tbuckley/cabot-search huggingface dataset:
Cyclosporin in the treatment of Churg-Strauss syndrome
Authors: E M MCDERMOTT, R J POWELL
Journal: Annals of the Rheumatic Diseases (1998)

Churg-Strauss syndrome (CSS) is an eosinophilic granulomatous vasculitic condition associated with asthma or allergic rhinitis, or both.1 Established management of severe disease includes high dose corticosteroids and intravenous cyclophophamide therapy.2 We present a patient with CSS who was resistant to treatment with pulse intravenous cyclophosphamide but responded to cyclosporin therapy.

A 31 year old white woman was admitted to hospital with a 10 day history of pain and numbness in the left foot, an erythematous rash on her chest and lower legs, generalised myalgia, polyarthralgia, and fevers. She had a eight year history of asthma that had deteriorated over the previous 12 months. Examination revealed a vasculitic rash on the chest and lower legs and a peripheral sensory neuropathy affecting the left foot. She was found to have an increased …
Effect of intravesical mitomycin C on recurrence of newly diagnosed superficial bladder cancer: interim report from the Medical Research Council Subgroup on Superficial Bladder Cancer (Urological Cancer Working Party)
Authors: D A Tolley, T B Hargreave, P H Smith, J L Williams, K M Grigor, M K B Parmar, L S Freedman, B M Uscinska
Journal: BMJ (1988)

A randomised control trial of intravesical instillation of mitomycin C was conducted in 457 patients with cancer of the bladder that was confined to the submucosa on histological examination. The events studied were the recurrence free rate, the recurrence rate/year, and the number of new tumours developing/year. At the initial cystoscopy the tumours were completely resected and the patients randomised to have no instillation of mitomycin C, a single instillation of 40 mg in 40 ml of water at that cystoscopy, or a single instillation and then four further instillations. All patients had follow up cystoscopies every three months for the first year, twice in the second year, and yearly thereafter. After a median of 12 months, follow up information was available for 397 patients. Patients receiving both the single instillation of mitomycin C and the instillations at five cystoscopic examinations had significantly lower yearly recurrence rates and tumour rates than those in the control group, and the group receiving multiple instillations fared significantly better than those receiving a single instillation. The figures on progression to invasive cancer were too small to allow conclusions to be drawn.
Progressive Disseminated Histoplasmosis
Authors: JAMES W. SMITH
Journal: Annals of Internal Medicine (1972)

The clinical, laboratory, and histopathologic features of progressive disseminated histoplasmosis in 26 patients were studied prospectively. The diagnosis was proved by culturing the fungus from bone marrow and blood, in most cases, or by culturing tissues such as oral lesions, lymph nodes, or liver. Serologic studies and skin testing were considerably less valuable. Liver involvement was a prominent feature in most cases. Hematologic abnormalities (anemia and thrombocytopenia) and pulmonary abnormalities were present in half the patients, and renal abnormalities and oral mucosal lesions were present in slightly less than half. Less common manifestations included meningitis, endocarditis, adrenal insufficiency, and gastrointestinal and cutaneous lesions. Amphotericin B was an effective agent in most patients, but relapses of infection occurred in half of those with favorable response.
Judge rules out coercion for liver transplant boy
Authors: F B Charatan
Journal: BMJ (1994)

The case of a 15 year old Florida boy who is facing a possible third liver transplant operation is posing a difficult problem for doctors and medical ethicists at Jackson Memorial Hospital in Miami.

Benito Agrelo was born jaundiced and with an enlarged liver and spleen. Dr Andreas G Tzakis performed Agrelo's first liver transplant operation in 1987 at Pittsburgh Children's Hospital when the boy was 8. After the first transplant failed Dr Tzakis did a second liver transplant operation in June 1992. Agrelo was then given the immunosuppressant drug FK506, …
Insulin Resistance, the Metabolic Syndrome, and Complication Risk in Type 1 Diabetes
Authors: Eric S. Kilpatrick, Alan S. Rigby, Stephen L. Atkin
Journal: Diabetes Care (2007)

