tbuckley/cabot-search huggingface dataset:
The Harveian Oration on Pathology as the Basis of Rational Medicine: Delivered before the Royal College of Physicians
Authors: P. H. Pye-Smith
Journal: BMJ (1893)

to Guy's Hospital.[AFTER referring to the conditions under which the annual oration was founded, Dr. Pye-Smith proceeded to deal in the first place with the claim of Harvey to have been the true discoverer of the circulation of the blood, pointing out that, although conjectures had been made upon the subject which nearly approached the truth, to Harvey belonged the honour of having appreciated the importance of the subject and of having proved it by argument founded on experiment and observa- tion." He," Dr. Pye-Smith said, "only discovers who proves."The orator next turned to a brief consideration of Harvey's treatise upon Generation, and then proceeded as follows:-] There is, however, a third phase of Harvey's intellectual work, of which, unfortunately, the records have perished, and which has not, perhaps, been duly appreciated.I do not speak of his practice.A file of his " bills," however in- teresting to the antiquarian, would probably be of as little therapeutical value as those of his contemporaries.Dia- gnosis, in the modern sense of the word, was scarcely thought of at that time, and treatment was either empirical or mischievous.What I believe Harvey contributed.or would, but for adverse fate, have contributed to medicine as distinct from physiology, was a systematic study of morbid anatomy.In the following passage he speaks of the great benefit that would ensue from the regular observation of the structural changes produced by disease:-In the same way that the dissection of healthy bodies is of the greatest importance for true scientific physiology, so the inspection of diseased bodies after death is no less necessary for scientific pathology.For physiology is the study of natural conditions, and must first be studied by physicians, inasmuch as what is normal is healthy, and the rule for its own rightness, as well as for every abnormal deviation there- from.But when deviations from health, or any abnormal conditions are defined by the light of healthy structures, then pathology, the science of disease, becomes intelligible.Then also from a knowledge of pathology the practice and art of healing, and numberless new methods of treatment, will naturally spring.No one would easily believe hlow greatly the viscera are altered by disease, particularly in chronic cases, and how extraordinary the ana- tomical effects of prolonged sickness often are.Indeed, I am confident that the opening and thorough inspection of one dead body, which has beeni wasted by slow disease or by infection, is of more real service to the art of healing than the dissection of ten corpses of healthy criminals.i
Case 40-1979
Authors: Richard C. Cabot, Robert E. Scully, James J. Galdabini, Betty U. McNeely, William C. Moloney, John C. Long
Journal: New England Journal of Medicine (1979)

Presentation of CaseA 70-year-old man was admitted to the hospital because of back pain.There was a remote history of hypertension, for which he had taken diazepam, alpha-methyldopa, hydrochlorothiazide, propranolol and triamterene. He was otherwise well until 11 months before admission, when exertional angina developed. Four months later he came to the hospital because of increasing pain in the chest. Examination revealed a dyspneic man with a blood pressure of 130/60 mm Hg. The general examination was negative; no lymphadenopathy was found, and the liver and spleen were not palpated. The urine was normal except for 15 red cells . . .
The pleura: with special reference to fibrothorax.
Authors: N R Barrett
Journal: Thorax (1970)

We have met to honour and to remember Arthur Tudor Edwards, who died after the Second World War and who devoted much of his professional life to the advancement of thoracic surgery.He lived and worked towards the end of an era when surgeons were 'prima donnas'.He was a man of handsome and commanding appear- ance: his convictions *were strong and to his friends he was a staunch
A Nutrition Paradox — Underweight and Obesity in Developing Countries
Authors: Benjamin Caballero
Journal: New England Journal of Medicine (2005)

A few years ago, I was visiting a primary care clinic in the slums of São Paulo. The waiting room was full of mothers with thin, stunted young children, exhibiting the typical signs of chronic undernutrition. Their appearance, sadly, would surprise few who visit poor urban areas in the developing world. What might come as a surprise is that many of the mothers holding those undernourished infants were themselves overweight.The combination of underweight in children and overweight in adults, frequently coexisting in the same family, is a relatively new phenomenon in developing countries undergoing the nutrition transition — the . . .
Distribution of Lipoproteins by Age and Gender in Adolescents
Authors: Courtney J. Jolliffe, Ian Janssen
Journal: Circulation (2006)

