tbuckley/cabot-search huggingface dataset:
Meeting Highlights
Authors: James J. Ferguson
Journal: Circulation (2000)

Background-Virtual reality techniques have recently been introduced into clinical medicine.This study examines the possibility of coronary artery fly-through using a dataset obtained by noninvasive coronary angiography with contrast-enhanced electron-beam computed tomography.Methods and Results-Ten patients were examined, and 40 to 60 transaxial tomograms (thickness, 1.5 mm; in-plane pixel dimensions, Ϸ0.5ϫ0.5 mm) were obtained after intravenous contrast injection.The datasets were processed on a graphics workstation using volume-rendering software.For fly-throughs, the contrast-enhanced lumen was made transparent and other tissue was made opaque.Then, key frames were selected in a path through the vessel, with software interpolation of frames between key frames.A typical movie contained 150 to 300 frames (10 to 15 key frames).Fly-throughs of coronary bypass grafts (nϭ3), left anterior descending arteries (LAD; nϭ6), and the intermediate branch (nϭ1) were reconstructed.Coronary calcifications were seen in 3 patients.The fly-through of the intermediate branch, the bypass grafts, and one of the LADs did not show any irregularities.In 2 cases, a stenosis was visible in the LAD; its presence was confirmed by conventional coronary angiography.Conclusions-Recent developments in fast-volume rendering using special-purpose hardware in combination with noninvasive coronary angiography with electron beam computed tomography have provided the possibility of performing coronary artery fly-throughs.(Circulation.2000;102:e6-e10.)
Sustained gallbladder stasis promotes cholesterol gallstone formation in the ground squirrel
Authors: Q Xu, M Mantle, J G Pauletzki, E A Shaffer
Journal: Hepatology (1997)

Although gallbladder stasis exists in most patients with cholesterol gallstones, it is unknown whether stasis is a causative factor of gallstone disease or merely a consequence of it. We studied the impact of sustained gallbladder stasis induced by a cholecystokinin (CCK)-A receptor antagonist (MK-329) on gallstone formation in ground squirrels fed either a trace or a high-cholesterol diet. MK-329 markedly inhibited gallbladder contraction in vitro in response to CCK (at EC 100 , control: 3.6 ± 0.5 vs. MK-329: 1.1 ± 0.3 g; P &lt; .05) and increased gallbladder fasting volume in vivo (control: 462 ± 66 vs. MK-329: 1,004 ± 121 μL P &lt; .05). Whereas the high-cholesterol diet alone (1%-cholesterol diet + placebo) increased the cholesterol saturation index (CSI) in control animals (trace-cholesterol diet + placebo), MK-329 significantly ( P &lt; .05) decreased the CSI in both hepatic and gallbladder bile in animals on the trace-(trace-cholesterol diet + MK-329) as well as on the high-cholesterol diets (1%-cholesterol diet + MK-329). The mucin content of the mucus layer on the epithelial surface of the gallbladder wall more than doubled ( P &lt; .05) with the high-cholesterol diet; adding MK-329 to the latter group produced a further 82% increase ( P &lt; .05). The cholesterol diet + MK-329 group had the highest (100%) incidence of cholesterol crystals that were evident in fresh gallbladder bile, coincident with a shortened nucleation time (2.5 ± 0.6 days; P &lt; .05 vs. the cholesterol diet + placebo group, 5.8 ± 1.0 days or the other 2 groups, &gt;21 days). Bile from animals on the trace-cholesterol diet, whether or not receiving MK-329, lacked crystals in bile and exhibited a normal nucleation time (&gt;21 days). Thus, stasis per se may lower the CSI, but its detrimental effect on the gallbladder predominates locally, and so accelerates cholesterol crystal formation in this model.
Reducing the speed limit to 20 mph in urban areas
Authors: P. Pilkington
Journal: BMJ (2000)

Road traffic accidents continue to pose a major threat to the health of children in the United Kingdom. Attention is often focused on deaths on the road during holiday seasons, but deaths and injuries occur all year round. Britain has one of the worst child pedestrian casualty rates in Europe, with 140 children being killed on its roads each year.1 There is now a new weapon available to tackle this problem: since last year local authorities have had the power to impose 20 mph (32 kph) speed limits in urban areas.

