tbuckley/cabot-search huggingface dataset:
Psychiatric discharge summaries.
Authors: M S Kerr
Journal: BMJ (1990)

Mortality of patients during trial period in trials with verapamil No of dcaths/No randomised Observed minus Verapamil Control expected Variance Bussman et al 0/29 0/25 0-0 0.0 Crca etalt 0/8 2/9 -0 9 0-5 Danish pilot" 3/28 4/33 -0-2 1-6 DAVITI 92/717 100/719 -3-9 41-6 Total 95/782 106/786 -5-0 43-7Pooled odds ratio 0-89.95% Confidence interval 0-66 to 1 20.care units do not have an acute myocardial infarction; but to be sure that all patients with an infarct were treated, treatment should start immediately in all patients-without exclusion criteria- admitted with a suspicion of acute myocardial infarction.Treatment should then stop if a diagnosis of acute myocardial infarction was ruled out.This means that we did not intend to treat the 3447 patients in coronary care units but only the 1436 with acute myocardial infarction.Naturally the effect of verapamil in patients who were treated but did not fulfil the inclusion criteria should be reported from a trial with such a design.We find it impossible, however, to evaluate the effect of verapamil on death and reinfarction after an infarct in the 2011 patients without acute myocardial infarction, most of whom were treated for only two or three days and none for more than a week.Based on the intention to treat principle and including all available trials with verapamil, which are all early intervention trials, an analysis shows a reduction in pooled odds ratio of 0 11 of mortality (table) and not an increased pooled odds ratio.The number of patients in verapamil trials (n= 1568) is still small compared with the numbers included in nifedipine (n=9464) and diltiazem (n=3151) trials, and a beneficial effect of verapamil on mortality and reinfarction cannot be excluded.A report ofthe results ofa further multicentre Danish verapamil infarction trial (DAVIT II) with late intervention is in preparation.
Chronic fatigue is the most important factor limiting health-related quality of life of chronic myeloid leukemia patients treated with imatinib
Authors: F Efficace, M Baccarani, M Breccia, F Cottone, G Alimena, G L Deliliers, C Baratè, G Specchia, R Di Lorenzo, L Luciano, D Turri, B Martino, F Stagno, M Dabusti, M Bergamaschi, P Leoni, M P Simula, L Levato, C Fava, D Veneri, S Sica, A Rambaldi, G Rosti, M Vignetti, F Mandelli
Journal: Leukemia (2013)
Outcomes into Clinical Practice; Measuring Health and Medical Outcomes
Authors: R. Greene
Journal: BMJ (1995)

Outcomes into Clinical Practice , Ed Tony Delamothe BMJ Publishing Group, £17.95, pp 169 ISBN 0 7279 0888 X

Measuring Health and Medical Outcomes , Ed Crispin Jenkinson UCL Press, £14.95, pp 215 ISBN 1 85728 084 9

In the past five years outcomes research has focused on evaluating the effectiveness of treatments for common illnesses. Its particular emphasis is on assessing the impact of treatment on a broad set of outcomes important to patients, including symptom relief, functional status, and health related quality of life.

Although measuring the effectiveness of treatment is not a new enterprise, established treatments for surprisingly large numbers of common illnesses have never been rigorously evaluated. For chronic …
Regulation of Protein Catabolism by Muscle-Specific and Cytokine-Inducible Ubiquitin Ligase E3α-II during Cancer Cachexia
Authors: Keith S. Kwak, Xiaolan Zhou, Vered Solomon, Vickie E. Baracos, James Davis, Anthony W. Bannon, William J. Boyle, David L. Lacey, H.Q. Han
Journal: Cancer Research (2004)

