tbuckley/cabot-search huggingface dataset:
Attitudes of Internal Medicine Faculty and Residents Toward Professional Interaction With Pharmaceutical Sales Representatives
Authors: W. Paul McKinney
Journal: JAMA (1990)

We surveyed faculty and residents from seven hospitals affiliated with three academic internal medicine training programs about their perceptions of the informational and service benefits vs the risks of ethical compromise involved in interactions with pharmaceutical sales representatives. Questionnaires were returned by 467 (81%) of 575 physicians surveyed. Residents and faculty generally had somewhat negative attitudes toward the educational and informational value of detailing activities at their institutions but indicated that representatives supported important conferences and speakers. Residents were more likely than faculty to perceive contacts with sales representatives as potentially influencing physician decision making. Sixty-seven percent of faculty and 77% of residents indicated that physicians could be compromised by accepting gifts. More than half of the physicians who suggested that such compromise was possible indicated that acceptance of gifts worth more than +100 from drug companies would be likely to compromise a physician's independence and objectivity. A majority of both faculty and house staff favored eliminating presentations by pharmaceutical representatives at their hospitals. Only 10% thought they had had sufficient training during medical school and residency regarding professional interaction with sales representatives.
Understanding and Reducing Variation in Surgical Mortality
Authors: John D. Birkmeyer, Justin B. Dimick
Journal: Annual Review of Medicine (2008)

Surgical mortality varies widely across hospitals and surgeons, more so than would be predicted by chance alone or differences in case mix. Although a large body of research has suggested the importance of procedure volume, clinical mechanisms underlying variation in surgical mortality remain largely unknown. Payers, policy makers, and professional organizations have implemented a variety of large-scale strategies aimed at improving outcomes. Selective referral, process compliance, and outcomes measurement reflect different philosophies on how best to improve surgical quality and have distinct advantages and disadvantages. The optimal strategy may depend on both the clinical context (e.g., which procedure) and political realities.
Effect of a Single Bout of Prior Moderate Exercise on Cutaneous Perfusion in Type 2 Diabetes
Authors: Sheri R. Colberg, Henri K. Parson, Tanja Nunnold, D. Robb Holton, Aaron I. Vinik
Journal: Diabetes Care (2006)

In diabetic individuals, increased shunting of circulation away from the skin may exist, contributing to their greater risk for ulcerations and poor cutaneous healing. In a prospective study (1), we previously found a lower skin perfusion during local heating in the foot dorsum of sedentary type 2 diabetic individuals compared with active people without diabetes. This defect was present despite normal increases in skin interstitial nitric oxide (NO), suggesting that NO is either ineffective or not involved (2). A prior bout of maximal exercise also lessened the impaired responsiveness to local heating of the dorsal foot in active type 2 diabetic individuals but not in their sedentary counterparts (3). Thus, this study examined the effect of a single bout of prior moderate cycle exercise on dorsal foot cutaneous perfusion and interstitial NO.

Thirty-two diabetic and 26 nondiabetic subjects of both sexes free of known cardiovascular disease, severe peripheral neuropathy, unstable proliferative retinopathy, end-stage renal disease, uncontrolled hypertension, insulin use, and angiotensin II receptor blocker or ACE inhibitor use participated in the study and were in one of the following groups: control exercisers ( n = 13), control sedentary ( n = 13), diabetic exercisers ( n = 15), and diabetic sedentary ( n = 17). By self-report, exercisers had participated in aerobic exercise for ≥30 min three times per week for ≥6 months.

Each subject underwent a graded, maximal exercise protocol on a cycle ergometer described previously (3). On another day, subjects returned to complete 20 min of moderate exercise at ∼50% of the predetermined …
Clinical Lecture on a Case Illustrative of the Cirrhotic Form of Bright's Disease
Authors: T. M. Anderson
Journal: BMJ (1877)

