tbuckley/cabot-search huggingface dataset:
Some Surgical Aspects of Mitral Stenosis
Authors: Dwight E. Harken
Journal: New England Journal of Medicine (1956)

AS a surgeon, it is my purpose to review the operative and late results in patients who have had valvuloplasty for mitral stenosis. In addition, I should like to review a few technical maneuvers that improve the quality of valvuloplasty.Operative MortalityThe improving operative mortality is correlated with better prevention of emboli. This reduction of emboli is largely due to technical improvement in the management of the clotted atrium and calcific valve rather than to temporary head-vessel occlusion. Improved preoperative and postoperative care has contributed to safer surgery and better late results, but this is a thesis in . . .
Seven steps to evidence based general practice
Authors: M. Lagnado
Journal: BMJ (2003)

EDITOR—In reporting the study by Prosser et al, Dobson highlights the finding that the pharmaceutical industry is the most common source of prescribing information for general practitioners. 1 2 He misses the key point of this study: lack of time, information overload, and irrelevance of medical journals to general practice are the main barriers to …
Health-Related Quality of Life Among German Youths With Early-Onset and Long-Duration Type 1 Diabetes
Authors: Anna Stahl, Klaus Straßburger, Karin Lange, Christina Bächle, Reinhard W. Holl, Guido Giani, Joachim Rosenbauer
Journal: Diabetes Care (2012)

To evaluate self- and parent reports of general health status and health-related quality of life (QoL) in children and adolescents with early-onset and long-lasting type 1 diabetes compared with the general population in Germany.A total of 629 subjects aged 11 to 17 years, with a type 1 diabetes onset occurring from age 0 to 4 years during the years 1993-1999, and their parents, completed questionnaires, including the generic KINDL-R Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents, revised version, to assess QoL. The comparison group (n = 6,813) was a representative sample from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study. Regression analyses were conducted using sociodemographic and health-related covariates.Intensified insulin therapy was used to treat 93% of children and adolescents with type 1 diabetes. They reported "excellent" general health as often as peers (adjusted OR 0.83 [95% CI 0.66-1.04] for an "excellent" rating), but the parent-rated general health was worse than that in the general population (OR 0.60 [0.48-0.74]). The patients reported increased self-esteem (adjusted difference β = 4.39 [SE 0.82]; P < 0.001) and well-being at school (β = 3.41 [0.77]; P < 0.001) but lower well-being within their families (β = -2.42 [0.80]; P = 0.002). The self- and parent-reported total QoL did not differ between the patient group and the general population. The adjusted difference (SE) between the two samples in total QoL was β = 0.89 (0.52; P = 0.087) in the self-reports and β = -0.98 (0.53; P = 0.066) in the parent-reports.Compared with the general population, the QoL and general health status were not impaired among those aged 11-17 years with early-onset type 1 diabetes, despite the challenges of modern therapy.
CONSERVATIVE BRAIN SURGERY.
Authors: S. V. CLEVENGER
Journal: JAMA (1895)

In "Lectures on Intracranial Surgery," published in thisJournal, June 8, 1895, by Dr. Emory Lanphear, certain statements are made that are not warranted by pathologic and alienistic knowledge, certain operations are recorded as having been performed that are not justified by the literature or experience of those most competent to judge; and the results of the operations being unfavorable, and in some instances causing death, the conclusions of the paper alluded to are improper, and if recklessly absorbed and acted upon by others may be productive of further discreditable surgical interferences, and revolt of the laity against "butchery," as many unsuccessful operations are styled, even when these are judiciously and justifiably done. That Dr. Lanphear is a "brilliant operator" is well known, but when this ability is unassociated with other requisites it is like pyrotechnics near a powder magazine. He speaks of "insanity from softening of the brain." He
Effect of Exercise on Blood Coagulation
Authors: Clifford E. Keeney, David W. Laramie
Journal: Circulation Research (1962)

