tbuckley/cabot-search huggingface dataset:
A score for predicting risk of death from cardiovascular disease in adults with raised blood pressure, based on individual patient data from randomised controlled trials
Authors: S. J Pocock, V. McCormack, F. Gueyffier, F. Boutitie, R. H Fagard, J.-P. Boissel
Journal: BMJ (2001)

<h3>Abstract</h3> <b>Objective:</b> To create a risk score for death from cardiovascular disease that can be easily used. <b>Design:</b> Data from eight randomised controlled trials of antihypertensive treatment. <b>Setting:</b> Europe and North America. <b>Participants:</b> 47 088 men and women from trials that had differing age ranges and differing eligibility criteria for blood pressure. <b>Main outcome measure:</b> 1639 deaths from cardiovascular causes during a mean 5.2 years of follow up. <b>Results:</b> Baseline factors were related to risk of death from cardiovascular disease using a multivariate Cox model, adjusting for trial and treatment group (active versus control). A risk score was developed from 11 factors: age, sex, systolic blood pressure, serum total cholesterol concentration, height, serum creatinine concentration, cigarette smoking, diabetes, left ventricular hypertrophy, history of stroke, and history of myocardial infarction. The risk score is an integer, with points added for each factor according to its association with risk. Smoking contributed more in women and in younger age groups. In women total cholesterol concentration mattered less than in men, whereas diabetes had more of an effect. Antihypertensive treatment reduced the score. The five year risk of death from cardiovascular disease for scores of 10, 20, 30, 40, 50, and 60 was 0.1%, 0.3%, 0.8%, 2.3%, 6.1%, and 15.6%, respectively. Age and sex distributions of the score from the two UK trials enabled individual risk assessment to be age and sex specific. Risk prediction models are also presented for fatal coronary heart disease, fatal stroke, and all cause mortality. <b>Conclusion:</b> The risk score is an objective aid to assessing an individual9s risk of cardiovascular disease, including stroke and coronary heart disease. It is useful for physicians when determining an individual9s need for antihypertensive treatment and other management strategies for cardiovascular risk. <h3>What is already known on this topic</h3> Many other factors are known to affect the risk of cardiovascular disease in patients with raised blood pressure A patient9s overall risk should be taken into account when determining their need for antihypertensive drugs and other strategies for improving cardiovascular health <h3>What this study adds</h3> A new score uses 11 risk factors to quantify an adult9s risk of death from cardiovascular disease, including stroke and coronary heart disease The score is based on a large cohort of participants in controlled trials of antihypertensive drugs An individual9s risk can be readily assessed as high or low compared with others of the same age and sex The website http://www.riskscore.org.uk/ is available for users of the risk score
LONG TERM IMPACT OF RACE/ETHNICITY ON DEATH, MYOCARDIAL INFARCTION AND STROKE AMONG PATIENTS ENROLLED IN THE BYPASS ANGIOPLASTY REVASCULARIZATION INVESTIGATION OF TYPE 2 DIABETES TRIAL (BARI 2D)
Authors: Nirat Beohar, Veronica Sansing, V.S. Srinivas, Andrew Davis, Stephen Thomas, Tarek Helmy, Luis Lepe, Maria Brooks
Journal: Journal of the American College of Cardiology (2010)
Measuring the impact of menopausal symptoms on quality of life.
Authors: E Daly, A Gray, D Barlow, K McPherson, M Roche, M Vessey
Journal: BMJ (1993)

