tbuckley/cabot-search huggingface dataset:
Ventricular arrhythmias in patients undergoing noncardiac surgery. The Study of Perioperative Ischemia Research Group
Authors: B. O'Kelly
Journal: JAMA (1992)

To determine the incidence, clinical predictors and prognostic importance of perioperative ventricular arrhythmias.Prospective cohort study (Study of Perioperative Ischemia).University-affiliated Department of Veterans Affairs Medical Center, San Francisco, Calif.A consecutive sample of 230 male patients, with known coronary artery disease (46%) or at high risk of coronary artery disease (54%), undergoing major noncardiac surgical procedures.We recorded cardiac rhythm throughout the preoperative (mean = 21 hours), intraoperative (mean = 6 hours), and postoperative (mean = 38 hours) periods using continuous ambulatory electrocardiographic monitoring. Adverse cardiac outcomes were noted by physicians blinded to information about arrhythmias.Frequent or major ventricular arrhythmias (greater than 30 ventricular ectopic beats per hour, ventricular tachycardia) occurred in 44% of our patients: 21% preoperatively, 16% intraoperatively, and 36% postoperatively. Compared with the preoperative baseline, the severity of arrhythmia increased in only 2% of patients intraoperatively but in 10% postoperatively. Preoperative ventricular arrhythmias were more common in smokers (odds ratio [OR], 4.1; 95% confidence interval [CI], 1.2 to 15.0), those with a history of congestive heart failure (OR, 4.1; 95% CI, 1.9 to 9.0), and those with electrocardiographic evidence of myocardial ischemia (OR, 2.2; 95% CI, 1.1 to 4.7). Preoperative arrhythmias were associated with the occurrence of intraoperative and postoperative arrhythmias (OR, 7.3; 95% CI, 3.3 to 16.0, and OR, 6.4; 95% CI, 2.7 to 15.0, respectively). Nonfatal myocardial infarction or cardiac death occurred in nine men; these outcomes were not significantly more frequent in those with prior perioperative arrhythmias, albeit with wide CIs (OR, 1.6; 95% CI, 0.4 to 6.2).Almost half of all high-risk patients undergoing noncardiac surgery have frequent ventricular ectopic beats or nonsustained ventricular tachycardia. Our results suggest that these arrhythmias, when they occur without other signs or symptoms of myocardial infarction, may not require aggressive monitoring or treatment during the perioperative period.
Lymphedema Following Breast Cancer
Authors: Sandra C. Hayes, Monika Janda, Bruce Cornish, Beth Newman
Journal: Journal of Clinical Oncology (2009)

Lymphedema—a chronic, disabling sequela of breast cancer treatment—is finally receiving the research attention it deserves. The work published by Norman et al1 in the January issue of Journal of Clinical Oncology supports the findings of this emerging literature, which demonstrates that lymphedema is common following breast cancer treatment, but that higher estimates are observed when self-report is used to assess lymphedema status compared with other measures such as circumferences, perometry, or bio-impedance spectroscopy. While Norman et al reported that the majority of cases occur within 2 years of diagnosis, work by us2 and others3 have demonstrated that the majority of cases (70% to 80%) occur within the first 12 months after diagnosis. Collectively, this work advocates for the measurement of lymphedema being included within routine presurgical and postsurgical care. However, until we know more about the effectiveness of lymphedema treatment, clinicians may remain skeptical about active screening for lymphedema.
The "Military Verb"
Authors: Nicholas P. Sinaly
Journal: JAMA (1962)

<h3>To the Editor:—</h3> I would like to make a few comments about the pathology of style which Alexander Gode, Ph.D., rather sarcastically derided in the filler "Just Words" (<i>JAMA</i><b>181</b>:34 [July 7] 1962). The only justification I can see for his statements is that he perchance dislikes the military or possibly is an enemy of succinctness which very refreshingly occasionally characterizes the military. I would like to comment that it took him 4 paragraphs to criticize something the point of which appears to escape this reader at least partially. I must confess that I am not military, nor am I a Ph.D., but find it rather amusing that a man of his talents should criticize medical writing by the military, which in general appears to me to be very much to the point which again I am forced to admit, is not in the case in many writings by
Expression of glycoconjugates during intrahepatic bile duct development in the rat: An immunohistochemical and lectin-histochemical study
Authors: Takahiro Sanzen, Kazuharu Yoshida, Motoko Sasaki, Tadashi Terada, Yasuni Nakanuma
Journal: Hepatology (1995)

