tbuckley/cabot-search huggingface dataset:
Anticoagulant drugs in the elderly: valuable in selected patients.
Authors: G. D. Lowe
Journal: BMJ (1988)

Anticoagulant drugs in the elderly: valuable in selected patients G D O Lowe Taken together, venous and arterial thromboembolism form the commonest causes of death, admission to hospital, and physical disability in the second half of life.Their incidence, prevalence, and mortality all increase steeply with age.The mechanisms are not known but may include changes related to age, such as increased concentrations of clotting factors,' increased activation of coagulation and platelets,2 decreased fibrinolytic activity,' increased immobility and venous stasis in the case of venous thrombosis, increased atherosclerosis in the case of arterial thrombosis, and increased frequency of atrial fibrillation in the case of arterial embolism.As fibrin is an important component of both venous and arterial thrombi and emboli, anticoagulant drugs, which reduce the formation of fibrin, should be effective in prevention and treatment.Although heparin and oral anticoagulant drugs have been used for over 40 years, proof has been slow in coming owing to the historical inability of doctors to perform adequately controlled trials,' as with many other treatments.Evidence is, however, increasing that anticoagulant drugs are indeed effective in preventing both venous and arterial thromboembolism, thereby reducing both morbidity and mortality.' 3-11 Low doses of anticoagulant treatment in preventing venous thromboembolismThe prevention of venous thromboembolism in elderly patients is important not only because of their high risk but also because of the increased difficulty in diagnosing pulmonary embolism before death.Fewer than 10% of patients aged over 70 with fatal pulmonary Effect on venous thromboembolism and mortality ofprophylactic low doses ofheparin (5000 units every eight to 12 hours subcutaneously) in surgical and general medical trials and acute stroke.Values are incidences (percentages) unless stated otherwise Group given Control Percentage odds Complication heparin group difference (SD) p Value Surgical trials'* Deep vein thrombosis 9 22
Varicella Vaccine — The First Six Years
Authors: Ann M. Arvin
Journal: New England Journal of Medicine (2001)

The live attenuated varicella vaccine is the only vaccine licensed for the prevention of a disease caused by a human herpesvirus. The origin of the vaccine can be traced back to 1952, when Weller and Stoddard recovered varicella–zoster virus by cell culture and reported the first successful propagation of a herpesvirus in vitro.1 In 1974, Takahashi and colleagues attenuated the wild-type Oka strain by serial passage in guinea-pig and human cells, while preserving its immunogenicity after subcutaneous inoculation.2 Clinical trials of varicella vaccine were initiated in the United States in 1980, leading to approval by the Food and Drug Administration . . .
Feasibility of Insulin-Glucose Infusion in Diabetic Patients With Acute Myocardial Infarction: A report from the multicenter trial: DIGAMI
Authors: Klas A Malmberg, Suad Efendic, Lars E Rydén
Journal: Diabetes Care (1994)

OBJECTIVE To investigate the effect of insulin-glucose infusion on metabolic control and hypoglycemie episodes and its feasibility and safety in patients with diabetes and myocardial infarction (MI) compared with conventional treatment. RESEARCH DESIGN AND METHODS Of 327 patients with suspected acute MI, 158 were randomized to insulin-glucose infusion for at least 24 h and 169 received conventional therapy. We determined the 24-h blood glucose profile in the infusion group, the degree of metabolic control, hypoglycemie events, and in-hospital complications within the two study groups. RESULTS Blood glucose fell from 14.6 ± 2.9 to 9.2 ± 2.9 mM during the first 24 h in patients receiving insulin-glucose and from 15.8 ± 4.3 to 12.0 ± 4.4 mM in control patients (P &amp;lt; 0.01). Serum potassium decreased 0.21 ± 0.56 mM in the infusion group (P &amp;lt; 0.001) and 0.11 ± 0.59 mM in the control group (P &amp;lt; 0.05). The difference between the groups was not significant. Twenty-eight of the 158 patients developed an episode of hypoglycemia (blood glucose &amp;lt; 3.0 mM) during the insulin-glucose infusion. There were no significant differences in the number of episodes of ventricular tachyarrhythmias or in ischemie events between patients with and without hypoglycemia. CONCLUSIONS The protocol outlined in this study gives more rapid and better metabolic control than does conventional treatment. This treatment seems to be a feasible alternative for clinical attempts. Before it can be recommended for general use, the impact on mortality needs to be evaluated.
Influence of an Oscillating Bed on Cutaneous Temperature and Oxygen Tension of Ischemic Toes
Authors: CARLOS FORNO, HUGH MONTGOMERY, ORVILLE HORWITZ
Journal: Circulation (1958)