Abstract The progressive depletion of skeletal muscle is a hallmark of many types of advanced cancer and frequently is associated with debility, morbidity, and mortality. Muscle wasting is primarily mediated by the activation of the ubiquitin-proteasome system, which is responsible for degrading the bulk of intracellular proteins. E3 ubiquitin ligases control polyubiquitination, a rate-limiting step in the ubiquitin-proteasome system, but their direct involvement in muscle protein catabolism in cancer remains obscure. Here, we report the full-length cloning of E3α-II, a novel “N-end rule” ubiquitin ligase, and its functional involvement in cancer cachexia. E3α-II is highly enriched in skeletal muscle, and its expression is regulated by proinflammatory cytokines. In two different animal models of cancer cachexia, E3α-II was significantly induced at the onset and during the progression of muscle wasting. The E3α-II activation in skeletal muscle was accompanied by a sharp increase in protein ubiquitination, which could be blocked by arginine methylester, an E3α-selective inhibitor. Treatment of myotubes with tumor necrosis factor α or interleukin 6 elicited marked increases in E3α-II but not E3α-I expression and ubiquitin conjugation activity in parallel. E3α-II transfection markedly accelerated ubiquitin conjugation to endogenous cellular proteins in muscle cultures. These findings show that E3α-II plays an important role in muscle protein catabolism during cancer cachexia and suggest that E3α-II is a potential therapeutic target for muscle wasting.
QT dispersion and malignant ventricular arrhythmia in patients with end-stage heart failure caused by ischemic vs. idiopathic cardiomyopathy
Authors: Guanggen Cui, Luyi Sen, Gregg C. Fonarow, Michele A. Hamilton, Paul Chang, Davis Drinkwater, Hillel Laks
Journal: Journal of the American College of Cardiology (1996)
Relaxation by urocortin of rat renal arteries: effects of diabetes in males and females
Authors: E Sanz
Journal: Cardiovascular Research (2003)

Objective: Urocortin is a peptide structurally related to corticotropin releasing factor (CRF), and the present study was performed to examine the effects of diabetes mellitus on the relaxation by urocortin of renal arteries from males and females. Methods: The response to urocortin was studied in isolated segments, 2 mm long, from renal arteries, from male and female, control (normoglycemic) and streptozotocin-induced diabetic rats. Results: In the renal arterial segments precontracted with endothelin-1, urocortin produced concentration-dependent relaxation, that was not different between males and females. Diabetes reduced the relaxation in renal arteries from females but not in those from males. The potassium channel blocker charybdotoxin (10−7 M) reduced the relaxation to urocortin of renal arteries from normoglycemic males and females. The cyclooxygenase inhibitor meclofenamate did not modify the relaxation to urocortin in renal arteries from normoglycemic males or females. The inhibitor of nitric oxide synthesis NW-nitro-l-arginine methyl ester (l-NAME, 10−4 M) reduced the relaxation to urocortin in renal arteries from normoglycemic females, but not in renal arteries from normoglycemic males. Neither charybdotoxin, l-NAME or meclofenamate modified the relaxation to urocortin of renal arteries from diabetic females. Conclusion: These results suggest that urocortin produces a marked vasodilation of renal arteries, which may be mediated by nitric oxide in females and by activation of potassium channels in both genders, and is reduced by diabetes in renal arteries from females.
Surgical Mask vs N95 Respirator for Preventing Influenza Among Health Care Workers
Authors: Mark Loeb, Nancy Dafoe, James Mahony, Michael John, Alicia Sarabia, Verne Glavin, Richard Webby, Marek Smieja, David J. D. Earn, Sylvia Chong, Ashley Webb, Stephen D. Walter
Journal: JAMA (2009)

Data about the effectiveness of the surgical mask compared with the N95 respirator for protecting health care workers against influenza are sparse. Given the likelihood that N95 respirators will be in short supply during a pandemic and not available in many countries, knowing the effectiveness of the surgical mask is of public health importance.To compare the surgical mask with the N95 respirator in protecting health care workers against influenza.Noninferiority randomized controlled trial of 446 nurses in emergency departments, medical units, and pediatric units in 8 tertiary care Ontario hospitals.Assignment to either a fit-tested N95 respirator or a surgical mask when providing care to patients with febrile respiratory illness during the 2008-2009 influenza season.The primary outcome was laboratory-confirmed influenza measured by polymerase chain reaction or a 4-fold rise in hemagglutinin titers. Effectiveness of the surgical mask was assessed as noninferiority of the surgical mask compared with the N95 respirator. The criterion for noninferiority was met if the lower limit of the 95% confidence interval (CI) for the reduction in incidence (N95 respirator minus surgical group) was greater than -9%.Between September 23, 2008, and December 8, 2008, 478 nurses were assessed for eligibility and 446 nurses were enrolled and randomly assigned the intervention; 225 were allocated to receive surgical masks and 221 to N95 respirators. Influenza infection occurred in 50 nurses (23.6%) in the surgical mask group and in 48 (22.9%) in the N95 respirator group (absolute risk difference, -0.73%; 95% CI, -8.8% to 7.3%; P = .86), the lower confidence limit being inside the noninferiority limit of -9%.Among nurses in Ontario tertiary care hospitals, use of a surgical mask compared with an N95 respirator resulted in noninferior rates of laboratory-confirmed influenza.clinicaltrials.gov Identifier: NCT00756574
Crypt loss, pericapillary hemorrhage, and severe gastrointestinal graft‐versus‐host disease
Authors: Philippe Ratajczak, Marjan Ertault, Allison Desveaux, Gérard Socié, Anne Janin
Journal: American Journal of Hematology (2007)

