tbuckley/cabot-search huggingface dataset:
Improving compliance with therapeutic regimens in hypertensive patients in a community health center.
Authors: J Takala, N Niemelä, J Rosti, K Sievers
Journal: Circulation (1979)

A 1-year, randomized study was conducted to test the possibility of improving compliance with therapeutic regimens in hypertensives by means of certain simple arrangements. Patients were given written treatment instructions concerning hypertension, a personal blood-pressure follow-up card, and, for those who failed to attend their blood-pressure check-up, an invitation for a new check-up. Using matched pairs, 202 Finnish hypertensives were randomly allocated either to an ordinary or a reorganized treatment group. By means of the latter system, patient compliance could be significantly (p less than 0.01) improved: Only 4% of the patients in this group dropped out of treatment, compared with 19% in the ordinary treatment group. By the end of the year, blood pressure had been lowered by at least 10% in 95% of the patients in the reorganized group and in 78% of those in the ordinary group (p less than 0.01). This was achieved in approximately 60% of cases using chlorthalidone alone.
Sensitivity and Acquired Resistance of BRCA1;p53-Deficient Mouse Mammary Tumors to the Topoisomerase I Inhibitor Topotecan
Authors: Serge A.L. Zander, Ariena Kersbergen, Eline van der Burg, Niels de Water, Olaf van Tellingen, Sjöfn Gunnarsdottir, Janneke E. Jaspers, Marina Pajic, Anders O.H. Nygren, Jos Jonkers, Piet Borst, Sven Rottenberg
Journal: Cancer Research (2010)

There is no tailored therapy yet for human basal-like mammary carcinomas. However, BRCA1 dysfunction is frequently present in these malignancies, compromising homology-directed DNA repair. This defect may serve as the tumor's Achilles heel and make the tumor hypersensitive to DNA breaks. We have evaluated this putative synthetic lethality in a genetically engineered mouse model for BRCA1-associated breast cancer, using the topoisomerase I (Top1) poison topotecan as monotherapy and in combination with poly(ADP-ribose) polymerase inhibition by olaparib. All 20 tumors tested were topotecan sensitive, but response heterogeneity was substantial. Although topotecan increased mouse survival, all tumors eventually acquired resistance. As mechanisms of in vivo resistance, we identified overexpression of Abcg2/Bcrp and markedly reduced protein levels of the drug target Top1 (without altered mRNA levels). Tumor-specific genetic ablation of Abcg2 significantly increased overall survival of topotecan-treated animals (P < 0.001), confirming the in vivo relevance of ABCG2 for topotecan resistance in a novel approach. Despite the lack of ABCG2, a putative tumor-initiating cell marker, none of the 11 Abcg2(-/-);Brca1(-/-);p53(-/-) tumors were eradicated, not even by the combination topotecan-olaparib. We find that olaparib substantially increases topotecan toxicity in this model, and we suggest that this might also happen in humans.
Abnormal distribution of pulmonary blood flow after the Glenn shunt or Fontan procedure: risk of development of arteriovenous fistulae.
Authors: A Cloutier, J M Ash, J F Smallhorn, W G Williams, G A Trusler, R D Rowe, M Rabinovitch
Journal: Circulation (1985)

Since the Fontan procedure results in low pulsatile pulmonary blood flow similar to that seen in patients with a Glenn shunt, it may also be associated with abnormal distribution of flow to the lower lung lobes and with the development of pulmonary arteriovenous fistulae (PAVF). In 12 patients 0.8 to 4.5 years after Fontan procedure and in 20 patients 0.2 to 18 years after receipt of Glenn shunts we assessed ventilation (with 133Xe) and perfusion (after a peripheral injection of 99mTc-macroaggregated albumin) to compare upper to lower lobe distribution of blood flow with that in a control group. The presence of PAVF was assessed by radionuclide activity in kidneys and the brain and by a two-dimensional echocardiographic contrast study. A decreased upper/lower lobe perfusion ratio was noted in 13 of 20 patients with Glenn shunts (65%) and correlated with the time after surgery (p less than .05). Despite the shorter follow-up period, two of 12 (16%) patients who had undergone the Fontan procedure also had a decreased upper/lower lobe perfusion ratio, and one of these developed right heart failure. Brain and kidney radionuclide counts above control values were observed in all patients with Glenn shunts and in 11 of 12 patients who had the Fontan operation. However, in only five of 20 (25%) patients with Glenn shunts were PAVF confirmed by the two-dimensional echocardiographic contrast study. Three of the five patients with PAVF had Glenn shunts of long duration.(ABSTRACT TRUNCATED AT 250 WORDS)
Exercise-induced ischemia: the influence of altered relaxation on early diastolic pressures.
Authors: J D Carroll, O M Hess, H O Hirzel, H P Krayenbuehl
Journal: Circulation (1983)

