tbuckley/cabot-search huggingface dataset:
901-3 The Potential for Unexpected Hazard of Intravenous Beta-Blockade for Acute Myocardial Infarction: Results from the GUSTO Trial
Authors: Sorin J. Brener, Jafna L. Cox, Matthias E. Pfisterer, Paul W. Armstrong, Robert M. Califf, Eric J. Topol
Journal: Journal of the American College of Cardiology (1995)
CARDIOVASCULAR (CV) RISK STRATIFICATION BY PRIMARY CARE PHYSICIANS (PCPS) USING FRAMINGHAM RISK SCORE (FRS) AND IN-OFFICE CAROTID ULTRASOUND: PRELIMINARY RESULTS FROM THE PRIMARY CARE AUDIT OF GLOBAL RISK MANAGEMENT (PARADIGM) STUDY
Authors: G.B. John Mancini, Subodh Verma, Michelle Tsigoulis, Mahesh Kajil, Muhammad Mamdani, Milan Gupta
Journal: Journal of the American College of Cardiology (2011)
Fatal Fat Embolism following Replacement Arthroplasty for Transcervical Fractures of Femur
Authors: G. A. Gresham, A. Kuczynski, D. Rosborough
Journal: BMJ (1971)

Seven cases are reported of death in old people associated with transcervical fractures of the femur and occurring shortly after insertion of a Thompson prosthesis. They are compared with six fatalities following similar injury but not surgically treated and with three which followed internal fixation. Positive controls for massive fat embolism were selected from fatal cases of multiple and severe skeletal fractures due to road accidents.It seems likely that patients undergoing this operation are peculiarly susceptible to lethal fat embolism. The clinical features, diagnosis, pathological aspects, and prevention of fat embolism are discussed.
Extracranial Occlusive Cerebrovascular Disease: Diagnosis and Management
Authors: Horace Norrell
Journal: JAMA (1971)

Most current information dealing with extracranial cerebrovascular disease has been published either as a symposium, with various contributions differing in quality, or as a cooperative study which often does not sustain a high degree of reader interest. Wylie and Ehrenfeld have produced a well-organized and comprehensive monograph based upon a critical analysis of 12 years' personal experience with more than 800 operations for extracranial cerebrovascular disease. They have artfully included a review of anatomy, physiology, pathology, and neurology accompanying altered cerebral blood flow. Everyone interested in cerebrovascular disease should read this short monograph. Although strong advocates of anticoagulant therapy may disagree with some aspects of the book, they will agree that it is filled with useful information. The sections on pathology, neurological syndromes, and surgical results are accompanied by appropriate patient group analyses. The illustrations, including diagrams and operative and surgical specimen photographs, are abundant and well chosen. The excellent
Changes in the Use of Medical Technologies, 1972–1977
Authors: Jonathan A. Showstack, Steven A. Schroeder, Michael F. Matsumoto
Journal: New England Journal of Medicine (1982)

Abstract To assess the degree to which use of hospital tests and procedures changed over a five-year period, we studied 1203 patients who were hospitalized at the University of California, San Francisco, in either 1972 or 1977 with one of 10 diagnoses: acute asthma, acute myocardial infarction, lung cancer, respiratory-distress syndrome of the newborn, cataract excision, cesarean section or vaginal delivery, kidney transplantation, stapedectomy, or total hip replacement. After careful adjustment for case severity, the total number of tests and procedures per hospital stay was found to be relatively unchanged over the five-year period for most but not all the diagnoses. However, the use of certain new diagnostic procedures (such as determination of arterial blood gases, ultrasonography, fetal monitoring, and radioisotope scanning) did increase significantly. Although generalization from these limited observations must be cautious, the data suggest that a "technology imperative" may apply more to the introduction of new technologies than to the expanding use of older, established tests and procedures. Effective cost-containment strategies must recognize the complexities of technology use among different diagnoses. (N Engl J Med. 1982; 306:706–12.)
Receipt of Disease-Modifying Antirheumatic Drugs Among Patients With Rheumatoid Arthritis in Medicare Managed Care Plans
Authors: Gabriela Schmajuk, Amal N. Trivedi, Daniel H. Solomon, Edward Yelin, Laura Trupin, Eliza F. Chakravarty, Jinoos Yazdany
Journal: JAMA (2011)