OBJECTIVE--To examine the impact of menopausal symptoms on the overall quality of life of women. DESIGN--Data collection with a questionnaire administered by an interviewer, incorporating two different quality of life measurement techniques (time trade off and rating scale). SETTING--Specialist menopause clinic and two general practices in Oxford. SUBJECTS--63 women aged 45-60 years recruited opportunistically during a clinic or appointment with a general practitioner; no exclusion criteria. RESULTS--Subjects gave very low quality of life ratings for health states with menopausal symptoms. The time trade off method of measuring preferences for these health states (on a scale from 0 to 1, where preference for full health is given as 1) yielded utility values of 0.64 for severe menopausal symptoms and 0.85 for mild symptoms. The rating scale measurement technique yielded even lower values: utilities of 0.30 and 0.65 were obtained for severe and mild symptoms respectively. Kappa scores indicated that the two methods produced results that were poorly related but not contradictory. Comparison of quality of life ratings before and after treatment with hormone replacement therapy showed significant improvements: with the rating scale measurement technique mean increases in utility values after the relief of severe and mild menopausal symptoms were 0.56 and 0.18 respectively. CONCLUSIONS--Quality of life may be severely compromised in women with menopausal symptoms, and perceived improvements in quality of life in users of hormone replacement therapy seem to be substantial. This emphasises the need to include quality of life measurements when assessing outcomes of hormone replacement therapy. Several limitations may exist with widely applied measurement techniques, calling for the development of appropriate and well validated instruments for measuring quality of life associated with reduced health states.
Do Adult Squirrels Castrate Each Other.
Authors: Edmund Andrews
Journal: JAMA (1898)

Chicago, Ill., Jan. 25, 1898. <h3>To the Editor:</h3> —In the article on eunuchs in the previous number of theJournalI stated that when adult gray squirrels engage in battle one often castrates the other. I had this information from a distinguished naturalist, who inferred it because a considerable portion of wild squirrels are found to be emasculated. Dr. A. S. Allen, an interne of Mercy Hospital, Chicago, furnishes the following facts observed by him which partly contradict the naturalist. Dr. Allen says that although about one-third of the wild squirrels killed by hunters are found to be castrated, yet he thinks it is not done in fighting. He says that a number of gray squirrels lived protected in the trees about his former residence. A female raised a litter of young in a tree close to the house. One day when the young were about one-quarter grown he observed
The differing tempo of growth in bone size, mass, and density in girls is region-specific
Authors: Shona Bass, Pierre D. Delmas, Georgina Pearce, Elke Hendrich, Aaron Tabensky, Ego Seeman
Journal: Journal of Clinical Investigation (1999)

The differing tempo and direction of growth of the periosteal and endocortical surfaces, and the differing tempo of growth of the axial and appendicular skeleton, may predispose to regional deficits in bone size, bone mineral content (BMC), and volumetric bone mineral density (vBMD). These traits were measured during 2 years by dual x-ray absorptiometry in 109 girls. By 7 years of age, bone size was approximately 80% of its maturational peak, and BMC was approximately 40% of its peak. Before puberty, the legs grew more rapidly than the trunk. During puberty, the growth spurt was truncal. Between 7 and 17 years, femoral and lumbar spine BMC increased by 50–150% because bone size increased. vBMD increased by 10–30%. Thus, growth builds a bigger, but only moderately denser, skeleton. Regions growing rapidly, or distant from their peak, may be more severely affected by illness than those growing slowly or nearer completion of growth. Depending on the age of exposure to disease, deficits may occur in limb dimensions (prepuberty), spine dimensions (early puberty), or vBMD by interference with mineral accrual (late puberty). As vBMD is independent of age before puberty, the position of an individual’s vBMD in the population distribution is established early in life. Bone fragility in old age may have its foundations in growth.
Auditory System: Physiology (CNS), Behavioral Studies, Psychoacoustics
Authors: Robert W. Cantrell
Journal: JAMA (1976)

This book is Part 2 of a three-book series on the auditory system, which is part of the larger nine volume, 23-book<i>Handbook of Sensory Physiology</i>. The publishers are to be complimented for undertaking this monumental task today when publishing costs are soaring. Realizing that the market for this set will be limited primarily to institutions, the publishers chose to be complete rather than restrict portions for economy's sake. Part 2 continues the excellent discussion of all aspects of the auditory system begun in Part 1 by Keidel and Neff. Again, some of the finest workers in the field of auditory physiology have written chapters. E. F. Evans authored the 108-page Chapter 1 on the cochlear nerve and cochlear nucleus, and the 13-page bibliography indicates the thoroughness with which he approached the subject. W. D. Neff, one of the editors, has written an excellent chapter with I. T. Diamond and
Drugs That Induce Repolarization Abnormalities Cause Bradycardia in Zebrafish
Authors: David J. Milan, Travis A. Peterson, Jeremy N. Ruskin, Randall T. Peterson, Calum A. MacRae
Journal: Circulation (2003)

