tbuckley/cabot-search huggingface dataset:
Obesity: The Role of Gastric Surgery
Authors: Harvey J. Sugerman
Journal: JAMA (1991)

<h3>To the Editor.</h3> —The Grand Rounds at the Clinical Center of the National Institutes of Health (NIH) by Dr Wilber entitled "Neural peptides, appetite regulation, and human obesity"1 that appeared in<i>JAMA</i>failed to describe gastric surgery for the management of severe obesity in the treatment section. This topic was recently discussed at a Consensus Panel on the Surgical Treatment of Severe Obesity at the NIH at which it was concluded that gastric surgery is appropriate for patients who have a body mass index of less than 40 without comorbidity and that patients who have significant comorbidity and a body mass index of 35 to 40 should be considered as candidates for the procedure. Clearly, this has had the most effective long-term efficacy in the management of severe obesity with the data now showing the average loss of excess weight between 50% to 60% for as long as 10 years
Racial Disparities in Outcomes of Adult Heart Transplantation
Authors: Arman Kilic, Robert S. D. Higgins, Bryan A. Whitson, Ahmet Kilic
Journal: Circulation (2015)

Background— This study evaluated whether minority orthotopic heart transplant (OHT) recipients tend to be transplanted at worse performing centers. Methods and Results— OHT recipients between 2000 and 2010 were identified in the United Network for Organ Sharing database and stratified by race. Center performance was evaluated using observed-to-expected mortality ratios that were calculated using validated indexes for recipient and donor risk in OHT. The primary outcome was 1-year post-OHT mortality. A total of 102 centers performed OHT in 18 085 patients. Blacks had higher unadjusted 1-year mortality, which was confirmed after risk adjustment. Blacks had increased risk-adjusted mortality at poor performing centers (observed-to-expected mortality ratio, &gt;1.2; odds ratio, 1.37 [95% confidence interval, 1.12–1.69]; P =0.002) and a strong trend toward increased mortality at excellent performing centers (observed-to-expected mortality ratio, &lt;0.8; odds ratio, 1.42 [95% confidence interval, 0.99–2.02]; P =0.06). A higher proportion of blacks were treated at centers with higher-than-expected mortality (56.4% versus 47.1% whites versus 48.1% Hispanics; P &lt;0.001), a finding that persisted after adjusting for insurance type and highest education level. In addition, there was a positive correlation between the percentage of blacks and observed-to-expected mortality ratios at the center level ( r =0.32; P =0.001). In multivariable analysis incorporating immunologic and socioeconomic variables, there was no clear dominant source for the disparities in outcomes of OHT between races. Conclusions— Blacks have a propensity to be transplanted at worse performing centers; however, center effect alone does not explain the mortality difference between ethnicities. Although referral of minorities to better performing centers would improve absolute survival, it would not likely eliminate the racial disparities that exist in OHT outcomes.
Resolution of Primary Amyloidosis During Chemotherapy
Authors: HARVEY JAY COHEN
Journal: Annals of Internal Medicine (1975)

A patient with primary amyloidosis with evidence for a plasma cell dyscrasia but no abnormal immunoglobulin components had nephrotic syndrome with severe renal impairment. Kidney and bone marrow had extensive amyloid infiltration. She was treated with penicillamine, melphalan, prednisone, and fluoxymesterone; through 6 months renal function gradually improved; urine protein excretion dropped dramatically, serum albumin rose; liver size decreased; the bone marrow returned towards normal. During the next 4½ years melphalan, prednisone, and fluoxymesterone treatment was continued with further improvement in renal function to normal levels. The morphologic characteristics and cellular relations of the amyloid fibrils in the bone marrow were studied before, during, and after successful chemotherapy; the findings are evidence for a dual role for the reticuloendothelial cell in the formation and destruction of primary amyloidosis. This patient's response suggests that a multi-agent chemotherapy approach should be further studied.
The Blood of the Lamb
Authors: David P. Steensma
Journal: Journal of Clinical Oncology (2009)