Context In 2005, the Healthcare Effectiveness Data and Information Set (HEDIS) introduced a quality measure to assess the receipt of disease-modifying antirheumatic drugs (DMARDs) among patients with rheumatoid arthritis (RA). Objective To identify sociodemographic, community, and health plan factors associated with DMARD receipt among Medicare managed care enrollees. Design, Setting, and Participants We analyzed individual-level HEDIS data for 93 143 patients who were at least 65 years old with at least 2 diagnoses of RA within a measurement year (during 2005-2008). Logistic regression models with generalized estimating equations were used to determine factors associated with DMARD receipt and logistic regression was used to adjust health plan performance for case mix. Main Outcome Measures Receipt or nonreceipt of DMARD. Results The mean age of patients was 74 years; 75% were women and 82% were white. Overall performance on the HEDIS measure for RA was 59% in 2005, increasing to 67% in 2008 ( P for trend &amp;amp;lt;.001). The largest difference in performance was based on age: patients aged 85 years and older had a 30 percentage point lower rate of DMARD receipt (95% confidence interval [CI], −29 to −32 points; P &amp;amp;lt; .001), compared with patients 65 to 69 years of age, even after adjusting for other factors. Lower percentage point rates were also found for patients who were men (−3 points; 95% CI, −5 to −2 points; P &amp;amp;lt; .001), of black race (−4 points; 95% CI, −6 to −2 points; P &amp;amp;lt; .001), with low personal income (−6 points; 95% CI, −8 to −5 points; P &amp;amp;lt; .001), with the lowest zip code–based socioeconomic status (−4 points; 95% CI, −6 to 2 points; P &amp;amp;lt; .001), or enrolled in for-profit health plans (−4 points; 95% CI, −7 to 0 points; P &amp;amp;lt; .001); and in the Middle Atlantic region (−7 points; 95% CI, −13 to −2 points; P &amp;amp;lt; .001) and South Atlantic regions (−11 points; 95% CI, −20 to −3 points; P &amp;amp;lt; .001) as compared with the Pacific region. Performance varied widely by health plan, ranging from 16% to 87%. Conclusions Among Medicare managed care enrollees carrying a diagnosis of RA between 2005 and 2008, 63% received a DMARD. Receipt of DMARDs varied based on demographic factors, socioeconomic status, geographic location, and health plan.
Discriminant Value of Thyroid Function Tests
Authors: D. B. Barnett, A. A. Greenfield, P. J. Howlett, J. C. Hudson, R. N. Smith
Journal: BMJ (1973)

Different thyroid function tests permitted a final classification of 204 consecutive patients with suspected thyroid disorders into three populations (thyrotoxic, euthyroid, and hypothyroid). Linear discriminant analysis was applied to all test results (10 variates) on adjacent population pairs. Two invitro tests (serum protein bound iodine (P.B.I.) and tri-iodothyronine (T-3) uptake values) gave good separation of thyrotoxic from euthyroid patients and fairly good distinction of hypothyroid patients. If a (131)I uptake figure was then added to the in-vitro results most patients (95.5%), including thse initially classified as equivocal, were correctly diagnosed. Other tests, including clinical questionnaires, were poor discriminants.Two new techniques of utilizing the test data were devised. Firstly, the data from the two in-vitro tests were also displayed graphically, and oblique boundary lines derived from the discriminant functions gave better separation of patients than previously used limits or mathematical expressions of "free thyroxine." Secondly, a nomogram incorporating the best four discriminants was designed as a diagnostic aid and proved to be the best means of interpreting the tests.Discriminant analysis of this kind can be used in the interpretation of diagnostic tests in any branch of medicine, and it allows the best use to be made of the available data.
Lethal influenza infection in the absence of the natural killer cell receptor gene Ncr1
Authors: Roi Gazit, Raizy Gruda, Moran Elboim, Tal I Arnon, Gil Katz, Hagit Achdout, Jacob Hanna, Udi Qimron, Guy Landau, Evgenia Greenbaum, Zichria Zakay-Rones, Angel Porgador, Ofer Mandelboim
Journal: Nature Immunology (2006)
Foxo1 is required in mouse spermatogonial stem cells for their maintenance and the initiation of spermatogenesis
Authors: Meredith J. Goertz, Zhuoru Wu, Teresa D. Gallardo, F. Kent Hamra, Diego H. Castrillon
Journal: Journal of Clinical Investigation (2011)