IN the investigation and in the treatment of patients, it is of the utmost importance that we should carefully discriminate between the affection and the disease.The difference between the two will be at once apparent if I give you an illustration.Two patients are labouring under painful affections of the joints; but in one case the pains are due to the presence of an excess of uric acid in the blood, while in the other they are dependent upon a syphilitic taint.In each, the lesion of the joints is the affection; while in the one the disease is gout, and in the other syphilis.The patient whose case is the subjeet of to-day's lecture was labour- ing under a variety of affections; but we shall see how beautifully they all fit into and harmonise with one another, and are dependent upon one and the same disease.He was forty-one years of age, a shoe- maker, unmarried, and was admitted into Ward 2, Bed 2, on January Sth, I876, complaining of palpitation with pain in the praecordial re- gion of eighteen months'; of loss of flesh, irritability of stomach, giddiness, pain in-the head, and dimness of vision, of eleven weeks'; and of cough, with expectoration, of two weeks' duration.The family history could not be satisfactorily ascertained; but his father died at the age of seventy-seven, and his mother at sixty; while, of eight brothers and sisters, only two survived.At the age of fourteen, he had scarlet fever; at seventeen, gastric fever; at nineteen, typhus; and at twenty, rheumatic fever.About fifteen years prior to admission, he had a gonorrhoea, which soon dis- appeared; and he seems never to have had any other form of venereal disease.
Intravascular ultrasound-guided treatment for angiographically indeterminate left main coronary artery disease
Authors: Amir-Ali Fassa, Kenji Wagatsuma, Stuart T. Higano, Verghese Mathew, Gregory W. Barsness, Ryan J. Lennon, David R. Holmes, Amir Lerman
Journal: Journal of the American College of Cardiology (2005)
Effect of stromal-cell-derived factor 1 on stem-cell homing and tissue regeneration in ischaemic cardiomyopathy
Authors: Arman T Askari, Samuel Unzek, Zoran B Popovic, Corey K Goldman, Farhad Forudi, Matthew Kiedrowski, Aleksandr Rovner, Stephen G Ellis, James D Thomas, Paul E DiCorleto, Eric J Topol, Marc S Penn
Journal: The Lancet (2003)
New Consensus Criteria for GDM
Authors: Robert G. Moses
Journal: Diabetes Care (2010)

For at least a generation there has been a divergence of opinions about gestational diabetes mellitus (GDM). On one hand were those who, on the basis of largely observational studies in humans and extrapolation of animal data, felt that women should be tested for GDM and have their diagnosed GDM treated. On the other hand, there were the “obskeptics” who felt that no significant action should be taken until evidence of benefits and risks was available. Clinicians of either persuasion undoubtedly have found developments over the last few years most exciting.

In 2005, Crowther et al. (1) published the results of the Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS). For women diagnosed with GDM, the rate of prespecified perinatal complications was lower for the women randomized to the intervention (treatment) group. In a recent publication, Landon et al. (2) found that women with mild glucose intolerance who were assigned to treatment had a significant reduction in prespecified complications, mainly related to fetal size.

Although universal testing for GDM was not applied in either study, the advantages of treatment …
Upregulation of the Cardiac Monocarboxylate Transporter MCT1 in a Rat Model of Congestive Heart Failure
Authors: Erlingur Jóhannsson, Per Kristian Lunde, Catherine Heddle, Ivar Sjaastad, Marion J. Thomas, Linda Bergersen, Andrew P. Halestrap, Theodor W. Blackstad, Ole Petter Ottersen, Ole M. Sejersted
Journal: Circulation (2001)

Cardiac metabolism becomes more dependent on carbohydrates in congestive heart failure (CHF), and lactate may be used as an important respiratory substrate. Monocarboxylate transporter 1 (MCT1) promotes cotransport of lactate and protons into and out of heart cells and conceivably flux of lactate between cells, because it is abundantly present in the intercalated disk.Six weeks after induction of myocardial infarction (MI) in Wistar rats, left ventricular end-diastolic pressures were >15 mm Hg, signifying CHF. MCT1 and connexin43 protein levels in CHF were 260% and 20%, respectively, of those in sham-operated animals (Sham), and the corresponding mRNA signals were 181% and not significantly changed, respectively. Confocal laserscan immunohistochemistry and quantitative immunogold cytochemistry showed that MCT1 density was much higher in CHF than in Sham both at the surface membrane and in the intercalated disk. In CHF, a novel intracellular pool of MCT1 appeared to be associated with cisternae, some close to the T tubules. In contrast, connexin43 particles, seen exclusively at gap junctions, were substantially fewer. Maximum lactate uptake was 107+/-15 mmol. L(-1). min(-1) in CHF and 42+/-6 mmol. L(-1). min(-1) in Sham cells (P<0.05). The K(m) values were between 7 and 9 mmol/L (P=NS).In cardiomyocytes from CHF rats, (1) the amount of functional MCT1 in the sarcolemma, including in the intercalated disk, is increased several-fold; (2) a new intracellular pool of MCT1 appears; (3) another disk protein, connexin43, is much reduced; and (4) increased reliance on lactate and other monocarboxylates (eg, pyruvate) could provide tight metabolic control of high-energy phosphates.
Angiogenesis: Potentials for Pharmacologic Intervention in the Treatment of Cancer, Cardiovascular Diseases, and Chronic Inflammation
Authors: Arjan W. Griffioen, Grietje Molema
Journal: Pharmacological Reviews (2000)