We investigated the expression of carbohydrate residues on the developing intrahepatic bile ducts of rats. At 17 days of gestation, immature biliary cells around the portal vein close to the hepatic hilum assumed one of the following forms: slitlike lumen, incomplete, or complete bile ductule-like structures. These immature biliary elements then rapidly spread throughout the liver along with development. At birth, a few mature interlobular bile ducts became visible in the portal tracts. The cytoplasm of immature biliary cells stained weakly for concanavalin A, Erythrina crista galli agglutinin, and Limax flavus agglutinin, whereas the luminal surface of immature biliary cells at 17 days of gestation was positive for lectins, similar to those that are expressed on the luminal surface of the mature bile ducts, including concanavalin A, succinyl wheat germ agglutinin, Vicia villosa agglutinin, soybean agglutinin, peanut agglutinin, Erythrina crista galli agglutinin, and Limax flavus agglutinin. As development progressed, the number of lectins binding to the cytoplasm of biliary cells gradually increased, and lectin bindings to the luminal surface of biliary cells gradually became intense. Immature biliary epithelial cells of three structures expressed similar carbohydrate residues in their cytoplasm and luminal surfaces. This study suggested that the profile of carbohydrate residues on the biliary epithelium changes with development. Therefore, this profile could be a useful tool with which to evaluate the development of the biliary tree as well as associated disorders.
Abstract 3713: Comparison of endpoints and data analysis methods for exposure of human tumor cells to dasatinib (NSC732517) and 6-MP (NSC755) in culture
Authors: Gurmeet Kaur, Sudhir B. Kondapaka, Beverly A. Teicher
Journal: Cancer Research (2012)

Abstract Previous research using the NCI60 cell line combination screen suggested that dasatinib (NSC732517) and 6-mercaptopurine (6-MP; NSC755) may have greater than additive cytotoxicity in selected cell lines. We have conducted a detailed combination study using 6-MP and dasatinib in p53 wild type (MCF-7, H460, A498) and p53 mutant (MDA-MB-468, H23, 786-O) breast, lung and renal cell lines. These studies were performed measuring ATP as the endpoint using Cell Titer Glo after 72h exposure to 6-MP and dasatinib alone or in combination and measuring survival using colony formation after 72hr exposure to the compounds alone or in combination. As a single agent, the lung and renal mutant cell lines (H23, 786-O) were 2-10 fold more sensitive to 6-MP than wild type (H460, A498) with the exception of MDA-MD-468 (mutant), which was more resistant to 6-MP than MCF-7 (wild type). On the other hand all cell lines were sensitive to dasatinib with the IC50 ranging from 0.2-2 μM. For the combination studies, additivity/synergy was calculated using CompuSyn Software (Chou and Martin) or MacSynergy (Prichard and Shipman). Combination index (CI) analysis of the single agent and combination data for 6-MP and dasatinib was additive or antagonist in most of the cell lines. In A498, 786-0, MCF-7 and H460 cell lines a synergistic effect was observed at &amp;gt;10 fold the clinical plasma levels of 6-MP (0.59 μM) or dasatinib (0.19 μM). NCI-H23 cell line demonstrated an additive effect at 0.3 μM of 6-MP and 0.2 μM of dasatinib (CI = 0.94). MDA-MB-468 cell lines demonstrated a strong synergy (CI = 0.2-0.4) for 6-MP (0.03-1 μM) and dasatinib (0.05 μM) at concentrations less than the clinical plasma levels. In a single agent colony formation assay, the H460 cells were sensitive to 6-MP (IC50= 0.21 μM) and resistant to dasatinib (IC50= &amp;gt;10 μM). In a combination study, a synergistic effect (CI = 0.59-0.8) was observed in H460 cell line at concentrations below the clinical plasma level of 6-MP (0.2 μM-0.6 μM) and dasatinib (0.1 μM). These drug effects will be further evaluated in all cell lines by the determination of survival using colony formation assay. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3713. doi:1538-7445.AM2012-3713
Withdrawing Life Support from Mechanically Ventilated Recipients of Bone Marrow Transplants: A Case for Evidence-Based Guidelines
Authors: Gordon D. Rubenfeld
Journal: Annals of Internal Medicine (1996)

