tbuckley/cabot-search huggingface dataset:
Local and systemic delivery of low molecular weight heparin stimulates the reendothelialization after balloon angioplasty
Authors: Martin Oberhoff, Simon Novak, Christian Herdeg, Andreas Baumbach, Alexander Kranzhöfer, Armin Bohnet, Barbara Horch, Hartmut Hanke, Karl K. Haase, Karl R. Karsch
Journal: Cardiovascular Research (1998)

Recent investigations revealed the importance of endothelial cell integrity and function in the pathogenesis of restenosis after angioplasty. Agents which stimulate reendothelialization may prevent restenosis after interventional procedures. The results of in vitro studies suggested that heparin and low molecular weight heparin administration may enhance the recovery of the endothelium. In this study the extent of endothelial denudation and the occurrence and time course of endothelial regeneration after experimental balloon angioplasty followed by subcutaneous or local delivery of low molecular weight heparin was investigated.A total of 102 rabbits were included in the study. An atheromatous plaque was induced by electrical stimulation in the right carotid artery of the animals. All animals underwent balloon angioplasty. Thirty-two rabbits received no further medical treatment. Twenty-five rabbits received subcutaneous low molecular weight heparin reviparin (400 anti-Xa-units/day) during the following 7 days. In 25 animals the dilated arterial segments were treated locally with reviparin (1500 anti-Xa-units/4 ml, 2 atm) using a porous balloon (2.5 mm, 35 holes, diameter 75 microns). Twenty animals served as control group without intervention. The vessels were excised 3, 7, 14, 28 and 56 days following intervention. Sections were stained with an antibody against von Willebrand factor and PECAM 1 to confirm the endothelial origin of the lining cells. After bromodeoxyuridine labeling, the extent of proliferation was determined by using a monoclonal antibody. In addition, morphometric analysis of the intimal and medial area was performed.Three days after balloon angioplasty histomorphological analysis showed a reduction of about 60% of the preinterventional endothelial cell number in all three groups. Already one week after intervention there was a significantly higher number of endothelial cells in both groups of low molecular weight heparin treated animals compared to the untreated group (s.c. group 144 +/- 33, local group 142 +/- 32 versus untreated 79 +/- 17 endothelial cells, p < or = 0.05). This significant difference was maintained during the following four weeks and demonstrated a 2-fold increase in endothelial proliferation in the heparin treated animals compared with the untreated group. In addition, immunohistological examination showed a significant decrease in smooth muscle cell proliferation in the s.c. and local reviparin treated animals and a subsequent reduction of intimal thickening.Local delivery of low molecular weight heparin promotes reendothelialization and contributes to the inhibition of smooth muscle cell proliferation.
RECOVERY FROM PIERCING OF BODY WITH HAY HARPOON.
Authors: C. A. HEATON
Journal: JAMA (1906)

While recoveries are recorded in cases of bullet wounds of the lungs, it is more rare to have recovery take place after a wound by as large an instrument as a large prong of a harpoon hay fork. On July 18, 1906, W. Z., 23 years of age, in robust health, was injured by the fall of a double-harpoon hay fork, weighing 20 pounds, from its attachment in the barn, 25 feet above him. One prong of the fork, having a diameter of 2 inches one way by ⅞ of an inch the other, perforated the chest, entering in the first intercostal space half an inch to the left of the sternum and emerging in the seventh intercostal space about five inches to the left of the spinal column. The distance between the two wounds was about 12 inches. The man fell on his knees, but did not lose consciousness
Splenectomy for Sicklers
Authors: Muzaffer Aksoy
Journal: JAMA (1964)

<h3>To the Editor:—</h3> In the communicacation of Egdahl and associates (<i>JAMA</i><b>186</b>:745 [Nov 23] 1963) it was suggested that splenectomy is a valuable procedure in patients who have sickle cell anemia, hypersplenism, and profound hemolysis. I have observed that patients with marked splenomegaly show the most severe anemia (<i>Atti Giornata Studio [Roma]</i><b>1</b>:98, 1961) and that childhood cases have always proved to be fatal. I have never observed an adult with marked splenomegaly. Furthermore, it is my belief that the prognosis of patients without splenomegaly is better than that of patients with marked splenomegaly and also that the size of the spleen is of prognostic significance. Therefore, I conclude that splenectomy is indicated not only for hypersplenism and hemolysis in sickle cell anemia but also for marked to moderate splenomegaly without frank evidence of hypersplenism and hemolysis.
6000 patients are left in limbo as private company fails to record radiograph results
Authors: N. Hawkes
Journal: BMJ (2012)

Six thousand patients sent for radiography by a 24 hour care centre in northwest London have been left in limbo, with no evidence that a specialist radiologist ever reviewed the radiographs to see if the patients had any serious conditions.

