tbuckley/cabot-search huggingface dataset:
Genetic Determinants of Hemostasis Phenotypes in Spanish Families
Authors: Juan Carlos Souto, Laura Almasy, Montserrat Borrell, Merce Garí, Elisabet Martínez, José Mateo, William H. Stone, John Blangero, Jordi Fontcuberta
Journal: Circulation (2000)

Background —Recent studies have described genetic mutations that affect the risk of thrombosis as a result of abnormal levels of such hemostatic parameters as protein C, protein S, and the activated protein C resistance ratio. Although these mutations suggest that genes play a part in determining variability in some hemostasis-related phenotypes, the relative importance of genetic influences on these traits has not been evaluated. Methods and Results —The relative contributions of genetic and environmental influences to a panel of hemostasis-related phenotypes were assessed in a sample of 397 individuals in 21 extended pedigrees. The effects of measured covariates (sex, age, smoking, and exogenous sex hormones), genes, and environmental variables shared by members of a household were quantified for 27 hemostasis-related measures. All of these phenotypes showed significant genetic contributions, with the majority of heritabilities ranging between 22% and 55% of the residual phenotypic variance after correction for covariate effects. Activated protein C resistance ratio, activated partial thromboplastin time, and Factor XII showed the strongest heritabilities, with 71.3%, 83.0%, and 67.3%, respectively, of the residual phenotypic variation attributable to genetic effects. Conclusions —These results clearly demonstrate the importance of genetic factors in determining variation in hemostasis-related phenotypes that are components of the coagulation and fibrinolysis pathways and that have been implicated in risk for thrombosis. The presence of such strong genetic effects suggests that it will be possible to localize previously unknown genes that influence quantitative variation in these hemostasis-related phenotypes that may contribute to risk for thrombosis.
Microvascular Obstruction and Left Ventricular Remodeling Early After Acute Myocardial Infarction
Authors: Bernhard L. Gerber, Carlos E. Rochitte, Jacques A. Melin, Elliot R. McVeigh, David A. Bluemke, Katherine C. Wu, Lewis C. Becker, João A. C. Lima
Journal: Circulation (2000)

Background —The presence of microvascular obstruction (MO) within infarcted regions may adversely influence left ventricular (LV) remodeling after acute myocardial infarction. This study examined whether the extent of MO directly alters the mechanical properties of the infarcted myocardium. Methods and Results —Seventeen dogs underwent 90 minutes of balloon occlusion of the left anterior descending coronary artery, followed by reperfusion. Gadolinium-enhanced perfusion MRI and 3D-tagging were performed 4 to 6 and 48 hours (8 animals) and 10 days (9 animals) after reperfusion. Early increase in LV end-diastolic volume (from 42±9 to 54±14 mL, P &lt;0.05) between 4 to 6 and 48 hours after reperfusion was predicted by both extent of MO ( r =0.89, P &lt;0.01) and infarct size ( r =0.83, P &lt;0.01), defined as MRI hypoenhanced and hyperenhanced regions, respectively. Multivariate analysis demonstrated that extent of MO had better and independent value to predict LV volume than overall infarct size. A strong inverse relationship existed between magnitude of first principal strain ( r =−0.80, P &lt;0.001) and relative extent of MO within infarcted myocardium. Also, infarcted myocardium involved by extensive areas of MO demonstrated reductions of circumferential ( r =−0.61, P &lt;0.01) and longitudinal ( r =−0.53, P &lt;0.05) stretching. Furthermore, significant reductions of radial thickening (9±6% versus 14±3%, P &lt;0.01) occurred in noninfarcted regions adjacent to infarcts that had increased (&gt;35%) amounts of MO. Conclusions —In the early healing phase of acute myocardial infarction, the extent of MO in infarcted tissue relates to reduced local myocardial deformation and dysfunction of noninfarcted adjacent myocardium. Such strain alterations might explain the increased remodeling observed in patients with large regions of MO.
Comparison of the lymphoid toxicities of mitobronitol and busulphan in mice: reduced B cell toxicity and improved thymic recovery as possible contributors to the reduced risk for complications following BMT with mitobronitol preconditioning
Authors: J Szebeni, K Barna, F Uher, J Milosevits, K Pálóczi, D Gaál, GG Petrányi, E Kelemen
Journal: Leukemia (1997)
The Patient-Physician Relationship: Is Three a Crowd?
Authors: Jonathan H. Lin
Journal: JAMA (1999)

