tbuckley/cabot-search huggingface dataset:
Reverse Structural and Gap-Junctional Remodeling After Prolonged Atrial Fibrillation in the Goat
Authors: Jannie Ausma, Huub M.W. van der Velden, Marie-Hélène Lenders, Erwin P. van Ankeren, Habo J. Jongsma, Frans C.S. Ramaekers, Marcel Borgers, Maurits A. Allessie
Journal: Circulation (2003)

Prolonged atrial fibrillation (AF) results in electrical, structural, and gap-junctional remodeling. We examined the reversibility of the changes in (ultra)structure and gap junctions.Four groups of goats were used: (1) sinus rhythm (SR), (2) 4 months' AF (4 mo AF), (3) 2 months' SR after 4 mo AF (2 mo post-AF), and (4) 4 months' SR after 4 mo AF (4 mo post-AF). Atria were characterized electrophysiologically, (ultra)structure was studied by light and electron microscopy, and structural and gap-junctional protein expression was studied by immunohistochemistry or Western blotting. The atrial effective refractory period had completely returned to normal values 2 mo post-AF. Induced AF episodes still lasted for minutes at 2 and 4 mo post-AF, compared with seconds in the SR group. Structural abnormalities were still present at 2 and 4 mo post-AF, although to a lesser extent. The increased atrial myocyte diameter was back to normal at 4 mo post-AF. The number of myocytes with severe myolysis had almost normalized 4 mo post-AF, whereas myocytes with mild myolysis remained significantly increased. Extracellular matrix area fraction after 4 mo AF was similar to SR. However, the extracellular matrix fraction per myocyte had increased after 4 mo AF and remained higher post-AF. Changes in expression of structural proteins were partially restored post-AF. The reduction of connexin 40 that was observed during AF was completely reversed at 4 mo post-AF.Recovery from structural remodeling after 4 mo AF is a slow process and is still incomplete 4 mo post-AF. Several months post-AF, the duration of AF episodes is still prolonged (minutes).
Points from Letters: Vasectomy
Authors: L. N. Jackson
Journal: BMJ (1970)

MBCLJOURNALbe administratively top-heavy without adding materially to the benefit of the patient.Many of our well-qualified senior regis- trars waiting patiently for a consultant post may feel justly envious of a medical social worker who finds himself appointed to a director's post with a sudden increase of 200% to 300% in salary, on a five-day-week basis, due
Battles of Life and Death
Authors: Don Riesenberg
Journal: JAMA (1986)

It is not surprising that good literature, which always reflects the human condition, so often deals with the practice of medicine. The title character in Tolstoy's<i>The Death of Ivan Ilyich</i>edges toward a miserable end, made worse by conflicting advice from his several physicians. In Shaw's<i>The Doctor's Dilemma</i>, a young man languishes while his physician friends debate therapeutic absurdities. Other writers, themselves physicians, have produced nonfiction, earthy accounts of frontline medicine. William Carlos Williams'<i>The Doctor Stories</i>and David Hilfiker's<i>Healing the Wounds</i>portray physicians as beleaguered and vulnerable, privileged and powerful. At its best, such work exposes "moments of a doctor's self-recognition— rendered in such a way that the particular becomes the universal, and the instantly recognizable," according to Robert Coles, another writing physician, in his introduction to<i>The Doctor Stories</i>. But the same material, clumsily handled, becomes self-serving, maudlin, and unlikely to inspire sympathy. These are
Missed and Delayed Diagnoses in the Ambulatory Setting
Authors: Thomas P. Clairmont
Journal: Annals of Internal Medicine (2007)