The presence of insulin resistance and the metabolic syndrome are known risk markers for macrovascular disease in patients with and without type 2 diabetes. This study has examined whether these also were predictors of micro- and macrovascular complications in type 1 diabetic patients participating in the Diabetes Control and Complications Trial (DCCT).International Diabetes Federation (IDF) criteria were used to identify the metabolic syndrome in 1,337 Caucasian DCCT patients at baseline. Insulin resistance was calculated using their estimated glucose disposal rate (eGDR). Insulin dose (units/kg) was also used as a separate marker of insulin resistance.The eGDR (but not insulin dose or metabolic syndrome) at baseline strongly predicted the development of retinopathy, nephropathy, and cardiovascular disease (hazard ratios 0.75, 0.88, and 0.70, respectively, per mg x kg(-1) x min(-1) change; P < 0.001, P = 0.005, and P = 0.002, respectively). Through mainly weight gain, the prevalence of the metabolic syndrome increased steadily from baseline to year 9 in conventionally treated (from 15.5 to 27.2%) and especially in the intensively treated (from 13.7 to 45.4%) patients.Higher insulin resistance at baseline in the DCCT (as estimated by eGDR) was associated with increased subsequent risk of both micro- and macrovascular complications. Insulin dose and the presence of IDF-defined metabolic syndrome were poor predictors by comparison. Although intensive treatment was associated with a higher subsequent prevalence of metabolic syndrome, the benefits of improved glycemia appear to outweigh the risks related to development of the metabolic syndrome.
Complete antithrombin deficiency in mice results in embryonic lethality
Authors: Kazuhiro Ishiguro, Tetsuhito Kojima, Kenji Kadomatsu, Yukiko Nakayama, Akira Takagi, Misao Suzuki, Naoki Takeda, Masafumi Ito, Koji Yamamoto, Tadashi Matsushita, Kazuo Kusugami, Takashi Muramatsu, Hidehiko Saito
Journal: Journal of Clinical Investigation (2000)

Antithrombin is a plasma protease inhibitor that inhibits thrombin and contributes to the maintenance of blood fluidity. Using targeted gene disruption, we investigated the role of antithrombin in embryogenesis. Mating mice heterozygous for antithrombin gene (ATIII) disruption, ATIII+/–, yielded the expected Mendelian distribution of genotypes until 14.5 gestational days (gd). However, approximately 70% of the ATIII–/– embryos at 15.5 gd and 100% at 16.5 gd had died and showed extensive subcutaneous hemorrhage. Histological examination of those embryos revealed extensive fibrin(ogen) deposition in the myocardium and liver, but not in the brain or lung. Furthermore, no apparent fibrin(ogen) deposition was detected in the extensive hemorrhagic region, suggesting that fibrinogen might be decreased due to consumptive coagulopathy and/or liver dysfunction. These findings suggest that antithrombin is essential for embryonic survival and that it plays an important role in regulation of blood coagulation in the myocardium and liver.
FRACTURE OF THE SUPERIOR MAXILLA IN A MAN 70 YEARS OLD, WITH RECOVERY.
Authors: VIDA A. LATHAM
Journal: JAMA (1900)

The subject of fractures of the superior maxilla must always be of interest to some of the profession. As a general rule, perhaps the injury comes first to the general surgeon, who may or may not call in a skilled dentist to assist him. In many instances, I am afraid a general practitioner is not as well informed in the treatment as he should be from a dental standpoint, and it is not to be wondered at when we consult our text-books or journals of surgery on the subject—the information being exceedingly meager and ancient. It may again be asked: Is the dental surgeon, unless doubly qualified,<sup>1</sup>capable of taking entire charge of such cases, especially as the injury is usually severe and may have complications, as shock, hemorrhage, meningitis and septicemia? The position of a dentist has recently been decided in at least one of the states by
GRANULOMA ANNULARE: TREATMENT WITH VITAMIN E.
Authors: THOMAS COCHRANE
Journal: British Journal of Dermatology (1950)

Journal Article GRANULOMA ANNULARE: TREATMENT WITH VITAMIN E. Get access THOMAS COCHRANE, B.Sc., M.D. THOMAS COCHRANE, B.Sc., M.D. Assistant Physician, Department of Dermatology, Royal Infirmary, Glasgow Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology and Syphilis, Volume 62, Issue 7-8, 1 July 1950, Pages 316–318, https://doi.org/10.1111/j.1365-2133.1950.tb15668.x Published: 01 July 1950
Radiofrequency Catheter Ablation of Atrial Flutter
Authors: Herve Poty, Nadir Saoudi, Mohan Nair, Frederic Anselme, Brice Letac
Journal: Circulation (1996)

