tbuckley/cabot-search huggingface dataset:
Fatal Malfunction of Edwards Low-Profile Mitral Valves
Authors: HOWARD T. HORSLEY, WILLIAM J. RAPPOPORT, PHILIP S. VIGODA, JOHN H. K. VOGEL
Journal: Circulation (1970)

Three of nine patients in whom the Edwards low-profile valve was placed in the mitral position have shown serious valve malfunction. Two of these expired despite emergency valve replacement. The third valve was replaced semielectively, with a good outcome. The valve malfunction has resulted from pannus formation on the uncovered metal struts, with severe limitation of motion and cocking of the valve disc. It is felt that careful serial evaluation of signs, symptoms, and valve cinefluorography is mandatory in patients with this valve. Should one or more of these parameters indicate valve malfunction, especially if serial observations indicate progressive worsening, valve replacement with another type of prosthesis should be very seriously considered. Serial cinefluorographic observation of the disc motion is indicated even in a setting of clinical well being.
Think Tank Helping to Get HIV Immune-Restoration Trials Off the Ground
Authors: Paul Cotton
Journal: JAMA (1993)

DURING THE NEXT 6 months, a change in emphasis in research on HIV disease should begin to take hold. Work that focuses more on repairing the damaged immune system than on directly killing the human immunodeficiency virus (HIV) shifts into high gear. The necessity of both treatment approaches has been evident since the early days of the AIDS epidemic. But research on immune restoration languished after the approval of the antiretroviral drug zidovudine (Retrovir, commonly called AZT, Burroughs Wellcome, Research Triangle Park, NC). What trials were done had disappointing or equivocal results. The pace is picking up now, in large part due to a unique think tank called Project Immune Restoration. It is made up of a broad array of researchers, government officials, and activists who, for the past 18 months, have focused intensively on finding out what can be done in the clinic now and what needs to be
Caring for Organs or for Patients? Ethical Concerns about the Uniform Anatomical Gift Act (2006)
Authors: Michael A. DeVita, Arthur L. Caplan
Journal: Annals of Internal Medicine (2007)

In 2006, the National Conference of Commissioners on Uniform State Laws rewrote the Uniform Anatomical Gift Act. To overcome the problem of family members prohibiting organ donation from their deceased loved ones even when a donor card existed, the commissioners modified the act to prevent end-of-life care from precluding organ donation. An unintended consequence of the new wording creates the potential for end-of-life care that prioritizes care of the potential donor organs over care and comfort of the dying person. The commissioners have now revised the act, but the original version has already been legislated in many states, with others poised to follow. To protect dying patients' wishes about their end-of-life care, states that have legislated or are considering the original act must replace it with the revised version. A long-term and important ethical precept must stand: Care of dying patients takes precedence over organs. Another laudable goal must be promoted as well: Organ donation is an important part of end-of-life care.
The Doctor's Image of Man
Authors: John C. Whitehorn
Journal: New England Journal of Medicine (1961)

THE topic chosen for discussion in this lecture — the human being — is the center of concern for all physicians. The relief of human suffering is their primary objective, in all branches of medicine. A person — the patient — is the primary focus of medical effort; yet the practice of medicine becomes increasingly impersonal. Symptoms are thought of as personal experience, and disease as an impersonal process. Although moved by compassion, the doctor subordinates his sympathetic responses and tries to direct his efforts against detectable disease processes and in support of recovery processes, in the expectation that success . . .
Entéroscanner avec opacification hydrique: outil diagnostic en cas de suspicion de tumeurs de l'intestin grêle?
Authors: L Milot, MG Lapalus, JA Chayvialle, PJ Valette, F Pilleul
Journal: Endoscopy (2007)

L'objectif de cette étude a été d'évaluer la performance de l'entéroscanner à l'eau dans la détection des lésions tumorales du grêle chez des patients symptomatiques.
C(−260)→T Polymorphism in the Promoter of the CD14 Monocyte Receptor Gene as a Risk Factor for Myocardial Infarction
Authors: Jaroslav A. Hubacek, Jan Pit’ha, Zdena Škodová, Vladimír Stanĕk, Rudolf Poledne
Journal: Circulation (1999)