NHS Brent has logged the failures at Brent Urgent Care Centre as a serious incident and has launched a full investigation. A review of 5% of the cases has indicated that 2% had “missed pathology” because their radiographs had not been reviewed—which means that up to 120 patients could potentially have experienced harm because of the failure.

The centre, which is located at Central Middlesex Hospital, is run by Care UK, a private company with many NHS contracts in primary and secondary care. It deals with minor illnesses and injuries that require urgent and immediate treatment, referring more serious cases to the emergency department at the hospital.

Care UK told NHS Brent on 30 March that it had …
Shall we Nationalize Medicine?
Authors: J. A. Ryle
Journal: BMJ (1945)

Written by a volunteer patient advisor, this issue brief provides at 50-foot view of patient engagement as seen through the eyes of various stakeholders including payers, providers, and patients. The benefits and barriers are noted, and the undeniable need for engaged patients is discussed. Many techniques and programs are reviewed including those offered from insurers, clinicians, caretakers, and community members. The overall message builds a case for why authentic patient engagement is the missing ingredient in health care if we truly want better outcomes, better health, and lower costs.
Low-dose rituximab and alemtuzumab combination therapy for patients with steroid-refractory autoimmune cytopenias
Authors: David Gómez-Almaguer, Manuel Solano-Genesta, Luz Tarín-Arzaga, José Luis Herrera-Garza, Olga Graciela Cantú-Rodríguez, César Homero Gutiérrez-Aguirre, José Carlos Jaime-Pérez
Journal: Blood (2010)
Role of Endogenous Endothelin in Chronic Heart Failure
Authors: Paul Mulder, Vincent Richard, Geneviève Derumeaux, Manuela Hogie, Jean Paul Henry, Françoise Lallemand, Patricia Compagnon, Bertrand Macé, Etienne Comoy, Brice Letac, Christian Thuillez
Journal: Circulation (1997)

Plasma levels of the vasoconstrictor peptide endothelin (ET) are increased in chronic heart failure (CHF), and ET levels are a major predictor of mortality in this disease. Thus, ET may play a deleterious role in CHF. The purpose of this study was to assess the effects of chronic treatment with the ET receptor antagonist bosentan in a rat model of CHF.Rats were subjected to coronary artery ligation and were treated for 2 or 9 months with placebo or bosentan (30 or 100 mg x kg(-1) x d(-1)). Bosentan 100 mg x kg(-1) markedly increased survival (after 9 months: untreated, 47%; bosentan, 65%; P<.01). Throughout the 9-month treatment period, bosentan significantly reduced arterial pressure and heart rate. After 2 or 9 months of treatment, the ET antagonist reduced central venous pressure and left ventricular (LV) end-diastolic pressure as well as plasma catecholamines, urinary cGMP, and LV ventricular collagen density. Bosentan also reduced LV dilatation (evidenced at 2 months by a shift in the pressure/volume relationship ex vivo). Echocardiographic studies performed after 2 months showed that the ET antagonist reduced hypertrophy and increased contractility of the noninfarcted LV wall. The lower dose of bosentan (30 mg x kg(-1)), which had no major hemodynamic or structural effects, also had no effect on survival.Long-term treatment with an ET antagonist markedly increases survival in this rat model of CHF. This increase in survival is associated with decreases in both preload and afterload and an increase in cardiac output as well as decreased LV hypertrophy, LV dilatation, and cardiac fibrosis. Thus, chronic treatment with ET antagonists such as bosentan might be beneficial in human CHF and might increase long-term survival in this disease.
Siamese twins to be separated against parents' will
Authors: C. Dyer
Journal: BMJ (2000)

Siamese twins born in England can be separated—against their parents' wishes—to save the life of the stronger baby, even though the operation will kill the weaker twin, a High Court judge ruled last week.

