tbuckley/cabot-search huggingface dataset:
Changes in ventriculoatrial intervals with bundle branch block aberration during reciprocating tachycardia in patients with accessory atrioventricular pathways.
Authors: C R Kerr, J J Gallagher, L D German
Journal: Circulation (1982)

During reciprocating tachycardia in patients with accessory atrioventricular pathways, the observation of changes in ventriculoatrial (VA) intervals with bundle branch block (BBB) aberration has been used to localize the site of the pathway and prove the participation of the pathway in the tachycardia. In this report we present the changes observed during BBB in 93 patients with single atrioventricular pathways in whom the site of their pathways was subsequently proved at the time of their surgical interruption. In patients with left or right free wall pathways, the minimum VA interval (VA min) increased by 61 +/- 19 msec with ipsilateral BBB, whereas no change occurred with contralateral BBB. The smallest increase in the VA interval was 35 msec. In 14 patients, shortening of the AH intervals resulted in changes in overall cycle length that were less than 35 msec. Patients with septal pathways all had changes in VA min of 25 msec or less with either right or left bundle branch block (RBBB or LBBB), which suggests that a clear differentiation between septal and free wall pathways can be made on the basis of changes in VA min. In patients with anteroseptal pathways, VA min intervals frequently prolonged with RBBB (16 +/- 9 msec) but not with LBBB. In patients with posteroseptal pathways, VA min frequently prolonged with LBBB (13 +/- 8 msec) but not with RBBB. Therefore, the observed changes in VA min with BBB may serve as an important indicator of the site of an accessory pathway and may provide guidance in the choice of surgical therapy.
Pituitary Adenoma with "Honeycomb Golgi" Appearance Showing a Phenotypic Change at Recurrence from Clinically Nonfunctioning to Typical Cushing Disease
Authors: Toshiaki Sano, Kalman Kovacs, Sylvia L Asa, Shozo Yamada, Naoko Sanno, Shunichi Yokoyama, Hiroshi Takami
Journal: Endocrine Pathology (2002)
Vanin-1–/– mice show decreased NSAID- and Schistosoma-induced intestinal inflammation associated with higher glutathione stores
Authors: Florent Martin, Marie-France Penet, Fabrice Malergue, Hubert Lepidi, Alain Dessein, Franck Galland, Max de Reggi, Philippe Naquet, Bouchra Gharib
Journal: Journal of Clinical Investigation (2004)

Vanin-1 is a membrane-anchored pantetheinase highly expressed in the gut and liver. It hydrolyzes pantetheine to pantothenic acid (vitamin B5) and the low-molecular-weight thiol cysteamine. The latter is believed to be a key regulating factor of several essential metabolic pathways, acting through sulfhydryl-disulfide exchange reactions between sulfhydryl groups of the enzymes and the oxidized form, cystamine. Its physiological importance remains to be elucidated, however. To explore this point, we developed Vanin-1–deficient mice that lack free cysteamine. We examined the susceptibility of deficient mice to intestinal inflammation, either acute (NSAID administration) or chronic (Schistosoma infection). We found that Vanin-1–/– mice better controlled inflammatory reaction and intestinal injury in both experiments. This protection was associated with increased γ-glutamylcysteine synthetase activity and increased stores of reduced glutathione, as well as reduced inflammatory cell activation in inflamed tissues. Oral administration of cystamine reversed all aspects of the deficient phenotype. These findings suggest that one cysteamine function is to upregulate inflammation. Consequently, the pantetheinase activity of Vanin-1 molecule could be a target for a new anti-inflammatory strategy.
Drug resistant cholera in India attributed to antibiotic misuse
Authors: G. Mudur
Journal: BMJ (2000)

Indian microbiologists have said that the widespread misuse of antibiotics in India has led to the emergence of drug resistant cholera, in a rerun of events that involved typhoid a decade ago.

