tbuckley/cabot-search huggingface dataset:
Statins for Improving Renal Outcomes
Authors: Sabrina Sandhu, Natasha Wiebe, Linda F. Fried, Marcello Tonelli
Journal: Journal of the American Society of Nephrology (2006)

Statins frequently are used to prevent cardiovascular events. Several recent studies suggest that statins also may have renal benefits, although this is controversial. This systematic review and meta-analysis were performed to assess the effect of statins on change in kidney function and urinary protein excretion. Medline, EMBASE, the Cochrane Central Register of Controlled Trials, conference proceedings, and the authors' personal files were searched. Published or unpublished randomized, controlled trials or crossover trials of statins that reported assessment of kidney function or proteinuria were included, and studies of individuals with ESRD were excluded. Data were extracted for study design, subject characteristics, type of statin and dose, baseline/change in cholesterol levels, and outcomes (change in measured or estimated GFR [eGFR] and/or urinary protein excretion). Weighted mean differences were calculated for the change in GFR between statin and control groups using a random-effects model. A random-effects model also was used to calculate the standardized mean difference for the change in urinary protein excretion between groups. Twenty-seven eligible studies with 39,704 participants (21 with data for eGFR and 20 for proteinuria or albuminuria) were identified. Overall, the change in the weighted mean differences for eGFR was statistically significant (1.22 ml/min per yr slower in statin recipients; 95% confidence interval [CI] 0.44 to 2.00). In subgroup analysis, the benefit of statin therapy was statistically significant in studies of participants with cardiovascular disease (0.93 ml/min per yr slower than control subjects; 95% CI 0.10 to 1.76) but was NS for studies of participants with diabetic or hypertensive kidney disease or glomerulonephritis. The standardized mean difference for the reduction in albuminuria or proteinuria as a result of statin therapy was statistically significant (0.58 units of SD greater in statin recipients; 95% CI 0.17 to 0.98). Statin therapy seems to reduce proteinuria modestly and results in a small reduction in the rate of kidney function loss, especially in populations with cardiovascular disease.
Clopidogrel Loading With Eptifibatide to Arrest the Reactivity of Platelets
Authors: Paul A. Gurbel, Kevin P. Bliden, Kazi A. Zaman, Jason A. Yoho, Kevin M. Hayes, Udaya S. Tantry
Journal: Circulation (2005)

Pretreatment is not the most common strategy practiced for clopidogrel administration in elective coronary stenting. Moreover, limited information is available on the antiplatelet pharmacodynamics of a 300-mg versus a 600-mg clopidogrel loading dose, and the comparative effect of eptifibatide with these regimens is unknown.Patients undergoing elective stenting (n=120) were enrolled in a 2x2 factorial study (300 mg clopidogrel with or without eptifibatide; 600 mg clopidogrel with or without eptifibatide) (Clopidogrel Loading With Eptifibatide to Arrest the Reactivity of Platelets [CLEAR PLATELETS] Study). Clopidogrel was administered immediately after stenting. Aggregometry and flow cytometry were used to assess platelet reactivity. Eptifibatide added a > or =2-fold increase in platelet inhibition to 600 mg clopidogrel alone at 3, 8, and 18 to 24 hours after stenting as measured by 5 micromol/L ADP-induced aggregation (P<0.001). Without eptifibatide, 600 mg clopidogrel produced better inhibition than 300 mg clopidogrel at all time points (P<0.001). Glycoprotein IIb/IIIa (GPIIb/IIIa) blockade was associated with lower cardiac marker release. Active GPIIb/IIIa expression was inhibited most in the groups treated with eptifibatide (P<0.05).In elective stenting without clopidogrel pretreatment, use of a GPIIb/IIIa inhibitor produces superior platelet inhibition and lower myocardial necrosis compared with high-dose (600 mg) or standard-dose (300 mg) clopidogrel loading alone. In the absence of a GPIIb/IIIa inhibitor, 600 mg clopidogrel provides better platelet inhibition than the standard 300-mg dose. These results require confirmation in a large-scale clinical trial.
Residencies down the Drain?
Authors: BARKLEY BEIDLEMAN
Journal: Annals of Internal Medicine (1972)