Background Radiofrequency ablation of type 1 atrial flutter (AFl) has recently evolved toward an anatomically guided procedure directed to isthmuses at the lower part of the right atrium (RA). However, different types of block at these isthmuses may be observed and potentially correlated with different late outcomes. In addition, because the ablation is anatomically guided, ablation should be possible during sinus rhythm. Methods and Results Forty-four patients underwent ablation of type 1 AFl performed during ongoing tachycardia (33 patients) or sinus rhythm (11 patients). Evidence of inferior vena cava–tricuspid annulus isthmus block was assessed by changes in RA impulse propagation while pacing from both sides of the ablation site. Apparent complete isthmus block was achieved in 43 of 44 patients with 9±7 pulses. However, incomplete block mimicking complete block because of intra-atrial conduction delay but leading to a different low RA activation pattern was individualized. At the end of the procedure, isthmus block was complete in 35 patients and incomplete in 8, but since AFl reinduction was no longer possible, patients were discharged. During a follow-up period of 12.1±5.5 months, 4 patients experienced AFl recurrence; all had shown incomplete or no block. Conclusions Detailed multiple-point low RA mapping is necessary to differentiate incomplete from complete isthmus block. Complete block is the best marker for long-term success of AFl ablation, although incomplete block may be sufficient to prevent recurrence in a significant number of cases. Isthmus block is achievable during sinus rhythm, and AFl induction is not mandatory.
Acute intermittent porphyria associated with hypoganglionosis in a young adult
Authors: A Hadary
Journal: Gut (2006)

<h3>Abstract</h3> The cell cycle is thought to be initiated by cyclin-dependent kinases (Cdk) inactivating transcriptional inhibitors of cell cycle gene-expression<i>(1, 2)</i>. In budding yeast, the G1 cyclin Cln3-Cdk1 complex is thought to directly phosphorylate Whi5, thereby releasing the transcription factor SBF and committing cells to division<i>(3-7)</i>. Here, we report that Cln3-Cdk1 does not phosphorylate Whi5, but instead phosphorylates the RNA Polymerase II subunit Rpb1’s C-terminal domain (CTD) on S<sub>5</sub> of its heptapeptide repeats. Cln3-Cdk1 binds SBF-regulated promoters<i>(8)</i> and Cln3’s function can be performed by the canonical S<sub>5</sub> kinase<i>(9)</i> Ccl1-Kin28 when synthetically recruited to SBF. Thus, Cln3-Cdk1 triggers cell division by phosphorylating Rpb1 at SBF-regulated promoters to activate transcription. Our findings blur the distinction between cell cycle and transcriptional Cdks to highlight the ancient relationship between these processes.
Renal Transplantation between HLA Identical Siblings
Authors: J. S. Cheigh, J. Chami, K. H. Stenzel, R. R. Riggio, S. Saal, J. A. Mouradian, M. Fotino, W. T. Stubenbord, A. L. Rubin
Journal: New England Journal of Medicine (1977)

We compared 26 HLA-A, B identical sibling kidney-transplant recipients followed for one to 10 years, with 104 HLA-A, B semi-identical kidney recipients from living, related donors to determine clinical differences. Graft-survival rates were significantly better in the HLA identical group at two years (85 per cent identical versus 53 per cent in semi-identical, P less than 0.005); patient-survival rates were high for both (96 per cent in identical and 87 per cent in semi-identical at two years, P less than 0.005). The incidence of complications was similar in HLA identical and semi-identical recipients. Nine of the 26 grafts in HLA identical recipients failed one week to eight years after transplantation. Rejection caused most of the graft failures. Recipients of HLA identical-sibling kidney transplants have a high patient and graft survival, but they also encounter many complications. Immunologic rejection occurs, even with negative mixed lymphocyte culture, suggesting the importance of donor determinants other than the HLAA, B and D other than the HLA-A, B and D.
Overuse of Hypotonic Fluids
Authors: Michael J. Moore
Journal: Annals of Internal Medicine (1990)

