tbuckley/cabot-search huggingface dataset:
Does verapamil improve left ventricular relaxation in patients with myocardial hypertrophy?
Authors: O M Hess, T Murakami, H P Krayenbuehl
Journal: Circulation (1986)

A beneficial effect of verapamil on left ventricular relaxation has been reported in patients with hypertrophic cardiomyopathy. The effect of 0.1 mg/kg intravenous verapamil on left ventricular relaxation and diastolic mechanics was studied in 10 patients with hypertrophic cardiomyopathy and 13 patients with aortic stenosis. M mode echocardiograms and left ventricular high-fidelity pressure measurements were obtained simultaneously in patients at rest and 10 to 15 min after verapamil. The time constant of left ventricular pressure decay (T; in msec) and the pressure intercept (PB; in mm Hg) were calculated from left ventricular pressure and negative dP/dt during isovolumetric relaxation with the use of a linear regression analysis. Left ventricular early and mean diastolic filling rates as well as diastolic pressure-diameter relationships before and after verapamil were determined from simultaneous echocardiographic and pressure measurements. After verapamil heart rate, left ventricular peak systolic pressure, and maximum and minimum dP/dt remained unchanged in both groups. Left ventricular end-diastolic pressure increased significantly from 15 to 17 mm Hg (p less than .02) in patients with aortic stenosis but did not change in those with hypertrophic cardiomyopathy. However, the time constant T decreased significantly from 79 to 60 msec (p less than .001) in patients with hypertrophic cardiomyopathy but increased significantly from 53 to 68 msec (p less than .025) in those with aortic stenosis. Parallel to the decrease in time constant, early (5.3 vs 7.3 cm/sec, p less than .05) and mean (3.0 vs 4.3 cm/sec, p less than .06) diastolic lengthening rate increased in patients with hypertrophic cardiomyopathy after verapamil. In contrast, early (7.7 vs 7.6 cm/sec, p = NS) and mean (4.3 vs 4.2 cm/sec, p = NS) diastolic lengthening rate remained unchanged in patients with aortic stenosis. The diastolic pressure-diameter relationship did not change in either group after verapamil. Cycle efficiency of the left ventricular pressure-diameter loop was significantly decreased in patients with hypertrophic cardiomyopathy when compared with that in those with aortic stenosis (71% vs 80%; p less than .01), but improved significantly from 71% to 77% (p less than .02) in patients with hypertrophic cardiomyopathy and remained unchanged in those with aortic stenosis (80% vs 80%) after verapamil. We conclude that verapamil improves left ventricular relaxation in patients with hypertrophic cardiomyopathy but delays relaxation in those with aortic stenosis.(ABSTRACT TRUNCATED AT 400 WORDS)
Being "tired of life" is not grounds for euthanasia
Authors: T. Sheldon
Journal: BMJ (2003)

In a landmark decision the Dutch Supreme Court has ruled that doctors may not perform euthanasia or help with suicide unless the request comes from a patient suffering from a medically classifiable physical or psychiatric sickness or disorder. Simply being “tired of life” is no basis for doctors to act.

In what the media have branded the “tired of life case,” the limits of euthanasia practice have been defined, after the case took two years to reach the highest court in the land. The decision has been welcomed by the Royal Dutch Medical Association for …
Analysis of minimal residual disease by Ig/TCR gene rearrangements: guidelines for interpretation of real-time quantitative PCR data
Authors: V H J van der Velden, G Cazzaniga, A Schrauder, J Hancock, P Bader, E R Panzer-Grumayer, T Flohr, R Sutton, H Cave, H O Madsen, J M Cayuela, J Trka, C Eckert, L Foroni, U zur Stadt, K Beldjord, T Raff, C E van der Schoot, J J M van Dongen
Journal: Leukemia (2007)
HBV, HIV, and the Proscription of Intercourse-Reply
Authors: Lawrence A. Kingsley
Journal: JAMA (1990)