Whole blood clotting time was measured before and after four different intensities and durations of exercise, using 12 male college students as subjects. The exercises consisted of a 15-minute walk on a motor-driven treadmill at 2.5 m.p.h., a 2-hour walk on the treadmill at 2.5 m.p.h., a run to near exhaustion on the treadmill at 6.25 m.p.h., and a stepping exercise on a 12-inch bench, 30 steps per minute for 15 minutes. Thromboplastin generation rate was measured before and after the stepping exercise on blood samples drawn from 14 subjects, and thrombin generation rate was similarly measured on samples drawn from 16 subjects. No statistically significant variation was found in whole blood clotting time of samples drawn before the exercise, 1 minute after the exercise, or 15 and 30 minutes after. Neither was there any significant change in the thromboplastin generation rate of samples drawn before, 1 minute after, and 30 minutes after exercise. Ten of the 16 subjects showed no change in thrombin generation rate after exercise. However, six subjects experienced an acceleration of thrombin generation from a mean time of maximum thrombin concentration at 5.2 minutes before exercise to 4.0 minutes one minute after exercise. This difference was statistically significant. From these data it was concluded that, in general, exercise was not followed by hypercoagulability. However, in some subjects, thrombin generation rate was increased due to undetermined factors.
Racial Differences in the Progression from Chronic Renal Insufficiency to End-Stage Renal Disease in the United States
Authors: Chi-yuan Hsu, Feng Lin, Eric Vittinghoff, Michael G Shlipak
Journal: Journal of the American Society of Nephrology (2003)

ABSTRACT. Black Americans experience a disproportionate burden of ESRD compared with whites. Whether this is caused by the increased prevalence of chronic renal insufficiency (CRI) among blacks or by their increased progression from CRI to ESRD was investigated. A birth cohort analysis was performed using data from the Third National Health and Nutrition Examination Survey and the United States Renal Data System. It was assumed that those who developed ESRD in 1996 aged 25 to 79 yr came from the source population with CRI aged 20 to 74 yr that was sampled in the Third National Health and Nutrition Examination Survey (midpoint 1991). GFR was estimated using the Modification of Diet in Renal Disease study equation. The prevalence of CRI (GFR 15 to 59 ml/min per 1.73 m 2 ) was not different among black compared with white adults (2060 versus 2520 per 100,000; P = 0.14). For each 100 blacks with CRI in 1991, five new cases of ESRD developed in 1996, whereas only one case of ESRD developed per 100 whites with CRI (risk ratio, 4.8; 95% confidence interval, 2.9 to 8.4). The increased risk for blacks compared with whites was only modestly affected by adjustment for age, gender, and diabetes. Blacks with CRI had higher systolic (147 versus 136 mmHg; P = 0.001) and diastolic (82 versus 77 mmHg; P = 0.02) BP and greater albuminuria (422 versus 158 μg urine albumin/mg urine creatinine; P = 0.01). The higher incidence of ESRD among blacks is not due to a greater prevalence of CRI among blacks. The key to understanding black–white differences in ESRD incidence lies in understanding the extreme differences in their progression from CRI to ESRD. E-mail: hsuchi@medicine.ucsf.edu
Decreased Catabolism of Fluorouracil in Peripheral Blood Mononuclear Cells During Combination Therapy With Fluorouracil, Leucovorin, and Interferon -2a
Authors: L. K. Yee, C. J. Allegra, S. M. Steinberg, J. L. Grem
Journal: JNCI Journal of the National Cancer Institute (1992)

Background : We previously reported that recombinant interferon α-2a (IFN α-2a) therapy was associated with a dose-dependent decrease in fluorouracil (5-FU) clearance. Purpose : In this study, we used peripheral blood mononuclear cells (PBMCs), which are responsive to IFNs, as surrogate tissue to determine whether the change in clearance might be explained by decrease in 5-FU catabolism during IFN α-2a therapy. Methods : The study population consisted of 45 patients with adenocarcinoma arising in the gastrointestinal tract. Thirty-seven patients received therapy containing IFN α-2a at a median dose of 5 million U/m 2 per day (range, 1.7–7.5 million U/m 2 per day) starting on day 1 and continuing through either day 7 or day 14 in conjunction with intravenous high-dose leucovorin (LV) followed by bolus 5-FU on days 2–6. Eight patients received the same schedule of 5-FU and LV daily for 5 days without IFN α-2a but with granulocyte-macrophage colony-stimulating factor starting on day 6 and ending at least 3 days prior to the start of the next cycle. Peripheral blood was collected during 70 cycles on days 1, 2, and 4 prior to the daily treatment with IFN α-2a + 5-FU + LV and during 19 cycles on days 1 and 4 prior to the daily treatment with 5-FU + LV without IFN α-2a. In a given patient cycle, matched samples were drawn at approximately the same time of day. PBMCs were isolated, and the intact cells were exposed to 4 μ M [ 3 H]5-FU, and the formation of [ 3 H]dihydrofluorouracil was determined by reverse-phase high-performance liquid chromatography. Results : In 47 matched patient cycles from IFN α-2a + 5-FU + LV-treated patients in which samples were available on days 1, 2, and 4, 5-FU catabolism decreased by 20% ( P2 =.03) and 41% ( P2 =.0001) from the baseline catabolic rate (2.5 ± 0.2 pmol/min per 10 6 cells [mean ± SE]) on days 2 and 4, respectively. Using information from all paired samples, the mean change from baseline on day 2 was −0.4 ± 0.2 pmol/min per 10 6 cells (n = 54; P2 =.05), and the change from baseline on day 4 was −1.3 ± 0.3 pmol/min per 10 6 cells (n = 63; P 2 =.0001). In contrast, changes in 5-FU catabolism were not evident in the PBMCs of the reference population receiving 5-FU + LV without IFN α-2a. Conclusions : The magnitude of the change in 5-FU catabolism is similar to the magnitude of the decrease in 5-FU clearance in our previous study. These observations suggest that changes in 5-FU catabolism during therapy with IFN α-2a, 5-FU, and LV may account for the decreased 5-FU clearance. [J Natl Cancer Inst 84:1820–1825, 1992]
Introduction of H-2Dd determinants into the H-2Ld antigen by site-directed mutagenesis.
Authors: D Koeller, R Lieberman, J Miyazaki, E Appella, K Ozato, D W Mann, J Forman
Journal: The Journal of Experimental Medicine (1987)

