tbuckley/cabot-search huggingface dataset:
Low-Dose Combined Therapy with Fluvastatin and Cholestyramine in Hyperlipidemic Patients
Authors: Dennis L. Sprecher
Journal: Annals of Internal Medicine (1994)

Objective: To compare the low-density lipoprotein (LDL) cholesterol-lowering efficacy of low-dose combinations of cholestyramine and fluvastatin. Design: Randomized, double-blind, parallel group, placebo-controlled trial with a 24-week double-blind treatment period divided into three phases. Setting: Office-based clinics. Patients: Hypercholesterolemic, with LDL cholesterol of 4.14 mmol/L or greater (≥ 160 mg/dL) and plasma triglycerides of 3.39 mmol/L or less (≤ 300 mg/dL). Four hundred sixty patients were screened; 224 patients were randomized into a double-blind treatment period; 203 completed the study; 6 dropped out because of adverse events. Intervention: Patients were treated with 10 mg or 20 mg of fluvastatin alone, 8 g or 16 g of cholestyramine alone, or combinations of these fluvastatin and cholestyramine dosages (six treatment groups). Measurements: Changes in lipid variables, particularly LDL cholesterol. Results: The 10-mg and 20-mg fluvastatin monotherapy groups showed considerable reductions in LDL cholesterol initially (−20.1% [SD, 8.8%] and −20.2% [SD, 10.1%], respectively); these reductions were maintained. Reductions in LDL cholesterol that resulted from the addition of cholestyramine, 8 g/d, to 10 mg of fluvastatin and 20 mg of fluvastatin were greater than those observed with monotherapy (10-mg fluvastatin − [10-mg fluvastatin plus cholestyramine], 9.1%; 95% CI, 3.8% to 14.4%) and 20-mg fluvastatin − [20-mg fluvastatin plus cholestyramine], 11.6%; CI, 6.5% to 16.8%). The increase in cholestyramine dose to 16 g/d in the three combination groups provided only a modest additional response. Conclusions: Low-density lipoprotein cholesterol reductions of about 25% to 30% can be achieved with low-dose combination therapy with fluvastatin and cholestyramine. The addition of low-dose resin appears to produce greater overall cholesterol reduction than does a simple doubling of the fluvastatin dosage. The low-dose combination treatment was highly successful in achieving the goals of the National Cholesterol Education Program guidelines.
Therapeutic applications of vitamin D analogues.
Authors: J Reeve
Journal: BMJ (1979)

In the sunnier parts of the world a dietary intake of vitamin D is unnecessary,* but for most of us it is a true vitamin. Its dihydroxylated metabolite 1,25-dihydroxyvitamin D3 (l,25(OH)2D3) is, however, a hormone synthesised in the kidney and borne by the bloodstream to distant target organs (gut, bone, and possibly the parathyroid glands) with a complex feedback mechanism regulating its rate of production.1 None of the other vitamin D metabolites has yet been confidently assigned a hormonal role in man. The unravelling of the interrelationships between vitamin D and its metabolites is one of the triumphs of recent medical research, and the stage has now been reached when treatment with synthetic metabolites of vitamin D is beginning to be available for several disorders. The major functional categories of endocrine disease are all represented among defects in the metabolism of l,25(OH)2D3. Hormone deficiency may occur from failure of tubular cell function; impairment of feedback control may result in subnormal or excessive production; or the disorder may be due to unresponsiveness in the target organs. Physiological considerations?Cholecalciferol (D3) is formed in the skin under the influence of ultraviolet light.2 Its pre cursors remain in situ because they are insoluble in water and
Triple Phase Bone Scanning of an Intraosseous Ganglion: Case Report and Discussion
Authors: J M WARDLAW, J J K BEST
Journal: Clinical Nuclear Medicine (1988)

The appearance of an intraosseous ganglion on a static bone scan has been described. This report describes the appearance on triple phase bone scanning, and discusses the implications for differential diagnosis of similar benign-looking subarticular cystic lesions of bone.
US government calls for tighter regulation of clinical trials
Authors: D. Josefson
Journal: BMJ (1998)

The US Department of Health and Human Services is calling for tighter regulation of clinical trials.

