tbuckley/cabot-search huggingface dataset:
New Drugs for Hypertension: An FDA Reply
Authors: J. Richard Crout
Journal: JAMA (1975)

To the Editor.—  In an editorial (229:689, 1974), Dr Edward D. Freis charged the Food and Drug Administration (FDA) with depriving American physicians and their patients of a number of useful antihypertensive drugs. Such   editorials have appeared in various journals in the past, and we are not able to respond to all of them. This particular editorial, however, has generated numerous inquiries to the FDA, undoubtedly because of the importance of hypertension and the prominence of Dr Freis. I would therefore like to comment on some of the points he raises and correct several inaccuracies. A more complete discussion of the drug lag issue by the FDA can be found in our testimony before subcommittees of the senate committees on labor and public welfare and on the judiciary on Aug 16 and Sept 27, 1974.  Dr Freis cited the absence from the United States of three antihypertensive drugs
Bleeding Esophageal Varices
Authors: V Navarro, A Reuben
Journal: New England Journal of Medicine (1994)

Figure 1. Bleeding Esophageal Varices. In an endoscopic photograph of the esophagus of a 56-year-old alcoholic man with massive hematemesis, blood can be seen spurting from a ruptured varix (arrow, Panel A). After injection sclerotherapy of the variceal trunk and immediate hemostasis, the source of bleeding was revealed as a white nipple, which represents what was thought to be a fibrin-platelet plug (arrow, Panel B). Endoscopic variceal ligation was performed for recurrent bleeding from the same source three weeks after the initial episode. The white object in Panel C (arrow) is the remnant of a banded varix.
The In-Training Examination in Internal Medicine
Authors: David P. Steensma
Journal: Annals of Internal Medicine (2003)

Letters17 June 2003The In-Training Examination in Internal MedicineDavid P. Steensma, MDDavid P. Steensma, MDMayo Clinic; Rochester, MN 55905 (Steensma)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-12-200306170-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Since the In-Training Examination in Internal Medicine (IM-ITE) is administered to many internal medicine residents in categorical programs for 3 consecutive years, it is possible that repeated test-taking itself contributes in part to the improved performance seen in postgraduate year (PGY) 2 and PGY3. Certainly, ongoing training in internal medicine must have a substantial effect. Garibaldi and colleagues (1) report that IM-ITE performance correlates well with the cumulative number of internal medicine rotations undertaken. In addition, annual increments in scores were lower for medicinepediatrics residents (who receive half the annual internal medicine training of categorical internal medicine ...Reference1. Garibaldi RA, Subhiyah R, Moore ME, Waxman H. The In-Training Examination in Internal Medicine: an analysis of resident performance over time. Ann Intern Med. 2002;137:505-10. [PMID: 12230352] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: David P. Steensma, MDAffiliations: Mayo Clinic; Rochester, MN 55905 (Steensma) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe In-Training Examination in Internal Medicine: An Analysis of Resident Performance over Time Richard A. Garibaldi , Raja Subhiyah , Mary E. Moore , and Herbert Waxman The In-Training Examination in Internal Medicine Joseph J. Nidiry The In-Training Examination in Internal Medicine Robin Dibner , Julia Andrieni , and Lawrence Smith The In-Training Examination in Internal Medicine Richard A. Garibaldi and Raja Subhiyah Metrics 17 June 2003Volume 138, Issue 12Page: 1009KeywordsResidency ePublished: 17 June 2003 Issue Published: 17 June 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Percutaneous excimer laser coronary angioplasty: Results in the first consecutive 3,000 patients
Authors: Frank Litvack, Neal Eigler, James Margolis, Donald Rothbaum, John F. Bresnahan, David Holmes, William Untereker, Martin Leon, Kenneth Kent, Augusto Pichard, Spencer King, Ziyad Ghazzal, Frank Cummins, Daniel Krauthamer, Igor Palacios, Peter Block, Geoffrey O. Hartzler, William O'Neill, Michael Cowley, Gary Roubin, Lloyd W. Klein, Phillip S. Frankel, Curtis Adams, Tsvi Goldenberg, James Laudenslager, Warren S. Grundfest, James S. Forrester
Journal: Journal of the American College of Cardiology (1994)

