tbuckley/cabot-search huggingface dataset:
The Positive Predictive Value of Cervical Smears in Previously Screened Postmenopausal Women: The Heart and Estrogen/progestin Replacement Study (HERS)
Authors: George F. Sawaya
Journal: Annals of Internal Medicine (2000)

Background: The benefits and risks of performing annual cervical smears on postmenopausal women are not well defined. The independent effect of hormone replacement therapy on development of cytologic abnormalities is unknown. Objective: To determine the positive predictive value of cervical smears in previously screened postmenopausal women and to determine the effect of oral estrogen plus progestin on incident cervical cytologic abnormalities. Design: Prospective cohort study (incidence) and randomized, double-blind, placebo-controlled trial (hormone therapy). Setting: 20 U.S. outpatient and community clinical centers. Participants: 2561 women with a uterus and normal cytologic characteristics at baseline. Interventions: Annual smears; oral conjugated equine estrogens, 0.625 mg/d, plus medroxyprogesterone acetate, 2.5 mg/d, or identical placebo. Measurements: Incident cytologic abnormalities (atypical squamous cells of undetermined significance, atypical glandular cells of undetermined significance, low-grade squamous epithelial lesion, and high-grade squamous epithelial lesion) and final histologic diagnoses. Results: The incidence of new cytologic abnormalities in the 2 years following a normal smear was 110 per 4895 person-years (23 per 1000 person-years [95% CI, 18 to 27 per 1000 person-years]). Among the 103 women with known histologic diagnoses, one had mild to moderate dysplasia. The positive predictive value of any smear abnormality identified 1 year after a normal smear, therefore, was 0% (CI, 0% to 5.0%) (0 of 78 women); the positive predictive value of abnormalities found within 2 years was 0.9% (CI, 0.0% to 3.0%) (1 of 110 women). In hormone-treated compared with non–hormone-treated women, the incidence of cytologic abnormalities was nonsignificantly higher (relative hazard, 1.36 [CI, 0.93 to 1.99]), largely because of a nonsignificant 58% greater incidence of atypical squamous cells of undetermined significance (relative hazard, 1.58 [CI, 0.99 to 2.52]). Conclusions: Because of a poor positive predictive value, cervical smears should not be performed within 2 years of normal cytologic results in postmenopausal women. Therapy with oral estrogen plus progestin does not significantly affect the incidence of cytologic abnormalities.
Adrenergic receptor desensitisation may serve a cardioprotective role
Authors: L.-B. Tan, I. J Benjamin, W. A Clark
Journal: Cardiovascular Research (1992)

Objective: The aim was to test the hypothesis that β adrenoceptor desensitisation is a form of cardioprotection whereby the myocardium is protected from the injurious effects of excessive adrenergic stimulation by isoprenaline. Methods: A new sensitive and specific method of identifying cardiac myocyte necrosis with monoclonal antimyosin was employed. Antibody labelled necrotic cardiomyocytes from male Sprague-Dawley rats (190-300 g) were identified by immunofluorescence. Homologous β adrenoceptor desensitisation was induced by 9 d pretreatment with isoprenaline infusion (20 mg·kg−1·d−1), and heterologous desensitisation by treatment with 0.15% propylthiouracil in the diet for six weeks. The effects of isoprenaline induced cardiomyocyte injury in these animals were compared with those in control rats. Results: In euthyroid control rats, treatment with the β adrenergic agonist, isoprenaline, produced prolonged tachycardia and hypotension, and a significant amount of cardiac myocyte necrosis subendocardially. When the same isoprenaline challenge was given to rats pretreated for 9 d with an isoprenaline infusion, the haemodynamic response was markedly attenuated and very little myocyte necrosis was noted. In the model of heterologous desensitisation occurring in hypothyroidism, isoprenaline challenge produced markedly diminished haemodynamic response and little cardiac myocyte necrosis. Conclusions: In both homologous and heterologous models of β adrenoceptor desensitisation, the susceptibility of the myocardium to isoprenaline induced cytotoxicity is markedly reduced.
Was It Pancreatitis?
Authors: Kenneth A. Hubel
Journal: JAMA (1966)