In Reply.—  We share Dr Harder's general concern about the loss of objectivity in scientific research. However, we firmly believe this concern is not applicable to the public health conclusions drawn in our article. Our article concludes, in essence, that the sexual transmission efficiency of hepatitis B virus (HBV) is 8.6-fold that for human immunodeficiency virus among homosexual men studied and that insertive anal intercourse was the major risk factor identified for HBV seroconversion. Our suggestions for HBV prevention among homosexual men, as stated in our article, include both immunization and use of condoms during sexual intercourse. Dr Harder has taken issue with our statement that condoms used during homosexual anal intercourse would be of benefit for prevention of HBV infection because we did not specifically test this hypothesis. His suggested conclusion is for the proscription of all anal intercourse. Since unprotected heterosexual vaginal intercourse is a well-known risk
Use of a homemade endoscopic guillotine to cut through a nasogastric tube inadvertently sutured to a colon–gastric anastomosis
Authors: Domenico Galasso, Andrea Tringali, Maria Riccioni, Guido Costamagna
Journal: Endoscopy (2013)

Suturing a nasogastric tube (NGT) while creating a surgical anastomosis is a rare complication. Once this has occurred however endoscopic removal of the NGT for the patient's relief can be very challenging.
Regular review: Bovine spongiform encephalopathy and variant Creutzfeldt-Jakob disease
Authors: P. Brown
Journal: BMJ (2001)

It is sometimes forgotten that in the story of bovine spongiform encephalopathy and variant Creutzfeldt-Jakob disease there is but one incontestable fact, that bovine spongiform encephalopathy is the cause of variant Creutzfeldt-Jakob disease. First suggested by their temporospatial association and the distinctive features of variant Creutzfeldt-Jakob disease, the link has since been proved by their equally distinctive and shared biological and molecular features.1–3 All the rest is speculation, more or less plausible according to the arguments advanced and the absence of any satisfactory alternative explanations.

From an epidemiological point of view bovine spongiform encephalopathy has been a classic epidemic and will undoubtedly become a textbook example for students (fig 1). From economic, political, and medical points of view it has been an unmitigated disaster. Why did it begin when it did, and how did it happen?

#### Summary points

The infectious agent that causes scrapie in sheep crossed the species barrier to bovines to cause bovine spongiform encephalopathy

Changes in the rendering of livestock carcases allowed infectivity to survive and contaminate meat and bone meal in livestock feed, amplifying infection to epidemic proportions

Export of contaminated meat and bone meal and live cattle incubating the disease caused the spread of bovine spongiform encephalopathy to other countries

Bovine spongiform encephalopathy caused variant Creutzfeldt-Jakob disease, most probably through adulteration of cooked meat products with mechanically recovered meat contaminated by compressed spinal cord and paraspinal ganglia

International regulatory measures are limiting the further spread of bovine spongiform encephalopathy, its entry into the human food chain, and potential secondary human to human spread of variant Creutzfeldt-Jakob disease, so that both diseases should gradually disappear



FIG 1 
Chronology of epidemic of bovine spongiform encephalopathy in United Kingdom, 1986-2000



The first case of a cow with bovine spongiform encephalopathy was diagnosed in 1986, and because of the long …
Endoscopic submucosal dissection or transanal endoscopic microsurgery for nonpolypoid rectal high grade dysplasia and submucosa-invading rectal cancer
Authors: S. Park, Y. Min, J. Shin, J. Choi, Y-H. Kim, J. Kim, Y. Cho, H. Kim, S. Yun, W. Lee, H-K. Chun, D. Chang
Journal: Endoscopy (2012)

<b>Background and study aims: </b>Transanal endoscopic microsurgery (TEM) has been shown to be highly effective for early rectal cancer, and endoscopic submucosal dissection (ESD) has been introduced to treat noninvasive colorectal neoplasia. The aim of this study was to compare the outcomes of ESD and TEM for superficial early rectal cancer. <b>Patients and methods: </b>We retrospectively analyzed 63 patients with nonpolypoid rectal high grade dysplasia or submucosa-invading cancer who were treated with ESD or TEM, and compared clinical outcomes and safety between the treatment groups. <b>Results: </b>30 patients underwent ESD and 33 underwent TEM. For ESD compared with TEM, en bloc resection rates were 96.7 % vs. 100 % (<i>P</i> = 0.476) and R0 resection rates were 96.7 % vs. 97.0 % (<i>P</i> = 1.000). There were no cases of local recurrence or distant metastasis in either group. Antibiotics were required in 11 patients (36.7 %) in the ESD group and 33 (100 %) in the TEM group (<i>P</i> < 0.001). There was no difference in net procedure time although ESD was associated with shorter total procedure time and hospital stay than TEM, with mean (standard deviation [SD]) 84.0 (51.2) vs. 116.4 (58.5) min (<i>P</i> = 0.0023), and 3.6 (1.2) vs. 6.6 (3.5) days (<i>P</i> < 0.001), respectively. There were no significant differences in complications between the two groups. <b>Conclusions: </b>Both ESD and TEM are effective and oncologically safe for treating nonpolypoid rectal high grade dysplasia and submucosa-invading cancers. ESD has the additional advantages of minimal invasiveness and avoidance of anesthesia. Therefore, ESD could be recommended as a treatment option for superficial early rectal cancers.
Noninvasive screening criteria for enhanced 4-year survival after aortocoronary bypass surgery.
Authors: R A Bruce, T A DeRouen, K E Hammermeister
Journal: Circulation (1979)