Measurements of temperature and oxygen tension of the skin demonstrated that treatment with an oscillating bed increases the circulation to ischemic toes. When the angle and duration of the dependent position of the foot of the bed were increased, further increments in circulation resulted.
An unusual finding on a pelvic radiograph
Authors: L. Manikam, P. J. Richards, T. Jordan
Journal: BMJ (2012)

A 74 year old man presented to the ear, nose, and throat department with breathlessness on exertion, intermittent voice hoarseness, and a sensation of catarrh in his throat. After a laryngoscopy with biopsy was performed, he was diagnosed as having a low grade chondrosarcoma of the larynx. Before surgical debulking of the lesion was carried out he underwent computed tomography of the chest, abdomen, and pelvis. This confirmed the presence of a subglottic mass in the larynx but also showed a mixed lytic and sclerotic expansile lesion (5.8 cm (longitudinal)×1.6 cm (axial)×4.5 cm) in the left iliac blade of the pelvis. The pelvic lesion was well corticated, with internal ossified septae and calcification. Expansion of the left iliac wing was noted, with no breach in the cortex.

He had no symptoms other than those that he presented with, which resolved after surgical debulking of the chondrosarcoma. He denied any pain and was independently mobile with a normal gait.

He had never smoked and drank less than 7 units of alcohol a week. He had no comorbidities and was not taking any drugs. All blood results and a chest radiograph were normal.

A plain radiograph of the pelvis was taken to help characterise the pelvic lesion. This showed a solitary well corticated lesion in the left iliac bone. There was evidence of ossification within the lesion but an absence of periostitis (figure⇓). Calcification of the lesion, endosteal scalloping, and expansion of …
The Evolution of Ty1-copia Group Retrotransposons in Gymnosperms
Authors: Caroline Stuart-Rogers, Andrew J. Flavell
Journal: Molecular Biology and Evolution (2001)

A diverse collection of Ty1-copia group retrotransposons has been characterized from the genome of Picea abies (Norway spruce) by degenerate PCR amplification of a region of the reverse transcriptase gene. The occurrence of these retrotransposable elements in the gymnosperms was investigated by Southern blot hybridization analysis. The distribution of the different retrotransposons across the gymnosperms varies greatly. All of the retrotransposon clones isolated are highly conserved within the Picea (spruce) genus, many are also present in Pinus (pine) and/or Abies (fir) genera, and some share strongly homologous sequences with one or more of cedar, larch, Sequoia, cypress, and Ginkgo. Further subclones of one of the most strongly conserved retrotransposon sequences, Tpa28, were obtained from Ginkgo and P. abies. Comparisons of individual sequence pairs between the two species show nucleotide cross-homologies of around 80%–85%, corresponding to nucleotide substitution rates similar to those of nuclear protein-coding genes. Analysis of Tpa28 consensus sequences reveals that strong purifying selection has acted on this retrotransposon in the lineages connecting Ginkgo and Picea. Collectively, these data suggest, first, that the evolution of the Ty1-copia retrotransposon group in the gymnosperms is dominated by germ line vertical transmission, with strong selection for reverse transcriptase sequence, and, second, that extinction of individual retrotransposon types has been comparatively rare in gymnosperm species lineages compared with angiosperms. If this very high level of sequence conservation is a general property of the retrotransposons, then their extreme sequence diversity implies that they are extremely ancient, and the major element lineages seen today may have arisen early in eukaryote evolution. The data are also consistent with horizontal transmission of particular retrotransposons between species, but such a mechanism is unnecessary to explain the results.
Pearson marrow pancreas syndrome in patients suspected to have Diamond-Blackfan anemia
Authors: Katelyn E. Gagne, Roxanne Ghazvinian, Daniel Yuan, Rebecca L. Zon, Kelsie Storm, Magdalena Mazur-Popinska, Laura Andolina, Halina Bubala, Sydonia Golebiowska, Meghan A. Higman, Krzysztof Kalwak, Peter Kurre, Michal Matysiak, Edyta Niewiadomska, Salley Pels, Mary Jane Petruzzi, Aneta Pobudejska-Pieniazek, Tomasz Szczepanski, Mark D. Fleming, Hanna T. Gazda, Suneet Agarwal
Journal: Blood (2014)
Hyaluronan Synthase HAS2 Promotes Tumor Progression in Bone by Stimulating the Interaction of Breast Cancer Stem–Like Cells with Macrophages and Stromal Cells
Authors: Hiroshi Okuda, Aya Kobayashi, Bo Xia, Misako Watabe, Sudha K. Pai, Shigeru Hirota, Fei Xing, Wen Liu, Puspa R. Pandey, Koji Fukuda, Vishnu Modur, Arnab Ghosh, Andrew Wilber, Kounosuke Watabe
Journal: Cancer Research (2011)

