tbuckley/cabot-search huggingface dataset:
The Power of a Legend
Authors: Dimitrios P. Kontoyiannis
Journal: Annals of Internal Medicine (2011)

On Being a Doctor20 September 2011The Power of a LegendDimitrios P. Kontoyiannis, MD, ScDDimitrios P. Kontoyiannis, MD, ScDFrom The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-6-201109200-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail One man gives freely, yet grows all the richer; another withholds what he should give, and only suffers want. A liberal man will be enriched, and one who waters will himself be watered.Proverbs 11:24–25Boston, May 1995. The last days of my clinical fellowship were like a heavily loaded lorry driving up a steep hill. I was emotionally exhausted and physically drained—one needed a lot of moonlighting to survive in Boston. I was also preoccupied with thoughts of my research transition into the high-power genetics lab.Shaun was sad and angry. He had leukemia and aspergillosis. Only 14 years old, ... Author, Article, and Disclosure InformationAffiliations: From The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030.Corresponding Author: Dimitrios P. Kontoyiannis, MD, ScD, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1460, Houston, TX 77030; e-mail, [email protected]org. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 20 September 2011Volume 155, Issue 6Page: 400KeywordsAdolescentsAspergillosisCaregiversComputed axial tomographyEmotionsFellowshipsGamesGeneticsInfectious diseases ePublished: 20 September 2011 Issue Published: 20 September 2011 Copyright & PermissionsCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Increased DJ-1 expression under oxidative stress and in Alzheimer's disease brains
Authors: Stéphanie Baulac, Hope Lu, Jennifer Strahle, Ting Yang, Matthew S Goldberg, Jie Shen, Michael G Schlossmacher, Cynthia A Lemere, Qun Lu, Weiming Xia
Journal: Molecular Neurodegeneration (2009)

Mutations in the DJ-1 gene have been linked to autosomal recessive familial Parkinson's disease. To understand the function of DJ-1, we determined the DJ-1 expression in both zebrafish and post mortem human brains. We found that DJ-1 was expressed early during zebrafish development and throughout adulthood. Knock down (KD) of DJ-1 by injection of morpholino did not cause dramatic morphologic alterations during development, and no loss of dopaminergic neurons was observed in embryos lacking DJ-1. However, DJ-1 KD embryos were more susceptible to programmed cell death. While a slight reduction in staining for islet-1 positive neurons was observed in both DJ-1 KD and H2O2 treated embryos, the number of apoptotic cells was significantly increased in both KD and H2O2 treated embryos. Interestingly, DJ-1 expression was increased in brains of zebrafish under conditions of oxidative stress, indicating that DJ-1 is a part of stress-responsive machinery. Since oxidative stress is one of the major contributors to the development of Alzheimer's disease (AD), we also examined DJ-1 expression in AD brains. Using DJ-1 specific antibodies, we failed to detect a robust staining of DJ-1 in brain tissues from control subjects. However, DJ-1 immunoreactivity was detected in hippocampal pyramidal neurons and astrocytes of AD brains. Therefore, our results strongly suggest that DJ-1 expression is not necessary during zebrafish development but can be induced in zebrafish exposed to oxidative stress and is present in human AD brains.
Diagnosis and Treatment of Clostridium difficile Colitis
Authors: Robert Fekety
Journal: JAMA (1993)

Pseudomembranous colitis associated with antibiotic therapy is almost always due to an overgrowth of Clostridium difficile. If untreated, pseudomembranous colitis can lead to severe diarrhea, hypovolemic shock, toxic dilatation of the colon, cecal perforation, hemorrhage, and death. However, C difficile-associated colitis can mimic the more common "benign" antibiotic-associated diarrhea that is not caused by C difficile. An algorithm for diagnosis management of hospitalized patients with antibiotic diarrhea and C difficile colitis is presented in this review. Diagnosis depends on sigmoidoscopy and/or stool tests for C difficile toxins in all patients with antibiotic-associated diarrhea. If the results of these tests are positive, either metronidazole or vancomycin is recommended for treatment of mild illness, and vancomycin is recommended for treatment of severe illness. Oral therapy is always preferred because it is more reliable. In patients with recurrent or relapsing colitis, treatment with either metronidazole or vancomycin is effective for that episode, but novel approaches, such as the oral or rectal introduction of competing nonpathogenic organisms, may prove to be more successful in prevention of relapses.
Trivalent Poliomyelitis Vaccine Administered Orally in a Cloistered Community
Authors: J. M. Ruegsegger, Mark Delery
Journal: New England Journal of Medicine (1960)

