tbuckley/cabot-search huggingface dataset:
Transcatheter Closure of Interatrial Communications for Secondary Prevention of Paradoxical Embolism
Authors: Leonhard Bruch, Anne Parsi, Marc Oliver Grad, Sascha Rux, Telse Burmeister, Heike Krebs, Franz Xaver Kleber
Journal: Circulation (2002)

Background — Patients with a patent foramen ovale (PFO) after cerebral, coronary, or systemic embolic events of presumed paradoxical origin are at risk for recurrent thromboembolism. We report our single-center experience of interventional closure of interatrial communications for secondary prevention of presumed paradoxical embolism. Methods and Results — Since 1997, percutaneous closure of interatrial communications was performed at our institution in 66 patients (mean age 47.8±12.7 years; 31 males) with a PFO or an atrial septal defect and at least 1 documented presumed paradoxical thromboembolic event. Fifty-eight patients had cerebral embolism, 10 had coronary embolism, and 3 had peripheral embolism. Several patients experienced multilocal arterial embolism. Fifty-four patients had a PFO, 33 of them with an atrial septal aneurysm, and 12 had an atrial septal defect. The implantation procedure was successful and without complication in all patients. After 3 months, only 2 patients showed a residual shunt, which disappeared in both cases after 12 months. In 112.2 patient-years of follow-up (range, 5 weeks to 3.5 years), we have not seen any recurrent thromboembolic event. Conclusions — Interventional closure of interatrial communications is a safe and effective therapeutic option for the secondary prevention of presumed paradoxical embolism. To further evaluate this strategy, randomized trials comparing interventional closure with anticoagulation have been initiated by us and others.
Computer Handling of Ambulatory Clinic Records
Authors: Richard P. Levy, Maxine R. Cammarn, Michael J. Smith
Journal: JAMA (1964)

A computer is used to improve the quality, consistency, and legibility of the patients' records in an ambulatory diabetes clinic of a large, teaching hospital. It has been programmed to produce printed records in a format familiar to the attending physician: the history and physical examination in a narrative style, and the laboratory data in a tabular display. When new data on a patient enter the system, a new report is generated automatically, superseding previous reports. Physicians enter data into the system by completing special forms which are a combination of check-lists and free narrative description. The results of the first six months of the routine operation of the system have encouraged its continued use and have stimulated the development of information searching programs, as well as automatic quality control reports.
Abstract 3908: Norton-Simon modeling for the optimization of dose and schedule of palifosfamide in breast cancer
Authors: Tiffany A. Traina, Clifford Hudis, Jonathan Lewis, Larry Norton
Journal: Cancer Research (2012)

Abstract Palifosfamide (P), the stabilized active metabolite of ifosfamide, is a bifunctional DNA alkylating agent with broad anticancer activity, including against cells with ALDH over-expression resistant to cyclophosphamide. In contrast to other agents of its class, P's favorable safety profile, rapid onset of action, and comparable activity by IV and PO routes permits optimization of dose-schedule. To this end we used Norton-Simon Modeling to analyze the growth curves of the MX-1 breast cancer xenograft model, unperturbed and perturbed by various dose-schedules of P. This method fits an equation ΔN(t)/αt=F(N)·G(t) to experimental data on tumor size N as a function of time t to define the magnitude and shape of the curve of growth perturbation G as a function of time t before, during, and after the administration of anticancer therapy. In general (as in this case), growth perturbation “peaks” at a number of days after administration and declines thereafter. This is largely due to the induction of spontaneously reversible resistance (tachyphylaxis) as evidenced by the cancers’ reversion to drug sensitivity after a period of drug absence. Hence, repeated cycles of intermittent therapy allows for further growth perturbation, providing for sustained anticancer effect. The solution of the Norton-Massague equation ΔN(t)/αt=aN^b-cN^d fit unperturbed growth exactly (r^2=0.99973). 180 mg/kg as a single dose caused tumor volume regression with a peak growth perturbation at 7 days after administration. The effect of lower dose levels in (growth perturbation as a % of that of 180 mg/kg as a single dose; peak at days after start of administration) were 120 mg/kg (75%; 7), 80 mg/kg (34%; 5), and 53 mg/kg (16%; 3). When P was given in divided doses over 5 days, 180 mg/kg cumulative dose resulted in (94%; 10), 120 mg/kg (55%; 6), and 80 mg/kg (16%; 3). Hence, the administration of P over 5 days preserved almost full efficacy but delayed the time of emergence of drug resistance by 43% (from 7 days to 10 days). Moreover, analysis of the effects of P alone, docetaxel alone, and the simultaneous combination indicates that the shapes and magnitudes of the single-agent curves add to perfectly predict that of the combination, with minimal loss of single-agent activity. Hence, the daily x 5 schedule (9 days off) at highest tolerated dose level is proposed for clinical study, both as a single agent and in combination with other anticancer medications. 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 3908. doi:1538-7445.AM2012-3908
Myocardial Infarction: Electrocardiographic Differential Diagnosis
Authors: I. Martin Grais
Journal: JAMA (1985)

