tbuckley/cabot-search huggingface dataset:
Perioperative myocardial infarction after coronary artery bypass surgery. Clinical significance and approach to risk stratification.
Authors: T Force, P Hibberd, G Weeks, A J Kemper, P Bloomfield, D Tow, M Josa, S Khuri, A F Parisi
Journal: Circulation (1990)

The clinical significance of perioperative myocardial infarction (MI) after coronary artery bypass surgery is not known. Therefore, strategies for the risk stratification of these patients do not exist. This study was undertaken to define the effect of perioperative MI on prognosis after discharge from the hospital and to develop an approach to the risk stratification of these patients. Fifty-nine patients with and 115 patients without perioperative MI were observed for 30 months for the development of cardiac events (death, nonfatal MI, and admission to hospital for unstable angina or congestive heart failure). Patients with perioperative MI were significantly more likely than patients without to have a cardiac event (31% versus 12%, p less than 0.01) and multiple events (19% versus 1%, p less than 0.001). Cox regression analysis identified two independent predictors of cardiac events other than perioperative MI (relative risk, 2.7): inadequate revascularization (relative risk, 3.5) and depressed (less than 40%) postoperative ejection fraction (EF) (relative risk, 2.1). Event-free survival rate of patients with perioperative MI varied markedly depending on the number of other negative prognostic variables present. Patients with perioperative MI who were adequately revascularized and had a postoperative EF greater than 40% had an event-free survival rate similar to patients without a perioperative MI (92% versus 87%, p = NS). Patients with perioperative MI who were inadequately revascularized and had depressed postoperative EF had an event-free survival rate of 13% (p less than 0.001 versus all other subsets). Event-free survival rate was intermediate (68%) in patients with perioperative MI and with only one of the other two variables (p less than 0.001 versus other subsets). In conclusion, perioperative MI adversely affects prognosis. Patients can be stratified into low, high, and intermediate risk subsets based on a simple assessment of the adequacy of revascularization and a determination of residual left ventricular function.
A NEW AND SIMPLE METHOD OF DETECTING FEIGNED UNILATERAL DEAFNESS
Authors: WALTER A. WELLS
Journal: JAMA (1923)

Simulation of deafness is one of the commonest forms of malingering encountered in civil as well as in military life, and this, no doubt, for the reason that it is generally regarded as a form of disability very easy to assume and very difficult to detect. The difficulty lies in the circumstance that deafness is a purely subjective phenomenon, which, though associated in a certain large class of cases (those of sound conducting apparatus) with demonstrable structural alterations, in another class (those of sound perceiving apparatus), in which we may have deafness of the gravest type, it is impossible by any method of examination at our command to discover objective changes to account for it. In the latter circumstance, recourse must be had to the so-called functional tests, and since information derived therefrom depends on the good faith of the subject examined, we must, when this is under sus picion,
Diagnosis and Staging of Cancer: A Radiologic Approach
Authors: Walter G. Gunn
Journal: JAMA (1977)

An impressive new book on the staging of cancer, primarily via radiodiagnostic methods, has become available for clinicians who work with cancer patients. Most multi-authored books of this type exhibit an uneven quality in writing style or content, and this volume is no exception. There are, however, many high points. I thought the chapter on lungs and mediastinum was superb: good writing, meaty content, excellent illustrations, extensive and up-to-date bibliography. Similarly, the chapters on Hodgkin disease and non-Hodgkin lymphoma were well put together. The section on colon and rectum was satisfactory, though I was surprised to read "The large bowel is the most common site for the development, of a life-threatening malignancy in man" as its opening statement. Indeed, we are told elsewhere in the volume that deaths from primary cancer of the lung for men alone in 1972 totaled 55,600, while deaths from cancer of the colon from men
Modern Ophthalmology. Vol 3 and 4
Authors: Arnall Patz
Journal: JAMA (1965)

