tbuckley/cabot-search huggingface dataset:
Periovarian Adhesions following Ovarian Wedge Resection or Laparoscopic Biopsy
Authors: José Portuondo, Juan Melchor, José Neyro, Alfonso Alegre
Journal: Endoscopy (1984)

The purpose of this paper is to describe the formation of periovarian adhesions after ovarian bilateral wedge resection or laparoscopic biopsy. Twelve patients with polycystic ovaries and infertility had bilateral ovarian wedge resection and second-look laparoscopy after a mean of 33 months. On the other hand, twenty-four patients with various menstrual disorders had laparoscopic ovarian biopsy and subsequent second-look after a mean of 8.8 months. Ninety-two per cent of the patients who had wedge resection had some periovarian adhesions, and in three cases the adhesions were extensive enough to produce mechanical infertility. Pregnancy occurred in four patients despite the presence of filmy or moderate adhesions. The patients who had laparoscopic ovarian biopsy were found to be free of periovarian adhesions during the second-look ovarian visualization. We conclude that ovarian resection should be reserved for nonresponders to a nonsurgical approach of anovulation, and ovarian biopsy when properly done is not followed by periovarian adhesions.
The Borrowed Imagery of Boxing
Authors: Robert W. Enzenauer
Journal: JAMA (1990)

To the Editor. —  Recently, the advisability of the continued promotion of major athletic events by cigarette manufacturers has been challenged as inappropriate. It has been decades since cigarette advertising graced the pages of medical journals. It seems equally incongruous thatJAMA, the leading medical authority calling for the abolition of boxing,1-3should month after month allow a major pharmaceutical company (Pfizer) to promote their latest cephalosporin (Cefobid) as the infection fighter that defeats nosocomial pneumonia and knocks out infections, usually illustrated with a boxer's hands raised in victory, a set of boxing gloves, or a pair of boxing trunks (JAMA. 1988;259:2603, 1989;261:2259, 1989;262:600,1989;262:1146).
Neonatal lupus erythematosus with congenital heart block and severe heart failure due to myocarditis and endocardititis of the mitral valve
Authors: G. Ferrazzini, M. Fasnacht, U. Arbenz, R. Seger, R. Biedermann, B. Simma, J. Uehlinger, P. Dangel, S. Fanconi
Journal: Intensive Care Medicine (1996)
The Sunny Side of Aging
Authors: James F. Fries
Journal: JAMA (1990)

When confronting the health and medical care costs of the aging of America, there are optimists and there are pessimists. In a most curious way the "optimists" have become those who believe that life is limited and that the average life expectancy of seniors is unlikely to grow rapidly in the future. "Pessimists" are those who believe that life expectancy increases will continue, and perhaps will even increase in the future. In a thoughtful article in this issue of<i>JAMA</i>, Schneider and Guralnik<sup>1</sup>beat the pessimistic drum loudly and clearly. Medicare costs may rise sixfold by the year 2040 in constant 1987 dollars. Dementia might ultimately afflict 28% or more of the senior population. We might expect 800 000 hip fractures annually by the year 2040. Research funding for the conditions that will pose the largest health care problems in the next century, including osteoarthritis, osteoporosis, and Alzheimer's disease,
Group A Meningococcal Carriage in Travelers Returning From Saudi Arabia
Authors: Patrick S. Moore
Journal: JAMA (1988)

In August 1987, an outbreak of group A meningococcal meningitis occurred during the annual pilgrimage to Mecca, Saudi Arabia, resulting in an attack rate among American pilgrims of 640 per 100 000. To determine risk factors for carriage, throat cultures were taken from passengers arriving on four consecutive flights from Saudi Arabia to the United States. Pilgrims were more likely to be group A meningococcal carriers than were nonpiligrims (relative risk, 11.1; 95% confidence interval, 3.7 to 33.1). Smoking, crowding, and meningococcal vaccination were not significantly associated with group A carriage. Pilgrims complaining of recent fever or sore throat, however, were more likely to be group A carriers, consistent with previous reports linking carriage and disease to preceding viral infections. Serogrouping of invasive meningococcal isolates can be used to monitor for indigenous transmission of this unusual strain in the United States, and we recommend routine vaccination of pilgrims to prevent future outbreaks of meningococcal disease. (<i>JAMA</i>1988;260:2686-2689)
Pyrimidine Metabolism in Man
Authors: Lloyd H. Smith
Journal: New England Journal of Medicine (1973)

