tbuckley/cabot-search huggingface dataset:
Late Results of Percutaneous Mitral Commissurotomy in a Series of 1024 Patients
Authors: Bernard Iung, Eric Garbarz, Pierre Michaud, Steeven Helou, Bruno Farah, Patricia Berdah, Pierre-Louis Michel, Bertrand Cormier, Alec Vahanian
Journal: Circulation (1999)

The optimal use of percutaneous mitral commissurotomy (PMC) in a wide range of patients requires accurate evaluation of late results and identification of their predictors.Late results of PMC were assessed in 1024 patients whose mean age was 49+/-14 years. Echocardiography showed that 141 patients (14%) had pliable valves and mild subvalvular disease, 569 (55%) had extensive subvalvular disease, and 314 (31%) had calcified valves. A single balloon was used in 26 patients, a double balloon in 390, and the Inoue Balloon in 608. Good immediate results were defined as valve area >/=1.5 cm2 without regurgitation >2/4 (Sellers' grade) and were obtained in 912 patients. Median duration of follow-up was 49 months. The 10-year actuarial rate of good functional results (survival with no cardiovascular death and no need for surgery or repeat dilatation and in New York Heart Association [NYHA] class I or II) was 56+/-4% in the entire population. Follow-up echocardiography was available in 90% of the patients who experienced poor functional results after good immediate results and showed restenosis in 97% of these. In multivariate analysis, the predictors of poor functional results were old age (P=0.0008), unfavorable valve anatomy (P=0.003), high NYHA class (P<0.0001), atrial fibrillation (P<0.0001), low valve area after PMC (P=0.001), high gradient after PMC (P<0.0001), and grade 2 mitral regurgitation after PMC (P=0.04).PMC can be performed with good late results in a variety of patient subsets. Prediction of late events is multifactorial. Knowledge of these predictors can improve patient selection and follow-up.
Prospectively randomised trial of proximal gastric vagotomy either with or without pyloroplasty in treatment of uncomplicated duodenal ulcer.
Authors: C Wastell, J Colin, T Wilson, E Walker, J Gleeson, R Zeegen
Journal: BMJ (1977)

A consecutive series of 100 men with uncomplicated duodenal ulcer was randomly divided into two groups: one group of 52 underwent proximal gastric vagotomy (PGV), the other group (48) underwent PGV with pyloroplasty (PGVP). Preoperative peak acid output (PAOP) was measured in all patients. Those with a higher preoperative PAOP were significantly more likely to develop recurrent ulceration. Three patients developed recurrent ulceration after PGV and seven after PGVP. Dumping was both more common and more severe after PGVP than PGV. An overall satisfactory result was achieved in 92% after PGV and 81% after PGVP. We conclude that combining pyloroplasty with PGV has no appreciable advantages.
Exaggerated Endothelin Release in High-Altitude Pulmonary Edema
Authors: Claudio Sartori, Laurent Vollenweider, Bernd-Michael Löffler, Alain Delabays, Pascal Nicod, Peter Bärtsch, Urs Scherrer
Journal: Circulation (1999)

Background —Exaggerated pulmonary hypertension is thought to play an important part in the pathogenesis of high-altitude pulmonary edema (HAPE). Endothelin-1 is a potent pulmonary vasoconstrictor peptide that also augments microvascular permeability. Methods and Results —We measured endothelin-1 plasma levels and pulmonary artery pressure in 16 mountaineers prone to HAPE and in 16 mountaineers resistant to this condition at low (580 m) and high (4559 m) altitudes. At high altitude, in mountaineers prone to HAPE, mean (±SE) endothelin-1 plasma levels were ≈33% higher than in HAPE-resistant mountaineers (22.2±1.1 versus 16.8±1.1 pg/mL, P &lt;0.01). There was a direct relationship between the changes from low to high altitude in endothelin-1 plasma levels and systolic pulmonary artery pressure ( r =0.82, P &lt;0.01) and between endothelin-1 plasma levels and pulmonary artery pressure measured at high altitude ( r =0.35, P =0.05). Conclusions —These findings suggest that in HAPE-susceptible mountaineers, an augmented release of the potent pulmonary vasoconstrictor peptide endothelin-1 and/or its reduced pulmonary clearance could represent one of the mechanisms contributing to exaggerated pulmonary hypertension at high altitude.
DISLOCATION OF CERVICAL VERTEBRA. DEATH—CASE RECORD AND NECROPSY.
Authors: G. W. BROOKE
Journal: JAMA (1894)

