tbuckley/cabot-search huggingface dataset:
Four futures for scientific and medical publishing
Authors: D. G Guest
Journal: BMJ (2003)

Editor—Abbasi et al are to be congratulated on their crystal ball gazing.1 Communication in the modern world is clearly changing, and even in the world of medical publishing the old ways are giving way to the new. Although Homer may make some minor changes, his children will never follow in his footsteps.

The future belongs to Lisa. Smart and articulate, she will thrive in a milieu that she manipulates so that useful information will flow towards her. By participating in her online communities and achieving status in these groups, she will be the one who knows (or at least who knows who knows) the required information.

Lisa will have accepted the basic precepts of the cluetrain manifesto (www.cluetrain.com), its essence being that communication in the modern world is based on continuous online conversations by email between service providers and clients, their immediacy and formality being somewhere between a letter and a telephone call. Lisa will participate continuously in her global conversations, irrespective of her physical location. The lines between her work and leisure will blur.

Abbasi et al seem unsure as to how many journals there will be in Lisa world. They list the range as 0 to 1 million. Conversation is great, but we still need to separate the wheat from the chaff and the signal from the noise. Fortunately the internet has given us the answer—one—the Wikipedia concept, which has developed as a result of the open source software model using free (wiki) software (www.wikipedia.org/wiki/Medicine). The essential features are a revision control system, unrestricted editing of articles on the wiki by any registered member, unrestricted membership of the wiki, and the ability to fork articles (or see current versions at the same time). In addition, no copies are deleted and the newer versions of an article comprise the original article with all additions made cumulatively.
Abstract 2349: Cryoablation for Atrioventricular Nodal Reentrant Tachycardia (AVNRT) in 154 Young Patients: 4mm vs. 6mm Catheter Tip Sizes
Authors: Nikhil K Chanani, Nancy A Chiesa, Anne M Dubin, Kishor Avasarala, George F Van Hare, Kathryn K Collins
Journal: Circulation (2007)

Introduction : Cryoablation of AVNRT has a high initial success rate and an excellent safety profile; however, there is a risk of recurrence. We hypothesized that the transition from a 4mm to a 6mm cryoablation catheter tip size would decrease recurrences without compromising safety. Methods/Results : We retrospectively reviewed all patients (n=154) who underwent cryoablation for AVNRT at the UCSF/Stanford Pediatric Arrhythmia Center from 1/04 –2/07. Initially, we used the 4mm tip, and then transitioned to a 6mm tip except for younger and smaller children. The majority of the patients had a structurally normal heart. 10 patients had congenital heart disease (3 ASDs, 3 aortic valve abnormalities, 1 Ebstein’s, 1 PDA, 1 unbalanced AV canal defect, 1 L-TGA). Typical AVNRT was inducible in 123 patients (80%), atypical in 13 (9%), and both typical and atypical in 1 patient. 17 (11%) had presumed AVNRT. Additional arrhythmias were documented in 18 patients (7 WPW, 6 AET, 4 atrial fibrillation, 1 JET). There was no difference in initial outcomes between the 4mm and 6mm tips. There was no permanent AV block. Recurrence rates were lower with the 6mm tip, but this did not reach statistical significance. The median time to recurrence was 2 (0.25–20) months. Follow-up time was longer in the 4mm group but did not significantly impact recurrence rate (p=0.61). Recurrences were not associated with any patient variable (age, size, heart disease, AVNRT inducibility, additional arrhythmias) or any procedural variable (fluoroscopy time, duration of cryoablation, transient AV block, presence of residual slow AV nodal pathway or echo beats). Conclusions : Initial outcomes of the 6mm cryoablation catheter tip for AVNRT are excellent and early recurrence rates are promising. However, we have yet to demonstrate a convincing advantage for the 6mm tip. Further improvements in cryoablation technique are necessary to reduce recurrences without sacrificing the safety profile. Cryoablation for AVNRT
A Phase 1/2 Study Of Blinatumomab In Pediatric Patients With Relapsed/Refractory B-Cell Precursor Acute Lymphoblastic Leukemia
Authors: Arend von Stackelberg, Gerhard Zugmaier, Rupert Handgretinger, Franco Locatelli, Carmelo Rizzari, Tanya M. Trippett, Arndt Borkhardt, Susan R. Rheingold, Peter Bader, Deepa Bhojwani, Todd Michael Cooper, Steven G. DuBois, Maureen M. O'Brien, Christian M. Zwaan, Chris Holland, Noemi Mergen, Anja Fischer, Min Zhu, Youssef Hijazi, James Whitlock, Lia Gore
Journal: Blood (2013)
Twenty-four-hour profiles of body temperature and plasma TSH in bipolar patients during depression and during remission and in normal control subjects
Authors: E Souetre, E Salvati, T A Wehr, D A Sack, B Krebs, G Darcourt
Journal: American Journal of Psychiatry (1988)