The molecular mechanisms that operate within the organ microenvironment to support metastatic progression remain unclear. Here, we report that upregulation of hyaluronan synthase 2 (HAS2) occurs in highly metastatic breast cancer stem-like cells (CSC) defined by CD44(+)/CD24(-)/ESA(+) phenotype, where it plays a critical role in the generation of a prometastatic microenvironment in breast cancer. HAS2 was critical for the interaction of CSCs with tumor-associated macrophages (TAM), leading to enhanced secretion of platelet-derived growth factor-BB from TAMs, which then activated stromal cells and enhanced CSC self-renewal. Loss of HAS2 in CSCs or treatment with 4-methylumbelliferone, an inhibitor of HAS, which blocks hyaluronan production, drastically reduced the incidence and growth of metastatic lesions in vitro or in vivo, respectively. Taken together, our findings show a critical role of HAS2 in the development of a prometastatic microenvironment and suggest that HAS2 inhibitors can act as antimetastatic agents that disrupt a paracrine growth factor loop within this microenvironment.
Germline mutations in TMEM127 confer susceptibility to pheochromocytoma
Authors: Yuejuan Qin, Li Yao, Elizabeth E King, Kalyan Buddavarapu, Romina E Lenci, E Sandra Chocron, James D Lechleiter, Meghan Sass, Neil Aronin, Francesca Schiavi, Francesca Boaretto, Giuseppe Opocher, Rodrigo A Toledo, Sergio P A Toledo, Charles Stiles, Ricardo C T Aguiar, Patricia L M Dahia
Journal: Nature Genetics (2010)
An Appreciation of Isaac Starr
Authors: Eugene A. Stead
Journal: New England Journal of Medicine (1979)

In 1978, the University of Pennsylvania held a symposium in honor of Isaac Starr. The university managed the affair with the poise and dignity characteristic of an honorable and distinguished institution. In events honoring great men, whether they are symposia or ceremonies to confer honorary degrees, our oldest universities have something to teach us younger fry.The papers presented there have now been published in a book entitled "Heart Failure," edited by Alfred Fishman (Hemisphere Publishing Corp., Washington, D.C.). The topics range from observations on the contractile mechanisms in cardiac muscle to the current status of cardiac transplantation, and the . . .
Reply from Authors re: Andrew J. Vickers, Hans Lilja. PSA Is Dead, Long Live PSA. Eur Urol 2012;61:467–8
Authors: Giorgio Guazzoni, Massimo Lazzeri, Luciano Nava, Giovanni Lughezzani, Alessandro Larcher, Vincenzo Scattoni, Giulio Maria Gadda, Vittorio Bini, Andrea Cestari, Nicolò Maria Buffi, Massimo Freschi, Patrizio Rigatti, Francesco Montorsi
Journal: European Urology (2011)
Management of Heart Failure
Authors: Kathleen Dracup
Journal: JAMA (1994)

This article reviews the role of counseling, education, dietary modifications, and exercise for patients with heart failure due to left ventricular systolic dysfunction.We reviewed studies published in English between 1966 and 1993 and referenced in MEDLINE or EMBASE. We used the search terms heart failure, congestive; congestive heart failure; heart failure; cardiac failure; and dilated cardiomyopathy in conjunction with terms for the specific areas of interest. Where data were lacking, we relied on opinions of panel members and peer reviewers. STUDY SELECTION AND DATA SYNTHESIS: Studies were reviewed to determine whether patients had heart failure due to systolic dysfunction (left ventricular ejection fraction, < 0.35 to 0.40) and whether clinical outcomes were reported. Studies that reported only intermediate outcomes (eg, hemodynamics) were not reviewed.Counseling and education can improve patient outcomes and decrease unnecessary hospitalizations. Patients with mild to moderate heart failure should be restricted to 3 g/d of sodium initially. Those who are unresponsive to this dosage or who have more severe disease should be advised to consume 2 g/d or less. Patients should be strongly advised to drink no more than 30 mL/d of alcohol or, preferably, to abstain completely. Exercise training is safe and can improve exercise duration and symptoms. Adherence to the treatment plan should be stressed and monitored at each visit. Clinicians should inform patients of the seriousness of their disease and their prognosis, but they should emphasize that patients can continue to remain active and enjoy a reasonable quality of life.
Sleep Deprivation and Performance of Residents
Authors: Mark W. Burlingame
Journal: JAMA (1989)

