tbuckley/cabot-search huggingface dataset:
Review: Low BP targets do not reduce mortality or CV events in hypertension
Authors: Finlay A. McAlister
Journal: Annals of Internal Medicine (2009)

ACP Journal Club17 November 2009Review: Low BP targets do not reduce mortality or CV events in hypertensionFinlay A. McAlister, MDFinlay A. McAlister, MDUniversity of Alberta, Edmonton, Alberta, Canada (F.A.M.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-151-10-200911170-02006 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationArguedas JA, Perez MI, Wright JM. Treatment blood pressure targets for hypertension. Cochrane Database Syst Rev. 2009;(3):CD004349. https://pubmed.ncbi.nlm.nih.gov/19588353Clinical Impact RatingsGIM/FP/GP: Cardiology: Endocrinology: Nephrology: References1 Lewington S, Clarke R, Qizilbash N, Peto R, Collins R; Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360:1903-13. [PMID: 12493255] Google Scholar2 Hansson L, Zanchetti A, Carruthers SG, et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomized trial. Hot Study Group. Lancet. 1998;351:1755-62. [PMID: 9635947] Google Scholar3 Turnbull F; Blood Pressure Lowering Treatment Trialists’ Collaboration. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Lancet. 2003;362:1527-35. [PMID: 14615107] Google Scholar4 UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ. 1998;317:703-13. [PMID: 9732337] Google Scholar Author, Article, and Disclosure InformationAffiliations: University of Alberta, Edmonton, Alberta, Canada (F.A.M.)This article was published at Annals.org on 3 November 2009. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTight BP control reduced left ventricular hypertrophy in nondiabetic patients with hypertension Finlay A. McAlister Metrics 17 November 2009Volume 151, Issue 10Page: JC5-6KeywordsBlood pressureHeart failureHypertensionMortalityMyocardial infarctionStrokeSystolic pressureTreatment guidelinesType 2 diabetesUrination ePublished: 17 November 2009 Issue Published: 17 November 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
The Treatment Advice of a Computer-Based Cancer Chemotherapy Protocol Advisor
Authors: DAVID H. HICKAM
Journal: Annals of Internal Medicine (1985)

Oncocin is a chemotherapy protocol advisor used experimentally in a university oncology clinic. The program combines formal protocol guidelines with judgments of oncologists who have experience adjusting therapy in complex clinical situations. We compared the chemotherapy administered by clinic physicians with the treatment that would have been recommended by ONCOCIN in 415 visits for 39 patients with lymphoma seen before the program's introduction. In 189 visits the program agreed with the therapy actually administered. In a blinded evaluation, four experts on lymphoma failed to find a significant difference between the treatments selected by physicians and those proposed by ONCOCIN. Further analyses showed that ONCOCIN tended to attenuate drug doses or delay treatment more than the experts recommended, whereas the physicians were less likely to attenuate doses to the extent the experts suggested. Our results show that ONCOCIN provides advice on lymphoma treatment similar to the treatment provided in a university oncology clinic.
Ancient Accounts of Mouth-to-Mouth Resuscitation
Authors: Herbert Freilich
Journal: JAMA (1964)

To the Editor:—  According to the biblical adage, There is nothing new under the sun. This certainly seems true regarding mouth-to-mouth resuscitation. This modern concept has actually been practiced for many years.  In his account of the assassination of President Lincoln, Dr. J. T. Seidensticker ( New Eng J Med  270: 788 [April 9] 1964) related that Dr. Leale, one of the first to reach the stricken President, employed mouth-to-mouth resuscitation.  Undoubtedly, other historical descriptions antedate this source. To my knowledge the oldest accounts are found in the Bible. One reference (I Kings 17:21) deals with the prophet Elijah. The text gives this vivid description of his treatment of an unconscious lad:  he stretched himself upon the child three times and cried unto the Lord.... And the Lord heard the voice of Elijah and the soul of the child came into him again and he revived.  The other reference (II
Critical Role of Gα12 and Gα13 for Human Small Cell Lung Cancer Cell Proliferation <i>In vitro</i> and Tumor Growth <i>In vivo</i>
Authors: Marius Grzelinski, Olaf Pinkenburg, Thomas Büch, Maike Gold, Stefanie Stohr, Hermann Kalwa, Thomas Gudermann, Achim Aigner
Journal: Clinical Cancer Research (2010)