The 24-hour patterns of body temperature and plasma thyrotropin (TSH) were measured in eight bipolar patients in both depressed and recovered (after 3 weeks of treatment) states and in eight normal control subjects. Clear circadian patterns were detected for both temperature and TSH. Nocturnal body temperature was increased and the nocturnal surge of TSH was blunted during depression; these abnormalities were corrected after recovery. The inverse relationship between changes in body temperature and TSH levels at night suggests that changes in thermoregulation may be responsible for the neuroendocrine disturbance and may play a role in the pathophysiology of depression.
392. High Intrinsic Expression of Manganese Superoxide Dismutase Is a Critical Protective Mechanism Against Oxidative Stress in Human Endothelial Progenitor Cells
Authors: Tongrong He, Timothy E. Peterson, Ekhson L. Holmuhamedov, Andre Terzic, Noel M. Caplice, Larry W. Oberley, Zvonimir S. Katusic
Journal: Molecular Therapy (2004)

Top of pageAbstract
Endothelial progenitor cells (EPCs) display a unique aptitude to promote angiogenesis in various ischemic sites and restore endothelial function of injured vessels. We hypothesized that EPCs are resistant to oxidative stress and that this resistance is due to high expression and activity of antioxidant enzymes. Outgrowth colonies of EPCs isolated from human blood of healthy subjects were cultured and expanded. Cobblestone appearance, incorporation of acetylated LDL and isolectin, as well as expression of vWF, Flk-1, CD31, CD144, and eNOS indicated endothelial phenotype. EPCs demonstrated a marked resistance to cytotoxic effect of LY83583 (a O2.− generator). The survival rates for EPCs and human umbilical vein endothelial cells (HUVECs) after treated with 5 μ M LY83583 for 3 days are 74.8± 7.7% and 7.4± 1.2% (n=3), respectively. LY83583 inhibited in vitro tube formation by HUVECs and coronary artery endothelial cells (CAECs), but not by EPCs. Compared to mature endothelial cells (HUVECs and CAECs), EPCs exhibited an about 3.5-fold higher expression and activity of mitochondrial manganese superoxide dismutase (MnSOD) (n=3–4, P<0.05) with no difference in cytosolic CuZnSOD and catalase (n=3–4). Confocal and electron microscopy studies showed that mitochondria of HUVECs swelled after treatment with LY83583, while remained normal in EPCs. Furthermore, trypan blue exclusion assay showed that overexpression of recombinant MnSOD protected HUVECs from cytotoxic effect of LY83583. These results suggest that augmented MnSOD expression is a critical intrinsic mechanism designed to protect EPCs against oxidative stress.
Abstract 17515: Factors Associated with Stent Thrombosis Causing ST- Segment Elevation Myocardial Infarction
Authors: Bhanu Duggal, Rishi Puri, Kathy Wolski, Amar Krishnaswamy, Dhruv Modi, William Magyar, E.Murat Tuzcu, Samir Kapadia
Journal: Circulation (2013)

Background:  Stent thrombosis (ST) causing ST-segment elevation myocardial infarction (STEMI) is a devastating complication following percutaneous coronary intervention (PCI). We sought to identify clinical and procedural factors leading to ST and subsequent STEMI.   Methods & Results:  Of 23,676 patients who underwent PCI at the Cleveland Clinic between January 1994 to July 2012, 244 patients presented with STEMI complicating ST. Clinical and procedural variables were analyzed(Table). The timing of ST was classified as early (≤30 days) or late (>30 days) following index PCI. Compared with patients presenting with late ST (n=164), those with early ST (n=80) were older, had a higher HbA1c, higher platelet count and were more likely to present with Kilip class III/IV heart failure, a hypercoagulable state and undergo multiple stent insertion. Late ST was more likely associated with discontinuation of dual anti-platelet therapy (DAT), lower aspirin dose (81 vs 325 mg) and use of drug eluting stents (DES) compared with early ST. In 58 patients (19 early ST, 39 late ST) at the time of STEMI, intravascular ultrasonography showed early ST to be associated with smaller minimal lumen (3.1 vs. 4.2 mm 2 , p=0.02) and vessel areas (14.8±3.0 vs. 17.9±3.9 mm 2  p=0.007), and numerically more edge dissections (p=0.02). Neoatherosclerosis was equally evident in 17% of very late ST following both BMS and DES insertion. A multivariable model assessing timing of ST found increasing age (p=0.003), higher platelet count (p=0.004) and use of multiple stents (p   Conclusion:  This largest consecutive series of ST to date outlines a number of systemic, vessel and procedural factors predisposing to the nature and timing of this rare, but serious complication following PCI.
The Doctor
Authors: David Memel
Journal: BMJ (2007)