The third and fourth volumes in this series onModern Ophthalmologycontinue the tradition of excellence that was established with the publication of the first two volumes. Dr. Sorsby and his contributors are all recognized authorities in their particular subject.  In volume 3 the first section deals with functional anomalies of the eye, including refractive problems, color anomalies and a section on strabismus. The 102 page article by Schlossman on strabismus represents a textbook within itself. It is well written and includes a current assessment of the more recent subject of pleoptics.  Dr. Sorsby has prepared the chapters on malformations and developmental defects in his usual superior fashion. The section on tumors is written by Dr. Blodi, an international authority on eye pathology. This section is clearly presented and adequately illustrated. The section on injuries, written by Dr. Roper-Hall, is also well prepared. The final section of volume 3 covers
Postprandial gall-bladder emptying in patients with gall stones.
Authors: D P Maudgal, R M Kupfer, P L Zentler-Munro, T C Northfield
Journal: BMJ (1980)

Gall-bladder emptying in response to a standard meal was assessed in 34 patients with radiolucent gall stones and 34 matched controls. Percentage gall-bladder emptying, derived from volume measurements made on standardised oral cholecystography, was significantly higher at 15 minutes in the patients than the controls (mean +/- SE of mean 38.0 +/- 3.7% v 28.0 +/- 3.8%). This difference was maintained at 30 and 60 minutes. It is concluded that postprandial gall-bladder emptying is increased in patients with cholesterol gall stones, and that this may be the cause of the small bile-acid pool found in these patients.
The Managed Care Manual
Authors: Max Burger
Journal: JAMA (1997)

The house-dust mite,<i>Dermatophagoides pteronyssinus</i>. From:<b>Color Atlas and Text of Clinical Medicine</b>, by Charles D. Forbes and William F. Jackson, 2nd ed, 534 pp, with illus, paper, $42.95, ISBN 0-7234-2198-6, London, England, Mosby-Wolfe, St Louis, Mo, Mosby, 1997; reproduced by permission. Managed care is payers telling physicians how to practice medicine. Whether this is bad or good depends on your point of view. In medical school we were never taught what the cost or the outcome of "standard" care was. Only since insurance companies, employers, and taxpayers have demanded that spiralling costs be controlled has the medical community come to focus on cost and outcome. The focus has been put on the providers of care, since 85% of the costs have been generated by them. Today, unless you are in a very small and remote town and the only physician practicing there, you probably have experienced some form of
Transient changes in the mononuclear phagocyte system following administration of the blood substitute liposome-encapsulated haemoglobin
Authors: Alan S. Rudolph, Richard O. Cliff, Barry J. Spargo, Helmut Spielberg
Journal: Biomaterials (1994)

We have examined the effects of administration of the blood substitute, liposome-encapsulated haemoglobin (LEH), in the normovolaemic rat. Test groups included LEH, lyophilized EH, the liposome vehicle, unencapsulated haemoglobin and normal saline, which were injected into the tail vein (n = 6; n = 3 for sham and saline groups). Administration of LEH (2.5g phospholipid, 1.25g haemoglobin/kg rat) was followed by blood sampling at 2h, 24 h, 1 wk and 2wk. Blood samples were analysed for alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyltransferase, total and indirect bilirubin, serum creatinine, albumin, total protein, lipase, cholesterol, blood urea nitrogen, haematocrit, haemoglobin and differential white blood cell counts. Observed effects following injection were mild and transient, with baseline values recovered at 1 wk. Alanine aminotransferase increased moderately in the LEH group at 24 h to 601 ± 143 IU/dl (P < 0.0001), with a return to baseline at 1 wk. Aspartate aminotransferase showed a smaller increase from 46 ± 5 to 162 ± 40 at 24 h and also returned to baseline at the 1 wk measurement (P < 0.001). The transient increase in serum transaminases was not observed for the lyophilized LEH group. Tissue sections showed accumulation of liposome groups in resident macrophages of the liver and spleen. Incubation of an adherent population of human peripheral blood monocytes with LEH in culture did not elicit the production of the inflammatory cytokine, tumour necrosis factor. Pre-incubation of monocytes with LEH prior to exposure to endotoxin did, however, result in a reduced expression of this inflammatory cytokine. Biomaterials (1994) 15, (10) 796–804
Patentability of Genetically Engineered Microorganisms
Authors: Andrea Cooper
Journal: JAMA (1983)

