tbuckley/cabot-search huggingface dataset:
The Stakes Are Not Very High in This Game
Authors: Stuart J. Youngner
Journal: The American Journal of Bioethics (2007)

"The Stakes Are Not Very High in This Game." The American Journal of Bioethics, 7(4), pp. 42–43 Notes 1. The Museum in the Royal College of Surgeons of Edinburgh (the College was founded exactly 500 years ago) has as part of its permanent exhibit a display about of Burke and Hare, the two infamous Scotsmen who killed people and sold their desirably fresh bodies to surgeons and anatomists for educational purposes (Royal College of Surgeons of Edinburgh 2006). Burke's death mask is there, as is a well-crafted leather wallet. When I visited and asked the curator of one of Europe's oldest and most respected medical museums why it was there, he joyfully replied, “Oh, Sir, that was made from Burke's skin after they publicly dissected him as punishment for his crimes.” I assume informed consent had not been obtained.
Clinical Light Damage by Indirect Ophthalmoscopy
Authors: Enrique Fariza, Miguel Castellote
Journal: New England Journal of Medicine (1993)

To the Editor: Damage induced by light has been a topic of great concern among ophthalmologists and visual scientists1. It has been described clinically in conjunction with gazing directly into the sun2 and with exposure to ophthalmic instrumentation, such as operating microscopes and endoillumination probes3. We describe a patient who had light-induced damage after clinical ophthalmoscopic examination. The patient was a 55-year-old woman with a history of severe myopia (right eye, 15 diopters; left eye, 16 diopters), high intraocular pressure (right eye, 22 mm Hg; left eye, 25 mm Hg), glaucoma (treated with 5 percent timolol eye drops), . . .
Monitoring Patients With Chest Pain
Authors: Jonas Brachfeld
Journal: JAMA (1977)

To the Editor.—  The correspondence regarding cardiac monitoring in the emergency room (ER) (237:2188, 1977) prompts me to the following remarks. Many ERs throughout the country have set up what could be called  coronary care units (CCU) for monitoring patients with chest pain. Effectiveness of these units, as compared to that of the main CCU, has not been evaluated, however. A few years ago I tried to collect statistics from the ERs in this area, and no one had valid data of morbidity and ultimate outcome. It seems to me that such auxiliary CCUs are wasteful both from an economic and professional point of view. The cost of providing equipment and of training ER personnel may not be justified by the parttime usage of these expensive commodities. The ER nurse uses these skills only a fraction of her working hours; even at those times they are interfered with by
Protective effects of adenosine in myocardial ischemia.
Authors: S W Ely, R M Berne
Journal: Circulation (1992)

Adenosine is released from the myocardium in response to a decrease in the oxygen supply/demand ratio, as is seen in myocardial ischemia; its protective role is manifested by coronary and collateral vessel vasodilation that increase oxygen supply and by multiple effects that act in concert to decrease myocardial oxygen demand (i.e., negative inotropism, chronotropism, and dromotropism). During periods of oxygen deprivation, adenosine enhances energy production via increased glycolytic flux and can act as a substrate for purine salvage to restore cellular energy charge during reperfusion. Adenosine limits the degree of vascular injury during ischemia and reperfusion by inhibition of oxygen radical release from activated neutrophils, thereby preventing endothelial cell damage, and by inhibition of platelet aggregation. These effects help to preserve endothelial cell function and microvascular perfusion. Long-term exposure to adenosine may also induce coronary angiogenesis.
Pancreatitis Associated With Incretin-Based Therapies
Authors: Shridhar N. Iyer, Robert J. Tanenberg, Carlos E. Mendez, R. Lee West, Almond J. Drake
Journal: Diabetes Care (2013)

In recent years, incretin-based therapies such as glucagon-like peptide-1 agonists (GLP-1) and dipeptidyl peptidase-IV inhibitors (DPP-IV) have become important therapeutic options for treatment of type 2 diabetes. Although these agents are considered safe, long-term safety outcome studies are lacking. Theoretically, the combination of these two classes of agents could increase efficacy, but there is no strong supporting clinical evidence. While both GLP-1 and DPP-IV agents are approved for use as monotherapy and with other diabetes drugs, the combined use of these drugs classes has not been approved by the U.S. Food and Drug Administration (FDA).