Left ventricular pressure (LVP) decay and early diastolic pressures were studied at rest and during exercise in three groups of patients. Patients in the ischemia group (n = 15) had coronary artery disease and developed new regional wall motion abnormalities documented by biplane LV cineangiography during exercise. Patients in the control group (n = 4) had a normal exercise response. Patients in the scar group (n = 5) had prior infarction, akinetic scars and no ischemia with exercise. Isovolumic pressure data were used to compute the time constant (T) of LVP decay (from the linear relation of LVP and negative dP/dt) and an extrapolated baseline pressure (PB) at dP/dt = 0. During exercise in the ischemia group, minimal LV diastolic pressure (PL) increased from 9 +/- 3 to 21 +/- 5 mm Hg (p less than 0.001), end-systolic volume increased from 38 +/- 7 to 55 +/- 8 ml/m2 (p less than 0.001) and PB rose from -10 +/- 7 to 11 +/- 8 mm Hg (p less than 0.001); T decreased (from 55 +/- 9 to 37 +/- 8 msec, p less than 0.001), although inadequately, compared with the decrease in the control group (from 49 +/- 15 to 22 +/- 2 msec, p less than 0.01). Relaxation at PL during exercise was incomplete in the ischemia group (2.2 +/- 0.4 T) and complete in the control group (3.8 +/- 0.7 T, p less than 0.05). The time course of LVP fall was extrapolated from the isovolumic period into the passive LV filling phase. The extrapolated pressure at the time PL occurred (PE) rose from 0 +/- 4 to 20 +/- 7 mm Hg with ischemia (p less than 0.001). Thus, the characteristics of LVP decay can account for the elevated early diastolic pressures during ischemia. In contrast, the scar group maintained a low PL during exercise (11 +/- 3 to 8 +/- 3 mm Hg), even though T decreased inadequately (from 66 +/- 10 to 36 +/- 5 msec, p less than 0.01), because PB did not shift upward. Ischemia-related pressure elevations involve both delayed relaxation and a pressure baseline shift. During exercise, LVP decay is normally adjusted to maintain low diastolic pressures; with exercise-induced ischemia, LVP decay is abnormal and early diastolic pressures are severely elevated.
Volatile Organic Compounds and Pulmonary Function in the Third NationalHealth and Nutrition Examination Survey, 1988–1994
Authors: Leslie Elliott, Matthew P. Longnecker, Grace E. Kissling, Stephanie J. London
Journal: Environmental Health Perspectives (2006)

BackgroundVolatile organic compounds (VOCs) are present in much higher concentrations indoors, where people spend most of their time, than outdoors and may have adverse health effects. VOCs have been associated with respiratory symptoms, but few studies address objective respiratory end points such as pulmonary function. Blood levels of VOCs may be more indicative of personal exposures than are air concentrations; no studies have addressed their relationship with respiratory outcomes.ObjectiveWe examined whether concentrations of 11 VOCs that were commonly identified in blood from a sample of the U.S. population were associated with pulmonary function.MethodsWe used data from 953 adult participants (20–59 years of age) in the Third National Health and Nutrition Examination Survey (1988–1994) who had VOC blood measures as well as pulmonary function measures. Linear regression models were used to evaluate the relationship between 11 VOCs and measures of pulmonary function.ResultsAfter adjustment for smoking, only 1,4-dichlorobenzene (1,4-DCB) was associated with reduced pulmonary function. Participants in the highest decile of 1,4-DCB concentration had decrements of −153 mL [95% confidence interval (CI), −297 to −8] in forced expiratory volume in 1 sec and −346 mL/sec (95% CI, −667 to −24) in maximum mid-expiratory flow rate, compared with participants in the lowest decile.ConclusionsExposure to 1,4-DCB, a VOC related to the use of air fresheners, toilet bowl deodorants, and mothballs, at levels found in the U.S. general population, may result in reduced pulmonary function. This common exposure may have long-term adverse effects on respiratory health.
Combination of Diffusion-weighted Magnetic Resonance Imaging and Extended Prostate Biopsy Predicts Lobes Without Significant Cancer: Application in Patient Selection for Hemiablative Focal Therapy
Authors: Yoh Matsuoka, Noboru Numao, Kazutaka Saito, Hiroshi Tanaka, Jiro Kumagai, Soichiro Yoshida, Fumitaka Koga, Hitoshi Masuda, Satoru Kawakami, Yasuhisa Fujii, Kazunori Kihara
Journal: European Urology (2012)
The Germ of Laziness: Rockefeller Philanthropy and Public Health in the New South
Authors: Frederick Butzen
Journal: JAMA (1982)

