tbuckley/cabot-search huggingface dataset:
`Attrition' rate disturbing after coronary artery bypass surgery
Authors: Phil Gunby
Journal: JAMA (1978)

A new follow-up study of patients undergoing coronary artery bypass graft surgery for angina pectoris indicates an "attrition" rate averaging 7% annually in the five years following the first postoperative year. The investigators, from the Montreal Heart Institute, defined attrition in two ways: the recurrence of pain in patients who have not experienced it since surgery, or an increase in anginal severity by at least two functional classes. Lucien Campeau, MD, who presented the data at the American Heart Association meeting in Dallas, said that other investigators have reported attrition rates ranging from 5% to 20%, depending on the definition of deterioration and the methods of calculations used. He said that the Montreal data do not argue against aortocoronary bypass grafting for angina if medical treatment yields a less than satisfactory degree of activity for the patient. It is important, he told<i>JAMA</i>MEDICAL NEWS, that the patient take part
Inhibition of Notch signaling reduces the stem-like cell population in T47D breast cancer cells and prevents mammosphere formation.
Authors: P Grudzien, P Strack, T Golde, L Miele, KE Foreman
Journal: Cancer Research (2009)

Abstract Abstract #106 Breast cancer has been proposed as a stem cell-derived disorder based on studies identifying cancer stem cells (CSCs) in breast tumors and established cell lines. These self-renewing CSCs are thought to be responsible for breast cancer formation, progression and recurrence; therefore, a deeper understanding of the signaling pathways regulating CSC survival will benefit development of novel therapeutic strategies. Notch signaling, which is known to be dysregulated in breast cancer and has been implicated in mammary stem cell self-renewal, can be effectively blocked by gamma-secretase inhibitors (GSIs). While GSIs are currently in clinical trials for breast cancer, it is unclear how these compounds will affect CSCs or if CSCs from different breast cancer phenotypes (estrogen receptor-alpha (ER)-positive and negative) will be differentially affected. Here, we demonstrate stem-like cells derived from the T47D breast cancer cell line show elevated levels of Notch signaling, with an ER-negative subclone (T47D-C42) having higher intrinsic levels of Notch activity compared to an ER-positive subclone (T47D-A18). Blockade of Notch signaling with three structurally distinct GSIs reduced the number of stem-like cells, and completely abolished secondary mammosphere formation, which is a measure of stem cell self-renewal. Importantly, this effect was irreversible with MRK-003, but not with the two other GSIs. Moreover, our results suggest that the ER-negative cell line was more sensitive to the GSIs compared to the ER-positive line. This is consistent with our recent report that loss of estrogen signals results in Notch activation. These novel findings support a role for Notch signaling in CSC self-renewal and proliferation, and they suggest Notch inhibition may have clinical benefits in targeting CSCs. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 106.
Evaluating Behavioral Interventions: Need for Randomized Controlled Trials-Reply
Authors: Thomas A. Peterman
Journal: JAMA (1994)

<h3>In Reply.</h3> —We thank Dr Gerber and colleagues for their endorsement of our recommendation for more randomized controlled trials of behavior change intervention for HIV and sexually transmitted disease prevention. We also commend the references they cite as excellent overviews of behavioral interventions to prevent HIV. Higgins et al<sup>1</sup>document the paucity of randomized trials. Kelly,<sup>2</sup>a pioneer in HIV-related community intervention trials, writes: "After more than 12 years of the HIV epidemic—an epidemic that can only be controlled by interventions to promote risk behavior change— the lack of research evaluating outcomes of interventions to prevent HIV infection is very troubling." Our call for more randomized trials of behavioral interventions has been misinterpreted by some as a statement that behavioral interventions do not work. We believe that some behavioral interventions, like some drug therapy interventions, are effective in some instances. Randomized controlled trials help determine which interventions are
A large-scale North American study of fungal isolates from nails: The frequency of onychomycosis, fungal distribution, and antifungal susceptibility patterns
Authors: M.A. Ghannoum, R.A. Hajjeh, R. Scher, N. Konnikov, A.K. Gupta, R. Summerbell, S. Sullivan, R. Daniel, P. Krusinski, P. Fleckman, P. Rich, R. Odom, R. Aly, D. Pariser, M. Zaiac, G. Rebell, J. Lesher, B. Gerlach, G.F. Ponce-de-Leon b, A. Ghannoum a, J. Warner, N. Isham, B. Elewski
Journal: Journal of the American Academy of Dermatology (2000)
GDF-15 is an inhibitor of leukocyte integrin activation required for survival after myocardial infarction in mice
Authors: Tibor Kempf, Alexander Zarbock, Christian Widera, Stefan Butz, Anika Stadtmann, Jan Rossaint, Matteo Bolomini-Vittori, Mortimer Korf-Klingebiel, L Christian Napp, Birte Hansen, Anna Kanwischer, Udo Bavendiek, Gernot Beutel, Martin Hapke, Martin G Sauer, Carlo Laudanna, Nancy Hogg, Dietmar Vestweber, Kai C Wollert
Journal: Nature Medicine (2011)
Thrombotic Thrombocytopenic Purpura and Vincristine-Reply
Authors: Thomas D. Stevenson
Journal: JAMA (1982)