Strains of Vibrio cholerae in India have become resistant to several antibiotics, and multidrug resistance is increasing, researchers at the National Institute of Cholera and Enteric Diseases in Calcutta said. Studies on V cholerae strains isolated from patients in eastern India over the past six years show that the bacilli are resistant to several …
THE EFFECT OF VITAMIN D ON CALCIUM AND PHOSPHORUS METABOLISM; STUDIES ON FOUR PATIENTS
Authors: Fuller Albright, Hirsh W. Sulkowitch
Journal: Journal of Clinical Investigation (1938)

Metabolic data on Patient 1 with rickets CalciumPhosphorus Serum Threeday Therapy period Urine Feces In- Bal-Urine Feces In- Bal-Calcium Phos-Phostake ance take ance phorus phatase grams grams grams grams grams grams grams grams mgm.per mgm.per Bodansky 1 0.61 0.08 0.30 -0.39 1.69 0.45 1. 78 -0.36 Low calcium diet 2 0.64 0.08 0.30 -0.42 1.69 0.39 1.78 -0.30 10.9(III)* 3.0 16.2 Low calcium diet 3 0.77 0.18 2.40 + 1.45 1.17 0.36 1.78 +0.25 Same plus calcium lactate p.o. 4 0.77 0.91 2.40 +0.72 1.11 0.58 1.78 +0.09Same plus calcium lactate p.o. 5 0.73 0.95 2.40 +0.72 1.02 0.63 1.78 +0.13 Same plus calcium lactate p.o. 9.3(I) 2.8 18.3 Same plus phosphate i.v. 60.60 1.10 2.40 +0.70 2.47 0.50 3.51 +0.54 10.7(II) 2.6 24.7 7 0.48 1.16 2.40 +0.76 2.25 0.61 3.51 +0.65 10.1(I) 2.8 17.3 Same plus phosphate i.v. 8 0.43 0.86 2.40 +1.11 2.23 0.54 3.51 +0.74 (I) 2.6 20.0 Same plus vitamin D 9 0.87 0.35 2.40 + 1.18 2.14 0.37 3.51 + 1.00 9.6(III) 3.1 15.7 Same plus vitamin D 10 1.09 0.25 2.40 +1.06 2.35 0.39 3.51 +0.77Same except phosphate p.o. 11 1.29 0.21 2.40 +0.90 2.36 0.36 3.54 +0.82 11.7(I) 3.6 14.8 Same except phosphate p.o.
Incidence and Prevalence of Clinical Peripheral Vascular Disease in a Population-based Cohort of Diabetic Patients
Authors: L Joseph Melton, M Macken Kathleen, P J Palumbo, Lila R Elveback
Journal: Diabetes Care (1980)

Clinical peripheral vascular disease (PVD) was studied in an incidence cohort of 1073 residents of Rochester, Minnesota, who were found to have diabetes mellitus in the period 1945–69. About 8%; of patients already had clinical evidence of PVD at the time of diagnosis of diabetes. The proportion increased with the age at which diabetes was discovered. Among those unaffected initially, the incidence of subsequent PVD was slightly greater for men, 21.3 per 1000 person-years, than for women, 17.6 per 1000, and it increased both with age and duration of diabetes. The cumulative incidence of subsequent PVD was estimated to be 15%; at 10 yr and 45% at 20 yr after the diagnosis of diabetes. The age-adjusted prevalence of residents with diabetes and a history of PVD was 3.3 per 1000 population 30 yr of age or over on 1 January 1970.
Screening of Preschool Children for Amblyopia
Authors: Edward Press
Journal: JAMA (1968)

A simplified, new method of screening the vision of 3- and 4-year-old children by parent-administered tests done at home has been devised. The test is based on the ability of the child to correctly identify the position in which the image of a human hand (a modified Sjogren hand test) is rotated. The results of trials by many pediatricians throughout the United States who gave the hand screening card to parents of their patients for testing at home (and then later confirmation by ophthalmologists) indicate that for many children this is a satisfactory method of early detection of unilateral impaired vision characteristic of amblyopia ex anopsia.
THE ABNORMAL COURSE OF BACTERIAL PROTEIN SYNTHESIS IN THE PRESENCE OF PENICILLIN
Authors: Rollin D. Hotchkiss
Journal: The Journal of Experimental Medicine (1950)