In<i>The Germ of Laziness</i>, historian John Ettling tells the fascinating story of the Rockefeller Sanitary Commission, an agency founded in 1909 to combat hookworm disease in the South. Ettling tells his story with great skill and sensitivity, weaving biography and analysis into a portrait of medical science and philanthropy at the beginning of this century. Hookworm disease was epidemic in the South at that time, but few American physicians knew of its existence before Charles Wardell Stiles began his one-man crusade against it. Stiles was a highly skilled zoologist who knew Virchow socially, and who had studied under Leuckart and Pasteur at the time when the hookworm was identified and its life cycle described. After his return to the United States he became aware of how widespread the disease was in the South, especially in the sandy coastal regions; he then began to travel about with specimens and a
Who will fund hypothesis testing studies?
Authors: Mira Harrison-Woolrych
Journal: BMJ (2006)

EDITOR—Although Loke et al concluded that case reports in pharmacovigilance have limited value,1 case reports or series are valuable as hypothesis generating papers, which benefit clinicians and patients. The number of follow-up studies is only one outcome by which to judge the value of case reports or series, but other outcomes may be more difficult to study.

Although case …
PRESENT STATUS OF BLOOD NITROGEN IN SURGICAL LESIONS OF THE KIDNEY
Authors: W. H. OLMSTED
Journal: JAMA (1922)

Since Folin and Denis,<sup>1</sup>in 1913, initiated methods for the rapid determination of the nonprotein blood nitrogen, a great mass of work has been done, especially in chronic nephritis, and its value has been demonstrated repeatedly. It has been shown that uric acid in the blood is retained in some cases very early, but not constantly so; that urea is retained at a later stage in the course of nephritis, and that creatinin is retained shortly before death in the great majority of cases. Before entering further into the discussion of nitrogen retentions, it is well to state our findings as to normal levels. Two years ago, we placed four of the hospital staff on high protein diets. These diets were prepared in the diet kitchen on the metabolic unit. The blood nonprotein nitrogen of these young men before they were given a high protein diet was from 28
COFFEE, ITS USE AND ABUSE.Read at the Louisville Meeting of the Mississippi Valley Medical Association, October 13, 1890.
Authors: I. N. LOVE
Journal: JAMA (1891)

I shall not attempt to present a history of the coffee plant, but rather give a few of the virtues it possesses, and draw attention to the fact that the commonplace is often overlooked in our desire to discover that which is new, striking and sensational. I recall a remark that I heard made a year or two ago by a very worthy but somewhat censorious member of our profession, to the effect that he did not propose to attempt to address the profession unless he had something absolutely original to offer. In this connection, I venture this thought: that which is good and true will bear repetition, and it is rarely original. In Southern Abyssinia the coffee plant grows wild in profusion, and has been in use from very ancient times. The name is probably taken from Koffa, the name of a district south of Abyssinia. The coffee-producing belt
Physicians’ Groups Say Nuclear Threats Are Even Greater Today Than in the Past
Authors: Tracy Hampton
Journal: JAMA (2012)

