tbuckley/cabot-search huggingface dataset:
Commentary: Japanese point of view
Authors: T. Sano, K. Maruyama
Journal: BMJ (1997)

Objectives:To examine the time taken to diagnose oesophageal or gastric cancer, identify the source of delay, and assess its clinical importance Design: Study of all new patients presenting to one surgical unit with carcinoma of the oesophagus or stomach.Setting: University department of surgery in a large teaching hospital.Subjects: 115 consecutive patients (70 men, mean age 66 years) with carcinoma of the oesophagus (27) or stomach (88).Main outcome measures: Interval from the onset of symptoms to histological diagnosis, final pathological stage of the tumour, and whether potentially curative resection was possible. Results:The median delay from first symptoms to histological diagnosis was 17 weeks (range 1 to 168 weeks).25% (29/115) of patients had a delay of over 28 weeks (median 39 weeks).Total delay was made up of the following components: delay in consulting a doctor (29%), delay in referral (23%), delay in being seen at hospital (16%), and delay in establishing the diagnosis at the hospital (32%).No relation was found between delay in diagnosis and tumour stage in patients with gastric cancer, but for oesophageal cancer those with stage I and II disease were diagnosed within 7 weeks compared with 21 weeks (P < 0.02) for those with stage III and IV disease.Conclusions: Long delays still occur in the diagnosis of patients with cancer of the stomach or oesophagus.Streamlined referral and investigation pathways are needed if patients with gastric and oesophageal carcinomas are to be diagnosed early in the course of the disease.
A Randomized, Prospective Cross-Over Trial Comparing Methylene Blue-Directed Biopsy and Conventional Random Biopsy for Detecting Intestinal Metaplasia and Dysplasia in Barrett’s Esophagus
Authors: K. Ragunath, N. Krasner, V. Raman, M. Haqqani, W. Cheung
Journal: Endoscopy (2003)

Background and Study Aims: The value of methylene blue-directed biopsies (MBDB) in detecting specialized intestinal metaplasia and dysplasia in Barrett's esophagus remains unclear. The aim of this study was to compare the accuracy of MBDB with random biopsy in detecting intestinal metaplasia and dysplasia in patients with Barrett's esophagus. Patients and Methods: A prospective, randomized, cross-over trial was undertaken to compare MBDB with random biopsy in patients with Barrett's esophagus segments 3 cm or more in length without macroscopic evidence of dysplasia or cancer. Dysplasia was graded as: indefinite for dysplasia, low-grade dysplasia, high-grade dysplasia, or carcinoma, and was reported in a blinded fashion. Results: Fifty-seven patients were recruited, 44 of whom were male. A total of 1269 biopsies were taken (MBDB-651, random biopsie-618). Analysis of the results by per-biopsy protocol showed that the MBDB technique diagnosed significantly more specialized intestinal metaplasia (75 %) compared to the random biopsy technique (68 %; P = 0.032). The sensitivity and specificity rates of MBDB for diagnosing specialized intestinal metaplasia were 91 % (95 % CI, 88 - 93 %) and 43 % (95 % CI, 36 - 51 %), respectively. The sensitivity and specificity rates of MBDB for diagnosing dysplasia or carcinoma were 49 % (95 % CI, 38 - 61 %) and 85 % (95 % CI, 82 - 88 %), respectively. There were no significant differences in the diagnosis of dysplasia and carcinoma - MBDB 12 %, random biopsy 10 %. The methylene blue staining pattern appeared to have an influence on the detection of specialized intestinal metaplasia and dysplasia/carcinoma. Dark blue staining was associated with increased detection of specialized intestinal metaplasia (P < 0.0001), and heterogeneous staining (P = 0.137) or no staining (P = 0.005) were associated with dysplasia and/or carcinoma detection. The MBDB technique prolonged the endoscopy examination by an average of 6 min. Conclusion: The diagnostic accuracy of the MBDB technique was superior to that of the random biopsy technique for identifying specialized intestinal metaplasia, but not dysplasia or carcinoma. The intensity of methylene blue staining has an influence on the detection of specialized intestinal metaplasia and dysplasia or carcinoma, which may help in targeting the biopsies. Although MBDB prolongs the endoscopy procedure slightly, it is a safe and well-tolerated procedure. Further clinical studies on the MBDB technique exclusively in endoscopically normal dysplastic Barrett's esophagus are needed.
Noninvasive Detection of Subclinical Coronary Atherosclerosis Coupled With Assessment of Changes in Plaque Characteristics Using Novel Invasive Imaging Modalities
Authors: Carlos A.G. Van Mieghem, Eugène P. McFadden, Pim J. de Feyter, Nico Bruining, Johannes A. Schaar, Nico R. Mollet, Filippo Cademartiri, Dick Goedhart, Sebastiaan de Winter, Gaston Rodriguez Granillo, Marco Valgimigli, Frits Mastik, Anton F. van der Steen, Willem J. van der Giessen, Georgios Sianos, Bianca Backx, Marie-Angèle M. Morel, Gerrit-Anne van Es, Andrew Zalewski, Patrick W. Serruys
Journal: Journal of the American College of Cardiology (2006)
Visualization of risk-area myocardium as a high-intensity, hyperenhanced “hot spot” by myocardial contrast echocardiography following coronary reperfusion
Authors: Hideki Kunichika, Barry Peters, Bruno Cotter, Hisashi Masugata, Naomi Kunichika, Paul L Wolf, Anthony N DeMaria
Journal: Journal of the American College of Cardiology (2003)
Abstract 2428: Patients Who Receive an Implantable Cardioverter Defibrillator for MADIT-II Criteria in Clinical Practice are Different From Patients Enrolled in MADIT-II
Authors: Sana M Al-Khatib, Yongfei Wang, Wojciech Zareba, Eric Peterson, Gillian D Sanders, Harlan Krumholz, Kerry L Lee, Daniel B Mark, Arthur J Moss
Journal: Circulation (2007)

