tbuckley/cabot-search huggingface dataset:
Natural History of Ventricular Septal Defect (VSD) in the Adult.
Authors: Herbert Mark
Journal: Annals of Internal Medicine (1964)

s1 October 1964Natural History of Ventricular Septal Defect (VSD) in the Adult.Herbert Mark, M.D., F.A.C.P., Doris J. W. Escher, M.D., Dennison Young, M.D., F.A.C.P.Herbert Mark, M.D., F.A.C.P.Search for more papers by this author, Doris J. W. Escher, M.D.Search for more papers by this author, Dennison Young, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-61-4-801_4 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo determine the life expectancy of the patient with an unoperated VSD, the fate of the patient with the small defect, and the nature of the complications that arise in the course of the disease, 33 patients, aged 17 to 73, with this congenital cardiac defect have been studied and followed for as long as 10 years. Five had small defects and the others more significant lesions based on clinical, physiologic and autopsy data. Heart failure in nine was related to increasing age, although only five of the entire group were past 40. Pulmonary hypertension in nine patients, six with... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New York, N. Y. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1964Volume 61, Issue 4Page: 801-802KeywordsAutopsyCongenital heart defectsHeart diseasesHeart failureLesionsLife expectancyPulmonary hypertensionVentricular septal defects Issue Published: 1 October 1964 PDF DownloadLoading ...
Volociximab, a Chimeric Monoclonal Antibody that Specifically Binds α5β1 Integrin: A Phase I, Pharmacokinetic, and Biological Correlative Study
Authors: Alejandro D. Ricart, Anthony W. Tolcher, Glenn Liu, Kyle Holen, Garry Schwartz, Mark Albertini, Geoffrey Weiss, Salim Yazji, Chee Ng, George Wilding
Journal: Clinical Cancer Research (2008)

This study aimed to assess the safety and feasibility of administering volociximab, a chimeric monoclonal antibody that specifically binds to alpha(5)beta(1) integrin, and to determine the pharmacokinetics, pharmacodynamics, and preliminary evidence of antitumor activity.Patients with advanced solid malignancies were treated with escalating doses of volociximab i.v. administered over 60 minutes. Blood samples were assayed to determine plasma pharmacokinetic parameters, detect human antichimeric antibody formation, and determine the saturation of alpha5beta1 sites on peripheral blood monocytes.Twenty-one patients received 223 infusions of volociximab at doses ranging from 0.5 to 15 mg/kg i.v. on days 1, 15, 22, 29, and 36; and weekly thereafter. Treatment was well tolerated, and dose-limiting toxicity was not identified over the range examined. Mild (grade 1 or 2), reversible fatigue was the principal toxicity of volociximab at the highest dose levels of 10 and 15 mg/kg. Nausea, fever, anorexia, headache, vomiting, and myalgias were mild and infrequent, and there was no hematologic toxicity. Volociximab had biexponential distribution; clearance was inversely related to increasing dose, and the half-life at 15 mg/kg was estimated as being 30 days. Three patients tested positive for anti-volociximab antibodies. Saturation of monocyte alpha5beta1 integrin sites was dose-dependent up to 15 mg/kg. There was one minor response (renal, 7 months) and one durable stable disease (melanoma, 14 months).Volociximab can be safely administered at 15 mg/kg i.v. per week. The absence of severe toxicities and preliminary activity at the highest dose level warrants further disease-directed studies.
Continuous Intravenous Insulin Infusion in the Management of Brittle Diabetes: Etiologic and Therapeutic Implications
Authors: Gareth Williams, John C Pickup, Harry Keen
Journal: Diabetes Care (1985)