This film is a classic portrayal of a doctor's transformation as a result of his own experience of illness. Like a lot of Hollywood movies, it shows the hero overcoming adversity and coming out a better person; it also a reflection on the different aspects of being a doctor.

William Hurt plays Dr Jack McKee, a cardiac surgeon, who is lively and technically competent, but also arrogant, and who has appalling doctor-patient communication skills. Why is it always the surgeons that seem to be this way? Maybe there is some truth in what Dr McKee says on his ward round with his subservient junior staff, that a surgeon needs to be quick and decisive, and that concentrating on the patient's agenda can be distracting. His big fear seems to be that if he becomes sensitive to the patients' needs and fears, he will be paralysed into inactivity.

Dr McKee develops an irritating cough, and eventually after coughing up blood he goes to see an ear, nose, and throat surgeon in his own hospital, the glamorous Dr Lesley Abbott. There is brilliant acting here by William Hurt, as he portrays a patient having a laryngoscope shoved down his choking throat and then being told bluntly by Dr Abbott, “You've got a growth, doctor.” She, rather like Margaret Thatcher, seems to feel that she has to be as tough as the men to survive in her professional world.

We follow Jack McKee trying to come to terms with his illness, while also carrying on his work as a heart surgeon, and we see just how difficult it is to be both a doctor and a patient, especially when you are playing both roles in the same hospital. The best scenes show the powerlessness and frustrations of being a patient, from nearly being given a barium enema intended for a neighbouring patient, to the endless waiting around and poor staff communication.

The film is much less effective when straying away from the medical arena to portray Jack's close relationships. Finding difficulty communicating with his wife, he seeks solace with a fellow radiotherapy patient, who is dying from a brain tumour. Despite being terminally ill, she is beautiful and elegant with her shaven hair, and they run away together, dancing into the sunset in the Nevada desert. Pure Hollywood schmaltz!

Jack discards his female ENT surgeon for a more sensitive male colleague whom he had previously ridiculed for being a nerd, but now clearly recognises as the sort of doctor he needs. He survives surgery and the temporary loss of his voice, and is finally reconciled with his long suffering wife. He returns to work as a much more caring and effective doctor, able to successfully combine the technical and human qualities of being a doctor.

I use this film extensively when teaching medical students, but it has a lot to teach all doctors, at all stages of their careers.
A Prospective, Randomized, 6-Month Comparison of the Coronary Vasomotor Response Associated With a Zotarolimus- Versus a Sirolimus-Eluting Stent
Authors: Jin Won Kim, Hong Seog Seo, Jae Hyoung Park, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Eung Ju Kim, Seung-Woon Rha, Chang Gyu Park, Dong Joo Oh
Journal: Journal of the American College of Cardiology (2009)
Abstract 5459: Unexpected Acceleration of Atherosclerosis in Ldlr-null Mice Reconstituted With Group X Secretory Phospholipase A2-Deficient Bone Marrow
Authors: Hafid Ait-Oufella, Christelle Coatrieux, Bhama Ramkhelawon, Olivier Blanc-Brude, Jérôme Sirvent, Ludivine Laurans, Gérard Lambeau, Ziad Mallat
Journal: Circulation (2009)

