tbuckley/cabot-search huggingface dataset:
Dose-Ranging Study of Intravenous Amiodarone in Patients With Life-Threatening Ventricular Tachyarrhythmias
Authors: Melvin M. Scheinman, Joseph H. Levine, David S. Cannom, Ted Friehling, Harry A. Kopelman, Donald A. Chilson, Edward V. Platia, David J. Wilber, Peter R. Kowey
Journal: Circulation (1995)

Oral amiodarone effectively suppresses ventricular arrhythmias; however, full activity may take days or weeks. In patients with frequent, life-threatening ventricular arrhythmias, this delay is not acceptable. Thus, in these patients, the speed and dosing accuracy of an intravenous formulation would be beneficial. The goal of this study was to demonstrate the efficacy of intravenous amiodarone in patients with refractory, recurrent hemodynamically destabilizing ventricular tachycardia or ventricular fibrillation by determining a dose response among three regimens.A total of 342 patients were enrolled at 46 medical centers in the United States. Patients received one of three randomized, double-blind dose regimens delivering 125, 500, or 1000 mg during the first 24 hours. Supplemental infusions (150 mg) of intravenous amiodarone could be given to treat breakthrough ventricular arrhythmias. The key efficacy end points were the arrhythmia event rate, time to first arrhythmic event, and number of supplemental infusions administered. The event rate decreased with increasing doses: median values were 0.07, 0.04, and 0.02 events per hour for the 125-, 500-, and 1000-mg dose groups, respectively, representing a significant decrease from baseline event rates (P = .043), and approached significance in the overall test for trend (P = .067). There was a significant dose-related increase in the time to first event (trend test P = .025) and a significant dose-related decrease in the number of supplemental boluses per hour (trend test P = .043). Hypotension was the most common (26%) treatment-emergent adverse event during intravenous amiodarone therapy; there was no dose-response relationship. Seventy-eight percent of the patients survived to at least 48 hours.Intravenous amiodarone is effective for the treatment of recurrent, life-threatening ventricular tachyarrhythmias.
A Randomized Trial Comparing Octylcyanoacrylate Tissue Adhesive and Sutures in the Management of Lacerations
Authors: James Quinn
Journal: JAMA (1997)

To assess the effectiveness of a new tissue adhesive for laceration closure.A prospective, randomized controlled trial.An adult teaching hospital.One hundred thirty patients with 136 lacerations who consented to enrollment during a 5-month period. The lacerations included all eligible nonmucosal facial lacerations, as well as selected extremity and torso lacerations (not on hands, feet, or joints). One hundred six lacerations were available for early follow-up, and 98 were available for 3-month evaluation.Lacerations were randomly allocated to have skin closure with octylcyanoacrylate adhesive or monofilament suture.A 3-month photograph of the wound was assigned a cosmesis score on a previously validated 100-mm visual analog cosmesis scale by a plastic surgeon who was unaware of the method of wound closure.There were no differences in the mean visual analog cosmesis scores (67 mm for octylcyanoacrylate vs 68 mm for sutures; P=.65). Similarly, there was no difference in the percentage of early (80% vs 82%; P=.80) or late (72% vs 75%; P=.74) optimal wound evaluation scores. The tissue adhesive was a faster method of wound repair (3.6 vs 12.4 minutes; P<.001) as well as being less painful (visual analog pain scores, 7.2 vs 18.0 mm; P<.001).Octylcyanoacrylate tissue adhesive effectively closes selected lacerations. This relatively painless and fast method of wound repair can replace the need for suturing several million lacerations each year.
Rapid donor T‐cell engraftment increases the risk of chronic graft‐versus‐host disease following salvage allogeneic peripheral blood hematopoietic cell transplantation for bone marrow failure syndromes
Authors: Jeremy Pantin, Xin Tian, Avni A. Shah, Roger Kurlander, Catalina Ramos, Lisa Cook, Hahn Khuu, David Stroncek, Susan Leitman, John Barrett, Theresa Donohue, Neal S. Young, Nancy Geller, Richard W. Childs
Journal: American Journal of Hematology (2013)