Letters and Corrections1 May 1990Overuse of Hypotonic FluidsMichael J. Moore, MDMichael J. Moore, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-112-9-716_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor:The recent article by Fraser and Arieff (1) is very well written and provides helpful information concerning the pathophysiology involved in hyponatremia. However, I read this article with dismay and sadness as I thought about the many who died because of the trend to use hypotonic solutions for intravenous fluid therapy. I became aware of this trend about 6 years ago and questioned younger surgeons and anesthesiologists about how it had developed. It appears that university hospital anesthesiologists were aware of a tendency of surgical patients having anesthesia to retain sodium, and hypotonic infusions were thought to...Reference1. FraserArieff CA. Fatal central diabetes mellitus and insipidus resulting from hyponatremia. A new syndrome. Ann Intern Med. 1990;112:113-9. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Michael J. Moore, MDAffiliations: Lewis-Gale Clinic, Inc. Salem, VA 24153 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1990Volume 112, Issue 9Page: 716-717KeywordsAnesthesiaHyponatremiaSodiumSurgeons ePublished: 1 December 2008 Issue Published: 1 May 1990 PDF downloadLoading ...
Effects of Metabolic Syndrome and Findings From Baseline Colonoscopies on Occurrence of Colorectal Neoplasms
Authors: Han-Mo Chiu, Yi-Chia Lee, Chia-Hung Tu, Li-Chun Chang, Wen-Feng Hsu, Chu-Kuang Chou, Kun-Feng Tsai, Jin-Tung Liang, Chia-Tung Shun, Ming-Shiang Wu
Journal: Clinical Gastroenterology and Hepatology (2014)
A Case of Pulmonary Tularemia Treated with Aureomycin
Authors: Edward L. Hamilton
Journal: New England Journal of Medicine (1953)

TULAREMIA, an acute disease caused by infection with Pasteurella tularensis, is widespread among animals and not uncommon in man. The organisms are usually transmitted by the bites of blood-sucking insects, by handling of sick rabbits and, rarely, by the ingestion of insufficiently cooked meat of an infected animal. The period of incubation is two to five days. The onset is sudden, with chill, fever, headache and general aching. There may be a generalized rash.1 Tularemia is usually divided into five types: ulceroglandular (the most common), oculoglandular, glandular, typhoidal and pulmonary. The diagnosis of pulmonary tularemia, sometimes difficult because of the . . .
Settling the UGDP Controversy
Authors: Thomas C. Chalmers
Journal: JAMA (1975)

A long-awaited assessment of the validity of the indictment of oral hypoglycemic agents by the University Group Diabetes Program (UGDP)<sup>1</sup>is appearing in this issue. Because the controversy stirred up by the report centered around the biostatistical aspects of this and other long-term trials of the oral agents, the Director of the National Institutes of Health (NIH) contracted with the prestigious Biometric Society to appoint a committee of distinguished biostatisticians to review the pertinent studies in detail. This has now been accomplished in a most thorough manner. The overall judgment of the experts is that the shortcomings of the UGDP study are not sufficient to invalidate the results, and these are not contradicted by the other studies. The probability that oral hypoglycemic agents cause premature deaths from cardiovascular disease remains valid. Statistically valid studies do not prove anything. They merely give the practitioner a probability estimate on which to
Intensive Glucose Regulation in Hyperglycemic Acute Coronary Syndrome
Authors: Maarten de Mulder, Victor A. Umans, Jan H. Cornel, Friso M. van der Zant, Frank Stam, Rohit M. Oemrawsingh, K. Martijn Akkerhuis, Eric Boersma
Journal: JAMA Internal Medicine (2013)