The current system is outdated and unwieldy and leaves hundreds of thousands of research participants inadequately protected, according to the department in a recent report. In a meeting with a congressional subcommittee, George Grob, deputy inspector general for evaluations and inspections, said: “The long established system for protecting human research subjects has vulnerabilities that threaten its effectiveness. …
An inadequate questionnaire on premature births
Authors: C. Dezateux, S. Logan, C. Peckham
Journal: BMJ (1989)

delayed the summary being typed and sent for up to six months after patients had been discharged.Such problems are not unique to our hospital.We decided to produce short computerised summaries as close to the time of discharge as practicable using purely medical input.This was achieved with a 16 bit MSDOS computer (RML Nimbus) with a hard disk, using the database
Infectious Diseases in Small Hospitals
Authors: MICHAEL R. BRITT
Journal: Annals of Internal Medicine (1978)

In a 1-day prevalence survey nosocomial infections were found in 7.2% and community acquired infections in 20.4% of 525 patients hospitalized in 18 small hospitals. Pneumonia was the reason for admission in 11% of patients in small hospitals. The patterns of nosocomial infections and antibiotic usage in small hospitals are similar to those found in large hospitals. The adequacy of bacteriologic services was assessed using a process audit technique. The routine approach to common bacteriologic specimens and antibiotic disk susceptibility tests was frequently inadequate. Approaches used in large hospitals for the control of nosocomial infection and the performance of bacteriology tests were not practical for most small hospitals. Specific research into methods for doing clinically adequate bacteriology and approaches for the control of nosocomial infection in the small hospital setting are needed.
Patient commentary: Direct access would beat receiving test results with the receptionist's interpretation
Authors: R. Snow
Journal: BMJ (2015)

Patient commentary: Direct access would beat receiving test results with the receptionist's interpretationThe authors on both sides of this debate have made an interesting assumption1: that the opposite of patients' direct access is a "traditional model," in which a clinician interprets test results for the patient.To assume that this is the default situation is to miss a vital part of the debate.In the real world, test results are not just delivered by supportive clinicians, with occasional lapses from that norm; direct access aside, the standard delivery of test results is much more varied than that.I have had results given to me by a general practice receptionist as part of the surgery's normal practice; this included the receptionist's interpretation of what the numbers meant.I have tried to get the results of blood test monitoring and been told by a nurse that these are not given out until the next appointment, with standard waiting time 12 months, by which time the information offered by the test would no longer be useful for self management.
Task Force III: Perspectives on the allocation of limited resources in cardiovascular medicine
Authors: Thomas J. Ryan, Thomas P. Graham, George J. Annas, Anthony N. Demaria, Norman C. Fost, Valentin Fuster, John Collins Harvey, Norman G. Levinsky, Laurence B. McCullough, Richard A. Rettig, William J. Schwartz, David N. Sundwall, Norman S. Talner, E.Douglas Wigle, Vallee L. Willman
Journal: Journal of the American College of Cardiology (1990)
Neutralization of CD95 ligand promotes regeneration and functional recovery after spinal cord injury
Authors: Deana Demjen, Stefan Klussmann, Susanne Kleber, Cecilia Zuliani, Bram Stieltjes, Corinna Metzger, Ulrich A Hirt, Henning Walczak, Werner Falk, Marco Essig, Lutz Edler, Peter H Krammer, Ana Martin-Villalba
Journal: Nature Medicine (2004)
Current Results of Operation for Mitral Stenosis
Authors: EDWARD M. MULLIN, D. LUKE GLANCY, LAWRENCE M. HIGGS, STEPHEN E. EPSTEIN, ANDREW G. MORROW
Journal: Circulation (1972)

Among 124 consecutive patients undergoing operation for pure or predominant mitral stenosis between 1964 and 1969, closed commissurotomy was carried out in 53 (43%). There were no early or late deaths, and the hemodynamic and symptomatic results of operation were excellent. In 51 (41%) of the patients, valvular anatomy was such that valve replacement proved necessary. As a group, these patients were more severely symptomatic preoperatively and had worse hemodynamics than patients in the closed-commissurotomy group. With replacement, operative (24%) and late (12%) mortality were high, but surviving patients enjoyed hemodynamic and symptomatic benefits comparable to those of the patients undergoing closed commissurotomy. In 20 patients whose preoperative clinical and hemodynamic characteristics were intermediate between those of the closed-commissurotomy and valve-replacement groups, open commissurotomy was performed. Early (10%) and late (5%) mortality were less than with mitral replacement, but in general hemodynamic and symptomatic benefits were modest.
Endoscopic Ultrasonography in the Preoperative Staging of Esophageal Cancer
Authors: J. C. Souquet, B. Napoléon, B. Pujol, O. Keriven, T. Ponchon, F. Descos, R. Lambert
Journal: Endoscopy (1994)

