs in early October that the commission would present a white paper on food safety before the end of the year. This would contain an action plan setting out a clear timetable for action over the next three years.

“Our aim is a fundamental review of food law, with all commission proposals to be put …
Justice Department calls medicare payments to Christian Science sanitoria unconstitutional
Authors: A. A. Skolnick
Journal: JAMA (1997)

IN A move that took all parties by surprise, the US Justice Department has switched sides in the fight over the constitutionality of provisions of federal law that allow Medicare and Medicaid funds to pay for Christian Science nursing care.  On January 23, Attorney General Janet Reno informed Congress that the Justice Department will no longer defend those provisions. In an 11-page letter to the US Senate Legal Counsel, Reno laid out the department's legal reasons for its turnabout from its previous position.  At first the Justice Department defended the constitutionality of the provisions when it represented defendants Donna Shalala, secretary of the Department of Health and Human Services, and Bruce C. Vladeck, administrator of the Health Care Finance Administration (HCFA), in a lawsuit filed by Children's Healthcare Is a Legal Duty (CHILD) Inc and 2 taxpayers. CHILD Inc is a nonprofit advocacy group based in Sioux City, Iowa, that
Microalbuminuria and Hypoxemia in Patients with Chronic Obstructive Pulmonary Disease
Authors: Ciro Casanova, Juan P. de Torres, Juan Navarro, Armando Aguirre-Jaíme, Pablo Toledo, Elizabeth Cordoba, Rebeca Baz, Bartolomé R Celli
Journal: American Journal of Respiratory and Critical Care Medicine (2010)

Rationale: Microalbuminuria (MAB), a marker of endovascular dysfunction, is a predictor of cardiovascular events and all-cause mortality in the general population. There is evidence of vascular dysfunction in patients with chronic obstructive pulmonary disease (COPD).Objectives: To assess the prevalence and relationship of MAB with clinical and physiological parameters in stable patients with COPD.Methods: We measured urinary albumin rate (urinary albumin to creatinine ratio: UACR), smoking history, arterial blood pressure, gas exchange, body mass index, lung function, BODE index (body mass index, airflow obstruction, dyspnea, exercise performance), and comorbidity index in 129 patients with stable COPD and 51 smokers with normal spirometry without known cardiovascular disease. MAB levels were compared between groups. A multivariate analysis was performed to determine the best determinants of MAB levels.Measurements and Main Results: MAB was higher in patients with COPD than in control smokers (8 [5th−95th percentile (P5–95), 2.9–113] vs. 4.2 [P5–95, 1.8–22.7] mg/g, P < 0.001]). The difference remained significant even after using the standard pathologic threshold (MAB, 30–299 mg/g in women and 20–299 mg/g in men; 24% in patients with COPD vs. 6% in control smokers; P = 0.005). In patients with COPD, there was a negative correlation between PaO2 and MAB (r = −0.40, P < 0.001). Using multivariate analysis, MAB was only associated with the PaO2 (relative risk, 0.934; 95% confidence interval, 0.880–0.992; P < 0.001) and with the systolic arterial blood pressure (relative risk, 1.034; 95% confidence interval, 1.011–1.057; P = 0.003).Conclusions: MAB is frequent in patients with COPD and is associated with hypoxemia independent of other cardiovascular risk factors. Further studies are necessary to investigate whether MAB could be an early simple biomarker of cardiovascular compromise in patients with COPD.
NHS spending should focus on mental rather than physical health to promote wellbeing
Authors: N. Hawkes
Journal: BMJ (2012)

Health budgets should be reallocated to focus on mental rather than physical health if the United Kingdom is serious about enhancing wellbeing, the former head of the Civil Service has said.

Lord O’Donnell, now retired as cabinet secretary and currently chair of a new government initiative to promote the measurement and use of wellbeing measurements, said that the work done by the Office for National Statistics (ONS) and similar bodies abroad “clearly shows” that a greater emphasis on mental health is justified. 

Lord Layard, an economist from the London School of Economics who has pioneered the economic studies of happiness, agreed. Emotional health correlated more strongly with an individual’s perception of wellbeing at the age of 34 than …
Effect of Vitamin E and Beta Carotene on the Incidence of Angina Pectoris
Authors: Janne M. Rapola
Journal: JAMA (1996)

