tbuckley/cabot-search huggingface dataset:
PHYSICAL MEDICINE PLUS CORTISONE FOR RHEUMATOID ARTHRITIS
Authors: Gordon M. Martin
Journal: JAMA (1952)

Because of the recent interest in cortisone and corticotropin (ACTH) in the treatment of rheumatoid arthritis, physical medicine and other measures that are of proved value in the management of patients with rheumatoid arthritis have been slighted. The purpose of the present study is to evaluate the relation of physical medicine to cortisone in the treatment of such patients. As the treatment with cortisone of increasing numbers of patients having rheumatoid arthritis has continued, it has become apparent that cortisone alone, as it is customarily used at present, does not always provide complete control of the disease. It is well recognized, as has been reported,<sup>1</sup>that cortisone alone will relieve much of the pain and stiffness and will produce a decrease in the synovial inflammatory reaction. However, in order for many patients with rheumatoid arthritis to obtain maximal objective signs of improvement in articular function while receiving safe suppressive
ULTRA HIGH FIELD MR CAROTID VESSEL WALL IMAGING: COMPARISON BETWEEN 7T AND 3T
Authors: Eleanore S. Kroner, Linda van Schinkel, Maarten Versluis, Jeroen Bax, Ernst van der Wall, Andrew Webb, H.J. Siebelink, Hildo Lamb
Journal: Journal of the American College of Cardiology (2012)
Inhaled Nitric Oxide in Premature Infants with the Respiratory Distress Syndrome
Authors: Michael D. Schreiber, Karen Gin-Mestan, Jeremy D. Marks, Dezheng Huo, Grace Lee, Pimol Srisuparp
Journal: New England Journal of Medicine (2003)

Inhaled nitric oxide improves gas exchange, decreases pulmonary vascular lability, and reduces pulmonary inflammation. We hypothesized that the use of inhaled nitric oxide would decrease the incidence of chronic lung disease and death in premature infants with the respiratory distress syndrome.We conducted a randomized, double-blind, placebo-controlled study of the effect of inhaled nitric oxide during the first week of life on the incidence of chronic lung disease and death in premature infants (less than 34 weeks' gestation) who were undergoing mechanical ventilation for the respiratory distress syndrome. Infants were randomly assigned to receive inhaled nitric oxide (10 ppm on day 1, followed by 5 ppm for six days) or inhaled oxygen placebo for seven days. We further randomly assigned the infants in each group to receive intermittent mandatory or high-frequency oscillatory ventilation.A total of 207 premature infants were enrolled. In the group given inhaled nitric oxide, 51 infants (48.6 percent) died or had chronic lung disease, as compared with 65 infants (63.7 percent) in the placebo group (relative risk, 0.76; 95 percent confidence interval, 0.60 to 0.97; P=0.03). There was no significant difference between the nitric oxide and placebo groups in the overall incidence of intraventricular hemorrhage and periventricular leukomalacia (33.3 percent and 38.2 percent, respectively), but the group given inhaled nitric oxide had a lower incidence of severe intraventricular hemorrhage and periventricular leukomalacia (12.4 percent vs. 23.5 percent; relative risk, 0.53; 95 percent confidence interval, 0.28 to 0.98; P=0.04). The type of ventilation had no significant effect on the outcome.The use of inhaled nitric oxide in premature infants with the respiratory distress syndrome decreases the incidence of chronic lung disease and death.
Severity of Coronary Artery Calcification by Electron Beam Computed Tomography Predicts Silent Myocardial Ischemia
Authors: Zuo-Xiang He, Thomas D. Hedrick, Craig M. Pratt, Mario S. Verani, Vincent Aquino, Robert Roberts, John J. Mahmarian
Journal: Circulation (2000)