ABSTRACT To the Editor:— The role of adrenal steroid treatment as a cause of  was reported by Schrier and Bulger (Steroid-Induced Pancreatitis, 194:564, 1965). The diagnosis of  was supported by only two findings: (1) Epigastric and right-upper-quadrant pain which radiated to the back, and (2) One serum amylase determination measuring 284 units/100 cc. Penetrating peptic ulcer as a cause of the hyperamylasemia was excluded by the normal gastrointestinal x-ray films and a lack of symptomatic response to antacids.Notably absent was a report of the abdominal findings at the time of the pain. In a case in which all the findings relative to the pancreatitis could be explained by disease of the biliary tree, no radiographic or chemical studies of biliary function are recorded. There was insufficient evidence to justify a diagnosis of pancreatitis.There was little reason to attribute the elevated serum amylase to prednisone rather than
Ventricular Localization of Bound Gamma Globulin in Idiopathic Disease of the Myocardium
Authors: Vernon Sanders
Journal: JAMA (1965)

Idiopathic disease of the myocardium (IDM) is a disorder of obscure origin. While the clinical and pathological features of this syndrome have been well characterized,<sup>1-3</sup>the underlying mechanism is unknown. Further confusion has arisen from the variety of synonyms employed in describing it: (1) chronic pernicious myocarditis, (2) idiopathic cardiomegaly, (3) adult fibroelastosis, (4) obscure cardiopathy, (5) primary myocardial disease, (6) noncoronary cardiomyopathies, (7) endocardial fibrosis, (8) heart disease of unknown etiology, (9) cardiac hypertrophy of unknown etiology, and (10) idiopathic myocardial hypertrophy. Because of the striking clinical and histological similarities between this entity and chronic infectious myocarditis, this study of IDM on an infectious-immune basis was made. <h3>Materials and Methods</h3> Tissue for this study was obtained either by biopsy or autopsy from nine patients meeting rigid predetermined criteria for inclusion in a clinical study of IDM.<sup>3</sup>Control materials were obtained from 16 consecutive autopsies. Of these control
Age-Related Differences in Susceptibility to Carcinogenesis: A Quantitative Analysis of Empirical Animal Bioassay Data
Authors: Dale Hattis, Robert Goble, Abel Russ, Margaret Chu, Jen Ericson
Journal: Environmental Health Perspectives (2004)

In revising cancer risk assessment guidelines, the U.S. Environmental Protection Agency (EPA) analyzed animal cancer bioassay data over different periods of life. In this article, we report an improved analysis of these data (supplemented with some chemical carcinogenesis observations not included in the U.S. EPA's original analysis) and animal bioassay studies of ionizing radiation. We use likelihood methods to avoid excluding cases where no tumors were observed in specific groups. We express dosage for animals of different weights on a metabolically consistent basis (concentration in air or food, or per unit body weight to the three-quarters power). Finally, we use a system of dummy variables to represent exposures during fetal, preweaning, and weaning-60-day postnatal periods, yielding separate estimates of relative sensitivity per day of dosing in these intervals. Central estimate results indicate a 5- to 60-fold increased carcinogenic sensitivity in the birth-weaning period per dose divided by(body weight(0.75)-day) for mutagenic carcinogens and a somewhat smaller increase--centered about 5-fold--for radiation carcinogenesis per gray. Effects were greater in males than in females. We found a similar increased sensitivity in the fetal period for direct-acting nitrosoureas, but no such increased fetal sensitivity was detected for carcinogens requiring metabolic activation. For the birth-weaning period, we found an increased sensitivity for direct administration to the pups similar to that found for indirect exposure via lactation. Radiation experiments indicated that carcinogenic sensitivity is not constant through the "adult" period, but the dosage delivered in 12- to 21-month-old animals appears a few-fold less effective than the comparable dosage delivered in young adults (90-105 days of age).
Giant-Cell Arteritis
Authors: Nathan Polasky
Journal: JAMA (1965)

A RECENT concept regards giant-cell arteritis as a systemic disease of unknown cause, affecting primarily large and medium-sized arteries.<sup>1</sup>The histological appearance is that of a panarteritis, with the inflammatory changes occurring mainly in the media, where focal necrosis and granulomatous inflammation with giant cells occur. The internal elastic lamina may be disrupted, and there may be diffuse fibrotic thickening of the intima, with narrowing of the lumen and often thrombus formation.<sup>2</sup> This disease, which usually affects the aged, often is self-limited, but is sometimes fatal. Paulley and Hughes<sup>3</sup>described the protean manifestations of giant-cell arteritis, the varying modes of clinical presentation depending upon the specific arteries or groups of arteries involved, as well as their respective organ systems. Classical temporal arteritis, as described by Hutchinson<sup>4</sup>and Horten et al,<sup>5</sup>is one manifestation of the disease. However, the disease may occur without headache.<sup>6</sup>Extracranial
Heberden Oration : A Broader Spectrum of Sjogren's Syndrome and Its Pathogenetic Implications
Authors: J. J. Bunim
Journal: Annals of the Rheumatic Diseases (1961)

