tbuckley/cabot-search huggingface dataset:
Long-Term Follow-up Study of Survival and Recurrence Rates following Myocardial Infarction in Exercising and Control Subjects
Authors: PETER A. RECHNITZER, H. A. PICKARD, ALLAN U. PAIVIO, MICHAEL S. YUHASZ, DAVID CUNNINGHAM
Journal: Circulation (1972)

Male subjects (N = 68), under age 51 years, with previous myocardial infarction, who participated in a program of graduated exercises over a 7-year period (1964-71), have been compared with a control group (N = 131) for incidence of nonfatal recurrence and cardiac death. The controls fulfilled the criteria to enter the exercise program, but did not. Of the 68 exercising subjects, 66 were traced in January 1971. Two (3.0%) had had a nonfatal recurrence. Of the 131 control subjects, only 117 gave valid information concerning possible recurrence. Thirteen (11.1%) had suffered a nonfatal recurrence ( P &lt; 0.10). The incidence of cardiac death (7.6%) was significantly lower ( P &lt; 0.05) in the exercising subjects than in the 127 control subjects (four of the 131 could not be traced). In 1969 a separate comparison of recurrence and survival over a 5-year period was made between 77 exercising subjects who had remained in the program for a minimum of 3 months and 127 control subjects in Toronto. One (1.3%) of the exercising subjects had had a nonfatal recurrence, and 31 (27.9%) of 111 Toronto control subjects (16 others were alive but information on recurrence was lacking) gave a history of nonfatal recurrence ( P &lt; 0.001). There were three (3.9%) deaths in the exercise group and 15 (11.8%) deaths in the Toronto control group ( P &lt; 0.10). Variables affecting prognosis, but not included in the study, were blood pressure, prior angina, and current angina. Although results of this investigation suggest that an exercise program in a selected group may favorably affect prognosis following recovery from myocardial infarction, they should be interpreted cautiously. One or more variables not related to the exercise program per se may have been operative in producing the apparent benefit.
Carcinoma is a Parasitic Disease: Being the Bradshaw Lecture delivered before the Royal College of Surgeons of England
Authors: H. T. Butlin
Journal: BMJ (1905)

IT is probable that cancer has been during many centuries regarded as a parasitic disease.To the ancients it presented.*In this connexion it Is very interesting to study the third plate of Thiersch's atlas.which is intended to show the origin of cancer of the skin from the processes of the epidermis.Two of the figures show precisely the same relation of the gro wth to the surface epithelium as' that which is exhibited in Ribbert and Borrmann's drawiDgs.and might be used for their purpose.But it either had esaaped the observation of Thiersch or had been differently in'erpreted by him.
Threats to Validity in the Design and Conduct of Preclinical Efficacy Studies: A Systematic Review of Guidelines for In Vivo Animal Experiments
Authors: Valerie C. Henderson, Jonathan Kimmelman, Dean Fergusson, Jeremy M. Grimshaw, Dan G. Hackam
Journal: PLoS Medicine (2013)

The vast majority of medical interventions introduced into clinical development prove unsafe or ineffective. One prominent explanation for the dismal success rate is flawed preclinical research. We conducted a systematic review of preclinical research guidelines and organized recommendations according to the type of validity threat (internal, construct, or external) or programmatic research activity they primarily address.We searched MEDLINE, Google Scholar, Google, and the EQUATOR Network website for all preclinical guideline documents published up to April 9, 2013 that addressed the design and conduct of in vivo animal experiments aimed at supporting clinical translation. To be eligible, documents had to provide guidance on the design or execution of preclinical animal experiments and represent the aggregated consensus of four or more investigators. Data from included guidelines were independently extracted by two individuals for discrete recommendations on the design and implementation of preclinical efficacy studies. These recommendations were then organized according to the type of validity threat they addressed. A total of 2,029 citations were identified through our search strategy. From these, we identified 26 guidelines that met our eligibility criteria--most of which were directed at neurological or cerebrovascular drug development. Together, these guidelines offered 55 different recommendations. Some of the most common recommendations included performance of a power calculation to determine sample size, randomized treatment allocation, and characterization of disease phenotype in the animal model prior to experimentation.By identifying the most recurrent recommendations among preclinical guidelines, we provide a starting point for developing preclinical guidelines in other disease domains. We also provide a basis for the study and evaluation of preclinical research practice. Please see later in the article for the Editors' Summary.
Reconsidering Ultrafiltration in the Acute Cardiorenal Syndrome
Authors: W.H. Wilson Tang
Journal: New England Journal of Medicine (2012)

