tbuckley/cabot-search huggingface dataset:
Comorbidity as a prognostic variable in multiple myeloma: comparative evaluation of common comorbidity scores and use of a novel MM–comorbidity score
Authors: M Kleber, G Ihorst, M Terhorst, B Koch, B Deschler, R Wäsch, M Engelhardt
Journal: Blood Cancer Journal (2011)

Comorbidities have been demonstrated to affect progression-free survival (PFS) and overall survival (OS), although their impact in multiple myeloma (MM) patients is as yet unsettled. We (1) assessed various comorbidities, (2) compared established comorbidity indices (CIs; Charlson comorbidity index (CCI), hematopoietic cell transplantation-specific comorbidity index (HCT-CI)), Kaplan Feinstein (KF) and Satariano index (SI) and (3) developed a MM-CI (Freiburger comorbidity index, FCI) in 127 MM patients. Univariate analysis determined moderate or severe pulmonary disease (hazard ratio (HR): 3.5, P<0.0001), renal impairment (via estimated glomerular filtration rate (eGFR); HR: 3.4, P=0.0018), decreased Karnofsky Performance Status (KPS, HR: 2.7, P=0.0004) and age (HR: 2, P=0.0114) as most important variables for diminished OS. Through multivariate analysis, the eGFR ⩽30 ml/min/1.73m(2), impaired lung function and KPS ⩽70% were significant for decreased OS, with HRs of 2.9, 2.8 and 2.2, respectively. Combination of these risk factors within the FCI identified significantly different median OS rates of 118, 53 and 25 months with 0, 1 and 2 or 3 risk factors, respectively, (P<0.005). In light of our study, comorbidities are critical prognostic determinants for diminished PFS and OS. Moreover, comorbidity scores are important treatment decision tools and will be valuable to implement into future analyses and clinical trials in MM.
Blue Dye, Blue Hands, and Sweat
Authors: BERNARD L. ALBERT
Journal: Annals of Internal Medicine (1976)

Comments1 October 1976Blue Dye, Blue Hands, and SweatBERNARD L. ALBERT, M.D., P.C.BERNARD L. ALBERT, M.D., P.C.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-85-4-541_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: I noted with interest the brief case report published in the May 1976 issue, "Blue Hands and Pseudocyanosis," by Dr. Jeffrey C. Darnell of Wishard Memorial Hospital.A much more detailed report of a similar case appeared under the title "Two Blue Hands" in the "Annals of Medicine" series in The New Yorker for 22 December 1975.This article, by Mr. Berton Roueché, tells about a 52-year-old paint chemist who was admitted to the Hershey Medical Center of Pennsylvania State University with blue hands. It was found that this "pseudocyanosis" was acquired by his warming his hands... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1976Volume 85, Issue 4Page: 541-541KeywordsChemistsSweat Issue Published: 1 October 1976 PDF downloadLoading ...
Compensation for Injured Research Subjects
Authors: Robert Steinbrook
Journal: New England Journal of Medicine (2006)

Two recent developments — increased awareness of the complications that may follow egg donation for stem-cell research and the disastrous consequences of a clinical trial of the humanized monoclonal antibody TGN1412 in which healthy volunteers nearly died (discussed in this issue by Wood and Darbyshire) — have focused renewed attention on the long-standing issue of compensation for injured research subjects.1 In the United States, despite decades of discussion and recommendations by national commissions, sponsors and institutions are not required to provide either free medical care or compensation, although some do. In contrast, many European countries mandate the provision of clinical-trials . . .
John Evans, M.D. (1814-1897)
Authors: Alfred S. Evans
Journal: JAMA (1961)

JOHN EVANS was a giant among men. He dominated and contributed to many areas of human endeavor. His activity in medicine alone included a professorship at Rush Medical College, investigations leading to an understanding of the transmission and control of cholera, including passage of the National Quarantine Law, promotion of medical education, editorship of a medical journal, and participation in the organization of the Chicago Medical Society and the American Medical Association. Moreover, he was founder and first superintendent of the Indiana Hospital for the Insane and pursued a distinguished career as an obstetrician. Most of us would be satisfied, indeed, with a life that included such accomplishments. To John Evans his work in medicine was just one of many fields of activity in which he distinguished himself. Educator, financier, railroad builder, statesman, and churchman, he was a founder of Northwestern University and the University of Denver, brought the
Alcohol and the emergency service patient.
Authors: S Holt, I C Stewart, J M Dixon, R A Elton, T V Taylor, K Little
Journal: BMJ (1980)

