tbuckley/cabot-search huggingface dataset:
THE THERAPEUTIC EFFICIENCY OF DIETHYLSTILBESTROL ESTERS
Authors: S. C. FREED
Journal: JAMA (1942)

The comparison of the activity of various estrogens for therapeutic standardization has until recent years depended for the most part on results obtained with laboratory animals. It has been frequently pointed out, however, that assays of estrogens vary extremely in the hands of investigators using different species of animals as well as various strains of the same animal. It is obvious that such a basis for the comparison of estrogens leads to confusion, and a number of investigators have recently suggested that estrogens be assayed directly in studies on man. In this regard changes in the endometrium or vaginal smear of menopausal women have been used for determining the potency of several estrogens. 1 We have pointed out that the use of the endometrial biopsies for assaying purposes is awkward and not sufficiently accurate, since a significant percentage of women in the menopause have varying degrees of endometrial development even without
Investigation of alveolar macrophage function using lucigenin-dependent chemiluminescence.
Authors: A J Williams, P J Cole
Journal: Thorax (1981)

A method using lucigenin-dependent phagocytic chemiluminescence is described for the assessment of alveolar macrophage metabolic activity in response to stimulation by opsonised particles or soluble agents.The requirement for superoxide anion (02-) in the production of chemiluminescence is suggested by inhibition (95%) using superoxide dismutase.The results obtained are correlated with those obtained using another method of detecting 2-release (r = 061; p < 005) and are also related by regression analysis to polymorphonuclear leucocyte contamination of the alveolar macrophage suspension.This shows that alveolar macrophages produce lucigenin-dependent chemiluminescence of the same order of magnitude as do polymorphonuclear leucocytes.
REHABILITATING CHRONIC NEUROPSYCHIATRIC PATIENTS
Authors: JAMES A. STRINGHAM
Journal: American Journal of Psychiatry (1952)

The case histories of 33 patients released on trial visit after 4½ years of hospitalization were analyzed. Though the patients were 53 years old on the average and had been continuously hospitalized on the average of 12 years, follow-ups averaging 30 months from the time the patients left the hospital revealed that 24 or 72% are still out of the hospital, 19 on their own or living at home and 5 in a soldiers' home, and 12 or 37% self-supporting. No particular complications were encountered in spite of serious family opposition in half the cases, and the long period of hospitalization. The work of the social service department was of paramount importance in this program.
In the Patient's Best Interest: Women and the Politics of Medical Decisions
Authors: Rose Laub Coser
Journal: JAMA (1989)

In the sociological analysis of doctorpatient relationships, the classic sociological theory, articulated by Talcott Parsons, states that physicians, in contrast to businesspeople, for example, are not self-oriented; rather, they are oriented to act in the interest of their patients. To the objection that many physicians do indeed act in their own self-interest, it is argued that the classic definition refers to institutionalized social norms and is not taken to mean that there aren't people who deviate from it. In this book the author, rejecting the classic definition, meets it on its own terms: she does not try to show up individual shortcomings in the doctor-patient relationship, but rests her case on institutionalized normative behavior. She shows that it is expected by both partners in the interaction, physicians and patients alike, that the former will use their institutional authority to define the patients' interests. Having selected as her problem of investigation
STUDIES ON THE VENOUS PULSE. I
Authors: J. A. E. Eyster
Journal: The Journal of Experimental Medicine (1910)

A wave is described occurring in the venous pulse of man late in the diastolic period. This wave is a diastolic wave, since in an increase in length of the cardiac cycle it follows the h wave at its regular interval and becomes separated from the a wave of the next cardiac cycle. There is no wave on the venous pulse in man which can be referred to a contraction of the region of the great veins or sinus region of the heart. The h wave is a normal occurrence in the venous pulse curve from man and the dog. It occurs, according to the experience in this work, in all normal individuals in which the heart rate is sufficiently slow to prevent its obliteration by the a wave. The x wave, while not infrequent, is not always present in man even when the cardiac cycle is of sufficient length to prevent its obliteration by the a wave. This wave has not been observed in the dog. There is no wave on the venous pulse curve of the dog that can be referred to a contraction of the sinus region of the heart. Extra-systoles from stimulation of the venous region of the dog's heart produce no contraction of this region sufficiently pronounced to be recorded on a venous pulse tracing. After an interval of from 0.07 to 0.I second, representing the interval of veno-auricular conduction plus the latent period of the auricle, the auricle contracts. Extrasystoles from stimulation of the right auricle show, after an interval following the stimulus much shorter than that noted above and representing the latent period of the auricle, an a wave followed by ventricular systole after the usual a-c interval. It would seem probable that the sinus region of the heart, while capable of irritability, conductivity and rhythmicity (Erlanger and Blackman (I6)), does not normally manifest contractility.
Characterization of the functional significance of subcritical coronary stenoses with H(2)15O and positron-emission tomography.
Authors: R M Knabb, K A Fox, B E Sobel, S R Bergmann
Journal: Circulation (1985)

