tbuckley/cabot-search huggingface dataset:
Risk Factors Related to Infections of Implanted Pacemakers and Cardioverter-Defibrillators
Authors: Didier Klug, Mamadou Balde, Dominique Pavin, Françoise Hidden-Lucet, Jacques Clementy, Nicolas Sadoul, Jean Luc Rey, Gilles Lande, Arnaud Lazarus, Jacques Victor, Claude Barnay, Bruno Grandbastien, Salem Kacet
Journal: Circulation (2007)

Background— The Prospective Evaluation of Pacemaker Lead Endocarditis study is a multicenter, prospective survey of the incidence and risk factors of infectious complications after implantation of pacemakers and cardioverter-defibrillators. Methods and Results— Between January 1, 2000, and December 31, 2000, 6319 consecutive recipients of implantable systems were enrolled at 44 medical centers and followed up for 12 months. All infectious complications were recorded, and their occurrence was related to the baseline demographic, clinical, and procedural characteristics. Among 5866 pacing systems, 3789 included 2 and 117 had &gt;2 leads; among 453 implantable cardioverter-defibrillators, 178 were dual-lead systems. A total of 4461 de novo implantations occurred and 1858 pulse generator or lead replacements. Reinterventions were performed before hospital discharge in 101 patients. Single- and multiple-variable logistic regression analyses were performed to identify risk factors; adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated. At 12 months, device-related infections were reported in 42 patients (0.68%; 95% CI, 0.47 to 0.89). The occurrence of infection was positively correlated with fever within 24 hours before the implantation procedure (aOR, 5.83; 95% CI, 2.00 to 16.98), use of temporary pacing before the implantation procedure (aOR, 2.46; 95% CI, 1.09 to 5.13), and early reinterventions (aOR, 15.04; 95% CI, 6.7 to 33.73). Implantation of a new system (aOR, 0.46; 95% CI, 0.24 to 0.87) and antibiotic prophylaxis (aOR, 0.4; 95% CI, 0.18 to 0.86) were negatively correlated with risk of infection. Conclusions— This study identified several factors of risk of device infection and confirmed the efficacy of antibiotic prophylaxis in recipients of new or replacement pacemakers or implantable cardioverter-defibrillators.
Revalidation will not reliably detect poorly performing doctors
Authors: L. Lowenthal
Journal: BMJ (2012)

Thank you, Nigel Hawkes, for your article on revalidation.1 The press has claimed that revalidation will safeguard the public from poorly performing doctors by using five yearly checks. As a GP with an interest in education and assessment I share your concern that the public has been misled.

The revalidation process will centre on self analysis by appraisees, and …
The choleretic effect of iodipamide.
Authors: G K Feld, P M Loeb, R N Berk, H O Wheeler
Journal: Journal of Clinical Investigation (1975)

It is well established that a number of organic anions are excreted by the liver into bile in association with a marked increase in bile flow. Previous studies have shown that iodipamide (3,3'-(adipoyl-diimino)bis[2,4,6-triiodobenzoic acid]), the radiographic contrast material used for intravenous cholangiography, is a potent choleretic. Experiments were performed in unanesthetized dogs to determine if the increased bile flow produced by iodipamide is canalicular or ductular in origin, to quantitate the choleresis associated with iodipamide and taurocholate excretion, and to correlate these findings with the results of in vitro studies in which the osmotic activities of iodipamide and taurocholate in both isotonic saline and bile were determined. The plasma erythritol clearance increase linearly with the excretion of iodipamide, indicating that iodipamide stimulates canalicular bile flow. The choleretic potency of iodipamide (22 ml/mmol) is approximately 3 times that of taurocholate (7.8 ml/mmol), yet the osmotic activity of iodipamide in bile (1.5 mosmol/mmol) is only twice as great as that of taurocholate in bile (0.8 mosmol/mmol). It therefore appears that, per unit of effective osmotic solute secreted, iodipamide carries more water into the bile canaliculi than does taurocholate.
Treatment of acne with intermittent isotretinoin
Authors: V. GOULDEN, S.M. CLARK, C. MCGEOWN, W.J. CUNLIFFE
Journal: British Journal of Dermatology (1997)