A lawyer in the Office of the General Counsel of the American Medical Association discusses the case history and implications of the Supreme Court decision Diamond v. Chakrabarty. The court held that genetically engineered microorganisms were patentable subject matter under the Patent Act. Disclaiming broad application of its decision, the court limited its opinion to microbes engineered by Chakrabarty's method and deferred public policy issues to the legislative process, leaving the decision whether other life forms are patentable to the Patent Office and lower courts.
Ferric carboxymaltose improved symptoms and quality of life in patients with chronic heart failure and iron deficiency
Authors: Robb D Kociol, L Kristin Newby
Journal: Annals of Internal Medicine (2010)

ACP Journal Club20 April 2010Ferric carboxymaltose improved symptoms and quality of life in patients with chronic heart failure and iron deficiencyRobb D. Kociol, MD, L. Kristin Newby, MD, MHSRobb D. Kociol, MDDuke Clinical Research Institute, Durham, North Carolina, USA (R.D.K., L.K.N.)Search for more papers by this author, L. Kristin Newby, MD, MHSDuke Clinical Research Institute, Durham, North Carolina, USA (R.D.K., L.K.N.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-8-201004200-02005 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationAnker SD, Comin Colet J, Filippatos G, et al. Ferric carboxymaltose in patients with heart failure and iron deficiency. N Engl J Med. 2009;361:2436-48. https://pubmed.ncbi.nlm.nih.gov/19920054Clinical Impact RatingsCardiology: Author, Article, and Disclosure InformationAffiliations: Duke Clinical Research Institute, Durham, North Carolina, USA (R.D.K., L.K.N.)This article was published at Annals.org on 6 April 2010. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byIron Status and Analysis of Efficacy and Safety of Ferric Carboxymaltose Treatment in Patients with Inflammatory Bowel DiseaseHeart failure in 2010 20 April 2010Volume 152, Issue 8Page: JC4-5KeywordsAnemiaHeart failureHemoglobinHospitalizationsIntent to treat analysisIron deficiencyIron deficiency anemiaLeft ventricular ejection fractionQuality of lifeSafety ePublished: 20 April 2010 Issue Published: 20 April 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
1061-89 Trends in non-ST-segment elevation myocardial infarction care: The national acute myocardial infarction project 1998–2001
Authors: JoAnne M Foody, Deron H Galusha, Saif S Rathore, Frederick A Masoudi, Edward P Havranek, Harlan M Krumholz
Journal: Journal of the American College of Cardiology (2004)
Internship in Africa: Death and Life
Authors: Elisabeth D. Riviello
Journal: Annals of Internal Medicine (2008)

On Being a Doctor2 September 2008Internship in Africa: Death and LifeElisabeth D. Riviello, MDElisabeth D. Riviello, MDFrom Brigham and Women's Hospital, Boston, MA 02115.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-5-200809020-00011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Fresh out of medical school, while applying for a residency in internal medicine, I spent a year in Lubango, Angola. This was my internship, to be followed by the United States' version the next year. But in Africa, I think I learned to be a doctor. In Africa, I learned about death and life.During my first week of internship, a 61-year-old man with cerebral malaria died. He had a large and devoted family, and I had spent significant time with them. It was clear that he was the well-loved patriarch of his family. In the first couple of days, ... Author, Article, and Disclosure InformationAffiliations: From Brigham and Women's Hospital, Boston, MA 02115.Corresponding Author: Elisabeth D. Riviello, MD, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115; e-mail, [email protected]harvard.edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 2 September 2008Volume 149, Issue 5Page: 353-354KeywordsBloodBreathingHIVHeartHeart rateMalariaNursesQuinineThoraxVomiting ePublished: 2 September 2008 Issue Published: 2 September 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Therapeutic Regimens in Advanced Breast Cancer
Authors: Arthur F. Hoge
Journal: JAMA (1975)