Endoscopic ultrasonography is the best available method for the locoregional staging of esophageal carcinoma. Its main limitations are represented by a) tumor stenosis, b) distinguishing between malignant and benign lymph nodes, and c) distinguishing between mucosal and submucosal cancer. In untreated esophageal carcinoma, three main groups can be distinguished, based on clinical and morphological evaluation (endoscopy, abdominal ultrasound and CT). EUS is not useful when palliative treatment aiming to relieve dysphagia is the only treatment. In tumors with a superficial pattern at endoscopy, EUS is necessary to distinguish T1 from more invasive tumors, but endoscopic treatment (photodynamic therapy, strip biopsy) is indicated only in nonsurgical patients. In the last, and largest, group of tumors with no clear surgical contraindication, EUS is necessary when surgery is not the only treatment considered. EUS staging then improves patient management (surgery alone, surgery with preoperative treatment, or nonsurgical treatment; type of surgery). Moreover, it provides a good evaluation of the prognosis, and allows better follow-up after nonsurgical treatment.
The Epidemiology of Motor Vehicle Accidents
Authors: Ross A. McFarland
Journal: JAMA (1962)

The methods of epidemiology are useful in the study of accidental injuries and deaths. The control of automobile accidents requires consideration of the interrelationships between the host (driver), the agent (vehicle), and the environment ( both physical and social). Host factors shown to be significant include age, experience and training, emotional adjustment, alcohol, drugs, disease, and physical defects. The vehicle should be designed with protective features and adapted to human capabilities, limitations, and tolerances. Environmental influences likewise need to be understood. Problems such as the high rate of accidents at night exemplify the interactions between the host, the agent, and the environment. Application of this approach has resulted in effective preventive measures.
Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Melanoma Metastatic to the Pancreas: Report of Two Cases and Review
Authors: J. M. DeWitt, J. Chappo, S. Sherman
Journal: Endoscopy (2003)

Malignant melanoma is a neoplasm which originates from melanocytes. Surgical exploration for abdominal metastases of cutaneous melanoma reveals pancreatic metastases in 16 % of patients which is usually accompanied by other intra-abdominal spread. Endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) of primary and metastatic pancreatic masses have already been described. We report the first use of EUS-FNA for the diagnosis of malignant melanoma metastatic to the pancreas. As our cases illustrate, these lesions may present as either cystic or solid pancreatic masses. Preparation of a cell block from the FNA aspirate and use of immunostaining may help to obtain the diagnosis. Despite thorough examination of the skin and mucous membranes, however, a primary site might not be found in these patients.
Scintigraphic Features of a Pure Estrogen-Secreting Adrenocortical Adenoma in a Patient with Gynecomastia
Authors: FABIO MINUTOLI, GIORGIO RESTIFO PECORELLA, SEBASTIANO COSENTINO, RENATO LIPARI, SERGIO BALDARI
Journal: Clinical Nuclear Medicine (2002)

MINUTOLI, FABIO M.D.*; RESTIFO PECORELLA, GIORGIO M.D.†; COSENTINO, SEBASTIANO M.D.†; LIPARI, RENATO M.D.†; BALDARI, SERGIO M.D.† Author Information
Changes in extracellular and intracellular pH in ischemic rabbit papillary muscle.
Authors: G X Yan, A G Kléber
Journal: Circulation Research (1992)