Group X (GX) secretory phospholipase A2 (sPLA2) has the most potent hydrolyzing activity toward phosphatidylcholine and elicits a marked release of arachidonic acid among several types of sPLA2. GX is expressed by vascular cells and inflammatory cells like macrophages and CD4+ T lymphocytes and is therefore believed to play a pathogenic role in atherosclerosis. We evaluated the effects of GX deficiency on systemic immune response and the development of atherosclerosis, a vascular disease sustained by lipid modifications and inflammation. GX KO mice showed increased spleen size confirmed by higher splenocyte number compared to C57BL6 controls (P&lt;0.01). LPS/IFN- γ -stimulated GX-deficient splenocytes produced more IL-12 than control splenocytes (3380 vs 1599 pg/ml, P&lt;0.05), with no difference in IL-10. Purified splenic CD4+ T cells from GX KO mice showed enhanced proliferation and production of the Th1 cytokine IFN- γ (5575 vs 1443 pg/ml, respectively, p&lt;0.05) compared with controls. GX-deficient blood mononuclear cells showed enhanced adhesion on activated HUVECs (8.8 vs 3.2 cell/field, P&lt;0.01) and on LDLr KO carotid arteries (4.2 vs 6.4 cell/mm, P&lt;0.01) ex vivo, compared to control cells. When challenged in vitro to test cell death susceptibility to a variety of apoptotic stimuli, bone marrow-derived GX-deficient macrophages displayed a significant increase of apoptosis compared to control cells. Finally, LDLr KO mice were lethally irradiated and reconstituted with either GX KO or wild type bone marrow. After 8 weeks of fat diet, mice reconstituted with GX KO bone marrow showed a ~100% increase of plaque size in the aortic sinus compared to mice with WT bone marrow (294 254 μ m2 vs 142 304 μ m2, respectively, P=0.001), despite similar plasma cholesterol level. This was associated with a more advanced plaque phenotype and marked accumulation of TUNEL-positive apoptotic cells (2.4 % vs 0.08 P&lt;0.001). Immunologic analysis of splenocytes and splenic CD4+ T cells from GX/LDLr chimeric mice showed increased immune cell activation and Th1-related cytokine production. In conclusion, GX sPLA2 deficiency increases innate and adaptive immune responses, enhances macrophage susceptibility to apoptosis and accelerates atherosclerosis in mice.
Abstract 1847: Prognostic Impact Of Previous Percutaneous Coronary Interventions On Coronary Artery Bypass Graft Surgery: A Multicentric Analysis FromThe German Federal State North-Rhine-Westphalia
Authors: Parwis Massoudy, Matthias Thielmann, Nils Lehmann, Anja Marr, Georg Kleikamp, Ariane Maleszka, Armin Zittermann, Reiner Körfer, Miriam Radu, Arno Krian, Jens Litmathe, Emmeran Gams, Ömer Sezer, Hans Scheld, Wolfgang Schiller, Armin Welz, Guido Dohmen, Rüdiger Autschbach, Ingo Slottosch, Thorsten Wahlers, Markus Neuhäuser, Rhein Ahr Campus Remagen, Karl-Heinz Jöckel, Heinz Jakob
Journal: Circulation (2007)

Background: We have previously shown that multiple prior percutaneous coronary intervention (PCI) procedures adversely affect outcome after subsequent coronary artery bypass grafting (CABG). We were now interested to investigate this effect on a multicentric basis. Methods: Eight cardiac surgical centers from the German Federal State of North-Rhine-Westphalia provided outcome data of 37140 consecutive patients having undergone isolated first-time CABG between 01/2000 and 12/2005. Twenty-two patient characteristics and outcome variables, which are part of a collection of data claimed by the national medical quality-control commission, were retrieved from the individual databases. Three groups of patients were analyzed for overall in-hospital mortality and major adverse cardiac events (MACE): Patients without a previous PCI procedure, patients with 1 previous PCI procedure and patients with ≥2 previous PCI procedures before surgery. Unadjusted univariable and risk-adjusted multivariable logistic regression analysis were applied. Computed propensity-score matching was performed based on 15 patient major risk factors to correct for and minimize selection bias. Results: A total of 10.3% of patients had 1 previous PCI procedure, and 3.7% of patients had ≥2 previous PCI procedures. Risk-adjusted multivariable logistic regression analysis of ≥2 previous PCI significantly correlated with in-hospital mortality (odds ratio [OR], 2.0; confidence interval [CI], 1.4–3.0; P &lt;0.0005) and MACE (OR, 1.5; CI, 1.2–1.9; P &lt;0.0013). After propensity score matching, conditional logistic regression analysis confirmed the results of adjusted analysis. A history of ≥2 previous PCI procedures was significantly associated with in-hospital mortality (OR, 1.9; CI, 1.3–2.7; P =0.0016) and MACE (OR, 1.5; CI, 1.2–1.9; P =0.0019). Conclusions: This large multicentric trial supports earlier results of our single-center analysis, multiple previous PCI procedures significantly increased the event of in-hospital mortality and MACE after subsequent CABG.
Treatment of severe weight loss in anorexia nervosa with hyperalimentation and psychotherapy
Authors: M J Maloney, M K Farrell
Journal: American Journal of Psychiatry (1980)