In a recent case report, Patel et al. (1) noted an improvement in glycemic control in a patient with type 2 diabetes on a combination of …
Odds and odds ratios
Authors: P. Sedgwick
Journal: BMJ (2013)

Researchers evaluated the efficacy of intravitreous injections of bevacizumab for the treatment of neovascular age related macular degeneration. A prospective, double blind, multicentre, randomised controlled trial study design was used. The intervention was intravitreous bevacizumab 1.25 mg, given as three loading injections at six week intervals and followed by further treatment if needed (again at six week intervals). The control was standard treatment—photodynamic therapy, intravitreal injections of pegaptanib, or intravitreal injections of placebo. Study participants were 131 patients (mean age 81 years) with wet age related macular degeneration.1

The primary outcome measure was a gain of 15 letters or more of visual acuity at one year from baseline assessed with an ETDRS (Early Treatment Diabetic Retinopathy Study) visual acuity chart. Of 65 participants allocated to the intervention, 21 (32%) gained 15 letters or more of visual acuity from baseline compared with two (3%) of the control group (n=66). The odds of a gain of 15 letters or more of visual acuity at one year were 21/44 for the intervention group and 2/64 for the control group. The unadjusted odds ratio for the primary outcome when comparing the intervention with the control was 15.3 (95% confidence interval 3.4 to 68.5). When adjusted for age, sex, and baseline visual acuity, the odds ratio for the primary outcome when comparing the treatments …
Tumor Necrosis Factor-α Is Expressed in Donor Heart and Predicts Right Ventricular Failure After Human Heart Transplantation
Authors: Emma J. Birks, Virginia J. Owen, Paul B. J. Burton, Anne E. Bishop, Nicholas R. Banner, Asghar Khaghani, Julia M. Polak, Magdi H. Yacoub
Journal: Circulation (2000)

Background —Myocardial failure is an important problem after heart transplantation. Right ventricular (RV) failure is most common, although its mechanisms remain poorly understood. Inflammatory cytokines play an important role in heart failure. We studied the expression of tumor necrosis factor (TNF)-α and other cytokines in donor myocardium and their relationship to the subsequent development of RV failure early after transplantation. Methods and Results —Clinical details were obtained, and ventricular function was assessed by transesophageal echocardiography in 26 donors before heart retrieval. A donor RV biopsy was obtained immediately before transplantation, and each recipient was followed for the development of RV failure. Reverse transcriptase–polymerase chain reaction was performed to detect TNF-α, interleukin-2, interferon-γ, and inducible nitric oxide synthase expression. Eight of 26 recipients (30.8%) developed RV failure. Seven of these 8 (87.5%) expressed TNF-α, but only 4 of the 18 (22.2%) who did not develop RV failure expressed TNF-α ( P &lt;0.005). As a predictor of RV failure, TNF-α mRNA had a sensitivity of 87.5%, a specificity of 83.3%, a positive predictive value of 70%, and a negative predictive value of 93.7%. Western blotting demonstrated more TNF-α protein in the myocardium of donor hearts that developed RV failure (658±60 versus 470±57 optical density units, P &lt;0.05). Immunocytochemistry localized TNF-α expression to cardiac myocytes. Reverse transcriptase–polymerase chain reaction detected interferon-γ in 2 (7.7%), interleukin-2 in 1 (3.8%), and inducible nitric oxide synthase mRNA in 1 (3.8%) of the 26 donor hearts, none of which developed RV failure. Conclusions —TNF-α expression in donor heart cardiac myocytes seems to predict the development of RV failure in patients early after heart transplantation.
William Alexander Hammond—1828-1900
Authors: Albert F. Heck
Journal: JAMA (1963)

DURING THIS CENTENNIAL of the Civil War it seems appropriate to recall once again the unusual story of Dr. William Alexander Hammond, Professor of Anatomy and Physiology at the University of Maryland in 1860-1861, Surgeon General of the United States Army in 1862-1864, and educator, author, and one of the founders of American neurology. The son of Dr. John W. Hammond and Sarah Pinckney Hammond, he was born at Annapolis, Md., on Aug. 28, 1828, and received his academic education at Harrisburg, Pa. Engaging in the study of medicine at the age of 16, he graduated from the Medical Department of the University of the City of New York in March, 1848, following which he worked for a year in the Pennsylvania Hospital, Philadelphia. In July, 1849, he married Helen Nisbet of that city.  He entered the U.S. Army in 1849 as an assistant surgeon and during the next 11
Meaning of the Downward Trend in Cardiovascular Mortality
Authors: William B. Kannel
Journal: JAMA (1982)