Background— Drug-induced QT prolongation and torsades de pointes remain significant and often unpredictable clinical problems. Current in vitro preclinical assays are limited by biological simplicity, and in vivo models suffer from expense and low throughput. Methods and Results— During a screen for the effects of 100 small molecules on the heart rate of the zebrafish, Danio rerio , we found that drugs that cause QT prolongation in humans consistently caused bradycardia and AV block in the zebrafish. Of 23 such drugs tested, 18 were positive in this initial screen. Poor absorption explained 4 of 5 false-negative results, as demonstrated by microinjection. Overall, 22 of 23 compounds that cause repolarization abnormalities were positive in this assay. Antisense “knockdown” of the zebrafish KCNH2 ortholog yielded bradycardia in a dose dependent manner confirming the effects of reduction of repolarizing potassium current in this model. Classical drug-drug interactions between erythromycin and cisapride, as well as cimetidine and terfenadine, were also reproduced. Conclusion— This simple high-throughput assay is a promising addition to the repertoire of preclinical tests for drug-induced repolarization abnormalities. The genetic tractability of the zebrafish will allow the exploration of heritable modifiers of such drug effects.
Cytogenetics of Leukemia
Authors: Robert S. Sparkes
Journal: New England Journal of Medicine (1984)

For many years it has been recognized that patients who apparently have the same type of leukemia have different prognoses and different responses to treatment. These differences have been thought to reflect the presence of indistinguishable diseases that superficially appear to be similar. Recent advances indicate that genetic changes in tumor cells may have a signal role in these differences. Although chromosomal changes in tumor cells have been suspected since the turn of the century, it has only recently become possible to demonstrate them. The establishment of the correct chromosome number in human beings in 1956 set the stage for . . .
Abstract 604: Olfactomedin 4 inhibits prostate stem/progenitor cells growth through regulating the hedgehog signaling pathway
Authors: Hongzhen Li, Wenli Liu, Weiping Chen, Jianqiong Zhu, Chu-Xia Deng, Griffin P. Rodgers
Journal: Cancer Research (2014)

Abstract The olfactomedin 4 gene (OLFM4) plays critical tumor suppressor roles in human and murine prostate cancer. We have previously reported that loss or reduce of OLFM4 expression is associated with the progression of human prostate cancer. We further found that loss of Olfm4 leads to prostate neoplastic progression in the Olfm4-knockout mouse model. To study the cellular and molecular mechanisms underlying neoplastic progression of the prostate, we have performed gene chip microarray and quantitative real-time RT-PCR analysis to compare Olfm4 knockout with wild-type mouse prostate. The gene-expression signature of prostate tissues from Olfm4-deficient mice revealed significant changes for genes associated with neoplastic progression. In this study, we further detected that hedgehog signaling-pathway components are up-regulated in Olfm4-knockout mice. Since hedgehog signaling pathways are involved in regulating prostate stem/ progenitor cell proliferation, we performed sphere formation analysis with Olfm4 mutant mouse prostate and found that loss of Olfm4 increased proliferative abilities of prostate stem/progenitor cells. Interestingly, administration of human OLFM4 protein and cyclopamine, a specific inhibitor of Shh-signaling pathway, into the sphere culture media reduced Olfm4-deficient mouse prostate stem/progenitor cell growth. To extend the observation from the mouse model, we established OLFM4-GFP fusion stably expressing cell clones by using human prostate cancer cell lines PC-3, 22RV1 and DU145. We found significant inhibition of sphere and colony formation in OLFM4 expressing cells compared with vector expressing control cells. The expression levels of Shh signaling pathway components were significantly inhibited in OLFM4 expression cells compared to vector expressing control cells. To detect whether or not OLFM4 down regulates the Shh signaling pathway through interaction with Shh protein, we performed co-immunopricipitation in 293T and PC-3 OLFM4 stably expressing cells. We found that OLFM4 directly interacts with Shh protein. We then carried out Gli- reporter assay using 293T and prostate cancer cells. We demonstrated that expression of OLFM4 inhibited Gli-reporter activity in a dose-dependent manner. Taken together, these results suggest that OLFM4 inhibits prostate stem/progenitor cells growth by mediating the Shh signaling pathway through a direct interaction of OLFM4 with Shh protein. Citation Format: Hongzhen Li, Wenli Liu, Weiping Chen, Jianqiong Zhu, Chu-Xia Deng, Griffin P. Rodgers. Olfactomedin 4 inhibits prostate stem/progenitor cells growth through regulating the hedgehog signaling pathway. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 604. doi:10.1158/1538-7445.AM2014-604
BI-CHLORIDE OF MERCURY IN DIPHTHERIA.
Authors: Madison Reece
Journal: JAMA (1883)