Two thousand one men with coronary heart disease (CHD) who were enrolled in the Exercise Testing Registry of the Seattle Heart Watch had symptom-limited maximal exercise tests at the initial clinical examination and follow-up surveillance of subsequent mortality for 4.1 +/- 1.6 years. When subdivided into three mutually exclusive subgroups, 636 patients did not have exertional myocardial ischemia, left ventricular dysfunction or cardiomegaly; 885 without cardiomegaly had only exertional ischemia; 480 had left ventricular dysfunction by either cardiomegaly and/or two noninvasive exertional criteria, with or without exertional myocardial ischemia. Three hundred thirty-one men had aortocoronary bypass surgery, while 1670 remained unopened for at least 4 years. Only 34% of the operated patients who had left ventricular dysfunction, as defined, showed a marked improvement in 4-year survival rates (p less than 0.01). Differences in the annual CHD mortality rates in relation to surgical treatment in the other two groups were not statistically significant. Restricting the analysis to a subset of patients who had invasive studies did not alter the conclusion. Accordingly, we suggest the use of noninvasive criteria to aid preliminary screening of patients for invasive studies and surgical treatment.
Guidance on preparing local rules to help implement the Health and Safety at Work etc Act.
Authors: B J Boucher
Journal: BMJ (1979)

Medical practitioners in the National Health Service should know that since 1975 all its staff have been both covered by, and liable under, the Health and Safety at Work Act (1974). Doctors may be concerned in safety as line managers, with responsibility for directing others, or as employees, with a duty to comply with directions given to them?often they are concerned in both ways at once. This entails more complexity than a first reading of the Act would suggest. We have found that direct guidance from DHSS or NHS sources or from professional bodies on what is now required from NHS staff for safety at work has been slow to appear and inadequate in its coverage of the diversity of NHS activities; codes of practice are not yet available for much of our work. We therefore thought that the guidance notes on preparing local rules on safety that were devised by the Tower Hamlets District Safety Committee might be of some help to others. Central collation and distribution of such material in all NHS fields is desirable, but in the interim self-help may be useful. We prepared a memo or check list to help heads of depart ments in our district in preparing written safety rules for their staff. There is a need for such written rules to be assessed, for their application to be monitored, and it is especially important for them to cover all work done by a department with specific details on hazards and on working arrangements.
Abstract 4582: Characterization of a new antibody that reacts with a tumor-specific variant of CEACAM-5 and CEACAM-6
Authors: Xiulian Du, Judith Kantor, Janos Luka, Lewis J. Stafford, Andrew Bristol
Journal: Cancer Research (2011)

