tbuckley/cabot-search huggingface dataset:
Pathologic and biochemical outcomes among African American and Caucasian men with low-risk prostate cancer in the search database: Implications for active surveillance candidacy.
Authors: Michael S. Leapman, Stephen J. Freedland, William J Aaronson, Christopher J. Kane, Martha K. Terris, Christopher L. Amling, Peter Carroll, Matthew R. Cooperberg
Journal: Journal of Clinical Oncology (2016)

76 Background: Racial disparities in the incidence and risk profile of prostate cancer (PCa) at diagnosis among African American (AA) men are well reported, however it remains unclear whether AA race is independently associated with adverse pathological findings among men with clinical low risk disease. Methods: We conducted a retrospective analysis among 895 men, with clinical low risk (Gleason 3+3, clinical stage ≤T2a, PSA≤10 ng/mL) treated with immediate radical prostatectomy within the Shared Equal Access Regional Cancer Hospital (SEARCH) database. We evaluated clinical and demographic characteristics by AA or Caucasian race. Associations between AA versus Caucasian race with pathologic Gleason upgrade (≥3+4), major upgrade (≥4+3), upstage (pT3a or higher), margin status and biochemical recurrence (BCR) were examined using chi-square, logistic regression, log-rank, and Cox proportional hazards analyses. Results: We identified 355 AA and 540 Caucasian men with low-risk tumors within the SEARCH cohort followed for a median of 6.3 (IQR 3.8-8.9). AA men were younger (mean 59.5vs. 62.0 years), and had higher median PSA (5.5 vs. 5.1). Following adjustment for relevant covariates, AA race was not significantly associated with pathological upgrade (OR 1.335, 95% CI 0.936-1.905, p=0.111), major upgrade (OR 0.561, 95% CI 0.300-1.049, p=0.070), upstaging (OR 1.111, 95% CI 0.670-1.844, p=0.683), or positive surgical margins (OR 1.046, 95% CI 0.732-1.494, p=0.806). The 5-year recurrence-free survival rates were 73.4% and 78.4% for AA and Caucasian men, respectively (log-rank p=0.178). After adjustment for clinical and pathological characteristics, AA race was not significantly associated with BCR (HR 1.1.054, 95% CI 0.814-1.501, p=0.521). Conclusions: In a cohort of low-risk men treated with prostatectomy within an equal access health system with a high representation of AA men, no significant differences were observed in the rates of pathologic upgrading, upstaging or biochemical recurrence. These data support continued use of AS in AA. Upgrading and upstaging remain concerning possibilities for all men regardless of race.
Forgotten Biliary Stent Trapped in an Impacted Stone: Successful Extraction After Combined Electrohydraulic Lithotripsy and Basket Retrieval By Cholangioscopy
Authors: C O’Neill, T Bana e Costa, P Figueiredo, C Chagas
Journal: Endoscopy (2021)

77-years-old woman with obstructive jaundice. Five-years earlier, underwent ERCP with plastic stent placement due to incomplete removal of bile stones and was lost to follow-up. Presently, abdominal-CT identified dilated CBD with stones and a stent. During ERCP the stent fragmented and was not retrieved. Cholangioscopy with SpyGlassDS revealed a plastic stent encased in stones impacted on the CBD. Electrohydraulic lithotripsy(EHL) followed by complete removal of the stent and stones was perfomed using the SpyGlass Retrieval Basket.
Acute myocardial infarction with normal coronary arteries: a possible manifestation of the billowing mitral leaflet syndrome.
Authors: EChesler, R EMatisonn, J BLakier, W APocock, I WObel, J BBarlow
Journal: Circulation (1976)

The findings in four young patients with the billowing mitral leaflet syndrome who presented with evidence of acute myocardial infarction are reported. Because technically adequate coronary arteriograms demonstrated patent vessels and the electrocardiograms initially showed pronounced elevation of the ST segments as occurs in Prinzmetal's angina, it is postulated that spasm of normal coronary arteries was the operative factor. Scrutiny of those cases of clinically apparent ischemic heart disease with normal coronary angiograms is suggested to establish whether there is in fact a causal relationship with the billowing mitral leaflet syndrome.
Use of therapeutic ultrasound in percutaneous coronary angioplasty. Experimental in vitro studies and initial clinical experience.
Authors: R JSiegel, JGunn, AAhsan, M CFishbein, R JBowes, DOakley, CWales, WSteffen, SCampbell, HNita
Journal: Circulation (1994)