I experienced genuine pleasure reading this slender, high-yield text. As suggested by the title, much of the discussion, appropriately, is on pseudoinfarction rather than myocardial infarction. From the beginnings of electrocardiography, physicians have been warned that there is great danger in misreading or misapplying the electrocardiogram (ECG) in clinical practice. The author's comprehensive description of both subtle and blatant infarction and of pseudoinfarction patterns is so extensive that the reader is amply forewarned. Any physician responsible for interpreting ECGs will want to have read this book or one as well written on the subject. Objectively, Dr Goldberger's book is tightly organized, clear, succinct, and complete. Part 1 deals with Q wave patterns of infarction and pseudoinfarction, the latter divided into chapters on normal variants, ventricular hypertrophy and dilatation, conduction defects, and noninfarction injury patterns. Part 2 assesses ST-T patterns of infarction and pseudoinfarction. Here there are chapters on ischemic causes
Ward rounds ain't what they used to be
Authors: David Crosby
Journal: BMJ (2004)

My first experience of ward rounds was as a first year clinical student in 1950. The professorial parade occurred on two afternoons a week, and, with the professor's known wartime naval career, there was a background of naval terminology, such as the ward being unofficially known as the quarterdeck. The professor's retinue of assistants, lecturers, house surgeons, and many others was so large that, by the time he had reached the second bed in the clockwise circuit of the Nightingale ward, the last of us were still coming in through the ward doors. After that the ward …
Effect of acetylcholine on the norepinephrine-induced positive chronotropy and increase in cyclic nucleotides of isolated rabbit sinoatrial node.
Authors: T Taniguchi, M Fujiwara, J J Lee, H Hidaka
Journal: Circulation Research (1979)

Transmural stimulation of, or application of nicotine to, the isolated rabbit sinoatrial (SA) node resulted in initial negative and late positive chronotropy. Simultaneous application of acetylcholine and norepinephrine produced a similar biphasic chronotropic effect. These procedures produced an initial increase in cyclic guanosine 3':5'-monophosphate (cyclic GMP) and a delayed elevation in cyclic adenosine 3':5'-monophosphate (cyclic AMP). The initial and late effects on rate and nucleotide levels were inhibited by pretreatment with atropine and propranolol, respectively. Pretreatment with atropine shortened the time of maximum increase in cyclic AMP level and heart rate from 3 to 1 minute after the simultaneous application of acetylcholine and norepinephrine and enhanced the positive chronotropic effect. Physostigmine prolonged the duration of the increase in cyclic GMP and negative chronotropic effect after the simultaneous application. These results suggest that when acetylocholine and norepinephrine are present simultaneously in the SA node region, the former interacts predominantly with muscarinic receptors and stimulates the cyclic GMP system, which in effect delays the cyclic AMP elevation and reduces the positive chronotropic effect of norepinephrine. However, these effects of acetylcholine cannot be explained solely on the basis of changes in the cyclic GMP level, because sodium nitroprusside produced a marked elevation of the cyclic GMP levels without decreasing the heart rate and did not affect the norepinephrine-induced increase in pacemaker rate and cyclic AMP. Sodium nitroprusside may affect cyclic GMP pools other than those susceptible to acetylcholine. These cyclic GMP pools may not exert chronotropic effects.
109 GIDEON (GLOBAL INVESTIGATION OF THERAPEUTIC DECISIONS IN HEPATOCELLULAR CARCINOMA AND OF ITS TREATMENT WITH SORAFENIB) SECOND INTERIM ANALYSIS: CLINICAL FINDINGS IN CHILD-PUGH B SCORE SUBGROUPS
Authors: J.-P. Bronowicki, S.-L. Ye, M. Kudo, J. Marrero, L. Dagher, J. Furuse, J.F. Geschwind, L. Ladron de Guevara, C. Papandreou, A.J. Sanyal, T. Takayama, S.K. Yoon, K. Nakajima, R. Lencioni
Journal: Journal of Hepatology (2012)
Coronary Heart Disease: Prevention, Detection, Rehabilitation With Emphasis on Exercise Testing
Authors: David H. Spodick
Journal: JAMA (1975)