During the past two and a half years I have used, exclusively, in the treatment of diphtheria, the bichloride of mercury in large and frequent doses. My attention was called to its use by reading the address dress of Dr. Wm. Pepper, chairman of the Section of Practical Medicine, before the American Medical Association for the year 1881. The statements therein made interested me to such an extent that, having on hand two cases of this disease of a malignant form, I determined to try its efficacy. Up to this time I had found (as who has not?) true diphtheria one of the most fatal forms of disease that could be encountered. I had used the usual remedies, so far as I could observe without any effect upon the progress of the disease, and had arrived at the conclusion that in the worst forms of the disease the patient would
Neurohumoral Prediction of Benefit From Carvedilol in Ischemic Left Ventricular Dysfunction
Authors: A. M. Richards, R. Doughty, M. G. Nicholls, S. Macmahon, H. Ikram, N. Sharpe, E. A. Espiner, C. Frampton, T. G. Yandle
Journal: Circulation (1999)

Plasma neurohormones were analyzed for prediction of adverse outcomes and response to treatment in 415 patients with ischemic left ventricular dysfunction randomly assigned to receive carvedilol or placebo.Atrial natriuretic peptide, brain natriuretic peptide (BNP), or norepinephrine (NE) levels above the group median were associated with increased mortality rates and heart failure. On multivariate analysis, both BNP and NE interacted with treatment to predict death or heart failure independent of age, New York Heart Association class, and left ventricular ejection fraction. For placebo, supramedian levels of BNP were associated with 3-fold the mortality rate of inframedian levels (20/104; 19% vs 6/99; 6%; P<0.01). For carvedilol, mortality rate was comparable in these 2 subgroups (12/109; 11% vs 8/94; 9%; NS). Corresponding rates for heart failure were 29/104 (28%) versus 3/99 (3%; P<0.001) for placebo and 16/109 (15%) versus 7/94 (7%; NS) for carvedilol. High NE levels did not predict additional benefit from carvedilol, which significantly reduced heart failure admissions only in those with NE levels below the median (13.1% to 4. 0%; P<0.01). In the 23% of the study population with supramedian BNP but inframedian levels of NE, carvedilol reduced hospital admission with heart failure by >90% (P<0.001).Carvedilol reduced mortality rates and heart failure in those with higher pretreatment BNP levels but lesser activation of plasma NE. Neurohumoral profiling may guide introduction of beta-blockade in heart failure.
The price of truth
Authors: G. Pink
Journal: BMJ (1994)

“Truth,” wrote Emily Dickinson, “is such a rare thing, it is delightful to tell it.” I cannot agree. Telling the truth of what I witnessed and was unwillingly party to has been a wretched, distressing, and costly business.

For three years, from August 1987, I worked as a charge nurse on night duty with overall responsibility for the care of 72 desperately ill and dying men and women on the short stay, medical, and geriatric wards at Stepping Hill Hospital, Stockport. Patients were admitted only if critically ill from a stroke, heart attack, chest infection, kidney failure, cancer, other life threatening illness, or, more usually, a combination of such conditions. Those few able to move alone were liable to wander. Often patients would end up on the floor and injure themselves. Incontinent patients required regular bed changes; the rest needed frequent toileting during the night.