DURING the ten-year period since the first patient was deliberately fed a culture of attenuated poliomyelitis virus1 until the present time, probably more than 10,000,000 human beings have been fed a similar culture of poliovirus or mixtures of polioviruses. Moreover, numerous other such immunization programs are being instituted in much of the Western world, indicating the relative, if not utter, safety of such procedures. Despite some laboratory evidence to the contrary,2 the theoretical possibility of reversion to virulence has not been observed as a clinical phenomenon. Most of the published observations have been made among children and young adults, especially . . .
Mild renal insufficiency is associated with increased cardiovascular mortality: The Hoorn Study
Authors: Ronald M.A. Henry, Piet J. Kostense, Griët Bos, Jacqueline M. Dekker, Giel Nijpels, Robert J. Heine, Lex M. Bouter, Coen D.A. Stehouwer
Journal: Kidney International (2002)
The Safety of MRI
Authors: Howard Bierman
Journal: JAMA (1989)

<h3>To the Editor. —</h3> The Food and Drug Administration<sup>1</sup>recently reclassified the magnetic resonance imaging (MRI) scanner from a class III to a class II device and issued revised guidelines for the safe clinical use of this imaging modality. Along with the reclassification, the previously recommended conservative levels of exposure to the electromagnetic fields required for MRI were relaxed significantly. The new recommended safe levels of exposure are as follows: static magnetic fields, 2 T; gradient magnetic fields, 6 T/s or less; and radiofrequency magnetic fields, exposure should not produce a core temperature increase in excess of 1°C or localized heating to greater than 38°C in the head, 39°C in the trunk, or 40°C in the extremities. No long-lasting, hazardous biologic effects have been observed, and none are anticipated from acute or short-term exposures of humans to the static magnetic fields currently used in commercially available MRI scanners.<sup>2-4</sup>
Hospitalizations and Mortality Associated With Norovirus Outbreaks in Nursing Homes, 2009-2010
Authors: Tarak K. Trivedi, Traci DeSalvo, Lore Lee, Aimee Palumbo, Maria Moll, Aaron Curns, Aron J. Hall, Manish Patel, Umesh D. Parashar, Benjamin A. Lopman
Journal: JAMA (2012)

Norovirus outbreaks are common among vulnerable, elderly populations in US nursing homes.To assess whether all-cause hospitalization and mortality rates are increased during norovirus outbreak vs nonoutbreak periods in nursing homes, and to identify factors associated with increased risk.A retrospective cohort study of Medicare-certified nursing homes in Oregon, Wisconsin, and Pennsylvania that reported at least 1 confirmed or suspected norovirus outbreak to the Centers for Disease Control and Prevention's National Outbreak Reporting System (NORS), January 2009 to December 2010. Deaths and hospitalizations occurring among residents of these nursing homes were identified through the Medicare Minimum Data Set (MDS).Rates of all-cause hospitalization and mortality during outbreak compared with nonoutbreak periods were estimated using a random-effects Poisson regression model controlling for background seasonality in both outcomes.The cohort consisted of 308 nursing homes that reported 407 norovirus outbreaks to NORS. Per MDS, 67 730 hospitalizations and 26 055 deaths occurred in these homes during the 2-year study. Hospitalization rates were 124.0 (95% CI, 119.4-129.1) vs 109.5 (95% CI, 108.6-110.3) hospitalizations per nursing home−year during outbreak vs nonoutbreak periods, yielding a seasonally adjusted rate ratio (RR) of 1.09 (95% CI, 1.05-1.14). Similarly, mortality rates were 53.7 (95% CI, 50.6-57.0) vs 41.9 (95% CI, 41.4-42.4) deaths per nursing home−year in outbreak vs nonoutbreak periods (seasonally adjusted RR, 1.11; 95% CI, 1.05-1.18). The increases in hospitalizations and mortality were concentrated in the first 2 weeks (week 0 and 1) and the initial week (week 0) of the outbreak, respectively. Homes with lower daily registered nurse (RN) hours per resident (<0.75) had increased mortality rates during norovirus outbreaks compared with baseline (RR, 1.26; 95% CI, 1.14-1.40), while no increased risk (RR, 1.03; 95% CI, 0.96-1.12) was observed in homes with higher daily RN hours per resident (P = .007 by likelihood ratio test); the increase in hospitalization rates did not show a similar pattern.Norovirus outbreaks were associated with significant concurrent increases in all-cause hospitalization and mortality in nursing homes.
Commission asked to investigate racist discrimination against doctors
Authors: S. Mayor
Journal: BMJ (2001)

A UK politician has asked the Commission for Racial Equality to investigate whether some doctors working for the NHS experience racial discrimination by being denied progression to consultant status.