Abstract Purpose: In small cell lung cancer cells (SCLC), various autocrine stimuli lead to the parallel activation of Gq/11 and G12/13 proteins. Although the contribution of the Gq/11-phospholipase C-β cascade to mitogenic effects in SCLC cells is well established, the relevance of G12/13 signaling is still elusive. In other tumor entities, G12/13 activation promotes invasiveness without affecting cellular proliferation. Here, we investigate the role of G12/13-dependent signaling in SCLC. Experimental Design: We used small hairpin RNA–mediated targeting of Gα12, Gα13, or both in H69 and H209 cells and analyzed the effects of Gα12 and/or Gα13 knockdown on tumor cells in vitro, tumor growth in vivo, and mitogen-activated protein kinase (MAPK) activation. Results: Lentiviral expression of small hairpin RNAs resulted in robust and specific Gα12 and Gα13 knockdown as well as markedly inhibited proliferation, colony formation, and bradykinin-promoted stimulation of cell growth. Analyzing the activation status of all three major MAPK families revealed nonredundant functions of Gα12 and Gα13 in SCLC and a marked p42/p44 activation upon Gα12/Gα13 knockdown. In a s.c. tumor xenograft mouse model, Gα12 or Gα13 downregulation led to decreased tumor growth due to reduced tumor cell proliferation. More importantly, Gα12/Gα13 double knockdown completely abolished H69 tumorigenicity in mice. Conclusions: Gα12 and Gα13 exert a complex pattern of nonredundant effects in SCLC, and in contrast to other tumor types, SCLC cell proliferation in vitro and tumorigenicity in vivo critically depend on G12/13 signaling. Due to the complete abolishment of tumorgenicity in our study, RNAi-mediated double knockdown may provide a promising new avenue in SCLC treatment. Clin Cancer Res; 16(5); 1402–15
Side-effects of Disulfiram
Authors: H. Wilson
Journal: BMJ (1962)

<h3>Introduction</h3> Preterm and very low birthweight infants are at increased risk for neurodevelopmental disorders, including cerebral palsy, sensory impairment and intellectual disability. Several early intervention approaches have been designed in the hope of optimising neurological development in this context. It seems important that the intervention takes into account parental mental health, focuses on parent–child interactions and lasts sufficiently long. This study aims to evaluate the effects of a stimulation programme administered by parents until 6 months post-term on motor and neurophysiological development of infants born preterm. <h3>Methods and analysis</h3> Participants will be infants born &lt;32 weeks’ gestation and/or with a birth weight &lt;1500 g recruited prospectively from two tertiary neonatal intensive care units. They will be randomly assigned to receive nationally recommended follow-up only (control group) or also a stimulation programme between 37 weeks’ gestation and 6 months’ corrected age. Perinatal, clinical neurodevelopmental, socio-demographic and neuroimaging (ultrasonography or MRI) data will be collected. Bayley Scales of Infant Development will be used up to 24 months’ corrected age and Parental Stress Index at 6, 12, 18 and 24 months’ corrected age. High-density (64 or 128 electrodes) EEG, visual, somatosensory and long latency auditory evoked potentials will be recorded at term age, 3, 6, 12, 18 and 24 months’ corrected age. They will be analysed for spatiotemporal frequency bands contents and source localisation. <h3>Ethics and dissemination</h3> The study was approved by the Ethics Committees of the Hôpital Universitaire des Enfants Reine Fabiola and CHU Saint-Pierre. Results dissemination will be made for stakeholders and families, reports will be written for parents, healthcare providers and policymakers, and scientific papers will be published. <h3>Trial registration number</h3> NCT02159534; Pre-results.
Neuropsychiatric problems in systemic lupus erythematosus.
Authors: R Bennett, G R Hughes, E G Bywaters, P J Holt
Journal: BMJ (1972)

