tbuckley/cabot-search huggingface dataset:
To the Editor of The Journal of the American Medical Association
Authors: Albert L. Gihon
Journal: JAMA (1884)

Sir:  —That I might not assume to possess a monopoly in  collection of eccentricities in medical acquirements, a friend, not in  Navy, but a man of mark in  profession, too modest, however, to wish me to print his name, gave me, a few evenings ago, these additional evidences of that regular medical education which is presumptive evidence of professional abilities and acquirements:  The oracle was full of black clots.  diohrea.  Ambrose Pare was a distinguished New York Surgeon, and  Sore eyes,  phonetic guise in which psoriasis appeared on a formal medical record.  I quote them as fitting companion pieces to  following:  the mad Stone that I hav advertised is as fine a one as I ever seen I hav no use for that one as I hav got one besides as it is useful to thos who has non when they need it it is
Effects of haemolysed blood and adenosine diphosphate on the pulmonary vascular resistance in calves
Authors: E. D. Silove
Journal: Cardiovascular Research (1971)

In newborn calves a portion of the pulmonary circulation was perfused at constant rate of flow to assess pulmonary vasomotor changes. Haemolysed blood and adenosine diphosphate (ADP) elevated the pulmonary vascular resistance. This effect was reversed by isoprenaline which also counteracted hypoxic pulmonary vasoconstriction. It is suggested that haemolysis releases ADP and that this has a vasoconstrictor effect on the pulmonary circulation.
Pulmonary function in acromegaly.
Authors: C C Evans, L J Hipkin, G M Murray
Journal: Thorax (1977)

The lung volumes of 12 female and eight male patients with acromegaly, chosen because of the absence of associated cardiorespiratory disease, were determined physiologically and radiographically. Enlarged lung volumes were found in half the males but in none of the females, due allowance being made for the presence of a significant thoracic kyphosis. Upper airway narrowing was suggested by an increase in the expiratory-inspiratory flow rate ratio in six patients, four of whom were male, and acromegaly of the larynx was confirmed in the three subjects who consented to laryngoscopy. Upper airway obstruction is more likely to account for respiratory death in acromegaly than disordered pulmonary function in enlarged acromegalic lungs. Neither of these respiratory findings could be correlated with the fasting level of growth hormone but there was a suggestion that they were more likely to occur when the duration of the disorder was longer.
Allogeneic stem cell transplantation for patients with chronic myeloid leukemia: Risk stratified approach with a long‐term follow‐up
Authors: Tsila Zuckerman, Tamar Katz, Nuhad Haddad, Riva Fineman, Eldad J. Dann, Irit Avivi, Yishai Ofran, Israel Gavish, Tal Faibish, Dvora Sahar, Eti Hertz, Edmond Sabo, Yair Reisner, Jacob M. Rowe
Journal: American Journal of Hematology (2012)

The use of allogeneic stem cell transplantation (SCT) for chronic myeloid leukemia (CML) was almost abandoned in recent years for very effective targeted therapy with tyrosine kinase inhibitors (TKIs). However, approximately one third of patients still need another treatment including SCT. 38 consecutive CML patients were treated (most in preimatinib era) with allogeneic SCT, using partial T cell depletion (TCD) and preemptive donor lymphocyte infusion (DLI), without post-transplant graft-versus-host disease (GvHD) prophylaxis. Conditioning included busulfan, cyclophosphamide, antithymocytic globulin, and fludarabine followed by donor stem cell transfusion. With a median follow up of 90.5 months (1-134), 32 patients are alive. 97% engrafted. 5-year leukemia free survival (LFS) and overall survival (OS) were 78.95% and 84.2%, respectively. All patients are in major molecular remission and 78% in complete molecular remission. Transplant-related mortality (TRM) was 13%. Twenty-four patients received DLI for residual disease. Acute GvHD, mostly Grades I-II, occurred in 18% of patients post-transplant and in 24% of patients receiving DLI. In conclusion, the risk-adapted approach using only partial TCD and preemptive escalated dose of DLI precluded the need for immunosuppressive medications and reduced the risk of significant GvHD without compromising engraftment and long-term disease control. Am. J. Hematol. 2012. © 2012 Wiley Periodicals, Inc.
Best use of cardiac biomarkers in patients with AL amyloidosis and renal failure
Authors: Giovanni Palladini, Andrea Foli, Paolo Milani, Paola Russo, Riccardo Albertini, Francesca Lavatelli, Laura Obici, Stefano Perlini, Remigio Moratti, Giampaolo Merlini
Journal: American Journal of Hematology (2012)