Background —The CD14 receptor of monocytes is an important mediator for the activation of monocytes/macrophages by endotoxins from the envelope of Gram-negative bacteria (lipopolysaccharides). We identified a polymorphism in the CD14 receptor and examined whether this genetic marker influenced the expression of the CD14 receptor on monocytes and affected the predisposition to myocardial infarction. Methods and Results —We identified a C(−260)→T nucleotide change, creating a Hae III polymorphism in the promoter of the CD14 gene. The polymorphism was determined in 178 male patients &lt;65 years old (cases; average age, 55.9±6.3 years) at the time of their first myocardial infarction and in 135 representative selected male control subjects (controls; average age, 55.2±11.5 years). The frequency of the T allele (absence of the cutting site) was 0.49 in cases and 0.35 in controls ( P =0.0005; OR, 1.781; 95% CI, 1.286 to 2.465). Subsequently, we measured the expression of monocyte CD14 by flow cytometry in 18 volunteers with different CD14 genotypes. A significantly higher density of the CD14 receptor was shown in the T/T homozygotes than in the others ( P =0.0028). Conclusions —A higher frequency of allele T(−260) in the promoter of the CD14 receptor gene was found in myocardial infarction survivors than in controls. At the same time, this variation was associated with a higher density of CD14 receptors in healthy volunteers. Therefore, we can conclude that in addition to the well-established risk factors, a genetically determined reaction of monocytes/macrophages to infectious stimuli could play an important role in the process of atherosclerosis.
Current approaches to drug therapy for the hypercholesterolemic patient.
Authors: J L Witztum
Journal: Circulation (1989)

CAD is a complex disease with multiple etiologies and aggravating events. Yet, elevated plasma cholesterol levels, chiefly in the form of LDL, are essential for the progression of the atherosclerotic lesion. Any total plasma cholesterol level above an ideal of 180 mg/dl (and an LDL cholesterol level of 100 mg/dl) must be considered atherogenic in the presence of other risk factors. In patients at high risk for death from CAD, combined diet and drug therapy should have as a goal the attainment of ideal lipoprotein values. Drug therapies are now available that make it possible to substantially lower elevated LDL levels in almost all patients and even to achieve ideal levels in those at highest risk.
Extra-Nuclear Estrogen Receptors: Functions in Breast Cancer.
Authors: E. Levin, E. Levin
Journal: Cancer Research (2009)

Abstract Pools of classical estrogen receptors alpha and beta exist in various cellular locations including the nucleus, plasma membrane, and in cytoplasmic organelles (e.g.-mitochondria). The roles and importance of the extra-nuclear receptors are under investigation but in some women with breast cancer, membrane ERalpha greatly exceeds the nuclear ER pool. To understand how these receptors traffic to the plasma membrane and function, we took a proteomic approach that identified Heat Shock Protein 27 (Hsp27) as an important promoter of membrane ER localization. Hsp27 physically interacts with the ERalpha monomer, promoting palmitoylation of the sex steroid receptor, leading to enhanced association with caveolin-1 in cytoplasm and subsequent trafficking to the membrane. Using RNAi for Hsp27, this protein was shown to be necessary for ERalpha to localize to the membrane and signal through ERK and PI3 kinase, accounting for about 50% of total cell proliferation induced by estradiol. Membrane ERalpha and not nuclear ERalpha also blocks DNA repair signaling through ATR and ATM kinases in both normal breast epithelial cells and breast cancer cells (Mol Biol Cell 20:3374,2009).This occurs in the setting of radiation or chemotherapy-induced cell damage, in-vitro. Inhibiting kinase signaling leads to loss of cell cycle checkpoints, delay of DNA repair, inhibition of p53 function, and enhanced chromosomal damage upon exposing cells to gamma radiation. As for ERbeta, we find that this receptor exists mainly in extra-nuclear, mitochondrial locations in breast cancer cell lines. There is evidence that the cytoplasmic ERbeta 2 isoform correlates to a poor prognosis in women with breast cancer (Clin Canc Res, 2008). We found that mitochondrial ERbeta regulates reactive oxygen species formation. This function importantly participates in the response to tamoxifen, sensitivity (apoptosis) versus resistance (survival and growth), in several breast cancer cell lines. Mechanisms involved will be explored at the meeting. In summary, new and potentially important functions of extra-nuclear ERalpha and ERbeta could contribute to breast pathobiology. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr BS2-1.
FACTS REGARDING CRIMINAL ABORTION.
Authors: DENSLOW LEWIS
Journal: JAMA (1900)