<h3>In Reply.—</h3> We think that the use of vincristine alone is justified since, in our opinion, treatment of TTP continues to be experimental. It did not jeopardize our patients, although this was learned in retrospect. We do not agree with the therapeutic approach suggested by Drs Gundlach and Tarnasky, since it would only perpetuate the current state of controversy and uncertainty about therapy for TTP. Instead, a well-designed clinical trial is needed to clarify the role of the various therapeutic measures.
Television and violence. The scale of the problem and where to go from here
Authors: B. S. Centerwall
Journal: JAMA (1992)

IN 1975, Rothenberg's Special Communication in<i>JAMA</i>, "Effect of Television Violence on Children and Youth," first alerted the medical community to the deforming effects the viewing of television violence has on normal child development, increasing levels of physical aggressiveness and violence.<sup>1</sup>In response to physicians' concerns sparked by Rothenberg's communication, the 1976 American Medical Association (AMA) House of Delegates passed Resolution 38: "The House declares TV violence threatens the health and welfare of young Americans, commits itself to remedial actions with interested parties, and encourages opposition to TV programs containing violence and to their sponsors."<sup>2</sup> Other professional organizations have since come to a similar conclusion, including the American Academy of Pediatrics and the American Psychological Association.<sup>3</sup>In light of recent research findings, in 1990 the American Academy of Pediatrics issued a policy statement: "Pediatricians should advise parents to limit their children's television viewing to 1 to 2
When a doctor goes wrong
Authors: K. Chinthapalli
Journal: BMJ (2013)

Good and evil medical practice on the roads to Damascus



On dealing with a murderous physician, Sherlock Holmes remarked, “When a doctor does go wrong he is the first of criminals. He has nerve and he has knowledge.”

One doctor also has nerve agents and knowledge of how to use them. At the Western Eye Hospital in London, Bashar al-Assad’s consultant supervisor said of him, “He was an extremely kind person and a warm personality . . . He would have been a good doctor.”1 A nurse said that he was “calm at the operating table and had a wonderful manner with the patients . . . He spoke with every patient just before surgery to reassure them all would be well.”

Now all is certainly not well for the millions of people under his care. Doctor Bashar—as Syrians once called him—president of Syria and a former ophthalmologist, is held indirectly or directly responsible for most of the 100 000 deaths and the two million refugees in his country’s ongoing civil war. After an incendiary bomb landed on a school last month, the head teacher, reported widely in the media, said, “There were dead people, people burning, and people running away, but where to? Where would they go? It is not safe anywhere.”

He may have been thinking of the …
How does angioplasty work? Serial analysis of human iliac arteries using intravascular ultrasound.
Authors: D W Losordo, K Rosenfield, A Pieczek, K Baker, M Harding, J M Isner
Journal: Circulation (1992)

