tbuckley/cabot-search huggingface dataset:
Outcomes and Associated Risk Factors for Aortic Valve Replacement in 160 Children
Authors: Tara Karamlou, Karen Jang, William G. Williams, Christopher A. Caldarone, Glen Van Arsdell, John G. Coles, Brian W. McCrindle
Journal: Circulation (2005)

Background— We sought to define patient characteristics, outcomes, and associated risk factors after aortic valve replacement (AVR) in children. Methods and Results— Clinical records from children undergoing AVR from 1974 to 2004 at our institution were reviewed. Competing-risks methodology determined the time-related prevalence of 3 mutually exclusive end states: death, repeated replacement, and survival without subsequent AVR and their associated risk factors. Longitudinal echocardiographic data were analyzed by mixed linear-regression models. Children (n=160) underwent 198 AVRs, with 33 having &gt;1. Competing-risks analysis predicted that 10 years from the initial AVR, 19% had died without subsequent AVR, 34% underwent a second AVR, and 47% remained alive without replacement. Risk factors for death without a second AVR included lower weight ( P &lt;0.001) and younger age at AVR ( P =0.04), performance of aortic arch reconstruction together with AVR ( P =0.03), and nonautograft use ( P =0.03). Risk factors for a second AVR included earlier operation year ( P =0.04) and implantation of a bioprosthetic or homograft valve ( P =0.004). Analysis of serial echocardiographic measurements showed that pulmonary autograft use was associated with slower progression of peak aortic gradient ( P =0.002), smaller left ventricular dimension ( P =0.04), and decreased prevalence of aortic regurgitation ( P =0.04). Conclusions— Mortality and repeated valve replacement are common after initial AVR in children, especially in younger patients and those with bioprosthetic or homograft valves. Pulmonary autograft use is associated with decreased mortality, slower gradient progression, and smaller left ventricular dimension.
Decision Model of Segmental Compared With Total Abdominal Colectomy for Colon Cancer in Hereditary Nonpolyposis Colorectal Cancer
Authors: Takafumi Maeda, Rebecca R. Cannom, Robert W. Beart, David A. Etzioni
Journal: Journal of Clinical Oncology (2010)

Purpose In choosing the appropriate surgical option for patients with colon cancer and Lynch syndrome, goals of treatment are to maximize life expectancy while preserving quality of life. This study constructs a decision model that encompasses these two related considerations. Methods We constructed a state-transition (Markov) model based on assumptions obtained from available data sources and published literature. Two strategies were considered for the treatment of colon cancer in a patient with Lynch syndrome: segmental colectomy (SEG) and total abdominal colectomy (TAC) with ileorectal anastomosis. Quality-adjusted life years (QALYs) were calculated based on utility states for patients based on the colectomy they received. Multiple sensitivity analyses were planned to examine the impact of each assumption on model results. Results For young (30-year-old) patients with Lynch syndrome, mean survival was slightly better with TAC than with SEG (34.8 v 35.5 years). When QALYs were considered, the two strategies were approximately equivalent, with QALYs per patient of 21.5 for SEG and 21.2 for TAC. With advancing age, SEG becomes a more favorable strategy. Results of our model were most sensitive to the utility state of TAC (relative to SEG), rates of metachronous occurrence, and stage of cancer at the time of such occurrence. Conclusion SEG and TAC are approximately equivalent strategies for patients with colon cancer and Lynch syndrome. The decision regarding which operation is preferable should be made on the basis of patient factors and preferences, with special emphasis on age and the ability of the patient to utilize intensive surveillance.
Fetal growth and subsequent risk of breast cancer: results from long term follow up of Swedish cohort
Authors: V A McCormack
Journal: BMJ (2003)

