tbuckley/cabot-search huggingface dataset:
Comparison of Outcome After Myocardial Infarction in Patients With and Without Abnormalities on Previous Stress Tc-99m Tetrofosmin Myocardial Perfusion Imaging
Authors: Abdou Elhendy, Arend F. L. Schinkel, Ron T. van Domburg, Jeroen J. Bax, Harm H. H. Feringa, Peter G. Noordzij, Olaf Schouten, Stefanos E. Karagiannis, Martin Dunkelgrun, Don Poldermans
Journal: Clinical Nuclear Medicine (2008)

Background: Acute myocardial infarction (MI) can occur in patients with previously normal stress myocardial perfusion imaging (MPI). It is not known whether the prognosis of these patients differ from those with MI who had an abnormal MPI on an earlier testing. The aim of this study was to compare the outcome of patients who sustained a MI during follow-up after stress MPI based on the presence or absence of perfusion abnormalities on the earlier test. Methods: We studied 109 patients (age 62 ± 11 years, 73 men) who developed MI 2.1 ± 2.7 years after exercise or dobutamine stress Tc-99m tetrofosmin MPI. Subsequently, a follow-up was done for the occurrence of death during or after the acute event. Results: Myocardial perfusion was normal in 31 patients and was abnormal in 78 (45 had reversible defects). During a mean follow-up of 3.1 ± 2.4 years after MI, death occurred in 35 (32%) patients. The death rate was 19% in patients with previously normal versus 33% in patients with abnormal perfusion (P < 0.01). In a Cox model, independent predictors of death were age (risk ratio (RR) 1.06, 95% CI: 1.02–1.10), heart failure (RR 2.7, CI: 1.3–5.5), and abnormal MPI (RR 2.5, CI: 1.3–4.5). Conclusion: Patients with a previously normal stress MPI are less likely to die after acute MI than patients who had an abnormal MPI.
Autologous Transfusion Endorsed
Authors: George E. McLaughlin
Journal: JAMA (1985)

To the Editor.—  The recent SPECIAL COMMUNICATION from the Hospital Transfusion Committee 1 overlooks what appears to be a major safety factor in the preoperative preparation of patients for elective surgical procedures. As a practicing rheumatologist, it is my policy, whenever feasible, to perform preoperative phlebotomy of two or three units prior to the performance of reconstructive surgical procedures such as total hip or knee arthroplasty. The transfusion of the patient's own blood eliminates the obvious problems mentioned in the initial paragraph of the SPECIAL COMMUNICATION and would essentially eliminate other viral-transmitted diseases.  Establishment of a preoperative phlebotomy protocol has been achieved with success in several of the community hospitals in which our patients undergo arthroplastic surgery. The medical as well as medicolegal advantages should be immediately apparent to both physician and administrator. I would suspect that almost any physician who feels he or she must undergo elective surgery would feel
RECONSTRUCTION AND REHABILITATION OF THE TUBERCULOUS SOLDIER
Authors: E. H. BRUNS
Journal: JAMA (1918)

Much has been said and done in this great war concerning the reconstruction and reeducation of the crippled soldier, but it must be remembered that reconstruction, in perhaps a less spectacular way, applies to medical cases as well. We should not forget, in our zeal to assist the wounded soldier in returning to useful employment, that his less fortunate comrade who becomes stricken with disease may need the same helping hand. The one that presents the most difficult problem is the ill-fated consumptive. No tokens of bravery or emblems of the hero are pinned on him, although the fact that he has broken down with tuberculosis means he has given every ounce of resistance to his country's cause.  It is well known among sanatorium physicians today that the ultimately bad result in the treatment of tuberculosis is usually due to the perfunctory way in which patients are discharged from institutions.
Diabetes and Glucose Tolerance as Risk Factors for Cardiovascular Disease: The Framingham Study
Authors: W B Kannel, D L McGee
Journal: Diabetes Care (1979)