We have previously developed a method employing cardiac positron-emission tomography (PET) with 15O (half-life 2.1 min)-labeled water (H2(15)O) and blood pool subtraction with C15O for assessment of myocardial perfusion. This study was performed to determine whether the method developed permits detection of the differences in blood flow, induced by vasodilator stress, indicative of functionally significant subcritical coronary stenosis despite normal perfusion at rest. Coronary stenoses were induced with a small Teflon cylinder placed in the left anterior descending coronary artery of the closed-chest dog. Regional myocardial blood flow was assessed tomographically with H(2)15O given intravenously and C15O given inhalation. Blood flow distal to the stenoses was normal under conditions of rest. However, significant reductions in the hyperemic response to dipyridamole were detected consistently in regions distal to 50% to 70% diameter stenoses. Flow distal to stenoses more than doubled in absolute terms in response to dipyridamole but was only 43 +/- 9% of the increased flow in normal regions in the same dogs or in corresponding anterior regions in normal dogs. Relative myocardial blood flow measured noninvasively with PET correlated closely with the distribution of radiolabeled microspheres measured in vitro (r = .88). Thus, assessment of myocardial blood flow with H(2)15O and PET in dogs at rest and during vasodilator-induced stress permits detection of physiologically significant coronary stenoses. The procedure should therefore prove useful diagnostically for the detection of coronary insufficiency in patients as well as for the assessment of clinical interventions designed to augment regional perfusion.
Circadian blood pressure during the early course of type 1 diabetes. Analysis of 1,011 ambulatory blood pressure recordings in 354 adolescents and young adults.
Authors: R W Holl, M Pavlovic, E Heinze, A Thon
Journal: Diabetes Care (1999)

OBJECTIVE: Little information is available on the early course of hypertension in type 1 diabetes. The aim of our study, therefore, was to document circadian blood pressure profiles in patients with a diabetes duration of up to 20 years and relate daytime and nighttime blood pressure to duration of diabetes, BMI, insulin therapy, and HbA1c. RESEARCH DESIGN AND METHODS: Ambulatory profiles of 24-h blood pressure were recorded in 354 pediatric patients with type 1 diabetes (age 14.6 +/- 4.2 years, duration of diabetes 5.6 +/- 5.0 years, follow-up for up to 9 years). A total of 1,011 profiles were available for analysis from patients not receiving antihypertensive medication. RESULTS: Although daytime mean systolic pressure was significantly elevated in diabetic subjects (+3.1 mmHg; P &amp;lt; 0.0001), daytime diastolic pressure was not different from from the height- and sex-adjusted normal range (+0.1 mmHg, NS). In contrast, both systolic and diastolic nighttime values were clearly elevated (+7.2 and +4.2 mmHg; P &amp;lt; 0.0001), and nocturnal dipping was reduced (P &amp;lt; 0.0001). Systolic blood pressure was related to overweight in all patients, while diastolic blood pressure was related to metabolic control in young adults. Blood pressure variability was significantly lower in girls compared with boys (P &amp;lt; 0.01). During follow-up, no increase of blood pressure was noted; however, diastolic nocturnal dipping decreased significantly (P &amp;lt; 0.03). Mean daytime blood pressure was significantly related to office blood pressure (r = +0.54 for systolic and r = +0.40 for diastolic pressure); however, hypertension was confirmed by ambulatory blood pressure measurement in only 32% of patients with elevated office blood pressure. CONCLUSIONS: During the early course of type 1 diabetes, daytime blood pressure is higher compared with that of healthy control subjects. The elevation of nocturnal values is even more pronounced and nocturnal dipping is reduced. The frequency of white-coat hypertension is high among adolescents with diabetes, and ambulatory blood pressure monitoring avoids unnecessary antihypertensive treatment.
Effect of vitiligo on self-reported health-related quality of life
Authors: K. Ongenae, N. Van Geel, S. De Schepper, J.M. Naeyaert
Journal: British Journal of Dermatology (2005)

