tbuckley/cabot-search huggingface dataset:
Effects of Acadesine on Myocardial Infarction, Stroke, and Death Following Surgery&lt;subtitle&gt;A Meta-analysis of the 5 International Randomized Trials&lt;/subtitle&gt;
Authors: Dennis T. Mangano
Journal: JAMA (1997)

<h3>Objective.</h3> —To determine the effects of a purine nucleoside, acadesine, on the incidence of fatal and nonfatal cardiovascular and cerebrovascular complications following coronary artery bypass graft (CABG) surgery. <h3>Data Sources.</h3> —Individual patient data from 5 randomized, placebo-controlled, double-blind clinical trials, including 81 international medical centers of the United States, Canada, and Europe. <h3>Study Selection.</h3> —All patients from all clinical trials were included: a total of 4043 patients undergoing CABG surgery, evaluable for efficacy, and randomized to receive either placebo (n= 2031) or acadesine (0.1 mg.kg<sup>-1</sup>.min<sup>-1</sup>;n=2012) by intravenous infusion for 7 continuous hours and via the cardioplegia solution. <h3>Data Extraction.</h3> —Individual patient data were collected prospectively using standardized forms and methods and double-data entry. A general parametric approach and analysis-by-patient meta-analysis were used, including both fixed effects and random effects models. Inclusion and exclusion criteria, general methodology, and outcome assessment techniques were similar for all trials. <h3>Data Synthesis.</h3> —Acadesine decreased the incidence of the primary outcome, perioperative myocardial infarction (MI) by 27% (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.51-0.95;<i>P</i>=.02), decreased the incidence of cardiac death through postoperative day 4 by 50% (OR, 0.52; 95% CI, 0.27-0.98;<i>P</i>=.04), and decreased the incidence of combined outcome (MI, stroke, or cardiac death) by 26% (OR, 0.73; 95% CI, 0.57-0.93;<i>P</i>=.01). The random effects models for these outcomes also yielded significant results. The incidence of cerebrovascular accident was not significantly reduced by acadesine (OR, 0.69; 95% CI, 0.44-1.08;<i>P</i>=.10). A secondary analysis of cardiac death following MI through postoperative day 4 demonstrated that acadesine decreased by 89% the number of deaths from 13.3% (13 deaths/98 MIs) in the placebo group to 1.4% (1 death/71 MIs) in acadesine-treated patients (<i>P</i>=.003). Acadesine also reduced the use of ventricular-assistance devices for severe postoperative heart failure by approximately one third (<i>P</i>=.05). Finally, regarding safety, the incidence of adverse events was similar in the acadesine vs placebo groups, with the exception of a transient increase in serum uric acid in the acadesine group. <h3>Conclusions.</h3> —The results of this meta-analysis indicate that in patients undergoing CABG surgery, treatment with acadesine before and during surgery can reduce early cardiac death, MI, and combined adverse cardiovascular outcomes.
TCT-476 Relationship Between Reference Vessel Diameter and the Incidence and Impact of Incomplete Coronary Revascularization Following PCI in ACS: The ACUITY Trial
Authors: Gregg Rosner, Philip Green, Ajay Kirtane, Philippe Genereux, Alexandra Lansky, Bernard Gersh, Giora Weisz, Helen Parise, Martin Fahy, Sorin Brener, Roxana Mehran, Gregg Stone
Journal: Journal of the American College of Cardiology (2012)
TESTIMONIALS FOR ANEDEMIN TABLETS
Authors: Theodore Diller
Journal: JAMA (1926)

<h3>To the Editor:</h3> —Please note the circular for Anedemin Tablets which came to my desk today. I was interested enough in this matter to look up the records of the men who signed these testimonials, and I give them to you as my secretary has culled them from the directory: Bell, David R.: University of Nebraska; homeopathic; born, 1856; licensed, 1885. Coleman, James I.: College of Physicians and Surgeons, Baltimore; born, 1859; licensed, 1885. Howell, W. E.: Lincoln Memorial University Medical Department, Knoxville; born, 1880; licensed, 1903; surgeon; member, American Medical Association. Surrett, I. W.: Medical College of Virginia; born, 1873; licensed, 1908; Fellow, American Medical Association. House, Albert L.: Yale University Medical Department; born, 1868; licensed, 1895; Fellow, American Medical Association. It appears very discouraging that three members of the American Medical Association would write boosting letters such as these are, made up of pure balderdash, trying to disguise
Most cancers in Europe avoidable
Authors: Roger Dobson
Journal: BMJ (2007)

Almost 700 000 cases of cancer a year in Europe could be avoidable, new research has shown ( International Journal of Cancer 2006 Dec 27, doi: 10.1002/ijc.22459). 