Spermatogonial stem cells (SSCs) capable of self-renewal and differentiation are the foundation for spermatogenesis. Although several factors important for these processes have been identified, the fundamental mechanisms regulating SSC self-renewal and differentiation remain unknown. Here, we investigated a role for the Foxo transcription factors in mouse spermatogenesis and found that Foxo1 specifically marks mouse gonocytes and a subset of spermatogonia with stem cell potential. Genetic analyses showed that Foxo1 was required for both SSC homeostasis and the initiation of spermatogenesis. Combined deficiency of Foxo1, Foxo3, and Foxo4 resulted in a severe impairment of SSC self-renewal and a complete block of differentiation, indicating that Foxo3 and Foxo4, although dispensable for male fertility, contribute to SSC function. By conditional inactivation of 3-phosphoinositide-dependent protein kinase 1 (Pdk1) and phosphatase and tensin homolog (Pten) in the male germ line, we found that PI3K signaling regulates Foxo1 stability and subcellular localization, revealing that the Foxos are pivotal effectors of PI3K-Akt signaling in SSCs. We also identified a network of Foxo gene targets--most notably Ret--that rationalized the maintenance of SSCs by the Foxos. These studies demonstrate that Foxo1 expression in the spermatogenic lineage is intimately associated with the stem cell state and revealed what we believe to be novel Foxo-dependent mechanisms underlying SSC self-renewal and differentiation, with implications for common diseases, including male infertility and testicular cancer, due to abnormalities in SSC function.
THE TREATMENT OF SMALLPOX PRINCIPALLY BY MEANS OF THE INTERNAL USE OF THE TINCTURE OF THE CHLORID OF IRON.
Authors: BEDFORD BROWN
Journal: JAMA (1895)

My personal experience in the observation and treatment of variola comprises about one hundred and fifty cases. About sixty of these were seen in the Confederate Army during the late war. The remainder were seen in an epidemic soon after the close of the war, and in an epidemic in this city about the year 1871. Of these cases, at least one-third were of the confluent form. The remainder were of the discrete type. Only about one-fourth of these cases had been vaccinated. In all those vaccinated the type was mild, what is known as varioloid. In the year 1863, smallpox appeared in the Confederate Army in the department of North Carolina, extending from Petersburg, Va., to Wilmington, N. C., and threatened to assume dangerous proportions, as an epidemic. As medical director of the department at that time, I received from the General commanding, G. W. Smith, plenary powers to
Peptic Ulcer as a Manifestation of Familial Polyendocrine Disease
Authors: William C. Mieher
Journal: JAMA (1962)

Two cases of polyendocrine disease occurring in sisters and presenting as intractable peptic ulcer are reported. In both cases the criteria of the Zollinger-Ellison syndrome were satisfied. One sister, aged 53, after a course of recurrent ulcer and perforation of the jejunum, died in renal failure caused by nephrocalcinosis. Abnormalities were found in the pituitary, parathyroids, pancreas, and adrenals. The other sister, aged 46, had intractable ulcer symptoms. Surgical findings indicated polyendocrine disease. She became virtually symptom-free after subtotal gastrectomy and removal of 3 pancreatic tumors. Eight other members of the family have been similarly affected. The authors believe that the Zollinger-Ellison syndrome is an expression of polyendocrine disease.
Glucose intolerance and 23-year risk of coronary heart disease and total mortality: the Honolulu Heart Program.
Authors: B L Rodriguez, N Lau, C M Burchfiel, R D Abbott, D S Sharp, K Yano, J D Curb
Journal: Diabetes Care (1999)

OBJECTIVE: The associations between glucose intolerance measured at the study entry date and the 23-year incidence of coronary heart disease (CHD), CHD mortality, and total mortality were examined at the Honolulu Heart Program. RESEARCH DESIGN AND METHODS: This prospective study followed a cohort of 8,006 Japanese-American men who were 45-68 years old and living on the island of Oahu, HI, in 1965. Baseline glucose was measured in a nonfasting state 1 h after a 50-g glucose load. History and use of medication for diabetes was obtained during an interview. The cohort was divided into four categories of glucose tolerance: low-normal, high-normal, asymptomatic hyperglycemia, and known diabetes. RESULTS: During the 23 years of follow-up, 864 incident cases of CHD, 384 deaths from CHD, and 2,166 total deaths occurred. The relative risks (RRs) were obtained using Cox proportional hazards modeling, with the low-normal category as a reference. The RRs were adjusted for age only, as well as for age, BMI, hypertension, cholesterol, triglycerides, smoking, alcohol, and a Japanese diet index. The age-adjusted and risk factor-adjusted RRs for all outcomes were significant for the asymptomatic hyperglycemic and known diabetes groups (P&amp;lt;0.05). The age-adjusted RRs for CHD incidence and total mortality were marginally significant in the high-normal group, but the RRs were not significant when adjusted for risk factors. CONCLUSIONS: These results suggest a dose-response relation of glucose intolerance at baseline with CHD incidence, CHD mortality, and total mortality, independent of other risk factors, in this cohort of middle-aged and older Japanese-American men.
A Side Light on Ethics.
Authors: W. H. Burr
Journal: JAMA (1903)