The risk of graft-rejection after allogeneic hematopoietic cell transplantation using conventional cyclophosphamide-based conditioning is increased in patients with bone marrow failure syndromes (BMFS) who are heavily transfused and often HLA-alloimmunized. Fifty-six patients with BMFS underwent fludarabine-based reduced-intensity conditioning and allogeneic peripheral blood progenitor cell (PBPC) transplantation at a single institution. The conditioning regimen consisted of intravenous cyclophosphamide, fludarabine, and equine antithymocyte globulin. Graft-versus-host disease (GVHD) prophylaxis included cyclosporine A alone or in combination with either mycophenolate mofetil or methotrexate. To reduce the risk of graft-rejection/failure, unmanipulated G-CSF mobilized PBPCs obtained from an HLA-identical or single HLA-antigen mismatched relative were transplanted rather than donor bone marrow. Despite a high prevalence of pretransplant HLA-alloimmunization (41%) and a heavy prior transfusion burden, graft-failure did not occur with all patients having sustained donor lympho-hematopoietic engraftment. The cumulative incidence of grade II-IV acute-GVHD and chronic-GVHD was 51.8% and 72%, respectively; with 87.1% surviving at a median follow-up of 4.5 years. A multivariate analysis showed pretransplant alloimmunization and rapid donor T-cell engraftment (≥95% donor by day 30) were both significantly (P < 0.05) associated with the development of chronic-GVHD (adjusted HR 2.13 and 2.99, respectively). These data show fludarabine-based PBPC transplantation overcomes the risk of graft-failure in patients with BMFS, although rapid donor T-cell engraftment associated with this approach appears to increase the risk of chronic-GVHD. (Clinicaltrials.gov identifier: NCT00003838).
Pleasing doctors: when it gets in the way
Authors: Robert Klitzman
Journal: BMJ (2007)

“You want your doctors to like you,” she said. “You want to be a good patient and sometimes are afraid to rock the boat.” The woman speaking to me was a physician with cancer. I was interviewing her as part of a study of doctors who had become sick with serious disease.1 To my surprise, she and others I talked to described repeatedly how they hesitated to be aggressive or “pushy” with their own healthcare providers and instead tried to please them.

“If I trust the doctor,” another doctor with cancer told me, “he feels good. The fewer questions I ask, the happier he is and the more positive he'll relate to me. I want him to know he's a good guy.”

In general, people want others in social interactions to feel positively, and doctor-patient interactions are no exception. Unfortunately such behaviour can hamper open communication between patients and their providers and hence impair care.

The best doctor-patient communication can enhance interpersonal relationships, information exchange, medical decision making, informed consent, and patients' satisfaction, adherence, understanding, and, possibly, health outcomes.2 3 4

As another …
TCT-748 First Human Cohort Transcatheter Aortic Valve Implantations Of The Colibri Heart Valve, A Pre-Mounted, Pre-Packaged, Low Profile Ready for Use, Dry Valve In A 14 French Delivery System. Fifteen months of Follow Up
Authors: David Paniagua, Pedro E. Urena, Ramon Almanzar, David E. Paniagua, Eduardo Induni, GERARDO DELAROSA, Lizy M. Paniagua, Erika M. Perez, Richard D. Fish, Bernard Chevalier
Journal: Journal of the American College of Cardiology (2014)
Sexual activity among patients in psychiatric hospital wards
Authors: J. Warner, N. Pitts, M. J Crawford, M. Serfaty, P. Prabhakaran, R. Amin
Journal: Journal of the Royal Society of Medicine (2004)

In psychiatric hospitals, sexual activity between patients raises special difficulties regarding consent. We undertook a questionnaire survey of inpatients in the mental health units of three hospitals to identify the nature and frequency of sexual activity. A contemporaneous staff questionnaire was used in an attempt to validate the patient reports. Of the 100 patients who participated (response rate 60%), 30 reported engaging in some form of sexual activity including 10 who had sexual intercourse. All sexual intercourse was consensual, but only 2 respondents used condoms. Staff questionnaires suggested levels of sexual activity congruent with patient reports. This survey underlines the conflict between an individual's right to sexual expression and the need to protect vulnerable patients.
Systemic treatment of cancer
Authors: I. H. Krakoff
Journal: CA A Cancer Journal for Clinicians (1996)

For the past 50 years, the search has continued for systematically administered agents that can produce profound and lasting effects on human cancers. This has led to the use of many cytoxically and hormonally active agents and, more recently, to the use of biologic agents. The author presents the 10th in a series of periodic updates in this journal on the current status of systematic treatment of cancer.
Digitalis Administration During Ventricular Tachycardia.
Authors: Gerald H. Whipple
Journal: Annals of Internal Medicine (1965)