Background: The generalizability of findings from randomized controlled trials to routine clinical practice is often unclear. We compared the characteristics of patients meeting MADIT-II criteria a...
Abstract 21061: Mild IKr inhibition Significantly Enhances IKur-induced Selective Prolongation of Atrial Refractoriness
Authors: Huabin Sun, Dezhi Xing, John Lloyd, James K Hennan, Paul C Levesque
Journal: Circulation (2010)

Introduction: The ultrarapid delayed rectifier K+ current (IKur) has been proposed as an atrial-selective target for antiarrhythmic treatment of AF. We previously demonstrated that the IKur inhibit...
Abstract 3840: The Performance of Subclinical Atherosclerosis as Screening Test for Coronary Heart Disease
Authors: Alain Simon, Gilles Chironi, Jerome Gariepy, Jean-Louis Megnien, Jaime Levenson
Journal: Circulation (2006)

Introduction Despite their etiologic importance, risk factors are inaccurate to predict coronary heart disease (CHD) as attested by 80% overlap existing in their distribution in subjects who died f...
FDG PET Imaging in Pneumocystis Pneumonia
Authors: Masanori Kono, Hiroyuki Yamashita, Kazuo Kubota, Toshikazu Kano, Akio Mimori
Journal: Clinical Nuclear Medicine (2015)

A 69-year-old woman with rheumatoid arthritis and pleuritis presented with dyspnea. On admission, she was afebrile and had an oxygen saturation of 97% on ambient air. Chest radiography and CT revealed only subtle ground-glass opacities. However, FDG PET revealed pathological uptake in both lungs. A diagnosis of Pneumocystis pneumonia was made based on a positive β-D-glucan assay and polymerase chain reaction amplification of Pneumocystis jirovecii from the sputum. Posttreatment FDG PET revealed resolution of the previously noted uptake. This case illustrates that FDG PET can be used to diagnose Pneumocystis pneumonia when the CT findings are equivocal.
Abstract 2317: Sinus Node Dysfunction, Tachy-brady Rhythm and Extensive Biatrial Scarring - Recognizing a New Clinical Syndrome of Atriomyopathy in Patients With Atrial Fibrillation
Authors: Jayasree Pillarisetti, Mazda Biria, Atul Verma, Subbareddy Vanga, Rhea Pimentel, Martin Emert, Loren Berenbom, Raghuveer Dendi, James L Vacek, Luigi diBiase, Dimpi Patel, Andrea Natale, Dhanunjaya Lakkireddy
Journal: Circulation (2009)
The borderline patient's intolerance of aloneness: insecure attachments and therapist availability
Authors: J G Gunderson
Journal: American Journal of Psychiatry (1996)

