tbuckley/cabot-search huggingface dataset:
HLA-B38 and Clozapine-induced Agranulocytosis
Authors: Geetha Joseph, Vu Nguyen, Jeffrey D. Smith
Journal: Annals of Internal Medicine (1992)

Letters1 April 1992HLA-B38 and Clozapine-induced AgranulocytosisGeetha Joseph, MD, Vu Nguyen, MD, Jeffrey D. Smith, MDGeetha Joseph, MDSearch for more papers by this author, Vu Nguyen, MDSearch for more papers by this author, Jeffrey D. Smith, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-116-7-605_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editors:Clozapine (Clozaril), a dibenzodiazepine neuroleptic, is associated with a 1% to 2% incidence of drug-induced agranulocytosis. Its use, therefore, has been largely limited to select patients with refractory schizophrenia. Very close monitoring of patients receiving this drug has significantly increased the cost of therapy. Lieberman and coworkers (1) noted a 20% incidence of agranulocytosis in a predominantly Jewish group of patients receiving the drug strongly correlating with the presence of the haplotype HLA-B38, DR4, DQw3. We report the occurrence of clozapine-induced agranulocytosis in two non-Jewish patients, both of whom expressed HLA-B38 but did not express DR4 or...References1. LiebermanYunisEgeaCanosoKaneYunis JJERJE. HLA-B38,DR4,DQw3 and Clozapine-induced agranulocytosis in Jewish patients with schizophrenia. Arch Gen Psych. 1990;47:945. CrossrefMedlineGoogle Scholar2. AlexanderCoggianoDanielWyatt RMDR. HLA antigens in schizophrenia. Psych Res. 1990;31:221. CrossrefMedlineGoogle Scholar3. McGuffinFarmerYonace PAA. HLA antigens and subtypes of schizophrenia. Psych Res. 1981;5:115. CrossrefMedlineGoogle Scholar4. Histocompatibility Testing 1980: Report of the Eighth International Histocompatibility Workshop. Los Angeles: UCLA Tissue Typing Laboratory; 1980:962. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Geetha Joseph, MD; Vu Nguyen, MD; Jeffrey D. Smith, MDAffiliations: University of Louisville Louisville, KY 40292 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byHuman Leukocyte Antigen-A1 Predicts a Good Therapeutic Response to Clozapine With a Low Risk of Agranulocytosis in Patients With SchizophreniaDrug-induced psychosis in Parkinson's disease (II): atypical neurolepticsNew Drugs for the Treatment of SchizophreniaA cytotoxic human hybridoma monoclonal antibody (TrJ5) specific for HLA-B38(16) and -B39(16)Clozapine 1 April 1992Volume 116, Issue 7Page: 605-605KeywordsAntipsychoticsDrug therapyDrugsHaplotypesSchizophreniaTherapeutic drug monitoring ePublished: 1 December 2008 Issue Published: 1 April 1992 PDF downloadLoading ...
Using Cost-Effectiveness To Target Cholesterol Reduction
Authors: Jack Beaird
Journal: Annals of Internal Medicine (2001)