s1 November 1965Digitalis Administration During Ventricular Tachycardia.Gerald H. Whipple, M.D. (Associate), Sidney Friedman, M.D.Gerald H. Whipple, M.D. (Associate)Search for more papers by this author, Sidney Friedman, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-63-5-903_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThis study analyzed the effect of a single dose of a rapidly acting digitalis preparation on hemodynamic parameters during continuing ventricular tachycardia and on the time required for "hemodynamic recovery" from congestive circulatory failure induced by chronic rapid electrical stimulation of the ventricles of intact dogs. Stimulation electrodes were attached to the right ventricles; chronic indwelling catheters were placed in the aorta, pulmonary artery, and right and left atria to permit determination of cardiac output, circulation time, pressures and various abstracted parameters. Congestive failure was induced in nine animals by stimulation rates ranging from 280 to 310 beats/min for an... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Gerald H. Whipple, M.D. (Associate); Sidney Friedman, M.D.Affiliations: Boston, Massachusetts PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 November 1965Volume 63, Issue 5Page: 903-903KeywordsAortaCardiac outputCathetersHemodynamicsPulmonary arteriesVentricular tachycardia ePublished: 1 December 2008 Issue Published: 1 November 1965 PDF downloadLoading ...
NICE recommendations are not evidence based and could expose many to unnecessary harm
Authors: S. Timimi, J. Jureidini, J. Leo
Journal: BMJ (2008)

The National Institute for Health and Clinical Excellence’s (NICE’s) single most important recommendation is for medication to be used as a first line treatment in “severe” attention-deficit/hyperactivity disorder (ADHD).1 Like other systematic reviews of ADHD medication treatment, NICE notes the inadequate reporting of study methodology, possible bias, limited reliability of results, and inadequate data regarding adverse events, correctly …
Major T Cell Progenitor Activity in Bone Marrow–derived Spleen Colonies
Authors: Christophe Lancrin, Elke Schneider, Florence Lambolez, Marie-Laure Arcangeli, Corinne Garcia-Cordier, Benedita Rocha, Sophie Ezine
Journal: The Journal of Experimental Medicine (2002)

Common lymphoid progenitors (CLP) are generated in adult bone marrow (BM), but the intermediate steps leading to T cell commitment are unknown, and so is the site at which this commitment occurs. Here, we show that colonies arising in the spleen 12 days after BM injection harbor T cell precursors that are undetectable in BM. These precursors did not generate myeloid cells in vivo but repopulated the thymus and the peripheral T cell compartment much faster than did CLP. Two lineage negative (Lin−) subpopulations were distinguished, namely CD44+ Thy1− cells still capable of natural killer generation and transient low-level B cell generation, and T cell–restricted CD44− Thy1+ cells. At a molecular level, frequency of CD3ε and preTα mRNA was very different in each subset. Furthermore, only the CD44− Thy1+ subset have initiated rearrangements in the T cell receptor β locus. Thus, this study identifies extramedullary T cell progenitors and will allow easy approach to T cell commitment studies.
Adalimumab (a fully human anti-tumour necrosis factor monoclonal antibody) in the treatment of active rheumatoid arthritis: the initial results of five trials
Authors: R Rau
Journal: Annals of the Rheumatic Diseases (2002)

Adalimumab (a fully human anti-tumour necrosis factor α monoclonal antibody) in the treatment of active rheumatoid arthritis: the initial results of five trials
Hyponatremia in the Syndrome of Inappropriate Secretion of Antidiuretic Hormone
Authors: Guy Decaux
Journal: JAMA (1982)

In the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), rapid elevation of serum sodium concentration may be imperative to correct neurological symptoms. Seven patients with hyponatremia secondary to SIADH were treated by oral intake of two to three doses of 30 g of urea over 24 hours or infusion of 80 g of urea as a 30% solution of over six hours, water restriction (500 mL/24 hr), and sodium supplements (120 to 360 mmole/24 hr). Serum sodium concentration increased from 117 +/- 2 to 126 +/- 1.4 mmole/L (mean +/- SEM) after eight hours, to 130 +/- 1.3 mmole/L after 12 hours, and to 134.5 +/- 1.2 mmole/L after 24 hours. The normalization of serum sodium was secondary to osmotic diuresis and to sodium retention induced by urea. Use of urea should be considered when symptomatic hyponatremia in SIADH must be quickly corrected.
Successful Treatment of Insulin Allergy in a 1-Year-Old Infant With Neonatal Diabetes by Lispro and Glargine Insulin
Authors: Cengiz Kara, Alev Oguz Kutlu, Olcay Evliyaoglu, Hatice Bilgili, Nurdan Yildirim
Journal: Diabetes Care (2005)

Systemic insulin allergy is a rare condition and has usually been reported in adults. Human insulin analogs have been proposed for the treatment of insulin allergy (1,2). Here we report a 1-year-old infant with generalized allergy to insulin who has been successfully treated with the insulin analogs lispro and glargine. To our knowledge, this case subject is the youngest child reported with systemic insulin allergy and the only patient who was treated without any adverse event by glargine insulin in infancy.