This jumbo loose-leaf book is a part of what is labeled a "learning system," specially aimed at applications of exercise for diagnosis, rehabilitation, and risk factor modification in coronary heart disease. Although one is easily put off by any loose use of the label "system," this book is a pleasant and refreshing surprise. It comprises more than a text, for with a group of tapes and slides on related subjects, we are indeed presented with a system. And what a system! It covers every aspect of major concern—from physiologic and pathologic responses to exercise, to exercise as a preventive measure and as therapy—and does not neglect practical testing—from details of procedure, expense, medicolegal problems, to the very nuts and bolts of equipment. For quality of presentation, it is hard to choose among ten major sections, each well illustrated and well documented. Its distinguished editor, Samuel Fox III, has assembled contributors
In vivo regulation of human mononuclear leukocyte 3-hydroxy-3-methylglutaryl coenzyme A reductase. Decreased enzyme catalytic efficiency in familial hypercholesterolemia.
Authors: P W Stacpoole, D M Bridge, I M Alvarez, R B Goldberg, H J Harwood
Journal: Journal of Clinical Investigation (1987)

3-Hydroxy-3-methylglutaryl coenzyme A reductase (HMG CoA reductase) controls the rate of cholesterol biosynthesis and is itself modulated through feedback suppression by internalized low density lipoprotein (LDL) cholesterol. We measured HMG CoA reductase protein concentration and microsomal enzyme activity in freshly isolated mononuclear leukocytes from normal individuals and patients with heterozygous or homozygous familial hypercholesterolemia (FH). Reductase protein concentration was similar in normal and heterozygous subjects, but was over twofold elevated in patients with homozygous FH. Reductase protein concentration was inversely related to LDL receptor status. Total activity and catalytic efficiency of reductase, however, were decreased in heterozygous and homozygous FH patients. The decrease in catalytic efficiency was not due to enzyme phosphorylation or thiol-disulfide formation. Reduction of plasma cholesterol concentration over 2 h by plasmapheresis increased reductase activity, the degree of which was directly proportional to the LDL-receptor status of the subjects. Decreased HMG CoA reductase activity and catalytic efficiency in mononuclear leukocytes and perhaps other cells in FH may represent a fundamental abnormality in the regulation of this enzyme independent of that induced by the LDL-receptor defect and may provide new insight into the control of cholesterol metabolism in FH.
Low incidence of secondary myelodysplasia and acute myeloid leukemia after high-dose chemotherapy as adjuvant therapy for breast cancer patients: a study by the Solid Tumors Working Party of the European Group for Blood and Marrow Transplantation
Authors: N. Kröger, A.R. Zander, G. Martinelli, P. Ferrante, J.M. Moraleda, G.A. Da Prada, T. Demirer, G. Socie, G. Rosti
Journal: Annals of Oncology (2003)
Uses of heparin. Withhold in acute ischaemic stroke.
Authors: R I Lindley, P A Sandercock
Journal: BMJ (1993)

this screening interval but did not strictly fulfil all the criteria.By analysing the smear histories of all women over the age of 50 living in the Dundee and Angus areas who were diagnosed as having cervical neoplastic disease in 1991 and 1992 we extended out initial study to cover four consecutive years.In 1991 and 1992 a total of 47 461 smears were taken and 710 cases of cervical intraepithelial neoplasia were diagnosed.Altogether 15-5% of smear tests
Hip1r is expressed in gastric parietal cells and is required for tubulovesicle formation and cell survival in mice
Authors: Renu N. Jain, Asma A. Al-Menhali, Theresa M. Keeley, Jianhua Ren, Mohammed El-Zaatari, Xunsheng Chen, Juanita L. Merchant, Theodora S. Ross, Catherine S. Chew, Linda C. Samuelson
Journal: Journal of Clinical Investigation (2008)