Early on Wednesday morning Nov. 29, 1893,1 was hastily summoned to visit a neighbor, Mr. Chester Allen, a strong, healthy man, age 50 years, living but a short distance from my residence. I found him in his barn, and learned that he had fallen a distance of about seven feet, through a hatchway, to the floor beneath. As near as could be ascertained, the accident occurred about three-quarters of an hour before. He was insensible for a time after he fell; how long a period he was unable to say, and when consciousness returned, he found that he was entirely helpless, and unable to make himself heard. He complained of intense pain in his neck, a few inches below the occiput, and on examination, I found complete paralysis, and loss of sensation below the seat of injury; heart's action very slow and feeble; pulse imperceptible at the wrist; extremities cold.
Inhibition of Indoleamine 2,3-Dioxygenase in Dendritic Cells by Stereoisomers of 1-Methyl-Tryptophan Correlates with Antitumor Responses
Authors: De-Yan Hou, Alexander J. Muller, Madhav D. Sharma, James DuHadaway, Tinku Banerjee, Maribeth Johnson, Andrew L. Mellor, George C. Prendergast, David H. Munn
Journal: Cancer Research (2007)

Abstract Indoleamine 2,3-dioxygenase (IDO) is an immunosuppressive enzyme that contributes to tolerance in a number of biological settings. In cancer, IDO activity may help promote acquired tolerance to tumor antigens. The IDO inhibitor 1-methyl-tryptophan is being developed for clinical trials. However, 1-methyl-tryptophan exists in two stereoisomers with potentially different biological properties, and it has been unclear which isomer might be preferable for initial development. In this study, we provide evidence that the d and l stereoisomers exhibit important cell type–specific variations in activity. The l isomer was the more potent inhibitor of IDO activity using the purified enzyme and in HeLa cell–based assays. However, the d isomer was significantly more effective in reversing the suppression of T cells created by IDO-expressing dendritic cells, using both human monocyte–derived dendritic cells and murine dendritic cells isolated directly from tumor-draining lymph nodes. In vivo, the d isomer was more efficacious as an anticancer agent in chemo-immunotherapy regimens using cyclophosphamide, paclitaxel, or gemcitabine, when tested in mouse models of transplantable melanoma and transplantable and autochthonous breast cancer. The d isomer of 1-methyl-tryptophan specifically targeted the IDO gene because the antitumor effect of d-1-methyl-tryptophan was completely lost in mice with a disruption of the IDO gene (IDO-knockout mice). Taken together, our findings support the suitability of d-1-methyl-tryptophan for human trials aiming to assess the utility of IDO inhibition to block host-mediated immunosuppression and enhance antitumor immunity in the setting of combined chemo-immunotherapy regimens. [Cancer Res 2007;67(2):792–801]
Cancer family syndrome associated with multiple malignant melanomas and a malignant fibrous histiocytoma
Authors: C. BUCKLEY, V. THOMAS, J. CROW, R. HOULSTON, J. SLACK, M.H.A. RUSTIN
Journal: British Journal of Dermatology (1992)

A 64-year-old female with the cancer family syndrome suffered from multiple malignant melanomas and a malignant fibrous histiocytoma. She has shown unusually long survival which is a feature of these patients.
Catalytic defect of medium-chain acyl-coenzyme A dehydrogenase deficiency. Lack of both cofactor responsiveness and biochemical heterogeneity in eight patients.
Authors: B A Amendt, W J Rhead
Journal: Journal of Clinical Investigation (1985)