On admission most were in shock, frightened, and often in despair. A sick or disabled spouse left alone at home would give them cause for great concern and worry. Others were completely alone in the world, perhaps grieving over the loss of a lifetime partner or in fear of impending death. Each was highly dependent. For example, the statistics for ward A14 (a 26 bed male ward) show that on average in 1989 each night over seven patients (28%) fell into category III (highly dependent) and 11 patients (42%) were in category IV (totally dependent). Total dependency means all care with feeding, hydration, turning, toileting, medication, treatment, close observation, etc. A typical handover report would contain liberal use of such words as incontinent, confused, unconscious, paralysed, distressed, aggressive, depressed, collapse, suicidal, moribund, very poorly, fell out of bed today, anxious, dysphagia, dementia, observe closely, wanders, vomiting, and tender loving care—an inelegant and often totally inappropriate …
GP struck off after 30 patients are infected with hepatitis B
Authors: C. Dyer
Journal: BMJ (2000)

A 70 year old GP in London who served a jail term for performing illegal abortions was struck off the medical register for the second time last week after he admitted causing an outbreak of acute hepatitis B.

Madhusudan Shivadikar, who ran the Finchley Alternative Medical Centre in north London, was found guilty of serious professional misconduct by the General Medical Council after causing 30 patients to become infected with hepatitis B.

The GMC's professional conduct committee said that he had a cavalier approach to the most basic medical procedures and had failed to take appropriate measures to protect patients from the risk of serious communicable diseases.

Dr Shivadikar admitted failing to exercise proper infection control and failing to make adequate provision for the disposal of needles and clinical waste. He also admitted failing to keep proper records for patients and acknowledged that he had misled an incident control team from Barnet health authority by failing to disclose that his daughter Miriam, who was not medically qualified, performed skin breaching techniques.

The committee heard that Dr Shivadikar's daughter had performed autohaemotherapy, an unproved technique that involves reinjecting patients with their own blood at various points around the body after mixing it with a saline solution. Between 80 and 90 patients had been treated between July 1997 and February 1998. The GMC's counsel, Lydia Barnfather, said it was fortunate that none had become infected with HIV.

In 1979 Dr Shivadikar was struck off the medical register after being convicted of two illegal abortions and sentenced to 18 months in prison. One of the women contracted an infection and was seriously unwell, the committee was told. But he was restored to the register less than a year later in March, 1999.

Dr Ian Bogle, chairman of the BMA's council, said: This man is clearly a public menace. It is essential that he is not allowed to slip through the net by continuing to work as an acupuncturist. Unlike medicine, acupuncture is not regulated by statute.

A spokesman for the London Borough of Barnet said that anyone wanting to work as an acupuncturist would need a licence from the local authority. Dr Shivadikar had applied for a licence after he was suspended by the GMC but had not replied to requests for further information.
Bronchoesophageal Fistula Secondary to Hodgkin's Disease
Authors: Luis L. Gonzalez
Journal: JAMA (1966)

THE DEVELOPMENT of a bronchoesophageal fistula is a life-threatening complication to which patients readily succumb because of continuous pulmonary aspiration of food and saliva.<sup>1</sup>Spontaneous closure of the fistula cannot be expected to occur, since the passage of food and saliva tends to keep the fistulous tract inflamed and patent. Because of a better prognosis, most of the interest in the management of these fistulas has been focused upon those secondary to infection or trauma.<sup>2</sup>Bronchoesophageal fistula resulting from carcinoma is usually a terminal manifestation and not amenable to curative therapy.1 Hodgkin's disease is a rare cause of bronchoesophageal fistula; however, the general improvement in the therapy for this disease may warrant a more aggressive therapeutic approach than that generally recognized. The present case report outlines a therapeutic approach which was used in the management of a patient with