tbuckley/cabot-search huggingface dataset:
The Care of the Aged, the Dying and the Dead
Authors: Arlie V. Bock
Journal: JAMA (1962)

This small volume of 3 lectures, classics of their kind, was first published in 1935 and now appears in a fourth printing. The views expressed are those of an outstanding family physician and reflect the result of more than 50 years of intimate knowledge gained through the care of his patients in their own homes. Dr. Worcester stresses repeatedly that his interest is not with disease, nor with scientific medicine, but with the art of medicine dealing as it should with the patient as a person who also has a family. In contrast to the growing interest and knowledge in the field of pediatrics, the author is concerned with the paucity of both literature and interest in senescence. "Normal babies perhaps can be cared for by the wholesale; not so old men and women. They need individual attention." He thus states his case in moving prose; "In normal senescence labor
CTLA4 blockade with ipilimumab to treat relapse of malignancy after allogeneic hematopoietic cell transplantation
Authors: Asad Bashey, Bridget Medina, Sue Corringham, Mildred Pasek, Ewa Carrier, Linda Vrooman, Israel Lowy, Scott R. Solomon, Lawrence E. Morris, H. Kent Holland, James R. Mason, Edwin P. Alyea, Robert J. Soiffer, Edward D. Ball
Journal: Blood (2008)
The Association Between Dietary Sodium Intake, ESRD, and All-Cause Mortality in Patients With Type 1 Diabetes
Authors: Merlin C. Thomas, John Moran, Carol Forsblom, Valma Harjutsalo, Lena Thorn, Aila Ahola, Johan Wadén, Nina Tolonen, Markku Saraheimo, Daniel Gordin, Per-Henrik Groop
Journal: Diabetes Care (2011)

Many guidelines recommend reduced consumption of salt in patients with type 1 diabetes, but it is unclear whether dietary sodium intake is associated with mortality and end-stage renal disease (ESRD).In a nationwide multicenter study (the FinnDiane Study) between 1998 and 2002, 2,807 enrolled adults with type 1 diabetes without ESRD were prospectively followed. Baseline urinary sodium excretion was estimated on a 24-h urine collection. The predictors of all-cause mortality and ESRD were determined by Cox regression and competing risk modeling, respectively.The median follow-up for survival analyses was 10 years, during which 217 deaths were recorded (7.7%). Urinary sodium excretion was nonlinearly associated with all-cause mortality, such that individuals with the highest daily urinary sodium excretion, as well as the lowest excretion, had reduced survival. This association was independent age, sex, duration of diabetes, the presence and severity of chronic kidney disease (CKD) (estimated glomerular filtration rate [eGFR] and log albumin excretion rate), the presence of established cardiovascular disease, and systolic blood pressure. During follow-up, 126 patients developed ESRD (4.5%). Urinary sodium excretion was inversely associated with the cumulative incidence of ESRD, such that individuals with the lowest sodium excretion had the highest cumulative incidence of ESRD.In patients with type 1 diabetes, sodium was independently associated with all-cause mortality and ESRD. Although we have not demonstrated causality, these findings support the calls for caution before applying salt restriction universally. Clinical trials must be performed in diabetic patients to formally test the utility/risk of sodium restriction in this setting.
Selective Inhibition of Factor Xa Is More Efficient Than Factor VIIa–Tissue Factor Complex Blockade at Facilitating Coronary Thrombolysis in the Canine Model
Authors: Jeffrey Lefkovits, Janis L. Malycky, J. Sunil Rao, Charles E. Hart, Edward F. Plow, Eric J. Topol, Francesca A. Nicolini
Journal: Journal of the American College of Cardiology (1996)
Preservation From Left Ventricular Remodeling by Front-Integrated Revascularization and Stem Cell Liberation in Evolving Acute Myocardial Infarction by Use of Granulocyte-Colony–Stimulating Factor (FIRSTLINE-AMI)
Authors: Hüseyin Ince, Michael Petzsch, Hans Dieter Kleine, Heike Schmidt, Tim Rehders, Thomas Körber, Carl Schümichen, Mathias Freund, Christoph A. Nienaber
Journal: Circulation (2005)