Background: Mechanical ventilation after bone marrow transplantation is associated with a high mortality rate. The available literature provides conflicting predictors of outcome in relatively small study groups. Objective: To identify predictors of death and mortality trends in mechanically ventilated transplant recipients. Design: Nested case–control study. Setting: The Fred Hutchinson Cancer Research Center in Seattle, Washington, which specializes in bone marrow transplantation. Patients: All survivors (cases, n = 53) and a group of patients matched for year of transplantation who did not survive (controls, n = 106) were selected from all mechanically ventilated patients (n = 865) who received a bone marrow transplant between January 1980 and July 1992. Patients who received mechanical ventilation for less than 24 hours after a procedure or who received mechanical ventilation after a second bone marrow transplantation were excluded. Measurements: Surviving patients were defined as those who were alive 30 days after extubation and who were discharged from the hospital. Daily laboratory, physiologic, and treatment variables were collected. Results: Survival was statistically associated with younger age, lower score on the Acute Physiology and Chronic Health Evaluation III, and a shorter time from transplantation to intubation. There were no survivors among an estimated 398 patients who had lung injury and either required more than 4 hours of vasopressor support or had sustained hepatic and renal failure. Through the use of these factors, an accurate prediction of death could have been made in the first 4 days of mechanical ventilation for more than half of the patients who did not survive. During the past 5 years, survival rate has changed from 5% to 16% (P = 0.008), an increase that was not explained by changes in the age of the patients, the rate or timing of intubation, or the percentage of allogeneic transplants that were not HLA-identical. Conclusion: Of the patients who required mechanical ventilation after bone marrow transplantation, no one survived with lung injury combined with either hemodynamic instability or hepatic and renal failure. However, survival after mechanical ventilation seems to be improving.
Defective expression of p56lck in an infant with severe combined immunodeficiency.
Authors: F D Goldman, Z K Ballas, B C Schutte, J Kemp, C Hollenback, N Noraz, N Taylor
Journal: Journal of Clinical Investigation (1998)

Severe combined immune deficiency (SCID) is a heterogeneous disorder characterized by profound defects in cellular and humoral immunity. We report here an infant with clinical and laboratory features of SCID and selective CD4 lymphopenia and lack of CD28 expression on CD8(+) T cells. T cells from this patient showed poor blastogenic responses to various mitogens and IL-2. Other T cell antigen receptor- induced responses, including upregulation of CD69, were similarly inhibited. However, more proximal T cell antigen receptor signaling events, such as anti-CD3 induced protein tyrosine phosphorylation, phosphorylation of mitogen-associated protein kinase, and calcium mobilization were intact. Although p59fyn and ZAP-70 protein tyrosine kinases were expressed at normal levels, a marked decrease in the level of p56lck was noted. Furthermore, this decrease was associated with the presence of an alternatively spliced lck transcript lacking the exon 7 kinase encoding domain. These data suggest that a deficiency in p56lck expression can produce a SCID phenotype in humans.
PERFORATION OF THE NORMAL INTESTINE BY AN ASCARIS LUMBRICOIDES.
Authors: LOUIS C. AGER
Journal: JAMA (1903)

<h3>NARRATION OF A CASE.</h3><h3>History.</h3> —The patient was American born, 36 years old, a carpenter. On Sept. 24, 1901, about 9 a. m., he walked into the Norwegian Hospital, Brooklyn, complaining of diffuse abdominal pain; temperature, 99; pulse, 90. He gave a history of diarrhea for a week, which had been checked by cholera mixture. The previous night he had taken a dose of castor oil. He was kept under observation, and rapidly grew worse. At 11 o'clock his temperature was 102; pulse, 120. The abdominal pain was localized in the right iliac fossa, and a diagnosis of appendicitis was made. An operation was decided on. At 12:15 p. m. his temperature was 104, pulse 136. <h3>Operation.</h3> —At 4 p. m. the abdomen was opened and a congested appendix was removed. Although there were indications of intestinal perforation, the alarming condition of the patient prevented any
Informing Physicians About Promising New Treatments for Severe Disease-Reply
Authors: Bernard Lo
Journal: JAMA (1990)