Letters21 August 2001Using Cost-Effectiveness To Target Cholesterol ReductionJack Beaird, MDJack Beaird, MDWoodlake Clinic, Richfield, MN 55423 (Beaird)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-4-200108210-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Dr. Garber argues that physicians and patients should use cost-effectiveness analysis to help make decisions about statin therapy (1). This a bad idea. Economists since the time of Adam Smith have known that the value of anything has two components: what it is worth to the person who has use of it and what can be gotten for it in exchange for something else (2). The first component is “value in use.” The second is “value in exchange.” Cost-effectiveness analysis is an economic tool that uses exchange value to measure what society can get for its health ...References1. Garber AM. Using cost-effectiveness analysis to target cholesterol reduction [Editorial]. Ann Intern Med. 2000;132:833-5. [PMID: 10819708] LinkGoogle Scholar2. Smith A. An Inquiry into the Nature and Causes of the Wealth of Nations. Chicago: Univ of Chicago Pr; 1976:32. Google Scholar3. Prosser LA, Stinnett AA, Goldman PA, Williams LW, Hunink MG, Goldman L, et al . Cost-effectiveness of cholesterol-lowering therapies according to selected patient characteristics. Ann Intern Med. 2000;132:769-79. [PMID: 10819699] LinkGoogle Scholar4. Ganz DA, Kuntz KM, Jacobson GA, Avorn J. Cost-effectiveness of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor therapy in older patients with myocardial infarction. Ann Intern Med. 2000;132:780-7. [PMID: 10819700] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Woodlake Clinic, Richfield, MN 55423 (Beaird) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCost-Effectiveness of Cholesterol-Lowering Therapies according to Selected Patient Characteristics Lisa A. Prosser , Aaron A. Stinnett , Paula A. Goldman , Lawrence W. Williams , Maria G.M. Hunink , Lee Goldman , and Milton C. Weinstein Cost-Effectiveness of 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase Inhibitor Therapy in Older Patients with Myocardial Infarction David A. Ganz , Karen M. Kuntz , Gretchen A. Jacobson , and Jerry Avorn Using Cost-Effectiveness Analysis To Target Cholesterol Reduction Alan M. Garber The Tragic Events of April 1996 Jack Coulehan Metrics 21 August 2001Volume 135, Issue 4Page: 299-300KeywordsCholesterolDecision analysisDrugsHealth careHealth economicsInfarctionLaboratory testsMyocardial infarctionQuality adjusted life yearsStatins ePublished: 21 August 2001 Issue Published: 21 August 2001 CopyrightCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Role of up-regulation of in action potential shortening associated with atrial fibrillation in humans
Authors: H ZHANG, C GARRATT, J ZHU, A HOLDEN
Journal: Cardiovascular Research (2005)

Objectives: Although previous studies in dogs have indicated a minimal role for changes in IK1 in the shortening of action potential duration (APD) associated with atrial fibrillation (AF), in humans, there is evidence for significant AF-induced up-regulation of this current. In this computer model study, we investigated the relative contributions of the remodeling of IK1, L-type calcium current, and other remodeled ionic channel currents to AF-induced APD reduction in human atrium.
TCTAP A-059 Comparison of Drug-Eluting Balloon First and then Bare Metal Stent with Drug-Eluting Stent for Treatment of De Novo Lesions (DEB First): A Randomized Controlled Single Center Clinical Trial
Authors: Chang-Hwan Yoon, Jung-Won Suh, Dong-Ju Choi, In-Ho Chae
Journal: Journal of the American College of Cardiology (2015)
Elastin-derived peptides potentiate atherosclerosis through the immune Neu1–PI3Kγ pathway
Authors: Stephanie Gayral, Roselyne Garnotel, Audrey Castaing-Berthou, Sebastien Blaise, Anne Fougerat, Elodie Berge, Aurelie Montheil, Nicole Malet, Matthias P. Wymann, Pascal Maurice, Laurent Debelle, Laurent Martiny, Laurent O. Martinez, Alexey V. Pshezhetsky, Laurent Duca, Muriel Laffargue
Journal: Cardiovascular Research (2013)

Elastin is degraded during vascular ageing and its products, elastin-derived peptides (EP), are present in the human blood circulation. EP binds to the elastin receptor complex (ERC) at the cell surface, composed of elastin-binding protein (EBP), a cathepsin A and a neuraminidase 1. Some in vitro functions have clearly been attributed to this binding, but the in vivo implications for arterial diseases have never been clearly investigated.Here, we demonstrate that chronic doses of EP injected into mouse models of atherosclerosis increase atherosclerotic plaque size formation. Similar effects were observed following an injection of a VGVAPG peptide, suggesting that the ERC mediates these effects. The absence of phosphoinositide 3-kinase γ (PI3Kγ) in bone marrow-derived cells prevented EP-induced atherosclerosis development, demonstrating that PI3Kγ drive EP-induced arterial lesions. Accordingly, in vitro studies showed that PI3Kγ was required for EP-induced monocyte migration and ROS production and that this effect was dependent upon neuraminidase activity. Finally, we showed that degradation of elastic lamellae in LDLR(-/-) mice fed an atherogenic diet correlated with atherosclerotic plaque formation. At the same time, the absence of the cathepsin A-neuraminidase 1 complex in cells of the haematopoietic lineage abolished atheroma plaque size progression and decreased leucocytes infiltration, clearly demonstrating the role of this complex in atherogenesis and suggesting the involvement of endogenous EP.Altogether, this work identifies EP as an enhancer of atherogenesis and defines the Neuraminidase 1/PI3Kγ signalling pathway as a key mediator of this function in vitro and in vivo.
Resting and Exercise Systolic Time Intervals
Authors: DAVID R. MCCONAHAY, CARROLL M. MARTIN, MELVIN D. CHEITLIN
Journal: Circulation (1972)