<h3>To the Editor. —</h3> In the recent study of Deaconson et al<sup>1</sup>entitled "Sleep Deprivation and Resident Performance," there seem to be major flaws in the design of the study. The authors state that performance was measured "close to the presumed nadir" and when "impaired performance was likely to be identified." I suggest that performance was measured at the presumed<i>zenith</i>and that the lack of significant difference in performance between study groups is not surprising. Daily testing took place between 6 AM and 8 AM, the earliest time following periods of rest, no matter how long or short. This is the time of day during which residents are nearing the zenith of performance: the time at which they are most rested. This flaw is further supported by the authors themselves, who noted no statistical difference in motivation or fatigue between the study groups. It is also erroneous to
Pimecrolimus does not affect Langerhans cells in murine epidermis
Authors: J.G. Meingassner, E. Kowalsky, H. Schwendinger, A. Elbe-Burger, A. Stutz
Journal: British Journal of Dermatology (2003)

Langerhans cells (LCs) function as specialized antigen-presenting cells in the epidermis, and therefore play a critical role in cutaneous immunological reactions. Topical treatment with corticosteroids is associated with a decrease in epidermal LC number and antigen-presenting capacity in laboratory animals and humans.To examine whether pimecrolimus, a nonsteroidal inflammatory cytokine inhibitor recently introduced for the topical treatment of atopic dermatitis, differs from corticosteroids in effects on LCs.Groups of BALB/c mice were treated twice daily on one to five consecutive days on the inner surface of the right ear with 10 micro L of ethanolic solutions of the test compounds at their clinically used concentrations (1% pimecrolimus, 0.1% betamethasone-17-valerate, 1% hydrocortisone and 0.05% clobetasol propionate) or with the vehicle (controls) alone. At selected time points after the treatment epidermal sheets were prepared and examined histomorphometrically for LCs immunolabelled with antibodies to major histocompatibility complex (MHC) class II and DEC 205, and adenosine diphosphatase staining.No changes in number or morphology of LCs were observed in epidermal sheets of mice treated for 5 days with pimecrolimus. In contrast, an almost complete depletion of LCs was observed in skin samples treated with hydrocortisone, betamethasone or clobetasol. Even a single-day treatment schedule with hydrocortisone, betamethasone or clobetasol caused a significant reduction in MHC class II+ LCs, by 31%, 62% and 87%, respectively.It is therefore unlikely that topically applied pimecrolimus affects epidermal LCs, in contrast to corticosteroids.
The effect of a histamine synthesis inhibitor on the immediate nasal allergic reaction
Authors: U. Pipkorn, G. Granerus, D. Proud, A. Kagey‐Sobotka, P. S. Norman, L. M. Lichtenstein, R. M. Naclerio
Journal: Allergy (1987)

We studied the effect of α‐fluoromethyl histidine, an irreversible histamine synthesis inhibitor, on the immediate nasal reaction to antigen challenge in a double‐blind, placebo controlled, randomized, parallel study using 13 subjects. The patients received either active drug 100 mg twice daily or placebo, for 3 weeks. A nasal allergen challenge was performed before and after at weekly intervals. Symptoms at challenge were assessed and the levels of histamine, TAME‐esterase activity and kinins were measured in nasal lavages before and after antigen challenge. Skin tests were also performed at weekly intervals. In addition, the urinary excretion of the main histamine metabolite, tele‐methylimidazole acetic acid, was measured before and after 3 weeks of treatment. The active treatment induced 60 % reduction in histamine levels in the lavage fluids before and after antigen challenge, as well as a reduction in the histamine levels in the lavage fluids before and after antigen challenge, as well as a reduction in the main urinary histamine metabolite. However, no reduction was found in nasal symptoms obtained after antigen challenge. The levels of kinins and TAME‐esterase activity were not significantly reduced.
Hot tub <i>Legionella</i> pneumonia outbreak
Authors: Maryam Ahmed, Naveed Mustfa
Journal: European Respiratory Journal (2014)

