tbuckley/cabot-search huggingface dataset:
Measuring Blood Pressure for Decision Making and Quality Reporting
Authors: Randy Wexler
Journal: Annals of Internal Medicine (2011)

Letters18 October 2011Measuring Blood Pressure for Decision Making and Quality ReportingRandy Wexler, MD, MPHRandy Wexler, MD, MPHFrom Ohio State University, Columbus, OH 43210.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-8-201110180-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The article by Powers and coworkers (1) is not only clinically important, it is directly relevant to the ongoing evolution of the health care system. Hypertension is the most common cardiovascular disease in the United States and is often the initial insult on the road to coronary artery disease and heart failure (2). As such, it is not surprising that blood pressure is a common quality measure used by the National Committee for Quality Assurance, the Centers for Medicare & Medicaid Services, and various insurers (3).As the country moves to public reporting for outcomes and physicians ...References1. Powers BJ, Olsen MK, Smith VA, Woolson RF, Bosworth HB, Oddone EZ. Measuring blood pressure for decision making and quality reporting: where and how many measures? Ann Intern Med. 2011;154:781-8, W-289-90. [PMID: 21690592] LinkGoogle Scholar2. Roberts CK, Barnard RJ. Effects of exercise and diet on chronic disease. J Appl Physiol. 2005;98:3-30. [PMID: 15591300] CrossrefMedlineGoogle Scholar3. National Committee for Quality Assurance. Diabetes Recognition Program. Washington, DC: National Committee for Quality Assurance; 2010. Accessed at www.ncqa.org/tabid/139/Default.aspx on 23 June 2011. Google Scholar4. Cushman WC, Evans GW, Byington RP, Goff DC, Grimm RH, Cutler JA, et al; ACCORD Study Group. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med. 2010;362:1575-85. [PMID: 20228401] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Randy Wexler, MD, MPHAffiliations: From Ohio State University, Columbus, OH 43210.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMeasuring Blood Pressure for Decision Making and Quality Reporting: Where and How Many Measures? Benjamin J. Powers , Maren K. Olsen , Valerie A. Smith , Robert F. Woolson , Hayden B. Bosworth , and Eugene Z. Oddone Measuring Blood Pressure for Decision Making and Quality Reporting Omega C. Logan Silva Measuring Blood Pressure for Decision Making and Quality Reporting Benjamin J. Powers , Eugene Z. Oddone , and Hayden B. Bosworth Metrics 18 October 2011Volume 155, Issue 8Page: 565KeywordsBlood pressureConflicts of interestDecision makingHealth careHealth care quality assessmentHeart failureHypertensionMedicareQuality indicatorsStable coronary artery disease ePublished: 18 October 2011 Issue Published: 18 October 2011 Copyright & PermissionsCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
1011-112 Use of abciximab prior to primary angioplasty in ST-segment elevation myocardial infarction results in early recanalization of the infarct-related artery: Results of the multicenter randomized ReoPro-BRIDGING study
Authors: Mariann Gyongyosi, Hans Domanovits, Birgit Heinisch, Wolfgang Benzer, Morritz Haugk, Kurt Huber
Journal: Journal of the American College of Cardiology (2004)
Functioning Intrapericardial Paraganglioma Diagnosed by 1-123 MIBG Imaging
Authors: JAVIER BANZO, ENRIQUE PRATS, JOS?? VELILLA, FRANCISCO J MONZ??N, MONSERRAT DELGADO
Journal: Clinical Nuclear Medicine (1991)

Intrapericardial paraganglioma is extremely rare. I-123 MIBG can locate most pheochromocytomas and neuroblastomas through intracellular storage of the tracer by an active process. When functioning extra-abdominal paraganglioma do occur, they are often clinically indistinguishable from adrenal pheochromocytoma, and they frequently require extraordinary diagnostic and therapeutic considerations.
MECHANISMS OF ACQUIRED RESISTANCE IN MOUSE TYPHOID
Authors: R. V. Blanden, G. B. Mackaness, F. M. Collins
Journal: The Journal of Experimental Medicine (1966)