BACKGROUNDPrevious studies have shown the feasibility of peripheral arterial ultrasound angioplasty.METHODS AND RESULTSIn this report, we describe the use of percutaneous therapeutic ultrasound for coronary angioplasty. In vitro, 11 postmortem, atherosclerotically occluded coronary arteries were obtained to assess catheter-delivered ultrasound for arterial recanalization as well as for assessment of the size of particulate debris. Clinically, coronary ultrasound angioplasty was performed in 19 patients (mean age, 56 years) to assess safety and feasibility for the treatment of obstructive coronary atherosclerosis. Three patients with unstable angina and 16 with exercise-induced myocardial ischemia were treated with a prototype 4.6F coronary catheter ultrasound ablation device with a 1.7-mm diameter ball tip. The ultrasound coronary catheter delivered ultrasound energy at 19.5 kHz, with a power output of 16 to 20 W at the transducer. Energy is delivered in a pulsed mode with a 50% duty cycle of 30 milliseco...
Reduction of coronary blood flow during coronary artery spasm occurring spontaneously and after provocation by ergonovine maleate.
Authors: D RRicci, A EOrlick, P WDoherty, P RCipriano, D CHarrison
Journal: Circulation (1978)

A 50-year-old man suffering from recurrent chest pain accompanied by transient ST-segment elevation developed spasm of the left anterior descending coronary artery after receiving ergonovine maleate. During spontaneous chest pain, thermodilution coronary sinus blood flow fell from 96 ml/min to 46 ml/min, while the coronary sinsu arteriovenous oxygen difference widened from 9.82 volumes percent to 11.3 volumes percent. During spontaneous relief of pain, coincident with resolution of the ST-segment changes, coronary sinus blood flow gradually rose to 135 ml/min, while coronary sinus arteriovenous oxygen difference narrowed to 6.82 volumes percent. Similar aterations in coronoary sinus blood flow accompanied chest pain provoked by ergonovine maleate. A thallium-201 scan confirmed a perfusion defect in the distribution the left anterior descending coronary artery. Thus, coronary artery spasm can produce a marked deficity in coronary blood flow that is associated with increased myocardial oxygen extraction; re...
Neuroleptic malignant syndrome
Authors: J L Levenson
Journal: American Journal of Psychiatry (1985)

Neuroleptic malignant syndrome is a rare but serious adverse effect of antipsychotic medication. The author describes three new cases and reviews 50 others published in the past 5 years. Demographic and clinical features, diagnosis, treatment, outcome, and pathophysiology are critically reviewed, and a new set of diagnostic criteria, incorporating physical signs and routine laboratory tests, is proposed.
Aneurysm of the membranous ventricular septum in transposition of the great arteries.
Authors: B AVidne, SSubramanian, H RWagner
Journal: Circulation (1976)

In patients with transposition of the great arteries (TGA), both the D- and L- forms, an aneurysm of the membranous ventricular septum (AMS) produces subpulmonic stenosis due to the higher right ventricular pressure which forces the aneurysm to protrude into the left ventricular, i.e., subpulmonic, outflow tract. The clinical signs and symptoms, hemodynamic findings as well as surgical results were analyzed in eight patients with TGA and AMS. The presence of an AMS should be suspected from hemodynamic data consisting of a combination of elevated left ventricular pressure, gradient across the left ventricular outflow tract and presence of a small ventricular septal defect with or without pulmonary artery hypertension. The AMS can be demonstrated by a right ventricular injection in the lateral view. The anomaly needs to be corrected at the time of the Mustard procedure. If uncorrected it may lead to postoperative death or progressive obstruction. In the presence of an aneurysm even small ventricular septal ...
Inhibition of coronary artery superoxide dismutase attenuates endothelium-dependent and -independent nitrovasodilator relaxation.
Authors: H AOmar, P DCherry, M PMortelliti, TBurke-Wolin, M SWolin
Journal: Circulation Research (1991)

