tbuckley/cabot-search huggingface dataset:
Effects of Percutaneous Transluminal Angioplasty and Endovascular Brachytherapy on Vascular Remodeling of Human Femoropopliteal Artery by Noninvasive Magnetic Resonance Imaging
Authors: Rolf Wyttenbach, Augusto Gallino, Mario Alerci, Felix Mahler, Luca Cozzi, Marcello Di Valentino, Juan J. Badimon, Valentin Fuster, Roberto Corti
Journal: Circulation (2004)

Percutaneous transluminal angioplasty (PTA) of severely stenotic peripheral vascular lesions is hampered by a higher restenosis rate. The effects of PTA on vascular wall as well as the effects of the antirestenotic properties of endovascular brachytherapy (EVBT) remain unclear. MRI allows in vivo noninvasive assessment of the vascular effects of such treatment strategies. We sought to elucidate the vascular effect of PTA and PTA+EVBT by serial MRI.Twenty symptomatic patients with severe stenosis of the femoropopliteal artery were randomly assigned to PTA (n=10) or PTA+EVBT (n=10; 14 Gy by gamma-irradiation source) and imaged by high-resolution MRI before and 24 hours and 3 months after intervention. An independent observer blinded to the procedure analyzed the MRI data. At 24 hours, cross-sectional MRI revealed that lumen area (86% and 67%) and total vessel area (47% and 34%) increased similarly in the PTA and PTA+EVBT groups, respectively. All patients showed severe splitting of the atherosclerotic plaque, resulting in an irregularly shaped lumen. At 3 months, MRI revealed a significant difference in lumen area change between the PTA and PTA+EVBT groups (40% and 106%, respectively; P=0.026) and in the total vessel area (14% and 39%, respectively; P=0.018). At 3 months, plaque disruption was still present in 50% of the patients treated with PTA+EVBT.After PTA, there is deep disruption of the atherosclerotic plaques and an extensive remodeling process of the arterial wall. Luminal loss after PTA is partially due to inward vessel remodeling. Brachytherapy prevents inward remodeling and induces an increase in lumen area but partially prevents healing of disrupted vessel surface.
Influence of Gender on Attention Deficit Hyperactivity Disorder in Children Referred to a Psychiatric Clinic
Authors: Joseph Biederman, Eric Mick, Stephen V Faraone, Ellen Braaten, Alysa Doyle, Thomas Spencer, Timothy E Wilens, Elizabeth Frazier, Mary Ann Johnson
Journal: American Journal of Psychiatry (2002)

OBJECTIVE: The substantial discrepancy in the male-to-female ratio between clinic-referred (10 to 1) and community (3 to 1) samples of children with attention deficit hyperactivity disorder (ADHD) suggests that gender differences may be operant in the phenotypic expression of ADHD. In this study the authors systematically examined the impact of gender on the clinical features of ADHD in a group of children referred to a clinic. METHOD: The study included 140 boys and 140 girls with ADHD and 120 boys and 122 girls without ADHD as comparison subjects. All subjects were systematically assessed with structured diagnostic interviews and neuropsychological batteries for subtypes of ADHD as well as emotional, school, intellectual, interpersonal, and family functioning. RESULTS: Girls with ADHD were more likely than boys to have the predominantly inattentive type of ADHD, less likely to have a learning disability, and less likely to manifest problems in school or in their spare time. In addition, girls with ADHD were at less risk for comorbid major depression, conduct disorder, and oppositional defiant disorder than boys with ADHD. A statistically significant gender-by-ADHD interaction was identified for comorbid substance use disorders as well. CONCLUSIONS: The lower likelihood for girls to manifest psychiatric, cognitive, and functional impairment than boys could result in gender-based referral bias unfavorable to girls with ADHD.
Amitriptyline reduces rectal pain related activation of the anterior cingulate cortex in patients with irritable bowel syndrome
Authors: V Morgan
Journal: Gut (2005)