Adults with acne represent an increasingly important population of acne sufferers referred for treatment. Acne, in these patients, is generally mild or moderate in severity but tends to be resistant to conventional antibiotic therapy. A study was carried out to assess the efficacy of intermittent moderate dose isotretinoin as a treatment for acne. Eighty consecutive patients, over the age of 25 years, referred with acne unresponsive to, or relapsing rapidly after three or more courses of conventional antibiotic therapy were recruited. Acne severity was assessed on the face, chest and back using the Leeds grading scale and the number of inflamed lesions was counted at the site showing the highest acne grade. The patients were 22 men and 58 women. The treatment regimen consisted of isotretinoin, 0.5 mg/kg per day for 1 week in every 4 week for a total period of 6 months. Seventy-five patients completed the study. The therapy was very well tolerated with mild cheilitis as the only side-effect. At the end of treatment, both total acne grade and lesion counts were significantly reduced (P < 0.0001). The acne had resolved in 68 (88%) patients. Twelve months after treatment, acne grades and inflamed lesion counts remained significantly improved (P < 0.0001) in the 68 patients who responded; however, 26 (39%) patients had relapsed. There was a significantly higher incidence of relapse in patients with predominantly truncal acne (P = 0.01). Patients who relapsed also had a significantly higher total acne grade, lesion count (P < 0.0001) and sebum excretion rate (P < 0.001) compared with those whose acne resolved. This study suggests that intermittent moderate dose isotretinoin may be a cost-effective alternative to full dose isotretinoin in a carefully selected group of adult patients with-acne. Selection criteria should include predominantly facial acne, total acne grade less than 1, inflamed lesion count less than 20 and sebum excretion rate less than 1.25 micrograms/cm2 per min.
Developing the Sentinel System — A National Resource for Evidence Development
Authors: Rachel E. Behrman, Joshua S. Benner, Jeffrey S. Brown, Mark McClellan, Janet Woodcock, Richard Platt
Journal: New England Journal of Medicine (2011)

Using the distributed data network of the new Mini-Sentinel program, the FDA can now query the electronic health information of more than 60 million people, posing specific questions in order to monitor the safety of approved medical products.
Chronic Hepatitis C Virus Infection
Authors: Steven K. Herrine
Journal: Annals of Internal Medicine (2003)

Letters2 September 2003Chronic Hepatitis C Virus InfectionSteven K. Herrine, MDSteven K. Herrine, MDFrom Thomas Jefferson University; Philadelphia, PA 19107.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-5_Part_1-200309020-00020-w2 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Kleinhaus's anecdote successfully describes the limitations of HCV tests. Although the accuracy of molecular testing for HCV and its subtypes has improved over the past several years, the diagnosis of HCV needs to made in the context of the clinical scenario. If the patient in question has a known risk factor and elevated aminotransferase levels, true infection is more likely. From a technical standpoint, discrepancies between HCV viral measures and genotyping may be seen at very low viral loads, since the primers used for these tests differ. Other causes of discordant test results may be a sample ... Author, Article, and Disclosure InformationAffiliations: From Thomas Jefferson University; Philadelphia, PA 19107.Acknowledgment: The author thanks David Gretch, MD, PhD, for consultation on this matter. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 2 September 2003Volume 139, Issue 5_Part_1Page: W-68KeywordsAminotransferasesChronic hepatitis CGenotypingInfectious hepatitisMedical risk factorsViral load ePublished: 2 September 2003 Issue Published: 2 September 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Dietary and Biochemical Control of Phenylketonuria
Authors: F. S. W. Brimblecombe, J. D. Blainey, M. E. R. Stoneman, B. S. B. Wood
Journal: BMJ (1961)

