tbuckley/cabot-search huggingface dataset:
Introduction of David G. Nathan, MD
Authors: Edward J. Benz
Journal: Journal of Clinical Investigation (2007)

President Olefsky, members and guests of the association: It is both a privilege and a pleasure to present Dr. David Gordon Nathan, the 2006 awardee of the George M. Kober medal of the Association of American Physicians, to this distinguished gathering of colleagues, friends, and family. Dr. Nathan is an exceptional awardee. Like the distinguished individuals who have preceded him in receiving this honor, he has made outstanding contributions as an investigator, caregiver, educator, and leader. However, there is another dimension to David that makes his receipt of this honor add special luster to the Kober Medal. Nathan has also used his talents and his stature to launch and nurture the careers of an incredibly large number of extraordinary scholars and leaders whose own contributions directly amplify David’s. They, in turn, have produced and are even now producing leaders. David Nathan’s extraordinary impact and positive influence on the field are, and will be, reverberating for generations. At a time when we fear the demise of the physician-scientist and physician-scholar, he is personally keeping the pipeline flowing.
Health secretary unveils 60 new performance indicators
Authors: A. Gulland
Journal: BMJ (2011)

England’s health secretary, Andrew Lansley, has unveiled 60 NHS performance indicators that will be used to hold the NHS Commissioning Board to account.

The indicators are part of the NHS Outcomes Framework 2012-13 for England, which, alongside the forthcoming public health and adult social care outcomes frameworks, will encourage collaboration and the “provision of integrated services for patients.”

The Department of Health says that the outcomes framework will be part of the “broader mandate” used to hold the commissioning board to account. “The mandate will set out the objectives that the board should seek to achieve, including the outcomes they will be expected to improve.”

The 60 indicators fall into five domains: preventing people from …
Ruth Annette Janie Willatt (nee Evershed)
Authors: P. Willatt
Journal: BMJ (2009)

Ruth Annette Janie Willatt (nee Evershed) was born in South Bersted, West Sussex, on 14 June 1915 and died 27 March 2009, aged 93.

She was a highly gifted schoolgirl and won multiple prizes at the Vyne School in Hampshire before matriculating from Queen’s College, London, to read medicine at Edinburgh University, where she won the anatomy medal and rowed for the ladies eight. She graduated in 1939 and married Duncan Willatt (obituary BMJ 2009;338:b2509), a former fellow Edinburgh medical student, on 18 February 1941 at Thakeham, Sussex.

During the second world war, while Duncan was taking part in the Burma campaign, Ruth undertook residencies at the Bath and Wessex Orthopaedic Hospital and at the Eastern General Hospital, Leith. She then worked in general practice in Congleton in Cheshire, Horley in Surrey, Slough in Berkshire, and, finally, Chichester in Sussex, where she and Duncan were reunited on his return from the war …
Apolipoprotein E genotype and the risk of gallbladder disease in pregnancy
Authors: Cynthia W. Ko, Shirley A.A. Beresford, Beth Alderman, Gail P. Jarvik, Scott J. Schulte, Byron Calhoun, Amy M. Tsuchida, Thomas D. Koepsell, Sum P. Lee
Journal: Hepatology (2000)

The E4 allele of apolipoprotein E (apoE4) has previously been associated with symptomatic gallstone disease. The aim of this study was to determine if apoE4 is associated with the development of gallbladder sludge and/or stones during pregnancy. We conducted a nested case-control study based on an ongoing cohort study of gallbladder disease in pregnancy. Women in this study receive gallbladder ultrasounds in each trimester of pregnancy. Cases (n = 52) were defined as women with incident gallbladder sludge or stones diagnosed at the third trimester ultrasound. Controls (n = 104) were defined as women without gallbladder sludge or stones on any of 3 study ultrasounds. ApoE genotyping was performed from stored white blood cell pellets. Data were analyzed by stratified analysis and multivariate logistic regression. Cases and controls were similar in baseline characteristics. Forty-two women had sludge, 6 had gallstones, and 4 had both sludge and stones. After adjusting for risk factors such as age, parity, and body mass index, the odds ratio (OR) for the association between heterozygosity or homozygosity for the apoE4 allele and incident gallbladder sludge or stones was 0.91 (95% confidence interval [CI], 0.41-2.02). Further adjustment for family medical history and serum lipid levels did not substantially change these results (OR, 0.73; 95% CI, 0.29-1.82). In conclusion, apoE4 appears to have little or no overall association with the development of new gallbladder sludge or stones in pregnancy. However, an effect could not be ruled out in certain subgroups, such as blacks or women who are homozygous for apoE4.
OPEN-AIR COUCH FOR INVALIDS.
Authors: J. MADISON TAYLOR
Journal: JAMA (1907)