<b>Background and aims:</b> Irritable bowel syndrome (IBS) is a disorder of intestinal hypersensitivity and altered motility, exacerbated by stress. Functional magnetic resonance imaging (fMRI) during painful rectal distension in IBS has demonstrated greater activation of the anterior cingulate cortex (ACC), an area relevant to pain and emotions. Tricyclic antidepressants are effective for IBS. The aim of this study was to determine if low dose amitriptyline reduces ACC activation during painful rectal distension in IBS to confer clinical benefits. Secondary aims were to identify other brain regions altered by amitriptyline, and to determine if reductions in cerebral activation are greater during mental stress. <b>Methods:</b> Nineteen women with painful IBS were randomised to amitriptyline 50 mg or placebo for one month and then crossed over to the alternate treatment after washout. Cerebral activation during rectal distension was compared between placebo and amitriptyline groups by fMRI. Distensions were performed alternately during auditory stress and relaxing music. <b>Results:</b> Rectal pain induced significant activation of the perigenual ACC, right insula, and right prefrontal cortex. Amitriptyline was associated with reduced pain related cerebral activations in the perigenual ACC and the left posterior parietal cortex, but only during stress. <b>Conclusions:</b> The tricyclic antidepressant amitriptyline reduces brain activation during pain in the perigenual (limbic) anterior cingulated cortex and parietal association cortex. These reductions are only seen during stress. Amitriptyline is likely to work in the central nervous system rather than peripherally to blunt pain and other symptoms exacerbated by stress in IBS.
Magnetic resonance imaging of the wrist in early rheumatoid arthritis reveals progression of erosions despite clinical improvement
Authors: F. M McQueen, N. Stewart, J. Crabbe, E. Robinson, S. Yeoman, P. L J Tan, L. McLean
Journal: Annals of the Rheumatic Diseases (1999)

<h3>OBJECTIVES</h3> To investigate the progression of joint damage in early rheumatoid arthritis (RA) using magnetic resonance imaging (MRI) of the wrist and determine whether this technique can be used to predict prognosis. <h3>METHODS</h3> An inception cohort of 42 early patients has been followed up prospectively for one year. Gadolinium enhanced MRI scans of the dominant wrist were obtained at baseline and one year and scored for synovitis, tendonitis, bone marrow oedema, and erosions. Plain radiographs were performed concurrently and scored for erosions. Patients were assessed clinically for disease activity and HLA-DRB1 genotyping was performed. <h3>RESULTS</h3> At one year, MRI erosions were found in 74% of patients (31 of 42) compared with 45% at baseline. Twelve patients (28.6%) had radiographic erosions at one year. The total MRI score and MRI erosion score increased significantly from baseline to one year despite falls in clinical measures of inflammation including erythrocyte sedimentation rate (ESR), C reactive protein (CRP), and swollen joint count (p &lt; 0.01 for all). Baseline findings that predicted carpal MRI erosions at one year included a total MRI score of 6 or greater (sensitivity: 93.3%, specificity 81.8%, positive predictive value 93.3%, p = 0.000007), MRI bone oedema (OR = 6.47, p &lt; 0.001), MRI synovitis (OR = 2.14, p = 0.003), and pain score (p = 0.01). Radiological erosions at one year were predicted by a total MRI score at baseline of greater than 13 (OR = 12.4, p = 0.002), the presence of MRI erosions (OR = 11.6, p = 0.005), and the ESR (p = 0.02). If MRI erosions were absent at baseline and the total MRI score was low, radiological erosions were highly unlikely to develop by one year (negative predictive value 0.91 and 0.92 respectively). No association was found between the shared epitope and erosions on MRI (p = 0.4) or radiography (p = 1.0) at one year. <h3>CONCLUSIONS</h3> MRI scans of the dominant wrist are useful in predicting MRI and radiological erosions in early RA and may indicate the patients that should be managed aggressively. Discordance has been demonstrated between clinical improvement and progression of MRI erosion scores.
THE BURIED UNABSORBABLE LIGATURE AND ITS SEQUELAE
Authors: C. H. Whiteford
Journal: BMJ (1903)