Angiogenesis, or the formation of new blood vessels out of pre-existing capillaries, is a sequence of events that is fundamental to many physiologic and pathologic processes such as cancer, ischemic diseases, and chronic inflammation. With the identification of several proangiogenic molecules such as the vascular endothelial cell growth factor, the fibroblast growth factors (like in FGFs), and the angiopoietins, and the recent description of specific inhibitors of angiogenesis such as platelet factor-4, angiostatin, endostatin, and vasostatin, it is recognized that therapeutic interference with vasculature formation offers a tool for clinical applications in various pathologies. Whereas inhibition of angiogenesis can prevent diseases with excessive vessel growth such as cancer, diabetes retinopathy, and arthritis, stimulation of angiogenesis would be beneficial in the treatment of diseases such as coronary artery disease and critical limb ischemia in diabetes. In this review we highlight the current knowledge on angiogenesis regulation and report on the recent findings in angiogenesis research and clinical studies. We also discuss the potentials, limitations, and challenges within this field of research, in light of the development of new therapeutic strategies for diseases in which angiogenesis plays an important role.
A randomised trial of home energy efficiency improvement in the homes of elderly COPD patients
Authors: L. M. Osman, J. G. Ayres, C. Garden, K. Reglitz, J. Lyon, J. G. Douglas
Journal: European Respiratory Journal (2009)

A randomised trial of 178 patients in Aberdeen, UK with a previous hospital admission for chronic obstructive pulmonary disease (COPD) was carried out in order to determine whether improving home energy efficiency improves health-related quality of life in COPD patients. 118 patients were randomised and 60 agreed to monitoring only. Energy efficiency upgrading was carried out in 42% of homes randomised to intervention. Independent energy efficiency action was taken by 15% of control participants and 18% in the monitoring group. The main outcome measures were respiratory and general health status, home energy efficiency and hospital admissions. Intention-to-treat analysis found no difference in outcomes between the two groups. In 45 patients, who had energy efficiency action independent of original randomisation, there were significant improvements in respiratory symptom scores (adjusted mean 9.0, 95% CI 2.5–15.5), decreases in estimated annual fuel costs (-£65.3, 95% CI -£31.9– -£98.7) and improved home energy efficiency rating (1.1, 95% CI 0–1.4). COPD patients are unlikely to take up home energy efficiency upgrading, if offered. Secondary “pragmatic” analysis suggests that those who do take action may achieve clinically significant improvement in respiratory health, which is not associated with an increase in indoor warmth.
Multi-Site Testing With a Point-of-Care Nerve Conduction Device Can Be Used in an Algorithm to Diagnose Diabetic Sensorimotor Polyneuropathy
Authors: Bruce A. Perkins, Andrej Orszag, Jaspreet Grewal, Eduardo Ng, Mylan Ngo, Vera Bril
Journal: Diabetes Care (2008)

OBJECTIVE—We aimed to establish whether multi-nerve testing with a point-of-care nerve conduction device could be used to diagnose diabetic sensorimotor polyneuropathy. RESEARCH DESIGN AND METHODS—A total of 72 consecutive patients with diabetes underwent a full neurological examination and a concurrent evaluation for nine standard electrophysiological parameters using conventional nerve conduction studies (the reference standard) and a point-of-care device. RESULTS—Spearman coefficients for correlation of point-of-care and conventional parameters ranged between 0.76 and 0.91 (P &amp;lt; 0.001 in all comparisons). Agreement by the method of Bland and Altman was acceptable despite small systematic biases. Fifty subjects (69%) had neuropathy according to conventional criteria. The sensitivity and specificity for the point-of-care device to identify such neuropathy was 88 and 82%, respectively. CONCLUSIONS—A novel point-of-care device has reasonable diagnostic accuracy and thus may represent a sufficiently accurate alternative for detecting the diffuse electrophysiological criteria necessary to make the diagnosis of diabetic sensorimotor polyneuropathy.
A morphodynamic evaluation of the portal and hepatic venous system in cirrhosis can predict a progression of portal hypertension
Authors: Antonio Manenti, Erica Pavesi, Alberto Farinetti, Dario Colasanto
Journal: Hepatology (2015)