Peter De Vries (1910-1993)—writer for the New Yorker, Poetry editor, once widely acknowledged as the top American comic novelist of his era—was best known for his clever wordplay, irreverent humor, and extended riffs on a broad range of human foibles. But despite De Vries’ reputation for puckish wit and for the skewering bon mot, his greatest novel is a tragedy—one that is all the more haunting because it is stuffed with autobiographical detail. The Blood of the Lamb, published in 1961, describes the growing estrangement of the main character (Don Wanderhope) from his origins in a close-knit, blue-collar, Chicagoland Dutch immigrant community. The death of a sibling, parental mental illness, and the strains of a volatile marriage contracted too hastily were heavy stones that stressed the increasingly rickety structure of Wanderhope’s boyhood religious faith, until that faith finally collapsed beneath the crush of a singular and devastating loss, re-emerging as something more ambiguous. Emily De Vries—her literary counterpart is Carol Wanderhope—De Vries’ youngest child and a chief existential consolation, died in September 1960, just a few days before her 11th birthday and 2 years after she was diagnosed with acute lymphoblastic leukemia (ALL). Through the filter of his prodigious literary gifts, De Vries poured out the monstrous, idiosyncratic grief of a bereft father, of a man who has lost something that really matters. The Blood of the Lamb was published just a year after Emily’s death, and the rawness of emotion sears its pages: often bitter, sometimes elegiac, and with scattered patches where the writing is less polished, less subtle than is typical for De Vries. The author’s seething anger over the unfairness of the world is frequently channeled into frustration at a paternalistic and ultimately impotent medical establishment, which provided plenty of facile reassurances, even as it failed to save his innocent “lamb” of a daughter from her own poisoned blood. De Vries eventually returned to writing comic novels after The Blood of the Lamb, but always with darker undertones, echoing the futility and chaotic meaninglessness of life that he felt so acutely during Emily’s terminal illness. These stylistic changes parallel the intellectual evolution of Charles Darwin a century earlier, after a similar event: Darwin lost his beloved daughter Annie in 1851, also at age 10 years from an unexplained illness—possibly tuberculosis, which was just as frightening and incurable in the 1850s as leukemia a century later. Darwin’s great-grandson suggests that the feelings of randomness and lack of ultimate purpose engendered by Annie Darwin’s untimely death pushed the great naturalist towards a reluctant full acknowledgment of the terrifying metaphysical implications of his mechanism of natural selection. The legacy of a child’s premature death can be long indeed.
"ENORMOUS NUMBER OF GALLSTONES IN A PATIENT"
Authors: J. F. Baldwin
Journal: JAMA (1927)

<h3>To the Editor:</h3> —In your issue of July 2, page 45, your Rio de Janeiro correspondent reported a case in which 1,445 gallstones were removed by Professor Brandão Filho. Quite a number of years ago, I had a case in which I removed more than 4,000 gallstones. (The nurse counted 4,000 and said there were a few more around on sponges, but she thought that was enough!) I thought I had perhaps broken the record, but when I looked the matter up I found that 17,000 had been reported, and so said nothing about it.
He Whose House Is of Glass...
Authors: Samuel Vaisrub
Journal: JAMA (1977)

The last paragraph of the last editorial in the Nov 15 issue ofThe Journalreads: But can the overstocked memory store also explain the selective amnesia of a clinical investigator who in his submitted report forgets the names of all those whose previous researches paved the ground for his "original" study? More important, can it account for his failure to remember the names of co-workers whose cooperation made the study possible? To the above two examples of selective amnesia must now be added a third—the forgetfulness of an editorial commentator who confuses the investigators he names. Through a twist of fate's irony, the last paragraph of the first editorial in the same issue, written by the selfsame commentator (yes, it is I) states: "Although characterized by much hesitancy and uncertainty, the new approaches to prevention and therapy of hepatitis B cannot fail to generate an air of optimism. The
Insulin bolus given by sprinkler needle: effect on absorption and glycaemic response to a meal.
Authors: B Edsberg, D Herly, P Hildebrandt, C Kuhl
Journal: BMJ (1987)