Speed is a major factor in road accidents. According to the Department of the Environment, Transport, and the Regions,inappropriate and excessive speed on the roads accounts for around 1200 deaths a year.2 Lack of speed restrictions rather than increased exposure to traffic has been shown to account for the excess deaths among child …
Recent Contributions to the Medical Problems of Old Age
Authors: Frederic D. Zeman
Journal: New England Journal of Medicine (1957)

"There are no diseases peculiar to old age and very few from which it is exempt." Alfred Worcester (1855–1951)EVER since the beginnings of his growing awareness man has resented and fought against the bodily changes associated with advancing years. Magicians, medicine men, priests and physicians, each in his own way, have attempted to combat graying hair, wrinkled skin, declining strength and mental weakness. For centuries the dictum prevailed that old age itself was a disease, and the remedies prescribed were aimed at what are now recognized as outward manifestations. Only with the rise of modern medicine, based on clinicopathological . . .
S1-6: Characterization of Breast Cancer Distant Metastasis Based on Outcome over Time Using a Gene Expression Profiling Approach and Identification of Pathway Activities of Late Relapse.
Authors: M Saghatchian, L Mittempergher, S Michiels, S Casinius, A Glas, V Lazar, P Roepman, P Dessen, S Benz, M Piccart, S Delaloge, L van't Veer
Journal: Cancer Research (2011)

Abstract Background Previous reports have described the use of microarrays to assess the molecular classification of human breast cancers and defined new subgroups based on gene expression that are relevant to patient management through their ability to predict metastatic relapse and survival relapse. However, different mechanisms may be associated with the development of early and late distant metastases. With the hypothesis that tumors may lead to early or distant metastases based on their intrinsic biological initial features, we aimed at defining molecular profiles for several subgroups of patients based on their outcome over time. Material and methods Breast primary tumors were selected from retrospective series of patients with frozen material available. These series include patients of all ages, LN- and LN+; Estrogen or Progesteron-receptor positive, Her2-negative, no adjuvant treatment, with a follow-up of more than 10 years (y) for the control group or distant metastatic relapse as first event (DM) for the study group (n=144). Patients tumors were classified in 4 groups: no relapse at 10 y (M0), DM before 3 y (M0-3, n=30), DM between 3 and 7 y (M3-7), DM after 7 y (M7+). Samples were collected in 2 different institutions (NKI series for identifying the signature and IGR series for validation). Gene expression analysis of breast tumor samples was performed using custom-made Agilent 44K high-density microarrays and hybridized against the Mammaprint® reference pool (MRP). Tumors were also assessed for their Mammaprint® status, wound-healing signature status and their intrinsic subtypes based on the Blueprint® signature. Moreover, we identified the pathway-level activities of the patient groups using PARADIGM. Results and Discussion For the NKI series, A subset of 144 samples was included based on the selection criteria: 57 M0, 31 M0-3, 25 M3-7, 31 M7+. None of the 3 previously mentioned signatures correctly identified M0 vs. M7+ patients. In order to identify a predictive signature of late relapse (after 7y) we considered M0 and M7+ MammaPrint-Low Risk patients and we split them in a training (n=41) and in a test (n=23) sets. A 73-gene signature was able to classify M7+ patients with 75% of sensitivity and 66% of specificity on the test set. DM after 7yr showed significant activation of pathway related to inflammatory response and angiogenesis. Detailed results and validation results on the independent IGR series will be presented at the meeting. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr S1-6.
Consolidation of Medical Groups Into Physician Practice Management Organizations
Authors: James C. Robinson
Journal: JAMA (1998)