Continuous intravenous insulin infusion (CIVII) was used to treat five brittle insulin-dependent diabetic women (aged 16-29 yr) who had failed to achieve satisfactory glycemic control during intensified subcutaneous insulin treatment including continuous subcutaneous insulin infusion (CSII). Insulin was infused through an indwelling central venous catheter by a portable pump for 3-16 mo. During CIVII, only three subjects obtained satisfactory glycemic control and only for short periods. Generally, as with CSII, control was erratic and unpredictable and three subjects intermittently had high insulin requirements (200 U/day). By contrast, three stable insulin-dependent diabetic subjects achieved near-normoglycemia within 1-3 days of starting CIVII with daily insulin dosages of 30-90 U. The lives of all five brittle subjects continued to be disrupted by frequent hospital admissions during CIVII treatment. Deliberate interference with their own treatment (including tampering with pumps and central venous catheters) was thought to be a major contribution to instability in two of the brittle subjects. In the others, the ineffectiveness of CIVII suggests that brittleness was not due solely to defective subcutaneous insulin absorption, as had previously been suggested in other CSII-unresponsive brittle subjects. Although CIVII has reportedly been successful in managing brittle diabetes, the technique may not be useful in all brittle individuals, as illustrated by the poor glycemic responses of these subjects and the serious complications (including local infection, septicemia, and thrombosis) they suffered.
Gender-Specific Outcomes After Sirolimus-Eluting Stent Implantation
Authors: Emilia Solinas, Eugenia Nikolsky, Alexandra J. Lansky, Ajay J. Kirtane, Marie-Claude Morice, Jeffrey J. Popma, Joachim Schofer, Erick Schampaert, Tereza Pucelikova, Jiro Aoki, Martin Fahy, George D. Dangas, Jeffrey W. Moses, Donald E. Cutlip, Martin B. Leon, Roxana Mehran
Journal: Journal of the American College of Cardiology (2007)
A23: Favorable Response to Belimumab in Childhood‐Onset Systemic Lupus Erythematosus
Authors: Joyce S Hui‐Yuen, Liza Mariel Bermudez‐Santiago, Josephine Isgro, Andrew H. Eichenfield, Amy J. Starr, Lisa F. Imundo, Anca Askanase
Journal: Arthritis & Rheumatology (2014)

Background/Purpose: Belimumab (Benlysta) is a human monoclonal antibody inhibiting soluble B‐lymphocyte stimulator that was approved by the Food and Drug Administration in 2011 for treatment of active, autoantibody‐positive, systemic lupus erythematosus (SLE) in adults. To date, there have been no published data on the use of belimumab in childhood‐onset SLE. Methods: This is a case series of patients with childhood‐onset SLE treated with belimumab at our institution. Data were collected on demographic and disease characteristics, clinical manifestations requiring treatment, concomitant medications, disease course, and treatment outcomes. Descriptive statistics were used when appropriate. Results: We describe 7 patients with childhood‐onset SLE treated with belimumab, 5 of whom are still receiving belimumab infusions at our institution, with a mean follow‐up of 9.3 months on belimumab. The mean age was 18.5 years old, mean disease duration 5.8 years at initiation of belimumab. Eighty‐six percent of the patients were female, 57% African American, 28% Hispanic, and 14% Caucasian. All patients were taking other background medications prior to initiation of belimumab (hydroxychloroquine 7/7, prednisone 7/7, azathioprine 2/7, mycophenolate mofetil 3/7). The most common indications for initiation of therapy were the inability to taper steroids (100%, mean prednisone equivalent dose 0.54mg/kg/day), rash (43%), fatigue (29%), and arthritis (14%), accompanied by worsening serologic activity (increasing anti‐dsDNA titers and hypocomplementemia). At the last follow‐up (mean 9.3 months after initiation of belimumab), average SLEDAI decreased from 6.4 to 4. We were able to taper steroids in 57% of patients, with 3/7 (43%) able to completely discontinue steroids. The average complement levels increased from 71 to 74 (lower limit of normal 83) for C3 and 8 to 10 (lower limit of normal 16) for C4. Six of the seven patients clinically responded to belimumab within three months, with marked improvement in rash, arthritis, and fatigue. Six of seven patients tolerated infusions well, with 1 patient who discontinued treatment due to recurrent vaginal moniliasis. Conclusion: This is the first study investigating the use of belimumab in childhood‐onset SLE across major ethnic groups. Our data demonstrate favorable clinical outcomes including the discontinuation of steroids in 3/7 (43%) of our patients, and improvement in C3 and C4 as early as 3 months after the initiation of belimumab, suggesting a quicker onset of action for belimumab in children than that observed in adult studies, which may support a larger role for belimumab in childhood‐onset SLE.
Association of HLA-DR11 with the anaphylactoid reaction caused by nonsteroidal anti-inflammatory drugs
Authors: Joaquin Quiralte, Florentino Sánchez-García, María-José Torres, Carlos Blanco, Rodolfo Castillo, Nancy Ortega, Felipe Rodríguez de Castro, Paloma Pérez-Aciego, Teresa Carrillo
Journal: Journal of Allergy and Clinical Immunology (1999)
Individual differences in selecting patients for regular haemodialysis.
Authors: T R Taylor, J Aitchison, L S Parker, M F Moore
Journal: BMJ (1975)