Dr Evan Harris, the health spokesman for the Liberal Democrat party, last week wrote to the Commission for Racial Equality, the statutory body responsible for enforcing the Race Relations Act, asking it to examine whether doctors from ethnic minorities were being treated unfairly in the limitations on their career progression.

He asked the commission to look specifically at the situation of doctors working in non-consultant career grade posts, over 60% of which are held by doctors from ethnic minorities.

One …
Intraoperative Continuous Norepinephrine Infusion Combined with Restrictive Deferred Hydration Significantly Reduces the Need for Blood Transfusion in Patients Undergoing Open Radical Cystectomy: Results of a Prospective Randomised Trial
Authors: Patrick Y Wuethrich, Urs E Studer, George N Thalmann, Fiona C Burkhard
Journal: European Urology (2013)
Randomised controlled trial of follow up care in general practice of patients with myocardial infarction and angina: final results of the Southampton heart integrated care project (SHIP)
Authors: K. Jolly, F. Bradley, S. Sharp, H. Smith, S. Thompson, A.-L. Kinmonth, D. Mant
Journal: BMJ (1999)

<h3>Abstract</h3> <b>Objective:</b> To assess the effectiveness of a programme to coordinate and support follow up care in general practice after a hospital diagnosis of myocardial infarction or angina. <b>Design:</b> Randomised controlled trial; stratified random allocation of practices to intervention and control groups. <b>Setting:</b> All 67 practices in Southampton and south west Hampshire, England. <b>Subjects:</b> 597 adult patients (422 with myocardial infarction and 175 with a new diagnosis of angina) who were recruited during hospital admission or attendance at a chest pain clinic between April 1995 and September 1996. <b>Intervention:</b> Programme to coordinate preventive care led by specialist liaison nurses which sought to improve communication between hospital and general practice and to encourage general practice nurses to provide structured follow up. <b>Main outcome measures:</b> Serum total cholesterol concentration, blood pressure, distance walked in 6 minutes, confirmed smoking cessation, and body mass index measured at 1 year follow up. <b>Results:</b> Of 559 surviving patients at 1 year, 502 (90%) were followed up. There was no significant difference between the intervention and control groups in smoking (cotinine validated quit rate 19% <i>v</i> 20%), lipid concentrations (serum total cholesterol 5.80 <i>v</i> 5.93 mmol/l), blood pressure (diastolic pressure 84 <i>v</i> 85 mm Hg), or fitness (distance walked in 6 minutes 443 <i>v</i> 433 m). Body mass index was slightly lower in the intervention group (27.4 <i>v</i> 28.2; P=0.08). <b>Conclusions:</b> Although the programme was effective in promoting follow up in general practice, it did not improve health outcome. Simply coordinating and supporting existing NHS care is insufficient. Ischaemic heart disease is a chronic condition which requires the same systematic approach to secondary prevention applied in other chronic conditions such as diabetes mellitus.
Surface topography of stenotic aortic valves by scanning electron microscopy.
Authors: J M Riddle, D J Magilligan, P D Stein
Journal: Circulation (1980)

Surface features of 19 stenotic aortic valves from patients undergoing valve replacement were investigated by scanning electron microscopy. Villi, prominent on five valves, were distributed either singularly or in clusters and differed in shape. Endothelial cells had microvilli and bulbous surface projections. Endothelial disruption with a focal loss of endothelial cells was uniformly observed. Erythrocytes were found scattered over the exposed subendothelial surface or enmeshed within fibrin networks on 11 of the valves. Activated leukocytes were seen on four valves and showed veil-like projections as well as microvilli. Platelets, observed on three valves, displayed pseudopodial formation and hyalomeric spreading, signifying an increased degree of membrane response. Most platelet aggregates were composed entirely of dendritic forms (reversible aggregates), but a few also contained spread forms (irreversible aggreates). Focal deposits of crystalline material, presumably containing calcium, were observed in areas of endocardial disruption.
Hemochromatosis and Vitamin C
Authors: Victor Herbert
Journal: Annals of Internal Medicine (1999)