We report the comprehensive results of the first consecutive 3,000 patients treated in an excimer laser coronary angioplasty registry.Excimer laser coronary angioplasty involves the use of a pulsed, 308-nm ultraviolet laser transmitted by optical fibers to reduce coronary stenoses. Preliminary reports have described safety and efficacy profiles in small numbers of patients.Patients were enrolled in a prospective, nonrandomized manner. The catheters used were 1.3, 1.6, 2.0, 2.2 and 2.4 mm in diameter, at energy densities up to 70 mJ/mm2. Procedures were performed by standard angioplasty technique with conventional guide catheters.Seventy-five percent of patients were male, 68% were in Canadian Cardiovascular Society functional class III or IV and the cohort included 3,592 lesions. Procedural success (final stenosis < or = 50% without in-hospital Q wave myocardial infarction, coronary artery bypass surgery or death) was 90% and did not differ between the first 2,000 and the last 1,000 patients treated. There was no significant difference in success or complication rates with respect to lesion length, nor were there differences between selected complex and simple lesions. Complications included in-hospital bypass surgery (3.8%), Q wave myocardial infarction (2.1%) and death (0.5%). Coronary artery perforation occurred in 1.2% of patients (1% of lesions) but significantly decreased to 0.4% in the last 1,000 patients (0.3% of lesions). Angiographic dissection occurred in 13% of lesions, transient occlusion in 3.4% and sustained occlusion in 3.1%. Comprehensive lesion morphologic data collected in the latter portion of the study showed the procedure predominantly limited to American College of Cardiology-American Heart Association type B2 and C lesions, with no significant difference in short-term outcome between groups.Excimer laser angioplasty can be safely and effectively applied, even in a variety of complex lesions not well suited for percutaneous transluminal coronary angioplasty. These types may include aorto-ostial, long lesions, total occlusions crossable with a wire, diffuse disease and vein grafts. Most recent data show a trend for the selection of predominantly complex lesions and a reduction in the incidence of perforation. This procedure may broaden the therapeutic window for the interventional treatment of selected complex coronary artery disease.
Neuroendocrine host factors and inflammatory disease susceptibility.
Authors: S Ligier, E M Sternberg
Journal: Environmental Health Perspectives (1999)

The etiology of autoimmune diseases is multifactorial, resulting from a combination of genetically predetermined host characteristics and environmental exposures. As the term autoimmune implies, immune dysfunction and dysregulated self-tolerance are key elements in the pathophysiology of all these diseases. The neuroendocrine and sympathetic nervous systems are increasingly recognized as modulators of the immune response at the levels of both early inflammation and specific immunity. As such, alterations in their response represent a potential mechanism by which pathologic autoimmunity may develop. Animal models of autoimmune diseases show pre-existing changes in neuroendocrine responses to a variety of stimuli, and both animal and human studies have shown altered stress responses in the setting of active immune activation. The potential role of the neuroendocrine system in linking environmental exposures and autoimmune diseases is 2-fold. First, it may represent a direct target for toxic compounds. Second, its inadequate function may result in the inappropriate response of the immune system to an environmental agent with immunogenic properties. This article reviews the relationship between autoimmune diseases and the neuroendocrine system and discusses the difficulties and pitfalls of investigating a physiologic response that is sensitive to such a multiplicity of environmental exposures.
Digital Rectal Examination and the Diagnosis of Prostate Cancer—a Study Based on 8 Years and Three Screenings within the European Randomized Study of Screening for Prostate Cancer (ERSPC), Rotterdam
Authors: Claartje Gosselaar, Monique J. Roobol, Roderick C.N. van den Bergh, Tineke Wolters, Fritz H. Schröder
Journal: European Urology (2008)
Treatment of acquired severe aplastic anemia with antilymphocyte globulin, cyclosporin A, methyprednisolone, and granulocyte colony‐stimulating factor
Authors: Günçağ Dinçol, Melih Aktan, Reyhan Diz‐Küçükkaya, Selim Yavuz, Meliha Nalçacı, Şükrü Öztürk, Şükrü Palanduz, Öner Doğan, Mehmet Ağan
Journal: American Journal of Hematology (2007)