PURINE metabolism in man has been studied extensively since the time of Garrod. Its end product is a readily measurable purine, uric acid, which reflects overall purine metabolism and, in uricotelic organisms, the major pathway of nitrogen excretion as well. In addition, gout, an important disease of purine metabolism, has been recognized since antiquity and has been identified with urate since Wollaston's studies in 1797 on tophaceous chemistry. In contrast, the study of pyrimidine metabolism has languished. The products of pyrimidine catabolism, largely carbon dioxide and ammonia, are submerged in the anonymity of these large metabolic pools. The only known . . .
Biologically inactive growth hormone caused by an amino acid substitution.
Authors: Y Takahashi, H Shirono, O Arisaka, K Takahashi, T Yagi, J Koga, H Kaji, Y Okimura, H Abe, T Tanaka, K Chihara
Journal: Journal of Clinical Investigation (1997)

Short stature caused by biologically inactive growth hormone (GH) is characterized by lack of GH action despite high immunoassayable GH levels in serum and marked catch-up growth to exogenous GH administration. We found a heterozygous single-base substitution (A-->G) in exon 4 of the GH-1 gene of a girl with short stature, clinically suspected to indicate the presence of bioinactive GH and resulting in the substitution of glycine for aspartic acid at codon 112. We confirmed the presence of mutant GH in the serum using isoelectric focusing analysis. The locus of mutation D112G was found within site 2 of the GH molecule in binding with GH receptor (GHR)/GH binding protein (GHBP). The expressed recombinant mutant GH tended to form a 1:1 instead of the 1:2 GH-GHBP complex normally produced by wild-type GH. The formation of a 1:2 GH-GHBP complex is compatible with the dimerization of GHRs by GH, a crucial step in GH signal transduction. Mutant GH was less potent than wild-type GH not only in phosphorylation of tyrosine residues in GHR, janus kinase 2 (JAK2), and signal transducers and activators of transcription 5 (STAT5) in IM-9 cells, but also in metabolic responses of BaF/GM cells, a stable clone transfected with cDNA of the chimera of the extracellular domain of human GHR, the transmembrane and the cytoplasmic domain of the human thrombopoietin receptor. These results indicate that the D112G mutation in the GH-1 gene causes production of bioinactive GH, which prevents dimerization of GHR and is therefore responsible for the patient's short stature.
Tranquilizing and antidepressive drugs.
Authors: Lawrence C. Parish
Journal: JAMA (1963)

A short, accurate monograph on the tranquilizers and the antidepressives is welcome, for the major texts have difficulty in keeping up with the rapidly progressing field of psychopharmacology. The discussion of the classification of these drugs, their pharmacodynamics, the side effects, and the use of such drugs as the phenothiazine compounds, those of the Rauwolfia family, and the mono-amine oxidase inhibitors will complement the physician's concepts. The generalist may wish to know more about dosage and the student may hope for further ramification of the mechanisms of action. Nevertheless, this book will serve as a handy reference manual.
Response to Letters Regarding Article, “Pilot Study of Extracorporeal Removal of Soluble Fms-Like Tyrosine Kinase 1 in Preeclampsia”
Authors: Ravi Thadhani, Linda Hemphill, Tuelay Kisner, Henning Hagmann, Stefanie Noack, Thomas Benzing, Verena Bossung, Peter Mallmann, Angela Kribs, Oliver A. Cornely, Wiebke Schaarschmidt, Alexander Jank, Holger Stepan, Claudia Kreyssig, Tom H. Lindner, Alan C. Rigby, Santosh Khedkar, S. Ananth Karumanchi
Journal: Circulation (2012)
Myocardial perfusion as an indicator of graft patency after coronary artery bypass surgery.
Authors: A J Kolibash, T D Call, C A Bush, M R Tetalman, R P Lewis
Journal: Circulation (1980)

Stress and resting myocardial perfusion were assessed in 38 patients who received 96 grafts. Stress perfusion was evaluated with thallium-201 and resting myocardial blood flow distribution with radiolabeled particles. When both stress and rest perfusion were normal, graft patency was 82% (51 of 62 grafts). Graft patency was also high (81%, 13 of 16) in areas where stress perfusion abnormalities resolved or become less apparent at rest. However, when stress perfusion defects remained unchanged at rest, the graft was likely to be occluded (73%, 11 of 15). Maintenance of normal rest perfusion or improvement of rest perfusion postoperatively was also associated with a high graft patency rate (80%, 35 of 44), whereas the development of new rest perfusion defects postoperatively implied graft occlusion (86%, six of seven).
Metformin and Heart Failure
Authors: Silvio E. Inzucchi
Journal: Diabetes Care (2005)