THE RECENT decline in deaths from coronary heart disease (CHD) and accelerated decline in cardiovascular mortality in general since 1968 have elicited great interest and speculation as to their cause.<sup>1</sup>The improvement has been attributed to possible impacts of medical advances, preventive measures, and changes in life-style. One unequivocal conclusion is that these diseases are not an inevitable consequence of aging or genetic makeup and can be prevented. Since the mid-1960s, there has been a substantial decline in mortality from cardiovascular disease. Age-adjusted cardiovascular death rates in the United States fell 25% in the decade ending in 1979, and the decline seems to be continuing through the present. This decline in cardiovascular mortality has also occurred in Canada and in some, but not all, of the industrialized countries of western Europe.<sup>2</sup> While the trend in cardiovascular mortality is encouraging, these diseases continue to rank first among the leading
PHILLIPS MEMORIAL PRIZE ORATION
Authors: LEO LOEB
Journal: Annals of Internal Medicine (1935)

Article1 July 1935PHILLIPS MEMORIAL PRIZE ORATIONTHE THYROID STIMULATING HORMONE OF THE ANTERIOR PITUITARY GLAND*LEO LOEBLEO LOEBSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-9-1-13 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMay I express to you, Mr. President and to the American College of Physicians, my deep appreciation of the honor you have conferred upon me. It is an interesting coincidence that you have invited me to discuss before you the thyroid stimulating hormone of the anterior pituitary gland here in Philadelphia, where about 30 years ago I began my investigations of the problems concerning internal secretions. At that time, I studied the functions of the corpus luteum and I found that one of its hormones sensitized the uterine mucosa so that when, subsequently, mechanical stimuli reached it, the maternal placentae... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: St. Louis, Missouri*Read at the Philadelphia meeting of the American College of Physicians, May 1, 1935.Department of Pathology, Washington University School of Medicine, St. Louis, Mo. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByThe Chemistry and Physiology of the Thyroid HormoneÜber die Wirkung von Vitamin C, thyreotropem Hormon und Thyroxin auf das Leberglykogen und die Schilddrüse sowie ihre gegenseitige BeeinflussungDisorders of internal gland secretion in children 1 July 1935Volume 9, Issue 1Page: 13-18KeywordsHormonesMucous membranesPituitary glandProlactinThyroid-stimulating hormone Issue Published: 1 July 1935 PDF DownloadLoading ...
Effects of reperfusion after coronary artery occlusion on post-infarction scar tissue.
Authors: C M Connelly, W M Vogel, A W Wiegner, E L Osmers, O H Bing, R A Kloner, D M Dunn-Lanchantin, C Franzblau, C S Apstein
Journal: Circulation Research (1985)

Early reperfusion after a coronary occlusion may reduce myocardial infarct size, but late reperfusion into necrotic myocardium may alter post-infarction healing. In rabbits, we compared 1- or 3-week-old scars resulting from permanent coronary occlusion to those resulting from a 1- or 3-hour occlusion followed by reperfusion. Reperfusion at 1 hour post-occlusion did not affect scar mechanical properties assessed at 1 week post-infarction, but at 3 weeks post-infarction, these scars had a tensile strength significantly lower than those not reperfused (78 +/- 11 vs. 158 +/- 15 g/mm2, P less than 0.001). They also were composed of a mixture of fibrous tissue (58 +/- 8%) and myocytes (43 +/- 8%) with a hydroxyproline content of 23 +/- 2.5 mg/g dry weight. The nonreperfused scars had a higher proportion of fibrous tissue (73 +/- 3%) by histological evaluation and a 35% higher hydroxyproline content (31 +/- 2 mg/g dry weight, P less than 0.001) than the scars reperfused after 1 hour. In contrast, 3-week-old scars resulting from "late" reperfusion at 3 hours post-occlusion were similar to nonreperfused scars in fibrous tissue composition and hydroxyproline content. Nonetheless, the tensile strength of these scars reperfused 3 hours post-occlusion was significantly less than that of the nonreperfused scars (72 +/- 5 vs. 158 +/- 15 g/mm2, P less than 0.001). The lower tensile strength was associated with a lower collagen cross-link density in this reperfused group of scars. At physiological stress levels (approximately 3 g/mm2), all groups of reperfused and nonreperfused scars had similar mechanical properties in terms of natural strain, stiffness, creep, and stress relaxation. Thus, although the reperfused scars ruptured more easily at high stresses, when assessed at physiological stresses their mechanical properties were not significantly different from those of nonreperfused scars.
Joint Effects of Environmental Exposures and Familial Susceptibility to Lung Cancer in Chinese Never Smoking Men and Women
Authors: Lap Ah Tse, Ignatius Tak-sun Yu, Nathaniel Rothman, Bu-Tian Ji, Hong Qiu, Xiao-rong Wang, Wei Hu, Joseph Siu-kie Au, Qing Lan
Journal: Journal of Thoracic Oncology (2014)
Is immunogenetic susceptibility to neuropsychiatric systemic lupus erythematosus (SLE) different from non-neuropsychiatric SLE?
Authors: L M Silva, E A Donadi
Journal: Annals of the Rheumatic Diseases (1996)