Abstract Introduction: h16C3 is a humanized monoclonal antibody being developed as a novel biological treatment for several types of solid tumor. By mass spectroscopy identification and target validation research, we determined that h16C3 appears to recognize a variant form of CEACAM-5 and CEACAM-6, molecules with a well-known association to cancer. Here we show the pre-clinical activities of this new mAb which shows great potential as a therapeutic agent to treat solid tumors. Methods: The 16C3 antibody was selected from hundreds of hybridoma clones generated from mice immunized with semi-purified membrane-associated proteins derived from biologically screened, pooled human allogeneic colon cancer tissues. In vitro assays and in vivo studies were performed to characterize the potential of h16C3 as a therapeutic modality for solid tumors that express the variant CEACAM antigens. Results: Here we show that unlike most modalities targeting the CEACAM molecules, h16C3 reacts with variant CEACAM-5/6 expressed specifically by human tumor tissues as follows: 98% of human colorectal tumor tissues, 80% of pancreatic tumor tissues, 76% of lung tumor tissues, 43% of uterus tumor tissues, and 29% of breast tumor tissues stained positively with h16C3. Importantly, h16C3 did not cross-react significantly with normal human tissues, except for occasional, weak binding to certain GI tract tissues, which may indicate a pre-malignant state. We showed further that the h16C3 antibody exhibits cell-specific binding and ADCC activity against human colorectal and pancreatic tumor cells, but not against antigen-negative control tumor cell lines. In vivo, the anti-tumor efficacy of h16C3 was tested using pre-established subcutaneous human tumor xenograft models. The data showed significant anti-tumor action compared to control treated mice, including some complete tumor regressions. The bio-distribution of radiolabeled h16C3 in mice with pre-established human tumors exhibited specific accumulation of h16C3 at the tumor site, with little or no binding or accumulation in several major organ systems. Conclusions: The pre-clinical studies of h16C3 to date indicate that it has significant, specific anti-tumor potency, and suggest that it may have clinical activity in cancer patients whose tumor expresses the variant CEACAM-5/6 epitope. The therapeutic humanized 16C3 antibody is being developed for testing in a Phase I clinical trial. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 4582. doi:10.1158/1538-7445.AM2011-4582
Entero-Vioform for Preventing Travelers' Diarrhea
Authors: Myron G. Schultz
Journal: JAMA (1972)

Travelers' diarrhea can be an unpleasant complication of a business or vacation trip abroad. The prospect of succumbing to the "Aztec two-step" or "Delhi belly" causes more anxiety on the part of the prospective traveler than any other health-related aspect of his trip. Because means are available for preventing malaria, smallpox, typhoid, and other more serious threats to the traveler, his natural inclination is to take something he thinks will protect him from diarrhea. The drug most commonly used for this indication is iodochlorhydroxyquin (Entero-Vioform), and over the years it has become the travelers' vade mecum. In this issue ofThe Journaltwo letters (p 275) and a case report (p 243) raise the issues of the safety and efficacy of iodochlorhydroxyquin. With the vacation season approaching, physicians should be aware of the controversy concerning iodochlorhydroxyquin and the best methods to prevent travelers' diarrhea. Diarrhea in travelers occurs most commonly
Kidney patients should get more care from nurse practitioners and have dialysis closer to home
Authors: Roger Dobson
Journal: BMJ (2007)

More kidney transplantations, care that is planned better, and more people having dialysis are among the priorities of England's new national clinical director for renal services. 

Donal O'Donoghue, a consultant renal physician who takes up his three days a week post immediately, also wants to see more seamless care, so that patients with kidney disease do not have to see a range of different professionals for their problems in areas such as blood pressure, diabetes, and cholesterol concentrations. 

“The appointment [of a national clinical director] is a recognition of renal services: …
Tamoxifen resistance by a conformational arrest of the estrogen receptor α after PKA activation in breast cancer
Authors: Rob Michalides, Alexander Griekspoor, Astrid Balkenende, Desiree Verwoerd, Lennert Janssen, Kees Jalink, Arno Floore, Arno Velds, Laura van `t Veer, Jacques Neefjes
Journal: Cancer Cell (2004)
Provision of acute beds in inner London. Are all Thames regions the same?
Authors: R M Greenhalgh
Journal: BMJ (1993)

increased intracranial pressure is invariably present in acute meningeal inflammation' and lumbar puncture should always be undertaken with caution.Theoretically, the risk of precipitating sudden intracranial pressure loss may be reduced by minimal physical restraint and avoiding neck flexion; use of a small bore needle; obtaining a minimal volume of cerebrospinal fluid (less than 1 ml); and retracting skin from the puncture site before removing the needle and thereafter generously applying collodion to pre- vent leakage of cerebrospinal fluid after puncture.
Coronary capillaries in patients with congestive cardiomyopathy or angina pectoris with patent main coronary arteries. Ultrastructural morphometry of endomyocardial biopsy samples.
Authors: M Mosseri, J Schaper, D Admon, Y Hasin, M S Gotsman, D Sapoznikov, J G Pickering, R Yarom
Journal: Circulation (1991)