Letters20 March 2007Missed and Delayed Diagnoses in the Ambulatory SettingThomas P. Clairmont Jr., MDThomas P. Clairmont Jr., MDFrom Portsmouth, NH 03801.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-146-6-200703200-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR: The article by Gandhi and colleagues (1) on malpractice cases is an interesting read, but it fails to help the primary care physician in his or her quest to maximize patient safety while preventing a suit for not doing so. While the authors lament the absence of a “silver bullet,” I believe there is a simple one.I propose full disclosure of every malpractice case to every physician in his county or state on a regular basis with information from the claim file—a repository of information accumulated by the insurer during the life of the claim. This ...Reference1. Gandhi TK, Kachalia A, Thomas EJ, Puopolo AL, Yoon C, Brennan TA, et al. Missed and delayed diagnoses in the ambulatory setting: a study of closed malpractice claims. Ann Intern Med. 2006;145:488-96. LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Portsmouth, NH 03801.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMissed and Delayed Diagnoses in the Ambulatory Setting: A Study of Closed Malpractice Claims Tejal K. Gandhi , Allen Kachalia , Eric J. Thomas , Ann Louise Puopolo , Catherine Yoon , Troyen A. Brennan , and David M. Studdert Missed and Delayed Diagnoses in the Ambulatory Setting Joseph E. Marine Missed and Delayed Diagnoses in the Ambulatory Setting Eta S. Berner , Randolph A. Miller , and Mark L. Graber Missed and Delayed Diagnoses in the Ambulatory Setting Tejal K. Gandhi , Allen Kachalia , and David M. Studdert Metrics 20 March 2007Volume 146, Issue 6Page: 469KeywordsBreast cancerConflicts of interestDisclosureSafety ePublished: 20 March 2007 Issue Published: 20 March 2007 Copyright & PermissionsCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
VIRAL ANTI-INFLAMMATORY PROTEIN TREATMENT SIGNIFICANTLY ALTERS GENE EXPRESSION IN CIRCULATING LEUKOCYTES FROM PATIENTS AFTER ATRIAL FIBRILLATION CRYOBALLOON ABLATION
Authors: Adisson Fortunel, Zheng Donghang, Mohammad Al-Ani, Thomas Burkart, William Miles, Matthew McKillop, Alexandra Lucas
Journal: Journal of the American College of Cardiology (2014)
Celiac Disease — How to Handle a Clinical Chameleon
Authors: Alessio Fasano
Journal: New England Journal of Medicine (2003)

Celiac disease is an immune-mediated enteropathy triggered by the ingestion of gluten-containing grains (including wheat, rye, and barley) in genetically susceptible persons. The disease is associated with HLA-DQ2 in 90 to 95 percent of cases and with HLA-DQ8 in 5 to 10 percent of cases and is self-perpetuating in the continued presence of gluten.1 It is the interplay between genes (both HLA and other types) and environment (i.e., gluten) that leads to the intestinal damage that is typical of the disease.2 Under physiologic circumstances, this interplay is prevented by competent intercellular tight junctions, structures that limit the passage of macromolecules . . .
Influence of sleep on ventilatory and upper airway response to CO2 in normal subjects and patients with COPD.
Authors: J C Meurice, I Marc, F Sériès
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

In order to investigate the influence of the dynamic changes in upper airway (UA) resistance in the pathophysiology of noctural hypoventilation in COPD, we compared the ventilatory pattern and UA resistance, measured at baseline and during CO2 rebreathing, in nine normal men and 13 patients with COPD. Measurements were made during wakefulness and during non-REM sleep during a morning nap after a sleep deprivation night. Ventilatory parameters (VE, VT, VT/TI) were calculated from flow measurements using a Fleich no. 3 pneumotachograph connected to a fitting nasal mask. Pharyngeal pressure was measured with a low-bias catheter referenced to the mask pressure. Baseline UA resistances (supraglottic resistance: SGR) values were similar in the two groups. They significantly increased in both groups from wakefulness to sleep. Furthermore, VE and VT/TI were higher in patients with COPD than in normal subjects during wakefulness and during sleep. The slope of the VE/PETCO2 relationship was significantly lower in patients with COPD than in normal subjects (p = 0.0001), without any significant decrease between wakefulness and sleep. SGR systematically decreased during CO2 rebreathing in both groups during wakefulness and during sleep. The slope of SGR/PETCO2 relationship was lower in patients with COPD than in control subjects during sleep and during wakefulness (p = 0.005), whereas the decrease in SGR with increased VE and VT/TI was similar in both groups and not influenced by sleep. We conclude that the impediment in UA resistance behavior in response to a hypercapnic stimulus in patients with COPD is related to the decrease in their ventilatory response.
Does This Patient Have Sinusitis?
Authors: Allan S. Brett
Journal: JAMA (1994)