This article describes the clinical and theoretical significance of intolerance of aloneness for patients with borderline personality disorder. It is intended to make their treatment more effective and less burdensome.Clinical observations from the author's more than 9,000 hours of psychotherapeutic work and 500 psychotherapy consultations with borderline patients are synthesized with findings of relevant empirical studies and attachment theory.Intolerance of aloneness is a deficit that is associated with the borderline patient's typical clinging and attention-seeking or detached forms of attachment. Suggestions are given for ways in which clinicians can respond to these dysfunctional attachment behaviors to diminish the patient's feared aloneness without encouraging unnecessary regressions. A framework for understanding the long-term attachment processes required to correct this deficit is offered.Intolerance of aloneness is a core deficit in borderline patients that can become less handicapping with reliable, but not excessive, responsiveness of the therapist.
Efficacy and Safety of Once-Weekly Dulaglutide Versus Insulin Glargine in Patients With Type 2 Diabetes on Metformin and Glimepiride (AWARD-2)
Authors: Francesco Giorgino, Marian Benroubi, Jui-Hung Sun, Alan G. Zimmermann, Valeria Pechtner
Journal: Diabetes Care (2015)

OBJECTIVE This study compared the efficacy and safety of once-weekly dulaglutide, a glucagon-like peptide-1 receptor agonist, with daily insulin glargine, both combined with maximally tolerated doses of metformin and glimepiride in patients with type 2 diabetes. The primary objective was noninferiority of dulaglutide 1.5 mg to glargine in the HbA1c change from baseline at 52 weeks. RESEARCH DESIGN AND METHODS In this 78-week, open-label study, 810 patients were randomized to dulaglutide 1.5 mg, dulaglutide 0.75 mg, or glargine. RESULTS The baseline mean ± SD HbA1c was 8.1 ± 1.0% (65.5 ± 10.8 mmol/mol). The least squares mean ± SE HbA1c change from baseline to the primary end point was −1.08 ± 0.06% (−11.8 ± 0.7 mmol/mol) for dulaglutide 1.5 mg, −0.76 ± 0.06% (−8.3 ± 0.7 mmol/mol) for dulaglutide 0.75 mg, and −0.63 ± 0.06% (−6.9 ± 0.7 mmol/mol) for glargine, with an end point mean ± SD dose of 29 ± 26 units (0.33 ± 0.24 units/kg), and a fasting plasma glucose (mean ± SD) of 118 ± 23 mg/dL from self-monitored plasma glucose. Statistical criteria for superiority were met with dulaglutide 1.5 mg and for noninferiority with dulaglutide 0.75 mg. More patients on dulaglutide 1.5 mg achieved HbA1c targets &amp;lt;7.0% (53 mmol/mol) versus glargine (P &amp;lt; 0.001). Body weight decreased with dulaglutide and increased with glargine. Total hypoglycemia rates were lower with dulaglutide; severe hypoglycemia was minimal. Increases in pancreatic enzymes were observed for dulaglutide. Incidence of nausea (15.4, 7.7, and 1.5%) and diarrhea (10.6, 9.2, and 5.7%) were more common with dulaglutide 1.5 mg and 0.75 mg than with glargine. CONCLUSIONS Once-weekly dulaglutide 1.5 mg, compared with daily insulin glargine without forced titration, demonstrated greater HbA1c reduction and weight loss, with a higher incidence of gastrointestinal adverse events and a lower risk of hypoglycemia.
2009 Stroke Council Award and Lecture—Stroke: A Chronic Disease
Authors: Pamela Duncan
Journal: Circulation (2009)

Stroke is managed as an acute illness, with mean lengths of stay of less than 5 days in acute-care hospitals. Recovery has been reported to be most dramatic in the first month and to plateau by 3 to 6 months. However, stroke is a chronic condition with multiple risk factors (diabetes, heart disease, hypertension, vascular cognitive impairments, depression, limited physical activity, and falls) for continued decline in health functional status and quality of life. Fewer than 50% of individuals with stroke have their stroke risk factors assessed, treated, or controlled; only 75% of individuals persist with secondary-prevention medications described at discharge; poststroke depression is underdiagnosed and undertreated; the level of physical activity in individuals with mild impairment after stroke is less than half that of healthy older individuals; and the risk of falls and fracture is 2 to 7 times higher in stroke survivors. Among individuals who receive inpatient rehabilitation services, recovery of walking speed is not sufficient to sustain physical activity and participation. Even among those among those with a high degree of early functional recovery, there are modest annual declines in function. Care management after acute stroke is highly variable and fragmented, and major quality-improvement initiatives to improve stroke outcomes (Paul Coverdale Registry and AHA Get With the Guidelines) do not extend beyond the acute-care hospital stay. There is an immediate need to develop more integrated and innovative poststroke management programs. The efforts to develop quality-improvement programs and quality indicators of care for acute care should be paralleled in chronic management after acute stroke.
Early and Late Benefits of Prasugrel in Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention
Authors: Elliott M. Antman, Stephen D. Wiviott, Sabina A. Murphy, Juri Voitk, Yonathan Hasin, Petr Widimsky, Harish Chandna, William Macias, Carolyn H. McCabe, Eugene Braunwald
Journal: Journal of the American College of Cardiology (2008)
Salmonella infections associated with reptiles: the current situation in Europe
Authors: Collective Editorial team, S Bertrand, R Rimhanen-Finne, F  X Weill, W Rabsch, L Thornton, J Perevoščikovs, W van Pelt, M Heck
Journal: Eurosurveillance (2008)

