tbuckley/cabot-search huggingface dataset:
Nature of pulmonary hypertension in congestive heart failure. Effects of cardiac transplantation.
Authors: R Naeije, A Lipski, M Abramowicz, P Lejeune, C Mélot, M Antoine, J M De Smet, J L Leclerc, G Primo
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

Pulmonary hypertension associated with congestive heart failure carries a risk of right ventricular failure after cardiac transplantation. Few data, however, are available on the hemodynamic behavior of the pulmonary circulation in these patients. We therefore studied mean pulmonary artery pressure minus left atrial pressure (estimated by pulmonary artery occluded pressure) versus cardiac output relationships in 20 patients with congestive heart failure evaluated for orthotopic cardiac transplantation, and we repeated this study either within the first 3 days postoperatively (n = 10) or 1 month postoperatively (n = 11). Cardiac output was increased by physical exercise or (in the early postoperative period) by an infusion of dobutamine. Reversibility of pulmonary hypertension was tested by an infusion of prostaglandin E1. At preoperative evaluation, the extrapolated pressure intercept of pulmonary vascular pressure:flow plots was negative in 10 of the patients, suggesting active exercise-induced pulmonary vasoconstriction. In the other 10 patients, the extrapolated pressure intercept was positive, suggesting that an increased closing pressure contributed to pulmonary hypertension. However, transplantation was constantly associated with proportional decreases of pulmonary artery pressure and left atrial pressure. On the other hand, pulmonary vascular pressure:flow plots were displaced to equal or lower pressures and to higher flows by prostaglandin E1 before as well as after transplantation. We conclude that in patients with congestive heart failure evaluated for cardiac transplantation, an increased pulmonary venous pressure more than a reversible increase in closing pressure determines the severity of pulmonary hypertension.
A look at autoimmunity and inflammation in the eye
Authors: Rachel R. Caspi
Journal: Journal of Clinical Investigation (2010)

Autoimmune and inflammatory uveitis are a group of potentially blinding intraocular inflammatory diseases that arise without a known infectious trigger and are often associated with immunological responses to unique retinal proteins. In the United States, about 10% of the cases of severe visual handicap are attributed to this group of disorders. As I discuss here, experimental models of ocular autoimmunity targeting retinal proteins have brought about a better understanding of the basic immunological mechanisms involved in the pathogenesis of uveitis and are serving as templates for the development of novel therapies.
Out-of-hours calls in a Leicestershire practice.
Authors: M G Crowe, D S Hurwood, R W Taylor
Journal: BMJ (1976)

In one year, 920 "out-of-hours" calls were received by a partnership of three general practitioners working from a health centre in semi-rural Leicestershire. The partners on duty saw 588 patients. Out of 898 patients on whom information was available only 75 (8-5%) were referred to hospital, mainly as casualties. The results are compared with a study of deputising services, and it is concluded that a partnership covering its own out-of-hours calls can provide a more personal service and appears to make fewer demands on NHS resources.
Balloon occlusion of atrial septal defect to assess right ventricular capability in hypoplastic right heart syndrome.
Authors: J L Bass, B P Fuhrman, J E Lock
Journal: Circulation (1983)

Early surgery for forms of hypoplastic right heart syndrome may increase right ventricular size but could leave the patient with a residual right-to-left atrial shunt. Previous attempts to assess the capability of the right ventricle to accept systemic venous return have relied on angiographic estimates of tricuspid valve and right ventricular sizes. Since the minimum adequate sizes have not been established, we used a more physiologic technique of temporarily occluding the interatrial communication with a balloon-tipped catheter at cardiac catheterization in six consecutive patients. Five patients tolerated complete occlusion, although the tricuspid valve anulus diameter was less than the fifth percentile in all, and right ventricular volume was less than the fifth percentile in four. These five underwent surgical closure of an interatrial communication without evidence of postoperative systemic venous hypertension. Attempted occlusion in the sixth patient caused profound systemic venous hypoxia and surgical closure was not attempted. Temporary balloon occlusion may improve selection of patients for definitive operation.
Monophasic action potentials in patients with coronary artery disease: reproducibility and electrical restitution and conduction at different stimulation rates
Authors: K. ENDRESEN, J. P AMLIE, K. FORFANG, S. SIMONSEN, O. JENSEN
Journal: Cardiovascular Research (1987)