Two studies were conducted investigating the effect of injecting short acting insulin subcutaneously by means of a sprinkler needle; this needle has 14 small holes in the wall but is sealed at the tip. In the first study absorption of 8 U iodine-125 labelled Actrapid HM injected subcutaneously at two separate sites in the abdominal wall was measured in 10 patients. One injection was given with the sprinkler needle and the other with a conventional needle. The initial dose absorbed during the first 30 minutes was significantly higher with the sprinkler needle. In the second study 10 U Actrapid HM was given to 11 other patients (all negative for C peptide and with low insulin binding antibody titres) on two separate days immediately before a standardised breakfast either by the sprinkler needle or by a conventional needle (random order). Plasma free insulin increased more rapidly and to higher concentrations with the sprinkler needle and the glycaemic response was considerably diminished. The sprinkler needle improves both the insulin absorption rate and the glycaemic response to a meal and may reduce the 30 minutes or so before meals that diabetics must inject to minimise postprandial hyperglycaemia.
There are no "basics" in child protection
Authors: L. D. Bortoli
Journal: BMJ (2009)

<h3>Background</h3> ‘Typical’ angina is often used to describe symptoms common among men, while ‘atypical’ angina is used to describe symptoms common among women, despite a higher prevalence of angina among women. This discrepancy is a source of controversy in cardiac care among women. <h3>Objectives</h3> To redefine angina by (1) qualitatively comparing angina symptoms and experiences in women and men and (2) to propose a more meaningful construct of angina that integrates a more gender-centred approach. <h3>Methods</h3> Patients were recruited between July and December 2010 from a tertiary cardiac care centre and interviewed immediately prior to their first angiogram. Symptoms were explored through in-depth semi-structured interviews, transcribed verbatim and analysed concurrently using a modified grounded theory approach. Angiographically significant disease was assessed at ≥70% stenosis of a major epicardial vessel. <h3>Results</h3> Among 31 total patients, 13 men and 14 women had angiograpically significant CAD. Patients describe angina symptoms according to 6 symptomatic subthemes that array along a ‘gender continuum’. Gender-specific symptoms are anchored at each end of the continuum. At the centre of the continuum, are a remarkably large number of symptoms commonly expressed by both men and women. <h3>Conclusions</h3> The ‘gender continuum’ offers new insights into angina experiences of angiography candidates. Notably, there is more overlap of shared experiences between men and women than conventionally thought. The gender continuum can help researchers and clinicians contextualise patient symptom reports, avoiding the conventional ‘typical’ versus ‘atypical’ distinction that can misrepresent gendered angina experiences.
Mortality benefits and the implantable cardioverter-defibrillator.
Authors: M O Sweeney, J N Ruskin
Journal: Circulation (1994)

The automatic implantable cardioverter-defibrillator (ICD) is highly effective in reducing sudden death rates in patients with life-threatening ventricular tachyarrhythmias. However, the magnitude of the ability of the ICD to improve overall survival is less certain. Data supporting the contention that the ICD prolongs survival are reviewed. It is evident that the mortality benefit consequent to the marked reduction in sudden death varies widely across subpopulations in a predictable manner. This observation reflects the powerful influence of other clinical factors that constrain survival in typical ICD patients. The implications for future studies on the ICD are discussed.
203. Salt Conditions during Polyplex Formation Significantly Alters Transfection
Authors: Qixin Leng, Jason Kahn, Jingsong Zhu, Puthapparampil Scaria, Archibald J. Mixson
Journal: Molecular Therapy (2006)

