tbuckley/cabot-search huggingface dataset:
Use of imatinib in a patient with cutaneous vasculopathy in the context of von Recklinghausen disease/neurofibromatosis
Authors: I. Khelifa, J.H. Saurat, C. Prins
Journal: British Journal of Dermatology (2014)

von Recklinghausen disease/neurofibromatosis (NF) is caused by an autosomal dominant mutation in NF1, resulting in a deficiency of neurofibromin 1, a protein with a tumour suppressor function in the Ras-extracellular regulated kinase pathway. The disease comprises a variety of clinical manifestations, including vascular abnormalities. Large vessel abnormalities are well known, while small vessels of the skin are very rarely involved. The latter can cause livedo, necrosis and painful ulcers. For such ulcers, all invasive therapies (e.g. surgery and radiotherapy) are harmful and should be avoided. Herein, we describe a patient with NF and cutaneous vasculopathy treated with imatinib, a tyrosine kinase inhibitor.
THE TREATMENT OF ANEURISM BY DIRECT, GRADUAL ARTERIAL CLOSURE.REPORT ON THE APPLICATION OF THE METHOD TO A CASE OF ANEURISM OF THE ABDOMINAL AORTA.
Authors: ROBERT T. STRATTON
Journal: JAMA (1906)

<h3>RATIONALE OF TREATMENT.</h3> The main basis for the suggestion of gradual arterial closure as a probable means of relief for certain cases of aneurism lies in three facts observed in human pathology and surgical experience: Gradual closure of a large blood vessel as from the pressure of a growing tumor, so far as such pressure is concerned, is not associated with depression of vital functions nor with nutritional or other disturbances within the area of its distribution. The anastomotic current is so gradually and perfectly established that the entire absence of symptoms due to circulatory disturbances may fail even to suggest the occlusion of a large blood vessel. In the larger proportion of those exceptional cases of aneurism in which a spontaneous cure occurs this results from the deposition of the laminated coagulum or so-called active clot, on the walls of the sac, and is caused by the slowing and
Serial Estimation of Urinary Fibrin/Fibrinogen Degradation Products in Kidney Transplantation
Authors: C. L. Hall, N. Pejhan, R. W. Thomson, P. Dawson-Edwards, A. D. Barnes, B. H. B. Robinson, M. J. Meynell, J. D. Blainey
Journal: BMJ (1973)

The urinary excretion of fibrin/fibrinogen degradation products (F.D.P.) of 81 human cadaver kidney transplants has been measured serially by the techniques of tanned red cell haemagglutination inhibition immunoassay and immunonephelometry. Acute rejection episodes in functioning transplants have been associated with increased F.D.P. excretion which in 80% of cases has preceded clinical diagnosis by periods of one to seven days. Recovery from these episodes has been associated with a rapid fall of F.D.P. excretion to undetectable levels. The level of F.D.P. excretion during a rejection episode is a guide to its ultimate outcome. Irreversibly rejected kidneys excrete high levels of F.D.P. for long periods. Viable kidney transplants with prolonged oliguric phases can be distinguished, while still oliguric, from rejected kidneys by their low F.D.P. excretion. F.D.P. cannot usually be detected in the urine of well-functioning transplants. Episodes of raised F.D.P. excretion in the absence of acute clinical rejection, however, occur occasionally and may be associated with permanent impairment of renal function.
Myocardial collagen metabolism in failing hearts before and during cardiac resynchronization therapy
Authors: Soban Umar, Jeroen J. Bax, Margreet Klok, Rutger J. van Bommel, Marleen H.M. Hessel, Brigit den Adel, Gabe B. Bleeker, Maureen M. Henneman, Douwe E. Atsma, Ernst E. van der Wall, Martin J. Schalij, Arnoud van der Laarse
Journal: European Journal of Heart Failure (2008)
Death by Diagnosis
Authors: Michael P. Jones
Journal: Annals of Internal Medicine (2001)