OPEN AND FRANK COMMUNICATION BETWEEN DOCTORS AND THEIR patients has always been the cornerstone of effective health care delivery. Patients willingly relinquish detailed information about their physical conditions plus personal and family histories to which few people, if any, are ever privy. Physicians are entrusted to use this private knowledge, not for personal gain, but to provide curative and palliative therapies that will unconditionally improve the patient’s well-being. These straightforward aims are threatened by the practical difficulties that arise when the competing objectives of other parties (nonphysician and nonpatient) enter the situation. As described by Joel Schofer and Martin Furmanski, societal exigencies can impinge on the relative sanctity of the patient-physician relationship, as during wartimes when government directives have contravened the privacy of the patient-physician relationship. Fortunately, such situations rarely occur. A more urgent factor changing the nature of the patient-physician relationship is the increasing prominence of cost containment in medical practice and the resulting pressure on physicians to see more patients in the same amount of time. As in any other human relationship, trust between the physician and patient requires time to become established. The patient may be initially skeptical of the physician’s abilities or intentions and withhold information necessary for a medical diagnosis. The physician may require time to attune to the behavior and speech nuances of a particular patient and appreciate the complete story. How long does it take for effective communication to happen? As Dan Reirden recounts in this issue, years can go by, and the physician may still not be completely aware of the circumstances surrounding a patient’s illness. In this age of 15-minute office visits, one can only wonder how much information that could have been useful in treating a patient’s condition is left unsaid. Other factors modify the way patients and physicians interact with one another. The growing number of non–Englishspeaking patients has necessitated introducing multilingual intermediaries between the physician and patient. As Lorna Breen discusses in this issue, information can be readily lost or distorted as the message is translated from one language to another. The articles in this and future issues of MSJAMA touch on only a few of the challenges faced by physicians in providing personalized and competent health care. As the new academic year begins, medical students would be well advised to keep abreast of the medical implications of changes in the patient population and, perhaps most importantly, the growing dominance of financial incentives in shaping the manner in which physicians interact with their patients.
REMOVAL OF ADHESIVE PLASTER
Authors: John P. Brandon
Journal: JAMA (1923)

<h3>To the Editor:</h3> —InThe Journal, July 7, Dr. H. F. Zoller recommended the use of ethyl acetate for the removal of adhesive plaster. Since this is almost impossible to obtain, especially in the country drug stores, I want to suggest the use of ordinary benzene. If the adhesive strips are moistened lightly with the benzene by daubing it on with bits of cotton, the plaster will come away nicely; then the stains from the adhesive plaster are scrubbed off with the remainder of the benzene in cotton.
The Oral Glucose Tolerance Test (OGTT): Effect of Rate of Ingestion of Carbohydrate and Different Carbohydrate Preparations
Authors: Robert J Heine, Ian Hanning, Linda Morgan, K George M M Alberti
Journal: Diabetes Care (1983)

The glucose load of the oral glucose tolerance test (OGTT) is well standardized. However, recommendations on rate of ingestion and nature of the load are vague. In this study the effect on blood glucose, serum insulin, C-peptide, and plasma gastric inhibitory polypeptide (GIP) of giving 75 g glucose in 300 ml over 1 and 10 min (G1 and G10) was investigated in six subjects. In five an isocaloric amount of partially hydrolyzed starch (Hycal) was also used (H1 and H10). The fast glucose intake, compared with the slow ingestion, resulted in an earlier rise in blood glucose levels, accompanied by a faster serum insulin and C-peptide response. Between 90 and 135 min blood glucose concentrations were significantly higher after the 10-min glucose intake. At 120 min blood glucose levels were 5.5 +/- 0.5 and 4.7 +/- 0.5 mmol/L, respectively, for G10 and G1 (P less than 0.05). In the first half hour after slow and fast Hycal intake no differences were seen in blood glucose, serum insulin, and C-peptide levels. Between 45 and 120 min blood glucose levels were significantly higher after the 10-min Hycal intake. At 120 min blood glucose levels were 5.3 +/- 0.2 and 4.4 +/- 0.1 mmol/L, respectively, for H10 and H1 (P less than 0.01). Except for a faster rise in glucose and insulin levels after glucose loading in 1 min, no further differences were found, when compared with Hycal. No significant differences were seen in the GIP responses. Thus differences in rates of ingestion can cause significant differences in later results. A standard time for glucose ingestion should be specified.
Primary Cutaneous Tuberculosis Resulting from Mouth-to-Mouth Respiration
Authors: Kenneth M. Heilman, Carl Muschenheim
Journal: New England Journal of Medicine (1965)