Huntingtin interacting protein 1 related (Hip1r) is an F-actin– and clathrin-binding protein involved in vesicular trafficking. In this study, we demonstrate that Hip1r is abundantly expressed in the gastric parietal cell, predominantly localizing with F-actin to canalicular membranes. Hip1r may provide a critical function in vivo, as demonstrated by extensive changes to parietal cells and the gastric epithelium in Hip1r-deficient mice. Electron microscopy revealed abnormal apical canalicular membranes and loss of tubulovesicles in mutant parietal cells, suggesting that Hip1r is necessary for the normal trafficking of these secretory membranes. Accordingly, acid secretory dynamics were altered in mutant parietal cells, with enhanced activation and acid trapping, as measured in isolated gastric glands. At the whole-organ level, gastric acidity was reduced in Hip1r-deficient mice, and the gastric mucosa was grossly transformed, with fewer parietal cells due to enhanced apoptotic cell death and glandular hypertrophy associated with cellular transformation. Hip1r-deficient mice had increased expression of the gastric growth factor gastrin, and mice mutant for both gastrin and Hip1r exhibited normalization of both proliferation and gland height. Taken together, these studies demonstrate that Hip1r plays a significant role in gastric physiology, mucosal architecture, and secretory membrane dynamics in parietal cells.
Unexplained periparturient thrombocytopenia
Authors: J. Freedman, E. Musclow, B. Garvey, D. Abbott
Journal: American Journal of Hematology (1986)

Abstract Since the advent of routine automated platelet counting we have observed unexplained periparturient thrombocytopenia (PPT) in an unexpected number of periparturient women, ie, during labor or within 24 hr postpartum. Mean ± SD platelet count in 686 random blood donors was 236 ± 50 ± 10 9 /L and 1.02% had a platelet count &lt; 136 ± 10 9 /L; in 2,204 random prenatal and postpartum women mean count was significantly higher (275 ± 86 ± 10 9 /L; p &lt; 0.001). Of 1,621 periparturient women, 74 (4.6%) had unexplained PPT (mean ± SD platelet count 122 ± 24 ± 10 9 /L, range 21‐135 ± 10 9 /L, N = 74). Platelet count in PPT usually rose to normal within 1 week of delivery; in 10% thrombocytopenia persisted &gt; 6 months. PPT occurred in successive pregnancies with normal intervening platelet counts. Nine of 34 newborns of mothers with PPT were thrombocytopenic; there was no correlation between mother's and baby's platelet counts. In no case of PPT was there excessive bleeding in mother or infant. Positive indirect platelet radioactive antiglobulin tests (PRAT) were seen in 11% of normal postpartum women and in 90% of 22 women with PPT; 65% of the positive tests in PPT were due to reactions with anti‐C3 only. In contrast, pregnant women with autoimmune thrombocytopenic purpura (AITP) had positive PRAT primarily because of anti‐IgG ( ± anti‐C3); only 10% were positive only with anti‐C3. Results were concordant in all of eight women with PPT tested by both indirect and direct PRAT. Amount of C3 bound per platelet in direct or indirect PRAT was not predictive of degree of thrombocytopenia, but there was correlation of fg C3 per platelet detected by the two assays in individual patients (r = 0.8). Mean levels of serum C3, C4, and factor B in women with PPT did not differ from normal; individual patients had abnormal serum complements but no characteristic pattern was observed. Increased immune complexes were observed in 6% of normal subjects and 33% of women with PPT. Etiology and mechanism of PPT is unclear. Despite lack of clinical evidence in women with PPT of syndromes associated with increased platelet destruction, the presence of preeclampsia cannot be absolutely excluded. Similarly, although the pattern of antiglobulin sensitization in PPT differed markedly from that seen in AITP, autoimmune disorder cannot be excluded. Alloantibodies did not appear to be responsible for PPT. While PPT is usually benign, some patients had a markedly reduced platelet count. Recognition of the phenomenon may be important in obstetrics.
Effect of lactation on the decline of brush border lactase activity in neonatal pigs.
Authors: D Kelly, T P King, M McFadyen, A J Travis
Journal: Gut (1991)

