tbuckley/cabot-search huggingface dataset:
Abstract 307: Regulator of G-protein Signaling 2 (RGS2) Suppresses Pathologic but not Physiologic Cardiac Hypertrophy
Authors: Steven Hsu, Eiki Takimoto, Hazim El-Haddad, Djahida Bedja, Kathleen Gabrielson, Hunter C Champion, David A Kass
Journal: Circulation (2008)

Regulator of G-protein signaling 2 (RGS2) is a GTPase activating protein thought to negatively regulate Gα q/11 -protein coupled signaling. In vitro RGS2 over-expression blunts Gα q/11 -stimulated hypertrophy, whereas its knockdown worsens it. Here we tested the impact of pathologic (aortic banding, AB) versus physiologic (swimming, SWM) cardiac stimulation on RGS2-cardiac regulation. Mice lacking RGS2 (RGS2 −/− ) develop modest hypertension but no baseline cardiac phenotype. RGS2 −/− subjected to AB developed accelerated hypertrophy (93% vs 47% increase in heart weight/tibial length at 1 wk, p&lt;0.05) and failure, and early mortality (40% vs. 0% mortality at 1 wk, p=0.012). Their hearts have enhanced activation of Gα q/11 -coupled hypertrophic mediators such as calcineurin (Cn), extracellular response kinase 1/2 (ERK1/2), and calmodulin-dependent protein kinase II (CaMK II) compared to controls. In sharp contrast, after 6 weeks of exercise swimming, control and RGS2 −/− mice developed similar increases in LV mass (17% and 15% increases in heart weight/tibial length; p&lt;0.001 compared to sedentary controls, NS between genotypes). Both groups also had similar increases in relative wall thickness and LV mass by echocardiography. Invasive pressure-volume loop analysis revealed enhanced cardiac output in swimming mice but no differences between genotypes. The only disparities were that heart rate declined slightly (5%) in controls but was unchanged in RGS2 −/− , and RGS2 −/− mice swam more slowly (mean velocity 5.0±0.3cm/s vs 6.7±0.3cm/s, by video tracking). Control and RGS2 −/− mice ± exercise had negligible changes in the Gα q/11 mediators Cn, ERK1/2, and CaMK II. Thus, RGS2 plays a central role in blunting cardiac hypertrophic signaling and mortality in response to pathological stress, but not to physiological stimulation. This highlights its in vivo specificity to the regulation of Gα q/11 signaling as opposed to the signaling of physiologic hypertrophy. Changes in Heart Weight/Tibial Length in response to Aortic Banding (AB) vs Swimming (SWM)
Possible mechanisms of embolization associated with an atrial septal aneurysm
Authors: Pierre Decoodt, Raymond Kacenelenbogen, Philippe Noël, André Capon, Jean-Paul Bar, José Castro-Rodriguez, F. Jopen, P Gurnet, H. Jardaneh, Béatrice Peperstraete, Thierry William Verbeet, Michel Telerman
Journal: Circulation (1992)
Clinical management of meningococcal disease
Authors: T. Stephenson, A P Winrow, K A V Cartwright, J M Stuart, P A L Wylie, D Stevens, W Drake, A. L Wood, M. J Gill, H. T. Sorensen, F. H. Steffensen, H. C Schonheyder, G. L. Nielsen, J. Olsen
Journal: BMJ (1998)