Experiments in vitro comparing normal mouse peritoneal macrophages with cells from Salmonella typhimurium-infected mice have shown that the "immune" macrophages have conspicuously enhanced microbicidal properties. Whereas normal macrophages could inactivate only 50 to 60% of intracellular S. typhimurium pretreated with immune serum, cells from infected animals killed virtually all ingested organisms and did so at an accelerated rate. Macrophages from Listeria monocytogenes-infected mice were shown to possess similarly enhanced microbicidal activity against S. typhimurium. Furthermore, the growth of S. typhimurium in the liver and spleen was more effectively restricted in Listeria-infected mice than in animals vaccinated with heat-killed S. typhimurium, even though the Listeria-infected animals possessed no demonstrable cross-reacting antibody to S. typhimurium. The lack of resistance in the mice vaccinated with heat-killed organisms could not be attributed to any deficiency of humoral factors, since the serum from these animals was as effective at promoting phagocytosis and killing by macrophages as serum from actively infected (and demonstrably resistant) mice. Conversely, Salmonella-infected mice were totally resistant to intravenous challenge with L. monocytogenes. The level of resistance in individual animals was related to the numbers of residual Salmonellae remaining in the tissues; mice with heavier residual infections being the more resistant. Specific antiserum from mice vaccinated with heat-killed S. typhimurium was found to be significantly protective only when the intraperitoneal route of challenge was employed. The foregoing studies have been interpreted to mean that enhancement of the microbicidal ability of macrophages is the mechanism of major importance in acquired resistance to S. typhimurium infection in mice.
Militant attacks are jeopardising famine relief in Horn of Africa
Authors: P. Moszynski
Journal: BMJ (2011)

Aid operations in and around Kenya’s Dadaab refugee camp, the world’s largest, have been severely disrupted after an attack by suspected Somali militants in which two Spanish staff from the aid group Medecins Sans Frontieres were abducted.

Montserrat Serra, aged 40, from Girona, and Blanca Thiebaut, aged 30, from Madrid, were working as logisticians for the medical charity, which is providing health services for almost half a million refugees who have fled famine and conflict in Somalia.

“We are in regular contact with the families of our colleagues involved and relevant authorities since the first moments. We are doing all we can to ensure their …
Acute reduction of lipoprotein(a) by tissue-type plasminogen activator.
Authors: R A Hegele, M R Freeman, A Langer, P W Connelly, P W Armstrong
Journal: Circulation (1992)

BACKGROUND Lipoprotein(a) [Lp(a)] is a low density lipoprotein-like particle whose apolipoprotein B (apo B) moiety is disulfide-linked to apo(a), a plasminogen-like inhibitor of fibrinolysis in vitro. We hypothesized that plasma concentrations of Lp(a) are acutely affected by intravenous tissue-type plasminogen activator (t-PA). METHODS AND RESULTS Patients with unstable angina were randomized to receive either intravenous t-PA (n = 15) or placebo (n = 11). Two-way ANOVA using repeated measures revealed a significant effect of t-PA on concentrations of Lp(a) (p = 0.026). There was a 48% fall in Lp(a) from baseline concentrations in the t-PA group at 12 hours (p = 0.031) but not at 72 hours. Lp(a) in the placebo group was unchanged. CONCLUSIONS We conclude that t-PA produces a sharp and substantial but reversible reduction in plasma Lp(a). These data suggest that Lp(a) concentration is not as static in vivo as had been believed and might be acutely modifiable through some mechanism that induces its removal from the freely circulating state.
Influence of tachycardia and arterial hypertension on infarct size in the pig
Authors: D. GARCIA-DORADO, P. THEROUX, J. ELIZAGA, F. F. AVILES, J. ALONSO, J. SOLARES
Journal: Cardiovascular Research (1988)

To investigate the clinically important but controversial question of how hypertension during coronary occlusion affects infarct size 24 pigs underwent 1 h occlusion of the mid left anterior descending coronary artery and 24 h reperfusion and were randomised to one of three treatment groups. In group 1 blood pressure was increased during the occlusion period by an infusion of methoxamine; in group 2 tachycardia was induced by atrial pacing; and in group 3 no intervention was performed. The area at risk and infarct size were quantified by digital planimetry of slices of myocardium previously marked with fluorescein and with triphenyl-tetrazolium. Methoxamine maintained mean aortic blood pressure at 117(SEM8) mmHg during occlusion, whereas the values were 80(6) mmHg in group 2 and 67(9) mmHg in group 3. Pacing increased heart rate to 146(1) beats-min−1 in group 2; it was 103(5) in group 1 and 99(8) in group 3. The pressure-rate product achieved was similar in groups 1 and 2 and significantly higher than in group 3. The pathological studies showed infarct size to be moderately but significantly larger in group 1 (14[3.5]% of the left ventricle) and similar in groups 2 (10.5[3.9]%) and 3 (10.1 [2.2]%). The ratio of infarct size to area at risk was also significantly higher (0.743[0.057]) in group 1 with no differences between group 2 (0.604[0.055]) and group 3 (0.613[0.027]). At similar pressure-rate product, infarct size was thus greater with hypertension but not with pacing alone, showing a deleterious effect of increasing blood pressure in this experimental model with negligible collateral blood flow.
Abdominal distension in female patients with irritable bowel syndrome: exploration of possible mechanisms.
Authors: D G Maxton, D F Martin, P J Whorwell, M Godfrey
Journal: Gut (1991)