The study, which looked at 11 cancers that can be prevented by changes to lifestyle, estimates that of 1.4 million cases, more than half—363 000 (59%) in men and 326 000 (45%) in women—could be avoidable. 

In men, the proportion was largest in Hungary (77%); in women, the proportion was largest in Belgium (54%). 

“Interventions directed at reducing smoking, obesity and alcohol use, as well as increasing physical activity …
Langerhans Cell Histiocytosis
Authors: Diane M. Komp
Journal: New England Journal of Medicine (1987)

Nearly a century has passed since Alfred Hand reported a case of "polyuria and tuberculosis,"1 later considered to be the first case of the Hand-Schül1er–Christian syndrome. Although early investigators considered this syndrome pathologically distinct from Letterer–Siwe disease, the later recognition of eosinophilic granuloma of bone as part of the same spectrum led Lichtenstein to propose the pathologically inclusive term "histiocytosis X" for the varying clinical manifestations.2 Modern pathological techniques have revealed the identity of the offending cell, and we can now call this disorder by its proper name, Langerhans cell histiocytosis.3 The Langerhans cell is a dendritic cell derived from . . .
Vasodilators in Aortic Regurgitation — Where Is the Evidence of Their Effectiveness?
Authors: Blase A. Carabello
Journal: New England Journal of Medicine (2005)

Although aortic regurgitation imposes a volume load on the left ventricle, it became clear more than two decades ago that the resulting large stroke volume and wide pulse pressure also lead to systolic hypertension and concomitant left ventricular pressure overload.1,2 In fact, afterload is much higher in aortic regurgitation than in mitral regurgitation and may be as high as that in the more typically recognized pressure overload of aortic stenosis.3 The excess afterload in aortic regurgitation, in turn, forms the basis for the idea that afterload-reducing agents, such as vasodilators, might be beneficial in the medical treatment of this . . .
The United States Needs a Health System Like Other Countries
Authors: Anthony M. Perry
Journal: JAMA (1994)

To the Editor.  —Although I'm sure that you will have considerable comment on Dr Glaser's 1 call for national health insurance, I found his article so particularly outrageous that I couldn't refrain from adding my own to the pile. I have little disagreement with his distaste for the grandiose social experiment of national managed competition, but the system that he offers in its place is probably the one substitute that would be worse. Perhaps what took me back most, however, was his characterizing market economics as utopian, while in the same breath extolling the fanciful benefits of extending political control by the federal government over our entire health care system.  One thing we must say about the present health care system is that, despite its many problems, it is delivering an excellent product, in most respects the best in the world. On the contrary, we need only look at the
Exaled nitric oxide and air trapping correlation in asthmatic children
Authors: L. Mappa, F. Cardinale, R. Camodeca, M. L. Tortorella, A. Pietrobelli, L. Armenio, A. L. Boner
Journal: Allergy (2005)

Exhaled nitric oxide (eNO) levels have been shown to correlate with atopy and with airway hyperresponsiveness but not with standard spirometry. The aim of our study was to evaluate the correlation between eNo levels and functional residual capacity (FRC), residual volume (RV), RV to total lung capacity (TLC) ratio, and pulmonary resistances in asthmatic children ages 6–13 years. Forty‐nine patients (35 males) were enrolled in the study. Nineteen of them were not receiving inhaled corticosteroids. The eNO levels were measured by chemiluminescence's analyzer and lung function study were performed by body box plethysmography. As expected, there was no correlation between eNO levels and forced vital capacity (FVC); forced expiratory volume in the first second (FEV 1 ); mid respiratory flow between 25 and 75% of the vital capacity (MEF 25‐‐75 ), FEV 1 /FVC, and pulmonary resistances. Instead a correlation was found between eNO level and RV both considering all the study population together ( r = 0.51, P = 0.001) and separately the asthmatic children not receiving ICS ( r = 0.6, P = 0.003). In the patients receiving ICS the correlation was still present ( r = 0.43, P = 0.01). The correlation between eNo levels and RV may reflect the effect of airway inflammation on NO production and diffusion as well as peripheral airway trapping and consequent RV.
PET Imaging of a Butterfly Glioblastoma
Authors: Norbert Galldiks, Michael Schroeter, Gereon R. Fink, Lutz W. Kracht
Journal: Clinical Nuclear Medicine (2009)