Isolated bovine coronary arteries were treated with 10 mM diethyldithiocarbamate (DETCA) for 30 minutes to deplete the cytosolic ZnCu form of superoxide dismutase (SOD). This treatment completely inhibited the endothelium- and cGMP-dependent relaxation to acetylcholine (mediated via the endothelium-derived relaxing factor, which is thought to be nitric oxide) without significantly inhibiting endothelium-dependent relaxation to arachidonic acid (mediated by prostaglandins). DETCA treatment of endothelial cells cultured from the coronary arteries inhibited bradykinin-elicited release of endothelium-derived relaxing factor, which was detected by bioassay on an isolated rabbit aorta in the presence of extracellular SOD. DETCA also inhibited cGMP-associated relaxations to nitric oxide and to vasodilators thought to function via the generation of this mediator (nitroglycerin and nitroprusside), but cAMP-associated relaxations to isoproterenol and papaverine were not altered. The inhibitory effects of DETCA agai...
Per Oral Pancreatico Scopy (POPS) Assisted Retrieval of Deeply Migrated Pancreatic Stent
Authors: A Bapaye, A Gandhi, R Pujari, H Bapaye
Journal: Endoscopy (2021)

Introduction Pancreatic stent migration - rare complication following pancreatic endotherapy. Retrieval is technically challenging.Video demonstrates PerOral PancreaticoScopy assisted retrieval of migrated Pancreatic stent.
Isolation perfusion for malignant melanoma of the extremity. A review.
Authors: H Schraffordt Koops, J Oldhoff
Journal: Journal of Clinical Oncology (1986)

Article Tools Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1986.4.3.441 Journal of Clinical Oncology - published online before print September 22, 2016 PMID: 3950681 Isolation perfusion for malignant melanoma of the extremity. A review. H Schraffordt KoopsxH Schraffordt KoopsSearch for articles by this author , J OldhoffxJ OldhoffSearch for articles by this author https://doi.org/10.1200/JCO.1986.4.3.441 PDF "Isolation perfusion for malignant melanoma of the extremity. A review.." Journal of Clinical Oncology, 4(3), pp. 441–442© 1986 by American Society of Clinical Oncology
Creatine kinase isoform analysis in the detection and assessment of thrombolysis in man.
Authors: P RPuleo, M BPerryman, M ABresser, RRokey, C MPratt, RRoberts
Journal: Circulation (1987)

Recent demonstrations of the efficacy of intravenous thrombolytic therapy in acute myocardial infarction have emphasized the need for a noninvasive index of successful reperfusion. The tissue form of MM creatine kinase (MM3) is known to undergo posttranslational conversion to modified forms MM2 and MM1 after release into the plasma following acute infarction. Since this conversion is rapid, sustained elevation of plasma MM3 may be a marker of the prolonged creatine kinase release characteristic of nonreperfused infarction. Therefore, we investigated the rate of decline of plasma MM3 in a consecutive series of patients undergoing thrombolytic therapy of acute myocardial infarction, all of whom underwent acute angiography to assess treatment success, as well as in 30 conventionally treated patients. Among 55 patients with angiographically documented successful reperfusion (group IA), the rate of decline of MM3 was 4.18 +/- 1.25%/hr (mean +/- SD); in contrast, the rate of decline was 2.37 +/- 1.11%/hr in 39 ...
Coronary artery spasm in intact dogs induced by potassium and serotonin.
Authors: J EPérez, J ESaffitz, F AGutiérrez, P DHenry
Journal: Circulation Research (1983)

Although coronary artery spasm has been implicated as an important cause of myocardial ischemia in humans, an animal model of reversible segmental coronary constriction has not been described. To provoke coronary spasm in open-chest dogs, selected vasoconstricting agents adsorbed to viscous ion exchange gels were applied topically to the surface of epicardial coronary arteries. The procedure provided a sustained localized release of drug, and minimized effects on contiguous myocardium or on the systemic circulation. Segmental arterial constrictor responses were evaluated by sonomicrometry, arteriography, and electromagnetic flow measurements. Potassium evoked sustained constrictions or spasms, and concomitantly reduced flow by -42 +/- 4% (SE; n = 34). Serotonin likewise produced sustained decreases in flow of -22 +/- 6% (SE; n = 5). Other constrictors, including norepinephrine and angiotensin, failed to evoke sustained constrictions. Spasms nearly abolished reactive hyperemic responses elicited by tempora...
Effects of ryanodine on contractile performance of intact length-clamped papillary muscle.
Authors: FUrthaler, A AWalker, R CReeves, L LHefner
Journal: Circulation Research (1989)