We used site-directed mutagenesis to localize serologically defined (s) and CTL (c)-defined alloantigenic determinants to discrete amino acid sequences of a murine MHC class I antigen. Based on the prediction that amino acid position 63-73 of the H-2Dd antigen forms s-allodeterminants, the H-2Ld gene was mutated in a sequential fashion to replace codons for amino acid positions 63, 65, 66, 70, and 73 with those of the H-2Dd amino acids. Epitopes of the mutant antigens expressed in L-cells were examined by the binding of a series of mAbs specific for the H-2Dd antigen. The mutant antigen M66 had substitutions at residues 63, 65, and 66, and resulted in the acquisition of a number of H-2Dd-specific s-epitopes. Mutant M70 had an additional substitution at residue 70, which led to the gain of multiple additional H-2Dd s-epitopes. Together, more than half of all the relevant H-2Dd s-epitopes were mapped into amino acid position 63-70 of the H-2Dd molecule, which was expressed in the mutant H-2Ld gene. The final mutation at residue 73 (M73) caused no new epitope gains, rather, a few Dd s-epitopes acquired by the preceding mutations were lost. All of the H-2Ld-specific s-determinants were retained in the mutant molecules, as were H-2Dd s-determinants specific for the alpha-2 or alpha-3 domains. Changes of these residues affected c-determinants defined by CTL. Anti-H-2Dd CTL cultures and an anti-H-2Dd CTL clone recognized the mutant H-2Ld molecules, M66 and M70. Some CTL clones generated against the Q10d molecule, which has an identical sequence to H-2Dd between residues 61 and 73, failed to recognize native H-2Dd or Ld but did crossreact with mutant Ld. While bulk-cultured anti-H-2Ld CTL cultures reacted strongly against M73, bulk-cultured H-2Ld restricted anti-vesicular stomatitis virus CTL did not. Finally, at the clonal level two of three anti-H-2Ld CTL clones lost reactivity with some or all of these mutant molecules. From these results we conclude that a stretch of amino acids from position 63 to 70 of the alpha-1 domain controls major s- and c-antigenic sites on the H-2Dd antigen and c-sites on H-2Ld antigen.
Solid-tumor mortality in the vicinity of uranium cycle facilities and nuclear power plants in Spain.
Authors: G López-Abente, N Aragonés, M Pollán
Journal: Environmental Health Perspectives (2001)