Potential conflict of interest: Nothing to report. To the Editor: We greatly appreciated the article of Berzigotti et al.1 concerning a study on factors involved in the development of clinically significant portal hypertension after liver resection for hepatocellular carcinoma. In our experience, a careful morphodynamic study of the portal and hepatic venous systems, through ultrasound, contrast‐enhanced computed tomography, magnetic resonance, and ultrasound elastography, helps in detecting the risks of development of a clinical portal hypertension. We found the following signs particularly meaningful: reduced portal blood flow velocity (<16 cm/second), delayed contrast‐enhancement of the liver compared with the enhancement of the spleen, distortion of the intrahepatic portal branches or their “pruned‐like” appearance, reduced diameter of the hepatic veins, portal vein diameter at the hepatic hilum >13 mm, congestion of the left gastric vein, and, in case of splenomegaly, diameter of the portal vein superior to that of the splenic vein.2 Following this policy, we studied a cohort of 30 patients, with Child‐Turcotte‐Pugh class B cirrhosis; four or more of these signs, excluding gastroesophageal varices or ascites, were present at the moment of patients’ enrollment. Within a period of 2 years, the natural course of the disease led to evident portal hypertension, proved by the presence of gastroesophageal varices in 24 cases (80%); this demonstrates a good predictive value of the considered group of signs. Besides, we consider every surgical abdominal procedure, as well as any other intercurrent pathological event, a negative prognostic factor on the portal hemodynamics.3 In conclusion, we propose, in Child‐Turcotte‐Pugh B patients, to complement the severity score with a morphodynamic evaluation of the hepatic and portal venous systems in order to detect an impending risk of portal hemodynamic worsening.4
Acute treatment of moderate to severe depression with hypericum extract WS 5570 (St John's wort): randomised controlled double blind non-inferiority trial versus paroxetine
Authors: A Szegedi, R Kohnen, A Dienel, M Kieser
Journal: BMJ (2005)

<h3>Abstract</h3> <b>Objective</b> To investigate the efficacy of hypericum extract WS 5570 (St John9s wort) compared with paroxetine in patients with moderate to severe major depression. <b>Design</b> Randomised double blind, double dummy, reference controlled, multicentre non-inferiority trial. <b>Setting</b> 21 psychiatric primary care practices in Germany. <b>Participants</b> 251 adult outpatients with acute major depression with total score ≥ 22 on the 17 item Hamilton depression scale. <b>Interventions</b> 900 mg/day hypericum extract WS 5570 three times a day or 20 mg paroxetine once a day for six weeks. In initial non-responders doses were increased to 1800 mg/day hypericum or 40 mg/day paroxetine after two weeks. <b>Main outcome measures</b> Change in score on Hamilton depression scale from baseline to day 42 (primary outcome). Secondary measures were change in scores on Montgomery-Åsberg depression rating scale, clinical global impressions, and Beck depression inventory. <b>Results</b> The Hamilton depression total score decreased by mean 14.4 (SD 8.8) points, corresponding to 56.6% (SD 34.3%) of the baseline value, in the hypericum group and by 11.4 (SD 8.6) points (44.8% (SD 33.5%) of baseline value) in the paroxetine group (intention to treat analysis; similar results were observed in the per protocol analysis). The intention to treat analysis (lower one sided 97.5% confidence limit 1.5 points for the difference hypericum minus paroxetine) and the per protocol analysis (lower confidence limit 0.7 points) showed non-inferiority of hypericum and statistical superiority over paroxetine. The lower limits in both cases exceeded the pre-specified non-inferiority margin of −2.5 points and the superiority margin of 0. The incidence of adverse events was 0.035 and 0.060 events per day of exposure for hypericum and paroxetine, respectively. <b>Conclusions</b> In the treatment of moderate to severe major depression, hypericum extract WS 5570 is at least as effective as paroxetine and is better tolerated.
Spontaneous Expression of Embryonic Factors and p53 Point Mutations in Aged Mesenchymal Stem Cells: A Model of Age-Related Tumorigenesis In Mice
Authors: Hanchen Li, Xueli Fan, Ramesh C. Kovi, YunJu Jo, Brian Moquin, Richard Konz, Calin Stoicov, Evelyn Kurt-Jones, Steven R. Grossman, Steven Lyle, Arlin B. Rogers, Marshall Montrose, JeanMarie Houghton
Journal: Cancer Research (2007)