I know a man of marked erudition who wrote a book on the primitive religions. His opening paragraph is as follows: "The facts in this book are true." There is more common sense than rhetoric in this remark. We are all liable to be mistaken in our estimate of conditions. Too many statements are accepted as true simply because frequent unchallenged repetition has made us believe there is no possibility of contradiction. Continued reiteration dulls the sense of perception and discourages investigation. Moreover, social conditions change, laws become obsolete, public opinion varies and our appreciation of justice is often irrational and selfish. For this reason it is important to know the truth. In a consideration of criminal abortion no prophylaxis is consistent without a knowledge of etiology, and discussion is without profit unless the naked facts are presented. When married women become pregnant, I estimate that 80 per cent, of
TRANSFERS OF CELL SODIUM AND POTASSIUM IN EXPERIMENTAL AND CLINICAL CONDITIONS 1
Authors: J. R. Elkinton, A. W. Winkler, T. S. Danowski
Journal: Journal of Clinical Investigation (1948)

In recent years much interest has been mani- fested in transfers of cellular electrolytes in vari- ous disease states.Loss of the main cation, po- tassium, in "excess" of nitrogen has been found in fasting (1), diarrhea (2), diabetic coma (3, 4), and dehydration (5).It has further been shown that at least partial replacement of deficits of cell potassium by increments of extracellular sodium occurs in animals on low potassium-high sodium
The American Society of Nephrology
Authors: GEORGE E. SCHREINER
Journal: Annals of Internal Medicine (1967)

Editorial Notes1 December 1967The American Society of NephrologyGEORGE E. SCHREINER, M.D., F.A.C.P.GEORGE E. SCHREINER, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-67-6-1343 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe first meeting of the newly founded American Society of Nephrology was held October 18 and 19, 1967, at Los Angeles, Calif. Seldom has a scientific society had a more auspicious beginning. Having enrolled over a thousand members in 10 months, the American Society of Nephrology attracted 287 abstracts and about 1,100 scientists for this inaugural meeting.Dr. Neal S. Bricker traced the history of the formation of the new Society in his Presidential Address and then addressed himself to the importantquestion of federal expenditures for chronic dialysis and transplantation. He acknowledged that the time for expansion of these facilities... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: GEORGE E. SCHREINER, M.D., F.A.C.P.Affiliations: Renal and Electrolyte Division Georgetown University Washington, D. C. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 December 1967Volume 67, Issue 6Page: 1343-1344KeywordsMedical dialysisNephrologyScientistsTransplantation ePublished: 1 December 2008 Issue Published: 1 December 1967 PDF downloadLoading ...
GP contract delivers on just two of 13 government aims
Authors: Zosia Kmietowicz
Journal: BMJ (2008)

The new contract for GPs in England has delivered good progress on only two of the 13 benefits that the Department of Health anticipated when it negotiated the deal, says a study from the public spending watchdog.

The contract, which was designed to modernise general practice and increase the number of GPs as well as improve morale among the profession, saw primary care trusts take on the role of commissioning primary care services from general practices.

But the contract, which was fully implemented in England in April 2004, has cost £1.76bn (€2.34bn; $3.46bn) more in its first three years than the Department of Health anticipated and has failed to increase productivity in the NHS, …
Towards characterization of palmoplantar keratoderma caused by gain-of-function mutation in loricrin: analysis of a family and review of the literature
Authors: M.M. Gedicke, H. Traupe, B. Fischer, S. Tinschert, H.C. Hennies
Journal: British Journal of Dermatology (2005)

Loricrin keratoderma is an autosomal dominant palmoplantar keratoderma heterogeneous in clinical appearance. We report a family with diffuse ichthyosis and honeycomb palmoplantar keratoderma but no occurrence of pseudoainhums or autoamputations. All patients were born as collodion babies and displayed prominent knuckle pads. We identified the previously reported mutation 730insG in LOR, which elongates loricrin by 22 amino acids because of delayed termination. As pseudoainhums are missing in all patients of the family reported, we propose two compulsory features of loricrin keratoderma: (i) honeycomb palmoplantar keratoderma and (ii) diffuse ichthyosiform dermatosis. Therefore we suggest that the condition should be described clinically as 'honeycomb palmoplantar keratoderma with ichthyosis'. Furthermore, we have assessed the amounts of transcript of LOR using pyrosequencing. This revealed an equal expression of mutant and wild‐type alleles of LOR in an affected individual. These findings further underline the gain‐of‐function theory for mutant LOR in loricrin keratoderma.
EUS-guided drainage of ruptured liver abscess
Authors: T. Ang, S. Seewald, E. Teo, K. Fock, N. Soehendra
Journal: Endoscopy (2009)