Background —Detection of subclinical coronary artery disease (CAD) before the development of life-threatening cardiac complications has great potential clinical relevance. Electron beam computed tomography (EBCT) is currently the only noninvasive test that can detect CAD in all stages of its development and thus has the potential to be an excellent screening technique for identifying asymptomatic subjects with underlying myocardial ischemia. Methods and Results —Over 2.5 years, we prospectively studied 3895 generally asymptomatic subjects with EBCT, 411 of whom had stress myocardial perfusion tomography (SPECT) within a close (median, 17 days) time period. SPECT and exercise treadmill results were compared with the coronary artery calcium score (CACS) as assessed by EBCT. The total CACS identified a population at high risk for having myocardial ischemia by SPECT although only a minority of subjects (22%) with an abnormal EBCT had an abnormal SPECT. No subject with CACS &lt;10 had an abnormal SPECT compared with 2.6% of those with scores from 11 to 100, 11.3% of those with scores from 101 to 399, and 46% of those with scores ≥400 ( P &lt;0.0001). CACS predicted an abnormal SPECT regardless of subject age or sex. Conclusions —CACS identifies a high-risk group of asymptomatic subjects who have clinically important silent myocardial ischemia. Our results support the role of EBCT as the initial screening tool for identifying individuals at various stages of CAD development for whom therapeutic decision making may differ considerably.
Regulation of human aortic endothelial cell-derived mesenchymal growth factors by allogeneic lymphocytes in vitro. A potential mechanism for cardiac allograft vasculopathy.
Authors: C R Wagner, T E Morris, G D Shipley, J D Hosenpud
Journal: Journal of Clinical Investigation (1993)

Cardiac allograft vasculopathy is thought to be triggered by an alloreactive response to the donor coronary vasculature, resulting in smooth muscle cell proliferation and ultimate occlusion of the donor coronary arteries. To determine whether allogeneic lymphocytes are capable of regulating endothelial-derived smooth muscle cell (SMC) growth factors, human aortic endothelial cells (HAECs) were exposed to allogeneic lymphocytes. The HAEC-lymphocyte co-cultures were assessed for (a) lymphocyte proliferation in response to the allogeneic HAECs; (b) release of soluble factors that stimulate human aortic SMC proliferation; and (c) alteration of HAEC mRNA levels for a panel of known SMC growth factors. Co-culture conditioned medium increased SMC proliferation, compared to medium conditioned by HAECs alone. HAECs exposed to allogeneic lymphocytes increased their expression of mRNA for basic fibroblast growth factor, transforming growth factors alpha and beta, and platelet derived growth factor A and B chains. These results demonstrate that allogeneic lymphocytes are capable of inducing HAECs to increase mRNA levels for several mesenchymal growth factors and to release bioactive products capable of stimulating SMC cell proliferation in vitro. Additionally, the data support the hypothesis that alloreactive lymphocytes can stimulate allogeneic donor endothelial cells to produce growth factors that may contribute to the intimal thickening seen in cardiac allograft vasculopathy.
Syncope and Visual Hallucinations, Apparently From Timolol
Authors: Donald Yates
Journal: JAMA (1980)

<h3>To the Editor.—</h3> Stephen A. Shaivitz, MD (242:1611, 1979), recently reported inThe Journalon aggravation of myasthenia with timolol maleate. Alan N. Kohn, MD (243:1131, 1980), warned of systemic effects. Timolol, a β-adrenergic receptor blocking agent, has been prescribed to thousands of patients since its recent Food and Drug Administration approval for glaucoma. I treated an alert, active, and unusually healthy 78-year-old woman with timolol starting in November 1978. It controlled her open-angle glaucoma well. Unlike most persons in this age group, she was taking no other medications. On Labor Day 1979, she was swimming in a lake and experienced an episode of syncope and nearly drowned. A hospital workup was noncontributory. On Feb 14, 1980, she experienced confusion, inability to speak or write for a few minutes, and vivid and frightening visual hallucinations for several days. She was hospitalized by an internist. Findings from a complete workup, including computerized
Rethinking childhood depression
Authors: Kate Walker
Journal: BMJ (2005)

Editor—What we, as clinical practitioners (or, as in my own case, former practitioner, now service coordinator), may need to learn is that the supposedly patently obvious is often obscured by our particular conditioned professional mindsets. The mindsets are influenced by the sociopolitics of healthcare delivery, and by, I suspect, an overly major focus on the individual (at the expense of the social and collective).

With regard to rethinking childhood depression,1 children these days are getting much less regular physical exercise than they used to 20 or so years ago and fewer opportunities exist for exercise. The prescribing of antidepressant drugs has gone through the roof in the past decade. Children now don't have the opportunities for essential play, to be a part of a social support network, or to be part of a cogent extended or otherwise “family” (read, again, “social support network”). They also do not have a reasonably viable outlet, for any and all those of the above, conflicts and frustrations.