Letters, Comments, and Corrections1 August 1972Residencies down the Drain?BARKLEY BEIDLEMAN, M.D., F.A.C.P.BARKLEY BEIDLEMAN, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-77-2-322_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In reference to Dr. Richard V. Ebert's lecture, "Training of the Internist as a Primary Physician" [Ann Intern Med76:653-656, 1972], I was with Dr. Ebert all the way until the last paragraph. To that point, he summarized very nicely—accurately and with adequate foundation, in fact—the problems that face the specialty of internal medicine in its role as provider of primary medical care. He also offers part of the solution in suggesting that residents in internal medicine serve in ambulatory care centers to obtain first-hand knowledge of delivery of primary care. Then he blows the whole thing!...Reference1. Graduate medical education. Annual report on graduate medical education in the United States. DIVISION OF MEDICAL EDUCATION OF AMA: JAMA 218:1229-1257, 1971 MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 August 1972Volume 77, Issue 2Page: 322-322KeywordsResidency Issue Published: 1 August 1972 PDF DownloadLoading ...
The Biology of Osteoarthritis
Authors: Franklin H. Epstein, David Hamerman
Journal: New England Journal of Medicine (1989)

OSTEOARTHRITIS, "an almost inevitable consequence of aging,"1 is second only to cardiovascular diseases in producing severe chronic disability, and it affects nearly 10 percent of the population over the age of 60.2 This prevalence and its costs — billions of dollars in medications, surgery, and days lost from work3 — account for the growing interest in uncovering the basic mechanisms by which this disease affects human joints.4 5 6 7 8 9 Osteoarthritis can involve axial, or spinal, as well as peripheral joints — those that bear weight (such as the hips and knees) as well as those that do not (such as the distal . . .
The Tragedy of the Commons Revisited
Authors: Rafid Fadul
Journal: New England Journal of Medicine (2009)

Garrett Hardin's essay “The Tragedy of the Commons”1 aptly describes the current state of the U.S. health care system. Hardin tells the story of herders who make what are individually rational decisions to exploit common land by grazing as many cattle as possible, to the ultimate detriment of the land and consequently the common good. The herders are not villains; rather, they are doing what makes sense given the system in place. Analogously, many observers are currently tempted to cast certain players in the health care arena as villains, but they are merely doing what is rational given the current . . .
Institute of Medicine responds
Authors: J. C. Gallagher, C. Rosen
Journal: BMJ (2011)

The Institute of Medicine (IOM) criticised inconsistencies and misrepresentations of data in the meta-analysis of vitamin D and fall prevention by Bischoff-Ferrari and colleagues.1 2 The authors replied to the IOM,3 and we respond to them as members of the IOM committee.

In assessing the dose-response relation between vitamin D dose, serum 25-hydroxyvitamin D concentration, and risk of a fall the authors opted to compare subgroups of studies above or below a cut off point of vitamin D dose and serum 25 hydroxyvitamin …
Narcolepsy and Highway Accidents
Authors: Thomas C. Grubb
Journal: JAMA (1969)

<h3>To the Editor:—</h3> Waller's recent report "Medical Impairment and Highway Crashes" (<b>208</b>:2293, 1969) stresses the importance of alcoholism but completely fails to mention another medical impairment—narcolepsy—which undoubtedly contributes to the total highway death and accident rate. In 1965 Bartels and Kushacioglu<sup>1</sup>called attention to the possible role of narcolepsy in automobile accidents. Based on 105 patient questionnaires, they reported that "77% of the patients with narcolepsy admitted driving while drowsy, as compared to 14% of the controls" and "40% of the patients with narcolepsy actually fell asleep while driving as compared with 7% of the controls." Roberts, who has made studies on narcolepsy among Negroes, also noted that patients with the disease were potential highway hazards. Some of his narcoleptic patients were even penalized for purported intoxication by misinterpretation of their symptoms.<sup>2,3</sup> It is difficult to estimate how much narcolepsy contributes to highway accidents for lack of
Effect of Glutathione on DNA Repair in Cisplatin-Resistant Human Ovarian Cancer Cell Lines
Authors: G.-M. Lai, R. F. Ozols, R. C. Young, T. C. Hamilton
Journal: JNCI Journal of the National Cancer Institute (1989)

