tbuckley/cabot-search huggingface dataset:
Effect of Cholesterol Reduction on Myocardial Ischemia in Patients With Coronary Disease
Authors: Thomas C. Andrews, Khether Raby, Joan Barry, Cameron L. Naimi, Elizabeth Allred, Peter Ganz, Andrew P. Selwyn
Journal: Circulation (1997)

Background Cholesterol lowering is associated with a reduction in cardiovascular morbidity and mortality. This study sought to determine whether cholesterol lowering also results in a reduction of myocardial ischemia during daily life. Methods and Results We enrolled 40 patients with proven coronary artery disease, total serum cholesterol between 191 and 327 mg/dL, and at least one episode of ST-segment depression on ambulatory ECG monitoring. Twenty patients were randomized to an American Heart Association Step 1 diet plus placebo (placebo group) and 20 to the same diet plus lovastatin (treatment group). Serum cholesterol and LDL cholesterol levels and ambulatory monitoring were repeated after 4 to 6 months of therapy. The two groups were comparable with respect to baseline characteristics, number of episodes of ST-segment depression, and baseline serum cholesterol levels. The treatment group had lower mean total and LDL cholesterol levels at study end and experienced a significant reduction in the number of episodes of ST-segment depression compared with the placebo group. ST-segment depression was completely resolved in 13 of 20 patients (65%) in the treatment group versus 2 of 20 (10%) in the placebo group. The treatment group exhibited a highly significant reduction in ischemia ( P &lt;.001). By logistic regression, treatment with diet and lovastatin was an independent predictor of ischemia resolution. Conclusions Cholesterol lowering with lovastatin appears to be effective in eliminating myocardial ischemia during daily life in a significant proportion of patients.
Concerted Action of Androgens and Mechanical Strain Shifts Bone Metabolism from High Turnover into an Osteoanabolic Mode
Authors: Ute M. Liegibel, Ulrike Sommer, Pascal Tomakidi, Ulrike Hilscher, Loes van den Heuvel, Rainer Pirzer, Joachim Hillmeier, Peter Nawroth, Christian Kasperk
Journal: The Journal of Experimental Medicine (2002)

Adhesion of bone cells to the extracellular matrix is a crucial requirement for osteoblastic development and function. Adhesion receptors connect the extracellular matrix with the cyto-skeleton and convey matrix deformation into the cell. We tested the hypothesis that sex hormones modulate mechanoperception of human osteoblastic cells (HOB) by affecting expression of adhesion molecules like fibronectin and the fibronectin receptor. Only dihydrotestosterone (DHT), but not 17β-estradiol, stimulated fibronectin (137%) and fibronectin receptor (252%) protein expression. The effects of deformation strain on HOB metabolism were investigated in a FlexerCell® strain unit. Cyclically applied strain (2.5% elongation) increased DNA synthesis (125%) and interleukin-6 (IL-6) production (170%) without significantly affecting alkaline phosphatase (AP) activity, type I collagen (PICP), or osteoprotegerin (OPG) secretion. 10 nM DHT pretreatment abolished the mitogenic response of HOB to strain and increased AP activity (119%), PICP (163%), and OPG production (204%). In conclusion, mechanical strain stimulates bone remodeling by increasing HOB mitosis and IL-6 production. DHT enhances the osteoanabolic impact of deformation strain by increasing bone formation via increased AP activity and PICP production. At the same time, bone resorption is inhibited by decreased IL-6 and increased OPG secretion into the bone microenvironment.
Toll-like Receptor 9 Triggers an Innate Immune Response to Helper-dependent Adenoviral Vectors
Authors: Vincenzo Cerullo, Michael P Seiler, Viraj Mane, Nicola Brunetti-Pierri, Christian Clarke, Terry K Bertin, John R Rodgers, Brendan Lee
Journal: Molecular Therapy (2007)