Context.—Medical groups are growing and merging to improve efficiency and bargaining leverage in the competitive managed care environment. An increasing number are affiliating with physician practice management (PPM) firms that offer capital financing, expertise in utilization management, and global capitation contracts with health insurance entities. These physician organizations provide an alternative to affiliation with a hospital system and to individual physician contracting with health plans.Objective.—To describe the growth, structure, and strategy of PPM organizations that coordinate medical groups in multiple markets and contract with health maintenance organizations (HMOs).Design.—Case studies, including interviews with administrative and clinical leaders, review of company documents, and analysis of documents from investment bankers, the Securities and Exchange Commission, and industry observers.Setting.—Medical groups and independent practice associations (IPAs) in California and New Jersey affiliated with MedPartners, FPA Medical Management, and UniMed.Outcome Measures.—Growth in number of primary care and specialty care physicians employed by and contracting with affiliated medical groups; growth in patient enrollment from commercial, Medicare, and Medicaid HMOs; growth in capitation and noncapitation revenues; structure and governance of affiliated management service organizations and professional corporations; and contracting strategies with HMOs.Results.—Between 1994 and 1996, medical groups and IPAs affiliated with 3 PPMs grew from 3787 to 25763 physicians; 65% of employed physicians provide primary care, while the majority of contracting physicians provide specialty care. Patient enrollment in HMOs grew from 285503 to 3028881. Annual capitation revenues grew from $190 million to $2.1 billion. Medical groups affiliated with PPMs are capitated for most professional, hospital, and ancillary clinical services and are increasingly delegated responsibility by HMOs for utilization management and quality assurance.Comment.—Physician practice management organizations and their affiliated medical groups face the challenge of continuing rapid growth, sustaining stock values, and improving practice efficiencies while maintaining the loyalty of physicians and patients.
Cyclosporin can be used in early rheumatoid arthritis
Authors: J K Dawson, B Roychowdhury, E J Tunn
Journal: BMJ (1997)

Nicotine replacement therapy should be prescribable on NHSEditor-I welcome the publication of the open letter to the prime minister about tobacco-the most important preventable cause of death in Europe. 1 As Jo E Asvall points out in the letter, tobacco control demands the support of, and action by, the total government, not just the Department of Health.Among the actions Asvall calls for is that "support for smoking cessation is made widely available, particularly through primary health care professionals, including doctors, nurses, pharmacists, and dentists."Nicotine replacement therapy (nicotine gum, patches, nasal spray, and oral inhaler) is now fully established as an effective adjunct to such professional advice and support.Systematic review of many trials has shown a doubling of sustained smoking cessation when nicotine replacement therapy is compared with placebo. 2 The offer of nicotine patches to motivated subjects for a week in the first instance could be a useful policy. 3 But the recommendation of such therapy by health professionals and the use of such therapy by smokers are severely limited by NHS "blacklisting."I can prescribe on the NHS for alcohol problems and even obesity.I can also prescribe for tobacco addiction-but only products of unproved efficacy for this problem, such as tranquillisers and antidepressants, not one of proved effectiveness.Why not nicotine replacement therapy?So much for evidence based medicine.
Prevention of colorectal cancer liver metastasis by exploiting liver immunity via chitosan-TPP/nanoparticles formulated with IL-12
Authors: Qiongming Xu, Lingchuan Guo, Xinhua Gu, Biao Zhang, Xin Hu, Jiajia Zhang, Jinghong Chen, Yi Wang, Cheng Chen, Bei Gao, Yuting Kuang, Shouli Wang
Journal: Biomaterials (2012)
Altruism and emotions
Authors: Herbert Gintis
Journal: Behavioral and Brain Sciences (2002)

If altruism requires self-control, people must consider altruistic acts as costly, the benefits of which will only be recouped in the future. By contrast, I shall present evidence that altruism is dictated by emotions: Altruists secure an immediate payoff from performing altruistic acts, so no element of self-control is present, and no future reward is required or expected.
Alterations in the protein composition of maturing phagosomes.
Authors: A Pitt, L S Mayorga, P D Stahl, A L Schwartz
Journal: Journal of Clinical Investigation (1992)

We investigated the protein composition of J774-E clone macrophage phagosomes isolated at different stages of phagolysosome biogenesis. Phagosomes formed by internalizing antibody-coated Staphylococcus aureus for 3 min followed by chase for 0, 4, 9, or 15 min were isolated by density gradient centrifugation. Enrichment and purity of the phagosome preparations were quantitated by radiolabeled ligand recovery, enzyme markers, and electron microscopy. One-dimensional SDS-PAGE analyses of the isolated phagosomes revealed virtually identical protein compositions. However, Western blot analyses with antibodies directed against selected proteins of known itineraries along the endocytic pathway demonstrated distinct differences in phagosome protein compositions. Accumulating within the maturing phagosome were the 31-kD subunit of the vacuolar proton pump, cathepsin D,beta-glucuronidase, the cation dependent mannose 6-phosphate receptor, and LAMP-1. Decreasing within the maturing phagosome were the FcII receptor, the mannose receptor, and alpha-adaptin. These results indicate that although the macrophage phagosome's total protein composition changes little during phagolysosome formation, the maturing phagosome both receives and eliminates, possibly by protein recycling, specific membrane and sequestered proteins.
Genetic and Environmental Factors in Alexithymia: A Population-Based Study of 8,785 Danish Twin Pairs
Authors: Michael Martini Jørgensen, Robert Zachariae, Axel Skytthe, Kirsten Kyvik
Journal: Psychotherapy and Psychosomatics (2007)

