tbuckley/cabot-search huggingface dataset:
Anomalous Left Coronary Artery Arising from the Pulmonary Artery in an Adult
Authors: IVAN LIKAR, J. MICHAEL CRILEY, KENNETH B. LEWIS
Journal: Circulation (1966)

The 29-year-old woman with anomalous left coronary artery arising from the pulmonary trunk whose case is presented is at the time of writing, the oldest patient on record in whom this condition has been diagnosed during life. The diagnosis was made by aortic cineangiography and confirmed by selective injection of contrast material into the right coronary artery. The collateral pathways between the right and the anomalous left coronary artery were thus defined. Vectorcardiographic and electrocardiographic patterns of anterolateral myocardial infarction with periinfarction block have not been observed in any of the previously reported adults with this type of rare congenital anomaly. The 27 cases of ligation of the aberrant left coronary artery arising from the pulmonary artery reported in the literature have been reviewed and the results of this operation discussed. Diagnosis of the anomalous left coronary artery in adult life is possible if it is considered in patients presenting with a continuous murmur at the base and electrocardiographic evidence of myocardial infarction.
Normal Serum in Asthma
Authors: A. G. Auld
Journal: BMJ (1935)

The striatum integrates limbic and neocortical inputs to regulate sensorimotor and psychomotor behaviors. This function is dependent on the segregation of striatal projection neurons into anatomical and functional components, such as the striosome and matrix compartments. In the present study the association of ephrin-A cell surface ligands and EphA receptor tyrosine kinases (RTKs) with the organization of these compartments was determined in postnatal rats. Ephrin-A1 and ephrin-A4 selectively bind to EphA receptors on neurons restricted to the matrix compartment. Binding is absent from the striosomes, which were identified by μ-opioid receptor immunostaining. In contrast, ephrin-A2, ephrin-A3, and ephrin-A5 exhibit a different mosaic binding pattern that appears to define a subset of matrix neurons. <i>In situ</i> hybridization for EphA RTKs reveals that the two different ligand binding patterns strictly match the mRNA expression patterns of EphA4 and EphA7. Ligand–receptor binding assays indicate that ephrin-A1 and ephrin-A4 selectively bind EphA4 but not EphA7 in the lysates of striatal tissue. Conversely, ephrin-A2, ephrin-A3, and ephrin-A5 bind EphA7 but not EphA4. These observations implicate selective interactions between ephrin-A molecules and EphA RTKs as potential mechanisms for regulating the compartmental organization of the striatum.
The Economic Impact of the First 10,000 Cases of Acquired Immunodeficiency Syndrome in the United States
Authors: Ann M. Hardy
Journal: JAMA (1986)

Acquired immunodeficiency syndrome (AIDS) is a serious, fatal disease affecting a relatively young population and has a great economic impact. Expenditures for hospitalization and economic losses from disability and premature death were estimated for the first 10,000 patients with AIDS reported in the United States. Extrapolation of data from surveys done in New York City, Philadelphia, and San Francisco suggests that these 10,000 patients with AIDS will require an estimated 1.6 million days in the hospital, resulting in over $1.4 billion in expenditures. Losses incurred for the 8,387 years of work that will be lost from disability and from the premature death of the 10,000 patients will be over $4.8 billion. The total economic burden of the AIDS epidemic will continue to rise as the number of diagnosed cases increases. These estimates reinforce the need for effective disease prevention strategies to reduce the number of cases. (<i>JAMA</i>1986;255:209-211)
Human Polyomavirus Infections with JC Virus and BK Virus in Renal Transplant Patients
Authors: Thomas F. Hogan, Ernest C. Borden, J. A. McBAIN, B. L. Padgett, D. L. Walker
Journal: Annals of Internal Medicine (1980)

Infection with the human polyomaviruses JC virus and BK virus was studied in 61 immunosuppressed renal transplant patients. Urine cytologic studies, indirect immunofluorescence microscopy, electron microscopy, and serologic studies were used to assess viral activity. Patients records were abstracted for events associated with polyomavirus infections. Polyomavirus excretion in urine was detected in 12 of 61 patients (20%). Eleven excreted JC virus and nine, BK virus. Fourfold hemagglutination-inhibition antibody titer rises occurred in 25 of 61 patients (41%). The serologic data suggested that most JC virus infections were primary, whereas most BK virus infections resulted from virus reactivation. During this 2-year study, 32 of 61 patients (52%) had evidence of active viral replication. Urinary tract excretion was associated with drug-requiring diabetes mellitus (P = 0.001), arterial occlusive disease (P = 0.03), and ureteral stricture with loss of renal function (P = 0.02). Antibody increases to BK virus were associated with a rising serum creatinine (P = 0.02) and need for transplant biopsy (P = 0.02). Polyomavirus replication was therefore associated with an increased frequency of transplant related complications.
Preventive Strategies in Sexually Transmitted Diseases-Reply
Authors: John M. Douglas
Journal: JAMA (1988)