Clinical management of meningococcal disease Coning may occur without lumbar puncture being doneEditor-Wylie et al do not give the ages of their 252 patients with meningococcal disease, but their recommendation for fewer lumbar punctures should be interpreted cautiously in children. 1 Four deaths were attributed to lumbar puncture, which was done in 198 patients.Two patients deteriorated after lumbar puncture, and postmortem examination showed brainstem herniation.Even when lumbar puncture is not performed, however, patients with meningococcal disease can deteriorate after admission and can cone secondary to raised intracranial pressure.A causal relation in these two cases is not proved.In two patients antibiotic treatment was delayed because initial examination of cerebrospinal fluid was normal.This is a criticism of clinicians, not a risk of lumbar puncture.The risk of cerebrospinal fluid initially giving false negative results and the difficulty of diagnosing meningitis clinically in young children are both recognised.If an ill child warrants a lumbar puncture then he or she should receive antibiotics for 48 hours pending the results of culture, irrespective of the initial results of microscopy.Lumbar puncture may be dangerous if patients have hypotension, coma, raised intracranial pressure, or focal signs and is unnecessary if there is a typical rash.In a series of 445 children with meningitis, the two children with meningococcal infection and cerebral herniation had contraindications to lumbar puncture. 2Lumbar puncture must be performed more readily in children than adults because of the difficulty of diagnosing meningitis clinically.In 86 children with meningococcal meningitis, only 34 had a typical haemorrhagic rash, and not always at presentation. 3 In Wylie et al's series, lumbar puncture gave a positive result initially in 177 of 198 cases and an overall positive result in 186.In children, a clinical diagnosis of meningitis is unlikely to have a similar sensitivity of 89-94%.Moreover, it is unclear how often a positive culture was obtained from another site in the 120 cases that yielded meningococci; molecular biological techniques give no information on antibiotic sensitivity.If fewer lumbar punctures are done in children with meningitis some will be missed and the start of treatment will be delayed.This increases the risk of death, 4 possibly above the 2% attributable to lumbar puncture in this series.Wylie et al have shown a high sensitivity and low mortality from lumbar puncture.Before recommending that the procedure be used less we need to be reassured that clinical diagnosis alone does not result in worse sensitivity and mortality, particularly in children.
A six-panel PCR of both plasma and blood for EBV-DNA as tumor marker for nasopharyngeal carcinoma patients treated in the United States
Authors: J. Weiss, M. Xavier, D. Tsai, S. Arnoldi, E. Sherman
Journal: Journal of Clinical Oncology (2009)

e17014 Background: Studies of plasma from nasopharyngeal carcinoma (NPC) patients from endemic regions demonstrate that circulating DNA derived from EBV may be used as a tumor marker, but data from non-endemic regions or in whole blood are limited. Methods: ViraCor Laboratories (Lee's Summit, MO) performed PCR for EBNA, EBER, and LMP on both plasma and whole blood of 11 NPC patients undergoing therapy at the Hospital of the University of Pennsylvania. Results were correlated with disease status via review of chart records and imaging reports. Results: 7 of 11 patients tested were positive for circulating EBV derived DNA. 2 patients were treated with induction chemotherapy with suppression to 0 copies of circulating DNA for all plasma measures, but not whole blood measures (LMP 0, EBER 100 and EBNA 200 copies for one patient and LMP 100, EBNA 100 and EBER 300 copies for the other). The first of these patients remains free of disease but the other retains a large mass believed to be active disease, but which has not grown over 8 months following therapy. 5 patients, including the 2 patients treated with induction therapy, were treated with chemoradiotherapy. PCR following therapy was negative on all plasma measures for the 4 patients who remain free of disease (at intervals of 7, 12, 13 and 16 months). 2 of these patients retained low-level EBV on at least 1 whole-blood measure–1 for EBNA alone (100 copies) and the other for both EBER and EBNA (300 and 100 copies). 2 patients were treated for metastatic disease. 3 episodes of progression were all accompanied by increases in plasma EBV (EBNA from 13,700 to 21,100 with EBER 1600 to 9400 and EBNA 1800 to 2200 to 3000 with EBER 100 to 100 to 500). Conclusions: This pilot data on a population treated in the United States is consistent with larger data sets obtained in endemic regions demonstrating that EBV is an effective tumor marker for prognosis and to follow therapy. It is the first to demonstrate greater specificity of plasma measures over whole blood measures, and it raises the hypothesis that whole blood measures may be more sensitive. Further prospective study is warranted in non-endemic populations both to validate the measure and to facilitate translational research into biologic factors driving the behavior of these tumors. [Table: see text]
Symptom burden in chronic myeloid leukemia (CML).
Authors: L. A. Williams, P. Ault, C. S. Cleeland, R. J. Reynolds, N. A. Shah, P. K. Shah, J. E. Cortes
Journal: Journal of Clinical Oncology (2010)