Synthetic histidine-lysine (HK) peptides, comprised of histidine and lysine, have been shown to be effective carriers of nucleic acids. We compared the transfection ability of one these HK peptides, H2K4b, in complex with plasmids prepared under three conditions: 1) water, 2) water and then Opti-MEM (or 150 mM NaCL), or 3) Opti-MEM (or 150 mM NaCL). When H2K4b in complex with a luciferase-containing plasmid complex was first formed in water before Opti-MEM was added, luciferase activity increased significantly in most cell lines compared to when the polyplex was formed in Opti-MEM; in two cell lines, this sequential change in salt (e.g., water/ then Opti-MEM) increased transfection activity by as much as five-fold. Furthermore, H2K4b: luciferase-containing plasmid complex formed only in water resulted in a marked decrease in luciferase activity compared to when the complex was formed in Opti-MEM or water/then Opti-MEM. Similarly, sequential changes in salt conditions (e.g., water/Opti-MEM) during the preparation of the H2K4b: β-galactosidase plasmid complex augmented galactosidase expression. H2K4b polyplexes, formed first in water and then in Opti-MEM were intermediate in size (761 ± 292 nm) compared to polyplexes formed in water (81.1 ± 25.6 nm) or Opti-MEM (1729 ± 559nm); atomic force microscopy confirmed these findings. Nevertheless, the surface charge on the H2K4b/plasmid DNA complex changed minimally despite different conditions in which the polyplex was formed. Variation in the salt conditions during formation of the HK:DNA complexes may increasetransfection due to the size and DNA release from the polyplexes.
Rapid Whole-Genome Sequencing for Investigation of a Neonatal MRSA Outbreak
Authors: Claudio U. Köser, Matthew T.G. Holden, Matthew J. Ellington, Edward J.P. Cartwright, Nicholas M. Brown, Amanda L. Ogilvy-Stuart, Li Yang Hsu, Claire Chewapreecha, Nicholas J. Croucher, Simon R. Harris, Mandy Sanders, Mark C. Enright, Gordon Dougan, Stephen D. Bentley, Julian Parkhill, Louise J. Fraser, Jason R. Betley, Ole B. Schulz-Trieglaff, Geoffrey P. Smith, Sharon J. Peacock
Journal: New England Journal of Medicine (2012)

Isolates of methicillin-resistant Staphylococcus aureus (MRSA) belonging to a single lineage are often indistinguishable by means of current typing techniques. Whole-genome sequencing may provide improved resolution to define transmission pathways and characterize outbreaks.
An Address ON IODINE IN EXOPHTHALMIC GOITRE: Delivered before the Norwich Medico-Chirurgical Society, October 14th, 1924
Authors: F. R. Fraser
Journal: BMJ (1925)

A RELATIONSHIp between endelmic goitre and-iodine appears to have been recogniized for many years.Coindet' in 1820 relported that by tlhe administration of iodinie goitres could be diminished in size.Chatin,2 a Firechi chemist, wroto (;xtensively in 1850 anid the years followinlg, reporting his inivestigations on the amlounits of iodinie in air and soil and water, anid lie (drew attenition to the hiiglh inicidence of endemic goitre anid cretinism in localities where the amount of iodine was low.He further mainitained that endemic goitre could be pirevented by increased ingestion-of iodinie.Following Cliatin's work, iodine was used extenisively in the treatment of goitr e until evidence accumulated to shiow that, followinig iodiine treatmenit of endemic goitre, the subjects frequently developed taclhcar-dia, tremor, loss of weight, etc. Krehl,3 Kocher,4 and others, pointed out that iodine treatmeilt in simple goitre could bring about a condition of exophtlalmic goitre, or Graves's disease, and war ned againist its use.Pr obably for this reason its emuployment becamiie much less general.In recent years it lhas been revived, lar-gely as tlle result of the work of Marine.
Mortality in Swedish women with cosmetic breast implants: Study found increased risk of suicides and cancer deaths
Authors: D. Zuckerman
Journal: BMJ (2003)

EDITOR—The increased suicides and lung cancers among implant patients reported by Koot et al is consistent with a study by Brinton et al at the US National Cancer Institute.1 2 However, Brinton et al found an increased risk of suicides and cancer deaths compared with other patients having plastic …
CAUSES OF FAILURE IN THE TREATMENT OF DIABETES OF CHILDREN
Authors: FRANK N. ALLAN
Journal: JAMA (1930)

Before the discovery of insulin, juvenile diabetes was almost invariably fatal. Senator,<sup>1</sup>in 1872, declared that the prognosis was hopeless and all treatment useless. More recent writers have made the same observation. Priesel and Wagner<sup>2</sup>stated that all patients who had been seen from 1912 to 1923 had died sooner or later from coma. In the experience of authorities such as Naunyn<sup>3</sup>and von Noorden,<sup>4</sup>there were few exceptions to the general rule. It is true that careful treatment frequently controlled the disease and prolonged life for a considerable time, but the ultimate fate was rarely avoided. Joslin,<sup>5</sup>who had treated 169 children with diabetes from 1914 to 1922, reported that one third were still living at the end of the period but expressed this achievement merely as "coma deferred." The experience in the Mayo Clinic was similar. Thirty-two children with diabetes were seen at
Restenosis after coronary angioplasty. Potential biologic determinants and role of intimal hyperplasia.
Authors: M W Liu, G S Roubin, S B King
Journal: Circulation (1989)