Eight clinicians in a renal dialysis unit were asked to classify the suitability of 100 cases (some real, some simulated) for regulat haemodialysis. Seven categories were used, ranging from "excellent prospect: accept without reservation" to "unequivocal rejection," based on 18 items of information previously agreed on as sufficient for the purpose. The ways in which they classified the cases different considerably; only six cases were placed in the same category by all eight clinicians, and this was the "unequivocal rejection" category. Analysis of the extent to which they made effective use of the items showed that between three and nine items were used to a sufficient extent to reach significance for the 100 cases.
Unique region of the minor capsid protein of human parvovirus B19 is exposed on the virion surface.
Authors: S J Rosenfeld, K Yoshimoto, S Kajigaya, S Anderson, N S Young, A Field, P Warrener, G Bansal, M S Collett
Journal: Journal of Clinical Investigation (1992)

Capsids of the B19 parvovirus are composed of major (VP2; 58 kD) and minor (VP1; 83 kD) structural proteins. These proteins are identical except for a unique 226 amino acid region at the amino terminus of VP1. Previous immunization studies with recombinant empty capsids have demonstrated that the presence of VP1 was required to elicit virus-neutralizing antibody activity. However, to date, neutralizing epitopes have been identified only on VP2. Crystallographic studies of a related parvovirus (canine parvovirus) suggested the unique amino-terminal portion of VP1 assumed an internal position within the viral capsid. To determine the position of VP1 in both empty capsids and virions, we expressed a fusion protein containing the unique region of VP1. Antisera raised to this protein recognized recombinant empty capsids containing VP1 and VP2, but not those containing VP2 alone, in an enzyme-linked immunosorbent assay. The antisera immunoprecipitated both recombinant empty capsids and human plasma-derived virions, and agglutinated the latter as shown by immune electron microscopy. The sera contained potent neutralizing activity for virus infectivity in vitro. These data indicate that a portion of the amino terminus of VP1 is located on the virion surface, and that this region contains intrinsic neutralizing determinants. The external location of the VP1-specific tail may provide a site for engineered heterologous epitope presentation in novel recombinant vaccines.
Immunosuppression in Aplastic Anemia — Postponing the Inevitable?
Authors: Malcolm A.S. Moore, Hugo Castro-Malaspina
Journal: New England Journal of Medicine (1991)

Mathé et al. reported in 1970 that when some patients with aplastic anemia received an allogeneic marrow transplant together with a conditioning immunosuppressive regimen of antilymphocyte globulin, they recovered autologous hematopoietic function.1 Subsequent trials of antilymphocyte globulin or antithymocyte globulin, alone or with steroids, resulted in hematologic improvement in 40 to 80 percent of patients with severe aplastic anemia. This effect was matched by improvement in one-year survival, from less than 25 percent with androgens alone to 40 to 75 percent with antilymphocyte globulin2 3 4 5 6 — a rate comparable to the 60 to 80 percent survival with transplantation of bone marrow . . .
Decision-Analytic Model and Cost-Effectiveness Evaluation of Postmastectomy Radiation Therapy in High-Risk Premenopausal Breast Cancer Patients
Authors: Jason H. Lee, Henry A. Glick, James A. Hayman, Lawrence J. Solin
Journal: Journal of Clinical Oncology (2002)

To present a decision model that describes the clinical and economic outcomes of node-positive breast cancer with and without postmastectomy radiation therapy (PMRT).A Markov process was constructed to project the natural history of breast cancer following mastectomy in premenopausal node-positive women. Biannual hazards of local and distant recurrence without PMRT were derived from a large meta-analysis of adjuvant systemic therapy trials for breast cancer. The addition of PMRT reduced the risk of disease relapse by an odds ratio of 0.69. Costs of PMRT ($11,600) and recurrent breast cancer ($4,250 to 16,200/year) were estimated from available literature. The model projected number of recurrences, relapse-free and overall survival, and costs to 15 years, using a discount rate of 3%. Cost-effectiveness ratios were calculated per incremental year of life and quality-adjusted year of life gained. One- and two-way sensitivity analyses were performed to determine the sensitivity of results to clinical and economic assumptions.The model projected 15-year relapse-free survival of 52% and 43% with and without PMRT, respectively. Overall survival was increased from 48% to 55% with PMRT, resulting in an incremental 0.29 years of life gained per subject. PMRT increased 15-year costs from $40,800 to $48,100. Cost per year of life gained was $24,900, or $22,600 when survival was adjusted for quality of life. Results of the model were relatively sensitive to radiation therapy cost and breast cancer relapse risk.This analysis suggests that PMRT offers substantial clinical benefits achieved in a cost-effective manner, with an average cost per year of life gained of $24,900. Results of the model were robust under a wide range of clinical and economic parameters.
Hyper-Reactivity to Atropine in Down's Syndrome
Authors: Willard S. Harris, Richard M. Goodman
Journal: New England Journal of Medicine (1968)