Considering experimental evidence that stem cells enhance myocardial regeneration and granulocyte colony-stimulating factor (G-CSF) mediates mobilization of CD34+ mononuclear blood stem cells (MNCCD34+), we tested the impact of G-CSF integrated into primary percutaneous coronary intervention (PCI) management of acute myocardial infarction in man.Fifty consecutive patients with ST-segment elevation myocardial infarction were subjected to primary PCI stenting with abciximab and followed up for 6 months; 89+/-35 minutes after successful PCI, 25 patients were randomly assigned in this pilot study (PROBE design) to receive subcutaneous G-CSF at 10 microg/kg body weight for 6 days in addition to standard care, including aspirin, clopidogrel, an ACE inhibitor, beta-blocking agents, and statins. By use of CellQuest software on peripheral blood samples incubated with CD45 and CD34, mobilized MNCCD34+ were quantified on a daily basis. With homogeneous demographics and clinical and infarct-related characteristics, G-CSF stimulation led to mobilization of MNCCD34+ to between 3.17+/-2.93 MNCCD34+/microL at baseline and 64.55+/-37.11 MNCCD34+/microL on day 6 (P<0.001 versus control); there was no indication of leukocytoclastic effects, significant pain, impaired rheology, inflammatory reactions, or accelerated restenosis at 6 months. Within 35 days, G-CSF and MNCCD34+ liberation led to enhanced resting wall thickening in the infarct zone of between 0.29+/-0.22 and 0.99+/-0.32 mm versus 0.49+/-0.29 mm in control subjects (P<0.001); under inotropic challenge with dobutamine (10 microg.kg(-1).min(-1)), wall motion score index showed improvement from 1.66+/-0.23 to 1.41+/-0.21 (P<0.004 versus control) and to 1.35+/-0.24 after 4 months (P<0.001 versus control), respectively, coupled with sustained recovery of wall thickening to 1.24+/-0.31 mm (P<0.001 versus control) at 4 months. Accordingly, resting wall motion score index improved with G-CSF to 1.41+/-0.25 (P<0.001 versus control), left ventricular end-diastolic diameter to 55+/-5 mm (P<0.002 versus control), and ejection fraction to 54+/-8% (P<0.001 versus control) after 4 months. Morphological and functional improvement with G-CSF was corroborated by enhanced metabolic activity and 18F-deoxyglucose uptake in the infarct zone (P<0.001 versus control).G-CSF and mobilization of MNC(CD34+) after reperfusion of infarcted myocardium may offer a pragmatic strategy for preservation of myocardium and prevention of remodeling without evidence of aggravated restenosis.
Low-Level Lead Exposure and Elevations in Blood Pressure during Pregnancy
Authors: Ellen M. Wells, Ana Navas-Acien, Julie B. Herbstman, Benjamin J. Apelberg, Ellen K. Silbergeld, Kathleen L. Caldwell, Robert L. Jones, Rolf U. Halden, Frank R. Witter, Lynn R. Goldman
Journal: Environmental Health Perspectives (2011)

Lead exposure is associated with elevated blood pressure during pregnancy; however, the magnitude of this relationship at low exposure levels is unclear.Our goal was to determine the association between low-level lead exposure and blood pressure during late pregnancy.We collected admission and maximum (based on systolic) blood pressures during labor and delivery among 285 women in Baltimore, Maryland. We measured umbilical cord blood lead using inductively coupled plasma mass spectrometry. Multivariable models were adjusted for age, race, median household income, parity, smoking during pregnancy, prepregnancy body mass index, and anemia. These models were used to calculate benchmark dose values.Geometric mean cord blood lead was 0.66 μg/dL (95% confidence interval, 0.61-0.70). Comparing blood pressure measurements between those in the highest and those in the lowest quartile of lead exposure, we observed a 6.87-mmHg (1.51-12.21 mmHg) increase in admission systolic blood pressure and a 4.40-mmHg (0.21-8.59 mmHg) increase in admission diastolic blood pressure after adjustment for confounders. Corresponding values for maximum blood pressure increase were 7.72 (1.83-13.60) and 8.33 (1.14-15.53) mmHg. Benchmark dose lower limit values for a 1-SD increase in blood pressure were < 2 μg/dL blood lead for all blood pressure end points.A significant association between low-level lead exposures and elevations in maternal blood pressure during labor and delivery can be observed at umbilical blood lead levels < 2 μg/dL.
The Importance of Severity of Illness in Assessing Hospital Mortality
Authors: Jesse Green
Journal: JAMA (1990)