This report examines prospectively, in the Framingham cohort, the relation of diabetes and impaired glucose tolerance to each of the cardiovascular sequelae, taking into account age, sex, and associated cardiovascular risk factors. The incidence of cardiovascular disease, as well as the levels of cardiovascular risk factors, were found to be higher in diabetic than in nondiabetic men and women. The relative impact of diabetes on coronary heart disease, peripheral vascular disease, or stroke incidence was the same in men and women, but for cardiovascular mortality and cardiac failure the impact is greater for women. Present evidence suggests that alleviation of associated cardiovascular risk factors is the most promising course in reducing cardiovascular sequelae in diabetic patients.
Rappaccini's progeny
Authors: R. V Lee
Journal: Journal of the Royal Society of Medicine (2002)

Nathanial Hawthorne, a great American teller of tales, published Rappaccini's Daughter in 1844. It is a grim story of young love, perverted science and parental possessiveness. Old Dr Rappaccini, a master of botanical poisons and horticulture, has raised his beautiful daughter Beatrice with the same loving care that he has devoted to his toxic plants. Indeed, she has been so imbued and infiltrated with poison that her breath and touch are toxic, lethal; any man who touches her will die. But when Beatrice is courted by the medical student Giovanni, Rappaccini approves of the match and contrives to exert his toxic transformation on the suitor, so that the two can consummate their love. The tale ends tragically. From his professor, Giovanni obtains an antidote to the toxicity, which he gives to Beatrice. She dies, and Giovanni is left in her place, unable to practise his medical craft or to re-enter human society without causing harm.

What possible relevance can this gothic tale have for the twenty-first century? There is a growing population antagonistic to contemporary life, suspicious of technology and science, in search of pure and simple living conditions; and a hazard of this flight from modernity is that healthy children are transformed from free-roaming social individuals to creatures confined at the mercy of their parents. One of the greatest achievements of the last century was the prevention of epidemics and disabling infectious diseases such as smallpox, poliomyelitis, rubella and measles—by immunization. The cessation of smallpox vaccination, we now realize, was premature because the virus was never made extinct. Stocks of frozen virus were preserved in the USSR and the USA, accessible to biological warfare strategists and scientists. With more than twenty years' worth of susceptibles, the earth's population is ripe for a devastating epidemic. Yet we are in danger of repeating this error, on a smaller scale, with other diseases. Today many young parents, perhaps believing that medicine has conquered infectious diseases and without personal experience of the devastating consequences of polio or congenital rubella syndrome, have decided that the risks of immunization are greater than the risks of disease. Like Rappaccini's daughter these children are not safe: their immunological naivety is a risk to themselves as well as to their community. They are both victims and vectors.
Umbilical Temperatures In Infants
Authors: Harvey Kravitz
Journal: JAMA (1966)

<h3>To the Editor:—</h3> In the editorial<b>195</b>:1144, 1966) on the death of a newborn infant from the perforation of the rectum by a thermometer, a safer method of taking rectal temperatures was suggested. A paper just published in the<i>Journal of Pediatrics</i>(<b>68</b>:418, 1966) entitled "Temperature of the Umbilicus" attempted to find out whether other means than rectal or oral temperatures might be clinically useful. The data showed that in small infants the temperatures of the umbilicus were between 0.45 F and 85 F lower than simultaneous rectal temperatures. The umbilical temperatures were closer in agreement with rectal temperatures than with axillary temperatures. These findings are of significance to European, African, and Asian countries where the axillary route is often used. In addition, the umbilicus may be a useful site for monitoring temperatures. Much remains to be done in the field of thermometry to develop safer means of taking
Risk factor for heart disease for over 40 years
Authors: R. A. Savage, S. Savage, H. Platts, A. Platts, S. Savage, M. B. Fowler, G. Fowler
Journal: BMJ (2010)