To investigate whether size at birth and rate of fetal growth influence the risk of breast cancer in adulthood.Cohort identified from detailed birth records, with 97% follow up.Uppsala Academic Hospital, Sweden.5358 singleton females born during 1915-29, alive and traced to the 1960 census.Incidence of breast cancer before (at age <50 years) and after (> or = 50 years) the menopause.Size at birth was positively associated with rates of breast cancer in premenopausal women. In women who weighed > or =4000 g at birth rates of breast cancer were 3.5 times (95% confidence interval 1.3 to 9.3) those in women of similar gestational age who weighed <3000 g at birth. Rates in women in the top fifths of the distributions of birth length and head circumference were 3.4 (1.5 to 7.9) and 4.0 (1.6 to 10.0) times those in the lowest fifths (adjusted for gestational age). The effect of birth weight disappeared after adjustment for birth length or head circumference, whereas the effects of birth length and head circumference remained significant after adjustment for birth weight. For a given size at birth, gestational age was inversely associated with risk (P=0.03 for linear trend). Adjustment for markers of adult risk factors did not affect these findings. Birth size was not associated with rates of breast cancer in postmenopausal women.Size at birth, particularly length and head circumference, is associated with risk of breast cancer in women aged <50 years. Fetal growth rate, as measured by birth size adjusted for gestational age, rather than size at birth may be the aetiologically relevant factor in premenopausal breast cancer.
Melanin Pigmentation and Its Endocrine Control
Authors: Stanley Deutsch, Herbert Mescon
Journal: New England Journal of Medicine (1957)

OBSERVATIONS of the differences in pigmentation in the races of man and in animals may be traced to the writings of Hippocrates, Aristotle, Galen, Rhazes and Pliny. Their works indicated a recognition of the association of pigmented spots with pregnancy and general diseases and the relation between exposure to sunlight and increased pigmentation of the skin. The variations from normal pigmentation were referred to as chloasma and melasma. Deposition of pigment was thought to be due to the mixing of the bile or to an inspissation of the "juices."1 Aristotle, in History of Animals, described the color changes of . . .
Funding policies for HIV and AIDS. Patients have access to palliative care.
Authors: A Tookman, A Kurowska
Journal: BMJ (1993)

teams to care for those with HIV infection or on the part of patients to use their general practitioners but because of a reluctance of hospital based teams to transfer responsibility to their colleagues in the community.The current arrangements for allocating funds to hospital based providers offer few incentives for HIV specialists to work with primary care teams.The failure to allocate resources to providers in the community must be urgently addressed by purchasers if general practitioners and district nurses are to be encouraged to participate in shared care for patients with HIV infection.
666 NON-INVASIVE DIAGNOSIS AND PROGNOSIS OF HEPATOCELLULAR CARCINOMA (HCC): PERFORMANCE OF PIVKA-II IN A WESTERN COHORT OF PATIENTS
Authors: V. Paradis, M. Albuquerque, M. Achahboun, H. Voitot, L. Castera, J. Belghiti, P. Bedossa
Journal: Journal of Hepatology (2013)
Use of Antihypertensive Medications and Breast Cancer Risk Among Women Aged 55 to 74 Years
Authors: Christopher I. Li, Janet R. Daling, Mei-Tzu C. Tang, Kara L. Haugen, Peggy L. Porter, Kathleen E. Malone
Journal: JAMA Internal Medicine (2013)

Antihypertensive agents are the most commonly prescribed class of medications in the United States. Evidence regarding the relationship between different types of antihypertensives and breast cancer risk is sparse and inconsistent, and prior studies have lacked the capacity to assess impacts of long-term use.To evaluate associations between use of various classes of antihypertensive medications and risks of invasive ductal and invasive lobular breast cancers among postmenopausal women.Population-based case-control study in the 3-county Seattle-Puget Sound metropolitan area. Participants were women aged 55 to 74 years, 880 of them with invasive ductal breast cancer, 1027 with invasive lobular breast cancer, and 856 with no cancer serving as controls.Recency and duration of use of antihypertensive medications.Risks of invasive ductal and invasive lobular breast cancers.Current use of calcium-channel blockers for 10 or more years was associated with higher risks of ductal breast cancer (odds ratio [OR], 2.4; 95% CI, 1.2-4.9) (P= .04 for trend) and lobular breast cancer (OR, 2.6; 95% CI, 1.3-5.3) (P= .01 for trend). This relationship did not vary appreciably by type of calcium-channel blocker used (short-acting vs long-acting, dihydropyridines vs non-dihydropyridines). In contrast, use of diuretics, β-blockers, and angiotensin II antagonists were not associated with risk.While some studies have suggested a positive association between calcium-channel blocker use and breast cancer risk, this is the first study to observe that long-term current use of calcium-channel blockers in particular are associated with breast cancer risk. Additional research is needed to confirm this finding and to evaluate potential underlying biological mechanisms.
Presymptomatic Wilson's disease: Further questions and comments
Authors: Harold O. Conn, Owen Epstein
Journal: Hepatology (1989)