In magnetic resonance imaging (MRI) a robust contrast enhancement usually includes glioblastoma. However, in a small percentage (4%) of patients with glioblastoma (GBM), there is minimal or even lacking contrast enhancement on MRI. We report the neuroimaging findings in a 37-year-old woman with a "butterfly" GBM. In contrast to a clearly bilateral increased 11C-11 methionine (MET) positron emission tomography (MET-PET) uptake pattern, contrast enhancement on MRI was only slightly increased despite a large tumor extension. The extent of the metabolically active tumor mass delineated by MET-PET was larger than the MRI lesion. Whereas MRI suggested a bifocal growth, MET-PET showed a widespread but continuous tumor mass. In this case of bihemispheric GBM, MRI findings were ill-defined and ambiguous. MET-PET imaging added substantial diagnostic information that strongly suggested the diagnosis of GBM and helped to delineate the tumor extension.
Direct Measurement of Intracardiac Blood Flow in Dogs with Experimental Ventricular Septal Defects
Authors: EMMANUEL MESEL
Journal: Circulation Research (1970)

Experimental ventricular septal defects (VSD's) were produced in dogs under general anesthesia by excising a 9-mm core of tissue from the septum with a cylindrical cutting tool. A specially designed electromagnetic flow transducer was wedged into the defect compressing the septal tissue around it, thus causing all of the shunted blood to pass through the lumen. The sensing electrodes were in direct contact with the blood stream, allowing the transducer to be calibrated externally, and to be used as a primary standard of measurement. When left-to-right shunts were measured by the Fick technique, the average error was 57percnt; (2% to 154%). When pulmonary arterial oxygen saturation exceeded 85%, measurements using the Fick method showed errors greater than 30% (61% to 154%) in 9 of 11 animals. The VSD's were of moderate size and resulted in right ventricular systolic pressures between 1/4; and 1/2; of systemic. The flow pattern and the interventricular pressure difference were remarkably similar in contour. Delay in right ventricular activation occurred in most animals as a result of surgical disturbance of the conduction system. Diastolic shunting, which varied between 15% and 25% of the total, was noted in animals with or without changes in conduction pattern. The sequence of ventricular activation was an important factor in controlling systolic shunting and may be an important factor in the distribution of myocardial work.
Left Atrial Volume
Authors: Jacob E. Møller, Graham S. Hillis, Jae K. Oh, James B. Seward, Guy S. Reeder, R. Scott Wright, Seung W. Park, Kent R. Bailey, Patricia A. Pellikka
Journal: Circulation (2003)

After acute myocardial infarction (AMI), diastolic function assessed by Doppler echocardiography provides important prognostic information that is incremental to systolic function. However, Doppler variables are affected by multiple factors and may change rapidly. In contrast, left atrial (LA) volume is less influenced by acute changes and reflects subacute or chronic diastolic function. This may be of importance when one assesses risk in patients with AMI.Three hundred fourteen patients with AMI who had a transthoracic echocardiogram with assessment of left ventricular (LV) systolic and diastolic function and measurement of LA volume during admission were identified. The LA volume was corrected for body surface area, and the population was divided according to LA volume index of 32 mL/m2 (2 SDs above normal). LA volume index was >32 mL/m2 in 142 (45%). The primary study end point was all-cause mortality. During follow-up of 15 (range 0 to 33) months, 46 patients (15%) died. LA volume index was a powerful predictor of mortality and remained an independent predictor (hazard ratio 1.05 per 1-mL/m2 change, 95% CI 1.03 to 1.06, P<0.001) after adjustment for clinical factors, LV systolic function, and Doppler-derived parameters of diastolic function.Increased LA volume index is a powerful predictor of mortality after AMI and provides prognostic information incremental to clinical data and conventional measures of LV systolic and diastolic function.
The influence of caffeine ingestion on incremental treadmill running.
Authors: L R McNaughton
Journal: British Journal of Sports Medicine (1986)