In the first case of its kind in Britain, Mr Justice Johnson gave the go-ahead at the High Court in London for surgeons to operate on the twin girls, born on 8 August at St Mary's Hospital, Manchester.

The twins, given the false names of Mary and Jodie to …
579 Anti-urokinase (UK) antibody but not anti-tissue type plasminogen activator (TPA) antibody or UK alone, augments phytonemagglutinin (PHA) induced proliferative responses (PR) of human peripheral blood lymphomonouclear cells (MNC)
Authors: M MURALI, H DURKIN, D AUCI
Journal: Journal of Allergy and Clinical Immunology (1991)
Comparative Transduction Efficiency of AAV Vector Serotypes 1–6 in the Substantia Nigra and Striatum of the Primate Brain
Authors: Eleni A Markakis, Kenneth P Vives, Jeremy Bober, Stefan Leichtle, Csaba Leranth, Jeff Beecham, John D Elsworth, Robert H Roth, R Jude Samulski, D Eugene Redmond
Journal: Molecular Therapy (2009)

Vectors derived from adeno-associated virus (AAV) are promising candidates for neural cell transduction in vivo because they are nonpathogenic and achieve long-term transduction in the central nervous system. AAV serotype 2 (AAV2) is the most widely used AAV vector in clinical trials based largely on its ability to transduce neural cells in the rodent and primate brain. Prior work in rodents suggests that other serotypes might be more efficient; however, a systematic evaluation of vector transduction efficiency has not yet been performed in the primate brain. In this study, AAV viral vectors of serotypes 1-6 with an enhanced green-fluorescent protein (GFP) reporter gene were generated at comparable titers, and injected in equal amounts into the brains of Chlorocebus sabaeus. Vector injections were placed in the substantia nigra (SN) and the caudate nucleus (CD). One month after injection, immunohistochemistry for GFP was performed and the total number of GFP+ cells was calculated using unbiased stereology. AAV5 was the most efficient vector, not only transducing significantly more cells than any other serotype, but also transducing both NeuN+ and glial-fibrillary-acidic protein positive (GFAP+) cells. These results suggest that AAV5 is a more effective vector than AAV2 at delivering potentially therapeutic transgenes to the nigrostriatal system of the primate brain.
Missing the Point: Substituting Exenatide for Nonoptimized Insulin
Authors: Julio Rosenstock, Vivian Fonseca
Journal: Diabetes Care (2007)

The recent American Diabetes Association/European Association for the Study of Diabetes consensus treatment algorithm for type 2 diabetes has advanced basal insulin treatment as a much earlier therapeutic option following a structured target-driven strategy (1). However, the misconception by both providers and patients that insulin should be regarded as the therapy of last resort still prevails and is perhaps the main barrier to insulin treatment, even at the price of many years of poor glycemic control. Insulin is the most effective diabetes agent, only limited by hypoglycemia; however, when used inappropriately in nonphysiological and nonoptimized regimens, many patients treated with insulin remain poorly controlled (2).

In the last decade, several new treatments have been developed for treating type 2 diabetes. It is conceivable that the initial American Diabetes Association/European Association for the Study of Diabetes consensus algorithm may eventually be revised to include additional therapeutic options for early use in combination with metformin once evidence regarding sustained efficacy and safety accumulates (3). New agents have been tested in combination with insulin with the main purpose of establishing a “proof of concept” of an independent effect by keeping insulin therapy unchanged or not optimized. However, this “regulatory approval approach” often resulted in relatively small A1C reductions, and at the end of the trials the mean levels often remained far above the desired A1C targets (4,5,6). Although some of these combinations may provide benefits such as reduced insulin resistance, less weight gain, lower insulin requirements, and possibly less hypoglycemia (4,5,6,7), none of these secondary gains can substitute for the primary objective of reaching the recommended glycemic targets.