Monophasic action potentials were recorded in the outflow tract of the right ventricle in patients with coronary artery disease during ventricular pacing at different basic cycle lengths and programmed stimulation. During continuous pacing (basic cycle length 600 ms) the time for 90% repolarisation (MAP90) and the QTa interval decreased exponentially during the first 1.5-2 min of pacing to 90% of control values. The reproducibility of the monophasic action potential signals and the ventricular effective refractory period were assessed as good when studied after repetitive trains of 8 beats for more than 1.5 min. The reproducibility of conduction, however, was less good. Electrical restitution of MAP90 duration of the premature beats determined at three different basic cycle lengths was different from that in single muscle preparations. The curves showed two phases with unchanged MAP90 durations despite longer coupling intervals. The first phase was close to the ventricular effective refractory period, probably because subnormal conduction left the diastolic interval constant for the earliest premature beats. This indicates that subnormal conduction may influence the premature dispersion of repolarisation.
PRAME mRNA levels in cases with acute leukemia: Clinical importance and future prospects
Authors: Semra Paydas, Kahraman Tanriverdi, Sinan Yavuz, Umut Disel, Fikri Baslamisli, Refik Burgut
Journal: American Journal of Hematology (2005)

The PRAME (preferentially expressed antigen of melanoma) gene has been shown to be expressed in high levels in some solid tumors and hemopoietic neoplasias but not or only weakly expressed in normal tissues. It encodes an antigen recognized by autologous cytolytic T lymphocytes. PRAME is a good candidate for tumor immunotherapy and is a useful marker gene for detection of minimal residual disease (MRD). In this study, PRAME mRNA using real-time RT-PCR was studied in 74 adult cases with acute leukemia-68 had de-novo acute leukemia, 3 had chronic myeloid leukemia-blastic crisis (CML-BC), and 3 had myelodysplastic/myeloproliferative syndrome-blastic transformation (MDS/MPD-BT)-and the results were compared with 30 age-matched healthy volunteers. Nineteen of 74 cases with leukemia expressed PRAME, while only 2 controls showed weak expression. The prevalence of PRAME expression in AML and ALL cases was 30% and 17%, respectively. We did not find any important correlation between PRAME expression and clinical characteristics, such as age, sex, organomegaly/lymphadenopathy, Hb, WBC count, platelet count, LDH level, alkaline phosphatase, albumin, cell-surface antigens, response to therapy, or progression-free and overall survival. PRAME was monitored in 15 cases during remission and/or relapse. There was a good correlation between PRAME mRNA and hematological remission and/or relapse. Interestingly, PRAME was very high in one case with AML but was not found 3 months after allogeneic transplantation. PRAME mRNA is observed in about one-third of AML cases; it may be a useful marker to detect MRD, and it may also be a good predictor for the timing of donor lymphocyte infusions (DLI) in the post-transplant period in cases of molecular relapse.
EU appoints Ebola coordinator
Authors: R. Watson
Journal: BMJ (2014)

The European Union is stepping up its efforts to tackle the Ebola crisis in west Africa by appointing an overall coordinator, increasing funding, and deploying more medical and support staff to the region.

The issue was high on the agenda of the EU leaders’ summit meeting in Brussels on 23 and 24 October. They agreed that, with the first confirmed cases of Ebola virus disease in Europe, protection of European countries and their citizens was “of the utmost importance.” They pointed to the need for precautionary measures “to reduce risks of contagion, including coordinated preventive …
Dealing with Uncertainty, Risks, and Tradeoffs in Clinical Decisions
Authors: A J Moskowitz, B J Kuipers, J P Kassirer
Journal: Annals of Internal Medicine (1988)