Phoenix, Ariz., Jan. 17, 1903.  To the Editor:  —Referring to the communication of Dr. Gillmore inThe Journal, January 3, A Side Light on Ethics, I would like to say that the Eminent Consultant is not only responsible for the bulldog tendency of to-day, but also for the increase of the horde of medical Arabs who, finding it difficult to be honest with the profession or public, and live, scour the deserts and cities, seeking whom they may devour.  The Eminent Consultant of the species described by Dr. Gillmore is a reproach to the profession, and does more to bring discredit on the profession and break up professional unity, nullify professional organizations and destroy charity than do the fakers and medical parasites.  I would submit as a remedy for this disease one which, though it may seem heroic and in itself subversive of some of the tenets of the Code
Reply to K. Tay et al
Authors: Marita Ziepert, Norbert Schmitz, Michael Pfreundschuh, Markus Loeffler
Journal: Journal of Clinical Oncology (2010)

The well-established International Prognostic Index (IPI) developed by Shipp et al 1 over many years allowed a widely accepted risk stratification of patients with aggressive lymphoma worldwide and guaranteed the international comparability of clinical trial results.The IPI, developed in the prerituximab era, was confirmed in many analyses comparing different treatment regimens in different lymphoma entities.Recently, marked improvement of treatment outcomes has been achieved by adding rituximab to chemotherapy.Prognostic factors may change with novel treatment strategies; we, therefore, checked whether the IPI score is valid also when rituximabcontaining regimens are used.Robust prognostic factors should reflect important biologic features of the tumor and thereforeagainst the statement from Tay et al 2 -should be effective largely independent from therapy. 1,3We investigated the validity of IPI score pooling the data from three prospective clinical trials.Data was included for patients Ͼ 60 years from the RICOVER-60 (cyclophosphamide, doxorubicin, vincristine, and prednisone plus rituximab [R-CHOP] for patients older than age 60 years) trial (n ϭ 610), patients Յ 60 years with a good prognosis from MInT (Mab-Thera International Trial; n ϭ 380), and patients Յ 60 years with a poor prognosis from MegaCHOEP (dose-escalated regimen of cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone) trial (n ϭ 72).All of these studies used rituximab and chemotherapy and confirmed that the IPI score is valid also in rituximab era.We analyzed the data of all three trials separately and demonstrated that the IPI was similarly effective in separating individual risk groups.Within each of the three populations we found significant differences between IPI score groups (see Fig 1 of our article 4 ).In the MInT and the RICOVER-60 trial (see Figs 2 and3 4 ) we showed that a shift to better treatment results occurs within each IPI group if rituximab is used.The different patient numbers representing our three populations, in particular the low number of young poor-prognosis patients, do not invalidate our results; they only reflect the relative scarcity of young high-risk patients in the population at large.Furthermore, we illustrated by a simulation that analyses of a prognostic factor system distinguishing four ordered groups requires larger samples sizes than reported by Sehn et al 5 in a retrospective analysis of data from only 365 patients or as mentioned by Tay et al (data not shown). 2Their sample sizes are too small to draw reliable conclusions as they are prone to random effects leading to overlays between different patient groups.In conclusion, the statements raised by Tay et al are not useful to make a case that the classical IPI system should be replaced.It should be used further on to allocate patients to risk groups and to report clinical trials in lymphomas as the reference.
Giant-cell Arteritis, or Arteritis of the Aged
Authors: J. W. Paulley, J. P. Hughes
Journal: BMJ (1960)

Giant-cell arteritis, once believed to run a benign course, kills or maims a number of those afflicted, and when in remission it may only sleep. We hope for wider recognition of this common disorder, which is treatable for the most part, but if untreated may progress slowly with pain, palsy, blindness, deafness, and madness in its train, or sometimes more rapidly to a fatal termination. Diagnostic failure is due to many diverse presentations, some of which are little known, and to continued acceptance of a too rigid profile of the disease, despite the fact that the literature is replete with clinical and pathological evidence of its systemic nature. It must be emphasized that classical involvement of the tem poral arteries may appear late, transiently, or possibly not at all during the period of observation ; it is only one incident of a disorder phased in time and widespread in its distribution.
Mouse hepatitis virus type 3 infection provokes a decrease in the number of sinusoidal endothelial cell fenestrae bothin vivo andin vitro
Authors: Anne-Marie Steffan, Carlos Augusto Pereira, Annick Bingen, Michele Valle, Jean-Pierre Martin, Françoise Koehren, Cathy Royer, Jean-Louis Gendrault, André Kirn
Journal: Hepatology (1995)