<h3>Objective.</h3> —To examine the effect of supplementation with vitamin E (alpha tocopherol), beta carotene, or both on the incidence of angina pectoris in men without known previous coronary heart disease. <h3>Design.</h3> —Randomized, double-blind, placebo-controlled trial. <h3>Setting and Participants.</h3> —Participants in the Alpha Tocopherol, Beta Carotene Cancer Prevention Study (N=29133) were male smokers aged 50 through 69 years who were living in southern and western Finland. Of these men, 22 269 were considered free of coronary heart disease at baseline and were followed up for the incidence of angina pectoris. <h3>Intervention.</h3> —Participants were randomized to receive 50 mg/d of alpha tocopherol, 20 mg/d of beta carotene, both, or placebo in a 2×2 design. <h3>Outcome Measures.</h3> —An incident case was defined as the first occurrence of typical angina pectoris identified in administering the annually repeated World Health Organization (Rose) Chest Pain Questionnaire. <h3>Results.</h3> —During a median follow-up time of 4.7 years (96427 person-years), 1983 new cases of angina pectoris were detected. Comparing alpha tocopherol— supplemented subjects with non—alpha tocopherol—supplemented subjects showed a relative risk (RR) of angina pectoris incidence of 0.91 (95% confidence interval [CI], 0.83 to 0.99;<i>P</i>=.04). The RR for incidence of angina pectoris for the beta carotene— supplemented subjects compared with those not receiving beta carotene was 1.06 (95% CI, 0.97 to 1.16;<i>P</i>=.19). Compared with those receiving placebo, the RRs for incidence of angina pectoris were 0.97(95% CI, 0.85 to 1.10) and 0.96(95% CI, 0.85 to 1.09) in the alpha tocopherol and alpha tocopherol plus beta carotene groups, respectively, and 1.13 (95% CI, 1.00 to 1.27) in the beta carotene group (<i>P</i>=.06). Baseline dietary intakes and serum levels of alpha tocopherol and beta carotene did not predict incidence of angina pectoris. <h3>Conclusions.</h3> —Supplementation with alpha tocopherol was associated with only a minor decrease in the incidence of angina pectoris. Beta carotene had no preventive effect and was associated with a slight increase in the incidence of angina. (<i>JAMA</i>. 1996;275:693-698)
Cardiology Update: Reviews for Physicians
Authors: Marcis T. Sodums
Journal: JAMA (1985)

The proliferation of medical information has served as a stimulus for topical review volumes intended for the busy consumer. The 1984 edition of<i>Cardiology Update</i>is the fourth volume in a series that intends to offer concise annual reviews of advances in cardiology. It is intended for practitioners, including cardiologists, internists, pediatricians, and cardiovascular surgeons, as well as house officers and students, and hopes to compile the most significant advances in diagnosis and therapy with emphasis on the practical, clinical aspects of treatments. The list of contributors includes several well-known authorities. The 11 chapters cover assessment and therapy of hypertension, medical and surgical management of coronary artery disease, electrophysiologic testing for patients with syncope, and drug and surgical therapy for patients with electrophysiologic problems. The surgical treatment of aneurysms of the proximal aorta and the management of atrial septal defects in the elderly are reviewed. Digital subtraction angiography and nuclear
Abstract 3484: Distinct cancer cell with stem cell like properties contribute to doxorubicin and paclitaxel resistance
Authors: Bhawna Sharma, Michelle L. Varney, Rakesh K. Singh
Journal: Cancer Research (2012)

Abstract Resistance to therapy and disease relapse is major concerns in the field of breast cancer management. Accumulating evidence suggests the existence of breast cancer stem cells and it has been proposed that their induction after chemotherapy could be contributing to therapy resistance and relapse. Our preliminary data demonstrate that expression of CXCL1 and CXCL8 (CXCR1/2 ligands) increases after chemotherapy. We also observed that expression of RANKL (ligand of RANK) goes up in a dose dependent manner in both Cl66 and 4T1 cells after treatment with paclitaxel and doxorubicin. Recently, the involvement of RANK/RANKL signaling in mammary tumorigenesis by maintaining the stem cell pool has been elucidated. Given that RANK-RANKL signaling and CXCR1/2 signaling share the common mediator, NFkB, our working hypothesis is that chemotherapy-induced expression of CXCR1/2 ligands and the RANK/RANKL signaling axis plays an important role in selecting a subset of mammary tumor cells with stem cell-like characteristics. We selected Cl66, mammary tumor cells against doxorubicin and paclitaxel. We observed that cells selected against these drugs express higher levels of CXCR1/2 ligands at both the mRNA and protein level. Moreover, 4T1 (6-thioguanine resistant cells) and Cl66 Dox 500 (cells resistant to doxorubicin) express RANK whereas Cl66-parent and Cl66 Pac 400 (cells resistant to paclitaxel) do not. This suggests that doxorubicin specifically selects RANK expressing cancer cells and 4T1 inherently express this receptor. Cl66 resistant cells injected in BALB/c mice grew slower than parent cells. Furthermore, the extent of neovascularization in doxorubicin resistant Cl66 tumors was significantly higher as compared to parent Cl66 tumors and paclitaxel resistant Cl66 tumors. As a result of their slow growth and difference in neovascularization, we analyzed the expression of stem cell markers in these cells. We observed that both Cl66-parent and paclitaxel resistant cells express ALDH1, but the expression was higher in paclitaxel resistant cells. Moreover, resistant cells showed enhanced expression of the mesenchymal marker, vimentin in comparison to parent cells. Overall, our results suggest that use of a particular chemotherapeutic agent may influence the selection of different sub-type of cancer cells with stem cell-like properties. This data also proposes the importance of a chemotherapy-induced cytokine-chemokine axis in maintaining the cancer stem cell pool. 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 3484. doi:1538-7445.AM2012-3484
Accurate Assessment of Personal Air Pollutant Exposures in Inner-City Asthmatic Children
Authors: Cullen M. Dutmer, Allison M. Schiltz, Anna Faino, Nathan Rabinovitch, Seung-Hyun Cho, Ryan T. Chartier, Charles E. Rodes, Jonathan W. Thornburg, Andrew H. Liu
Journal: Journal of Allergy and Clinical Immunology (2015)
Nasal involvement in allergic asthma
Authors: G.‐J. Braunstahl, W. Fokkens
Journal: Allergy (2003)