<h3>To the Editor.</h3> —The article on sinusitis by Williams and Simel<sup>1</sup>is a valuable contribution, but the authors overstate their case in two areas. First, they cite two studies of maxillary sinusitis<sup>2,3</sup>to support their claim that "randomized trials have shown that sinusitis requires antibiotics for rapid resolution." The word "requires" is too strong here, since a majority of untreated subjects in both studies were improved or cured at 10 days. Moreover, one was a pediatric study that may not be applicable to adults.<sup>2</sup>The other was an adult study with methodologic weaknesses.<sup>3</sup>A primary end point was "subjective" improvement, but patients and investigators were not blinded to treatment; and the "nasal decongestant only" group had more bilateral sinusitis and completely opacified sinuses than the lincomycin group, suggesting that more complicated cases might have been assigned to the no-antibiotic group. Interestingly, an authority cited by Williams
TCT-249 Differential Impact Of Diabetes Mellitus On Safety And Efficacy Of New Versus First Generation Drug-eluting Stents Among Women: A Patient-level Pooled Analysis Of 26 Randomized Trials
Authors: Usman Baber, Giulio G. Stefanini, Stephan Windecker, Marie-Claude Morice, Samantha Sartori, Martin Leon, Gregg W. Stone, Philippe G. Steg, Alaide Chieffo, Roxana Mehran
Journal: Journal of the American College of Cardiology (2014)
Histoplasmin Tine Test As a New Diagnostic Aid
Authors: Abel Froman
Journal: JAMA (1969)

Recent reports indicate that histoplasmosis is a widespread infection or disease or both, affecting rural and urban populations. Long known to be endemic in Mississippi and Ohio River valley communities, the infection has now become the concern of eastern and midwestern communities.<sup>1-6</sup> Infection is usually transmitted by airborne dust which contains<i>Histoplasma capsulatum</i>spores. Birds are considered to play some role in the life cycle of this organism, probably by adding to the soil, through excreta, a factor that favors the growth of the fungus. They may also aid in disseminating this agent by carrying to new locations, on feet and feathers, fecal dust infested with spores. The grounds of the Manteno State Hospital, which is the largest mental facility in Illinois with a bed capacity of approximately 5,000, have been under study as a microenvironment of histoplasmosis during the past ten years. Many portions of these grounds which
Measles Vaccination with Reduced Dosage
Authors: R. G. Hendrickse, D. Montefiore
Journal: BMJ (1968)

A field trial is reported in which good sero-conversion rates were obtained when a dose of 200 TCID(50) Beckenham 31 strain (Wellcovax) measles vaccine was administered by Ped-O-Jet subcutaneously in a volume of 0.5 ml. per dose. It is suggested that use of this reduced dosage would lead to a significant reduction in the cost per dose of the vaccine, especially when administered on a scale large enough to justify the use of multidose containers.
Pediatric Trauma: Getting Triage Right-Reply
Authors: Christoph R. Kaufmann
Journal: JAMA (1990)

<h3>In Reply.—</h3> Dr Di Scala points out a valid concern. While overtriage is a resource utilization problem, undertriage resulting in inadequate medical care is important to the individual patient. This study used an Injury Severity Score of 15 as the indicator for appropriate triage in evaluating the Revised Trauma Score and the Pediatric Trauma Score as triage tools. Although an Injury Severity Score greater than 15 is often used as a proxy for severe injury and has been useful in evaluating populations of patients, this value is arbitrary and for an individual patient may either overestimate or underestimate the actual need for trauma center care. Other criteria of appropriate triage need to be developed. Examination of individual patients receiving undertriage by the Revised Trauma Score but not by the Pediatric Trauma Score may demonstrate that some of these patients did not actually need trauma center care as evaluated by other
Diabetic cardiomyopathy? An echocardiographic study of young diabetics.
Authors: J E Sanderson, D J Brown, A Rivellese, E Kohner
Journal: BMJ (1978)

An echocardiographic study was carried out on 23 young diabetics, 19 of whom had retinopathy. Their diastolic function was analysed by comparing the timing and pattern of mitral valve opening with the pattern of left ventricular wall movement. Only six patients had all their values within the normal range. Fourteen patients had abnormalities similar to those seen in patients with cardiomyopathy; the close time relation between mitral valve movement and wall movement was lost and mitral valve opening delayed in eight patients. Three other patients had considerable outward wall movement before mitral valve opening, which is characteristic of ischaemic heart disease. Although these studies provide no definite evidence of a cause, the abnormalities found may reflect a subclinical diabetic cardiomyopathy due to small-vessel disease.
Painful scoliosis: a need for further investigation.
Authors: L J Taylor
Journal: BMJ (1986)