We have studied the effect of glutathione reduction by buthionine sulf-oximine (BSO), a specific inhibitor ofλ -glutamyl cysteine synthetase, on DNA repair after cisplatin damage in an ovarian cancer cell line with invitro induced resistance to cisplatin. In addition, we have examined the effect of aphidicolin, a specific inhibitor of DNA polymerase a, in combination with BSO on cisplatin-associated DNA repair. BSO treatment was found topartially inhibit DNA repair, and the addition of aphidicolin caused nearly a100% inhibition in DNA repair activity. Treatment of cells with glutathioneester after BSO resulted in complete recovery of DNA repair activity or par-tial recovery if aphidicolin was present. The significance of these results to the chemosensitizing effects of BSO medi-ated glutathione reduction is discussed. [J Natl Cancer Inst 81:535-539, 1989]
Early damage of vascular endothelium during cardiac ischaemia
Authors: W. C HULSMANN, M.-L. DUBELAAR
Journal: Cardiovascular Research (1987)

Journal Article Early damage of vascular endothelium during cardiac ischaemia Get access WILLEM C HÜLSMANN, WILLEM C HÜLSMANN From the Department of Biochemistry I, Erasmus University Rotterdam, Rotterdam, The Netherlands Search for other works by this author on: Oxford Academic PubMed Google Scholar MARIE-LOUISE DUBELAAR MARIE-LOUISE DUBELAAR From the Department of Biochemistry I, Erasmus University Rotterdam, Rotterdam, The Netherlands Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 21, Issue 9, September 1987, Pages 674–677, https://doi.org/10.1093/cvr/21.9.674 Published: 01 September 1987 Article history Received: 28 August 1986 Accepted: 24 February 1987 Published: 01 September 1987
Psychiatric Inpatients from an Urban Community, 1968-72
Authors: T. Fryers
Journal: BMJ (1973)

The psychiatric inpatient population from Salford was analysed in five successive annual censuses, from 1 January 1968 to 1 January 1972. Short-stay and medium-stay patients (under one year) remained constant. Long-stay patients reduced only slowly, and the length of stay increased. Over 200 patients (60%) had been in for 20 years or more at 1 January 1972. Analysis showed that the 1968 long-stay cohort diminished by 122 patients (29%) in four years, while 54 new long-stay patients accumulated. There seems little prospect of emptying large psychiatric hospitals of their long-stay population.
Targeting of p53-Transcriptional Dysfunction by Conditionally Replicating Adenovirus Is Not Limited by p53-Homologues
Authors: Florian Kühnel, Engin Gürlevik, Thomas C Wirth, Nina Strüver, Nisar P Malek, Martina Müller-Schilling, Michael P Manns, Amancio Carnero, Lars Zender, Stefan Kubicka
Journal: Molecular Therapy (2009)

A hallmark of human tumors is the loss of p53 or its transcriptional functions. In this study, we describe the generation of the conditionally replicating adenovirus Adp53sensor for the treatment of p53-dysfunctional tumors. p53-selective attenuation of viral replication was achieved by using p53-dependent expression of the transcriptional repressor Gal4-KRAB that was directed against the adenoviral E1A locus. Adp53sensor shows efficient replication in p53-dysfunctional, but not in p53-active cells. In p53-dysfunctional cells, p53-analogous transcriptional activity by other p53 family members was not sufficient to compromise replication of Adp53sensor. In comparison with a genetically similar, but p53-insensitive virus, Adp53sensor replication was inhibited after systemic infection of p53-wt-mice, but not in p53-ko-mice thus confirming the correct function of the chosen approach. Adp53sensor showed efficient lytic and replicative properties in all investigated cells with p53-dysfunction and successfully inhibited the growth of subcutaneous xenotransplants in vivo. We further demonstrated that intravenous injection of Adp53sensor lead to significantly reduced liver damage compared to the control virus. Together, our data show that Adp53sensor is an oncolytic, p53-selective adenovirus for efficient treatment of p53-dysfunctional tumors with a favorable toxicity profile. Moreover, Adp53sensor provides a strategy that should be applicable to other transcriptionally regulated DNA viruses.
Immune response against lymphocytic choriomeningitis virus infection in mice without CD8 expression.
Authors: W P Fung-Leung, T M Kündig, R M Zinkernagel, T W Mak
Journal: The Journal of Experimental Medicine (1991)