Letters21 August 2001Death by DiagnosisMichael P. Jones, MDMichael P. Jones, MDNorthwestern University Medical School, Chicago, IL 60611 (Jones)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-4-200108210-00031 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I recently reviewed a malpractice claim involving a woman who died of mesenteric ischemia. She presented with pain, vomiting, and diarrhea. She had low-grade fever, but her abdomen was fairly unremarkable on examination. She was admitted, observed, and discharged several days later with a diagnosis of “chronic abdominal pain.” She returned after 2 days with similar but worsening symptoms. The emergency department physician noted her recent admission for chronic abdominal pain and, observing no deterioration since discharge, advised follow-up with her physician. She went to another hospital, where surgical exploration revealed intestinal necrosis. She died soon thereafter.... Author, Article, and Disclosure InformationAuthors: Michael P. Jones, MDAffiliations: Northwestern University Medical School, Chicago, IL 60611 (Jones) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAbdominal Pain 21 August 2001Volume 135, Issue 4Page: 307KeywordsAbdominal painEmergency departmentHealth economicsIschemiaMouthNecrosisPatientsPerceptionQuality of lifeVomiting ePublished: 21 August 2001 Issue Published: 21 August 2001 Copyright & PermissionsCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Vascular Superoxide Production and Vasomotor Function in Hypertension Induced by Deoxycorticosterone Acetate–Salt
Authors: Mark J. Somers, Kreton Mavromatis, Zorina S. Galis, David G. Harrison
Journal: Circulation (2000)

Background —Angiotensin II–induced hypertension is associated with increased vascular superoxide production, which contributes to hypertension caused by the octapeptide. In cell culture, stretch increases endothelial and vascular smooth muscle production of reactive oxygen species (ROS). In perfused isolated vessels, elevations of pressure can increase vessel angiotensin II production. The effects of low-renin hypertension on vascular ROS production remain unclear. Furthermore, the role of ROS in vascular function and hypertension in low-renin hypertension is undefined. Methods and Results —Rats were treated with DOCA and saline drinking water for 3 weeks. Both systolic blood pressure (189±4 versus 126±2 mm Hg) and aortic superoxide production (3972±257 versus 852±287, P &lt;0.05) were increased compared with controls. Relaxations of vascular segments to acetylcholine (ACh, 100±2% versus 75±2%, P &lt;0.05) and the calcium ionophore A23187 (92±2% versus 72±3%, P &lt;0.05) were also impaired in DOCA-salt. Heparin-binding superoxide dismutase (1200 U/d IV for 3 days) had no effect on blood pressure but significantly improved relaxations to ACh and A23187. Losartan (25 mg · kg −1 · d −1 PO) for 7 days did not correct the hypertension or endothelium-dependent vessel relaxation in DOCA-salt rats, excluding a role of a local renin/angiotensin II system. Conclusions —These findings indicate that increased vascular superoxide production occurs not only in angiotensin II–induced hypertension but also in hypertension known to be associated with low-renin states. Increased superoxide production alters large-vessel endothelium-dependent vascular relaxation but does not modulate blood pressure in low-renin hypertension.
Liver Transplantation in Man--III, Studies of Liver Function, Histology, and Immunosuppressive Therapy
Authors: R. Williams, R. Y. Calne, I. D. Ansell, B. S. Ashby, P. A. Cullum, J. L. Dawson, A. L. W. F. Eddleston, D. B. Evans, P. T. Flute, P. M. Herbertson, V. Joysey, A. M. C. McGregor, P. R. Millard, I. M. Murray-Lyon, J. R. Pena, M. O. Rake, R. A. Sells
Journal: BMJ (1969)

The experience gained from 13 hepatic transplant operations is described, with particular reference to the findings in nine patients who survived the immediate operative period. A major problem was found to be infection. Fulminant pneumonia caused death in two adults, at a time when liver function was virtually normal. Infection related to bile fistula and sepsis may be overcome by an improved method of biliary drainage by cholecyst-dochostomy, which was carried out in the last two patients. Jaundice in the second week due to rejection was observed in several patients. The striking histological change was centrilobular cholestasis. The jaundice, which was not prevented by administration of antilymphocyte globulin, was rapidly controlled by temporarily increasing die dose of prednisone. One patient who survived for four and a half months and who had a poor tissue match subsequently developed chronic rejection with progressive cholestatic jaundice. Five of the patients were able to go home and at time of publication two are alive and well 14 and 20 weeks after treatment.
Epinephrine for Anaphylactic Shock-Reply
Authors: Richard M. Nowak
Journal: JAMA (1985)

<h3>In Reply.—</h3> Drs Bennett and Hirshman feel that our article concerning epinephrine usage in anaphylactic shock gives the erroneous impression that epinephrine is the sole therapeutic modality for use in this clinical situation. However, we clearly stated that "other modalities are<i>crucial</i>to a successful therapeutic outcome. Air-way patency, supplemental oxygen, establishment of an IV access for fluids and drugs, cardiac monitoring, and ancillary medications are all important but beyond the scope of this article." Furthermore, they suggest that our discussion should have included, in detail, a complete regimen for the treatment of anaphylactic shock. From a standpoint of space, this was an impossibility, and we desired to narrow our focus such that "the intent of this article was to describe safe guidelines for the use of epinephrine in systemic anaphylactic shock."<sup>1</sup> It is interesting that Drs Bennett and Hirshman state that in our case report "133 μg/min is
At either end of the tube
Authors: B. M. Schyma, R. Kerr, S. Alam
Journal: BMJ (2012)