Previous studies regarding the mechanism by which balloon angioplasty increases luminal patency have generally used animal models or postmortem specimens from occasional fatal cases of angioplasty performed in human patients. In either case, conclusions regarding participatory mechanisms have relied exclusively on nonserial, postangioplasty histopathological examination.In the present study, intravascular ultrasound examination was performed before and after balloon angioplasty in 40 consecutive patients with iliac artery stenoses. The areas of the arterial wall, plaque, lumen, and areas resulting from angioplasty-induced plaque fractures were measured immediately after angioplasty in vivo and compared with findings recorded immediately before angioplasty. Angioplasty increased luminal cross-sectional area (CSA) from 11.5 +/- 0.6 mm2 before angioplasty to 25.4 +/- 1.2 mm2 after angioplasty (p = 0.0001). CSA of the portion of the postangioplasty neolumen contained within angioplasty-induced plaque fractures measured 10.0 +/- 0.8 mm2; the neolumen excluding the area contributed by these plaque fractures measured 15.4 +/- 0.8 mm2. Thus, the area contained within plaque fractures accounted for 10.0 mm2 (71.9%) of the 13.9-mm2 increase in luminal CSA after angioplasty. Analysis of CSA occupied by atherosclerotic plaque disclosed that plaque CSA decreased from 33.8 +/- 1.8 mm2 before angioplasty to 22.5 +/- 1.5 mm2 after angioplasty (p = 0.0001). Plaque CSA was thus reduced ("compressed") by 11.3 +/- 1.1 mm2. Total artery CSA increased ("stretched") slightly from 45.3 +/- 2.6 mm2 before angioplasty to 47.8 +/- 2.0 mm2 after angioplasty (p = 0.0025).In vivo analysis of iliac stenoses by intravascular ultrasound immediately before and after angioplasty demonstrates that plaque fractures and "compression" of atherosclerotic plaque are the principal factors responsible for increased luminal patency resulting from balloon angioplasty. "Stretching" of the arterial wall provides an additional, but minor, contribution.
Electrocardiographic left ventricular hypertrophy is associated with mortality and left ventricular rupture in patients with acute myocardial infarction
Authors: David S. Marks, Surendra B. Gudapati, James F. Kleczka, Sabina A. Murphy, Christopher P. Cannon, Eugene Braunwald, C.M. Gibson
Journal: Journal of the American College of Cardiology (2002)
Differential Diagnosis in Pediatric Neurology
Authors: Arthur L. Drew
Journal: JAMA (1972)

Despite the author's choice of title, this excellent book is truly an introduction to pediatric neurology. One of the few books that is precisely what it purports to be, "a primary source book," achieving the author's stated aim, it is admirably suited to medical student, junior house officer, and nonneurological trainees and practitioners. The author is to be congratulated on its organization which lends itself to easy and immediately practical reference. The numerous tables of classification are extremely useful as well as being quite comprehensive. The text material is refreshingly succinct but quite comprehensive as well. The present reviewer can take exception to only two points; one is a matter of opinion, but the other really should be corrected as being misleading, perhaps dangerously so. Electromyography in infants and young children has, in most hands, not been as specifically diagnostic as Dr. Lagos implies. More important, though, is the failure
Epidemic of Mycoplasma pneumoniae infection in Denmark, 2010 and 2011
Authors: S  A Uldum, J M Bangsborg, B Gahrn-Hansen, R Ljung, M Mølvadgaard, R Føns Petersen, C Wiid Svarrer
Journal: Eurosurveillance (2012)

Denmark experienced two waves of Mycoplasma pneumoniae infection during autumn and early winter in 2010 and 2011, respectively. Both affected the whole country. The proportion of positive results was almost the same for both, indicating that the two waves were probably of equal size. High macrolide consumption during the epidemics did not seem to affect levels of macrolide resistance in M. pneumoniae, which remain low in Demark (1% to 3%).
A Western Opinion of the Journal.
Authors: J. N. Hall
Journal: JAMA (1895)

<h3>FROM ONE OF THE STATE BOARD MEDICAL EXAMINERS.</h3> Denver, Colo., Oct. 15, 1895. <h3>To the Editor:</h3> —......Let me congratulate you upon the great improvement in ourJournalrecently. I feel sure that its tone comes more nearly meeting the approbation of the part of the profession which it should reach, than if gotten up in more popular " crossroads" style. Yours very truly,
Insulin Secretion in Malignant Hyperpyrexia
Authors: M. A. Denborough, G. L. Warne, R. F. W. Moulds, P. Tse, F. I. R. Martin
Journal: BMJ (1974)

An increased glucose-induced insulin response has been observed in patients susceptible to malignant hyperpyrexia. This raises the possibility that the membrane abnormality present in the calcium-storing membranes in the muscle cell in malignant hyperpyrexia may be present also in the beta cell of the pancreas.
Cell-Nonautonomous Function of Ceramidase in Photoreceptor Homeostasis
Authors: Jairaj K. Acharya, Ujjaini Dasgupta, Satinder S. Rawat, Changqing Yuan, Parthena D. Sanxaridis, Ikuko Yonamine, Pusha Karim, Kunio Nagashima, Michael H. Brodsky, Susan Tsunoda, Usha Acharya
Journal: Neuron (2008)
SPECT for Acute Knee Pain
Authors: I P C MURRAY, J DIXON, L KOHAN
Journal: Clinical Nuclear Medicine (1990)