NEW YORK CITYSINCE the advent of the chemotherapy of tuberculosis primary cutaneous tuberculosis has become a rare clinical entity. With the reinstitution of mouth-to-mouth artificial respiration the physician has increased his chances of exposure to the tubercle bacillus. The case of primary cutaneous tuberculosis reported below presented an interesting problem in differential diagnosis and treatment. It also serves as a warning of some of the hazards of mouth-to-mouth resuscitation.Case ReportK.M.H., a 25-year-old intern in the Second (Cornell) Medical Division at Bellevue Hospital, had enjoyed good health his entire life and had had negative P.P.D. tests throughout medical . . .
Familial Sensitivity to Suxamethonium Due to Atypical Pseudocholinesterase
Authors: A. B. M. Telfer, D. J. F. MacDonald, A. J. Dinwoodie
Journal: BMJ (1964)

A simple apparatus which can deliver a painful electric shock to the subject for aversion therapy is described. It has advan tages over nausea-producing drugs, particularly in allowing the patient to treat himself even at home. The use of the apparatus is illustrated by cases of fetishism, obsessional rumi nations, smoking, writer's cramp, and alcoholism. Technical details are given of the components and their assembly which requires only the most rudimentary knowledge of electricity.
Effects of erythropoietin on muscle O2 transport during exercise in patients with chronic renal failure.
Authors: R M Marrades, J Roca, J M Campistol, O Diaz, J A Barberá, J V Torregrosa, J R Masclans, A Cobos, R Rodríguez-Roisin, P D Wagner
Journal: Journal of Clinical Investigation (1996)

Erythropoietin (rHuEPO) has proven to be effective in the treatment of anemia of chronic renal failure (CRF). Despite improving the quality of life, peak oxygen uptake after rHuEPO therapy is not improved as much as the increase in hemoglobin concentration ([Hb)] would predict. We hypothesized that this discrepancy is due to failure of O2 transport rates to rise in a manner proportional to [Hb]. To test this, eight patients with CRF undergoing regular hemodialysis were studied pre- and post-rHuEPO ([Hb] = 7.5 +/- 1.0 vs. 12.5 +/- 1.0 g x dl-1) using a standard incremental cycle exercise protocol. A group of 12 healthy sedentary subjects of similar age and anthropometric characteristics served as controls. Arterial and femoral venous blood gas data were obtained and coupled with simultaneous measurements of femoral venous blood flow (Qleg) by thermodilution to obtain O2 delivery and oxygen uptake (VO2). Despite a 68% increase in [Hb], peak VO2 increased by only 33%. This could be explained largely by reduced peak leg blood flow, limiting the gain in O2 delivery to 37%. At peak VO2, after rHuEPO, O2 supply limitation of maximal VO2 was found to occur, permitting the calculation of a value for muscle O2 conductance from capillary to mitochondria (DO2). While DO2 was slightly improved after rHuEPO, it was only 67% of that of sedentary control subjects. This kept maximal oxygen extraction at only 70%. Two important conclusions can be reached from this study. First, the increase in [Hb] produced by rHuEPO is accompanied by a significant reduction in peak blood flow to exercising muscle, which limits the gain in oxygen transport. Second, even after restoration of [Hb], O2 conductance from the muscle capillary to the mitochondria remains considerably below normal.
Osteogenic graft vascularization and bone resorption by VEGF-expressing human mesenchymal progenitors
Authors: Uta Helmrich, Nunzia Di Maggio, Sinan Güven, Elena Groppa, Ludovic Melly, Rene D. Largo, Michael Heberer, Ivan Martin, Arnaud Scherberich, Andrea Banfi
Journal: Biomaterials (2013)
AZT (Zidovudine) Just a Step Away From FDA Approval for AIDS Therapy
Authors: Charles Marwick
Journal: JAMA (1987)