Many diseased conditions, acute as well as chronic, are being treated by an extended life in the open air. The usual form of couch is the steamer chair or hammock. No matter how much protection is used on them in the way of blankets, rugs, etc., the air circulates too freely under as well as over the patient. In cold weather the chill of this double exposure is excessive. I offer a device which is comfortable, light, portable, cheap and does not permit the cold air to circulate under so freely. It can be artificially heated if necessary. Various modifications and improvements will suggest themselves. <h3>False Doctorin'.</h3> —An ancient villager, during an illness, refused to see a doctor, relying instead on a certain quack medicine. The vicar urged on the man's wife that the conduct was almost equivalent to suicide. "Yes, sir," replied the wife; "I know it; and many
Correlation of oestrogen receptor gene polymorphism with gouty arthritis
Authors: C-M Huang, S-F Lo, H-C Lin, M-L Chen, C-H Tsai, F-J Tsai
Journal: Annals of the Rheumatic Diseases (2006)

progressive reduction in urinary excretion of NTX, resulting from an improvement in the bone resorption.However, there was no significant change in alkaline phosphatase or osteocalcin levels.The z score of the lumbar spine improved significantly over the treatment period, suggesting an improvement in BMD, which may reflect an improvement in the balance between bone formation and resorption.We believe that these patients require an intensive and prolonged course of treatment, and a close follow-up that will help delineate the beneficial effect of the treatment.
Aspirin Use and All-Cause Mortality Among Patients Being Evaluated for Known or Suspected Coronary Artery Disease
Authors: Patricia A. Gum, Maran Thamilarasan, Junko Watanabe, Eugene H. Blackstone, Michael S. Lauer
Journal: JAMA (2001)

Although aspirin has been shown to reduce cardiovascular morbidity and short-term mortality following acute myocardial infarction, the association between its use and long-term all-cause mortality has not been well defined.To determine whether aspirin is associated with a mortality benefit in stable patients with known or suspected coronary disease and to identify patient characteristics that predict the maximum absolute mortality benefit from aspirin.Prospective, nonrandomized, observational cohort study conducted between 1990 and 1998 at an academic medical institution, with a median follow-up of 3.1 years.Of 6174 consecutive adults undergoing stress echocardiography for evaluation of known or suspected coronary disease, 2310 (37%) were taking aspirin. Patients with significant valvular disease or documented contraindication to aspirin use, including peptic ulcer disease, renal insufficiency, and use of nonsteroidal anti-inflammatory drugs, were excluded.All-cause mortality according to aspirin use.During 3.1 years of follow-up, 276 patients (4.5%) died. In a simple univariable analysis, there was no association between aspirin use and mortality (4.5% vs 4.5%). However, after adjustment for age, sex, standard cardiovascular risk factors, use of other medications, coronary disease history, ejection fraction, exercise capacity, heart rate recovery, and echocardiographic ischemia, aspirin use was associated with reduced mortality (hazard ratio [HR], 0.67; 95% confidence interval [CI], 0.51-0.87; P =.002). In further analysis using matching by propensity score, 1351 patients who were taking aspirin were at lower risk for death than 1351 patients not using aspirin (4% vs 8%, respectively; HR, 0.53; 95% CI, 0.38-0.74; P =.002). After adjusting for the propensity for using aspirin, as well as other possible confounders and interactions, aspirin use remained associated with a lower risk for death (adjusted HR, 0.56; 95% CI, 0.40-0.78; P<.001). The patient characteristics associated with the most aspirin-related reductions in mortality were older age, known coronary artery disease, and impaired exercise capacity.Aspirin use among patients undergoing stress echocardiography was independently associated with reduced long-term all-cause mortality, particularly among older patients, those with known coronary artery disease, and those with impaired exercise capacity.
Risk of acute myeloid leukemia and myelodysplastic syndromes after multiple myeloma and its precursor disease (MGUS)
Authors: Sham Mailankody, Ruth M. Pfeiffer, Sigurdur Y. Kristinsson, Neha Korde, Magnus Bjorkholm, Lynn R. Goldin, Ingemar Turesson, Ola Landgren
Journal: Blood (2011)
Conduction Disturbances Associated with Myocardial Infarction: Correlation of Pathologic and Electrocardiographic Data.
Authors: James R. Harper
Journal: Annals of Internal Medicine (1967)