Medium-chain acyl-coenzyme A (CoA) dehydrogenase (MCADH; EC 1.3.99.3) deficiency (MCD) is an inborn error of beta-oxidation. We measured 3H2O formed by the dehydrogenation of [2,3-3H]acyl-CoAs in a 3H-release assay. Short-chain acyl-CoA dehydrogenase (SCADH; EC 1.3.99.2), MCADH, and isovaleryl-CoA dehydrogenase (IVDH; EC 1.3.99.10) activities were assayed with 100 microM [2,3-3H]butyryl-, -octanoyl-, and -isovaleryl-CoAs, respectively, in fibroblasts cultured from normal controls and MCD patients. Without the artificial electron acceptor phenazine methosulfate (PMS), MCADH activity in fibroblast mitochondrial sonic supernatants (MS) was 54% of control in two MCD cell lines (P less than 0.05). Addition of 10 mM PMS raised control acyl-CoA dehydrogenase activities 16-fold and revealed MCADH and SCADH activities to be 5 (P less than 0.01) and 73% (P greater than 0.1) of control, respectively. Thus, the catalytic defect in MCD involves substrate binding and/or dehydrogenation by MCADH and not the subsequent reoxidation of reduced MCADH by electron acceptors. 20 microM flavin adenine dinucleotide (FAD) did not stimulate MCD MCADH activity in either the 3H-release or electron-transfer(ring) flavoprotein-linked dye-reduction assays. Mixing experiments revealed no MCADH inhibitor in MCD MS; IVDH activities were identical in both control and MCD MS. In postmortem liver MS from another MCD patient, 3H2O formation from [2,3-3H]octanoyl-CoA was 15% of control. When 3H2O formation was assayed with 200 microM [2,3-3H]acyl-CoAs, 15 mM PMS, and 20 microM FAD in fibroblast sonic supernatants from seven MCD cell lines, SCADH, MCADH, and IVDH activities were 72-112% (P greater than 0.1), 4-9% (P less than 0.01), and 86-135% (P greater than 0.1) of control, respectively, revealing no significant biochemical heterogeneity among these patients.
A structure-activity relationship for induction of meningeal inflammation by muramyl peptides.
Authors: M Burroughs, E Rozdzinski, S Geelen, E Tuomanen
Journal: Journal of Clinical Investigation (1993)

Components of bacterial peptidoglycans have potent biological activities, including adjuvant effects, cytotoxicity, and induction of sleep. Mixtures of peptidoglycan components also induce inflammation in the lung, subarachnoid space, and joint, but the structural requirements for activity are unknown. Using a rabbit model for meningitis, we determined the biological activities of 14 individual muramyl peptides constituting > 90% of the peptidoglycan of the gram-negative pediatric pathogen Haemophilus influenzae. Upon intracisternal inoculation, most of the muropeptides induced leukocytosis in cerebrospinal fluid (CSF), influx of protein into CSF, or brain edema, alone or in combination. The disaccharide-tetrapeptide, the major component of all gram-negative peptidoglycans, induced CSF leukocytosis and protein influx at doses as low as 0.4 microgram (0.42 nM). Modification of the N-acetyl muramic acid or substitution of the alanine at position four in the peptide side chain decreased leukocytosis but enhanced brain edema. As the size of the muropeptide increased, the inflammatory activity decreased. Muropeptide carrying the diaminopimelyl-diaminopimelic acid cross-link specifically induced cytotoxic brain edema. These findings significantly expand the spectrum of biological activities of natural muramyl peptides and provide the basis for a structure-activity relationship for the inflammatory properties of bacterial muropeptides.
Accelerated senescence of cord blood endothelial progenitor cells in premature neonates is driven by SIRT1 decreased expression
Authors: Paula Frizera Vassallo, Stéphanie Simoncini, Isabelle Ligi, Anne-Line Chateau, Richard Bachelier, Stéphane Robert, Julia Morere, Samantha Fernandez, Benjamin Guillet, Maxime Marcelli, Edwige Tellier, Alain Pascal, Umberto Simeoni, Francine Anfosso, Frédérique Magdinier, Françoise Dignat-George, Florence Sabatier
Journal: Blood (2014)
The Comatose Patient
Authors: Jerome B. Posner
Journal: JAMA (1975)

OF THE acute situations in clinical medicine, there is none more difficult than the treatment of the comatose patient. The difficulty exists in part because coma is a symptom, representing failure of cerebral metabolism, rather than a specific disease entity. Coma may be a symptom of diseases as diverse as hypoglycemia on the one hand or brain tumor on the other. Because there are so many potential causes of coma, and because the time the physician has in which to make the appropriate diagnostic and therapeutic judgments is often very brief before irreversible brain damage ensues, a systematic approach to differential diagnosis and treatment is necessary. A detailed description of the pathophysiology of coma,<sup>1</sup>its specific causes, and management are beyond the scope of this article, but certain general principles concerning the approach to and treatment of the comatose patient encountered in a hospital emergency room are outlined here.
Carbamazepine for Central Sleep Apnea
Authors: George B. Murray
Journal: JAMA (1977)