A major obstacle to the clinical application of systemic adenoviral gene replacement therapy is the host innate immune response. Although recent studies have attempted to characterize the cellular basis for this response to systemically administered helper-dependent adenoviral vector (HD-Ad), the underlying molecular components of the innate immune repertoire required to recognize the viral vector have yet to be identified. Here, we show that primary macrophages can sense HD-Ad vectors via the Toll-like Receptor 9 (TLR9) and respond by increasing pro-inflammatory cytokine secretion. Moreover, TLR9 sensing is involved in the rapid innate immune response to HD-Ad in vivo. TLR9 deficiency attenuates the innate immune response to HD-Ad, whereas TLR9 blockade reduces the acute inflammatory response after intravenous injection of the vector. Moreover, HD-Ad upregulates TLR9 gene expression independent of TLR9 function, suggesting that additional innate signaling pathways work cooperatively with TLR9. The identification of the components of the innate immune response to adenovirus will facilitate the development of combinatorial therapy directed at increasing the maximal tolerated dose of systemically delivered adenoviral vectors.
A NEW ADAPTATION OF THE FACE MASK IN CONTROL OF CONTAGIOUS DISEASE
Authors: JOSEPH A. CAPPS
Journal: JAMA (1918)

One of the most troublesome problems confronting the medical staff of the base hospitals in camps is the prevention of cross infections.  A mistaken diagnosis in the examining room may place measles in a scarlet fever ward, or meningitis in a clean diagnostic ward. These mistakes are partially remedied by sending all doubtful patients to an observation ward, where they may be differentiated at leisure.  The development of a secondary infection as a result of an exposure some time previous to entrance into the hospital is unavoidable.  On the other hand, the contraction of a secondary infection directly from another individual in the same ward demands the most serious effort in the way of prevention. When a case of scarlet fever breaks out in a measles ward, the ward must be placed in quarantine for a week. By the end of the week another case may develop and require another
Chronic Hepatic Dysfunction in Heroin Addicts
Authors: H. Phelps Potter
Journal: JAMA (1960)

Liver function tests performed on 69 non-jaundiced heroin addicts showed one or more abnormal tests in 52. Only 7 of 43 non-addict control subjects had any abnormal tests. The thymol turbidity, isocitric dehydrogenase, zinc turbidity, and thymol flocculation were the most frequently abnormal tests in the addicts. Only 3 of 57 addicts who were interviewed gave a history of jaundice, although 14 admitted prior association with jaundiced addicts. None of the addicts had practiced adequate sterilization of their injection equipment, and most of them had shared equipment with other addicts. The etiology of this liver disturbance is not known, but chronic viral hepatitis is considered a good possibility. Some heroin addicts are blood carriers of hepatitis virus and represent a serious risk as blood donors. Abnormalities in liver function tests may be a useful means of detecting addicts who attempt to conceal their addiction.
Consultations in general practice: a comparison of patients' and doctors' satisfaction.
Authors: A. Rashid, W. Forman, C. Jagger, R. Mann
Journal: BMJ (1989)

OBJECTIVE--To provide an objective means of assessing patients9 and doctors9 satisfaction with a consultation. DESIGN--Questionnaire study of patients and general practitioners after consultations. SETTING--Urban general practice. SUBJECTS--250 Patients attending consecutive consultations conducted by five general practitioners. MAIN OUTCOME MEASURE--Identification of deficiencies within a consultation as perceived by both doctors and patients. RESULTS--The doctor9s and patient9s questionnaires for each consultation were matched and the results analysed on a group basis. The response rate for individual questions was high (81-89%). The doctors and patients significantly disagreed about the doctors9 ability to assess and put patients at ease, to offer explanations and advice on treatment, and to allow expression of emotional feelings and about the overall benefit that the patients gained from the consultation. In all cases of disagreement the doctor had a more negative view of the consultation than the patient. CONCLUSIONS--The results of giving structured questionnaires on consultations to both patients and doctors could be a useful teaching tool for established doctors or those in training to improve the quality and sensitivity of care they provide.
Age related macular degeneration: Macular relocation surgery was not taken into account
Authors: D. Wong
Journal: BMJ (2003)