Abstract In AL amyloidosis prognosis depends on the severity of heart dysfunction which is best assessed by natriuretic peptides (BNP and NT‐proBNP). However, their clearance relies on glomerular filtration rate (GFR) and their concentration increases with renal failure. We evaluated the diagnostic and prognostic performance of NT‐proBNP and BNP in 248 patients with AL amyloidosis with different degrees of renal failure. Patients were grouped according to GFR. Group 1 comprised 109 patients with GFR ≥60 mL/min/1.73 m 2 , Group 2, 77 subjects with GFR &lt;60 and ≥15 mL/min/1.73 m 2 , and Group 3, 62 patients with GFR &lt;15 mL/min/1.73 m 2 . The ability of natriuretic peptides to detect heart involvement and to predict survival in the three groups was assessed. Decreasing eGFR required higher cutoffs of both NT‐proBNP and BNP for detecting heart involvement and predicting survival. Both natriuretic peptides were independent prognostic markers in Groups 1 and 2, whereas in Group 3 only BNP independently predicted survival. Natriuretic peptides are powerful and useful markers of cardiac dysfunction and prognosis, provided that eGFR is considered in interpreting their clinical meaning. BNP should be preferred in patients with end‐stage renal failure. Am. J. Hematol. 87:465–471, 2012. © 2012 Wiley Periodicals, Inc.
PREVALENCE OF CORONARY ARTERY DISEASE DETECTED ON ROUTINE ECG-GATED COMPUTED TOMOGRAPHY EVALUATION OF CONGENITAL THORACIC AORTIC ANEURYSMS
Authors: Chris J. Rowan, Lee M. Mitsumori, James H. Caldwell, William P. Shuman, Joshua L. Busch, Kelley R. Branch
Journal: Journal of the American College of Cardiology (2011)
Trajectories of Growth among Children Who Have Coronary Events as Adults
Authors: David J.P. Barker, Clive Osmond, Tom J. Forsén, Eero Kajantie, Johan G. Eriksson
Journal: New England Journal of Medicine (2005)

Low birth weight is a risk factor for coronary heart disease. It is uncertain how postnatal growth affects disease risk.We studied 8760 people born in Helsinki from 1934 through 1944. Childhood growth had been recorded. A total of 357 men and 87 women had been admitted to the hospital with coronary heart disease or had died from the disease. Coronary risk factors were measured in a subset of 2003 people.The mean body size of children who had coronary events as adults was below average at birth. At two years of age the children were thin; subsequently, their body-mass index (BMI) increased relative to that of other children and had reached average values by 11 years of age. In simultaneous regressions, the hazard ratios associated with a 1 SD increase in BMI were 0.76 (95 percent confidence interval, 0.66 to 0.87; P<0.001) at 2 years and 1.14 (95 percent confidence interval, 1.00 to 1.31; P=0.05) at 11 years among the boys. The corresponding figures for the girls were 0.62 (95 percent confidence interval, 0.46 to 0.82; P=0.001) and 1.35 (95 percent confidence interval, 1.02 to 1.78; P=0.04). Low BMI at 2 years of age and increased BMI from 2 to 11 years of age were also associated with raised fasting insulin concentrations (P<0.001 for both).On average, adults who had a coronary event had been small at birth and thin at two years of age and thereafter put on weight rapidly. This pattern of growth during childhood was associated with insulin resistance in later life. The risk of coronary events was more strongly related to the tempo of childhood gain in BMI than to the BMI attained at any particular age.
No man's land: men, illness, and the NHS
Authors: I. Banks
Journal: BMJ (2001)

An important obstacle to improving men's health is their apparent reluctance to consult a doctor. US research shows that men with health problems are more likely than women to have had no recent contact with a doctor regardless of income or ethnicity.1 This reluctance means that men often do not seek help until a disease has progressed.2 Late presentation can have serious consequences. For example, deaths from melanoma are 50% higher in men than women despite a 50% lower incidence of the disease. So why do men delay seeking help, and what can be done to overcome the problem?