<h3>To the Editor.—</h3> Carbamazepine Tegretol), a tricyclic, has been used successfully in trigeminal neuralgia and partial seizure with complex symptomatology. It has been tried also in the Kluver-Bucy syndrome, hiccups, compulsive water drinking, stammering, psoriasis, Pickwickian syndrome, and diabetic and amyloid neuropathy. Although other tricyclics have been used in the treatment of central sleep apnea,<sup>1</sup>I have not found a citation that mentions carbamazepine used for this syndrome. Sleep apnea syndromes are more numerous than previously considered.<sup>2</sup>I have been treating a patient for partial seizure and complex symptomatology with 1,200 mg/day of carbamazepine with good control of seizures and symptomatology for seven months. The patient sleeps better since I discontinued therapy with phenytoin and began carbamazepine therapy. Usually I see the patient alone; one day I saw the patient with his wife, who remarked that her husband did not snore nor did he "hold his breath" anymore
Most Plastic Products Release Estrogenic Chemicals: A Potential Health Problem That Can Be Solved
Authors: Chun Z. Yang, Stuart I. Yaniger, V. Craig Jordan, Daniel J. Klein, George D. Bittner
Journal: Environmental Health Perspectives (2011)

Chemicals having estrogenic activity (EA) reportedly cause many adverse health effects, especially at low (picomolar to nanomolar) doses in fetal and juvenile mammals.We sought to determine whether commercially available plastic resins and products, including baby bottles and other products advertised as bisphenol A (BPA) free, release chemicals having EA.We used a roboticized MCF-7 cell proliferation assay, which is very sensitive, accurate, and repeatable, to quantify the EA of chemicals leached into saline or ethanol extracts of many types of commercially available plastic materials, some exposed to common-use stresses (microwaving, ultraviolet radiation, and/or autoclaving).Almost all commercially available plastic products we sampled--independent of the type of resin, product, or retail source--leached chemicals having reliably detectable EA, including those advertised as BPA free. In some cases, BPA-free products released chemicals having more EA than did BPA-containing products.Many plastic products are mischaracterized as being EA free if extracted with only one solvent and not exposed to common-use stresses. However, we can identify existing compounds, or have developed, monomers, additives, or processing agents that have no detectable EA and have similar costs. Hence, our data suggest that EA-free plastic products exposed to common-use stresses and extracted by saline and ethanol solvents could be cost-effectively made on a commercial scale and thereby eliminate a potential health risk posed by most currently available plastic products that leach chemicals having EA into food products.
The Numbered Diseases: First Through Sixth
Authors: Lewis Shapiro
Journal: JAMA (1965)

<h3>To the Editor:—</h3> In the article "Erythema Infectiosum" (<i>JAMA</i><b>192</b>:58, 1965) William B. Wadlington states that in the early 1900's the exanthemata rubeola, scarlet fever, rubella, and exanthema subitum were numbered 1 to 4 in that order and that erythema infectiosum was given number 5 (also presumably in the early 1900's although this is not specifically stated). The statement that exanthema subitum is the fourth disease is in error, although the numbering of the other four diseases mentioned is correct. In 1900, Clement Dukes, a physician to the Rugby School in England, reported<sup>1</sup>an epidemic of an exanthem which he thought he was able to distinguish from the three classical exanthemata, most particularly German measles. This he tentatively named fourth disease pending an authoritative decision as to how the disease was to be named. L. Cheinisse of Paris in 1905 gave the number 5 to erythema infectiosum.<sup>2</sup>
Evidence based care
Authors: Peter Brocklehurst, William McGuire
Journal: BMJ (2004)

The ethos of basing practice on the best available evidence is well established in perinatal medicine. The introduction to clinical practice of major interventions, such as antenatal corticosteroids and exogenous surfactant, was informed by evidence from seminal randomised controlled trials and systematic reviews.

Equally important has been the development and evaluation of interventions that have been shown not to have major benefits for preterm infants. For example, strong evidence from preclinical research studies indicated that antenatal thyrotropin releasing hormone might act synergistically with corticosteroids to reduce the risk of respiratory distress syndrome in preterm infants. Despite the biological plausibility of this treatment and evidence of effect in animal models, randomised controlled trials (involving over 4500 women) did not show any improvement in outcomes, including mortality, for preterm infants. Also, antenatal thyrotropin releasing hormone was shown to be associated with adverse effects for mothers and infants, including a higher risk of infants needing mechanical ventilation. On the basis of this evidence, antenatal thyrotropin releasing hormone does not have a role in the management of threatened preterm birth.