To analyse frequency of HLA class II antigens (DR and DQ) and lymphocytotoxic autoantibodies in patients with systemic lupus erythematosus (SLE) and subsets with or without neuropsychiatric involvement.Ninety three patients with SLE (42 with neuropsychiatric features) were typed for HLA class II antigens and investigated for the presence of lymphocytotoxic autoantibodies by a complement dependent microlymphocytotoxicity assay. A total of 191 controls of similar ethnic background were also typed for HLA antigens.HLA-DR3 antigen was increased in the total group of patients with SLE (p = 0.003) and in the neuropsychiatric group (p = 0.002). HLA-DR4 antigen frequency was increased in non-neuropsychiatric patients (p = 0.001) and decreased in patients with neuropsychiatric SLE (p = 0.0005). Comparisons of HLA frequencies between subgroups of patients showed decreased HLA-DR4 (p < 0.0001) and increased HLA-DR9 and HLA-DQ2 antigens (p = 0.0008 and 0.005 respectively) in the neuropsychiatric group. The frequency of lymphocytotoxic autoantibodies was increased in neuropsychiatric patients with SLE having HLA-DR9 specificity (p = 0.04).HLA-DR4 may have a protective specificity for the development of neuropsychiatric features of SLE and HLA-DR9, in addition to HLA-DR3, and the presence of lymphocytotoxic auto-antibodies may predispose to neuropsychiatric abnormalities.
Urinary metabolites of histamine and leukotrienes before and after placebo‐controlled challenge with ASA and food additives in chronic urticaria patients
Authors: G. Di Lorenzo, M. L. Pacor, A. M. Vignola, M. Profita, M. Esposito‐Pellitteri, D. Biasi, R. Corrocher, C. Caruso
Journal: Allergy (2002)

Background: The recovery of mediator metabolites from urine has the potential to provide a rapid, safe, and easily available index of release of mediators. We aimed to determine urinary metabolites of both histamine and leukotrienes (LTs) in patients affected by chronic urticaria (CU). Methods: Twenty patients with CU were studied. They were selected on the basis of double‐blind placebo‐controlled challenge (DBPC) with acetyl salicylic acid (ASA) and food additives. Ten patients (group B) were negative to both challenges. Ten patients (group C) presented urticaria and/or the appearance of angioedema during or 24 h after challenge, with reactions to ASA (five patients) or food additives (five patients). We recruited 15 healthy volunteers as controls (group A). During a second challenge, groups B and C were challenged double‐blind with a single dose of ASA, or a specific food additive, or placebo. The healthy group was challenged only with a placebo (talc capsule). Patients in groups B and C were challenged twice: with placebo (as groups B1 and C1) and with ASA (groups B2 and C2) or food additives (C2). Four samples of urine were collected; one during the night before the specific or sham challenge (baseline), and three at 2, 6 and 24 h after the challenge. Urinary methylhistamine (N‐MH) and LTE 4 were analyzed and normalized for urinary creatinine. Results: For urinary N‐MH at baseline, there was a significant difference only between group A and groups B1, B2, C1 and C2 (A vs. B1, P &lt; 0.0001; A vs. B2, P &lt; 0.0001; A vs. C1, P &lt; 0.0001; A vs. C2, P &lt; 0.0001). We detected a significant variation in urinary methylhistamine excretion only in group C2 after 2 h, 6 h and 24 h ( P &lt; 0.0001). However, no variations were observed in N‐MH excretion rate in the other groups (A, B1, C1) after challenge with placebo, and in B2 after challenge with ASA 20 mg. For urinary LTE 4 at baseline no differences were found between the mean values for the different groups. After specific challenge, only C2 patients showed significantly increased excretion rates of urinary LTE 4 compared with the other groups challenged with placebo (A, B1, C1), or ASA (B2) ( P &lt; 0.0001). No significant correlation was seen between urinary LTE 4 and methylhistamine excretion rate in any patients. Conclusion: Our results show that urinary excretion of N‐MH and LTE 4 is different for CU patients without ASA or food hypersensitivity, compared to those with CU with ASA or food additive hypersensitivity after specific challenge.
Regulation of Skeletal Muscle Oxidative Capacity and Insulin Signaling by the Mitochondrial Rhomboid Protease PARL
Authors: Anthony E. Civitarese, Paul S. MacLean, Stacy Carling, Lyndal Kerr-Bayles, Ryan P. McMillan, Anson Pierce, Thomas C. Becker, Cedric Moro, Jean Finlayson, Natalie Lefort, Christopher B. Newgard, Lawrence Mandarino, William Cefalu, Ken Walder, Greg R. Collier, Matthew W. Hulver, Steven R. Smith, Eric Ravussin
Journal: Cell Metabolism (2010)
Isosorbide-5-Mononitrate in Angina Pectoris
Authors: Udho Thadani
Journal: Annals of Internal Medicine (1994)