YUTHE BIRIED IJNABSORBABLE LIGATURE.[MICA; d',URg.&Lblreathing a few lhours later became regular.Evening temperature II.03.0nu June 12th the morning temiiperature was I90.40, patienit sleepiug eoill- fortably.In the evening knee-jerk returnod; patient could undelstand what was said to himn.On June I3th he could auswvler questious; com- plained of severe headaclie; evening temiiperature 980.June I7tll.To-day for the first time, nine days after the fracture, tliere was a diselarge cf bl6odstained cerebro-spinal fluid fromii tihe ear.Thlis dischlarge lasted till July x4tlh, tlat is, for four weeks.Tle patient left the lospital quite well on July 25tl1.a Asi3 in.-Dr.Hawkins of Broxbourne kindly lets inc publish this case.The patient, a middle-aged miian, was thrown out of a trap on Marelh i3tlh last, and was picked up unconscious, with no visible injury except a trivial cut over the left eyebrow, and a broken wrist.The left pupil was widely dilated and iminovable, and tllere was complete loss of power, but not of reflex miioveimieut, in the left arm and leg.For a day or-two lhe renidined wlholly unconscious; then there came a return toward con- sciousness, and lie could answer questions, and said a word or two now and igaiu; and at niglits lie was restless, talking wildly.;He reonained in this state for a fortnight.On the fourteenth or fifteentlh day he took a chauge for the worse; tllere was a sliglht rise of teiiipera- ture, witlh quickened pulse and respiration, inore coiiplete paraly sis, and deeperunconsciousuess.I saw liini for the first timne on April ist, the
MEDICATION DOSING ADHERENCE IN OUTPATIENTS WITH HEART FAILURE FOLLOWING IMPLEMENTATION OF A PRACTICE-BASED PERFORMANCE IMPROVEMENT INTERVENTION: RESULTS FROM IMPROVE HF
Authors: Mihai Gheorghiade, Gregg C. Fonarow, Nancy M. Albert, Anne B. Curtis, Wendy Gattis Stough, J Thomas Heywood, Mark L. McBride, Patches Johnson Inge, Mandeep R. Mehra, Christopher M. O’Connor, Dwight Reynolds, Mary N. Walsh, Clyde W. Yancy
Journal: Journal of the American College of Cardiology (2010)
Antitumor Activity of Small Interfering RNA/Cationic Liposome Complex in Mouse Models of Cancer
Authors: Junichi Yano, Kazuko Hirabayashi, Shin-ichiro Nakagawa, Tohru Yamaguchi, Masaki Nogawa, Isao Kashimori, Haruna Naito, Hidetoshi Kitagawa, Kouichi Ishiyama, Tadaaki Ohgi, Tatsuro Irimura
Journal: Clinical Cancer Research (2004)

Abstract Purpose: The RNA interference effect is an alternative to antisense DNA as an experimental method of down-regulating a specific target protein. Although the RNA interference effect, which is mediated by small interfering RNA (siRNA) or micro-RNA, has potential application to human therapy, the hydrodynamic method usually used for rapid administration of oligonucleotides is unsuitable for use in humans. In this study, we have investigated the antitumor activity of a synthetic siRNA, B717, which is sequence specific for the human bcl-2 oncogene, complexed with a novel cationic liposome, LIC-101. Experimental Design: In a mouse model of liver metastasis, we administered B717/LIC-101 by bolus intravenous injection, adjusting the rate and volume of administration to what is feasible in human therapy. In a mouse model bearing prostate cancer in which the cells were inoculated under the skin, B717/LIC-101 was administered subcutaneously around the tumor. Results: The B717/LIC-101 complex inhibited the expression of bcl-2 protein and the growth of tumor cell lines in vitro in a sequence-specific manner in the concentration range of 3 to 100 nmol/L. Furthermore, the complex had a strong antitumor activity when administered intravenously in the mouse model of liver metastasis. B717 (siRNA) was shown to be delivered to tumor cells in the mouse liver, but only when complexed with LIC-101. The complex also inhibited tumor cell growth in the mouse model bearing prostate cancer. Conclusions: By combining siRNA with our cationic liposome, we overcame the difficulty of administering siRNA to animals in ways that can be applied in human therapy. Although our siRNA/liposome complex is not yet in clinical trials, it is expected to provide a novel siRNA therapy for cancer patients.
Hydrolysis of fat by human gastric juice
Authors: S. Bank, L. H. Krut, I. N. Marks, B. Bronte-Stewart, P. J. Ler. Uys
Journal: Gut (1964)

EDITORIAL SYNOPSIS It is currently thought that the lipolytic activity of gastric juice is not important.These studies show that human gastric juice produces partial hydrolysis of a triglyceride emulsion and may make a significant initial contribution to the process of fat absorption.
Recurrence of Achilles tendon injuries in elite male football players is more common after early return to play: an 11-year follow-up of the UEFA Champions League injury study
Authors: Mariann Gajhede-Knudsen, Jan Ekstrand, Henrik Magnusson, Nicola Maffulli
Journal: British Journal of Sports Medicine (2013)