The immune response against lymphocytic choriomeningitis virus (LCMV) was studied in a mutant mouse strain that does not possess CD8+ T lymphocytes. Virus-specific cytotoxic T cell activity was generated in spleens of wild-type mice in an acute LCMV infection but was not measurable in mutant mice. Injection of replicating LCMV into footpads of wild-type mice induced a CD8+ T cell-mediated swelling that peaked on day 8, followed by a CD4+ T cell-mediated swelling that peaked on day 11, whereas mutant mice exhibited only the CD4+ T cell-mediated swelling. After intracerebral inoculation with LCMV-Armstrong, all wild-type mice died of classical CD8+ T cell-dependent choriomeningitis in 8-10 days. Mutant mice showed symptoms of general malaise but most of them survived. Mutant mice depleted of CD4+ T cells by monoclonal antibody treatment showed no clinical signs of sickness. On day 9 after intravenous infection with LCMV-WE, virus was detected at high titers in spleens and livers of mutant mice but not in those of wild-type mice. On day 70 after injection of LCMV-WE into footpads, virus was not detected in wild-type mice and in one of the three mutant mice tested, but was still measurable in kidneys of the other two mutant mice. These results confirm in a new animal model that CD8+ T cell-mediated immunity is crucial in LCMV clearance and in the immunopathological disease during LCMV infection. In addition, our results demonstrated a less severe form of choriomeningitis mediated by CD4+ T cells and slow clearance of LCMV by alternative pathways independent of CD8+ T cells.
Distribution of Heart Potentials on Dog's Thoracic Surface
Authors: Bruno Taccardi
Journal: Circulation Research (1962)

The distribution of equipotential lines on the surface of the trunk has been determined experimentally in the dog at 8 to 15 instants of time during ventricular depolarization. Multiple potential maxima and minima are simultaneously present on the explored area during a large part of the activation time: their number, shape, and location vary continuously during ventricular excitation, following the same general scheme in all the animals studied. The single dipole theory does not account for the experimental data, reported in this paper. As far as surface potentials are concerned, the dog heart behaves as a multipolar generator. Complete exploration of the chest surface yields much more information about the electrical activity of the heart than is obtainable from routine limb and chest electrocardiograms. The relationships between the location of the potential maxima and minima on the body surface and the probable situation of the excitation waves in the heart are tentatively discussed.
"Whistling face" deformity in compound cranio-facio-corporal syndrome.
Authors: R. N. Sharma, S. N. Tandon
Journal: BMJ (1970)

We report a case with an unusual combination of multiple congenital deformities, one of which, the "whistling face" deformity, is extremely rare.The face appears stiff, immobile, and masklike, but no solid mass of muscle is palpable in the buccal region.Burian (1963) reported four cases of a compound cranio-facio-corporal syndrome, but there do not appear to be any other similar reports in the literature.
A Discussion on Cerebral Complications in Relation to Middle-Ear Disease
Authors: W. Macewen
Journal: BMJ (1895)

of their success.They include without exception all the patients under my care who have been operated upon in this way since June 23rd, 1893.The results must be regarded as very encouraging, as in every instance the goal aimed at was attained-namely, the removal of a purulent process in the middle ear and temporal bone, which had for years baffled all other methods of treatment carried out personally by well-known specialists.Dr. MILLIGAN (Manchester) agreed with Dr. Barr as to the advantage of the burr in the mastoid operation.In the treat- ment of those cases which depend upon supparative disease of the tympanic attic he thought that the line of procedure to be adopted should depend upon the exact etiological factors which produce the suppuration.He had found dis- tinct advantage in retaining a permanent mastoid fistula, not only on account of the ease with which the parts might be inspected, but also because he had found in several cases an improvement in the hearing.
Turnover of lymphocytes and conceptual paradigms in HIV infection
Authors: Guido Silvestri, Mark B. Feinberg
Journal: Journal of Clinical Investigation (2003)

