tbuckley/cabot-search huggingface dataset:
The Past 50 Years of Cardiovascular Surgery
Authors: D. A. Cooley, O. H. Frazier
Journal: Circulation (2000)

Cardiovascular surgery has developed so rapidly that it is hard to believe that this specialty is little more than a half-century old. In fact, had it not been for World War II, the emergence of modern cardiac surgery may have been delayed further. In 1943 and 1944, Dwight Harken,1 then a captain in the medical corps, successfully removed foreign bodies from in and around the hearts of >100 soldiers who had been injured in battle. Harken’s work helped overcome the notion that the heart could not be surgically manipulated and, not only did it pave the way for the incredible progress of the last 50 years, it was a catalyst for the event that would mark the dawn of this era: the creation of the first Blalock-Taussig shunt for treating tetralogy of Fallot in 1944.2 The striking results from this procedure, which increased the circulation through the pulmonary arterial system, caused much excitement in the surgical community.

In those early days at the midpoint of the 20th century, many warned about operating on children, particularly those with cardiovascular disease, severe cyanosis, and hypoxia. There was great concern that it would not be possible to anesthetize these young patients safely and to see them through an operation. Helen Taussig believed that one should not try to operate on a child younger than 4 years with tetralogy of Fallot or a child younger than 8 years with an aortic coarctation. Many pediatricians heeded these warnings, and it was with enormous trepidation that the anesthesia staff undertook the first congenital heart operations in very young patients. (In the earliest days of heart surgery, nurse-anesthetists usually administered anesthesia.) However, this did not deter those who believed that successful cardiac surgery could be undertaken in younger patients. By 1959, those at Texas Children’s …
ADJUSTMENT TO ALDOSTERONE OR DESOXYCORTICOSTERONE ACETATE INDUCED SODIUM RETENTION IN PATIENTS WITH ADDISON'S DISEASE *
Authors: J. Thomas August, Don H. Nelson
Journal: Journal of Clinical Investigation (1959)

Long term administration of aldosterone (1) or desoxycorticosterone acetate (DCA) (2) to nor- mal subjects has been shown, in certain instances, to produce continued renal potassium loss but only transient sodium and chloride retention.This adjustment of the renal response to sodium-retaining adrenal steroids has been termed an "escape"(3) from the expected effects of these compounds, and is seen clinically in the absence of edema with primary aldosteronism.The mechanism of this "escape" from sodium retention, that occurs de- spite continued excess of steroid sodium-retaining substances, is unknown.Some findings have sug- gested that the adrenal gland may play a role by producing a substance which either promotes sodium excretion or inhibits the sodium-retaining effect of other hormones.An adrenal cortical "salt-losing hormone" was postulated by Wilkins and Lewis (4) and Jailer (5) to explain renal salt loss in cases of congenital adrenal hyperplasia.Rosemberg (6) suggested that this might be explained by an aldosterone-in- hibiting effect of certain 21-desoxypregnane ste- roids, and Klein and co-workers (7) reported that partially purified material from urine of pa- tients with congenital adrenal hyperplasia caused increased urinary sodium excretion in rats.Re- cently, Neher, Meystre and Wettstein (8) re- ported the isolation of 3a,16a-dihydroxy-pregnan- 20-one from patients with the adrenogenital salt- losing syndrome and demonstrated a salt-losing potential of this steroid in adrenalectomized rats.Increased renal sodium excretion has been re-
Endocrine Function of the Thymus
Authors: J.F.A.P. Miller
Journal: New England Journal of Medicine (1974)

The immunologic function of the thymus was established in 1961, when it was shown that neonatally thymectomized mice were susceptible to infection, often died prematurely, and had a diminished population of lymphocytes in blood and tissues and an impaired capacity to reject alien skin.1 These findings have been widely confirmed and extended to other species, and it is now known that lymphocytes can be divided into two major categories: thymus-derived, or T, cells involved in cellular immunity (e.g., cellular resistance to infection, delayed hypersensitivity reactions), and non-thymus-derived or B cells (originating from the bursa of Fabricius in birds and from . . .
Integrin α <sub>6</sub> β <sub>1</sub> Is the Main Receptor for Vascular Laminins and Plays a Role in Platelet Adhesion, Activation, and Arterial Thrombosis
Authors: Mathieu Schaff, ChaoJun Tang, Eric Maurer, Catherine Bourdon, Nicolas Receveur, Anita Eckly, Béatrice Hechler, Christiane Arnold, Adèle de Arcangelis, Bernhard Nieswandt, Cécile V. Denis, Olivier Lefebvre, Elisabeth Georges-Labouesse, Christian Gachet, François Lanza, Pierre H. Mangin
Journal: Circulation (2013)