Aggressive diuretic therapy in a patient who is hospitalized for acute decompensated heart failure often leads to progressive renal dysfunction despite persistent congestion. The underlying mechanisms of this so-called acute cardiorenal syndrome are complex and not fully understood.1,2 As initial therapy in this setting, ultrafiltration as compared with diuretic therapy may result in a higher rate of sodium and volume removal, with greater weight loss and less frequent rehospitalizations.3,4 These findings have suggested that ultrafiltration can provide more effective relief of congestion than pharmacologic therapy can, particularly in the setting of cardiorenal compromise. Ultrafiltration may also reduce diuretic-induced . . .
Complement in Pericardial Fluid of Lupus Erythematosus
Authors: GENE G. HUNDER
Journal: Annals of Internal Medicine (1974)

Concentrations of whole hemolytic complement, three components (C1q, C4, C3), and C1INH were lower in the pericardial fluids of two patients with systemic lupus erythematosus with pericarditis than in the pericardial fluids of two control patients with valvular heart disease. Complement-fixing material was present in the systemic lupus erythematosus fluids, and evidence was found in these fluids but not the control fluids for in-vivo activation of both the classical and alternate complement pathways. These results suggest that immune mechanisms may contribute to the development of pericarditis in systemic lupus erythematosus.
The Rape of the Phallus —A Sequel
Authors: Louis J. Swichkow
Journal: JAMA (1965)

<h3>To the Editor:—</h3> While it is true that this rite had been practiced among other peoples before Israel in the ancient world, for the Jews the practice of circumcision has nothing whatsoever to do with the assumptions cited by Dr. Morgan. The reason for the Jewish rite of circumcision is based solely on the divine commandment to Abraham some 3,600 years ago: "This is My covenant, which you shall keep, between Me and you, and your children after you: every male shall be circumcised..." (Genesis 17: 9-14). Thus for Abraham and his descendants this rite was to be the external sign of the covenant, the eternal symbol of the consecration of the children of Abraham to the God of Abraham. The Maccabean martyrs died for its observance, and in the times of the Hadrianic persecutions Jews sacrificed even their lives in defense of this sacred rite. W. K. C. M.
Observations on an unusual enzyme distribution pattern in the colon of a case of familial polyposis with malignant changes
Authors: V. Maggi, A. P. Wyatt
Journal: Gut (1970)

Acid and alkaline phosphatases, esterases, and β-glucuronidase were studied histochemically in the colon of a patient with familial polyposis in whom malignant changes had occurred. The acid hydrolases were found to be localized mainly in the supranuclear region of the cells of the epithelium of the normal mucosa. In the polyp epithelium these enzymes were found mainly in the basal areas of the epithelium at the junction between the latter and the lamina propria. In the cancer cells enzyme activity was decreased and distributed randomly. Alkaline phosphatase was present only in the capillaries in the normal and the polypmucosa. In the cancer tissue this enzyme was found in the capillaries, the smooth muscle cells, and the invading cells of epithelial origin.
Detection of Ischemic Heart Disease
Authors: HERBERT S. KING
Journal: Annals of Internal Medicine (1975)

Comments and Corrections1 March 1975Detection of Ischemic Heart DiseaseHERBERT S. KING, M.D.HERBERT S. KING, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-82-3-429_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The editorial by O'Rourke and Ross (1) entitled "Ambulatory Electrocardiographic Monitoring to Detect Ischemic Heart Disease" raises important questions to which insufficient attention is given.That coronary bypass operations, among other but unspecified "new forms of therapy," should play a role in increased interest in the improved diagnosis of early and even asymptomatic ischemic heart disease (I paraphrase the authors) is, at the very least, anomalous. Such surgery is not new nor, it is my guess, is it ever likely to be, indicated in early or asymptomatic cases.The article by Wolf, Tzivoni, and Stern (2) referred...References1. O'ROURKEROSS RJ: Ambulatory electrocardiographic monitoring to detect ischemic heart disease. Ann Intern Med 81:695-1974 LinkGoogle Scholar2. WOLFTZIVONISTERN EDS: Comparison of exercise tests and 24-hour electrocardiographic monitoring in detection of ST-T changes. Br Heart J 36:90-95, 1974 CrossrefMedlineGoogle Scholar3. DEMANYTAMBEZIMMERMAN MAH: Correlation between coronary arteriography and the postexercise electrocardiogram. Am J Cardiol 19:526-530, 1967 CrossrefMedlineGoogle Scholar1. STERNTZIVONI SD: Early detection of silent ischaemic heart disease by 24-hour electrocardiographic monitoring of active subjects. Br Heart J 36:481-486, 1974 CrossrefMedlineGoogle Scholar2. TZIVONISTERNSTERN DZS: Correlation between ambulatory ECG monitoring and coronary arteriogram (abstract). Circulation 50 (suppl 3):599, 1974 Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Staten Island Medical Group 307 Victory Boulevard Staten Island, New York 10301 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 March 1975Volume 82, Issue 3Page: 429-429KeywordsCardiovascular therapyCoronary heart diseaseElectrocardiographySurgery Issue Published: 1 March 1975 PDF downloadLoading ...
Bone mineral density, serum insulin-like growth factor I, and bone turnover markers in viral cirrhosis
Authors: Francisco J. Gallego-Rojo, Jorge L. Gonzalez-Calvin, Manuel Muñoz-Torres, Jose L. Mundi, Ramon Fernandez-Perez, Dolores Rodrigo-Moreno
Journal: Hepatology (1998)