<h3>In Reply.—</h3> Dr Hertzman, Ms Cairns, and Ms Lowe highlight the importance of providing physicians with timely and complete information about newly recognized diseases, such as the tryptophan—associated eosinophilia-myalgia syndrome. Dr Harnes raises a number of points that, while interesting for discussion, are beyond the scope of our article. In general, reporters, regardless of whether they are trained as physicians, should seek to provide accurate, fair, and comprehensive coverage of medical news. Many reporters who specialize in medical coverage routinely include in their articles the types of information that Dr Harnes suggests. As our article pointed out, press releases frequently are flawed and inadequate sources of medical information. Such news releases should be accompanied by sufficient scientific information, preferably a complete scientific report, to allow both physicians and nonphysicians to make informed judgments about the findings. Two recent developments related to the subject of our article may be of interest
Primary care trusts should relinquish budgets to GPs right away, say NHS chiefs
Authors: C. White
Journal: BMJ (2010)

Primary care trusts in England should start devolving commissioning to family doctors straight away, despite widespread uncertainty about transition arrangements and concern about a lack of accountability and relevant competencies among GPs.

NHS chiefs issued the call to action last week in Liverpool at the annual conference of the NHS Confederation, which represents most NHS trusts, on the grounds that GP commissioning is likely to take some considerable time to set up.

The policy, which will see hundreds of GP consortiums taking on some £80bn (€100bn; $120bn) of the total NHS budget and all but around 4% of commissioned care, is set to roll out in April 2012, when strategic health authorities will also have been dissolved.

Nigel Edwards, the confederation’s acting chief executive, said, “One thing …
Abortion and Reproductive Rights: A Comprehensive Guide to Medicine, Ethics and the Law
Authors: Lawrence O. Gostin
Journal: JAMA (1997)

A review of<i>Abortion and Reproductive Rights</i>requires not simply the standard examination of its contents but, more important, an assessment of the medium it adopts. The text is in CD-ROM form. As such, it provides, in one source, a voluminous amount of information about abortion and reproductive rights—medical, ethical, and legal aspects. The CD-ROM format provides a research tool that goes far beyond the capacity of any single reference text, enabling the reader to effortlessly browse through major book excerpts, articles, statutes, Congressional hearings, and judicial cases; rapidly locate relevant text on issues of particular interest; and efficiently compare and contrast different approaches in the disciplines of law, medicine, and ethics. CD-ROMs can capture the reader's imagination in ways that are different from books, particularly through multimedia presentations of audio, video, and imagery. J. Douglas Butler's CD-ROM, for example, provides a captivating audio presentation of
Spontaneous Resolution of a Pubic-Symphysis Diastasis
Authors: David Chang, Bruce S Markman
Journal: New England Journal of Medicine (2002)

Figure 1. A 27-year-old, 45-kg primigravid woman presented in early labor at 40 weeks' gestation. Six hours into her labor, an urgent vacuum-assisted vaginal delivery was performed because of fetal bradycardia. A healthy 3010-g male infant was delivered, with Apgar scores of 9 and 9 at one and five minutes, respectively. Immediately after delivery the patient reported anterior pelvic pain and was unable to move from the table. An anteroposterior radiograph of her pelvis was obtained while she lay on the delivery table and revealed a 5-cm diastasis of the pubic symphysis (Panel A). Because the sacroiliac joints were not . . .
Secretory component-dependent binding of immunoglobuin A in the rat, monkey and human: A comparison of intestine and liver
Authors: Christopher K. Daniels, Douglas L. Schmucker
Journal: Hepatology (1987)

The source and significance of immunoglobulin A in bile remains controversial. In the rat, and several other species, immunoglobulin A is transported through hep-atocytes by a specific receptor, secretory component. In humans, immunohistochemical methods have indicated a distinct lack of receptors for immunoglobulin A on hepatocytes. Binding assays with 125 I-immunoglobulin A and membranes from hepatocytes and intestinal cells of the rat display secretory component-dependent binding. Primate intestinal cells also show secretory component-specific binding of immunoglobulin A. Primate liver, on the other hand, does not show immunoglobulin A binding mediated by the polymeric immunoglobulin receptor.
Treatment of Reticuloendotheliosis
Authors: Paul Freud
Journal: JAMA (1961)