Background Vitiligo is a pigmentary disorder affecting at least 1% of the total population. Although the disease does not produce direct physical impairment, it may considerably influence the psychological well-being of the patients. It has been suggested that patients suffer from low self-esteem, poor body image and a poor quality of life. The majority of the studies on the psychosocial impact of vitiligo were conducted in the U.S.A. and England. Objectives This study aims to quantify the burden of vitiligo by estimating health-related quality of life in the Dutch-speaking Belgian population (Flanders). This is compared with the level of disability caused by psoriasis in a similarly recruited population. It is also our purpose to detect those at risk of experiencing a poor quality of life and to identify variables that might predict this impairment. Patients and methods Patients with vitiligo (n = 119) and 162 patients with psoriasis were included in a postal survey. In order to obtain a patient-based measurement of quality of life we used the Dermatology Life Quality Index (DLQI), a widely validated questionnaire that is easy to use and allows comparison between several skin disorders. Other survey questions were related to demographic data and disease-related characteristics. Results We obtained excellent response rates in both patient groups. The overall mean DLQI score for vitiligo (4·95) was lower than that for psoriasis (6·26) (P = 0·01). Patients with vitiligo experienced significantly less impairment of life quality from the symptoms and treatment of the disease (P < 0·001). The highest individual mean scores in vitiligo were found for Q2 (feelings), Q4 (clothing), Q5 (social and leisure activities) and Q3 (daily routine). The interaction of disease and sex on the DLQI score was highly significant (P = 0·001). While men with vitiligo scored significantly lower than men with psoriasis (P < 0·001), we found a comparable overall DLQI score for women in these disease groups. The number of consultations (P = 0·005) and severity of the disease (P < 0·001) were independently related to the DLQI. Conclusions Our study quantifies the burden on the quality of life caused by vitiligo and indicates specific areas of patients' lives which are most affected by the disease. Sex, number of consultations and subjective disease severity independently predict the quality of life. The quality of life impairment in women affected with vitiligo equals the impairment caused by psoriasis in our study population. These results should awake the interest of physicians in this 'cosmetic' disease, since appropriate treatment is likely to improve the quality of life of vitiligo patients.
55 HEMODYNAMIC EFFECTS AND SAFETY OF ONE-MONTH SIMVASTATIN TREATMENT IN PATIENTS WITH CIRRHOSIS AND PORTAL HYPERTENSION. A DOUBLE-BLIND, RANDOMIZED, PLACEBO-CONTROLLED MULTICENTER TRIAL
Authors: J.G. Abraldes, A. Albillos, J. Turnes, R. Banares, R. Gonzalez, M. Gonzalez, J.C. Garcia-Pagan, J. Bosch
Journal: Journal of Hepatology (2008)
HLA-A and -B antigens in inflammatory bowel disease.
Authors: I Biemond, W R Burnham, J D'Amaro, M J Langman
Journal: Gut (1986)

We examined all available data on HLA-A and -B antigen distributions in patients with Crohn's disease and ulcerative colitis. The risk of Crohn's disease was significantly increased in individuals with HLA-A2, having a relative risk of 1.25, in 730 pooled Caucasoid patients compared with 10 863 pooled controls, and decreased in individuals with HLA-A11, having a relative risk of 0.62. The risk of ulcerative colitis was also significantly increased in individuals with HLA-B27 and -Bw35, having a relative risk of 1.81 and 1.41 respectively, in 560 pooled Caucasoid patients compared with 6151 pooled controls, whilst in 144 pooled Japanese patients who were compared with 442 pooled controls, the risk of colitis was increased in individuals with HLA-B5 with a relative risk of 2.79. All differences remained significant after correction for the number of antigens examined. The bases for these genetic associations are unclear.
On the Theory of Disinfectants
Authors: T. P. Blunt
Journal: BMJ (1871)