Previous studies suggest that low bone mass is a complication of alcoholic liver disease. Nevertheless, little is known about bone mass and bone metabolism in viral cirrhosis. To evaluate the prevalence and magnitude of hepatic osteopenia in these patients, bone remodeling status, and its relationship with the severity of liver disease and serum levels of insulin-like growth factor I (IGF-I), we studied 32 consecutive patients with viral cirrhosis and no history of alcohol intake. Bone mineral density (BMD) was measured by dual x-ray absorptiometry in the lumbar spine (LS) and femoral neck (FN), and the values were expressed as the z score. Bone metabolism markers and hormone profiles were measured. Patients with viral cirrhosis showed reduced BMD in all sites (LS: −1.27 ± 1.06, P &lt; .001; FN: −0.48 ± 0.96; P &lt; .01). Of the 32 patients, 53% met the diagnostic criteria for osteoporosis. In patients, urine deoxypyridinoline (D-Pyr) as a marker of bone resorption and serum bone alkaline phosphatase (b-AP) as a marker of bone formation were significantly higher than in control subjects ( P &lt; .001 and P &lt; .01, respectively). Serum IGF-I was lower than in control subjects ( P &lt; .001), and significant differences were also found between patients with and without osteoporosis ( P &lt; .05). BMD in LS correlated with severity of the disease, with serum levels of IGF-I, and with urine D-Pyr. Our findings show that viral cirrhosis is a major cause of osteoporosis in men, and that low serum IGF-I levels seem to play a role in the bone mass loss in these patients. The biochemical markers of bone remodeling suggest high-turnover osteoporosis in patients with viral cirrhosis.
F-18 FDG PET Scan After Radiotherapy for Early-Stage Larynx Cancer
Authors: HAN J. KIM, JAMES BOYD, FRANK DUNPHY, VAL LOWE
Journal: Clinical Nuclear Medicine (1998)

Fluorine-18-fluorodeoxyglucose (F-18 FDG) PET was used to evaluate early-stage larynx cancer before and after radiotherapy. Less radical salvage surgery might be possible after timely diagnosis of recurrent or persistent tumor after radiotherapy. Eight patients with early-stage laryngeal cancer (two carcinoma in situ; six stage T1: tumor limited to vocal cords with normal mobility) underwent irradiation for potential cure. Five patients had pre- and postradiotherapy F-18 FDG PET, and three had postradiotherapy F-18 FDG PET only. All patients underwent a CT scan of the neck at the time of the F-18 FDG PET scan. One patient had a positive result of postradiotherapy F-18 FDG PET but a negative result of a CT of the neck, and biopsy revealed recurrent squamous carcinoma. Seven patients who had negative results of postradiotherapy F-18 FDG PET were free of disease at the 15-month median follow-up evaluation. (Three of them had no cancer on biopsy of the larynx, and four others were followed with periodic endoscopic examinations that revealed complete disappearance of the tumor.) F-18 FDG PET scan may be useful for earlier diagnosis of recurrent or persistent laryngeal cancer after radiotherapy and is preferable to repeated biopsies, which would traumatize radiation-damaged tissues. A prompt early diagnosis of failure of radiotherapy will lead to less radical salvage surgery.
Prospectus: The Prevention of Bacteremic Pneumococcal Pneumonia
Authors: Allen B. Kaiser
Journal: JAMA (1974)