Laminins are major components of basement membranes, well located to interact with platelets upon vascular injury. Laminin-111 (α1β1γ1) is known to support platelet adhesion but is absent from most blood vessels, which contain isoforms with the α2, α4, or α5 chain. Whether vascular laminins support platelet adhesion and activation and the significance of these interactions in hemostasis and thrombosis remain unknown.Using an in vitro flow assay, we show that laminin-411 (α4β1γ1), laminin-511 (α5β1γ1), and laminin-521 (α5β2γ1), but not laminin-211 (α2β1γ1), allow efficient platelet adhesion and activation across a wide range of arterial wall shear rates. Adhesion was critically dependent on integrin α6β1 and the glycoprotein Ib-IX complex, which binds to plasmatic von Willebrand factor adsorbed on laminins. Glycoprotein VI did not participate in the adhesive process but mediated platelet activation induced by α5-containing laminins. To address the significance of platelet/laminin interactions in vivo, we developed a platelet-specific knockout of integrin α6. Platelets from these mice failed to adhere to laminin-411, laminin-511, and laminin-521 but responded normally to a series of agonists. α6β1-Deficient mice presented a marked decrease in arterial thrombosis in 3 models of injury of the carotid, aorta, and mesenteric arterioles. The tail bleeding time and blood loss remained unaltered, indicating normal hemostasis.This study reveals an unsuspected important contribution of laminins to thrombus formation in vivo and suggests that targeting their main receptor, integrin α6β1, could represent an alternative antithrombotic strategy with a potentially low bleeding risk.
Randomised controlled trials: the importance of sample size
Authors: P. Sedgwick
Journal: BMJ (2015)

The effects of pelvic floor muscle training on pelvic floor symptoms in a primary care population were investigated using a randomised controlled trial. The intervention of pelvic floor muscle training was provided individually and combined with home exercises. The control treatment was watchful waiting. Participants were women aged 55 years and over with symptomatic mild pelvic organ prolapse. The primary outcome was change in bladder, bowel, and pelvic floor symptoms, as measured by the Pelvic Floor Distress Inventory-20 (PFDI-20), three months after the start of treatment. The PFDI-20 is patient completed and the scores range from 0 to 300; a higher score indicates a greater symptom burden.1

The sample size calculation was based on detecting a reduction in symptom burden as indicated by a difference of 15 points between treatment groups in the mean change from baseline in PFDI-20 scores. It was assumed that the mean PDFI-20 score at baseline would be 60 points and that the standard deviation of the change in scores at three months from baseline would be 36 points in each group. To detect this treatment effect with a power of 80% and a critical level of significance of 0.05, 92 women were needed in each treatment arm. To allow for an estimated 15% dropout rate it was necessary to recruit 216 women. In total, 287 women were recruited and randomised to pelvic floor muscle training (n=145) or watchful waiting (n=142). Follow-up questionnaires were completed by 250 (87%) women.

The intervention group showed a significant reduction in symptom burden compared with the control group at three months of follow-up. The mean reduction in PFDI-20 scores from baseline was on average 9.1 (95% confidence interval 2.8 to 15.4) points greater in the intervention group than in the watchful waiting group (P=0.005). …
Erythromycin Ointment for Ocular Prophylaxis of Neonatal Chlamydial Infection
Authors: M R Hammerschlag, J W Chandler, E R Alexander, M English, W T Chiang, L Koutsky, D A Eschenbach, J R Smith
Journal: JAMA (1980)

We compared the efficacy of erythromycin ophthalmic ointment vs 1% silver nitrate drops for the prevention of neonatal conjunctivitis or respiratory tract infection from Chlamydia trachomatis. The organism was isolated from the cervix of 67 (12%) of 572 pregnant women. They gave birth to 559 infants who were randomly assigned to either prophylaxis immediately after birth. Thirty-six of 60 infants born to Chlamydia-positive women received silver nitrate; 24 received erythromycin. Twelve (33%) of the 36 infants who received silver nitrate had chlamydial conjunctivitis, but none of the 24 infants who received erythromycin did. Ten (29%) of 36 infants receiving silver nitrate had chlamydial nasopharyngeal infection (three later had pneumonia), as opposed to five (21%) of 24 who received erythromycin (one had pneumonia). Thus, erythromycin ointment is effective in prevention of chlamydial conjunctivitis, but it may not reduce nasopharyngeal infection or subsequent pneumonia.
The Department of Defense's External Civilian Peer Review of Medical Care
Authors: Karen G. Kelly
Journal: JAMA (1989)