The aim of this study was to determine the effects of caffeine ingestion on estimated substrate utilisation during treadmill running at an initial level of 70%-75% of maximal oxygen consumption after which subjects ran to exhaustion. Twelve subjects undertook either a control, placebo, a small (10 mg X kg-1) or a large (15 mg X kg-1) dose of caffeine in a double-blind design to determine whether caffeine affected the substrate usage during running. Venous blood was collected prior to and during the experimental runs and was later analysed for free fatty acids (FFA), glycerol, triglycerides, lactate and glucose concentrations. The results of this experiment suggest that maximal running performance can be increased by large doses of caffeine. Furthermore, the subjects' respiratory exchange ratios were lower and FFA concentrations were higher following the ingestion of large amounts of caffeine than during other trials, suggesting that a larger proportion of energy was derived from fat being used preferentially during the trial following ingestion of this large dose of caffeine. The subjects rating of perceived exertion (RPE) were lower following the ingestion of a large dose of caffeine than it was in any of the other trials. This study differs from others in this area in so much that caffeine has been found to have positive effects during maximal running when used in large doses.
Waiting times for cancer treatment
Authors: A I Malik, S Tou, A Huang
Journal: Journal of the Royal Society of Medicine (2004)

Sarah Duff and her colleagues (March 2004 JRSM1) report on the difficulties in meeting waiting time targets for treatment of colorectal cancer. An important cause of delay was shortage of staff and equipment for preoperative radiotherapy. Others have noted the contribution of delays before referral.2 The Government's targets are based on a belief, rather than scientific evidence, that earlier treatment will produce more cures. A scientific approach would consider not only the entire clinical course but also the phenomenon of ‘biological predeterminism’,3 whereby tumour behaviour is determined early in the pre-clinical phase. Indeed, ACPGBI guidelines4 on bowel cancer referral raise the question ‘whether early diagnosis in an anatomical sense can be achieved by earlier symptomatic diagnosis in the temporal or chronometric sense... ’.
Effects of high glucose and TGF-β1 on the expression of collagen IV and vascular endothelial growth factor in mouse podocytes
Authors: M. Carmen Iglesias-de la Cruz, Fuad N. Ziyadeh, Motohide Isono, Martine Kouahou, Dong Cheol Han, Raghu Kalluri, Peter Mundel, Sheldon Chen
Journal: Kidney International (2002)
Death from Lightning-stroke, with Multiple Injuries
Authors: D. A. Skan
Journal: BMJ (1949)

B ioR tongue remained for a week.The dorsum of the tongue again ulcerated and took a further fortnight to heal.It seems clear, therefore, in view of the fact that fungous and bacillary infections were ruled out, that this was a surface necrosis of the mucous membrane of the tongue, cheek, and lips directly due to streptomycin.
A double-blind controlled cross-over trial of cyproterone acetate in females with hidradenitis suppurativa
Authors: P.S. MORTIMER, R.P.R. DAWBER, MARY A. GALES, R.A. MOORE
Journal: British Journal of Dermatology (1986)

In order to examine whether anti-androgen therapy was effective in hidradenitis suppurativa (HS), ethinyloestradiol 50 micrograms/cyproterone acetate 50 mg in a reverse sequential regimen was compared with ethinyloestradiol 50 micrograms/norgestrel 500 micrograms (Eugynon 50) in 24 female patients. Both treatments produced substantial improvement in disease activity. Seven patients cleared and have remained free of disease for 18 months, five patients improved, four remained unchanged, while two deteriorated. Cyproterone acetate was not clinically significantly more effective than E50, and both gave a similar reduction in free androgen index. Anti-androgen therapy appears to be beneficial in the treatment of hidradenitis suppurativa.
Wolfram Syndrome (Diabetes Insipidus, Diabetes, Optic Atrophy, and Deafness)
Authors: Giuseppe d'Annunzio, Nicola Minuto, Elena D'Amato, Teresa de Toni, Fortunato Lombardo, Lorenzo Pasquali, Renata Lorini
Journal: Diabetes Care (2008)

Wolfram syndrome is an autosomal recessive neurodegenerative disorder characterized by diabetes insipidus, diabetes (nonautoimmune), optic atrophy, and deafness (a set of conditions referred to as DIDMOAD). The WFS1 gene is located on the short arm of chromosome 4. Wolfram syndrome prevalence is 1 in 770,000 live births, with a 1 in 354 carrier frequency.We evaluated six Italian children from five unrelated families. Genetic analysis for Wolfram syndrome was performed by PCR amplification and direct sequencing.Mutation screening revealed five distinct variants, one novel mutation (c.1346C>T; p.T449I) and four previously described, all located in exon 8.Phenotype-genotype correlation is difficult, and the same mutation gives very different phenotypes. Severely inactivating mutations result in a more severe phenotype than mildly inactivating ones. Clinical follow-up showed the progressive syndrome's seriousness.
Medically unexplained symptoms
Authors: J. Tripp
Journal: Journal of the Royal Society of Medicine (2004)

Professor Butler and colleagues propose an approach whereby both patients and clinicians can regard ‘medically unexplained symptoms’ as unambiguously medical (May 2004 JRSM1).