Even since the late 19th century, a relationship has been suspected between upper airway disease and the subsequent development or aggravation of asthma symptoms. To date, it has been generally accepted that pathologic conditions of the upper airways, e.g. allergic rhinitis, chronic sinusitis and nasal polyposis, may influence the lower airways. However, the mechanisms underlying this relationship were, for a long time, poorly understood. Recently, evidence has been accumulating which indicates a systemic connection as one of the responsible mechanisms in nasobronchial crosstalk. In this review, the pathophysiologic and immunologic aspects of the interaction between upper and lower airways will be discussed.
Possible interrelations among environmental toxicants, amphibian development, and decline of amphibian populations.
Authors: C Carey, C J Bryant
Journal: Environmental Health Perspectives (1995)

Many amphibian populations are declining in a number of geographical locations throughout the world. In most cases, the cause or causes are unknown, but are assumed to result from man-made alterations in the environment. We review existing evidence concerning how environmental xenobiotics could contribute to declines of amphibian populations by impacting growth and development of the young. This paper examines the potential roles of toxicants in: a) affecting the susceptibility of young to disease; b) retarding growth and development of amphibian young; c) affecting the ability of larvae to avoid predation; d) affecting the development of physiological, morphological, or behavioral processes in a manner that subsequently impairs the ability of the young for future reproduction; and e) directly causing mortality of young. These issues are not well studied, and more studies are needed before the roles of environmental xenobiotics in amphibian declines are fully understood.
Neonatal alloimmune thrombocytopenia
Authors: R Rayment
Journal: BMJ (2003)

Neonatal alloimmune thrombocytopenia—caused by movement of maternal alloantibodies directed against fetal platelet antigens across the placenta—is the most common cause of severe neonatal thrombocytopenia.1 These alloantibodies cause thrombocytopenia, which may result in intracranial haemorrhage.2 3 Most cases arise unexpectedly, and prompt diagnosis and treatment are essential to reduce the chances of death and disability caused by the haemorrhaging.4 5 Neonatal alloimmune thrombocytopenia should be strongly suspected in cases of neonatal thrombocytopenia with no evidence of sepsis, systemic disease, or skeletal anomalies associated with thrombocytopenia, and where maternal idiopathic thrombocytopenic pupura has been excluded. We describe two cases with typical clinical presentations in which standard methods for detection of maternal antibodies gave negative results, and we show that empirical treatment with human platelet antigen 1a negative platelets yielded successful outcomes in both cases.

A two day old girl presented with several left sided and secondary generalised tonic-clonic seizures. She had been delivered normally at full term, after an uneventful gestation. Neurological examination between seizures had normal results, and otherwise she was completely well.

Her platelet count was 5x109/l, haemoglobin concentration was 158 g/l, and white cell count was 16.7x109/l. A magnetic resonance scan showed fresh extensive haemorrhage in the interhemispheric fissure and sulci (1). The brain and ventricles were normal. Viral swabs and culture showed no infectious cause for the thrombocytopenia. The baby's mother had a normal platelet count.