Prevailing views concerning the pathogenic mechanisms of AIDS have shifted from models that focus primarily on direct HIV-mediated killing of CD4+ T cells to models that emphasize the pathogenic role of generalized immune system activation. The observation that increases in T cell turnover seen in HIV-infected individuals primarily reflect increased proliferation of effector-memory T cells supports the concept that chronic immune activation plays a prominent, if not predominant, role in the pathogenesis of AIDS.
ACUTE APPENDICITIS IN CHILDREN
Authors: G. P. MULLER
Journal: JAMA (1924)

This paper is based on an analysis of fifty-eight cases of acute appendicitis in which we have operated at the University Hospital, since September, 1920. These were consecutive cases, the last patient having been operated on during the first month of the present year. All of the cases were diagnosed as acute appendicitis, and the pathologic report confirmed the operative diagnosis. Cases in which a diagnosis of acute appendicitis was made but was not confirmed by the pathologic examination have been omitted. Of these there were two cases. <h3>DIAGNOSIS</h3> Diagnosis is complicated in children for numerous reasons. Small children cannot clearly describe symptoms, nor do they accurately localize pain. The classical symptoms of pain, nausea and vomiting, tenderness, rigidity and elevation of temperature are frequently observed in children who are not suffering from appendicitis. Many writers on the subject have erroneously stated that the pain of appendicitis in children varies
Operations on the Mastoid Process
Authors: P. McBride
Journal: BMJ (1888)

adopted in the recent formation of the British Laryngological Association, especially in the manner of choosing office-bearers, would, I think, in this case, prove satisfactory.I trust, gentlemen, that at this meeting you may take the initiatory steps which will lead at no distant.period to the formation of a British Otological Society.By the publication of the transactions of such a society our Continental
Streptomycin Resistance in Pulmonary Tuberculosis
Authors: J. Crofton, D. A. Mitchison
Journal: BMJ (1948)

MEDIATLS 1009 draw attention to the possibility of preventing virus disease in the future by means rather different from orthodox immunological methods.Recent Progress in Prophylaxis of Other Virus Infections I will conclude with some very brief items of news con- cerning other viruses not already mentioned.Mumnps.-Mumps virus has now been grown in fertile eggs
Primary Care Physicians' Response to Domestic Violence
Authors: Nancy Kathleen Sugg, Thomas Inui
Journal: JAMA (1992)

To explore primary care physicians' experiences with domestic violence victims to determine the barriers to problem recognition and intervention in the primary care setting.Ethnography, a qualitative research method involving the use of open-ended, semistructured interviews.An urban health maintenance organization serving a predominantly white, middle-income population.Thirty-eight physicians, predominantly family practitioners (89%), were interviewed.Analysis of the interviews revealed that physicians found exploring domestic violence in the clinical setting analogous to "opening Pandora's box." Their issues include lack of comfort, fear of offending, powerlessness, loss of control, and time constraints.This study revealed several barriers that physicians perceived as preventing them from comfortably intervening with domestic violence victims. These issues need to be addressed in training programs. Further studies should be done to assess generalizability of these findings to other groups of physicians.
"Craziness" and "visions": experiences after a stroke.
Authors: D Wender
Journal: BMJ (1987)

For a stroke victim there may be at least three types of strange occurrences: incorrect saying, seeing, and thinking. To the patient only the third seems to be "crazy". After a stroke (left hemisphere), which mainly produced serious aphasia, I (the patient) felt crazy two or three times when someone said something I expected him to say. On the other hand, my initial aphasic "gibberish speech" and an occasional false vision did not seem crazy. In my case the vision is always a car or a child, seen on my extreme right, where I am otherwise blind from the stroke. I am always driving when it happens; in recent years this phenomenon occurs when I am tired or tense, or the light is poor. These rapid visions do not seem insane but merely physical problems in my eyes, much like ordinary people9s dreams.