Crypt loss, pericapillary hemorrhage, and severe gastrointestinal graft-versus-host diseaseTo the Editor: The very complete study of Melson et al. [1] demonstrates the value of crypt loss as a marker of severity in acute graft-versus-host disease (GVHD) in a series of colonic biopsies in twenty seven patients.Interestingly, the authors underline that ''crypt loss was not evident in the absence of accompanying apoptosis, confirming prior reports that the presence of crypt loss is specific of gastrointestinal GVHD and accompanies the presence of apoptosis''.They also report that in the three patients of their series who underwent simultaneous biopsy of the colon and upper gastrointestinal tract, severe crypt loss was also present in the duodenum.This point is important because it indicates an extensive disease of the whole digestive tract.In a previous study of ninety five patients with upper gastrointestinal biopsies [2], we also found such an extensive GVHD of the whole digestive tract in the fourteen patients with concomitant duodenal and colonic biopsies.Moreover, we found that the number of apoptotic cells was significantly correlated with the severity of GVHD in this series.In an experimental model of acute GVHD, we demonstrated that endothelial cells, as well as epithelial cells can be the target of the allogeneic reaction, and that both types of cells undergo apoptosis through the activation of the Fas/ FasL pathway [3].In human, cutaneous endothelial cell damage was reported in chronic GVHD, with progressive loss of microvessels [4].We also found endothelial cell apoptosis in duodenal biopsies of patients with acute GVHD, with resulting pericapillary hemorrhage, and this latter damage was significantly correlated with GVHD severity [5].Taken together, these concordant results suggest that apoptosis of target cells, both epithelial, with crypt loss, and endothelial, with pericapillary hemorrhage, induces severe extensive damage in the digestive tract.Moreover, the loss of crypts, whose epithelium contain cells able to repair the upper part of the digestive epithelium, can also contribute to poor therapeutic response, by impairing the mechanism of digestive tract tissue repair.
PURULENT OPHTHALMIA. AND ITS TREATMENT.Read in the Section on Ophthalmology, at the Forty-fifth Annual Meeting of the American Medical Association, held at San Francisco, June 5-8, 1894.
Authors: X. C. SCOTT
Journal: JAMA (1894)

In speaking of purulent ophthalmology I embrace under the one name all forms of this disease as described in most text-books, under the name of purulent ophthalmia, gonorrheal ophthalmia and ophthalmia neonatorum. It has always been a mystery to me why authors persist in making this unnecessary division, unless it is to mystify the general practitioner or increase the number of pages in their books. It seems much more simple to designate all three forms of this disease under simply purulent ophthalmia or conjunctivitis blennorrhea, for the parts involved are the conjunctiva and subconjunctiva, with a serous effusion into their tissues and also into the stroma of the lids. The only difference that can be found is the presence of the gonococcus of Neisser in cases of gonorrhea, but these gonococci are not always present, and even their presence I am unwilling to admit renders the disease more dangerous if
Diagnosis of the hemolytic state using serum levels of erythrocyte adenylate kinase
Authors: Edward R. Burns, Anjali Kale, Vadaraja V. Murthy
Journal: American Journal of Hematology (2000)