s1 May 1967Conduction Disturbances Associated with Myocardial Infarction: Correlation of Pathologic and Electrocardiographic Data.James R. Harper, M.D., Alexander Harley, M.D., Donald B. Hackel, M.D., E. Harvey Estes Jr., M.D.James R. Harper, M.D.Search for more papers by this author, Alexander Harley, M.D.Search for more papers by this author, Donald B. Hackel, M.D.Search for more papers by this author, E. Harvey Estes Jr., M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-66-5-1036_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptGraphic, three-dimensional representation of actual pathologic lesions can be correlated with a high degree of accuracy with electrocardiographic changes indicating abnormalities in the major conducting tissues. By integrating two methods of anatomic-pathologic study, reconstruction of the atrioventricular node, common bundle, and major bundle branches with scaled representation is possible. The first technique involves a study of the vascular anatomy of the interventricular septum by injections of barium-gelatin mixtures and using enlarged photographs of X rays of the region of the atrioventricular node. The second technique uses scanning of continuous serial sections through the conducting tissue taken at 7-µ intervals, placed... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Durham, North Carolina PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1967Volume 66, Issue 5Page: 1036-1036KeywordsElectrocardiographyLesionsMyocardial infarction Issue Published: 1 May 1967 PDF DownloadLoading ...
Modern Psychiatry and the Health Plans
Authors: D. G. McKerragher
Journal: New England Journal of Medicine (1959)

HEALTH insurance programs protect more than 70 per cent of all Americans and Canadians. Yet excluded from these benefits is the one group of disorders that disables the largest number of people.Mental illness fills 50 per cent of all hospital beds. Most general practitioners say that a third of their office patients come because of emotional problems. Yet an account for treating a disorder, correctly labeled psychiatric, will usually be turned down by the staff of a prepaid plan. So the patient who thought he had purchased comprehensive coverage is badly jarred when charged extra for psychiatric service. Since . . .
TREATMENT OF SCHIZOPHRENIC REACTIONS WITH PHENOTHIAZINE DERIVATIVES
Authors: JESSE F. CASEY, JULIAN J. LASKY, C. JAMES KLETT, LEO E. HOLLISTER
Journal: American Journal of Psychiatry (1960)

Six hundred forty newly-admitted schizophrenic men in 35 VA hospitals were randomly assigned to chlorpromazine, triflupromazine, mepazine, prochlorperazine, perphenazine and phenobarbital groups. Treatment followed a double blind procedure for 12 weeks. Patients were started on low "equivalent" doses of each drug which were gradually increased in a predetermined manner during the first 4 weeks. During the final 8 weeks, each prescribing physician adjusted the dose for each of his patients in order to evoke an optimal therapeutic response. Average daily doses during the flexible period were: chlorpromazine, 635 mg.; triflupromazine, 175 mg.; mepazine, 190 mg. ; prochlorperazine, 90 mg. ; and perphenazine, 50 mg. Clinical evaluations using two rating scales provided 24 criteria of change. For each criterion, the mean of each of the 6 treatment groups adjusted for the net effect of 12 control variables was compared by analysis of multiple covariance with the mean of every other treatment group at each of three evaluation periods; first month, the following 2 months, and over the entire 3 months. Side effects, hematologic and hepatic function data were also recorded during the course of treatment. One hundred sixty-eight patients failed to complete the study. In general, the results indicated that all 5 phenothiazine derivatives were therapeutically more effective than phenobarbital. Mepazine was less effective than the other 4 drugs at the doses employed. No significant differences in therapeutic efficacy were noted between chlorpromazine, triflupromazine, prochlorperazine, and perphenazine. Criterion measures showing change toward improvement after treatment with phenothiazine derivatives included resistiveness, belligerence, thinking disturbance, and degree of illness. Other criteria affected favorably, especially by the 4 more potent phenothiazines, were motor disturbance, paranoid projection, perceptual distortion and withdrawal. Only 21 patients (3%) were discontinued from treatment because of side reactions or deviant laboratory tests. Most side reactions, especially the extrapyramidal syndromes, were produced by perphenazine and prochlorperazine. Phenobarbital was associated with a number of side reactions ("turbulence," autonomic symptoms) commonly attributed only to the phenothiazine derivatives. Abnormal hematologic tests including eosinophilia, leucocytosis and leucopenia were neither frequent nor severe. The distribution of the 36 patients with leucopenia was not significantly different among the treatment groups. Continued treatment with the drugs in 31 leucopenic patients produced no case of agranulocytosis. Although abnormal hepatic tests occurred in 88 patients, these were sporadic. No clearcut case of jaundice or hepatic dysfunction was encountered during treatment.
Alexithymia and Acquired Immune Deficiency Syndrome
Authors: Annette Thome
Journal: Psychotherapy and Psychosomatics (1990)