A retrospective study of the methods of treatment in 98 patients with advanced breast cancer over the past five years showed striking differences in remission rates, duration of remissions, and overall survival according to the method of treatment. Adrenalectomy and oophorectomy produced remissions in 58% of patients, with a median duration of 22 months. Survival curves were impressive and favored the surgically ablated group, who had a median survival of 32 months. Sixty-seven percent of responders continue to survive at four years. Chemotherapy with single agents produced remissions in 30% of patients, having a median duration of nine months. Additive endocrine therapy produced 33% to 36% remission rates, with median durations of 12 to 16 months. Responses were more frequent and longer lasting in older patients. Radiotherapy, when used without supplemental therapy, resulted in good local control, but a short median survival of 7.5 months.
THE ACTION OF CHEMOTHERAPEUTIC AGENTS ON PSORIATIC EPIDERMIS
Authors: LIONEL FRY, R. M. H. McMINN
Journal: British Journal of Dermatology (1968)

SUMMARY. —Mitotic counts and histological features have been studied in 35 psoriatic patients prior to treatment, and during treatment with topically applied fluocinolone acetonide, methotrexate, dithranol and coal tar. Prior to treatment there was considerable variation in the mitotic counts in the 35 biopsies. The granular layer was absent in 10 biopsy specimens, partially formed in small areas in 21, well formed in most areas in 2, and normal in 2. There was no correlation between the mitotic counts and state of the granular layer. With methotrexate and dithranol treatment the granular layer showed improvement prior to a significant fall in the mitotic counts. With fluocinolone acetonide the improvement in the granular layer appeared at the same time as a significant fall in the mean mitotic count, but the granular layer had completely reformed in 7 of the 9 patients while the mitotic count was still considerably raised compared to uninvolved psoriatic skin. With coal tar the results were not uniform; some patients showed a significant fall in mitotic counts prior to improvement in the granular layer and others first showed improvement in the granular layer. It is suggested that in clearing psoriasis these drugs have an action other than, or in addition to, inhibiting mitosis.
Abnormal Renal Uptake in lndium-111- Chloride Scanning
Authors: HUSSEIN M. ABDEL-DAYEM, EUGENE V. LESLIE
Journal: Clinical Nuclear Medicine (1978)

A patient with severe alcoholic liver disease, in whom there was almost complete suppression of function of the reticuloendothelial system of the liver as noted on a 99Tc-SC scan is discussed. Obstructive biliary disease was suggested on 131l-rose bengal imaging. The depressed RES function was confirmed on 111In-chloride scan, showing abnormal uptake in the kidneys which could be secondary to inflammatory infiltration in the renal parenchyma from urinary tract infection with gamma enterococci.
Demonstration of increased levels of type I collagen mRNA using quantitative polymerase chain reaction in fibrotic and granulomatous skin diseases
Authors: None Tasanen, None Palatsi, None Oikarinen
Journal: British Journal of Dermatology (1998)

Collagen changes occur in localized scleroderma, scleredema and sarcoidosis. Previous biochemical, immunohistochemical and in situ hybridization studies have revealed increased collagen synthesis in these diseases. In the present study, we measured the proα1(I) collagen and β-actin mRNA levels in skin punch biopsy specimens from lesional and healthy skin using a quantitative polymerase chain reaction (PCR). In this method, the targeted mRNA and a synthetic RNA as a internal standard are co-amplified together with the same primers. The amount of proα1(I) collagen mRNA in cutaneous sarcoidosis lesions was found to be increased about two- to threefold compared with the values obtained for the healthy skin of the same two patients. In lesional skin of three patients with localized scleroderma the number of proα1(I) collagen molecules was increased about two-fold. The β-actin mRNA values were at the same level in the affected and unaffected skin of all the patients studied. In conclusion, a marked increase in type I collagen gene expression was seen in localized scleroderma and scleredema, leading to fibrosis of the skin, and in a granulomatous skin disease, cutaneous sarcoidosis.
Computed tomography in predicting gall stone solubility: a prospective trial.
Authors: A Caroli, G Del Favero, F Di Mario, F Spigariol, P Scalon, T Meggiato, C Zambelli, R Naccarato
Journal: Gut (1992)