Hyperalimentation is a feeding technique in which all essential nutrients are infused intravenously to sustain patients who cannot eat. Although no panacea for anorexia nervosa, hyperalimentation can provide calories for intractable, malnourished patients. The authors describe the psychiatric and hyperalimentation treatment for four severely anorectic patients who had lost up to 44% of their body weight before entering the study. With treatment their percentage of ideal weight rose from a mean of 59% to a mean of 81% during hospitalization, and to a mean of 94% on outpatient follow-up of 5--16 months. The authors discuss the indications, limitations, and need for interdisciplinary collaboration in this treatment.
Scimitar Syndrome
Authors: Victor A. Ferrari, Muredach P. Reilly, Leon Axel, Martin G. St. John Sutton
Journal: Circulation (1998)

A 27-year-old male truck driver presented with recurrent rapid palpitations associated with near-syncope for 6 months.He was noted to have had "isolated" dextrocardia soon after birth.There was no family history of congenital heart disease.Before a herniorrhaphy at age 4 years, a chest radiograph demonstrated anomalous venous drainage of the right lung.He was otherwise asymptomatic, with a normal exercise tolerance.On examination, he was acyanotic, in sinus rhythm, with a blood pressure of 120/80 mm Hg.His apical impulse was not palpable, and heart sounds were best heard to the right of the sternum.The first heart sound was normal, and the second sound was widely split, with a holosystolic murmur of tricuspid regurgitation.A chest radiograph showed dextrocardia and a small right lung with a prominent anomalous right pulmonary vein.Two-dimensional echocardiography demonstrated an enlarged right heart but an intact atrial septum by contrast injection.Cardiac-gated MRI showed dextrocardia, a dilated and hypertrophied right ventricle, and a large pulmonary vein that joined the inferior vena cava (IVC) below the level of the diaphragm (Fig 1).Three-dimensional (3D) MR angiography with gadolinium contrast enhancement unequivocally demonstrated that the venous drainage of the whole of the diminutive right lung was by an anomalous vein whose entire course to the suprahepatic IVC was visualized.The arterial supply of the right lung was seen to originate from a normal right pulmonary artery (Figs 2 and 3).A 24-hour ECG monitor revealed recurrent long R-P narrow complex tachycardia, with rates of up to 230 bpm.Cardiac catheterization showed a pulmonary artery systolic pressure of 38 mm Hg and a left-to-right shunt ratio of 1.8:1.0.The patient underwent electrophysiological testing and atrioventricular nodal modification to control his supraventricular tachycardia.He is off all medications and feeling well, without recurrence of arrhythmia, 8 months after the procedure and is being conservatively managed with respect to his anomalous venous drainage.
2011 ACCF/AHA Focused Update of the Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction (Updating the 2007 Guideline)
Authors: R. Scott Wright, Jeffrey L. Anderson, Cynthia D. Adams, Charles R. Bridges, Donald E. Casey, Steven M. Ettinger, Francis M. Fesmire, Theodore G. Ganiats, Hani Jneid, A. Michael Lincoff, Eric D. Peterson, George J. Philippides, Pierre Theroux, Nanette K. Wenger, James Patrick Zidar
Journal: Journal of the American College of Cardiology (2011)
Abstract 2030: High Sensitivity C-Reactive Protein Predict Early-Onset Atrial Fibrillation in Patients with Acute Myocardial Infarction Who have No Atrial Dilatation
Authors: Hye Jin Hwang, Boyoung Chung, Jin-Bae Kim, Jong-Won Ha, Moon Hyoung Lee, Yangsoo Jang, Namsik Chung, Sung Soon Kim
Journal: Circulation (2007)

Introduction There is increasing evidence that inflammation may play a role in the pathogenesis of atrial fibrillation (AF) and acute myocardial infarction (AMI). It has been demonstrated that high...
Transverse Leukonychia
Authors: D W Miles, R D Rubens
Journal: New England Journal of Medicine (1995)

Figure 1. Transverse Leukonychia.Multiple white lines are present in the fingernails of a patient undergoing anthracycline chemotherapy for metastatic carcinoma of the breast. The spacing of the lines coincides with the three-week intervals between cycles of chemotherapy. The cause of the lines is unclear, but they may be a consequence of abnormal keratinocyte maturation.