tbuckley/cabot-search huggingface dataset:
Interaction between verapamil and contrast media in coronary arteriography: comparison of standard ionic and new nonionic media.
Authors: C B Higgins, M Kuber, R A Slutsky
Journal: Circulation (1983)

Coronary arteriography is frequently performed in patients receiving verapamil ther- apy.Since verapamil and contrast media both cause depression in electrophysiologic and contractile function of the heart and since both may exert these effects by actions on ionic calcium, the interaction of verapamil and intracoronary contrast media was assessed in 16 anesthetized dogs.Before verapamil, ionic contrast medium (Renografin 76, 3 ml) caused significant (p < .01)decreases in left ventricular peak systolic pressure, left ventricular dP/dt, extent of segment length shortening, and rate of change of segment length (dL/dt).The hemodynamic effects of verapamil and Renografin were additive, but the severity of the hemodynamic changes in response to Renografin in the presence of verapamil were not significantly different from those produced before verapamil.On the other hand, PR interval prolongation by Renografin 76 was significantly greater in the presence of verapamil (p < .001);most of the animals developed second-degree heart block in response to Renografin 76 in the presence of verapamil.Both before and in the presence of verapamil, Renografin 76 induced a similar decline in Na+ and Ca"+ levels and an increase in Na+/Ca"+ of coronary sinus blood.Nonionic contrast medium (iohexol) caused small but significant increases in peak dP/dt and dL/dt both before and in the presence of verapamil.This contrast medium caused no significant changes in the PR interval before or in the presence of verapamil.The changes in Na+, Ca" , and Na+/Ca+ + were significantly (p < .01)less marked than those caused by Renografin 76 and were not significantly different before or in the presence of verapamil.The major finding of this study is that the effect of ionic contrast media on atrioventricular conduction is markedly enhanced in the presence of verapamil.On the other hand, nonionic media cause no deleterious inotropic or dromotropic effects, either in the presence or absence of verapamil.Circulation 68, No. 3, 628-635, 1983.VERAPAMIL and other calcium antagonists were ini- tially used in the treatment of coronary arterial spasm and have subsequently been effective in the management of other forms of ischemic heart disease.1"2Con- sequently, many patients are now undergoing coronary arteriography while being treated with calcium antagonists.In addition to a potent vasodilatory action, some antagonists have important cardiac effects.Verapamil, in particular, has actions on the heart.3 4 The cardiac effects and cellular mechanism involved in these ac-
Why the 1948 MRC trial of streptomycin used treatment allocation based on random numbers
Authors: Iain Chalmers
Journal: Journal of the Royal Society of Medicine (2011)

The history of randomized clinical trials may be traced back to the biometricians’ work and it seems to be a good example of ‘applied statistics’. On the one hand there was a direct lineage from Pearson to Bradford Hill via Fisher and Major Greenwood... On the other hand, it is not too difficult to argue for conceptual legacy, since the basic concepts grounding the choice of randomisation can be traced back to RA Fisher’s work.
To E or Not To E—How Do We Tell?
Authors: Joseph L. Witztum
Journal: Circulation (1998)

linical disease resulting from atherosclerosis continues to cause extensive mortality and morbidity and uses an exorbitant amount of the financial resources available for health care.Atherosclerosis is a complex, multifactorial, and chronic disease influenced by a wide variety of genetic, environmental, and behavioral activities.However, it is at last widely recognized that among the known risk factors, hypercholesterolemia is one of the most important.Recent clinical trials indicate that for most individuals, and certainly for those at high risk, the lower the plasma cholesterol level, the lower the risk for subsequent development of clinical events.The mechanisms by which elevated levels of lipoproteins, chiefly the apoB containing lipoproteins such as LDL, cause an acceleration of atherogenesis are only incompletely understood.Yet there seems to be an emerging body of evidence to support the contention that the atherogenicity of LDL derives in large part from the fact that it becomes modified in one or more ways.In particular, it is widely held that the oxidative modification of LDL is intimately involved in the atherogenic process.
Serum Amylase and Acute Abdominal Disease
Authors: W. Burnett, T. D. Ness
Journal: BMJ (1955)