HYPOPHYSECTOMY IN BREAST CANCER BRDICJO7AL93 patients.Preliminary results indicate that the initial high levels (Whitaker, 1960) fall coincident with satis- factory clinical response.Serum phosphohexose- isomerase has also been estimated serially (Boesen, unpublished) in many of these patients, and the level, although fluctuant, appears to correlate with the clinical course.Two patients had dermatomyositis: one had been treated with prednisone with some improvement.The prednisone was discontinued before she underwent hypophysectomy for progression of her disseminated metastatic disease.The dermatomyositis improved after hypophysectomy while the patient was on maintenance cortisone.However, her disseminated metastatic disease continued to progress and she died of bronchopneumonia after hypophysectomy. ConclusionThis larger series and recent series of surgical hypophysectomy of other workers (Jessiman et al., 1959; Pearson and Ray, 1960; Atkins et al., 1960) have confirmed our previous impressions.Hypophysectomy is no longer an experimental procedure.Its place has been established as a method of palliating advanced carcinoma of the breast.The risks of the operation are reduced with greater experience, although it can never be a routine procedure.The major problem remains the selection of patients for operation, for at present only about half the cases respond. SummaryPituitary ablation has been performed on 111 unselected patients with disseminated carcinoma of the breast over the past five years-104 by surgical hypophysectomy and 7 by stereotaxic procedure.The assessment and management of the cases are discussed.Regression or arrest has occurred in 42% of the patients assessed and the average expectation of life was increased by 12 months.A favourable response was more likely in patients who had responded well to previous endocrine therapy, and those in whom there was a long interval between the primary disease and the appearance of metastases.It is also possibly indicated by the meno- pausal status.Complications and metabolic effects of the operation are reviewed.We are indebted to the British Empire Cancer Campaign for a whole-time grant to one of us (E.B.) and to the Royal Free Hospital endowment fund for financial assistance.We thank Dr. J. N.
A prospective study on the incidence of rheumatoid arthritis among people with persistent increase of rheumatoid factor
Authors: H D Halldorsdottir
Journal: Annals of the Rheumatic Diseases (2000)

<h3>OBJECTIVES</h3> To study the stability of rheumatoid factor (RF) increases and to compare the incidence of rheumatoid arthritis (RA) in people with transient or persistent increase of one or more RF isotypes. <h3>METHODS</h3> From an original cohort of nearly 14 000 participants in a population study, 135 previously RF positive persons were recruited in 1996 and evaluated according to the 1987 ACR criteria. The observation time ranged from 9–22 years (mean 16.5). Blood samples were obtained from all participants at entry and again in 1996. <h3>RESULTS</h3> About 40% of the participants who had only one raised RF isotype in the original sample had become RF negative in 1996 compared with only 15% of those with increase of two or three RF isotypes (p=0.002). The seven participants who developed RA during the study period all had persistently raised RF. Six of the 54 participants with more than one RF isotype raised in 1996 developed RA, corresponding to an annual incidence of 0.67%, which was 7.5 times higher than observed in the other participants (p=0.045). <h3>CONCLUSION</h3> Symptom free persons with persistently raised RF have greatly increased risk of developing RA. This suggests that dysregulation of RF production is a predisposing factor in RA.
Gynecology and Gynecolgists in Paris.
Authors: W. S. Caldwell
Journal: JAMA (1898)

Paris, March 1898. <h3>To the Editor:</h3> —It is an unfortunate attribute of human nature, that our thoughts and our actions, instead of flowing on in a steady and even current, are too often marked by great tidal waves that, rising to a certain height, settle back again to their original level. We seem in this respect to be governed by the same laws that govern the progress of great, wide-spread epidemics, like, for instance, the influenza which beginning at a certain point disseminates itself until it encircles the entire globe. Following the same law, we see level headed men, who have amassed a fortune by their economy and industry, seized by a speculative craze, and squander the savings of a lifetime in a single day. Religious epidemics attack communities and during their prevalence, men of small caliber are able to convert their thousands, while, when this wave of excitement has
Dimerization of soluble major histocompatibility complex-peptide complexes is sufficient for activation of T cell hybridoma and induction of unresponsiveness.
Authors: J P Abastado, Y C Lone, A Casrouge, G Boulot, P Kourilsky
Journal: The Journal of Experimental Medicine (1995)

Major histocompatibility complex (MHC) class I molecules are cell-surface proteins that present peptides to CD8+ T cells. These peptides are mostly derived from endogenously synthesized protein. Recombinant, soluble MHC class I molecules were produced, purified, and loaded homogeneously with synthetic peptide. These MHC-peptide complexes were used to activate a T cell hybridoma. While monomers of MHC-peptide bound to the T cell, they showed no stimulatory activity. Dimers fully triggered the T cell hybridoma to secrete interleukin 2. This response was followed by a state in which the T cell was refractory to restimulation as a result of defective signal transduction through the T cell receptor.
Recombinant Adeno-associated Virus Transduction and Integration
Authors: Brian R Schultz, Jeffrey S Chamberlain
Journal: Molecular Therapy (2008)