In ninety families with at least one proven case of Wilson's disease, seen over 32 years, all close relatives were examined and “presymptomatic” disease was diagnosed in 30.11 had one or more abnormal physical signs when examined and 7 of these had Kayser Fleischer rings. In a further 10 patients the abnormalities of copper metabolism were so pronounced as to leave no doubt as to the diagnosis. 6 patients were not seen until they had been on treatment for 2 years or more; in some, much of the evidence on which the diagnosis was based is not available. In 3 patients there were only minor histological abnormalities in the liver and no increase in urinary copper but other indices of copper metabolism pointed to a diagnosis of Wilson's disease. 2 patients had transient neurological signs after starting treatment; otherwise, all but one (who died in an accident) have remained well for up to 26 years.
The relationship between alveolar epithelial proliferation and airway obstruction after ozone exposure
Authors: A.‐S. Jang, I.‐S. Choi, Y.‐I. Koh, C.‐S. Park, J.‐S. Lee
Journal: Allergy (2002)

Proliferating cell nuclear antigen (PCNA) is a component of multiprotein complexes that are expressed during cell proliferation. Ozone induces cell necrosis and a consequent increase in cell proliferation.To investigate the effects of acute ozone inhalation on cell proliferation and airway obstruction in BALB/C mice, we examined enhanced pause (Penh) as an index of airway obstruction and PCNA expression by immunohistochemical staining.Compared with controls that received filtered air, the ozone-exposed groups had increased PCNA expression in the alveolar epithelial cells. In rank order, the highest PCNA index was found following 2.0 p.p.m. ozone exposure. In the 2.0 p.p.m. ozone group, there was a PCNA index of 16.83 +/- 0.57% (mean +/- SEM; P< 0.01), compared with 4.25 +/- 0.5% at 0.12 p.p.m., 6.83 +/- 0.60 at 0.5 p.p.m and 12.16 +/- 0.48% at 1 p.p.m. Following ozone exposure, Penh was increased in a dose-dependent manner. There was a significant correlation between the PCNA index in alveoli and Penh (r = 0.63, P< 0.01).These data suggest that ozone can induce alveolar epithelial cell proliferation in a dose-dependent manner, and that alveolar epithelial cell proliferation is correlated with airway obstruction.
Stress proteins in medicine
Authors: V. Winrow
Journal: Annals of the Rheumatic Diseases (1996)

All cells have an innate response to physiological stress which results in the rapid synthesis of protective molecules termed heat shock or stress proteins.In the past 10 years, the heat shock response has figured prominently in the medical literature.A dominating concept has been that phylogenetic conservation of the highly immunogenic stress proteins leads to an inability of the immune system to discriminate between self and foreign antigens, thereby inducing immune mediated diseases ('autoimmunity').Consequently, Stress proteins in medicine has a strong immunological bias.Moreover, as early investigations were carried out in arthritis, it is perhaps not surprising that almost one quarter of the chapters are dedicated to rheumatological diseases.However, the complexities of this rapidly expanding field are exemplified by the fact that, in the 36 chapters of this book, although reference lists are extensive, there is remarkably little overlap.Structurally, the book has four sections.The first comprises five excellent introductory reviews on the classification, biochemistry, and immunopathogenicity of the stress proteins.There is excusable editorial indulgence, with a chapter dedicated to experimental arthritis!A second section of 15 chapters covers 'specific immune responses' to stress proteins.Here, the rheumatological bias is strong, with chapters on rheumatoid arthritis, juvenile chronic arthritis, systemic lupus erythematosus, Lyme disease and Behcet's disease.Nevertheless, infection, transplantation, infertility, and oncogenicity are explored, in addition to diabetes, Crohn's disease, and multiple sclerosis.The third section concentrates on involvement by association (stress protein expression in diseased tissue).Clinical conditions covered include asthma, cardiovascular and neuromuscular diseases, and gastroenteropathies.There is some overlap with
Epidemiology of Arterial Blood Pressure
Authors: Ancel Keys
Journal: JAMA (1981)

Hope for the prevention of coronary heart disease focuses on riskfactors identified by prospective studies. Among these, none is more important than the arterial blood pressure. Moreover, arterial pressure is in a class by itself as a risk factor for stroke. The editors of this book remind us that whereas coronary heart disease is mainly a problem for the more prosperous Western societies, elevated blood pressure is ubiquitous, except in some rare isolated groups. So, control of blood pressure is a prime challenge to public health everywhere. Four chapters concern methodology, stressing the need for standardized equipment and procedures and for measurements on repeated occasions before judging the blood pressure status. In those chapters, and elsewhere in the book, it is emphasized that the arterial pressure is a continuously distributed variable with the ill consequences following suit; the time is overdue to discard the artificial dichotomy of "hypertension" and "normotension."
Academic Geriatric Programs in US Allopathic and Osteopathic Medical Schools
Authors: Gregg A. Warshaw
Journal: JAMA (2002)