BRMT clinical picture conformed to the diagnosis of Tay-Sachs disease, the cherry-red spot at the macula was missing. SummaryTwo cases of cerebromacular degeneration of Tay-Sachs type are described in Sinhalese children.They showed mental retardation, myoclonic fits, blindness with a dark purple patch at the fovea centralis sur- rounded by a white halo of avascular degenerated tissue, and primary optic atrophy.In one case, which started at 2 months of age, the duration of the illness was two years and eight months; in the other case, which started at 2 years, the duration was only two months.The usual microscopical changes described by others were found.The only unusual feature was the presence of large hyaline masses undergoing calcification in some parts of the brain substance and in the pia arachnoid.The nature of these is unknown.We wish to thank
Defective Macrophage Function in a Patient with Common Variable Immunodeficiency
Authors: Martha M. Eibl, Josef W. Mannhalter, Gerhard Zlabinger, Wolfgang R. Mayr, Gernot P. Tilz, Rafi Ahmad, Christoph C. Zielinski
Journal: New England Journal of Medicine (1982)

COMMON variable immunodeficiency is characterized by different immunologic abnormalities responsible for agammaglobulinemia.1 In this disease, impaired B-cell differentiation has been observed at different levels,2 and defects of B-cell function in connection with abnormalities of regulatory T cells have been reported.3 4 5 6 Even though macrophages are known to play an essential part in the initiation and regulation of the immune response,7 a defect in macrophage function has not been identified in connection with common variable immunodeficiency.In this study, we report on a patient who, like most of our patients with common variable immunodeficiency, had a depressed T-cell proliferative response to Escherichia . . .
Abstract 2967: CCL3 autocrine signaling regulate retention of metastasis associated macrophages and promote breast cancer metastasis
Authors: Bin-Zhi Qian, Takanori Kitamura, Jeffrey W. Pollard
Journal: Cancer Research (2012)

Abstract Macrophages abundantly found in the tumor microenvironment enhance malignancy. At metastatic sites a distinct population of metastasis associated macrophages (MAMs) promotes tumor cell extravasation, seeding and persistent growth. These macrophages are derived from circulating inflammatory monocytes recruited by CCL2/CCR2 chemokine signaling. Our current study identified a distinct gene expression signature of the MAMs in comparison with resident macrophages in lung and spleen. Majority of these genes encodes cell surface proteins and secreted factors which mediate MAM's interaction with the metastatic microenvironment. Interestingly, we identified another chemokine, CCL3, is highly expressed by MAMs in a CCL2/CCR2 dependent manner. This indicates that CCL2 not only regulate MAM recruitment but also its function. RNA interference mediated CCL3 knockdown significantly reduced their potential in promoting tumor cell extravasation in vitro. Anti-CCL3 antibody and genetic ablation of CCL3 significantly reduced tumor cell metastatic potential in vivo. Importantly, MAM also express high level of CCR1 and CCR5, receptors for CCL3, upon differentiation. Anti-CCL3 inhibitory antibody significantly reduced MAM retention in pulmonary metastasis. Together, our data indicates an autocrine signaling via CCL3 regulated by CCL2/CCR2 controls MAM retention and promote breast tumor lung metastasis which identified a novel therapeutic target for treating metastatic breast disease. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2967. doi:1538-7445.AM2012-2967
FDA breached integrity over investigation of contaminated heparin
Authors: J. H. Tanne
Journal: BMJ (2010)

The US Food and Drug Administration has been criticised for the way it investigated how a batch of contaminated heparin came into medical use in 2008.

The contaminated heparin, produced by Baxter Healthcare Corporation, was recalled in 2008 after 81 patients died and 350 adverse events were reported ( BMJ 2008;336:412, doi:10.1136/bmj.39496.419248.DB).

Baxter provides about half the supply of heparin in the United States. But the blood product’s main ingredient was imported from a Chinese source that was never traced, as some Chinese producers refused to cooperate with the FDA.