Each year, the Health Care Financing Administration (HCFA) releases a report comparing hospital mortality rates with predicted rates. Some argue that the HCFA's prediction model does not adequately account for patient severity. We tested this hypothesis by comparing the HCFA's model (replicated as closely as we could) to a second that added a severity measure (the Stage of Principal Diagnosis at Admission, a subscale of the Severity of Illness Index). In our simulation, the HCFA's model had very limited capacity to predict mortality (average R2, 2.5%). Patients grouped according to admission severity had markedly different mortality rates, which the HCFA's model's predictions could not differentiate. The HCFA model also failed to predict large differences in mortality between hospitals with low- and high-severity admissions. Adding severity to the HCFA's model yielded more than an eightfold increase in the R2, to 21.5%, and reduced instances of higher than expected hospital mortality to chance levels. These findings suggest that the HCFA's mortality release needs to be made much more sensitive to admission severity before it can be used to make valid inferences about the quality or effectiveness of hospital care.
P2-039: Mechanisms controlling survival and induction of apoptosis following 12-lipoxygenase (LOX) inhibition in non small cell lung cancer (NSCLC)
Authors: Vikki Campbell, Joanne Lysaght, Kathy Gately, Elaine Kay, John Reynolds, Graham P. Pidgeon, Kenneth J. O’Byrne
Journal: Journal of Thoracic Oncology (2007)
Clinical Outcome of Patients with HIV-1 Infection according to Immunologic and Virologic Response after 6 Months of Highly Active Antiretroviral Therapy
Authors: Sophie Grabar
Journal: Annals of Internal Medicine (2000)

Background: The prognostic value of discordant immunologic (CD4 cell increase) and virologic (plasma HIV RNA level decrease) responses to antiretroviral treatment is not known. Objective: To study the relation between clinical outcome of HIV-infected patients receiving highly active antiretroviral therapy (HAART) and early immunologic and virologic responses to such therapy. Design: Prospective cohort study. Setting: 68 hospitals in France. Patients: 2236 protease inhibitor–naive patients. Intervention: Initiation of HAART with one protease inhibitor and two nucleoside analogues between July 1996 and March 1997. Measurements: Immunologic and virologic response at 6 months. Multivariate Cox models were used to assess the relation between these responses and progression to a new AIDS-defining event or death. Results: On the basis of 6-month immunologic and virologic responses, patients were classified into four groups: complete response (47.5%), complete nonresponse (16.2%), immunologic response only (19.0%), and virologic response only (17.3%). After month 6 and within a median of 18 months, 69 patients died and 123 experienced a new AIDS-defining event. After adjustment, complete nonresponders and those with only a virologic response had significantly higher risks for clinical progression at 6 months (relative risk, 3.38 [95% CI, 2.28 to 5.02] and 1.98 [CI, 1.26 to 3.10], respectively) than complete responders. The difference between complete responders and those with only an immunologic response at 6 months was weaker and nonsignificant (relative risk, 1.55 [CI, 0.96 to 2.50]). Conclusions: Immunologic response after 6 months of HAART indicates a favorable clinical outcome in HIV-infected patients regardless of virologic response. This suggests that both immunologic and virologic markers should be used in clinical practice to evaluate treatment response.
Are the New Policies on Hyperandrogenism in Elite Female Athletes Really Out of Bounds? Response to “Out of Bounds? A Critique of the New Policies on Hyperandrogenism in Elite Female Athletes”
Authors: Stéphane Bermon, Martin Ritzén, Angelica Lindén Hirschberg, Thomas H. Murray
Journal: The American Journal of Bioethics (2013)

Women are participating in sport in ever-increasing numbers. Those with the opportunity to compete at the elite level should be provided with a fair chance to win based on their talent and dedicati...
Simultaneous Right and Left Heart Real-Time, Free-Breathing CMR Flow Quantification Identifies Constrictive Physiology
Authors: Paaladinesh Thavendiranathan, David Verhaert, Michael C. Walls, Jacob A. Bender, Sanjay Rajagopalan, Yiu-Cho Chung, Orlando P. Simonetti, Subha V. Raman
Journal: JACC. Cardiovascular imaging (2012)
Biventricular Response After Pulmonary Valve Replacement for Right Ventricular Outflow Tract Dysfunction
Authors: Alessandra Frigiola, Victor Tsang, Catherine Bull, Louise Coats, Sachin Khambadkone, Graham Derrick, Bryan Mist, Fiona Walker, Carin van Doorn, Philipp Bonhoeffer, Andrew M. Taylor
Journal: Circulation (2008)