To determine the prevalence of alcohol use in casualty patients breath-alcohol analysis was performed on 702 patients attending the accident and emergency department of a large teaching hospital during the evening. Forty per cent of patients had consumed alcohol before attending and 32% had a blood alcohol concentration exceeding 17.4 mmol/l (80 mg/100 ml). Clinical assessment of intoxication resulted in a false-negative diagnosis in 10% of inebriated patients, indicating that an objective measurement of the blood alcohol concentration by a test, such as breath-alcohol analysis, may be of additional value. These findings confirm that a high proportion of emergency-service patients are affected by alcohol and suggest that alcoholism treatment facilities need to be integrated with accident and emergency services.
Effort and Coronary Occlusion
Authors: Walter Menaker
Journal: JAMA (1961)

<h3>To the Editor:—</h3> Dr. Arthur M. Master has claimed that neither effort nor rest play a role in acute coronary occlusion. Table 5 in his paper (The Journal[Oct. 22] 1960), headed "Activity at Onset of Coronary Occlusion (1,639 Attacks)," shows 376, or 22.9%, of such attacks occurring during sleep. As the average duration of sleep is 7.5 to 8 hours in each 24, we should expect there to be twice as many, i.e., 752 attacks while awake if 16 hours of each day are spent awake, or 2.2 times as many, i.e., 823 attacks while awake, if 16.5 hours are spent awake. But Dr. Master reports 1,639 less 376, or 1,263 attacks for the waking period. This is 1.68 times as high as the expected 752 waking attacks if 8 hours' sleep is assumed, and 1.53 times as high as the expected 823 waking attacks if 7.5 hours' sleep
THE EFFECT OF DIIODOTYROSINE ON THE BASAL METABOLISM IN MYXEDEMA 1
Authors: Willard O. Thompson, Joseph M. Alper, Phebe K. Thompson, Lois F. N. Dickie
Journal: Journal of Clinical Investigation (1934)

Much speculation has developed concerning the role of diiodotyrosine in the thyroid, particularly since the report of its isolation from the gland by Harington and Randall (1) in 1929.According to these authors, the iodine of the thyroid is about equally divided between diiodotyrosine and thyroxine and diiodotyrosine is to be regarded as the precursor of thy- roxine.Observations on the biological effects of diiodotyrosine had been started some years before their report.Strouse and Voegtlin (2) in 1909 did not notice any clinical improvement following the administration of 0.1 gram three times a day for ten days and two weeks to a patient with myxedema and to a cretin respectively.Knipping and Wheeler-Hill (3) gave 100 mgm. of diiodotyrosine daily by mouth for several weeks to men and observed no effect on the basal metabolism, pulse, weight, or vege- tative nervous system.Hoffmann (4) gave 3, 5, diiodo-1-tyrosine sub- cutaneously to normal men in total doses varying from 100 mgm. in one day to 8.4 grams in fourteen days and he likewise observed no effect on the basal metabolism.Beumer and Kornhuber (5) gave 19.5 grams of diiodotyrosine over an eight-day period to a four year old child and noted no influence on diuresis or weight.In a two year old cretin, who had improved greatly on thyroid, a relapse occurred when they gave from 0.5 to 1.0 gram of diiodotyrosine three times daily for eight weeks.The only contradictory observation appears to be that of Abderhalden ( 6), who re- ported beneficial results from feeding 3, 5, diiodo-1-tyrosine to three chil- dren (siblings) who all showed well marked symptoms of myxedema.As in the case of man, the data reported on lower animals do not fur- nish satisfactory evidence of a thyroid-like action of diiodotyrosine.Strouse and Voegtlin (2) observed that it was without effect on the nitrogen metabolism and blood pressure in dogs.Abelin (7) and Gaddum '(8) reported that it did not increase the metabolism of normal rats.Abderhalden and Wertheimer (9) showed that while thyroxine reduced the weight rapidly in rabbits and guinea pigs, diiodotyrosine had only a
Quantification of experimental myocardial infarction using nuclear magnetic resonance imaging and paramagnetic ion contrast enhancement in excised canine hearts.
Authors: M R Goldman, T J Brady, I L Pykett, C T Burt, F S Buonanno, J P Kistler, J H Newhouse, W S Hinshaw, G M Pohost
Journal: Circulation (1982)