<h3>In Reply.</h3> —Condoms and their use in prevention of HIV infection are much in the news. Our recent<i>JAMA</i>article recommends the use of condoms as a preventive measure against HIV infection, in concurrence with the Surgeon General's recommendations.<sup>1</sup>Our recommendations are based on the demonstrated ability of latex condoms to prevent virus penetration in vitro<sup>2,3</sup>and the effectiveness of condoms in preventing other sexually transmitted diseases such as gonorrhea and nongonococcal urethritis. Unfortunately, the lay press chose to imply in a widely circulated article (<i>Los Angeles Times</i>, Aug 18, 1987, p 1) that condoms might be ineffective in preventing HIV infection. There is no evidence to suggest that this is the case. Properly randomized controlled trials of condom use in preventing HIV infection have not been and probably will not be performed because of practical and ethical considerations. The absence of data from such trials led to
Malaria: Are We Prepared?
Authors: Charles B. Clayman
Journal: JAMA (1981)

<i>Plasmodium falciparum</i>resistant to chloroquine sulfate has now been documented in two nonimmune travelers exposed in Tanzania and Kenya. Symptoms of malaria developed after their return to the United States. Laboratory studies confirming prior ingestion of chloroquine and showing resistance of the parasites to chloroquine in vitro provide key elements of the documentation. This work adds to the data establishing the presence of chloroquine-resistant<i>P falciparum</i>in Africa. Areas of the world from which chloroquine-resistant<i>P falciparum</i>has been reported now include Kenya, Tanzania, Nigeria, and Ivory Coast in Africa; Brazil, Colombia, Ecuador, French Guiana, Guyana, Panama, Surinam, and Venezuela in the Americas; and Bangladesh, Democratic Kampuchea, India, Indonesia, Laos, Malaysia, Papua New Guinea, the Philippines, Thailand, and Vietnam in Asia. Chloroquine-resistant<i>P falciparum</i>is prevalent throughout malarious areas in some countries such as Thailand; in others it has been documented or reported either sporadically or only in certain parts
Safe Sex for Men With Coronary Artery Disease
Authors: Thomas H. Marwick
Journal: JAMA (2002)

ILDENAFIL HAS BEEN IN WIDESPREAD USE FOR 3 YEARS, but concerns persist regarding its safety in patients with a history of cardiac disease. Major adverse effects, including myocardial infarction and death, have been recorded in case reports and postmarketing surveillance. 1 However, questions have been raised regarding the accuracy of these reports, the potential for reporting bias, and whether the number of reported events exceeds that expected in a population of this age. 2 The central issue is to what extent these adverse events reflect a risk from the drug and to what extent they reflect the risks of physical activity in patients with coronary artery disease. The study by Arruda-Olson and colleagues 3 in this issue of THE JOURNAL suggests that the cardiovascular effects of sildenafil are limited, even in patients with coronary artery disease. In an elegant study using a crossover design, the authors evaluated 105 men with known or suspected coronary disease who underwent exercise echocardiography an hour after receiving placebo or 50 or 100 mg of sildenafil. The hemodynamic effects of the drug included an average systolic blood pressure reduction of 7 mm Hg compared with baseline, with no difference in exercise capacity or hemodynamic response to exercise while patients were receiving sildenafil. These effects are consistent with the reported decrease of less than 10 mm Hg in resting systolic blood pressure in healthy individuals at peak plasma levels, about an hour after sildenafil administration. 4,5 In patients with stable ischemic heart disease, intravenous doses of sildenafil provoked a similar decrease in systolic blood pressure at rest and after exercise. 4,6 Dramatic decreases in blood pressure may occur with administration of nitrates within 24 hours of taking sildenafil, and the combination is therefore contraindicated. 7
Pharmacokinetic interaction between the hepatitis C virus protease inhibitor boceprevir and cyclosporine and tacrolimus in healthy volunteers
Authors: Ellen Hulskotte, Samir Gupta, Fengjuan Xuan, Marga van Zutven, Edward O'Mara, Hwa-Ping Feng, John Wagner, Joan Butterton
Journal: Hepatology (2012)