Your Short Cuts article suggests that subclinical hypothyroidism as a risk factor for coronary heart disease has been rediscovered.1 Research based on careful observation of the natural history of coronary heart disease in families led Fowler to this conclusion …
Improved clinical outcomes with abciximab therapy in acute myocardial infarction: A systematic overview of randomized clinical trials
Authors: David E. Kandzari, Vic Hasselblad, James E. Tcheng, Gregg W. Stone, Robert M. Califf, Sorin J. Brener, Gilles Montalescot, Franz-Josef Neumann, Adnan Kastrati, Robert A. Harrington
Journal: Journal of the American College of Cardiology (2003)
Quantum modeling of common sense
Authors: Hamid R. Noori, Rainer Spanagel
Journal: Behavioral and Brain Sciences (2013)

Abstract Quantum theory is a powerful framework for probabilistic modeling of cognition. Strong empirical evidence suggests the context- and order-dependent representation of human judgment and decision-making processes, which falls beyond the scope of classical Bayesian probability theories. However, considering behavior as the output of underlying neurobiological processes, a fundamental question remains unanswered: Is cognition a probabilistic process at all?
Supporting smoking cessation
Authors: N. A. Zwar, C. P. Mendelsohn, R. L. Richmond
Journal: BMJ (2014)

#### Summary points

Despite the decrease in prevalence of tobacco use in developed countries, smoking remains the most common preventable cause of disease and death in the world today.

Advice on smoking cessation from doctors and other health professionals has been shown to improve quit rates and is highly cost effective.1 Given the importance to health of tobacco use and the benefits of cessation, every doctor should encourage attempts to stop, be able to provide brief smoking cessation intervention, and be aware of referral options (see box 1).

Over the past decade there have been advances in the science and practice of smoking cessation support. These include new medicines to treat nicotine dependence, new ways of using existing medicines, and increasing use of technology to support behavioural change. This review provides an update on evidence based approaches to maximise the effectiveness of the treatment of tobacco dependence.

#### Sources and selection criteria

This review is based on evidence synthesis from relevant Cochrane systematic reviews; review and distillation of clinical practice guidelines from Australia, the United States, and New Zealand; information from UK National Centre for Smoking Cessation and Training (www.ncsct.co.uk); and other evidence from the authors’ personal libraries. We have focused on developments since the review by Aveyard and West in 2007.2

The prevalence of tobacco use varies around the world. Of …
India seeks to pay extra to attract doctors into villages, but health workers are sceptical
Authors: G. Mudur
Journal: BMJ (2009)

The Indian government plans to increase its budget for rural healthcare services by 16% this year and has promised doctors extra pay to work in remote rural areas. But experts in public health have cautioned that attracting doctors into India’s remote and underserved villages will take more than just money.

The health ministry announced last week that it would make available funds for “significantly higher monetary incentives” for doctors who accept positions in primary healthcare centres in the “most difficult and inaccessible areas.”

Health officials have said the increase in pay for doctors would depend on the location, with salaries rising with the toughness of the area. At some …
A1.32 The role of hematopoietic stem cells (HSC) in systemic autoimmunity
Authors: M Grigoriou, P Verginis, G Bertsias, DT Boumpas, A Banos
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background and objectives</h3> HSCs represent a cell population that gives rise to every lineage of blood cells, including granulocytes, lymphocytes, monocytes and endothelial cells, all of which have been implicated in the pathogenesis of Systemic Lupus Erythematosus (SLE). Although HSCs are thought to exist in a dormant state in bone marrow niche, recent evidence suggest that in lupus mice they over proliferate due to both intrinsic and extrinsic effects. Whether such alteration in the HSC compartment contributes to lupus pathogenesis, remains elusive. Furthermore, the molecular identity of this cell type after the inflammatory impact is unknown. Our working hypothesis is that the fundamental immune aberrations in SLE –genetic or epigenetic- may be easier to be traced back to the HSC population. <h3>Materials and methods</h3> Hematopoietic stem cell progenitors were isolated from either healthy or NZB x NZW F1 lupus prone mice bone marrow. The selection markers used are Lin<sup>-</sup>Sca-1<sup>+</sup>c-Kit<sup>+</sup> (LSK) cells, including long and short term HSCs. Cell sorting of the aforementioned populations was performed for enumeration and RNA extraction. RNA-seq analysis was performed. <h3>Results</h3> Significantly increased frequencies as well as absolute numbers of HSCs were observed in the BM of lupus mice with established disease as compared to young NZB x NZW F1 mice or to C57/BL6 control mice. Importantly, our results show that bone marrow populations such as HSPCs, lymphoid and myeloid lineages seem to differ in homogeneity, correlating with either age or disease, indicating an alteration in HSC potential under inflammatory conditions. In depth bioinformatics analysis of the RNA-seq results of HSCs is in process. <h3>Conclusions</h3> Our results will characterise the global gene expression of HSCs originating by lupus mice. Simultaneously, we plan to map SNPs in the genetic background of lupus mice and pinpoint the important ones for HSCs integrity. Acquired knowledge will provide insights into the contribution of HSC in lupus pathogenesis as well as will demonstrate how the respective environment could shape the HSC compartment function.
Paediatric oral peanut challenges: a comparison of practice in London and Western Switzerland
Authors: S. Ludman, J. Wassenberg, G. Du Toit, A. T. Fox, G. Lack, P. A. Eigenmann
Journal: Allergy (2013)