Throughout the world and for many years, metformin has been a mainstay of therapy for patients with type 2 diabetes. This highly effective and usually well-tolerated oral agent is, to date, the only one demonstrated to reduce cardiovascular disease (CVD) complications in newly diagnosed type 2 diabetic patients (1). It's precise mechanism of action remains enigmatic, although it clearly results in a reduction of endogenous glucose production, primarily hepatic gluconeogenesis, most likely involving the stimulation of AMP-activated protein kinase activity (2). A peripheral insulin-sensitizing effect in skeletal muscle has also been demonstrated by some, but not all, investigators (3). In small studies, metformin appears to exert benefit on various other fundamental biological processes that influence atherogenesis, such as lipid metabolism, inflammation, and vascular endothelial function (4). Another insulin sensitizer category, the thiazolidinediones (TZDs), has also been proposed to reduce CVD risk, but that class carries with it concerns of weight gain and fluid retention. As a result, TZDs remain more popular in combination therapy regimens. Perhaps of greatest import to clinicians is the recognition that metformin is the only oral antidiabetic agent associated with weight loss. Accordingly, metformin remains, in the eyes of many authorities, the optimal initial drug choice in most type 2 diabetic patients if diet and exercise have not succeeded in adequately reducing blood glucose levels (5).

Approval of metformin in the U.S. was delayed because of previous experience with phenformin, which was associated with lactic acidosis. Although the risk of such metabolic decompensation with metformin was known to be significantly lower than with the earlier biguanide, a fair amount of debate occurred during the approval process (6). The Food and Drug Administration (FDA) eventually sanctioned metformin's use, with the stipulation that strong warnings be included in the package insert regarding potential risks (7). Since metformin …
Correction: Acid Produced
Authors: B. Meyers, E. Bottone, S. Hirschman, S. Schneierson
Journal: Annals of Internal Medicine (1972)

Letters, Comments, and Corrections1 April 1972Correction: Acid ProducedB. MEYERS, M.D., E. BOTTONE, M.S., S. HIRSCHMAN, M.D., S. SCHNEIERSON, M.D.B. MEYERS, M.D.Search for more papers by this author, E. BOTTONE, M.S.Search for more papers by this author, S. HIRSCHMAN, M.D.Search for more papers by this author, S. SCHNEIERSON, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-76-4-674_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We want to call attention to an error in our paper "Infections Caused by Microorganisms of the Genus Erwinia," which appeared in the January issue of the ANNALS OF INTERNAL MEDICINE, pages 9-14.The second sentence of the second paragraph on page 10, beginning "No acid was produced . . ." should be corrected to read "Acid was produced . . ." The word "no" should not have been included.... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1972Volume 76, Issue 4Page: 674-675 ePublished: 1 December 2008 Issue Published: 1 April 1972 PDF downloadLoading ...
Mental disorder and clinical care in people convicted of homicide: national clinical survey
Authors: J. Shaw, L. Appleby, T. Amos, R. McDonnell, C. Harris, K. McCann, K. Kiernan, S. Davies, H. Bickley, R. Parsons
Journal: BMJ (1999)

<h3>Abstract</h3> <b>Objectives:</b> To estimate the rate of mental disorder in those convicted of homicide and to examine the social and clinical characteristics of those with a history of contact with psychiatric services. <b>Design:</b> National clinical survey. <b>Setting:</b> England and Wales. <b>Subjects:</b> Eighteen month sample of people convicted of homicide. <b>Main outcome measures:</b> Offence related and clinical information collected from psychiatric court reports on people convicted of homicide. Detailed clinical data collected on those with a history of contact with psychiatric services. <b>Results:</b> 718 homicides were reported to the inquiry between April 1996&nbsp;and November 1997.&nbsp;Of the 500&nbsp;cases for whom psychiatric reports were retrieved, 220&nbsp;(44%; 95% confidence interval 40% to 48%) had a lifetime history of mental disorder, while 71 (14%; 11% to 17%) had symptoms of mental illness at the time of the homicide. Of the total sample, 102&nbsp;(14%; 12% to 17%) were confirmed to have been in contact with mental health services at some time, 58&nbsp;(8%; 6% to 10%) in the year before the homicide. The commonest diagnosis was personality disorder (20&nbsp;cases, 22%; 13% to 30%). Alcohol and drug misuse were also common. Only 15 subjects (18%; 10% to 26%) were receiving intensive community care, and 60&nbsp;(63%; 53% to 73%) were out of contact at the time of the homicide. <b>Conclusions:</b> There are substantial rates of mental disorder in people convicted of homicide. Most do not have severe mental illness or a history of contact with mental health services. Inquiry findings suggest that preventing loss of contact with services and improving the clinical management of patients with both mental illness and substance misuse may reduce risk, but clinical trials are needed to examine the effectiveness of such interventions.
Kenneth David MacRae
Authors: J. Wright
Journal: BMJ (2002)