THROUGHOUT HISTORY, PHYSIcians and other health care workers have dealt with catastrophes, caring for the victims and often feeling helpless when a disaster is so great that many lives are instantly lost or are beyond saving. For decades, a group of physicians has been urging other clinicians, political leaders, and the public to imagine an event of apocalyptic proportions that could very possibly occur today. The cause would be nuclear war. In the early 1960s, the newly formed Physicians for Social Responsibility (PSR) published a comprehensive analysis of a clearly defined thermonuclear attack on the United States, including its human and ecologic consequences in a given area, specifically metropolitan Boston and southern New England (Ervin FR et al. N Engl J Med. 1962;266:1127-1137). In the Boston area alone, the analysis estimated, the blast, heat, and radiation from a thermonuclear attack would kill 1.4 million people and injure another 1.25 million. Of the latter, 1 million would die because no effective health care intervention would be possible. The authors urged physicians to educate people about such health dangers and to work to prevent them, as they do in other areas of preventive medicine (Sidel VW et al. N Engl J Med. 1962; 266[22]:1137-1145). The work by PSR grew into an international movement, leading to the 1980 founding of International Physicians for the Prevention of Nuclear War (IPPNW), which recruited more than 150 000 doctors worldwide, held numerous international conferences that included US and Russian military leaders, met with world political leaders, and appeared on specially produced television programs broadcast throughout the former Soviet Union and the United States. In 1985, the Nobel Peace Prize was awarded to IPPNW for its service to humankind by spreading
CLINICAL REPORT ON SERO-DIAGNOSIS.
Authors: R. C. CABOT
Journal: JAMA (1897)

I have collected and placed upon the blackboard the statistics relating to sero-diagnosis from all parts of the world, so far as I have been able to get hold of them, including those of good, bad and indifferent technique, and therefore open to criticism. The figures, as you see, show a very large proportion of successful serum tests. Out of 1,826 cases supposed to be typhoid, the result of the serum test was confirmed by autopsy or by the subsequent course of the case in 1,740, or 95.2 per cent. Out of 1,649 cases known to be other than typhoid, the serum reaction was negative in 1,592, or 96.5 per cent. Out of a total of 3,475 cases examined, in 98.8 per cent. the results of the serum test have been borne out by the court of ultimate appeal, the clinician. These are the combined results of seventy-one articles, twenty-five
Patient education is not a treatment modality
Authors: J. J Jones
Journal: BMJ (2002)

EDITOR— In their editorial Riemsma et al treat patient education in rheumatoid arthritis as a treatment modality, showing that it produces some minor improvements in a series of outcome measures.1

I have some reservations about treating patient education in this way. Providing people with medical conditions with information about their options is now an ethical requirement so that they can give informed consent. In such an …
Effect of Silibinin on biliary lipid composition experimental and clinical study
Authors: G. Nassuato, R.M. Iemmolo, M. Strazzabosco, F. Lirussi, R. Deana, M.A. Francesconi, M. Muraca, D. Passera, A. Fragasso, R. Orlando, G. Csomós, L. Okolicsányi
Journal: Journal of Hepatology (1991)
ENDOTHELIAL PROGENITOR CELLS MOBILIZATION IS INCREASED AMONG HIGH-PERFORMANCE ATHLETES
Authors: Maria Cristina Izar, Celia R. Bittencourt, Carolina N. França, Henrique A. Fonseca, Erika F. Silva, Henrique T. Bianco, Eloara V. Ferreira, Francisco A. Fonseca
Journal: Journal of the American College of Cardiology (2011)
Acetazolamide and Sodium Bicarbonate in Treatment of Salicylate Poisoning in Adults
Authors: A. G. Morgan, A. Polak
Journal: BMJ (1969)

Ten adults suffering from salicylate overdosage were treated successfully with a combination of sodium bicarbonate and acetazolamide to exploit the increase in salicylate clearance which is known to occur in very alkaline urine. The advantages of the method include the absence of important complications and the small volume of fluid required.
Retinoblastoma, melanoma and the atypical mole syndrome
Authors: V. BATAILLE, R. HILES, J. A. NEWTON BISHOP
Journal: British Journal of Dermatology (1995)