it would be for the (loctor.The doctor's bills would now no longer be questioned, for " particulars" would be given in full-they would simply be fees for extraordinary visits.He would also know, as a general rule, whlat was his day's work by breakfast time ; and, this wvork being done, 'he would niot only be comparatively free, but would have the very great comfort of feeling so ; anid wvhen a summons did come he w-ould be sure that it was not a imiere whim of some iniconsiderate or fanciful patient whims and fancies wvould at least be r-educed to a minimum if the doc- tor's house were sutr-rounded by a cor-don which could only be broken by a golden key.I arnticipate, farther, that the relation between the doctor anti the family wi-ouild be immensely improved, and that he would no longer be a "'servant' anad his patienits "slaves"; their relation to each other would be that of " fr-ienids", and it wvould be much less liable to -disturbance.People would, no doubt, be more careful, and take a longer timne in maling their clhoice of a doctor, but, havinc made it
MANUAL ASPIRATION THROMBECTOMY (MAT) DOES NOT IMPACT SHORT OR LONG TERM SURVIVAL IN PRIMARY PCI: INSIGHTS FROM THE BLUE CROSS BLUE SHIELD OF MICHIGAN CARDIOVASCULAR COLLABORATIVE (BMC2)
Authors: Marta Bande, Milan Seth, Daniel Menees, Simon Dixon, Cindy Grines, David Wohns, James Mitchiner, Hitinder S. Gurm
Journal: Journal of the American College of Cardiology (2014)
Cholesterol Lowering for All: A Closer Look
Authors: P. J. Palumbo
Journal: JAMA (1989)

The National Cholesterol Education Program (NCEP)<sup>1</sup>has done an admirable job of calling the attention of physicians and the public to the importance of cholesterol level as a risk factor for cardiovascular disease. The target for this message remains the high-risk individual younger than 60 years. What has been lost in the fine print and the hype is the cautionary note that for individuals older than 60 years the recommendation for intervention should be based on the<i>judgment</i>of the physician and the<i>preference</i>of the patient. Patient preferences vary. Individuals younger than 60 years might be less motivated in the absence of symptoms to modify behavior or take medications, whereas individuals older than 60 years are more likely to be symptomatic and thus to be motivated. Clinical judgment regarding treatment of primary hypercholesterolemia must be based on current scientific evidence. Certainly, no one will argue that diet and
Drugs for Alzheimer's disease and related dementias
Authors: Serge Gauthier
Journal: BMJ (2005)

Clear rules about stopping treatment in individual patients are needed 

The article by Ballard et al in this issue (p 874) offers an opportunity to discuss the role of drugs in the treatment of Alzheimer's disease and related dementias.1 This investigator driven randomised clinical trial has tested the hypothesis that the atypical neuroleptic quetiapine and the cholinesterase inhibitor rivastigmine would be better than placebo for treating agitation in institutionalised patients in severe stages of Alzheimer's disease. Using measures of agitation (the Cohen-Mansfield agitation inventory) and cognition (the severe impairment battery) appropriate for this stage of dementia, the authors showed that agitation improved equally in the three arms of the trial but a measurable decline in cognition occurred in patients taking quetiapine. …
How much should doctors earn?
Authors: Fiona Godlee
Journal: BMJ (2007)

Giant cell tumour (GCT) of bones in the hand is very rare, only 2% of all hand tumours, but unacceptably high recurrence rates (up to 90%) have been reported by several authors. Diagnosis can be challenging due to its rarity and enchondroma-mimicking characteristics. We report on a case of GCT of the middle phalanx of the left middle finger in a 49-year-old woman who underwent middle phalanx resection and reconstruction with bone grafting. At the 1-year follow-up, no evidence of recurrence was detected and the patient was pain-free.
T cell cross-reactivity between coxsackievirus and glutamate decarboxylase is associated with a murine diabetes susceptibility allele.
Authors: J Tian, P V Lehmann, D L Kaufman
Journal: The Journal of Experimental Medicine (1994)