Abstract Fifty‐six adult patients with newly diagnosed acquired severe aplastic anemia (SAA) received horse antilymphocyte globulin (ALG), cyclosporin A (CyA), methylprednisolone (Mpred), granulocyte colony‐stimulating factor (G‐CSF) as first‐line therapy. The median age was 34 (range, 17–72) and median neutrophil count 0.280 × 10 9 /L. Trilineage hematologic recovery (at a median interval of 105 days from treatment) was seen in 46 patients (37 complete, 9 partial) after one ( n = 38) or two ( n = 8) courses of ALG. Cytogenetic abnormalities were observed in three unresponders, clonal hematologic disease in three complete responders, and relapse of marrow aplasia in four complete responders. Median follow up for surviving patients was 1,668 days (range, 237–4,012). The actuarial survival at 5 years was 82%, falling to 77.1% at 7 years and was stationary at 7 and 8 years. Survival was not influenced by the neutrophil count (72% vs. 87%, for neutrophils less than vs. greater than 0.2 × 10 9 /L; P = 0.54). Immunosuppressive treatment of SAA with the 4‐drug combination appears to be effective. The significant prognostic effect of an enduring increase of the white blood cell (WBC) count during G‐CSF treatment may suggest complete and partial response to therapy. In nonresponders, the WBC count either did not change or elevated values gradually returned to nearly their initial levels while the patients were still under G‐CSF treatment. In patients not responsive to treatment but living under CyA and G‐CSF, the possibility of developing cytogenetic abnormalities does not seem to be low, despite the absence of findings attributable to manifest myelodysplastic syndrome. Am. J. Hematol., 2007. © 2007 Wiley‐Liss, Inc.
Regulation and revalidation of doctors: Dangers and opportunities
Authors: Brian D Keighley
Journal: BMJ (2006)

Editor-The report from the chief medical officer for England has implications for all UK doctors and needs to be considered very carefully. 1Its aim is a system of medical regulation that puts patients' safety first through the early detection, and where possible, remediation, of poor performance.If the report contributes to that aim, and commands public and professional support, it should be welcomed by everyone involved in health care.The Merrison report was the collective effort of Sir William Merrison and the other 14 members of his committee of inquiry, who took both oral and written evidence. 2A different process has been followed in this case.The government, sensibly, has therefore decided on a period of consultation during which the recommendations can be properly debated, tested, and costed.We have already said that we believe that the recommendations to divorce oversight of medical education from the other regulatory functions of standards, registration, and fitness to practise are not in patients' best interests.We will now be consulting widely with our partners before we submit our considered response.It may be another 30 years before there is another opportunity such as this.We must seize it so that future generations of patients can say that we did not fail them.
Effects of dopamine on myocardial metabolism in patients with ischaemic heart disease
Authors: C. CREXELLS, M. G. BOURASSA, P. BIRON
Journal: Cardiovascular Research (1973)

Journal Article Effects of dopamine on myocardial metabolism in patients with ischaemic heart disease Get access C. CREXELLS, C. CREXELLS 2 From the Montreal Heart Institute and Departments of Pharmacology and Medicine, University 2Present address: Cedars-Sinai Medical Center, Los Angeles, California. Search for other works by this author on: Oxford Academic PubMed Google Scholar M. G. BOURASSA, M. G. BOURASSA From the Montreal Heart Institute and Departments of Pharmacology and Medicine, University Search for other works by this author on: Oxford Academic PubMed Google Scholar P. BIRON P. BIRON From the Montreal Heart Institute and Departments of Pharmacology and Medicine, University Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 7, Issue 4, July 1973, Pages 438–445, https://doi.org/10.1093/cvr/7.4.438 Published: 01 July 1973
Preservation of faecal continence during rises in ultra-abdominal pressure.
Authors: D C Bartolo
Journal: Gut (1988)