<h3>Background and Objectives:</h3> Compensation strategies are essential in Parkinson’s disease (PD) gait rehabilitation. However, besides external cueing, these strategies have rarely been investigated systematically. We aimed to: (1) establish the patients’ perspective on the efficacy and usability of five different compensation strategies; (2) quantify the efficacy of these strategies on spatiotemporal gait parameters; and (3) explore associations between the effects of specific strategies and patient characteristics. <h3>Methods:</h3> We recruited persons with PD and self-reported disabling gait impairments for this lab-based, within-subject study. Clinimetrics included: questionnaires (NFOG-Q, VMIQ-2, GMSI), cognitive assessments (ANT, MoCA, Brixton), and physical examinations (MDS-UPDRS III, Mini-BEST, tandem gait, rapid turns test). Gait assessment consisted of six 3-minute trials of continuous walking around a 6-meter walkway. Trials comprised: 1) baseline gait; 2) external cueing; 3) internal cueing; 4) action observation; 5) motor imagery; and 6) adopting a new walking pattern. Spatiotemporal gait parameters were acquired using 3D motion capture analysis. Strategy efficacy was determined by the change in gait variability compared to baseline gait. Associated patient characteristics were explored using regression analyses. <h3>Results:</h3> 101 participants (50 men; median[range] age: 66[47-91] years) were included. The effects of the different strategies varied greatly among participants. While participants with higher baseline variability showed larger improvements using compensation strategies, participants without freezing of gait, with lower MDS-UPDRS III scores, higher balance capacity and better performance in orienting attention, also showed greater improvements in gait variability. Higher MoCA scores were associated with greater efficacy of external cueing. <h3>Discussion:</h3> Our findings support the use of compensation strategies in gait rehabilitation for PD, but highlight the importance of a personalized approach. Even patients with high gait variability are able to improve through the application of compensation strategies, but certain levels of cognitive and functional reserve seem necessary to optimally benefit from them. <h3>Classification of Evidence:</h3> This study provides Class III evidence that gait compensation strategies can be effective in persons with PD.
TCT-607 Atherosclerotic Swine Model Reveals Favorable Impact of Abluminal Bioresorbable Polymer on the Time Course of Para-Strut Inflammation in Comparison to BMS and Durable Polymer DES
Authors: Masahiko Shibuya, Michael J. Eppihimer, Jenn McGregor, Gregory J. Wilson, Carlos A. Gongora, Barbara A. Huibregtse, Juan Granada, Greg L. Kaluza
Journal: Journal of the American College of Cardiology (2014)
Breast cancer surgeon is struck off because of risk to patients
Authors: C. Dyer
Journal: BMJ (2011)

A 64 year old former consultant breast surgeon who botched a string of operations and whose performance assessment showed that she posed “a great risk to patients” has been struck off by the General Medical Council.

Puvaneswary Markandoo’s performance was so poor that it did not reach the level of a newly qualified doctor, a GMC fitness to practise panel heard.

After various clinical posts at registrar and consultant level, she was appointed as a consultant oncoplastic breast surgeon at Barnsley Hospital NHS Foundation Trust in Yorkshire in February 2005. But she …
The effect of atrial natriuretic peptide on pulmonary acid injury in a pig model.
Authors: M Tanabe, M Ueda, M Endo, M Kitajima
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

The effect of exogenous atrial natriuretic peptide (ANP) on pulmonary injury induced by aspiration of hydrochloric acid (0.1 N HCl, 2.0 ml/kg) was examined in anesthetized pigs ventilated with 100% oxygen. Group-specific diuretic treatment was used 60 min after aspiration and followed for a further 120 min. No diuretics were used for Group 1, 0.1 microg/kg/min of ANP was infused intravenously for 60 min in Group 2, and 0.05 mg/kg of furosemide was injected (intravenous bolus) in Group 3. Total urine volume after diuretic treatment did not differ significantly between Groups 2 and 3. However, the increase in PaO2 (to 386.3 +/- 67.5 mm Hg) after infusion of ANP was significantly higher than the increase in PaO2 (to 275.9 +/- 63.3 mm Hg) after furosemide treatment, and in the no treatment control (to 171.1 +/- 31.5 mm Hg). Pulmonary hypertension induced by acid aspiration was significantly reduced (p < 0.01 versus Groups 1 and 3) during ANP infusion. ANP has a beneficial effect on acute lung injury, possibly through its diuretic and/or pulmonary vasodilating action.
Goserelin reduces ovarian failure associated with breast cancer chemotherapy, study shows
Authors: S. Mayor
Journal: BMJ (2015)