Abdominal distension is a common but little understood symptom of the irritable bowel syndrome. The authenticity of the symptom was confirmed by appreciable increases in girth measurement during the day in 20 patients with the irritable bowel syndrome compared with 20 control subjects. Objective corroboration of this finding was shown in the group with the irritable bowel syndrome by a highly significant increase in lateral abdominal 'profile' on computed tomography. Previously postulated mechanisms for distension--namely, retention of gas, depression of the diaphragm, and excess lumbar lordosis--were excluded by the radiological findings. Voluntary protrusion of the abdomen produced a completely different pattern on computed tomography to that observed in the irritable bowel syndrome. These observations suggest that abdominal distension may be related to changes in motility or tone of gastrointestinal smooth muscle.
TCTAP A-045 Impact of Diabetes Status on Long-term (6 Years) Outcomes After Percutaneous Coronary Intervention of Left Main Disease: Result from a Real World Experience of 1,528 Consecutive Patients
Authors: Ye-lin Zhao, Bo Xu, Philippe Généreux, Yue-jin Yang, Liang Xu, Shu-bin Qiao, Yong-jian Wu, Hong-bing Yan, Martin B. Leon, Run-lin Gao
Journal: Journal of the American College of Cardiology (2014)
CXM: A New Tool for Mapping Breast Cancer Risk in the Tumor Microenvironment
Authors: Michael J. Flister, Bradley T. Endres, Nathan Rudemiller, Allison B. Sarkis, Stephanie Santarriaga, Ishan Roy, Angela Lemke, Aron M. Geurts, Carol Moreno, Sophia Ran, Shirng-Wern Tsaih, Jeffery De Pons, Daniel F. Carlson, Wenfang Tan, Scott C. Fahrenkrug, Zelmira Lazarova, Jozef Lazar, Paula E. North, Peter S. LaViolette, Michael B. Dwinell, James D. Shull, Howard J. Jacob
Journal: Cancer Research (2014)

The majority of causative variants in familial breast cancer remain unknown. Of the known risk variants, most are tumor cell autonomous, and little attention has been paid yet to germline variants that may affect the tumor microenvironment. In this study, we developed a system called the Consomic Xenograft Model (CXM) to map germline variants that affect only the tumor microenvironment. In CXM, human breast cancer cells are orthotopically implanted into immunodeficient consomic strains and tumor metrics are quantified (e.g., growth, vasculogenesis, and metastasis). Because the strain backgrounds vary, whereas the malignant tumor cells do not, any observed changes in tumor progression are due to genetic differences in the nonmalignant microenvironment. Using CXM, we defined genetic variants on rat chromosome 3 that reduced relative tumor growth and hematogenous metastasis in the SS.BN3(IL2Rγ) consomic model compared with the SS(IL2Rγ) parental strain. Paradoxically, these effects occurred despite an increase in the density of tumor-associated blood vessels. In contrast, lymphatic vasculature and lymphogenous metastasis were unaffected by the SS.BN3(IL2Rγ) background. Through comparative mapping and whole-genome sequence analysis, we narrowed candidate variants on rat chromosome 3 to six genes with a priority for future analysis. Collectively, our results establish the utility of CXM to localize genetic variants affecting the tumor microenvironment that underlie differences in breast cancer risk.
Selective Treatment of Multiple Sclerosis
Authors: Allan H. Ropper
Journal: New England Journal of Medicine (2006)