Liver abscesses are usually drained percutaneously. If drainage is inadequate, surgery may be necessary [1]. Endoscopic ultrasound (EUS)-guided drainage of pancreatic, pelvic, subphrenic, and splenic abscesses has been reported [2]. There has been one reported case of EUS-guided drainage of a well-encapsulated liver abscess [3]. A ruptured liver abscess is usually an indication for surgery [1]. We report a case of ruptured liver abscess with a walled-off left subhepatic collection that was successfully treated by EUS-guided drainage using a double-wire technique [4] that facilitated the placement of multiple stents.
Glucose Control and Medication Adherence Among Veterans With Diabetes and Serious Mental Illness: Does Collocation of Primary Care and Mental Health Care Matter?
Authors: Judith A. Long, Andrew Wang, Elina L. Medvedeva, Susan V. Eisen, Adam J. Gordon, Julie Kreyenbuhl, Steven C. Marcus
Journal: Diabetes Care (2014)

OBJECTIVE Persons with serious mental illness (SMI) may benefit from collocation of medical and mental health healthcare professionals and services in attending to their chronic comorbid medical conditions. We evaluated and compared glucose control and diabetes medication adherence among patients with SMI who received collocated care to those not receiving collocated care (which we call usual care). RESEARCH DESIGN AND METHODS We performed a cross-sectional, observational cohort study of 363 veteran patients with type 2 diabetes and SMI who received care from one of three Veterans Affairs medical facilities: two sites that provided both collocated and usual care and one site that provided only usual care. Through a survey, laboratory tests, and medical records, we assessed patient characteristics, glucose control as measured by a current HbA1c, and adherence to diabetes medication as measured by the medication possession ration (MPR) and self-report. RESULTS In the sample, the mean HbA1c was 7.4% (57 mmol/mol), the mean MPR was 80%, and 51% reported perfect adherence to their diabetes medications. In both unadjusted and adjusted analyses, there were no differences in glucose control and medication adherence by collocation of care. Patients seen in collocated care tended to have better HbA1c levels (β = −0.149; P = 0.393) and MPR values (β = 0.34; P = 0.132) and worse self-reported adherence (odds ratio 0.71; P = 0.143), but these were not statistically significant. CONCLUSIONS In a population of veterans with comorbid diabetes and SMI, patients on average had good glucose control and medication adherence regardless of where they received primary care.
The Australia Antigen
Authors: Thomas J. Gill
Journal: JAMA (1984)

The article by Blumberg and associates describing the antigen that was ultimately found to be associated with infection by the hepatitis B virus (HBV)<sup>1</sup>presents a classic example of serendipity in scientific research and the fact that "chance favors the prepared mind." It also presents a fascinating insight into the nature of the scientific process and the way in which important discoveries are made.<sup>2</sup> The work was careful, logical, and meticulous. It provided solid evidence for the presence of an antigenic system that was later identified as that of the HBV. The initial interpretation of the work was colored by a fortuitous association between the presence of the antigen and patients with leukemia. However, Blumberg and colleagues quickly grasped the true significance of their finding, ie, that the presence of the antigen was associated with blood transfusion and the subsequent development of hepatitis. Their observations became a new
Digoxin Antibodies and Digitalis Intoxication
Authors: James E. Doherty
Journal: New England Journal of Medicine (1982)

When Butler and Chen first produced digoxin antibodies in 19671 it was hoped that the availability of a radioimmunoassay of serum levels of digoxin would lead to safer and more effective use of digitalis glycosides. Most physicians would agree that this hope has been realized. Digitalis intoxication is occurring less often,2 and as special problems with the drug in specific disease states have been noted, management has improved.3 In addition, interactions of digitalis with other drugs have been recognized, and methods have evolved for dealing with them.4 5 6 The term "antibody," of course, suggested a potential for treatment of digitalis toxicity . . .
A Randomized Trial of a Strategy for Increasing High-Density Lipoprotein Cholesterol Levels: Effects on Progression of Coronary Heart Disease and Clinical Events
Authors: Edwin J. Whitney, Richard A. Krasuski, Bradley E. Personius, Joel E. Michalek, Ara M. Maranian, Mark W. Kolasa, Erik Monick, B. Gregory Brown, Antonio M. Gotto
Journal: Annals of Internal Medicine (2005)