Elevated plasma glucose levels in patients with acute coronary syndrome (ACS) on hospital admission are associated with increased mortality. Clinical trials of glucose regulation have provided inconsistent results with respect to cardiovascular outcomes, perhaps because target glucose levels have been suboptimal.To study the effectiveness and safety of intensive glucose management in patients with ACS who have hyperglycemia, aiming at strict blood glucose normalization.Single-center, prospective, open-label, randomized clinical trial in a large teaching hospital. Patients with ACS with an admission plasma glucose level of 140 to 288 mg/dL were eligible for inclusion and enrolled from July 23, 2008, to February 8, 2012. Patients with insulin-dependent diabetes mellitus were excluded. Informed consent was obtained from 294 patients, who were randomized. Of these, 93.6% received percutaneous coronary intervention (PCI).Intensive glucose management strategy, aiming at a plasma glucose level of 85 to 110 mg/dL by using intravenous insulin, or to conventional expectative glucose management.End points were assessed according to the intention-to-treat principle. The primary end point was high-sensitivity troponin T value 72 hours after admission (hsTropT72); secondary end points, area under the curve of creatine kinase, myocardial band (AUC-CK-MB), release and myocardial perfusion scintigraphy findings at 6 weeks' follow-up.In the intensive management arm, median hsTropT72 was 1197 ng/L (25th and 75th percentiles of distribution, 541-2296 ng/L) vs 1354 ng/L (530-3057 ng/L) in the conventional arm (P = .41). Median AUC-CK-MB was 2372 U/L (1242-5004 U/L) vs 3171 U/L (1620-5337 U/L) (P = .18). The difference in median extent of myocardial injury measured by myocardial perfusion scintigraphy was not significant (2% vs 4%) (P = .07). Severe hypoglycemia (<50 mg/dL) was rare and occurred in 13 patients. Before discharge, death or a spontaneous second myocardial infarction occurred in 8 patients (5.7%) vs 1 (0.7%) (P = .04). CONCLUSIONS AND RELEVANCE Intensive glucose regulation did not reduce infarct size in hyperglycemic patients with ACS treated with PCI, and was associated with harm. Future studies should focus on patients with ACS who have persistently elevated blood glucose after PCI, and should evaluate alternative strategies for optimizing glycemia.www.trialregister.nl Identifier: NTR1205.
A Mobile Coronary Care Unit: An Evaluation for Its Need
Authors: YOON H. PYO
Journal: Annals of Internal Medicine (1970)

Although the few existing mobile coronary care units have proved effective, the establishment of a new unit is expensive. In order to determine the usefulness of such a unit an evaluation of present patterns for care of the acute myocardial infarct patients and patients dead on arrival at a west-side Cleveland hospital was made. The greatest delay in the care of the acute myocardial infarct patient was his own unwillingness to call for help. The median time for transport of patients to the hospital was 25 min. The study of patients dead on arrival at the hospital showed that the time needed for rescue squads to reach the patients was too long in almost all cases for effective resuscitation to be accomplished. This study shows that present transportation facilities for the acute myocardial infarct patients in this community are adequate. Added equipment and training of personnel for the existing units could obviate the need for a centrally based and more costly mobile coronary care unit.
Cranial Irradiation for Lung Cancer-Reply
Authors: James D. Cox
Journal: JAMA (1981)

<h3>In Reply.—</h3> Dr Young has criticized the study with regard to the analysis of subgroups, the use of one-sided vs two-sided tests, and the number of patients entered into the study. We would agree with Dr Young that reports of clinical trials should undergo a critical review where such questions should be asked. But we think that his criticisms are unjustified and that he has missed the major point of this article. The objective of the study was to determine if prophylactic irradiation to the brain can reduce the spread of the disease to this site. Because there are some toxic effects, primarily alopecia, associated with the administration of brain irradiation, the study conclusions of either no difference in the rates or an increase in the rate of brain metastases with brain irradiation would lead us to the same clinical decision—do not administer prophylactic brain irradiation. Thus, we think that
Impaired fibrinolysis in coronary atherectomy specimens in acute coronary syndromes: Increased plasminogen activator inhibitor‐1 and apolipoprotein(a)
Authors: T. Sakamoto, T. Ishibashi, J. Shindo, M. Kijima, K. Nakazato, K. Nagata, A. Hirosaka, K. Maehara, T. Saitoh, Y. Maruyama
Journal: European Journal of Heart Failure (2000)
Monitoring and Ensuring Safety During Clinical Research
Authors: Michael A. Morse
Journal: JAMA (2001)

Increased numbers of clinical trials, many of which are large, multicenter, and sometimes international, and the marked shift of funding for clinical trials to industry have made apparent the inadequacy of mechanisms for protecting human subjects that were developed when clinical research was generally carried out on a small scale at single institutions. To address concerns regarding the protection of human subjects, a group of professionals with expertise in various aspects of clinical trials was assembled in May 2000. Participants described and evaluated the mechanisms by which clinical trials are monitored, focusing on adverse event reporting and the processes by which various parties with oversight responsibilities interact in the course of these trials. In this article, we describe the manner in which adverse event reporting might function to enhance safety and the role of data monitoring committees in using aggregate data from these reports, outline the problems that now exist for institutional review boards as they are faced with multiple adverse event reports from clinical trials while conducting continuing review, and offer recommendations for improving the current approach.