In the assessment of acute knee pain following recent trauma frequently related to sporting activities, bone scintigraphy was performed on 52 patients; in 40 of these patients, scintigraphy immediately preceded arthroscopy. SPECT was critical in providing delineation and sitting of the abnormalities; this would not have been feasible with conventional planar imaging in 45 of the patients. Multiple sites of focal uptake were frequently visualized at ligamentous insertions or in intra-articular areas of cartilaginous erosion. Damaged anterior cruciate ligaments were only identified in 5 out of 10 patients, occurring when there was avulsion of the tibial attachment, but changes resulting from patellar injury were demonstrated in all 8 patients. The most characteristic scintigraphic change resulted from meniscal tears, which was diagnosed in 31 out of 35 patients in whom the lesion had been suspected clinically. In the identification of this common injury, SPECT had a sensitivity of 88%, specificity of 87%, and diagnostic accuracy of 88%. Thus, although trauma readily induces scintigraphic abnormalities in and around the knee, the patterns of alteration associated with particular lesions can be identified by SPECT and can provide considerable assistance in management, particularly in determining the need for arthroscopy.
Identification and Classification of Acute Cardiac Rejection by Intragraft Transcriptional Profiling
Authors: Cécile T.J. Holweg, Luciano Potena, Helen Luikart, Tianwei Yu, Gerald J. Berry, John P. Cooke, Hannah A. Valantine, Edward S. Mocarski
Journal: Circulation (2011)

Background— Treatment of acute rejection (AR) in heart transplantation relies on histopathological grading of endomyocardial biopsies according to International Society for Heart and Lung Transplantation guidelines. Intragraft gene expression profiling may be a way to complement histological evaluation. Methods and Results— Transcriptional profiling was performed on 26 endomyocardial biopsies, and expression patterns were compared with the 1990 International Society for Heart and Lung Transplantation AR grades. Importantly, transcriptional profiles from settings with an equivalent AR grade appeared the same. In addition, grade 0 profiles could not be distinguished from 1A profiles, and grade 3A profiles could not be distinguished from 3B profiles. Comparing the AR groupings (0+1A, 1B, and 3A+3B), 0+1A showed more striking differences from 1B than from 3A+3B. When these findings were extrapolated to the 2005 revised guidelines, the combination of 1A and 1B into a single category (1R) appears to have brought together endomyocardial biopsies with different underlying processes that are not evident from histological evaluation. Grade 1B was associated with upregulated immune response genes, as 1 categorical distinction from grade 1A. Although grade 1B was distinct from the clinically relevant AR grades 3A and 3B, all of these grades shared a small number of overlapping pathways consistent with common physiological underpinnings. Conclusion— The gene expression similarities and differences identified here in different AR settings have the potential to revise the clinical perspective on acute graft rejection, pending the results of larger studies.
In Vivo Monitoring of Inflammation After Cardiac and Cerebral Ischemia by Fluorine Magnetic Resonance Imaging
Authors: Ulrich Flögel, Zhaoping Ding, Hendrik Hardung, Sebastian Jander, Gaby Reichmann, Christoph Jacoby, Rolf Schubert, Jürgen Schrader
Journal: Circulation (2008)

In this study, we developed and validated a new approach for in vivo visualization of inflammatory processes by magnetic resonance imaging using biochemically inert nanoemulsions of perfluorocarbons (PFCs).Local inflammation was provoked in 2 separate murine models of acute cardiac and cerebral ischemia, followed by intravenous injection of PFCs. Simultaneous acquisition of morphologically matching proton ((1)H) and fluorine ((19)F) images enabled an exact anatomic localization of PFCs after application. Repetitive (1)H/(19)F magnetic resonance imaging at 9.4 T revealed a time-dependent infiltration of injected PFCs into the border zone of infarcted areas in both injury models, and histology demonstrated a colocalization of PFCs with cells of the monocyte/macrophage system. We regularly found the accumulation of PFCs in lymph nodes. Using rhodamine-labeled PFCs, we identified circulating monocytes/macrophages as the main cell fraction taking up injected nanoparticles.PFCs can serve as a "positive" contrast agent for the detection of inflammation by magnetic resonance imaging, permitting a spatial resolution close to the anatomic (1)H image and an excellent degree of specificity resulting from the lack of any (19)F background. Because PFCs are nontoxic, this approach may have a broad application in the imaging and diagnosis of numerous inflammatory disease states.
Endophthalmitis Associated with Microbial Keratitis
Authors: Ingrid U. Scott, Harry W. Flynn, William Feuer, Stephen C. Pflugfelder, Eduardo C. Alfonso, Richard K. Forster, Darlene Miller
Journal: Ophthalmology (1996)