Determination of myocardial infarct size is important for clinical management of patients with ischemic heart disease and for research on limiting infarct size. Nuclear magnetic resonance (NMR) imaging permits tomographic depiction of the distribution of mobile tissue protons. NMR images have demonstrated high spatial resolution and contrast. To evaluate the potential of this technique in measuring myocardial infarct size, NMR imaging was performed in six canine hearts excised 24 hours after circumflex coronary artery ligation. Before sacrifice, the dogs received i.v. manganous chloride (0.05 mmol/kg). After NMR imaging, the heart were sectioned and the myocardial slices were stained with triphenyl tetrazolium chloride. The pathologically determined infarct size was compared with the infarct size measured by NMR imaging. The correlation was good (regression line slope 1.06; r = 0.94). We conclude that NMR imaging with paramagnetic contrast agents can be used to determine infarct size in excised hearts.
Ferumoxtran-10 Ultrasmall Superparamagnetic Iron Oxide–Enhanced Diffusion-weighted Imaging Magnetic Resonance Imaging for Detection of Metastases in Normal-sized Lymph Nodes in Patients with Bladder and Prostate Cancer: Do We Enter the Era After Extended Pelvic Lymph Node Dissection?
Authors: Ansje S. Fortuin, Hanneke Meijer, Les C. Thompson, J. Alfred Witjes, Jelle O. Barentsz
Journal: European Urology (2013)
Urea Therapy in Sickle-Cell Disease
Authors: ROBERT M. NALBANDIAN
Journal: Annals of Internal Medicine (1973)

Letters, Comments, and Corrections1 February 1973Urea Therapy in Sickle-Cell DiseaseROBERT M. NALBANDIAN, M.D.ROBERT M. NALBANDIAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-78-2-312_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The recent letter of Drs. Rudders and Pisciotta (Ann Intern Med 77:659-660, 1972) sets forth their understandable demurral on urea therapy in sickle-cell disease. Our views can be supported by documentation from current literature.Independent reports of the successful use of oral urea therapy are now available. Targino de Araujo, Wronowski, and Cimino (1) managed 20 patients on oral urea, with 20 controls. They noted that all 20 of the treated patients, previously refractory to other therapeutic regimens, "presented marked clinical improvement." Also, they found evidence of increased hemoglobin synthesis in 4 of the 20 treated patients....References1. TARGINO DE ARAUJOWRONOWSKICIMINO JAJ: Demonstration of Hb A1 in patients with sickle-cell Anemia (Hb SS) and the synthesis of A1 and S hemoglobins following administration of urea orally. XIV International Congress of Hematology, Sao Paulo, Brazil, Abstract No. 353, 16-21 July 1972 Google Scholar2. Proceedings 20th annual Blood Symposium, Sickle Cell Disease, Wayne State University School of Medicine, Detroit, Michigan, 20-21 January 1972. Thromb Diath Haemorr (suppl) In press, 1972. 2a. LUSCHER JM, BARNHART MI: Oral prophylactic use in sickle cell disease. 2b. SCRIMGEOUR AW: Oral prophylactic urea treatment in sickle cell disease and problems encountered. Google Scholar3. NALBANDIANNICHOLSSTEHOUWER RBE: Urea, urease, cyanate, and the sickling of hemoglobin S. Clin Chem 18:961-964, 1972 CrossrefMedlineGoogle Scholar4. HERNÁNDEZCASTROPORTUONDO PRH: Utilizacion de la urea endovenosa en al tratamiento de las crisis dolorosas de la anemia de celulas falcisormes. Rev Invest Clin 24:83-89, 1972 MedlineGoogle Scholar5. NALBANDIANBARNHARTHENRY RMR: Sickle cell disease: clinical advances by the Murayama molecular hypothesis. Milit Med 137:215-220, 1972 CrossrefMedlineGoogle Scholar6. BARNHARTVETTRAINOLUSHER MAJ: Microscopy as an aid in the evaluation and management of sickle cell disease. See Reference 2. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1973Volume 78, Issue 2Page: 312-312KeywordsHemoglobinUrea ePublished: 1 December 2008 Issue Published: 1 February 1973 PDF downloadLoading ...
Texas hospital sued for keeping pregnant woman on life support despite family's objections
Authors: M. McCarthy
Journal: BMJ (2014)

The husband of a woman who has been kept on life support in a Texas hospital because she is pregnant has filed a suit against the hospital, claiming that it is violating Texas law by continuing to treat someone who is “clinically and legally” dead.