Effect of prenatal thyrotropin releasing hormone (TRH) for preterm birth on mortality before hospital discharge. Data from Crowther CA et al. Cochrane Database Syst Rev. 2003;(4): C19



Obtaining the best evidence to guide clinical practice is not always easy. In particular, undertaking clinical trials to evaluate interventions for preterm infants is difficult. Although about 3000 randomised controlled trials have been reported in the field of neonatology, many interventions have not yet been subjected to unbiased evaluation. This could be because the trials have not been attempted, or have been flawed methodologically, or have been too small to detect clinically important effects. Large perinatal trials have problems with recruitment. This could be related to the issues surrounding the public perception of perinatal trials and the …
Quantitative<b><i>RARβ2</i></b>Hypermethylation
Authors: Carmen Jerónimo, Rui Henrique, Mohammad O. Hoque, Franclim R. Ribeiro, Jorge Oliveira, Daniel Fonseca, Manuel R. Teixeira, Carlos Lopes, David Sidransky
Journal: Clinical Cancer Research (2004)

Abstract Retinoic acid receptor β2 (RARβ2) is a tumor suppressor gene frequently hypermethylated in several human neoplasms. To further characterize this epigenetic alteration in prostate cancer progression, we examined tumor tissue from 118 patients with prostate carcinoma (PCa), 38 paired high-grade prostatic intraepithelial neoplasias (HGPIN), and non-neoplastic prostate tissue from 30 patients with benign prostate hyperplasia (BPH), using quantitative methylation-specific PCR. We found RARβ2 hypermethylation in 97.5% of PCa, 94.7% of HGPIN, and 23.3% of BPH. Methylation levels were significantly higher in PCa compared with HGPIN and BPH (P &amp;lt; 0.00001). By establishing an empiric cutoff value, we were able to discriminate between neoplastic and non-neoplastic tissue, with 94.9% sensitivity and 100% specificity. Moreover, RARβ2 methylation levels correlated with higher pathological stage (r = 0.30, P = 0.0009). This quantitative assay represents a novel and promising molecular marker that may augment current approaches for prostate cancer detection.
Objectively Measured Physical Activity and Mortality in Older Adults
Authors: Steven N. Blair, William L. Haskell
Journal: JAMA (2006)

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Infarction Due to Myocardial Bridging
Authors: Karam Souibri, Gilles Grollier
Journal: New England Journal of Medicine (2005)

A 45-year-old man with dyslipidemia had a sudden onset of retrosternal chest pain and presented to the emergency department. Findings on the physical examination were unremarkable. His electrocardiogram showed ST-segment elevation in the anterior leads (Panel A). Coronary angiography was immediately performed. The left anterior descending (LAD) coronary artery and two large diagonal branches appeared to be normal during diastole (Panel B) but were severely compressed during systole (Panel C), suggesting compression by myocardial bridging. A rate of flow classified as grade 2 (according to the criteria of the Thrombolysis in Myocardial Infarction [TIMI] trial) was observed in these three . . .
Active and passive smoking in married couples: results of 25 year follow up.
Authors: J P Vandenbroucke, J H Verheesen, A de Bruin, B J Mauritz, C van der Heide-Wessel, R M van der Heide
Journal: BMJ (1984)

Electrocardiographs after overdose of tricyclic antidepressants: (a) 2 2 hours after ingestion (pulse 50 beats/min); (b) 4 hours after ingestion (pulse 104 beats/min, systolic blood pressure 75 mm Hg); and (c) 5 hours after ingestion (pulse 150 beats/min, systolic blood pressure 75 mm Hg).of atropine 0 3 mg intravenously was ineffective.She was given 10", mannitol 10 ml for any cerebral oedema and activated charcoal via the nasogastric tube.One hour later blood gas results showed correction of her acidosis (pH 7 5, carbon dioxide partial pressure 3-5 kPa (26-3 mm Hg), oxygen partial pressure 20 kPa (150 mm Hg), base excess -1-5 mmol/l, and bicarbonate 23 mmol/l).Shortly after this her pulse suddenly returned to 104 beats/min, and her blood pressure was 75 mm Hg systolic.Her electrocardiogram still showed widened QRS complexes (figure (b)), but there was a gradual improvement over the next few hours with narrowing of the QRS complexes, some ST depression, and ventricular ectopic beats (figure (c)).Ventilation was continued to maintain her respiratory alkalosis, and her electrocardiogram was monitored.Ten hours after ingestion of the tablets she responded to pain and showed some spontaneous limb movements.She was extubated after 48 hours and made an uneventful recovery.There were no residual symptoms or signs three months later.