The concept of adding a new therapy to insulin was the initial strategy employed with troglitazone to get fast regulatory approval in 1997. The …
IL-21 is pivotal in determining age-dependent effectiveness of immune responses in a mouse model of human hepatitis B
Authors: Jean Publicover, Amanda Goodsell, Stephen Nishimura, Silvia Vilarinho, Zhi-en Wang, Lia Avanesyan, Rosanne Spolski, Warren J. Leonard, Stewart Cooper, Jody L. Baron
Journal: Journal of Clinical Investigation (2011)

HBV is a noncytopathic hepadnavirus and major human pathogen that causes immune-mediated acute and chronic hepatitis. The immune response to HBV antigens is age dependent: viral clearance occurs in most adults, while neonates and children usually develop chronic infection and liver disease. Here, we characterize an animal model for HBV infection that recapitulates the key differences in viral clearance between early life and adulthood and find that IL-21 may be part of an effective primary hepatic immune response to HBV. In our model, adult mice showed higher HBV-dependent IL-21 production in liver, compared with that of young mice. Conversely, absence of the IL-21 receptor in adult mice resulted in antigen persistence akin to that of young mice. In humans, levels of IL-21 transcripts were greatly increased in blood samples from acutely infected adults who clear the virus. These observations suggest a different model for the dichotomous, age-dependent outcome of HBV infection in humans, in which decreased IL-21 production in younger patients may hinder generation of crucial CD8+ T and B cell responses. These findings carry implications for therapeutic augmentation of immune responses to HBV and potentially other persistent liver viruses.
Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery
Authors: WILLIAM H. NECHES, ROBERT A. MATHEWS, SANG C. PARK, CORA C. LENOX, JAMES R. ZUBERBUHLER, RALPH D. SIEWERS, HENRY T. BAHNSON
Journal: Circulation (1974)

Anomalous origin of the left coronary artery from the pulmonary artery has been surgically corrected by means of a technique that avoids direct suturing of the coronary artery itself. The anomalous left coronary artery is removed from the pulmonary artery with a cuff of pulmonary artery tissue about its orifice. In a five-and-one-half-year-old patient the anomalous coronary artery was anastomosed directly to the aorta using this technique. In another patient, seven months of age, the anomalous coronary artery could not be anastomosed directly to the aorta and a segment of the patient's subclavian artery was interposed between the left coronary artery and the aorta to complete the anastomosis. In the latter patient, profound hypothermia and circulatory arrest were used during construction of the anastomosis in an attempt to minimize further myocardial damage. The establishment of a two coronary artery system has been demonstrated to be feasible in the infant or young child with this anomaly.
Normal Blood Iron Values
Authors: Guy Haven
Journal: JAMA (1974)

<h3>To the Editor.—</h3> The article by Crosby et al (227:310, 1974) concerning serum iron levels in normal people vividly illustrates that serious misconceptions regarding normal-range establishment persist. Even among laboratory-based physicians using a normal range established in other laboratories, on different patient populations, using different analytic techniques, and without regard for time of sample collection, the authors express amazement that 6% of blood donors in a small study and 3.5% of donors in a larger study had "high serum iron values." Establishment of normal range by use of the most common statistical tools (mean±2 SD) in the same laboratory, on the same population, and at the same time of day yields, under the most ideal conditions, 4.55% abnormals, approximately half above and half below the normal range.<sup>1</sup>In addition, the authors do not point out that the normal range for their patient population is less than 1% prevalence of
Cloning and expression in yeast Pichia pastoris of a biologically active form of Cyn d 1, the major allergen of Bermuda grass pollen
Authors: Penelope M. Smith, Cenk Suphioglu, Irwin J. Griffith, Kelly Theriault, R.Bruce Knox, Mohan B. Singh
Journal: Journal of Allergy and Clinical Immunology (1996)
Creative Part-Time Faculty Arrangements
Authors: Wendy Levinson
Journal: Annals of Internal Medicine (1994)