6133 Background: Symptom burden is the combined impact of symptoms from disease and treatment on daily functioning. Lack of symptom recognition may result in failure to address symptoms and maximize patient functioning. Patient-reported outcomes (PROs) can be endpoints in clinical trials to establish treatment benefits. The purpose of this study was to define the content domain for a PRO measure of chronic myeloid leukemia (CML) symptom burden. Methods: This is stage I of a study to develop a PRO CML symptom-burden measure. Thirty-five patients with Philadelphia-chromosome-positive CML described symptoms over the disease course in single qualitative interviews. Content analysis was used to identify symptoms and define the content domain. After the interview, patients reported symptoms in the last 24 hours on the M. D. Anderson Symptom Inventory (MDASI) to provide context for analysis. Results: Mean patient age was 52.7 years (standard deviation [sd] = 13.8), 54.3% female, and 94.3% chronic phase receiving kinase inhibitors. Content analysis found a total of 44 symptoms, 26 reported by 20% or more patients, occurring over the disease course. Fatigue (followed by pain and nausea) was the symptom reported most often over the disease course. During the interviews, patients volunteered ways in which symptoms interfered with daily activities and how symptoms were managed to maintain acceptable quality of life. Symptoms led some patients to stop or consider stopping treatment or to decrease the dose or frequency of treatment. On the MDASI, fatigue (followed by trouble remembering and disturbed sleep) was the symptom reported most often in the last 24 hours. Fatigue had the highest mean severity rating (3.37, sd = 2.77, 0-10 scale) on the MDASI. Conclusions: Patients with CML experience numerous symptoms related to disease and treatment, with fatigue being the most prominent throughout the disease course. These symptoms can cause significant interference with daily activities, leading to therapy reductions. Accurate assessment and management of symptoms is critical to ensure optimal treatment with the best quality of life. The content domain for a PRO symptom-burden measure of CML encompasses the severity and activity interference of common symptoms of CML and its treatment. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Bristol-Myers Squibb, Novartis Bristol-Myers Squibb, Novartis Bristol-Myers Squibb, Novartis, Wyeth
Substantial harm but substantial benefit
Authors: J. Savulescu
Journal: BMJ (1996)

Ms Delany is right to focus attention on the often neglected interests of bone marrow donors. Donating marrow is not in donors' medical interests, but is it in their overall interests? Delany minimises the benefits: “the only positive aspects” are “pleasure at helping the…recipient” and “basking in the approval of parents and medical staff.”

We should distinguish between donation to people to whom we are strongly attached and donation to others. Delany undervalues the extent to which our own wellbeing is intertwined with that of those close to us. To save the life of a loved one is one of the most important things we can do.

Delany …
Abstract 2730: Results from the SALT 1 and 2 Trials: Multicenter, Randomized, Placebo-controlled Trials in Patients with Euvolemic and Hypervolemic Hyponatremia
Authors: Robert Schrier, Mihai Gheorghiade, Joseph Verbalis, Tomas Berl, Peter Gross, Frank Czerwiec, Cesare Orlandi
Journal: Circulation (2006)

Background: Hyponatremia (Na+≤134 mEq/L) predicts higher mortality in CHF, cirrhosis and SIADH. Current treatments are ineffective. Earlier CHF studies indicate tolvaptan, an oral vasopressin V2 re...
Abstract 187: Code Team Members’ Perception of Family Presence During Cardiopulmonary Resuscitation at an Academic Medical Center
Authors: Jonathan McCoy, Ginette Bell, Kristen Hausman, Jennifer Joiner, Karen Magarelli, Kathy Mahoney, Linda Maldanado, Kelly Keefe Marqoux, Kari Mastro, Amy M Milloria, Linda Tamburri, Dawn Tortajada, Zavotsky Kathleen
Journal: Circulation (2013)