Binary file ES_Abstracts_Final_ECDC.txt matches
How to Get Medical Information from the Internet
Authors: Robert Kiley
Journal: Journal of the Royal Society of Medicine (1997)

Despite the complexity of the Internet, most novices are pleasantly surprised how easy it is to search for information. Both the Netscape Navigator and the Microsoft Internet Explorer the two most popular Web browsers-have a 'Net Search' button. Clicking this button takes you to a Web page where you can either run a search on a chosen Internet database-Netscape currently points to AltaVistaor select another search engine from a reasonably exhaustive list. Either way, searching for a subject simply requires the user to input a word or phrase in the searchbox, and press the 'Enter' key. When you are looking for health/medical information, however, the shortcomings associated with this method of searching soon become all too evident.
Abstract 12628: Incremental Prognostic Value of CT Coronary and Functional Findings for Predicting Major Adverse Cardiac Events in Emergency Department Patients with Chest Pain
Authors: Quynh A Truong, Christopher L Schlett, Dahlia Banerji, Emily L Siegel, Sam Lehman, Fabian Bamberg, Maros Ferencik, Ian S Rogers, Thomas J Brady, John T Nagurney, Udo Hoffmann
Journal: Circulation (2010)

Background: We sought to determine the incremental prognostic value of cardiac computed tomography (CT) for predicting major adverse cardiac events (MACE). Methods: We followed 368 patients (53±12 ...
Antagonism of NAADP mediated calcium signaling ameliorates arrythmias in the heart
Authors: M. Nebel, A. Schworer, C. C. Siebrands, A-C. Limbrock, J. M. Swarbrick, M. Hohenegger, A. Geisler, L. Herich, S. Schlegel, T. Eschenhagen, B. V. L. Potter, H. Ehmke, A. H. Guse
Journal: Circulation (2012)
Impact of the Everolimus-Eluting Stent on Stent Thrombosis
Authors: Usman Baber, Roxana Mehran, Samin K. Sharma, Somjot Brar, Jennifer Yu, Jung-Won Suh, Hyo-Soo Kim, Seung-Jung Park, Adnan Kastrati, Antoinette de Waha, Prakash Krishnan, Pedro Moreno, Joseph Sweeny, Michael C. Kim, Javed Suleman, Robert Pyo, Jose Wiley, Jason Kovacic, Annapoorna S. Kini, George D. Dangas
Journal: Journal of the American College of Cardiology (2011)
Abstract 3009: Mst1 Induces the Unfolded Protein Response Through Direct Phosphorylation of PERK
Authors: Soichiro Usui, Yasuhiro Maejima, Tong Lui, Hong Li, Masayuki Takamura, Shuichi Kaneko, Junichi Sadoshima
Journal: Circulation (2009)

Mammalian sterile 20-like kinase1 (Mst1) is a serine/threonine kinase which plays an important role in mediating apoptosis in response to ischemia/reperfusion and during cardiac remodeling in the h...
Distribution of black physicians in the United States, 1967
Authors: M. A. Haynes
Journal: JAMA (1969)

Only 2% of all physicians are black. Howard University College of Medicine and Meharry Medical College graduate about 83% of the black physicians. Of the predominantly white schools, the University of Illinois graduated the largest number of black physicians who are members of the National Medical Association. Black physicians are more highly concentrated in California, New York, and Washington, DC, than in other areas. They are less likely to practice in groups and more likely to be general practitioners. Internal medicine claims more specialists than any other specialty, but only 20% of these are board certified. Fifty-five percent of all NMA members are members of the American Medical Association.
Abstract 19188: Effects of Continuous-Flow Left Ventricular Assist Device Unloading on the Diastolic Function of the Failing Human Heart
Authors: Omar Wever-Pinzon, Josef Stehlik, Abdallah G Kfoury, Samuel Passi, Edward M Gilbert, Rami Alharethi, Bruce B Reid, Deborah Budge, Nikolaos Diakos, Rory Farnan, Feras M Bader, Dean Y Li, Craig H Selzman, Stavros G Drakos
Journal: Circulation (2012)