&lt;i&gt;Background:&lt;/i&gt; The role of genetic and environmental factors for developing alexithymia is still unclear, and the aim of this study was to examine these factors in a large population-based sample of twins. &lt;i&gt;Methods:&lt;/i&gt; The Toronto Alexithymia Scale-20 (TAS-20) was included in a mail survey of 46,418 individuals born between 1931 and 1982 and registered with the Danish Twin Registry. The response rate was 75.3%. A total of 8,785 twin pairs, where both cotwins had completed all items of the TAS-20, were selected for this study. Analyses were conducted for total TAS-20 scores and the subscales of (1) difficulties in identifying feelings, (2) difficulties in describing feelings, and (3) externally oriented thinking. The phenotypes were analyzed both as categorical and continuous data. &lt;i&gt;Results:&lt;/i&gt; All measures of similarity suggested that genetic factors added to all facets of alexithymia. Structural equation modeling of the noncategorical data, an ACE model including additive genetic, shared environmental and nonshared environmental effects, provided the best fit for all three facets of alexithymia as well as total alexithymia scores, with heritabilities of 30–33% and the remaining variance being explained by shared (12–20%) and nonshared environmental effects (50–56%). &lt;i&gt;Conclusion:&lt;/i&gt; The results from this large population-based sample suggest that genetic factors have a noticeable and similar impact on all facets of alexithymia. While the results suggested a moderate influence of shared environmental factors, our results are in concordance with the general finding that environmental influences on most psychological traits are primarily of the nonshared rather than the shared type.
Remarks on the Arrest of Haemorrliage after the Extraction of Teeth: With some Account of a New Instrument for that Purpose
Authors: J. Higginbottom
Journal: BMJ (1842)

nembers of the Association, and wvill subjoini a few.brief remarks oni the calculi, anid the poilnts of diffi- culty in their extractioni.'rhe oval calculus, which was the first extracted, is composed of lithic acid, with a partial thin crust of
Procedures in Consultation and Referral
Authors: Henry F. Howe
Journal: New England Journal of Medicine (1959)

I AM deeply grateful for the honor of being thought worthy to join the parade of distinguished physicians who, almost every year for a century and a half, have delivered formal addresses on this occasion before the Society. So formidable are their names, and so striking are the contributions that many of them made in their orations, that one approaches this test of eloquence with some trepidation, and with a feeling that what one says here should not be merely an exercise in entertainment, but rather a statement of some important principle that concerns the medical profession in the Commonwealth. . . .
Quality End-of-Life Care
Authors: Peter A. Singer, Douglas K. Martin, Merrijoy Kelner
Journal: JAMA (1999)

Quality end-of-life care is increasingly recognized as an ethical obligation of health care providers, both clinicians and organizations. However, this concept has not been examined from the perspective of patients.To identify and describe elements of quality end-of-life care from the patient's perspective.Qualitative study using in-depth, open-ended, face-to-face interviews and content analysis.Toronto, Ontario.A total of 126 participants from 3 patient groups: dialysis patients (n = 48), people with human immunodeficiency virus infection (n = 40), and residents of a long-term care facility (n = 38).Participants' views on end-of-life issues.Participants identified 5 domains of quality end-of-life care: receiving adequate pain and symptom management, avoiding inappropriate prolongation of dying, achieving a sense of control, relieving burden, and strengthening relationships with loved ones.These domains, which characterize patients' perspectives on end-of-life care, can serve as focal points for improving the quality of end-of-life care.
Hepatic and serum levels of miR-122 after chronic HCV-induced fibrosis
Authors: Jonel Trebicka, Evrim Anadol, Natalia Elfimova, Ingo Strack, Michael Roggendorf, Sergei Viazov, Inga Wedemeyer, Uta Drebber, Jürgen Rockstroh, Tilman Sauerbruch, Hans-Peter Dienes, Margarete Odenthal
Journal: Journal of Hepatology (2012)
Massive and Widely Distributed Splenosis
Authors: JOHN A. VENTO, FANGYU PENG, RICHARD P. SPENCER, WILLIAM H. RAMSEY
Journal: Clinical Nuclear Medicine (1999)