Extent, time course, and underlying mechanisms of the negative inotropic effect of ryanodine were examined in 22 length-clamped ferret right ventricular papillary muscles paced 12/min at 25 degrees C. After 60 minutes of exposure to 5 microM ryanodine a new steady state was attained with developed forces averaging 10-15% of maximum twitch force. Ryanodine does not pharmacologically excise the sarcoplasmic reticulum (SR) in this preparation. Ryanodine does not appreciably inhibit the ability of the SR to take up Ca2+ as evidenced by the potentiated beats obtained after a short pause that are nearly as large after ryanodine as before. On comparing equipotent beats before and after ryanodine, we found that ryanodine actually increases the rate at which Ca2+ is released during the twitch if the SR Ca2+ stores are equal or similar. The evidence for this conclusion is a larger maximum rate of tension rise and briefer time to peak tension after ryanodine. Since ryanodine increases the time that SR Ca2+ release c...
Indium-111-monoclonal antimyosin antibody studies after the first year of heart transplantation. Identification of risk groups for developing rejection during long-term follow-up and clinical implications.
Authors: MBallester, DObrador, ICarrió, J MAugé, CMoya, GPons-Lladó, J MCaralps-Riera
Journal: Circulation (1990)

The long-term clinical course and results of biopsies in 21 patients studied with monoclonal antimyosin antibodies more than 12 months after heart transplantation according to the presence and degree of antimyosin-antibody uptake is described. Eighteen men and three women aged 20-52 years (39 +/- 9 years) were studied with antimyosin antibodies 12-40 months (mean, 22 +/- 9 months) after heart transplantation, and followed for a mean of 18 months (10-28 months). The number of biopsies performed during follow-up was 102. Results showed normal antimyosin-antibody studies in nine patients and abnormal studies in 12 patients. Myocyte damage was identified in 18 of the 102 biopsies (17.6%), one in the normal antimyosin-antibody group of patients and 17 in those patients with myocardial antimyosin-antibody uptake. Patients who developed rejection comprised 11% and 67% of each respective group; the mean number of rejection episodes per patient was 0.11 +/- 0.33 and 1.41 +/- 1.41, respectively (p less than 0.01). ...
Echocardiographic recognition of the mitral valve-posterior aortic wall relationship.
Authors: B LStrunk, S BGuss, R EHicks, M NKotler
Journal: Circulation (1975)

Aortic-mitral valve discontinuity has previously been described in double outlet right ventricle, endocardial cushion defect, single ventricle, tetralogy of Fallot, and prolapse of the mitral valve. We are reporting two additional examples of aortic-mitral valve discontinuity including 15 cases of gross left ventricular dilation and a case of acute pneumococcal bacterial endocarditis with a large subannular erosion. While nonspecific, aortic-mitral valve discontinuity is a clinically important sign that should be sought with slow-M-mode scanning and strip chart recording.
Smoking and fibrinolysis.
Authors: LJanzon, I MNilsson
Journal: Circulation (1975)

In order to study the fibrinolytic activity of vein walls in smokers and nonsmokers, 71 randomly selected heavy smokers, i.e., smoking more than 15 g tobacco per day, and 41 nonsmokers from the population group Men born in 1914 residing in Malmo were invited to undergo a health examination. When examined after 12 hours' abstention from tobacco, the smokers were found to have the same fibrinolytic activity as nonsmokers. Out of the 71 heavy smokers, 31 refrained from smoking during 8-9 weeks (as monitored with questionaire and COHb-determinations). Neither in those who had abstained from smoking nor in the controls did the fibrinolytic activity differ from that initially recorded. In a randomly selected subsample of 19 individuals examined after only one week's abstention from tobacco, the fibrinolytic activity, after venous occlusion of forearms, tended to be lower in the blood as well as in superficial hand veins, but the difference was not significant. The effect of smoking six cigarettes during three...
Effectiveness of right heart catheterization: time for a randomized trial
Authors: R. P. Lewis
Journal: JAMA (1997)

To the Editor.  —Clinical intuition suggests that the availability of better physiological information should lead to better outcomes by enabling physicians to manage patients in a more sophisticated manner. The article by Dr Connors and colleagues 1 is a provocative study that questions the validity of that concept and illustrates the importance of evidencebased clinical decision making.  The authors are careful to point out many of their study's limitations, principally its observational design, and offer several plausible explanations for their findings. They do not, however, mention an important limitation: the composition of the patient population. Most of the patients in the study appear to have had noncardiac illnesses (respiratory failure and multiorgan system failure). Patients with acute myocardial infarction (MI) are conspicuously absent from the study population. Thus, the study's patient population may be a subset of critically ill patients who are least likely to benefit from application of the information available from
Morphological and quantitative angiographic analyses of progression of coronary stenoses. A comparison of Q-wave and non-Q-wave myocardial infarction.
Authors: SDacanay, H LKennedy, EUretz, J EParrillo, L WKlein
Journal: Circulation (1994)