Blood, cerebrospinal fluid, and respiratory isolates from 632 adults with pneumococcal pneumonia hospitalized from 1968 through 1972 were typed. The results were correlated with the 14 types currently being tested in pneumococcal vaccines. More than 80% of the bacteremic pneumonia isolates and two thirds of respiratory isolates were "vaccine types." Sixty percent of 43 patients with bacteremic pneumonia and 55% of patients who died from their infections would theoretically have benefited from an immunization program designed to include all persons 50 years of age and older and all younger patients with recognized underlying disease. Unexplained swings in the annual rate of pneumococcal infections, siteto-site variation in the recovery of pneumococcal types, geographic and temporal differences in the distribution of types, and the selection pressure associated with the use of a limited number of vaccine types will complicate vaccine use. (<i>JAMA</i>230:404-408, 1974)
Immediate and long-term outcome of percutaneous mitral valvotomy in patients 65 years and older.
Authors: E M Tuzcu, P C Block, B P Griffin, J B Newell, I F Palacios
Journal: Circulation (1992)

We analyzed the immediate and long-term outcome of percutaneous balloon mitral valvotomy (PMV) in 99 patients who were greater than or equal to 65 years of age (81 women and 18 men; mean +/- SEM age, 72 +/- 0.5 years).There were 84 patients in New York Heart Association (NYHA) class III or IV; 26 patients had previous surgical commissurotomy; 64 had one or more comorbidities; 73 had fluoroscopically visible mitral valve (MV) calcification; and 63 had echocardiographic score greater than 8 (mean +/- SEM score, 9.2 +/- 0.2). There were three procedural deaths, all occurring in our early experience. Pericardial tamponade occurred in five patients, thromboembolism in three, and transient atrioventricular block in one. After PMV, MV area was greater than or equal to 1 cm2 in 86 patients and greater than or equal to 1.5 cm2 in 56. A successful outcome (defined as MV area greater than or equal to 1.5 cm2 without a greater than or equal to 2-grade increase in mitral regurgitation and without left-to-right shunt with a pulmonary-to-systemic flow ratio of greater than or equal to 1.5:1) was achieved in 46 patients. The best multivariate predictor of success was the combination of echocardiographic score, NYHA functional class, and inverse of MV area. Mean follow-up was 16 +/- 1 months. Actuarial survival (79 +/- 7% versus 62 +/- 10%, p = 0.04), survival without MV replacement (71 +/- 8% versus 41 +/- 8%, p = 0.002), and survival without MV replacement and NYHA class III or IV (54 +/- 12% versus 38 +/- 8%, p = 0.01) at 3 years were significantly better in the successful group of 46 patients than in the unsuccessful group of 53 patients. Low echocardiographic score was the only independent predictor of survival. Lack of MV calcification and low NYHA class, low mean left atrial pressure, and low pulmonary artery pressure were the independent predictors of event-free survival.PMV can be performed safely in selected patients greater than or equal to 65 years old with good immediate and long-term results. In addition to clinical examination, echocardiographic evaluation of the mitral valve and fluoroscopic screening for valvular calcification are the most important steps in patient selection for successful outcome.
The Electrocardiogram in Acute Myocardial Infarction
Authors: John E Madias
Journal: New England Journal of Medicine (2003)

to the editor: The review article by Zimetbaum and Josephson (March 6 issue) 1 on the usefulness of the electrocardiogram in the diagnosis of acute myocardial infarction is essential reading for anyone who cares for patients with a suspected acute myocardial infarction. Some qualifications regarding the diagnosis of acute myocardial infarction in patients with left bundle-branch block are in order. Although proposed criteria 2 facilitate the diagnosis, an occasional problem arises when reliance on the criterion of an ST-segment elevation of more than 5.0 mm in leads with primarily negative QRS complexes leads to a false positive diagnosis of acute myocardial infarction. This criterion is nonspecific for acute myocardial infarction, and some patients who have left bundle-branch block without an acute myocardial infarction, but with left ventricular hypertrophy or dilatation, have electrocardiograms with ST-segment elevations that are much larger than 5.0 mm. 3,4 An association between large ST-segment elevations and large QRS complexes has been reported. 3 Repeating electrocardiography may also be of value, since a change in the amplitude of the ST-segment elevation suggests an acute myocardial infarction. 5 Finally, since measurements of ST-segment elevations are being used for the diagnosis of acute myocardial infarction in patients with left bundle-branch block, it is prudent to mark the thorax in order to ensure reproducible serial electrocardiograms. 5
Now I'm a believer
Authors: T. Dalrymple
Journal: BMJ (2009)

When I was a student I attended a public faith healing meeting. I went as a joke, but what I saw angered me. The American evangelist—to my eyes obviously a crook—told the hopeless cases assembled there that if they believed deeply and sincerely enough they would be cured. They weren’t, and therefore it was their own fault. I found it cruel, repellent, and grossly exploitative.