Abstract Background There are guidelines on how to develop a food challenge protocol, but at present there is no gold standard guidance on method, and separate units produce differing protocols. Methods We performed a retrospective analysis of 200 patients’ data from the paediatric allergy units in Lausanne and Geneva, Western Switzerland, and St Thomas’ Hospital ( STH ), UK . Results St Thomas’ Hospital has a younger cohort with a lower overall mean spIgE (2.36 kU /l vs 8.00 kU /l, P = 0.004). The target peanut protein volumes differed: Switzerland 4.4 g vs STH 8.4 g. Despite this, the dose actually achieved in positive challenges was not significantly different (2.33 g vs 1.49 g, P = 0.16). 26% of challenges reacted at 4 g or more of peanut protein. Conclusions The differences in results highlight how the variation in reasoning behind food challenge alters the outcome. Standardization of food challenges would allow easy comparison between hospitals and geographical areas for research purposes.
My Right Knee
Authors: Donald M. Berwick
Journal: Annals of Internal Medicine (2005)

Despite some impressive recent gains, improving the glaring deficiencies in health care quality is proving to be very hard. Improvement is local, rather than system-wide, and is sustained with difficulty, rather than becoming an intrinsic feature of care. My right knee will probably need to be replaced soon. This has given me the opportunity to define, in very personal terms, 5 specific dimensions of "total quality" that I will require from the medical institution that does my surgery and that every patient has the right to require of their encounters with the health care system. Don't kill me (no needless deaths). Do help me, and don't hurt me (no needless pain). Don't make me feel helpless. Don't keep me waiting. And don't waste resources, mine or anyone else's. Given my requirements, it is not clear that any health care institution in the United States will want to take me on as a patient. Although at this point individual institutions can meet some of these requirements, no single institution can deliver on all of them. Generating the energy, insight, and courage we need to get to "total quality" may require those of us who work in health care to get much better at seeing images of ourselves in the people we help. As Gandhi said, "You must be the change you wish to see in the world."
Studies on the Bacteremia of Bacterial Endocarditis
Authors: Anthony S. Werner
Journal: JAMA (1967)

In 206 cases of bacterial endocarditis with positive blood cultures, 95% of 789 blood cultures were positive for the causative microorganisms. In streptococcal endocarditis, the first blood culture was positive in 96% of the cases, and one of the first two blood cultures was positive in 98% of the cases. In endocarditis caused by microorganisms other than streptococci, the first blood culture was positive in 82% of the cases, and one of the first two blood cultures was positive in all of the cases. The incidence of positive cultures was slightly reduced in those cases in which the patient had received an antimicrobial agent within two weeks prior to blood culture. The bacteremia in the 206 cases of bacterial endocarditis was persistent and of low magnitude.
Internal Fixation of Bone with a Metal Pin (1862)
Authors: William M. Deyerle, Russell V. Bowers
Journal: New England Journal of Medicine (1962)