Background— The timing of pulmonary valve replacement (PVR) for free pulmonary incompetence in patients with congenital heart disease remains a dilemma for clinicians. We wanted to assess the determinants of improvement after PVR for pulmonary regurgitation over a wide range of patient ages and to use any identified predictors to compare clinical outcomes between patient groups. Methods and Results— Seventy-one patients (mean age 22±11 years; range, 8.5 to 64.9; 72% tetralogy of Fallot) underwent PVR for severe pulmonary regurgitation. New York Heart Association class improved after PVR (median of 2 to 1, P &lt;0.0001). MRI and cardiopulmonary exercise testing were performed before and 1 year after intervention. After PVR, there was a significant reduction in right ventricular volumes (end diastolic volume 142±43 to 91±18, end systolic volume 73±33 to 43±14 mL/m 2 , P &lt;0.0001), whereas left ventricular end diastolic volume increased (66±12 to 73±13 mL/m 2 , P &lt;0.0001). Effective cardiac output significantly increased (right ventricular: 3.0±0.8 to 3.3±0.8 L/min, P =0.013 and left ventricular: 3.0±0.6 to 3.4±0.7 L/min, P &lt;0.0001). On cardiopulmonary exercise testing, ventilatory response to carbon dioxide production at anaerobic threshold improved from 35.9±5.8 to 34.1±6.2 ( P =0.008). Normalization of ventilatory response to carbon dioxide production was most likely to occur when PVR was performed at an age younger than 17.5 years ( P =0.013). Conclusions— A relatively aggressive PVR policy (end diastolic volume &lt;150 mL/m 2 ) leads to normalization of right ventricular volumes, improvement in biventricular function, and submaximal exercise capacity. Normalization of ventilatory response to carbon dioxide production is most likely to occur when surgery is performed at an age ≤17.5 years. This is also associated with a better left ventricular filling and systolic function after surgery.
Occupational asthma in a hairdresser caused by persulphate salts
Authors: F. M. Parra, J. M. Igea, S. Quirce, M. C. Ferrando, J. A. Martin, E. Losada
Journal: Allergy (1992)

Persulphate salts, which are common constituents of hair bleaches, have occasionally been reported to cause occupational asthma in hairdressers. We describe the clinical and immunological studies carried out in a hairdresser who developed cutaneous and respiratory symptoms, about 1 year after being employed in a hairdressing salon. Skin prick tests with 1:5 w/v potassium and sodium persulphate extracts were positive in our patient at 15 min and negative in control subjects. The European standard contactans (ECDRG) and a battery of hairdressing agents were patch tested with positive result to KATHON CG (isothiazolinone). The methacholine‐inhalation test showed airway hyper responsiveness. Bronchial provocation test with a 1:50 w/v potassium persulphate extract elicited a non immediate asthmatic reaction, followed by recurrent nocturnal fall in FEV, lasting up to 3 days after the test. Plethysmography results revealed air trapping caused by a marked increase of airway resistance 3 h after the specific bronchial challenge. Histamine release test was not conclusive, and the determinations of specific IgA, IgM, IgG and IgG subclasses by EIA and IgE by RAST against persulphate salts were negative.
Single Versus Combined Blood Pressure Components and Risk for Cardiovascular Disease
Authors: Stanley S. Franklin, Victor A. Lopez, Nathan D. Wong, Gary F. Mitchell, Martin G. Larson, Ramachandran S. Vasan, Daniel Levy
Journal: Circulation (2009)

The utility of single versus combined blood pressure (BP) components in predicting cardiovascular disease (CVD) events is not established. We compared systolic BP (SBP) and diastolic BP (DBP) versus pulse pressure (PP) and mean arterial pressure (MAP) combined and each of these 4 BP components alone in predicting CVD events.In participants in the original (n=4760) and offspring (n=4897) Framingham Heart Study who were free of CVD events and BP-lowering therapy, 1439 CVD events occurred over serial 4-year intervals from 1952 to 2001. In pooled logistic regression with the use of BP categories, combining SBP with DBP and PP with MAP improved model fit compared with individual BP components (P<0.05 to P<0.0001). Significant interactions were noted between SBP and DBP (P=0.02) and between PP and MAP (P=0.01) in their respective multivariable models. Models with continuous variables for SBP+DBP and PP+MAP proved identical in predicting CVD events (Akaike Information Criteria=10 625 for both). Addition of a quadratic DBP(2) term to DBP and SBP further improved fit (P=0.0016).Combining PP with MAP and SBP with DBP produced models that were superior to single BP components for predicting CVD, and the extent of CVD risk varied with the level of each BP component. The combination of PP+MAP (unlike SBP+DBP) has a monotonic relation with risk and may provide greater insight into hemodynamics of altered arterial stiffness versus impaired peripheral resistance but is not superior to SBP+DBP in predicting CVD events.
NEUROHUMORAL RESPONSE AFTER TRANSCATHETER AORTIC VALVE IMPLANTATION
Authors: Rodrigo Hernán Bagur, Haïfa Mahjoub, Éric Dumont, Robert de Larochellière, Daniel Doyle, Mélanie Côté, Jacques Villeneuve, Olivier F. Bertrand, Philippe Pibarot, Josep Rodés-Cabau
Journal: Journal of the American College of Cardiology (2011)
Whooping cough in adults.
Authors: B Trollfors, E Rabo
Journal: BMJ (1981)