The woman, Marlise Munoz, is a 33 year old mother of one who collapsed at her home on 26 November 2013. She was found without a pulse by her husband, Erick …
Adolescent Maladjustment or Affective Disorder?
Authors: JOHNNIE L. GALLEMORE, WILLIAM P. WILSON
Journal: American Journal of Psychiatry (1972)

Data were obtained on 35 patients under age 21 from the time they appeared for treatment. All had illnesses compatible with the basic psychological and biological disturbances seen in affective disorders in adults. However, their presenting symptoms were heavily influenced by concerns of adolescence. The data suggest that primary affective disorders are not uncommon in young patients; correct diagnosis and treatment of emotional illness in this age group is important.
Renal Aplastic Dysplasia and Ipsilateral Ectopic Ureter Obstructing the Seminal Via: A Possible Cause of Male Infertility
Authors: Antonio Carbone, Giovanni Palleschi, Giulio Tomiselli, Maurizio Inghilleri, Rocco Rago, Andrea Lenzi, Antonio Luigi Pastore
Journal: European Urology (2007)
L3T4 antigen expression by hemopoietic precursor cells.
Authors: G G Frederickson, R S Basch
Journal: The Journal of Experimental Medicine (1989)

L3T4 (CD4) is expressed on immature hematopoietic cells. Sorting bone marrow cells on the basis of their expression of this antigen produces populations of cells that are markedly enriched for multipotential stem cells (CFU-s) and for myeloid precursors (CFU-c). We believe that L3T4 is transiently expressed by most, if not all, hematopoietic precursors early in their maturation. We suggest that the expression of CD4 molecules on the surface of immature precursors is required for their interaction with Ia bearing cells within the hemopoietic inductive microenvironment(s) of the marrow and thymus.
Epigenetic regulation of insulin resistance in nonalcoholic fatty liver disease: Impact of liver methylation of the peroxisome proliferator-activated receptor γ coactivator 1α promoter
Authors: Silvia Sookoian, Maria Soledad Rosselli, Carolina Gemma, Adriana L. Burgueño, Tomas Fernández Gianotti, Gustavo O. Castaño, Carlos J. Pirola
Journal: Hepatology (2010)

Insulin resistance (IR) and mitochondrial dysfunction play a central role in the pathophysiology of nonalcoholic fatty liver disease (NAFLD). We hypothesized that genetic factors and epigenetic modifications occurring in the liver contribute to the IR phenotype. We specifically examined whether fatty liver and IR are modified by hepatic DNA methylation of the peroxisome proliferator-activated receptor γ coactivator 1α (PPARGC1A) and mitochondrial transcription factor A (TFAM) promoters, and also evaluated whether liver mitochondrial DNA (mtDNA) content is associated with NAFLD and IR. We studied liver biopsies obtained from NAFLD patients in a case-control design. After bisulfite treatment of DNA, we used methylation-specific polymerase chain reaction (PCR) to assess the putative methylation of three CpG in the PPARGC1A and TFAM promoters. Liver mtDNA quantification using nuclear DNA (nDNA) as a reference was evaluated by way of real-time PCR. Liver PPARGC1A methylated DNA/unmethylated DNA ratio correlated with plasma fasting insulin levels and homeostasis model assessment of insulin resistance (HOMA-IR); TFAM methylated DNA/unmethylated DNA ratio was inversely correlated with insulin levels. PPARGC1A promoter methylation was inversely correlated with the abundance of liver PPARGC1A messenger RNA. The liver mtDNA/nDNA ratio was significantly higher in control livers compared with NAFLD livers. mtDNA/nDNA ratio was inversely correlated with HOMA-IR, fasting glucose, and insulin and was inversely correlated with PPARGC1A promoter methylation.Our data suggest that the IR phenotype and the liver transcriptional activity of PPARGC1A show a tight interaction, probably through epigenetic modifications. Decreased liver mtDNA content concomitantly contributes to peripheral IR.
Association of host pharmacodynamic effects with virologic response to pegylated interferon alfa-2a/ribavirin in chronic hepatitis C
Authors: Raymond T. Chung, Fred F. Poordad, Tarek Hassanein, Xiaolei Zhou, Ellen Lentz, Avinash Prabhakar, Adrian M. Di Bisceglie
Journal: Hepatology (2010)