By 2030, 20% of the US population will be older than 65 years compared with 12.4% in 2000. The development of geriatric medicine research and training programs to prepare for this increasing number of older individuals is largely dependent on the successful establishment of academic geriatric medicine programs in medical schools.To assess the structure, resources, and activities of academic geriatric medicine programs in US allopathic and osteopathic schools of medicine.Survey distributed to the academic geriatric medicine leaders of the 144 US allopathic and osteopathic medical schools in March 2001.Organizational structure, program information, curriculum, budgetary issues, and characteristics of academic geriatric medicine leaders.A total of 121 program directors (84%) responded. Most schools (87%) had an identifiable academic geriatric program structure, with 67% established after 1984. The greatest proportion of faculty and staff time (40%) was spent in clinical practice, followed by research and scholarship (12%), residency and fellowship education (10% each), and medical student education (7.8%). Clinical practice accounted for the greatest portion (27%) of revenue, and 25.7% of the programs had total annual budgets of less than $250,000, while 11% had budgets of greater than $5 million. The largest obstacles to achieving the goals of an academic geriatric medicine program were a lack of research faculty and fellows and poor clinical reimbursement.Most US medical schools have an identifiable academic geriatric medicine program; most have been established within the last 15 years. Resources are needed to train faculty for roles as teachers and researchers and to develop medical school geriatric programs of the size and scope equivalent to other academic disciplines.
Assessment of Left Ventricular Mechanics Using Speckle Tracking Echocardiography in Patients with Subclinic Hypothyroidism
Authors: Yasemin Kaya, Havva Keskin, Kamuran Kalkan, Selim Topçu, İbrahim Halil Tanboğa, Ahmet Kaya, Enbiya Aksakal
Journal: Journal of the American College of Cardiology (2013)
Dr Theodore de Mayerne
Authors: Bernadine Z. Paulshock
Journal: JAMA (1981)

To the Editor.—  Until I read the fascinating and scholarly essay by M. Therese Southgate, MD (1981;245:427), I did not know that the redoubtable Dr Theodore Turquet de Mayerne was, in addition to being physician to two English kings, William Shakespeare's physician.  Mayerne's clientele alone, plus his having been painted by Rubens, would have secured him a place in medical history, but he had other even more important medical achievements.  Dr de Mayerne's influence with King James I was probably behind the King's decree in 1617 by which the Society of Apothecaries was chartered and their medicaments thus subject to regulation by the London College of Physicians. 1   A year later, the first London Pharmacopoeia was issued (in two editions). Mayerne wrote the preface as well as the chapter on those newfangled remedies, The Clinical Compounds. His belief in the therapeutic efficacy of various acids and salts was one of
STUDIES IN THE METABOLISM OF SODIUM r-LACTATE. I. RESPONSE OF NORMAL HUMAN SUBJECTS TO THE INTRAVENOUS INJECTION OF SODIUM r-LACTATE
Authors: Alexis F. Hartmann, Milton J.E. Senn
Journal: Journal of Clinical Investigation (1932)

Cunningham and Darrow (4) have recently overcome this objection by partly neutralizing sodium bicarbonate previously sterilized in the dry state with hydrochloric acid.
Adjusted Subcutaneous Heparin or Continuous Intravenous Heparin in Patients with Acute Deep Vein Thrombosis
Authors: D. J. DOYLE
Journal: Annals of Internal Medicine (1987)