During the 1970s whooping cough returned in Sweden after an absence of more than 10 years and is now seen in all age groups, During a three-year period 174 adults with culture-verified whooping cough were identified in Gothenburg. Most of the patients had typical symptoms with whooping attacks and often vomiting. The disease was long lasting but complications were rare. Physicians should be aware that whooping cough may occur in adults, since adults may be an important source of infection for infants and erythromycin given in the catarrhal phase may modify the clinical course.
Tolerance and efficacy of oral ribavirin treatment of chronic hepatitis C: A multicenter trial
Authors: H C Bodenheimer, K L Lindsay, G L Davis, J H Lewis, S N Thung, L B Seeff
Journal: Hepatology (1997)

Hepatitis C is a common cause of chronic liver disease that may progress to cirrhosis. We conducted a multicenter double-blind placebo-controlled trial of ribavirin 600 mg given orally twice daily for 36 weeks with follow-up off therapy for an additional 16 weeks. Fifty-nine patients with compensated chronic hepatitis C were entered. Efficacy was measured at the end of therapy and after follow-up by normalization of alanine aminotransferase (ALT), improvement in liver histology, reduction in hepatitis C virus (HCV) RNA level and improvement of symptoms. Among the ribavirin recipients, 12 of 29 (41.4%) had normal ALT values at 36 weeks compared with only 1 of 30 (3.3%) placebo recipients (P &lt; .001). No patient maintained a normal ALT when therapy was stopped. No significant decrease in level of HCV RNA was observed during the study. Histological improvement among subjects who normalized ALT (-1.67 Knodell index) was significantly greater than that in other treated patients (+0.33 Knodell index; P &lt; .05). Fatigue improved in 19.2% of ribavirin-treated subjects and in 8.3% of placebo recipients whereas no worsening of fatigue was reported by ribavirin recipients compared with 16.7% of controls. This difference in fatigue was significant at weeks 36 and 52 (P &lt; .05; .02, respectively). Adverse events were generally comparable between treatment groups except for a reversible hemolytic anemia experienced by ribavirin recipients. Chest pain was noted in four patients on ribavirin. Ribavirin was well tolerated and improved aminotransferase values and reduced fatigue in patients with hepatitis C viral infection while treatment was being administered. Because this action was produced without change in viral level, the mechanism of action of this agent requires further investigation.
Parsimony, Likelihood, and the Role of Models in Molecular Phylogenetics
Authors: Mike Steel, David Penny
Journal: Molecular Biology and Evolution (2000)

Methods such as maximum parsimony (MP) are frequently criticized as being statistically unsound and not being based on any "model." On the other hand, advocates of MP claim that maximum likelihood (ML) has some fundamental problems. Here, we explore the connection between the different versions of MP and ML methods, particularly in light of recent theoretical results. We describe links between the two methods—for example, we describe how MP can be regarded as an ML method when there is no common mechanism between sites (such as might occur with morphological data and certain forms of molecular data). In the process, we clarify certain historical points of disagreement between proponents of the two methodologies, including a discussion of several forms of the ML optimality criterion. We also describe some additional results that shed light on how much needs to be assumed about underling models of sequence evolution in order to successfully reconstruct evolutionary trees.
The Psychiatrist as Physician
Authors: James F. Maddux
Journal: JAMA (1976)

<h3>To the Editor.—</h3> In his commentary on "The Psychiatrist as Physician" (234:603, 1975), Dr Ludwig suggested that we define mental illness as any debilitating cognitive-affective-behavior disorder due primarily to known, suggestive, or presumed biological brain dysfunction. In his proposed concept of mental illness, he includes alcoholism, drug dependence, and anxiety neurosis. He excludes social adjustment reactions, character disorders, and some other conditions because, he presumes, these occur with intact neurophysiological function and are produced primarily by psychosocial variables. Anxiety neurosis may indeed, as Dr Ludwig implies, arise from brain dysfunction, but in modern textbooks of psychiatry, its cause is usually attributed to adverse psychosocial experience. Character disorders may also arise from brain dysfunction, but their cause is often attributed to psychosocial experience. Since presuming is allowed, we could presume that chronic psychosocial stress leads to persisting electrochemical dysfunction in the brain, and that this brain dysfunction then continues to produce