Indirect systolic time intervals (STI) corrected for heart rate were compared at rest and immediately following 3 minutes of moderate supine exercise in 33 normal subjects and 32 age- and sex-matched patients with coronary artery disease (CAD). The intervals were correlated with measurements of cardiac index (CI), stroke volume index (SVI), mean pulmonary artery and wedge pressures obtained under identical conditions of rest and exercise, and with resting left ventricular end-diastolic pressure (LVEDP), LV dp/dt, exercise factor, ejection fraction (EF), and extent of CAD. Total electromechanical systole (Q-A2 c ) was the same at rest in both normal and CAD groups and did not change with exercise in either group. The CAD group had a significantly longer preejection period PEP c ), shorter left ventricular ejection time (LVET c ), and larger PEP/LVET at rest and exercise than the normal group. Both groups responded to exercise with a significant reduction of PEP c , prolongation of LVET c , and reduction of PEP/LVET. Significant correlations were found between these STI and SVI, CI, LV dp/dt, LVEDP, and EF, which explained the differences in STI between the normal and CAD groups. However, exercise did not improve the sensitivities of the STI in detecting disordered hemodynamics in the patients with CAD. Furthermore, the STI failed to predict reliably hemodynamic abnormalities in the individual patient which were not already clinically obvious.
Qualifying and quantifying medical uncertainty in 10th-century Baghdad: Abu Bakr al-Razi
Authors: Peter E Pormann
Journal: Journal of the Royal Society of Medicine (2013)

Abu Bakr Muhammad ibn Zakariya’ al-Razi (d. 925) was one of the most interesting and innovative clinicians of the medieval world.1 He distinguished smallpox from measles, experimented on an ape to establish the toxicity of quicksilver (mercury) and used a control group to assess whether bloodletting was an effective treatment for ‘brain fever’.2–5 Al-Razi stated in one of his treatises:

My aim and objective is [to provide] things useful to people who practise and work, not for those engaged in research and theory5 (pp. 112–13).



Hospitals in 10th-century Baghdad
Al-Razi rose to become a hospital director both in Rayy (his home town, and now a suburb of Tehran) and Baghdad. This hospital environment proved important for his medical research. By the 10th century, hospitals in Baghdad had developed into quite sophisticated institutions. For instance, in the 920s and 930s, a powerful vizier by the name ‘Ali ibn ‘Isa endeavoured to improve public health, both by maintaining hospitals and sending doctors to areas where there was inadequate medical provision. The hospitals were Islamic charitable foundations with sometimes substantial endowments, so they benefitted from both legal and financial security; but ‘Ali ibn ‘Isa specified that they should serve non-Muslims as well as Muslims.6

Moreover, the medicine practised in these hospitals was not based on religious beliefs, but on the humoral pathology inherited from the Greeks, as the writings of the hospital physician al-Kaskari demonstrate.7 In this sense, the Islamic hospitals offered – somewhat paradoxically – a non-religious and non-sectarian service: physicians and other practitioners from various backgrounds catered for equally diverse patients in a non-confessional medical system. The development of the hospitals meant that elite medicine moved to them, and some of the most highly regarded doctors looking after patients in the upper echelons of society worked and taught in them. In addition, given their large numbers of patients, hospitals provided an infrastructure for research.
Subacute hypersensitivity pneumonitis in an HIV infected patient receiving antiretroviral therapy
Authors: A. M Morris
Journal: Thorax (2000)

Abnormal pulmonary immune response to various antigens can lead to hypersensitivity pneumonitis. This disease has not previously been reported in HIV infected patients. This case report describes an HIV infected woman who developed subacute hypersensitivity pneumonitis in response to bird exposure. The disease manifested itself only after the patient experienced an improvement in her CD4 positive T lymphocyte count secondary to antiretroviral therapy. This case emphasises the need to consider non-HIV associated diseases in patients with HIV and suggests that diseases in which host immune response plays an essential role in pathogenesis may become more prevalent in HIV infected patients receiving effective antiretroviral therapy.
Internal Medicine: Infectious Diseases
Authors: John G. Bartlett
Journal: JAMA (1982)