A 45-year-old man, seropositive for hepatitis C, was examined because his liver was palpable well below the costal margin. A CT examination revealed multiple nodules within the liver and also several sites of ectopic tissue. The patient had a splenectomy 25 years before. A radiocolloid study showed uptake, consistent with splenosis, in the thorax, abdomen, pelvis, and possibly the left arm. The magnitude of the ectopic tissue, and its multiple locations, indicated the ability of splenic cells to grow in a variety of body sites.
Percutaneous endoscopic gastrostomy tube placement complicated by a gastric pseudoaneurysm and recurrent hemorrhage
Authors: F. Fatade, D. Axelrod, K. Lien, D. Kaplan, S. Nagula
Journal: Endoscopy (2012)

Percutaneous endoscopic gastrostomy (PEG) tube placement is a common and safe procedure. We present a rare case of PEG tube placement complicated by visceral pseudoaneurysm formation with associated recurrent hemorrhage.
Differential Citation Rates of Major Cardiovascular Clinical Trials According to Source of Funding
Authors: David Conen, Jose Torres, Paul M Ridker
Journal: Circulation (2008)

Prior work indicates that therapeutic trials funded by for-profit organizations are more likely to report positive findings than trials funded by not-for-profit organizations. What impact, if any, funding source has on subsequent dissemination of trial data is uncertain. To address this issue, we used the number of citations per publication per year to assess differences in trial dissemination according to funding source.We assessed 303 consecutive superiority trials of cardiovascular medicine published between January 1, 2000, and July 30, 2005, in the Journal of the American Medical Association, The Lancet, and the New England Journal of Medicine. The primary outcome measure was the number of citations per publication per year up to December 31, 2006. Overall, the median number of citations per publication per year was 46 for trials funded exclusively by for-profit organizations, 37 for trials jointly funded, and 29 for trials funded by not-for-profit organizations (P=0.0007). Higher citation rates for trials funded by for-profit organizations were consistently observed in analyses stratified by journal and various trial design features and were most striking when the new intervention was favored over the standard of care; in this subgroup, the median number of citations per publication per year was 52 for trials funded by for-profit organizations compared with 25 for trials funded by not-for-profit organizations (P=0.0006). In marked contrast, in analyses limited to trials in which the new intervention was significantly worse than the standard of care, an inverse pattern was observed with fewer citations per publication per year for trials funded by for-profit organizations compared with not-for-profit organizations (33 versus 41; P=0.048). Higher citation rates were observed for industry-funded trials than for federally funded trials even when the trials dealt with similar issues and were published back-to-back in the same journal.Dissemination of clinical trial results is important for clinical practice but appears to be biased in favor of for-profit entities. Consideration should be given to more extensive promotion of clinical trial results that are funded by not-for-profit organizations.
Association between psychological symptoms in adults and growth in early life: longitudinal follow up study
Authors: Y B Cheung, K S Khoo, J Karlberg, D Machin
Journal: BMJ (2002)

Abstract Objectives: To test the hypothesis that birth weight for gestational age and weight gain in early childhood have a long term association with psychological distress in adults. Design: Longitudinal study of 1958 birth cohort followed to age 42 years. Setting: Population based birth cohort study. Participants: 9731 cohort members with valid perinatal, postnatal, and adult data. Main outcome measures: Malaise inventory scores measured at ages 23, 33, and 42 years. Generalised estimating equations approach used to analyse repeated measures. Results: Psychological distress score was inversely related to birthweight z score and weight gain from birth to the age of 7 years. A unit increase in birthweight z score or childhood weight gain was associated with a mean reduction in psychological distress score of 0.10 (95% confidence interval 0.05 to 0.15) and 0.06 (0.02 to 0.10), respectively. Birth weight and weight gain were also inversely related to the odds of having a high level of psychological distress, with odds ratios being 0.90 (0.85 to 0.95) and 0.93 (0.89 to 0.98), respectively. Conclusions: Psychological health in adults is related to fetal growth and growth in early childhood.