Patients positive for human immunodeficiency virus (HIV) may resort to hibernation or unceasing hyperactivity to eject overpainful representations and affects. In these states overwhelming emotions can be at the origin of somatic disorders and can precipitate the onset of the acquired immune deficiency syndrome. A psychotherapy such as relaxation which can relieve excessive emotional tension and stimulate the representation of emotions in words and images seems to me to be particularly suitable for these patients. This type of psychotherapy soothing and containing, helps them to give up their dangerous behavior and to become less vulnerable to the HIV.
Roles of apolipoproteins B and E in the cellular binding of very low density lipoproteins.
Authors: E S Krul, M J Tikkanen, T G Cole, J M Davie, G Schonfeld
Journal: Journal of Clinical Investigation (1985)

Apoproteins B and E both interact with cellular low density lipoprotein (LDL) apolipoprotein B and E (apo B,E)-receptors, and very low density lipoproteins (VLDL) contain both apo B and apo E. Our aim was to study the relative importance of apo B and apo E in the binding of VLDL subfractions to cells. Two monoclonal anti-LDL-apo B antibodies (464B1B3 and 464B1B6, 2a and 2b, respectively) and two anti-apo E antibodies (1506 A1.4 and 1907 F6.4) were used to inhibit lipoprotein-cell interactions. In confirmation of previous findings, the binding and degradation of 125I-LDL by human fibroblasts were inhibited approximately 90% by antibodies 2a or 2b or the antigen-binding fragments of 2a, whereas the cellular processing of 125I-VLDL3 (Sf20-60), 125I-VLDL2 (Sf60-120), and 125I-VLDL1 (Sf greater than 120) were inhibited by only approximately 50%, approximately 25%, and less than 10%, respectively. The VLDL1-3 and LDL-dependent intracellular esterification of cholesterol with [3H]oleate were inhibited to a similar extent. Other monoclonal anti-human apo B antibodies inhibited lipoprotein-cell interactions much less effectively and nonimmune IgG isolated from mouse serum did not inhibit at all. 20-fold excesses of LDL produced about the same patterns of inhibition of degradation of 125I-VLDL1-3 and LDL by cells as did antibodies 2a and 2b, whereas homologous unlabeled VLDL1-3 in like amounts inhibited the matched 125I-VLDL subfraction more effectively. Two anti-apo E monoclonal antibodies and a polyclonal anti-apo E antibody inhibited cell-mediated degradation of and lipoprotein-dependent cholesterol esterification by VLDL1 but not VLDL3 or LDL. The results suggest that receptor recognition sites on apo E in preference to sites on apo B mediate the cellular binding of hypertriglyceridemic VLDL1. However, the proportion of particles bound via apo B seems to increase as VLDL decreases in size toward LDL, and virtually all of LDL binding is mediated by apo B.
Protective Role of Bradykinin in Cardiac Anaphylaxis
Authors: Lisa E. Rubin, Roberto Levi
Journal: Circulation Research (1995)