#### Summary points

Men do care about health issues but often find it difficult to expresses their fears

Men tend to attend their general practitioner later in the course of a condition than women and this phenomenon is exacerbated by social class inequalities

Uptake of health information and health services can be improved by making them male friendly, anonymous, and more convenient

Better use should be made of services such as NHS Direct, pharmacists, occupational health, and online advice

The nature of medical school education and medical training may contribute to potential problems in consultations between male doctors and patients

Suicide is now the single greatest cause of death among young men in most of the United Kingdom. One reason that more men die from suicide than women is that men are more likely to choose methods such as hanging or shooting that leave little room for medical intervention. Even so, men are less likely to talk about their problems with their peers or health professionals. Although the Samaritans claim that a large proportion of men have visited their general practitioner in the months before they take their own lives,3 a report by the Men's Health Forum concludes the opposite. A …
Longitudinal Pigmentation Of the Nails
Authors: John A. Parrish
Journal: JAMA (1971)

To the Editor.—  Although this is an important finding, most pigmented nail bands seen in clinical practice are due to less esoteric causes. A host of factors can be related to local or diffuse discoloration of the nail bed or nail plate, and many of these have characteristic physical findings. Subcutaneous hemorrhage, the most common cause of darkening of part of a nail, is usually accompanied by a history of pain or trauma. Pigmentation of the nail caused by chromogenic fungae is accompanied by onycholysis. Multiple bands can be seen in patients with Peutz-Jeghers syndrome1,2and some drugs, such as antimalarials, can produce longitudinal pigmentation in the nail bed. Increase in melanin in the nail bed is also seen with vitamin B12deficiency3and pinta.4  Narrow pigmented bands which extend from the proximal nail fold to the distal free edge in an otherwise normal nail suggest
Treatment of asthma by the inhaled corticosteroid ciclesonide given either in the morning or evening
Authors: D.S. Postma, C. Sevette, Y. Martinat, N. Schlösser, J. Aumann, H. Kafé
Journal: European Respiratory Journal (2001)

The study addressed the question whether the novel inhaled prodrug corticosteroid ciclesonide is equally effective when inhaled in the morning compared to the evening. For this purpose a double-blind, randomized, parallel group study was initiated in which 209 asthmatic patients (forced expiratory volume in one second=50–90% predicted) inhaled either 200 µg ciclesonide in the morning or in the evening, for 8 weeks. Efficacy was assessed by means of spirometry as well as daily recordings of morning and evening peak expiratory flow (PEF), symptoms and use of rescue medication. The 24-h urinary cortisol excretion was measured to evaluate any effect on hypothalamic-pituitary-adrenol axis. Ciclesonide significantly improved asthma control. Morning and evening administration was shown to be equally effective for the different spirometry variables, evening PEF, symptoms, use of rescue medication and number of asthma exacerbations. Regarding morning PEF, the improvements after evening dosing were more prominent and equivalence of morning and evening administration could not be demonstrated. No relevant influence on cortisol excretion was found. Overall, the study indicates that ciclesonide can be given either in the morning or in the evening to meet the patients' preference and individual medical needs, although evening administration may lead to a more pronounced improvement in morning peak expiratory flow.
EXPERIENCES WITH THE MURLESS HEAD EXTRACTOR IN CESAREAN SECTION
Authors: Abner I. Weisman
Journal: JAMA (1952)

In 1948, Murless, of Durban, South Africa, reported in the<i>British Medical Journal</i><sup>1</sup>on the use of a new head extractor in low-segment cesarean section. He devised an original single-blade instrument, which he used in 100 low-flap operations to good advantage. Murless suggested that his blade be tried by others and improved, if necessary, so that its "routine use will simplify what most surgeons still regard as a difficult manoeuvre." Accordingly, one of us (A. I. W.) wrote to Murless, and arrangements were made to obtain one of his extractors through the inventor's assistance. In late 1950, the instrument arrived from England,<sup>2</sup>and its use was evaluated on our service in a large New York City hospital. Our experience with this apparatus is reported herewith. The extractor is a single-blade fenestrated instrument, which at first glance would appear to be a cross between the blade of an ordinary
Women's health : The childbearing years and after
Authors: N. Craft
Journal: BMJ (1997)