INTRO: Despite increased acceptance, barriers remain for family presence during cardiopulmonary resuscitation (CPR). Few have focused on the entire code response team. Our objective was to determine the perceived role of family presence, its benefit to patients and/or the code team, and barriers to implementation. We hypothesized that perceptions of family presence would vary by team member role. Methods: We conducted an IRB approved survey at an urban academic Level 1 trauma center during August, 2012. Subjects were members of the adult or pediatric code teams, including chaplains, clinical care techs (CCTs), registered nurses (RNs), advanced practice nurses (APNs), physicians, pharmacists, patient equipment techs, security officers, and respiratory therapists. A convenience sample was asked to complete an online family presence survey tool adapted with permission from Nykiel et al. Most responses used a five point likert scale ranging from strongly disagree (1) to strongly agree (5). Results: Five hundred eighty-eight of 3000 staff responded. They were 78% RNs and 25% adult critical care. Seventy percent had participated in family presence situations. More RNs, physicians, CCTs, and chaplains felt that family presence during CPR was part of their job (mean 4.1, 3.6, 3.6, 4.2 respectively) compared to respiratory therapists, pharmacists, security, and patient equipment techs (mean 2.2, 2.0, 1.5 respectively). Similarly, more RNs, physicians, CCTs, and chaplains felt comfortable providing emotional support to family members during CPR (mean 3.7, 4.1, 3.3, 4.2 respectively) compared to respiratory therapists, pharmacists, security, and patient equipment techs (mean 2.8, 1.9, 2.0, 1.8 respectively). Overall, they felt family presence benefits the family (72%), patients (59%) and the code team (41%). Perceived barriers were lack of space, increased staff stress, staff objections, interruptions of care, and lack of identified support person (72, 68, 56, 48, 44% respectively). CONCLUSION: Code team members have varied perceptions about family presence during CPR depending upon their role. This suggests that specific education strategies for the entire code team may be necessary to improve the family presence experience.
Managed care: Implications of managed care for health systems, clinicians, and patients
Authors: G. Fairfield, D. J Hunter, D. Mechanic, F. Rosleff
Journal: BMJ (1997)

The rhetoric and realities of managed care are easily confused. The rapid growth of managed care in the United States has had many implications for patients, doctors, employers, state and federal programmes, the health insurance industry, major medical institutions, medical research, and vulnerable patient populations. It has restricted patients' choice of doctors and limited access to specialists, reduced the professional autonomy and earnings of doctors, shifted power from the non-profit to the for-profit sectors and from hospitals and doctors to private corporations. It has also raised issues about the future structuring and financing of medical education and research and about practice ethics. However, managed care has also accorded greater prominence to the assessment of patient satisfaction, profiling and monitoring of doctors' work, the use of clinical guidelines and quality assurance procedures and indicated the potential to improve the integration and outcome of care.
Abstract 67: GSK-3 Dephosphorylation by PP2A Modulates Age-dependent Cardiac Growth and Hypertrophic Response
Authors: Maradumane L Mohan, Elizabeth E Martelli, Sathyamangla V Naga Prasad
Journal: Circulation Research (2014)

Glycogen synthase kinase-3 (GSK-3) is a known negative regulator of cardiac hypertrophic response and much remains unknown about its dephosphorylation process that activates GSK-3. Since GSK-3 function is regulated by PI3K, age based assessment of cardiac hypertrophic response was measured in PI3Kγ knockout (PI3Kγ KO) mice. Interestingly, we observed marked reduction in heart size in PI3Kγ KO mice compared to littermate controls. Consistent with the reduced size, we observed elevated PP2A activity and dephosphorylation mediated activation of GSK-3 in PI3Kγ-KO hearts. Mechanistically, we found that higher PP2A activity in PI3Kγ-KO was due to PP2A methylation mediated by elevated PP2A methyl transferase (PPMT-1) activity. To test in vivo whether PI3K activity regulates GSK-3 dephosphorylation mediated cardiac growth, we generated mice with cardiac specific overexpression of inactive PI3Kγ (PI3Kγinact) and constitutively active PI3Kγ (myrPI3Kγ) in the PI3Kγ-KO background. Age based hypertrophic response and cardiac function was assessed by heart weight/body weight ratios and echocardiography. The heart size was significantly increased in PI3Kγinact (LVEDD- 3.41+/- 0.12) and myrPI3Kγ (LVEDD- 3.73 +/- 0.14) overexpressing mice, when compared to WT (LVEDD- 3.00 +/- 0.15) mice at 18 months age, indicating that kinase activity of PI3Kγ is inconsequential for age-dependent regulation of cardiac growth. Similar cardiac growth due to overexpression of active and inactive form of PI3Kγ suggests that the kinase independent function potentially overrides the kinase activity of PI3Kγ. Correspondingly, PP2A activity was normalized and was associated with decreased GSK-3 dephosphorylation with overexpression of PI3Kγinact. This led to normalization of heart size in these mice compared to PI3Kγ-KO littermates correlating with the decreased GSK-3 dephosphorylation and consequent inhibition of GSK-3 activity. Regulation of PP2A mediated dephosphorylation of GSK-3 by PI3Kγ combined with similar level of increased cardiac growth in PI3Kγ-KO mice with cardiac overexpression of PI3Kγinact or myrPI3Kγ, suggests a non-canonical role of PI3Kγ in hypertrophy of the heart due to age related increase in mechanical demand.
MEDICAL EDUCATION IN COMMUNITY HOSPITALS
Authors: A M BURGESS
Journal: Annals of Internal Medicine (1960)