A report from the independent Government Accountability Office criticises …
THE EXCHANGE OF CHIEFS OF SERVICE
Authors: I. H. MARCUS
Journal: Annals of Internal Medicine (1939)

Editorial1 July 1939THE EXCHANGE OF CHIEFS OF SERVICEI. H. MARCUSI. H. MARCUSSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-13-1-194 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptExchange professorships at universities exist now in all countries, and their advantage is universally recognized. The chief of a hospital service is the analogue in the clinical field of the professor in the academic field. Would there not be many advantages to a system of exchanges of chiefs of services?Just as a college exchanges professors for a while with some other college, so could a hospital exchange temporarily with another in its city one of its chief physicians or surgeons. A physician responsible for the organization and the conduct of a service in a hospital could thus spend a... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 July 1939Volume 13, Issue 1Page: 194-195KeywordsSurgeons ePublished: 1 December 2008 Issue Published: 1 July 1939 PDF downloadLoading ...
Pseudosarcoma of the oesophagus
Authors: T. W. Shields, J. B. Eilert, H. Battifora
Journal: Thorax (1972)

Pseudosarcoma of the oesophagus previously has been well documented in only six patients. The present case history illustrates the characteristics originally described by Stout of a polypoid lesion composed of sarcoma-like cells adjacent to squamous cell carcinoma. Earlier reports have postulated that the sarcomatous cells represent an unusual stromal proliferation in response to the adjacent squamous cell carcinoma. Another theory has been that the two cellular elements represent two separate lesions occurring coincidentally. Routine microscopic examination of the present lesion revealed it to be composed principally of pleomorphic spindle-shaped cells with areas of larger, more rounded cells resembling squamous carcinoma. However, electron microscopic examination of this tumour revealed that the sarcomatous cells contained tonofibrils and particularly desmosome-associated tonofibrils. These findings, we believe, definitely establish that the sarcoma-like cells originate from squamous epithelium. It is postulated that cells of both the sarcomatous and carcinomatous elements may be derived from the basal elements of the epithelium and this may account for the relatively benign clinical behaviour of this tumour.
Painful Sickle Cell Crisis
Authors: James D. H. Reynolds
Journal: JAMA (1971)

In a 25-year-old Negro woman with painful abdominal crisis of hemoglobin sickle cell disease, therapy with hyperbaric oxygen at 2 atmospheres pressure produced dramatic subjective improvement on three separate occasions. It is suggested that hyperbaric oxygen therapy may occasionally be a useful form of treatment for painful sickle cell crisis.
Testosterone-Induced Remission in Aplastic Anemia of Both Acquired and Congenital Types
Authors: Nasrollah T. Shahidi, Louis K. Diamond
Journal: New England Journal of Medicine (1961)

THE term aplastic anemia may have various meanings in different clinics. Occasionally, it is used for a condition in which there is peripheral pancytopenia but a normally cellular or even hypercellular bone marrow. Such a state may be associated with a good prognosis even without therapy. As described in this report, aplastic anemia is a physiologic and anatomic failure of the bone marrow, with marked decrease or absence of blood-forming elements in the marrow, peripheral pancytopenia and no splenomegaly, hepatomegaly or lymphadenopathy.§ Most children with this disease die from anemia, hemorrhage or infection, despite treatment with antimicrobial drugs, corticosteroids and . . .
A quarter of stroke patients are still not treated in a stroke unit
Authors: Z. Kmietowicz
Journal: BMJ (2009)