Natalizumab, a recombinant monoclonal antibody against α4 integrins, is the first selective immunomodulating drug for the treatment of multiple sclerosis and, by several criteria, is an advance over current therapies. The antibody was developed to block the adhesion of activated T cells to endothelial cells and thereby reduce the inflammatory feature of the multiple sclerosis plaque. Parenthetically, this advance attests to the value of translational research in a disease for which there is only partial knowledge of the mechanism. Natalizumab has also evinced interest for the treatment of Crohn's disease and rheumatoid arthritis but with less certain results in . . .
ON THE METHOD OF MEASURING THE SYSTOLIC PRESSURE IN MAN, AND THE ACCURACY OF THIS METHOD
Authors: L. Hill, M. Flack
Journal: BMJ (1909)

On December 17th the temperature in the morning was 100.60 F.; -the pulse 108, of good volume.He had passed a motion on the previous night.Respiration was less laboured.Flatus had been passed; abdlominal distension was much less and the patient felt better.A morphine injection was given at bedtime.On December 18th the pulse was 126 ; he had slept well.In the, evening he passed five loose motions.Morphine was repeated.On December 19th the pulse was 110; he had slept very well; the bowels had been moved three times only.JBismuth and morphine was given internally.The abdomen became distended, but this was relieved by a soap enema.On December 20th the morning temperature was 99.80, the pulse 108 and of good volume.He had passed only one motion, and had slept well after a chloral and bromide draught.From December 21st to 27th the temperatutre ran an irreftlar course; the bowels also moved freely, but no attempt was made to check the motions completely, as it produced distension and discomfort.Whenever the motions were too frequent bismuth and morphine were given internally.In the meantime he was given digitalis and nux vomica in a mixture, and was fed on cowls milk, malted milk, chicken broth, liquid peptonoids, brandy, etc. ' From December 27th, 1907, to January 1st, 1908, his temperature was normal, but there was then again a slight rise, not exceeding 990 F.The abdominal wound became infected, and had to be dressed daily.At one time a little faecal matter passed through the lower end of the wound, but it has since ceased.Now the wound is 'almost healed, and the patient is enjoying'ordinary diet.Widal's test proved negative three times.
Topical tacrolimus in the treatment of atopic dermatitis—does it benefit the airways? A 4-year open follow-up
Authors: Hannele Virtanen, Anita Remitz, Pekka Malmberg, Paula Rytilä, Tuula Metso, Tari Haahtela, Sakari Reitamo
Journal: Journal of Allergy and Clinical Immunology (2007)
In vivo imaging with oligonucleotides for diagnosis and drug development
Authors: B Tavitian
Journal: Gut (2003)

Molecular imaging, the science that combines non-invasive in vivo imaging and molecular biology, has begun to use labelled oligonucleotides as radiotracers. Antisense oligonucleotides target gene expression at the RNA level, while aptamer oligonucleotides are designed to hit proteins of interest. Oligonucleotides for imaging cover a large range of applications, from the invention of new contrast agents for diagnosis to exquisite research tools for the development of new drugs.
A comparison of the acute hemodynamic effects of inhaled nitric oxide and aerosolized iloprost in primary pulmonary hypertension
Authors: Marius M. Hoeper, Horst Olschewski, Hossein A. Ghofrani, Heinrike Wilkens, Joerg Winkler, Mathias M. Borst, Jost Niedermeyer, Helmut Fabel, Werner Seeger
Journal: Journal of the American College of Cardiology (2000)
Driving Pressure and Respiratory Mechanics in ARDS
Authors: Stephen H. Loring, Atul Malhotra
Journal: New England Journal of Medicine (2015)

In this issue of the Journal, Amato et al.1 use data from previously published trials to determine whether it is possible to predict outcomes in patients with the acute respiratory distress syndrome (ARDS) on the basis of the settings of their mechanical ventilators or parameters derived from monitoring the mechanics of the ventilation achieved. Previous articles published in the Journal had shown that a lung-protective strategy — that is, limiting the tidal volume (Vt) and plateau pressure while providing relatively high positive end-expiratory pressure (PEEP), can improve survival in ARDS,2,3 thus demonstrating the importance of respiratory mechanics . . .
Dopamine receptors: applications in clinical cardiology.
Authors: L I Goldberg, S I Rajfer
Journal: Circulation (1985)