American children start school at 6-61/2, but schools will usually accept foreign children who have started school at home.Inoculation against measles, mumps, and German measles in addition to diphtheria, pertussis and tetanus and polio may be required before admission to school, but this can be arranged on arrival. LecturesPrepare a couple of seminars, with slides, on any original work or investigation previously performed.In addition, slides of British cities and countryside are worth having for informal lectures to show at the children's school and to friends.
New Light on William Harvey
Authors: William C. Gibson
Journal: JAMA (1979)

This expansion of Pagel's earlier essay<i>William Harvey Revisited</i>continues the scholarly work that readers so enjoyed in his 1967 publication<i>William Harvey's Biological</i>Ideas. The book is divided into ten chapters, some short, with chapter 10 on "Harvey, Aristotle, and Medieval Revisionism" running to 40 pages. Useful appendices of more than 50 pages precede a brief final assessment. Despite 467 footnotes there is an additional bibliography and an excellent index. This is a volume written by a scholar's scholar. He makes clear at the outset that if there was any discovery, it was Harvey's idea that the blood must in some way circulate if one attempted to account (1) for the vast volume of fluid pumped and (2) for the positioning of valves in the veins and in the heart. Pagel, to good effect, quotes Sir Henry Dale's view of Harvey: "He created and displayed for all time the
CD34 immunohistochemistry of bone marrow biopsies: Prognostic significance in primary myelodysplastic syndromes
Authors: Davide A. Soligo, Alessandro Oriani, Claudio Annaloro, Agostino Cortelezzi, Rossella Calori, Ermanno Pozzoli, Diego Nosella, Attilio Orazi, Giorgio Lambertenghi Deliliers
Journal: American Journal of Hematology (1994)

Abstract Bone marrow (BM) biopsies from 58 patients with primary myelodysplastic syndrome (MDS) were studied using QBEND10, a monocional antibody that recognizes the human progenitor CD34 antigen in routine aldehyde‐fixed paraffin‐embedded samples. FAB subtypes were RA (5 patients), RARS (9 patients), RAEB (20 patients), RAEBt (11 patients), CMML (3 patients). In addition, 10 MDS patients whose BM biopsies revealed heavy reticulum fibrosis were included. Neither the percentage of CD34 + cells nor the number of CD34 + aggregates (defined as clusters of 3 or more cells) correlated with the presence and morphology of abnormal localizations of immature precursors (ALIP). When all patients were considered, median survival was 69 months in those with less, and 25 months in patients with more than 1% CD34 + cells ( P &lt; 0.05). Median survival was 15 months in patients with CD34 + aggregates and 41 months in those without aggregates ( P = 0.0017). When RAEB patients were considered median survival was 41 months in those with less than 1%, and 29 months in those with more than 1% CD34 + cells; the 4‐year survival chance was 45% in the former and 18.3% in the latter group. Therefore, CD34 positivity of more than 1% identifies a subset of RAEB patients with shorter life expectancy. In addition, leukemic transformation was observed in 11 of 35 patients (31%) with no CD34 aggregates, but in 14 of 23 patients (60%) with aggregates ( P &lt; 0.05). CD34 immunostaining, which can be easily performed on routinely prepared BM biopsies, was found to be a powerful prognostic tool for predicting survival and outcome in MDS. © 1994 Wiley‐Liss, Inc.
Phosphorylation of Cell Surface Receptors: A Mechanism for Regulating Signal Transduction Pathways
Authors: DAVID R. SIBLEY, JEFFREY L. BENOVIC, MARC G. CARON, ROBERT J. LEFKOWITZ
Journal: Endocrine Reviews (1988)