Anti-1-amino-3-<sup>18</sup>F-fluorocyclobutane-1-carboxylic acid (<sup>18</sup>F-FACBC) is a synthetic amino acid analog PET radiotracer undergoing clinical trials for the evaluation of prostate and other cancers. We aimed to describe common physiologic uptake patterns, incidental findings, and variants in patients who had undergone <sup>18</sup>F-FACBC PET. <b>Methods:</b> Sixteen clinical trials involving 611 <sup>18</sup>F-FACBC studies from 6 centers, which included dosimetry studies on 12 healthy volunteers, were reviewed. Qualitative observations of common physiologic patterns, incidental uptake, and variants that could simulate disease were recorded and compared with similar observations in studies of the healthy volunteers. Quantitative analysis of select data and review of prior published reports and observations were also made. <b>Results:</b> The liver and pancreas demonstrated the most intense uptake. Moderate salivary and pituitary uptake and variable mild to moderate bowel activity were commonly visualized. Moderate bone marrow and mild muscle activity were present on early images, with marrow activity decreasing and muscle activity increasing with time. Brain and lungs demonstrated activity less than blood pool. Though <sup>18</sup>F-FACBC exhibited little renal excretion or bladder uptake during the clinically useful early imaging time window, mild to moderate activity might accumulate in the bladder and interfere with evaluation of adjacent prostate bed and seminal vesicles in 5%–10% of patients. Uptake might also occur from benign processes such as infection, inflammation, prostatic hyperplasia, and metabolically active benign bone lesions such as osteoid osteoma. <b>Conclusion:</b> Common physiologic uptake patterns were similar to those noted in healthy volunteers. The activity in organs followed the presence of amino acid transport and metabolism described with other amino acid–based PET radiotracers. As with other PET radiotracers such as <sup>18</sup>F-FDG, focal nonphysiologic uptake may represent incidental malignancy. Uptake due to benign etiologies distinct from physiologic background also occurred and could lead to misinterpretations if the reader is unaware of them.
Intramuscular vs Intradermal Hepatitis B Vaccination: A 6-Year Follow-up
Authors: Johan Wiström
Journal: JAMA (1995)

To the Editor.  —We previously reported 1 the results of a randomized trial evaluating the immunogenicity of a DNA-recombinant hepatitis B (HB) vaccine (Recombivax-HB, Merck Sharp & Dohme, West Point, Pa) administered intradermally (ID) at a dose of 2 μg or intramuscularly (IM) at a dose of 10 μg to 80 healthy adults at 0,1, and 6 months. Twelve months after the first vaccination, the number of responders (vaccinees with anti-hepatitis B surface antigen [anti-HBsAg] levels ≥ 10 IU/L) was found to be significantly higher ( P  2 ) in the IM group (36/37, 97%) than in the ID group (21/38, 55%).  Six years (mean, 72 months; range, 66 to 78 months) after initiation of vaccination, we obtained serum from 53 (33 women and 20 men; mean age, 36 years; range, 26 to 61 years) of those 68 vaccinees who initially had anti-HBsAg levels greater than 1 IU/L. Twenty subjects
1082-183 The presence of chlamydia pneumoniae contributes to atherosclerotic plaque vulnerability
Authors: Masato Yamamoto, Masato Nakamura, Masao Moroi, Tsuyoshi Ono, Atsushi Ono, Itaru Yokouchi, Masamichi Wada, Masanori Shiba, Raisuke Iijima, Takahiro Tsuji, Rintaro Nakajima, Hidehiko Hara, Hisao Hara, Takashi Yoshitama, Taro Tsunoda, Kaoru Sugi
Journal: Journal of the American College of Cardiology (2004)
Amnesty International fears for safety of human rights activists in Sudan
Authors: P. Moszynski
Journal: BMJ (2009)

Concern is growing for the welfare of human rights activists and victims of torture in Sudan after last month’s security service raids on the offices of organisations that provide rehabilitation to survivors of torture.

The raids occurred within hours of an arrest warrant being issued by the International Criminal Court against President Omar al Bashir for war crimes and crimes against humanity, which also led to the expulsion of numerous international humanitarian charities.