Retinoblastoma patients and their relatives appear to have an increased risk of other cancers, especially melanoma, which represents 7% of second primaries in retinoblastoma survivors. Individuals belonging to families with the atypical mole syndrome (another family cancer syndrome with a genetic susceptibility to melanoma) have a recognizable phenotype, with many atypical melanocytic naevi. We report two families in which both retinoblastoma and melanoma occurred. It is of interest that in these families atypical melanocytic naevi were also demonstrated.
Adrenoleukodystrophy
Authors: Hugo W. Moser, Gerald V. Raymond, Prachi Dubey
Journal: JAMA (2005)

X-linked adrenoleukodystrophy (X-ALD), which was first described in 1923, was viewed until 1976 as a rare and inexorably fatal neurodegenerative disorder that affected boys. The genetic defect and biochemical abnormalities have now been defined. Ongoing research has resulted in new findings: (1) there is a wide range of phenotypic expression. At least half of patients with X-ALD are adults with somewhat milder manifestations, and women who are carriers may become symptomatic. X-ALD is often misdiagnosed as attention-deficit/hyperactivity disorder in boys and as multiple sclerosis in men and women, and is not an uncommon cause of Addison disease; (2) the incidence of X-ALD, estimated to be 1:17,000 in all ethnic groups, approximates that of phenylketonuria; (3) noninvasive and presymptomatic diagnosis and prenatal diagnosis are available; family screening and genetic counseling are key to disease prevention; and (4) new therapies, applied early, show promise. Neonatal screening is likely to become available, and a wider awareness of X-ALD and its various modes of presentation permit new proactive approaches to this distressing disorder.
Limitations of routine long-term electrocardiographic monitoring to assess ventricular ectopic frequency.
Authors: J Morganroth, E L Michelson, L N Horowitz, M E Josephson, A S Pearlman, W B Dunkman
Journal: Circulation (1978)

Variations in the frequency of ventricular premature depolarizations (VPDs) were evaluated with three consecutive 24-hour long-term electrocardiography monitor recordings from 15 clinically stable patients with various cardiac disorders. Mean hourly VPD frequencies ranged from 37--1,801 per hour. Data were subjected to 4 and 5 factor nested analyses of variance. The extent of spontaneous variation in arrhythmia frequency that occurred in individual patients from day to day was 23%, between 8-hour periods within days was 29%, and from hour to hour was 48%. In addition, the variability between repeated three-day monitoring periods over time was quantified in five patients and found to be 37%. This analysis determined that to distinguish a reduction in VPD frequency attributable to therapeutic intervention rather than biologic or spontaneous variation alone required a greater than 83% reduction in VPD frequency if only two-24-hour monitoring periods were compared, and greater than 65% reduction if two 72-hour periods were compared. The limitations of routine 24-hour electrocardiographic monitoring must be considered in diagnostic and therapeutic decision-making.
A new method of analysing indicator dilution curves
Authors: R.A.F. Linton, N.W.F. Linton, D.M. Band
Journal: Cardiovascular Research (1995)

Objective: We are currently developing a new indicator dilution method of measuring cardiac output using lithium chloride as the indicator. The aim of the present study was to develop a simple and accurate method of deriving the area under the primary indicator dilution curve: that is, the area which would have been inscribed had there been no recirculation of the indicator. Method: A model based upon the representation of the mixing in the circulation as similar to that of the passage of an impulse through a series of filter elements was studied. This was represented physically by a model which consisted of a series of mixing chambers. The model was analysed theoretically using Laplace transforms and was used to test the new method of deriving the area of primary indicator dilution curves. Results: Theoretical analysis showed that such a filter model produces curves which closely approximate the shape of a lognormal distribution over a range of skewness greater than that of human indicator dilution curves. The single pass curves from the physical model were shown to be similar in shape to lognormal distributions, as were the curves obtained from patients to the point when recirculation occurred. A method of estimating the area under the primary curve based upon the lognormal distribution was developed and equations derived. The use of these equations to calculate flows from lithium dilution curves in the mixing chamber model was validated by comparing the results with simultaneous timed collection. Conclusions: Theoretical justification for treating primary indicator dilution curves as lognormal is presented. A simple method of deriving the integral of the primary indicator dilution curve is described. It uses the whole of the curve up to a point short of recirculation, avoiding the problem which can occur with the classical Hamilton extrapolation method when the cardiac output is low and recirculation distorts the primary curve in the early part of the washout.