An iconoclastic clear thinker in epidemiology and medical research

Ken MacRae was one of the most exciting medical statisticians and philosophers of his generation. He was a gifted teacher, combining an ability to put across complex concepts with hilarious style, reducing his audience to helpless mirth. He also salvaged countless MD theses. Many distinguished consultants throughout the country owe their higher degrees to his intervention.

He was the scourge of the epidemiological establishment, challenging the analysis and interpretation of data on oral contraceptive risk and pertussis vaccine to the fury of those holding entrenched views.

Ken came from a family of crofters and was the first in his family to go to university. A natural mathematician, he read psychology and mathematics at Aberdeen before undertaking postgraduate studies in mathematical statistics and biometry. He went on to do a PhD on sequential statistical decision making, awarded in 1970. He was appointed lecturer in medical statistics at Queen's University, Belfast. At university he was an enthusiastic member of the Royal Air Force flying corps, throwing fast jets around the sky with abandon.


In 1984 he was appointed senior lecturer and subsequently reader in medical statistics at Charing Cross Hospital Medical School. His personal courtesy combined with excoriating wit won him many friends and left his opponents in academic skirmishes in disarray. 




His early work looked at relative risk of thrombosis with the oral contraceptive pill, causing enormous controversy at the time as he attacked the received wisdom, a theme to which he returned with his risk analysis of the third generation pill. He analysed multicentre clinical trials particularly in relation to prostate and breast cancer. He was appointed professor of medical statistics at the University of Surrey, and concentrated on forensic statistics for major medicolegal cases, specifically pertussis vaccine in the United Kingdom, and, controversially, tobacco litigation in the United States. His broad teaching experience allowed him to put across complex concepts to lawyers, judges, and juries with charm and the appropriate simplicity. His forensic skills and catholic knowledge were well employed on the BMJ “hanging committee,” which decides whether or not to publish submitted papers.

The Calvinism of Ken's early upbringing did not suit and there was a strong extrovert side to his character. He had a love of music, particularly the later Beethoven and Shostakovitch string quartets, to whose complexity of sound and emotion he was particularly drawn. He was gregarious, delighting in conversation, good food, wine, and, of course, malt whisky.

Predeceased by a son, he leaves a wife, Jane; and two sons.

Kenneth MacRae, professor of medical statistics University of Surrey; b 1942; PhD, FIS; died suddenly from myocardial ischaemia on around 6 April 2002. He had had diabetes for some years.
Chronic Bundle-Branch Block
Authors: John H. McAnulty
Journal: JAMA (1981)

IT HAS been of concern that bundle-branch block is a precursor of complete heart block. The concept of the distal conduction system being composed of three discrete pathways is one reason for this concern. The bundle branches connect the atrioventricular node to the ventricle. Although this distal conduction system is a syncytium, it can be divided into three major fascicles: the right bundle and the two portions of the left bundle, the anterior fascicle, and the posterior fascicle.  Block of one of these fascicles, unifascicular block, can be recognized as either right bundle-branch block, left anterior fascicular block (left-axis deviation of at least —30 degrees with initial R waves in leads II, III, aV f , and Q wave in lead I, aV l ), or left posterior fascicular block (right axis deviation of +105 degrees or greater, with Q waves in II, III, aV f , and initial R waves in I,
ABC of clinical genetics. Prenatal diagnosis.
Authors: H. M. Kingston
Journal: BMJ (1989)