New Diseases  Recent developments in the field of infectious disease include the detection of several new microbial pathogens, most of which appear to be old agents that are newly recognized. In 1977, Legionella pneumophila was successfully cultivated on artificial media, characterized, and proposed for taxonomic rank as a new genus. Reexamination of previously isolated organisms or stored serum specimens showed evidence for infections involving L pneumophila or related bacteria dating back to 1943. 1 Data from the Centers for Disease Control (CDC) now suggest that L pneumophila accounts for 28% of unexplained pneumonias, but the reporting efficiency is estimated at only 1% to 2%, indicating either that legionellosis is overlooked or the diagnosis is not confirmed in the great majority of cases. 2 The current proposed taxonomy includes six species of Legionella that appear to cause similar diseases and are susceptible to erythromycin.  In 1980, an epidemiologist from Minnesota notified
TURNIP TOP TREATMENT OF CHRONIC DIARRHEA AND AMEBIC DYSENTERY.
Authors: CUNNINGHAM WILSON
Journal: JAMA (1907)

Nothing has given more concern than the treatment of chronic diarrhea and dysentery. In reporting our experience in the treatment of such conditions with the boiled tops of the turnip, spinach, mustard and phytolacca we feel fully convinced of the specific action of this diet, and append the report of some cases so treated. Our attention was first called to this treatment during 1904 in the following manner: A patient, male, white, aged 28, consulted us for a chronic diarrhea. He had suffered for several months and had tried the various astringent and dietetic remedies commonly employed in such conditions. He was pale; had lost in flesh; had four to six stools a day with very little pain. The stools were chalky in color, semi-solid and very offensive. We advised him to go into a hospital, where he was put on rigid milk diet with astringent enemata. He grew worse,
Drugs Five Years Later: Calcitonin as a Drug
Authors: LEONARD J. DEFTOS
Journal: Annals of Internal Medicine (1981)

Calcitonin is a peptide hormone produced by the C-cells of the thyroid gland. Its main biological effect is to inhibit the resorption of bone. This effect, in combination with a calciuric action of calcitonin, can produce a lowering of blood calcium. These biological effects of calcitonin have made it useful in the treatment of hypercalcemic and hyperresorptive disorders.
Secret Passions, Secret Remedies: Narcotic Drugs in British Society, 1820-1930
Authors: Alvin E. Rodin
Journal: JAMA (1984)

This book does not quite live up to its suggestive main title, but does live up to its subtitle. It is an engaging account of the economic, social, and political history of the British experience with addictive drugs. The major orientation is to opium, with two chapters on its alkaloid, morphine, occasional references to cocaine, and a mention of heroin. There is an enlightening discussion of reasons for the initial acceptance and then rejection of such drugs by Victorian Britain. Opium was a cheap and readily available antidote for the harsh life of the time and more effective than the traditional massive dosing by physicians. Its addictive nature gradually became apparent, and nonaddictive pain relievers such as aspirin became available. The nature of addiction is not discussed in any detail, aside from the author's definition of it as a physical discomfort and craving on withdrawal. The fact that cocaine is
Methoxyflurane nephrotoxicity. A study of dose response in man
Authors: M. J. Cousins
Journal: JAMA (1973)

Dose-related abnormalities in renal function occurred in ten of 18 patients following administration of methoxyflurane (Penthrane) with the usual anesthetic adjuvants. Eight control patients anesthetized with halothane (Fluothane) showed no abnormalities in renal function. Subclinical toxicity occurred following methoxyflurane at minimum alveolar concentration (MAC) for 2.5 to 3 hours, that is 2.5 to 3 MAC hours (serum inorganic fluoride, &gt;50 micromols/liter), while clinical toxicity was present in all patients at dosages greater than five MAC hours (serum inorganic fluoride, &gt;90 micromols/liter). Superimposed on the dose-response relationship were other factors that probably increased nephrotoxicity. These were as follows: individual variations in metabolism of methoxyflurane; increased sensitivity to the nephrotoxic effects of inorganic fluoride; presence of enzyme induction; and interaction of methoxyflurane with other nephrotoxic drugs. The use of methoxyflurane in clinical anesthesia should be restricted to situations where it offers specific advantages and where dosages less than 2.5 MAC hours can be attained.
A Surgeon With AIDS-Reply
Authors: Frank S. Rhame
Journal: JAMA (1990)