Abstract Aging is the single most common risk factor for cancer. Peripheral and marrow-derived stem cells are long lived and are candidate cells for the cancer-initiating cell. Repeated rounds of replication are likely required for accumulation of the necessary genetic mutations. Based on the facts that mesenchymal stem cells (MSC) transform with higher frequency than other cell types, and tumors in aged C57BL/6 mice are frequently fibrosarcomas, we used a genetically tagged bone marrow (BM) transplant model to show that aged mice develop MSC-derived fibrosarcomas. We further show that, with aging, MSCs spontaneously transform in culture and, when placed into our mouse model, recapitulated the naturally occurring fibrosarcomas of the aged mice with gene expression changes and p53 mutation similar to the in vivo model. Spontaneously transformed MSCs contribute directly to the tumor, tumor vasculature, and tumor adipose tissue, recruit additional host BM-derived cells (BMDC) to the area, and fuse with the host BMDC. Unfused transformed MSCs act as the cancer stem cell and are able to form tumors in successive mice, whereas fusion restores a nonmalignant phenotype. These data suggest that MSCs may play a key role in age-related tumors, and fusion with host cells restores a nonmalignant phenotype, thereby providing a mechanism for regulating tumor cell activity. [Cancer Res 2007;67(22):10889–98]
Efficacy and Safety of a Novel Cholesteryl Ester Transfer Protein Inhibitor, JTT-705, in Humans
Authors: Greetje J. de Grooth, Jan Albert Kuivenhoven, Anton F.H. Stalenhoef, Jacqueline de Graaf, Aeilko H. Zwinderman, Jan L. Posma, Arie van Tol, John J.P. Kastelein
Journal: Circulation (2002)

Background — Cholesteryl ester transfer protein (CETP) mediates the transfer of neutral lipids between lipoproteins. High plasma levels of CETP are correlated with low HDL cholesterol levels, a strong risk factor for coronary artery disease. In earlier studies, JTT-705, a novel CETP inhibitor, was shown to increase plasma HDL cholesterol and to inhibit the progression of atherosclerosis in cholesterol-fed rabbits. This study describes the first results using this CETP inhibitor in humans. Methods and Results — In a randomized, double-blind, and placebo-controlled trial, we evaluated the efficacy and safety of daily treatment with 300, 600, and 900 mg JTT-705 in 198 healthy subjects with mild hyperlipidemia. Treatment with 900 mg JTT-705 for 4 weeks led to a 37% decrease in CETP activity ( P &lt;0.0001), a 34% increase in HDL cholesterol ( P &lt;0.0001), and a 7% decrease in LDL cholesterol ( P =0.017), whereas levels of triglycerides, phospholipid transfer protein, and lecithin-cholesterol acyltransferase were unaffected. In line with the increase of total HDL, a rise of HDL 2, HDL 3 , and apolipoprotein A-I was also noted. JTT-705 showed no toxicity with regard to physical examination and routine laboratory tests. Conclusions — We show that the use of the CETP inhibitor JTT-705 in humans is an effective means to raise HDL cholesterol levels with minor gastrointestinal side effects ( P =0.06). Although these results hold promise, further studies are needed to investigate whether the observed increase in HDL cholesterol translates into a concomitant reduction in coronary artery disease risk.
Enteral nutrition as primary therapy in short bowel syndrome.
Authors: I W Booth
Journal: Gut (1994)

The spectacular success of parenteral nutrition in supporting patients during small intestinal adaptation after massive resection, tends to obscure the prolonged periods often needed for such adaptation to take place. After neonatal small intestinal resection for example, it may take more than five years before adaptation is complete. There is therefore a strong argument for examining ways in which adaptation can be facilitated, in particular, by the addition of novel substrates to enteral feeds. Pectin is completely fermented by colonic bacteria to short chain fatty acids. In the rat, addition of pectin to enteral feeds led to a more rapid adaptive response in both the small and large intestine after massive small intestinal resection, although faecal nitrogen losses were increased. In a similar rat model, the provision of 40% of non-protein energy as short chain triglycerides facilitated the adaptive response in the jejunum, colon, and pancreas. The importance of glutamine as a metabolic substrate for the small intestine makes it another potential candidate and some, but not all animal studies, have suggested a therapeutic effect: increasing the glutamine content of feeds to 25% of total amino acids produced enhanced jejunal and ileal hyperplasia, even on a hypocaloric feed, and an improved overall weight gain. Studies in humans are very limited, but such promising results in the experimental animal suggest that this is probably a fruitful area for further study.