Restenosis after successful PTCA remains a major problem limiting the efficacy of the procedure. The pathophysiologic mechanism of restenosis has been enigmatic so far, but accumulated evidence strongly suggests that intimal hyperplasia is the major mechanism. Based on current understanding of the process of intimal hyperplasia, one unifying concept may be that there are at least two major local biologic determinants influencing this process, lesion characteristics and regional flow dynamics. Lesion characteristics include the plaque structure and the quantity of smooth muscle. These may provide the anatomic substrate that determines the extent of injury and the degree of smooth muscle cell proliferation. The amount of smooth muscle cells in the stenotic lesion activated by injury to undergo proliferation may determine the eventual bulk of the restenotic lesion. In addition, low wall shear stress could promote intimal hyperplasia and cause structural change of vessels to decrease the lumen, whereas high wall shear stress exerts the opposite effects. Intimal hyperplasia after balloon injury is a complex process involving platelets, growth factors, endothelial cells, smooth muscle cells, mechanical injury, wall shear stress, and probably other unknown factors. Platelets not only contribute growth factors such as PDGF but also cause organized thrombus. Different growth factors may be involved in initiating smooth muscle cell proliferation and may come from many different sources, including smooth muscle cells, endothelial cells, and macrophages. Intact confluent endothelial cells may produce heparin sulfates and inhibit intimal proliferation; however, regenerating endothelial cells may have the opposite effect. Thus, the proliferative potential of smooth muscle cells, endothelial recovery, extent of injury, wall shear stress, and other unknown factors may all influence this process. Based on these concepts concerning the biology of restenosis, some research directions concerning potential forms of therapy are proposed.
Bone mineral density in nonsteroid treated early rheumatoid arthritis.
Authors: B D Shenstone, A Mahmoud, R Woodward, D Elvins, R Palmer, F Ring, A K Bhalla
Journal: Annals of the Rheumatic Diseases (1994)

OBJECTIVES--To determine whether significant reduction in bone mass is detectable in early disease in patients with rheumatoid arthritis (RA) and to examine the possible influences of disease activity and physical disability on bone mineral density (BMD) of the lumbar spine (LS) and femoral neck (FN). METHODS--LS and FN BMD values were measured and Z scores determined in a cross-sectional study of 104 patients with RA of less than five years duration. BMD values were also compared between a subgroup of 64 patients and a normal control group matched for age, sex, menopausal status and body mass. BMD values and Z scores were correlated with disease activity, measured by the Stoke Index, disability, measured by HAQ score, and disease duration. RESULTS--Premenopausal female patients with RA had significantly reduced mean FN Z scores (-0.62, 95% CI -0.30 to -0.94) which correlated with HAQ scores (Rs 0.358, p = 0.05) and age (Rs 0.397, p = 0.03). There were no significant changes of BMD in males or postmenopausal females. Disease duration and disease activity did not correlate with BMD changes. CONCLUSION--BMD is reduced in premenopausal female patients with early RA possibly related to the attainment of peak bone mass. No significant reduction of BMD was found in males or postmenopausal females with early disease. Physical disability but not disease activity appears to play a role in the reduction of FN bone mass.
Artemisinins: their growing importance in medicine
Authors: Sanjeev Krishna, Leyla Bustamante, Richard K. Haynes, Henry M. Staines
Journal: Trends in Pharmacological Sciences (2008)

Artemisinins are derived from extracts of sweet wormwood (Artemisia annua) and are well established for the treatment of malaria, including highly drug-resistant strains. Their efficacy also extends to phylogenetically unrelated parasitic infections such as schistosomiasis. More recently, they have also shown potent and broad anticancer properties in cell lines and animal models. In this review, we discuss recent advances in defining the role of artemisinins in medicine, with particular focus on their controversial mechanisms of action. This safe and cheap drug class that saves lives at risk from malaria can also have important potential in oncology.