Recombinant adeno-associated virus (rAAV) holds promise as a gene therapy vector for a multitude of genetic disorders such as hemophilia, cystic fibrosis, and the muscular dystrophies. Given the variety of applications and tissue types toward which these vectors may be targeted, an understanding of rAAV transduction is crucial for the effective application of therapy. rAAV transduction mechanisms have been the subject of much study, resulting in a body of knowledge relating to events from virus-cell attachment through to vector genome conformation in the target cell nucleus. Instead of utilizing one mechanism in each phase of vector transduction, rAAV appears to employ multiple possible pathways toward transgene expression, in part dependent on rAAV serotype, dose, and target cell type. Once inside the nucleus, the rAAV genome exists in a predominantly episomal form; therefore, nondividing cells tend to be most stably transduced. However, rAAV has a low frequency of integration into the host cell genome, often in or near genes, and can be associated with host genome mutations. This review describes the current understanding of the mechanisms and rate-limiting steps involved in rAAV transduction.
Possible application of urinary analysis to estimate dissolution of some man-made vitreous fibers.
Authors: A Wastiaux, O Blanchard, S Honnons
Journal: Environmental Health Perspectives (1994)

A preliminary study at the institut National de l'Environnement Industriel et des Risques (INERIS) examined the dissolution of three man-made vitreous fiber samples (glasswool, rockwool, glass microfibers: JM 100) after intraperitoneal injections in male Wistar rats. The chemical composition of the original fibers was determined by inductively coupled plasma spectrometry (ICP). The urine of the rats was collected at fixed times between day 1 and day 204, and the ICP was used to look for elements known to be present in the original fibers. At day 204, a piece of omentum was removed at autopsy, ashed and analyzed by energy dispersive X-ray analysis (EDXA) to identify the elements remaining in the fibers. Silicon and aluminium were retained in the fibers from all samples at day 204. Losses in calcium, sodium, magnesium, and sulfur were observed, but these elements were not studied in the urine samples because they are naturally present in relatively high concentrations in rat cells and biological fluids. Although there was a loss of zinc from the glass microfibers, no corresponding difference was observed between the zinc levels excreted by the treated animals and by the controls. Similarly, despite the loss of manganese from the rockwool fibers at day 204, none was detectable in the urine samples. Titanium, present at the 0.3% level in rockwool, was not detectable by EDXA at day 204, but small quantities were detected in the first 2 weeks in the urine samples of rats treated with rockwool.(ABSTRACT TRUNCATED AT 250 WORDS)
High-density lipoprotein subfractions in normolipidemic patients with coronary atherosclerosis.
Authors: J G Brook, M Aviram, A Viener, E Shilansky, W Markiewicz
Journal: Circulation (1982)

High-density lipoprotein (HDL) levels were studied in 10 male patients with severe coronary atherosclerosis and in 10 well-matched controls. All subjects were normolipidemic, and the presence of a disease or other factor influencing HDL levels were excluded. Very low density lipoprotein and low-density lipoprotein levels were similar in both groups, but HDL concentration was significantly lower in the patient group. Analysis of HDL subfractions revealed that both HDL2 and HDL3 concentrations were significantly lower in the patient group. The composition of both HDL subfractions was also altered in the patient group: an increased cholesterol-to-protein ratio was found. These data strengthen the evidence in support of an important and independent role for HDL in the pathogenesis of coronary atherosclerosis. It appears that both HDL2 and HDL3 are implicated and that both the concentration and composition of HDL are important.
Value of Routine Cardiac Monitoring in the Management of Acute Myocardial Infarction outside a Coronary Care Unit
Authors: P. J. B. Hubner, M. J. Goldberg, C. W. Lawson
Journal: BMJ (1969)