It has been shown that during the early phase of lactation porcine milk contains high concentrations of hormones and growth factors. The aim of the present investigation was to examine the hypothesis that the temporal coordination of intestinal maturation in piglets can be extrinsically regulated through changes in the composition of milk during the suckling period. Gut morphology and the ontogeny of brush border lactase activity were investigated in piglets reared on two suckling regimens designed to expose the animals to compositionally distinct milk. The first group of animals were cross-fostered onto postcolostrum sows and thereafter suckled normally for up to eight weeks. These normally suckled (N) animals consequently received both early and late lactation products. The second group of piglets were cross-fostered each week, for up to eight weeks, onto newly farrowed sows which were postcolostrum. As a result of this repeated cross-fostering (CF) these animals received only early lactation products. Animals were sacrificed at one, three, five, seven, and eight weeks postpartum. Biochemically active lactase decreased significantly (p less than 0.001) in both groups over eight weeks, but the rate of loss of activity was greater in the CF animals than in the N pigs by approximately 50% at week 3 and 25% at week 8. Quantitative histochemical analysis of lactase activity corroborated the biochemical data. At three weeks maximal enzyme activity was observed approximately 400 microns from the villus/crypt junction. Histochemically detected lactase decreased throughout the suckling period, but the intensity of reaction product was consistently weaker over the entire villus surface in the CF animals. Immunocytochemically detectable lactase was identified at the same sites as the histochemical reaction products. In addition, immunofluorescence microscopy showed the presence of histochemically undetectable enzyme on the basolateral and brush border membranes of both villus and crypt cells. Villus/crypt ratios were significantly lower (p&lt;0.001) in the CF animals than in the N pigs between weeks 3 and 5. The results of this study suggest that lactation products can accelerate the loss of brush border lactase activity. The observed decline in biochemically and histochemically detected lactase was considered to be a consequence of reduced enterocyte lifespan, decreased synthesis of enzyme protein, or altered post-translational modification of enzyme protein, or a combination of there.
Diagnosis of Stress Fractures
Authors: Robert C. George
Journal: JAMA (1980)

To the Editor.—  The article by Norfray and associates (243:1647, 1980) on bone scanning of stress fractures in joggers clearly demonstrates the usefulness of the radionuclide bone scan (RBS). What it does not do is illustrate the necessity for such diagnostic testing. Although Norfray et al do not suggest a bone scan on every jogger with lower extremity pain, they say if a stress fracture is suspected clinically and the conventional roentgenograms are normal, an RBS is indicated.  I believe such a policy illustrates the ready feasibility of using advanced modern technology to raise the cost of medical care. Any orthopedist dealing frequently with sportsrelated injuries can make a clinical diagnosis of fatigue fracture a high percentage of the time. Treatment can be promptly instituted, and the subsequent course is almost always as expected. The use of bone scanning should be reserved for the situation where the clinical picture is in
607 High incidence of de novo diabetes mellitus type 1 during or after treatment with pegylated interferon in patients with chronic hepatitis C virus infection
Authors: T.C.M.A. Schreuder, H.G. Gelderblom, C.J. Weegink, H.W Reesink, J.B.L. Hoekstra, P.L.M. Jansen
Journal: Journal of Hepatology (2006)
Rupture of the Normal Stomach after Therapeutic Oxygen Administration
Authors: Paul M. Walstad, William S. Conklin
Journal: New England Journal of Medicine (1961)

RUPTURE of the healthy stomach, unassociated with trauma, may occur from overdistention created by food or gas.1 2 3 4 5 6 This type of rupture is rare and seldom diagnosed and exacts a high mortality.Little attention, however, has been paid to the therapeutic use of oxygen as an inciting cause of such rupture. Pendergrass and Booth7 mentioned the intratracheal use of oxygen as a possible contributing factor. Musser8 considered the administration of oxygen to be a common cause of rupture in infants. McCormick,9 however, found less than a third of the patients in the reported pediatric cases receiving oxygen by any method. A . . .