To generate hypotheses about how physicians make difficult clinical decisions, we analyzed transcripts of the "thinking aloud" behavior of expert clinicians making a testing or treatment decision with an uncertain diagnosis. We compared the clinicians' reasoning with a decision analysis of the same problem. The experts did not formulate a global outline of their decision, but chained together a sequence of decisions based on available and incomplete information. Despite effective and efficient problem solving, the clinicians used numeric terms only as symbolic representations of likelihood, used limited information in choosing among alternatives, and dismissed the possibility that a less conventional strategy, empiric therapy, might yield equivalent outcome. We describe cognitive problem-solving strategies and knowledge representations that permit persons to make successful decisions despite limited processing resources. The same cognitive procedures probably contribute to observed errors in decision-making under uncertainty.
Acute upper gastrointestinal bleeding in patients with AIDS: a relatively uncommon condition associated with reduced survival.
Authors: F Parente, M Cernuschi, L Valsecchi, G Rizzardini, M Musicco, A Lazzarin, G Bianchi Porro
Journal: Gut (1991)

To determine the cumulative incidence of acute upper gastrointestinal bleeding and its effect upon survival in patients with AIDS, 453 consecutive AIDS patients diagnosed in our hospital between June 1985 and March 1989 were followed for a median period of six months (maximum 42 months). The cumulative probability of acute gastrointestinal bleeding was 3% at six months and 6% at 14 months. This event was associated with significantly reduced survival. Independent risk factors for bleeding were: severe thrombocytopenia at the time of diagnosis and non-Hodgkin9s lymphoma as the first clinical manifestation of AIDS. The potential causes of bleeding were investigated in all cases by emergency endoscopy or by necropsy examination in those patients whose clinical condition precluded the procedure. In nine of 15 patients, bleeding was due to lesions specifically associated with AIDS, but in the remainder the source of bleeding was not a direct consequence of HIV infection. We conclude that acute upper gastrointestinal bleeding rarely complicates the course of AIDS, but its occurrence is associated with decreased survival. As many of the causes are potentially treatable, a complete diagnostic approach is indicated in these patients, except those who are terminally ill.
Abstract 3587: XL184: c-Met inhibition is effective in a mouse xenograft model of metastatic uveal melanoma
Authors: Iwei Yeh, Klaus Griewank, Vivianne W. Ding, Boris C. Bastian
Journal: Cancer Research (2011)

Abstract Oncogenic mutation of GNAQ is an early event in uveal melanoma development. Identification of critical downstream effectors of GNAQ could allow for targeted therapy of this deadly form of melanoma. We identified c-Met upregulation as a downstream effect of GNAQ Q209L mutation by analyzing expression changes in immortalized mouse melanocytes transduced with GNAQ Q209L. By Western blot, we established that c-Met protein expression is increased in human uveal melanoma cell lines that harbor a GNAQ activating mutation compared to lines with wild-type GNAQ. XL184 is a small-molecule tyrosine kinase inhibitor that has activity against c-Met. In vitro assays of XL184 demonstrated preferential activity against human uveal melanoma cell lines (OMM1.3 and Mel202) with GNAQ activating mutations. Intravenous injection of 1×106 OMM1.3 cells into immunocompromised NSG mice results in the development of multiple liver tumor nodules after 6-8 weeks, recapitulating liver tropism (over 80% of patients with metastatic uveal melanoma have liver metastases). We treated mice starting four weeks after OMM1.3 intravenous injection with XL184. After four weeks of treatment, the treated mice demonstrated decreased liver tumor size with central tumor necrosis on histologic examination. The activity of XL184 is likely through its inhibition of c-Met signaling as we found little expression of the other targets of XL184 in OMM1.3. In conclusion, XL184 demonstrates activity in a mouse xenograft model of metastatic uveal melanoma, and has potential to be active against hepatic metastases of uveal melanoma, the major cause of mortality in this rare cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3587. doi:10.1158/1538-7445.AM2011-3587
Occupational skin exposure to water: a population-based study
Authors: I. Anveden Berglind, M. Alderling, B. Järvholm, C. Lidén, B. Meding
Journal: British Journal of Dermatology (2008)