Fig 1 
Magnetic resonance image showing fresh extensive haemorrhage in the interhemispheric fissure and sulci (case 1) …
Angiotensin induces the urinary peristaltic machinery during the perinatal period.
Authors: Y Miyazaki, S Tsuchida, H Nishimura, J C Pope, R C Harris, J M McKanna, T Inagami, B L Hogan, A Fogo, I Ichikawa
Journal: Journal of Clinical Investigation (1998)

The embryonic development of mammalian kidneys is completed during the perinatal period with a dramatic increase in urine production, as the burden of eliminating nitrogenous metabolic waste shifts from the placenta to the kidney. This urine is normally removed by peristaltic contraction of the renal pelvis, a smooth muscle structure unique to placental mammals. Mutant mice completely lacking angiotensin type 1 receptor genes do not develop a renal pelvis, resulting in the buildup of urine and progressive kidney damage. In mutants the ureteral smooth muscle layer is hypoplastic and lacks peristaltic movements. We show that angiotensin can induce the ureteral smooth muscles in organ cultures of wild-type, but not mutant, ureteral tissues and that, in wild-type mice, expression of both renal angiotensin and the receptor are transiently upregulated at the renal outlet at birth. These results reveal a new role for angiotensin in the unique cellular adaptations of the mammalian kidney to the physiological stresses of postnatal life.
Post-Irradiation Fractures
Authors: Philip Rubin
Journal: JAMA (1961)

<h3>To the Editor:—</h3> I wish to commend you on the fine editorial which was published inThe Journal, Jan. 21, page 255, regarding post-irradiation fractures of the femoral neck. The experience of Bickle, Childs, and Porretta at the Mayo Clinic is well recorded and most deserving of attention. The concept that radiation changes are progressive and irreversible is something which is continually being stressed in the literature without any tempering based on clinical experience. Articles such as these emphasize that although the underlying biologic process may be severely impaired, clinical healing and reversibility of the situation can occur. Since many of the patients who show such late radiation injuries have often been cured of cancer, it is important to dispel the pessimism regarding such late injuries. This is not only true of the bone but also applies to many other organ systems where proper surgical or medical care can make
Rapid response activatable molecular probes for intraoperative optical image-guided tumor resection
Authors: Samuel Achilefu, Roberto J. Groszmann, Yasuko Iwakiri, Tamar H. Taddei
Journal: Hepatology (2012)

The ability of the unaided human eye to detect small cancer foci or accurate borders between cancer and normal tissue during surgery or endoscopy is limited. Fluorescent probes are useful for enhancing visualization of small tumors but are typically limited by either high background signal or the requirement for administration hours to days before use. We synthesized a rapidly activatable, cancer-selective fluorescence imaging probe, γ-glutamyl hydroxymethyl rhodamine green (gGlu-HMRG), with intramolecular spirocyclic caging for complete quenching. Activation occurs by rapid one-step cleavage of glutamate with γ-glutamyltranspeptidase (GGT), which is not expressed in normal tissue, but is overexpressed on the cell membrane of various cancer cells, thus leading to complete uncaging and dequenching of the fluorescence probe. In vitro activation of gGlu-HMRG was evident in 11 human ovarian cancer cell lines tested. In vivo in mouse models of disseminated human peritoneal ovarian cancer, activation of gGlu-HMRG occurred within 1 min of topically spraying the tumor, creating high signal contrast between the tumor and the background. The gGlu-HMRG probe is practical for clinical application during surgical or endoscopic procedures because of its rapid and strong activation upon contact with GGT on the surface of cancer cells.
Increased FDG Uptake by Bone Marrow in Major Beta-Thalassemia
Authors: V Aflalo-Hazan, F Gutman, K Kerrou, F Montravers, D Grahek, J N. Talbot
Journal: Clinical Nuclear Medicine (2005)

A 26-year-old man with a history of major beta-thalassemia was referred to our center for suspicion of femoral bone sepsis. He was treated 12 years ago for femoral bone sepsis that occurred after epiphysis trauma and was scheduled for further surgery. He underwent both F-18 FDG coincidence detection–emission tomography (CDET) and Tc-99m HDP bone scintigraphy in our department. As expected because of beta-thalassemia, bone scintigraphy showed both increased diffuse uptake in all metaphyses and epiphyses and elevated renal activity. FDG-CDET images showed increased diffuse uptake in the bone marrow. The pattern of FDG uptake by the bone marrow in beta-thalassemia should be recognized because of the risk of false positive results.
Elevated serum tryptase levels identify a subset of patients with a myeloproliferative variant of idiopathic hypereosinophilic syndrome associated with tissue fibrosis, poor prognosis, and imatinib responsiveness
Authors: Amy D. Klion, Pierre Noel, Cem Akin, Melissa A. Law, D. Gary Gilliland, Jan Cools, Dean D. Metcalfe, Thomas B. Nutman
Journal: Blood (2003)