BACKGROUND The coronary microvasculature may be abnormal even in the presence of angiographically normal epicardial arteries. Abnormalities of small coronary vessels have been invoked as a cause of angina. METHODS AND RESULTS To quantitatively evaluate the morphology of capillaries in patients with idiopathic dilated cardiomyopathy (DCM) or the syndrome of angina and small vessel disease (SVD), we performed electron microscopic morphometry of capillaries in right ventricular biopsy samples taken from 32 patients. Ten had angina, normal epicardial coronary arteries, and evidence for SVD; 12 had DCM; and 10 had normal hearts. In patients with DCM, the ratio of microvessels to myocytes was not different than that of controls (0.49 +/- 0.06 versus 0.51 +/- 0.05). Mean cross-sectional areas of the capillaries (lumen plus wall) and lumen were significantly greater than those of controls (45.3 +/- 15.1 versus 22.7 +/- 8.3 micron 2, p less than 0.001; 17.6 +/- 6.9 versus 11.6 +/- 6.2 micron 2, p less than 0.05, respectively). Fibrous content of the myocardium, as assessed by quantitative light microscopy, was significantly increased (16.3 +/- 3.3% versus 5.0 +/- 2.4%, p less than 0.001). In contrast, in patients with SVD, the capillary-to-myocyte ratio was reduced (0.33 +/- 0.08, p less than 0.001). Although mean cross-sectional areas of the entire capillary (32.4 +/- 19.7 micron 2) and the lumen (8.9 +/- 7.8 micron 2) were not statistically different than those of controls, there was an absence of capillaries less than 15 micron 2 in cross-sectional area, and the frequency distribution of the lumen area was skewed to the left. Swollen endothelial cells frequently encroached upon the lumen. There was a mild increase in fibrous content (9.5 +/- 3.7%, p less than 0.05). CONCLUSIONS Enlarged capillaries and a normal ratio of capillaries to myocytes appear to be features of DCM. Of the patients with SVD, there was both a relative lack of capillaries and capillary lumen narrowing from swollen endothelium. These changes may induce ischemia and angina and may result in mild fibrosis.
Focus on neglected tropical diseases to take people out of poverty, says WHO
Authors: J. Zarocostas
Journal: BMJ (2010)

More emphasis on the detection, prevention, and treatment of neglected tropical diseases can help to break “a cycle of infection, disability, and lost opportunities that keep people in poverty,” said the director of the World Health Organization at the launch of its first report on the issue.

“Together these diseases blind, maim, disfigure, disable, and otherwise impair the lives of an estimated 1.2 billion people,” said Margaret Chan. “Less visibly, they damage internal organs, cause anaemia, retard the growth of children, impair cognitive development, and compromise pregnancy outcomes.”

The report provides information and strategies concerning 17 …
Pathobiology of Prediabetes in a Biracial Cohort (POP-ABC): Retention Strategies
Authors: Sotonte Ebenibo, Chimaroke Edeoga, Ann Ammons, Nonso Egbuonu, Samuel Dagogo-Jack
Journal: Diabetes Care (2013)

The Pathobiology of Prediabetes in a Biracial Cohort (POP-ABC) study is a prospective evaluation of incident prediabetes among African American and Caucasian offspring of parents with type 2 diabetes (1). Recruitment occurred over 3.4 years, with metabolic assessments during 2.1–5.5 years of quarterly follow-up. In studies that offer lifestyle intervention or medication, the potential health benefit is a strong motivation for retention (2,3). However, there is limited information on strategies for retaining healthy subjects in long-term observational studies requiring frequent, extensive metabolic assessments. This report describes retention strategies used among the 376 subjects (217 African Americans and 159 Caucasians) enrolled in the POP-ABC study.

Anticipating known retention threats (4,5), our strategies focused on participant motivation, amelioration of barriers related to clinic visit logistics, and community-building activities. All participants received clear written …
The Age Threshold for Isoniazid Chemotherapy
Authors: William C. Taylor
Journal: JAMA (1987)

<h3>To the Editor.—</h3> Although the decision analysis by Rose et al<sup>1</sup>applies a useful model to explore how risks and benefits must be weighed in deciding whether the individual with a positive tuberculin reaction should take isoniazid, we believe that the analysis is flawed by two major problems. First, the authors misapplied cross-sectional data to their longitudinal model and thereby greatly overestimated the number of cases of tuberculosis that would be expected over the lifetime of individuals whose only risk factor for the development of tuberculosis is a positive tuberculin reaction. The longitudinal studies cited by Rose et al demonstrate that the longer a tuberculin reactor goes without developing tuberculosis, the lower the likelihood that tuberculosis will develop. Rather than incorporating this fact into their model (or at least performing a sensitivity analysis to demonstrate its implications), the authors merely mention in their discussion that this issue "was not