provision of affordable anti-inflammatory inhaler therapies and improved care of asthma in general.We are supportive of this categorisation of severe asthma within the WHO definition.The ERS/ATS definition identifies the group of patients encompassed by categories 1 and 3. We see the ERS/ ATS guidelines as entirely complementary to the WHO document focusing on these two categories, particularly treatment-resistant severe asthma, where approaches to phenotyping and targeted novel therapies will be needed, once the issue of untreated asthma at the individual level has been excluded.We thank J. Bousquet and colleagues for giving us the opportunity to clarify these issues.
Blackwell's Primary Care Essentials: Travel Medicine
Authors: Philip C. Carling
Journal: Annals of Internal Medicine (2002)

Medical Writings: Book Notes17 September 2002Blackwell's Primary Care Essentials: Travel MedicinePhilip C. Carling, MDPhilip C. Carling, MDInfectious Diseases Section, Carney Hospital, Boston, Massachusetts.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-6-200209170-00039 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Smith RP, Sears ST. 299 pages. Malden, MA: Blackwell Science; 2002. $39.95. ISBN 0632044829. Order phone 800-216-2522.Field of medicine: Ambulatory and general medical care.Format: Softcover book (pocket-size).Audience: Primary care and emergency medicine physicians and nurse practitioners caring for travelers.Purpose: To serve as a ready reference for medical providers preparing travelers for trips and evaluating travelers upon return.Content: This is the seventh publication of 10 planned volumes of Blackwell's Primary Care Essentials series. The handbook is divided into a section on prevention and a larger section on the diagnosis and management of travel-related illness. Brief appendices ... Author, Article, and Disclosure InformationAffiliations: Infectious Diseases Section, Carney Hospital, Boston, Massachusetts. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 17 September 2002Volume 137, Issue 6Page: 554KeywordsEmergency medicineInfectious diseasesNursesPathogensPregnancySkin infectionsSoft tissue infectionsSoft tissuesSoftware toolsToxic shock syndrome ePublished: 17 September 2002 Issue Published: 17 September 2002 Copyright & PermissionsCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Medical Illustration
Authors: Robert H. Albertin
Journal: JAMA (1961)

With the increase of national, state, and local medical meetings, the need to improve existing techniques of visual communication has expanded. Today's physician is speaking publicly more often to larger audiences with greater pressures to curtail his speaking time. This report is an attempt to aid the physician in preparing and presenting better lantern slides to meet these demands, together with an evaluation and comparison of illustrative techniques for publication. Pre-meeting rehearsals, with actual projection of lantern slides and with several colleagues serving as critics, help to eliminate most of the common pitfalls.
The Yentl Syndrome
Authors: Bernadine Healy
Journal: New England Journal of Medicine (1991)

Yentl, the 19th-century heroine of Isaac Bashevis Singer's short story,1 had to disguise herself as a man to attend school and study the Talmud. Being "just like a man" has historically been a price women have had to pay for equality. Being different from men has meant being second-class and less than equal for most of recorded time and throughout most of the world. It may therefore be sad, but not surprising, that women have all too often been treated less than equally in social relations, political endeavors, business, education, research, and health care.Two studies published in this issue . . .
The Selected Correspondence of Karl A. Menninger, 1919-1945
Authors: George H. Pollock
Journal: JAMA (1989)

On July 22, 1988, Karl A. Menninger celebrated his 95th birthday. His recently published correspondence from 1919 to 1945, edited by H. Faulkner and V. Pruitt, professors of English at Washburn University in Topeka, Kan, is almost as remarkable a volume as the life of Dr Karl. Incidentally, Karl Menninger attended Washburn (then Washburn College) from age 17 to 19. Before I discuss this unusual book, let me make a few introductory comments. The history of psychiatry is now undergoing a major renaissance. Historians, biographers, philosophers of science, sociologists, economists, as well as mental health professionals are among the leaders in this rebirth. One can speculate as to the reasons for this return to "our roots"—perhaps we are old enough to be worthy of historical study, perhaps the exciting developments in psychiatric research spawn a curiosity about the origins and leaders of this medical specialty, perhaps the multiple approaches to