Limited regions of amino acid sequence similarity frequently occur between microbial antigens and host proteins. It has been widely anticipated that during infection such sequence similarities could induce cross-reactive T cell responses, thereby initiating T cell-mediated autoimmune disease. However, the nature of major histocompatibility complex (MHC)-restricted antigen presentation confers a number of constraints that should make this type of T cell cross-reactivity a rare, MHC allele-dependent event. We tested this prediction using two insulin-dependent diabetes mellitus (IDDM)-associated antigens, coxsackievirus P2-C (Cox P2-C) protein and glutamate decarboxylase (GAD65), which share a prototypic sequence similarity of six consecutive amino acids within otherwise unrelated proteins. We surveyed a panel of 10 murine MHC class II alleles that encompass the spectrum of standard alleles for the ability to cross-reactively present Cox P2-C and GAD65. Out of the 10 restriction elements tested, the sequence similarity regions were both dominant determinants and were cross-reactively displayed after the natural processing of whole antigens, only in the context of I-Anod. These data show that cross-reactive T cell recognition of sequence similarity regions in unrelated proteins is confined to certain MHC alleles, which may explain MHC association with autoimmune disease. It is striking that these two diabetes-associated antigens were cross-reactively recognized only in the context of a diabetes susceptibility allele. Since the human and the murine class II alleles associated with IDDM share conserved features, cross-reactive T cell recognition of GAD65 and Cox P2-C may contribute to the pathogenesis of human IDDM and account for the epidemiological association of coxsackievirus with IDDM.
Chelation therapy for neurodegenerative diseases
Authors: Silvia Bolognin, Denise Drago, Luigi Messori, Paolo Zatta
Journal: Medicinal Research Reviews (2009)

Abstract Mounting evidence suggests a central role for transition biometals in the etiopathogenesis of neurodegenerative diseases (ND). Indeed, while studying the molecular basis for this heterogeneous group of diseases, it has become increasingly evident that biometals and nonphysiological Al are often involved in pathology onset and progression, either by affecting the conformation of specific proteins or by exacerbating local oxidative stress. The apparently critical role played by metal dishomeostasis in ND makes chelation therapy an attractive pharmacological option. However, classical metal chelation approaches, relying on potent metal ligands, turned out to be successful only in those rare cases where exceptional brain metal accumulation occurs due to specific defects in metal metabolism. In contrast, metal‐targeted approaches using ligand of intermediate strength seem to be more appropriate in fighting the major ND, although their benefits are still questioned. We report here a survey of recent evidences supporting the use of a variety of metal ligands, and even functionalized nanoparticles, for the treatment of the most common ND. The beneficial neuropharmacological actions of metal‐targeted agents most likely arise from local metal redistribution rather than from massive metal removal. The perspectives for the development of new effective agents against ND are critically discussed. © 2009 Wiley Periodicals, Inc. Med Res Rev
Asymptomatic bacterascites: Is it spontaneous bacterial peritonitis?
Authors: Gilles Pelletier, Gilles Lesur, Olivier Ink, Hervé Hagege, Pierre Attali, Catherine Buffet, Jean-Pierre Etienne
Journal: Hepatology (1991)

Asymptomatic bacterascites is defined as the presence of bacteria in ascitic fluid without clinical features of peritonitis or increased ascitic fluid polymorphonuclear cells. Asymptomatic bacterascites is a controversial entity, and little information is available regarding its spontaneous evolution. Clinical features, bacteriological data and outcome in 22 cirrhotic patients with asymptomatic bacterascites are reported and are compared with those of a group of 36 cirrhotic patients with spontaneous bacterial peritonitis. Eleven patients had gram-negative bacteria and 11 had one gram-positive bacteria. Only in three patients (13.6%) did peritonitis develop. Twelve patients received no antibiotic therapy, and in none did peritonitis develop. At 1 month, 27% of patients with asymptomatic bacterascites had died. Patients with asymptomatic bacterascites had less-severe liver disease; they more frequently had gram-positive bacteria in ascitic fluid and had a lower 1-mo mortality rate than did patients with spontaneous bacterial peritonitis. We conclude that asymptomatic bacterascites is usually the transient residence of bacteria in ascitic fluid. Peritonitis rarely develops in patients with asymptomatic bacterascites and, in most of them, antibiotic therapy is not required. (HEPATOLOGY 1991;14:112-115.)