Something has to be very wrong, don't you think?
Combined one- and two-dimensional ultrasound system for monitoring fetal breathing movements.
Authors: J W Wladimiroff, C M Ligtvoet, J A Spermon
Journal: BMJ (1976)

A combined one- and two-dimensional ultrasonic system for monitoring respiratory movements in the human fetus has been developed. A real-time cross-sectional image of the fetal chest at the level of the fetal heart can be obtained, and a time motion recording of fetal respiratory movements can then be written on a strip-chart recorder. Combining the features of one-dimensional and two-dimensional systems produces an accurate means of investigating fetal breathing movements.
Studies of cellular toxicity of unconjugated bilirubin in kernicteric brain.
Authors: S Schenker, D W McCandless, P E Zollman
Journal: Journal of Clinical Investigation (1966)

1 "Bilirubin encephalopathy" is probably a more accu- rate term, inasmuch as pigmentation may affect any part of the brain.The word "kernicterus" has been used in this report because of its brevity and common usage.
Epidermal Toxin Production by Staphylococcus aureus Strains from Patients with Toxic Shock Syndrome
Authors: FRANK A. KAPRAL
Journal: Annals of Internal Medicine (1982)

Staphylococcus aureus strains recovered from patients with toxic shock syndrome were examined for their ability to produce epidermal toxin. Seventy-three percent of 52 strains elaborated the toxin whereas only 18% of 106 control strains did so. There was no significant difference in the hemolysin patterns shown by the two groups of organisms.
Comparison of front-loaded recombinant tissue-type plasminogen activator, anistreplase and combination thrombolytic therapy for acute myocardial infarction: Results of the thrombolysis in myocardial infarction (TIMI) 4 trial
Authors: Christopher P Cannon, Carolyn H McCabe, Daniel J Diver, Steve Herson, Robert M Greene, Prediman K Shah, Raphael F Sequeira, Ferdinand Leya, James M Kirshenbaum, Raymond D Magorien, Sebastian T Palmeri, Vicki Davis, C.Michael Gibson, W.Kenneth Poole, Eugene Braunwald
Journal: Journal of the American College of Cardiology (1994)

Objectives. The aim of our study was to determine a superior tbrombolytic regimen from three: anistreplase (APSAC), frontloaded recombinant tissue-type plasminogen activator (rt-PA) or combination thrombolytic therapy. Background. Although thrombolytic therapy has been shown to reduce mortality and morbidity after acute myocardial infarction, it has not been clear whether more aggressive thrombolyticantithrombotic regimens could improve the outcome achieved with standard regimens. Methods. To address this issue, 382 patients with acute myocardial infection were randomized to receive in a double-blind fashion (along with intravenous heparin and aspirin) APSAC, front-loaded rt-PA or a combination of both agents. The primary end point "unsatisfactory outcome" was a composite clinical end point assessed through hospital discharge. Results. Patency of the infarct-related artery (Thrombolysis in Myocardial Infarction [TIMI] grade 2 or 3 flow) at 60 min after the start of thrombolysis was significantly higher in rt-PA-treated patients (77.8% vs. 59.5% for APSAC-treated patients and 59.3% for combination-treated patients [rt-PA vs. APSAC, p = 0.02; rt-PA vs. combination, p = 0.03]). At 90 min, the incidence of both infarct-related artery patency and TIMI grade 3 flow was significantly higher in rt-PA-treated patients (60.2% had TIMI grade 3 flow vs. 42.9% and 44.8% of APSAC- and combination-treated patients, respectively [rt-PA vs. APSAC, p < 0.01; rt-PA vs. combination, p = 0.02]). The incidence of unsatisfactory outcome was 41.3% for rt-PA compared with 49% for APSAC and 53.6% for the combination (rt-PA vs. APSAC, p = 0.19; rt-PA vs. combination, p = 0.06). The mortality rate at 6 weeks was lowest in the rt-PA-treated patients (2.2% vs. 8.8% for APSAC and 7.2% for combination thrombolytic therapy [rt-PA vs. APSAC, p = 0.02; rt-PA vs. combination, p = 0.06]). Conclusions. Front-loaded rt-PA achieved significantly higher rates of early reperfusion and was associated with trends toward better overall clinical benefit and survival than those achieved with a standard thrombolytic agent or combination thrombolytic therapy. These findings support the concept that more rapid reperfusion of the infarct-related artery is associated with improved clinical outcome.
Letter by Rottenberg Regarding Article “Improved Neurological Outcome With Continuous Chest Compressions Compared With 30:2 Compressions-to-Ventilations Cardiopulmonary Resuscitation in a Realistic Swine Model of Out-of-Hospital Cardiac Arrest”
Authors: Eric M. Rottenberg
Journal: Circulation (2008)