To the Editor. —  The Department of Defense undertook an extensive, undoubtedly expensive, review designed to assess the quality of care given by their physicians. 1 While the concern for quality is praiseworthy, this program points up several of the limitations of current quality assurance methods.  When it is difficult to list objective standards with which all physicians can agree, the standards are likely to be fairly broad. Thus, in this study, hysterectomy passes review if the uterus is more than 9 weeks' size, and cholecystectomy if there are gallstones and flatulence. This tends to trivialize quality assurance.  The very topics that are selected for review are likely to be those that lend themselves most easily to this sort of standardization and not the more complicated cases for which standards are more difficult to generate. But these complex cases, often involving chronically ill patients with multiple diagnoses, are increasingly common
Relationship Between Previous Training and Experience and Results of the Certification Examination in Cardiovascular Computed Tomography
Authors: Allen J. Taylor, Jonathan Patrick, Suhny Abbara, Daniel S. Berman, Sandra S. Halliburton, Jerome L. Hines, John McB. Hodgson, John R. Lesser, L. Samuel Wann, Kim A. Williams, Jack A. Ziffer, Lorraine J. Lennon, Dawn M. Edgerton, Manuel D. Cerqueira
Journal: JACC. Cardiovascular imaging (2010)
Multiple Cases of Leukemia In One Household
Authors: Betty B. Wray
Journal: JAMA (1969)

<h3>To the Editor:—</h3> Regarding "Multiple Cases of Leukemia Associated with One House" as reported by McPhedran and Heath (<b>209</b>:2021, 1969), I would like to suggest that a study of the mold population of the house be made. Mycotoxin produced by a species of<i>Fusarium</i>and possibly other genera were responsible for "toxic alimentary aleukia" and resulting death in humans in Russia in 1944 after the victims ate bread prepared from infested grain which had wintered in the field. The disease is characterized by agranulocytosis, necrotic and hemorrhagic skin lesions, and hemorrhages particularly of the intestinal tract.<sup>1</sup>This is one of the few instances of disease in man traced directly to mycotoxins, but it is well known that mycotoxins are responsible for certain diseases in animals (ie, facial eczema in sheep and cattle, stachybotryotoxicosis in horses, hemorrhagic disease in poultry, aspergillus toxicosis in cattle, moldy corn toxicosis in swine.
Relation of 2-substituted Thiadiazoles to Purine and Nicotinamide Metabolism.
Authors: I. H. Krakoff
Journal: Annals of Internal Medicine (1961)

s1 May 1961Relation of 2-substituted Thiadiazoles to Purine and Nicotinamide Metabolism.I. H. Krakoff, M.D., F.A.C.P., M. E. Balis, Ph.D., D. A. Karnofsky, M.D.I. H. Krakoff, M.D., F.A.C.P.Search for more papers by this author, M. E. Balis, Ph.D.Search for more papers by this author, D. A. Karnofsky, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-54-5-1045_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Excerpt2-ethylamino-1,3,4-thiadiazole (TDA) and related 2-substituted thiadiazoles have been found to produce a parallel increase in blood and urinary uric acid in man. Studies of the incorporation into uric acid of isotopically labeled purines and purine precursors have shown that this "uricogenic" effect is the result of an increase in de novo biosynthesis of uric acid.The increase in uric acid synthesis and the characteristic glossitis produced by TDA were blocked by nicotinamide or nicotinic acid and by the nicotinamide precursor, tryptophan. The uricogenic effect, but not the glossitis, was prevented by azaserine (O-diazo-acetyl-L-serine), DON (6-diazo-5-oxo-L-norleucine), and 6-mercaptopurine, compounds which are... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New York, N. Y. (CI) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPurine metabolism and human diseaseMetabolism of Oxypurines In ManFeedback Inhibition of Purine Biosynthesis de novo in Mouse Tissues in vivoPurine metabolism in the chick embryo: Influence of 2-substituted thiadiazolesTHE MOLECULAR BASIS OF CANCER CHEMOTHERAPY 1 May 1961Volume 54, Issue 5Page: 1045-1046KeywordsBiosynthesisBloodNiacinPurine metabolismPurinesTryptophanUric acid ePublished: 1 December 2008 Issue Published: 1 May 1961 PDF downloadLoading ...
The role of vasopressin and the sympathetic nervous system in the cardiovascular response to vagal cold block in the conscious dog.
Authors: E M Hasser, J R Haywood, A K Johnson, V S Bishop
Journal: Circulation Research (1984)