Kaposi,L in his original description of systemic lupus erythema- tosus (S.L.E.), noted recurrent delirium in 2 out of 11 patients.During the past few years there has been a resurgence of interest in the central nervous system manifestations of S.L.E., together with an increasing awareness of their importance.In a recent large prospective study of S.L.E., central nervous system involvement, including psychosis, was seen in 59% of patients and was second only to renal involvement as a cause of death.'The use of sensitive tests for the diagnosis of S.L.E., in particular deoxyribonucleic acid (DNA) antibody titres' and cerebrospinal fluid complement levels,4 may contribute to a more widespread recognition of this complication.The most difficult diagnostic and therapeutic problems have related to cases where psychiatric symptoms predominate.'In this review case histories of five patients with central nervous system lupus seen recently at Hammersmith Hospital are reported to illustrate some of the clinical problems. Case Reports cASm 1A 53-year-old Jamaican woman was initially seen as an outpatient with labile hypertension and depression for which she was treated with imipramine.Four years later she was noted to have active synovitis in the small joints of the hands and ankles.In addition she was severely depressed and had a peripheral sensory neuropathy, generalizd muscle weakness (without wasting or tenderness), and an
Low risk of liver decompensation among human immunodeficiency virus/hepatitis C virus–coinfected patients with mild fibrosis in the short term
Authors: Juan Macías, María Mancebo, Manuel Márquez, Dolores Merino, Francisco Téllez, Antonio Rivero, Miguel A. von Wichmann, Luis F. López‐Cortés, Nicolás Merchante, Jesús Santos, Miguel Raffo, Montserrat Pérez‐Pérez, Ángela Camacho, Jose A. Iribarren, Juan A. Pineda
Journal: Hepatology (2014)

Liver fibrosis is used to make decisions about the timing of therapy against hepatitis C virus (HCV) in routine clinical practice, which should be based on the short‐term likelihood of liver decompensations. Thus, we aimed at evaluating the risk of decompensations and death among human immunodeficiency virus (HIV)/HCV–coinfected individuals according to their baseline fibrosis classified by either liver biopsy or liver stiffness measurement (LSM). Patients coinfected with HIV/HCV, naive or without sustained virological response to HCV therapy, were included in this cohort. Fibrosis was classified by biopsy in 683 patients and by LSM in 1046 individuals. Reference categories were fibrosis stage 0 and LSM &lt;6 kPa. For patients with biopsy, the adjusted subhazard ratio for decompensations and 95% confidence interval (95% CI) by fibrosis stage were as follows: stage 1, 2.3 (0.27‐20.3), P = 0.443; stage 2, 2.8 (0.33‐24), P = 0.345; stage 3, 4.91 (0.60‐41), P = 0.137; stage 4, 9.89 (1.25‐79.5), P = 0.030. For patients with LSM, the adjusted subhazard ratio and 95% CI by LSM category were as follows: 6‐9.4 kPa, 1.89 (0.18‐20.3), P = 0.599; 9.5‐14.5 kPa, 6.59 (0.73‐59.2), P = 0.092; ≥14.6 kPa, 59.5 (8.3‐427), P &lt; 0.0001. Regarding the risk of death, the adjusted hazard ratio and 95% CI for death by fibrosis stage were as follows: stage 1, 1.3 (0.4‐4.11), P = 0.677; stage 2, 2.68 (0.86‐8.36), P = 0.090; stage 3, 2.58 (0.82‐8.15), P = 0.106; stage 4, 4.35 (1.43‐13.3), P = 0.010. For patients with LSM, the adjusted hazard ratio and 95% CI for death by LSM were as follows: 6‐9.4 kPa, 1.7 (0.63‐4.79), P = 0.288; 9.5‐14.5 kPa, 3.38 (1.2‐9.5), P = 0.021; ≥14.6 kPa, 12.7 (4.9‐33.6), P &lt; 0.0001. Conclusion : Patients coinfected with HIV/HCV without advanced fibrosis are at very low risk of decompensations in the short term; deferral of HCV therapy for a few years and monitoring fibrosis progression is a safe option until cheaper, more effective, and more convenient HCV treatment becomes widely available. (H epatology 2015;61:1503–1511)
An Open Letter on Inoculation as a Preventive of Yellow Fever.
Authors: J. McFadden Gaston
Journal: JAMA (1894)

Atlanta, Ga., Dec. 15, 1893. <h3>To the Editor:</h3> —As you are aware, I have taken great interest in the matter of preventive inoculation against yellow fever since the publication of the experience of Dr. Domingos Freire appeared in Brazil, more than ten years ago. My efforts were first directed to enlisting the influence of Dr. Joseph Holt of New Orleans, in support of a thorough investigation of this subject, under the impression that the people of that city ought to feel an interest in the results of such an inquiry. As a sequel of the agitation of this question by him before the American Public Health Association, and through the public prints, it was deemed proper by the United States Government to send Surgeon G.M. Sternberg, U.S.A., to Rio de Janeiro to observe the working of yellow fever inoculation and report upon the same. Being impressed with the great difficulties
A Central Institutional Review Board for Multi-Institutional Trials
Authors: Michaele C Christian, Jacquelyn L Goldberg, Jack Killen, Jeffrey S Abrams, Mary S McCabe, Joan K Mauer, Robert E Wittes
Journal: New England Journal of Medicine (2002)