In Reply.—  My editorial concluded that it is acceptably safe, from the stand-point of HIV transmission risk, for HIV-infected surgeons to perform most operations. Dr Fulghum raises two of the most important corollary issues: What are the disclosure obligations of the HIV-infected surgeon? What are the implications of the physical and mental impairment that HIV infection ultimately produces? These issues are best considered in the context of other potential disclosure obligations and accommodations to physician impairment. The implications of HIV infection in health care workers are analyzed thoroughly in a position paper developed by the Association for Practitioners in Infection Control and the Society of Hospital Epidemiologists of America. 1   There are many situations that might lead patients to switch physicians but that produce no or virtually no increased risk and are not ordinarily disclosed to patients. Examples include past drug use, recent physical or mental illness, or a
Effects of Body Surface Boundary and of Tissue Inhomogenelty on the Electrocardiogram of the Dog
Authors: Allen M. Scher, Winfried W. Ohm, Wallace G. L. Kerrick, Steven M. Lewis, Allan C. Young
Journal: Circulation Research (1971)

The voltage-current relationship between intrathoracic ‘dipoles’ and body surface locations was examined in anesthetized dogs. Controlled currents were applied at body surface points, and potentials were recorded at the intrathoracic dipoles. A technique of fastening the electrodes to a cast made on the animal's torso permitted exact measurement of the torso and electrode geometry. The potentials recorded in the animal were compared with (1) an infinite-medium simulation performed on a digital computer, (2) a bounded- medium simulation performed in the plaster cast of each torso studied, and (3) a simulation involving a torso model containing heart and lungs. The correlation between recorded and simulated potentials was fair for the infinite-medium simulation, improved by the boundary, and further improved by the addition of inhomogeneity. Implications for electrocardiography are discussed.
A Multisite, Double-blind, Placebo-Controlled Clinical Trial to Evaluate the Safety and Efficacy of Vigabatrin for Treating Cocaine Dependence
Authors: Eugene C. Somoza, Douglas Winship, Charles W. Gorodetzky, Daniel Lewis, Domenic A. Ciraulo, Gantt P. Galloway, Scott D. Segal, Michael Sheehan, John D. Roache, Warren K. Bickel, Donald Jasinski, Donnie W. Watson, Steven R. Miller, Peggy Somoza, Theresa Winhusen
Journal: JAMA Psychiatry (2013)

Cocaine dependence is a significant public health problem, yet no validated pharmacological treatment exists. The potent γ-aminobutyric acid (GABA)ergic medication vigabatrin has previously been shown to be effective in a double-blind single-site study conducted in Mexico.To evaluate the safety and efficacy of vigabatrin for the treatment of cocaine dependence in a U.S. sample.Multisite, randomized, double-blind, placebo-controlled, 12-week clinical trial with follow-up visits at weeks 13, 16, 20, and 24 in 11 U.S. sites.In total, 186 treatment-seeking participants with cocaine dependence (mean age, 45 years). Approximately 67% were male, and about 60% were of African American race/ethnicity.Participants received twice-daily doses of vigabatrin (total dosage, 3.0 g/d) or matched placebo, plus weekly computerized cognitive behavioral therapy and biweekly individual counseling for 13 weeks. Contingency management encouraged the provision of urine samples.The primary outcome measure was the proportion of participants with cocaine abstinence during the last 2 weeks of the 12-week treatment phase as assessed by self-reports and quantitative urine drug screens. The weekly fraction of cocaine use days and the number of drug-free urine samples during weeks 1 through 13 were key secondary measures.No significant differences were observed between the vigabatrin group and the placebo group on the primary outcome measure (P = .67), key secondary measures (P > .99), or other outcome measures. However, while pill counts and self-reports indicated that more than 66% of all participants (and >63% of the vigabatrin group) took more than 70% of their medication, post hoc vigabatrin urine concentration levels suggested that approximately 40% to 60% of patients taking vigabatrin may not have been adherent. This lack of adherence may have obscured any evidence of vigabatrin efficacy. No visual acuity or visual field deterioration occurred in any of the participants.No protocol-defined differences in efficacy between vigabatrin treatment and placebo were detected for any outcome variable. This may have been due to medication nonadherence or, alternatively, due to the weak efficacy of vigabatrin.clinicaltrials.gov Identifier: NCT00611130.