Letters21 September 1999Hemochromatosis and Vitamin CVictor Herbert, MD, JDVictor Herbert, MD, JDMount Sinai School of Medicine; Veterans Affairs Medical Center; Bronx, NY 10468 (Herbert)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-6-199909210-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITORBarton and colleagues (1), members of the Hemochromatosis Management Working Group, stated that “it seems prudent to advise [patients with hemochromatosis] to limit ingestion of synthetic vitamin C supplements to 500 mg/d.” This toxic quantity will accelerate both organ damage and sudden fatal cardiac arrhythmias.At the bottom of the first page of Barton and colleagues' paper (1), a footnote indicates that I was also a member of the Working Group. I am stunned that the documentation (2, 3) of the harms that supplements of 100 mg or more of synthetic vitamin C daily presents to persons ...References1. Barton JC, McDonnell SM, Adams PC, Brissot P, Powell LW, Edwards CQ, et al . Management of hemochromatosis. Ann Intern Med. 1998;129:932-9. LinkGoogle Scholar2. Herbert V, Shaw S, Jayatilleke E. Vitamin C-driven free radical generation from iron. J Nutr. 1996;126 Suppl 4 1213S-20S. CrossrefMedlineGoogle Scholar3. Cao A, Gabutti V, Galanello R, Masera G, Modell B, di Palma A, et al . Management Protocol for the Treatment of Thalassaemia Patients. Nicosia, Cyprus: Thalassaemias International Federation; 1997. Google Scholar4. Herbert V. Point/counterpoint: forget vitamin C supplements?: Yes. Physician's Weekly. 1998; xv:1. Google Scholar Author, Article, and Disclosure InformationAuthors: Victor Herbert, MD, JDAffiliations: Mount Sinai School of Medicine; Veterans Affairs Medical Center; Bronx, NY 10468 (Herbert) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoManagement of Hemochromatosis James C. Barton , Sharon M. McDonnell , Paul C. Adams , Pierre Brissot , Lawrie W. Powell , Corwin Q. Edwards , James D. Cook , and Kris V. Kowdley , and The Hemochromatosis Management Working Group*Hemochromatosis and Vitamin C James C. Barton , Paul C. Adams , and Lawrie W. Powell Metrics Cited byFamine, tea, and bread in Ireland: C282Y and modern human microevolutionDisordered vascular compliance in haemochromatosisCardiac Involvement in HemochromatosisIron Overload in Human DiseaseAscorbic Acid Does Not Increase the Oxidative Stress Induced by Dietary Iron in C3H MiceVitamin CNephrogenic diabetes insipidus associated with hemochromatosisHemocromatosis hereditaria. Actualización 21 September 1999Volume 131, Issue 6Page: 475-476KeywordsArrhythmiaChildrenEffective doseExcretionGlobal healthHemochromatosisIngestionToxicityVitamin C ePublished: 15 August 2000 Issue Published: 21 September 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Building Momentum as Democrats Forge Health Care Reform
Authors: John K. Iglehart
Journal: New England Journal of Medicine (2009)

In the midst of dealing with countless challenges, both foreign and domestic, and a deep ideological divide in Congress, the Obama administration and its Democratic allies have nevertheless made important strides in their aggressive pursuit of health care reform legislation. In what President Barack Obama characterized as “a historic day, a watershed event in the long and elusive quest for health care reform,” major organizations representing the nation's physicians, hospitals, health plans, and medical suppliers pledged to do their part to achieve the administration's goal of reducing by 1.5% annually the growth of health care spending over the next decade . . .
No, Virginia, Marriage Isn't Bizarre
Authors: Russel V. Lee
Journal: JAMA (1964)

<h3>To the Editor:—</h3> I want to complain, somewhat plaintively, of the image created by the reporting of my remarks at the University of California<i>Symposium, Man and Civilization: The Family's Search for Survival.</i>I quite understand why the sensational and dramatic parts of this speech were emphasized (those are the parts that attract the public's attention), but as the father of five physicians and the grandfather of 20 children, and as a husband of 46 years of marriage to one woman, I am pained by being presented in the sense of an apostle of polygamy and profligacy, which, indeed, I am not. The fact that my last remarks in this Symposium asserted that "no institution has ever been devised that is as satisfactory for the procreation and the raising of children as the family" was disregarded by practically every reporter. The whole gist of my remarks could be summarized thusly—that
Are we overusing IVF?
Authors: E. I. Kamphuis, S. Bhattacharya, F. van der Veen, B. W. J. Mol, A. Templeton
Journal: BMJ (2014)