Treating women with the gonadotrophin releasing hormone agonist goserelin during chemotherapy for breast cancer significantly reduced the subsequent risk of ovarian failure and improved fertility, an international randomised trial reported in the New England Journal of Medicine has shown.1

The Prevention of Early Menopause Study (POEMS) randomised 257 premenopausal women with operable hormone receptor negative breast cancer to standard chemotherapy either alone …
RANTES and macrophage inflammatory protein 1 alpha induce the migration and activation of normal human eosinophil granulocytes.
Authors: A Rot, M Krieger, T Brunner, S C Bischoff, T J Schall, C A Dahinden
Journal: The Journal of Experimental Medicine (1992)

The cellular infiltrates of certain inflammatory processes found in parasitic infection or in allergic diseases consist predominantly of eosinophilic granulocytes, often in association with activated T cells. This suggests the existence of chemotactic agonists specific for eosinophils and lymphocyte subsets devoid of neutrophil-activating properties. We therefore examined four members of the intercrine/chemokine superfamily of cytokines (monocyte chemotactic peptide 1 [MCP-1], RANTES, macrophage inflammatory protein 1 alpha [MIP-1 alpha], and MIP-1 beta), which do not activate neutrophils, for their ability to affect different eosinophil effector functions. RANTES strongly attracted normal human eosinophils by a chemotactic rather than a chemokinetic mechanism with a similar efficacy as the most potent chemotactic myeloid cell agonist, C5a. MIP-1 alpha also induced eosinophil migration, however, with lower efficacy. RANTES and MIP-1 alpha induced eosinophil cationic protein release in cytochalasin B-treated eosinophils, but did not promote leukotriene C4 formation by eosinophils, even after preincubation with interleukin 3 (IL-3), in contrast to other chemotactic agonists such as C5a and formyl-methionyl-leucyl-phenylalanine (FMLP). RANTES, but not MIP-1 alpha, induced a biphasic chemiluminescence response, however, of lower magnitude than C5a. RANTES and MIP-1 alpha both promoted identical transient changes in intracellular free calcium concentration ([Ca2+]i), with kinetics similar to those induced by chemotactic peptides known to interact with G protein-coupled receptors. No cross-desensitization towards other peptide agonists (e.g., C5a, IL-8, FMLP) was observed, suggesting the presence of specific receptors. Despite its weaker eosinophil-activating properties, MIP-1 alpha was at least 10 times more potent on a molar basis than RANTES at inducing [Ca2+]i changes. Interestingly, RANTES deactivated the MIP-1 alpha-induced [Ca2+]i changes, while the RANTES response was preserved after MIP-1 alpha stimulation. MCP-1, a potent monocyte chemoattractant and basophil agonist, as well as MIP-1 beta, a peptide with pronounced homology to MIP-1 alpha, did not activate the eosinophil functions tested. Our results indicate that RANTES and MIP-1 alpha are crucial mediators of inflammatory processes in which eosinophils predominate.
Application of Computers in Clinical Practice
Authors: William A. Spencer
Journal: JAMA (1965)

Less than six years ago a group of physicians and J scientists gathered at the Rockefeller Institute in New York to discuss the role of computers in medicine.<sup>1</sup>The physician who attended that conference could easily fire his imagination and envision an era when widespread use of computers would permit precise automatic diagnoses, rapid solutions to complex physiological problems, accurate automatic analysis of laboratory and functional tests, and easy retrieval of clinical and research data. Subsequent to that original meeting, the scientific and lay literature have been flooded with articles, mostly speculative, describing potential applications of computers in various fields of medical practice. As a result, a climate of expectation has developed, the general feeling being that practicality in these usages is just around the corner. An appraisal of the tangible effects of the application of computers in medicine to date reveals that some of the early expectations have
What Is a Diagnosis?
Authors: Lester S. King
Journal: JAMA (1967)