Background There is limited information about Achilles tendon disorders in professional football. Aims To investigate the incidence, injury circumstances, lay-off times and reinjury rates of Achilles tendon disorders in male professional football. Methods A total of 27 clubs from 10 countries and 1743 players have been followed prospectively during 11 seasons between 2001 and 2012. The team medical staff recorded individual player exposure and time-loss injuries. Results A total of 203 (2.5% of all injuries) Achilles tendon disorders were registered. A majority (96%) of the disorders were tendinopathies, and nine were partial or total ruptures. A higher injury rate was found during the preseason compared with the competitive season, 0.25 vs 0.18/1000 h (rate ratio (RR) 1.4, 95% CI 1.1 to 2.0; p=0.027). The mean lay-off time for Achilles tendinopathies was 23±37 (median=10, Q 1 =4 and Q 3 =24) days, while a rupture of the Achilles tendon, on average, caused 161±65 (median=169, Q 1 =110 and Q 3 =189) days of absence. Players with Achilles tendon disorders were significantly older than the rest of the cohort, with a mean age of 27.2±4 years vs 25.6±4.6 years (p&lt;0.001). 27% of all Achilles tendinopathies were reinjuries. A higher reinjury risk was found after short recovery periods (31%) compared with longer recovery periods (13%) (RR 2.4, 95% CI 2.1 to 2.8; p&lt;0.001). Conclusions Achilles tendon disorders account for 3.8% of the total lay-off time and are more common in older players. Recurrence is common after Achilles tendinopathies and the reinjury risk is higher after short recovery periods.
Involvement of IFN Regulatory Factor (IRF)-1 and IRF-2 in the Formation and Progression of Human Esophageal Cancers
Authors: Yan Wang, Dong-Ping Liu, Ping-Ping Chen, H. Phillip Koeffler, Xiang-Jun Tong, Dong Xie
Journal: Cancer Research (2007)

Abstract IFN regulatory factor (IRF)-1 and IRF-2 are generally regarded as a tumor suppressor and an oncoprotein, respectively. However, little is known about their expression and function in esophageal squamous cell carcinomas (ESCC). In our present work, IRF-1 expression was decreased and IRF-2 expression was increased in ESCCs compared with matched normal esophageal tissues. Moreover, statistical data indicated that IRF-2 expression was tightly correlated with progression of ESCCs. As expected, overexpression of either IRF-1 or IRF-2 in an ESCC cell line resulted in either suppression or enhancement of cell growth, respectively. Also, proliferation- and apoptosis-related molecules (p21WAF1/CIP1, cyclin-D1, Bcl-2, and histone H4) were regulated by IRF-1 and IRF-2. Additionally, high levels of IRF-2 blocked the function of IRF-1 by preventing the latter from translocating into the nucleus; in contrast, knock down of IRF-2 by small interfering RNA permitted nuclear localization and activity of IRF-1. In vivo assay using nude mice indicated that the tumorigenicity of ESCC cells was enhanced with IRF-2 overexpression but dramatically attenuated after forced expression of IRF-1. In conclusion, IRF-1 and IRF-2 are able to regulate tumorigenicity of ESCC cells as antioncoprotein and oncoprotein, respectively. Relative amounts of IRF-1 to IRF-2 are functionally very important for the development and progression of ESCCs, and reduction of the ratio of IRF-1/IRF-2 may lead to the enhancement of tumorigenicity of ESCC cells. Therefore, levels of IRF-1 and IRF-2 are useful indicators in diagnosis and prognosis for ESCCs, and these molecules are potential drug targets for ESCC therapy. [Cancer Res 2007;67(6):2535–43]
Admissions to hospital with exacerbations of chronic obstructive pulmonary disease: effect of age related factors and service organisation
Authors: M J Connolly
Journal: Thorax (2006)

<b>Background:</b> Exacerbations of chronic obstructive pulmonary disease (COPD) have a high rate of mortality which gets worse with advancing age. It is unknown whether this is due to age related deficiencies in process of care. A study was undertaken in patients with COPD exacerbations admitted to UK hospitals to assess whether there were age related differences in the process of care that might affect outcome, and whether different models of care affected process and outcome. <b>Methods:</b> 247 hospital units audited activity and outcomes (inpatient death, death within 90 days, length of stay (LOS), readmission within 90 days) for 40 consecutive COPD exacerbation admissions in autumn 2003. Logistic regression methods were used to assess relationships between process and outcome at p&lt;0.001. <b>Results:</b> 7514 patients (36% aged ⩾75 years) were included. Patients aged ⩾75 years were less likely to have blood gases documented, to have FEV<sub>1</sub> recorded, or to be given systemic corticosteroids. Those admitted under care of the elderly (CoE) physicians were less likely to enter early discharge schemes or to receive non-invasive ventilation when acidotic. Overall inpatient and 90 day mortality was 7.4% and 15.3%, respectively. Inpatient and 90 day adjusted odds mortality rates for those aged ⩾85 years (versus ⩽65 years) were 3.25 and 2.54, respectively. Mortality was unaffected by admitting physician (CoE <i>v</i> general <i>v</i> respiratory). Age predicted LOS but not readmission. Age related deficiencies in process of care did not predict inpatient or 90 day mortality, readmission, or LOS. <b>Conclusions:</b> Management of COPD exacerbations varies with age in UK hospitals. Inpatient and 90 day mortality is approximately three times higher in very elderly patients with a COPD exacerbation than in younger patients. Age related deficiencies in the process of care were not associated with mortality, but it is likely that they represent poorer quality of care and patient experience. Recommended standards of care should be applied equally to elderly patients with an exacerbation of COPD.
Elderly Medicine: A Training Guide
Authors: Sarah Fowler
Journal: Journal of the Royal Society of Medicine (2002)