Washed staphylococcal cells separated from peptone-broth cultures containing penicillin G did not differ markedly from cells not exposed to penicillin in their rate of oxygen, phosphate, glutamic acid, or amino nitrogen utilization. Washed normal staphyloccal cells, respiring in solutions containing glucose and various mixtures of amino acids, utilized the amino acids with an increase in the cellular protein nitrogen. Similar cells under the same conditions, but exposed to penicillin G, utilized oxygen, phosphate, and amino acids at essentially the same rates, but there was no increase in the protein nitrogen of the cells. Penicillin-treated washed cells, when utilizing amino acids, produced increased amounts of extracellular substances containing non-amino nitrogen in quantities approximately equivalent to the amino acid nitrogen utilized. The non-amino fraction could be tentatively identified as polypeptide, which was produced, instead of cellular protein, when penicillin was present.
P379 BIOCHEMICAL MARKERS FOR INTRAHEPATIC CHOLESTASIS OF PREGNANCY AND PRURITUS GRAVIDARUM IN WOMEN WITH GESTATIONAL PRURITUS
Authors: C. Ovadia, S. Abu-Hayyeh, P.H. Dixon, J. Chambers, A. Lövgren-Sandblom, R. Bolier, D. Tolenaars, U. Beuers, R. Oude-Elferink, E. Jansen, P.T. Seed, H.-U. Marschall, C. Williamson
Journal: Journal of Hepatology (2014)
Randomized Trial of Tamoxifen Versus Tamoxifen Plus Aminoglutethimide as Adjuvant Treatment in Postmenopausal Breast Cancer Patients With Hormone Receptor-Positive Disease: Austrian Breast and Colorectal Cancer Study Group Trial 6
Authors: Marianne Schmid, Raimund Jakesz, Hellmut Samonigg, Ernst Kubista, Michael Gnant, Christian Menzel, Michael Seifert, Karin Haider, Susanne Taucher, Brigitte Mlineritsch, Peter Steindorfer, Werner Kwasny, Michael Stierer, Christoph Tausch, Michael Fridrik, Viktor Wette, Günther Steger, Hubert Hausmaninger
Journal: Journal of Clinical Oncology (2003)

To determine whether the addition of aminoglutethimide to tamoxifen is able to improve the outcome in postmenopausal patients with hormone receptor-positive, early-stage breast cancer.A total of 2,021 postmenopausal women were randomly assigned to receive either tamoxifen for 5 years alone or tamoxifen in combination with aminoglutethimide (500 mg/d) for the first 2 years of treatment. Tamoxifen was administered at 40 mg/d for the first 2 years and at 20 mg/d for 3 years.All randomized and eligible patients were included in the analysis according to the intention-to-treat principle. After a median follow-up of 5.3 years, the 5-year disease-free survival in the aminoglutethimide plus tamoxifen group was 83.6% versus 83.7% in the monotherapy group (P =.89). The corresponding data for overall survival at 5 years were 91.4% and 91.2%, respectively (P =.74). More patients failed to complete combination treatment (13.7%) because of side effects as compared to tamoxifen alone (5.2%; P =.0001).Aminoglutethimide given for 2 years in addition to tamoxifen for 5 years does not improve the prognosis of postmenopausal patients with receptor-positive, lymph node-negative or lymph node-positive breast cancer.
More to be learnt from the discussion than the diagnosis
Authors: E. Peile
Journal: BMJ (2003)

Two thirds of the 120 rapid responses to this case report came from outside Europe, with fairly even representation of North America, South America, the Middle East, and India and Pakistan.1 Family doctors were in the minority, as physicians with backgrounds in internal medicine, cardiology, and emergency medicine debated the likelihood of different critical illnesses. It was good to see lively contributions from junior doctors and medical students too. The responses suggested three distinct focuses of learning (box). #### Focuses of learning from interactive case report
Anticentromere antibodies in subjects with no apparent connective tissue disease.
Authors: S L Lee, G J Tsay, R T Tsai
Journal: Annals of the Rheumatic Diseases (1993)