The hepatitis C virus protease inhibitor boceprevir is a strong inhibitor of cytochrome P450 3A4 and 3A5 (CYP3A4/5). Cyclosporine and tacrolimus are calcineurin inhibitor immunosuppressants used to prevent organ rejection after liver transplantation; both are substrates of CYP3A4. This two-part pharmacokinetic interaction study evaluated boceprevir with cyclosporine (part 1) and tacrolimus (part 2). In part 1, 10 subjects received single-dose cyclosporine (100 mg) on day 1, single-dose boceprevir (800 mg) on day 3, and concomitant cyclosporine/boceprevir on day 4. After washout, subjects received boceprevir (800 mg three times a day) for 7 days plus single-dose cyclosporine (100 mg) on day 6. In part 2A, 12 subjects received single-dose tacrolimus (0.5 mg). After washout, they received boceprevir (800 mg three times a day) for 11 days plus single-dose tacrolimus (0.5 mg) on day 6. In part 2B, 10 subjects received single-dose boceprevir (800 mg) and 24 hours later received boceprevir (800 mg) plus tacrolimus (0.5 mg). Coadministration of boceprevir with cyclosporine/tacrolimus was well tolerated. Concomitant boceprevir increased the area under the concentration-time curve from time 0 to infinity after single dosing (AUC(inf) ) and maximum observed plasma (or blood) concentration (C(max) ) of cyclosporine with geometric mean ratios (GMRs) (90% confidence interval [CI]) of 2.7 (2.4-3.1) and 2.0 (1.7-2.4), respectively. Concomitant boceprevir increased the AUC(inf) and C(max) of tacrolimus with GMRs (90% CI) of 17 (14-21) and 9.9 (8.0-12), respectively. Neither cyclosporine nor tacrolimus coadministration had a meaningful effect on boceprevir pharmacokinetics.Dose adjustments of cyclosporine should be anticipated when administered with boceprevir, guided by close monitoring of cyclosporine blood concentrations and frequent assessments of renal function and cyclosporine-related side effects. Administration of boceprevir plus tacrolimus requires significant dose reduction and prolongation of the dosing interval for tacrolimus, with close monitoring of tacrolimus blood concentrations and frequent assessments of renal function and tacrolimus-related side effects.
Disabled people face difficulties in accessing primary care
Authors: Andrew Cole
Journal: BMJ (2006)

People with mental health problems or learning disabilities have worse physical health and die younger than the general population, concludes a major investigation by the Disability Rights Commission of Great Britain. But they are less likely to get treatment, and most face difficulty in getting to see their GP.

The commission—the statutory watchdog body for disabled people in England, Wales, and Scotland—has warned that if these discriminatory practices are not eradicated the government could face prosecution under the new disability equality …
Big pharma often commits corporate crime, and this must be stopped
Authors: P. C. Gotzsche
Journal: BMJ (2012)

When a drug company commits a serious crime, the standard response from the industry is that there are bad apples in any enterprise. Sure, but the interesting question is whether drug companies routinely break the law.

I googled the names of the 10 largest drug companies in combination with the term “fraud” and looked for offences on the first page for each company. The most common recent crimes were illegal marketing by recommending drugs for non-approved (off label) uses, misrepresentation of research results, hiding data on harms, and Medicaid and Medicare fraud.1 All cases were related to the United States and involved huge settlements or fines, exceeding $1bn (£620.6m; €769m) each for four companies.