Resuscitation in a Realistic Swine Model of Out-of-Hospital Cardiac Arrest"Ewy and colleagues 1 published an animal study of witnessed out-of-hospital sudden ventricular fibrillation that compared 24-hour neurologically normal survival in swine receiving continuous-chestcompression (CCC CPR) versus swine receiving CPR with a compression/ventilation ratio of 30:2 (30:2 CPR).They concluded that the rate of neurologically normal survival 24 hours after resuscitation in animals receiving CCC CPR was significantly better than that in animals receiving 30:2 CPR.However, that study does not realistically simulate human bystander CPR in the majority of cardiac arrest victims.Moreover, the results of the human study 2 cited by Ewy et al likely only suggests that CCC CPR is more effective for out-of-home arrests.In humans, the tongue, soft palate, and/or epiglottis can act as a 1-way valve that prevents gasping and leads to forced exhalation during sternal compression without reexpansion of the lung (or prevents passive ventilation from recoil of the chest).Therefore, only animal studies in which the airway is occluded at end-expiration realistically simulate what likely occurs during bystander CPR in the majority of arrest victims.Dorph and colleagues 3 used an inspiratory impedance threshold valve to achieve airway occlusion at endexpiration during CPR in a swine model of sudden ventricular fibrillation that compared CCC CPR with 30:2 CPR.They concluded that during cardiac arrest with an obstructed airway, pulmonary ventilation should be strongly recommended.Whitehurst and colleagues 4 showed that adequate passive ventilation from recoil of the chest is highly dependent on the quality/ technique of CPR.The blood gas profiles from the animals receiving CCC CPR indicated that their compression technique did not move sufficient air to allow physiologically significant pulmonary gas exchange.Moreover, CCC CPR with an open airway failed to achieve a blood gas profile measurably superior to that in animals receiving CCC CPR with a completely blocked endotracheal tube, which was occluded by clamping the endotracheal tube.The study did not specify whether it was done at end-expiration.Therefore, unlike as evidenced by the study by Ewy et al, 1 not all patients who are fortunate enough to maintain an adequately open airway during chest compression/decompressions receive the substantial level of ventilation suggested in their study.
Clinical trials update from the American College of Cardiology 2009: ADMIRE‐HF, PRIMA, STICH, REVERSE, IRIS, partial ventricular support, FIX‐HF‐5, vagal stimulation, REVIVAL‐3, pre‐RELAX‐AHF, ACTIVE‐A, HF‐ACTION, JUPITER, AURORA, and OMEGA
Authors: John G.F. Cleland, Alison P. Coletta, Andrew L. Clark, Damien Cullington
Journal: European Journal of Heart Failure (2009)
A Case of Renal Failure and Osteosclerosis
Authors: R. F. Fletcher, A. C. Frazer
Journal: BMJ (1962)

Chronic azotaemic renal failure is often accompanied by changes in the skeleton which include (alone or in combination) rickets, osteomalacia, and osteitis fibrosa (Stanbury, 1957).The bones are usually of decreased over-all density with irregular denser areas which do not follow the normal architecture (Fourman, 1960).Rarely, there is a more extensive osteosclerosis, particu- larly involving the spine and skull (Crawford et al., 1954; Wolf and Denko, 1958; Kaye et al., 1960).The cause of this osteosclerosis is not known, and the number of patients with this condition who have been studied in detail is small. Case ReportA 40-year-old housewife first attended hospital three and a half years before her death with pain in the right chest.
Cell Cycle Disturbances and Mitotic Catastrophes in HeLa Hep2 Cells following 2.5 to 10 Gy of Ionizing Radiation
Authors: David Eriksson, Per-Olov Löfroth, Lennart Johansson, Katrine Åhlström Riklund, Torgny Stigbrand
Journal: Clinical Cancer Research (2007)