Patients with Down's syndrome respond with abnormally great mydriasis to conjunctivally instilled atropine. This finding has been attributed to a structural anomaly of the Iris. To define the systemic reactivity to atropine in mongolism, the effects of intravenous atropine on heart rate were determined in three age-matched groups: 12 patients with Down's syndrome; 10 retardates without the syndrome; and 10 normal subjects. The patients with Down's syndrome, although reacting normally to atropine's bradycrotic or vagotonic action, had a markedly increased (twice normal or greater) sensitivity to the cardioacceleratory effects of atropine. This increased sensitivity, a pharmacogenetic abnormality, may result from the genetic imbalance imposed by an extra chromosome 21 in Down's syndrome.
Characterization of the in vivo and in vitro Effects of Indomethacin on Human Natural Killer Cell Activity
Authors: B. K. Pedersen, P. Oxholm, K. Klarlund
Journal: Allergy (1986)

The in vivo and in vitro effects of indomethacin on the natural killer (NK) cell activity against K 562 target cells were studied In vivo administration of indomethacin, 3 × 50 mg for 7 days to normal donors did not influence baseline NK cell activity, which means that treatment with prostaglandin (PG) inhibitors can be allowed in studies on NK cell activity of persons with normal PG production. The NK cell activity of fresh mono‐nuclear cells was boosted with pharmacological concentrations of indomethacin in vitro , while frozen cells were not. Our results indicate that indomethacin enhances the NK cell activity in vitro by blocking the prostaglandin production of monocytes, since monocyte depleted effector cells were not boosted by indomethacin.
Tipping the Balance Towards Primary Health Care
Authors: C. Silagy
Journal: BMJ (1995)

Ed Tom Rathwell, Joana Godinho, Marjorie Gott Avebury, pounds sterling35, pp 235 ISBN 1 85628 941 9

Health care in the 1970s and early 1980s was characterised by the growth of high tech hospital medicine. However, the current decade has seen the pendulum swing back towards a renewed emphasis on a strong primary health care sector. The WHO resolution “Health for All by the Year 2000” in 1977 was followed closely by the now famous Alma Ata declaration, which sought to foster a broad based primary health care approach encompassing concepts of multidisciplinary teamwork with strong community participation.

With this …
TCT-57 Angiographic Reperfusion Indices Predict Infarct Size and Mortality: The INFUSE-AMI Trial
Authors: Sorin Brener, Akiko Maehara, Joe Dizon, Martin Fahy, Bernhard Witzenbichler, Helen Parise, Magdi El-Omar, Jan-Henk Dambrink, Roxana Mehran, Keith Oldroyd, C. Michael Gibson, Gregg Stone
Journal: Journal of the American College of Cardiology (2012)
Unlicensed nicotine skin patches.
Authors: M J Jarvis, M A Russell, C Feyerabend
Journal: BMJ (1993)

Unlicensed nicotine skin patches EDITOR,-Nicotine skin patches were launched in Britain in June 1992.Three licensed patches (Nicabate, Nicorette, Nicotinell) are now available over the counter from pharmacies.There is convincing evidence from clinical trials that these patches are an effective aid to stopping smoking.'In the past two months there has been a rash of newspaper advertisements for unlicensed patches available by mail order.We are aware of brands going under the names Nicostop, Nicorene, Nicotine Patch, Nicocheck, and Nicoban.The advertisements for two brands, for example, make extravagant claims: "Guaranteed to stop you smoking" (Nicostop); "With Nicoban's help you stop smoking painlessly, simply, permanently....You wear it on your arm, and it releases a measured dosage of nicotine extract throughout the day which really does take away the desire to smoke.So simple, so easy.And above all ... so effective."Common to these patches is the claim that they deliver either nicotine or "nicotine extract" and the promise of great savings over patch products "sold by our competitors."But none of these mail order products has undergone regulatory scrutiny.We
<i>Interleukin-17 Receptor-Like</i> Gene Is a Novel Antiapoptotic Gene Highly Expressed in Androgen-Independent Prostate Cancer
Authors: Zongbing You, Xu-Bao Shi, Grayson DuRaine, Dominik Haudenschild, Clifford G. Tepper, Su Hao Lo, Regina Gandour-Edwards, Ralph W. de Vere White, A. Hari Reddi
Journal: Cancer Research (2006)