As a clinician I found myself wondering how this new formulation of medically unexplained symptoms would actually help in my clinical work where I see a significant number of such patients. In contrast to the authors' assertion that clinicians are required ‘to do an awkward dance of collusion with the patient’ I find that a rational understandable discussion of the ways in which normal sensations are modified on a continuous basis by the brain (e.g. the perception of touch that changes when the ring is moved from its usual finger to a different finger) or the effects of the brain on somatic symptoms (e.g. stage fright causing vomiting and diarrhoea) a remarkably powerful and intuitively useful explanation to the patient. I then go on to explain that this process occurs in the subconscious mind which is not amenable to reason or voluntary control. The only way to deal with these symptoms is to train, rather than persuade, the subconscious mind to behave differently.

I am at a loss to see how bringing in another dimension—i.e. that their symptom is somehow due to their ‘reaction to the world’—helps, or how this assists patients to see their problems as unambiguously medical. Nevertheless an enjoyable and challenging article.
A global health fund: a leap of faith?
Authors: R. Brugha, G. Walt
Journal: BMJ (2001)

See also Editorial by Verheul and Rowson and Paper p 139 

After the 2000 G8 summit at Okinawa, the leaders of the world's richest countries announced an ambitious commitment to achieve substantial reductions in the global burden of disease and death due to HIV infection and AIDS, tuberculosis, and malaria by 2010.1 A new global health fund, to be highlighted at the forthcoming G8 summit in Genoa, could form the cornerstone for meeting this commitment. The fund will be heavily dependent on resources from the richest countries, working in partnership with United Nations' agencies (especially the World Health Organization), the commercial sector (especially major pharmaceutical companies), other donors, non-governmental organisations, and governments of developing countries. Funds are intended to be additional to existing aid from multilateral and bilateral agencies and will be managed and disbursed by a new entity, the Global Health Fund. This is a major new form of governance (see box 1).

The Global Health Fund follows a plethora of recent global public-private partnerships to promote wider availability of existing products and stimulate product development as well as initiatives with a broader focus on health systems (see box 2).2 Debates about these partnerships in the past year are relevant to the proposed global fund; they concern issues such as governance structures and functions, the balance of power between partners, the ability of recipient countries to determine how resources are used, and the balance between support to health systems and funding of health products. International policymakers are looking to the Global Alliance for Vaccines and Immunization (GAVI) for lessons, as this is one of the first such partnerships, with an established fund for disbursing free vaccines and funds to support health systems in some countries with a gross domestic product less than $1000 (£714).

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Mutations in<i>EXPH5</i>result in autosomal recessive inherited skin fragility
Authors: L. Liu, J.E. Mellerio, A.E. Martinez, J.R. McMillan, S. Aristodemou, M. Parsons, J.A. McGrath
Journal: British Journal of Dermatology (2013)

Several different genes have been implicated in the pathophysiology of inherited blistering skin diseases. Recently, autosomal recessive loss-of-function mutations in EXPH5 (encoding exophilin-5, also known as Slac2-b, a protein involved in intracellular vesicle transport) were identified in a new mechanobullous disease resembling a form of epidermolysis bullosa simplex (EBS). Here, we searched for mutations in EXPH5 in a 4-year-old white boy with EBS in whom initial Sanger sequencing of known genes implicated in intraepidermal skin fragility failed to identify pathogenic mutations. Transmission electron microscopy of rubbed nonlesional patient skin revealed disruption of keratinocytes in the lower epidermis with cytolysis and acantholysis, keratin filament clumping and prominent perinuclear cytoplasmic vesicles, and provided the clue to the candidate gene pathology. Sanger sequencing of genomic DNA showed compound heterozygosity for two new mutations in EXPH5, c.1947dupC (p.Pro649fsPro*11) and c.2249C>A (p.Ser750*). Immunofluorescence microscopy of patient skin showed a complete absence of exophilin-5 labelling. This case represents the third pedigree with EXPH5 mutations resulting in inherited skin fragility. The clinical and molecular data expand genotype-phenotype correlation in this new form of EBS and demonstrate the important role of exophilin-5 in keratinocyte cell biology.