immuno-fluorescent technique with intact reciprocals of median titres.~~~~~~~~~~~ 5 * By immuno-fluorescent technique with intact nuclei.t Figures in ( ) are reciprocals of median tires.
Lung Function and Risk of Myocardial Infarction and Sudden Cardiac Death
Authors: Gary D. Friedman, Arthur L. Klatsky, A.B. Siegelaub
Journal: New England Journal of Medicine (1976)

In a search for risk factors for myocardial infarction and sudden cardiac death, the mean total vital capacity as measured at multiphasic health checkups was lower in persons who later had a first myocardial infarction than in risk-factor-matched controls (3.17 vs. 3.29 liters, 395 pairs, P<0.05) and non-risk-factor-matched controls (3.16 vs. 3.41 liters, 401 pairs, P<0.001). Findings were little affected by age and height adjustment and were similar for sudden cardiac death. The first-second vital capacity was also inversely related to later development of these conditions, but the ratio of that measurement to total vital capacity was not. Heavy smoking, productive cough, exertional dyspnea and cardiac enlargement were associated with diminished total vital capacity. However, exclusion of subjects with these findings did not reduce the predictive value of total vital capacity. Diminished vital capacity deserves continued attention as a possible coronary risk factor. Its relation to subsequent coronary events is not well explained. (N Engl J Med 294:1071–1075, 1976)
Water turnover rates in sedentary and exercising middle aged men.
Authors: J B Leiper, A Carnie, R J Maughan
Journal: British Journal of Sports Medicine (1996)

To assess the effect of exercise on water turnover in endurance trained middle aged men.Water turnover was assessed using 2H2O as a tracer for water in six exercising and six sedentary middle aged men over seven consecutive days. The exercising subjects ran on average 14.8 km per day, while the sedentary group did not take part in any regular physical activity.The average median (range) rate of water turnover (ml.d-1) was higher in the exercising group [4673 (4320 to 9606)] than in the sedentary group [3256 (2055 to 4185); P = 0.001]. Although there was a tendency for non-renal water losses (ml.d-1) to be greater in the exercising group [1746 (1241 to 5196)] than in the sedentary group [1223 (1021 to 1950); P = 0.08], the major difference in water loss between the groups was the greater urine output (ml.d-1) in those who exercised [3021 (2484 to 4225)] compared to those who were sedentary [(1883 (925 to 2266); P = 0.001].The results suggest that fluid intake in middle aged men who exercise regularly must be greater than that of sedentary individuals of the same age group, and that the difference in volume is in excess of that required to replace exercise induced sweat and respiratory water losses.
Combined Intramyocardial Delivery of Human Pericytes and Cardiac Stem Cells Additively Improves the Healing of Mouse Infarcted Hearts Through Stimulation of Vascular and Muscular Repair
Authors: Elisa Avolio, Marco Meloni, Helen L. Spencer, Federica Riu, Rajesh Katare, Giuseppe Mangialardi, Atsuhiko Oikawa, Iker Rodriguez-Arabaolaza, Zexu Dang, Kathryn Mitchell, Carlotta Reni, Valeria V. Alvino, Jonathan Rowlinson, Ugolini Livi, Daniela Cesselli, Gianni Angelini, Costanza Emanueli, Antonio P. Beltrami, Paolo Madeddu
Journal: Circulation Research (2015)