BACKGROUNDThe purpose of this study was to determine differences in coronary stenosis severity and morphology and time course of progression between Q-wave and non-Q-wave myocardial infarction (MI).METHODS AND RESULTSWe studied 32 patients with new Q-wave MI and 38 patients with new non-Q-wave MI who underwent coronary angiography both before and after MI without interval revascularization procedures. Quantitative coronary angiographic analysis was performed by the caliper method, and morphological analysis of coronary angiograms was obtained before and soon after acute MI. Before infarction, the stenosis severity at the site of future MI was worse in Q-wave (44 +/- 25%) versus non-Q-wave (23 +/- 35%) MI patients (P < .01). Eccentric and irregular plaques were more common in Q-wave MI patients (18 of 32, 56%, versus 5 of 38, 13%; P < .001). Non-Q-wave MI patients were more frequently found to have significant collaterals after MI compared with Q-wave MI patients (18 of 38, 47%, versus 1 of 32, 3%; P < .00...
Atrial fibrillation in patients with Wolff-Parkinson-White syndrome: incidence after surgical ablation of the accessory pathway.
Authors: A DSharma, G JKlein, G MGuiraudon, SMilstein
Journal: Circulation (1985)

The effect of surgical ablation of ablation of atrioventricular accessory pathways on the incidence of atrial fibrillation in patients with Wolff-Parkinson-White syndrome was examined and the results of preoperative electrophysiologic testing were studied to determine factors predictive of outcome. Among 50 consecutive surgical cases, 19 patients were identified with a past history of at least one episode of spontaneous atrial fibrillation documented by electrocardiogram before surgery. The mean number of episodes of atrial fibrillation was 1.97/patient/year during a mean symptomatic period of 6.9 years before surgery. These patients were compared with 19 consecutive patients undergoing surgery during the same time period who had a history of only reciprocating tachycardia. Patients with atrial fibrillation had a significantly shorter antegrade accessory pathway effective refractory period (270 +/- 39 vs 330 +/- 107 msec; p less than .05) and much faster ventricular rates during induced atrial fibrillatio...
Myocardial angiogenesis and coronary perfusion in left ventricular pressure-overload hypertrophy in the young lamb. Evidence for inhibition with chronic protamine administration.
Authors: M FFlanagan, A MFujii, S DColan, R GFlanagan, J ELock
Journal: Circulation Research (1991)

In contrast to young growing animals, pressure-overload hypertrophy in adults is frequently associated with diminished myocardial capillary density and maximal coronary flow per gram. To determine the role of angiogenesis in maintaining perfusion capacity in the hypertrophying heart, the angiogenesis inhibitor protamine sulfate was administered to young lambs during the development of left ventricular (LV) pressure-overload hypertrophy. Baseline and maximum (adenosine) myocardial perfusion was measured in four groups of chronically instrumented 10-week-old lambs subjected to 1) ascending aortic bands since the age of 4 weeks (LVH group, n = 10), 2) sham operation at the age of 4 weeks (SHAM group, n = 8), 3) aortic bands and twice daily injections of protamine since the age of 4 weeks (LVH + P group, n = 9), 4) sham operation and injection of protamine (SHAM + P group, n = 8). Capillary density was measured postmortem. Peak LV pressure and the LV/body weight ratio were similarly increased in LVH and LVH +...
Guidelines of care for the management of actinic keratosis
Authors: Daniel B. Eisen, Maryam M. Asgari, Daniel D. Bennett, Suzanne M. Connolly, Robert P. Dellavalle, Esther E. Freeman, Gary Goldenberg, David J. Leffell, Sue Peschin, James E. Sligh, Peggy A. Wu, Lindsy Frazer-Green, Sameer Malik, Todd E. Schlesinger
Journal: Journal of the American Academy of Dermatology (2021)
The future of FHSAs.
Authors: S J Jachuck
Journal: BMJ (1993)

The future ofFHSAs EDrrOR,-June Huntingdon's article on the future of family health services authorities contains several misleading assertions.'I practise in the London Borough of Newham and also give medical advice to the family health services authority through the department of general practice and primary care of the Joint Medical Colleges of St Bartholomew's and the London Hospitals.As medical adviser, I have met some of the practi- tioners with "typically small lists, [who] have trained overseas and entered general practice before vocational training became mandatory."'My experience of practitioners trained overseas and with small lists is that most are good doctors committed to caring for their patients to the best of their ability.Historically, they were exploited because of their lack of understanding of the