Amniocentesis * Chorionic villus sampling * Fetoscopy ,* Embryo biopsy -safe -performed in second trimester -procedure risk 0-5% -performed in second trimester -widely available -procedure risk 2% -performed in first trimester -specialised technique -procedure risk 3% -performed in second trimester -very specialised technique -future techniquePrenatal diagnosis is important in detecting and preventing genetic disease.Two main advances in recent years have been the development of chorionic villus sampling procedures in the-first trimester and the application of recombinant DNA techniques to the diagnosis of many mendelian disorders.Various prenatal procedures are available, generally being performed between eight and 20 weeks' gestation.The timing, safety, and accuracy of prenatal tests are important factors that must be considered.Having prenatal tests and waiting for results is stressful for couples, and they must be supported during this time and given the results as soon as possible.Many couples who face a high risk of a serious genetic disorder in their children will consider embarking on a pregnancy only if reliable prenatal diagnosis is available.Prenatal testing may also be appropriate for couples in whom the pregnancies are at fairly low risk, often allowing a pregnancy to continue with less anxiety.* High genetic risk.
EFFECT OF HIGH CALCIUM INTAKE ON STRONTIUM85 METABOLISM IN MAN*
Authors: Herta Spencer, Margaret Li, Joseph Samachson
Journal: Journal of Clinical Investigation (1961)

The effect of high Ca intake of varying duration was studied on Sr/sup 8/ /sup 5/ metabolism in 14 patients under controlled dietary conditions. The Ca intake of 10 patients was approximately 10 times as high during high intake as during low intake. Tracer doses of Sr/sup 8//sup 5/ were given orally or intravenously in separate studies during-low and high Ca intake to the same subject. The intestinal absorption of orally administered tracer doses of Sr/sup 8//sup 5/ was of similar magnitude during low and high calcium intake in 7 of 11 patients and was lower in 4 patients during high than during low Ca intake. The addition of Ca to the diet resulted in increased urinary excretion of Ca in most patients. This increase was accompanied by a somewhat higher excretion of Sr/sup 8//sup 5/ after intravenous doses in 4 of 6 patients, while in general, no increase of urinary Sr/sup 8//sup 5/ excretion occurred when Sr/sup 8//sup 5/ was given orally. (auth)
Prognostic value of thyroid hormone levels in patients evaluated for liver transplantation
Authors: David H. Van Thiel, Mahendra Udani, Robert R. Schade, Agit Sanghvi, Thomas E. Starzl
Journal: Hepatology (1985)

The thyroid hormones T 4 , T 3 , rT 3 and TSH were assayed in 134 adult patients evaluated and accepted as potential liver transplant candidates at the Universty of Pittsburgh from March, 1981 to December, 1983. The subsequent course of these patients was evaluated with respect to the levels of these hormones obtained at the time of acceptance for transplantation. T 4 levels were increased significantly while their T 3 levels were reduced (both p &lt; 0.01) in those who survived and were discharged home as compared to either those who died waiting to be transplanted or died following the procedure. As a result, the ratio of T3/T4 was reduced markedly (p &lt; 0.01) in those who were transplanted and survived as compared to those not transplanted or dying following transplantation. Importantly, the rT3 levels clearly separated (p &lt; 0.01) those who would die prior to transplantation from those who would survive to be transplanted. Finally, the ratio rT3/T3 even more clearly separates those who will die prior to transplantation (p &lt; 0.01) from the other two groups. These data suggest that thyroid hormone levels, particularly rT3 levels, might be useful in setting priorities for which patients referred for a transplantation evaluation should be accepted into the program and in determining who among accepted patients should be operated upon in preference to others also accepted and waiting to be transplanted.
Erythrocyte Filterability and Herne Catabolism During the Menstrual Cycle
Authors: CLAES MERCKE
Journal: Annals of Internal Medicine (1976)

Erythrocyte filterability, reticulocyte count, total serum bilirubin, and CO hemoglobin percent saturation (COHb) were measured throughout one menstrual cycle in 17 women. The filterability was significantly depressed during the progesterone phase compared with the estrogen phase. The depressed filterability was accompanied by significant increases in reticulocyte count, total serum bilirubin, and COHb. Significant correlations were seen between filterability, reticulocyte count, and total serum bilirubin. However, COHb did not correlate significantly with any of the other variables studied. This is probably due to increased ventilation during the progesterone phase balancing the increased endogenous production of CO. It is possible that cyclic variations in heme turnover are related to changes in erythrocyte characteristics during the progesterone phase.