This study examined the role of arginine vasopressin in the pressor response to vagal cold block and evaluated a possible interaction between vasopressin and the sympathetic nervous system during vagal block in conscious dogs with (carotid sinus intact) and without (sinoaortic denervated) functional arterial baroreflexes. In both carotid sinus intact and sinoaortic denervated dogs, elimination of the arginine vasopressin pressor system by the specific vasopressin antagonist d(CH2)5Tyr(Me)AVP did not alter the response to vagal block, as evaluated by changes in arterial pressure. Subsequent removal of the sympathetic nervous system by ganglionic blockade abolished the response to vagal block. When ganglionic blockade was induced in the absence of the vasopressin antagonist, the pressor response to vagal block was reduced by only 60%. Arginine vasopressin antagonist after ganglionic blockade reduced the response to vagal block by an amount equivalent to 45% of the original increase in pressure. The effects of blockade of either vasopressin or the sympathetic nervous system on the pressor response to vagal block were significantly greater when the other system had previously been eliminated. Data suggest that both arginine vasopressin and the sympathetic nervous system contribute to the pressor response to vagal block. One interpretation of these results is that vasopressin also interacts centrally to inhibit sympathetic outflow and thus modulates the hemodynamic manifestation of interruption of vagal afferents.
Platelet activation during coronary angioplasty in humans.
Authors: C M Gasperetti, S L Gonias, L W Gimple, E R Powers
Journal: Circulation (1993)

BACKGROUND Previous studies have indicated that balloon angioplasty is associated with local platelet activation. In addition, different contrast media have different effects on thrombus formation during angioplasty in humans. We hypothesized that coronary angioplasty in humans is associated with activation of platelets to specific platelet agonists and that this activation may be differently modified by different angiographic contrast agents. METHODS AND RESULTS We studied 25 patients referred for angioplasty of the left anterior descending or circumflex coronary arteries. All patients were pretreated with aspirin and received heparin. Blood samples for assessment of platelet aggregation to serotonin, ADP, epinephrine, and collagen were obtained from the coronary sinus before any contrast injection, after initial diagnostic contrast injections, and after three balloon inflations. Patients were randomized to receive iopamidol, diatrizoate, or ioxaglate. Contrast alone was not associated with altered platelet aggregation. However, balloon angioplasty was consistently associated with increased platelet aggregation to serotonin but not to ADP, epinephrine, or collagen. These effects were similar with the three contrast agents studied except that the use of iopamidol was associated with increased platelet responsiveness to all concentrations of ADP after balloon dilation. CONCLUSIONS Coronary angioplasty in humans was associated with increased platelet aggregation in blood drawn from the coronary sinus. This effect was primarily seen when serotonin was used as an agonist.
Chronic Nicotine Alters NO Signaling of Ca <sup>2+</sup> Channels in Cerebral Arterioles
Authors: Volodymyr Gerzanich, Fangyi Zhang, G. Alexander West, J. Marc Simard
Journal: Circulation Research (2001)