Letters15 February 1994Creative Part-Time Faculty ArrangementsWendy Levinson, MD and Janet BickelWendy Levinson, MDGood Samaritan Hospital and Medical Center; Portland, OR 97210Association of American Medical Colleges; Washington, DC 20037Search for more papers by this author and Janet BickelGood Samaritan Hospital and Medical Center; Portland, OR 97210Association of American Medical Colleges; Washington, DC 20037Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-4-199402150-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We congratulate Dr. Ziring and her Chair for negotiating a change to part-time status. Many women drop out of academia to find feasible ways to juggle the responsibilities of motherhood and medicine, resulting in a loss of potential creativity and productivity for academic institutions. Others, in their endeavor to be all things to all people, become so frustrated that the negatives outweigh the positives.Several medical schools are developing policies to accommodate faculty who prefer to work less than 100% for a given period. The model described by Drs. Tesch and Nattinger is a good example. The faculty ... Author, Article, and Disclosure InformationAuthors: Wendy Levinson, MD; Janet BickelAffiliations: Good Samaritan Hospital and Medical Center; Portland, OR 97210Association of American Medical Colleges; Washington, DC 20037 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 February 1994Volume 120, Issue 4Page: 346-347KeywordsAcademic medicineCreativity ePublished: 15 August 2000 Issue Published: 15 February 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Influence of socioeconomic deprivation on the primary care burden and treatment of patients with a diagnosis of heart failure in general practice in Scotland: population based study
Authors: F A McAlister, N F Murphy, C R Simpson, S Stewart, K MacIntyre, M Kirkpatrick, J Chalmers, A Redpath, S Capewell, J J V McMurray
Journal: BMJ (2004)

<h3>Abstract</h3> <b>Objective</b>To examine whether there are socioeconomic gradients in the incidence, prevalence, treatment, and follow up of patients with heart failure in primary care. <b>Design</b>Population based study. <b>Setting</b>53 general practices (307 741 patients) participating in the Scottish continuous morbidity recording project between 1April 1999 and 31 March 2000. <b>Participants</b>2186 adults with heart failure. <b>Main outcome measures</b>Comorbid diagnoses, frequency of visits to general practitioner, and prescribed drugs. <b>Results</b>2186 patients with heart failure were seen (prevalence 7.1 per 1000 population, incidence 2.0 per 1000 population). The age and sex standardised incidence of heart failure increased with greater socioeconomic deprivation, from 1.8 per 1000 population in the most affluent stratum to 2.6 per 1000 population in the most deprived stratum (odds ratio 1.44, P = 0.0003). On average, patients were seen 2.4 times yearly, but follow up rates were less frequent with increasing socioeconomic deprivation (from 2.6 yearly in the most affluent subgroup to 2.0 yearly in the most deprived subgroup, P = 0.00009). Overall, 812 (80.6%) patients were prescribed diuretics, 396 (39.3%) angiotensin converting enzyme inhibitors, 216 (21.4%)βblockers, 208 (20.7%) digoxin, and 86 (8.5%) spironolactone. The wide discrepancies in prescribing between different general practices disappeared after adjustment for patient age and sex. Prescribing patterns did not vary by deprivation categories on univariate or multivariate analyses. <b>Conclusions</b> Compared with affluent patients, socioeconomically deprived patients were 44% more likely to develop heart failure but 23% less likely to see their general practitioner on an ongoing basis. Prescribed treatment did not differ across socioeconomic gradients.
Primary Hyperparathyroidism
Authors: David Powell, Peter M. Shimkin, John L. Doppman, Sam Wells, Gerald D. Aurbach, Stephen J. Marx, Alfred S. Ketcham, John T. Potts
Journal: New England Journal of Medicine (1972)

To achieve preoperative localization of abnormal parathyroid tissue in 33 patients suspected of having primary hyperparathyroidism, blood samples were obtained before operation by catheter from the small veins of the thyroid venous plexus. Parathyroid hormone concentrations in the samples were determined by radioimmunoassay. The correctness of the predicted lateralization was confirmed in all 21 patients who were operated on. A unilateral hormone gradient was seen in patients who had a single adenoma; bilateral gradients were seen in those who had multiple abnormal glands. The technic seems useful for localizing the site of abnormal parathyroid tissue, for preoperative differentiation of a single abnormal gland (adenoma) from multiple abnormal glands (hyperplasia), and it also may be helpful in establishing the existence of hyperparathyroidism in certain patients who pose special diagnostic problems.
Incidental Detection of an Anterior Cruciate Ligament Injury With FDG PET
Authors: Michael A. Walsh, Yoav Morag, Richard K. J. Brown
Journal: Clinical Nuclear Medicine (2006)

The detection and staging of many cancers is rapidly becoming dependent on positron emission tomography (PET) with the glucose analog 18 fluorine fluorodeoxyglucose (FDG). FDG demonstrates increased uptake in a majority of malignant lesions as well as an increasing number of benign conditions that can be confused with a malignant neoplasm. Osseous injury associated with anterior cruciate ligament (ACL) and meniscal tears have been detected with bone scanning agents.