We intended to assess the ability of current-generation 256-slice coronary CT angiography (CCTA) to measure left atrial volume (LAV), comparing patients with a high heart rate (HiHR) of at least 70 bpm and patients with heart rate variability such as atrial fibrillation (AFib). <b>Methods:</b> Using the prospective Converge Registry of patients undergoing 256-detector CCTA on a Revolution scanner, we enrolled 121 HiHR patients (74 men; mean age, 62.7 ± 12.5 y) and 102 AFib patients (72 men; mean age, 60.5 ± 11.0 y) after obtaining informed consent. Quantitative data analysis of LAV was performed using automated methods, and end-systolic phases were chosen for measurements from CCTA. A Student <i>t</i> test, Wilcoxon rank-sum test, or χ<sup>2</sup> test assessed baseline parameters. Univariate and multivariate linear regression analysis was used to assess LAV and LAV index (LAVI) while adjusting potentially confounding variables. <b>Results:</b> Mean LAV was significantly higher in AFib subjects (148.6 ± 57.2 mL) than in HiHR subjects (102.1 ± 36.5 mL) (<i>P</i> &lt; 0.0001). Similarly, mean LAVI was significantly higher in AFib subjects (72.4 ± 28.1 mL/m<sup>2</sup>) than in HiHR subjects (51.5 ± 19.0 mL/m<sup>2</sup>) (<i>P</i> &lt; 0.0001). After adjusting for age, body mass index, sex, diabetes, hypertension, hyperlipidemia, and smoking, subjects with AFib had, on average, LAV measures higher by 41.2 ± 6.7 mL and LAVI values higher by 23.1 ± 3.4 mL/m<sup>2</sup> (<i>P</i> &lt; 0.0001). <b>Conclusion</b>: Misalignment and motion artifacts in CCTA images affect diagnostic CT performance, especially in patients with elevated heart rates or profound arrhythmia. However, the new-generation Revolution CCTA provides detailed information on left-atrium-complex morphology and function, in addition to coronary anatomy, in HiHR and AFib patients without additional radiation, scanning, or contrast requirements.
The Pill, Pygmy Chimps, and Degas' Horse: The Autobiography of Carl Djerassi
Authors: Lawrence Grouse
Journal: JAMA (1992)

Dr Djerassi is a Renaissance man. He is a distinguished scientist, an able entrepreneur, and a talented writer. However, his autobiography is a bewildering sequence of anecdotes, confessions, commentaries, and lectures that do not work together. This is not to say that there aren't some interesting moments. Djerassi is a profound observer of modern medical history, and his experiences are of great interest. In particular, he has had success as a scientist-entrepreneur, coupling academe and industry. I would have liked to have found a more extensive analysis of how and why he succeeded and how other synergies of US industry and academe could develop. For me the most enjoyable parts of the book were those in which Djerassi presents his own creative ideas. His efforts to develop a computer program that would function as a referee for a scholarly journal, his concepts of scientists as modern seafarers, and his ideas
<i><i>Bifidobacterium infantis</i></i>35624 modulates host inflammatory processes beyond the gut
Authors: David Groeger, Liam O’Mahony, Eileen F. Murphy, John F. Bourke, Timothy G. Dinan, Barry Kiely, Fergus Shanahan, Eamonn M.M. Quigley
Journal: Gut Microbes (2013)

Certain therapeutic microbes, including Bifidobacteria infantis (B. infantis) 35624 exert beneficial immunoregulatory effects by mimicking commensal-immune interactions; however, the value of these effects in patients with non-gastrointestinal inflammatory conditions remains unclear. In this study, we assessed the impact of oral administration of B. infantis 35624, for 6‒8 weeks on inflammatory biomarker and plasma cytokine levels in patients with ulcerative colitis (UC) (n = 22), chronic fatigue syndrome (CFS) (n = 48) and psoriasis (n = 26) in three separate randomized, double-blind, placebo-controlled interventions. Additionally, the effect of B. infantis 35624 on immunological biomarkers in healthy subjects (n = 22) was assessed. At baseline, both gastrointestinal (UC) and non-gastrointestinal (CFS and psoriasis) patients had significantly increased plasma levels of C-reactive protein (CRP) and the pro-inflammatory cytokines tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) compared with healthy volunteers. B. infantis 35624 feeding resulted in reduced plasma CRP levels in all three inflammatory disorders compared with placebo. Interestingly, plasma TNF-α was reduced in CFS and psoriasis while IL-6 was reduced in UC and CFS. Furthermore, in healthy subjects, LPS-stimulated TNF-α and IL-6 secretion by peripheral blood mononuclear cells (PBMCs) was significantly reduced in the B. infantis 35624-treated groups compared with placebo following eight weeks of feeding. These results demonstrate the ability of this microbe to reduce systemic pro-inflammatory biomarkers in both gastrointestinal and non-gastrointestinal conditions. In conclusion, these data show that the immunomodulatory effects of the microbiota in humans are not limited to the mucosal immune system but extend to the systemic immune system.
Fine-Needle Aspiration of the Thyroid
Authors: M. E. Zappi, H. F. Moussouris, J. F. Gillooley, I. Young, R. Eberle
Journal: JAMA (1991)