Background: The high-density lipoprotein (HDL) cholesterol level is a strong predictor of cardiovascular events in epidemiologic studies. Until recently, it has been less extensively studied as a therapeutic target. Objective: To assess the angiographic and clinical effects of a pharmacologic strategy to increase HDL cholesterol levels. Design: Randomized, double-blind, placebo-controlled trial conducted from 1993 to 1996. Setting: Outpatient specialty clinic of a large U.S. military medical center. Participants: 143 military retirees younger than 76 years of age with low HDL cholesterol levels and angiographically evident coronary disease. Intervention: Gemfibrozil, niacin, and cholestyramine or corresponding placebos, with aggressive dietary and lifestyle intervention at baseline. Measurements: Change from baseline to 30 months and a composite measure of clinical events that included hospitalization for angina, myocardial infarction, transient ischemic attack and stroke, death, and cardiovascular procedures. Results: At baseline, mean (±SD) lipid values were as follows: total cholesterol, 5.1 ± 0.8 mmol/L (196 ± 31 mg/dL); low-density lipoprotein (LDL) cholesterol, 3.3 ± 0.7 mmol/L (128 ± 27 mg/dL); and HDL cholesterol, 0.9 ± 0.2 mmol/L (34 ± 6 mg/dL). Compared with placebo, the pharmacologically treated group experienced a 20% (95% CI, 14.8% to 24.3%) decrease in total cholesterol level, a 36% (CI, 28.4% to 43.5%) increase in HDL cholesterol level, a 26% (CI, 19.1% to 33.7%) decrease in LDL cholesterol level, and a 50% (CI, 40.5% to 59.2%) reduction in triglyceride levels. Focal coronary stenosis increased by 1.4% in the placebo group but decreased by 0.8% in the drug group (difference, −2.2 percentage points [CI, −4.2 to −0.1 percentage points]). A composite cardiovascular event end point was reached in 26% of patients in the placebo group and 13% of those in the drug group (difference, 13.7 percentage points [CI, 0.9 to 26.5 percentage points]). Side effects, particularly flushing and gastrointestinal intolerance, were more common in the drug group but rarely led to withdrawal from the study. Limitations: The study was small and used a composite clinical outcome. Whether improvements in angiographic findings were due to reductions in LDL cholesterol or increases in HDL cholesterol was not established. Flushing may have led to inadvertent unblinding in patients who were randomly assigned to active study drugs. Conclusions: A combination regimen aimed at increasing HDL cholesterol levels improves cholesterol profiles, helps prevent angiographic progression of coronary stenosis, and may prevent cardiovascular events in some people who exercise regularly and eat low-fat diets.
Antigen presentation in patients with recrudescent orofacial herpes simplex virus infections
Authors: J.P. VESTEY, M. NORVAL, S.E.M. HOWIE, J.P. MAINGAY, W. NEILL
Journal: British Journal of Dermatology (1990)

Recovery from epidermal herpes simplex virus (HSV) infection depends primarily on development of an effective cell-mediated immune response, possibly generated following antigen (Ag) presentation by epidermal cells (EC). The ability of EC to present HSV Ag was investigated in 12 subjects with occasional recrudescent facial HSV infections. All had circulating HSV specific antibodies and cell-mediated immunity to the virus. Peripheral blood mononuclear cell suspensions, depleted of antigen presenting cells (APC) by glass adherence and then enriched for T cells by adsorption on nylon wool columns, did not proliferate in response to HSV Ag. Both EC suspensions, prepared from suction blister roofs, and glass-adherent peripheral blood mononuclear cells (AC) preincubated with ultraviolet-inactivated HSV, reconstituted the T-cell proliferative response to HSV. EC were more efficient than AC at presenting HSV Ag to T cells. Depletion of CD1+ cells from EC suspensions by cell sorting reduced their ability to present HSV Ag and augmentation of CD1+ cell numbers supplemented it. Preincubation of EC or AC with monoclonal antibodies to major histocompatibility complex class II antigens DP, DQ or DR, blocked the lymphoproliferative response to HSV Ag. Evidence was obtained that cells co-ordinately expressing products of the DP, DQ and DR loci are involved in presentation of HSV Ag by both EC and AC.