OBJECTIVES--To study the association of anticentromere antibodies (ACA) in various diseases. METHODS--A total of 4800 consecutive serum samples were tested for ACA by indirect immunofluorescence using HEp-2 cells as substrates and by immunoblotting of Molt-4 cell mitotic chromosomal antigens and recombinant CENP-B protein. RESULTS--Anticentromere antibodies were identified in the serum samples of 24 subjects, including eight without apparent connective tissue diseases, six with primary biliary cirrhosis, two with diffuse scleroderma, one with pulmonary hypertension, one with primary Raynaud9s phenomenon, one with CREST syndrome (calcinosis, Raynaud9s phenomenon, oesophageal dysmotility, sclerodactyly, telangiectasia), and five with other connective tissue diseases. By immunoblotting using Molt-4 cells mitotic chromosomal antigens three centromere antigens were recognised by these serum samples. These were: CENP-A (17 kilodalton recognised by 22 of 24 ACA positive serum samples); CENP-B (80 kilodalton recognised by 22 of 24 ACA positive serum samples); and CENP-C (140 kilodalton recognised by 19 of 24 ACA positive serum samples). There was no specific pattern for serum samples from patients with different groups of diseases on immunoblotting. Recombinant CENP-B proteins were all recognised by these samples. Patients without apparent connective tissue disease often had a lower ACA titre than patients with primary biliary cirrhosis. CONCLUSIONS--These data suggest that a positive result for ACA does not always indicate the presence of a connective tissue disease.
A Top-Five List for Emergency Medicine
Authors: Jeremiah D. Schuur, Dylan P. Carney, Everett T. Lyn, Ali S. Raja, John A. Michael, Nicholas G. Ross, Arjun K. Venkatesh
Journal: JAMA Internal Medicine (2014)

IMPORTANCE The mean cost of medical care in the United States is growing at an unsustainable rate; from 2003 through 2011, the cost for an emergency department (ED) visit rose 240%, from $560 to $1354. The diagnostic tests, treatments, and hospitalizations that emergency clinicians order result in significant costs. OBJECTIVE To create a "top-five" list of tests, treatments, and disposition decisions that are of little value, are amenable to standardization, and are actionable by emergency medicine clinicians. DESIGN, SETTING, AND PARTICIPANTS Modified Delphi consensus process and survey of 283 emergency medicine clinicians (physicians, physician assistants, and nurse practitioners) from 6 EDs. INTERVENTION We assembled a technical expert panel (TEP) and conducted a modified Delphi process to identify a top-five list using a 4-step process. In phase 1, we generated a list of low-value clinical decisions from TEP brainstorming and e-mail solicitation of clinicians. In phase 2, the TEP ranked items on contribution to cost, benefit to patients, and actionability by clinicians. In phase 3, we surveyed all ordering clinicians from the 6 EDs regarding distinct aspects of each item. In phase 4, the TEP voted for a final top-five list based on survey results and discussion. MAIN OUTCOMES AND MEASURES A top-five list for emergency medicine. The TEP ranked items on contribution to cost, benefit to patients, and actionability by clinicians. The survey asked clinicians to score items on the potential benefit or harm to patients and the provider actionability of each item. Voting and surveys used 5-point Likert scales. A Pearson interdomain correlation was used. RESULTS Phase 1 identified 64 low-value items. Phase 2 narrowed this list to 7 laboratory tests, 3 medications, 4 imaging studies, and 3 disposition decisions included in the phase 3 survey (71.0% response rate). All 17 items showed a significant positive correlation between benefit and actionability (r, 0.19-0.37 [P ≤ .01]). One item received unanimous TEP support, 4 received majority support, and 12 received at least 1 vote. CONCLUSIONS AND RELEVANCE Our TEP identified clinical actions that are of low value and within the control of ED health care providers. This method can be used to identify additional actionable targets of overuse in emergency medicine.
Poet's Corner
Authors: Irene Warsaw
Journal: JAMA (1974)

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Abstract 2695: Lactobacillus plantarum induces TRAIL production and facilitates natural killer activity against cancer cells
Authors: Mano Horinaka, Tatsushi Yoshida, Atsuko Kishi, Kaoru Akatani, Takashi Yasuda, Junji Kouhara, Miki Wakada, Toshiyuki Sakai
Journal: Cancer Research (2011)