AN ADVISORY COMMITTEE of the Food and Drug Administration (FDA), by a vote of ten to one, has recommended that the FDA commissioner approve the anti-viral drug azidothymidine (AZT) for the treatment of acquired immunodeficiency syndrome (AIDS). The United States Adopted Name (USAN) designation for AZT, decided upon earlier this year, is zidovudine. The drug has been shown to inhibit the enzyme that the AIDS virus uses to replicate in the cell. It also appears to have other advantages in the management of patients with AIDS, such as the ability to penetrate the blood-brain barrier. The committee's action is not binding on the agency, but such advice always carries considerable weight. Given the present poor outlook for patients with AIDS and the lack of effective treatment for the disease, the agency is unlikely to reject the committee's recommendation. Yet, even when approved, AZT will be restricted to those groups of
Maternal Weight Gain Is Associated With Infant Insulin Concentrations During the 1st Year of Life
Authors: Donna M. Winham, Carol S. Johnston, Kristen M. Rhoda
Journal: Diabetes Care (2006)

Since hyperinsulinemia tracks from childhood to adulthood and is associated with diabetes risk, identifying modifiable conditions during gestation that may impact insulin metabolism in offspring is important. We conducted a pilot study to investigate associations between maternal weight gain and infant insulin concentrations in an underserved population at high risk for diabetes. Mexican or Native American women with an infant <1 year of age provided written consent. Infant weight-for-age Z scores (WAZ) were calculated, and nonfasting plasma samples were analyzed for insulin by standard assay. Pearson’s bivariate test was used to assess relationships between variables, and …
PET Imaging of Tumor Neovascularization in a Transgenic Mouse Model with a Novel 64Cu-DOTA-Knottin Peptide
Authors: Carsten H. Nielsen, Richard H. Kimura, Nadia Withofs, Phuoc T. Tran, Zheng Miao, Jennifer R. Cochran, Zhen Cheng, Dean Felsher, Andreas Kjær, Juergen K. Willmann, Sanjiv S. Gambhir
Journal: Cancer Research (2010)

Due to the high mortality of lung cancer, there is a critical need to develop diagnostic procedures enabling early detection of the disease while at a curable stage. Targeted molecular imaging builds on the positive attributes of positron emission tomography/computed tomography (PET/CT) to allow for a noninvasive detection and characterization of smaller lung nodules, thus increasing the chances of positive treatment outcome. In this study, we investigate the ability to characterize lung tumors that spontaneously arise in a transgenic mouse model. The tumors are first identified with small animal CT followed by characterization with the use of small animal PET with a novel 64Cu-1,4,7,10-tetra-azacylododecane-N,N',N'',N'''-tetraacetic acid (DOTA)-knottin peptide that targets integrins upregulated during angiogenesis on the tumor associated neovasculature. The imaging results obtained with the knottin peptide are compared with standard 18F-fluorodeoxyglucose (FDG) PET small animal imaging. Lung nodules as small as 3 mm in diameter were successfully identified in the transgenic mice by small animal CT, and both 64Cu-DOTA-knottin 2.5F and FDG were able to differentiate lung nodules from the surrounding tissues. Uptake and retention of the 64Cu-DOTA-knottin 2.5F tracer in the lung tumors combined with a low background in the thorax resulted in a statistically higher tumor to background (normal lung) ratio compared with FDG (6.01±0.61 versus 4.36±0.68; P<0.05). Ex vivo biodistribution showed 64Cu-DOTA-knottin 2.5F to have a fast renal clearance combined with low nonspecific accumulation in the thorax. Collectively, these results show 64Cu-DOTA-knottin 2.5F to be a promising candidate for clinical translation for earlier detection and improved characterization of lung cancer.
Drug-induced autoimmune hepatitis: Clinical characteristics and prognosis
Authors: Einar Björnsson, Jayant Talwalkar, Sombat Treeprasertsuk, Patrick S. Kamath, Naoki Takahashi, Schuyler Sanderson, Matthias Neuhauser, Keith Lindor
Journal: Hepatology (2010)