The medical student spends much of his curriculum learning how to make a diagnosis. The practicing physician devotes a major part of his efforts to actually making them. Newer techniques try to automate the process. Writers of medical texts and periodical literature employ the term profusely. But with rare exceptions, no one discusses what diagnosis reallyisordoes.  Diagnosis as Process  In the popular mind the term diagnosis brings up the image of a white-coated physician who at one time dangled a stethoscope but who now is more likely to utilize complex sophisticated apparatus and to study laboratory reports. Yet, although diagnosis ordinarily has medical connotations, this is not essential, for the term involves activities by no means unique to medicine. Although we may think of diagnosis as the identification of disease, such usage is far too narrow. The word meansto distinguish. It involves the process of deliberate
Developmental changes in modulation of calcium currents of rabbit ventricular cells by phosphodiesterase inhibitors.
Authors: T Akita, R W Joyner, C Lu, R Kumar, H C Hartzell
Journal: Circulation (1994)

We have previously shown major differences in beta-adrenergic and muscarinic modulation of L-type calcium currents (ICa) in newborn and adult rabbit heart. However, little is known about developmental changes in modulation of ICa by phosphodiesterases (PDEs), which also regulate intracellular cAMP concentration by its hydrolysis.Enzymatically isolated adult and newborn (1- to 3-day-old) rabbit ventricular myocytes were used to study the effects of PDE inhibitors on ICa measured by the whole-cell patch-clamp method. 3-Isobutyl-1-methyl-xanthine (IBMX), a nonselective PDE inhibitor, increased ICa in a dose-dependent manner for both groups. The maximal effect of IBMX, expressed as percentage increase in ICa over control levels, was greater for newborn myocytes than for adult myocytes, but the effects of IBMX applied alone were observed only at concentrations > 10 mumol/L. The concomitant use of 0.1 mumol/L isoproterenol produced a significant potentiation of the IBMX effect on ICa, with a significant additive effect of IBMX in newborn myocytes even at 0.05 mumol/L IBMX. The concomitant use of a subthreshold concentration of IBMX (0.1 mumol/L) did not potentiate the dose dependence of adult ICa on isoproterenol but did markedly potentiate the dose dependence of newborn ICa on isoproterenol. The Emax and EC50 of isoproterenol in the presence of 0.1 mumol/L IBMX on newborn ICa were 235% and 8 nmol/L, respectively, whereas the Emax and EC50 of isoproterenol in the absence of IBMX on newborn ICa were 111% and 81 nmol/L, respectively. The addition of 50 mumol/L IBMX to 10 mumol/L isoproterenol markedly increased the newborn ICa density up to a level equivalent to that reached with 200 mumol/L cAMP in the pipette (14.9 +/- 1.2 versus 13.4 +/- 0.7 pA/pF). Our data suggest that the inhibition constant (Ki) of IBMX for inhibiting PDEs that participate in the regulation of ICa is much lower in newborn than in adult myocytes. Milrinone 1 mumol/L, a selective PDE III inhibitor, increased the 0.1 mumol/L isoproterenol-stimulated ICa of adult myocytes but had no significant additive effect for the 0.1 mumol/L isoproterenol-stimulated ICa of newborn myocytes. Rolipram 1 mumol/L, a selective PDE IV inhibitor, increased the 0.1 mumol/L isoproterenol-stimulated ICa for newborn myocytes but had no significant additive effect for the 0.1 mumol/L isoproterenol-stimulated ICa for adult myocytes.These results suggest that the most important PDE isozyme for regulation of ICa of rabbit myocytes changes from PDE IV to PDE III during the postnatal period.
Circulating monocyte-platelet aggregates are an early marker of acute myocardial infarction
Authors: Mark I Furman, Marc R Barnard, Lori A Krueger, Marsha L Fox, Elizabeth A Shilale, Darleen M Lessard, Peter Marchese, A.L Frelinger, Robert J Goldberg, Alan D Michelson
Journal: Journal of the American College of Cardiology (2001)
Harvard's Holden Chapel
Authors: Herbert A. Shaw
Journal: JAMA (1967)

To  Editor:—  The cover photograph of your Nov 21 issue shows  main building of  Fairfield Medical Institution, and  caption reads, the building is probably  oldest extant medical school structure in this country.  Actually, we believe that  oldest-building kudos, if so they may be defined, belong to Holden Chapel in Harvard Yard (Figure). This small structure, built in 1744, served as  home of  Harvard Medical School from 1783 to 1810. First classes of  school were held in  basement of Harvard Hall but soon moved to  chapel (which adjoins  hall) when space demands dictated. Holden Chapel is now  home of  Harvard Glee Club's activities.  As a corollary to your article, Dr. Lyman Spalding was  first president of  College of Physicians and Surgeons of  Western District, also in Fairfield, NY. Evidently Fairfield was a popular spot