The extracellular pH (pHo) and intracellular pH (pHi) were simultaneously measured with H(+)-sensitive microelectrodes in the rabbit papillary muscle during normal arterial perfusion and no-flow ischemia. The preparation was kept in an artificial gaseous atmosphere (N2 and CO2 during ischemia) without a surrounding fluid layer. Cylindrical muscles of small diameters (less than 1.0 mm) were selected to prevent major diffusion gradients of CO2 within the muscle cylinder during ischemia. In normal perfusion with CO2/HCO3(-)-buffered blood at PCO2 of 35 mm Hg, pHi was 7.03 +/- 0.03. During early ischemia, extracellular acidification was much more prominent than intracellular acidification. Consequently, the transmembrane pH gradient reversed (pHo less than pHi) at approximately 8 minutes. At 14 minutes of ischemia, pHo was 6.64 and pHi was 6.93. A moderate increase in PCO2 from 35 to 67 mm Hg before ischemia enhanced intracellular acidification in ischemia. Simulation of CO2 accumulation (increase of PCO2 in the surrounding atmosphere), as encountered in midmural ventricular layers during in vivo ischemia, produced a significant decrease of pHo (6.30 versus 6.64) and pHi (6.65 versus 6.93) at 14 minutes of ischemia. The presence of red blood cells in the intravascular space after arrest of coronary perfusion showed a pronounced effect on extracellular and intracellular acidosis. If the muscles were perfused with CO2/HCO3(-)-buffered perfusate in the absence of red blood cells, the changes of pHo and pHi were significantly larger (pHo, 6.00 versus 6.64; pHi, 6.46 versus 6.93 at 14 minutes) during ischemia. Actively developed force during ischemia was not significantly influenced by conditions modulating pHi. It decreased by 82% after 5 minutes, even when no significant change of pHi was recorded. By contrast, ischemic contracture was dependent on intracellular acidification. It developed earlier in the absence of red blood cells or with low extracellular buffer capacity. It is concluded that during acute myocardial ischemia 1) extracellular acidification exceeds intracellular acidification, 2) the decrease in pHi is inhomogeneous because of local variation in CO2 accumulation and diffusion, 3) the decrease in pHi is relatively small in the presence of red blood cells, and 4) the development of ischemic contracture but not the early decline in active tension is sensitive to changes in pHi.
German doctors challenge antiterrorism law
Authors: N. Stafford
Journal: BMJ (2009)

Jorg-Dietrich Hoppe, president of the German Medical Association, has joined a lawsuit challenging the constitutionality of a new antiterrorism law that gives German authorities broad surveillance powers. He says that the law threatens the relationship of trust between doctors and patients because doctors can no longer guarantee confidentiality.

The lawsuit was filed in late April in Germany’s Federal Constitutional Court by Dr Hoppe and five other prominent complainants representing psychological therapists, journalists, and lawyers.

Dr Hoppe said that he joined …
Abstract 659: Intake of fiber and fiber-rich plant foods associated with lower risk of renal cell carcinoma in a large U.S. cohort
Authors: Carrie R. Daniel, Wong-Ho Chow, Yikyung Park, Barry I I. Graubard, Albert R. Hollenbeck, Rashmi Sinha
Journal: Cancer Research (2012)

Abstract Renal cell carcinoma (RCC) accounts for nearly all adult kidney malignancies. The age-adjusted incidence of RCC has more than doubled over the last three decades in the U.S., mirroring the growing epidemic of obesity, which along with smoking comprise the most well-established RCC risk factors. Plant-based and fiber-rich diets high in vegetables, fruits, and whole grains are recommended for the prevention of cancer, as well as chronic conditions positively associated with RCC incidence, such as hypertension and diabetes. Thus, diet may play a role in RCC etiology directly and/or indirectly. In a large prospective cohort of U.S. men and women, we comprehensively investigated dietary intake of a range of plant foods and their nutritional components in relation to RCC risk. We further examined whether associations varied by history of hypertension or diabetes, body mass index, smoking status, or alcohol intake. At baseline (1995-1996), 492,186 participants of the National Institutes of Health-AARP Diet and Health Study completed a self-administered questionnaire of demographics, diet, lifestyle, and medical history. Over 9 (mean) years of follow-up we identified 1,814 incident cases of RCC. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated within quintiles (Q) using multivariable Cox proportional hazards regression. Intake of legumes, whole grains, and cruciferous vegetables were associated with a statistically significant 16-18% reduced risk of RCC. Conversely, refined grain intake was positively associated with RCC risk [Q5 vs. Q1, HR and 95% CI: 1.19 (1.02-1.39); P-trend =0.04] and we found no association with fruit intake. These findings were consistent with the strong inverse association we observed for total dietary fiber intake [Q5 vs. Q1, HR and 95% CI: 0.81 (0.69-0.95); Ptrend =0.005], as well as fiber derived from various dietary sources. The association between fiber intake and RCC did not vary substantially by smoking status [Q5 vs. Q1, HR and 95% CI: 0.65 (0.49-0.87) and 0.50 (0.25-1.02) in never vs. current smokers, respectively], history of hypertension [0.73 (0.52-1.02) and 0.75(0.57-1.00) in negative vs. positive history, respectively], or other major risk factors. In conclusion, intake of fiber and fiber-rich plant foods was associated with a significantly lower risk of renal cell carcinoma in this large U.S. cohort. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 659. doi:1538-7445.AM2012-659
The effect of infectious burden on the prevalence of atopy and respiratory allergies in Iceland, Estonia, and Sweden
Authors: Christer Janson, Hulda Asbjornsdottir, Alda Birgisdottir, Rúna Björg Sigurjonsdottir, María Gunnbjörnsdottir, Davíd Gislason, Isleifur Olafsson, Elízabet Cook, Rain Jögi, Thorarinn Gislason, Bjarni Thjodleifsson
Journal: Journal of Allergy and Clinical Immunology (2007)
Immune response of infants in tropics to injectable polio vaccine.
Authors: R Krishnan, M Jadhav, R Selvakumar, T J John
Journal: BMJ (1982)