Patients receiving therapy for chronic hepatitis C virus (HCV) infection frequently experience cytopenias and weight loss. We retrospectively assessed the pharmacodynamic effects of pegylated interferon (PEG-IFN) alfa-2a and ribavirin by evaluating the relationship between changes in hematologic parameters, body weight, and virologic response. Patients with HCV genotypes 1, 4, 5, or 6 receiving 24 or 48 weeks of PEG-IFN alfa-2a and ribavirin therapy were pooled from four phase 3/4 trials. Maximum decreases in hemoglobin level, neutrophil count, platelet count, and weight during therapy were assessed according to virologic response category (sustained virologic response [SVR], relapse, breakthrough, and nonresponder) and race/ethnicity. Of 1,778 patients analyzed, more than half were male, non-Hispanic Caucasian, and infected with HCV genotype 1; had a baseline HCV RNA >800,000; and had alanine aminotransferase levels ≤3 × the upper limit of normal. Virologic responders (SVR, relapse, and breakthrough) experienced greater maximum decreases from baseline in hemoglobin level, neutrophil count, platelet count, and weight compared with nonresponders; however, no clear trend was observed between SVR, relapse, and breakthrough. After adjusting for drug exposure and treatment duration, only decreases in neutrophil count remained associated with virologic response. Significantly greater declines in neutrophil (P < 0.0001) and platelet (P < 0.005) count were observed at weeks 4, 12, and 24 of therapy in virologic responders compared with nonresponders. This difference between responders and nonresponders was also observed among racial/ethnic groups, although statistical significance was not consistent across all groups.This post hoc analysis of HCV patients treated with PEG-IFN alfa-2a and ribavirin shows that maximum decreases from baseline in hematologic parameters and weight loss were associated with virologic response. However, after adjusting for drug exposure and accounting for duration of therapy, only neutropenia was independently associated with virologic response.
Thinking Outside the Box: Fostering Innovation and Non–Hypothesis-Driven Research at NIH
Authors: Richard Aragon
Journal: Science Translational Medicine (2011)

The National Institutes of Health (NIH) has long been known as an institution that supports biomedical advances through hypothesis-driven research. Another aspect of NIH, however, has received comparatively little attention and may be critical to advancing translational science beyond its current limitations. Specifically, this aspect of NIH focuses on supporting innovation through the development of high-risk technologies that have the potential to empower research.
Hospital information management: the need for clinical leadership
Authors: J. C Wyatt
Journal: BMJ (1995)

On 12 July the Audit Commission published For Your Information, a well researched report about information and its management in acute hospitals in Britain, how and why it is failing, and steps that clinicians, managers, and the NHS should take to correct this. This article discusses why information management matters to clinicians and considers the problems identified by the Audit Commission--most of which will strike chords with doctors--and possible remedies. Finally, it describes possible routes to administer these remedies and the proposal, recently supported by the BMA Council, for a national centre for health informatics with the goals of educating and enthusing clinicians about informatics, empowering them to participate in local and national information management decisions; exploring how information can be used to improve patient care and outcomes; and evaluating clinical information systems and helping to realise their benefits.
Clinical Features of Hemorrhagic Fever of Central Vietnam.
Authors: Elliston Farrell
Journal: Annals of Internal Medicine (1970)

Meeting Abstracts1 May 1970Clinical Features of Hemorrhagic Fever of Central Vietnam.Elliston Farrell, M.D., F.A.C.P.Elliston Farrell, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-72-5-798_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptBetween August 29 and October 18, 1969, 145 of 474 patients admitted to the adult contagious diseases wards of Hue Central Hospital, Vietnam, in addition to fever, had external evidence of bleeding, usually from the respiratory, gastrointestinal, or genitourinary tracts. One hundred and twenty-one of these had at least four of the following findings and were regarded as valid cases of hemorrhagic fever (HF): [1] fever, [2] hemorrhages, [3] positive Rumpel-Leede tests, [4] leukopenia, and [5] thrombocytopenia. An approximately equal number (120) of cases of HF on the children's service under the care of Dr. Richard W. Nixon served as... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Irvine, Calif. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1970Volume 72, Issue 5Page: 798-798KeywordsChildrenFeversGastrointestinal tractHemorrhageHemorrhagic feversPulmonary diseases Issue Published: 1 May 1970 PDF DownloadLoading ...