It was easy to find additional crimes committed by these same companies and committed outside the US.1 As the crimes were widespread and repetitive, they are probably committed deliberately—because crime pays. Pfizer, for example, agreed in 2009 to pay $430m to resolve charges related to illegal marketing of gabapentin (Neurontin), but as sales were $2.7bn in 2003 alone, and as about 90% was for off label use, such …
Histamine H2 Receptor-Antagonists
Authors: Samuel Vaisrub
Journal: JAMA (1976)

Histamine H 2 receptor-antagonists—burimamide, metiamide, cimetidine—are currently arousing much anticipatory excitement. The relatively recent concept that there is more than one receptor for histamine is based on the observation that pyrilamine (mepyramine) and other, older antihistamines have no effect on histamine-mediated secretion of gastric acid or on the heart rate. Intrigued by this observation and mindful of the analogous situation that existed in the field of catecholamines before adrenergic receptors were shown to be of two kinds (α and β), Black and his colleagues 1 in 1964 began to synthesize and test potential inhibitors of another histamine receptor that may be involved in pyrilamine-insensitive responses. Their work culminated in precise definition of the pyrilamine-sensitive H 1 and pyrilamine-insensitive H 2 receptors and in the synthesis of burimamide, 1 the first of the synthetic H 2 receptor-antagonists.  Burimamide, which is more effective intravenously than orally, and the subsequently synthesized metiamide and
Poor performers in general practice will be targeted, new inspector tells conference
Authors: G. Iacobucci
Journal: BMJ (2013)

The newly appointed chief inspector of general practice in England has pledged to expose examples of poor care in the system, claiming that primary care has tolerated underperformers “for too long.”

Steve Field, a GP in Birmingham who was appointed to the new role with the healthcare regulator the Care Quality Commission in August, said that he wanted to tackle “great variation” in standards of primary care. But he maintained that general practice in England was “among the best in the world.”

Speaking to delegates at the National Association of Primary Care’s Best Practice 2013 conference in Birmingham, Field said that the CQC was aiming to recruit a raft of GPs to lead its revamped …
Short term use of HRT increases risk of ovarian cancer, analysis finds
Authors: Z. Kmietowicz
Journal: BMJ (2015)

Women who take hormone replacement therapy (HRT) even for a few years are 40% more likely to develop two of the most common types of ovarian cancer than women who have never taken HRT, an analysis of data from epidemiological studies has found.

A coauthor of the study, Richard Peto, of the University of Oxford in the United Kingdom, said, “For women who take HRT for five years from around age 50, there will be about one extra ovarian cancer for every 1000 users and one extra ovarian cancer death for every 1700 …
Five-Year Outcomes Following Psychiatric Consultation to a Tertiary Care Emergency Room
Authors: Michael T. Lambert, James P. LePage, Andrew L. Schmitt
Journal: American Journal of Psychiatry (2003)

OBJECTIVE: The authors prospectively examined inpatient psychiatric hospitalization and mortality rates of psychiatric patients seen in the emergency room of a large Department of Veterans Affairs medical center. METHOD: Charts of 504 patients receiving evening psychiatric consultation during a 13-month period were assessed 5 years after the consultation to determine rates of psychiatric hospitalization and mortality. RESULTS: Patients with multiple psychiatric diagnoses, including comorbid addiction disorders, had significantly higher rates of psychiatric hospitalization 5 years after an emergency room visit. Comorbid psychiatric disorders increased the rate of inpatient psychiatric hospitalization across diagnoses. Seventy-eight patients died during the study period. CONCLUSIONS: These findings reveal relationships between diagnostic profiles and future psychiatric hospitalization and mortality rates. This information could focus psychiatric and medical interventions for high-risk patients.
Leiomyosarcoma: A Diagnostic Challenge
Authors: Abba A. Messe
Journal: JAMA (1960)

In this series of nine cases of abdominal leiomyosarcoma not involving the uterus, the clinical picture varied markedly. The most common features were gastrointestinal bleeding, the presence of a palpable mass, and the finding of anemia. In no case was a definite diagnosis made before operation. In only three of the nine cases was the diagnosis made with reasonable certainty at the time of operation. The finding of a nontender, large, smooth, or lobulated abdominal mass suggests leiomyosarcoma. Roentgenograms may show an intramural extramucosal tumor or a sinus tract leading outside the intestine, but there is no single characteristic roentgenographic appearance.
<scp>EAACI</scp> consensus statement for investigation of work‐related asthma in non‐specialized centres
Authors: G. Moscato, G. Pala, C. Barnig, F. De Blay, S. R. Del Giacco, I. Folletti, E. Heffler, P. Maestrelli, G. Pauli, L. Perfetti, S. Quirce, J. Sastre, A. Siracusa, J. Walusiak‐Skorupa, R. Gerth van Wjik
Journal: Allergy (2012)