Abstract —Smoking is a major health hazard with proven deleterious effects on the cerebral circulation, including a decrease in cerebral blood flow and a high risk for stroke. To elucidate cellular mechanisms for the vasoconstrictive and pathological effects of nicotine, we used a nystatin-perforated patch-clamp technique to study Ca 2+ channels and Ca 2+ -activated K + (BK) channels in smooth muscle cells isolated from cerebral lenticulostriate arterioles of rats chronically exposed to nicotine (4.5 mg/kg per day of nicotine free base, 15 to 22 days via osmotic minipump). Two major effects were observed in cells from nicotine-treated animals compared with controls. First, Ca 2+ channels were upregulated (0.48±0.03 pS/pF [20 cells] versus 0.35±0.01 pS/pF [31 cells], P &lt;0.005) and BK channels were downregulated (12±3 pA/pF [14 cells] versus 34±7 pA/pF [14 cells], P &lt;0.05), mimicking the effect of an apparent decrease in bioavailability of endogenous NO. Second, normal downregulation of Ca 2+ channels by exogenous NO (sodium nitroprusside [SNP], 100 nmol/L) and cGMP (8-bromo-cGMP, 0.1 mmol/L) was absent, whereas normal upregulation of BK channels by these agents was preserved, suggesting block of NO signaling downstream of cGMP-dependent protein kinase. In pial window preparations, chronic nicotine blunted NO-induced vasodilation of pial vessels and the increase in cortical blood flow measured by laser-Doppler flowmetry, demonstrating the importance of Ca 2+ channel downregulation in NO-induced vasorelaxation. These findings elucidate a new pathophysiological mechanism involving altered Ca 2+ homeostasis in cerebral arterioles that may predispose to stroke.
Extensive pityriasis alba and atopic dermatitis
Authors: R. Wolf, M. Sandbank, A. Krakowski
Journal: British Journal of Dermatology (1985)

Journal Article Extensive pityriasis alba and atopic dermatitis Get access R. Wolf, R. Wolf Dermatology Service, Barzilai Medical Centre, Ashkelon, Israel Search for other works by this author on: Oxford Academic Google Scholar M. Sandbank, M. Sandbank Department of Dermatology, Beilinson Medical Centre, Petah‐Tiqva, Israel Search for other works by this author on: Oxford Academic Google Scholar A. Krakowski A. Krakowski Department of Dermatology, Ichilov Hospital, Tel‐Aviv, Israel Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 112, Issue 2, 1 February 1985, Page 247, https://doi.org/10.1111/j.1365-2133.1985.tb00093.x Published: 01 February 1985
NICE recommends new treatment for breast and bowel cancer
Authors: S. Mayor
Journal: BMJ (2003)

The National Institute for Clinical Excellence (NICE) has, in guidance issued last week, recommended capecitabine as the second line treatment for metastatic or locally advanced breast cancer.

Capecitabine and another antimetabolite, tegafur with uracil, have been recommended as options for the first line treatment of metastatic bowel cancer. NICE recommends capecitabine in combination with docetaxel for metastatic or locally advanced breast cancer when anthracycline based treatment has failed or is unsuitable.

A committee that included NHS healthcare professionals and lay people reviewed …
The Care of Elderly Patients with Hip Fracture
Authors: John F. Fitzgerald, Patricia S. Moore, Robert S. Dittus
Journal: New England Journal of Medicine (1988)

Abstract We hypothesized that the care provided to elderly patients with hip fracture in community hospitals has changed since the implementation of prospective payment systems (PPS) in 1983. We reviewed records of elderly patients admitted with hip fracture to a large community hospital from 1981 to 1986. During that period, the mean length of hospitalization decreased (from 21.9 to 12.6 days; P<0.0001), inpatient physical therapy decreased (from 7.6 to 6.3 sessions; P<0.04), and the maximal distance walked before discharge fell (from 27 to 11 m [93 to 38 ft]; P<0.0001). Concomitantly, the proportion of patients discharged to nursing homes rose (from 38 to 60 percent; P<0.0001), as did the proportion remaining in nursing homes one year after hospitalization (from 9 to 33 percent; P<0.0001). Neither in-hospital mortality nor one-year mortality changed significantly. As compared with beneficiaries of conventional Medicare after the implementation of PPS, HMO enrollees had shorter hospitalizations (7.3 vs. 14.0 days; P<0.0001), received less physical therapy (3.5 vs. 7.1 sessions; P<0.0001), walked shorter distances at discharge (3 vs. 13 m [11 vs. 44 ft]; P<0.01), and were more frequently transferred to nursing homes (83 vs. 55 percent; P<0.01). One year later, however, fewer HMO patients remained in nursing homes (16 vs. 35 percent; P<0.07). We conclude that since the implementation of PPS, hospitals have reduced the amount of care given to patients with hip fracture and have shifted much of the rehabilitation burden to nursing homes. The increase in the number of such patients remaining in nursing homes one year after the fracture suggests that the overall quality of care for these patients may have deteriorated. (N Engl J Med 1988;319:1392–7.)