To ascertain solid tumor mortality in towns near Spain's four nuclear power plants and four nuclear fuel facilities from 1975 to 1993, we conducted a mortality study based on 12,245 cancer deaths in 283 towns situated within a 30-km radius of the above installations. As nonexposed areas, we used 275 towns lying within a 50- to 100-km radius of each installation, matched by population size and sociodemographic characteristics (income level, proportion of active population engaged in farming, proportion of unemployed, percentage of illiteracy, and province). Using log-linear models, we examined relative risk for each area and trends in risk with increasing proximity to an installation. The results reveal a pattern of solid-tumor mortality in the vicinity of uranium cycle facilities, basically characterized by excess lung [relative risk (RR) 1.12, 95% confidence interval (CI), 1.02-1.25] and renal cancer mortality (RR 1.37, 95% CI, 1.07-1.76). Besides the effects of natural radiation, these results could well be evincing the influence on public health exerted by the environmental impact of mining. No such well-defined pattern appeared in the vicinity of nuclear power plants. Monitoring of cancer incidence and mortality is recommended in areas surrounding nuclear fuel facilities and nuclear power plants, and more specific studies are called for in areas adjacent to installations that have been fully operational for longer periods. In this regard, it is important to use dosimetric information in all future studies.
Abstract 1417: CXCR2 plays critical roles in colitis and colitis-associated cancer through trafficking of myeloid-derived suppressor cells.
Authors: Hiroshi Katoh, Dingzhi Wang, Sun-Hee Kim, Raymond N. DuBois
Journal: Cancer Research (2013)

Abstract A large body of evidence indicates that chronic inflammation is a risk factor for colorectal cancer (CRC). However, all of the mechanisms by which inflammation promotes CRC development are not fully understood. Our lab previously showed that PGE2 promotes CRC progression through angiogenic chemokine CXCL1 (Wang et al., 2006). CXCL1 exerts its downstream functions via binding to its receptor, CXCR2, which is a G-protein-coupled receptor. Our previous study showed that CXCR2 expression is also elevated mainly in endothelial and immune cells of human colorectal carcinomas. CXCR2 is expressed on neutrophils and involved in neutrophil trafficking. These results prompted us to hypothesize that CXCR2 may be one of mediators connecting inflammation and CRC. To address this question, preliminary experiments were performed to determine whether CXCR2 is involved in inflammation-enhanced CRC progression. Our results revealed that deletion of CXCR2 significantly attenuated AOM/DSS induction of chronic colonic inflammation and tumor burden, suggesting that CXCR2 is required for promoting chronic inflammation and tumor formation and growth in the colon. Among immunocytes we tested, loss of CXCR2 only significantly suppressed a massive infiltration of MDSCs (CD11b+Ly6G+) into the colonic mucosa in both normal (water treatment) and chronic inflammatory (DSS treatment) conditions. We further found that the status of CXCR2 did not affect MDSC populations in the bone marrow of mice treated with either water or DSS. Interestingly, treatment with DSS more dramatically reduced MDSC populations in the circulatory system of WT mice than of CXCR2 knockout mice, suggesting that CXCR2-deficient MDSCs have less ability to migrate to local organs. Our in vitro results further demonstrated that treatment with CXCL1 or CXCL5 were able to induce chemotaxis of WT-mice derived MDSCs but not MDSCs isolated from CXCR2-/- mice. Collectively, these results suggest that CXCR2-expressing MDSCs contribute to chronic inflammation and colitis-associated tumor formation and growth. Our findings are novel and provide a rationale for development of new therapeutic approaches to subvert tumor-induced immunosuppression by using CXCR2 antagonists and neutralized antibodies. Citation Format: Hiroshi Katoh, Dingzhi Wang, Sun-Hee Kim, Raymond N. DuBois. CXCR2 plays critical roles in colitis and colitis-associated cancer through trafficking of myeloid-derived suppressor cells. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1417. doi:10.1158/1538-7445.AM2013-1417
Taste and Smell Losses in Normal Aging and Disease
Authors: Susan S. Schiffman
Journal: JAMA (1997)

To review the scientific literature on the alterations in the senses of taste and smell in the elderly, including causes, diagnosis, prognosis, and treatment.Original reports and reviews obtained through MEDLINE searches from 1966 through June 1997 using the MeSH headings of "taste," "taste buds," "taste disorders," "taste thresholds," "smell," "odors," "aged," and "aging." Articles frequently cited in reference lists were also included.All articles were reviewed, tabulated, and summarized.Criteria for extraction included data quality and validity, statistical treatment of the data, venue of publication, and relevance to clinical care.Losses of taste and smell are common in the elderly and result from normal aging, certain disease states (especially Alzheimer disease), medications, surgical interventions, and environmental exposure. Deficits in these chemical senses cannot only reduce the pleasure and comfort from food, but represent risk factors for nutritional and immune deficiencies as well as adherence to specific dietary regimens. Chemosensory decrements can lead to food poisoning or overexposure to environmentally hazardous chemicals that are otherwise detectable by taste and smell. Use of flavor-enhanced food can increase enjoyment of food and have a positive effect on food intake and immune status.
Precision vs Convenience
Authors: Henry Blackburn
Journal: JAMA (1972)