Study Objective: To determine the efficacy and safety of adjusted subcutaneous calcium heparin compared with continuous intravenous calcium heparin as the initial treatment for acute deep vein thrombosis. Design: Randomized control trial. Setting: University-affiliated general hospital. Patients: Of 111 consecutive patients considered, 103 had acute proximal or calf vein thrombosis confirmed by ascending venography and met all other eligibility criteria. Interventions: Patients were randomly assigned to receive subcutaneous or intravenous heparin. The subcutaneous regimen consisted of an initial dose of 15 000 U, adjusted thereafter to prolong the activated partial thromboplastin time to 50 to 70 seconds. The continuous intravenous regimen was begun as a bolus injection of 5000 U, followed by an infusion of 1250 U/h, adjusted to maintain the activated partial thromboplastin time at 50 to 70 seconds. Measurements and Main Results: There was no significant difference in the rate of new pulmonary embolism between the two groups, as defined by new high-probability defect on repeat ventilation-perfusion scintigrams of the lung in 96 (93%) of the patients after 7 to 10 days of treatment. Five of forty-seven patients in the subcutaneous group and 5 of 49 in the intravenous group developed pulmonary embolism (95% confidence interval [CI] for the difference, -13.1% to 12.2%). Similarly, there was no significant difference in the frequency of hemorrhagic complications. Five of fifty-one patients in the subcutaneous group and 5 of 52 in the intravenous group had hemorrhagic complications (95% CI for the difference, -11.2% to 11.6%). Conclusion: Adjusted subcutaneous calcium heparin may be an effective and safe alternative to continuous intravenous calcium heparin in the initial treatment of acute proximal deep vein thrombosis.
Expression of fibroblast growth factor in the left ventricle of patients with idiopathic cardiomyopathy
Authors: Yoshifumi Tomita, Chikao Ibuki, Yasuhiro Nagae, Koichi Setsuta, Yoshihiko Seino, Kazuo Munakata, Hiroshi Kishida, Hirokazu Hayakawa
Journal: Journal of the American College of Cardiology (1996)
Aquagenic pruritus, PUVA and capsaicin treatments
Authors: G. Hautmann, P. Teofoli, T. Lotti
Journal: British Journal of Dermatology (1994)

Journal Article Aquagenic pruritus, PUVA and capsaicin treatments Get access G. Hautmann, G. Hautmann Department of Dermatology, University of florence, Italy Search for other works by this author on: Oxford Academic Google Scholar P. Teofoli, P. Teofoli Department of Dermatology, University of florence, Italy Search for other works by this author on: Oxford Academic Google Scholar T. Lotti T. Lotti Department of Dermatology, University of Siena, Italy Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 131, Issue 6, 1 December 1994, Pages 920–921, https://doi.org/10.1111/j.1365-2133.1994.tb08612.x Published: 01 December 1994
Neurologists Study Abnormal CSF, Stroke Associated With AIDS
Authors: Marsha F. Goldsmith
Journal: JAMA (1988)

STROKE IS 40 times more likely to occur in persons under 45 years of age who are infected with the human immunodeficiency virus (HIV) than in similarly aged noninfected persons, according to a report presented to the American Academy of Neurology. Speaking recently in Cincinnati at the group's 40th annual meeting, John Engstrom, MD, chief resident in neurology at the University of California, San Francisco, reported on a study of 1600 white male homosexuals with acquired immunodeficiency syndrome (AIDS) in which the frequency of stroke occurrence was 1%. The rate in the general population 35 to 45 years of age is 25 per 100000 (0.025%). Of 28 patients with severe neurological problems, Engstrom said, 13 had suffered cerebral infarction (stroke), 13 had transient neurological deficit, and two had both conditions. The youngest patient with stroke was 27 years old. Stroke was the initial manifestation of AIDS in nine of the
CLEANLINESS THE FIRST PRINCIPLE OF HYGIENE.
Authors: WILHELM HOTZ
Journal: JAMA (1897)

Hygiene, the science of health, is undoubtedly the first foundation of therapeutics, the science of restoring lost health, because without knowing the laws which maintain health, no physician can tell his patient the right way that leads him to health and give him the proper advice how to regain it. Hence disease, as we call lost health, must be in one or the other way the consequence of departure from the natural path of life, or, in other words, disease is the indication of the loss of the vital equilibrium; its symptoms are the manifestation of the vital force to regain the normal state. By studying such abnormal conditions and the way by which nature is seeking to lead the organism back to the prior state of health, we will find out not only the proper way of cure, but learn also how to keep up our health,<i>i. e</i>
103 RELATIVE ADRENAL INSUFFICIENCY IN CIRRHOSIS: RELEVANCE IN PATIENTS WITH ASCITES AND TREATMENT WITH HYDROCORTISONE IN REFRACTORY ASCITES
Authors: C. Alessandria, L. Mezzabotta, M. Carello, W. Debernardi-Venon, S. Martini, M. Rizzetto, A. Marzano
Journal: Journal of Hepatology (2009)