Abstract Cardiac anaphylaxis, an acute ischemic dysfunction comprising coronary vasoconstriction and arrhythmias, is a model of clinically recognized immediate hypersensitivity reactions affecting the heart. Bradykinin, a mediator of hypersensitivity, is also a potent coronary vasodilator, acting via nitric oxide and prostacyclin production. Because ischemia increases bradykinin outflow from the heart, we questioned whether bradykinin might mitigate anaphylactic coronary vasoconstriction. Antigen challenge of hearts isolated from presensitized guinea pigs was associated with an ≈30% increase in bradykinin overflow. Furthermore, (1) when the half-life of bradykinin was prolonged with the kininase II/angiotensin-converting enzyme inhibitors captopril and enalaprilat, anaphylactic coronary vasoconstriction was attenuated and reversed, and arrhythmias were alleviated; (2) the bradykinin B 2 -receptor antagonist HOE 140 prevented these effects; and (3) HOE 140 exacerbated both anaphylactic coronary vasoconstriction and arrhythmias. During cardiac anaphylaxis, the coronary overflow of cGMP, a marker of nitric oxide production, and 6-ketoprostaglandin F 1α , a stable prostacyclin metabolite, increased twofold and fourfold, respectively. Because neither enalaprilat nor HOE 140 affected these changes, the enhanced overflow of cGMP and 6-ketoprostaglandin F 1α is likely to reflect the actions of other hypersensitivity mediators (eg, histamine and leukotrienes). We postulate that bradykinin plays a protective role in cardiac anaphylaxis by accumulating at the luminal surface of the coronary endothelium and promoting, in an autocrine mode, a B 2 -receptor–mediated production of nitric oxide and prostacyclin in concentrations sufficient to elicit a paracrine effect on coronary vascular smooth muscle, thus opposing the vasoconstricting effects of other anaphylactic mediators.
The elderly patient with severe arterial insufficiency of the lower extremity: limb salvage by femoro-popliteal reconstruction.
Authors: F A Reichle, K P Rankin, R R Tyson, C R Shuman, A J Finestone
Journal: Circulation (1979)

To determine the feasibility of limb salvage in elderly patients in whom severe ischemia of the lower extremity is present, the results of femoro-popliteal reconstruction done primarily for limb salvage were reviewed. Of 310 femoro-popliteal bypasses, 72 were performed on patients 70 years of age or older. In the over-70 group, ischemic necrosis was present in 70.8% rest pain in 22.2%, and claudication in 7.0%. Initial limb salvage patients 70 years of age or older was 71.4%. Cumulative limb salvage at 5 years was 51.1% and at 10 years was 44.8%. Operative mortality, including mortality of subsequent amputation, when required, was 8.3%. Appreciable limb salvage can be achieved by femoro-popliteal arterial reconstruction in lieu of primary amputation in elderly patients in whom severe arterial insufficiency of the lower extremity is present.
Abstract IA15: Genetic and functional tumor heterogeneity
Authors: Charles Swanton
Journal: Cancer Research (2013)

Abstract Despite advances in genomic technologies, most advanced solid tumors remain incurable and drug resistance is almost inevitable with limited biomarkers available to personalize therapy. Two important lessons have emerged from the comprehensive genomic analyses of cancers, which may provide an explanation for difficulties that have been encountered in biomarker development. First, each tumor contains an individual assortment of multiple genomic aberrations, few of which are shared between patients with the same histopathological tumor subtype. Second, emerging evidence suggests that these anomalies appear to vary within the tumor, indicating substantial intratumor heterogeneity. Increasingly, molecular evidence suggests that intratumor heterogeneity may contribute to tumor growth through a branched (polytypic) rather than a linear pattern of tumor evolution. Branched evolutionary growth and intratumor heterogeneity results in coexisting cancer cell subclones with variegated genotypes and associated phenotypes that may be regionally separated within the same tumor and alter in dominance over time. Variegated phenotypes, resulting from intratumoral genetic heterogeneity and the emergence of new subclones at relapse, are likely to have important implications for developing novel targeted therapies and for preventing the emergence of drug resistance. Intratumor heterogeneity and sampling bias may also contribute to the recently reported failures in implementation of robust biomarkers in the clinical setting. In this talk, evidence for genetic, epigenetic and transcriptomic intratumour heterogeneity, impacting upon signal transduction pathway phenotypic heterogeneity, will be reviewed. Darwinian models for biomarker discovery will be discussed based on trunk and branched tumor growth models that may improve drug discovery and clinical outcome prediction. Citation Format: Charles Swanton. Genetic and functional tumor heterogeneity. [abstract]. In: Proceedings of the Third AACR International Conference on Frontiers in Basic Cancer Research; Sep 18-22, 2013; National Harbor, MD. Philadelphia (PA): AACR; Cancer Res 2013;73(19 Suppl):Abstract nr IA15.