The current National Cholesterol Education Program lipoprotein classification system for children and adolescents is recommended for use among 2- to 19-year-olds. This classification system does not take into account gender differences or the natural fluctuations in lipoprotein concentrations that occur with growth and maturation.Data from the National Health and Nutrition Examination Surveys were used to develop age- and gender-specific thresholds that can be used to denote abnormal levels of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides. Each curve was linked to the adult National Cholesterol Education Program Adult Treatment Panel III lipoprotein thresholds using LMS (Lambda-Mu-Sigma) growth curve regression methods. A series of growth curves and tables are presented that can be used to diagnose high-risk lipoprotein levels in the clinical and research settings. For example, in 1-year increments for males starting at age 12 and extending to age 19 years, the high-risk thresholds for total cholesterol were 6.03, 5.83, 5.70, 5.70, 5.77, 5.88, 6.02, and 6.16 mmol/L. The corresponding high-risk threshold for adults (> or = 20 years) is 6.22 mmol/L.The present study is the first attempt at developing age- and gender-specific lipoprotein threshold concentrations for adolescents. This new classification system should provide a more accurate diagnosis of high-risk lipoprotein levels and associated cardiovascular risks in adolescents.
1053 TREATMENT WITH CLEVUDINE FOR 24 WEEKS RESULTS IN SUSTAINED ANTIVIRAL RESPONSE ASSOCIATED WITH CONTINUED HBsAg DECREASE 24 WEEKS POST-TREATMENT IN HBeAg-POSITIVE PATIENTS
Authors: J.H. Kim, B.C. Yoo, J.E. Yeon, B.I. Kim, W.K. Jeon, H.S. Kim, C.H. Lee, J.W. Lee, H.S. Kang, S.U. Lee, S. Lee, H. Park, D.Y. Kim, K.S. Lee, B.H. Kim, S.Y. Kwon, Yun Soo Kim, H.I. Lee, J.M. Yang, Young Seok Kim, H.S. Lee
Journal: Journal of Hepatology (2009)
Overall Diet History and Reversibility of the Metabolic Syndrome Over 5 Years
Authors: Tasnime N. Akbaraly, Archana Singh-Manoux, Adam G. Tabak, Markus Jokela, Marianna Virtanen, Jane E. Ferrie, Michael G. Marmot, Martin J. Shipley, Mika Kivimaki
Journal: Diabetes Care (2010)

OBJECTIVE We examined the impact of adherence to the Alternative Healthy Eating Index (AHEI), a set of dietary guidelines targeting major chronic diseases, on metabolic syndrome (MetS) reversion in a middle-aged population. RESEARCH DESIGN AND METHODS Analyses were carried out on the 339 participants (28% women, mean age 56.4 years) from the Whitehall II study with MetS as defined by the National Cholesterol Education Program Adult Treatment Panel III criteria. Reversion was defined as not having MetS after 5 years of follow-up (158 case subjects). RESULTS After controlling for potential confounders, adherence to AHEI was associated with MetS reversion (odds ratio 1.88 [95% CI 1.04–3.41]), predominantly in participants with central obesity and in those with high triglyceride. CONCLUSIONS Our findings support the benefit of adherence to AHEI dietary guidelines for individuals with MetS, especially those with central obesity or high triglyceride levels.
Representation of South Asian people in randomised trials: Population's ethnic profile should be recorded in all medical data
Authors: M. R D Johnson
Journal: BMJ (2003)

EDITOR—Mason et al provide hard evidence of a scandal many had suspected.1 So called institutional racism is operationalised by such processes. We needed their data for our paper, which was based on indirect measures.2

In the national research register (www.doh.gov.uk/research/nrr.htm) of over 1000 randomised controlled trials recorded, only nine referred to ethnic minority …
Treatment Matching in the Posthospital Care of Depressed Patients
Authors: Ivan W. Miller, Gabor I. Keitner, Christine E. Ryan, David A. Solomon, Esteban V. Cardemil, Christopher G. Beevers
Journal: American Journal of Psychiatry (2005)