Red cell hemolysis is classically diagnosed by a combination of nonspecific laboratory tests, including serum bilirubin, LDH, and the reticulocyte count. None of these tests alone or in combination has the specificity to reliably ascertain the presence of hemolysis. We have previously demonstrated that erythrocyte adenylate kinase (EAK) is a red cell specific enzyme released from damaged red cells. Its activity can be measured in serum by rapid electrophoresis or immunological methods and correlates linearly with the degree of hemolysis in vitro. We now report on a clinical study comparing EAK levels in patients with and without hemolysis. The clinical diagnosis of hemolysis was established in hospitalized patients with anemia by the combined elevation of the bilirubin, LDH, and reticulocyte count in the absence of liver disease and demonstrable blood loss. The normal range of serum EAK was determined in 30 healthy nonanemic voluntary blood donors and was 0–3.5 Units (mean = 0.5). In 25 patients with hemolytic anemia due to sickle cell disease, hemolytic transfusion reactions, or TTP, the mean EAK level was 62.4 with a range 0–298 Units (P < 0.001 compared to normals). Levels of EAK exceeded the normal range in 24 of 25 patients (96%). In a control group of 44 hospitalized patients with liver disease or myocardial infarction and no clinical evidence of hemolysis, the mean EAK level was 0.12 with a range of 0–3.2 (P = 0.1, NS compared to normals and P < 0.001 compared to patients with hemolysis). None of the control patients had EAK levels that exceeded the normal range. The diagnostic sensitivity of the EAK assay for hemolysis, as calculated according to Baye's algorithm, was 96%, with a specificity and accuracy of 97%. Measurement of serum EAK represents a highly sensitive and specific test for the diagnosis of hemolytic anemia. Am. J. Hematol. 64:180–183, 2000. © 2000 Wiley-Liss, Inc.
US drug sales continue to rise
Authors: S. Gottlieb
Journal: BMJ (2003)

Despite continuing pricing pressures and competition from generic drugs, total US pharmaceutical sales grew 12% last year to $220bn (£140bn; ‡202bn), according to new data.

The pace of growth in US sales of prescription products slowed in 2002, compared with the 18% increase in 2001, according to the PharmaTrends 2002 report, released by healthcare tracking firm NDC Health.

The top five classes of drug remained in the same position as in 2001. Cholesterol …
TCTAP C-223 Simultaneous Transcatheter Aortic Valve Implantation and Bifurcation Stenting of the Left Main Coronary Artery
Authors: David G. Iosseliani, Oleg Sukhorukov, Dzhamil Arif Asadov, Ilya Alexandrivich Kovalchuk
Journal: Journal of the American College of Cardiology (2015)
Specialists attack government for not prioritising HIV
Authors: J. Carlowe
Journal: BMJ (2002)

A report into the care of patients with HIV infection in the United Kingdom has shown an upturn in the number of patients, with specialist clinics stretched to breaking point. In addition, experts have lambasted the government for failing to prioritise the disease, warning of an impending public health crisis.

The report, produced jointly by the Terrence Higgins Trust and the British HIV Association, reported an average of 25 patients per HIV clinician. It quoted the Public Health Laboratory Service's figures estimating that more than 33 000 people are living with HIV infection in the United Kingdom and that new diagnoses have nearly doubled, from …
The Quality and Influence of JAMA
Authors: Frederick Hecht
Journal: JAMA (1988)

<h3>To the Editor.</h3> —In my senior year of medical school, one professor devoted an hour or so of each class to the matter of education beyond medical school; he recommended that each of us subscribe to a general medical journal from that point to the end of our days in medicine. We should not limit ourselves to reading within our areas of special interest, but rather we should keep informed generally in medicine. Among the general medical journals my professor mentioned were<i>The Lancet, New England Journal of Medicine</i>, and<i>JAMA</i>. This was in 1960. Not being a surgically decisive person, I chose not to select one of these diverse journals but to read all three, and have done so, missing nary a week, since my commencement in 1960. It is my impression that these general medical journals are like people. They have their ups and downs. To base things
Cyclophosphamide-Induced Cystitis and Bladder Cancer in Patients with Wegener Granulomatosis
Authors: Cheryl Talar-Williams
Journal: Annals of Internal Medicine (1996)