Each year more than 150 million women become pregnant, and more than 15%—23 million women—develop complications needing skilled treatment.1 Each year, over half a million women die from causes related to pregnancy and childbirth.2 The risk of dying varies from country to country: the lifetime risk of dying from causes related to pregnancy and childbirth in Africa is 1 in 23, compared with 1 in 4000 in North America.3 The risks of childbirth are higher when there are other health problems such as high blood pressure, heart disease, malaria, and diabetes. Pregnancy also carries a higher risk for relatively young and old women and for women who have many babies in a short space of time. The dramatic falls in maternal mortality in developed countries over the past 100 years have largely been attributed to the move towards having babies in hospital.4 But women have been increasingly unhappy with the medicalisation of childbirth. In response to this, the British government set up the Cumberledge Committee, which reported in 1993. The committee found no evidence to support the medical paradigm for maternity care for most women and recommended that all the care for pregnant women should be provided by midwives. Most of the deaths from causes related to pregnancy and childbirth occur in the developing world, and almost all of these deaths are preventable with existing knowledge and technology. In response to this challenge, the international health community, including the World Bank, the World Health Organisation, the United Nations Population Fund, and agencies in 45 countries, launched the Safe Motherhood Initiative in 1987. The initiative aimed to halve the number of maternal deaths by the year 2000 by providing programmes focusing on the provision of services in three areas:
Paraproteins and bence jones protein
Authors: J. R. Hobbs
Journal: BMJ (1967)

AdU MNA -oI)-N& J,,as Shown by direct evidence quoted by him and by ourselves, but this does not remove the jpossibility that in the other cases the 0effect Is produced via the parathyroids.His parade of facts such as the prompt fall in the serum calcium after surgery, the absence .ofskeletal metastases, and the hypophos- phataemia, all of which could equally well loccur with either mechanism, and his refer- ence to Albrnght's suggestion in 1941' that tumours of non-parathyroid origin might pro- -dece a substance with the activity of this hor- mone avail nothing.The latter prognostication merely indicates how far advanced in his thought this individual was, and in fact no ouch hormone was found in that case by the metds then used.Furthermore, in so far l-as it is not totally irrelevant owing to the different hormone system involved, Mr. Keynes's reference to the work of Liddle ,et a.,' who found corticotrophin, or a closely related polypeptide, in tumour tissue, supports -he possibility of an indirect hormonal effect.As we stated, direct evidence alone in each .casewill be the final answer.We would be >-genuinely grateful if Mr. Keynes, if he for- gives us our sharpish reply, or anyone else, could assay the tumour in our case for hor- monal activity, as we still have half of it in the deep-freeze.The patient remains entirely well three years after operation.-Weare, etc.,
Effects of Alprazolam on Glucose Regulation in Diabetes: Results of double-blind, placebo-controlled trial
Authors: Patrick J Lustman, Linda S Griffith, Ray E Clouse, Kenneth E Freedland, Seth A Eisen, Eugene H Rubin, Robert M Carney, Janet B McGill
Journal: Diabetes Care (1995)

OBJECTIVE To determine the effects of alprazolam on glucose regulation in anxious and nonanxious patients with poor glycemic control and establish whether regulatory benefits are related to anxiolytic effects of the medication. RESEARCH DESIGN AND METHODS Fifty-eight patients with poor glycemic control, 16 (27.6%) of whom had a symptomatic generalized anxiety disorder, were entered into a randomized, double-blind, placebo-controlled, 8-week trial using alprazolam (up to 2 mg/day) as the active agent. Generalized anxiety disorder was determined in accordance with Diagnostic and Statistical Manual of Mental Disorders criteria, and anxiety symptoms were measured using the Hopkins Symptom Checklist. Glycated hemoglobin levels were used to determine glucose regulation. Compliance behavior was assessed using glucometers and medication monitors equipped with electronic memory. RESULTS A statistically significant reduction in glycated hemoglobin level was observed in patients treated with alprazolam compared with those receiving placebo (−1.1 vs. −0.3%, P = 0.04). This treatment effect was not a function of differences in compliance behaviors. Anxiety symptoms decreased in both alprazolam- and placebo-treated patients with generalized anxiety disorder, but reduction in glycated hemoglobin level was not dependent on alleviation of anxiety. CONCLUSIONS A short course of alprazolam improved glucose regulation in patients with a history of poor diabetes control. This effect was not directly related to concomitant changes in anxiety. Alprazolam treatment of anxious patients with poorly controlled diabetes may result in decreased anxiety and improved glucose regulation through independent mechanisms.
A Randomized Controlled Trial of Prednisone in Patients with Idiopathic Membranous Nephropathy
Authors: Daniel C. Cattran, Terry Delmore, Janet Roscoe, Edward Cole, Carl Cardella, Richard Charron, Susan Ritchie
Journal: New England Journal of Medicine (1989)