THE DISCOVERY of the renal vasodilating action of dopamine more than 20 years ago led to extensive research that demonstrated other unusual actions of this endogenous catecholamine.1-' Investigators using traditional pharmacologic models and modern biochemical techniques have documented the existence of distinct dopamine receptor subtypes that mediate these responses.Appreciation of the structure-activity re- quirements of these receptors has led to the synthesis of drugs that may have a profound influence on the management of the patient with heart disease.Taxonomy of dopamine receptors.Rigid criteria must be met to prove the existence of a new receptor by classical pharmacologic methods, including con- struction of a unique potency series of agonists and demonstration of specific antagonism.4 5 In contrast, biochemical techniques are applied to tissue homog- enates, and different standards are frequently used to classify receptors.P 7 After many years of research, two distinct dopamine receptor subtypes, DA, and DA2, were identified con- clusively by classical criteria in physiologic preparations.5DA receptors are located postsynaptically and subserve vasodilation in renal, mesenteric, coronary, and cerebral blood vessels (figure 1).DA,-induced vasodilation can be observed in other vascular beds, but the response is less prominent, probably because of the lower density of dopamine receptors.The molecu- lar structure required for activation of DA, receptors is very strict.4Currently, all active compounds have two hydroxyl groups in positions analogous to the 3-and 4- positions on the benzene ring of the dopamine mole- cule, and a limited distance exists between the hydroxyl groups and the amino group.
Treatment of Uterine Fibroids — Is Surgery Obsolete?
Authors: Togas Tulandi
Journal: New England Journal of Medicine (2007)

In the early 1990s, Jacques H. Ravina first applied the technique of embolization of uterine arteries to treat uterine fibroids in women at high risk for complications during surgery1 in an effort to control uterine bleeding. Embolization was then expanded for the treatment of patients who were undergoing myomectomy in order to decrease intraoperative bleeding. In 1993, Ravina and colleagues started using uterine-artery embolization as a primary treatment for uterine fibroids.Today, interventional radiologists worldwide perform uterine-artery embolization. Most of them embolize the uterine arteries bilaterally and not only the branch supplying blood to a particular fibroid (Figure 1). In . . .
IL-2/B7.1 (CD80) Fusagene Transduction of AML Blasts by a Self-Inactivating Lentiviral Vector Stimulates T Cell Responses in Vitro: a Strategy to Generate Whole Cell Vaccines for AML
Authors: Lucas Chan, Nicola Hardwick, Dave Darling, Joanna Galea-Lauri, Joop Gäken, Steve Devereux, Mike Kemeny, Ghulam Mufti, Farzin Farzaneh
Journal: Molecular Therapy (2004)

Combined expression of costimulatory factors and proinflammatory cytokines stimulate effective immune-mediated tumor rejection in a variety of murine tumor models. Specifically, syngeneic tumor cells genetically modified to express B7.1 (CD80) have been shown to induce rejection of previously established murine solid tumors, and transduction with IL-2 can further increase survival. However, poor rates of gene transfer and inefficient expression of multiple transgenes encoded by single vectors have hampered the development of such autologous tumor cell vaccines for clinical trials in acute myeloid leukemia (AML) patients. Here we describe the development of a self-inactivating lentiviral vector encoding B7.1 and IL-2 as a single fusion protein postsynthetically cleaved to generate biologically active membrane-anchored B7.1 and secreted IL-2. This enables the efficient transduction of both established and primary AML blasts, resulting in expression of the transgenes in up to 98% of the cells following a single round of infection at an m.o.i. of 10. The combined expression of IL-2 and B7.1 in AML blasts enables increased stimulation of both allogeneic and autologous T cells. The stimulated lymphocytes secrete greater levels of Th1 cytokines and show evidence of specificity, as indicated by their increased proliferation in the presence of autologous AML compared to remission bone marrow cells.
Medical Licensure
Authors: Jefferson B. Fordham
Journal: JAMA (1965)

As a lawyer engaged in legal education, I bring to this symposium the perspective of another profession and a citizen's concern about our health services.  I begin with the point that the objective of a professional licensure system is to further the public welfare by the use of a public mechanism to assure a minimum level of competence of those engaged in professional activity. Of course, there is the substantial secondary purpose of maintaining conformity to professional standards, through the power of license revocation or suspension. A rather conspicuous development has been the proliferation of state laws the country over relative to licensing in various occupations which would not be classified as professional. It is my observation that an important consideration in much of this regulation has been the protection of persons we may describe as the ins, those already engaged in the activity. It is likely that in the