1<h3>Abstract</h3> <h3>Motivation</h3> The advent of inexpensive high-throughput sequencing (HTS) places new demands on motif discovery algorithms. To confront the challenges and embrace the opportunities presented by the growing wealth of information tied up in HTS datasets, we developed K-mer motif multinomial mixtures (KMMMs), a flexible class of Bayesian models for identifying multiple motifs in sequence sets using K-mer tables. Advantages of this framework are inference with time and space complexities that only scale with K, and the ability to be incorporated into larger Bayesian models. <h3>Results</h3> We derived a class of probabilistic models of K-mer tables generated from sequence containing multiple motifs. KMMMs model the K-mer table as a multinomial mixture, with motif and background components, which are distributions over K-mers overlapping with each of the latent motifs and over K-mers that do not overlap with any motif, respectively. The framework casts motif discovery as a posterior inference problem, and we present several approximate inference methods that provide accurate reconstructions of motifs in synthetic data. Finally we apply the method to discover motifs in DNAse hypersensitive sites and ChIP-seq peaks obtained from the ENCODE project.
Further Analysis of Trials With Azacitidine in Patients With Myelodysplastic Syndrome: Studies 8421, 8921, and 9221 by the Cancer and Leukemia Group B
Authors: Lewis R. Silverman, David R. McKenzie, Bercedis L. Peterson, James F. Holland, Jay T. Backstrom, C.L. Beach, Richard A. Larson
Journal: Journal of Clinical Oncology (2006)

Purpose Within the last two decades, a new understanding of the biology of myelodysplastic syndrome (MDS) has developed. With this understanding, new classification systems, such as the WHO diagnostic criteria, and the International Prognostic Scoring System and response criteria guidelines reported by the International Working Group (IWG) have been developed. We report the combined results of three previously reported clinical trials (n = 309) with azacitidine using the WHO classification system for MDS and acute myeloid leukemia (AML) and IWG criteria for response. Patients and Methods Data from three sequential Cancer and Leukemia Group B trials with azacitidine were recollected and reanalyzed as part of the New Drug Application process. The trials were conducted with either intravenous or subcutaneous azacitidine (75 mg/m 2 /d for 7 days every 28 days). Results Complete remissions were seen in 10% to 17% of azacitidine-treated patients; partial remissions were rare; 23% to 36% of patients had hematologic improvement (HI). The median number of cycles to first response was three, and 90% of responses were seen by cycle 6. Using current WHO criteria, 103 patients had AML at baseline; 35% to 48% had HI or better responses. The median survival time for the 27 AML patients randomly assigned to azacitidine was 19.3 months compared with 12.9 months for the 25 patients assigned to observation. Furthermore, azacitidine did not increase the rate of infection or bleeding above the rate caused by underlying disease. Conclusion Azacitidine provides important clinical benefits for patients with high-risk MDS.