The indications for IVF have expanded from tubal disorders to many causes of subfertility, including unexplained. But with limited evidence underpinning its extended remit <b>Esme Kamphuis and colleagues</b> explain how the risks could outweigh the benefits
A study of cold cardioplegic myocardial protection in rats: an experimental model using the uptake of technetium 99m pyrophosphate and enzyme activity as parameters of injury
Authors: C G A McGREGOR, J HANNAN, A F SMITH, A L MUIR, D J WHEATLEY
Journal: Cardiovascular Research (1983)

This study compares the use of St Thomas' cardioplegia and cold saline cardioplegia at 4°C for protection against global myocardial ischaemia in a model of heterotopic cardiac transplantation in rats of isogeneic strain. The parameters of myocardial injury applied were the uptake of Technetium 99m pyrophosphate (Tc 99m Pyp) in the transplanted heart and the measurement of serum total creatine kinase (CK) and creatine kinase MB (CK:MB) isoenzyme activity. The findings indicate that St Thomas' cardioplegic solution confers improved myocardial protection compared with normal saline as judged by statistically significant differences between: (a) the uptake of Tc 99m Pyp between the two solutions at 30 min storage: and (b) the peak total serum creatine kinase enzyme activity at 90 min storage. Excellent correlation was present between the uptake of Tc 99m Pyp and peak total serum creatine kinase activity. Further application of this model is described.
Reflex Vascular Responses to Left Ventricular Outflow Obstruction and Activation of Ventricular Baroreceptors in Dogs
Authors: Allyn L. Mark, Francois M. Abboud, Phillip G. Schmid, Donald D. Heistad
Journal: Journal of Clinical Investigation (1973)

Reflex vascular responses to acute left ventricular outflow obstruction were studied in anesthetized dogs. The studies were done to compare the effects of activation of ventricular baroreceptors on vascular resistance in skeletal muscle (gracilis muscle) and skin (hindpaw); to identify afferent and efferent pathways which mediate the reflex vasodilatation; and to assess the relative contribution of ventricular baroreceptors and baroreceptors in left atrium and pulmonary vessels in responses to left ventricular outflow obstruction. The gracilis artery and the cranial tibial artery to the paw were perfused separately at constant flow. Changes in perfusion pressure to each bed reflected changes in vascular resistance. Outflow obstruction was produced by inflating a balloon in the left ventricular outflow tract for 15 s while pressures in the left ventricle and aortic arch were measured. Inflation of the balloon increased left ventricular pressure and decreased pressure in the aortic arch. Low and high levels of obstruction produced dilator responses averaging -5+/-3 (SE) and -42+/-11 mm Hg in muscle and -1+/-1 and -3+/-2 mm Hg in paw. Denervation, phentolamine, and glyceryltrinitrate caused greater dilatation in paw than did left ventricular outflow obstruction. This indicates that dilator responses in the paw were not limited by a low level of resting neurogenic constrictor tone or by a negligible dilator capacity of these vessels. Obstruction to left ventricular inflow increased left atrial pressure, but did not cause reflex vasodilatation. This suggests that low pressure baroreceptors in atria or pulmonary vessels did not contribute to vasodilator responses to left ventricular outflow obstruction. Vasodilator responses to outflow obstruction were blocked by bilateral vagotomy, sectioning the sciatic and obturator nerves, and administration of phentolamine, but were not decreased by atropine or tripelennamine. The results indicate that activation of left ventricular baroreceptors produces striking vasodilatation in skeletal muscle, but only slight vasodilatation in skin. The data suggest that the difference in dilator responses in the two beds results from greater withdrawal of adrenergic constrictor tone to skeletal muscle than to skin. Activation of sympathetic cholinergic or histaminergic dilator pathways does not contribute to the dilatation.
INTEGRATED QUANTITATIVE MEASUREMENT OF ADVERSE PLAQUE FEATURES FROM CORONARY CT ANGIOGRAPHY TO PREDICT IMPAIRED MYOCARDIAL FLOW RESERVE BY 13N-AMMONIA-PET
Authors: Damini Dey, Erick Alexanderson Rosas, Annika Schuhbaeck, Yuka Otaki, Luis EJ Orozco, Ryo Nakazato, Guido Germano, Aloha Meave, Daniel Berman, Stephan Achenbach, Piotr Slomka
Journal: Journal of the American College of Cardiology (2013)
Requirement for T-cell apoptosis in the induction of peripheral transplantation tolerance
Authors: Andrew D. Wells, Xian Chang Li, Yongsheng Li, Matthew C. Walsh, Xin Xiao Zheng, Zihao Wu, Gabriel Nuñez, Aimin Tang, Mohamed Sayegh, Wayne W. Hancock, Terry B. Strom, Laurence A. Turka
Journal: Nature Medicine (1999)