Objective: To describe the incidence of, clinical manifestations of, and risk factors for cyclophosphamide-induced urinary bladder toxicity in patients treated for nonmalignant disease. Design: Retrospective analysis of patients followed at the National Institutes of Allergy and Infectious Diseases from 1967 to 1993. Setting: The Warren G. Magnuson Clinical Center of the National Institutes of Health (NIH). Patients: 145 patients who received cyclophosphamide for the treatment of Wegener granulomatosis and were followed for 0.5 to 27 years (median, 8.5 years), for a total of 1333 patient-years. Measurements: Clinical characteristics, cystoscopic findings, results of cytologic examination of urine, surgical pathology, and total dose and duration of cyclophosphamide therapy were recorded and analyzed using a computer-based information retrieval system. Results: Nonglomerular hematuria occurred in 73 of 145 patients treated with cyclophosphamide (50%). Sixty of the 73 patients with nonglomerular hematuria (82%) had cystoscopy at the NIH. Forty-two of the 60 patients (70%) who had cystoscopy had macroscopic changes consistent with cyclophosphamide-induced bladder injury. Seven patients (5%) developed transitional-cell carcinoma of the urinary bladder. In 6 of these 7 patients, the total cumulative cyclophosphamide dose exceeded 100 g, and the cumulative duration of cyclophosphamide therapy exceeded 2.7 years. Before they were given a diagnosis of bladder cancer, all 7 patients had had one or more episodes of microscopic or gross nonglomerular hematuria. In contrast, none of the 72 patients who had never had nonglomerular hematuria developed bladder cancer. Cox proportional-hazards regression analysis showed that only microscopic nonglomerular hematuria was a significant risk factor for the development of bladder cancer (P < 0.01). Conclusion: Long-term oral cyclophosphamide therapy is associated with substantial urotoxicity, including the development of transitional-cell carcinoma of the urinary bladder. In this cohort of patients, the estimated incidence of bladder cancer after the first exposure to cyclophosphamide was 5% at 10 years and 16% at 15 years. Nonglomerular hematuria was a frequent manifestation of cyclophosphamide-induced cystitis, and it identified a subgroup of patients at high risk for the development of bladder cancer.
Comparison of Azathioprine, Cyclophosphamide, and Gold in Treatment of Rheumatoid Arthritis
Authors: H. L. F. Currey, J. Harris, R. M. Mason, J. Woodland, T. Beveridge, C. J. Roberts, D. W. Vere, A. St. J. Dixon, J. Davies, B. Owen-Smith
Journal: BMJ (1974)

Azathioprine, cyclophosphamide, and gold have been compared under double-blind conditions in the treatment of relatively early rheumatoid arthritis. Over 18 months the two “immunosuppressive” agents produced clinical improvement comparable to that achieved with gold, and they also facilitated a reduction in the dosage of corticosteroids and retarded radiological joint deterioration. Drug management was easiest with azathioprine. Cyclophosphamide was perhaps marginally the most effective drug but it produced azoospermia in males. If the long-term hazards of malignancy and mutagenesis prove to be acceptable then the anti-proliferative agents provide a useful alternative to gold therapy and can with advantage be given relatively early in the course of rheumatoid arthritis.
Thermistor Recording of Forehead Skin Temperature as an Index of Carotid Artery Disease
Authors: MARGARET C. CONRAD, JAMES F. TOOLE, RICHARD JANEWAY
Journal: Circulation (1969)

Skin temperatures were recorded from the medial upper orbital area and above the nasal, mid and lateral portions of the brows in normal subjects and in patients with suspected cerebrovascular disease. Temperatures were reduced across the brow in patients with external carotid artery disease. Temperatures were lower than normal in the orbit in patients with internal carotid artery disease except when the internal carotid circulation was severely compromised. In such patients the supraorbital temperature was higher than normal, suggesting significant reversed flow via the supraorbital artery. With internal carotid occlusion, lateral brow temperatures suggested increases in external carotid flow. The interpretation of results was more reliable when temperatures were compared to normal values than when they were judged as differences between the two sides as is done in thermography.
Immunisation of infants at risk of perinatal transmission of hepatitis B: retrospective audit of vaccine uptake
Authors: D. E Wallis, E. H Boxall
Journal: BMJ (1999)

Perinatal transmission of hepatitis B virus is the infection of infants at birth by mothers who are positive for hepatitis B surface antigen.1 Around 85% of babies born to mothers who are also positive for hepatitis B e antigen become infected.2

Immunoprophylaxis initiated shortly after birth—that is, after exposure to the virus—can prevent perinatal transmission. Passive prophylaxis with hepatitis B immunoglobulin is 50-90% efficacious, active prophylaxis with hepatitis B vaccine is 75-90% efficacious, and combined active and passive prophylaxis is >90% efficacious.2

Antenatal screening for hepatitis B surface antigen is universal in the West Midlands. The vaccination schedule for all babies of mothers with hepatitis B virus is 0 (within 48 hours of birth), 1, 2, and 12 months. Babies of mothers positive for hepatitis B e antigen are given 200 IU of hepatitis B …