THIS historical case report deals with a portion of the distal third of a human radius, which was recently discovered in a mass battlefield grave of the Cold Harbor engagement, Hanover County, Virginia, by the use of the modern World War II mine detector.It was found that a metal pin through the distal third of the right radius of the forearm was causing the reaction of the mine detector. The portion of the bone found is demonstrated in Figure 1. An x-ray film of the bone showing the pin going through it, and adjacent to this film one of a . . .
Biochemical evidence for the rapid assembly and disassembly of processed antigen-major histocompatibility complex class II complexes in acidic vesicles of B cells.
Authors: E W Marsh, D P Dalke, S K Pierce
Journal: The Journal of Experimental Medicine (1992)

Helper T cell recognition of antigen requires that it be processed within antigen-presenting cells (APC) to peptide fragments that subsequently bind to major histocompatibility complex (MHC) class II molecules and are displayed on the APC surface. Heretofore, processed antigen-MHC class II complexes have been detected by functional assays, measuring the activation of specific T cells. We now report direct, biochemical evidence for the assembly of processed antigen-MHC class II complexes within splenic B cells as APC. The I-Ek MHC class II molecules were immunoprecipitated from B cells that had processed the model protein antigen cytochrome c radiolabeled across its entire length by reductive methylation of lysine residues and covalently coupled to Ig-specific antibodies, allowing internalization after binding to surface Ig. Our previous studies showed that I-Ek immunoaffinity purified from B cells that had processed cytochrome c contains functional processed antigen--MHC class II complexes and that approximately 0.2% of the I-Ek molecules are specifically associated with one of two predominant processed antigenic fragments. Here we show that these complexes are rapidly assembled, within 30-60 min after antigen binding to surface Ig on splenic B cells. Maximal numbers of complexes are assembled by 2 h in a process that is sensitive to acidic vesicle inhibitors but not to inhibitors of protein synthesis. The processed antigen-I-Ek complexes have a relatively short half-life of 2-4 h and are disassembled or degraded within 8 h after antigen is first internalized. The disassembly or degradation of the processed antigen-I-Ek complexes requires acidic vesicle function, and in the presence of an acidic vesicle inhibitor the complexes are long lived. Thus, using a biochemical assay to monitor processed antigen-I-Ek complexes, we find that, in B cells, processed antigen is relatively rapidly associated in acidic vesicles with preexisting MHC class II molecules, and the complexes are disassembled 4-6 h later in processes that also require acid vesicle function.
LONG–TERM RESULTS OF SELF–EXPANDABLE STENT IMPLANTATION TO CHRONIC TOTAL OCCLUSION IN SUPERFICIAL FEMORAL ARTERY OF TRANSATLANTIC INTER–SOCIETY CONSENSUS D
Authors: Junya Matsumi, Shigeru Saito, Satoshi Takeshita, Takeshi Akasaka, Saeko Takahashi, Yutaka Tanaka, Masato Murakami, Hidetaka Suenaga, Futoshi Yamanaka, Kazuya Sugitatsu, Nobuhiro Okamura
Journal: Journal of the American College of Cardiology (2013)
Development of Tolerance to Ergot Alkaloids in a Patient with Unusually Severe Migraine
Authors: William Q. Wolfson, John R. Graham
Journal: New England Journal of Medicine (1949)

ERGOTAMINE tartrate (Gynergen) and the closely related dihydroergotamine methylsulfate (D.H.E. 45) appear to be the most successful pharmacologic agents yet proposed for the treatment of migraine attacks. Careful study of the properties and liabilities of these agents is justified by the fact that they may become irreplaceable in the treatment of very severe migraine unless the risks of narcotic addiction or intracranial surgery are to be assumed. It seems worth while, therefore, to report a case in which tolerance to these drugs developed and to describe the heroic measures that subsequently became necessary to control the patient's pain.When properly . . .