Rationale: Optimization of cell therapy for cardiac repair may require the association of different cell populations with complementary activities. Objective: Compare the reparative potential of saphenous vein–derived pericytes (SVPs) with that of cardiac stem cells (CSCs) in a model of myocardial infarction, and investigate whether combined cell transplantation provides further improvements. Methods and Results: SVPs and CSCs were isolated from vein leftovers of coronary artery bypass graft surgery and discarded atrial specimens of transplanted hearts, respectively. Single or dual cell therapy (300 000 cells of each type per heart) was tested in infarcted SCID (severe combined immunodeficiency)-Beige mice. SVPs and CSCs alone improved cardiac contractility as assessed by echocardiography at 14 days post myocardial infarction. The effect was maintained, although attenuated at 42 days. At histological level, SVPs and CSCs similarly inhibited infarct size and interstitial fibrosis, SVPs were superior in inducing angiogenesis and CSCs in promoting cardiomyocyte proliferation and recruitment of endogenous stem cells. The combination of cells additively reduced the infarct size and promoted vascular proliferation and arteriogenesis, but did not surpass single therapies with regard to contractility indexes. SVPs and CSCs secrete similar amounts of hepatocyte growth factor, vascular endothelial growth factor, fibroblast growth factor, stem cell factor, and stromal cell–derived factor-1, whereas SVPs release higher quantities of angiopoietins and microRNA-132. Coculture of the 2 cell populations results in competitive as well as enhancing paracrine activities. In particular, the release of stromal cell–derived factor-1 was synergistically augmented along with downregulation of stromal cell–derived factor-1–degrading enzyme dipeptidyl peptidase 4. Conclusions: Combinatory therapy with SVPs and CSCs may complementarily help the repair of infarcted hearts.
Myocardial Medley: Medical Anecdotes and Humour
Authors: Thomas Sheffield
Journal: JAMA (1991)

This is a pocket-sized book in softcover convenient for a jacket pocket. One could look forward to reading one of the short essays in between appointments or while waiting in the cafeteria. The book is self-categorized as "Medical Anecdotes and Humour." I am a cardiologist with what I fancy to be a sense of humor, and I expected this little book to be just my cup of tea, but it was not quite what I expected. Although the book has six sections with titles such as "Tools of the Trade," "Cardiac Arrest," and "Hypertension," there are really only two kinds of anecdotes included: essays on memorable patients and others on the practice of medicine. Those about patients tend to poke gentle fun at their obesity, overuse of salt, and such. Those about medical practice involve wistful reflections, eg, on student and house staff use of medical jargon. They display skepticism
DISPERSION OF REGIONAL LONGITUDINAL STRAIN IN NONISCHEMIC LEFT VENTRICULAR SEGMENTS: INSIGHTS FROM SPECKLE TRACKING DOBUTAMINE STRESS ECHOCARDIOGRAPHY
Authors: Karina A. Wierzbowska-Drabik, Nikolina Roszczyk, Maria Sobczak, Michał Plewka, Radosław Krecki, Jaroslaw Kasprzak
Journal: Journal of the American College of Cardiology (2014)
Comorbidity in the context of neural network properties
Authors: Juliana Yordanova, Vasil Kolev, Roumen Kirov, Aribert Rothenberger
Journal: Behavioral and Brain Sciences (2010)

Cramer et al.'s network approach reconceptualizes mental comorbidity on the basis of symptom space originating from psychometric signatures. We argue that the advantages of this approach need to be regarded in the context of the multi-level functional organization of the neural substrate, ranging from neurogenetic to psychometric. Neuroelectric oscillations are proposed as a level-integrating principle.
CASES ILLUSTRATING THE DIAGNOSIS OF DISEASES OF THE HEART
Authors: W. O. Markham
Journal: BMJ (1854)

we vred portion of the cornea was normal, as was the ins as far as it could be scrutinised, and the anterior aqueous chamber.The conjunctiva covering the lower lid wa more red than natural; in other parts, it was healthy.The patient was sometimes troubled by a copious flow of tears, which were not scalding; also with occasional brow headache.The left eye was quite well.His appetite was imp d.
Phylogenetic analysis of hepatitis C virus isolates and their correlation to viremia, liver function tests, and histolog
Authors: S Zeuzem, A Franke, J Lee, G Herrmann, B Rüster, W K Roth
Journal: Hepatology (1996)