<h3>To the Editor.</h3> —We recently compared the histopathological follow-up of 146 patients who underwent prior evaluation of their thyroid enlargements by fine-needle aspiration biopsy (FNAB) prior to surgery (during the period from 1984 to June 1990) with a group of 182 patients who had thyroid surgery without preoperative FNAB during the period from 1962 to 1964. <h3>Study.</h3> —In our current experience, the four most frequent diagnoses at surgery were follicular adenoma and carcinoma (32.9% and 8.8%, respectively), papillary adenocarcinoma (31.5%), and nodular goiter (15.8%). These four entities accounted for 89% of all patients. During the 1962 to 1964 period, nodular goiter accounted for 41.8% and follicular adenoma for 34.6% of the final histopathological diagnoses; papillary adenocarcinoma followed chronic thyroiditis in frequency (7.7% and 8.2%, respectively). These four diagnostic categories accounted for 92.3% of the experience at that time. Comparing the results at surgery for these two periods is instructive (Table).
The Black knights: Sir James and Sir Douglas
Authors: J. O. Drife
Journal: BMJ (2010)

<h3>Introduction</h3> Uterine morcellation in minimally invasive surgery has recently come under scrutiny because of inadvertent dissemination of malignant tissue, including leiomyosarcomas commonly mistaken for fibroids. Identification of preoperative risk factors is crucial to ensure that oncologic care is delivered when suspicion for malignancy is high, while offering minimally invasive hysterectomies to the remaining patients. <h3>Objectives</h3> The aim of this study was to characterize risk factors for uterine leiomyosarcomas by reviewing preoperative, intraoperative, and postoperative data with an emphasis on the presence of concurrent fibroids. <h3>Methods</h3> A retrospective case-control study of women undergoing hysterectomy with pathologic diagnosis of uterine leiomyosarcoma at a tertiary care center between January 2005 and April 2014. <h3>Results</h3> Thirty-one women were identified with leiomyosarcoma and matched to 124 controls. Cases with leiomyosarcoma were more likely to have undergone menopause and to present with larger uteri (19- vs 9-week sized), with the most common presenting complaint being a pelvic mass (35.5% vs 8.9%). Controls were ten times more likely to have undergone a tubal ligation (30.6% vs 3.2%). Endometrial sampling detected malignancy preoperatively in only 50% of cases. Leiomyosarcomas were more commonly present when pelvic masses were identified in addition to fibroids on preoperative imaging. Most leiomyosarcoma cases (77.4%) were performed by oncologists via an abdominal approach (83.9%), with only 2 of 31 leiomyosarcomas being morcellated. Comparative analysis of preoperative imaging and postoperative pathology showed that in patients with leiomyosarcoma, fibroids were misdiagnosed 58.1% of the time, and leiomyosarcomas arose directly from fibroids in only 6.5% of cases. <h3>Conclusions</h3> Leiomyosarcoma risk factors include older age/postmenopausal status, enlarged uteri of greater than 10 weeks, and lack of previous tubal ligation. Preoperative testing failed to definitively identify leiomyosarcomas, although the presence of synchronous pelvic masses in fibroid uteri should raise clinical suspicion. Given the difficulty of preoperative identification, future efforts should focus on the development of safer minimally invasive techniques for uterine morcellation.
EFFICACY OF DIVIDED AND SINGLE DOSE SCHEDULES IN INSULIN COMA THERAPY
Authors: ARNOLD G. BLUMBERG, PETER LADERMAN, MAX FINK
Journal: American Journal of Psychiatry (1960)