SPECIFIC receptors, located in the plasma membranes of cells, are crucially involved in mediating the acute and chronic effects of a wide variety of hormones, drugs, growth factors, antigens, and other ligands. Some membrane receptors are involved in transporting various important molecules into the cell by a process known as receptor-mediated endocytosis. An important insight which has emerged from recent research is that both the function and subcellular distribution of many such receptors are dynamically regulated. Phosphorylation/dephosphorylation represents perhaps the most intensively studied reversible covalent modification of enzymes which is known to have regulatory significance (1, 2). Considerably more is known about the kinases than the phosphatases. Only recently has it begun to be appreciated that the function of noncatalytic proteins, such as receptors, may also be regulated in this way. We review here the important plasma membrane receptor systems thus far studied whose function and/or cellular trafficking has been demonstrated to be regulated by phosphorylation. Available information suggests a number of principles which may be generally applicable as well as several testable hypotheses.
Immunoblot assay for detection of salivary antibodies directed against Helicobacter pylori
Authors: S KARVAR, W BURGHARDT, U GROSS
Journal: Gut (1998)

Editor,—The study by Reilly et al ( Gut 1997; 40 :454–8) showing that analysing saliva for the presence of Helicobacter pylori specific antibodies might be useful for diagnosis is interesting and prompted us to investigate the H pylori specific antibody response of the IgA and IgG class in serum and saliva using the immunoblot assay in 90 patients with chronic gastritis who underwent gastroscopy. H pylori carrier status was defined …
Mass Media Antismoking Campaigns: A Powerful Tool for Health Promotion
Authors: Michael Siegel
Journal: Annals of Internal Medicine (1998)

Cigarette advertising and promotion have been shown to influence smoking in young persons, but the powerful effect of the mass media on behavior can also be used to promote health.Several states have earmarked a portion of their cigarette excise tax revenues to fund mass media antismoking campaigns, which have been effective in reducing cigarette consumption and in helping persons quit smoking. Despite their successes, the campaigns have been hindered by tobacco industry-supported attempts to cut their funding or restrict their scope. The most aggressive campaigns, which attack the tobacco industry and challenge social norms about tobacco use and promotion, are the most controversial but also the most effective. Mass media antismoking campaigns are a promising tool for health promotion, but only if sustained funding can be guaranteed and the development of the advertisements can be protected from intrusion by political forces.
Failure of parathyroid hormone antagonists to inhibit in vitro bone resorbing activity produced by two animal models of the humoral hypercalcemia of malignancy.
Authors: S M D'Souza, K J Ibbotson, G R Mundy
Journal: Journal of Clinical Investigation (1984)

The humoral hypercalcemia of malignancy (HHM) is caused by tumor cells that release a circulating factor which stimulates osteoclastic bone resorption. Recently, it has been reported that tumors associated with HHM contain factors that stimulate renal and bone cell adenylate cyclase. The activity was inhibited by parathyroid hormone (PTH) antagonists, and this led to the hypothesis that hypercalcemia is due to bone resorbing factors that engage PTH receptors in bone. Since it is not known whether the bone resorbing factors act via PTH receptors in bone, we examined the effects of PTH antagonists on PTH-stimulated bone resorption and bone resorbing activity that was produced by two tumor models of HHM which also release these adenylate cyclase stimulating factors. The PTH antagonists [8,18norleucine, 34tyrosine]bovine PTH (3-34) amide and [34tyrosine]bovine PTH (7-34) completely inhibited PTH-stimulated bone resorption. Neither antagonist inhibited bone resorption that was stimulated by the conditioned medium from cells that were derived from the Walker rat 256 tumor model of HHM. Both antagonists also failed to inhibit bone resorption that was stimulated by culture media from cells that were derived from the rat Leydig cell tumor. These data suggest that in these two models of HHM, the bone resorbing factors do not exert their effects by interacting with PTH receptors on bone.
Serum Ferritin and Iron Enrichment
Authors: William H. Crosby
Journal: New England Journal of Medicine (1974)

On April 1, 1970, the Federal Register contained a proposal to require that the dose of iron added to enriched flour be increased to a level 400 per cent of that now added (present level, 3 mg of iron per 100 g of flour, and proposed level, 13 mg per 100 g). This means that everyone in the United States would have the amount of iron in his diet substantially increased. The legislation's intent is to prevent iron-deficiency anemia, especially among young women — that is to say, menstruating women.Opposition to the proposal has, thus far, blocked its implementation. . . .