In a coronary care unit patients and electrocardiographic monitors are under almost continuous observation by trained personnel. This paper suggests that in a general medical ward without this facility routine cardiac monitoring with E.C.G. oscilloscopes is unlikely to lower the overall mortality from acute myocardial infarction. A mortality of 25% for acute myocardial infarction was the same for a hospital without a coronary care unit where monitoring was routinely performed and for two neighbouring hospitals which did not routinely use monitoring during the period of analysis.The need to train personnel in the recognition of E.C.G. monitor tracings and the difficulties associated with monitor alarm systems are emphasized.
The Role of Cdk5 in Neuroendocrine Thyroid Cancer
Authors: Karine Pozo, Emely Castro-Rivera, Chunfeng Tan, Florian Plattner, Gert Schwach, Veronika Siegl, Douglas Meyer, Ailan Guo, Justin Gundara, Gabriel Mettlach, Edmond Richer, Jonathan A. Guevara, Li Ning, Anjali Gupta, Guiyang Hao, Li-Huei Tsai, Xiankai Sun, Pietro Antich, Stanley Sidhu, Bruce G. Robinson, Herbert Chen, Fiemu E. Nwariaku, Roswitha Pfragner, James A. Richardson, James A. Bibb
Journal: Cancer Cell (2013)
Restenosis after successful coronary angioplasty in patients with single-vessel disease.
Authors: P P Leimgruber, G S Roubin, J Hollman, G A Cotsonis, B Meier, J S Douglas, S B King, A R Gruentzig
Journal: Circulation (1986)

To determine risk factors for restenosis, we studied 998 patients who underwent elective coronary angioplasty (PTCA) to native coronary arteries between July 1980 and July 1984. Restenosis, defined as a luminal narrowing of greater than 50% at follow-up, was present in 302 patients (30.2%). Univariate analysis of 29 factors revealed seven factors related to restenosis: vessel dilated (circumflex coronary artery 18%, right coronary artery 27%, left anterior descending artery 34%; p less than .01), final gradient of 15 mm Hg or less compared with greater than 15 mm Hg (27% vs 38%, p less than .01), duration of angina greater than 2 months compared with angina of shorter duration (27% vs 35%, p = .01), post-PTCA stenosis of 30% or less compared with 31% to 50% (28% vs 36%, p less than .025), stable vs unstable angina (26% vs 34%, p less than .05), presence vs absence of intimal dissection (26% vs 32%, p = .07), and female gender vs male gender (25% vs 32%, p = .08). Multivariate analysis revealed five factors independently related to increased risk of restenosis in the following order of importance: PTCA in the left anterior descending artery, absence of intimal dissection immediately after PTCA, final gradient greater than 15 mm Hg, a large residual stenosis after PTCA, and unstable angina. Restenosis after PTCA is a multifactorial problem. The hemodynamic and angiographic result at the time of PTCA significantly influences long-term outcome, but additional measures aimed at reducing the rate of recurrence of atherosclerotic plaque are required.
Genome-wide association analysis of Vogt-Koyanagi-Harada syndrome identifies two new susceptibility loci at 1p31.2 and 10q21.3
Authors: Shengping Hou, Liping Du, Bo Lei, Chi Pui Pang, Meifen Zhang, Wenjuan Zhuang, Minglian Zhang, Lulin Huang, Bo Gong, Meilin Wang, Qi Zhang, Ke Hu, Qingyun Zhou, Jian Qi, Chaokui Wang, Yuan Tian, Zi Ye, Liang Liang, Hongsong Yu, Hong Li, Yan Zhou, Qingfeng Cao, Yunjia Liu, Lin Bai, Dan Liao, Aize Kijlstra, Jianfeng Xu, Zhenglin Yang, Peizeng Yang
Journal: Nature Genetics (2014)
Prestigious Journals and Flawed Papers
Authors: SAUL B. GILSON
Journal: Annals of Internal Medicine (1983)

Letters and Corrections1 August 1983Prestigious Journals and Flawed PapersSAUL B. GILSON, M.D.SAUL B. GILSON, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-99-2-277_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Shinn and Logue describe in their editorial (1) a group of misleading reports of cancer therapy in which the improper selection of control groups invalidated each study. The editorial concluded that the internist should critically evaluate "studies . . . in the increasingly voluminous and confusing literature."Unmentioned was the editorial failure of the prestigious journais (including theAnnals) that printed such studies. I have read much of the importance of experimental controls, but the very journals (and not just theAnnals) that on one page criticize improper experimental design will on another page publish just such...Reference1. SHINN D and LOGUE G. Analysis of survival in cancer clinical trials [Editorial]. Ann Intern Med. 1983;98:665-66. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: SAUL B. GILSON, M.D.Affiliations: 469 Washington Avenue; New York, NY 10033 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 August 1983Volume 99, Issue 2Page: 277-277KeywordsResearch design ePublished: 1 December 2008 Issue Published: 1 August 1983 PDF downloadLoading ...