A neonate girl, the first child of consanguineous parents, was born at full term after uneventful pregnancy. She was small for gestational age with a birth weight of 1,430 g. Although the infant had been fed properly from …
Fish Oil Supplementation Does Not Lower Plasma Cholesterol in Men with Hypercholesterolemia
Authors: Timothy J. Wilt
Journal: Annals of Internal Medicine (1989)

Study Objective: To determine the effects of fish oil supplementation on plasma cholesterol in middle-aged men with isolated hypercholesterolemia. Design: Randomized double-blind placebo-controlled (safflower oil) two-period crossover trial with 12-week treatment periods. Setting: Outpatient general medicine clinic at a university-affiliated Veterans Affairs hospital. Patients: Thirty-eight men with plasma cholesterol between 5.68 and 7.76 mmol/L (220 to 300 mg/dL), triglyceride levels less than 3.39 mmol/L (300 mg/dL), and free of coexisting diseases. Interventions: Fish oil and placebo (safflower oil) supplementation. After basal measurements and a 4-week lead-in period, twenty 1-g capsules of either fish oil or placebo oil were provided for 12 weeks (period 1). After a 4-week washout phase participants then received the other oil for an additional 12 weeks (period 2). Measurements and Main Results: Blood was drawn at the beginning and end of each study period and analyzed for levels of total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, apolipoprotein A1, and apolipo-protein B. Low-density lipoprotein (LDL) cholesterol was calculated using the Friedewald equation. Total and LDL cholesterol increased from the before treatment values by 4.8% and 9.1%, respectively, after ingestion of fish oil. Compared with placebo, LDL cholesterol was significantly higher (4.5 compared with 4.1 mmol/L, P = 0.01) and triglycerides lower (1.3 compared with 1.8 mmol/L, P = 0.01) after fish oil. Total and HDL cholesterol and apolipoprotein A1 and B levels did not differ. Conclusions: Fish oil supplements do not lower plasma cholesterol levels in middle-aged men with hypercholesterolemia without elevated triglycerides. They should not be recommended as a method to lower plasma cholesterol in these patients.
A biodegradable, injectable, gel system based on MPEG-b-(PCL-ran-PLLA) diblock copolymers with an adjustable therapeutic window
Authors: Yun Mi Kang, Sang Hyo Lee, Ju Young Lee, Jin Soo Son, Byung Soo Kim, Bong Lee, Heung Jae Chun, Byoung Hyun Min, Jae Ho Kim, Moon Suk Kim
Journal: Biomaterials (2009)
Lipoprotein(a), Measured With an Assay Independent of Apolipoprotein(a) Isoform Size, and Risk of Future Cardiovascular Events Among Initially Healthy Women
Authors: Jacqueline Suk Danik, Nader Rifai, Julie E. Buring, Paul M Ridker
Journal: JAMA (2006)

Controversy exists as to whether lipoprotein(a), a lipoprotein with homology to plasminogen, is a clinically meaningful cardiovascular risk marker in women. There is also poor agreement among lipoprotein(a) levels obtained by different assays.To determine the association of lipoprotein(a) levels, measured with an assay independent of apolipoprotein(a) isoform size, with the incidence of future cardiovascular events.Prospective study of 27,791 initially healthy women in the Women's Health Study, enrolled between November 1992 and July 1995 and followed up for 10 years. Lipoprotein(a) level was measured in blood samples obtained at baseline with an assay independent of apolipoprotein(a) isoform size.Hazard ratios (HRs) for first-ever major cardiovascular events (nonfatal myocardial infarction, nonfatal cerebrovascular event, coronary revascularization, or cardiovascular deaths).During follow-up, there were 899 incident cardiovascular events. After adjusting for age, smoking, blood pressure, body mass index, total cholesterol, high-density lipoprotein cholesterol, diabetes, hormone use, C-reactive protein, and randomization treatment groups, women in the highest quintile of lipoprotein(a) (> or =44.0 mg/dL) were 1.47 times more likely (95% CI, 1.21-1.79; P for trend <.001) to develop cardiovascular events than women in the lowest quintile (< or =3.4 mg/dL). This association, however, was due almost entirely to a threshold effect among those with the highest lipoprotein(a) levels. After adjusting for all of the variables listed above, the HR associated with lipoprotein(a) levels exceeding the 90th percentile (> or =65.5 mg/dL) was 1.66 (95% CI, 1.38-1.99); 95th percentile (> or =83 mg/dL), 1.87 (95% CI, 1.50-2.34); and 99th percentile (> or =130.7 mg/dL), 1.99 (95% CI, 1.32-3.00), with almost no risk gradient at lower levels. Associations were strongest among women with low-density lipoprotein cholesterol (LDL-C) above the median level. In this subgroup, the adjusted HR associated with lipoprotein(a) levels exceeding the 90th percentile was 1.81 (95% CI, 1.48-2.23); 95th percentile, 1.93 (95% CI, 1.51-2.48); and 99th percentile, 1.93 (95% CI, 1.21-3.05) (P value for interaction with LDL-C = .001).In this cohort of initially healthy women, extremely high levels of lipoprotein(a) (> or =90th percentile), measured with an assay independent of apolipoprotein(a) isoform size, were associated with increased cardiovascular risk, particularly in women with high levels of LDL-C. However, the threshold and interaction effects observed do not support routine measurement of lipoprotein(a) for cardiovascular stratification in women.
Social and economic factors in patients with coronary disease
Authors: N. Frasure-Smith
Journal: JAMA (1992)