These are difficult times for the nation's system of protection for human subjects in research.110 On the basis of a series of reports, the Office of the Inspector General of the Department of Health and Human Services concluded that institutional review boards (IRBs) are now forced to “review too much, too quickly, with too little expertise,” and with inadequate resources.6 One consequence is that there is minimal, often perfunctory, review of ongoing research. In addition, IRB members have become disillusioned as a result of both public criticism concerning the perceived failures of the boards and the increasing amount of . . .
ADXS11-001 immunotherapy targeting HPV-E7: final results from a Phase II study in Indian women with recurrent cervical cancer
Authors: Robert G Petit, Ajay Mehta, Minish Jain, Sudeep Gupta, Rajnish Nagarkar, Vijay Kumar, Sumana Premkumar, Rakesh Neve, Subhashini John, Partha Basu
Journal: Journal for ImmunoTherapy of Cancer (2014)

Meeting abstracts ADXS11-001 immunotherapy is a live attenuated Listeria monocytogenes ( Lm ) bioengineered to secrete a tLLO-HPV-16-E7 fusion protein targeting HPV-transformed cells. The Lm vector serves as its own adjuvant and infects APC where it cross presents HPV-E7-tLLO fusion peptide,
Law in the Practice of Psychiatry: A Handbook for Clinicians
Authors: Manuel P. Pardo
Journal: JAMA (1981)

In the last several years, a number of books have been written on the subject of psychiatry and the law. Some are interesting and informative, others are just a rehash of old material. Seymour Halleck, a winner of the Isaac Ray Award of the American Psychiatric Association, is another expert who has written a book on forensic psychiatry. His work, as well as being interesting and informative, is exceptionally relevant to the everyday practice of every psychiatric clinician. The material is presented in three parts. Part 1 deals with malpractice issues. Part 2 covers the broader area of the regulation of psychiatric practice through legislation and court decisions. Part 3 deals with the role of psychiatrist as an expert witness. No other specialty in the field of medicine has come under such tremendous legal attack as psychiatry. This book addresses itself to the major issues that directly affect the conduct
Mobile phones are given the all clear by UK group
Authors: J. Wise
Journal: BMJ (2014)

An 11 year research programme has found no evidence of adverse effects on health from use of mobile phones or their base stations.1

The Mobile Telecommunications and Health Research programme was set up in 2001 as part of the government’s response to the recommendations of the Independent Expert Group on Mobile Phones, led by William Stewart, chairman of Tayside University Hospitals NHS Trust. The £13.6m (€16.4m; $22.3m) programme, funded jointly by the UK government and the telecommunications industry, was overseen …
Pit cells (hepatic natural killer cells) of the rat induce apoptosis in colon carcinoma cells by the perforin/granzyme pathway
Authors: David Vermijlen, Dianzhong Luo, Bernard Robaye, Carine Seynaeve, Marijke Baekeland, Eddie Wisse
Journal: Hepatology (1999)

The high mortality of colon cancer is to a large extent caused by the frequent occurrence of liver metastasis. This is remarkable, because the liver harbors two distinct cell populations that can eliminate invading cancer cells, namely hepatic natural killer (NK) cells and Kupffer cells. These hepatic NK cells, known as pit cells, are the most cytotoxic cells of the naturally occurring NK cells. However, the mechanism by which pit cells eliminate tumor cells is largely unknown. Because we recently found an indication that apoptosis is involved, we tried to assess the role of this mode of cell death using an in vitro system with isolated pure pit cells (&gt;90%) and CC531s cells, a rat colon carcinoma (CC) cell line. Pit cells induced apoptosis in CC531s cells as shown by quantitative DNA fragmentation, agarose gel electrophoresis, and different modes of microscopy. When extracellular Ca 2+ was chelated by ethylene glycol–bis(β–aminoethyl ether)– N , N ,–tetraacetic acid (EGTA) during coincubation or when the pit cells were preincubated with the granzyme inhibitor 3,4–dichloroisocoumarin (DCI), the induction of apoptosis was abolished. These results show that pit cells use the Ca 2+ –dependent perforin/granzyme pathway to induce apoptosis in the CC531s cells, and not the alternative Ca 2+ –independent Fas pathway. To further exclude the possibility of the involvement of the Fas pathway, we treated CC531s cells with recombinant Fas ligand. This treatment did not result in the induction of apoptosis, indicating that CC531s cells are resistant to Fas–mediated apoptosis. We conclude therefore that pit cells induce apoptosis in CC cells in vitro by the perforin/granzyme pathway.
Pulmonary vascular impedance analysis of adaptation to chronically elevated blood flow in the awake dog.
Authors: R A Hopkins, J W Hammon, P A McHale, P K Smith, R W Anderson
Journal: Circulation Research (1979)