OBJECTIVE: This study assessed the efficacy of 1) matching patients to treatments and 2) adding additional family therapy or cognitive therapy in a group of recently discharged patients with major depression. METHOD: Patients with major depression were recruited during a psychiatric hospitalization. After discharge, they were randomly assigned to one of four treatment conditions that were either "matched" or "mismatched" to their pattern of cognitive distortion and family impairment. The four treatment conditions were 1) pharmacotherapy alone; 2) combined pharmacotherapy and cognitive therapy; 3) combined pharmacotherapy and family therapy; and 4) combined pharmacotherapy, cognitive therapy, and family therapy. Randomly assigned treatment continued for 24 weeks on an outpatient basis. RESULTS: Among patients with at least moderate depressive symptoms at hospital discharge, low rates of remission (16%) and improvement (29%) were obtained. Matched treatment led to a significantly greater proportion of patients who improved and greater reductions over time in interviewer-rated depressive symptoms than mismatched treatment. However, matched treatment did not produce greater change in self-reported depression or interviewer-rated suicidal ideation. Treatment that included a family therapy component also led to a greater proportion of patients who improved and to significant reductions in interviewer-rated depression and suicidal ideation than treatment without family therapy. CONCLUSIONS: These results suggest that 1) current treatments are not very efficacious in the aftercare of hospitalized depressed patients, 2) treatment matching moderately improves outcome for patients who are symptomatic at hospital discharge, and 3) inclusion of family therapy improves the outcome of posthospital care for depressed patients.
Chloroquine-Resistant Falciparum Malaria
Authors: Maynard D. Poland
Journal: JAMA (1968)

To the Editor:—  It was with great interest I read the letters on chloroquine-resistant falciparum malaria ( 202 :989, 1967). Before returning to private practice, I was chief of medicine at an Army evacuation hospital in Vietnam for seven months. Having seen literally hundreds of patients with falciparum malaria, I am writing to support the statements of Blount, et al. The status of a falciparum malaria patient is difficult to evaluate, and postponing the use of quinine in these patients is quite dangerous when they have come from an area where resistant strains occur. Prior to the time when the urgent need for quinine in such cases was appreciated, I personally saw one patient go into blackwater fever before the drug was given.  It is mandatory that physicians in the United States understand that the early initiation of quinine will prevent far more disease complications than quinine itself will induce... when
Effects of prostaglandins PGE1, PGE2, PGF1alpha, and PGF2gamma on the synovial microcirculation.
Authors: D M Grennan, I J Zeitlin, W S Mitchell, W C Dick
Journal: Annals of the Rheumatic Diseases (1975)

Prostaglandins are now thought to be important mediators of the inflammatory response (Willis, 1969) and have been shown in increased amounts in the joints of experimentally induced arthritis in rabbits (Blackham and others, 1973) and in the synovial fluid of patients with rheumatoid arthritis (Levine, 1973).We considered the documentation of the effects of the various prostaglandins on synovial perfusion to be fundamental to further understanding of their role in joint disease and in this study we have in- vestigated the effects of prostaglandins El, E2, Fl, and F2 on synovial perfusion in the diarthrodial joints of 20 normal dogs.We have compared the effects of the pro- staglandins in our model with those of similar dose ranges ofbradykinin and serotonin.The animals were anaesthetized with a standard technique and blood pressure and blood gases were monitored throughout all experiments.Synovial perfusion Mean %change +2-1%
Carfilzomib in multiple myeloma patients with renal impairment: pharmacokinetics and safety
Authors: A Z Badros, R Vij, T Martin, J A Zonder, L Kunkel, Z Wang, S Lee, A F Wong, R Niesvizky
Journal: Leukemia (2013)