The neuromuscular depolarizing block induced by intra-arterially injected ACh was studied to determine the variability in the same subject and in different subjects without disorders at the motor end-plate. Amplitude of action potentials of the opponens pollicis muscle evoked by intermittent repetitive supramaximal stimulation of the median nerve at the wrist were recorded for one hour from the beginning of ACh injection. The features of prompt and late depression stages after the injection were analysed statistically. Re-testing of the same subjects after a while shows that, in spite of all efforts to maintain the same experimental conditions, variations do occur in late depression. Time course and duration are particularly affected, while the degree of depression is altered but slightly. The presence of such variations limits this test to evaluation of the influence of other factors only within their already established statistical limits.
Serious Haemorrhage After Partial Gastrectomy in Unsuspected Chronic Myeloid Leukaemia
Authors: E. K. Blackburn, O. Daniel
Journal: BMJ (1957)

Serious Haemorrhage After Partial Gastrectomy inUnsuspected Chronic Myeloid LeukaemiaConditions which predispose to dangerous bleeding following surgery are usually recognized by ordinary clinical exami- nation before operation.Precautionary measures can then be taken.In the following case the patient developed severe haemorrhage associated with unsuspected chronic myeloid leukaemia which produced no recognizable symptoms or signs before operation. CAsE HISTORYIn November, 1955, a 59-year-old man was referred to hospital with vague abdominal symptoms of many years' duration, and anorexia and loss of weight for one year.Repeated investigation elsewhere had yielded negative re- sults.His main complaint was severe pain in both loins and across the middle of the abdomen, made worse by standing, relieved by rest, and not related to meals.There had been no other significant symptom.
Active and passive immunization against angiotensin II in the rat and rabbit. Evidence for a normal regulation of the renin-angiotensin system.
Authors: P Oster, H Bauknecht, E Hackenthal
Journal: Circulation Research (1975)

Active or passive immunization has been used repeatedly as a tool in studies on the role of the renin-angiotensin system in the control of blood pressure and kidney function. The results are not consistent among each other, and they are also at variance with other studies using different approaches. To evaluate the possible causes of these discrepancies, the biological characteristics of angiotensin antibodies were studied in rats. Following the intravenous injection of angiotensin II antibodies (purified by affinity chromatography), the plasma concentration of the antibodies declined in a two-exponential curve with half times of 11 hours and 7 days, which probably reflect distribution in the extracellular space and elimination, respectively. Plasma angiotensin II levels rose from preinjection levels of 100 pg/ml to 12,000 pg/ml within 10 minutes and then declined concomitantly with the decline in antibody concentration. We calculated that only a samll fraction of the circulating antibody was occupied by angiotensin II. Plasma renin concentrations were initially elevated both in controls and in antibody-injected rats, but they returned to the control level after 30 minutes and remained at that level throughout the rest of the experiment (10 days). This fact indicates that feedback mechanisms which control renin secretion, such as free plasma angiotensin II concentrations, are in the normal range. We therefore concluded that the renin-angiotensin system in antibody-injected rats was regulated at a normal level. Similar conditions seemed to exist in rabbits actively immunized against angiotensin II; these animals exhibited high concentrations of total immunoreactive angiotensin II (up to 200,000 pg/ml) and a small increase in plasma aldosterone and corticosterone concentrations.
773-5 Percutaneous Translumlnal Coronary Angioplasty (PTCA) and Intracoronary Radiation Therapy (ICRT): A Possible New Modality for the Treatment of Coronary Restenosis: A Preliminary Report of the First 10 Patients Treated with Intracoronary Radiation Therapy
Authors: José Ant Condado, Orlando Gurdiel, Raúl Espinoza, Juan Gonzales Brito, Mark L. Harrison, Lee Roy Joyner, Samuel F. Liprie
Journal: Journal of the American College of Cardiology (1995)
Pruritus as a leading symptom: clinical characteristics and quality of life in German and Ugandan patients
Authors: E. Weisshaar, C. Apfelbacher, G. Jäger, E. Zimmermann, T. Bruckner, T.L. Diepgen, H. Gollnick
Journal: British Journal of Dermatology (2006)