The coma produced with the divided insulin doses did not occur earlier and was not deeper than that produced by the single dose. The increased effort in divided dose schedules is justified neither by increased safety nor by increased depth or duration of the induced hypoglycemia. There was no evidence that the initial dose of insulin sensitized the subject so that subsequent doses produced a greater hypoglycemic effect. The total hypoglycemic effect of divided doses appears to be less, if anything, than the effect of a single dose.
PREDICTING EPISODE-BASED CARE COSTS FOLLOWING CORONARY INTERVENTION
Authors: Matthew Bunte, Matthew Cavender, Rory Hachamovitch, Robert Mackenzie, Pamela Goepfarth, Julianne Nichols, Dhanesh Shah, Kenneth Kissel, Shaheen Bhanji, Jacob Miller, Matthew Pohlman, Jason Gilder, Anil Jain, Joseph Cacchione
Journal: Journal of the American College of Cardiology (2013)
Emulation theory offers conceptual gains but needs filters
Authors: Catherine L. Reed, Jefferson D. Grubb, Piotr Winkielman
Journal: Behavioral and Brain Sciences (2004)

Much can be gained by specifying the operation of the emulation process. A brief review of studies from diverse domains, including complex motor-skill representation, emotion perception, and face memory, highlights that emulation theory offers precise explanations of results and novel predictions. However, the neural instantiation of the emulation process requires development to move the theory from armchair to laboratory.
Highlights from recent National Surgical Adjuvant Breast and Bowel Project studies in the treatment and prevention of breast cancer
Authors: B. Fisher
Journal: CA A Cancer Journal for Clinicians (1999)

Findings from major National Surgical Adjuvant Breast and Bowel Project studies in women with breast cancer and negative axillary nodes are reported and discussed. Results of the B-13 and B-19 studies demonstrated that systemic chemotherapy (either with methotrexate and sequentially administered fluorouracil followed by leucovorin, or with cyclophosphamide plus methotrexate and fluorouracil) increased overall disease-free survival in women 49 years of age or younger, as well as in those 50 years old or older. Women older than 50 also experienced a survival advantage with chemotherapy. Moreover, women who received systemic chemotherapy after lumpectomy plus radiation therapy were significantly less likely to develop an ipsilateral recurrence of tumor. The B-14 study established the benefit of tamoxifen. When chemotherapy was added to tamoxifen in the B-20 trial, there was an increased benefit. The B-18 trial demonstrated that the outcome of patients who received preoperative chemotherapy was comparable to that of patients who received the same therapy postoperatively. Moreover, results suggested that breast tumor response to preoperative chemotherapy correlated with outcome. Also, larger tumors were sufficiently downstaged by preoperative chemotherapy to permit lumpectomy rather than mastectomy. The B-17 study in women with ductal carcinoma in situ concluded that radiation therapy should follow lumpectomy in women with localized, mammographically detected lesions. The P-1 Breast Cancer Prevention trial showed that tamoxifen was effective in significantly reducing the incidence of both invasive and noninvasive breast tumors in women at high risk for the disease. Although many questions remain, and a new study, P-2, has been designed to compare tamoxifen and raloxifene, it is appropriate to offer tamoxifen to women who are similar to those in the P-1 study and who may benefit from it.
Does Helicobacter pylori really cause duodenal ulcers? Yes
Authors: A. C Ford, N. J Talley
Journal: BMJ (2009)

The link between duodenal ulcer and <i>Helicobacter pylori</i> has revolutionised treatment. <b>Alexander Ford</b> and <b>Nicholas Talley</b> argue that the association is causal, but <b>Michael Hobsley and colleagues</b> (doi:10.1136/bmj.b2788) believe acid secretion is the key
JAMA Begins European Printing, Distribution Using Long-Lasting Acid-Free Text, Cover Stock
Authors: Phil Gunby
Journal: JAMA (1994)

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Beyond one-way streets: The interaction of phonology, morphology, and culture with orthography
Authors: Madeleine E. L. Beveridge, Thomas H. Bak
Journal: Behavioral and Brain Sciences (2012)

Frost's claim that universal models of reading require linguistically diverse data is relevant and justified. We support it with evidence demonstrating the extent of the bias towards some Indo-European languages and alphabetic scripts in scientific literature. However, some of his examples are incorrect, and he neglects the complex interaction of writing system and language structure with history and cultural environment.