Fenestrations of hepatic endothelial cells play an active role as a sieving barrier allowing extensive exchange between the blood and liver parenchyma. Alteraction of these structures may be induced in the course of various pathological events and provoke important perturbations of liver function. We demonstrate here that sinusoidal endothelial cells are permissive for mouse hepatitis virus 3 (MHV3) in vivo and in vitro and that this infection leads to a striking decrease in the number of fenestrae. The disappearance of these structures observed under scanning electron microscopy or in cryofracture preparations in vivo and in vitro cannot be reversed by the action of cytochalasin B on the microfilament network. The decrease in the porosity seems to be related directly to the productive infection of the endothelial cells, because it was not observed in A/J mice resistant to the virus and in susceptible BALB/c mice immunized with a thermosensitive mutant in which no viral replication occurs. In conclusion, a viral infection of liver endothelial cells may cause extensive loss of the fenestrations and thus lead to important functional pertubations. (Hepatology 1995; 22:395-401.)
TREATMENT OF CIRRHOSIS OF THE LIVER BY A NUTRITIOUS DIET AND SUPPLEMENTS RICH IN VITAMIN B COMPLEX
Authors: Arthur J. Patek, Joseph Post
Journal: Journal of Clinical Investigation (1941)

Clinical data on paients with, cirrhosis of the liver Treated series (54 patients) Control series (386 patients) Group 1 Group 2 Group 3 T 20 patients 12 patients 22 patients Total number o ctale | Number Per cent recovered improved failede cn
Gene Therapy for Myocardial Angiogenesis
Authors: Douglas W. Losordo, Peter R. Vale, James F. Symes, Cheryl H. Dunnington, Darryl D. Esakof, Michael Maysky, Alan B. Ashare, Kishor Lathi, Jeffrey M. Isner
Journal: Circulation (1998)

Background —We initiated a phase 1 clinical study to determine the safety and bioactivity of direct myocardial gene transfer of vascular endothelial growth factor (VEGF) as sole therapy for patients with symptomatic myocardial ischemia. Methods and Results —VEGF gene transfer (GTx) was performed in 5 patients (all male, ages 53 to 71) who had failed conventional therapy; these men had angina (determined by angiographically documented coronary artery disease). Naked plasmid DNA encoding VEGF (phVEGF 165 ) was injected directly into the ischemic myocardium via a mini left anterior thoracotomy. Injections caused no changes in heart rate (pre-GTx=75±15/min versus post-GTx=80±16/min, P =NS), systolic BP (114±7 versus 118±7 mm Hg, P =NS), or diastolic BP (57±2 versus 59±2 mm Hg, P =NS). Ventricular arrhythmias were limited to single unifocal premature beats at the moment of injection. Serial ECGs showed no evidence of new myocardial infarction in any patient. Intraoperative blood loss was 0 to 50 cm 3 , and total chest tube drainage was 110 to 395 cm 3 . Postoperative cardiac output fell transiently but increased within 24 hours (preanesthesia=4.8±0.4 versus postanesthesia=4.1±0.3 versus 24 hours postoperative=6.3±0.8, P =0.02). Time to extubation after closure was 18.4±1.4 minutes; average postoperative hospital stay was 3.8 days. All patients had significant reduction in angina (nitroglycerin [NTG] use=53.9±10.0/wk pre-GTx versus 9.8±6.9/wk post-GTx, P &lt;0.03). Postoperative left ventricular ejection fraction (LVEF) was either unchanged (n=3) or improved (n=2, mean increase in LVEF=5%). Objective evidence of reduced ischemia was documented using dobutamine single photon emission computed tomography (SPECT)-sestamibi imaging in all patients. Coronary angiography showed improved Rentrop score in 5 of 5 patients. Conclusions —This initial experience with naked gene transfer as sole therapy for myocardial ischemia suggests that direct myocardial injection of naked plasmid DNA, via a minimally invasive chest wall incision, is safe and may lead to reduced symptoms and improved myocardial perfusion in selected patients with chronic myocardial ischemia.