<h3>To the Editor.—</h3> Your EDITORIAL, "Precision Over Convenience." (222:85, 1972) was instructive and useful. It represents, however, a traditional and perhaps limited viewpoint when it insists on precision where precision is often not possible or even necessary. How important is it to know most intravascular measurements with quantitative precision? Precision in measurements having wide variations for biological reasons may be comparable to the medieval speculations about the number of angels on the head of a pin. Rather, how much more important it is to have, for most purposes, a reliable, repeatable, standard, safe, painless, inexpensive, and convenient method that is a good index of what we wish to know. The eventual validation of noninvasive measurements depends not only on how precisely they reflect the results of invasive measurements, but how well they answer the scientific or clinical questions asked. Often those questions involve simple comparisons, changes over time, predictive power
Abstract 2700: The use of a novel receptor targeted (CD206) Tc99m-labeled intraoperative node mapping agent for preoperative SPECT/CT in imaging head/neck cancer, breast cancer and melanoma Phase 3 trials: Localization and concordance in lymph nodes
Authors: Wendy Rich Metz, Nathan Hall, Stephen Povoski, Amit Agrawal, Jo Shuping, Bonnie Abbruzzese, Simon Blackburn, Beth Potter, Frederick O. Cope
Journal: Cancer Research (2012)

Abstract The intraoperative lymphaticmapping (ILM) concept, based on evidence that colored agents injected into tissues leads to tracing of the agents into lymphatic structures, has carried over from observations dating back to the 1920s. The modern concept of using the pathological status of the lymph nodes to decide whether regional lymphatic clearance should be done was clearly articulated by Cabanas in 1977. Refinement of the concept as it would be reduced to a practical methodology of lymph node identification both in Europe and the United States began in earnest in the 1990s. Development of the application of sentinel node mapping has been built upon the concept of an anatomic/biologic nexus between the solid tumor bed and the immediate versus the distal lymphatic structures. It is the “biological proximity” that defines the probability of found disease in the adnexa, between the tumor bed and the lymphatic structures. It is inferred that the probability of disseminated disease in any lymphatic anatomy is highest when anatomic or biologic nexuses actually exist, as opposed to the lack of any anatomic nexuses where disease dissemination probabilities in lymphatic structures are lowest. To date, agents that have been employed in this procedure bear only simple designs that utilize simple physiologic pulse/draining of the lymphatics and provide no specificity for targeting the lymphatic tissue of interest. We present here patient results of three Phase III studies in head/neck squamous cell carcinoma, breast cancer, and melanoma where a novel 99mTc-labeled receptor targeted agent (99mTc-tilmanocept) not only out performed standard of care agents, but lent itself to remarkable concordance of intraoperative nodal localization with preoperative SPECT/CT imaging. The conclusion of these studies is that 99mTc-tilmanocept provides higher localization rates, degree of localization, lower failed detection rates, and reliable concordance between imaging and intraoperative findings. This work was supported by Neoprobe Corporation, Dublin, OH 43017 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 2700. doi:1538-7445.AM2012-2700
Bureaucracy gone mad
Authors: P. Wenham
Journal: BMJ (1996)

Ron's wife lay dying of terminal breast cancer. Ron married her 54 years ago when he was an engineer in the navy serving in the West Indies, but now as she lay dying they were separated, separated by a wall of pseudoscience and clinical paranoia.

You see, Ron had had methicillin resistant staphylococcus aureus (MRSA). Although his infected wound was covered and his recent swabs were negative, Ron was treated as the leper of the 20th century health service, a hazard to all he met and a headache to the hospital. He could not visit his wife because “she might catch MRSA” but then she would be dead from her cancer within the week. He could not visit …
Response to Letter Regarding Article, “Hormone Therapy and Venous Thromboembolism Among Postmenopausal Women: Impact of the Route of Estrogen Administration and Progestogens: The ESTHER Study”
Authors: Marianne Canonico, Emmanuel Oger, Geneviève Plu-Bureau, Pierre-Yves Scarabin, Jacqueline Conard, Guy Meyer, Hervé Lévesque, Nathalie Trillot, Marie-Thérèse Barrellier, Denis Wahl, Joseph Emmerich
Journal: Circulation (2007)