Drug-induced autoimmune hepatitis (DIAIH) has been reported to be caused by several drugs. There is a lack of data comparing these patients with other patients with autoimmune hepatitis (AIH). A search was performed using the Mayo Clinic diagnostic medical index for AIH patients and DIAIH patients identified over 10 years. Individuals with overlap syndromes and decompensated liver disease were excluded. Overall, 261 patients (204 females, median age 52) were identified, and 24 (9.2%) were DIAIH cases with a median age of 53 (interquartile range, 24-61). Two drugs, nitrofurantoin (n = 11) and minocycline (n = 11), were the main causes. A similar proportion of DIAIH patients had positive antinuclear antibodies (83% versus 70%) and smooth muscle antibodies (50% versus 45%) as compared with AIH patients. Histological grade and stage were similar in patients with DIAIH versus AIH; however, none of the DIAIH patients had cirrhosis at baseline; this was present in 20% of matched AIH cases. Liver imaging was normal in all minocycline cases. Eight of 11 (73%) nitrofurantoin patients had abnormalities on hepatic imaging (mainly liver atrophy), a finding seen in only 8 of 33 (24%) of a random sample of the rest of the AIH group (P = 0.0089). Corticosteroid responsiveness was similar in DIAIH and the AIH patients. Discontinuation of immunosuppression was tried and successful in 14 DIAIH cases, with no relapses (0%), whereas 65% of the AIH patients had a relapse after discontinuation of immunosuppression (P < 0.0001).A significant proportion of patients with AIH have drug-induced AIH, mainly because of nitrofurantoin and minocycline. These two groups have similar clinical and histological patterns. However, DIAIH patients do not seem to require long-term immunosuppressive therapy.
Intraoperative and Postoperative Biliary Endoscopy (Choledochoscopy)
Authors: G. Berci
Journal: Endoscopy (1989)

The majority of choledocholithiasis patients still require surgery. If the stones are removed, the patient is cured. With modern cholangiography, the anatomy and the location of the calculi can be immediately identified at the beginning of the operation. In 6% of cases, anomalies of surgical importance are detected. The general surgeon is not an endoscopist and therefore, choledochoscopy is used infrequently. The introduction of video techniques changed this pattern because the learning curve is shorter and the procedure is easier and faster to perform with a higher success rate. A permanent (objective) record of the findings and the visualization of the sphincter location and function is an added bonus. If a stone is missed and the T-tube is inserted in the proper fashion, the same video choledochoscope which is employed in the intraoperative phase can be used in the postoperative period. In our experience (108 cases) we had a success rate of 98%. It can be performed on an outpatient basis. The surgeon should be acquainted with intraoperative and postoperative biliary endoscopy to improve the final outcome of this common and important surgical procedure.
How to improve surgical research
Authors: P. McCulloch
Journal: BMJ (2011)

A change in attitudes, training, and infrastructure, and much lobbying, are needed

On 15 June the Royal College of Surgeons published its report From Theory to Theatre: Overcoming Barriers to Innovation in Surgery ,1 which outlined the problems that surgical research faces and how they might be solved. Surgery has advanced spectacularly in the past 50 years, but many advances have not come from carefully planned research using valid study designs. Consequently, neither the public nor the surgical community seems convinced that we need scientific research into surgery, as opposed to research into diseases that surgeons can treat. That this perception is dangerously wrong is one of the key messages of the college’s report.

The report highlights past surgical achievements to a degree that might lead the naive observer to ask why—if surgeons are doing so well—they need to change anything. However, it also cites the decline of academic surgery in universities, the disappearance of meaningful contact with research from surgical training programmes, and the enormous practical difficulties caused by past failure to build a robust research infrastructure or an intellectual support network within surgery. The most …
A "Practical Note."
Authors: A. P. Brown
Journal: JAMA (1891)

<h3>To the Editor:</h3> —I am very glad to see your "Practical Notes." Keep it up and enlarge, and as you have one for carbuncle I will try to help you out with mine. In 1855 Stone and Hunt, of New Orleans, taught the + incision. I keep it up under cocaine. Now then fill the carbuncle full of dry salicylic acid, it completely dissolves all the hard white tissue; wash it away with sublimate soap and hot water; fill cavity with peroxide of hydrogen; when bubbling ceases sponge out with cotton; dress with basilican ointment and as soon as matter reforms repeat acid, etc. It makes a rapid and painless cure. Fort Worth, Tex., Feb. 19, 1891.