Background: The serial effects of continuous-flow left ventricular assist devices (LVADs) on the diastolic function of the failing human heart are not known. We sought to evaluate the effects of continuous-flow mechanical unloading on the diastolic function of the failing heart. Methods: Consecutive patients with baseline characteristics consistent with end-stage chronic heart failure referred for LVAD implantation as a bridge to transplantation or destination therapy between 2008 and 2011 were prospectively enrolled. Serial echocardiograms were performed at the time of LVAD implant and at pre-defined time points during the first year of LVAD support. Results: Eighty patients (age 56±16 years, 80% males) formed the study group and the main echocardiographic findings are summarized in the Table. Effective and sustained unloading (Figure-panel A) was achieved by CF-LVADs as evaluated by the E/E’ ratio. Similarly, diastolic function improved as early as 1 month after LVAD implant and changes were sustained over a year period (Figure-panel B). Further, these changes were sustained under increased loading conditions (turn down echocardiograms). Conclusions: Continuous-flow LVADs effectively unload the left ventricle and improve its diastolic function. These findings might be important in the new and rapidly growing field of LVAD induced myocardial recovery.
First International Congress of Biochemistry
Authors: D.H. Moore, C.E. Sunderlin
Journal: BMJ (1949)

THE First International Congress of Biochemistry, initiated by the (British) Biochemical Society, which was held in Cambridge during August 19–25, was opened in the Senate House of the University by the president, Prof. A. C. Chibnall Viscounet Addison, Lord Privy Seal, welcome the members on behalf of the Government, and Dr. E. C. Raven, the vice-chancellor, on behalf of the University.
Nonalcoholic Fatty Liver Disease (NAFLD) Activity Score and the Histopathologic Diagnosis in NAFLD: Distinct Clinicopathologic Meanings §Δ
Authors: Elizabeth M. Brunt, David E. Kleiner, Laura A. Wilson, Patricia Belt, Brent A. Neuschwander-Tetri
Journal: Hepatology (2010)

Abstract The diagnosis of nonalcoholic steatohepatitis (NASH) is defined by the presence and pattern of specific histological abnormalities on liver biopsy. A separate system of scoring the features of nonalcoholic fatty liver disease (NAFLD) called the NAFLD Activity Score (NAS) was developed as a tool to measure changes in NAFLD during therapeutic trials. However, some studies have used threshold values of the NAS, specifically NAS ≥5, as a surrogate for the histologic diagnosis of NASH. To evaluate whether this unintended use of the NAS is valid, biopsy and clinical data from the 976 adults in NASH Clinical Research Network (CRN) studies were reviewed. Biopsies were evaluated centrally by the NASH CRN Pathology Committee. Definite steatohepatitis (SH) was diagnosed in 58.1%, borderline SH in 19.5% and “not SH” in 22%. The NAS was ≥5 in 50% and ≤4 in 49%; in this cohort only 75% of biopsies with definite SH had an NAS ≥5, whereas 28% of borderline SH and 7% of “not SH” biopsies had NAS ≥5. Of biopsies with an NAS ≥5, 86% had SH and 3% “not SH”. NAS ≤4 did not indicate benign histology; 29% had SH and only 42% had “not SH.” Higher values of the NAS were associated with higher levels of alanine aminotransferase and aspartate aminotransferase, whereas the diagnosis of SH was associated with features of the metabolic syndrome. Conclusion: The diagnosis of definite SH or the absence of SH based on evaluation of patterns as well as individual lesions on liver biopsies does not always correlate with threshold values of the semiquantitative NAS. Clinical trials and observational studies should take these different performance characteristics into account. (Hepatology 2011)
Abstract 12710: Cardiac Magnetic Resonance Imaging in Today's Economic Climate; a Cost Effectiveness Analysis
Authors: Vinayak A Hegde, J. Ronald Mikolich, Mark Doyle, Vikas K Rathi, June A Yamrozik, Ronald B Williams, Robert W Biederman
Journal: Circulation (2010)

Background: In the face of the current health care crisis, significant concerns have been raised about the independent clinical utilities of various cardiac imaging modalities. Particularly, Cardia...