With its population getting older, the UK is increasingly in need of well-trained and enthusiastic elderly-care physicians. Fifty years ago geriatrics dealt mainly with continuing care and rehabilitation but it has evolved into a specialty encompassing acute general medicine with a holistic multidisciplinary approach. In future years the national service framework for older people may well generate opportunities for subspecialty work in areas such as stroke, falls and intermediate care.

Rai and Mulley's Guide does not set out to be exhaustive. It offers practical advice on common problems, incorporating clinical trial evidence where possible and common sense where not. The text is easy to read and the layout allows one to skip between chapters and diagnoses with ease. Some sections deal with frequent dilemmas in the elderly such as falls and instability, pressure care and practical management of stroke. Others address diseases that affect all age groups, such as cancer and respiratory disease, but with a bias towards management and diagnosis in the elderly. On certain matters, such as Parkinson's disease, the detail struck me as insufficient; and coronary heart disease is not covered at all. But these can be pursued elsewhere. Clinical issues apart, aspiring consultants in old age medicine will appreciate the guide's helpful words on negotiating with managers, service development and interview practice.

Overall I was very impressed by the book, which draws on the experience of a wide range of individuals. I recommend it to trainees in geriatric medicine, and it will be useful to other doctors in training whose day-to-day practice includes older people.
Smooth-Muscle Calponin in Mesangial Cells
Authors: Youichi Sugenoya, Ashio Yoshimura, Hisako Yamamura, Kiyoko Inui, Hiroyuki Morita, Hideaki Yamabe, Noboru Ueki, Terukuni Ideura, Katsuhito Takahashi
Journal: Journal of the American Society of Nephrology (2002)

The basic or h1 calponin gene, which encodes an actin-binding protein involved in the regulation of smooth-muscle shortening velocity, is known to be a smooth-muscle differentiation-specific gene. It was found that basic calponin was expressed by cultured mesangial cells and localized along the actin filaments. Among the growth factors involved in the mesangial cell pathophysiology, including platelet-derived growth factor-BB (PDGF-BB), tumor necrosis factor-alpha (TNF-alpha), and transforming growth factor-beta1 (TGF-beta1), TNF-alpha potently downregulates basic calponin expression in both the mRNA and protein levels, whereas TGF-beta1 upregulates the calponin expression. PDGF-BB also reduced its mRNA expression. The half-life of basic calponin mRNA was determined to be similar between TNF-alpha-treated and -untreated mesangial cells, whereas cell transfection assays that used a luciferase reporter gene construct containing the functional basic calponin promoter showed that TNF-alpha and PDGF-BB reduced the transcriptional activity. Because stimulation with TNF-alpha and PDGF-BB was associated with mesangial cell proliferation, basic calponin may play a role in the suppression of mesangial cell proliferation. Treatment with anti-glomerular basement membrane antibody in calponin knockout mice induced more severe nephritis than in wild type mice, as judged from an increase in the urinary protein excretion, glomerular cellularity, and number of proliferating cell nuclear antigen-positive cells in glomerulus. These results suggest that basic calponin expression may serve as one of the intrinsic regulators of glomerular nephritis. Elucidation of the molecular mechanisms for regulation of the basic calponin expression in mesangial cells may improve the understanding of the molecular basis and pathogenesis of the glomerular response to injury.
Improved outcomes in elderly patients with metastatic castration-resistant prostate cancer treated with the androgen receptor inhibitor enzalutamide: results from the phase III AFFIRM trial
Authors: C.N. Sternberg, J.S. de Bono, K.N. Chi, K. Fizazi, P. Mulders, L. Cerbone, M. Hirmand, D. Forer, H.I. Scher
Journal: Annals of Oncology (2014)