Abstract We have recently identified a new gene, interleukin-17 receptor-like (IL-17RL), which is expressed in normal prostate and prostate cancer. This investigation is focused on the role of IL-17RL in prostate cancer. We found that IL-17RL was expressed at significantly higher levels in several androgen-independent prostate cancer cell lines (PC3, DU145, cds1, cds2, and cds3) and tumors compared with the androgen-dependent cell lines (LNCaP and MLC-SV40) and tumors. In an in vivo model of human prostate tumor growth in nude mice (CWR22 xenograft model), IL-17RL expression in tumors was induced by androgen deprivation. The relapsed androgen-independent tumors expressed higher levels of IL-17RL compared with the androgen-dependent tumors. Overexpression of IL-17RL in tumor necrosis factor α (TNFα)–sensitive LNCaP cells inhibited TNFα-induced apoptosis by blocking activation of caspase-3 downstream to caspase-2 and caspase-8. Reciprocally, knocking down IL-17RL expression by small interfering RNA induced apoptosis in all the prostate cancer cell lines studied. Taken together, these results show that IL-17RL is a novel antiapoptotic gene, which may confer partially the property of androgen-independent growth of prostate cancer by promoting cell survival. Thus, IL-17RL is a potential therapeutic target in the treatment of prostate cancer. (Cancer Res 2006; 66(1): 175-83)
Chronic myelogenous leukemia with e13a3 (b2a3) type of BCR-ABL transcript having a DNA breakpoint betweenABL exons a2 and a3
Authors: Li‐Gen Liu, Hideo Tanaka, Kinro Ito, Taiichi Kyo, Takuo Ito, Akiro Kimura
Journal: American Journal of Hematology (2003)

Abstract We describe a patient with chronic myelogenous leukemia (CML), in whom the DNA breakpoint in the BCR‐ABL fusion gene was determined to result in a rare e13a3 (b2a3) transcript. The breakpoint in BCR was intron 13, which was 30 bp downstream from exon 13, and the breakpoint in ABL was intron 2, and was 46 bp downstream from exon a2. This case conforms to the mechanism of DNA breakage occurring within ABL intron 2, but not at 5′ to ABL exon a2. With our review of this case and the literature, it seems that CML with the BCR ‐a3 fusion product is associated with a low proportion of circulating immature cells, mild or lack of splenomegaly, slow progressiveness, rather resistance to IFN‐α, and good response to imatinib mesylate. This is the first report of BCR ‐a3‐type CML in which the exact DNA breakpoint was identified and located between exons a2 and a3 of the ABL gene. Am. J. Hematol. 74:268–272, 2003. © 2003 Wiley‐Liss, Inc.
Points: Climacteric flushing in a man
Authors: J. Ginsburg, B. O'Reilly
Journal: BMJ (1983)

write: Dr Lightman (6 August, p 422) has missed the point.We were not reviewing the variety of lesions that might provoke hot flushes.The object of our case presentation (23 July, p 262) was the objective demonstration that climacteric flushing in a man was associated with circulatory responses virtually identical to those we had shown during the meno- pausal hot flush.'Every blush is not a flush, however, and until the phenomena reported in different circumstances in either sex are recorded by tech- niques capable of following the rapid circulatory changes that occur during the hot flush our under- standing of the mechanisms responsible for the menopausal hot flush will remain obscure.
Long-Term Results After Directional Atherectomy of Femoro-Popliteal Lesions
Authors: Thomas Zeller, Aljoscha Rastan, Sebastian Sixt, Uwe Schwarzwälder, Thomas Schwarz, Ulrich Frank, Karlheinz Bürgelin, Christian Müller, Uwe Rothenpieler, Peter-Christian Flügel, Gunnar Tepe, Franz-Josef Neumann
Journal: Journal of the American College of Cardiology (2006)