Abstract Purpose: Experimental radioimmunotherapy delivering absorbed doses of 2.5 to 10 Gy has been shown to cause growth retardation of tumors. The purpose of this study was to elucidate the sequential molecular and cellular events occurring in HeLa Hep2 cells exposed to such doses. Methods: Dose-response curves, activation of cell cycle checkpoints, and mitotic behavior were investigated in HeLa Hep2 cells following 2.5- to 10-Gy irradiation by carrying out 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assays, Western blots, fluorescence-activated cell sorting analysis, and immunofluorescence stainings. Terminal deoxyribonucleotidyl transferase–mediated dUTP nick end labeling staining was used to detect apoptosis. Results: A G2-M arrest was shown by fluorescence-activated cell sorting analysis. p53 and p21 were found to be up-regulated but were not immediately related to the arrest. The G2-M arrest was transient and the cells reentered the cell cycle still containing unrepaired cellular damage. This premature entry caused an increase of anaphase bridges, lagging chromosomal material, and multipolar mitotic spindles as visualized by propidium iodide staining and immunofluorescence staining with α-tubulin and γ-tubulin antibodies. Furthermore, a dose-dependent significant increase in centrosome numbers from 12.6 ± 6.6% to 67 ± 5.3% was identified as well as a dose-dependent increase of polyploid cells from 2.8 ± 1.3% to 17.6 ± 2.1% with the highest absorbed dose of 10 Gy. These disturbances caused the cells to progress into mitotic catastrophe and a fraction of these dying cells showed apoptotic features as displayed by terminal deoxyribonucleotidyl transferase–mediated dUTP nick end labeling staining 5 to 7 days after irradiation. Conclusion: An absorbed dose of 2.5 to 10 Gy was shown to force HeLa Hep2 cells into mitotic catastrophe and delayed apoptosis. These might be important cell death mechanisms involved in tumor growth retardation following radioimmunotherapy of solid tumors.
Abstract P4-05-03: Unique genetic, epigenetic, and transcriptomic changes in premenopausal breast cancer suggest novel strategies for therapy
Authors: G Liao, RJ Hartmaier, S Luthra, U Chandran, KP McGuire, SL Puhalla, AV Lee, GC Tseng, S Oesterreich
Journal: Cancer Research (2013)

Abstract Breast cancer in premenopausal women (preM) is frequently associated with worse prognosis compared to that in postmenopausal women (postM) even when controlling for prognostic variables. In particular, preM ER+ tumors have a poor prognosis on endocrine therapy. There is, however, a paucity of studies characterizing molecular alterations in premenopausal tumors, a potential avenue for finding personalized therapies for this group of women. We analyzed gene expression, CNV, methylation, and somatic mutations in tumors from preM (≤45; ER+ n = 110, and ER- n = 39) and postM (≥55, ER+ n = 392, and ER- n = 102) women in The Cancer Genome Atlas (TCGA). Unbiased hierarchical clustering of 2,900 most variably expressed genes (using both RNA-seq and Agilent expression array data) in the whole dataset (n = 643) identified four major subtypes which correlated highly with the PAM50 defined subtypes LumA, LumB, Basal and HER2; however, there wasn't any separation between preM and postM samples. Similarly, principal component analysis using 10,000 genes with the highest inter-quartile range (IQR) demonstrated high similarity across preM and postM samples. Direct examination of gene expression differences between PreM and PostM ER+ tumors using unpaired t-test (5% FDR) identified 3,044 differentially expressed genes. The genes most upregulated in premenopausal tumors included AREG, TFPI2, MSMB, TCN1, and GLRA3. Ingenuity Pathway Analysis revealed a highly significant enrichment for TGFb (p&amp;lt;1.9E-16) pathway activity in preM tumors. Intriguingly, no significant gene expression differences between preM and postM ER- tumors were identified. We thus then focused on genetic and epigenetic alterations that may underlie these transcriptomic changes in ER+ preM tumors. Comparison of methylation (450K Illumina array) between preM and postM ER+ tumors showed a difference in 1% (n = 1,738) of the probes. Genes with the largest difference included ESR1, SIM2, and KLF6. Significant differences in DNA copy number variation (Affymetrix SNP 6.0 array) were also identified in ER+ preM tumors. A number of somatic mutations were significantly enriched in preM ER+ tumors including DSPP and GATA3. Integrated analysis also showed that approximately half of the observed differences in gene expression are driven by CNVs. Conclusion: Our in silico study has identified a number of genes and pathways which are significantly altered between preM and postM ER+ breast cancer. Distinct genetic and epigenetic differences suggest unique etiology for some preM tumors. Currently ongoing Paradigm analysis, and confirmatory studies using METABRIC data are expected to further identify pathways that could specifically be targeted in premenopausal breast cancer. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-05-03.