I grew less ill disposed to faith healing when I attended the annual ceremony of the Black Christ of Esquipulas in Guatemala many years later. There the halt, lame, and paralytic were promised nothing, and there was no implication that if they failed …
THE USE OF THE GALL-BLADDER TO RESTORE A PROLAPSED LIVER.
Authors: A. F. JONAS
Journal: JAMA (1902)

Conditions concerning a descent or displacement of the abdominal organs have all too often escaped notice and are not sufficiently considered in the management and treatment of the disturbed secretory and digestive functions. That every organ should occupy its normal location to perform its proper function is self-evident; and that any deviation from the normal position is at the expense of its real office, is easily understood. Our attention to-day will be directed to one organ, the liver. That this organ is sometimes displaced downward to a considerable degree will be shown by the two following cases. That there is usually modified function and a well-defined clinical picture belonging to this change of position will also be shown. <h3>Case 1.</h3> —Mrs. S., aged 41, housewife, entered St. Joseph's Hospital, June, 1896. She had for three years suffered from paroxysms of severe pain located in the right hepatic region. These pains,
Midwifery in the New Curriculum
Authors: J. Young
Journal: BMJ (1935)

<h3>Background</h3> RGC (Response Gene to Complement)-32 is a cell cycle regulator widely expressed in normal tissues including brain, kidney, spleen, thymus, multiple tumors and in a variety of cell lines. RGC-32 is localized in the cytoplasm and translocates to the nucleus upon upregulation by complement activation, growth factors and cytokines. RGC-32 is induced by TGFβ in fibroblasts, astrocytes and human renal proximal tubular cells and mediates TGFβ dependent profibrotic pathways. RGC-32 is preferentially upregulated in murine Th17 cells and promotes their differentiation. Patients with Systemic Lupus Erythematosus (SLE) display increased serum levels, expanded frequency of IL-17 producing cells. Whether RGC-32 plays a role in human Th17 differentiation pathway and in Th17 abnormalities in lupus patients has not yet been investigated. <h3>Methods</h3> RGC-32 expression in naïve CD4<sup>+</sup> T cells from normal controls stimulated with cytokines alone or under Th0, Th1, Th2, Th17 and Treg conditions was determined by flow cytometry and RT-PCR. RGC-32 mRNA expression in PBMCs of lupus patients was assessed with the Autoimmune Disease Profiling cDNA Array spotted with cDNA from CD3<sup>+</sup>, CD19<sup>+</sup> and CD14<sup>+</sup> cells and by RT-PCR and flow cytometry. RGC-32 nuclear translocation after stimulation under Th17 conditions was assessed by Western blotting. RGC-32 overexpression and silencing was performed by nucleofection and the effect on IL-17A mRNA levels in CD4<sup>+</sup> T cells under Th17 conditions was determined by RT-PCR. <h3>Results</h3> RGC-32 mRNA expression was upregulated by TCR stimulation and TGFβ and was more robust under Th17 (3.2±fold) and Treg (2.6±0.8 fold) vs Th1 (1.3±0.4 fold) and Th2 (1.8±0.1 fold) conditions. Moreover, upon stimulation with anti-CD3/CD28 and TGFβ, RGC-32 was translocated into the nucleus. Other cytokines such as IFNα, IL-1β, TNFα did not upregulate RGC-32 mRNA either alone or in combination with TCR stimulation. Overexpression or silencing of RGC-32 in CD4<sup>+</sup> T cells upregulated, respectively downregulated IL-17A transcript levels and protein secretion. RGC-32 mRNA and protein level were significantly increased in CD19<sup>+</sup> B cells and CD3<sup>+</sup> T from lupus patients compared to controls. <h3>Conclusions</h3> These results suggest that RGC-32 promotes the differentiation of human Th17 cells. Furthermore, T cells from patients with SLE exhibit increased expression of RGC-32 compared to controls. These data support the idea that RGC-32 signaling may enhance disease expression in SLE by promoting abnormalities in the Th17 pathway and provide a compelling rationale for further investigating the therapeutic potential of blocking RGC-32 in SLE.