Pruritus is the most frequent and distressing symptom associated with dermatoses and various internal and neurological diseases.To investigate two different populations of patients with pruritus, one in Germany and one in Uganda, with a particular focus on clinical characteristics, aetiology and quality of life.We investigated by questionnaire 132 patients (59 men, 73 women, mean age 54.5 years) who were referred to the Department of Dermatology at the University Hospital of Magdeburg, Germany, with the diagnosis of pruritus as a leading symptom. The questionnaire was also applied in 84 patients who consulted the Dermatology Clinic at Mbarara, Uganda for pruritus. The questions referred to personal data and disease history of the individual, history and present occurrence of concomitant diseases, present and past therapy, quality, frequency and triggers of itching and scratching, other disorders and complaints, quality of life and impact on work and disability.Seventy-five (57%) of the German patients had pruritus due to dermatoses, 47 patients (36%) had pruritus due to a systemic disease and in 10 patients (8%) pruritus was of unknown origin. Most had a history of pruritus of several months up to years. Pruritus associated with dermatoses mostly affected the whole body and was permanent with an undulatory character. Affective reactions such as aggression and depression occurred more frequently in dermatological patients compared with those with systemic pruritus. The former group felt that pruritus had a greater impact on their lives. Almost all Ugandan patients had pruritus due to dermatoses except for three patients with pruritus of unknown origin. Eczema and prurigo were the most frequently observed dermatoses in both German and Ugandan patients. Patients with pruritus in both populations showed an impaired quality of life. There was no pronounced difference between the populations with regard to feelings of depression and suicidal thoughts.A great deal of helpful information in this complex group of patients can be obtained using this questionnaire. Pruritus has a major impact on quality of life and especially impairs those patients with pruritus associated with dermatoses and pruritus of unknown origin.
ARTERIAL STIFFNESS IS ASSOCIATED WITH LEFT VENTRICULAR SYSTOLIC AND DIASTOLIC FUNCTION IN NEVER-TREATED HYPERTENSIVES
Authors: Dimitrios Terentes-Printzios, Charalambos Vlachopoulos, Athanasios Bratsas, Konstantinos Aznaouridis, Nikolaos Alexopoulos, Katerina Baou, Nikolaos Ioakeimidis, Aikaterini Siama, Panagiota Pietri, Christodoulos Stefanadis
Journal: Journal of the American College of Cardiology (2010)
1002-86 Direct Quantitation of Atrial Septal Defect Size by Volume-Rendered Three-Dimensional Echocardiography: In Vitro Validation Studies
Authors: Oi-Ling Cao, Lissa Sugeng, Alain Delabays, Giuseppina Magni, Gerald Marx, Achi Ludomirski, Michael Vogel, Natesa Pandian
Journal: Journal of the American College of Cardiology (1995)
Recent Advances in Radiation Therapy
Authors: RONALD W. THOMPSON
Journal: Annals of Internal Medicine (1971)

In the past 15 years significant advances in radiation therapy have occurred, made possible by a qualitative and quantitative appreciation of the biological effects of ionizing radiation and by dramatic technological developments. Application of this new knowledge and technology has resulted in more widespread use of radiation therapy as a curative modality in the treatment of cancer. To illustrate the modern application of radiation therapy and its contribution in cancer management, the problems of Hodgkin's disease and carcinomas of the genitourinary tract are presented.
Benign Familial Hyperphosphatasemia
Authors: Patricia A. Siraganian
Journal: JAMA (1989)

Elevated alkaline phosphatase activity in serum suggests bone or liver disease or a neoplasm but can also indicate pregnancy or another benign condition. A family with benign hyperphosphatasemia was studied to elucidate the genetics and enzyme defect. Serum total alkaline phosphatase activity was greater than the population mean in all six family members, and more than 7 SDs above the mean in two of four offspring. Monoclonal antibodies to three alkaline phosphatase isoenzymes, intestinal, placental, and tissue nonspecific (liver/bone/kidney), demonstrated markedly increased intestinal alkaline phosphatase levels (29% to 44% of total) in all family members and significantly elevated liver/bone/kidney activity in the two offspring. Guanidine hydrochloride denaturation of the liver/bone/kidney component showed high alkaline phosphatase activity from liver in both siblings and from bone in one. The mode of inheritance in this family is obscure, but a complex regulation of the products of two different alkaline phosphatase genes seems likely. Steps toward diagnosis are suggested. Early recognition of this benign biochemical abnormality should help to avoid unnecessary diagnostic tests.