Background Occupational exposure to skin irritants, in particular to water, is an important risk factor for hand eczema. Objectives To assess occupational skin exposure to water in the general population. Methods As part of a public health survey in Stockholm, Sweden, 18 267 gainfully employed individuals aged 18–64 years completed a questionnaire with previously validated questions regarding occupational skin exposure to water. Results Altogether 16% reported exposure to water for ½ h or more a day, and 13% reported exposure to water more than 10 times a day. Furthermore, 7% reported water exposure of more than 2 h and 6% of more than 20 times a day. Women reported more water exposure than men and many female‐dominated occupations were seen to comprise water exposure. Women were also more exposed than men within the same jobs. Young adults were more exposed than older. A total of 18% were employed in high‐risk occupations for hand eczema. Fifty‐nine per cent of individuals employed in high‐risk occupations reported water exposure at work, compared with 11% in low‐risk occupations. Conclusions A total of 20% of the population of working age acknowledged occupational skin exposure to water, which was found to be more common in young adults and women. Using job title as a proxy for water exposure gives an underestimation due to misclassification. In assessing occupational skin exposure to water, both exposure time and frequency should be considered.
IMPROVED SURVIVAL-RATES IN PRESENSITISED RECIPIENTS OF KIDNEY TRANSPLANTS BY IMMUNOSUPPRESSION WITH MATERNAL-SOURCE GAMMA-GLOBULIN
Authors: RobertR. Riggio, SungJ. Kim, StuartD. Saal, WilliamT. Stubenbord, JhoongS. Cheigh, KurtH. Stenzel, AlbertL. Kubin
Journal: The Lancet (1978)
An Address Delivered at the Opening of the Section of Obstetric Medicine and Gynaecology
Authors: T. Savage
Journal: BMJ (1890)

able office.The matter is I think of great importance alike to the public and the profession, and of supreme moment to our medical students.The subject I refer to is the teaching of operative surgery in our schools.Among a body of experts I need not dwell upon the im- portance of such teaching.Each one of us knows that years after our book studies, and after having passed our examinations, we were diligent students in the art of our calling; to some operative dexterity never comes even atter years of practice-to none does it come without reite- rated experiences.
The Long-Term Effect of Premier Pay for Performance on Patient Outcomes
Authors: Ashish K. Jha, Karen E. Joynt, E. John Orav, Arnold M. Epstein
Journal: New England Journal of Medicine (2012)

Pay for performance has become a central strategy in the drive to improve health care. We assessed the long-term effect of the Medicare Premier Hospital Quality Incentive Demonstration (HQID) on patient outcomes.We used Medicare data to compare outcomes between the 252 hospitals participating in the Premier HQID and 3363 control hospitals participating in public reporting alone. We examined 30-day mortality among more than 6 million patients who had acute myocardial infarction, congestive heart failure, or pneumonia or who underwent coronary-artery bypass grafting (CABG) between 2003 and 2009.At baseline, the composite 30-day mortality was similar for Premier and non-Premier hospitals (12.33% and 12.40%, respectively; difference, -0.07 percentage points; 95% confidence interval [CI], -0.40 to 0.26). The rates of decline in mortality per quarter at the two types of hospitals were also similar (0.04% and 0.04%, respectively; difference, -0.01 percentage points; 95% CI, -0.02 to 0.01), and mortality remained similar after 6 years under the pay-for-performance system (11.82% for Premier hospitals and 11.74% for non-Premier hospitals; difference, 0.08 percentage points; 95% CI, -0.30 to 0.46). We found that the effects of pay for performance on mortality did not differ significantly among conditions for which outcomes were explicitly linked to incentives (acute myocardial infarction and CABG) and among conditions not linked to incentives (congestive heart failure and pneumonia) (P=0.36 for interaction). Among hospitals that were poor performers at baseline, mortality was similar in the two groups of hospitals at the start of the study (15.12% and 14.73%; difference, 0.39 percentage points; 95% CI, -0.36 to 1.15), with similar rates of improvement per quarter (0.10% and 0.07%; difference, -0.03 percentage points; 95% CI, -0.08 to 0.02) and similar mortality rates at the end of the study (13.37% and 13.21%; difference, 0.15 percentage points; 95% CI, -0.70 to 1.01).We found no evidence that the largest hospital-based pay-for-performance program led to a decrease in 30-day mortality. Expectations of improved outcomes for programs modeled after Premier HQID should therefore remain modest.
The Comparative Pathology of Genetically Engineered Mouse Models for Neuroendocrine Carcinomas of the Lung
Authors: Adi F. Gazdar, Trisha K. Savage, Jane E. Johnson, Anton Berns, Julien Sage, R. Ilona Linnoila, David MacPherson, David G. McFadden, Anna Farago, Tyler Jacks, William D. Travis, Elisabeth Brambilla
Journal: Journal of Thoracic Oncology (2015)
Allogeneic hematopoietic cell transplantation following nonmyeloablative conditioning as treatment for hematologic malignancies and inherited blood disorders
Authors: Frédéric Baron, Rainer Storb
Journal: Molecular Therapy (2005)