Amnesty International last week warned that Mohamed Al-Mahjoub, director of the Amal Centre for Treatment and Rehabilitation for Victims of Torture in North Darfur, was arrested on 11 April and taken to a National Intelligence and Security Services detention centre in El Fasher. So far he …
Advice for the Patient with Silent Gallstones
Authors: Robert M. Donaldson
Journal: New England Journal of Medicine (1982)

Patient: So what's the verdict, doctor?Physician: Well, Mrs. Gladstone, do you remember those x-rays we took because of your constipation?Patient: But that's all cleared up now.Physician: I'm very glad about that, and your bowel looks perfectly normal. But I'm afraid those same x-rays showed us some gallstones. That's why we did the ultrasound test and had you take those tablets to let us see your gallbladder. It functions very well but definitely contains at least four stones.Patient: And that means surgery, I suppose. Everything happens to me!Physician: Now, I'm not all that certain you need . . .
Coagulation Changes during Termination of Pregnancy by Prostaglandins and by Vacuum Aspiration
Authors: M. H. H. Badraoui, J. Bonnar, K. Hillier, M. P. Embrey
Journal: BMJ (1973)

Serial studies on coagulation factors were performed on 12 patients having termination of mid-trimester pregnancy by extra-amniotic prostaglandin F<sub>2</sub>α and 11 patients terminated by vacuum aspiration during the first trimester. A significant change in the activity of factors V, VII and X, VIII, and X, and a decrease of the prothrombin time and platelet count were found with prostaglandin termination but no such changes occurred during vacuum aspiration. These findings suggest that the coagulation system is activated during induction of mid-trimester abortion with extra-amniotic prostaglandin F<sub>2</sub>α. This is probably related to the physiological changes in the coagulation mechanism which occur by the second trimester of pregnancy. Termination of pregnancy in the mid-trimester may, however, be expected to give rise to defective blood coagulation and thromboembolic complications.
Fumonisin b1 carcinogenicity in a two-year feeding study using F344 rats and B6C3F1 mice.
Authors: P C Howard, R M Eppley, M E Stack, A Warbritton, K A Voss, R J Lorentzen, R M Kovach, T J Bucci
Journal: Environmental Health Perspectives (2001)

Fumonisin B1 (FB1) is a mycotoxin isolated from Fusarium fungi that contaminate crops worldwide. A previous study demonstrated that FB1 promoted preneoplastic foci in initiated rats and induced hepatocellular carcinomas in BD IX rats at 50 parts per million (ppm), but fundamental dose-response data were not available to assist in setting regulatory guidelines for this mycotoxin. To provide this information, female and male F344/N/Nctr BR rats and B6C3F1 Nctr BR mice were fed for two years a powdered NIH-31 diet containing the following concentrations of FB1: female rats, 0, 5, 15, 50, and 100 ppm; male rats, 0, 5, 15, 50, and 150 ppm; female mice, 0, 5, 15, 50, and 80 ppm; male mice, 0, 5, 15, 80, and 150 ppm. FB1 was not tumorigenic in female F344 rats with doses as high as 100 ppm. Including FB1 in the diets of male rats induced renal tubule adenomas and carcinomas in 0/48, 0/40, 9/48, and 15/48 rats at 0, 5, 15, 50, and 150 ppm, respectively. Including up to 150 ppm FB1 in the diet of male mice did not affect tumor incidence. Hepatocellular adenomas and carcinomas were induced by FB1 in the female mice, occurring in 5/47, 3/48, 1/48, 19/47, and 39/45 female mice that consumed diets containing 0, 5, 15, 50, and 80 ppm FB1, respectively. This study demonstrates that FB1 is a rodent carcinogen that induces renal tubule tumors in male F344 rats and hepatic tumors in female B6C3F1 mice.
Contamination of bone marrow transplants from peripheral blood
Authors: M Farrington, I Matthews, R Marcus, M A Scott, E Caffrey, C J Hunt
Journal: BMJ (1994)

coping."Guidelines on referral can help to over- come such difficulties.Any suggested inquiry into death rates should cover all providers of long stay care.This would allow a comparison of the rates across all providers, thus keeping results for nursing homes in context.Death rates in nursing homes may not be appreciably different from those for other providers of long stay care.We must be careful when discussing the many factors that influence death rates, and particularly in any attempts to link death rates to care previously given.We agree with Bowman that our survey shows that the population in nursing homes is dynamic and changing.More research is required to address some of the points raised generally by our survey and the response to our paper.