The purpose of the study is to investigate possible risk factors, organisms cultured, and visual acuity outcomes of endophthalmitis associated with microbial keratitis.Records were reviewed of all patients with both positive corneal and positive intraocular cultures at the Bascom Palmer Eye Institute between January 1, 1990, and March 31, 1995.Thirteen (92.9%) of 14 patients identified had documented keratitis before the diagnosis of endophthalmitis was made. Thirteen (92.9%) patients recently had used 1% prednisolone acetate eye drops, 2 (14.3%) received oral prednisone, and 5 (35.7%) were being treated for systemic conditions associated with relative immune dysfunction. Eight (57.1%) patients had a history of ocular surgery, and seven (50.0%) had wound abnormalities. Eight (57.1%) patients lacked an intact posterior capsule, four (28.6%) had a corneal perforation, and three (21.4%) had a history of dry eye. Gram-negative organisms (7), Staphylococcus aureus (3), streptococcal species (2), and fungi (4) were the most frequently isolated organisms. Coagulase-negative staphylococci were not isolated. Six (42.9%) patients achieved a post-treatment visual acuity of 20/200 or better. Three (21.4%) patients underwent enucleation or evisceration. Although not statistically significant, there was an association between appropriate initial antibiotic therapy and improved visual outcomes.Patients in whom endophthalmitis associated with microbial keratitis develops have a frequent history of corticosteroid use, systemic conditions associated with relative immune dysfunction, lack of an intact posterior capsule, dry eye, wound abnormalities, and/or corneal perforation. In general, agents cultured consisted of organisms less frequently reported to be the causative agents in series of postoperative and post-traumatic endophthalmitis. Post-treatment visual outcomes generally were poor.
The effects of serotonin antagonists in an animal model of sleep-disordered breathing.
Authors: S C Veasey, K A Panckeri, E A Hoffman, A I Pack, J C Hendricks
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

Recent studies have shown excitatory effects of serotonin on upper airway motoneurons. This excitatory effect is normally present and arises from cells in the caudal raphe nuclei. The firing of these serotonergic neurons is reduced during sleep. To determine the importance of serotonin in the maintenance of patient airways and normal respiration in waking in obstructive sleep apnea, we studied the effects of two serotonin antagonists on upper airway dilator muscle activity, diaphragm activity, Sao2, and upper airway cross-sectional area in an animal model of sleep-disordered breathing, the English bulldog. Systemic administration of both antagonists resulted in significant reductions in the peak amplitudes of upper airway muscle respiratory bursts (range, 39 to 62% suppression; p < 0.05). Lesser reductions in diaphragm activity were noted (range, 10 to 33% suppression; p < 0.05). Oxyhemoglobin saturations also fell (p < 0.05), coinciding with suppressions in upper airway muscle activity. With reductions in dilator muscle activity, upper airway cross-sectional areas, as measured with cine CT, showed significant inspiratory collapse. These results support the hypothesis that serotonin is important in the maintenance of patent upper airways in obstructive sleep apnea.
A clinical study of the effects of etretinate on bone in children and adolescents
Authors: M.T. Glover, D.J. Atherton, M. Peters
Journal: British Journal of Dermatology (1987)

Recent reports have described the development of skeletal abnormalities in patients treated with etretinate (Tigason®). We have therefore examined 19 children and adolescents who have been continuously treated with etretinate for several years (median duration of treatment 5 years). Their overall mean daily dose ranged from 0·4 to 1 mg/kg (median 0·8 mg/kg). All subjects received musculoskeletal assessment and a 99mtechnetium methylene diphosphonate (99mTc MDP) whole body bone scan, which results in a lower total radiation dose than a skeletal survey, and is more sensitive. Bone scans identify sites of abnormal turnover of bone earlier than plain radiographs, and are valuable in the early assessment of abnormalities of the growth plate, provided high resolution collimation is used. These studies revealed no evidence of significant bony abnormality in any patient. We therefore believe that long‐term etretinate therapy can probably be given with a low risk of musculoskeletal toxicity if certain precautions are taken, particularly use of low doses, early investigation of musculoskeletal symptoms and regular 99mTc MDP bone scans.