This prospective study was undertaken to evaluate the correlation between densitometric values of gall stones assessed by computed tomography and the success rate of litholytic therapy in 28 patients eligible for oral treatment. A densitometric study of the stones was performed in all patients before treatment. A cut off point of 60 Hounsfield units (HU) was chosen to divide the subjects into two groups--group 1, 14 patients with low density stones (less than 60 HU) and group 2, 14 patients with high density stones (greater than 60 HU). All patients were treated with ursodeoxycholic acid (8-10 mg/kg/day) for 12 months and followed up by ultrasound. In group 1, dissolution was complete in 50% of the patients and partial in a further 20%. In group 2 patients, complete dissolution was not observed but 33% showed partial dissolution. The number of patients with total dissolution at 12 months was significantly higher in group 1 compared with group 2 (p less than 0.02). These results suggest that computed tomography can be used to select patients with a better likelihood of successful stone dissolution after bile acid therapy.
Effects of oxidant stress on endothelium-derived relaxing factor-induced and nitrovasodilator-induced cGMP accumulation in vascular cells in culture.
Authors: N Marczin, U S Ryan, J D Catravas
Journal: Circulation Research (1992)

The effects of hydrogen peroxide (H2O2) on the action of basally produced endothelium-derived relaxing factor (EDRF) were investigated by measuring cGMP accumulation in single and cocultures of calf pulmonary artery endothelial cells (CPAEs) and rabbit pulmonary artery smooth muscle cells (RPASMs) as a model for determining the contribution of EDRF dysfunction to altered vascular tone and reactivity frequently associated with oxidant-induced vascular injury. Higher cGMP levels in long-term cocultures (20.4 +/- 1.8 pmol/mg protein/15 min) than in single-cell cultures (CPAE, 9.6 +/- 0.9 pmol/mg protein/15 min; RPASM, 3.7 +/- 0.2 pmol/mg protein/15 min), and CPAE-induced increases (fivefold) in intracellular RPASM cGMP content in short-term cocultures suggest basal release of EDRF. Basal generation and release of an L-arginine-derived endothelial labile factor accounted for the increases in cGMP, since the response was completely blocked by pretreatment of CPAEs with NG-monomethyl L-arginine. Pretreatment of long-term cocultures with H2O2 for 30 minutes resulted in a dose-dependent (0.5-2 mM) decrease in cGMP formation (49-79%). To determine the effects of H2O2 on EDRF synthesis, transport, and RPASM responsiveness, CPAEs or RPASMs were selectively pretreated with H2O2 before establishment of short-term cocultures. In cocultures of H2O2-pretreated CPAEs with untreated RPASMs, RPASM cGMP levels were reduced, suggesting a decrease in EDRF production rather than deterioration of EDRF during transport, because cGMP levels were unaffected by posttreatment with oxygen radical scavengers during coculture. Pretreatment of RPASMs with H2O2 attenuated the untreated CPAE-induced, the putative EDRF S-nitroso-L-cysteine-induced, or the nitroprusside-induced increases in RPASM cGMP levels. This attenuation was prevented by pretreatment with either dimethylthiourea, deferoxamine, or dithiothreitol, suggesting a mechanism of H2O2 action involving iron-catalyzed formation of intracellular hydroxyl radicals and their attack on cellular thiols. H2O2 diminution of cGMP accumulation was not associated with lytic cell injury in the experimental time frame, because morphology and 51Cr release from prelabeled RPASMs and CPAEs were unchanged.
Twenty four risk factors responsible for nearly half of annual deaths, says WHO
Authors: J. Zarocostas
Journal: BMJ (2009)

Twenty four risk factors are responsible for 44% of the estimated 60 million global deaths that occur each year and cause 34% of the loss of healthy life years worldwide, says a World Health Organization report.

The five leading global risks for mortality are high blood pressure, which is responsible for 12.8% of all deaths globally; tobacco use (8.7%); high blood glucose (5.8%); physical inactivity (5.5%), and overweight and obesity (5%), it says.

Other key global risk factors among the top 10 causes of death include high cholesterol (4.5%), unsafe sex (4%), alcohol use (3.8%), childhood underweight (3.8%), and indoor smoke from solid fuels (3.3%).

The report concludes that these leading risks are responsible for raising the risk of chronic diseases such as heart disease, diabetes, and cancers.

For instance, 57% of cardiovascular deaths, it says, can be traced back to three risk factors—high blood pressure, high body mass index, and physical inactivity.

Similarly, it says that raised blood pressure changes the structure of arteries and increases …