To the Editor.  —The article by Case et al 1 concerned with the long-term prognostic impact of living alone after a myocardial infarction (MI) is a major contribution to the growing evidence that psychosocial factors have important prognostic significance following MI. It was therefore surprising to see that in the authors' consideration of hypothetical mechanisms linking social isolation with poor outcome (including a possible neuroendocrine response to human contact), no reference was made to the potential intervening role of negative emotions including anxiety and depression.  There is increasing evidence that psychological factors are linked to neurohormonal and cardiovascular changes that may result in atherosclerosis, ischemia, MI, and sudden death. 2 In addition, several recent studies have demonstrated a relationship between measures of post-MI psychological status (eg, anxiety, depression, and emotional distress) and prognosis, independent of standard cardiac risk variables. 3-5 Thus, it could be hypothesized that one reason that the
Mucosal secretory IgA and secretory piece in adult coeliac disease
Authors: R. J. Shiner, J. Ballard
Journal: Gut (1973)

Immunofluorescence studies with specific antisera to secretory IgA (11S IgA) and secretory piece were carried out on the jejunal mucosa of nine patients with adult coeliac disease (treated and untreated). The results were compared with those obtained in four normal patients and in four patients with local and systemic IgA (7S) deficiency. 11S IgA and secretory piece were localized to the upper third of the epithelial cells of both surface and glandular epithelium in all groups of patients. However, in the untreated coeliac patients fluorescence was also demonstrated in the basement membrane and connective tissue of the mucosa (returning to normal on treatment). On the basis of our findings, a revised pathway for the normal production of 11S IgA is proposed as well as an additional pathway involving a `backflow9 of 11S IgA into the lamina propria in pathological states such as coeliac disease. This backflow is reversed by an adequate gluten-free diet. It is suggested that 7S IgA and 11S IgA may be involved in immune reactions in the mucosa with antigens such as gluten.
Venereal Diseases Today
Authors: Nicholas J. Fiumara, Bernard Appel, William Hill, Herbert Mescon
Journal: New England Journal of Medicine (1959)

Clinical ProgressGonorrheaGonorrhea is admittedly the oldest of the five venereal diseases. Medical historians believe that the "issues" (vaginal discharge) mentioned in the 15th chapter of the Book of Leviticus were due to gonorrhea. An Egyptian papyrus dating from 3500 B.C. prescribes plant extracts to alleviate the dysuria of gonorrhea. The disease was known and described by Hippocrates (460 B.C.), but it was Galen, the Greek physician, who called it gonorrhea (from the Greek words for semen and flow), believing the urethral discharge to be an involuntary flow of semen. Rhazes (860–932), the Arabian physician, developed the first sound, . . .
Multicentric tracheobronchial and oesophageal granular cell myoblastoma.
Authors: D J O'Connell, H MacMahon, T R De Meester
Journal: Thorax (1978)

Two patients with multiple intrathorcic granular cell myoblastomas are described. In one case multiple tumours were present in the major airways and oesophagus. The patient presented with recurrent pulmonary infections and stridor due to airway obstruction. In the other case dysphagia caused by multiple oesophageal granular cell myoblastomas was the major symptom. Granular cell myoblastoma is a rare tumour of neurogenic origin with a characteristic histological appearance. The pattern of multiple tracheobranchial and oesophageal tumours is uncommon and forms the basis of this report.