Nucleotide sequence analysis of hepatitis C virus (HCV) strains showed substantial variability leading to a classification into several genotypes and subtypes. The data correlating HCV genotypes and subtypes with hepatitis C viremia levels, demographic characteristics of patients (age, mode of transmission, duration of infection), and severity of liver disease are conflicting. The interpretation of several studies is further complicated because the molecular methods used lacked specificity for genotyping/subtyping and underestimated viremia levels, especially in patients infected with HCV genotypes 2 and 3. In the present study we investigated 97 consecutive patients with chronic hepatitis C using molecular “gold standard” methods. HCV subtyping was performed by sequence and phylogenetic analysis of the nonstructural (NS)–5 region and serum HCV–RNA concentration was assessed by a validated genotype–independent quantitative reverse– transcription–polymerase chain reaction assay using an internal RNA standard. Patients infected with subtypes HCV–1b, HCV–2a–c, and HCV–4 were older than patients infected with HCV–1a and HCV–3a. Serum HCV–RNA levels ranged from 1.5 × 104 to 1.0 × 108 copies/mL with no significant differences between median serum HCV–RNA concentrations in patients infected with different genotypes/subtypes. Although patients infected with HCV–1b were older, no biochemical or histological evidence was obtained that this subtype is associated with more severe liver disease. Furthermore, the present study showed a lack of correlation between the serum HCV–RNA concentration, biochemical parameters, and liver histology. The median serum HCV–RNA levels in patients with chronic persistent hepatitis, chronic active hepatitis, and liver cirrhosis were 5.0 × 106 copies/mL, 2.5 × 106 copies/mL, and 5.0 × 106 copies/mL, respectively. These differences were not significant. In conclusion, using optimized and validated molecular techniques, the present cross–sectional study showed no correlation between HCV genotypes/subtypes, viremia, liver function test results, and histology.
Medical Education in Outpatient Settings
Authors: Daniel D. Federman
Journal: New England Journal of Medicine (1989)

The education of a doctor requires the longest training of any profession. In addition to its length, the process is remarkable for how much of the training is conducted on the job. Business students don't manage companies, law students don't try cases, and government students don't legislate while paying tuition. But medical students assist in the care of very ill patients, and residents independently perform surgery, complicated medical therapies, and cardiopulmonary resuscitation. To ensure that this progressive clinical responsibility is safe for patients, medical trainees are part of a system whose teacher–student ratio is very high; the result is a . . .
MYOMECTOMY PER VAGINAM.
Authors: J. RIDDLE GOFFE
Journal: JAMA (1900)

There are probably no two subjects that so enlist the attention of gynecologists at the present time as those that are suggested in the title of my paper. The first is the value of myomectomy as contrasted with hysterectomy in the treatment of fibroid tumors of the uterus, and the second is the superiority of the vaginal method of approach over the abdominal route in the surgical treatment of pelvic disease in women. Regarding the first, there are staunch advocates of myomectomy as the operation of choice, as the dominant operation in the treatment of fibroid tumors of the uterus; and, on the other hand, there are strong advocates of the sweeping and uncompromising dictum, that in all cases of fibroid tumors of the uterus nothing short of hysterectomy should be entertained. For myself, I believe in conservatism in gynecologic surgery. If part of an ovary can be saved and
Zinc enhancement of nonviral salivary gland transfection
Authors: Edmund J Niedzinski, David C Olson, Yen-J.u Chen, Judy A Udove, Michael H Nantz, Hsein C Tseng, Janice L Bolaffi, Michael J Bennett
Journal: Molecular Therapy (2003)

Gene transfer to exocrine glands, including the major salivary glands, presents an attractive method to deliver proteins for therapeutic applications. Previous efforts using nonviral gene delivery to these glands have resulted in limited success. In this report, zinc and other divalent transitions were coadministered with plasmid DNA in an effort to improve nonviral salivary gland transfection efficiency. The inclusion of zinc into plasmid DNA solutions resulted in a 20-fold enhancement in transgene expression without noticeable inflammation compared to a solution of plasmid DNA only. This observed enhancement in transgene expression was dependent upon the DNA dose and correlated with the accumulation of plasmid DNA by salivary gland tissues.
Underexpansion and Ad Hoc Post-Dilation in Selected Patients Undergoing Balloon-Expandable Transcatheter Aortic Valve Replacement
Authors: Marco Barbanti, Jonathon Leipsic, Ronald Binder, Danny Dvir, John Tan, Melanie Freeman, Bjarne Norgaard, Nicolaj Hansson, Anson Cheung, Jian Ye, Tae-Hyun Yang, Kasia Maryniak, Rekha Raju, Angus Thompson, Philipp Blanke, Sandra Lauck, David Wood, John Webb
Journal: Journal of the American College of Cardiology (2013)
The Climate of Madeira
Authors: F. D. Dyster
Journal: BMJ (1876)

Necrosis of bone also occurred on the right side, and a number of small pieces continued to come away from time to time nearly up to the date of the operation.Altogetlher, less bone, she states, came away from the righlt side than from the left.Small l)ieces of l)one also camiie away through two sinuses under the chin, indicated by the small cicatrices alluded