Allogeneic hematopoietic cell transplantation (HCT) after myeloablative conditioning regimens has been an effective treatment for many patients with hematologic malignancies or inherited blood disorders. Unfortunately, such regimens have been associated with significant toxicity, limiting their use to otherwise healthy, relatively young patients. In an attempt to extend treatment by allogeneic HCT to older patients and those with comorbid conditions, several groups of investigators have developed reduced-intensity or truly nonmyeloablative conditioning regimens, lacking such toxicity. Analogous to conventional regimens, reduced-intensity regimens both eliminated host-versus-graft (rejection) reactions and produced major anti-tumor effects. In contrast, nonmyeloablative regimens have relied on optimizing both pre-and posttransplant immunosuppression to overcome host-versus-graft reactions, while anti-tumor responses have depended mainly on immune-mediated graft-versus-tumor effects. In this review, we define reduced-intensity and truly nonmyeloablative regimens, describe the preclinical development and clinical application of a very low intensity nonmyeloablative regimen, and review results with reduced-intensity regimens in patients with hematologic malignancies or inherited blood disorders.
Autonomic Neuropathy Influences Great Toe Blood Pressure
Authors: Luigi Uccioli, Giovanna Monticone, Laura Durola, Francesco Russo, Flaminio Mormile, Gioacchino Mennuni, Guido Menzinger
Journal: Diabetes Care (1994)

OBJECTIVE To assess the influence of autonomic neuropathy on toe blood pressure (TBP), a parameter used currently as an ischemic index. RESEARCH DESIGN AND METHODS The age-matched study subjects included 20 non-insulin-dependent diabetes mellitus (NIDDM) patients with autonomic neuropathy (DN) and 10 NIDDM patients without autonomic neuropathy (D), assessedby standard cardiovascular tests and galvanic skin response, and 8 control subjects (C). None of the subjects had peripheral vascular disease (PVD) (ankle/brachial index 0.9–1.1. RESULTS The TBP and toe/brachial index (TBI) were significantly lower in DN than in C and D (P &amp;lt; 0.01). The saturation index (SI), the ratiobetween foot venous and arterial partial pressure of oxygen (PO2), was significantly higher in DN than in C and D (P &amp;lt; 0.05). An inverse relationship was found between TBI and SI (r = 0.554, P = 0.001). CONCLUSIONS The autonomic nervous system directly influences peripheral circulation. In diabetic patients without PVD, a failure of sympathetic fibers caused by autonomic neuropathy could lead to a reduction of TBP. Therefore, TBP cannot be used as an ischemic index in diabetic patients.
ACTN1-related thrombocytopenia: identification of novel families for phenotypic characterization
Authors: Roberta Bottega, Caterina Marconi, Michela Faleschini, Gabriele Baj, Claudia Cagioni, Alessandro Pecci, Tommaso Pippucci, Ugo Ramenghi, Simonetta Pardini, Loretta Ngu, Carlo Baronci, Shinji Kunishima, Carlo L. Balduini, Marco Seri, Anna Savoia, Patrizia Noris
Journal: Blood (2014)
THE TREATMENT OF THE BLADDER IN GUNSHOT INJURIES OF THE SPINAL CORD
Authors: F. Kidd
Journal: BMJ (1919)

TU BLADDER' Bladder.~A.In the central nervous system: (1) Response to tension on, IN GUNSHOT INJURIES OFthe part of the-detrusor muscle;(2) re'laaation of the~sphincter' uruscle;(3)-exrae mcl "Imass" i6tdlexe.'Thes hold goof THE SPINAL CORD.~~~~eveii in the40M~In$bt absence of -the spinal -ord.The site of tbeleson-hi he-ear nikeono difference.flY L~~~~~~~~~B.Shock, fever, and" other general states.E!-Cystitig,