Abstract Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is a promising anti-tumor agent due to its induction of apoptosis in various types of malignant tumor cells with little or no toxicity in normal cells. TRAIL is an endogeneous cytokine, and thus, it may be possible to develop agents that can induce endogeneous TRAIL production as an anti-tumor strategy. Here, we show for the first time that lactobacilli induce TRAIL production in normal human peripheral blood mononuclear cells (PBMC). Treatment with heat-killed Lactobacillus (L.) plantarum, a type of lactobacilli, induced TRAIL expression on the surface of PBMC. L. plantarum also enhanced the release of soluble TRAIL into the culture medium. Moreover, L. plantarum increased the level of TRAIL mRNA as well as TRAIL protein, indicating that L. plantarum up-regulates TRAIL gene expression. L. plantarum also increased the secretion of interferon-γ (IFN-γ) from PBMC. The release of soluble TRAIL from PBMC was partially blocked by IFN-γ neutralization antibody, indicating that the TRAIL production induced by L. plantarum at least partially depends on IFN-γ. To examine whether TRAIL production by L. plantarum leads to cytotoxicity in cancer cells, we co-cultured prostate cancer cells with L. plantarum-treated PBMC and measured natural killer (NK) activity. L. plantarum facilitated NK activity, and the dominant negative form of TRAIL receptor and TRAIL neutralization antibody efficiently prevented NK activity. Our results indicate that L. plantarum facilitates TRAIL-dependent NK activity through TRAIL production, and raise the possibility of a new strategy for TRAIL-based prevention or therapy against malignant tumors. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2695. doi:10.1158/1538-7445.AM2011-2695
Roosters, Reifenstein's Syndrome and Hormone Resistance
Authors: Jean D. Wilson
Journal: New England Journal of Medicine (1977)

The development of insight into the pathogenesis of the Reifenstein syndrome illustrates an interesting development in the evolution of modern endocrinology. From their studies of the syndrome of pseudohypoparathyroidism, Fuller Albright and his colleagues, in 1942, developed the concept that endocrinopathies can result when circulating hormone levels are normal (or elevated) but resistance to the action of hormones exists at the target cell. Albright immediately recognized the theoretical implications of this concept and drew the analogy between pseudohypoparathyroidism and the Seabright-Bantam strain of chickens in which a female feathering pattern develops in an otherwise normal rooster with putatively normal androgen . . .
Mitral valve replacement combined with myocardial revascularization: early and late results for 300 patients, 1970 to 1983.
Authors: B W Lytle, D M Cosgrove, C C Gill, R W Stewart, L A Golding, M Goormastic, P C Taylor, F D Loop
Journal: Circulation (1985)

Of 300 consecutive patients undergoing primary operation for mitral valve replacement combined with coronary bypass grafting, 22 (7.3%) died in-hospital. Multivariate testing of preoperative and operative descriptors identified radiographic cardiac enlargement, preoperative paced rhythm or atrial fibrillation, 70% or more left main coronary obstruction, and serum bilirubin of more than 2 mg% as factors associated with an increase in in-hospital mortality. Follow-up of the 278 hospital survivors (mean interval 48 months, range 2 to 165 months) documented survival of 85%, 66%, and 31% and an event-free survival of 65%, 46%, and 21% at 2, 5, and 10 postoperative years, respectively. Cox proportional-hazard regression models of late risk implicated in-hospital ventricular arrhythmias, left ventricular dysfunction, and rheumatic or ischemic causes of mitral valve disease in decreasing long-term survival. In addition, patients with bioprostheses without warfarin anticoagulation had better survival and event-free survival than those with bioprostheses taking warfarin and those with mechanical prostheses with or without warfarin.
A case of a twisted ankle.
Authors: I S Loudon, A J Harrold
Journal: BMJ (1977)

The patient is 40 and a rather highly strung qualified school teacher who left her job to buy an antique business. She is intermittently separated from her husband (who is not a patient of the practice) and the basic reasons for her marital difficulties are complex and sensitive. Although this may seem rather irrelevant to her present story, it explains why establishing a working doctor-patient relationship has been difficult. The story is that the patient went over on her ankle three weeks ago while on a country walk. Her ankle was painful and slightly swollen at the time, and a nurse, who is a neighbour of the patient, applied an Elastoplast strapping. Ability to walk quickly returned, but the top of her foot is still hurting her, and she thinks there is an abnormal bony lump there. Her friend has again applied a strapping and told her she requires an x-ray examination. In addition the nurse-who has worked in the local casualty unit-has told the patient that between five and six is the best time to go, and also advised her to  your doctor to give you a line. When I examined the foot there was no evidence whatever to suggest that radiography was necessary. No local tenderness was present, there was no swelling, and there was a good, though not yet complete, range of pain-free movement. The dilemma is simple: the patient wants an x-ray examination; her friend who is experienced in casualty work has advised her to have one and how to get this done. I am sure she does not need one (physically) but do not want to fall out with her, especially when she has been courteous enough to consult the practice first. What should I have done ?