Editorial1 June 1960MEDICAL EDUCATION IN COMMUNITY HOSPITALSALEX. M. BURGESS SR., M.D.ALEX. M. BURGESS SR., M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-52-6-1363 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIt is important to realize that American Medicine as practiced today is preponderantly medicine of the community hospital. Figures compiled by the American Hospital Association in 1957 show that for every bed in a university affiliated hospital there are almost four in community (non-university affiliated) hospitals which have been accredited by the Joint Commission. The latter group is divided almost evenly between those which support internships and/or residencies and those which do not.* In addition, there is a substantial number of community hospitals which offer approved residency training of one sort or another but do not have interns.It has... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *200 Hospitals with medical school affiliations 104,291 beds600 Hospitals without such affiliation and with internships 173,215 beds4,499 Hospitals without approved internships 202,162 beds PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1960Volume 52, Issue 6Page: 1363-1365KeywordsHospital medicineMedical educationResidency ePublished: 1 December 2008 Issue Published: 1 June 1960 PDF downloadLoading ...
Abstract 3601: Remnant Lipoprotein is Superior to Non-HDL-cholesterol for Prediction of Cardiovascular Events in Patients with Coronary Artery Disease after Achievement of LDL-cholesterol Goals
Authors: Takamitsu Nakamura, Mitsumasa Hirano, Yoshinobu Kitta, Yasushi Kodama, Jun-ei Obata, Hajime Takano, Ken-ichi Kawabata, Akira Mende, Kiyotaka Kugiyama
Journal: Circulation (2007)

NCEP ATPIII guidelines recommend non-HDL-cholesterol (C) as a secondary target for management of hyperlipidemia after achieving LDL-C goals. Non-HDL-C contains remnant lipoprotein cholesterol which...
SOME SOCIAL IMPLICATIONS OF MEDICAL PROGRESS
Authors: F G DICKINSON
Journal: Annals of Internal Medicine (1951)

Article1 October 1951SOME SOCIAL IMPLICATIONS OF MEDICAL PROGRESSFRANK G. DICKINSON, Ph.D.FRANK G. DICKINSON, Ph.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-35-4-889 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptINTRODUCTIONWhen I received the invitation from President Middleton several months ago to give this paper, I was congratulated by several of my physician friends. I consider this opportunity to address you as a very real honor. Accordingly, I have tried to prepare something more philosophic than statistical. It will also be obvious that I am speaking to you as a social scientist, and that the views which I express are my own and not necessarily those of the American Medical Association.MEDICAL PROGRESS SINCE 1900I can remember the days when diphtheria was the scourge of childhood, when the... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Chicago, Illinois*Presented at the Thirty-second Annual Session of the American College of Physicians, St. Louis, Mo., April 13, 1951.From the Bureau of Medical Economic Research of the American Medical Association. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byBIBLIOGRAPHY OF VITAL STATISTICS IN AUSTRALIA AND NEW ZEALAND* 1 October 1951Volume 35, Issue 4Page: 889-897KeywordsDiphtheriaScientists Issue Published: 1 October 1951 PDF downloadLoading ...