Pulsatile pulmonary hemodynamics were analyzed in a chronic awake canine high flow model. Standard mean flow and pulsatile flow hemodynamics were measured and alterations in the proximal pulmonary vascular physical properties were quantified by the characteristic impedance (Zo). Pulmonary vascular resistance (PVR), which assesses arteriolar-capillary recruitment of perfusing radius and measures a more distal pulmonary vascular response to changing flows, also was calculated. Twelve control dogs were studied and had mean Qpa (pulmonary blood flow) = 2.02 +/- 0.15 liters/min, Zo = 193 +/- 20 dyne sec cm-5 and PVR = 416 +/- 32 dyne sec cm-5. Ten dogs were studied awake 20 weeks after creation of bilateral arteriovenous fistulae. Five of these shunted dogs, designated group A, developed Qpa = 3-4 liters/min (mean = 3.80 +/- 0.09, P less than 0.001 different from control group); the other five dogs (group B) developed Qpa = 4-8 liters/min (mean = 5.87 +/- 0.16, P less than 0.001). In group A, Zo = 143 +/- 8 (P less than 0.05) and PVR = 249 +/- 6 (P less than 0.10). In group B, Zo = 90 +/- 5 (P less than 0.005) and PVR = 126 +/- 14 (P less than 0.01). The total input power (potential and kinetic) was 125% above the controls for group A (P less than 0.001) and 264% for group B (P less than 0.001), but the mean energy components increased significantly more than did the pulsatile components. These data demonstrate a lower impedance to pulsatile flow during chronically elevated total flow which effects a reduction in both the work load of the right ventricle and the transmission of energy to the precapillary bed. Analysis of the alterations in characteristic impedance suggests a distinct proximal pulmonary vascular mechanism of decreased vessel stiffness (decreased elastic moduli) for adaptation to chronically elevated flow loads which is in addition to the two geometric alterations of proximal arterial dilation and distal vascular channel recruitment.
POSSIBLE CAUSES OF RENAL BLEEDING WHICH CANNOT BE ACCURATELY DIAGNOSED
Authors: GEORGE R. LIVERMORE
Journal: JAMA (1924)

The aids for making a correct diagnosis available to the present day urologist have practically eliminated undiagnosable cases. Despite these aids, however, we occasionally encounter cases of unexplained hematuria that baffle our every effort to determine their etiology. These naturally classify themselves under the caption of essential, or idiopathic, hematurias. I have always doubted the existence of hematuria without a definite cause, and have felt that the use of such terms was simply a cloak of unscientific verbiage behind which we hid our ignorance. That bleeding from the kidney does not occur without a positive etiologic factor is my contention, and I am borne out by a review of the literature, in which I have found a preponderance of evidence to prove that when such kidneys have been removed and carefully studied, some pathologic condition has been found. Israel,<sup>1</sup>in 1901, wrote, "The result of the analysis of my
The Litigation on Contraception
Authors: Peter Bridgman, Cynthia L. Harden
Journal: New England Journal of Medicine (2013)

To the Editor: In his Perspective article, Jost (Jan. 3 issue)1 discusses insurance coverage of contraceptives. We wish to highlight another health benefit associated with such coverage: the use of contraceptives by patients who need to use teratogenic medications. As neurologists, we often care for women with conditions such as epilepsy. We prescribe medications, such as valproic acid and topiramate, that have considerable teratogenic effects. We inform women of childbearing age about the possible effects on a fetus and advise them about the need to use effective birth control.2 In these situations, denying insurance coverage for prescription contraceptives can increase . . .
Stem cell transplantation can provide durable disease control in blastic plasmacytoid dendritic cell neoplasm: a retrospective study from the European Group for Blood and Marrow Transplantation
Authors: Damien Roos-Weil, Sascha Dietrich, Ariane Boumendil, Emmanuelle Polge, Dominique Bron, Enric Carreras, Arturo Iriondo Atienza, William Arcese, Dietrich W. Beelen, Jan J. Cornelissen, Nicolaus Kröger, Giuseppe Milone, Giuseppe Rossi, Fabrice Jardin, Christina Peters, Vanderson Rocha, Anna Sureda, Mohamad Mohty, Peter Dreger
Journal: Blood (2012)