In the treatment of reticuloendotheliosis good responses were obtained by administering steroids in doses as high as 250 mg. per day for infants and 350 mg. for older children. Harmful side-effects necessitate interruption of such treatment after a certain time, but reticuloendotheliosis recurs as early as two weeks after such interruption. Recurrence can be prevented by giving antifolic acid compounds during such interruptions. Four of the five patients here studied responded well to this treatment, and the pathological signs and symptoms disappeared. Abnormalities of lungs and bones were the last to disappear. Nothing definite can yet be said about the possibility of relapse after months or years.
Risk of Lower and Upper Gastrointestinal Bleeding, Transfusions, and Hospitalizations With Complex Antithrombotic Therapy in Elderly Patients
Authors: Neena S. Abraham, Christine Hartman, Peter Richardson, Diana Castillo, Richard L. Street, Aanand D. Naik
Journal: Circulation (2013)

Background— Complex antithrombotic therapy (CAT) prescribed to elderly patients increases the risk of gastrointestinal bleeding. We quantified upper (UGIE) and lower gastrointestinal (LGIE) events, transfusions, and hospitalizations in a national cohort of elderly veterans prescribed CAT. Methods and Results— Veterans ≥60 years of age prescribed anticoagulant-antiplatelet, aspirin (ASA)-antiplatelet, ASA-anticoagulant, or triple therapy (ie, TRIP, anticoagulant-antiplatelet-ASA) were identified from the national pharmacy database (October 1, 2002 to September 30, 2008). Prescription-fill data were linked to Veteran Affairs and Medicare encounter files, each person-day of follow-up was assessed for CAT exposure, and outcomes were defined by using diagnostic code algorithms derived following chart abstraction. Incidence density ratios (compared with the reference category of no CAT) and survival analysis was conducted. Among 78 133 veterans (98.6% white; mean age, 72.3 [standard deviation 7.7]), 64% were prescribed ASA-antiplatelet and anticoagulant-antiplatelet and 6% were prescribed TRIP. The incidence of UGIE was 20.1/1000 patient-years, and the incidence of LGIE was 70.1/1000 patient-years. ASA-anticoagulant and TRIP were associated with the highest incidence of transfusion and hospitalization. A 40% to 60% increased risk of UGIE was observed with all strategies. LGIE was 30% higher with anticoagulant-antiplatelet, and transfusion increased with ASA-anticoagulant (hazard ratio, 6.1; 95% confidence interval, 5.2–7.1) and TRIP (hazard ratio, 5.0; 95% confidence interval, 4.2–5.8). Increased risk of hospitalization was noted with all strategies. The number needed to harm for UGIE or LGIE ranged from 52 to 65 and 15 to 23, respectively. The number needed to harm for hospitalization was 39 (anticoagulant-antiplatelet), 34 (ASA-anticoagulant), 67 (ASA-antiplatelet), and 45 (TRIP) patients. Conclusions— Among elderly patients, CAT-related LGIE and UGIE are clinically relevant risks resulting in increased hospitalizations and transfusions.
Determination of β-globin gene cluster haplotypes and prevalence of α-thalassemia in sickle cell anemia patients in Venezuela
Authors: A. Arends, M. Alvarez, D. Velázquez, M. Bravo, R. Salazar, J.M. Guevara, O. Castillo
Journal: American Journal of Hematology (2000)

Sickle cell anemia and α-thalassemia have a heterogeneous distribution in Venezuela with a high frequency in the coastal area (sea level) and few cases in the mountains. Most of our population is an ethnic admixture of Europeans (Spaniards colonists), Africans (slaves), and Amerindians. The purpose of our study was to determine the origin of the βs globin haplotype, age and survival dependency, and the admixture among the different African groups in our population. The α3.7 globin gene deletion status was also studied and found in a very high frequency. DNA from peripheral blood of 191 non-related patients (81 with HbS homozygous and 15 patients compound heterozygous for HbS, HbC, HbD with β-thalassemia, and 95 with sickle cell trait) were studied. The βs chromosome was linked 51% to the Benin Haplotype, 29.5% with the CAR, 12.5% to the Senegal, and 2.5% to the Cameroon. We did not find any significant difference between the haplotype distribution among adults and children and among sickle cell patients and traits. Only 8.6% of the patients have homozygosity for the Benin haplotype. These results show a very high frequency of admixture in our African origin population. Am. J. Hematol. 64:87–90, 2000. © 2000 Wiley-Liss, Inc.