Abstract Work‐related asthma ( WRA ) is a relevant problem in several countries, is cause of disability and socioeconomic consequences for both the patient and the society and is probably still underdiagnosed. A correct diagnosis is extremely important to reduce or limit the consequences of the disease. This consensus document was prepared by a EAACI T ask F orce consisting of an expert panel of allergologists, pneumologists and occupational physicians from different E uropean countries. This document is not intended to address in detail the full diagnostic work‐up of WRA , nor to be a formal evidence‐based guideline. It is written to provide an operative protocol to allergologists and physicians dealing with asthma useful for identifying the subjects suspected of having WRA to address them to in‐depth investigations in a specialized centre. No evidence‐based system could be used because of the low grade of evidence of published studies in this area, and instead, ‘key messages’ or ‘suggestions’ are provided based on consensus of the expert panel members.
Response from Hepatitis C Trust, BASL, BIA, BVHG, BSG, and BHIVA to article asking whether widespread screening for hepatitis C is justified
Authors: G. R. Foster, C. Gore, M. Hudson, P. Moss, A. Ustianowski, S. Ryder, S. Bhagani
Journal: BMJ (2015)

Koretz and colleagues argue that hepatitis C virus (HCV) screening should be delayed.1 We disagree. HCV transmission was common in the 1960s-80s, and because mortality occurs 30-40 years after infection deaths will rise exponentially over the next decade.2 Delaying effective intervention will have a massive impact. The authors argue that because a community study showed an increase in liver and non-liver mortality most infected people will not die from HCV. Infection can cause or exacerbate renal disease, diabetes, and dyslipidaemia and treatment reduces all cause mortality,3 indicating that both liver and non-liver related deaths are caused by …
Diagnostic and therapeutic assessment by telephone electrocardiographic monitoring of ambulatory patients.
Authors: Y Hasin, D David, S Rogel
Journal: BMJ (1976)

The electrocardiograms of ambulatory patients have been monitored over the telephone by staff of the intensive cardiac care unit using equipment in the unit. Telephone monitoring is a useful way of diagnosing transient symptomatic arrhythmias and a reliable aid in supervising the patient's rhythm at the beginning or end of treatment. The doctor has direct contact with the patient at the time of his symptoms so that he can reassure or instruct him. This system costs relatively little in manpower and equipment and permits relatively long periods of follow-up. It is effective, however, only in symptomatic cases in which the rate or rhythm disturbances last long enough to be transmitted. Also important are the negative findings when the patient complains of symptoms and abnormal findings during routine telephone transmissions. Accurate detection of transient ischaemic changes seems to be less reliable, and further technical improvements are required.
Is ego depletion too incredible? Evidence for the overestimation of the depletion effect
Authors: Evan C. Carter, Michael E. McCullough
Journal: Behavioral and Brain Sciences (2013)

The depletion effect, a decreased capacity for self-control following previous acts of self-control, is thought to result from a lack of necessary psychological/physical resources (i.e., "ego depletion"). Kurzban et al. present an alternative explanation for depletion; but based on statistical techniques that evaluate and adjust for publication bias, we question whether depletion is a real phenomenon in need of explanation.
Carcinoma of Head of Pancreas with Spread to Local Lymph Nodes
Authors: Arthur O. Weber
Journal: JAMA (1963)

FIVE-YEAR SURVIVAL of patients with carcinoma of the head of the pancreas is sufficiently rare to appear to justify this report of a single case. Whipple and associates<sup>1</sup>first described a successful two-stage pancreaticoduodenal resection for carcinoma of the ampulla of Vater in 1935. As late as 1949, 14 years after Whipple's report and only 15 years ago, Cattell and Pyrtek<sup>2</sup>reviewed 60 cases of pancreaticoduodenectomy and reported: "It must be admitted that no patient has yet been cured or lived five years or more." The first case of 5-year survival in carcinoma of the head of the pancreas was reported by Miller and Claggett in 1951.<sup>3</sup>A review of the literature by Orr,<sup>4</sup>in 1952, on patients surviving 5 or more years showed only four cases; in 1956, by Dennis and Varco,<sup>5</sup>a total of 12 cases; and as late as 1959, by Tender
1138-44 Platelet glycoprotein IIIa genotype is not a risk factor for target vessel revascularization following percutaneous coronary intervention
Authors: Laxmi S Mehta, Kimberly A Skelding, Demetri Demetrious, Mark Emerick, Judith Boura, James A Goldstein, William W O'Neill
Journal: Journal of the American College of Cardiology (2004)