This phase 2 study assessed the safety, pharmacokinetics, pharmacodynamics and efficacy of carfilzomib, a selective proteasome inhibitor, in patients with multiple myeloma and varying degrees of renal impairment, including patients on chronic hemodialysis. Patients were grouped by creatinine clearance: >80 ml/min, 50–80 ml/min, 30–49 ml/min, <30 ml/min and chronic hemodialysis. Carfilzomib was administered on days 1, 2, 8, 9, 15 and 16 in 28-day cycles: 15 mg/m2 (Cycle 1), 20 mg/m2 (Cycle 2) and 27 mg/m2 (Cycles 3+). There were no differences in carfilzomib clearance or exposure among patients with normal renal function and any group with renal impairment. Grade 3/4 adverse events (AEs) included anemia (28.0%), thrombocytopenia (20.0%), lymphopenia (18.0%) and fatigue (14.0%). AEs were similar among groups. At 15 mg/m2, proteasome inhibition up to 85% was observed and did not differ among groups. Although nearly 50% of patients were refractory to both bortezomib and lenalidomide, end of study partial response or better (overall response rate) was 25.5% with 7.9 months median duration of response. In conclusion, the pharmacokinetics and safety of carfilzomib were not influenced by the degree of baseline renal impairment, including in patients on dialysis, and carfilzomib was well tolerated and demonstrated promising efficacy.
Atypical familial juvenile hyperuricemic nephropathy associated with a hepatocyte nuclear factor-1β gene mutation
Authors: Coralie Bingham, Sian Ellard, William G. van't Hoff, H. Anne Simmonds, Anthony M. Marinaki, Michael K. Badman, Peter H. Winocour, Amanda Stride, Christopher R. Lockwood, Anthony J. Nicholls, Katharine R. Owen, Ghislaine Spyer, Ewan R. Pearson, Andrew T. Hattersley
Journal: Kidney International (2003)
A rat decellularized small bowel scaffold that preserves villus-crypt architecture for intestinal regeneration
Authors: Giorgia Totonelli, Panagiotis Maghsoudlou, Massimo Garriboli, Johannes Riegler, Giuseppe Orlando, Alan J. Burns, Neil J. Sebire, Virpi V. Smith, Jonathan M. Fishman, Marco Ghionzoli, Mark Turmaine, Martin A. Birchall, Anthony Atala, Shay Soker, Mark F. Lythgoe, Alexander Seifalian, Agostino Pierro, Simon Eaton, Paolo De Coppi
Journal: Biomaterials (2012)

Management of intestinal failure remains a clinical challenge and total parenteral nutrition, intestinal elongation and/or transplantation are partial solutions. In this study, using a detergent-enzymatic treatment (DET), we optimize in rats a new protocol that creates a natural intestinal scaffold, as a base for developing functional intestinal tissue. After 1 cycle of DET, histological examination and SEM and TEM analyses showed removal of cellular elements with preservation of the native architecture and connective tissue components. Maintenance of biomechanical, adhesion and angiogenic properties were also demonstrated strengthen the idea that matrices obtained using DET may represent a valid support for intestinal regeneration.
The Medical Curriculum and Human Values
Authors: Casey Truett
Journal: JAMA (1969)

The student presentation before the Congress on Medical Education on "Medical Curriculum and Human Values" represented a radical change in student input. Originally, the student panel was designed to respond only to the faculty presentations. However, following the student confrontation before the Association of American Medical Colleges deans' meeting, it was appropriately decided that what the students had to say was more important. To facilitate the presentation, the subject was divided into four major parts, with each student presenting one part. Casey Truett began with an analysis of human values in present curriculum. Art Douville then indicated how concern over loss of human values in medical school was being transformed into activism. Bruce Fagel followed with a survey of student activism and a review of the present status of student programs in curricular reform. Merle Cunningham then concluded with a look toward the future and an appeal for cooperation from
A pathological inhibitor of fibrin cross-linking
Authors: L. Lorand, A. Jocobsen, Joyce Bruner-Lorand
Journal: Journal of Clinical Investigation (1968)

Lewis et al. recently reported on a patient who died of hemorrhages attributable to an acquired inhibitor of fibrin-stabilizing factor. They indicated that the inhibitor was associated with the immune globulins. Using the postmortem serum in the isolated fibrin cross-linking system, we have now further localized the site of inhibition in the scheme of blood coagulation. The interference occurs at the transpeptidation step catalyzed by the thrombin-activated fibrin-stabilizing factor. The patient's serum also uniquely delayed the clotting time of Homarus plasma, a test for specific inhibitors of transpeptidation. Since the inhibitor was effective in two such widely different systems, it probably is not an antibody, but falls into the category of cross-linking inhibitors which we have previously described (4, 5, 10, 12-17). While the exact nature of the inhibitor remains unknown, we raise the question whether some unusual metabolic transformation of isonicotinic acid hydrazide (with which the patient was treated and which itself we found to be a potent inhibitor fibrin cross-linking), in combination with a macromolecule, might not have given rise to an inhibitory compound.
Primary carcinoma of the trachea: mixed squamous and oat cell type.
Authors: P E Thornley, S R Howatson
Journal: Thorax (1980)