Letters1 October 1994Isosorbide-5-Mononitrate in Angina PectorisUdho Thadani, MBBSUdho Thadani, MBBSSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-7-199410010-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Poss and colleagues question the clinical significance of an increase in exercise duration and prevention of tolerance during twice-daily treatment with IS-5-MN because angina frequency was not decreased [1]. Angina frequency is a poor measure of drug efficacy [1]. Patients with stable angina pectoris restrict their activity to avoid unpleasant anginal attacks [2]. Patients often state that they have few episodes of angina during daily activities, and yet they experience angina during treadmill exercise at a relatively low work load [3], just as we observed. Seasonal changes in patients' outdoor activity can affect angina frequency.Only patients who ...References1. Thadani U, Maranda CR, Amsterdam E, Spaccavento L, Friedman RG, Chernoff R, et al. Lack of pharmacologic tolerance and rebound angina pectoris during twice-daily therapy with isosorbide-5-mononitrate. Ann Intern Med. 1994; 120:353-9. Google Scholar2. Bassan MM. The day-long pattern of the antiangial effect of long-term three times daily administered isosorbide dinitrate. J Am Coll Cardiol. 1990; 16:936-40. Google Scholar3. Bittar N, Corder CN, Eich R, McGrew FA, Paulk EA, Zellner S. Efficacy of nifedipine gastrointestinal therapeutic system in combination with β blockers in the management of exertional angina. A multicenter study of 54 patients. Am J Med. 1987; 83(Suppl 6B):30-3. Google Scholar4. Thadani U, Glasser S, Bittar N, Beach CL, for the Diltiazem CD Study Group. Dose response evaluation of once-daily therapy with diltiazem CD in angina pectoris (Abstract). Cardiovasc Drugs Ther. 1993; 7(Suppl 2):445. Google Scholar5. Thadani U, Prasad R, Hamilton SF, Voyles WF, Doyle R, Karpow SA. Isosorbide-5-mononitrate in angina pectoris: plasma concentration and duration of effects after acute therapy. Clin Pharmacol Ther. 1987; 42:58-65. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1994Volume 121, Issue 7Page: 547KeywordsAnginaCalcium channel blockerDrugsExerciseWalking Issue Published: 1 October 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
AN UNUSUAL ANOMALY OF THE FAUCIAL TONSIL.
Authors: GEORGE L. RICHARDS
Journal: JAMA (1901)

The patient was a woman, 60 years old, who reported that her throat had been paining her for the past two years, and that for a long time, almost as long as she could remember, she had had more or less discomfort in the region of each tonsil. The right was found to be somewhat hypertrophied, and she had pain running to the ear from this region. She did not at first want the tonsil removed, and was treated for some weeks with chromic acid applications. This was followed by some improvement in the sensation. Later she consented to the removal of the right tonsil; the left one was not large. On applying a tonsillotome I was surprised to find that I was unable to cut through the tonsil, and on examining with the finger found that a bony mass penetrated the tonsil almost to its outer border. This was