We conducted a prospective randomized study in which patients with biopsy-confirmed idiopathic membranous nephropathy were assigned to receive either a six-month course of prednisone given on alternate days (45 mg per square meter of body-surface area; n = 81) or no specific treatment (n = 77). The mean duration of follow-up was 48 months. Patients in the prednisone group (median age, 46 years) entered with a mean disease duration of 15 months, a median creatinine clearance of 1.2 ml per second per 1.73 m2 (range, 0.25 to 2.6), and a median rate of urinary protein excretion of 6.8 g per day (0.3 to 26). The annual change in the corrected creatinine clearance at six months did not differ between the prednisone group and the control group (0.10 vs. 0.06 ml per second; P = 0.8), or at the last follow-up evaluation (-0.07 vs. -0.02 ml per second; P = 0.2; 95 percent confidence interval on the difference, -0.03 to 0.13). The proportion of patients with complete remission of proteinuria was also similar in the groups at 6 and 12 months and after a mean of 48 months. Outcomes were similar in the two groups with respect to progression to renal failure (3 vs. 4 patients), death (3 vs. 1 patient), complete remission of proteinuria at 36 months (16 vs. 19 patients), and a decline of 25 percent or more in the creatinine clearance at 60 months (32 vs. 25 percent of patients). A multivariate analysis, which adjusted for differences at entry in sex distribution, urinary protein excretion, and creatinine concentration, as well as other prognostic variables, failed to provide an explanation for the lack of effect of prednisone. We conclude that a six-month course of therapy in which prednisone is given on alternate days is of no benefit to patients with idiopathic membranous nephropathy. (N Engl J Med 1989; 320:210–5.)
Insurance premium reductions. A motivating factor in long-term hypertensive treatment
Authors: M. Moser
Journal: JAMA (1984)

Elevated blood pressure substantially increases mortality and requires, therefore, high premium payments for life insurance coverage. Most life insurance companies are willing to reduce the cost of yearly premiums when blood pressure is successfully treated and controlled for several years. Physicians should bring these facts to their patients' attention as a motivating factor to improve adherence to therapy. (<i>JAMA</i>1984;251:756-757)
Relationship between Polycyclic Aromatic Hydrocarbon–DNA Adducts, Environmental Tobacco Smoke, and Child Development in the World Trade Center Cohort
Authors: Frederica P. Perera, Deliang Tang, Virginia Rauh, Yi Hsuan Tu, Wei Yann Tsai, Mark Becker, Janet L. Stein, Jeffrey King, Giuseppe Del Priore, Sally Ann Lederman
Journal: Environmental Health Perspectives (2007)

Polycyclic aromatic hydrocarbons (PAHs), including benzo[a]pyrene (BaP), are air pollutants released by the World Trade Center (WTC) fires and urban combustion sources. BaP-DNA adducts provide a measure of PAH-specific genetic damage, which has been associated with increased risk of adverse birth outcomes and cancer. We previously reported that levels of BaP-DNA adducts in maternal and umbilical cord blood obtained at delivery were elevated among subjects who had resided within 1 mile of the WTC site during the month after 9/11; and that elevated blood adducts in combination with in utero exposure to environmental tobacco smoke (ETS) were significantly associated with decreased fetal growth.Our aim was to assess possible effects of prenatal exposure to WTC pollutants on child development.After 11 September 2001, we enrolled a cohort of nonsmoking pregnant women who delivered at three lower Manhattan hospitals. We have followed a subset of children through their third birthdays and measured cognitive and motor development using the Bayley-II Scales of Child Development (BSID-II).In multivariate analyses, we found a significant interaction between cord blood adducts and in utero exposure to ETS on mental development index score at 3 years of age (p = 0.02, n = 98) whereas neither adducts nor ETS alone was a significant predictor of (BSID-II) cognitive development.Although limited by small numbers, these results suggest that exposure to elevated levels of PAHs in conjunction with prenatal ETS exposure may have contributed to a modest reduction in cognitive development among cohort children.