Primary carcinoma of the trachea is a rare neoplasm.In a combined multicentre series only two primary carcinomas of trachea were found in 47 600 nec- ropsies.1In 30 years at the Mayo Clinic 47 primary carcinomas of trachea were diagnosed.2These included 24 squamous carcinomas, which was the commonest histological type, but only two oat cell tumours.We report a case of primary carcinoma of trachea with an unusual mixed histological pattern of oat cell and squamous cell type.This mixed cellular pattern was also seen in varying proportions in metastases at different sites. Case reportThe patient, a 60-year-old man, had had increasing breathlessness on exertion for over six months, which eventually limited his walking to about 270 m on level * ; : < < -. . . .; .V .. ground.He had smoked 30 cigarettes daily for about 40 years and had chronic morning cough and sputum.Recently the cough had persisted during the day and, at night, was associated with paroxysms of breathless- ness.There had been streaky haemoptyses in his usual mucoid sputum for several weeks.He had lost 19 kg
Morphological, biochemical, and molecular biological characterization of a rat rhabdomyosarcoma cell line during differentiation induction in vitro.
Authors: C D Gerharz, J Doehmer, H Mayer, F Oesch, H Gabbert
Journal: Environmental Health Perspectives (1990)

BA-HAN-1C is a clonal rat rhabdomyosarcoma cell line consisting of proliferating mononuclear tumor cells, some of which spontaneously fuse to form terminally differentiated postmitotic myotubelike giant cells. Exposure to retinoic acid resulted in an inhibition of proliferation and a marked increase in cellular differentiation. The number of myotubelike giant cells significantly increased, and about 30% of the mononuclear tumor cells exhibited morphological features of rhabdomyogenic differentiation which were not observed in the mononuclear cells of untreated cultures. Morphological differentiation was paralleled by an increase in total creatine kinase activity as a biochemical marker of differentiation. These effects of retinoic acid were preceded by an increased expression of proto-oncogene raf and transient expression of proto-oncogene fos. The maximum level of fos expression was observed at 15 min and of raf at 12 hr after exposure to retinoic acid. No expression of the proto-oncogenes src, myb, myc, ros, mos, erbA, and erbB was detected.
The Augmentor Action of the Sympathetic Cardiac Nerves
Authors: WALTER C. RANDALL, WAYNE G. ROHSE
Journal: Circulation Research (1956)

An augmentor action of the cardiac sympathetic nerves is demonstrated to elicit profound elevations in systolic blood pressure. Diastolic pressure does not rise in an equivalent amount and significant increase in pulse pressure occurs. This persists for a considerable time after removal of the stimulation. During stimulation of the left cardiac sympathetic, an augmentor action is often not accompanied by acceleration. Stimulation of the right cardiac sympathetic evokes both effects. The elevation of blood pressure is chiefly produced by augmentation of ventricular beats, not by cardiac acceleration.
Role of Arousals in the Pathogenesis of Obstructive Sleep Apnea
Authors: Magdy Younes
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

Arousal is believed to be needed for upper airway opening in obstructive hypopneas–apneas, without compelling evidence to support this notion. The association may be incidental. I studied the temporal relation between arousal and opening and impact of arousal on flow response at opening in 82 patients (apnea–hypopnea index, 46 ± 35/hour). Obstructive apneas–hypopneas were induced by dial-down of continuous positive airway pressure. Obstructions and hypopneas occurred in 44 and 56% of dial-downs, respectively. When arousal occurred (83% of dial-downs), the temporal relation between arousal and opening was inconsistent between and within patients. Frequency of opening without or before arousal increased with milder obstructions (p < 10−9) and with delta power of EEG (p < 10−6). Time of opening was unaffected by whether arousal occurred before or after opening (18.0 ± 9.8 vs. 18.1 ± 10.5 seconds). Flow response was already excessive when opening occurred without or before arousal (180 ± 148% of initial flow decline) and was considerably higher when arousal occurred (267 ± 154%, p < 10−10). Flow undershoot after first ventilatory response was greater if arousal occurred (p < 0.01). It is concluded that arousals are incidental events that occur when thresholds for arousal and for arousal-independent opening are close. They are not needed to initiate opening or to obtain adequate flow and they likely increase the severity of the disorder by promoting greater ventilatory instability.